MINUTES OF THE
SENATE Committee on Human Resources and Facilities
Seventy-second Session
February 26, 2003
The Senate Committee on Human Resources and Facilities was called to order by Chairman Raymond D. Rawson, at 1:42 p.m., on Wednesday, February 26, 2003, in Room 4100 of the Legislative Building, Carson City, Nevada. The meeting was videoconferenced to the Grant Sawyer State Office Building, Room 4406, 555 East Washington Avenue, Las Vegas, Nevada. Exhibit A is the Agenda. Exhibit B is the Attendance Roster. All exhibits are available and on file at the Research Library of the Legislative Counsel Bureau.
COMMITTEE MEMBERS PRESENT:
Senator Raymond D. Rawson, Chairman
Senator Barbara Cegavske, Vice Chairman
Senator Maurice E. Washington
Senator Dennis Nolan
Senator Joseph Neal
Senator Bernice Mathews
Senator Valerie Wiener
STAFF MEMBERS PRESENT:
H. Pepper Sturm, Committee Policy Analyst
Patricia Vardakis, Committee Secretary
OTHERS PRESENT:
Randall L. Todd, Dr. P.H., State Epidemiologist, Health Division, Department of Human Resources
Lucille Lusk, Lobbyist, Nevada Concerned Citizens
Bill Welch, Lobbyist, Nevada Hospital Association
Randal Munn, Senior Deputy Attorney General, Human Resources Division, Office of the Attorney General
Gary Peck, Lobbyist, Executive Director, American Civil Liberties Union
Stephanie Beck, R.N., Emergency Medical Services Coordinator, Washoe County District Health Department
Lawrence P. Matheis, Lobbyist, Nevada State Medical Association
Lynn Chapman, Lobbyist, Nevada Eagle Forum
Janine Hansen, Lobbyist, Nevada Eagle Forum
Helen A. Foley, Lobbyist, Clark County Health District
Stan Olsen, Lobbyist, Las Vegas Metropolitan Police, and Nevada Sheriff’s and Chief’s Association South
James F. Nadeau, Lobbyist, Washoe County Sheriff’s Office, and Nevada Sheriff’s and Chief’s Association North
Carlos Brandenburg, Ph.D., Administrator, Division of Mental Health and Developmental Services, Department of Human Resources
David A. Rosin, M.D., Medical Director, Southern Nevada Adult Mental Health Services
Debra Scott, R.N., M.S., A.P.N., Executive Director, State Board of Nursing
Sally Ramm, Elder Rights Attorney, Office of Specialist for the Rights of Elderly Persons, Aging Services Division, Department of Human Resources
Alexander Haartz, M.P.H., Deputy Administrator, Health Division, Department of Human Resources
Chairman Rawson:
We will open the hearing on Senate Bill (S.B.) 82.
SENATE BILL 82: Makes various changes concerning public health laws. (BDR 40-677)
Chairman Rawson:
I have a slide presentation (Exhibit C) to introduce S.B. 82. We can look at bio‑terrorism in our public health preparedness for issues we were not overly concerned about a few years ago because we never considered there would be a bio-terrorism attack in this country. We were shocked and had our eyes opened to some of the potentials. We saw massive destruction and many innocent lives were taken. One of the biggest surprises we had was biological weapons being used against us. We do not know where they came from. It opens the window for something we were not prepared to deal within our country. There are a number of deadly scenarios. Biological weapons have been prepared with anthrax, tularemia, typhus, and others. Not all stockpiles of biological weapons have been located. If we had a biological attack in one of our large populated areas, the deaths we would see would be massive.
We live in sophisticated communities and tend to think it will always be the same. We are within a heartbeat of what happened in Afghanistan because of weapons of mass destruction. A city such as Paris can be turned into rubble. The sophistication, ease, and comfort we have built in this country are held together with a thin thread. There is a growing element of disaffected people; such as, anarchists, terrorists, and revolutionists who want to bring down organized freedom and democracy. There are at least a dozen dictators who have demonstrated their willingness and ability to kill innocent civilians. The killing of 900 civilians has happened within the last decade. They may have been poor, but are not different from us.
Chairman Rawson:
It may be difficult for us to understand there are thousands of people who want nothing more than to kill Americans at any cost. There has been a concerted effort not to frighten people in this country. There are some issues with which we should be concerned. The country has tried to gear up and make a difference. We see the significant difference in our airports where everything is searched. It becomes harder every time you fly. We understand because we are concerned about being safe.
Our police and emergency services are gearing up to deal with the issues. We know we have a significantly higher level of public health preparedness today than we did 2 years ago. If you have tried to correspond with Congress recently, and send something in color, it will be irradiated and colors will run. You should either use fax or e-mail if you want to correspond with your congressman.
Our public health community is developing the capabilities to respond. When the first anthrax scare occurred, there were not enough isolation suits in the country to deal with the issue. When the Hart Building was closed, people panicked about a serious illness they knew little about. There was a run on antibiotics. There are many legal questions. Who would receive priority treatment if there were a national disaster? Would it be just the infected people, injured people, just those exposed, or would it be based on age? There are numerous complications in deciding who would receive the first treatment.
The first small pox vaccines were set-aside for health care workers and government people. Who would receive the vaccine? Would it be the wealthy or those on Medicaid rolls? What would be the deciding factors? There is an interest in covering the whole population, but what do we do if people do not want to be covered?
During the last year we have wrestled with these issues. We are trying to come to a reasonable approach by using accepted public health principles. We are aware some people do not believe in modern medicine. They may want alternative approaches. There is a need for consensual treatment. As we weigh each issue, there is a serious threat of small pox in this country, probably 3 million people would die from a large epidemic.
Isolation and quarantine are public health’s tried-and-true method of controlling disease. In our lifetime we have never had to deal with the issue of isolating 100,000 people. We live in a tourist economy where 100,000 visitors are in the State on a weekend. What would be the legal issues and the humanitarian issues? Would we let people make phone calls or use cell phones? How would we handle the press? Who is liable for the decisions being made? There are so many legal decisions.
Chairman Rawson:
Many things need to be done in this country and there should be preplanning, not just responding to emergencies. These issues need to be carefully considered so our freedoms and constitutional rights are not jeopardized. We need to consider the vulnerable areas of our society. How well is our food supply protected? Do we feel secure going to a Super Bowl Game or any large gathering? Subway transportation is not just a target for terrorists, but individuals who would try to create havoc. Those are big issues today.
Smallpox is a disease we thought was eradicated. Ten years ago a smallpox vaccine was not considered necessary. Today it only exists in weapon stockpiles. Unfortunately, the stockpiles have not all been identified. It is a tragedy that large sophisticated countries have built millions of weapons of this type.
This is an introduction as to why this bill is before us. There are three issues the bill addresses as well as amendments. First, it establishes syndromic reporting requiring our health department to develop the regulations for syndromic reporting. If we had a person with a contagious disease in this room, many people would be affected. How would we know about it? It would be by recognizing, seeing, and reporting. Then we could cope with the situation. The better the reporting, the fewer people will be harmed in the initial outbreaks. Secondly, we must have a mechanism for quarantine or isolation. Ten years ago I wrote the existing statutes. I am familiar with what can be done. At present we have the authority to isolate and quarantine people.
This bill concerns large groups of people. Do you use the same process for thousands of people as you would for a few? We need to make the procedure practical, yet people’s rights should not be jeopardized. Finally, this bill establishes a due process to protect people being isolated.
Senator Washington:
How many states have adopted emergency measures for biological epidemics?
Chairman Rawson:
A few states have adopted the Model State Emergency Health Powers Act. Most of the states have considered some aspect of the act. There are 30 states that have updated their infectious disease statutes to be more useful in the event of an emergency. This happened after our last session. We are about the last state to consider changes.
Senator Washington:
Are we in the last stages of this bill, barring amendments?
Chairman Rawson:
Yes. Essentially the bill is the product of the work committee on health care.
Senator Mathews:
Is this the total fiscal note in the back of the bill?
Chairman Rawson:
Paying for 10,000 people in isolation would require a large fiscal note. The authority to isolate is there, so the cost would go along. I have essentially dismissed the fiscal note.
Randall L. Todd, Dr.P.H., State Epidemiologist, Health Division, Department of Human Resources:
Senate Bill 82 will allow public health authorities to respond appropriately to the threat of biological terrorism. I will read from prepared testimony (Exhibit D). On page 3 I have provided a marked copy of the bill with our proposed changes.
Senator Washington:
Have you coordinated your efforts with Mr. Bussell?
Dr. Todd:
We have been working very closely with Mr. Bussell, the Governor’s Special Advisor on Homeland Security, to implement a number of strategies to better prepare the State to deal with a biological terrorist event.
Lucille Lusk, Lobbyist, Nevada Concerned Citizens:
We are offering three amendments (Exhibit E) to S.B. 82. When a person is detained, they have a right to a phone call as soon as possible. There are several places in the bill where this should be added or be made into a separate section. First, contact with loved ones will ease unnecessary stress and anger. Second, the right to testify on one’s behalf is protected. The bill states “an individual may not be allowed to appear in person at a hearing because of the potential danger to others, but would be able to appear telephonically by videoconference.” The third amendment concerns an individual who challenges an isolation or quarantine in court. If the court determines the detention was unjustified, the individual would not be responsible for the cost of counsel.
Chairman Rawson:
We will discuss your amendments in a work session.
Bill Welch, Lobbyist, Nevada Hospital Association:
I represent the Nevada Hospital Association, and the Nevada Homeland Security Council. I am a facilitator for the Nevada Bio-Terrorism Grant. This grant was written by the Nevada Hospital Association on behalf of the State and has three focuses: the identification of a bio-terrorism attack, an alert system, the development of a bio-terrorism response plan for regional, State, and multi-state response. We have developed a committee for the facilitation of this grant and have been actively involved in this process. I have referred this language to them for the purpose of clarification, not opposition. The hospitals in Nevada must be State and federal certified.
We will review the bill and look for Health Insurance Portability and Accountability Act of 1997 compliance, isolation of patient compliance, restraint of patient compliance, and the disposition of waste materials. What is written is logical and appropriate. Our concern is the bill is not in conflict with federal law. Perhaps, the Legislative Counsel Bureau could resolve those issues by incorporating language in the bill. We would ask homeland security on a national level to acknowledge the local situation and provide us with relief from federal regulations that would be affected by the situation at hand.
Randal Munn, Senior Deputy Attorney General, Human Resources Division, Office of the Attorney General:
The suggestions I have heard are reasonable. This bill is about protecting public health and not taking away people’s rights.
Gary Peck, Lobbyist, Executive Director, American Civil Liberties Union:
We recognize the difficult task to balance the need to respond effectively and quickly to public health emergencies and terrorist threats, but a person’s civil liberties need to be respected. We have a number of concerns I will submit in writing (Exhibit F). By moving the language relating to the least restrictive environment to the front of the bill, it clarifies the framework for legislation. Every court we have worked with has applied that standard in the context of this type of legislation. We support the person’s right to contact an attorney, family, and friends. In section 24, we would include a person’s right to refuse treatment, to communicate electronically, and to challenge orders in court. Our concerns are listed in Exhibit F, especially number 7 concerning emergency isolation. These are difficult and important decisions because they carry civil liberty implications. We feel only a physician can make those decisions. We have concerns regarding religious or conscience exemptions for medical examinations or tests. We feel there is room for significant changes by making the legislation before us sensitive to the civil liberty concerns that are consistent to other state legislatures who have passed, without compromising, the government’s ability to respond to bio-terrorism threats.
Stephanie Beck, R.N., Emergency Medical Services Coordinator, Washoe County District Health Department:
We support S.B. 82. We have an amendment to section 14 (Exhibit G). We suggest the language be changed to reflect the petition be filed where the isolation or quarantine occurs, not where the individual resides.
Chairman Rawson:
We appreciate the amendment.
Lawrence P. Matheis, Lobbyist, Nevada State Medical Association:
We support S.B. 82 and will help with clarifications of the bill. A decade ago we revamped and updated Nevada’s health law in response to the human immunodeficiency virus (HIV) epidemic. There has never been a generation where public health law had to be revised in a short period of time. The issues of how this system will interface with the system treating people who have been exposed, how the emergency services will continue to be provided, and how to maintain a standard of normality during a period of abnormality will be decided in future discussions.
Lynn Chapman, Lobbyist, Nevada Eagle Forum:
The Nevada Eagle Forum is concerned about religious exemptions and ask they be included in the bill.
Chairman Rawson:
We believe religious exemptions are addressed in existing law and there is language concerning all treatment is consensual. We will make sure the issue is covered.
Janine Hansen, Lobbyist, Nevada Eagle Forum:
In response to Senator Washington’s question, Florida was the only state that passed the Model Emergency Health Powers Act in its original form. We appreciate the inclusion of consensual medical treatment on page 4, and quarantine can be in home or residence. I wanted to verify the intent of S.B. 82 was not to isolate or quarantine a child without the consent of the parent.
I have a question concerning “pursuant to the order and without a warrant” on page 5, line 18. We understand the order to quarantine or isolate someone can be without warrant. Who presents the order to the individual person or persons so they know the order is by a legal authority?
Chairman Rawson:
A physician, police officer, or other authority would notify the person to be quarantined. This would be a quick way of handling a situation when a known pathogen is released. There is no warrant, there is language in the bill defining what must happen within a matter of hours.
Ms. Hansen:
Without documentation there could be a problem.
Chairman Rawson:
I will discuss your concern with the public health authorities.
Ms. Hansen:
We agree with the amendments Ms. Lusk has presented to the committee. On page 10 the language states people may stay in their home. We would add the location of quarantine or isolation should be a safe place, free from interpersonal violence, and employ sanitary conditions. On page 12, lines 1 and 2, the language should not be at the discretion of the court, but a person should have the right to testify on their behalf. On line 27, the language states “the court may order the most appropriate course of treatment.” This causes concern regarding religious exemption or forced treatment.
Chairman Rawson:
There is existing law addressing the issue of religious exemption.
Ms. Hansen:
The existing language is very narrow. It only includes people of a particular religion. Has it been updated?
Chairman Rawson:
The language has been changed.
Ms. Hansen:
Regarding syndromic reporting and active surveillance, the right to privacy and confidentiality of medical records must be observed.
Mr. Peck:
In section 8 there is no clear language giving people who are quarantined the right to seek an immediate injunction.
Helen A. Foley, Lobbyist, Clark County Health District:
We support the concept of S.B. 82. It is essential for groups to be quarantined, whereas the current law only addresses individuals. There are issues concerning the procedures such as who will transport people, and to what location, kinds of vehicles to be used, and the financial ramifications in this issue. In Clark County all the emergency medical services have been planning strategies in the event of a disaster.
Stan Olsen, Lobbyist, Las Vegas Metropolitan Police, and Nevada Sheriff’s and Chief’s Association South:
We agree with the concerns Ms. Foley has brought to the committee’s attention.
Chairman Rawson:
We know the National Guard and our police will have significant authority if there is an emergency situation.
Senator Neal:
Will the individuals transporting quarantined persons also be placed in quarantine? I have concerns with sections 5 and 6. Section 6 lists political appointees who will make decisions concerning people who have been exposed and quarantined. Has communicable disease been defined in statute?
Chairman Rawson:
It has to be declared as a serious life-threatening emergency. The law defines an infectious disease. Senate Bill 82 does not change the definition but builds upon it. Your questions will be answered.
Senator Neal:
I would like to have those questions answered in order to vote.
Senator Nolan:
I may be able to answer Senator Neal’s questions. I am a member of the Emergency Planning Council in southern Nevada responsible for developing disaster response programs to hazardous materials. After the terrorist attack of September 11, 2001, disaster we focused on bio-terrorism. The emergency medical personnel, who have the appropriate protective equipment and systems in place to transport infected people, would respond to this type of emergency, when identified as a biological hazard.
In response to Ms. Hansen’s concern about not having documentation when approached to be quarantined, if emergency medical personnel in orange bio‑hazard suits appeared at your door informing you that you were infected, you might be inclined to go with them.
Senator Neal:
My concerns are of a more serious nature.
James F. Nadeau, Lobbyist, Washoe County Sheriff’s Office, and Nevada Sheriff’s and Chief’s Association North:
We believe law enforcement is going to have an integral part in this process. We will continue to address some of the transportation issues. We do not want to expose the men and women of law enforcement to unnecessary risk.
Senator Wiener:
Have we established a state-of-the-art communications system in the event of emergency?
Mr. Nadeau:
In Washoe County we are in the process of establishing an 800-megahertz communication system, which will be multi-agency and multi-discipline, meaning a variety of entities will be involved.
Mr. Olsen:
In Clark County we are not using the 800-megahertz system, but there are other systems able to meld the different frequencies together to communicate. We have the 911 dispatch operation for police, fire, and medical. In addition, we have a common channel frequency where agencies can communicate through the dispatch operation.
Senator Mathews:
It is my understanding the communication system is not working.
Mr. Olsen:
The Nevada Highway Patrol’s (NHP) system uses a different frequency and we cannot communicate directly with them. The Southern Nevada law enforcement can communicate through a common channel. We can communicate with NHP officers in the valley through our common channel.
Chairman Rawson:
I will close the hearing on S.B. 82 and ask Senator Cegavske to preside over the hearing of S.B. 83.
Vice Chairman Cegavske:
We will open the hearing on S.B. 83.
SENATE BILL 83: Expands circumstances under which registered nurses are authorized to dispense dangerous drugs. (BDR 40-533)
Carlos Brandenburg, Ph.D, Administrator, Division of Mental Health and Developmental Services, Department of Human Resources:
Senate Bill 83 was introduced by the division after we determined our nurses in the rural clinics of Nevada did not have medication dispensing authority.
David A. Rosin, M.D., Medical Director, Southern Nevada Adult Mental Health Services:
Senate Bill 83 extends psychiatric medication dispensing authority to registered nurses working in the Community Rural Clinics Mental Health Services providing service to severely mentally ill people living in rural Nevada.
Under the current Nevada Revised Statutes (NRS) 454.215 registered nurses working in the rural clinics do not have the authority to dispense psychiatric medications to their patients. This bill requests these nurses have the authority to do so.
As of December 2002, there were over 1200 mentally ill patients residing in rural Nevada. These clients are seen in medication clinics throughout the State at 16 different sites. All require psychiatric medications for stability and treatment for severe psychiatric illness. In the 16 clinics there are only 2.23 fulltime equivalent contract psychiatrists prescribing these medications. In some locations the psychiatrists only comes to the clinic once a month making the registered nurse the person providing ongoing care. Because of the scarcity of psychiatrists and other scheduling issues, the psychiatric nurse is the only medical professional available to dispense medications, which come through the mail. Working with the guidance of the State Board of Pharmacy, we developed an interim measure negotiated with the Department of Human Resources, Health Division, to allow, on a temporary basis, our nurses to work as agents of the Health Division. Under the current statute the State Board of Pharmacy recognizes nurses in rural health clinics to dispense certain medications.
Senate Bill 83 extends the prescribing right for psychiatric medications under protocol to enlarge the provisions to enable us to treat our patients in the rural areas.
Senator Mathews:
Did you work with the State Board of Pharmacy and the State Board of Nursing?
Dr. Rosin:
Yes.
Senator Wiener:
How are the psychiatric medications established under protocol?
Dr. Rosin:
The protocol developed with the Health Division was submitted to the State Board of Pharmacy. It outlines the medications nurses can prescribe. They are the medications we prescribe on our formulary such as, antipsychotic, antidepressant, and antianxiety medications. They do not extend beyond the mental health area.
Senator Wiener:
Does the language in S.B. 83 define the psychiatric medications Dr. Rosin explained? As it is written, I see a full range unless NRS 433.233 defines the medication range?
Dr. Brandenburg:
The statute does not define the medication range. We could amend the language limiting it to psychiatric medications.
Senator Wiener:
Would that serve your needs and purpose?
Dr. Brandenburg:
It is the purpose.
Vice Chairman Cegavske:
We will have committee staff research your concern.
Senator Neal:
The bill calls for a dangerous drug to be dispensed by a registered nurse to a patient at a rural clinic. What is the procedure?
Dr. Rosin:
We have less than three psychiatrists making the rounds in the rural clinics. They do the prescribing of medications after the evaluation of the clients. Most of our clients in the rural areas obtain medications directly by mail. The manufacturers supply a large portion of our pharmacy service. These medications are under the direction of the doctor with specifications for dispensing. The pharmacies at the hospital in Sparks, as well as in Clark County, service the rural clinics filling prescriptions received from physicians and are mailed to the rural clinics. After the prescriptions are inventoried, the medications are dispensed according to the physicians’ instructions.
Senator Neal:
How is the procedure different from what nurses presently do?
Dr. Rosin:
Under the direct supervision of a physician, a nurse can dispense medications in a hospital setting. Our physicians are not on-site. They are contract doctors who practice elsewhere. They are not at the clinic when the medication arrives. In the rural areas there are certain protocols for treatment allowing the nurses to give the medications when the doctors are not at the clinics. I can provide you with a more technical answer.
Senator Neal:
Are there specific instructions from the doctor to the nurse?
Dr. Rosin:
The medication order on the prescription goes to the pharmaceutical house, is filled and sent to the clinic with the directions and patient’s name, or it comes from our pharmacy with directions. These patients are seen in the clinics and are given a prepackaged amount of medication with the doctor’s instructions. The nurse would review the instructions and give the medications to the client. At present we have nonmedical people because, without this provision, the nurses cannot involve themselves in that process.
Debra Scott, R.N., M.S., A.P.N., Executive Director, State Board of Nursing:
My understanding is S.B. 83 concerns dispensing, not prescribing medications. Nurses can dispense medications based on limited procedures and policies in limited places based on the bill. Otherwise, they need dispensing privileges through the State Board of Pharmacy.
Dr. Rosin:
This is purely dispensing, not prescribing medications. Prescribing is by physicians only. This will grant authority to the State Board of Pharmacy to give nurses the ability to dispense medications.
Ms. Scott:
The State Board of Nursing is in support of S.B. 83.
Mr. Matheis:
We support S.B. 83. The bill is narrowly drawn to specifically address a problem that could put patients and others working at the facility at risk. It is cleaner than extending the public health nurse definition for these exclusive settings.
Vice Chairman Cegavske:
We will close the hearing on S.B. 83.
Chairman Rawson:
We will open the hearing on Senate Bill (S.B.) 84.
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, Office of Specialist for the rights of Elderly Persons, Aging Services Division, Department of Human Resources:
We are here to support S.B. 84, a bill requested by the Aging Services Division. This bill proposes changes in the surety bonds currently required in NRS 449.065. I am reading from prepared testimony (Exhibit H). The law provides good protection for Nevada’s senior citizens, and we support these changes.
Chairman Rawson:
What is the amount of bond required?
Ms. Ramm:
The purposed amount is $5000 for a facility with less than seven employees, $25,000 for a facility with 8 to 25 employees, and $50,000 for a facility with more than 25 employees.
Chairman Rawson:
What is the current cost?
Ms. Ramm:
It depends upon the facility. If it has excellent credit, it is 1 percent of the bond. Another company may charge 2 percent.
Chairman Rawson:
Are the facilities complaining they are having a problem?
Ms. Ramm:
We hear complaints because there are only two companies selling the surety bonds. The facilities would like more competition among companies, but they are pleased to have the protection.
Chairman Rawson:
Could the facility put money in an interest-bearing account?
Ms. Ramm:
Yes. According to the statute the interest goes to the facility. If the facility were solvent, they would have assets in an account to meet their needs.
Alexander Haartz, M.P.H., Deputy Administrator, Health Division, Department of Human Resources:
The Health Division views S.B. 84 as a housekeeping bill. Since the Bureau of Licensure and Certification already tracks this information, it is proper to move the function to the Health Division. We are in support of S.B. 84.
Senator Neal:
Why is this being moved to the Health Division?
Ms. Ramm:
The primary reason is the surety bond is required for licensing. Currently, the proof of the bond is sent to the Aging Services Division where it is recorded and sent to the Bureau of Licensure and Certification. Instead of going through our office, it would go directly to the Bureau of Licensure and Certification.
Senator Neal:
What is happening?
Mr. Haartz:
In the statute we are proposing to change the location of where the bonds are filed and who will administer them.
SENATOR WIENER MOVED TO DO PASS S.B. 84.
SENATOR NEAL SECONDED THE MOTION.
THE MOTION CARRIED. (SENATORS NOLAN AND WASHINGTON WERE ABSENT FOR THE VOTE.)
*****
Chairman Rawson:
Was there anything controversial discussed in my absence concerning S.B. 83?
Senator Wiener:
I have talked to Dr. Brandenburg and Pepper Sturm, Committee Policy Analyst. There is a need to create language to limit the type of medications dispensed.
Chairman Rawson:
Are you referring to mental health medications?
Senator Mathews:
In the rural clinics there is a need for physical medications as well. The drugs need to be identified.
Chairman Rawson:
Would that include antibiotics, for example?
Senator Mathews:
Antibiotics are a good example.
Chairman Rawson:
Then there are controlled substances and pain medications.
Senator Mathews:
The people writing the bill would need to decide. I believe it should not be limited to psychiatric medications.
Chairman Rawson:
The language in the bill is, “a dangerous drug may be dispensed.”
SENATOR MATHEWS MOVED TO DO PASS S.B. 83.
SENATOR CEGAVSKE SECONDED THE MOTION.
THE MOTION CARRIED. (SENATORS NOLAN AND WASHINGTON WERE ABSENT FOR THE VOTE.)
*****
Chairman Rawson:
We could consider a motion of amend and do pass S.B. 82 and the committee could review the bill before it goes forward.
SENATOR CEGAVSKE MOVED TO AMEND AND DO PASS S.B. 82.
SENATOR MATHEWS SECONDED THE MOTION.
THE MOTION CARRIED. (SENATOR NEAL VOTED NO. SENATORS NOLAN AND WASHINGTON WERE ABSENT FOR THE VOTE.)
*****
Chairman Rawson:
We have Bill Draft Request (BDR) R-680 for committee introduction. It urges the Department of Human Resources to establish a statewide information and referral system. There is no appropriation in the BDR and it will be returned to this committee.
BILL DRAFT REQUEST R-680: Urges Department of Human Resources to establish statewide informational and referral system for health, welfare, human and social services. (Later introduced as Senate Concurrent Resolution 11.)
SENATOR WIENER MOVED TO INTRODUCE BDR R-680.
SENATOR CEGAVSKE SECONDED THE MOTION.
THE MOTION CARRIED. (SENATORS NOLAN AND WASHINGTON WERE ABSENT FOR THE VOTE.)
*****
Chairman Rawson:
There being no further issues before us today, I adjourn the meeting at 3:14 p.m.
RESPECTFULLY SUBMITTED:
Patricia Vardakis,
Committee Secretary
APPROVED BY:
Senator Raymond D. Rawson, Chairman
DATE: