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 Section 1. The legislature finds and declares that the combination of

1-2 public needs and available resources for the provision of medical care to

1-3 patients uninsured or receiving public assistance in Clark County, the

1-4 state’s largest metropolitan area, and the lack of functioning precedents for

1-5 a unified system for this purpose, are unique to that county and that a

1-6 general law cannot be made applicable to the unified provision of that care.

1-7 Clark County is therefore hereby authorized to discharge its obligation as a

1-8 county, under general law, to serve the needs of its medically needy

1-9 population by seeking waivers under the federal program of Medicaid to

1-10 establish a suitable special program for that purpose.

1-11 Sec. 2. As used in sections 2 to 8, inclusive, of this act, unless the

1-12 context otherwise requires:

1-13 1. "Board" means the board of directors of the system.

1-14 2. "System" means the County Health System.

2-1 Sec. 3. 1. The County Health System is hereby created as a nonprofit

2-2 public corporation to serve a municipal and charitable purpose. The system

2-3 shall be deemed to be a local government for the purpose of eligibility for

2-4 any federal benefit related to the purposes of the system.

2-5 2. The board of county commissioners of Clark County, as hospital

2-6 trustees ex officio, shall appoint the board of directors of the corporation,

2-7 consisting of seven members nominated by the board of county

2-8 commissioners and two members nominated by the governor. Vacancies on

2-9 the board of directors must be filled in the same manner as the initial

2-10 appointments.

2-11 Sec. 4. 1. The nominees to serve as directors must reside or be

2-12 employed in Clark County and be broadly representative of the cities and

2-13 towns of the county and experienced in business or community affairs. A

2-14 director may not be an elected officer or an employee of the county, a

2-15 provider of health care or an employee of a provider of health care.

2-16 2. Members of the board shall serve for terms of 2 years.

2-17 Sec. 5. 1. The board shall hold at least six regular meetings each

2-18 year.

2-19 2. The board shall adopt rules for its proceedings. A majority of the

2-20 members constitutes a quorum, but the approval of an official act requires

2-21 four affirmative votes unless the number of members prohibited by conflict

2-22 of interest from voting reduces the number of members eligible to vote to

2-23 fewer than four, in which case approval of the official act requires

2-24 affirmative votes of all members eligible to vote on the matter.

2-25 3. Each member of the board is entitled to receive from the system $80

2-26 for each meeting of the board he attends, and the board may provide the

2-27 same remuneration for attendance at meetings of committees of the board,

2-28 but the total for all meetings attended in a calendar month may not exceed

2-29 $320. In addition, a member is entitled to reimbursement for actual and

2-30 necessary expenses for attending meetings, at the rate payable to county

2-31 officers and employees generally.

2-32 Sec. 6. 1. The board shall remove a member from office if a majority

2-33 of the other members find that he:

2-34 (a) Neither lives nor is employed in Clark County;

2-35 (b) Has been convicted of a felony;

2-36 (c) Has failed to attend three consecutive meetings of the board or a

2-37 majority of the meetings of the board held in the most recent calendar year,

2-38 unless good cause is shown, as determined by the board; or

2-39 (d) Has failed to perform his duties as a member of the board.

2-40 2. The board shall remove a member from office at the written request

2-41 of the governor or the board of county commissioners of Clark County,

2-42 whichever nominated the member, if the request sets forth the manner in

2-43 which he no longer meets the criteria for his nomination.

3-1 Sec. 7. 1. Except as otherwise provided in this section, the system

3-2 may apply through the department of human resources for all waivers from

3-3 federal regulation and all approvals from the Federal Government which

3-4 are necessary to establish and operate its program of services, including a

3-5 demonstration project pursuant to 42 U.S.C. § 1315. The demonstration

3-6 project may not be used to curtail any existing rights of persons receiving

3-7 Medicaid at the time of the application.

3-8 2. An application for a waiver or approval may include providing

3-9 services pursuant to Medicaid through the program to persons who

3-10 otherwise would not receive medical assistance pursuant to Medicaid.

3-11 3. The system shall not apply for a waiver of the provisions concerning

3-12 payment to federally qualified health centers or noninstitutional providers

3-13 of health care pursuant to 42 U.S.C. § 1396(a)(10), (13), (30) or (37). As

3-14 used in this subsection, federally qualified health center has the meaning

3-15 ascribed to it in paragraph (a) of subsection 4 of NRS 422.273.

3-16 Sec. 8. The board shall report to the 71st session of the Nevada

3-17 Legislature, immediately upon the convening of that session, concerning its

3-18 progress in obtaining waivers pursuant to section 7 of this act and any

3-19 related recommendations for legislation.

3-20 Sec. 9. 1. This act becomes effective upon passage and approval for

3-21 the purpose of appointing members of the board of directors pursuant to

3-22 section 3 of this act and on July 1, 1999, for all other purposes.

3-23 2. This act expires by limitation on July 1, 2001. The terms of all

3-24 members of the board of directors expire on that date.