Nevada 2023 Regular Session

Nevada Senate Bill SB4 Compare Versions

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1	1
2	2
3	3	- 82nd Session (2023)
4	4	Senate Bill No. 4–Committee on
5	5	Health and Human Services
6	6
7	7	CHAPTER..........
8	8
9	9	AN ACT relating to public health; revising provisions governing the
10	10	use of certain proceeds of litigation against manufacturers of
11	11	tobacco products to pay for prescription drugs,
12	12	pharmaceutical services and other benefits; and providing
13	13	other matters properly relating thereto.
14	14	Legislative Counsel’s Digest:
15	15	Existing law creates the Fund for a Healthy Nevada and requires the State
16	16	Treasurer to deposit into the Fund a portion of any proceeds that the State of
17	17	Nevada receives from settlement agreements with and civil actions against
18	18	manufacturers of tobacco products. (NRS 439.620) Existing law requires the
19	19	Department of Health and Human Services to allocate money in the Fund for
20	20	certain purposes, including, without limitation and subject to legislative
21	21	authorization, for direct expenditure by the Department to pay for prescription
22	22	drugs, pharmaceutical services and other benefits for senior citizens and persons
23	23	with disabilities. Existing law also authorizes the Department to use such allocated
24	24	money to subsidize these costs for senior citizens and persons with disabilities.
25	25	(NRS 439.630) Existing law establishes the procedure for allocating and revoking
26	26	such subsidies. (NRS 439.635-439.690) Existing law requires the Department to
27	27	submit a quarterly report to the Governor and certain other entities regarding the
28	28	general manner in which these expenditures have been made. (NRS 439.630)
29	29	Section 3 of this bill removes: (1) the requirement that such money must be
30	30	directly expended by the Department; and (2) the limitation that such money must
31	31	be used only to pay for benefits for senior citizens and persons with disabilities.
32	32	Section 3 instead authorizes the Department to allocate money to provide grants
33	33	and enter into contracts or intergovernmental agreements to pay for or subsidize the
34	34	cost of prescription drugs, pharmaceutical services and other benefits for natural
35	35	persons who: (1) are residents of Nevada; and (2) meet other criteria for eligibility
36	36	established by regulation of the Department. Section 3 also requires the
37	37	Department to submit the report concerning such expenditures annually rather than
38	38	quarterly. Section 4 of this bill repeals the existing provisions governing the direct
39	39	subsidization of prescription drugs, pharmaceutical services and other benefits for
40	40	senior citizens and persons with disabilities by the Department. Sections 1 and 2 of
41	41	this bill make conforming changes to remove references to the repealed provisions.
42	42
43	43	EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.
44	44
45	45
46	46	THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
47	47	SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
48	48
49	49	Section 1. NRS 439.529 is hereby amended to read as follows:
50	50	439.529 1. The Department may, to the extent that money is
51	51	available, administer a program pursuant to 42 U.S.C. §§ 300ff-21
52	52	et seq. to provide therapeutics to treat certain persons who have
53	53	been diagnosed with the human immunodeficiency virus and to
54	54	– 2 –
55	55
56	56
57	57	- 82nd Session (2023)
58	58	prevent the serious deterioration of the health of such persons. The
59	59	program may include the provision of subsidies and pharmaceutical
60	60	services.
61	61	2. The Director shall:
62	62	(a) Establish the criteria for eligibility for participation in the
63	63	program administered pursuant to this section, which must be in
64	64	accordance with the provisions of 42 U.S.C. §§ 300ff-21 et seq.; and
65	65	(b) Prescribe the manner in which the program will be
66	66	administered and services will be provided.
67	67	3. The Department may use any other program administered by
68	68	the Department to facilitate the provision of subsidies and services
69	69	pursuant to this section . [, including, without limitation, the
70	70	provision of subsidies for pharmaceutical services to senior citizens
71	71	and persons with disabilities pursuant to NRS 439.635 to 439.690,
72	72	inclusive.] If the Department uses another program to facilitate the
73	73	provision of subsidies and services pursuant to this section, the
74	74	Department shall not commingle the money available to carry out
75	75	the provisions of this section and the money available to carry out
76	76	the other program.
77	77	4. Money available to carry out the provisions of this section
78	78	must be accounted for separately by the Department.
79	79	Sec. 2. NRS 439.620 is hereby amended to read as follows:
80	80	439.620 1. The Fund for a Healthy Nevada is hereby created
81	81	in the State Treasury. The State Treasurer shall deposit in the Fund:
82	82	(a) Sixty percent of all money received by this State pursuant to
83	83	any settlement entered into by the State of Nevada and a
84	84	manufacturer of tobacco products; and
85	85	(b) Sixty percent of all money recovered by this State from a
86	86	judgment in a civil action against a manufacturer of tobacco
87	87	products.
88	88	2. The State Treasurer shall administer the Fund. As
89	89	administrator of the Fund, the State Treasurer:
90	90	(a) Shall maintain the financial records of the Fund;
91	91	(b) Shall invest the money in the Fund as the money in other
92	92	state funds is invested;
93	93	(c) Shall manage any account associated with the Fund;
94	94	(d) Shall maintain any instruments that evidence investments
95	95	made with the money in the Fund;
96	96	(e) May contract with vendors for any good or service that is
97	97	necessary to carry out the provisions of this section; and
98	98	(f) May perform any other duties necessary to administer the
99	99	Fund.
100	100	– 3 –
101	101
102	102
103	103	- 82nd Session (2023)
104	104	3. The interest and income earned on the money in the Fund
105	105	must, after deducting any applicable charges, be credited to the
106	106	Fund. All claims against the Fund must be paid as other claims
107	107	against the State are paid.
108	108	4. The State Treasurer or the Department may submit to the
109	109	Interim Finance Committee a request for an allocation for
110	110	administrative expenses from the Fund pursuant to this section.
111	111	Except as otherwise limited by this subsection, the Interim Finance
112	112	Committee may allocate all or part of the money so requested. The
113	113	annual allocation for administrative expenses from the Fund must:
114	114	(a) Not exceed 2 percent of the money in the Fund, as calculated
115	115	pursuant to this subsection, each year to pay the costs incurred by
116	116	the State Treasurer to administer the Fund; and
117	117	(b) Not exceed 5 percent of the money in the Fund, as calculated
118	118	pursuant to this subsection, each year to pay the costs incurred by
119	119	the Department, including, without limitation, the Aging and
120	120	Disability Services Division of the Department, to carry out its
121	121	duties set forth in NRS 439.630 . [and to administer the provisions
122	122	of NRS 439.635 to 439.690, inclusive.]
123	123	 For the purposes of this subsection, the amount of money
124	124	available for allocation to pay for the administrative costs must be
125	125	calculated at the beginning of each fiscal year based on the total
126	126	amount of money anticipated by the State Treasurer to be deposited
127	127	in the Fund during that fiscal year.
128	128	5. The money in the Fund remains in the Fund and does not
129	129	revert to the State General Fund at the end of any fiscal year.
130	130	6. All money that is deposited or paid into the Fund is hereby
131	131	appropriated to be used for any purpose authorized by the
132	132	Legislature or by the Department for expenditure or allocation in
133	133	accordance with the provisions of NRS 439.630. Money expended
134	134	from the Fund must not be used to supplant existing methods of
135	135	funding that are available to public agencies.
136	136	Sec. 3. NRS 439.630 is hereby amended to read as follows:
137	137	439.630 1. The Department shall:
138	138	(a) Conduct, or require the Grants Management Advisory
139	139	Committee created by NRS 232.383 to conduct, public hearings to
140	140	accept public testimony from a wide variety of sources and
141	141	perspectives regarding existing or proposed programs that:
142	142	(1) Promote public health;
143	143	(2) Improve health services for children, senior citizens and
144	144	persons with disabilities;
145	145	(3) Reduce or prevent alcohol and other substance use
146	146	disorders; and
147	147	– 4 –
148	148
149	149
150	150	- 82nd Session (2023)
151	151	(4) Offer other general or specific information on health care
152	152	in this State.
153	153	(b) Establish a process to evaluate the health and health needs of
154	154	the residents of this State and a system to rank the health problems
155	155	of the residents of this State, including, without limitation, the
156	156	specific health problems that are endemic to urban and rural
157	157	communities, and report the results of the evaluation to the Joint
158	158	Interim Standing Committee on Health and Human Services on an
159	159	annual basis.
160	160	(c) Subject to legislative authorization, allocate money [for
161	161	direct expenditure by] to the Department to provide grants and
162	162	enter into contracts or intergovernmental agreements to pay for
163	163	prescription drugs, pharmaceutical services and, to the extent money
164	164	is available, other benefits, including, without limitation, dental and
165	165	vision benefits and hearing aids or other devices that enhance the
166	166	ability to hear, for [senior citizens and persons with disabilities
167	167	pursuant to NRS 439.635 to 439.690, inclusive.] natural persons
168	168	who are residents of this State and meet the criteria for eligibility
169	169	established by regulation of the Department. From the money
170	170	allocated pursuant to this paragraph, the Department may subsidize
171	171	any portion of the cost of providing prescription drugs,
172	172	pharmaceutical services and, to the extent money is available, other
173	173	benefits, including, without limitation, dental and vision benefits
174	174	and hearing aids or other devices that enhance the ability to hear, to
175	175	[senior citizens and persons with disabilities pursuant to NRS
176	176	439.635 to 439.690, inclusive.] such natural persons. The
177	177	Department shall consider recommendations from the Grants
178	178	Management Advisory Committee in carrying out the provisions of
179	179	[NRS 439.635 to 439.690, inclusive.] this paragraph. The
180	180	Department shall submit [a quarterly] an annual report to the
181	181	Governor, the Interim Finance Committee, the Joint Interim
182	182	Standing Committee on Health and Human Services and any other
183	183	committees or commissions the Director deems appropriate
184	184	regarding the general manner in which expenditures have been made
185	185	pursuant to this paragraph.
186	186	(d) Subject to legislative authorization, allocate, by contract or
187	187	grant, money for expenditure by the Aging and Disability Services
188	188	Division of the Department in the form of grants for existing or new
189	189	programs that assist senior citizens and other specified persons with
190	190	independent living, including, without limitation, programs that
191	191	provide:
192	192	(1) Respite care or relief of informal caretakers, including,
193	193	without limitation, informal caretakers of any person with
194	194	– 5 –
195	195
196	196
197	197	- 82nd Session (2023)
198	198	Alzheimer’s disease or other related dementia regardless of the age
199	199	of the person;
200	200	(2) Transportation to new or existing services to assist senior
201	201	citizens in living independently; and
202	202	(3) Care in the home which allows senior citizens to remain
203	203	at home instead of in institutional care.
204	204	 The Aging and Disability Services Division of the Department
205	205	shall consider recommendations from the Grants Management
206	206	Advisory Committee concerning the independent living needs of
207	207	senior citizens.
208	208	(e) Allocate $200,000 of all revenues deposited in the Fund for a
209	209	Healthy Nevada each year for direct expenditure by the Director to
210	210	award competitive grants to finance the establishment or expansion
211	211	of assisted living facilities that provide services pursuant to the
212	212	provisions of the home and community-based services waiver which
213	213	are amended pursuant to NRS 422.3962. The Director shall develop
214	214	policies and procedures for awarding grants pursuant to this
215	215	paragraph. If any money allocated pursuant to this paragraph
216	216	remains after awarding grants to all eligible applicants, the Director
217	217	must reallocate such money to the Aging and Disability Services
218	218	Division of the Department to be used for the purposes described in
219	219	paragraph (d).
220	220	(f) Subject to legislative authorization, allocate to the Division
221	221	money for programs that are consistent with the guidelines
222	222	established by the Centers for Disease Control and Prevention of the
223	223	United States Department of Health and Human Services relating to
224	224	evidence-based best practices to prevent, reduce or treat the use of
225	225	tobacco and the consequences of the use of tobacco. In making
226	226	allocations pursuant to this paragraph, the Division shall allocate the
227	227	money, by contract or grant:
228	228	(1) To the district board of health in each county whose
229	229	population is 100,000 or more for expenditure for such programs in
230	230	the respective county;
231	231	(2) For such programs in counties whose population is less
232	232	than 100,000; and
233	233	(3) For statewide programs for tobacco cessation and other
234	234	statewide services for tobacco cessation and for statewide
235	235	evaluations of programs which receive an allocation of money
236	236	pursuant to this paragraph, as determined necessary by the Division
237	237	and the district boards of health.
238	238	(g) Subject to legislative authorization, allocate, by contract or
239	239	grant, money for expenditure for programs that improve the health
240	240	– 6 –
241	241
242	242
243	243	- 82nd Session (2023)
244	244	and well-being of residents of this State, including, without
245	245	limitation, programs that improve health services for children.
246	246	(h) Subject to legislative authorization, allocate, by contract or
247	247	grant, money for expenditure for programs that improve the health
248	248	and well-being of persons with disabilities. In making allocations
249	249	pursuant to this paragraph, the Department shall, to the extent
250	250	practicable, allocate the money evenly among the following three
251	251	types of programs:
252	252	(1) Programs that provide respite care or relief of informal
253	253	caretakers for persons with disabilities;
254	254	(2) Programs that provide positive behavioral supports to
255	255	persons with disabilities; and
256	256	(3) Programs that assist persons with disabilities to live
257	257	safely and independently in their communities outside of an
258	258	institutional setting.
259	259	(i) Maximize expenditures through local, federal and private
260	260	matching contributions.
261	261	(j) Ensure that any money expended from the Fund will not be
262	262	used to supplant existing methods of funding that are available to
263	263	public agencies.
264	264	(k) Develop policies and procedures for the administration and
265	265	distribution of contracts, grants and other expenditures to state
266	266	agencies, political subdivisions of this State, nonprofit
267	267	organizations, universities, state colleges and community colleges.
268	268	A condition of any such contract or grant must be that not more than
269	269	8 percent of the contract or grant may be used for administrative
270	270	expenses or other indirect costs. The procedures must require at
271	271	least one competitive round of requests for proposals per biennium.
272	272	(l) To make the allocations required by paragraphs (f), (g) and
273	273	(h):
274	274	(1) Prioritize and quantify the needs for these programs;
275	275	(2) Develop, solicit and accept applications for allocations;
276	276	(3) Review and consider the recommendations of the Grants
277	277	Management Advisory Committee submitted pursuant to
278	278	NRS 232.385;
279	279	(4) Conduct annual evaluations of programs to which
280	280	allocations have been awarded; and
281	281	(5) Submit annual reports concerning the programs to the
282	282	Governor, the Interim Finance Committee, the Joint Interim
283	283	Standing Committee on Health and Human Services and any other
284	284	committees or commissions the Director deems appropriate.
285	285	(m) Transmit a report of all findings, recommendations and
286	286	expenditures to the Governor, each regular session of the
287	287	– 7 –
288	288
289	289
290	290	- 82nd Session (2023)
291	291	Legislature, the Joint Interim Standing Committee on Health and
292	292	Human Services and any other committees or commissions the
293	293	Director deems appropriate.
294	294	(n) After considering the recommendations submitted to the
295	295	Director pursuant to subsection 6, develop a plan each biennium to
296	296	determine the percentage of available money in the Fund for a
297	297	Healthy Nevada to be allocated from the Fund for the purposes
298	298	described in paragraphs (c), (d), (f), (g) and (h). The plan must be
299	299	submitted as part of the proposed budget submitted to the Chief of
300	300	the Budget Division of the Office of Finance pursuant to
301	301	NRS 353.210.
302	302	(o) On or before September 30 of each even-numbered year,
303	303	submit to the Grants Management Advisory Committee, the Nevada
304	304	Commission on Aging created by NRS 427A.032 and the Nevada
305	305	Commission on Services for Persons with Disabilities created by
306	306	NRS 427A.1211 a report on the funding plan submitted to the Chief
307	307	of the Budget Division of the Office of Finance pursuant to
308	308	paragraph (n).
309	309	2. The Department may take such other actions as are
310	310	necessary to carry out its duties.
311	311	3. To make the allocations required by paragraph (d) of
312	312	subsection 1, the Aging and Disability Services Division of the
313	313	Department shall:
314	314	(a) Prioritize and quantify the needs of senior citizens and other
315	315	specified persons for these programs;
316	316	(b) Develop, solicit and accept grant applications for allocations;
317	317	(c) As appropriate, expand or augment existing state programs
318	318	for senior citizens and other specified persons upon approval of the
319	319	Interim Finance Committee;
320	320	(d) Award grants, contracts or other allocations;
321	321	(e) Conduct annual evaluations of programs to which grants or
322	322	other allocations have been awarded; and
323	323	(f) Submit annual reports concerning the allocations made by
324	324	the Aging and Disability Services Division pursuant to paragraph
325	325	(d) of subsection 1 to the Governor, the Interim Finance Committee,
326	326	the Joint Interim Standing Committee on Health and Human
327	327	Services and any other committees or commissions the Director
328	328	deems appropriate.
329	329	4. The Aging and Disability Services Division of the
330	330	Department shall submit each proposed grant or contract which
331	331	would be used to expand or augment an existing state program to
332	332	the Interim Finance Committee for approval before the grant or
333	333	contract is awarded. The request for approval must include a
334	334	– 8 –
335	335
336	336
337	337	- 82nd Session (2023)
338	338	description of the proposed use of the money and the person or
339	339	entity that would be authorized to expend the money. The Aging
340	340	and Disability Services Division of the Department shall not expend
341	341	or transfer any money allocated to the Aging and Disability Services
342	342	Division pursuant to this section to subsidize any portion of the cost
343	343	of providing prescription drugs, pharmaceutical services and other
344	344	benefits, including, without limitation, dental and vision benefits
345	345	and hearing aids or other devices that enhance the ability to hear [,
346	346	to senior citizens or persons with disabilities] pursuant to [NRS
347	347	439.635 to 439.690, inclusive.] paragraph (c) of subsection 1.
348	348	5. A veteran may receive benefits or other services which are
349	349	available from the money allocated pursuant to this section for
350	350	senior citizens or persons with disabilities to the extent that the
351	351	veteran does not receive other benefits or services provided to
352	352	veterans for the same purpose if the veteran qualifies for the benefits
353	353	or services as a senior citizen or a person with a disability, or both.
354	354	6. On or before June 30 of each even-numbered year, the
355	355	Grants Management Advisory Committee, the Nevada Commission
356	356	on Aging and the Nevada Commission on Services for Persons with
357	357	Disabilities each shall submit to the Director a report that includes,
358	358	without limitation, recommendations regarding community needs
359	359	and priorities that are determined by each such entity after any
360	360	public hearings held by the entity.
361	361	Sec. 4. NRS 439.635, 439.648, 439.650, 439.655, 439.660,
362	362	439.665, 439.670, 439.675, 439.680, 439.685 and 439.690 are
363	363	hereby repealed.
364	364	Sec. 5. This act becomes effective on July 1, 2023.
365	365
366	366	20 ~~~~~ 23