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Policy Priorities

Supporting Older Texans & the Aging Services Workforce

Proposed Policy Priorities for the 89th Texas Legislative Session
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PRESERVE & STRENGTHEN THE NURSING HOME DIRECT CARE STAFF RATE ENHANCEMENT

Medicaid is an essential source of coverage for long-term services and support in Texas – covering 62% of older Texans living in nursing homes. LeadingAge Texas supports a Medicaid payment system that promotes accountability, rewards high-quality care, and drives toward long-term improvement across the field.

Recommendations: 

  • Strengthen & simplify the Nursing Facility Staff Rate Enhancement Program.
    • Appropriate funds for the biennium to fully fund the program in SFY 2026-27.
    • Allow recouped funds to be returned to high-performing nursing homes, rather than general revenue.      

PROTECT PROPERTY TAX EXEMPTIONS FOR CHARITABLE ORGANIZATIONS SERVING THE ELDERLY

Property tax in Texas is a locally assessed and locally administered tax. To qualify for a property tax exemption, a not-for-profit organization must be engaged primarily in performing one or more of the statutory charitable functions outlined in Tax Code §11.18. Not-for-profit senior housing providers and retirement communities are primarily faithbased mission driven organizations committed to serving older Texans in need. In addition to permanent housing, these organizations offer various social, healthcare, and educational services that improve the lives of their residents, families, and caregivers. Unfortunately, some organizations have had their property tax exemptions challenged or revoked despite the substantial benefits these organizations provide to the citizens of Texas, and despite the various ways these organizations address obligations that would otherwise fall to the State. Such determinations are made possible by ambiguity in the Tax Code.

Recommendations: 

  • Support legislation that creates uniformity for charitable organizations serving the elderly by improving language and clarifying the requirements for exemption, like those applied to charitable hospitals.

PRIORITIZE TRANSPARENCY IN STATE FUNDS FOR NURSING HOMES

LeadingAge Texas believes that providers should be transparent with respect to how they are allocating state funds. More specifically, providers should demonstrate that a majority of state funds received are going toward cost centers that directly correlate to improved quality of care.

Recommendation: 

  • Support legislation that promotes transparency for all nursing homes receiving state and federal funds.
  • Promote policies that require a percentage of funds go toward staffing.

MODERNIZE THE CONTINUING CARE RETIREMENT COMMUNITY (CCRC) STATUTE

The statute regulating CCRCs has been effectively the same since 1987, failing to keep pace with industry developments regarding the delivery of care. Additionally, ambiguity in the statute offers opaque guidance on what fully constitutes “continuing care” and who should register as a “continuing care retirement community”. In some instances, independent living providers simply responding to resident life alerts have triggered calls for those providers to register as CCRCs, despite not providing progressive levels of care. LeadingAge Texas supports legislation that will better define CCRCs to ensure peace of mind for seniors looking to reside in settings that offer various care settings to accommodate them in all stages of life.

Recommendation:

  • Support legislation that better defines “continuing care” and who should register as a CCRC to reflect current and emerging trends in the delivery of care.

SUPPORT INITIATIVES TO REBUILD THE LONG-TERM CARE WORKFORCE

According to a 2022 DSHS study, Texas is currently experiencing a shortage of approximately 29,000 registered nurses, with an estimated unmet demand of 57,000 by 2032. The pandemic exacerbated this threat making it critical the 89th Texas Legislature act to strengthen the long-term care workforce and protect the most vulnerable Texans.

Recommendation:

  • Support legislation offering funding scholarships, loan repayment, and retention measures specific to the longterm care workforce.

EASE REGULATIONS THAT INCREASE COSTS AND DISTRACT FROM PATIENT CARE

Administrative and regulatory burdens have continued to increase for long-term care providers. Paperwork and reporting obstacles get in the way of providers spending time with patients and increase costs. Regulations should be balanced with a primary focus on patient care not checking a box. The existing regulatory approach continues to increase the cost of care for providers and consumers.

Recommendation:

  • Support regulatory reforms that streamline regulations, remove unnecessary burdens, and reduce costs to improve the patient experience.

OPPOSE ANY POLICIES THAT WOULD IMPOSE A BED TAX IMPACTING SENIOR TEXANS

LeadingAge Texas supports efforts to increase Medicaid funding for nursing facilities, however, we do not support the creation of a tax across provider types with no promise of incentivizing higher quality care. Senior Texans should not be made to foot the bill for providers prioritizing profits over the delivery of care. Any efforts to increase nursing home funding should be associated with funding direct care staff, transparency, and should not drive up the cost of living for other senior Texans.

Recommendation:
  • Oppose any funding schemes that would result in a provider tax, driving up the cost of care for senior Texans.

CONTINUE TO DEFEND TORT REFORM PROVISIONS

In 2003, medical liability reforms were passed to protect both providers and patients. These reforms have successfully reduced lawsuits and liability costs increasing the number of quality providers who specialize in geriatric medicine and aging services.

Recommendation:
  • Continue to support these medical liability reforms to ensure adequate access to high-quality care.