MINUTES OF THE ASSEMBLY COMMITTEE ON HEALTH AND HUMAN SERVICES Sixty-eighth Session March 27, 1995 The Committee on Health and Human Services was called to order at 1:30 p.m., on Monday, March 27, 1995, Chairman Vivian L. Freeman presiding in Room 330 of the Legislative Building, Carson City, Nevada. Exhibit A is the Agenda. Exhibit B is the Attendance Roster. COMMITTEE MEMBERS PRESENT: Mrs. Vivian L. Freeman, Chairman Mrs. Jan Monaghan, Chairman Mrs. Jan Evans, Vice Chairman Mr. William Z. (Bill) Harrington, Vice Chairman Mrs. Deanna Braunlin Mrs. Barbara E. Buckley Mr. David Goldwater Ms. Saundra (Sandi) Krenzer Mr. Dennis Nolan Mrs. Dianne Steel Ms. Patricia Tripple Mr. Wendell P. Williams STAFF MEMBERS PRESENT: H. Pepper Sturm, Chief Principal Research Analyst OTHERS PRESENT: Ted Zuend, Fiscal Division, Legislative Counsel Bureau Jeff Fontaine, Nevada State Health Division Douglas Coulter, Washoe County District Health Dept. Fred Hillerby, Sun Valley General Improvement District Assemblywoman Vivian Freeman opened the meeting by welcoming Assemblywoman Patricia Tripple and Assemblyman David Goldwater to the Committee as two new additional members. Mrs. Freeman presented the Committee with a request from the Nevada Society of Emergency Physicians for a bill draft. The intent of the bill draft would be to solve existing problems whereby emergency physicians in hospitals are required to provide emergency medical care but some insurance companies have refused to pay for that care given to their employees at health plan hospitals and for treatment administered without prior approval. ASSEMBLYMAN WENDELL WILLIAMS MOVED TO HAVE THIS BILL DRAFTED. ASSEMBLYWOMAN JAN MONAGHAN SECONDED THE MOTION. THE MOTION CARRIED UNANIMOUSLY. (ASSEMBLYWOMAN SANDI KRENZER AND ASSEMBLYMAN BILL HARRINGTON ABSTAINED.) ********* ASSEMBLY BILL 367- Requires boards of health to avoid conflicts with statutory provisions governing general improvement districts when adopting regulations concerning disposal of sewage. Mrs. Freeman opened the hearing on A. B. 367 which came out of an interim study committee. Ted Zuend, Deputy Fiscal Analyst, presented his testimony in support of A. B. 367 (Exhibit C,) which requires future state board of health regulations pertaining to the disposal of sewage not conflict with chapter 318 of the Nevada Revised Statutes (NRS) and also that the State Board of Health and each district board review their existing regulations on the disposal of sewage and amend or repeal any that are in conflict with chapter 318. Jeff Fontaine, Supervisor of Public Health Engineering representing the State Health Division, commented on A. B. 367. The health division is responsible for implementing Nevada Administrative Code (NAC) Chapter 445, the regulations governing individual sewage systems which were adopted by the State Board of Health in 1972. They have subsequently been amended as needed. They believe NAC 445 has been working well. Chapter 445 is efficient and effective to implement, relatively easy for the public to understand and comply with and is protective of public health. They do not see any necessity to require the State Board of Health to amend its regulations to comply or conform with Chapter 318 of NRS. Mrs. Freeman asked what kind of legal advice the interim committee had that advised them of a conflict. Mr. Fontaine responded his division was not present at the committee hearings and this is the first time they have had an opportunity to respond to the bill. In his eight years with the health division Mr. Fontaine has never been aware of a situation where a homeowner was denied a septic system permit because they fell under that grey area of the 400 foot rule and whether it is to the residence or to the property line. They would prefer not to have to amend their regulations to deal with an exception which they would deal with on a case- by-case basis should it ever come up. Assemblywoman Monaghan inquired if one of the reasons for the health division's opposition is that the division would have to review its regulations. Mr. Fontaine stated the division is not opposed to any requirement for them to review their regulations, they do that anyway to be certain they are current and reflect new technology and the desires of the people they affect. They believe they do not have a problem and amending their regulations to conform with a general improvement district's would affect the entire state. They would prefer to stay with the way they do business which is 400 feet to the property line. That is the way they regulate everyone else including municipalities and private sewage disposal systems. Just the NRS 318 districts are different. Assemblyman Nolan, speaking as one who built his own house and installed a septic system, stated the people at the health district are meticulous in their requirements and measurements. If there is any opportunity for ambiguity in the statutes, someone will soon find it and he would be more comfortable with one standard. Mrs. Freeman commented none of this Committee participated in the interim study committee and would like research on their reasoning and intent before taking action. Assemblywoman Buckley agreed she does not know what the recommendations of the study committee were and those would be helpful to have before proceeding. She added that, from a legal point of view, whenever there is a conflict between a statute and a regulation, the statute always governs. Fred Hillerby, representing the Sun Valley General Improvement District, agreed Ms. Buckley has raised the important issue. In his sanitation district, this very problem has occurred and there has been a dispute as to whether or not there is a requirement for an individual to tie into the district's sewer lines. All the bill is asking for is conformity. If, in the process of reviewing the health division's regulations, there is a better standard from a public safety and health standpoint, than the statute, then the statute should be changed and the conflict removed. His experience has been it is easier to change regulations, where appropriate, than statute. Doug Coulter, Washoe County District Health Department, stated the health department is in favor of A. B. 367, but it does leave some area for clarification. For instance, how is the 400 feet measured, is it as the crow flies or along the alignment of the street? Whatever is adopted as a statute must be enforced by people out in the field and must be clear enough to address those questions. If the sewer line is within 400 feet but you have to cross private property, does that mean the sewer is available and the person has to hook up? Those are questions that should be addressed and kept in mind when considering adopting or changing sections in the statute. The Washoe County Health Department is in favor of the 400 foot rule but would ask the Committee make it clear enough that the law can be enforced intelligently. Mrs. Freeman asked what the number on the interim study was. Ted Zuend responded it was A.C.R. 47 and added it was about to be printed. He further stated the study does not contain considerable information about this point even though it was an apparent conflict. It was a taxing district study and the committee did not want to get into policy issues regarding sewage. They just asked for a bill draft to resolve the conflict. If a policy decision is made that the 400 foot standard in regulation is better than the one currently in the NRS 318 statute, no one would oppose that because the committee was not looking at the policy issue of which standard was better, they just realized one was in conflict with the other. Mrs. Freeman assigned Ms. Buckley to follow through and return with a recommendation to the full Committee. There being no further business, the meeting was adjourned at 2:00 p.m. RESPECTFULLY SUBMITTED: Terry Horgan, Committee Secretary APPROVED BY: Assemblyman Vivian L. Freeman, Chairman Assemblyman Jan Monaghan, Chairman Assembly Committee on Health and Human Services March 27, 1995 Page