Lawmakers gave Birth to Three workers a raise, but WV cuts pay for virtual therapists

The pay cut — especially as the state is struggling to retain its workforce — came as a surprise to lawmakers.

“I don’t think I will speak [just] for myself when I say I didn’t hear from a single legislator who was in favor of cutting the pay to any Birth to Three service provider. This was a department decision,� said Sen. Ben Queen, R-Harrison, who serves on the Senate Finance Committee. Queen’s 1-year-old son is receiving services through the program.

“It does disappoint me,� he added. “I think the department celebrated and spiked the football that they got pay raises for their employees and then passed down a pay decrease.�

Katie Comer Reidy has worked as a speech therapist with Birth to Three for nearly 10 years and now provides virtual services. It’s “such a happy job,� she said. She uses Zoom to coach families on how to help their children reach milestones.

According to the state health department, the rate for virtual providers will decrease by 15%.

“I was excited to see that Birth to Three got a raise … but I was disappointed to see that the virtual providers took a bit of a cut. I do feel that the virtual providers are a big part of Birth to Three now,â€� said Comer Reidy, who lives in ÂÒÂ×ÄÚÉä. “I fear that it will decrease the amount of virtual providers, and then, because of that … some of these families in rural counties might have a harder time getting the services that they need.â€�

Birth to Three started offering virtual services to children during the COVID-19 pandemic.

Gailyn M. Markham, director of communications for the state Department of Health, said that while determining the pay rates, the agency wanted to “ensure the state’s budget for the Birth to Three program could meet the growing needs of children and families in West Virginia.�

Birth to Three served 8,510 children in 2023. The program’s budget needs to account for the growing number of children, as well as a decreasing number of Medicaid-eligible children following the “unwinding� of Medicaid post-pandemic and increasing costs of assistive technology, Markham explained.

“The funding provided by the state Legislature was based on the department’s projected need after these factors were evaluated,� she wrote in an email, adding that the state also receives $2.2 million in federal funding for the program.

“To meet the needs of families during the pandemic, virtual services were permitted and reimbursed at the in-person rate. Post-pandemic, virtual services will remain allowable but the rate was reduced by 15%, recognizing that services provided virtually and at the service provider location are able to be offered at a lower cost than in person services,� she continued.

‘It’s a serious issue’

Not every state has a no-cost program like Birth to Three, which can be especially critical as West Virginia has the highest rate of prenatal exposure to drugs. This puts these children at a higher risk for a variety of physical and mental disabilities, and experts say early intervention is key.

Birth to Three uses 900 practitioners to provide physical, speech and occupational therapies and other services to children in all 55 counties. It served 16% of the state’s zero to 2-year-old population in 2023.

Comer Reidy said one of the most rewarding parts of the job was connecting with parents — not just the child who is being helped. “You then become a person that moms and dads will call when they’re having a hard time, and you [are] able to be a support system for somebody,� she said.

During the legislative session, the House of Delegates and Senate each pushed bills that specifically gave Birth to Three workers a raise.

Sen. Brian Helton, R-Fayette, introduced a version in the Senate, and it passed through the chamber unanimously but got held up in the House Finance Committee, where state budget concerns regularly stalled bills with price tags.

His bill proposed a 25% increase raise for all workers; he said the allocated money in the final state budget would give in-person therapists around a 15% raise.

“These are the most vulnerable children in our society, the ones having problems getting off to a good start,� Helton said. “When you look at inflation over the past decade or so, and you consider the fact that in today’s environment, it’s hard to find good quality, skilled people from lots of positions that we as a state, we just couldn’t afford to take chances to lose these workers who provide such valuable service.�

Helton was also surprised to learn that pay had been cut for virtual providers, saying, “You never like to see anyone get a decrease.� But he said that in-person therapy offered benefits for children, and the pay increase could push more therapists to provide in-person services.

“When you look at all the numbers, my understanding was some of that was done just to drive more people out into the field and to ensure that they’re actually getting … in person with people that work with these babies,� Helton said.

Queen said the Senate Finance Committee will be looking into why the pay was cut for virtual providers.

“It’s a reality of some sort of a budget issue that they didn’t share with us in a hearing process. And I hope we can get to the bottom of it sooner than later and not discourage people from leaving the system,� he said. “I haven’t personally heard of anyone jumping ship, but I can tell you that when you decrease someone’s pay in 2025 when the rest of the folks inside the very same department got a pay raise, it’s very discouraging.�

He continued, “It’s a serious issue, and I hope that this creates more conversation and transparency. We want departments to be successful.�