MINUTES OF THE ASSEMBLY COMMITTEE ON WAYS AND MEANS Sixty-eighth Session June 16, 1995 The Committee on Ways and Means was called to order at 1:45 p.m., on Friday, June 16, 1995, Chairman Morse Arberry, Jr., presiding in Room 119 of the Legislative Building, Carson City, Nevada. Exhibit A is the Agenda. Exhibit B is the Attendance Roster. ASSEMBLY COMMITTEE MEMBERS PRESENT: Mr. Morse Arberry, Jr., Chairman Mr. John W. Marvel, Chairman Mrs. Jan Evans, Vice Chairman Ms. Sandra Tiffany, Vice Chairman Mr. Dennis L. Allard Mrs. Maureen E. Brower Mrs. Vonne Chowning Mr. Jack D. Close Mr. Joseph E. Dini, Jr. Mr. Thomas A. Fettic Ms. Chris Giunchigliani Mr. Lynn Hettrick Mr. Bob Price Mr. Larry L. Spitler STAFF MEMBERS PRESENT: Mark Stevens, Fiscal Analyst Gary L. Ghiggeri, Principal Deputy Fiscal Analyst ASSEMBLY BILL 653 Requires state welfare administrator to include in state plan for assistance to medically indigent coverage for transplant of person's heart under certain circumstances. Andy Maline noted Vikki High was a Medicaid recipient who currently is in the hospital because of a diagnosis of terminal heart disease and was in need of a heart transplant. He stated A.B. 653 was critically important to Vikki High and would be important to other people in the years to come who were on Medicaid. Mr. Maline read from prepared testimony which is attached as Exhibit C. Mr. Allard inquired if the $162,000 cost for a heart transplant included post transplant care. Mr. Maline replied it was for the operation only and did not include post transplant care nor the screening, evaluation or analysis preceding the transplant. Mr. Allard asked if the procedures preceding the transplant had already been performed. Mr. Maline responded yes and indicated Medicaid had absorbed much of those costs. Chairman Arberry inquired if physicians were present to testify. Mr. Maline indicated they were present. Chairman Arberry noted there was a time limit because the Senate Committee on Commerce had a hearing in Room 119 at 3:00 p.m. Scott A. Ames, M.D., Assistant Professor of Surgery, Nevada School of Medicine, and Chief of Transplantation services, University Medical Center, read from prepared testimony which is attached as Exhibit D. Mr. Allard inquired if it was less expensive for a person to have a heart transplant as opposed to receiving long-term medical care. Dr. Ames stated it was often true that a heart transplant is less expensive, although it may not be true for all cases. In the end it is the least expensive to allow a person to die, but the point is that a decision to allow long- term care is based on humanitarian reasons and not on a cost- effective basis. Heart transplantation is probably cost effective when compared to more established therapies such as kidney transplantation and dialysis. Mr. Allard asked how many other states had the exact program as was being proposed in A.B. 653. Dr. Ames noted in 1985 50% of the states covered heart transplants through their Medicare programs and presently it is 78%. A notable program in Oregon creates a list which numbers health care interventions and provides a cut-off at a certain point. If a heart transplant falls below that certain point, it is not performed. The caveats to Oregon's plan are: 1) It was not acceptable by the federal government; and 2) Private funding and re-established Medicaid funds for heart transplantation now place Oregon in the 39 states who do cover heart transplantation. Mr. Allard queried if patients would be put on the list of qualified recipients along with other patients who are privately insured or would other recipients be bumped from the list. Dr. Ames indicated the heart transplantation list of patients depends on several factors, the first being disease severity. As was the case with the liver transplant for Micky Mantel, he was placed at the top of the list, not because he was famous, to which the system is blinded, but because he needed the organ. While that may not be the least expensive way to supply transplantable organs to people who would die otherwise, it is the most fair. The person with the greatest need receives the organ first. Mr. Allard inquired if other factors were taken into consideration. Dr. Ames stated financial needs were not among the factors. For heart transplants the only factors are size and blood type matching. Mrs. Brower asked about the quality of life after heart transplantation and the length of time before a person gets back to normal and might be able to go back to work. Dr. Ames deferred to Dr. Cooper for a response to Mrs. Brower's questions. Chairman Arberry recessed the hearing on A.B. 653 until 3:30 p.m. and opened the hearing on S.B. 416. Additional testimony on A.B. 653 is included later in meeting minutes. SENATE BILL 416 Makes various changes regarding sentencing of persons convicted of felonies. Mark A. James, Senator, Clark County Senate District No. 8, stated S.B. 416 was the culmination of a session's long work by the Senate Judiciary Committee, members of the Senate, members of the Assembly, Assembly Judiciary Committee, and also the efforts of law enforcement officials, judges, victims groups, and other advocates of criminal justice reform throughout the state of Nevada. No other issue that faced the legislature at the beginning of the session was as acute a problem as that of crime. Senator James noted Nevada was on the top of the list of crimes in terms citizen safety and the dangers children and citizens face from the terrible scourge of crime. In 1994 Nevada ranked seventh in the crime rankings of the United States. In 1995 Nevada's crime escalated to third in the country. At the beginning of the legislative session, Senator James pointed out, the Senate and Assembly Judiciary Committees divided responsibilities. The Senate Judiciary Committee initiated an inquiry of the status of the parole system and sentencing practices in the criminal justice system and the way sentences were actually served in the prison system. A number of joint hearings were held which included presentations from the Department of Prison, Parole and Probation, and the Parole Board. It was learned there is a grave problem with the current status of Nevada laws. Both houses of the legislature studied criminal activities which had previously been defined and the prison sentence or other penalty which was assigned to the defined crime. Senator James called attention to a recent case where one of the members of the law enforcement community was killed by a person who had a long record in the criminal justice system and had recently been sentenced to a period of ten years for the crime of armed robbery. The question was raised about how a person who was sentenced to prison in 1992 could commit a murder in 1995. Senator James explained the statutory crime of robbery has a penalty of 1 to 15 years. A judge will give a determinate sentence of, for example, ten years in prison. What the judge does not say, and what the victim and the criminal do not hear, is that after the sentence is given, various issues turn the sentence into something it was never intended to be. First, the eligibility for parole under the statutes vests after three years served. The number is further reduced by the operation of sentence-reducing credits, which provide that an offender has his or her sentence reduced on a monthly basis by a certain number of days for good behavior. Sentence-reducing credits also include prisoner participation in other rehabilitation activities such as attending school, receiving a GED, and learning vocational skills. The effect is reducing sentences for violent offenders well below what should be served and the undermining of truth in sentencing in the criminal justice system. Other states addressed the problem by eliminating parole by requiring every offender to serve the sentence handed down or requiring that 85% of the sentence must be served. S.B. 416, however, creates five categories of felonies listed in terms of severity. Category A contains felonies which the judge may impose a sentence of death or the possibility of life in prison with or without the possibility of parole. Category B contains serious violent felonies for which a person can receive a term of years in prison. Category C contains serious nonviolent crimes for which a term of years is given. Category D contain less serious crimes and the term of years is short. Category E is a relatively narrow group of offenses covering many offenders which represent nonviolent crimes, primarily involving drug use in small quantities, not to include the sale of drugs, for which prison is not the best option. Senator James stated S.B. 416 changes the way sentences are imposed. Instead of giving a determinate sentence, a judge will give an indeterminate sentence assigning two numbers. For example, if the statutory range is 1 to 15 years for a crime, a judge may impose 4 to 10 years or 6 to 15 years. The first number represents the minimum number of years which must be served by the offender. No good-time credits or parole eligibility would occur during the minimum number. The parole board would have no power to parole anyone within the minimum number of years to be served. The second number represents the maximum term which can be reduced by the use of good-time credits and under which the offender can be subject to parole. It was felt the maximum number should be included during sentencing because it is important to control the behavior of a prisoner through an incentive of rehabilitation through the prison system. A maximum sentence reducible by good behavior and other rehabilitation provides the incentive. Secondly, it is not good policy to release an offender into society with no supervision without further state inquiry into the offender's activities. The parole system provides an incentive to the offender to conform his or her behavior to certain conditions of parole. Senator James explained S.B. 416 made adjustments and changes to the various sentences set forth in the present statute. As a general rule, the maximum sentence for violent crimes is increased, and category D and E crimes require offenders be diverted out of the prison system. Based on a statistical study by the Department of Prisons at the request of Senator James, the average time served based on a 12-month sample for the crime of murder in the state of Nevada was 5.8 years. The time served for the crime of first degree sexual assault was approximately 7 years. The time served for the crime of robbery with a deadly weapon was approximately 3 years. In other words, offenders of nonviolent crimes are occupying beds while violent offenders are released into society to commit further crimes far earlier than they should be. One other aspect of S.B. 416 includes the realization that judges need additional tools for the purpose of assisting the parole and probation officers by creating in Sections 197 and 198 a private system of secured probation which a judge can optionally give to an offender who has the ability to post a bond and participate in such a program. Another major aspect of the bill is to insure that a sentence of life in prison without the possibility of parole cannot be commuted to a sentence of life in prison with the possibility of parole by the Board of Pardons. That provision of the bill is consistent with a bill proposed by Governor Miller in his anti-crime measure. The final provision of the bill deals with habitual offenders. Senator James summarized his remarks by saying S.B. 416 together with the two proposals by Governor Miller and Mr. Dini were sweeping crime measures which would work well together, would go a long way toward addressing the terrible problem of crime in Nevada, and represented the most sweeping, broad-based reform of the criminal justice system in the history of Nevada. Senator James pointed out the bill was mindful of the fiscal consequences in the current biennium as well as future bienniums. Staff members made certain assumptions regarding the behavior of judges and parole members when making their projections. He noted the administration has a contract with the National Council of Crime and Delinquency, which provides prison projections for the state of Nevada. The council reviewed S.B. 416 to help with the possible effects of the bill on future prison populations. He noted the display charts depict the effect of changes in the incarceration for violent crimes and the crime rate for society. Comparing the incarceration rate to the crime rate for the years 1960 to 1992 depict an inversion proportion. When the incarceration rate decreased, the crime rate increased dramatically and vice versa. He stressed a violent offender imprisoned for a longer period of time cannot commit additional crimes. The National Council on Crime and Delinquency made a projection assuming the implementation of S.B. 416 over a period of ten years, which can be broken down into three parts. The first part, based on category D or E felonies, would result in a drop in the number of offenders actually in the prison system in the first two years. In 1997 the line crosses the zero mark and increases as truth in sentencing comes into play. After ten years the graph depicts between 300 and 400 additional offenders in prison. Senator James pointed out that Robin Bates, Chief of Classification and Planning, felt the projections were well balanced and represented a hardening of the prison population. In other words, a few years after the implementation of the bill, the prison population will represent a greater percentage of violent offenders than are housed presently. Senator James drew attention to the Nevada Department of Prisons population projection comparison (Exhibit E) which shows a modest increase in the prison population as a result of S.B. 416. The bill is based on a 35% parole rate in the future. If the parole rate is lower, the numbers as depicted on Exhibit E would increase. The importance of the analysis is the relationship between the projected S.B. 416 incarceration rate and existing projection. Senator James called attention to page 4 of Mr. Arberrycomparison of current sentencing practices (Exhibit F) and noted there were ten options available to a judge as depicted in the first column, the minimum parole eligibility for each option in the second column, and the expiration of the sentence without reference to parole release in the third column. It is important to understand that the number used by the National Council on Crime and Delinquency is the parole eligibility date. A ten-year sentence has a parole eligibility date of two years under current law. The proposed law presents twice as many options to the judge, with the minimum eligibility being one year. The spike represented on the display chart for 1996 is the effect of requiring people who receive a minimum one-year sentence to serve one year. The number is driven largely by DUI offenses involving substantial bodily harm or death, and offenders will be required, under S.B. 416, to serve the minimum sentence. In other words, the minimum eligibility is doubled under the new law. The reason the years column goes only to four, Senator James explained, is because the law includes a rule that the minimum sentence can be no greater than 40% of the maximum sentence. A concern was raised during the development of the bill that judges not be given the discretion to hand a sentence down with a minimum/maximum of 14/15 years. The bill also provides assurance that the minimum is removed far enough from the maximum sentence so the offender serving the minimum will not expire the maximum with the operation of sentence-reducing credits. Chairman Arberry complimented Senator James and the Senate Judiciary Committee for drafting S.B. 416. He requested an explanation of the good-time credits. Senator James drew attention to Subsection 2 of Section 235 of the bill and explained after July 1, 1995, sentence-reducing credits of any type in the Nevada code can only operate to reduce a maximum sentence and cannot operate to reduce a minimum sentence. Chairman Arberry inquired if the time an offender is in jail waiting to be sentenced or waiting on the trail can be included in their time served, and Senator James replied yes. Chairman Arberry requested an explanation of the 35% parole figure, and Senator James remarked that figure was included in the projections of the National Council on Crime and Delinquency. Chairman Arberry asked why a parole board would be necessary in light of the provisions in S.B. 416. By way of explanation, Senator James noted the 35% parole rate was a statistical projection. The parole board's function is to review each case individually and decide whether an offender should be paroled. The 35% parole rate reflects what the parole board has done in the past, and a projection is made based on that figure. Senator James stress the 35% parole rate was the rate used by the administration in preparation of the budgets and was adopted by the administration's contracting agency, the National Council on Crime and Delinquency who did the fiscal analysis on S.B. 416. It does not matter what parole rate is used for purposes of analyzing the bill as long as the same parole rate is used for the budget projections. Chairman Arberry noted there did not appear to be a fiscal note for the current biennium as a result of S.B. 416 but it spikes dramatically in the next biennium. Senator James pointed out the bill accounts for the minimum sentences having to be served. He drew attention to the case of Donald Cameron who came before the Parole Board on a ten-year sentence and who had almost no time left on his sentence because of the operation of sentence- reducing credits. The Parole Board had to decide whether to parole him with conditions attached to his release or wait until July of 1996 when the sentence would expire and he would walk free without any conditions on his release. Chairman Arberry noted the bill says it will go into effect after July 1, 1995, and he inquired about the offenders in jail waiting sentencing. Senator James explained no one in the prison system would be affected by the bill except those people serving a life sentence without the possibility of parole for first degree murder. Mr. Marvel noted the unknowns were the reason an $8 million contingency was recommended to be added to the IFC contingency fund, and he complimented Senator James and the Senate Judiciary Committee for their work in creating S.B. 416. Ms. Giunchigliani inquired if the people who were placed in honor camps because their sentences were reduced was discussed during the drafting of S.B. 416. Senator James said that was discussed, and Director Bayer did not indicate an adjustment needed to be made during the current biennium. Ms. Giunchigliani asked if the number of beds needed in the future as a result of the enactment of S.B. 416 would be for medium security offenders and if so, how far into the future. Senator James responded yes, but no projections were made as to how far into the future. He noted the National Council on Crime and Delinquency makes the projection. Classifications must then be made by the state, but no changes have been recommended in the current biennium. Ms. Giunchigliani commented the zero fiscal note is not realistic for the future. Senator James remarked the contingency fund was an appropriate measure to deal with the fiscal note during the upcoming biennium. Ms. Giunchigliani expressed concern about shuffling money from schools to prisons. Senator James stated he did not believe any money was shuffled from schools to pass S.B. 416. Mr. Price congratulated Senator James for his work on S.B. 416. He inquired if the bill took into consideration any plea bargaining which might occur prior to sentencing. Senator James stated that would not change, other than the fact that in many cases the prosecutor would be carrying a bigger stick. Mr. Price asked if good-time credits would still be in effect as a means of providing an incentive for good behavior, and Senator James replied yes. An inquiry was made by Mr. Price if the bill helped the Division of Parole and Probation keep a better handle on parolees. Senator James indicated the enactment of S.B. 416 would help Parole and Probation by insuring that violent offenders will not be on the street as early as in the past. Categorizing felonies and convicting people of certain crimes in either violent or nonviolent categories assists parole and probation by recommending the appropriate sentences. Once an appropriate sentence is recommended and adopted by a judge, there is predictability about release of the offender. It also insures that the level of supervision given an offender is similar to other offenders so sentenced. Chairman Arberry noted the time was 3:00 p.m., and there were people in southern Nevada and in the committee room who wished to testify. Chairman Arberry called for public testimony from those people in southern Nevada who wished to speak regarding S.B. 416, and the following individuals from Las Vegas spoke in support of S.B. 416: - George Glanville, past president and assistant executive director of Families of Murder Victims, urged the committee to pass S.B. 416 and to send it to the Assembly floor for a vote. He presented written testimony which is attached as Exhibit G. - Arlene Hayes noted she had lost her husband and her son as a result of violent crimes committed by convicted felons. She urged the committee's support of S.B. 416. - Eva Collenberger, executive director of Families of Murder Victims, expressed her support for S.B. 416. She read from prepared testimony which is attached as Exhibit H. - Louise Lizzi expressed support of S.B. 416. Her daughter was murdered by a person who had been released on parole after serving seven years on a life sentence. - Sandy Heverly, representing Stop DUI, voiced her support of S.B. 416 because it was the belief of her organization that the sentencing phase of the criminal justice system is a mockery. The fiscal impact must be considered against the risks and benefits to Nevada citizens. - Barbara Schell, Program Administrator, Clark County District Attorney's Office, Victim Witness Center, urged the committee's support in the passage of S.B. 416. - Irene Signor also expressed support of S.B. 416. James A. Stone, Judge, Second Judicial District, stated he was not representing any other judge nor the Nevada District Judges Association, of which he is the vice president. He came to speak as an individual on behalf of S.B. 416. Judge Stone noted the bill did interfere with judicial discretion, which was not necessarily a bad thing. The most frustrating part of Judge Stone's job was sentencing criminals. He stated the fiscal impact may be less than expected because categories D and E felons would not go to prison and would be diverted to house arrest or drug treatment programs. Chairman Arberry recessed the hearing and indicated the meeting would continue in Room 352. SENATE BILL 386 - 1st Reprint - Makes various changes concerning program of accountability of public schools and statewide achievement and proficiency testing of pupils. The prime sponsor of the bill, Senator Bill Raggio, Washoe County Senatorial District No. 3, explained the bill had previously been heard and acted upon in the Assembly Committee on Education. As amended, S.B. 386 - 1st Reprint removed the sunset provision presently in law; and revised, to some extent, the content of the school-by-school accountability reports provided to the residents of each school district on or before March 31st of each year. These reports had received a great deal of favorable attention from the public, Senator Raggio said, and he believed the taxpayers, teachers and other members of the public were interested in what their money was providing and what the results were. S.B. 386 would require comparisons of pupil achievement for each school, and the district as a whole, for grades 4, 8 and 11, the grades in which state- mandated achievement and proficiency examinations were administered. Senator Raggio submitted an amendment to S.B. 386 - 1st Reprint (Exhibit I), which would also require a report of other grades, on the results of examinations of pupil achievement. This had been the original intent of the bill, the Senator stated, but had not been mandated in the present writing of S.B. 386 - 1st Reprint. Senator Raggio indicated there were also additions which required the reporting of drop-out rates, truancy, transiency rates, incidents of violence involving weapons, and numbers of pupils suspended or expelled. Continuing, Senator Raggio explained among other things, the bill required state-mandated examinations of achievement and proficiency in mathematics and writing be given in each school district at a time prescribed by the State Board of Education, and the exams had to be selected on a uniform basis by a private vendor. This would allow comparison of these pupils with a national reference group. Senator Raggio went on to review the basic provisions of the bill. Pointing out the reason the bill was before the Ways and Means Committee, Senator Raggio commented S.B. 386 contained a General Fund appropriation of $670,030. This amount relieved the Department's and School District's cost of purchasing, administering and scoring these mathematics and reading exams in the required grades; and would provide for new exams, classroom guides, guides for test administrators, answer sheets and a study to equate the new exams with scores on tests currently in use. He noted the Executive Budget had proposed $479,000, and the additional request was recommended to fully pay for the cost, not only of the replacement and the rating of the math tests, but for these other purposes. Mr. Marvel questioned whether there had been any opposition to the bill, to which Senator Raggio replied there had been none he recalled. He believed the major part of the bill was a combination of all the requests in the various accountability bills, and noted all schools appeared to value the school-by- school accountability. Mary Peterson, Superintendent of Public Instruction, stated S.B. 386 combined four bills regarding accountability which had been heard during the Session; and the Department of Education and the State Board of Education were in full support of the bill. Dr. David Smith, who said he had compiled the accountability reports, and Dr. Tom Cline, in charge of the proficiency tests, commented briefly they were in full support of the bill. Reopening the hearing on S.B. 416, Co-Chairman Marvel called forward Richard Gammick, Washoe County District Attorney, and John Dodson, Chief of Police for the Sparks Police Department, to comment on the bill. Mr. Gammik indicated "frustration" was, under the current system, sentencing a man to 18 years in the Nevada State Prison and having that same prisoner out in 18 months. Mr. Gammik went ahead to emphasize the areas of frustration experienced in the Washoe County District Attorney's Office. Therefore, he said, he was very strongly in support of S.B. 416; and he predicted most of the other District Attorneys in the state would support the bill. Chief Dodson indicated total support of S.B. 416, and said this was shared with Chief Jim Weston (Reno Police Department), members of the Reno Police Department, Sheriff Dick Kirkland and the members of the Washoe County Sheriff's Department and Sheriff Jerry Maples and the members of the Douglas County Sheriff's Office. He believed the bill was well thought out, reasonable, and the remedy needed in Nevada. It would serve to allow citizens and individuals sentenced in the courts to know and understand exactly what minimum sentence they would serve before being eligible for parole. He believed the 40 percent rule was very reasonable, and that good-time credits would still allow some leverage in determining parole. Co-Chairman Marvel pointed out the reason for the present hearing of S.B. 416 was more for the fiscal impact than to consider the impact of the bill itself. Responding to Co- Chairman Marvel's question regarding how soon the fiscal impact might make itself felt, Mr. Gammick said he believed it would be at least two years, if not longer, before a fiscal impact would be seen. Also, he believed the bill would be successful in keeping violent, repeat criminals in prison longer. Questioning the longer term of minimum sentence, Mr. Dini wondered whether this would provide a deterrent, or whether it was just a matter of keeping the individual off the street. Acknowledging this was a well-worn discussion, Mr. Gammick believe it basically kept those repeat, violent offenders -- the ones who could not be rehabilitated -- in prison longer. Mr. Dodson, also responding to Mr. Dini, said he did not believe anyone could absolutely predict an individual would not be back before the courts again, but for certain, he knew law enforcement saw a great deal of recidivism in a revolving door system. Senator Maurice Washington, Washoe Senatorial District 2, came forward to testify in support of S.B. 416. He explained the task laid before the Legislative subcommittee made up of Senator Mark James, Senator Ernie Adler and himself, to develop a comprehensive plan which would encompass the entire judicial system, parole and probation, sentencing reform, and all related areas. Senator Washington described the long and intense efforts to come up with a bill which would: 1) Give victims a 100 percent truth in sentencing; 2) create more respect in the judicial and criminal system; and 3) provide a system for the judges which would give them an opportunity to sentence felons with a sentence that would not be diminished. Although Senator Washington saw the present efforts as dealing with the back end of the problem, he said he hoped next Session they could continue to work on the front end, to deal with juveniles before they became offenders and hardened criminals. Referring to the fiscal note attached to the bill, Senator Washington commented the fiscal note attached to the victims of crime was often not taken into account. Representing the District Attorneys' Association, Ben Graham from the Clark County District Attorney's Office, pointed out while it was unknown ultimately how many people would fill the prisons and how hardened that group would be, it was also unknown what positive effects would be attained by sending fewer of the lower-level violators to prison. Hopefully, those people would not go on to more violent offenses. If that was the case, Mr. Graham suggested this might provide a positive fiscal impact. Mr. Dini wondered if there would be any effect to the judicial system as far as the original trials or plea bargaining. Mr. Graham answered there had been some speculation that a few more people would be willing to plead to life with the possibility of parole, although the more violent offenders would still probably opt to go trial. The following individuals also spoke in support of S.B. 416: - Kathy Jacobsen, victim of violent crime. Although S.B. 416 represented a fiscal impact, Ms. Jacobsen pointed out she and her children were true victims of crime. She said she did not mind paying more in taxes to help keep violent criminals in prison; - Tony Angelini provided a written statement by A. E. Angelini (Exhibit J) and stated in May 1990 her father Tony Angelini was murdered in their family delicatessen by a repeat offender with a lengthy record. She said she and her family were in attendance to help see that S.B. 416 was passed; - Kim Walsh. Reiterated support for the bill; - Deborah Leathers. Observed there always appeared to be money for parks and for highways, but when it came to supporting victims, money was always a fiscal obstacle. In empathy, Chairman Arberry said he had had two nephews and a niece killed by ex-felons. He said he understood their concerns only too well. Ann Andrini, speaking on behalf of Governor Bob Miller in support of S.B. 416, said the Governor totally supported the concepts of sentence reform embodied in the bill. S.B. 416 completely restructured the criminal sentencing code, kept violent criminals off the street for longer periods of time and extended strictly supervised alternative sentencing systems for certain non-violent offenders. There was a sense of security in knowing that a person, when told they would serve a certain number of years, would, indeed, serve that number of years. Ms. Andrini also pointed out good time credits could no longer be used to whittle down a tough initial sentence to only a negligible sentence. Only after serving a clear-cut sentence would an individual have an opportunity to be released from system. Ms. Andrini said S.B. 416 worked hand-in-hand with the Governor's crime package contained in A.B. 317 and with Mr. Dini's juvenile gun bill in A.B. 393. She inserted a note of caution to be aware the dramatic changes posed by the bill would lead to a degree of uncertainty as to what the final fiscal impact would be. However, there were two items of insurance. First, there would be a Sentencing Commission which would be the key to determining what methods and resources would be needed to continue to fight the menace of crime in the long term; and secondly, the Governor and staff applauded the Legislature for establishing a correctional system contingency fund of $8 million which would enable the Department of Prisons and the Division of Parole and Probation to deal with any unforeseen increase in the numbers of inmates during this biennium. Speaking on behalf of the Governor, Ms. Andrini commended Senator James and his subcommittee for their work on the bill. Representing Nevada Concerned Citizens, Lucille Lusk called attention to the fact that her organization's support represented an ordinary citizens' group interested in the proper function of government on behalf of the citizens. This bill, she stated, was a bill the Legislature should implement, regardless of the fiscal impact. Assemblywoman Genie Ohrenschall, Assembly District 12, reported she had received many phone calls from her constituents in favor of both A.B. 317 and S.B. 416. These calls not only reflected support for the bills, but they also showed the people wished predictability and logic in sentencing. S.B. 416 would give that predictability and logic. Judy Jacoboni, Chapter President of Mothers Against Drunk Driving (MADD), also spoke in support of S.B. 416, specifically mentioning Sections 325 and 326 pertaining to DUI offenders. Additionally, Ms. Jacoboni suggested in the future when bills affecting public policy were considered that a cost benefit analysis be done. This should reveal not just the cost for prison beds and space, but what the cost would be to future victims of crime. Ms. Jacoboni told the committee she was also a member of a newly formed group called Save Our Communities, now meeting regularly in northern Nevada, and particularly concerned about the issue of parole reform. Speaking on that group's behalf, she said they also supported S.B. 416. Called forward by Mr. Dini, Senator Mark James, Clark County Senatorial District 8, spoke on the surety bond issue. Senator James indicated in working on the bill, he had studied everything on crime he had received in the mail, and one piece of information discussed "conditional early release," which had been used by many states, including Nevada. This article, which included a model bill, indicated one way to involve the private sector on a limited basis was to institute a secured release program similar to bail. In this concept, a person would be required to post a bond or other security to assure their appearance on a pretrial basis. Some of the concepts suggested had been used by Senator James and applied to probation programs instead of early release. It would just provide the judge the flexibility to put someone on probation with an additional modicum of assurance the person would behave and conform to the conditions of probation. Senator James agreed the provision was fairly restrictive, and since there was a desire to err on the side of caution, a liability on the part of surety for any mistakes, had been written into the language. Although $15,000 was perhaps excessive, it would allow all involved parties to see if the program worked. Senator James also pointed out there was written into the language a provision which would allow a judge to determine a community sentence, not a traditional probation, which could be in conjunction with the secured release. Flexibility had been built in to assure compliance with the terms of probation and rehabilitation. Mr. Price observed there were limits being placed on the Board of Pardons to grant pardons under certain conditions, although the bill did not appear to limit the constitutional right of the Governor to grant a pardon. Senator James answered the bill did not deal with any kind of constitutional power for pardon now given to the Governor. Expressing some concern, Mr. Price asked if Senator James had considered Article 5, Sections 13 and 14 of the Constitution, with regard to pardons. Senator James said they had not carefully considered this section of the Constitution, other than to acknowledge the clemency provisions of that Section could not be affected by statute. Voicing her support for the bill, Assemblywoman Vonne Chowning said she also represented a district heavily impacted by crime, and on behalf of the victims in her district she commended the people who had worked on the bill. This completed the testimony on S.B. 416. Chairman Arberry reopened the hearing on A.B. 653. Dr. Matthew Cooper, a cardiothoracic surgeon experienced in heart, lung and heart-lung transplantation, submitted a copy of his written remarks (Exhibit J), and read his testimony into the record. Following Dr. Cooper's testimony, Mr. Price questioned the aspect of discrimination with employment against patients who had undergone heart transplant. He wondered if this applied to other transplant patients, and Dr. Cooper said he believed this applied to most organ transplant patients. Had any state statutory action been taken against this type of discrimination, Mr. Price asked. Dr. Cooper said he was unaware of any statutory action, but, of course, it was possible. He indicated the International Society of the Heart and Lung Transplantation and the United Network for Organ Sharing would certainly have more information on this question. Mr. Price asked that the Legislative Counsel Bureau staff research this aspect. The expenses posed for the state, and funds available from other sources, were discussed between Dr. Cooper and Ms. Chowning. Mr. Close believed the problem was complicated by: 1) The lack of donors; and 2) the difficulty in matching tissue. Dr. Cooper agreed they absolutely had to match blood type, and generally, they matched size. From 1988 on, Dr. Cooper said the number of transplants done in the United States had reached a plateau, due to donor shortage; however, the number of candidates for transplant had continued to increase. Mechanical assist technologies were within 5 years of fully implantable, permanent mechanical assistance. Mr. Andy Maline then came forward to speak in favor of the bill, and in particular to discuss Vikki High, a young mother with heart disease. He referred to Exhibit C and said he understood the fiscal note on the bill could be amended at the request of the Ways and Means Committee or voluntarily by the Department of Welfare. The third option, he pointed out, was to amend the fiscal note on the record. Mr. Maline suggested he would be happy to work through the interim in setting up a public/private arrangement with some of the organizations around the country, so a good plan could be presented in the 1997 Session. The committee was shown a video presentation showing Ms. High and the progress of her heart disease. The Administrator of the State Welfare Division, Myla Florence, submitted a copy of her written remarks (Exhibit K), and read her testimony into the record. Ms. Florence stressed this was a most difficult issue for the staff when they had to advise individuals this was a service not covered in the state of Nevada. She said they would have no objections to incorporating this into the Medicaid state plan. The last time the provision had been reviewed by their medical advisory board, about 18 months ago, the committee made no recommendation to her office that this was a service which should be covered. Speaking to the bill, Ms. Florence said if this was to pass in the current form, it would be the only medical service prescribed in state statute, and would represent an unusual situation. During the 1992 budget crisis, she said, the Welfare Division had been required to make a number of reductions in services provided by Medicaid in order to accomplish a $22 million reduction in services. She therefore suggested if the committee was interested in directing her office to pursue coverage in this area, she recommended it be handled as a letter of intent and dealt with budgetarily, as opposed to a statutory requirement, which would give them the ability to deal with budget requirements outside her office's control. Finally, she said she believed the Arizona Supreme Court decision had made the state vulnerable, and Nevada might be challenged with regard to denial of this kind of service. However, since Medicaid was a capped budget, she again asked this be considered with regard to extraordinary costs as a result of a new service. Mr. Allard asked Ms. Florence if she was empowered to produce this service administratively, without statute. She answered affirmatively, it would just be included as part of the Medicaid state plan. While the Department could do that now, the current budget did not encompass this kind of cost since it had not, in the past, been a covered service. Additionally, she pointed out the costs she had projected should be considered in light of federal contributions which would mean it was 50 percent federally funded and 50 percent state funded. Referring to the cap, Ms. Florence told Mr. Price the division was capped because the Legislature had passed a bill some years ago which stipulated Ms. Florence's office could not approach the Interim Finance Committee for supplemental funds. Referring to the video showing Ms. High, Mr. Price asked if he was correct in his understanding that even if the Legislature issued a letter of intent and whatever else was needed to aid Ms. High, it was true there was no assurance of how long it would be before a proper heart was found. Dr. Cooper interjected the average waiting period for a heart was approximately 12 to 18 months, and the mortality rate while waiting on the list was approximately 30 percent. Mr. Price called attention to the fact Ms. High was presently in Sunrise Hospital in Las Vegas under state care, which already represented a cost to the state. Calling attention to the letter of intent, Ms. Florence stated if the committee wished to indicate this intent, it would have to be with regard to offering transplantation to any eligible candidate. This completed the testimony on A.B. 653. At 5:02 p.m. Chairman Arberry announced the committee was adjourned until after General Assembly the following day. RESPECTFULLY SUBMITTED: Jonnie Sue Hansen, Committee Secretary Assembly Committee on Ways and Means June 16, 1995 Page