MINUTES OF THE
SENATE COMMITTEE ON HUMAN RESOURCES AND FACILITIES
Sixty-seventh Session
April 19, 1993
The Senate Committee on Human Resources and Facilities was called to order by Chairman Raymond D. Rawson, at 1:30 p.m., on Monday, April 19, 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
GUEST LEGISLATORS PRESENT:
Senator Dina Titus, District 7, Clark County
STAFF MEMBERS PRESENT:
Judy Alexander, Committee Secretary
Pepper Sturm, Research Analyst
OTHERS PRESENT:
Robert Hadfield, Lobbyist, Executive Director, Nevada Association of Counties, Indigent Accident Fund
Mary Ellen McCarthy, Lobbyist, Attorney, Nevada Legal Services
Henry Etchemendy, Lobbyist, Executive Director, Nevada Association of School Boards
Jerry Ash, Lobbyist, President, Nevada Hospital Association
Lindsey Jydstrup, Lobbyist, Nevada State Education Association
Mary Peterson, Deputy Superintendent, Department of Education
Chairman Rawson opened the hearing on Senate Bill (S.B.) 343.
SENATE BILL 343: Requires certain facilities used by members of public to have sufficient number of toilets for use by patrons.
Senator Dina Titus, District 7, from Clark County, testified S.B. 343 was introduced by the women's caucus of the senate and by Senator Bob Coffin. She presented to the committee, News Articles (Exhibit C) and Minimum Plumbing Facilities (Exhibit D) and stated, this bill is commonly referred to as dealing with potty parity. She explained to the committee, the problem of unequal bathrooms for women. The law of equal protection means that people that are similarly situated are treated similarly. In the case of restrooms, equivalent square footage does not provide equivalent opportunity to complete one's business. This issue gained national attention in 1990, when a young woman named Denise Wells was arrested and tried for using the men's restroom at a concert in Houston, Texas. This was in violation of a local ordinance and she had committed a misdemeanor, resulting in a fine of $200. This prompted two professors at Virginia Polytechnic Institute & State University to do a study about how long it takes women and men to go to the bathroom. They found women take an average of 153 to 181 seconds, where as men take an average between 84 and 113 seconds. There were similar findings at Cornell University, following a study on the length of lines for men's and women's restrooms. The study showed that lines for women's restrooms were much longer. Both studies concluded that women need more restrooms than men.
She explained, there were other factors that contribute to the fact that women take longer. First, older people spend more time using the restroom and statistics show that women live to be older than men. Second, it is usually the woman who takes the children to the restroom, adding additional time. Women usually do the shopping and frequently carry packages, which takes additional time to manipulate.
California, New York, Pennsylvania and Washington have an active statute that calls for some potty parity and legislation is pending in Colorado, Florida, Michigan and Oregon. A number of other states have adopted regulations and national plumbing codes to deal with the problem, rather than addressing it through a statute.
She referred to a problem that has happened in Reno at the Pioneer Center for the Performing Arts Exhibit C, section 3. At the 1,428 seat theater, there were five women's restrooms and seven men's restrooms and seven urinals. Because of discrimination for women, a lawsuit has resulted. She stated in southern Nevada a similar situation resulted at Thomas & Mack Center. A $4.5 million dollar renovation was completed to double capacity in the women's restroom from 48 to 96 toilets and increased the men's by 50 percent as well.
She urged the support of the committee on this bill, so that future problems like this would not be allowed to develop and build up the extreme cost of difficulty that has in the past. In her opinion, it is the right thing to do, to get rid of this kind of last bastion of sexism.
She explained, she had patterned this bill after the Pennsylvania law that allowed the health department to come up with regulations. Since drafting this bill, members of the health department have suggested an amendment to the bill (Exhibit E). She referred to the last page of Exhibit D, that requires any kind of construction in the state to meet the uniform plumbing code and explained, that is not being enforced at the local level and suggested to add paragraph 4, of Exhibit E, on page 2. She pointed out, that the first pages of Exhibit D include information on regulations that have already been developed by the uniform plumbing code. She noted, this code could be used but needs stronger language that would say, this code would be enforced.
Senator Titus responded to a question from Chairman Rawson and explained, that in the chart for uniform plumbing codes (Exhibit D), each one has a different standard.
Senator Brown referred to paragraph 4, on page 2, of the amendment (Exhibit E) and asked, if the uniform plumbing code has guidelines for hotels, food establishments, children's camps and schools, why would there be exceptions. Senator Titus stated that with the amendment, there would not be the exceptions that are listed there. She said, if the legislature passed the amendment, it would eliminate those exceptions and the chart would be the only guidelines (Exhibit D).
Chairman Rawson stated to the committee, in his opinion, there should not be a lot of debate, that the committee should deal with the issue and move on.
Senator O'Donnell brought it to the attention of the committee that when most of the older buildings were designed, most architects were men. Senator Titus concurred with Senator O'Donnell and stated that some of the older buildings, like the Pioneer Center in Reno, were originally designed as a convention center, and at that time mostly men attended conventions.
Senator Titus asked that the testimony (Exhibit F) of Darrell Rasner, Chief, Bureau of Health Protection Services, Nevada Division of Health, be entered into the record. Also, written testimony (Exhibit G) from Lauren Nelson, University Women, should be added to the record.
Chairman Rawson closed the hearing on S.B. 343.
SENATOR O'DONNELL MOVED TO AMEND AND DO PASS S.B. 343.
SENATOR GLOMB SECONDED THE MOTION.
THE MOTION CARRIED UNANIMOUSLY.
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Chairman Rawson opened the hearing on S.B. 369.
SENATE BILL 369: Allows payment from fund for hospital care to indigent persons for hospital care rendered by hospital in another state.
Robert Hadfield, Lobbyist, Executive Director, Nevada Association of Counties (NACO), Indigent Accident Fund (IAF), testified in support of S.B. 369. He noted, the fund was created in 1983 and in 1989 the language was removed that allowed payment to out-of-state hospitals. He explained, he appeared before the committee in support of changing the language, that requires payment only to hospitals in Nevada. The reason was that there were very few cases where there were residents of Nevada, who would otherwise qualify for payment through the fund, that were transferred to out-of-state hospitals. This is particularly possible in the eastern part of Nevada where University of Utah Hospital & Clinics in Salt Lake City, Utah, is the trauma facility where patients are transported. There has been a situation in Douglas County, where Barton Memorial Hospital, South Lake Tahoe, California, was the hospital of choice, rather than Carson Tahoe Hospital, Carson City, Nevada, becauce it was more convenient to transfer the patient, due to bad weather conditions.
He stated, prior to the change in 1989, the IAF fund only paid two claims to out-of-state hospitals between 1983 and 1989, to the total of $82,000. Since that time, there have been two instances where out-of-state hospitals requested payment. He pointed out, the Board of Trustees of the fund want the ability to consider the cases and make payment, but did not want to be mandated. He stressed, it was important that the language of S.B. 369 would not mandate the board to make payment. Since the board has the ability to establish regulations for the fund, he was advised that this would allow them to have the ability to make payment, but the board would have control. One of the claims that the board would have liked to have paid, was for a young child that was sent to Salt Lake City, because no Nevada hospital could deal with the particular problem that child had, as a result of an accident. Mr. Hadfield stated, the hospital successfully treated the child, but because of the statute, the board did not make payment. He explained, the State of Utah has been very cooperative in helping the board, over the years, with this fund. The board wants to do everything to assist and show good faith with the State of Utah.
Mr. Hadfield responded to questions by Senator Glomb and advised the Board of Trustees of the fund is appointed by the Governor and is comprised of five county commissioners. The board meets twice a year to review the claims submitted by the hospitals through the counties. The counties determine the eligibility and the board reviews the claims and takes action on the individual claims. He explained the fund is funded through a ad valorem tax statewide and administered by the Board of Trustees.
Senator Brown questioned the term permissive and asked, if someone could get care here, but chose to go to another state, would IAF not have to reimburse them. Mr. Hadfield recommended that the criteria on regulations be made very specific for the Board of Trustees and should be passed into law. He presented to the committee a letter from Michelle Bero (Exhibit H).
Mary Ellen McCarthy, Lobbyist, Attorney, Nevada Legal Services, stated she represented indigent people. She explained, this particular fund deals with people who have had a motor vehicle accident or similar type of injury. The emergency medical personnel who arrive at the scene, transport the injured to the nearest facility that is capable of dealing with the trauma. She explained, the Medicaid system already has regulations governing, when out-of-state claims are to be paid. There are provisions for certain kinds of prior approval or approval within 72 hours of a emergency. Health Maintenance Organizations (HMOs) have similar types of regulations and, in her opinion, it could be easily regulated, so that IAF would not have to pay a lot of out-of-state claims.
Jerry Ash, Lobbyist, President, Nevada Hospital Association (NHA) also represented the Nevada Rural Hospital Project for Bill Welch, Executive Director, who was unable to attend the hearing. He stated, NHA has indicated opposition to the bill and noted that perhaps, by regulation, some of their concerns might be addressed. The concern was that it would open the door to a great deal of outflow of money from the indigent care funds to other states. He explained, many of those counties funds are depleted long before the end of a particular year, which means that anything that would cause that money to flow out of the state would mean that the funds would end sooner within those counties. Then those counties would have to deal with those patients as uncompensated care. As it has been recently testified, the intent of the bill is to deal with one or two incidents. The referral pattern of hospitals in eastern Nevada, particularly Elko and White Pine counties, for all types of care is to Salt Lake City, not to other hospitals within Nevada. He stated, the rural hospital project has concern, if the result of this bill would be that a substantial amount of the indigent accident funds would be flowing out, to an out-of-state situation. He encouraged the committee to consider these issues, when looking at the bill and encourage the Indigent Accident Fund to deal with this by regulation.
Chairman Rawson stated, he would be inclined to process S.B. 369, because of concern of losing the network, that is important to the rural districts. He stressed, the survivability of the rural hospitals is paramount and explained that President Clinton's proposal would emphasize our regeneralization of care by using Utah and Idaho more freely than Nevada does now. In his opinion, it is an issue that the legislature should watch closely.
Chairman Rawson expressed his concern, that this is a matter of life or extended permanent injury. He noted that oftentimes, there isn't a hospital of enough sophistication to give the best of care to someone that was injured on a Nevada highway. He stated, it can make a significant difference in the outcome of their life, over the long run. If these networks are fostered, then there will be a higher level of care for rural areas, than if hugh amounts of money were put into trying to build that kind of care in the rural area itself.
Mr. Ash stated, the issue for NHA was not that the person does not receive service when transported to Utah, but whether or not Nevada pays for that service, once it has been rendered. Mr. Ash questioned, when our hospital serves a patient from Utah, who is indigent, are Nevadians getting the same kind of reciprocal treatment. Mr. Hadfield responded, they do cooperate, and stated, the board would be happy to work with the hospital association in drafting regulations that would prevent, what might be perceived as an open door.
Chairman Rawson advised the committee that Michael McMahon, Welfare Director, Churchill County, was unable to attend to speak on this bill, therefore, the committee would hold the bill, just for his input, and then process it.
Senator Glomb asked, has the fund been depleted or is there a carryover. Mr. Hadfield stated, the balance of the fund has been spent. In 1989, the levee of the fund was increased from 1 cent to 1 1/2 cents. He stated, the hospitals have been very supportative of how it has been administered and the payments that were made through it.
Senator Glomb asked, with the one-half cent increase, has it still been spent down. Mr. Hadfield stated it depends, one trauma case may take as much as $300,000 and the needs of the future cannot be predicted.
Chairman Rawson closed the hearing on S.B. 369.
Chairman Rawson read to the committee two bill draft requests (BDRs).
BILL DRAFT REQUEST 38-1275: Allows use of certain benefits paid to child to pay portion of cost of care and support of children in Nevada children's homes.
SENATOR O'DONNELL MOVED TO INTRODUCE BDR 38-1275.
SENATOR NEAL SECONDED THE MOTION.
THE MOTION CARRIED UNANIMOUSLY.
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BILL DRAFT REQUEST 34-692: Requires count of enrollment for month with greatest enrollment of certain handicapped minors and pupils enrolled in certain special schools or programs to be used for calculation of final apportionment for school district.
SENATOR O'DONNELL MOVED TO INTRODUCE BDR 34-692 AND REFER TO THE SENATE COMMITTEE ON FINANCE.
SENATOR GLOMB SECONDED THE MOTION.
THE MOTION CARRIED UNANIMOUSLY.
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Chairman Rawson presented to the committee, amendment number 275 (Exhibit I) for S.B. 64.
SENATE BILL 64: Redefines "surgical center for ambulatory patients" for purposes of licensure and regulation.
He explained, the assembly had cut out lines 6 through 8, and finished off the line, "care as a patient in the facility for more than 24 hours." The refinements have been taken out, where it was indicated that an oral surgeon's office wouldn't be considered an outpatient surgical center. He advised, in his opinion, to not agree with the assembly.
SENATOR COFFIN MOVED TO NOT CONCUR AND SEND TO A CONFERENCE COMMITTEE.
SENATOR O'DONNELL SECONDED THE MOTION.
THE MOTION CARRIED UNANIMOUSLY.
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Chairman Rawson asked Senator Coffin and Senator O'Donnell to serve on the conference committee.
Chairman Rawson advised the committee had been asked early in the session, for a bill to be drafted for Mothers Against Drunk Drivers (MADD), that would set up a youthful offenders program, where those kids that are guilty of driving under the influence of alcohol or a controlled substance, would spend some time at the coroner's office viewing an autopsy and spend time discussing the effects of alcohol. There are examples of this program in various parts of the country and it appears to have a very good effect, as far as decreasing repeat offenses.
SENATOR O'DONNELL MOVED FOR A BILL DRAFT REQUEST.
SENATOR BROWN SECONDED THE MOTION.
THE MOTION CARRIED UNANIMOUSLY.
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Chairman Rawson stressed, the bill must address the liability of having the youth, in the coroner's office on county time.
Senator O'Donnell reported to the committee, amendments have been worked out on S.B. 149.
SENATE BILL 149: Requires commission on professional standards in education to adopt regulations setting forth educational requirements for endorsements for teachers.
He explained the State Board of Education, would remain in control and the commission would draft the professional standards, as before.
Henry Etchemendy, Executive Director, Nevada Association of School Boards stated, that when S.B. 149 was heard before the committee, that it dealt with two areas. One, with the regulations for teacher education, which is the responsibility of the Commission on Professional Standards in Education and secondly, it dealt with the courses of study that are required to be taught at universities, which is a function of the State Board of Education. There was no amendment within the bill itself with respect to those functions of the state board. Realizing that was the intent of S.B. 149, the amendments do two things. The first section of S.B. 149 deals with regulations and amends a statute, that deals with the Commission on Professional Standards and Education and puts that language in as an amendment. Section two deals with the courses of study at the university and the approval of those, and put those in as an amendment to the current statutes which relates to the state board's responsibilities. Language was drafted language which would accommodate what the State Board of Education's responsibility is, with respect to having that information available to teachers who are seeking information, on what to take to get endorsement.
Chairman Rawson asked, would the process be easier because of this. Lindsey Jydstrup, Lobbyist, Nevada State Education Association, stated definitely. She explained the professional standards commission, the State Board of Education and people from personnel worked out a system, that may not solve every problem, but came up with a very workable solution that would make great strides in providing teachers help, in figuring out what to take for relicensure.
Mary Peterson, Deputy Superintendent, Department of Education, concurred with Mr. Etchemendy and Ms. Jydstrup, that the president of the professional standards commission was in agreement that this was a step in the right direction. She added that this would not be a cure all and the main problem is a severely understaffed office.
Senator O'Donnell concurred with Ms. Peterson, with regard to staffing. He explained, there are 1100 teachers that need to be relicensed or dealt with in some form, in Las Vegas every year and pointed out, there are only two staff members in that office.
SENATOR O'DONNELL MOVED TO AMEND AND DO PASS S.B. 149.
SENATOR GLOMB SECONDED THE MOTION.
THE MOTION CARRIED UNANIMOUSLY.
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Senator Glomb gave a report on the subcommittee for A.B. 154.
ASSEMBLY BILL 154: Revises requirements for equipment that must be installed on school buses.
She explained the committee suggested the following language:
This bill does not preclude school districts from upgrading and or replacing this equipment with more efficient/effective equipment as approved by the State Board of Education.
SENATOR GLOMB MOVED TO AMEND AND DO PASS A.B. 154.
SENATOR BROWN SECONDED THE MOTION.
THE MOTION CARRIED UNANIMOUSLY.
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There being no further business, Chairman Rawson adjourned the meeting at 2:45 p.m.
RESPECTFULLY SUBMITTED:
Judy Alexander,
Committee Secretary
APPROVED BY:
Senator Raymond D. Rawson, Chairman
DATE:
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Senate Committee on Human Resources and Facilities
April 19, 1993
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