S.B. 8 - *SB8* SENATE BILL NO. 8–COMMITTEE ON HEALTH AND HUMAN SERVICES (ON BEHALF OF THE AGING AND DISABILITY SERVICES DIVISION OF THE DEPARTMENT OF HEALTH AND HUMAN SERVICES) PREFILED OCTOBER 29, 2024 ____________ Referred to Committee on Health and Human Services SUMMARY—Revises provisions relating to services provided by the Aging and Disability Services Division of the Department of Health and Human Services. (BDR 38-288) 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 disability services; revising the categories of persons who receive certain services from the Aging and Disability Services Division of the Department of Health and Human Services; renaming the Attorney for the Rights of Older Persons and Persons with a Physical Disability, an Intellectual Disability or a Related Condition; and providing other matters properly relating thereto. Legislative Counsel’s Digest: Existing law creates the Office of Attorney for the Rights of Older Persons and 1 Persons with a Physical Disability, an Intellectual Disability or a Related Condition 2 within the Aging and Disability Services Division of the Department of Health and 3 Human Services. (NRS 427A.123) Existing law also requires: (1) the Governor to 4 appoint the Attorney for the Rights of Older Persons and Persons with a Physical 5 Disability, an Intellectual Disability or a Related Condition; and (2) the Attorney to 6 provide advocacy, training and technical assistance relating to the legal rights of 7 older persons and persons with a physical disability, an intellectual disability or a 8 related condition. (NRS 427A.1232, 427A.1234) Existing law also provides for and 9 regulates services for persons with intellectual disabilities and developmental 10 disabilities. (Chapter 435 of NRS) Sections 1, 5 and 6 of this bill substitute the 11 term “person with a developmental disability” for the term “person with a related 12 – 2 – - *SB8* condition” in provisions relating to the Attorney. Section 2 of this bill defines the 13 term “person with an intellectual disability,” as used in provisions relating to the 14 Attorney, to mean a person with an intellectual disability, as the term “intellectual 15 disability” is currently defined in existing law governing services for persons with 16 intellectual disabilities and developmental disabilities. (NRS 435.007) Sections 1, 17 2, 5 and 6 thereby ensure that those categories of persons served by the Attorney 18 are the same categories of persons who receive services for persons with 19 intellectual disabilities and developmental disabilities. Sections 3, 4, 6 and 7 of this 20 bill accordingly revise the title of the Attorney to “Attorney for the Rights of Older 21 Persons and Persons with a Physical Disability, an Intellectual Disability or a 22 Developmental Disability.” 23 Existing law authorizes the Division to establish by regulation a program to 24 facilitate the transition of older persons and persons with physical disabilities, 25 persons with intellectual disabilities and persons with related conditions from a 26 hospital to their places of residence. (NRS 427A.290) Section 8 of this bill: (1) 27 substitutes the term “developmental disability” for “related condition”; and (2) 28 provides that the term “intellectual disability” has the same definition as in 29 provisions governing services for persons with intellectual disabilities and 30 developmental disabilities. Section 8 thereby ensures that those categories of 31 persons eligible for assistance through the program are the same as the categories of 32 persons who receive services for persons with intellectual disabilities and 33 developmental disabilities. 34 THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS: Section 1. NRS 427A.1224 is hereby amended to read as 1 follows: 2 427A.1224 “Person with a [related condition” means a person 3 of any age who has a severe, chronic disability which: 4 1. Is attributable to: 5 (a) Cerebral palsy or epilepsy; or 6 (b) Any other condition, other than mental illness, found to be 7 closely related to an intellectual disability because the condition 8 results in impairment of general intellectual functioning or adaptive 9 behavior similar to that of a person with an intellectual disability 10 and requires treatment or services similar to those required by a 11 person with an intellectual disability; 12 2. Is manifested before the person affected attains the age of 22 13 years; 14 3. Is likely to continue indefinitely; and 15 4. Results in substantial functional limitations in three or more 16 of the following areas of major life activity: 17 (a) Taking care of oneself; 18 (b) Understanding and use of language; 19 (c) Learning; 20 (d) Mobility; 21 (e) Self-direction; and 22 – 3 – - *SB8* (f) Capacity for independent living.] developmental disability” 1 means a person with a developmental disability, as defined in 2 NRS 435.007. 3 Sec. 2. NRS 427A.1226 is hereby amended to read as follows: 4 427A.1226 “Person with an intellectual disability” means a 5 person [of any age with significantly subaverage general intellectual 6 functioning existing concurrently with deficits in adaptive behavior 7 and manifested during the developmental period.] with an 8 intellectual disability, as defined in NRS 435.007. 9 Sec. 3. NRS 427A.123 is hereby amended to read as follows: 10 427A.123 The Office of Attorney for the Rights of Older 11 Persons and Persons with a Physical Disability, an Intellectual 12 Disability or a [Related Condition] Developmental Disability is 13 hereby created within the Aging and Disability Services Division of 14 the Department. 15 Sec. 4. NRS 427A.1232 is hereby amended to read as follows: 16 427A.1232 1. The Governor shall appoint the Attorney for 17 the Rights of Older Persons and Persons with a Physical Disability, 18 an Intellectual Disability or a [Related Condition] Developmental 19 Disability for a term of 4 years. The person appointed: 20 (a) Must be an attorney licensed to practice law in this State; 21 (b) Must be qualified by training and experience to perform the 22 duties and functions of the office; 23 (c) Is in the unclassified service of the State; and 24 (d) Shall report upon request to the Administrator regarding the 25 performance of the duties and the functioning of the office. 26 2. The Governor may remove the Attorney for the Rights of 27 Older Persons and Persons with a Physical Disability, an Intellectual 28 Disability or a [Related Condition] Developmental Disability from 29 office for inefficiency, neglect of duty or malfeasance in office. 30 Sec. 5. NRS 427A.1234 is hereby amended to read as follows: 31 427A.1234 1. The Attorney for the Rights of Older Persons 32 and Persons with a Physical Disability, an Intellectual Disability or a 33 [Related Condition] Developmental Disability shall: 34 (a) Provide advocacy and education relating to the legal rights of 35 older persons, persons with a physical disability, persons with an 36 intellectual disability or persons with a [related condition] 37 developmental disability and shall facilitate the development of 38 legal services to assist those persons in securing and maintaining 39 their legal rights. 40 (b) Provide, upon request, technical assistance, training and 41 other support relating to the legal rights of older persons, persons 42 with a physical disability, persons with an intellectual disability or 43 persons with a [related condition,] developmental disability, as 44 appropriate, to: 45 – 4 – - *SB8* (1) An attorney who is providing legal services for an older 1 person, a person with a physical disability, a person with an 2 intellectual disability or a person with a [related condition;] 3 developmental disability; 4 (2) An employee of a law enforcement agency; 5 (3) The Ombudsman or an advocate; 6 (4) An employee of an office for protective services of any 7 county; 8 (5) An employee of the Division; and 9 (6) Groups that advocate for older persons, persons with a 10 physical disability, persons with an intellectual disability or persons 11 with a [related condition.] developmental disability. 12 (c) Review existing and proposed policies, legislation and 13 regulations that affect older persons, persons with a physical 14 disability, persons with an intellectual disability or persons with a 15 [related condition] developmental disability and make 16 recommendations as appropriate to the Administrator. 17 (d) Review and analyze information relating to the nature and 18 extent of abuse, neglect, exploitation, isolation and abandonment of 19 older persons, persons with a physical disability, persons with an 20 intellectual disability or persons with a [related condition] 21 developmental disability to identify services that need to be 22 provided, including, without limitation: 23 (1) Methods of intervening on behalf of an older person, a 24 person with a physical disability, a person with an intellectual 25 disability or a person with a [related condition] developmental 26 disability to protect the older person, person with a physical 27 disability, person with an intellectual disability or person with a 28 [related condition] developmental disability from abuse, neglect, 29 exploitation, isolation or abandonment; and 30 (2) Enforcing the laws of this state governing abuse, neglect, 31 exploitation, isolation and abandonment of older persons, persons 32 with a physical disability, persons with an intellectual disability or 33 persons with a [related condition.] developmental disability. 34 2. The Attorney for the Rights of Older Persons and Persons 35 with a Physical Disability, an Intellectual Disability or a [Related 36 Condition] Developmental Disability may: 37 (a) Have access to, inspect, copy and subpoena all records in the 38 possession of any clerk of a court, law enforcement agency or public 39 or private institution, wherever situated, that relate to the abuse, 40 neglect, exploitation, isolation or abandonment of an older person, a 41 person with a physical disability, a person with an intellectual 42 disability or a person with a [related condition.] developmental 43 disability. 44 – 5 – - *SB8* (b) Have access to all written records in the possession of any 1 person, government, governmental agency or political subdivision 2 of a government that relate to the abuse, neglect, exploitation, 3 isolation or abandonment of an older person, a person with a 4 physical disability, a person with an intellectual disability or a 5 person with a [related condition.] developmental disability. 6 (c) Represent and assist any incapacitated older person, person 7 with a physical disability, person with an intellectual disability or 8 person with a [related condition] developmental disability until a 9 guardian is appointed for that person. 10 (d) Use the information obtained pursuant to paragraphs (a) and 11 (b) to resolve complaints relating to the abuse, neglect, exploitation, 12 isolation or abandonment of an older person, a person with a 13 physical disability, a person with an intellectual disability or a 14 person with a [related condition.] developmental disability. 15 (e) Develop services relating to financial management for an 16 older person, a person with a physical disability, a person with an 17 intellectual disability or a person with a [related condition] 18 developmental disability who is at risk of having a guardian 19 appointed by a court to manage his or her property. 20 (f) Act as the state legal assistance developer as described in 42 21 U.S.C. § 3058j. 22 (g) Appear as amicus curiae on behalf of older persons, persons 23 with a physical disability, persons with an intellectual disability or 24 persons with a [related condition] developmental disability in any 25 court in this state. 26 (h) Perform such other functions as are necessary to carry out 27 the duties and the functions of the office of the Attorney for the 28 Rights of Older Persons and Persons with a Physical Disability, an 29 Intellectual Disability or a [Related Condition.] Developmental 30 Disability. 31 Sec. 6. NRS 427A.1236 is hereby amended to read as follows: 32 427A.1236 All records in the possession of the Attorney for 33 the Rights of Older Persons and Persons with a Physical Disability, 34 an Intellectual Disability or a [Related Condition] Developmental 35 Disability relating to his or her counseling or representation of an 36 older person, a person with a physical disability, a person with an 37 intellectual disability or a person with a [related condition] 38 developmental disability are confidential and must not be released 39 to any other person except upon order of a court of competent 40 jurisdiction or pursuant to NRS 239.0115. 41 Sec. 7. NRS 427A.175 is hereby amended to read as follows: 42 427A.175 1. Within 1 year after an older patient sustains 43 damage to his or her property as a result of any act or failure to act 44 by a facility for intermediate care, a facility for skilled nursing, a 45 – 6 – - *SB8* residential facility for groups, a home for individual residential care, 1 an agency to provide personal care services in the home, an 2 intermediary service organization, a community health worker pool 3 or an agency to provide nursing in the home in protecting the 4 property, the older patient may file a verified complaint with the 5 Division setting forth the details of the damage. 6 2. Upon receiving a verified complaint pursuant to subsection 7 1, the Administrator shall investigate the complaint and attempt to 8 settle the matter through arbitration, mediation or negotiation. 9 3. If a settlement is not reached pursuant to subsection 2, the 10 facility, home, agency, organization or older patient may request a 11 hearing before the Attorney for the Rights of Older Persons and 12 Persons with a Physical Disability, an Intellectual Disability or a 13 [Related Condition.] Developmental Disability. If requested, the 14 Attorney for the Rights of Older Persons and Persons with a 15 Physical Disability, an Intellectual Disability or a [Related 16 Condition] Developmental Disability shall conduct a hearing to 17 determine whether the facility, home, agency, pool or organization 18 is liable for damages to the patient. If the Attorney for the Rights of 19 Older Persons and Persons with a Physical Disability, an Intellectual 20 Disability or a [Related Condition] Developmental Disability 21 determines that the facility, home, agency, pool or organization is 22 liable for damages to the patient, the Attorney for the Rights of 23 Older Persons and Persons with a Physical Disability, an Intellectual 24 Disability or a [Related Condition] Developmental Disability shall 25 order the amount of the surety bond pursuant to NRS 449.065 or the 26 substitute for the surety bond necessary to pay for the damages 27 pursuant to NRS 449.067 to be released to the Division. The 28 Division shall pay any such amount to the older patient or the estate 29 of the older patient. 30 4. The Division shall create a separate account for money to be 31 collected and distributed pursuant to this section. 32 5. As used in this section: 33 (a) “Agency to provide nursing in the home” has the meaning 34 ascribed to it in NRS 449.0015; 35 (b) “Agency to provide personal care services in the home” has 36 the meaning ascribed to it in NRS 449.0021; 37 (c) “Community health worker pool” has the meaning ascribed 38 to it in NRS 449.0028; 39 (d) “Facility for intermediate care” has the meaning ascribed to 40 it in NRS 449.0038; 41 (e) “Facility for skilled nursing” has the meaning ascribed to it 42 in NRS 449.0039; 43 (f) “Home for individual residential care” has the meaning 44 ascribed to it in NRS 449.0105; 45 – 7 – - *SB8* (g) “Intermediary service organization” has the meaning 1 ascribed to it in NRS 449.4304; 2 (h) “Older patient” has the meaning ascribed to it in NRS 3 449.065; and 4 (i) “Residential facility for groups” has the meaning ascribed to 5 it in NRS 449.017. 6 Sec. 8. NRS 427A.290 is hereby amended to read as follows: 7 427A.290 1. To the extent that money is available for this 8 purpose, the Division may establish by regulation a program to 9 facilitate the transition of older persons and persons with disabilities 10 from a hospital to their places of residence. The program must: 11 (a) Provide for collaboration between: 12 (1) Hospital staff who are responsible for discharging an 13 older person or a person with a disability; and 14 (2) The older person or person with a disability and any 15 caregivers or other persons assisting the older person or person with 16 a disability; and 17 (b) Facilitate the coordination of health care and social services 18 to support the older person or person with a disability and any 19 caregivers or other persons assisting the older person or person with 20 a disability. 21 2. The Division may: 22 (a) Limit the program established pursuant to this section to 23 particular groups of older persons or persons with disabilities within 24 the limits of available funding; 25 (b) Accept gifts, grants and donations for the purpose of 26 establishing and operating the program; and 27 (c) Use other options available to fund the program, including, 28 without limitation, billing third parties for the services provided by 29 the program to persons currently covered by the third parties. 30 3. As used in this section: 31 (a) “Older person” means a person who is 60 years of age or 32 older. 33 (b) “Person with a disability” means: 34 (1) A person with a physical disability, as defined in 35 NRS 427A.1222; 36 (2) A person with a [related condition,] developmental 37 disability, as defined in NRS [427A.1224;] 435.007; or 38 (3) A person with an intellectual disability, as defined in 39 NRS [427A.1226.] 435.007. 40 (c) “Third party” means: 41 (1) An insurer, as defined in NRS 679B.540; 42 (2) A health benefit plan, as defined in NRS 687B.470, for 43 employees which provides coverage for services and care at a 44 hospital; 45 – 8 – - *SB8* (3) A participating public agency, as defined in NRS 1 287.04052, and any other local governmental agency of the State of 2 Nevada which provides a system of health insurance for the benefit 3 of its officers and employees, and the dependents of officers and 4 employees, pursuant to chapter 287 of NRS; or 5 (4) Any other insurer or organization providing health 6 coverage or benefits in accordance with state or federal law. 7 The term does not include an insurer that provides coverage 8 under a policy of casualty or property insurance. 9 Sec. 9. 1. Any contracts or other agreements entered into by 10 an officer or agency whose name has been changed or whose 11 responsibilities have been transferred pursuant to the provisions of 12 this act to another officer or agency are binding upon the officer or 13 agency to which the responsibility for the administration of the 14 provisions of the contract or other agreement has been transferred. 15 Such contracts and other agreements may be enforced by the officer 16 or agency to which the responsibility for the enforcement of the 17 provisions of the contract or other agreement has been transferred. 18 2. Any action taken by an officer or agency whose name has 19 been changed or whose responsibilities have been transferred 20 pursuant to the provisions of this act to another officer or agency 21 remains in effect as if taken by the officer or agency to which the 22 responsibility for the enforcement of such actions has been 23 transferred. 24 Sec. 10. The Legislative Counsel shall, in preparing 25 supplements to the Nevada Administrative Code, appropriately 26 change any references to an officer, agency or other entity whose 27 name is changed or whose responsibilities are transferred pursuant 28 to the provisions of this act to refer to the appropriate officer, 29 agency or other entity. 30 Sec. 11. This act becomes effective upon passage and 31 approval. 32 H