- 82nd Session (2023)
Senate Bill No. 4–Committee on
Health and Human Services
CHAPTER..........
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
Treasurer to deposit into the Fund a portion of any proceeds that the State of
Nevada receives from settlement agreements with and civil actions against
manufacturers of tobacco products. (NRS 439.620) Existing law requires the
Department of Health and Human Services to allocate money in the Fund for
certain purposes, including, without limitation and subject to legislative
authorization, for direct expenditure by the Department to pay for prescription
drugs, pharmaceutical services and other benefits for senior citizens and persons
with disabilities. Existing law also authorizes the Department to use such allocated
money to subsidize these costs for senior citizens and persons with disabilities.
(NRS 439.630) Existing law establishes the procedure for allocating and revoking
such subsidies. (NRS 439.635-439.690) Existing law requires the Department to
submit a quarterly report to the Governor and certain other entities regarding the
general manner in which these expenditures have been made. (NRS 439.630)
Section 3 of this bill removes: (1) the requirement that such money must be
directly expended by the Department; and (2) the limitation that such money must
be used only to pay for benefits for senior citizens and persons with disabilities.
Section 3 instead authorizes the Department to allocate money to provide grants
and enter into contracts or intergovernmental agreements to pay for or subsidize the
cost of prescription drugs, pharmaceutical services and other benefits for natural
persons who: (1) are residents of Nevada; and (2) meet other criteria for eligibility
established by regulation of the Department. Section 3 also requires the
Department to submit the report concerning such expenditures annually rather than
quarterly. Section 4 of this bill repeals the existing provisions governing the direct
subsidization of prescription drugs, pharmaceutical services and other benefits for
senior citizens and persons with disabilities by the Department. Sections 1 and 2 of
this bill make conforming changes to remove references to the repealed provisions.
EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.
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:
439.529 1. The Department may, to the extent that money is
available, administer a program pursuant to 42 U.S.C. §§ 300ff-21
et seq. to provide therapeutics to treat certain persons who have
been diagnosed with the human immunodeficiency virus and to
– 2 –
- 82nd Session (2023)
prevent the serious deterioration of the health of such persons. The
program may include the provision of subsidies and pharmaceutical
services.
2. The Director shall:
(a) Establish the criteria for eligibility for participation in the
program administered pursuant to this section, which must be in
accordance with the provisions of 42 U.S.C. §§ 300ff-21 et seq.; and
(b) Prescribe the manner in which the program will be
administered and services will be provided.
3. The Department may use any other program administered by
the Department to facilitate the provision of subsidies and services
pursuant to this section . [, including, without limitation, the
provision of subsidies for pharmaceutical services to senior citizens
and persons with disabilities pursuant to NRS 439.635 to 439.690,
inclusive.] If the Department uses another program to facilitate the
provision of subsidies and services pursuant to this section, the
Department shall not commingle the money available to carry out
the provisions of this section and the money available to carry out
the other program.
4. Money available to carry out the provisions of this section
must be accounted for separately by the Department.
Sec. 2. NRS 439.620 is hereby amended to read as follows:
439.620 1. The Fund for a Healthy Nevada is hereby created
in the State Treasury. The State Treasurer shall deposit in the Fund:
(a) Sixty percent of all money received by this State pursuant to
any settlement entered into by the State of Nevada and a
manufacturer of tobacco products; and
(b) Sixty percent of all money recovered by this State from a
judgment in a civil action against a manufacturer of tobacco
products.
2. The State Treasurer shall administer the Fund. As
administrator of the Fund, the State Treasurer:
(a) Shall maintain the financial records of the Fund;
(b) Shall invest the money in the Fund as the money in other
state funds is invested;
(c) Shall manage any account associated with the Fund;
(d) Shall maintain any instruments that evidence investments
made with the money in the Fund;
(e) May contract with vendors for any good or service that is
necessary to carry out the provisions of this section; and
(f) May perform any other duties necessary to administer the
Fund.
– 3 –
- 82nd Session (2023)
3. The interest and income earned on the money in the Fund
must, after deducting any applicable charges, be credited to the
Fund. All claims against the Fund must be paid as other claims
against the State are paid.
4. The State Treasurer or the Department may submit to the
Interim Finance Committee a request for an allocation for
administrative expenses from the Fund pursuant to this section.
Except as otherwise limited by this subsection, the Interim Finance
Committee may allocate all or part of the money so requested. The
annual allocation for administrative expenses from the Fund must:
(a) Not exceed 2 percent of the money in the Fund, as calculated
pursuant to this subsection, each year to pay the costs incurred by
the State Treasurer to administer the Fund; and
(b) Not exceed 5 percent of the money in the Fund, as calculated
pursuant to this subsection, each year to pay the costs incurred by
the Department, including, without limitation, the Aging and
Disability Services Division of the Department, to carry out its
duties set forth in NRS 439.630 . [and to administer the provisions
of NRS 439.635 to 439.690, inclusive.]
For the purposes of this subsection, the amount of money
available for allocation to pay for the administrative costs must be
calculated at the beginning of each fiscal year based on the total
amount of money anticipated by the State Treasurer to be deposited
in the Fund during that fiscal year.
5. The money in the Fund remains in the Fund and does not
revert to the State General Fund at the end of any fiscal year.
6. All money that is deposited or paid into the Fund is hereby
appropriated to be used for any purpose authorized by the
Legislature or by the Department for expenditure or allocation in
accordance with the provisions of NRS 439.630. Money expended
from the Fund must not be used to supplant existing methods of
funding that are available to public agencies.
Sec. 3. NRS 439.630 is hereby amended to read as follows:
439.630 1. The Department shall:
(a) Conduct, or require the Grants Management Advisory
Committee created by NRS 232.383 to conduct, public hearings to
accept public testimony from a wide variety of sources and
perspectives regarding existing or proposed programs that:
(1) Promote public health;
(2) Improve health services for children, senior citizens and
persons with disabilities;
(3) Reduce or prevent alcohol and other substance use
disorders; and
– 4 –
- 82nd Session (2023)
(4) Offer other general or specific information on health care
in this State.
(b) Establish a process to evaluate the health and health needs of
the residents of this State and a system to rank the health problems
of the residents of this State, including, without limitation, the
specific health problems that are endemic to urban and rural
communities, and report the results of the evaluation to the Joint
Interim Standing Committee on Health and Human Services on an
annual basis.
(c) Subject to legislative authorization, allocate money [for
direct expenditure by] to the Department to provide grants and
enter into contracts or intergovernmental agreements to pay for
prescription drugs, pharmaceutical services and, to the extent money
is available, other benefits, including, without limitation, dental and
vision benefits and hearing aids or other devices that enhance the
ability to hear, for [senior citizens and persons with disabilities
pursuant to NRS 439.635 to 439.690, inclusive.] natural persons
who are residents of this State and meet the criteria for eligibility
established by regulation of the Department. From the money
allocated pursuant to this paragraph, the Department may subsidize
any portion of the cost of providing prescription drugs,
pharmaceutical services and, to the extent money is available, other
benefits, including, without limitation, dental and vision benefits
and hearing aids or other devices that enhance the ability to hear, to
[senior citizens and persons with disabilities pursuant to NRS
439.635 to 439.690, inclusive.] such natural persons. The
Department shall consider recommendations from the Grants
Management Advisory Committee in carrying out the provisions of
[NRS 439.635 to 439.690, inclusive.] this paragraph. The
Department shall submit [a quarterly] an annual report to the
Governor, the Interim Finance Committee, the Joint Interim
Standing Committee on Health and Human Services and any other
committees or commissions the Director deems appropriate
regarding the general manner in which expenditures have been made
pursuant to this paragraph.
(d) Subject to legislative authorization, allocate, by contract or
grant, money for expenditure by the Aging and Disability Services
Division of the Department in the form of grants for existing or new
programs that assist senior citizens and other specified persons with
independent living, including, without limitation, programs that
provide:
(1) Respite care or relief of informal caretakers, including,
without limitation, informal caretakers of any person with
– 5 –
- 82nd Session (2023)
Alzheimer’s disease or other related dementia regardless of the age
of the person;
(2) Transportation to new or existing services to assist senior
citizens in living independently; and
(3) Care in the home which allows senior citizens to remain
at home instead of in institutional care.
The Aging and Disability Services Division of the Department
shall consider recommendations from the Grants Management
Advisory Committee concerning the independent living needs of
senior citizens.
(e) Allocate $200,000 of all revenues deposited in the Fund for a
Healthy Nevada each year for direct expenditure by the Director to
award competitive grants to finance the establishment or expansion
of assisted living facilities that provide services pursuant to the
provisions of the home and community-based services waiver which
are amended pursuant to NRS 422.3962. The Director shall develop
policies and procedures for awarding grants pursuant to this
paragraph. If any money allocated pursuant to this paragraph
remains after awarding grants to all eligible applicants, the Director
must reallocate such money to the Aging and Disability Services
Division of the Department to be used for the purposes described in
paragraph (d).
(f) Subject to legislative authorization, allocate to the Division
money for programs that are consistent with the guidelines
established by the Centers for Disease Control and Prevention of the
United States Department of Health and Human Services relating to
evidence-based best practices to prevent, reduce or treat the use of
tobacco and the consequences of the use of tobacco. In making
allocations pursuant to this paragraph, the Division shall allocate the
money, by contract or grant:
(1) To the district board of health in each county whose
population is 100,000 or more for expenditure for such programs in
the respective county;
(2) For such programs in counties whose population is less
than 100,000; and
(3) For statewide programs for tobacco cessation and other
statewide services for tobacco cessation and for statewide
evaluations of programs which receive an allocation of money
pursuant to this paragraph, as determined necessary by the Division
and the district boards of health.
(g) Subject to legislative authorization, allocate, by contract or
grant, money for expenditure for programs that improve the health
– 6 –
- 82nd Session (2023)
and well-being of residents of this State, including, without
limitation, programs that improve health services for children.
(h) Subject to legislative authorization, allocate, by contract or
grant, money for expenditure for programs that improve the health
and well-being of persons with disabilities. In making allocations
pursuant to this paragraph, the Department shall, to the extent
practicable, allocate the money evenly among the following three
types of programs:
(1) Programs that provide respite care or relief of informal
caretakers for persons with disabilities;
(2) Programs that provide positive behavioral supports to
persons with disabilities; and
(3) Programs that assist persons with disabilities to live
safely and independently in their communities outside of an
institutional setting.
(i) Maximize expenditures through local, federal and private
matching contributions.
(j) Ensure that any money expended from the Fund will not be
used to supplant existing methods of funding that are available to
public agencies.
(k) Develop policies and procedures for the administration and
distribution of contracts, grants and other expenditures to state
agencies, political subdivisions of this State, nonprofit
organizations, universities, state colleges and community colleges.
A condition of any such contract or grant must be that not more than
8 percent of the contract or grant may be used for administrative
expenses or other indirect costs. The procedures must require at
least one competitive round of requests for proposals per biennium.
(l) To make the allocations required by paragraphs (f), (g) and
(h):
(1) Prioritize and quantify the needs for these programs;
(2) Develop, solicit and accept applications for allocations;
(3) Review and consider the recommendations of the Grants
Management Advisory Committee submitted pursuant to
NRS 232.385;
(4) Conduct annual evaluations of programs to which
allocations have been awarded; and
(5) Submit annual reports concerning the programs to the
Governor, the Interim Finance Committee, the Joint Interim
Standing Committee on Health and Human Services and any other
committees or commissions the Director deems appropriate.
(m) Transmit a report of all findings, recommendations and
expenditures to the Governor, each regular session of the
– 7 –
- 82nd Session (2023)
Legislature, the Joint Interim Standing Committee on Health and
Human Services and any other committees or commissions the
Director deems appropriate.
(n) After considering the recommendations submitted to the
Director pursuant to subsection 6, develop a plan each biennium to
determine the percentage of available money in the Fund for a
Healthy Nevada to be allocated from the Fund for the purposes
described in paragraphs (c), (d), (f), (g) and (h). The plan must be
submitted as part of the proposed budget submitted to the Chief of
the Budget Division of the Office of Finance pursuant to
NRS 353.210.
(o) On or before September 30 of each even-numbered year,
submit to the Grants Management Advisory Committee, the Nevada
Commission on Aging created by NRS 427A.032 and the Nevada
Commission on Services for Persons with Disabilities created by
NRS 427A.1211 a report on the funding plan submitted to the Chief
of the Budget Division of the Office of Finance pursuant to
paragraph (n).
2. The Department may take such other actions as are
necessary to carry out its duties.
3. To make the allocations required by paragraph (d) of
subsection 1, the Aging and Disability Services Division of the
Department shall:
(a) Prioritize and quantify the needs of senior citizens and other
specified persons for these programs;
(b) Develop, solicit and accept grant applications for allocations;
(c) As appropriate, expand or augment existing state programs
for senior citizens and other specified persons upon approval of the
Interim Finance Committee;
(d) Award grants, contracts or other allocations;
(e) Conduct annual evaluations of programs to which grants or
other allocations have been awarded; and
(f) Submit annual reports concerning the allocations made by
the Aging and Disability Services Division pursuant to paragraph
(d) of subsection 1 to the Governor, the Interim Finance Committee,
the Joint Interim Standing Committee on Health and Human
Services and any other committees or commissions the Director
deems appropriate.
4. The Aging and Disability Services Division of the
Department shall submit each proposed grant or contract which
would be used to expand or augment an existing state program to
the Interim Finance Committee for approval before the grant or
contract is awarded. The request for approval must include a
– 8 –
- 82nd Session (2023)
description of the proposed use of the money and the person or
entity that would be authorized to expend the money. The Aging
and Disability Services Division of the Department shall not expend
or transfer any money allocated to the Aging and Disability Services
Division pursuant to this section to subsidize any portion of the cost
of providing prescription drugs, pharmaceutical services and other
benefits, including, without limitation, dental and vision benefits
and hearing aids or other devices that enhance the ability to hear [,
to senior citizens or persons with disabilities] pursuant to [NRS
439.635 to 439.690, inclusive.] paragraph (c) of subsection 1.
5. A veteran may receive benefits or other services which are
available from the money allocated pursuant to this section for
senior citizens or persons with disabilities to the extent that the
veteran does not receive other benefits or services provided to
veterans for the same purpose if the veteran qualifies for the benefits
or services as a senior citizen or a person with a disability, or both.
6. On or before June 30 of each even-numbered year, the
Grants Management Advisory Committee, the Nevada Commission
on Aging and the Nevada Commission on Services for Persons with
Disabilities each shall submit to the Director a report that includes,
without limitation, recommendations regarding community needs
and priorities that are determined by each such entity after any
public hearings held by the entity.
Sec. 4. NRS 439.635, 439.648, 439.650, 439.655, 439.660,
439.665, 439.670, 439.675, 439.680, 439.685 and 439.690 are
hereby repealed.
Sec. 5. This act becomes effective on July 1, 2023.
20 ~~~~~ 23