MINUTES OF THE SENATE COMMITTEE ON COMMERCE AND LABOR Sixty-eighth Session May 11, 1995 The Senate Committee on Commerce and Labor was called to order by Chairman Randolph J. Townsend, at 8:30 a.m., on Thursday, May 11, 1995, in Room 227 of the Legislative Building, Carson City, Nevada. Exhibit A is the Agenda. Exhibit B is the Attendance Roster. COMMITTEE MEMBERS PRESENT: Senator Randolph J. Townsend, Chairman Senator Ann O'Connell, Vice Chairman Senator Sue Lowden Senator Kathy M. Augustine Senator Raymond C. Shaffer Senator John B. (Jack) Regan Senator Joseph M. Neal, Jr. STAFF MEMBERS PRESENT: Beverly Willis, Committee Secretary Scott Young, Senior Research Analyst OTHERS PRESENT: Patricia Justice, Lobbyist, Clark County Art Besser, Chief of Licensing, Clark County Department of Business License Robert Vanselow, Physician Assistant, Nevada Academy of Physician Assistants Ann Davis, Director of State Government Affairs, American Academy of Physician Assistants (PA) and The Nevada Academy of Physician Assistants Caroline Ford, Assistant Dean/Director, University of Nevada School of Medicine Center for Education and Health Services Outreach Susan Vanslow, Physician Assistant, Nevada Academy of Physician Assistants Daniel Hickey, President, Nevada Academy of Physician Assistants Marsha Berkbigler, Lobbyist, Nevada State Medical Association Paula Berkley, Lobbyist, Landscape Architectural Board Ellis Antunez, Board Member, State of Nevada Board of Landscape Architecture Kevin Higgins, Director, Fraud Control Unit for Industrial Insurance, Office of the Attorney General Joan Kruse, Deputy Administrator, Real Estate Division, Department of Business & Industry Dorothy Zimmerman, License Manager, Real Estate Division. Department of Business & Industry Senator Townsend opened the meeting with the introduction of Bill Draft Request (BDR) 54-435. BILL DRAFT REQUEST 54-435: Provides for licensing and regulation of massage as therapy. Patricia Justice, Lobbyist, Clark County, was first to testify, noting there is support for this BDR throughout the state. Ms. Justice then introduced Art Besser, Chief of Licensing, Clark County Department of Business License, who spoke, noting this legislation will enable those involved the ability to transfer within the state without testing for each county/employer. SENATOR LOWDEN MOVED FOR INTRODUCTION OF BILL DRAFT REQUEST 54-435. SENATOR REGAN SECONDED THE MOTION. THE MOTION CARRIED UNANIMOUSLY. * * * * * Senator Townsend then closed the hearing on BDR 54-435 and opened the hearing on Senate Bill (S.B.) 458. SENATE BILL 458: Makes various changes to provisions relating to industrial insurance. SENATOR O'CONNELL MOVED TO DO PASS SENATE BILL 458. SENATOR REGAN SECONDED THE MOTION. THE MOTION CARRIED UNANIMOUSLY. * * * * * Senator Neal stated, "I will vote to get the bill out of committee, but I probably will be opposing the bill if certain amendments are not passed on the floor." The hearing was closed on S.B. 458 and the hearing opened on S.B. 389. SENATE BILL 389: Authorizes physicians' assistants to prescribe controlled substances. First to testify, Robert Vanselow, Physician Assistant, Nevada Academy of Physician Assistants, gave background and the reasons for this bill. Mr. Vanselow declared his work is performed under the supervision of a physician and trust exists between the supervisory physician and the physician assistants. Mr. Vanselow stated when a physician assistant prescribes a drug, often, the pharmacist will have difficulty being reimbursed, since the physician assistant does not have a federal registration number. These numbers are given to practitioners who are allowed to prescribe controlled substances. Senator Lowden and Mr. Vanselow continued, discussing the various reasons for and against this bill. Senator Augustine raised questions regarding the amount of education required for the physician assistant, identifying the fact that the physician assistant requires only 2 years of training. Ann Davis, Director of State Government Affairs, American Academy of Physician Assistants (PA) and The Nevada Academy of Physician Assistants, gave more testimony concerning the Physician Assistants' (PA) training. Ms. Davis asserted the PA training is 2 to 3 years in length and instead of an exact degree, PA education is based on "competency based education." Ms. Davis explained, every approved program has to be accredited by an accreditation agency that has input from the American Medical Association, the American Academy of Family Physicians, and the American Academy of Pediatrics and says exactly what a physician assistant must know. According to Ms. Davis, this is roughly two-thirds of medical school. She went on to note PAs practice with supervision forever. Senator Augustine noted she still has concerns regarding the legislation. Senator Neal and Mr. Vanselow had further discussion pertaining to the duties of a physician assistant. Mr. Vanselow went on to state that part of his training is to know when he does not know what to do in a given medical situation. Senator Neal reiterated his concerns. Senator Shaffer expressed concerns pertaining to those new to the program as to the effect this will have on the public. Senator Augustine again voiced concerns. Hoping to alleviate the various concerns voiced by members of the committee, Mr. Vanselow noted the physician assistant is required to have 100 hours of continuing education every 2 years. Caroline Ford, Assistant Dean/Director, University of Nevada School of Medicine, Center for Education and Health Services Outreach, provided information on the amount and depth of training required. Ms. Ford maintained physician assistants are placed in a position where they will receive proper supervision. Others to testify in favor of this legislation were Susan Vanselow, Physician Assistant, Nevada Academy of Physician Assistants, and Daniel Hickey, President, Nevada Academy of Physician Assistants. Mr. Hickey gave his background and asked for assistance for the physician assistants, by giving them the tools to do what they and their supervisors feel necessary. Next to testify on S.B. 389, Marsha Berkbigler, Lobbyist, Nevada State Medical Association, noted her organization has great respect for the physician assistants; however, the association does have some concerns. Ms. Berkbigler went on to note if this legislation is made into law, it will make the physician assistants independent of their physician. Ms. Berkbigler noted, although her organization is not really in opposition to this legislation, they are not in favor of it either and wanted this so noted. Senator Lowden inquired if language could be clarified in order to allow the physician assistant to write prescriptions for controlled substances, under the auspices of a physician, in order to relieve the physician. Ms. Berkbigler agreed, declaring this might be acceptable noting, however, the pharmacy board might need to be involved. Senator Regan and Ms. Berkbigler continued with deliberation concerning this proposed legislation. At this time, Senator Townsend closed the hearing on S.B. 389 and opened the hearing on S.B. 422. SENATE BILL 422: Makes various changes relating to landscape architects. Paula Berkley, Lobbyist, Landscape Architectural Board, introduced Ellis Antunez, Board Member, State of Nevada Board of Landscape Architecture. Senator Townsend inquired which sections of this legislation deal with protection of the public. Ms. Berkley presented Exhibit C and pointed out the significant sections. Ms. Berkley proceeded to explain. Mr. Antunez and Senator Augustine discussed the disciplinary process, referring to Exhibit C. SENATOR NEAL MOVED TO DO PASS SENATE BILL 422. SENATOR SHAFFER SECONDED THE MOTION. THE MOTION CARRIED UNANIMOUSLY. * * * * * Senator Townsend opened the hearing on Assembly Bill (A.B.) 59. ASSEMBLY BILL 59: Makes various changes to provisions governing investigation, prosecution and punishment of crimes related to industrial insurance. Kevin Higgins, Director, Fraud Control Unit for Industrial Insurance, Office of the Attorney General, testified, explaining the legislation. Mr. Higgins stated the implementation of A.B. 59 will facilitate prosecution and he gave his reasons. SENATOR REGAN MOVED TO DO PASS ASSEMBLY BILL 59. SENATOR AUGUSTINE SECONDED THE MOTION. THE MOTION CARRIED UNANIMOUSLY. * * * * * Senator Townsend then opened the hearing on A. B. 344. ASSEMBLY BILL 344: Revises provisions governing regulation of real estate licenses. First to testify, Joan Kruse, Deputy Administrator, Real Estate Division, Department of Business & Industry, introduced Dorothy Zimmerman, License Manager, Real Estate Division, Department of Business & Industry. Ms. Kruse stated the Real Estate Division requested this legislation. Senator Townsend posed an inquiry concerning the contract fee for real estate exams. Ms. Zimmerman explained. Senator Townsend went on with several questions regarding fee information from Ms. Kruse, referring to Exhibit D and Exhibit E. SENATOR NEAL MOVED TO DO PASS ASSEMBLY BILL 344. SENATOR REGAN SECONDED THE MOTION. THE MOTION CARRIED. (SENATOR LOWDEN WAS ABSENT FOR THE VOTE.) * * * * * There being no further business, the meeting was adjourned at 10: 20 a.m. RESPECTFULLY SUBMITTED: Beverly Willis, Committee Secretary APPROVED BY: Senator Randolph J. Townsend, Chairman DATE: Senate Committee on Commerce and Labor May 11, 1995 Page