MINUTES OF THE
SENATE Committee on Human Resources and Facilities
Seventy-First Session
March 28, 2001
The Senate Committee on Human Resources and Facilitieswas called to order by Vice Chairman Maurice Washington, at 1:30 p.m., on Wednesday, March 28, 2001, in Room 2135 of the Legislative Building, Carson City, Nevada. The meeting was video conferenced 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 Maurice Washington, Vice Chairman
Senator Mark Amodei
Senator Bernice Mathews
Senator Michael Schneider
Senator Valerie Wiener
COMMITTEE MEMBERS ABSENT:
Senator Raymond D. Rawson, Chairman (Excused)
Senator Randolph J. Townsend, (Excused)
GUEST LEGISLATORS PRESENT:
Assemblyman Lynn C. Hettrick, Douglas County and Carson City Assembly District No. 39
Senator Bill R. O’Donnell, Clark County Senatorial District No. 5
STAFF MEMBERS PRESENT:
H. Pepper Sturm, Committee Policy Analyst
Cynthia Cook, Committee Secretary
OTHERS PRESENT:
Alexander Haartz, Deputy Administrator, Health Division, Department of Human Resources
Mary C. Walker, Lobbyist, Carson City
Robin Keith, Lobbyist, Nevada Rural Hospital Project Foundation
Caroline Ford, M.P.H., Director, Office of Rural Health, University of Nevada, School of Medicine
James L. Wadhams, Lobbyist, Nevada Hospital Association
John Berkich, City Manager, Carson City
Tom Metcalf, Trustee, Carson-Tahoe Hospital
Carol Broersma, Concerned Citizen
Keith Thomas, Concerned Citizen
Frank Keane, Concerned Citizen
Lynn Tynan, Concerned Citizen
Keen Stacy, Concerned Citizen
Mildred Wendt, Concerned Citizen
Jim Bandy, Concerned Citizen
Mitzi Price, Concerned Citizen
Harriet Evans, Concerned Citizen
Lorri J. Ahlm, Concerned Citizen
Livi Bandy, Concerned Citizen
George Ragsdale, Concerned Citizen
John Barwiske, Concerned Citizen
Vice Chairman Washington called the meeting to order, and announced that Senate Bill (S.B.) 328 would be the first item to be heard.
SENATE BILL 328: Revises provisions regarding requirement to obtain prior approval of certain expenditures for new construction by or on behalf of health facilities in certain counties. (BDR 40-408)
Alexander Haartz, Deputy Administrator, Health Division, Department of Human Resources, testified presently the Department of Human Resources is responsible for conducting a review and approving certain new construction by or on behalf of a health facility in a county whose population is less than 100,000. He stated the department has submitted this bill with the intent of providing those counties with a population of less than 100,000 the ability to perform this review and approval process themselves. Mr. Haartz noted the department has had discussions with representatives of the counties to provide greater clarification of responsibilities, and is supportive of the suggested amendments.
Mary C. Walker, Lobbyist, Carson City, testified the intent of S.B. 328 is to allow the counties to take over the Certificate of Need (CON) process. She said the proposed amendment (Exhibit C) answers some questions and concerns the Department of Human Resources had. Ms. Walker said Carson City has decided to go ahead with a pilot program, with the help of the University Of Nevada Office of Rural Health, and the Department of Human Resources. She stated fees collected for the assessment process will be based upon the actual costs involved, and there is a requirement for the applicants to provide a description of their commitment to serve the medically indigent and uninsured. Ms. Walker said Carson City would like to start the pilot process July 1, 2001, and the proposal is consistent with the Governor’s fundamental review program of moving various types of services from state to local government.
In answer to a query by Vice Chairman Washington, Mr. Haartz stated the Department of Human Resources agrees with the pilot project, and Carson City was chosen because they have expressed the most interest.
Robin Keith, Lobbyist, Nevada Rural Hospital Project Foundation, expressed the foundation’s approval of the project, noting the foundation has been interested in such a measure for some time.
Caroline Ford, M.P.H., Director, Office of Rural Health, University of Nevada School of Medicine, testified the office is motivated to become involved in the project and foresees the positive economic impact of bringing new services to the rural areas. She stated the office has a history of looking at modes of delivery of health services in the rural counties for the past 25 years, along with trying to look for the things that work best for the rural counties.
Responding to Senator Wiener, Ms. Ford said the Office of Rural Health is working on behalf of the University of Nevada for the implementation of tele-medicine [the use of telecommunications and computer technologies with medical expertise to facilitate remote healthcare delivery], and the rural clinics, with the exceptions of Tonopah and Owyhee, are using it. She continued, the system works by appointment and in the near future there will be an automated scheduling system. Ms. Ford said the physician on the consulting end would be scheduled in 20-minute slots, and Medicare has made adjustments in reimbursements to make it economically more viable to the clinics.
Vice Chairman Washington asked Ms. Ford to submit any impact studies to staff for review. He also added the bill will be amended to assure there are reporting requirements, and an effective date for the regulations.
Ms. Walker said S.B. 328 has an effective date of July 1, 2001, and would like that to remain.
James L. Wadhams, Lobbyist, Nevada Hospital Association, and John Berkich, City Manager, Carson City, and Tom Metcalf, Trustee, Carson-Tahoe Hospital, testified they support S.B. 328, and the pilot program for Carson City.
Vice Chairman Washington closed the hearing on S.B. 328 and opened the hearing on Assembly Bill (A.B.) 12.
ASSEMBLY BILL 12: Revises provisions governing issuance of supplementary certificates of birth by state registrar of vital statistics. (BDR 40-458)
Assemblyman Lynn C. Hettrick, Douglas County and Carson City Assembly District No. 39, described A.B. 12 as significant legislation he wished to sponsor.
Carol Broersma, Concerned Citizen, described the excessive complexity she and her husband went through in order to obtain a birth certificate for the son they adopted from Liberia. She continued, there are thousands of children who have no record of birth from their native countries, and since Liberia was involved in a civil war at the time of the adoption, they were allowed to seek adoption-by-proxy through the neighboring country of Cote d’Ivoire. Ms. Broersma said in order to finalize the adoption and obtain a Nevada birth certificate, they went to the registrar of vital statistics, where they were refused because the African evidence for their son was in French, and a birth record could only be issued if the evidence of birth was in his native tongue, which is English. Currently, there are no allowances for children born in a country that has no working relationship with the United States.
Vice Chairman Washington commented the members of the committee were certainly unaware of the circumstances described by Ms. Broersma.
Assemblyman Hettrick added the Governor’s office tried to intervene on behalf of the Broersmas, to no avail. He said Judge David R. Gamble, Department 1, Ninth Judicial Court, issued a court order and the birth certificate was then obtained. Assemblyman Hettrick added A.B. 12 would fix the portion of the law concerning foreign adoptions, and clarify the language.
Mr. Haartz said the Health Division supports A.B. 12 and the legislation will allow foreign-born children to obtain birth certificates based on the adoption decrees. He said the information on the new birth certificate would show the child’s country of birth, date of birth, and adoptive parents’ names, thus enabling the child to register for school, participate in sports, and satisfy any other legal need for a certified birth certificate.
Vice Chairman Washington closed the hearing on A.B. 12 and opened the hearing on A.B. 14.
ASSEMBLY BILL 14: Increases compensation of members of certain boards of hospital trustees for rural county hospitals. (BDR 40-845)
Assemblyman Hettrick testified that A.B. 14 was developed at the request of certain hospital boards in order to increase the current $60 stipend per meeting to $85 for the chairman and $80 for the other members. He added under the bill, the hospitals would also be able to offer health insurance, if desired. Assemblyman Hettrick asserted the bill would help promote more civic-minded people to be active in the administration of rural hospitals.
Ms. Walker said the stipend has been increased just one time in the past 20 years, and the increase also falls in line with amounts members of other boards receive. Ms. Keith added her approval of A.B. 14 on behalf of the Nevada Rural Health Project Foundation.
Vice Chairman Washington closed the hearing on A.B. 14 and opened the hearing on S.B. 319.
SENATE BILL 319: Provides for licensing and regulation of halfway houses for alcohol and drug abusers as facilities for dependent and repeals requirements for certification of operators of such halfway houses. (BDR 40-1211)
Senator Bill R. O’Donnell, Clark County Senatorial District No. 5, stated he brought this measure forward along with Senator Ann O’Connell, Clark County Senatorial District No. 5. He summarized the problem, stating in Las Vegas there has been a clustering of halfway houses in one area of town, and it has had a chilling effect on the quality of life in the neighborhood. He said S.B. 319 deletes from the law those statutes dealing with certification, and puts into place a licensing procedure, which will assure every county code, including zoning, is adhered to. Under present county housing authority zoning regulations, the halfway houses cannot be closer than 660 feet to another group-home, and a proposed assembly bill will ask this be changed to 1500 ft. According to Senator O’Donnell, this will curb the clustering problem in Clark County.
Vice Chairman Washington asked Senator O’Donnell if the responsibility would then lie with the county to assure the halfway homes are not clustered. Senator O’Donnell said the county zoning department would enforce an ordinance stating the homes cannot be closer than 660 feet. Upon passage of S.B. 319, the existing homes will be required to apply for a license and some will have to move.
Mr. Haartz testified the present certification process does not extend to inspecting a facility for compliance with Life Safety Code Standards according to federal regulations, and S.B. 319 would bring halfway houses for alcohol and drug abusers under a requirement whereby they must meet all applicable local zoning requirements prior to being licensed by the state. In answer to Vice Chairman Washington, Mr. Haartz clarified the Bureau of Alcohol and Drug Abuse (BADA) would continue to handle the treatment aspect, while the Bureau of Licensure and Certification would manage the licensing. Both entities are within the Health Division, Department of Human Resources.
Senator Wiener asked if there would continue to be some mechanism for BADA to provide treatment programs if the halfway house requested it. Mr. Haartz said BADA is responsible for approving programs, and a halfway house could apply to BADA for programmatic certification.
Keith Thomas, Concerned Citizen, stated he sits on the board of trustees for a halfway house. He said he supports halfway houses, and considers them the best approach to serve the community. Mr. Thomas noted the houses receive no taxpayer funds and are self-supporting.
Vice Chairman Washington said he believes the bill would “uncuff” the hands of the city and county to “uncluster” the halfway houses.
Frank Keane, Concerned Citizen, testified he is associated with Silkworth House, which is a halfway house that takes residents from all agencies, including the courts. He said there is no funding of any type from any agency. The resident, who must get a job immediately, makes payment, must participate in a 12-step program, and commit to a 90-day stay. There is an interview and screening process for all applicants. Mr. Keane said the focus is on long-term recovery, and there are many volunteers who are former residents. He concluded the profits for halfway houses are marginal, and there should be further discussion on S.B. 319.
Lynn Tynan, Concerned Citizen, testified on behalf of the Nevada Women’s Coalition of Recovery Homes. She said the residents in the halfway houses have been through detoxification, are sober and drug free, and should not be referred to as alcohol and drug abusers. She stated the houses are actually “sober living homes.” Ms. Tynan questioned why the homes were not consulted when S.B. 319 was formulated, and would like there to be further discussion on the bill.
Vice Chairman Washington informed Ms. Tynan the target of the bill is to eliminate clustering, not to eliminate group homes. Ms. Tynan responded there is no mention at all of clustering in S.B. 319.
Keen Stacy, Concerned Citizen, testified in support of the bill. He said there are four group homes in his neighborhood presently, and he believes the minimum distance between the homes should be 2,500 feet.
Mildred Wendt, Concerned Citizen, asked why the “sober living” homes need to be regulated by the Health Division? She said, since the residents are clean and sober, and no public funding is used for the homes, they should not be regulated in this respect. She encouraged further discussion on the bill.
Jim Bandy, Concerned Citizen, testified he has heard discrepancies today concerning halfway houses. He claimed some homes exist for the purpose of rehabilitating alcoholics and drug addicts, and others exist for the express purpose for making money and clustering.
Mitzi Price, Concerned Citizen, told the committee as a recovering alcoholic, she feels prejudiced against today. She pointed out that approximately 80 percent of the population has been affected, one-way or another, by alcoholism. In answer to Vice Chairman Washington’s comment this bill is not an attempt to vilify anybody, Ms. Price stated there simply is no need for any additional regulations.
Senator O’Donnell stated some people have misconceptions about what this bill really does. Technically every halfway house must be certified under chapter 458 of Nevada Revised Statutes(NRS). He continued S.B. 319 deletes current regulations and puts into place a licensing process that will require each home to be licensed instead of certified. The bill will allow the state to assure all regulations, including zoning regulations, are strictly adhered to, and it is in this manner clustering will be addressed.
Harriet Evans, Concerned Citizen, told the committee when she purchased her home she thought the neighborhood was entirely residential, and believes the density of the halfway homes is overdone. She told of many people coming to the halfway homes and leaving within a short time, which gives the neighborhood a transient quality.
Lorri J. Ahlm, Concerned Citizen, stated she was probably to blame for the issue on clustering, which was not her intent. As the operator of Easy Living Halfway House, she said she has always adhered to the 660-foot limitation between houses. Ms. Ahlm said she is trying for one more house, 529 feet from the nearest facility, and she has applied for a special use permit. She noted her facilities are run with rules and regulations, and the clients sometimes stay over a year. She repeated she has tried to follow all known ordinances along the way, and these homes offer a phenomenal opportunity to help people integrate back into the community.
Livi Bandy, Concerned Citizen, testified as a homeowner in the neighborhood she would like to see S.B. 319 passed because it will give those concerned the ability to go to the Bureau of Licensure and Certification, Department of Human Resources, when there are questions or complaints.
George Ragsdale, Concerned Citizen, stated he believes the houses should be no closer than 2500 feet apart; and it is his opinion that the current operators have followed all the rules and regulations. He said he would like to see more representation in the meetings.
John Barwiske, Concern Citizen, testified there should be a list available for people to access of all halfway houses. He said if all the houses were registered, anybody could look on the Internet.
Senator O’Donnell asked the audience to please send a facsimile to him for those who did not receive an opportunity to testify.
Vice Chairman Washington closed the hearing on S.B. 319, and adjourned the meeting at 3:00 p.m.
RESPECTFULLY SUBMITTED:
Cynthia Cook,
Committee Secretary
APPROVED BY:
Senator Maurice Washington, Vice Chairman
DATE: