MINUTES OF MEETING

      ASSEMBLY COMMITTEE ON HEALTH AND HUMAN SERVICES

 

      Sixty-seventh Session

      January 28, 1993

 

 

 

The Assembly Committee on Health and Human Services was called to order by Chairman Jan Evans at 1:30 p.m., Thursday, January 28, 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:

 

      Ms. 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

      Ms. Gene W. Segerblom

      Ms. Stephanie Smith

      Mr. Louis A. Toomin

      Mr. Wendell P. Williams

 

 

COMMITTEE MEMBERS ABSENT:

 

      None

 

GUEST LEGISLATORS PRESENT:

 

      None

 

STAFF MEMBERS PRESENT:

 

      Kerry Carroll Davis, Research Analyst

 

OTHERS PRESENT:

 

      See attached attendance roster (EXHIBIT B).

 

 

Copies of Nevada's Health Profile report from the Center for Disease Control were distributed to the committee members.

 

Yvonne Sylva, Acting Administrator, Nevada State Health Division introduced Dr. Donald Kwalick, State Health Officer, who gave a presentation on the status of the state's health.  He reviewed the information contained in the Center of Disease Control report.  Ms. Sylva continued to give an overview of the services provided by the agency (EXHIBIT C) and passed out a packet of information for the committee's review (EXHIBIT D on file in the Research Library).

 

Mr. Toomin asked Dr. Kwalick what effect Nevada's 24-hour life style had on distorting the figures in relation to the rest of the United States.  Dr. Kwalick explained the figures presented were based on residents.  Individuals working in casinos where there was a high pollution rate of tobacco would be in an adverse position regarding their health.

 

Mrs. Smith asked if sleep deficit contributes to a high rate of accidents and ultimately to health problems.  Dr. Kwalick said if people were not sleeping then they were under stress of all kinds which would affect their health.

 

Mr. Petrak noted many seniors migrate to Nevada for health reasons and asked how these individuals were reflected in the statistics.  Dr. Kwalick explained statistics related to mortality were age adjusted.

 

Mrs. Segerblom asked if putting a tax on cigarettes would encourage people to quit smoking.  Dr. Kwalick said yes, this has been demonstrated in California where consumption has decreased.  This is especially effective with minors who do not have the money to buy cigarettes.

 

Dave Rice, Washoe County District Health Officer, passed out the department's annual report (EXHIBIT E on file in the Research Library).  Mr. Rice echoed the comments made by Dr. Kwalick in regard to the Nevada Health Profile and the American Public Health Association Reportcard.  Mr. Rice indicated a community process called Planned Approach to Community Health (PATCH) was in the process of developing a Washoe County health profile which would be made available to the committee.  PATCH was a partnership between the Washoe County District Health Department, Center for Disease Control, and the State Health Division.  Mr. Rice indicated there was a shift from diagnosis and treatment of health problems to prediction and management of high risk cases.  He told the committee the primary concerns of the District Health Department were health aid to counties, continuation of the WIC program, consumer health, water and air quality, solid and liquid waste, and prenatal care.

 

Cherie Louvat, Director, Food Bank of Northern Nevada, summarized the goals and objectives of the program.  The Food Bank is a non-profit, privately funded organization whose mission is to ensure adequate nutrition.  The organization served as a support system for 70 agencies statewide.  There were 74,000 children in Nevada who were hungry or at risk of hunger.  To address this issue a campaign to end childhood hunger was initiated in conjunction with federal, state, and county programs.  The organization submitted a bill draft supporting the emergency food network.

 

Mrs. Segerblom asked if the Food Bank was completely funded by donations.  Ms. Louvat indicated operating expenses came from contributions and federal grants.

 

Dr. John Beeston, M.D., spoke to the committee on behalf of the American Association of Retired Persons regarding the delivery of health care (EXHIBIT F).

 

Ms. Augustine commented specialization was necessary for the future of medicine in the United States and she believed there was a federal mandate whereby individuals could continue their health insurance after they changed jobs.  Dr. Beeston indicated individuals could maintain their insurance for 18 months which is limited and not available to everyone.  Also, specialization was needed for high quality care but there were far too many specialists.  More primary care physicians were needed.

 

Mr. Petrak asked why so many unnecessary tests were performed in emergency rooms.  Dr. Beeston replied hospitals need to protect themselves against liability and to try to get an exact diagnosis.

 

Rick Pugh, Nevada Aids Foundation, discussed the work of his organization (EXHIBIT G).  Natalie Selva, NAF Board Member, indicated aids was still considered a "gay" disease but in fact impacted all members of society.  Women and children were the fastest rising group of affected.  Education was the biggest weapon in the fight against aids.

 

Mrs. Segerblom asked if Ms. Selva had been able to take an aids  program into the public schools.  Ms. Selva indicated she had been requested by the State Department of Education to do programs in the rural counties.

 

 

Dr. Victor Knutzen, Vice-Chairman, Maternal and Child Health Advisory Board, hightlighted the activities of the Board (EXHIBIT H) and discussed the recommendations made in the Board's annual report to the governor (EXHIBIT I).

 

Donna Turner, Regional Director, American Lung Association of Nevada, discussed respiratory health issues.  She noted the rapid rise in tuberculosis with 27,000 new cases of TB being reported in the U.S. last year.  Ms. Turner distributed a copy of the association's TB guide for communities and states to control the epidemic.  The Lung Association is working along with the State Health Division and the county health departments to form a statewide coalition.  Ms. Turner pointed out air quality was a contributing factor to lung disease.

 

Ms. Smith commented on her experience with TB, it could become epidemic in which case the disease would be resistant to drugs.

 

Phil Gillette, Chairman, Plan Development Committee, State Health Coordinating Council, gave a brief overview of the planning process and discussed the contents of the State Health Plan (EXHIBIT J).

 

Jerry Ash, President, Nevada Hospital Association, distributed  a copy of his remarks regarding healthcare cost containment to the committee (EXHIBIT K).

 

Shelia Leslie, Executive Director, The Children's Cabinet, announced the services of a comprehensive adolescent health care program in Washoe County (EXHIBIT L).

 

Mrs. Segerblom asked if there was a comparable program in Clark County.  Ms. Leslie said there was a tremendous need in Clark County and the Family Cabinet in Southern Nevada was investigating the program.

 

There being no further business to come before committee, the meeting was adjourned at 3:30 p.m.

 

      RESPECTFULLY SUBMITTED:

 

 

                              

      CONNIE CAMPBELL

      Committee Secretary

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Assembly Committee on Health and Human Services

January 28, 1993

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