NRS: CHAPTER 428 - INDIGENT PERSONS

[Rev. 6/29/2024 4:03:48 PM--2023]

CHAPTER 428 - INDIGENT PERSONS

MISCELLANEOUS PROVISIONS

NRS 428.010 Duty of county to provide aid and relief to indigents; duties of county commissioners.

NRS 428.015 Requirements and standards of eligibility for medical and financial assistance to be established; limitations on denial of eligibility for medical assistance; payment for medically necessary care.

NRS 428.020 Determination of county of residence.

NRS 428.030 Eligibility for relief; payment for treatment of indigent patients; powers of county commissioners.

NRS 428.040 Indigent person to provide information and cooperation when applying for relief.

NRS 428.045 Custody, use, preservation and confidentiality of information relating to applicants for and recipients of public assistance.

NRS 428.050 Levy of tax ad valorem; establishment of maximum rate; limitations on expenditures and transfers.

NRS 428.060 Application by nonresident indigent: Temporary relief; notification of county of residence; removal to county; payment to or recovery by county granting relief.

NRS 428.070 Responsibility of relative and recipient of aid for hospitalization provided by county: Reimbursement of county; determination of financial responsibility; action to enforce collection.

NRS 428.080 Expenditure for transportation of nonresident indigent to place of residence.

NRS 428.090 Medical assistance to and disposal of remains of nonresidents and other persons; limitations on responsibility of county.

NRS 428.093 Denial by county of medical or financial assistance: Form and contents of adverse decision; judicial review.

NRS 428.095 Liability insurance for persons rendering medical care.

NRS 428.110 Criminal and civil penalties for bringing nonresident indigent into county.

HOSPITAL CARE FOR INDIGENT PERSONS

NRS 428.115 Definitions.

NRS 428.125 “Board” defined.

NRS 428.136 “Fund” defined.

NRS 428.145 “Hospital” defined.

NRS 428.155 “Hospital care” defined.

NRS 428.165 “Injury in a motor vehicle crash” defined.

NRS 428.175 Fund for Hospital Care to Indigent Persons.

NRS 428.185 Levy of tax ad valorem for remittance to Fund.

NRS 428.195 Board of Trustees of Fund: Composition; terms; vacancies; designees.

NRS 428.205 Board of Trustees of Fund: Powers.

NRS 428.206 Agreement to transfer money from Fund to Division of Health Care Financing and Policy of Department of Health and Human Services to include in State Plan for Medicaid enhanced rate of reimbursement for hospital care provided to Medicaid recipients or to make supplemental payments to hospitals for such care.

NRS 428.209 Application by counties to Board for reimbursement for charges for care furnished to certain patients; procedure for application; review of application; payment to county from Fund; reimbursement of provider of care by county; Board subrogated to right of county; lien on proceeds of recovery.

NRS 428.215 Collection of charges for care by hospital; request for determination of indigency.

NRS 428.225 Certification of indigency.

NRS 428.235 Application for reimbursement of charges; hospitals eligible for reimbursement.

NRS 428.245 Review of application; payment to hospital from Fund; reimbursement of physician by hospital; Board subrogated to right of hospital or physician; lien on proceeds of recovery.

NRS 428.255 Reimbursement of Fund by counties.

OTHER MEDICAL CARE

NRS 428.265 Definitions.

NRS 428.275 Fund for medical assistance to indigent persons.

NRS 428.285 Levy of tax ad valorem for remittance to fund and Intergovernmental Transfer Account; certain smaller counties to remit certain amount of money to allow State Plan for Medicaid to include payment of certain expenditures relating to long-term care; certain counties to remit certain amount for credit to Fund for Hospital Care to Indigent Persons.

NRS 428.295 Allocation of money in budget; payment of excess from fund.

COMMUNITY SERVICES BLOCK GRANTS

NRS 428.355 Definitions.

NRS 428.365 Director to administer allotment; expenditure of allotment; money not obligated for expenditure.

NRS 428.375 Plan for statewide use and distribution of money; public hearings on proposed plans; preparation and filing of final plan; distribution of allotment; applications for grants.

_________

MISCELLANEOUS PROVISIONS

NRS 428.010 Duty of county to provide aid and relief to indigents; duties of county commissioners.

1. Except as otherwise provided in NRS 422.382, to the extent that money may be lawfully appropriated by the board of county commissioners for this purpose pursuant to NRS 428.050, 428.285 and 450.425, every county shall provide care, support and relief to the poor, indigent, incompetent and those incapacitated by age, disease, accident or motor vehicle crash, lawfully resident therein, when those persons are not supported or relieved by their relatives or guardians, by their own means, or by state hospitals, or other state, federal or private institutions or agencies.

2. Except as otherwise provided in NRS 439B.330, the boards of county commissioners of the several counties shall establish and approve policies and standards, prescribe a uniform standard of eligibility, appropriate money for this purpose and appoint agents who will develop regulations and administer these programs to provide care, support and relief to the poor, indigent, incompetent and those incapacitated by age, disease, accident or motor vehicle crash.

[1:51:1861; B § 3749; BH § 1981; C § 2154; RL § 2915; NCL § 5137] + [1:11:1905; RL § 2926; NCL § 5148]—(NRS A 1971, 1181; 1985, 2033; 1987, 91, 882, 1514; 1993, 1971; 1995, 1430; 2015, 1674)

1. The board of county commissioners shall adopt an ordinance and any related policies which establish the requirements and standards of eligibility for medical and financial assistance to indigent persons. The ordinance and policies must specify the allowable income, assets and other resources or potential resources of persons eligible for assistance, and any other requirements applicable to an applicant for assistance. The board of county commissioners shall file the ordinance and policies with the Secretary of State within 30 days after adoption. Any amendment to the ordinance or policies must be filed with the Secretary of State within 30 days after adoption.

2. A county’s standards of eligibility for medical assistance must not deny eligibility to a person living in a household which has a total monthly income of less than:

(a) For one person living without another member of a household, $438.

(b) For two persons, $588.

Ê For the purposes of this subsection, “income” includes the entire income of a household and the amount which a county projects a person or household is able to earn. “Household” is limited to a person and the spouse, parents, children, brothers and sisters residing with the person.

3. A county’s program of medical assistance to indigent persons must provide payment for:

(a) Emergency medical care; and

(b) All other medically necessary care rendered in a medical facility designated by the county.

4. As used in this section:

(a) “Emergency medical care” means any care for an urgent medical condition which is likely to result in serious and permanent bodily disability or death if the patient is transported to a medical facility designated by the county.

(b) “Medically necessary care” does not include any experimental or investigative medical care which is not covered by Medicaid or Medicare.

(Added to NRS by 1987, 1512; A 1995, 2567)

NRS 428.020 Determination of county of residence. For the purposes of NRS 428.010 to 428.110, inclusive:

1. The county of residence of a person is the county in which the person is physically present with the intent to reside, at least for an indefinite period.

2. The county of residence of a person placed in institutional care is the county of residence of that person before the person was placed in institutional care.

[2:11:1905; RL § 2927; NCL § 5149]—(NRS A 1989, 1858; 1991, 1743; 1993, 277)

NRS 428.030 Eligibility for relief; payment for treatment of indigent patients; powers of county commissioners.

1. When any person meets the uniform standards of eligibility established by the board of county commissioners or by NRS 439B.310, if applicable, and complies with any requirements imposed pursuant to NRS 428.040, the person is entitled to receive such relief as is in accordance with the policies and standards established and approved by the board of county commissioners and within the limits of the money which may be lawfully appropriated pursuant to NRS 428.050, 428.285 and 450.425 for this purpose.

2. The board of county commissioners of the county of residence of indigent inpatients shall pay hospitals for the costs of treating those indigent inpatients and any nonresident indigent inpatients who fall sick in the county an amount which is not less than the payment required for providing the same treatment to patients pursuant to the State Plan for Medicaid within the limits of money which may be lawfully appropriated pursuant to NRS 428.050, 428.285 and 450.425 for this purpose.

3. The board of county commissioners may:

(a) Make contracts for the necessary maintenance of indigent persons;

(b) Appoint such agents as the board deems necessary to oversee and provide the necessary maintenance of indigent persons;

(d) Provide for the necessary maintenance of indigent persons by the exercise of the combination of one or more of the powers specified in paragraphs (a), (b) and (c).

4. A hospital may contract with the Department of Health and Human Services to obtain the services of a state employee to be assigned to the hospital to evaluate the eligibility of patients applying for indigent status. Payment for those services must be made by the hospital.

[4:51:1861; A 1943, 86; 1943 NCL § 5140]—(NRS A 1971, 1182; 1973, 1107; 1985, 2034; 1987, 91, 883, 1514, 1632; 1989, 1800, 1858; 1993, 1971; 1995, 1430, 2568; 1997, 1246)

NRS 428.040 Indigent person to provide information and cooperation when applying for relief. When an application is made by an indigent person to the board of county commissioners of any county for relief, the board of county commissioners shall require the indigent person to:

1. Provide the information necessary to determine the indigent person’s county of residence or nonresident status.

2. Provide the information necessary to determine the indigent person’s financial condition and eligibility for medical and financial assistance.

3. Cooperate fully in applying for any federal or state assistance for which the indigent person may be eligible.

[7:51:1861; A 1867, 116; R 1911, 413; A 1933, 8; 1931 NCL § 5143]—(NRS A 1979, 442; 1989, 1859; 1995, 2569)

NRS 428.045 Custody, use, preservation and confidentiality of information relating to applicants for and recipients of public assistance.

1. To restrict the use or disclosure of any information concerning applicants for or recipients of public assistance to those purposes directly related to the administration of this chapter, and to provide safeguards therefor, the board of county commissioners of each county shall establish and enforce ordinances governing the custody, use and preservation of the records, files and communications related to those persons that are filed with the board.

2. If, under the provisions of law or the ordinances of a board of county commissioners adopted pursuant to subsection 1, the names and addresses of, or information concerning, applicants for or recipients of public assistance are furnished to or held by any other agency or department of government, the agency or department shall comply with the ordinances of the board of county commissioners prohibiting the publication of lists and records thereof or their use for purposes not directly connected with the administration of this chapter.

3. Except for purposes directly related to the administration of this chapter, no person may publish, disclose or use, or permit or cause to be published, disclosed or used, any confidential information relating to an applicant for or a recipient of public assistance under the provisions of this chapter.

4. As used in this section, “public assistance” means medical or financial assistance provided by a county pursuant to this chapter.

(Added to NRS by 1997, 2266)

NRS 428.050 Levy of tax ad valorem; establishment of maximum rate; limitations on expenditures and transfers.

1. In addition to the tax levied pursuant to NRS 428.185 and 428.285 and any tax levied pursuant to NRS 450.425, the board of county commissioners of a county shall, at the time provided for the adoption of its final budget, levy an ad valorem tax to provide aid and relief to those persons coming within the purview of this chapter. In a county whose population is 700,000 or more, this levy must not exceed that adopted for the purposes of this chapter for the fiscal year ending June 30, 1971, diminished by 12.3 cents for each $100 of assessed valuation. In a county whose population is less than 700,000 the rate of the tax must be calculated to produce not more than the amount of money allocated pursuant to NRS 428.295.

2. The board of county commissioners of any county in which there was no levy adopted for the purposes of this chapter for the fiscal year ending June 30, 1971, may request that the Nevada Tax Commission establish a maximum rate for the levy of taxes ad valorem by the county to provide aid and relief pursuant to this chapter.

3. No county may expend or contract to expend for that aid and relief a sum in excess of that provided by the maximum ad valorem levy set forth in subsection 1 of this section and NRS 428.185, 428.285 and 450.425, or established pursuant to subsection 2, together with such outside resources as it may receive from third persons, including, but not limited to, expense reimbursements, grants-in-aid or donations lawfully attributable to the county indigent fund.

4. Except as otherwise provided in this subsection, no interfund transfer, medium-term obligation procedure or contingency transfer may be made by the board of county commissioners to provide resources or appropriations to a county indigent fund in excess of those which may be otherwise lawfully provided pursuant to subsections 1, 2 and 3 of this section and NRS 428.185, 428.285 and 450.425. If the health of indigent persons in the county is placed in jeopardy and there is a lack of money to provide necessary medical care under this chapter, the board of county commissioners may declare an emergency and provide additional money for medical care from whatever sources may be available.

[Part 8:51:1861; A 1867, 116; R 1911, 413; A 1933, 8; 1931 NCL § 5144]—(NRS A 1971, 1182; 1979, 1244; 1985, 2034; 1987, 91, 1241, 1308, 1632, 1674; 1989, 597, 1925; 1991, 480; 1997, 558; 2011, 1253)

NRS 428.060 Application by nonresident indigent: Temporary relief; notification of county of residence; removal to county; payment to or recovery by county granting relief.

1. If it appears to the satisfaction of the board of county commissioners that the county of residence of an indigent person applying for relief is another county in this State, the board shall provide temporary relief for the indigent person in accordance with the policies and standards established and approved by the board of county commissioners and within the limits of money which may be lawfully appropriated thereby for this purpose pursuant to NRS 428.050, 428.285 and 450.425, and shall notify immediately the board of county commissioners of the county of residence of the indigent person.

2. The notice must be in writing, attested by the clerk of the board of county commissioners, and deposited in the post office, addressed to the board of county commissioners of the other county.

3. The board of county commissioners receiving the notice may cause the indigent person to be removed immediately to that county, and shall pay a reasonable compensation for the temporary relief afforded. If the board of county commissioners chooses not to remove the indigent person, the county affording relief has a legal claim against any money lawfully available in that county for the relief necessarily furnished, and may recover it in a suit at law.

[Part 8:51:1861; A 1867, 116; R 1911, 413; A 1933, 8; 1931 NCL § 5144] + [9:51:1861; B § 3757; BH § 1989; C § 2162; RL § 2923; NCL § 5145]—(NRS A 1971, 1182; 1979, 442; 1985, 2035; 1987, 91, 883; 1989, 1859)

NRS 428.070 Responsibility of relative and recipient of aid for hospitalization provided by county: Reimbursement of county; determination of financial responsibility; action to enforce collection.

1. The father or mother of sufficient financial ability so to do shall pay to the county which has extended county hospitalization to any natural child under the provisions of NRS 428.030 the amount granted to such natural child.

2. The child of a natural parent receiving county hospitalization pursuant to NRS 428.030 is not liable for the amount paid by the county for that parent, except where the natural child promised to support the natural parent in writing, has access to and control of the natural parent’s assets or income and has sufficient financial ability to support the natural parent.

3. A recipient of aid under the provisions of NRS 428.030 who later acquires sufficient financial ability so to do shall reimburse the county which extended county hospitalization to the recipient for any unpaid portion of the aid granted. Action against the relatives of such person is not a condition precedent to action against the person.

4. The father, mother or child of sufficient financial ability, as appropriate, shall pay to the county the amount the county paid for the burial, entombment or cremation of a natural child or a natural parent.

5. The board of county commissioners shall advise the Attorney General of the failure of a responsible person to pay such amount and the Attorney General shall cause appropriate legal action to be taken to enforce the collection of all or part of such amount. If suit is filed to enforce the collection, the court shall determine the question of the sufficiency of the financial ability of the person against whom such action is filed, but the board of county commissioners shall determine the responsible person to be sued, and failure of an action against one such person shall not preclude subsequent or concurrent actions against others.

6. In determining the amount to be ordered for support pursuant to subsections 2 and 4, the court shall consider the circumstances of each party, including:

(a) The earning capacity and needs of each party;

(b) The obligations and assets of each party;

(d) The relationship between the parties; and

(e) Any other factor which the court deems just and equitable.

[4.5:51:1861; added 1949, 592; 1943 NCL § 5140.01]—(NRS A 1961, 92; 1969, 440; 2009, 1666)

NRS 428.080 Expenditure for transportation of nonresident indigent to place of residence. Notwithstanding any other provision of law, the board of county commissioners may make budgetary provision for the transportation of an indigent person who is a nonresident or whose county of residence is another county, to the state or county of residence of the indigent person. If money is so budgeted, the board of county commissioners is authorized to direct their expenditure for that purpose.

[1:97:1949; 1943 NCL § 1981.01]—(NRS A 1989, 1859)

NRS 428.090 Medical assistance to and disposal of remains of nonresidents and other persons; limitations on responsibility of county.

1. When a nonresident or any other person who meets the uniform standards of eligibility prescribed by the board of county commissioners or by NRS 439B.310, if applicable, falls sick in the county, not having money or property to pay the person’s board, nursing or medical aid, the board of county commissioners of the proper county shall, on complaint being made, give or order to be given such assistance to the poor person as is in accordance with the policies and standards established and approved by the board of county commissioners and within the limits of money which may be lawfully appropriated for this purpose pursuant to NRS 428.050, 428.285 and 450.425.

2. If the sick person dies, the board of county commissioners shall give or order to be given to the person a decent burial or cremation.

3. Except as otherwise provided in NRS 422.382, the board of county commissioners shall make such allowance for the person’s board, nursing, medical aid, burial or cremation as the board deems just and equitable, and order it paid out of the county treasury.

4. The responsibility of the board of county commissioners to provide medical aid or any other type of remedial aid under this section is relieved to the extent provided in NRS 422.382 and to the extent of the amount of money or the value of services provided by:

(a) The Department of Health and Human Services to or for such persons for medical care or any type of remedial care under the State Plan for Medicaid; and

(b) The Fund for Hospital Care to Indigent Persons under the provisions of NRS 428.115 to 428.255, inclusive.

[6:51:1861; B § 3754; BH § 1986; C § 2159; RL § 2920; NCL § 5142]—(NRS A 1957, 347; 1963, 929; 1967, 1166; 1969, 112; 1971, 1183; 1973, 1406; 1979, 1245; 1981, 1911; 1983, 1942; 1985, 2035; 1987, 91, 884; 1993, 1972; 1995, 1429, 1430; 1997, 1246; 1999, 2235)

NRS 428.093 Denial by county of medical or financial assistance: Form and contents of adverse decision; judicial review.

1. A person who is denied by a county medical or financial assistance pursuant to this chapter may appeal that denial in accordance with procedures adopted by the county. Each county shall adopt procedures for appeals which comply with the requirements of this section.

2. The procedures must provide for adequate notice to the person denied assistance and the opportunity for a hearing. Any employee or other representative of the county who investigated or made the initial decision to deny assistance shall not participate in any decision made pursuant to the hearing.

3. A decision adverse to the person denied assistance must be in writing and set forth the factual basis for the decision and the applicable regulation. A copy of the decision must be served personally or by certified mail upon each party and the representative of each party.

4. A person aggrieved by the final decision of the county may, within 30 days after the date on which the written notice of the decision is served or mailed, petition the district court where the person resides to review the decision. The court shall review the decision on the record of the case before the county, a copy of which must be certified as correct by the county and filed with the court as part of its answer to the petition.

5. Before the date set by the court for a hearing, an application may be made to the court by motion, with notice to the opposing party and an opportunity for that party to respond, for leave to present additional evidence. If it is shown to the satisfaction of the court that the additional evidence is material and that there were good reasons for failure to present it in the proceeding before the county, the court may order that the additional evidence be taken before the county upon conditions determined by the court. The county may modify its findings and decisions by reason of the additional evidence and shall file that evidence and any modifications, new findings or decisions with the reviewing court.

6. The review must be conducted by the court without a jury and must be confined to the record. The court, at the request of a party, may hear oral arguments and receive written briefs.

7. The court shall not substitute its judgment for that of the county as to the weight of the evidence on questions of fact. The court may affirm the decision of the county or remand the case for further proceedings. The court may reverse the decision and remand the case to the county for further proceedings if it determines that substantial rights of the appellant have been prejudiced because the county’s findings, inferences, conclusions or decisions are:

(a) In violation of constitutional, statutory or regulatory provisions;

(b) In excess of the statutory authority of the county;

(d) Affected by other errors of law;

(e) Clearly erroneous in view of the reliable, probative and substantial evidence on the whole record; or

(f) Arbitrary and capricious.

8. An aggrieved party may appeal any final judgment of the district court to the appellate court of competent jurisdiction pursuant to the rules fixed by the Supreme Court pursuant to Section 4 of Article 6 of the Nevada Constitution in the same manner as a civil case.

(Added to NRS by 1987, 1513; A 2013, 1783)

NRS 428.095 Liability insurance for persons rendering medical care.

1. Counties in which physicians, dentists, their respective assistants and county hospitals render treatment to indigents or needy persons without charge or at cost or below cost may procure, carry and maintain liability insurance protecting such members of the healing arts and hospitals and indemnifying them against any claim or action by or on behalf of any such indigent or needy person or contribute to the cost of such insurance.

2. If such insurance is provided it shall be coverage in the amount of at least $100,000 for each occurrence.

3. The liability insurance provided in subsections 1 and 2 shall provide for indemnity whether or not the physician, dentist, assistant or hospital is required by law or the rules of his or her profession to treat any indigent or needy person without charge.

(Added to NRS by 1971, 1491; A 1977, 959)

NRS 428.110 Criminal and civil penalties for bringing nonresident indigent into county.

1. Any person who brings into or leaves within, or aids another person in bringing into or leaving within any county, an indigent person who is a nonresident or whose county of residence is another county, knowingly and for the purpose of imposing the indigent person as a public charge on the county to which the person is brought or left is guilty of a misdemeanor.

2. Any person who brings into or leaves within any county, an indigent person who is a nonresident or whose county of residence is another county, knowing him or her to be an indigent person, shall forfeit and pay the sum of $100 for each offense, to be sued for and recovered by and to the use of the county in a civil action before any court of competent jurisdiction.

[11:51:1861; B § 3759; BH § 1991; C § 2164; RL § 2925; NCL § 5147] + [3:11:1905; RL § 2928; NCL § 5150]—(NRS A 1967, 576; 1989, 1859)

HOSPITAL CARE FOR INDIGENT PERSONS

NRS 428.115 Definitions. As used in NRS 428.115 to 428.255, inclusive, unless the context otherwise requires, the words and terms defined in NRS 428.125 to 428.165, inclusive, have the meanings ascribed to them in those sections.

(Added to NRS by 1983, 1939; A 1993, 333; 2005, 1675; 2013, 2882)

NRS 428.125 “Board” defined. “Board” means the Board of Trustees of the Fund.

(Added to NRS by 1983, 1939)

NRS 428.136 “Fund” defined. “Fund” means the Fund for Hospital Care to Indigent Persons.

(Added to NRS by 1993, 332)

NRS 428.145 “Hospital” defined. “Hospital” means an establishment which has the staff and equipment to provide diagnosis, care and treatment of all stages of human injury and illness and which provides 24-hour medical care.

(Added to NRS by 1983, 1939; A 1989, 758; 1993, 333)

NRS 428.155 “Hospital care” defined. “Hospital care” means:

1. Services furnished by a hospital to a patient between the time of admission and the time of discharge, including:

(a) Bed and board;

(b) Drugs; and

(c) Anesthesia, nursing services, equipment, supplies and laboratory and radiological services, whether furnished directly by the hospital or pursuant to a contractual arrangement made by the hospital; and

2. Services of a physician rendered to a patient in a hospital between the time of admission and the time of discharge.

(Added to NRS by 1983, 1939)

NRS 428.165 “Injury in a motor vehicle crash” defined. “Injury in a motor vehicle crash” means any personal injury caused in, by or as the proximate result of the movement of a motor vehicle on a public street or highway, whether the injured person was the operator of the vehicle or another vehicle, a passenger in the vehicle or another vehicle, a pedestrian, or had some other relationship to the movement of a vehicle.

(Added to NRS by 1983, 1940; A 2015, 1674)

NRS 428.175 Fund for Hospital Care to Indigent Persons.

1. The Fund for Hospital Care to Indigent Persons is hereby created as a special revenue fund for the purposes described in NRS 428.115 to 428.255, inclusive.

2. Except as otherwise provided in subsection 3, money collected or recovered pursuant to NRS 428.115 to 428.255, inclusive, and the interest earned on the money in the Fund must be deposited for credit to the Fund.

3. Any money paid by a county pursuant to NRS 428.255 must be accounted for separately in the Fund and must be used to reimburse or partially reimburse a hospital for unpaid charges for hospital care pursuant to NRS 428.115 to 428.255, inclusive, as other claims against the Fund are paid.

4. Claims against the Fund must be paid on claims approved by the Board.

5. Any money remaining in the Fund at the end of each fiscal year does not revert to the State General Fund and must be carried over into the next fiscal year.

(Added to NRS by 1983, 1941; A 1987, 207; 1997, 125; 2005, 1675; 2011, 345, 1910; 2013, 2882; 2015, 361)

NRS 428.185 Levy of tax ad valorem for remittance to Fund.

1. In addition to the taxes levied pursuant to NRS 428.050 and 428.285 and any tax levied pursuant to NRS 450.425, the board of county commissioners of each county shall levy an ad valorem tax at a rate which must be calculated by:

(a) First multiplying the tax rate of 1.5 cents on each $100 of assessed valuation by the assessed valuation of all taxable property in this State, including new real property, possessory interests and mobile homes, during the next fiscal year.

(b) Then subtracting the amount of unencumbered money in the Fund on May 1 of the current fiscal year.

(c) Then setting the rate so that the revenue from the tax does not exceed the amount resulting from the calculations made in paragraphs (a) and (b).

2. The tax so levied and its proceeds must be excluded in computing the maximum amount of money which the county is permitted to receive from taxes ad valorem and the highest permissible rate of such taxes.

3. The proceeds of this tax must be remitted in the manner provided for in NRS 361.745 to the State Controller for credit to the Fund.

(Added to NRS by 1983, 1942; A 1987, 208; 1989, 1860; 1991, 481; 1993, 2789; 2001, 2926)

NRS 428.195 Board of Trustees of Fund: Composition; terms; vacancies; designees.

1. The Fund must be administered by a Board of Trustees composed of five members appointed by the Governor as follows:

(a) Four county commissioners; and

(b) One director of a social services agency of a county.

2. The members of the Board of Trustees must be appointed by the Governor from a list of nominees submitted by the Board of Directors of the Nevada Association of Counties. The list of nominees must include six nominees who are county commissioners and three nominees who are directors of a social services agency of a county.

3. Each member of the Board of Trustees shall serve a term of 2 years or until a successor has been appointed and has qualified.

4. The position of a member of the Board of Trustees shall be considered vacated upon the loss of any of the qualifications required for the appointment of the member and in that event the Governor shall appoint a successor from a list of nominees submitted by the Board of Directors of the Nevada Association of Counties. The list of nominees must include two county commissioners if the member of the Board is a county commissioner or two directors of a social services agency if the member of the board is the director of a social services agency of a county.

5. The director of a social services agency who is appointed to the Board of Trustees may designate a person to carry out his or her duties on the Board of Trustees when the director is unavailable, and any such designee has the same power as any other member of the Board of Trustees for the period in which he or she is designated to act on behalf of the director.

6. As used in this section, “social services agency” means any public agency or organization that provides social services in this State, including, without limitation, providing welfare and health care services.

(Added to NRS by 1983, 1941; A 2011, 345)

NRS 428.205 Board of Trustees of Fund: Powers. The Board shall administer the Fund and for that purpose may:

1. Enter into all necessary contracts and agreements, including, without limitation, contracts and agreements to obtain the services of consultants, attorneys, auditors, accountants, actuaries and managers of risk.

2. Purchase appropriate insurance to cover that portion of a claim for which the Fund is liable and which exceeds an amount agreed upon by the Board and the insurer.

3. Employ personnel as necessary and prescribe their compensation and working conditions.

4. Rent, lease, purchase or otherwise procure or receive real or personal property.

5. Adopt regulations necessary for carrying out the provisions of NRS 428.115 to 428.255, inclusive.

(Added to NRS by 1983, 1941; A 2013, 2883; 2015, 362)

1. The Board of Trustees of the Fund for Hospital Care to Indigent Persons may enter into an agreement with the Division of Health Care Financing and Policy of the Department of Health and Human Services whereby:

(a) The Board agrees to transfer an agreed upon amount of money each year from the Fund to the Division;

(b) The Division agrees to use the money so transferred to:

(1) Include in the State Plan for Medicaid an enhanced rate of reimbursement for hospital care provided to recipients of Medicaid or to make supplemental payments to the hospital for the provision of such hospital care through increased federal financial participation;

(2) Offset any decrease in savings generated by any component of the upper payment limit program established under the State Plan for Medicaid that results from providing supplemental payments to hospitals from the Fund pursuant to subparagraph (1); and

(3) Satisfy any portion of the obligation of a county to pay the nonfederal share of expenditures pursuant to NRS 422.272;

(c) The Division agrees to return any money transferred to the Division pursuant to the agreement if the Federal Government does not approve the enhanced rate of reimbursement or supplemental payments included in the State Plan;

(d) The Board agrees to continue to transfer not less than the same amount of money as the previous year if the State Plan is approved by the Federal Government until the Board has requested the Division to exclude the enhanced rate of reimbursement or supplemental payments from the State Plan and the Federal Government approves the State Plan without such enhanced rates or supplemental payments; and

(e) The Division agrees to exclude the enhanced rate of reimbursement or supplemental payments from the State Plan when it is next submitted to the Federal Government for approval if so requested by the Board.

2. Any money transferred from the Fund to the Division pursuant to this section must not be used to replace or supplant funding available from other sources for the same purpose.

3. As used in this section, “upper payment limit program” means a program providing for supplemental payments, not to exceed a limit calculated in the manner prescribed in the State Plan for Medicaid, to hospitals owned or operated by a governmental entity other than this State or an agency of this State.

(Added to NRS by 2013, 2881; A 2019, 2432)

1. The Board may authorize counties to apply to the Board for reimbursement or partial reimbursement of unpaid charges for hospital care in excess of $25,000 to any one person which have been incurred by a person certified as indigent by the board of county commissioners pursuant to this chapter.

2. The Board shall set forth the circumstances under which and the manner in which counties may apply for reimbursement pursuant to this section, including, without limitation, any amount of money that the county must expend before it may apply for reimbursement pursuant to this section.

3. The Board may review an application it receives pursuant to this section and approve or disapprove reimbursement of all or part of the unpaid charges in excess of $25,000. If reimbursement or partial reimbursement is approved, payment to the county must be made from the Fund, to the extent money is available in the Fund, and the county must reimburse the provider of care for the care given to any one indigent person which exceeds $25,000 but only to the extent of the money reimbursed or partially reimbursed to the county from the Fund on account of that patient.

4. Upon payment to the county, the Board:

(a) Is subrogated to the right of the county to recover unpaid charges from the indigent person or from other persons responsible for the support of the indigent person, to the extent of the reimbursement or partial reimbursement paid; and

(b) Has a lien upon the proceeds of any recovery by the county from the indigent person or other person responsible for the support of the indigent person, to the extent of the reimbursement or partial reimbursement paid from the Fund.

(Added to NRS by 2005, 1674)

NRS 428.215 Collection of charges for care by hospital; request for determination of indigency. Whenever hospital care is furnished to a person on account of an injury suffered by the person in a motor vehicle crash, the hospital shall use reasonable diligence to collect the amount of the charges for that care from the patient or any other person responsible for the support of the patient. The hospital may request the board of county commissioners of the county in which:

1. The crash occurred, if the person is not a resident of this state and the crash occurred in this state; or

2. The person resides, if the person is a resident of this state,

Ê to determine whether the person who received the care is an indigent person.

(Added to NRS by 1983, 1940; A 1989, 758; 2015, 1674)

NRS 428.225 Certification of indigency.

1. If, after investigation, the board of county commissioners determines that the person is an indigent person, the board of county commissioners shall so certify in writing to the hospital and to the Board of Trustees of the Fund.

2. For the purposes of this section, a person shall be deemed an indigent person and unable to pay for the hospital care furnished if it appears that, upon diligent search and inquiry, neither the person nor any other person responsible for his or her support can be found for service of process or that, if an action were brought and judgment secured against the person, or against any person responsible for his or her support, for the amount of the unpaid charges, execution on the judgment would be unavailing.

(Added to NRS by 1983, 1940)

NRS 428.235 Application for reimbursement of charges; hospitals eligible for reimbursement.

1. If the hospital receives a certification that the person is an indigent person and it has complied with the procedures for collection established by the Board of Trustees of the Fund, it may apply to the Board for reimbursement or partial reimbursement of the unpaid charges for hospital care furnished to the indigent person.

2. The application must be in such form and contain such information as the Board requires.

3. If such an indigent patient is transferred, within 3 days after the first admission of the indigent patient, from one hospital to another, both hospitals are entitled to reimbursement in full for their unpaid charges.

(Added to NRS by 1983, 1940; A 1987, 1663)

NRS 428.245 Review of application; payment to hospital from Fund; reimbursement of physician by hospital; Board subrogated to right of hospital or physician; lien on proceeds of recovery.

1. The Board shall review the application and approve or disapprove reimbursement of all or part of the unpaid charges. If reimbursement or partial reimbursement is approved, payment to the hospital must be made from the Fund, to the extent money is available in the Fund for this purpose, and the hospital must reimburse pro rata any private physician whose charges were included in the application.

2. Upon payment to the hospital:

(a) The Board is subrogated to the right of the hospital or physician to recover the unpaid charges from the patient or other person responsible for the support of the patient, to the extent of the reimbursement or partial reimbursement paid, and may maintain an independent action therefor; and

(b) The Board has a lien upon the proceeds of any recovery by the hospital or physician from the patient or other person responsible for the support of the patient, to the extent of the reimbursement or partial reimbursement paid.

(Added to NRS by 1983, 1940; A 1987, 1664)

NRS 428.255 Reimbursement of Fund by counties.

1. Any reimbursement or partial reimbursement made from the Fund for unpaid charges for hospital care furnished to a person which are not greater than $3,000, is a charge upon the county in which:

(a) The crash occurred, if the person is not a resident of this state and the crash occurred in this state; or

(b) The person resides, if the person is a resident of this state,

Ê and must be paid to the Fund upon a claim presented by the Board as other claims against the county are paid.

2. Money paid by a county pursuant to this section must be accounted for separately and expended in accordance with the provisions of subsection 3 of NRS 428.175.

(Added to NRS by 1983, 1941; A 1987, 1664; 1989, 758; 2011, 346; 2015, 1675)

OTHER MEDICAL CARE

NRS 428.265 Definitions. As used in NRS 428.265 to 428.295, inclusive, “fund” means the fund for medical assistance to indigent persons.

(Added to NRS by 1985, 2031; A 1987, 91; 1991, 1769; 2005, 1675; 2015, 362)

NRS 428.275 Fund for medical assistance to indigent persons.

1. The board of county commissioners of a county shall before July 1, 1985, by ordinance, create in the county treasury a fund to be designated as the fund for medical assistance to indigent persons.

2. The money in the fund must be used in the manner set forth in NRS 428.295.

3. All money collected or recovered pursuant to this section and NRS 428.285, and the interest earned on the money in the fund must be deposited for credit to the fund. Claims against the fund must be paid on claims approved by the board of county commissioners. Any money remaining in the fund at the end of any fiscal year does not revert to the county general fund.

(Added to NRS by 1985, 2031; A 1987, 91, 1308; 2005, 1675; 2011, 2502)

1. The board of county commissioners of each county shall establish a tax rate of at least 6 cents on each $100 of assessed valuation for the purposes of the tax imposed pursuant to subsection 2. A board of county commissioners may increase the rate to not more than 10 cents on each $100 of assessed valuation.

2. In addition to the levies provided in NRS 428.050 and 428.185 and any tax levied pursuant to NRS 450.425, the board of county commissioners shall levy a tax ad valorem at a rate necessary to produce revenue in an amount equal to an amount calculated by multiplying the assessed valuation of all taxable property in the county by the tax rate established pursuant to subsection 1, and subtracting from the product the amount of unencumbered money remaining in the fund on May 1 of the current fiscal year.

3. For each fiscal year beginning on or after July 1, 1989, the board of county commissioners of each county shall remit to the State Controller from the money in the fund an amount of money equivalent to the amount collected from 1 cent on each $100 of assessed valuation of all taxable property in the county for credit to the Intergovernmental Transfer Account in the State General Fund.

4. For each fiscal year beginning on or after July 1, 2013, in a county whose population is less than 100,000, the board of county commissioners shall, pursuant to an interlocal agreement with the State, remit to the State Controller an amount of money determined by the Director of the Department of Health and Human Services to be adequate for the State Plan for Medicaid to include the payment of the nonfederal share of expenditures set forth in NRS 422.272. In such a county, the amount of money that the board of county commissioners may be required to remit, as determined by the Director pursuant to this subsection, must not exceed an amount of money equivalent to the amount collected from 8 cents on each $100 of assessed valuation of all taxable property in the county.

5. Not later than January 1, 2014, and not later than January 1 of each year thereafter, the board of county commissioners of each county shall remit to the State Controller an amount equal to the amount collected by the board of county commissioners pursuant to NRS 439B.340 for the previous fiscal year for credit to the Fund for Hospital Care to Indigent Persons created by NRS 428.175.

6. The tax so levied and its proceeds must be excluded in computing the maximum amount of money which the county is permitted to receive from taxes ad valorem and the highest permissible rate of such taxes.

(Added to NRS by 1985, 2031; A 1987, 91; 1989, 1860; 1991, 481; 2001, 2926; 2005, 1675; 2013, 2865, 2883; 2015, 362)

NRS 428.295 Allocation of money in budget; payment of excess from fund.

1. For each fiscal year the board of county commissioners shall, in the preparation of its final budget, allocate money for assistance to indigents pursuant to this chapter.

2. In a county whose population is less than 700,000, the amount allocated must be calculated by multiplying the amount allocated for that purpose for the previous fiscal year by 104.5 percent.

3. In a county whose population is 100,000 or more, the board of county commissioners may allocate money from its fund for medical assistance to indigent persons to make an intergovernmental transfer of money to the Division of Health Care Financing and Policy of the Department of Health and Human Services in accordance with the regulations adopted pursuant to NRS 422.390 and for any or all of the following purposes:

(a) If an upper payment limit program is established in the State Plan for Medicaid, to provide supplemental payments to any public hospital located in the county that is eligible for supplemental payments under the program.

(b) If authorized under any other supplemental payment program administered by the Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services, to:

(1) Provide an enhanced rate of reimbursement to any public hospital located in the county for the hospital care provided to recipients of Medicaid; or

(2) Make supplemental payments to any public hospital located in the county for the provision of such hospital care through increased federal financial participation.

4. When, during any fiscal year, the amount of money expended by the county for any program of medical assistance for those persons eligible pursuant to this chapter exceeds the amount allocated for that purpose in its budget, the board of county commissioners shall, to the extent that money is available in the fund, pay claims against the county from the fund for that purpose.

5. In a county whose population is 700,000 or more, the board of county commissioners may by resolution allocate money from the fund in any fiscal year, in an amount not to exceed the equivalent of the amount collected from 2 cents on each $100 of assessed valuation of all taxable property in the county, to make grants to any public hospital located in the county. Such a grant may be used by a hospital only to:

(a) Construct or acquire capital assets, including, without limitation, land, improvements to land and major items of equipment; and

(b) Renovate existing facilities of the hospital. Money granted for the renovation of facilities must not be used for the normal, recurring maintenance of the facilities.

6. As used in this section, “upper payment limit program” means a program providing for supplemental payments, not to exceed a limit calculated in the manner prescribed in the State Plan for Medicaid, to hospitals owned or operated by a governmental entity other than this State or an agency of the State.

(Added to NRS by 1985, 2032; A 1987, 91, 1242; 1989, 1861; 2011, 1254; 2013, 2883; 2017, 1009; 2023, 196)

COMMUNITY SERVICES BLOCK GRANTS

NRS 428.355 Definitions. As used in this section and NRS 428.365 and 428.375, unless the context otherwise requires:

1. “Community Services Block Grant Act” means the federal act set forth in 42 U.S.C. §§ 9901 et seq.

2. “Director” means the Director of the Department of Health and Human Services.

3. “Eligible entity” has the meaning ascribed to it in 42 U.S.C. § 9902.

(Added to NRS by 1987, 1665; A 1993, 1621; 2001, 1019; 2005, 22nd Special Session, 39)

NRS 428.365 Director to administer allotment; expenditure of allotment; money not obligated for expenditure.

1. The Director shall administer any federal allotment received by this State pursuant to the Community Services Block Grant Act for the amelioration of the causes of poverty within this State.

2. The Director shall not spend more than 5 percent of each federal allotment, or $55,000, whichever is greater, for the administrative expenses of the Department of Health and Human Services relating to the allotment. The Director shall grant not less than 90 percent of the allotment to eligible entities for the purposes specified in the Community Services Block Grant Act. The Director may spend the remainder of the allotment in any manner not inconsistent with the terms of the federal grant.

3. Money granted to an eligible entity and not obligated for expenditure before the end of the year of the grant may be recaptured and redistributed by the Director to the extent and in the manner set forth in 42 U.S.C. § 9907.

(Added to NRS by 1987, 1665; A 1993, 1621; 2001, 1019)

NRS 428.375 Plan for statewide use and distribution of money; public hearings on proposed plans; preparation and filing of final plan; distribution of allotment; applications for grants.

1. The Director, after consulting with eligible entities, shall develop a plan for the statewide use and distribution of the money to be provided through the Community Services Block Grant Act as set forth in 42 U.S.C. § 9908.

2. The Director shall hold at least one public hearing to receive public comment on each proposed plan for the statewide use and distribution of the money to be provided through the Community Services Block Grant Act.

3. The Interim Finance Committee shall hold a public hearing to receive public comment on each proposed plan for the statewide use and distribution of the money to be provided through the Community Services Block Grant Act.

4. After reviewing the comments made at the public hearings held pursuant to subsections 2 and 3, the Director shall prepare the final plan for the statewide use and distribution of the money to be provided through the Community Services Block Grant Act and file a copy of the plan with the Interim Finance Committee.

5. The proposed distribution of the portion of each allotment set aside for eligible entities must allocate, as nearly as practicable:

(a) A base amount for each community action agency which was authorized pursuant to 42 U.S.C. § 2790 before that section was repealed and which received money from the allotment for the previous federal fiscal year;

(b) A uniform base amount for each of the other eligible entities in the state; and

(c) The remainder among all eligible entities based on the comparative number of persons in the respective counties whose income is at or below the federally designated level signifying poverty.

6. To apply for a grant, an eligible entity must submit an application to the Director in the manner established by the Director. The application must include a detailed description of the proposed use of the grant.

7. The Director shall provide for assistance and instruction for all potential applicants, including eligible entities, in the preparation of applications and the requirements related to the use of the grants.

(Added to NRS by 1987, 1665; A 2001, 1020)