MINUTES OF MEETING
ASSEMBLY COMMITTEE ON HEALTH AND HUMAN SERVICES
Sixty-seventh Session
April 1, 1993
The Assembly Committee on Health and Human Services was called to order by Chairman Jan Evans at 1:35 p.m., April 1, 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
Mr. Wendell P. Williams
COMMITTEE MEMBERS ABSENT:
None
GUEST LEGISLATORS PRESENT:
None
STAFF MEMBERS PRESENT:
Kerry Carroll Davis, Research Analyst
OTHERS PRESENT:
Myla Florence, Administrator/State Welfare Division
Jon Sasser, Nevada Legal Services
Bill Loncar, Nevada PTA
Ed Fend, AARP
Janine Hansen, President/Nevada Eagle Forum
Jim Wadhams, Nevada Hospital Association
Joel Hansen
Assembly Committee on Health and Human Services
April 1, 1993
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ASSEMBLY BILL 276: Revises provisions of state plan relating to aid to dependent children.
Myla Florence, Administrator/State Welfare Division, explained a revised fiscal note to AB276 had been provided to consider amendments proposed by Nevada Legal Services. She noted essentially the amendments would limit the "Fill-the-Gap" budgeting program to earned income only and would only permit individuals having been on the rolls for three months to participate in the program. In terms of "Fill-the-Gap" budgeting, four areas were identified as having an impact (Exhibit C).
Responding to Mrs. Evans'inquiry as to ADC and Medicaid totals, Ms. Florence indicated $1.3 million in fiscal year 1994 and $4.9 million in fiscal year 1995, representing state and federal shares combined.
In summary, Ms. Florence noted assumptions were based on known data within the Division. Secondly, the waivered program must show cost neutrality over a 5 year period and must be considered only in the context of the biennium. Within the language of the bill, a preferred effective date would be January 1, 1994 as it would take at least 6 months for data processing changes to be made for any welfare reform change considered during the session.
Following committee discussion Mrs. Evans asked Mr. Jon Sasser of Nevada Legal Services to refresh the committee's memory by reviewing once again the proposed amendments. He stated the proposed amendments would do two things to the original bill:
1) "Attempt to remove the fear that the cost of this would be astronomical due to people who are presently working and having incomes that fall below the Standard of Need but above our payment level who would come onto the program basically to get Medicaid benefits. So the program is limited to current recipients (those persons who have been on the program for 3 consecutive months and will qualify for the program without the aid of "Fill-the-Gap" budgeting before they could utilize "Fill-the-Gap.)
2) This program would not be effective because the waiver by the federal government is required unless that waiver is approved by the federal government."
Mr. Sasser submitted to the committee, "Challenged Assumptions in Fiscal Note to AB 276" (Exhibit D).
MRS. FREEMAN MOVED AMEND AND DO PASS ON AB 276.
MR. TOOMIN SECONDED THE MOTION.
THE MOTION CARRIED UNANIMOUSLY.
Mr. Bill Loncar, speaking on behalf of Nevada PTA, presented an emergency resolution (Exhibit E) passed at their State Convention regarding "Fill-the-Gap" program and the ADC in support of the program.
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ASSEMBLY JOINT RESOLUTION 25:Urges selection of Nevada as state for testing evolving National Health Program.
Mr. Ed Fend, representing AARP, urged the committee to consider AJR 25 as a possibility. He suggested, inasmuch as Nevada had two main population centers and a very large rural area, the population could be easily tested as far as the various programs were concerned, with a least amount of money. He indicated a letter writing campaign was being conducted through all the state chapters of the AARP, going to Nevada's Congressional representatives and directly to Mrs. Clinton, indicating this was a statewide support program.
Responding to Mr. Gibbons' inquiry as to the status of the test program, Mr. Fend said it could only be second-guessed as to what they would do in Washington. He noted 33,000 Nevadans were without health insurance and there were a significant number of under-insureds. He stated, "We hope it is good, and if it is to be tested somewhere, why not here."
Janine Hansen, President/Nevada Eagle Forum, speaking in opposition to AJR 25, indicated there were many people unable to afford insurance. Big companies were able to buy insurance with pre-tax dollars. On the other hand, an individual buying insurance, would be compelled to use after-tax dollars (after having paid income tax and Social Security.) That person would thus have paid twice as much for health insurance. This discrimination, Ms. Hansen indicated, needed to be eliminated and replaced by tax fairness, which would permit everyone to buy health insurance with pre-tax dollars. One way would be to ask Congress to equalize those tax laws. Another suggestion was Individual Medical IRAs (Exhibit F).
Mr. Heller asked Ms. Hansen if she opposed AJR 25. She said she was opposed to endorsing Clinton's health plan because its "Managed Health Care" reduced individual choices; thus, she stood in opposition to AJR 25 and simply encouraged the committee to look into alternatives.
Jim Wadhams, Nevada Hospital Association, reiterated Mr. Heller's and Mrs. Segerblom's suggestion that the resolution urged Nevada be used as a"guinea pig." His recommendation was to "Wait until May 3rd when the plan is announced, as everything coming out of Washington D.C. is not necessarily favorable for Nevada."
The hearing on AJR 25 was closed with no action taken.
SENATE BILL 197: Requires health authority to allow child under 12 years of age to use public spa under certain circumstances.
Joel Hansen, speaking in support of SB 197, clarified why the bill was before the committee. Some years ago he and his wife purchased a condominium at Lake Tahoe where he would take his family on vacation for one week each year. One of the reasons for the purchase was the clubhouse and swimming pool with accompanying Jacuzzi. About 1982 or 1983, a sign was posted specifying children 12 years and under could no longer use the Jacuzzi under violation of Nevada law.
Mr. Hansen subsequently wrote the Nevada Board of Health (Exhibit G) asking for justification of the regulation. A two inch stack of material was sent back to him and he found almost nothing to justify the fact they had totally excluded children from the spas. He did find a letter (Exhibit H) to the Health Department from the Public Health Engineer, Stephen Hyde, saying, "There seems to be no agreement by spa manufacturers, health officials, and doctors that spas should not be used by children."
Mr. Hansen continued to say Nevada was the only state precluding children from using Jacuzzis. He noted the only justification he could find in all materials sent him was a statement by a public health officer, "If we prevent one case of brain damage in these little children, it will have been worth it." However, there were no reported cases of brain damage in all the materials reviewed.
Extensive discussion ensued between committee members and Mr. Hansen. Problems were voiced such as time limits, water temperature, enforcement of rules on weekends when managers were not on location, etc.
There being no further testimony, Mrs. Evans closed the hearing on SB 197. She asked Mr. Toomin to chair a subcommittee with Mr. Heller and Ms. Smith as members, to work with Mr. Hansen.
There being no further business to come before committee, the meeting was adjourned at 3:13 p.m.
RESPECTFULLY SUBMITTED:
CHRISTINE SHAW
Committee Secretary
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Assembly Committee on Health and Human Services
April 1, 1993
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