MINUTES OF THE
SENATE Committee on Finance
Seventy-second Session
March 26, 2003
The Senate Committee on Finance was called to order by Chairman William J. Raggio, at 8:11 a.m., on Wednesday, March 26, 2003, in Room 2134 of the Legislative Building, Carson City, Nevada. Exhibit A is the Agenda. Exhibit B is the Attendance Roster. All exhibits are available and on file at the Research Library of the Legislative Counsel Bureau.
COMMITTEE MEMBERS PRESENT:
Senator William J. Raggio, Chairman
Senator Raymond D. Rawson, Vice Chairman
Senator Dean A. Rhoads
Senator Barbara K. Cegavske
Senator Sandra J. Tiffany
Senator Bob Coffin
Senator Bernice Mathews
GUEST LEGISLATORS PRESENT:
Senator Joseph M. Neal Jr., Clark County Senatorial District No. 4
STAFF MEMBERS PRESENT:
Gary L. Ghiggeri, Senate Fiscal Analyst
Bob Guernsey, Principal Deputy Fiscal Analyst
Pamela Carter, Committee Secretary
OTHERS PRESENT:
Michael J. Willden, Director, Department of Human Resources
Robert S. Hadfield, Lobbyist, Nevada Association of Counties
Todd M. Butterworth, Long Term Services Coordinator, Rehabilitation Division, Department of Employment, Training and Rehabilitation
Jon L. Sasser, Lobbyist, Washoe Legal Services, Nevada Legal Services
Lynda Parven, Administrator, Nevada Equal Rights Commission
Bobbie Gang, Lobbyist, National Association of Social Workers – Nevada, Nevada Women’s Lobby
David K. Schumann, Lobbyist, Independent American Party of Nevada
Leslie Danihel, Chief, Eligibility and Payments, Welfare Division, Department of Human Resources
Scott J. Watts, Lobbyist, Nevada Alliance for Retired Americans
Debbra J. King, Administrative Officer IV, Division of Health Care Financing and Policy, Department of Human Resources
Stephen C. McFarlane, Ph.D., Dean, School of Medicine, University of Nevada
Caroline Ford, M.P.H., Assistant Dean/Director, Center for Education and Health Services Outreach, School of Medicine, University of Nevada
George J. Furman, M.D.
Gar Elison, Executive Director, Utah Medical Education Council
Steven C. Hansen, Chief Executive Officer, Nevada Health Centers, Inc.
Charles Duarte, Administrator, Division of Health Care Financing and Policy, Department of Human Resources
Steve L. Tognoli, District Chief, Mason Valley Fire Protection District
Buffy Gail Martin, Lobbyist, American Cancer Society – Reno
Patrick J. Ferrillo, Jr., D.D.S., Dean, School of Dentistry, University of Nevada, Las Vegas
Carol O’Hare, Executive Director, Nevada Council on Problem Gambling
Bo Bernhard, Ph.D., Assistant Professor, Director of Gambling Research, William F. Harrah College of Hotel Administration, University of Nevada, Las Vegas
Tim Crowley, Lobbyist, Nevada Resort Association
Maureen Brower, Lobbyist, Westcare
Denise F. Quirk, M.A., Red Hawk Counseling
Senator Raggio asked staff to explain changes in the General Fund balance. Gary L. Ghiggeri, Senate Fiscal Analyst, Fiscal Analysis Division, Legislative Counsel Bureau, said the budget division confirmed approximately $61.2 million in additional General Fund reversions has been reduced to $57.5 million. He explained $3,300,000 identified by the Governor as a budget reduction was included twice in the budget and is included once in the Governor’s recommended supplemental appropriations of $71,750,340 in the Distributive School Account (DSA). He noted this reduces the estimated ending fund balance in fiscal year (FY) 2003 to approximately $99.6 million, approximately $1.1 million below the 5 percent threshold.
Senator Raggio said the committee should watch this changing situation. He asked whether the DSA balance would change from its current balance of $71,750,340. Mr. Ghiggeri replied yes, the balance could change depending on the amount of sales tax revenue collected during this fiscal year.
Senator Raggio opened the hearing to Senator Neal and Senate Bill (S.B.) 22.
SENATE BILL 22: Broadens applicability of laws relating to unlawful employment practices. (BDR 53-132)
Senator Joseph M. Neal Jr., Clark County Senatorial District No. 4, said S.B. 22 is the result of a Nevada Supreme Court case involving an employee working for an employer with 15 employees or less. He explained even though the employee had a good case for employment discrimination, the Supreme Court ruled against the employee based on the fact that the employer had 15 or fewer employees. He asked the committee to consider the fiscal impact (Exhibit C) and passage of S.B. 22.
Senator Raggio said the Equal Employment Opportunity Commission (EEOC) would not participate in discrimination cases involving employers with less than 15 employees. He added the source of funding for S.B. 22 will require a General Fund appropriation.
Senator Mathews asked whether the five employees mentioned in the amendment to S.B. 22 are full-time or part-time employees. Senator Neal replied any five employees would be affected.
Senator Raggio opened the hearing on Senate Bill (S.B.) 137.
SENATE BILL 137: Establishes Legislative Committee on Persons With Disabilities. (BDR 17-700)
Senator Raggio said S.B. 137 is not in the bill book. He explained S.B. 137 is being considered today because of the fiscal note attached to it. He asked Mr. Willden to explain the fiscal note (Exhibit D).
Michael J. Willden, Director, Department of Human Resources (DHR), said S.B. 137 results from the interim committee study on persons with disabilities. He explained DHR will be required to perform assessments on 3100 skilled nursing and intermediate care nursing home residents to determine whether those persons can be moved to community settings. He stated the fiscal note for approximately $500,000 is based on contracting a consultant to perform a neutral setting feasibility study for 3100 individuals at a contractor rate of approximately $75 per hour. Mr. Willden pointed out his letter to Senator Raggio (Exhibit E), dated March 21, 2003, withdrawing the fiscal note to S.B. 137. He said withdrawing the fiscal note is the result of conducting a feasibility study for 125 residents, representing a sampling of residents in skilled and intermediate care facilities.
Senator Raggio asked for an explanation of Section 9 in the proposed amendment to S.B. 137 (Exhibit F), “The Department of Human Resources shall examine the feasibility of implementing the ‘money follows the person’ model of community-based services as recommended by the federal Health and Human Services Administration.” Mr. Willden replied DHR can determine whether a nursing home resident can be moved to a community setting. He said Medicaid monies allotted to a nursing home resident would follow the resident to a community setting.
Senator Raggio asked whether the Office of Community-Based Services, the Aging Services Division, the Division of Health Care Financing and Policy (HCFP), county social services, the Developmentally Disabled Planning Council, and the Independent Living Advisory Council will perform a feasibility study assessing 125 nursing home residents if the fiscal note is withdrawn. Mr. Willden replied the Office of Community Based Services, the Aging Services Division, the Division of Health Care Financing and Policy, county social services, the Developmentally Disabled Planning Council, and the Independent Living Advisory Council have asked to be included in the study. Senator Raggio said their involvement should be included in the bill.
Senator Raggio asked for an explanation of line 38 in the proposed amendment. He asked why the word “any” is inserted in front of “assessments.”
Mr. Willden replied the intent of inserting “any” in front of assessments helps clarify that a comprehensive assessment of each individual resident of the sample 125 residents will not be performed.
Senator Raggio suggested the wording of the proposed amendment should reflect the feasibility study will be performed based on a “sampling” of 125 nursing home residents. He said the current wording mandates “any and all assessments made of persons…”. Senator Raggio suggested Mr. Willden rewrite the proposed amendment.
Robert S. Hadfield, Lobbyist, Nevada Association of Counties (NACO), stated S.B. 137 is a partnership between the counties and the State. He said he does not consider the feasibility study an unfunded mandate.
Senator Raggio said the committee will hold the bill until the wording is changed.
Senator Raggio asked the committee to look at Senate Bill (S.B.) 164.
SENATE BILL 164: Creates the Office of Disability Services within Department of Human Resources to coordinate and administer certain services and programs for persons with disabilities. (BDR 38-701)
Senator Raggio asked Mr. Willden to explain the amendments to S.B. 164 (Exhibit G). Mr. Willden replied there are two amendments to S.B. 164. He said one amendment to S.B. 164 adds language to section 11 indicating the office of disability services will provide a program for the deaf and hard of hearing. He noted if new levels of services are provided, staffing will be needed. Mr. Willden explained the other amendment to S.B. 164 creates an advisory committee for the deaf and hard of hearing.
Senator Raggio asked whether those services are currently being performed adequately.
Todd M. Butterworth, Long Term Services Coordinator, Rehabilitation Division, Department of Employment, Training and Rehabilitation (DETR), replied yes, the services are currently being provided through a $110,000 General Fund allocation for deaf resource centers in southern and northern Nevada.
Senator Raggio asked whether budgeted surcharge monies are paid to Sprint telephone company for teletype (TTY) services. Mr. Butterworth replied yes, telecommunications surcharge monies are paid to Sprint. He said he will be addressing this issue today in greater detail.
Mr. Butterworth said DETR is requesting reinstatement of the deaf services coordinator position. He indicated services outlined in the amendment are currently being provided by the community deaf resource centers.
Senator Raggio replied deaf and hard of hearing persons do not believe adequate services are being provided by the deaf resource centers. He asked whether DETR has spoken to anyone about services. Mr. Butterworth replied he has spoken to several members of the deaf community. He said the $110,000 deaf resource centers allocation was reduced to approximately $80,000, and levels of staffing and services are inadequate. Senator Raggio asked how much funding is needed to provide adequate services. Mr. Butterworth replied increasing the $110,000 allocation to between $150,000 and $200,000 annually would also increase needed resource center staffing. He noted increased staff will offer more adequate levels of services to the deaf and hard of hearing.
Senator Raggio requested DETR provide the committee with a suggested budget. He said the committee would like to reasonably accommodate the concerns of the deaf and hard of hearing.
Senator Mathews asked whether TTY is going to be used and funded by surcharge monies. Mr. Butterworth replied yes, TTY will be used. He stated under Nevada Revised Statute (NRS) 707.360, telecommunications surcharge monies, 8 cents per line, can only be used to fund Relay Nevada and the TTY distribution program. He explained Relay Nevada enables someone utilizing TTY to communicate with someone using a telephone. He noted Sprint relays 40,000 calls per month in Nevada.
Senator Raggio stated the deaf community believes Relay Nevada is not needed as often since nearly everyone today has their own TTY equipment. Mr. Butterworth replied distribution of TTY has leveled off in recent years.
Senator Raggio said the Legislature may consider amending the statute to reflect accessibility of funds for TTY services.
Mr. Willden stated the second amendment to S.B. 164 creates an advisory committee on deaf and hard of hearing issues.
Senator Raggio closed the hearing on S.B. 164 and re-opened the hearing on S.B. 22.
Jon Sasser, Lobbyist, Washoe Legal Services, Nevada Legal Services, spoke from written testimony (Exhibit H) in support of S.B. 22. Mr. Sasser explained Nevada statutes, as written, require an employer with 15 or more employees to comply with Nevada’s employment discrimination laws. He said employers with less than 15 employees are not required to comply with Nevada’s employment discrimination laws. He stated Senator Neal is attempting to amend the statute to cover employers with 5 or more employees rather than 15 or more employees. He reiterated S.B. 22 addresses employment discrimination.
Senator Coffin indicated reducing employee numbers may not make a difference in employment discrimination.
Mr. Sasser added the fiscal note to S.B. 22 assumed caseloads would increase over the next 2 fiscal years based on current experience. He said caseload growth may not occur.
Lynda Parven, Administrator, Nevada Equal Rights Commission (NERC), stated NERC based its fiscal note estimates on caseload growth utilizing current statistics. Ms. Parven said NERC’s work-sharing agreement with EEOC will not allow the imposition of fees against an employer as indicated by Mr. Sasser. She explained Mr. Sasser’s reference to finding probable cause in a case against an employer and accessing fees to that employer for costs of investigation and processing of the case. Ms. Parven again stated EEOC would not allow the imposition of fees against an employer. She referenced supporting documentation on NRS 624.300 and S.B. 22 from Senator Randolph J. Townsend (Exhibit I) attached to his March 10, 2003, letter to Senator Raggio.
Senator Raggio stated since EEOC will not participate in discrimination cases involving employers with more than 15 employees, the source of funding for S.B. 22 would require a General Fund appropriation.
Mr. Sasser stated although he appreciates conserving General Funds, he would hate to see changes in S.B. 22 die on a fiscal note.
Bobbie Gang, Lobbyist, National Association of Social Workers – Nevada, Nevada Women’s Lobby, spoke in support of S.B. 22. She asked the committee to look at the fairness of the fiscal note since there are many Nevada employers with more than 15 employees.
David K. Schumann, Lobbyist, Independent American Party (IAP) of Nevada, said he would like to address the fiscal note because it is unfair. He explained the fiscal note should say, “the State would reimburse any employer accruing over $1000 in expenses for Americans with Disabilities Act (ADA) compliance, and the State should require Washoe Legal Services to post a $5 million bond to reimburse the State for ADA expenses.”
Senator Raggio said S.B. 22 requires certain physical construction changes to accommodate employees with disabilities.
There being no further testimony, Senator Raggio closed the hearing on S.B. 22 and opened the hearing on Senate Bill (S.B.) 138.
SENATE BILL 138: Requires Department of Human Resources to enter into agreement with Federal Government to determine eligibility for Medicaid at same time Federal Government determines eligibility for Supplemental Security Income Program. (BDR 38-703)
Leslie Danihel, Chief, Eligibility and Payments, Welfare Division, Department of Human Resources, spoke from written testimony (Exhibit J) in support of S.B. 138. She explained the legislative committee studying services offered to people with disabilities supports S.B. 138. She said she would provide information on the possible impact of requiring the Department of Human Resources (DHR) to enter into an agreement with the federal Social Security Administration (SSA) in determining eligibility for Medicaid at the same time eligibility is determined for Supplemental Security Income (SSI). She explained if S.B. 138 is passed, all applicants determined eligible for SSI would automatically be determined eligible for Medicaid. She said this ensures total enrollment of SSI recipients for Medicaid assistance. She added eligibility information would be automatically interfaced to the Welfare Division, and annual redeterminations of SSI eligibility would include notification to the Welfare Division of Medicaid eligibility. She stated the current estimated cost of determinations is $8.84 per case in this fiscal year. She noted per case cost of determinations is projected to be $9.19 in FY 2004 and $9.56 in FY 2005. She said increased costs are based on maximum estimates.
Scott J. Watts, Lobbyist, Nevada Alliance for Retired Americans (NARA), spoke from written testimony (Exhibit K) in support of S.B. 138. He said NARA supports this legislation, and the State should use the same standards in determining Medicaid eligibility at the same time SSI eligibility is determined. He stressed simplification of governmental procedures will assist retirees and older Americans in simplifying their lives.
Senator Mathews asked why it costs more to determine Medicaid eligibility at the same time SSI eligibility is determined.
Debbra J. King, Administrative Officer IV, Division of Health Care Financing and Policy, Department of Human Resources, replied SSA currently reports in December 2002, there were 28,285 SSI-eligible persons, and only 25,813 of the 28,285 applied for Medicaid. She explained the cost per eligible person is a weighted cost of aged and disabled persons.
Senator Raggio asked whether a General Fund appropriation of $747,549 in FY 2004 and $750,953 in FY 2005 is accurate and necessary if S.B. 138 is passed. He said an additional $50,000 is being requested in FY 2004 and $4000 in FY 2005. He noted the program is also built on Title XIX Medicaid monies estimated between $800,000 and $900,000. He stated the revenue requirement is extremely high if S.B. 138 is implemented.
Ms. Danihel replied yes, it is. She explained every individual deemed eligible for SSI is automatically deemed eligible for Medicaid. She said individuals accessing Medicaid services determine estimated costs of the program.
Mr. Sasser spoke against the fiscal note to S.B. 138. He said the fiscal note is built on the difference between the 28,285 SSI-eligible persons and the 25,813 persons who applied for Medicaid. He explained the fiscal note assumes if the nearly 2500 individuals are automatically deemed eligible for Medicaid services, they will access services at the same rate as the 25,813 individuals who have applied for Medicaid services.
There being no further testimony, Senator Raggio closed the hearing on S.B. 138 and opened the hearing on Senate Bill (S.B.) 188.
SENATE BILL 188: Makes various changes concerning access to health care services for persons in this state. (BDR 40-743)
Senator Rawson spoke briefly from prepared testimony (Exhibit L) stating the high cost of malpractice insurance coverage heightens the health care provider shortage in Nevada. He said Nevada does not have enough obstetricians to deliver the estimated 37,000 babies due this year. He explained part of the solution is temporarily subsidizing malpractice insurance premiums and training more individuals to meet the demand. He added S.B. 188 provides subsidies for obstetricians treating low-income patients, increases training for residents, and creates a medical education council to address current health care issues.
Stephen C. McFarlane, Ph.D., Dean, School of Medicine, University of Nevada, said the school of medicine has been given the responsibility to meet Nevada’s health care needs. He stated access to health care is an important issue.
Caroline Ford, M.P.H., Assistant Dean/Director, Center for Education and Health Services Outreach, School of Medicine, University of Nevada, referenced the Center for Education and Health Services Outreach handout (Exhibit M. Original is on file in the Research Library.). She spoke in favor of S.B. 188 and said Nevada’s crisis in health workforce development is “the perfect storm” because Nevada is failing to meet health workforce production projections, there is unremitting population growth in Nevada, and the State is experiencing a budget crisis. She pointed out Nevada’s current and projected nursing shortage by stating within 2 years, an additional 1850 nurses will be needed in addition to those nurses already in training. She said primary care physicians will be needed in metropolitan and rural areas of Nevada. Ms. Ford noted access to dental care and mental health services is compromised by deficiencies in the health care workforce.
Ms. Ford explained the school of medicine proposes to expand obstetrical access by utilizing the current rural obstetrical access program within the University of Nevada as a base. She stated Nevada has dropped from 37th in the nation to 48th for adequacy of prenatal care.
Ms. Ford said the Nevada Rural Hospital Flexibility (FLEX) Program has advanced health care in rural Nevada by certifying six rural critical access hospitals in Medicare and Medicaid services; providing technical assistance to 12 critical access hospitals, including on-site survey preparation, financial feasibility studies, reviewing hospital policies and procedures, development of network agreements and contracts, board of education, and strategic hospital planning; implementing network development, telemedicine expansion, emergency medical services (EMS) integration in over 30 rural areas of Nevada; developing and publishing the Nevada Rural Health Plan; undertaking comprehensive rural community health assessments; collecting, analyzing, and disseminating data from rural areas; developing and implementing health care quality improvement projects in all rural hospitals; and improving collaboration among rural health care providers and patients.
Ms. Ford stated combined net operating revenue between five rural critical access hospitals increased by $1.5 million between June 30, 2000, and June 30, 2002.
Ms. Ford said the school of medicine would like to develop a medical education council to ensure Nevada has a well-trained health care workforce to meet the needs of Nevada residents. She referenced Senate Bill (S.B.) 305.
SENATE BILL 305: Requires Board of Regents of University of Nevada to establish Council on Graduate Medical Education. (BDR 34-931)
Senator Raggio asked who would serve on the medical education council.
Mr. McFarlane replied the Dean of the University of Nevada School of Medicine, three representatives actively involved in medical education, three representatives from the public, and one representative from the health care insurance industry.
Ms. Ford stated the school of medicine is asking to amend language in S.B. 188 as evidenced in its handout (Exhibit N).
Senator Raggio said the committee has the amended language from the school of medicine and a proposed amendment to S.B. 188 from the University and Community College System of Nevada (UCCSN) (Exhibit O).
Senator Coffin asked whether S.B. 188 allows loan provisions to physicians or helps subsidize their malpractice insurance premiums if 30 percent of their caseload is in unserved or underserved areas or is deemed indigent care.
Ms. Ford replied the purpose and intent behind obstetrical education loans is to keep current Nevada physicians in Nevada and entice back to Nevada the 30 physicians who quit practicing in Clark County.
Mr. McFarlane replied the school of medicine hopes to retain many resident student physicians schooled in Nevada. He said the malpractice insurance issue in southern Nevada has driven many Nevada physicians to other states.
Senator Coffin asked whether the malpractice insurance issue relates more to obstetrics rather than gynecology. Mr. McFarlane replied yes, it does relate more to obstetrics.
Senator Raggio asked that a breakdown of appropriation utilization be given to the committee. He stated there is a large amount of money involved in S.B. 188 and S.B. 305.
George J. Furman, M.D., spoke in favor of S.B. 188. He said recently two hospitals in rural Nevada requested his obstetrical services. He stated he could not offer his services today because of the malpractice insurance issue. He noted passage of S.B. 188 will help rural areas obtain proper obstetrical care, and he urged the passage of S.B. 188.
Gar Elison, Executive Director, Utah Medical Education Council, spoke in favor of a medical education council. He said the council was formed because national health care policy was inconsistent with Utah’s health care needs. He explained the council is allowed to control planning for workforce requirements and maximize State resources by better matching federal resources to ensure the financial viability of training programs. He stated the council also ensures health care services are delivered to rural areas.
Senator Raggio asked when Utah’s council was formed and how the council is funded. Mr. Elison replied Utah’s council was formed in 1997 and it is voluntarily funded by the hospitals. He added the council has an annual budget of approximately $500,000.
Steven C. Hansen, Chief Executive Officer, Nevada Health Centers, Inc. (NHC), spoke in favor of S.B. 188. He said NHC is one of two federally qualified, nonprofit community health centers in Nevada. He stated NHC provided outpatient services to approximately 70,000 patients during 2002 in Clark County. He added NHC’s mission is to provide primary care to underserved populations in the State. Mr. Hansen said NHC has 14 medical clinics throughout the State. He explained 10 of the 14 clinics are in rural areas, and 4 are in Las Vegas.
Mr. Hansen said NHC requests expansion of the Las Vegas clinics for obstetric and gynecological (OB/GYN) services. He added NHC will hire two OB/GYN physicians, two nurse-midwives, and six support personnel.
Senator Raggio asked how the clinics are funded. Mr. Hansen replied 40 percent of funding for primary care services provided in rural Nevada is from the federal Bureau of Primary Health Care (BPHC), 30 percent from patient revenue, and 30 percent from rural counties.
Senator Raggio asked how much the NHC expansion will cost. Mr. Hansen replied $500,000 per year until the program realizes net revenue.
Charles Duarte, Administrator, Division of Health Care Financing and Policy, Department of Human Resources, spoke from written testimony (Exhibit P) in support of S.B. 188. He said provisions in S.B. 188 will establish the medical education council of Nevada allowing for definitive health resource planning throughout Nevada. He stated HCFP is concerned about the medical education council’s role in policy setting authority created through S.B. 188. He explained some of its authority supercedes the existing authority of HCFP and the Medicaid office. He said amended language for S.B. 188 advises the Medicaid director on Nevada’s health plan. He stated HCFP supports the intent of S.B. 188. He added there is a limitation on State funding for university teaching programs because of the federal payment ceiling related to Medicaid services.
Senator Raggio stated HCFP should work with supporters of S.B. 188 to amend the language of this bill. He added HCFP should work with the Medicaid director on issues related to State and federal funding. Mr. Hansen agreed.
Steve L. Tognoli, District Chief, Mason Valley Fire Protection District, spoke from written testimony (Exhibit Q) on section 15 of S.B. 188 regarding data collection. He explained lack of consistent, verifiable health care data has made the data collection process difficult, resulting in a poor report. He said the Governor’s task force for development of a strategic plan for rural health care includes the creation of a central data repository. He stated a central data repository will allow anyone working in health care to access current and consistent health care data.
Mr. Watts spoke in favor of S.B. 188, stressing the importance of prenatal care and referencing his written testimony (Exhibit R).
Senator Raggio closed the hearing on S.B. 188.
Senator Raggio opened the hearing on Senate Bill (S.B.) 352.
SENATE BILL 352: Designates Nevada Cancer Institute as official cancer institute of State of Nevada and makes appropriation for creation of infrastructure needed to establish oral cancer and forensic institute. (BDR 40-650)
Senator Rawson explained S.B. 352 designates the Nevada Cancer Institute as the official cancer institute for Nevada.
Buffy Gail Martin, Lobbyist, American Cancer Society – Reno, spoke from a prepared statement (Exhibit S. Original is on File in the Research Library.) in support of S.B. 352. She said passage of S.B. 352 would establish Nevada as a leader in cancer research and treatment. She stated the Nevada Cancer Institute, located in Las Vegas, is positioned to become a state-of-the-art research and treatment center. She explained the infrastructure appropriation, needed to establish an oral cancer and forensic institute, will save lives.
Senator Raggio asked about the Nevada Cancer Institute. Senator Rawson replied the Nevada Cancer Institute is a statewide effort. He said members on the board of directors are currently being selected, and pending federal legislation will help fund the institute.
Patrick J. Ferrillo, Jr., D.D.S., Dean, School of Dentistry, University of Nevada Las Vegas, spoke in favor of S.B. 352. He explained the Nevada Cancer Institute will offer instruction in biomedical sciences. He added the institute will develop public awareness of oral cancer.
There being no further testimony, Senator Raggio closed the hearing on S.B. 352 and opened the hearing on Senate Bill (S.B.) 349.
SENATE BILL 349: Provides for certification of gambling counselors and course of study and funding of programs for treatment and prevention of problem gambling. (BDR 54-155)
Senator Rawson said S.B. 349 defines problem gambling, creates a board to certify counselors in problem gambling, and funds programs for the prevention and treatment of problem gambling.
Carol O’Hare, Executive Director, Nevada Council on Problem Gambling, spoke in favor of S.B. 349. She said this bill complements the goals and objectives of the council by establishing essential certification for counselors. She explained S.B. 349 creates a five-member board devoted to ensuring mental health professionals are appropriately trained as problem gambling counselors.
Senator Raggio stated letters of support for S.B. 349 have been received from Kevin M. Kelly, an attorney in Las Vegas, and Geoffrey Stormzand from Henderson (Exhibit T).
Bo Bernhard, Ph.D., Assistant Professor, Director of Gambling Research, William F. Harrah College of Hotel Administration, University of Nevada, Las Vegas, spoke in support of S.B. 349, stating researchers, clinicians, and policy makers have been working together and will continue to work together in addressing problem gambling. He urged committee passage of S.B. 349.
Tim Crowley, Lobbyist, Nevada Resort Association (NRA), spoke in support of S.B. 349 saying NRA members fully support this bill. He said there are three essential components to effectively address problem gambling: education, certification, and treatment. He stated S.B. 349 creates a board to ensure counselors are trained to treat problem gambling. Mr. Crowley referenced the Table 13 Prevalence by Type of Gambling handout (Exhibit U) to illustrate problem gambling among individuals participating in specific types of gambling.
Senator Raggio asked how the NRA council to treat problem gambling is funded. Mr. Crowley replied the council is funded by private donations.
Senator Mathews asked how much treatment costs per person and what is the incidence of suicide related to problem gambling. Mr. Crowley replied there is a high incidence of suicide related to problem gambling. Senator Mathews asked whether NRA will match funding. Mr. Crowley replied NRA will continue contributing private donations to the council.
Senator Coffin asked why there are no psychiatrists or psychologists on the board. Ms. O’Hare replied there will be two licensed professionals, including psychiatrists and psychologists, and two certified drug and alcohol counselors on the board. Senator Coffin asked whether a noncertified gambling counselor who claims to be a certified gambling counselor is in violation of the law. Ms. O’Hare replied yes, a person not certified in problem gambling, but claiming to be certified in problem gambling, is in violation of the law. Senator Coffin confirmed only a person certified in problem gambling can claim to be a certified gambling counselor. Ms. O’Hare agreed.
Senator Mathews applauded Senator Rawson on drafting S.B. 349. She said the gaming industry has a responsibility for treatment and recovery of problem gamblers. Mr. Crowley agreed.
Maureen Brower, Lobbyist, Westcare, spoke in support of S.B. 349. She said Nevada will be well served by certified counselors and a treatment program.
Ms. Gang said she believes mental health professionals, such as social workers, are trained and competent counselors. Ms. O’Hare replied social workers must demonstrate they are trained and competent in the area of problem gambling.
Senator Rawson stated board members are currently not certified as counselors in problem gambling. He said they will become certified.
Senator Raggio recognized Mr. William Bible, Director, Nevada Resort Association, in the audience. He stated Mr. Bible once worked for the Legislature and State as Budget Director in the Department of Administration. He thanked Mr. Bible for his attendance.
Denise F. Quirk, M.A., Red Hawk Counseling, spoke in support of S.B. 349. She stated she has national certification qualifications in problem gambling. She said she supports the need for specific education and qualifications for future counselors in problem gambling.
Senator Coffin asked whether a treatment goal for problem gambling is curbing or quitting gambling entirely. Ms. Quirk replied different therapists have different goals. She stated her goal is to help individuals stop gambling entirely. She said she advocates curbing gambling as a program of treatment.
Senator Coffin asked what the strategy is for curbing gambling. Ms. Quirk replied providing a 12-step treatment plan with a goal to stop gambling entirely.
Senator Raggio referenced Table 19 Differences in Physical and Mental Health between nonproblem and problem gamblers (Exhibit V), noting incidences of depression, alcohol, tobacco, and drug use in problem gamblers.
Senator Rawson stated the gaming industry supports this type of legislation.
There being no further testimony or comments, Senator Raggio closed the hearing on S.B. 349.
The chairman adjourned the meeting at 10:53 a.m.
RESPECTFULLY SUBMITTED:
Pamela Carter,
Committee Secretary
APPROVED BY:
Senator William J. Raggio, Chairman
DATE: