MINUTES OF THE
SENATE Committee on Human Resources and Facilities
Seventy-second Session
April 4, 2003
The Senate Committee on Human Resources and Facilities was called to order by Chairman Raymond D. Rawson, at 12:20 p.m., on Friday, April 4, 2003, in Room 2135 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 K. 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
GUEST LEGISLATORS PRESENT:
Senator Sandra J. Tiffany, Clark County Senatorial District No. 5
OTHERS PRESENT:
Terri Miller, Committee Coordinator, Nevada Coalition Against Sexual Violence
Debora C. Tullgren
Bobbie Gang, Lobbyist, Nevada Women’s Lobby
Blanca Vazquez, Lobbyist, Clark County
Carol Johnston, Acting Deputy Administrator, Division of Child and Family Services, Department of Human Resources
May S. Shelton, Lobbyist, Washoe County
V. Robert Payant, Lobbyist, Executive Director, Nevada Catholic Conference, and Religious Alliance in Nevada:
Lucille Lusk, Lobbyist, Nevada Concerned Citizens
Sharon P. Shaffer, Chairman, State Board of Funeral Directors, Embalmers and Operators of Cemeteries and Crematories
William Vassiliadis, Lobbyist, Employers Insurance Company of Nevada
Morgan R. Baumgartner, Employers Insurance Company of Nevada
Lisa Black, Lobbyist, Nevada Nurses Association
Ned Phillips
Kyle West
Richard R. Ziser, Lobbyist, Coalition for the Protection of Marriage
Bill Welch, Lobbyist, Nevada Hospital Association
Chairman Rawson:
I will open the hearing on Senate Bill (S.B.) 383.
SENATE BILL 383: Makes various changes concerning reporting of child abuse. (BDR 38-194)
Terri Miller, Committee Coordinator, Nevada Coalition Against Sexual Violence:
I support S.B. 383 and mandatory reporting. There has been an extensive lack of reporting by school personnel concerning suspected child abuse. I have submitted to the committee information on cases (Exhibit C. Original is on file in the Research Library.). I have been involved with Clark County and Statewide. On page 1 (Exhibit C), there is a case from Pahrump, concerning a teacher permitted to sexually abuse students over a 20-year period. Reports were made to administrators at the Pahrump Valley High School but they neglected to make a mandated report to law enforcement. Many of the administrators are holding their positions and have continued to fail to file reports of suspected child and sexual abuse within the school system. I have personal experience; they have reported suspected abuse within my family, which resulted in a mandatory report being made immediately. The subsequent investigation revealed there was no abuse. I am asking the same standard be applied when they suspect abuse within their faculty.
There are cases in Clark County where the principal failed to make a report when he was made aware of potential abuse, which resulted in a sexual assault. The teacher is serving 13 years in prison. If the report had been made timely this would not have happened. Please review the cases and data (Exhibit C) I have provided. I ask you to consider the forfeiture of certification or license of anyone failing to make a report and stop the continuation of abuse.
Chairman Rawson:
Do you have any changes to the language in the bill?
Ms. Miller:
I do not have any changes to the language as written. I ask the penalty be increased to a gross misdemeanor and automatic forfeiture of certification or licensure.
Debora C. Tullgren:
I am the mother of a victim who was sexually molested by the clergy. The superiors of the clergy were aware of the circumstances. I feel the stiffer the penalty the more likely a report will be made, thereby saving my son and others from future consequences. My son’s offender previously committed a similar act but a report was not filed. I support S.B. 383.
Bobbie Gang, Lobbyist, Nevada Women’s Lobby:
We support the changes in this legislation. There are many volunteers working with our youth and they are in a position to observe and are cognizant of these situations. Volunteers would report child abuse more readily if they felt it was their obligation to do so.
Chairman Rawson:
Lines 7 and 8 on page 3 of S.B. 383 would be added. Is this covered in existing law?
Ms. Gang:
I do not recall this requirement as part of a volunteer’s responsibilities.
Chairman Rawson:
I am looking at line 44 on page 2. The language seems narrowly defined.
Ms. Gang:
The language addresses a volunteer within a child care facility, Girl/Boy Scouts, and any other youth group.
Blanca Vazquez, Lobbyist, Clark County:
Clark County is in support of S.B. 383. I am reading a statement from Susan Klein-Rothschild, Director of the Clark County Family Services Department, for the record (Exhibit D).
Carol Johnston, Acting Deputy Administrator, Division of Child and Family Services, Department of Human Resources:
We are in support of S.B. 383. I will be reading the prepared testimony of Edward E. Cotton, Administrator, Division of Child and Family Services, Department of Human Resources (Exhibit E).
Chairman Rawson:
What is the difference between a misdemeanor and gross misdemeanor? Is it the amount of a fine or prison term?
Senator Washington:
A misdemeanor is up to a 6-month jail term and a gross misdemeanor is 6 months to 1 year.
May S. Shelton, Lobbyist, Washoe County:
We support and urge the committee to vote in favor of S.B. 383.
V. Robert Payant, Lobbyist, Executive Director, Nevada Catholic Conference, and Religious Alliance in Nevada (RAIN):
This is another opportunity to protect our children. The churches have a number of activities. Senate Bill 383 will place a burden on them but it is one we are willing to undertake.
Senator Washington:
I would like to speak as a member of the clergy. Reporting neglect or child abuse will place a burden on church volunteer organizations but also will create a split in the congregation. Our responsibility is to keep families whole and provide another option.
Chairman Rawson:
The situation would be true for the workplace, but what is the important issue?
Mr. Payant:
The protection of the children is primary.
Senator Mathews:
What is the name of your organization?
Mr. Payant:
The organization is called Religious Alliance in Nevada. It is composed of the Presbyterian Church of Nevada, the United Methodist Church, the Lutheran ELCA Lutherans, the Roman Catholics, and the Episcopalians.
Lucille Lusk, Lobbyist, Nevada Concerned Citizens:
There are concerns related to this issue that are not covered by S.B. 383. Our concern is about the scope of the bill as written. An entity providing organized activities for children is a broad term. It would include Parent Teachers Association, any church with a Sunday school, Girl/Boy Scouts and many other groups. Our primary concern is with the definition of volunteer. This is not limiting to regular volunteers but would take in the occasional volunteer, such as fill-ins. Training for those types of volunteers would be impossible but they would also come under this jurisdiction. I feel the individuals who give their time without compensation should not be subject to this type of threat. It could result in erroneous reports causing problems within the organizations. There would be additional time and work for professionals dealing with these charges. Most importantly, it would discourage volunteer service at a time when it is needed. The concern is with the scope and reach of the bill, not the intent.
Chairman Rawson:
I will close the hearing on S.B. 383 and open the hearing on S.B. 386.
SENATE BILL 386: Revises provisions concerning visitation rights of patients of certain health care facilities and disposition of body of person upon death. (BDR 40-957)
Sharon P. Shaffer, Chairman, State Board of Funeral Directors, Embalmers and Operators of Cemeteries and Crematories:
I am here to introduce my colleagues in Las Vegas.
William Vassiliadis, Lobbyist, Employers Insurance Company of Nevada:
This bill is not intended to circumvent, negate, or redefine family in Nevada law. The intent of S.B. 386 is to account for individuals such as senior citizens who choose to live together, a grandmother who takes custody of her grandchild, same-sex couples, or heterosexual individuals who live together. There are provisions in Nevada law and the patient bill of rights to address the problem but what the law does not address is unconscious patients and individuals who cannot state at the time of crisis their preference for who can help make decisions on their behalf. We are trying to find a reasonable way to provide comfort, help, and dignity to people who are in crisis. In addition, it will give guidance to health care professionals.
Morgan R. Baumgartner, Lobbyist, Employers Insurance Company of Nevada:
Section 2 adopts the Joint Commission on Accreditation of Health Care Organizations (JCAHO) definition of family. They certify and set the rules for the hospitals. The intent of section 2 was to allow parity for non-blood-related people to see patients in the hospital. A friend will be extended the same family visitation privileges if they were so designated. We believe hospitals operate under this definition because it is the JCAHO definition.
Section 3 allows the execution of an affidavit by a patient who will be admitted to the hospital or as part of the preadmission form. This allows the patient to designate an individual permission to visit and be accorded the same privileges as a family member.
Section 4 allows a similar affidavit to execute in the event of a person’s death. This individual would be designated to dispose of the person’s body. Section 5 is cleanup language. Section 6 allows an anatomical gift to be made and the decisions concerning such a gift. Current law provides for a spouse, adult sons or daughters, parents, brothers, or guardian. The suggested language is, a person who can demonstrate they hold property and joint tenancy, maintain a joint bank account, is the majority beneficiary of a life insurance policy, or is designated as a dependant for a health care insurance policy to make the decisions concerning anatomical gifts. The second half of section 6 allows an affidavit demonstrating the same to be executed, similar to the burial affidavit. Section 7 addresses those individuals who make the decision to order cremation in the event no one is designated.
Senator Nolan:
Is the intent for adults to make the decisions not children?
Ms. Baumgartner:
Correct.
Senator Nolan:
I question the need for the inclusion of anatomical gifts. If a person has not made the determination prior to death then they may not have wanted this to be done.
Ms. Baumgartner:
Current law provides that the spouse can make the decisions. There would have been prior conversations, an organ donation card signed, and this is a further step to ensure decisions are properly made.
Senator Cegavske:
The language concerning business partners is too broad or needs to be more defined.
Chairman Rawson:
I see language concerning joint tenancy.
Ms. Baumgartner:
I did not mention business partner. Section 6 sets out the list of people who can present evidence that they have this type of relationship.
Chairman Rawson:
The coroner is always concerned about the cremation rights.
Senator Sandra J. Tiffany, Clark County Senatorial District No. 5:
I am here to testify in favor of S.B. 386. I am in support of this bill because there are many relationships outside of the traditional family that could be as significant to you especially at a time when trauma would strike. This bill gives people other possibilities.
Lisa Black, Lobbyist, Nevada Nurses Association:
I am reading from prepared testimony (Exhibit F). I, as a registered nurse have cared for many patients and families who have struggled with complex health care and end-of-life decisions. Patients must be afforded the fundamental right to define whom they wish to be involved in their care and whom they wish to be recognized as family. I urge your support of S.B. 386.
Chairman Rawson:
How can the definitions in the bill be strengthened without addressing the issue of family?
Ms. Black:
Any person recognized by someone to be his or her family should be defined as such.
Chairman Rawson:
This could be pursued through an advanced care directive or an affidavit where you can define anyone to have authority.
Senator Cegavske:
What would happen in a domestic violence case?
Chairman Rawson:
The current language in the bill does list an order of authority.
Senator Cegavske:
There may be reasons to keep someone out of the line of the authority.
Ms. Black:
Current statute does define the lineage of authority unless there has been another designee.
Mr. Payant:
I speak in favor of S.B. 386. I see no purpose in enlarging the definition of family with this legislation. I would propose section 2 be eliminated. In section 3, the language should be revised to show this is a designated person rather than a new family member. In section 6, lines 17 through 26 should not precede lines 27 through 32.
Ned Phillips:
I am the vice president of Palm Mortuary. My concerns are in the anatomical gift and cremation areas of the bill. In sections 6 and 7, there is inconsistency in the order of next-of-kin. We feel the language on lines 17 through 19 covers the issue and there is no need for lines 20 through 26 on page 3 of S.B. 386. Another concern is the ambiguity of the language on lines 20 through 26. This language should be clarified for administration as well as the consumer’s understanding. There has been previous testimony concerning these alternatives applying in the event you do not have family members. The bill does not address this as being an alternative.
Chairman Rawson:
I did not understand your last comment.
Mr. Phillips:
Ms. Baumgartner testified the intent of the language was if you do not have family members then there was an order of authority. The clearer the language is in the delineation of next of kin the fewer problems will occur.
Kyle West:
We have concerns with the language on lines 20 through 26. This language may involve our industry in financial matters of which we do not need to be involved. The language is vague.
Senator Cegavske:
How do the mortuaries resolve these situations currently?
Mr. Phillips:
We follow the next-of-kin order. I agree with prior testimony regarding “significant other.”
Senator Cegavske:
What happens when there are no family members and someone comes forward as a friend?
Mr. Phillips:
A court order would be required or a public administrator becomes involved.
Senator Wiener:
There needs to be clarification in the order of authority.
Chairman Rawson:
Lines 11 and 12, of section 6 define the order of priority listed.
Ms. Baumgartner:
The problems called to your attention concerning the priority list and the differences between anatomical gift and cremation section are changes in law. The amendatory language we suggested is consistent through both sections. On line 24 the designated word is “or” not “and.”
Senator Nolan:
Order is important in this area. Based on statute the bloodline is used for notification of next of kin and identification of a deceased person. Could you give an example of cases involving significant others?
Mr. West:
The way social security and pension benefits are set up you may have an adult couple living together. They live as a married couple with joint financial and other responsibilities and may not have anyone else as family members. We would turn the case over to public administrators. Senate Bill 386 would help but there is wording in the bill which could hinder us.
Mr. Phillips:
Ms. Baumgartner testified sections 6 and 7 were the same, but they are not. Line 27 on page 3, is not the same as line 6 on page 5, of S.B. 386. Line 29 in section 6 refers to an adult brother or sister of the decedent whereas that is not mentioned in section 7. Consistency in the language will be helpful for the consumer because the rules are the same for similar situations.
Mr. Sturm:
Section 6 of the bill is the list. Each designation is an “and,” and would be in the order of priority on the list. Lines 20 through 26 could be in any order, they would be the “or.”
Chairman Rawson:
We will clarify the language.
Richard R. Ziser, Lobbyist, Coalition for the Protection of Marriage:
This issue was raised during the campaign for Ballot Question 2, the protection of marriage initiative. We contended throughout the campaign this was not an issue in terms of hospital visitation, those rights are in existence. I am here to clarify our position. Section 2 can be omitted. I have given the committee a copy of the Patient’s Rights (Exhibit G). These rights grant a patient the option of having friends visit them in the hospital.
Currently in hospitals you can have advanced directives, a power of attorney which accomplishes the task of an affidavit. There are other alternatives. We do not see the need for changing the family definition and there are other means to accomplishing a person’s preferences. The affidavits in the bill would be duplication.
Ms. Lusk:
Our concerns are with the specific language and scope of the bill as written, not in its intent. Our understanding is the first part of the bill would apply to any age. We would ask that be checked and it only applies to persons who have reached the age of majority so there is no conflict with parental authority. It is not clear how the affidavits in the bill differ from the health care powers of attorney. We do not have objection to them.
In section 6 on page 3, the purpose of the language is the order of priority listed when there is no affidavit. Lines 17 through 19 should precede line 16. The language regarding maintaining a joint bank account is too broad and could cause problems.
Senator Cegavske:
What is the current hospital practice if a patient dies without trust? Could the forms be utilized by someone in a hospital? Would a legal procedure be necessary?
Bill Welch, Lobbyist, Nevada Hospital Association:
Hospitals do provide for visitation of individuals other than the immediate family unless it is designated by the family not to have other visitors. There are forms within the hospital but the forms in S.B. 386 would provide additional protection for the hospitals. If an issue arose and there were not family members or legal guardians provided, the hospital would need to look to the courts in order to move forward.
On page 3, line 21, the word “held” should be changed to “currently holds.” Also, the language on lines 21 and 22 referring to “property” and “bank accounts” the term “right of survivorship” should be inserted. This would clarify the intent of authority to speak on behalf of the deceased.
Senator Neal:
I do not understand your amending language. The person is deceased.
Mr. Welch:
The scenario could be that they held joint accounts with other individuals in the past for business or family purposes. There should be language clarifying it is an existing status at the time of death.
Senator Wiener:
The language “held or maintained at the time of death” would clarify the intent.
Chairman Rawson:
I will close the hearing on S.B. 386. Senator Wiener and Senator Cegavske each have a bill for the committee’s consideration, S.B. 307 and S.B. 390.
SENATE BILL 307: Requires posting of signs in certain food establishments warning of risk of drinking alcoholic beverages during pregnancy and merges Advisory Subcommittee on Fetal Alcohol Syndrome into Advisory Board on Maternal and Child Health. (BDR 40-6)
SENATOR WIENER MOVED TO AMEND AND DO PASS S.B. 307.
SENATOR MATHEWS SECONDED THE MOTION.
Senator Cegavske:
Have you spoken to the persons opposing the bill?
Senator Wiener:
I have not. I have worked with the people in the Nevada Resort Association and they support the bill. After this bill passed in both houses last session, there was no remaining floor session for it to return to the senate for a “concur.” Since then, 3500 establishments serving alcohol on the premises have voluntarily taken the signs. Many of these have been restaurants.
THE MOTION CARRIED UNANIMOUSLY.
*****
Senator Cegavske:
The teachers association testified in support of Senate Bill 390.
SENATE BILL 390: Requires persons who serve on Commission on Professional Standards in Education as teachers to hold certain national certification. (BDR 34-892)
Senator Cegavske:
They came to me the next day and said there were problems with the bill. They explained there are not enough accredited teachers in the system. The only positions available to replace would not become open until the year 2007. They do not want to displace anyone. If the person chooses not to remain in that position then it would be open. Senator Rawson proposed an amendment. Extending it to when “the next position becomes available rather than a person with a national board certification could be placed in that position.”
Chairman Rawson:
Language that there will be a reconsideration to fill the positions with national board certified teachers could be added. The concern is there are 20,000 teachers, of which 109 are national board-certified. One of the slots on the commission is special education and there are only five nationally certified special education teachers. It narrows it down to a small group that would be eligible for the commission. A specific date could be inserted or there be an effort to use replacements that are national board certified.
Senator Cegavske:
My understanding is when the consideration for the next opening and insert “at least by 2007.” It could be earlier or at least by 2007. It is important certification be a part of the education process.
Senator Neal:
Why are we acting upon a proposal that has not been adequately researched?
Senator Nolan:
I agree. We should determine whether the teachers’ union needs this change. Or, is it a manipulation as to who will be placed in this position?
Senator Wiener:
Did we pass language, “at least one?” It could be in any one of the specialties.
Chairman Rawson:
Yes.
Senator Washington:
Could this be changed in the Assembly or on the Senate Floor?
Chairman Rawson:
It is possible. The work should be accomplished in committee. The amendment is not ready to report to the floor.
Senator Cegavske:
There were two positions, a special education and a counselor position. The persons in those positions have already served one term. They are eligible to serve a second term and one would have to be removed. We had made the commitment no one be removed if they choose to be reinstated.
Chairman Rawson:
Is the committee willing to clarify the amendment previously made?
Senator Neal:
I do not have a problem with your suggestion.
Senator Wiener:
Would there be a greater grace period? Is it being changed to the year 2007 because there is a lack of nationally certified teachers?
Senator Cegavske:
Yes, we are extending it.
SENATOR WIENER MOVED TO REDEFINE THE AMENDMENT AND DO PASS S.B. 390.
SENATOR CEGAVSKE SECONDED THE MOTION.
THE MOTION CARRIED UNANIMOUSLY.
*****
Chairman Rawson:
There being no further business for this meeting, I will adjourn this meeting at 1:50 p.m.
RESPECTFULLY SUBMITTED:
Patricia Vardakis,
Committee Secretary
APPROVED BY:
Senator Raymond D. Rawson, Chairman
DATE: