Bureaucracy Never Gives a Road Map
Plus: The national push for Medicaid payments to 5.4 million family caregivers; and, Texas schools see sharp increases in special education students, while its group homes have little accountability.
Traversing the Bureaucracy Mountain Range is long and steep climb. Lenore Eklund nails the experience of medical motherhood again in her monthly cartoon. Except, I don’t know about that faceless person laying out all the steps at the beginning. In my experience, it’s usually: One more step, then one more, then oh, I forgot, can you just….
On the second Sunday of every month, we feature Where is the Manual for This?!, an editorial cartoon about the medical mom life from Lenore Eklund.
Medical Motherhood’s news round up
Snippets of news and opinion from outlets around the world. Click the links for the full story.
• From San Antonia Express News via DisabilityScoop: “School Districts Face Soaring Demand For Special Education”
[…]Sophia was one of nearly 765,000 Texas students who received special education services last year, according to state data. That total, a record high, marks a 32% increase in the number of public school students with disabilities since before the 2020 start of the pandemic.
School officials say parents’ heightened awareness, improved testing procedures and pandemic-era learning losses have contributed to the spike in students requiring specialized instruction. So has a new law that puts the state’s swelling dyslexic population under the vast umbrella of special education, in addition to changes in state rules and regulations.
In San Antonio, public schools are struggling to meet the rising demand for special education amid an ongoing staffing shortage and stagnant state funding. Unable to hire enough special education teachers, paraprofessionals, school psychologists and speech pathologists, districts have had to rely on costly contracts with third-party agencies to fill vacancies — even as they grapple with record budget deficits.
An exodus of special educators has exacerbated the problem, leaving remaining employees with bigger caseloads and undermining the consistency high-need students often require in the classroom — such as interacting with the same teacher at the same time of day.
[…]Northside ISD, San Antonio’s largest school district with over 100,000 students, served 13,851 students with disabilities during the 2019-2020 school year. Now, more than 17,000 students require specialized instruction, said Veronica Mechler, the district’s special education director.
“We’ve seen an increase in students with emotional disabilities, autism, learning disabilities,” she said. “It’s been a huge jump, and it’s across the board.”
Northside isn’t the only district hit by the surge. The number of students qualifying for special education services has increased since the pandemic at every Bexar County school district, from San Antonio’s urban core to the growing, more affluent suburbs.
Mechler, an educator for more than two decades, said parents have become better informed on what to look for in their children, and there’s less of a stigma around having them tested for a disability. […]
• From the National Conference of State Legislatures (NCSL): “State Options for Improving Care for People with Intellectual and Developmental Disabilities”
[…]Family caregivers provide significant support to people with IDD. According to the University of Kansas' State of the States in Intellectual and Developmental Disabilities, more than 5.4 million families provide care to a family member with IDD and 72% of individuals with IDD live with a family caregiver. More than one in four family caregivers are 60 years of age or older, highlighting the aging nature of this caregiving population.
Family caregiving can help reduce reliance on institutional care and mitigate effects of direct care workforce shortages but also comes with challenges. Family caregivers may experience increased stress, loss of income and reduced health and quality of life, according to the National Association of State Directors of Developmental Disabilities Services.
While states have a wide range of policy options to support family caregivers, recent efforts have focused on allowing Medicaid to compensate family caregivers for providing care. During the COVID-19 pandemic, states had greater flexibility to pay family caregivers through the Medicaid program. Since then, some states have extended these flexibilities permanently or otherwise expanded paid family caregiving options. Since 2023, at least eight states (Alaska, Connecticut, Illinois, Nevada, North Dakota, Oregon, Tennessee, Virginia) have passed legislation to extend Medicaid payments for family caregivers.
While paying family caregivers can support people with IDD and their families, historically there have been legal limits to ensure payment is appropriate. Paid family caregiving policies may require nuance and stakeholder engagement to consider:
Who is eligible to be a paid caregiver.
How to ensure the rights, preferences and needs of the person with IDD.
How to fairly distribute limited resources and support families with the greatest needs. […]
• From Houston Public Media: “Texas group homes for intellectually disabled are in systemic crisis, say advocates”
Last month, employees of Maofu Home Health, a provider of group homes for people with intellectual disabilities with facilities across the state, were arrested for abusing a 29-year-old resident with severe autism less than a year after a 15-year-old boy in a Sugar Land Maofu facility nearly died.
The incident raised new red flags about long held concerns around how these types of facilities are regulated by the state.
“The reason these systemic issues persist is because the State has failed to establish a regulatory system that holds providers accountable,” said Beth Mitchell, supervising attorney for Disability Rights Texas.
Mitchell said investigations into providers are often delayed, allegations are minimized, and enforcement actions are weak.
“Providers have little incentive to improve, and vulnerable individuals continue to pay the price.” she said.
[…]At the now defunct C3 Christian Academy, a child was allegedly abused and neglected 12 times, at one point being dropped off at a hospital with a broken jaw. The director of the facility admitted in court that she didn’t always report abuse allegations. The facility was finally closed in 2023.
“These failures are not isolated,” Mitchell said, highlighting issues with another provider, Sevita/D&S group homes.
HHSC in a statement said it had imposed more than $400,000 in administrative penalties and took more than three-dozen enforcement actions against 34 providers.[…]
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It still puzzles and frustrates me that US schools have not adopted universal learning strategies and training for ALL school personnel. We have data from the innovative models that have implemented programs. It does work! If done right diverse learners can thrive together. I have seen this work from class room visits in Canada and Bellaruis, Russia! The “school choice” legislation in many states is essentially emptying our classrooms except for students with disabilities, learning challenges, and low income resourced learners. Let’s turn this into opportunity to re-imagine our schools and teach kids the way we know and data proves they learn.