A bill allowing nursing facilities to pull down federal funds finally ran into an obstacle it could not overcome last Wednesday in the waning days of the legislative session.

House Bill 2766 by Rep J.D. Sheffield and Sen. Juan “Chuy” Hinojosa would have established a reinvestment allowance in Texas, allowing Texas providers to close an average Medicaid funding gap of $20 per patient day.

The bill passed the House on May 11 with a 97-46 vote. On May 21, the Senate Health & Human Services Committee approved the bill by a 6-3 margin.

However, that gave it very little time to pass in the full Senate. The bill reached the Senate Calendar on the last day that chamber could pass any bill this session. Senate rules require bills get a 4/5 vote in order to be brought up on the last day. HB 2766 had more than enough votes to be brought up and passed any other day but it fell two votes short under these rules.

THCA President and CEO Kevin Warren praised the efforts of providers across the state and the education legislators received on the problem of Medicaid underfunding.

“But I know none of that helps now as the industry struggles to find staff, make improvements, and pay bills,” he said. “For NFRA, we came together to address our funding issues. We must continue to do so with focus and determination until our political leaders stop looking the other way and finally provide the support that is needed.

“That is our only way forward.”

As in previous sessions, THCA worked to both prevent and improve the passage of bills that would make it harder to run quality facilities in this state. Among those bills also focused on this legislative session:

  • Legislation that would have tied the liability limits of a health care claim to the consumer price index.
  • Increased penalties for unnecessary use of psychoactive medications.
  • Mandatory health care liability insurance for certain long-term care facilities
  • Requirements for managing wheelchair self-release seat belts in facilities.
  • Increased penalties and enforcement actions related to providing care to persons with Alzheimer’s disease or related disorders

THCA also monitored carefully any legislation that could have been amended to allow the carrying of guns in nursing facilities and worked to ensure those changes were not made.

Look for a more complete breakdown of the 85th Legislature’s impact on long term care later this month.


Fulfilling the only obligation the State Constitution requires of the Legislature, members of both chambers passed a $217 billion two-year budget during the final days of the 85th Session.

The budget was worked out between the chambers in a conference committee. It addressed the large shortfall that faced members when the session started by taking $1 billion out of the Rainy Day Fund and using an accounting trick to use $2 billion from funding intended for highway projects.

That helped avoid deep cuts in the budget but allowed for few programs to receive increases. The budget does not fully fund expected cost growth in Medicaid—that will have to be paid for next session. Funding for Medicaid residents in long term care was maintained at current levels.

It continues to provide $800 million for border security.

The bill passed the House on a 135-14 vote and the Senate on a vote of 30-1.

Senator Sylvia Garcia, D-Houston, was the lone dissenter in the upper chamber.

“This budget is more of the same and fails Texas families,” she said. “It continues to shortchange education and healthcare.”

It now heads to Governor Greg Abbott, who is expected to sign it.



Legislation that would provide for a study of over bedding in Medicaid facilities was poised to pass the Texas House early in May before getting thwarted by a group of retribution-seeking legislators.

HB 2570 by Rep. Travis Clardy (R-Nacogdoches) had been placed on the House Local and Consent Calendar, which is intended to help non-controversial bills gain quick passage.

But it was caught up with more than 100 other bills and forced off the last calendar in the House for House bills in what some in the Capitol are calling “The Mother’s Day Massacre.”

The link below from the Texas Tribune provides details:


However, through continued communications with the bill author and House leadership, a study on Medicaid Bed Allocation and the process of certification and decertification is expected to be an interim charge in the House. Interim charges are anticipated to come out this fall.