Austin Am-Statesman Editorial Board Opinion: Texas needs to help — not pick on — children with disabilities

I fully agree with the Austin American-Statesman editorial review board that we must never hurt children with disabilities, particularly by denying them services.  This piece outlines the tawdry legislative history associated with serving children with disabilities involving the privatization of Medicaid as "part of a multiyear transition into the state-created STAR Kids managed care program, approved by the Legislature in 2013."  

It should concern us deeply that "Between February and May, 12 percent of children with the severest disabilities were denied Medicaid services, triple the overall rate of 2016, according to the Texas Health and Human Services Commission." (A-7, Nov. 11, 2017)  More than 2, 500 registered complaints this year signal that something is woefully wrong.  Other recommendations listed herein:

 The commission should mandate that no child with a disability be denied service or coverage until all necessary fixes to the assessment tool are complete.

Legislators must demand transparency and appoint resources to ensure that, in this case, managed care organizations deliver on contract expectations.

C'mon Statesman board.  You can do better than that.  With the word, "until," your sentence suggests that at some point, under some conditions, some kids can be denied services that they need!?  What the heck is government for if not to take care of our state's most vulnerable?  

It should enrage us that right now in Texas, many "children are being denied coverage and services without explanations."  I would therefore amend the Austin American-Statesman's Editorial Board Opinion by suggesting that no child in Texas that needs disability services ever gets denied these.  

This troubling tale provides yet another example of why privatizing services is the wrong way to go.  Our senators and representatives need to hear from our communities. 

We're not at all helpless as parents or communities.  We are all "constituents" to some legislator that represents us and they need to hear from them or else the status quo prevails.  If you do not know who represents you, visit the Texas Legislature online and plug in your information here, and it'll let you know.  

Disability Rights Texas is an excellent advocacy group to reach out to, by the way.   Follow them on Twitter: @DisRightsTx

Let's also be forward looking and let's get these people who fail to respect democratic principles like the public good out of office. 

Angela Valenzuela 
c/s

Viewpoints: Texas needs to help — not pick on — children with disabilities

Editorial Board
12:17 p.m Friday, Nov. 10, 2017 Viewpoints 


On Oct. 26, 2017, Lilian Dinh, student at the University of St. Augustine for Health Sciences, helped Ben Sears undergo physical therapy at his home. (RESHMA KIRPALANI / AMERICAN-STATESMAN)

Picking on the most vulnerable is not the Texas way. Yet, it is exactly what state lawmakers do each time they take aim at programs that serve children with disabilities. It’s no surprise then that in its quest to change how it handles Medicaid, Texas has hurt more than help hundreds of children with disabilities.
The list of hurt caused by cuts and the privatization of Medicaid is long. Families report less access to much-needed medical services, such as life-altering therapies and critical prescription drugs for children, the American-Statesman’s Julie Chang reported. Less timely access to services has created life-or-death situations for some children and regressed hard-fought progress for others.
The list of hurt caused by cuts and the privatization of Medicaid is long. Families report less access to much-needed medical services, such as life-altering therapies and critical prescription drugs for children, the American-Statesman’s Julie Chang reported. Less timely access to services has created life-or-death situations for some children and regressed hard-fought progress for others.
This can’t continue. The Legislature needs to help Texas find its way back to standing up for these children, not knocking them down.
SPECIAL REPORT: How Texas Medicaid is failing children with disabilities.
Lawmakers can start by reinstating funds for therapy services and to early intervention programs that help improve the quality of life for children with disabilities. State leaders should also demand transparency from organizations managing Medicaid programs and set aside enough resources to properly supervise those contracts.
For years now, a Republican-dominated Legislature has cut programs that serve the state’s poor and vulnerable. That includes the Legislature’s steady course to the privatization of Medicaid, a state and federally funded program that has successfully served children with disabilities from families of all economic statuses. Cuts to such programs, lawmakers say, save us money. Meanwhile, the state’s most vulnerable continue to pay the price.
Consider that in 2011, a tough budget year for the state, lawmakers cut costs by limiting eligibility for Early Childhood Intervention services to children with the severest disabilities. Such services for children up to 3 years old help kids with developmental delays and disabilities prepare for kindergarten while saving the state money on costly special education services down the road.
Since the state’s narrower eligibility requirement, enrollment for Early Childhood Intervention services has dropped 14 percent statewide to 59,000. Funding for services has declined 11 percent to $142 million in 2017, Chang reported.
In 2015, the Texas Legislature lowered Medicaid reimbursement rates to physical, occupational and speech therapists that serve children with disabilities by $350 million. Lawmakers restored a quarter of the cuts this year, but health commission officials made more reductions in September.
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Without proper therapy, progress a child has achieved can stall or reverse. Legislators should reinstate those funds.
Then last year, Texas turned over Medicaid services for children with disabilities to private companies and hospitals, called managed care organizations.
The move was part of a multiyear transition into the state-created STAR Kids managed care program approved by the Legislature in 2013. Now, instead of handling the medical services for 164,000 children with disabilities, Texas pays managed care organizations by the patient, not the services delivered. The program is expected to save the state hundreds of millions of dollars.
As many suspected, the move has been anything but smooth.
Between February and May, 12 percent of children with the severest disabilities were denied Medicaid services, triple the overall rate of 2016, according to the Texas Health and Human Services Commission.
Under STAR Kids, surgeries previously approved are now being denied; access to critical medication and medical supplies has become difficult; patients are waiting longer periods between appointments and receiving less time with specialists and therapists; and children are being denied coverage and services without explanations.
It’s not surprising. Less services mean more profits for managed care organizations.
Texas’ least fine hour came when the Legislature chose to continue with a managed care model knowing it would be riddled with problems. State leaders know that health insurers cut corners and can inflate diagnoses to maximize profits. Still, they proceeded.
Shameful.
As expected, grievances have been plentiful. Since last November, more than 2,500 complaints from providers and families have been lodged against STAR Kids, according to the health commission.
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The commission is addressing the increase in denials by analyzing whether the STAR Kids assessment tool used by managed care organizations to determine services is accurate. The commission should mandate that no child with a disability be denied service or coverage until all necessary fixes to the assessment tool are complete.
Legislators must demand transparency and appoint resources to ensure that, in this case, managed care organizations deliver on contract expectations.
Texas once placed importance on investments that help our most vulnerable. We need to get back to those values.

Important, if grim, sobering report on Child Protective Services in the state of Texas.  A shocking close to 800 children died in Texas in less than five years of abuse or neglect.  This is the first of a three-part series about those deaths and CPS' responsibilities therein. 

"Texas is not publicly reporting hundreds of abuse- and neglect-related child deaths each year. Between 2010 and 2014 the Department of Family and Protective Services did not publicly report 655 child abuse-related fatalities, even though the department confirmed that those children had been mistreated prior to their deaths.
Nearly half of the children who died were already on CPS’s radar. Of those 380 fatalities, 144 families — more than a quarter — had been the subject of a CPS investigation at least 3 times. In 12 instances, CPS had seen the family 10 or more times. CPS had contact with one family more than 20 times before the child died."

A constructive response to this should save lives.

-Angela

Missed Signs.  Fatal Consequences.

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How Texas missed deadly patterns and key pieces of information that could have helped protect vulnerable children.

In 2009, the Legislature ordered Child Protective Services to publicly record every abuse- and neglect-related death in the state in hopes of identifying patterns and discovering ways to prevent abuse deaths. But the Statesman has learned that CPS has not systematically analyzed those reports, meaning that in important ways, Texas’ child protection workers effectively have been operating with blinders, missing deadly patterns and key pieces of information that could help protect kids.

For the last six months, Statesman reporters Andrea Ball and Eric Dexheimer analyzed each of those 779 reports and uncovered a series of troubling findings:

• Texas is not publicly reporting hundreds of abuse- and neglect-related child deaths each year. Between 2010 and 2014 the Department of Family and Protective Services did not publicly report 655 child abuse-related fatalities, even though the department confirmed that those children had been mistreated prior to their deaths.
• Nearly half of the children who died were already on CPS’s radar. Of those 380 fatalities, 144 families — more than a quarter — had been the subject of a CPS investigation at least 3 times. In 12 instances, CPS had seen the family 10 or more times. CPS had contact with one family more than 20 times before the child died.
• In 125 instances, a child had been previously separated from the home prior to his death because of safety concerns. In 41 cases, the child who eventually died was the one removed from the home.
• Even though the agency has a unit dedicated to finding missing families, at least 15 kids died after they dropped off CPS’s radar.
• Since 2009, more than 50 CPS workers have been caught lying to prosecutors, ignoring court orders, falsifying state records or obstructing law enforcement investigations, according to an American-Statesman review of state and court documents. At least four former CPS employees are currently facing criminal charges for their alleged misconduct.
• Of the nearly 300 child abuse homicides and suspected homicides analyzed, some cases unaccountably drug out for years. The paper also found that one of every five child abuse beating or strangulation deaths — the way most children are killed — has been left unsolved, leaving relatives, law enforcement and local communities bereft of closure or justice.

Read on here.