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Dinolfo proposes rate increase for pre-k special ed services 

County Executive Cheryl Dinolfo wants to raise the rates the county pays for pre-school special education services for the first time since 2009.   Tuesday morning, she submitted legislation that would boost the rates paid to certain service providers by 15 percent.

The increase won't happen unless the County Legislature passes the proposal. However, the Republican majority generally approves any legislation Dinolfo submits by Dinolfo, and Republican Majority Leader Brian Marianetti stood with Dinolfo as she announced her proposal during a press conference Tuesday.

The state requires counties to provide pre-school special education services to children 3 to 5 years old. State law gives counties the responsibility to set the rates it'll pay to reimburse providers of specific services, including occupational therapy, physical therapy, speech therapy, psychology, education of the visual and hearing impaired, one-on-one services, assistive technologies, counseling, coordination of services, interpreting, music therapy, orientation and mobility services, audiology, and parent counseling and training.

The state covers 59.5 percent of reimbursement for those services, said Bob Franklin, the county's finance director. The county's costs will increase by an estimated $600,000 to $800,000, though the number is difficult to ballpark, Franklin said.

Dinolfo framed the proposed increase as a proactive move to keep providers in the field. Without the investment in providers, "things fall apart and children and families pay the price."

She directly contrasted her proposal to increase reimbursement rates with the state's handling of the separate, but related, Early Intervention program, under which counties ensure that children up to 3 years old with disabilities or developmental delays receive services at no cost to families. The state reimburses providers and sets the rates, which it hasn't increased in 20 years. It actually decreased the Early Intervention reimbursement rates in 2010 and 2011.

As a direct result of the stagnant rates, the county has lost Early Intervention service providers; the number of children who need services has also been increasing. Families face potentially long waits to work with service providers such as speech therapists, physical therapists, and occupational therapists.

The agencies that traditionally provide Early Intervention services coordination have also pulled out of the program, since the rates were so low that they could no longer afford to participate.  The county is responsible for ensuring service coordination, and when the last large provider pulled out at the end of 2018, officials were in a bind. 

Dinolfo's administration hired three additional service coordinators this year and shuffled some staff around to alleviate some of the pressure.  In December, as the County Legislature prepared to vote on the 2019 county budget, Democrats unsuccessfully pushed for the addition of six more service coordinator positions. Local children's advocates say the county workers are overwhelmed, and Early Intervention services will likely be an issue in the county exec's race, where Dinolfo faces a challenge from Democratic County Clerk Adam Bello, and in the Legislature races.

Counties across the state are facing similar difficulties with their Early Intervention services, and they generally say the statewide program is in crisis due to the suppressed rates.

Governor Andrew Cuomo included a 5 percent rate increase for direct Early Intervention service providers in his 2019-20 budget proposal. The rate for service coordination would not increase.

Advocates and county officials across the state argue that the rate needs to be still higher.  Dinolfo challenged the governor and state legislators to raise the Early Intervention rates by 15 percent across the board.

"Follow our lead and match our investment," Dinolfo said.

Tuesday afternoon, Legislature Democratic Minority Leader Cynthia Kaleh released the following statement in response to Dinolfo's legislation:

“I am pleased that the families that rely on these services and those that provide them will finally find some relief. However, I find it laughable Ms. Dinolfo would call this proposal ‘proactive’ as the parents, workers, and child advocates have been asking for this for months. The Democratic Caucus tried to have these discussions during last year’s budget process to no avail. While the end result is something we all have worked for, the process was needlessly drawn out. I would suggest that when she is thanked for taking action, she apologize for taking so long.” 
Bello, the Democratic candidate for county executive, also released a statement:

"County government’s decision to increase rates for pre-school special education services for the first time since 2009 is welcome news. This is something countless speakers at County Legislature meetings have been asking for months. Calling this step proactive is an insult to the families with children on waiting lists right now.

"Early intervention advocates had no idea this move was coming. Leadership is about bringing people together. We have a wealth of talented and committed people in this community. It’s a mistake for government to not involve them in the process. If this is going to be the community we want it to be, everyone needs to work together. "
This posted has been updated to include a statement from Democratic Minority Leader Cynthia Kaleh.

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