MINUTES OF THE
SENATE COMMITTEE ON HUMAN RESOURCES AND FACILITIES
Sixty-seventh Session
May 10, 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, May 10, 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:
Assemblywoman Jan Evans, District 3
STAFF MEMBERS PRESENT:
Judy Alexander, Committee Secretary
Pepper Sturm, Research Analyst
Gary Crews, Legislative Auditor
OTHERS PRESENT:
Blanche M. Zucher, Chairperson, Committee for Protection of Children, Department of Human Resources, State of Nevada
May Shelton, Director, Washoe County Department of Social Services, Vice Chairperson, State Committee for the Prevention of Child Abuse
Kathleen Stewart, Committee Member, Committee for the Protection of Children, Children's Trust Fund
Barbara Ballentine, Executive Director, Young Women's Christian Association (YWCA), Reno-Sparks
John H. Sarb, Administrator, Division of Child and Family Services, State of Nevada
Caroline Ford, Assistant Dean/Director, Center for Education and Health Services Outreach, School of Medicine, University of Nevada, Reno
Yvonne Sylvia, Acting Administrator, State Health Division
Bob Barengo, Lobbyist, Humana
Chairman Rawson opened the hearing on Assembly Concurrent Resolution (A.C.R.) 35.
Assemblywoman Jan Evans, District 3, gave remarks regarding A.C.R. 35.
ASSEMBLY CONCURRENT RESOLUTION 35: Establishes goals for prevention of child abuse and neglect and commends Nevada's Committee for the Protection of Children.
She explained, a bill sponsored by Assemblyman David E. Humke in 1985, started the Children's Trust Account and the Committee for the Protection of Children. She introduced Blanche M. Zucher, Chairperson, Committee for Protection of Children, Department of Human Resources, State of Nevada and May Shelton, Director, Washoe County Department of Social Services, Vice Chairperson, State Committee for the Prevention of Child Abuse, who spoke in support of A.C.R. 35.
Ms. Zucher explained, the Committee for Protection of Children administers the Children's Trust Fund, which was established by legislative action in 1985, for funding the child abuse and neglect prevention programs statewide. She read from her prepared testimony (Exhibit C).
Ms. Shelton provided the committee with a graph (Exhibit D), which shows the number of child abuse and neglect reports made to the state central registry, which is maintained by the Division of Child and Family Services. She read from her prepared testimony (Exhibit E). She explained, the committee is looking for outside funding from foundation grants, donations, etc.
Kathleen Stewart, Member, Committee for the Protection of Children, Children's Trust Fund, read from a prepared testimony in support of A.C.R. 35 (Exhibit F).
Barbara Ballentine, Executive Director, Young Women's Christian Association (YWCA), Reno-Sparks, testified in support of A.C.R. 35 (Exhibit G).
Senator Brown explained to Ms. Ballentine, the committee unanimously passed Senate Bill (S.B.) 260, which would require that students between grades 6 and 12 in the schools, be taught how to deal with children. .
SENATE BILL 260: Requires completion of course in child development and human interaction skills for graduation from high school.
She asked Ms. Ballentine, did she see that as helpful towards this type of goal, that is being set out. Ms. Ballentine answered, absolutely. She pointed out that people focused on what should not be done for a long time. To take a proactive approach, where those skills would be taught in the schools, is very critical.
Chairman Rawson closed the hearing on A.C.R. 35.
SENATOR GLOMB MOVED TO ADOPT A.C.R. 35.
SENATOR TOWNSEND SECONDED THE MOTION.
THE MOTION CARRIED. (SENATORS O'DONNELL AND NEAL WERE ABSENT FOR THE VOTE.)
Chairman Rawson opened the hearing on Senate Bill 411.
SENATE BILL 411: Allows use of certain benefits paid to child to pay portion of cost of care and support of children in Nevada children's homes.
John H. Sarb, Administrator, Division of Child and Family Services, State of Nevada, explained the bill came out of the Legislative Commission's Audit Subcommittee. It was pointed out in the course of the audit, the state is specifically exempted in the 1961 statute, from using social security and veteran's administration funds, paid to children for the cost of their care. Those funds, when paid by social security, the Supplemental Security System (SSI), or the Veteran's Association (VA), go towards the cost of care. In every other instance in the division, when children receive similar funds, that money is credited towards their cost of care. For reasons that no one can recall, there is a specific mention in the children's home statute, Nevada Revised Statute (NRS) 423 in 1961, prohibiting that. He believed the audit subcommittee felt, that it made more sense to have the children's home statute consistent with the practice in the rest of the state.
Chairman Rawson asked, is that money set aside for them and used for them as a stipend or like a scholarship, when they left the home. Mr. Sarb responded yes, when the child returns home, that money is returned to them.
Chairman Rawson expressed concern, that the child not just be abandoned when they turned 18 and that there would be something that would help them to become successful. Mr. Sarb said, he would prefer that the money would be set aside for them, at least for the last year the child is in state care, so they would have a nest egg when they turn 18. He noted, they do have an independent living program that seeks to cushion the blow for children reaching a majority and going out, which is a good program, in his opinion. He stated, the current practice does not make sense. The children's home statute contemplates a different arrangement for children than is a fact in the children's home at the present time. Chairman Rawson asked is the social security money that is provided for the care and upbringing of the children, such as to buy food, clothing and shelter, is it being used or a portion of that used for their stay. Mr. Sarb said, it is paying for what it is legislated to pay for.
Senator Glomb asked why did this not say, children in state custody, so it could be used towards a child who might be in foster care or a group home. Mr. Sarb explained, in every other circumstance, except the children's home, that is the practice. If a child is in foster care and receives social security, that social security paid to the child is then credited towards their cost of care. The exception to that is the children's home. If a child is in foster care receiving social security, that money would be credited to their cost of care. If the child would be moved to the children's home, that money would stop being credited towards the cost of care and would go into an account for the child.
Senator Glomb referred to line 23, and asked, did release from the school, mean release from the facility. Mr. Sarb explained, that is statutory for the children' home.
Chairman Rawson noted, that this is new language and his first impression was that this must be a statement that is consistent with other law. He suspected that someone was making a statement, that they did not want to change a policy, so they drafted the bill. Senator Glomb said, it would seem that support payments should be used. Mr. Sarb explained, court ordered support payments, in every other instance, are credited towards the cost of care, just as are social security payments. Senator Rawson said that he knew there was an interest, in trying to help them build a nest egg, so they could start their first years of schooling, business or whatever they were going to do. He commented that he would suspect there was no reason why the court ordered money should not be used. Mr. Sarb stated, he was not aware of any.
Chairman Rawson responded to a statement from Senator Glomb and advised the committee to look at the language in line 11, where the child is a ward of the state, under the provisions of NRS 423. He asked that it be indicated there, upon release from being a ward of the state, under the provisions of such and such.
Gary Crews, Legislative Auditor, explained that in several audits, his department identified that social security money was being taken from children and that was prohibited by laws. Chairman Rawson asked, was this bill drafted just to give the authority to do what they were doing. Mr. Crews stated, they did not make this recommendation, they present it to the Legislative Commission's Audit Subcommittee, and it was then presented to the legislative commission. When it was presented to the legislative commission, Senator Adler became concerned and thought it should be changed, to be consistent with the rest of the provisions for foster care. Chairman Rawson asked, did he have any concern, that it is poor policy to pass the bill. Mr. Crews responded no, and explained, it is thought this is a policy decision and they do not have a problem with that policy. Chairman Rawson asked, is anyone included in the Governor's budget, who would come under this, at this point. Mr. Crews stated, he could not say, at that point. Chairman Rawson asked Mr. Sarb, was that no? Mr. Sarb said, no. He explained, the money that they expect to get from these payments, for all the other children, is a part of the budget. The best estimate was that, if this bill were to pass, it would bring in approximately $24,000 a year. That would come from one quarter, where there were some mistaken billings or notations and about $6,000 is indicated for the quarter.
Chairman Rawson closed the hearing on S.B. 411.
Chairman Rawson opened the hearing on S.B. 418.
SENATE BILL 418: Requires establishment of primary health care network for improving health status of mothers and children.
Caroline Ford, Assistant Dean/Director, Center for Education and Health Services Outreach, School of Medicine, University of Nevada, Reno spoke in support of S.B. 418. She explained, the history behind this bill was that for a number of years, the School of Medicine had been working with the State Health Division on maternal and child health issues. She stated, it is their belief, they need to provide some level of medical, clinical leadership in this arena. They requested that a position be established, that would be jointly shared between the School of Medicine and the State Health Division, for the purpose of improving the health status of mothers and children, and to look at the issues of access to care. She read from a prepared testimony (Exhibit H), which includes several amendments. The amendment to section 3, page 2, line 15, infers that the person would be directly responsible for going to geographically disadvantaged areas to provide care. She stated, they would like to be able to address that person working with a network of providers, in how to insure access to care, especially because of geography or socioeconomic status. She stated, the next amendment would address page 2, line 35, and they would like this to read that the health division may employ a management assistant, rather than the medical directors, since the procedure of the employing agency would be to use their personnel department.
She asked, beginning on line 38, section 4 forward to the end of the bill, to be deleted. There were some additions through the Legislative Council Bureau. She stated, anyplace there is reference to maternal child health or clinical practice, that this medical person is inserted, to have a role in responsibility for management, including some fiscal matters, and that is not the intent of the legislation. They are requesting that any provisions from line 38 on be deleted.
Ms. Ford stated, the last change would be to the fiscal note which addresses a .5 full time equivalency (FTE) practioner. The bill itself addresses that there is a full time practioner that is divided 50 percent of the time in each location. The amendment would be that it needs to reflect a full time practioner that is employed by two agencies. Chairman Rawson drew attention to the fact there would have to be an appropriate budget adjustment. He asked, would that increase the fiscal note. Ms. Ford stated, it would increase the fiscal note and if that would be a problem for the committee, the School of Medicine could work with the State Health Division in making adjustments, in some of the other operating expenses that are attached.
Chairman Rawson explained, if this bill passed this committee, they would have to re-refer it to the Senate Committee on Finance. He asked, is there an agreement within the agencies, that they want this concept to fly and that they would be willing to make other adjustments. Ms. Ford stated, that is her understanding and the State Health Division was present, if Chairman Rawson wanted them to make comments.
Chairman Rawson asked, how many of the women, who would access this program, would be on Aid to Dependent Children (ADC). Ms. Ford referred the question to Yvonne Sylvia, Acting Administrator, State Health Division. Ms. Ford explained, what they are striving for is looking at all issues of access, not just for people who fall within certain covered programs. All people and people that definitely are disadvantaged, even if they are in a health insurance program, who have a problem because of geographic access.
Senator Glomb asked, did this come from the Maternal and Child Health Advisory Board or was this from the School of Medicine. Ms. Ford stated, the School of Medicine was the original instigator of the bill, though they did work closely with the Maternal and Child Health Board.
Senator Glomb referred to the fiscal note and asked, would half be for the health department and half be for the School of Medicine. Ms. Ford responded, no, only half of the fiscal, which applies to the physician's salary, would apply to the School of Medicine, The rest of the fiscal note rests within the State Health Division and is not included in the Governor's budget.
Senator Coffin commented, the fiscal note directs the committee in other directions. It also indicates there are some definitional problems. They would not be able, according to the fiscal note, to determine the impact, until adequate maternal and child health care was defined, which appears in the bill on page 2, line 16. He asked, should the committee undertake to define it, during the committee discussion, or were there other resources that had defined it, of which the maker of the fiscal note was unaware.
Chairman Rawson stated, there is a network.
Yvonne Sylvia, Acting Administrator, State Health Division, asked Senator Coffin if he was referring to line 16, page 2, and explained that Ms. Ford recommended the section be modified to say, "to develop a plan." She stated, adequate maternal and child health services is a very nebulous term and that she was not sure that could be defined very well. Senator Coffin responded, he did not hear Ms. Ford say she wanted to amend out that language.
Ms. Ford explained, her language is to address the development of a plan, to provide access to care for those mothers and children disadvantaged, due to geographic and or socioeconomic status.
Senator Coffin asked Ms. Ford, did she indicate this at that time, that would reduce or increase the fiscal note. Ms. Ford explained, at that particular time, the fiscal note address came after that. The problem is that there is not enough salary budgeted to have this person be a full time physician. It is budgeted at half time and the way the bill reads, is that the time is split 50 percent in each location, so it would mean that there would be a quarter time and the state would have a quarter time of delivering service.
Senator Coffin asked was it common policy to name employees of the state to be required to be citizens of the United States at a particular level. He pointed out, that is referenced on section 2, page 1, line 10. Ms. Ford responded, she thought the Legislative Council Bureau had put that in and it may have something to do with the Board of Medical Examiner requirements, to be licensed as a physician in the state of Nevada. Senator Coffin commented, he was not sure that all physicians that are licensed, are required to be citizens. Many of them are Canadian and citizens not naturalized, he thought. Ms. Ford stated, that was not addressed by the School of Medicine.
Senator Glomb asked Ms. Ford, why did she find this necessary when there is a maternal and child health advisory board and there are several doctors who serve on the board. She added, that she was trying to understand the need for another physician to be doing those activities. Ms. Ford explained, the continuity is at issue, in terms of insuring that there is a position, within the State Health Division, that could provide clinical leadership in overseeing protocols and overseeing programs that affect mothers and children for that continuity.
Senator Brown stated, if this bill would have the effect of improving primary health care for mothers and children, in addition to state paid health costs, there would be huge savings throughout the entire state, but the savings would not show up until 3 years later. She pointed out that the fiscal note does not show offsets or minuses for what would be saved, and asked, was that ever included in the fiscal note. Ms. Ford responded, she did not think it was requested, but that had actually been a long standing message by the maternal and child health board, the health division and the School of Medicine, that the preventative aspects of accessing care early, especially in the case of prenatal care, is a cost savings and the School of Medicine has demonstrable evidence that can be provided to the committee. Senator Brown asked, were the numbers brought up to the Senate Committee on Finance. Ms. Ford explained, the School of Medicine would be happy to work with the state in providing information related to that.
Ms. Sylvia commented that the fiscal note was prepared solely by the State Health Division, not by the School of Medicine. She drew attention to the fact that Ms. Ford alluded to the possibility of negotiating some of the other cost downward, and reminded the committee, because the School of Medicine has not included their costs associated with an additional half time physician, there would also be additional operating costs. She was referring to the fact the person would need to have a space, a telephone, paper, supplies, etc. Chairman Rawson stated he may put this into a subcommittee, as far as the amendments and would then ask for a new fiscal note.
Robert R. Barengo, Lobbyist, Humana, explained he represented Sunrise Hospital and stated, this type of legislation would have an effect upon the provider tax, because it seeks to direct patients and the way the provider tax is currently being discussed, as to how it is going to work with having a free flow of patients.
Chairman Rawson closed the hearing on S.B. 418.
Chairman Rawson brought S.B. 72 to the attention of the committee.
SENATE BILL 72: Authorizes certain additional persons to enforce laws pertaining to illegal disposal of garbage.
Chairman Rawson advised the committee, this is an amendment that redefines garbage and refuse, but the bill itself is about illegal dumping, not about landfills or dumps. The amendment seems to bring some of the commercial garbage collection into the controversy surrounding this. He explained there were some subcommittees working now and suggested that the committee does not concur.
SENATOR NEAL MOVED TO NOT CONCUR WITH S.B. 72.
SENATOR TOWNSEND SECONDED THE MOTION.
THE MOTION CARRIED.
* * * * *
Chairman Rawson brought before the committee a bill draft request (BDR).
BILL DRAFT REQUEST 35-78: Creates recreational trail advisory board and provides funding for recreational trails.
After discussion by the committee, it was decided to allow the Committee on Government Affairs introduce the BDR.
Chairman Rawson asked the committee to look at 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.
Chairman Rawson stated that S.B. 57 had been requested by Clark County Social Services, to allow that agency the option of excluding single employables from receiving general assistance grants. He explained, John Sasser of the Nevada Legal Services opposed the measure, unless employable was defined in a certain manner. He stated, the committee could pass this bill the way it is, it could be defined or could allow the counties to develop their own definitions.
Chairman Rawson directed the committee to look at section 2 of S,B, 57. He explained, if lines 12 through 15 on page 2 were deleted and this language is inserted, 12 through 15 authorizes the payment of cash grants for necessary maintenance directly to only those indigent persons deemed by the board to be unemployable and responsible for dependent children. If that language be changed to establish specific categories of persons listed in section 1 of NRS 428, for the purposes of establishing eligibility, determining type of benefit and assigning time limits for duration of benefits and add another subsection, establish by regulation criteria for determining eligibility for each category, that could be left.
Senator Glomb stated her understanding of the purpose of the bill, is so they can set priorities and in essence give the county the authority to sometimes deny service, if in fact there are a large number of mothers children needing service. In her opinion, it is against the law to do that.
Chairman Rawson stated this would allow the county to finish things like the workfare program and whether or not that is legal, depends on how strict they are in their exclusions.
Senator Coffin commented, this would allow the county to spread their money around, he did not see this as harmful and did not see the amendment as making a great deal of change. He supports the bill as it is, but he would be willing to accept the amendment.
Chairman Rawson explained that staff had been asked to study this and it appeared from the staff review, states may establish separate categories of persons eligible for general assistance. Then the type and duration of the benefits could be established. He explained, if the general assistance area be established, then what this bill is asking for could be done.
Senator Brown commented, she thought this bill is in response to the lawsuit brought against the gate program. The gate program in Clark County requires that for an able bodied person who has no children, to receive assistance, he or she would have to do some service and must show up for that job, day-to-day. She explained, she thought they were trying to avoid getting sued over making those kinds of decisions, by having the legislators say, this is legal. Chairman Rawson added, not only would the person be willing to work but they would have to possess the necessary ability to work. He noted that Carol Vilardo, Lobbyist, Nevada Taxpayers Association, had some potential language on that and that was not in our options. It is his understanding that John Sasser approved of it. He advised the committee, they would review the language, bring the bill back and try to dispose of the bill one way or another on Wednesday.
Senator Brown stated, her notes on the bill reflect that there was a problem with ex-prisoners and that the committee may have wanted to look at requiring 6 months residence for them to be eligible.
There being no further business, Chairman Rawson adjourned the meeting at 2:35 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
May 10, 1993
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