MINUTES OF THE

SENATE Committee on Human Resources and Facilities

 

Seventy-First Session

February 26, 2001

 

 

The Senate Committee on Human Resources and Facilitieswas called to order by Chairman Raymond D. Rawson, at 1:42 p.m., on Monday, February 26, 2001, in Room 2135 of the Legislative Building, Carson City, Nevada.  The meeting was videoconferenced to the Grant Sawyer Office Building, Room 4401, 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:

Senator Terry John Care, Clark County Senatorial District No. 7

 

STAFF MEMBERS PRESENT:

 

H. Pepper Sturm, Committee Policy Analyst

Patricia Di Domenico, Committee Secretary

 

OTHERS PRESENT:

 

Judith Wright, Chief, Bureau of Family Health Services, Department of Human Resources

Lesley A. Pittman, Lobbyist, March of Dimes

Colleen A. Morris, M.D., Department of Pediatrics, Division of Genetics,             University of Nevada School of Medicine

Tina Marie Phyfer, Research Coordinator, Department of Obstetrics and             Gynecology, University of Nevada School of Medicine

Jonathan R. Sias, Director, Nevada Veterans’ Nursing Home, Office of Veterans’             Services

Ed Gobel, Lobbyist, Council of Nevada Veterans Organizations

Charles W. (Chuck) Fulkerson, Executive Director, Office of Veterans’ Services

Jack McLaughlin, Superintendent of Public Instruction, Department of Education

Dr. John Gwaltney, Member, State Board of Education and State Board for             Occupational Education

Theresa Malone, Member, State Board of Education and State Board for             Occupational Education

 

Chairman Rawson introduced Judith Wright, Chief, Bureau of Family Health Services, Department of Human Resources.  Ms. Wright provided written testimony concerning the status of Nevada’s Birth Defects Registry (Exhibit C).  She explained Assembly Bill 238 of the Seventieth Session amended Nevada Revised Statutes (NRS) 442.300 to allow the development of the birth defects registry; it also provided for the exclusion of the name of a patient if it is requested in writing by the parent or guardian, and required the State Board of Health to adopt regulations to carry out the statute. 

 

ASSEMBLY BILL 238 OF THE SEVENTIETH SESSION:  Provides for             establishment and maintenance of system for collection and analysis of             information concerning birth defects and other adverse birth outcomes             and makes various changes to Uniform Anatomical Gift Act. (BDR 40-72)

 

Ms. Wright noted the goals of the registry are to: develop and implement a surveillance system to provide early identification of neural tube defects, malformations, and exposures to teratogenic agents which are linked to conditions such as fetal alcohol syndrome; use the data to design, implement, and evaluate programs to prevent birth defects; and improve the access of persons with birth defects to comprehensive, community-based, family-centered care. 

 

Ms. Wright stated the abstraction of medical records began with the review of infants and children born or admitted to a hospital after January 1, 2000, and by October, 2000, there were 714 records reviewed by the federal Centers for Disease Control and Prevention (CDC) coordinator.  Ms. Wright said Nevada was comparable to the national birth defect types and incidence of these disorders. She pointed out that of the 940 records in the birth defects registry, only ten families have declined participation.  Ms. Wright referred to a letter dated February 22, 2001 from Larry D. Edmonds, Chief, State Services Section, Birth Defects and Pediatric Genetics Branch, CDC (Exhibit D), supporting the Nevada Birth Defects Registry Program.

 

Ms. Wright emphasized research has established that the intake of folic acid can prevent neural-tube defects.  She said the Bureau of Family Health Services collaborated with the Pacific Southwest Regional Genetics Network and the March of Dimes to initiate a folic acid campaign statewide.  Ms. Wright noted the bureau’s perinatal nurse consultant has been providing seminars on the use of folic acid.

 

Ms. Wright provided the “Birth Defect Registry Preliminary Report” (Exhibit E) for the committee’s review.

 

Chairman Rawson commented the neo-natal units in Nevada are doing a good job because of the high number of low-weight births. He said in some states the health departments are dispensing folic acid to anyone who needs it because it is an inexpensive way to deal with the problem.  Chairman Rawson asked if Nevada had a similar program.  Ms. Wright answered there is no funding in Nevada for such a program at this time.  Chairman Rawson urged Ms. Wright to look into such a program.  Chairman Rawson asked Ms. Wright to clarify her testimony concerning the birth defects registry totals of 714 records and 940 records.  Ms. Wright explained there were 714 records when Larry Edmonds, birth defects coordinator for CDC, reviewed the preliminary report in October 2000, and the total records collected to date are 940.

 

Senator Wiener asked if the data they were compiling showed any significant relationship to fetal alcohol syndrome.  Ms. Wright responded that they have been concentrating on extracting records from the hospitals.  She explained fetal alcohol syndrome is a difficult diagnosis to make and needs to be correctly recorded.

 

Chairman Rawson recommended that as problems surface we should be pro-active about handling them.  Ms. Wright agreed.  Senator Schneider mentioned a newspaper article concerning a connection between folic acid and heart disease.  He suggested the Nevada Birth Defects Registry work with the American Heart Association. 

 

Lesley Pittman, Lobbyist, March of Dimes, voiced support of the Nevada Birth Defects Registry.  Reading from prepared testimony (Exhibit F), she pointed out the mission of the March of Dimes is to improve the health of babies by preventing birth defects and infant mortality.  Ms. Pittman congratulated the Nevada legislators for their leadership in establishing the Nevada Birth Defects Registry and the Family Health Services for securing CDC funding.  She acknowledged the efforts of the state and the University of Nevada School of Medicine in establishing the registry and the Centers for Disease Control and Prevention. 

 

Ms. Pittman emphasized the need for further state funding beyond the start-up funding already received because the Birth Defects Registry has relied on federal grant monies and there is no guarantee that those funds will continue.  She expounded on the effects that a fully operational surveillance system in Nevada would have on birth defects.

 

Chairman Rawson queried the timing of the expiration of the CDC funding.  Ms. Wright replied the Birth Defects Registry funding expires at the end of 2002.  Chairman Rawson asked Ms. Wright if we were funded until 2003.  She answered they were not.  He requested the Birth Defects Registry submit an estimate of the funding necessary to continue the operation of the registry through the biennium. 

 

Ms. Pittman elucidated that the CDC has indicated they will choose 8 states for continued funding from among the 18 states that have instituted a birth defect registry.  Chairman Rawson voiced optimism about receiving the funding, but stated even partial funding would be helpful. 

 

Colleen A. Morris, M.D., Department of Pediatrics, Division of Genetics, University of Nevada School of Medicine, provided written testimony (Exhibit G) on the objectives of a birth defects monitoring program and future directions and suggestions to enhance the effectiveness of the Nevada’s Birth Defects Registry.  She reiterated support for the importance of the continuation of the registry.  Chairman Rawson asked if there are services available to treat the children with these diseases.  Dr. Morris stated the medical community is equipped to handle the individual treatment of such children, but a coordinated effort is needed.  She highlighted access to care, barriers to care, and location within the state as obstacles. 

 

Chairman Rawson noted that special children’s clinics have waiting lists.  Dr. Morris agreed and stated the clinics are a key player and in some instances the only access for genetics evaluation.  Chairman Rawson asked if midwives had to report birth defects.  Dr. Morris responded that most midwives work with a physician.  Chairman Rawson questioned how the information could be obtained if a baby is born at home.  Dr. Morris answered only if the birth defect is listed on the birth certificate or if the child is brought into a reporting unit later.  Chairman Rawson recommended looking into the issue to determine if a reporting requirement is necessary. 

 

Tina Marie Phyfer, Research Coordinator, Department of Obstetrics and Gynecology, University of Nevada School of Medicine, spoke in support of the Birth Defects Registry and provided written testimony (Exhibit H).  She said the department has received a small grant to collaborate with the State of Nevada and initiate a research and prevention project to enhance A.B. 238.  Ms. Phyfer listed prenatal data, prenatal events, and environmental exposure as it relates to the defect of the child as examples of data they collect.  She explained that when providers notify their hotline, they respond within 48 hours; and subsequently conduct an interview with the family.  Ms. Phyfer pointed out that education is provided to the family about folic acid, a child’s birth defect specifically, and the general number of birth defects.  She emphasized that future funding is vital to the continued existence of the registry and the formation of an official birth defects advisory board. 

 

Ms. Phyfer listed three advantages to officially incorporating the Department of Obstetrics and Gynecology, Division of Research with the Birth Defects Registry.  She noted, as a single entity it could develop or participate in local and national studies that investigate and identify preventable causes of birth defects; unification would enhance funding opportunities; and would be a collection of professionals dedicated to the appropriate utilization of the Birth Defects Registry.

 

Chairman Rawson opened the hearing on Senate Bill (S.B.) 135 and introduced Senator Terry John Care, Clark County Senatorial District No. 7. 

 

SENATE BILL 135:  Makes various changes concerning veterans’ homes. (BDR 37-1032)

 

Senator Care stated the purpose of S.B. 135 is to create the position of administrator of the Nevada Veterans’ Nursing Home, and allow the executive director to appoint that position.  He explained the administrator of the veterans’ home must be licensed as a nursing facility administrator, and the bill would permit the administrator to manage the money deposited in the veterans’ home account, but only for the purposes currently allowed by law.  Senator Care said S.B. 135 allows the money received from the sale of veterans license plates to be put into the gift account and if money is left, it would remain in the gift account, and not revert to the General Fund.  He said an amendment to S.B. 135 is needed to include in the gift account the exemptions veterans sign off on such as the property tax and legal privilege tax. 

 

Jonathan R. Sias, Director, Nevada Veterans’ Nursing Home, Office of Veterans’ Services, testified the intent of S.B. 135 is to honor decisions of veterans to make a gift by purchasing their veterans license plates, or by taking advantage of their veterans’ exemptions and paying the full tax and having the exempted amount go to the nursing home. 

 

Ed Gobel, Lobbyist, Council of Nevada Veterans Organizations, voiced support for the basis of S.B. 135.  However, he stated his opposition to and requested the deletion of language on lines 48 and 49 on page 2, and lines 1, 2, and 3 on page 3 of S.B. 135.  Mr. Gobel reasoned, the language proposed in S.B. 135 would create a new position requiring a higher salary then is presently needed because another veterans’ home would not be constructed for some time and the money could be put to better use. 

 

Charles W. (Chuck) Fulkerson, Executive Director, Office of Veterans’ Services, rebutted portions of Mr. Gobel’s testimony.  He said Mr. Gobel said the bill’s use of the term “administrator” creates a new position.  Mr. Fulkerson stated it is not the intent to create a new position, but to change the “terminology of the existing one.”  He further explained that the objective was not to automatically allow the present director of the southern Nevada veterans’ home to gain control of future veterans’ homes.  Mr. Fulkerson noted it was his understanding that each nursing home would be separate and each director would report to the executive director. 

 

Mr. Sias suggested pluralizing the term “administrator” in lines 48 and 49 on page 2, and lines 1, 2, and 3, on page 3, of S.B. 135, to account for future veterans’ homes.  He opined the language pursuant to having an application pending before the State Board of Examiners should remain because of the reciprocity from one state to another. 

 

Chairman Rawson closed the hearing on S.B. 135. 

 

Jack McLaughlin, Superintendent of Public Instruction, Department of Education, introduced the “State Department of Education Status Report” (Exhibit I.  Original is on file in the Research Library.), and the “Superintendent’s Report to the Governor and Legislature” (Exhibit J.  Original is on file in the Research Library.).  Mr. McLaughlin said his report is based on what he has observed and the areas in education that need to be pursued.  Mr. McLaughlin stated a top priority to move forward is to recruit, train, and retain qualified staff.  He said the student population is projected to grow from 250,000 students in 1995, to 515,346 in 2010. 

 

Mr. McLaughlin referred to pages 12 through 30, titled the “Research Bulletin”, as the statistical portion of the report (Exhibit I).  He said, on page 2 of the report are listed the strengths of the staff whom he defined as a hard-working and dedicated staff serving K-12 education.  Mr. McLaughlin commended the individuals employed in the department for their knowledge, professional skill, numerous accomplishments, and their positive attitudes, and remarked about the helping approach they have dealing with the public.  He stated there is an outstanding public school system in place even though they are operating in a crisis scenario in Clark County because of the growth in that area.  Mr. McLaughlin praised the Legislature for their optimism and leadership in putting in place the funding, programs, and training that was necessary for education. 

 

Continuing his testimony, Mr. McLaughlin outlined the challenges that need to be addressed.  An area of concern for him was to observe if the direct services to students were being provided where the majority of the population exists.  He mentioned his goal is to spend 1 day per week in Las Vegas to work with staff and the community on various projects.  Pointing out that the team concept may not be the most efficient way to organize staff, Mr. McLaughlin referred to page 58 of the “Superintendent’s Report to the Governor and Legislature” (Exhibit J), stating there are not many state-funded staff members and there is a need for a more hands-on structure. 

 

Mr. McLaughlin said that communication is another challenge.  He said there is a need to improve communications between the Department of Education, the Governor, state agencies, the Legislature, the school districts, and the general public.  Mr. McLaughlin claimed said there is no formal mechanism in place for that to occur on a regular basis. 

 

Mr. McLaughlin assessed there is a perceived attitude that the department is nonresponsive and almost “passive aggressive” on some issues.  He stated another challenge for him is resource development.  Mr. McLaughlin explained there are funding opportunities available and acknowledged that staff go beyond their responsibilities to bring in other monies to the department.  In the area of research, he noted the department works with data but does not go beyond that point.  He referred to a letter from the University of Nevada, Reno, pages 49, 50 and 51 of the education status report (Exhibit I), which speaks to the issue of grant activity. 

 

Mr. McLaughlin stated there is no hands-on mechanism to monitor items regarding classroom instruction such as textbook or curriculum issues; but there are monitoring systems for federal projects, special education, and other sorts of funding areas.  Mr. McLaughlin said another challenge is in the assessment area where the department has not requested funding to implement the social studies portion of the Criterion Reference Test at the third- and fifth-grade levels, as per NRS 389.550.  He noted legislators have indicated delaying the testing, but there has not been enabling legislation to modify NRS 389.550 to allow that to happen.  

 

Mr. McLaughlin addressed his next challenge concerning the Statewide Management of Automated Record Transfer (SMART).  He said it is a state system that will not be in full operation until 2003, and will require continued funding.

 

The next area of challenge that Mr. McLaughlin noted was, “relevance to student population.”  He stated there are many major areas of concern, such as  the special needs of English-language learners.  He also mentioned the special needs and issues related to race, poverty and class will continue and must be addressed.  Continuing, Mr. McLaughlin praised the achievement of the 26 students who were National Merit Semi-finalists and the 10 students who earned National Merit Scholarship status last year, but pointed out that there needs to be more attention given to that type of student.  He noted there is not a single, funded department employee position dealing with Gifted and Talented Education.

 

Mr. McLaughlin touched on the quandary of local control versus state control, meaning local schools and districts do something a certain way without any defined statutory authority.  His next area of challenge was what he termed the fragmentation of K-12 education decision-making. Mr. McLaughlin stated what is needed is a state master plan for K-12 education.

 

Mr. McLaughlin, referring to pages 9, 10, and 11 of the education status report (Exhibit I), listed 14 short-term and 6 long-term tasks that he will be recommending to the State Board of Education.

 

Chairman Rawson asked if we should be considering a K-16 program versus a K-12 program of education.  Mr. McLaughlin answered in the affirmative.  He pointed out there is a post-secondary arm to the present K-12 system, but said we should be looking into a seamless model of education.  Chairman Rawson suggested Mr. McLaughlin confer with the committee staff analyst and discuss the possibilities of such a program. 

 

Senator Washington queried Mr. McLaughlin about his concepts on department consolidation and the “team” approach.  Mr. McLaughlin reiterated his desire to have a hands-on approach to education.  He expounded on his philosophy of examining what is presently in place and getting the most out it.  Senator Washington questioned whether there were efficiencies that the Department of Education could pursue.  Mr. McLaughlin responded by noting compliance is an area to consider, and looking for efficiencies and then aligning the responsibilities of the department. 

 

Dr. John Gwaltney, Member, State Board of Education and State Board for Occupational Education, testified the board members are committed to ”continuing and expanding the credibility of the Department of Education and the level of education and its excellence in the State of Nevada.”  He said he would be serving as cochairman of the legislative committee along with Theresa Malone.

 

Theresa Malone, Member, State Board of Education and State Board for Occupational Education, commended the committee on their hard work and dedication to the education of Nevada’s children. 

 

 

Chairman Rawson adjourned the meeting at 3:03 p.m.

 

RESPECTFULLY SUBMITTED:

 

 

 

Patricia Di Domenico,

Committee Secretary

 

 

APPROVED BY:

 

 

 

                       

Senator Raymond D. Rawson, Chairman

 

 

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