Commercial Services helps area businesses export products.

It's a one-man operation, with Andrew Edlefsen as its incoming director, international trade specialist and self-described salesman.

It's not necessary to go through the export office to ship goods out of the country, but the office does offer services (some with a price tag) to help companies establish connections in the selected destination and even determine where the best market for the product is, he told In Business.

"There are a lot of obstacles to navigate when exporting," Edlefsen said. "We want to help companies avoid pitfalls and achieve success exporting."

In 2007 Nevada exported $5.7 billion worldwide.

Switzerland, with its purchase of gold, accounted for $2.6 billion of exports made from the state. Canada, China, Japan and Mexico, consecutively, follow Switzerland.

The U.S. exported $1.2 trillion last year, according to the Commerce Department.

"A lot of companies are ready to start exporting, but they don't know how to," Edlefsen said. "If they have a good product, they should start exporting."

The export office also develops partnerships with companies to further assist businesses, including one with Los Angeles-based City National Bank, which acquired Business Bank of Nevada in 2007. Other partnerships include eBay, Google, FedEx and UPS.

"Export success is what we want to accomplish," he said.

The export office can be reached at 388-6694 or buyusa.gov/nevada.

Over the past several years, the Medicaid program has trimmed its beneficiaries' stays in long-term care facilities, adding more emphasis on home and community-based services, an AARP report shows.

The association, which released "A Balancing Act: State Long-Term Care Reform" this month, advocates on behalf of people age 50 and older.

Medicaid, unlike federally funded Medicare, is supported through a mix of federal and state money. It provides health insurance to low-income children, as well as adults and senior citizens with physical or mental disabilities.

In the study, which separates adults and senior citizens with physical disabilities from other long-term care users, it found that Nevada is slightly behind the curve in caring for adult and older Medicaid patients at home. Sixty-eight percent still receive institutional care in nursing homes. Nationwide, 75 percent of those patients receive their care in nursing homes.

At 85 percent of their revenue, Medicaid is the primary funding source of nursing homes.

Although more people are staying home for their long-term care treatment, there's been an increase of Medicaid spending from $92 million in 2001 to $150 million in 2006, the study shows.

Home-based care grew from $15 million in 2001 to $69 million in 2006.

The report says that three people can be cared for in their home at the same cost to Medicaid it takes to care for one person in a nursing home.

One in three Medicaid dollars pays for long-term care treatment, the report says.

Oregon tops the report's chart, with 55 percent of Medicaid expenditures directed toward home-based care in 2006. At the bottom was the District of Columbia, which spends 23 percent on the same, although five years ago, it was a meager 1 percent.

Following Oregon's lead are New Mexico, Alaska, Vermont and Wyoming. Nevada ranked 35th.

At the outset, the report based its study on people with physical disabilities desiring to live at home and receive care there.

In 2004, on any given day, 2,600 Medicaid patients were in a nursing home, an increase of 5 percent from 1999.