DALLAS (AP) — A drop in state funding and shrinking reimbursement rates are contributing to a sharp decline in the number of young children receiving care for often debilitating development and physical disabilities, according to a report released Tuesday.
A nonprofit child advocacy group, Texans Care for Children, argues in the report that the number of children enrolled in the state's Early Childhood Intervention program fell from about 59,000 in 2011 to approximately 50,000 four years later.
A slumping amount of state money coupled with flagging Medicaid reimbursements have caused service providers to drop out, according to the report. There were 58 providers statewide in 2010 and that number has dwindled to 47 today, with contractors in El Paso and Tyler withdrawing in recent weeks and a third in Wichita Falls planning to cease services, the advocacy group said.
"They are required to meet the needs of each child that comes through the door but they don't have the financing to necessarily meet that need," Stephanie Rubin, CEO of Texans Care for Children, said of the providers.
Versions of Texas' Early Childhood Intervention program can be found in many other states, under different names, and are similar to what state officials here are trying to achieve: providing children up to 3 years old with a range of services to help with physical disabilities and developmental disorders such as autism and Down syndrome. Offering treatment early in life can allow children and their families to avoid a range of expensive services later while also minimizing special education costs.
Rubin said most states contribute a greater amount than the federal mix of money that goes toward early intervention efforts, but Texas is more dependent on the money coming from Washington.
The combined state and federal appropriation for the program in Texas in 2014 was about $155 million, according to the Texas Health and Human Services Commission, and that amount slipped to approximately $142 million for the current fiscal year.
Carrie Williams, spokeswoman for Health and Human Services, said significant changes have occurred with eligibility requirements but says Texas when compared to other states is considered to have broader eligibility standards.
She acknowledged that some providers are stepping away from their contracts with the state but that other agencies are being recruited to replace them.
"We know this program is important to families, and we take that to heart," Williams said. "We worked quickly to replace contractors and keep families updated, with the goal of minimizing breaks in service."
Program enrollment has actually risen in recent years, she said, just not back to prior levels.
The report notes that the Houston area and parts of North Texas, such as Collin and Denton counties, have been particularly hard-hit by stiff enrollment drops. All demographic groups are affected, according to the report, but black children at a higher rate.
"The state is not keeping up with a growing population of young kids," Rubin said. "Over the years they've put in added administrative challenges to providers and cut back on reimbursement rates."
But Williams said state officials must contend with a limited pot of available funding and also "the need for a consistent, research-based assessment for determining developmental delay" in children.
"Exiting contractors typically have both performance issues and financial issues that may be related," Williams said.