Most therapists who specialize in Illinois' Early Intervention program do so not for the money, but because they take pride in knowing they're improving the future for babies and toddlers with special needs.
But now money is what may drive some therapists away from Early Intervention work.
Beginning last fall, therapists statewide were forced to wait two to four months for payments from the Illinois Comptroller's Office. While the state is now working to catch up on payments, many therapists still worry for their own livelihood and about the future of Early Intervention services.
"I have started exploring other options because the reality is, if this continues, it won't pay the bills," says Yvonne Figueredo, a bilingual speech therapist who meets a critical need by serving many Hispanic families in Chicago.
Early Intervention, which serves children under 3 who have a diagnosed disability or risk of delay, provides a range of therapies, often in the child's home. The state receives federal funding to cover the services that a family's private insurance does not, including regular assessments.
The delay in funds prompted eight Illinois members of the U.S. Congress, including Reps. Luis Gutierrez and Jessie Jackson Jr., to send a letter to Gov. Pat Quinn, expressing concern. "Delayed payments," they wrote, "threaten the financial viability of providers and the developmental well-being of children who already are identified as having developmental delays or disabilities."
Illinois Department of Human Services spokesperson Marielle Sainvilus says that before the state can access federal funds, it must first meet its own debt service and payroll obligations. Federal guidelines require hospitals and nursing homes to receive payments every month as well.
"After the state meets these obligations, everyone else gets in line to be paid from whatever is left," she says. "This means that the comptroller usually has to sit on bills until enough cash builds up."
The state expected to receive funds in January from pension obligation notes and hoped to use $750 million of it to catch up on payments, she says.
Sainvilus says her department understands the urgency of fixing the problem, but acknowledged that this extended payment cycle has been a problem for years. To fix it long term requires cooperation from the governor and the Illinois General Assembly, she says.
Figueredo says she needs to be reassured that a better system will be in place for payments before she decides to stay with Early Intervention. "As an independent provider, I feel like nobody cares whether I stay or go ... except for the families that I work with," she says.
Becky Wellman, a music and developmental therapist who works in
DuPage and Kane counties, says some families in less populated
areas have felt the impact.
"I've had several families tell me they have a therapist who is going back to clinic or other work, so families have lost a therapist they trust, and they're not sure how long they'll have to wait for another one."
Some therapists, especially those who receive some of their income from private insurance, remain optimistic.
"For the most part, I wouldn't trade this work for anything," says occupational therapist Cheryl Mercado. "Maybe I'm naive, but it is a federally funded program, so I feel like I've just got to trust that the payments will get worked out."
Lisa Applegate is a freelance writer and mom of one living in Chicago.
See more of Lisa's stories here.