MINUTES OF MEETING
ASSEMBLY COMMITTEE ON HEALTH AND HUMAN SERVICES
Sixty-seventh Session
April 29, 1993
The Assembly Committee on Health and Human Services was called to order by Chairman Jan Evans at 1:35 p.m. 1993, in Room 330 of the Legislative Building, Carson City, Nevada. Exhibit A is the Meeting Agenda, Exhibit B is the Attendance Roster.
COMMITTEE MEMBERS PRESENT:
Mrs. Jan Evans, Chairman
Mrs. Vivian L. Freeman, Vice Chairman
Ms. Kathy M. Augustine
Ms. Marcia de Braga
Mr. James A. Gibbons
Mr. Dean A. Heller
Mr. William A. Petrak
Mrs. Gene W. Segerblom
Ms. Stephanie Smith
Mr. Louis A. Toomin
Mr. Wendell P. Williams
COMMITTEE MEMBERS ABSENT:
None
GUEST LEGISLATORS PRESENT:
None
STAFF MEMBERS PRESENT:
Kerry Carroll Davis, Research Analyst
OTHERS PRESENT:
Myla Florence, Administrator/Nevada State Welfare Division
Nancy Angres, AG/Welfare Division
Gary Crews, Legislative Auditor
Mary Ellen McCarthy, Senior Attorney/Nevada Legal Services
May Shelton, Director/Washoe County Social Services
Mary Liveratti,Deputy Administrator/Division Aging Services
BDR 40-2001Increases number of persons that serve on certain boards of hospital trustees and increases amount of compensation certain trustees are entitled to receive.
MR. TOOMIN MOVED FOR COMMITTEE INTRODUCTION OF BDR 40-2001.
MS. AUGUSTINE SECONDED THE MOTION.
MOTION CARRIED UNANIMOUSLY.
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SENATE BILL 311: Revises provision concerning examination of persons alleged to be mentally ill.
MRS. FREEMAN MOVED DO PASS ON SB 311.
MS. SMITH SECONDED THE MOTION.
MOTION CARRIED UNANIMOUSLY.
Mrs. Evans assigned Mr. Toomin to make the floor statement.
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ASSEMBLY JOINT RESOLUTION 27:Urges Congress to support "ENABLE" program.
MS. DE BRAGA MOVED DO PASS ON AJR 27.
MR. HELLER SECONDED THE MOTION.
MOTION CARRIED UNANIMOUSLY.
Mrs. Evans assigned Ms. de Braga to make the floor statement.
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ASSEMBLY CONCURRENT RESOLUTION 37:
Urges State Welfare Administrator to require recipients of Medicaid to participate in educational program on family planning as condition of receiving certain financial assistance.
Mrs. Freeman distributed the proposed amendment to ACR 37 (Exhibit C.)
MRS. FREEMAN MOVED TO AMEND AND ADOPT ACR 37.
MR. HELLER SECONDED THE MOTION.
MOTION CARRIED UNANIMOUSLY.
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ASSEMBLY BILL 504: Revises requirement to mark area of proposed excavation or demolition.
MR. TOOMIN MOVED TO INDEFINITELY POSTPONE AB 504.
MR. PETRAK SECONDED THE MOTION.
MOTION CARRIED UNANIMOUSLY.
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BDR S-1085 An act making appropriation to the department of human resources for the establishment of a grant program for organizations that provide pre-natal care to low income women.
MRS. SEGERBLOM MOVED FOR COMMITTEE INTRODUCTION OF BDR S- 1085.
MS. DE BRAGA SECONDED THE MOTION.
MOTION CARRIED UNANIMOUSLY.
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ASSEMBLY BILL 503: Authorizes welfare division of department of human resources to recover benefits paid for assistance to medically indigent.
Myla Florence, Administrator/Nevada State Welfare Division, indicated Nevada was one of only fourteen states in the nation not employing a Medicaid estate recovery program. Her testimony (Exhibit D) in support of AB 503, was submitted with accompanying amendments.
Mr. Gibbons queried whether a notice would be given the Medicaid recipient that a claim ultimately would be made upon his/her estate. Ms. Florence indicated the person would be informed at the point of application that the state would have a recovery program and he could be held responsible. Nancy Angres, Chief Deputy AG, having been introduced by Ms. Florence, added, "If there was a lien against a property, it would have to go through a probate court." Mr. Gibbons further questioned what the priority of claims would be if other claims arose against the estate in a probate proceeding. Ms. Angres explained in current probate law, burial expenses would take priority over other claims.
Mrs. Evans wondered since Medicaid was a federal matching program, would merely state dollars be reclaimed. Ms. Florence stated the intent was to reclaim both state and federal monies and return the federal share to the federal government.
Responding to Mr. Heller's inquiry as to where recouped dollars would be deposited, Ms. Florence specified they would revert to the General Fund.
Gary Crews, Legislative Auditor, distributed a handout entitled "Legislative Audit AB 503" (Exhibit E) and described same to the committee. Discussion ensued between Mr. Crews and committee members concerning Medicaid Trusts as discussed in the handout.
Mary Ellen McCarthy, Senior Attorney/Nevada Legal Services, raised concerns with respect to AB 503. She indicated federal law prohibited recovery of Medicaid monies correctly paid and noted the estate recovery provision was an exception to the general federal law. Exhibit F referenced specific problems with the proposed legislation and specified examples as to how the bill should be amended to a general enabling statute so as to comply with federal requirements.
Ms. McCarthy encouraged the committee to accept the recommendation put forth by Assemblyman Smith to change the term "known assets" to "knowingly fails to report."
Mr. Petrak posed a question concerning transfer of property. Ms. McCarthy indicated federal statute provided a 30 month limit on transfer of assets. If an estate was transferred within 30 months of applying for Medicaid, a person would be disqualified for a period of time.
May Shelton, Director/Washoe County Social Services, spoke next in support of AB 503. Her prepared testimony is submitted as Exhibit G.
Mary Liveratti, Deputy Administrator/Division of Aging Services, expressed concern regarding the implementation of the bill. She stressed those applying for the program should be informed of incurring costs at the time of application. A second area of concern involved hardship cases. There were existing situations of not only unmarried men and women living together but elderly people such as a sister and brother; the concern being, "We would be displacing an elderly person if there was not some kind of hardship provision that the Welfare Division would be at the discretion of looking at it on a case by case basis and making a determination."
In view of the fact the estate recovery program estimated a need for three staff members, Mrs. Evans asked Ms. Florence for further clarification. The three staff members, according to Ms. Florence, included a management analyst, a legal assistant and a program assistant. The Attorney General's office also had indicated they would require one additional full-time Deputy Attorney General assigned to the division. She concluded the staff investment to the division would amount to approximately $100,000 for the first year of the biennium; the AG cost being another $89,000.
Responding to Mrs. Freeman's inquiry as to the total Medicaid budget, Ms. Florence indicated $600 million for the upcoming biennium.
Mrs. Evans asked Ms. Florence, Ms. Angres and Ms. McCarthy to meet with a subcommittee consisting of Mrs. Segerblom, Ms. Smith and Mr. Heller to resolve existing differences.
Finally, Mr. Toomin applauded the concept of AB 503 but shared concerns with Mr. Heller as to the physical responsibility of the bill and advocated delving further into the money projections. He further expressed serious reservations with some of the constitutional issues and suggested referring the bill to the Judiciary Committee. Mrs. Evans suggested first seeing what was forthcoming in terms of proposed amendments.
There being no further business to come before committee, the meeting was adjourned at 3:00 p.m.
RESPECTFULLY SUBMITTED:
CHRISTINE SHAW
Committee Secretary
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Assembly Committee on Health and Human Services
April 29, 1993
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