MINUTES OF THE meeting

of the

ASSEMBLY Committee on Health and Human Services

 

Seventy-First Session

February 7, 2001

 

 

The Committee on Health and Human Serviceswas called to order at 1:37 p.m. on Wednesday, February 7, 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

Ms.                     Sharron Angle

Ms.                     Merle Berman

Mrs.                     Vivian Freeman

Ms.                     Dawn Gibbons

Ms.                     Sheila Leslie

Mr.                     Mark Manendo

Ms.                     Bonnie Parnell

Ms.                     Debbie Smith

Ms.                     Sandra Tiffany

Mr.                     Wendell Williams

 

COMMITTEE MEMBERS ABSENT:

 

None

 

GUEST LEGISLATORS PRESENT:

 

None

 

STAFF MEMBERS PRESENT:

 

Marla McDade Williams, Committee Policy Analyst

Darlene Rubin, Committee Secretary

 

OTHERS PRESENT:

 

None

 

Chairman Koivisto introduced and welcomed new members to the committee: Assemblywoman Debbie Smith, Assemblywoman Sandra Tiffany, and Assemblywoman Bonnie Parnell.  Mrs. Koivisto then introduced Marla McDade Williams, Committee Policy Analyst, and asked her to discuss the standing rules  (Exhibit C), and the Committee Policy Brief (Exhibit D).

 

Marla McDade Williams remarked she was very pleased to again serve as committee staff and looked forward to a very productive Seventy-First Legislative Session.  Mrs. Williams then referred the committee to Rule No. 2 of the standing rules (Exhibit C), which would be deleted as the information that referred to the quorum had been detailed in footnote 1 on page 2 of that document; namely, seven members of the committee constituted a quorum.

 

Among the other rules discussed were:

 

• Assembly Standing Rule 100 detailed the rules under which the committee was organized;

 

• 3. Motions required a second;

 

• 4.  Requirements for voting;

 

• 5.  Duties of the Chairman;

 

• 6.  Duties of the Vice Chairman; 

 

• 7.  Duties of the secretary;

 

• 8.  Prompt reporting of members to meetings;

 

• 9.  Members were to advise Chairman when leaving committee meeting for extended period and those not in attendance when final action was taken on a measure were to be marked absent for the vote.

 

• 10.  Members were to advise chairman of intended absence;

 

• 13.  Members who submitted a minority report were to do so in accord with Section 674 of Mason’s Manual of Legislative Procedure;

 

• 15. The chairman had the discretion to call a meeting outside of the regularly scheduled day and time;

 

• 16.  Witnesses would address requests to testify to the chairman;

 

• 17.  The chairman would determine the order of speakers according to the guest list available for sign-in prior to the meeting;

 

• Rules No. 18 and 19 pertained to subcommittees, which were to be created at the discretion of the chairman, and all such subcommittee meetings would be recorded; and

 

• Rule No. 20 pertained to the communications from the chairman to the staff of the committee and to the personnel of the Legislative Counsel Bureau.

 

Chairman Koivisto asked for questions or recommendations for changes.  There were none. 

 

            ASSEMBLYMAN WENDELL WILLIAMS MOVED TO ADOPT THE

           

            STANDING RULES AS PRESENTED, EXCLUDED RULE NO. 2 WHICH

 

            WOULD BE DELETED.

 

 

            ASSEMBLYWOMAN SHEILA LESLIE SECONDED THE MOTION.

 

 

            THE MOTION CARRIED UNANIMOUSLY.

 

 

Ms. Williams then referenced the Committee Policy Brief (Exhibit D), which included among its contents the following:

 

Jurisdiction of the committee:  A listing of the chapters of the Nevada Revised Statutes (NRS) that fell under the committee’s jurisdiction was specified.  Title 38, public welfare, Chapters 422 through 432B; Title 39, mental health and retardation, Chapters 433 through 436; Chapters 439 through 442, 444, 446, 447, 449 through 455B, 457, 458, and 460 of Title 40, which related to public health and safety; and Chapters 583 through 585 of Title 51, which related to food and other commodities;

 

Ms. Williams summarized major legislation that was considered by members of the committee during the 1999 Legislative Session (Exhibit D, pages 2-14); issues that had been considered during the 1999-2000 interim; and issues that may be considered during the 2001 Legislative Session (Exhibit D, pages 15-16):

 

·        Group homes:  Addressed by Assembly Bill 167, Senate Bill 163, Senate Bill 391, and Assembly Bill 573 and codified in the NRS;

 

·        Hospitals:  Covered in Assembly Bill 251, Assembly Bill 275, and Assembly Bill 533;

 

·         Providers:  Senate Bill 519 and Assembly Bill 409;

 

·        Miscellaneous health issues adopted during the 1999 session included Assembly Bill 238, which addressed birth defects and organ donation and transplantation, and Senate Bill 560 which addressed health and human services appropriations.  The latter bill included appropriations for the Nevada Humanities Committee office, the Pediatric Diabetes and Endocrinology Center at the University of Nevada School of Medicine, the purchase of paratransit vehicles, continuation of the Nevada Commission for National and Community Services Program for promoting citizen volunteerism, programs, funding and operations by the Alliance for the Mentally Ill of Nevada, “Kids Count,” a statistical collection program administered by the Center for Business and Economic Research at the University of Nevada, Las Vegas (UNLV), suicide hotline services, and other appropriations more specifically detailed in the Committee Policy Brief (Exhibit D);   

 

·        Health insurance and public health were considered in Senate Bill 556;

 

·        Mental health, mental illness, and mental retardation:  Assembly Bill 305 changed the name of the Mental Hygiene And Mental Retardation Division of the Department of Human Resources to the Division of Mental Health and Developmental Services, among other changes. Senate Bill 557 dealt with mental health parity.  Senate Bill 469 extended services for the mentally retarded, and Assembly Bill 280 prohibited the use of aversive intervention techniques on persons with a disability;

 

·        Dental issues were addressed by a number of bills including Assembly Bill 527, Assembly Bill 284, and Assembly Bill 689;

 

·        Medicaid Issues:  Assembly Bill 429, which clarified the duties of the Division of Health Care Financing and Policy of the Department of Human Resources, and Assembly Bill 386, which required the Department of Human Resources to conduct a study of the disproportionate share issue, were adopted during the 1999 Legislative Session;

 

·        Substance Abuse Issues:  Assembly Bill 181, Senate Bill 197, and Senate Bill 161 were considered;

 

·        Tobacco Settlement:  A key issue of the 1999 Legislative Session related to the settlement funds of approximately $48 million per year and the disbursement of the 60 percent earmarked for health related topics. Assembly Bill 474 set forth the state’s priorities and created the Fund for a Healthy Nevada from a portion of the proceeds, among other provisions.  Senate Bill 370 specified certain eligibility factors for senior citizens;

 

·        A description of issues that were addressed by members of the Legislative Committee on Health Care during the 1999-2000 interim;

 

·        A discussion of possible health and human services issues that may be considered by the committee during the 2001 Legislative Session, including significant state and federal initiatives that pertained to prevention of needlestick injuries; creating a county organized health system; programs and services for senior citizens; newborn hearing screening; diabetes issues; foster care issues; prescription drug; and mental health and welfare provisions.  Existing laws may be debated which related to physical, mechanical, and chemical restraints on disabled persons; “do-not-resuscitate” provisions related to emergency services; suicide prevention; dental health; and directives and power of attorney for health care;

 

·        Detailed background information related to prescription drugs (Exhibit D, pages 16-17).  Data was obtained primarily from the National Conference of State Legislatures’s Web site which was continually updated based on what states were doing;

 

·        Some of the other measures that were requested as bill drafts in the 1999 Legislative Session and may go forward in the 2001 Legislative Session were detailed (Exhibit D, page 18);

 

·        Issues that would affect persons who were disabled, in particular Medicaid waiver services, employment potential, the “Olmstead” court decision, and the priorities of Governor Guinn in The Executive Budget for the 2001 Legislative Session;

 

·        Medical assistance for the aged, blind, and disabled (MAABD).  Information on Medicaid and Medicaid waiver services based on information obtained from the welfare division’s State Fiscal Year 2000 Fact Book which outlined the categories of assistance for disabled persons.  Also included was length of processing time for certain eligibility categories (Exhibit D, pages 18-20);

 

·        Background information was also provided on the physically disabled waiver, specifically that the 1997 legislature had authorized $500,000 for a program that would enable physically disabled persons residing in a skilled nursing facility to receive services that would allow them to move from the facility into an alternative home or community placement.  In 1999, the legislature increased that amount to $1 million;

 

·        Ticket to Work and Work Incentives Improvement Act of 1999 (Exhibit D, pages 20-21) were outlined.  The Legislative Committee on Health Care adopted a bill draft request and a copy of the law was included in that committee’s report.  The Division of Health Care Financing had a grant from the Health Care Financing Administration (HCFA) pursuant to the federal act to start developing the services to move into the Ticket to Work Act;

 

·        Olmstead v. L.C. ex rel. Zimring, which set forth responsibilities of states to provide community-based services for disabled persons, was detailed (Exhibit D, page 21).  Ms. Williams noted that among Governor Guinn’s priorities in the “State of the State” address was to establish an office of disability resource development and planning which combined existing state agencies into the Nevada Department of Human Resources and created a long-range plan that would better provide services to individuals of all ages with disabilities;

 

·        Issues from other states Exhibit D, pages 22-23) summarized their key issues as compiled by the National Conference of State Legislatures (NCSL);

 

·        Significant federal issues (Exhibit D, pages 23-25) were outlined and included presidential proposals and selected other federal issues;

 

·        Other reports were referenced (Exhibit D, page 25), which were available in the Legislative Counsel Bureau’s (LCB) Research Library, and which included information on issues that may go before the committee;

 

·        Three reference sections were included with the exhibit:  a table of titles and chapters of the Nevada Revised Statutes (NRS) with recommended committee referrals; web site addresses for locating information about health and human services related topics; and a state, county, and other agencies contact list.

 

 

Chairman Koivisto opened the meeting to questions or comments. 

 

Assemblywoman Sheila Leslie complimented Ms. Williams on her excellent presentation.  She commented on one of the issues mentioned therein, the suicide prevention resolution passed by the committee in the 1999 Legislative Session, noting that at the time Assemblyman Mark Manendo had been disturbed that no money was attached to the resolution.  Accordingly, then-committee chairman Vivian Freeman appointed a subcommittee comprised of Assemblyman Manendo, Assemblywoman Leslie and Assemblywoman Gibbons, who had succeeded in convincing the Committee on Ways and Means to put in $200,000 for the suicide prevention hotline; consequently, it became operational.  Mrs. Leslie added the Governor had been so pleased with the results of the hotline in Las Vegas, in particular, where calls had increased over 300 percent, that funds had been placed in the budget on an ongoing basis.  Mrs. Leslie added that it was because of the committee such a significant service came into being; the committee could make a difference, and the committee needed to begin the new session with the realization it could have that kind of impact.

 

Mrs. Leslie mentioned several other issues she believed were not simply “money” issues but were core health issues:  the senior prescription program, the “Olmstead” bill draft, which Mrs. Leslie and Senator Rawson co-sponsored, and the Governor’s plan for the new disability resource and planning office.   Bill drafts had been requested and she hoped the Committee on Health and Human Services would schedule appropriate hearings so its members could hear the bills in addition to those on the Committee on Ways and Means and Senate Finance.

 

Chairman Koivisto concurred hearings should be held on those bills so the committee had input.

 

Assemblyman Williams commented on the report given by Committee Policy Analyst Marla McDade Williams.  He noted he had served on the committee since 1987 and many people had staffed the committee during that time.  He acknowledged that Ms. Williams had always done an excellent job and had always been helpful to the committee and its individual members in any legislation they had pursued.

 

Assemblywoman Gibbons asked if data was available on the success and/or use of the prescription drug program since its inception in January 2001.  Ms. Williams had no current information available but would provide it at a later date.

 

Vice Chairman McClain echoed the sentiments of other members in complimenting Ms. Williams for an excellent job on behalf of the committee.  Ms. McClain also noted how pleased she was to be back on the committee for the 2001 Legislative Session.  She added she wanted to include the issue of long-term care under disabled services as an area for special attention.  Policy needed to be set in the committee because that was a very important issue in the state.

 

Assemblywoman Tiffany asked about adding a hearing on the leukemia cases in Fallon.  Chairman Koivisto responded that joint hearings with the Assembly Committee on Natural Resources had been scheduled for February 12, 13, and 14, 2001.  She also wanted to determine what the revenue streams were for the premiums on the senior prescription program and how those premiums were paid.

 

Ms. Williams announced the leukemia hearings would begin at 1 p.m. in Room 1214. 

 

Ms. Williams presented a final exhibit (Exhibit E), a calendar of the 2001 Legislative Session key deadlines.

 

Assemblyman Manendo verbalized how pleased he was to be back on the committee and acknowledged and thanked Chairman Koivisto for the engraved binder she had presented to each committee member.

 

 

 

 

 

 

 

 

Chairman Koivisto announced there were no further issues before the committee at that time but added no bills would be heard until after the joint hearings on the leukemia cases.   She then adjourned the meeting at 2:07 p.m.

 

 

 

RESPECTFULLY SUBMITTED:

 

 

 

Darlene Rubin

Committee Secretary

 

 

APPROVED BY:

 

 

 

                       

Assemblywoman Ellen Koivisto, Chairman

 

 

DATE: