MINUTES OF THE
SENATE COMMITTEE ON HUMAN RESOURCES AND FACILITIES
Sixty-seventh Session
March 3, 1993
The Senate Committee on Human Resources and Facilities was called to order by Chairman Raymond D. Rawson, at 1:30 p.m., on Wednesday, March 3, 1993, in Room 226 of the Legislative Building, Carson City, Nevada. Exhibit A is the Meeting Agenda. Exhibit B is the Attendance Roster.
COMMITTEE MEMBERS PRESENT:
Senator Raymond D. Rawson, Chairman
Senator William R. O'Donnell, Vice Chairman
Senator Randolph J. Townsend
Senator Joseph M. Neal, Jr.
Senator Bob Coffin
Senator Diana M. Glomb
Senator Lori L. Brown
STAFF MEMBERS PRESENT:
Pepper Sturm, Research Analyst
Judy Alexander, Committee Secretary
Susan Henson, Committee Secretary
OTHERS PRESENT:
Wilford Beck, Ph.D., Clinic Director, Mental Hygiene and Mental Retardation Division
Jerry Zadny, Ph.D., Administrator, Mental Hygiene and Mental Retardation Division
Verlia M. Davis, Deputy Director, Clark County Social Services
Lucille K. Lusk, Nevada Coalition of Concerned Citizens (NCCC)
Jon L. Sasser, Coordinator of Litigation and Training, Nevada Legal Services
Ross Nelson, Recipient, General Assistance, Washoe County
Jim Nadeau, Lieutenant, Washoe County Sheriff's Office
Nile D. Carson, Jr., Deputy Chief, City of Reno Police Department
Randy Oaks, Captain, Las Vegas Metropolitan Police Department
Victor Freeman, Undersheriff, Carson City
Robert Gagnier, Executive Director, State of Nevada Employee's Association (SNEA)
Michael Bender, Caseworker, Haven of Hope, Reno
Art Melders, Correctional Lieutenant, Lake's Crossing
Todd Shipley, Detective, City of Reno Police Department
Carlos Brandenburg, Director, Forensic Services, Lake's Crossing
Dennis J. Healy, Nevada Corrections Association
Chairman Rawson opened the hearing on Senate Bill (S.B.) 63.
SENATE BILL 63: Clarifies that transferral of certain medical records may not violate applicable federal law. (BDR 39-653)
Wilford Beck, Ph.D., Clinic Director, Nevada State Division of Mental Hygiene and Mental Retardation (MH/MR), testified in favor of S.B. 63. He explained the Federal Drug and Alcohol Treatment Act established strict guidelines for the disclosure of client records. Last session the legislature passed Nevada Revised Statutes 433.332(1) which obliges MH/MR to forward copies of client medical records without the client's consent when the client is transferred to another facility. If the division were to follow NRS 433.332(1), in the case of clients who have substance abuse problems, it would be in direct violation of federal law and subject to a fine of $500 to $5,000. S.B. 63 exempts client records covered by federal law from disclosure without the client's consent, or a court order, and therefore allows the division to comply with both state and federal laws. The division requests and recommends passage of S.B. 63.
Chairman Rawson asked if this might interfere with future treatments or actions by the state, in other words, could it bring harm to patients? Dr. Beck responded in his opinion it would not.
Senator Neal asked if Dr. Beck was referring to federal law 42 U.S.C.. Dr. Beck replied, "yes, that is the federal law bearing on substance abuse treatment of clients." Chairman Rawson asked how the division was currently dealing with the issue. Dr. Beck replied MH/MR is in violation if they transfer records. NRS indicates the division is obliged to transfer records without the patient's consent, but federal law indicates the division is in violation if they do not have the patient's consent, for those clients in substance abuse treatment, or for those who have substance abuse problems.
Chairman Rawson questioned if the bill passed, would MH/MR attempt to get the patient's permission to forward records, although no longer a requirement, it might be helpful for someone treating the patient in the future. Dr. Beck stated currently, in most cases, the division attempts to get patient permission prior to transferring records.
Senator Glomb asked if this bill would allow the division to transfer medical records to a facility within the division, as well as facilities outside the division? Dr. Beck replied only within the division. The division is unable at this point to transfer records of those clients having substance abuse problems which are identified, or substance abuse treatment, without their permission.
Jerry Zadny, Ph.D., Administrator, Nevada State Mental Hygiene and Mental Retardation Division, clarified, originally this law was passed to facilitate transfer of patients, which was a worthwhile purpose. However, federal law states these patients have a right to consent to the transfer of their medical records. Dr. Zadny testified he instructed staff to honor federal law and not state law, because the penalties associated with federal law are severe and could be incurred by the division, as well as individuals who fail to honor the federal law. Currently they are asking for each patient's permission to transfer records. In the case of division facilities, Dr. Zadny testified he received an informal opinion from the attorney general this past week stating it would be okay to transfer records without the patient's permission. However, when a patient is sent to a nursing home, outside the division, staff needs to ask for permission, which is in direct conflict with state law. Dr. Zadny stated he would like to see state law changed so it comports with federal law.
Senator Glomb pointed out sending a patient to a nursing home is not within the division. Dr. Zadny agreed and stated if the division followed current state law, they would send the medical record without patient permission and therefore be in violation of federal law. He would like the law clarified so his division would have to obtain permission from the patient to send records and thus not be in violation of state law.
Chairman Rawson closed the hearing on S.B. 63.
SENATOR O'DONNELL MOVED TO DO PASS S.B. 63.
SENATOR NEAL SECONDED THE MOTION.
THE MOTION CARRIED UNANIMOUSLY.
* * * * *
Chairman Rawson opened the hearing on S.B. 57.
SENATE BILL 57: Authorizes county to exclude indigent person deemed to be employable and with no dependent children from cash grants for necessary maintenance. (BDR 38-216)
Verlia M. Davis, Deputy Director, Clark County Department of Social Service (CCSS), spoke in support of S.B. 57 (Exhibit C). She testified Clark County is going broke in its attempts to assist single employable individuals. Ms. Davis pointed out a line of single employable individuals, waiting for assistance, forms daily in front of their offices, starting as early as 5:00 a.m. in the morning, often to the detriment of mothers and children who are also looking for assistance but do not arrive until 7:00 a.m. when the offices open. Legal Services advised CCSS they would violate the constitutional rights of an individual if they tried to allow women and children, or sick people, ahead of a single employable individual.
Ms. Davis pointed out CCSS has attempted to develop innovative programs in Clark County to assist the single employables. The welfare work program requires applicants to provide 16 hours a week community service to the agency and other county departments. She said CCSS is currently developing work sites in the community as a payback, so when the individuals are not working, they are in the community looking for other jobs. CCSS is attempting to get them into a training program. CCSS is not trying to eliminate a group of people, rather they are looking for alternatives and some flexibility to not serve people who do not comply with the regulations set up by CCSS. The work program signed up 521 clients and 277 have actually participated, which is a 53 percent rate of participation. Legal Services is threatening to sue CCSS because they do not feel people should be required to work for any type of welfare assistance. CCSS is attempting to help those in the programs build self-esteem, give them an opportunity to develop some skills and get back into the work force.
Ms. Davis stressed another related problem is the impact of large numbers of ex-prisoners on the program. A survey was done in August of 1992 to determine the impact of newly released ex-prisoners on the system. Should a prisoner from around the country desire to relocate to Clark County, the prison sends a letter to the CCSS stating said individual will be in Las Vegas on a certain date and please extend all services to that person. When that individual arrives in Clark County, they go to the social services office and demand services. Ms. Davis pointed out her agency has hired 1-1/2 security guards to maintain crowd control, due to the large numbers of individuals standing in line daily. In addition, because the mental health system has ignored the population of mentally ill in Nevada, CCSS has a lot of mentally ill individuals coming to their offices. She stated nationally, as part of the new administration's program on welfare reform, states and counties will have some flexibility in whom they serve. Those who are sick or disabled, or individuals with other problems will not be cut off from assistance.
Chairman Rawson inquired about people on Aid to Dependent Children (ADC). Ms. Davis replied individuals seeking assistance are not on ADC, however, because it takes the state a long time to approve people applying for ADC, during that pending period, these individuals are the county's responsibility, which further impacts resources. Chairman Rawson asked Ms. Davis for the number of people being seen by CCSS per month. Ms. Davis noted between 600 to 700, mostly single men.
Chairman Rawson asked for further clarification as to the ex-prisoners. He inquired if these ex-prisoners are either on parole or released directly with a finished sentence, to which Ms. Davis responded, "yes." Chairman Rawson asked if these ex-prisoners were referred to social services from other counties within the state. Ms. Davis pointed out the prisoner need only request relocation into Clark County. Ex-prisoners are referred from the prison system in Nevada, and the prison systems in other states, and private prison systems from other states. Chairman Rawson asked if there is any residency requirement, or if it is possible to get off their list for referral. Ms. Davis replied they have written to the prisons who contacted them for referral and advised them Clark County's resources are limited and therefore no longer a viable option for relocation.
Senator Glomb questioned if this language authorizes the Board of Commissioners to decide on anyone that is receiving assistance . . . . is this general assistance? Ms. Davis answered "yes", this is the only program which provides direct financial assistance to an individual. Senator Glomb asked if CCSS had set guidelines which individuals must follow in order to receive aid . . . . do they have to show they have gone for job interviews, etc. If the individual does not comply with the guidelines, can CCSS drop them from the role? Ms. Davis stated that prior to Clark County Social Services Department vs. Newkirk, 106 Nev. 177, 789 P.2d. 277 (1990), CCSS did not serve single employables. However, after the Newkirk decision, Clark County had no option and must serve single employables if they meet the requirements. She explained Washoe County serves them for 30 days, once a year, but Legal Services deemed that Clark County will serve them. Ms. Davis pointed out if their requirements are not met they then have the option of dropping them from the roll. Senator Glomb asked what precludes Clark County from setting a 30 or 60 day limit for assistance, like Washoe County? Ms. Davis remarked she is not sure how Washoe County gets around the Newkirk supreme court ruling which states they must offer assistance for an unlimited amount of time.
Senator Brown remarked the term employable seems broad. She referred to the General Assistant for Temporary Employment (GATE) program where employment is offered and turned down. Ms. Davis stated when employment is offered and turned down under the GATE program, CCSS will discontinue assistance for a period of time; however, when they come back to participate in the program, services are reinstated. At this point if they stop participating CCSS will then cut them off for up to a year. Senator Brown indicated this particular language talks about anyone who is employable, whether employment exists for that person or not. She asked if Ms. Davis interpreted the language as being broad, to which she replied "yes." Senator Brown asked if the individual is employable but cannot find a job, are they cut off from general assistance? Ms. Davis stressed the individual will continue to get assistance if he is making an effort and searching for jobs weekly.
Senator Brown declared the language is too broad. She suggested an amendment which would limit assistance to people who are employable, have the opportunity for employment and have turned it down.
Chairman Rawson asked Ms. Davis if she could accept an amendment that would tie this to an unemployment rate of over 10 percent, which would create an exemption. Ms. Davis stated that would be acceptable, or some other language giving CCSS the flexibility to discontinue people from assistance who are not willing to participate in the programs.
Senator O'Donnell reviewed the situation which occurs in Clark County, of women and children standing in line seeking financial assistance. As CCSS has limited resources to allocate, those in line first, usually the single employables, receive the assistance. Ms. Davis remarked some individuals spend the night in the parking lot in order to be first in line.
Senator O'Donnell asked Ms. Davis how the new language would clean up what the supreme court has said CCSS must do. Ms. Davis replied it would allow their agency the flexibility not to serve this group of people, without their compliance with certain rules and regulations.
Senator Glomb commented her interpretation of S.B. 57 is that it grants authority to deny assistance if a person is not complying with the rules of the program in terms of seeking employment. Ms. Davis replied the division does have flexibility; however, when an individual is denied assistance, Legal Services questions the denial and applies for a fair hearing and forces CCSS to go through a process, and because of the Newkirk decision, it is generally determined CCSS must serve the individual. Senator Glomb asked if the new language would block Legal Services' ability to challenge the agency's decision. Ms. Davis replied, "yes, until they go back to the supreme court."
Lucille K. Lusk, Nevada Coalition of Concerned Citizens (NCCC) testified in support of S.B. 57. For clarification purposes, she was not sure the language in the bill would accomplish the intent. She pointed out the purpose of the bill was to provide permissive language for the county to set and enforce standards for the giving of cash grants.
She stated NCCC recognizes individuals in need of assistance, those who cannot work, those who are ill, those with children or those who are employable but cannot obtain employment at this time. However, thought should be given to those with legitimate needs versus those unwilling to comply with the guidelines. Ms. Lusk suggested assistance be tied to individual circumstances, rather than the employment rate.
Chairman Rawson stated he had been working with a group of dentists in southern Nevada to set up a voluntary clinic at the University Medical Center to assist the approximate 2,000 to 3,000 people in need.
Ms. Davis reviewed CCSS's proposed changes to S.B. 57. She stated the word "household" should be deleted due to the difficulty in defining a household. She remarked at one time a household was a mother, father, brother, sister, and/or grandmother. Today household could be a man and his common law wife, a woman and her significant other, or someone with an alternative lifestyle. As the law is currently written, CCSS cannot serve individuals with alternative lifestyles, two women living together, or two men living together. The new language would define alternative lifestyles as part of a household.
Jon L. Sasser, Coordinator of Litigation and Training, Nevada Legal Services, spoke in opposition to S.B. 57, as referenced in his summary (Exhibit D). Ms. Sasser explained the Newkirk decision, page 2, (Exhibit D). He stated under the present statute, counties cannot deny services to certain categories, but must offer the same services to all groups of the poor who cooperate with the program requirements. Washoe County offers benefits, but limits them to 30 days, the same as for women with children who are awaiting action on their ADC applications. In the rural counties, there is no ongoing general assistance program, only a once a year emergency assistance program. That must be offered to all poor by category. No other county in the state discriminates against a group or separates them out as a separate category. The Newkirk decision does not say counties cannot set up reasonable program requirements to verify eligibility, to require people to search for work, to require people go through a work program, such as the GATE program, or require that people not quit jobs without good cause.
Mr. Sasser wished to respond to the issue of "lines." He stated it was his understanding in order to apply for assistance the individual had to make an appointment, which feasibly could take up to 4 weeks. The agency reserves 10 to 15 emergency slots per day. Those arriving early are attempting to get the "emergency slot," and if not successful the first day, they come back daily, or wait until their appointed time. Mr. Sasser expressed his concern with this problem and questioned whether CCSS could exclude the 600 to 700 needy people. He felt there were other mechanisms available to resolve the problem.
Mr. Sasser pointed out the proposed changes are coming only from Clark County as it is the only county providing ongoing general assistance. He concluded there is no need for this legislation and urged referral to a subcommittee to consider amendments rather than adopting the bill in its present form. Mr. Sasser pointed out Ms. Davis did not provide any statistical documentation to support the claim Clark County is going broke.
Chairman Rawson requested further information from Ms. Davis as to the number of individuals who have received aid, how long aid was received, those who were refused aid, the number of individuals demonstrating a need, and how many individuals would be capable of providing their own care. He mentioned this session is concerned with streamlining welfare laws to see the limited resources available are used effectively.
Senator Coffin asked Mr. Sasser if general assistance is a voluntary program on the part of a county. He pointed out counties are not obligated to provide any particular level of assistance. He pointed out rural counties have limited funds and thus provide less assistance. Senator Coffin wondered if the county would discontinue the program if they were mandated to grant benefits under certain circumstances, beyond what is already in law. Mr. Sasser stated he felt the counties acknowledged the need for assistance and thus far have continued with the program. He reiterated the cash assistance program is voluntary; however, medical assistance is not.
Senator Glomb asked Mr. Sasser if Clark County could limit the program to 30 days as Washoe County has done. He replied there is nothing in the present law preventing that. The Senator wondered if Legal Services would have legal grounds to sue Clark County if they limited the program to 30 days. He replied he had not researched the issue.
Senator Glomb inquired if Clark County, under the law, would be precluded from serving families with children first, perhaps offering them 60 days assistance versus offering a single person with no children 30 days assistance, in other words prioritize families with children. Mr. Sasser said this issue had not been litigated. He drew attention to the statute which says counties may provide assistance to those of general poverty. Whether the county could come up with a rational basis for different levels of assistance to different groups has not been litigated.
Senator Neal expressed concern with the definition of the word "poor." Mr. Sasser pointed out the Nevada statute says, "the counties shall serve the poor," and the Newkirk case was decided on the Nevada statute. Chairman Rawson stated the basis for S.B. 57 is to prioritize. Mr. Sasser explained in the Newkirk case the court did not address some of the constitutional questions raised, but merely dealt with the issue as a statutory construction decision.
Chairman Rawson expressed concern about those individuals capable of providing for themselves receiving money, and thus creating a risk for those incapable of taking care of themselves. Mr. Sasser questioned the definition of "capable" which is more complex than whether someone is totally physically disabled or not.
Ross Nelson, Recipient, General Assistance, Washoe County, spoke in opposition to S.B. 57, as is referenced in his summary (Exhibit E).
A discussion ensued between Chairman Rawson and Mr. Nelson. In response to the chairman's questions, Mr. Nelson stated he was not on parole, but "completely released" and he had applied for unemployment, but was denied as he resigned from his last employment due to medical reasons. Chairman Rawson asked if his health problems were resolved. He stated he was in the hospital on January 25th for attempted suicide but was not currently being treated and, although mental health felt he had a drinking problem, he had not had a drink in over a month.
Michael Bender, Caseworker, Haven of Hope, Reno, Nevada, submitted his written testimony to the committee (Exhibit F). In addition, he submitted written testimony from Carole Allison, Director of Haven of Hope (Exhibit G).
S.B. 57 was referred to subcommittee with Chairman Rawson acting as chairman.
Chairman Rawson closed the hearing on S.B. 57.
Chairman Rawson opened the hearing on S.B. 62.
SENATE BILL 62: Makes various changes regarding emergency admissions to mental health facilities. (BDR 39-661)
Dr. Beck testified in the support of S.B. 62. He explained this bill updates obsolete language in the section of NRS pertaining to emergency admission of acutely mentally ill persons to division inpatient facilities. It would have two effects, first it would formalize the existing practice of law enforcement transporting acutely mentally ill persons to division inpatient facilities. Second, it would eliminate language pertaining to persons appointed by the Department of Human Resources to act as agents for filing applications for emergency admission. No such agents exist and the division has no means to transport acutely mentally ill persons. The division requests and recommends passage of this bill.
Senator Glomb asked if this would allow a police officer to take a person in for evaluation and treatment. Dr. Beck replied, "yes, it would allow transport of a person who was committed on an emergency or involuntary commitment." He went on to explain this bill cleans up language in the existing statute, clarifying it is law enforcement's responsibility to transport patients committed involuntarily, or on an emergency basis, to a division inpatient facility.
Dr. Zadny explained law enforcement officers already have authority to start the process; however, the bill will make it clear to all involved the responsibility of transport is to be done by law enforcement, as state personnel does not have the means.
Senator Glomb asked if this has anything to do with the triage problem experienced by Washoe County. Dr. Zadny explained Assembly Bill (A.B.) 168 more directly addresses that issue.
Senator Glomb asked if a fiscal note had been done on this bill. Dr. Zadny stated there would be no fiscal impact as law enforcement is already performing the task. The bill would clarify law enforcement's responsibility to transport and thus avoid arguments between local law enforcement and his division. Senator Glomb asked if law enforcement was circumventing the issue. Dr. Zadny pointed out law enforcement generally transports an emergency admission. However, there are cases when the local hospitals can have an ambulance transport.
Chairman Rawson then asked who has the responsibility to transport? Dr. Zadny explained the last session defined people that are eligible for admission as those dangerous to themselves or others. Given that definition, you need personnel who are equipped and trained to transport that kind of person. Dr. Zadny testified it was his understanding law enforcement officers are best equipped and trained to handle that class of person. The exception would be the patient best handled in an ambulance.
Senator Brown asked if there are instances when an ambulance could transport, why have mandatory language. Dr. Zadny felt there needed to be some clarity on the subject so there are no arguments on a case-by-case basis. He went on to explain Las Vegas facilities have reached a reasonable accommodation as to the hospitals using ambulances for transport, or other means, and then using law enforcement at their discretion. Federal law states a facility (hospital) discharging someone to another hospital has to make arrangements for transportation, so the facility has some discretion as to who they call.
Chairman Rawson stressed he did not want to mandate something upon the counties without giving them the ability to pay for it.
Senator Neal drew attention to section 1 one of the proposal, the person who can make the application is, "an officer authorized to make arrests in the state of Nevada, or a physician, psychologist, social worker or registered nurse . . . ." He asked if the individuals who can now make application to admit these people are associated with mental health. Dr. Zadny replied it could be a psychologist working for the division, or a psychologist in private practice. Senator Neal asked if this meant any person who holds himself out to be a psychologist can admit a person for treatment on emergency basis. Dr. Zadny stated they can make application which is followed up with a physical. There are three types of admissions, voluntary, emergency and court ordered, and what we are discussing today is emergency admission, the person is out-of-control and immediate action must be undertaken.
Senator Neal wished to discuss emergency admission, how long is that period of time? Dr. Zadny replied a person can be held for 72 hours before filing papers for court commitment. Senator Neal questioned if any person who is a registered nurse, physician, psychologist, or social worker could admit a person for 72 hours. Dr. Zadny answered they can make application for admission, but at least two other people will be looking at the person before admission is granted.
Senator Neal asked to whom application is made. Dr. Zadny stated it can be made to a number of facilities, but the discussion seems to be regarding his facility, MH/MR. He pointed out if he filed the application for admission, a doctor, maybe from Washoe Medical Center, would look at the person, and then a psychiatrist would look at the paperwork and make the final decision as to whether the person is admitted.
Senator Neal asked if after the application is made, are there two other individuals who have to agree with the decision before the person is admitted. Dr. Zadny stated, "yes, at least two." Senator Neal asked if those two individuals would come from the institution to which the person is being referred. Dr. Zadny replied they could, but most commonly they come from two different institutions, usually a private physician or one from a local hospital, and a professional from his facility.
Senator Neal asked if the two individuals rendering judgment on the admission of the individual had to physically see the person. Dr. Zadny replied in the case of the person doing the physical exam, "yes," but in the case of the person acting on behalf of our facility, or another facility, "no." The more common practice is for a nurse to look at the person, look at the paperwork, at which time the psychiatrist is contacted by phone to give verbal permission to admit the person.
Senator Neal asked if application meant one person looking at the paperwork and another having physical contact with the individual, or could we have two individuals merely looking at the paperwork and the person being admitted? Dr. Zadny stated the person filing the petition would be making an inspection of the individual, as they must make a statement for admission based on the examination.
Senator Neal pointed out the statute does not require the individual be physically examined. Dr. Zadny stated Senator Neal was technically correct in his assessment. He stressed his response is based on his experience and it is common in his facility to take a look at the person and then have a professional see that person when they arrive at the facility before the admission is completed. He stated there are other ways to get admitted into the facility, which is covered in a different section of the law. Senator Neal asked if a person could be admitted to a facility based on paperwork alone, without a physical examination. Dr. Zadny replied not in his facility, but it might be possible.
Jim Nadeau, Lieutenant, Washoe County Sheriff's Office, spoke in opposition to S.B. 62. He testified there are many situations when law enforcement should not be involved in the transport of the individuals. The current language in S.B. 62 says "may" and he felt this word inappropriate. He explained law enforcement must comply with certain guidelines, policies and safeguards when transporting an individual. He stated if you have an individual with a mental health problem, the site of a uniform or hard restraints, such as handcuffs, aggravates the situation. He pointed out law enforcement does not have soft restraints available to them. Lieutenant Nadeau stressed the language in S.B.62, making it mandatory for law enforcement to transport, will have a fiscal impact. When called upon, officers not only transport the individual to a facility, but must stand by during the medical and mental examination, and if that individual is not accepted by mental health, then make a decision as to disposition. This process takes the officers off the street for 3 to 4 hours.
Chairman Rawson asked Lieutenant Nadeau to prepare an estimate of the fiscal impact.
Senator Neal asked Lieutenant Nadeau if an officer had the authority to take a mentally ill person into custody. Lieutenant Nadeau replied, "yes." Senator Neal questioned the difference between the old and new language. Lieutenant Nadeau clarified the new language mandates under all circumstances involving an emergency commitment, if law enforcement is called to transport, they are required to transport. It was his opinion the use of law enforcement for transport is not always in the best interest of the patient. He went on to explain some situations call for soft restraints or a less confrontational transport.
Senator Glomb wished to clarify if the request to transport is made to law enforcement, they are required to comply; however, the language in the bill does not mandate the request always be made to law enforcement.
Nile D. Carson, Jr., Deputy Chief, City of Reno Police Department, spoke in opposition to S.B. 62. He pointed out resources are going down and demand for services are going up. Their department is down 65 people and 27 officers and facing a 12 percent increase in calls for service, yearly.
Deputy Chief Carson outlined two ways the department comes in contact with mentally ill individuals. First, the department has a cooperative agreement with the hospital. When an individual is picked up the department takes them to the hospital in Reno which does a physical examination, makes a determination as to their state of mind, makes a call to Nevada Mental Health Institute (NMHI) to advise the individual will be delivered, and makes arrangements to speed up the process with some professional involvement.
Deputy Chief Carson explained the second scenario. If the hospital has an individual with a propensity for violence who came to them in another fashion, they will call the police department and, when time permits, our department will transport them to NMHI.
He pointed out the department receives requests from private hospitals, or psychiatric hospitals to transport individuals to Washoe Medical Center for physical evaluation prior to admittance. In the past, the department has refused. S.B. 62 will not allow this in the future.
Deputy Chief Carson suggested the new language will create at least four ways the department will be coming in contact with the mentally ill individual, thus four times the amount of requests for transport, which would adversely affect the department. It is Deputy Chief Carson's opinion the mentally ill are not a police problem, rather a medical problem. He pointed out that police officers, although trained to deal with violent people, are trained to use hard restraints, pain compliance, etc. Medical people are trained in soft restraints and have a calming effect. Deputy Chief Carson stressed passage of this bill would have an adverse impact on his department and thus would not recommend passage.
Randy Oaks, Captain, Las Vegas Metropolitan Police Department spoke in opposition to S.B.62. He cited an example wherein any person could have a problem with a family member and call a social worker, physician, or nurse who is a friend to aid in having the family member committed. According to this bill, the police department could get the call from the social worker, physician or nurse, who has not seen the patient, and the department would have to transport that person. The bill allows no room for discretion. The department must transport the individual to a facility and wait while a determination is made as to the individual's well being, whether it be alcohol related, or otherwise. This process can take up 3 to 4 hours of law enforcement time. It is Captain Oaks' opinion S.b. 62 will have a fiscal impact.
Senator O'Donnell drew attention to the additional paperwork which must be completed by the officer upon return to the department, requiring additional time.
Victor Freeman, Undersheriff, Carson City, representing the Nevada Sheriff's and Chiefs Association, spoke in opposition to S.B. 62. He cited an example which confirms the fiscal impact on local law enforcement. He testified that Sheriff Neal Harris in Elko County was required to make two transports to NMHI in Sparks from Elko County. Sheriff Neal's policy dictates two police officers or two deputy sheriffs do the transport. One round-trip required 14 hours, thus he lost two deputies for 28 hours while they did the transports.
Undersheriff Freeman further explained the Carson City Sheriff's Office has an employee contract for minimum manning, which means if they drop below minimum manning, they must call someone back on overtime to fill a vacant shift. The contract states if staff is not available for service within the community, the vacant position must be filled. Oftentimes the transports are under the influence of drugs or alcohol and NMHI will not admit them, so law enforcement must then deal with the individual.
Captain Oaks addressed Senator Neal's concerns that law enforcement only wants to deal with law breakers and not the mentally ill, but wished to point out S.B. 62 will have a fiscal impact on local law enforcement.
Chairman Rawson closed the hearing on S.B. 62.
Chairman Rawson opened the hearing on S.B. 89.
SENATE BILL 89: Confers powers of peace offices upon certain employees of mental hygiene and mental retardation division of department of human resources. (BDR 39-467)
Robert Gagnier, Executive Director, State of Nevada Employees Associations (SNEA), spoke in favor of S.B. 89. He gave a brief outline of the bill. Section 1 provides, "Forensic technicians and correctional officers employed by the division at facilities for mentally disordered offenders have the powers of peace officers when performing duties prescribed by the administrator." Section 2 is a companion to that and prescribes that the employees so employed must be certified by Peace Officers Standards and Training (P.O.S.T.). He added generally they are certified, but this bill would make it a requirement.
Mr. Gagnier explained that several years ago it came to the SNEA's attention the forensic technicians and correctional officers employed at Lake's Crossing have one of the more dangerous jobs in state government, and are exposed to much the same thing as correctional officers in the prison system. They have all of the points necessary for inclusion in the early retirement system as a peace officer, except they had never been designated as peace officers. Another area of concern is the risk, because they exercise powers of peace officers, but they are not peace officers. Mr. Gagnier introduced Art Melders.
Art Melders, Correctional Lieutenant, Lake's Crossing, spoke in support of S.B. 89, as referenced in his summary (Exhibit H). In addition he showed a videotape to the committee (Exhibit I), which spoke to the overcrowded conditions at Lake's Crossing, which houses the most dangerous criminals in the state of Nevada.
Chairman Rawson pointed out the individuals working at Lake's Crossing have not been offered and do not have peace officer status. He asked Mr. Melders if employee reclassification under this bill would be for retirement purposes, benefit purposes, or protection from lawsuits. Mr. Melders said for all those reasons. Chairman Rawson then asked what the objection in the past has been to giving the employees police powers. Mr. Melders stated this issue came up in the last session and subsequently died.
Senator O'Donnell asked if the Lake's Crossing employees were P.O.S.T. trained. Mr. Melders stated after 1980 the P.O.S.T. program was instituted, but it is merely for training, as they are not recognized by the P.O.S.T. commission. He would like to see a mandate that all the employees have to meet the P.O.S.T. certification requirement to maintain proper security of the facility and provide protection for the community. Senator O'Donnell asked if Lake's Crossing employees have more or less training than Nevada State Prison (NSP) employees, to which Mr. Melders replied, "more training."
Chairman Rawson inquired if the job classifications within the prison system have police powers to which Mr. Melders replied, "yes."
Senator Glomb asked if this bill would have a fiscal impact. Mr. Melders asserted the fiscal impact would be for the retirement package as the contribution rate between regular retirement and the police-fire retirement is different. He stressed it would have no impact on pay, as pay is equal within the same category.
Senator Neal asked what types of inmates are housed in Lake's Crossing facility. Chairman Rawson explained it houses those who have not gone through trial. Mr. Melders stated 80 percent of the inmates have felony charges against them, and more than half of those are for violent crimes, as seen in the summary (Exhibit H). They house those with mental problems from throughout the state. The individuals are transported to Lake's Crossing by law enforcement officials and some are so dangerous they use special tactical units for transport. If the inmate needs medical treatment, the correctional officers at Lake's Crossing must transport.
Senator Neal questioned if these individuals are found guilty are they transferred to NSP where those employees have peace officer status. Mr. Melders replied, "yes."
Senator Coffin asked if any of the Lake's Crossing employees would be coming into retirement soon. Mr. Melders stated the staff is fairly young and did not think retirement would be an issue for approximately 5 or more years, but did not have figures available.
Mr. Gagnier clarified those employees in the police and fire retirement system are allowed to retire 5 years earlier than those in the regular retirement system. Senator Coffin asked if reclassification to police officer status would change the retirement benefits for the Lake's Crossing employees, if they became peace officers. Mr. Gagnier stated they would have to be certified by the retirement board . . . . they would not automatically go into the early retirement system. Mr. Gagnier explained the retirement system previously rated the Lake's Crossing employees and said they should be in the early retirement system as they meet the requirements, the same level of danger, same level of physical exertion, etc.
Senator Coffin pointed out if these employees were reclassified, and the state pays more into the system for those individuals with this classification, the legislators would have to adjust the budget to cover the increased contribution by the department. He inquired how many employees this would affect. Mr. Gagnier stated Lake's Crossing has 28 correctional officers. The contribution for the peace officer classification is 26 to 27 percent of pay versus 20 percent. Chairman Rawson pointed out this group has the highest rate of lost time, due to injury, within the system.
Mr. Gagnier pointed out the vast majority of the inmates from Lake's Crossing end up in the prison system.
Todd Shipley, Detective, City of Reno Police Department, representing the Reno Police Protective Association and the Peace Officer's Research Association of Nevada, which represents 700 officers throughout the state, testified. He outlined the past two legislative sessions have attempted to come to concurrence on how peace officer powers are delineated and how they are defined. Currently there is no definition under state statute which defines a peace officer and what the requirements are to gain that status. The legislature over the years has given powers to those who asked for it. He stated everybody from dog catcher to rank and file police officer, or sheriff deputy has peace officer powers.
Chairman Rawson commented the employees at Lake's Crossing are working with people of the worst nature. He inquired if Detective Shipley was asking the committee to refuse S.B. 89, or making a plea that the legislators get something into the works describing peace officer powers.
Detective Shipley replied a little of both. There are 1,000 references in NRS to peace officer powers, with over 100 categories. He reiterated, if employees are doing law enforcement work they should have the powers, if they are doing mental health technician work, they should not have the powers, but we need to be able to differentiate. He stated he had heard testimony in the past that Lake's Crossing employees spend more time doing mental health work. It needs to be statutorily defined if they need full power or limited power and when they can use and enforce those powers.
Chairman Rawson announced the remainder of the agenda items would be rescheduled due to time restraints.
Senator Neal asked if Detective Shipley's agency had been called to take individuals out to some treatment facility. Detective Shipley stated he would not know the answer to this as he personally does not work the street. Senator Neal then asked if Detective Shipley was in agreement with the Nevada prison guards having peace officer status. He replied "yes, if they need the powers and if they are of equivalent nature, they should have the powers." There is no mechanism in state law for legislators to evaluate whether a job class needs powers totally or in part. There needs to be some reform in law enforcement. He stated we have been trying to reform who has powers and who has authority so that it is not abused.
Carlos Brandenburg, Director of Forensic Services, Lake's Crossing, also representing Dr. Jerry Zadny of the Division of Mental Health and Mental Retardation testified. Chairman Rawson asked if the Lake's Crossing employees spent a preponderance of time in law enforcement or in mental health. Mr. Brandenburg reiterated that all inmates are pretrial inmates, they usually come from maximum security in Clark County detention facility, or Washoe County, or even maximum security in the Ely prison. He stated his legislative mandate is to provide treatment in a maximum security setting. His staff has to do clinical work as well as security work. It is a difficult situation to assess, but 60 to 70 percent of staff's time is spent doing security-oriented work. At the same time, they are counselors doing individual and group therapy and taking steps to de-escalate the situation.
Mr. Brandenburg stated his position administratively is to take a neutral stance, and he stressed he was not before the committee to advocate for or against the bill, nor is Dr. Zadny for or against the bill. He pointed out they are testifying to provide the committee with information it needs to better understand the Lake's Crossing staff and help the committee make an accurate determination.
SENATOR O'DONNELL MOVED TO DO PASS S.B. 89.
SENATOR GLOMB SECONDED THE MOTION.
A general discussion ensued.
Dennis J. Healy, Nevada Corrections Association, spoke in favor of S.B. 89, and stated he had amending language to present to the committee. He pointed out earlier testimony that said employees in the department of prisons all have peace officer status. He corrected this by stating the 42 forensic technicians in the department of prisons do not have that classification.
Mr. Healy spoke in favor of amending NRS 481.054(15) (Exhibit J), which already includes the superintendent and correctional officers. He would like to see, "and forensic technicians of the department of prisons" added to that language. The prison systems all have mental health facilities. Chairman Rawson pointed out the mental health facilities within the prison are very secure. Mr. Healy pointed out the employees in the prison system are P.O.S.T. trained.
Senator O'Donnell asked Mr. Healy if the 42 forensic technicians he referred to earlier were in addition to the Lake's Crossing employees. Mr. Healy answered, "yes."
Senator Neal felt there was a difference between working in a prison system, with armed guards, to working at Lake's Crossing. He pointed out he would not readily include the prison technicians in the bill at this time. He felt the technicians working at Lake's Crossing were dealing with the most violent individual who would subsequently end up in the prison system. Those persons who work inside the prison, the forensic technicians, have the presence of an armed guard force.
Mr. Brandenburg apologized that Tom McNevin, President of Nevada Corrections, was not able to stay and testify. Mr. Brandenburg summarized Mr. McNevin's comments that the people within the prison have the same job he does, that of a correctional officer. Their duties are to supervise, control, and manage prisoners in the mental health facilities of the Nevada Department of Prisons. The armed guards are closer, but within the mental health facility of the prison itself, they are exposed.
Senator Neal further emphasized mental health technicians within the prison are doing specific work within the prison walls compared to the technicians at Lake's Crossing who are performing different duties in a less secure situation.
Chairman Rawson processed the bill.
THE MOTION CARRIED UNANIMOUSLY.
* * * * *
There being no further business, Chairman Rawson adjourned the meeting at 3:55 p.m.
RESPECTFULLY SUBMITTED:
Susan Henson,
Committee Secretary
APPROVED BY:
Senator Raymond D. Rawson, Chairman
DATE:
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Senate Committee on Human Resources and Facilities
March 3, 1993
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