Lawmakers, Guinn officials debate care for disabled

Brendan Riley

Wednesday, Jan. 26, 2000 | 5:53 a.m.

CARSON CITY - Officials in Gov. Kenny Guinn's administration faced more criticism Wednesday as they explained delays in an effort authorized last May to increase help for badly disabled Nevadans.

Critics at a legislative hearing included Rick Cline of Sparks, a quadriplegic who asked for commonsense solutions to ensure that long-promised benefit enhancements occur as soon as possible.

"I don't mean to speak meanly, but this has been hard," Cline added in urging the lawmakers' interim Committee on Health Care to continue pushing Guinn's administration for improvements.

"Promises were made to these people back in 1997 and promises were made again in the last Legislature," said Assemblywoman Ellen Koivisto, D-Las Vegas, chairwoman of the panel.

"And it seems to be taking a really long time for these people to see results."

Assemblywoman Vivian Freeman, D-Reno, echoed Koivisto, adding that there should be enough budget flexibility to quickly provide the promised help. "I for one would like to see some movement," she said.

Janice Wright, head of the Division of Health Care Financing and Policy, told the lawmakers that she wants the same thing, but staff turnovers, hearings and plan revisions - some sought by disabled advocates - delayed paperwork.

The committee also got a letter from Guinn, who said the waiver changes could have been speeded up if Wright hadn't held hearings to get comment from the disabled community. But the first-term GOP governor said those discussions "improved the final product."

To expand the services, the state must get a waiver from federal Medicaid rules. That strategy was outlined last spring, but an application wasn't filed until Wednesday with the fiscal year more than half over.

About 165 Nevadans now benefit from the waiver that lets them earn between $500 and $1,500 a month without being cut off from Medicaid benefits that help them avoid institutions or other highly restrictive living arrangements.

The plan endorsed by Nevada lawmakers before they adjourned last May was to extend that benefit to another 30 disabled people this year and another 30 in the coming fiscal year.

Just over $1 million in state funds was authorized to help cover costs of changes in the physically disabled waiver program, a small part of a $500 million-a-year Medicaid system run by the state.

Controversy over the waiver predates the 1999 legislative session: Lawmakers in 1997 had approved another type of waiver and had allotted $500,000 for it. But nothing was done and the money was reverted last year.

HRD and the state Department of Employment, Training and Rehabilitation had been charged with completing the earlier waiver application but didn't get the job done, lawmakers were told.

The Legislature also was told that Nevada spends less money than any other state to keep its residents out of nursing homes.

Researchers said Nevada ranked at or near the bottom in overall Medicaid money spent on alternatives to institutional care, long-term care spending and home and community-based services.