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Early Childhood Intervention Providers in North Texas, Elsewhere Face Shrinking Funding


For more than 20 years, The Warren Center Executive Director Amy Spawn has been a speech therapist within the state’s Early Childhood Intervention program, which is built for kids younger than three with disabilities or developmental delays.

When she started, there were seven Dallas County providers under ECI. Today, there are three.

Spawn says shrinking state funding has made it increasingly difficult for the Warren Center—a Richardson-based organization that serves more than 800 ECI children each month—to keep up with higher demand through the years. But recent cuts to Medicaid children’s therapy funding has put even more stress on ECI providers across the state.

As the Texas Tribune reported this week, many of those providers have come to difficult conclusions that they could no longer viably remain open. The number of ECI providers across Texas is down to 44, from 58 providers in 2010, the Trib says. The outlet’s report preceded a House subcommittee meeting on the topic, which was scheduled for Wednesday.

Dallas County’s three providers are the Dallas Center, Metrocare Services, and The Warren Center. LifePath Systems is the provider in Collin County, and MHMR of Tarrant County is the lone ECI provider in both Tarrant and Denton counties.

For Spawn, decreases in funding have forced her to cut back in several areas, including the number of therapists on staff. Each therapist now sees more children, adding to the stress of an already difficult job. And although families with kids in the program pay on a sliding scale based on income, the scale has changed by the year—putting more financial pressure on the families, Spawn says.

“Watching the burden be put back on the families that are already stretched to the max is horrendous,” she says. She added that not being able to hire enough therapists has had an impact on quality of care, as well.

Spawn says that The Warren Center leadership and its board of trustees are on the same page: They’ll do whatever they have to in order to keep the doors open. She’s not worried about closing. But that hasn’t been the case everywhere. As the Trib reports, the Behavioral Health Center of Nueces County will exit the program in June. Texoma Community Center—which is the provider for six counties—is bowing out on May 31.

The root of the program’s most recent troubles, a $350 million cut to Medicaid children’s therapy services, was passed by the Texas Legislature in 2015 and put into effect in December 2016. Legislators later restored 25 percent of the payments for 2018 and 2019, the Trib says. Federal law requires that all ECI-eligible children receive care, so shrinking funding means less money per child.

The Trib writes that legislators turned down a Texas Health and Human Services request for additional funding of $20 million to account for expected growth of the program over the next two years. Ultimately, that’s what Spawn tells me she’d like to see—funding to match the growth of the program, so that her resources don’t spread any thinner.

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