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Amend HB 1218 (Senate committee printing) by adding the
following appropriately numbered SECTION to the bill:
SECTION ____. LONG-TERM CARE INCENTIVES. (a) Subchapter
B, Chapter 32, Human Resources Code, is amended by adding Section
32.0283 to read as follows:
Sec. 32.0283. PAY-FOR-PERFORMANCE INCENTIVES FOR CERTAIN
NURSING FACILITIES. (a) In this section, "nursing facility" means
a convalescent or nursing home or related institution licensed
under Chapter 242, Health and Safety Code, that provides long-term
care services, as defined by Section 22.0011, to medical assistance
recipients.
(b) If feasible, the executive commissioner of the Health
and Human Services Commission by rule shall establish an incentive
payment program for nursing facilities that is designed to improve
the quality of care and services provided to medical assistance
recipients. The program must provide additional payments in
accordance with this section to the facilities that meet or exceed
performance standards established by the executive commissioner.
(c) In establishing an incentive payment program under this
section, the executive commissioner of the Health and Human
Services Commission shall, subject to Subsection (d), adopt
outcome-based performance measures. The performance measures:
(1) must be:
(A) recognized by the executive commissioner as
valid indicators of the overall quality of care received by medical
assistance recipients; and
(B) designed to encourage and reward
evidence-based practices among nursing facilities; and
(2) may include measures of:
(A) quality of life;
(B) direct-care staff retention and turnover;
(C) recipient satisfaction;
(D) employee satisfaction and engagement;
(E) the incidence of preventable acute care
emergency room services use;
(F) regulatory compliance;
(G) level of person-centered care; and
(H) level of occupancy or of facility
utilization.
(d) The executive commissioner of the Health and Human
Services Commission shall:
(1) maximize the use of available information
technology and limit the number of performance measures adopted
under Subsection (c) to achieve administrative cost efficiency and
avoid an unreasonable administrative burden on nursing facilities;
and
(2) for each performance measure adopted under
Subsection (c), establish a performance threshold for purposes of
determining eligibility for an incentive payment under the program.
(e) To be eligible for an incentive payment under the
program, a nursing facility must meet or exceed applicable
performance thresholds in at least two of the performance measures
adopted under Subsection (c), at least one of which is an indicator
of quality of care.
(f) The executive commissioner of the Health and Human
Services Commission may:
(1) determine the amount of an incentive payment under
the program based on a performance index that gives greater weight
to performance measures that are shown to be stronger indicators of
a nursing facility's overall performance quality; and
(2) enter into a contract with a qualified person, as
determined by the executive commissioner, for the following
services related to the program:
(A) data collection;
(B) data analysis; and
(C) reporting of nursing facility performance on
the performance measures adopted under Subsection (c).
(b) Subsection (a), Section 32.060, Human Resources Code,
as added by Section 16.01, Chapter 204 (H.B. 4), Acts of the 78th
Legislature, Regular Session, 2003, is amended to read as follows:
(a) The following are not admissible as evidence in a civil
action:
(1) any finding by the department that an institution
licensed under Chapter 242, Health and Safety Code, has violated a
standard for participation in the medical assistance program under
this chapter; [or]
(2) the fact of the assessment of a monetary penalty
against an institution under Section 32.021 or the payment of the
penalty by an institution; or
(3) any information obtained or used by the department
to determine the eligibility of a nursing facility for an incentive
payment, or to determine the facility's performance rating, under
Section 32.028(g) or 32.0283(f).
(c) The Health and Human Services Commission shall conduct a
study to evaluate the feasibility of providing an incentive payment
program for the following types of providers of long-term care
services, as defined by Section 22.0011, Human Resources Code,
under the medical assistance program similar to the incentive
payment program established for nursing facilities under Section
32.0283, Human Resources Code, as added by this section:
(1) intermediate care facilities for persons with
mental retardation licensed under Chapter 252, Health and Safety
Code; and
(2) providers of home and community-based services, as
described by 42 U.S.C. Section 1396n(c), who are licensed or
otherwise authorized to provide those services in this state.
(d) Not later than September 1, 2010, the Health and Human
Services Commission shall submit to the legislature a written
report containing the findings of the study conducted under
Subsection (c) of this section and the commission's
recommendations.
(e) As soon as practicable after the effective date of this
Act, the executive commissioner of the Health and Human Services
Commission shall adopt the rules required by Section 32.0283, Human
Resources Code, as added by this section.