MINUTES OF THE SENATE COMMITTEE ON HUMAN RESOURCES AND FACILITIES Sixty-eighth Session March 22, 1995 The Senate Committee on Human Resources and Facilities was called to order by Chairman Raymond D. Rawson, at 1:30 p.m., on Wednesday, March 22, 1995, in Room 226 of the Legislative Building, Carson City, Nevada. Exhibit A is the Agenda. Exhibit B is the Attendance Roster. COMMITTEE MEMBERS PRESENT: Senator Raymond D. Rawson, Chairman Senator Sue Lowden, Vice Chairman Senator Maurice Washington Senator Kathy M. Augustine Senator Joseph M. Neal, Jr. Senator Bob Coffin Senator Bernice Mathews STAFF MEMBERS PRESENT: Kerry Carroll Davis, Senior Research Analyst Mary Gavin, Committee Secretary Linda Chapman, Committee Secretary OTHERS PRESENT: David Perlman, Administrator, Commission on Postsecondary Education Keith Rheault, Deputy Superintendent, State Department of Education Fred Hillerby, Lobbyist, Washoe Medical Center and Valley Medical Center Janice C. Pine, Director, Governmental Relations, Saint Mary's Medical Center Michael de la Torre, Consultant, Second Language Acquisition Programs, State Department of Education Carolyne W. Edwards, Legislative Lobbyist, Clark County School District Chairman Rawson opened the hearing on Assembly Bill (A.B.) 7. ASSEMBLY BILL 7: Transfers commission on postsecondary education from department of business and industry to department of education. David Perlman, Administrator, Commission on Postsecondary Education, Department of Business and Industry, testified in support of A.B. 7. He explained that the commission is a four- person agency supporting a seven-member, Governor-appointed commission which is charged with providing assurances to the public that the education offered by private postsecondary schools is valid and the students have access to certain remedies through the commission. Mr. Perlman said the proposed legislation hopefully meets the initial goals of reorganization, while placing the commission in a more logical position within the organizational chart of state government. Mr. Perlman then testified from prepared text (Exhibit C with attachments A, B, C. and D thereto) explaining the purpose of the proposed legislation. Mr. Perlman concluded his presentation by saying there are numerous educational issues shared by both the State Board of Education and the commission. Adoption of A.B. 7 would logically rejoin these two entities, allowing for better coordination of processes, flow of information and utilization of limited resources. A.B. 7 does not incur any General Fund costs, it is noncontroversial, nonpolitical and only offers to make government work more efficiently. Chairman Rawson asked if business will have adequate access to the commission if it is within the Department of Education. Mr. Perlman said yes, as one of the things required for licensure is an adequate business plan. Chairman Rawson asked if the commission will function differently under the Department of Education. Mr. Perlman said he does not really think so. The chairman concluded by saying it seems like a logical move. Keith Rheault, Deputy Superintendent, State Department of Education, testified from prepared text (Exhibit D) in support of A.B. 7. Mr. Rheault concluded his testimony by saying the department supports this bill wholeheartedly and will do whatever it can to assist the committee. Senator Augustine asked if postsecondary education was taken out during the Governor's reorganization, and is that how it got shifted to the Department of Business and Industry. Mr. Rheault said the commission had been independent from 1975 to the 1993 reorganization. Chairman Rawson said he recalled that in the reorganization, there were a few people for whom they did not have a place, so the commission was placed under the Department of Business and Industry. The chairman pointed out many schools that are licensed have a fly-by-night reputation. He said students borrow money, and there is a federal guarantee on those student loans. Often the schools quit, the students quit and the state is left holding the bag on the money. He asked Mr. Rheault if that issue has been worked out and if now there is better control. Mr. Rheault replied affirmatively, and continued by saying the federal government has said federal loans would have to be forgiven if a school closes and students are not allowed to continue with their education. The chairman asked if someone wants to start a new school, will there be access to do that in the future. Mr. Rheault replied in the affirmative. SENATOR AUGUSTINE MOVED TO DO PASS A.B. 7. SENATOR MATHEWS SECONDED THE MOTION. THE MOTION CARRIED UNANIMOUSLY. * * * * * Senator Augustine asked if this bill would now have to go to finance. The chairman said what has been done at this hearing will not change the budget, so he does not think so. The hearing was opened on Senate Bill (S.B.) 251. SENATE BILL 251: Provides for licensure and regulation of ambulances which are used solely to transfer patients between medical facilities. SENATOR LOWDEN MOVED TO INDEFINITELY POSTPONE S.B. 251. SENATOR COFFIN SECONDED THE MOTION. THE MOTION CARRIED UNANIMOUSLY. * * * * * The hearing on Senate Bill (S.B.) 257 was then opened. SENATE BILL 257: Requires certain medical facilities to provide information and training on appropriate procedures in event of fire or other emergency. Senator Neal explained that this request came to him from an individual in Clark County. He was asked to submit this bill to allow for information to be provided to instruct employees in the proper procedures to follow in case of fire in an oxygen- rich environment in a medical facility. Senator Neal said he contacted the fire department in the Clark County area and asked about this situation. They have indicated through their lobbyist that they do not have any position on this, and they have taken a neutral stand in their support of this particular measure. Senator Neal continued by saying that he does not have an incident to cite, other than the individuals who contacted him indicated there is a need for this measure. This is a concern of his as it relates to fire prevention and making sure that people do not lose their lives because of an unexpected fire in an oxygen-rich environment, a very volatile situation. The senator stated standard procedures of evacuation should be in place as a safety measure. Senator Lowden asked if there are not existing regulations, perhaps federal regulations, already in place to cover such procedures. Senator Neal said he was approached about this because of his interest in the bill that required the retrofitting of the hotels. He is unaware of any regulation governing this type of situation. Senator Augustine asked about facilities that actually sell and store oxygen. Senator Neal replied he does not know whether or not they are required to have an evacuation plan, but they are required to comply with fire department regulations insofar as storage is concerned. Senator Augustine said this must be covered already. Senator Neal replied he does not know if there are any rules or regulations to take care of it. Senator Augustine wanted to know if the request is from a hospital, and Senator Neal replied affirmatively. Fred Hillerby, Lobbyist, Washoe Health System and Valley Medical Center, said that he could only speak for hospitals since he represents Washoe Health System and Valley Hospital Medical Center. Mr. Hillerby advised that the National Fire Protection Association codifies rules about fire in their Code 99, Chapter 8, which puts these types of conditions and regulations on hospitals and these are enforced by the Occupational Safety & Health Administration (OSHA). Further, most of the rooms in hospitals, especially the operating rooms, have oxygen-rich environments. Mr. Hillerby continued by saying all employees in the hospitals from top to the bottom have in-service training. At Washoe Health System, there is a safety coordinator in every department. Hospital management is very cognizant of this issue and of the dangers involved. New technologies involving lasers in the operating rooms pose a high danger because lasers can ignite oxygen if not properly used. He said there are definite standards and ongoing training in the hospitals. Senator Mathews agreed with Mr. Hillerby, and said her personal experience at St. Mary's Hospital and Washoe Health System indicates that in-house training is ongoing insofar as fire safety is concerned. OSHA requires certain standards be met in a hospital setting and enforces these standards. Chairman Rawson asked the committee to look at the bill closely and see if there is anything that is too onerous. It is asking a medical facility which provides medical examinations or surgical service, which could be any free-standing clinic or any outpatient facility, to provide information to and instruct employees on appropriate procedures in the event of a fire or other emergencies. Chairman Rawson continued, saying that a standard will be established by this bill whereby any facility that has not provided information and training to their employees on appropriate procedures to be followed in the event of fire or other emergency will be in violation of the law. Senator Coffin referred to paragraph 1(b) of S.B. 257, and asked if there is any conflict with other associations which are recognized and approved? Janice C. Pine, Director, Governmental Relations, Saint Mary's Regional Medical Center, pointed out that it may not be to the best advantage to put this into statute when these regulations are already in place under OSHA. She said the joint commission for hospitals, as well as others, require strict adherence to these guidelines, and possibly misunderstandings may arise because of conflicting guidelines set up under statute and those already in place under OSHA. Senator Lowden asked that before any action is taken on this bill, the committee look into the exact OSHA guidelines and various regulations already in place to make sure the proposed statute is not a duplication thereof or in conflict with existing regulations. The chairman directed staff to get some information on this matter by contacting the organizations mentioned in testimony and stated this bill will be discussed again when this information is available. Senator Coffin asked if the nurses' organization is cognizant of anything going on in this respect. The chairman responded that staff will investigate and advise. Senator Mathews responded that nurses historically avoid such issues, and there are already procedures in place for addressing them. Kerry Carroll Davis, Senior Research Analyst, explained to the committee the new format (Exhibit E) developed to simplify and expedite the handling of work session bills. She said this format divides the bills by using a pink sheet for bills without amendment and other colors for bills with amendment. The chairman said this procedure would simplify the tracking of bills. The chairman then opened the hearing on Assembly Bill (A.B.) 5, which was requested by the Storey County School District. ASSEMBLY BILL 5: Revises provisions governing term of employment of superintendent of schools of school district. The chairman asked if there is any concern about this bill. Mr. Rheault confirmed that he is in support of this bill. SENATOR COFFIN MOVED TO DO PASS A.B. 5. SENATOR WASHINGTON SECONDED THE MOTION. THE MOTION CARRIED UNANIMOUSLY. * * * * * The hearing was then opened on Senate Bill (S.B.) 36, which was requested by the interim study committee on criminal justice. SENATE BILL 36: Requires development of program to track prescriptions for controlled substances filled by pharmacies. The chairman advised there are several amendments that have been proposed, and the committee will look at those now. Ms. Davis stated that in the attachments to Exhibit E, the second green page relates to S.B. 36 and contains language submitted by Keith Macdonald, Executive Secretary, State Board of Pharmacy, to ensure the multi-disciplinary coordination of the investigations of suspected abusers (Exhibit F). Ms. Davis continued, explaining that the amendments to S.B. 36 proposed by Senator Augustine (Exhibit G) can be found on the third green page of Exhibit E. Senator Augustine explained that she met with Mr. Hillerby, who represents the Board of Pharmacy, and a consensus was reached on the amendments. In item 3 of Mr. Macdonald's proposed amendments, he has suggested language to cover intractable pain, as follows : "The program shall not infringe on the legitimate use of controlled substances for the management of severe or intractable pain." Senator Augustine further stated that a communication was received from National Rx Services Inc. of Nevada (Exhibit H) signed by their pharmacists in support of proposed amendments to S.B. 36. SENATOR MATHEWS MOVED TO AMEND AND DO PASS S.B. 36. SENATOR LOWDEN SECONDED THE MOTION. THE MOTION CARRIED UNANIMOUSLY. * * * * * The hearing was opened on Senate Bill (S.B.) 88 requested by the Clark County School District. SENATE BILL 88: Requires school districts to establish programs providing bilingual education. The chairman advised that there are some proposed amendments. Ms. Davis advised that these proposed amendments (Exhibit I) on the first blue page of Exhibit E were submitted by Mary Peterson, Superintendent of Public Instruction, State Department of Education, and would allow the school districts to use either English as a Second Language (ESL) or a bilingual approach and, in addition, the amendment also proposes to replace the term "limited English proficient" with the more updated term of "English language learner." The second blue page shows how Nevada Revised Statutes (NRS), Chapter 388, would read after amendment to S.B. 88. Senator Coffin explained that the Hispanic educators who requested this bill were overreaching with the first concept. This bill would have a fiscal impact if it did become a mandate and a requirement on the districts. He expressed an opinion that the department's amendment makes a lot of sense because it removes the fiscal impact, updates the language and gives the Hispanic educators what they asked for in the first place, which is a definition of ESL, which, under the amendment, would be "English language learner." There has been a good deal of public interest in this bill. Senator Coffin expressed his support of the bill as amended. Senator Augustine said that Mr. Boulet, Executive Director of the English First organization of Washington, D.C., has expressed opposition (Exhibit J) to S.B. 88 as amended. This organization has a tracking system, and they track bills in every state that refer to language amendments in the educational system. The senator continued by saying that not all school districts in the state of Nevada need this type of program. Perhaps this is needed in Clark and Washoe Counties, but not in those with smaller populations, such as White Pine and Storey, where it would be a burden. Chairman Rawson indicated that this does not appear to be a dangerous bill. Senator Augustine explained that on line 3 where it reads, "The board of trustees of each school district shall..." could be changed to "may," so the language would be more permissive. Using "may," it would not require every district to do this. Chairman Rawson asked those present from education to help the committee on this bill. Michael de la Torre, Consultant, Second Language Acquisition Programs, State Department of Education, testified that he is involved in second language programs in civil rights issues. He thinks the amendment is needed. He spoke to the 13-page memorandum which was received from English First (Exhibit J), the first point of which is that it mandates bilingual education in the state of Nevada. Mr. de la Torre said that is not true. Senator Augustine remarked that Mr. de la Torre has not been supplied with a copy of the amendment to S.B. 88. The chairman asked Mr. de la Torre if his impression is that Mr. Boulet was taking a very hard stance on the original bill. Mr. de la Torre agreed, but said he had not read the response to the amendment. However, Mr. de la Torre continued, he would like to comment about changing "shall" to "may." He said that at the federal level, it is not a permissive activity; it is an obligatory activity. Mr. de la Torre then referred to a booklet (Exhibit K) published by the Office for Civil Rights entitled The Provision of an Equal Education Opportunity to Limited English Proficient Students. This gives a summary of the Office for Civil Rights provisions and policy guidelines. It sets forth such items as the 1974 Supreme Court Case entitled Lau v. Nichols, several district court cases that have not only held the school districts, but the state agency, jointly liable for providing guidance for second language programs. Mr. de la Torre went on to say probably 14 out of the 17 school districts in Nevada have second language programs. Clark County has a very sophisticated program with over 13,000 youngsters in it, and they have some guidelines. Washoe County has 1,800 youngsters in its program, and they have some very fine guidelines. Mr. de la Torre continued by saying, frankly, the state is the weak link in this whole process. At the federal level, they said this had to be done; the districts are doing it and the department has worked with the superintendents' association, as well as the second language program coordinators around the state, and the department is currently promulgating some guidelines. The department is just asking that the continuum be kept consistent. Senator Lowden commented that the purpose of the bill is not necessarily to coordinate this as a statewide effort if each school district still develops its own language development program and asked Mr. de la Torre to clarify that point. Mr. de la Torre advised it is because the current situation is not without its flaws, and it would be an effort to provide some consistency. Some districts believe that the department has an ESL math class and an ESL computer class, and ESL this and that, but the students are in the same classroom all day long with two teachers. That is ESL segregation. He continued by saying there are other instances where students are bused to one side of town because that is where the ESL program is, and the department certainly wouldn't do this with a special education program; another, more logical, approach would be made. The department would want some consistency. Senator Rawson asked the difference between bilingual and language development. Mr. de la Torre explained that language development is a process of learning English. Bilingual and ESL are merely two different approaches. A bilingual program does not work in every situation because if there are 10 students with five different languages, only one language at a time can be used in the classroom, so, by necessity, an ESL-sheltered instruction program would have to be used. The chairman asked if in the bilingual approach, for instance Spanish, does the teacher have to speak Spanish, and in an ESL program, does a teacher that speaks English teach English? Mr. de la Torre answered affirmatively, stating that every bilingual program necessarily involves an ESL component. The chairman asked if the language development class is a looser standard in the sense that it can be more easily adapted by not having to have a person speak that language who teaches the course. Mr. de la Torre responded affirmatively, adding "if they choose an ESL approach." The chairman asked if this bill would not allow the department more flexibility, and Mr. de la Torre said yes, that it would. The chairman asked if there are German-speaking students, are those students or their parents more upset when the department goes to an English language learner program rather than a bilingual program? Carolyne W. Edwards, Legislative Lobbyist, Clark County School District (CCSD), said she would try to answer those questions as a developer of this bill and as an elementary school principal. She said if the school has a very large population of non- English-speaking children from every part of the world, the number one goal of the school is to have the students speak the mainstream language, period, and for them to get comfortable and confident with the English language as quickly as possible. Ms. Edwards continued by saying the original language in the bill raised some real problems. The amended language that is before the committee is everything that has been discussed. It gives the department the right to do what it wants in reaching its main goal, which is "English first." Nevada is an "English first" state. The goal in this program is to have these children come in and be able to quickly assimilate into the mainstream. Senator Augustine remarked the bill is going above and beyond what is needed. On page 6 of the State Department of Education booklet, The Provision of an Equal Education Opportunity to Limited English Proficient (LEP) Students, (Exhibit K), it says that "... school districts have the flexibility to decide on the education approach that best meets the needs of their language minority students...." That has already been provided for, and the senator questioned the need to put into state statute something already guaranteed at the federal level under these programs. Ms. Edwards said that the exact purpose of the bill is to bring the CCSD into compliance. That is why the CCSD is working with the State Department of Education. She stressed it very often happens that there is a federal mandate and federal statute, and CCSD has lagged behind in its language. Clark County is making an effort to be consistent with federally accepted mandates, and Clark County often brings statutes to the Legislature which are referred to as housekeeping bills. Ms. Edwards further said these small housekeeping bills sometimes appear to be more than that, but when Clark County brought this bill to the committee, this amendment is a housekeeping act for the State of Nevada to bring CCSD into compliance with the section Senator Augustine just read so that our statutes reflect that wording. Again, she stated, it is a mark of respect to the many people from the many countries who are part of the citizenry of Nevada and who are asking for this recognition within statute. That is what Clark County is looking to accomplish here. Senator Lowden asked if, in essence, with this amendment the Legislature is codifying the existing federal mandate, and Ms. Edwards responded affirmatively. Senator Lowden further asked if Ms. Edwards has a problem with "shall" and "may." Mr. de la Torre answered that it has to be "shall" because it is obligatory; it is not permissive. Citing the section Senator Augustine read on page 6 of the publication by the State Department of Education where it says "the districts are allowed the flexibility," what that makes reference to is a 1974 Supreme Court case out of San Francisco, California, called Lau v. Nichol. That referred to the kind of language program the district could provide if they chose to use a bilingual approach. Mr. de la Torre continued by saying in Clark County there are 1,500 youngsters in a bilingual program. That is what it made reference to, that the court was not going to mandate one process over the other; ESL versus bilingual. Senator Augustine remarked that the State Department of Education's booklet was printed in December of 1992, which means the federal issues must have been decided some 3-plus years ago. Further, the Legislature gets so bogged down that the Legislature continues to put things into state statute that don't need to be there because the federal government has already passed the laws. She asked if the school districts are not already doing these things in the schools? Ms. Edwards replied that the testimony is very simple. CCSD joined with the State Department of Education. This is a matter of record keeping, and it is done a lot. She stated CCSD is already doing the recognition, and this is merely to keep the statutes clean and defined. It is a process not so much of adding, as it is cleanup language. The district wants to make sure the statute includes a definition that is acceptable and respects the language learners in the state who now comprise quite a percentage of the population. Again, it is definitely housekeeping. The chairman asked if Clark County has people that are gleaning the statutes all the time, looking for reasons to sue the district or to find some special edge. Senator Coffin remarked that Senator Augustine's concern in the first hearing as to whether or not a program established by the department might try to conform a smaller county's needs to those of Clark County would be something that would hinder her approval of this bill, as it would hinder his own approval of the bill. Senator Coffin continued by saying as he reads this amended bill, it does set into statute the definition which brings Clark County into conformance, but also allows the district to establish programs that are flexible so that they will vary from district to district, based on the wishes of those local people. Mr. de la Torre said that is correct. He said he had spoken this morning with the Office for Civil Rights. The department has been working with them, as well as the coordinators in the different school districts, and he has a draft of the guidelines that the department hopes to promulgate. He stressed the strategy is to promote minimum standards; basically, identification criteria, assessment criteria, a definition of what the programs are. Mr. de la Torre continued by saying if the standards say the school has a bilingual program and the justification for that is Mrs. Martinez speaks Spanish, that is not a bilingual program. The department will have minimum criteria for the program; some entering, exit, reclassification criteria. It will be the minimum standards. SENATOR COFFIN MOVED TO AMEND SENATE BILL 88 WITH THE AMENDMENT PROPOSED BY THE STATE DEPARTMENT OF EDUCATION AND DO PASS THIS MEASURE. SENATOR NEAL SECONDED THE MOTION. Senator Augustine remarked that if the committee is going to accept the amendment, it needs to go further and clean up the summary and possibly the title on the bill because the summary still states "bilingual education." The chairman responded it is understood that these changes will be a part of the amendment. THE MOTION CARRIED. (SENATOR AUGUSTINE AND SENATOR WASHINGTON VOTED NO.) * * * * * Chairman Rawson reported he had received correspondence from two groups asking that the committee draft an alternative dispute resolution bill that would allow for arbitration in health care disputes and various tort actions with physicians, hospitals and patients. SENATOR NEAL MOVED FOR SUCH A BILL DRAFT. SENATOR COFFIN SECONDED THE MOTION. THE MOTION CARRIED UNANIMOUSLY. * * * * * There being no further business, the meeting adjourned at 5:50 p.m. RESPECTFULLY SUBMITTED, _______________________________ _ Mary Gavin, Committee Secretary APPROVED BY: _____________________________________ Senator Raymond D. Rawson, Chairman DATE: _______________________________ Senate Committee on Human Resources and Facilities March 22, 1995 Page