LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 85TH LEGISLATIVE REGULAR SESSION April 27, 2017 TO: Honorable Richard Peña Raymond, Chair, House Committee on Human Services FROM: Ursula Parks, Director, Legislative Budget Board IN RE:HB2454 by Klick (Relating to the provision of a nursing facility quality-based payment incentives program and a program to increase direct care staff and wages under Medicaid.), As Introduced The fiscal implications of the bill cannot be determined at this time but a significant cost to state and federal funds is anticipated. The bill would amend statute related to Medicaid nursing facility rates, removing a requirement that the rates provide for a program offering incentives for increasing direct care staff and direct care wages and benefits. That requirement is replaced with a requirement that the rates provide for both a program offering nursing facility quality-based payment incentives and also for a program for increasing direct care staff and direct care wages and benefits. A requirement that the rates only provide for the programs to the extent appropriated funds are available after funding is allocated to base rate adjustments is removed.The Health and Human Services Commission already operates a direct care staff rate enhancement program through STAR+PLUS. It is assumed this existing program would meet the requirement related to direct care staff, wages, and benefits. It is assumed that the bill would require a second program be established to provide nursing facility quality-based payment incentives. The degree to which rates would be increased to operate such a program is not known, nor is the number of facilities that might qualify for a quality-based increase to payments; therefore, the fiscal impact cannot be determined but would be expected to result in a significant cost to both state and federal funds. Local Government Impact No significant fiscal implication to units of local government is anticipated. Source Agencies:529 Health and Human Services Commission LBB Staff: UP, LR, KCA
LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 85TH LEGISLATIVE REGULAR SESSION
April 27, 2017
TO: Honorable Richard Peña Raymond, Chair, House Committee on Human Services FROM: Ursula Parks, Director, Legislative Budget Board IN RE:HB2454 by Klick (Relating to the provision of a nursing facility quality-based payment incentives program and a program to increase direct care staff and wages under Medicaid.), As Introduced
TO: Honorable Richard Peña Raymond, Chair, House Committee on Human Services
FROM: Ursula Parks, Director, Legislative Budget Board
IN RE: HB2454 by Klick (Relating to the provision of a nursing facility quality-based payment incentives program and a program to increase direct care staff and wages under Medicaid.), As Introduced
Honorable Richard Peña Raymond, Chair, House Committee on Human Services
Honorable Richard Peña Raymond, Chair, House Committee on Human Services
Ursula Parks, Director, Legislative Budget Board
Ursula Parks, Director, Legislative Budget Board
HB2454 by Klick (Relating to the provision of a nursing facility quality-based payment incentives program and a program to increase direct care staff and wages under Medicaid.), As Introduced
HB2454 by Klick (Relating to the provision of a nursing facility quality-based payment incentives program and a program to increase direct care staff and wages under Medicaid.), As Introduced
The fiscal implications of the bill cannot be determined at this time but a significant cost to state and federal funds is anticipated.
The fiscal implications of the bill cannot be determined at this time but a significant cost to state and federal funds is anticipated.
The bill would amend statute related to Medicaid nursing facility rates, removing a requirement that the rates provide for a program offering incentives for increasing direct care staff and direct care wages and benefits. That requirement is replaced with a requirement that the rates provide for both a program offering nursing facility quality-based payment incentives and also for a program for increasing direct care staff and direct care wages and benefits. A requirement that the rates only provide for the programs to the extent appropriated funds are available after funding is allocated to base rate adjustments is removed.The Health and Human Services Commission already operates a direct care staff rate enhancement program through STAR+PLUS. It is assumed this existing program would meet the requirement related to direct care staff, wages, and benefits. It is assumed that the bill would require a second program be established to provide nursing facility quality-based payment incentives. The degree to which rates would be increased to operate such a program is not known, nor is the number of facilities that might qualify for a quality-based increase to payments; therefore, the fiscal impact cannot be determined but would be expected to result in a significant cost to both state and federal funds.
Local Government Impact
No significant fiscal implication to units of local government is anticipated.
Source Agencies: 529 Health and Human Services Commission
529 Health and Human Services Commission
LBB Staff: UP, LR, KCA
UP, LR, KCA