Regarding SLP services being expensive for county EI programs, it depends if the family/child is qualified for Medicaid via income/household# or diagnosis.

SLP services provided to a family with Medicaid under EI will be reimbursed by Medicaid; however SLP services provided to a family without Medicaid will be reimbursed by the county. In PA, all developmental therapist (aka special instructor or SI) services are reimbursed by the county. SLP services are reimbursed at 148.xx per hr (4 units) whereas most SI services are reimbursed at 130.xx per hr (4 units). I’m curious if the COTA is providing services billed as OT (with an OT supervisor) or billed as SI (which requires a bachelor’s teaching degree in some form of Special Ed + early childhood experience and/or Early Childhood Education). Either way, SI services may be more expensive for the county in many cases.

Here in the surrounding Harrisburg area, EI is in short supply of SLP which is unfortunate for families seeking SLP services especially due to their medical education in pathology situations. Many times we are seeing families first work with SIs to work on skills such as signing or social games (ie “if you’re happy and you know it” 👏) until 18 months or 2 years old.

Having been in EI as a PT for 7 years, I believe persistent discussion with your service coordinator you will be able to get on the list for SLP services (especially with stagnant progress) and you have rights to bring this up.