Assembly Bill No. 402–Assemblymen Sherer, Knecht, Brown, Collins, Conklin, Geddes, Hettrick, Koivisto and Marvel

 

March 17, 2003

____________

 

Referred to Committee on Health and Human Services

 

SUMMARY—Makes various changes concerning approval of certain medical helicopters and certain health facilities. (BDR 40‑816)

 

FISCAL NOTE:  Effect on Local Government: No.

                           Effect on the State: No.

 

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

 

AN ACT relating to health care; requiring a person to obtain the approval of the State Health Officer before operating a new medical helicopter under certain circumstances; revising the requirements concerning the approval by the Director of the Department of Human Resources of certain construction projects on behalf of a health facility; 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 439A of NRS is hereby amended by

1-2  adding thereto a new section to read as follows:

1-3  1.  No person may operate or undertake any proposed

1-4  expenditure for the operation of a new medical helicopter that will

1-5  provide medical helicopter services in an area located within 150

1-6  miles from the base of an existing medical helicopter without first

1-7  applying for and obtaining the written approval of the State

1-8  Health Officer or the designee of the State Health Officer.

1-9  2.  Except as otherwise provided in subsection 3, the State

1-10  Health Officer or the designee of the State Health Officer may

1-11  approve an application submitted pursuant to subsection 1 only if

1-12  the applicant demonstrates that:

2-1  (a) Based on the needs of the specific population to be served

2-2  by the new medical helicopter and on the projected number of

2-3  persons who have or will have a need for the proposed service, the

2-4  population to be served has a need for the new medical helicopter;

2-5  (b) The existing medical helicopter services in the area to be

2-6  served by the new medical helicopter cannot or will not meet the

2-7  projected needs of the population to be served by the new medical

2-8  helicopter;

2-9  (c) The applicant has the financial stability to provide medical

2-10  helicopter services to the population to be served by the new

2-11  medical helicopter for a significant period of time;

2-12      (d) The new medical helicopter will result in a significant

2-13  savings in costs for users of and payors for medical helicopter

2-14  services;

2-15      (e) The new medical helicopter will not have an adverse effect

2-16  on the quality of care provided to users of medical helicopter

2-17  services and will not have an unnecessarily negative effect on the

2-18  cost of medical helicopter services for users of or payors for such

2-19  services; and

2-20      (f) The approval of the application will not adversely affect an

2-21  existing provider of medical helicopter services.

2-22      3.  The State Health Officer or the designee of the State

2-23  Health Officer shall not approve an application submitted

2-24  pursuant to subsection 1 if:

2-25      (a) The applicant fails to provide sufficient, relevant,

2-26  demonstrative evidence for the approval of the application; or

2-27      (b) The evidence opposing the application outweighs the

2-28  evidence supporting the application.

2-29      4.  In determining whether to approve an application

2-30  submitted pursuant to subsection 1, the State Health Officer or the

2-31  designee of the State Health Officer shall:

2-32      (a) Contact existing providers of medical helicopter services,

2-33  ensure that existing providers of medical helicopter services have

2-34  an opportunity to participate in any public hearing concerning the

2-35  application, and seek the input of existing providers of medical

2-36  helicopter services concerning the application; and

2-37      (b) Consider:

2-38          (1) The level of medical care to be provided by the applicant

2-39  to the population to be served by the new medical helicopter;

2-40          (2) The impact of the new medical helicopter on the rates,

2-41  quality of service and safety of existing providers of medical

2-42  helicopter services and on the level of medical care provided by

2-43  such providers;

2-44          (3) The effect of the new medical helicopter on the cost of

2-45  health care services; and

3-1       (4) Any other information the State Health Officer or the

3-2  designee of the State Health Officer deems relevant.

3-3  5.  An applicant whose application is rejected pursuant to this

3-4  section may appeal the decision of the State Health Officer or the

3-5  designee of the State Health Officer to the State Board of Health.

3-6  The decision of the State Board of Health is a final decision for

3-7  the purposes of judicial review.

3-8  6.  As used in this section, “medical helicopter” means a

3-9  helicopter especially designed, constructed, modified or equipped

3-10  to be used for the transportation of injured or sick persons. The

3-11  term does not include any commercial helicopter carrying

3-12  passengers on regularly scheduled flights.

3-13      Sec. 2.  NRS 439A.100 is hereby amended to read as follows:

3-14      439A.100  1.  Except as otherwise provided in this section, in

3-15  a county whose population is less than 100,000, no person may

3-16  undertake any proposed expenditure for new construction by or on

3-17  behalf of a health facility in excess of the greater of $2,000,000 or

3-18  such an amount as the Department may specify by regulation, which

3-19  under generally accepted accounting principles consistently applied

3-20  is a capital expenditure, without first applying for and obtaining the

3-21  written approval of the Director. The Health Division of the

3-22  Department of Human Resources shall not issue a new license or

3-23  alter an existing license for such a project unless the Director has

3-24  issued such an approval.

3-25      2.  The provisions of subsection 1 do not apply to:

3-26      (a) Any capital expenditure for:

3-27          (1) The acquisition of land;

3-28          (2) The construction of a facility for parking;

3-29          (3) The maintenance of a health facility;

3-30          (4) The renovation of a health facility to comply with

3-31  standards for safety, licensure, certification or accreditation;

3-32          (5) The installation of a system to conserve energy;

3-33          (6) The installation of a system for data processing or

3-34  communication; or

3-35          (7) Any other project which, in the opinion of the Director,

3-36  does not relate directly to the provision of any health service; or

3-37      (b) Any project for the development of a health facility that has

3-38  received legislative approval and authorization.

3-39      (c) A project for the construction of a hospital in an

3-40  unincorporated town if:

3-41          (1) The population of the unincorporated town is more than

3-42  24,000;

3-43          (2) No other hospital exists in the town;

4-1       (3) No other hospital has been approved for construction or

4-2  qualified for an exemption from approval for construction in the

4-3  town pursuant to this section; and

4-4       (4) The unincorporated town is at least a 45-minute drive

4-5  from the nearest center for the treatment of trauma that is licensed

4-6  by the Health Division of the Department.

4-7  Upon determining that a project satisfies the requirements for an

4-8  exemption pursuant to this subsection, the Director shall issue a

4-9  certificate which states that the project is exempt from the

4-10  requirements of this section.

4-11      3.  In reviewing an application for approval, the Director shall:

4-12      (a) Comparatively assess applications for similar projects

4-13  affecting the same geographic area; and

4-14      (b) Base his decision on criteria established by the Director by

4-15  regulation. The criteria must include:

4-16          (1) The need for and the appropriateness of the project in the

4-17  area to be served;

4-18          (2) The financial feasibility of the project;

4-19          (3) The effect of the project on the cost of health care; and

4-20          (4) The extent to which the project is consistent with the

4-21  purposes set forth in NRS 439A.020 and the priorities set forth in

4-22  NRS 439A.081.

4-23      4.  The Department may by regulation require additional

4-24  approval for a proposed change to a project which has previously

4-25  been approved if the proposal would result in a change in the

4-26  location of the project or a substantial increase in the cost of the

4-27  project.

4-28      5.  The decision of the Director is a final decision for the

4-29  purposes of judicial review.

4-30      6.  As used in this section, “hospital” has the meaning

4-31  ascribed to it in NRS 449.012.

4-32      Sec. 3.  The Director of the Department of Human Resources

4-33  shall issue a certificate of exemption for any project for which an

4-34  application for approval has been filed pursuant to NRS 439A.100

4-35  that is pending on July 1, 2003, if the application is exempt from the

4-36  requirement of approval pursuant to the amendatory provisions of

4-37  section 2 of this act.

4-38      Sec. 4.  The provisions of section 1 of this act apply

4-39  retroactively to each medical helicopter that did not provide medical

4-40  helicopter services on or before December 31, 2002.

4-41      Sec. 5.  1.  This section and sections 1 and 4 of this act

4-42  become effective upon passage and approval.

 

 

5-1  2.  Sections 2 and 3 of this act become effective on July 1,

5-2  2003.

 

5-3  H