Senate Concurrent Resolution No. 4–Committee on

Legislative Affairs and Operations

FILE NUMBER........

Whereas, The State of Nevada has experienced unprecedented growth

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

elderly persons who have retired in this state; and

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

disabilities generally have the highest incidence of chronic illness and the

greatest need for long-term care services; and

Whereas, The health care needs of this growing segment of the

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

best resources available within this state; and

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

available to elderly persons who are unable to live safely alone without

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

home with supportive services, group care facilities or assisted living

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

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

care even though several studies have concluded that community-based

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

Whereas, It is important to determine the availability of alternatives for

providing long-term care other than institutionalized care within the State

of Nevada, the costs of each alternative type of care, and the advantages

and disadvantages of each alternative type of care to ensure that persons in

need of long-term care and the agencies of the state and local governments

responsible for administering public programs for the elderly are able to

make informed decisions concerning health care services; and

Whereas, Approximately 80 percent of the funding for nursing homes

comes from public sources, including, without limitation, Medicare,

Medicaid and county medical assistance programs; and

Whereas, Acute care services provided to elderly persons through

Medicare are currently not integrated with long-term care services provided

to elderly persons through Medicaid; and

Whereas, The lack of coordination between Medicare and Medicaid

leads to conflicting incentives for payment, shifting of costs between

programs and providers, and duplicative administrative provisions that

impede good clinical care and efficient delivery of services to elderly

persons who are eligible for both Medicare and Medicaid; and

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

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

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

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

Whereas, The requirement that persons in this state impoverish

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

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

determining how to receive the health care services that they need to

survive; and

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

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

Resolved by the Senate of the State of Nevada, the Assembly

Concurring, That the Legislative Commission is hereby directed to

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

State of Nevada; and be it further

Resolved, That the study must include, without limitation:

1. The identification, review and evaluation of alternatives to

institutionalization for providing long-term care, including, without

limitation:

(a) Analyzing the costs of the alternatives to institutionalization and the

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

state;

(b) Determining the positive and negative effects of the different

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

persons receiving those services in this state;

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

long-term care services in this state; and

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

services provided to all persons who are receiving or who are eligible to

receive such services in this state;

2. An evaluation of the possibility of obtaining a waiver from the

Federal Government to integrate and coordinate acute care services

provided through Medicare and long-term care services provided through

Medicaid in this state; and

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

Federal Government to eliminate the requirement that elderly persons in

this state impoverish themselves as a condition of receiving assistance for

long-term care; and be it further

Resolved, That any recommended legislation proposed by the

subcommittee must be approved by a majority of the members of the

Senate and a majority of the members of the Assembly appointed to the

subcommittee; and be it further

Resolved, That the Legislative Commission shall submit a report of the

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

session of the Nevada Legislature.

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