DALLAS - For his family, Cagen Dixon's slow progress with simple tasks in life is easy to measure.
"Used to, he wouldn't do anything," said Michelle Landers, his mother. "He was like a very heavy Raggedy Ann doll."
Cagen is physically slow, but mentally sharp.
Landers said he was in fetal distress and born premature. Doctors never pinpointed exactly what went wrong with her pregnancy, but now say her teenager is physically disabled.
Regardless, at 13, Cagen speaks now, can move on his own and is more self-sufficient than ever, though he is still confined to a motorized wheelchair.
None of that progress would have been possible, his mother stressed, if the state's Health and Human Services Commission had not paid for therapists to visit his home.
"He's learning that it's OK to be like he is, but then there's always room for improvement," Landers said.
But Texas now wants to slash what it pays those therapists; in some cases, cut reimbursement rates in half.
Home health care agencies said it could drive them out of business, and jeopardize the future of thousands like Cagen.
"This is going to hurt their chance at becoming independent, at becoming a productive citizen, at owning a company some day and contributing to the State of Texas," said Jennifer Riley of Therapy 2000.
The Health and Human Services Commission wants to reduce rates partly because it says it pays more than other states. Still, HHSC acknowledges this is a delicate balance: trying to operate more efficiently for taxpayers, while recognizing these are critical services for people in need.
The state reviews rates every two years and said that's what it is doing now. Health and Human Services projects it could save $150 million a year if these cuts are enacted. The commission wanted them to take effect in January but with so much backlash it's uncertain when or if that will happen.
"It's our hope that we can work with the provider community to come up with options that keep our Medicaid rates in line with other payers, and allow providers to continue to serve our Medicaid clients," said Stephanie Goodman, a HHSC spokeswoman.
Cagen's mom is hopeful her 13-year-old won't lose his therapists. But if her son has taught her anything, it's to take one day at a time.