Parents, therapists tell Suffolk County Legislature preschool special-education reimbursement rates are causing a provider shortage

A wave of parents, therapists and school administrators told the Suffolk County Legislature on March 5 that preschool special-education services in Suffolk County are in crisis because the county’s reimbursement rate has not risen in 27 years.

Speakers at the meeting said the county rate of $45 per session — established in the 1990s — is now insufficient to retain providers and that children approved for legally mandated services are waiting weeks or months. "I am here today to tell you that the preschool special education is facing a crisis," said Laura Baisch, a pediatric physical therapist with 42 years of experience. "Therapists and special education teachers are abandoning this field because they simply can't work to afford 1980 salaries in 2024."

Why it matters: Multiple presenters, including school district administrators and agency leaders, said early intervention is time-sensitive and that missed services at ages 0–5 can produce long-term educational and financial costs. Doreen Itzkin of Long Island Head Start reported that hundreds of Head Start referrals were made this year and that roughly 26 children in her program were waiting for mandated services to begin. She cited federal requirements under the Individuals with Disabilities Education Act (IDEA) that services should begin no later than 30 days after a CPSE recommendation.

What presenters said: Providers and agency representatives offered consistent examples of the effects of low reimbursement. Michael Grossfeld, president of Agencies for Children’s Therapy Services, said districts complete rigorous eligibility evaluations but that the county’s rate prevents delivery of mandated services. "The County needs to step up and pay the rate so that the children that are designated by their districts to receive services get the services; it's really a simple equation," he said. Several speakers cited comparative rates in other New York counties and private-sector salaries in hospitals and outpatient care as reasons therapists are leaving the preschool field.

Parents described the consequences for children. Jeaneille Clarke, a mother of two autistic sons, said her younger child was approved in October but has faced long delays and interrupted care, and that "every day spent waiting is a missed opportunity for growth." Other parents described having to travel long distances to secure services when local providers lacked capacity.

Numbers and context: Several witnesses said Suffolk County’s $45/session rate is effectively worth roughly $23 per session after inflation adjustments. Providers and administrators noted some New York counties pay $70–$80 per session, and that hospitals and other employers offer much higher salaries to related-service professionals.

Legislative response and next steps: Presiding Officer McCaffrey acknowledged the volume of testimony and said committee chairs would follow up; legislators identified the Health and Education committees (Clerk noted the issue might be routed to Health) and invited speakers to testify in committee. Several legislators said they wanted a staff-level briefing with budget implications and options for rate increases.

What remains unresolved: No formal County action or appropriation was taken at the March 5 meeting; speakers asked the Legislature to consider a substantial and sustained rate increase to retain providers and meet legally mandated obligations to preschool students.