Assembly Bill No.
501–Committee on
Health and Human Services
CHAPTER..........
AN ACT relating to public assistance; revising provisions governing meetings of the State Welfare Board; transferring certain duties relating to the State Program for Medicaid to the Department of Human Resources and the Director of the Department; revising provisions governing the program to provide temporary assistance for needy families; requiring the Welfare Division of the Department of Human Resources to adopt regulations establishing a schedule of penalties for failure to comply with the terms of a plan for personal responsibility; revising provisions governing the determination of eligibility of qualifying relatives in a program to assist relatives with legal guardianship of children; 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. NRS 422.110 is hereby amended to read as follows:
422.110 1. The members of the Board shall meet at least
twice each calendar year to consider any issues related to public
assistance and other programs for which the Welfare Division is
responsible that may be of importance to members of the general
public, the Governor or the Welfare Division, at such places as the
Board, the Chairman of the Board, the State Welfare Administrator
or the Director deems appropriate.
2. Four members of the Board constitute a quorum, and a
quorum may exercise all the power and authority conferred on the
Board.
3. The Board shall:
(a) At least [45] 14 days before the date it holds a meeting,
provide public notice of the date, time and location of the meeting,
in addition to the notice required pursuant to NRS 241.020.
(b) Keep minutes of all meetings of the Board, which must
include records of testimony and written comments presented to the
Board, and file the minutes with the Welfare Division. The minutes
must be maintained as public records.
Sec. 2. NRS 422.215 is hereby amended to read as follows:
422.215 1. The State Welfare Administrator or his designated
representative may administer oaths and take testimony thereunder
and issue subpoenas requiring the attendance of witnesses before
the Welfare Division at a designated time and place and the
production of books, papers and records relative to[:
(a) Eligibility] eligibility or continued eligibility for public
assistance . [; and
(b) Verification of treatment and payments to a provider of
medical care, remedial care or other services pursuant to the State
Plan for Medicaid.]
2. The Director or his designated representative may
administer oaths and take testimony thereunder and issue
subpoenas requiring the attendance of witnesses before the
Department at a designated time and place and the production of
books, papers and records relative to verification of treatment and
payments to a provider of medical care, remedial care or other
services pursuant to the State Plan for Medicaid.
3. If a witness fails to appear or refuses to give testimony or to
produce books, papers and records as required by [the subpoena ,] a
subpoena issued pursuant to this section, the district court of the
county in which the investigation is being conducted may compel
the attendance of the witness, the giving of testimony and the
production of books, papers and records as required by the
subpoena.
Sec. 3. NRS 422.222 is hereby amended to read as follows:
422.222 The State Welfare Administrator may adopt such
regulations as are necessary for the administration of NRS 422.160
to [422.2345,] 422.230, inclusive, 422.2931 to 422.2936, inclusive,
and 422.310 to 422.3754, inclusive, and any program of the
Welfare Division.
Sec. 4. NRS 422.230 is hereby amended to read as follows:
422.230 The State Welfare Administrator shall:
1. Supply the Director with material on which to base proposed
legislation.
2. Cooperate with the Federal Government and state
governments for the more effective attainment of the purposes of
this chapter.
3. Coordinate the activities of the Welfare Division with other
agencies, both public and private, with related or similar activities.
4. Keep a complete and accurate record of all proceedings,
record and file all bonds and contracts, and assume responsibility
for the custody and preservation of all papers and documents
pertaining to his office.
5. Inform the public in regard to the activities and operation of
the Welfare Division, and provide other information which will
acquaint the public with problems relating to welfare.
6. Conduct studies into the causes of the social problems with
which the Welfare Division is concerned.
7. Provide leadership in the community in order that all welfare
activities are pointed toward the single goal of improving the public
welfare.
8. Invoke any legal, equitable or special procedures for the
enforcement of his orders or the enforcement of the provisions of
NRS 422.160 to [422.2345,] 422.230, inclusive, 422.2931 to
422.2936,inclusive, and 422.310 to 422.3754, inclusive.
9. Exercise any other powers that are necessary and proper for
the standardization of state work, to expedite business, to ensure
fair consideration of applications for aid, and to promote the
efficiency of the service provided by the Welfare Division.
Sec. 5. NRS 422.2345 is hereby amended to read as follows:
422.2345 1. The [State Welfare Administrator] Director or
his designated representative shall:
(a) Promptly comply with a request from the Unit for access to
and free copies of any records or other information in the
possession of the [Welfare Division] Department regarding a
provider; and
(b) Refer to the Unit all cases in which he suspects that a
provider has committed an offense pursuant to NRS 422.540 to
422.570, inclusive.
2. As used in this section:
(a) “Provider” means a person who has applied to participate or
who participates in the State Plan for Medicaid as the provider of
goods or services.
(b) “Unit” means the Medicaid Fraud Control Unit established
in the Office of the Attorney General pursuant to NRS 228.410.
Sec. 6. NRS 422.287 is hereby amended to read as follows:
422.287 1. As part of the health and welfare programs of this
state, the [Welfare Division or the] Division of Health Care
Financing and Policy or any other division designated by the
Director may provide prenatal care to pregnant women who are
indigent, or may contract for the provision of that care, at public or
nonprofit hospitals in this state.
2. The [Welfare Division or the] Division of Health Care
Financing and Policy or any other division designated by the
Director shall provide to each person licensed to engage in social
work pursuant to chapter 641B of NRS, each applicant for
Medicaid and any other interested person, information concerning
the prenatal care available pursuant to this section.
3. The [Welfare Division or the] Division of Health Care
Financing and Policy or any other division designated by the
Department shall adopt regulations setting forth criteria of
eligibility and rates of payment for prenatal care provided pursuant
to the provisions of this section, and such other provisions relating
to the development and administration of the Program for Prenatal
Care as the [State Welfare Administrator] Director or the
Administrator of the Division of Health Care Financing and Policy,
as applicable, deems necessary.
Sec. 7. NRS 422.2931 is hereby amended to read as follows:
422.2931 The State Welfare Administrator and the Welfare
Division shall administer the provisions of NRS 422.160 to
[422.2345,] 422.230, inclusive, 422.2931 to 422.2936, inclusive,
and 422.310 to 422.3754, inclusive, subject to administrative
supervision by the Director.
Sec. 8. NRS 422.29314 is hereby amended to read as follows:
422.29314 1. The [Welfare Division] Department shall
provide public assistance pursuant to:
(a) The program established to provide Temporary Assistance
for Needy Families;
(b) Medicaid; or
(c) Any program for which a grant has been provided to this
state pursuant to 42 U.S.C. §§ 1397 et seq.,
to a qualified alien who complies with the requirements established
by the [Welfare Division] Department pursuant to federal law and
this chapter for the receipt of benefits pursuant to that program.
2. As used in this section, “qualified alien” has the meaning
ascribed to it in 8 U.S.C. § 1641.
Sec. 9. (Deleted by amendment.)
Sec. 10. NRS 422.2932 is hereby amended to read as follows:
422.2932 1. Except as otherwise provided in subsection 3, as
a condition to the receipt of public assistance, a recipient must:
(a) Ensure that each dependent child for whom the recipient is
receiving assistance has received the standard immunizations
established for children by the regulations adopted pursuant to
NRS 439.550.
(b) Within 6 months after the determination of his eligibility for
public assistance, submit to the Welfare Division, in the manner
specified in NRS 432A.230 and 432A.260 for admission to a child
care facility, proof that each dependent child for whom the recipient
is receiving assistance has received those standard immunizations.
2. The Welfare Division shall advise each recipient of the
availability of those standard immunizations through clinics for the
immunization of children held pursuant to NRS 439.535.
3. The Welfare Division shall waive the requirements of
subsection 1 if the failure to immunize a dependent child is because
of a religious belief or medical condition and the recipient submits
to the Welfare Division a written statement of that fact in the
manner specified in NRS 432A.240 or 432A.250 for admission to a
child care facility.
4. A head of a household that is receiving benefits pursuant to
the program to provide Temporary Assistance for Needy Families
who does not comply with the requirements of this section:
(a) Shall be deemed to have failed to comply with the terms of
the plan for personal responsibility signed by the head of the
household pursuant to NRS 422.3724; and
(b) Is subject to the penalties prescribed [in] by the Welfare
Division pursuant to NRS 422.3736 for failing to comply with the
terms of that plan.
Secs. 11-14. (Deleted by amendment.)
Sec. 15. NRS 422.362 is hereby amended to read as follows:
422.362 “Cardholder” means the person named on the face of a
Medicaid card to whom or for whose benefit the Medicaid card is
issued by the [Welfare Division.] Department.
Sec. 16. NRS 422.363 is hereby amended to read as follows:
422.363 “Medicaid card” means any instrument or device
evidencing eligibility for receipt of Medicaid benefits that is issued
by the [Welfare Division] Department for the use of a cardholder in
obtaining the types of medical and remedial care for which
assistance may be provided under the Plan.
Sec. 17. NRS 422.366 is hereby amended to read as follows:
422.366 1. A person who:
(a) Steals, takes or removes a Medicaid card from the person,
possession, custody or control of another without the cardholder’s
consent; or
(b) With knowledge that a Medicaid card has been so taken,
removed or stolen, receives the Medicaid card with the intent to
circulate, use or sell it or to transfer it to a person other than the
[Welfare Division] Department or the cardholder,
is guilty of a category D felony and shall be punished as provided in
NRS 193.130. In addition to any other penalty, the court shall order
the person to pay restitution.
2. A person who possesses a Medicaid card without the
consent of the cardholder and with the intent to circulate, use, sell
or transfer the Medicaid card with the intent to defraud is guilty of a
category D felony and shall be punished as provided in NRS
193.130. In addition to any other penalty, the court shall order the
person to pay restitution.
3. A person who has in his possession or under his control two
or more Medicaid cards issued in the name of another person is
presumed to have obtained and to possess the Medicaid cards with
the knowledge that they have been stolen and with the intent to
circulate, use, sell or transfer them with the intent to defraud. The
presumption established by this subsection may be rebutted by clear
and convincing evidence. The presumption does not apply to the
possession of two or more Medicaid cards if the possession is with
the consent of the [Welfare Division.] Department.
Sec. 18. NRS 422.3722 is hereby amended to read as follows:
422.3722 1. The Welfare Division shall [not provide benefits
to an applicant therefor until it makes] make an assessment of the
skills, prior work experience and employability of each member of
the applicant’s household.
2. The assessment required pursuant to subsection 1 must
include [a determination] an evaluation of whether the members of
the household [require] need additional services, including,
without limitation, job training, child care, treatment for the abuse
of alcohol or drugs, mental health services or any other services .
[deemed necessary by the Welfare Division.]
3. The applicant must, as a condition to the receipt of those
benefits, cooperate with the Welfare Division in making the
assessment required pursuant to subsection 1.
4. If the assessment required pursuant to subsection 1 indicates
that a member of the household may require mental health services,
the Welfare Division shall refer that member of the household to a
person professionally qualified in the field of psychiatric mental
health.
5. As used in this section, “person professionally qualified in
the field of psychiatric mental health” has the meaning ascribed to
it in NRS 433.209.
Sec. 19. NRS 422.3724 is hereby amended to read as follows:
422.3724 1. The Welfare Division shall, with the
participation of the head of a household who is applying for
benefits, establish a written plan for personal responsibility for the
household. The plan for personal responsibility must be based on
the assessment made pursuant to NRS 422.3722[.] and 42 U.S.C. §
608.
2. In addition to the requirements set forth in 42 U.S.C. § 608,
the plan required pursuant to subsection 1 must:
(a) Identify the role of each member of the household and his
obligations pursuant to the plan;
(b) Be signed by the head of the household within 60 days after
he is determined to be eligible for benefits; and
(c) Specify a date, not later than 24 months after the date the
plan becomes effective, upon which the plan will expire.
3. The Welfare Division shall periodically review the plan
required pursuant to subsection 1 [not less than once every 6
months] to determine whether the needs of the household have
changed. The Welfare Division may, with the participation of the
head of the household, amend the plan as it deems appropriate.
4. If a member of the household is an unmarried parent who is
less than 18 years of age, the plan required pursuant to subsection 1
must include a provision which:
(a) Requires the head of the household to ensure that the
unmarried parent attends training to learn the skills necessary to care
for the child; and
(b) Encourages the head of the household to ensure that the
unmarried parent participates in a program which provides mentors
for unmarried parents who are less than 18 years of age.
Sec. 20. NRS 422.3732 is hereby amended to read as follows:
422.3732 1. Subject to the provisions of 42 U.S.C. § 607(e),
the Welfare Division shall require each head of a household who is
not suffering from a hardship described in subsection 7 of NRS
422.374 to perform work:
(a) Within a reasonable time after the Welfare Division
determines that the head of the household is capable of finding and
performing work; or
(b) Not later than the date on which the head of the household
has received benefits for 24 months, regardless of whether those
months are consecutive or cumulative,
whichever occurs earlier.
2. A head of a household who does not comply with the
requirements of this section:
(a) Shall be deemed to have failed to comply with the terms of
the plan for personal responsibility signed by him pursuant to NRS
422.3724; and
(b) Is subject to the penalties prescribed [in] by the Welfare
Division pursuant to NRS 422.3736 for the failure to comply with
the terms of that plan.
3. The State Welfare Administrator shall adopt regulations
setting forth the activities that will constitute work for the purposes
of this section.
Sec. 21. NRS 422.3734 is hereby amended to read as follows:
422.3734 1. [If] Except as otherwise provided in this
section, if the plan for personal responsibility signed by the head of
a household pursuant to NRS 422.3724 includes a requirement that
the head of the household complete a program of job training, the
Welfare Division may exempt the head of the household from that
requirement upon determining that:
(a) The head of the household:
(1) Is ill or physically incapacitated;
(2) Must care for an ill or incapacitated member of his
household;
(3) Is receiving payments or is awaiting approval for the
receipt of payments pursuant to the Supplemental Security Income
Program;
(4) Is a single custodial parent of a child who is less than 1
year of age;
(5) Is not a recipient of benefits but receives benefits on
behalf of a member of his household who is a dependent;
(6) Is a person who is:
(I) Sixty years of age or older;
(II) The caretaker of a child; and
(III) A relative, other than a parent, of that child; or
(7) Is pregnant and has been deemed unable to work by her
physician; or
(b) Any other good cause exists to exempt the head of the
household from the requirement to complete the program of job
training.
2. A head of a household may not claim the exemption
prescribed in subparagraph (4) of paragraph (a) of subsection 1 for
more than 12 months during his lifetime, regardless of whether
those months are consecutive or cumulative.
3. The Welfare Division shall not exempt a head of a
household pursuant to this section if the exemption would violate
a requirement of federal law or a condition to the receipt of
federal money.
Sec. 22. NRS 422.3736 is hereby amended to read as follows:
422.3736 1. Except as otherwise provided in this section:
(a) If the Welfare Division determines that the head of a
household has not complied with the terms of the plan for personal
responsibility signed by the head of the household pursuant to NRS
422.3724 or the agreement of cooperation signed by the head of the
household pursuant to NRS 422.3726, the Welfare Division shall
notify him that if his failure to comply does not cease within 30
days after he is notified of the failure to comply, the benefits
provided to his household will be reduced pursuant to paragraph
(b).
(b) The Welfare Division shall[:
(1) If the failure to comply has not ceased within the period
prescribed in paragraph (a), reduce for 1 month the total amount of
the benefits provided to the household by one-third or by an amount
equal to the total amount of the benefits provided to the household
divided by the number of members of the household, whichever is
greater;
(2) If the failure to comply has not ceased by the end of the
period of reduction required by subparagraph (1), reduce for 1
month the total amount of benefits provided to the household by
two-thirds or by an amount equal to the total amount of the benefits
provided to the household divided by the number of members of the
household, whichever is greater; and
(3) If the failure to comply has not ceased by the end of the
period of reduction required by subparagraph (2), discontinue
providing benefits to the household for 3 months or until the failure
to comply ceases, whichever occurs last.
(c) If the Welfare Division resumes providing benefits to a
household whose benefits were discontinued pursuant to
subparagraph (3) of paragraph (b), and the Welfare Division later
determines that the head of the household has again failed to
comply with the terms of the plan for personal responsibility or the
agreement of cooperation, the Welfare Division shall:
(1) Reduce for 1 month the total amount of the benefits
provided to the household by one-third or by an amount equal to the
total amount of the benefits provided to the household divided by
the number of members of the household, whichever is greater;
(2) If the failure to comply has not ceased by the end of the
period of reduction required by subparagraph (1), reduce for 1
month the total amount of benefits provided to the household by
two-thirds or by an amount equal to the total amount of the benefits
provided to the household divided by the number of members of the
household, whichever is greater; and
(3) If the failure to comply has not ceased by the end of the
period of reduction required by subparagraph (2), discontinue
providing benefits to the household for 6 months or until the failure
to comply ceases, whichever occurs last.
(d) If the Welfare Division resumes providing benefits to a
household whose benefits were discontinued pursuant to
subparagraph (3) of paragraph (c), and the Welfare Division later
determines that the head of the household has again failed to
comply with the terms of the plan for personal responsibility or the
agreement of cooperation, the Welfare Division shall:
(1) Reduce for 1 month the total amount of the benefits
provided to the household by one-half; and
(2) If the failure to comply has not ceased by the end of the
period of reduction required by subparagraph (1), permanently
terminate the household’s benefits.] adopt regulations establishing
a schedule of progressive penalties pursuant to which the benefits
to the household will be reduced or terminated because of the
failure of the head of the household to comply with the terms of
the plan.
2. The Welfare Division shall not reduce, discontinue or
terminate any benefits pursuant to this section if the reduction,
discontinuance or termination would violate a requirement of
federal law or a condition to the receipt of federal money.
Sec. 23. NRS 422.392 is hereby amended to read as follows:
422.392 1. The Department, through a division of the
Department designated by the Director, shall establish and
administer a program to provide supportive assistance to qualifying
relatives of children who provide care for and obtain the legal
guardianship of those children.
2. As a condition to the provision of any supportive assistance
pursuant to this section:
(a) The child must:
(1) Have been placed in the care of his qualifying relative for
not less than 6 months; and
(2) If he is 14 years of age or older, consent to the legal
guardianship; and
(b) The qualifying relative must:
(1) Reside in this state;
(2) Have attained such a minimum age as the Department
specifies by regulation;
(3) Verify his relationship to the child; and
(4) File for and obtain court approval of the legal
guardianship and comply with any requirements imposed by the
court . [; and
(c) The Department must determine that the personal and
criminal history of the qualifying relative is satisfactory.]
3. The supportive assistance provided pursuant to this section
mustinclude, within the limitations of available funding:
(a) Reimbursement of all or a portion of the legal fees incurred
by the qualifying relative to establish the legal guardianship;
(b) Payments of not more than the amount that the Department
would provide to a foster parent if the child had been placed in
foster care;
(c) Assistance with:
(1) Child care;
(2) Respite care; and
(3) Transportation; and
(d) Any other assistance the Department deems appropriate.
4. The Department shall adopt such regulations as are
necessary to carry out the provisions of this section.
5. As used in this section, unless the context otherwise
requires, “qualifying relative” means a person specified in 45
C.F.R. § 233.90(c)(1)(v)(A).
Secs. 24-28. (Deleted by amendment.)
Sec. 29. NRS 228.410 is hereby amended to read as follows:
228.410 1. The Attorney General has primary jurisdiction to
investigate and prosecute violations of NRS 422.540 to 422.570,
inclusive, and any fraud in the administration of the Plan or in the
provision of medical assistance pursuant to the Plan. The provisions
of this section notwithstanding, the [Welfare Division] Department
of Human Resources and the Division of Health Care Financing
and Policy of the Department of Human Resources shall enforce the
Plan and any regulations adopted pursuant thereto.
2. For this purpose, the Attorney General shall establish within
his office the Medicaid Fraud Control Unit. The Unit must consist
of a group of qualified persons, including, without limitation, an
attorney, an auditor and an investigator who, to the extent
practicable, have expertise in nursing, medicine and the
administration of medical facilities.
3. The Attorney General, acting through the Medicaid Fraud
Control Unit:
(a) Is the single state agency responsible for the investigation
and prosecution of violations of NRS 422.540 to 422.570,
inclusive;
(b) Shall review reports of abuse or criminal neglect of patients
in medical facilities which receive payments under the Plan and,
when appropriate, investigate and prosecute the persons
responsible;
(c) May review and investigate reports of misappropriation of
money from the personal resources of patients in medical facilities
that receive payments under the Plan and, when appropriate, shall
prosecute the persons responsible;
(d) Shall cooperate with federal investigators and prosecutors in
coordinating state and federal investigations and prosecutions
involving fraud in the provision or administration of medical
assistance pursuant to the Plan, and provide those federal officers
with any information in his possession regarding such an
investigation or prosecution; and
(e) Shall protect the privacy of patients and establish procedures
to prevent the misuse of information obtained in carrying out the
provisions of this section.
4. When acting pursuant to NRS 228.175 or this section, the
Attorney General may commence his investigation and file a
criminal action without leave of court, and he has exclusive charge
of the conduct of the prosecution.
5. As used in this section:
(a) “Medical facility” has the meaning ascribed to it in
NRS 449.0151.
(b) “Plan” means the State Plan for Medicaid established
pursuant to NRS 422.271.
Sec. 30. NRS 422.391 and 422.393 are hereby repealed.
Sec. 31. A Medicaid card issued by the Welfare Division of
the Department of Human Resources before October 1, 2003, shall
be deemed to have been issued by the Department of Human
Resources.
Sec. 32. (Deleted by amendment.)
Sec. 33. This act becomes effective upon passage and approval
for the purpose of adopting regulations and on October 1, 2003, for
all other purposes.
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