(REPRINTED WITH ADOPTED AMENDMENTS)
SECOND REPRINT S.B. 539
Senate Bill No. 539–Committee on Human Resources and Facilities
(On Behalf of Department of Human
Resources—Director's Office)
March 26, 2001
____________
Referred to Committee on Human Resources and Facilities
SUMMARY—Makes various changes concerning fund for a healthy Nevada and program to provide prescription drugs and pharmaceutical services to senior citizens with low incomes under certain circumstances. (BDR 40‑536)
FISCAL NOTE: Effect on Local Government: No.
~
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).
AN ACT relating to the fund for a healthy Nevada; providing that a portion of the money in the fund may be used to pay certain administrative costs incurred by the state treasurer and the department of human resources; providing for the appointment and terms of office of certain officers of the task force; revising the program of subsidies for the provision of prescription drugs and pharmaceutical services to senior citizens; directing the development of an additional subsidized state program to provide prescription drugs and pharmaceutical services to senior citizens with low incomes and repealing the existing insurance-based program under certain circumstances; 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 439 of NRS is hereby amended by adding thereto
1-2 the provisions set forth as sections 2 to 10, inclusive, of this act.
1-3 Sec. 2. As used in sections 2 to 10, 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. “Household income” has the meaning ascribed to it in NRS
1-7 361.820.
1-8 Sec. 4. “Income” has the meaning ascribed to it in NRS 361.823.
1-9 Sec. 5. “Senior citizen” means a person who is domiciled in this
1-10 state and is 62 years of age or older.
2-1 Sec. 6. The department is responsible for the administration of the
2-2 provisions of sections 2 to 10, inclusive, of this act and may:
2-3 1. Prescribe the content and form of a request for a subsidy required
2-4 to be submitted pursuant to section 9 of this act.
2-5 2. Designate the proof that must be submitted with such a request.
2-6 3. Adopt regulations to protect the confidentiality of information
2-7 supplied by a senior citizen requesting a subsidy pursuant to section 9 of
2-8 this act.
2-9 4. Adopt such other regulations as may be required to carry out the
2-10 provisions of sections 2 to 10, inclusive, of this act.
2-11 Sec. 7. The department of human resources shall, in cooperation
2-12 with the department of taxation and the various counties in this state:
2-13 1. Combine all possible administrative procedures required for
2-14 determining those persons who are eligible for assistance pursuant to
2-15 NRS 361.800 to 361.877, inclusive, and sections 2 to 10, inclusive, of this
2-16 act;
2-17 2. Coordinate the collection of information required to carry out
2-18 those provisions in a manner that requires persons requesting assistance
2-19 to furnish information in as few reports as possible; and
2-20 3. Design forms that may be used jointly by the department of human
2-21 resources, the department of taxation and the various counties in this
2-22 state to carry out the provisions of NRS 361.800 to 361.877, inclusive,
2-23 and sections 2 to 10, inclusive, of this act.
2-24 Sec. 8. 1. The department shall, within the limits of the money
2-25 available for this purpose in the fund for a healthy Nevada, develop and
2-26 carry out a program for senior citizens to provide prescription drugs and
2-27 pharmaceutical services to them at a subsidized cost whereby the state
2-28 will pay the difference between the copayment required by the program
2-29 and the actual cost of the drug from the pharmacist. The department
2-30 shall refer to this program as the “Senior Option Program” and cause it
2-31 to be marketed under that name.
2-32 2. Within the limits of the money available for this purpose in the
2-33 fund for a healthy Nevada, a senior citizen who:
2-34 (a) Is not eligible for Medicaid; and
2-35 (b) Is accepted into the program that is made available pursuant to
2-36 subsection 1,
2-37 is entitled to an annual grant from the trust fund to subsidize a portion of
2-38 the cost of his prescription drugs and pharmaceutical services if he has
2-39 been domiciled in this state for at least 1 year immediately preceding the
2-40 date of his application and his household income is less than $21,500.
2-41 3. The department may pay its costs for administering this program
2-42 from the fund for a healthy Nevada and shall include as components of
2-43 the subsidized program:
2-44 (a) A maximum annual application fee of $25.
2-45 (b) A requirement that a generic drug be used to fill the prescription,
2-46 unless the substitution of a generic drug for a drug with a brand name is
2-47 specifically prohibited by the provider of health care who issued the
2-48 prescription.
3-1 (c) A maximum required copayment for generic drugs of $10 per
3-2 prescription.
3-3 (d) A maximum required copayment for nongeneric drugs of $25 per
3-4 prescription.
3-5 (e) The formulary for the program must be the same formulary as is
3-6 used for the state plan for Medicaid.
3-7 (f) The maximum limitation per year on the subsidy each person may
3-8 receive under this program is $5,000.
3-9 (g) Allow persons who are participating in the program to fill their
3-10 prescriptions by mail.
3-11 (h) A maximum of $100 as the amount of deductible expenses that
3-12 may be required of participants before they are eligible to receive benefits
3-13 under this program.
3-14 (i) The rebates from pharmaceutical manufacturers for drugs
3-15 purchased through this program must be at least equal to the rebates
3-16 provided for drugs purchased pursuant to the state plan for Medicaid and
3-17 must be deposited in the fund for a healthy Nevada to support this
3-18 program.
3-19 (j) A pharmacy benefits manager may be hired by contract to assist in
3-20 the development and administration of this program, if deemed advisable
3-21 and fiscally prudent by the department.
3-22 (k) The rates negotiated by the department or its representative for the
3-23 prescription drugs sold by the pharmacies that agree to participate in this
3-24 program must not be more than the rates charged to the department
3-25 under the state plan for Medicaid, if not the best and lowest prices
3-26 available from the pharmacy to any customer.
3-27 4. If the Federal Government provides any coverage of prescription
3-28 drugs and pharmaceutical services for senior citizens who are eligible for
3-29 a subsidy pursuant to subsections 1, 2 and 3, the department may, upon
3-30 approval of the legislature, or the interim finance committee if the
3-31 legislature is not in session, change any program established pursuant to
3-32 sections 2 to 10, inclusive, of this act and otherwise provide assistance
3-33 with prescription drugs and pharmaceutical services for senior citizens
3-34 within the limits of the money available for this purpose in the fund for a
3-35 healthy Nevada.
3-36 5. The provisions of subsections 1, 2 and 3 do not apply if the
3-37 department provides assistance with prescription drugs and
3-38 pharmaceutical services for senior citizens pursuant to subsection 4.
3-39 6. The department may waive the eligibility requirement set forth in
3-40 subsection 2 regarding household income upon written request of the
3-41 applicant if the circumstances of the applicant’s household have changed
3-42 as a result of:
3-43 (a) Illness;
3-44 (b) Disability; or
3-45 (c) Extreme financial hardship based on a significant reduction of
3-46 income, when considering the applicant’s current financial
3-47 circumstances.
3-48 An applicant who requests such a waiver shall include with that request
3-49 all medical and financial documents that support his request.
4-1 Sec. 9. 1. A senior citizen who wishes to receive a subsidy pursuant
4-2 to sections 2 to 10, inclusive, of this act must file a request therefor with
4-3 the department.
4-4 2. The request must be made under oath and filed in such form and
4-5 content, and accompanied by such proof, as the department may
4-6 prescribe.
4-7 3. The department shall, within 45 days after receiving a request for
4-8 a subsidy, examine the request and grant or deny it.
4-9 4. The department shall determine which senior citizens are eligible
4-10 to receive a subsidy pursuant to sections 2 to 10, inclusive, of this act and
4-11 pay the subsidy in the manner set forth in the program.
4-12 Sec. 10. 1. The department shall deny any request for a subsidy
4-13 received pursuant to sections 2 to 10, inclusive, of this act to which the
4-14 senior citizen is not entitled.
4-15 2. The department may deny in total any request which it finds to
4-16 have been filed with fraudulent intent. If any such request has been paid
4-17 and is afterward denied, the amount of the subsidy must be repaid by the
4-18 senior citizen to the department.
4-19 3. Any amounts received by the department pursuant to this section
4-20 must be deposited with the state treasurer for credit to the fund for a
4-21 healthy Nevada for credit to this program.
4-22 Sec. 11. NRS 439.620 is hereby amended to read as follows:
4-23 439.620 1. The fund for a healthy Nevada is hereby created in the
4-24 state treasury. The state treasurer shall deposit in the fund:
4-25 (a) Fifty percent of all money received by this state pursuant to any
4-26 settlement entered into by the State of Nevada and a manufacturer of
4-27 tobacco products; and
4-28 (b) Fifty percent of all money recovered by this state from a judgment
4-29 in a civil action against a manufacturer of tobacco products.
4-30 2. The state treasurer shall administer the fund. As administrator of the
4-31 fund, the state treasurer:
4-32 (a) Shall maintain the financial records of the fund;
4-33 (b) Shall invest the money in the fund as the money in other state funds
4-34 is invested;
4-35 (c) Shall manage any account associated with the fund;
4-36 (d) Shall maintain any instruments that evidence investments made with
4-37 the money in the fund;
4-38 (e) May contract with vendors for any good or service that is necessary
4-39 to carry out the provisions of this section; and
4-40 (f) May perform any other duties necessary to administer the fund.
4-41 3. The interest and income earned on the money in the fund must, after
4-42 deducting any applicable charges, be credited to the fund. All claims
4-43 against the fund must be paid as other claims against the state are paid.
4-44 4. Upon receiving a request from the state treasurer or the
4-45 department for an allocation for administrative expenses from the fund
4-46 pursuant to this section, the task force shall consider the request within
4-47 45 days after receipt of the request. If the task force approves the amount
4-48 requested for allocation, the task force shall notify the state treasurer of
4-49 the allocation. If the task force does not approve the requested allocation
5-1 within 45 days after receipt of the request, the state treasurer or the
5-2 department, as applicable, may submit its request for allocation to the
5-3 interim finance committee. Except as otherwise limited by this
5-4 subsection, the interim finance committee may allocate all or part of the
5-5 money so requested. The annual allocation for administrative expenses
5-6 from the fund, whether allocated by the task force or the interim finance
5-7 committee must not exceed:
5-8 (a) Not more than 2 percent of the money in the fund [may be used] , as
5-9 calculated pursuant to this subsection, each year to pay the costs [of
5-10 administering] incurred by the state treasurer to administer the fund[.] ;
5-11 and
5-12 (b) Not more than 3 percent of the money in the fund, as calculated
5-13 pursuant to this subsection, each year to pay the costs incurred by the
5-14 department, including, without limitation, the aging services division of
5-15 the department, to carry out its duties set forth in NRS 439.625 to
5-16 439.690, inclusive.
5-17 For the purposes of this subsection, the amount of money available for
5-18 allocation to pay for the administrative costs must be calculated at the
5-19 beginning of each fiscal year based on the total amount of money
5-20 anticipated by the state treasurer to be deposited in the fund during that
5-21 fiscal year.
5-22 5. The money in the fund remains in the fund and does not revert to the
5-23 state general fund at the end of any fiscal year.
5-24 6. All money that is deposited or paid into the fund is hereby
5-25 appropriated to the department and, except as otherwise provided in
5-26 paragraphs (c) and (d) of subsection 1 of NRS 439.630, may only be
5-27 expended pursuant to an allocation made by the task force for the fund for
5-28 a healthy Nevada. Money expended from the fund for a healthy Nevada
5-29 must not be used to supplant existing methods of funding that are available
5-30 to public agencies.
5-31 Sec. 12. NRS 439.620 is hereby amended to read as follows:
5-32 439.620 1. The fund for a healthy Nevada is hereby created in the
5-33 state treasury. The state treasurer shall deposit in the fund:
5-34 (a) Fifty percent of all money received by this state pursuant to any
5-35 settlement entered into by the State of Nevada and a manufacturer of
5-36 tobacco products; and
5-37 (b) Fifty percent of all money recovered by this state from a judgment
5-38 in a civil action against a manufacturer of tobacco products.
5-39 2. The state treasurer shall administer the fund. As administrator of the
5-40 fund, the state treasurer:
5-41 (a) Shall maintain the financial records of the fund;
5-42 (b) Shall invest the money in the fund as the money in other state funds
5-43 is invested;
5-44 (c) Shall manage any account associated with the fund;
5-45 (d) Shall maintain any instruments that evidence investments made with
5-46 the money in the fund;
5-47 (e) May contract with vendors for any good or service that is necessary
5-48 to carry out the provisions of this section; and
5-49 (f) May perform any other duties necessary to administer the fund.
6-1 3. The interest and income earned on the money in the fund must, after
6-2 deducting any applicable charges, be credited to the fund. All claims
6-3 against the fund must be paid as other claims against the state are paid.
6-4 4. Upon receiving a request from the state treasurer or the department
6-5 for an allocation for administrative expenses from the fund pursuant to this
6-6 section, the task force shall consider the request within 45 days after
6-7 receipt of the request. If the task force approves the amount requested for
6-8 allocation, the task force shall notify the state treasurer of the allocation. If
6-9 the task force does not approve the requested allocation within 45 days
6-10 after receipt of the request, the state treasurer or the department, as
6-11 applicable, may submit its request for allocation to the interim finance
6-12 committee. Except as otherwise limited by this subsection, the interim
6-13 finance committee may allocate all or part of the money so requested. The
6-14 annual allocation for administrative expenses from the fund, whether
6-15 allocated by the task force or the interim finance committee must not
6-16 exceed:
6-17 (a) Not more than 2 percent of the money in the fund, as calculated
6-18 pursuant to this subsection, each year to pay the costs incurred by the state
6-19 treasurer to administer the fund; and
6-20 (b) Not more than 3 percent of the money in the fund, as calculated
6-21 pursuant to this subsection, each year to pay the costs incurred by the
6-22 department, including, without limitation, the aging services division of
6-23 the department, to carry out its duties set forth in NRS 439.625 [to
6-24 439.690, inclusive,] , 439.630, and sections 2 to 10, inclusive, of this
6-25 act.
6-26 For the purposes of this subsection, the amount of money available for
6-27 allocation to pay for the administrative costs must be calculated at the
6-28 beginning of each fiscal year based on the total amount of money
6-29 anticipated by the state treasurer to be deposited in the fund during that
6-30 fiscal year.
6-31 5. The money in the fund remains in the fund and does not revert to the
6-32 state general fund at the end of any fiscal year.
6-33 6. All money that is deposited or paid into the fund is hereby
6-34 appropriated to the department and, except as otherwise provided in
6-35 paragraphs (c) and (d) of subsection 1 of NRS 439.630, may only be
6-36 expended pursuant to an allocation made by the task force for the fund for
6-37 a healthy Nevada. Money expended from the fund for a healthy Nevada
6-38 must not be used to supplant existing methods of funding that are available
6-39 to public agencies.
6-40 Sec. 13. NRS 439.625 is hereby amended to read as follows:
6-41 439.625 1. The task force for the fund for a healthy Nevada is hereby
6-42 created. The membership of the task force consists of:
6-43 (a) Three members appointed by the majority leader of the senate, one
6-44 of whom must be a senator and one of whom must be a member of a
6-45 nonprofit organization dedicated to health issues in this state; [and]
6-46 (b) Three members appointed by the speaker of the assembly, one of
6-47 whom must be an assemblyman and one of whom must be a member of a
6-48 nonprofit organization dedicated to health issues in this state; and
7-1 (c) Three members appointed by the governor, one of whom must
7-2 have experience with and knowledge of matters relating to health
7-3 care.
7-4 Each member appointed pursuant to this subsection must be a resident of
7-5 this state and must not be employed in the executive or judicial branch of
7-6 state government.
7-7 [2.] Each person who appoints members pursuant to this subsection [1]
7-8 shall ensure that insofar as practicable, the members whom he appoints
7-9 reflect the ethnic and geographical diversity of this state.
7-10 2. At its first meeting on or after July 1 of each odd-numbered year,
7-11 the task force shall select the chairman and vice chairman of the task
7-12 force from among the legislative members of the task force. Each such
7-13 officer shall hold office for a term of 2 years or until his successor is
7-14 selected. The chairmanship of the task force must alternate each
7-15 biennium between the houses of the legislature.
7-16 3. For each day or portion of a day during which a member of the task
7-17 force who is a legislator attends a meeting of the task force or is otherwise
7-18 engaged in the work of the task force, except during a regular or special
7-19 session of the legislature, he is entitled to receive the:
7-20 (a) Compensation provided for a majority of the members of the
7-21 legislature during the first 60 days of the preceding session;
7-22 (b) Per diem allowance provided for state officers and employees
7-23 generally; and
7-24 (c) Travel expenses provided pursuant to NRS 218.2207.
7-25 The compensation, per diem allowances and travel expenses of the
7-26 legislative members of the task force must be paid from the legislative
7-27 fund.
7-28 4. Members of the task force who are not legislators serve without
7-29 salary, except that they are entitled to receive travel expenses provided for
7-30 state officers and employees generally. The travel expenses of:
7-31 (a) A member of the task force who is an officer or employee of a local
7-32 government thereof must be paid by the local government that employs
7-33 him.
7-34 (b) Each remaining member of the task force must be paid from the
7-35 legislative fund.
7-36 5. Each member of the task force who is an officer or employee of a
7-37 local government must be relieved from his duties without loss of his
7-38 regular compensation so that he may perform his duties relating to the task
7-39 force in the most timely manner practicable. A local government shall not
7-40 require an officer or employee who is a member of the task force to:
7-41 (a) Make up the time he is absent from work to fulfill his obligations as
7-42 a member of the task force; or
7-43 (b) Take annual leave or compensatory time for the absence.
7-44 6. The legislative counsel bureau and the department shall provide
7-45 such administrative support to the task force as is required to carry out the
7-46 duties of the task force. The state health officer shall provide such technical
7-47 advice and assistance to the task force as is requested by the task force.
7-48 Sec. 14. NRS 439.630 is hereby amended to read as follows:
7-49 439.630 1. The task force for the fund for a healthy Nevada shall:
8-1 (a) Conduct public hearings to accept public testimony from a wide
8-2 variety of sources and perspectives regarding existing or proposed
8-3 programs that:
8-4 (1) Promote public health;
8-5 (2) Improve health services for children, senior citizens and persons
8-6 with disabilities;
8-7 (3) Reduce or prevent the use of tobacco;
8-8 (4) Reduce or prevent the abuse of and addiction to alcohol and
8-9 drugs; and
8-10 (5) Offer other general or specific information on health care in this
8-11 state.
8-12 (b) Establish a process to evaluate the health and health needs of the
8-13 residents of this state and a system to rank the health problems of the
8-14 residents of this state, including, without limitation, the specific health
8-15 problems that are endemic to urban and rural communities.
8-16 (c) Reserve not more than 30 percent of all revenues deposited in the
8-17 fund for a healthy Nevada each year for direct expenditure by the
8-18 department to pay for prescription drugs and pharmaceutical services for
8-19 senior citizens pursuant to NRS 439.635 to 439.690, inclusive. From the
8-20 money reserved to the department pursuant to this paragraph, the
8-21 department shall subsidize all of the cost of policies of health insurance
8-22 that provide coverage to senior citizens for prescription drugs and
8-23 pharmaceutical services pursuant to NRS 439.635 to 439.690, inclusive.
8-24 The department shall consider recommendations from the task force for
8-25 the fund for a healthy Nevada in carrying out the provisions of NRS
8-26 439.635 to 439.690, inclusive. The department shall submit a quarterly
8-27 report to the governor , the task force for the fund for a healthy Nevada
8-28 and the interim finance committee regarding the general manner in which
8-29 expenditures have been made pursuant to this paragraph and the status of
8-30 the program.
8-31 (d) Reserve not more than 30 percent of all revenues deposited in the
8-32 fund for a healthy Nevada each year for allocation by the aging services
8-33 division of the department in the form of grants for existing or new
8-34 programs that assist senior citizens with independent living, including,
8-35 without limitation, programs that provide:
8-36 (1) Respite care or relief of family caretakers;
8-37 (2) Transportation to new or existing services to assist senior citizens
8-38 in living independently; and
8-39 (3) Care in the home which allows senior citizens to remain at home
8-40 instead of in institutional care.
8-41 The aging services division of the department shall consider
8-42 recommendations from the task force for the fund for a healthy Nevada
8-43 concerning the independent living needs of senior citizens.
8-44 (e) Allocate for expenditure not more than 20 percent of all revenues
8-45 deposited in the fund for a healthy Nevada each year for programs that
8-46 prevent, reduce or treat the use of tobacco and the consequences of the use
8-47 of tobacco.
8-48 (f) Allocate for expenditure not more than 20 percent of all revenues
8-49 deposited in the fund [each year] for a healthy Nevada each year for
9-1 programs that improve health services for children and [for] the health and
9-2 well-being of persons with disabilities.
9-3 (g) Maximize expenditures through local, federal and private matching
9-4 contributions.
9-5 (h) Ensure that any money expended from the fund for a healthy
9-6 Nevada will not be used to supplant existing methods of funding that are
9-7 available to public agencies.
9-8 (i) Develop policies and procedures for the administration and
9-9 distribution of grants and other expenditures to state agencies, political
9-10 subdivisions of this state, nonprofit organizations, universities and
9-11 community colleges. A condition of any such grant must be that not more
9-12 than 8 percent of the grant may be used for administrative expenses or
9-13 other indirect costs. The procedures must require at least one competitive
9-14 round of requests for proposals [.] per fiscal year.
9-15 (j) To make the allocations required by paragraphs (e) and (f) : [of
9-16 subsection 1:]
9-17 (1) Prioritize and quantify the needs for these programs;
9-18 (2) Develop, solicit and accept grant applications for allocations;
9-19 (3) Conduct annual evaluations of programs to which allocations
9-20 have been awarded; and
9-21 (4) Submit annual reports concerning the programs to the governor
9-22 and the interim finance committee.
9-23 (k) Transmit a report of all findings, recommendations and expenditures
9-24 to the governor and each regular session of the legislature.
9-25 2. The task force may take such other actions as are necessary to carry
9-26 out its duties.
9-27 3. The department shall take all actions necessary to ensure that all
9-28 allocations for expenditures made by the task force are carried out as
9-29 directed by the task force.
9-30 4. To make the allocations required by paragraph (d) of subsection 1,
9-31 the aging services division of the department shall:
9-32 (a) Prioritize and quantify the needs of senior citizens for these
9-33 programs;
9-34 (b) Develop, solicit and accept grant applications for allocations;
9-35 (c) As appropriate, expand or augment existing state programs for
9-36 senior citizens upon approval of the interim finance committee;
9-37 (d) Award grants or other allocations;
9-38 (e) Conduct annual evaluations of programs to which grants or other
9-39 allocations have been awarded; and
9-40 (f) Submit annual reports concerning the grant program to the governor
9-41 and the interim finance committee.
9-42 5. The aging services division of the department shall submit each
9-43 proposed grant which would be used to expand or augment an existing
9-44 state program to the interim finance committee for approval before the
9-45 grant is awarded. The request for approval must include a description of
9-46 the proposed use of the money and the person or entity that would be
9-47 authorized to expend the money. The aging services division of the
9-48 department shall not expend or transfer any money allocated to the aging
9-49 services division pursuant to this section to subsidize any portion of the
10-1 cost of policies of health insurance that provide coverage to senior
10-2 citizens for prescription drugs and pharmaceutical services pursuant to
10-3 NRS 439.635 to 439.690, inclusive.
10-4 6. The department, on behalf of the task force, shall submit each
10-5 allocation proposed pursuant to paragraph (e) or (f) of subsection 1 which
10-6 would be used to expand or augment an existing state program to the
10-7 interim finance committee for approval before the grant is awarded. The
10-8 request for approval must include a description of the proposed use of the
10-9 money and the person or entity that would be authorized to expend the
10-10 money.
10-11 Sec. 15. NRS 439.630 is hereby amended to read as follows:
10-12 439.630 1. The task force for the fund for a healthy Nevada shall:
10-13 (a) Conduct public hearings to accept public testimony from a wide
10-14 variety of sources and perspectives regarding existing or proposed
10-15 programs that:
10-16 (1) Promote public health;
10-17 (2) Improve health services for children, senior citizens and persons
10-18 with disabilities;
10-19 (3) Reduce or prevent the use of tobacco;
10-20 (4) Reduce or prevent the abuse of and addiction to alcohol and
10-21 drugs; and
10-22 (5) Offer other general or specific information on health care in this
10-23 state.
10-24 (b) Establish a process to evaluate the health and health needs of the
10-25 residents of this state and a system to rank the health problems of the
10-26 residents of this state, including, without limitation, the specific health
10-27 problems that are endemic to urban and rural communities.
10-28 (c) Reserve not more than 30 percent of all revenues deposited in the
10-29 fund for a healthy Nevada each year for direct expenditure by the
10-30 department to pay for prescription drugs and pharmaceutical services for
10-31 senior citizens pursuant to [NRS 439.635 to 439.690, inclusive.] sections 2
10-32 to 10, inclusive, of this act. From the money reserved to the department
10-33 pursuant to this paragraph, the department shall subsidize all of the cost of
10-34 policies of health insurance that provide coverage to senior citizens for
10-35 prescription drugs and pharmaceutical services pursuant to [NRS 439.635
10-36 to 439.690, inclusive.] sections 2 to 10, inclusive, of this act. The
10-37 department shall consider recommendations from the task force for the
10-38 fund for a healthy Nevada in carrying out the provisions of [NRS 439.635
10-39 to 439.690, inclusive.] sections 2 to 10, inclusive, of this act. The
10-40 department shall submit a quarterly report to the governor, the task force
10-41 for the fund for a healthy Nevada and the interim finance committee
10-42 regarding the general manner in which expenditures have been made
10-43 pursuant to this paragraph and the status of the program.
10-44 (d) Reserve not more than 30 percent of all revenues deposited in the
10-45 fund for a healthy Nevada each year for allocation by the aging services
10-46 division of the department in the form of grants for existing or new
10-47 programs that assist senior citizens with independent living, including,
10-48 without limitation, programs that provide:
10-49 (1) Respite care or relief of family caretakers;
11-1 (2) Transportation to new or existing services to assist senior citizens
11-2 in living independently; and
11-3 (3) Care in the home which allows senior citizens to remain at home
11-4 instead of in institutional care.
11-5 The aging services division of the department shall consider
11-6 recommendations from the task force for the fund for a healthy Nevada
11-7 concerning the independent living needs of senior citizens.
11-8 (e) Allocate for expenditure not more than 20 percent of all revenues
11-9 deposited in the fund for a healthy Nevada each year for programs that
11-10 prevent, reduce or treat the use of tobacco and the consequences of the use
11-11 of tobacco.
11-12 (f) Allocate for expenditure not more than 20 percent of all revenues
11-13 deposited in the fund for a healthy Nevada each year for programs that
11-14 improve health services for children and the health and well-being of
11-15 persons with disabilities.
11-16 (g) Maximize expenditures through local, federal and private matching
11-17 contributions.
11-18 (h) Ensure that any money expended from the fund for a healthy
11-19 Nevada will not be used to supplant existing methods of funding that are
11-20 available to public agencies.
11-21 (i) Develop policies and procedures for the administration and
11-22 distribution of grants and other expenditures to state agencies, political
11-23 subdivisions of this state, nonprofit organizations, universities and
11-24 community colleges. A condition of any such grant must be that not more
11-25 than 8 percent of the grant may be used for administrative expenses or
11-26 other indirect costs. The procedures must require at least one competitive
11-27 round of requests for proposals per fiscal year.
11-28 (j) To make the allocations required by paragraphs (e) and (f):
11-29 (1) Prioritize and quantify the needs for these programs;
11-30 (2) Develop, solicit and accept grant applications for allocations;
11-31 (3) Conduct annual evaluations of programs to which allocations
11-32 have been awarded; and
11-33 (4) Submit annual reports concerning the programs to the governor
11-34 and the interim finance committee.
11-35 (k) Transmit a report of all findings, recommendations and expenditures
11-36 to the governor and each regular session of the legislature.
11-37 2. The task force may take such other actions as are necessary to carry
11-38 out its duties.
11-39 3. The department shall take all actions necessary to ensure that all
11-40 allocations for expenditures made by the task force are carried out as
11-41 directed by the task force.
11-42 4. To make the allocations required by paragraph (d) of subsection 1,
11-43 the aging services division of the department shall:
11-44 (a) Prioritize and quantify the needs of senior citizens for these
11-45 programs;
11-46 (b) Develop, solicit and accept grant applications for allocations;
11-47 (c) As appropriate, expand or augment existing state programs for
11-48 senior citizens upon approval of the interim finance committee;
11-49 (d) Award grants or other allocations;
12-1 (e) Conduct annual evaluations of programs to which grants or other
12-2 allocations have been awarded; and
12-3 (f) Submit annual reports concerning the grant program to the governor
12-4 and the interim finance committee.
12-5 5. The aging services division of the department shall submit each
12-6 proposed grant which would be used to expand or augment an existing
12-7 state program to the interim finance committee for approval before the
12-8 grant is awarded. The request for approval must include a description of
12-9 the proposed use of the money and the person or entity that would be
12-10 authorized to expend the money. The aging services division of the
12-11 department shall not expend or transfer any money allocated to the aging
12-12 services division pursuant to this section to subsidize any portion of the
12-13 cost of policies of health insurance that provide coverage to senior citizens
12-14 for prescription drugs and pharmaceutical services pursuant to [NRS
12-15 439.635 to 439.690, inclusive.] sections 2 to 10, inclusive, of this act.
12-16 6. The department, on behalf of the task force, shall submit each
12-17 allocation proposed pursuant to paragraph (e) or (f) of subsection 1 which
12-18 would be used to expand or augment an existing state program to the
12-19 interim finance committee for approval before the grant is awarded. The
12-20 request for approval must include a description of the proposed use of the
12-21 money and the person or entity that would be authorized to expend the
12-22 money.
12-23 Sec. 16. NRS 439.665 is hereby amended to read as follows:
12-24 439.665 1. The department shall enter into contracts with private
12-25 insurers who transact health insurance in this state to arrange for the
12-26 availability, at a reasonable cost, of policies of health insurance that
12-27 provide coverage to senior citizens for prescription drugs and
12-28 pharmaceutical services.
12-29 2. Within the limits of the money available for this purpose in the fund
12-30 for a healthy Nevada, a senior citizen who is not eligible for Medicaid and
12-31 who purchases a policy of health insurance that is made available pursuant
12-32 to subsection 1 is entitled to an annual grant from the trust fund to
12-33 subsidize [a portion of] the cost of that insurance , including premiums
12-34 and deductibles, if he has been domiciled in this state for at least 1 year
12-35 immediately preceding the date of his application and his household
12-36 income is [within one of the income ranges for which grants are provided
12-37 pursuant to this subsection to the extent determined by the percentage
12-38 shown opposite his household income on the following schedule:
12-39 Percent of
12-40 Amount of Household Cost of Insurance Allowable
12-41 Income Is Over But Not Over as a Subsidy
12-42 $0 - $12,70090
12-43 12,700 - 14,80080
12-44 14,800 - 17,00050
12-45 17,000 - 19,10025
12-46 19,100 - 21,50010] not over $21,500.
12-47 3. The [amount of any] subsidy granted pursuant to this section must
12-48 not exceed the annual cost of insurance that provides coverage for
13-1 prescription drugs and pharmaceutical services [or $480 per year,
13-2 whichever is less.] , including premiums and deductibles.
13-3 4. A policy of health insurance that is made available pursuant to
13-4 subsection 1 must provide for:
13-5 (a) A copayment of not more than $10 per prescription drug or
13-6 pharmaceutical service that is generic as set forth in the formulary of the
13-7 insurer; and
13-8 (b) A copayment of not more than $25 per prescription drug or
13-9 pharmaceutical service that is preferred as set forth in the formulary of
13-10 the insurer.
13-11 5. The department may waive the eligibility requirement set forth in
13-12 subsection 2 regarding household income upon written request of the
13-13 applicant if the circumstances of the applicant’s household have changed
13-14 as a result of:
13-15 (a) Illness;
13-16 (b) Disability; or
13-17 (c) Extreme financial hardship based on a significant reduction of
13-18 income, when considering the applicant’s current financial
13-19 circumstances.
13-20 An applicant who requests such a waiver shall include with that request
13-21 all medical and financial documents that support his request.
13-22 6. If the Federal Government provides any coverage of prescription
13-23 drugs and pharmaceutical services for senior citizens who are eligible for
13-24 a subsidy pursuant to subsections 1 to 5, inclusive, the department may,
13-25 upon approval of the legislature, or the interim finance committee if the
13-26 legislature is not in session, change any program established pursuant to
13-27 NRS 439.635 to 439.690, inclusive, and otherwise provide assistance with
13-28 prescription drugs and pharmaceutical services for senior citizens within
13-29 the limits of the money available for this purpose in the fund for a
13-30 healthy Nevada.
13-31 7. The provisions of subsections 1 to 5, inclusive, do not apply if the
13-32 department provides assistance with prescription drugs and
13-33 pharmaceutical services for senior citizens pursuant to subsection 6.
13-34 Sec. 17. NRS 439.670 is hereby amended to read as follows:
13-35 439.670 1. A senior citizen who wishes to receive a subsidy pursuant
13-36 to NRS 439.665 must file a request therefor with the department.
13-37 2. The request must be made under oath and filed in such form and
13-38 content, and accompanied by such proof, as the department may prescribe.
13-39 3. The department shall, within 45 days after receiving a request for a
13-40 subsidy, examine the request [,] and grant or deny it . [, and if granted,
13-41 shall determine the amount of the subsidy to which the senior citizen is
13-42 entitled.]
13-43 4. The department shall determine which senior citizens are eligible to
13-44 receive a subsidy pursuant to NRS 439.665 and pay the subsidy directly to
13-45 an insurer with whom the department has entered into a contract pursuant
13-46 to NRS 439.665.
13-47 Sec. 18. NRS 439.675 is hereby amended to read as follows:
13-48 439.675 1. The department shall deny any request for a subsidy
13-49 received pursuant to NRS 439.670 to which the senior citizen is not
14-1 [entitled or any amount in excess of that to which the senior citizen is]
14-2 entitled.
14-3 2. The department may deny in total any request which it finds to have
14-4 been filed with fraudulent intent. If any such request has been paid and is
14-5 afterward denied, the amount of the subsidy must be repaid by the senior
14-6 citizen to the department.
14-7 3. Any amounts received by the department pursuant to this section
14-8 must be deposited with the state treasurer for credit to the fund for a
14-9 healthy Nevada.
14-10 Sec. 19. NRS 218.6827 is hereby amended to read as follows:
14-11 218.6827 1. Except as otherwise provided in subsections 2 and 3, the
14-12 interim finance committee may exercise the powers conferred upon it by
14-13 law only when the legislature is not in regular or special session.
14-14 2. During a regular session, the interim finance committee may also
14-15 perform the duties imposed on it by subsection 5 of NRS 284.115,
14-16 subsection 2 of NRS 321.335, NRS 322.007, subsection 2 of NRS 323.020,
14-17 NRS 323.050, subsection 1 of NRS 323.100, subsection 1 of NRS 341.145,
14-18 NRS 353.220, 353.224, 353.2705 to 353.2771, inclusive, and 353.335,
14-19 paragraph (b) of subsection 4 of NRS 407.0762, NRS 428.375, 439.620,
14-20 439.630, subsection 6 of NRS 445B.830 and NRS 538.650. In performing
14-21 those duties, the senate standing committee on finance and the assembly
14-22 standing committee on ways and means may meet separately and transmit
14-23 the results of their respective votes to the chairman of the interim finance
14-24 committee to determine the action of the interim finance committee as a
14-25 whole.
14-26 3. During a regular or special session, the interim finance committee
14-27 may exercise the powers and duties conferred upon it pursuant to the
14-28 provisions of NRS 353.2705 to 353.2771, inclusive.
14-29 4. If the interim finance committee determines that a fundamental
14-30 review of the base budget of a state agency is necessary, it shall, by
14-31 resolution, notify the legislative commission of that finding for assignment
14-32 of the review to a legislative committee for the fundamental review of the
14-33 base budgets of state agencies established pursuant to NRS 218.5382.
14-34 Sec. 20. NRS 439.635, 439.640, 439.645, 439.650, 439.655, 439.660,
14-35 439.665, 439.670, 439.675, 439.680, 439.685 and 439.690 are hereby
14-36 repealed.
14-37 Sec. 21. 1. The department of human resources shall:
14-38 (a) Periodically review the formulary that is covered by a policy of
14-39 health insurance that is made available pursuant to NRS 439.635 to
14-40 439.690, inclusive, and ensure that the formulary includes prescription
14-41 drugs and pharmaceutical services that senior citizens generally require;
14-42 and
14-43 (b) File a report on December 1, 2002, with the governor and the
14-44 director of the legislative counsel bureau setting forth:
14-45 (1) The number of senior citizens who are insured by a policy of
14-46 health insurance that is made available pursuant to NRS 439.635 to
14-47 439.690, inclusive, and the number of those senior citizens who are
14-48 receiving an annual grant from the fund for a healthy Nevada to subsidize
14-49 the cost of that insurance; and
15-1 (2) Whether, based on the money available to the department of
15-2 human resources for the period from January 1, 2002, to December 31,
15-3 2002, for providing subsidies to senior citizens pursuant to NRS 439.635 to
15-4 439.690, inclusive, the department had the financial ability to provide
15-5 subsidies to at least 4,700 senior citizens and the coverage and benefits set
15-6 forth in NRS 439.635 to 439.690, inclusive.
15-7 2. If the Governor determines that it is in the best interests of the state
15-8 that the Senior Option Program set forth in sections 2 to 10, inclusive, of
15-9 this act be implemented before January 1, 2003, to replace the provisions
15-10 of NRS 439.635 to 439.690, inclusive, he shall issue a proclamation to that
15-11 effect.
15-12 Sec. 22. 1. As soon as practicable after July 1, 2001, the task force
15-13 for the fund for a healthy Nevada shall select:
15-14 (a) The chairman of the task force from among the members of the task
15-15 force who are members of the senate; and
15-16 (b) The vice chairman of the task force from among the remaining
15-17 legislative members of the task force.
15-18 2. Each officer selected pursuant to subsection 1 shall hold office for a
15-19 term of 2 years or until his successor is selected.
15-20 Sec. 23. 1. On July 2, 2001, after reserving the amount of the
15-21 administrative costs which may be allocated pursuant to subsection 4 of
15-22 NRS 439.620 for fiscal year 2001-2002, the state treasurer shall allocate
15-23 from the remaining amount of money in the fund for a healthy Nevada
15-24 thirty percent to the department of human resources for expenditure
15-25 pursuant to NRS 439.635 to 439.690, inclusive.
15-26 2. If applicable, on July 1, 2002, after reserving the amount of the
15-27 administrative costs which may be allocated pursuant to subsection 4 of
15-28 NRS 439.620 for fiscal year 2002-2003, the state treasurer shall allocate
15-29 from the remaining amount of money in the fund for a healthy Nevada
15-30 thirty percent to the department of human resources for expenditure
15-31 pursuant to NRS 439.635 to 439.690, inclusive.
15-32 Sec. 24. 1. This section and sections 11, 13, 14, 16 to 19, inclusive,
15-33 21, 22 and 23 of this act become effective upon passage and approval.
15-34 2. Sections 1 to 10, inclusive, and 12, 15 and 20 of this act become
15-35 effective:
15-36 (a) Upon proclamation by the Governor pursuant to subsection 2 of
15-37 section 21 of this act; or
15-38 (b) On January 1, 2003, if the report filed by the department of human
15-39 resources pursuant to paragraph (b) of subsection 1 of section 21 of this act
15-40 indicates either that:
15-41 (1) There are fewer than 3,500 senior citizens enrolled in and
15-42 receiving subsidies pursuant to a program established pursuant to NRS
15-43 439.635 to 439.690, inclusive; or
15-44 (2) The annual allocation of money available to the department of
15-45 human resources for the period from January 1, 2002, to December 31,
15-46 2002, to provide subsidies to senior citizens pursuant to NRS 439.635 to
15-47 439.690, inclusive, was not sufficient to provide at least 4,700 senior
15-48 citizens with the subsidized insurance-based coverage and benefits set forth
15-49 in NRS 439.635 to 439.690, inclusive.
16-1 LEADLINES OF REPEALED SECTIONS
16-2 439.635 Definitions.
16-3 439.640 “Household income” defined.
16-4 439.645 “Income” defined.
16-5 439.650 “Senior citizen” defined.
16-6 439.655 Administration: Powers and duties of department.
16-7 439.660 Administration: Cooperation between state and local
16-8 agencies.
16-9 439.665 Contracts for provision of insurance coverage for
16-10 pharmaceutical services; eligibility for and amount of subsidies.
16-11 439.670 Request for subsidy; action on request; payment of
16-12 subsidy.
16-13 439.675 Denial of request for subsidy; repayment of amount
16-14 received pursuant to fraudulent request.
16-15 439.680 Judicial review of decision to deny request for subsidy.
16-16 439.685 Revocation of subsidy and payment of restitution.
16-17 439.690 Restrictions on use of information contained in request for
16-18 subsidy.
16-19 H