- [Steph] Two and a half year old Levi loves to play and run around.

- More?

- I want more.

- You want more, good job.

- [Steph] He also has some delays that have concerned his mom, Olivia Ippolito, since he was a baby.

Developmentally, she says, he's about 18 months old.

He was late to walk and struggles with speaking.

- He can say a lot of things but they don't make sense together.

- [Steph] From birth until age three, children in Rhode Island with developmental disabilities, just like Levi, are entitled at no cost to services known as early intervention.

Roughly 4,000 children are in the program each year.

But getting Levi in proved difficult.

- I didn't realize it would take that long and then I would have to hound people for so long.

- What were they telling you?

- Sorry, we have a wait list.

- [Steph] Levi's pediatrician referred him last year.

Ippolito says all she got at first were pamphlets.

- I was pretty mad about it.

What am I gonna do?

Report them to the government, they're the government.

- [Steph] Federal law requires children wait less than 45 days for an initial visit, but for Levi, it took a full nine months.

His occupational therapist now comes to his home to work with him.

- Ba, ba, bye.

- But after waiting all this time, at two and a half, Levi is just months away from turning three which will make him ineligible for the program.

What are you most worried about when it comes to how long it has taken for him to get these services.

- That he is gonna get stuck?

It's a very tight window.

- They're waiting a really long time.

I mean, it's criminal.

It is just awful.

- [Steph] John Kelly is the president of Meeting Street, the largest provider of early intervention in Rhode Island.

There are nine private agencies total overseen by the state.

Meeting Street alone has a wait list of more than 400 children.

The backlog started during the pandemic.

- We have a service requirement you have to provide, you have to do that initial visit within 45 days, the 45-day rule, we weren't meeting it.

No provider was meeting it.

- [Steph] Initially, the state took over the wait list in 2021.

It grew to more than 1,000 infants and toddlers.

Ultimately, the providers asked for control back.

So now there are nine separate waiting lists.

As of August, Rhode Island had more than 900 children waiting for early intervention services.

Many of them, like Levi, far beyond the 45-day timeframe in federal law.

- The child gets on the wait list and by the time you're able to get them, they're within a year of aging out.

And we know how critical it is to get through them those early years and that's painful.

- [Steph] Kelly says he is clear about what's causing the long wait.

- We're short staffed.

Everybody's short staffed.

And unfortunately, people don't wanna hear it but that comes down to money.

- [Steph] Private providers like Meeting Street are paid for early intervention through a family's health insurance, either Medicaid or private insurers, but it doesn't fully cover the cost, Kelly says, the nonprofit has to ask for donations to support its special education programs including early intervention.

- So the federal government and the state have said, "No, this is a mandated entitlement.

"We're just not gonna pay for it all."

- And what do you think of that?

- I think it's outrageous.

If you think it's that important, pay for it.

- [Steph] Speech, physical and occupational therapists are in high demand in other settings such as hospitals and schools where they can make more money than in an early intervention program.

- We're getting interviews and they're turning us down because of pay.

- [Steph] For the first time in two decades, Rhode Island lawmakers raised the Medicaid reimbursement rates by 45% last year but Kelly says it wasn't enough.

- Speaker Shekarchi was very helpful, we were grateful for that.

And you're nervous about, you know what I mean?

Thank you but we need the rest.

So that's kinda where we are.

- Early intervention is run out of the State's Health and Human Services Agency where a spokesperson declined to make anyone available to talk about the crisis or how Governor McKee's administration plans to fix it.

In an email, the spokesperson pointed to COVID relief money McKee has directed to early intervention providers and said the state has led an effort to recruit more staff.

The U.S. Department of Education tracks state's compliance with the 45-day timeframe to get an initial meeting.

Here's how Rhode Island stacks up against the rest of New England.

Connecticut and New Hampshire are meeting the requirements of the law according to the federal agency.

Massachusetts and Maine are categorized under needs assistance for one year.

And Rhode Island and Vermont are under needs assistance for two or more consecutive years.

- Having 900 Or more kids waiting for early intervention services is really not something that we should be doing.

- Leanne Barrett is the senior policy analyst at Rhode Island Kids Count which tracks data and advocates for children's wellbeing.

- Every single day, every week, every month that a kid does not get the services they need for healthy development and learning including an infancy, that the further they fall behind their peers who are getting the services they need.

- What would be an acceptable wait list number?

- Well, I don't think that we should have any wait list.

There should be no children who are waiting more than 45 days.

The numbers should be zero.

- [Steph] Kids Count is part of a larger group called the Right From The Start campaign that's asking for another Medicaid rate increase in next year's state budget.

A rate increase would also apply to private insurers.

- We're also looking at trying to get a cost of living adjustment into state law.

We're looking at what else can we do to help recruit people to work in early intervention.

What can we do to raise those wages to be competitive with the community?

- Early childhood and particularly early intervention is not valued the way it should be valued.

- [Steph] And John Kelly says, failing to provide timely early intervention has an enormous ripple effect.

- Not having a robust early childhood system has long-term implications on society and on our functioning of everything.

The impact that has on a child's employability, on a child's happiness, on a child's sociability, on the tax revenues of a state or municipality is profound.

And it's really, it starts at that age.

- [Steph] For Olivia Ippolito, the effects have already been staggering.

While waiting for early intervention, she says Levi was forced to leave his daycare.

The childcare center told her he needs one-on-one attention which they couldn't offer.

- They're like, "Well, he needs a smaller ratio," but there are no smaller ratios anywhere.

- [Steph] As a single mom without childcare, this past summer, Ippolito says she couldn't go to her job as a licensed practical nurse where she works with children with medical needs.

- There's a whole family that's gonna suffer because I don't have anywhere to send him to daycare.

- Because you can't work.

- Because I can't work.

So it's at least one to two other families that are affected.

- If you had a chance to meet with the governor, meet with state leaders and tell them your story, what would you say to them?

- Why do you think that my kids aren't worth it?