EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. Green numbers along left margin indicate location on the printed bill (e.g., 5-15 indicates page 5, line 15).

1-1 Whereas, Persons with disabilities are often forced to live in long-term

1-2 care facilities when they become unable to perform certain activities of

1-3 daily living; and

1-4 Whereas, Many of these persons would be able to remain in their

1-5 homes with the assistance of a personal care assistant; and

1-6 Whereas, Persons who receive services from personal care assistants

1-7 rather than living in a long-term care facility enjoy a higher quality of life,

1-8 experience increased independence and contribute more to society; and

1-9 Whereas, The Health Care Financing Administration of the United

1-10 States Department of Health and Human Services has recognized that

1-11 Medicaid programs are biased towards institutional care rather than

1-12 providing home-based and community-based care; and

1-13 Whereas, The Health Care Financing Administration has appointed a

1-14 task force to study this problem, is adopting new regulations to reduce the

1-15 bias towards institutional care and is encouraging states to be more creative

1-16 so that more recipients of Medicaid are able to remain in their homes; and

1-17 Whereas, Recipients of Medicaid in this state have experienced

1-18 difficulty in obtaining the services of personal care assistants because the

1-19 rate of reimbursement does not attract the necessary portion of the

1-20 workforce to provide this type of service and because of the requirement

1-21 that personal care assistants purchase industrial insurance; and

2-1 Whereas, Additional problems with the use of personal care assistants

2-2 in the Medicaid program in this state exist because the Department of

2-3 Human Resources does not have an adequate system in place to provide a

2-4 substitute when a personal care assistant unexpectedly is unable to work as

2-5 scheduled; and

2-6 Whereas, Presently the Department of Human Resources only

2-7 provides personal care assistants who are independent contractors and does

2-8 not actively recruit a sufficient number of personal care assistants to handle

2-9 the high turnover rate in this profession; and

2-10 Whereas, The Nevada Legislature recognizes the need to provide

2-11 persons with disabilities the necessary support to enable them to maintain

2-12 independence and continue as productive members of society; now,

2-13 therefore, be it

2-14 Resolved by the Assembly of the State of Nevada, the Senate

2-15 Concurring, That the Nevada Legislature hereby urges the Department

2-16 of Human Resources to:

2-17 1. Provide easier access to and promote the use of personal care

2-18 assistants to recipients of Medicaid;

2-19 2. Authorize the use of personal care assistants and provide

2-20 reimbursement for the use of personal care assistants any time that such

2-21 use is authorized by law;

2-22 3. Develop an approach to providing the services of personal care

2-23 assistants for recipients of Medicaid that is focused on the needs of the

2-24 recipients;

2-25 4. Budget for increased use of personal care assistants by recipients of

2-26 Medicaid;

2-27 5. Increase the rate of reimbursement to personal care assistants who

2-28 provide services for recipients of Medicaid to ensure that the rate provided

2-29 is at least equal to the rate provided to other persons who provide

2-30 substantially similar services;

2-31 6. Contract with private agencies for the provision of services of

2-32 personal care assistants for recipients of Medicaid and develop penalties

2-33 for such agencies if they do not fulfill the terms of the contract; and

2-34 7. Develop solutions concerning the cost of industrial insurance for

2-35 personal care assistants who are independent contractors; and be it further

2-36 Resolved, That the Chief Clerk of the Assembly prepare and transmit

2-37 a copy of this resolution to the Director of the Department of Human

2-38 Resources.