New Report from Texas: Thousands of Young Kids with Disabilities Excluded from Early Intervention Amid State Cuts

Smiling Baby Boy

By Rebecca Hornbach and Stephanie Rubin, Texans Care for Children

As the President-elect and Congress consider significant changes to the way the federal government works with states to support children and families, and our state lawmakers here in Texas prepare for a legislative session with this new administration in Washington, they should consider our recent report on Early Childhood Intervention (ECI). Our report shows that these federal-state support programs can make a real difference in kids’ lives – and that chipping away at them can have disconcerting consequences for children.

ECI is Texas’ Part C IDEA program, funded in part by federal education funds as well as Medicaid for eligible enrollees. It provides targeted, high-quality interventions for children under three years old with disabilities and developmental delays, such as Down syndrome, speech and language delays, autism, and significant developmental delays. Through the program, the state contracts with community non-profit organizations to provide therapies that help children learn to walk, communicate with their families, swallow their food, get ready for school, or meet other goals.

Despite the program’s effectiveness, since 2011 Texas policymakers have reduced state funding for ECI, narrowed eligibility criteria, reduced Medicaid reimbursement rates, and placed new administrative and financial burdens on the already-strained community agencies offering ECI services.

With support from the Episcopal Health Foundation, Methodist Healthcare Ministries of South Texas, and the Harold Simmons Foundation, our team here at Texans Care for Children embarked on a research effort over the past year to assess the impact of these recent state policy changes and funding reductions on families’ enrollment in ECI. What we uncovered was startling and has led to increased media and policymaker attention to the issue.

Our work culminated in our new report, Left Out: The Impact of State Cuts to Early Childhood Intervention (ECI) on Young Texas Kids with Disabilities and Developmental Delays.

As reported in media outlets across the state, our research paints a troubling picture of Texas’ commitment to infants and toddlers with special needs. Specifically, we found that:

  • Texas legislators reduced ECI funding by 11 percent, from $160 million in FY 2010 to $142 million in FY 2017.
  • Enrollment in ECI services fell 14.3 percent between 2011 and 2015, while the population of children under three grew 2.18 percent across the state. In some regions of the state, including Dallas, Houston, Austin and East Texas, the enrollment drops ranged from 20 percent to 37 percent.
  • Enrollment declines have impacted black children in Texas the most: ECI enrollment of black children statewide decreased 27 percent from 2011 to 2015, compared to 14 percent among Hispanic children and 11 percent among White children.
  • Strained ECI contractors have reduced critical outreach staff: 43 percent of contractors eliminated dedicated Child Find positions due to fiscal constraints.
  • Over two-thirds of contractors expect to reduce the number (69 percent) and frequency (67 percent) of services to eligible children as a result of the Legislature approving reductions to Medicaid pediatric therapy rates in 2015.
  • In 2014, Texas ranked 43rd nationally for the percentage of children under age three enrolled in the program.

The report recommends state leaders ensure sufficient funding for the ECI program so all eligible children can access the critical services they need, maintain current eligibility, boost outreach efforts, and take other steps to fill services gaps and make the best use of limited funds.

Policymakers are paying attention. While the Texas Health and Human Services Commission just announced it would start implementing the Medicaid cuts for pediatric therapies passed last session, the Speaker of the Texas House immediately responded. He said “maybe they were a mistake” and vowed that the House would pass a supplemental budget that replaces funds for these therapies during the current fiscal year. With this hopeful progress, we will continue working to educate state and federal leaders of the importance of maintaining strong, effective Medicaid and IDEA programs to support Texas children and families.

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