MINUTES OF MEETING
ASSEMBLY COMMITTEE ON HEALTH AND HUMAN SERVICES
Sixty-seventh Session
January 19, 1993
The Assembly Committee on Health and Human Services was called to order by Chairman Jan Evans at 1:15 p.m., Tuesday, January 19, 1993, in Room 330 of the Legislative Building, Carson City, Nevada. Exhibit A is the Meeting Agenda, Exhibit B is the Attendance Roster.
COMMITTEE MEMBERS PRESENT:
Mrs. Jan Evans, Chairman
Mrs. Vivian L. Freeman, Vice Chairman
Ms. Kathy M. Augustine
Ms. Marcia de Braga
Mr. James A. Gibbons
Mr. Dean A. Heller
Mr. William A. Petrak
Mrs. Gene W. Segerblom
Ms. Stephanie Smith
Mr. Louis M. Toomin
Mr. Wendell P. Williams
COMMITTEE MEMBERS ABSENT:
None
GUEST LEGISLATORS PRESENT:
None
STAFF MEMBERS PRESENT:
Kerry Carroll Davis, Research Analyst
OTHERS PRESENT:
See attendance roster (Exhibit B).
Mrs. Evans welcomed everyone to the first meeting of the Health and Human Services Committee and introduced the Vice-chairman, Research Analyst, and Secretary. A copy of the Standing Rules (Exhibit C) were distributed to each member of the committee for review and approval.
ASSEMBLYWOMAN FREEMAN MOVED TO ADOPT THE STANDING RULES.
ASSEMBLYMAN WILLIAMS SECONDED THE MOTION.
THE MOTION CARRIED UNANIMOUSLY.
Mrs. Evans discussed the distribution of the committee minutes, bill books, and other reference sources.
Mrs. Evans indicated that during the next few weeks the committee would be holding issue briefings to acquaint the members with the work of the Department of Human Services. Public input would be welcome. Reference materials handed out during the meetings would be compiled by staff for the convenience of the members.
Mary Liveratti, representing The Division of Aging Services, addressed the committee. An outline of her remarks (Exhibit D) was distributed to each member of the committee. The duties and functions of the Division's four units were reviewed and the key issues for the coming year were identified.
Ms. Augustine questioned the limited number of calls to the eldercare helpline. Ms. Liveratti indicated the Division had been unable to publicize the helpline due to staff constraints.
Mrs. Segerblom inquired about the investigation of the Henderson Nursing Home. Ms. Liveratti explained that the Health Division, Division for Aging Services and the Welfare Division were jointly involved in the investigation. Criminal charges were being investigated by the Medicaid Fraud Unit. The Division was currently involved in the movement of residents to another facility; however, some facilities in Las Vegas do not accept Medicaid patients.
Mr. Petrack asked what the budget cost would be for two additional ombudsmen. Ms. Liveratti stated that the cost would be approximately $50,000.
Harry Clemons discussed the American Association of Retired Persons 1993 legislative priorities. A pamphlet was distributed to the committee members (Exhibit E).
Marv Teixeira at the request of the Division of Aging Services gave the committee an overview of issues related to the State Commission on Aging.
Mrs. Freeman asked if the lack of access to physicians for seniors was related to Medicaid. Mr. Teixeira responded that seniors on Medicaid have been refused access to doctors.
Robert Hadfield, Executive Director, Nevada Association of Counties, discussed the effect on county government of the laws enacted by the legislature (Exhibit F).
Michael McMahon representing the Nevada Association of County Welfare Directors commented on public assistance programs in Nevada and called attention to the partnership existing between state and local governments. Mr. McMahon handed out an overview of health and human services for the public sector (Exhibit G).
Wendy Van Curen-Simons, Chairman, Older American's Advisory Council of Northern Nevada, spoke to the committee on behalf of the Division of Aging Services. She handed out a summary of her comments to the committee (Exhibit H).
Mrs. Freeman inquired about the licensure of providers of residential care. Ms. Van Curen-Simons reiterated what had happened during the last legislative session. Mrs. Freeman asked about the focus on the rural areas. Ms. Van Curen-Simons explained the difference between licensure and certification of facilities and operators.
Mary Ellen McCarthy, Attorney with Nevada Legal Services, gave an overview of benefits available to seniors in Nevada. She handed out a comparison of income eligibility requirements for various government benefits in Nevada for 1993 (Exhibit I). Ms. McCarthy indicated her concern regarding service delivery in the rural counties and consumer protection as it relates to medical coverage.
Ms. Augustine noted that a new position had been created to investigate the double billing of patient services. Ms. McCarthy indicated that she would like to see some statutory provisions which would penalize people engaged in certain practices.
Mrs. Freeman asked if the abuses were primarily in nursing homes or acute care facilities and Ms. McCarthy responded abuses occurred across the board. Patient money was supposed to be kept in a separate trust account and was not being released properly.
Mrs. Segerblom asked if an individual could keep his home and still receive Medicaid. Ms. McCarthy responded it was a myth that upon entering a nursing home the state would take away one's home. However, legislation would be introduced that would allow a claim against the estate of a Medicaid patient after death. This fear discouraged people from applying for needed care.
Steven Shaw, Administrator, Nevada Division of Rehabilitation, gave an overhead presentation. He indicated the division was comprised of the Bureau of Vocation Rehabilitation, Bureau of Alcohol and Drug Abuse, Bureau of Disability Adjudication, Bureau of Services to the Blind, and Office of Community Service Development and Developmental Disabilities. The work performed, clients served, delivery system, source of funds, and budget of each bureau was discussed (Exhibit J).
Mrs. Freeman asked what happened to the bill pertaining to the tax on beer. Mr. Shaw responded that he did not recall the specifics.
Ms. Augustine noted a discrepancy on the budget listed for the Bureau of Disability Adjudication--$3 million was listed on the handout and $4 million on the overhead. Mr. Shaw thought that the different figures reflected different budget cycles.
Mrs. Segerblom inquired as to how much of the $25 million budget was federally funded. Mr. Shaw replied about 70 percent.
John Butterworth, President of Nevada Technologies Inc., handed out a newsletter which highlighted the work being performed by the Lifetools Foundation (Exhibit K). NTI is a non-profit organization operated by disabled Nevadans in partnership with government and business. Mr. Butterworth also spoke in support of programs that fund personal care attendants for the disabled.
Mary and Ramo Paradiso addressed the committee on behalf of the Nevada Association for the Deaf. Their comments were interpreted by Diana Callahan. Mrs. Paradiso indicated that she had been working with the Department of Vocational Rehabilitation to establish a training workshop to test and evaluate certified interpreters. Because Nevada does not have a school for the deaf, deaf children are mainstreamed into public schools. Therefore, if teachers could learn sign language the students can learn quicker. Her organization would like to establish a team to certify and evaluate interpreters.
Mrs. Evans asked where someone would go to be able to learn to sign. Mrs. Paradiso replied many colleges have classes, however, in Las Vegas it would take another one to two years before someone could get a degree in sign language.
Ms. Smith asked about the difference in teaching sign language vs. lip reading. Mrs. Paradiso explained deaf children should learn to lip read and speak if possible, however, sign language is the primary form of deaf communication.
Mr. Petrak asked how many men, women and children in Nevada have a need for this service Mrs. Paradiso did not know, however, she felt that information should be disseminated to doctors so that these individuals could be identified.
Mike Goodwin representing Community Services Agency discussed the Personal Care Attendant Program stressing the cost effectiveness and the need for the program (Exhibit L). CSA receives funding through the Division of Rehabilitation to provide in-home care four hours a day for the elderly and people with disabilities. These clients are not eligible for the CHIP Program or Medicaid.
Lonnie James, Executive Director with United Cerebral Palsy, discussed the program for training individuals with severe disabilities who were unable to maintain permanent employment. He mentioned personal care attendant services were also provided to these clients as well as an Assistant Technology Program which provided low-income loans to people with disabilities. He urged the committee to provide funding and establish policies in support of these programs.
There being no further business to come before committee, the meeting was adjourned at 3:25 p.m.
RESPECTFULLY SUBMITTED:
CONNIE CAMPBELL
Committee Secretary
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Assembly Committee on Health and Human Services
January 19, 1993
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