Report: Houston-Area Kids with Disabilities Miss ECI Services After State Cuts

For Immediate Release
CONTACT: Peter Clark, pclark@txchildren.org, 512-473-2274

Enrollment Fell Among Babies and Toddlers of All Backgrounds, But Plummeted Among Black Children in Harris County

Austin – Following state budget cuts, over 2,500 Gulf Coast babies and toddlers with disabilities and developmental delays have missed out on Early Childhood Intervention (ECI) services, according to a new report by Texans Care for Children. Between 2011 and 2016, ECI enrollment in the 13-county Gulf Coast region fell from 12,026 children to 9,482 despite a growing population of young children. The 21 percent decline in the region was more than double the statewide enrollment decline of 10 percent.

While enrollment fell among children of all backgrounds, there was a 44 percent decline among Black children in the region. In Harris County, there was a shocking 52 percent decline in enrollment among Black children, falling from 1,432 to 687 children while the population of young Black children in the area increased.

“Local ECI organizations do a terrific job supporting children with autism, speech delays, Down syndrome, and other disabilities,” said Stephanie Rubin, CEO of Texans Care for Children. “Thanks to ECI, children learn to walk, swallow, communicate with their families, and get ready for school. It’s heartbreaking to know that children are missing these opportunities due to state cuts. We urge the Legislature to fully fund ECI, reverse the therapy funding cuts, and investigate why a disproportionate number of Black children are losing services.”

Under the state-federal ECI program, the Health and Human Services Commission (HHSC) contracts with 44 community organizations to provide coordinated services to children under age three with disabilities and developmental delays. The largest contractors in the Gulf Coast region are Easter Seals Greater Houston and The Harris Center, formerly known as the MHMR Authority of Harris County.

State Policy

State appropriations for ECI have fallen since 2011, decreasing from $166 million in FY 2011 to $148 million in FY 2018. In 2015, Texas legislators also reduced the Medicaid reimbursement rates paid to providers who offer speech, physical, occupational, and other therapies to children with disabilities. The Texas House unanimously passed legislation to reverse the Medicaid cuts during the recent special session, but the Governor and Senate did not take up the issue, leaving the cuts in place.

The Speaker of the Texas House has already instructed the House Appropriations Committee to look into the Medicaid therapy cuts before the next legislative session. Additionally, he directed the Committee to:

Examine the Early Childhood Intervention Program (ECI) in Texas, including a review of historical funding levels, programmatic changes, challenges providers face within the program, and utilization trends. Evaluate ECI's impact on reducing the long-term costs of public education and health care. Identify solutions to strengthen the program.

Statewide Update on ECI

The report is the third and final Texans Care for Children report on ECI in a particular region of the state. Previous reports focused on the Dallas-Fort Worth region and the Northeast Texas region that includes Tyler, Longview, and Texarkana. Both reports found significant declines in ECI enrollment in the region, among other findings.

Today’s report provides a statewide update on ECI, particularly addressing the closure of ECI programs. Six contractors withdrew from the state ECI program in 2016 and 2017, leaving 44 contractors in place.

A seventh contractor, Texoma Community Center in Sherman, recently notified the state that it will shut down its ECI program in February. If it is not replaced with a new contractor, the Northeast Texas region will be down to 2 contractors and the state will be down to 43.

The report shows that children often lose services when these community organizations close down their ECI programs. In many cases, even when state officials immediately find a new contractor to serve children in the area, families do not receive adequate information about transferring to the new contractor; the new organization needs time to hire and train staff; and families, pediatricians, and other community members lose confidence in and knowledge of their local ECI program.

The report’s statewide update also addresses enrollment changes. The report notes that state funding cuts have forced ECI contractors to scale back their “Child Find” outreach levels, leading to lower enrollment. While ECI enrollment has partially rebounded in recent years, including a five percent increase between 2015 and 2016, overall enrollment is 10 percent lower than in 2011 despite a 4 percent increase in the number of Texas children under age three. The state cuts affected children of all backgrounds, but there was a disproportionate impact on Black children. Statewide ECI enrollment of Black children decreased 30 percent from 2011 to 2016, compared to 10 percent among Hispanic children and 8 percent among White children.

Additional Findings Regarding ECI on the Gulf Coast

The report examines the 13 counties in Region 6 of the state’s Texas Public Health System.

The report shows that ECI enrollment in Harris County declined 30 percent from 2011 to 2016 while the population of children under age three rose 4 percent between 2011 and 2015. There were some bright spots outside of Harris County. ECI enrollment in Fort Bend, Waller, Matagorda, Liberty, Chambers, Galveston, Wharton, and Colorado counties surpassed their 2011 enrollment levels in 2016.

Two developments this year will likely place further strain on ECI contractors in the region and the children they serve. This year, two ECI contractors serving the region – Easter Seals East Texas and UTMB-Galveston –closed their ECI programs. Additionally, the report notes that Hurricane Harvey has placed additional strain on ECI children, families, and contractors, particularly as contractors have faced lost revenue and the costs associated with hurricane damage to their facilities.

###