The Senate Committee on Human Resources and Facilities was called to order by Chairman Raymond D. Rawson, at 11:45 a.m., on Friday, April 9, 1999, in Room 2135 of the Legislative Building, Carson City, Nevada. Exhibit A is the Agenda. Exhibit B is the Attendance Roster. All exhibits are available and on file at the Research Library of the Legislative Counsel Bureau.

COMMITTEE MEMBERS PRESENT:

Senator Raymond D. Rawson, Chairman

Senator Maurice Washington, Vice Chairman

Senator Randolph J. Townsend

Senator Mark Amodei

Senator Bernice Mathews

Senator Michael Schneider

Senator Valerie Wiener

STAFF MEMBERS PRESENT:

Patricia Di Domenico, Committee Secretary

Chairman Rawson opened the work session on Senate Bill (S.B.) 519.

Pepper Sturm, Committee Policy Analyst, Research Division, Legislative Counsel Bureau, referring to Attachment A, page 3 of Exhibit C., explained the amendments to S.B. 519: one, provide that the L.P.N./R.N. be under the direction of a Nevada medical director of the health care agency or facility; two, limit the immunizations that pharmacists may administer to adult immunizations and the protocols must be written by a Nevada-licensed physician.

SENATOR WIENER MOVED TO AMEND AND DO PASS AS AMENDED SENATE BILL 519.

SENATOR AMODEI SECONDED THE MOTION.

Senator Mathews raised the concern of the registered nursing communities about pharmacists being able to administer immunizations. Senator Mathews added the registered nursing community considers this an encroachment on their scope of practice.

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Chairman Rawson introduced Senate Bill 520.

Mr. Sturm noted Attachment B, C, and D, pages 4 through 8 of Exhibit C and explained that the amendments on page 4 eliminate references to the entity becoming a health maintenance organization. He pointed out that the amendments on pages 5, 6, and 7 were proposed by the University Medical Center (UMC), and he opined that it appears UMC still would have the ability to provide capitated services. Mr. Sturm stated that this has raised some concerns. Referencing Amendment D on page 8, Chairman Rawson indicated there are two types of waivers and the amendment would allow 2 years to pursue the waivers. Chairman Rawson indicated that, based on his investigation, most hospitals and managed care organizations are agreeable. Senator Mathews asked if UMC was agreeable. Chairman Rawson answered in the affirmative.

SENATOR SCHNEIDER MOVED TO AMEND AND DO PASS S.B. 520 WITH AMENDMENT D OF EXHIBIT C.

SENATOR MATHEWS SECONDED THE MOTION.

THE MOTION CARRIED UNANIMOUSLY.

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Chairman Rawson introduced Senate Bill (S.B.) 370.

Chairman Rawson indicated that the Welfare Division of the Department of Human Resources expressed concerns and submitted amendments to S. B. 370 that would address the Medicaid regulations concerning estate recovery. Further, the proposed amendment would add phrasing to the extent allowable by federal law. Referring to Attachment F, page 9 of Exhibit C, Chairman Rawson said that the concept embodied by S.B. 370 should be incorporated into an interim legislative study. He noted Attachment F, pages 10 and 11 of Exhibit C, and suggested that the proposals presented by Governor Guinn for subsidized long-term care insurance for low-income seniors, pharmaceutical insurance, asset protection for middle income seniors, and rural health care programs for tobacco education and prevention be incorporated in S.B. 370. Chairman Rawson stated the Governor’s proposal fit the subject and is a good vehicle for both houses to address. He noted that the motion should be to amend and re-refer to the Senate Committee on Finance. In addition, the issues should be included in an interim legislative study.

SENATOR AMODEI SECONDED THE MOTION.

During the ensuing discussion, Senator Townsend asked for clarity on the motion. Chairman Rawson replied that the issue of combining Medicaid with private insurance would be placed in a legislative study. Chairman Rawson explained that a letter on the issue would be sent from the Senate Committee on Human Resources and Facilities to the Senate Committee on Legislative Affairs and Operations, and the Governor’s proposal would be incorporated in S.B. 370.

THE MOTION CARRIED UNANIMOUSLY.

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Chairman Rawson introduced Senate Bill (S.B.) 489.

Mr. Sturm referring to Attachment G, page 12 of Exhibit C, explained that this amendment would delete the restriction that prohibits out-of-state schools from competing in post-season competition for Nevada championship status and replace it with the requirement that post-season Nevada championship games must be played in Nevada; and the Nevada Interscholastic Activities Association (NIAA) is authorized to create championship trophies to be awarded to the best Nevada teams in the association’s post-season competition. He said this would authorize the NIAA to issue dual trophies.

SENATOR AMODEI MOVED TO AMEND AND DO PASS S.B. 489.

SENATOR WASHINGTON SECONDED THE MOTION.

Senator Wiener commented that there was a request for a Nevada team to be playing in the finals and she had dialogue with Senator Amodei on the issue. Senator Amodei acknowledged the discussion but said he concurred with the amendment as proposed.

THE MOTION CARRIED UNANIMOUSLY.

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Chairman Rawson introduced Senate Bill (S.B.) 206.

Senator Amodei stated that this is a housekeeping provision under the federal act that designates our intent and starts the process to file a notice of nonconcurrence. Senator Amodei suggested the bill be re-referred to the Senate Committee on Finance because there is a fiscal note, and the fiscal note has been requested. Senator Amodei pointed out that S.B. 507 and S.B. 206 could be heard at the same time for funding.

SENATOR AMODEI MOVED TO RE-REFER S.B. 206 TO THE COMMITTEE ON FINANCE.

SENATOR WIENER SECONDED THE MOTION.

THE MOTION CARRIED UNANIMOUSLY.

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Chairman Rawson stated the Senate Committee on Human Resources and Facilities amended Senate Joint Resolution 6 on April 7, 1999, and it will be returned to the committee for review.

Chairman Rawson adjourned the meeting at 12:08 p.m.

RESPECTFULLY SUBMITTED:

Patricia Di Domenico,

Committee Secretary

APPROVED BY:

Senator Raymond D. Rawson, Chairman

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