MINUTES OF THE meeting
of the
ASSEMBLY Committee on Health and Human Services
Seventy-First Session
May 30, 2001
The Committee on Health and Human Serviceswas called to order at 1:36 p.m., on Wednesday, May 30, 2001. Chairman Ellen Koivisto 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. Ellen Koivisto, Chairman
Ms. Kathy McClain, Vice Chairman
Mrs. Sharron Angle
Mrs. Dawn Gibbons
Ms. Sheila Leslie
Mr. Mark Manendo
Ms. Bonnie Parnell
Mrs. Debbie Smith
Ms. Sandra Tiffany
Mr. Wendell Williams
COMMITTEE MEMBERS ABSENT:
Mrs. Vivian Freeman
Ms. Merle Berman
GUEST LEGISLATORS PRESENT:
Senator Raymond Rawson, Senate District 6
STAFF MEMBERS PRESENT:
Marla McDade Williams, Committee Policy Analyst
Darlene Rubin, Committee Secretary
OTHERS PRESENT:
Paul Gowins, State ADA Coordinator, Disability Forum
Chris Forsch, Nevada Dental Hygiene Association
Bobby Gang, Nevada Women’s Lobby
Sylvia Halgrimson, American Association of Retired Persons (AARP)
Mary Liveratti, Administrator, Division for Aging Services
Mary Wherry, Deputy Administrator, Nevada Medicaid
Jon L. Sasser, Esq., Washoe Legal Services
May Shelton, Consultant, Washoe County
Martin Bibb, Executive Director, Retired Public Employees of Nevada
Danny Coyle, President, Retiree Chapter of State of Nevada Employees Association (SNEA)
Chairman Koivisto opened the hearings with S.B. 207.
Senate Bill 207: Requires department of human resources to establish program for provision of medical assistance to certain working persons with disabilities. (BDR 38-227)
The interim Legislative Committee on Health Care referred the bill for review. Chairman Koivisto called on Paul Gowins and Jon L. Sasser, Esq., to review the specifics of the legislation.
Jon L. Sasser, Esq., Washoe Legal Services, voiced support of S.B. 207. He began by sharing the concept of the legislation that had been around since 1997 when Congress, through the Balanced Budget Act, gave states options in the Medicaid Program. One option allowed disabled Medicaid recipients who remained at home and did not work to return to work and retain their Medicaid while simultaneously buying into the program. The problems encountered were only about 1 percent of those nationally on Supplemental Security Income or disability returned to work, while 70 percent were not employed but would like to be; however, with the additional earnings, their Medicaid was stopped due to the limits set for Medicaid eligibility. Moreover, those individuals who did return to work and were fortunate enough to receive insurance benefits found those benefits did not include some of the coverage they had received under Medicaid. Examples included PCA (personal care attendant) services, durable medical equipment, and certain prescription drugs.
Continuing, Mr. Sasser said Congress recognized that problem and offered states the opportunity to apply for grants for planning additional changes that came about in 1999 as a result of the “Ticket to Work Act.” That act offered opportunities to expand Medicaid with some liberalization of the rules and other support services for disabled individuals returning to work. Some of those services included incentives to employers to hire the disabled or training that might be necessary to return to work.
Nevada had received a $625,000 planning grant, with up to four additional future payments of $500,000 each, to provide a staff in state government to implement the program.
Continuing, Mr. Sasser commented that Nevada had received that grant. Charles Duarte, Administrator of Health Care Financing and Policy, Nevada Division of Health, attended the last meeting of the interim Legislative Committee on Health Care in December 2000, to announce he did not plan to go forward with Medicaid buy-in in the upcoming biennium. His Division would study what needed to be done for the following two years. The Governor mentioned the program in the State of the State address and promoted it, but talked about using the planning money. Mr. Sasser noted the disabled community had been waiting for that option since 1997 and asked why it was necessary to plan for another two years. He strongly urged the committee not to wait until next session to implement a program.
Mr. Sasser noted the interim committee had attached a cost of $1.5 million for each year of the biennium; however, because of the budget shortfall, the decision was made in the Senate that there was no additional money to fund the program currently. Accordingly, Mr. Sasser brought forward a revenue- neutral amendment, and the bill did pass the Senate. Under the current amended version of S.B. 207, the Division of Health Care Financing and Policy (HCFP) would use the planning grant they received to develop some options for the program. They would present those options to the Interim Finance Committee by March 2002 and inform the committee whether or not they had been able to develop a revenue-neutral version of the program for implementation in the biennium. If they could not develop a program that was revenue neutral, they would know approximately what it would cost. The Interim Finance Committee could then make a decision whether to go forward in the coming biennium or wait to see if it would be in the budget for the next biennium. Mr. Sasser said his written testimony (Exhibit C) outlined some possibilities for a revenue-neutral program, based on preliminary research from other states, like Colorado and New Mexico.
Highlights of Mr. Sasser’s written testimony were as follows:
· The Problem: The probability was high that disabled individuals who went back to work would be declared ineligible for Medicaid if they earned more than a nominal amount of money, and they would be unable to obtain comparable health insurance in the private sector. An individual who tried to save money would run afoul of the asset rules that limited resources to about $2,000.
· Current Benefits for People with Disabilities: Social Security Disability Income (SSDI) and Supplemental Security Income (SSI). SSDI recipients became eligible for Medicare coverage after a waiting period of two years; however, they were not eligible for Medicaid unless they received SSI benefits to supplement Social Security Disability Income, or they participated in a Home and Community Based Services (HCBS) waiver program. While that coverage did not provide prescription drugs, PCA (personal care attendant) services, or durable medical equipment, it did provide basic hospital and physician services. Recipients of SSI, a means-tested program, were eligible for Medicaid and monthly cash income to low-income persons with limited resources, on the basis of age, blindness, and/or disability.
· Medicaid Waiver for Persons with Disabilities: Persons with disabilities whose incomes were above SSI limits of $500 per month were financially ineligible for Medicaid, unless lucky enough to obtain one of the scarce slots in a waiver program. In order to obtain waiver services, the services must be necessary to avoid institutionalization. The disabled waiver was funded to serve 205 individuals in fiscal year 2001, and the Governor had requested an increase to 380 for fiscal year 2003.
· Medicaid Options Under the Ticket to Work/Work Incentives Improvement Act: Under the Ticket to Work options, the state could create a Medicaid buy-in program with no income cap. States could not set a quota on participation; however, through the use of cost-sharing mechanisms, states had substantial flexibility in limiting program participation. The Ticket to Work program permitted program participants to be employed at the time of application and did not require applicants to be currently Medicaid eligible.
· S.B. 207 Could Be Made Cost Neutral: The Division could develop a cost-neutral Medicaid waiver for submission to the federal government by restricting the program eligibility for the program to persons receiving Medicaid. It would cost no more to provide Medicaid to someone in the workplace than to someone sitting idly at home. In fact, it cost less because of the savings when the recipient started using Medicaid as a wraparound to new insurance gained through employment.
Concluding, Mr. Sasser stated that Medicaid buy-in had been discussed since 1997. Some individuals would need more extensive services. Other Medicaid recipients would be able to return to work immediately if allowed to retain Medicaid. The latter group should not have to wait for the needs of the first group to be determined. Some of the staff time purchased by the study grant should immediately address the design of a cost-neutral program to begin operation in the second year of the biennium. Mr. Sasser urged the committee to “free those who are currently ready to return to work” by passing S.B. 207 as amended.
Chairman Koivisto asked if the state had already received the $625,000 planning grant. Mr. Sasser said the planning grant became effective in October 2000. Some of the staff were hired under the grant, and remaining staff were being interviewed. Jonathan Andrews was hired as the state coordinator, thus they thought it was realistic to bring the bill forward by March 2002. The administrator and deputy administrator had met at length with staff to set the agreed upon timeframes.
Paul Gowins, State ADA (Americans with Disabilities Act) Coordinator, Disability Forum, added his full support for the program. The disabled community would have preferred to see the new process take place in 1997. Now, four years later, they hoped the grant would be the impetus to move the process forward.
Mary Wherry, Deputy Administrator, Nevada Medicaid, reported there had been meetings with the advocacy group for the physically disabled population, and she felt there was a good faith effort to analyze the opportunity in a timely manner. She, Mr. Gowins, and Mr. Sasser had a conference call with the Health Care Financing Administration (HCFA) central office staff in Baltimore, Maryland, to discuss the eligibility concepts. She related that one of the first comments was, “This is an enhancement program, I don’t know how you can make it cost-neutral.” Nevertheless, Ms. Wherry said her group would put forth a good faith effort. She would also make sure that, in the analysis, they factored into the equation that a large group of the population who could benefit from the “Ticket to Work” program was low-income group, for example, those with a mental disability versus a physical disability. Individuals with physical disabilities tended to be higher-end income earners. She added they needed to “mesh” those together in terms of premium and cost-sharing concepts that would impact the ability for the program to be cost-neutral.
Concluding, Ms. Wherry said she was not overly optimistic that the program would be cost neutral, but would do everything she could to get the program up and running as quickly as possible.
Assemblywoman Leslie referenced page 3 where it discussed the timeframes and asked if the program would be presented to the Interim Finance Committee (IFC) before March 2002. Ms. Wherry stated her understanding was to have the analysis done during January 2002, for the March 2002 IFC meeting. If it turned out to be a cost-neutral proposal, it would be brought forward in the spring with implementation in October 2002. Assemblywoman Leslie concurred that the program probably would not be cost-neutral. Ms. Wherry stated one assumption, based upon the Colorado and New Mexico legislation, was there would not be a new group of people covered; however, what should be taken into consideration was there was not a medically-needy Medicaid program in Nevada. Nevada had a categorically-needy program. Accordingly, when compared to those states that had a medically-needy program, she wanted to be sure any comparisons made used a similar cross-section of people.
Chairman Koivisto asked the committee’s wishes.
ASSEMBLYWOMAN LESLIE MOVED TO DO PASS S.B. 207.
ASSEMBLYWOMAN GIBBONS SECONDED THE MOTION.
THE MOTION PASSED UNANIMOUSLY BY THOSE PRESENT.
ABSENT FOR THE VOTE WERE ASSEMBLYWOMAN FREEMAN
AND ASSEMBLYWOMAN BERMAN.
Chairman Koivisto closed the hearing on S.B. 207 and opened the hearing on S.B. 208.
Senate Bill 208: Makes various changes to provisions concerning public dental health. (BDR 40-738)
Senator Raymond D. Rawson, Senate District 6, southern Nevada, stated the bill had been through numerous Senate committees and had just cleared the Senate Committee on Finance. In the process, the appropriation originally listed in the bill was removed. From a policy standpoint, S.B. 208 allowed the Heath Division to appoint a State Dental Health Officer, an unclassified employee. The position had been inactive until 1981, when budget restraints forced the closure of the Belrose Clinic in Las Vegas, home to the Medicaid children’s dental clinic. All of the equipment had been sold, and it was unlikely the office would reopen. Senator Rawson explained most states had a dental health officer, and the individual interfaced with the federal government and other states, a process denied to Nevada since 1981. Therefore, the state was unable to provide proper information on a national level and was out of the loop for receiving information on grants, gifts, and programs available to other states, due to lack of state dental officer representation.
Continuing, Senator Rawson said from a public health standpoint there was a significant dentistry program in Nevada, and many bills had been brought forward in the current session related to that issue. Dental residencies had been established, as well as rural health initiatives and a dental school. It was believed those programs would help the more than 100,000 children throughout the state with no access to appropriate dental care. In fact, 80 percent of those children were in the lowest 20 percent of the population socio-economically. The public health approach was the best way to deal with the problem. It started with a dental health officer.
The bill also created a Public Health Dental Hygienist, a new position throughout the country. Several states had been working with the Nevada representatives to establish the criteria for the position. The Milbank Foundation had voiced an interest in supporting the program, as well as helping to establish the curriculum and the necessary training. Essentially, the Public Health Hygienist would work within the public schools, nursing homes, and other public health arenas where there was no one qualified to do that type of work. The state dental officer and the dental hygienist would determine the needs of the state and make recommendations to the State Health Division.
Continuing, Senator Rawson said the bill was originally set up to be funded by the General Fund, with money provided to develop a curriculum. That appropriation was removed and the process amended to allow the individual to be appointed from the University System, since there were already dentists working in various programs. As a dentist himself, Senator Rawson disclosed he worked in the University System; however, he had not proposed the position for himself and would never serve in that capacity. The bill had been written the way it was, he said, because there were many others on staff and on salary who could assume the duties, and there was no reason to stop the process due to lack of funds.
After the Senate Finance Committee hearing, Senator Rawson was contacted by the Health Division who indicated they had several grants through the Centers for Disease Control (CDC) that might be used to fund those positions. Therefore, he presented additional amendments (Exhibit D) that allowed the Nevada Health Division to solicit and accept gifts and grants to fund the costs associated with the positions. Senator Rawson stated he wanted it clarified that the legislation was written so that the university could supply the director, but in no way did he want that taken away from the Health Division. He noted the second reprint of the bill had been written in transitional language, which disappeared after the session, and he was concerned that those who were unfamiliar with transitional language might be confused.
Assemblywoman Leslie thanked Senator Rawson for bringing the bill forward and stated it was sad that it had taken 20 years to reinstate the State Dental Health Officer position. Ms. Leslie asked if the state would require that the state dentist and the state hygienist come from the University System. Senator Rawson said “no.” The point of writing the bill that way was to make it possible for the University System to be able to appoint someone who was in the system and already on salary, but the individual could come from anywhere. The funding for the position would come from gifts and grants. Ms. Leslie asked if the grants were one-time only or ongoing. Senator Rawson said he envisioned the funding to be a state responsibility, as it had been in the past and as it was in all other states. Meanwhile, if Nevada had to provide the services for 10 or 20 years, it could be filled by someone already employed by the University System. The amount of available funding would dictate where the person came from in the future. Ideally, he added, sometime in the future, it would be an individual who would be funded through the General Fund by the state and would act independently of others.
Chairman Koivisto stated e-mail was received from the Legal Division pointing out a conflict between Section 12 of S.B. 208 and Section 8 of the enrolled version of S.B. 133. Senator Rawson stated there was no attempt to work against S.B. 133, and he hoped it could be resolved without holding up the bill. He said they had tried to describe new law regarding the hygienist, and S.B. 133 indicated the person must be certified by the national board, pass the examination with a score of 75, and be examined by the board. If that had to be clarified and did not address dentists, it should be described with the same terminology as found in S.B. 133. Chairman Koivisto said Marla McDade Williams, Committee Policy Analyst, would make sure it was done properly.
Assemblywoman Tiffany asked about the verbiage “develop curriculum,” and wanted to know if that meant to develop a program. Senator Rawson said he was talking about developing a curriculum for a public health hygienist, which would be a masters level dental hygiene degree. The money was not presently available, but the University System was looking at the issue of hygiene degrees and would do that without any funding. Assemblywoman Tiffany asked what he anticipated the dental health officer and hygienist would accomplish. Senator Rawson saw them determining the dental health needs throughout Nevada. He had conducted studies to see what the decayed, missing, and filled rate was for children. In every indicator, they found Nevada placed last throughout the country, with the highest rate of caries, the highest rate of unfilled caries, the highest number of missing teeth, and overall very poor oral health. The two positions would determine the depth of the problem and the manpower needs. With the needs determined, applications could be made to federal programs such as the Federally Qualified Health Centers. Although available in Nevada, it had no dentists affiliated with the program because no one was able to provide the figures that determined the need. It was the State Dental Health Officer who provided that data. The State Dental Health Officer would work with the associations and advocacy groups, such as a shelter, who had people in need of dental care. Information on where dental services could be obtained would be provided to those in need by the State Dental Health Officer. In short, the position filled a huge hole in public dental health in the state of Nevada. Senator Rawson explained that the position would also advise dental schools on the types of dental care needed, such as less aesthetic and more reparative dentistry.
Concluding, Senator Rawson stated he would be happy to work with the Nevada Division of Health staff to assure the Legal Division that S.B. 208 did not in any way contradict S.B. 133.
Christine Forsch, representing the Nevada Dental Hygienists Association, stated they were in support of S.B. 208, especially the establishment of a state Public Dental Health Hygienist. Ms. Forsch submitted her written testimony (Exhibit E). Her primary concern was Section 11 of the bill. She stated the Association wanted to ensure that the current educational standards were maintained in Nevada. The Association supported increased access to care, but not at the expensed of lowering educational standards.
Mr. Sasser reiterated his support of the bill on behalf of the Covering Kids Coalition for which he was the state Chairman. The shortage of dental care in the state was critical, and he urged support and passage of the bill.
Chairman Koivisto called for a motion.
ASSEMBLYWOMAN TIFFANY MOVED TO AMEND AS
ARTICULATED BY SENATOR RAWSON AND DO PASS
S.B. 208.
ASSEMBLYWOMAN PARNELL SECONDED THE MOTION.
THE MOTION CARRIED UNANIMOUSLY BY THOSE PRESENT.
NOT PRESENT FOR THE VOTE WERE ASSEMBLYWOMAN
FREEMAN AND ASSEMBLYWOMAN BERMAN.
Chairman Koivisto closed the hearing on S.B. 208 and opened the hearing on S.B. 402.
Senate Bill 402: Expands authority of legislative committee on health care to review certain issues relating to long-term care. (BDR 40-972)
Bobbie Gang, Lobbyist, Nevada Women’s Lobby, stated the bill was amended to give authority to the Statutory Committee on Health Care to review long-term care. Originally there was interest in extending the special Task Force on Long-Term Care, but the fiscal note became a problem. Through the Senate committee studies, it was decided to give the responsibility for that review to the Statutory Committee on Health Care, thereby eliminating the fiscal note.
Ms. Gang emphasized the study of long-term care was something that needed to be addressed during the interim. It was an issue that would expand rapidly with the need for long-term care for senior citizens and the disabled. Long-term care would be very costly to the state, both in the area of finance and through human resources, and since the needs existed, solutions needed to be found. She felt it must be addressed in the upcoming interim. A special task force process was preferred, but the bill required an advisory group to be appointed to study and advise the Statutory Committee on Health Care. It was a way of looking at the issue in order to present it to the legislature in 2003. Ms. Gang urged support of the study.
Chairman Koivisto asked what outcome was envisioned. Ms. Gang said very little came out of the past interim study. One of the main things recommended was the appointment of a special task force to continue the study, because they had been unable to reach conclusive recommendations. Section 14 defined the items to be addressed during the 2003 Legislative Session.
Vice Chairman McClain stated that was one of the suggestions from the Long-Term Care Interim Study because, when talking about long-term care and senior issues in general, there were so many issues, there was not enough time to develop them. They were not just talking about nursing home care or institutionalization, but assisted-living programs and long-term care insurance. There were so many issues, it was difficult to pinpoint and combine all concerns. She felt it was the American Association of Retired Persons’ (AARP) platform that wanted the standing committee on long-term care, but she did not feel the bill addressed the areas of investigation as a whole. She stated she was a supporter of subcommittees to advisory groups because they were the individuals who knew about programs and issues. An interim health care committee was the best way to address the problems and to develop a program. She added, it was unfortunate the study could not be totally funded because there were dozens of issues.
May Shelton, a consultant representing Washoe County, expressed support for the bill and stated the counties had some responsibility for payment of long-term care beds for certain people. Medicaid had responsibility for people who made no more than $827 a month. If they received that from Social Security they had a patient liability that went toward the cost of care. If the cost was $2,000, all but $30 of the patient’s stipend went to pay for the cost of care. Medicaid then picked up the balance. If they earned between $827 and $1,590 a month, that was 300 percent of Supplemental Security Income (SSI). That fell under the 300 percent match program in which all 17 counties had to participate. When their income increased beyond $1,590, they became the county’s responsibility. Above that, if their income still did not cover the cost of care, the county assumed that responsibility.
Continuing, Ms. Shelton said that population of clients was growing. In 1995-96, for the 300 percent match, as well as a county match, Washoe County paid out almost $2.6 million. Last fiscal year, it paid out $4.1 million. It was not necessarily that the cost of care was increasing, but the number of clients who needed care was increasing. Cost of care and who paid were important factors to the counties. Quality of care was important and should be improved, especially in a time when there was full employment, and getting people to work in nursing homes was a challenge. There were many issues to be examined to help improve the system.
Vice Chairman McClain commented that in some of the smaller rural counties, having one or two individuals in a nursing home could almost bankrupt them because they simply did not have the ability to pay. It was a serious concern for the less affluent counties.
Ms. Shelton added that in the 300 percent match program, the counties put up half of the cost of care and the federal government, through Medicaid, put up the other half. All 17 counties had to participate, and if one county defaulted, the whole program collapsed. That was the reason for the so-called “bail-out fund” approved by the Senate Finance and Assembly Ways and Means Committees.
Assemblywoman Gibbons asked if the counties had looked into partnering with the federal government and buying long-term care insurance, because that might afford more coverage for more people. Ms. Shelton said that with the counties, they did not have people who signed up. Individuals presented themselves when they needed assistance, so it was a problem to identify them in advance. Mrs. Gibbons felt there would be a way to calculate a percentage of persons in the state who might fall into that category in a certain year, and perhaps there could be a guaranteed amount that the county was responsible for every year. As the population increased, so, too, could the guarantee amount; however, Mrs. Gibbons was not certain if such coverage was actually available. Ms. Shelton responded that when a person purchased long-term care insurance at a young age it was more cost effective. For older people, it was very expensive. It was something committees had discussed in the past for state employees.
Ms. Gang reminded the committee that the focus of the bill was to make sure that in the next interim the issue was further studied. Without that, another biennium might go by without addressing the issue, and the longer it was delayed, the more costly the needs of that population and the greater the drain on the other services provided to the needy citizens of the state.
Mr. Sasser, representing Ernie Neilson, Washoe County Senior Law Project, expressed support of S.B. 402 and stated there would be a number of activities going on with the Executive Branch in the current session for which he hoped there would be legislative oversight. There was a good chance that some independent living grants from tobacco money would be used to develop some assisted-living infrastructure through the states, under an obligation from the Olmstead decision, to look at alternatives to institutionalization, both for seniors and the disabled. He felt the Health Committee was an appropriate body to oversee what the state was doing, and it also fit under the rubric of the bill. Mr. Sasser encouraged support and passage of the bill.
Martin Bibb, Executive Director, Retired Public Employees of Nevada (RPEN), voiced support for the bill. There were two areas of particular interest, one provided for an analysis of the cost of alternatives to institutionalization for long-term care, and the other discussed methods of funding long-term care. Both were very important to RPEN, that had a membership of 7,700 persons across the state, and long-term care was a serious issue that lay ahead. He had worked with many other groups during the S.C.R. 4 study. He regretted there was not the needed funding to conduct the type of panel he and others envisioned. Moreover, he and the other groups were not happy there was an additional bill that would have funded insurance policies for retired and active state employees relative to long-term care, which was not because of the fiscal situation alluded to earlier. Nevertheless, they would not simply give that up.
Mr. Bibb recalled that Ms. Shelton referred to some of the impact on Medicaid budgets of the counties, and he echoed that statement that the entire Medicaid budget of small counties could be consumed by having two or three people in long-term care. If it was necessary to choose between that and the Meals on Wheels programs or something similar, probably there would be some hastened solutions but perhaps not the right ones.
Mr. Bibb said his group enthusiastically supported the bill but recognized it was not exactly at the level that many of the committee’s members would like to see; however, it was a good start, and he pledged support of the whole concept of the advisory committee. He had been in contact with an expert who got the California self-funded long-term care program off the ground. The individual had demonstrated a willingness to serve as a pro bono advisor to the committee. They started about six or seven years ago without a program in California, and now there were 144,000 lives insured with policies of long-term care insurance through CALPERS (California Public Employees Retirement System), which, if its own individual company, it would be the sixth or seventh largest insurer of long-term care in the country.
Chairman Koivisto expressed hope that Mr. Bibb would be available to the Health Care Committee during the interim. Mr. Bibb responded in the affirmative.
Danny Coyle, President of the Retiree Chapter of the State of Nevada Employees Association (SNEA), voiced strong support for S.B. 402. He echoed Mr. Bibb’s sentiments and offered to work with the committee. He felt interlocal and interstate cooperative agreements needed to be addressed due to the number of retirees who resided out- of-state.
Sylvia Halgrimson, American Association of Retired Persons (AARP), supported the bill. She stated she attended all of the interim committee meetings and complimented their accomplishments overall for such a complicated issue. AARP, too, wanted to see the original task force, but the bill in question was a very good beginning.
Assemblywoman Parnell said she testified on A.C.R. 36, a resolution requesting an interim study on the Public Employees Benefits Program, which was related to the bill in question. It showed, as Ms. Gang pointed out, how much the system would be impacted. People were retiring from state government, as well as from a multitude of local government entities. Many would be opting for the state health insurance system because it cost approximately $150 less per month than many of the other programs. One of the comments made during testimony was there were a number of people getting to the age of retirement and, not long after that, finding out long-term health care was an option in their lives. She did not feel anyone could overstate the financial and social impact that Nevada and all states would be facing in the next 10 to 15 years. She applauded the efforts of S.B. 402 and wished the task force could have been funded.
ASSEMBLYWOMAN MCCLAIN MOVED TO DO PASS S.B. 402.
ASSEMBLYWOMAN PARNELL SECONDED THE MOTION.
THE MOTION CARRIED UNANIMOUSLY BY THOSE PRESENT.
ABSENT FOR THE VOTE WERE ASSEMBLYWOMAN FREEMAN
AND ASSEMBLYWOMAN BERMAN.
Chairman Koivisto closed the hearing on S.B. 402 and opened the hearing on S.B. 574.
Senate Bill 574: Transfers responsibility for administering program for property tax assistance for senior citizens from department of taxation to aging services division of department of human resources. (BDR 38-1552)
Mary Liveratti, Administrator, Division for Aging Services, began by explaining that the Senior Citizens Property Tax Assistance Program provided relief to eligible seniors who were carrying an excessive residential property tax burden in relation to their income. The program was available not only to homeowners but renters as well. It was recommended as part of the Fundamental Review of Government to transfer the Senior Citizens Property Tax Assistance Program from the Department of Taxation to the Division for Aging Services. The bill facilitated the transfer. The transfer was included in the budget closings for the Aging Services Division, Budget Account 2363. The Division supported the transfer and believed the integration would enhance assistance for low-income seniors.
Chairman Koivisto asked how the program would work concerning renters. Ms. Liveratti answered there was a certain percentage of the annual rent allowed for a tax burden. The savings rate was 8.5 percent and, through the legislation, increased to 10 percent and was based on the total rent paid.
Vice Chairman McClain asked if all of NRS 361 was being deleted, with the information being included in NRS 422. Ms. Liveratti answered that was correct, and NRS 427A was the statute for the Division for Aging Services, thus taking from the Taxation statutes and putting it into the Aging Services statutes. She clarified the only change was the increased savings for renters from the 8.5 percent to the 10 percent.
Assemblywoman Parnell referenced page 4 and asked if the poverty rate of 150 percent was used for the eligibility guidelines. Ms. Liveratti was unsure but thought it looked very close.
Chairman Koivisto called for a motion.
ASSEMBLYWOMAN PARNELL MOVED TO DO PASS S.B. 574.
ASSEMBLYWOMAN GIBBONS SECONDED THE MOTION.
THE MOTION PASSED UNANIMOUSLY BY THOSE PRESENT.
NOT PRESENT FOR THE VOTE WERE ASSEMBLYWOMAN
FREEMAN AND ASSEMBLYWOMAN BERMAN.
Turning to S.B. 319, jointly sponsored by Senators O’Connell and O’Donnell, Chairman Koivisto reported the Senators were still in Floor session.
Senate Bill 319: Provides for licensing and regulation of halfway houses for alcohol and drug abusers as facilities for dependent and repeals requirements for certification of operators of such halfway houses. (BDR 40-1211)
Chairman Koivisto explained the bill provided for licensing and regulation of halfway houses for alcohol and drug abusers, and it repealed the requirements for certification of operators. She then queried the committee about legislation that requested certification for operators of such homes during the 1999 Legislative Session.
Assemblywoman Parnell said two bills were heard in Government Affairs that contained similar language. She stated if the bill was presented, it would be necessary to check for conflicts with other legislation.
Assemblyman Williams concurred with Assemblywoman Parnell. He felt if they heard the bill, he would only feel comfortable with rereferral to the Committee on Government Affairs. The issue had been dealt with during every session in Government Affairs, and there were also several bills in the current session that dealt with the same subject. Chairman Koivisto agreed with Assemblyman Williams. Because the Committee on Government Affairs had been dealing with the issue, the Chairman called for a motion to rerefer.
ASSEMBLYMAN WILLIAMS MOVED TO REREFER S.B. 319
TO THE COMMITTEE ON GOVERNMENT AFFAIRS.
ASSEMBLYMAN MANENDO SECONDED THE MOTION.
THE MOTION PASSED UNANIMOUSLY BY THOSE PRESENT.
NOT PRESENT FOR THE VOTE WERE ASSEMBLYWOMEN
FREEMAN AND BERMAN.
Chairman Koivisto thanked the committee for their hard work though the session and, with no further business before the committee, adjourned the meeting at 2:40 p.m.
RESPECTFULLY SUBMITTED:
Darlene Rubin
Committee Secretary
APPROVED BY:
Assemblywoman Ellen Koivisto, Chairman
DATE: