Texas’s Most Vulnerable Deserve Efficient, Well-Funded Healthcare

Long-term care is a reality that touches us all at some point in our lives. Whether it’s caring for an aging parent, recovering from a serious surgery, or supporting a loved one with a disability, these healthcare services are essential for individuals from all walks of life.

We should all be eternally grateful for the dedicated staff that provide such critical care to us and our loved ones in our time of need.

But it’s not an easy business. Providers face many challenges that hinder their ability to care for our residents and families. Some of these obstacles are outdated regulations the State has yet to revise. Some are “solutions” for problems that never existed in the first place that cause more harm than good. And some are purely financial challenges.

That’s where Texas Health Care Association (THCA) steps in – to help identify and remove these obstacles so we can improve quality of care across the state for these vulnerable residents.

Before becoming President and CEO of THCA, I served for six sessions as a state representative in the Texas House. While serving, long-term care was a priority for me and I am proud to now steward this crucial organization.

I have firsthand experience watching our amazing providers care for our most vulnerable, and THCA wants to make their lives and their jobs easier. THCA has adopted five priorities for the 2025 legislative session that are essential to deliver the best health care possible:

1. Confirming Medicaid Presumptive Eligibility

Whenever Medicaid is involved, there is a lot of bureaucratic red tape for care providers to cut through. THCA has 3 proposals for the Legislature to address this issue:

• Increase the number of Medicaid eligibility review staff to help make determinations faster
• Allow nursing facilities the ability to presume a patient is eligible for Medicaid, rather than making them wait on the state for a review (again, this helps expedite care)
• Streamline the enrollment process so it’s less cumbersome for patients over the age of 65.

2. Establishing a Behavioral Health Add-On for Texas Medicaid

THCA supports expanding Texas Medicaid coverage to address behavioral health needs. This one is pretty straightforward, and it is desperately needed to ensure dollars flow where they are most needed.

3. Streamlining the Change of Ownership Process for Nursing Facilities

Another process that slows the provision of long-term care for Texans comes when a nursing facility changes ownership. This process used to take about 90 days. Now it takes almost 9 months. THCA is pushing for long-overdue updates to make this process more efficient.

4. Reforming the Dispute Resolution Process & Ending Duplicative Penalties

Sometimes providers get caught in the complicated web of regulations that govern them, resulting in fines. Currently, multiple government entities can impose fines for the same issue, something we call “Double Dipping.” This needlessly increases costs to providers, once again pulling away resources that should be going into healthcare. This must change.

5. Implementing the Patient-Driven Payment Model Rider

During the last legislative session, the Texas Legislature provided $100 million in funding for the patient-driven payment model (PDPM) in Medicaid nursing facility services. THCA is pushing to ensure funding stays in place and we build on this past win.

The upcoming 2025 legislative session presents a pivotal opportunity to drive meaningful change in our long-term care system. We are working towards a future where every Texan has efficient, affordable access to the care they need when they need it.

As I look ahead to this legislative session, I am filled with hope and determination. The potential for transforming long-term care in Texas is vast, and we are already hard at work!