MINUTES OF THE meeting
of the
ASSEMBLY Committee on Commerce and Labor
Seventy-Second Session
March 21, 2003
The Committee on Commerce and Laborwas called to order at 12:09 p.m., on Friday, March 21, 2003. Chairman David Goldwater presided in Room 4100 of the Legislative Building, Carson City, Nevada, and via simultaneous videoconference, in Room 4401 of the Grant Sawyer State Office Building, Las Vegas, Nevada. Exhibit A is the Agenda. Exhibit B is the Guest List. All exhibits are available and on file at the Research Library of the Legislative Counsel Bureau.
Note: These minutes are compiled in the modified verbatim style. Bracketed material indicates language used to clarify and further describe testimony. Actions of the Committee are presented in the traditional legislative style.
COMMITTEE MEMBERS PRESENT:
Mr. David Goldwater, Chairman
Ms. Barbara Buckley, Vice Chairman
Mr. Bob Beers
Mr. David Brown
Mrs. Dawn Gibbons
Ms. Chris Giunchigliani
Mr. Josh Griffin
Mr. Lynn Hettrick
Mr. Ron Knecht
Ms. Sheila Leslie
Mr. John Oceguera
Mr. David Parks
Mr. Richard Perkins
COMMITTEE MEMBERS ABSENT:
Mr. Morse Arberry Jr. (excused)
GUEST LEGISLATORS PRESENT:
Assemblywoman Vonne Chowning
STAFF MEMBERS PRESENT:
Vance Hughey, Committee Policy Analyst
Wil Keane, Committee Counsel
Diane Thornton, Senior Research Analyst
Corey Fox, Committee Secretary
OTHERS PRESENT:
John Vergeils, Representing Nevada State Board of Cosmetology
Joe Lamarca, Owner of Euphoria Salons and Day Spas
David Neil Austin, Nevada State Board of Cosmetology
Curtis Potts, D.C., President of the Nevada Chiropractic Association
Jim Werbeckes, Farmers Insurance
Lisa Foster, AAA Nevada
Joe Guild, State Farm Insurance Companies
Tom Scancke, Nevada Oriental Medical Society
Steve Holloway, Associated General Contractors
Jack Jeffrey, Southern Nevada Building and Construction Trades Council, B&E Auto Auction
Chairman Goldwater:
We will bring the Commerce Committee to order. Mark all members present; Mr. Arberry is excused. Note a quorum is present as well. We will do some Committee business and before we get to the work session, we have two bill draft introductions. One is the opticians bill.
BDR 54-541 - Revises statutes to establish jurisdiction over businesses conducting ophthalmic dispensing. (Later introduced as A.B. 452.)
ASSEMBLYMAN BEERS MOVED FOR COMMITTEE INTRODUCTION OF BDR 54-541.
ASSEMBLYWOMAN GIUNCHIGLIANI SECONDED THE MOTION.
THE MOTION CARRIED. (Mr. Arberry was not present for the vote.)
BDR 53-1197 - Provides that certain forms of cancer contracted by firemen are occupational diseases under certain circumstances. (Later introduced as A.B. 451.)
ASSEMBLYMAN KNECHT MOVED FOR COMMITTEE INTRODUCTION OF BDR 53-1197.
ASSEMBLYMAN GRIFFIN SECONDED THE MOTION.
THE MOTION CARRIED. (Mr. Arberry was not present for the vote.)
We have two bills on the agenda and a work session. We will get started on the bills. Let’s get started on the cosmetology bill. Ms. Giunchigliani?
Assembly Bill 258: Revises provisions relating to cosmetology. (BDR 54-912)
Assemblywoman Giunchigliani, District No. 9, Clark County:
Thank you, Chairman Goldwater and members of the Committee. The bill before you is Assembly Bill 258. I sponsored it on behalf of an owner of one the health spas down in Las Vegas, Mr. Lamarca. I know he is on his way to the state office building but do not know if he has arrived yet. Let me tell you what A.B. 258 is trying to do. Basically, it adds a new type of job, called a shampoo assistant. Currently, in Nevada law, you have to be a cosmetologist to shampoo hair, which does not seem to make sense. That is a lot more education experience, a lot more costly, and you make more money as a cosmetologist. This will actually open up another job market because there are young men and women that just want to deal with shampooing and do not want to go into the full area of cosmetology. The intent of this [A.B. 258] is to at least create that. It implements a shampoo assistant and then puts in the training requirements, the fees and so forth.
In addition to that, if you look at page 2, Section 5, it does allow, which currently can happen at cosmetologist establishments, to hire a barber. I tried to put protections in there for the barbers to make sure that they are licensed by the Barbers’ Board. The Barbers’ Board still has jurisdiction over them. The establishment may not put up a barber pole or advertise accordingly. Many of these places are designed, and then they hire someone after the fact. The barbers have a regulation, which I just became aware of, that requires that they work in a cubicle. It must be 10’ x10’ with an 8’ high wall to the ceiling and it must be located by a front entrance. That is fine if it is a barbershop, but if you are being hired to work within another establishment, it does not seem to make sense to go in and tell a businessperson they have to remodel their entire premises simply to hire one individual to do barbering.
The Barbers’ Board has not contacted me yet, but I did get e-mail from somebody today. I am hoping that somebody [will] be there to explain why they would object, because they [the Barbers’ Board] still have jurisdiction over them. I thought we put in the protections so that we are not invading their territory, so to speak. We will have to hear testimony, Mr. Chairman, because I have not heard anything at this point. I did meet with my favorite councilman down south, who is a barber, and he is concerned about that part of it. I could not get to the issue of why you need a 10’ x 10’ cubicle, because in the barbershops, you do not have to do that. They have a square footage requirement, but their chairs are actually closer than what you are making the requirement for one in a cosmetology establishment, so that may be an issue.
I did have an amendment (Exhibit C) to clarify three sections, adding to the list of what a shampoo assistant does. They are allowed to comb your hair out after [they] wash it. In addition to that, I have a typo and I apologize. On page 7, Section 19, add “professionally licensed” in front of the term “person.” Then on page 7, Section 21, capping the amount of time, and I think this came from the president of the Cosmetology Board, to 1800 hours but not to exceed 36 months. I agreed to that amendment as well. Those are the three amendments before you. I would be happy to answer any questions, or if you would, allow Mr. Lamarca to come to the table in southern Nevada to see if he has anything to add to the bill.
John Vergeils, Representing Nevada State Board of Cosmetology:
It looks like the folks down south are going to testify. We have had sort of a “wait and see” attitude toward this and have had some non-support, but we are not against some of this language. It looks like, from doing a vote count, it is probably going to move forward. Maybe that is why they are not stepping up. That is all we have to say right now. [Chairman Goldwater asked if Mr. Lamarca wanted to testify.]
Joe Lamarca, Owner, Euphoria Salons and Day Spas:
[Introduced himself] Euphoria Salons is the largest salon and day spa company in Nevada. We employ 600 people in southern Nevada and about 50 in Arizona. In addition, I own Euphoria Institute of Beauty Arts and Sciences, which has about 230 students enrolled. It is a school for hair stylists, manicurists, and aestheticians. I am speaking in favor of A.B. 258 with the proposed amendments that Ms. Giunchigliani just made. Let me review some of the key components of the bill and give you a rationale as to why we are proposing them. A lot of this stuff is [industry jargon], and if I use words that you do not understand I will try to explain them.
First, this bill creates a new licensed category in cosmetology, shampoo assistants. A shampoo assistant would wash, condition, and comb a client’s hair before the stylist actually works on that client. Now, to do the same thing, a person would have to go to school for ten months, pay between $8,000‑$15,000 in education, and then end up washing hair. We are proposing that this just be 300 hours of training, which would take about seven weeks to do. Let me give you an example of this. If this bill were to pass, it would immediately create 24 full-time jobs at Euphoria Salons alone. Each one of the jobs would pay about $15,600 to start, plus tips. This would be a whole new employment category for us in Nevada. In addition to that, it would allow hair stylists to get done with their clients quicker or to do more clients in a day.
The second part of the bill I would like to address is leveling the playing field between the barbers and the hair stylists. At the present time, in order for a barber to work in a hair salon, he or she must be in an enclosed room that measures at least 10’ x 10’. That room must be near an entrance to the establishment. Unfortunately, my experience with the Barbers’ Board tells me that the definition of near an entrance is a subjective view on the part of the Barbers’ Board. In most barbershops, the barber operates in less than 100 square feet around his chair and does not have to be in a private room. Like Ms. Giunchigliani said, no one has ever given me a rational explanation as to why this discrepancy exists, other than it has always been this way. In reality, it is designed by the Barbers’ Board to have a chilling effect on barbers practicing within a hair salon.
Another part of the bill would bring consistency to the wording of the law in the area of cosmetology instructors at a school. Presently, in order to be a provisional instructor, which means student teacher, a person must have been practicing cosmetology for three years. Elsewhere in the law, it says that to be a student teacher, a person only needs one year of experience. This bill proposes to make it consistent at one year throughout both sections of the law.
Another part of the proposed legislation states that salons and spas can allow people working at a location who are licensed by other state boards and agencies, other than the Cosmetology Board. The present law prohibits this. That means that in reality, all of the spas in Nevada are in violation to the law because we have either doctors, who are licensed by the state, or massage therapists, who are licensed by the city, practicing within our spas. This change will bring reality into the law and make it reflective of what is actually going on in the marketplace.
Another part of the bill would allow students at a cosmetology school to earn their degrees in less than ten months. Presently, students need to be enrolled for at least ten months in order to get their degree.
The final change this bill would do is eliminate the need for speakers and trainers at a salon or a spa to go to the state board and buy a temporary license in order to demonstrate techniques. That about covers it. Thank you for the opportunity.
Chairman Goldwater:
Thank you, Mr. Lamarca. Are there any questions for Mr. Lamarca? I see none, thank you. Is there anybody here who would like to testify? In the south? Is that Mr. Austin and Mr. Rich? [They confirmed that they were.]
David Neil Austin, Nevada State Board of Cosmetology:
Before we start, Mr. Chairman, I would like to disclose for the record that I am the Chair of the Cosmetology Board, and I am an employee of Euphoria Salons, but I am not a salaried employee. I will exercise my independence of judgment in matters related to my Board position.
In going over A.B. 258, there are portions of A.B. 258 about which the Board has some concerns. First of all, in the shampoo assistant, we are a little concerned about overfragmenting the licenses. We are starting with shampoo assistants, and we are concerned that next session somebody will come up with a “polisher” or a “nail polish remover.” We understand that this portion will possibly get passed, and please, in the future, reconsider overfragmenting. We now have a cosmetic demonstrators portion, which was put through in the last legislative session and now we are looking at a shampoo assistant. The Board is very concerned with adding on little fragmented portions.
On Section 5, as far as with the Barbers’ Board, I think that was clarified. We were concerned with who would actually have jurisdiction over the barbers if they were in the cosmetological establishment. Is the Barbers’ Board going to come in and inspect what the barbers are doing, or does the Cosmetology Board… when our inspectors go in and inspect what they are doing, turn in and report any problems to the Barbers’ Board? So, we would like more specific clarification on jurisdiction.
Then on page 3, Section 9, actually going down to (b) on that, changing it from three years to one year. The board feels that one year for a PIL [Provisional Instructor License] license is not sufficient. We understand that three years is a long time. We came to an agreement on two years, which would be a sufficient amount of time because an instructor’s license is different than a PIL. A PIL is somebody who has had time in the field and who can actually teach classes. The student teacher does not actually teach without somebody supervising in the room with them, a PIL can be on their own. So, we feel that two years’ experience would be more sufficient.
On page 7, Section 19, number 2, Ms. Giunchigliani had mentioned that we put in there “professionally licensed.” Again, we are concerned with the governing bodies. Let’s say we have somebody who is doing nursing, who happens to be in there doing some kind of procedures. Is the Nursing Board going to come in and inspect? The Cosmetology Board? Would our inspectors go in? How would they handle these things? Who is going to have jurisdiction over these other people? Also, we would like to add the word “professionally licensed persons ‘related.’” Somehow in a related field, rather than having realtors hanging licenses in spas, we would like to see it clarified over who is going to have jurisdiction.
Chairman Goldwater:
We appreciate your concern, and hope that Ms. Giunchigliani noted them and could work them out.
David Neil Austin:
Are there any questions for us as far as how the inspection staff would handle them? [Chairman Goldwater noted there did not seem to be any questions.]
Chairman Goldwater:
Anyone else who wishes to testify on this bill? I will close the hearing. Ms. Giunchigliani, maybe for our next work session, you can clean it up a little bit. We will start the hearing on A.B. 280. We will open that hearing, but I will tell you that as soon as Ms. Buckley gets here, we will start the work session because I know there are some members that have to leave and we will need to vote. We will open the hearing on A.B. 280 with the proviso that when Ms. Buckley arrives we will start the work session.
Assembly Bill 280: Revises certain provisions governing policies of insurance for motor vehicles. (BDR 57-1090)
Assemblywoman Giunchigliani:
Thank you, Mr. Chairman. There should be amendments and rewrite of the Assembly Bill 280 for you to work off of (Exhibit D). I introduced A.B. 280 on behalf of some of the Chiropractic Association who had concern about med pay. I do want to make a statement that this is not an attempt to get into a “no fault” business and we wanted to make an assurance on that part of it. We have individuals that are injured and suffer bodily injury when they are operating or occupying a vehicle. Because we do not have a med pay fee or a column on our insurance within the state of Nevada, this would anticipate creating that. That is really the heart of A.B. 280, to make sure individuals who are injured at least have access to medical coverage when that occurs. If I might, Mr. Chairman, I would like to turn this over to those who are more expert on this piece of legislation.
Curtis Potts, D.C., President, Nevada Chiropractic Association:
The position that we have behind this is that we are submitting a bill that requires all Nevada motorists to obtain and concurrently hold a med pay health care policy of $15,000 per automotive insurance policy. This bill will champion motor vehicle accident precedents by allowing the injured to seek proper care. Mandatory med pay is just completing the job that was intended for mandatory liability insurance. Motor vehicle accidents are a financial burden to the citizens as a whole. As health care costs skyrocket, a portion of these costs are redistributed, following motor vehicle accidents, from citizens who are uninsured. Individuals who do not and are not able to pay for charges of emergency medical personnel, ambulance fees, and hospital emergency care are immediately exposed to burden of payment or sent to collections. These patients are forced into premature settlement of their claims in order to pay for the ambulance and hospital bills, resulting in incomplete care. If the claim is not settled in a timely manner, these people are forced into bankruptcy and the burden of payment then falls on the taxpayers of this state.
In addition to financial hardships, the accident victim also suffers physical hardships. As a health care provider, we treat accident victims who need phase 2 injury care after being stabilized by emergency room personnel. If they have no health insurance, which is approximately 22-25% of the people in Nevada, then their capability to acquire rehabilitated care is jeopardized and/or compromised. These untreated injuries persist for subsequent years in the form of loss productivity and, ultimately, disability, which has a huge impact on the economy.
The fees for med pay are very reasonable at approximately $13 per month for a $15,000 policy. Annual cost is minor compared with the public hardship caused by motor vehicle accidents. In our current model of accident care, uninsured patients are often faced with utilizing hospital emergency rooms, particularly the taxpayer-supported county hospitals. A.B. 280 will shift this financial burden toward drivers and release the non-driving citizens, as a whole. Consequently, citizens who do not drive will no longer be absorbing the cost for health care of accident victims. Therefore, it should be mandatory that Nevada drivers carry protection so that they do not burden our taxpayers, county hospitals, and employers, or raise health insurance premiums for all citizens.
The bill helps the public by establishing a preemptive health care policy that will decrease economic hardship to the public, health care providers, and health care institutions. In short, this is a cost-shifting bill that shifts costs from taxpayers, county hospitals, employers, and health insurance companies, to drivers at a very little cost, while increasing patient choice and the quality of their much‑needed health care. Thank you. [Chairman Goldwater asked for any questions from the Committee.]
Assemblyman Oceguera:
You emphasized in your speech that it was a shifting of the burden. It seems to me that it may be a shifting of the burden the other way as well. If we raise the cost of insurance, then you have more people who are not insuring their vehicles and shifting it in the opposite direction. Wouldn’t this cost more for the insurer? [Mr. Potts clarified that Mr. Oceguera thought the insured would not obtain the insurance then.] Correct. It would cost more to obtain insurance now, so more people would be uninsured.
Curtis Potts:
What we are saying with the uninsured portion is for people who do not currently have med pay insurance, which is not mandatory, and they do not have health insurance. They do not qualify for Medicaid or those services by county or health institutions that are state-funded; therefore, they would not have this out-of-pocket expense. It would already be included in their automobile insurance, as opposed to the people that do not have the financial capabilities to pay for their health care after an accident if they have no health insurance.
Assemblywoman Giunchigliani:
Let me try also, Mr. Oceguera. Yes, it will have an impact on rate premiums. We do not know how much. I think the study that the doctors have done has been approximately $13 a month. Would that cause more people to drop or violate law because they are required to carry auto insurance to maybe go without insurance? Some very well could. I think the idea of this legislation is to say we have a lot of uninsured, not just in the automotive area. Health care, worker’s comp, and so forth, have no ability to get their coverage. This might be an avenue to consider, policy-wise. It is a policy decision to allow those individuals, at least those who are following the law with automobile coverage, to have that additional protection for if they are injured in a car accident. As you know, so many people are being dumped into health care that used to be worker’s comp cases and they are actually using their medical coverage in order to be able to do that, if they have medical coverage. This just may fill one more piece of the puzzle, so that people do have access to other kinds of coverage. I think that is the intent of the legislation. [Assemblyman Oceguera thanked Assemblywoman Giunchigliani.]
Assemblyman Hettrick:
Thank you, Mr. Chairman. I guess my concern is Section 1, subsection 1(a). It says “an injury arising out of the maintenance or use of a vehicle.” I think what you are doing is adding a huge section of risk that is now assumed by health insurance, if they have it. If they do not have it, this is becoming health insurance policy, rather than automobile insurance policy. I have a concern that it would be a very significant cost, which would go to Mr. Oceguera’s questions as to whether or not people would buy insurance if the cost goes up significantly. So I want some assurance that we are not going to compound the cost by adding “maintenance, or.”
Assemblywoman Giunchigliani:
I will find out from drafting. I do not know that that was something necessarily anything we crafted but I will double-check that for you. I do have the cost per month. They did a survey of 13 different auto insurance companies. The cost per month ranges from as low as $1.70, upwards to about $13. We can get you a copy of that, as well.
Chairman Goldwater:
Ms. Giunchigliani, you should be aware that Legal has contacted us and told us that they are not quite sure what this language does. It is language that was provided by you and they are not entirely sure whether or not this accomplishes what you intend to. [Assemblywoman Giunchigliani indicated that she would go back to the original draft and find out the intent of that language.]
Other questions for these witnesses? Do you want to add anything, Dr. Hamtak? [He believed that all questions had been answered.] Thank you. Mr. Hettrick, please?
Assemblyman Hettrick:
Thank you, Mr. Chairman. I just want to clarify something to make sure that I am correct. The quotes that you gave us on the sheet that was just passed out (Exhibit E), the numbers that are quoted there, I presume, are just a med pay quote, not based off this language, but a med pay quote that was requested? [Dr. Curtis Potts indicated that was correct.] That is all that I wanted to confirm, that it did not include that maintenance clause. Thank you very much.
Chairman Goldwater:
Is there anybody else who wants to testify for this bill? Those against it? Lisa, Joe, Jim?
Jim Werbeckes, Farmers Insurance:
We are not here opposing the bill. We are here more on a neutral position. Assemblywoman Giunchigliani is correct. This is a policy issue that needs to be set by the Legislature. It is a major change. Right now, 15/30/10 is a third‑party claim that protects the party. This bill will essentially provide a first‑party benefit, a no fault-benefit, $15,000 for medical benefits and $20,000 for additional living expenses, lost wages, whatever that may be. A first-party benefit is paid without any regard to fault. You can be at fault in the accident and that benefit still pays, so this benefit would be used much more often in an accident than your third party benefit would be used on a 15/30/10. Obviously, this is an incredible amount of risk you are adding to your basic policy. It is an additional $35,000 worth of risk an insurance carrier is going to have to absorb. That comes with additional costs. Our actuary did not have an opportunity to finish putting the number together on this bill specifically. I have a handout (Exhibit F) using two different scenarios from a 52-year-old male and 24-year-old female in Las Vegas. It would be right around the Jones Flamingo area that they would reside. You can see the basic policy for a 15/30/10 is $380. When you add $2,000 worth of med pay, that jumps by $102. At $5,000, it is $205, and then for $10,000, it jumps to $300. That is a pretty substantial increase, and again, this is not scientific, because this is not based on insuring every customer out there, but I wanted to put some type of numbers to what we are talking about.
Chairman Goldwater:
That is a good segue, because we have the world’s greatest actuary, who is back joining us. He was a valuable asset to the state; Mr. Knaus is over there. He is an old friend of the Committee. Would you like to testify on what Mr. Werbeckes has said? Please come up and testify.
Charles Knaus, Contract Actuary, Insurance Commissioners Office:
I would begin by commenting that the current insuring agreement for medical payments, as I remember it, does include coverage for use maintenance or operation of the vehicle. I believe that language is already part of the insuring agreement; I heard the Committee talking about that. Do you remember that to be true, Jim? [Mr. Werbeckes did.] I think the word “maintenance” should not be a particular problem to the Committee. The Insurance Division has not done any pricing of the bill either. It is clear that you would be requiring additional coverage for an additional premium.
I think the discussion that has gone forward on that has been reasonably conclusive in terms of presenting the Committee with information. My memory is, and I have not researched this, that the current medical payment circumstance in Nevada requires insurance companies to offer it and allows the insured the opportunity to refuse it in writing. So, you do have a current law on medical payments that is on the books. I believe the minimum coverage there is $1,000. I think that the coverage, in some ways, is very desirable. In other ways, it is true that you may price some people into the point where they will not want to buy insurance. That is about all that I would offer in testimony and then I would stand ready to answer any questions.
Jim Werbeckes:
Yes. One of our concerns is that we are starting to price people out of the marketplace. That creates a whole other can of worms with the uninsured motorist. Currently today, Farmers [Insurance Company] does offer med pay coverage and Mr. Knaus is correct. It is mandatory that we must offer med pay coverage. If we fail to have the insured sign a waiver that he does not want it, we automatically have to provide $1,000 worth of med pay coverage, today. Other than that, any questions for me?
Assemblyman Oceguera:
When was the last time the 15/30/10 was changed?
Jim Werbeckes:
Last session, several of us made an attempt to change that. If I recall correctly, 1967 was the last time the minimum limits were changed.
Assemblyman Brown:
I am just trying to understand some of the interaction here, and I wonder about subrogation and things like that. If there is a third party, or if there is a two‑party action and the first party would have to kick in, or kick in quickly, how does that work?
Jim Werbeckes:
In the market today, under med pay, there are no subrogation rights. That is case law today. We cannot subrogate med pay. If we make a payment of $5,000 on behalf of our insured and the claimant was at fault, we cannot go after the claimant for the $5,000. That is a benefit that they have paid and to receive payment on, with regards to the $20,000 worth of reimbursement coverage, that would be some concern. We can subrogate that today, lost wages and those items.
Assemblyman Brown:
If a third party caused the injury, and there was litigation, or liability was at issue, and so the first party med pays, do they have the right of subrogation, if subsequently liability was established on the other party?
Jim Werbeckes:
In today’s market, we cannot subrogate med pay, period, no matter who is at fault. Once you pay, you pay, under med law. [Assemblyman Brown indicated that he understood and he thanked the Chairman.]
Charles Knaus:
The law, as written, includes both commercial auto insurance and private passenger auto insurance. There has not been any discussion of that yet. In commercial auto insurance there is the possibility of interaction with worker’s compensation and other coverages, so you may want to just consider some sort of differentiation between commercial vehicles and private passenger vehicles. If your intent is to have people covered for medical when they are in commercial circumstances, they will have worker’s compensation. [Chairman Goldwater thanked Mr. Knaus and asked Lisa Foster to testify.]
Lisa Foster, AAA Nevada:
I have nothing more to add, either. I would like to state our agreement with Mr. Werbeckes and Farmers. We have an additional concern, probably on behalf of our auto club members, because it does seem to shift some of the burden of the issue to drivers. Thank you.
Joe Guild, State Farm Insurance Companies:
I would repeat Mr. Werbeckes’ opening remarks. We are not here to oppose the bill, but I would give the Committee some information from State Farm regarding the costs associated with this. Currently, the average premium for med pay coverage in Nevada, which we are required to offer as has been said, is about $90 per year per vehicle. If A.B. 280 passed, it would double that cost to about $180 per year per vehicle. So, in a two-vehicle family, it would be a $360 additional average cost on premiums for State Farm customers. That is all I have, Mr. Chairman.
Chairman Goldwater:
I appreciate that. I see no other questions. Was there anybody else here who wanted to testify for or against A.B. 280? I do not see anybody. I will close the hearing. Ms. Giunchigliani, let’s get it figured out. Also, to the witnesses, some good basis in number for the Committee to make a decision would be helpful to understand what this would really cost. You too, Mr. Knaus, if we could know a little bit better exactly what this would cost, I think the Committee would have a much easier time making a decision. We will then go to the work session document for today.
Assembly Bill 21: Makes changes related to practice of Oriental medicine. (BDR 54-226)
Vance Hughey, Legislative Council Bureau, Research Division:
The first bill on your work session document (Exhibit G) is Assembly Bill 21. Assemblywoman Giunchigliani and Assemblywoman Gibbons, to revise the qualifications for members of the State Board of Oriental Medicine and to revise requirements for a license to practice Oriental medicine, brought this bill forward. During the hearing on this bill, Assemblywoman Giunchigliani had presented some proposed amendments to address certain concerns. Those amendments are reflected in the mock-up of A.B. 21, which appears behind tab A in your work session document (Exhibit G). In addition, she proposed the deletion of the reference of “Doctor of Oriental Medicine,” which is on page 2, line 36, of the bill, and a change from five years to three years, the practice requirement, which is on page 2, line 41, of the bill. These proposed changes are also included in the mock-up under tab A (Exhibit G).
Chairman Goldwater:
Ms. Giunchigliani, do you want to give some follow-up?
Assemblyman Giunchigliani:
Thank you, Mr. Chairman. I commend your staff. They are very good. I tried to take some of the considerations from both the e-mails and individuals I have spoken with. That is why we removed the reference to the “doctor of Oriental medicine,” because there are some places that do issue degrees and some that do not. You just have to have a degree in Oriental medicine. So, that way, as these schools around the United States change their terms, which they have done in the last two years, it would follow with that flow. The five years to three years, although every other licensing board has a five-year requirement, I felt was reasonable because it is still such a small group of individuals that are actually practicing. It would at least allow for a larger pool for appointment purposes. Then, I made it clear that medical examiners and a public person are the people that could be appointed in the second tier. That is all that I have, thank you.
Chairman Goldwater:
Further discussion? Mr. Brown, please.
Assemblyman Brown:
Thank you. If it was stated, I apologize, but what was the rationale or reasoning for changing the residency requirement from one to two years?
Assemblywoman Giunchigliani:
I paired it with what the other boards tended to do as far as a requirement, if they noted it in their statute. That was really it.
Assemblyman Brown:
Was one [year] acceptable in the first instance, then?
Assemblywoman Giunchigliani:
No, that actually was a request from the sponsors of the bill, to change from one to two years. I think there just needs to be a residency standard because you do not want, even on an attorneys board, if you have only practiced one year, and only been a resident one year in the state, you need to be somewhat familiar, and I think the idea was that we paralleled it with what most other professions did. I am open to discussion on that or if Mrs. Gibbons is.
Assemblywoman Gibbons:
Thank you, Mr. Chairman. That was actually requested by one of my constituents. During the interim, I had many complaints in regard to the Board because it is difficult to get people on the Board. The people that would apply and find out right away had very little experience, and so they were concerned that in the future we might get some members that are not as qualified as they should be. So, I have worked with the Attorney General’s Office and these people. They suggested that we should put it in legislation.
Assemblyman Brown:
I just do not see the reason behind it. My impression was that, for the most part, the practice is fairly standard throughout the United States, and I may be misguided, but that is just what I came up with. So, I do not necessarily see the basis for two years versus one. It is not a major sticking point at all. Thank you, Mr. Chairman.
Tom Scancke, Nevada Oriental Medical Society:
The two-year [residency standard] came about because two years ago an individual was appointed to the State Board of Oriental Medicine who had not resided in the state of Nevada for more than about three months. He was appointed to the Board and currently resides in California and Nevada. It was a request of the Society to put a two-year requirement on there so that people could not be appointed immediately once they were licensed. I think that it is reasonable, because of the profession and because of the issues that have arisen in the past two years with this issue, that a two-year time period is probably more appropriate than a year.
Assemblyman Beers:
Thank you, Mr. Chairman. I think that the [parents] of the individuals they are referencing are constituents of mine and in fact are responsible for opening this discussion in the Legislature two years ago. I still have big problems with removing the definition for “accredited.” We have a long history in Nevada of the Board irresponsibly handling that responsibility. Providing the outside accreditation for schools, it seems to me, is essential. It was apparent through the testimony that we heard two years ago that licensing was far more a throttle on the supply of practitioners than anything else. Between the expansion of responsibility for the Board to create a test, the preponderance of states that are going exactly the other way and the removal of the accreditation definition language, I cannot support this, even with these amendments. [Chairman Goldwater asked for the pleasure of the Committee.]
Assemblywoman Giunchigliani:
If Mrs. Gibbons would agree, back to Mr. Brown’s question, I think just having a standard for residency is the key. I would not have an objection to moving it back to one year. It would at least deal with the issue that Mr. Scancke raised, so that they are not immediately licensed with immediate placement on a Board. I would agree to make that change if Mrs. Gibbons is all right with that. [Mrs. Gibbons indicated that she was.] Then I would make the motion to amend and do pass and change the residency back to one year.
Chairman Goldwater:
Ms. Giunchigliani has offered a motion to amend and do pass, with the outline changes as well as changing the residency requirement from two to one year. It has been seconded by Mrs. Gibbons. [After concerns by Committee members on the amendment, Chairman Goldwater asked Ms. Giunchigliani to withdraw that motion.]
ASSEMBLYWOMAN GIUNCHIGLIANI MOVED TO AMEND AND DO PASS A.B. 21, INCLUDING THE FOLLOWING AMENDMENT:
· CHANGE THE RESIDENCY REQUIREMENT, IN BOTH SECTIONS, FROM TWO YEARS BACK TO ONE YEAR.
ASSEMBLYWOMAN GIBBONS SECONDED THE MOTION.
THE MOTION CARRIED WITH MR. KNECHT, MR. HETTRICK, AND MS. LESLIE VOTING NO. (Mr. Arberry was not present for the vote.)
Assembly Bill 119: Revises provisions governing determination of expiration date for certain prescription drugs or medicines. (BDR 54-238)
Vance Hughey:
The next bill in your work session document (Exhibit G) is Assembly Bill 119, which was proposed by Assemblyman Williams to prohibit a pharmacist from putting an expiration date on a medicine label of a prescription that is sooner than the date specified by the manufacturer of the drug. He proposed subsection 6 be amended as indicated on your work session document (Exhibit G). This is his wording: “This proposed amendment would prohibit a pharmacist from specifying on a label an expiration date that is earlier than the expiration date specified by the manufacturer.” One note on this suggested wording; I have spoken with our legal counsel [Wil Keane], and he believes that we will probably restructure that a little bit to remove the portion that deals with “except as otherwise provided.” The nature of the change makes that unnecessary. Also, the parenthetical phrase “pharmacist” would be removed when the amend is done. That is just for clarification so that people understand the practitioner, in this case, is the pharmacist.
Chairman Goldwater:
I recall there being no opposition to this bill in testimony. I was not contacted that there was. Feeling of the Committee?
ASSEMBLYMAN HETTRICK MOVED TO AMEND AND DO PASS A.B. 119.
ASSEMBLYMAN KNECHT SECONDED THE MOTION.
THE MOTION CARRIED. (Mr. Arberry was not present for the vote.)
Assembly Bill 157: Revises provisions relating to consolidated insurance programs. (BDR 53-370)
Vance Hughey:
Assembly Bill 157 is the third bill on your work session document (Exhibit G). This bill was brought forward by Assemblywoman Giunchigliani to address concerns regarding owner-controlled insurance programs. In response to several issues that were raised during testimony on this bill, she proposed that the changes that are reflected in the mock-up of A.B. 157, which is included under tab B of your work session document (Exhibit G). The changes remove the proposed limitation on the physical size of the construction project under a consolidated insurance program. They list certain requirements that must be met before a consolidated insurance program can cover more than one construction project. In addition, I believe you have a suggested amendment proposed by Clark County (Exhibit H). I would just point out that, unless somebody wants to correct me, the only difference between this proposed amendment and what is in the mock-up is under subsection 3, which talks about “will be completed within the same three-year period.” They wanted to change it. Originally it was two, but we have, in fact, incorporated that change in our mock-up, so I do not believe that there is anything in this proposed amendment that is different from what is in your mock-up.
Chairman Goldwater:
The issue of OCIPs (Occupational Consolidated Insurance Program) is pretty complicated. Mr. Holloway, have you had a chance to review the proposed amendments?
Steve Holloway, Associated General Contractors:
Mr. Chairman, to answer your question, yes. We, as well as the other proponents of this bill concur with these amendments. [Chairman Goldwater asked Mr. Musgrove and Mr. Jeffrey the same question.]
Jack Jeffrey, Southern Nevada Building and Construction Trades Council:
[Introduced himself] We do concur with the amendment.
Chairman Goldwater:
What is the feeling of the Committee?
ASSEMBLYWOMAN GIUNCHIGLIANI MOVED TO AMEND AND DO PASS A.B. 157.
ASSEMBLYWOMAN LESLIE SECONDED THE MOTION.
Assemblywoman Giunchigliani:
We had one thing brought up in the hearing, and we were not sure on how to include it, regarding the safety on each site. We had the [Division of Insurance] testify on that. Can I ask Wil to explain, because we probably just need to clarify, in NRS 616B, the intent? It is somewhat confusing, and we probably should use this opportunity to make sure that the intent is to keep a safety person on each site. If there is no objection, we would just refer to 616B.725, and clarify that in the drafting, if that is acceptable? Can I have Wil just explain what it does? Or what we came across? Thank you.
Wil Keane:
Thank you, Mr. Chair. We would suggest adding 616B.725 and similar sections to the bill with conceptual changes such as the following: In subsection 3, it specifies that two people shall be hired as safety coordinators. We would modify that to say, “not less than two people.” In subsection 6, it says that a coordinator shall be present at the site of the construction project. To account for multiple sites, we would change that to “each site” of the construction project. To accomplish this objective, we would make other changes as needed.
Assemblywoman Giunchigliani:
If I might, Mr. Chair, the reason for that was brought up by the insurance industry. That is their interpretation. It did not ever make it into writing. So Wil came across this and suggested that if we wanted to clear that up, this would probably be the opportunity to do that.
Assemblyman Hettrick:
My question, I think, was answered. I saw 616B.725 referred to in the proposed amendment in Section 7, so I presumed it was there. So what you are actually doing is amending that and not including that provision. I do recall that the testimony was that the interpretation was “each site,” not “the site.” I will be all right with that.
Chairman Goldwater:
That was the interpretation. The amend and do pass was a Giunchigliani/Leslie motion, I believe. Discussion?
THE MOTION CARRIED. (Mr. Arberry was not present for the vote.)
Assembly Bill 168: Revises provisions governing industrial insurance. (BDR 53‑255)
Vance Hughey:
A.B. 168 makes various changes governing industrial insurance. As you will recall, there was considerable testimony during the hearing on this bill. As a result of that testimony, Assemblywoman Giunchigliani worked with interested parties and has proposed amendments to the bill that staff has incorporated into the mock-up of A.B. 168 included as tab C in your work session document (Exhibit G). We have had some discussion since we drafted this mock-up and one particular I would point you to is on page 19, Section 16. That provision deals with appeals of decisions of the administrator. I think we have some clarification now that we would actually rewrite the amendment to this portion, essentially to make the technical changes, as far as the dates that are indicated in the box to the right of the text. In addition, we would clarify that, for an administrative fine, the appeal process would be directly to District Court. For the benefit penalty, the appeals process would be first to the appeals officer and then beyond that. So, I make that clarification, and I believe that Assemblywoman Giunchigliani would be prepared to discuss any of the other changes.
Assemblywoman Giunchigliani:
Thank you, Mr. Chairman, and thanks to your staff again. I spent about three hours with about 20 of my former friends and Mr. Hettrick’s former friends and those who served on the old Management Committee. The concern regarding the “any willing provider” language, as you will note, was taken out. What we ended up coming up with, which was actually suggested by some of the “self‑insurers,” was the 1993 language that dealt with “access.” That is the language that you see here. Also, what was proposed was to go back to the 20-mile issue that actually benefited, in a lot of your rural areas. Don Jayne from the Nevada Self Insured Association brought me a suggestion to better assist. In the 20-mile area, we might want to say, “within the employee residence, or employer’s location,” because in some cases that may actually benefit them a little bit better, from being able to access their medical care. That would be acceptable. That is not contained within the document.
In addition to that, everybody agreed, or at least did not object to the AMA [American Medical Association] Guide going in. Mr. Kim has still been lobbying me to change the effective date to January 1, but I have not agreed to that. I would just put that out on the record for that purpose. In addition to that, we clarified on behalf of DIR so I agreed to put in here the issue of their audits. That [section] is the new section that is noted on page 7. That will assist them with being able to do their audit cycle in a more appropriate time manner. It is changing it from three years to five years. That was at the Director’s request.
In addition to that, you will see the 20-mile rule on page 8. Again, the suggestion was to say “within their residence or employment location.” We added that language regarding the panel, and then there is an appeal to the DIR if they do not have enough access to an individual.
Page 11 was a discussion brought by the Clark County School District. It was just a misinterpretation, but what we came up with was that people were confusing “temporary” and “light duty” with “temporary light duty.” This states that they may offer temporary light-duty employment to the employee. If they accept or reject that “temporary light duty,” it will not impact the employee’s future compensation or the employee’s ability to get vocational rehab services. Then, the suggestion came that we should probably, at some time, reduce it to writing. If it is not in writing, it does not exist. They then landed on the idea that at least that employer, then, would reduce that to writing within ten days, so at least there was documentation that they offered “temporary light-duty” for a period of time. On page 12 and, I think, also, page 14, they suggested adding “employment” in front of “benefits,” so that it was a narrow construction. That is what we are talking about regarding returning them to their position.
We realigned on page 15 and 16 and eliminated “through fraud, coercion, duress or undue influence.” It was a standard that was not working and did not need to be there anymore, so we eliminated that but removed paragraph d. Both private sector and attorneys felt that it was responsible to move that up to the subsequent beginning of that section, so if you refuse to process a claim, or if you induce a claimant to fail to report an accidental injury, those are two “no‑no’s,” period. That went into the initial premise at the beginning of that section and then took their “without justification” persuaded a claimant to do the following and then those are benefit penalties that could occur. Then we deleted that reference on page 16, then, so we just realigned that, basically. Then we just changed some of the timelines. I did fax this to Brian Nix to make sure that he was going to get back to me if he had any objections, and I have not heard from him, so I am assuming that is satisfactory to him.
Vance explained what we are trying to do. Part of what came out of this meeting is a request for a one-time, not an ongoing, but an interim committee, possibly, to look at the whole issue of benefit penalties of the $36,000 cap, which might need to be reviewed, since we went to the three-way private insurance; we have not really looked at our statutes, regarding that. That seemed to be across the board, from DIR, attorneys, the private insurers, and so forth. So, if the body does not have objection, in Elections, I may request that. At least we could focus, in the Interim, on those specific areas that we were not able to address here in A.B. 168. An example would be, there is a problem with the flow of who has jurisdiction on fines and how you deal with fines versus benefit penalties, and they are kind of convoluted and mixed and matched, but we did not feel we had enough time to do all of that kind of a change, so that will be handled within the interim committee, as well. I will be happy to try to answer any questions.
Assemblyman Hettrick:
There’s obviously a lot to digest quickly, so bear with me if I ask questions that seem stupid, but I need to make sure what is going on. The very last page, 21, repeals NRS 616D.280, the employee safety device. Are we repealing the part about removal, or are we repealing the part about the employer failing to provide? I did not get a chance to go and look it up.
Assemblywoman Giunchigliani:
Thank you. I apologize; I did not comment on that. We got into a very interesting discussion about how you deal with if the safety guard is there, or the safety guard is not there. If it’s three times treble damages, what do you do? And, finally the whole group just said, you know what, just get rid of it all. It does not really need to be there. It is not being implemented. It gets into finger-pointing, “he said/she said,” so the recommendation was to repeal that and take it completely out of the section for both the employer and the employee.
Assemblyman Hettrick:
I do not doubt your word; I just would like to have somebody confirm that they are comfortable with that. If I may then, Mr. Chairman, I would go back to Section 16, page 19. Are we going to have a request by the demonstrator, given the changes of completing an investigation within 90 days instead of 120, to change from 30 to 70 [days], the time given to respond to written requests and to change from 70 to 30 the number of days and so on? Are we going to get a request for money for more people to do the investigations more quickly, and are they aware we changed the days?
Assemblywoman Giunchigliani:
Yes. I faxed it and e-mailed it to Brian [Nix] on Monday, or even Friday, I think, but I do not think that he received it. Then we sent it again on Monday and I talked to him and told him that I needed to know by yesterday and I have never heard anything back, one way or another.
Assemblyman Hettrick:
I guess the only other question I have concerns the mandatory 1-year adoption of the AMA Guide.
Assemblywoman Giunchigliani:
That was not objected to by anyone in the meeting, other than Mr. Kim, who just wanted a different date for putting it into place. I did not agree to that. The AMA Guide, everybody felt comfortable enough, because we do not do pain in Nevada. The impact of the cost will not be as much as what the NCII had said and could even be as low as no impact. Because they are also allowed, in the second paragraph, to make modification, so they can select certain sections out of the Guide that they will not implement and let them use for rating purposes. Everybody felt comfortable because DIR also has that ability, and currently has that ability, and they do segregate certain sections out for range of motion and so forth. That was acceptable. Some of the group is here, so they could possibly clarify that.
Chairman Goldwater:
This is a lot of work and fairly reasonable too. [Assemblywoman Giunchigliani stated that the group was excellent to work with and she wanted to thank them for their time because it was a long meeting.]
Jack Jeffrey, Southern Nevada Building and Construction Trades Council:
I do not have a statement, but I have a question. When we talk about the 20‑mile rule, does that mean if somebody in Yerington, for example, worked in Reno, would he have to go to Reno for medical care?
Assemblywoman Giunchigliani:
No, the intent would be that they would have access to the doctor nearest to either their residence, or if they happen to be injured at their employment and could access a doctor closer to them, and then they could access them. I believe that is what Mr. [Don] Jayne was trying to get at. That makes better sense, actually, I would not want to make them drive all the way back home where they probably did not have access to a doctor and they probably had better chance at it in Reno. [Mr. Jeffrey indicated that it was his only concern that the patients did not have to leave their residence to get care.] I see, thank you.
Chairman Goldwater:
Other comments or thoughts from the Committee?
ASSEMBLYWOMAN GIUNCHIGLIANI MOVED TO AMEND AND DO PASS A.B. 168.
ASSEMBLYMAN PARKS SECONDED THE MOTION.
THE MOTION CARRIED. (Mr. Arberry was not present for the vote.)
Thank you very much, Ms. Giunchigliani, for your hard work.
Assembly Bill 221: Revises requirements concerning consignment of vehicles. (BDR 43-215)
The final bill on your work session document (Exhibit G) is A.B. 221. This bill was brought forward by Assemblywoman Chowning to address a problem associated with consignment sales of automobiles. She proposed an amendment to A.B. 221 that replaces the requirement that a dealer display a sign with a requirement that the dealer file a form at the Office of the Secretary of State and [that the dealer must] obtain a signed form from the customer that advises the customer that he could lose his vehicle if the dealer’s creditors find it necessary to seize the dealer’s property. The form also advises the customer that he is protected from loss if the dealer has filed a form, as required by the bill. The proposed amendment also makes a misdemeanor a violation of these new provisions. The proposed amendment is incorporated in your work session document (Exhibit G). A mock-up of the bill with the amendments is in your work session document under tab D.
Chairman Goldwater:
The sponsor of the bill is with us. Ms. Chowning, do you have something briefly?
Assemblywoman Vonne Chowning, District No. 28 (Clark County):
Thank you, Mr. Chairman. No, except to tell you that I really appreciate your research analyst for working so diligently. The Auto Dealers Association, the DMV, and most especially the consumers have agreed upon this amendment. Thank you.
Chairman Goldwater:
Ms. Chowning, I have been contacted by someone who did not know they had an issue here. That is that the licensed salvage pools would like to be exempted from this. Do you know anything about that?
Assemblywoman Chowning:
I do not know anything about that. [Mr. Goldwater indicated that those were “junkyard dogs.”] If the junkyard dogs had a concern, then I think that they should [be exempt]. I do not know how they could be affected, but if this is a serious concern, then I will ask the Committee’s forgiveness because this has not been brought to me before.
Jack Jeffrey, representing B&E Auto Auction:
I have to apologize to the sponsor of the bill. To be honest with you, I did not catch it myself until I came in for the work session on the other matters that you had on the docket. There is a similar bill in the Senate and we asked for the exemption in that bill. DMV had no objection to it. The salvage pools are not the problem. In fact they are not allowed to do business with the public, so we just want to be clearly exempt from it.
Assemblywoman Chowning:
Thank you, Mr. Chairman. I would say that if a salvage dealer would not mind if their vehicle being sold on consignment would be “gobbled” up in a financial institution’s inventory that was taken from the auto dealer, then I do not have any problem with that. I do not see the instance where a salvage dealer’s vehicle would be a part of a regular auto dealer’s inventory being sold on consignment.
Assemblywoman Buckley:
Do salvage pools take cars on consignment?
Jack Jeffrey:
Yes, they do. [Ms. Buckley asked how that worked.] Basically, they are on consignment from the insurance companies. They deal only with the insurance companies. On occasion, they may sell a vehicle that somebody from the general public brings in, but they do not sell any vehicle to the general public. I would say over 99 percent, maybe even more, is with the insurance companies, but that is on a consignment basis.
Chairman Goldwater:
So, Ms. Chowning, you said that you did not mind them being excluded if they wanted to be at risk?
Assemblywoman Chowning:
Mr. Chairman, that is exactly my statement. If they do not mind being at risk, then I do not see why we should not allow them to be at risk. After all, the main emphasis and focus of this bill is the average consumer, who is on a one‑time basis taking their vehicle, maybe two, to a dealer, but certainly not on a regular basis, such as insurance companies, so I would not mind. Thank you.
Wil Keane:
Just for my benefit, when I am drafting this, I want to make sure that I understand the exemption that we are talking about. Do we mean that the salvage yards would be exempt from having to fill out these forms for a person who is leaving a car for the salvage yard to sell? Or, would the salvage yards be exempt when they had somebody else sell a car for them?
Jack Jeffrey:
I think we need to be clear, first of all, on what we are really talking about. A separate statute covers a salvage pool. They are separately licensed. There are only two salvage pools in the state that I am aware of. There may be another one, but I think there are two, and they are already licensed and regulated. Those are the only people that I am talking about with an exemption, not a salvage yard. Does that answer your question?
Wil Keane:
My question was, are you saying you want to be exempt when you are the consignee, or are you saying you want to be exempt when you are the consignor? [Mr. Jeffrey indicated that they wanted to be exempt in both situations.]
ASSEMBLYWOMAN GIUNCHIGLIANI MOVED TO AMEND AND DO PASS A.B. 221, INCLUDING THE FOLLOWING AMENDMENT:
· EXEMPTING SALVAGE POOLS AS CONSIGNEES AND CONSIGNORS.
ASSEMBLYMAN GRIFFIN SECONDED THE MOTION.
THE MOTION CARRIED. (Mr. Arberry was not present for the vote.)
Chairman Goldwater:
I believe that is it. Lastly, there is one more thing to come before the Committee. The Insurance Commissioner’s omnibus bill is here, BDR 57-546.
ASSEMBLYMAN HETTRICK MOVED FOR COMMITTEE INTRODUCTION OF BDR 57-546.
ASSEMBLYWOMAN BUCKLEY SECONDED THE MOTION.
THE MOTION CARRIED. (Mr. Arberry was not present for the vote.)
Anything else to come before the Committee today? Please check your agenda. Things are coming on and off the agenda kind of rapidly. With that, thank you for your time. [Chairman Goldwater adjourned the meeting at 1:30 p.m.]
RESPECTFULLY SUBMITTED:
Corey Fox
Committee Secretary
APPROVED BY:
Assemblyman David Goldwater, Chairman
DATE: