By: Deuell, et al. S.B. No. 318
 
 
A BILL TO BE ENTITLED
AN ACT
relating to Medicaid incentive payments for direct nursing care
provided by nursing homes.
       BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
       SECTION 1.  Subsections (g) and (i), Section 32.028, Human
Resources Code, are amended to read as follows:
       (g)  Subject to Subsection (i), the Health and Human Services
Commission shall ensure that the rules governing the determination
of rates paid for nursing home services improve the quality of care
by:
             (1)  providing a program offering incentives for
increasing direct care staff and direct care wages and benefits,
[but only to the extent that appropriated funds are available after
money is allocated to base rate reimbursements] as determined by
the Health and Human Services Commission's nursing facility rate
setting methodologies; and
             (2)  if appropriated funds are available after money is
allocated for payment of incentive-based rates under Subdivision
(1), providing incentives that incorporate the use of a quality of
care index, a customer satisfaction index, and a resolved
complaints index developed by the commission.
       (i)  Changes in funding for nursing facility payment rates
are intended to change the base rate and incentive-based rate by
equal percentages. The Health and Human Services Commission shall
ensure that rules governing the incentives program described by
Subsection (g)(1):
             (1)  provide that participation in the program by a
nursing home is voluntary;
             (2)  do not impose on a nursing home not participating
in the program a minimum spending requirement for direct care staff
wages and benefits;
             (3)  do not set a base rate for a nursing home
participating in the program that is more than the base rate for a
nursing home not participating in the program; and
             (4)  establish a funding process to provide incentives
for increasing direct care staff and direct care wages and benefits
in accordance with appropriations provided.
       SECTION 2.  If before implementing any provision of this Act
a state agency determines that a waiver or authorization from a
federal agency is necessary for implementation of that provision,
the agency affected by the provision shall request the waiver or
authorization and may delay implementing that provision until the
waiver or authorization is granted.
       SECTION 3.  This Act takes effect September 1, 2007.