Report Shows Thousands of Texas Babies & Toddlers with Disabilities Left Out of Services During Years of State Cuts to ECI Funding

For Immediate Release
Peter Clark, 512-473-2274

ECI Contractor Scheduled to Cease Services this Week is Third Community Organization to Withdraw Amid State Cuts to Reimbursement Rates for Children’s Therapies

AUSTIN – A new report shows that Texas’ youngest children with disabilities and developmental delays have been left out of critical services during years of state cuts to Early Childhood Intervention (ECI) and new Medicaid reimbursement rate cuts for children’s therapies. The state’s ECI program provides coordinated therapies to children under age three with disabilities and developmental delays.

The report by Texans Care for Children shows that statewide enrollment in ECI fell 14 percent from 59,092 children in 2011 to 50,634 children in 2015. The sharp enrollment decline coincided with an increase in the state’s population of children under age three, which should have led to more Texas kids requiring ECI services. 

The number of community organizations contracting with the state ECI program has also fallen, declining from 58 in 2010 to 47 today. Contractors in El Paso and Tyler withdrew from the program in recent weeks and a third, in Wichita Falls, is scheduled to cease services this week. The state has been scrambling to identify new ECI contractors for those regions as Texas is required to ensure that all children eligible for ECI receive the therapies and supports they need under federal law (IDEA Part C). 

“The Legislature’s decisions to cut funding for the youngest Texans with speech delays, Down syndrome, autism, and other developmental challenges means that many children will have an even harder struggle to reach their full potential,” said Stephanie Rubin, CEO of Texans Care for Children, a non-profit children’s policy organization. “Thousands of Texas kids are missing out on therapies that could help them communicate with their families, walk on their own, or be ready for school.”

The report confirms ECI is effective when children are able to enroll. Seventy-seven percent of participating Texas children demonstrated a significant increase in their acquisition of new skills. ECI also reduces demand for costly special education services. Nationwide, 32 percent of children in their state’s early intervention programs did not need special education when they started school.

Yet Texas legislators have reduced funding for ECI over the last several years, appropriating $160 million in Fiscal Year 2010 but just $142 million in the current Fiscal Year 2017, a decline of 11 percent. Reduced funding coincides with a downward spiral of decreased outreach and enrollment, lower projected caseloads, and additional reductions in funding. 

For example, facing reduced funding, over the last four years 43 percent of ECI contractors stopped employing full-time Child Find staff dedicated to supporting enrollment through outreach to families and to community members, such as pediatricians, that refer families to ECI.

Texans Care for Children also found that enrollment declines hit certain communities the hardest. Among the counties with the largest populations of young children, the greatest reductions in enrollment occurred in Collin County (37 percent decline from 2011 to 2015), Denton County (32 percent), and Harris County (31 percent). 

The decline in enrollment hit all demographic groups, although the greatest reduction was among Black children. From 2011 to 2015, enrollment of Black children fell by 27 percent and enrollment of Hispanic children fell by 14 percent despite increases in the population of young Black and Hispanic children. Enrollment of White children fell by 11 percent despite the population of young White children in Texas having declined by nearly 3 percent.

“The state leaders we’ve talked to share our concerns about the loss of services for young kids with disabilities and developmental delays. As we saw with the creation of the state’s new pre-k grant program, state leaders have a growing understanding that children’s experiences during the first few years of life literally shape their brain architecture, providing a foundation for the rest of their lives,” said Ms. Rubin. “We’re optimistic that the Legislature will work to restore ECI services for these vulnerable kids during the next legislative session. Texas families will be watching closely to make sure they do.”

The report includes the following recommendations to state policymakers:

  • Halt and evaluate pediatric therapy rate reductions to ensure they do not harm kids by reducing their access to ECI
  • Boost funding for ECI to meet the needs of all eligible children
  • Ensure sufficient funding for Child Find services
  • Evaluate and address the causes of the disproportionate decline in ECI enrollment of Black children
  • Measure ECI performance based on outcomes, not service hours
  • Review and revise the ECI fiscal and administrative framework, including Family Cost Share requirements and handling of mid-year budget adjustments
  • Maintain current eligibility requirements for ECI
  • Provide technical assistance to ECI contractors

The report draws on data obtained from the state and collected in surveys of all state ECI contractors.

The report is available online here.