MINUTES OF THE
SENATE Committee on Human Resources and Facilities
Seventy-First Session
April 18, 2001
The Senate Committee on Human Resources and Facilitieswas called to order by Chairman Raymond D. Rawson, at 2:49 p.m., on Wednesday, April 18, 2001, in Room 2135 of the Legislative Building, Carson City, Nevada. The meeting was video conferenced to the Grant Sawyer Office Building, Room 4412, Las Vegas, Nevada. Exhibit A is the Agenda. Exhibit B is the Attendance Roster. All exhibits are available and on file at the Research Library of the Legislative Counsel Bureau.
COMMITTEE MEMBERS PRESENT:
Senator Raymond D. Rawson, Chairman
Senator Maurice Washington, Vice Chairman
Senator Randolph J. Townsend
Senator Mark Amodei
Senator Bernice Mathews
Senator Michael Schneider
Senator Valerie Wiener
GUEST LEGISLATORS PRESENT:
Assemblyman Douglas (Doug) A. Bache, Clark County Assembly District No. 11 Assemblywoman Bonnie L. Parnell, Carson City (part) Assembly District No. 40
STAFF MEMBERS PRESENT:
H. Pepper Sturm, Committee Policy Analyst
Joan Polichio-Palm, Committee Secretary
OTHERS PRESENT:
Al Bellister, Lobbyist, Nevada State Education Association
Keith Rheault, Deputy Superintendent for Instructional, Research, and Evaluative Services, Department of Education
Kathy Apple, R.N., Lobbyist, Executive Director, Nevada State Board of Nursing
Kathy Williams, President, Nevada State Association of School Nurses, Incorporated
Deborah K. Cahill, Lobbyist, Nevada State Education Association
Dori Pro, School Nurse, Clark County School District, and Nevada Nurses Association
Randy Robison, Lobbyist, Rural Alliance
James T. Russell, Lobbyist, Carson City School District
George Ann Rice, Assistant Superintendent, Human Resources Division, Clark County School District
Richard Cawley, Special Education Representative, Commission on Professional Standards in Education
Chairman Rawson opened the hearing on Assembly Bill (A.B.) 380.
ASSEMBLY BILL 380: Revises provisions governing educational personnel. (BDR 34-1272)
Assemblyman Douglas (Doug) A. Bache, Clark County Assembly District No. 11, stated A.B. 380 would allow teachers the ability to move from one school district to another in a similar position and maintain a comparable place on the salary schedule. He explained this bill would allow teachers a break in service, up to 5 years, yet maintain their previously earned post-probationary status. Assemblyman Bache said this would not be available to teachers who are pending suspension, demotion, dismissal or refusal to reemploy. He declared this measure would help to retain good employees who leave for various reasons and want to return to service.
Chairman Rawson asked if the bill would be limited to teachers within the state or if teachers from out of state could also qualify.
Assemblyman Bache answered, the provisions of A.B. 380 would only benefit teachers within the state. He noted the district negotiates with teachers from other states to determine an acceptable salary, regardless of their previous salary or classification.
Senator Mathews queried if the intent of A.B. 380 is to allow a teacher to work in another profession and then return to the teaching profession. Chairman Rawson inquired if the purpose of the bill is to allow teachers to change their mind and return to the profession after leaving.
Assemblyman Bache answered there could be a variety of reasons including personal or family situations that need attention. He said A.B. 380 would allow a teacher to return to teaching as long as it was within the 5 years, yet maintain their post-probationary status.
Al Bellister, Lobbyist, Nevada State Education Association, expressed support for A.B. 380. He suggested substituting “another” with “any” on page 3, line 2 of the bill. Mr. Bellister stated this change would allow a teacher to return to the same district or move to another district while maintaining a comparable salary and a post–probationary status.
Chairman Rawson closed the hearing on A.B. 380 and opened the hearing on A.B. 223.
ASSEMBLY BILL 223: Authorizes commission on professional standards in education to provide exemption for certain persons from examinations required for initial licensure of educational personnel. (BDR 34-398)
Keith Rheault, Deputy Superintendent for Instructional, Research, and Evaluative Services, Department of Education, stated A.B. 223 was requested in order to address problems with recruiting experienced teachers to Nevada. He informed the committee that Nevada has only had reciprocity agreements with 35 states for the past 5 to 6 years. He maintained current statutes require testing of all teachers, and the commission does not have the authority to waive testing. He expounded this measure would allow the commission to develop regulations to address the testing requirements for experienced teachers. Experienced teachers under the current regulations, Mr. Rheault explained, must have taught 3 of the last 5 years in a state and hold a valid teacher’s license equal to one held in Nevada. He declared this bill would remove the requirement for experienced teachers being recruited to Nevada to take the “Praxis Series Tests” which are the subject-specific test or the teacher-knowledge test. Mr. Rheault commented that Nevada’s testing requirements dissuade experienced teachers from other states to accept positions in Nevada because they can go to another state that will grant them full reciprocity for their experience without additional testing.
Senator Wiener asked if a teacher from another state would still be required to take an examination on laws of Nevada relating to schools and the Constitution of Nevada.
Mr. Rheault explained if the Commission on Professional Standards in Education chooses to waive the Nevada Law and Constitution examinations in their regulations, teachers from other states would be exempt from taking those examinations.
Chairman Rawson closed the hearing on A.B. 223 and opened the hearing on A.B. 1.
ASSEMBLY BILL 1: Revises provisions regarding school nurses. (BDR 34-135)
Assemblywoman Bonnie L. Parnell, Carson City (part) Assembly District No. 40, declared A.B. 1 adds the requirement that nursing services in a school district must be under the supervision of a “chief administrative” nurse. Secondly, she stated, the bill removes the exemption from the requirement to provide a chief administrative nurse for school districts with less than 35,000 pupils in order to include all districts regardless of size. Since there are three small school districts that contract services with the public health nurse, she noted, an allowance for smaller counties in the language was made by using the word “or” on page 1.
Assemblywoman Parnell surmised few people really understand the scope of practice regulations related to school health practitioners, and the need for continuity of care throughout Nevada’s school districts is critical. She emphasized A.B. 1 does not have a fiscal note and the goal is quality and consistent care of school children, not compensation for a chief “administrative” nurse.
Kathy Apple, R.N., Lobbyist, Executive Director, Nevada State Board of Nursing, urged the committee’s support for A.B.1. She explained this measure is needed to clarify the legal concerns expressed by many school nurses and to take the best possible care of students. Ms. Apple provided the following examples of frequently asked questions or statements made by school nurses: A school nurse was told because she does not practice in a hospital she does not have to follow the nurse practicing act. Ms. Apple stated regardless of the setting, nurses must follow nursing law; another school nurse questioned if a principal may delegate the administration of medication. Ms. Apple stated this would be considered practicing nursing without a license; and a licensed practical nurse (LPN) was asked to be in charge of the assessment of a student and to set up a health care plan for this student. Ms. Apple remarked these functions are not within the scope of duties to be delegated to an LPN.
Ms. Apple claimed these and similar questions are clearly from districts without a chief nurse, districts that may risk violating nursing statutes. She maintained these concerns led to discussions with school nurses throughout the state. She testified it is a requirement that nursing services are under the purview and responsibility of a registered nurse (R.N.), referred to as the “chief administrative nurse.” The board, Ms. Apple restated, is supportive of A.B. 1 and urged the committee to support the amended bill in order to clarify nursing law.
Chairman Rawson asked if there would be a problem if the position were referred to as a “chief nurse.” Ms. Williams responded it would not be a problem with the State Board of Nursing.
Chairman Rawson inquired if the nurses in school districts throughout Nevada belong to the bargaining units. Assemblywoman Parnell stated all district nurses are part of the bargaining process.
Chairman Rawson inquired if using the term “administrative” would create a new position. Assemblywoman Parnell replied A.B. 1 was never intended to create an administrative position. She recognized there was great concern by school district personnel as using the word “administrative” would require this person to be on the administrative salary scale. Assemblywoman Parnell stressed the necessity to use the term “chief administrative nurse” as written in the Nevada Revised Statutes; and that mandate nursing services in any system for the delivery of health care must be under the direction and the supervision of a chief administrative nurse, who is a registered nurse. For compliance purposes, she explained, it would be best to continue using “chief administrative nurse.” Assemblywoman Parnell offered to provide a letter of intent to specify A.B. 1 was never intended to create an administrative position. She concluded this measure will ensure all nursing practitioners will be directly supervised by a registered nurse who is the “chief administrative nurse.”
Chairman Rawson stated there is far more health care going on in the school system than people realize.
Assemblywoman Parnell stated when she was the Parent-Teacher Association president, nurses emphasized the need for a chief administrative nurse was more critical to address within the statutes than to lower the nurse to student ratio.
Chairman Rawson inquired if problems arise with nurses when health aides perform nurses’ duties; and if nurses have the authority, under current law, to delegate the duties that are being delegated.
Ms. Apple testified the board worked with school nurses throughout Nevada approximately 10 years ago to develop an advisory opinion to give school nurses the authority to delegate certain nursing tasks. That advisory opinion has been successfully implemented, and was recently entered into regulation.
Chairman Rawson expressed his concerns for nursing care assistants who work with disabled persons performing nursing duties without proper training. He requested clarification regarding this problem to help the committee’s understanding of this issue in order to be better prepared to deal with future bills. Chairman Rawson acknowledged his request was beyond the scope of school nursing. Chairman Rawson said he hoped nurse’s aides or health aides in schools are not being asked to change catheters or perform tasks that nursing care assistants are asked to perform.
Ms. Apple responded the disabled community requested an exemption from nurse licensing to delegate specific duties to certain persons, through the authority of a physician or others. She commented the additional piece of legislation that was put into effect was a delegation process to add a safety element. Senator Rawson acknowledged Ms. Apple was correct.
Senator Mathews stated the questions and the responses to the questions clarified the need for a chief nurse who is knowledgeable about the process and can delegate the duties.
Kathy Williams, President, Nevada State Association of School Nurses, Incorporated, read from prepared testimony in support of A.B. 1 (Exhibit C). She stated the purpose of A.B. 1 is to ensure that school-aged children receive the best possible care by the most-qualified person: a school nurse or registered nurse. To decrease exposure to potential liability, she explained, health care decisions should be made by professional nurses, not administrators. Ms. Williams claimed A.B. 1 ties the practice of school nursing to the nurse-practicing act. She emphasized school districts must comply with the Individuals with Disabilities Education Act (IDEA), while serving students with special needs. She reiterated concerns of the potential liability to school districts when unsafe decisions are made regarding students’ health.
Deborah K. Cahill, Lobbyist, Nevada State Education Association, testified in support for A.B. 1 as amended.
Dori Pro, School Nurse, Clark County School District, and Nevada Nurses Association, testified in support of A.B. 1. She stated A.B. 1 ties the practice of school nursing to the Nevada nurse practicing act, which is the mechanism for ensuring safety of the public. She emphasized the safety of children is in question. Ms. Pro explained the nurse practicing act provides a structure for decision-making regarding how care should be directed and delegated. She stated it is the responsibility of the school district to ensure the health procedures for students are being performed safely and correctly. She expounded by abiding by the nurse practicing act, school nurses follow procedural guidelines, obtain appropriate orders from licensed health care providers, and make decisions regarding how health procedures can be safely provided in the school setting. Ms. Pro said this includes having knowledge of the procedures, providing instruction, and ensuring compliance with protocols and procedures by continual training, observation and evaluation.
Assembly Bill 1 and the Nevada nurse practicing act require a chief administrative nurse provide the supervision and direction for care. Ms. Pro stated this works well in a school setting, as the chief nurse is under the direction of an educational administrator. She said the chief nurse assumes the responsibility for decisions concerning safe management of student health needs; and the educational administrator oversees the chief nurse, to ensure the decisions are in line with the best educational practices as well as the mandates of special education and disability law. She stated if someone other than a chief nurse provides direct supervision for nurses, the best choices for nursing care are not always made. Ms. Pro continued, administrators who are not nurses do not have the nursing education or knowledge base regarding safe care practices; and legal issues from other jurisdictions showed district liability for students harmed when unsafe delegation practices were followed. She said nurses employed in a school district are responsible and accountable for their actions and could risk the discipline or loss of license if directed to delegate inappropriately.
Ms. Pro stated the nursing department in Clark County School District provides services to medically fragile students in the schools by prioritizing and shifting staff to meet changing needs on a daily basis. She said the ability to respond accordingly requires knowledge of the health care needs of the students and the level and skills of staff. Nursing supervisors, she emphasized, assist schools and school nurses to make difficult decisions, regardless if students can be maintained at school. Ms. Pro continued, because the overall supervision of decisions comes from a nursing administrator or a chief nurse, standards have been maintained with consistency throughout the district.
Ms. Pro proclaimed there is no person in a better position to supervise and evaluate the practice of school nurses than a nurse administrator or chief nurse who meets the requirements of the Nevada nurse practicing act. She stressed the constant changes in technology and the severity of health concerns of many students require staff continually work to maintain the necessary knowledge and skills to perform safely and effectively. Ms. Pro explained planning begins immediately when the Health District of Clark County is informed of a student entering the district who will require a nurse to perform procedures, including training, and back-up. She remarked for some students a nurse must be available from the time they board the bus until they are returned home. She stated these efforts are coordinated centrally to ensure staff is always available. Ms. Pro concluded A.B. 1 mandates a model of school nurse practice consistent with appropriate professional practice and is in the best interest of the students and the school districts.
Randy Robison, Lobbyist, Rural Alliance, explained the Rural Alliance is made up of 15 local school boards designated as rural. Mr. Robison stated the Rural Alliance considered the minimal immediate fiscal impact on some of the smaller rural counties against the serious nature of the potential liability. He stated the alliance supports A.B. 1, in spite of removing the cap and the difficulty of finding qualified staff in smaller school districts and within some rural counties. Mr. Robison stated the potential liability far outweighs those concerns and the Rural Alliance will do everything possible to meet the requirement of the statute. He said he would be in favor of accepting Assemblywoman Parnell’s offer to provide a letter of intent clarifying personnel issues associated with A.B. 1.
James T. Russell, Lobbyist, Carson City School District, stated opposition to the portion of A.B. 1 that would require the district to hire or elevate a current position to “chief administrative” nurse. Mr. Russell commented financial concerns are a major issue to the school district and would be further burdened by paying for the position without increased funding. He asserted A.B. 1 would be an unfunded mandate and would take funds from students and from teacher salaries to pay for the “chief administrative” nurse. He stated the district does not oppose nursing services being supervised by a nurse. He reiterated the district only opposes the additional costs associated with A.B. 1.
Chairman Rawson asked would it help if “administrative” were removed from A.B. 1. Mr. Russell answered the removal of “administrative” would help, from a legal standpoint, if the district could take an existing position and elevate it to a “chief administrative nurse” without additional costs. Mr. Russell emphasized the intent of the bill was not to create a fiscal impact.
Chairman Rawson said if an issue of illegal practice of nursing is identified, it must be straightened out. Mr. Russell agreed with Chairman Rawson and asserted the district is in compliance. Chairman Rawson asked how many nurses are employed by the Carson City School District. Mr. Russell replied the Carson City School District has nine nurses for nine schools. He clarified not all the nurses are registered nurses.
Chairman Rawson said what if an existing nurse was designated as the “chief nurse” while maintaining responsibility for the school. Mr. Russell stated the district would be fine with that, but A.B. 1, as it is worded, mandates the district to create a position.
Chairman Rawson commented although the legislature has previously passed unfunded mandates, it should not occur. Mr. Russell stated if the committee would like to give the district the money they would be glad to create the position.
Senator Mathews stated for the record:
You brought up something that’s been a sore spot to me for many, many years. A nurse is not a nurse is not a nurse. There are R.N.s and there are R.N.s and that is the only real nurse, anywhere. So when you talk about nine nurses, if you have some people who are calling themselves nurses, R.N.s are the only nurses you have; the other ones are licensed vocational people or certified aides or whatever. But a nurse is a nurse only if they have an R.N.
Assemblywoman Parnell said she would provide a friendly amendment that would hopefully resolve the confusion over the term “administrative” pertaining to A.B. 1. She suggested the deletion of the word “administrative” and use the term “nurse” as defined in Nevada Revised Statutes (NRS) 632.240. She explained the definition of chief administrative nurse would still be in current statute, but in reference to education, the language would be “chief nurse.” She expressed support for this amendment and the letter of intent.
Senator Amodei disclosed for the record, for the purposes of A.B.1, that he and Mr. Russell are partners in the same law firm. Senator Amodei stated he would check with the Legal Division of the Legislative Counsel Bureau to see if Mr. Russell’s appearance on this matter would allow him (Senator Amodei) to participate in voting on this measure. He stated he would abstain from voting on A.B. 1 until he received notification from the Legal Division of the Legislative Counsel Bureau.
Senator Wiener commented she had a conversation on an airplane with a school nurse regarding students with eating disorders. She emphasized the nurse was very articulate and knowledgeable about eating disorders and expressed deep concern for students who have eating disorders. Senator Wiener expressed gratitude for this nurse and all school nurses who are dedicated, committed, and who go above and beyond job requirements to understand children in order to help them.
In answer to an inquiry by Chairman Rawson, Ms. Williams stated Nevada has endorsed school nurses to permit the StateBoard of Education to hire them. She stated a school nurse is an R.N. who requires additional training and education above a bachelor’s degree. Ms. Pro agreed with the proposed changes to the bill.
Chairman Rawson closed the hearing on A.B. 1 and called for a motion.
SENATOR MATHEWS MOVED TO AMEND AND DO PASS A.B. 1.
SENATOR WIENER SECONDED THE MOTION.
THE MOTION CARRIED. (SENATOR WASHINGTON WAS ABSENT FOR THE VOTE. SENATOR AMODEI ABSTAINED FROM THE VOTE.)
Chairman Rawson reopened the hearing on A.B. 223.
George Ann Rice, Assistant Superintendent, Human Resources Division, Clark County School District, testified in support of A.B. 223. She asserted the developers of the Praxis Series exams have testified during court hearings that the exams, which test for pedagogy (the art, science or profession of teaching) or methods and content, are designed for beginning teachers applying for initial licensure. Ms. Rice reiterated support for A.B. 223, which would not require experienced or veteran teachers from other states to take the Praxis Series exams.
Ms. Cahill urged the committee to support A.B. 223. She noted during the last legislative session a resolution was passed to encourage the Commission on Professional Standards in Education to move forward with true reciprocity. Ms. Cahill said A.B. 223 would allow the Commission on Professional Standards in Education to determine if an experienced teacher from another state should be granted a teaching license in Nevada.
Richard Cawley, Special Education Representative, Commission on Professional Standards in Education, testified in support of A.B. 223 so the commission could make regulations to entice more experienced teachers to come to Nevada. He noted A.B. 223 would help to fill the need forexperienced teachers throughout the state. Mr. Cawley reiterated the test currently used for teacher licensure was not intended for experienced teachers.
Chairman Rawson closed the hearing on A.B. 223 and called for a motion.
SENATOR WIENER MOVED TO DO PASS A.B. 223.
SENATOR MATHEWS SECONDED THE MOTION.
THE MOTION CARRIED. (SENATOR WASHINGTON WAS ABSENT FOR THE VOTE.)
*****
Chairman Rawson reopened the hearing on A.B. 380.
ASSEMBLY BILL 380: Revises provisions governing educational personnel. (BDR 34-1272)
Ms. Rice directed the committee’s attention to page 2, line 12 of A.B. 380 and requested the word “shall” be replaced with “may.” She explained the current pay schedule for teachers in Clark County School District (CCSD) has a different number of ranges from other districts. Ms. Pro stated any credits above 32, at the bachelor’s or master’s degree level are not recognized on the salary schedule, unlike they are in other districts. Assembly Bill 380, she claimed, would require CCSD to give a teacher from another district recognition for credits earned that the district would not give to its own teachers. She statedAssemblyman Bache indicated the district would not have to make an offer, but could make a lesser offer if the district was not willing to pay a comparable amount. Ms. Rice suggested if “shall” was changed to “may” the district could make the offer within the salary schedule and be able to make an offer to a teacher from another district without giving them placement on the salary schedule which the district cannot give their own teachers under the negotiated agreement.
Chairman Rawson asked if language could be developed for teachers to receive an equivalent pay or position to what they would get from Clark County School District with the same experience. He clarified it may not be exact, dollar for dollar, between the districts but it would give recognition for the years of service, special endorsements, and the step advancements according to the Clark County School District.
Ms. Rice stated current law requires years of service must be recognized within the salary schedule. She noted the district recognizes special endorsements and additional credits up to 32 credit hours. Ms. Rice remarked A.B. 380 would require CCSD to recognize ranges by placing a teacher from another district at a comparable range so they could receive approximately the same salary. Ms. Pro said this would force the district to give teachers from other districts recognition of additional credits above 32 and pay increases beyond the limits of the current salary schedule.
Mr. Bellister stated opposition to amending A.B. 380 by replacing “shall” with “may.” He said this change would make the current law permissive in granting years of experience. Mr. Bellister also stated section 1, subsection 3, paragraph (c), of the bill states a classification “comparable to” the classification on the schedule of salaries. Chairman Rawson acknowledged the need to recognize teachers’ achievements, accomplishments, and time on task. He asked Mr. Bellister if he was referring to “dollar for dollar.” Mr. Bellister replied no, it does not say “identical,” it says “comparable.”
Chairman Rawson asked for clarification from Ms. Rice. Ms. Rice replied if a teacher from another district came to CCSD with a bachelor’s degree plus 90 credits, the district would recognize this teacher on the salary schedule with a bachelor’s degree plus 32 credits. She stated this is the highest salary CCSD could recognize through their own negotiated agreement for their teachers. Ms. Rice reiterated CCSD cannot pay a teacher for any more credit hours accumulated above the 32 credits at each level. She stated the teacher must earn the actual degree to move over on the salary schedule, and maintained if this would be acceptable to the drafter of this bill then CCSD would have no problems with A.B. 380. Chairman Rawson agreed with Ms. Rice’s interpretation, but stated he may not be interpreting it correctly.
Ms. Rice asked if the Clark County School District could provide an amendment to clarify the language. Chairman Rawson said certainly and there would be further discussions to clarify language before it is processed. Chairman Rawson stated he understood, in concept, the intent of the bill.
Chairman Rawson closed the hearing on A.B. 380 and adjourned the meeting at 3:48 p.m.
Joan Polichio-Palm,
Committee Secretary
APPROVED BY:
Senator Raymond D. Rawson, Chairman
DATE: