Children in the Galveston and Hill Country areas are going to be without state-funded speech, occupational and physical therapy services as two more providers prepare to leave the Early Childhood Intervention program.

The Texas Health and Human Services Commission confirmed Monday that the University of Texas Medical Branch and Hill Country MHDD Centers are ending services through the program. The university serves children in the Galveston area, while Hill Country MHDD Centers offer services for kids in Bandera, Blanco, Comal, Edwards, Gillespie, Hays, Kendall, Kerr, Kimble, Kinney, Llano, Mason, Medina, Menard, Real, Schleicher, Sutton, Uvalde and Val Verde counties.

Cheryl A. Sadro, executive vice president and chief business and finance officer for the University of Texas Medical Branch, wrote in a May 3 letter obtained by The Texas Tribune that the school was leaving the program “due to restrictions for patients to qualify for therapy services coupled with the financial impacts of decreased cost reimbursement funding per enrolled patient.”

While the University of Texas Medical Branch won’t offer services through the state run Early Childhood Intervention program after Aug. 31, but Sadro said they will continue to offer children physical, occupational and speech therapy services through their Department of Pediatrics.

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Ross C. Robinson, executive director for Hill Country MHDD Centers, wrote a June 13 letter to the commission that echoed Sadro’s letter. He said the Legislature’s 2018-2019 budget was “not substantial enough to compensate for the deficits that we now experience related to previous funding and policy decisions.” The organization said it will end services Oct. 11.

“We cannot overcome the rate reduction in per-child expenses, the lack of funding to cover services that we provide to children and families who are beyond our funded target numbers and the rate reductions for Medicaid-funded therapies,” Robinson said.

Brazos Valley-based Easter Seals East Texas announced in April that they’re also ending services on Aug. 31.

The Health and Human Services Commission is now charged with finding new providers for all three areas.

“We're working quickly to try to find replacement contractors for those areas so kids can have access to the services they need in their communities," said Carrie Williams, a commission spokeswoman. “ECI is a real support for families. It's challenging when a contractor terminates.”

A $350 million cut to Medicaid children's therapy services in Texas went into effect in December, prompting fears from parents that providers would stop offering services, leaving eligible Texas children without therapy that they're entitled to receive under federal law.

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House Speaker Joe Straus vowed in November to reverse the cuts during the regular legislative session that ran from January to May, but despite hearing tearful testimony from families pleading that the budget process spare any more cuts for children therapy services, the Senate resisted House efforts to restore the cuts during budget negotiations.

Ultimately, the chambers reached an agreement to give therapy providers a 25 percent restoration of their Medicaid payments in 2018 and 2019.

Advocates also found a silver lining in the budget when offered up an additional $4 million for the Early Childhood Intervention program for the rest of the 2016-2017 budget cycle. Legislators have said the commission can request additional funding for the program if needed.

However, advocates expressed disappointment that legislators did not fund the Health and Human Services Commission's request for $20 million to partially cover the Early Childhood Intervention program’s expected enrollment growth in the next two years.

And those affected say the damage is already done.

They said Medicaid therapy rate cuts are exacerbating historical underfunding of the state’s Early Childhood Intervention program, which serves 50,000 children under 3 years old with developmental issues including autism, speech delays and Down syndrome. Providers, often serving in both programs, are paid little for their services. Therapy providers in El Paso, Tyler and Wichita Falls left the program in 2016. Since 2010, the state has gone from 58 providers in the program to 46.

Stephanie Rubin, CEO of Texans Care for Children, said in an email statement that news of the two providers ending services is “more bad news for kids” with disabilities and her heart breaks for parents racing to find someone else to provide care.

“When these programs shut down, we usually see a drop off in the number of kids receiving services, even after HHSC lines up another provider to take its place,” Rubin said. “How many ECI providers have to shut down before the Legislature takes action?”

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Parents of affected children still have one hope, albeit a dim one, that the cuts will be restored. As lawmakers settle in for the special legislative session that started July 18, House Appropriations Committee members are preparing to hear testimony on Tuesday for House Bill 25, which aims to reverse the Medicaid therapy rate cuts.

It’s a long shot — the Legislature wrapped up budget talks during the regular session, it wasn't on Abbott's 20-item special session agenda and senators have been adamant about not reversing the cuts.

Disclosure: The University of Texas Medical Branch has been a financial supporter of The Texas Tribune. A complete list of Tribune donors and sponsors is available here.

Read related Tribune coverage:

  • The House grudgingly voted to accept the Senate's supplemental budget proposal, which would not restore funding for disabled children's therapy services. [Full story]

  • Easter Seals East Texas officials have put the Texas Health and Human Services Commission on notice they are ending services for 230 children in the Brazos Valley area on Aug. 31. [Full story]

  • In a wide-ranging interview with the Texas Tribune's Evan Smith, House Speaker Joe Straus shed light on his priorities for state lawmakers. [Full story]

  • A significant cut to the amount of money Texas pays therapists who treat children with disabilities was finally cleared to take effect when the Texas Supreme Court declined to hear a lawsuit over the budget cut's legality. [Full story]

  • As Texas seeks to implement a $350 million cut to the Medicaid budget for children’s therapy services, Texas health officials are scrambling to maintain a robust network of providers. [Full story]

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