The Committee on Commerce and Labor was called to order at 6:25 p.m., on Thursday, April 1, 1999. Chairman Barbara Buckley presided in Room 3142 of the Legislative Building, Carson City, Nevada. Exhibit A is the Agenda. Exhibit B is the Guest List. All Exhibits are available and on file at the Research Library of the Legislative Counsel Bureau.

COMMITTEE MEMBERS PRESENT:

Ms. Barbara Buckley, Chairman

Mr. Richard Perkins, Vice Chairman

Mr. Morse Arberry, Jr.

Mr. Bob Beers

Ms. Merle Berman

Mr. Joe Dini, Jr.

Mrs. Jan Evans

Ms. Chris Giunchigliani

Mr. David Goldwater

Mr. Lynn Hettrick

Mr. David Humke

Mr. Dennis Nolan

Mr. David Parks

Mrs. Gene Segerblom

GUEST LEGISLATORS PRESENT:

Assemblyman Tom Collins, Assembly District 1

STAFF MEMBERS PRESENT:

OTHERS PRESENT:

Following roll call, Chairman Buckley opened the hearing on A.B. 204.

Kathy Apple, Executive Director for the Nevada State Board of Nursing testified on A.B. 204. She introduced Sam McMullen who represented the board, and Cookie Bible who was the resident of the board. Ms. Apple requested 2 amendments to A.B. 204, (Exhibit C). The board wanted to amend section 4, page 1, line 11, by deleting the words, "in good faith and." She noted that had been agreed upon with the group who represented trial lawyers. The other amendment was in section 8, page 2, lines 23 to 40, by deleting all new language to Nevada Revised Statute (NRS) 632.0169. The definition of "Practice of nursing" would remain as it was in the statute. That was a result of a variety of groups who had concerns.

Chairman Buckley asked Ms. Apple to highlight the bill for the committee.

Ms. Apple provided members with the "Nevada State Board of Nursing Fact Sheet" (Exhibit D). Sections 2, 6, 20, 21,22, and 23 all related to the board’s request to place their role and responsibility regarding oversight of nursing schools up to national standards. Her organization wanted to be consistent with language and definitions which were used nationally. The definition of the word "accreditation" currently used in Nevada law was defined differently on a national basis. The word "approval" was suggested as a replacement because it was more appropriate. She stated it did not change the board’s function, but aligned them with proper language. Approval typically indicated a mandatory process, whereas accreditation generally indicated a voluntary process.

Section 3 came about in the drafting process of the bill; it was a section that was removed from another statute because it was thought to be more appropriate. Section 4 was requested by the board who felt its members would feel more comfortable and safe when working on a board with that section.

In sections 7, 9, 10, 15, and 16 she proposed the deletion of the words "for compensation" from the practice of registered nurses, professional nurses, and nurses assistants. She explained that language was from a 1955 American Nurses Association definition and most boards around the country had deleted it many years prior. It was related to the board’s role to ensure ongoing competency of providers. For license renewal, advanced practitioners of nursing (APNs) were required 800 hours of minimum practice in the 2 years prior, and 45 hours of continuing education. Certified nursing assistants (CNAs) were required 400 hours of minimum practice and 24hours of continuing education. Registered Nurses (RNs) and Licensed practical nurses (LPNs) were required to take a refresher course if they had not practiced in 5 years, and 30 hours of continuing education. Her organization was instrumental in facilitating the development of in-state refresher courses easily attained by nurses in Nevada. Work was considered "practice" as long as the nurses were paid. She pointed out parish nurses, who worked on a voluntary basis were concerned that after 5 years of volunteering, they would not be able to renew their license. The board felt the consumer deserved equal protection whether the nurses were paid or not, that was the reason for the deletion of the "for compensation" language.

Sections 11, 12, 13, 18, and 19 were simply requested clarifications. Section 17 was regarding the statute which related to all the fees the board charged. The board was specifically asking for an increase in the range of fees that could be charged related to the practice of nursing assistants. The board had been regulating that practice for 10 years with no fee increase. The board contracted with the Health Division to implement the federal law related to nursing assistants. That included maintenance of the nurse aid registry, approval and inspection of training programs, and investigation of allegations of abuse, neglect, and misappropriation. Federal money provided through the contract was the primary support of that program. Fees collected by the board supplemented the program, and covered the state requirements. Currently those fees accounted for 20 percent of the cost of running the program.

When Ms. Apple began as executive director in 1996, she reviewed the entire program and found there had been a decrease in federal funding by 37 percent in the previous 6 years. Additionally, in 1995 and 1996 Congress considered removing the funded mandate of training programs for nursing assistants. Given the unpredictability of the federal support and the decreasing budget over time, the board wanted to be able to increase fees when needed. Therefore, they wanted the range to be expanded so they could act accordingly to budget shortfalls in the future.

Chairman Buckley asked if the collected revenue went into the general fund, or a special nursing board fund. Ms. Apple replied it did not go into the general fund, the board operated solely on fees they collected, their budget was approved through the Governor’s Office then by the legislature. Ms. Buckley asked if the fee increase was approved by the governor, she was concerned the bill would be vetoed because of the fee increase.

Amy Halley Hill, representing the Nursing Board, stated she had a conversation with Denice Miller, Senior Policy Director of the Office of the Governor, and it appeared the bill met criteria that was acceptable to the governor to proceed forward. It was Ms. Hill’s understanding if a unified industry supported a fee increase, that would be a reason not to veto the legislation. She explained the situation the Nevada Nursing Board faced with the possibility of losing federal funding, and while A.B. 204 needed further review, it appeared to have the support of the majority of the industry.

Assemblywoman Giunchigliani pointed out the term "accreditation" was deleted in section 13; however, it remained in section 6, and asked why. Ms. Apple stated they needed to use two terms. Nursing schools went through two levels of review, one by the board of nursing; and usually on a voluntary basis, by a national nursing organization that accredited them, so that met the definition. If there had been a recent accreditation, the board would review that material rather than do a full survey. Ms. Giunchigliani asked why there was a 35,000 population cap in section 14. Ms. Apple said a school district with less than 35,000 enrolled pupils would not be required to have a chief nurse.

Sam McMullen noted the Nurses Association, Medical Society, hospitals and trial lawyers were all in agreement with A.B. 204.

Assemblyman Parks referred to the fee schedule in section 17, and wondered what the typical renewal fee was. Ms. Apple replied the renewal fee for a nurse’s assistant was $20 for 2 years. Mr. Parks noticed there were many additional fees, for example A.B. 204 read "for approval of training programs," he asked if those were mandatory and how they were calculated into such a fee. Ms. Apple stated it did not relate to the fee the nursing assistant paid, it related to the facility that was offering a training program.

Assemblyman Hettrick commented it was nice to see a board propose legislation that was not simply for their protection, but it looked like they were trying to clean up the law and make it work better.

Tim M. Fries, Legislative Advocate, representing the Nevada Nurses Association did not testify, but provided members with written testimony which noted the Nevada Nurses Association’s support for A.B. 204 (Exhibit E).

Chairman Buckley closed the hearing on A.B. 204. She asked members to entertain a motion.

Chairman Buckley opened the hearing on A.B. 278.

Assemblyman Tom Collins, Assembly District 1, presented the bill. He stated a constituent of his, Loretta Eichelberger, requested A.B. 278. He provided copies of proposed amendments (Exhibit F). In the bill, there were several areas in which he requested the word "may" be replaced with the word "shall." The second amendment, which dealt with contractors, or affiliates of a contractor, would exempt individuals who were loaning money of their own on projects. He stated the bill provided more accountability under the state regulation.

Chairman Buckley noted the bill was very comprehensive and was presented late in the session when time was limited. She asked Mr. Collins if he could explain the bill to the committee particularly what A.B. 278 accomplished in terms of the law. She asked how the bill related to the interim study and what provisions were contained in other bills that were currently being processed.

Mr. Collins stated much of the content of A.B. 278 was included in A.B. 64. He suggested his amendments be added to A.B. 64 in order to require more responsibility of mortgage companies, with the exception of those that were doing their own financing.

Mr. Goldwater stated Mr. Collins had been on the subcommittee that regulated mortgage investments. Most of what was in A.B. 278 was included in A.B. 64. Mr. Goldwater stated the single-net worth requirement in section 2 of A.B. 278 was a significant difference, it was not bifurcated as it was in A.B. 64. Also in section 17 it removed the exemption for Federal National Mortgage Association (FNMA) and U.S. Department of Housing and Urban Development (HUD) currently in chapter 645B of the Nevada Revised Statute (NRS).

Chairman Buckley asked Mr. Collins the reason for removing the exemption. Mr. Collins explained the only recourse for any Nevadan was that they would have to go to federal court, as Nevada had no jurisdiction because of that exemption. The Nevada Consumer Affairs Division, Financial Institutions Division of Nevada, nor the attorney general would do anything for a citizen.

Chairman Buckley asked Mr. Collins if the amendment from Lionel Sawyer, page 1of Exhibit F, re-established the exemptions, and regarding paragraph 6, she asked if that created a new exemption for contractors. Mr. Collins stated in section 17 where it removed the exemptions, that amendment reinstated the exemptions for those who built many homes, and did their own financing and mortgaging. They would not be in the same category as builders who sought outside finances.

Chairman Buckley closed the hearing on A.B. 278. She stated she felt uncomfortable because of the major policy steps the bill addressed, it was late in the session, and much of A.B. 278 was covered in A.B. 64.

Mr. Goldwater suggested because of the lateness of the session, it was difficult to deal with major policy issues. If Mr. Collins was comfortable, Mr. Goldwater wanted to proceed with A.B. 64 and consider some of the policy issues in A.B. 278 at another time. Mr. Collins agreed with Mr. Goldwater and noted if A.B. 278 could not be handled as a separate bill, certain items could certainly be incorporated in A.B. 64. Chairman Buckley noted currently A.B. 64 would be reprinted, and the committee would process it the following week and consider further amendments.

ASSEMBLYMAN DINI MOVED TO INDEFINITELY POSTPONE A.B. 278.

ASSEMBLYMAN HETTRICK SECONDED THE MOTION.

THE MOTION CARRIED UNANIMOUSLY.

Chairman Buckley opened work session.

Vance Hughey, Principal Research Analyst, noted the sponsor of A.B. 63, Assemblyman Anderson, had indicated there was no need proceed with the bill at the time.

ASSEMBLYMAN HETTRICK MOVED TO INDEFINITELY POSTPONE A.B. 63.

ASSEMBLYMAN DINI SECONDED THE MOTION.

THE MOTION CARRIED UNANIMOUSLY.

Mr. Hughey referred to the work session document (Exhibit G). He noted Assemblyman Humke had worked with the Department of Motor Vehicles (DMV), and had proposed some amendments. Assemblyman Humke stated his constituent had approved the amendments; he proceeded to explain each proposed amendment to the bill (Exhibit G).

Ray Sparks, Deputy Director for the Department of Motor Vehicles (DMV) and Public Safety, introduced Dana Mathieson, who represented the Drivers License Division of the DMV. He stated they had worked with Mr. Humke to arrive at amendments that were mutually acceptable, and confirmed they had no problems with those proposed by Mr. Humke. Chairman Buckley asked if those amendments would cause harm to any other businesses. To which Mr. Sparks answered "No."

ASSEMBLYWOMAN GIUNCHIGLIANI MOVED TO AMEND AND DO PASS A.B.492.

ASSEMBLYMAN GOLDWATER SECONDED THE MOTION.

THE MOTION CARRIED UNANIMOUSLY

Chairman Buckley adjourned the hearing at 7:20 p.m.

RESPECTFULLY SUBMITTED:

Meagen Colard,

Committee Secretary

APPROVED BY:

Assemblywoman Barbara Buckley, Chairman

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