SRC-CTC C.S.H.B. 1001 77(R)BILL ANALYSIS


Senate Research CenterC.S.H.B. 1001
By: Naishtat (Zaffirini)
Health & Human Services
5/8/2001
Committee Report (Substituted)


DIGEST AND PURPOSE 

The House Human Services Committee reports that both industry
representatives and nursing home resident advocacy groups point to the
methodology for calculating Medicaid reimbursement rates as an underlying
cause for much of the nursing home industry's problems.  The current
methodology may not accurately reflect all justifiably reimbursable costs 
of doing business.  In addition, the current Texas Index for Level of
Effort (TILE) reimbursement system does not always reflect the true
resource needs of residents.  For example, facilities generally receive the
lowest rate of reimbursement for patients with Alzheimer's or related 
dementia, even though caring for these patients demands more staff time.
Furthermore, the reimbursement methodology does not provide incentives for
increased direct care spending.  C.S.H.B. 1001 requires the Health and
Human Services Commission and the Department of Human Services to review
the base reimbursement methodology for nursing home care.  

RULEMAKING AUTHORITY

This bill does not expressly grant any additional rulemaking authority to a
state officer, institution, or agency. 

SECTION BY SECTION ANALYSIS

SECTION 1.  REVIEW OF REIMBURSEMENT RATES.  (a) Requires the Health and
Human Services Commission (commission), subject to the availability of
funds and in conjunction with the Texas Department of Human Services
(department), to evaluate the methodology used for determining Medicaid
reimbursement rates for nursing facilities.  Sets forth certain
requirements of the commission and the department.   

(b) Requires the commission, in conjunction with the department, to
evaluate and examine certain items.   

(c) Sets forth certain criteria for measuring the level of performance
under Subsection (b)(3) of this section. 

SECTION 2.  REVIEW OF TILE CLASSIFICATION SYSTEM.  (a) Requires the
commission, subject to the availability of funds and in conjunction with
the department, to evaluate the Texas Index for Level of Effort
classification system used to quantify the intensity of the care needs of
individuals in nursing facilities and to assign daily reimbursement rates
for that care to determine whether the system accurately accounts for the
care needs of patients with dementia, including patients with Alzheimer's
disease. 

(b) Requires the commission, in conducting the evaluation required by this
section, to seek the input of relevant professionals and other individuals
or organizations with expertise in caring for people with dementia,
including Alzheimer's disease. 

SECTION 3.  REPORT TO LEGISLATURE.  Requires the commission to report the
results of the  evaluations conducted under this Act to the governor, the
lieutenant governor, and the speaker of the house of representatives not
later than September 1, 2002. 

SECTION 4.  Effective date: September 1, 2001.

SUMMARY OF COMMITTEE CHANGES

Amends Engrossed H.B. 1001 as follows:

SECTION 1.  Adds text relating to the availability of funds and relating to
items the commission is required to examine. 

SECTION 2.  Adds text relating to the availability of funds.

SECTION 3.  Changes the date by which the report required of the commission
is due from December 1, 2002, to September 1, 2002.