Honorable James B. Frank, Chair, House Committee on Human Services
FROM:
Jerry McGinty, Director, Legislative Budget Board
IN RE:
HB795 by Thompson, Ed (Relating to emergency generators or other power sources for nursing facilities and assisted living facilities.), As Introduced
The fiscal implications of the bill cannot be determined because the Health and Human Services Commission does not have enough information to determine the impact that the cost of acquiring an emergency generator would have on the facility expenses considered in Medicaid rate calculations.
The bill would require nursing facilities licensed under Health and Safety Code 242 and assisted living facilities licensed under Health and Safety Code 247 to equip the facility with an emergency generator or comparable emergency power source and with a sufficient amount of fuel to operate the generator or power source for a minimum of 72 hours during a power outage.
The bill would require facilities to comply with the requirements of the bill no later than September 1, 2024. The bill would allow facilities to request an extension to the Health and Human Services Commission (HHSC) concerning compliance.
The bill would require HHSC to conduct an annual inspection of the generator or other power source. The bill would require the executive commissioner of HHSC to prescribe a checklist for an inspection.
The bill would take effect immediately upon receiving a two-thirds majority vote in each house. Otherwise, the bill would take effect September 1, 2023.
Due to insufficient information related to the number of impacted facilities and related square footage of each impacted facility, the fiscal implications of the bill cannot be determined at this time.
According to information provided by HHSC, the bill may impact Medicaid fee-for-service and Medicaid managed care capitation rates. Nursing facilities and assisted living facilities operational costs may be impacted, and would be provided in cost reports to HHSC and used by HHSC for reimbursement rate determination. However, according to information provided by the agency, it is not known how many facilities do not currently meet the requirements of the bill and would be financially impacted in order to come into compliance with the bill. In addition, facilities with larger square footage would have costs greater than those of facilities with lower square footage, which would also impact costs associated to come into compliance with the bill.
According to information provided by HHSC, additional regulatory staff would be needed to comply with the bill. It is assumed HHSC would need additional staff as follows: 22.0 Safety Officer II to conduct annual generator inspections; 8.0 Program Specialist I to process checklists and send findings to the facilities; 1.0 Management Analyst III, 2.0 Program Specialist V, and 1.0 Program Specialist IV to conduct regulatory enforcement reviews for facilities that do not comply with the bill or fail a generator inspection; and 0.6 Program Specialist V for indirect agency functions. Analysis assumes a total of 34.6 full-time-equivalents (FTEs) are needed in fiscal year 2024 through fiscal year 2028 to implement the provisions of the bill. Personnel related costs, including salaries, travel, and overhead, are estimated to total $3,688,696 in All Funds in fiscal year 2024 and $3,503,268 in All Funds in fiscal year 2025. Amounts are not included in the table above, but are noted here to provide additional fiscal implications associated with the bill.
Local Government Impact
The fiscal implications of the bill cannot be determined at this time.