Texas moves forward with cuts of therapy services for disabled children

^{*Correction appended.}

More than a year after lawmakers originally ordered it, Texas announced Monday it will enact significant cuts to the money that it pays therapists who treat vulnerable children with disabilities in two weeks.

Medicaid reimbursement rates are used to pay for pediatric therapy services provided to disabled babies and toddlers. Carrie Williams, spokeswoman for the state's Health and Human Services Commission, said that Texas will apply cuts on Medicaid rates on Dec. 15 in attempt to achieve savings directed by the Texas Legislature in 2015.

"The most important job we have is making sure kids have the services they need and that we are responsible with taxpayer dollars," Williams said in an e-mail. "We will monitor the reduction of rates to ensure access to care is not impacted and that Texans around the state receive the much-needed therapies required to improve their lives."

A group of concerned Texans last year filed a lawsuit seeking to block the $350 million cut to Medicaid, the federal-state insurance program for the poor and disabled, from taking effect. That group included speech, physical and occupational therapy providers and the families of children who receive their service. They argued that the cuts were so steep that providers would have to close their businesses and forgo seeing as many as 60,000 children.

In September, the Texas Supreme Court declined to hear their case, upholding a lower court's ruling that the lawsuit lacked standing.

The commission and several health insurers with state contracts have spent the last year arguing that the cuts will not cause children to lose access to services. State officials point to a state-commissioned study that found in-home therapy providers were overpaid by Medicaid when compared to other public insurance programs.

But Stephanie Rubin, chief executive of the advocacy group Texans Care for Children, said in an e-mailed statement that schools will now have more students who will struggle in classrooms and need expensive special education services. 

"This is terrible news for Texas kids with disabilities and developmental delays and their families," Rubin said. "Kids with autism, speech delays, Down syndrome, and other disabilities and delays rely on these therapies to learn to walk, communicate with their families, get ready for school, and meet other goals."

The advocacy group recently released a report outlining how enrollment in the state's Early Childhood Intervention program, which provides therapy services for for babies and toddlers with disabilities, dropped 14 percent from 2011 to 2015 after continued funding cuts and policy changes. 

In the statement, Rubin called on Gov. Greg Abbott, Lt. Gov. Dan Patrick and legislators to stop the cuts before they take effect. 

"Our most vulnerable children and their struggling families should not bear the brunt of this shortsighted and cruel budget decision," Rubin said. "Texans are watching to see what state leaders do to protect services for these kids."

John Branham, spokesman for Any Baby Can, a nonprofit provider in the state’s Early Childhood Intervention program, said the state's cuts would likely amount to a loss of hundreds of thousands of dollars in support for the organization.

“We either close that gap or evaluate whether or not our program will be sustainable,” Branham said. “By taking therapies away from children, you’re not solving a problem, you’re just pushing a problem down the line. We’re trying to get these children school ready. The problem is not going to go away.”

Read related coverage:

• Nearly 300 East Texas children with disabilities who are part of the state's Early Childhood Intervention program have no one to provide them with medically necessary therapies after the region’s lone provider closed its doors this week in response to hefty budget cuts ordered by state lawmakers.
• Texas health officials testified in court in 2015 that they had not studied how the budget cuts would affect children’s access to medically necessary therapy treatments.

Correction: An earlier version of this story stated that Texas had quietly announced it would soon enact cuts of therapy services for disabled children. The Health and Human Services Commission emailed the news to several reporters.