Proposed Texas Medicaid Cuts Threaten Home Care and Therapy for Disabled Children
April 18, 2017 03:56 PM
Texas state officials are proposing to slash tens of millions of dollars to at-home Medicaid services for people with intellectual disabilities.
The proposed cuts, $70 million over the next two years, could go into effect on July 1, 2017 and many of those affected by the proposal say it will put Texas’ most vulnerable children in harms way by forcing them to turn to low-quality providers.
About 32,000 Texans with intellectual disabilities receive at-home services through Medicaid and another 113,000 are on waiting lists to receive services, according to advocates.
The Texas Health and Human Services Commission has suggested cutting the reimbursement rates for at-home attendants by 21 percent in two Medicaid waiver programs. The cuts would reduce rates to $17.73 per hour, starting on July 1.
The attendants provide in-home care to people with intellectual disabilities, assisting them with tasks like shopping and dressing, but also more complicated services, such as medical care and therapy.
While there has been bipartisan criticism of the Texas Health and Human Services Commission for the rate cuts, the Commission believes it is merely carrying out the policies of the state legislature when it voted for the Medicaid cuts in 2015.
The Commission has also proposed switching from paying by the hour to reimbursing therapists by the care provided in 15-minute periods. This seemingly small change, however, could prove financially disastrous for home care providers who are not paid for administrative and travel costs through Medicaid.
"Changing the payment methodology to home health therapy providers while the Legislature is actively engaged in efforts to restore funds that were cut is baffling and counterproductive," Rachel Hammon, executive director of the Texas Association of Home Care and Hospice told the Dallas News.
Advocates for the disabled in Texas say the proposed cuts will cost the state more in the long run because the home-based services help people avoid institutionalization, which tends to be far more costly.
The Texas state legislature approved $350 million in Medicaid cuts over two years to therapy providers and the cuts took effect on December 15, 2016. Those cuts have forced therapy providers out of Medicaid or the therapy business entirely, according to industry groups in Texas. The cuts have also interrupted care for thousands of disabled and poor children who on wait lists for services. The rate cuts have particularly affected families in rural areas where therapy options are few and far between.
The general public will have the opportunity to speak against the proposed rate cuts on May 17.