MINUTES OF THE meeting
of the
ASSEMBLY Committee on Health and Human Services
Seventy-Second Session
April 16, 2003
The Committee on Health and Human Serviceswas called to order at 1:40 p.m., on Wednesday, April 16, 2003. Chairwoman Ellen Koivisto presided in Room 3138 of the Legislative Building, Carson City, Nevada, and, via simultaneous videoconference, in Room 4406 of the Grant Sawyer Office Building, 555 E. Washington Avenue, Las Vegas, Nevada. Exhibit A is the Agenda. Exhibit B is the Guest List. All exhibits are available and on file at the Research Library of the Legislative Counsel Bureau.
Note: These minutes are compiled in the modified verbatim style. Bracketed material indicates language used to clarify and further describe testimony. Actions of the Committee are presented in the traditional legislative style.
COMMITTEE MEMBERS PRESENT:
Mrs. Ellen Koivisto, Chairwoman
Ms. Kathy McClain, Vice Chairwoman
Mrs. Sharron Angle
Mr. Joe Hardy
Mr. William Horne
Ms. Sheila Leslie
Mr. Garn Mabey
Ms. Peggy Pierce
Ms. Valerie Weber
Mr. Wendell P. Williams
COMMITTEE MEMBERS ABSENT:
None
GUEST LEGISLATORS PRESENT:
Senator Dina Titus, Senatorial District No. 7
Senator Randolph Townsend, Senatorial District No. 4
STAFF MEMBERS PRESENT:
Marla McDade Williams, Committee Policy Analyst
Terry Horgan, Committee Secretary
OTHERS PRESENT:
Sally Ramm, Elder Rights Attorney, Nevada Division of Aging Services, Department of Human Resources
Alex Haartz, Deputy Administrator, State Health Division, Nevada Department of Human Resources
Janice Pine, Director, Governmental Relations, Saint Mary’s Health Network
Michael Johnson, Manager, Outreach Programs, Saint Mary’s Health Network
Jack Middleton, Guide Dog Owner
Linda Lueck, Member, Governor’s Committee on Employment of People With Disabilities
Chairwoman Koivisto:
The Committee on Health and Human Services will come to order, please. [Roll taken.] We have three Senate bills on our agenda today and we will start with S.B. 84. We have some folks from the Division of Aging Services and the Health Division to present the bill.
Senate Bill 84: Revises provisions relating to surety bonds and other obligations required of certain facilities that provide care for elderly persons. (BDR 40-498)
Sally Ramm, Elder Rights Attorney, Division of Aging Services:
[Introduced herself.] We’re here to support S.B. 84. With me is Carol Sala, who is the Administrator of the Division of Aging Services, and Alex Haartz, who is the Deputy Administrator of the Health Division.
This bill was requested by the Division of Aging Services. It proposes changes in the surety bonds currently required in NRS [Nevada Revised Statutes] 449.065. These bonds are required of long-term care facilities and are used to protect residents who lose their personal property. As a general rule, when the resident is admitted to a facility, they are told, in writing, of the limits of the facility’s liability for normal possessions. When these possessions are unreasonably disappearing, the facility must replace them. When disputes arise over what is reasonable, the Division of Aging Services provides mediation services to solve the problem. If mediation doesn’t work, the Division provides a hearing officer. If the hearing officer decides in favor of the resident, the facility must reimburse the resident for the losses. If the facility would then refuse to pay, the Division can file a claim against the surety bond and use that money to pay the resident.
[Ms. Ramm, continued] The surety bond requirement for licensing has been law since 1997. Since that time there have been six formal mediations and two hearings, but no claims have ever been filed against the bonds. As it turns out, having the bonds provides great leverage in our mission to protect the consumers. NRS 449.067 provides as a substitute for obtaining a surety bond that a facility may deposit a secure obligation in a financial institution in the same amount as the surety bond, assigned to the Division of Aging Services. This requires approval by the Administrator of the Division. Additionally, the Division of Aging Services’ Administrator may exempt a facility due to hardship. Currently, 447 facilities have surety bonds, 13 have certificates of deposit, and 1 has been exempted due to hardship.
S.B. 84 proposes three changes to the statute. The first change proposes to move the function of monitoring whether or not facilities have surety bonds from the Division of Aging Services to the Health Division, which is the regulatory agency. The Division of Aging Services will maintain the mediation and hearing functions and will remain the indemnity on the bonds. There will be no fiscal impact as a result of this transfer, but it makes monitoring the bonds as a requirement for licensing more efficient.
Secondly, S.B. 84 proposes to exempt all facilities owned and/or operated by the state of Nevada from this licensing requirement. Currently, federal facilities are exempt. This will save the state money and will affect only one facility at this time, which is already exempted through a memorandum of understanding.
Finally, S.B. 84 proposes to decrease the required amounts on the surety bonds by 50 percent. Given our experience as to the amounts of potential claims and the increasing insurance rates, this will give the operators of the facilities some financial relief and will maintain the consumer protection the law is meant to provide. The proposed amounts are $5,000 for a facility with fewer than 7 employees, $25,000 for a facility with 8-25 employees, and $50,000 for a facility with more than 25 employees. This law provides good protection for Nevada’s senior citizens and we support these changes.
Vice Chairwoman McClain:
Could you repeat your logic behind lowering these bonds?
Sally Ramm:
Our experience has been that the claims have been much lower than the amounts on the surety bonds now currently required. We have never had a claim that came anywhere close to the limits. Insurance rates are increasing, so we feel that we could still provide the protection that we need to provide to the consumer and give the facilities the financial relief of reducing the amount of the bonds.
Vice Chairwoman McClain:
Originally, why was it based on the number of employees and not on the number of residents?
Sally Ramm:
I believe that the number of employees depends on the number of residents. You could probably [base] it on either one and come up with the same numbers.
Alex Haartz, Deputy Administrator, State Health Division:
There is a relationship; however, I believe the issue was originally tied to staff because it would be based upon staff action. It’s not residents who are necessarily causing the losses, and it indemnifies the facility.
Vice Chairwoman McClain:
I understand that, but my point is the more residents you have, the more possibility of losing their stuff.
Assemblyman Hardy:
The residents only have so many places they can hide the stuff, whereas staff actions probably [lead to] permanent losses.
Assemblyman Horne:
[I am concerned that] if we were to reduce these bonds because there is not a need for them to be that high right now, if we have to revisit this [issue] in the next session or [the one after that], how much opposition are we going to get if we have to ask for the increase? It’s much easier to go backwards than to go forwards. If we do this and then we find a need [for higher bonds in the future], are you going to be [coming] before us saying no, this increase will be too big a burden?
Sally Ramm:
We gave this some thought before we decided to ask for this reduction but there was such a large difference. In the large facilities, we were asking for $100,000 in surety bond, but the largest claim we’ve ever had was so much under that, it’s [even] under $50,000. The largest claim we’ve ever had was $10,000 [for] a diamond ring. We thought there was still enough room between our experience and what we were asking for that we could safely lower the [bond] amounts without having to face coming back and asking for [higher bonds] in a later session.
Vice Chairwoman McClain:
What would happen if you lowered the bond to $50,000 and in one facility you had six, $10,000 rings disappear due to one employee? Who would make up that other $10,000?
Sally Ramm:
That would be six $10,000 diamond rings that the facility refused to pay for and that the hearing officer said they had to pay for? [Vice Chairwoman McClain agreed.] As I said, our experience hasn’t borne out any [such scenario]. Honestly, there could be a rash of diamond rings disappearing in one facility and it could even be in a small facility, but our experience hasn’t shown that. We’re basing this mostly on the experience we’ve had since 1997.
Vice Chairwoman McClain:
What happens if the loss is more than the bond? Who’s liable for that additional money?
Sally Ramm:
It would have to become a civil action in the courts. I imagine that the resident would have to take the facility to court and get a judgment against them.
Vice Chairwoman McClain:
These surety bonds are strictly for property loss? [Ms. Ramm agreed.]
In Section 1, it says that “each facility for intermediate care, skilled nursing, residential facility…,” and then in subsection 7 it says, “the requirement set forth in this section does not apply to intermediate care, skilled nursing,…” the same language.
Sally Ramm:
The difference in subsection 7 is that it’s only those facilities operated and maintained by the state of Nevada that are being exempted.
Assemblyman Mabey:
I would like to understand what a surety bond is. For example, if a person wants a $50,000 surety bond, they don’t have to come up with $50,000, do they? They just pay a percentage according to their credit [rating]?
Sally Ramm:
That’s exactly right. My understanding is that there are two companies in the state of Nevada selling surety bonds. If you have very, very good credit, with one company you can get [a bond] for one percent of the face amount of the bond. The other company charges two percent.
Assemblyman Mabey:
So one percent of $50,000 is all they would have to pay once a year, or how does that work?
Sally Ramm:
I believe [payment is due] once a year and it is 1 or 2 percent of the face amount of the bond. If [the facility] is going to put the money into a protected account, they have to put the full amount in.
Alex Haartz:
I just want to go on record as saying that the Health Division supports S.B. 84 and the transfer of the responsibilities to the Division.
Vice Chairwoman McClain:
I don’t see that anybody else has signed in on S.B. 84. Is there anybody in the audience who wants to speak to this bill? [There was no response.] We’ll bring this bill back to Committee and close the hearing.
We will open the hearing on S.B. 96.
Senate Bill 96: Removes certain mobile units from requirement of being regulated as medical facility. (BDR 40-744)
Janice Pine, representing Saint Mary’s Health Network:
Senator Rawson sends his regrets that he is unable to be here to talk about this bill and asked that I handle that for him.
This bill was necessitated by action that was taken during the last legislative session. [Wording for] the mobile units asking to be exempted in this bill is at the bottom of page 2 and the top of page 3. The new language basically transfers that exemption from where it was erroneously placed last session to a place where it defines the exemptions from the mobile unit definition. Saint Mary’s supports this bill, and it would be our mobile units as well as the Mammovan of Nevada and [similar] units that would fall under this category.
I have with me today Michael Johnson, manager of our mobile outreach programs, and he’d like to say a few words on the bill.
Michael Johnson, Manager, Mobile Health Outreach Programs, Saint Mary’s Health Network:
I’m testifying today in favor of S.B. 96 that corrects language in the state statute that created unintended regulations for some mobile medical facilities. The Saint Mary’s Medical Take Care-A-Van provides basic screening and referral services for the medically underserved through a unique blend of partnerships and collaborations. By bringing together a variety of community agencies, we are able to provide these services at no cost to underserved patients. The mobile approach to health services removes many of the barriers that prevent patients from accessing health care, and the services we provide are on par or less invasive than those conducted in general practice physicians’ offices. We are only able to provide these services at no cost because of Saint Mary’s partner and donor support.
The existing mobile medical licensing codes would require our facility to obtain a state license to continue our operation. This state license would be in addition to our existing accreditation by the Joint Commission for the Accreditation of Health Organizations [JCAHO], which is the recognized accrediting body for hospitals and health care providers. This accreditation is conducted to exact national standards. The JCAHO accreditation reviews the financial, clinical, safety, security, staffing, and physical components of our operation. Additional state licensure would be redundant, adding additional expense to our operation while achieving little for that expense. Additional state licensure would not ensure increased quality or accountability in those systems that are already in place for our JCAHO accreditation.
Saint Mary’s also operates mobile dental facilities. Occasionally we utilize our dental units to provide basic medical screening and referral services when our medical unit is otherwise committed. The current licensure requirements would mandate that we obtain licensure and inspection of the dental units for such occasional medical practices. Mobile dental units are not governed by the existing mobile medical unit regulations, but to provide even the most basic medical screening, such as height, weight, and immunizations, would require the licensure of these dental units, too. That expense would prohibit these dental units from being used for such services, thus reducing services to the community.
This summer Saint Mary’s is obtaining another mobile medical unit that is a combination medical and dental mobile facility. The ability to provide both medical and dental services to hard-to-reach populations has great advantages. This unit would also have to receive state licensure and oversight to provide medical services, again increasing our operational cost [to comply with a] regulation that is redundant. Please understand that this combination medical/dental unit will also have to be regulated by JCAHO.
I urge you to pass S.B. 96 to correct the existing regulations governing the licensing of mobile medical units in Nevada. The proposed changes will maintain medical services to the underserved while not compromising the quality of care.
Assemblywoman Leslie:
I think this is a good idea. Can you explain how often JCAHO actually inspects the vans? I’ve been on them and they seem clean to me, but what actual process do they go through to look at the vans and how often is it?
Michael Johnson:
The JCAHO accreditation process is an every-three-year, in-depth visitation process. Constantly taking place is our own internal monitoring as required by JCAHO so that at that three-year period we can demonstrate [that] we’ve been [doing] our own monitoring over that three-year period of time.
Assemblyman Horne:
I’m a fan of these medical vans and the like but I don’t know what the scope of the inspections is. Immunizing people seems like more of a medical procedure, so could you explain about the types of medical screening that go on?
Michael Johnson:
There are multiple levels of accreditation that will take place. Tire pressure and air pressure and so forth are heavily regulated by the Department of Transportation. We have to meet their standards for annual inspections of the mechanical components of the mobile medical facility itself.
When the Joint Commission for the Accreditation of Health Care Organizations comes, they would come onsite as they choose to look at whatever medical facility we’re operating. [They] review not only the physical plant and its specifications, such things as cleanliness and so forth, but the records of clinical procedures and so forth that we would offer. They would also look at personnel records, personal policy, and financial records that have been maintained over that three-year period of time.
When procedures are conducted such as laboratory procedures, which we have not done but are contemplating doing, finger sticks for hemoglobin levels and things like that, we have to have [federal] licensure. [They would also] look at records provided for each incidence of [specimen] collection, and they regulate the staff and their credentials to do those types of things. Multiple layers [of testing] would occur that would look not only at that day, but also over the history of the operation.
Assemblyman Horne:
What other types of procedures do they do besides height, weight, immunizations, and finger pricks?
Michael Johnson:
At this time the range of medical procedures includes height and weight, and examinations done by nurse practitioners without any invasive types of procedures whatsoever. We’re not doing any finger sticking or specimen gathering at this time until that license is in place. We are doing interviews with individuals, blood pressures, temperatures, visual inspections of individuals, gathering oral histories, and so forth.
Janice Pine:
Because this is a division of the hospital, the [state] Health Division has the right at any time, should there be a complaint, to inspect that complaint. We would still fall under their rules and regulations about inspecting the hospital. The hospital manages this program, so we still have the obligation under the Health Division, which always has the right, should they receive some kind of complaint or concern, to come and inspect the premises.
Assemblywoman Weber:
Do you know how many mobile units there are in the state that are performing similar functions? Also, are the credentials of personnel posted so the public has access to that information?
Janice Pine:
As I recall from the interim health care committee discussion, Saint Mary’s is the only hospital in the north running this type of vehicle. The Mammovan is operated by the Nevada Health Centers. In the southern part of the state, I believe the dental school has a unit for dental procedures. Other than that, I’m not sure if additional units are out there.
Alex Haartz:
In answer to the last question, there are several types of mobile medical facilities. Many times private physicians’ offices and private dental offices also operate a van or some type of vehicle as an extension of their own practices. Those mobile facilities are not regulated by the Health Division and were never intended to be under this particular bill because they’re not licensed as medical facilities.
[Mr. Haartz, continued] The other types such as the type that Saint Mary’s operates and that the Nevada Health Centers operates for mobile mammography, as well as several being operated in the south, are operating as an extension of an already licensed medical facility. That was the intent of this bill originally and that was the nuance that was omitted during the final drafting. It was our belief that those facilities that are already licensed as medical facilities, that are already regularly inspected by the Health Division as well as going through an accreditation process, did not need to be captured under this bill. It’s my understanding that the intent was originally one medical facility that a physician was proposing to bring on that was more than a physician’s practice and that was the catalyst for this bill. That individual was actually seeking licensure, I believe, as a mechanism to enhance reimbursement. Somewhere around 15 mobile medical facilities were caught up in this bill and what this revision is attempting to accomplish.
Assemblywoman Weber:
[Could you respond to] my second question regarding individuals who are practicing out of these vehicles, or mobile units?
Janice Pine:
In our situation, the individuals who perform the duties [in the mobile units] are hired by the Network and work under the auspices of our regional medical center, which is a tertiary care hospital. Their qualifications are not posted any more than they would be in a physician’s office or they would be in one of the wings of our hospital, but they all wear official name badges with their name and title on them.
Vice Chairwoman McClain:
Are there any more questions? [There was no response.] Did you want to comment any more on the bill?
Alex Haartz:
I just want to go on record as saying the Health Division is in support of this bill and what it’s attempting to accomplish.
Vice Chairwoman McClain:
Is there anyone else in the audience or in Las Vegas who would like to comment on this bill? [There was no response.] We’ll close the hearing on S.B. 96 and I’ll pass the gavel back to the Chair.
Chairwoman Koivisto:
We have S.B. 231 and Senator Titus is going to present this bill.
Senate Bill 231: Revises provisions concerning service animals. (BDR 38-98)
Dina Titus, Senatorial District No. 7 (Clark County):
This is a bill that’s brought to you by Senator Townsend and myself. This bill did pass unanimously out of the Senate and is a bill that prohibits a person or a dog he owns, harbors, or controls from injuring, disabling, or causing the death of a service animal. The offense is punishable as a gross misdemeanor except if the violation is willful and malicious, in which case it’s punishable as a Class C felony. The measure also makes it a Category C felony for a person to obtain or exert unauthorized control over a service animal with the intent to deprive the person using the animal of the use of that animal. In addition, it provides for restitution for damages that may result from this criminal activity involving harm of a service animal. Lastly, it clarifies the definition of “service animal” to include a guide dog, hearing dog, and helping dog.
Assemblywoman Leslie:
What’s a helping dog? I’ve never heard that description before.
Jack Middleton, Guide Dog User:
A service dog is a dog trained to assist people who are primarily in wheelchairs. They actually can retrieve things that are lost. Sometimes they can answer the phone or do other things to help a person in a wheelchair. Some can even pull the wheelchair.
Randolph Townsend, Senatorial District No. 4 (Portions of Washoe County and Carson City):
We appreciate your taking the time to listen to us on these issues. When I was in grade school my parents were financial supporters of Guide Dogs for the Blind in San Rafael, California. We used to attend the graduations and even as a kid, [I saw such a look of joy] on the faces of the individuals who received their dogs at the graduation, and how both the dogs’ and the owners’ faces lit up and how important that was.
Jack Middleton:
The bill primarily provides the same protections under the law for my dog as it provides for an individual. As you walk the streets there are a number of dogs not on leashes or [roaming] unattended that could seriously injure my dog or myself. I walk daily with my dog, and it’s a very important thing to me. To be without the dog would be devastating.
[Mr. Middleton, continued] I spent the month of February in San Rafael, California, receiving a replacement guide dog [because] my former dog retired. This is a very strenuous process, a lengthy and time-consuming process. It’s seven days a week from 6:00 a.m. until 9:30 p.m. There were 17 other folks getting new or replacement dogs. There was one lady getting a replacement dog because as she exited a bus she was attacked by another dog. She was injured. Her dog lost an eye and was put out of service. This happened in November in California and she did not receive a new dog until February. She was off work that entire time and the California courts [are still working out the particulars] as to who is going to pay the vet bills for her dog and the charges for her time off [from work] and her injury.
There’s also a part in this bill that deals with people who are misrepresenting their pet dog as a service dog in order to take their dog with them into restaurants and stores. This is also of great concern to me. [My guide] dog is very well trained because I need to be able to move in society and [function]. If for some reason you or your dog is injured, it is very devastating, and I wholeheartedly recommend passage of this legislation.
Assemblywoman Leslie:
That brought up a complaint I have heard several times in Reno, and I think you are addressing it in this bill in Section 11, which is that people like yourself are harassed when they have a service dog and they go into a restaurant. I [also] think we’ve had a problem in Reno with taxis. I notice you made several changes in Section 11. They look like minor clean-up changes, but it basically remains the same that you folks have a card that shows that you have a service animal. Is that sufficient, or is there something else we should be doing to strengthen that?
Jack Middleton:
NRS 426 has been on the statutes for a long time. [It lays] out what is a service dog, the definitions of guide dogs, and guarantees access on public transportation and in all public facilities. These are also covered under the federal access bills. I have been thrown out of fine establishments and once they tell you to leave, you’re not so sure you want to push the issue and eat their food anyhow.
I’ve gone through the process that’s set up under NRS 426 and [it is unfair] because by the time you get around to processing [a complaint], months have gone by, it’s your word against the restaurant owner’s, and not much can really happen. The best advice I can give somebody is, if you really want to push the issue call law enforcement and wait there and let them solve it and then walk out.
Assemblywoman Leslie:
Even when you show them your card, they don’t believe you?
Jack Middleton:
A lot of people just don’t understand the law. They’ll say, “Oh, you can’t bring a dog in here. The Health Division’ll take away our license.” You find this a lot in some of the foreign-type restaurants. In the puppy raising program they take those dogs into restaurants [because] it’s an education process. You don’t always have the people educated. I’ve been in downtown Sacramento where you’d think everybody would know the law and you run into somebody who says “you can’t do that.” Taxi drivers are notoriously the worst. [They’ll say], “I don’t want any dog in my cab. He’s going to get hair all over it.” I don’t think changing the law is going to solve the problem. Yes, we carry an identity card, my dog has his license number tattooed in his ear. He also has a tag with his name and address and license number [from Guide Dogs] on it. There’s a little booklet that has all the states’ laws that we carry.
Assemblyman Horne:
I really like this bill. If you’ve lost your sight and you’re given a dog, it [won’t] give your sight back but it allows you to find your way. I’ve seen helping dogs jump up on counters and retrieve items. It may not have given you your legs back, but it’s given you reach. To have those things taken away would be devastating. If the Chairwoman would entertain a motion, I would move Do Pass.
Assemblywoman Weber:
We had a service animal bill come through Government Affairs [Committee] and I just wanted to make sure that…. [Mr. Middleton interrupted, “A.B. 332”] Yes, a great bill. [Mr. Middleton noted that it had been amended.] In Section 8 of S.B. 231 regarding the school for hearing dogs, guide dogs, and helping dogs, my understanding is that we do not have schools here in Nevada and we only have the puppy-in-training program. I wasn’t sure what that section meant.
Jack Middleton:
There are no guide dog schools in the state of Nevada; there are only ten in the country. The bill [A.B. 332] as it was originally written would have had the Rehabilitation Division licensing all of these schools. What it also had in there was, if the school, say San Rafael, was not licensed by the state of Nevada, then no dog of any visitor or resident of the state would be covered under NRS 426. I have not seen it in its amended form. I’m not sure this bill [S.B. 231] gives us any additional stuff. I know [A.B. 332] was rewritten and paralleled the Senate bill [S.B. 231], and the Senate bill is much farther through the session, so you want to ride a horse that’s out in front.
Chairwoman Koivisto:
Down in Las Vegas we have Linda Lueck.
Linda Lueck:
I work with the Governor’s Committee on Employment of People With Disabilities. I, too, am a graduate of Guide Dogs for the Blind in San Rafael.
About three years ago I had written a proposal and submitted it to the Legislature for consideration. It did not make it in the last session, but I was told that it would be in this session. That bill originally included parts of [S.B. 231] and parts of A.B. 332. [My] original proposal was split in half. Another lady offered a similar bill, and that is what is before you. Unfortunately, there need to be some changes to [S.B. 231] only because of certain sections that are not within the power of the state.
I am totally for this bill [S.B. 231] with the exclusion of Section 11, [subsection] 2, which refers to the Department of Employment, Training and Rehabilitation [DETR] being the certifying Division certifying schools or trainers of service animals. DETR has never had and does not ever want any part of that. The law was written many years ago and has just lain on the books. Part of the original proposal was to delete that because it has no effect. We do not have any schools in this state. We do have some trainers that claim to be professional trainers of service animals in their advanced training.
Parts of [S.B. 231] were also included in A.B. 332, and when that went through committee about ten days ago we did amend it. I worked with the Nevada Disability Advocacy and Law Center and their attorneys, with Nevadans For Equal Access, with the Department of Employment, Training and Rehab, and the Governor’s Committee in making the amendments to that bill, which basically should be tagged onto this one.
There are parts of this bill in Section 8, [subsection] 2, that require you to provide certification and identification [for a service animal]. According to the Americans With Disabilities Act [ADA], that is not true. In the questions and answers that are provided online through the Department of Justice under the ADA’s civil rights division, there is a pamphlet [containing] commonly asked questions about service animals, and it specifically outlines that you may not require certification or identification of a service animal.
[Ms. Lueck, continued] What you must recognize is, does this animal, and I stress the point “animal” [because] it is not only a dog, does it provide a service or benefit the person with the disability? The reason that is so vague in the federal regulations is that there are so many different types of service animals and there is no national certification that will identify a service animal. There are some schools, about ten accredited schools nationally, that train guide dogs. There are other schools that train hearing dogs, alert dogs, signal dogs, and helping dogs. There are seizure dogs, emotional support dogs, dogs that help people who have different intellectual disabilities, anxiety dogs, and there’s all types of services that they provide. Who am I or you or anyone to decide whether that is a bona fide, verified service animal? The Department of Justice does not want to take that on and I don’t think that Nevada should, either.
We cannot supercede the Americans with Disabilities Act by requiring something that does not exist. We have no way of providing a certification or identification for every service animal that comes to our state, as no state does. Until there is a national certification program, which I doubt will ever happen, there’s no way that we can have this portion of the law on our books and enforce it. The main [thrust] of S.B. 231 is to offer the protection that is so badly needed in this state to service animals and the people using those service animals.
A service animal is an extension of that person’s disability. It is a life tool. It provides them a major portion of their independence, their ability to work, their ability to get to and from wherever they need to go, and conduct their life [on an] equal playing field [like] everybody [else].
There have been incidences in the southern part of the state that I know of, and oddly enough at a service dog convention right here in Las Vegas. A man in a wheelchair went out to relieve his dog in a grassy area behind the hotel. His dog was a helper dog, an assistance dog for a wheelchair. A man who was homeless had a pit bull running loose and sicced his pit bull on that dog. The service animal was injured beyond repair. The trauma and the injuries forced that dog into retirement. Even though the man in the wheelchair called the police, they stood and watched as the dog was torn apart. They offered to call animal control, which never got there in time. By this time, the damage was done.
There is no responsibility. There is no liability in this state for people who would deliberately, maliciously, or ignorantly let their animal attack a service animal or interfere with their duties. We in Nevada are behind. Many other states, including California, already have this law in place. Most of the wording in S.B. 231 revolving around the attack and protection areas is already in the booklet Mr. Middleton referred to regarding service dog users. It’s an international booklet circulated amongst all service dog users.
[Ms. Lueck, continued] I would support [S.B. 231] but there needs to be a little bit of “tweaking” to it. In A.B. 332 the attorneys and I worked diligently to include the portions of the ADA that would affect this part of the bill as far as the identification and requirement of certification. We also have extended it to every area, including the protection area, so that not only service dogs or service animals, but service animals in training have the same protection. This is a part that is being overlooked. If these puppies, whether they’re three months, six months, or a year old, cannot be exposed to the same social exposures that they would be exposed to as a service animal and have the same rights and protection, then we cannot have them as guide dogs.
The deletion [of identification and requirement for certification] is already in A.B. 332. It also expands a bit on the definition of a service animal or one in training and identifies one as any animal that would provide a service for any person with a sensory-type disability. The attorneys at NDALC and I are always open to working with anybody. We want to see the balance of this bill pass but there are certain areas that cannot be passed.
Senator Titus:
This is the first we’ve heard of these problems, but if that bill is moving forward to the Assembly and this one’s over here, they can both be passed and those problems can be resolved in a conflict amendment.
Assemblywoman Leslie:
I agree with what you said about the conflicts. We can work that out. As far as this being placed in DETR, we just transferred the Office of Community- Based Services from DETR to DHR [Department of Human Resources]. Would that be a better place to oversee this?
Senator Titus:
That could well be. This was existing law and had been in place for years, so perhaps that would be something you could look at.
Assemblywoman Leslie:
Maybe the Departments can give us some feedback, but that seems like a logical place to me to work on these kinds of issues. That might be something for the Committee to consider.
Senator Titus:
[With] all the new reorganization of the Office of the Disabled now coming forward out of Senate Finance, that would certainly be an appropriate place.
Assemblyman Horne:
Is there a way we can get those provisions in the ADA that speak to guide dogs? I’m particularly concerned about the testimony about not being permitted to ask for identification. If that were true, anybody [could] say that [their] dog’s a service dog.
Jack Middleton:
[The guide dog school in] San Rafael does issue a certification card and a photo I.D. [identification] and the dog is so marked. I don’t know if that’s from all schools. I think most individuals who have a legitimate dog are not ashamed of having that dog or reluctant to show that that is in fact a service animal. NRS 426, as it’s in the statutes now, does not cover that myriad of dogs mentioned. There are three types of dogs covered by Nevada statutes and those are strictly a hearing dog, a service dog, and a guide dog, or Seeing Eye dog. These are all defined in law very specifically. All those other dogs for people in nursing homes or anxiety dogs [et cetera] do not exist in Nevada statute. I don’t know of any schools specifically training dogs for this variety of [other purposes]. That’s where, I think, you run into problems with dogs who truly are not trained, who don’t necessarily have the control to go in a place and not leave a deposit on the floor or the kinds of things a fully trained service animal or guide dog is.
I don’t know if we’re in the business of trying to develop a law that’s going to help all the people who want to take their dogs somewhere or call their dog an anxiety dog or whatever. Having dealt with the federal government on a lot of issues, who knows. I hate to see a bill held up at this late date. I also know if two bills that are close together have [issues] that can be solved in committee [then it’s not] a problem.
Chairwoman Koivisto:
I think you’re right. I think we should be able to put the bills together and come to a conclusion.
Assemblyman Horne:
If the ADA does prohibit asking for identification for such dogs, we would be precluded from putting [that requirement] into statute because the federal law would trump.
Jack Middleton:
I think it’s already in statute.
Assemblyman Horne:
I’m just saying that if the ADA says we cannot ask for identification cards, whether the statute is in there or not, it would be moot.
Senator Titus:
Perhaps staff could tell us if the ADA does indeed require that, or if it’s some people’s interpretation of the ADA, and then we would know.
Chairwoman Koivisto:
That’s what we’ll do. Marla will check that out for us and verify it. I don’t think LCB [Legislative Counsel Bureau] as a rule drafts things that violate federal law.
Assemblyman Mabey:
This is from an ADA Web site: “How can I tell if an animal is really a service animal and not just a pet?” Answer: “Some, but not all, service animals wear special collars and harnesses. Some, but not all, are licensed or certified and have identification papers. If you are not certain that an animal is a service animal, you may ask the person who has the animal if it is a service animal required because of a disability. However, an individual who is going to a restaurant or theater is not likely to be carrying documentation of his or her medical condition or disability; therefore, such documentation generally may not be required as a condition for providing service to an individual accompanied by a service animal. Although a number of states have programs to certify service animals, you may not insist on proof of state certification before permitting a service animal to accompany the person with the disability.”
Chairwoman Koivisto:
It would appear that maybe we need to have some clarifying language added to those sections of the bill that require [proof]. The only place I see where anything is required is where a landlord may require proof, and it says “may” require proof. Maybe we just need to have language that we’re going to be in compliance with ADA regulations, it might be as simple as that.
We’ll bring S.B. 231 back to Committee and we will wait for some clarifying language on that issue.
[Chairwoman Koivisto, continued] Let’s go back to Senate Bill 84. Were there questions on S.B. 84 that need to be answered? [There was no response.] Is everybody O.K. with that? I’ll accept a motion.
ASSEMBLYMAN HORNE MOVED TO DO PASS S.B. 84.
ASSEMBLYWOMAN McCLAIN SECONDED THE MOTION.
THE MOTION CARRIED UNANIMOUSLY.
Let’s go to S.B. 96. Were there questions or concerns about S.B. 96? [There was no response.]
ASSEMBLYMAN HARDY MOVED TO DO PASS S.B. 96.
ASSEMBLYWOMAN ANGLE SECONDED THE MOTION.
THE MOTION CARRIED UNANIMOUSLY.
We’ll hold S.B. 231 and try to get some clarifying language, and see where the Government Affairs bill is as well because it deals in part with some of the same things. With nothing else to come before the Committee, we are adjourned [at 2:50 p.m.].
RESPECTFULLY SUBMITTED:
Terry Horgan
Committee Secretary
APPROVED BY:
Assemblywoman Ellen Koivisto, Chairwoman
DATE: