Texas budget cuts threaten health of disabled children, parents say

From The San Antonio Express-News:

Estella Longoria takes her two small children to the doctor as many as five times a month.

Tristan, 7, has autism and Attention Deficit Hyperactivity Disorder. He sees his regular doctor as well as a psychiatrist, to make sure his medication is working properly.

Twenty-month-old Nathanael has Down syndrome, asthma, a hole in his heart and is legally blind. In addition to regular doctor visits, he needs intensive physical therapy to build muscle tone and help him learn things that come more easily to other children. Perhaps more so even than his brother, the attention he's given now will have a bearing on the quality of his life later on.

“It's not just a cough or an earache,” she said. “These are things that are going to affect the rest of their lives.”

Longoria takes her boys to the Frank Bryant Health Center on East Commerce, about three minutes from her East Side home. If the $60 billion in cuts passed by the U.S. House of Representatives last week become law, their primary-care provider could end up being a hospital emergency room.

“We wouldn't know where to start,” she said. “I wouldn't be able to help my children.”

The Frank Bryant Center is run by CommuniCare Health Centers, a nonprofit organization that serves more than 40,000 patients on San Antonio's East and West Sides. (Disclosure: My wife works part-time for CommuniCare.) Longoria's children are covered by Medicaid, but more than 70 percent of CommuniCare patients have no health insurance.

The House budget resolution, now in the Senate, included $1.3 billion in cuts to health centers nationwide. Among the casualties: two grant programs originally funded with stimulus dollars and later included in last year's health care reform act — both prime targets of budget-slashing Republicans.

Laurie Casias, CommuniCare's chief development officer, said CommuniCare didn't try for a backup plan once the grants were approved. If the cuts go through, she estimates that 8,628 patients served by CommuniCare in Bexar and Hays counties won't receive the care they did last year. Expansion plans to help meet medical and dental needs for thousands of new patients would have to be shelved.

All budget-cutting isn't bad, and the federal government desperately needs to narrow the gap between spending and revenue. But if lawmakers opt for the meat-axe approach, a lot of people — a lot of children — will be hurt.

“Community health centers in general have very strong bipartisan support,” Casias said. “Even President Bush significantly expanded the health center program because there was a recognition that there was a need for the uninsured, a place for them to go and secure care to keep them out of the emergency room.”

Longoria and her boys met me at the Bryant Center. Nathanael slept in her arms as she arrived but woke up while we were talking. He and Tristan played quietly together until we finished.

Longoria and her husband have learned a lot about Down syndrome in the last couple of years. They've come to adore Nathanael's sunny temperament, and she glows when she talks about him.

Before I departed, Nathanael took a good hard look at me. Then he broke into a broad, trusting smile that made me feel like I'd known him forever.

It's the face I'd like members of Congress to see before they cast any more votes.