HB 1717-FN – AS INTRODUCED

2006 SESSION

06-2567

01/10

HOUSE BILL 1717-FN

AN ACT requiring certain direct care services in nursing homes.

SPONSORS: Rep. Gile, Merr 10; Rep. Gargasz, Hills 5

COMMITTEE: Health, Human Services and Elderly Affairs

ANALYSIS

This bill requires nursing homes to provide a minimum of 4 hours of direct nursing care, as defined in Medicare and Medicaid requirements, for medically fragile elderly persons, including persons who are Medicaid eligible, residing in such a facility.

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Explanation: Matter added to current law appears in bold italics.

Matter removed from current law appears [in brackets and struckthrough.]

Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

06-2567

01/10

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Six

AN ACT requiring certain direct care services in nursing homes.

Be it Enacted by the Senate and House of Representatives in General Court convened:

1 Purpose. According to 42 C.F.R. Section 483.30, Quality of Life Nursing Services Criteria in Medicaid Standards of Care, there must be sufficient nursing staff to provide nursing and related services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident of nursing facilities and of those persons receiving home-based or community-based care. Therefore, it is the intent of this act to establish a minimum number of direct nursing care hours per resident in nursing home facilities.

2 New Section; Direct Care Required. Amend RSA 151 by inserting after section 25 the following new section:

151:25-a Minimum of Nursing Direct Care Required. Any nursing home licensed under this chapter shall provide at a minimum 4 hours of direct nursing care, as defined in Medicare and Medicaid requirements and should plan by 2010 to meet recommended minimum staffing standards for nursing homes developed by the National Citizen’s Coalition for Nursing Home Reform (NCCNHR), for medically-fragile elderly persons, including those who are Medicaid eligible, residing in such a facility. The assignment of such direct care hours shall be determined by resident need and acuity level and at the discretion of the director of nursing services at the nursing home, and in consultation with the elderly person’s family members.

3 Effective Date. This act shall take effect 60 days after its passage.

LBAO

06-2567

Revised 12/29/05

HB 1717 FISCAL NOTE

AN ACT requiring certain direct care services in nursing homes.

FISCAL IMPACT:

The Department of Health and Human Services and the New Hampshire Association of Counties state this bill will increase county revenue and expenditures by an indeterminable amount in FY 2007 and each year thereafter. There will be no fiscal impact on state and local revenue or expenditures.

METHODOLOGY:

The Department of Health and Human Services assumed this bill would be effective beginning in FY 2007. The Department estimated the cost to meet the minimum standard of 4 hours of nursing care by computing the average cost per minute for FY 2004, and applying medical inflation of 4.6% annually until the year 2010. The average cost per minute was then multiplied by the difference between the minimum standard of 4 hours proposed by this bill and the current average of 3 hours, 47.8 minutes to yield the following result:

The Department assumed that these expenditures will be above the direct care median cap of Medicaid would not be paid by the Medicaid Program and be borne by nursing homes. The Department is unable to project how much of the additional cost will be to the counties and how much will be a cost to private nursing homes.

The New Hampshire Association of Counties assumed this bill will increase the number of direct care staff required at the county nursing homes and in other Medicaid nursing facilities for which the counties are responsible for 50% of the non-federal share of costs. The Association is not able to estimate the additional cost.