Long-term care is a reality that touches all of us at some point in our lives. Whether caring for an elderly parent, recovering from a serious surgery, or supporting a loved one with a disability, these medical services are essential for individuals from all walks of life.
We should all be forever grateful to our dedicated staff for providing such vital care to us and our loved ones in our time of need.
But it’s not an easy business. Healthcare providers face many challenges that impede their ability to care for residents and families. Some of these obstacles are outdated regulations that states have not yet revised. Some “solutions” to problems that never existed can do more harm than good. There are also purely economic challenges.
That’s where the Texas Health Care Association (THCA) steps in to help identify and remove these barriers and improve the quality of care for these vulnerable populations across the state.
Prior to becoming President and CEO of THCA, I served six terms as a state representative in the Texas House of Representatives. Long-term care has been a top priority for me throughout my career, and I am proud to now manage this important organization.
I have the experience of seeing first-hand the amazing health care providers caring for our most vulnerable. THCA wants to make their lives and jobs easier. To this end, THCA has adopted five priorities for the 2025 Congress. THCA has adopted five priorities for the 2025 Congress that are essential to providing the best health care possible.
1. Confirm presumptive eligibility for Medicaid
Whenever Medicaid is involved, there is a lot of red tape that health care providers have to navigate. THCA has three proposals to Congress to address this issue.
* Increase the number of staff reviewing Medicaid eligibility to help make decisions faster.
* Allow nursing homes to presume patients are eligible for Medicaid rather than having to wait for state review (also helps speed up care)
* Streamline the registration process to ease the burden on patients age 65 and older.
2. Establishing a Behavioral Health Add-on for Texas Medicaid
THCA supports expanding Texas Medicaid coverage to address behavioral health needs. This is very simple and absolutely necessary to ensure that funds flow to where they are needed most.
3. Improving the efficiency of nursing facility ownership change procedures
Another process that slows the delivery of long-term care to Texans occurs when nursing homes change ownership. This process previously took approximately 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 and abolishing redundant penalties
In some cases, providers may find themselves caught in a complex web of regulations and subject to fines. Currently, multiple government agencies can issue fines for the same issue, a phenomenon known as “double dipping.” This unnecessarily increases costs for healthcare providers and again takes away resources that should be devoted to healthcare. This has to change.
5. Introduction of patient-driven payment model rider
During the last legislative session, the Texas Legislature provided $100 million in funding for patient-driven payment models (PDPM) for Medicaid nursing home services. THCA is committed to securing funding and we are building on this past victory.
The upcoming 2025 Congress presents a pivotal opportunity to advance our long-term social transformation.
Regular medical treatment system. We are working toward a future where all Texans receive the care they need, when they need it, efficiently and affordably.
As I approach this Congress, I am filled with hope and determination. The potential to transform long-term care in Texas is enormous, and we are already hard at work.
Editor’s note: The above guest column was written by Texas Health Care Association President Travis Clardy. Published in the Rio Grande Guardian with permission of the author.
