MINUTES OF THE meeting
of the
ASSEMBLY Committee on Health and Human Services
Seventy-Second Session
May 14, 2003
The Committee on Health and Human Serviceswas called to order at 1:45 p.m., on Wednesday, May 14, 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 State Office Building, 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 Valerie Wiener, Senatorial District No. 3
STAFF MEMBERS PRESENT:
Marla McDade Williams, Committee Policy Analyst
Terry Horgan, Committee Secretary
OTHERS PRESENT:
Chelsea Bibb, Senior Journalism Student, University of Nevada, Reno
Kathryn Landreth, Chair, Southern Nevada Mental Health Coalition; Legal Counsel, Las Vegas Metropolitan Police Department
Tom Murtha, CEO, Bristlecone Family Resources
Maria Canfield, Chief, Bureau of Alcohol and Drug Abuse, Health Division, Department of Human Resources
Maureen Brower, Chair of the Board, WestCare Nevada
Theresa Malone, Elected Member, Representative, Nevada State Board of Education
Bobbie Gang, representing the Nevada Women’s Lobby and the National Association of Social Workers
Lisa Foster, representing AAA Nevada
Laurel Stadler, Chapter Director, State President, Mothers Against Drunk Driving
Kathy Bartosz, Grants and Program Analyst, Juvenile Justice Commission, Health Division, Department of Human Resources
Chairwoman Koivisto:
The Committee on Health and Human Services will come to order, please. [Roll taken.] We will start as a subcommittee. Please mark the members present as they arrive.
Chelsea Bibb, a 22-year old senior at the University of Nevada, Reno, is going to talk to us this afternoon.
Chelsea Bibb, senior Journalism student, University of Nevada, Reno:
Thank you, Chairwoman Koivisto and Committee members. I appreciate the opportunity to testify before the Assembly Health and Human Services Committee on a subject dear to me—vision.
For one, I have always valued my eyesight. Without it, who among us would ever be able to appreciate a sunset, fully share our families’ smiles and tears or drink in the raw beauty of Lake Tahoe, Nevada’s amazing desert or mighty Hoover Dam? For me, having eyesight has been a big part of being independent.
[Chelsea Bibb] However, in the past year or two, eyesight has taken on a far greater meaning. As a member of Delta Gamma [sorority] at UNR (University of Nevada, Reno), I learned of our organization’s national philanthropy, something known as “Service for Sight.” Since 1952, Delta Gamma has raised more than a million dollars toward the goal of blindness prevention.
I have tried to be an activist in my life. So it was a couple of months ago, in part in search for a little more college scholarship assistance, that I entered the Miss UNR competition. A little surprisingly to me, I won. And perhaps even more surprising to my parents, I was named Miss Congeniality.
For that process, I selected a community service platform. For me it was easy: Service for Sight. Since then, I’ve done work and research to become more involved in the fight against blindness.
Last month at UNR our local chapter sponsored a one-day all-campus fundraiser, Anchor Splash, that raised $5,000 toward that goal. Half the money went to our national organization to help support three schools for the blind and education for the prevention of blindness. Of the remaining $2,500, half went to the UNR Disability Resource Center to purchase a reader for blind and visually impaired students. With a little lobbying, I’m pleased to say the other $1,250 went to the Carson City Guide Dog Club.
My three main objectives with Service for Sight are education, prevention, and action. I am going about trying to educate citizens at large about the importance and ease of prevention of much blindness. Statistics indicate an estimated 17 million Americans have diabetes, which can lead to blindness. Sadly, almost one-third of them are not even aware they have the disease. About 40 percent of all diabetics have diabetic retinopathy, which can be prevented in 90 percent of the cases with a simple eye exam. If people don’t know that, how can they begin to correct it?
Regarding prevention, I’m focusing on the group most often affected by blindness, adults age 45 and older. Nearly 8.7 million Americans age 45 and older, 9 percent of the total, report severe vision impairment. That’s defined as a person unable to even recognize a friend at arm’s length even when wearing glasses or contact [lenses], or as being unable to read ordinary newspaper print. That’s frightening because what comes along with a loss of vision is the devastating loss of independence I mentioned.
As far as a plan of action, I’m working to take the message forward that blindness truly threatens the independent lifestyle so important to older Americans and to you, the lawmakers of this state who deal with that subject. I’m looking for opportunities to speak out publicly on prevention as well as to support guide dog programs. These pets literally serve as the eyes and companions of those with severe vision loss. The program costs are expensive, but well worth it.
[Ms. Bibb continued] My primary focus remains prevention of blindness. That’s why I support Assemblywoman McClain’s A.B. 283, which would add limited dental and vision benefits for senior citizens of this state through the Fund for a Healthy Nevada. I applaud this Committee for passing A.B. 283 because decision-makers like you are critical to the process. Now, if we can just find the ways and means, the money, to get that job done.
As a journalism major, mercifully one nearing graduation, I recognize the estimated billion-dollar deficit facing Nevada. But we can’t quit fighting. Why? Because statistics reveal that more than 208,000 Nevadans suffer from vision challenges ranging from impairment to blindness, cataracts, glaucoma, diabetic retinopathy, and macular degeneration (Exhibit C); and because prevention is more cost-effective than treatment. As America’s fastest-growing state, if untreated, the problem in Nevada will only get worse. I see prevention as the best available path.
My sincere thanks to Chairwoman Koivisto and Vice Chairwoman McClain for permitting me to appear here today, and to all of you for giving back to Nevada through serving. I’ve been here to see a couple of legislative closings and I know how hard you work.
I must admit that I have been a little nervous here today, but in the name of fighting blindness, the “butterflies” were worth it. I know you’re extremely busy this time of the year and I thank you for giving me a few minutes.
Assemblywoman McClain:
Chelsea, I just want to thank you very much for bringing this issue to our attention. I encourage you to keep pursuing the Service for Sight project and I wish you lots of luck on being Miss UNR. You will go on to possibly [becoming] Miss Nevada?
Chelsea Bibb:
Possibly. I have a 1 in 16 chance right now of walking away with the title of Miss Nevada and using the crown as a megaphone for my platform, which is what I would do with it. I would also like to thank Senator Wiener for her generous scholarship and all of her contributions to the Reynolds School of Journalism, and [I would also like to thank] Bonnie Parnell.
Chairwoman Koivisto:
Thank you so much for sharing your message with us. S.B. 62 will be heard in the Education Committee today and it has to do with electronic versions of instructional materials to students with print access disabilities.
We have S.B. 94 on our agenda today. In Las Vegas, are you presenting S.B. 94?
Senate Bill 94 (2nd Reprint): Provides for medical treatment in medical facility other than hospital under certain circumstances for certain allegedly mentally ill persons and for medical treatment for certain persons who are under influence of controlled substance. (BDR 39-745)
Kathryn Landreth, Chair, Southern Nevada Mental Health Coalition; Legal Counsel, Las Vegas Metropolitan Police Department:
[Introduced herself.] [The Coalition is] an organization of approximately 35 agencies representing all sectors of mental health service provision and advocacy groups. We have over 80 members. I’d be happy to speak as much or as little as you want on the need for this bill. We support it because it is critical to improving mental health service delivery in southern Nevada.
As you may know, the Southern Nevada Mental Health Coalition has had, over the past two years, a couple of very important legislative agendas, some of which, we hope, are well on their way to becoming reality. They include the expansion of the mental health budget for the state of Nevada, and we’re very pleased at the progress that’s being made in the Legislature on that front; as well as the enhancement of the mental health facility in southern Nevada.
In addition to that, an important aspect for addressing the tremendous unmet need for mental health services has been the establishment of a crisis triage center in Las Vegas which represents an alternative to transporting people strictly to hospital emergency rooms. We provided a handout for Committee members (Exhibit D). I will not go through all of the numbers, but to summarize briefly, the cost of untreated mental health just [for] hospital emergency rooms and in our jails exceeds $20 million a year in southern Nevada. That’s money not spent on treatment, but simply on warehousing people in crisis, either in jails or in hospital emergency rooms.
One alternative is our [WestCare] crisis triage center where police officers would be able to take people experiencing a mental health crisis as an alternative to taking them to a hospital emergency room. On a recent day in southern Nevada, we had 58 people housed on gurneys around our valley hospitals waiting for one of the 10 or 20 emergency observation beds at the mental health hospital. Many of these people can be diverted to the crisis triage center rather than getting in a queue and waiting for an available bed at the state mental hospital.
[Ms. Landreth continued] It’s the consensus of our mental health care providers that a number of the people who, right now, have had to go to emergency rooms would not need to if there was a crisis triage center where they could go instead. This bill [S.B. 94] would authorize police officers to divert people who are not in need of being held under a Legal 2000 directly to WestCare crisis triage center, or some other similar facility, where they can get immediate assessment and attention for their mental health needs.
Chairwoman Koivisto:
Questions from the Committee? [There were none.] Several of our Committee members also serve on the Assembly Judiciary Committee where this bill was heard before it came to us. For those folks who haven’t heard testimony on this previously, do you have questions or concerns about the bill? [There were no questions.]
Tom Murtha, CEO, Bristlecone Family Resources:
[Introduced himself.] My board of directors and I have a couple of concerns we’d like to talk about. We wholeheartedly support Clark County’s efforts and what they’re attempting to do with this and we in no way want to [cause problems]. On the other hand, we’re concerned about Section 2, paragraphs 1 and 2, where it says that “a peace officer may deliver the person to a licensed facility for the treatment of persons who abuse controlled substances or other appropriate facility for observation and care.” In Section 2 it states that the peace officer “must immediately take to a secure detoxification unit, or other appropriate medical facility” an individual who’s impaired or under the influence. Our concern is that we operate a detox unit in Reno. We’re not a triage unit; we’re not an acute care facility; we don’t have a crash cart, we don’t have a crash team on staff, and we don’t have a defibrillator. We do what we’re supposed to do and we do it well, but we’re not a triage unit. If someone wants to give us the money to become one, we would do that.
As I say, we in no way want to interfere with the intent of this bill for Clark County. We just have some concerns for what it means for [areas] outside of Clark County. If we have peace officers dropping people at our doorstep that we’re not equipped to handle, that could be a public health issue.
Chairwoman Koivisto:
Mr. Murtha, [S.B. 94] was heard in the Senate, passed out of there, and then was heard in the Assembly Judiciary Committee. Did you share your concerns [on those occasions]?
Tom Murtha:
No, I did not, and I only have one excuse; I’m new. I just found out about this a while ago. I talked briefly with Mr. Anderson about it and appreciate the opportunity [to speak to your Committee]. I beg your indulgence.
Chairwoman Koivisto:
This may help allay your concerns a little: On the top of page 3, the second line, the peace officer “may” deliver. To me that indicates if you don’t have a facility up here that’s able to do the triage, your police officer shouldn’t be delivering people there.
Tom Murtha:
We have a wonderful relationship with law enforcement and EMS [emergency medical services] in the Reno area. I just wanted to bring to your attention that we were concerned this might mean something different for us outside Clark County. In Section 2 it talks about a peace officer “must immediately” take an individual to a secure detox. I don’t want to bring up the issue about what a secure detox is, but I just wanted to bring that to your attention.
Assemblyman Horne:
I was also going to point out in paragraph 2 where it said, “Must immediately be taken to a secure detoxification unit, or other appropriate medical facility.” I think we’re covered for those concerns.
Assemblywoman Leslie:
I was wondering if we could have Maria Canfield from BADA (Bureau of Alcohol and Drug Abuse), who is in the audience, come up. I think the “may” language does cover this issue; I’m comfortable with that. My concern is more about what Mr. Murtha mentioned in passing, “must immediately be taken to a secure detoxification unit.” I was wondering, Maria, if BADA has a definition for what a “secure” detoxification unit is? Does that mean CPC (civil protective custody) where people are basically locked down and prevented from leaving?
My understanding is that Bristlecone isn’t set up that way. The CPC unit at the jail of course, is; but I have no idea what WestCare is doing right now. Can you enlighten me on that?
Maria Canfield, Chief, Bureau of Alcohol and Drug Abuse, Health Division, Department of Human Resources:
My understanding is that number 4 of Section 2, on page 3 of [S.B. 94], defines secure detox unit “to include without limitation a detox unit in which the staff of the detoxification unit ensure the security of the detoxification unit,” and current regulations do define what a detox unit is. I think if you put those two things together we’ve defined “secure” detox, [which is] basically, in lay terms, a “safe” detox unit. So I think we’re covered.
Assemblywoman Leslie:
I do see that definition, but go back to the paragraph above that, number 2. It says a person who’s unlawfully under the influence, who’s arrested or taken into custody, “must immediately be taken to a secure detoxification…,” and then we have the definition for that. Bristlecone is not that, so does that mean that the police can’t do what they’re already doing in Washoe County? Does that create a problem there, or not?
Tom Murtha:
Here’s where I have a little difficulty. I’m not sure what you mean by a “secure” detox, as Maria Canfield described. We lock our door at night. We have a staff who assist individuals to make sure that they’re safe and secure in the sense that they’re not in need of emergency medical attention and that they’re not violent or aggressive. When those situations arise, we call the appropriate authorities and deal with the situation in that manner.
Assemblywoman Leslie:
Are you saying that you are a secure detoxification unit? It is kind of vague in number 4. What he’s described does kind of sound like it would fit, but that’s not what I thought “secure” [meant]. “Secure” to me means they can’t leave, but I guess that’s not what we’re saying.
Maria Canfield:
I believe that since this is in the proposed law, that this is the definition that would be used to define that term within the law. I think we probably agree with you that it’s open for interpretation, but since it is defined this way it seems logical that was the intent.
Assemblywoman Leslie:
It’s kind of sloppy, though. I predict next session we’ll be back here perhaps looking at that, but it does sound like it answers the concerns that Bristlecone has, so I’m fine.
Chairwoman Koivisto:
Ms. Brower, you look like you could shed some light [on this issue].
Maureen Brower, Chair of the Board, WestCare Nevada:
WestCare was also a part of the task force that worked on this significant issue. We were the only organization that stepped up to the plate and offered to be part of this to help alleviate the problems.
This was the best way we could build the bill to make sure that we were able to take care of the problems. The task force tried to [resolve the problem by using language that] said the individual must be immediately taken to a secure detox, “or other appropriate facility.” I would hope that would take care of Bristlecone and SageWinds’ concerns.
WestCare has been working diligently on this since they recognized that they would be the facility in charge. They are already taking steps to make sure that we do have a secure facility, that it is a medical model, and that all the appropriate actions are taken. The Board has been very involved in every part of this and very much in favor of it.
Chairwoman Koivisto:
Questions for Ms. Brower? [There were none.] I don’t see anyone else signed in on S.B. 94. Is there any other testimony on S.B. 94? [There was no response.]
I will bring S.B. 94 back to the Committee.
ASSEMBLYMAN HORNE MOVED TO DO PASS S.B. 94.
ASSEMBLYWOMAN McCLAIN SECONDED THE MOTION.
Assemblywoman Leslie:
I’m fine with the bill with those safeguards, but I would like to get on the record that the legislative intent of this bill is not to interfere with the way law enforcement is currently handling the situation in Washoe County through Bristlecone. I am a little worried about that “secure detoxification unit.” I don’t think that’s a very clear definition, but I’m willing to let it go as long as we have that on the record that that’s not our legislative intent.
THE MOTION CARRIED UNANIMOUSLY.
Chairwoman Koivisto:
Senator Wiener, welcome back.
Senate Concurrent Resolution 12: Encourages school administrators, teachers and other educational personnel involved in pre-kindergarten through 12th grade to promote nutrition and physical fitness in schools. (BDR R-698)
Senator Valerie Wiener, Clark County Senatorial District No. 3:
On the record, but not related to either resolution, thank you for your support for S.B. 327 and the other measures that have come before [this] Committee. I appreciate your willingness to give it a shot.
[Introduced herself.] I appear before you seeking your support for Senate Concurrent Resolution 12. This resolution encourages school personnel, grades prekindergarten through 12, to promote nutrition and physical fitness in schools. As I’ve asserted many times to anyone who’s willing to listen, fitness of body is fitness of mind at any age.
This particular resolution was inspired by a conference I attended last October in Washington, D.C. It was the first-ever Healthy School Summit and was sponsored by more than 30 national organizations. One of the organizations involved in sponsorship was the National Conference of State Legislatures (NCSL). NCSL had contacted me and asked if I would accept their sponsorship to the conference. I was one of four state senators that they sent to participate in this summit.
More than 500 participants were involved, by invitation only, and they had a waiting list. First Lady Laura Bush was the honorary chair and former Surgeon General David Satcher was the Summit chair. Nevada, as other states that participated, was represented by a hand-picked team comprised of people representing education, health, and nutrition. We have a member of our state team in Las Vegas to testify. Throughout the summit, the Nevada team shared information and exchanged ideas that we could take back to our particular venues to help promote a healthy message. S.C.R. 12 is my part of the team’s commitment.
Another by-product of the Summit is a little bit more personal. Prior to that event, each sponsoring organization was asked to submit the name of one nominee to be named a national “Healthy School Hero.” In the final session of the summit 27 people were selected, and I was fortunate enough to be one of them. It wasn’t the recognition that meant a lot to me as much as the $1,000 that came with it. Robert Wood Johnson sponsored the Healthy School Heroes and I had the opportunity to donate that money to a project or program that involved healthy choices for kids.
[Senator Wiener continued] I decided to adopt a school in Las Vegas, Paul Culley Elementary School. It’s in my Senate district and I visited it several times. I helped establish a pilot program in health and fitness. In addition, I donated $481.77, which reflects my total score in last year’s [Nevada] Senior Olympics in both fitness and weight lifting, so about $1,500 is in the school coffers to provide incentives and rewards to children who accomplish fitness and nutrition goals as they move forward.
[The principal of Paul Culley Elementary School], Dennis Cobia, and his staff have been working on this and I would hope that we could replicate it in other schools. We’ve designed a program that you can reproduce and [that costs nothing].
I’m so proud of what they’ve done [at the school] since January. [The program is in] kindergarten through fifth grades and just in these last few months they’ve established a running program during recess. Initially, all the children participated. Those who’ve been sticking it out, because it’s all voluntary, run laps and [record] their mileage in a log. They measure their own personal progress, then there’s a bulletin board where all those miles are tallied. The school, collectively, [plots a course] on a map to see how far they’ve run. They’ve run a virtual trip to Los Angeles from Las Vegas. Mr. Cobia said he should have taken them east instead of west because they ran into the ocean and he didn’t know what to do with them. Now they’re running east on Route 66 and right now, with their cumulative miles, they’re in tornado country in the Midwest. Once they get to the East Coast with their total mileage they’ll return to the West by a different route. The kids are watching [where they’re traveling], so they’re getting a geography lesson, too.
The school is also highly involved in intramural sports for the upper grades. When they started the program in January they had soccer and basketball. Since my testimony on this in the Senate they’ve expanded not just the sports, but also the number of participants. They’ve now added flag football for both boys and girls and hockey. In their physical education classes the children are logging what they eat so they can learn about food groups and how to make healthy food choices.
The UNR Cooperative Extension Service made a commitment to me but I don’t know what stage it is [in development]. Their nutrition specialists have talked with me and I asked them if they would work on lesson plans, and one in particular—how to read food labels. When [the children] shop with mom and dad they’ll learn how to read [labels for nutritional values and do the appropriate calculations for healthy dietary choices]. They can be role models for their parents.
[Senator Wiener continued] It’s not just the kids that have to produce outcomes at a “healthy school,” [as envisioned] by the Summit. The president of the National Association of Student Councils reflected on a national survey they [took of] young people across the country. Seventy percent of those surveyed said, “We need healthy role models to make healthy choices.” Mr. Cobia took the lead on that at Culley Elementary. He developed a yoga program for the teachers, taught by a volunteer teacher, and a program called the “Teacher Walkie-Talkie Program.” In January when he started this, about six or seven teachers would participate. Now the entire faculty, except for six or seven teachers, is doing it. They walk in pairs or small groups around the school before or after school, or during their prep period. Not only did they develop healthier lives and feel better about their experience in the classroom, but also they’re great role models for the kids.
What is in S.C.R. 12? We talk about obesity as being the number 2, and now inching into number 1, preventable cause of death in our country, which affects almost every other health condition in a negative way. Statistically, obese kids and adults are very likely to become obese adults. We have changed our lifestyles unfortunately, and instead of walking or bicycling [to go places] we often take the car instead. The lack of physical activity in a child’s early years will likely cause reduced alertness and decreased productivity in the classroom. We also know that it will affect their social and emotional development.
Fast foods are a problem, inside and outside the school. Poor nutrition we know negatively affects behavioral and cognitive development. Kids cannot learn when they’re not nutritionally sound. S.C.R. 12 has a lot of information in it about the problem and has information about what we hope to do in the “Resolved” section of the resolution. We have calculated that we will need 900 additional copies of this resolution if you are so kind as to pass it through your house, so that we can distribute it to the people and organizations listed in the back to help create awareness. The resolution [can be used] as an informational tool for those people who can create positive changes in the lives of children. It’s for those reasons that I urge your support for S.C.R. 12.
Chairwoman Koivisto:
I think the CBS Evening News in the last couple of weeks has done a number of spots on good nutrition and how the schools need to make changes, and some schools are.
Senator Wiener:
I had asked for an interim study on obesity, [which would be undertaken by a subcommittee of the Standing Health Committee], because it’s such a huge health issue. In my four sessions here, I was never as affected as [I was when] working on these two resolutions and at the level of the problem and of the opportunity for change. Because of that, I’m asking that the Department of Education and the Health Division be participants in the study as members on the subcommittee. I have also provided for you a handout (Exhibit E) including letters from some of the endorsers of the resolution, one being the State Board of Education.
Theresa Malone, elected member and representative of the Nevada State Board of Education:
[Introduced herself.] I’m here today to tell you that S.C.R. 12 is so important the State Board of Education has recommended a request for the Legislature’s endorsement. I call your attention to page 3 and the last two paragraphs in the “Resolved” section. It says that this will “promote health in school-aged children,” and for “school districts to implement ideas and build upon existing models for physical fitness and nutrition.” That is the most important part of this bill right now for education in the classroom. As you know, school districts have control over their curriculums. [This issue] is so important we’re hoping that at some point the school districts will, with your recommendations, support, and encouragement, implement the policies in S.C.R. 12 and align those with their curriculums.
Something we look forward to happening is physical fitness married with nutrition. As you know from all the information you’ve received as legislators, student achievement increases with the marriage of physical fitness and nutrition. We encourage your support of S.C.R. 12 and we thank Senator Wiener for all her efforts. She has been such a valuable member of the Healthy Schools team and represents Nevada well. The team is growing, and we want you to know that all the organizations involved in nutrition and obesity concerns are very much excited that this is a national effort.
Madam Chairwoman, as you alluded to a news report, I pulled off the Internet an item that appeared this morning as I was watching ABC News. It said, “Obesity is reported to cost the United States government $93 billion a year.” If that’s a concern nationally, it’s definitely a concern in Nevada. I think this is the first step. We want to make sure [our Nevada citizens are] healthy; we want to make sure our children are healthy, and that we’ll succeed. We [appreciate] your assistance.
Assemblyman Mabey:
Just a comment; I support this. What concerns me is that the schools have vending machines, but they have terrible food in those machines for kids. I realize that the schools make a profit off of those vending machines and then use those proceeds for supplies, school uniforms, or whatever.
Senator Wiener:
One of the presenters at the summit Theresa Malone and I attended was an executive director for a school district. He was defending the vending machines. One thing that’s uniform across the country is that [the profits from vending machines] are considered discretionary dollars, so it’s like found money. What we also learned, though, and it’s been verified over and over, is if you have a vending machine menu with healthier choices but maybe knock a nickel off the price, you’re going to make it up in volume. Kids will buy healthy food if given a choice. I’m not asking for the universe, maybe pretzels instead of bagged popcorn. Fortunately, water has become [popular] because it’s a designer kind of thing. They found over and over again that kids will buy healthy food if you give them a choice; just knock the price down a little bit. That is one of the big issues we have to address.
The State Board of Education did come forward supporting a look at obesity and all the issues connected to it. With their support for this I think we have a good attitude in the state now [and might be able] to address the concerns of health and nutrition.
Theresa Malone:
In response to Assemblyman Mabey, [I’ve been disappointed] when I’ve attended briefings on No Child Left Behind sponsored by the U.S. Department of Education. I have critiqued and voiced my opinion loudly that conferences, especially relating to education, serve soda, coffee, a number of other kinds of beverages, and even have pay-for-alcohol receptions at these national conferences. I’ve said, “How about setting an example at the Healthy Schools Conference and serving milk. Let’s serve those juices.” When Senator Wiener and I and the members of the Nevada team attended the Healthy Schools Conference, we had choices of strawberry milk, chocolate milk, and regular white milk in very attractive containers. I think those are the kinds of things our children would be more inclined to buy from vending machines, products that look more attractive, not the standard white milk cartons. Because of concerns about obesity and nutrition, you’re going to see marketing changes and changes in how products are promoted.
Assemblyman Horne:
I thought we had experimented with healthy food and vending machines and that the kids weren’t buying it. In fact, they noticed an increase of students leaving campus and that became a problem. It might have been some time ago, but I remember something along those lines.
Senator Wiener:
I remember. There are administrators who are resistant to that, too. It’s so hard to mandate that, although some districts are making an effort.
As Theresa said, packaging is a big selling point. Kids love the designer look. For example, milk cartons are miserable to handle. They found in some school districts that sales soar when they have something that’s easy to manage and easy to hold. Part of it is the handling of the food and how attractive it is. I cannot speak to the Nevada experience, but I can restate what was shared with us that in school districts where they knocked the price down, maybe a nickel or a dime, they made it up in volume. I’m not saying it’s so healthy that it’s unappealing. There are ways to make food fun, and if there’s anything you learn with kids it’s if you can make it fun, they’re usually willing to try it. That’s what we learned at the conference.
Bobbie Gang, representing the Nevada Women’s Lobby:
[Introduced herself.] We do support this resolution. I believe I heard a report about the same study Theresa Malone was referring to. [A radio personality] mentioned a new study that was done that talked about the severe and harmful effects of obesity. [The study] was touted as being very valid and [obesity as] something that was going to have a financial impact on states and insurance companies. All the health [issues] that you see in the third and fourth “Whereas” sections [of S.C.R. 12 have] severe and very debilitating health consequences.
You have been discussing the types of foods available on campus which are of lesser nutritional value and don’t teach kids good nutrition habits. I think having more information for school personnel and making them cognizant of the harmful effects of these foods [might] help change their procedures and policies. We support this resolution.
Chairwoman Koivisto:
Questions or comments from the Committee? [There was no response.] I’m going to bring S.C.R. 12 back to Committee and I heard a motion.
ASSEMBLYMAN WILLIAMS MOVED TO ADOPT S.C.R. 12.
ASSEMBLYWOMAN LESLIE SECONDED THE MOTION.
THE MOTION CARRIED UNANIMOUSLY.
Senate Concurrent Resolution 15 (1st Reprint): Encourages Department of Human Resources to study problem of alcohol and drug abuse by teenagers and young adults while driving motor vehicles. (BDR R-4)
Senator Valerie Wiener, Clark County Senatorial District No. 3:
I appear before you to seek your support for Senate Concurrent Resolution 15. This resolution addresses the problem of teenagers and young adults who drink or use drugs while operating a motor vehicle.
This particular resolution is the response to a request I received long before we adjourned last legislative session. I was contacted by an organization called “Aluminum Anonymous.” They were seeking me out to introduce a measure to increase legislative and public awareness about teens or young adults who drink or abuse substances while operating a motor vehicle. This particular issue is important for all of us to recognize and then do something about. As I was working on the resolution I developed a keen awareness about how important it is to make a message very clear and on the record.
S.C.R. 15 is not intended to condone underage drinking. When we talk about underage drinking and driving there may have been some who thought that we weren’t addressing the issue of underage drinking separately: “Well, if you’re drinking, just don’t drive.” I wanted to make sure with the language of the resolution that we don’t condone underage drinking, but we have to realize that it does occur. To address that part of it, Laurel Stadler from MADD is in the audience and [plans to] come forward.
Unfortunately, legal or not legal, underage drinking does occur and many of those drinkers also operate motor vehicles. The focus of S.C.R. 15 talks about this concern. The 2001 Risk Behavior Survey cited 30 percent of our high school students reported having ridden with a drinking driver during the past month. Research indicates that young drivers are more often involved in alcohol-related accidents than any other age group. The peak age for fatal crashes is 21. The next highest ages for fatalities in alcohol-related accidents were, in respective order, 19, 22, 20, and 23.
In 2001 the National Transportation Safety Board reported that 21-24-year-olds have the highest percentage of alcohol-related driver deaths of any age group and accounts for 53 percent of all alcohol-related driver fatalities. In Nevada, only 1 percent of the nearly $500 million we spend annually in direct and indirect costs involving substance abuse programs, and this includes alcohol abuse, is used in the prevention and treatment arena. Roughly 99 percent is used in cleaning up the wreckage and picking up the pieces of what substance abuse and addiction have caused. Now that we know there’s a problem, which we all do, what do we do about it?
[Senator Wiener continued] S.C.R. 15 is intended to be an important informational tool to create change. You’ll see several recommendations for a study by the Department of Human Resources on page 2 of the Resolution. I know that there’s an awful lot of information already out there; however, all of us realize that data doesn’t make much sense unless we put it to work in ways to help produce changed behaviors.
Equally important, you’ll see a substantial distribution list on page 3. It’s my hope, if your Committee and house pass this resolution, that we create an opportunity for information sharing and that we convey legislative awareness and concern to people who, with their knowledge, can be prominent, front-line change agents. This was not part of the original plan in the Senate. At the conclusion of the hearing on this [resolution] I pledged $1,000 toward a pilot program, a study, or whatever format it takes, to help us take this information and put it to work. I’m going to renew that pledge in your Committee today. It’s my hope that this seed money will help us, as a state, find ways to address the causes, the whys of this behavior, which is a dangerous behavior, and find ways to ensure healthy alternatives for our young people. Because we have a problem with underage drinking, because we have a problem with 15—25-year-olds who drink, or do drugs, and drive; and because we have an opportunity with the message that’s delivered in this Resolution, I urge your support for S.C.R. 15.
Lisa Foster, AAA (American Automobile Association) Nevada:
[Introduced herself.] We’re here in support of S.C.R. 15. At AAA we try to make the roads safer for motorists and passengers and we feel this bill will go far in helping us reach that goal. AAA has a number of programs through our National Foundation For Traffic Safety and through local offices. We feel that the study that this bill addresses could help us improve those programs because we’d have the data to target where our money would go more successfully.
We know that there are a number of factors in young driver crashes from inexperience, to lower seatbelt use, to other risky behaviors, including alcohol and drugs. If you look at some of the data, the risky behavior of seatbelt use is often combined with the risky behavior of alcohol and drugs. Young drivers are less likely to use restraints when they’ve been drinking. In 2001, 70 percent of the young drivers in fatal crashes in the United States who had been drinking were not wearing their seatbelts.
[Ms. Foster continued] Another important fact is that the severity of a crash increases with alcohol involvement. In 2001, 3 percent of young drivers involved in property-damage-only crashes were drinking, but 23 percent of those in fatal crashes had been drinking. So when they are drinking or using drugs, the crash itself is typically worse.
We know a lot of statistics, but there are many things we don’t know, such as what messages and programs would work best to make young drivers avoid risky behaviors. We believe this study will give law enforcement, traffic safety professionals, policy makers, and others some important tools to address the tragedy of young driver crashes. We urge your support and have committed to Senator Wiener to work with her and the Department should the study be undertaken.
Laurel Stadler, Chapter Director, State President, Mothers Against Drunk Driving:
[Introduced herself.] I want to thank Senator Wiener for looking at this very important issue and trying to get all of the state agencies and community groups to look at the problem of teen and young adult alcohol and drug use and abuse.
Youth have been over-represented in crash data for many years, and programs to address this, such as GDL laws, graduated driver’s licensing laws, have been very successful in reducing crashes and fatalities. To further affect these numbers, I believe that the study that needs to be done is to determine why youth are so over-represented in the drinking data. Youth account for the consumption of 1.1 billion cans of beer annually and they also drink 35 percent of all wine coolers. The study that needs to be done is why our federal funds, state funds, school district funds, and community grants are being used to promote programs that condone underage drinking. Why do principals allow their schools to be involved with programs using staff time and allowing students to promote “don’t drink and drive messages” to students who are clearly under the legal drinking age? The only appropriate message to anyone under 21 is “don’t drink.”
In 1987, the average age for first alcohol consumption was 17 years old and now, just 15 years later, the average age for first alcohol consumption is 12 years old. Additionally, it’s estimated that 11,000 young people try alcohol for the first time each day in our country. The 2001 Nevada Youth Risk Behavior Study reports that 50 percent of middle schoolers and 80 percent of high school students have been underage drinkers. It also reports that over 10 percent of middle and high schoolers had their first full drink of alcohol at age 8 or younger.
[Ms. Stadler continued] Our MADD chapter has focused its efforts for many years on educating everyone, the schools, the community, law enforcement, and this Legislature to send a clear, consistent, no-use message to everyone under 21. We become very frustrated when studies and programs address the societal problems like teen drinking and driving, teen pregnancy, the drop-out rate, et cetera, without addressing the root problem which in many cases is the underage drinking. We believe that this resolution would encourage the Department of Human Resources to effectively study ways to prevent underage drinking, starting in elementary school, which will, in turn, help to reduce all of the other alcohol-related problems.
We need everyone’s commitment to a no-use message for those under 21. Our mission with MADD is to stop drunk driving, to support the victims of this violent crime, and to prevent underage drinking.
Chairwoman Koivisto:
I think we need to make sure that parents are aware of what their children are doing. Questions from the Committee for Ms. Stadler? [There were none.]
Bobbie Gang, representing the Nevada Women’s Lobby and the National Association of Social Workers, Nevada Chapter:
[Introduced herself.] Both organizations recognize the seriousness of the problem identified in this bill—drinking and driving and other risky behaviors. We would like to emphasize the tragic consequences that can result from this and we encourage you to support S.C.R. 15.
Maria Canfield, Chief, Bureau of Alcohol and Drug Abuse, Health Division, Department of Human Resources:
[Introduced herself.] S.C.R. 15 encourages DHR [Department of Human Resources] to study the problem of adolescents and young adults who drink and use drugs while driving. It encourages the Department to collaborate with the Departments of Transportation, Public Safety, and Education to conduct a study that would include:
· Compilation of available statistics.
· Determination of the causes of this behavior.
· Assessment of the effectiveness of available public and private programs and existing policies.
· Identification of gaps in services and public knowledge relating to the cause, prevalence, and incidence of the behavior.
· An appraisal of the adequacy of current interagency collaboration including data sharing, program development, and cross training.
[Maria Canfield continued] Additionally, it allows the Department to accept gifts, grants, and donations. The resolution directs DHR to report during the next legislative session on a plan of action for modifying existing policies and programs. This study would require staff, resources, equipment, development of data collection procedures, computer programming for data analysis, and extensive collaboration between agencies.
DHR agrees with the intent of S.C.R. 15 and its recognition that youth substance abuse is a serious problem. Having data to form public policy development is always a good idea; however, the Department does not have the resources to fully implement the bill, but does have data and the intent and the desire to cooperate on the project.
Kathy Bartosz, Juvenile Justice Commission, Division of Child and Family Services, Department of Human Resources:
[Introduced herself.] [The Juvenile Justice Programs office] oversees a rather large project called the Enforcing Underage Drinking Laws Program statewide. Approximately 80 percent of those dollars go to local law enforcement agencies to curtail the availability of alcohol to young people through their enforcement initiatives. About another 10 percent goes to local community coalitions, and a little less than 10 percent goes toward the Stand Tall, Don’t Fall Youth Teams across the state. Those young people are dedicated to reducing alcohol use by young people through the glamorizing and normalizing of non-drinking behaviors. We also support a parenting program and we acknowledge the importance of parents in this process.
Through the Enforcing Underage Drinking Laws Program, without the dedication of new funds or new resources, I believe we can accomplish much of what is intended within this Resolution and would be very happy to do so in cooperation with the other organizations listed in this bill. We already work very closely with Maria Canfield, the Bureau of Alcohol and Drug Abuse, the Office of Traffic Safety, and several community-based organizations such as the Safe Community Partnership down in Las Vegas, and several other organizations that are actively involved in this issue already and have the data.
I believe that working together we can [assemble] this data. Meetings we’re already having with the Enforcing Underage Drinking Laws Project can be maximized by adding this item to their agendas, and hopefully we can come back to you with some solid recommendations in the Seventy-third Legislative Session.
Assemblywoman Leslie:
I kind of heard a wishy-washy statement from Maria [Canfield] about whether this could happen, then I heard a stronger statement from Kathy [Bartosz]. My only concern with the bill is whether this report will actually happen. I’m the mother of a teenager. I know how sneaky they can be, how hard it is to keep track of them, and how important this issue is. I have no problem with the concept and I think we need to do it.
There’s another issue that ties into this that I’d like you to comment on. There’s been a raging controversy for several sessions in the Ways and Means Committee about alcohol and drug abuse prevention programs and whether we know where they are, how effective they are, and why we are funding 25 of them. Shouldn’t we be funding the 3 most effective? We’ve asked the Department of Education for several sessions to do a study on what is the most effective and recommend that back to us. Both sessions I’ve been here they’ve been asked to do it but they’ve come back the next session, including this one, saying, “We didn’t have the money. We wanted to do the study but it didn’t get done.” Can we tie that issue to this? Is this going to happen or is this going to be another situation where we’ll come back in two years and say, “Well, it was a good idea, but we didn’t have the money?”
Maria Canfield:
The study will happen. Generally speaking, I believe we will use secondary data sources, as Kathy [Bartosz] alluded to, that already exist. I believe we will be able to make some recommendations for your consideration during the next session.
Assemblywoman Leslie:
Will we have this recommended plan of action for modifying existing policies and programs? [Ms. Canfield affirmed they would.] Okay, that’s what I wanted to hear.
Maria Canfield:
[I will] address the second part of your question. As you may or may not know, the state of Nevada recently received a large substance abuse prevention grant from the Substance Abuse Mental Health Services Administration’s Center for Substance Abuse Prevention. The grant was awarded to the Governor’s office and is referred to as a “State Incentive Grant.” It’s for $3 million for 3 years. The project technically started in October. The money was received by IFC (Interim Finance Committee), we got permission in November, and we’ve had the first of the Governor’s Advisory Committee meetings a couple of weeks past. Ms. Leslie is on the Committee and was able to attend part of the meeting.
[Maria Canfield] There are two main goals of this project. One of them is to get a handle on where all substance abuse prevention funding in the state is occurring, what services are being provided, and to move the state system to establishing a common framework in order to document model programs that are being used, what the outcomes of the programs are, and where the services are being provided. The second goal is for us as state agencies to get our act together in order to facilitate the development of infrastructure at the local community level in order to be able to enhance and expand substance abuse prevention programs that are effective and to document their effectiveness. I anticipate that over the life of the project we’ll be able to answer these questions for you.
Kathy Bartosz:
Nevada’s not going to be doing this in isolation, either. I know that Senator Wiener alluded to “Aluminum Anonymous,” which is actually spearheaded by Dennis Brezina, aka the “Roadside Warrior.” He’s a Harvard graduate who has actually spent his time going along the freeways and highways of this great nation counting discarded cans and bottles along the side of the road. He has come up with a scientifically valid formula for calculating how much drinking is done in vehicles and by what age groups that has actually been endorsed by the National Traffic Safety Administration.
He has gotten a resolution passed already in at least 11 other states and I know there are 5 others considering it as we speak, so some of our sister organizations in other states will also be working on this issue. We run into them all the time at various national organizations we go to through the Enforcing of Underage Drinking Laws Program. We work [with other states] to see what kinds of interesting and innovative ideas they come up with to deter this kind of behavior. You were saying she sounded somewhat wishy-washy, but that’s because she is not the mother, as I am, of a 14-year old son.
Assemblywoman Weber:
I have been thinking about all of the tools that we have to be able to address the problem. At the same time, I’m trying to think from the viewpoint of the Department of Motor Vehicles. If we look at the driver handbook, how much information is available there in this whole area, especially for the first-time young driver? The most important thing for young people seems to be their first driver’s license. If, somehow, we could enhance materials that will be in their hands already while they’re studying, hopefully, to be good drivers. I was curious whether the handbook contains any material about all of these things we’re trying to accomplish as well as [what it would contain] in the area of testing. [Are there any quantitative-type questions on] the [driver’s] test or any tests about how drinking and driving don’t mix?
Kathy Bartosz:
We’ve actually engaged in some conversations with folks over at the Department of Motor Vehicles about that very issue and about what other kinds of educational opportunities we can seize to help young people understand the importance of not drinking, and especially not drinking and driving, before they get their license. One of the greatest steps that’s happened with that right now is Senator Cegavske’s Graduated Sanctions License and some of the programs that are going to be put into place and secured through that. That is just one of the things we’re looking at and if that is adequate in addressing those issues, we’re looking at other ways of getting that information to young people prior to them taking and passing the driver’s test.
Assemblywoman McClain:
When they have driver’s ed [classes], do they still show those gross movies to kids about, “Here’s what happens when you get drunk and you go off a bridge?” I can remember seeing those and I can still remember them and that was quite a long time ago.
Kathy Bartosz:
I cannot speak to the driver education programs in all the schools. Laurel Stadler might have some information as far as the schools in this area. I do know that Sandy Haverly with Stop DUI down in Las Vegas, on an invitation basis, will put on an assembly within the high schools. Her videos are extremely graphic and do leave an impression on those young people but for how long, we don’t know. I know that they come out of those assemblies quite affected.
Assemblywoman Leslie:
As a mother of a 16-year old, I am very familiar with what they do and don’t get at this point, and they show those videos but they don’t have as much impact because of all the gore. The kids have video games now that you and I can’t even fathom, so I don’t think they’re as affected, but what is very effective is when they go into the schools and stage the drunk driving situation where kids die. What’s the name of that group?
Kathy Bartosz:
Stand Tall, Don’t Fall is one of them. There are also other organizations. Some of the SADD (Students Against Drunk Driving) chapters down south have sponsored the “Every 15 Minutes,” also known as the “Grim Reaper Program.”
Assemblywoman Leslie:
That had more effect on my daughter than anything else, for a while. That’s why I think this study is so important and why we need to look at what is effective and what is not. The DARE (Drug Abuse Resistance Education) Program comes to mind and there’ve been studies that say it’s not effective at all; there are studies that say it’s a little effective. That’s the frustration we feel on the Ways and Means Committee. We’re funding things but we don’t know really, in 2003, what will be effective [as opposed to what was effective] in 1973, 30 years ago.
Kathy Bartosz:
Speaking of 30 years ago, which was when I was last teaching in junior high schools, we had the highway patrol come and show videos and we had various other organizations come and talk from a variety of perspectives. But one of the things we found was most effective and the person who made the biggest impression on the group of young people that I had, especially the boys, was the insurance salesman who came in and told them what would happen to their insurance if they were caught with an open container in their vehicle and how this would put their ability to drive at severe risk. He had their full attention.
Chairwoman Koivisto:
Other questions from the Committee? [There were none.]
ASSEMBLYMAN WILLIAMS MOVED TO ADOPT S.C.R. 15.
ASSEMBLYMAN HORNE SECONDED THE MOTION.
THE MOTION CARRIED UNANIMOUSLY.
Chairwoman Koivisto:
That’s all the business we have. Thank you, Committee, for all your hard work this session. Just a reminder, our Committee party is scheduled for the 21st. We’re doing our party in conjunction with the Education and Transportation Committees and if you have not yet responded, please [do so].
Oh, we haven’t moved out Senate Bill 459. That’s the Senior Rx bill that no one from
the Governor’s office was interested enough to come and offer testimony
on. We’ve not heard from the Governor’s
office that they even want to pass this bill or that they have any interest in
this bill. I guess Mike Willden
testified [on it]. [S.B. 459]
just raises the limits [to qualify] but I want to know where they’re getting
the money and what they’re taking it from.
I think we’ll
meet behind the Bar of the Assembly.
[The meeting was adjourned at 3:06 p.m.]
RESPECTFULLY SUBMITTED:
Terry Horgan
Committee Secretary
APPROVED BY:
Assemblywoman Ellen Koivisto, Chairwoman
DATE: