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

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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 prov iding 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 Dep artment to support 7

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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 c are 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 ex isting 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 f unded 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

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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 o f 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

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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 identifi ed 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 limitatio n, 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 clinic al 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

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manner that addresses the critical shortages and unm et 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 fun ded 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 Pro gram 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

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(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 comprehensive cancer 12
center by the National Cancer Institute, or its successor 13
organization; 14
(b) Governmental entities; and 15
(c) Nonprofit organizations that provide direct care to patients, 16
training for providers of health care or services aimed at 17
expanding access to health care. 18
3. To be eligible for a grant from the Account, a proposed 19
project must: 20
(a) Be designed to increase the number of providers of health 21
care, improve the expertise of providers of health care or improve 22
access to clinical services or innovative treatments. 23
(b) Directly address one or more certified areas of need. 24
(c) Include specific, measurable outcomes to demonstrate an 25
increase in the number of providers of health care, improved 26
access to health care and the enhanced capacity of the health care 27
work force in a manner that addresses the certified area s of need 28
identified in paragraph (b). 29
(d) Secure from the Federal Government or any other source , 30
or receive from the Federal Government or any other source a 31
commitment to provide, an amount of matching funds and in-kind 32
contributions for which the tota l value is at least equal to the 33
amount of the grant for which the applicant is applying. Matching 34
funds from the Federal Government meet the requirements of this 35
section only if the applicant demonstrates that the project qualifies 36
for and is likely to re ceive such federal money. In -kind 37
contributions may consist of, without limitation: 38
(1) Construction or procurement of machinery or 39
infrastructure; 40
(2) Recruitment of providers of health care; 41
(3) The provision of free health care; 42
(4) Charitable c ontributions after the completion of the 43
project; and 44
(5) Unfunded research. 45

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(e) Demonstrate the potential for financial and operational 1
sustainability after the expiration of the grant, including, without 2
limitation, through: 3
(1) Plans for continued staffing, budget sustainability and 4
continued allocation of resources; and 5
(2) An impact assessment concerning the potential long -6
term effects of the project on survival, quality of life and the 7
experience of patients. 8
Sec. 11. An entity described in subsection 2 of section 10 of 9
this act that wishes to receive a grant from the Account to support 10
a project described in subsection 3 of section 10 of this act must 11
apply to the Department in the form prescribed by the Department 12
during an open application period established by the Department. 13
The application must include, without limitation: 14
1. A comprehensive proposal for the project to be funded by 15
the grant that outlines: 16
(a) The goals and objectives of the proposed project; 17
(b) The specific certified areas of need that the proposed 18
project will address; and 19
(c) Detailed plans to recruit, retain or train providers of health 20
care. 21
2. A detailed budget that clearly sets forth the projected costs 22
and sources of funding for the proposed project and the manner in 23
which that funding will be used to pay those projected costs. Such 24
sources of funding must include, without limitation, the matching 25
funds and in -kind contributions described in paragraph (d) of 26
subsection 3 of section 10 of this act, where applicable. 27
3. Evidence of approval or commitment from the persons and 28
entities that will provide the matching funds or in -kind 29
contributions described in paragraph (d) of subsection 3 of section 30
10 of this act or otherwise contribute to or collaborate on the 31
project. 32
4. Documentation of the qualifications and relevant 33
experience of the applicant, including, without limitation: 34
(a) A demonstrated a bility to produce measurable, long -term 35
improvements in rates of survival, quality of life and the 36
experience of patients; and 37
(b) The experience and organizational capacity necessary to 38
implement and sustain the project successfully. 39
5. Identification of the key personnel who will be involved in 40
the project and any relevant partnerships with persons and entities 41
engaged in the provision of health care, educational institutions, 42
governmental entities or other persons and entities. 43
6. A timeline for imp lementing the proposed project that 44
includes, without limitation, defined milestones, measurable 45

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performance indicators and a plan for reporting progress and 1
evaluating outcomes at regular intervals. 2
7. A detailed operational plan for the proposed project that: 3
(a) Outlines staffing, facilities, equipment and other logistical 4
requirements; and 5
(b) Addresses potential challenges in recruiting and retaining 6
providers of health care. 7
8. A plan for sustainability that addresses the manner in 8
which the proposed project will continue to provide benefits after 9
the expiration of the grant, including, without limitation, possible 10
sources of funding, partnerships or strategies for reinvestment. 11
9. Any additional information required by regulation of the 12
Department for: 13
(a) Assessing the feasibility, impact and sustainability of 14
projects and the alignment of projects with the objectives set forth 15
in subsection 3 of section 10 of this act; or 16
(b) Ensuring accountability and preventing the misuse of 17
funds. 18
Sec. 12. 1. The Department shall review applications 19
submitted pursuant to section 11 of this act to determine which 20
applicants will be recommended to receive funding pursuant to 21
section 13 of this act. 22
2. In reviewing app lications and determining which 23
applicants to recommend for funding, the Department shall: 24
(a) Give first priority for recommendation to projects that will 25
most effectively address unmet needs; 26
(b) Give secondary priority for recommendation to projects 27
that will provide the greatest benefit in certified areas of need; 28
(c) Give tertiary priority for recommendation to projects that 29
will be located in: 30
(1) Areas designated by the Health Resources and Services 31
Administration of the United States Departme nt of Health and 32
Human Services as having a shortage of providers of health care , 33
including, without limitation: 34
(I) Areas designated as medically underserved areas or 35
health professional shortage areas with high scores; 36
(II) Areas designated as health professional shortage 37
areas for primary care; and 38
(III) Areas with populations that have been designated 39
as medically underserved populations; or 40
(2) Geographic areas where at least 30 percent of the 41
population is enrolled in Medicaid, as determ ined by the 42
Department or the Centers for Medicare and Medicaid Services of 43
the United States Department of Health and Human Services; and 44

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(d) To the extent practicable, make recommendations to fund 1
projects in different geographic areas of this State. 2
3. The Department shall consider the following criteria when 3
reviewing applications pursuant to subsection 1: 4
(a) The severity and urgency of the shortage of providers of 5
health care in the certified areas of need targeted by the proposed 6
project; 7
(b) The potential of the proposed project to produce 8
measurable, long-term improvements in rates of survival, quality 9
of life and the experience of patients, including, without 10
limitation, by causing high levels of improvement for underserved 11
populations; 12
(c) The potential of the proposed project to create lasting 13
improvement in accessibility to health care and the availability of 14
providers of health care in the community affected by the proposed 15
project, including, without limitation, by meeting specific metri cs 16
for improvements to access to health care, health care outcomes 17
and the capacity of the health care workforce; 18
(d) The extent of the proposed investment in and establishment 19
of capital infrastructure to address certified areas of need over the 20
long ter m and support sustainable access to health care, 21
including, without limitation: 22
(1) The construction of medical facilities and other health 23
care facilities; 24
(2) The acquisition of medical equipment or equipment 25
related to the advancement of medical research; 26
(3) The expansion of capabilities for delivering services 27
through precision medicine, early -phase clinical trials and 28
telehealth; and 29
(4) The development of facilities for residencies or other 30
training of providers of health care; 31
(e) The level of financial commitment from sources other than 32
the State, including, without limitation, the degree to which the 33
matching funds and in -kind contributions exceed the amount 34
required by paragraph (d) of subsection 3 of section 10 of this act; 35
(f) The level of collaboration between the applicant and other 36
entities in the public and private sectors to enhance the overall 37
impact of the project; 38
(g) The qualifications and organizational capacity of the 39
applicant to effectively implement and sustain the propo sed 40
project, including, without limitation, a demonstrated ability to 41
manage similar projects, meet projections concerning outcomes 42
and maintain compliance with the requirements of sections 2 to 43
18, inclusive, of this act and any regulations adopted pursua nt 44
thereto; and 45

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(h) The degree to which the proposed project will strategically 1
use technology or innovative models of delivering health care in a 2
manner that may reduce costs, improve outcomes and expand 3
access to underserved populations. 4
4. As used in this section, “telehealth” has the meaning 5
ascribed to it in NRS 629.515. 6
Sec. 13. 1. After reviewing applications pursuant to section 7
12 of this act, the Department shall submit to the Interim Finance 8
Committee recommendations for the awarding of grants from the 9
Account for the approval of the Committee. 10
2. When making recommendations pursuant to subsection 1, 11
the Department: 12
(a) Shall ensure that all applicants for grants from the 13
Account meet the requirements of section 10 of this act; 14
(b) May recommend funding one or more proposed projects, 15
within the limits of money in the Account; 16
(c) Shall, to the extent that qualified applicants are available, 17
recommend awarding all of the money in the Account for a fiscal 18
year as grants; and 19
(d) May not recommend awarding a total amount of money 20
during any funding period that exceeds the amount available in 21
the Account for that funding period. 22
3. The Department shall maintain a public record of all 23
decisions to recommend the award of funding to an entity that 24
submits an application pursuant to section 11 of this act or to 25
refuse to make such a recommendation. 26
4. Upon receiving approval of a recommendation from the 27
Interim Finance Committee pursuant to subsection 1, the 28
Department shall issue a written notice of the approval to 29
the applicant to whom the recommendation pertains. Such written 30
notice must include, without limitation: 31
(a) The total amount of money being awarded; and 32
(b) The schedule of disbursements and specific conditions that 33
will be included in the applicable funding agreement. 34
Sec. 14. 1. Not later than 30 days after the Interim Finance 35
Committee approves a grantee to receive funding pursuant to 36
section 13 of this act, the Department shall enter into a funding 37
agreement with the grantee. Such a funding agreement must 38
outline the terms and conditions of the gra nt and the 39
responsibilities of the grantee in a manner that ensures that the 40
grantee satisfies the requirements and objectives specified in 41
subsection 3 of section 10 of this act. 42
2. A funding agreement entered into pursuant to subsection 1 43
must: 44

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(a) Provide for the disbursement of the grant in installments 1
that are contingent on the achievement of specific milestones, 2
goals and indicators of performance relating to increases in the 3
number of providers of health care, improved access to health care 4
and improvements to infrastructure; 5
(b) Require the grantee to submit documentation that the 6
grantee has achieved the milestones, goals and indicators of 7
performance prescribed in the agreement pursuant to paragraph 8
(a) before money may be disbursed, including, without limitation: 9
(1) Financial reports detailing expenditures of money and 10
allocations of matching funds; 11
(2) Operational progress reports that demonstrate 12
measurable achievements in recruiting providers of health care, 13
improving health care infrastructure or expanding the availability 14
of health care or clinical services; and 15
(3) Any additional information required by the Department 16
for the purposes specified in this paragraph; 17
(c) Require the grantee to submit to the Department an annual 18
report that includes, without limitation, details regarding the 19
financial status of the project, efforts to recruit providers of health 20
care and the impact of the project; 21
(d) Require the grantee to comply with any request made by 22
the Department or the Office of Finance in accordance with 23
section 16 of this act; 24
(e) Specify the date on which the portion of the project funded 25
by the grant is scheduled to terminate; and 26
(f) Require the grantee to meet any additional conditions 27
imposed by the Department to ensur e accountability, the 28
achievement of the objectives of the project and the sustainability 29
of the project. 30
3. A funding agreement entered into pursuant to subsection 1 31
may require that the matching funds be: 32
(a) Held in escrow by an independent third par ty before the 33
disbursement of money from the Account; 34
(b) Secured through an irrevocable trust, letter of credit or 35
surety bond; or 36
(c) Verified through financial reporting to confirm the 37
availability and appropriate use of the matching funds. 38
4. A funding agreement entered into pursuant to subsection 1 39
may require that the matching funds and in -kind contributions be 40
subject to an independent verification process that may include, 41
without limitation: 42
(a) Certification by a certified public accountant o r other 43
qualified third party; 44

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(b) Submission of documentation demonstrating the value and 1
availability of matching funds or in -kind contributions, including, 2
without limitation: 3
(1) Financial statements; 4
(2) Governance documents; 5
(3) Appraisals or market valuations of in -kind 6
contributions; and 7
(4) Documentation of cost basis or fair market value, as 8
appropriate; 9
(c) Periodic reports concerning the valuation of in -kind 10
contributions that are aligned with the disbursement schedule 11
established pursuant to paragraph (a) of subsection 2; and 12
(d) Adherence to generally accepted accounting principles for 13
the valuation of in-kind contributions. 14
Sec. 15. 1. If a grantee significantly modifies a project that 15
has received funding pursuant to sections 2 to 18, inclusive, of this 16
act, or if there are changes in the availability of funding for such a 17
project, the grantee shall immediately notify the Department and 18
submit to the Department a revised plan for the project. Upon 19
receiving such notification, the Depa rtment may, to ensure that 20
money from the Account is used efficiently and effectively in a 21
manner that complies with section 10 of this act, adjust the terms 22
of the funding agreement, including, without limitation, the terms 23
for disbursement and the amount of funding, or suspend or 24
terminate the funding agreement. 25
2. If a grantee terminates a project that has received funding 26
pursuant to sections 2 to 18, inclusive, of this act, before the date 27
of termination specified in the applicable funding agreement or if 28
such a project remains inactive for 12 consecutive months, the 29
grantee shall: 30
(a) Notify the Department; and 31
(b) Submit to the Department a revised plan for the project. 32
3. Upon receiving notice pursuant to subsection 2 of the early 33
termination or inactivity of a project, the Department may: 34
(a) Place a lien or other security interest on assets related to 35
the project until at least half of the goals and indicators of 36
performance included in the applicable funding agreement are 37
met; 38
(b) Reallocate unspent money to other approved projects or 39
deposit unspent money in the Account to support grants for other 40
projects pursuant to sections 2 to 18, inclusive, of this act; 41
(c) Require the grantee to take corrective action within 60 42
days; 43
(d) Suspend or terminate the grant; 44

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(e) Require the grantee to repay money previously disbursed; 1
or 2
(f) Take any combination of the actions described in 3
paragraphs (a) to (e), inclusive. 4
4. Not later than 60 days after the early termination of a 5
project for which a grantee received a grant pursuant to sections 2 6
to 18, inclusive, of this act, a grantee shall submit to the 7
Department a report which includes, without limitation: 8
(a) The total amount of money spent on the project; 9
(b) The amount of money disbursed from the Account that was 10
spent on the project; 11
(c) The reasons for the early termination of the project; and 12
(d) A proposed plan to repay money disbursed from the 13
Account, if required by the Department. 14
Sec. 16. 1. The Department shall conduct site visits, audits 15
or reviews at least annually to ensure that a project funded 16
pursuant to sections 2 to 18, inclusive, of this act comply with the 17
requirements of those sections and the applicable funding 18
agreement. 19
2. The Offic e of Finance may audit any project funded 20
pursuant to sections 2 to 18, inclusive, of this act to ensure that the 21
grantee is using the money awarded pursuant to 2 to 18, inclusive, 22
of this act in an effective and efficient manner that accords with 23
state and federal law and the applicable funding agreement. 24
Sec. 17. If the Department concludes, as the result of a site 25
visit, audit or review pursuant to section 16 of this act or for any 26
other reason, that a grantee who has rec eived funding pursuant to 27
sections 2 to 18, inclusive, of this act has failed to: 28
1. Comply with the terms of a funding agreement, including, 29
without limitation, by failing to achieve the milestones, goals and 30
indicators of performance prescribed in the agreement pursuant to 31
paragraph (a) of subsection 2 of section 14 of this act, the 32
Department may: 33
(a) Suspend or terminate the grant; 34
(b) Require the grantee to take corrective action within 60 35
days; 36
(c) Require the grantee to repay money that was previously 37
disbursed to the grantee; 38
(d) Reallocate unspent money to other approved projects or 39
deposit unspent money in the Account to support grants for other 40
projects pursuant to sections 2 to 18, inclusive, of this act; 41
(e) Take such other measures as are necessary to ensure 42
compliance with the provisions of sections 2 to 18, inclusive, of 43
this act, the regulations adopted pursuant thereto, other state and 44
federal law and the applicable funding agreement; or 45

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(f) Take any combination of the actions described in 1
paragraphs (a) to (e), inclusive. 2
2. Comply with any provision of sections 2 to 18, inclusive, of 3
this act, any regulation adopted pursuant thereto or any other 4
state or federal law, or has misused funds or submitted fraudulent 5
information to the Department, the Department: 6
(a) Shall suspend or terminate the grant; 7
(b) May refer the matter to a district attorney who has 8
jurisdiction over the matter or the Attorney General, where 9
appropriate; and 10
(c) May additionally take any other action or combination of 11
actions described in subsection 1. 12
Sec. 18. Upon completing a project for which a grantee 13
received a grant pursuant to sections 2 to 18, inclusive, of this act, 14
and again 10 years after the completion of such a project, the 15
grantee shall submit to the Department a report that includes, 16
without limitation: 17
1. A summary of the achievements of the project relative to 18
the initial goals of the project, focusing on improvements in access 19
to health care or clinical services and the capacity of the he alth 20
care workforce in the area affected by the project; 21
2. Financial accounting of all money received for the project 22
pursuant to sections 2 to 18, inclusive, of this act and from other 23
sources, including, without limitation, matching funds and an 24
itemized statement of expenditures of such money; 25
3. A narrative evaluation of the impact of the project on the 26
community affected by the project, including, without limitation, 27
benefits realized, challenges encountered and lessons learned for 28
future projects; 29
4. Any relevant data on patient outcomes, measurements of 30
community health or the retention and expansion of the health 31
care workforce attributable to the project; and 32
5. Feedback or testimonials concerning the project from 33
beneficiaries, partners and other affected persons and entities. 34
Sec. 19. NRS 218E.405 is hereby amended to read as follows: 35
218E.405 1. Except as otherwise provided in subsection 2, 36
the Interim Finance Committee may exercise the powers conferred 37
upon it by law only when the Legislature is not in a regular or 38
special session. 39
2. During a regular or special session, the Interim Finance 40
Committee may also perform the duties imposed on it by NRS 41
228.1111, subsection 5 of NRS 284.115, NRS 285.070, subsection 2 42
of NRS 321.335, NRS 322.007, subsection 2 of NRS 323.020, 43
NRS 323.050, sub section 1 of NRS 323.100, subsection 3 of NRS 44
341.126, NRS 341.142, paragraph (f) of subsection 1 of 45

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NRS 341.145, subsection 3 of NRS 349.073, NRS 353.220, 1
353.224, 353.2705 to 353.2771, inclusive, 353.288, 353.335, 2
353.3375, 353C.224, 353C.226, paragraph (b) of subsection 4 of 3
NRS 407.0762, NRS 428.375, 433.732, 439.4905, 439.620, 4
439.630, 445B.830, subsection 1 of NRS 445C.320 and NRS 5
538.650 [.] and sections 8 and 13 of this act. In performing those 6
duties, the Senate Standing Committee on Finance and th e 7
Assembly Standing Committee on Ways and Means may meet 8
separately and transmit the results of their respective votes to the 9
Chair of the Interim Finance Committee to determine the action of 10
the Interim Finance Committee as a whole. 11
3. The Chair of the Interim Finance Committee may appoint a 12
subcommittee consisting of six members of the Committee to 13
review and make recommendations to the Committee on matters of 14
the State Public Works Division of the Department of 15
Administration that require prior approva l of the Interim Finance 16
Committee pursuant to subsection 3 of NRS 341.126, NRS 341.142 17
and paragraph (f) of subsection 1 of NRS 341.145. If the Chair 18
appoints such a subcommittee: 19
(a) The Chair shall designate one of the members of the 20
subcommittee to serve as the chair of the subcommittee; 21
(b) The subcommittee shall meet throughout the year at the 22
times and places specified by the call of the chair of the 23
subcommittee; and 24
(c) The Director or the Director’s designee shall act as the 25
nonvoting recording secretary of the subcommittee. 26
Sec. 20. (Deleted by amendment.) 27
Sec. 21. (Deleted by amendment.) 28
Sec. 21.2. There is hereby appropriated from the State General 29
Fund to the Statewide Health Care Access and Recruitment Program 30
Account created in the State General Fund by section 8 of this act 31
the sum of $10 ,000,000 for the purposes described in subsections 3 32
and 4 of section 8 of this act. 33
Sec. 21.5. In lieu of conducting the assessment described in 34
paragraph (a) of subsection 1 of section 9 of this act on or before 35
July 1, 2026, the Department of Health and Human Services shall: 36
1. Review existing assessments of the health care needs of this 37
State that, to the extent available, carry out the purposes described in 38
subsection 2 of section 9 of this act; and 39
2. Utilize the assessments described in subsection 1 to: 40
(a) Create the summary described in paragraph (a) of subsection 41
3 of section 9 of this act; and 42
(b) Make the recommendations described in paragraphs (b) and 43
(c) of subsection 3 of section 9 of this act. 44

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Sec. 22. The provisions of subsection 1 of NRS 218D.380 do 1
not apply to any provision of this act which adds or revises a 2
requirement to submit a report to the Legislature. 3
Sec. 23. 1. This section becomes effective upon passage and 4
approval. 5
2. Sections 1 to 21, inclusive, 21.5 and 22 of this act become 6
effective on July 1, 2025. 7
3. Section 21.2 of this act becomes effective on July 1, 2026. 8

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