‘It was because KHOU got involved’ | After losing crucial Medicaid coverage, Conroe family finds relief following public outcry

MONTGOMERY COUNTY, Texas — A Montgomery County family is breathing a sigh of relief after a battle with their Medicaid provider over essential healthcare support finally came to an end after KHOU 11 brought attention to their case.

Catherine St Clair has spent nearly two decades as the primary caregiver for her sister Lisa, who has severe cerebral palsy. When Medicaid suddenly cut 30 hours of overnight protective supervision from Lisa’s home healthcare plan, the family was stunned.

“The eligibility requirements hadn’t changed. Her condition hadn’t improved. And there was a 12-year precedent,” Catherine told KHOU 11’s Stephen Goin.

The cuts meant Catherine would lose crucial overnight help — support that allowed her to sleep while Lisa was under supervised care. Despite multiple appeals, the denials kept coming. But everything changed after KHOU 11 aired the family’s story last week.

The very next day, officials from Community Health Choice, the Medicaid provider, visited the family’s home in Conroe to re-evaluate Lisa’s case. The company partially reversed the decision, reinstating the 30 hours, but then proposed cutting 10.5 hours from a separate Medicaid program due to a dispute over who manages Lisa’s feeding tube.

Catherine wrote a letter directly to the CEO of Community Health Choice. Then, she received a call.

“They want to nitpick how much time is spent on her feeding routine,” she said. “They wanted to clear up some confusion because they feel like somebody just did the math wrong,” 

By the end of that call, all of Lisa’s in-home assistance hours were fully restored.

“I felt incredible relief. Like we finally crossed the finish line,” she said. “Honestly, Stephen, I didn’t think we were going to win this one.”

Catherine credits the public attention from KHOU 11’s reporting for prompting the reversal.

“I absolutely believe the story you ran reached enough people that phone calls were being made and walls were being rattled,” she said. “And it was because KHOU got involved, and I deeply appreciate that.”

Now, with Lisa’s care back in place, Catherine hopes their story inspires others to keep pushing back when essential care is denied.

“Find people who are disability rights advocates,” she urged. “Point you in the direction where you need to go.”

For Catherine, this victory is just the beginning. She says more changes are needed to ensure families like hers don’t have to fight so hard just to get the care their loved ones deserve.

“One thing I’ve learned from this is that there are thousands of people that genuinely cared about Lisa and I’m hoping this will start the momentum to get more people to stand up and say, ‘No, we’re not going to do this,'” she said.