[Rev. 4/16/2014 11:28:43 AM]

[NAC-427A Revised Date: 4-14]

CHAPTER 427A - SERVICES TO AGING PERSONS AND PERSONS WITH DISABILITIES

ADVOCATES FOR RESIDENTS OF FACILITIES FOR LONG-TERM CARE

427A.010         Definitions.

427A.012         “Family council” interpreted.

427A.014         “Notify” interpreted.

427A.016         “Person or persons designated as responsible for decisions regarding the resident” interpreted.

427A.018         “Resident council” interpreted.

427A.020         Scope and construction.

427A.030         Severability.

427A.040         Deviation from requirements.

427A.042         Training of advocates.

427A.044         Forming and activities of residents’ councils and family councils.

427A.046         Visits to facilities by volunteer advocates.

427A.048         Posting of notice regarding Ombudsman and advocate and procedure for making complaint.

427A.050         Communications to hearing officer.

427A.060         Service of documents: Method.

427A.070         Service of documents: Proof.

427A.080         Computation of time.

427A.090         Pleadings: Designation; execution.

427A.100         Pleadings: Filing; availability.

427A.110         Pleadings: Amendment; construction.

427A.120         Complaints: Appointment of investigator; form, contents and filing; notice.

427A.125         Ombudsman or advocate may advocate for and assist resident during discharging process.

427A.130         Answers to complaints.

427A.140         Hearings: Presiding officer; location; notice.

427A.150         Hearings: Rights of parties.

427A.160         Hearings: Appearance of parties.

427A.170         Hearings: Failure to appear.

427A.180         Hearings: Conduct of persons.

427A.190         Hearings: Preliminary procedure.

427A.200         Hearings: Order of procedure.

427A.210         Hearings: Rules of procedure and evidence.

427A.220         Hearings: Oaths of witnesses.

427A.230         Hearings: Consolidation.

427A.240         Hearings: Continuances.

427A.250         Stipulations of parties.

427A.260         Briefs; setting matter for oral argument.

427A.270         Official notice.

427A.280         Records of formal hearings.

427A.290         Submission of matter for decision.

427A.300         Issuance of decision.

427A.310         Appeal of decision.

COMPLAINTS FOR DAMAGE TO PROPERTY OF OLDER PATIENTS OF CERTAIN FACILITIES, AGENCIES AND ORGANIZATIONS

427A.320         Definitions.

427A.3205       “Complainant” defined.

427A.321         “Division” defined.

427A.3215       “Older patient” defined.

427A.322         “Person” defined.

427A.3225       “Respondent” defined.

427A.323         “Specialist” defined.

427A.3235       Scope and construction.

427A.324         Severability.

427A.3245       Deviation from requirements.

427A.325         Communications to Specialist.

427A.3255       Service of documents: Method.

427A.326         Service of documents: Proof.

427A.3265       Computation of time.

427A.327         Pleadings: Designation; execution.

427A.3275       Pleadings: Filing; availability.

427A.328         Pleadings: Amendment; construction.

427A.3285       Complaints: Form, contents and filing.

427A.329         Settlement conferences.

427A.3295       Answers to complaints.

427A.330         Hearings: Presiding officer; location; notice.

427A.3305       Hearings: Rights of parties.

427A.331         Hearings: Appearance of parties.

427A.3315       Hearings: Failure to appear.

427A.332         Hearings: Conduct of persons.

427A.3325       Hearings: Preliminary procedure.

427A.333         Hearings: Order of procedure.

427A.3335       Hearings: Rules of procedure and evidence.

427A.334         Hearings: Oaths of witnesses.

427A.3345       Hearings: Consolidation.

427A.335         Hearings: Continuances.

427A.3355       Stipulations of parties.

427A.336         Briefs; setting matter for oral argument.

427A.3365       Official notice.

427A.337         Records of formal hearings.

427A.3375       Submission of matter for decision.

427A.338         Issuance of decision.

427A.3385       Report of Specialist summarizing proceedings.

427A.339         Case record of hearing; submission and retention of case record and recording.

427A.3395       Appeal of decision.

PROGRAM TO PROVIDE COMMUNITY-BASED SERVICES TO FRAIL ELDERLY PERSONS

General Provisions

427A.350         Definitions.

427A.354         “Asset” defined.

427A.356         “Case management” defined.

427A.358         “Case manager” defined.

427A.364         “Commission” defined.

427A.365         “COPE” defined.

427A.367         “Designated representative” defined.

427A.372         “Fiscal year” defined.

427A.374         “Income” defined.

427A.378         “Legal representative” defined.

427A.379         “Nursing facility” defined.

427A.3797       “Recipient” defined.

427A.380         “Respite care” defined.

427A.381         “Social Services Manager” defined.

427A.3815       “Standardized assessment tool” defined.

427A.384         Designation of representative to act on behalf of recipient.

427A.386         Transfer of case between regions of State.

427A.388         Confidentiality and release of records of recipient.

427A.390         Review and copying of case file of recipient.

Enrollment and Determination of Eligibility

427A.400         Enrollment in Program: Procedure; denial.

427A.402         Eligibility for Program; duties of Division when no provider is available.

427A.404         Evaluation of income and assets of applicant or recipient.

427A.406         Income of applicant or recipient: Limitation; determination; reporting.

427A.408         Income of applicant or recipient: Exclusions.

427A.410         Assets of applicant or recipient: Limitation.

427A.422         Cooperation with Division in determining eligibility; notification of change in circumstances material to eligibility.

427A.424         Provision by recipient of monthly statements of bank accounts; action by Division on information received between reassessments.

Provision of Services

427A.428         Qualifications of case manager.

427A.430         Individual assessment of recipients.

427A.432         Plan of care for recipient: Development and revision; contents; provision of copy to recipient.

427A.436         Periodic reassessment of recipient and reauthorization of services.

427A.438         Duties of case manager.

427A.440         Provision and scope of services under Program.

427A.442         Provision of respite care.

427A.450         Procedure when recipient, applicant or person residing with recipient or applicant has communicable disease.

427A.452         Procedure upon placement of recipient in hospital or nursing facility.

427A.454         Reduction of services: Notification of recipient; reasons; request by recipient.

427A.456         Termination of services: Grounds; notification of recipient.

Administrative Review

427A.460         Right of review.

427A.462         Request for review.

427A.464         Preliminary conference for resolution of matter.

427A.466         Appointment and initial duties of reviewing officer; provision of notice; postponement; withdrawal of request; failure to appear.

427A.468         Continuation of services during review.

427A.470         Right to representation.

427A.472         Attendance by case manager; procedure when case manager unable to attend.

427A.474         Disclosure of documents, records and additional relevant information.

427A.476         Conducting of review.

427A.478         Recording of review.

427A.480         Case record of review; submission and retention of case record and recording.

427A.482         Procedure upon review.

427A.484         Decision of reviewing officer.

427A.486         Notification of decision and right to appeal; request for appeal.

427A.488         Report of reviewing officer summarizing proceedings.

SERVICES FOR CERTAIN PERSONS WITH AUTISM SPECTRUM DISORDERS

427A.551         Definitions.

427A.552         “Autism spectrum disorder” defined.

427A.553         “Norm-referenced instrument” defined.

427A.554         “Public agency providing autism services” defined.

427A.555         Determination of autism spectrum disorder: Approved diagnostic tools; waiver to use alternative diagnostic tools.

427A.556         Assessments conducted by public agency providing autism services.

427A.557         Annual report from Division of Public and Behavioral Health.

427A.558         Annual report from Department of Employment, Training and Rehabilitation.

PROGRAM FOR PERSONS WITH TRAUMATIC BRAIN INJURIES

427A.600         Definitions.

427A.603         “Applicant” defined.

427A.605         “Contractor” defined.

427A.607         “Program” defined.

427A.610         “Recipient” defined.

427A.613         Establishment; provision of services.

427A.615         Division to conduct annual review; evaluation.

427A.617         Quarterly reports to Division of Public and Behavioral Health.

427A.620         Application to participate in Program: Form; requirements.

427A.623         List of approved applicants; services to be provided in certain order; retention of position on or removal from list.

427A.625         Requirements for contract between Division and contractor; duties of contractor.

427A.627         Monitoring and evaluation of contractor; submission of reports to Division.

427A.630         Appeal of decision relating to eligibility for services or services provided.

427A.633         Grounds for termination of services.

USE OF SIGNATURE STAMPS BY CERTAIN PERSONS WITH PHYSICAL DISABILITIES

427A.650         “Signature stamp” defined.

427A.655         Ownership of stamp required for use.

427A.660         Photographic identification of person using stamp.

427A.665         Liability for damages caused by use of stamp by person other than owner.

PROGRAM TO ENABLE PERSONS WITH PHYSICAL DISABILITIES TO LIVE IN UNSUPERVISED SETTINGS

General Provisions

427A.675         Definitions.

427A.680         “Administrator” defined.

427A.685         “Contractor” defined.

427A.687         “Division” defined.

427A.690         “Essential personal care” defined.

427A.695         “Financial assistance” defined.

427A.700         “Person with a physical disability” defined.

427A.705         “Personal care attendant” defined.

427A.707         “Program manager” defined.

427A.710         “Recipient” defined.

427A.720         “Support services for independent living” defined.

427A.725         Eligibility for financial assistance; provision of care by Division.

427A.730         Eligibility for provision of financial assistance; priority given under certain circumstances.

427A.735         Scope of essential personal care.

427A.740         Duties of program manager.

427A.743         Contract for provision of essential personal care and other services.

427A.745         Monitoring and evaluation of contractors; submission by contractors of reports and proposed procedural changes.

427A.750         Notification of program manager of changes in income or need for essential personal care of recipient.

427A.755         Application for financial assistance; statement of need for care; notification and date of eligibility; notification of position on waiting list.

427A.765         Determination of financial eligibility; determination of portion of cost to be paid by recipient; payment of costs by contractor.

427A.770         Grounds for termination of care.

Administrative Review

427A.775         Right of review.

427A.776         Request for review.

427A.777         Preliminary conference for resolution of matter.

427A.778         Appointment and initial duties of review team; provision of notice; postponement; withdrawal of request; failure to appear.

427A.779         Continuation of services during review.

427A.780         Right to representation.

427A.781         Attendance by certain member of staff; procedure when member of staff unable to attend.

427A.782         Disclosure of documents, records and additional relevant information.

427A.783         Conducting of review.

427A.784         Recording of review.

427A.785         Case record of review; submission and retention of case record and recording.

427A.786         Procedure upon review.

427A.787         Decision of review team.

427A.788         Notification of decision and right to appeal; request for appeal.

427A.789         Report of review team summarizing proceedings.

 

 

ADVOCATES FOR RESIDENTS OF FACILITIES FOR LONG-TERM CARE

      NAC 427A.010  Definitions. (NRS 427A.070, 427A.135, 427A.138)  As used in NAC 427A.010 to 427A.310, inclusive, unless the context otherwise requires:

     1.  “Advocate” includes a volunteer advocate appointed by the Administrator pursuant to NRS 427A.127.

     2.  “Complainant” means a resident who files a complaint pursuant to NRS 427A.125 to 427A.165, inclusive, or a person who files a complaint on behalf of a resident. The term includes a person claiming retaliation for having filed a complaint, a person who provides information regarding a complaint, and an advocate or the representative of an advocate.

     3.  “Hearing officer” means the Specialist for the Rights of Elderly Persons or a person designated by him or her.

     4.  “Person” means a natural person, partnership, association, corporation or other public or private entity.

     5.  “Resident” means a resident of a facility for long-term care who is 60 years of age or older.

     6.  “Respondent” means a person against whom a complaint has been filed.

     7.  “Specialist for the Rights of Elderly Persons” means the person appointed pursuant to NRS 427A.1232.

     (Added to NAC by Aging Services Div., eff. 6-19-90; A by R163-06, 9-18-2007; A by Aging & Disability Services Div. by R017-10, 7-22-2010)

      NAC 427A.012  “Family council” interpreted. (NRS 427A.070)  For the purposes of NRS 427A.125, the Administrator will interpret the term “family council” to mean a group of family members of residents of a facility for long-term care that is formed to discuss concerns about the facility, communicate those concerns to the staff of the facility and cooperate with the staff in developing solutions to the concerns.

     (Added to NAC by Aging & Disability Services Div. by R017-10, eff. 7-22-2010)

      NAC 427A.014  “Notify” interpreted. (NRS 427A.070)  For the purposes of NRS 427A.155, the Administrator will interpret the term “notify” to include verbal notification.

     (Added to NAC by Aging & Disability Services Div. by R017-10, eff. 7-22-2010)

      NAC 427A.016  “Person or persons designated as responsible for decisions regarding the resident” interpreted. (NRS 427A.070)  For the purposes of NRS 427A.145, the Administrator will interpret the phrase “person or persons designated as responsible for decisions regarding the resident” to mean a person or persons designated by a resident as able to receive information about the resident and make decisions on the resident’s behalf, including, without limitation, such a person who is a member of the resident’s family or the resident’s attorney-in-fact.

     (Added to NAC by Aging & Disability Services Div. by R017-10, eff. 7-22-2010)

      NAC 427A.018  “Resident council” interpreted. (NRS 427A.070)  For the purposes of NRS 427A.125, the Administrator will interpret the term “resident council” to mean a group of residents of a facility for long-term care that is formed to discuss concerns about the facility, communicate those concerns to the staff of the facility and cooperate with the staff in developing solutions to the concerns.

     (Added to NAC by Aging & Disability Services Div. by R017-10, eff. 7-22-2010)

      NAC 427A.020  Scope and construction. (NRS 427A.070, 427A.135, 427A.138)  The provisions of NAC 427A.010 to 427A.310, inclusive:

     1.  Govern all practice and procedure for a hearing held pursuant to NRS 427A.135 or 427A.138; and

     2.  Must be liberally construed to secure a just, speedy and economical determination of all issues presented to the hearing officer.

     (Added to NAC by Aging Services Div., eff. 6-19-90; A 9-19-90)

      NAC 427A.030  Severability. (NRS 427A.070, 427A.135, 427A.138)  Each provision of NAC 427A.010 to 427A.310, inclusive, is hereby declared to be severable and the invalidity of any provision does not affect the validity of any other provision.

     (Added to NAC by Aging Services Div., eff. 6-19-90)

      NAC 427A.040  Deviation from requirements. (NRS 427A.070, 427A.135, 427A.138)  In special cases, upon a showing of good cause, the hearing officer may permit deviation from the requirements set forth in NAC 427A.010 to 427A.310, inclusive, if compliance is impractical or unnecessary.

     (Added to NAC by Aging Services Div., eff. 6-19-90)

      NAC 427A.042  Training of advocates. (NRS 427A.070)  The training of advocates provided by the Ombudsman pursuant to NRS 427A.125 will include, without limitation:

     1.  A minimum of 40 hours of initial training which is based on standards of the Administration on Aging of the United States Department of Health and Human Services and which includes, without limitation:

     (a) An introduction to the Ombudsman Program administered by the Administration on Aging, including the history of that program and related state programs and the role and responsibilities of ombudsmen; and

     (b) Instruction concerning:

          (1) Federal, state and local law and policies with respect to the program established in this State by the Ombudsman to assist residents of facilities for long-term care and with respect to facilities for long-term care in this State, including laws and policies concerning confidentiality and consent;

          (2) Ethics, advocacy and problem solving with respect to the program established in this State; and

          (3) Investigative techniques, periodic visits to facilities for long-term care and techniques for resolving complaints with respect to the program established in this State; and

     2.  At least 8 hours of in-service training on an annual basis.

     (Added to NAC by Aging & Disability Services Div. by R017-10, eff. 7-22-2010)

      NAC 427A.044  Forming and activities of residents’ councils and family councils. (NRS 427A.070)  The Ombudsman or an advocate may assist in the forming and activities of the residents’ councils and family councils in any facility for long-term care.

     (Added to NAC by Aging & Disability Services Div. by R017-10, eff. 7-22-2010)

      NAC 427A.046  Visits to facilities by volunteer advocates. (NRS 427A.070)

     1.  A volunteer advocate may enter any facility for long-term care and any area within the facility at reasonable times with or without prior notice. Upon arrival at the facility, the volunteer advocate shall make his or her presence known to the staff of the facility and shall present appropriate identification.

     2.  A volunteer advocate who visits a long-term care facility shall:

     (a) Meet with residents of the facility and the staff of the facility during the visit; and

     (b) Report to the Ombudsman or a designee of the Ombudsman concerning the visit.

     (Added to NAC by Aging & Disability Services Div. by R017-10, eff. 7-22-2010)

      NAC 427A.048  Posting of notice regarding Ombudsman and advocate and procedure for making complaint. (NRS 427A.165)

     1.  Each facility for long-term care shall post a notice which describes the purpose of the Ombudsman and an advocate and sets forth the procedure for making a complaint to the Ombudsman or an advocate if a resident’s rights have been violated.

     2.  The notice described in subsection 1:

     (a) Must be posted in prominent locations throughout the facility for long-term care, including, without limitation:

          (1) The entry area;

          (2) The dining area; and

          (3) An area where residents convene for activities; and

     (b) Must include, without limitation:

          (1) The name of the program established in this State by the Ombudsman to assist residents of facilities for long-term care; and

          (2) The address and telephone number of each office of the Aging and Disability Services Division in this State.

     3.  As used in this section, “resident’s rights” includes the rights of a resident of a facility for long-term care as set forth in 42 C.F.R. § 483.10.

     (Added to NAC by Aging & Disability Services Div. by R017-10, eff. 7-22-2010)

      NAC 427A.050  Communications to hearing officer. (NRS 427A.070, 427A.135, 427A.138)  Formal written communications and documents must be addressed to the hearing officer and shall be deemed to be received officially only when delivered to the hearing officer.

     (Added to NAC by Aging Services Div., eff. 6-19-90)

      NAC 427A.060  Service of documents: Method. (NRS 427A.070, 427A.135, 427A.138)  Notices, findings of fact, opinions and decisions of the hearing officer, and any document filed by a party, may be served by mail. Service shall be deemed to be complete when a true copy of the document, properly addressed and with postage paid, is deposited with the United States Postal Service.

     (Added to NAC by Aging Services Div., eff. 6-19-90)

      NAC 427A.070  Service of documents: Proof. (NRS 427A.070, 427A.135, 427A.138)  Each document which is required to be served must contain an acknowledgment of service or certificate of mailing.

     (Added to NAC by Aging Services Div., eff. 6-19-90)

      NAC 427A.080  Computation of time. (NRS 427A.070, 427A.135, 427A.138)  The time within which any act required by NAC 427A.010 to 427A.310, inclusive, must be accomplished is computed by excluding the first day and including the last day unless the last day is a Saturday, Sunday or legal holiday, in which case the next business day is the last day of the time limit.

     (Added to NAC by Aging Services Div., eff. 6-19-90; A by R163-06, 9-18-2007)

      NAC 427A.090  Pleadings: Designation; execution. (NRS 427A.070, 427A.135, 427A.138)  Each pleading must be:

     1.  Designated as a complaint, answer or motion; and

     2.  Signed by the party submitting it.

     (Added to NAC by Aging Services Div., eff. 6-19-90)

      NAC 427A.100  Pleadings: Filing; availability. (NRS 427A.070, 427A.135, 427A.138)

     1.  An original and two legible copies of each pleading must be filed with the hearing officer in all matters before him or her.

     2.  The hearing officer may direct that the party who filed a pleading make copies of it available to any other person who has requested copies, if the hearing officer first determines that the person making the request may be affected by the proceeding.

     (Added to NAC by Aging Services Div., eff. 6-19-90)

      NAC 427A.110  Pleadings: Amendment; construction. (NRS 427A.070, 427A.135, 427A.138)  The hearing officer may allow any pleading to be amended or corrected or any omission to be supplied. Pleadings must be liberally construed and defects which do not affect a substantial right of a party must be disregarded.

     (Added to NAC by Aging Services Div., eff. 6-19-90)

      NAC 427A.120  Complaints: Appointment of investigator; form, contents and filing; notice. (NRS 427A.070, 427A.135, 427A.138)

     1.  The Administrator of the Aging and Disability Services Division of the Department of Health and Human Services shall appoint an investigator to investigate each complaint concerning an alleged violation of NRS 427A.135 or 427A.138.

     2.  The complaint must be in writing and signed and verified by the complainant, and two copies must be filed with the Specialist for the Rights of Elderly Persons within 1 year after the act complained of was committed.

     3.  A complaint must be stated with sufficient particularity to enable the respondent to prepare a defense.

     4.  If, from the complaint, it appears that the charges may be well founded, the Specialist for the Rights of Elderly Persons shall send written notice to the person charged by certified mail at least 20 days before the date set for the hearing. The notice must set forth the charges and the date of the hearing.

     (Added to NAC by Aging Services Div., eff. 6-19-90; A 9-19-90; R163-06, 9-18-2007)

      NAC 427A.125  Ombudsman or advocate may advocate for and assist resident during discharging process. (NRS 427A.070)  In attempting to resolve a complaint made by or on behalf of a resident of a facility for long-term care, the Ombudsman or an advocate, upon request, may advocate for and assist a resident or a member of a resident’s family during the process of discharging the resident from a facility for long-term care, including, without limitation, any appeal from a notice of discharge given to the resident.

     (Added to NAC by Aging & Disability Services Div. by R017-10, eff. 7-22-2010)

      NAC 427A.130  Answers to complaints. (NRS 427A.070, 427A.135, 427A.138)

     1.  A respondent has 10 days after being served a complaint in which to file his or her answer with the hearing officer.

     2.  Matters alleged by way of an affirmative defense must be separately stated and numbered.

     3.  If the respondent fails to answer within 10 days, the respondent shall be deemed to have denied generally the allegations of the complaint, and except with the consent of all opposing parties and the hearing officer, he or she may not raise any affirmative defense at the hearing.

     4.  If no answer is filed, the hearing will proceed solely upon the issues set forth in the complaint, unless the hearing is continued to a future date by order of the hearing officer.

     (Added to NAC by Aging Services Div., eff. 6-19-90)

      NAC 427A.140  Hearings: Presiding officer; location; notice. (NRS 427A.070, 427A.135, 427A.138)

     1.  A hearing held pursuant to NRS 427A.135 or 427A.138 must be held before the hearing officer.

     2.  Notice of the place, date and hour of a hearing must be served at least 20 days before the date set for the hearing.

     3.  A hearing which has previously been continued may be rescheduled with at least 10 days’ notice.

     4.  Each hearing must be held at a place in the State designated by the hearing officer in the notice of hearing.

     (Added to NAC by Aging Services Div., eff. 6-19-90; A 9-19-90; R163-06, 9-18-2007)

      NAC 427A.150  Hearings: Rights of parties. (NRS 427A.070, 427A.135, 427A.138)  At any hearing, each party may enter appearances, introduce evidence, examine and cross-examine witnesses, make arguments and generally participate in the proceeding.

     (Added to NAC by Aging Services Div., eff. 6-19-90)

      NAC 427A.160  Hearings: Appearance of parties. (NRS 427A.070, 427A.135, 427A.138)  A party may enter an appearance at the beginning of a hearing or at any time designated by the hearing officer by giving the party’s name and address and stating his or her position or interest to the hearing officer. The appearance must be recorded in the transcript of the hearing.

     (Added to NAC by Aging Services Div., eff. 6-19-90)

      NAC 427A.170  Hearings: Failure to appear. (NRS 427A.070, 427A.135, 427A.138)

     1.  If the complainant or the respondent fails to appear at a scheduled hearing and no continuance has been requested or granted, the hearing officer may hear the evidence of witnesses who have appeared and may proceed to consider the matter and dispose of it on the basis of the evidence before the hearing officer.

     2.  Any person who fails to appear for a scheduled hearing or to request a continuance because of accident, sickness or other reasonable cause may, within 15 days after the failure, apply to the hearing officer to reopen the proceedings.

     3.  The hearing officer, upon finding the cause sufficient and reasonable, will immediately fix a time and place for the rescheduled hearing and give notice thereof.

     4.  At the time and place fixed, a hearing must be held at which the person may testify in the person’s own behalf or present other evidence beneficial to his or her cause.

     5.  Witnesses who have previously testified are not required to appear at a second hearing on the same matter unless so directed by the hearing officer.

     (Added to NAC by Aging Services Div., eff. 6-19-90; A by R163-06, 9-18-2007)

      NAC 427A.180  Hearings: Conduct of persons. (NRS 427A.070, 427A.135, 427A.138)  Each party to a hearing, his or her counsel and all spectators shall conduct themselves in a respectful manner.

     (Added to NAC by Aging Services Div., eff. 6-19-90)

      NAC 427A.190  Hearings: Preliminary procedure. (NRS 427A.070, 427A.135, 427A.138)  The hearing officer will call the proceeding to order, take the appearances and make any introductory remarks. Each party may then make an opening statement.

     (Added to NAC by Aging Services Div., eff. 6-19-90)

      NAC 427A.200  Hearings: Order of procedure. (NRS 427A.070, 427A.135, 427A.138)  Matters must be heard at a hearing in the following order:

     1.  The opening statements of the complainant and the respondent.

     2.  The presentation of the case of the complainant, followed by cross-examination.

     3.  The presentation of the respondent’s case, if any, followed by cross-examination.

     4.  The rebuttal testimony by the complainant, if any.

     5.  The rebuttal testimony by the respondent, if any.

     6.  The closing arguments, in the following order:

     (a) The argument of the complainant, if any.

     (b) The argument of the respondent.

     (c) The rebuttal argument of the complainant.

     (Added to NAC by Aging Services Div., eff. 6-19-90; A by R163-06, 9-18-2007)

      NAC 427A.210  Hearings: Rules of procedure and evidence. (NRS 427A.070, 427A.135, 427A.138)

     1.  In conducting a hearing, the hearing officer is not bound by the Nevada Rules of Civil Procedure and no informality in any proceeding or in the manner of taking of testimony invalidates any decision the hearing officer issues.

     2.  The Nevada Rules of Civil Procedure may be generally followed, but may be relaxed by the hearing officer if deviation from those rules of evidence will aid in ascertaining the facts.

     3.  If an objection is made to the admissibility of evidence, the evidence may be received but it is subject to any subsequent ruling of the hearing officer.

     4.  The hearing officer may exclude inadmissible, incompetent, cumulative or irrelevant evidence.

     5.  A party objecting to the introduction of evidence shall briefly state the grounds of the objection at the time the evidence is offered.

     6.  Evidence admitted at hearings must be material and relevant to the issues.

     (Added to NAC by Aging Services Div., eff. 6-19-90)

      NAC 427A.220  Hearings: Oaths of witnesses. (NRS 427A.070, 427A.135, 427A.138)  All testimony to be considered in a hearing must be taken under oath. Before taking the witness stand, each person must swear before the hearing officer to the truthfulness of the testimony the person is about to give in the hearing.

     (Added to NAC by Aging Services Div., eff. 6-19-90)

      NAC 427A.230  Hearings: Consolidation. (NRS 427A.070, 427A.135, 427A.138)

     1.  The hearing officer may consolidate two or more proceedings into one hearing if it appears that the issues are substantially the same and the interests of the parties will not be prejudiced by consolidation.

     2.  The hearing officer will determine the order of procedure in a consolidated hearing.

     (Added to NAC by Aging Services Div., eff. 6-19-90)

      NAC 427A.240  Hearings: Continuances. (NRS 427A.070, 427A.135, 427A.138)  The hearing officer may, before or during a hearing, and on a proper showing, grant continuances for submission of further proof of any matter or for any other just cause.

     (Added to NAC by Aging Services Div., eff. 6-19-90)

      NAC 427A.250  Stipulations of parties. (NRS 427A.070, 427A.135, 427A.138)

     1.  With the approval of the hearing officer, the parties may stipulate to any fact at issue by a written stipulation introduced in evidence as an exhibit or by oral statements shown upon the record.

     2.  Any stipulation is binding upon all parties to it, and may be treated as evidence at the hearing.

     3.  The hearing officer may demand proof by requiring evidence of the facts stipulated.

     (Added to NAC by Aging Services Div., eff. 6-19-90)

      NAC 427A.260  Briefs; setting matter for oral argument. (NRS 427A.070, 427A.135, 427A.138)

     1.  The hearing officer may order briefs to be filed and specify a time limit for their filing.

     2.  Three copies of any requested brief must be filed with the hearing officer in matters before him or her.

     3.  Each brief must be accompanied by an acknowledgment of service or a certificate of mailing to other parties of record.

     4.  Following the filing of briefs and after deciding contested motions, the hearing officer may set the matter for oral argument and give reasonable notice to all parties.

     (Added to NAC by Aging Services Div., eff. 6-19-90)

      NAC 427A.270  Official notice. (NRS 427A.070, 427A.135, 427A.138)  The hearing officer may take official notice of:

     1.  The rules, regulations, official reports, decisions and orders of any regulatory agency of the State.

     2.  Matters of common knowledge and established technical or scientific facts.

     3.  Official documents, if relevant and properly introduced into the record of formal proceedings by reference. A proper and definite reference to the documents must be made by the party offering them and the documents must be published and generally circulated so that the parties in interest may examine the documents and present rebuttal evidence.

     (Added to NAC by Aging Services Div., eff. 6-19-90)

      NAC 427A.280  Records of formal hearings. (NRS 427A.070, 427A.135, 427A.138)  The hearing officer will cause a record to be made of all formal hearings. Any party who wishes to secure a copy of the record may obtain it from the hearing officer upon payment of the proper fee.

     (Added to NAC by Aging Services Div., eff. 6-19-90; A by R163-06, 9-18-2007)

      NAC 427A.290  Submission of matter for decision. (NRS 427A.070, 427A.135, 427A.138)  Unless otherwise ordered, a proceeding stands submitted for decision by the hearing officer after the taking of evidence, the filing of briefs or the presentation of oral argument required by the hearing officer.

     (Added to NAC by Aging Services Div., eff. 6-19-90)

      NAC 427A.300  Issuance of decision. (NRS 427A.070, 427A.135, 427A.138)

     1.  The hearing officer will issue a decision not later than 60 days after the hearing.

     2.  The hearing officer will mail or personally deliver a copy of the decision to the Administrator of the Aging and Disability Services Division of the Department of Health and Human Services and each party of record or his or her representative.

     3.  Additional copies of the decision may be obtained by making a written request to the hearing officer.

     (Added to NAC by Aging Services Div., eff. 6-19-90; A by R163-06, 9-18-2007)

      NAC 427A.310  Appeal of decision. (NRS 427A.070, 427A.135, 427A.138)  Any person aggrieved by a decision issued pursuant to a hearing held pursuant to NRS 427A.135 or 427A.138 may appeal to the Director of the Department of Health and Human Services whose decision on the appeal is a final decision.

     (Added to NAC by Aging Services Div., eff. 6-19-90; A 9-19-90)

COMPLAINTS FOR DAMAGE TO PROPERTY OF OLDER PATIENTS OF CERTAIN FACILITIES, AGENCIES AND ORGANIZATIONS

      NAC 427A.320  Definitions. (NRS 427A.070, 427A.175)  As used in NAC 427A.320 to 427A.3395, inclusive, the words and terms defined in NAC 427A.3205 to 427A.323, inclusive, have the meanings ascribed to them in those sections.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.3205  “Complainant” defined. (NRS 427A.070, 427A.175)  “Complainant” means an older patient who files a complaint pursuant to NRS 427A.175.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.321  “Division” defined. (NRS 427A.070, 427A.175)  “Division” means the Aging and Disability Services Division of the Department of Health and Human Services.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.3215  “Older patient” defined. (NRS 427A.070, 427A.175)  “Older patient” has the meaning ascribed to it in NRS 449.065.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.322  “Person” defined. (NRS 427A.070, 427A.175)  “Person” means a natural person, partnership, association, corporation or other public or private entity.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.3225  “Respondent” defined. (NRS 427A.070, 427A.175)  “Respondent” means a facility, organization or agency against which a complaint has been filed pursuant to NRS 427A.175.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.323  “Specialist” defined. (NRS 427A.070, 427A.175)  “Specialist” means the Specialist for the Rights of Elderly Persons appointed pursuant to NRS 427A.1232.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.3235  Scope and construction. (NRS 427A.070, 427A.175)  The provisions of NAC 427A.320 to 427A.3395, inclusive:

     1.  Govern all practice and procedure for a complaint filed by an older patient for damage to property pursuant to NRS 427A.175 and for the investigation and hearing of that complaint; and

     2.  Must be liberally construed to secure a just, speedy and economical determination of all issues presented to the Administrator of the Division and the Specialist.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.324  Severability. (NRS 427A.070, 427A.175)  Each provision of NAC 427A.320 to 427A.3395, inclusive, is hereby declared to be severable and the invalidity of any provision does not affect the validity of any other provision.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.3245  Deviation from requirements. (NRS 427A.070, 427A.175)  In special cases, upon a showing of good cause, the Specialist may permit deviation from the requirements set forth in NAC 427A.320 to 427A.3395, inclusive, if compliance is impractical or unnecessary.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.325  Communications to Specialist. (NRS 427A.070, 427A.175)  Formal written communications and documents must be addressed to the Specialist and shall be deemed to be received officially only when delivered to the Specialist.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.3255  Service of documents: Method. (NRS 427A.070, 427A.175)  Notices, findings of fact, opinions and decisions of the Specialist, and any document filed by a party, may be served by mail. Service shall be deemed to be complete when a true copy of the document, properly addressed and with postage paid, is deposited with the United States Postal Service.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.326  Service of documents: Proof. (NRS 427A.070, 427A.175)  Each document that is required to be served must contain an acknowledgment of service or certificate of mailing.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.3265  Computation of time. (NRS 427A.070, 427A.175)  The time within which any act required by NAC 427A.320 to 427A.3395, inclusive, must be accomplished is computed by excluding the first day and including the last day unless the last day is a Saturday, Sunday or legal holiday, in which case the next business day is the last day of the time limit.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.327  Pleadings: Designation; execution. (NRS 427A.070, 427A.175)  Each pleading must be:

     1.  Designated as a complaint, answer or motion; and

     2.  Signed by the party submitting it.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.3275  Pleadings: Filing; availability. (NRS 427A.070, 427A.175)

     1.  An original and two legible copies of each pleading must be filed with the Specialist in all matters before him or her.

     2.  The Specialist may direct that the party who filed a pleading make copies of it available to any other person who has requested copies, if the Specialist first determines that the person making the request may be affected by the proceeding.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.328  Pleadings: Amendment; construction. (NRS 427A.070, 427A.175)  The Specialist may allow any pleading to be amended or corrected or any omission to be supplied. Pleadings must be liberally construed and defects that do not affect a substantial right of a party must be disregarded.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.3285  Complaints: Form, contents and filing. (NRS 427A.070, 427A.175)

     1.  An older patient who wishes to file a complaint pursuant to NRS 427A.175 must file two copies of the complaint with the Division within 1 year after the older patient sustains damage to his or her property. The complaint must be in writing and signed and verified by the complainant.

     2.  A complaint must be stated with sufficient particularity to enable the respondent to prepare a defense.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.329  Settlement conferences. (NRS 427A.070, 427A.175)

     1.  Within 10 days after the Division receives a complaint, the supervisor of the region in which the respondent is located shall contact the complainant or his or her representative to schedule a settlement conference in accordance with subsection 2 of NRS 427A.175 with the Administrator of the Division or the Administrator’s designee to attempt to resolve the matter without the necessity of a hearing.

     2.  The Administrator of the Division or his or her designee shall:

     (a) Preside at the conference; and

     (b) Complete a report on the outcome of the conference.

     3.  The conference does not affect the right of the complainant or respondent to a hearing.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.3295  Answers to complaints. (NRS 427A.070, 427A.175)

     1.  A respondent has 10 days after being served a complaint in which to file his or her answer with the Specialist, regardless of whether a settlement conference is scheduled pursuant to NAC 427A.329.

     2.  If the respondent fails to answer within 10 days, the respondent shall be deemed to have denied generally the allegations contained in the complaint.

     3.  If no answer is filed and a hearing is requested pursuant to NAC 427A.330, the hearing will proceed solely upon the issues set forth in the complaint, unless the hearing is continued to a future date by order of the Specialist.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.330  Hearings: Presiding officer; location; notice. (NRS 427A.070, 427A.175)

     1.  If a settlement is not reached pursuant to subsection 2 of NRS 427A.175 and the complainant or respondent requests a hearing, the hearing must be before the Specialist.

     2.  Notice of the place, date and hour of a hearing must be served at least 20 days before the date set for the hearing.

     3.  A hearing which has previously been continued may be rescheduled with at least 10 days’ notice.

     4.  Each hearing must be held at a place in the State designated by the Specialist in the notice of hearing.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.3305  Hearings: Rights of parties. (NRS 427A.070, 427A.175)  At any hearing, each party may enter appearances, introduce evidence, examine and cross-examine witnesses, make arguments and generally participate in the proceeding.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.331  Hearings: Appearance of parties. (NRS 427A.070, 427A.175)  A party may enter an appearance at the beginning of a hearing or at any time designated by the Specialist by giving his or her name and address and stating his or her position or interest to the Specialist. The appearance must be recorded in the transcript of the hearing.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.3315  Hearings: Failure to appear. (NRS 427A.070, 427A.175)

     1.  If the complainant or the respondent fails to appear at a scheduled hearing and no continuance has been requested or granted, the Specialist may hear the evidence of witnesses who have appeared and may proceed to consider the matter and dispose of it on the basis of the evidence before him or her.

     2.  Any person who fails to appear for a scheduled hearing or to request a continuance because of accident, sickness or other reasonable cause may, within 15 days after the failure, apply to the Specialist to reopen the proceedings.

     3.  The Specialist, upon finding the cause to reopen the proceedings sufficient and reasonable, will immediately fix a time and place for the rescheduled hearing and give notice thereof.

     4.  At the time and place fixed, a second hearing must be held at which the person who requested the second hearing may testify in his or her own behalf or present other evidence beneficial to his or her cause.

     5.  Witnesses who have previously testified are not required to appear at a second hearing on the same matter unless so directed by the Specialist.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.332  Hearings: Conduct of persons. (NRS 427A.070, 427A.175)  Each party to a hearing, his or her counsel and all spectators shall conduct themselves in a respectful manner.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.3325  Hearings: Preliminary procedure. (NRS 427A.070, 427A.175)  The Specialist will call the proceeding to order, take the appearances and make any introductory remarks. Each party may then make an opening statement.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.333  Hearings: Order of procedure. (NRS 427A.070, 427A.175)  Matters must be heard at a hearing in the following order:

     1.  The opening statements of the complainant and the respondent.

     2.  The presentation of the case of the complainant, followed by cross-examination.

     3.  The presentation of the case of the respondent, if any, followed by cross-examination.

     4.  The rebuttal testimony by the complainant, if any.

     5.  The rebuttal testimony by the respondent, if any.

     6.  The closing arguments, in the following order:

     (a) The argument of the complainant.

     (b) The argument of the respondent.

     (c) The rebuttal argument of the complainant.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.3335  Hearings: Rules of procedure and evidence. (NRS 427A.070, 427A.175)

     1.  In conducting a hearing, the Specialist is not bound by the Nevada Rules of Civil Procedure and an informality in any proceeding or in the manner of taking of testimony does not invalidate any decision the Specialist issues.

     2.  The Nevada Rules of Civil Procedure may be generally followed, but may be relaxed by the Specialist if deviation from those rules of evidence will aid in ascertaining the facts.

     3.  If an objection is made to the admissibility of evidence, the evidence may be received but it is subject to any subsequent ruling of the Specialist.

     4.  The Specialist may exclude inadmissible, incompetent, cumulative or irrelevant evidence.

     5.  A party objecting to the introduction of evidence shall briefly state the grounds of the objection at the time the evidence is offered.

     6.  Evidence admitted at hearings must be material and relevant to the issues.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.334  Hearings: Oaths of witnesses. (NRS 427A.070, 427A.175)  All testimony to be considered in a hearing must be taken under oath. Before taking the witness stand, each person must swear before the Specialist to the truthfulness of the testimony the person is about to give in the hearing.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.3345  Hearings: Consolidation. (NRS 427A.070, 427A.175)

     1.  The Specialist may consolidate two or more proceedings into one hearing if it appears that the issues are substantially the same and the interests of the parties will not be prejudiced by consolidation.

     2.  The Specialist will determine the order of procedure in a consolidated hearing.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.335  Hearings: Continuances. (NRS 427A.070, 427A.175)  The Specialist may, before or during a hearing, and on a proper showing, grant continuances for submission of further proof of any matter or for any other just cause.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.3355  Stipulations of parties. (NRS 427A.070, 427A.175)

      1.  With the approval of the Specialist, the parties may stipulate to any fact at issue by a written stipulation introduced in evidence as an exhibit or by oral statements shown upon the record.

     2.  Any stipulation is binding upon all parties to it and may be treated as evidence at the hearing.

     3.  The Specialist may demand proof by requiring evidence of the facts stipulated.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.336  Briefs; setting matter for oral argument. (NRS 427A.070, 427A.175)

     1.  The Specialist may order briefs to be filed and specify a time limit for their filing.

     2.  Three copies of any requested brief must be filed with the Specialist in matters before him or her.

     3.  Each brief must be accompanied by an acknowledgment of service or a certificate of mailing to the other parties of record.

     4.  After the filing of briefs and the deciding of contested motions, the Specialist may set the matter for oral argument and give reasonable notice to all parties.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.3365  Official notice. (NRS 427A.070, 427A.175)  The Specialist may take official notice of:

     1.  The rules, regulations, official reports, decisions and orders of any regulatory agency of the State.

     2.  Matters of common knowledge and established technical or scientific facts.

     3.  Official documents, if relevant and properly introduced into the record of formal proceedings by reference. A proper and definite reference to the documents must be made by the party offering them, and the documents must be published and generally circulated so that the parties in interest may examine the documents and present rebuttal evidence.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.337  Records of formal hearings. (NRS 427A.070, 427A.175)  The Specialist will cause a record to be made of all formal hearings. Any party who wishes to secure a copy of the record may obtain it from the Specialist upon payment of the proper fee.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.3375  Submission of matter for decision. (NRS 427A.070, 427A.175)  Unless otherwise ordered, a proceeding stands submitted for decision by the Specialist after the taking of evidence, the filing of briefs or the presentation of oral argument required by the Specialist.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.338  Issuance of decision. (NRS 427A.070, 427A.175)

     1.  The Specialist will issue a decision not later than 60 days after the hearing.

     2.  The Specialist will mail or personally deliver a copy of the decision to the Administrator of the Division and each party of record or his or her representative.

     3.  Additional copies of the decision may be obtained by making a written request to the Specialist.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.3385  Report of Specialist summarizing proceedings. (NRS 427A.070, 427A.175)

     1.  The Specialist shall summarize the proceedings in a written report using the following format:

 

     A.  INTRODUCTION—The date, time and place of the hearing and the name of each person present at the hearing.

     B.  NATURE OF CASE—Overview of the issues presented during the hearing.

     C.  FINDINGS OF FACT—The facts of the case as determined by the Specialist.

     D.  CONCLUSIONS OF LAW—The laws, regulations, procedural rules and policies which support the findings and decision of the Specialist.

     E.  DECISION—The decision of whether the respondent is liable for damages to the complainant and, if the respondent is liable for damages, the amount of the surety bond pursuant to NRS 449.065 or the substitute for the surety bond necessary to pay for the damages pursuant to NRS 449.067 to be released to the Division.

 

     2.  The Specialist shall submit the written report prepared pursuant to this section to the Administrator of the Division with the case record required pursuant to NAC 427A.339.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.339  Case record of hearing; submission and retention of case record and recording. (NRS 427A.070, 427A.175)

     1.  The Specialist shall keep the record of each hearing that he or she conducts which contains:

     (a) All correspondence that the Specialist has received regarding the subject matter of the hearing;

     (b) All exhibits presented and accepted during the hearing; and

     (c) A narrative log of all contacts that the Specialist has had with the complainant or the complainant’s representative, the respondent, members of the staff of the Division, or legal counsel for any of the participants in the hearing.

     2.  The case record established by the Specialist constitutes the official record of the hearing.

     3.  After the Specialist has rendered a decision, he or she shall submit the case record and the audiotape recording of the hearing to the office of the Division in Carson City. That office shall retain the record of the hearing and the audiotape recording for:

     (a) Four years after the date of the decision; or

     (b) Until the resolution of a judicial review of the decision,

Ê whichever occurs later.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

      NAC 427A.3395  Appeal of decision. (NRS 427A.070, 427A.175)  Any person aggrieved by a decision issued pursuant to a hearing held pursuant to NRS 427A.175 may appeal to the Administrator of the Division whose decision on the appeal is a final decision.

     (Added to NAC by Aging Services Div. by R167-06, eff. 9-18-2007)

PROGRAM TO PROVIDE COMMUNITY-BASED SERVICES TO FRAIL ELDERLY PERSONS

General Provisions

      NAC 427A.350  Definitions. (NRS 427A.250)  As used in NAC 427A.350 to 427A.488, inclusive, unless the context otherwise requires, the words and terms defined in NAC 427A.354 to 427A.3815, inclusive, have the meanings ascribed to them in those sections.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A by R163-06, 9-18-2007; A by Aging & Disability Services Div. by R018-10, 7-22-2010)

      NAC 427A.354  “Asset” defined. (NRS 427A.250)  “Asset” means income and resources that:

     1.  Belong to an applicant or recipient; and

     2.  Have monetary value.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A by R163-06, 9-18-2007)

      NAC 427A.356  “Case management” defined. (NRS 427A.250)  “Case management” means a process in which a person is assisted in gaining access to services provided by COPE and to medical, educational, social and other services, without regard to the source of funding from which the access is gained.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A by R163-06, 9-18-2007; A by Aging & Disability Services Div. by R018-10, 7-22-2010)

      NAC 427A.358  “Case manager” defined. (NRS 427A.250)  “Case manager” means a person who meets the qualifications set forth in NAC 427A.428 and who carries out the duties of case management for a recipient of COPE.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A by R163-06, 9-18-2007)

      NAC 427A.364  “Commission” defined. (NRS 427A.250)  “Commission” means the Nevada Commission on Aging.

     (Added to NAC by Aging Services Div., eff. 7-16-92)

      NAC 427A.365  “COPE” defined. (NRS 427A.250)  “COPE” means the Community Service Options Program for the Elderly established by the Division pursuant to NRS 427A.250 to provide community-based services to frail elderly persons.

     (Added to NAC by Aging Services Div. by R163-06, eff. 9-18-2007)

      NAC 427A.367  “Designated representative” defined. (NRS 427A.250)  “Designated representative” means a person designated to act on behalf of a recipient pursuant to NAC 427A.384.

     (Added to NAC by Aging Services Div. by R163-06, eff. 9-18-2007)

      NAC 427A.372  “Fiscal year” defined. (NRS 427A.250)  “Fiscal year” means a period beginning on July 1 and ending on June 30 of the following year.

     (Added to NAC by Aging Services Div., eff. 7-16-92)

      NAC 427A.374  “Income” defined. (NRS 427A.250)  “Income” means the receipt of money or other thing of value.

     (Added to NAC by Aging Services Div., eff. 7-16-92)

      NAC 427A.378  “Legal representative” defined. (NRS 427A.250)  “Legal representative” means:

     1.  A person who has been designated to act for an applicant or a recipient of COPE by a power of attorney;

     2.  A legal guardian of an applicant or a recipient; or

     3.  Any other person who is legally authorized to act for an applicant or a recipient.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A by R163-06, 9-18-2007)

      NAC 427A.379  “Nursing facility” defined. (NRS 427A.250)  “Nursing facility” means a facility for intermediate care as defined in NRS 449.0038, or a facility for skilled nursing as defined in NRS 449.0039.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A 1-10-97)

      NAC 427A.3797  “Recipient” defined. (NRS 427A.250)  “Recipient” means a person who is enrolled in COPE.

     (Added to NAC by Aging Services Div. by R163-06, eff. 9-18-2007)

      NAC 427A.380  “Respite care” defined. (NRS 427A.250)  “Respite care” means care for a patient that provides a respite for the primary caregiver from the stresses and responsibilities that result from the daily care of the patient.

     (Added to NAC by Aging Services Div., eff. 7-16-92)

      NAC 427A.381  “Social Services Manager” defined. (NRS 427A.250)  “Social Services Manager” means the Social Services Manager of community-based care of the Division.

     (Added to NAC by Aging Services Div. by R163-06, eff. 9-18-2007)

      NAC 427A.3815  “Standardized assessment tool” defined. (NRS 427A.250)  “Standardized assessment tool” means the form used to measure the needs of a recipient of COPE.

     (Added to NAC by Aging Services Div. by R163-06, eff. 9-18-2007)

      NAC 427A.384  Designation of representative to act on behalf of recipient. (NRS 427A.250)  If a recipient has difficulty acting on his or her own behalf, the recipient may designate a representative to act on his or her behalf. If the recipient designates such a representative, the recipient shall notify the Division and all subsequent correspondence from the Division must be sent to the recipient and his or her designated representative.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A by R163-06, 9-18-2007)

      NAC 427A.386  Transfer of case between regions of State. (NRS 427A.250)  If a recipient moves from one region in this State to another, his or her case must be transferred to the office of the Division responsible for the region to which the recipient has moved.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A by R163-06, 9-18-2007)

      NAC 427A.388  Confidentiality and release of records of recipient. (NRS 427A.250)

     1.  The records of a recipient are confidential and may only be released to:

     (a) A person who is authorized by the recipient or his or her legal representative pursuant to a signed, written authorization to release information.

     (b) A person who is authorized to view the records of a recipient pursuant to an order of a court of competent jurisdiction.

     (c) An employee of the Division, if the Social Services Manager deems it necessary.

     (d) A member of the staff of an agency that is required by state or federal law to investigate allegations of crimes committed against older persons, persons with mental illness or persons with disabilities if the member of the staff provides:

          (1) A written request for the records; and

          (2) A written authorization to release the records which is signed by the recipient or his or her legal representative.

     (e) A member of the staff of an agency that is required by state or federal law to pursue legal, administrative or other remedies to ensure the rights of older persons, persons with mental illness or persons with disabilities if the member of the staff provides:

          (1) A written request for the records; and

          (2) A written authorization to release the records which is signed by the recipient or his or her legal representative.

     2.  The records of a recipient may be released for statistical or evaluative purposes if they are used in such a way that the identity of the recipient is not disclosed.

     3.  To the extent necessary for a recipient to make a claim, or for a claim to be made on behalf of a recipient, for aid, insurance or medical assistance to which the recipient may be entitled, information from the records may be released if the recipient or his or her legal representative has signed a written authorization to release information for such a purpose.

     4.  A written authorization to release information is effective until the case to which the information authorized to be released pertains is closed by the Division.

     5.  Any review and release of records must comply with the Health Insurance Portability and Accountability Act, 42 U.S.C. §§ 300gg, et seq.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A 1-10-97; R163-06, 9-18-2007; A by Aging & Disability Services Div. by R018-10, 7-22-2010)

      NAC 427A.390  Review and copying of case file of recipient. (NRS 427A.250)

     1.  The Division will make a recipient’s case file available for review upon the request of the recipient.

     2.  A recipient may authorize another person to review the recipient’s case file by signing a form for the release of information. The form will be provided by the Division. The signing of the form must be witnessed by a person other than the person who is being authorized to review the file.

     3.  A copy of the plan of care, statement of understanding or release of information must be provided at no charge to the recipient or the person authorized to review the file. A copy of any other document in the case file must be furnished to the recipient or the person authorized to review the file at a charge not to exceed the actual cost to the Division of producing the copy.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A by R163-06, 9-18-2007)

Enrollment and Determination of Eligibility

      NAC 427A.400  Enrollment in Program: Procedure; denial. (NRS 427A.250)

     1.  A person may apply for enrollment in COPE by completing an application and submitting it to an office of the Division. If an applicant meets the criteria for eligibility listed in NAC 427A.402 and funds are available, the Division will authorize services from COPE for the applicant and the applicant must be enrolled in COPE. The eligibility of a recipient must be reestablished annually.

     2.  The Division may, at the discretion of the Administrator, establish a waiting list for enrollment in COPE to ensure service will be provided within a reasonable time as established by the Department of Health and Human Services.

     3.  If an applicant is denied enrollment, the staff of the Division shall inform the applicant in writing of the reason or reasons why his or her application was denied and provide to the applicant written information regarding the right to an appeal.

     4.  If possible, referrals must be made to other agencies for the provision of services to an applicant who has been denied enrollment in COPE.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A 1-10-97; R163-06, 9-18-2007; A by Aging & Disability Services Div. by R018-10, 7-22-2010)

      NAC 427A.402  Eligibility for Program; duties of Division when no provider is available. (NRS 427A.250)

     1.  To be eligible for COPE, a person must:

     (a) Be 65 years of age or older.

     (b) Function at a level required for a person under the care of a nursing facility and be determined to be at risk of placement in a nursing facility within 30 days if not for the services provided by COPE.

     (c) Be:

          (1) A citizen of the United States;

          (2) An alien who was legally admitted into the United States for permanent residency; or

          (3) An alien who has been granted temporary residency under the Immigration Reform and Control Act of 1986, 8 U.S.C. §§ 1101, et seq.,

Ê and sign the application or an addendum to the application certifying that the person is a citizen of the United States or an alien with such lawful immigration status. The Division may require an applicant to provide additional verification of the requirements of this paragraph.

     (d) Reside in this State with the intention of making this State his or her place of residence for an indefinite period.

     (e) Provide the Division with his or her social security number. An applicant who has not been issued a social security number shall obtain a number and provide it to the Division within a reasonable time after submitting his or her application.

     (f) Meet the requirements for monthly income and assets as set by:

          (1) Medicaid, as noted in the “Eligibility and Payments Manual” of the Division of Welfare and Supportive Services of the Department of Health and Human Services; and

          (2) The Commission.

     (g) Reside in a private residence.

     (h) Not be receiving care at an acute care hospital or nursing facility.

     (i) Not be receiving services that duplicate the services of COPE.

     (j) Agree to accept the services of COPE.

     (k) Demonstrate a continued need for the services of COPE.

     (l) Agree to use available personal and financial resources to support his or her need for services.

     2.  If an applicant has been approved for service, but no providers of service are available in his or her area, the Division will make reasonable efforts to obtain services for the applicant. The Division will notify the applicant if there are no providers of service available in his or her area.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A 1-10-97; R163-06, 9-18-2007; A by Aging & Disability Services Div. by R018-10, 7-22-2010)

      NAC 427A.404  Evaluation of income and assets of applicant or recipient. (NRS 427A.250)  The Division will evaluate the income and assets of an applicant or a recipient in determining the eligibility or continued eligibility of the applicant or recipient for enrollment in COPE. Such evaluation must be conducted on an annual basis.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A by R163-06, 9-18-2007)

      NAC 427A.406  Income of applicant or recipient: Limitation; determination; reporting. (NRS 427A.250)

     1.  The allowable gross monthly income of a recipient must be determined during any month that services are provided by COPE in accordance with the institutional guidelines established by the Division of Welfare and Supportive Services of the Department of Health and Human Services subject to the amendments set forth by the Commission, if any.

     2.  To determine the gross monthly income of an applicant or a recipient, any income excluded pursuant to NAC 427A.408 during the month on which the determination is based must be subtracted from the total amount of income received by the applicant or recipient for that month.

     3.  All income, except income excluded pursuant to NAC 427A.408, must be verified, documented and counted in determining the eligibility of an applicant or the continued eligibility of a recipient.

     4.  An applicant or a recipient shall:

     (a) Report to the Division all changes in his or her income.

     (b) Ensure that all income and verification of that income is reported to the Division.

     5.  If any income of the applicant or recipient is distributed among more than one person, only the applicant’s or recipient’s portion of the income may be counted in determining the eligibility of the applicant or the continued eligibility of the recipient.

     6.  Any money that is deposited in a bank account will be considered income for the month it is deposited and will thereafter be considered an asset.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A 1-10-97; R163-06, 9-18-2007)

      NAC 427A.408  Income of applicant or recipient: Exclusions. (NRS 427A.250)  The following income must be excluded from the determination of the eligibility of an applicant or continued eligibility of a recipient:

     1.  A refund of taxes.

     2.  Any money from a state agency that is intended to supplement the needs of the applicant or recipient. Such money may not come from federal funds.

     3.  A payment from the United States Department of Housing and Urban Development.

     4.  A payment from the Energy Assistance Program.

     5.  Infrequent and irregular income if the total income does not exceed $20 monthly and it is impossible to estimate such income in the future.

     6.  A payment from Volunteers in Service to America.

     7.  A payment from the Retired and Senior Volunteer and Foster Grandparent Programs.

     8.  A payment from Indian General Assistance.

     9.  Aid and Attendance or Housebound Benefits received from the Veteran’s Administration.

     10.  Income necessary for a plan of achieving self-support for an applicant or recipient who is blind or has a disability. The plan must be an individual plan, in writing and approved by the Social Security Administration.

     11.  A reimbursement from the Veteran’s Administration for unusual medical expenses.

     12.  A payment received from an absent parent or stepparent for child support.

     13.  Infrequent gifts from friends, including gifts of cash received on a special occasion such as Christmas, a birthday or an anniversary.

     14.  A payment on Medicare premiums.

     15.  Money received pursuant to a loan.

     16.  A payment in cash from an insurance company as reimbursement for medical costs paid by the recipient or to be applied toward medical bills.

     17.  Money received by members of an Indian tribe for the satisfaction of a judgment entered pursuant to a lawsuit or per capita payments made pursuant to Public Law 98-64, 25 U.S.C. §§ 117a, et seq.

     18.  Income the applicant or recipient receives as a result of another person’s death that is used for the expenses of the deceased person’s last illness or burial. Any portion of such income remaining after deducting such expenses must be counted as income for the month the income was received. As used in this subsection, “expenses for a person’s last illness or burial” include related hospital and medical expenses and expenses for the funeral, burial plot, interment, new clothing to wear to the funeral, food for visiting relatives and taxi fare to and from the hospital and funeral home.

     19.  A refund for a deposit or overcharge.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A 1-10-97; R163-06, 9-18-2007)

      NAC 427A.410  Assets of applicant or recipient: Limitation. (NRS 427A.250)  The assets of an applicant or recipient may not exceed the limit for assets set forth in the institutional guidelines established by the Division of Welfare and Supportive Services of the Department of Health and Human Services subject to the amendments set forth by the Commission, if any.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A 1-10-97; R163-06, 9-18-2007)

      NAC 427A.422  Cooperation with Division in determining eligibility; notification of change in circumstances material to eligibility. (NRS 427A.250)

     1.  An applicant or a recipient or his or her designated representative shall cooperate with the Division in securing any information necessary to determine the applicant’s eligibility or the recipient’s continued eligibility for enrollment in COPE. If the applicant or recipient or the designated representative fails to so cooperate, the Division will deny the application or terminate the services of COPE.

     2.  If the application process is delayed because the applicant or his or her designated representative is not cooperating pursuant to subsection 1, and the applicant or his or her designated representative cooperates on or before the Division’s deadline for processing the application, the process must be continued.

     3.  An applicant or a recipient or his or her designated representative shall inform the Division if any of the following changes concerning the applicant or recipient occurs:

     (a) His or her address changes;

     (b) His or her living arrangements change;

     (c) His or her income or assets change;

     (d) The applicant or recipient is hospitalized or placed under institutional care;

     (e) The applicant or recipient changes his or her name; or

     (f) Any other change in circumstances material to the applicant’s eligibility or recipient’s continued eligibility for enrollment in COPE.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A by R163-06, 9-18-2007)

      NAC 427A.424  Provision by recipient of monthly statements of bank accounts; action by Division on information received between reassessments. (NRS 427A.250)

     1.  A recipient may be required to provide copies of statements of his or her bank accounts each month.

     2.  Any information received by the Division between each reassessment that may affect the eligibility of the recipient will be evaluated and acted on if applicable.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A by R163-06, 9-18-2007)

Provision of Services

      NAC 427A.428  Qualifications of case manager. (NRS 427A.250)  To be eligible to act as a case manager, a person must:

     1.  Hold a current license as a social worker or associate in social work issued pursuant to chapter 641B of NRS;

     2.  Hold a current license as a registered nurse issued pursuant to chapter 632 of NRS; or

     3.  If the person does not hold a current license as a social worker:

     (a) Meet the criteria for licensure as a social worker;

     (b) Hold a current license in a related capacity, including, without limitation, a marriage and family therapist licensed pursuant to chapter 641A of NRS or a counselor who is certified pursuant to chapter 641C of NRS; and

     (c) Be exempt from the provisions of chapter 641B of NRS pursuant to NRS 641B.040.

     (Added to NAC by Aging Services Div. by R163-06, eff. 9-18-2007)

      NAC 427A.430  Individual assessment of recipients. (NRS 427A.250)  All recipients must receive an individual assessment which is conducted by qualified personnel of the Division using the standardized assessment tool to identify the specific needs of the recipient. The assessment must be conducted in a face-to-face meeting with the recipient in the setting in which the services of COPE will be provided and must be completed before the services of COPE will be initiated.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A by R163-06, 9-18-2007; A by Aging & Disability Services Div. by R018-10, 7-22-2010)

      NAC 427A.432  Plan of care for recipient: Development and revision; contents; provision of copy to recipient. (NRS 427A.250)

     1.  A written plan of care must be developed for each recipient after the assessment required by NAC 427A.430 is completed. The recipient, the recipient’s family or his or her designated representative shall participate in the process of developing the plan. The plan of care must be reviewed and signed by the case manager and the recipient or a designated representative of the recipient.

     2.  The plan of care must be a written document that includes, without limitation:

     (a) A description of the recipient’s need for care and services which is based on the assessment conducted pursuant to NAC 427A.430;

     (b) The specific services to be provided, including the frequency and identity of the provider of such services; and

     (c) The individualized goals of the recipient.

     3.  The plan of care must provide for service in the most integrated setting possible.

     4.  After the plan of care is completed, it may be revised at any time. Any revision to the plan must be discussed with the recipient or his or her designated representative by the case manager.

     5.  A copy of the plan of care must be given to the recipient or his or her designated representative.

     6.  A new plan of care must be developed by the case manager and signed by the recipient at least once every 365 days or upon a significant change in the condition of or support available to the recipient.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A 1-10-97; R163-06, 9-18-2007; A by Aging & Disability Services Div. by R018-10, 7-22-2010)

      NAC 427A.436  Periodic reassessment of recipient and reauthorization of services. (NRS 427A.250)

     1.  A recipient must be reassessed by his or her case manager in a face-to-face meeting with the recipient in the setting in which the services of COPE are provided at least once every 365 days, using the standardized assessment tool, to:

     (a) Determine whether the Division should reauthorize services for the recipient.

     (b) If necessary, revise any information gathered during the assessment made pursuant to NAC 427A.430.

     (c) Review the recipient’s:

          (1) Ability to perform activities of daily living, including, without limitation, the need for minimum essential personal assistance, as defined in NRS 426.723;

          (2) Need for ongoing services; and

          (3) Systems of support such as family, friends or volunteers.

     (d) Evaluate the services being provided by COPE and any progress made toward the goals listed in the plan of care.

     (e) Assist in the development of a new or revised plan of care.

     2.  The Division will reauthorize services from COPE for a recipient for not more than 365 days if the recipient’s:

     (a) Level of functioning continues to meet the requirements for a patient under the care of a nursing facility; and

     (b) Financial status has not changed so as to render him or her ineligible for COPE. A recipient is rendered ineligible for COPE if, within 60 months before submitting an application for enrollment in COPE pursuant to NAC 427A.400, the recipient divests or transfers his or her assets in an attempt to qualify for services from COPE.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A 1-10-97; R163-06, 9-18-2007; A by Aging & Disability Services Div. by R018-10, 7-22-2010)

      NAC 427A.438  Duties of case manager. (NRS 427A.250)

     1.  A case manager shall:

     (a) Collect information to verify the eligibility of a recipient.

     (b) Evaluate the level of care needed by the recipient.

     (c) Develop a plan of care for the recipient.

     (d) Estimate the costs of services for the recipient.

     (e) Monitor, on an ongoing basis, the provision of services, including, without limitation, the plan of care for the recipient.

     (f) Carry out the duties prescribed in paragraphs (a) to (e), inclusive, for a recipient on an annual basis.

     2.  A case manager shall provide services that assist persons in gaining access to services provided by COPE and to medical, social, educational and other services, without regard to the source of funding from which access to the service is gained. The services of a case manager must be provided by the Division.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A 1-10-97; R163-06, 9-18-2007; A by Aging & Disability Services Div. by R018-10, 7-22-2010)

      NAC 427A.440  Provision and scope of services under Program. (NRS 427A.250)

     1.  If economically feasible, the following services will be made available to recipients:

     (a) Adult day care, if such service is provided:

          (1) In a licensed facility for the care of adults during the day, as the term is defined in NRS 449.004;

          (2) For 4 or more hours per day;

          (3) On a regularly scheduled basis; and

          (4) For 1 or more days per week.

     (b) The provision of a personal care attendant to assist a recipient who is functionally impaired with activities of daily living, including bathing, dressing, using the toilet, mobility and eating. The provision of services by a personal care attendant does not require an order from a physician.

     (c) The provision of a homemaker to assist a recipient who is functionally impaired with instrumental activities of daily living, including laundry, cleaning and preparing meals. The provision of services by a homemaker does not require an order from a physician.

     (d) The provision of a companion for a recipient to provide relief for the primary caregiver. The provision of services by a companion will be provided in the recipient’s home and will include nonmedical care, supervision and socialization. The companion will not be required to perform the services of a personal care attendant pursuant to paragraph (b).

     (e) Case management services.

     (f) A personal emergency response system.

     (g) Services to assist with heavy household chores necessary to maintain a clean, sanitary and safe home environment.

     (h) Respite services provided to recipients unable to care for themselves. Respite services must be provided on a short-term basis due to an absence of or need for relief of those persons normally providing the care.

     2.  Any services provided pursuant to this section must be provided in accordance with the recipient’s plan of care, and any person providing such services must be under the supervision of the providing agency and the case manager.

     3.  As used in this section:

     (a) “Adult day care” means social services provided during the day in a community group setting for the purpose of supporting frail, impaired or elderly adults or adults with disabilities who can benefit from care in a group setting.

     (b) “Personal emergency response system” means an electronic device that enables a person to secure help in an emergency.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A 1-10-97; R163-06, 9-18-2007; A by Aging & Disability Services Div. by R018-10, 7-22-2010)

      NAC 427A.442  Provision of respite care. (NRS 427A.250)

     1.  If the Social Services Manager has determined that a recipient is eligible to receive respite care at the recipient’s residence, such care will be made available only if:

     (a) The recipient has a primary caregiver who lives at the recipient’s home;

     (b) The caregiver needs relief from his or her duties as a caregiver;

     (c) The recipient needs supervised care at his or her residence at all times;

     (d) There are trained respite workers available in the recipient’s area; and

     (e) Funds for respite care are available.

     2.  Respite care governed by subsection 1 must not be provided to a recipient for more than 336 hours per fiscal year.

     3.  A plan of care must be developed for respite care provided to a recipient at his or her home. The plan may include the services of a personal care attendant and the services of a homemaker or companion.

     4.  Regularly scheduled services of COPE may be suspended during any period in which respite care is being provided. The provider of respite care may perform any suspended services of COPE that were provided at the recipient’s home.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A 1-10-97; R163-06, 9-18-2007; A by Aging & Disability Services Div. by R018-10, 7-22-2010)

      NAC 427A.450  Procedure when recipient, applicant or person residing with recipient or applicant has communicable disease. (NRS 427A.250)

     1.  If a recipient, an applicant or a person who resides with the recipient or applicant has a communicable disease, the provision of service to the recipient or the processing of the application must be temporarily suspended until the infected person has been examined by a licensed physician, a registered nurse or a physician assistant and has been determined to be free of the disease or is no longer contagious.

     2.  As used in this section, “communicable disease” means a disease that is caused by a specific infectious agent or its toxic products, and that can be transmitted, either directly or indirectly, from one person to another. The term does not include acquired immune deficiency syndrome or the human immunodeficiency virus.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A 1-10-97; R163-06, 9-18-2007)

      NAC 427A.452  Procedure upon placement of recipient in hospital or nursing facility. (NRS 427A.250)

     1.  If a recipient is placed in a hospital or a nursing facility, the Division will suspend the recipient’s services during the time he or she is in the hospital or nursing facility.

     2.  If the recipient remains in the hospital or nursing facility for 45 days or more, the Division will terminate the recipient’s services and close his or her case.

     3.  If the recipient remains in the hospital or nursing facility for less than 45 days, the Division will review the recipient’s case and his or her services may be reinstated or the case may be closed.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A 1-10-97; R163-06, 9-18-2007)

      NAC 427A.454  Reduction of services: Notification of recipient; reasons; request by recipient. (NRS 427A.250)

     1.  If any services of COPE must be reduced, the recipient or his or her designated representative will be notified by the Division before the reduction of those services takes effect. This notification will include the reason for the reduction of services and information regarding the right of the recipient to an administrative review.

     2.  The Division may reduce the services of COPE for the following reasons:

     (a) The recipient or his or her designated representative requests a reduction in services.

     (b) The recipient no longer needs the service.

     (c) The recipient no longer needs the number of service hours previously provided.

     (d) Another agency, program or support system will provide the service.

     (e) Available funds have been expended.

     3.  A recipient or his or her designated representative may request a reduction of services provided by COPE. The Division will record the request in the recipient’s case file and revise the plan of care for the recipient to reflect the change in services.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A by R163-06, 9-18-2007)

      NAC 427A.456  Termination of services: Grounds; notification of recipient. (NRS 427A.250)

     1.  In addition to any other requirements for closing a case and terminating the services of COPE set forth in NAC 427A.350 to 427A.488, inclusive, the Division will close a case and terminate services if:

     (a) The recipient dies.

     (b) The recipient fails to meet the criteria for eligibility listed in NAC 427A.402.

     (c) The recipient or his or her designated representative requests the discontinuation of the services.

     (d) The recipient fails to apply for, pursue or accept a claim for other benefits or fails to provide information essential to establish such a claim.

     (e) The recipient’s residence becomes unsafe for the recipient or his or her providers of service.

     (f) The recipient or his or her designated representative participates in any activity designed to defraud COPE or the Division.

     (g) The cost of services provided to the recipient is more than 100 percent of the average cost of care for a patient who receives care in a nursing facility.

     (h) The recipient fails to cooperate with the established plan of care.

     (i) Funds previously available have been expended.

     2.  The Division may close a case if service becomes unavailable in the area where the recipient resides.

     3.  Except in the case of the death of a recipient, the Division will notify a recipient or his or her designated representative, in writing, if the recipient’s case is being closed. The notice will be given at least 15 days before the services are to be terminated and will include:

     (a) The effective date the case is closed;

     (b) The reason or reasons for closing the case;

     (c) A statement of the rights of the recipient to an administrative review; and

     (d) The process for filing a request for an administrative review.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A 1-10-97; R163-06, 9-18-2007; A by Aging & Disability Services Div. by R018-10, 7-22-2010)

Administrative Review

      NAC 427A.460  Right of review. (NRS 427A.250)

     1.  An applicant for services of COPE is entitled to an administrative review if his or her application is denied.

     2.  A recipient is entitled to an administrative review if:

     (a) The recipient’s services are terminated;

     (b) The recipient’s services are reduced without his or her concurrence;

     (c) The recipient has not been given a choice between community home-based care and institutional care; or

     (d) The recipient has a grievance concerning the delivery, quality, duration or scope of his or her services.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A by R163-06, 9-18-2007)

      NAC 427A.462  Request for review. (NRS 427A.250)

     1.  An applicant or a recipient or his or her designated representative may request an administrative review by:

     (a) Signing, dating and returning to the office of the Division responsible for the region in which the applicant or recipient resides the letter notifying the applicant or recipient of the action to be taken by the Division; or

     (b) Submitting a written request to the office of the Division responsible for the region in which the applicant or recipient resides.

     2.  Except as otherwise provided in subsection 4, the request for an administrative review must be received in the regional office of the Division within 15 days after the date of the letter notifying the applicant or recipient or his or her designated representative of the action to be taken. The date of the letter shall be deemed the first day of the 15-day period.

     3.  If the 15th day falls on a holiday or weekend, the time for submitting a request will be extended to the next working day.

     4.  The Division will not accept a request for an administrative review received after the time specified in subsection 2 unless the applicant or recipient or his or her designated representative demonstrates good cause for the failure to comply with the deadline.

     5.  The Administrator of the Division or a person designated by the Administrator will review any requests to waive the deadline for good cause and shall make a determination within 10 days after the receipt of the request.

     6.  If the Administrator or a person designated by the Administrator determines that the applicant or recipient or his or her designated representative has demonstrated good cause for the failure to comply with the 15-day deadline, he or she will schedule an administrative review for the applicant or recipient.

     7.  If the Administrator or a person designated by the Administrator determines that the applicant or recipient or his or her designated representative has not demonstrated good cause for the failure to comply with the 15-day deadline, he or she will notify the applicant or recipient or his or her designated representative that the request for an administrative review is denied.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A by R163-06, 9-18-2007; A by Aging & Disability Services Div. by R018-10, 7-22-2010)

      NAC 427A.464  Preliminary conference for resolution of matter. (NRS 427A.250)

     1.  Within 10 days after the Division receives a request for an administrative review, the Social Services Manager of the region in which the applicant or recipient resides shall contact the applicant or recipient or his or her designated representative to schedule a conference with a member of the staff of the Division to attempt to resolve the matter without the necessity of an administrative review.

     2.  The Social Services Manager shall:

     (a) Preside at the conference; and

     (b) Complete a report on the outcome of the conference.

     3.  The conference does not affect the right of the applicant or recipient to an administrative review.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A by R163-06, 9-18-2007; A by Aging & Disability Services Div. by R018-10, 7-22-2010)

      NAC 427A.466  Appointment and initial duties of reviewing officer; provision of notice; postponement; withdrawal of request; failure to appear. (NRS 427A.250)

     1.  If, after the conference is held, the applicant or recipient wishes to continue with the administrative review, the Administrator of the Division will appoint a reviewing officer. Within 15 days after the appointment, the reviewing officer shall establish a date, time and location for the review.

     2.  The Division will mail a notice of the date, time and location of the administrative review to the applicant or recipient or his or her designated representative at least 10 working days before the date scheduled for the review, unless the applicant or recipient or his or her designated representative requests a review in a shorter period.

     3.  If requested by the Division or by the applicant or recipient or his or her designated representative, the reviewing officer may postpone an administrative review for good cause. If the reviewing officer determines that a postponement is warranted, the reviewing officer shall reschedule the administrative review for a date which is not later than 15 days after the original date for the review.

     4.  The applicant or recipient or his or her designated representative is entitled to withdraw the request for an administrative review any time before the reviewing officer renders a decision. The withdrawal must be in writing, dated and signed by the applicant or recipient or his or her designated representative and mailed or delivered to the regional office of the Division which received the request for the administrative review. If an applicant or a recipient or his or her designated representative indicates verbally a desire to withdraw a request for an administrative review, the Division will instruct him or her to submit a written withdrawal.

     5.  The reviewing officer shall cancel the administrative review if the applicant or recipient or his or her designated representative fails to appear for the scheduled administrative review after receiving proper notification. The reviewing officer shall notify the applicant or recipient or his or her designated representative within 1 working day after the failure to appear that the administrative review will be considered cancelled unless the applicant or recipient or his or her designated representative can demonstrate good cause for failing to appear. The applicant or recipient or his or her designated representative must submit the reasons for failing to appear within 10 days after the date of the letter notifying the applicant or recipient or his or her designated representative of the cancellation if the applicant or recipient or his or her designated representative wishes to continue the administrative review. The Administrator of the Division will determine whether good cause has been demonstrated for failing to appear.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A by R163-06, 9-18-2007)

      NAC 427A.468  Continuation of services during review. (NRS 427A.250)

     1.  A recipient is entitled to receive services from COPE while an administrative review of a termination of those services is pending, if funding is available, unless the recipient or his or her designated representative requests in writing that the services be discontinued.

     2.  If the services are continued and the decision to terminate those services is upheld, the recipient may be required to pay for the cost of any services provided after the date on which those services were originally scheduled to be terminated.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A by R163-06, 9-18-2007; A by Aging & Disability Services Div. by R018-10, 7-22-2010)

      NAC 427A.470  Right to representation. (NRS 427A.250)  An applicant or a recipient is entitled to represent himself or herself or to be represented by another person, including a legal representative, at the administrative review. The Division will inform the applicant or recipient or his or her designated representative of this right:

     1.  At the time he or she applies for enrollment in COPE; and

     2.  In a letter notifying the recipient of the action of the Division that is subject to administrative review.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A by R163-06, 9-18-2007)

      NAC 427A.472  Attendance by case manager; procedure when case manager unable to attend. (NRS 427A.250)

     1.  A reviewing officer shall request the case manager responsible for the contested action of the Division to attend the administrative review.

     2.  If the case manager is unable to attend the review:

     (a) The supervisor for the region in which the applicant or recipient resides shall serve as the representative of the Division.

     (b) The case manager shall provide the reviewing officer with a report that contains:

          (1) A summary of the factors on which the contested action of the Division is based; and

          (2) All applicable laws, regulations and policies of the Division or the Division of Welfare and Supportive Services of the Department of Health and Human Services.

Ê The reviewing officer shall cause the report of the case manager to be read into the record and entered into evidence during the administrative review.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A by R163-06, 9-18-2007)

      NAC 427A.474  Disclosure of documents, records and additional relevant information. (NRS 427A.250)

     1.  An applicant or a recipient or his or her designated representative is entitled to receive:

     (a) Before the administrative review, a photocopy of all documents and records that will be used in the administrative review. The Division will provide these photocopies at no charge.

     (b) From the Division, photocopies of additional relevant information that will not be used at the administrative review upon payment of a charge not to exceed the actual cost to the Division of producing the photocopies.

     2.  During the review, the Division will provide the applicant or recipient or his or her designated representative with a photocopy of all documents presented by the Division at the administrative review.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A by R163-06, 9-18-2007)

      NAC 427A.476  Conducting of review. (NRS 427A.250)

     1.  A reviewing officer shall:

     (a) Conduct the administrative review in an informal manner; and

     (b) Ensure that all relevant issues are considered during the administrative review.

     2.  The reviewing officer may cause the removal from the administrative review of any person who:

     (a) Uses disrespectful language;

     (b) Engages in contemptuous conduct; or

     (c) Refuses to comply with the directions of the reviewing officer.

     (Added to NAC by Aging Services Div., eff. 7-16-92)

      NAC 427A.478  Recording of review. (NRS 427A.250)

     1.  A reviewing officer shall record the administrative review with an audiotape recorder.

     2.  The reviewing officer’s tape recorder is the only recording device that may be allowed at the administrative review.

     (Added to NAC by Aging Services Div., eff. 7-16-92)

      NAC 427A.480  Case record of review; submission and retention of case record and recording. (NRS 427A.250)

     1.  A reviewing officer shall keep a case record of each administrative review that he or she conducts which contains:

     (a) All correspondence that the reviewing officer has received regarding the subject matter of the administrative review;

     (b) All exhibits presented and accepted during the administrative review; and

     (c) A narrative log of all contacts that the reviewing officer has had with the applicant or recipient or his or her designated representative, members of the staff of the Division, or legal counsel for any of the participants in the administrative review.

     2.  The case record established by the reviewing officer constitutes the official record of the hearing.

     3.  After the reviewing officer has rendered a decision, the reviewing officer shall submit the case record and the audiotape recording to the office of the Division in Carson City. That office shall retain the case record and the audiotape recording for:

     (a) Four years after the date of the decision; or

     (b) Until the resolution of a judicial review of the decision,

Ê whichever occurs later.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A by R163-06, 9-18-2007)

      NAC 427A.482  Procedure upon review. (NRS 427A.250)

     1.  At the beginning of the administrative review, the reviewing officer shall:

     (a) Introduce himself or herself;

     (b) Announce the date and time;

     (c) State the name of the person requesting the administrative review;

     (d) State the reason for the administrative review;

     (e) Cause each person present to introduce himself or herself and to state the person’s purpose in attending the administrative review; and

     (f) Advise those present that the administrative review is being recorded by an audiotape recorder.

     2.  The representative of the Division shall state the basis of the contested action taken by the Division. If the case manager is not present, the report prepared by the case manager pursuant to subsection 2 of NAC 427A.472 must be read into the record.

     3.  The reviewing officer shall allow the applicant or recipient or his or her designated representative to make a statement concerning the grievance and to present supporting evidence.

     4.  The reviewing officer shall collect, number and log all relevant evidence.

     5.  The reviewing officer, the applicant or recipient or his or her designated representative or the representative of the Division may request that evidence which is not available at the administrative review be submitted. If such a request is made, the reviewing officer may:

     (a) Continue the administrative review and order further investigation or request a party to produce the additional evidence; or

     (b) Close the administrative review but hold the record open to permit submission of any additional evidence.

Ê If additional evidence is submitted, the reviewing officer shall provide each party with the opportunity to examine that evidence.

     6.  If the reviewing officer determines after the administrative review is closed that the record is unclear or insufficient to make a decision, the reviewing officer may contact the applicant or recipient or his or her designated representative or the representative of the Division for clarification or additional information. Any material submitted after the close of the review must be made available to all participants in the administrative review and each shall have the opportunity for rebuttal. The reviewing officer may reopen the administrative review if the nature of the additional information or the rebuttal thereof makes further consideration necessary.

     7.  Before closing the review, the reviewing officer shall advise those present that:

     (a) The reviewing officer will base his or her decision on the case record and the testimony and evidence presented at the administrative review;

     (b) The reviewing officer will render a decision within 15 days after the date of the administrative review;

     (c) The reviewing officer will inform the applicant or recipient or his or her designated representative by mail of the decision; and

     (d) The applicant or recipient or his or her designated representative may appeal the decision of the reviewing officer to the Administrator of the Division.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A by R163-06, 9-18-2007)

      NAC 427A.484  Decision of reviewing officer. (NRS 427A.250)

     1.  The decision of a reviewing officer must:

     (a) Be based on the evidence and information presented at the administrative review and any additional information submitted pursuant to subsection 6 of NAC 427A.482;

     (b) Comply with the regulations of the Division that were in effect at the time the Division took the contested action;

     (c) Comply with the policies of COPE;

     (d) Contain a summary of the findings of fact;

     (e) Identify supporting evidence and regulations;

     (f) Respond to any reasonable arguments of the applicant or recipient or his or her designated representative; and

     (g) Be submitted in writing to the Administrator of the Division with the case record and all exhibits presented during the administrative review.

     2.  In issuing a decision, the reviewing officer shall not consider changes in physical or social factors that occur after the close of the administrative review.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A by R163-06, 9-18-2007)

      NAC 427A.486  Notification of decision and right to appeal; request for appeal. (NRS 427A.250)

     1.  A reviewing officer shall mail the written decision to the applicant or recipient or his or her designated representative within 15 days after the close of the administrative review. In addition to the written decision, the reviewing officer shall notify the applicant or recipient or his or her designated representative by mail of:

     (a) The right to appeal the decision of the reviewing officer to the Division; and

     (b) The process to request an appeal to the Administrator of the Division.

     2.  A request for an appeal to the Administrator of the Division must be received by the Administrator within 10 days after the date of the decision.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A by R163-06, 9-18-2007)

      NAC 427A.488  Report of reviewing officer summarizing proceedings. (NRS 427A.250)

     1.  A reviewing officer shall summarize the proceedings in a written report using the following format:

 

     A.  INTRODUCTION—The date, time and place of the administrative review and the name of each person present at the administrative review.

     B.  NATURE OF CASE—Overview of the issues presented during the administrative review.

     C.  FINDINGS OF FACT—The facts of the case as determined by the reviewing officer.

     D.  CONCLUSIONS OF LAW—The laws, regulations, procedural rules and policies which support the findings and decision of the reviewing officer.

     E.  DECISION—The decision to either uphold or overrule the action of the Division.

 

     2.  The reviewing officer shall submit the written report to the Administrator of the Division with the case record.

     (Added to NAC by Aging Services Div., eff. 7-16-92)

SERVICES FOR CERTAIN PERSONS WITH AUTISM SPECTRUM DISORDERS

      NAC 427A.551  Definitions. (NRS 427A.872)  As used in NAC 427A.551 to 427A.558, inclusive, unless the context otherwise requires, the words and terms defined in NAC 427A.552, 427A.553 and 427A.554 have the meanings ascribed to them in those sections.

     (Added to NAC by Aging & Disability Services Div. by R013-12, eff. 9-14-2012)

      NAC 427A.552  “Autism spectrum disorder” defined. (NRS 427A.872)  “Autism spectrum disorder” has the meaning ascribed to it in NRS 427A.875.

     (Added to NAC by Aging & Disability Services Div. by R013-12, eff. 9-14-2012)

      NAC 427A.553  “Norm-referenced instrument” defined. (NRS 427A.872)  “Norm-referenced instrument” means an instrument that is administered to a reference group and allows for a comparison of the trait of a person to whom the instrument is administered to traits of the reference group.

     (Added to NAC by Aging & Disability Services Div. by R013-12, eff. 9-14-2012)

      NAC 427A.554  “Public agency providing autism services” defined. (NRS 427A.872)  “Public agency providing autism services” means the State or a local government or an agency thereof that provides, either directly or through a grant, contract or other agreement, assessments, interventions and diagnoses of persons with autism spectrum disorders or who are suspected of having autism spectrum disorders through the age of 21 years.

     (Added to NAC by Aging & Disability Services Div. by R013-12, eff. 9-14-2012)

      NAC 427A.555  Determination of autism spectrum disorder: Approved diagnostic tools; waiver to use alternative diagnostic tools. (NRS 427A.872)

     1.  Except as otherwise provided in subsection 2, when determining whether a person is a person with autism spectrum disorder pursuant to NRS 427A.872, a public agency providing autism services shall:

     (a) Use the module of the Autism Diagnostic Observation Schedule, adopted by reference in subsection 3, that is appropriate to the person;

     (b) Use a diagnostic tool approved by the Division that includes a formal interview with the parents of the person or, if found to be appropriate by the professional making the determination, a different relative or caregiver of the person; and

     (c) Ensure that any professional making the determination is fully trained in the use of the Autism Diagnostic Observation Schedule and the diagnostic tool.

     2.  If a public agency providing autism services wishes to use a diagnostic tool other than the tools listed in subsection 1 to determine whether a person is a person with autism spectrum disorder, the public agency providing autism services must obtain a waiver from the Division before using the alternative diagnostic tool. The Division may grant such a waiver if the public agency providing autism services demonstrates that the alternative diagnostic tool includes, without limitation:

     (a) Direct observation of the person by the professional conducting the assessment;

     (b) A review of the person’s developmental history; and

     (c) Components to:

          (1) Determine the person’s cognitive level;

          (2) Measure the person’s adaptive, social and emotional behavior; and

          (3) Assess the person’s receptive and expressive language levels.

     3.  The most recently published version of the Autism Diagnostic Observation Schedule by Western Psychological Services is hereby adopted by reference and is effective unless, within 30 days after its publication, the Administrator gives written notice that all or part of the revisions to the Autism Diagnostic Observation Schedule are not suitable for this State. If the Administrator gives notice pursuant to this subsection, any part deemed unsuitable is not effective in this State beginning 30 days after the notice is published. This publication is available by mail from Western Psychological Services, 625 Alaska Avenue, Torrance, California 90503-5124, or at the Internet address http://www.wpspublish.com/ for the price of $1,995.

     (Added to NAC by Aging & Disability Services Div. by R013-12, eff. 9-14-2012)

      NAC 427A.556  Assessments conducted by public agency providing autism services. (NRS 427A.872)

     1.  A public agency providing autism services shall conduct an assessment, as described in subsection 3, of a person with autism spectrum disorder or who is suspected of having autism spectrum disorder:

     (a) Before providing services to the person or, if a diagnosis of autism spectrum disorder is made after the public agency providing autism services begins to provide services to the person, after the diagnosis is made.

     (b) Except as otherwise provided in subsection 2, at the time the person ceases to receive services from the public agency providing autism services.

     2.  The requirements of paragraph (b) of subsection 1 do not apply if the person with autism spectrum disorder began receiving early intervention services from the Division of Public and Behavioral Health of the Department not more than 90 days before the person reached the age of 3 years.

     3.  An assessment conducted pursuant to this section must include, without limitation, an assessment of the:

     (a) Physical health of the person, including, without limitation, the vision and hearing of the person;

     (b) Cognitive ability of the person using a norm-referenced instrument;

     (c) Receptive and expressive language levels of the person using a norm-referenced instrument; and

     (d) Adaptive behavior of the person in multiple settings using a standardized measure of adaptive behavior.

     4.  As used in this section, “early intervention services” has the meaning ascribed to it in 20 U.S.C. § 1432.

     (Added to NAC by Aging & Disability Services Div. by R013-12, eff. 9-14-2012)

      NAC 427A.557  Annual report from Division of Public and Behavioral Health. (NRS 427A.872)

     1.  On or before August 31 of each year, in addition to the information required to be reported pursuant to NRS 442.760, the Division of Public and Behavioral Health of the Department shall report to the Aging and Disability Services Division data concerning each person with autism spectrum disorder who receives services through a program operated by the Division of Public and Behavioral Health or through a grant, contract or other agreement with the Division of Public and Behavioral Health. Such data must include, without limitation, as appropriate to the age of the person, the:

     (a) Generalized imitation skills of the person;

     (b) Ability of the person to visually discriminate;

     (c) Ability of the person to follow a two-step instruction;

     (d) Ability of the person to express wants and needs;

     (e) Ability of the person to play appropriately with at least five toys;

     (f) Cognitive level of the person;

     (g) Adaptive, social and emotional behavior of the person; and

     (h) Receptive and expressive language levels of the person at intake and, if available, when services ceased.

     2.  In addition to the data reported pursuant to subsection 1, the Division of Public and Behavioral Health shall include in the report submitted to the Aging and Disability Services Division the number of persons who:

     (a) Are determined to be persons with autism spectrum disorders through the use of the Autism Diagnostic Observation Schedule, adopted by reference in NAC 427A.555, as one of the tools required to be used when making a determination pursuant to NAC 427A.555; and

     (b) Receive services through a program operated by the Division of Public and Behavioral Health or through a grant, contract or other agreement with the Division of Public and Behavioral Health.

     (Added to NAC by Aging & Disability Services Div. by R013-12, eff. 9-14-2012)

      NAC 427A.558  Annual report from Department of Employment, Training and Rehabilitation. (NRS 427A.872)

     1.  On or before August 31 of each year, in addition to the information required to be reported pursuant to NRS 615.205, the Department of Employment, Training and Rehabilitation shall report to the Division data about each person with autism spectrum disorder receiving vocational rehabilitation services through the Department of Employment, Training and Rehabilitation. To the extent applicable, such information must include, without limitation, the:

     (a) Types of support or training needed by the person to obtain employment or remain employed;

     (b) Amount of money spent on support or training for the person by the Department of Employment, Training and Rehabilitation since August 31 of the previous year;

     (c) Number of hours worked by the person since August 31 of the previous year;

     (d) Average hourly rate of compensation received by the person since August 31 of the previous year;

     (e) Number of times the person has returned to the Department of Employment, Training and Rehabilitation for supplemental vocational rehabilitation services;

     (f) Date on which the person began working and the job title of the position;

     (g) Date on which the person stopped receiving vocational rehabilitation services; and

     (h) Reason for which the person stopped receiving vocational rehabilitation services.

     2.  As used in this section, “vocational rehabilitation services” has the meaning ascribed to it in NRS 615.140.

     (Added to NAC by Aging & Disability Services Div. by R013-12, eff. 9-14-2012)

PROGRAM FOR PERSONS WITH TRAUMATIC BRAIN INJURIES

      NAC 427A.600  Definitions. (NRS 427A.850, 427A.860)  As used in NAC 427A.600 to 427A.633, inclusive, unless the context otherwise requires, the words and terms defined in NAC 427A.603 to 427A.610, inclusive, have the meanings ascribed to them in those sections.

     (Added to NAC by Aging & Disability Services Div. by R019-12, eff. 9-14-2012)

      NAC 427A.603  “Applicant” defined. (NRS 427A.850, 427A.860)  “Applicant” means a person who applies for services through the Program.

     (Added to NAC by Aging & Disability Services Div. by R019-12, eff. 9-14-2012)

      NAC 427A.605  “Contractor” defined. (NRS 427A.850, 427A.860)  “Contractor” means any person or governmental entity with which the Division enters into a contract to provide services for the Program.

     (Added to NAC by Aging & Disability Services Div. by R019-12, eff. 9-14-2012)

      NAC 427A.607  “Program” defined. (NRS 427A.850, 427A.860)  “Program” means the Program for Persons With Traumatic Brain Injuries established pursuant to NAC 427A.613.

     (Added to NAC by Aging & Disability Services Div. by R019-12, eff. 9-14-2012)

      NAC 427A.610  “Recipient” defined. (NRS 427A.850, 427A.860)  “Recipient” means a person who receives services for a traumatic brain injury through the Program.

     (Added to NAC by Aging & Disability Services Div. by R019-12, eff. 9-14-2012)

      NAC 427A.613  Establishment; provision of services. (NRS 427A.850, 427A.860)

     1.  The Program for Persons With Traumatic Brain Injuries is hereby established.

     2.  The Division will provide services for traumatic brain injuries through the Program either directly or through one or more contractors.

     (Added to NAC by Aging & Disability Services Div. by R019-12, eff. 9-14-2012)

      NAC 427A.615  Division to conduct annual review; evaluation. (NRS 427A.850, 427A.860)

     1.  The Division will conduct a review of the Program on an annual basis.

     2.  When conducting a review pursuant to subsection 1, the Division will evaluate:

     (a) The facility of each contractor to determine whether the facility is accessible to persons with disabilities;

     (b) A sample of the case files of recipients to determine whether the case files are maintained in compliance with all applicable policies and procedures of the Division;

     (c) The satisfaction of a sample of the recipients with the services received;

     (d) The impact of the Program on the independence of recipients;

     (e) The effectiveness of the Program; and

     (f) The delivery of services to recipients by each contractor to determine whether services were delivered in compliance with all applicable policies and procedures of the Division and the contract with the Division.

     (Added to NAC by Aging & Disability Services Div. by R019-12, eff. 9-14-2012)

      NAC 427A.617  Quarterly reports to Division of Public and Behavioral Health. (NRS 427A.850, 427A.860)  The chief administrative officer of each hospital in this State shall ensure that the hospital submits to the Division of Public and Behavioral Health of the Department the quarterly reports required pursuant to NAC 450B.768. Submission of the quarterly reports satisfies the requirements of NRS 427A.820.

     (Added to NAC by Aging & Disability Services Div. by R019-12, eff. 9-14-2012)

      NAC 427A.620  Application to participate in Program: Form; requirements. (NRS 427A.850, 427A.860)  A person who wishes to participate in the Program must submit an application on a form prescribed by the Division to the Division or to a contractor designated by the Division. The application must require an applicant to demonstrate that the applicant:

     1.  Is a resident of this State;

     2.  Has been diagnosed with a traumatic brain injury;

     3.  Requires assistance in one or more of the areas described in NRS 427A.850;

     4.  Has exhausted all other resources available to pay for the services offered through the Program, including, without limitation, public and private health insurance; and

     5.  Meets any other requirements of the Division to establish that the applicant is suitable to be a recipient.

     (Added to NAC by Aging & Disability Services Div. by R019-12, eff. 9-14-2012)

      NAC 427A.623  List of approved applicants; services to be provided in certain order; retention of position on or removal from list. (NRS 427A.850, 427A.860)  The Division or the contractor will maintain a list of applicants who have been approved to participate in the Program in the order in which their applications are approved. The Division or the contractor will provide services to each such applicant in the order in which the name of the applicant appears on the list. If an applicant is not prepared to accept services when offered, the services will be offered to the next applicant on the list. In such a case, the applicant who does not accept services may elect whether to retain his or her position on the list or be removed from the list.

     (Added to NAC by Aging & Disability Services Div. by R019-12, eff. 9-14-2012)

      NAC 427A.625  Requirements for contract between Division and contractor; duties of contractor. (NRS 427A.850, 427A.860)

     1.  Any contract entered into between the Division and a contractor will contain provisions that require the contractor to:

     (a) If the contractor provides rehabilitation services under the Program, establish and maintain accreditation with CARF International or its successor organization;

     (b) Maintain employees who have personal or professional knowledge of traumatic brain injuries and an understanding of the services required by a person with a traumatic brain injury; and

     (c) Determine whether an applicant is eligible for services pursuant to NAC 427A.620.

     2.  The contractor shall:

     (a) Provide services in accordance with the contract entered into with the Division and within the scope of NRS 427A.850; and

     (b) Provide referrals to recipients as necessary for other services that are not provided by the contractor.

     (Added to NAC by Aging & Disability Services Div. by R019-12, eff. 9-14-2012)

      NAC 427A.627  Monitoring and evaluation of contractor; submission of reports to Division. (NRS 427A.850, 427A.860)

     1.  The Division will monitor the management and financial records of each contractor and will evaluate the effectiveness of each contractor in carrying out its duties established in its contract with the Division.

     2.  Each contractor shall submit to the Division:

     (a) Reports summarizing the services provided through the Program to persons with traumatic brain injuries at the times and on the forms specified by the Division; and

     (b) Any other reports requested by the Division.

     (Added to NAC by Aging & Disability Services Div. by R019-12, eff. 9-14-2012)

      NAC 427A.630  Appeal of decision relating to eligibility for services or services provided. (NRS 427A.850, 427A.860)

     1.  An applicant or recipient who disagrees with a decision of a contractor relating to eligibility for services or the services provided through the Program may, within 15 working days after the applicant or recipient receives notice of the decision, file an appeal with the contractor.

     2.  The contractor:

     (a) May require the applicant or recipient to submit, in writing, evidence to support the appeal; and

     (b) Shall render a decision in writing within 30 days after it receives the appeal.

     3.  An applicant or recipient may appeal the decision of a contractor pursuant to subsection 2 to the Administrator by filing a notice of appeal within 15 working days after the applicant or recipient receives notice of the decision.

     4.  The Administrator:

     (a) Will review the decision in an informal proceeding;

     (b) May require the applicant, recipient or contractor to submit, in writing, additional evidence to support the appeal or the decision, as applicable; and

     (c) Will render his or her decision in writing within 30 days after receiving the notice of the appeal.

     5.  The decision of the Administrator is a final decision for the purposes of judicial review.

     (Added to NAC by Aging & Disability Services Div. by R019-12, eff. 9-14-2012)

      NAC 427A.633  Grounds for termination of services. (NRS 427A.850, 427A.860)  Services provided to a recipient may be terminated if the recipient:

     1.  Fails to provide any documents needed to evaluate his or her eligibility for services through the Program or in the recipient’s plan of care;

     2.  Willfully defrauds the Program;

     3.  Fails to comply with any provision of NAC 427A.600 to 427A.633, inclusive; or

     4.  Voluntarily withdraws from the Program.

     (Added to NAC by Aging & Disability Services Div. by R019-12, eff. 9-14-2012)

USE OF SIGNATURE STAMPS BY CERTAIN PERSONS WITH PHYSICAL DISABILITIES

REVISER’S NOTE.

      NAC 426.650 to 426.665, inclusive, have been renumbered and moved to chapter 427A of NAC in accordance with section 91 of chapter 428, Statutes of Nevada 2009, at page 2407, which authorized the related provisions of chapter 426 of NAC to be renumbered and moved to chapter 427A of NAC.

 

      NAC 427A.650  “Signature stamp” defined. (NRS 427A.755)  As used in NAC 427A.650 to 427A.665, inclusive, unless the context otherwise requires, “signature stamp” has the meaning ascribed to it in NRS 427A.755.

     (Added to NAC by Dep’t of Health & Human Services by R004-06, eff. 5-4-2006)—(Substituted in revision for NAC 426.650)

      NAC 427A.655  Ownership of stamp required for use. (NRS 427A.755)  A person shall not use a signature stamp unless the person is the owner of the signature stamp.

     (Added to NAC by Dep’t of Health & Human Services by R004-06, eff. 5-4-2006)—(Substituted in revision for NAC 426.655)

      NAC 427A.660  Photographic identification of person using stamp. (NRS 427A.755)

     1.  A person, government, governmental agency or political subdivision of a government may require a person who uses a signature stamp pursuant to NRS 427A.755 to present photographic identification as proof of his or her identity to ensure that the person using the signature stamp is the owner of the signature stamp.

     2.  A person, government, governmental agency or political subdivision of a government that requires a person to present photographic identification pursuant to subsection 1 shall accept a driver’s license, identification card, passport and any other documentation which contains a photograph of the person issued by a governmental entity which the person, government, governmental agency or political subdivision of a government deems to be satisfactory proof of a person’s identity.

     (Added to NAC by Dep’t of Health & Human Services by R004-06, eff. 5-4-2006)—(Substituted in revision for NAC 426.660)

      NAC 427A.665  Liability for damages caused by use of stamp by person other than owner. (NRS 427A.755)

     1.  Except as otherwise provided in subsections 2 and 3, the owner of a signature stamp is liable for any damages caused by the use of the signature stamp by a person other than the owner of the signature stamp.

     2.  The owner of a signature stamp is not liable for damages caused by the use of the signature stamp by a person other than the owner of the signature stamp if the signature stamp was lost or stolen and the owner reported the loss or theft of the signature stamp to:

     (a) The appropriate law enforcement agency;

     (b) The financial institutions with which the owner of the signature stamp has accounts;

     (c) The registrar of voters of the county in which the owner of the signature stamp resides or the county clerk of the county in which the owner of the signature stamp resides if the owner of the signature stamp resides in a county in which a registrar of voters has not been appointed pursuant to NRS 244.164; and

     (d) The county recorder of the county in which the owner of the signature stamp resides,

Ê within 10 days after the date of discovery of the loss or theft.

     3.  A person, government, governmental agency or political subdivision of a government is liable for any damages caused by the use of a signature stamp by a person other than the owner of the signature stamp if the person, government, governmental agency or political subdivision of a government had an opportunity to verify, in person, the identity of the person who used the signature stamp and the person, government, governmental agency or political subdivision of a government failed to verify the identity of the person who used the signature stamp.

     (Added to NAC by Dep’t of Health & Human Services by R004-06, eff. 5-4-2006)—(Substituted in revision for NAC 426.665)

PROGRAM TO ENABLE PERSONS WITH PHYSICAL DISABILITIES TO LIVE IN UNSUPERVISED SETTINGS

REVISER’S NOTE.

      NAC 426.675 to 426.770, inclusive, have been renumbered and moved to chapter 427A of NAC in accordance with section 91 of chapter 428, Statutes of Nevada 2009, at page 2407, which authorized the related provisions of chapter 426 of NAC to be renumbered and moved to chapter 427A of NAC.

 

General Provisions

      NAC 427A.675  Definitions. (NRS 427A.793)  As used in NAC 427A.675 to 427A.789, inclusive, unless the context otherwise requires, the words and terms defined in NAC 427A.680 to 427A.720, inclusive, have the meanings ascribed to them in those sections.

     (Added to NAC by Dep’t of Health & Human Services by R005-06, eff. 5-4-2006; A by Aging & Disability Services Div. by R024-10, 7-22-2010; R016-12, 9-14-2012)—(Substituted in revision for NAC 426.675)

      NAC 427A.680  “Administrator” defined. (NRS 427A.793)  “Administrator” means the Administrator of the Division.

     (Added to NAC by Dep’t of Health & Human Services by R005-06, eff. 5-4-2006)—(Substituted in revision for NAC 426.680)

      NAC 427A.685  “Contractor” defined. (NRS 427A.793)  “Contractor” means any person or governmental or private agency or organization with which the Division enters into a contract pursuant to NAC 427A.743.

     (Added to NAC by Dep’t of Health & Human Services by R005-06, eff. 5-4-2006; A by Aging & Disability Services Div. by R024-10, 7-22-2010)—(Substituted in revision for NAC 426.685)

      NAC 427A.687  “Division” defined. (NRS 427A.793)  “Division” means the Aging and Disability Services Division of the Department of Health and Human Services.

     (Added to NAC by Dep’t of Health & Human Services by R005-06, eff. 5-4-2006)—(Substituted in revision for NAC 426.695)

      NAC 427A.690  “Essential personal care” defined. (NRS 427A.793)  “Essential personal care” means the tasks described in NAC 427A.735.

     (Added to NAC by Dep’t of Health & Human Services by R005-06, eff. 5-4-2006)—(Substituted in revision for NAC 426.690)

      NAC 427A.695  “Financial assistance” defined. (NRS 427A.793)  “Financial assistance” means assistance provided by a program manager to persons with physical disabilities for such essential personal care as is necessary to enable them to live in a noninstitutional or unsupervised residential setting.

     (Added to NAC by Aging & Disability Services Div. by R024-10, eff. 7-22-2010)

      NAC 427A.700  “Person with a physical disability” defined. (NRS 427A.793)  “Person with a physical disability” has the meaning ascribed to it in NRS 427A.791.

     (Added to NAC by Dep’t of Health & Human Services by R005-06, eff. 5-4-2006)—(Substituted in revision for NAC 426.700)

      NAC 427A.705  “Personal care attendant” defined. (NRS 427A.793)  “Personal care attendant” means a person who has the knowledge and skill to provide essential personal care pursuant to NAC 427A.675 to 427A.789, inclusive.

     (Added to NAC by Dep’t of Health & Human Services by R005-06, eff. 5-4-2006; A by Aging & Disability Services Div. by R016-12, 9-14-2012)—(Substituted in revision for NAC 426.705)

      NAC 427A.707  “Program manager” defined. (NRS 427A.793)  “Program manager” means:

     1.  The Division; or

     2.  A person, agency or organization outside of the Division with which the Division has entered into a contract pursuant to NAC 427A.743.

     (Added to NAC by Aging & Disability Services Div. by R024-10, eff. 7-22-2010)

      NAC 427A.710  “Recipient” defined. (NRS 427A.793)  “Recipient” means a person who receives financial assistance for essential personal care pursuant to NAC 427A.675 to 427A.789, inclusive.

     (Added to NAC by Dep’t of Health & Human Services by R005-06, eff. 5-4-2006; A by Aging & Disability Services Div. by R016-12, 9-14-2012)—(Substituted in revision for NAC 426.710)

      NAC 427A.720  “Support services for independent living” defined. (NRS 427A.793)  “Support services for independent living” includes, without limitation:

     1.  Assisting a recipient in developing a comprehensive plan to support his or her ability to live independently;

     2.  Offering assistance, support or direction in performing activities of daily living; and

     3.  Coordinating such services with other services and coordinating providers of other services on behalf of a recipient.

     (Added to NAC by Dep’t of Health & Human Services by R005-06, eff. 5-4-2006)—(Substituted in revision for NAC 426.720)

      NAC 427A.725  Eligibility for financial assistance; provision of care by Division. (NRS 427A.793)

     1.  To be eligible for financial assistance pursuant to NAC 427A.675 to 427A.789, inclusive, a person must:

     (a) Be a resident of the State;

     (b) Be diagnosed as a person with a physical disability by a licensed physician;

     (c) Require assistance as determined pursuant to subsection 1 of NAC 427A.730;

     (d) Use all other resources in the community that provide essential personal care or financial assistance for essential personal care before requesting financial assistance pursuant to NAC 427A.675 to 427A.789, inclusive;

     (e) Except as otherwise provided in subsection 2, require not more than 35 hours of essential personal care each week from this program to live independently;

     (f) Be capable of supervising the attendant who provides the care, except that in extraordinary circumstances the Division may designate a responsible person to supervise the attendant on behalf of the otherwise eligible person;

     (g) Be capable of participating in a plan for independent living; and

     (h) Be financially eligible pursuant to the provisions of NAC 427A.765.

     2.  Except as otherwise provided in this subsection, the Division may provide not more than 35 hours of essential personal care each week to a recipient. In addition, the Division may, based upon its budget and its determination of need:

     (a) If a portion of the 35 hours or less of essential personal care that was allocated to a recipient for a week is not used by that recipient in that week, provide temporary:

          (1) Emergency care to another recipient if his or her disability is exacerbated or he or she has a short-term illness that is not related to the disability.

          (2) Respite care to relieve a family member who provides care for a person on the waiting list of persons eligible to receive financial assistance pursuant to subsection 1 that is maintained by the Division.

     (b) Provide 120 hours or less per year of respite care to relieve a family member who provides care for a recipient.

     3.  The provisions of this section do not prohibit the Division from providing 35 hours or less of essential personal care each week for a person who is also receiving services from another program.

     (Added to NAC by Dep’t of Health & Human Services by R005-06, eff. 5-4-2006; A by Aging & Disability Services Div. by R024-10, 7-22-2010; R016-12, 9-14-2012)—(Substituted in revision for NAC 426.725)

      NAC 427A.730  Eligibility for provision of financial assistance; priority given under certain circumstances. (NRS 427A.793)

     1.  Financial assistance may be provided to an eligible person who:

     (a) Has a traumatic brain injury; or

     (b) Requires assistance with at least two of the following tasks:

          (1) Bathing.

          (2) Toileting.

          (3) Eating.

     2.  The program manager shall give priority in the provision of financial assistance to an eligible person who:

     (a) Has a condition that is terminal and is not expected to live for more than 1 year;

     (b) Receives acute or extended care in an institutional setting but who, with financial assistance provided pursuant to NAC 427A.675 to 427A.789, inclusive, would be able to function in a setting in which the person controls and manages his or her daily activities; or

     (c) Is experiencing a crisis as determined by the program manager due to an unanticipated change in the circumstances of the eligible person.

     (Added to NAC by Dep’t of Health & Human Services by R005-06, eff. 5-4-2006; A by Aging & Disability Services Div. by R024-10, 7-22-2010; R016-12, 9-14-2012)—(Substituted in revision for NAC 426.730)

      NAC 427A.735  Scope of essential personal care. (NRS 427A.793)  Essential personal care is limited to assisting a person who is eligible to receive financial assistance pursuant to NAC 427A.675 to 427A.789, inclusive:

     1.  In the elimination of wastes from the body;

     2.  In dressing and undressing;

     3.  In bathing and grooming;

     4.  In the preparation and eating of meals;

     5.  In getting in and out of bed;

     6.  In repositioning while asleep;

     7.  In the use of prostheses and other medical equipment;

     8.  In moving about, including, without limitation, assisting a person:

     (a) In moving from a wheelchair, bed or other piece of furniture;

     (b) With ambulation; and

     (c) With exercises to increase the range of motion;

     9.  In essential laundry;

     10.  In light housekeeping;

     11.  With support services for independent living if the person has an injury to the brain and those services do not exceed 14 hours per week; and

     12.  In other minor needs directly related to maintenance of personal hygiene.

     (Added to NAC by Dep’t of Health & Human Services by R005-06, eff. 5-4-2006; A by Aging & Disability Services Div. by R016-12, 9-14-2012)—(Substituted in revision for NAC 426.735)

      NAC 427A.740  Duties of program manager. (NRS 427A.793)  The program manager shall:

     1.  Reevaluate a recipient’s eligibility every 12 months and when his or her need for essential personal care changes.

     2.  Coordinate the provision of essential personal care to eligible persons.

     3.  Provide assessments of recipients. An assessment must:

     (a) Be conducted by a licensed professional who is familiar with essential personal care and the independent living needs of persons with physical disabilities;

     (b) Whenever possible, be conducted at the location where the services are offered; and

     (c) Include the requirements for completing specific tasks, the time required for completion of the tasks and a statement by the recipient concerning the recipient’s perspective of his or her needs for care.

     4.  Provide referrals to independent living and other services as appropriate for the needs of recipients.

     (Added to NAC by Dep’t of Health & Human Services by R005-06, eff. 5-4-2006; A by Aging & Disability Services Div. by R024-10, 7-22-2010; R016-12, 9-14-2012)—(Substituted in revision for NAC 426.740)

      NAC 427A.743  Contract for provision of essential personal care and other services. (NRS 427A.793)  The Division may enter into a contract with a contractor to provide essential personal care and other services pursuant to NAC 427A.675 to 427A.789, inclusive.

     (Added to NAC by Aging & Disability Services Div. by R024-10, eff. 7-22-2010; A by R016-12, 9-14-2012)

      NAC 427A.745  Monitoring and evaluation of contractors; submission by contractors of reports and proposed procedural changes. (NRS 427A.793)

     1.  If the Division has entered into a contract pursuant to NAC 427A.743, the Division will monitor the management and the financial records of the contractor and will evaluate the contractor’s efficiency in administering the provisions of the contract.

     2.  The contractor shall submit to the Division:

     (a) Reports summarizing the activities of programs providing essential personal care at times and on forms as determined by the Division.

     (b) Any proposed procedural changes for review and approval before they are carried out.

     (c) Such other reports as the Division requests.

     (Added to NAC by Dep’t of Health & Human Services by R005-06, eff. 5-4-2006; A by Aging & Disability Services Div. by R024-10, 7-22-2010)—(Substituted in revision for NAC 426.745)

      NAC 427A.750  Notification of program manager of changes in income or need for essential personal care of recipient. (NRS 427A.793)  A recipient shall notify the program manager of any change in the recipient’s:

     1.  Income, the income of the recipient’s spouse or, if the recipient is a dependent child or adult who has no income and is financially supported by his or her family, the income of the recipient’s family that would affect the recipient’s eligibility; and

     2.  Need for essential personal care.

     (Added to NAC by Dep’t of Health & Human Services by R005-06, eff. 5-4-2006; A by Aging & Disability Services Div. by R024-10, 7-22-2010)—(Substituted in revision for NAC 426.750)

      NAC 427A.755  Application for financial assistance; statement of need for care; notification and date of eligibility; notification of position on waiting list. (NRS 427A.793)

     1.  An applicant for financial assistance must submit to the program manager a completed application and a written statement from a licensed physician, physician assistant or registered nurse certifying the applicant’s need for essential personal care.

     2.  The program manager shall, within 30 days after receiving a completed application, notify the applicant in writing whether he or she is eligible for financial assistance.

     3.  If money is available, a person may be eligible to receive financial assistance on the date the determination of eligibility is made.

     4.  If money is not available, the program manager shall notify the person that the person will be placed on the waiting list maintained by the Division of persons eligible for financial assistance in the order of their priority.

     (Added to NAC by Dep’t of Health & Human Services by R005-06, eff. 5-4-2006; A by Aging & Disability Services Div. by R024-10, 7-22-2010)—(Substituted in revision for NAC 426.755)

      NAC 427A.765  Determination of financial eligibility; determination of portion of cost to be paid by recipient; payment of costs by contractor. (NRS 427A.793)

     1.  An applicant is not eligible to receive financial assistance pursuant to subsection 1 of NAC 427A.725, if his or her gross monthly income, less the expenses set forth in paragraphs (a) to (d), inclusive, of subsection 2, is more than 800 percent of the federally designated level signifying poverty, divided by 12, for the size of family applicable to the applicant, as determined by the United States Department of Health and Human Services and published annually in the Federal Register.

     2.  In determining the financial eligibility of an applicant, one-half of the gross monthly income of the applicant earned through employment, any additional gross monthly income of the applicant and the gross monthly income of the applicant’s spouse must be counted. From the total must be deducted any amount paid directly by the applicant or the applicant’s spouse that is not reimbursed by any other source for:

     (a) Medicine prescribed for the applicant or the applicant’s spouse or dependent child by a physician;

     (b) Medical care provided to the applicant or the applicant’s spouse or dependent child by a doctor, hospital or other medical facility;

     (c) Special equipment, services or supplies to help the applicant or any other member of the household who also has a disability do what a person who is not disabled can do; and

     (d) Health insurance and the cost thereof, including, without limitation, the payment of premiums and copayments for the applicant or the applicant’s spouse or dependent child.

Ê As used in this subsection, “medical facility” has the meaning ascribed to it in NRS 449.0151 and includes a facility for the rehabilitation of persons with physical disabilities.

     3.  A recipient whose gross monthly income, less the expenses set forth in paragraphs (a) to (d), inclusive, of subsection 2, is less than 300 percent of the federally designated level signifying poverty, divided by 12, is not required to pay any of the cost for essential personal care. Except as otherwise provided in this section, a recipient whose gross monthly income, less the expenses set forth in paragraphs (a) to (d), inclusive, of subsection 2, is 300 percent or more of the federally designated level signifying poverty, divided by 12, but not greater than 800 percent of the federally designated level signifying poverty, divided by 12, shall pay a portion of the total cost to provide essential personal care to the recipient according to the following formula:

 

Monthly amount of recipient’s payment for essential personal care =

(A-(B+C)) x (D)

 

     (A-B)

 

Ê where “A” is the recipient’s gross monthly income; “B” is the sum, on a monthly basis, of the recipient’s and his or her spouse’s expenses and, if applicable, the expenses of the recipient’s family, set forth in paragraphs (a) to (d), inclusive, of subsection 2; “C” is the amount that equals 300 percent of the federally designated level signifying poverty, divided by 12, for the size of family applicable to the recipient; and “D” is the cost of providing services for essential personal care, on a monthly basis, for that recipient.

     4.  Notwithstanding the formula set forth in subsection 3, in no case may the recipient’s payment for essential personal care, on a monthly basis, exceed 20 percent of the amount that equals the difference between A and the sum of B and C.

     5.  If there are compelling and urgent circumstances, including, without limitation, the circumstance in which payment of any portion of the cost to provide essential personal care to the recipient will cause severe hardship to the recipient, the contractor, with the approval of the Administrator, or the Division, as applicable, may pay 100 percent of the cost of the essential personal care of a recipient.

     (Added to NAC by Dep’t of Health & Human Services by R005-06, eff. 5-4-2006; A by Aging & Disability Services Div. by R024-10, 7-22-2010; R016-12, 9-14-2012)—(Substituted in revision for NAC 426.765)

      NAC 427A.770  Grounds for termination of care. (NRS 427A.793)  Care provided by a personal care attendant to a recipient may be terminated if the recipient:

     1.  Fails to pay his or her share of the cost of such care;

     2.  Fails to provide documents needed for reevaluation;

     3.  Willfully defrauds the program; or

     4.  Fails to comply with the requirements of NAC 427A.750.

     (Added to NAC by Dep’t of Health & Human Services by R005-06, eff. 5-4-2006)—(Substituted in revision for NAC 426.770)

Administrative Review

      NAC 427A.775  Right of review. (NRS 427A.793)

     1.  An applicant for financial assistance is entitled to an administrative review if his or her application is denied.

     2.  A recipient is entitled to an administrative review if:

     (a) The recipient’s financial assistance is terminated;

     (b) The recipient’s financial assistance is reduced without his or her concurrence;

     (c) The recipient has not been given a choice between community home-based care and institutional care; or

     (d) The recipient has a grievance concerning the delivery, quality, duration or scope of his or her financial assistance.

     (Added to NAC by Aging & Disability Services Div. by R016-12, eff. 9-14-2012)

      NAC 427A.776  Request for review. (NRS 427A.793)

     1.  An applicant for financial assistance or a recipient or his or her designated representative may request an administrative review by:

     (a) Signing, dating and returning to the office of the Division responsible for the region in which the applicant or recipient resides the letter notifying the applicant or recipient of the action to be taken by the Division; or

     (b) Submitting a written request to the office of the Division responsible for the region in which the applicant or recipient resides.

     2.  Except as otherwise provided in subsection 4, a request for an administrative review must be received in the regional office of the Division within 15 days after the date of the letter notifying the applicant or recipient or his or her designated representative of the action to be taken. The date of the letter shall be deemed the first day of the 15-day period.

     3.  If the 15th day falls on a holiday or weekend, the time for submitting a request will be extended to the next working day.

     4.  The Division will not accept a request for an administrative review received after the time specified in subsection 2 unless the applicant or recipient or his or her designated representative demonstrates good cause for the failure to comply with the deadline.

     5.  The Administrator or a person designated by the Administrator will review any requests to waive the deadline for good cause and will make a determination within 10 days after the receipt of the request.

     6.  If the Administrator or a person designated by the Administrator determines that the applicant or recipient or his or her designated representative has demonstrated good cause for the failure to comply with the 15-day deadline, he or she will schedule an administrative review for the applicant or recipient.

     7.  If the Administrator or a person designated by the Administrator determines that the applicant or recipient or his or her designated representative has not demonstrated good cause for the failure to comply with the 15-day deadline, he or she will notify the applicant or recipient or his or her designated representative that the request for an administrative review is denied.

     (Added to NAC by Aging & Disability Services Div. by R016-12, eff. 9-14-2012)

      NAC 427A.777  Preliminary conference for resolution of matter. (NRS 427A.793)

     1.  Within 10 days after the Division receives a request for an administrative review, the program manager of the region in which the applicant for financial assistance or recipient resides shall contact the applicant or recipient or his or her designated representative to schedule a conference with a member of the staff of the Division to attempt to resolve the matter without the necessity of an administrative review.

     2.  The program manager shall:

     (a) Preside at the conference; and

     (b) Complete a report on the outcome of the conference.

     3.  The conference does not affect the right of the applicant or recipient to an administrative review.

     (Added to NAC by Aging & Disability Services Div. by R016-12, eff. 9-14-2012)

      NAC 427A.778  Appointment and initial duties of review team; provision of notice; postponement; withdrawal of request; failure to appear. (NRS 427A.793)

     1.  If, after the conference is held, the applicant for financial assistance or recipient wishes to continue with the administrative review, the Administrator will appoint a review team made up of two or more members from the Subcommittee on Personal Assistance for Persons with Severe Functional Disabilities of the Nevada Commission on Services for Persons with Disabilities and one member of the staff of the Division. Within 15 days after the appointment, the review team must establish a date, time and location for the review.

     2.  The Division will mail a notice of the date, time and location of the administrative review to the applicant or recipient or his or her designated representative at least 10 working days before the date scheduled for the review, unless the applicant or recipient or his or her designated representative requests a review in a shorter period.

     3.  If requested by the Division or by the applicant or recipient or his or her designated representative, the review team may postpone an administrative review for good cause. If the review team determines that a postponement is warranted, the review team must reschedule the administrative review for a date which is not later than 15 days after the original date for the review.

     4.  The applicant or recipient or his or her designated representative is entitled to withdraw the request for an administrative review any time before the review team renders a decision. The withdrawal must be in writing, dated and signed by the applicant or recipient or his or her designated representative and mailed or delivered to the regional office of the Division which received the request for the administrative review. If an applicant or a recipient or his or her designated representative indicates verbally a desire to withdraw a request for an administrative review, the Division will instruct him or her to submit a written withdrawal.

     5.  The review team shall cancel the administrative review if the applicant or recipient or his or her designated representative fails to appear for the scheduled administrative review after receiving proper notification. The review team shall notify the applicant or recipient or his or her designated representative within 1 working day after the failure to appear that the administrative review will be considered cancelled unless the applicant or recipient or his or her designated representative can demonstrate good cause for failing to appear. The applicant or recipient or his or her designated representative must submit the reasons for failing to appear within 10 days after the date of the letter notifying the applicant or recipient or his or her designated representative of the cancellation if the applicant or recipient or his or her designated representative wishes to continue the administrative review. The Administrator will determine whether good cause has been demonstrated for failing to appear.

     (Added to NAC by Aging & Disability Services Div. by R016-12, eff. 9-14-2012)

      NAC 427A.779  Continuation of services during review. (NRS 427A.793)

     1.  A recipient is entitled to receive financial assistance while an administrative review of a termination of that financial assistance is pending, if funding is available, unless the recipient or his or her designated representative requests in writing that the financial assistance be discontinued.

     2.  If financial assistance is continued and the decision to terminate that financial assistance is upheld, the recipient may be required to repay the amount of any financial assistance provided after the date on which that financial assistance was originally scheduled to be terminated.

     (Added to NAC by Aging & Disability Services Div. by R016-12, eff. 9-14-2012)

      NAC 427A.780  Right to representation. (NRS 427A.793)  An applicant for financial assistance or a recipient is entitled to represent himself or herself or to be represented by another person, including a legal representative, at the administrative review. The Division will inform the applicant or recipient or his or her designated representative of this right:

     1.  At the time he or she applies for financial assistance; and

     2.  In a letter notifying the applicant or recipient or his or her designated representative of the action of the Division that is subject to administrative review.

     (Added to NAC by Aging & Disability Services Div. by R016-12, eff. 9-14-2012)

      NAC 427A.781  Attendance by certain member of staff; procedure when member of staff unable to attend. (NRS 427A.793)

     1.  A review team shall request the member of the staff of the Division who made the decision that is the subject of the contested action of the Division to attend the administrative review.

     2.  If that member of the staff is unable to attend the review:

     (a) The supervisor for the region in which the applicant for financial assistance or recipient resides must serve as the representative of the Division.

     (b) That member of the staff must provide the review team with a report that contains:

          (1) A summary of the factors on which the contested action of the Division is based; and

          (2) All applicable laws, regulations and policies of the Division.

     3.  The review team shall cause the report it receives pursuant to paragraph (b) of subsection 2 to be read into the record and entered into evidence during the administrative review.

     (Added to NAC by Aging & Disability Services Div. by R016-12, eff. 9-14-2012)

      NAC 427A.782  Disclosure of documents, records and additional relevant information. (NRS 427A.793)

     1.  An applicant for financial assistance or a recipient or his or her designated representative is entitled to receive:

     (a) Before the administrative review, a photocopy of all documents and records that will be used in the administrative review. The Division will provide those photocopies at no charge.

     (b) From the Division, photocopies of additional relevant information that will not be used at the administrative review upon payment of a charge not to exceed the actual cost to the Division of producing the photocopies.

     2.  During the review, the Division will provide the applicant or recipient or his or her designated representative with a photocopy of all documents presented by the Division at the administrative review.

     (Added to NAC by Aging & Disability Services Div. by R016-12, eff. 9-14-2012)

      NAC 427A.783  Conducting of review. (NRS 427A.793)

     1.  A review team shall:

     (a) Conduct the administrative review in an informal manner; and

     (b) Ensure that all relevant issues are considered during the administrative review.

     2.  The review team may cause the removal from the administrative review of any person who:

     (a) Uses disrespectful language;

     (b) Engages in contemptuous conduct; or

     (c) Refuses to comply with the directions of the review team.

     (Added to NAC by Aging & Disability Services Div. by R016-12, eff. 9-14-2012)

      NAC 427A.784  Recording of review. (NRS 427A.793)

     1.  A review team shall record the administrative review with an audiotape recorder.

     2.  The review team’s audiotape recorder is the only recording device that may be allowed at the administrative review.

     (Added to NAC by Aging & Disability Services Div. by R016-12, eff. 9-14-2012)

      NAC 427A.785  Case record of review; submission and retention of case record and recording. (NRS 427A.793)

     1.  A review team shall keep a case record of each administrative review that it conducts which contains:

     (a) All correspondence that the review team has received regarding the subject matter of the administrative review;

     (b) All exhibits presented and accepted during the administrative review; and

     (c) A narrative log of all contacts that the review team has had with the applicant for financial assistance or recipient or his or her designated representative, members of the staff of the Division or legal counsel for any of the participants in the administrative review.

     2.  The case record established by the review team constitutes the official record of the hearing.

     3.  After the review team has rendered a decision, the review team shall submit the case record and the audiotape recording to the office of the Division in Carson City. That office shall retain the case record and the audiotape recording:

     (a) For 4 years after the date of the decision; or

     (b) Until the resolution of a judicial review of the decision,

Ê whichever occurs later.

     (Added to NAC by Aging & Disability Services Div. by R016-12, eff. 9-14-2012)

      NAC 427A.786  Procedure upon review. (NRS 427A.793)

     1.  At the beginning of the administrative review, the review team shall:

     (a) Introduce each member of the review team;

     (b) Announce the date and time;

     (c) State the name of the person requesting the administrative review;

     (d) State the reason for the administrative review;

     (e) Cause each person present to introduce himself or herself and to state the person’s purpose in attending the administrative review; and

     (f) Advise those present that the administrative review is being recorded by an audiotape recorder.

     2.  The representative of the Division shall state the basis of the contested action taken by the Division. If the member of the staff of the Division who made the decision that is the subject of the contested action of the Division is not present, the report prepared by that member of the staff pursuant to paragraph (b) of subsection 2 of NAC 427A.781 must be read into the record.

     3.  The review team shall allow the applicant for financial assistance or recipient or his or her designated representative to make a statement concerning the grievance and to present supporting evidence.

     4.  The review team shall collect, number and log all relevant evidence.

     5.  The review team, the applicant or recipient or his or her designated representative or the representative of the Division may request that evidence which is not available at the administrative review be submitted. If such a request is made, the review team may:

     (a) Continue the administrative review and order further investigation or request a party to produce the additional evidence; or

     (b) Close the administrative review but hold the record open to permit submission of any additional evidence.

Ê If additional evidence is submitted, the review team shall provide each party with the opportunity to examine that evidence.

     6.  If the review team determines after the administrative review is closed that the record is unclear or insufficient to make a decision, the review team may contact the applicant or recipient or his or her designated representative or the representative of the Division for clarification or additional information. Any material submitted after the close of the review must be made available to all participants in the administrative review and each shall have the opportunity for rebuttal. The review team may reopen the administrative review if the nature of the additional information or the rebuttal thereof makes further consideration necessary.

     7.  Before closing the review, the review team shall advise those present that:

     (a) The review team will base its decision on the case record and the testimony and evidence presented at the administrative review;

     (b) The review team will render a decision within 15 days after the date of the administrative review;

     (c) The review team will inform the applicant or recipient or his or her designated representative by mail of the decision; and

     (d) The applicant or recipient or his or her designated representative may appeal the decision of the review team to the Administrator.

     (Added to NAC by Aging & Disability Services Div. by R016-12, eff. 9-14-2012)

      NAC 427A.787  Decision of review team. (NRS 427A.793)

     1.  The decision of a review team must:

     (a) Be based on the evidence and information presented at the administrative review and any additional information submitted pursuant to subsection 6 of NAC 427A.786;

     (b) Comply with the regulations of the Division that were in effect at the time the Division took the contested action;

     (c) Contain a summary of the findings of fact;

     (d) Identify supporting evidence and regulations;

     (e) Respond to any reasonable arguments of the applicant for financial assistance or recipient or his or her designated representative; and

     (f) Be submitted in writing to the Administrator with the case record and all exhibits presented during the administrative review.

     2.  In issuing a decision, the review team shall not consider changes in physical or social factors that occur after the close of the administrative review.

     (Added to NAC by Aging & Disability Services Div. by R016-12, eff. 9-14-2012)

      NAC 427A.788  Notification of decision and right to appeal; request for appeal. (NRS 427A.793)

     1.  The review team shall mail the written decision to the applicant for financial assistance or recipient or his or her designated representative within 15 days after the close of the administrative review. In addition to the written decision, the review team shall notify the applicant or recipient or his or her designated representative by mail of:

     (a) The right to appeal the decision of the review team to the Administrator; and

     (b) The process to request an appeal to the Administrator.

     2.  A request for an appeal to the Administrator must be received by the Administrator within 10 days after the date of the decision.

     3.  The decision of the Administrator is a final decision for the purposes of judicial review.

     (Added to NAC by Aging & Disability Services Div. by R016-12, eff. 9-14-2012)

      NAC 427A.789  Report of review team summarizing proceedings. (NRS 427A.793)

     1.  The review team shall summarize the proceedings in a written report using the following format:

 

     A.  INTRODUCTION—The date, time and place of the administrative review and the name of each person present at the administrative review.

     B.  NATURE OF CASE—Overview of the issues presented during the administrative review.

     C.  FINDINGS OF FACT—The facts of the case as determined by the review team.

     D.  CONCLUSIONS OF LAW—The laws, regulations, procedural rules and policies which support the findings and decision of the review team.

     E.  DECISION—The decision to either uphold or overrule the action of the Division.

 

     2.  The review team shall submit the written report to the Administrator with the case record.

     (Added to NAC by Aging & Disability Services Div. by R016-12, eff. 9-14-2012)