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From YouTube: 3/8/2021 - Senate Committee on Commerce and Labor
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A
C
B
A
And
please
mark
senator
hardy
president
when
he
arrives,
welcome
to
the
audience
joining
us
remotely
and
anyone
listening
over
the
internet.
A
Today
we
have
hearings
on
senate
bill
44
and
90,
and
we
have
a
work
session
on
senate
bill
103
just
a
few
housekeeping
items.
I
would
like
to
take
a
moment
to
go
over
some
basic
items.
As
you
know,
legislative
building
is
currently
closed
as
a
public
safety
measure
to
reduce
the
spread
and
infection
rate
of
covet
19
to
the
public,
and
so
all
committee
meetings
will
be
held
virtually
meaning
that
committee
members
staff
and
everyone
else
will
participate
either
through
zoom
video
conference
or
by
telephone.
A
However,
there
are
various
ways
members
of
the
public
can
engage
with
us
and
participate
throughout
the
process.
These
include
registering
to
participate
through
nellis,
where
you
have
an
opportunity
to
testify
on
a
bill
or
provide
public
comment.
During
the
meeting
submitting
written
comment
to
the
committee,
email
address
or
fax
number
listed
on
the
agenda,
sharing
your
opinion
via
the
legislature's
opinion,
application
on
nellis
or
viewing
committee
meetings
online
through
nellis
or
on
the
legislature's
youtube
channel
to
register
click.
A
The
participate
button
near
the
committee
meeting
date
and
time
then
fill
in
the
required
information,
such
as
your
name,
the
agenda
item.
You
are
interested
in
and
your
position
on
the
bill
once
your
registration
has
been
submitted,
you
will
see
a
confirmation
screen
and
you
will
also
receive
an
email
with
the
phone
number
and
meeting
id
to
call
at
the
time
of
the
meeting.
A
A
I
will
announce
the
time
frame.
That's
how
many
minutes
for
each
response,
or
against
and
neutral.
It
will
be
helpful
if
more
than
one
person
in
an
organization
wishes
to
comment
to
remember
that
ditto
is
a
good
response.
When
someone
has
already
covered
your
points,
this
will
allow
time
for
more
people
to
comment
during
that
time
frame.
A
A
A
A
The
proposed
amendment
must
be
submitted
in
writing.
24
hours
prior
to
the
meeting,
please
include
the
bill
number,
a
statement
of
intent
and
your
contact
number
when
testifying.
Please
remember
to
unmute
your
microphone
and
clearly
state
your
name
and
the
entity
you
represent
at
the
beginning
of
your
testimony,
speak
clearly
and
project
your
voice.
A
This
will
ensure
that
those
watching
remotely
can
hear
your
testimony.
Please
remember
to
turn
the
microphone
off
when
you
finish
speaking
a
reminder
to
all
those
who
testified
pursuant
to
nevada,
revised
statute.
218E
085,
it
is
unlawful
for
a
person
to
knowingly
misrepresent
facts
when
testifying
before
a
legislative
committee,
a
person
who
knowingly
does
so
is
guilty
of
a
misdemeanor.
A
The
chair
and
members
of
the
other
committee
may
request
any
testifier
to
submit
documentation
supporting
their
testimony
to
committee
members.
During
these
virtual
meetings.
When
the
agenda
item
calls
for
a
vote,
our
committee
will
be
using
roll
call
to
do
so.
When
the
committee
secretary
calls
your
name,
please
answer
with
yes
or
no,
so
there
is
no
confusion.
A
B
B
senate
bill
103
prohibits
an
insurer
from
refusing
to
issue
canceling,
refusing
to
renew
or
increasing
the
premium
for
a
property
insurance
policy
on
the
sole
basis
of
the
breed
of
a
dog
that
is
kept
on
the
property.
The
bill
provides
an
exemption
for
this
prohibition
if
the
particular
dog
is
known
or
declared
to
be
dangerous
or
vicious,
and
there
are
no
amendments
to
this
bill.
A
Yes,
senator
pickard.
C
Thank
you,
man,
I'm
sure
I
had
the
opportunity
to
talk
to
the
bill's
presenters.
C
They
even
sent
me
the
study
upon
which
they
relied
suggesting
that
there's
no
connection
to
breed
and
the
statistics
regarding
the
I
forget
the
term
they
used,
but
the
the
fatalities
that
resulted
from
a
dog
bite
or
a
dog
attack,
and
it
turns
out
that
the
study
was
actually
whether
or
not
you
could
prevent
a
dog
bite
based
on
the
breed
and
and
of
course,
everyone
knows,
or
most
people
know
that
all
dogs
bite.
C
The
question
is
you
know
what
kind
of
damage?
What
kind
of
injury
do
they
inflict
when
they
attack,
and
so
because
the
the
support
for
it
really
wasn't
on
point.
They
were
studying
something
else
and
because
this
is
something
that
really
should
be
controlled
by
the
marketplace
and
in
fact,
with
rare
exception,
it
appears
that
there
are
plenty
of
options
for
people
to
choose
insurance
companies
that
don't,
in
fact,
most
of
the
major
ones.
C
E
Thank
you,
man,
I'm
sure.
Looking
through
the
medical
literature,
one
of
the
common
themes
is
the.
There
are
some
breeds
associated
with
more
fatalities
than
others,
and
I
think
it's
not
so
much
which
dogs
bite
and
don't
bite,
but
medical
literature
looks
at
the
fatalities
and
fatalities
are
more
predominant
in
some
greats
than
others.
I
appreciate
the
bill
sponsor
and
the
reaching
out
of
the
people
who
were
helping
the
bill
appreciate
their
time,
but
I
will
be
a
no
on
this.
Thank
you,
madam
chair.
A
Thank
you
senator
hardy,
senator
schaible.
Would
you
actually
respond.
F
Sure
I
I
think
that
the
the
literature
is
actually
very
on
point
for
the
question
that
this
bill
asks,
which
is:
can
you
predict
the
likelihood
of
any
particular
animal
causing
any
particular
type
of
harm,
and
is
there
a
way
to
measure
that
risk
against
the
costs
associated,
and
the
answer
is
no
because
between
the
the
chances
of
any
particular
dog
engaging
in
this
kind
of
violent
behavior
and
causing
any
kind
of
damage
and
the
type
of
damage
that
may
or
may
not
be
caused,
the
link
just
can't
be
made
between
any
particular
breed
and
any
particularly
insurance
claim.
F
So
I'm
confident
in
in
the
science
behind
the
bill.
But
I
certainly
understand
that.
Maybe
some
of
my
colleagues
have
concerns
that
can
or
cannot
be
assuaged.
I
would
be
happy
to
meet
with
them
again
happy
to
provide
them
with
more
information
if
they
want.
Otherwise,
I
think
we
can
proceed
with
the
work
session.
A
Okay,
so
now
I
will
entertain
a
motion
to
do
pass.
E
E
C
B
A
Senator
settlemeyer
there's
something
going
on,
I
think
with
your
sound,
but
anyway
I
think
we
have
four.
Yes.
Is
that
correct.
A
A
We
have
joint
presenters,
fergus,
lockridge,
rural
regional
behavior
health
policy
board
and
valerie
haskins
coordinator
rural
regional
behavior
health.
I
will
now
open
this
hearing
on
senate
bill
44.
It
revises
provisions
governing
behavioral
health
professionals.
Mr
rahir
lockridge.
Please
proceed
with
the
bill
when
you
are
ready.
G
Good
morning
for
the
record,
this
is
actually
valerie,
pope
haskin
rural,
regional
behavioral
health
coordinator.
Thank
you,
madam
chair
and
members
of
the
committee
for
this
opportunity
to
present
senate
bill
44
on
behalf
of
the
rural
regional
behavioral
policy
board.
Unfortunately,
my
board
chair,
who
is
going
to
pro
co-present
with
me
today,
fergus
lockridge,
is
unable
to
attend
today
due
to
unforeseen
circumstances.
G
G
This
publication
was
just
sent
the
printer
late
last
week,
so
this
is
about
as
fresh
of
data
as
we
can
get.
This
first
map
shows
areas
within
the
state
which
have
been
designated
by
the
u.s
health
resources
and
service
administration
or
hersa
as
shortage
areas
for
mental
health
providers.
Specifically,
there
are
several
factors
that
determine
the
score,
which
is
categorized
in
colors
shown.
These
factors
include
the
number
of
provider
facilities,
volume
of
persons
needing
care
and
other
factors
that
affect
access
to
timely
and
appropriate
mental
health
care.
G
In
this
graph,
the
number
of
marriage
and
family
therapists
or
mfts
is
represented
in
blue,
while
the
number
of
clinical,
professional,
counselors
or
cpcs
is
represented
in
orange.
Again,
we
see
many
counties
without
adequate
coverage
and
some
with
no
providers
at
all
these
deficits
are
further
exacerbated.
When
we
look
at
the
number
of
psychologists
available,
please
note
that
the
scale
on
the
y-axis
is
much
different
than
the
two
previous
graphs,
while
carson
city
and
washoe
county
appear
to
have
comparatively
good
access
to
psychologists.
G
G
As
the
means
digital
gaps
in
all
forms
of
health
care
during
the
pandemic,
the
governor's
directive
011
allows
licensed
medical
and
behavioral
health
professionals
from
out
of
state
to
skip
the
majority
of
licensing
processes
in
order
to
begin
serving
nevadans
with
this
directive.
The
process
undertaken
by
the
behavioral
health
licensing
boards
to
get
these
professionals
is
nevada.
Licensure
by
endorsement
has
gone
from
sometimes
months
to
a
matter
of
a
few
days,
so
it
can
be
done.
G
Furthermore,
I
reached
out
to
the
four
behavioral
health
licensing
boards
that
are
affected
by
sb44
in
january
and
asked
them
first,
how
many
consumer
complaints
they
had
received
against
providers
since
april
1st
of
2020,
and
then
of
those
how
many
providers
were
practicing
here
under
the
governor's
directive
011.,
while
only
three
of
the
four
boards
responded.
The
answer
was
pretty
clear:
while
the
licensing
boards
had
received
consumer
complaints,
possibly
more
than
usual,
none
of
them
at
that
time
were
regarding
providers
practicing
under
the
emergency
directive.
G
In
other
words,
many
of
the
quality
controls
for
licensure
by
endorsement
which
had
been
put
in
place
by
the
licensing
boards
had
been
removed,
which
could
be
considered.
The
worst
case
scenario,
but
the
concerns
over
poor
quality
of
care
appear
to
not
have
really
come
to
fruition
and
effective
practice.
G
Just
as
we've
defined
what
we
mean
by
behavioral
health
in
this
presentation,
we
also
needed
to
define
what
licensing
boards
would
be
affected
by
the
bill.
The
licensing
boards
affected
by
sb44
include
the
board
of
psychological
examiners,
the
board
of
examiners
for
marriage
and
family
therapists
or
clinical
professional
counselors,
which
I
may
refer
to
later,
as
the
mft
cpc
board.
G
G
Let's
briefly,
walk
through
the
process
that
was
used
to
develop
the
bill
over
the
course
of
the
past
two
years.
I
have
been
continuously
meeting
with
local,
regional
and
state
level
stakeholders
to
identify
their
challenges
regarding
behavioral
health
in
our
region,
provider
shortages
kept
coming
up
as
one
of
the
main
challenges
in
building
out
more
robust
behavioral
programming.
G
As
2020
began,
I
started
having
more
targeted
conversations
with
stakeholders
regarding
what
the
policy
board
could
focus
on
in
this
legislative
session
to
improve
the
behavior
health
system.
Requests
to
address
the
behavioral
health
licensing
boards,
particularly
regarding
licensure
by
endorsement,
floated
to
the
top
as
primary
concern
that
could
be
affected
by
nrs
from
there.
I
worked
with
my
policy
board
to
communicate
what
issues
stakeholders
were
experiencing
and
what
policy
changes
they
were
asking
for
that
could
be
affected
during
this
session.
G
Thus,
on
july
21st
2020,
the
board
voted
to
focus
his
bill
on
issues
regarding
behavior
health
provider
licensure
to
build
out
the
bdr,
I
launched
a
statewide
work
group
that
included
a
broad
variety
of
stakeholders
to
develop
the
concepts
from
there.
My
board
chair
and
I
developed
and
submitted
the
concepts
of
the
bdr
and
held
further
meetings
with
key
stakeholders.
G
After
the
initial
bdr
language
was
released
to
gain
further
feedback,
which
we
received
quite
a
bit
of
at
the
last
meeting
of
the
rural
regional
behavioral
policy
board
on
february
24th,
the
current
amendment
concepts
were
approved.
These
were
submitted
to
the
lcd
staff
last
week
and
we
continue
to
work
with
them
to
ensure
we
are
moving
forward
with
the
amendments.
G
G
Nevada
is
currently
one
of
only
five
or
so
states
that
do
not
offer
this
type
of
licensure,
and
it
makes
it
very
difficult
for
the
board
of
social
work
to
enter
into
interstate
compacts
for
licensure
reciprocity
without
having
this
licensure
type
and
interstate
compacts
are
kind
of
the
gold
standard
of
streamlining
these
processes
we're
not
directly
affecting
reciprocity
with
this
bill.
Also,
the
board
of
social
work
already
has
in
statute
that
they
can
proceed
with
these
compacts
but
they're
timely.
G
Furthermore,
without
offering
the
lmsw
licensure,
there
is
no
designation
for
licensure
between
social
workers
who
hold
only
a
bachelor's
degree
and
a
master's
degree.
Thus,
the
addition
of
the
lmsw
provides
an
opportunity
for
social
workers
who
have
taken
that
extra
step
to
complete
an
approved
advanced
degree
in
social
work
to
have
that
professional
distinction.
G
This
is
something
that's
required
to
prove
that
they
did
actually
complete
their
programs
satisfactorily
and
that
the
course
work
matches
what's
needed.
Initial
conversations
led
us
to
believe
that
this
was
one
of
the
big
hold
ups
in
the
licensure
process.
However,
as
you'll
see
shortly,
we're
going
to
be
amending
this
piece
to
have
greater.
G
Lastly,
because
specific
mechanisms
that
were
causing
delays
and
licensure
by
endorsement
process
couldn't
be
pinpointed
in
larger
work
group
meetings.
The
current
bill
language
includes
an
interim
study
by
the
interim
committee
on
healthcare
to
evaluate
the
processes
of
licensing
boards
and
identify
the
necessary
barriers
to
licensure.
G
G
Additionally,
the
opportunity
for
new
graduates
who
are
wanting
to
complete
their
practice
hours
for
licensure
is
affected
across
all
rural
and
frontier
counties
by
the
number
of
supervisors
who
are
available
to
take
them
off.
I've
tried
to
help
connect
some
interns
with
supervisors,
as
I
can
even
myself,
but
this
is
a
reoccurring
issue
that
has
been
experienced
by
my
board
members,
other
partner
organizations
and
many
local
residents,
while
the
this
doesn't
necessarily
affect
licensure.
G
All
right
so
now
we'll
go
through
the
proposed
amendments.
First,
my
board
would
like
to
remove
the
interim
study
and
the
licensing
board's
processes
and
their
efficiency,
because
there's
no
immediate
change
made.
Instead,
the
board
wishes
to
revise
language
in
nrs
for
all
four
licensing
boards
regarding
licensure
by
endorsement
using
the
language
from
the
board
of
pharmacists
as
a
template.
G
G
At
the
beginning
of
each
section
of
nrs,
regarding
licensure
for
endorsement
for
each
board,
the
language
states
that
the
licensing
board
may
grant
licensure
by
endorsement
to
applicants
who
qualify,
given
the
processes
that
follow
rather
than
shall
the
rural
regional
behavioral
policy
board
would
like
to
strengthen
that
language
by
amending
the
language
to
say
shall
instead,
this
creates
licensure
as
a
default
choice.
If
there
are
any
questions
as
to
whether
or
not
the
licensing
board
in
question
will
grant
licensure
to
a
qualified
applicant.
G
Currently,
at
least
three
of
the
four
licensing
boards
have
explored
remote
supervision
possibilities
for
interns.
It
is
our
understanding
that
the
board
of
social
workers
has
implemented
this
strategy
on
a
part-time
basis.
The
mft
cbc
board
has
been
implementing
remote
supervision
full-time
since
covid,
and
the
alcohol
and
drug
board
has
also
explored
this
option.
However,
at
best,
the
provision
of
remote
supervision
options
is
only
included
in
nac,
not
nrs.
G
Last
but
not
least,
my
board
would
like
to
amend
the
current
bill
language
to
provide
a
lower
application
fee
for
members
of
the
armed
forces
veterans,
their
spouses
and
surviving
spouses
as
a
means
to
honor
those
who
have
served
our
country.
We
believe
it
is
unlikely
that
the
licensing
boards
will
not
be
severely
affected
by
the
volume
of
applications
submitted
by
qualified
persons
under
this
provision.
G
When
all
is
said
and
done,
the
proposed
amendments
to
sb44
the
bill
will
go
from
having
three
main
components.
The
interim
study,
provisional
licensure
by
pending
official
transcript,
submission
an
addition
of
the
lmsw
licensure
type
to
including
four
components:
the
revised
licensure
by
endorsement
processes,
provisional
licensure,
pending
fingerprinting
options
for
results,
remote
supervision
options,
as
well
as
the
previous
edition
of
the
almost
w
licensure
type.
G
A
Ms
haskins
committee
members,
any
questions
vice
chairman.
D
Thank
you,
madam
chair,
so
thank
you
for
going
over
those
amendments
because
I
was
I
was
getting
sideways,
so
I
have
a
question
section
17
of
your
existing
bill.
I
didn't
see
that
as
a
change
to
the
language
and
I'm
asking
questions
about
this
one
because
I
I
don't
know
if
it
was
missed,
but
last
session
in
commerce
and
labor
ab
319.
D
Basically
it
was
a
general
regulatory
provision
about
boards
under
nrs
622
that
basically
we're
going
to
disqualify
someone
for
a
crime
number
one.
The
board
needs
to
list
the
crimes
that
will
disqualify
them.
D
This
was
a
assembly
woman,
tolls
bill
from
2019
and
the
governor
signed
it,
and
you
need
to
allow
a
way
for
them
to
petition
if
they
are
denied
and
they're
found
that
the
licensing
is
denied,
and
so
I
didn't
see
a
provision
in
here
that
spoke
to
that
or
because
it
just
seemed
that
there
was
going
to
be
a
denial
for
any
crime
related
to
it.
It
was
a
blanket
exception
for
all
crimes,
and
so
I
wanted
to
ask
you
about
that.
G
Thank
you,
madam
vice
chair,
for
that.
That
is
something
that
I
had
not
seen
in
nrs
either.
So
I
could
definitely
reach
back
around
to
my
board
chair
and
see
if
that's
something
that
we
could
work
into
an
amendment
and
make
sure
that
we
can
kind
of
tighten
that
up.
D
So
yeah,
so
if
you
want
to
reference
it,
it
was
ab319
tolls.
She
had
it
governor,
signed
it
2019.,
nrs
622,
and
then
it
amended
nrs
648.
C
Thank
you
man,
I'm
I
just
I
I
I
gotta
say
I
love
the
bill.
I
like
the
idea
of
expanding
our
access
to
behavioral
health,
particularly
in
the
days
of
the
pandemic,
but
even
without
it
I
mean
that
we're
we're
so
needful
of
this.
C
I
just
have
a
couple
of
quick
questions
and
I
think
we've
addressed
some
of
this,
but
I'm
concerned
that
we
might,
we
might
be
attacking
the
wrong
side
of
it,
or
at
least
not
completely
thinking
about
what
we're
doing
with
the
original
transcripts
or
official
transcripts.
Rather,
one
of
the
things
we
saw
in
a
couple
of
contexts
within
the
sunset
subcommittee
and
then
last
session,
with
some
licensure
by
endorsement
within
the
medical
community,
is
that
sometimes
the
schools
go
out
of
business.
C
My
concern
is
that
if
we
are
going
to
require
official
transcripts
only
that
we
now
have
just
made
it
difficult
for
some
of
these
people,
whose
institutions
no
longer
exist
and
they
can't
produce
a
an
official
transcript,
we'll
be
precluding
them
and
so
we've.
C
G
That's
an
excellent
question.
I
think
the
probably
the
best
tactic
for
for
me
to
take
is
to
reach
out
to
the
lcd
and
see
how
we
can
work
on
that
language.
The
answer
is
short
answer.
Is,
I
don't
know.
C
C
That's
fine.
I
just
think
that
to
avoid
a
problem
since
we're
going
to
be
amending
it
anyway,
we
might
want
to
take
a
look
at
finding
language
that
allows
for
unofficial
transcripts
or,
as
we
discussed
with
the
medical
board
last
session,
there
may
be
an
opportunity,
through
the
compact
or
through
some
other
mechanism,
to
verify
that
the
person's
you
know
transcripts
were
original
at
some
point
in
their
licensure,
but
that
we
don't
preclude
them
from
coming
to
nevada,
simply
because
our
institution
isn't
able
to
provide
that
official
transcript
anymore.
C
And
madam
chair
with
your
indulgence,
I
have
another
question
on
section:
21
darn,
I'm
sorry,
it's
section,
22.
we're
talking
about
the
definition
of
unlawful
practice,
of
of
social
work
in
this
case,
and
then
we've
added
some
exceptions
and
my
concern
here
is
that
I
don't
see-
and
maybe
I
missed
it,
because
this
is
not
my
practice
area,
but
this
appears
to
give
someone
a
pass
if
they
have
a
license
in
another
state.
They
just
can't
practice
here.
C
The
expectation
is
that
they
get
a
license,
but
you
know
here
if
they
hold
it
under
it's
22b2
if
they
hold
an
active
license
elsewhere,
I
don't
see
any
language
that
requires
them
to
to
obtain
a
license
in
nevada.
So
just
a
little
that
just
tricked
me
up
a
little
bit,
we
might
want
to
make
sure
that
we
give
them
a
time
frame
with
an
exception
for
emergencies,
or
something
like
that.
C
I
would
imagine
that
you
know,
particularly
as
we
get
into
more
telehealth
and
we
could
conceivably
allow
a
competent
counselor
from
anywhere
in
the
world
to
participate
in
an
emergency
situation
as
we've
seen
in
nevada.
For
the
most
part.
I
would
imagine
we
you
know
we
we
could
probably
require
them
to
obtain
a
license.
Is
there?
G
Thank
you
senator
for
the
for
the
record
valley.
No,
I
think
we've
missed
that.
So
thank
you
for
bringing
that
up.
That's
definitely
something
that
we
can
work
with
the
license
with
the
sport
of
social
work
on,
because
I'm
sure
that
they
will
be
enthusiastic
to
make
sure
that
that's
tightened
up.
E
Thank
you,
madam
chair,
for
your
patience,
trying
to
get
there
along
the
same
lines,
we're
waiting,
obviously,
for
the
written
conceptual
amendment
and
all
of
the
powerpoint
slides
were
very
impressive.
E
I
appreciate
the
intent
and
mike
the
question
is
with
this
pandemic
we
see
people
who
used
to
be
retired,
and
this
is
just
picking
your
brain.
If
you
don't
mind,
have
we
looked
at
people
who
have
been
out
of
practice
for
six
months
a
year
and
said
you
know?
Why
did
I
do
that?
Maybe
I
should
do
something
else
and
get
involved
with
nola
health
telemedicine.
E
G
Thank
you
senator
hardy
again
for
the
record
fellow
cua
pay
hasken.
I
think
that
would
be
a
really
great
option
to
explore.
With
these
amendment
concepts,
I
know
that
the
board
is
always
open
to
looking
at
ways
to
actually
further
the
number
of
providers
that
we
have
here
and
I
believe
that
there
are
some
bills
out
there
that
are
looking
to
identify
some
of
the
data.
G
When
we
have
a
number
of
providers
listed-
maybe
they're
retired-
maybe
they
aren't
maybe
they're
full-time,
maybe
they're
part-time,
and
so
I
think,
it'd
be
really
a
great
opportunity
to
capitalize
on
people
who
may
be
existing
within
these
communities
and
able
to
provide
services,
but
just
aren't
at
the
moment.
So
thank
you
for
that.
We
will
look
into
that.
A
Thank
you
committee
members,
additional
questions.
A
A
It
might
be
difficult
for
children.
The
challenge
might
be
insurmountable,
so
my
question
would
be
as
we
look
at
this.
Are
you
looking
at
even
for
mfts?
Are
you
looking
at
anyone
who
might
have
a
particular
specialty
that
deals
with
children
or
deals
with
pediatrics?
A
We
look
at
some
way
to
make
sure
that
we
are
recruiting
people
with
specialties
to
help
to
help
our
students
when
they
go
back,
get
back
to
school,
because
we
we
certainly
can't
go
back
to
school
with
the
same
lame
excuse.
We
don't
have
the
money
to
provide
social
workers.
A
G
Thank
you,
chair,
spearman,
again
for
the
record
valerie
payhaskin.
The
way
that
it's
currently
or
the
amendments
are
currently
proposed.
The
remote
supervision
piece
would
help
persons
who
don't
have
access
to
supervisors
who
have
specific
types
of
experience
such
as
those
who
work
specifically
with
children
or
those
who
work
with
specific
populations.
G
It
would
allow
them
to
access
those
supervisors,
so
in
that
way
it
does
affect
improving
the
providers
who
will
be
available.
However,
I
think
you
make
an
excellent
point
with
recruitment,
and
that
is
something
that
we
could
definitely
look
at
as
well.
A
And
I'm
that
that
is
a
theme
of
mine
as
we
get
closer
to
schools,
reopening
I'm
against
it.
If
we're
not
going
to
fund
social
workers
or
fund
some
type
of
a
program
that
will
help
students
deal
with
that
that
type
of
of
death,
you
mentioned
that
there
were
only
three
or
four
boards
who
answered
or
responded
to
the
survey.
Can
you
tell
me
which
one
did
not
and
why
not?.
G
I
believe
if
I
fingers
crossed,
I
think,
I'm
correct
with
this,
but
I
believe
it
was
the
drug
and
alcohol
board
that
did
not
respond.
I
don't
know
if
it
was
a
busyness
issue
or
what
what
the
issue
was,
but
I
did
receive
feedback
from
the
board
of
psych
examiners,
the
social
work
board
and
the
mft
cpc
board.
A
Okay,
this
is
this
is
something
that
irritates
me,
because
we've
had
the
same
situation
when
we
have
requested
information
back.
So
I'm
just
going
to
put
this
out
here:
ask
the
drug
and
alcohol
board
to
reconsider
their
decision,
because
there
may
be
ramifications
for
not
following
through
with
instructions,
there's
a
reason
that
we
ask
people
to
reply
and
absent,
absent
a
note
from
god.
I'm
not
sure
if
there's
any
reason,
why
why
they
don't?
When
did
your
request
go
out?
How
long
ago.
G
It
was
january,
I
believe,
the
25th.
It
was
a
couple
of
days
before
the
board
meeting,
to
which
I
presented
the
information
january
this
year.
A
One
of
the
things
that
happens
with
reciprocity
and
with
compacts
is
the
ability
for
military
spouses
to
make
a
seamless
transition
both
into
nevada
and
when
they're,
leaving
going
to
another
place.
Another
state
that
might
have
a
compact
so
have
you
have
you
looked
at
any
particular
ways
to
perhaps
reach
out
to
some
of
the
bases
that
are
close,
especially
those
that
are
in
frontier
areas,
and
if
it's
not
active
duty,
then
perhaps
it's
national
guard
or
reservist.
A
That
might
help
augment
what
we're
trying
to
do
in
those
areas
where
we
have
deficiencies.
But
we
also
have
a
great
need.
Third
thing,
I
would.
I
would
ask
second
thing
I
would
ask
on
that-
is
that
I
do
know
that
some
seminaries
train
pastors
in
personal
and
family
counseling.
It
is
not
to
the
extent
of
an
mft,
but
you
can
get
that
as
an
endorsement
in
some
seminaries.
A
So
the
question
would
be:
have
you
looked
at
ways
to
fill
out
if
you
will
of
the
vacancies,
the
needs
and
some
of
the
frontier
communities
by
perhaps
looking
at
those
who
have
been
certified
as
as
pastors
certified
in
personal
and
family
counseling,
and
that
that
that
doesn't
take
it
to
the
whole?
You
know
to
the
whole
level,
but
I'm
just
saying
I
know
when
when
I
was
a
pastor
there
were
certain
things
I
could
talk
to
people
about
and
then,
when
I
reached
a
certain
level
I
say
hey.
A
This
is
this
is
beyond
my
scope,
and
so
here
are
some
names
that
you
you
might
follow
up
with.
So
we
looked
at
doing
something
like
that,
because
one
of
the
things
that
discharged
me
greatly
is
here
in
our
state.
We
don't
have
enough
counselors,
behavioral
health,
we
don't
have
enough
mental
and
the
other
piece
of
that
would
be.
What
are
we
doing
to
make
sure
that
outreach
to
bipolar
communities
is
culturally
effective.
A
In
in
bipod
communities
many
times
unless
there
is
someone
who
looks
like
or
the
person
who
needs
help
feels
like
that
person
has
has
an
understanding
of
their
lived
experience.
A
Then
it
doesn't
matter
if
you
put
10
counselors
there,
they're
not
going
so.
What
have
we
put
in
place
to
make
sure
during
this
transition
and
moving
forward?
What
are
we
doing
to
make
sure
that
in
bipolar
communities
we
are
reaching
out
to
people
who
would
have
the
lived
experience?
And
I'm
talking
specifically
about
black
and
brown
therapists?
A
You
know
indigenous,
I'm
that's
what
I'm
talking
about.
I
know
one
of
the
things
that
we
did
and
we
did
not.
I
don't
think
we
did
it
very
well.
We
just
had
this
massive.
You
know
at
this
level
we're
going
to
have
five
or
six
counselors
and
people
can
call
that's
not
going
to
work
in
a
black
community.
It's
not
going
to
work
in
a
brown
community.
You
know
I'm
not
calling
somebody
that
I
can't
see
their
face
and
know
whether
they're
scrunching
up
their
nose
they're
laughing
at
me.
I'm
not
doing
that.
A
G
Thank
you,
chair
spearman
again,
this
is
valerie
pope
haskins
for
the
record.
I
so
a
lot
a
lot
of
what
you're
discussing
there's
a
lot
of
things
that
are
happening
at
the
local
level
outside
of
the
legislature,
where
programs
are
starting
to
shift
and
there's
more
focus
being
put
on.
How
can
we
connect
with.
G
Religious
communities
and
their
leaders
through
not
only
the
kobit
19
pandemic
because
that's
been
something
that
has
worked
out
very
well
in
several
of
our
communities,
but
also
when
we're
talking
about
behavioral
health
in
general
and
we're
talking
about
not
only
12-step
programs
but
also
beyond
that
and
moving
forward
into
other
programming.
G
I
know
there's
some
things
that
we
have
looked
at
with
the
governor's
challenge
team
to
end
suicide
among
service
members
veterans
and
their
families
regarding
how
we
can
work
with
church
groups
in
order
to
better
connect
with
these
smvf
service
members
veterans
and
family
members,
smvf
groups
across
the
state.
I
it's
something
that
I
haven't
heard
of
any
needed
changes
in
statute
per
se.
G
That's
not
to
say
that
there
isn't
a
need
if
there
is
one
we'd,
be
happy
to
explore
that
speaking
on
behalf
of
the
board,
as
I
to
the
extent
that
I
can
today,
but
there's
also
a
lot
going
on,
it's
just
a
matter
of
trying
to
get
buy-in
also
from
those
religious
leaders
within
our
region.
Again,
I'm
just
the
regional
coordinator
for
the
rural
region.
G
So
I'm
only
somewhat
intimately
aware
with
the
counties
which
I
serve
and
I
can't
speak
to
the
efforts
that
are
going
on
statewide
in
other
communities
in
other
counties,
but
I
think
that
there's
definitely
more
and
more
of
a
push
in
engaging
religious
groups,
so
I
think,
there's
definitely
some
opportunities
to
improve
there,
specifically
when
we
are
talking
about
bipolar
community.
So
thank
you.
A
Thank
you.
I
just
have
two
more
questions
and
I'll
be
brief.
We
talked
about
telehealth
as
a
part
of
this.
A
Processes,
whatever
program,
whatever
equipment
that
is
needed
for
to
use
the
telehealth,
because
that's
coming
up
a
lot
this
session
as
well.
Perhaps
that
can
be
a
way
and-
and
it
has
to
be
video
conferenced
not
just
on
the
telephone,
because
they
have
to
see
who
they're
talking
to
and
what
the
response
is,
so
that
would
that
would
be
one
the
other
one
would
be.
A
Unfortunately,
in
clark
county,
I
believe
we've
had
20
suicides
death
by
completed
suicides
by
students.
One
is
too
many
and
20
ought
to
set
our
hair
and
all
our
wigs
in
the
house
on
fire.
G
So
in
regards
to
the
community
that
I
serve,
I'm
I'm
sorry
again
for
the
record
valerie
qualpe
haskin.
I
have
heard
a
lot
of
concern.
Unfortunately,
so
we've
got
the
data
and
then
what
we
know
anecdotally
right
with
the
kovid
19
pandemic.
A
lot
of
the
healthcare
organizations
that
collect
that
sort
of
data
they
have
their
resources
have
shifted
with
data
collection
reporting
to
cobit
itself.
G
So
what
I'm
hearing
is
what
I'm
hearing
from
social
workers
and
behavioral
health
providers
within
the
hospitals
usually,
but
I
don't
necessarily
have
quality
data
to
back
that
up.
So
please
keep
that
in
mind.
Their
main
concern
is
that
in
many
of
these
communities
there
is
an
increase
that
they're
seeing
of
youth
coming
into
hospitals
with
either
what
appears
to
be
suicide,
attempts,
suicidal
ideation
or
other
forms
of
crisis.
G
G
And
what
they're
crediting
for
this
is
that
at
the
school
district
level,
the
school
district
has
really
worked
over
the
last
several
years
to
create
robust
prevention,
programs
and
change
school
culture,
to
provide
opportunities
for
people
to
learn
how
to
talk
about
mental
illness,
to
talk
about
depression,
anxiety
and
talk
about
grief
and
keep
people
at
a
point
where
they
can
not
only
reach
out,
but
they
can
also
reach
out
to
their
friends
and
they
see
those
signs
of
suicide
and
suicidal
ideation
and
help
connect
them
to
care.
G
So
I
think
for
when
we're
talking
about
youth,
persian
county
itself
is
really
a
success
story.
The
other
counties
it's
in
my
region,
it's
been
a
little
bit
more
difficult
depending
on
the
county.
A
lot
of
it
has
to
do
with,
I
believe,
misunderstanding
of
use,
suicide,
suicidal
ideation
and
substance
use
and
the
causes
thereof.
G
It's
something
that's
very
difficult
for
a
lot
of
adults
to
imagine
the
youth
in
their
lives
experiencing
or
being
a
part
of,
and
it's
it's
I'm
trying
to
think
of
a
way
to
say
this
to
be
tactful,
but
it's
easier
to
think
that
it's
somebody
else's
kids
than
one
song
and
as
a
soon-to-be
mom.
I
I
understand
that,
but
at
the
same
time
we
need
to
protect
our
youth.
G
So
I
have
been
working
with
the
department
of
education
and
other
stakeholders
to
see
how
we
can
support
our
school
districts
in
making
more
robust
changes
to
their
their
programming,
even
through
covid
and
especially
through
kobit.
I
think
that's
been
the
problem
with
a
lot
of
our.
G
What
we've
seen
in
2020
is
this
increased
need
for
services
and
more
robust
programming,
but
everyone's
so
busy
with
cobit
itself
that
there
isn't
necessarily
the
staffing
or
or
other
resources
available
for
behavioral
health,
particularly
where
there
aren't
enough
providers
or
just
not
enough
staff
in
general.
So
I
I
don't
think
that's
necessarily
an
excuse,
but
that's
what's
going
on!
A
Well,
what
well
it
does
and-
and
it
affirms
what
I
what
I
thought
was
happening-
here's
the
thing
that
I
would,
I
would
say
somehow
to
encourage
people
that
you
are
working
with
in
rural
and
frontier
communities.
A
To
understand
just
because
you
ignore
it
doesn't
mean
it's
going
away
and
also
encourage
you,
and
I
I'm
just
saying
you're
trying
to
remember.
We
had
a
bill
senate
bill
204
last
session,
that
required
required
training
to
recognize
depression
and
suicide
ideation
and
to
make
sure
that
there
was
information
available
to
students,
so
they
could
get
it
without
their
friends,
knowing
that
they
were
getting
it
and
you
know,
and
that
sort
of
thing
so
go
back
and
look
at
that
senate
bill
204.
A
I
know
that
I
want
to
say
it
was
2015.
I
think
it
was
assemblywoman.
Benitez
thomas
had
a
a
requirement
for
people
who
were
in
counseling.
I
think
in
social
work
to
get
some
type
of
training,
because
statistics
show
that
people
who
have
committed
who
have
completed
suicide
have
seen
a
doctor,
a
medical
profession
within
the
last
30
days.
So
let's
check
and
see
how
how
well
that
is
or
is
not
working.
A
We
have
to
get
better
because
miss
me
on
the
excuse.
I
don't
have
time
miss
me
on
the
excuse.
We
don't
have
enough
people.
This
is
something
we
have
to
do
so
we
better
figure
it
out,
I'm
not
fussing
at
you.
This
is
just
it's
it's
something
that
that
irritates
me,
especially
in
covet
19,
because
we're
continuing
the
same
lane,
processing
that
we
were
doing
before
then.
A
So
all
that
other
stuff
miss
me
on
that.
Okay,
I'm
sorry!
No!
I'm
not!
I'm
not
sorry.
For
saying
what
I'm
saying,
I
don't
want
you
to
think
it's
against
you!
So
are
there
any
other
questions
from
the
committee
members.
A
Okay,
thank
you
very
much.
What
I'd
like
to
do
now
is
I'd
like
to
open
it
up
for
the
public
to
weigh
in
those
who
are
in
support
of
senate
bill
44.
A
We
can
get
a
lot
more
people
to
be
able
to
speak
if
you
will
not
come
in
and
comment
again
on
on
a
subject
or
something
that
has
said
five
times
so
I'm
gonna
encourage
people.
If
you
hear
what
you
had
to
say
already,
ditto
is
a
real
good
response
and
no
one
will
think
you're
crazy,
so
so
broadcast.
Will
you
open
up
the
lines
please?
This
is
in
support,
30
minutes
and
three
minutes
per
speaker.
Thank
you.
H
H
H
D
Thank
you
so
much
good
morning
sheriff
spearman
and
members
of
the
committee.
My
name
is
vicky
erickson.
D
D
D
H
D
S-A-R-A-H-A-D-L-E-R
of
silver
state
government
relations
representing
vitality,
unlimited
and
new
frontier
good
morning,
madam
chair
and
members
of
the
committee,
both
vitality,
unlimited
and
new
frontier,
are
residential
substance,
abuse,
treatment,
centers
and
certified
community
behavior
health
clinics
located
in
elko,
fallon
dayton
and
carson
city.
These
two
organizations
are
background
providers
of
these
services
to
rural
nevada.
D
D
I
want
to
note
that
we
have
been
working
with
the
board
of
alcohol
and
drug
counselors
on
remote
supervision,
which
we
appreciate,
but
we
welcome
this
bill
as
well
and
then,
finally,
to
speak
to
issues
raised
by
senator
and
chair
spearman,
I
am
very
hopeful
that
by
allowing
remote
supervision,
we
may
allow
a
rural
intern
who
may
well
be
caucasian
to
get
some
guidance
from
a
counselor
who's,
a
member
of
the
bipoc
community
and
thus
increase
the
cultural
competence
of
that
intern
in
delivering
their
services.
D
H
H
H
H
H
A
Thank
you,
many
members,
any
additional
questions
or.
A
Comments,
I
don't
see
any
hands,
so
I
will
take
that
as
a
note.
This
guy's
essence
thank
you
for
your
time
and
for
the
detailed
information
that
you've
given
us.
A
I
would
say
please
take
the
comments
and
the
questions
back
to
the
board
and
not
especially
mine,
but
I
really
need
to
make
sure
that
they
hear
what
I'm
saying
and
not
just
hear
what
I'm
saying
with
my
mouth
here
my
heart,
the
children
are
crying
out
and
we
better
get
it
together
and
figure
out
how
we're
going
to
help
them
going
back
to
school
without
the
proper
behavioral
mental
and
psychological
help
will
not
cure
the
problem.
G
A
Thank
you
thank
you,
and
so
there
are
no
other
questions
or
comments.
I
will
close
the
hearing
on
senate
bill
44
and
we
will
open
a
hearing
on
senate
bill
90..
A
E
E
E
This
goes
on
the
national
practitioner's
data
bank
as
a
naked
as
a
negative
admission,
even
if
it
was
dismissed
by
the
medical
board
or
every
license
application
or
credentialing
form
or
an
insurance
network.
This
must
be
justified
and
verified.
That
slows
down
the
process
be
allowed
to
treat
patients.
E
We
placed
in
statute
in
ab474
in
2017
the
different
way
to
approach
complaints
when
we
use
the
words
well
review
and
evaluate
unquote
as
dealing
particularly
with
controlled
substances.
This
per
this
proposed
bill.
Sp90
looks
to
use
those
same
words
if
the
quote
review
and
evaluation
unquote
shows
a
problem,
it
goes
officially
to
an
investigation.
E
E
E
A
Thank
you
senator
horning.
Will
they
go
in
any
particular
order
or
have
you
talked
to
them?
I
just
said.
E
J
A
J
Hello
and
thank
you
for
allowing
me
to
speak
for
the
record.
My
name
is
student,
dr
ryan
briggs,
I'm
a
second
year
medical
student
at
toro,
university
nevada.
I
conducted
research
relating
to
this
topic
last
summer
and
you'll
find
my
poster
in
nellis.
I
am
a
nevadan
and
I
hope,
to
match
into
a
nevada
residency
to
stay
and
practice
in
southern
nevada.
I
have
two
daughters
who
will
be
entering
into
the
clark
county
education
system.
The
oldest
has
expressed
her
desire
to
be
a
doctor,
as
well
as
a
future
practicing
physician
in
nevada.
J
J
This
means
that
physicians
will
have
to
answer
to
the
affirmative
when
asked
if
they
have
been
investigated
by
potential
employers
or
hospital
systems
with
which
they're
applying
for
privileges,
even
though
no
wrongdoing
was
discovered,
this
could
affect
physician
retention
in
the
in
an
area
where
there's
already
a
physician
shortage.
There
is
precedent
for
sb90
in
2017
ab470
created
a
review
and
evaluation
of
complaints
relating
to
controlled
substance.
J
Prescriptions
under
that
law,
a
physician
does
not
have
to
claim
an
investigation
was
opened
if
the
executive
director
of
a
healthcare
governing
board
determines
that
a
licensee
has
not
issued
a
fraudulent,
illegal
unauthorized
or
otherwise,
an
appropriate
prescription
for
a
controlled
substance.
Sb90
will
standardize
that
all
complaints
be
treated
equally
under
the
law.
In
our
research,
we
also
found
that
most
nevada
state
boards
treat
control
substances,
controlled
substance,
prescription,
complaints
and
all
other
complaints.
K
Good
morning,
for
the
record,
my
name
is
dallin
hilton.
I
am
a
nevadan
and
a
second
year
medical
student
at
toro
nevada.
I
intend
to
do
my
residency
here
in
nevada
after
medical
school,
and
I
also
intend
to
practice
here
one
day.
My
concern
is
that
when
anyone
contacts
the
board
with
a
complaint
and
the
complaint
is
within
the
jurisdiction
of
the
board,
whether
or
not
it
is
notorious,
we
have
the
stigma
of
being
investigated
from
then
on
for
the
entirety
of
our
career.
K
The
review
and
evaluation
process
already
exist
in
the
law
for
controlled
substance
complaints.
Those
are
not
considered
an
investigation.
So
if
the
complaint
is
unnotorious,
it
is
not
carried
forever
by
the
physician.
They
do
not
carry
around
the
associated
stigma
of
having
been
investigated
for
the
rest
of
their
career.
K
The
boards
will
still
be
doing
exactly
what
they
are
right
now.
This
is
just
a
change
in
the
wording
to
benefit
physicians
and
prevent
any
unintentional
or
unmerited
stigma.
Chairman
spearman
and
members
of
the
committee.
I
want
to
thank
you
for
allowing
me
the
opportunity
to
advocate
for
sb
90,
which
I
believe
will
benefit
physicians
and
future
physicians
throughout
nevada.
Thank.
I
You,
my
name
is
weldon
havens.
W-E-L-D-O-N
last
name
is
havens,
h-a-v
is
in
victor
I-n-s
and
sam.
I
am
a
nevada,
physician
and
nevada
attorney
have
been
licensed
in
nevada
to
practice
medicine
since
1974
and
passed
the
bar
in
1998..
I
I
am
a
professor
emeritus
at
turo
university
nevada
past
president
of
the
nevada
state
medical
association,
former
executive
director
of
the
nevada
board
of
osteopathic
medicine,
I'm
currently
a
member
of
the
nevada
board
of
medical
examiners
and
I'm
on
the
board
of
the
governor's
office
of
economic
development.
I
am
speaking
as
an
individual.
I
I
This
would
just
generalize
we're
using
this
term
instead
of
investigation
until
a
complaint
moves
forward
as
a
formal
complaint-
and
I
am
in
favor
of
sv90,
I
think
we
should
support
our
students.
They
are
the
future.
These
are
the
folks
that
are
going
to
be
taking
care
of
us,
so
I
am
in
favor
of
sb90.
Thank
you,
chair.
A
Right
so
we
will
begin
a
comment
on
this
bill
bill
90..
A
H
H
D
S-U-S-A-N-F-I-S-H-E-R
with
mcdonald
carano
speaking
this
morning
on
behalf
of
the
nevada
state
board
of
osteopathic
medicine,
we
operate
under
nrs
633,
which
is
included
in
this
bill
and,
in
short,
we
do
support
sb
90..
Our
current
practice
is,
if
we
receive
a
complaint,
we
investigate,
if
there's
no
finding
of
wrongdoing
all
records
relative
to
that
investigation
are
deemed
confidential
and
are
not
released
unless
there
is
a
court
order
requiring
release
of
the
records.
D
D
H
I
Good
morning,
madam
chair
members
of
the
committee,
stephen
cohen,
again,
for
the
record
previously
identified
just
want
to
also
ditto,
as
madam
chair,
hit
on
with
respect
to
the
earlier
bill.
I
A
Thank
you.
We
will
then
move
to
those
neutral,
30
minutes
this
time
frame,
three
minutes
per
individual.
A
Thank
you,
many
members,
any
additional
questions
or
comments.
E
Thank
you,
madam
chair.
I
appreciate
the
intention
that
we
all
have
to
get
more
providers,
more
quality
care,
more
access
to
care
in
the
state
of
nevada,
and
I
think
this
is
just
one
small
way
to
assure
that.
The
people
who
are
coming
or
who
are
here
or
who
are
going
to
be
applying
for
applications
and
credentialing
with
insurances,
will
have
some
comfort
level
in
coming
here,
staying
here
and
being
able
to
care
for
our
children,
our
veterans,
our
mothers,
our
fathers,
our
special
people
of
every
different
sort.
A
The
state
of
nevada,
thank
you,
madam
chair,
thank
you
and
seeing
no
additional
comments
or
questions.
I
will
close
the
hearing
on
senate
bill
90
and
we
will
open
it
up
now
for
public
comment,
we'll
take
just
a
short
break
to
allow
broadcast
to
set
things
up
and
as
a
reminder
to
provide
public
comment.
Please
register
online
on
nellis
on
the
legislative
website
and
after
you
register,
you
should
have
received
a
an
email
with
and
with
the
telephonic
information.
Let
you
participate.
A
If
you
have
decided
not
to
comment
verbally,
you
may
also
email
and
fax.
Your
comments
to
the
committee
submit
or
submit
your
opinion
on
the
bill
resolution
by
using
the
options.
I'm
sorry
the
opinions
application
on
the
legislative
website.
Remember
when
speaking,
please
remember
to
clearly
state
and
spell
your
name
and
limit
your
comments
to
three
minutes.
A
H
A
Hey
thank
you
broadcast.
There
are
no
the
comments
on
the
public
comment
line.
This
will
conclude
our
meeting
for
today,
and
our
next
meeting
will
be
wednesday
march
10th
at
8
o'clock
am
the
meeting
is
now
adjourned.
Thank
you
for
your.