Policy Watch Investigates

DHHS looking at cuts to program for disabled babies, toddlers after ENC consolidation plan falls apart

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The state health agency’s cost-saving plan to shut down three offices serving developmentally delayed babies and toddlers has unexpectedly derailed, leaving questions about how deeply services will be cut.

With the offices now staying open, the N.C. Department of Health and Human Services still needs to find $10 million worth of cuts the legislature wants for this coming year, in a program that advocates for the disabled children say is already stretched thin by previous budget reductions.

The N.C. Department of Health and Human Services announced in February it planned to close three children’s developmental services agencies (CDSA) offices in New Bern, Rocky Mount and Wilmington in July in order to meet a legislative mandate to cut $10 million from the program for this upcoming year.

The work would then be shifted to East Carolina University’s Brody Medical School, which currently has a contract to run one of the state’s 16 children’s developmental services agencies (CDSA) that screen babies for developmental issues and provide in-home therapies for families of affected children.

But ECU recently declined to take on the additional responsibilities of providing services to developmentally delayed infants and toddlers in the 21 affected Eastern North Carolina counties served by the three offices, DHHS spokesperson Kevin Howell confirmed late Monday.

“ECU has informed DHHS that it will not pursue any expansion of its CDSA catchment area,” said DHHS spokesman Kevin Howell in a written statement. “DHHS will implement the cuts mandated in the state budget in a way that will minimize its impact on the infants, toddlers and families we serve.”

The three offices will stay open but Howell did not provide any other details about how DHHS would attain the $10 million in cuts for the program.

ECU didn’t have the ability to take on the additional work, with the CDSA currently run out of the university already contending with declining funding and the effects of previous budget cuts, said Dr. Paul Cunningham, the dean of ECU’s medical school.

“The declining reimbursements for patient care, the loss of some funding due to actions by the General Assembly last summer, and the potential for more state budget cuts this summer calls for us to spend 100 percent of our time on our current workload,” Cunningham said, in a written statement released by the school.

The legislature could reverse the upcoming $10 million in cuts to the early intervention program, if it wishes, when it comes into session next month. But the chances appear slim, with Republican legislative leaders saying there will be little wiggle room in the budget with raises for teachers and an expected Medicaid shortfall of $120 to $140 million to contend with.

Cuts made last year to program for young disabled children

The N.C. Infant-Toddler Program, through a combination of state and federal funding, screens and treats an estimated 20,000 babies and toddlers each year for developmental delays and disabilities. Therapists working from the state’s 16 children-developmental services association (CDSAs) make in-home visits helping families with children’s motor skills and other needs, in hopes that the specialized attention will help the young disabled children catch up with to their peers.

The program has had successes, with half of the children treated catching up to their peer groups while 70 percent of those helped made “greater than expected progress,” according to a presentation DHHS made in March to lawmakers.

In last year’s budget, state lawmakers called for $18 million in cuts over a two-year period, with $8 million in the current year and $10 million in cuts for the fiscal year beginning on July 1.

To meet those budget demands, DHHS officials told the 173 staff members in the New Bern, Rocky Mount, Wilmington CDSAs in February that they were closing the offices and staff would be out of jobs as of July 1. Dr. Robin Cummings, a DHHS deputy secretary that oversees the early education and treatment program, said the shift to ECU was necessary to meet the $10 million in cuts and would offer more flexibility in filling vacant therapist positions. Existing staff could reapply for their jobs under the new configuration at ECU.

“A major goal in this expansion is to maintain the expertise of CDSA staff in serving these infant and toddlers and their families,” Cummings wrote in a Feb. 10 memorandum to staff. “ECU, as another state agency, has a wealth of benefits to offer the program and the staff it will hire.”

In March, DHHS staff made a presentation to legislative leaders reiterating that the proposed shift to ECU was the best way to absorb $10 million in cuts without disrupting services.

But Cummings and other state leaders appear to have misjudged the interest and ability that staff at ECU’s child development support had in taking over a 21-county area at the level of funding desired by the state health officials.

Rob Thompson, with the children’s advocacy group N.C. Child, said he hopes that lawmakers will reconsider the cuts to the program, with little room to trim expenses in the program without cutting services.

“These are the children that need intensive services more than other people in the state,” Thompson said. “The fact that the state is unable to come to terms on this contract really shows the difficulty in performing these services with limited resources.”

Vicki Smith, the executive director of Disability Rights North Carolina, called the N.C. Infant-Toddler program “critical” for disabled babies and toddlers and said her group will be looking to see how services are affected.

“Early education and early intervention programs are essential for infants and toddlers with disabilities to receive appropriate services as early as possible,” Smith said. “We certainly hope that the state chooses to maintain them at the current level.”

Questions? Comments? Reporter Sarah Ovaska can be reached at (919) 861-1463 or sarah@ncpolicywatch.com.

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