Hill Country MHDD Centers Serving the Greater TEXAS Hill Country
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August 2, 2017

Hill Country Discontinues Early Childhood Intervention (ECI) Services

After more than 20 years of providing Early Childhood Intervention (ECI) services, Hill Country MHDD Centers has made the difficult decision to terminate its ECI contract with the Health and Human Services Commission (HHSC).  We will cease providing these services in early October 2017.

ECI is a program that serves children under the age of three who have been diagnosed with disabilities or developmental delays.  States are required by federal law (IDEA Part C) to administer these programs to all eligible children.  Examples include children diagnosed with autism, speech, vision, or hearing difficulties, Down syndrome, or other disabilities and delays.  ECI helps more than 50,000 Texas children meet developmental goals including learning to swallow food, communicating with their families, walking, and otherwise developing skills necessary to succeed in elementary school.  Hill Country MHDD Centers currently serves 435 children and their families in 15 central and west Texas counties. 

Unfortunately, state appropriations for ECI have declined by 11 percent since 2010.  In 2016, the Medicaid reimbursement rates for therapists were reduced, and Hill Country MHDD Centers experienced a decrease in funding, even though its target for numbers of children to serve increased by 2%.  With the exception of 2012, Hill Country MHDD Centers incurred a financial loss in its ECI budget every year since 2010.  However, in spite of cost-containment and service efficiencies enacted over these years of funding reductions, the cumulative cuts are leading to expected FY 2017 losses of over $300,000.  “These losses were unavoidable,” said Ross Robinson, Executive Director for Hill Country MHDD Centers.  “The State contracts with us to serve 375 children and families; however, since ECI is an entitlement program, we cannot turn anyone away who qualifies for our services.  So far this year, we have served  458 children and families—83 more than our contract allocation.  But, we receive no additional state funding for these services, which means our expenses often are unreimbursed if the family has no insurance and does not receive Medicaid.  Likewise, the State does not reimburse travel time and expense, yet we serve rural and frontier counties such as Kinney, Real, Kimble, Mason, and Menard.  Our services are conducted in the child’s home, so a therapist or intervention specialist may drive three or more hours to see one child, and the allocation for the service does not cover the expense associated with the employee or contractor’s time and travel.   To date, of our anticipated financial loss, more than $130,000 consists of unreimbursed travel expenses.”

“We are very appreciative of the efforts undertaken in the most recent 85th Session of the Texas Legislature to restore some of the funds that were reduced two years ago,” continued Robinson.  “However, our legislators warned us prior to the Session that funding would be tight, and difficult choices would have to be made.  The difference in state funding between 2015 and 2017 is $250,000 which, when combined with the policy of not providing funds for time and travel, and serving additional children without any additional funds, amounts to well over $300,000.  HHSC expects us to bill Medicaid for these services, but only 54.6% of our families have Medicaid. Unfortunately, the amount of money available to our elected representatives and senators was not sufficient to allow us to overcome this shortfall and continue with the program.”

Going forward, HHSC must ensure that ECI programs and services continue without interruption in the counties that have been served by Hill Country MHDD Centers.  Mr. Robinson stated, “We are in active communication with HHSC so that we may do everything possible to ensure a smooth transition of services to other providers.  Hopefully, parents and children will experience little, if any, impact or change to the excellent assistance they currently receive.”

Over thirty employees are impacted by the closure of the ECI program. “We are equally committed to the staff employed in this program,” said Mr. Robinson, “and will work closely with them either to transition their employment to the new providers or to secure other employment within our organization.” 

“We are thankful to our families and personnel who have worked together so effectively over these many years, and to our legislators who have advocated valiantly for much needed funding,” said Mr. Robinson.  “We especially want to thank our counties and communities for their support and know that they will be invaluable allies to the providers who assume the functions of the program.” 

Hill Country MHDD Centers provides mental health, intellectual and developmental disability, substance abuse, and other behavioral health services throughout 19 counties of the greater Texas Hill Country.