PROVIDENCE — Rhode Island has significantly whittled down the long wait-list for Early Intervention services for infants and toddlers with development delays, after state leaders funneled more money to the critical program.
The federally mandated program, which is run by the state at no cost to families, was struggling for years with long wait times for the young children to get services such as speech pathology, occupational therapy, and physical therapy, seen by experts as crucial in helping children catch up to their peers developmentally before they go to school.
Federal law requires children to have an initial evaluation within 45 days of a referral, but since 2021, hundreds of children have waited months on end — even up to a year — to even be evaluated.
Since children are no longer eligible once they turn 3, some aged out before they ever got off the wait-list.
As of March 8, Rhode Island had 174 children who have been waiting longer than 45 days, according to state-collected data, a precipitous drop from the 736 that had been waiting longer than the legal time frame in January 2024.
“It was so tragic,’’ said Margaret Holland McDuff, the CEO of Family Service Rhode Island, one of the state’s nine providers of Early Intervention services. “It was really upsetting for all of us to have those kinds of wait-lists.’’
She said Family Service now has no waiting list after increasing salaries by 10 to 20 percent, making the jobs more competitive with pay rates in Massachusetts and Connecticut. Previously, families were waiting up to six months for an evaluation.
“In the life of a baby, every week is critical,’’ Holland McDuff said.
The long wait times date back to the pandemic, when severe staffing issues emerged. But the shortage did not resolve after the initial economic crisis was over, prompting alarm. The nine private agencies contracted by the state to provide the services said they struggled to retain staff because of low wages and high turnover rates.
There had been no children waiting longer than 45 days for an evaluation prior to 2021, officials have said.
Since families don’t pay for Early Intervention services, the agencies rely on reimbursements from the child’s health insurance. Roughly half of those children are on Medicaid.
Rhode Island lawmakers initially raised Medicaid reimbursement rates by 45 percent in 2022 — the first increase in two decades — and COVID relief funds were also directed to the program. The money helped, providers said, but the wait-list remained stubbornly high at the end of 2023 and early 2024.
Governor Dan McKee then announced in January 2024 he would invest another $4 million in the program by raising Medicaid reimbursement rates, which were later approved by lawmakers and took effect Oct. 1.
In the six months since the second rate increase took effect, the wait-list has continued to drop. The number of children waiting longer than the legal time frame has gone down 75 percent since January 2024.
The wait-list number should be zero, said Sam Salganik, the executive director of the Rhode Island Parent Information Network. But the big drop is an early sign of success.
“I certainly would not want to put a ‘mission accomplished’ banner on an aircraft carrier,’’ Salganik said. “The success is very fragile, new, incomplete. But it’s also real, and the direction is something to be celebrated.’’
Kerri White, a spokesperson for the state’s Executive Office of Health and Human Sevices, which oversees the program, attributed the diminished wait-list to the rate increases, plus additional mental health supports for workers and efforts by the nine providers to attract and retain more staff.
“It’s not rocket science: when you invest in early intervention, the early intervention providers are able to invest in wages, you have a better workforce, you’re able to serve more kids more effectively and more efficiently,’’ Salganik said.
In addition to new funding, Holland McDuff noted changes in the labor market have helped the agency retain staff.
In Rhode Island, private health insurers must pay at least the Medicaid rate for Early Intervention services. That means raising the Medicaid rates also raised the amounts that providers get from private insurers. (At least one insurer, Blue Cross Blue Shield of Rhode Island, opted to raise its rates voluntarily before it was mandated by the government.)
At age 3, a child’s local school district becomes responsible for providing special education services. That preschool system has also been plagued with waiting lists and staff shortages.
The federal government has not yet sent its 2025 annual letter about Rhode Island’s compliance with the law governing Early Intervention. As of last year, Rhode Island and California were the worst-performing states, listed under the “needs intervention’’ category for Early Intervention, which is part of the Individuals with Disabilities Education Act.
According to the US Department of Education, 29 states were in compliance with the law last year when it comes to Early Intervention.
Massachusetts was listed under “needs assistance’’ in 2024, while Connecticut, New Hampshire, Vermont, and Maine were meeting the requirements of the law.
“When kids receive timely services, many of them catch up with their peers and end up entering school without a need for further services,’’ Salganik said. “Which has a tremendous impact throughout their K-12 experience and beyond.’’
Steph Machado can be reached at steph.machado@globe.com. Follow her @StephMachado.
