SB 434 — Creates a program to award grants to address shortages of providers of health care. (BDR 40-1107)

EXEMPT (Reprinted with amendments adopted on MayApril 26,21, 2025) SECONDFIRST REPRINT S.B.

making an appropriation;

(NRS 433.702-433.744, 439.4921-439.525, 439.529- 439.5297, 439.600-439.690, 439A.111-439A.185, 439A.200-439A.290, 442.710- 442.745, 457.230-457.280, 458.025, 458A.090, 458A.100, 458A.110) This bill establishes- the*SB434_R1* Statewide– Health2 Care– Accesswhich andis Recruitmenta Grantcompetitive Program,grant -program *SB434_R2*managed –by 2the –Department of Health and Human Services to support projects to address critical shortages of providers of health care or clinical services or expertise in this State.

Section 821 authorizes the Director of thethis Department,bill withappropriates the approval of the Interim Finance Committee, to transfer money frominto the Account to another account for the purposepurposes of obtainingthe additionalProgram. federal financial participation under Medicaid.

Section 198 aauthorizes legislativethe session.sDirector of the InterimDepartment, Financewith Committeethe toapproval issueof suchthe approvalfor duringthe Existingpurpose law:of obtaining additional federal financial participation underunt Medicaid.

Section 19 of this bill authorizes the Interim Finance Committee to issue such approval during a legislative session.

Existing law:

Existing law requires certain transfers of money to be made from the State General Fund to the Rainy Day Fund, including, without limitation, an annual transfer of 1 percent of the anticipated revenue for the State during the current fiscal year into the Rainy Day Fund.

(NRS 353.288) Beginning on July 1, 2027, section 8 requires the Statee Rainy Controller to annually transfer 0.5 percent of the anticipated revenue for the State during the current fiscal year into the Statewide Health Care Access andorand the State Recruitment Program Account.

Section 20 of this bill reduces the amount that the State Controller is required to transfer to the Rainy Day Fund in fiscal years when the State Controller transfers money to the Statewide Health Care Access and Recruitment Program Account to 0.5 percent of the anticipated revenue for the State during the next fiscal year.

Section 8 prohibits a transfer into the Statewide Health Care Access andandt fiscal Recruitment Program Account if the balance of the Rainy Day Fund is less than $1 billion, and section 20 requires the money that would otherwise be transferred into the Account under those circumstances to instead be transferred into the Rainy Day Fund.

ToSection the9 extentof thatthis moneybill isrequires availablethe fromDepartment rebatesof receivedHealth byand thisHuman StateServices forto prescriptionconduct drugs,a sectionbiennial 8assessment authorizesof the Director,health notcare laterneeds thanof Junethis 30State, ofwhich eachmust fiscalidentify year,health tocare requestprofessions theand approvalspecialties ofand thetypes Interimof Financeclinical Committeeservices forand aexpertise transferand ofgeographic notareas moreexperiencing thancritical $25,000,000shortages of thatproviders moneyof Department to theutilize Statewideexisting Healthassessments Carein Accesslieu andof Recruitmentconducting Programthe Accountfirst forschedulede thatassessment fiscalon year.or before July 1, 2026.

Section 9 of this bill requires the Department of Health and Human Services to identify health care professions and specialties and types of clinical services and expertise and geographic areas experiencing critical shortages of providers of health care or clinical services or expertise.

Section 21.5 of this bill requires the Department to utilize existing assessments in lieu of conducting the first scheduled assessment on or before July 1, 2026.

Section 10 imposes certain additional requirements for a project to be eligible to receive such funding, including a requirement that the applicant has secured matching financial or in-kind contributions valued at an amount at least equal to the amount of the grant being sought.

Section 11 of this bill prescribes the required contents of an application for suchDepartment ato grant.review applications and, with the approval of the Interim Finance Committee, award grants.

Sections 12 and 13 of the bill prescribe the process for the Department to review applications and, with the approval of the Interim Finance - *SB434_R2* – 3 – Committee, award grants.

After a grant is awarded, section 14 of this bill requires the Department to enter into a funding agreement with the grantee that outlines the terms and conditions- of*SB434_R1* grantee– to3 notify– andconditions submitof athe revisedgrant planand to the Departmentresponsibilities if:of the grantee.

(1)Section the15 granteeesof this bill requires a significantlygrantee modifiesto notify and submit a fundedrevised project;plan to the Department if:

(2)(1) the amountgrantee ofsignificantly moneymodifies available for a funded projectproject; changes;

(3)(2) athe fundedamount projectof becomesmoney inactiveavailable for at least 12 months;

Section 16 of this bill authorizes the Department and the Office of Finance to provide certain oversight of a funded grantproject. or take certain other actions if it determines that the grantee has failed toa comply with a funding agreement.

Section 17 alsoof requiresthis bill authorizes the Department to suspend or terminate a grant or take certain other actions if it determines that the grantee has failed to suspend or terminate a grant if it determines that the grantee has violated applicable law, misused funds or submitted fraudulent information to the Department.

- *SB434_R2* – 4 – Sec.

Except as otherwise provided in subsections 4 and 5, commencing with the fiscal year that begins on July 1, 2027, each - *SB434_R1* – 4 – year after the close of the previous fiscal year and before the issuance of the State Controller’s annual report, the State Controller shall transfer from the State General Fund to the Account 0.5 percent of the total anticipated revenue for the fiscal year in which the transfer will be made, as projected by the Economic Forum for that fiscal year pursuant to paragraph (e) of subsection 1 of NRS 353.228 and as adjusted by any legislation enacted by the Legislature that affects state revenue for that fiscal year.

To the extent that money is available from rebates received by this State for prescription drugs, the Director may, not later than June 30 of each fiscal year, request the approval of the Interim Finance Committee for a transfer of not more than $25,000,000 of that money to the Account for that fiscal year.

7.

(b) Any money transferredappropriated toby the AccountLegislature; pursuant to subsection 6;

(c) Any money appropriatedreceived bythrough thegifts, Legislature;grants and donations pursuant to subsection 10;

and (d) Any money receivedprovided throughby gifts,any grantsother andsource donationsto pursuantcarry out the provisions of sections 2 to subsection18, 11;inclusive, of this act.

and7. (e) Any money provided by any other source to carry out the provisions of sections 2 to 18, inclusive, of this act.

8.

Money that remains in the Account at the end of a fiscal year does - *SB434_R2* – 5 – not revert to the State General Fund, and the balance in the Account must be carried forward to the next fiscal year.

9.8.

Except as otherwise provided in subsection 10,9, money in the Account must be used to carry out the provisions of sections 2 to 18, inclusive, of this act.

10.9.

11.- *SB434_R1* – 5 – 10.

- *SB434_R2* – 6 – (1) Essential health care professions and specialties and essential clinical services or expertise currently experiencing shortages;

- *SB434_R1* – 6 – (a) A summary of the assessment conducted pursuant to subsection 1, including, without limitation:

The Department shall, in accordance with sections 2 to 18, inclusive, of this act, establish and administer the Statewide Health Care Access and Recruitment Grant Program as a competitive program to award grants of money from the Account to entities described in subsection 2 seeking to address shortages - *SB434_R2* – 7 – of providers of health care or clinical services or expertise and difficulties in accessing health care identified in the assessment conducted pursuant to section 9 of this act.