Thousands of Disabled Texans Face Service Cuts

Milla and her mother, Cassie, do stretching exercises on the living room floor.
Milla and her mother, Cassie, do stretching exercises on the living room floor.

For Milla Powell, a 12-year-old from Austin with cerebral palsy, the little things make all the difference. Massage therapy to increase flexibility and ease her tightened muscles. Recreational programs, in which therapists take her into the community to help her build her social skills. Music therapy to help Milla, who is nonverbal, connect without words.

Services like these are on the chopping block for thousands of Texans with disabilities — yet another casualty of the significant budget cuts state lawmakers passed in May.  

Directed to find $31 million in savings, Texas’ Department of Aging and Disability Services will by Dec. 1 put new caps on services provided to people enrolled in four state disability programs. The programs, designed to keep people with profound disabilities out of nursing homes and institutions, enroll nearly 48,000 people combined, roughly a fifth of whom are under age 21. The department estimates that the new service caps could affect up to 12,000 people.

The limits will not affect life-saving services like nursing care, emergency response systems and meal delivery. But they will slash services disability rights advocates say are essential to clients and their families, from speech and physical therapy to respite hours that give caregivers a brief break. So-called specialized therapies, like aquatic and horseback therapy, will see the biggest cuts.

“These programs are where we should be focusing resources, creating a lifelong improvement, rather than cutting them back,” said Dennis Borel, executive director of the Coalition of Texans with Disabilities. “Anytime you do things like this, you’re going to see an uptick in institutionalization.”

Under the agency’s cost-containment plan, the clients receiving the most extensive care in these less-essential service areas will see the greatest cuts; others could see no cuts at all. Those facing cuts can appeal them — and win if they prove their health or welfare will be endangered.

Allison Lowery, a spokeswoman for the department, said agency officials have warned lawmakers that “quite a few individuals” will likely win their appeals. “Therefore, we might not be able to achieve the $31 million cost-savings target,” Lowery said in an email.

Recreation Therapist Bethany Humble guides Milla to her van for a trip out for ice cream..

Milla, who is legally blind, uses a wheelchair and depends on her caregivers for a wide range of assistance, from bathing to toileting. The services she receives through the state’s Community Living Assistance and Support Services program are not just keeping her alive — they are helping her thrive, said her mother, Cassie Powell.

An attendant comes to help Milla so that Powell, who also has two teenage sons and a baby, can take a break to turn to the needs of the rest of her family. 

A speech therapist teaches Milla to communicate with a touch-screen computer, and a recreational therapist takes her on field trips so she can practice in the community.

“To think she’s going to get up and walk someday, to use her hands or feet, that’s difficult and far out there,” Powell said. “But being able to have a conversation with someone —we’re getting there on a daily basis. And her therapy makes a huge difference in her progress.” 

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