SUMMARY--Makes various changes and appropriations concerning mental illnesses. (BDR 39-1288)
FISCAL NOTE: Effect on Local Government: No.
Effect on the State or on Industrial Insurance: Contains Appropriation not included in Executive Budget.
EXPLANATION - Matter in italics is new; matter in brackets [ ] is material to be omitted.
AN ACT relating to mental health; authorizing the acceptance and use of certain donations, gifts and grants for programs that provide services to persons who are mentally ill or mentally retarded; limiting certain charges for insurance coverage for mental illnesses; requiring the mental hygiene and mental retardation division of the department of human resources to fill certain vacant positions; requiring the legislative commission to study the feasibility of an outpatient civil commitment law; making appropriations for certain programs and the renovation and construction of certain facilities; and providing other matters properly relating thereto.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1 Chapter 433 of NRS is hereby amended by adding thereto a new section to read as follows:
1. Upon approval of the director of the department, the administrator may accept:
(a) Donations of money and gifts of real or personal property; and
(b) Grants of money from the Federal Government,
for use in public or private programs that provide services to persons in this state who are mentally ill or mentally retarded.
2. The administrator shall disburse any donations, gifts and grants received pursuant to this section to programs that provide services to persons who are mentally ill or mentally retarded in a manner that supports the plan to coordinate services created by the commission pursuant to subsection 7 of NRS 433.316. In the absence of a plan to coordinate services, the administrator shall make disbursements to programs that will maximize the benefit provided to persons who are mentally ill or mentally retarded in consideration of the nature and value of the donation, gift or grant.
3. Within limits of legislative appropriations or other available money, the administrator may enter into a contract for services related to the evaluation and recommendation of recipients for the disbursements required by this section.
Sec. 2. NRS 353.335 is hereby amended to read as follows:
353.335 1. Except as otherwise provided in subsections 5 and 6, a state agency may accept any gift or grant of property or services from any source only if it is included in an act of the legislature authorizing expenditures of nonappropriated money or, when it is not so included, if it is approved as provided in subsection 2.
2. If:
(a) Any proposed gift or grant is necessary because of an emergency as defined in NRS 353.263 or for the protection or preservation of life or property, the governor shall take reasonable and proper action to accept it and shall report the action and his reasons for determining that immediate action was necessary to the interim finance committee at its first meeting after the action is taken. Action by the governor pursuant to this paragraph constitutes acceptance of the gift or grant, and other provisions of this chapter requiring approval before acceptance do not apply.
(b) The governor determines that any proposed gift or grant would be forfeited if the state failed to accept it before the expiration of the period prescribed in paragraph (c), he may declare that the proposed acceptance requires expeditious action by the interim finance committee. Whenever the governor so declares, the interim finance committee has 15 days after the proposal is submitted to its secretary within which to approve or deny the acceptance. Any proposed acceptance which is not considered within the 15-day period shall be deemed approved.
(c) The proposed acceptance of any gift or grant does not qualify pursuant to paragraph (a) or (b), it must be submitted to the interim finance committee. The interim finance committee has 45 days after the proposal is submitted to its secretary within which to consider acceptance. Any proposed acceptance which is not considered within the 45-day period shall be deemed approved.
3. The secretary shall place each request submitted to him pursuant to paragraph (b) or (c) of subsection 2 on the agenda of the next meeting of the interim finance committee.
4. In acting upon a proposed gift or grant, the interim finance committee shall consider, among other things:
(a) The need for the facility or service to be provided or improved;
(b) Any present or future commitment required of the state;
(c) The extent of the program proposed; and
(d) The condition of the national economy, and any related fiscal or monetary policies.
5. A state agency may accept:
(a) Gifts, including grants from nongovernmental sources, not exceeding $10,000 each in value; and
(b) Governmental grants not exceeding $50,000 each in value,
if the gifts or grants are used for purposes which do not involve the hiring of new employees and if the agency has the specific approval of the governor or, if the governor delegates this power of approval to the chief of the budget division of the department of administration, the specific approval of the chief.
6. This section does not apply to:
(a) The state industrial insurance system;
(b) The University and Community College System of Nevada; or
(c) The department of human resources while acting as the state health planning and development agency pursuant to paragraph (d) of subsection 2 of NRS 439A.081 [.] or for donations, gifts or grants to be disbursed pursuant to section 1 of this act.
Sec. 3. NRS 689A.030 is hereby amended to read as follows:
689A.030 A policy of health insurance must not be delivered or issued for delivery to any person in this state unless it otherwise complies with this code, and complies with the following:
1. The entire money and other considerations for the policy must be expressed therein.
2. The time when the insurance takes effect and terminates must be expressed therein.
3. It must purport to insure only one person, except that a policy may insure, originally or by subsequent amendment, upon the application of an adult member of a family, who shall be deemed the policyholder, any two or more eligible members of that family, including the husband, wife, dependent children, from the time of birth, adoption or placement for the purpose of adoption as provided in NRS 689A.043, or any children under a specified age which must not exceed 19 years except as otherwise provided in NRS 689A.045, and any other person dependent upon the policyholder.
4. The style, arrangement and overall appearance of the policy must not give undue prominence to any portion of the text, and every printed portion of the text of the policy and of any endorsements or attached papers must be plainly printed in light-faced type of a style in general use, the size of which must be uniform and not less than 10 points with a lower case unspaced alphabet length not less than 120 points. "Text" includes all printed matter except the name and address of the insurer, the name or the title of the policy, the brief description, if any, and captions and subcaptions.
5. The exceptions and reductions of indemnity must be set forth in the policy and, other than those contained in NRS 689A.050 to 689A.290, inclusive, must be printed, at the insurer's option, with the benefit provision to which they apply or under an appropriate caption such as "Exceptions" or "Exceptions and Reductions," except that if an exception or reduction specifically applies only to a particular benefit of the policy, a statement of that exception or reduction must be included with the benefit provision to which it applies.
6. Each such form, including riders and endorsements, must be identified by a number in the lower left-hand corner of the first page thereof.
7. The policy must not contain any provision purporting to make any portion of the charter, rules, constitution or bylaws of the insurer a part of the policy unless that portion is set forth in full in the policy, except in the case of the incorporation of or reference to a statement of rates or classification of risks, or short-rate table filed with the commissioner.
8. The policy must provide benefits for expense arising from care at home or health supportive services if that care or service was prescribed by a physician and would have been covered by the policy if performed in a medical facility or facility for the dependent as defined in chapter 449 of NRS.
9. The policy must provide, at the option of the applicant, benefits for expenses incurred for the treatment of abuse of alcohol or drugs, unless the policy provides coverage only for a specified disease or provides for the payment of a specific amount of money if the insured is hospitalized or receiving health care in his home.
10. The policy must provide benefits for expense arising from hospice care.
11. The amount of any deductible, copayment or coinsurance for the treatment of mental illnesses may not be more than the amount due for the same purpose from an insured for the treatment of physical illnesses.
Sec. 4. Chapter 689B of NRS is hereby amended by adding thereto a new section to read as follows:
If a group health insurance policy provides coverage for mental illnesses, the amount of any deductible, copayment or coinsurance for the treatment of mental illnesses must not be more than the amount due for the same purpose from an insured for the treatment of physical illnesses.
Sec. 5. NRS 689C.115 is hereby amended to read as follows:
689C.115 1. A health benefit plan offered by a carrier pursuant to this chapter must include coverage of basic medical and hospital care.
2. In addition to the coverage required by subsection 1, a carrier may offer additional coverage for an additional cost upon the approval of the commissioner.
3. The amount of any deductible, copayment or coinsurance for the treatment of mental illnesses may not be more than the amount due for the same purpose from an insured for the treatment of physical illnesses.
Sec. 6. The mental hygiene and mental retardation division of the department of human resources shall fill the vacant positions of clinical director and allied therapy director at the Nevada mental health institute not later than October 1, 1997, unless a qualified applicant does not accept the offer of employment in which case the division shall continue its diligent efforts to fill the position until a qualified person accepts the offer of employment. The minimum qualification for the clinical director must be a Ph.D. in psychology and the allied therapy director must be a registered occupational therapist.
Sec. 7. 1. The legislative commission shall appoint a committee to conduct an interim study concerning the feasibility of enacting an outpatient civil commitment law in this state.
2. The legislative commission shall report the results of the study and any recommendations for legislation to the 70th session of the Nevada legislature.
3. Any recommended legislation proposed by the committee must be approved by a majority of the members of the senate and by a majority of the members of the assembly appointed to the committee.
Sec. 8. 1. There is hereby appropriated from the state general fund to the mental hygiene and mental retardation division of the department of human resources for the establishment and operation of an outreach program within southern Nevada adult mental health services for the evaluation and treatment of senior citizens who are at risk because of a mental illness:
For the fiscal year 1997-1998 $167,000
For the fiscal year 1998-1999 $197,000
2. There is hereby appropriated from the state general fund to the mental hygiene and mental retardation division of the department of human resources the sum of $10,831,640 for the construction of a facility at the Nevada mental health institute including accommodations for 80 persons requiring inpatient services and 10 persons requiring psychiatric emergency services. This appropriation must be reduced by the amount of any other appropriation made for the same purpose by the 69th session of the Nevada legislature.
3. There is hereby appropriated from the state general fund to the mental hygiene and mental retardation division of the department of human resources the sum of $102,750 for the renovation of building 7 at the Nevada mental health institute for a crisis unit that will provide emergency psychiatric services. This appropriation must be reduced by the amount of any other appropriation made for the same purpose by the 69th session of the Nevada legislature.
4. There is hereby appropriated from the state general fund to the mental hygiene and mental retardation division of the department of human resources for the operation of a crisis unit for emergency psychiatric services at the Nevada mental health institute:
For the fiscal year 1997-1998 $584,230
For the fiscal year 1998-1999 $1,124,458
5. There is hereby appropriated from the state general fund to the mental hygiene and mental retardation division of the department of human resources for the establishment and operation of a community outreach and case management program at the Nevada mental health institute for persons who are at risk during the transition from inpatient to outpatient treatment programs:
For the fiscal year 1997-1998 $214,141
For the fiscal year 1998-1999 $296,586
6. There is hereby appropriated from the state general fund to the mental hygiene and mental retardation division of the department of human resources for the expansion of the psycho-social rehabilitation program at the Nevada mental health institute:
For the fiscal year 1997-1998 $184,525
For the fiscal year 1998-1999 $225,355
to provide vocational rehabilitation training to persons who are in transition from inpatient to outpatient status through the addition of a vocational coordinator, two positions for the daily living skills program and three positions for the patient-worker program. All positions in this program, including both additional and existing positions, must be provided for day treatment programs only.
7. There is hereby appropriated from the state general fund to the mental hygiene and mental retardation division of the department of human resources to provide a stipend for the patient-worker program:
For the fiscal year 1997-1998 $25,000
For the fiscal year 1998-1999 $25,000
This appropriation is in addition to and must not be reduced by the amount of any other appropriation made for the same purpose by the 69th session of the Nevada legislature.
8. There is hereby appropriated from the state general fund to the mental hygiene and mental retardation division of the department of human resources the sum of $5,884,848 to establish and operate a program to provide medications to persons who are mentally ill. This appropriation must be reduced by the amount of any other appropriation made for the same purpose by the 69th session of the Nevada legislature.
9. There is hereby appropriated from the state general fund to the mental hygiene and mental retardation division of the department of human resources the sum of $53,750 for computer equipment and software to establish a network for data relating to the management of mental health cases that will be accessible to law enforcement agencies and public and private organizations that provide mental health services.
10. There is hereby appropriated from the state general fund to the mental hygiene and mental retardation division of the department of human resources for the operation of two facilities to be located in Clark and Washoe counties including at least 16 beds in each facility for persons in need of transitional housing:
For the fiscal year 1997-1998 $876,054
For the fiscal year 1998-1999 $1,122,002
This appropriation must be reduced by the amount of any other appropriation made for the same purpose by the 69th session of the Nevada legislature.
11. There is hereby appropriated from the state general fund to the mental hygiene and mental retardation division of the department of human resources for the position of a psychologist to perform mental health evaluations at the Washoe Detention Center:
For the fiscal year 1997-1998 $44,000
For the fiscal year 1998-1999 $44,000
The money appropriated by this subsection must not be distributed until an equal amount of money is provided by Washoe County for the same purpose.
12. There is hereby appropriated from the state general fund to the University and Community College System of Nevada the sum of $220,000 for an additional full-time instructor, support staff and operating expenses relating to the expansion of the curriculum at community colleges by the spring semester of 1998 to include an associate degree program for technicians which includes the curriculum necessary to qualify the person earning the degree for employment as a technician by the mental hygiene and mental retardation division of the department of human resources.
13. There is hereby appropriated from the state general fund to the mental hygiene and mental retardation division of the department of human resources for the establishment of a program for assertive community treatment (PACT) in Clark and Washoe counties to provide comprehensive, integrated and continuing mental health care and services to persons with long-term serious mental illness, in their own natural environment:
For the fiscal year 1997-1998 $609,728
For the fiscal year 1998-1999 $800,592
This appropriation must be reduced by the amount of any other appropriation made for the same purpose by the 69th session of the Nevada legislature.
Sec. 9. Any balance of the appropriations made by subsections 1, 4, 5, 6, 7, 10, 11 and 13 of section 8 of this act remaining at the end of the respective fiscal years must not be committed for expenditure after June 30 and reverts to the state general fund as soon as all payments of money committed for the fiscal year have been made.
Sec. 10. Any remaining balance of the appropriations made by subsections 2, 3, 8, 9 and 12 of section 8 of this act must not be committed for expenditure after June 30, 1999, and reverts to the state general fund as soon as all payments of money committed have been made.
Sec. 11. This act becomes effective upon passage and approval or on June 30, 1997, whichever occurs earlier.