MINUTES OF THE

SENATE Committee on Human Resources and Facilities

 

Seventy-First Session

April 30, 2001

 

 

The Senate Committee on Human Resources and Facilitieswas called to order by Chairman Raymond D. Rawson, at 1:30 p.m., on Monday, April 30, 2001, in Room 2135 of the Legislative Building, Carson City, Nevada.  The meeting was video conferenced to the Grant Sawyer Office Building, Room 4406, 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:

 

Assemblywoman Debbie Smith, Washoe County Assembly District No. 30

Assemblywoman Ellen Marie Koivisto, Clark County Assembly District No. 14

 

STAFF MEMBERS PRESENT:

 

H. Pepper Sturm, Committee Policy Analyst

Patricia Vardakis, Committee Secretary

 

OTHERS PRESENT:

 

Lisa M. Black, Lobbyist, Nevada Nurses Association

Deborah K. Cahill, Lobbyist, Nevada State Education Association

Teri Cantley, Director, Region 6, Nevada Parent Teacher Association

Anne K. Loring, Lobbyist, Washoe County School District

Craig Kadlub, Lobbyist, Clark County School District

Theresa Malone, Las Vegas, District 2-G, State Board of Education and State             Board for Occupational Education, Department of Education

Moises Denis, Treasurer, Nevada Parent Teachers Association

Nancy J. Hollinger, Lobbyist, Washoe County School District

Lawrence P. Matheis, Lobbyist, Nevada State Medical Association

Shirley L. Hughes, Registered Nurse

Christine Sawyer, Registered Nurse

Carin R. Franklin, Lobbyist, Operating Engineers Local 3

 

Vice Chairman Washington opened the hearing on Assembly Concurrent Resolution (A.C.R.) 7 and invited Lisa M. Black, Lobbyist, Nevada Nurses Association, to testify.

 

ASSEMBLY CONCURRENT RESOLUTION 7: Directs Legislative Committee on Health Care to conduct interim study concerning development of system for reporting medical errors. (BDR R-226)

 

Ms. Black presented supportive testimony on A.C.R. 7 stating the bill would direct the interim Legislative Committee on Health Care to study medical errors in Nevada and develop effective reporting mechanisms and system improvements.  She said recent studies indicated, current mechanisms to identify, evaluate, and correct these problems were inadequate.

 

Ms. Black stated the health care delivery system has undergone tremendous changes in the last decade.  She explained the results of a recent survey indicated 75 percent of nurses surveyed reported the quality of health care has declined, and 40 percent would not recommend their facility to friends or family members. 

 

Ms. Black declared a safer health care delivery system needed to be designed, which would protect patients and reduce errors.  She emphasized a system of reporting and addressing errors will not increase litigation but would address the flaws in the health care delivery system.  She stressed the need to support A.C.R. 7 to ensure patients receive the highest quality of care.

 

Vice Chairman Washington suspended testimony on A.C.R. 7 and introduced Assemblywoman Debbie Smith, Washoe County Assembly District No. 30, to speak on Assembly Bill (A.B.) 201. 

 

ASSEMBLY BILL 201: Requires state board of education and school districts to adopt policies encouraging parental involvement. (BDR 34-846)

 

Assemblywoman Smith told the committee A.B. 201 requires the State Board of Education to involve education personnel and the general public in adopting a parent involvement policy by December 1, 2001.  She stated A.B. 201 also requires local school boards to adopt a parent involvement policy by          March 1, 2002. 

 

Assemblywoman Smith noted the policies adopted must be consistent with the National Standards for Parent/Family Involvement Programs.  She listed the six standards: communicating, student learning, parenting, volunteering, advocacy and decision-making, as well as collaborating with the community.  Assemblywoman Smith pointed out when parents are involved in their children’s education, student attendance improves, student achievement increases, parent’s self-esteem and self-confidence increases, and there is more school support.

 

Vice Chairman Washington questioned whether there was a difference between Assembly Bill 201 and Senate Bill 73.

 

SENATE BILL 73:  Requires state board of education to prescribe form for reports of parental involvement in education of children. (BDR 34-315)

 

Assemblywoman Smith replied A.B. 201 is setting a positive policy and would be the first step in improving parental involvement in children’s education.

 

Senator Mathews voiced concern over legislating parents to be involved with their children.  Assemblywoman Smith said A.B. 201 does not mandate or legislate, but does promote and encourage a parental involvement policy. 

 

Vice Chairman Washington queried whether the state or school boards would set the policy.  Assemblywoman Smith answered the state school board would adopt a policy, and the local school boards would adopt individual policies using the state policy as a guide.  Vice Chairman Washington questioned the sources of input for these policies.  Assemblywoman Smith assured the committee, educational personnel and parents would be involved in the process.             Vice Chairman Washington called attention to the language “develop a dialog or a two-way meaningful communication between home and school,” on line 1, page 2 of A.B. 201, and asked for an explanation.  Assemblywoman Smith responded there are numerous ways to achieve this association, but the methods could differ because of a student’s grade level.  Assemblywoman Smith reiterated, having a parental involvement policy in place would focus and sustain the existing programs. 

 

Senator Wiener pointed out two places in A.B. 201, which “encourage” or “require” but do not “mandate” parental involvement. She asked Assemblywoman Smith to explain the method by which the “National   Standards for Parent/Family Involvement Programs” were established.        Assemblywoman Smith responded an overview of the standards are listed in lines 1 through 12, on page 2 of A.B. 201, which encourages parents to be involved in their children’s education. 

 

Senator Mathews noted a mandate existed in A.B. 201 on lines 24 through 26, and expressed concern about putting such mandates into public policy.  Assemblywoman Smith reiterated the bill “simply encourages” parental involvement, but the review outlined on line 25, page 2 of A.B 201 is for the policy to be reviewed each year by the state board and board of trustees of each school district.

 

Deborah K. Cahill, Lobbyist, Nevada State Education Association (NSEA), recalled the voter’s polling involved with the Nevada Tax Fairness and School Funding Accountability Act and the dialog concerning the disbursement of funding.  She explained the result was the Quality Schools Plan, which consisted of four pillars, and one pillar was parental involvement. 

 

Ms. Cahill remarked upon the feasibility of legislating parental involvement.  She told the committee Assembly Bill (A.B.) 57 requests $2 million for programs promoting parental involvement. 

 

ASSEMBLY BILL 57:  Makes appropriation to Department of Education to             provide grants for centain programs that promote parental involvement.              (BDR S-326)

 

Ms. Cahill said the standards outlined in A.B. 201 were incorporated in A.B. 57.  She encouraged the committee to support A.B. 201. 

 

Teri Cantley, Director, Region 6, Nevada Parent Teacher Association, stated most parents want to be involved in their children’s education.  She testified some parents want to be involved in every aspect of their children’s education but have been denied the right to enter the classroom by a teacher.               Ms. Cantley acknowledged students achieve more and have better self-worth when their parents are involved in school activities. 

 

Ms. Cantley related her personal experience in the “Success For All” program, which encourages parents to help their children read for 20 minutes each evening.  She stated there are parents who wish to be more involved in their children’s education but are “pushed away“ by the school.  Ms. Cantley stressed A.B. 201 would enable parents who want to be involved an opportunity to do so. 

 

Vice Chairman Washington asked Ms. Cantley whether the number of parents involved in their children’s education would increase by implementing a parent involvement policy.  Ms. Cantley opined the response would not be immediate but would increase over time.  Vice Chairman Washington queried Ms. Cantley about the testimony concerning parents being prohibited from entering the classroom.  Ms. Cantley affirmed parents have not been encouraged or invited to participate in their children’s activities in school.  She mentioned, in      Carson City a parent who wishes to volunteer in the classroom must be fingerprinted, but teachers still feel uncomfortable.  

 

Vice Chairman Washington questioned whether an interim study was necessary.  Ms. Cantley responded parental involvement should be a standard not an exception. 

 

Assemblywoman Smith related her past experiences as a Parent Teacher Association president and said her efforts to adopt policies with the school districts were to no avail.  She said that was the genesis for A.B. 201. 

 

Anne K. Loring, Lobbyist, Washoe County School District, voiced support of    A.B. 201.  She stated parent involvement is key to the academic achievement of students.  Ms. Loring informed the committee, in the Washoe County School District’s central office staff, there is a parent coordinator who researches the country for new methods of involving parents.  She said A.B. 201 is a statement to all schools in Nevada that parental involvement is critical to students and the work of educators. 

Craig Kadlub, Lobbyist, Clark County School District, stated for the record Clark County School District was in support of A.B. 201.

 

Theresa Malone, Las Vegas, District 2-G, State Board of Education and State Board for Occupational Education, Department of Education, voiced support of A.B. 201.  She quoted line 3, on page 2 of A.B. 201 and recalled for the committee the “Baby Your Baby “ program.  Ms. Malone opined A.B. 201 would assist parents in being more involved in their children’s education.                She encouraged the committee to support A.B. 201.

 

Vice Chairman Washington questioned the intent of lines 9 and 10, on page 2 of A.B. 201.  Assemblywoman Smith explained, when educational decisions are made, parents would be involved in the process.

 

Moises Denis, Treasurer, Nevada Parent Teacher Association, testified A.B. 201 would encourage parental involvement in the school and urged the committee to support the bill.  He told the committee parent participation at the high school level is a challenge and A.B. 201 would be a help in that direction. 

 

Senator Townsend stated his distress concerning the testimony about parents being prohibited from participating in their children’s education.  Assemblywoman Smith acknowledged a policy at the district level is communicated to administrators, and teachers would lay the groundwork to prevent this situation from happening.  Senator Townsend questioned whether without a policy in place school districts condone not allowing parents to be involved.  Assemblywoman Smith said without a policy in place there is nothing that addresses the issue. 

 

Senator Townsend commented there are two issues which needed to be addressed: one, parents wanting to be involved but who have been denied; and two, the problem of non-participation by parents.  Continuing, Senator Townsend expounded on the issue of showing parents the benefit of participating in their children’s education. 

 

Senator Mathews queried whether school time schedules could be flexible to accommodate parents.  She said there are caring teachers extending themselves to visiting student’s homes to involve the parents.  Assemblywoman Smith reiterated A.B. 201 is a “beginning step” in opening the doors to parents and a start in innovative thinking. 

Vice Chairman Washington closed the hearing on A.B. 201 and opened the hearing on A.B. 28.

 

ASSEMBLY BILL 28: Revises provisions governing sale of certain school property. (BDR 34-822)

 

Nancy J. Hollinger, Lobbyist, Washoe County School District, testified in support of A.B. 28.  Ms. Hollinger explained, as a form of education, students have built several houses to code, and are trained in all aspects of construction.  Ms. Hollinger said A.B. 28 provides a procedure for the sale of a house or other structure.

 

Senator Mathews asked whether the school‘s houses are listed or raffled for sale.  Senator Wiener pointed out page 2, lines 8 through 27 of A.B. 28, address the procedure for the list of realtors, the sale of the property, and the apportionment of the commission. 

 

Vice Chairman Washington questioned whether the revenue received from a sale reverts back into the program.  Ms. Hollinger affirmed the revenue reverts back into the program and is used for further construction.

 

Senator Mathews reflected the program existed for a school year and is a learning tool for vocational education.  Ms. Hollinger reiterated all aspects of construction are covered.  

 

Senator Wiener asked whether houses were the only structures built by the students.  Ms. Hollinger replied the focus has been on houses.

 

Vice Chairman Washington closed the hearing on A.B. 28 and reopened the hearing on A.C.R. 7.

 

Lawrence P. Matheis, Lobbyist, Nevada State Medical Association, voiced support of A.C.R. 7.  He said A.C.R. 7 directs the Legislative Committee on Health Care to form an advisory committee to study the issue of implementing the recommendations of the National Institute of Medicine’s study called       “To Err Is Human.”  Mr. Matheis stated the study consisted of patient safety and system problems in the health care industry which can result in medical errors, risk, and injury to patients, as well as, finding ways to incorporate proven interventions, in a cost-effective way. 

Mr. Matteis suggested a review of what is being accomplished nation-wide would be beneficial.  He said “Health Insight,” which is the professional review organization for Nevada, has undertaken reviews of problems and has made recommendations to hospitals concerning changes in procedures which have been beneficial. 

 

Vice Chairman Washington invited Assemblywoman Ellen Marie Koivisto,     Clark County Assembly District No. 14, to testify on A.C.R. 7.

 

Assemblywoman Koivisto informed the committee the genesis for A.C.R. 7 resulted from the Institute of Medicine’s report of high numbers of deaths caused by medical errors, which went from 44,000 to 98,000 deaths a year.  She stated medical errors are the eighth leading cause of death in the country.  Assemblywoman Koivisto stated until there is compiled data showing the reasons for the deaths occurring, the system cannot be fixed.  She pointed out the errors occur at various stages of diagnosis and treatment, but the majority are system errors. 

 

Assemblywoman Koivisto stated A.C.R. 7 would create a subcommittee of the Legislative Committee on Health Care with the responsibility to study the system and develop an approach for the reporting of errors.  She maintained the causes need to be identified, and then the improvements could be made.  Assemblywoman Koivisto envisioned a voluntary reporting system, patterned after the “Aviation Reporting System,” which has radically improved safety in that industry.  She emphasized the information may not be disclosed, and individuals are given some freedom from liability.  Assemblywoman Koivisto said the adoption of the same format would be needed in health care. 

 

Assemblywoman Koivisto suggested the committee be comprised of persons from the medical society, nurses, pharmacists, insurers, hospitals, legislators, and trial lawyers, to enable the system to work. 

 

Senator Wiener questioned whether the advisory committee would have voting rights.  Assemblywoman Koivisto replied the committee would be advisory in nature, but their input is vital. 

 

Mr. Mathies concurred with Assemblywoman Koivisto’s suggestions about the composition of the subcommittee.  He told the committee approximately         40 states are presently in the process of studying the incorporation of the recommendations of the Institute of Medicine’s report into state law.  He said the Congress would define what the expectations are in terms of state reporting so a national database could be created.

 

Shirley L. Hughes, Registered Nurse, testified as a member of Service Employees International Union (SEIU) 1107 Nurse Alliance, and said the nurses of SEIU testified before the 1999 Legislative Session concerning staffing deficiencies in local hospitals.  She told the committee, through patient, family and nurse’s testimony, it became clear there is a systemic problem resulting in patients getting incorrect medications, hospital acquired infections, and other errors.  Ms. Hughes reported a recent survey revealed 41 percent of registered nurses said they do not have sufficient time to access every patient on their shift; 46 percent revealed there were delayed medications, or mistreatments on a given shift; 7 percent reported patients receiving incorrect medication.        Ms. Hughes stressed there is a direct correlation between staffing levels, incidents of error, and hospital acquired infections.  She stated A.C.R. 7 is a response to a systemic problem. 

 

Christine Sawyer, Registered Nurse, speaking as the chairman of the SEIU 1107 Nurse Alliance, voiced support of A.C.R. 7 and approved the concept of legislators, industry representatives, frontline nurses, and consumers coming together to develop a response to a system-wide problem.  She urged the committee to consider three elements which would make A.C.R. 7 more effective: one, to develop a system of reporting errors and making information available for purchasers of health care; two, the protection of employees who come forward and report errors; and three, to ensure the confidentiality of patients.  Ms. Sawyer urged the inclusion of practicing, bedside nurses on the committee.

 

Carin R. Franklin, Lobbyist, Operating Engineers Local 3, testified in support of A.C.R. 7.  She reiterated the inclusion of nurses on the committee was vital.  Ms. Franklin told the committee many hospitals have “occurrence reports,” where instances including visitors falling, equipment malfunction, and medication errors are reported.  She said nurses are instructed not to copy these reports nor reference them in the patient’s chart.  Registered nurses are afraid of discipline and retaliation related to these reports. 

 

Vice Chairman Washington closed the hearing on A.C.R. 7.

 

The meeting was adjourned at 2:59 p.m.

 

 

RESPECTFULLY SUBMITTED:

 

 

 

Patricia Vardakis,

Committee Secretary

 

 

APPROVED BY:

 

 

 

                       

Senator Raymond D. Rawson, Chairman

 

 

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