MINUTES OF THE meeting
of the
ASSEMBLY COMMITTEE ON WAYS AND MEANS/SENATE FINANCE
Joint subCommittee on K-12/human resources
Seventy-First Session
February 13, 2001
The Joint Subcommittee on K-12/Human Resourceswas called to order at 8:16 a.m., on Tuesday, February 13, 2001. Chairwoman Giunchigliani presided in Room 3137 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.
ASSEMBLY COMMITTEE MEMBERS PRESENT:
Ms. Chris Giunchigliani, Chairwoman
Mrs. Barbara Cegavske
Mr. Joseph Dini, Jr.
Mr. David Goldwater
Ms. Sheila Leslie
Ms. Sandra Tiffany
SENATE COMMITTEE MEMBERS PRESENT:
Senator Raymond Rawson
Senator William J. Raggio
Senator Bob Coffin
Senator Bernice Mathews
STAFF MEMBERS PRESENT:
Mark Stevens, Fiscal Analyst (Assembly)
Gary Ghiggeri, Fiscal Analyst (Senate)
Larry Peri, Senior Program Analyst
Carol Thomsen, Committee Secretary
Chairwoman Giunchigliani announced the subcommittee would begin with review of the human services budgets.
DHR ADMINISTRATION – BUDGET PAGE HR ADMIN-1
Charlotte Crawford, Director, Department of Human Resources (DHR), introduced Debbra King, Administrative Services Officer IV, and called the subcommittee’s attention to Exhibit C entitled, “Budget Presentation to the Senate Finance and Assembly Ways and Means Joint Subcommittee.” Ms. Crawford commenced with review of the organizational chart contained therein, and explained the director’s office basically consisted of three primary components: (1) administration and coordination; (2) community connections; and (3) divisions and agencies. A large part of the duties assigned to the director’s office was to provide interfacing coordination services among the DHR’s divisions and agencies. Ms. Crawford explained the director’s office of the DHR was somewhat unique, in that it did not play a purely directive role for the divisions; the divisions each contained administrative structures. Funding flowed between the divisions, policies connected the divisions and available services, and constituencies and consumers were shared. Ms. Crawford noted the director’s office played the role of coordinator, and the role of policy interface between the Governor’s Office, the legislature, and the constituent divisions, to ensure that the DHR implemented policy consistently within the state of Nevada.
The coordination function fell under the administration and coordination component of the director’s office, and Ms. Crawford reported there were ten positions within the director’s office, consisting of five professional and five support positions. Those positions, which oversaw the coordination and were responsible for the direction of the DHR, had only increased by two over the past 12 years. According to Ms. Crawford, the functions which she felt needed strengthening, and which were identified by the Governor’s Steering Committee to Conduct a Fundamental Review of State Government, included audit needs, and ways the DHR could more effectively operate as a department.
Ms. Crawford next addressed the community connections component of the department. That component was not an office or entity, but rather was a descriptor of the set of services and programs offered. Two significant proposals evolved out of the fundamental review process for restructuring and refocusing within the DHR: (1) a Grants Management Unit; and, (2) an Office of Resource Development and Planning.
Chairwoman Giunchigliani inquired about the DHR’s performance indicators as depicted in The Executive Budget. The first indicator read, “Number of program initiatives or program enhancements identified as a result of attendance in national or regional forums,” with the projected attendance for FY2003 at five, and the actual attendance for FY2000 at one. Chairwoman Giunchigliani asked what the DHR had identified as federal initiatives which the state might want to consider. She also referenced indicator number five, “Number of identified activities that spare or enhance state general fund resources through the identification of federal funding,” which went from the actual figure of five to a projected figure of nine; Chairwoman Giunchigliani requested clarification regarding that projection.
Electing to respond was Ms. King, who explained the program identified via performance indicator number one was the Ticket to Work and Work Incentive Improvement Act of 1999 (TWWIIA) grant, which was a joint endeavor of the DHR and the Department of Employment, Training, and Rehabilitation (DETR). Ms. King stated the identified activities that spared or enhanced the state General Fund, as outlined in performance indicator number five, included:
Chairwoman Giunchigliani requested further information regarding projected activities for performance indicator number one, other than the TWWIIA grant. Ms. King replied that the DHR requested enhancements for funding and staffing, in anticipation of engaging in more collaborative efforts such as the TWWIIA grant. Chairwoman Giunchigliani stated there did not appear to be any other new regional or national forums, as stipulated by the indicator, and noted that the indicator tied into the DHR’s proposed Grants Management Proposal and staffing. Chairwoman Giunchigliani next referenced the Title XX shortfall, and asked what action the DHR had taken to stem that shortfall. Ms. King explained that Exhibit C contained a document entitled, “Title XX Social Services – Funding Reductions 1990 to 2000,” which addressed the Title XX shortfall of approximately $500,000.
According to Ms. King, the budget for many divisions of the DHR included Title XX funding, and when that funding was not received at the projected levels, the service delivery levels were impacted. Resources identified by the fiscal analysis team for the DHR were: (1) divisions that had Title XX money included in their budgets, and were not able to generate other funding sources, the authority was provided to transfer funds between budgets; and, (2) the ability of the DHR to transfer TANF funds of approximately 4.25 percent for FY2000 into the Title XX grants. Ms. King indicated that a work program had been presented to the Interim Finance Committee (IFC), which transferred funds to address the shortfall in Title XX funding, without requesting additional General Fund allocations. Chairwoman Giunchigliani asked whether the same formula would hold true for FY2001-03. Ms. King noted that division budgets anticipated an additional 5 percent decrease in Title XX funding, and the DHR proposed to transfer TANF funds into those budgets to cover that decrease. However, Ms. King explained that the TANF to Title XX transfer rules required a client eligibility determination process and, therefore, the transfer of funds had been proposed for those divisions where such an eligibility process was already in place. Chairwoman Giunchigliani requested the DHR provide a report to the subcommittee that identified which agencies had received TANF funds.
Chairwoman Giunchigliani solicited additional information regarding the MAXIMUS revenue maximization program. Ms. King reported the contract was ongoing with the MAXIMUS firm, which performed revenue maximization for the DHR. The firm identified opportunities where the possibility existed that the DHR had not been billing the federal government for all expenditures, or where programs and initiatives were available that the DHR had not identified as revenue sources. In exchange for that service, MAXIMUS received 9 percent of the funding recoveries. Ms. King conveyed that MAXIMUS revenue had not been included in the base budget for the director’s office, because the DHR was unsure of the exact amount the program would realize. In the current fiscal year, projections were for approximately $2 million in funding from the program and, to date, the DHR had received approximately $131,000. Chairwoman Giunchigliani inquired whether MAXIMUS provided the projection or whether it was provided in conjunction with the DHR. Ms. King replied that MAXIMUS provided the projection, and several million dollars had been reverted at the end of FY2000. The DHR did balance-forward $500,000 in MAXIMUS funding to transfer to the Bureau of Alcohol and Drug Abuse (BADA) in accordance with the Letter of Intent from the Senate Finance and Assembly Ways and Means Committees. Ms. King anticipated that same action in FY2002-03, should funding be available. Chairwoman Giunchigliani asked how much of the approximately $2 million would actually be collected. Ms. King explained that the DHR did not know how much of the approximately $2 million would be collected, because it was based on a projection that MAXIMUS would identify initiatives where enhanced revenues could be located. At times those projections were unattainable, as had happened in the past.
Ms. Crawford reported that MAXIMUS projections were dependent upon the current environment. Since the 1996 legislation, which enacted welfare reform, social services in Congress had been extremely fluid, and substantial changes had been noted in the funding streams, the rules and regulations, and the intent. Many of the functions of MAXIMUS consisted of specialized expertise regarding those changes, along with identification of the opportunities for the state because of changes in federal laws and regulations, which would enhance the federal match. Chairwoman Giunchigliani noted the projected funds had been received last biennium, however, were received later than anticipated. Ms. Crawford reiterated that the amounts were projected, and those projections had decreased over the years, as the state took advantage of the opportunities uncovered by MAXIMUS. Unfortunately, the DHR was unable to provide a firm projection because the figures provided by MAXIMUS were estimated.
Chairwoman Giunchigliani indicated that MAXIMUS had requested a collection authority of $2.5 million, which would amount to an increase. Ms. Crawford stressed that MAXIMUS was not requesting an increase, but rather was projecting revenues which could be identified for the state. Chairwoman Giunchigliani indicated that the projection could be “locked” into the DHR budgets, as had been done over the last biennium. Regarding drug programming, Ms. Crawford stated that Governor Guinn proposed once again to stipulate to the intent that should funding become available, the first $500,000 collected would be dedicated to BADA. Per Ms. Crawford, MAXIMUS funds were paid into a reserve account in the director’s office, and could not be otherwise used except with the explicit instructions and approval of the IFC. Ms. Crawford reiterated that MAXIMUS was under contract with the state. Ms. King further explained that the contract with MAXIMUS had been extended to December 31, 2001; that contract had been processed via the standard approval process, i.e., approval by the Board of Examiners, and the Attorney General (AG), et cetera. Chairwoman Giunchigliani inquired whether the DHR could approach the IFC during the interim with a work program to access those funds. Ms. King replied in the affirmative.
Ms. Leslie stated the DHR had indicated that $500,000 of the money received from the MAXIMUS contract would be transferred to BADA each year, and asked what the disposition would be of the remaining approximately $1.5 million. Ms. Crawford explained that funding for BADA was projected via a Letter of Intent that expressed how those funds would be used should specific funding be realized. That was the process outlined by the legislative Letter of Intent for BADA. Ms. Crawford stated that arrangement was viable as long as all parties understood the figures were projected and might not be realized. The Governor had proposed once again that the DHR dedicate the first $1 million to BADA, in order to sustain the commitment that the legislature authorized in its Letter of Intent.
Senator Rawson indicated the MAXIMUS group currently enjoyed national status, and inquired what the state paid the group. Ms. Crawford reported that the MAXIMUS contract had not changed since it was executed six years ago, which was 9 percent of realized revenues over a two-year period. The DHR prepared a baseline on each project in order to establish an agreement regarding what the revenue methodology would be in order to realize the projected amount of additional funds. Ms. Crawford concurred that MAXIMUS had changed its corporate structure and was currently a national corporation. Senator Rawson agreed that because MAXIMUS worked in several different states, it could amass information regarding available funding sources. Senator Rawson wondered whether the DHR had considered making the program in‑house to alleviate the fees contracted to MAXIMUS. Senator Rawson felt the DHR could build a decent program involved in cost-saving measures, while creating a functioning, ongoing agency.
Ms. Crawford relayed that the reason the DHR utilized a contract was because it did not have the resources dedicated to conducting a revenue maximization program. According to Ms. Crawford, such a program would require dedicated resources, along with highly trained personnel, very familiar with existing and proposed regulations, to perform the work. Many opportunities were realized through an intimate knowledge of federal laws and regulations, and an understanding of other state’s programs. Ms. Crawford saw no reason that such a program could not be initiated, and the director’s office was keenly aware that the DHR had not built the resources that would allow it to dedicate time to such a revenue maximization program. The DHR could initiate such a program in the event the resources were made available.
Ms. Crawford reiterated that, under the contract with MAXIMUS, 9 percent of the realized revenues were committed to the support of that program. Senator Rawson indicated that over a long period of time, there was something fundamentally wrong with the state institutionalizing the program, and he felt the state should attempt to secure savings via an in-house program. Senator Rawson felt two or three high-powered persons, along with an appropriate travel allocation, would prove beneficial to the state over the long run.
Senator Rawson remarked that as the MAXIMUS contract came to an end, it would be difficult to sever the relationship, but he would like to see some contingency to build the program into the state budget rather than continue the contract. According to Ms. Crawford, the contract had been executed for a determined period of time because the DHR believed it would require review, and not because the department did not recognize the federal opportunities that were available; the DHR simply did not have the resources to act appropriately. Ms. Crawford stressed there was nothing unique about a revenue maximization program that would require a contract relationship, however, dedicated, trained staff would be required in order to execute such a program. Senator Rawson indicated that, while he had nothing negative to say about the MAXIMUS program, he did not feel the revenue maximization program should be institutionalized, which recognized the fact that the state would continue in a contract situation, and never have complete control over the program. Senator Rawson emphasized that he would be willing to allocate the necessary resources to create an in-house program, which would ultimately generate its own revenue source.
Chairwoman Giunchigliani requested an explanation for the increased Department of Information Technology (DoIT) charges included in decision unit M-100, as no information had been provided in Exhibit C. Ms. King reported that the increase in charges was due primarily to the DoIT cost allocations. One of the largest increases in that area was the request by DoIT for a planning position, which would be allocated to the DHR director’s office on a part-time basis. Ms. King indicated both the DoIT and the DHR recognized the need for system development across the divisions. One issue facing the DHR was the implementation of the Health Insurance Portability and Accountability Act of 1997 (HIPAA), which would require system, technology, policy, and procedural changes. According to Ms. King, the anticipated part-time position would be a high-level planning position, which would allow the DHR to implement programs across the divisions, i.e., a joint Medicaid and Nevada Check-Up Program application.
To clarify, Chairwoman Giunchigliani asked whether the position would be part‑time, shared between both departments. Ms. King indicated it would be a full-time position within the DoIT, however, would be allocated on a part-time basis to direct issues pertaining to the DHR. Chairwoman Giunchigliani inquired whether the allocations of $69,661 in FY2002, and $90,730 for FY2003 for that position were fixed amounts to be charged to the DHR budget. Ms. King replied those amounts were budgeted based on DoIT cost allocations. Ms. Tiffany recommended that the DHR maintain the accounting for the half-time position, should it be approved. She also expressed concern whether the planning person for the DHR should be a DoIT person, because the HIPAA requirements were extremely specific. Ms. King explained the DHR had developed a committee which met on a regular basis to identify HIPAA issues. The department recognized it would involve technology, policy, and procedural issues. Ms. King reported that the department would ask for review by the AG’s Office, because a change of contract would be necessary to comply with the privacy issues required by the HIPAA.
Ms. Tiffany noted that the HIPAA requirements were invasive and costly, and inquired whether those costs were built into the department’s budget. Ms. King conveyed that the DHR was currently reviewing funding methodologies and had asked its divisions to ascertain whether their federal grantor agencies would assist with the process. The DHR had recently participated in a national conference regarding the HIPAA issue, and it was being viewed by many states as an unfunded mandate. Ms. King reported that the DHR did not currently have funding built into its budget for that expense, however, within the Division of Health Care Financing and Policy (HCF&P), the funding of the Medicaid Management Information System (MMIS) would assist in implementation of HIPAA for that division; there were, however, no funding mechanisms within other division budgets. The budget did include a one-shot request for $300,000 for a Business Process Reengineering (BPR) for the billing system, and Ms. King indicated the DHR might be required to amend that one‑shot request to include the cost for additional HIPAA implementation. Ms. Tiffany reiterated that she did not feel a half-time planning position from the DoIT would solve the problem. Ms. King pointed out that the position was not intended to solve all the problems, because it would involve technology, policy, and procedural issues.
Chairwoman Giunchigliani indicated the subcommittee would note that position as a concern, and because it appeared to be under development according to what HIPAA requirements would be addressed, it was somewhat premature. Chairwoman Giunchigliani inquired whether the position was an agency request. Ms. Crawford explained that the HIPAA was a major issue for the DHR, and what implementation would mean to the department was still undetermined. The DHR was not completely certain what budget items to request, as the HIPAA requirements were still under evaluation. Chairwoman Giunchigliani commented that when the committee reviewed the budgets, it attempted to determine which items were included at the request of the agency, as opposed to items recommended by the Governor. The request for the position did not appear to be an agency request, which would explain the lack of backup material for the subcommittee to review. Ms. King indicated the M‑100 decision unit was developed in accordance with budget instructions from the Budget Division, and reflected the cost allocations for the DoIT charges; the position would be fully documented in the DoIT budget.
The next item for consideration was decision unit E-276, and Chairwoman Giunchigliani requested a brief explanation of the three new positions and duties. Ms. King remarked that the decision unit requested three new positions for caseload and performance data evaluation across the divisions, the internal controls audit and study follow-up, analysis of budgets, funding sources, work programs, and contracts. Ms. King referenced Exhibit C, which contained a complete explanation regarding the need for each position, along with projected performance indicators. All divisions within the DHR compiled caseload performance data, however, because of staffing, there was no opportunity for the director’s office to review that data. Ms. King disclosed that the caseloads of the various divisions were interrelated; the DHR proposed that the anticipated positions would be trained on a department-wide basis, rather than specialized within an individual division.
According to Ms. King, the DHR currently did not have a position which reviewed the activities of the divisions on a department-wide basis. Regarding internal controls, audits, and follow-ups, Ms. King explained the DHR, at any given time, had at least one audit being conducted in one of its divisions. The director’s office received copies of the audits, and divisions responded to the audits, however, the director’s office, because of staffing, was unable to determine whether any action was taken based upon internal controls, the audit recommendations and studies, or the follow-ups. Continuing, Ms. King related the DHR included 89 budgets, a matrix of funding sources across the divisions, with Title XX funding three divisions. The proposed Grants Management Unit would provide oversight of those issues on a department-wide basis.
Chairwoman Giunchigliani indicated the concern arose from The Executive Budget, which indicated the new positions would provide the DHR with the same staffing levels as the Budget Division and the LCB, and asked whether that was the rationale for requesting the three new management analyst positions. Chairwoman Giunchigliani noted that each of the divisions within the DHR already had a budget person on staff. Ms. Crawford emphasized that there were no other entities, with the exception of the director’s office and the Governor’s Office, which provided oversight to the divisions within the DHR. LCB Fiscal Division staff was assigned to each division, as were Budget Division analysts, however, there was no entity outside the director’s office that reviewed, and was responsible for, the division interface.
According to Ms. Crawford, 53 percent of the funding for the DHR was realized from federal programs, and much of the work done by an entity such as MAXIMUS was in understanding the interface between state and federal programs. Ms. Crawford emphasized that TANF did not simply fund welfare, Medicaid did not simply fund services in the HCF&P, and the interfacing matrix required oversight. Ms. Crawford pointed out that in order to assure that the DHR was effectively securing Title XIX dollars to match state efforts in the Medicaid match, the DHR needed to be certain that the method of billing for such services would maximize that effort. Per Ms. Crawford, individual divisions might not have the level of expertise required to maintain current information on the finer points of Medicaid to maximize the billing effort. Ms. Crawford felt that was a unique activity and in order to be effective and maximize the state’s federal dollars, and to ensure that state programs were effective on both the delivery and funding fronts, the DHR would be required to understand how the funding sources and services interfaced. Ms. Crawford reiterated that no other entity within the DHR, outside of the director’s office, had responsibility for that function.
Chairwoman Giunchigliani stated that was a somewhat different job description from that reviewed by the subcommittee, and should the proposed positions lead to action, such as the idea presented by Senator Rawson regarding the DHR taking over the revenue maximization program, it would make sense. Creating positions to ensure the division’s compliance with audit recommendations, when those recommendations had already been acknowledged by a responsible division director, would seem to be a duplicative effort. Chairwoman Giunchigliani felt decision unit E-276 would require further review. Ms. Crawford indicated she would like to respond regarding a specific audit, which would shed some light on the issue. She explained an audit had recently been completed on the institute within the Mental Health and Developmental Services Division, and one of the findings was related to the billing process to access federal funding under the auspices of Medicaid and Medicare. Ms. Crawford reported that for the DHR to assure the legislature that those federal dollars were being effectively recovered would require appropriate follow-up and action on the audit findings. An auditor position could help the DHR perform that review, and assist with constructing policies, because a similar billing policy was currently in use by the DCFS.
Chairwoman Giunchigliani inquired whether the existing contract would allow the DHR to direct MAXIMUS to work with the Mental Health and Developmental Services Division to incorporate and implement the audit recommendations regarding billing. Ms. Crawford replied that MAXIMUS was extremely willing to perform whatever duties the DHR requested, however, the focus of duties had been restricted to activities not performed by the DHR. Ms. Crawford would not recommend use of MAXIMUS to manage audit recommendations. Chairwoman Giunchigliani stated that she did not necessarily mean management of the audits, but because it appeared that MAXIMUS had not located the total amount of funding that could be accessed, it would make sense to have MAXIMUS assist the divisions in securing federal dollars, rather than placing an auditor position within the DHR.
Ms. Crawford indicated that MAXIMUS identified policies and regulations the DHR had not interpreted or understood, and noted that the audit issue was not novel. The DHR understood how to process the billing for federal dollars, and also understood revenue recovery, however, those programs had not been executed. Ms. Crawford did not feel the DHR should pay 9 percent to MAXIMUS to implement something that the DHR clearly understood, i.e., policy, regulations, and federal interface. The problem would be solved should the DHR be permitted to secure an auditor position which could dedicate itself to that function. Ms. Crawford noted that the director’s office had one fiscal officer for the DHR, and that person could not ensure that all audit recommendations were implemented. Ms. Crawford further explained that she did have concerns because repeat audits often indicated the same findings that had been discovered in previous years, which had not been corrected. That occurred because the DHR did not have dedicated staff to ensure that the situation would be corrected. Chairwoman Giunchigliani then inquired whether there was a current audit position within each division. Ms. Crawford indicated the evidence showed that compliance with recommendations was not being addressed, and the DHR needed an audit position that would ensure action was taken, rather than simply reporting the findings. Chairwoman Giunchigliani indicated she felt compliance with audit recommendations would be each division director’s final responsibility. Ms. Crawford stated the director was responsible for the department, and the structure had not been created to give divisions separate accountability, with good reason. Viewing each division as an individual “silo,” would cause a loss of funding opportunities and would not be effective.
Chairwoman Giunchigliani referenced decision unit E-277, which recommended an agency loss control coordinator position, and inquired whether the DHR had experienced a problem in that area. Ms. King stated the DHR was currently second in the state for the number of injuries under worker’s compensation and third in the state for cost relative to industrial injuries. Exhibit C contained a letter from the Risk Management Division which outlined the DHR’s losses, and a list of tasks that would be performed by a loss control coordinator. The exhibit also contained information regarding the background, duties, and performance indicators for the position. Chairwoman Giunchigliani inquired whether the divisions had internal loss control coordinator positions. Ms. King explained that the divisions did not have loss control coordinators, but did have workplace safety teams. Some teams operated under the auspices of personnel sections, and others under fiscal sections. Chairwoman Giunchigliani asked whether the teams were in place within each division. Ms. King replied in the affirmative, and stated if the requested position saved time and worker’s compensation losses, the savings would be realized in the Risk Management Division’s budget.
Chairwoman Giunchigliani asked for review of decision unit E-278. Ms. King indicated that unit requested a personnel analyst position for recruitment for the difficult-to-fill positions, evaluation of future staffing needs, and consultation on selection procedures, as a means to assist with employee retention efforts. Exhibit C contained the detailed justification for the requested position. Also included in the request were allocations of approximately $20,000 in FY2002 and $38,000 in FY2003 for advertising. Ms. King advised that the Department of Personnel’s budget for the advertising of open positions was approximately $18,000 statewide. The DHR had experienced difficulty in filling some vacancies for such positions as social workers, psychologists, and nurses. According to Ms. King, the personnel analyst position would be responsible for recruiting. Chairwoman Giunchigliani asked whether positions within the DHR were slated for a salary increase, as she felt that was the number one issue regarding the difficulty in recruitment of staff. Ms. King explained that the difficulty was mitigated in the rural areas, and was not always because of salary.
Chairwoman Giunchigliani inquired about the $58,000 allocation requested for advertising. Ms. King stated that would be used to advertise for vacant positions. Contained in Exhibit C was the explanation for the requested allocation, and Ms. King indicated the DHR would advertise in various mediums. Chairwoman Giunchigliani stated that in comparison with the Department of Personnel’s advertising allocation, which was $18,000, the $58,000 requested by the DHR seemed exorbitant; she asked for clarification. Ms. King reported that the Department of Personnel, when it advertised, placed small ads in local newspapers. The DHR proposed to advertise in national journals, newspapers, magazines from the National Social Workers’ Association, and would advertise throughout the nation. For example, commented Ms. King, compared to the state of Oklahoma, Nevada’s salary ranges were quite good. Chairwoman Giunchigliani remarked that she felt the Department of Personnel was the more appropriate agency for advertising costs.
Regarding the Personnel Analyst III position, Chairwoman Giunchigliani asked for specific information about the duties. Ms. King replied that would be the position responsible for the recruitment for vacant positions. Chairwoman Giunchigliani stated the DHR budget already contained a Personnel Officer III position, Grade 41, which was the highest-ranking position in the personnel officer series. Ms. King explained that the Personnel Officer III position would be responsible for the coordination of personnel policies across the department, and would work directly with the personnel officers and analysts within the various divisions.
According to Ms. King, the DHR had accomplished a great many things via its Committee on Personnel Effectiveness in development of drug testing, and exit interview policies. Ms. King remarked that the section contained in Exhibit C entitled, “Recruiting New Personnel Effectively,” had been developed by the aforementioned committee. The $58,000 allocation would be used solely for the advertising budget. The DHR budget contained additional funding for travel expenses, i.e., recruitment efforts at various college campuses where social worker programs were prevalent. Chairwoman Giunchigliani asked about the salary for the Personnel Analyst III position. Ms. King replied the total salary plus benefits would be $38,000 the first year and $55,000 the second year. The total decision unit funding request was $72,000 in first year of the biennium, and approximately $103,000 the second year.
Mr. Dini noted that the Personnel Analyst III position was recommended by the Rural Recruitment and Retention Subcommittee, and felt that the rural areas presented a real problem for recruitment. Mr. Dini asked whether the problem might arise from recruitment in areas where persons were not compatible with the rural environment. Ms. Crawford explained that was an area of review by the subcommittee, because the DHR had experienced substantial problems in the area of attaining and retaining qualified staff in rural areas. That area was particularly problematic because of the lack of resources and also because of the lifestyle. The Rural Recruitment and Retention Subcommittee actually spent a substantial amount of time talking to employees in the rural areas, asking for the pros and cons of rural living and employment. There were some extremely good findings from that subcommittee regarding a better support system for rural employees, and ways the DHR could more effectively recruit and match persons to the work environment. Ms. Crawford stated that, unfortunately, the Department of Personnel had not dedicated itself to some of the specialized and challenging problem areas in recruitment. The DHR went across divisions to look at the problem, seeking effective ways to recruit and apply resources for the rural areas. Ms. Crawford felt that salary was a key issue, however, there were also other issues the DHR should address.
Ms. Leslie referenced the rural area differential recommendation outlined in Exhibit C, which would pay rural employees additional salary, and asked whether that allocation was included in the DHR budget. Ms. Crawford stated that, unfortunately, it was not included in the budget. Ms. Leslie asked what had been recommended in the budget other than the personnel position. Ms. King replied the DHR was also recommending funding for recruitment and advertising. Ms. Leslie stated she would prefer that the budget included the rural area salary differential, which would make a difference, rather than funding an attempt to recruit persons to work in the rural area. Ms. Leslie recommended that the subcommittee review the recommendations for rural area recruitment in more depth.
Ms. Tiffany asked how many counties were supported from Carson City DHR offices as opposed to the DHR staff being permanently stationed in the county. Ms. King indicated she was unsure of the number, and would provide that information. While Ms. Tiffany realized that a “traveling” employee, who visited rural areas, would not understand the culture of those rural counties or know the individual clients, she wondered whether the DHR had researched the issue of providing qualified personnel who spent a specific amount of time each week in various communities, i.e., a “traveling” employee.
Ms. Crawford related that the DHR included a variety of positions, and she would provide a breakdown of office locations. Ms. Crawford also explained that many functions of the DHR were performed on an itinerant basis, i.e., community health nurses. Ms. Tiffany then inquired what was different about the proposal for rural areas, and where the problems arose. Ms. Crawford stated that since problem solutions depended upon the type of service offered, along with the location, it would be difficult to provide a simple answer to that question. The DHR offered an array of services, and in some cases it did not make sense to utilize an itinerant service. Ms. Crawford stated the DHR would provide additional information regarding that particular service method. According to Ms. Crawford, there were different models of delivery, i.e., Clark and Washoe Counties provided child protective services, however, in the balance of the state, the DHR and its divisions provided that service. What services were delivered at the local level versus what was delivered via the itinerant method was an extremely complex issue.
Chairwoman Giunchigliani asked for clarification regarding the intended duties of the Management Analyst III position contained in decision unit E-279. Ms. King reported that position was requested as an assistant to the director. The duties of the director’s office were varied and complex, and dealt with many issues because of the multitude of services offered by the divisions. Ms. King stated the director needed an assistant to handle some of the more routine issues. She explained that the current Management Assistant IV position had attempted to act as an executive assistant, however, the duties proved too complex for that level of employee. Ms. King felt the assistant to the director should be a management analyst position at a high enough level to ensure that the person could be assigned responsibilities regarding tracking and/or writing legislation, and understanding the interrelated sections of the DHR.
Chairwoman Giunchigliani asked whether there had been an assistant to the director in the past. Ms. Crawford stated there had not been such a position in her memory; at one time the deputy position was in the clerical series and acted as an assistant. Ms. Crawford pointed out that the duties were not clerical in nature, and the proposed position would also function as the public information officer for the DHR. Chairwoman Giunchigliani asked for a listing of the duties of the deputy director along with a listing of duties anticipated for the proposed Management Analyst III position; Ms. Crawford replied that she would provide that information.
Chairwoman Giunchigliani referenced decision unit E-280, which requested a full-time employee development manager and a Training Officer II; she asked for an explanation regarding the need for those two new positions. Ms. King stated the needs and duties were described in Exhibit C, and the positions would be responsible for the development of training programs and providing training to the DHR staff on a statewide basis. The two positions would not duplicate the training provided by the divisions, which tended to be industry-specific to the division’s functions and activities. Continuing, Ms. King noted that the Department of Personnel did have responsibility for training, but had only assigned five positions for training throughout the state. The DHR was comprised of over 3,800 employees, and to train the entire staff would utilize approximately 75 percent of the Department of Personnel’s resources.
Chairwoman Giunchigliani indicated that Exhibit C noted the Department of Personnel would not request any budget enhancements for training, therefore the DHR requested the new positions. Chairwoman Giunchigliani asked what the driving need was for the training. Ms. King indicated one of the recommendations was to encourage all department training representatives to coordinate classes and create additional training opportunities in the rural areas by offering department-sponsored training and virtual college access. Chairwoman Giunchigliani asked whether the university or community college system could accommodate such training. Ms. King reported that those programs generally were not specific enough to meet the needs of the DHR. The proposed training would include management and supervisory skills training. Each division had created specific training agendas that addressed specific staff needs, such as social workers.
Chairwoman Giunchigliani noted that in decision unit E-806, the budget recommended an upgrade of the current classified Administrative Services Officer (ASO) IV to an unclassified deputy director position, and asked for comment. Ms. Crawford acknowledged that the proposal was to change the current ASO IV position to an unclassified deputy director position in recognition of the level of responsibility and skills required of that position. Other responsibilities included oversight of the budget for the DHR, which was fairly sizeable, and knowledge of the interfacing funding streams. Ms. Crawford declared that the degree of knowledge and oversight required of the position would not duplicate division knowledge, and would include:
Ms. Crawford stated the DHR did interact a great deal with the Washington, D.C. Office and the Governor’s Office to ensure that the department was playing the necessary role in identifying potential changes or changes in Congress that would benefit or harm Nevada. The current ASO IV position played a chief role in performing those duties, and in providing the leadership to financial and fiscal staff within the divisions, to ensure they were appropriately tuned to those issues.
Ms. Crawford explained it would be impossible for one individual to have the depth of understanding it would take to be cognizant of all the Health and Human Services’ federal programs and budgets. The Washington, D.C. Office did a very good job of keeping the DHR informed of current activities; the DHR assisted by identifying what congressional issues it believed were important, and provided the expertise regarding how specific congressional action would affect Nevada. Such assistance required an understanding of Nevada’s funding streams and programs, and how it used those to interface with specific policies such as Medicaid or TANF.
Mr. Goldwater pointed out that Nevada had two congressmen and two senators in Washington, D.C., with staff that were knowledgeable about the existing needs in Nevada, and asked why that staff could not assist the DHR. Ms. Crawford indicated that to say those staff members did not have an understanding about Nevada’s needs would not be a fair characterization; however, she pointed out that the DHR provided the same type of information to Nevada’s delegation as it did to the Washington, D.C. Office. In order to be effective in Congress, Nevada’s delegates and the Governor’s Washington, D.C. Office needed to understand what the impact of proposals under consideration would mean to Nevada. Ms. Crawford reiterated that Health and Human Services covered a very large policy area, and the DHR had the expertise to provide information, and recognized the interfaces. It was a continuing dialogue where the DHR identified issues, along with issues identified by the Washington, D.C. Office. Ms. Crawford then referenced cases where congressional action would have been both positive and negative for Nevada, i.e., TANF, Block Grants, and Medicaid.
Chairwoman Giunchigliani indicated the issue centered around the justification for the upgrade, because the DHR already had a deputy director on staff, and the proposed upgrade would add a second deputy director position. Ms. Crawford explained the DHR would have two deputies within the director’s office, which was not unique in agencies where there was a deputy position over fiscal and a deputy position over programs. Chairwoman Giunchigliani inquired whether those positions were part of the DHR’s new flow chart. Ms. Crawford replied that the positions would be depicted in Exhibit C, Table of Organizations. The responsibilities of the current ASO IV position would not change because of the upgrade, however, the present classification did not properly reflect the level of responsibility required of the incumbent.
Ms. Crawford explained that the ASO IV position in the director’s office had another level of responsibility in addition to overseeing and providing leadership to fiscal personnel within the divisions. Chairwoman Giunchigliani asked what would occur should the reorganization not be approved. Ms. Crawford emphasized that it was not reorganization per se, but rather would be an upgrade of an existing position. It was in recognition of the level of responsibility, and would appropriately place that position in the correct category. Should the upgrade not be approved, the person in that position would continue to perform responsibilities above the level of other individuals similarly classified. Ms. Crawford noted the position was currently under classified for the level of responsibility. Chairwoman Giunchigliani asked whether an upgrade had been requested in the past. Ms. Crawford remarked that the DHR had previously reviewed the position, however, since the department had continued to add responsibilities to the position, it now felt an upgrade to the unclassified category would be appropriate. Chairwoman Giunchigliani asked whether there had been an attempt to reclassify the position within the past ten years. Ms. Crawford stated the DHR had not contemplated substantive restructuring of the administrative function of the director’s office.
Chairwoman Giunchigliani remarked that it seemed more like centralization, and the subcommittee found it difficult to follow the flow of the reorganization. Ms. Crawford stated the administrative structure had been very constant within the DHR with a chief financial officer, a director, a deputy, and a personnel officer for the past ten years. Chairwoman Giunchigliani asked whether there were any vacancies in the director’s office at the current time. Ms. Crawford remarked that she was aware of no vacancies; Ms. King concurred.
Chairwoman Giunchigliani referenced the request for a one-shot appropriation of $1.8 million for development of a long-term strategic plan, and asked for clarification. Ms. Crawford stated the plan was outlined in Exhibit D, and explained there were six primary focus areas. The DHR believed the strategic plan was necessary, not just in the sense of identifying the needs, but rather a plan that would address each of the six areas:
Ms. Crawford indicated the only way to address those needs was to conduct a comprehensive identification and evaluation of the composition of the target population, i.e., the parameters and characteristics of the target population, and the projections for the next ten years for that population. The plan would identify several descriptors, such as the number of seniors, age groups, geographical distribution, insurance status, and/or income status, to facilitate creation of a clear picture regarding seniors’ needs. Ms. Crawford indicated the DHR also proposed to conduct a review of current resources and services available, where gaps existed, and what models would most appropriately meet the needs of Nevada’s senior citizens. One area the department was deeply concerned about was the current reliance on long-term care and nursing care, the lack of community-based options, and the absence of residential and/or group settings, which were very popular in the private sector. Ms. Crawford explained the strategic plan would develop a model which would include a continuum of services to appropriately meet the identified needs. The plan would also identify the funding levels and sources necessary to maintain the proposed services.
Senator Rawson indicated he did believe in long-range and strategic planning, and considered it a valuable tool. One criticism currently facing the legislature was the fact that people were not included in the process. Reviewing Exhibit D, Senator Rawson noted the estimated funding distribution for individuals with disabilities was $350,000 from state funds, $200,000 from federal funds, and he inquired whether that would be used for community activities. Ms. Crawford called the subcommittee’s attention to page 2 of Exhibit D, which identified components of the plan. According to Ms. Crawford, the plan development process was envisioned to be an inclusive one. The DHR expected to execute contracts to accomplish the actual development of the plan, rather than the proposal for a plan. Ms. Crawford stated the DHR expected to bring together the entire community of users, providers, and payers to design the model.
Senator Rawson asked whether there would be different consultants compiling the plan in each of the six identified areas. Ms. Crawford stated she believed that each was a specialty area, which contained some common elements. As the DHR reviewed the development of a blueprint for health and human services, which did not exist at the present time, the areas would be separate, and other areas would be included as the process was undertaken. Ms. Crawford stated the DHR recognized there was no clear vision or blueprint regarding where the department was headed and how it would commit funds for the next decade. That process required planning, and Ms. Crawford emphasized that the funding would facilitate development of the actual strategic plan.
Mr. Goldwater commented that rather than spending $1.8 million on a strategic plan, the funding should be put into existing, proven programs. Seniors needed both long-term care and prescription drug programs, the disabled community needed funding for existing, proven programs, and Mr. Goldwater felt the money would be better spent in that manner. The DHR did not need Washington, D.C. correspondents, because there were already persons studying how the state would be impacted by legislation. Mr. Goldwater commented that non-profit organizations maintained a Washington, D.C. correspondent, the state hired a lobbyist, the counties hired lobbyists, and he felt the state needed to quit planning and put the money into existing programs that were proven to work. He questioned why the DHR did not know what seniors or the disabled community wanted, i.e., funding for programs that worked.
Ms. Leslie referenced the domestic violence section of the strategic plan, asking whether the DHR had discussed the idea with the Domestic Violence Prevention Council headed by Attorney General Frankie Sue Del Papa. Ms. Leslie indicated she sat as a member of the council and did not recall any discussion regarding the matter; she noted there was already a plan in place regarding domestic violence. According to Ms. Crawford, the domestic violence section in Exhibit D stated, “Building on existing plans and planning efforts…,” which demonstrated that the DHR did recognize the existence of other plans. Ms. Crawford explained Governor Guinn was deeply concerned that Nevada continued to experience an increase in incidents of domestic violence. The proposed $100,000 one-shot appropriation was intended to bring together the existing planning parties and the affected individuals, in an attempt to develop an action plan to reduce incidents of domestic violence.
Ms. Leslie emphasized that there was a current action plan, and one reason for the increase in the awareness of incidents was because of the work done to promote awareness about domestic violence. That justification simply did not “ring” with her, and Ms. Leslie asked whether the DHR proposed to take the $100,000 funding from existing domestic violence programs. Ms. Crawford remarked that the $1.8 million would be a one-shot appropriation. Ms. Leslie commented that it appeared to be extra money that could be used by existing, proven programs, as suggested by Mr. Goldwater, rather than put into redoing the plan. Ms. Crawford stated the proposal was to prepare an actual action plan, and she realized there was an existing plan with recommendations for action. Ms. Leslie agreed, and noted the current plan contained very specific recommendations, and she felt that the funding would be clearly wasted on further development of a plan, when a plan had already been developed with very specific objectives.
Ms. Leslie then inquired about the substance abuse component in the strategic plan. Ms. King explained that the BADA within the Health Division had funding in its account to develop plans specific to substance abuse. Ms. Leslie asked whether the BADA plan would be coordinated with the strategic plan. Ms. Crawford indicated the strategic plan contained focus areas, and there could never be a plan that encompassed every aspect; she reiterated the plan contained focus areas, and the Governor had expressed his concern regarding planning for the future, as well as providing services for today.
Chairwoman Giunchigliani inquired how the matching $600,000 in federal funding would be realized. Ms. Crawford indicated federal funding could be obtained in the areas within the one-shot appropriation that the DHR felt were a match for certain activities, i.e., in the senior continuum. Many of the services offered for senior citizens were funded via Medicaid, which did support strategic planning efforts. Chairwoman Giunchigliani stated she believed Aging Services compiled a state plan, which was required on a yearly basis. Over the years, the legislature had been criticized about the state not preparing long-term planning, however, Chairwoman Giunchigliani felt existing plans should not be duplicated, and it would make more sense to ensure that the existing plan was enforced and funded. She asked whether the one-shot appropriation included Title XX money. Ms. Crawford indicated the DHR recognized the fact that there were federal funds available, which could be used to match state dollars.
Chairwoman Giunchigliani announced that the subcommittee would commence with review of the next budget account.
HEALTHY NEVADA FUND – BUDGET PAGE HR ADMIN-9
Ms. King noted that the Healthy Nevada Fund-Administration account, approved by the IFC in May 2000, contained three full-time positions, and was allocated a one-quarter time clerical position. Two programs were accounted for within the budget account: (1) the Senior Prescription Drug Program (Senior Rx Program), which provided a subsidy to the cost of prescription drug insurance for seniors; and, (2) the Grants Administration Program, for the grants awarded by the Task Force for the Fund for a Healthy Nevada. The only enhancement decision unit in the budget was E-250, which proposed to transfer two programs and two positions within the account into the Grants Management Unit.
Chairwoman Giunchigliani asked how many seniors were actually enrolled in the Senior Rx Program at the present time. Ms. King indicated there were 124 persons receiving benefits effective February 1, 2001, and 68 applications were pending that would begin receiving benefits on March 1, 2001. Chairwoman Giunchigliani stated the main concern of the subcommittee was the performance indicator which sought to measure programs funded through grants to address community needs that were not previously being met, and asked for clarification. Ms. King explained the Task Force for the Fund for a Healthy Nevada allocated funds for two “pools” of money; (1) programs that reduced, eliminated or treated the effect of tobacco use; and, (2) programs to improve the health of the disabled community and children. In its grant application process, the Task Force attempted to fund new and innovative programs, which related to the referenced performance indicator.
Chairwoman Giunchigliani asked about the $1 million one-shot appropriation for marketing efforts and subsidy enhancements for the Senior Rx Program. Ms. King stated only about 1,000 seniors had been notified prior to February 1, 2001, of their eligibility for the program. The process commenced with an application, and within approximately one month the senior applicant would be notified whether the application was successful. Ms. King explained that approximately 40 percent of those who applied in November 2000 were actually signed up for the program at the current time. Chairwoman Giunchigliani noted the concern that surrounded the DHR’s plan for the $1 million one-shot appropriation. Ms. King remarked that the funding would be used to assist in the promotional efforts for the Senor Rx Program. The DHR had received 1,500 applications, however, there were approximately 260,000 persons over the age of 62 in Nevada. Chairwoman Giunchigliani commented perhaps that indicated the plan was not effective for senior needs, and it was difficult for low-income seniors to attempt the co-pay. There were also seniors who did not qualify for the program, even with limited resources and income levels. Chairwoman Giunchigliani felt that should the plan be accessible to more seniors, the state would not need to spend money on marketing or subsidizing the premium payment. The subcommittee would require a more precise descriptor regarding allocation of the funds prior to authorization of the one-shot appropriation.
Ms. Crawford stated that to understand the plan meant to also understand the program. She explained there was a 60-day period allotted seniors to arrive at a decision regarding the insurance. According to Ms. Crawford, the percentage of applicants ultimately being enrolled was not reflective of the overall program. The $1 million appropriation would, in aggregate, add to the funds available to support the subsidy to the Senior Rx Program. Chairwoman Giunchigliani inquired how much had been expended to date on the marketing program. Ms. Crawford replied that there were no marketing funds included in the original allocation. The DHR would be happy to review the program for the subcommittee, and Ms. Crawford felt that the current discussion did not reflect the true aspect of the program. Chairwoman Giunchigliani indicated that she suspected the program was simply too difficult for seniors to access, and programs should ensure that the target population could easily access the information.
Ms. Leslie inquired about the grants process, noting that she had received many complaints from agencies that the rules kept changing; she asked whether the fund would be moved to a specific division within the DHR. Ms. King explained that under the terms of A.B. 474 of the Seventieth Session, grant awards could only be made by the Task Force for the Fund for a Healthy Nevada. The task force was served by LCB, Legal Division staff, and the DHR staff was responsible for writing contracts, mailing the Request for Proposal (RFP) documents, and ensuring the contractor was paid. Ms. Leslie inquired whether the DHR monitored the contracts regarding outcomes, et cetera. Ms. Crawford emphasized that the DHR was staff to the task force, and carried out those duties assigned to it by the task force. The DHR was not the decision-making entity, nor did it define the process for the distribution; that was done in accordance with Nevada Revised Statutes (NRS). Ms. Leslie again asked whether the DHR was monitoring contracts. Ms. Crawford specified that contract monitoring was conducted as directed by the task force.
Mr. Dini asked for a brief overview of the Grants Management Unit, Budget Account 3195, as it appeared resources were being funneled into that budget for consolidation. Ms. King explained that the rationale behind the Grants Management Unit was included in Exhibit C, and the objective was to act as a pass-through entity for awarding, managing, evaluating, and tracking grant funds to non-state entities. The DHR felt that would accomplish standardization of the process for grantees, and would also allow staff to be cross-trained. The staff within the budget account would be cross-trained in both program and fiscal areas. Overall, Ms. King stated, the effect of the Grants Management Unit would create administrative costs of less than 5 percent across-the-board, rather than the fluctuating cost of up to 15 percent. According to Ms. King, because of the projected increase in federal funding, the pass-through funds would remain approximately the same (Exhibit C).
Chairwoman Giunchigliani indicated decision unit E-250 would transfer two positions and their associated costs into the Grants Management Unit budget account, and perhaps the creation of a new “funnel” would “choke” the process. Ms. Crawford advised the positions would not be transferred out of the DHR divisions, with the exception of the domestic violence programs and funding, which was already managed by the community connections segment of the budget. Domestic violence was an area identified by The Governor’s Steering Committee to Conduct a Fundamental Review of State Government, where it was noted that the DHR had three different divisions handling six different granting processes. Chairwoman Giunchigliani felt the issue was why programs, such as the Senior Rx Program, were not administered out of the Aging Services Division, et cetera.
With no further comments forthcoming, Chairwoman Giunchigliani announced the subcommittee would commence with review of the Family to Family Connection budget.
FAMILY TO FAMILY CONNECTION – BUDGET PAGE HR ADMIN-22
Ms. Crawford indicated that Governor Guinn proposed to retarget the Family to Family Connection program. When the program was originally developed, it was to provide three specific programs: (1) home, hospital, and clinic-based visitation to families; (2) new baby centers; and, (3) resource lending libraries. Ms. Crawford explained the program was provided for all families in Nevada with newborn babies. The program targeted and supported 50 percent of the newborn’s families. During the last biennium, that target population was reduced to 25 percent. Ms. Crawford stated the program continued to be distributed across Nevada in order to reach and access all families. In a review of state services, and in the belief that the state needed to provide services that were most essential to those who might not otherwise be able to access such services, along with the realization that state government could not effectively be all things to all people, Governor Guinn retargeted the Family to Family Connection program. Per Ms. Crawford, that target group included families of newborns in at-risk neighborhoods. The program was built to serve 50 percent of newborns in at-risk neighborhoods; services would by no means be tested or restricted, and any family could access the program. However, the location and funding of the services would be for families within at-risk neighborhoods.
Ms. Crawford explained that the distribution of the funds had previously been to 13 infant support districts in the form of grant allocations, awarded on a competitive basis to entities within each district. The new redistribution would be via the Family Resource Centers’ distribution methodology. Ms. Crawford noted there were Family Resource Centers’ governing boards in northern Nevada, southern Nevada, and in the rural areas, which would distribute the funds on a competitive basis; however, the funding would be proportionately targeted to at-risk neighborhoods. Release of funds and development of programs would be focused on at-risk neighborhoods in order to provide resources for families in those neighborhoods. Ms. Crawford also noted the funding had been reduced to reflect the change in the target population.
Chairwoman Giunchigliani stated the performance indicators showed the DHR had conducted an assessment and found that 93 percent of the families were satisfied with the services, and asked whether that was correct. Ms. Crawford stated the Family to Family Connection program had met with great satisfaction and great utilization. The change was not because the program had not worked well and effectively, but rather was a choice of the Governor because he felt the state could not be all things to all people, and the need existed to target some programs to those who most needed assistance. Chairwoman Giunchigliani asked whether that was the reason for the reduction from $2.2 million to $625,000. Ms. Crawford stated that was correct, and explained the program had originally been projected via live births. That projection remained the same, however, it now was for live births in at-risk neighborhoods.
Chairwoman Giunchigliani asked whether the program was intended to interface with Family Resource Centers. Ms. Crawford stated the aforementioned change would occur via distribution through the Family Resource Centers’ governing boards; there was a natural relationship and coordination which occurred between the centers and the Family to Family Connection program. It was the expectation and hope of the DHR that the collaboration would continue. Ms. Crawford emphasized that Family Resource Centers were located in at-risk neighborhoods, which would become the target group for the Family to Family Connection program. However, it should be noted that the Family Resource Centers would not be required to provide Family to Family Connection program services.
Chairwoman Giunchigliani noted the original intent of the Family to Family Connection program was to assist any Nevada family, regardless of income, with the care of newborns, and asked whether the proposed changes would focus the program toward the at-risk areas where Family Resource Centers were located. Ms. Crawford concurred. Chairwoman Giunchigliani noted that would change the actual intent of the Family to Family Connection program and the group it would accommodate. Ms. Crawford agreed that the target group would be changed, however, the intent of the program would remain the same. Chairwoman Giunchigliani asked for documentation to justify why the target group should be changed. Ms. Crawford reiterated that the Governor felt that the state could not be all things to all people, and individuals in at-risk neighborhoods were the population with the least ability to otherwise access those support services. Chairwoman Giunchigliani remarked that the fact the program was working with a 93 percent satisfaction rate apparently had not been taken into account, and the budget had simply been slashed. She viewed the program as more of a prevention tool, and noted the need would not be as large in the at-risk areas if the problems were prevented ahead of time. Chairwoman Giunchigliani referenced the case of a constituent who was a working mother and had decided to stay home with her first child. The constituent had advised how tremendous the Family to Family Connection program had been for her, and Chairwoman Giunchigliani felt that to reduce the program to such a degree, would cause a great deal of harm to Nevada’s citizens.
Ms. Leslie noted that the program originally realized $2.2 million in funding and would now be reduced to $627,489, and asked for an analysis of the impact of that cut, i.e., how many Infant Support Districts (ISDs) would be required to close, and where. She also asked why funding for the program should be administered via the Family Resource Centers’ governing boards, which would appear to add a layer of bureaucracy. Ms. Leslie referenced testimony presented to the Legislative Commission’s Budget Subcommittee, which indicated the 15 percent fee to the Family Resource Centers’ governing boards to administer the program was not included in the $627,489, and asked where that was located in the budget. According to Ms. Leslie, she fully understood the Family Resource Centers’ concept and why there might be technical assistance from the local governing boards, however, Family to Family Connection was an established program. Reference to at-risk neighborhoods held true in urban areas, however, Ms. Leslie commented that for the rural areas, i.e., Fallon, Hawthorne, Ely, Elko, et cetera, the Family Resource Centers and the Family to Family Connection program were not in at-risk neighborhoods, but rather served entire communities. Ms. Leslie felt that the targeting aspect was a nice way of indicating the budget would be slashed and the program would not serve nearly as many people.
Ms. Crawford explained that the DHR proposed to use the Family Resource Centers’ governing boards because it presented an existing structure that provided a very similar process in at-risk neighborhoods on an application and competitive basis. The distribution was the same as that being proposed for the Family to Family Connection program. Ms. Crawford indicated the DHR would use an existing structure to perform a very similar function for a very similar funding source. Ms. Crawford explained that technical assistance was provided to the Family to Family Connection program via state positions; those positions were being proposed for elimination and/or relocation to other divisions. The DHR would no longer provide the technical support function, because that function was intended to support new baby centers to the extent that there would be a program that provided advice and guidance to families. Ms. Crawford stated the Family to Family Connection program was being reduced in terms of the total number of individuals served, because the intent was to refocus and retarget the program. Ms. Crawford reiterated that the proposal was the result of the Governor’s Steering Committee to Conduct a Fundamental Review of State Government. According to Ms. Crawford, the change would create an impact because the DHR would no longer fund 13 ISD’s; local communities that had very successfully supported new baby centers would be free to apply for funding distribution.
Senator Raggio asked, in targeting the at-risk group, how the amount of $627,489 for each year of the upcoming biennium had been determined. Ms. Crawford stated in the original construction of the Family to Family Connection program, the DHR determined the per-newborn cost in order to allocate services; that cost was adjusted to the identified number of live births projected for at-risk neighborhoods in order to arrive at the reduced figure. Ms. Crawford indicated the DHR had a breakdown of births, the projected birth rate, along with the statistical determination of at-risk neighborhoods, and that information was used as the base to determine the number of births for at-risk neighborhoods. Senator Raggio asked for a copy of the breakdown; he commented that there was some merit in targeting the at-risk population, should such budget cuts prove necessary. Senator Raggio indicated he wanted some measure of comfort in the knowledge that the at-risk population, once identified and understood, would be adequately served should the reduced budget be approved. Ms. King advised that the information would be provided.
Senator Rawson inquired how the State Children’s Health Insurance Program (SCHIP), which provided federal funding for the Nevada Check-Up Program, would correlate with Family Resource Centers, i.e., would paperwork be distributed regarding the program, and would eligibility workers be available at those locations. Ms. Crawford indicated she was not aware of staff availability on site at Family Resource Centers, however, the DHR had certainly attempted to use the centers to promote the Nevada Check-Up program, along with encouraging other agencies to be knowledgeable about the program. There was a proposal for a one-shot appropriation to construct an electronic application for both Medicaid and the Nevada Check-Up program, which the DHR felt would substantially enhance the user-friendly aspect of those programs. According to Ms. Crawford, the DHR did not have out-stationed eligibility workers in Family Resource Centers.
Janelle Mulvenon, Community Connections, DHR, stated Family Resource Centers and the Family to Family Connection program’s new baby centers did hand out enrollment forms for the Nevada Check-Up program. Senator Rawson indicated he felt a number of other programs would suffer should the Family to Family Connection program’s funding be decreased, and he wondered whether the other programs could support or bolster that program somewhat.
Since the subcommittee seemed to be discussing both budgets, Chairwoman Giunchigliani suggested the subcommittee hear simultaneous testimony regarding the Family Resource Centers’ budget.
FAMILY RESOURCE CENTERS – BUDGET PAGE HR ADMIN-27
Chairwoman Giunchigliani inquired about the $500,000 one-time appropriation to fund a Family Resource Coordination Program, and asked where it would be located and what the program would entail. Ms. Crawford indicated the Family Resource Coordination Program was introduced by Don Hataway, Deputy Director of the Budget Division, in his overview of that agency’s budget, and the program would be administered via the Governor’s Office. Chairwoman Giunchigliani indicated the program could be housed within any one of several different state agencies, and the subcommittee wanted to know whether the DHR was familiar with the program.
Ms. Crawford explained that the Governor was attempting to develop a methodology that would improve the transmission of information about, and the availability of, state services, along with coordination of that effort. According to Ms. Crawford, the Governor was extremely frustrated that the state offered programs that people in need were unaware of. Chairwoman Giunchigliani indicated the DHR’s budget included a $500,000 one-time appropriation, and inquired how those funds would be used. Ms. Crawford replied that the funding was intended to support the Family Resource Coordination Program in those efforts through technology, advertising, or by initiating mechanisms that would facilitate the communication component. Chairwoman Giunchigliani noted the $302,642 appropriation for the Governor’s Office would be via a request from the General Fund, and the $500,000 appropriation would be a one-time appropriation, and asked for clarification. Ms. Crawford emphasized that she did not know the source of funding for the Governor’s Office, however, the $500,000 was a one-time appropriation included in the DHR’s budget request. Chairwoman Giunchigliani commented that the issue appeared to be why revenue was not being spent on direct services, rather than on coordination.
Ms. Leslie asked for further clarification regarding the $500,000 one-time appropriation. Ms. Crawford indicated it would be used to support the Family Resource Coordination Program effort. The funds would be used to support the efforts of the Family Resource Coordination Program, whether it was for technology or Web-based development, et cetera, in order to facilitate the achievement of the goal to initiate a greater level of awareness and coordination of available programs. Ms. Leslie inquired whether the Family Resource Centers were involved in the planning for the coordination program. Ms. Crawford indicated that the Family Resource Coordination Program and the Family Resource Centers were different entities. Ms. Leslie indicated the budget presentation stated the main purpose behind the Family Resource Coordination Program was to assist families with navigation of the system, which was precisely the purpose of the Family Resource Centers. Ms. Crawford stated the Governor felt there was a need to develop a high-level profile and emphasize the importance of communication regarding programs and availability. While there were mechanisms in place, Ms. Crawford indicated the state was not effectively communicating the availability of services to all its citizens. Ms. Leslie commented that it was a large sum of money for more coordination, and inquired whether the subcommittee would receive further detail regarding the $500,000 one-time appropriation. Ms. Crawford indicated the DHR would provide additional detail. Ms. Leslie indicated she was extremely concerned about the lack of input from the community regarding the program, and felt it might not be necessary.
Chairwoman Giunchigliani inquired whether a Bill Draft Request (BDR) had been submitted that would consolidate the Family to Family Connection program and the Family Resources Centers’ budgets. Ms. Crawford emphasized that the two programs were not being consolidated. Chairwoman Giunchigliani stated in The Governor’s Steering Committee to Conduct a Fundamental Review of State Government, Final Report to the Governor for 2000, recommendation number 77 proposed submittal of a BDR. Ms. Crawford indicated she was unaware of that recommendation, and advised that the discussion with the steering committee communicated the desire to retarget the Family to Family Connection program. Ms. Crawford felt there was some misunderstanding regarding how the two programs actually functioned. Chairwoman Giunchigliani asked Ms. Crawford whether, to her knowledge, there was a BDR to consolidate the two programs. Ms. Crawford testified that there was a refocus of the Family to Family Connection program and the Family Resource Centers’ program would continue in its current format. Chairwoman Giunchigliani stated it was her understanding that previous testimony indicated the Family Resource Coordination Program would create a high level profile and ensure that the public was aware of available programs; Ms. Crawford acknowledged that was the outcome the Governor hoped to achieve. Chairwoman Giunchigliani asked whether people were aware of the proposed funding cut for the Family to Family Connection program. Chairwoman Giunchigliani felt the subcommittee should ponder the situation at greater length, and would welcome input from the DHR to alleviate duplication of effort within the programs.
Ms. Tiffany related that she had received information which indicated some Family Resource Centers were being used extensively, while the Family to Family Connection program was not enjoying the same level of use. Ms. Tiffany had been advised that there had been community involvement in the presentation to The Governor’s Steering Committee to Conduct a Fundamental Review of State Government, and there were persons involved who made suggestions that would attempt to fully utilize available resources; Ms. Tiffany asked whether that had actually occurred. Ms. Crawford indicated the information presented to the steering committee had been presented by two individuals representing Family Resource Centers. The original recommendation had been for consolidation of the two programs, which was somewhat different from what had been executed via a reduction in the budget for the Family to Family Connection program. Ms. Tiffany noted that the Henderson Family Resource Center should be expanded because of overwhelming participation, and she would rather see funding go directly to existing programs.
Chairwoman Giunchigliani closed the hearing on both budget accounts, and opened public testimony regarding the two programs.
Jan Gilbert, representing the Progressive Leadership Alliance of Nevada, announced that she was a member of the Block Grant Commission, and it was that commission’s duty to oversee the Family to Family Connection program. According to Ms. Gilbert, the commission had been kept apprised of the program throughout its existence. The program experienced a slow beginning, and in 1999 the statistics were not as promising as they were now. Ms. Gilbert indicated the Community Connections Office oversaw the Family to Family Connection program, and that office recently furnished the commission with a report that contained valuable information regarding both programs, i.e., areas where the programs coexisted.
According to Ms. Gilbert, Family Resource Centers and the Family to Family Connection program were very different in some communities, with some Family Resource Centers making a determination that the at-risk population was senior citizens, while others determined it was children. Ms. Gilbert stressed that the programs were not duplicative, and did not provide the same services. Ms. Gilbert noted that she appeared before The Governor’s Steering Committee to Conduct a Fundamental Review of State Government, and felt the Family to Family Connection program had not been properly represented to that committee. Even though she was not personally involved in the program, Ms. Gilbert noted the presentation did not include an overview of the Family to Family Connection program.
Ms. Gilbert presented packets to the subcommittee entitled, “Family to Family Connection,” and “Family to Family Connection, Report to the Block Grant Commission, January 2001,” Exhibit E. The documents explained the program and how it assisted families. According to Ms. Gilbert, the Family to Family Connection program was probably the first comprehensive prevention program of its type in the state. It was a tremendous program and the exhibits reflected the percentage of unduplicated services provided to one family. Ms. Gilbert emphasized that an enormous amount of service had been provided with the available dollars. The exhibit explained the cost per service per child was $75, which was not much to provide a service that accomplished so much for the community. Ms. Gilbert indicated the Block Grant Commission had discussed the Family to Family Connection program and its funding at length, and there were many commissioners who felt the cut in funding would “kill” the program, so why bother funding it at all. Ms. Gilbert indicated that 60 to 70 percent of the total funding of approximately $627,000 would be utilized in the Las Vegas area. Ms. Gilbert felt very strongly about the Family to Family Connection program and predicted it would create a savings in the long run via education and a reduction in the prison population. Studies showed that the first three years of life were what determined a child’s success or failure, and Ms. Gilbert urged the subcommittee to reconsider the budget.
Testifying next before the subcommittee was Irene Huntington, who appeared as a concerned parent and as a representative for all parents who were unable to attend the hearing. She felt the proposed budget cuts would affect children and parents not only in the Carson City area, but throughout the state as well. Ms. Huntington expressed disappointment that Governor Guinn could not see the long-term effect the Family to Family Connection program would have on the state of Nevada. While she understood the need to move funding to programs for at-risk children, there were also long-term positive effects to be realized from programs such as the Family to Family Connection.
Ms. Huntington indicated that early intervention in a child’s life would lessen the need for at-risk attention, and intervention at birth cost much less than intervention at the age of 14. The message sent by the Family to Family Connection program was quite impressive, and new mothers received a message from the state while still in the hospital that children were a valuable asset. The program assisted mothers by providing classes, assistance from trained professionals, a lending library, and instructional videos and toys.
Ms. Huntington stated she did not know whether there was a way to reverse the actions of the Governor regarding the Family to Family Connection program, but she urged the subcommittee to consider placing the program within an existing agency that had the budget to accommodate the program in full. According to Ms. Huntington, good parenting skills did not just happen, regardless of the financial situation, and quality parenting had to be taught. In society today, it was rare to find a two-parent home, let alone one with a stay‑at-home parent. Ms. Huntington stated parents in Nevada needed to be educated, and the Family to Family Connection program was a beginning toward that endeavor.
In conclusion, Ms. Huntington asked the subcommittee to ensure that the needs of parents would be addressed via a program that was available to everyone in every county of Nevada.
Testifying next was Jamie Hefner, who informed the subcommittee she had been using the facility and program at Incline Village for the past year. Ms. Hefner explained that she knew nothing about child development, and after the birth of her daughter, she was frightened about parenting. At the Family to Family Connection program, Ms. Hefner stated she found a wealth of resources, information, and people who could assist her. According to Ms. Hefner, she and her significant other earned less than $35,000 per year, which was well below the poverty level at Incline Village. Ms. Hefner emphasized that the community needed the Family to Family Connection program for the readily available information it provided regarding parenting.
Ms. Hefner pointed out that there appeared to be a huge misconception within society, and people did not understand that child development was a science, and the time frame for teaching certain ideas to children was quite significant. Ms. Hefner felt most people believed parenting skills were innate, and women were born with the ability to take care of children. Children should be given the proper advantages by parents who knew what a child needed to learn and when to introduce that learning. Ms. Hefner commented that she did not learn parenting skills in college, and the Family to Family Connection program offered information that was not available through other sources. According to Ms. Hefner, she would remain at home for the next approximately three years, until her daughter was capable of entering a learning school environment. She explained she would like to have more children in the future, and would like to have the program available to provide assistance. Ms. Hefner felt the Family to Family Connection program provided a wealth of information to help families overcome problems.
Ms. Gilbert indicated she would like to add to her testimony, and stated the Family to Family Connection program, at its inception, included many guidelines and restrictions. Ms. Gilbert requested that, should the funding level be maintained, the guidelines be changed. The current structure stipulated that after a child reached the age of one year, the program ceased to serve the family, and Ms. Gilbert felt all involved in the Family to Family Connection program would be in favor of raising the age to three years. According to Ms. Gilbert, the Family to Family Connection program was not allowed to contact parents, even when it was via a referral from another agency, because it was a voluntary program. She felt that should be the second recommendation, to allow the Family to Family Connection program to contact those parents who were referred for services.
Cynthia Freeman, District Manager for ISD No. 4, presented Exhibit F, a packet containing the district’s strategic plan. Ms. Freeman indicated she resided in the city of Sparks and was the mother of three children, one of which was 15 months old. She stated she was also the District Manager of the Family to Family Connection program in Churchill, Pershing, and Humboldt Counties. Ms. Freeman indicated she would testify regarding the impact the program had on her parenting skills, as well as the impact on other families within her ISD. In November 1999 Ms. Freeman stated she gave birth to a premature son, which created definite and specific needs, despite the fact that she had two other children in their teens. Ms. Freeman explained she had personally utilized the Family Resource Centers and the Family to Family Connection program in the Reno/Sparks area, and her own district dozens of times, and they had made a big difference in her son’s life. Ms. Freeman remarked that her son had graduated from the special children’s clinic and no longer suffered from developmental delays; she personally believed the Family to Family Connection program had played a large part in that success.
According to Ms. Freeman, she witnessed a blossoming of the program that showed much promise for Nevada families. Ms. Freeman explained that she began working for the Family to Family Connection program in June 1998 and since that time, the district had been contracted to serve a total of 855 families over a three-year period. The program had actually provided over 1,044 families with services, and was only contracted to provide a minimum of one service to each family, however, the program had actually provided 391 visits, or 370 percent of the ISDs actual goal.
Ms. Freeman reported that numbers alone would not show the true picture of what the Family to Family Connection program would mean to Nevada’s families. In the two and one-half years the program had been operational in her district, Ms. Freeman indicated a diverse group of families had been served from all income levels and all walks of life. Ms. Freeman emphasized that family income and background were not the determining factors in use of the program. For example, since its inception, the program had served over 20 teen parents, and not one of those teen parents had had a subsequent pregnancy. Considering two of the counties in Ms. Freeman’s district had placed in the top five in Nevada for the highest teen pregnancy rates, she considered that statistic to be a significant achievement.
According to Ms. Freeman, ISD No. 4 had also been successful in having its program accepted into high schools as part of the curriculum, thereby allowing teen families to actually participate for credit, and come to the Family Resource Centers to interact with their infants. The program had also served a number of families with disabled children, along with families where parents suffered from developmental delays. Ms. Freeman indicated that via attendance in the program, those parents had been able to raise their infants alone, after learning how to provide for the infant’s needs. There had been a number of children referred to the Family to Family Connection program, and families had voluntarily participated, which assisted those families in the parenting of their children.
In conclusion, Ms. Freeman indicated that in Churchill, Pershing, and Humboldt Counties, the Family to Family Connection program had been successful in raising $250,000 in additional funding to expand services to include expectant parents, and families with children up to the age of five. Family to Family Connection program funding served as a base, and was used as matching funds, and Ms. Freeman stated should those matching funds not be available, the program could quite possibly cease to exist. Ms. Freeman urged the subcommittee to continue funding the Family to Family Connection program at the current level.
Ms. Leslie referenced previous testimony from Ms. Gilbert relative to the 60 to 70 percent of available funds that would be allocated to programs in the Las Vegas area, based on population, and concurred with that percentage. The rural areas were usually only allocated 16 or 17 percent of available funding, and Ms. Leslie stated that compared to the number of ISDs in rural Nevada, the percentage would not equate to a great amount of funding, given the proposed overall reduction. Ms. Leslie asked if the rural districts were awarded 17 percent of the proposed $629,000 allocation on a competitive basis, whether most of the districts would lack the funding to continue their programs. Ms. Freeman stated Ms. Leslie was absolutely correct, and based upon the numbers she had been given, it correlated to an allocation of approximately $100,000 available for the rural ISDs. Should every one of the existing eight centers receive an equal amount of money, it would equate to approximately $12,000.
Testifying next before the subcommittee was Michele Paulsen, who explained she was the mother of a ten-and-one-half-month-old son. Ms. Paulsen explained that even though she was 31 years of age and had been married for 10 years, she still needed help and found an incredible resource in the Family to Family Connection program at Incline Village. Ms. Paulsen indicated she could have spent many hours and many thousands of dollars in an attempt to find the information that was so readily available via the Incline Village Family Resource Center. According to Ms. Paulsen, Incline Village was a rural area and was without many of the services offered by the program. Ms. Paulsen emphasized that mothers simply needed the information necessary to raise their own children, which was being provided by the Family to Family Connection program. She urged the subcommittee to visit a Family to Family Connection site and talk to the parents participating in the program. It would be a great detriment to Incline Village should the program cease to function.
Reverend Robert Porterfield, Sr., pastor of St. John’s Lutheran Church, informed the subcommittee that he had been involved in the project from its inception, and St. John’s supported ISD No. 4, which covered Churchill, Pershing, and Humboldt Counties (Exhibit G). Reverend Porterfield stated that every child born was an at-risk child, regardless of the family income level or parental education level. It was the state’s responsibility to realize that, and provide assistance in any way it could. Reverend Porterfield stated the Family to Family Connection program did not cover prenatal care initially, nor did it cover children past the age of one year, and through grants garnered from other sources, the ISD was able to cover a child from prenatal through age five. Reverend Porterfield explained the ISD also conducted programs for pregnant high school girls. Rather than cutting the funding allocation, Reverend Porterfield felt the state should expand the funding to provide coverage to families from prenatal through age five. In many areas, Family to Family Connection programs could “dovetail” with the Family Resource Centers’ programs, however, Reverend Porterfield noted that the programs did not always overlap.
During The Governor’s Steering Committee to Conduct a Fundamental Review of State Government’s review and proposal to combine the Family to Family Connection program and the Family Resource Centers’ program, Reverend Porterfield indicated testimony was provided specific to the Winnemucca Family Resource Center and the Family to Family Connection program operating as a collaborative example. It was reported that the programs had been successfully merged, however, Reverend Porterfield did not feel that was a true picture. St. John’s Lutheran Church had been the ISD fiscal overseer from inception of the program. The negotiated working agreement had not worked as claimed, and Reverend Porterfield stated it had been St. John’s staff that approached the county for in-kind rent for the program, thereby making the program virtually rent-free. According to Reverend Porterfield, the St. John’s ISD manager, Ms. Freeman, either wrote the collaborative grants, or they were written under her direction. There were continuing problems with Family Resource Centers in the areas of cost accountability, reporting, and following the procedures.
Reverend Porterfield reiterated that the programs could not always work together, and it would be helpful to have an overseer for both programs. A cut in funding would do a tremendous disservice in both the short and long run to the citizens of Nevada. Reverend Porterfield urged the subcommittee to consider reinstatement of the funding for the Family to Family Connection program.
Brad Powell introduced himself to the subcommittee, and advised he was a parent and user of the Family to Family Connection program. He explained he had been a military pilot and could fly an aircraft, but had no idea how to parent his son. According to Mr. Powell, he and his wife were dedicated parents, had read shelves full of books, and thought they knew what they were doing. Mr. Powell stated he and his wife discovered the Family to Family Connection program during the past month, and with the drills and guidance provided by the experts at the program, his son was progressing rapidly. Mr. Powell stressed that the program provided a valuable service.
According to Mr. Powell, he and his wife came from very solid, middle-class backgrounds with intact homes, and the term “at-risk” seemed to address the allocation of resources. He asked that children not be marginalized because of the area in which they lived. Mr. Powell further stated that the issue was not about child care, but rather was about parents working and learning how to deal with their children. The guidance which had been provided by an expert pediatric nurse via the Family to Family Connection program was invaluable to Mr. Powell, and he reiterated that the program worked, produced very tangible results, and might even pay dividends not imagined. As a user of the program, Mr. Powell asked the subcommittee to retain the full funding allocation for the Family to Family Connection program.
Amy Angella testified that she was also from Incline Village, Nevada, having grown up and attended school there. Ms. Angella stated use of the program provided the first instance where she felt something was being given back to her from the state; the program provided an amazing array of services. The staff at the Incline Village Family to Family Connection program was outstanding, and had come to Ms. Angella’s home to assist with her child. Ms. Angella indicated the program provided assistance for those participants who were isolated and did not have family or friends to rely on for help. She felt that children should come first in the funding allocations, before additional positions or programs were approved.
Julie Hernandez explained that she had moved to Nevada from California seven months ago, and was currently employed by the Incline Village ISD. Ms. Hernandez stated she was impressed by the Family to Family Connection program, and even before she was hired to work for the ISD, her grandson was a participant. Her biggest fear was that a cutting-edge program would be eliminated; Nevada was at the forefront currently, leading the nation with a program that would affect children in a manner that could not be measured in mere months. Ms. Hernandez stated it would be years before Nevada realized the benefits of the program. According to Ms. Hernandez, she was reading a book entitled, Ghosts in the Nursery, and suggested subcommittee members also read the book before approving a funding cut for the Family to Family Connection program. The book included frightening statistics about the development of infants, and how programs were “missing the boat.” Ms. Hernandez stated the program should be expanded in order to reach even more families.
Chairwoman Giunchigliani stated that many legislators had been cautious about the Family to Family Connection program during the 1999 session, but wanted to take a step in the direction of doing something right. It was rewarding to learn that a program that legislators actually took a risk on appeared to be viable. Chairwoman Giunchigliani agreed that government could not be all things to all people, but the legislature did have an obligation and responsibility to help those who needed assistance to ensure that those persons would not depend on government assistance in the future. That was part of the intent of state programs, and Chairwoman Giunchigliani indicated she was personally thrilled to hear about the positive changes taking place in families because of the Family to Family Connection program.
Janine Hansen, State President, Nevada Eagle Forum, wondered whether there was any component to protect family privacy within the Family to Family Connection program and the Family Resource Centers. Ms. Hansen noted that many records were being gathered by governmental and quasi-governmental organizations, and she asked about oversight in safeguarding those sensitive family medical and financial records. Ms. Hansen inquired whether the programs created an electronic profile of the participants, and noted there was a growing national problem in the area of identity theft. Ms. Hansen cited a case where a woman had her identity stolen as a result of information she had provided to her doctor. Because of increasing problems with identity theft, programs should be very concerned about confidentiality. Ms. Hansen indicated that at times insurance companies would deny medical insurance because of confidential information gleaned from medical records. According to Ms. Hansen the legislature had passed the State Parent and Pupil Protection Act, which helped protect records pertaining to school children, however, when records were being collected by such programs as the Family to Family Connection, there was no indication that the records were protected or confidential, and could only be released upon consent of the family. Ms. Hansen indicated the state had an obligation to safeguard the fourth amendment rights of its citizens, as reinforced in the Nevada Constitution, which was the right of the people to be secure in their persons, houses, papers, and their effects. According to Ms. Hansen, it was very important in the electronic age, because data was collected and easily transferred or accessible to many persons, that there be concern about information being released into the hands of those who might abuse it, or being shared without the consent of the individuals involved.
Joyce Allen, Pershing County Coordinator, Family to Family Connection program, indicated she was proud of the parents who had testified in support of the program. Ms. Allen reported that the program worked very diligently to make a difference in the lives of participating families. Children did not come with instructions, and Ms. Allen explained she could have used the program with her three sons, had it been available. Ms. Allen stated she had lived in Nevada for 13 years, moving from Washington, D.C., without any idea of what she would encounter in rural Nevada. Ms. Allen emphasized that she was proud to live in rural Nevada and prayed that the legislature would continue to help Nevada’s children.
Larry Struve, registered lobbyist for the Religious Alliance in Nevada, testified that the alliance represented the Catholic Dioceses of Las Vegas and Reno, the Episcopal Diocese of Nevada, the Lutheran Advocacy Ministry in Nevada, the Sierra Nevada District of the United Methodist Church, and the Nevada Presbytery of the Presbyterian Church. With congregations throughout the state, Mr. Struve indicated there were thousands of members involved in the advocacy of five major issues, one of which was the continuation of support for the Family to Family Connection program and similar programs for families. Mr. Struve stated when the program was fashioned in 1997 the alliance was very much involved. The congregations dealt with many problems at the local level, and had seen how assistance in the first years of life could help to ward off problems that might occur later on. Mr. Struve indicated he was present to offer support to the program, and the alliance would monitor the program. The group had learned with dismay that the Family to Family Connection program was being proposed for a funding cut, as the alliance had not been involved in The Governor’s Steering Committee to Conduct a Fundamental Review of State Government. Mr. Struve indicated that though government could not be everything to everyone, it could be an instrument to pursue the common good. The state had a program in place with 13 ISDs, with thousands of Nevada families being helped and was, at least, making some progress. According to Mr. Struve, should the ISDs be dismantled, the state would be required to start over, and he did not feel the faith-based groups represented by the alliance would be able to pick up the slack. He requested that the subcommittee consider at least maintaining the current funding level for the Family to Family Connection program, and hopefully build on the program should resources become available.
Robert Payant indicated he represented the Nevada Catholic Conference, a new organization of the two dioceses within the state. Mr. Payant stated he would echo Mr. Struve’s comments, and voiced the conference’s support for the continued proper funding of the Family to Family Connection program. The previous eloquent testimony from parents who participated in the program was enough to satisfy everyone regarding the success of the program.
Chairwoman Giunchigliani stated as a teacher, she noted that approximately 30 to 40 percent of the parents were actually grandparents raising their grandchildren, and she hoped the Family to Family Connection program and the Family Resource Centers would provide programs to assist those who were on their second round of raising children and might need some refurbishment. Chairwoman Giunchigliani indicated there would be legislation presented regarding foster and/or kinship care regarding grandparents who wanted to adopt their grandchildren. It would be helpful if those programs did not assume everyone was a first time parent and provided help accordingly.
Chairwoman Giunchigliani explained that budgets on the agenda that were not addressed would be rescheduled, and apologized for any inconvenience. With no further public testimony forthcoming, the hearing was adjourned at 10:58 a.m.
RESPECTFULLY SUBMITTED:
Carol Thomsen
Committee Secretary
APPROVED BY:
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Assemblywoman Chris Giunchigliani, Chairwoman
DATE: