As Recommended by House Committee on

Health and Human Services


H.B. 2969 creates a new law under which the Secretaries of Social and Rehabilitation Services and Aging are to create a quality enhancement wage pass-through program as a part of the state Medicaid plan. Under the plan, nursing facilities that elect to participate would be allowed a payment option of up to $4.00 per resident day to increase salaries or benefits, or both, for those employees that provide direct care and support service to employees. Employees eligible to receive the wage pass-through include nurse aides, medication aides, restorative-rehabilitative aides, licensed mental health technicians, plant operating and maintenance personnel, nonsupervisory dietary personnel, laundry personnel, housekeeping personnel, and activity directors.

The plan created pursuant to the direction of H.B. 2969 would have to include a pass-through wage system designed to reimburse nursing facilities during the reimbursement period in which the wage pass-through costs are incurred. Wage pass-through moneys would be paid to the nursing facility outside of cost center limits or occupancy penalties as a labor cost reimbursement. The pass-through cost would be included in the cost report base. No wage pass-through moneys could be used to increase management compensation or facility profits.

The bill requires quarterly wage audits for all nursing facilities that participate in the program as set out in the bill to assure the pass-through moneys were used to increase salaries or benefits for eligible direct care and support staff or to hire additional eligible staff. A nursing facility that failed to file required audit reports would be terminated from the program and required to repay all pass-through amounts received for the reporting period.


The introduction of H.B. 2969 was requested by the Kansas Health Care Association. In the Committee hearing on H.B. 2969, support was expressed by representatives of the Kansas Association of Homes and Services for the Aging and the Kansas Health Care Association, the Administrator of McCrite Plaza Health Care Center, and the Executive Director of Windsor Place in Coffeyville. Generally, the testimony depicted the bill as offering one way to enhance the quality of care in nursing facilities through the reduction in turnover in direct care staff and the attraction and retention of health care staff.

The fiscal note on H.B. 2969 states the Departments on Aging and Social and Rehabilitation Services indicate the passage of the bill would have a significant fiscal impact. The total cost of additional nursing facility reimbursement for the three categories of residents covered by Medicaid is estimated to be as much as $18.9 million of which $7.6 million would be State General Fund money or as little as $5.9 million of which $2.4 million would be State General Fund costs. Additional costs would be incurred for staffing for the audit function. Any expenditure increase occurring due to passage of H.B. 2060 would be in addition to the amount included in The FY 1999 Governor's Budget Report.

1. *Supplemental notes are prepared by the Legislative Research Department and do not express legislative intent. The supplemental note and fiscal note for this bill may be accessed on the Internet at