For Gov.-elect Tom Wolf and the Pennsylvania Legislature, job one in January will be to come up with a budget that closes an estimated $1.85 billion shortfall - that's billion, with a B.

Here at Schreiber Pediatric Rehab Center, we follow budget matters closely. Every year, close to 90 percent of the revenue from the nearly 4,000 children and young people we serve, from newborns to 21-year-olds, comes from Medicaid. These dollars are used to cover all children and young adults with disabilities, regardless of household income.

Funding for people with disabilities makes up a big chunk of the state's Medicaid program.

Pennsylvania spent $17.6 billion in Medicaid payments in 2010, with 73 percent of that going to the elderly and disabled individuals, according to research by the Pew Charitable Trusts. And that number is only going up as the population ages and more people become eligible for Medicaid.

We have an idea we think will help the state begin saving money almost immediately.

Right now, for every $100 of therapy services Schreiber provides, Medicaid pays about $60. Many health-care providers across Pennsylvania have stopped offering pediatric therapy services because they lose money. Schreiber Pediatric remains committed to providing outpatient therapy services, but we have to raise more than $1 million a year from private donors to cover the difference between what Medicaid pays and what it actually costs to provide the services that help thousands of children walk, speak, or function independently.

Given the budget circumstances, elected leaders in Harrisburg might be tempted to make additional cuts to what the state pays to therapy providers. But that would be shortsighted, and here's why.

We know that access to services is declining in Pennsylvania. Parents of children with special needs have to travel farther - in some cases more than 100 miles each way - to find qualified providers. Additional reductions in reimbursements will make it even harder for providers to offer services, which will accelerate the trend of declining access.

We also know that investments in early-childhood services, especially for children up to age 5, when the greatest development occurs, make a substantial difference in how much it costs to care for children with disabilities, who grow up to become adults with disabilities.

How much of a difference? Some estimates put the amount at $1 million. In other words, a child who misses out on critical therapy services at a young age will cost taxpayers $1 million more in support services over the course of his lifetime.

To put this in more tangible terms: Some of the parents Schreiber is helping now were told by health-care and education professionals when their children were 2 or 3 years old to have their kids fitted for wheelchairs so they would have an easier time when they began school.

Instead, Schreiber has worked with these children, helping them strengthen their limbs and build independence. Now those kids are walking up and down school bus steps without assistance. That means no special school buses and no dedicated aides are required to help these children. These savings to taxpayers are not in the distant future. They are happening now.

Pennsylvania's elected officials would be wise to invest in expanding access to services for children with disabilities today to give them and everyone in the commonwealth a better tomorrow.

James DeBord is president of Schreiber Pediatric Rehab Center in Lancaster. jdebord@schreiberpediatric.org