| 1 | 1 | | 85R8764 KFF-F |
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| 2 | 2 | | By: Klick, et al. H.B. No. 2454 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | A BILL TO BE ENTITLED |
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| 6 | 6 | | AN ACT |
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| 7 | 7 | | relating to the provision of a nursing facility quality-based |
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| 8 | 8 | | payment incentives program and a program to increase direct care |
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| 9 | 9 | | staff and wages under Medicaid. |
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| 10 | 10 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 11 | 11 | | SECTION 1. Sections 32.028(g) and (i), Human Resources |
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| 12 | 12 | | Code, are amended to read as follows: |
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| 13 | 13 | | (g) Subject to Subsection (i), the executive commissioner |
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| 14 | 14 | | shall ensure that the rules governing the determination of rates |
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| 15 | 15 | | paid for nursing facility services improve the quality of care by: |
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| 16 | 16 | | (1) providing a program offering nursing facility |
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| 17 | 17 | | quality-based payment incentives and a program for increasing |
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| 18 | 18 | | direct care staff and direct care wages and benefits[, but only to |
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| 19 | 19 | | the extent that appropriated funds are available after money is |
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| 20 | 20 | | allocated to base rate reimbursements as determined by the |
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| 21 | 21 | | commission's nursing facility rate setting methodologies]; and |
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| 22 | 22 | | (2) if appropriated funds are available after money is |
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| 23 | 23 | | allocated for payment of incentive-based rates under Subdivision |
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| 24 | 24 | | (1), providing incentives that incorporate the use of a quality of |
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| 25 | 25 | | care index, a customer satisfaction index, and a resolved |
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| 26 | 26 | | complaints index developed by the commission. |
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| 27 | 27 | | (i) The executive commissioner shall ensure that rules |
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| 28 | 28 | | governing an [the] incentives program described by Subsection |
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| 29 | 29 | | (g)(1): |
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| 30 | 30 | | (1) provide that participation in the program by a |
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| 31 | 31 | | nursing facility is voluntary; |
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| 32 | 32 | | (2) do not impose on a nursing facility not |
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| 33 | 33 | | participating in the program a minimum spending requirement for |
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| 34 | 34 | | direct care staff wages and benefits; |
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| 35 | 35 | | (3) do not set a base rate for a nursing facility |
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| 36 | 36 | | participating in the program that is more than the base rate for a |
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| 37 | 37 | | nursing facility not participating in the program; and |
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| 38 | 38 | | (4) establish a funding process to provide incentives |
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| 39 | 39 | | for increasing direct care staff and direct care wages and benefits |
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| 40 | 40 | | in accordance with appropriations provided. |
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| 41 | 41 | | SECTION 2. If before implementing any provision of this Act |
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| 42 | 42 | | a state agency determines that a waiver or authorization from a |
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| 43 | 43 | | federal agency is necessary for implementation of that provision, |
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| 44 | 44 | | the agency affected by the provision shall request the waiver or |
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| 45 | 45 | | authorization and may delay implementing that provision until the |
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| 46 | 46 | | waiver or authorization is granted. |
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| 47 | 47 | | SECTION 3. This Act takes effect immediately if it receives |
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| 48 | 48 | | a vote of two-thirds of all the members elected to each house, as |
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| 49 | 49 | | provided by Section 39, Article III, Texas Constitution. If this |
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| 50 | 50 | | Act does not receive the vote necessary for immediate effect, this |
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| 51 | 51 | | Act takes effect September 1, 2017. |
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