MINUTES OF THE
SENATE Committee on Human Resources and Facilities
Seventy-second Session
March 17, 2003
The Senate Committee on Human Resources and Facilities was called to order by Chairman Raymond D. Rawson, at 1:56 p.m., on Monday, March 17, 2003, in Room 2135 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 Raymond D. Rawson, Chairman
Senator Barbara K. Cegavske, Vice Chairman
Senator Maurice E. Washington
Senator Dennis Nolan
Senator Joseph Neal
Senator Bernice Mathews
Senator Valerie Wiener
GUEST LEGISLATORS PRESENT:
Senator Alice Costandina (Dina) Titus, Clark County Senatorial District No. 7
STAFF MEMBERS PRESENT:
H. Pepper Sturm, Committee Policy Analyst
Patricia Vardakis, Committee Secretary
OTHERS PRESENT:
Robert Desruisseaux, Independent Living Specialist, Northern Nevada Center for Independent Living, Nevada Statewide Independent Living Council
Mary Liveratti, Deputy Director, Department of Human Resources
Jon L. Sasser, Lobbyist, Washoe County Senior Law Project
Michael J. Willden, Director, Department of Human Resources
We have two bill draft requests (BDRs) for introduction.
BILL DRAFT REQUEST 32-1180: Increases tax on transfer of real property. (Later introduced as Senate Bill 385.)
SENATOR CEGAVSKE MOVED TO INTRODUCE BDR 32-1180.
SENATOR NEAL SECONDED THE MOTION.
THE MOTION CARRIED. (SENATORS WASHINGTON AND NEAL WERE ABSENT FOR THE VOTE.)
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BILL DRAFT REQUEST 40-957: Revises provisions concerning visitation rights of patients of certain health care facilities and disposition of body of person upon death. (Later introduced as Senate Bill 386.)
SENATOR WIENER MOVED TO INTRODUCE BDR 40-957.
SENATOR CEGAVSKE SECONDED THE MOTION.
THE MOTION CARRIED. (SENATORS WASHINGTON AND NEAL WERE ABSENT FOR THE VOTE.)
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Chairman Rawson:
I am putting Senate Bill (S.B.) 235 into subcommittee. There is a technical error in the bill. This is a complex issue and there have been many amendments submitted. It will return to our committee for a hearing. If there are any amendments for this bill, please submit them for consideration.
SENATE BILL 235: Revises provisions governing payment of hospitals for treating disproportionate share of Medicaid patients, indigent patients or other low-income patients. (BDR 38-746)
Chairman Rawson:
We have two issues for consideration Senate Concurrent Resolution (S.C.R.) 11, and Senate Bill (S.B.) 239.
SENATE CONCURRENT RESOLUTION 11: Urges Department of Human Resources to establish statewide informational and referral system for health, welfare, human and social services. (BDR R-680)
SENATE BILL 239: Requires Department of Human Resources to establish statewide information and referral system for health, welfare, human and social services. (BDR 40-702)
Senate Bill 239 has a fiscal note. It would be beneficial to hear and take testimony on both the bill and resolution. If S.B. 239 is processed, it will be re‑referred to the Senate Committee on Finance because of the fiscal note.
Robert Desruisseaux, Independent Living Specialist, Northern Nevada Center for Independent Living, Nevada Statewide Independent Living Council:
We were involved with the State of Nevada Department of Human Resources Strategic Plan for Seniors and People with Disabilities. This was one of the recommendations. The 211 system and the recommendations are detailed on pages 107 through 109 in the plan.
Chairman Rawson:
Senator Titus has arrived and will give her remarks on S.B. 239. We will then resume with Mr. Desruisseaux’s testimony.
Senator Alice Costandina (Dina) Titus, Clark County Senatorial District No. 7:
This is a recommendation that came from our interim study on the State’s programs for the disabled. Senate Bill 239 is described on page 14 of the State of Nevada Department of Human Resources Strategic Plan for Seniors and People with Disabilities. We need to move toward One Stop Shopping or No Wrong Door. Many people told us there were services available, but not everyone is aware of them. There is a need for a clearinghouse and better coordination of those programs, especially for the disabled community because accessibility is key for them. This recommendation would establish, develop, and find a 211 universal access line for Nevada. This would ensure one system for individuals to obtain programs about social services. It would be similar to a 911 number. The 211 system would be informational for the disabled thereby moving us toward the No Wrong Door.
Chairman Rawson:
I indicated to the committee we would process the resolution and the bill.
Senator Neal:
Did a particular circumstance lead to this introduction?
Senator Titus:
A recommendation came from the Study of State Program for Providing Services to Persons with Disabilities. Caregivers, members of the disabled community, experts in the field, and governmental agencies all spoke on the issues. The committee concluded there was a need for the State to coordinate the services available and make them accessible for this group of people.
Senator Neal:
Did this come to light because someone did not receive services due to the absence of the 211 number?
Senator Titus:
We heard this complaint repeatedly.
Chairman Rawson:
There were hours of testimony on the issue.
Senator Cegavske:
Is there a system in place which can be implemented by July 1, 2003?
Senator Titus:
The agency can answer your question. The interim committee made strides in getting the system together. Another recommendation is to reorganize in the Executive Branch in order to create an office for the disabled and bring State programs together.
Mr. Desruisseaux:
Senator Tutus covered the need for S.B. 239. The need became apparent to us to develop a system outside of government. We looked at the United Way. They have a track record in Florida and other states. Instead of creating an additional burden in State government, it was our hope to create a community partnership to develop this concept and run it through an agency such as the United Way.
Chairman Rawson:
We will pursue your request.
Mary Liveratti, Deputy Director, Department of Human Resources:
I am here to support the development of a statewide information and referral system accessed by dialing 211. I will read my written testimony (Exhibit C). We do not believe legislation mandating a 211 system should be passed at this time. We suggest passage of S.C.R. 11, which would allow the Department of Human Resources to continue to develop a business plan, identify funding sources, and work with community partners to determine the best implementation strategy.
Chairman Rawson
Mr. Desruisseaux, do you have any concerns about whether we pass the bill or resolution?
Mr. Desruisseaux:
The Strategic Plan Committee’s consensus was the need for this system not to be disputed. The disabled community feels strongly it should not be within State government.
Senator Wiener:
Could you tell us what the 311 and 711 systems are (Exhibit C)?
Ms. Liveratti:
The 311 number is for nonemergency police services. The 711 number is for the relay services for the deaf.
Senator Wiener:
Page 2, line 7 of S.B. 239 refers to information updated periodically. Would every community in Nevada be able to access the 211 number? If so, will the information be localized?
Ms. Liveratti:
We anticipate all local resources will be available. The Atlanta, Georgia regions’ system is on a city- and countywide basis, and it is expanding to be a statewide service. We could have a regional basis in Nevada. Ann Corey, of United Way, told me all three United Way Organizations support the 211 concept. Keeping data accurate and up-to-date is very important for this system to be effective. Also, there are training issues. The staff needs to have the most current information. They need to know how to access information for people who call the 211 number.
Senator Wiener:
In a referral-type system, endorsement of services can be a problem. Do the providers of services meet certain standards? Will you have to address that issue? Is there a level of competence required of those people offering services?
Ms. Liveratti:
It would be like our legal and doctor referral services with the same type of screening used in those systems. Yes, there is a danger when you give a number to someone; it is like a seal of approval. We would be wary of not giving that impression.
Chairman Rawson:
People will be calling the number for help. I envisioned case managers and social workers being able to access cases from this type of system, and ensuring people receive appropriate help. It is a more complex issue than it seems on the surface.
Senator Cegavske:
Have other states or models been studied?
Ms. Liveratti:
We did study other states. In December, people from Atlanta came and talked to us about their system. There is a national effort to get a 211 system across the United States, especially with homeland security. It is becoming more important to have an integrated system to reach the public. Twenty percent of the United States have 211 systems.
Senator Cegavske:
How many states have systems?
Chairman Rawson:
Approximately 10 states.
Senator Cegavske:
Is there information in the interim study we can examine?
Chairman Rawson:
Yes.
Senator Cegavske:
Senate Concurrent Resolution 11 does not have a time line. This system will not come together in a short period of time.
Senator Wiener:
Another alternative would be to make the effective date 2005.
Chairman Rawson:
We could turn the bill into a report and forward it to the Seventy-third Legislative Session along with the budgets. This would keep it moving.
Senator Neal:
How did you calculate your costs?
Ms. Liveratti:
We studied other states. We judged what would be reasonable for our State using a nationwide report. We do not have details of the local exchange carrier telephone companies’ costs. The charges could be per region, per minute, or per call. There are varied pricing methods.
Senator Wiener:
Have any of the phone companies volunteered to join in partnership?
Ms. Liveratti:
Yes.
Jon L. Sasser, Lobbyist, Washoe County Senior Law Project:
I speak in favor of the 211 concept. It is also an important concept for children’s health and the Nevada’s Covering Kids Coalition. The concern for the committee is how to move this issue forward without a detailed cost estimate or money to deal with the issue this session. I suggest the committee do a report and forward it back with a budget. If this bill goes to the Senate Committee on Finance, they may have the ability to write a letter of intent. They would report back to the Interim Finance Committee on how this issue is unfolding. Some mechanism is needed to keep the Legislature involved.
Chairman Rawson:
Is this issue complicated enough to do an interim study?
Mr. Sasser:
There is a lot of work to be done.
Chairman Rawson:
Another approach would be to amend the bill and create an interim study. We could put consultants to work on creating the system.
Mr. Sasser:
I agree, but the Department of Human Resources may have thoughts on the subject.
Chairman Rawson:
Do you have concerns?
Michael J. Willden, Director, Department of Human Resources:
I do not have a problem with your suggestion. There is a guideon how to install a 211 number. The guide has many details and to go over each one is a slow process. It would take until July 2004 to put in place all the processes reported by Ann Corey to the committee. There is a significant amount of processing to be accomplished just to put a system in place. Even if money were available, it would be a year before we could implement the system.
Chairman Rawson:
Do you know how much money would be needed?
Mr. Willden:
The Atlanta system was over $900,000 the first year, and $1,400,000 the second year. It depends on the call volume and what the anticipated volume will be. I agree, professionals, and not an information referral system, should answer the calls.
Chairman Rawson:
If the committee passed the resolution, will the department work on this issue?
Mr. Willden:
Absolutely. This is in the strategic plan and is one of the plan’s accountability issues we intend to work on through the next year. It is a long-term plan and a top priority. It will change the culture throughout the department. We have the No Wrong Door philosophy: a person should be able to go to any service organization and receive information about all the available services. We intend to work on the senior and disability plans.
Chairman Rawson:
We will close the hearing on S.B. 239 and S.C.R. 11.
SENATOR CEGAVSKE MOVED TO ADOPT S.C.R. 11.
SENATOR WIENER SECONDED THE MOTION.
THE MOTION CARRIED UNANIMOUSLY.
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Chairman Rawson:
We will take no further action on S.B. 239 at this time. Senate Bill 235 will be placed in subcommittee. The members of the committee will be listed in the posting. There are no further issues for this meeting. I adjourn this meeting at 2:26 p.m.
RESPECTFULLY SUBMITTED:
Patricia Vardakis,
Committee Secretary
APPROVED BY:
`Senator Raymond D. Rawson, Chairman
DATE: