MINUTES OF THE ASSEMBLY COMMITTEE ON HEALTH AND HUMAN SERVICES Sixty-eighth Session May 15, 1995 The Committee on Health and Human Services was called to order at 1:30 p.m., on Monday, May 15, 1995, Chairman Vivian 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 Dr. William Z. (Bill) Harrington, Vice Chairman Mrs. Deanna Braunlin Ms. Barbara E. Buckley Mr. David Goldwater Ms. Saundra (Sandi) Krenzer Mr. Dennis Nolan Ms. Dianne Steel Ms. Patricia A. Tripple GUEST LEGISLATORS PRESENT: Mr. John C. Carpenter STAFF MEMBERS PRESENT: H. Pepper Sturm, Chief Principal Research Analyst OTHERS PRESENT: Deanne Blazzard, Foster Parents of Southern Nevada Garry Alsdorf, Northeastern Foster Parents Milton Alsdorf, Northeastern Foster Parents Kathleen Shane, Washoe County Social Services Jorgee Hampton, Foster Parents Association of Carson City John Sarb, Chief, Division of Child and Family Services Sonia Martin, Nevada Women's Lobby ASSEMBLY BILL 524 - Makes various changes to provisions governing family foster care for children. Assemblyman Carpenter opened testimony on A.B. 524 which he sponsored in response to a number of concerns from foster parents in Elko and Clark Counties. He mentioned foster care was a vital link in the care of children in Nevada and the state was fortunate there were people who would take on that responsibility. Mr. Carpenter suggested the most controversial part of A.B. 524 would probably be the proposed increase in fees paid to foster parents. Quoting a handout prepared for the Committee by Deanne Blazzard of Foster Parents of Southern Nevada, (Exhibit C,) Mr. Carpenter stated Nevada reimburses foster care givers about half the amount necessary to raise a child, according to the U.S. Department of Agriculture (U.S.D.A.). Also noted in the handout is the fact Nevada seems to be losing ground as far as foster parents are concerned. In 1995 the Division of Child and Family Services expects to license 219 foster care providers but lose 244. Chairman Freeman congratulated Mr. Carpenter for sponsoring A.B. 524. She mentioned adequate reimbursement for foster parents was an ongoing problem and had caused a lack of emergency foster care homes in Washoe County. Assemblywoman Monaghan, referring to page 1, number (e) on line 19 of A.B. 524, asked what type of retaliatory action was being referred to. Mr. Carpenter replied he was not certain but believed it to be a catchall phrase because items (a) through (d) were fairly specific and (e) might simply be a bill drafter's way of including anything else that might come up. Mrs. Freeman, noting the bill had been concurrently referred to Ways and Means, inquired what the fiscal note on the bill was. Mr. Carpenter said he did not know, but believed foster parents, while not expecting nor asking to be reimbursed at the U.S.D.A. rate, would be thankful and grateful for whatever increase could be provided. The proposed amount would increase reimbursement $30 per child per month. He noted people under contract to provide emergency foster care were reimbursed at a much higher rate which he believed was understandable because those people were basically on call to take children at any time. He reiterated any raise in compensation would be welcomed. Assemblywoman Steel inquired about section 8 which allows a visit to a child after that child leaves the care of the provider. Mr. Carpenter explained after a child had been in a home for a number of months, the care givers become attached and want to know how the child is doing and that was the reason for the provision. He added the child must agree to the visit and the division must determine the visitation is in the best interests of the child. Ms. Steel agreed she understood the attachment that would develop between the foster parent and child, but was concerned about who would enforce the provision if the child were adopted and the adoptive parents did not live nearby or felt too much competition from the foster parents. Mr. Carpenter replied the division would ultimately have to determine that but he assumed in most situations it would probably be a mutual understanding that the foster parents would be able to visit the child. He emphasized one would not want a situation where visitation would be forced upon a child and added the division and the foster parents should work the details out depending upon the circumstances. Mrs. Freeman interjected section 8 was in chapter 424 of Nevada Revised Statutes which deals specifically with foster homes. Deanne Blazzard, representing the Foster Parents of Southern Nevada, elaborated on the proposed amendment allowing visitation by foster parents. She pointed out when a child is moved out of a foster home the former foster parents generally do not receive any information or feedback about the child. Basically the foster parents do not want to intrude, she stated, but the child has usually grown attached to the foster parents and a visit might aid in the transition, help bridge the gap and help the foster parent through the grieving process. Ms. Blazzard began her testimony with a recitation of changes proposed by A.B. 524 explaining section 3 would allow foster parents to refuse to accept placement of a child without fear of retribution. Section 4 would ensure providers had a clear understanding of the agency, the birth family, their role as a provider and the skills needed to be effective. Section 5 requires the agency inform providers about case plans for the child and explain any changes in the plan. In addition the agency would be required to consult with the provider on the daily care of the child and to consider the daily routines of the provider when addressing any issues. In section 6 the division would be required to provide the family foster care provider with all medical and behavioral history of the child both before and any time during placement. The provider may receive information concerning a child after the child has left his home. This section also requires family foster care providers to maintain confidentiality of information. Ms. Blazzard pointed out many times children are placed in foster homes and the foster parents are given very little information. She noted sometimes the agency simply does not have any information yet, but even the agency admitted at other times they are afraid a family would not take a child if they had full information. Ms. Blazzard testified taking a child who sets fires, abuses other children or has other severe behavioral problems can be very dangerous. Section 7 would establish a procedure for hearing grievances related to the issuance, suspension or revocation of license and the provider would have the right to be represented by legal counsel. Ms. Blazzard explained currently there is no good procedure to follow if there are any problems. Section 9 requires the division carry and maintain liability insurance for the protection of family foster care providers. Ms. Blazzard mentioned this item was in the budget, however foster care providers are currently without insurance and stand to lose everything if there is a lawsuit. She commented that high risk children with behavioral problems pose a real threat of a lawsuit. Section 10 would allow providers to have copies of records maintained by the division concerning that provider and also would allow the provider, by appointment, to inspect those records. Ms. Blazzard pointed out they are not allowed to see the annual licensure evaluations on foster parents made by the division. She believed the ability to see what the division believes are her strengths and weaknesses would enable her to improve her skills as a foster parent. Section 11 requires the division establish a program by which providers can receive respite from the stresses and responsibilities of family foster care. It also requires the division to establish a program to provide assistance for family foster care providers 24 hours a day, seven days a week. It also requires the division provide training and support to providers to enhance and develop their skills. Ms. Blazzard emphasized if a child has an accident or needs hospitalization on a weekend it can be a real problem because the foster parent does not always have the right to admit the child to a hospital nor is the foster parent always able to contact the case worker. Section 13 would require the division establish a schedule of reimbursement to providers consistent with the most recent U.S.D.A. guidelines for the cost of raising a child using the urban west middle income level. Ms. Blazzard noted the rest of A.B. 524 just cleans up some of the old language. Ms. Blazzard emphasized reimbursement rate was the topic foster care groups were emphasizing in proposing A.B. 524. She mentioned the requested increase in reimbursement may seem high but added that is what it costs. She emphasized foster care providers are willing to take care of the children and provide for them emotionally and physically, however they cannot ask their families to give up what is theirs nor dip into their own pockets. These children are the responsibility of everyone in the state and even though foster parents have big hearts, the emotional and physical strain on a family is enough. When a financial burden is added too, their own children's well being is put at risk as well as retirement plans or any other normal plans a family might include in their future. Ms. Blazzard testified many foster parents had pretty good sized savings accounts when entering foster care however as time went on their savings disappeared as more clothes were needed for the kids. Savings and personal money also provided the innumerable little things one does for children to make them feel part of a family, part of the community and try to heal the wounds and build their self-esteem. Ms. Blazzard testified family foster care providers are the most cost effective way of caring for the children in Nevada's custody because group homes, institutions and out-of-state facilities are much more expensive. She explained even if Nevada paid foster care providers 100 percent of the U.S.D.A. reimbursement, it would be less expensive than the other alternatives. She mentioned a two percent raise in 1988 was the last increase in reimbursement foster parents had received even though the cost of living had risen 37 percent since then. Ms. Blazzard reiterated foster parents are quitting the program because they do not feel the children are a priority with the state nor is the situation being recognized. Ms. Blazzard showed Committee members what the proposed clothing allowance of $66 for a child four years and under would buy: one pair of shoes; one package of underwear; two pair of socks; two short sleeved T-shirts; two pair of shorts; one pair of long pants and one pair of pajamas. She asked Committee members if they would dress their children in those clothes and noted foster parents dip into their own pockets to make up the difference which she believed constituted an unfair tax on foster parents. Mrs. Freeman inquired if the $66 was a one-time disbursement. Ms. Blazzard replied the allowance was distributed three times a year. She added the clothes were worn out by the time the next allowance arrived. Mrs. Freeman asked if the amount of the clothing allowance depended at all upon the age of the child. Ms. Blazzard replied at age five there was a small increase and again when the child becomes a teen but was still insufficient. Assemblywoman Evans, referring to the handout and chart, noted a foster care provider would currently be receiving $304 per month. Ms. Blazzard agreed and added that included the clothing allowance factored in. Mrs. Evans replied a mother and two children on welfare currently received $348 per month and added Nevada must not value her children. Mrs. Freeman interjected everyone who had signed up to speak on A.B. 524 was in support of the bill. Assemblyman Nolan asked what current requirements were to become foster parents and whether any training was required. Ms. Blazzard answered in Las Vegas new foster parents receive 20 hours of training, although by law they are only required to have eight hours. Ongoing training amounts to four hours a year, she added. Mrs. Freeman inquired if every county determined their own length of training. Ms. Blazzard was not certain but knew in Clark County the trainers had developed their 20 hour program and required it of the people coming into the program. Assemblywoman Tripple asked whether there was a sliding scale of reimbursement because some children are much more difficult than others. Ms. Blazzard replied there is some rate-setting using a point system so foster parents caring for a child with more severe emotional or physical problems would be paid a little more. Jorgee Hampton, a foster parent dealing with special needs children, explained when she was asked to care for the foster child she has now, the child was very, very ill but no one knew what was wrong with him and he was not expected to live. Ms. Hampton was happy to say the child had responded so well to her care, he had been removed from special classes at school because he had attained his level in mental, physical and emotional development. Ms. Hampton and her family had learned how to care for the child by taking special classes and seeking help from specialists all over the west coast. The child was finally diagnosed with cystic fibrosis and she mentioned she and her husband stayed months in Las Vegas to get him through the last medical emergency. Her own two teenagers have been willing to give of their parents so the foster child could attain the success he has. Ms. Hampton emphasized the state has special needs parents who are well qualified, but they are leaving for lack of sufficient reimbursement or backup resources which would enable a respite. She mentioned they can no longer leave their foster child because it takes so long to train someone who could assess his medical condition well enough to care for him. Ms. Hampton told Committee members more special needs children are entering foster care every day but the problems these children have are medical, drug related or emotional in nature and foster parents are getting burned out. Families can be torn apart without sufficient resources to assist them and Ms. Hampton pleaded with the Committee to help foster parents care for these children. She stressed the need for a home setting which would require Nevada pay more for the care of foster children, however she maintained even with a pay increase the state is ahead keeping its children here instead of sending them to another state. Mrs. Freeman requested those present from the governmental sector address preceding testimony. Kathleen Shane, Director of Children's Services for Washoe County Social Services, stated she would defer to the state for proposed amendments or recommendations regarding any parts of A.B. 524. She emphasized foster parents are such a valuable resource for abused and neglected children who have been removed from their parental care-giver because they are unable to care for the children. Ms. Shane, overwhelmingly thankful for foster parents who can care for these children, stated the hard fact is foster parents are grossly underpaid. They receive about half of what should be paid to meet minimum U.S.D.A. recommendations. Ms. Shane testified a year ago Washoe County was so desperate to find placements for children they wound up placing them in a 24 hour day care facility that is totally inadequate to meet the needs of children. Subsequently, they recruited emergency placements for the children at a substantially higher cost than the recommendations in A.B. 524. Washoe County is now in the process of building their second emergency shelter facility to house an additional 25 children which they believe will be full the day it opens. She stated children need to leave emergency shelter and go to family foster care and stressed the need for plentiful, well paid homes. She testified Washoe County is strongly supporting the rate increase for foster parents. Mrs. Freeman inquired if other counties had emergency shelters. Ms. Shane replied there are two county child protection agencies in Nevada, one in Washoe and one in Clark. The balance of the services are provided by the Division of Child and Family Services, the state agency. John Sarb, Administrator of the Division of Child and Family Services, testified his agency was in support of A.B. 524, (Exhibit D). He added many provisions in the bill were currently in their regulations or policy so passage of the bill would simply elevate those provisions to statute. The division regards family foster care as one of the most important and probably most difficult pieces of the entire child welfare system. However, Mr. Sarb commented he was concerned about some sections and noted section 6, lines 30 and 31, as written would require the agency to provide the entire medical and behavioral history of the child. Most of the time the agency does not have all of that information, he stated, so he would like the section amended by deleting the words "without limitation" in line 30 and by adding "to the extent known by the division" at the end of line 31. Regarding section 9 which required the division to obtain liability insurance that is primary coverage for foster parents, Mr. Sarb maintained they had been unable to find anyone in the county who would write primary coverage insurance. He noted the executive budget, for the first time, included a liability policy that would be secondary to homeowners' insurance or other personal liability insurance and was the best he could find. For that reason, he would like section 9 stricken from A.B. 524. Referring to section 11, subsection 1(b), Mr. Sarb stated it was unclear what had been envisioned with that section and to provide "any other required assistance" could prove too far-reaching. He suggested working with foster parents to clarify exactly what they had in mind. Mr. Sarb explained section 13, subsection 3 proposed a dramatic increase in foster parent reimbursement and a major change in the premise of family foster care. Reimbursement in family foster care is designed to offset the actual cost of care which is not what the U.S.D.A. figure represents, he testified. U.S.D.A. calculations divide household expenditures, including a pro-rata share of the house and car payments, by members of the household. As a result, using the U.S.D.A. figures, Mr. Sarb repeated, it was not the same as reimbursing for cost of care. He emphasized the division had requested an increase in the foster care reimbursement rate plus increased clothing allowance which together would bring Nevada closer to the median paid foster care providers by other states. He added each one percent increase in the basic reimbursement rate plus the foster care rate would cost about $44,000. Mr. Sarb believed using U.S.D.A. guidelines and writing into statute a reimbursement provision that would automatically add cost of living increases would be bad fiscal policy. Assemblyman Harrington inquired about self-insurance to provide protection. Mr. Sarb explained two years previously it had been proposed the state indemnify or represent foster parents however that had not worked out because they are considered volunteers and independent contractors. He also indicated the interests of the state and the interests of the foster parents may not always be the same. If the state wound up self-insuring them, a situation could arise where the attorney general would be defending claims against the self insurance and the state cannot be in that position. Assemblywoman Krenzer asked whether other states provided liability insurance. Mr. Sarb replied possibly ten states offer it. Ms. Krenzer wondered if any western states provided insurance but Mr. Sarb did not have data on which states. Ms. Krenzer mentioned if a market for that type of insurance were created, insurers would provide it. Mr. Sarb reiterated he did not want to see a requirement the division could not possibly meet written into statute. Assemblywoman Buckley wondered if the visitation provisions outlined in section 8 included visits after adoption as well as while a child was in the state's care. Mr. Sarb replied most likely the division would not determine visits after adoption to be in the best interests of the child. Ms. Buckley mentioned possible litigation might arise over that issue after adoption. Mr. Sarb agreed and added the same problem could arise if a child was returned to its biological parents. He did mention under some circumstances continued visits and contact could be very beneficial but in other cases it could be very detrimental. Mr. Nolan asked what type of claims had been or could be filed on behalf of a child, or by a child, against someone who was providing reasonable and proper care. Mr. Sarb responded claims had been filed but he could not recall a successful suit. The problem is the foster parent must defend himself, which is an expense. He mentioned a situation where a child in foster care falls off a bicycle, breaks his arm and the biological parent, from whom the child was removed for good cause, sues the foster parent and stated that is the protection the division would like to arrange for foster parents. Mr. Nolan asked about requiring joint filing of a lawsuit so the attorney general would defend both the state and the foster parent. Mr. Sarb replied there are situations where the state's interest is different than the foster parent's and only the foster parent would be named in the lawsuit. He stated there might also be situations where the foster parent is not comfortable with attorney general representation and would like to be able to arrange counsel of their own. Mr. Nolan responded it appeared to him foster parents would be comfortable with anything more than they currently have. Ms. Steel mentioned in all the talk of money heard previously, there had been no mention made of salary. She added because this is a volunteer position, foster parents are paid nothing at all except reimbursement for what the children consume or wear while in care. She expressed surprise Nevada has any foster parents at all on this amount of money. Mr. Sarb replied foster parents lie somewhere between saint and saint. Ms. Steel asked if there was any good Samaritan legislation "on the books" so foster parents would be immune from lawsuits except against something malicious so if frivolous cases were brought, foster parents would be reimbursed for their costs. Mr. Sarb responded two years ago that option had been explored however it had not worked out. Ms. Steel suggested it might be something to look into. Ms. Krenzer questioned how much it cost to have a child a ward of the state. Mr. Sarb explained it depended upon the child and the circumstances. Ms. Krenzer asked about the cost to care for a child at Child Haven or Kids Cottage. Mr. Sarb objected those were emergency, temporary shelters and not foster homes. Ms. Krenzer pointed out those facilities cost around $30,000 per year. Mr. Sarb stated Kids Cottage charged the state $96 per day and Child Haven would be going up to $103 per day. Ms. Krenzer noted it is only $4,000 per year to keep a child in a foster home and emphasized it was a disgrace what is paid for foster care and she maintained the state was negligent not paying them more. Ms. Krenzer, speaking as the adoptive parent of two girls who spent a year in foster care, wholeheartedly agreed with visitation as outlined in A.B. 524 as being in the best interests of the child. She stated she did not know if section 8 of the bill covered or precluded child visitation after adoption, but indicated visitation of the foster home would certainly have been an asset for her children. Ms. Krenzer qualified that by saying she did not necessarily intend weekly visits, but just going back to the home and seeing the family so continuity and memories could be maintained. Mr. Sarb, noting his concern was primarily with visits to foster homes of children returning to their biological parents, stated open adoptions are now possible so visits are now legal in adoption circumstances where all parties agree. Ms. Steel asked how much it cost to send children out of state and wondered if Nevada could pay foster parents more and keep those children in state. Mr. Sarb testified in fiscal year 1994, $8.5 million was spent on 182 children out of state, most of whom would never be appropriate for family foster care, no matter what the reimbursement rate was. Mr. Sarb added the division was working to develop in state services for those children, however those services were not expected to be family foster care type services. Ms. Steel commenting on Mr. Sarb's preceding statement that most of the children would not be appropriate for family foster care, inferred some of the children sent out-of-state would then be suitable for family foster care. Mr. Sarb explained he never uses "never", but suspected there might be a few children who could be placed with exceptional family foster care givers within Nevada. For the most part, he added, children sent out of state have serious emotional disturbances requiring acute psychiatric care with 24 hour availability or are adolescent sex offenders who would be a danger to others. Ms. Steel inquired what type of facility the children were placed in when they go out of state. Mr. Sarb responded the facilities have acute units available or are like Willow Springs in Reno with medical and psychiatric availability 24 hours a day. Mrs. Freeman asked what age group primarily was sent out of state. Mr. Sarb explained the children are all ages but probably weighted more heavily toward adolescents than younger children. Mrs. Freeman mentioned she did not understand why those services were not available in Nevada. Mr. Sarb indicated the current budget included a 56 bed facility that would care for precisely that population to be built as a state run facility in Southern Nevada this biennium. Mrs. Freeman questioned if the children being sent out of state were being housed in private, for-profit facilities that Nevada contracts with. Mr. Sarb indicated some were for-profit facilities but some were not. Deanne Blazzard, speaking for the foster parents, responded to some of Mr. Sarb's testimony. She stated she recently attended the National Foster Parent Conference, spoke with a representative of the company that provides liability coverage for foster parents and asked him about secondary and primary insurance. She was told secondary insurance was available, however if the foster parents do not have homeowners' insurance because they rent, or for some other reason, it becomes primary insurance. Ms. Blazzard mentioned a survey by the Council of Affiliated States of the National Foster Parent Association asked whether liability insurance for foster parents was available. Thirty-eight states responded to the survey of which 24 states indicated liability insurance was available in their state. Ms. Blazzard mentioned in many cases homeowners' insurance will not accept claims by foster parents. In responding to Mr. Sarb's rebuttal of reimbursement for foster parents, Ms. Blazzard stated she bought a much larger house because she was caring for foster children and she even added on to her home when the foster children attained an age where a brother and sister could no longer sleep in the same room. Likewise with her car; she bought a van to transport the foster children she cares for rather than a smaller passenger car for her family of four. Garry Alsdorf, reading from a prepared text, (Exhibit E,) stated she lives in Elko County, had been a foster parent for five years and emphasized Elko County is in crises. She stated the Division of Child and Family Services picked up eleven children last month with only nine active foster homes, four of which are completely full. She mentioned a for-profit state contractor named Maple Star which cares for children formerly in foster family care, but at a much higher cost to the state. Mrs. Freeman inquired about Maple Star and what kind of facility it is. Mrs. Alsdorf explained Maple Star is contracted by Nevada to take therapeutic children who are usually adolescents and consists of foster homes just like hers. Mrs. Freeman requested further clarification from Mr. Sarb. Mr. Sarb stated Nevada contracts with an agency to provide theraputic foster care which is a more intense foster home environment than regular foster care. Mrs. Freeman asked what "contracting with an agency" meant. Mr. Sarb explained, as an example, when they contracted with Maple Star they said they would pay $2,400 per child per month with specific services to be provided by Maple Star outlined. Mrs. Freeman inquired whether Maple Star were a privately funded organization. Mr. Sarb replied it is a private, non-profit corporation. Mrs. Freeman asked what services were provided and was there a building housing Maple Star. Mr. Sarb responded there is no building, just a number of foster homes that care for no more than two children each. In addition a therapeutic worker is available to those foster homes 24 hours a day, seven days a week to respond to crises and provide active treatment. He noted these are basically the same kind of services that would be available in a residential treatment center but without the cost of the building. Mr. Sarb added this is a particularly effective model for rural areas where the demand for services was too low to support a large facility like Willow Springs. Garry Alsdorf reiterated the only difference between her home in Elko and the Maple Star homes is the availability of the therapeutic worker. She testified foster home providers have left the state to work for Maple Star where they receive $900 per child per month in contrast to Mrs. Alsdorf who receives $315 per child per month. Mrs. Alsdorf's written testimony included information about a little girl from Elko County who has been supported in San Diego by the state for the past two years at a cost of $91,615 per year. She commented when this girl is brought to Elko to visit, state Medicaid pays plane fares for her and her therapist and all other travel expenses. Even though the therapeutic home in San Diego is being highly paid, three photographs, (Exhibit F,) show the kind of clothing she was wearing on her last trip home to Elko. Mrs. Alsdorf showed the Committee the clothing she was wearing at $251 per day: shoes with holes, unmatched socks and underwear grossly too small for her size. Picture number three shows the girl when she left her former foster home. Mrs. Alsdorf testified the foster mother would have taken this girl back at $315 per month but the state could not provide her with respite care at least once or twice a month. Mentioning respite care, Mrs. Alsdorf commented one foster family in Elko with four foster children in its care, was taking the summer off because of burnout. One foster child is a suicidal teenager; one is a chronic runaway; one is a three year old with learning disabilities who never, ever sleeps day or night and the fourth child is his one year old sister. Mrs. Alsdorf commented instead of a good respite program, the children are moved. She reiterated the only way to get a day off in the state of Nevada is for foster parents to quit. Mrs. Freeman asked if Elko County could offer any help. Mrs. Alsdorf stated they rely on the state Division of Child and Family Services because there is no one at the local level except for Assemblyman John Carpenter. Ms. Krenzer stated foster parents in the state should just boycott, and then the state would discover what the real costs of child care are. She added foster families care for the same children who are eligible for Maple Star and stressed foster parents are really being abused until the state realizes what it costs to properly care for the children. Mrs. Alsdorf mentioned she and her husband occasionally take county probation children. Elko County pays them $50 to agree to take a child and $30 per day for each day, which totals $900 per month. Mrs. Freeman inquired if Maple Star and the other two contractors have homes statewide and if this situation had been brought to the attention of the other legislative committees. Mrs. Alsdorf stated Maple Star had been in Elko County approximately one year and this was the first time she had been to the legislature. She emphasized it was very hard for her to see Maple Star's providers paid $900 for the exact same child because they have one social worker and she is only paid $315. Sonia Martin testified the Nevada Women's Lobby was in support of A.B. 524. Mrs. Freeman stated her intention to place A.B. 524 in a subcommittee and asked who on the Committee would like to volunteer. Ms. Krenzer, Mrs. Monaghan and Mrs. Braunlin all volunteered for the subcommittee with Mrs. Monaghan chairing. Milton Alsdorf, also representing Northeastern Foster Parents, stated he had a written statement he would leave with Committee members to read later, (Exhibit G,) which included letters from two other Elko County foster care providers. He believed most of A.B. 524 resulted from past problems foster parents had experienced and explained foster parents wanted those provisions included in the bill to protect themselves. He emphasized the three items in the bill most important to foster parents which were liability insurance; respite care and increased reimbursement for foster care providers. Mr. Alsdorf mentioned foster parents in conjunction with the state were currently rewriting the way foster care will be handled. He explained a team concept had been proposed to care for foster children in the communities using professional people in addition to the Division of Child and Family Services, the natural parent, the foster parent and anyone else involved. Reunification is the goal and he stressed how important it is for the child. He believed the team concept would heal the child and the family and get the child back into the home within 18-24 months instead of a child being in foster care for years. Mrs. Freeman mentioned the members of the subcommittee were all from Clark County and requested they look into the problems in Elko County which is such a fast growing county. She noted there appeared to be no social services on the county level nor anyone who could work with Elko County foster parents. She would like the subcommittee to investigate why and what could be done at the state level to get more local involvement to assist with foster care issues. She also requested the issue with Maple Star be investigated. Ms. Krenzer suggested there may be a similar situation in Clark and Washoe Counties where private entities like Maple Star are being paid more than state paid foster care parents. Mrs. Freeman closed the hearing on A.B. 524. Next order of business was a request by Mrs. Freeman for Committee introduction of BDR 40-903 which provides that certain persons arrested must be tested for sexually transmitted disease. ASSEMBLYWOMAN JAN MONAGHAN MOVED FOR COMMITTEE INTRODUCTION OF BDR 40-903. ASSEMBLYWOMAN DEANNA BRAUNLIN SECONDED THE MOTION. THE MOTION CARRIED. There being no further business, the meeting was adjourned at 3:15 p.m. RESPECTFULLY SUBMITTED: Terry Horgan, Committee Secretary APPROVED BY: Assemblywoman Vivian L. Freeman, Chairman Assemblywoman Jan Monaghan, Chairman Assembly Committee on Health and Human Services May 15, 1995 Page