SB434 - Creates a program to award grants to address shortages of providers of health care. (BDR 40-1107)

EXEMPT (Reprinted with amendments adopted on June 2, 2025) THIRD REPRINT S.B. 434 - *SB434_R3* SENATE BILL NO. 434–SENATOR CANNIZZARO MARCH 24, 2025 ____________ Referred to Committee on Health and Human Services SUMMARY—Creates a program to award grants to address shortages of providers of health care. (BDR 40-1107) FISCAL NOTE: Effect on Local Government: No. Effect on the State: Contains Appropriation not included in Executive Budget. ~ EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. AN ACT relating to health care; creating the Statewide Health Care Access and Recruitment Program Account; providing for certain transfers of money out of the Account; requiring a biennial assessment of the health care needs of this State; establishing the Statewide Health Care Access and Recruitment Grant Program to award grants of money to fund certain projects to address shortages of providers of health care or clinical services or expertise identified by the assessment; requiring a grantee to enter into a funding agreement with the Department of Health and Human Services; providing for certain oversight of projects funded through the Program; authorizing the Department to take certain actions in response to certain changes to a funded project or if a grantee fails to comply with a funding agreement or applicable law; making an appropriation; and providing other matters properly relating thereto. Legislative Counsel’s Digest: Existing law requires the Department of Health and Human Services, or 1 divisions thereof, to conduct various programs for the improvement of public health 2 and health care in this State. (NRS 433.702-433.744, 439.4921-439.525, 439.529- 3 439.5297, 439.600-439.690, 439A.111-439A.185, 439A.200-439A.290, 442.710- 4 442.745, 457.230-457.280, 458.025, 458A.090, 458A.100, 458A.110) This bill 5 establishes the Statewide Health Care Access and Recruitment Grant Program, 6 which is a competitive grant program managed by the Department to support 7 – 2 – - *SB434_R3* projects to address critical shortages of providers of health care or clinical services 8 or expertise in this State. Sections 3-7 of this bill define certain terms, and section 9 2 of this bill establishes the applicability of those definitions. Section 8 of this bill 10 establishes the Statewide Health Care Access and Recruitment Program Account to 11 hold money to fund the Program. Section 8 authorizes the Director of the 12 Department, with the approval of the Interim Finance Committee, to transfer money 13 from the Account to another account for the purpose of obtaining additional federal 14 financial participation under Medicaid. Section 19 of this bill authorizes the Interim 15 Finance Committee to issue such approval during a legislative session. 16 Section 9 of this bill requires the Department to conduct a biennial assessment 17 of the health care needs of this State, which must identify health care professions 18 and specialties and types of clinical services and expertise and geographic areas 19 experiencing critical shortages of providers of health care or clinical services or 20 expertise. Section 21.5 of this bill requires the Department to utilize existing 21 assessments in lieu of conducting the first scheduled assessment on or before 22 July 1, 2026. Section 10 authorizes certain entities involved in the provision of 23 health care, governmental entities and certain nonprofit organizations to apply for a 24 grant of money from the Account to support a project to address those critical 25 shortages. Section 10 imposes certain additional requirements for a project to be 26 eligible to receive such funding, including a requirement that the applicant has 27 secured matching financial or in-kind contributions valued at an amount at least 28 equal to the amount of the grant being sought. Section 11 of this bill prescribes the 29 required contents of an application for such a grant. Sections 12 and 13 of the bill 30 prescribe the process for the Department to review applications and, with the 31 approval of the Interim Finance Committee, award grants. Section 19 authorizes 32 the Interim Finance Committee to issue such approval during a legislative session. 33 After a grant is awarded, section 14 of this bill requires the Department to enter 34 into a funding agreement with the grantee that outlines the terms and conditions of 35 the grant and the responsibilities of the grantee. Section 15 of this bill requires a 36 grantee to notify and submit a revised plan to the Department if: (1) the grantee 37 significantly modifies a funded project; (2) the amount of money available for a 38 funded project changes; (3) a funded project becomes inactive for at least 12 39 months; or (4) a funded project is terminated. Section 15 authorizes the Department 40 to take certain actions in response to such notice. Section 16 of this bill authorizes 41 the Department and the Office of Finance to provide certain oversight of a funded 42 project. Section 17 of this bill authorizes the Department to suspend or terminate a 43 grant or take certain other actions if it determines that the grantee has failed to 44 comply with a funding agreement. Section 17 also requires the Department to 45 suspend or terminate a grant if it determines that the grantee has violated applicable 46 law, misused funds or submitted fraudulent information to the Department. Upon 47 the completion of a funded project and again 10 years after the completion of a 48 funded project, section 18 of this bill requires the grantee to submit a report to the 49 Department concerning the project. 50 THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS: Section 1. Chapter 439A of NRS is hereby amended by 1 adding thereto the provisions set forth as sections 2 to 18, inclusive, 2 of this act. 3 Sec. 2. As used in sections 2 to 18, inclusive, of this act, 4 unless the context otherwise requires, the words and terms defined 5 – 3 – - *SB434_R3* in sections 3 to 7, inclusive, of this act have the meanings ascribed 1 to them in those sections. 2 Sec. 3. “Account” means the Statewide Health Care Access 3 and Recruitment Program Account created by section 8 of this act. 4 Sec. 4. “Certified area of need” means a critical shortage of 5 providers of health care who practice a health care profession or 6 specialty, a critical shortage of providers of health care in a 7 geographic area of this State or a critical shortage of clinical 8 services or expertise in this State or a geographic area of this 9 State, as identified by the assessment conducted pursuant to 10 section 9 of this act. 11 Sec. 5. “Funding agreement” means a funding agreement 12 between the Department and a grantee entered into pursuant to 13 section 14 of this act. 14 Sec. 6. “Medical facility” has the meaning ascribed to it in 15 NRS 449.0151. 16 Sec. 7. “Provider of health care” has the meaning ascribed 17 to it in NRS 629.031. 18 Sec. 8. 1. There is hereby created in the State General 19 Fund the Statewide Health Care Access and Recruitment Program 20 Account. The Department shall administer the Account. 21 2. Any interest earned on money in the Account, after 22 deducting any applicable charges, must be credited to the Account. 23 Money that remains in the Account at the end of a fiscal year does 24 not revert to the State General Fund, and the balance in the 25 Account must be carried forward to the next fiscal year. 26 3. Except as otherwise provided in subsection 4, money in the 27 Account must be used to carry out the provisions of sections 2 to 28 18, inclusive, of this act. The Department may use not more than 1 29 percent of the money in the Account to pay the administrative 30 costs necessary to carry out those provisions. 31 4. With the approval of the Interim Finance Committee, the 32 Director may transfer money from the Account to another account 33 for the purpose of obtaining additional federal financial 34 participation under Medicaid. 35 5. The Department may accept gifts, grants and donations to 36 carry out the provisions of sections 2 to 18, inclusive, of this act. 37 The Director shall deposit such gifts, grants and donations into 38 the Account. 39 Sec. 9. 1. On or before July 1 of each even-numbered year, 40 the Department shall: 41 (a) Conduct a comprehensive assessment of the health care 42 needs in this State; and 43 (b) Compile a report of the results of the assessment and 44 submit the report to the Governor and the Director of the 45 – 4 – - *SB434_R3* Legislative Counsel Bureau for transmittal to the Joint Interim 1 Standing Committee on Health and Human Services and the next 2 regular session of the Legislature. 3 2. The assessment conducted pursuant to paragraph (a) of 4 subsection 1 must consist of: 5 (a) A quantitative analysis of the health care workforce in this 6 State, including, without limitation: 7 (1) A determination of the total number of providers of 8 health care in this State and the total number of providers of 9 health care in this State who practice different professions and 10 different specialties within those professions; 11 (2) A determination of the total number of providers of 12 health care who practice in different geographic areas of this State 13 and the total number of providers of health care who practice 14 different professions and different specialties within those 15 geographic areas; and 16 (3) A comparison of the numbers of providers of health 17 care identified pursuant to subparagraphs (1) and (2) with 18 benchmarks established by the Health Resources and Services 19 Administration of the United States Department of Health and 20 Human Services or nationally recognized organizations that 21 prescribe such benchmarks; 22 (b) A determination of the most critical shortages in the health 23 care workforce of this State, prioritizing: 24 (1) Essential health care professions and specialties and 25 essential clinical services or expertise currently experiencing 26 shortages; and 27 (2) Geographic areas of this State that are experiencing the 28 most critical shortages of providers of health care or clinical 29 services or expertise; and 30 (c) An identification of unmet needs for specific health 31 technology and therapies, including, without limitation, genomic 32 testing, clinical trials, cellular therapies and palliative care. 33 3. The report compiled pursuant to paragraph (b) of 34 subsection 1 must include, without limitation: 35 (a) A summary of the assessment conducted pursuant to 36 subsection 1, including, without limitation: 37 (1) An analysis of shortages of providers of health care, 38 shortages of clinical services or expertise and unmet health needs 39 in this State; and 40 (2) A description of shortages of providers of health care 41 and the shortages of clinical services or expertise by geographic 42 region, including rural and urban areas; 43 (b) A prioritized list of recommendations for allocating 44 funding pursuant to sections 2 to 18, inclusive, of this act in a 45 – 5 – - *SB434_R3* manner that addresses the critical shortages and unmet needs 1 identified in the assessment conducted pursuant to subsection 1; 2 (c) Recommendations for legislation and regulatory changes 3 to improve the recruitment and retention of providers of health 4 care; and 5 (d) An analysis of the effects of projects funded pursuant to 6 sections 2 to 18, inclusive, of this act on the health care workforce 7 and health needs of this State. 8 4. As used in this section, “palliative care” means a 9 multidisciplinary and patient- and family-centered approach to 10 specialized medical care for a person with a serious illness, which 11 approach focuses on the care of a patient throughout the 12 continuum of an illness and involves addressing the physical, 13 emotional, social and spiritual needs of the patient, as well as 14 facilitating patient autonomy, access to information and choice of 15 care. The term includes, without limitation, discussion of the goals 16 of the patient for treatment and discussion of treatment options 17 appropriate to the patient, including, where appropriate, hospice 18 care and comprehensive management of pain and symptoms. 19 Sec. 10. 1. The Department shall, in accordance with 20 sections 2 to 18, inclusive, of this act, establish and administer the 21 Statewide Health Care Access and Recruitment Grant Program as 22 a competitive program to award grants of money from the Account 23 to entities described in subsection 2 seeking to address shortages 24 of providers of health care or clinical services or expertise and 25 difficulties in accessing health care identified in the assessment 26 conducted pursuant to section 9 of this act. The Department may 27 adopt any regulations necessary to carry out the provisions of 28 sections 2 to 18, inclusive, of this act. 29 2. The following entities are eligible to apply for a grant from 30 the Account: 31 (a) Entities that provide health care or coordinate or otherwise 32 facilitate the provision of health care, including, without 33 limitation: 34 (1) Medical facilities and community health clinics; 35 (2) Group practices of providers of health care; 36 (3) Federally-qualified health centers, as defined in 42 37 U.S.C. § 1396d(l)(2)(B): 38 (4) Accredited institutions of higher education that offer 39 programs to train providers of health care, including, without 40 limitation, residency and fellowship programs for providers of 41 health care; 42 (5) Entities that provide behavioral health care; 43 (6) Facilities for the treatment of alcohol or other 44 substance use disorders, as defined in NRS 449.00455; 45 – 6 – - *SB434_R3* (7) Detoxification facilities or programs certified pursuant 1 to NRS 458.025; 2 (8) Substance use disorder prevention coalitions certified 3 pursuant to NRS 458.033; and 4 (9) Oncology organizations, including, without limitation, 5 oncology organizations that: 6 (I) Offer programs for transplantation and cellular 7 therapy; 8 (II) Provide or facilitate the provision of clinical trials; 9 (III) Host fellowships in oncology and oncology 10 subspecialties; or 11 (IV) Have been designated as a compr [Text truncated for display. 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