The Committee on Health and Human Services was called to order at 2:10 p.m., on Wednesday, March 17, 1999. Chairman Vivian Freeman presided in Room 3138 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. Sharron Angle

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

STAFF MEMBERS PRESENT:

OTHERS PRESENT:

Following roll call, the meeting was called to order by Vice-Chairman Ellen Koivisto who announced A.B. 301, A.B. 302, and A.B. 354 would be heard together.

Assemblywoman Vivian Freeman, representing Assembly District 24, stated she and Assemblyman Williams, A.B. 301 sponsor, and Sheila Leslie, A.B. 354 sponsor, had been working with staff to create an amendment to A.B. 302 that would address the issue in a comprehensive manner. The sponsors were all very familiar with the childcare issue; Mrs. Freeman and Ms. Leslie in Reno, and Mr. Williams in Las Vegas. It was their job to be the policymakers for the state and that was what they were trying to do. They would be willing to work with childcare providers who had concerns about the issue.

Mrs. Freeman chaired an Interim Study on Childcare in 1990. One of the major issues had been training for childcare; previously it was 3 hours, now it was 12 hours. Individuals who worked in childcare facilities were paid very low wages, in fact, people who groomed dogs or worked at McDonald's made more money. She found it appalling. The other side of the coin however, were people who used childcare often could not afford to pay more than a minimal amount. The owner of a childcare center was between a rock and a hard place. How could they provide training and benefits for employees, meet the rules and regulations at the county and state levels, and still have a little profit margin. In most cases there was a profit margin involved. In Reno one nonprofit center existed on grants and some public money and there was always a long waiting list.

In the 1997 session when the bill on welfare reform was passed a large amount of money came into the state. The Miller Administration had been very generous in the amount given for childcare for welfare recipients. However, at the same time more funding had been available and the numbers of children who needed care increased proportionately. There were still a large number of children of working parents waiting for care. A major concern had been what would happen when the 2 year period ended and people were required to go off welfare, what would they do for childcare. Could they stay in the job market without having childcare.

The sponsors had attempted to address all those issues with their three bills. There was one amendment (EXHIBIT C), which Marla Williams, Committee Policy Analyst, explained. The amendment essentially had taken all of the provisions in A.B. 354 and put them in A.B. 302. Two provisions of A.B. 301, the training program and the appropriation to the city of Las Vegas, as well as the loan program for construction and renovation of childcare facilities, had been implemented into A.B. 302.

In A.B. 302, all of section 2 would be deleted. Instead of requiring a toll free hotline be established by the Bureau of Services for Child Care (bureau), the Bureau was asked to work with organizations that offered a toll free childcare number to provide information and referrals that would encourage their expansion to include all childcare facilities currently licensed pursuant to NRS 432A.131. The amendment created a new section 3 and 4, which incorporated substantial portions of A.B. 354. It deleted section 3, lines 18 through 29 of A.B. 302 and inserted new language for the childcare quality fund found at section 3 of A.B. 354. A change transferring authority from the director to the chief of the bureau, leaving lines 30 through 40 which asked the chief to submit a report to the board and the legislative commission on certain items. Section 4 on page 2 of A.B. 302 established a payment schedule applicable to all programs. Included was section 2 and section 4 (I) of A.B. 354, primarily related to the criteria set forth for the use of the fund. The amendment deleted section 5 through section 8 and inserted new language that asked the board to adopt regulations for appropriate training and continuing education in childcare and the operations of a childcare facility. The required instruction had to be obtained in courses approved for the award of academic credit by a university or community college within the university or community college system of Nevada; or a credentialed program approved by the bureau equivalent to a child development associate credential from a university or community college in Nevada. The previous requirement was deleted which would have required childcare providers have a degree.

Section 8 on page 3 of A.B. 302 asked an operator of a childcare facility to display, in a conspicuous place clearly visible to general public, his license to operate and the most recent reports received regarding inspection results. The language remained in section 9, which stated the bureau shall not renew the license of a child care facility unless the bureau had inspected the facility. And also the language in (a), (b), and (c) was unchanged. A new section (d) was added which stated a correction plan be approved by both the bureau and the facility. Sub-section 2 in section 9 was unchanged. Section 10 was unchanged. In the original bill there had been a change from five or more children to four or more children. That change would not occur in A.B. 302, it would return to the old language.

On page 5, section 14, (b) was deleted. The only new language in that section was at line 36. On page 7, section 17 through section 21, which referred to the portion of the bill that required the establishment of an advisory council, was deleted. New language was added regarding the appropriation of $350,000 to the city of Las Vegas for continued support of the childcare training program currently operated by the city, and $50,000 to create the childcare quality fund.

Ms. Williams pointed out on the bottom of the second page of EXHIBIT C, where it stated "replace with Sec. 5. (a) (1) through (5)," some language had not been carried over and would need to be added. It referred to the provision for turnover criteria, brought over from A.B. 354, and its omission had been an oversight.

Mrs. Freeman said the intent was to pass A.B. 302 from committee and rerefer to the Committee on Ways and Means because there was a fiscal note.

Assemblywoman Leslie made preliminary remarks about her portion of the bill. The idea originated from a study done by the Nevada Institute for Children and focused on improving childcare quality based on her extensive background in the childcare issue. The low wages paid to childcare providers had always been a problem. The study showed the only people who made less than childcare workers were the people who washed cars. When the legislature passed the bill to fund the Automobile Museum, many in the childcare field used to joke "if we named our children Porsche or Mercedes we might get some money out of the legislature." The study also showed 41 percent of the people taking care of the state's most vulnerable citizens had a high school diploma or less.

Taking care of a group of children was a very difficult job. Yet, the average wage for a childcare worker was $6.40 an hour. Obtaining higher education or a child development associate credential was a cost problem for people who made that kind of money. The purpose of the legislation was to establish a childcare quality fund to assist childcare workers in obtaining a child development associate credential or furthering their education. Ms. Leslie said her piece of the legislation established the fund, and she felt private money could also be obtained. It would be a public-private partnership; the public sector had a duty to "step up to the plate." And in fact she, too, would step up to the plate with a $1,000 donation. She pledged her commitment and believed Ms. Gibbons would be right behind her with a similar commitment. She had worked with gaming and other industries in the state for many years on quality childcare. The fund would be a mechanism for their contributions. Although she could not actively solicit funds during session, she would when session ended. She would like to see the state put money into it, she would put money into it, and would go out and raise more money. Once the training was underway the fund could be used to assist in other quality childcare issues as well. Ms. Leslie confirmed the bill was specific to childcare providers only and not home care providers.

Vice-Chairman Koivisto asked if a dollar amount had been requested. Ms. Leslie said $50,000 in the revised bill over a 2-year period.

Assemblyman Wendell Williams said he was pleased parts of his bill would be combined with his colleagues' bills. In the 1997 session only a small amount of money had been appropriated for his childcare bill that initiated training for individuals who wanted to enter the childcare profession. Targeted were individuals on welfare who were interested becoming childcare providers and those interested in establishing their own childcare business in the future. The program had been moving along very well. The appropriation requested for the City of Las Vegas would continue the childcare training in Clark County. There had been considerable interest in expanding the program throughout the state. It had been very rewarding, Mr. Williams said, to visit with some of the ladies who had been on welfare and were now moving into the childcare profession. They were individuals who had never had employment or been in the job market in any way.

Mr. Williams presented an interesting 4-minute video of students who had graduated from the program. The video had been shown on a Las Vegas television program called City Beat that highlighted various programs throughout the city. The video was produced through the Office of Federal, State & Local Initiatives in Las Vegas. The agency hosted "Childcare 2000," a statewide conference, at the MGM Hotel last fall. Networking statewide had begun to occur.

Mr. Williams explained the individuals in the video had received 7 weeks of life skills training before entering actual childcare training. In the first classes held people who previously had been too timid to speak or even give their names were now very excited, had a tremendous amount of self-esteem, and were looking forward to making a contribution in the field.

Prior to passage of the welfare reform legislation there had been a 5 percent vacancy rate in the state for childcare providers. In Clark County there had been a zero vacancy. Much work remained to be done; the number of people joining the employment ranks combined with population increase created a tremendous need. On the opposite side, there had been total disregard for the childcare field, in fact, just less than a year ago, the U.S. Department of Labor listed childcare as a profession for the first time. Legislators needed to work to change disregard for the childcare field into high regard for an important profession. In view of the high value placed on education, what was needed was to examine the education process starting at the early childcare level because preparing an academic mind started at a very young age. This was an issue of ultimate importance, Mr. Williams said, and he, Mrs. Freeman, and Ms. Leslie looked forward to expanding it in the future.

Mrs. Freeman concurred with Ms. Leslie's suggestion that the private sector become involved with the program. In past efforts to involve the business community she had been told there were too many problems in providing onsite childcare. However, in northern Nevada for many years there had been child-care centers onsite at Washoe Medical Center and at International Gaming Technology where they contracted with a private provider. Not only were they wonderful childcare centers, but the benefits to both employer and employee had been significant. A few other onsite childcare centers in Reno and Las Vegas had been successful as well, and efforts to encourage the business community's involvement should be continued. Ms. Leslie's proposal to solicit donations from businesses who did not want onsite childcare centers made it possible for those businesses to still participate in the program. Mrs. Freeman reported her lack of success in getting money from the Committee on Ways and Means for the last five sessions, and she hoped Assemblyman Williams would be able to convince the committee finally the state needed to put some money into the childcare program.

Due to time constraints of the shortened session, Mrs. Freeman apologized for being unable to get the amended bill reprinted and distributed to committee members prior to the meeting.

Vice-Chairman Koivisto invited those who supported the bill to testify first.

Jane Hogue identified herself as representing the Nevada Association for the Education of Young Children. As a long time preschool and Head Start teacher, she expressed support of A.B. 302. Particularly she felt strongly about the need to increase the educational requirements and training for early childcare providers.

Rebecca Carter Steele, representing the Reno Association for the Education of Young Children, had worked in the early childhood field for many years with homeless and low-income families doing educational programming, and in the childcare industry directly. She expressed support for A.B. 302. Research had shown education of childcare providers to be one of the indicators of quality childcare. Because Nevada ranked among the lowest of states in childcare regulations, passage of the bill would be an opportunity to begin to raise the standards and decrease the turnover rate for childcare providers.

Crystal Swank identified herself and said she had been working in early childhood education for 15 years. During that time continued efforts had been made to recognize the need to improve quality in childcare. She echoed Mr. Williams comment that quality childcare reaches the youngest in the community at a time when they were most vulnerable and at the most critical time for brain development and future academic learning. The measures in the bill lead to improved quality and she strongly urged passage.

Sherry Waugh representing the Nevada Association for the Education of Young Children and also the director of a university-sponsored program for early childhood. She voiced strong support for A.B. 302 and believed it to be a good first effort in making a difference for young children. Earlier she had met with program leaders across the country to discuss what could be done to improve the quality of childcare. A number of states had made efforts similar to Nevada's, some had gone substantially farther in trying to improve the quality of care for very young children. Nevada could examine those models and use them as an example for ways to proceed in the future.

Eva Essa identified herself as an advocate for children who taught early childhood development and education at the University of Nevada. Like previous speakers, she had been involved in the field for nearly 30 years. Over the last several decades considerable research had been done in early childhood, some in large well-executed national studies. There had been two components: (1) elements of quality, the ratio of adults to children, group size, and education of those caregivers; and (2) the impact on children, and the studies clearly showed that when the quality of care was higher children benefited. Their emotional and social development and behavior were better, as well as cognitive development and language skills, and later their performance in school.

Next to speak was Penny Royce Rogers, a child advocate for over 30 years who had worked at every level from Head Start to the University of Nevada to early childhood special education. For the last 5 years she had been the executive director and director of the RAVE Family Center (EXHIBIT D) which provided respite care to families of young children with disabilities and also trained high school students to work with children. There were 75 students in the program whose career goals were working with children. Ms. Rogers strongly supported A.B. 302. She added it was the best bill she had seen in 30 years and commended Mrs. Freeman, Ms. Leslie and Mr. Williams for their efforts.

Mrs. Freeman pointed out that in addition to the assembly members who had co-sponsored A.B. 302, eight senators also signed on to the bill which was strong evidence of the support for the childcare issue in both houses.

Joann Everts identified herself as president of Nevada Association for Education of Young Children, chair of the Childcare Licensing Board, and part of the steering committee for Success By Six that supported a variety of programs and issues for young children. She said it was very exciting for the licensing board to think about how they could work with the bill to provide the leadership to support training and develop a system. What had happened in other states that worked was the development of a career ladder and the passage of A.B. 302 would allow that to begin in Nevada.

Additionally, Ms. Everts pledged strong support for Assemblywoman Leslie's childcare fund portion of the bill and made a commitment to do whatever she could to seek foundation donations.

Sharon Rogers, an early childhood education consultant for the Nevada Department of Education, said one of the department's goals was to have all children start school ready to learn. Her testimony, provided as EXHIBIT E, stated in part:

• Recent brain research emphasized the relationships and experiences of young children created or failed to create certain brain connections that affected how well prepared a child would be for future learning.

• She represented the department on several statewide committees and organizations concerned about early childcare and education and the environments of young children. One of those, Early Intervention Interagency Coordinating Council, was concerned about natural environments for young children with developmental delays and disabilities. Families of such special needs children found it difficult to obtain competent and willing caregivers. The quality of caregivers in many facilities was one of the biggest issues in Nevada and was the priority of groups like the Nevada Association for the Education of Young Children, Success by Six, Statewide Coalition, and Nevada Kids Count.

• Low wages meant high turnover and children were unable to form long-term attachments with caregivers who had adequate knowledge of child development and learning. Working families needed to have confidence in the stability and skill of the people they entrusted with their children. Ms. Rogers echoed the sentiments of other speakers regarding the importance of the career ladder for caregivers.

For those and other reasons she urged passage of A.B. 302.

Next to speak was Jan Gilbert representing the League of Women Voters. She had been an advocate of welfare reform for many years and was also a certified teacher. Welfare reform could not succeed without childcare. She voiced the sentiments of the experts who preceded her plus another key point. A great deal of importance had been placed on the certification of teachers of children age 5 and above. The same effort and importance had not been given to certifying people who worked with very young children in the most formative time of their lives.

Ms. Gilbert applauded the efforts of Assemblywomen Freeman and Leslie and Assemblyman Williams, as well as Assemblyman Thomas who also had a childcare bill. She urged the passage of A.B. 302.

Mrs. Freeman directed her comments to Joann Everts regarding childcare licensing. A childcare provider in her district, when asked what issues the legislature should be addressing, said all childcare centers should have TV monitors and there needed to be adequate facility inspections.

Joann Everts believed that while some facilities had TV monitors, well-trained, quality teachers and staff were a safeguard for the well-being of children in their care. In the public school systems there were no monitors and teachers were to provide that safety. Regarding inspections, she felt the inspectors had done very well considering the high number of sites and the low salaries for those state and county workers. She hoped as programs for improving childcare quality developed the technical support services for childcare centers would also be included.

Mrs. Freeman recalled an incident in Reno a few years earlier where a child drowned in a pool or a ditch behind a center despite a fence installed to prevent such an accident. She asked if there were state or county regulations to prevent that sort of thing happening again. Ms. Everts said she was unsure of the regulations in that regard; however, much could be done to prevent that through training and good supervision and child-to-staff ratio. Whether those kinds of accidents could always be prevented was impossible to predict, but in training people to be watchful of children at all times and always be in the room with them would go a long way in keeping them safe. Mrs. Freeman said they all had a big job ahead in lobbying the governor's office to see that the funding was accomplished. It was a priority for the committee.

Vice-Chairman Koivisto asked those opposed to the bill to testify. The first to speak was Suzanne Magleby, Clark County Social Services, Childcare Licensing Division. She said their concerns had been addressed by the amendments presented.

Linda Hollis, owner/director of the Magic Treehouse Preschool, was also a state-certified teacher for 23 years, said she shared the feeling the industry needed positive changes. However, the changes needed to be carefully chosen and not eliminate the people who were doing a great job. She had used student teachers over the years, individuals enrolled in college and desirous of a career in childhood education. A great deal of mutual benefit had been gained. As the bill read, those people would not be accepted employees which was a concern to Ms. Hollis.

Cathleen Cooke, owner of Sunflower Preschool, in Reno, said in essence she applauded A.B. 302 and its purpose. She had reservations however about the methods and the proposals presented. She had an associate degree from the University of Nevada and had been in business 27 years. She had been committed to excellence in staffing and read from her brochure the credentials of her staff, most held bachelors or masters degrees.

She said she did have some concerns on how the provisions of the bill would be implemented. In the past 27 years she had only one teacher from the University of Nevada apply for and become a part of her staff, and two people from Truckee Meadows Community College who joined her staff. The teachers were not out there. Often they were encouraged to go into other areas regarding children. She felt it important to let the committee know that. Her experience with Nevada Association for Young Children had not been good. Ms. Cooke hoped that other accreditation organizations would be available and an option. She believed the standards proposed by the bill were absolutely necessary and supported efforts to rise to a new level of respect for childcare workers as professionals who were well-paid, but it needed to be a reasonable and attainable goal.

Finally, Ms. Cooke mentioned a national "worthy wage" campaign she believed sponsored by Nevada Association for Young Children, and asked if Ms. Leslie was familiar with it.

Ms. Leslie said she knew about the worthy wage campaign and strongly supported it. The effort had been led nationally by the Children's Defense Fund.

Ms. Leslie also clarified, for Ms. Cooke's benefit, the amended bill would not prevent her from hiring people such as those already on her staff. A.B. 302, in its amended form, had no requirement for but rather encouraged more training and education. The desire was for workers to move toward a child development associate credential, but that was not mandated to be accomplished by a certain date.

Sandy Blake-Toles, identified herself as Administrator, Office of Federal, State & Local Initiatives, in Las Vegas, and expressed support for A.B. 302. She recalled a time when she was a college-going young mother and she and her husband had been fortunate to find a childcare center across from the university for their 6 months-old baby who, 5 years later, "had to be pried away." She was given quality childcare, introduced to ballet, swimming, all types of cultural events and as a result became a well-rounded, safe child. Because of that experience, her daughter had gone on to graduate at the top of her class, obtain a master's degree and be recruited to a top profession. Her grown daughter fondly remembered Cinderella Childcare, in Las Vegas, the nontraditional hours, and the qualified staff. While Ms. Toles and her husband were fortunate to be able to provide that for their child, many around them could neither find that type of quality care nor afford it. The State of Nevada needed to recognize the need for quality and safe care for children. For too long children had been devalued.

Ms. Toles provided a brochure (EXHIBIT F) titled "Child Care 2000" Opportunities For Child Care Training in Las Vegas, administered by the Office of Federal, State & Local Initiatives. Part of the funding her office received from the state in 1997 enabled them to do requests for proposals (RFPs) for existing day care centers. The sum of $4,500 was allotted for training of existing staff or upgrading of their facilities. She received many letters of thanks and appreciation for the funding from the State of Nevada from those day care facilities who were doing excellent work "because someone stopped to give them a hand up and not a hand out." She also provided a brochure from the Reach Out Center that had been funded with some of the money from the state. The center provided for children with AIDS, and the brochure was distributed to educate the community about the youngsters for whom they cared that had either HIV Virus or full-blown AIDS. The state money also allowed the center to purchase two computers and upgrade some of the software programs for their children.

In closing, Ms. Toles thanked the committee for the previous funding and said, "When I came before you 2 years ago, I said if we get the funding we will go out and make a difference in the community. I think we have demonstrated that." She urged the committee to pass A.B. 302.

Mrs. Freeman thanked Ms. Toles for appearing and congratulated her and Mr. Williams for all they had accomplished for quality childcare in Las Vegas.

Next to speak was Gary Vause, owner/operator of preschools and licensed kindergartens, before and after-school programs and more. He had opposed the bill in its pre-amended form. He opined no one in the childcare field would be opposed to better training or quality childcare. The problem was attracting people to the field in the first place. Needed were incentives to attract childcare workers. A few sessions ago the legislature voted in an "employee head tax." He could pay higher wages if not for that tax on his workers. To attract childcare workers he offered subsidized childcare, health insurance, paid vacations, paid holidays, a new 401K plan, and he had an in-house Child Development Associate (CDA) training program. He opened an approved CDA training center in northern Las Vegas in 1995, and offered the program to his employees at no charge.

Assemblyman Manendo asked what starting salary Mr. Vause paid his workers.

Mr. Vause answered untrained individuals started at minimum wage, credentialled teachers were earning $12 or more an hour. He was happy to pay his employees a good salary but would have to increase his rates. Mr. Manendo followed up by asking what the average wage was and how many employees were earning that amount. Mr. Vause said the average was $6.75 an hour, and actually no one started at federal minimum wage, rather they started at about $6 an hour.

Mrs. Koivisto asked Mr. Vause if he had specific amendments he would like to see put in the bill. He replied all references to the National Association for the Education for Young Children should include national or other associations that offered credential programs or degrees or accreditation. The second item was the requirement for posting the latest inspection report. He said there was information on the report, for instance regarding employees, that he was uncomfortable about posting. He suggested a grading system similar to that used by the health department for restaurant inspections, where the grade would be posted and if lower than "A," a re-inspection would be required to move back up. Ms. Koivisto asked Mr. Vause to put the amendment request in writing and give it to the committee secretary.

Arthur Willans, Ph.D., owner/operator of A Child's World, in Reno, testified in opposition of A.B. 302. He said it was not something he wanted to do, he was not opposed to quality childcare rather to certain provisions of the bill. Some of those provisions had been eliminated by amendment and he commended the committee for that. He also commended the committee for their effort and goals of trying to improve the quality of childcare.

His specific concerns however were in regard to the feasibility and financial impact of certain provisions. He provided written testimony, EXHIBIT G, which stated in part:

• Each time an unlicensed or substandard provider was left open it had a significant impact on the quality of childcare.

• Strengthen the regulatory agencies. Give the agencies the authority to close substandard programs.

• Help operators in the development and maintenance of operating systems.

Joan McCusker, owner/director of Just For Kids, in Reno, said she would like to see home-licensed care providers included in the training requirements. Also, as a facilitator for many child development classes that childcare providers had to attend, she felt someone was needed to regulate the quality. However, the classes offered at the community college or university might not be appropriate for some of the issues faced in the classroom.

Art Willans concurred with the recommendation made by Ms. McCusker to include home care providers in training requirements.

Assemblywoman Von Tobel commented the insight from business owners was important to the committee's understanding of the issue. She said also that last session a great deal of money was put into childcare and she would like to know what had been done with that. Further, because Nevada was a fast-growing state other funds were available from Temporary Assistance to Needy Families (TANF) and she wanted to know if that money could be used for training.

Vice-Chairman Koivisto stated the committee wanted to pass A.B. 302 out and rerefer to the Committee on Ways and Means. She asked for a motion.

ASSEMBLYWOMAN FREEMAN MOVED TO AMEND AND DO PASS AND REREFER A.B.302 TO THE COMMITTEE ON WAYS AND MEANS.

ASSEMBLYMAN MANENDO SECONDED THE MOTION.

MOTION CARRIED, WITH MS. ANGLE, MS. VON TOBEL, AND MS.

BERMAN ABSTAINING.

With no further business before the committee, the meeting was adjourned at 3:35 p.m.

RESPECTFULLY SUBMITTED:

Darlene Rubin,

Committee Secretary

APPROVED BY:

Assemblywoman Vivian Freeman, Chairman

DATE: