Following the Texas Legislature’s $350 million cut to Medicaid reimbursement for children’s therapy services in 2015, local pediatric therapy clinics, therapists and families with disabled children are still reeling from the effects. The cut reduced rates, or the rates therapists can charge per session, by 25%, said Paige Kinkade, CEO of MedCare Pediatric Group.
Some rates have since been restored, but further reductions and a restructuring of rates means therapists are leaving, clinics are closing and children are left without services, Kinkade said.
“We just can’t function at these rates,” she said.
In January, MedCare Pediatric Group closed its clinic on I-45 in Spring, letting go of 12-15 clinicians and discharging 150 clients. Across all its locations in Texas, MedCare has 1,300 clients on a waitlist and also recently closed its clinics in Katy and Pasadena, Kinkade said.
Clinics are also fighting to retain therapists following the state cuts, she said. Also, a change in billing practices in 2017 removed travel and documentation time, which accounts for about 25% of working time as a home health therapist, she added.
“[Therapists won’t stay] if they can go work at a hair salon or eyelash studio … and make way more than you can make as a master’s- and doctorate-level pediatric clinician,” she said.
Kinkade said she, along with other stakeholders and parents, had looked to this legislative session for rate restoration and restructuring the billing rates, but none came to fruition. Now, Kinkade said MedCare will likely have to close all of its locations, which include Stafford and Houston.
Spring resident Angelica Garza said her homebound 16-year-old son has not received occupational therapy in almost four years. Garza said she was told that his occupational therapist no longer qualifies to treat him, and her insurance also stopped paying for his treatment.
She said she has not found another therapist and has been administering therapy on her own.
“We have seen the direct impact of him not having the therapy,” she said. “It has physically changed him with his hip issues, his leg issues, his whole medical issues.”
Conroe resident Melissa Ensminger said her autistic son stopped receiving therapy services since the Spring MedCare location closed. Ensminger said there is an apparent shortage of qualified therapists.
“We’ve never had any issues with seeing private services with him until about the last year,” she said. “It’s been very challenging to get services for him.”