MINUTES OF THE
SENATE Committee on Human Resources and Facilities
Seventy-second Session
May 21, 2003
The Senate Committee on Human Resources and Facilities was called to order by Chairman Raymond D. Rawson, at 2:50 p.m., on Wednesday, May 21, 2003, in Room 2135 of the Legislative Building, Carson City, Nevada. The meeting was videoconferenced to the Grant Sawyer State Office Building, Room 4401, 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
GUEST LEGISLATORS PRESENT:
Assemblywoman Barbara E. Buckley, Assembly District No. 8
Assemblyman Morse Arberry Jr., Assembly District No. 7
STAFF MEMBERS PRESENT:
H. Pepper Sturm, Committee Policy Analyst
Cynthia Cook, Committee Secretary
OTHERS PRESENT:
Scott J. Watts, Lobbyist, Nevada Alliance for Retired Americans
Danny N. Coyle, Lobbyist, Nevada Alliance for Retired Americans
Michael J. Willden, Director, Department of Human Resources
Robert Desruisseaux
Thelma Clark, Lobbyist, Nevada Silver Haired Legislative Forum
Warren Wish
Jack Middleton
Mary Yoshisato
Chairman Rawson:
We will open the hearing on Assembly Bill (A.B.) 504.
ASSEMBLY BILL 504 (2nd Reprint): Makes various changes concerning provision of health care services in this state. (BDR 38-1207)
Scott J. Watts, Lobbyist, Nevada Alliance for Retired Americans:
I am here to testify in support of A.B. 504. The Nevada Alliance for Retired Americans represents over 5,000 retirees in the State. Health issues and medications are the main concerns of our members. In some cases seniors are choosing between buying food or medication. We feel this type of legislation can provide needed prescription services and savings to seniors, disabled persons, and low-income residents of Nevada. The program relies on funds from the tobacco settlement, and we are confident those funds will flow into the State for many years. Nevada’s Senior Rx Program helps many in the State, and this additional program could provide another level of assistance in making the lives of seniors easier. The disabled, working poor, and low-income residents struggle daily to find funds for medication and health care. We hope you can assist those who need help the most.
Danny N. Coyle, Lobbyist, Nevada Alliance for Retired Americans:
I am here to support A.B. 504. I am sure most of you are aware of evidence of Nevada’s senior citizens on limited incomes trying to maintain a decent standard of living. The bill will cost the State of Nevada very little in the way of administrative costs. It provides for stringent oversight by the Interim Finance Committee when the Legislature is not in session. We believe the provisions in the bill setting forth the duties of the Task Force for the Fund for a Healthy Nevada are comprehensive and more than adequate to implement the program. Allowing the director to hire or contract for a competent pharmacy benefits manager is timely and essential given the state of health care in Nevada.
Assemblywoman Barbara E. Buckley, Assembly District No. 8:
This bill requires the director of the Department of Human Resources to apply to the federal government for a Medicaid waiver to extend coverage for pharmacy coverage. The plan will bring in federal monies to help fund a successful senior prescription program. It limits administrative costs for this program to 10 percent. The director believes this attainable goal would serve more people. Assembly Bill 504 also creates a new pilot program for a prescription program in favor of the disabled population. I believe what we are suggesting is a modest first approach to capitalize on using some existing funds for the disabled from the tobacco settlement monies. The percentages of the tobacco funds disbursed will not be changed. The disability community is supportive of this bill.
Senator Wiener:
Page 7, line 11, of the bill refers to a reserve of not more than 2.5 percent of all revenues deposited in the Fund for a Healthy Nevada for direct expenditure by the department to fund the program. Do you have any idea of that amount?
Assemblywoman Buckley:
That amount is estimated to be $571,000.
Senator Cegavske:
Why was the Fund for a Healthy Nevada chosen?
Assemblywoman Buckley:
The Fund for a Healthy Nevada is the account that receives the tobacco settlement money annually, and it is then distributed.
Chairman Rawson:
It will be administered by the new grant-funding unit that has been approved in the budget.
Senator Cegavske:
The bill mentions a task force. Is there one in existence? In addition, could you please describe the pilot program?
Assemblywoman Buckley:
The task force is already in place. The term “pilot program” is used because helping individuals with disabilities with their prescription drugs has never been done. The proposal from the administration was to do a capped enrollment program, and see what the preliminary numbers are.
Michael J. Willden, Director, Department of Human Resources:
The capitation will depend on the total dollars made available. The first part of the bill directs the department to obtain a senior waiver, and the second part is the disability waiver. The pilot program will depend upon the amount of total money available, which is estimated to be $571,000. There are between 160 and 210 disabled individuals.
Senator Cegavske:
Is this dependent upon whether or not we receive federal money in addition to tobacco settlement funds?
Mr. Willden:
Yes and no. Section 10 of the bill states 2.5 percent will be available in the second year of the biennium. Those funds are already committed through the Task Force for the Fund for a Healthy Nevada. This legislation would make a 25 percent share of the $571,000 become available in the second year of the biennium. In the first year of the biennium, implementation is dependent on the success of the application waivers to the federal government.
Senator Cegavske:
In the bill you have 10 percent of all revenue deposited in the Fund for a Healthy Nevada.
Mr. Willden:
Under current law, 20 percent of the tobacco money goes into the fund for programs that improve health services for children. On page 6, line 39, we changed that portion to 10 percent each year, and then allocated 7.5 percent for programs that improve the health and well being of persons with disabilities. The remaining 2.5 percent of revenues will be used to fund any program established by section 3 of the bill.
Robert Desruisseaux:
As an advocate for the Northern Nevada Center for Independent Living, I urge you to support A.B. 504. For years we have been trying to find a solution to this problem. Having these priorities outlined in the bill as well as the 2.5 percent for the prescription program is fantastic. The prescription drug program is most likely to help the working poor. These are individuals with a work history who became disabled. Their income levels are too high for other programs, yet too low to afford prescriptions. We do want to be careful as we go forward because we do not want to set a precedent by using tobacco settlement funds to implement programs within Medicaid. I mention that because we know Medicaid is a monster in the State, and it can eat a lot. These are funds we hope to utilize to serve populations that are not qualified for Medicaid.
Chairman Rawson:
For the fiscally concerned, there cannot be a better plan than to use tobacco settlement dollars to receive matching funds.
Senator Neal:
When will the pharmacy benefit manager be hired?
Mr. Willden:
There is an “if” statement on page 2, line 27. I cannot tell you when the pharmacy benefit manager will be hired. The way the bill is structured, the first thing is to get the senior waiver approved by the federal government. When it is in place, it will free up monies for the disability waiver. Depending upon the federal government’s approval of that waiver, we anticipate hiring a manager in January 2004.
Senator Neal:
The language in A.B. 504 presupposes the funds are available. You would be required to apply to the Interim Finance Committee in order to proceed with the waiver.
Mr. Willden:
We would apply for permission to proceed, but not request new funds. In the first year of the biennium, funding for the disability prescription program is based upon freeing some of the current monies allocated for the Senior Rx Program by receiving the waiver. If we are not able to obtain the waiver in 2004, the monies identified on page 6 of the bill would take place in 2005, and the disability prescription waiver can proceed. We will be able to continue somewhere between January and July 2004.
Senator Neal:
From where would the money deposited in the Fund for a Healthy Nevada come?
Assemblywoman Buckley:
That is money from the tobacco settlement, and the account is already in force.
Senator Washington:
What is the cause and effect on the existing Senior Rx Program as a result of this bill?
Mr. Willden:
I have been very clear about reaching the goal of enrolling 12,000 seniors in the Senior Rx Program. After we reach that goal and can show funding capabilities, we will move to the second part of the bill.
Senator Cegavske;
If there were roughly 180 disabled individuals, the average cost would be approximately $3000 per individual. Also, the bill includes respite care, behavioral support, and assistance to a person with disabilities.
Chairman Rawson:
That is setting other priorities. This group is the most expensive group as far as pharmacy costs are concerned.
Senator Cegavske:
The administrative costs must come off the top. Do you have something existing to facilitate this?
Assemblywoman Buckley:
There are two issues. The total percentage for administrative costs would remain at 10 percent.
SENATOR WIENER MOVED TO DO PASS A.B. 504.
SENATOR MATHEWS SECONDED THE MOTION.
THE MOTION CARRIED UNANIMOUSLY.
*****
Chairman Rawson:
We will open the hearing on Assembly Joint Resolution (A.J.R.) 15.
ASSEMBLY JOINT RESOLUTION 15: Urges Congress to provide comprehensive plan for coverage of prescription drugs within Medicare program. (BDR R‑1330)
Thelma Clark, Lobbyist, Nevada Silver Haired Legislative Forum:
The forum requested this legislation, because we believe it would have more clout coming from the Legislature than from the Nevada Silver Haired Legislative Forum. We were not aware that some of the language in the bill came from a study conducted by the American Association of Retired Persons. I believe the information may be wrong.
Chairman Rawson:
We will see what the numbers are, and if a technical correction is necessary. We will close the hearing on A.J.R. 15, and open the hearing on A.B. 332.
ASSEMBLY BILL 332 (2nd Reprint): Makes various changes relating to persons with disabilities, service animals and service animals in training. (BDR 38‑1)
Assemblyman Morse Arberry Jr., Assembly District No. 7:
An advocate for the blind who also owns guide dogs brought this bill to me. This bill was crafted to specify people who are training guide dogs to be licensed. The bill states it is unlawful to deny admittance to a building to a person who is accompanied by a service animal or a service animal in training. There is also a Senate bill relating to guide dogs. This bill differs from the Senate bill because it defines what a trainer must do to be licensed.
Warren Wish:
I am the leader of the Carson City guide dog program. This Legislative Session started with two bills that had a common central theme: to give additional protection to individuals partnered with guide dogs or service dogs that are attacked by out of control vicious dogs. Senate Bill (S.B.) 231 has passed the Senate and the Assembly, and is a clear bill that focuses on that issue.
SENATE BILL 231: Revises provisions concerning service animals. (BDR 38-98)
Mr. Wish:
Unfortunately, the Assembly bill in front of you is convoluted and confusing. There are several areas of concern. Page 7, line 15, has language that says a service animal in training can only be brought to a place of employment by a person with a disability. Right below an entire area has been deleted. The deleted area is based upon a U.S. Supreme Court decision in 1994 allowing individuals with service animals in training access to all places of employment. By eliminating that language, service dogs in training can only be brought to the workplace by disabled individuals. It fails to recognize the vast majority of service dogs receive initial training by able-bodied people.
Chairman Rawson:
Are you saying a dog could not be adequately trained if the dog could not be brought into these settings?
Mr. Wish:
A guide dog needs to be trained from a very young age in all settings in order to be fully functional.
Chairman Rawson:
Was this language deleted in the original bill, or was it an amendment that struck that language?
Mr. Wish:
This original bill strikes the language “refuse admittance or service to a person training such an animal.”
Chairman Rawson:
Was there testimony given on the Assembly side?
Mr. Wish:
Originally A.B. 332 was more confusing. It was amended when we testified against the section that concerned the licensing of trainers. The entire section was deleted.
Chairman Rawson:
Rather than take a stance that might kill the bill, let us see if we can straighten out the problem.
Senator Wiener:
My sense is the language at the top of page 8, which refers to a person who is accompanied by a service animal in training, addresses your concerns.
Mr. Wish:
What confuses the situation is in section 15, subsection 6. It states it is unlawful business practice for an employer, directly or indirectly, to refuse to allow an employee with a disability to keep his animal with him at all times in his place of employment. I do not understand why, in this bill, there is a distinction. We want service animals in training to have access to the workplace. To say there needs to be a separate section for a person with a disability to train such an animal, and then another section for able-bodied people, confuses the law in our minds.
One of the things pointed out in the work document prepared by Assembly staff (Exhibit C) is, under current law, individuals who have service animals have a form of identification for the animal. People who are graduates of recognized dog training schools have a card that identifies the animal as being a graduate. This bill takes that out, and it becomes unlawful for a person to require certification of the service animal. We believe the public needs to know this is an animal being trained and not someone pretending an animal is in training. In section 10, the law is changed and no longer are we talking about a service dog. We are talking of a service animal trained to assist or accommodate a person with a disability. I bring that up because the Assembly staff analyzed the two sections, and that definition has troubling possibilities. In fact, the staff member wrote, “This definition is broader than the current language and potentially includes animals other than those specifically trained to assist a disabled person.”
Under the proposed language of A.B. 332, a person could say they have a pig, a rabbit, or any animal and claim the animal is a service animal. We have 80 years of experience with guide dogs. This language opens up a can of worms. We recognize it is unlawful for a person with a disability to be asked for identification. We believe, in the interest of public safety, trained licensed dogs need a form of identification.
Jack Middleton:
If the bill Assemblyman Arberry described to you was truly this bill, it would be a great bill. This amends all of the protections found in chapter 426 of Nevada Revised Statutes (NRS) out of existence. My guide dog was in training for nearly 2 years before he was given to me. Of all the dogs trained only half of them make the cut. It is extremely distressing when you have an untrained dog around a trained dog. They are automatically distracted and it is a bad scene. A truly trained animal can help a disabled person.
Mary Yoshisato:
The Americans with Disabilities Act protects people with disabilities. It does not protect the animals. It is State law that protects the animals. Service animals do something for a disabled person, which they are unable to do for themselves. They are their eyes, ears, or arms.
Chairman Rawson:
Maybe the term “guide dog” is outdated. Is service animal a more appropriate term?
Mr. Wish:
Guide dog describes dogs specifically trained to guide their blind handlers. The term “service animal” was coined to describe any type of animal providing a service that mitigates the handler’s disability. The concern is the broader definition of what the word “animal” means.
Senator Neal:
New language describes a service animal that has been trained to assist or accommodate a person with a disability. The disability language is somewhat confusing when you talk about it in terms of training. I think this is the problem with the bill. How would a person with a disability actually train an animal? When you look at the disability language in section 2, it is somewhat limited in terms of training capabilities. I believe it can be amended or deleted.
Mr. Wish:
Senate Bill 231 includes new language describing a service animal as an animal, which has been or is being trained to provide a specialized service to a handicapped person by a school that is approved by the division to train such an animal and includes, without limitation, a guide dog, hearing dog, and helping dog. We believe S.B. 231 says it all, and there is no further need for other additions.
Chairman Rawson:
I would like this issue to be resolved by Friday, May 23, 2003. Senator Wiener and Senator Cegavske are appointed to a subcommittee to compare this bill with the policy the Senate passed. Is there a motion on A.J.R. 15?
SENATOR NEAL MOVED TO DO PASS A.J.R. 15.
SENATOR CEGAVSKE SECONDED THE MOTION.
THE MOTION CARRIED. (SENATORS NOLAN AND WIENER WERE ABSENT FOR THE VOTE.)
*****
Chairman Rawson:
We will review a series of amendments presented by the Assembly on various Senate bills. We will begin with Senate Bill 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)
H. Pepper Sturm, Committee Policy Analyst:
This was an amendment by the Assembly Committee on Judiciary. It deletes the provisions to provide limited immunity from liability for transporting patients.
SENATOR CEGAVSKE MOVED TO NOT CONCUR WITH AMENDMENT NO. 602 TO S.B. 94.
SENATOR WASHINGTON SECONDED THE MOTION.
THE MOTION CARRIED. (SENATORS NOLAN AND WIENER WERE ABSENT FOR THE VOTE.)
*****
Chairman Rawson:
The next bill is S.B. 327.
SENATE BILL 327 (1st Reprint): Provides for reuse of certain prescription drugs. (BDR 39-66)
SENATOR WIENER MOVED TO CONCUR WITH AMENDMENT NO. 720 TO S.B. 327.
SENATOR CEGAVSKE SECONDED THE MOTION.
THE MOTION CARRIED. (SENATOR NOLAN WAS ABSENT FOR THE VOTE.)
*****
Chairman Rawson:
The next bill is S.B. 287.
SENATE BILL 287 (1st Reprint): Establishes Arthritis Prevention and Control Program to increase public awareness of and educate persons on matters relating to arthritis. (BDR 40-596)
SENATOR WIENER MOVED TO CONCUR WITH AMENDMENT NO. 715 TO S.B. 287.
SENATOR CEGAVSKE SECONDED THE MOTION.
THE MOTION CARRIED. (SENATOR NOLAN WAS ABSENT FOR THE VOTE.)
*****
Chairman Rawson:
The next bill is S.B. 253.
SENATE BILL 253 (2nd Reprint): Revises provisions governing school attendance required to obtain credit or to be promoted to next higher grade. (BDR 34-788)
SENATOR CEGAVSKE MOVED TO CONCUR WITH AMENDMENT NO. 716 TO S.B. 253.
SENATOR WIENER SECONDED THE MOTION.
THE MOTION CARRIED. (SENATOR NOLAN WAS ABSENT FOR THE VOTE.)
*****
Chairman Rawson:
The Assembly has refused to concur with Senate Amendment No. 663 to Assembly Bill 132.
ASSEMBLY BILL 132 (2nd Reprint): Provides that proceedings concerning abuse or neglect of children are presumptively closed to public. (BDR 38-689)
SENATOR CEGAVSKE MOVED TO NOT RECEDE FROM AMENDMENT NO. 663 TO A.B. 132.
SENATOR WASHINGTON SECONDED THE MOTION.
THE MOTION CARRIED. (SENATOR NEAL VOTED NO. SENATOR NOLAN WAS ABSENT FOR THE VOTE.)
*****
Chairman Rawson:
I will assign Senators Wiener, Washington, and Nolan to be members of a conference committee on A.B. 132. The next bill is S.B. 307.
SENATE BILL 307 (2nd Reprint): Requires posting of warnings in certain food establishments regarding 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 CONCUR WITH AMENDMENT NO. 629 TO S.B. 307.
SENATOR CEGAVSKE SECONDED THE MOTION.
THE MOTION CARRIED. (SENATOR NOLAN WAS ABSENT FOR THE VOTE.
*****
Chairman Rawson:
The final bill is S.B. 59.
SENATE BILL 59 (2nd Reprint): Revises provisions governing alternative schedules of school districts. (BDR 34-736)
The Assembly Amendment No. 732 requires any alternative scheduling by a school district must be subject to collective bargaining.
SENATOR CEGAVSKE MOVED TO NOT CONCUR WITH AMENDMENT NO. 732 TO S.B. 59.
SENATOR WASHINGTON SECONDED THE MOTION.
THE MOTION CARRIED. (SENATORS WIENER AND MATHEWS VOTED NO. SENATOR NOLAN WAS ABSENT FOR THE VOTE.)
*****
There being no further business for the committee, I will adjourn the meeting at 3:57 p.m.
RESPECTFULLY SUBMITTED:
Cynthia Cook,
Committee Secretary
APPROVED BY:
Senator Raymond D. Rawson, Chairman
DATE: