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, The State of Nevada has experienced unprecedented growth

1-2 in population, and a large percentage of this growth is attributable to

1-3 elderly persons who have retired in this state; and

1-4 Whereas, Persons who are 65 years of age or older and persons with

1-5 disabilities generally have the highest incidence of chronic illness and the

1-6 greatest need for long-term care services; and

1-7 Whereas, The health care needs of this growing segment of the

1-8 population must be addressed to ensure that their needs are met with the

1-9 best resources available within this state; and

1-10 Whereas, There are generally three types of long-term care services

1-11 available to elderly persons who are unable to live safely alone without

1-12 assistance, including, community-based care for those who can remain at

1-13 home with supportive services, group care facilities or assisted living

1-14 facilities, and nursing home care provided in a medical facility; and

1-15 Whereas, Spending for long-term care is biased toward institutional

1-16 care even though several studies have concluded that community-based

1-17 care offers a cost-effective alternative to institutional care; and

1-18 Whereas, It is important to determine the availability of alternatives

1-19 for providing long-term care other than institutionalized care within the

1-20 State of Nevada, the costs of each alternative type of care, and the

1-21 advantages and disadvantages of each alternative type of care to ensure

1-22 that persons in need of long-term care and the agencies of the state and

1-23 local governments responsible for administering public programs for the

2-1 elderly are able to make informed decisions concerning health care

2-2 services; and

2-3 Whereas, Approximately 80 percent of the funding for nursing homes

2-4 comes from public sources, including, without limitation, Medicare,

2-5 Medicaid and county medical assistance programs; and

2-6 Whereas, Acute care services provided to elderly persons through

2-7 Medicare are currently not integrated with long-term care services

2-8 provided to elderly persons through Medicaid; and

2-9 Whereas, The lack of coordination between Medicare and Medicaid

2-10 leads to conflicting incentives for payment, shifting of costs between

2-11 programs and providers, and duplicative administrative provisions that

2-12 impede good clinical care and efficient delivery of services to elderly

2-13 persons who are eligible for both Medicare and Medicaid; and

2-14 Whereas, To be eligible for Medicaid in a nursing home, a single

2-15 person must possess less than $2,000 in nonhousing assets and must

2-16 contribute all of his income toward the cost of his care, except for a small

2-17 allowance for personal needs, which is generally $30 per month; and

2-18 Whereas, The requirement that persons in this state impoverish

2-19 themselves to become eligible for long-term care benefits places many

2-20 persons in need of long-term care in a very difficult situation when

2-21 determining how to receive the health care services that they need to

2-22 survive; and

2-23 Whereas, The growing number of persons in need of long-term care is

2-24 of grave concern to this legislative body; now, therefore, be it

2-25 Resolved by the Senate of the State of Nevada, the Assembly

2-26 Concurring, That the Legislative Commission is hereby directed to

2-27 appoint a subcommittee to conduct an interim study of long-term care in

2-28 the State of Nevada; and be it further

2-29 Resolved, That the study must include, without limitation:

2-30 1. The identification, review and evaluation of alternatives to

2-31 institutionalization for providing long-term care, including, without

2-32 limitation:

2-33 (a) Analyzing the costs of the alternatives to institutionalization and the

2-34 costs of institutionalization for persons receiving long-term care in this

2-35 state;

2-36 (b) Determining the positive and negative effects of the different

2-37 methods for providing long-term care services on the quality of life of

2-38 persons receiving those services in this state;

2-39 (c) Determining the personnel required for each method of providing

2-40 long-term care services in this state; and

2-41 (d) Determining realistic methods for funding the long-term care

2-42 services provided to all persons who are receiving or who are eligible to

2-43 receive such services in this state;

3-1 2. An evaluation of the possibility of obtaining a waiver from the

3-2 Federal Government to integrate and coordinate acute care services

3-3 provided through Medicare and long-term care services provided through

3-4 Medicaid in this state; and

3-5 3. An evaluation of the possibility of obtaining a waiver from the

3-6 Federal Government to eliminate the requirement that elderly persons in

3-7 this state impoverish themselves as a condition of receiving assistance for

3-8 long-term care; and be it further

3-9 Resolved, That any recommended legislation proposed by the

3-10 subcommittee must be approved by a majority of the members of the

3-11 Senate and a majority of the members of the Assembly appointed to the

3-12 subcommittee; and be it further

3-13 Resolved, That the Legislative Commission shall submit a report of

3-14 the results of the study and any recommendations for legislation to the 71st

3-15 session of the Nevada Legislature.