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Nevada PASRR Level II Program and
Promising Practices
Dave Caloiaro, MSW, LISW
Chief, Administrative Programs, Planning and Quality
Nevada Division of Public and
Behavioral Health (DPBH)
General DPBH Overview:
Mental Health (MH) Services
 Statutorily, DPBH is the State Mental
Health Authority (SMHA) in Nevada.
 In FY 2012, DPBH provided mental
health services to 16,758 Nevadans.
 DPBH offers a full range of mental
health services through four
statewide agencies, including, but not
limited to, inpatient hospitalization,
outpatient therapy, medication clinic,
case management, psychosocial
rehabilitation, residential programs
and program for assertive community
treatment (PACT).
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General DPBH Overview:
Alcohol and Substance Abuse
Services
 Substance Abuse
Prevention and Treatment
Agency (SAPTA) is the is
the AOD authority in
Nevada
 SAPTA provides alcohol
and other drugs prevention
and treatment services
through community
providers).
 IN FY 2012 SAPTA
contracted service providers
provided treatment services
to 10,522 Nevadans.
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PASRR Level II Program
Nevada contracts the PASRR Level I and Level II
program processes to Hewlett Packard Enterprise
Services (HPES). They do the client evaluation
and make the nursing facility placement
Specialized Services recommendations.
Nevada PASRR Level II
Evaluation
 A comprehensive face-to-face evaluation is
conducted by an LCSW
 Evaluation utilizes a 13-page evaluation form
that includes level of support needed for ADLs
and medical needs, identifies whether the
needs can be met in an alternative community
setting and includes recommendations for
specialized services.
Nevada PASRR Level II
Evaluation (cont)
 Documentation includes H&P,
psychiatric/psychological evaluation, psychosocial
assessment, progress notes, and, in addition to
talking with the patient, the evaluator may also
interview the caregiver, family legal guardian or
facility staff.
 All evaluations are reviewed by a HPES
psychiatrist or psychologist, who determines level
of service provided by a NF and is NF placement
is needed, the specialized services is needed for
the management of the client.
PASRR Level II Resident and
Specialized Services Coordination
 The Nevada Division of Public and Behavioral
Health assigns a regional PASRR Coordinator to
NF residents screened as PASRR II-B, to ensure
the client receives the provision of Specialized
Services they require.
 There are Mental Health PASRR Coordinators in
three locations of the state – north, south and rural.
PASRR II-B Resident and Specialized
Services Coordination (cont)
The DPBH Regional PASRR Coordinator:
 Performs quarterly onsite reviews of the PASRR II-B
client at the nursing facility (out-of-state performs
medical record reviews), to assure PASRR clients are
receiving the provision of Specialized services they
require.
 Whenever possible, serves as a member on the client’s
multi-discipline Treatment/Care Plan team.
 Assists acute care hospital discharge planners with
finding alternatives to nursing facility placement, if
requested.
Nevada PASRR II-B
Specialized Services
For Persons with Mental Illness
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Psychotropic Medications
Psychiatrist Follow-up Services
Psychotherapy
Psychiatric or Psychological Evaluation
Transitioning Services, to assist in moving to a less
restrictive environment
 Monitoring and Advocacy
DPBH Bi-Annual PASRR Level II
Program Compliance Reviews
 DPBH conducts a comprehensive PASRR Program
Compliance Review on a bi-annual basis, in three parts:
1) Desk review of the PASRR QIO-like contractor/vendor,
shared jointly by Medicaid and DPBH, of randomly selected
PASRR Level II case determinations (and accompanying
medical records),
2) Onsite review of PASRR II-B residents who require
Specialized Services, in a number of Nevada and out-of-state
nursing facilities; and
3) Performance review of each of DPBH’s three regional
PASRR coordinators.
DPBH’ Continuing Commitments
with the Nevada PASRR Program
 Continuing the close working relationship
and partnership with Nevada Medicaid.
 Maintaining the Nevada Statewide Nevada
PASRR Committee, which meets quarterly,
and includes members from Medicaid, the
PASRR Vendor, DPBH’s three statewide
MH PASRR coordinators, and the Division
of Aging and Disability Services’ three
regional Intellectual Disability PASRR
Coordinators.
 When funding resources permit it, continuing
to provide education and training to nursing
facility staff with respect to Nevada PASRR
requirements, including documentation
requirements.
Contact Information:
Dave Caloiaro, MSW, LISW
Chief, Administrative Programs, Planning and Quality
Nevada Division of Public and Behavioral Health (DPBH)
(775) 684-5970
Email: [email protected]