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Critics Warn Cuts Will Harm Services to Toddlers

Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

  Blaming a budget shortfall, the Florida Department of Health has laid off most of the administrators at the Early Steps program, which serves babies and toddlers with developmental disabilities and delays.

The department said the cuts won't affect services to families. But critics of the move say it will leave the program --- which gets the majority of its funding from the federal government --- unable to meet requirements that keep the money flowing.

The workers received letters of termination Thursday, advising that their last day would be March 2.

Department officials wouldn't confirm the number of people in the Early Steps central office who were laid off. But Arnetta Givens, one of those leaving, said 13 Early Steps employees got letters of termination. Several other positions, Givens said, were already vacant.

That leaves five people to support the 15 local Early Steps offices, which work with tens of thousands of children and their families across the state.

The Early Steps program serves babies and toddlers with developmental disabilities or delays during their first three years. Experts say the younger the age at which children are diagnosed and treated, the greater the chance of reducing the effects of a developmental disability or delay.

"No services will be reduced or interrupted for the children served at the Early Steps program," Department of Health spokeswoman Tiffany Cowie wrote in an email. "All changes to this program are related to administrative costs."

Senate Health and Human Services Appropriations Chairman Rene Garcia, R-Hialeah, said the department made the same "assurances" to him.

"My question was, 'Is this going to affect services at the local level?' " Garcia told The News Service of Florida. "And they said 'Absolutely not.' "

But some supporters of the program warned that the cuts could have severe consequences in the future.

D'Lo Trejo, who retired as the Early Steps quality-assurance coordinator in 2011, said five staff members aren't enough to keep the program in compliance with federal requirements.

She said the federal funding comes from what is known as the Individuals with Disabilities Education Act (IDEA), Part C, which requires children to be seen and treated within a certain number of days at each step in the process.

"I'm concerned that children will not get the proper services within the required timeline --- services that the children need to make sure they overcome their developmental delays and are ready for school," Trejo said.

Lynn Marie Firehammer, who retired as the Early Steps bureau chief in March 2013, said the idea that five people could do the work that 23 people had done "is just sort of crazy."

She agreed with department officials that the effects of the layoffs wouldn't be felt locally --- at first.

"But in the long term, because of all the IDEA's federal requirements for general supervision of the program --- which is what the state office staff do --- that's got to affect the ability of Florida to even get the grant in the first place," Firehammer said. "So if we fall enough out of compliance, the feds could say, 'We're sorry, but we will no longer give you a grant for Part C.' And I fear that, in the long term, would be the result."

According to the Department of Health, 43,788 children were referred to Early Steps in fiscal year 2013-2014. Of those, 27,265 children and families received early intervention services.

The department would not respond to questions about the budget shortfall that caused the cuts.

Last month, however, the department backed off a different plan to cut $4.2 million from Early Steps. Officials had notified the 15 local Early Steps programs that the money would be taken from their budgets immediately --- in the middle of the fiscal year.

Department budget official Michele Tallent told the House Health Care Appropriations Subcommittee on Jan. 21 that the cuts had originated in Washington.

"The grant for the Early Steps was reduced by over $3 million," Tallent said. "So therefore, there was a reduction in the federal budget authority that was needed."

But U.S. Rep. Kathy Castor, D-Fla., disputed that federal cuts were at issue.

"Governor Rick Scott's and state health officials' cuts to an early-intervention initiative that serves babies and toddlers with developmental disabilities and delays are not coming from the federal level," Castor said in an email this week. "The U.S. Department of Education confirmed to me that not only were federal Individuals with Disability Education Act Part C funds for Early Steps not cut recently, but the state of Florida actually received an increase between FY13 and FY14."

After Garcia met with Surgeon General John Armstrong, the state's top health official, on Jan. 23, the department dropped the plan to cut the local office budgets.

On Feb. 4, Armstrong told Garcia's committee that the department had discovered a $6.9 million budget shortfall in the Early Steps program in January.

"The source of that shortfall was a series of contract challenges that go back to the last decade," Armstrong said.

Garcia said department officials had told him that Early Steps was being reorganized.

"We're monitoring it," Garcia said. "We're on it --- it's that important."