Lack of funding makes some Early Intervention professionals ponder career shifts
By Kevin Beese Staff Writer — May 21, 2024Second in a series looking at Early Intervention funding in the state
Stephanie Novak loved working in Early Intervention services so much that she was willing to do the work if she could just cover the cost of her 9-month-old’s full-time care.
After several months of trying to serve youths from birth to age 3, she couldn’t make it work and moved on to providing physical therapy for another age group of kids.
“It was the worst decision I ever had to make,” Novak said. “I didn’t want to do it.”
The Chicago resident said her new job is fulfilling, but it is “not with the patient population I wanted to serve.”
With no paid leave after having a child in August, Novak went back to work, content to work three days a week if her childcare costs were met.
“I was not able to pay for the childcare,” Novak said. “My husband and I decided I needed another source of income. Early Intervention was the work I wanted to be doing, but at what point is meeting their needs at the detriment of our own needs?”
Novak’s new job is with a hospital system where she is an hourly employee, guaranteed a 10-hour shift, regardless of the number of calls she makes.
“In Early Intervention, if I wanted to see seven clients a day, I needed to schedule 10½ hours, but I only got paid for the seven hours I would see clients. In that time, two of the kids might be sick, traffic might be bad and I might be late seeing a child. If a child falls asleep, I could do some parent-coaching, but I am probably not going to stay and bill for the full hour.
“There is a high cancellation rate. I might only see five kids. I was not paid for my driving, and I
needed to cover childcare. A 10½-hour schedule wasn’t even enough.”
Novak has been out of serving newborns to 3-year-olds for a few weeks now but has still gone to two birthday parties for Early Intervention clients who she worked with in therapy.
“They consider me part of the family,” Novak said of her clients and their parents. “I had such a good relationship with all of them. It was a tough decision to leave the field, but it is even tougher to leave the families.”
With workers like Novak leaving the field, Early Intervention proponents are seeking a $40 million increase in the state’s fiscal year 2025 budget to address an EI workforce crisis and Early Intervention service wait lists.
Gov. J.B. Pritzker has proposed a $6 million increase for EI services in next year’s budget. State lawmakers allocated $156 million for Early Intervention services in the current budget.
Zareen Kamal, a policy specialist at Start Early, a Chicago-based nonprofit public-private partnership advancing early learning and care, noted that half of the proposed $40 million state budget increase for EI would go toward a 10 percent pay hike for service providers. The other half would go toward reducing waiting lists for services.
“We have seen providers leaving the system,” Kamal said. “Many of them have advanced degrees. They have options to leave the Early Intervention workforce and go to other settings. They can go to hospitals, schools or into private practice.
“We do see that hundreds of people have left the system and service delays have gone up in that same time. Delays have doubled in the last couple of years.”
Karen Berman, senior director of Illinois policy at Start Early, said EI professionals leaving the field is part of why waiting list are so high.
She noted that COVID-19 changed things and put an increased demand on EI services. It took the state a while to pivot and get payments to the largely independent service providers.
“They needed to find other ways to get income,” Berman said. “We see providers not returning year over year because of a neglect in compensation. We are at a tipping point.”
Berman said even if EI service providers were provided a 30 percent rate increase, it would only get them back to 2004 in buying power when accounting for inflation.
“There is no disagreement that we have a problem. A multistate study brought out the fact that we have providers leaving and waiting lists are at historically high levels,” she said. “How do we account for providers getting no reimbursement for travel, no reimbursement for missed appointments?
“They are dealing with babies with medically complex cases who might need to miss therapy appointments. There is no funding for that.
“A time study was developed showing that on average EI therapist only bills for three of eight hours worked.”
Kristen Peters has been working in Early Intervention services for most of her 20-year career.
“I believe in the mission, that’s for sure,” Peters said. “If you are starting with school kids, age 5 or 6, there is so much to catch up on, it’s overwhelming. You need to get them ready before they get to preschool.
“Being one of their Early Intervention therapists, I get them at the beginning. You see the most Improvement when you start therapy early.”
A speech pathologist and feeding specialist, Peters loves being able to help parents make an emotional connection with their child.
“Even if it is just waving or an eye roll, it is a great feeling for me. I get to be there when the foundation is established, when we get joint communication,” Peters said. “Once a foundation is established, the sky’s the limit.”
Peters is thankful that health benefits are not a factor for her.
“The only reason I can do this is that my benefits are through my husband,” Peters said. “If I was a single mom, there is no way I could do EI and put food on the table.”
She has seen many peers leave the industry.
“A lot go to private clinics,” Peters said. “They get private insurance, a retirement plan, a lot of amenities. A lot pay off their loans.”
She said lawmakers need to understand the vital role that Early Intervention services play.
“There is desperation you see in a caregiver’s or parent’s eyes, when they throw up their arms and say, ‘I don’t know how to communicate with my child.’
“Early Intervention therapists give them a ticket into that child’s world, to have them jointly engage in communication. You get in at the ground level and it is so empowering.
“It takes all of us for lawmakers to hear. They don’t realize how many lives EI affects in a positive way.”
kbeese@chronicleillinois.com