Parents of disabled kids despair of seeing state cuts for therapy services restored

“Can we get out of here?” asks Aidan, who has disabilities that affect his immune and cardiac system, energy levels and ability to get around.

“It’s just the start, I’m afraid,” Hannah Mehta responds, running her hand through Aidan’s thick, black hair. 

The pair from Flower Mound have spent countless days during the special session in the basement of the Texas Capitol complex, lobbying lawmakers to restore deep cuts to a Medicaid therapy program that assists about 6,000 medically fragile children, like Aiden, who gets help learning to chew and swallow his food.

But with the abrupt end of the special session Tuesday night, the prospect of relief is off for now.

While the House agreed unanimously to restore funding to the Medicaid therapy program, House Bill 25 made no progress in the Senate, and Gov. Greg Abbott never added the issue to the ambitious, 20-item call he laid out at the start of the special session. 

Abbott’s office did not return a request for comment, but previously had said the governor wouldn’t add to the agenda until all his items were approved. Several of those, including the so-called bathroom bill, died as the special session came to an unexpected close one day early.                                

Affected families and some lawmakers were concerned that if the money wasn’t restored now, they would have to wait until the next Legislative session in 2019 to try again, when they warn that far more children with disabilities may have lost critical therapies.

“Some of these kids can’t wait the 16 months for relief,” said Rep. Matt Krause, a Republican from Fort Worth and a member of the tea-party-aligned Texas Freedom Caucus. “If the governor does call us back for (another) special session, I am hoping with the momentum we have built up, it might lead to him putting it on the call.”

It remains to be seen whether Abbott decides to call another special session. Republicans in control of the Senate, however, seem unwilling to revive the issue at this time.

It was a point of contention during the regular session, too, when the Senate agreed to reinstate just 25 percent of the cuts made to the therapy program, which is supported by both state and federal dollars.

“We looked at that during the session and we restored a portion of it. And we need to see how that does, as far as affecting access,” said Sen. Charles Schwertner, R-Georgetown, chairman of the Senate Committee on Health and Human Services.

 The Senate had been far more reluctant than the House to address anything that wasn’t on Abbott’s 20-point agenda.

Therapy providers say they’ve yet to see any benefit from the partial restoration of funds, and some don’t expect to at all. Because the Health and Human Services Commission is reworking the way home health agencies are paid, therapy providers say they are bracing for more losses this fall.

 “We’re not feeling the restoration taking effect. We’re feeling major, major cuts,” said TJ Caplinger, CEO at Child’s Play Therapeutic Homecare based in San Antonio. “I will be discharging kids come September because I won’t have the staff.”

 Lawmakers ordered reductions to the Medicaid program in 2015, after a state report showed reimbursement rates for pediatric acute therapy services were higher than in other states.

 Some House members now contend that report was flawed. Since the reductions took effect last year, home health agencies say they have had to cut therapist pay and shrink the number of clients they see. As a result, families report they have lost therapy that helps them care for their children in their own homes.

 Aidan, who used to see a feeding therapist three times a week to learn how to chew and swallow his food, now gets the assistance just once a week.

 Hannah Mehta says several factors are to blame, including the program cuts and the recent transition of her son’s health care to a managed care model. That switch has made it harder for families to get approval for life-sustaining medications and supplies, she said.

 “The industry as a whole has taken a hit,” Hannah Mehta said. “We have other families who have lost everything, all of their therapies have been denied.”

The legislated cuts reduced Medicaid reimbursement rates for speech, occupational and physical therapists who help children with severe disabilities.

 At least three therapy providers in the state have shut down due to the cuts, leaving their 60 child clients in need of new care, according to data from the Texas Health and Human Services Commission.

 “We have seen providers closing, providers are contracting their service areas, providers are letting therapists go,” said Rachel Hammon, executive director of Texas Association for Home Care and Hospice. “This has had quite a snowball effect.”

 San Antonio Sen. Carlos Uresti said Texas has more than enough money in its $10 billion rainy day fund to cover the $70 million in state costs laid out in HB 25.

 “Our No. 1 goal up here shouldn’t be these other issues, it should be be about taking care of children,” said Uresti, a Democrat and vice chairman of the Senate Committee on Health and Human Services. “We have got to quit hiding behind the fact that there may have been a few providers who were overcharging.”

 Mehta said there is no “Plan B.”

 “We will continue to advocate and fight for our families and for our children who can’t fight for themselves,” she said. “That’s our only option.”