2005 Nevada Revised Statutes - Chapter 439A — Planning for the Provision of Health Care

CHAPTER 439A - PLANNING FOR THE PROVISIONOF HEALTH CARE

NRS 439A.010 Definitions.

NRS 439A.012 Departmentdefined.

NRS 439A.0125 Directordefined.

NRS 439A.015 Healthfacility defined.

NRS 439A.017 Healthservices defined.

NRS 439A.0195 Practitionerdefined.

NRS 439A.020 Purposesof chapter.

NRS 439A.081 Departmentis state agency for health planning and development; powers of Director; fees.

NRS 439A.082 Directorto contract with Nevada System of Higher Education to collect and analyzeinformation from health facilities and purchasers of health care.

NRS 439A.083 Directorto establish procedure for review of statutes, regulations and standardsgoverning approval, licensing or certification of health facilities;preparation of report for Governor and Legislature.

NRS 439A.086 ChiefResearch and Statistical Analyst: Position created.

NRS 439A.087 ChiefResearch and Statistical Analyst: Appointment and qualifications. [Repealed.]

NRS 439A.088 ChiefResearch and Statistical Analyst: Duties. [Repealed.]

NRS 439A.100 Approvalof Director required for certain projects; criteria for review of application.

NRS 439A.104 Approvalof State Health Officer required for operation of certain medical helicopters;criteria for review of application.

NRS 439A.110 Injunctions.

NRS 439A.120 Civilpenalties.

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NRS 439A.010 Definitions. As used in this chapter, unless the context otherwiserequires, the words and terms defined in NRS439A.012 to 439A.0195, inclusive,have the meanings ascribed to them in those sections.

(Added to NRS by 1971, 566; A 1977, 253; 1979, 967;1981, 1214; 1985, 1357; 1991, 2110; 1995, 1485)

NRS 439A.012 Departmentdefined. Department means the Department ofHealth and Human Services.

(Added to NRS by 1981, 1213)

NRS 439A.0125 Directordefined. Director means the Director of theDepartment.

(Added to NRS by 1981, 1213)

NRS 439A.015 Healthfacility defined. Health facility means a facilityin or through which health services are provided, except for the office of apractitioner used solely to provide routine services for health to hispatients. The term includes any parent, affiliate, subsidiary or partner ofsuch a facility and any other entity which has a primary purpose of providing abenefit to such a facility. For the purposes of this section, office of apractitioner used solely to provide routine services for health to hispatients does not include a facility which is or will be qualified to receivereimbursement, other than for the services of a practitioner, as a healthfacility from any public agency.

(Added to NRS by 1981, 1213; A 1985, 1358, 1749;1991, 1075; 1995, 1485)

NRS 439A.017 Healthservices defined. Health services means thecare and observation of patients, the diagnosis of human diseases, thetreatment and rehabilitation of patients, or related services. The termincludes treatment of patients for alcohol or drug abuse, services related tomental health and diagnostic services.

(Added to NRS by 1981, 1213; A 1983, 1524)

NRS 439A.0195 Practitionerdefined. Practitioner means a physicianlicensed under chapter 630, 630A or 633 ofNRS, dentist, licensed nurse, dispensing optician, optometrist, registeredphysical therapist, podiatric physician, licensed psychologist, chiropractor,doctor of Oriental medicine in any form, medical laboratory director ortechnician, pharmacist or other person whose principal occupation is theprovision of services for health.

(Added to NRS by 1985, 1357; A 1991, 1133; 1993,2232)

NRS 439A.020 Purposesof chapter. The purposes of this chapter areto:

1. Promote equal access to quality health care at areasonable cost;

2. Promote an adequate supply and distribution ofhealth resources;

3. Promote uniform, effective methods of deliveringhealth care;

4. Promote and encourage the adequate distribution ofhealth and care facilities and man power;

5. Promote and encourage the effective use of methodsfor controlling increases in the cost of health care;

6. Encourage participation in health planning bymembers of the several health professions, representatives of institutions andagencies interested in the provision of health care and the reduction of thecost of such care, and the general public;

7. Utilize the viewpoint of the general public formaking decisions;

8. Encourage public education regarding properpersonal health care and methods for the effective use of available healthservices; and

9. Promote a program of technical assistance topurchasers to contain effectively the cost of health care, including:

(a) Providing information to purchasers regarding thecharges made by practitioners.

(b) Training purchasers to negotiate successfully for apolicy of health insurance.

(c) Conducting studies and providing other informationabout measures to assist purchasers in containing the cost of health care.

(Added to NRS by 1971, 566; A 1977, 254; 1983, 1524;1985, 1358)

NRS 439A.081 Departmentis state agency for health planning and development; powers of Director; fees.

1. The Department is the agency of the State of Nevada for health planning and development, and shall carry out the state administrativeprogram and perform the functions of health planning and development for theState in accordance with the following priorities:

(a) Providing for the effective use of methods forcontrolling increases in the cost of health care;

(b) Providing for the adequate supply and distributionof health resources;

(c) Providing for equal access to health care of goodquality at a reasonable cost; and

(d) Providing education to the public regarding properpersonal health care and methods for the effective use of available healthservices.

2. In order to carry out the provisions of thischapter, the Director may:

(a) Delegate the duties of the Director and theDepartment pursuant to this chapter to any of the divisions of the Department;

(b) Hire employees in the classified service;

(c) Adopt such regulations as are necessary; and

(d) Apply for, accept and disburse money granted by theFederal Government for the purposes of health planning and development.

3. The Department may, by regulation, fix fees to becollected from applicants seeking approval of proposed health facilities orservices. The amounts of such fees must be based upon the Departments costs ofexamining and acting upon the applications.

4. In developing and revising any state plan forhealth planning and development, the Department shall consider, among otherthings, the amount of money available from the Federal Government for healthplanning and development and the conditions attached to the acceptance of thatmoney, and the limitations of legislative appropriations for health planningand development.

(Added to NRS by 1977, 257; A 1979, 967; 1981, 1216,1899; 1983, 1525; 1985, 1359; 1989, 1945; 1991, 2110; 1995, 1485)

NRS 439A.082 Directorto contract with Nevada System of Higher Education to collect and analyzeinformation from health facilities and purchasers of health care. The Director, through the Division of Health CareFinancing and Policy of the Department, shall contract with the Nevada Systemof Higher Education to collect and analyze information from health facilitiesand purchasers of health care to:

1. Respond to requests for information from theLegislature.

2. Provide technical assistance to purchasers ofhealth care.

3. Provide the Department with information necessaryto carry out the provisions of this chapter.

4. Provide other persons with information relating tothe cost of health care.

(Added to NRS by 1985, 1357; A 1993, 403; 1997, 2632;1999, 2242)

NRS 439A.083 Directorto establish procedure for review of statutes, regulations and standardsgoverning approval, licensing or certification of health facilities; preparationof report for Governor and Legislature. The Directorshall:

1. Establish procedures for the review of allstatutes, regulations and standards governing the approval, licensing orcertification of health facilities. The procedures must provide forparticipation in the review by providers of health care and the general public.

2. Before December 31 of each even-numbered year,prepare a report to the Governor and the Legislature identifying any statutes,regulations and standards which add to the cost of health care withoutproviding a significant benefit and the action which has been taken or isrequired to eliminate any such statutes, regulations and standards.

(Added to NRS by 1985, 1357)

NRS 439A.086 ChiefResearch and Statistical Analyst: Position created. Theposition of Chief Research and Statistical Analyst is hereby created in theHealth Division of the Department. This position is in the unclassified serviceof the State.

(Added to NRS by 1989, 1399; A 2005, 22nd SpecialSession, 55)

NRS 439A.087 ChiefResearch and Statistical Analyst: Appointment and qualifications. Repealed. (See chapter 1, Statutes of Nevada2005, 22nd Special Session, at page 63.)

NRS 439A.088 ChiefResearch and Statistical Analyst: Duties. Repealed.(See chapter 1, Statutesof Nevada 2005, 22nd Special Session, at page 63.)

NRS 439A.100 Approvalof Director required for certain projects; criteria for review of application.

1. Except as otherwise provided in this section, in acounty whose population is less than 100,000, no person may undertake anyproposed expenditure for new construction by or on behalf of a health facilityin excess of the greater of $2,000,000 or such an amount as the Department mayspecify by regulation, which under generally accepted accounting principlesconsistently applied is a capital expenditure, without first applying for andobtaining the written approval of the Director. The Health Division of theDepartment shall not issue a new license or alter an existing license for sucha project unless the Director has issued such an approval.

2. The provisions of subsection 1 do not apply to:

(a) Any capital expenditure for:

(1) The acquisition of land;

(2) The construction of a facility for parking;

(3) The maintenance of a health facility;

(4) The renovation of a health facility tocomply with standards for safety, licensure, certification or accreditation;

(5) The installation of a system to conserveenergy;

(6) The installation of a system for dataprocessing or communication; or

(7) Any other project which, in the opinion ofthe Director, does not relate directly to the provision of any health service;

(b) Any project for the development of a healthfacility that has received legislative approval and authorization; or

(c) A project for the construction of a hospital in anunincorporated town if:

(1) The population of the unincorporated town ismore than 24,000;

(2) No other hospital exists in the town;

(3) No other hospital has been approved for constructionor qualified for an exemption from approval for construction in the townpursuant to this section; and

(4) The unincorporated town is at least a45-minute drive from the nearest center for the treatment of trauma that islicensed by the Health Division of the Department.

Upondetermining that a project satisfies the requirements for an exemption pursuantto this subsection, the Director shall issue a certificate which states thatthe project is exempt from the requirements of this section.

3. In reviewing an application for approval, theDirector shall:

(a) Comparatively assess applications for similarprojects affecting the same geographic area; and

(b) Base his decision on criteria established by theDirector by regulation. The criteria must include:

(1) The need for and the appropriateness of theproject in the area to be served;

(2) The financial feasibility of the project;

(3) The effect of the project on the cost ofhealth care; and

(4) The extent to which the project is consistentwith the purposes set forth in NRS439A.020 and the priorities set forth in NRS 439A.081.

4. The Department may by regulation require additionalapproval for a proposed change to a project which has previously been approvedif the proposal would result in a change in the location of the project or asubstantial increase in the cost of the project.

5. The decision of the Director is a final decisionfor the purposes of judicial review.

6. As used in this section, hospital has the meaningascribed to it in NRS 449.012.

(Added to NRS by 1971, 568; A 1977, 256; 1979, 491,968; 1981, 1216; 1983, 1526; 1985, 1360; 1987, 873, 1627; 1989, 1946, 2111;1991, 1075; 1995, 1486; 2003, 1324)

NRS 439A.104 Approvalof State Health Officer required for operation of certain medical helicopters;criteria for review of application.

1. No person may operate or undertake any proposedexpenditure for the operation of a new medical helicopter that will providemedical helicopter services in an area located within 150 miles from the baseof an existing medical helicopter without first applying for and obtaining thewritten approval of the State Health Officer or the designee of the StateHealth Officer.

2. Except as otherwise provided in subsection 3, theState Health Officer or the designee of the State Health Officer may approve anapplication submitted pursuant to subsection 1 only if the applicantdemonstrates that:

(a) Based on the needs of the specific population to beserved by the new medical helicopter and on the projected number of persons whohave or will have a need for the proposed service, the population to be servedhas a need for the new medical helicopter;

(b) The existing medical helicopter services in thearea to be served by the new medical helicopter cannot or will not meet theprojected needs of the population to be served by the new medical helicopter;

(c) The applicant has the financial stability toprovide medical helicopter services to the population to be served by the newmedical helicopter for a significant period of time;

(d) The new medical helicopter will result in asignificant savings in costs for users of and payors for medical helicopterservices;

(e) The new medical helicopter will not have an adverseeffect on the quality of care provided to users of medical helicopter servicesand will not have an unnecessarily negative effect on the cost of medicalhelicopter services for users of or payors for such services; and

(f) The approval of the application will not adverselyaffect an existing provider of medical helicopter services.

3. The State Health Officer or the designee of theState Health Officer shall not approve an application submitted pursuant tosubsection 1 if:

(a) The applicant fails to provide sufficient,relevant, demonstrative evidence for the approval of the application; or

(b) The evidence opposing the application outweighs theevidence supporting the application.

4. In determining whether to approve an applicationsubmitted pursuant to subsection 1, the State Health Officer or the designee ofthe State Health Officer shall:

(a) Contact existing providers of medical helicopterservices, ensure that existing providers of medical helicopter services have anopportunity to participate in any public hearing concerning the application,and seek the input of existing providers of medical helicopter servicesconcerning the application; and

(b) Consider:

(1) The level of medical care to be provided bythe applicant to the population to be served by the new medical helicopter;

(2) The impact of the new medical helicopter onthe rates, quality of service and safety of existing providers of medicalhelicopter services and on the level of medical care provided by suchproviders;

(3) The effect of the new medical helicopter onthe cost of health care services; and

(4) Any other information the State HealthOfficer or the designee of the State Health Officer deems relevant.

5. An applicant whose application is rejected pursuantto this section may appeal the decision of the State Health Officer or thedesignee of the State Health Officer to the State Board of Health. The decisionof the State Board of Health is a final decision for the purposes of judicialreview.

6. As used in this section, medical helicopter meansa helicopter especially designed, constructed, modified or equipped to be usedfor the transportation of injured or sick persons. The term does not includeany commercial helicopter carrying passengers on regularly scheduled flights.

(Added to NRS by 2003, 1323)

NRS 439A.110 Injunctions.

1. Except as provided in subsection 2, the Departmentmay apply to any court of competent jurisdiction to enjoin any person, stateagency or local governmental agency which has engaged in or is about to engagein any act which violates any provision of this chapter or the regulationsadopted pursuant thereto. Such injunction may be issued without proof of actualdamage sustained by any person.

2. The Department shall not seek injunctive reliefunder this section if it has imposed a civil penalty for the same violation.

(Added to NRS by 1977, 257; A 1983, 1528)

NRS 439A.120 Civilpenalties.

1. Except as otherwise provided in subsection 2, anyperson who violates any of the provisions of this chapter is liable to theState for a civil penalty of:

(a) Where the provision violated governs the licensingof a project which is required to be approved pursuant to NRS 439A.100, not more than 10 percent ofthe proposed expenditure for the project.

(b) Where any other provision is violated, not morethan $20,000 for each violation.

2. The Department shall not impose a penalty underthis section if it applies for injunctive relief to prevent the same violation.

(Added to NRS by 1983, 1523; A 1991, 1077; 1995,1488)