Texas Supreme Court Puts Sweeping Pediatric Medicaid Therapy Cuts on Hold

Martha Meyers teaches Jaime how to say his R's and L's.
Martha Meyers teaches Jaime how to say his R's and L's.
Meagan Flynn

Just two weeks before sweeping Medicaid therapy rate cuts would have jeopardized services for thousands of poor, disabled kids across the state, one therapist told us that trying to stop the cuts felt like trying to stop a train.

Therapists and parents of disabled children had been protesting the Medicaid cuts for nearly a year, concerned the Texas Health and Human Services Commission's decision to cut speech, occupational and physical therapists' pay rates by roughly 20 percent across the board would create massive access-to-care problems. Last session, the Legislature ordered the commission to contain costs, and the commission responded by proposing to cut $350 million in Medicaid reimbursement rates over the next two years. Diana Dinn, an administrator at Kids Developmental Therapy, said toward the end of June that everyone was simply crossing his fingers for a miracle that the cuts wouldn't go through.

On Friday, though, their long-shot wishes were granted: The Texas Supreme Court issued a temporary injunction to halt the cuts for now — a decision that echoes a district court's initial temporary injunction last fall after parents filed a lawsuit, but is at odds with an appellate court's decision in April that the parents did not have standing to sue, which opened the door to HHSC's moving full speed ahead with the cuts. Now, though, parents and therapists will have one last shot to convince the state to lessen the blow and amend the cuts.

Last month we interviewed Samantha Romero, whose seven-year-old son, Jaime Soto, was born with a developmental disorder that has made it difficult for him to articulate his thoughts, connect objects with words, or comprehend simple questions or directions. News of the injunction came as a relief, she said.

“When I first heard the news, I was excited, because it means he's not going to lose his therapy,” Romero said. “But at the same time, okay, they put a stop to it for now, but in the back of my mind, I still have fear that they'll go on with the cuts in the future.”

Jaime is, in many ways, a testament to the effectiveness of therapy, which is necessary for kids with disorders like his as well as autism, cerebral palsy, severe brain damage or spina bifida, for example. A few years ago, before speech and occupational therapy, Jaime couldn't tell his mother if he was hungry or in pain, and couldn't complete basic tasks like brushing his teeth or washing his hands or, sometimes, even chewing. Jaime responded so well to occupational therapy that he was discharged last year. He talks plenty now, but still has trouble articulating his thoughts or saying his R's and L's. Sometimes he says he understands something even if his therapist, Martha Meyers, says it in Spanish — a language he doesn't know.

Concerned that her son could take huge steps backward without access to therapy, Romero was among hundreds of parents who traveled to Austin last July to voice opposition to the cuts at an HHSC public hearing. But she said that, still, the efforts felt futile: It didn't appear the commissioners were truly listening to what they had to say — evidenced further when they made slim changes to the cuts in response to the parents, which did nothing to mitigate their fears. A spokesman told us the commission doesn't have any plans for now to hold another hearing.

Romero said that, if anything, she's thinking about traveling down to Austin with her husband to organize a protest, bearing signs that plead with lawmakers to halt the cuts, even though she isn't sure lawmakers will pay any mind.

“The only other thing I can think to do is to make sure he doesn't have any missed visits with Martha, his therapist, and make sure that I follow through all the home programs that she gives me just in case the cuts happen.”

Just in case she has to learn how to do the job herself — which Romero says she knows won't be nearly enough for her son.


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