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From YouTube: 2/22/2021 - Assembly Committee on Commerce and Labor
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C
C
D
C
A
Here
thanks,
mr
secretary,
please
indicate
that
all
members
are
present
before
we
begin.
I
will
go
over
our
housekeeping
items.
Please
remember
all
exhibits,
written
testimony
and
amendments
must
be
submitted
by
noon
on
the
business
day
prior
to
the
committee
meeting.
People
who
wish
to
provide
testimony
or
attend
the
meeting
virtually
must
pre-register
online
by
visiting
the
legislature's
website
help.
The
public
is
strongly
encouraged
to
submit
written
testimony
in
advance
of
the
meeting.
A
Zoom
chat
is
reserved
for
committee
business.
Only
members,
please
remember
to
keep
your
camera
on
at
all
times.
This
will
ensure
that
we
have
a
quorum
unless
you
are
stepping
away
from
non-committee
related
business
members
and
presenters.
Please
remember
to
be
muted
at
all
times,
just
unmute
yourself
prior
to
speaking,
and
then
promptly
mute
yourself
when
you
are
done.
Thank
you
to
everyone
who
is
here
and
we
can
get
started
with
our
agenda
items.
We
have
three
bill
hearings
on
our
agenda.
E
Thank
you
so
much
good
afternoon
chairwoman
and
members
of
the
assembly
committee
on
commerce
and
labor,
I'm
theresa
benitez-thompson
representing
assembly,
district
27,
and
I
have
the
pleasure
of
sponsoring
assembly
bill
91,
which
seeks
to
add
an
advanced
practicing
registered
nurse
to
the
state
board
of
nursing,
a
quick
history
of
how
we
got
to
today's
bill
request.
E
The
aprn
licensing
designation
was
authorized
in
1987
and
allowed
an
aprn
to
provide
some
diagnostic
and
treatment
work
with
patients.
Well,
under
the
supervision
of
a
physician
by
1991,
there
were
1991
licensed,
active
aprns
in
nevada,
conversation
and
interest
about
increased
responsibility
for
the
profession
began
to
grow.
Many
of
these
attempts
have
been
successful,
but
it's
taken
some
time
in
1991
there
was
a
failed
attempt
to
allow
aprns
to
prescribe
controlled
substances.
E
This
was
a
significant
policy
shift,
allowing
the
profession
to
flourish
from
760
licensees
to
3
300
licensees
in
2015
assembly
bill
292
allowed
aprns
to
offer
certain
services
via
telehealth
and
in
the
last
two
legislative
sessions,
their
scope
of
work
has
increased
as
well.
They
can
now
sign
death
certificates.
They
can
write
provider
orders
of
life,
sustaining
treatment,
which
is
a
pulse
and
also
write
orders
for
home
health
care.
The
next
evolution
is
for
them
to
have
a
seat
at
their
professions
governing
board.
The
state
board
of
nursing
consists
of
seven
members
and
assembly
bill.
E
F
Thank
you.
Thank
you
very
much
assemblywoman
benitez
thompson
and
thank
you
so
much
for
your
support
of
this
bill.
I'm
kathy
dinauer
and
I'm
the
executive
director
for
the
board
of
nursing
and
as
assemblyman
assemblywoman
benitez
thompson
said.
We
have
over
3
200
nurse
practitioners
in
our
state
and
we
do
not
have
a
mandate
to
have
an
aprn
on
our
board.
F
We
have
been
fortunate
that
over
the
last
10
years,
by
sort
of
the
luck
of
the
draw,
we
have
had
an
aprn
who
is
on
the
board,
but
it
is
not
something
that
has
been
mandated
and
currently
two
of
our
rn
members
happen
to
be
aprns
and
aprns
represent
a
very
significant
population
of
nursing
in
our
state
and
have
and
having
representation
on
the
board
would
really
complement.
The
current
makeup.
F
Ab-91
would
not
increase
the
number
of
board
members,
but
would
require
that
one
of
the
rn
members
be
an
aprn
and
I've
provided
the
committee
with
a
map
of
states
that
require
an
aprn
to
be
on
their
board
and,
as
you
can
see
on
the
map,
most
states
do
require
between
one
or
more
aprns
to
be
on
the
board.
There's
only
a
few
states,
nevada
being
one
that
does
not
have
that
requirement.
So
that's
what
we're
seeking
with
ab91
and
I'll
answer
any
questions.
A
Thank
you,
mr
nauer
majority
leader
benitez
thompson
was
mr
hillary
going
to
be
presenting
with
you
as
well.
E
I
think
we
have
them
available
just
to
help
answer
questions,
but
I
think
mr
hilleby
did
you
have
prepare
comments.
G
Michael
hillary,
for
the
record,
no
matter
majority
leader
do
not
here
to
answer
questions.
C
Thank
you
chair
my
question
and
that
certainly
I'm
in
favor
of
that.
That
sounds
like
a
good
idea
to
put
that
into
statute.
What
the
practice
is.
I
just
had
a
question
on
section
that
would
be
section.
One
number
five,
where
we
had
member
of
the
board
may
serve
more
than
two
consecutive
terms
for
the
purpose
of
the
subsection
service
of
two
or
more
years
and
filling
an
unexpired
term
constitutes
a
term,
and
then
I
notice
that's
being
removed
without.
G
Assembly,
woman,
michael
hillary,
on
behalf
of
the
state
board
of
nursing,
that
in
2017
the
legislature
added
a
general
provision
in
nrs
622.207
that,
unless
specifically
identified
otherwise
all
title
54
boards
and
commissions
members
are
subject
to
three
term
limits
to
three
terms.
So
in
while
drafting
legal
made
the
recommendation
that
we
remove
that
language
so
that
we
were
consistent
with
the
legislature's
most
recent
intent
in
2017,
and
I
will
tell
you
that
language
dates
back
to
at
least
1947,
so
predates
even
me,
and
I've
been
around
here
a
while.
G
So
we
don't
really
have
the
history
on
why
there
was
originally
that
particular
limit
put
in
but
again.
A
A
I
C
I
B
Good
afternoon,
chair
and
members
of
the
committee,
my
name
is
cameron
duncan
c-a-m-e-r-o-n-d-u-n-c-a-n
and
I
am
a
practicing
primary
care
and
psychiatric
mental
health
nurse
practitioner
in
reno
nevada
and
I'm
also
the
vice
president
of
the
nevada,
advanced
practice,
nurses
association,
I'm
providing
the
statement
in
support
of
ab91
on
behalf
of
nasa,
dr
cindy
pitlock.
Our
president
has
also
submitted
a
written
statement
into
the
record
since
2013
when
full
practice
authority
was
provided.
B
They
will
advise
the
board
on
prescribing
standards
and
they're,
also
able
to
provide
expert
in
case
review
and
decision
making
on
disciplinary
cases,
which
is
important
to
protect
all
nevadans
across
the
state.
It's
also
important
to
note
that
nevada
state
board
of
nursing
is
a
member
of
the
national
council
of
state
boards
of
nursing.
B
I
A
A
I
A
A
E
I
appreciate
that
chair
reagan.
I
just
want
to
thank
the
committee
for
their
time
and,
of
course,
make
sure
you
know
that
I'm
available
to
have
any
additional
conversations
if
you
have
a
thought
later
today
or
the
next
couple
of
days,
anything
that
you
want
to
talk
about,
feel
free
to
reach
out
and
I'll
look
forward
to
hearing
from
you.
Thank
you
for
your
time.
A
L
Good
good
morning,
madam
chair
members
of
the
assembly
committee
on
commerce
and
labor,
my
name
is
steve
yeager
and
I
represent
assembly
district
nine
in
southwest
las
vegas.
It's
my
pleasure
this
afternoon
to
present
assembly
bill
101
to
you,
it's
nice
to
be
back
in
front
of
this
committee.
I
enjoyed
serving
on
the
committee
last
session,
so
I
I
miss
all
of
you
and
it's
a
pleasure
to
be
back
here
this
afternoon.
L
Madam
chair,
with
your
permission,
what
I
would
like
to
do
is
just
make
some
very
brief
introductory
remarks,
and
then
I
would
like
to
hand
it
over
to
the
experts
who
can
kind
of
talk
about
the
bill
and
how
it
might
work
in
the
real
world.
Those
include
jennifer,
pedego,
executive
director
of
the
state
nevada
board
of
veterinary
medicine.
L
Excuse
me
the
state,
the
nevada
board
of
veterinary
medical
examiner.
I
think
she
is
on
the
zoom
with
us
and
we
might
also
have
I'm
not
sure
if
it's
on
the
zoom
or
by
phone,
but
dr
stacy
hosking
veterinarian,
who
is
also
on
the
board
and
then
after
that,
we
would
be
happy
to
answer
any
questions
that
you
might
have.
L
L
A
L
L
J
I
thank
you,
chair
hardage
and
thank
you,
assemblyman
yeager
jennifer,
pedego
executive
director
of
the
nevada
veterinary
board
for
the
record
good
afternoon,
so
the
board
office
over
the
years
has
received
quite
a
number
of
inquiries
from
professionals
and
the
public
confused
about
their
ability
to
have
these
conversations
and
discuss
the
use
of
cbd.
There
isn't
a
lot
of
clarification
in
the
state
and
especially
from
the
federal
government.
J
J
One
of
the
most
fundamental
reasons
for
this
bill
is
to
allow
practitioners
who
are
informed
about
the
risks
and
benefits
of
cbd,
be
able
to
make
recommendations
and
have
discussions
about
product
safety
and
applicability
for
their
animals
and
treatment
and
have
that
relationship
with
the
pet
owners
about
this
product
and
as
assemblyman
yeager
stated,
we
do
have
dr
stacy
hosking,
who
is
a
veterinarian
as
well
as
an
internal
medicine
specialist,
a
veterinary,
obviously,
and
she
is
prob,
maybe
on
the
phone
line
or
in
the
public
comments.
J
M
Thank
you
very
much,
madam
chair,
so
I
guess
I
just
want
to
understand
so
you
they
wouldn't
actually
be
prescribing
this.
This
would
be
considered
a
therapy.
Where
do
we
think
the
veterinarians
are
going
to
be
getting
the
the
cbd
hemp?
What
whatever
they're
going
to
be
using?
M
J
Oh,
thank
you
vice
chair
carlton.
I
think
dr
hoskin
can
speak
specifically
about
types
of
products,
but
typically
in
the
sale
of
this
and
you're
correct.
There
is
no
prescription.
J
It's
it's
a
recommendation
now
by
the
definition
of
this
that
is
in
this
bill,
which
is
the
threshold
of
thc
less
than
0.3
percent.
That
is
the
threshold
of
the
federal
farm
bill
which
stipulates
that
that
is
considered
a
hemp
product.
J
So
the
testing
of
these
products,
which
is
I
I
don't
there-
is
an
issue
with
the
federal
testing.
Obviously,
the
fda
does
not
test
these,
like
they
do
with
other
supplemental
products,
but
we
do
have
testing
capabilities
here
in
nevada
and
a
lot
of
these
independent
companies
do
test
independently
and
from
what
I
understand
in
discussions
with
board
of
pharmacy.
J
The
stipulations
of
the
practitioners
have
to
be
that
they
have
at
least
investigated
the
efficacy
or
the
testing
parameters
of
these
products,
so
that
you
know
we're
not
getting
a
snake
oil
issue
here,
but
in
terms
of
a
regulatory
framework
that
only
exists
so
insofar
as
it
already
does
exist.
I
guess
I
would
say,
and
again
I
don't
know
if
dr
hosking
is
available
or
if
she's
on
the
public
line,
but
she
might
be
able
to
expand
more
on
that.
L
Madam
chair,
this
is
steve
yeager.
I
don't
see
that
she's
on
the
zoom
with
us,
but
I
suspect
she
may
be
on
one
of
the
call-in
lines
or
else
maybe
she
had
a
technical
difficulty.
But
might
I
suggest
for
questions
like
those
when
we
go
to
supportive
testimony?
I
think
if
she's
on
the
phone
she'd
be
able
to
answer
them
and
if,
for
some
reason
she
was
not
able
to
join
us
today,
I'm
taking
notes
of
all
these
questions-
and
I
certainly
can
circle
back
and
get
those
answered
for
committee
members.
A
C
Yeager
so
much
for
bringing
this
bill
about
three
and
a
half
years
ago
I
had
a
yorkie
who
was
treated
by
actually
dr
hoski,
and
she
had
several
tests
done.
Nothing
was
conclusive,
but
it
was
a
respiratory
thing
and
I
asked
about
cbd
treatments
and
of
course
they
could
not
guide
me
because
it
was
illegal.
So
I
did.
C
A
C
Chair
and
thank
you
for
the
presentation,
my
question
might
be
one
that
requires
some
follow-up
afterwards,
but
you've
mentioned
veterinarians,
who
are
informed
or
veterinarians
have
that
have
investigated
the
cbd
and
how
to
to
to
work
with
it.
My
question
is:
are
there
any
training
or
education
that
veterinarians,
who
are
not
familiar
with
this,
can
get,
or
is
there
some
way
for
them
to
find
more
education
and
more
information
about
it?.
J
Sorry
didn't
quite
get
contact
with
them.
You
button.
Thank
you
for
the
question
assemblywomanconsidine.
So
yes,
short
story
or
you
know
short
short
form.
There
are
continuing
education
courses
that
are
available
both
from
a
scientific
and
treatment
perspective
and
using
it
as
a
therapy
and
then
also
from
a
product,
safety
and
efficacy
standpoint.
We
don't
have
specific,
or
at
least
our
board
does
not
have
specific
requirements
of
requiring
that.
But
there
is
that
information
available
to
practitioners.
D
Thank
you,
madam
chair.
I
apologize
I'm
having
internet
issues
also.
I
just
need
some
explanation
if
they
could,
on
section
one
two
where
it
reads,
the
board
shall
not
take
any
disciplinary
action
against
a
licensed,
veterinarian,
etc,
etc,
engages
in
the
practice
of
medicine
solely
for
administering
or
recommending
the
use
of
products
pursuant
to
subsection
one.
So
the
only
thing
the
vet
is
working
on
is
cbd.
Only
can
you
explain
that
where
that
would
be
in
the
practice.
J
Thank
you
assembly
mononeal.
I
don't
know
if
I
specifically
understand
your
question.
The
inclusion
of
that
was
to
ensure
that,
and
again
the
very
specific
nature
of
that
statement
is
the
solely.
J
J
Yeah,
it's
cbd,
it's
just
this
particular
act
and
in
that
respect,.
D
J
Thank
you,
assemblyman
o'neill,
and
I
I
do
think
that
would
be
I
can
get
about.
Halfway
to
that
question
and
dr
hosking
may
be
able
to
answer
it
further.
J
We
don't
have
information
on
how
it's
being
used
now
in
veterinary
practices,
because,
as
far
as
we
know,
it's
not
being
discussed
or
used
in
veterinary
practices
because
of
the
lack
of
this
protective
layer,
at
least
for
those
discussions
in
the
human
in
the
pet
owner
avenue.
I
imagine
that
it's
a
very
big
industry,
just
on
the
basis
of
the
prevalence
and
saturation
of
these
products
that
are
available
either
online
or
in
in
just
the
general
marketplace,
so
I
do
foresee
it
being
a
decent
market.
It
does
have
limits
if
it's
used.
J
You
know
when
used
appropriately.
It's
and
advertising,
obviously
for
scope
of
this
of
this
treatment.
For
you
know
it's
not
going
to
cure
cancer,
at
least
as
far
as
we
know,
based
on
medical
evidence
from
veterinary
studies
that
have
been
done,
but
it
does
have
great
potential
for
use
in
pain
management,
there's
studies
being
done
for
epilepsy
and
again
that's
information
dr
hosking
could
speak
to,
but
given
the
current
market
for
pets
in
general,
there
is
a
large
basis
for
which
this
could
be
used.
A
A
Thank
you
thank
you,
broadcasting
and
it
looks
like
I
did
have
dr
stacy
hosking
signed
in
in
support.
She
might
have
just
had
significant
technical
difficulties
and
not
been
able
to
get
on
video.
Okay,
I
don't
see
I
have
anyone
signed
in
on
video
for
opposition.
Can
we
check
the
phone
line
to
see
if
there's
anyone
on
the
phone
line
for.
I
L
L
I
want
to
thank
you
for
hearing
the
bill.
I
think
what
we're
trying
to
do
is
make
sure
that
veterinarians
aren't
punished
for
either
administering
or
recommending
this
kind
of
treatment,
because
in
some
cases
it
will
be
appropriate
and
right
now
it's
really
just
kind
of
a
a
gray
area.
A
J
No,
I
just
wanted
to
thank
the
committee
today
for
hearing
this
bill
and
I
did
confirm
with
dr
hosking.
She
was
hitting
the
buttons
as
much
as
she
could
and
wasn't
getting
through,
so
I
will
make
sure
to
get
follow-up
from
her.
So
thank
you
for
your
time.
I
appreciate
it.
A
Thank
you
everyone.
I
will
now
close
the
hearing
on
assembly
bill
101.
Our
last
bill
for
the
afternoon
is
assemblyville
81.
I
will
now
open
the
hearing
on
assembly
bill
81.
I
believe
I
have
assembly
member
haven
here
to
present
the
bill
assembly
member
haven,
welcome
to
the
committee
and
when
you're
ready,
you
can
get
started.
N
Thank
you
and
good
afternoon,
chair
howdy
and
members
of
the
assembly
committee
on
commerce
and
labor.
I
am
gregory
hayfin
ii
representing
assembly
district
36,
and
it
is
my
absolute
honor.
I
am
very
grateful
to
be
presenting
assembly
81
today
for
your
consideration.
N
Existing
law,
which
is
codified
in
nrs,
629
or
50,
currently
prohibits
healthcare
providers
who
have
not
actively
practiced
their
profession
continuously
for
the
immediately
proceeding
three
years
from
providing
voluntary
health
care
services
in
association
with
a
sponsoring
organization
such
as
the
remote
area,
medical
or
ram
program.
N
N
However,
he
did
not
meet
the
requirements
under
the
existing
law
in
the
department
of
health
and
human
services
had
to
decline
his
services,
as
they
noted
residents
throughout
nevada,
especially
the
rural
areas,
benefit
from
these
free
pop-up
medical
clinics.
In
paramp,
a
citizen
came
to
a
free,
pop-up
clinic
sponsored
by
ram
to
receive
gentle
work.
N
A
dental
provider
with
the
ram
program
was
able
to
address
her
dental
needs
and
she
now
has
been
placed
on
a
transplant
list.
Without
this
voluntary
health
care
work,
she
may
not
have
been
able
to
have
this
opportunity
further.
I
have
met
with
the
department
of
health
and
human
services,
the
deputy
directors,
deborah
hassett
and
beth
handler.
They
have
no
issues
or
concerns
and
remain
neutral
on
assembly
bill
81..
N
Several
health
care,
related
agencies
and
organizations
support
assembly
bill
81,
including,
but
not
limited
to
amr
and
medic
west
ambulance,
culinary
health
fund
desert
view
hospital
dignity,
health,
healthy
communities,
coalition,
the
nevada
state
society
of
anesthesiologists,
nevada,
orthopedic
society,
ny
community
coalations,
net
county
manager,
tim
sutton
and
the
state
board
of
optopastic
medicine
and
then
touching
on
the
bill.
Section,
subsection
2c
of
section
1
of
the
bill
removes
the
restriction,
the
provider
of
healthcare
who
has
not
actively
practiced
his
or
her
profession
continuously,
with
immediately
proceeding
three
years
from
providing
voluntary
health
care
services.
N
With
the
help
of
these
volunteers,
nevada,
rural
residents
have
an
opportunity
to
receive
the
care
they
desperately
need.
In
order
to
live
a
healthier
life,
then
I
wanted
to
touch
on
nevada,
revised
statute
629-430,
as
a
few
questions
have
come
up
relating
to
medical
professionals
who
are
retired
and
have
not
practiced
within
the
most
recent
three
preceding
years
and
the
possibility
of
them
practicing
in
a
hospital
setting
and
possibly
doing
surgical
procedures.
N
I
have
caroline
deberry,
the
chief
external
officer
for
ram
here,
to
touch
a
little
bit
further
on
that,
but
before
I
turn
it
over
to
her,
I
am
proposing
a
very
minor
amendment
that
I'm
very
happy
to
do.
As
this
was
a
pre-filed
bill.
N
Senators,
hardy
and
senator
orrinshaw
and
assembly
members
hanson
hardy
leavitt,
matthews,
wynn,
o'neal,
orton,
liquor,
titus
torres
and
tolls
would
all
like
to
be
added
as
co-sponsors
to
this
bill
and,
as
I
stated
previously
today,
caroline
deberry
is
here
to
provide
some
additional
information
to
the
committee
and
at
the
end
of
her
testimony,
we
will
both
be
available
to
answer
questions
of
the
committee.
A
H
Okay,
I
apologize.
Hopefully
this
is
even
better
all
right
good
afternoon
chair
how
to
gee
and
members
of
the
assembly
committee
on
commerce
and
labor.
For
the
record,
I
am
caroline
deberry
chief
external
affairs
officer
for
remote
area,
medical
or
ram.
I
am
honored
to
be
here
today
to
support
assembly
bill
81.
Thank
you
so
much
for
this
opportunity.
H
H
The
law
currently
allows
providers
with
out-of-state
licenses
to
provide
volunteer
free
quality
health
care
with
a
sponsoring
organization
such
as
remote
area,
medical
assembly,
bill
81
would
broaden
this
important
law
by
removing
the
law's
current
restriction.
That
requires
any
such
volunteers
to
have
been
actively
practicing
for
at
least
three
years
before
providing
these
health
care
services.
Remote
area
medical
wholeheartedly
supports
this
legislation
because
it
would
increase
the
number
of
volunteers
who
can
provide
desperately
needed
free
health
care
services
throughout
nevada,
remote
area.
H
Medical
is
an
international
nonprofit
that
has
been
providing
free,
dental
vision
and
medical,
pop-up
or
mobile
clinics
for
over
35
years.
Ram
relies
on
its
thousands
of
volunteers
with
unencumbered
licenses
from
all
over
the
nation
to
provide
these
free
services.
In
the
last
several
years,
ram
has
held
14
such
weekend.
Clinics
in
nevada,
such
as
in
perron
for
our
clinics
in
perron
bram,
has
worked
with
his
partner.
The
nine
communities
coalition
to
ensure
a
list
of
volunteer
providers
is
submitted
to
the
department
of
health
and
human
services.
H
The
department
then
completes
a
thorough
vetting
of
the
volunteers.
Even
before
the
pandemic
ram
witnessed
firsthand
the
crisis
our
nation
was
already
facing.
We
saw
the
growing
underserved
population
and
growing
shortage
of
healthcare
workers.
Now,
during
and
after
the
pandemic,
the
needs
are
and
will
be
greater
than
ever.
The
three-year
requirement
currently
in
statute
reduces
the
amount
of
free
healthcare.
Nevadans
can
access
assembly
bill.
H
N
Thank
you,
caroline,
and
this
is
again
assemblyman
gregory
hayfin
ii,
for
the
record,
and
I
wanted
to
just
add
two
quick
things.
One.
The
other
thing
that
one
of
the
other
things
that
this
bill
does
is
brings
us
further
into
compliance
with
a
recent
bill
that
was
passed
in
the
congress.
It's
called
it's
hr
2216
and
this
bill
provides
an
appropriation
of
56
million
dollars
to
help
assist
the
the
programs
and
the
volunteers
throughout
the
nation,
and
so
there's
there's
federal
dollars
that
are
available
to
to
assist.
N
A
M
Here
we
go.
Thank
you,
madam
chair
and
good
afternoon,
mr
aphan,
so
I
guess
one
of
the
things
I'd
I'd
like
to
clarify,
though,
is
you
read
off
a
list
of
folks
that
were
in
support,
but
only
some
of
those
I
have
letters
on
so
if
they're
listed
on
another
document,
as
in
in
support
I'd
like
to
get
a
copy
of
that,
because
I
see
that
you
do
have
some
of
these
other
letters
here,
but
you
listed
some
that
weren't.
M
So
if
those
are
available
somewhere
and
I've
missed
them,
I'd
like
to
be
sure
and
get
a
copy,
and
this
is
basically
changing
assembly
bill
228
from
the
2013
session
that
I
worked
on
with
then
assemblyman
tom
grady
on
this
issue,
and
he
did
a
very
good
job
of
trying
to
address
an
issue
that
had
come
up
and
being
able
to
get,
and
this
was
really
more
focused
on
volunteers
coming
in
from
outside
the
state
rather
than
from
inside
the
state.
There
was
never
talk
of
recent
graduates.
M
Really.
We
were
looking
at
experienced
medical
providers
being
able
to
come
in
and
volunteer
in
the
state
to
give
these
services
and
in
go
going
back
and
and
rereading
it
to
make
sure
that
I
remember
correctly.
We
specifically
put
that
three
years
in
because
we
wanted
to
make
sure
that
folks
had
some
experience
and
knew
what
they
were
doing,
and
we
also
wanted
to
be
able
to
take
a
look
at
their
record.
In
case
there
had
been
a
problem
in
another
state.
We
didn't
want
someone
who
was
having
issues
coming
to
nevada.
M
M
Is
that
if
it's
volunteer
health
care
you're
protected
by
the
good
samaritan
law,
so
the
the
patient
has
no
recourse
if
any
harm
is
done,
so
that
that
was
one
of
the
issues
that
he
and
I
had
spoke
about,
talked
with
the
sponsors
of
the
bill
back
then
and
in
2013,
and
and
they
were
very
comfortable
in
having
that
three
years.
So
I
have
concerns
about
eliminating
the
three
years.
N
Yes,
through
youtube's
chair
to
assemblywoman
carlton,
I
would
be
more
than
glad
to
provide
you
with
copies
of
the
letters
of
support.
N
It
was
brought
to
my
attention
during
this
committee
hearing
that
some
of
the
letters
of
support
for
some
reason
were
not
able
to
be
uploaded
to
nellis,
and
I
guess
that's
been
an
ongoing
problem
with
our
virtual
committee
hearings
and
part
of
the
issues
of
trying
to
zoom
everything.
N
But
I
would
be
more
than
glad
to
address
that
in
regards
to
the
previous
legislative
intent
not
being
for
recent
graduates.
I
greatly
appreciate
you
bringing
that
up.
We've
run
into
this
the
last
two
years
with
the
ram
program,
and
we
have
extensively
talked
to
the
department
of
health
and
human
services
and
legal
counsel
for
the
lc
at
the
lcb,
because
I
too
did
not
believe
that
that
was
the
intent
of
the
laws
to
prohibit
recent
graduates
from
providing
voluntary
services.
M
And
madam
chair,
I
want
to
make
sure
something's
perfectly
clear.
I
wasn't
saying
that
I
agreed
with
mr
hafen.
I
was
stating
that
the
three
years
was
put
in
there
for
protection
purposes,
so
we
because
of
the
three
years
we
never
discussed
the
other
side.
So
I'm
not
saying
that
I
agree
and
or
support
this
particular
provision.
I
have
serious
concerns
about
allowing
someone
who
has
not
been
in
practice
on
their
own
being
able
to
do
this
this,
but
the
original
bill
was
aimed
at
folks
coming
in
from
outside
of
the
state.
M
So
I
believe
allowing
recent
graduates
is
a
totally
different
conversation
when
it
comes
to
that
and
my
biggest
concern
is
when
you
eliminate
this
from
the
bill,
we
will
not
be
able
to
look
at
those
people
coming
in
from
outside
the
state
and
they
could
have
a
current
malpractice
suit
or
be
under
some
type
of
discipline
from
another
board
in
another
state
and
there's
nothing
we'll
be
able
to
do
about
it
because
we
will
have
eliminated
that
three
years.
A
Thank
you
vice
chair
carlton,
I
believe
speaker
fryerson,.
O
Thank
you,
madam
chair,
and
thank
you
so
much
and
thank
you
for
getting
back
to
me.
You
provided
us
with
a
copy
of
the
bill
and
my
question
and
I
addressed
it
with
you-
was
actually
looking
at
the
three-year
provision
differently.
O
Just
correct
me:
if
I'm
wrong
my
reading
is
that
by
removing
it
there
is
no
time
requirement
or
limitation,
so
it
could
also
go
the
other
way,
and
was
it
contemplated
that
someone
could
not
practice
for
20
years
and
be
able
to
provide
this
service,
so
it's
kind
of
on
the
opposite
end
of
the
spectrum
of
of
a
new
practitioner.
O
N
And
thank
you
through
you,
chair
to
mr
speaker,
and
I
appreciate
the
question
and
it
brings
it
back
to
assemblywoman
carlton's
question
as
well,
and
the
department
of
health
and
human
services
does
an
extensive
vetting
program
to
ensure
that
every
professional
that
comes
into
this
state
and
is
going
to
be
providing
services
is
fully
vetted.
N
In
addition
to
that,
in
a
hospital
setting
which
this
bill
doesn't
really
affect
the
hospital
settings,
they
would
have
to
go
through
the
privilege
program.
Our
process,
which
is
a
six
to
eight
month,
process
of
vetting
the
individuals
and-
and
I
do
have
mr
berry
here-
that
can
hopefully
further
expand
on
how
the
the
vetting
process
goes.
So
we
can,
we
do
ensure
that
everyone
that
comes
here
to
practice
doesn't
have
those
outstanding
malpractice
concerns
and
is
fully
qualified
to
do
so.
H
I'm
caroline
deberry
through
you
chair
to
assembly,
member
hayfit.
I
thank
you
so
much
for
this
opportunity
to
clarify
so
so
again
and
I'll
lean
closer
to
the
microphone
again.
So
again,
I'll
use
the
parom
clinic
examples.
Those
are
our
most
recent
nevada
clinics.
We
work
with
our
partner
to
submit
a
list
of
volunteer
providers
to
the
department
of
health
and
human
services
and,
as
assembly
hayfin
was
saying,
the
department
does
a
complete,
thorough
vetting
of
the
volunteer
providers
and
then
gets
back
with
everybody.
H
You
know
making
sure
that
that
these
are
providers
that
they
trust
to
handle
this
properly.
The
other
key
piece
of
that
is
ram,
of
course,
also
does
our
check
to
make
sure
that
there
is
no
unencumbered
license
to
and
so
to
an
earlier
comment
or
concern.
H
If
someone
is
a
recent
graduate,
so
you
know
they're
they're
a
fully
licensed
provider,
they
can
go
to
any
doctor's
office,
dentist's
office
whatever
and
practice
freely,
without
any
any
challenges
or
restrictions
that
same
provider
then
can
if
this
requirement
is
removed,
can
go
ahead
and
then
provide
their
same
quality
free
services
at
our
clinics,
as
opposed
to
only
in
a
paid
environment.
So
that's
really.
The
only
difference
here
is
trying
to
remove
that
three-year
requirement.
That's
not
imposed
on
them.
H
If
they're
getting
paid
it
removes
it
so
that
then
they
can
still
do
the
same
quality
work
just
in
a
free
environment,
providing
it
as
on
a
volunteer
basis.
You
know
at
these
clinics-
and
so
then
also-
and
I
mentioned
this
earlier,
but
I
want
to
kind
of
reiterate
that
and
kind
of
bouncing
off
of
or
going
off
of
what
assembly
member
haven
said.
H
There
is
federal
legislation
that
has
been
introduced
in
the
past
couple
congresses
and
has
gained
some
interest
even
from
senator
schumer's
office
and
others,
and
this
legislation
would
incentivize
states
to
pass
laws
similar
to
nevada's
and
it
was
partially
written.
It's
called
the
healthier
act
and
the
last
congress
it
was
h.r
2216
has
been
very
bipartisan,
and
even
prior
congresses
and
the
national
council
of
state
boards
of
nursing
and
the
federation
of
state
medical
boards
worked
to
help
write
that
legislation
and
that
legislation
does
not
include
a
three-year
requirement.
H
O
Just
just
a
little
bit,
it
is
helpful.
I
think
it
would
be
helpful
for
this
committee
to
get
some
backup
support
from
the
department
about
that
vetting.
That
takes
place
to
make
sure
that
I,
I
think
to
my
colleagues,
satisfaction
having
been
a
bill
that
she
worked
on
some
years
ago.
O
That
number
one
folks
are
qualified
number
two.
Their
background
is
being
looked
into
and
for
me
number
three
that
they're
not
stale,
that
that
they're,
not
someone
who
has
been
out
of
practice
for
20
years
and
is
coming
in
providing
some
type
of
service
that
you
know.
Maybe
technology
has
left
them,
maybe
advances
since
they
last
practiced
have
left
them
and
what
that
process
is.
But
I
think
it
would
be
helpful
for
the
committee
if
we
could
get
some
information.
O
Excuse
me
some
information
from
the
department
about
that
vetting
process
to
give
some
folks
in
comfort
that
we're
not
you
know
putting
some
folks
in
in
in
more
harm's
way
than
than
not,
and
I
don't
obviously
that's
not
the
intent.
So
I
think
that
the
information
from
the
department
would
be
helpful.
P
Thank
you,
madam
chair,
for
the
question
and
thank
you
assemblyman
hafen,
for
bringing
this
forward.
P
My
questions
are
just
a
little
bit
different,
so
she
mostly
talked
about
the
the
ram
organization.
So
is
it
would
it
be
primarily
limited
to
rural
areas
or
it
could
be
throughout
the
state?
And
then,
if
you
could
just
talk
a
little
bit
about
the
specifics
as
to
what
these
volunteer
providers
could
do
like
you
know,
you
mentioned
dental
some
vision.
P
N
H
Thank
you
very
much,
caroline
deberry
through
you,
chair
to
the
assembly
member.
Yes,
that
is
correct.
This
would
apply
to
throughout
the
state.
This
is
not
exclusive
to
rural.
As
a
little
background,
remote
area,
medical
was
founded
to
really
address
rural
regions,
but
a
lot
of
times.
The
requests
that
we
have
actually
do
come
as
well
from
metro
areas,
and
so
on
is
really
wherever
there's
a
health
care
shortage
need.
H
And,
yes,
we
do
very
primary
care
type
services
and
we're
certainly
not
going
to
be
trying
to
do
some
complex
surgery
like
brain
surgery
or
anything
like
that.
We
usually
set
up
in
a
location
such
as
a
fairgrounds
gymnasium,
so
on.
We
have
bring
in
the
necessary
equipment,
make
sure
everything
is
sterilized
and
so
on
and
the
format
for
these
are
yes
basic
dental
procedures.
H
We
actually
have
more
requests
for
dental
extractions
than
almost
any
other
dental
procedure,
but
also
cleanings
and
so
on,
and
then
again,
typical
checkups
helping
provide
you
know
helping
our
patients
recognize
that
they
have
diabetes,
or
you
know
different
things
like
that
and
then
trying
to
connect
them
with
the
nearest
local
resources.
That
may
be
available.
P
Yes,
thank
you.
I
appreciate
that
that
gives
some
clarity
and
you
know
I
too
agree
that
we
want
to
make
sure
that
these,
the
people
that
we
are
volunteering
they're
properly
vetted,
and
you
know
so
that
we
have
that
security
and
safety
is
to
the
these
folks
that
are
providing
services.
So
thank
you.
A
I
want
to
follow
up
on
assemblymember
hardy's
question
and
you
might
have
answered-
and
I
just
missed
it,
but
is
there
a
list
of
services
that
can
be
provided
in
a
list
of
services
that
can't
be
provided
at
these
affairs.
H
This
is
caroline
deberry
to
the
chair.
I
believe
that
question
was
directed
to
me
if
that's
correct,
but
yes,
we
can
certainly
provide
a
list
of
the
services
that
we
do
provide.
That
is
not
something
I
have
submitted
for
the
record,
but
I'm
more
than
happy
to
share
that
later
on
and
then,
of
course
also,
we
work
with
the
state
to
make
sure
we're
aware
of
what
services
are
able
to
be
provided
and
so
on.
A
Yes,
if
you
could
mr
berry,
if
you
could
provide
that
list
to
our
committee
manager,
so
she
can
distribute
it
to
the
committee.
I'd
like
to
see
a
list
of
what
services
are
approved
for
the
fairs
and
what
services,
what
services
are
approved.
A
You
and
I
would
assume
that
services
not
listed
on
there
cannot
be
performed
at
the
fairs.
I
have
assembly
member
dickman
next.
Thank
you
so
much.
M
Madam
chair,
I
just
wanted
to
say
it
with
the
critical
medical
shortages
that
we
have
in
our
state
and
especially
in
the
rural
areas.
It.
C
N
Chair
through
you
to
assemblywoman
dickman,
first
and
foremost,
I
would
be
more
than
glad
to
add
additional
co-sponsors
and
it's
an
honor
to
be
here
today
and
to
an
honor
to
have
as
much
support
as
I
do,
and
then
I
just
did
want
to
just
touch
on
on
what
you
just
stated,
because
I
I
do
agree
with
the
governor's
recent
executive
directive.
That
is
actually
doing
exactly
what
you
just
said.
N
It's
allowing
medical
professionals
that
are
licensed
in
any
state
to
come
in
here
and
actually
work,
whereas
my
bill
is
just
opening
up
the
volunteer
voluntary
portion
of
this,
and
so
I
think
many
of
us
know
that
the
governor-
and
I
don't
always
agree
on
things.
But
this
is
one
thing
that
I
do
agree
with
him
and
think
that
he's
done
an
excellent
job
on.
A
A
I
I
B
Thank
you
chair
and
members
of
the
committee
for
the
record.
This
is
dylan
keith
k-e-I-t-h
with
the
vegas
chamber.
We
are
in
support
of
ab-81,
as
it
has
long
been
a
priority
of
both
the
vegas
chamber
and
the
southern
nevada
forum
to
fix
the
doctor
shortage
that
we
have
in
this
state.
We
believe
this
is
a
step
in
the
right
direction,
especially
for
our
medically
underserved
commit
communities.
I
B
Thank
you
chair.
How
did
you
and
to
all
the
committee
members?
My
name
is
ryan
luccio
r-y-a-n-m,
as
in
mary?
U
c
c,
I
o
I'm
the
co-chair
for
the
prem,
promote
area,
medical
events
as
well
as
the
secretary
of
the
board
for
the
nia
communities
coalition,
which
is
the
sponsoring
organization
for
the
ram
clinic
the
past
six
years.
B
I'm
calling
today
to
voice
my
support
for
ab-81,
as
I
have
personally
witnessed
over
the
past
six
years,
how
counter-productive
the
portion
of
the
law
in
question
has
been
to
the
ability
to
our
ability
to
serve
individuals
who
otherwise
would
not
be
able
to
access
quality
healthcare,
as
assemblyman
haven
mentioned
during
the
2020
ram
event.
We
met
a
lady
who
was
not
able
to
receive
a
kidney
transplant
until
she
cleared
up
infections
in
her
mouth,
fortunately,
because
of
our
partnership
with
unlv
dental
students
and
other
dental
providers.
B
Last
year
we
did
have
enough
dental
providers
and
were
able
to
provide
care
for
her,
and
she
was
able
to
make
it
onto
the
transplant
list
without
an
event
like
this
there's,
no
telling
what
the
outcome
would
have
been
on
behalf
of
our
entire
ram
committee
and
the
citizens
who
have
received
care
from
our
clinics.
I
would
greatly
appreciate
your
support
of
ab-81.
Thank
you
for
your
time
and.
I
C
C
I
just
wanted
to
briefly
call
in
to
leonard's
support
and
acknowledge
that
we
have
provided
a
letter
of
support
to
the
committee
on
behalf
of
saint
rose,
of
which
I
noticed
our
letter
was
one
of
those
that
hadn't
been
added
to
the
exhibits
for
this
hearing.
So
I
will
send
around
the
letter
to
the
committee
members
once
again
for
your
viewing
after
this,
and
then
I
also
wanted
to
put
on
the
record
that
dignity,
health
nate
rose
dominican
is
in
support
of
80
91,
not
on
opposition,
as
mentioned
in
the
first
bill
hearing.
C
A
I
D
Madam
chair
members
of
the
committee,
it's
mark,
fiorentino
last
name
is
f.
I
o
r
e
n
t
I
n
o.
Thank
you
for
the
opportunity
to
speak
briefly.
I
do
represent
nye
county
and
I
am
calling
to
express
our
support
of
this
bill
as
you
as
you've
heard.
Obviously,
there
are
a
number
of
people
in
nye
county,
especially
in
perup,
and
I
suspect
in
many
other
areas
of
the
state
who
depend
on
these
volunteer
services
to
obtain
medical
care.
D
In
fact,
many
of
them
probably
would
have
no
access
without
the
volunteer,
so
we're
supportive
of
the
bill,
and
I
am
offering
my
services
to
assemblyman
hafen
and
you,
madam
chair,
and
the
committee
members.
It
seems
like
the
concerns
that
have
been
raised
about
making
sure
that
professionals
are
vetted
and
qualified
and
up-to-date
on
knowledge
is
something
that
we
can
work
through
and
I'm
happy
to
work
with
the
sponsor
of
the
bill
and
the
committee
to
to
help
get
us
there
and
be
happy
to
answer
any
questions
that
you
have.
D
I
A
C
C
We
fully
ensure
that
they
have
a
current
license
and
have
no
outstanding
malpractice
or
motions
against
their
license
of
any
sort
and
would
be
otherwise
well
qualified
to
practice
in
the
state
and
I'd
be
happy
to
send
documentation
that
provides
support
of
our
our
processes
to
the
committee
managers
for
your
review.
Thank
you.
A
I
K
K
Nine
communities
coalition
has
hosted
the
remote
area
medical
for
the
last
six
years
and
has
collaborated
on
a
variety
of
other
volunteer
medical
events
in
our
rural
frontier
communities.
For
many
years.
A
key
issue
in
our
area
and
across
the
state
is
our
access
to
medical,
dental
and
vision
care.
Much
of
the
state
is
identified
by
the
hersa
and
the
usda
as
medically
underserved
areas.
K
The
volunteer-based
events
are
so
important
to
our
community
members
and
they
give
us
this
opportunity
to
get
access
to
the
medical,
dental
and
visual
care
that
many
of
them
would
not
have
the
process
established
through
the
registration
of
the
sponsored
free
health
care.
Events
that
ms
heatherd
was
just
speaking
for
allows
the
state
of
nevada
and
the
host
agency
to
screen
those
health
care
providers
to
ensure
that
the
medical
professionals
are
going
to
provide
quality,
safe
care
to
our
communities.
K
I
participate
in
this
process
every
year
and
engage
with
the
division
of
health
to
ensure
that
the
professional
volunteers
are
qualified
and
able
to
safely
serve
our
community
members
they're
going
to
be
referred
back
to
the
staff
at
night
communities
coalition
for
follow-up
they're
going
to
be
contacting
us,
so
I'm
going
to
want
to
make
sure
that
these
people
are
receiving
the
best
possible
care
they're.
My
neighbors
there's
my
friends
they're
my
clients
and
I'm
going
to
be
interacting
with
them
for
years
to
come.
K
Removing
the
restrictions
on
the
years
of
practice
will
allow
us
to
increase
the
number
of
community
members
served
while
continuing
to
deliver
those
quality
services
during
the
2019
ram
event
and
prompt
one
community.
Member
told
me
this
was
the
first
dentist
that
she
had
seen
in
more
than
15
years.
K
N
Thank
you,
madam
chair
and
committee
members.
I
greatly
appreciate
the
opportunity
to
present
today
and
as
promised
I
will,
I
will
provide
you
with
a
couple
of
the
letters
of
support
that,
for
some
reason,
did
not
make
it
up
on
nellis
and
we
will
work
on
getting
you
some
additional
information
on
the
vetting
process,
as
well
as
the
list
of
services
that
are
approved.
N
Having
said
that,
I
thank
you
so
much
for
this
opportunity
and
look
forward
to
answering
any
further
questions
you
may
have.
Thank
you.
A
Thank
you
member
happening.
Yes,
it
was
the
list
of
services
provided
at
the
fairs.
What
type
of
vetting
is
done
and
then
also
just
the
documentation
on
how
you
addressed
the
point
that
speaker
fryerson
made
as
well
on
a
practitioner
who
might
be
licensed
for
20
years,
but
has
been
out
of
the
practice
for
20
years,
making
sure
that
they're
still
that
they're
not
stale
to
you?
Thank
you.
I
will
now
close
the
hearing
on
assembly
bill
81
members.
This
brings
us
to
our
last
item
on
the
agenda
public
comment.
A
A
I
would
like
to
remind
those
who
will
be
testifying
under
public
comment
or
giving
providing
public
comment
that
this
is
an
opportunity
to
discuss
general
matters
that
fall
within
the
purview
of
this
committee.
The
public
has
already
given
has
been
given
time
to
support
or
oppose
a
specific
legislation,
and
we
open
and
close
hearings
on
bills
so
that
we
establish
a
record
of
the
public
testimony
on
the
bill.
Therefore,
public
comment
is
not
intended
to
be
a
continuation
of
a
bill
hearing
broadcasting.
A
Can
we
check
to
see
that
there
check
to
see
if
there
are
members
or
public
on
the
telephone
line
to
get
public
comment.