NEVADA

Nevada ranks number one in the nation in regard to the increase of people with disabilities during the past decade. Today, more than 375,000 people with disabilities live in the state; at least 50,000 of them are children or young adults. The disability population of the state increased 157 percent during the past decade compared to a decrease of 2 percent nationally.

To keep pace with the growth of this population and to comply with the Olmstead decision, the 2001 Legislature enacted Assembly Bill 513 to provide for the development of four long-term strategic plans concerning the health care needs of the citizens of Nevada. The four plans are: 1) People with Disabilities, 2) Provider Rates, 3) Rural Health Services, and 4) Senior Services. They were completed by October 2002 and can be found at http://hr.state.nv.us/shcp/shcp_reports.htm#Strategic.

Each plan is a comprehensive, long-range plan that involves the following strategies: involvement of people with disabilities and the families providing their care; early, standardized, successive and comprehensive assessment of individual needs; availability of community integrated settings; informed choice; and quality assurance. Each strategy lists the amount and sources of funds needed from FY 2004 through FY 2011.

In part because of the strategic planning efforts, the following legislation was enacted during the 2003 legislative session.

Assembly Bill 323 makes changes to long-term care for people with dementia.

Assembly Bill 504 authorizes the Department of Human Resources to apply for a Pharmacy Plus Medicaid Waiver for senior citizens and people with disabilities

Senate Bill 98 makes an appropriation for the maintenance of a statewide system for collection and analysis of information concerning birth defects and other adverse birth outcomes.

Senate Bill 137 creates the Legislative Committee on People with Disabilities. Provides for membership, leadership, meetings, compensation and rules. The committee may study and comment on issues related to people with disabilities in this state, including, without limitation, programs for the provision of services to people with disabilities in this state, methods to enhance such programs, and methods to ensure that people with disabilities are receiving services in the most appropriate setting.

Senate Bill 138 creates a single application for SSI and Medicaid.

Senate Bill 164 creates an Office of Disability Services within the Department of Human Resources, as recommended in the Strategic Plan for People with Disabilities, to operate as the state-level coordinating body for the provision of services for people with disabilities.

Senate Bill 288 reestablishes the Senior Ride program, which allows senior citizens and people with disabilities in a specific county to buy discounted coupon books for 50 percent off taxi rides.

Senate Bill 459 revises income limits for eligibility and establishes limits for couples for Senior Rx Program.

Senate Resolution 10 supports the Strategic Plan for People with Disabilities.

Senate Resolution 11 urges the creation of a statewide information and referral system for health, welfare, human and social services. (211 system).

Senate Resolution 36 supports the four strategic plans (for people with disabilities, seniors, rural health and rates).

Overall, the state's Medicaid caseload growth is expected to increase by 26 percent from FY 2002 to fiscal year 2004 and by more than 9 percent in FY 2005. State funding ($143.6 million) and federal funding ($194.6 million) were budgeted to keep pace with the growth.

Expansion of the state's waiver programs also was funded. The Community Home-based Initiative Program, a Medicaid waiver program that serves frail seniors, was expanded by 11 percent to serve an additional 181 seniors and increased the total number of seniors who can participate in the program to 1,620 by the end of FY 2005. The Group Care Waiver for the Elderly was expanded to serve additional 117 seniors, for a total of 318 to participate by the end of FY 2005. The state expanded its Physically Disabled Waiver from 327 in June 2003 o 947 in June 2005.

In addition, the Senior Rx program was expanded from 7,500 seniors in June 2003 to 12,160 in June 2005, representing a 62 percent increase. The state's Ticket to Work program was approved and funded for implementation in July 2004 to increase and improve employment opportunities for people with disabilities.

Nevada's counties match federal fundsto pay for long-term care services for institutionalized Medicaid recipients with incomes between 156 percent and 300 percent of the federal SSI benefit rate. Rural counties, however, had not been able in recent years to generate sufficient tax revenue to meet this obligation. They now will be capped at

$ .08 ad valorem; the Medicaid program was funded with $2 million to keep the program going.

Early intervention services for children from birth through age two with known or suspected developmental delays were consolidated into a single service organization within the state health division instead of four separate state programs. Additional general funds of $3.6 million were appropriated to serve about 1,000 new children annually.

Rate increases of 7 percent in FY 2004 and 8 percent in FY 2005 were provided to critical service providers-Supported Living Arrangements and Jobs and Day Training providers). State officials consider this rate increase a good start toward a recommended 35 percent increase by the Rates Task Force of the Human Services Strategic Planning process.

A new 150-bed psychiatric hospital in the Las Vegas area will be built and opened in late 2005 or early 2006 because of a new $32 million capital improvement allocation. Medication Clinic Services for people with mental illness were funded at $5.9 million to accommodate caseload growth. A second team of professionals was funded to work with the homeless mentally ill to keep them out of hospitals and living safely in the community. A Mobile Crisis Team also was funded to evaluate people with mental illness in Las Vegas area emergency rooms to expedite admissions to the state mental hospital or to release them into the community with necessary supports.

The governor will establish four oversight committees to monitor progress on the strategic plans. The state is waiting to hear from the federal government on a number of different grant proposals, including those related to quality improvement, resource centers, and money follows the person.