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From YouTube: 5/11/2021 - Assembly Committee on Ways and Means
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C
A
And
I
am
here
and
please
mark
assemblywoman
how
to
be
absent
excused,
so
we
have
a
number
of
bills
before
us
this
evening,
committee
we'll
start
off.
We
have
two
bdr
introductions
so
that
we
can
get
them
to
the
floor
tomorrow
and
get
them
right
back
to
us.
Then
we
have
some
agency
bills
and
some
personal
bills.
A
My
intent
is
to
move
the
bills
in
the
400
series
to
keep
them
moving
so
that
everything
is
staged
appropriately.
So
unless
there's
an
issue
as
we
work
through
these,
it
would
be
the
chair's
intent
to
get
these
things
taken.
Care
of
ways
and
means
will
meet
as
long
as
senate
finance
this
evening.
There's
other
work
to
be
done
when
both
committees
are
free,
so
finance
ends
before
us.
Any
bills
that
are
left
over
will
be
rolled
until
our
next
meeting,
but
if
they
go
longer
than
us,
then
we
can
get
our
work
done.
A
C
Revising
certain
deadlines
for
requiring
requirements
placed
on
board
of
county
commissioners
relating
to
transfer
of
responsibilities
for
the
provisions
of
indigent
defense
services
to
the
state
public
defender
and
provides
other
matters
properly
related.
There
too,
do
you
want
me
to
do
the
other
one.
A
C
This
act
relates
to
crime
requiring
the
division
of
child
and
family
services
at
the
department
of
health
and
human
services.
To
the
extent
money
is
available
for
the
per
for
this
purpose
to
designate
a
statewide
center
to
provide
assistance
to
certain
victims
authorizing
the
administrator
of
the
division
to
accept
any
gifts,
grants,
donations,
requests
or
other
sources
of
money
for
the
purposes
of
carrying
out
the
duties
related
to
the
center
and
providing
matters
properly
relating
there,
too,.
A
A
Ms
kaufman
mentioned,
if
not
I'll,
take
a
motion
from
vice
chair
monroe,
moreno
second
from
mrs
bidenos
thompson,
any
other
questions
or
comments,
seeing
none
all
those
in
favor,
please
signify
by
saying
aye
any
in
opposition
hearing
no
opposition
passes
unanimously,
we'll
send
them
to
the
floor,
so
they
can
send
them
right
back
to
us.
So
with
that,
let's
go
ahead
and
get
our
agenda
rolling
for
this
evening.
The
first
bill
that
we're
going
to
be
talking
about
will
be
assembly.
A
Bill
461
makes
an
appropriation
to
the
office
of
attorney
general
for
the
cost
of
replacing
standard,
glass
windows
and
doors
with
ballistic
glass
and
frames
at
the
carson
city
office.
So
miss
adair
nice
to
see
you
this
evening.
I'm
sorry
we
have
to
talk
about
a
bill
like
this,
but
I
guess
that
day
has
come.
So
if
you
would
please
go
ahead
and
just
give
us
a
high
level
overview
of
the
bill
and
then
we'll
ask
some
questions.
D
Thank
you,
chair,
jessica.
Dare
for
the
record
my
feelings
exactly!
I'm
also
joined
today
by
our
cfo
jessica
hoban.
This
is
a
very
limited
replacement
of
this
glass.
It
is
just
for
the
two
windows
for
the
attorney
general's
personal
office
here
in
the
carson
city
office,
as
well
as
the
window
that
faces
carson
street
with
the
attorney
general's
executive
conference
room.
D
A
And
thank
you
very
much
and
I
guess
my
question
would
be
is
how
did
you
decide
which
windows
to
be
placed,
because
we
know
a
lot
of
people
work
on
the
first
floor
and
we
want
to
make
sure
everyone
is
safe.
So
what
were
the
discussion
points
and
did
you
consider
more
or
less?
How
did
you
settle
upon
this
particular
amount
of
renovation.
D
Thank
you,
chair
jessica
there
for
the
record.
We
made
this
decision
based
upon
some
specific
threats
to
the
attorney
general
himself.
Unfortunately,
rather
than
the
office
as
a
whole,
I
agree
with
you
that,
ideally,
we
would
likely
replace
all
of
the
glass,
but
that
seemed
to
be
cost
prohibitive,
for
particularly
for
this
building,
it's
a
historic
building,
and
so
they
have
to
replace
the
glass
in
a
specific
way.
D
However,
there
aren't
many
staff
whose
office
windows
are
on
the
ground
floor
that
face
carson
street,
it's
mainly
the
ag's
office
and
that
executive
conference
room,
so
that
was
another
factor
in
our
in
our
decision.
A
And
thank
you
for
putting
that
on
the
record.
We
just
want
to
make
sure
that
we
understand
it
fully.
A
number
of
years
ago
there
was
a
proposal
to
build
in
all
types
of
interior
barriers
and
such
and
I
remember
seeing
the
diagrams
and
when
you
walked
into
the
attorney
general's
office,
it
was
going
to
look
like
you
were
going
through
the
airport
and
we
just
said.
No,
we
don't
think
that's
the
perception
that
we
want.
A
So
I'm
glad
you're,
considering
the
outside
glass
and
trying
to
maintain
the
historic
components
I'm
going
to
channel
assemblywoman,
heidi
swank.
For
just
a
moment.
I
think
she
would
approve
of
a
ballistic
glass.
She
would
understand
replacing
those
windows
so
with
that
committee
members.
Are
there
any
questions
for
mr
darren
in
the
attorney
general's
office?
Ms
miller,
thank.
B
You
chair
and
miss
adair.
That
was
my
line
of
questioning
too,
considering
that
it
is
a
historic
building
and
we
want
to
keep
the
you
know
that
that
historic
look
to
it,
but
also
with
structurally-
and
you
already
mentioned
that
you
know
getting
estimates
based
on
because
it
will,
the
actual
renovations
will
be
different.
Based
on
you,
know
the
age
of
the
building
and
such
is
this
total
right
here.
The
final
estimate,
because
again
any
type
of
renovations,
especially
trying
to
keep
something
structurally
sound
like
this,
is
there
a
possibility
that
it
would.
D
Thank
you,
assemblywoman
jessica
there
for
the
record.
We
worked
with
a
another,
a
an
approved
vendor,
as
well
as
buildings,
and
grounds
to
ensure
that
that
the
vendor
was
an
appropriate
vendor
who
understood
how
to
replace
glass
in
a
historic
building
and
ensure
that
there
was
going
to
be
no
damage
to
the
building
or
a
any
change
in
the
appearance
of
the
building
that
it
would
just
look
like
a
different.
The
glass
would
just
be
replaced.
D
I
don't
believe
that
we
will
go
over
that
estimated
cost,
because
that
is
the
quote
that
we
received.
I
suppose
anything
is
possible
when
working
with
the
vendor
and
if
they,
if
they
see
that
their
initial
quote,
wasn't
accurate.
However,
we
don't
anticipate
that
happening,
because
that
number
is
from
the
vendor
itself.
G
Thank
you,
madam
chair.
I
thank
you
for
the
presentation
not
having
been
in
the
committee
that
heard
this
initially.
I
was
just
curious
if
there's
any
other
buildings
in
the
state
or
any
other
offices
that
are
looking
at
in
the
future,
to
have
this
type
of
renovation.
D
Jessica,
dare
for
the
record
not
that
I
know
of
the
ag's
office
and-
and
I
can
only
speak
to
the
ag's
office.
The
ag
has
three
offices
in
our
three
main
buildings:
reno
las
vegas
and
carson
city
in
las
vegas.
His
office
is
located
in
a
place
that
we
believe
is
more
more
secure
or
less
less
of
an
obvious
threat.
I
I
hate
to
talk
about
this.
D
It
makes
me
so
sad,
but
his
office
is
not
located
immediately
off
of
a
busy
street
and
in
the
reno
office
we
actually
released
from
a
private
office
building
that
there
is
no
window
access
that
we
have
to
be
concerned
about.
I
can't
speak
to
the
other
agencies
or
what
they
might
be
interested
in
doing
based
upon
their
security,
but
I
don't
believe
that
we
have
any
other
intention
to
make
any
changes
to
our
office
based
upon
the
information
that
we
have
at
this
time.
Great.
G
Thank
you
follow
up
man,
I'm
sure
I
guess
I
didn't
realize
that
I
now
realize
that
this
wasn't
in
a
another
committee,
so
it
hasn't
had
those
kind
of
questions
hadn't
been
asked.
So
thank
you
for
that
indulgence.
I
just
was
wondering
if
there's
any
other
departments,
if
he
had
a
if
this
is
a
perceived
threat
or
actual
threat,
because
again
there
are,
it
is
a
crazy
world.
We
live
in.
G
I
like
the
chair,
I'm
sorry
that
we
have
to
have
a
discussion
to
protect
our
folks
and
if
we
have
to
have
it,
we
have
to
have
it,
but
there's
other
departments
that
have
certainly
been
under
a
lot
of
stress.
This
last
election
cycle
wanted
to
make
sure
that
we're
keeping
all
nevada
all
nevadans,
oliver
elected,
safe
and
so
just
want
to
know
if
there
was
any
other
future
plans
to
to
expand
this.
D
Jessica,
dare
for
the
record.
That
is
a
great
question.
We
unfortunately
have
been
in
receipt
of
information
due
to
our
position.
That
would
indicate
that
a.g
ford
is
not
the
only
recipient
of
these
kinds
of
threats,
but
I
can't
speak
to
the
plans
of
other
state
agencies
to
fortify
for
lack
of
a
better
word,
their
their
buildings.
G
A
Committee
members,
are
there
any
other
questions
at
this
time,
not
seeing
any
other
questions.
This
is
the
hearing
for
assembly
bill
461,
so
we'll
go
ahead
and
open
it
up
for
support
opposition
and
neutral
so
broadcast
services.
If
you
would
check
the
phone
lines
please
to
see
if
there
is
anyone
in
support
of
assembly
bill.
A
Thank
you
very
much
so
with
that
we'll
close
the
hearing
on
assembly
bill
461
and
we
will
open
up
the
hearing
on
assembly
bill
462,
making
an
appropriation
to
the
department
of
corrections
for
an
upgrade
to,
and
reintegration
of,
certain
management
systems,
replacement,
cameras,
storage
area
networks
and
ovens.
This
is
the
one
I've
been
waiting
for.
I
want
to
hear
about
this
oven,
but
we
have
had
conversations
previously
about
replacement
cameras
and
and
the
network
so
with
that.
I
I
So
notice
is
our
fender
management
system
that
we've
had
since
we
implemented
in
2007
and
at
the
time
we
had
that
we
had
purchased
the
and
implemented
the
module
to
do
our
offender
sentence.
Management
legislation
came
down
that
we
had
to
do
aggregation,
so
we
in-house
we
pulled
that
out
of
notice
and
we
built
an
application
in-house
well,
as
time
has
gone
on,
we
no
longer
have
that
position
is
vacant,
so
we
no
longer
have
an
employee
in
in-house
to
work
on
the
back
end
of
that
in
the
code.
I
So
if
this
were
to
fail,
it's
mission
critical,
we
wouldn't
be
we'd,
be
out
of
compliance
with
the
laws
for
the
state
of
nevada.
I
We
have
the
ability
to
put
it
back
into
notice
and
they
have
the
ability
to
do
real-time
calculations
and
so
we'd
have
real-time
reports
for
the
various
offices
that
also
use
this,
and
we
would
do
reporting
to
and
then
the
other
part
of
this
is
the
whole
notice
system.
We
would
be
upgrading
that
to
their
next
generation
version
right
now.
It's
a
standalone
application
that
uses
internet
explorer,
which
is
reaching
its
end
of
life
for
support.
I
A
Yes,
yes,
okay,
good,
tell
me
about
the
oven.
I
I
Madam
chair
and
honorable
members
of
the
committee
for
the
record,
my
name
is
adrian
monroe,
I'm
the
acting
chief
of
physical
for
the
department,
the
combi
ovens
are
a
very
versatile
but
very
expensive
oven.
It's
called
a
combi
because
it's
really
a
combination
oven.
I
It
can
do
cooking
with
steam
or
dry
air
like
a
convection,
oven
or
a
combination
of
both
high
desert
state
prison
has
had
the
five
combi
ovens
that
were
original
to
the
institution
back
in
the
year
2000
and
the
the
expected
asset
life
cycle
of
this
piece
of
equipment
is
15
to
20
years.
If
you
take
good
care
of
it,
so
we
definitely
reached
our
end
of
life
on
that
we
had
a
health
inspection
in
october
of
2019.
I
I
They
are
so
old
that
we
can
no
longer
get
parts
for
them,
so
we
really
need
to
make
sure
that
we
have
a
sufficient
number
of
ovens
to
feed
the
3
500
inmates
daily,
and
this
this
request,
this
funding
request
of
102
747,
will
afford
us
the
purchase
of
three
base
model,
combi
ovens
with
the
minimal
packages
that
are
required
for
prison
packages
that
have
safe,
safe
door
locks
and
some
other
things
on
them.
A
Thank
you
very
much.
We
appreciate
it.
My
curiosity
has
been
been
dealt
with
so
with
that
committee
members.
Do
we
have
any
questions
for
the
department
at
this
time?
I
believe
the
assemblywoman
tolls
thank.
D
A
Okay,
so
with
that
not
seeing
any
other
serious
questions,
thank
you
for
dealing
with
the
committee
this
evening.
It's
been
it's
been
a
crazy
week
and
it's
only
tuesday,
so
seeing
no
other
questions.
This
is
the
hearing
on
assembly
bill
462,
let's
bring
it
back
in
so
with
that
we'll
go
to
broadcast
services.
If
you
could,
please
open
up
the
phone
lines
for
anyone
who
may
be
in
support
of
assembly
bill
462.
A
Thank
you
very
much
broadcast
services.
We
will
go
ahead
and
close
the
hearing
on
assembly
bill
462
and
we
will
open
up
the
hearing
on
assembly
bill
463
makes
a
supplemental
appropriation
to
the
state
department
of
conservation
and
natural
resources
for
an
unanticipated
shortfall
in
the
forest
fire
suppression
budget.
Account
we've
seen
this
one
a
number
of
times
before
so
with
that.
If
I
could
have
the
agency
hello,
miss
casey
casey,
how
are
you
this
evening.
A
I
Thank
you
good
evening,
madam
chair
members
of
the
committee
for
the
record
casey
casey
state
forester,
fire
warden
for
the
nevada
division
of
forestry
assembly
bill
463
is
a
supplemental
appropriation
request
for
the
division
that
covers
projected
shortfalls
in
the
forest.
Fire
suppression
budget
account
in
the
amount
of
two
million
three
hundred
and
fifty
nine
thousand
one
hundred
and
sixty
eight
dollars.
I
I
The
incident
the
ndf
incident
billing
unit
is
caught
up
to
fy
21
fire
bills,
excluding
cost
share
and
fire
management
assistance
grants.
Fires
which
take
much
longer
to
finalize
the
billing
process,
will
be
further
expedited
and
made
more
accurate
with
the
new,
automated
fire
billing
system
approved
in
the
last
legislative
session,
ndf
has
received
the
new
fire
billing
system
and
is
currently
training.
Our
federal
and
local
government
partners
on
inputting
their
data
into
the
system,
so
they
can
begin
use.
All
users
will
begin
using
this
automated
billing
system
on
july
1st
of
this
year.
A
And
thank
you
very
much
miss
casey,
so
we
have
one
number
in
the
bill
and
then
we
have
an
amendment
proposed.
Would
you
please
repeat
the
number
to
make
sure
that
I
have
the
most
accurate
data.
I
A
G
Thank
you,
madam
chair,
and
thank
you
director
for
being
here.
I
I
just
wonder
I
saw
the
exhibits
with
this
bill
and
that's
from
the
city
of
loughlin
supports
it,
but
I'm
wondering,
and
then
you
mentioned
the
new
billing
system,
which
I
greatly
appreciate,
because
I've
been
critical
of
the
past
of
you
submitting
requests
for
additional
funds
from
bills
that
you
received
that
happened
years
ago.
So
hopefully
it's
current,
but
I
don't
see
anything
about
this
particular
two
million.
I
Thank
you,
dr
titus,
for
the
question
for
the
record
again:
casey
casey,
the
expenditures
for
this
two
million
three
hundred
and
fifty
nine
thousand
one.
Sixty
eight
are
for
past
expenses
for
past
and
current
year
fires.
So
those
are
all
of
the
cooperators
or
agency
staff
that
showed
up
to
fight
the
fires,
the
contractors
everything
that
we
we
are
required
to
pay
for
for
past
fire
years.
I
So
there
should
have
been
a
backup
in
the
spreadsheet
that
showed
all
of
the
expenses
that
are
incurred
today,
and
we
did
try
to
just
put
into
the
supplemental
the
things
that
we
know.
We
need
to
pay
currently
not
projecting
a
whole
lot
of
future
needs,
as
we
know,
we're
going
to
start
a
new
budget
in
july
1st.
A
Thank
you,
dr
titus,
so
miss
casey,
one
of
the
things
that
has
been
pointed
out
to
me,
is
that
the
five
million
dollars
that
was
allocated
to
the
agency
through
the
interim
finance
committee
over
the
summer,
the
conversations
that
we
had
around
that
apparently
there
was
no
reversion
date
of
unspent
funds
put
in
there.
A
So
if
there
would
happen
to
be
some
out
of
mount,
it
would
just
sit
there
and
not
have
any
direction
on
what
to
go
so
we're
contemplating
having
an
establishment
of
a
reversion
date
out,
like
maybe
june
30th
of
2025,
give
you
plenty
of
time
to
use
it.
We
just
want
to
make
sure
that
money
doesn't
sit
in
account
and
never
really
gets
cleared
out
as
as
things
change.
So
that
will
be
one
of
the
consideration
points
that
we
address
when
we
process
the
bill.
I
Thank
you,
madam
chair,
for
the
question
again
for
the
record:
casey
casey.
No,
I
talked
to
elsie
fiscal
staff
today
and
I
was
aware
of
that
change
and
we
very
much
actually
appreciate
that
change.
We
wanted
to
move
these,
that's
a
lot
of
money
for
us.
We
it's
tied
to
a
large
grant.
We
have
with
or
our
program
we
have
with
nv
energy,
so
it's
matching
those
funds
and
we
have
allocated
a
good
portion
of
those
to
local
government
fire
districts
in
order
to
get
a
lot
of
work
done.
A
Okay,
thank
you
very
much
committee
members.
Are
there
any
other
questions
of
miss
casey
not
seeing
any?
This
is
the
hearing
for
assembly
bill
463
we'll
go
ahead
and
go
to
broadcast
services
and
open
it
up
if
we
could
have
folks
in
support,
please.
A
Okay,
thank
you
very
much
so
committee
members.
At
the
end
of
the
meeting,
we
will
come
back
and
deal
with
these
three
bills,
so
keep
them
in
your
memory
for
right
now,
with
that,
we
will
go
ahead
and
go
to
the
top
of
the
order.
We
have
miss
gorlo
with
two
bills:
we're
just
going
to
have
her.
Do
them
both
at
one
time.
So
we
first
step
will
be
assembly
bill
189
and
then
we
will
go
to
assembly
bill
216..
K
K
Expansion
of
eligibility
for
pregnant
women
to
200
percent
of
the
federal
poverty
level
will
provide
insurance
to
more
women
and
the
estimate
of
pregnant
women
between
ages,
12
and
44
is
3640
in
fiscal
year
2022
and
3749
in
fiscal
year.
2023,
eliminating
the
five-year
residence
requirement
for
legal
residents
would
also
provide
health
coverage
to
more
women.
It
is
estimated
that
this
program
would
serve
approximately
52
women
in
fiscal
year,
2022
and
97
in
fiscal
year
2023.
K
Lastly,
providing
postpartum
care
from
60
days
to
one
year
giving
birth
can
be
difficult
on
a
woman's
body,
especially
if
there
are
already
complications
such
as
gestational,
diabetes,
preeclampsia
or
cesarean
section,
which
accounts
for
over
30
percent
of
the
deliveries
in
nevada.
In
addition,
women
can
suffer
from
postpartum
depression
and
in
severe
cases
psychosis.
K
However,
if
we
add
the
addition
to
the
postpartum
coverage,
that
would
add
an
additional
three
million
seven
hundred
and
seventy
three
thousand
five
hundred
and
twelve
dollars
coverage
for
legal
residing
pregnant
women
would
be
seventy
five
thousand
one
hundred
sixty
nine
dollars
and
again,
the
additional
impact
for
the
postpartum
care
coverage
would
be
an
additional
one
hundred
and
twelve
thousand
two
hundred
and
nine
dollars
and
then
the
twelve
month.
Postpartum
coverage
would
be
eight
million
one
hundred
and
thirty
dollars
480s.
K
A
You
very
much
miss
gorlow
in
the
document
that
I
have
of
this.
The
summary
I
have
some
different
numbers
so
please
be
sure
that
the
document
that
you're
reading
from
you
make
available
to
the
committee
members
so
that
we
have
that
and
then
I'm
going
to
go
to
mr
young
to
possibly
help
us
walk
through
some
of
these
numbers
to
make
sure
that
what
I
have
on
my
chart
and
what
you
have
and
what
they
have
all
comes
together.
A
Not
seeing
any
questions
so
with
that
I'm
going
to
go
to
mr
young
and
mr
young,
if,
if
you
could
help
us,
go
through,
we
see
the
original
fiscal
note,
but
we
realized
it
was
amended.
So
you
guys
got
out
the
calculator
and
you
did
a
number
on
this
one.
Didn't
you
so
just
want
to
make
sure
that
we
actually
understand
how
you
came
to
arrive
at
some
of
these
numbers.
L
B
L
Deeply,
we
would
go.
I
may
turn
over
some
to
her
as
well
as
miss
lisa
suerjen,
who
is
the
chief
of
eligibility
and
payments
to
address
the
dwis
portion,
which
is
the
eligibility
portion
just
on
presumptive
eligibility
for
the
department
of
health
and
human
services,
and
for
the
record
I
am
dwane
young,
deputy
administrator
of
programs
for
the
division
of
health
care
financing
and
policy.
L
We
can
actually
walk
through,
and
the
document
that
assemblywoman
gorlo
was
actually
walking
through
is
something
that
we
provided
to
her
to
just
help
prepare
for
this
presentation
tonight.
So
we
can
go
to
a
couple
different
pieces.
Obviously
I
think
probably
one
of
the
easiest
to
understand
is
the
coverage
for
lawfully
residing
pregnant
women,
and
so
these
are
women
who
are
lawfully
resigning
united
states,
but
not
have
have
not
not
yet
met
their
five-year
requirement
for
residency
during
the
2017
session.
L
If
you
remember,
there
was
a
bill
that
expanded
this
for
children.
It
is
allowable
to
also
receive
match
to
expand
this
for
the
mothers,
and
we
did
not
do
that
at
that
time
in
2017,
and
so
this
that
this
is
that
component,
it
would
estimate
really,
as
simply
when
gorlo
pointed
out,
and
so
the
total
computable
on
that
is,
is
about
108
thousand
dollars
on
the
state.
General
fund
portion
would
be
37
000..
She
did
provide
an
additional.
A
Mr
young,
if
I
could
stop
you
for
just
a
moment,
if
you're
referring
to
any
particular
budget
category,
either
3178
3158,
where,
where
you
actually
are,
so
that
I
can
help
track
where
these
these
numbers
actually
belong,
if
it's
actually
in
one
of
the,
if
is
it
in
one
of
the
fiscal
notes,
because
I
know
they
amended
one
bill
into
the
other,
so
are
we
talking
what
category
are
we
in?
So
I
know
which
sheet
of
paper
I'm
looking
at.
That
would
be
very
helpful.
A
A
L
And
these
are
purely
demonstrated
for
medical
cost
within
3243.
For
this
fiscal
note,
the
additional
figure
that
assemblywoman
gorilla
quoted
is
the
addition
that,
if
the
committee
and
what
we
did
is
we
tried
to
break
this
out
into
piecemeal
because
it's
a
marriage
of
options.
But
if
the
committee
did
pass
the
additional
portion
that
says
for
12
months,
postpartum
coverage
that
state
general
fund
obligation
in
3243
would
jump
from
37
000
to
55,
000
and
so,
and
that
would
also
increase
the
total
computable
amount
from
108
000
to
161
000.
L
There
is
no
county
obligation
for
this
aid
category,
and
so
these
are
all
only
state
and
federal
funds
that
we're
discussing.
L
The
next
and
I
will
will
be
the
presumptive
eligibility
portion
this
this
category
is
all
in
3243
because
it
speaks
to
our
portion
and
I'll
turn
it
over
to
ms
swear
to
walk
through
the
dewis
new.
Our
portion
speaks
to
the
expanded
categories
of
coverage
and
so
the
expanded
months
of
coverage.
L
As
we
know,
many
of
these
women
would
be
newly
eligibles
or
parent
and
child
category
and
fall
within
managed
care,
particularly
because
they
live
in
the
urban
areas,
some
with
them
fee
for
service
and
so
there's
a
calculation
of
the
additional
fee
for
service
expenditures,
as
well
as
the
managed
care
capitation
months,
and
that
is
in
3243,
and
that
is
a
total
computable
of
454
000,
with
a
state
fund
obligation
of
155
000
again,
there
are
no
county
match
funds
on
this,
so
we're
speaking
solely
to
state
or
federal.
L
This
calculation
is
not
impacted
by
the
additional
postpartum
months,
and
so
this
figure
is
solely
dealing
with
that
extra
months
of
eligibility
in
those
pre-trimesters
of
catching
those
individuals.
Early.
L
L
I
do
see
only
the
presumptive
eligibility
piece
that
we've
just
discussed.
Now.
That's
posted
that
these
numbers,
these
numbers
should
track
to
the
same.
A
And
I
don't
think
we
have
the
fiscal
note
for
193.,
so
I
I
have
a
document
that
refers
to
193,
but
I
don't
believe
a
fiscal
note
for
1
9.
We
actually
have
a
fiscal
note
for
193,
but
now
that
we
know
where
to
look,
we
can
figure
it
out
just
wanted
to
make
sure
that
we're
working
off
of
the
same
song
sheet.
A
Okay,
if
you
would
go
ahead,
I
type
what
we're
going
to
do
is
because
we've
started.
I
don't
want
to
just
stop
and
not
go
forward
if
you
would
go
ahead
and
just
walk
us
through
a
couple
more
of
the
components
and
then
I'm
going
to
ask
you
to
put
all
this
together
in
a
little
more
comprehensive
package
for
us
and
send
it
to
ms
gorlo
and
myself.
So
we
can
go
over
it
and
make
sure
that
we're
all
on
the
same
page
and
then
I'll
forward
it
on
to
to
fiscal
staff.
A
They've
got
a
lot
of
other
things,
they're
trying
to
deal
with
right
now
so
we'll
take
this
over.
But
when
we're
done
here,
I'd
like
you
to
put
together
a
document
that
gives
us
a
a
real
picture
of
this
to
make
it
a
little
bit
easier,
rather
than
a
fiscal
note
for
189
and
a
fiscal
note
for
193
that
we
have
to
merge
together.
We're
going
to
ask
you
to
do
that
for
us
and
get
it
to
us
and
then
we'll
be
able
to
move
forward.
L
Most
certainly,
please
accept
my
apologies
chair
that
we
will
find
out
what
the
disconnection
from
getting
over
from
the
governor's
finance
office
to
you
all
the
combined
note.
We
will
provide
that
to
you
as
well
as
the
document
that
we
provided
assemblywoman
gorlo,
to
prepare
her
for
the
presentation
this
evening.
The
last
two
components
of
this
is
the
expansion
to
200
percent
of
the
federal
poverty
level.
You
know,
as
mentioned
earlier,
32
states,
including
nevada,
have
expanded
federal
poli
poverty
level,
but
cms
allows
that
expansion
up
to
200.
L
This
would
be
moving
that,
and
so
we
looked
at
a
total
computable
and
again.
This
is
for
the
additional
impact
of
covering
those
capitated
member
months
within
managed
care,
as
well
as
the
additional
fee
for
service
claims
for
that
postpartum
period
a
year.
We
currently
I
mean
for
those
additional
women
that
are
covered
up
to
200
percent,
and
so
there
are
two
components
of
this
again.
L
One
is
the
fiscal
note
that
is
quoted
as
eight
million
in
year,
one
and
10
million
in
year,
two
of
state
general
funds,
and
there
is
an
additional
enhancement
of
three
million
in
each
state
year.
Roughly
that,
if
this
committee
were
to
consider
passing
the
additional
point
of
12
months,
postpartum
coverage
that
we
do
not
cover
that
would
be
covered
in
this
period
of
covering
those
women
up
to
those
additional
fmap,
because
they
would
be
covered
for
their
traditional
coverage
as
well
as
that
extended
portion.
L
Currently
we
cover
up
to
60
days
postpartum,
and
then
these
women
are
then
out
of
the
market,
and
so
this
sole
fiscal
note
looks
at
what
it
takes
to
expand
that
coverage
for
those
additional
10
months
and
again,
those
would
be
for
service
claims,
as
well
as
managed
their
capitation
for
those
additional
10
months.
L
And
so
what
we
are
looking
at
within
the
first
year
is
an
additional
7
million
and
then
an
8
million
in
the
second
year
of
the
biennium
for
a
total
of
roughly
15.3
million
state
general
fund
over
the
biennium,
knowing
that
it
has
impacts
on
those
previous
categories
that
I
mentioned,
of
including
up
to
200
percent,
as
well
as
as
well
as
the
lawfully
residing
women,
but
not
an
impact
on
the
presumptive
eligibility.
A
Okay,
thank
you,
mr
young.
We
appreciate
that
and
I
apologize
for
any
of
the
confusion.
Committee
members
will
make
sure
we
get
all
these
documents
put
together.
Everyone
gets
them
we'll
work
through
them.
I'll
work
with
miss
gorlow
on
it,
and
mr
young
will
probably
have
a
conversation
with
you
in
the
future.
Just
to
make
sure
that
we
have
this
all
lined
out.
I
mean
I
never
thought
I
would
see
a
medicaid
christmas
tree,
but
here
is
one
right
in
front
of
us,
so
it's
kind
of
an
unusual
situation.
A
E
You
so
much,
I
know
we're
going
to
work
out
the
back
piece
of
making
sure
our
numbers
kind
of
match
up,
but
I
guess,
as
I
read
the
bill,
and
I
think
what
might
be
helpful
is
so
I
love
the
idea.
I
think
that
we've
had
a
few
conversations
in
this
building
about
preemptive
eligibility
for
medicaid
and
I
think,
have
at
least
made
one
attempt
in
the
past
to
try
to
get
it
to
work.
A
couple
attempts
to
get
it
to
work,
so
it
would
be
great
to
say
this
is
it.
E
This
is
we're
gonna
do
it,
but,
as
I
look
through
this-
and
I
guess
as
I'm
as
we're
moving
forward
with
the
conversation,
should
we
take
section
one
as
kind
of
like
a
complete
package
or
if
we
had
to
if
we
figured
out
that
in
terms
of
affordability,
we
could
do
one
piece
of
this
over
the
other
in
terms
of
this
population.
Do
you
have
a
priority
or
preference
that
you
would
or
thoughts
that
you
would
want
us
to
hold
in
mind
as
we
move
forward
on
this
conversation.
K
Thank
you
for
the
question
for
the
record
assembly,
one
michelle
gorlow.
If
we
had
to
take
portions
of
this
bill,
I
would
say
presumptive
eligibility
would
be
my
first
selection.
I
think
that
will
allow
us
to
really
improve
our
early
access
to
prenatal
care,
because
what
happens
many
times
is
women
find
out
that
they're
pregnant
when
they're
six
seven
eight
weeks
along
and
if
it
takes
an
average
of
45
days,
if
they
have
all
the
paperwork
together
many
times,
there's
always
a
document,
that's
not
correct
or
they
need
to
add
something.
K
So
that
adds
longer
onto
the
time
when
they're
eligible
for
medicaid
that
takes
them
out
of
early
prenatal
care.
So
that
would
be
my
first
preference
and
then
my
next
I
would
say,
eliminating
the
five-year
residency
requirement
for
legal
residence.
That
would
be
my
next
choice,
followed
by
expanding
medicaid
eligibility
and
then
providing
the
postpartum
care.
E
G
You
thank
you,
madam
chair,
for
the
question
and
thank
you,
someone
gurlo
for
asking
me
to
be
a
primary
co-sponsor
on
this.
I
was
excited
to
do
so.
G
G
Is
there
a
ballpark
figure
that
we
know
and
what
the
goal
is
as
far
as
how
much
money
we're
going
to
save
by
maybe
having,
even
if
we
saved
one
baby
on
what
the
potential
cost
would
be
and
and
potential
savings
of
good
outcomes.
K
So
if
we
take
an
average
of
about
70
000
per
preterm
birth,
it
would
actually
take
us
less
than
a
hundred
births
to
reach
about
six
million
dollars,
and
I
don't
have
a
calculator
off
the
top
of
my
head,
but
then
there's
also
the
cost,
that
of
like
a
28
week,
baby
that
baby
averages
about
a
quarter
of
a
million
so
250
000..
K
So
if
we
can
take
that
28
week
baby
and
bring
it
to
30
or
32,
that's
going
to
cut
down
on
nicu
tremendously,
not
to
mention
the
long-term
cost
of
early
intervention
possible.
You
know
tutoring
physical
therapy,
the
developmental
delays,
so
there's
more
to
that
in
which
perhaps
mr
young
can
go
more
into.
But
currently
we
do
about
3
800
of
preterm
babies
a
year,
so
really
less
than
a
hundred
would
get
us
at
about
six
million
dollars.
G
A
Thank
you
very
much,
dr
titus,
and
I
remember
I
might
have
even
been
sitting
in
no
sitting
in
4100
with
former
assemblywoman
sheila
leslie,
with
the
joint
health
committee
meeting
back
in
the
early
2000s
trying
to
convince
folks
what
presumptive
eligibility
really
meant,
and
it
was
hard
for
people
to
wrap
their
brains
around.
I'm
glad
we're
able
to
have
this
conversation
again
and
in
a
very
serious
manner
and
start
putting
dollars
to
the
conversation
to
see
where
we
can
go
with
it.
A
So
other
committee
members
are
there
any
other
questions
of
miss
gorlo
at
this
time,
we'll
work
on
getting
a
more
comprehensive
document
that
reflects
the
bill
in
its
first
reprint,
so
that
we
have
one
document
to
work
from
and
when
we
do
that,
then
we'll
bring
it
back
in
front
of
the
committee
to
have
more
conversation
about
it.
So
with
that
this
is
the
hearing
for
assembly
bill,
189
I'll,
go
ahead
and
open
it
up.
Is
there
anyone
on
zoom
wishing
to
testify
in
favor
of
assembly,
bill
189.
A
H
H
I
Thank
you
chair
and
members
of
the
committee.
My
name
is
tess
opterman,
so
that's
spelled
o-p-s-e-r-m-a-n
speaking
on
behalf
of
the
nevada
women's
lobby.
We
realize
this
is
a
money
committee.
So
we'll
keep
our
comments
brief,
but
we
did
want
to
get
our
support
on
the
record.
Thank
you
for
making
time
for
this
hearing
tonight.
I
K
No,
madam
chair,
thank
you
very
much
for
letting
me
come
up
late,
actually,
misty
grimmer
for
the
record
representing
silver
summit
health
plan,
we're
one
of
the
state's
three
medicaid
mcos
and
we
would
actually
want
to
testify
in
support.
Thank.
A
A
So
with
that
committee
members,
we
will
go
ahead
and
close
the
hearing
on
assembly
bill
189
and
we'll
go
ahead
and
open
up
the
hearing
on
assembly
bill
216,
which
ms
gorlow
is
handling,
also
get
these
two
out
of
the
way.
So
with
that,
ms
gorlo,
if
you
give
us
a
high
level
overview
and
then
we'll
open
it
up
for
questions
great.
K
Thank
you
very
much
again
for
the
record
assembly.
One
michelle
gorilla
ab216
requires
the
director
to
include
in
the
state
plan
for
medicaid
to
pay
for
cognitive
assessment
and
care
planning
for
persons
experiencing
signs
or
symptoms
of
cognitive
impairment.
A
fiscal
note
was
submitted
in
the
amount
of
a
little
over
900
000.
However,
I
did
receive
an
email
from
mr
dwayne
young
on
april
15th,
stating
that
the
fiscal
note
was
reevaluated
and
it
has
been
removed.
A
B
A
B
K
E
You
so
much
so
I
guess
on
since
the
provisions
of
the
fiscal
net
have
been
removed.
I
guess
I'm
wondering
has,
has
intent
or
scope
around
the
bill
been
changed.
I
guess
it
was
there
a
thinking
about
how
this
bill
would
be
envisioned
in
in
one
way
and
there's
been,
I
guess,
a
coming
together
minds
to
realize
that
there's
a
path
to
walk
forward
that
doesn't
cost
money.
K
Thank
you
for
the
record
assignment
michelle
gorlo
is
my
understanding
that
the
cost
was
look
at
what
it
would
cost
to
put
somebody
in
a
facility
versus
the
actual
treatment
and
that
the
treatment
was
less
than
the
facility,
and
that's
why
the
fiscal
note
was
removed.
But
mr
dwayne
young
might
be
able
to
provide
more
information
on
that.
L
Thank
you,
chair,
carlton
and
assemblywoman
benitez
thompson
for
the
question
I
do.
That
is
correct.
I
do
actually
want
to
just
give
thanks
to
minority
leader,
robin
titus,
who
helped
us
work
with
this
as
well.
L
To
look
at
what
we
did
is
we
examined
those
individuals
who
are
55
to
65
those
65
and
older
would
be
dual
eligibles
and
be
paid
for
by
medicare,
and
so
what
we
examined
is
that
the
percentage
of
individuals
that
we
would
test
and
would
get
this
code
on
the
savings
for
those
and
less
than
eight
percent,
who
are
actually
in
cognitive
decline
in
the
state
in
that
age
range
the
savings
that
we
would
get
if
we
could
provide
other
services,
such
as
home
health,
personal
care
services
just
from
those
providing
those
services
and
not
having
them
in
the
facility
just
for
six
months,
then
it
would
more
than
cover
the
savings
of
actually
allowing
this
code
to
be
open
for
those
between
the
age
of
55
and.
E
Yes,
so
I'm
following
you
pretty
well,
but
could
you
like
restate
all
of
it?
So
no
I'm
like
fascinated,
so
I
hear
the
dual
eligible.
I
hear
the
conversation,
so
I
see
the
part
here
about
the
state
plan
and
medicaid
shall
pay
the
non-federal
share.
So
I
guess,
are
you
saying,
there's
there's
no
upfront
cost
or
just
the
savings
will
will
eat
the
cost.
So
I'm
hearing
about
the
medicare
programs
right.
So
let's
push
them
into
home
health
and
do
those
kinds
of
assessments,
but
I
guess
that
the
assumption
would
be.
E
L
Get
picked
up
again:
dwayne
young
deputy
administrator
for
the
record,
chair
college
and
through
youtube,
assemblywoman,
vidinius
thompson
most
certainly,
and
so
you'll
actually
hear
me
again
tonight,
speak
about
how
we
applied
savings
in
different
budget
categories.
This
would
all
be
within
3243,
and
so
there's
no
system
cost
that
we
applied,
because
it's
it's
not
creating
a
new
provider
type
or
developing,
or
some
lift.
L
It's
really
just
opening
codes
that
are
already
existing
within
medicaid
to
providers
who
would
provide
these
assessments,
and
so
what
we
assumed
and
what
we
know
from
research
is
that
seven
percent,
roughly
of
the
the
adults
who
are
tested
in
this
age
group,
end
up
going
into
cognitive
decline.
So
we
base
the
savings
solely
off
of
that
seven
percent.
So
we
get
to
test
the
other
93,
even
though
they
may
not
be
in
cognitively
decline.
L
They
have
the
peace
of
mind
and
the
insurance
and
the
savings
is
achieved
off
of
those
who
are
caught
early.
Even
if
we
only
were
able
to
stay
there
stay
in
the
nursing
home
six
months.
L
We
thought
that
was
a
reasonable
way
to
calculate
savings,
because
that
was
based
off
of
a
couple:
different
peer-reviewed
articles,
which
really
focused
on
the
cognitive
engagement
piece
and
delaying
of
in
someone
entering
into
long-term
care
facility
by
six
months,
and
this
was
based
out
of
a
north
carolina
study
as
well
as
some
additional
studies
that
we
looked
at.
That
really
backed
up
this
thinking.
And
so
that
is
how
that
how
we
apply
that
across
that
spectrum.
L
A
Okay,
thank
you
very
much,
mr
young,
so
with
that
ms
benitez
thompson
I'll
go
ahead
and
move
on
dr
titus,
did
you
have
a
question.
G
A
Okay
and
thank
you,
dr
titus,
for
your
work
with
mr
young
and
assemblywoman
gorlo
to
get
this
addressed.
We
do
appreciate
that
so
committee
members,
are
there
any
other
questions
of
ms
gorlo
or
mr
young
at
this
time?
A
K
Thank
you,
madam
chair
committee,
members
misty
grammer
with
the
fraud
group
representing
the
the
nevada
alzheimer's
association.
I
know
this
is
not
a
policy
committee,
so
I
won't
go
into
the
details.
I
just
want
to
say
thank
you
to
the
committee
for
processing
this
bill.
It's
a
very
important
piece
of
legislation
and
thank
you
assemblywoman
gorlo,
for
for
carrying
the
bill,
and
we
appreciate
it,
and
I
thought
I
should
add
my
potholders
still
going
strong.
A
22
years
later,
and
I'm
still
working
off
of
potholders,
okay,
so
with
that
broadcast
services,
is
there
anyone
on
the
phone
line
in
support
of
assembly
bill
216.
H
B
Good
afternoon
my
name
is
dr
tiffany
tyler,
garner
t-I-f-s-a-n-y
t-y-l-e-r
hyphen
g-a-r-n-e-r,
and
I
believe
this
is
an
error
of
actually
calling
in
to
a
firm
support
and
endorsement
of
189,
particularly
the
commitment
to
presumptive
eligibility
in
the
ways
in
which
it
broadens
health
care.
Access
for
for
many
residents
is
of
critical
importance
and
just
wanted
to
affirm
the
support
for
it.
B
Sorry,
for
the
era.
A
No
problem,
dr
tiffany
tyler,
don't
worry
about
that!
I
will
have
committee
staff,
take
your
support
and
put
it
in
with
assembly
bill
189
with
broadcast
services
and
with
the
way
this
is
working.
This
isn't
the
first
time
it's
happened
and
I'm
sure
it's
not
going
to
be
the
last
in
the
next
18
days.
So,
but
thank
you
very
much
for
hanging
in
there
and
putting
your
support
on
the
record.
We
appreciate
it
so
with
that.
Thank
you.
You're
welcome
broadcast
services.
Is
there
anyone
else
in
support
of
assembly
bill
216.
H
I
Thank
you
chair
and
members
of
the
committee
for
the
record.
My
name
is
tess
opterman,
that's
o-p-f-e-r-m-a-n.
Speaking
on
behalf
of
the
retired
public
employees
of
nevada.
We
realize
this
is
not
a
policy
committee,
but
we
do
want
to
be
on
the
record
in
support
and
we
want
to
thank
you
for
your
time
this
evening.
I
A
Thank
you,
and
can
we
go
to
anyone
in
neutral?
Please.
A
Thank
you
and
I
believe
we
were
on
neutral,
so
let
we'll
have
to
make
sure
that
we're
good.
So
with
that
not
seeing
anyone
wishing
to
testify,
I
believe
that
takes
care
of
216..
I
don't
think
miss
gorlo
needs
to
do
any
wrap
up
on
that
one.
So
we'll
go
ahead
and
close
the
hearing
on
assembly
bill,
216
and
committee
members.
You
may
see
this
bill
pop
up
again
in
the
very
near
future,
so
be
prepared
with
that.
A
I
have
assemblywoman
summers:
armstrong
with
us
that
came
into
the
room
and
I
believe
her
bill
is
for
assembly
bill
2
56
we'll
go
ahead
and
open
up
the
hearing
on
assembly
bill,
256,
welcome,
assembly
woman.
Please
give
us
a
high
level
overview
and
we'll
go
from
there.
Thank
you
very
much.
F
F
Affectionately
known
as
the
doula
bill
assembly,
bill,
256
has
a
simple
purpose
and
that
is
to
allow
a
doula
surfaces
to
be
covered
by
medicaid
medicare.
Pardon
me,
this
is
you
know.
Having
babies
is,
is
is
dangerous
undertaking
for
women.
We
know
that
black
women
have
an
exorbitantly
high
rate
of
mortality
during
childbirth,
and
we
are
hopeful
that
you
all
will
understand
the
important
role
that
doulas
play
in
the
birthing
process.
F
These
are
non-medical
support.
Folks,
their
job
is
to
provide
emotional
and
educational
information
for
the
mom
to
be
there
to
be
her
advocate
during
the
birthing
process,
and
we
believe
that
this
will
be
a
cost
savings,
as
we
know
from
national
statistics
that
when
doulas
are
present,
births
go
better
and
when
that
happens
and
women
are
able
to
have
healthy
babies,
we
save
money.
F
I
would
like
to
allow
dwayne
young
from
health
and
human
services
to
kind
of
break
down
the
cost
savings
for
you,
and
we
can
have
some
additional
comments
from
quentin
savoie
from
make
it
work,
nevada,
who
was
kind
enough
to
bring
this
important
legislation?
Actually,
let's,
let's
switch
it
quentin.
F
If
you
could
just
have
a
few
words,
I'm
kind
of
nervous,
I
don't
know
why
and
if
quentin
could
go
ahead
and
sort
of
amplify
some
of
the
things
that
I
said
and
then
we
can
go
to
dwayne
and
give
us
the
the
really
important
stuff
which
are
the
numbers.
So
we'll
we'll
tell
get
your
heart
strings
for
a
few
more
minutes
and
then
we'll
go
to
the
numbers.
A
B
Absolutely
chairwoman
and
assemblywoman:
thank
you
so
much.
I
will
just
introduce
myself,
I'm
quentin
savoie
the
deputy
director
at
make
it
work
nevada.
We
work
alongside
black
women,
black
families
to
build
power
for
economic,
racial
and
reproductive
justice.
Indeed,
I
understand
this
is
not
the
policy
committee,
but
I
did
want
to
outline
that
this
is
community
driven
policy.
B
So,
at
its
core,
this
bill
is
about
nevada's,
kids
and
getting
them
started
freshly
and
making
sure
that
we're
thinking
about
the
mothers
that
are
going
to
be
birthing,
these
children
and
making
sure
they
have
successful
birth
outcomes
as
well.
We
have
we
can
do
something
about
this,
and
I
hope
that
we
do.
Thank
you
so
much
and
I'll
defer
to
mr
young.
L
Sure
carlton
again
for
the
record,
my
name
is
dwayne
young,
deputy
administrator
for
the
division
of
healthcare
financing
policy.
I
just
want
to
thank
the
work
that
we
did
with
mr
savoir
and
make
it
work
in
community
organizations
over
the
last
year
and
the
work
with
assemblywoman
summers
armstrong
shortly
after
her
election
allowed
us
time
to
do
some
peer-reviewed
research,
and
so
we
based
this
fiscal
note
off
of
there's
an
immediate
savings,
one
and
kind
of
the
discussion
earlier.
L
We
with
assemblywoman
girls
bills,
the
savings
that
could
apply
with
nicu
babies,
so
you'll
hear
us
break
that
percentage
down.
We
know
that
we
will
always
have
some
babies
in
the
nicu,
but
we
know
we
can
have
better
outcomes,
and
so
we've
applied
some
of
that
savings
across
each
bill.
But
where
you'll
see
the
most
immediate
savings
is
the
difference,
because
medicaid
has
a
different
reimbursement
for
a
vaginal
and
cesarean.
L
What
you'll
see
is
demonstrated
within
the
fiscal
note
is
that
we
estimated
a
very
modest
six
percent,
and
so
we
knew
that
not
everyone
will
embrace
these
services
the
availability
of
these
services,
but
if
we
could
increase
six
percent
of
the
women
to
to
utilize
these
services,
that's
also
based
on
the
number
of
doulas
already
existed
within
the
state,
particularly
if
we
could
see
better
outcomes
in
urban
and
and
even
in
our
rural
areas,
with
their
confidence
of
engaging
with
the
practitioner,
we've
had
some
discussions
over
how
the
quality
of
care
plays
into
the
experience
of
the
mom.
L
So
we
estimated
that
about.
If
six
percent
of
these
women
took
these
services,
the
state
would
see
an
immediate
savings
of
about
hundred
thousand
dollars
in
year,
one
of
the
biennium
and
eight
hundred
thousand
dollars
in
year,
two
of
the
body
union
giving
us
a
combined
effect
of
nearly
1600
effect
on
the
the
biennium.
L
There
is
one
direct
cost,
and
that
is
out
of
31.58.
The
savings
comes
out
of
3243
3158
has
system
cost
of
around
58
000
that
we've
included
in
this
new.
That
is
these.
That
is
the
cost
to
create
a
new
provider
type,
because
we
want
this
to
be
its
own
provider
type
and
that
will
allow
us
to
track
for
data
purposes
and
research
purposes
so
that
we
can
publish
some
of
those
articles
on
savings.
But
what
so
there
will
be
an
ask
to.
L
There
will
be
a
divisions,
need
to
transfer
medical
savings
from
3243
to
3158
as
part
of
system
hours.
As
you
are
quite
aware-
and
the
committee
is
quite
aware-
you
do
approve
our
administrative
budget
in
3158,
and
some
system
hours
are
are
maintained
in
that.
L
But
in
order
to
do
some
of
these
extra
things,
we
do
have
to
get
more
system
hours
from
our
vendor,
and
so
what
we
are
asking
is
if
we
were
allowed
to
transfer
those
funds,
those
to
our
administrative
or
front
those
funds
of
our
administrative
budget
and
cover
them
later.
We
know
that
we
would
see
an
immediate
savings
of
impact
from
getting
this
service
out
within
that
savings
between
that
cesarean
and
that
vaginal
rate.
A
And
thank
you,
mr
young,
so,
and
that's
that's
where
my
line
of
questioning
was
going
to
go.
We
appreciate
the
fact
that
this
will
now
be
billable,
that
there
are
prospective
savings
in
the
future.
A
L
Again,
dwayne
young
deputy
administrator
for
the
record,
so
we
always
pay
anything
that
is
a
system
system
costs
or
expenses.
We
always
pay
those
out
of
our
administrative
budget.
What
happens
that
and
you,
you
of
all
people,
know
well.
This
all
committee
knows
we've
had
to
come
to
transfer
funds
from
other
budget
categories
to
administrative,
but
we've
had
unforeseen
system
costs,
and
so
we
know
that
these
are
bills
that
are
not
accounted
for
in
our
current
budget.
L
A
E
So
much,
and
so
as
I'm
reading
the
kind
of
the
methodology
on
the
fiscal
note,
I
just
had
a
couple
of
questions,
so
I
make
sure
I'm
understanding
right.
So
the
estimated
number
of
bursts
of
doula
would
support
then
multiplied
by
dollars
and
that
I'm
looking
at
your
sub
note
6
under
the
methodology
and
that
this
was
a
comparable
weight
from
oregon.
E
So
does
that
mean
that
the
and
all
this
is
going
to
be
decapitated
right
part
of
the
decapitated
plan?
So
does
that
mean
that
it's
the
each
the
I
guess
the
rate
for
the
doula
is
350
for
a
birthing
event
kind
of
I
guess
I
would
say
soup
to
nuts
or
I
could
probably
come
up
with
a
better
analogy.
A
F
Thank
you.
Thank
you.
Assemblywoman
benitez,
thomas,
the
example
that
is
in
the
the
backup
documents
is
a
total
of
five
visits.
It
is
two
pre-birth
the
birthing
event
and
then
two
post,
and
that
is
where
the
350
comes
in.
E
Perfect,
I
appreciate
that
so
350
for
the
the
five
visits
and
then
the
savings
assumed
are
986
per
boo
per
bir,
supported
by
doula.
So
is
that
I
I
heard
the
the
reference
I
see
a
reference
to
a
cost-effectiveness
study.
I
also
heard
the
reference
to
savings
forum,
avoiding
caesareans,
and
so
is
that
986,
it's
a
savings
because
they're
they're
delivering
vaginally
or
to
savings
because
just
some
supports.
I
guess
I
wanted
to
kind
of
nail
down
a
little
bit
more,
that
that
986
number
that
and
that's
the
sub
note
7
on
the
methodology.
L
L
Majority
leader
benitez
thompson:
yes,
that
is
exactly
that.
Savings
is
based
on
the
difference
between
the
vaginal
and
caesarean
birth.
But
then
it's
also
calculated
the
overall
outcomes,
and
so
there
is
a
percentage
that
we
did
look
at
very
small
percentage
of
nicu
births
and
birthing
outcomes.
But
that
is
largely
reflected
by
the
difference
between
the
vaginal
and
caesarean
birth
and
those
direct
studies
that
focused
on
the
differences
within
medicaid
and
the
increased
outcomes
with
medicaid
programs.
E
Sorry,
just
quick
follow-up,
so
I
guess
that
I
guess
what
the
the
2016
study
on
the
cost-effectiveness
then
for
doulas
is
telling
us.
I
guess
the
that
we,
what
we're
seeing
is
a
stark
difference
between
those
who
deliver
with
one
versus
those
who
deliver
without
one,
and,
I
would
say,
the
modality
of
the
birth.
I
don't
know
what
else.
L
Again,
dwayne
young
deputy
administrator
for
the
record
majority
leader
benice
thompson.
Yes,
that
is
correct,
and
I
will
just
add
that
this
committee-
and
it
was
of
hot
discussion
during
last
year's
medicaid
budget
work
session
about
some
data
that
we
quoted
about
the
experience
of
women
in
nevada
and
their
lack
of
favorable
experience
leading
to
bad
outcomes,
and
so
this
service,
what
cannot
be
discounted?
I
know
we
do
not
discuss
the
merits
of
the
policy
but
cannot
be
discounted.
L
A
Thank
you
very
much
committee
members,
any
other
questions
of
mr
young
or
the
assemblywoman,
not
seeing
any
other
questions
at
this
time.
So
assemblywoman,
I
believe
in
in
discussing
with
staff
and
the
proposal
that
mr
young
brought
out
about
being
able
to
use
dollars
and
transfer
dollars.
A
We
had
thought
we
might
needed
some
transfer
language
in
the
bill,
but
it
looks
as
though
we
would
be
investigating
just
adding
some
back
language
to
the
bill
to
make
sure
that
medicaid
has
the
authority
to
do
what
it
needs
to
do
in
this
room.
We
call
it
a
technical
adjustment,
but
we'll
make
sure
that
there's
some
language
to
make
sure
that
what
you're
trying
to
accomplish
you
can
actually
get
done
over
the
interim.
So
dr
titus
did
you
have
a
question.
G
Yes,
thank
you,
madam
chair,
mr
young.
I
guess
for
clarification
for
me
early
on
in
the
testimony
it
was
stated
that
this
is
for
non-medical
services
and
so
we're
paying
for
a
non-medical
service.
I'm
just
wondering
about.
Are
there
other
just
for
our
reference
other
services
that
medicaid
pays
for
that
they
define
it's?
Not
medical.
L
Again,
thank
you
so
much
as
assembly
minority
leader
titus
for
the
question
dwayne
young,
for
the
record
and
so
medicaid.
We
know
that
they
must
meet
a
level
of
medical
necessity,
and
so
this
is-
and
we
wanted
to
make
it
clear
that
it's
not
medical,
because
it
is
being
added
in
under
the
medical
category
and
would
be
contained
in
our
physician
services.
Medicaid
pays
for
services
that
allow
for
advocacy
all
the
time
we
pay
for
targeted
case
management.
We
pay
for
support
through
the
waivers.
L
Just
last
year
we
approved
a
tenancy
support
and
we
have
supports
through
specialized
foster
care.
So
there
are
medical
advocacy
would
probably
be
a
better
term
than
med
than
non-medical
service,
but
medicaid
certainly
has
a
history
and
does
pay
for
these
services
and
sees
outcomes
from
those
services,
as
well
as
when
there's
someone
that
is
able
to
help
the
recipient
advocate
on
behalf
of
themselves.
A
You're
welcome
dr
titus
any
other
questions
or
comments
from
the
committee
members
at
this
time.
Not
seeing
any
this
is
the
hearing
for
assembly
bill
256
we'll
go
ahead
and
open
it
up.
Is
there
anyone
here
in
the
room
wishing
to
testify
in
support
of
assembly
bill
256,
not
seeing
anyone?
We
will
go
ahead
and
go
to
broadcast
broadcast
services.
Do
we
have
anyone
on
the
line
in
support
of
assembly
bill
256.
A
Thank
you
very
much,
we'll
close
the
hearing
on
assembly
bill
256.
Thank
you
very
much
assemblywoman
for
being
here
this
evening,
we'll
investigate
what
we
need
to
do
next
and
proceed
from
there.
So
with
that
we'll
go
ahead
and
go
back
up
to
the
top
of
the
batting
order,
which
would
be
assembly
bill
191.
B
Thank
you,
chair
and
members
of
the
committee
for
the
record.
I'm
david
orent
liquor,
assembly,
district
20.,
I'm
here
to
present
assembly
bill
191
on
behalf
of
the
legislative
committee
on
health
care,
and
this
bill
would
require
medicaid
to
reimburse
services
provided
by
community
health
workers,
and
the
idea
here
is
to
increase
the
health
system
capacity
for
prevention
and
early
intervention
and,
as
a
result,
to
realize
cost
savings.
B
Community
health
workers
do
valuable
work
with
educating
patients,
screening
and
risk
identification
for
serious
diseases
and
also
chronic
disease
management.
As
a
result,
we
see
a
reduction
in
emergency
department,
visits
and
hospitalizations
and
hence
the
very
nice
fiscal
that
dwayne
young
will
now
walk
us
through.
So
thank
you.
A
L
For
the
record,
duane
young,
deputy
administrator
for
the
division
of
healthcare,
financing
and
policy-
and
so
this
fiscal
note
is
demonstrated
by
the
support
that
community
health
workers
and
again
this
is,
would
be
classified
as
a
non-medical
services,
but
def
advocacy
support
and
educational
service,
and
so
this
is
services
really
focuses
on
helping
the
recipients
and
the
provider
manage
the
recipients,
chronic
conditions,
and
we
were
able
to
provide
testimony
throughout
the
years
that
this
would.
The
the
role
of
community
health
workers
has
been
highlighted
by
the
covet
19
pandemic.
L
I
know
we're
not
here
to
discuss
the
merits
of
that
policy,
but
I
did
just
want
to
set
that
up,
because
it
is
very
similar
to
the
last
service.
In
that
aspect,
this
fiscal
note
is
demonstrated
by
again
out
of
budget
account
3243
if
we
were
to
allow
for
community
health
workers
and
again
we
associated
this
note-
and
we
built
this
off
of
a
rate
what
the
cap,
what
the
cost
would
cost
in
managed
care
and
in
fee
for
service.
L
It
is
actually
a
little
bit
higher
in
fee
for
service,
because
we
know
that
we
have
higher
instances
of
chronic
disease
and
the
populations
that
we
have
within
fee
for
service
that
don't
have,
as
many
supports
those
in
the
rural
populations
and
those
in
the
age
traditionally
medically
aged
behind
a
disabled
category.
And
so
we
see
there
that
if
we
were
to
allow
community
health
workers,
we
would
see
a
two
percent
reduction
in
services
from
the
result
of
those
that
utilize,
the
community
health
worker.
L
L
3158
is
roughly
about
50
000,
and
so
again
it
would
be
the
same
to
be
able
to
demonstrate
if
we
were
to
upfront
the
system
cost
in
our
administrative
budget,
but
then
be
able
to
transfer
funds
to
cover
the
the
work
that
was
done
within
the
first
year.
We
could
get
that
off
the
ground.
We
would
see
that
savings
back
plus
an
additional
roughly
three
hundred
thousand
dollars.
L
I
think
it
is
just
worth
pointing
out
that
this
is
we've
had
this
discussion
at
this
at
the
legislature
several
years,
and
so
we
have
always
in
previous
years
brought
this
as
a
zero
impact,
but
because
of
our
work
in
the
interim
with
the
interim
health
committee
and
various
stakeholder
groups,
we
were
able
to
really
apply
specific
peer-reviewed
articles
that
focus
on
medicaid
and
the
impact
that
community
health
workers
have
that
doesn't
even
touch
what
obviously,
the
the
covet
19
pandemic
has
magnified
the
importance
of
community
health
workers,
and
so
that
wasn't
even
accounted
for
in
our
research.
L
A
And
thank
you
very
much,
mr
young.
I
think
there's
one
other
item.
I
would
like
you
to
address
with
the
effective
date
of
2021
in
this.
This
would
be
a
change
in
mid-year
certification
for
the
managed
care.
So
would
this
have
an
impact
on
that?
I
know
it
has
to
meet
a
certain
threshold
before
it
would
impact
that
that
mid-year
certification.
So
where
do
you
stand
with
that
with
this
particular
effective
date,
and
is
this
the
appropriate
date.
L
Certainly
dwayne
young
deputy
administrator
for
the
record
and
miss
dr
crescillas
can
correct
me
if
I'm
wrong,
but
we
did
not
actually
include
capitational
adjustments
because
of
the
small
size
of
this
service,
and
so
it
does
not
trip
that
threshold
that
you
see
demonstrated
in
our
other
fiscal
notes.
L
What
I
might
add
is
that
many
of
our
our
managed
care
organizations
have
been
already
using
community
health
workers
as
well
as
many
grants
have
stood
up
community
health
workers
across,
and
so
we,
when
we
talk
about
standing
up
new
provider
types,
there
is
some
difficulty,
often
within
medicaid.
But
this
is
not
one
because
the
they
already
have
certain
certifications
and
requirements.
There
are
many
entities
already
using
them,
and
so
this
would
be
just
a
simple
easy
in
standing
up
the
system
to
prepare
them
for
a
simple,
easy
enrollment
into
medicaid.
A
Right,
thank
you
very
much,
mr
young
just
wanted
to
make
sure
that
we
got
that
on
the
record.
I
know
that
threshold
can
be
bumped
up
against
at
sometimes
so
with
that
committee
members.
Are
there
any
questions
of
the
assemblyman
or
mr
young
at
this
time?
I
believe
the
same
issue
would
apply
to
this
bill.
191
that
applied
to
ms
summers
armstrong's
bill
earlier
about
the
state
portion
that
would
be
needed,
the
transferability
that
you
would
need
within
your
budget
accounts.
A
We
double
checked
the
back
language,
so
there
there
is
a
provision
that
we
can
use.
So
we
don't
slow
the
bills
down
the
bills.
Won't
need
to
be
amended
with
that,
but
we
can
make
sure
that
we
give
you
that
authority
as
we
move
forward
if
the
bill
gets
processed.
So
thank
you
very
much,
mr
young
committee
members.
Any
other
questions
not
seeing
any
at
this
time.
So
with
that
this
is
the
hearing
for
assembly
bill
191
we'll
go
ahead
and
open
it
up.
A
H
H
B
S-T-E-V-E-M-E-S-S-I-N-G-E-R
with
the
nevada
primary
care
association
representing
the
state's
community
health
centers,
we
enthusiastically
support
ab191
health
sooners
have
seen
firsthand
the
savings
to
insurers
from
chws
when
a
patient
connects
to
a
specialist
completes,
a
test
or
screening
or
is
able
to
access
transportation
vouchers
to
reach
their
appointment.
We
submitted
further
comments
to
the
committee
yesterday.
B
A
Thank
you
very
much
broadcast
services.
Anyone
else
in
support,
please.
H
I
A
Thank
you
very
much
so
with
that.
I
believe
we
can
go
ahead
and
close
the
hearing
on
assembly
bill
191
folks
keep
it
close.
I
think
this
is
one
we
might
be
able
to
deal
with
also
to
keep
our
decks
cleared
so
with
that
committee
members.
Our
last
bill
that
we
have
listed
for
this
evening
is
assembly
bill
358.
A
It
has
the
speaker's
name
on
it,
but
he
will
not
be
presenting.
We
will
be
having
the
folks
from,
I
believe,
corrections.
B
A
B
About
that,
if
there's
someone
available
to
address
the
reason,
it's
in
ways
then
so
be
it
otherwise
I'll
have
to
coordinate.
A
Mr
speaker
would
be
happy
to
to
roll
this
to
another
time.
If
you
would
like,
I
apologize
if
the
word
didn't
get
to
the
the
right
person,
I
I
thought
we
did,
but
so
I'll
make
sure
that
miss
nguyen
is
notified
and
then
not
sure.
If
we're
having
another
meeting
this
week,.
B
Madam
chair,
if,
if,
if
I
may
as
assume
a
woman
win,
makes
her
weigh
in
it
appears
that
my
attitude
was
notified
but
because
I
didn't
present
the
bill
and
don't
have
a
folder
on
the
bill.
Maybe
he
just
thought
I
get
notified
about
everything.
B
So
assemblywoman
win
was
not
notified,
so
we
were
willing
to
roll
it.
But
I
appreciate
assuming
woman
when
coming
down.
Nevertheless,.
A
A
A
A
A
A
So
I
do
believe
we
have
a
couple
of
folks
on
zoom.
If
the
folks
who
are
here
for
assembly
bill
358
can
go
ahead
and
turn
their
cameras
on,
we
would
appreciate
it
and
if
whoever
wants
to
flip
the
cl,
oh
there's
three,
you
can't
flip
a
coin.
So
whoever
would
like
to
draw
the
short
straw
and
give
us
a
brief
overview
of
assemblyville
58
and
then
walk
us
through
the
fiscal
note.
That
would
be
very
helpful.
A
E
Go
ahead,
rochelle
win
for
the
record
representing
assembly
district
10.,
essentially
what
assembly
bill
358
is
interesting
because
it
was
brought
by
three
different
members
of
the
legislative
body
this
session.
So
the
one
that
we
are
hearing
today
is
358.
E
It
would
also
help
with
the
continuity
of
care
because
they
would
be
set
up.
They
would
have
providers
that
we
would
be
able
to
work
with
if
they're
on
parole,
they
would
be
able
to
work
with
their
parole
officers
and
have
that
kind
of
continuity
of
care
that
is
required
for
them
to
be
successful.
Once
they
are
released
either
after
expiration
of
their
sentence
or
after.
E
A
And
thank
you
very
much,
mr
nguyen.
So
if
someone
was
already
on
medicaid,
this
would
just
allow
it
to
go
into
a
pause
rather
than
be
terminated
and
have
them
have
to
reapply
again.
So
if
they
went
into
the
institution
with
medicaid
as
they
prepared
to
leave
the
institution
that
medicaid
could
be
reactivated
there
for
whatever
health
care,
they
would
need
as
they
leave
there,
wouldn't
be
that
45
60
days
of
them
waiting
to
get
the
medications
that
they
would
need
to
succeed
or
any
other
health
care.
A
E
I
know
that
ndoc
actually
brought
a
bill
that
I
think
has
already
made
its
way
through
the
senate,
if
I'm
not
mistaken,
that
did
allow
them
to
get
birth
certificates
for
all
individuals
that
were
incarcerated
prior.
It
had
to
be
like
a
couple
months
or
a
month
before
or
after
their
release,
and
so
there
was
a
bill
and
I
apologize.
It
was
like
I
want
to
say
it
was
maybe
assembly
bill,
19
or
16.
E
A
And-
and
that
helps,
but
in
addition
to
that
other
documentation,
then
they
would
still
have
a
medicaid
card
when
they
left,
so
they
could
just
instead
of
having
to
fly
over.
They
could
just
get
the
card
back
and
move
forward
from
there.
So
I'll
go
ahead
and
go
to
the
department
to
have
a
conversation
about
the
submitted
fiscal
note
and
the
the
reason
behind
the
fiscal
notes.
B
J
A
A
So
I
guess
I'm
trying
to
wrap
my
brain
around
why
we
would
need
so
many
extra
people
I
mean
I
I
could
understand
the
workload
at
taking
a
bit
of
time
for
each
one,
but
it's
hard
for
me
to
imagine
that
I
believe
you
said
6
000
people
that
you
would
need
this
many
more
folks
to
handle
that
one
function
for
that
particular
inmate
leaving
the
institution.
So
how
did
you
come
up
with
a
program
officer
too
and
all
these
program
officer
ones
for
this?
For
this
bill.
J
Yes,
yes,
ma'am
terrifying
me
go
ahead
and
answer
your
question
and
doing
that
program.
Officers
have
a
dual
role
of
doing
evidence-based
instruction,
as
well
as
any
identification
and
leaving
sp
236
had
had
put
additional
caveats
on
those
pieces,
one
of
which
was
medicaid
up
until
this
point,
medicaid
was
only
processed
if
it
was
requested
by
the
president
themselves,
the
inmate
themselves.
J
J
For
that,
and
so
the
application
itself
is
approximately
14
pages
long
in
being
14
pages
long
and
processing
that
for
every
person
that
would
be
exiting,
as
the
law
has
has
stated,
the
time
frames
to
do
that,
the
time
frame
to
make
sure
that
we
can
process
that
and
get
that
actually
over
to
the
to
the
respective
department.
J
It
was
taken
into
consideration
to
this
piece
so
that
we
would
have
someone
that
was
solely
in
charge
of
making
sure
that
they
go
forward
with
each
of
these
components
based
upon
and
the
needs
of
each
of
the
institutions.
Our
numbers
were
processed
in
a
small
number
again
by
request
only
60
to
90
days.
This
would
open
the
window,
so
we
could
start
at
any
time
put
it
into
suspension.
J
It
would
remain
in
suspension
for
up
to
a
year
once
they
are
approved,
should
they
be
approved
for
this,
and
that
would
leave
us
to
go
forward
with
these
components
because
of
the
processing
time
because
of
the
the
way
in
which
we
have
to
process
these.
We
do
not
have
an
electronic
processing
component
to
this.
A
And-
and
thank
you
very
much
for
that
explanation,
but
I'm
going
to
make
a
suggestion
here
and
I'm
not
sure
if
mr
young
or
someone
from
medicaid
is
still
on
the
line
or
one
of
them
are
listening.
So
is
there
an
opportunity
for
the
department
of
corrections
to
partner
with
medicaid
to
set
up
a
phone
line
to
actually
have
the
inmate?
L
Good
evening,
sir
carlton,
I
am
actually,
this
is
the
eligibility
portion
handled
by
the
division
of
welfare
and
supportive
services.
Okay,
so
my
colleague
mr
joe
garcia,
is
on
the
is
on
the
zoom,
so
he'll
actually
walk
you
to
the
eligibility
portion.
E
And
chair
carlton,
rochelle
won
for
the
record
just
so
you
know.
This
is
also
something
that
was
brought
up
during
the
committee
hearing
director
whitley
had
indicated
that
he
has
tried
for
years
to
work
with
ndoc
to
be
able
to
do
this,
but
I'm
sure
mr
garcia
can
go
through
it
in
greater
detail.
M
Yes,
joe
garcia,
chief
of
program
operations,
support
and
training
for
the
division
of
welfare
and
supportive
services,
so
we
have
been
working
with
department
of
corrections.
Since
july
of
last
year,
we
started
a
pilot
project
providing
applications
to
the
department
of
corrections
so
that
they
could.
We
could
get
inmates
on
medicaid
prior
to
them
being
released
well,
not
prior
to
them
being
released.
Let
me
correct
that
statement.
M
M
M
It
just
depends
what
department
of
corrections
is,
allowing
they
can
change
their
address
and
the
card
will
go
to
that
address
or
they
can
walk
into
an
office
and
request
a
card
or
change
their
address
there
at
the
office,
and
we
will
get
them
our
get
one
mailed
out
as
soon
as
possible,
so
they
won't
have
the
card,
but
we
can
issue
them
the
medicaid
billing
number,
because
we
do
get
that
right
away
when
we
put
them
into
our
system
and
that
they
can
go
to
go
and
see
a
doctor.
M
It
takes
about,
and
duane
can
correct
me
if,
if
I
misspeak
here,
but
it
takes
about
four
24
to
48
hours
for
the
system
to
show
them
eligible.
So
if
they
walk
into
a
pharmacy
the
day
they
walk
out
of
prison
more
than
likely,
they
are
not
going
to
show
eligible
it's
going
to
take,
like
I
said,
24
to
48
hours
for
them
to
actually
show
eligible.
M
That
is
something
that
we
haven't
been
able
to
change,
and
I
don't
know
that
we
can
change
it.
M
The
other
thing
that
department
of
corrections
that
elizabeth
dixon
was
coleman
was
mentioning
is
the
application.
The
application
is
14
pages,
but
it's
double-sided,
so
it
it's
actually
20
some
odd
pages.
M
We
are
working
on
trying
to
get
another
application
through
cms,
but
we
haven't
had
any
luck
with
that
yet
either
and
don't
know
if
we
will,
because
we
we
do,
we
do
understand
shortening
that
application
would
be
a
benefit
to
the
department
of
corrections,
especially
because
they're
single
households,
it's
one
person.
M
And
we
don't
need
a
lot
of
those
questions
that
are
on
on
the
our
basic
application.
So
there
was
another
question
about.
Let
me
think
here
there
was
one
more
question:
oh
phones,
so
we
do
have
a
call
center
that
we
can
have
that
we
actually
take
applications
over
the
phone,
the
and
we
could
set
that
up
with
department
of
corrections.
But
I
think
department
of
corrections
and
elizabeth
can
certainly
speak
to
this.
M
There
may
be
some
security
issues
with
the
inmates
using
the
phone
if
they
could
be
provided
a
phone
and
that
I'll
let
elizabeth
answer,
but
we
can
certainly
work
something
out
if
they
are
allowed
to
use
a
phone.
I
will
say
that
we
have
offered
a
couple
of
different
options,
but
with
covid
and
the
lockdowns
and
the
short
staff
that
are
the
staffing
situation,
that
the
department
of
corrections
was
facing
kind
of
interfered
and
hindered
our
progress.
It's
not
that
department
of
corrections
wasn't
trying.
M
They
were
trying
they're
they're
doing
the
best
they
can
with
what
they
have
and
we
have
been
processed.
We
have
been
receiving
applications
on
a
monthly
basis
from
them.
Would
we
like
larger
numbers?
Yes,
but
we
totally
get
what's
happening
at
department
of
corrections?
I
mean
you
know,
there's
there's
nothing.
We
can
do
about
the
lockdown
and
we
have
been
assured
by
department
of
corrections
that
coming
out
of
covid.
M
M
However,
there
is
going
to
be.
There
will
be
some
work
involved
with
that,
because
that
call
center
I'm
talking
about
is
for
the
entire
state.
So
there's
sometimes
so,
as
I'm
sure
you've
heard,
there's
some
times
of
waiting,
they're
waiting,
30
minutes,
40
minutes
it
just
depends
on
what
time
of
the
month.
It
is
our
staffing
at
the
time
we
do
try
to
staff
it.
We
have
backup
staff
that
come
on.
M
If
we
get
past
a
threshold
and
but
like
I
said,
we
can
certainly
work
on
on
working
with
department
of
corrections
to
try
to
get
some
kind
of
phone
setup.
But
again,
that's
department
of
corrections
call
as
to
whether
or
not
security
there
would
allow
for
inmates
to
have
access
to
a
phone
before
they
leave.
A
And,
and
and
thank
you
very
much,
I
think
I'm
gonna
speaker
ferguson-
did
you
have
a
a
comment
at
this
time.
B
Thank
you,
madam
charlie,
you
asked
the
main
question
that
I
was
gonna
ask,
but
I
I
just
want
to
point
out
that
this
is
done
elsewhere,
without
a
cost
associated
with
it,
and
I
would
imagine
significantly
more
volume
and
frequency
when
the
clark
county
detention
center
can
do
it
without
an
additional
cost.
I
I
in
my
career,
I
know
that
whether
it's
ndoc
or
the
local
jail
inmates
have
to
be
accommodated
to
talk
to
their
lawyers.
B
So
it's
there
are
phones,
it's
not
like
they're
sending
home
pigeons
out
that
they
have
to
be
able
to
talk
to
their
attorneys
and
they
have
to
be
able
to
do
it
in
private,
and
so
this
would
seem
to
me
to
be
an
opportunity
to
defray
costs
of
of
medical
expenses,
as
folks
are
transitioning
out
and-
and
I'm
just
a
little
surprised
at
the
reluctance,
especially
recognizing
that
there's
been
efforts
to
address
this
for
some
time
now
that
an
effort
to
partner
up
with
insurance
companies
or
any
other
entity
to
to
or
medicaid
directly
to
to
to
make
this
happen,
just
seems
to
me
should
be
a
priority
and
it
feels
like
there's
kind
of
excuses.
A
And
thank
you
speaker
so
with
that.
I
think
I'd
like
to
go
back
to
ndoc
after
hearing
this,
this
conversation
and
see
if
they
have
any
observations
or
comments
and-
and
I
would
ask
you
to
look
into
working
with
eligibility
to
figure
out
a
way
to
move
forward.
I
understand
the
numbers
you're
talking
about,
but
it
it
seems
to
me
as
though
there
might
be
a
system
out
there
that
may
work
better
for
you.
J
Madam
chair
elizabeth
dixon
coleman
for
the
record
nevada
department
of
corrections,
statewide
re-entry
administrator,
yes
and
the
pilot
we
have
looked
at
some
of
these
things
because
we're
looking
at
a
larger
release
number
several
things
have
come
into
play
as
as
assemblyman
fryerson
actually
brought
forward.
Ccdc
and
some
of
the
other
facilities
actually
have
had
a
a
an
individual
go
in
from
dwss
and
dhhs
to
make
sure
that
they
can
help
gather
those.
Those
are
one
facility
working
with
one
release
coordinator.
J
We
have
18
facilities,
statewide,
which
are
scattered
all
over
the
place,
primarily
with
a
cluster
in
the
northern
area
and
the
southern
area.
However,
we
do
have
rural
facilities
that
we
do
release
from,
depending
on
on,
as
as
we
go
forward
with
that,
the
accessibility
to
the
telephone,
one
of
the
things
that
has
come
out
of
our
working
group,
we
we
meet
monthly
with
both
agencies
to
make
sure
that
we
can
go
forward
to
see
the
best
way.
J
We
can
tackle
this
in
honoring,
not
only
ab236,
but
any
current
legislation
going
forward
with
this
and
in
these
monthly
meetings.
One
of
the
pieces
was
the
the
security
compliance
for
hipaa
and
and
security
components
to
make
sure
and
transferring
data
back
and
forth
between
the
agencies
and
sharing
those
things
and
then
also
the
accessibility
of.
If
we
would
utilize
a
telephone
line
in
those
those
ways
would
we
have
dedicated
lines,
dedicated
services
etc.
Neither
of
those
agencies
have
that
staffing
ability
to
do
that.
J
J
So
we
we
opted
to
do
the
paper
application
in
that
time
frame
we
were
covered,
so
we
have
been
in
talks
about.
Will
the
will
the
the
agencies
dwh
it
d,
w
h,
e
w?
I
s
s
and
dhhs:
have
the
accessibility
to
send
actual
workers
from
them
to
come
in
to
assist
with
our
pieces
with
numbers?
Should
questions
need
to
be
answered,
etc,
they're
looking
into
some
of
those
things,
but
to
ensure
that
we're
going
forward
with
that?
J
We
opted
again
for
the
paper
allocation
for
that
component
and
with
that
in
the
small
numbers
that
we
were
doing
again.
It
was
by
request
and
60
to
90
days
to
release
for
those
that
would
be
eligible
under
that
component
for
us
applying.
We
do
yes
get
back
a
component,
but
we're
also
making
sure
that
we're
monitoring
and
tracking
and
recording
that
data
in
which
we're
sharing
back
and
forth
between
awss
and
dhhs
and
our
own,
so
that
we
can
have
their
website
match
the
data.
J
That's
actually
coming
from
the
department
corrections
to
actually
paint
that
very
deep
picture
so
that
we're
not
constantly
coming
back
and
asking
and
asking
and
asking
in
interim
finance
as
we
as
we
build
onto
these
components,
but
ensuring
that
we
could
do
this
in
the
best
quality
way
and
going
forward
is,
is
the
reason
why
we
presented
forward
with
the
fiscal
notice,
as
we
did.
Man.
A
And,
and-
and
thank
you
very
much-
this
is
a
a
lot
of
moving
pieces
and
parts,
but
I
have
to
say
that
I
would
have
more
concerns
about
the
paper
document
and
security
than
I
would
about
a
phone
call,
so
I
hope
you'll
take
that
into
consideration
and
also
the
speaker's
comment
about
a
secure
line
and
confidentiality
when
speaking
to
your
your
legal
representative.
A
So
with
that
committee
members,
I
think
we've
asked
enough
questions.
Thank
you.
Miss
nguyen
we're
going
to
keep
digging
into
this
one
and
see
where
we
can
go
with
it.
So
seeing
no
other
questions
or
comments
at
this
time.
This
is
the
hearing
for
assembly
bill
358.
So
I'm
going
to
go
ahead
and
open
it
up.
Is
there
anyone
in
the
room
in
support
of
assembly
bill
358,
not
seeing
anyone
in
support
with
that?
We
will
go
to
the
phone
lines.
A
Thank
you
very
much
so
with
that
we'll
go
ahead
and
close
the
hearing
on
assembly
bill
358.
Thank
you
very
much,
mr
winn.
For
being
the
pinch,
hitter
there's
a
little
bit
more
work
to
be
done
on
this,
we'll
we'll
follow
up
with
the
appropriate
folks
and
see
where
we
can
go
and
I'm
sure
you'll
follow
up
with
them.
Also.
So,
thank
you
very
much
so
with
that
committee
members.
I
believe
there
are
a
couple
of
bills
that
we
can
move
this
evening.
A
We
can
get
them
reported
out
and
keep
things
rolling
towards
the
senate,
so
hold
on
for
just
a
moment
and
we'll
go
through
the
list.
A
A
All
right
committee
members
so
for
the
public's
information
and
for
yours,
I
believe
we
can
go
ahead
and
move
some
bills
this
evening.
The
two
that
we
will
not
be
moving
are
ab189.
Ms
gorlo
is
still
going
to
work
on
that
with
mr
young
and
combine
those
fiscal
notes
together.
So
we
have
a
comprehensive
fiscal
note
to
look
at
and
assembly
bill
358,
which
we
just
discussed.
A
That
needs
some
more
discussion
so
with
that
the
other
bills
that
we
heard
this
evening,
the
chair
is
comfortable
and
moving
does
do
any
of
the
committee
members
have
any
concerns
on
any
of
those
bills
at
this
time,
not
seeing
anyone
wishing
to
be
recognized,
we'll
go
ahead
and
turn
it
over
to
ms
kaufman
and
we
will
just
go
through
the
bills
in
order.
So
ms
kaufman.
C
Thank
you,
madam
chair
assembly,
bill
191
requires
a
state
plan
for
medicaid
to
include
coverage
for
the
services
of
community
health
workers.
Under
certain
circumstances,
there
was
a
discussion
related
to
a
savings
that
was
provided
in
fiscal
year,
2022
of
342
446
dollars
and
in
fiscal
year,
2023
of
837
thousand
two
hundred
and
forty
three
dollars
in
fiscal
year.
Twenty
twenty
three.
I
would
note
that
there
was
also
discussion
related
to
expenses
that
would
be
incurred
through
the
medicaid
management
information
system.
C
That
would
require
expenditures
of
forty
nine
thousand
five
hundred
dollars,
and
mr
young
testified
that
they
would
be
able
to
transfer
some
of
the
savings
that
were
would
be
provided
in
budget
account.
3243,
which
is
the
medicaid
account
to
the
administrative
account
to
support
these
expenditures.
A
C
Madam
chair,
that
is
correct,
that
language
can
be
added
to
the
appropriations
act.
A
So
are
there
any
questions
or
comments
on
assembly
bill
191
at
this
time,
not
seeing
any?
I
would
accept
a
motion
to
okay
wait,
a
minute.
This
is
where
they
try
to.
Oh,
it's
not
been
worked
on,
so
I
would
accept
a
motion
to
do
pass.
Assembly
bill.
191,
miss
bonitas
thompson,
a
second
from
dr
titus,
any
questions
or
comments
on
the
motion.
A
C
C
A
A
A
C
Thank
you,
madam
chair.
Summon
bill
256,
as
amended
requires
a
state
plan
for
medicaid
to
provide
coverage
of
doula
services
to
the
extent
authorized
by
federal
law
and
requires
the
department
of
health
and
human
services
to
apply
for
a
waiver
or
state
plan.
Amendment
receive
federal
funding
coverage
for
the
doula
services.
The
division
of
health
care,
finance
and
policy
testified
that
there
would
be
savings
resulting
from
this
bill
of
four
hundred
and
fourteen
thousand
two
hundred
ten
dollars
in
fiscal
year.
C
Twenty
twenty
two
and
eight
hundred
forty
thousand
six
hundred
dollars
in
fiscal
year
2023
in
their
medicaid
account.
However,
the
admin
account
would
have
expenditures
58
000
related
to
their
medicaid
management
information
system
upgrades
that
they
would
need
to
do
as
a
result
of
this
bill.
C
Mr
young
had
testified
that
the
savings
that
would
be
generated
in
budget
account
3243
could
be
transferred
to
their
admin
budget
in
order
to
cover
these
expenditures
and
again,
this
bill
would
also
be
required
to
have
the
back
language
provided
for
in
the
appropriations
act
in
order
to
provide
that
transfer.
C
A
You
very
much
committee
members,
any
questions
on
comments
on
assembly
bill
256,
not
seeing
any
so
with
that
this
is
the
first
print
reprint,
so
this
would
be
a
do
pass
as
amended.
I
have
a
motion
from
miss
beninez
thompson.
Second,
from
miss
monroe,
moreno,
any
questions
or
comments
on
the
motion,
dr
titus.
G
Thank
you,
madam
chair.
I
was
a
no
on
this
when
I
first
heard
this
bill,
but
I
will
tell
you
that
I
am
going
to
support
this
building
about
yes
on
it,
anything
that
improves
healthcare
outcomes
and
saves
state
medicaid,
which
I'm
convinced
that
this
bill
will
do
I'm
going
to
support.
So
thank
you,
madam
chair.
A
Thank
you,
dr
titus,
so
with
that
any
other
questions
or
comments
on
the
motion
hearing,
none
all
those
in
favor,
please
signify
by
saying
aye,
any
opposition
hearing
no
opposition
passes
unanimously.
The
member's
president.
We
will
give
the
bill
back
to
ms
summers,
armstrong,
but
miss
monroe
moreno.
Would
you
be
the
backup
in
case
there's
a
fiscal
question
that
she
can't
not
may
not
be
familiar
with
so
always
good
to
have
a
committee
member
do
back
up
on
that,
so
that
is
256.
C
C
A
Okay,
thank
you
very
much
so
committee
members.
Are
there
any
questions
on
assembly
bill
461,
not
seeing
any
the
motion
would
be
a
do
pass
I'll,
accept
that
from
miss
benitez
thompson.
Second,
from
miss
monroe
moreno,
any
questions
or
comments
on
the
motion
seeing
none
all
in
favor,
please
signify
saying
aye
any
opposed
hearing
none
passes
unanimously
of
the
members
present,
mr
watts.
Would
you
handle
this
bill
on
the
floor?
Please
there
you
go
moving
on
to
462.
C
Thank
you,
madam
chair.
The
next
bill
summer
bill
462,
makes
various
appropriations
department
of
corrections
for
upgrades
to,
and
integration
of,
certain
management
systems
for
the
replacement
of
cameras,
storage
areas
and
networks,
as
well
as
ovens.
The
individual
who
testified
on
this
bill
was
lisa
lucas
from
the
nevada
department
of
corrections,
and
there
were
no
individuals
who
testified
in
support
opposition
or
neutral
for
this
bill.
G
I
have
a
burning
desire
to
go
ahead
and
move
this
bill.
A
You,
madam
chair
I'll,
have
to
have
some
of
those
shipped
back
up
here,
there's
still
about
15
000
of
them
left
when
I
mis
messed
up
the
order.
Okay,
so
anyway,
back
on
track
so
committee
members,
are
there
any
serious
questions
on
ab462
at
this
time,
not
seeing
any.
The
chair
would
accept
a
motion
to
do
pass
assembly
bill
462
from
ms
beninis
thompson,
a
second
from
dr
titus,
any
questions
or
comments
on
the
motion,
none
of
them
being
facetious.
A
Please
hearing
none,
because
I'm
not
looking
up
all
those
in
favor,
please
signify
by
saying
hi
ending
in
opposition
hearing.
No
opposition
passes
unanimously.
The
members
present,
who
should
we
give
this
bill
to?
Oh,
mr
watts,
we're
going
to
give
this
one
to
you
too.
Okay
and
whatever
happens
on
the
floor.
I
will
not
be
your
backup.
Thank
you
very
much
there
we
go
all
righty
moving
on
to
the
next
bill.
463
we've
got
to
get
these
folks
out
of
here
I'm
about
to
lose
control
of
the
committee.
Here
we
go.
C
I
would
note
that
casey
casey
provided
testimony
on
this
bill
and
identified
a
an
amendment
to
the
bill
and
the
amount
of
so
the
amount
would
actually
be
reduced
to
two
million
three
hundred
fifty
nine
thousand
one
hundred
sixty
eight
dollars,
and
I
would
also
note
that
there
was
discussion
related
to
providing
a
language
in
this
bill
related
to
a
bill
that
was
provided
senate
bill
508
of
the
2019
session
that
provided
funds
of
5
million
to
the
interim
finance
committee
for
the
support
of
these
wildfire
prevention.
C
A
So
with
that
committee
members,
this
would
be
ms
kaufman.
We
would
need
to
make
this
an
amend
and
do
pass
so
that
we
can
amend
in
that
particular
language.
Then
correct.
Madam
chair,
that's
correct.
Thank
you
very
much
just
wanted
to
confirm
that
so
committee
members.
This
would
be
an
amended
due
pass.
Are
there
any
questions
from
the
committee
at
this
time
on
this
bill?
A
A
There's
two
bills
left,
but
those
are
bills
that
we're
going
to
be
working
on
in
the
future
so
committee.
Thank
you
very
much
for
your
hard
work
this
evening.
I
think
we
got
a
lot
done
moving
forward.
So
with
that.
The
last
thing
on
our
agenda
for
this
evening
would
be
public
comment.
Broadcast
services.
H
B
Good
evening
chairwoman,
carlton
and
members
of
the
committee,
I
know
it's
late.
This
is
eric
spradley,
nevada,
sheriffs
and
chiefs
association.
I
sat
with
you
the
last
couple
hours
and
at
the
very
last
of
the
testimony
from
the
ndoc
on
ab358.
B
My
phone
went
blank,
and
so
I
don't
know
what
happened
it's
the
world
we're
living
in,
but
our
membership
supports
ab358.
Our
membership
operate
the
county
and
local
jails
greatest
hindrance
to
people
being
successful.
Coming
out
of
prison.
Is
us
it's
the
government?
It's
bureaucracy.
Can
we
help
these
individual
individuals
be
successful?
B
We
appreciate
assemblywoman
wynn
stepping
up
to
present
this
bill.
The
testimony
by
the
professionals
you
heard,
we
actually
appreciate
the
technology
glitches,
because
at
least
we've
got
technology
to
connect
this,
and
we
appreciate
speaker
fryerson
for
bringing
ab358
forward.
Please
support
that
bill.
Thank
you,
madam
chair.
A
A
Thank
you
very
much
broadcast
services.
You
guys
help
us
out
every
single
day
so
with
that
committee
members,
our
business
for
this
evening
is
done.
There
are
subcommittee
meetings
tomorrow,
I'm
not
sure
what
the
rest
of
the
week
looks
like,
but
plan
on
being
here
a
lot
through
the
end
of
this
week.
So
with
that
we
are.