Senate Bill No. 433-Senators Rawson, Adler, Coffin, James, Mathews, O'Donnell, Regan, Schneider, Townsend, Washington and Wiener
May 30, 1997
____________
Referred to Committee on Finance
SUMMARY--Creates office of disability services within department of human resources. (BDR 38-379)
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 persons with disabilities; creating an office of disability services within the department of human resources and providing its duties; establishing a commission on eligibility and standards for the provision of services by the office of disability services and providing its duties; transferring certain services provided to persons with traumatic brain injuries from the department of employment, training and rehabilitation to the office of disability services; requiring the submission of biennial reports to the governor and the legislature; making an appropriation; 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 426A of NRS is hereby amended by adding thereto the provisions set forth as sections 2 to 19, inclusive, of this act.
Sec. 2 "Chief" means the chief of the office of disability services.
Sec. 3 "Commission" means the commission on eligibility and standards for the provision of services by the office of disability services.
Sec. 4 "Developmental disability" means a severe, chronic disability of a person that:
1. Is attributable to a mental or physical impairment, or a combination thereof;
2. Is manifested before the person has reached the age of 22 years;
3. Is likely to continue indefinitely;
4. Results in substantial limitations in three or more of the following life activities:
(a) Self-care;
(b) Receptive and expressive language;
(c) Learning;
(d) Mobility;
(e) Self-direction;
(f) Capacity for independent living; or
(g) Economic self-sufficiency; and
5. If the person is:
(a) Six years of age or older, reflects the need of the person for a combination or sequence of special, interdisciplinary or generic care, treatment or services that is of lifelong or extended duration and is individually planned and coordinated; or
(b) Less than 6 years of age, is likely to cause substantial developmental delays or specific congenital or acquired conditions with a high probability of resulting in developmental disabilities if such services are not provided.
Sec. 5 "Director" means the director of the department of human resources.
Sec. 6 "Office of disability services" means the office of disability services of the department of human resources.
Sec. 7 "Person with disabilities" means a person with a developmental disability or other severe disability who needs support services to participate and contribute independently in the community in which he lives. The term includes, but is not limited to, a person who has a health impairment, sensory impairment, autism, traumatic brain injury, orthopedic impairment or physical disability.
Sec. 8 "Traumatic brain injury" means a sudden shock or damage to the brain or its coverings which is not of a degenerative nature and which produces an altered state of consciousness or temporarily or permanently impairs the mental, cognitive, behavioral or physical functioning of the brain. The term does not include:
1. A cerebral vascular accident;
2. An aneurysm; or
3. A congenital defect.
Sec. 9 1. There is hereby created an office of disability services within the department of human resources.
2. The chief of the office of disability services:
(a) Is responsible for the operation of the office of disability services, which must be easily accessible to the clients of the office.
(b) Must be appointed by the director.
(c) Is in the unclassified service of the state.
(d) Shall appoint and supervise such additional employees as are necessary to carry out the duties of the office of disability services. The employees of the office of disability services are in the classified service of the state.
Sec. 10 1. The office of disability services shall provide a comprehensive program for the coordination and provision of services, other than vocational services, to persons with disabilities who are not otherwise eligible to receive services pursuant to chapter 395 of NRS or Title 39 of NRS.
2. The office of disability services shall:
(a) Establish and oversee a comprehensive system of services to be provided to persons with disabilities through appropriate community, nonprofit and private providers of such services.
(b) Consult with persons with disabilities and their families relating to:
(1) The design, prioritization and delivery of the services needed by such persons and their families; and
(2) The evaluation and cost effectiveness of the services provided.
(c) Establish a toll-free telephone line to provide information and make referrals concerning available services.
(d) Coordinate with providers of health care to ensure the optimal integration into the community of persons with disabilities who are receiving services from the office of disability services.
(e) Enter into service agreements with other governmental, public and private agencies that provide services which are similar to those provided by the office of disability services, including, but not limited to, agencies that provide services to children or to elderly persons who are disabled.
(f) Encourage innovation by governmental, public and private agencies in developing family support and delivery of services in compliance with the Americans with Disabilities Act of 1990 and other similar statutory provisions.
(g) Establish service agreements, as needed, with agencies of other states and the Federal Government.
Sec. 11 The office of disability services shall provide services relating to:
1. Habilitation, including individualized therapeutic interventions in the form of night habilitations.
2. The provision of appropriate housing, including the coordination of services to deliver supported living arrangements or environments, or both, to a person with disabilities.
3. The modification of the environment of a person with disabilities, including:
(a) Assisting a person with disabilities in acquiring specialized devices and equipment needed to assist him in participating in and contributing to the community in which he lives; and
(b) Providing assistance and support to the family of a person with disabilities to make any needed adaptations to make the living environment of the family more accessible to the person with disabilities.
4. Supportive or habilitative personal assistance for a person with disabilities, including, but not limited to, personal assistance in routine health and hygiene skills.
5. Transportation, including, but not limited to, the provision of specialized transportation, training in the use of automobiles and buses and any other related service designed to ensure that a person with disabilities is able to participate and contribute in the community.
6. Case management, including the provision of information and referral services, assessment, screening, limited counseling and program coordination.
Sec. 12 1. The chief shall apply for all waivers from federal law or regulation which are necessary for the provision of services pursuant to this chapter relating to:
(a) Case management;
(b) Homemaking;
(c) Respite care;
(d) Habilitation;
(e) Residential habilitation;
(f) Environmental modifications;
(g) Supported living;
(h) Supported living habilitation; and
(i) Supported personal care.
2. If a waiver is denied or altered, the chief shall take all appropriate steps to comply with the directives of the Federal Government.
3. The director shall review existing and proposed waivers requested by this state for nonvocational services for persons with disabilities to ensure equity between the services provided by the office of disability services pursuant to a waiver in accordance with this section and any other nonvocational services provided to persons with disabilities pursuant to waivers in accordance with the provisions of this Title or Title 39 of NRS.
Sec. 13 1. A person with disabilities is eligible to receive the services provided by the office of disability services if:
(a) The person has a disability, other than mental retardation or mental illness, that substantially affects his ability to participate in and contribute to the community in which he lives; and
(b) The office of disability services offers services for the type and severity of the disability.
2. To receive any service from the office of disability services, a person with disabilities, or his parent or legal guardian, must apply to the office of disabilities in such form and manner as prescribed by regulation by the office of disability services.
3. The office of disability services shall evaluate the case of each person who applies for the services provided by the office to determine if the person is eligible to receive such services. In making its evaluation, the office shall consider:
(a) The severity of the disability;
(b) The extent to which the person with disabilities is capable of participating in and contributing to the community in which he lives;
(c) The ability of the person with disabilities or the office of disability services to find similar services from sources other than the office of disability services; and
(d) The willingness of the person with disabilities to accept support services through the office of disability services.
4. In determining the eligibility of a person with disabilities to receive services provided by the office of disability services, the office shall not consider the age of the person with disabilities.
5. The office of disability services may adopt regulations which set forth criteria to be used by the office of disability services in evaluating applications.
Sec. 14 1. If an application submitted by a person with disabilities pursuant to section 13 of this act is rejected or if the office of disability services terminates the provision of services to a person with disabilities, the chief shall notify the applicant in writing of the rejection, setting out the reasons therefor.
2. Within 90 days after the chief mails the notice of rejection of the application or notice of termination of services, as applicable, the person with disabilities, or his parent or legal guardian, may appeal the rejection or termination to the commission. The commission shall review the application or the decision by the office of disability services to terminate services, as appropriate, and the reasons therefor. The commission may receive documentary or testimonial evidence to aid it in its decision.
3. Upon completion of its review, the commission shall issue:
(a) For an appeal from the denial of an application, the decision of the commission to reject the application or remand the application to the chief for approval; or
(b) For an appeal from the termination of services, the decision of the commission to uphold the termination of services or to order the office of disability services to restore the provision of such services to the person with disabilities.
4. The decision of the commission is a final decision for the purposes of judicial review.
Sec. 15 1. Upon determining that a person with disabilities is eligible to receive the services provided by the office of disability services, the office of disability services shall create a plan for individual and family support services for the person with disabilities that is specifically tailored to meet the needs of that person. In creating such a plan, the office of disability services shall consider the strengths and the current level of need of the person with disabilities and his family.
2. A determination by the office of disability services that a person with disabilities is eligible for a specific service, and the provision by the office of disability services of a specific service, does not create a presumption that the person with disabilities or any member of his family is entitled to receive any other service provided by the office of disability services.
Sec. 16 1. The commission on eligibility and standards for the provision of services by the office of disability services is hereby created. The commission consists of:
(a) Five members who are persons with disabilities who are eligible to receive services from the office of disability services;
(b) Five members who are advocates for persons with disabilities;
(c) Four members who are professionally qualified in a field relating to disabilities; and
(d) One member who is professionally qualified in a field relating to disabilities who represents the University and Community College System of Nevada.
2. The chief shall appoint members to the commission. To the extent possible, the chief shall ensure that not less than two of the members described in paragraphs (b), (c) and (d) of subsection 1 are persons with disabilities.
3. While engaged in the business of the commission, each member of the commission is entitled to receive from the office of disability services the per diem allowance and travel expenses provided for state officers and employees generally.
4. A member of the commission serves at the pleasure of the chief.
Sec. 17 1. The commission shall meet at least once every 3 months.
2. The commission shall elect one of its members to serve as chairman.
3. The chief shall provide such staff and other support from the office of disability services as is necessary for the commission to perform its duties.
Sec. 18 The commission shall:
1. Discuss issues related to the provision of services by the office of disability services.
2. Advise the office of disability services concerning the progress, activities and general direction of the office of disability services.
3. Provide written recommendations to the office of disability services relating to the efficient provision of services to persons with disabilities.
Sec. 19 On or before December 31 of each even-numbered year, the director shall:
1. Prepare a summary report which describes the effectiveness of the services provided by the office of disability services, and the satisfaction of persons who received and sought to receive such services, during the preceding 24 months; and
2. Submit the report to the governor and the director of the legislative counsel bureau for transmittal to the legislature.
Sec. 20 NRS 426A.010 is hereby amended to read as follows:
426A.010 As used in this chapter [:
1. "Department" means the department of employment, training and rehabilitation.
2. "Traumatic brain injury" means a sudden shock or damage to the brain or its coverings which is not of a degenerative nature and produces an altered state of consciousness or temporarily or permanently impairs the mental, cognitive, behavioral or physical functioning of the brain. The term does not include:
(a) A cerebral vascular accident;
(b) An aneurism; or
(c) A congenital defect.] , unless the context otherwise requires, the words and terms defined in sections 2 to 8, inclusive, of this act, have the meanings ascribed to them in those sections.
Sec. 21 NRS 426A.020 is hereby amended to read as follows:
426A.020 The [department] office of disability services shall:
1. Establish and maintain a system for the reporting of information relating to persons with traumatic brain injuries; and
2. Adopt regulations which prescribe the information which must be reported to the [department] office of disability services and the procedure for reporting that information.
Sec. 22 NRS 426A.030 is hereby amended to read as follows:
426A.030 1. The chief administrative officer of each hospital in this state shall submit to the [department] office of disability services the information required by the regulations adopted pursuant to NRS 426A.020.
2. Any person who violates this section is guilty of a misdemeanor.
Sec. 23 NRS 426A.040 is hereby amended to read as follows:
426A.040 Each year the [department] office of disability services shall prepare and submit to the legislative commission a statistical report which summarizes and interprets the information obtained pursuant to NRS 426A.020.
Sec. 24 NRS 426A.050 is hereby amended to read as follows:
426A.050 A person who provides information to the [department] office of disability services pursuant to NRS 426A.020 may not be held liable in a civil or criminal action for disclosing confidential information unless he has done so in bad faith or with malicious purpose.
Sec. 25 NRS 426A.060 is hereby amended to read as follows:
426A.060 1. The advisory committee on traumatic brain injuries, consisting of 11 members, is hereby created.
2. The director shall appoint to the committee:
(a) One member who is an employee of the [rehabilitation division of the department.] office of disability services.
(b) One member who is an employee of the welfare division of the department of human resources and participates in the administration of the state program providing assistance to the medically indigent.
(c) One member who is a licensed insurer in this state.
(d) One member who represents the interests of educators in this state.
(e) One member who is a person professionally qualified in the field of psychiatric mental health.
(f) Two members who are employees of private providers of rehabilitative health care located in this state.
(g) One member who represents persons who operate community-based programs for head injuries in this state.
(h) One member who represents hospitals in this state.
(i) Two members who represent the recipients of health care in this state.
3. After the initial appointments, each member of the committee serves a term of 3 years.
4. The committee shall elect one of its members to serve as chairman.
5. Members of the committee serve without compensation and are not entitled to receive the per diem allowance or travel expenses provided for state officers and employees generally.
6. The committee may:
(a) Make recommendations to the director relating to the establishment and operation of any program for persons with traumatic brain injuries.
(b) Make recommendations to the director concerning proposed legislation relating to traumatic brain injuries.
(c) Collect information relating to traumatic brain injuries.
7. The committee shall prepare a report of its activities and recommendations each year and submit a copy to the:
(a) Director;
(b) Chief of the office of disability services;
(c) Legislative committee on health care; and
[(c)] (d) Legislative commission.
8. As used in this section:
(a) ["Director" means the director of the department.
(b)] "Person professionally qualified in the field of psychiatric mental health" has the meaning ascribed to it in NRS 433.209.
[(c)] (b) "Provider of health care" has the meaning ascribed to it in NRS 629.031.
Sec. 26 NRS 426A.070 is hereby amended to read as follows:
426A.070 1. The [rehabilitation division of the department] office of disability services shall establish a program for persons with traumatic brain injuries.
2. The program may, subject to legislative appropriation, provide:
(a) The following services to persons with traumatic brain injuries:
(1) Treatment during the day on an outpatient basis;
(2) Care provided in a facility operated and maintained to furnish food, shelter, assistance and limited supervision;
(3) Care provided in the home;
(4) Instruction in the skills required for independent living;
(5) Placement for jobs; and
(6) Counseling and treatment for the abuse of drugs or alcohol.
(b) Support services for families of persons with traumatic brain injuries.
(c) For the dissemination of information for the prevention of traumatic brain injuries.
3. The [rehabilitation division] office of disability services shall evaluate the program and submit a report containing the evaluation and any recommended legislation to each regular session of the legislature.
Sec. 27 NRS 426A.080 is hereby amended to read as follows:
426A.080 The [rehabilitation division of the department] office of disability services shall adopt regulations concerning the care of persons with traumatic brain injuries. The [division] office of disability services shall, in adopting the regulations, consider the criteria established by the Commission on Accreditation of Rehabilitation Facilities for the care of such persons.
Sec. 28 NRS 232.300 is hereby amended to read as follows:
232.3001. The department of human resources is hereby created.
2. The department consists of a director and the following divisions:
(a) Aging services division.
(b) Health division.
(c) Mental hygiene and mental retardation division.
(d) Welfare division.
(e) Division of child and family services.
3. The office of disability services is within the department.
4. The department is the sole agency responsible for administering the provisions of law relating to its respective divisions [.] and offices.
Sec. 29 NRS 232.320 is hereby amended to read as follows:
232.3201. Except as otherwise provided in subsection 2, the director:
(a) Shall appoint, with the consent of the governor, chiefs of the divisions of the department, who are respectively designated as follows:
(1) The administrator of the aging services division;
(2) The administrator of the health division;
(3) The state welfare administrator; and
(4) The administrator of the division of child and family services.
(b) Shall administer, through the divisions and offices of the department, the provisions of chapters 210, 423, 424, 425, 426A, 427A, 432A to 442, inclusive, 446, 447, 449 and 450 of NRS, NRS 127.220 to 127.310, inclusive, 422.070 to 422.410, inclusive, 432.010 to 432.139, inclusive, 444.003 to 444.430, inclusive, and 445A.010 to 445A.050, inclusive, and all other provisions of law relating to the functions of the divisions and offices of the department, but is not responsible for the clinical activities of the health division or the professional line activities of the other divisions.
(c) Shall, after considering advice from agencies of local governments and nonprofit organizations which provide social services, adopt a master plan for the provision of human services in this state. The director shall revise the plan biennially and deliver a copy of the plan to the governor and the legislature at the beginning of each regular session. The plan must:
(1) Identify and assess the plans and programs of the department for the provision of human services, and any duplication of those services by federal, state and local agencies;
(2) Set forth priorities for the provision of those services;
(3) Provide for communication and the coordination of those services among nonprofit organizations, agencies of local government, the state and the Federal Government;
(4) Identify the sources of funding for services provided by the department and the allocation of that funding;
(5) Set forth sufficient information to assist the department in providing those services and in the planning and budgeting for the future provision of those services; and
(6) Contain any other information necessary for the department to communicate effectively with the Federal Government concerning demographic trends, formulas for the distribution of federal money and any need for the modification of programs administered by the department.
(d) May, by regulation, require nonprofit organizations and state and local governmental agencies to provide information to him regarding the programs of those organizations and agencies, excluding detailed information relating to their budgets and payrolls, which he deems necessary for his performance of the duties imposed upon him pursuant to this section.
(e) Has such other powers and duties as are provided by law.
2. The governor shall appoint the administrator of the mental hygiene and mental retardation division.
Sec. 30 NRS 232.920 is hereby amended to read as follows:
232.920The director:
1. Shall:
(a) Organize the department into divisions and other operating units as needed to achieve the purposes of the department;
(b) Upon request, provide the director of the department of administration with a list of organizations and agencies in this state whose primary purpose is the training and employment of handicapped persons; and
(c) Except as otherwise provided by a specific statute, direct the divisions to share information in their records with agencies of local governments which are responsible for the collection of debts or obligations if the confidentiality of the information is otherwise maintained under the terms and conditions required by law.
2. Is responsible for the administration, through the divisions of the department, of the provisions of chapters 426, [426A,] 458, 612 and 615 of NRS, and all other provisions of law relating to the functions of the department and its divisions, but is not responsible for the professional line activities of the divisions or other operating units except as specifically provided by law.
3. Is responsible for the preparation of a consolidated state plan for the bureau of services to the blind, the bureau of vocational rehabilitation and any other program administered by the rehabilitation division which he considers appropriate to incorporate into the consolidated state plan before submission to the Federal Government. This subsection does not apply if any federal regulation exists which prohibits a consolidated plan.
4. In developing and revising state plans pursuant to subsection 3, shall consider, among other things, the amount of money available from the Federal Government for the programs of the division and the conditions attached to the acceptance of that money, and the limitations of legislative appropriations for the programs.
5. May employ, within the limits of legislative appropriations, such staff as is necessary to the performance of the duties of the department.
Sec. 31 NRS 615.173 is hereby amended to read as follows:
615.1731. [The] To the extent that such assistance is not otherwise provided by the office of disability services pursuant to chapter 426A of NRS, the department shall, through its divisions, establish a program to provide financial assistance to physically disabled persons for such essential personal care as is necessary to enable them to live in a noninstitutional or unsupervised residential setting.
2. The department shall adopt regulations:
(a) Establishing the procedures for applying for assistance for essential personal care;
(b) Prescribing the criteria for determining the eligibility of an applicant;
(c) Prescribing the nature and the amounts of assistance which may be provided and the conditions imposed; and
(d) Prescribing such other provisions as the department considers necessary to administer the program.
3. The decision of the department regarding the eligibility of an applicant is a final decision for the purposes of judicial review.
Sec. 32 1. There is hereby appropriated from the state general fund to the office of disability services of the department of human resources created pursuant to section 9 of this act the sum of $2,000,000 to carry out its duties pursuant to this act.
2. Any remaining balance of the appropriation made by subsection 1 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. 33 1. The administrative regulations of the department of employment, training and rehabilitation:
(a) That were adopted pursuant to chapter 426A of NRS;
(b) That relate to persons with traumatic brain injuries; and
(c) The authority to adopt which is transferred pursuant to the provisions of this act to the office of disability services of the department of human resources,
become the regulations of the office of disability services of the department of human resources.
2. The contracts or other agreements entered into by the department of employment, training and rehabilitation that relate to the provision of nonvocational services provided to persons with disabilities for whom services are to be provided by the office of disability services of the department of human resources are binding upon and may be enforced by the office of disability services of the department of human resources.
3. Any action that relates to the provision of nonvocational services to persons with disabilities taken by the department of employment, training and rehabilitation remains in effect as if taken by the office of disability services of the department of human resources.
Sec. 34 1. Except as otherwise provided in paragraph (a) of subsection 2 of NRS 426A.060, as amended by section 25 of this act, the appointment of members to the advisory committee on traumatic brain injuries created pursuant to NRS 426A.060 made by the director of the department of employment, training and rehabilitation remains in effect as if made by the director of the department of human resources.
2. The position on the advisory committee on traumatic brain injuries that is held by the employee of the department of employment, training and rehabilitation in accordance with paragraph (a) of subsection 2 of NRS 426A.060 shall be deemed to be vacant on the effective date of this act. Not later than 60 days after the effective date of this act, the director of the department of human resources shall appoint an employee of the office of disability services of the department of human resources to fill the vacancy for the remainder of the term.
Sec. 35 This act becomes effective upon passage and approval or on June 30, 1997, whichever occurs earlier.
Sec. 36 The legislative counsel shall:
1. In preparing the reprint and supplements to the Nevada Revised Statutes, with respect to any section that is not amended by this act or is further amended by another act, appropriately change any references to the department of employment, training and rehabilitation in provisions relating to persons with traumatic brain injuries to refer to the office of disability services of the department of human resources.
2. In preparing supplements to the Nevada Administrative Code, appropriately change any references to the department of employment, training and rehabilitation in provisions relating to persons with traumatic brain injuries to refer to the office of disability services of the department of human resources.