Increasing Reimbursement Rates

Published On: October 31st, 2019Categories: Archived Advocacy

October 31, 2019

The ABCD Early Intervention Provider Association (EIPA) has been in existence since 2006 and has been a tireless advocate for improving the Early Intervention System (EIS) and making recommendations to the New Jersey Department of Health (NJDOH) that foster provider sustainability in a competitive and changing environment. The thirteen member organizations of ABCD EIPA operate independent of one another and collectively provide services to more than 60% of the total number of children served in the State of New Jersey.

The provider agencies are reimbursed by NJDOH on a fee-for-service basis for the face-to-face direct services provided to children and their families. The rates of reimbursement were established as a result of a rate study funded by the NJDOH back in 2002. During the past 17 years, the rates have increased a cumulative total of 1.78%, whereas the Medicare Economic Index has increased more than 21% for the same period of time.

A as result of this disparity, all provider organizations across the State are struggling with attracting qualified personnel to serve those children deemed eligible for services. These organizations are competing with the hospital industry, nursing home and assisted living industries, as well as the 573 public school districts throughout NJ (2018-19 School Year) that hire or retain related service disciplines in a clinic or congregate setting.

The home-based pediatric assignment in Early Intervention is not considered a coveted position with regards to those related services disciplines (physical therapy, occupational therapy and speech therapy). The center-based service locations represent the preferred employment locations which is in direct competition with the EIS and its model of serving and evaluating children in their “natural environments.” This limits the pool of interested applicants to serve in the EIS which has resulted in a significant increase in children waiting to be served (No Provider Available List).

It should also be noted that other Departments in the State of New Jersey have rolled out programs in the past 5 years that also fund community based intervention services for children

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