TAHC&H Decries Cuts to Therapy Services for Kids and Seniors by $350,000,000 Without a Single Public Hearing

The Texas House and Senate budget conferees late last Thursday night adopted a cost containment rider that would drastically cut physical, occupational and speech therapy for children and seniors by at least 25 percent or $175 million in 2016 and totaling $175 million in 2017. Payments to therapy providers were also reduced in 2010, 2012, and 2014. Preliminary research shows the $350 million reduction in rates is the single largest reduction to a provider group in Texas in at least a decade.

Therapies help children with birth defects, genetic disorders, physical or cognitive disabilities and those born prematurely to function in daily life. For seniors and adults, the therapy may help in recovery from a broken hip or with progressive diseases such as Alzheimer’s or Parkinson’s. A doctor prescribes the therapy in response to a patient’s medical need and many studies prove early intervention produce cost savings.

Rachel Hammon, executive director for the Texas Association for Home Care and Hospice (TAHC&H), commenting on the drastic reductions said: “We are enormously disappointed in the decisions of the budget conferees to dramatically reduce therapy services, mostly for children with disabilities, with no public input and no chance to make our case in front of the public and the key committees charged with addressing these issues. We worked in good faith to bring forward recommendations for savings that would improve the delivery, utilization and efficiency of these programs. Instead it appears a hatchet was taken to therapy providers and ultimately the Texas kids in need of this vital care.”

“These actions will have a devastating impact on the availability of this therapy for Texas children and vulnerable seniors who need care. No effort was made to hear from the families impacted. When the process happens behind closed doors, the end result can be destructive and truly harmful, as is the case here,” Hammon added.

According to the Texas Health and Human Services Commission, the Texas Medicaid program spent approximately $680 million on all therapy service in 2014, with the state’s portion totaling $291 million. The budget rider adopted last Thursday night requires a cut of at least $50 million in state money in both years (2016 and 2017) with the additional balance coming from $25 million in potential policy changes each year. When matched with federal funds, these cuts equate to $350 million. Curiously, if the policy changes and potential efficiencies envisioned in the rider exceed $25 million, the rider does not allow that to count against the overall reduction, thereby removing an incentive to find innovative ways to meet or exceed cost reductions and improve efficiency.

The impetus for these reductions appeared to emanate from a hastily compiled report attempting to compare therapy rates from other states. The report was to be delivered to the Legislature last summer but was not provided until February 2015, after the House committee had concluded their preliminary budget efforts. TAHC&H and therapy providers have decried the report as highly biased, citing errors such as comparisons of rates for therapy codes providers don’t bill under Medicaid, inaccurate state by state comparisons, inaccurate comparisons to commercial insurance therapy payments and data that in many cases was portrayed in an extremely misleading manner.

“I cannot imagine a life without therapy services for Dylan…without therapies Dylan would not be as successful, happy, or thriving the way he is now,” said Stacy Tassin, in a written testimonial of her son’s therapy story that she authorized be made public.

Mrs. Tassin’s son Dylan receives the types of therapy cut by House and Senate budget conferees.

“Dylan would not be able to stand with assistance without the therapy he receives and he would not be eating and gaining weight without his current therapy,” said Tassin in her written testimonial. “A life without therapy for Dylan would more than likely result in increased medical and health complications. I know for a fact that each of his therapies have helped to reduce each of these.”

The budget cuts were made without the opportunity for families to share public testimony with lawmakers about the life changing and lifesaving importance of therapy for their children. Because there were no public hearings, the cuts have left families reeling and searching for answers according to Hammon.

“The kids we are talking about – the kids like Dylan that are seeing therapy services cut – are truly the most vulnerable in our society and the ones most in need of care,” said TAHC&H’s Hammon.

In recent years, state policymakers have also crafted therapy policy in accordance with the settlement of the Alberto N. v. Don Gilbert lawsuit, one of the most significant legal cases regarding how therapy and other benefits are delivered to Medicaid beneficiaries under the age of 21. The rider’s policy recommendations appear to run contrary to the settlement agreement under Alberto N. and contain new policy recommendations that could result in additional litigation and expense for the state.

“The process and policy behind these cuts are patently destructive and leave so much to be desired. Ultimately the TAHC&H wants to see that individuals who need these services can access them in the way that is most effective for them and most efficient for the taxpayer. We fear in the zeal to gain arbitrary savings, a number of budget decision makers lost sight of the significance of access to care for Texas’ most vulnerable children and seniors,” said Hammon.

TAHC&H represents over 1,300 companies that are committed to supporting the daily needs of fellow Texans in their homes, where they belong.

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