Brief(1)
As amended by House Committee, S.B. 126 creates a new law under which the Secretaries of Social and Rehabilitation Services and Aging are to create a quality enhancement wage pass-through program as a part of the state Medicaid plan. Under the plan, nursing facilities and intermediate care facilities for the mentally retarded that elect to participate would be allowed a payment option of up to $4.00 per resident day to increase salaries or benefits, or both, for those employees that provide direct care and support service to residents of nursing facilities. Employees eligible to receive the wage pass-through include nurse aides, medication aides, restorative-rehabilitative aides, licensed mental health technicians, plant operating and maintenance personnel, nonsupervisory dietary personnel, laundry personnel, housekeeping personnel, and non-supervisory activity staff. Expenditures under the bill are made subject to appropriations.
The plan created pursuant to the direction of S.B. 126 would have to include a pass-through wage system designed to reimburse nursing facilities during the reimbursement period in which the wage pass-through costs are incurred. Wage pass-through moneys would be paid to the nursing facility outside of cost center limits or occupancy penalties as a labor cost reimbursement. The pass-through cost would be included in the cost report base. No wage pass-through moneys could be used to increase management compensation or facility profits.
The bill requires quarterly wage audits for all nursing facilities that participate in the program to assure the pass-through moneys were used to increase salaries or benefits for eligible direct care and support staff or to hire additional eligible staff. A nursing facility that fails to file required audit reports would be terminated from the program and required to repay all pass-through amounts received for the reporting period.
The Senate Committee amendment deletes references to hydration and nutrition aides, categories of nurse aides that are not currently authorized.
The House Committee amendments define the term "nursing facilities" and clarify the circumstances in which expenditures may be made under the bill.
Background
The introduction of S.B. 126 was requested by the Kansas Health Care Association, whose representative noted the bill provides a way in which Medicaid reimbursement for additional staffing costs can be obtained by the facility without waiting for the cost increase to be reflected in the following year's cost centers. Pass-through payments would be in addition to the reimbursement system for nursing facilities which is based on actual costs documented by the facilities in cost reports.
In the Committee hearing on the bill, support was expressed by representatives of the Kansas Association of Homes and Services for the Aging and the Kansas Health Care Association. Kansas Advocates for Better Care expressed concerns about the bill. Generally, the testimony depicted the bill as offering one way to enhance the quality of care in nursing facilities through a reduction in turnover in direct care staff and the attraction and retention of health care staff. Conferees noted the program authorized by S.B. 126 is to be a one-time program rather than continuing to be reauthorized.
The revised fiscal note on S.B. 126 states the Departments on Aging and Social and Rehabilitation Services indicate the passage of the bill would have a significant fiscal impact. The Department on Aging indicates the cost of the program would depend on the number of facilities that choose to participate and could be $17.2 million ($6.9 million State General Fund) in FY 2000. The Department estimates administrative costs of $250,000. The Department of Social and Rehabilitation Services has no way of estimating how many nursing facilities for mental health and for mental retardation would participate in the program authorized by S.B. 126. The maximum additional cost would be $1.7 million ($1.0 million State General Fund). Administrative costs for audits are estimated to be $41,122 ($34,131 State General Fund).
1. *Supplemental notes are prepared by the Legislative Research Department and do not express legislative intent. The supplemental note and fiscal note for this bill may be accessed on the Internet at http://www.ink.org/public/legislative/bill_search.html.