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H 7586Special Education

Health and Safety - Maternal and Child Health Services for Children with Special Health Care Needs

This bill increases Medicaid funding for early intervention services for disabled infants and mandates public tracking of waitlists and staffing.

Held for study
Population
Affected
8
Email Legislator
Introduced Feb 6, 2026Committee House Finance

Plain-English Summary

This legislation updates the Rhode Island Early Intervention Program, which supports infants and toddlers with developmental delays or disabilities. It transfers the oversight of the program to the Executive Office of Health and Human Services (EOHHS) and mandates a Medicaid payment rate increase for service providers by October 1, 2026. This funding aims to help providers pay competitive wages to hire necessary staff, such as speech and physical therapists. Additionally, the bill requires EOHHS to maintain a public website tracking waiting lists and staff vacancies to ensure accountability and timely access to care for families.

For younger readers

This law is designed to help babies and toddlers who have trouble learning or growing like other children their age. Sometimes, these children need special teachers or doctors to help them catch up, but right now, there aren't enough of these helpers available. This law gives more money to the programs that help these children so they can hire enough workers. It also tells the government to keep a list on a website showing how long children are waiting for help, to make sure every child gets the support they need as fast as possible.

Who & Where It Applies

Impacted groups
Infants and toddlers with developmental delaysParents and guardiansEarly intervention service providersTherapists (Occupational, Physical, Speech)Executive Office of Health and Human Services
Impacted communities
All

Constitutional & Fiscal Check

None Likely

Estimated cost
$0.14
Estimated revenue
None

Bill Analysis

Both viewpoints
For Progressives
  • Strengthens the social safety net by mandating funding increases for early intervention services, directly benefiting vulnerable infants and toddlers with disabilities and their families.
  • Promotes transparency and government accountability by requiring the creation of a public dashboard that tracks waiting lists and staffing vacancies, exposing gaps in care.
  • Addresses labor concerns by aiming to increase Medicaid reimbursement rates, which is intended to allow providers to offer competitive wages and benefits to attract and retain qualified therapists and educators.
  • The mandated rate increase is not required to be implemented until October 1, 2026, leaving a significant gap in time where current staffing shortages and waitlists may persist.
  • The estimated allocation of roughly $211,000 may be viewed as insufficient to fully reverse the damage caused by a twenty-year Medicaid rate freeze mentioned in the legislative findings.
  • Relies on a system of private providers reimbursed by Medicaid rather than establishing a direct, state-run corps of early intervention specialists, potentially leaving services vulnerable to market fluctuations.
For Conservatives
  • Streamlines government administration by consolidating oversight under the Executive Office of Health and Human Services rather than having responsibilities split or misaligned with the Department of Human Services.
  • Imposes strict performance metrics and reporting requirements on the government, ensuring that tax dollars are tracked against specific outcomes like wait times and staffing levels.
  • Supports a model of utilizing private sector providers for service delivery rather than expanding the number of permanent state government employees.
  • Mandates an increase in state spending and Medicaid allocations, which contributes to the overall growth of the state budget and taxpayer burden.
  • Expands the regulatory scope and administrative duties of the Executive Office of Health and Human Services, increasing the size and reach of the state bureaucracy.
  • Codifies specific funding amounts and mandates into law, potentially reducing the flexibility of future legislatures to adjust budgets based on changing economic conditions.

Votes

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Full Bill Text

Changes to existing Rhode Island law · 46 additions · 23 deletions

SECTION 1. Legislative findings. The general assembly hereby finds and declares the following:

(1) The Rhode Island early intervention program, a program established under part C of the federal Individuals with Disabilities Education Act and overseen and managed by the executive office of health and human services, is a core component of the state’s commitment to ensuring that families with infants and toddlers with or at substantial risk for developmental delays and disabilities receive high-quality services as early as possible in order that children can develop to their fullest potential and succeed in school and life.

(2) According to the center on the developing child at Harvard University, healthy development in the early years (particularly birth to age three (3)) provides the building blocks for educational achievement, economic productivity, responsible citizenship, and lifelong health. Effective early intervention services help infants and toddlers make developmental progress and can help them catch up with their peers. Research has shown that about one-third (1/3) of children who receive early intervention services no longer had a developmental delay or special education need in kindergarten.

(3) Due to the twenty (20) year Medicaid rate freeze, state-certified early intervention programs experienced significant difficulties paying competitive wages and benefits to attract and retain qualified staff. These staffing challenges became so severe that in November 2021, the state established a waiting list for early intervention.

(4) Rate increases enacted in state fiscal year 2023 and 2025 have greatly improved staffing and reduced the size of the waiting list for early intervention but there are still over one hundred

(100) children who wait more than forty-five (45) days for an evaluation and staff vacancies persist, particularly for speech, occupational, and physical therapists.

SECTION 2. Section 23-13-22 of the General Laws in Chapter 23-13 entitled "Maternal and Child Health Services for Children with Special Health Care Needs" is hereby amended to read as follows: 23-13-22. Early intervention program for developmentally disabled infants. Early intervention program for infants and toddlers with developmental delays and/or disabilities.

(a) The director of the department of human services shall ensure that all developmentally disabled infants from birth to three (3) years of age shall be enrolled in the early intervention program The secretary of the executive office of health and human services (EOHHS) shall ensure that all infants and toddlers with developmental delays and/or disabilities who are under the age of three (3) are provided with early intervention services as required under Part C of the federal Individuals with Disabilities Education Act (IDEA), 42 U.S.C § 1470 et seq. Regulations governing the delivery of services under this program, including eligibility criteria, shall be promulgated by the department of human services executive office of health and human services, with the advice of the interagency coordinating council; provided, however, that all regulations promulgated by the department of health shall remain in full force and effect until the time they are replaced by regulations promulgated by the department of human services. The regulations shall stipulate, at a minimum, the following provisions that are consistent with the intent of this chapter:

(1) The director secretary shall develop and maintain a procedure for the earliest possible identification and efficient referral and evaluation of all developmentally disabled infants children under age three (3) who may be eligible for services under part C of IDEA and shall ensure individualized family service plans are developed and IDEA services are provided in a timely fashion for eligible children;

(2) The director shall ensure that every infant identified and referred to this program is enrolled as soon as possible after birth; and further, that for infants placed on a waiting list for facility based group programming, an early intervention program shall be made available within a thirty (30) day period from the time a need is identified in the individual program plan;

(3) Unless parents refuse the service, the home visiting component of the program shall commence as soon as the infant has been identified as having a possible developmental disability;

(4) Any parent(s) who is/are dissatisfied with decisions or termination of service evaluations, eligibility determinations, the amount and type of early intervention services offered under Part C of IDEA or with practices and procedures of a particular certified early intervention agency or the department of human services EOHHS shall notify the director of the department of human services secretary of the EOHHS in writing within thirty (30) calendar days and the complaint shall be reviewed in accordance with department of health EOHHS policy and procedures, as amended, and the Administrative Procedures Act, chapter 35 of title 42. The EOHHS shall post clear information about the right and process for parents to make a complaint about early intervention services delivered under the Part C of IDEA on the main public webpage for early intervention consumers. The office shall ensure information about the right of parents to complain and the process to file a complaint is translated accurately into most common languages spoken by families in the state using the office’s website translation system. (5)(3) An early intervention program for purposes of this section shall mean a comprehensive array of educational, developmental, health, and social services provided on a calendar year basis to eligible infants, children, and their families as specified in program regulations.

(b) Within ninety (90) days after October 1, 2004, an evaluation plan describing outcome measures that document the program’s successes and shortcomings from the previous fiscal year shall be submitted to the speaker of the house of representatives, the president of the senate and the house oversight committee and the governor and the interagency coordinating council. Development of the plan shall be made in consultation with the entities with expertise in this area and the interagency coordinating council. The plan shall include a memorandum of understanding between the department of health, department of human services and the department of elementary and secondary education that demonstrates coordination and continuity of early intervention services among these departments.

(c) Within six (6) months after January 1, 2005 where prescribed outcomes documented in the evaluation plan have not been accomplished the responsible agencies shall submit written explanations for the shortfalls, together with their proposed remedies. The report shall also include evaluation of the progress of the coordination efforts between the department of health and the department of human services and the department of elementary and secondary education and the interagency coordinating council and shall include any recommendations regarding modifications of the reimbursement mechanisms of this chapter.

(d) Within twelve (12) months after August 1, 2005 a final report shall include the progress of the coordination efforts between the department of health and the department of human services and department of elementary and secondary education, interagency coordinating council and shall include any recommendations regarding modifications to the comprehensive array of educational, developmental, health and social services provided on a calendar year basis to eligible infants, children and their families as specified in an early intervention system.

(e) All reports or documents required to be produced pursuant to 20 U.S.C. § 1471 et seq., shall be submitted to the speaker of the house, president of the senate and the chairpersons of the appropriate house of representatives and senate oversight committees and the governor and the interagency coordinating council. Adherence to such plans and reporting requirements, and budgets and the timely achievement of goals contained therein shall be considered by the oversight committees of the house of representatives and senate, among other relevant factors, in determining appropriations or other systemic changes.

(f) The EOHHS shall:

(1) Pursue a Medicaid state plan amendment and allocate sufficient state general revenue, estimated at two hundred eleven thousand two hundred dollars ($211,200), to increase Medicaid payment rates for early intervention services by the amount recommended in the 2025 social and human service programs review report by the Rhode Island office of the health insurance commissioner. Rate increases will be implemented on or before October 1, 2026, to ensure rates enable early intervention service providers to cover the costs of adequately staffing the program with qualified service coordinators, early educators, and licensed professionals to deliver all services required under Part C of the Individuals with Disabilities Education Act.

(2) Maintain at least two (2) years of data on the early intervention data dashboard on the office’s public website, and include:

(i) Monthly updates on the number of active children receiving IDEA Part C services, the number of children who have been waiting more than forty-five (45) days for an evaluation by city or town of child residence, and the average number of days the children with delayed evaluations have been waiting.

(ii) Regular updates, at least every six (6) months, on the number of unique staff and full- time equivalent staff providing IDEA Part C services directly to children and their families and the number and percentage change of staff vacancies by occupation.

SECTION 3. This act shall take effect upon passage.