MINUTES OF THE
SENATE COMMITTEE ON HUMAN RESOURCES AND FACILITIES
Sixty-seventh Session
April 26, 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 26, 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 Diana M. Glomb
Senator Lori L. Brown
COMMITTEE MEMBERS ABSENT:
Senator Randolph J. Townsend
Senator Joseph M. Neal, Jr.
Senator Bob Coffin
STAFF MEMBERS PRESENT:
Judy Alexander, Committee Secretary
Pepper Sturm, Research Analyst
OTHERS PRESENT:
Michael J. McMahon, Welfare Director, Churchill County
Michelle Bero, Fund Manager, Indigent Accident Fund, Nevada Association of Counties
Yvonne Sylva, Acting Administrator, State Health Division
Chairman Rawson opened the hearing on Senate Bill (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.
Michael J. McMahon, Welfare Director, Churchill County and Chairperson, Nevada Association of County Welfare Directors (NACWD), testified NACWD brought S.B. 369 before the legislature for their consideration. He explained, the Indigent Accident Fund (IAF) was created several years ago by the collective counties to assist the counties in their obligation and to provide indigent medical care. He expounded, the theory was that one motor vehicle accident could financially wipe out all of the 10 cent monies, that a county would have, to provide medical care to its residents. The IAF trustees had come to the welfare directors association and requested that language be drafted, that would enable them to consider paying medical facilities outside of the state, for indigent medical care. Two such cases were presented to the indigent accident trustees this past year, that resulted in the individuals being transported out of the state of Nevada to receive emergency care. He explained, the NACWD was not asking for language which would mandate or open a flood gate, so to speak, to have these funds paid to outside of the state medical facilities, but rather to allow the board to have the option of considering paying those bills when due. He stressed, the eligibility criteria for this particular IAF fund is very narrow. The NACWD would like to enhance or continue being able to provide critical medical care, for victims of motor vehicle accidents. He stated, he spoke with Mr. Bill Welch, of the Nevada Rural Hospital Association, who had expressed concerns and noted, there was some confusion over the funds, from which this would come. He explained, there are two funds. One is a 10-cent fund, which takes care of the counties obligation for indigent medical care and the other fund is a 1 1/2 cent fund, which is the IAF fund.
Chairman Rawson noted, Mr. Welch advised that he supports this, now that he has a clear understanding of the two funds.
Mr. McMahon responded to a question from Chairman Rawson and explained that this was an option to help the counties most effected, that border other states. All counties participate in the IAF fund, because it is a mechanism to assist them in providing their obligation.
Michelle Bero, Fund Manager, Indigent Accident Fund, and with the Nevada Association of Counties, testified there will be approximately 3.5 million dollars in the fund this year. She explained, annually 120 to 150 claims are paid out of this fund and the fund is depleted every year. Biannual board meetings are held to review the claims that have been submitted by all of the counties. Once the claims have been totaled, the funds are prorated out to all of the claims.
Chairman Rawson closed the hearing on S.B. 369.
Chairman Rawson opened the hearing on Assembly Bill (A.B.) 131.
ASSEMBLY BILL 131: Revises provisions relating to reporting information on certain cases of cancer.
Yvonne Sylva, Acting Administrator, State Health Division testified in support of A.B. 131, as referenced in her summary (Exhibit C).
Chairman Rawson stated, this simply adds oral and maxillofacial surgery offices, which would also include plastic surgery offices, and allow them to do their own abstracting.
Senator Glomb referred to page 1, section 2, subsection 3, and asked, would certain facilities be charged more than other facilities. Ms. Sylva explained, the way the Nevada Revised Statutes (NRS) is currently written, the State Health Division can only access a fee for those abstractions done by them. Passage of A.B. 131 would allow the health division to set up an additional fee, for those facilities that do their own abstractions and it would cause the division not to charge more than one-third of what the regular charges are, for that purpose. Senator Glomb stated, so it should be a flat fee, if the state is doing the abstracting and be a reduced fee for those facilities that do their own. Ms. Sylva answered, that is correct.
In response to a question from Senator O'Donnell, in reference to fees, Ms Sylva stated, the operation of the Cancer Registry has a total cost associated with it and is based upon the number of cancer cases that are abstracted within the state, regardless of whomever was doing the abstracting. She explained, there are costs associated with the program operation that do not go away, just because someone else is doing the abstraction. A fee must be paid to the Rocky Mountain Cancer System for each case that has been entered into it. The fee is currently $2.15 per abstraction that is entered. She stated, the current fixed fee charged by the State Health Division, is $20 per abstract, which means, per patient. She explained, that is based upon the way NRS is currently written, it would be no more than one-third of what the fee was.
Senator O'Donnell asked, how much money does it take to run the entire program. Ms. Sylva responded, that currently $100,000 of the program is based upon the collection of fees and about $40,000 is from General Funds. Combined, the funds total $140,000 for the operating cost.
Chairman Rawson closed the hearing on A.B. 131.
Chairman Rawson asked the committee to look at S.B. 369.
SENATOR O'DONNELL MADE A MOTION TO DO PASS S.B. 369.
SENATOR BROWN SECONDED THE MOTION.
THE MOTION CARRIED. (SENATORS TOWNSEND, NEAL AND COFFIN WERE ABSENT FOR THE VOTE.)
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Chairman Rawson asked the committee to look at A.B. 131.
SENATOR BROWN MADE A MOTION TO DO PASS A.B. 131.
SENATOR GLOMB SECONDED THE MOTION.
THE MOTION CARRIED. (SENATORS TOWNSEND, NEAL AND COFFIN WERE ABSENT FOR THE VOTE.)
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Chairman Rawson addressed Senate Joint Resolution (S.J.R.) 20.
SENATE JOINT RESOLUTION 20: Urges selection of Nevada as state for testing evolving National Health Program.
Chairman Rawson noted, there was concern expressed on part of the committee, regarding approval of this, not knowing more about the health program. He advised, he would hold this until the next work session.
Chairman Rawson addressed Assembly Concurrent Resolution (A.C.R.) 16.
ASSEMBLY CONCURRENT RESOLUTION 16: Supports national educational goals for State of Nevada.
Chairman Rawson noted, there were some specific criticisms, that the Nevada 2000 goals should be more specific, rather than going along with whatever the country decides. He advised that the committee would wait for Senator Coffin's input, at a later work session.
Chairman Rawson addressed A.C.R. 18.
ASSEMBLY CONCURRENT RESOLUTION 18: Urges boards of trustees of county school districts to adopt daily class schedules for public elementary schools which include fixed period of uninterrupted teaching time during each school day.
Senator Brown stated, she no longer had concerns with this bill.
Pepper Sturm, Research Analyst advised the committee, the bill was requested by the Interim Study [A.C.R. 85] On Elementary and Secondary Education, on which he served as staff. He stated, this was one of the suggestions made by the Nevada State Education Association.
SENATOR O'DONNELL MOVED TO ADOPT A.C.R. 18.
SENATOR GLOMB SECONDED THE MOTION.
THE MOTION CARRIED. (SENATORS TOWNSEND, NEAL AND COFFIN WERE ABSENT FOR THE VOTE.)
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Senator Glomb advised the committee that she had received a letter (Exhibit D) from Denell A. Hahn, Director, Clark County Social Services requesting to see no further action on S.B. 58. Bertha J. Warrick, Division Manager, Social Services, Clark County had also contacted her with the same request.
SENATE BILL 58: Excludes financial resources of certain incapacitated persons in determining eligibility for assistance to medically indigent persons.
SENATOR GLOMB MOVE TO INDEFINITELY POSTPONE S.B. 58.
SENATOR O'DONNELL SECONDED THE MOTION.
Senator Brown asked what would be done with people who do not have a guardian and cannot be covered during that time. Chairman Rawson stated, there was testimony indicating that this may fall under the public administrators' statutes as it is, so it may be taken care of. He advised, Clark County Social Services do want further study on the issue in the form of an interim study.
THE MOTION CARRIED. (SENATORS TOWNSEND, NEAL AND COFFIN WERE ABSENT FOR THE VOTE.)
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There being no further business, Chairman Rawson adjourned the meeting at 2 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 26, 1993
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