Patch the state budget for fragile kids

Unfortunately it takes a controversy like restoring cuts to the state’s acute therapy program to bring to light the negative effects of rapid growth in government healthcare programs and our failure to reform them. These factors are hurting Texas’ ability to care for the most vulnerable in our state.

During the 2015 session, lawmakers greatly reduced the reimbursement rates for some Medicaid services. Overall, this was a much needed correction to nationally high rates. However, I was concerned that the rate cuts might have an adverse effect on access to care for some children in the acute therapy program. After asking HHSC and others, I was assured that there would be no access-to-care issues.

Once the rate cuts took effect at the end of last year, I started hearing reports that contradicted those assurances. The problem seemed to be widespread. During this time, I had the privilege of meeting  some fragile kids, their parents and their caretakers in my office. The parents explained the difficulties they had moving into a new managed care organization system and how the acute therapy cuts were keeping their kids from getting the therapy they desperately need.

Fragile kids are precious but not typical children. They struggle with many of the everyday activities that come so naturally to healthy children. These fragile kids have rare diseases and conditions. They must work hard every day to conquer everyday activities such as breathing and swallowing. It is heartbreaking, but also inspiring, to see the way these kids and their parents make life work.

So, I resolved to find a way to help them as we began the 85th Session. Unfortunately, our funding and structural reforms did not make it into law. The failure to help out these fragile kids and their families was one of my biggest regrets when the session ended.

I tried to find a way to address these issues in the special session. Unfortunately, the issue was not germane to any of the 20 items on the governor’s agenda.

That brings us to House Bill 25. It would restore about $70 million annually for these acute therapy services. It is also a great vehicle to make the necessary structural changes that need to be made. Therefore, I signed on to the bill and wrote a letter to Gov. Greg Abbott asking him to add HB 25 to the call.

My only hesitation with the bill was that the funding would come from the Economic Stabilization Fund (a.k.a. Rainy Day Fund). I am proud to have stood with many of my conservative colleagues during the regular session to protect the ESF from being drained for ongoing expenses. It’s always preferable to pay for our priorities from general revenue. Because of that position, my office is looking for other funding sources to restore the therapy cuts. And we hope to have identified these sources before HB 25 reaches the full House for debate.

However, I have not taken ESF funds off the table — a standard Lt. Gov. Dan Patrick and other conservatives have held in similar situations. In the budget that overwhelmingly passed both chambers and was signed by the governor, we used roughly $1 billion in ESF money for various purposes. Each of those expenses could be considered ongoing (border security, higher education, etc.). However, you could legitimately argue that each of those line items under the ESF spending could be one-time expenses.

The same holds true for using ESF money in this instance — and I would argue this is much more of an emergency than many of the ESF items in the full budget. This should be the one and only time we use our savings account to help out these children. In the future, ensuring acute therapy for these fragile children should be one of the legislature’s first budget priorities.

We don’t have much time left in this special session. But I am still hopeful we can find a way to get these kids the help they need. Since session started, I have gladly worn my “20-for-20” pin — a sign of support for each of the governor’s 20 agenda items. I think it’s time to make it “21 for 21.” I hope Gov. Abbott agrees. Helping out these fragile kids is the right thing to do!

Matt Krause

State representative, R-Fort Worth