Four months without pay, some health workers quit state program

By Matt Porter

August 1, 2013 Updated Aug 2, 2013 at 1:15 AM EDT

Greene, NY (WBNG Binghamton) When Nancy Dean's 3-year-old daughter Arden was born with Down syndrome, she said it was the therapists in the state's Early Intervention Program that gave her life.

Dean's said physical and speech therapists helped her daughter learn to speak and express her needs for her parents.

"If she does something we've been working on, I can phone my therapist at nine o'clock tonight and say, 'Guess what Arden did today?' And they're so excited."

But, her speech pathologist recently quit the state program.

Dozens of health workers in the state program have walked away from their jobs since money from private insurers hasn't come through in four months.

The state health department said in a statement that a paperwork issue between private insurers and the fiscal agents have delayed payments.

The fiscal agent is adjusting state software programming to fix the issue.

Dean said she was sad to see her provider go, but she understood why.

"To go for 16, 17 weeks now without a paycheck," Dean said, "I mean, who can do that?"

On April 1, the state took over the claims process from counties.

A state fiscal agent was put in charge to interact and process claims with private insurers.

Lynne Pelsklo, Dean's former speech pathologist, said the state seemed disorganized from day one.

"Unfortunately, New York state was not really prepared for the takeover," Pelsklo said, "And since April 1, no therapist has been receiving any payment from the insurance companies."

She called the situation a disaster.

"Everyday I'm on my computer two, three hours a day emailing New York state, the Bureau of Early Intervention, trying to find out where our money is," Pelsklo said.

The problem only affects payments from private insurers.

The bulk of payments to all health care workers in the Early Intervention Program come through Medicare and Medicaid, which are unaffected.

More than $100 million in payments have been made from public insurers since April.

However, since 90 percent of Pelsklo's clients were privately insured, she said she decided last month to leave and take a similar job in Florida.

That's left Dean to travel more than 40 minutes away to Binghamton, for the same care she used to receive in her backyard.

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