S.B. 54
- *SB54*
SENATE BILL NO. 54–COMMITTEE ON
HEALTH AND HUMAN SERVICES
(ON BEHALF OF THE CITY OF LAS VEGAS)
PREFILED NOVEMBER 20, 2024
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Referred to Committee on Health and Human Services
SUMMARY—Requires Medicaid to provide coverage of certain
services for persons experiencing homelessness.
(BDR 38-412)
FISCAL NOTE: Effect on Local Government: No.
Effect on the State: Yes.
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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 Medicaid; requiring Medicaid to provide
coverage for medical respite care for persons
experiencing homelessness, if federal financial
participation is available; requiring the development of a
model for providing such medical respite care; and
providing other matters properly relating thereto.
Legislative Counsel’s Digest:
Existing law requires the Department of Health and Human Services to 1
administer Medicaid. (NRS 422.270) If Federal financial participation is available, 2
section 1 of this bill requires the Director of the Department to include coverage 3
under Medicaid for medical respite care provided to persons experiencing 4
homelessness, by a facility that meets certain requirements. Section 1 requires the 5
Department to apply to the Federal Government for any waiver or amendment 6
necessary to receive federal financial participation to provide such coverage. 7
Section 1 defines “medical respite care” to refer to certain medical care and support 8
services. Section 1 additionally requires the Division of Health Care Financing and 9
Policy of the Department to coordinate with the Division of Public and Behavioral 10
Health of the Department to develop a model for providing medical respite care to 11
persons experiencing homelessness. Section 2 of this bill makes a conforming 12
change to indicate that the provisions of section 1 will be administered in the same 13
manner as the provisions of existing law governing Medicaid. 14
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THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 422 of NRS is hereby amended by adding 1
thereto a new section to read as follows: 2
1. To the extent that federal financial participation is 3
available, the Director shall include under Medicaid coverage for 4
medical respite care, for not more than 90 days during any 12-5
month period, provided by a facility that meets the requirements of 6
subsection 2 to persons experiencing homelessness. Such medical 7
respite care must include, without limitation: 8
(a) Case management, including, without limitation, 9
development of case plans; 10
(b) Coordination of care; 11
(c) Behavioral health services and referrals for such services; 12
(d) Food and housing services and support; 13
(e) Storage and management of medications; 14
(f) Acute and post-acute medical care; 15
(g) Care before or after a medical procedure or operation, 16
including, without limitation, wound care; 17
(h) Transportation to and from scheduled medical 18
appointments; 19
(i) Evaluation, assessment and immediate interventions for 20
medical, psychological, vocational, cultural, social or 21
environmental factors; and 22
(j) Care for and education on substance use disorders. 23
2. A facility that wishes to receive reimbursement through 24
Medicaid pursuant to subsection 1 for medical respite care must: 25
(a) Operate in accordance with the model developed pursuant 26
to subsection 4. 27
(b) Be staffed 24 hours each day, 7 days each week by 28
providers of health care who are qualified to provide medical 29
respite care and have received training concerning: 30
(1) Trauma-informed care; 31
(2) De-escalation techniques; and 32
(3) Mental health first aid, including, without limitation: 33
(I) Recognizing the symptoms of a mental illness or 34
substance use disorder; 35
(II) Providing initial assistance to persons experiencing 36
a mental health or substance use crisis; 37
(III) Guiding persons requiring assistance with mental 38
health issues, including, without limitation, persons experiencing 39
a mental health or substance use crisis, to professionals qualified 40
to provide such assistance; 41
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(IV) Comforting a person experiencing a mental health 1
or substance use crisis; 2
(V) Helping a person with a mental illness or substance 3
use disorder avoid a mental health or substance use crisis; and 4
(VI) Promoting healing, recovery and good mental 5
health. 6
3. The Department shall apply to the Secretary of Health and 7
Human Services for any waiver of federal law or apply for any 8
amendment of the State Plan for Medicaid that is necessary for 9
the Department to receive federal funding to provide the coverage 10
required by this section. The Department shall fully cooperate in 11
good faith with the Federal Government during the application 12
process to satisfy the requirements of the Federal Government for 13
obtaining a waiver or amendment pursuant to this section. 14
4. The Division shall coordinate with the Division of Public 15
and Behavioral Health of the Department to develop a model for 16
providing medical respite care to persons experiencing 17
homelessness. The model must accord with the standards 18
prescribed by the National Institute for Medical Respite Care, or 19
its successor organization, for programs providing medical respite 20
care, to the extent that those standards do not conflict with federal 21
or state law. 22
5. As used in this section: 23
(a) “Medical respite care” means acute and post-acute medical 24
care and other support services to persons who are experiencing 25
homelessness who: 26
(1) Are unable to completely recover from an illness, injury 27
or disease; and 28
(2) Do not require care from a hospital or other inpatient 29
medical facility. 30
(b) “Person experiencing homelessness” means a person who 31
is transient, at imminent risk of homelessness or homeless. 32
Sec. 2. NRS 232.320 is hereby amended to read as follows: 33
232.320 1. The Director: 34
(a) Shall appoint, with the consent of the Governor, 35
administrators of the divisions of the Department, who are 36
respectively designated as follows: 37
(1) The Administrator of the Aging and Disability Services 38
Division; 39
(2) The Administrator of the Division of Welfare and 40
Supportive Services; 41
(3) The Administrator of the Division of Child and Family 42
Services; 43
(4) The Administrator of the Division of Health Care 44
Financing and Policy; and 45
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(5) The Administrator of the Division of Public and 1
Behavioral Health. 2
(b) Shall administer, through the divisions of the Department, 3
the provisions of chapters 63, 424, 425, 427A, 432A to 442, 4
inclusive, 446 to 450, inclusive, 458A and 656A of NRS, NRS 5
127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and 6
section 1 of this act, 422.580, 432.010 to 432.133, inclusive, 7
432B.6201 to 432B.626, inclusive, 444.002 to 444.430, inclusive, 8
and 445A.010 to 445A.055, inclusive, and all other provisions of 9
law relating to the functions of the divisions of the Department, but 10
is not responsible for the clinical activities of the Division of Public 11
and Behavioral Health or the professional line activities of the other 12
divisions. 13
(c) Shall administer any state program for persons with 14
developmental disabilities established pursuant to the 15
Developmental Disabilities Assistance and Bill of Rights Act of 16
2000, 42 U.S.C. §§ 15001 et seq. 17
(d) Shall, after considering advice from agencies of local 18
governments and nonprofit organizations which provide social 19
services, adopt a master plan for the provision of human services in 20
this State. The Director shall revise the plan biennially and deliver a 21
copy of the plan to the Governor and the Legislature at the 22
beginning of each regular session. The plan must: 23
(1) Identify and assess the plans and programs of the 24
Department for the provision of human services, and any 25
duplication of those services by federal, state and local agencies; 26
(2) Set forth priorities for the provision of those services; 27
(3) Provide for communication and the coordination of those 28
services among nonprofit organizations, agencies of local 29
government, the State and the Federal Government; 30
(4) Identify the sources of funding for services provided by 31
the Department and the allocation of that funding; 32
(5) Set forth sufficient information to assist the Department 33
in providing those services and in the planning and budgeting for the 34
future provision of those services; and 35
(6) Contain any other information necessary for the 36
Department to communicate effectively with the Federal 37
Government concerning demographic trends, formulas for the 38
distribution of federal money and any need for the modification of 39
programs administered by the Department. 40
(e) May, by regulation, require nonprofit organizations and state 41
and local governmental agencies to provide information regarding 42
the programs of those organizations and agencies, excluding 43
detailed information relating to their budgets and payrolls, which the 44
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Director deems necessary for the performance of the duties imposed 1
upon him or her pursuant to this section. 2
(f) Has such other powers and duties as are provided by law. 3
2. Notwithstanding any other provision of law, the Director, or 4
the Director’s designee, is responsible for appointing and removing 5
subordinate officers and employees of the Department. 6
Sec. 3. 1. This section becomes effective upon passage and 7
approval. 8
2. Sections 1 and 2 of this act become effective: 9
(a) Upon passage and approval for the purpose of adopting any 10
regulations and performing any other preparatory administrative 11
tasks that are necessary to carry out the provisions of this act; and 12
(b) On January 1, 2026, for all other purposes. 13
H