The Committee on Health and Human Services was called to order at 1:35 p.m. on Monday, February 22, 1999. Chairman Vivian Freeman presided in Room 4100 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:

Mrs. Vivian Freeman, Chairman

Mrs. Ellen Koivisto, Vice Chairman

Ms. Merle Berman

Ms. Barbara Buckley

Ms. Dawn Gibbons

Ms. Sheila Leslie

Mr. Mark Manendo

Ms. Kathy McClain

Mr. Kelly Thomas

Ms. Kathy Von Tobel

Mr. Wendell Williams

COMMITTEE MEMBERS ABSENT:

Ms. Sharron Angle

STAFF MEMBERS PRESENT:

OTHERS PRESENT:

Simultaneous video teleconference was held in Room 4401, Grant Sawyer State Office Building, 555 East Washington Avenue, Las Vegas, Nevada.

OTHERS PRESENT:

Following roll call, Chairman Freeman announced three Bill Draft Requests (BDRs) for committee introduction and approval.

BDR S-1643 - Proposes an appropriation of $200,000 to Clark County for guardian ad litem model program for children who are abused and neglected.

ASSEMBLYMAN MANENDO MOVED FOR COMMITTEE INTRODUCTION

OF BDR S-1643.

ASSEMBLYWOMAN GIBBONS SECONDED THE MOTION.

THE MOTION CARRIED UNANIMOUSLY.

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BDR 1219 - Makes various changes concerning liability of foster homes for acts of children placed in their care.

ASSEMBLYWOMAN BUCKLEY MOVED FOR COMMITTEE INTRODUCTION OF BDR 1219.

VICE-CHAIRMAN KOIVISTO SECONDED THE MOTION.

THE MOTION CARRIED UNANIMOUSLY.

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BDR 39-443 – Proposed change the name of Mental Hygiene and Mental Retardation, Department of Human Resources, and certain budget accounts and facilities of division. (A.B. 305)

ASSEMBLYWOMAN BUCKLEY MOVED FOR COMMITTEE INTRODUCTION.

VICE-CHAIRMAN KOIVISTO SECONDED THE MOTION.

THE MOTION CARRIED UNANIMOUSLY.

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Chairman Freeman announced the balance of the meeting would be informational only. A representative from the Governor's Office and the Attorney General would speak regarding the tobacco settlement money. There would be no public testimony or questions.

Scott Scherer, General Counsel, Governor's Office, identified himself and thanked the committee for the opportunity to speak regarding the State of Nevada's interest in the National Tobacco Settlement. His testimony (EXHIBIT C) stated in part:

The tobacco settlement was national in scope and provided for certain national programs. Each state had filed its own lawsuit. In Nevada, the lawsuit was filed in the Second Judicial District Court in Washoe County. The State of Nevada was the only plaintiff in the Nevada lawsuit. It was not a class action suit.

The states' lawsuits were settled through a Master Settlement Agreement, approved by the states and participating manufacturers in November 1998. On December 10, 1998, the Second Judicial Court for the State of Nevada approved a consent decree (EXHIBIT D, CONSENT DECREE AND FINAL JUDGMENT) adopting the Master Settlement Agreement (MSA) and enjoined the participating manufacturers from engaging in certain conduct (primarily involved with marketing tobacco products to minors).

Pursuant to the MSA, the proceeds would be available when 80 percent of the participating states achieved "state specific finality" or June 30, 2000, whichever was earlier.

Mr. Scherer stated certain risks had to be taken into account:

• The Federal Government would withhold Medicaid matching funds in an amount it calculated as its share of the proceeds. Governor Guinn believed the Federal Government was not entitled to a share of the proceeds. Nevertheless, the State of Nevada might be unable to stop them from trying and might have to sue the Federal Government to force them to make their Medicaid contribution. Governor Guinn had been working with the National Governors Association to oppose the Federal Government's claim. Mr. Scherer acknowledged the Attorney General had also worked on the issue, and while the Governor and the Attorney General might not have agreed on how the state should spend the proceeds, they had agreed the Federal Government should not get it.

• The risk the government would be successful in curbing smoking. If a significant decline in the number of people who used tobacco occurred over the next 25 years, some of the participating manufacturers might go out of business or might not be able to make their required payments. The liability of the manufacturers had been several and not joint. Thus, the other manufacturers were not responsible if one of them failed to pay its share.

The major issue had been: What could be done with the money? Mr. Scherer stated the legislature could do anything it chose to do, within the bounds of the Nevada Constitution. The Attorney General did not need the legislature's approval to file or settle the lawsuit, nor did the legislature need the Attorney General's approval with regard to spending it. Mr. Scherer based his confidence on an antiquated doctrine in Article 3, Section 1 of the Nevada Constitution called "Separation of Powers," which stated, "no persons charged with the exercise of powers properly belonging to one of these departments shall exercise any functions, appertaining to either of the others, except in the cases expressly directed or permitted in this constitution."

Mr. Scherer cited Nevada Revised Statutes 353.323, as well as the numerous articles and sections of the Nevada Constitution, that nowhere had a specific exception been made to allowing the Attorney General to limit the legislature's authority to spend the proceeds of the settlement.

Paragraph L of Section VI of the State of Nevada's CONSENT DECREE AND FINAL JUDGMENT (AKA, "CONSENT DECREE") (EXHIBIT D), stated: The funds provided to the State of Nevada under Section IX of the Agreement are to be held by the State with specific expenditures to be determined by the Governor and the Legislature through the normal appropriation process. Additionally, Paragraph L went on to state that "it is the intent and recommendation of the parties to the Agreement that such funds be used for public health purposes only."

Mr. Scherer said it apparently stated the Attorney General's intent, however, was not binding upon the legislature or the governor. If the proceeds were required to be spent for public health purposes only, the Consent Decree would have so stated in absolute terms, not with an expression of intent. It had not, because attempting to limit the legislature's authority to spend the proceeds, would have been impermissible under the Nevada Constitution without legislative approval. Rather, the operative language of the Consent Decree was the provision "specific expenditures to be determined by the Governor and the Legislature through the normal appropriation process." He said it was important to note the MSA contained no restriction of expenditure of the state's share of the proceeds. The "intent" language quoted above was inserted in the state specific Consent Decree.

Other states proposed spending the proceeds in a number of ways:

• Building schools
• Shoring up the teacher's retirement program
• Reducing the deficit and cutting taxes

Mr. Scherer brought up other arguments for Governor Guinn's position. He then outlined the Governor's proposal for using half the state's share of the proceeds for the "Millennium Scholarship" plan. The thesis for the plan, which he supported with various statistics, was outlined on page 4 of EXHIBIT C and followed the Attorney General's advice in her January 15, 1999, letter to Senator Raggio (EXHIBIT E).

In summation, Mr. Scherer said Governor Guinn believed after funding his proposed Millennium Scholarships the remainder of the money should be used for various public health programs, which he believed would provide the greatest benefit to the State of Nevada.

Frankie Sue Del Papa, Attorney General, State of Nevada, identified herself and provided a document titled "Public Health Issues for Consideration Regarding Nevada's Tobacco Settlement Proceeds: A Report to the Governor and Legislature" (EXHIBIT F).

Ms. Del Papa pointed out two important statistics in that document:

• Nevada ranked first in the nation in estimated deaths attributable to smoking.

• Nevada ranked last in the nation in per capita expenditures for health programs.

The document (EXHIBIT F) had been presented to provide the background of the litigation and the settlement process. Additionally, Ms. Del Papa stated the Attorney General's website contained information on the status of the issue from its inception which had included:

• A letter to Nevada citizens (EXHIBIT F, page 21)

• Press releases

• Comments made contemporaneous with the settlement

• Summary of the tobacco settlement proposal

• Allocation of proceeds

• Proposed Master Settlement Agreement

• Nevada tobacco timeline

• Provision for attorneys fees and costs

• Health Division policy statement

• Attorney General's comments

The Attorney General's office had been engaged in that issue for the past few years. Limited resources in the beginning allowed only monitoring the issue as it unfolded at the national level. When it became clear the benefits of the litigation justified the state's participation, the Attorney General's office entered the litigation. Statements and commitments had been made that litigation had been initiated primarily to address public health needs, particularly those of young people, and that the settlement proceeds would be used for public health purposes. The Attorney General's office had partnered with Nevada's public health community every step of the way, especially in terms of what the state might be able to do if it were successful in the litigation.

Ms. Del Papa said Mr. Scherer's testimony concerning the Consent Decree had omitted the "Whereas" clause. The clause stated, "Whereas, the parties desire to resolve this action in a manner which appropriately addresses the state's public health concerns while conserving the parties resources as well as those of the court which would otherwise be expended in litigating a matter of this magnitude." The Attorney General's office had filed with the Consent Decree legal points and authorities (EXHIBIT G, STATE OF NEVADA'S MEMORANDUM IN SUPPORT OF MOTION TO APPROVE SETTLEMENT AND CONSENT DECREE) which addressed the facts and the arguments that discussed the standards of approval of a consent decree. As the Committee on Health and Human Services was aware, there had been a history of this state being engaged in consent decrees which were subjected to continued judicial policing. Among other arguments made by the Attorney General's Consent Decree was that approval would enable the state to protect adolescents now.

The proceeds could not be disbursed until state specific finality was reached. Approximately 26 states had reached state specific finality in most of the litigation; however, two of the larger states—California and New York—had been engaged in legal proceedings relative to that process. As those states represented over 20 percent of the population, actually reaching state specific finality would be a challenge. An exact date could not be predicted, but should be no later than June 30, 2000.

There had been several federal challenges, Ms. Del Papa reported. Her office had kept the Governor, the legislature, and other interested individuals apprised because some large hurdles had to be overcome before anything could be done with the proceeds. Several entities had expressed their desire to share in the settlement proceeds. However, she believed it had been premature and unwise to rely on the settlement proceeds for any purpose until all of the federal challenges had been resolved.

As mentioned previously by Mr. Scherer, and outlined in Ms. Del Papa's report (EXHIBIT F), the Federal Government may exercise its claim for up to 50 percent of the amount actually received by the State of Nevada. That was based on the fact 50 percent of all Medicaid costs were paid by the Federal Government; the other 50 percent were paid by the state. Ms. Del Papa cautioned final recommendations for allocation of funds be reserved until the federal challenge and other remaining issues had been resolved.

She referred to General Provisions on page 4 of EXHIBIT F, which stated in part:

• Funds shall be used for an initiative to prevent tobacco use, including controlling access, preventing associated unhealthy behaviors, and reducing tobacco-related disease.

• Funds cannot be used to supplant existing funding for those activities.

• No more than 5 percent of funds may be used for administration, management, or indirect associated costs.

• A method of fiscal accountability, monitoring, and valid scientific program evaluation be established for all funded activities.

On page 4, EXHIBIT F, Program Activity Areas stated in part:

• County Prevention Programs

• Statewide and Targeted Community-Based Programs

• School Programs

• Enforcement

• Partnership Grants

• Statewide Multimedia Campaign

• Cessation Programs

• Research and Evaluation

• Local Incentive Funding

The general provisions and activity areas had been compiled as a result of input from Nevada's public health community. Also taken into account had been the U. S. Center for Disease Control and Prevention's best practices model issued as a discussion pursuant to tobacco settlement proceeds. Other specific proposals had been communicated to the Attorney General's office and to the Governor's office on how to spend the settlement money. It was envisioned these types of program activities would be considered after prior claims for medical care for tobacco-related illness had been handled.

Ms. Del Papa found it interesting there had been so much discussion concerning the proceeds—"What were we going to do with this money." But there had not been a corresponding amount of discussion in terms of the prevention efforts needed—Why was the state's health ranking so low.

Ms. Del Papa stated she strongly shared the Governor's commitment to higher education and believed his intentions ("Governor's Scholarship Proposal," page 5 of EXHIBIT F) were laudable. She believed, however, the proposal be viewed carefully by the legislature in terms of the:

• Consent Decree

• Commitment made from the outset of the litigation and throughout the litigation and settlement process.

• Partnership communicated to Nevada's public health community.

No issue could be taken with the need for improvement in education, however, the health needs of the state could not be ignored. The goal of attracting high school graduates to Nevada's University System could be achieved through alternative funding mechanisms. An appropriate source might be the estate pickup tax already earmarked for education. The Governor's scholarship proposal should be funded by alternative means since it did not fit the criteria of the Consent Decree and the covenant that the proceeds be used for public health purposes.

Ms. Del Papa declared everyone in the state needed to be concerned about the school dropout rate and other issues like juvenile crime, the teen birth rate, and the number of children who lacked health insurance. She cited a former U.S. Surgeon General who had said, "You cannot educate a child who is not healthy; you cannot keep a child healthy who is not educated." A commitment had been made to the public health community; that commitment should be honored.

In conclusion, the Attorney General commented on her January 15, 1999, letter to Senator Raggio (EXHIBIT E), copies of which had been sent to the Governor and all Nevada legislators, which detailed what had happened with the tobacco settlement nationally. The letter further detailed Nevada's expressed intention to use the funds for public health purposes. Thus, the letter could not be used as an excuse or a rationale for doing any type of specific program with the funds; it was meant to be used as a cautionary device. The federal challenges were real and allocation of proceeds should be delayed until such time as the challenges had been resolved. She had also encouraged a joint task force approach to planning for the use of the funds over the long term, and suggested the legislature considered a resolution expressing an intention to use the funds for public health purposes subject to the normal appropriation process. Constitutional law with reference to the separation of powers had been clear. On behalf of the State of Nevada, Ms. Del Papa had stated Nevada's intent throughout the litigation and settlement process, and as Attorney General her intention had been to honor that commitment. She welcomed the opportunity to work with the legislature and with the Governor in every way.

Chairman Freeman opened the meeting to questions from committee members.

Assemblywoman Buckley thanked Attorney General Del Papa for what she had done in terms of negotiating the settlement for Nevada's share of the tobacco settlement. Ms. Buckley then asked about using some portion of the funds for scholarships. She referenced the "Democratic Legislative Plan to Provide Scholarships and Improve Health Care in Nevada" (EXHIBIT H), which proposed using 25 percent of the proceeds and added accountability to make sure:

1. it went to those who were financially eligible;
2. students stayed in school; and
3. first priority be given to individuals seeking careers in health-related or education fields.

Ms. Del Papa said any program undertaken should have an element of accountability, as outlined in her report (EXHIBIT F). There had been depth and breadth in the Consent Decree as to the final expenditures. She reiterated her belief in the importance of honoring what had been said in the Consent Decree and the public commitment made throughout the entire process. The more it could be tied to a health-related measure the closer the state came to reaching its goal. And finally, when all the funds had been received and allocated, the State of Nevada had to be willing to tally up and declare how the funds had been used.

Mr. Scherer stated the Governor's plan contained accountability. Governor Guinn and his staff had met with experts in the field of running scholarship programs and had discussed the various details. The issues detailed in the "Democratic Legislative Plan" (EXHIBIT H) had been discussed in those meetings. The Governor had not ignored those details or the accountability factor; he had received input from the experts and would include that in his Bill Draft Request. The Governor believed it would be appropriate to spend the money on scholarships, and would be willing to discuss the other details in the "Democratic Legislative Plan" (EXHIBIT H) and work with the legislature.

Assemblywoman Von Tobel asked the Attorney General about the multimedia-marketing program described on page 5 of EXHIBIT F. She understood the state had signed a waiver that any multimedia or advertising would not attack the tobacco companies. How, then, she wondered, could discussions with young people about the evils of tobacco be broached. Ms. Del Papa replied that any program undertaken to reach a large and diverse population required a multimedia component. The agreement signed by the State of Nevada restricted mention of any one tobacco company. Ms. Von Tobel cited the television program 60 MINUTES, which had aired on February 21, 1999, and detailed anti-tobacco company advertisements prepared by the young people in the state of Florida—a state that had not signed the aforementioned waiver. The advertisements had been very successful.

Ms. Del Papa stated the MSA prohibited targeting youth in any kind of advertising, promotions, or marketing. It banned industry actions aimed at initiating, maintaining, or increasing youth smoking. What could be done, she said, would be to ban:

• cartoon characters;

• restrict sponsorship by brand names (most of the major tobacco companies would be limited to sponsoring one event per year);

• outdoor advertising;

• placement of tobacco products;

• sale of merchandise with tobacco brand names;

• youth access to free samples;

• proof-of-purchase gifts; and

• third parties from using tobacco brand names.

Ms. Del Papa reiterated any serious commitment to prevention demanded reaching an age-specific group and required a media component.

Chairman Freeman said she had watched 60 MINUTES too, and questioned the advantage of the waiver when anti-tobacco advertising could not state "Don't smoke Marlboro" but could state "Don't smoke" for some other reason.

Ms. Del Papa admitted she had not watched 60 MINUTES, however, Florida had been a unique situation because it had been one of the four settling states, and that had to be taken into consideration with questions relative to Florida, Texas, Mississippi and Minnesota. There had been a different set of rules, and each state had been different in relation to the other states.

Assemblywoman Leslie expressed thanks to Attorney General Del Papa for her work in getting the settlement. Directing her remarks to Mr. Scherer, she cited the Attorney General's testimony that one of the reasons to go forward with the settlement had been to protect adolescents now. But, Ms. Leslie had not heard any similar comment from the Governor's office, nor had Governor Guinn's plan, nor Mr. Scherer's testimony, cited the well-documented fact that tobacco had been a gateway drug for adolescents into other drugs. The Governor's plan, she said, mentioned using the other half of the settlement proceeds for seniors.

Mr. Scherer replied better educated students were less likely to smoke, or if already smoking were more likely to quit. The Governor would be very willing to work with the legislature on spending the other half of the proceeds. Public health would be an appropriate place to spend a portion of the proceeds, and if the legislature felt it should be directed toward anti-smoking for adolescents the Governor's Office would be willing to work with them. According to national statistics, $1.45 billion had been set aside at the national level to deal with smoking prevention programs for youth and another $250 million for research into preventative programs. He wanted to be sure the state would be supplementing those programs in positive ways, not duplicating them.

Ms. Leslie suggested when he looked at those programs to bear in mind Nevada had been 47^th in the nation in terms of the money spent on substance abuse prevention for our children. The Committee on Health and Human Services would be considering a bill to greatly improve that situation. She expressed the statistics included in the Attorney General's report (EXHIBIT F) were "astonishing, horrifying, and appalling" and encouraged Mr. Scherer to look at that.

Ms. Del Papa followed up on an issue mentioned earlier. Some of the percentages of payments were tied to the percentage of sales. Sales, for example, in the "gray market" (cigarettes sent overseas and shipped back in) could be done in a way so they were not reflected in the overall tobacco sales numbers. Many contingencies had to be considered and for that reason the theme expressed by the Attorney General's office had been caution. She felt it would be best to get the money in hand before sending it out the door. That would not detract from any of the proposals. However, industry-related and other challenges impacted on how the money would be spent and it behooved the state to take a more prudent and conservative path.

Another point not widely considered had been the population factor. In California, 11.3 percent of the population, plus the population in New York, or a total of more than 20 percent would taken off the top of any funds Nevada might receive from those national programs. The programs would probably be population-based, in which case Nevada's share turned out to be very small.

Assemblywoman Buckley queried Mr. Scherer about the Governor's plan to fund the University System at 2 percent growth, when the anticipated growth was 6 percent. She asked about the "hole in the budget" for the university library and the concerns of southern Nevada about quality in university funding. Also what had been the Governor's plan with regard to getting more children into college. Had the bill draft addressed that. Mr. Scherer responded the Governor had spoken with all of the university and community college officials throughout the state. All had stated they were willing to work with what they had and believed they would be able to make do in the biennium. The scholarship program would impact the class of 2000 during the biennium. That would be only one-fourth the total number of students ultimately seen. The Governor had been committed to working in the next biennium with the University System to ensure the state had the facilities and the operating funds needed to take care of those students headed for college.

Assemblywoman Gibbons asked what percentage of students registered at the University of Nevada had a B-average. Ms. Del Papa said someone from the University System would be better qualified to answer. However, she related a phone call she had received from a teacher following Governor Guinn's State of the State address who said as wonderful as the program sounded it would put a great deal of pressure on teachers; no one wanted to be the teacher who cost someone a scholarship. There was an additional factor of grade inflation. As Assemblywoman Buckley had stated earlier, there had to be accountability and procedures in place to address those issues.

Another factor Ms. Del Papa mentioned was the dropout rate, and the issue of students who had dropped out in the middle grades later turning up in the criminal justice system. The state faced some incredible challenges in terms of education, dropout rates, and so on before the issue of the B-average would even be reached.

Mr. Scherer indicated statistics had revealed approximately 40 percent of Nevada students graduated with a B-average or above. The percentage was higher among those who actually enrolled in college. A proficiency test had to be passed in order to graduate and be eligible for the program. Students also had to be accepted by one of the colleges or universities and meet the admissions criteria. Those safeguards were in place.

Assemblyman Manendo commented about the advertising campaigns that had warned of the dangers of drinking during pregnancy, or drinking and driving. Those had not been targeted against a particular industry, rather about the dangers that resulted from certain behavior. Therefore he felt a similar positive plan about the dangers of smoking could be created to capture adolescent attention. Mr. Manendo asked whether the Governor had a plan to use the other 50 percent of the funds to correct the problem of the hypothetical "flood of students" headed for college. Mr. Scherer stated the Governor had said he wanted to use the other 50 percent for public health and related purposes. However, the Governor's office believed from a legal standpoint the commitment made by the Attorney General to the public health community was not binding. She did not have the authority to bind the legislature in how they spent the money. If the legislature decided the money should be spent for other purposes it was their decision to make. The Governor had spoken of doing a fundamental review of every state agency and every dollar spent in state government. Thereafter, to evaluate long-term needs and then make a proposal on how he believed the state should meet those needs. The Governor was willing to take responsibility for doing that, but it would take some time.

Assemblywoman Von Tobel questioned Attorney General Del Papa about going with the scenario that 50 percent would be used for the scholarship program, had she prioritized the list of program activity areas to be covered by the remaining 50 percent. Ms. Del Papa said the legislature did not need the Attorney General's approval to spend the money. However, the court approved the language of the Consent Decree. The language was very specific. It stated that subject to the appropriations process that involved the governor and the legislature, it was the intent and recommendation of the parties that those proceeds be used for public health purposes only. Ms. Del Papa related an incident that occurred outside court after the Consent Decree had been approved, the attorney for one of the major tobacco companies said to her, "I really hope you can hold them to this."

Ms. Del Papa declared she would do everything she could to try to hold the legislature to that commitment. Nevertheless, there was no question but that the final decision rested with the legislature. However, they had to remember that throughout the entire process, it had been no secret about why the state had entered into the process. The state went into the litigation to address public health needs. She reiterated she intended to honor the commitment made to the people of the State of Nevada throughout the process. It would be up to the legislature, subject to continuing judicial review, whether the legislature chose to honor it. The Consent Decree had that language in it. There were many different ways to meet the requirements and the more discussions held as to how best to meet the requirements the better. The recommendations included in EXHIBIT F had not been her own, rather, they had been based on input from Nevada's public health community and taken into consideration with the best practices model by the U.S. Centers for Disease Control. Further, she added, Nevada faced some critical health-related needs, such as rural hospitals that could not afford to keep their doors open and many other challenges dealing with important public health issues.

Ms. Del Papa related discussions she had with Governor Guinn on public health issues and how they could be addressed with little or no funding. It had been well known money spent on prevention saved money in the long run.

Another consideration, the states would not be the only ones who wanted funding. Huge metropolitan areas with programs would have access to some of the money. There would be competition for those dollars. Any decisions made had to consider the county component and community-based programming. She spoke of progress already made by Nevada with the small amount of funding it had received to target anti-smoking. The over-the-counter sale rate had been reduced from 60 percent to less than 20 percent with public service announcements and other means. Other activities needed to be considered such as a program within the university, continued commitment to enforcement, some mechanism to partner with other community organizations, and a cessation program to address the 28 percent of Nevada's population who smoked.

In conclusion, Attorney General Del Papa said she realized the meeting had been called the "beginning of a great debate." She had not seen it that way. She wanted to work with Governor Guinn; he needed everyone's help. Everyone in the state needed to be committed to education. Similarly, everyone needed to be committed to public health. There were difficult challenges in both areas. But until the money was in hand, no one should make commitments or raise expectations. Prudence and caution were important. She believed the Governor had been very sincere in his intentions, just as she had been, and through continued discussions a way could be found to meet the challenges. However, Ms. Del Papa would continue to advocate the priority for using the proceeds for public health.

Chairman Freeman, as a long time public health professional, had seen the tobacco industry actively promote smoking; something needed to be done to counteract the damage done for so many decades and which continued. Further, health care in the State of Nevada needed help, if only by augmenting the public health system in the counties, it had an unmatched track record of accomplishment. But when cutbacks in local government occurred, it had been very difficult for those programs and agencies to provide the needed services.

The legislature had worked very hard over the years to get money for immunization, a service that had been provided to children by government. It had become the source of argument about how to pay for children to be protected. The State of Nevada had a system that could be built on and although Mrs. Freeman had been a strong supporter of education, she believed it would be wrong not to use those funds in the most efficient way possible. She welcomed bills from the Governor, the Attorney General, and others for the use of the funds; all would get a fair hearing. Hopefully, she added, by the time the legislative session ended on May 31, they would have arrived at a decision they could be proud of as legislators.

With no further testimony forthcoming, Chairman Freeman adjourned the meeting at 2:50 p.m.

RESPECTFULLY SUBMITTED:

Darlene Rubin,

Committee Secretary

APPROVED BY:

Assemblywoman Vivian Freeman, Chairman

DATE: