MINUTES OF MEETING

      ASSEMBLY COMMITTEE ON HEALTH AND HUMAN SERVICES

 

      Sixty-seventh Session

      March 23, 1993

 

 

 

The Assembly Committee on Health and Human Services was called to order by Chairman Jan Evans at 1:20 p.m., Tuesday, March 23, 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 A. Toomin

     

 

COMMITTEE MEMBERS ABSENT:

     

      Mr. Wendell P. Williams

     

GUEST LEGISLATORS PRESENT:

 

      Senator Diana Glomb

 

STAFF MEMBERS PRESENT:

 

      Kerry Carroll Davis, Research Analyst

 

OTHERS PRESENT:

 

      John Sarb, Division of Child and Family Services; Jon Sasser, Nevada Legal Services; Dr. Kwalick, Health Division; Lisa Fitzsimmons and Janice Pine, Saint Mary's Regional Medical Center; David Howard, Reno/Sparks Chamber of Commerce; Debbie Cahill, Nevada State Education Association; Kim Mason, Nevada Dietetic Association; Phillipe Bishop, medical student; and Jim Wadhams, Nevada Hospital Association.

 

 

Mrs. Evans opened the hearing on Senate Bill 81.

 

SENATE BILL 81 -  Provides for establishment of fees for child and family services.

 

Senator Diana Glomb, Washoe District 1, testified in support of SB 81 and briefly reviewed the history of the bill (EXHIBIT C).

 

John Sarb, Administrator, Division of Child and Family Services, addressed the committee.  Mr. Sarb discussed the services provided by the division, associated fees and the need to establish a sliding-scale fee schedule.

 

Mrs. Smith asked for an example of what fees would be charged.  Mr. Sarb indicated there was no charge for a special-needs child, the maximum for an adoption would be $2,500 and a fee not higher than the cost of care for out-patient counseling.  The division is currently using the fee structure developed by MH/MR. 

 

Mrs. Segerblom asked if there were many children with special needs which were not adopted.  Mr. Sarb said it was always a problem to find parents for special-needs children, however some adoptions could be subsidized.

 

Mr. Toomin asked what kind of revenue would be generated by the fee structure.  Mr. Sarb indicated it would be approximately the same as in other divisions. 

 

Ms. Augustine noted she had a problem with charging fees for adoption services and asked for a definition of "special needs."  Mr. Sarb agreed to provide more specific information to the committee.

 

Mr. Gibbons asked if the approximate cost for adoption services had been established.  Mr. Sarb believed it was $5,000 but a more accurate figure would have to be calculated.  Discussion ensued regarding section 1, subsection 2 of the bill.

 

Mrs. Evans inquired if there were private non-profit agencies which provided adoptions and what fees were charged.  Mr. Sarb noted private adoptions were not permitted in Nevada.  The four agencies which provided adoption services were the Division of Child and Family Services, LDS Social Services, Jewish Family Services, and Catholic Family Services.  The maximum fee they could charge was $7,500.

 

Mrs. Evans closed the hearing on SB 81.

 

Jon Sasser, Nevada Legal Services, presented proposed amendments to Assembly Bill 276 (EXHIBIT D).

 

ASSEMBLY BILL 276 -     Revises provisions of state plan relating to aid to dependent children.

 

Mrs. Evans asked how the fiscal note would change with the proposed amendments.  Mr. Sasser indicated the state was in the process of recalculating the figures.

 

Mr. Gibbons asked if the proposed amendments took into consideration unearned income such as grants and loans.  Mr. Sasser explained the bill was limited to earnings and he did not know if a business loan would be considered earned or unearned income.

 

Mrs. Augustine asked for clarification of the projected costs.

 

Mrs. Evans indicated the amendments would be reviewed before any action was taken by the committee.

 

Mrs. Evans opened the hearing on Assembly Concurrent Resolution 20.

 

ASSEMBLY CONCURRENT RESOLUTION 20 -      Encourages employers to establish programs to promote employee wellness, physical fitness and prevention of disease and accidents.

 

Mrs. Freeman explained this resolution came from the standing committee on health care.

 

Dr. Kwalick, State Health Officer, testified in support of ACR 20 (EXHIBIT E).

 

Mrs. Segerblom asked whether most businesses were already engaged in this type of program.  Dr. Kwalick responded more and more businesses were becoming involved, however many were not.

 

Mrs. Evans passed out a packet of information submitted by the YMCA of Southern Nevada regarding a corporate wellness program (EXHIBIT F is on file in the Research Library).

 

Lisa Fitzsimmons, Saint Mary's Health Promotion Center, testified in support of ACR 20.  A copy of her remarks was submitted as EXHIBIT G.

 

David Howard, spoke in support of ACR 20 on behalf of the Reno/Sparks Chamber of Commerce.  Mr. Howard noted there was no better way to contain the cost of health care than wellness.

 

Debbie Cahill indicated the Nevada State Education Association supported ACR 20.

 

Kim Mason, Nevada Dietetic Association, testified in favor of ACR 20 (EXHIBIT H).

 

Phillipe Bishop, Medical Student, testified in support of ACR 20.  Mr. Bishop noted individual health care was complicated by Nevada's lifestyle.  This resolution would be instrumental in promoting the well-being of individuals.

 

Jim Wadhams, Nevada Hospital Association, spoke in support of ACR 20 and commented with regard to fewer health care dollars being spent by people who took care of themselves.

 

Mr. Petrak observed senior citizens had been taking advantage of various exercise programs and would like to see more participation by younger individuals.  The hospitals should set an example for others to follow.  Mr. Wadhams agreed.

 

Mrs. Freeman asked if St. Mary's Hospital could provide any figures regarding the effectiveness of their wellness program.  Lisa Fitzsimmons indicated they had statistics on employees who participated in various screening programs.  Some employers implemented mandatory screening programs and have seen dramatic results.  Mrs. Freeman inquired if similar programs were being offered in Southern Nevada.  Ms. Fitzsimmons said she has not been able to find a similar screening program in Las Vegas.  Mrs. Segerblom noted Boulder City had a program available to seniors.

 

      ASSEMBLYMAN HELLER MOVED TO ADOPT ACR 20.

 

      ASSEMBLYMAN PETRAK SECONDED THE MOTION.

 

      MOTION CARRIED UNANIMOUSLY.

 

Mrs. Evans called attention to a proposed amendment to Assembly Joint Resolution 17 (EXHIBIT I).

 

ASSEMBLY JOINT RESOLUTION 17 -      Urges Congress to enact legislation allowing states greater flexibility in carrying out coordinated programs of health care.

 

      ASSEMBLYMAN SEGERBLOM MOVED TO AMEND AJR 17.

 

      ASSEMBLYMAN DE BRAGA SECONDED THE MOTION.

 

      MOTION CARRIED UNANIMOUSLY.

 

      * * * * * * * * * * * * * * *

 

      ASSEMBLYMAN SMITH MOVED TO AMEND AND DO PASS AJR 17.

 

      ASSEMBLYMAN SEGERBLOM SECONDED THE MOTION.

 

      MOTION CARRIED UNANIMOUSLY.

 

      * * * * * * * * * * * * * * *

 

      ASSEMBLYMAN GIBBONS MOVED THE COMMITTEE APPROVE THE MINUTES OF JANUARY 19, 1993 THROUGH MARCH 9, 1993.

 

      ASSEMBLYMAN FREEMAN SECONDED THE MOTION.

 

      MOTION CARRIED UNANIMOUSLY.

 

 

There being no further business to come before committee, the meeting was adjourned at 2:25 p.m.

 

      RESPECTFULLY SUBMITTED:

 

 

                             

      CONNIE CAMPBELL

      Committee Secretary

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Assembly Committee on Health and Human Services

March 23, 1993

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