Assembly Bill No. 635–Committee on Health and
Human Services

 

(On Behalf of Interim Committee on Health Care)

 

March 26, 2001

____________

 

Referred to Concurrent Committees on Health and Human
Services and Ways and Means

 

SUMMARY—Creates commission on autism. (BDR 39‑225)

 

FISCAL NOTE:    Effect on Local Government: No.

                                 Effect on the State: Contains Appropriation not included in Executive Budget.

 

~

 

EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.

 

AN ACT relating to health care; creating the commission on autism; providing for its membership; requiring the commission to establish certain centers to provide services relating to autism; making an appropriation; and providing other matters properly relating thereto.

 

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN

SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

 

1-1    Section 1. Chapter 433 of NRS is hereby amended by adding thereto

1-2  the provisions set forth as sections 2 to 22, inclusive, of this act.

1-3    Sec. 2.  As used in sections 2 to 22, inclusive, of this act, unless the

1-4  context otherwise requires, the words and terms defined in sections 3, 4

1-5  and 5 of this act have the meanings ascribed to them in those sections.

1-6    Sec. 3.  “Autism” includes any developmental disorder specified by

1-7  the commission.

1-8    Sec. 4.  “Center” means a center for providing services for autism

1-9  created pursuant to section 10 of this act.

1-10    Sec. 5.  “Commission” means the commission on autism created by

1-11  section 6 of this act.

1-12    Sec. 6.  1.  The commission on autism, consisting of 12 members, is

1-13  hereby created within the division. The commission consists of:

1-14    (a) One member of the Statewide Autism Task Force, appointed by the

1-15  task force from among its members;

1-16    (b) One member who represents users of services for autism,

1-17  appointed by the Statewide Autism Task Force;

2-1    (c) One member who represents the University Affiliated Project of

2-2  the University of Nevada, Reno, appointed by the chairman of the

2-3  department that oversees the project;

2-4    (d) One member who represents the Early Childhood Autism Program

2-5  of the University of Nevada, Reno, appointed by the chairman of the

2-6  department of psychology;

2-7    (e) One member who represents a department of the University of

2-8  Nevada, Las Vegas, that specializes in the study of autism, appointed by

2-9  the chairman of that department;

2-10    (f) One member who represents an association or other organization

2-11  of residential providers of services for autism, appointed by the

2-12  administrator;

2-13    (g) One member who represents Families for Effective Autism

2-14  Treatment, appointed by the governing body of that organization;

2-15    (h) One member who represents the Autism Society of America,

2-16  selected by a majority of the members of the governing bodies of the

2-17  chapters of that organization located in this state;

2-18    (i) One member who represents Nevada Parents Encouraging

2-19  Parents, Incorporated, appointed by the board of directors of that

2-20  organization;

2-21    (j) One member who represents the University of Nevada School of

2-22  Medicine, appointed by the dean of that school;

2-23    (k) One member who is an employee of the department of

2-24  employment, training and rehabilitation and has knowledge and

2-25  experience concerning community-based services provided by the

2-26  department, appointed by the director of the department; and

2-27    (l) One member who is an employee of the department of education

2-28  and has knowledge and experience concerning special education,

2-29  appointed by the superintendent of public instruction.

2-30    2.  If any appointing entity specified in subsection 1 ceases to exist,

2-31  the appointments required by that subsection must be made by the

2-32  successor in interest of the entity or, if there is not a successor in interest,

2-33  by the chairman of the commission.

2-34    3.  After the initial terms, each member of the commission serves a

2-35  term of 3 years. A member may be reappointed for an additional term. A

2-36  vacancy occurring in the membership of the commission must be filled in

2-37  the same manner as the original appointment.

2-38    4.  At its first meeting, and annually thereafter, the commission shall

2-39  elect a chairman from among its members. A member of the commission

2-40  may serve as chairman for more than one term.

2-41    Sec. 7.  1.  The commission shall meet at such times and places

2-42  specified by a call of the chairman or by a majority of the members of the

2-43  commission.

2-44    2.  A majority of the members of the commission constitute a quorum,

2-45  and a quorum may exercise all the powers and duties of the commission.

2-46    3.  The division shall provide the necessary staff to assist the

2-47  commission in carrying out its duties.

2-48    Sec. 8.  1.  Each member of the commission:

2-49    (a) Serves without compensation; and

3-1    (b) Except as otherwise provided in subsection 2, is entitled to receive

3-2  the per diem allowance and travel expenses provided for state officers

3-3  and employees generally.

3-4    2.  The members of the commission who are state employees are

3-5  entitled to receive the per diem allowance and travel expenses provided

3-6  for state officers and employees generally if they are required to attend to

3-7  the business of the commission outside Carson City.

3-8    3.  A claim for payment pursuant to the provisions of this section

3-9  must be made on a voucher approved by the chairman of the commission

3-10  and paid as other claims against the state are paid.

3-11    4.  The members of the commission who are state employees must be

3-12  relieved from their duties without loss of compensation to perform their

3-13  duties relating to the business of the commission in the most timely

3-14  manner practicable. The state employees must not be required to make

3-15  up or take annual or compensatory time for any period during which

3-16  they are relieved from their duties pursuant to the provisions of this

3-17  section.

3-18    Sec. 9.  The commission shall:

3-19    1.  Monitor and supervise each center;

3-20    2.  Encourage the availability of services at those centers for persons

3-21  with autism;

3-22    3.  Promote awareness of autism and facilitate advocacy for persons

3-23  with autism and their families;

3-24    4.  Provide consultation, training and technical assistance for persons

3-25  with autism and their families;

3-26    5.  Develop methods for consolidating services for autism that are

3-27  provided by more than one agency of this state;

3-28    6.  Conduct an assessment of the services that are provided in this

3-29  state for persons with autism and develop goals for the delivery of

3-30  services for autism in this state;

3-31    7.  Review any programs or other services provided for persons with

3-32  autism in other states and evaluate the appropriateness of providing

3-33  those programs or services in this state;

3-34    8.  Insofar as practicable, solicit recommendations from the families

3-35  of persons with autism concerning the services that are available in this

3-36  state for those persons and their families;

3-37    9.  Establish a statewide network of support for persons with autism

3-38  to encourage communication and the exchange of information

3-39  concerning autism between the families of those persons and persons

3-40  who provide services relating to the treatment of autism; and

3-41    10.  Submit recommendations to the department and the department

3-42  of education concerning the care and treatment of persons with autism.

3-43    Sec. 10.  1.  The commission shall establish a center in the northern

3-44  portion of this state and a center in the southern portion of this state. For

3-45  each center, the commission:

3-46    (a) Shall employ:

3-47      (1) A director who is qualified pursuant to section 15 of this act;

3-48      (2) An evaluator who is qualified pursuant to section 16 of this act;

4-1       (3) A diagnostician who is qualified pursuant to section 17 of this

4-2  act; and

4-3       (4) A program designer who is qualified pursuant to section 18 of

4-4  this act; and

4-5    (b) May employ one or more:

4-6       (1) Behavioral interventionists who are qualified pursuant to

4-7  section 19 of this act; or

4-8       (2) Case managers who are qualified pursuant to section 20 of this

4-9  act.

4-10    2.  The commission shall adopt regulations setting forth the

4-11  procedure by which a person with autism may apply to receive the

4-12  services of a center.

4-13    Sec. 11.  1.  Each center shall ensure that the following services are

4-14  available for each person with autism who is qualified to receive the

4-15  services and the members of his family:

4-16    (a) A network of support;

4-17    (b) The establishment of a team to provide services in accordance with

4-18  the provisions of section 14 of this act;

4-19    (c) A support staff;

4-20    (d) Programs to provide training in communication, academics, social

4-21  and vocational skills and daily living;

4-22    (e) Programs to provide recreation and leisure activities; and

4-23    (f) Any other service required by the commission.

4-24    2.  Each center may provide the services specified in subsection 1 or

4-25  refer a person who is qualified to receive those services to another

4-26  provider of those services.

4-27    3.  Each center may coordinate with any other person, including a

4-28  government, governmental agency or a political subdivision of a

4-29  government, to provide the services specified in subsection 1.

4-30    Sec. 12.  1.  Each center shall:

4-31    (a) Serve as a clearinghouse for information relating to autism;

4-32    (b) Provide advice and information relating to autism and any services

4-33  provided in this state for the treatment of autism; and

4-34    (c) Support activities that increase or improve those services within

4-35  the area of service of the center.

4-36    2.  Each center may conduct research relating to the treatment of

4-37  autism.

4-38    Sec. 13.  1.  Each center shall ensure that any person who is

4-39  assigned to the staff of any residential facility operated by the center:

4-40    (a) Is qualified for the position to which he is assigned in accordance

4-41  with regulations adopted by the commission; and

4-42    (b) Provides services at the residential facility in a gentle and humane

4-43  manner.

4-44    2.  Any services provided at a residential facility specified in

4-45  subsection 1 must, insofar as practicable, be:

4-46    (a) Designed to improve the well-being and quality of life of the

4-47  person for whom the services are provided;

5-1    (b) Designed to teach skills in accordance with the capacity of the

5-2  person to learn those skills as determined by the director of the center;

5-3  and

5-4    (c) Provided in the least restrictive manner as is practicable.

5-5    3.  Each center shall ensure that:

5-6    (a) Any services that are provided at the residential facility, including,

5-7  without limitation, any programs for training a person who receives

5-8  services at the residential facility, are monitored and supervised by a

5-9  person who is qualified to provide that monitoring and supervision as

5-10  determined by the director of the center; and

5-11    (b) The ratio of the number of persons receiving services at the

5-12  residential facility to the number of members of the staff of the

5-13  residential facility is sufficient to satisfy any requirements for health,

5-14  safety and treatment for each person who receives services at the facility.

5-15    4.  Each center shall review and consider any recommendations

5-16  submitted to the center concerning the provision of services at the

5-17  residential facility.

5-18    Sec. 14.  1.  If a person with autism is qualified to receive services

5-19  provided by a center and if requested by a member of his family, the

5-20  center shall establish a team to provide services for the person. The

5-21  members of the team may include:

5-22    (a) The person with autism, if determined to be appropriate by the

5-23  director of the center;

5-24    (b) Each member of his family who provides care directly to the

5-25  person, as determined by the director;

5-26    (c) A diagnostician employed by the center;

5-27    (d) A program designer employed by the center;

5-28    (e) A behavior interventionist employed by the center; and

5-29    (f) Any other person specified by the director.

5-30    2.  Each team established pursuant to subsection 1 shall, as soon a

5-31  practicable after it is established, conduct a meeting of the members of

5-32  the team and prepare a plan of service for the person. After conducting

5-33  the initial meeting and preparing the plan of service, the team shall

5-34  periodically conduct meetings to determine the effectiveness of the plan

5-35  and revise the plan if required to provide additional services to the person

5-36  or to ensure the effectiveness of the plan.

5-37    Sec. 15.  1.  Each director of a center must:

5-38    (a) Have a doctorate degree in psychology, education or a related

5-39  discipline approved by the commission;

5-40    (b) Have successfully completed courses relating to child and human

5-41  development and the theory of learning that are approved by the

5-42  commission;

5-43    (c) Have not less than 5 years of experience in the field of autism; and

5-44    (d) Possess the following knowledge and skills relating to autism:

5-45      (1) Knowledge of assessments, diagnoses, treatment and delivery of

5-46  services for persons with autism;

5-47      (2) Experience coordinating services and developing programs;

5-48      (3) Ability to develop plans for the treatment of autism;

6-1       (4) Ability to communicate with persons with autism and their

6-2  families;

6-3       (5) Knowledge of the manner in which treatment is provided for

6-4  persons with autism, including, without limitation, behavioral treatment;

6-5       (6) Ability to work with persons who have a severe mental or

6-6  physical disability;

6-7       (7) Ability to establish requirements for programs for behavioral

6-8  intervention, including, without limitation, the ability to supervise a

6-9  member of the staff of the center who administers behavioral

6-10  intervention; and

6-11      (8) Knowledge of and ability to use a functional behavioral

6-12  assessment and analysis and a plan to provide positive behavioral

6-13  support; and

6-14    (e) Satisfy any other requirements for qualification prescribed by the

6-15  commission.

6-16    2.  Each director of a center shall:

6-17    (a) Supervise the operation of the center;

6-18    (b) Coordinate the services provided by the center;

6-19    (c) Report periodically to the commission concerning the operation of

6-20  and services provided by the center;

6-21    (d) If requested by a person, refer the person to a diagnostician for an

6-22  evaluation pursuant to section 17 of this act; and

6-23    (e) Perform any other duties assigned to him by the commission.

6-24    Sec. 16.  1.  Each evaluator employed by the commission pursuant

6-25  to section 10 of this act must:

6-26    (a) Have received a bachelor’s degree from a college or university

6-27  approved by the commission;

6-28    (b) Have the ability to:

6-29      (1) Interview and communicate with persons with autism and their

6-30  families; and

6-31      (2) Document and report information obtained during an

6-32  evaluation of a person with autism to determine the services that are

6-33  available from the center for that person; and

6-34    (c) Satisfy any other requirements for qualification prescribed by the

6-35  commission.

6-36    2.  Each evaluator shall:

6-37    (a) Prepare and maintain a registry that includes the name of each

6-38  person with autism who resides within the area of service of the center

6-39  where the evaluator is employed;

6-40    (b) Monitor any services relating to the treatment of autism that are

6-41  provided in this state to determine the effectiveness of those services;

6-42    (c) Upon the request of a member of the family of a person with

6-43  autism, provide assistance to the member of the family to ensure that any

6-44  services provided to the person with autism are appropriate for him; and

6-45    (d) Perform any other duties assigned to him by the commission or the

6-46  director of the center.

6-47    Sec. 17.  1.  Each diagnostician employed by the commission

6-48  pursuant to section 10 of this act must:

7-1    (a) Be a physician, psychiatrist or psychologist who is licensed to

7-2  practice in this state;

7-3    (b) Have not less than 5 years of experience working with persons

7-4  with autism or a related disorder specified by the commission; and

7-5    (c) Satisfy any other requirements for qualification prescribed by the

7-6  commission.

7-7    2.  Each diagnostician shall, for each person who is referred to him

7-8  by the director:

7-9    (a) Conduct an evaluation of the person to determine whether he has

7-10  autism and, if so, whether he is qualified to receive services at the center

7-11  or from any other person approved by the commission to provide those

7-12  services;

7-13    (b) Determine whether the person has any conditions specified by the

7-14  commission; and

7-15    (c) Perform any other duties assigned to him by the commission or the

7-16  director of the center.

7-17    3.  In conducting an evaluation of a person specified in subsection 2,

7-18  the diagnostician shall consider:

7-19    (a) The characteristics of autism;

7-20    (b) The level at which the person is able to function, including,

7-21  without limitation, his strengths and weaknesses; and

7-22    (c) Whether the person exhibits any conditions specified by the

7-23  commission.

7-24    Sec. 18.  1.  Each program designer employed by the commission

7-25  pursuant to section 10 of this act must:

7-26    (a) Have received a bachelor’s degree from a college or university

7-27  approved by the commission;

7-28    (b) Have not less than 1 year of experience under the supervision of a

7-29  person who:

7-30      (1) Has a doctorate degree in a discipline approved by the

7-31  commission; and

7-32      (2) Has obtained such training and skills as are prescribed by the

7-33  commission in developing and carrying out plans for behavioral

7-34  intervention; and

7-35    (c) Satisfy any other requirements for qualification prescribed by the

7-36  commission.

7-37    2.  Each program designer shall:

7-38    (a) Prepare a plan for behavioral intervention for each person who

7-39  receives services at the center;

7-40    (b) Coordinate the administration of any strategy of intervention used

7-41  by a behavioral interventionist employed by the center;

7-42    (c) Supervise each behavioral interventionist employed by the center;

7-43    (d) Insofar as practicable:

7-44      (1) Coordinate the administration of the plan prepared pursuant to

7-45  paragraph (a) with any other person or agency that provides services for

7-46  the treatment of autism to the person for whom the plan is prepared or

7-47  the members of his family; and

7-48      (2) Ensure that each person and agency specified in subparagraph

7-49  (1) understands the provisions of the plan; and

8-1    (e) Perform any other duties assigned to him by the commission or the

8-2  director of the center.

8-3    3.  In carrying out his duties, the program designer shall:

8-4    (a) Assess the results of any diagnostic tests administered to a person

8-5  who receives services at the center;

8-6    (b) Review the family history of the person;

8-7    (c) Identify the behavioral characteristics of the person; and

8-8    (d) Insofar as practicable, ensure that the services provided to the

8-9  person, including the provisions of the plan prepared pursuant to

8-10  subsection 2, are appropriate for the person.

8-11    4.  In preparing a plan specified in subsection 2, the program

8-12  designer may use any behavioral method prescribed by the commission.

8-13    Sec. 19.  1.  Each behavioral interventionist employed by the

8-14  commission pursuant to section 10 of this act must:

8-15    (a) Obtain such training and skills as are prescribed by the

8-16  commission;

8-17    (b) Have knowledge of and the ability to administer any behavioral

8-18  assessments and strategies specified by the commission; and

8-19    (c) Satisfy any other requirements for qualification prescribed by the

8-20  commission.

8-21    2.  Each behavioral interventionist shall:

8-22    (a) Work directly with each person for whom a plan of behavioral

8-23  intervention is prepared pursuant to section 18 of this act and his family

8-24  to change the behavior of the person by using methods for intervention

8-25  and skills for development specified by the commission;

8-26    (b) Assist the family in administering the plan of behavioral

8-27  intervention;

8-28    (c) Collect information concerning the effectiveness of the plan of

8-29  behavioral intervention and review the plan in consultation with the

8-30  family and the program designer to determine whether any revision of

8-31  the plan is required to ensure the effectiveness of the plan; and

8-32    (d) Perform any other duties assigned to him by the commission or

8-33  director of the center.

8-34    3.  Each behavioral interventionist must complete a probationary

8-35  period specified by the commission. During the probationary period, the

8-36  program designer shall directly supervise the behavioral interventionist

8-37  to ensure that he satisfactorily performs the duties set forth in subsection

8-38  2. After the expiration of the probationary period, the behavioral

8-39  interventionist may perform those duties without the direct supervision of

8-40  the program designer.

8-41    Sec. 20.  1.  Each case manager employed by the commission

8-42  pursuant to section 10 of this act must obtain such training and

8-43  education as are prescribed by the commission.

8-44    2.  Each case manager shall for each person who receives services at

8-45  the center:

8-46    (a) Coordinate the meetings of the team established for the person

8-47  pursuant to section 14 of this act;

8-48    (b) Ensure that any plan for providing services to the person at the

8-49  center is carried out, including, without limitation, ensuring that any

9-1  evaluations required by the plan are conducted and any additional care is

9-2  provided to the person;

9-3    (c) Communicate regularly with the family of the person;

9-4    (d) Prepare and maintain a record of each meeting specified in

9-5  paragraph (a) and any services provided by the center to the person or

9-6  his family;

9-7    (e) Determine whether any services for the person are available from

9-8  any other person and whether any money is available to pay for those

9-9  services; and

9-10    (f) Perform any other duties assigned to him by the commission or

9-11  director.

9-12    Sec. 21.  The commission may:

9-13    1.  Employ such professional, technical and clerical staff as are

9-14  necessary to assist the commission in carrying out the provisions of

9-15  sections 2 to 22, inclusive, of this act;

9-16    2.  Cooperate with any person, including any government,

9-17  governmental agency or political subdivision of a government, to:

9-18    (a) Provide services to persons with autism; or

9-19    (b) Avoid duplication of or obtain money to pay for those services;

9-20    3.  Prepare and submit to the director of the legislative counsel

9-21  bureau for transmittal to the legislature any recommendations for

9-22  legislation relating to autism; and

9-23    4.  Apply for and accept any gift, grant, appropriation or donation,

9-24  and use the gift, grant, appropriation or donation to carry out its duties

9-25  pursuant to the provisions of sections 2 to 22, inclusive, of this act.

9-26    Sec. 22.  The commission shall adopt regulations to carry out the

9-27  provisions of sections 2 to 22, inclusive, of this act. The regulations must

9-28  include, without limitation, provisions that set forth:

9-29    1.  The procedure by which:

9-30    (a) A person who provides care in his home for a person with autism

9-31  may apply to the commission for a grant of money from the commission

9-32  to assist the person in providing that care; and

9-33    (b) A residential care center that provides residential services to a

9-34  person with autism may apply for such a grant to increase the rates of

9-35  reimbursement to the residential care center; and

9-36    2.  The criteria that the commission will consider in determining

9-37  whether to award a grant of money.

9-38    Sec. 23.  1.  The appointment of the members of the commission on

9-39  autism created by section 6 of this act must be made as soon as practicable

9-40  after July 1, 2001.

9-41    2.  As soon as practicable after all the members of the commission are

9-42  appointed, the members of the commission shall, by lot, choose:

9-43    (a) Three members whose terms expire on June 30, 2002;

9-44    (b) Four members whose terms expire on June 30, 2003; and

9-45    (c) Five members whose terms expire on June 30, 2004.

9-46    Sec. 24.  1.  There is hereby appropriated from the state general fund

9-47  to the division of mental health and developmental services of the

9-48  department of human resources the sum of $700,000 to pay that portion of

9-49  the costs to carry out the provisions of sections 2 to 22, inclusive, of this

10-1  act that is not covered by grants from the fund for a healthy Nevada or by

10-2  discretionary money available to the University Affiliated Project of the

10-3  University of Nevada, Reno, and the department of employment, training

10-4  and rehabilitation.

10-5    2.  Any remaining balance of the appropriation made by subsection 1

10-6  must not be committed for expenditure after June 30, 2003, and reverts to

10-7  the state general fund as soon as all payments of money committed have

10-8  been made.

10-9    Sec. 25.  1.  This section and section 24 of this act become effective

10-10  upon passage and approval.

10-11  2.  Sections 1 to 23, inclusive, of this act become effective on July 1,

10-12  2001.

 

10-13  H