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Texas has failed to ensure children with developmental delays have early access to speech and occupational therapy and other services, according to a letter written this week by U.S. education officials who say the state is not complying with federal special education guidelines.
The Texas Health and Human Services Commission has three months to draw up a plan to ensure that a program that pays for infants and toddlers to receive such early intervention therapies is reaching all eligible Texans, federal officials wrote. Failure to do so could cost the state federal funding.
After years of budget cuts in Texas caused nonprofit therapy providers to drop out of the program, U.S. Department of Education officials found Texas to be in “significant noncompliance” with education guidelines on early intervention services.
Children's advocates called on state leaders to provide additional funding to Texas' Early Childhood Intervention program, also known as ECI.
"The investigation clearly shows that state funding cuts to ECI made it harder for Texas toddlers with autism, speech delays, Down syndrome, and disabilities to get the services they need,” said Stephanie Rubin, chief executive of the nonprofit Texans Care for Children.
"Because so much brain development happens during the first couple years of life, we know that investing in infants and toddlers has a huge payoff in terms of kids meeting developmental goals, being ready for school, and growing up healthy," she added.
Christine Mann, a spokesperson for the Texas Health and Human Services commission, said the agency is reviewing the report to determine its next steps.
The Early Childhood Intervention program pays for caseworkers to work with families to track the progress of developmentally delayed children under 3 years old, and to connect families with speech, physical and occupational therapists. The goal is to help catch children up with their peers before they enroll in preschool or kindergarten.
The program’s funding in Texas has not fully recovered after deep cuts made during previous state budget shortfalls. The program’s funding fell from $166 million in fiscal year 2011 to about $148 million in 2019, federal officials wrote. And that was on top of payment reductions the Texas Legislature made in 2015 to therapy providers from Medicaid, the federal-state insurance program for the poor and disabled, which covers many low-income children in Texas.
Children's advocacy groups say Texas is among three states with the lowest share of children receiving early intervention services.
Those funding cuts were “a significant cause” of nonprofit providers closing their doors or dropping out of the program, which resulted in gaps in services for children with special needs, the federal officials wrote.
The letter follows a lengthy federal inquiry into Texas’ support system for children with special needs. It highlighted one example from 2016, when the Andrews Center, a nonprofit in Tyler, withdrew from the early education program after telling state officials it could not afford to continue its operation.
“Although a provider was secured for the region previously served by the Andrews Center, many children impacted by that program closure did not receive services for several months,” the federal education officials wrote.
Funding cuts contributed to the closure of 16 early intervention service providers, the U.S. Department of Education found, and many providers remaining in the program are serving more children than what is funded under their contracts.
Earlier this year, Texas officials proposed additional funding cuts to the early intervention program, but the agency withdrew that proposal. Instead, the Texas Health and Human Services Commission has floated the possibility of cuts to its workforce and other administrative expenses to come up with about $130 million in budget reductions ordered by Gov. Greg Abbott and other top Republicans in response to the economic slowdown caused by the coronavirus pandemic.
The letter suggests that the Texas Health and Human Services Commission may need to ask the Texas Legislature for more Early Childhood Intervention funds when lawmakers convene next year. “A significant cause of the findings ... is the level of funding that the State has made available for [the Early Childhood Intervention] program, and the State will need to take into consideration this and other root causes as it implements corrective actions,” the federal officials wrote.
That finding is remarkable, said Steven Aleman, a senior policy specialist for Disability Rights Texas, which advocates for people with disabilities, because "it’s not just implicating the administrative agency, but our state lawmakers in their role as appropriators."