SB423 - Revises provisions governing public health. (BDR 40-349)

EXEMPT (Reprinted with amendments adopted on April 21, 2025) FIRST REPRINT S.B. 423 - *SB423_R1* SENATE BILL NO. 423–COMMITTEE ON HEALTH AND HUMAN SERVICES (ON BEHALF OF THE JOINT INTERIM STANDING COMMITTEE ON HEALTH AND HUMAN SERVICES) MARCH 24, 2025 ____________ Referred to Committee on Health and Human Services SUMMARY—Revises provisions governing public health. (BDR 40-349) FISCAL NOTE: Effect on Local Government: May have Fiscal Impact. Effect on the State: Yes. ~ EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. AN ACT relating to public health; creating the Account for Public Health; authorizing allocations from the Account to certain entities who have jurisdiction over public health; requiring the Division of Public and Behavioral Health of the Department of Health and Human Services and entities which receive an allocation from the Account to prepare reports concerning the use of money in the Account; and providing other matters properly relating thereto. Legislative Counsel’s Digest: Existing law creates a health district in any county whose population is 700,000 1 or more (currently Clark County), which has jurisdiction over all public health 2 matters in the health district. (NRS 439.361, 439.362, 439.366) Existing law 3 authorizes the creation of a health district with similar jurisdiction in counties 4 whose population is less than 700,000 (currently all counties other than Clark 5 County), subject to the approval by the State Board of Health, by affirmative vote 6 of: (1) the board of county commissioners of two or more counties; (2) the 7 governing bodies of two or more cities or towns within any county; or (3) the board 8 of county commissioners and the governing body or bodies of any incorporated city 9 or cities, town or towns, in such a county. (NRS 439.370) 10 Senate Bill No. 312 of this session proposes to create: (1) the Tribal Health 11 Advisory Council; and (2) the Account for Tribal Health to fund the activities of 12 the Council. Sections 2 and 2.5 of this bill define the term “health authority” for 13 the purposes of this bill to include health districts which are formed by one or more 14 – 2 – - *SB423_R1* counties and, if Senate Bill No. 312 of this session is not enacted, federally 15 recognized Indian tribes which are located in whole or in part in this State. 16 Existing law requires each insurer to pay to the Department of Taxation a tax 17 upon net direct premiums and net direct considerations written at the rate of 3.5 18 percent. (NRS 680B.027) Sections 3 and 3.5 of this bill create the Account for 19 Public Health in the State General Fund and require the Division of Public and 20 Behavioral Health of the Department of Health and Human Services to administer 21 the Account. Section 7 of this bill requires the State Treasurer to deposit: (1) the 22 first $4,925,000 of revenues collected from the tax on net direct premiums and net 23 direct considerations during each biennium in the Account; and (2) any revenues 24 collected from the tax during the biennium in excess of $4,925,000 in the State 25 General Fund. Sections 3 and 3.5 require the Division to use any money which is 26 deposited in the Account to: (1) protect and promote public health; (2) make 27 allocations to health authorities in certain specified amounts from the money 28 deposited in the Account during the biennium; and (3) if Senate Bill No. 312 of this 29 session is enacted, allocate a specified amount of the money deposited in the 30 Account during the biennium to the Account for Tribal Health created by that bill. 31 Sections 3 and 3.5 require the Division to submit to the State Board of Health a 32 report regarding the use of money in the Account. 33 Section 4 of this bill requires the Division to publish on its Internet website, on 34 or before December 1 of each odd-numbered year, an estimate of the amount of 35 money in the Account which will be available for allocation to health authorities for 36 the biennium. Section 4 authorizes a health authority, on or before January 1 of 37 each even-numbered year, to submit to the Division a request for an allocation from 38 the Account, which must be accompanied by a proposal for the use of the allocation 39 that includes certain information. Section 4 requires the Division to make 40 allocations from the Account on or before April 1 of each even-numbered year to 41 health authorities whose requests are approved and provides that money which is 42 not expended or committed for expenditure by the health authority before June 30 43 of an odd-numbered year reverts to the Account. Section 4 requires a health 44 authority that receives an allocation from the Account to submit a report to the 45 Division concerning the use of the allocated money. 46 THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS: Section 1. Chapter 439 of NRS is hereby amended by adding 1 thereto the provisions set forth as sections 2 to 4, inclusive, of this 2 act. 3 Sec. 2. As used in sections 3 and 4 of this act, unless the 4 context otherwise requires, “health authority” means: 5 1. A health district created pursuant to NRS 439.362 or 6 subsection 1 of NRS 439.370; or 7 2. A federally recognized American Indian tribe pursuant to 8 25 C.F.R. §§ 83.1 to 83.12, inclusive, that is located in whole or in 9 part in this State. 10 Sec. 2.5. As used in sections 3.5 and 4 of this act, unless the 11 context otherwise requires, “health authority” means a health 12 district created pursuant to NRS 439.362 or subsection 1 of 13 NRS 439.370. 14 – 3 – - *SB423_R1* Sec. 3. 1. The Account for Public Health is hereby created 1 in the State General Fund. 2 2. The Division shall administer the Account. 3 3. The interest and income earned on money in the Account 4 must be credited to the Account. 5 4. Except as otherwise provided in subsection 8 and 6 subsection 4 of section 4 of this act, any money remaining in the 7 Account at the end of each fiscal year does not revert to the State 8 General Fund and must be carried forward to the next fiscal year. 9 5. Except as otherwise provided in subsection 6, money 10 credited to the Account pursuant to NRS 680B.060 during each 11 biennium must be used for the following purposes in the following 12 prescribed amounts: 13 (a) Eight hundred thousand dollars for use by the Division to 14 protect and promote public health. 15 (b) Three hundred thousand dollars to make allocations 16 pursuant to section 4 of this act to health authorities which are 17 Indian tribes. 18 (c) Two hundred twenty-five thousand dollars per each county 19 which is not within the jurisdiction of a health district created 20 pursuant to NRS 439.362 or subsection 1 of NRS 439.370, for use 21 by the Division to protect and promote public health in each such 22 county. 23 (d) Two hundred twenty-five thousand dollars per each county 24 within the jurisdiction of a health district created pursuant to NRS 25 439.362 or subsection 1 of NRS 439.370 to make allocations 26 pursuant to section 4 of this act to each such health district. 27 6. Except for money which reverts to the Account from a 28 health authority pursuant to subsection 4 of section 4 of this act, 29 money remaining in the Account on April 2 of an even-numbered 30 year and money which is credited to the Account pursuant to NRS 31 680B.060 after April 1 of an even-numbered year and on or before 32 June 30 of an odd-numbered year which would otherwise be 33 required to be used for the purpose described in paragraph (b) or 34 (d) of subsection 5 becomes part of the reserve of the Account. 35 Money in the reserve may be used by the Division to protect and 36 promote public health. 37 7. Any money allocated from the Account to the Division 38 pursuant to paragraphs (a) and (c) of subsection 5 that is not 39 committed for expenditure for the purpose for which it was 40 distributed on or before June 30 of an odd-numbered year reverts 41 to the Account, becomes part of the reserve of the Account and 42 must be included in the calculation of the reserve on June 30 for 43 the purposes of subsection 8. 44 – 4 – - *SB423_R1* 8. Any reserve of the Account which exceeds 4 percent of the 1 total money credited to the Account pursuant to NRS 680B.060 2 during the then current biennium and has not been committed for 3 expenditure on or before June 30 of an odd-numbered year reverts 4 to the State General Fund. 5 9. If the amount of money credited to the Account pursuant 6 to NRS 680B.060 during the biennium is insufficient to allocate 7 the full amounts prescribed by subsection 5, the money credited to 8 the Account pursuant to NRS 680B.060 during the biennium must 9 be allocated for the purposes prescribed by subsection 5 in the 10 same proportion as the amounts prescribed by subsection 5. 11 10. On or before November 30 of an odd-numbered year, the 12 Division shall submit to the State Board of Health a report 13 concerning the use of money in the Account. 14 Sec. 3.5. 1. The Account for Public Health is hereby 15 created in the State General Fund. 16 2. The Division shall administer the Account. 17 3. The interest and income earned on money in the Account 18 must be credited to the Account. 19 4. Except as otherwise provided in subsection 8 and 20 subsection 4 of section 4 of this act, any money remaining in the 21 Account at the end of each fiscal year does not revert to the State 22 General Fund and must be carried forward to the next fiscal year. 23 5. Except as otherwise provided in subsection 6, money 24 credited to the Account pursuant to NRS 680B.060 during each 25 biennium must be used for the following purposes in the following 26 prescribed amounts: 27 (a) Eight hundred thousand dollars for use by the Division to 28 protect and promote public health. 29 (b) Three hundred thousand dollars for remittance to the 30 Account for Tribal Health created by section 9 of Senate Bill No. 31 312 of this session for use by the Tribal Health Authority Council 32 created by section 5 of Senate Bill No. 312 of this session. 33 (c) Two hundred twenty-five thousand dollars per each county 34 which is not within the jurisdiction of a health district created 35 pursuant to NRS 439.362 or subsection 1 of NRS 439.370, for use 36 by the Division to protect and promote public health in each such 37 county. 38 (d) Two hundred twenty-five thousand dollars per each county 39 within the jurisdiction of a health district created pursuant to NRS 40 439.362 or subsection 1 of NRS 439.370 to make allocations 41 pursuant to section 4 of this act to each such health district. 42 6. Except for money which reverts to the Account for Public 43 Health from a health authority pursuant to subsection 4 of section 44 4 of this act, money remaining in the Account on April 2 of an 45 – 5 – - *SB423_R1* even-numbered year and money which is credited to the Account 1 pursuant to NRS 680B.060 after April 1 of an even-numbered year 2 and on or before June 30 of an odd-numbered year which would 3 otherwise be required to be used for the purposes described in 4 paragraph (d) of subsection 5 becomes part of the reserve of the 5 Account. Money in the reserve may be used by the Division to 6 protect and promote public health. 7 7. Any money allocated from the Account to the Division 8 pursuant to paragraphs (a) and (c) of subsection 5 that is not 9 committed for expenditure for the purpose for which it was 10 distributed on or before June 30 of an odd-numbered year reverts 11 to the Account, becomes part of the reserve of the Account and 12 must be included in the calculation of the reserve on June 30 for 13 the purposes of subsection 8. 14 8. Any reserve of the Account which exceeds 4 percent of the 15 total money credited to the Account pursuant to NRS 680B.060 16 during the then current biennium and has not been committed for 17 expenditure on or before June 30 of an odd-numbered year reverts 18 to the State General Fund. 19 9. If the amount of money credited to the Account pursuant 20 to NRS 680B.060 during the biennium is insufficient to allocate 21 the full amounts prescribed by subsection 5, the money credited to 22 the Account pursuant to NRS 680B.060 during the biennium must 23 be allocated for the purposes prescribed by subsection 5 in the 24 same proportion as the amounts prescribed by subsection 5. 25 10. On or before November 30 of an odd-numbered year, the 26 Division shall submit to the State Board of Health a report 27 concerning the use of money in the Account. 28 Sec. 4. 1. On or before December 1 of each odd-numbered 29 year, the Division shall publish on the Internet website of the 30 Division an estimate of the amount of money in the Account for 31 Public Health which will be available for allocation pursuant to 32 this section to health authorities during the then current 33 biennium. 34 2. On or before January 1 of each even-numbered year, a 35 health authority may submit to the Division a request for an 36 allocation from the Account for Public Health. The request must 37 be accompanied by a proposal for the use of the allocation which 38 includes, without limitation: 39 (a) An evaluation and identification of the public health needs 40 of residents of the area under the jurisdiction of the health 41 authority; 42 (b) A determination of the level of priority of the public health 43 needs identified pursuant to paragraph (a); and 44 – 6 – - *SB423_R1* (c) A plan for spending the money allocated from the Account 1 for Public Health which is in accordance with the levels of priority 2 determined pursuant to paragraph (b) and includes spending for 3 one or more of the following public health services: 4 (1) Control of communicable diseases; 5 (2) Prevention of chronic diseases and injuries; 6 (3) Environmental public health; 7 (4) Maternal, child and family health; 8 (5) Access to and linkage with medical, oral and behavioral 9 health services; 10 (6) Vital records; 11 (7) Assessing the health of populations; 12 (8) Planning for public health emergencies; 13 (9) Communications; 14 (10) Development and support of policy; 15 (11) Development of community partnerships; 16 (12) Business [Text truncated for display. 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