MINUTES OF THE meeting
of the
ASSEMBLY Committee on Commerce and Labor
Seventy-First Session
April 6, 2001
The Committee on Commerce and Labor was called to order at 11:30 a.m. on Friday, April 6, 2001. Chairman Joseph Dini, Jr. 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:
Mr. Joseph Dini, Jr., Chairman
Ms. Barbara Buckley, Vice Chairman
Mr. Morse Arberry Jr.
Mr. Bob Beers
Mrs. Dawn Gibbons
Ms. Chris Giunchigliani
Mr. David Goldwater
Mr. Lynn Hettrick
Mr. David Humke
Ms. Sheila Leslie
Mr. Dennis Nolan
Mr. John Oceguera
Mr. David Parks
Mr. Richard D. Perkins
GUEST LEGISLATORS PRESENT:
Assemblyman John Lee
STAFF MEMBERS PRESENT:
Crystal McGee, Committee Policy Analyst
Vance Hughey, Committee Policy Analyst
Ann M. VanNostrand, Committee Secretary
OTHERS PRESENT:
Louis Ling, General Counsel, Nevada Board of Pharmacy
Keith Macdonald, Nevada Board of Pharmacy
Jack Kim, Health Plan of Nevada
Mary Lau, Retail Association of Nevada
Steve Hansen, CEO, Nevada Rural Health Centers
Roger Volker, Great Basin Primary Care
Janice Pine, St. Mary’s Health Network
Kelly Testolin, Hale Lane & Associates
Doug DeVries, Eye Care Associates of Nevada
Fred Hillerby, Eye Care Associates of Nevada
Thomas Conklin, Nevada Ophthalmologic Society
Jeanette Belz, Nevada Ophthalmologic Society
Larry Matheis, Nevada State Medical Association
Robert Barengo, Nevada State Board of Medical Examiners
Richard Legarza, General Counsel, Nevada State Board of Medical Examiners
David Spencer, Private Investigators Board
David Walker, Department of Business and Industry, Real Estate Division
Melody Luetkehans, Nevada Association of Realtors
J. C. Melvin, Nevada Association of Realtors
Chairman Dini opened the meeting with the hearing on A.B. 415.
Assembly Bill 415: Revises provisions relating to pharmacy. (BDR 54-104)
Assemblyman John Lee, Clark County District 3, introduced A.B. 415 to accomplish two important innovations:
Assemblyman Lee stated he became interested in the E-prescription issue through his sister who was a pharmaceutical technician in a retail pharmacy in Las Vegas through her employment in Vons Stores. She alerted him to the problem of illegibility with physicians’ handwriting that could not be interpreted by the pharmacist, creating a clear danger for patients. Certain physicians had interpretable handwriting, but if the patient must have a prescription filled at a pharmacy in another part of town, that pharmacist or pharmacy technician was not as familiar with the doctor’s script. It was at those times errors were made. When Assemblyman Lee looked into the electronic writing of prescriptions, he discovered Nevada’s present laws did not allow for the use of almost all E-prescribing devices. A.B. 415 would allow E-prescribing using all possible technologies. The Board of Pharmacy would be directed to create regulations to address confidentiality, security, and other issues relating to E-prescribing. This bill allowed doctors to use a computer to generate prescriptions, thus assuring easy-to-read narrative and safer dispensing of the medication(s). It:
Assemblyman Lee stated the federal government had already passed legislation to cover the electronic transmission of controlled substance prescriptions.
Keith Macdonald, Nevada State Board of Pharmacy, introduced Louis Ling to describe the program. Briefly, Mr. Macdonald talked about the internship issue, stating it came about because all pharmacy college students today had a B.A. degree before entering the College of Pharmacy. The opportunity to start immediately in a pharmacy setting allowed integration of their experiential learning, along with the curriculum provided by the colleges. Referencing Section 5, lines 3 and 4 of page 4, Mr. Macdonald stated private reprimands had not been used in the past, though that discipline was provided for in the law and was being removed to harmonize with S.B. 315. Exhibit C was an overview of the benefits of E-prescribing.
Louis Ling, General Counsel for the Nevada Board of Pharmacy, expressed his desire for the bill to be approved. Questions during the last biennium had been raised to allow electronic prescribing even though unable to do so. Upon trying to pass a regulation, the Legislative Counsel Bureau (LCB) pointed out that the law stated a manual signature with pen was required for prescriptions. Therefore, E-prescribing was not passed. There were many physicians, in Las Vegas in particular, who were ready to begin E-prescribing. Hand-held, extremely sophisticated devices needed for issuing E-prescriptions were set-up and waiting for approval.
The equipment, inclusive of palm pilots with all data required for each patient at hand, provided the following:
1. Prescriptions were processed and entered into the patient’s permanent record in the computer;
2. Alerted the doctor if the drug was not covered by the patient’s insurance;
3. Processed insurance adjustments; and
4. Finally, by pressing “go,” the prescription was written and entered into the patient’s file.
What the bill did was draft regulations to cover any potential future permutations. Presently, everything was done, inclusive of printing out a legible written prescription, faxing to the pharmacy, and within two or three years, via connections between doctor and pharmacy computers, eliminating the chance of data entry errors.
The states that presently allowed this form of medication prescription saw reduction in error rates, saving of lives, and saving injury to patients because there was no longer a problem of deciphering illegible handwriting. Also, immediately upon entering the drug in to the patient’s record, it alerted the physician if there was a conflict with other medications the patient was presently prescribed. He commended Assemblyman Lee for his insight into a serious problem and thanked him for asking the Nevada Board of Pharmacology to join him in drafting the bill.
Assemblywoman Giunchigliani inquired as to why LCB actually rejected the regulations other than the statute required a manual signature. Mr. Ling stated they had asked the LCB to accept an electronic signature as valid and they could not. He understood their denial, thus the drafting of the bill, which went far beyond their original request. Assemblywoman Giunchigliani asked how the authenticity of the signature was verified if electronically transmitted. Mr. Ling stated federal law recognized many ways to verify the prescription was received from a physician’s office and not some other entity. The bill allowed the broadest possible way to E-prescribe. Some of the palm pilots actually had a signature window such as those used by FedEx. In the case where the palm pilot did not have that attribute, those physicians would be assigned a unique identifying number or other combination of facts so that when received by the pharmacy, the pharmacist would know the physician had indeed sent the E-script. Assemblywoman Giunchigliani called attention to page 3, subsection 5 of Section 4, and reaffirmed that the federal government had authorized the use of electronic transmission and facsimile for controlled substances. Mr. Ling stated they were working to allow all variance of that fact, and introduced technology to assure confidentiality and safety. She understood since the bill did not include a complete list, the bill would not go into effect until authorization was received from the federal government.
Keith Macdonald, Nevada State Board of Pharmacy, interjected the federal government was acting quickly to include Schedule 2 prescriptions and the ability to transmit them electronically. According to their regulations, Schedules 3, 4, and 5 medications were transmitted by facsimile now. They were working to develop an encryption system and biometric identification, either thumbprints or retinal scans, that would be available on palm pilots. Assemblywoman Giunchigliani asked for confirmation the section was not added to try to interfere with the medical marijuana legislation. Mr. Macdonald indicated there was no interest in that. She then asked what type of confidentiality controls were being developed relating to name, address and phone number of patients.
Chairman Dini quoted from Section 1, page 1, line 15, “ . . . insure the security and confidentiality of the data . . .” Assemblywoman Giunchigliani asked if there was language in other places that related to the security language represented. Mr. Macdonald stated there were other confidentiality regulations involved in the drafting of the bill. She requested confirmation that social security numbers were not used as the unique identifying number. He answered that was correct.
Vice Chairman Buckley, though unrelated to the bill, had read that former Governor O’Callahan expressed in his column in the Las Vegas Sun that the Board of Pharmacy had taken over jurisdiction of orthotic and prosthetic appliances, indicating that was done without hearing or input from that industry. She requested an explanation regarding the above.
Mr. Macdonald stated the Nevada Association of Medical Providers (NAMP), providers of medical equipment, gasses, and devices, approached the Board of Pharmacy, as did the Medicaid program in the State of Nevada, and requested that those agencies be licensed. On the show 60 Minutes, the state of California identified nearly $200 billion worth of fraud in the medical durable equipment and gasses issues. It took an Attorney General effort to clean up that issue in California. In the year 2000, Medicaid had over 300 requests for licensure of medical providers in the state of Nevada. The reason for the licensure was because it was becoming impossible for Medicaid and Medicare to identify small businesses quickly enough to charge fraud. There were new up-start companies that would obtain patient identification numbers and charge services. When an investigation was set in motion, the smaller disreputable companies would close the business and disappear. The regulations were not expanded to encompass those areas, but were advised by law, NRS 454, to license those individuals. Regarding the prosthetic devices, they were requested by the people of the industry to include those items that required a doctor’s prescription. One individual instrumental in the prosthetic device business in 1966 had a concern and contacted former Governor O’Callahan who, in turn, contacted NAMP. He explained there were public meetings that were properly announced, plus regulations were adopted through the hearings process according to procedures described in state law. The industry was very pleased with the results.
Vice Chairman Buckley noted that NRS 454 addressed poisons, dangerous drugs and hypodermics. She asked for the specific statute that authorized NAMP to regulate prosthetic and orthotic devices as opposed to dangerous gasses. Mr. Macdonald corrected his former statement and stated the law was covered in NRS 639, which gave authority for medical devices. Vice Chairwoman Buckley stated that would be investigated.
Chairman Dini addressed A.B. 415 as a straightforward bill with no potential amendments.
Jack Kim, Health Fund of Nevada, Southwest Medical Associates, offered support of the bill. It allowed advantages through technology.
Mary Lau, Executive Director, Retail Association of Nevada (RAN), stated through RAN there was a chain drug committee that oversaw all of the chain drug stores throughout the state of Nevada and national association chain drug stores. They continually attended the Board of Pharmacy meetings and worked on all pharmacy issues, which covered pharmacy errors, manpower shortages and the problems connected with the pharmaceutical industry. Part of her job was to attend board retreats, and at one of the meetings, RAN requested the board to consider a bill to mandate that doctors provide legible prescriptions. She stated erroneously filled prescriptions were caused by not being able to read the prescriptions as written, and acknowledged that damages caused were at times catastrophic. RAN was very enthusiastic about Assemblyman Lee’s bill and was in complete support of the legislation.
Chairman Dini called for a motion on A.B. 415.
ASSEMBLYMAN NOLAN MOVED TO DO PASS A.B. 415.
ASSEMBLYMAN PARKS SECONDED THE MOTION.
THE MOTION CARRIED UNANIMOUSLY BY THOSE PRESENT. ASSEMBLYMAN ARBERRY AND ASSEMBLYMAN HETTRICK WERE ABSENT FOR THE VOTE.
Chairman Dini opened the hearing on A.B. 452
Assembly Bill 452: Requires certain providers of health insurance to contract with federally qualified health centers as providers of health care under certain circumstances. (BDR 57-1177)
Assemblywoman Giunchigliani stated A.B. 452 was a simple piece of legislation developed from the Safety Net Day festivities. In speaking with many of the federally qualified health care centers, the conversation turned to lack of access, thus the legislation was drafted. It was not targeted toward any one insurance company; it simply was a mechanism to assure the community health care programs and clinics met the qualifications for the applications with properly licensed doctors on staff. At that point, they were allowably added to the listing for PPL, HMO and/or other insurance programs. They needed to be looked at as a group, therefore if a closed panel was used as an excuse to not allow them in because of all slots being filled, they then did not have qualified health care coverage options. They wanted to get one on each list to continue coverage across the state as they presently allowed. It allowed them, as a business, to be able to have a mix of dollars. When a clinic was within a neighborhood and an individual became ill, that clinic was the preferred provider. At times there were walk-ins who were insured, but the clinics were unable to serve or collect insurance coverage payments because they were not on the list.
Steve Hansen, CEO of Nevada Rural Health Centers (NRHC), stated they operated 13 federally qualified health centers around the state of Nevada, 3 of which were in Clark County. He voiced support of the bill. It allowed continuance of services and diversified funding streams, and being allowed onto various HMO panels would allow offering services and off-set losses when administering to uninsured and nominal-fee patients. Chairman Dini asked for an explanation of how the program worked.
Mr. Hansen stated to get on a panel, a contract was provided by an insurance company, which NRHC filed for coverage. The physicians, nurse practitioners, or nurses filed a credentialing form, basically background information for prior claims against them, after which a rate was negotiated and submitted. The insurance company would then either accept or reject the application. Chairman Dini asked if more than one group could be involved on a panel or was it exclusive coverage per clinic. Mr. Hansen stated he was not sure how the panels were accepted. At times panels were closed, thus the reason for A.B. 452 being drafted. There were a number of HMO denials in Las Vegas. Within the rural areas they had not received any denials. In essence, the panels would not accept additional physicians, thus not all physicians were covered. Chairman Dini asked if the bill would open those panels. Assemblywoman Giunchigliani answered the intent was one federally qualified offer at each of the insurance sites. In discussing this with knowledgeable industry staff, the insurance companies looked to a number of doctors and stated they were full. The bill would cover an entire clinic, and as long as the doctors were contained within that clinic, they had no one else on the panel. To argue that the panel was full because they had a certain number of pediatricians, nurses, etc., was not viable. Thus, the bill asked that a community health center as a whole be added to the panel, as the employees did not provide services on an individual basis. That would also model what was done throughout the rest of the state. Chairman Dini asked who sent the information provided to the committee. Assemblywoman Giunchigliani answered the Health Plan of Nevada.
Roger Volker, Director, Great Basin Primary Care Association (GBPCA), stated GBPCA represented all of Nevada’s federally qualified health centers, including community health centers and tribal clinics. They went on record in support of the “spirit” of the bill. Federally qualified health centers were the safety net of protection to those within a community who did not have the ability to pay for health care; therefore, citizens were accepted at the community health care centers regardless of ability to pay. For that reason, there were times when federally qualified health centers should be given special consideration beyond others in the industry in order to maintain viable health centers throughout the communities. In Clark County there was a strategic planning process underway in the Clark County Health Access Consortium, and 100 community leaders gathered together for the past nine months to plan health care access in the Las Vegas area. The number one priority was the development of viable community health centers throughout that community. By viable it was important to understand that the health centers had to be financially able to function in order for them to be maintained within the community. There were about 500 community health centers across the country and they maintained, on average, a payer mix of about 50 percent of their patients who did not have the capacity to pay for services and were uninsured. The other 50 percent were able to pay through mechanisms of private insurance or because they belonged to HMO’s or had government assisted programs such as Medicaid. In Las Vegas today, 75 percent of the patients who visited the community health centers were uninsured. Thus, the reason for their support of A.B. 452 was it allowed them to maintain viable community health centers throughout the communities by looking at ways to increase the number of patients with the capacity to pay.
Mr. Kim offered amendments of clarification (Exhibit D). When first reviewing the bill, they noted it mandated contracting with health centers. To HPN, that meant they had to contract with health centers even if they did not meet their qualifications or all credentialing and payment issues. Those were areas that had to be met for all other clients such as Medicare and Medicaid. Further testimony was verbatim of Exhibit D. The proposal was to change subsection 1 of all areas listed.
Assemblywoman Giunchigliani appreciated the help provided by Mr. Volker and Mr. Kim. The goal of the bill was to ensure access to medical care for the noninsured.
Janice Pine, St. Mary’s Health Network representative, voiced opposition to the bill. Verbatim testimony was found in Exhibit E.
Assemblywoman Leslie understood St. Mary’s Health Network presently had a contract with HOC and met the requirement of the proposed legislation. Ms. Pine replied that as long as HOC had a contract with the Independent Physician’s Association, a member of that group had a contract. Assemblywoman Leslie stated she understood St. Mary’s was already meeting the intent of the legislation. Assemblywoman Giunchigliani stated St. Mary’s was already in compliance and would not be affected by the bill, though she understood Ms. Pine’s testimony because they had a different structure on how they accessed the panel. Creativity was blessed and competition wonderful, and she hoped the amendments presented were workable for the three areas where that type of commitment was yet to be obtained.
Ms. Pine stated the bill would mandate a different procedure, situation, and treatment for a group or class of physicians.
Chairman Dini called for a motion.
VICE CHAIRWOMAN BUCKLEY MOVED TO AMEND AND DO PASS A.B. 452.
ASSEMBLYWOMAN LESLIE SECONDED THE MOTION.
MOTION PASSED UNANIMOUSLY WITH ASSEMBLYMAN ARBERRY, ASSEMBLYWOMAN GIBBONS, AND ASSEMBLYMAN NOLAN NOT PRESENT FOR THE VOTE.
Chairman Dini opened the hearing on A.B. 491.
Assembly Bill 491: Authorizes optometrist to collaborate with ophthalmologist under certain conditions. (BDR 54-1280)
Assemblyman Humke, Assembly District 26, presented A.B. 491. He began by relating there was an amendment proposed that he had not seen but was approved by Mr. Hillerby and Ms. Belz, the amendment to be presented by Mr. Hillerby.
Fred Hillerby, representative of Eye Care Associates of Nevada, shared a reprint of A.B. 491 (Exhibit F), which included the amendment referred to by Assemblyman Humke. The amendment dealt with the agreement between ophthalmology and optometry. With that as an introduction, Mr. Hillerby turned to Kelly Testolin, who walked through the bill.
Kelly Testolin, representing the firm of Hale Lane, stated the purpose of the bill plus the amendments, was because current law did not allow ophthalmologists and optometrists to jointly associate in medical practice. The restriction posed difficulties with respect to the conduct of postgraduate residency programs for optometrists. As previously drafted, the bill authorized ophthalmologists and optometrists to cooperate in the formation of either a professional corporation or a professional association, allowing them to conduct a joint practice. When the bill was reviewed, it was realized that as drafted the bill was broader than the need. As a result, the bill authorized an ophthalmologist and optometrist to jointly own and operate a professional corporation, but only if that corporation conducted a one-year, postgraduate residency program under the sponsorship of a college of optometry accredited by the Council of Optometric Education and operated as an extended clinical facility of the sponsoring college.
The need for the residency stemmed from the fact that the scope of an optometrist license was considerably narrower than that of an ophthalmologist. By virtue of his/her extended training, an ophthalmologist provided a much wider variety of services and procedures and treated a greater variety of medical conditions of the eye than did an optometrist. As a result, an ophthalmology practice provided greater exposure to pathology and diseases of the eye than did an optometric practice. While optometrists were in medical training, they were provided with academic and clinical exposure to all varieties and pathologies of the eye. With residency in an ophthalmology practice, the resident would be provided an intense day-in and day-out exposure to eye pathology and diseases, particularly in advanced stages, helpful to residents who wished to broaden their expertise and understanding. For that reason, colleges of optometry were hoping to establish residency programs at ophthalmology practices.
An ophthalmologist wishing to facilitate training of optometrists by conducting a residency at his/her practice was hampered by the fact that under present law he was not allowed to associate and practice with the optometrist who served as the medical director and supervised the residents in the completion of the program. Again, that was because present law disallowed an ophthalmologist and optometrist to conjointly own and operate a professional corporation that operated the clinical practice as an adjunct of the College of Optometry in the training program. The proposal in the bill was the relaxing of the prohibition for ophthalmology practices that operated residencies and allowed them to be legally operated. It would allow the ophthalmologist and optometrist to conjointly own a professional corporation and association only in the circumstances of conducting a one-year postgraduate residency program sponsored by an accredited college, and operated as an extended clinical facility. The bill additionally required that ophthalmologists retain voting control of the jointly owned professional corporation or association. They felt that requirement was prudent because of the broader scope of licensure of the ophthalmologist. If the relationship was inverted and optometrists controlled the association or corporation, it might force a complaint that they were controlling someone with a broader scope of licensure.
Mr. Testolin referenced the copy of the bill (Exhibit F) and addressed each section.
Assemblyman Nolan asked the size of Eye Care Associates and what parts of the state it represented.
Doug DeVries, Eye Care Associates, stated they had offices in Reno and Las Vegas, with residents assigned to both facilities for the coming year. They also served Ely, Elko, and Winnemucca with surgical services through the community hospitals in those areas.
Assemblywoman Giunchigliani said she had not yet heard of “need” for creating the partnership. Mr. Testolin answered current law did not allow the two entities to unite into a single, professional corporation to basically hold the residency program. The residency was today a licensed facility of the college, and there was no corpus to hold it, in which the sponsoring ophthalmologist and optometrist who ran the residency conducted and ran the program. It was very difficult to operate the program without such a joining as there was no central entity to hold the malpractice insurance, to contract with the school, and to hold the tax identification the billing was under to collect and bill for all services provided. Assemblywoman Giunchigliani understood it to mean there was presently no residency program and asked if there was one offered through the university. Mr. Testolin stated there was a current program but not organized in optimal fashion. It was very clumsy to organize without a corpus to hold it. Assemblywoman Giunchigliani asked if that program was through the college. Mr. Testolin answered in the affirmative. She then understood that a corporation would need to be formed and asked if an optometrist or an ophthalmologist could form corporations versus conjoining a corporation to offer a residency program. Mr. Testolin stated theoretically they could register as separate corporations, which required two contracts with the college, two separate malpractice policies with cross coverage, and two separate tax identification numbers. Under state, and more particularly federal law, when you had separate tax identification numbers and billed the patient under both, it was considered a referral. Many laws were on the books that governed referrals where there were financial arrangements, which then addressed a technical referral subjected to the laws that provided restrictions on how to relate the two entities together. There were limited and cumbersome means for getting around those laws. It was not impossible to proceed with two separate corporations, but was very cumbersome and limited. Assemblywoman Giunchigliani then led to the subject of self-referral. The committee had maintained cautiousness as they had, in the past, prohibited procedures that had occurred and then had to amend the legislation the following session. She queried if chiropractors were still not allowed to incorporate with medical doctors, an area they skirted because of the potential of cross referring within one’s own business and tracking the dollars. She could not see where A.B. 491 was any different from the chiropractic/medical doctor corporate development, other than having a residency.
Mr. Hillerby stated the incorporation would be in line with a group practice. There were group practices in existence where various specialties within the group occupied the same facility. That was not considered self-referral. The patient went to the group practice and sought out the doctor dedicated to the medical expertise needed for the patient’s malady. That was basically, in addition to the residency program, a group practice. The patient would see the optometrist for primary care, with the ophthalmologist entering the picture if a specific disease required treatment or surgery was prescribed. The environment in question did not involve the Stark Law and prohibition of self-referral. In fact, in Nevada’s self-referral law, there was exclusion for group practices.
Assemblywoman Giunchigliani asked which statute dealt with group practices and would the conjoining of ophthalmologists and optometrist be defined as such through the bill. Mr. Hillerby stated he did not have the citation in hand but would provide it. Mr. Testolin stated group practice was not defined as such in state law, the Professional Corporations Act, or the Professional Association Act, which said you could form a corporation and then conduct the practice. The forming of the corporation made the group practice. She then asked how that differed from an IPA. Mr. Testolin answered an IPA was a group of doctors that gathered together to bargain with payers, but did not merge their practices.
Mr. DeVries provided a brief synopsis of the need for residency programs. When an optometrist finished four years of optometry college, they went directly into practice. There were those, however, who wanted and requested additional training in a specific area. The training within the residency program was modeled after a medical residency program where there was an attending optometrist or ophthalmologist to mentor the resident as he or she continued to obtain increased skills and autonomy within the practice. It provided a greater level of education around the country by providing more sites.
Mr. Hillerby responded to Assemblywoman Giunchigliani, stating he felt ophthalmology approached the optometrists and indicated a real need for the program. There was a unique situation between optometry and ophthalmology called co-management, where the optometrist may have diagnosed a particular condition that needed surgery, and then referred the patient to an ophthalmologist. After the surgery, the patient returned to the optometrist for post surgical care. Medicare had recognized that procedure for cataract patients since the 1980s. With the advent of laser surgery, similar situations had occurred; therefore, the ophthalmologists provided the amendment.
Jeanette Belz presented testimony on behalf of the Nevada Ophthalmologic Society (NOS) and appreciated the opportunity to work with Mr. Hillerby and the sponsor of the bill. In trying to develop an amendment to suit all parties, the issue was the bill created a new relationship between ophthalmologists and optometrists. She introduced Dr. Conklin to explain the amendments.
Thomas Conklin, MD, introduced himself as a private practice Ophthalmologist in Reno for the past 23 years. He commented Mr. Hillerby addressed “management,” which was the thrust of the amendment presented as Exhibit G. Dr. Conklin read from the text of the letter drafted by George W. Blankenship, M.D., President, The Eye M.D. Association from the American Academy of Ophthalmology. He commented the bill originally cemented the relationship between optometrist and ophthalmologist in a business sense to further co-management. In order to look out for the rights of individual patients in Nevada, it was important to provide definition and disclosure. Dr. Conklin also shared a paper explaining Ophthalmic Postoperative Care (Exhibit H).
Ms. Belz reported the NOS was unable to support Mr. Hillerby’s first amendment regarding the narrowing of the bill. Research indicated there was only one residency program available in the state, and based on the testimony heard, they did not understand why the bill was necessary. She stated the residency program in question had been in place since 1993; therefore, they were not sure of the necessity to narrow down the bill.
Mr. Hillerby pointed out they should understand that although the amendment was attached to A.B. 491, the law would apply to any co-management arrangement. Since the 1980s, there had been optometrists and ophthalmologists co-managing Medicare patients for cataract surgery, and the law would not apply to just anyone who set up those types of arrangements. He emphasized it would not just apply within a corporate setting. Ms. Belz was correct in the fact the residency program was in progress. The bill would help with tighter organization of such a program, and incorporating professionally would extend certain protections. With the school of optometry involved in the practice, those protections extended to them equally, not putting the entire group responsible for the actions of one entity of the group. Mr. Hillerby offered any assistance necessary to re-explain the intention of the bill.
Assemblywoman Giunchigliani asked how insurance coverage would work with the PPO and HMO programs. Was re-bargaining involved to meet the qualifications of the PPO/HMO lists as a professional corporation? Mr. Hillerby was not sure how that would apply. He deferred to Ms. Belz or Mr. Testolin.
Ms. Belz returned to the subject of narrowing the bill and stated they were still questioning the need for the amendment, because without the amendment there could be corporations available to both ophthalmologist and optometrists throughout the state. If the group wanted to avail themselves of that option, it was available without the amendment.
Mr. Testolin spoke to Ms. Belz’s point. The reason for proposing the bill was because under present law a corporation jointly owned by an ophthalmologist and optometrist was not allowed. The residency had been conducted since 1993, but there were a number of problems with the process, which were highlighted in earlier testimony. There was a cross liability but not one policy because of working together in treating patients. That provided a problem in coordinating policies and whenever entering a defense situation. There was no single corpus in coordination of the program. Two tax identification numbers made treatment of a patient across the gap a referral under state and federal statutes, which caused severe problems when referrals intermingled in financial arrangements not within a single practice. There were confidentiality issues such as: who owned the medical records, two consents for release of information were required, and two malpractice policies.
It was safe to say the continuation of the situation as presently operated was cumbersome, but upon analysis and through advice, the continuation of it was in jeopardy without the professional corporation allowed by the bill.
Assemblywoman Giunchigliani posed another question before receiving an answer to her insurance query. She understood the amendments to affect only one business. Mr. Testolin stated it would immediately affect one business but it would affect any practice that operated the residency. There would then be no restriction on where the schools of optometry could assign resident schools. The current amendment also allowed an ongoing program to continue and encourage others to form programs because the bill removed the obstacles. Assemblywoman Giunchigliani voiced again her concerns regarding PPO/HMO insurance coverage with the contracts currently in place. Mr. Testolin answered they were insured as individuals, as well as a company. Upon formation of the corporation they would have to rebid but they were in hopes the contracts would be transferred without any delay in service to patients.
Chairman Dini asked how the amendments proposed by the Nevada Ophthalmological Society affected the original bill. Mr. DeVries stated the NOS proposals would not affect the original intent of the bill or have any impact on it. Assemblywoman Giunchigliani asked about the scope of practice and asked if it would allow optometrists to move into a scope of practice beyond what they already enjoyed. Mr. Testolin stated they remained restricted by their scope of licensure and were required to act within those limitations. She asked if both entities were considered equal entities under the bill. Mr. Testolin the bill arranged the charging of one fee and splitting it among themselves under certain conditions. Assemblywoman Giunchigliani stated the original bill indicated one would be an employee under the other, and she felt that was not the purpose of the bill.
Larry Matheis, Executive Director of the Nevada State Medical Association, voiced opposition to the bill based on principles. It was about the professional corporation statute, not ophthalmology and optometry, and why the statute existed. He asked for very good rationale if there was going to be a change in the present statute. It existed because Nevada allowed a certain number of privileged licenses to professionals, and that meant the structure of accountability as to what the professional may do. The practical considerations were how to incorporate the professional practice to optimize it. Therefore, independently licensed professionals were allowed to join for purposes of creating efficient professional practices. What was not allowed was a lawyer and a doctor to create a professional corporation, or a doctor and an architect to create a professional corporation, or any other permutations of the 45 to 60 privileged license categories available. Unlike entities were not able to form a professional corporation to maximize their ability to deliver the professional service they were specifically permitted by law in Nevada to perform within the scope of their licenses. The wall of protection was constructed for the public to avoid abuse by nonprofessionals, whereby the latter could hide behind a professional corporation and perform as if they were professionals. It was also to protect the public from a corporation acting as if it were a licensed professional. Thus they allowed the formation of a professional corporation of physicians, and the statute stated an individual was a physician in Nevada if licensed under NRS 630 as a medical doctor, licensed under NRS 633 as a doctor of osteopathy, or licensed under NRS 630A as a homeopathic physician, who must be a medical doctor or a doctor of osteopathy. That was what it meant to be defined as a physician. The language permitted an M.D., a D.O., or a homeopath to form a professional corporation, making clear that physicians could form a professional corporation. To break that generations-old protection for the public was questionable, while also encouraging or allowing licensed professionals in the same profession to join together for purposes of hiring support staff, having offices, doing all of those things that are part of what that professional must do, every precaution should be taken.
Mr. Matheis continued, stating the proposal said that ophthalmology and optometry may join and create a professional corporation. Unfortunately ophthalmologists were not licensed as ophthalmologists, but as physicians under NRS 630, NRS 630A, or NRS 633. In reality, it meant that a physician and an optometrist may form a professional corporation to practice which profession? They were two separately licensed professions. They may have done business as one entity, but the protection of the public was not present when someone who was licensed as one profession practiced another profession. Why it was necessary to address an 80-year-old set of rules on how professionals of the same licensure came together to create a corporation was beyond him. The testimony heard indicated that advanced training of optometrists was to be within an optometric residency program as that was the best and easiest way, or the attorney’s advised way of changing Nevada law to encourage that particular training. Was it the only way? The answer was, “No.” According to Mr. Matheis, residency programs were usually operated under schools of higher education. Arrangements could be made through the university system. There could be a nonprofit incorporation for the purpose of doing training, and then a contract with optometrists or ophthalmologists to provide educational or faculty positions necessary. There were many variations without going to the heart of one of the basic protections of the public as to how professionals who had a privileged license in the state of Nevada organized themselves simply for the business side of what they were doing.
Mr. Matheis offered the apologies of Dr. John Ellerton who had hoped to testify but had other commitments, though Dr. Ellerton did provide his comments to the committee members through e-mail. Mr. Matheis asked that if the bill was processed, which they hoped would not happen, the amendments of NOS be incorporated in one way or another. He pointed out there would be major circumlocution into statute to get around the problems being created for the public by allowing the fairly noticeable exception to the professional corporation act. His experience had taught him that once an exception had been allowed, it was not the last time exceptions would be requested. He did not feel it would always be within the medical field, but was certain that it would indeed a create a cascading effect on those who were licensed to do one thing and those licensed to do another, who together would try to create an entrepreneurial enterprise. There were plenty of other ways to structure entrepreneurial ideas without creating confusion in the public mind, or to remove the barricade of protection when dealing with licensed professionals that had privileged licensure in this state.
Vice Chairwoman Buckley asked for questions from the committee. Assemblywoman Gibbons asked if he saw a danger in the future of insurance companies using the incorporation to obtain lower rate of payment for services and victimize the patients. Mr. Matheis felt that was a discussion for another day within another bill. He emphasized an area adjunct to the subject was the growing confusion of the public. With the redrawing of laws that affected the professional licensure within the medical-care field, confusion was created, which, over time, the Legislature, the licensing boards, and the professions themselves would have to clarify. That was why physicians were specifically defined in the Nevada Revised Statutes. There were many doctors but not all were physicians. There also were groups, which we had allowed, for advertising purposes, two-name designations that included physicians, but the single professional title of physician was restricted only to the categories of medical doctors, doctors of osteopathy, and doctors of homeopathy.
Changing NRS 689.050, as well as the other parts of that Chapter, had to be viewed very skeptically unless it was absolutely essential in providing care to someone who had a compelling case history. Presently, the only argument was convenience for one operation to be able to do that for the combining of ophthalmologists and optometrists, one a physician and one not. He felt there should be a compelling reason to suddenly remove a statute that was in place specifically to protect the public. It allowed a very limited set of activities by professionals, licensed under the same license for their needs, while making certain it did not go over the line. Mr. Matheis suggested finding other ways to handle the issue. He did indicate some of the suggestions from the NOS helped on the issue, but he was not in favor of changing, weakening, or providing openings that reduced the proficiency of the Professional Corporation Act.
Robert Barengo, representing the Nevada State Board of Medical Examiners (NSBME), offered a neutral position toward the bill but opposed the amendment. He introduced Richard Legarza, General Counsel for the NSBME. Mr. Barengo referenced the amendment to be placed in NRS 636, the optometric section, which implied that the Board of Medical Examiners (BME) (paragraph 2) required that the patient’s medical records contain information from both the ophthalmologist and optometrist. That implied the Board of Medical Examiners could take action against an ophthalmologist, which did not comply with the law. The licensing structure in NRS 630 for medical doctors was such that competency was licensed, not the professional business practices of a doctor as the latter was outside their jurisdiction. The amendment suggested the inclusion of managing office practices. He asked if the law with amendment was enacted, would that section imply the BME would provide regulation. In Nevada, a medical doctor was licensed as such and qualified in a specialty area through various colleges, fellowships, and training.
Mr. Legarza voiced opposition to the amendment as proposed by Larry Hillerby on behalf of the Optometric Association. He remained confused as to who was to be protected other than perhaps a “turf” agreement between ophthalmologists and optometrists. He could see nothing in the language that was beneficial to a patient and did not know what was meant by “processing such on a case-by-case basis.” Also, there was no indication of what was expected on the part of the NSBME by way of disciplinary action against a physician. They did not believe the law a proper place for disciplinary action to be brought by a licensee of the NSBME, but in the Board of Optometry chapter.
Mr. Legarza stated they did not license or regulate by medical specialty. When speaking of special arrangements between medical doctors and other people, the Legislature was not considering the NSBME licensing, for instance, respiratory therapists who worked with pulmonologists. NSBME did not micromanage, did not want to micromanage, and did not believe the government belonged in the micromanagement of a business of a professional. The NSBME was requested to insert the above in their Chapter, which they refused. There were 113 ophthalmologists in the state of Nevada. There were 6,000 licensed medical doctors in the state of Nevada. Therefore, the bill represented 113 professionals only. There were 115 specialties, and subspecialties in the NSBME. They did not license or regulate by specialties, and they did not want something in the optometry statutes to cause a breach of an ophthalmologist’s duties to a patient. They believed NRS 630 adequately addressed fee splitting, full disclosure to patients, and items representative of possible kickbacks.
They did not want to see one of their licensed professionals referred to as having some sort of an obligation to a patient through a statute the NSBME might be expected to regulate.
Mr. Hillerby clarified the amendment agreed to was presented by the ophthalmologic society, which related to disclosure to patients and not business arrangements. In the existing languages in Section 5, subsection 2, four professions were listed and three of the four were individually licensed. Clearly an architect was not an engineer and vice versa, which equated to an already established precedence. Though there was possibly confusion as to what an ophthalmologist, optometrist and optician were, the general consensus was those individuals focused on practices relating to eyes. He felt there was no subterfuge in that respect when all who wanted to form the professional corporation worked within the same arena, the human eye. Mr. Hillerby reference the setting of a doctor’s office where there was a physician, a nurse (he also represented the State Board of Nursing), and the nurse did not practice outside of her scope under her license just because she worked with a physician. All involved would still be bound by their scope of licensure.
Vice Chairwoman Buckley closed the hearing on A.B. 491 and opened the hearing on A.B. 492.
Assembly Bill 492: Revises provisions governing certain licenses issued by and membership of private investigator’s licensing board. (BDR 54-1014)
Assemblyman David Humke, District 26, stated the bill was presented to him by constituents who operated infrared technology, otherwise known as a thermal technician. That individual worked in the area of fire science as a contractor and became concerned about the invasive nature of the technology if used in the wrong hands by looking into an individual’s house, vehicle or office to obtain information meant to remain confidential or privy only to the owners. The testimony from Mr. Jerry Gamron (Exhibit I) was presented to the committee by Assemblyman Humke. To that extent, the bill drafter suggested that the placement for this board would be an addition to the Private Investigator (PI) Licensing Board of Nevada. Mr. Gamron, a friend and acquaintance for the past 20 years of Assemblyman Humke, discussed the process with board member David Spencer, of the Private Investigators Board, who was present to testify on behalf of Mr. Gamron’s proposal.
Assemblyman Humke presented two amendments to the bill to make it more conducive to operating within the private investigator licensing board. The first amendment was at Section 2, page 1, lines 8 through 11, with the last full sentence providing that any current licensed PI could obtain a camera or device and become a thermal technician. That was not the intent of the bill and that was perhaps not appropriate. What they wanted to do was require anyone currently holding a PI license who wished to be licensed as a thermal technician to have to apply separately under the other terms of the bill. Assemblyman Humke stated he would provide verbiage for that amendment. The second amendment addressed Section 7; the new language reversed adding a licensed thermal technician to the PI Board. Other areas to be deleted were related amendments in Section 10 and Section 13, the effective date of the addition of the member. The reason was a policy consideration. The PI Board currently handled at least two other types of professions besides private investigators; those being process servers and polygraph operators. The latter two professions did not have a seat on the board and felt it would not be fair to those professions to give thermal technicians a seat on the board. Therefore, he wanted to amend those provisions out of the bill. Assemblyman Humke referenced Section 7 and pointed out the need to change the “5” to “4” members of the board.
Vice Chairwoman Buckley asked how many schools certified thermal technicians. Assemblyman Humke offered to get the information requested. Vice Chairwoman Buckley stated she had never heard of such a profession. Assemblyman Humke stated if Mr. Spencer was unable to provide that information, he would contact Mr. Gamron for the data. She then asked about the “five years of experience” verbiage, wondering if this was a “gray” area similar to that in the acupuncture legislation. Assemblyman Humke stated Mr. Gamron decided on the time line in order to “grandfather in” persons who were currently involved in that area in the private sector, trying to prevent a barrier to new licensure and protection for those already adept in the process.
Assemblyman Oceguera asked why infrared cameras used by public agencies would be exempt, stating that impression was not received in the language presented in the bill. He asked for a reference point in the bill that addressed the exemption. Assemblyman Humke stated they had looked for the exemption and found none. He then referenced where it said, “Persons with peace officer and fire fighter powers were exempt,” though it did not provide that for others. Mr. Gamron’s intent was to provide complete exemption for anyone working for a public agency. He stated an amendment would be drafted to clarify that area.
Assemblyman Beers addressed lines 9, 10, and 11 on page 1, where it grandfathered in landscape architects, contractors, engineers, environmental health specialists, and accountants. He asked if licensed under Title 54, it included professions, occupations and businesses. Assemblyman Humke stated the intent of the bill drafter was to place the language in NRS 648, which referred to the Private Investigator Licensing Board, while Title 54 referenced many types of professions. He felt the bill pointed directly to PI licensure.
The bill sponsor, regarding his intent and what he had hoped to accomplish, contacted David Spencer, licensed Private Investigator in the State of Nevada and a member of the Private Investigator’s Licensing Board. A poll of three of the four board members saw no problem with regulation under the Private Investigators Licensing Board; however, there were a few changes to be addressed. The board was in agreement that due to the recently accelerated use of thermal technology, it was well-spent legislation that would protect the public.
Vice Chairwoman Buckley asked, without licensure to use this type of investigative procedure, would they not already be violating the chapter in the law. Mr. Spencer stated the intent was to help designate the difference between spying on people and conducting an investigation. By being regulated, it would lessen the chance of that type of technology being used to “spy” on people illegally. He stated he had used the technology for loss prevention in warehouse theft; it was a tremendous aid at night. At the same time, if not regulated and it fell into the wrong hands, the mind could conjure up all types of areas where the technology could be illegally used. Vice Chairwoman Buckley asked if there were other cases where someone was using that type of equipment and was not licensed as a private investigator. Mr. Spencer replied personally no, but was told by Mr. Gamron, who was also in support of the bill, that it was used to defraud the elderly by using the technology fraudulently to “assess” their residences for potential for fire damage, etc. Vice Chairwoman Buckley then asked if a plumber used the technology to detect a leak, would they have to be licensed under the private investigator statues. She stated her plumber used that type of technology to detect a leak in plumbing encased in concrete. Assemblyman Humke stated the placement of this type of licensure was within the Private Investigator Licensing Board under a separate license as a thermal technician. Vice Chairwoman Buckley suggested differentiating between using it for investigations, but during testimony it was talked about it being used for buildings and defects within buildings. If someone was very well trained as a contractor, would they not be licensed under Title 54? She was concerned about plumbers and electricians.
Vice Chairwoman Buckley closed the public hearing on A.B. 492 and moved to A.B. 541.
Assembly Bill 541: Provides for regulation of certain instructors of courses required for issuance and renewal of license as real estate broker, broker-salesman or real estate salesman. (BDR 54-551)
David Walker, Deputy Administrator of the Real Estate Division, stated the board was in place to assure real estate transactions were completed in a proper and ethical manner. One of the greatest areas of concern and 80 percent of their efforts centered on education. They believed it was absolutely essential that brokers and salespersons who represented any party in a real estate transaction be educated to the point that they could do so intelligently and were aware of all the laws and statutes. Consequently, what brought forth the bill was the requirement of continuing education on license renewal to further emphasize that changes were continuous and education was necessary. There was a recent incident where an instructor issued certificates of education without the realtors actually attending, studying and/or testing in the assigned course. Basically, they felt the certificates were being sold with no benefit to anyone except the purchaser. The only recourse was to remove the course from the approved course list, leaving them no repercussions against the instructor who illegally sold the certificates of completion. It was the Board of Realtor’s contention the bill would close the “loop hole” and hold instructors accountable for their actions. In drafting the bill they felt the language was necessary. During further discussions with the Nevada Association of Realtors, they agreed with the friendly amendments proposed (Exhibit J). They sought the authorization to license instructors and create the criteria by regulation.
Vice Chairwoman Buckley applauded efforts to tighten the bill to assure the course certificates were legitimately earned and not purchased. She felt the legislation a bit rigid and asked how other occupations handled such a situation. She referenced real estate attorneys in good standing and asked if they would require fingerprinting as suggested in the bill. Mr. Walker stated “No,” and the reason for asking permission was to develop the criteria by regulation. She stated the statute made fingerprinting mandatory in Section 3. Mr. Walker stated that would be eliminated through the amendment presented.
Melody Luetkehans, General Counsel for the Nevada Association of Realtors, shared the division’s concern for quality education for real estate licensees. In an effort to promote enabling language and to clarify the language that they believed was more efficient, they contacted the real estate division and proposed the friendly amendment to basically supplement the LCB-drafted language. Vice Chairwoman Buckley pointed out Exhibit J and stated the amendment completely replaced the bill as drafted, allowing the division to regulate the process to ensure quality control.
Assemblyman Beers asked if there were existing laws for continuing education. Mr. Walker answered in the affirmative. It seemed to Assemblyman Beers that a more expedient approach would be to revoke the continuing education certificate for a fraudulent course, thereby revoking the realtor’s license. He felt that would provide the community with the knowledge that such interaction would not be tolerated. Assemblyman Beers was tempted to ask for an amendment prohibiting asking for fingerprints from instructors. He felt it tremendous overkill and had not seen it done in very many professions. Ms. Luetkehans indicated that section was being withdrawn. Again Assemblyman Beers stated he understood and suggested, having seen the original proposal and the amendment to revert it to regulations, insertion of an amendment prohibiting asking for fingerprints. Vice Chairwoman Buckley asked if there was any intention of including the fingerprinting in regulation. Mr. Walker stated “no”; the policy sent down by LCB and other licensing areas had always included fingerprinting. They did not feel it was necessary to reapply to this situation. Most of the instructors were licensed brokers and/or broker/salespersons in the real estate area. Consequently they did not foresee having them be fingerprinted. Many of the pre-licensing instructors were licensed under the post-secondary education regulations, and the board relied heavily upon their approval of the licensees. The board’s licensing did not supercede or impede the license whatsoever, but designated instructors to the real estate portion, which was addressed in regulations. They sought the input of other organizations as regulations were developed.
Assemblyman Beers asked for a repeat of an earlier answer relating to an attorney who offered a class on real estate law to real estate agents would have to be separately licensed by the Board of Realtors. Mr. Walker stated the understanding was correct. Ms. Luetkehans stated it was her understanding that attorneys licensed in the state of Nevada were exempt under the requirements of NRS 645, the licensing requirement for real estate. If the legislation was included in NRS 645, the attorneys were exempt. Vice Chairwoman Buckley stated Assemblyman Beers raised a good point. In other Chapters, such as physical therapists, what they had was, “the board shall require CLE, and the board shall, by regulation, prescribe the curriculum, approve the courses or training, and establish the fees for the program,” allowing the board to ensure the curriculum was real and of benefit without requiring the licensing of the actual instructor. If someone was a fraud she suggested not approving the course, thus quality control had been provided without requiring licensing of every person offering the courses. Mr. Walker stated that was an option, however, it was not an impedance for them to stop their current behavior. He felt there was a need for a form of disciplinary control through the board. If the course was eliminated, there were 100 other courses the same individual could offer and instruct. Vice Chairwoman Buckley argued that if the course was not approved for the continuing education, presumably the agents would refrain from taking it, thus cutting off the fraudulent instructors in that way. Mr. Walker stated every approved course had to be assigned a course number. There were many courses available that were approved and any independent instructor, without license, could teach or prescribe, and offer a certificate for a course assigned a valid number. The courses were offered, and the instructors would sell certificates to those who did not show up for class.
Ms. Luetkehans introduced J. C. Melvin, a real estate licensee and extremely well known seminar speaker and teacher throughout the state of Nevada.
Mr. Melvin addressed Assemblyman Beers’ concern. He recognized the concern the Board of Realtors faced, with potential legislation by statute that was too confining, which was why they determined they might be much better off with some enabling statute legislation allowing the education be defined by regulation. Section 3 addressed active real estate agents, brokers, and current instructors who became involved in the work group to insure that experts and those instructors nationally approved through the National Association of Realtor Societies Institutes and Councils were included. There was no preference if the instructors were from the State Water Engineering Department or attorneys with expertise in certain areas. With the deputy’s concern about the classes being sold inappropriately, the Real Estate Division was looking to raise the bar of education and found over the past few years there were a number of instructors throughout the state that were approved to teach continuing education credits. Perhaps, because the system was not in place before, it should probably not be approved. The bar was looking to be raised but not to be exclusionary.
Assemblyman Beers suggested the Real Estate Board present to the committee during the upcoming week a list of other state industries that were regulated and actually licensed continuing education instructors. Mr. Melvin stated it was not a licensure issue but that of certification.
Presented to the committee for their perusal and information was Exhibit K as written by David Perlman, Administrator, Commission on Postsecondary Education, which covered proposed changes to NRS 394.450 and NRS 394.465 as related to A.B. 541.
Vice Chairwoman Buckley closed the hearing on A.B. 541 and opened the hearing on A.B. 621.
Assembly Bill 621: Revises provisions relating to real estate. (BDR 54-552)
Mr. Walker returned to the witness table and explained the purpose of A.B. 621. The Real Estate Commission currently had jurisdiction in the areas of revocation and fines after proper hearings. One of the problems that existed was in some of the serious cases where there had been much fraud, and the agent merely turned in his or her licenses and walked away from any disciplinary action. The bill was proposed to close such a loophole so the perpetrators were held accountable for their fraudulent actions while licensed or even after allowing their license to expire, or was suspended or revoked. Vice Chairwoman Buckley asked if the definition of “property manager” was in current law or being added. Mr. Walker stated “property manager” was stated in the current law under NRS 645. The question arose regarding a homeowners association who enlisted a property manager. As defined in NRS 645, a property manager was a licensed agent in property management with certification working under the direction of a broker.
Chairman Dini called for a vote on A.B. 621.
ASSEMBLYWOMAN GIUNCHIGLIANI MOVED TO DO PASS A.B. 621.
ASSEMBLYMAN HUMKE SECONDED THE MOTION.
MOTION PASSED UNANIMOUSLY BY THOSE PRESENT. ASSEMBLYMAN ARBERRY, ASSEMBLYMAN PERKINS, ASSEMBLYMAN GOLDWATER, AND ASSEMBLYMAN NOLAN WERE NOT PRESENT FOR THE VOTE.
Chairman Dini opened the work session addressing A.B. 192.
Assembly Bill 192: Revises provisions relating to barber schools. (BDR 54-735)
Chairman Dini spoke of amendments that met with the agreement of the committee members. He then called for a motion.
ASSEMBLYWOMAN GIUNCHIGLIANI MOVED TO DO PASS A.B. 192.
ASSEMBLYMAN HUMKE SECONDED THE MOTION.
MOTION PASSED UNANIMOUSLY BY THOSE PRESENT. ASSEMBLYMAN ARBERRY, ASSEMBLYMAN PERKINS, ASSEMBLYMAN GOLDWATER, AND ASSEMBLYMAN NOLAN WERE NOT PRESENT FOR THE VOTE.
Chairman Dini opened the work session on A.B. 204.
Assembly Bill 204: Provides that knowing falsification of application for credit relating to retail installment transaction is deceptive trade practice and requires award of court costs and attorney’s fees to certain victims of consumer fraud. (BDR 52-1091)
Vice Chairwoman Buckley stated the original language in the bill related to credit applications and having the creditor initial all areas in which they entered information. There was testimony against that throughout the industry, therefore, it was redrafted (pages 4-6 of Exhibit L) and added that it was accepted trade practice to knowingly falsify a credit application, and with this unfair and deceptive trade practice, it entitled the victim to payment of attorney’s fees and costs. With that, John Sandee, lobbyist, was amenable to the change as it was his language. Chairman Dini called for a motion.
ASSEMBLYWOMAN GIUNCHIGLIANI MOVED TO AMEND AND DO PASS A.B. 204.
ASSEMBLYWOMAN LESLIE SECONDED THE MOTION.
MOTION PASSED UNANIMOUSLY BY THOSE PRESENT. ASSEMBLYMAN ARBERRY, ASSEMBLYMAN PERKINS, ASSEMBLYMAN GOLDWATER, AND ASSEMBLYMAN NOLAN WERE NOT PRESENT FOR THE VOTE.
Chairman Dini opened the work session on A.B. 245.
Assembly Bill 245: Makes various changes relating to advertising and charges by certain tour brokers and tour operators and requires certain tour brokers and tour operators to deposit security. (BDR 52-1021)
Chairman Dini reported there was an amendment that the subcommittee agreed upon and called upon Vance Hughey, Committee Policy Analyst, for an explanation.
Mr. Hughey referenced pages 7-8 of Exhibit L, the subcommittee report presented by Chairman Humke. Basically the amendment required tour operators or brokers, with limitations, to post a $10,000 bond, letter of credit, or certificate of deposit. Paragraph 3 in the report expressed the proposed amendment:
(1)A tour broker conducting business in this state who advertises a tour that originates in a county with a population of 500,000 or more, or;
(2)A tour operator conducting business in this state who conducts a tour that originates in a county with a population of 500,000 or more, must file with the division a bond, letter of credit, or certificate of deposit in an amount of $10,000.
Another area Assemblywoman Chowning asked to be addressed was that the committee consider adding a provision to provide guidance to the division with respect as to how the bond, letter of credit, or certificate of deposit was handled. Included as pages 9-10 of Exhibit L was a sample from the credit service organization statute that provided tremendous detail on how the bonds and letters of credit and certificates would be handled, and the thought would be to ask the bill drafters to work with language similar but not identical. For example, the first statute NRS 598.2807 included, “the bond would be executed by a corporate surety approved by the commissioner and licensed to do business in this state.” If it were a letter of credit, it would be one issued by a bank with federally insured deposits. Another provision referenced the term of the bond, letter of credit or certificate of deposit of not less than one year.
There were many things already in the deceptive trade practices statutes with respect to other bond requirements, and he urged the committee to consider if that was appropriate for this bill as well. Chairman Dini felt it good policy to put into law. Vice Chairwoman Buckley’s concern was it appeared to apply only to Clark County and asked if there were any small Clark County tours, or was it by definition limited to the airline/helicopter tours. She did not want to require small entrepreneurs doing a tour of a downtown site or a museum to have to post such a bond. Chairman Dini suggested deferring action until the following Tuesday, April 10, 2001, when Assemblywoman Chowning would be present to answer the questions raised.
Assemblyman Oceguera stated that area was discussed during the subcommittee meetings and provided the information that a $10,000 bond only cost $1,000. The subcommittee did not think it was too much to ask someone to put up a minimum of $1,000. Vice Chairwoman Buckley stated she did not want someone who was providing a tour of historic homes to have to put out that type of money. Chairman Dini again suggested waiting until Assemblywoman Chowning could be present for further input.
Chairman Dini referenced subcommittee reports on A.B. 355 and A.B. 379. Assemblyman Oceguera, as subcommittee chairman, suggested indefinitely postponing both bills.
Assembly Bill 355: Provides for establishment of minimum standards for education, training and certification of electricians. (BDR 53-714)
ASSEMBLYWOMAN BUCKLEY MOVED TO INDEFINITELY POSTPONE A.B. 355.
ASSEMBLYMAN BEERS SECONDED THE MOTION.
MOTION PASSED UNANIMOUSLY BY THOSE PRESENT. ASSEMBLYMAN ARBERRY, ASSEMBLYMAN PERKINS, ASSEMBLYMAN GOLDWATER, AND ASSEMBLYMAN NOLAN WERE NOT PRESENT FOR THE VOTE.
Assembly Bill 379: Provides for establishment of minimum standards for education, training and certification of plumbers. (BDR 53-1154)
ASSEMBLYWOMAN BUCKLEY MOVED TO INDEFINITELY POSTPONE A.B. 379.
ASSEMBLYMAN BEERS SECONDED THE MOTION.
MOTION PASSED UNANIMOUSLY BY THOSE PRESENT. ASSEMBLYMAN ARBERRY, ASSEMBLYMAN PERKINS, ASSEMBLYMAN GOLDWATER, AND ASSEMBLYMAN NOLAN WERE NOT PRESENT FOR THE VOTE.
Chairman Dini announced the next meeting for Tuesday, April 10, 2001 at 7:00 p.m. and adjourned the meeting at 3:12 p.m.
RESPECTFULLY SUBMITTED:
Ann M. VanNostrand
Committee Secretary
APPROVED BY:
Assemblyman Joseph Dini, Jr., Chairman
DATE: