S.B. 4
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SENATE BILL NO. 4–COMMITTEE ON
HEALTH AND HUMAN SERVICES
(ON BEHALF OF THE AGING AND DISABILITY
SERVICES DIVISION OF THE DEPARTMENT OF
HEALTH AND HUMAN SERVICES)
PREFILED NOVEMBER 16, 2022
____________
Referred to Committee on Health and Human Services
SUMMARY—Revises provisions governing certain programs to
pay for prescription drugs, pharmaceutical services
and other benefits. (BDR 40-220)
FISCAL NOTE: Effect on Local Government: No.
Effect on the State: Yes.
~
EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.
AN ACT relating to public health; revising provisions governing the
use of certain proceeds of litigation against manufacturers
of tobacco products to pay for prescription drugs,
pharmaceutical services and other benefits; and providing
other matters properly relating thereto.
Legislative Counsel’s Digest:
Existing law creates the Fund for a Healthy Nevada and requires the State 1
Treasurer to deposit into the Fund a portion of any proceeds that the State of 2
Nevada receives from settlement agreements with and civil actions against 3
manufacturers of tobacco products. (NRS 439.620) Existing law requires the 4
Department of Health and Human Services to allocate money in the Fund for 5
certain purposes, including, without limitation and subject to legislative 6
authorization, for direct expenditure by the Department to pay for prescription 7
drugs, pharmaceutical services and other benefits for senior citizens and persons 8
with disabilities. Existing law also authorizes the Department to use such allocated 9
money to subsidize these costs for senior citizens and persons with disabilities. 10
(NRS 439.630) Existing law establishes the procedure for allocating and revoking 11
such subsidies. (NRS 439.635-439.690) Existing law requires the Department to 12
submit a quarterly report to the Governor and certain other entities regarding the 13
general manner in which these expenditures have been made. (NRS 439.630) 14
Section 3 of this bill removes: (1) the requirement that such money must be 15
directly expended by the Department; and (2) the limitation that such money must 16
be used only to pay for benefits for senior citizens and persons with disabilities. 17
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Section 3 instead authorizes the Department to allocate money to provide grants 18
and enter into contracts or intergovernmental agreements to pay for or subsidize the 19
cost of prescription drugs, pharmaceutical services and other benefits for natural 20
persons who: (1) are residents of Nevada; and (2) meet other criteria for eligibility 21
established by regulation of the Department. Section 3 also requires the 22
Department to submit the report concerning such expenditures annually rather than 23
quarterly. Section 4 of this bill repeals the existing provisions governing the direct 24
subsidization of prescription drugs, pharmaceutical services and other benefits for 25
senior citizens and persons with disabilities by the Department. Sections 1 and 2 of 26
this bill make conforming changes to remove references to the repealed provisions. 27
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. NRS 439.529 is hereby amended to read as follows: 1
439.529 1. The Department may, to the extent that money is 2
available, administer a program pursuant to 42 U.S.C. §§ 300ff-21 3
et seq. to provide therapeutics to treat certain persons who have 4
been diagnosed with the human immunodeficiency virus and to 5
prevent the serious deterioration of the health of such persons. The 6
program may include the provision of subsidies and pharmaceutical 7
services. 8
2. The Director shall: 9
(a) Establish the criteria for eligibility for participation in the 10
program administered pursuant to this section, which must be in 11
accordance with the provisions of 42 U.S.C. §§ 300ff-21 et seq.; and 12
(b) Prescribe the manner in which the program will be 13
administered and services will be provided. 14
3. The Department may use any other program administered by 15
the Department to facilitate the provision of subsidies and services 16
pursuant to this section . [, including, without limitation, the 17
provision of subsidies for pharmaceutical services to senior citizens 18
and persons with disabilities pursuant to NRS 439.635 to 439.690, 19
inclusive.] If the Department uses another program to facilitate the 20
provision of subsidies and services pursuant to this section, the 21
Department shall not commingle the money available to carry out 22
the provisions of this section and the money available to carry out 23
the other program. 24
4. Money available to carry out the provisions of this section 25
must be accounted for separately by the Department. 26
Sec. 2. NRS 439.620 is hereby amended to read as follows: 27
439.620 1. The Fund for a Healthy Nevada is hereby created 28
in the State Treasury. The State Treasurer shall deposit in the Fund: 29
(a) Sixty percent of all money received by this State pursuant to 30
any settlement entered into by the State of Nevada and a 31
manufacturer of tobacco products; and 32
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(b) Sixty percent of all money recovered by this State from a 1
judgment in a civil action against a manufacturer of tobacco 2
products. 3
2. The State Treasurer shall administer the Fund. As 4
administrator of the Fund, the State Treasurer: 5
(a) Shall maintain the financial records of the Fund; 6
(b) Shall invest the money in the Fund as the money in other 7
state funds is invested; 8
(c) Shall manage any account associated with the Fund; 9
(d) Shall maintain any instruments that evidence investments 10
made with the money in the Fund; 11
(e) May contract with vendors for any good or service that is 12
necessary to carry out the provisions of this section; and 13
(f) May perform any other duties necessary to administer the 14
Fund. 15
3. The interest and income earned on the money in the Fund 16
must, after deducting any applicable charges, be credited to the 17
Fund. All claims against the Fund must be paid as other claims 18
against the State are paid. 19
4. The State Treasurer or the Department may submit to the 20
Interim Finance Committee a request for an allocation for 21
administrative expenses from the Fund pursuant to this section. 22
Except as otherwise limited by this subsection, the Interim Finance 23
Committee may allocate all or part of the money so requested. The 24
annual allocation for administrative expenses from the Fund must: 25
(a) Not exceed 2 percent of the money in the Fund, as calculated 26
pursuant to this subsection, each year to pay the costs incurred by 27
the State Treasurer to administer the Fund; and 28
(b) Not exceed 5 percent of the money in the Fund, as calculated 29
pursuant to this subsection, each year to pay the costs incurred by 30
the Department, including, without limitation, the Aging and 31
Disability Services Division of the Department, to carry out its 32
duties set forth in NRS 439.630 . [and to administer the provisions 33
of NRS 439.635 to 439.690, inclusive.] 34
For the purposes of this subsection, the amount of money 35
available for allocation to pay for the administrative costs must be 36
calculated at the beginning of each fiscal year based on the total 37
amount of money anticipated by the State Treasurer to be deposited 38
in the Fund during that fiscal year. 39
5. The money in the Fund remains in the Fund and does not 40
revert to the State General Fund at the end of any fiscal year. 41
6. All money that is deposited or paid into the Fund is hereby 42
appropriated to be used for any purpose authorized by the 43
Legislature or by the Department for expenditure or allocation in 44
accordance with the provisions of NRS 439.630. Money expended 45
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from the Fund must not be used to supplant existing methods of 1
funding that are available to public agencies. 2
Sec. 3. NRS 439.630 is hereby amended to read as follows: 3
439.630 1. The Department shall: 4
(a) Conduct, or require the Grants Management Advisory 5
Committee created by NRS 232.383 to conduct, public hearings to 6
accept public testimony from a wide variety of sources and 7
perspectives regarding existing or proposed programs that: 8
(1) Promote public health; 9
(2) Improve health services for children, senior citizens and 10
persons with disabilities; 11
(3) Reduce or prevent alcohol and other substance use 12
disorders; and 13
(4) Offer other general or specific information on health care 14
in this State. 15
(b) Establish a process to evaluate the health and health needs of 16
the residents of this State and a system to rank the health problems 17
of the residents of this State, including, without limitation, the 18
specific health problems that are endemic to urban and rural 19
communities, and report the results of the evaluation to the Joint 20
Interim Standing Committee on Health and Human Services on an 21
annual basis. 22
(c) Subject to legislative authorization, allocate money [for 23
direct expenditure by] to the Department to provide grants and 24
enter into contracts or intergovernmental agreements to pay for 25
prescription drugs, pharmaceutical services and, to the extent money 26
is available, other benefits, including, without limitation, dental and 27
vision benefits and hearing aids or other devices that enhance the 28
ability to hear, for [senior citizens and persons with disabilities 29
pursuant to NRS 439.635 to 439.690, inclusive.] natural persons 30
who are residents of this State and meet the criteria for eligibility 31
established by regulation of the Department. From the money 32
allocated pursuant to this paragraph, the Department may subsidize 33
any portion of the cost of providing prescription drugs, 34
pharmaceutical services and, to the extent money is available, other 35
benefits, including, without limitation, dental and vision benefits 36
and hearing aids or other devices that enhance the ability to hear, to 37
[senior citizens and persons with disabilities pursuant to NRS 38
439.635 to 439.690, inclusive.] such natural persons. The 39
Department shall consider recommendations from the Grants 40
Management Advisory Committee in carrying out the provisions of 41
[NRS 439.635 to 439.690, inclusive.] this paragraph. The 42
Department shall submit [a quarterly] an annual report to the 43
Governor, the Interim Finance Committee, the Joint Interim 44
Standing Committee on Health and Human Services and any other 45
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committees or commissions the Director deems appropriate 1
regarding the general manner in which expenditures have been made 2
pursuant to this paragraph. 3
(d) Subject to legislative authorization, allocate, by contract or 4
grant, money for expenditure by the Aging and Disability Services 5
Division of the Department in the form of grants for existing or new 6
programs that assist senior citizens and other specified persons with 7
independent living, including, without limitation, programs that 8
provide: 9
(1) Respite care or relief of informal caretakers, including, 10
without limitation, informal caretakers of any person with 11
Alzheimer’s disease or other related dementia regardless of the age 12
of the person; 13
(2) Transportation to new or existing services to assist senior 14
citizens in living independently; and 15
(3) Care in the home which allows senior citizens to remain 16
at home instead of in institutional care. 17
The Aging and Disability Services Division of the Department 18
shall consider recommendations from the Grants Management 19
Advisory Committee concerning the independent living needs of 20
senior citizens. 21
(e) Allocate $200,000 of all revenues deposited in the Fund for a 22
Healthy Nevada each year for direct expenditure by the Director to 23
award competitive grants to finance the establishment or expansion 24
of assisted living facilities that provide services pursuant to the 25
provisions of the home and community-based services waiver which 26
are amended pursuant to NRS 422.3962. The Director shall develop 27
policies and procedures for awarding grants pursuant to this 28
paragraph. If any money allocated pursuant to this paragraph 29
remains after awarding grants to all eligible applicants, the Director 30
must reallocate such money to the Aging and Disability Services 31
Division of the Department to be used for the purposes described in 32
paragraph (d). 33
(f) Subject to legislative authorization, allocate to the Division 34
money for programs that are consistent with the guidelines 35
established by the Centers for Disease Control and Prevention of the 36
United States Department of Health and Human Services relating to 37
evidence-based best practices to prevent, reduce or treat the use of 38
tobacco and the consequences of the use of tobacco. In making 39
allocations pursuant to this paragraph, the Division shall allocate the 40
money, by contract or grant: 41
(1) To the district board of health in each county whose 42
population is 100,000 or more for expenditure for such programs in 43
the respective county; 44
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(2) For such programs in counties whose population is less 1
than 100,000; and 2
(3) For statewide programs for tobacco cessation and other 3
statewide services for tobacco cessation and for statewide 4
evaluations of programs which receive an allocation of money 5
pursuant to this paragraph, as determined necessary by the Division 6
and the district boards of health. 7
(g) Subject to legislative authorization, allocate, by contract or 8
grant, money for expenditure for programs that improve the health 9
and well-being of residents of this State, including, without 10
limitation, programs that improve health services for children. 11
(h) Subject to legislative authorization, allocate, by contract or 12
grant, money for expenditure for programs that improve the health 13
and well-being of persons with disabilities. In making allocations 14
pursuant to this paragraph, the Department shall, to the extent 15
practicable, allocate the money evenly among the following three 16
types of programs: 17
(1) Programs that provide respite care or relief of informal 18
caretakers for persons with disabilities; 19
(2) Programs that provide positive behavioral supports to 20
persons with disabilities; and 21
(3) Programs that assist persons with disabilities to live 22
safely and independently in their communities outside of an 23
institutional setting. 24
(i) Maximize expenditures through local, federal and private 25
matching contributions. 26
(j) Ensure that any money expended from the Fund will not be 27
used to supplant existing methods of funding that are available to 28
public agencies. 29
(k) Develop policies and procedures for the administration and 30
distribution of contracts, grants and other expenditures to state 31
agencies, political subdivisions of this State, nonprofit 32
organizations, universities, state colleges and community colleges. 33
A condition of any such contract or grant must be that not more than 34
8 percent of the contract or grant may be used for administrative 35
expenses or other indirect costs. The procedures must require at 36
least one competitive round of requests for proposals per biennium. 37
(l) To make the allocations required by paragraphs (f), (g) and 38
(h): 39
(1) Prioritize and quantify the needs for these programs; 40
(2) Develop, solicit and accept applications for allocations; 41
(3) Review and consider the recommendations of the Grants 42
Management Advisory Committee submitted pursuant to 43
NRS 232.385; 44
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(4) Conduct annual evaluations of programs to which 1
allocations have been awarded; and 2
(5) Submit annual reports concerning the programs to the 3
Governor, the Interim Finance Committee, the Joint Interim 4
Standing Committee on Health and Human Services and any other 5
committees or commissions the Director deems appropriate. 6
(m) Transmit a report of all findings, recommendations and 7
expenditures to the Governor, each regular session of the 8
Legislature, the Joint Interim Standing Committee on Health and 9
Human Services and any other committees or commissions the 10
Director deems appropriate. 11
(n) After considering the recommendations submitted to the 12
Director pursuant to subsection 6, develop a plan each biennium to 13
determine the percentage of available money in the Fund for a 14
Healthy Nevada to be allocated from the Fund for the purposes 15
described in paragraphs (c), (d), (f), (g) and (h). The plan must be 16
submitted as part of the proposed budget submitted to the Chief of 17
the Budget Division of the Office of Finance pursuant to 18
NRS 353.210. 19
(o) On or before September 30 of each even-numbered year, 20
submit to the Grants Management Advisory Committee, the Nevada 21
Commission on Aging created by NRS 427A.032 and the Nevada 22
Commission on Services for Persons with Disabilities created by 23
NRS 427A.1211 a report on the funding plan submitted to the Chief 24
of the Budget Division of the Office of Finance pursuant to 25
paragraph (n). 26
2. The Department may take such other actions as are 27
necessary to carry out its duties. 28
3. To make the allocations required by paragraph (d) of 29
subsection 1, the Aging and Disability Services Division of the 30
Department shall: 31
(a) Prioritize and quantify the needs of senior citizens and other 32
specified persons for these programs; 33
(b) Develop, solicit and accept grant applications for allocations; 34
(c) As appropriate, expand or augment existing state programs 35
for senior citizens and other specified persons upon approval of the 36
Interim Finance Committee; 37
(d) Award grants, contracts or other allocations; 38
(e) Conduct annual evaluations of programs to which grants or 39
other allocations have been awarded; and 40
(f) Submit annual reports concerning the allocations made by 41
the Aging and Disability Services Division pursuant to paragraph 42
(d) of subsection 1 to the Governor, the Interim Finance Committee, 43
the Joint Interim Standing Committee on Health and Human 44
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Services and any other committees or commissions the Director 1
deems appropriate. 2
4. The Aging and Disability Services Division of the 3
Department shall submit each proposed grant or contract which 4
would be used to expand or augment an existing state program to 5
the Interim Finance Committee for approval before the grant or 6
contract is awarded. The request for approval must include a 7
description of the proposed use of the money and the person or 8
entity that would be authorized to expend the money. The Aging 9
and Disability Services Division of the Department shall not expend 10
or transfer any money allocated to the Aging and Disability Services 11
Division pursuant to this section to subsidize any portion of the cost 12
of providing prescription drugs, pharmaceutical services and other 13
benefits, including, without limitation, dental and vision benefits 14
and hearing aids or other devices that enhance the ability to hear [, 15
to senior citizens or persons with disabilities] pursuant to [NRS 16
439.635 to 439.690, inclusive.] paragraph (c) of subsection 1. 17
5. A veteran may receive benefits or other services which are 18
available from the money allocated pursuant to this section for 19
senior citizens or persons with disabilities to the extent that the 20
veteran does not receive other benefits or services provided to 21
veterans for the same purpose if the veteran qualifies for the benefits 22
or services as a senior citizen or a person with a disability, or both. 23
6. On or before June 30 of each even-numbered year, the 24
Grants Management Advisory Committee, the Nevada Commission 25
on Aging and the Nevada Commission on Services for Persons with 26
Disabilities each shall submit to the Director a report that includes, 27
without limitation, recommendations regarding community needs 28
and priorities that are determined by each such entity after any 29
public hearings held by the entity. 30
Sec. 4. NRS 439.635, 439.648, 439.650, 439.655, 439.660, 31
439.665, 439.670, 439.675, 439.680, 439.685 and 439.690 are 32
hereby repealed. 33
Sec. 5. This act becomes effective on July 1, 2023. 34
LEADLINES OF REPEALED SECTIONS
439.635 Definitions.
439.648 “Person with a disability” defined.
439.650 “Senior citizen” defined.
439.655 Administration: Powers and duties of Department.
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439.660 Administration: Cooperation between state and
local agencies.
439.665 Contracts to subsidize cost of prescription drugs,
pharmaceutical services and other benefits; eligibility for
subsidies; waiver of eligibility requirements; coverage provided
by Federal Government; authority of Department to change
programs; eligibility of veterans for subsidies.
439.670 Request for subsidy; action on request; payment of
subsidy.
439.675 Denial of request for subsidy; repayment and
deposit of amount received pursuant to fraudulent request.
439.680 Judicial review of decision to deny request for
subsidy.
439.685 Revocation of subsidy and payment of restitution.
439.690 Restrictions on use of information contained in
request for subsidy.
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