1. BUILD NURSING HOMES IN TEXAS Salman Moti HPA 430, Summer 2013 University of Illinois, Chicago School of Public Health

2.  The demand for nursing home beds is expected outpace supply in the five most populous cities in the State of Texas [Austin, Dallas, Fort Worth, Houston, and San Antonio] by 2030. This shortage will have a significant adverse impact, especially on the state’s seniors aged 65+. 2

3.  85.8% of nursing home residents are aged 65+  Between 2010 and 2030 the number of citizens aged 65+ is expected to increase drastically  Between 2010 and 2030 the number of nursing home residents in Austin, Dallas, Fort Worth, Houston, and San Antonio is expected to increase drastically Population 65+ YearAustinDallasFort WorthHoustonSan Antonio 201057,707105,19566,200170,898136,171 2020108,557168,569121,686303,975210,526 2030184,974240,117211,181462,380301,154 Number of Nursing Home Residents YearAustinDallasFort WorthHoustonSan Antonio 20102,7585,0273,1638,1666,507 20205,1878,0555,81514,52610,060 20308,83911,47410,09122,09514,391 3

4.  Presently there are only 220 nursing home facilities located in the cities of Austin, Dallas, Fort Worth, Houston, and San Antonio  These 220 facilities offer a total of 25,743 certified nursing home beds  To keep pace with demand the supply of certified nursing home beds must increase by 60% before year 2030  If the supply of certified nursing beds fails to increase, significant bed shortages are expected 4 Number of Nursing Home Residents YearAustinDallasFort WorthHoustonSan AntonioTotalBed Shortage 20102,7585,0273,1638,1666,50725,621- 20205,1878,0555,81514,52610,06043,64317,897 20308,83911,47410,09122,09514,39166,89041,144

5.  The PREPARE campaign aims to urge state lawmakers and constituents to financially incentivize the building of and investment in nursing homes in the five most populous cities in the State of Texas by introducing an amendment to the Texas Administration Code. 5

6.  The PREPARE campaign aims to garner support for an amendment to Texas Administration Code, Title 40, Part 1, Chapter 19, Subchapter D, Rule §19.344 which would allow financial incentivization for new nursing home construction and expansions. 6

7. The Prepare Campaign seeks to introduce an amendment to Section (1A-1G) of the Texas Administration Code, Title 40, Part 1, Chapter 19, Subchapter D, Rule §19.344. This section of the administration code outlines the process to be followed by applicants seeking to build or expand nursing homes within the State of Texas and under the jurisdiction of the Texas Department of Human Services (DHS). Language of Proposed Amendment Between 01-01-2015 and 12-31-2020 organizations may apply for a reimbursement of previously approved building or renovation costs incurred under the Prepare initiative. Reimbursement only applies to nursing homes built within the city limits of: - Austin - Dallas - Fort Worth - Houston - San Antonio (continued on next slide) 7

8. The percentage of costs reimbursed by the state is based on the completion date of the new construction or renovation project. The final building plans must be approved by the Texas Department of Human Services for reimbursement prior to the beginning of construction activity. In addition to approval by the Texas Department of Human Services, the project must comply with all other standard state, county, and city building codes and ordinances. Facilities seeking reimbursement are subject to routine inspection to ensure minimum guidelines are being met. Funds for this incentive program are limited and available on a “first come first served” basis. Once the funds have been exhausted applications for reimbursement will no longer be accepted. Project Completion Date and Maximum Reimbursement Percentage Date Range% 01-01-2015 to 12-31-201630 01-01-2017 to 12-31-201815 01-01-2019 to 12-31-202010 8

9.  State Rep. Richard Pena Raymond – House Committee on Human Services, Chair  State Rep. Lois W. Kolkhorst – House Committee on Public Health, Chair  State Rep. Mike Villarreal – House Committee on Investments and Financial Services, Chair 9

10.  Current and future nursing home residents concerned about availability of skilled care facilities  Insurance companies concerned about the declining health of its policy holders and the inability to provide options for skilled care facilities 10

11.  Department of State Health Services  Department of Aging and Disability Services 11

12.  AARP & Retirement Planning Magazines  Robert Wood Johnson Foundation Policy Podcast 12

13.  Entrepreneur & Investment Publications  Professional Organization Partnerships 13

14.  T-shirts  Hats 14

15.  Billboards  Bus Stop Signage 15

16. Salman Moti, PREPARE Director www.PrepareTexas.weebly.com (817) 319 – 2459 SMoti2@uic.edu Centers for Medicare & Medicaid Services https://data.medicare.gov/data/nursing-home-compare U. S. Department of Commerce http://quickfacts.census.gov/qfd/states/48000.html Texas 2012 State Plan Population Projections http://www.twdb.state.tx.us/waterplanning/data/projections/2012/popproj.asp Texas State Data Center http://txsdc.utsa.edu/data/TPEPP/Projections/Index.aspx Texas Comptroller of Public Accounts http://www.window.state.tx.us/specialrpt/tif/population.html CMS Nursing Home Data Compendium http://www.cms.gov/Medicare/Provider-Enrollment-and- Certification/CertificationandComplianc/downloads/nursinghomedatacompendium_508.pdf U.S. Department of Health and Human Services, Administration on Aging http://www.aoa.gov/Aging_Statistics/Profile/2011/docs/2011profile.pdf 16

17. Legal This presentation is designed for course HPA 430 at the University of Illinois at Chicago. This presentation is for educational purposes only. The information contained herein may not be used for any other purpose. The images contained herein are property of their respective companies. These companies and their affiliates are not endorsed by the University of Illinois at Chicago.