MINUTES OF THE
SENATE Committee on Human Resources and Facilities
Seventy-First Session
April 11, 2001
The Senate Committee on Human Resources and Facilitieswas called to order by Chairman Raymond D. Rawson, at 1:55 p.m., on Wednesday, April 11, 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
STAFF MEMBERS PRESENT:
H. Pepper Sturm, Committee Policy Analyst
R. René Yeckley, Committee Counsel
Cynthia Cook, Committee Secretary
OTHERS PRESENT:
Carl R. Cahill, Division Director, Environmental Health Services Division,
District Health Departmfent, Washoe County
Alfredo Alonso, Lobbyist, California/Nevada Soft Drink Association
Paul Larsen, Attorney, Nevada Beverage Company
Linville Jorde, Industrial Medical Group
Daniel Maxson, Supervisor, Environmental Health Division, Health District,
Clark County
Glen Savage, Supervisor, Environmental Division, Health District, Clark County
Paul Klouse, Supervisor, Environmental Division, Health District, Clark County
Gary E. Millikin, Lobbyist, American Medical Response
Neal Marek, D.P.M., Concerned Citizen
Janice C. Pine, Lobbyist, St. Mary’s Health Network
Philip F. Weyrick, Administrative Services Officer III, Health Division, Department of Human Resources
Marie H. Soldo, Lobbyist, Nevada Association of Health Plans
Jonathan W. Bunker, President, Health Plan of Nevada
Robert A. Ostrovsky, Lobbyist, Nevadans for Affordable Health Care
James J. Spinello, Lobbyist, Clark County
Kami L. Dempsey, Lobbyist, Las Vegas Chamber of Commerce
Bill M. Welch, Lobbyist, Nevada Hospital Association
Fred L. Hillerby, Lobbyist
Robert Barengo, Lobbyist, Sunrise Hospital and Medical Center
Chairman Rawson opened the hearing on Senate Bill (S.B.) 352.
SENATE BILL 352: Excludes wholesale dealer of nonalcoholic beverages from regulation as food establishment. (BDR 40-1489)
Carl R. Cahill, Division Director, Environmental Health Services Division, District Health Department, Washoe County, testified the bill does not appear to have much consequence in terms of public health, and could erode the surveillance segment of public health duties. He said Washoe County Health District opposes the bill, and it seems to be an issue between The Coca Cola Bottling Company in Clark County and the Clark County Health District.
Chairman Rawson said the bill seems to deal with requirements for a food handler’s health card, and a strong case can be made for anyone who works with open containers.
Mr. Cahill responded the issue is a local one in Clark County. He said the premise is you exempt a certain group of food products from surveillance. Mr. Cahill explained in warehouse situations where there may be rat infestations, or specific hazards, a certain level of surveillance is required, and the determination of what that ought to be is made at the local level.
In answer to Chairman Rawson, Mr. Cahill said the bill specifies non-alcoholic beverages, which can include soda pop, milk, or fruit juices. He agreed with Chairman Rawson that milk is covered elsewhere in the law, and said fruit juices are also. He informed Chairman Rawson there is a fee charged in Clark County for a food handler’s health card, but not in Washoe County, although warehouses are still inspected. Mr. Cahill agreed there needs to be warehouse surveillance on a statewide basis.
Alfredo Alonso, Lobbyist, California/Nevada Soft Drink Association, told the committee there are some misconceptions about the bill, and it specifically does not change existing regulations. He continued saying S.B. 352 would exempt the premises of a wholesale dealer of non-alcoholic beverages from regulation as a food establishment, just as beer is already exempted. He added, Los Angeles and Orange Counties do not require a health card, or does any other jurisdiction in the country to his knowledge. Mr. Alonso said the costs involved for the issuance of a food handler’s health card include training, vaccinations, and the certification of employees.
Chairman Rawson said the way the bill is written, it does not stop surveillance. Mr. Alonso agreed it puts non-alcoholic beverages in the same category as beer and alcoholic beverages.
Paul Larsen, Attorney, Nevada Beverage Company, testified the changing of the definition of food establishment is in order to agree with legislation passed in 1983. He said since 2000, food handlers’ health cards have been required of any person employed in or operating a food establishment, and the Clark County Health District is now requiring anybody who works in a warehouse to have a food handler’s health card, including forklift drivers. Mr. Larsen said the association has explained to the district the legislative opinion by Frank W. Daykin, former Legal Counsel, Legal Division, Legislative Counsel Bureau, stated the purpose of requiring permits for food establishment is to assure safe food service, avoid the sale of potentially hazardous food, and prevent any other eminent health hazards. Mr. Larsen asserted the opinion went on to say a wholesaler of sealed bottles does not appear to implicate any of those concerns, therefore, a wholesaler who only stores and moves sealed products need not be regulated as a food establishment.
Chairman Rawson commented the legislative opinions of Mr. Daykin were considered absolute. He asked Mr. Larsen how many employees this clarification will impact. Mr. Larsen answered he was not sure, but the financial impact for the Coca Cola Company would be about $30,000 per year. Chairman Rawson then asked if the company or the worker would pay for the food handler’s health card. Mr. Larsen responded it could be passed on to either, but if the worker did not have a card the company would be in violation.
Linville Jorde, Industrial Medical Group, stated as an observer to the Coca Cola warehouse he has seen nothing but sealed containers, and does not believe there is any necessity for a food handler’s health card.
Chairman Rawson inquired if retail sales employees are required to have the cards. Mr. Larsen responded in the affirmative, and added the regulations in California require cards only when the beverage is put into the container, and again when it reaches the retail market.
Mr. Alonso interjected the types of employees involved here do not touch the individual cans. He said they are warehouse supervisors, sales and marketing personnel, and forklift operators.
Daniel Maxson, Supervisor, Environmental Health Division, Health District, Clark County, testified all food warehouses have a potential to create health problems. He said Clark County has encountered many problems, and enforcement has not been uniform over the past 18 to 20 years. Mr. Maxson added the Clark County Health Division began administering Hepatitis A vaccine to all food handlers beginning in 1999, and for any program to be effective all should be immunized. In January of 2000, the district decided to include prepackaged beverage warehouses in the program, he added. Mr. Maxson said the division believes major wholesale food distributors, supplying only prepackaged food to hotels and casinos, will follow suit if this bill is to pass.
Mr. Maxson stated S.B. 352, as currently written, would not only remove the need for health cards but would prevent the regulation of this type of facility by any health authority in the state of Nevada. He said the goal of the Clark County Health Division remains the reduction of Hepatitis A and other food borne diseases on a permanent basis.
In answer to Senator Mathews, Mr. Maxson said the division has been responsible for issuing food handler’s health cards since 1963, but has not forcefully enforced this on a consistent basis. He added with the Hepatitis A vaccine program, and a new health officer on board, the division is now pursuing this. Mr. Maxson responded to Senator Mathews indicating the fee for the card is $30 for 3 years.
Glen Savage, Supervisor, Environmental Division, Health District, Clark County, informed the committee, Arizona and San Diego are some areas, which have references in their ordinances requiring health cards. He stated this is not about forklift operators or office workers, and there is a possibility they could be exempt from getting health cards. Mr. Savage said significant health issues have been found in inspections, and individuals need training.
Mr. Maxson reported on a visit to a Coca Cola warehouse, employees were observed outdoors using a galvanized wash trough and no chlorinated water to clean off a sticky product. He said, occasionally, 6-packs and 12-packs of soda are repackaged, and the containers need to be properly washed so the customer gets a clean and sanitary product.
Paul Klouse, Supervisor, Environmental Division, Health Division, Clark County, said this seems to be a discussion of food handler versus food establishment, whereas the division understood this was to be about the definition of a food handler. He added, under the bill, the warehouses would be eliminated from regulation, which is not in the best interest of public health.
Senator Rawson closed the hearing on S.B. 352.
SENATOR WASHINGTON MOVED TO DO PASS S.B. 352.
SENATOR MATHEWS SECONDED THE MOTION.
THE MOTION CARRIED. (SENATOR TOWNSEND WAS ABSENT FOR THE VOTE.
*****
Chairman Rawson opened the hearing on S.B. 483.
SENATE BILL 483: Requires state board of health to license mobile medical facilities. (BDR 40-1482)
Gary E. Millikin, Lobbyist, American Medical Response, introduced Neal Marek, D.P.M., Concerned Citizen, who requested the bill.
Dr. Marek explained he has had a clinic located in Pahrump for 10 years. He continued, in many cases he had to send patients to Las Vegas for additional treatments, which were not available in the rural area and entailed expense to the patient or the family. He explained the use of mobile units, which are large trailers that can be moved from site to site, and could provide care to underserved areas. Dr. Marek stated some units have been in practice for many years, including dental, mammogram, and others. Additionally, he pointed out, the units can be utilized for emergency disaster use and prisons, which could potentially reduce expenses.
Chairman Rawson asked Dr. Marek if the purpose of the bill is to allow for billing for Medicare and Medicaid services or various insurances plans. Dr. Marek said it would allow for accreditation and reimbursement. Chairman Rawson noted, presently, dental vans are not considered to be a medical facility and do not require licensing. Dr. Marek said there are no additional regulations requested in the bill.
Mr. Milliken explained an amendment would be suggested to clarify the chairman’s inquiry.
Janice C. Pine, Lobbyist, St. Mary’s Health Network, presented an amendment which will add the language “and if the mobile unit is operated by a licensed medical facility that is accredited by the Joint Commission on Accreditation of Healthcare Organizations or the American Osteopathic Association, the bureau is not required to make an annual on-site inspection of the mobile unit” on page 2, line 29 of the bill, after the word “location.”
Chairman Rawson expressed his concern, stating currently dental offices are not regulated in such a way, and so a mobile dental office should not be regulated. He asked Ms. Pine and Mr. Milliken if they would object to language stating if under normal operation such regulations were not required, they would not be required for mobile operations. Ms. Pine and Mr. Milliken said they had no objections.
Philip F. Weyrick, Administrative Services Officer III, Health Division, Department of Human Resources, testified the bill requires the division to license mobile medical facilities, and establish regulations. He estimated there would be costs of approximately $5000, and the division will establish fees to cover the costs.
SENATOR MATHEWS MOVED TO AMEND AND DO PASS S.B. 483.
SENATOR SCHNEIDER SECONDED THE MOTION.
THE MOTION CARRIED. (SENATOR TOWNSEND WAS ABSENT FOR THE VOTE.)
*****
Chairman Rawson opened the hearing on S.B. 484.
SENATE BILL 484: Revises provisions requiring major hospitals to reduce their billed charges for certain services. (BDR 40-1233)
Marie H. Soldo, Lobbyist, Nevada Association of Health Plans, stated after a presentation by Jonathan W. Bunker, President, Health Plan of Nevada, there would be some suggested amendments to S.B. 484.
Jonathon W. Bunker, President, Health Plan of Nevada, read prepared testimony (Exhibit C), a summary of the problems Health Plan of Nevada has encountered as a result of their members being diverted to a hospital, not under contract with the plan, in an emergency situation. He said S.B. 484 recommends the hospital bill for these services be limited to not more than 150 percent of the average daily operating revenue per inpatient of the hospital.
Ms. Soldo said the suggested amendment asks the average daily operating revenue be determined by the year-end report, which is required to be filed by the hospital with the Division of Health Care Financing and Policy, Department of Human Resources. She added the cause of diversions is a shortage of hospital beds in Clark County, and since there are a number of new hospitals planned for the county, the bill should expire in 2005. Ms. Soldo asserted the bill could be limited to health plans now receiving the home office tax credit Nevada Revised Statutes (NRS) 680B.050), including public and state health plans, and be limited to counties with a population of at least 400,000.
Chairman Rawson said, as a public policy, the legislature does not like to be involved in rate setting; however, in this case, the market circumstance makes this a public purpose. He asked Ms. Soldo if there were any concern about specifying this is only for patients who have been diverted in an emergency situation.
Ms. Soldo replied S.B. 484 does specify, “diverted emergency inpatient” on page 1, line 4 of the bill.
Chairman Rawson asked would most plans be contracted with one hospital or several? Ms. Saldo answered most plans contract with more than one hospital, and this issue is impacting premiums. She stated the association would be glad to report during the interim on the progress of this bill.
Ms. Soldo explained to Chairman Rawson Exhibit C includes the cover of a report each hospital is required to submit to the Division of Health Care Financing and Policy, Department of Human Resources. She added the report shows operating revenue, and it is 150 percent of this figure that S.B. 484 would authorize as payment for a diverted emergency inpatient.
Mr. Bunker said 150 percent of operating revenue represents more clearly what the hospital is actually running on, versus what they are billing.
Senator Wiener inquired if reporting during the interim would be a part of the amendments also?
Chairman Rawson requested the amendments include a requirement for a yearly report to the interim Legislative Committee on Health Care.
Senator Washington asked if Washoe County can be excluded from the bill, and Ms. Soldo said that would be no problem. Mr. Bunker added the divert situation occurs less frequently in the north, it is really a southern Nevada problem.
Robert A. Ostrovsky, Lobbyist, Nevadans for Affordable Health Care, advised the committee the membership is in favor of this bill, and would do anything to help.
James J. Spinello, Lobbyist, Clark County, testified a review of reports required by Clark County in order to monitor response time verifies the exceptions in response time is due to diverted emergency services. He said as recently as 1997 divert was seasonal, perhaps at the height of the flu season, and it now a constant throughout the year.
Chairman Rawson commented on the problem of divert, and said the legislature would like to do something to help improve the hospital environment for all personnel.
Kami L. Dempsey, Lobbyist, Las Vegas Chamber of Commerce, said the chamber members are in favor of S.B. 484.
Bill M. Welch, Lobbyist, Nevada Hospital Association, explained he would like to respond to comments made by some of the previous speakers. He said in the past, health care plans have not attempted to sign with every contractor in the area. Mr. Welch said daily revenue is driven by reimbursement, and Medicare and Medicaid compensation drives the average down. He also referred to the discounts hospitals give managed care plans. Mr. Welch read prepared testimony (Exhibit D) prepared by the association to explain why the association objects to S.B. 484, and urged the committee not to support the bill.
Fred L. Hillerby, Lobbyist, speaking for The Valley Health System, told the committee the discount the Legislature will impose with this bill is a benefit to those with home offices in Nevada, primarily Saint Mary’s Health Network, Hometown Health Plan, and Sierra Health Services Incorporated in Clark County. He asserted Sierra Health Service Incorporated has told hospitals if they do not like the contract being offered, do not sign it. Valley Hospital chose not to sign it, and now they are being told to set a rate. He continued saying the divert system is not contrived, hospitals are not benefiting from it, and the rate being recommended does not address the costs of emergency care. Mr. Hillerby described situations at Desert Springs Hospital; when they receive an emergency patient they are not always sure if it is because of divert, or because they are located the closest to the emergency. Mr. Hillerby alleged the payer will contend the patient is a divert, and how to resolve who is a divert patient has not been ascertained.
Chairman Rawson asserted the health plans do contract more exclusively with certain hospitals because they will get a better rate, and that is part of the marketplace. He said the divert situation is beyond the power of a health plan to control, and he had not heard any discussion today about setting a rate, which is an improvement over what is suggested in the bill.
Mr. Hillerby speculated the three hospitals in Clark County not contracting with Sierra Health Services Incorporated are the hospitals where most of the diverts are treated.
Chairman Rawson said again the unpredictable ingredient to this is the divert status of our hospitals, and the fact it is out of control.
Mr. Welsh said the highest cost center in a hospital is the emergency room, and using average daily operating revenue to set a rate does not make any sense.
Chairman Rawson stated if these hospitals contract with anybody at a daily rate of $2200 or less then this covers their average contracted rate.
Mr. Welsh said talk here has been about the divert situation being out of the plan’s control, but he would like the committee to be aware it is also out of the hospital’s control. He added all of the hospitals have expanded in the past five years to help meet the needs in Clark County.
Mr. Hillerby explained, in answer to a question by Chairman Rawson, if an indigent patient were diverted, if they were county-eligible and the hospital had met its free care requirement, the hospital would be reimbursed Medicaid rates. He added in the case of the three hospitals he represents, it is predictable to which hospitals the Sierra Health Services Incorporated diverts patients.
Senator Wiener said one of the pivotal factors in Mr. Hillerby’s concerns seems to be the home office tax credit, which singles out Sierra Health Services, Incorporated in southern Nevada. She asked what language would be agreeable to him.
Mr. Hillerby responded he does not have an amendment, but by suggesting only the health plans receiving the home office tax are to benefit from this bill is bad policy. He drew attention to the fact the health plans paying only one-half of the premium tax would receive the benefit; whereas the health plans paying the full premium tax to the state would receive no benefit. Mr. Hillerby maintained none of the health plans should benefit, because it is not the fault of the hospitals the divert situation developed.
Ms. Soldo said the submission of the amendment was intended for Nevada insurers or health plans that qualify, but, if the committee sees fit, all insurers could be included. She emphasized S.B. 484 is not intended for Sierra Health Services Incorporated, only, and should cover all payers; nor is it meant for any particular hospital, because all hospitals could one day sign a contract with the plan as agreements are rotated. Chairman Rawson interjected, the fact there is a limited number of beds helps to shape the marketplace.
Robert Barengo, Lobbyist, Sunrise Hospital and Medical Center, said, “If the scope of the bill is broadened to companies that should not partake of any policy benefit by being Nevada companies, then we would have some problems with it.”
Chairman Rawson closed the hearing on S.B. 484, and asked for a motion by the committee.
Senator Wiener asked for clarification on the home office credit. Chairman Rawson explained the way the bill was presented there was no limitation. He said an amendment would state the bill would be applicable to a Nevada insurer or health plan that qualified for the home office tax credit. Senator Wiener said from testimony heard today, that would be just one insurer in southern Nevada. Chairman Rawson said in addition to Sierra Health Service Incorporated it would probably include county and state health insurance.
Ms. Soldo added there are Nevada-domiciled insurers that do not have the home office credit, and there are Nevada-domiciled insurers that do have the home office credit.
Mr. Barengo said, “On behalf of Sunrise Hospital, we are not interested in supporting the county. They do not want to support us; we do not want to support them.”
SENATOR WASHINGTON MOVED TO AMEND AND DO PASS S.B. 484.
THE MOTION FAILED FOR LACK OF A SECOND.
*****
Chairman Rawson opened the hearing on S.B. 485.
SENATE BILL 485: Requires provider of health care to notify patient or certain other persons before destroying health care records of patient. (BDR 54-1232)
Mr. Hillerby stated that there are no people present to testify on the bill.
Chairman Rawson said he would not process the bill at this time since nobody is present to support it. He then opened the work session.
Pepper Sturm, Committee Policy Analyst, Research Division, Legislative Counsel Bureau, explained the handout titled Work Session Document April 11, 2001 (Exhibit E), first considers S.B. 73.
SENATE BILL 73: Requires state board of education to prescribe form for reports of parental involvement in education of children. (BDR 34-315)
Chairman Rawson called for a motion. There was no motion made. Chairman Rawson closed the hearing on S.B. 73, and opened the hearing on S.B. 289.
SENATE BILL 289: Makes various changes concerning responses to certain crises involving violence on school property, at school activities or on school buses. (BDR 34-200)
Mr. Sturm explained the proposed amendments for the bill under tab B of Exhibit E.
Senator Wiener said there is one additional proposed amendment regarding gifts grants, and donations she would like added to the bill. She said a ruling from Brenda Erdoes, Legislative Counsel, Legal Division, Legislative Counsel Bureau, (Exhibit F) states previous legislation mandated schools to develop a plan involving crises on school property, and, therefore, there would be no costs incurred for S.B. 289.
Mr. Sturm added a second proposed amendment is noted on page one of Exhibit E, to delete the requirement for school-level reports.
Senator Wiener said she would have trouble accepting that, based on the work of the Legislative Commission on School Safety and Juvenile Violence.
Chairman Rawson called for a motion on S.B. 289.
SENATOR WIENER MOVED TO AMEND AND DO PASS S.B. 289, WITH THE ADDITIONAL AMENDMENT PROPOSED BY SENATOR WIENER.
SENATOR AMODEI SECONDED THE MOTION.
THE MOTION CARRIED. (SENATOR TOWNSEND WAS ABSENT FOR THE VOTE.)
*****
Chairman Rawson called for discussion on S.B. 290.
SENATE BILL 290: Creates public corporation to establish and operate program of services for medically indigent population of Clark County. (BDR S-182)
Mr. Sturm explained the proposed amendments for the bill under tab C of Exhibit E.
SENATOR MATHEWS MOVED TO INDEFINITELY POSTPONE S.B. 290.
SENATOR WIENER SECONDED THE MOTION.
THE MOTION CARRIED. (SENATOR SCHNEIDER VOTED NO; SENATOR TOWNSEND WAS ABSENT FOR THE VOTE.)
*****
Chairman Rawson called for discussion on S.B. 291.
SENATE BILL 291: Makes various changes concerning reporting and investigation of certain violent or sexual offenses committed on school property, on school buses or at school activities. (BDR 34-199)
Mr. Sturm explained the proposed amendments for the bill under tab D of Exhibit E.
Senator Wiener said she noticed requirements are still in place for the school administrator to report any incidents in districts where there are no school police officers. Mr. Sturm stated there were comments by the school police in favor of the requirement.
Chairman Rawson asked the committee to consider using a number of bills as a vehicle for an in-depth interim study on the entire issue of school violence, and school police jurisdiction. He said his concern is to not change policy without all of the input, thought, and circumstances reviewed in order to have an orderly decision. He added interlocal agreements may be developed while the issues are being studied.
Senator Wiener said if this could be a vehicle for a more comprehensive look at public policy she favors such an idea. Chairman Rawson said he is not trying to cut the work of the commission out of the process, but he believes this should be done as a legislative study. Senator Mathews said she does not mind if the issues concerning jurisdiction are rolled into an interim study. Chairman Rawson said the idea of consolidating some of the police forces could also come out of the study.
Senator Washington agreed with Chairman Rawson and added the jurisdictions of the various policing forces should be clarified in such a study.
Chairman Rawson said he does not think it is in the best interest of the committee to be establishing different jurisdictions, territories, and bargaining units because of the potential for disputes; issues may be dropped and children hurt in the meantime. He asked Senator Wiener if she would mind if staff prepared a specific direction for this bill and bring it to the committee for work session. Senator Wiener said she was agreeable to the idea.
Chairman Rawson closed discussion on S.B. 291 and opened the discussion hearing on S.B. 302.
SENATE BILL 302: Revises certain provisions governing payment of hospital for serving disproportionately large share of low-income patients. (BDR 40- 962)
Mr. Sturm explained the proposed amendments for the bill under tab E of Exhibit E.
Chairman Rawson said as the committee looks at these subjects there is a fundamental policy issue of state versus local control. He questioned whether the Legislature should set the threshold rate (as is done in this bill) for defining disproportionate share of county indigent patients, or continue to allow the county commissioners to use its definition. He said the argument is confusing because the state has interjected itself by establishing a policy, which defines a certain number of people who have to be treated free. Chairman Rawson said he would like the term clarified and simplified.
Senator Washington said if the definition of disproportionate share were clarified it might set a level playing field for everybody.
Chairman Rawson agreed and stated the committee might have to set a date when this would take effect, so plans, contracts, et cetera, can be fulfilled without economic harm. He said another concern is whether local control should be balanced against the disproportionate share system. Chairman Rawson opined maintaining the current system, with University Medical Center receiving all the county indigent funds, results in cost-shifting to other hospitals, which also treat a significant number of indigent patients. He stated these are hard issues; for example the paying patient at those hospitals, or their insurers, ultimately make up the difference should the county hospital maintain its monopoly on the county indigent funds.
Senator Washington alleged this is a public policy, which needs to be dealt with at the state level now, since the state has already interjected itself into the issue.
Senator Mathews asked if the amendments include a clarification of what rate the hospitals should be paid for indigent care. Chairman Rawson said the bill holds that, if a hospital is serving a disproportionate share of low-income patients using the federal definition of uncompensated care, it should qualify for county disproportionate share, although the county claims that is not an accurate reflection of what is going on. He added perhaps it is time to reevaluate the entire law, which says the county has a responsibility to provide for the health care of all indigent patients.
Mr. Sturm reminded the committee the county is allowed to pay at a rate higher than the disproportionate share rate, for example in Washoe County, the rate paid for indigent care is the Medicaid rate.
Chairman Rawson asked what the implication would be if the current requirement stating a hospital shall provide, without charge, in each fiscal year, care for indigent inpatients in an amount that represents 0.6 percent of its net revenue for the hospital’s preceding fiscal year, were eliminated, and established the Medicaid rate as the minimum payment to all hospitals serving county indigent patients. He said the committee could make some suggestions, and then take testimony on the pros and cons of the ideas.
Senator Wiener referred to previous testimony implying the county hospital is near capacity on indigent care, which means the other hospitals accept those patients.
Chairman Rawson said the committee will suggest some parameters and then serve notice for participation in Monday’s meeting. He said under consideration is: dropping the .06 percent requirement; all hospitals receive a basic rate, perhaps the Medicaid rate; if a county wished they could enrich the rate; and the net outcome would be to set a baseline and be more fair to those who end up with the burden.
Chairman Rawson closed the discussion on S.B. 302 and opened the discussion 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)
Mr. Sturm explained there were no proposed amendments for the bill.
Chairman Rawson stated it has been determined the bill would require a fiscal note, and it would be appropriate to re-refer it to the Committee on Finance.
SENATOR AMODEI MOVED TO DO PASS AND RE-REFER TO THE COMMITTEE ON FINANCE.
SENATOR WIENER SECONDED THE MOTION.
THE MOTION CARRIED. (SENATOR TOWNSEND WAS ABSENT FOR THE VOTE.)
*****
Chairman Rawson closed the discussion on S.B. 319, and opened the discussion on S.B. 482.
SENATE BILL 482: Establishes prohibited and required conduct of person who uses skateboard park and limits liability of skateboard park operator. (BDR 40-415)
Mr. Sturm explained the proposed amendments for the bill under tab F of Exhibit E.
SENATOR SCHNEIDER MOVED TO AMEND AND DO PASS S.B. 482.
SENATOR WASHINGTON SECONDED THE MOTION.
THE MOTION CARRIED. (SENATOR TOWNSEND WAS ABSENT FOR THE VOTE.)
*****
The meeting adjourned at 4:28 p.m.
Cynthia Cook,
Committee Secretary
APPROVED BY:
Senator Raymond D. Rawson, Chairman
DATE: