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From YouTube: 5/5/2021 - Senate Committee on Commerce and Labor
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For agenda and additional meeting information: https://www.leg.state.nv.us/App/Calendar/A/
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A
Good
morning,
everyone
and
welcome
to
this
edition
of
the
senate
committee
on
commerce
and
labor
for
the
81st
legislative
session.
Before
we
begin,
please
be
sure
to
mute
your
microphone
when
you
are
not
speaking
to
minimize
background
noise.
Madam
secretary,
please
call
enroll
senator
hardy
senator.
A
Spearman
here
thank
you
and
if
there
are
any
that
are
out,
please
mark
and
present
once
they
get
here
today
we
will
have
a
hearing
on
assembly
bills,
200,
47,
330
and
391
in
that
order,
just
in
case
anyone
has
to
schedule
your
phone
time
make
sure
again
that
you
turn
your
phone
on
silent.
A
A
Share
your
opinion
via
the
legislators,
opinion,
application
view,
committing
meetings
and
to
register
on
nellis
simply
click
the
participate
button
near
the
committee
meeting
date
and
time
and
fill
in
the
required
information.
Then
you
will
receive
an
email
with
the
meeting
id
number
and
the
telephone
of
your
call
at
the
time
of
the
meeting.
If
you
request
to
participate
in
person,
you'll
receive
additional
email
with
instructions
on
how
to
enter
the
building.
Just
to
note
that,
while
registering
is
necessary,
it
does
not
guarantee
that
you
will
be
able
to
speak
during
a
public
comment.
A
That's
one
reason
why
I
ask
everyone:
if
someone
has
already
made
your
points,
please
open
the
mic.
Please
open
your
phone
line
and
simply
say
ditto
that
way
we
get
more
people
who
have
an
opportunity
to
speak
I'll,
announce
the
time
frame
for
each
response,
that's
for
against
and
neutral,
and
it
will
be
helpful
if
more
than
one
person
is
representing
an
organization.
If
you
will
select
one
person
to
do
so
when
you're
on
the
phone,
please
pay
attention
to
which
bill
is
being
considered
and
follow.
A
The
verbal
prompts
provided
by
the
bps,
the
bps
staff.
I
can
talk
this
morning,
the
bps
staff,
so
that
you
know
which
keys
to
press
raise
your
hand
or
mute
yourself
and
staff
are
calling
you
to
speak
by
the
last
three
digits
of
your
phone
number.
If
you
want
to
receive
electronic
notification
or
need
additional
information,
please
send
the
send
a
request
to
the
email
that's
listed
on
the
agenda
page.
A
A
I
will
not
entertain
any
amendments
if
the
bill
sponsor
is
not
aware
of
the
amendment.
The
proposed
amendment
must
be
submitted
in
writing
24
hours
prior
to
the
meeting,
and
please
include
the
bill
number
statement
of
intent
and
your
contact
information
pursuant
to
nevada,
revised
statute.
218
e.085
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,
the
chair
or
any
member
of
this
committee
may
request
a
testifier
to
submit
documentation
supporting
their
testimony
and
committee
members.
A
If
you
have
a
question,
please,
while
we're
in
this
virtual
environment,
please
open
your
mic
and
I
will
acknowledge
you
or
if
you
are
on
zoom,
raise
your
hand
via
the
zoom
application
and
finally,
finally,
again,
please
put
all
your
cell
phones
and
laptop
laptops
on
silent
mode.
During
the
meeting
and
just
before
I
open
up
the
hearing
on
senate
bill.
200
I've
been
informed.
There
is,
I
guess,
a
an
amendment
for
senate
bill.
I'm
sorry
assembly
bill
391,
I'm
not
clear
that
everything
has
been
worked
out.
A
So
while
we
are
doing
the
other
bills,
those
of
you
who
are
involved,
please
try
to
get
together
and
work
it
out.
If
there
is
an
amendment
that
the
sponsor
has
agreed
to
or
not,
I
need
to
make
sure
that
that
has
happened
before
we
hear
your
before.
We
hear
your
bill.
Okay,
so
work
it
out
and
you
can
keep
our
policy
staff
person
in
the
end.
A
While
you
try
to
do
that,
if
you're
not
ready
for
it
today,
you
need
to
get
ready
for
it
really
quick,
because
we
only
have
until
next
friday
to
get
all
the
bills
out
of
committee
and
with
that,
let's
open
a
hearing
on
assembly
bill
200.,
it's
assembly,
woman,
billboard,
x-ray,
alyssa,
elisa
navworth,
danny
thompson,
dr
susie
ko
costas
and
dr
j.j
gokutiya
gokuchiya,
and
michelle
wagner,
so
it
revises
provisions
governing
veterinary
medicine.
So
some
women,
please
begin
when
you're
ready.
D
D
D
At
this
critical
time,
when
nevada's
nevadans
are
more
reliant
on
technology
than
ever,
nevada
has
an
opportunity
to
shape
the
direction
of
telemedicine
for
optimal
animal
health
and
welfare
benefits.
To
date,
nevada
law
and
regulations
are
silent
in
regards
to
telemedicine
to
ensure
nevada
consumers
can
access
the
resources
and
benefits
of
telemedicine
without
sacrificing
quality
of
care.
Ab200
clearly
authorizes
the
use
of
telemedicine
in
nevada
for
continued
care
of
an
animal
that
has
previously
been
seen
by
a
licensed
nevada,
veterinarian
ab200
formally
established
and
allows
for
telemedicine
as
part
of
veterinary
practice
act
in
nevada.
D
The
intent
of
ab200
is
to
provide
clarity
for
both
the
consumer
and
veterinarians
as
to
the
appropriate
use
of
telemedicine
to
treat
animals.
I
want
to
run
briefly
through
what
the
bill
does.
Ab200
affirmatively
allows
for
a
licensed
nevada
veterinary
to
practice
veterinary
telemedicine
in
nevada
for
animals.
They
have
previously
examined
this
legislation
affirms
that
the
nevada
state
board
of
veterinary
medical
examiners
have
clear
authority
to
oversee
and
govern
the
acts
of
veterinary
telemedicine.
D
D
D
Patient
relationship
sometimes
referred
to
as
vcpr
telemedicine
does
not
alone
fulfill
a
veterinarian's
professional
obligation
for
thorough
in-person
examinations
which
employ
all
of
the
veterinary
senses
and
expertise
and
elicits
animal
responses,
all
of
which,
which
are
imperative,
because
veterinary
patients
cannot
verbally
convey
history
or
symptoms
to
be
planar,
nevada,
pets
and
agriculture.
Animals
cannot
speak
for
themselves
and
nevada.
Pet
owners
aren't
professionally
trained
to
assess
the
status
of
their
pet's
health
and
to
communicate
that
to
the
veterinarian.
D
Accordingly,
nevada
must
adopt
a
responsible
telemedicine
policy
in
the
state
that
takes
into
account
the
importance
of
physical
exams
necessary
to
appropriately
take
care
of
nevada
animals
in
requiring
a
physical
exam
and
combination
of
the
tools
available
through
telemedicine.
This
legislation
aligns
nevada
law
with
federal
law
under
federal
law.
An
in-person
physical
exam
of
an
animal
and
a
timely
visit
to
the
premises
is
required
to
establish
a
veterinary
client
patient
relationship.
D
This
is
because
it's
a
federal
requirement.
It
applies
to
all
states
federal
requirement
of
the
veterinary
client.
Patient
relationship
applies
to
any
extra-label
drug
use
and
the
writing
of
veterinary
feed
directives.
Finally,
the
legislation
will
expand
access
to
care
of
nevada,
pet
owners
who
have
previously
had
them
their
animals
seen
by
a
licensed
veterinarian.
D
This
will
be
easily
taxed.
It
will
make
it
easy
to
access
ongoing
care
absence.
The
passage
of
ab200
veterinary
medicine
will
continue
to
be
unregulated
in
nevada.
This
will
not
only
expose
nevada
consumers
to
potentially
predatory
behavior
by
out-of-state
interest
looking
to
profit
off
them,
but
it
will
also
leave
nevada
veterinarians
without
appropriate
guidelines
as
to
what
is
and
what
is
not
appropriate.
Telemedicine
ab200
was
born
on
out
of
ongoing
conversations
in
the
2019-2020
interim
amongst
veterinarians,
pet
owners
and
the
real
need
for
responsible
veterinary
telemedicine
in
nevada,
with
the
passage
of
ab200.
D
D
I
love
animals,
as
at
least
one
person
on
this
committee
knows
I,
my
pitbull
mia
gets
her
apoquil
through
a
chewy
actually
up
here,
because
it's
a
little
bit
cheaper,
but
she
has
a
vet
that
she
goes
to
and
after
six
months
of
getting
the
apoquil
she
comes
in
and
sees
sees
her
veterinarian
and
the
veterinarian
takes
her
blood
to
make
sure
that
her
kidneys
look
good
and
everything.
So,
even
though
we
can
she
can
access
some
of
these
things.
D
It's
important
that
pets
have
that
interaction
with
an
actual
veterinarian
in
the
state
because,
as
I
said
before,
they
can't
speak
for
themselves,
and
you
know
you
don't
know.
You
think
that
your
dog
has
a
symptom,
but
I'm
not
a
veterinarian
as
much
as
I
maybe
I
should
have
been,
but
I'm
not
so
with
that.
I
will
turn
this
over
to
alyssa
navworth,
who
will
go
over
the
sections
of
the
bill.
Thank
you
for
your
consideration.
A
Thank
you
assemblywoman,
and
just
even,
if
you're
with
your
presentation,
you
don't
have
to
ask
me
permission
to
do
that
and
whenever
you
all
are
responding
to
questions
from
the
community
members
just
go
direct
no
need
to
go
through
me.
Okay,.
E
We
want
to
thank
assemblywoman,
bilbray
axrad
for
her
leadership
on
this
important
legislation.
I've
been
asked
to
walk
the
committee
through
the
bill
section
by
section
section.
Two
of
the
legislation
defines
veterinary
telemedicine.
This
definition
was
drafted
to
be
consistent
with
federal
law,
to
ensure
clarity
for
consumers
and
veterinarians
alike.
E
Section
three
of
the
legislation
clearly
states
that
veterinary
telemedicine
is
an
appropriate
tool
to
be
used
to
treat
nevada
animals
for
ongoing
treatment.
Once
the
timely
veterinary
client
patient
relationship
through
the
physical
examination
has
been
established,
it
has
been
nevada
law
for
over
20
years
that
a
timely
physical
examination
is
required
to
establish
what
is
called
a
vcpr,
which
is
a
legal
term
of
art.
Section
3
brings
that
requirement
currently
codified
under
nac
6380197
into
statute.
E
There
is
also
a
proposed
friendly
amendment
requested
by
the
nevada
board
of
veteran
medical
examiners
that
I've
been
asked
to
present
it's
listed
on
nellis
under
my
name
again.
This
is
considered
a
friendly
amendment
and
is
available
on
nellis.
I
believe
the
board
is
available
today
for
questions.
The
proposed
amendment
includes
the
following:
it
removes
a
notice
requirement
requiring
publication
and
various
news
outlets
if
personal
service
cannot
be
made,
it's
my
understanding
that
the
spurt
of
some
requirement
is
no
longer
needed
associated
with
various
notices.
E
Second,
the
proposed
amendment
would
allow
the
board
to
accept
licensure
applications
online
by
removing
the
requirement
for
notarization.
Third,
the
proposed
amendment
would
allow
the
board
to
hold
renewals
on
a
bi-annual
basis
and
remove
the
renewal
expiration
to
june
30th,
which
is
a
less
hectic
time
for
licensees
to
conduct
renewals
of
their
licenses.
It
also
make
it
more
efficient
use
of
board
staff,
time
and
expenditures.
E
E
The
board
often
finds
that
an
individual's
conduct
does
not
rise
to
the
level
of
permanent
disciplinary
action,
but
could
prevent
further
actions
or
harm
by
taking
course
in
record
keeping
or
communication
with
clients.
These
letters
of
correction,
akin
to
a
moving
violation
ticket,
would
allow
them
to
obtain
education
and
prevent
further
liabilities.
E
Oh
and
one
last
note
dr
j.j
gorkichio,
who
was
with
us
for
the
last
hearing,
couldn't
make
it
because
he's
back
on
the
ranch
and
servicing
his
clients,
and
so
he
sends
extends
his
regards
and
is
going
to
submit
his
testimony.
F
Hi
there,
for
the
record,
my
name
is
dr
susie
costa.
I
am
a
native
nevadan.
Thank
you
for
being
here
to
listen
to
our
comments
regarding
ab200.
Our
goal
is
to
establish
clear
guidelines
in
nevada
for
the
use
of
telemedicine
in
the
field
of
veterinary
medicine.
F
I
was
the
owner
of
spencer
springs
animal
hospital
for
the
last
six
years,
I'm
currently
the
medical
director
of
that
hospital.
I
have
built
my
practice
on
basic
core
values
with
the
clients,
trust,
reliability,
communication
and
a
nice
working
relationship
with
the
clients
and
trying
to
provide
the
absolute
best
in
patient
care.
F
So
much
has
changed
for
our
veterinarians
over
the
past
year
in
our
efforts
to
decrease
the
negative
effects
of
coven
19
in
the
lives
of
all
of
us,
by
supporting
social,
distancing
and
decreasing
person-to-person
contact.
The
veterinary
profession
has
increasingly
begun
to
offer
curbside
service
virtual
visits
and
telemedicine,
thereby
limiting
in-person
client
visits
to
ensure
a
safe
environment
telemedicine.
I
feel
that
it
was
already
beginning
to
become
a
common
phenomenon
in
human
medicine,
and
it
is
a
way
to
make
healthcare
more
available
and
more
convenient,
because
that
is
what
everybody
wants.
F
Nowadays
is
convenience:
there
have
been
countless
advertisements
for
new
telemedicine,
software
and
programs
to
or
have
practices
incorporate
their
incorporate
into
their
veterinary
practices,
and
but
when
not
regulated,
these
have
the
potential
to
harm
both
the
consumers
and
their
pets.
F
In
my
opinion,
nothing
can
replace
a
thorough
physical
exam
of
our
veterinary
patients.
It's
the
foundation
of
veterinary
medicine.
Without
this
we
accomplish
nothing.
We
need
to
listen
to
our
clients,
tell
us
how
the
patient
has
been
doing.
We
need
to
auscultate
our
patients.
We
need
to
listen
to
their
heart
and
lungs
for
indications
of
illness.
We
need
to
look
at
our
patients.
We
need
to
use
our
hands
to
evaluate
their
skin,
their
body,
their
joints,
their
feet.
We
need
to
watch
them
breathe.
F
We
need
to
look
at
the
color
of
their
mucous
membranes
and
make
sure
the
insides
of
their
ears
are
the
right
color.
This
is
the
basis
of
our
veterinary
client,
patient
relationship
establishing
with
those
patients
and
their
parents
a
thorough
physical
exam,
so
that
we
can
make
the
best
diagnosis
and
provide
the
best
care
communication
is
is
key
throughout
this
whole
thing,
the
after
the
initial
exam,
a
relationship
has
then
been
established,
and
only
after
that
veterinary
client
patient
relationship
has
been
established.
F
And
please
don't
misunderstand
me:
there
are
great
things
about
telemedicine.
It
allows
us
to
help
those
who
don't
have
access
to
transportation
or
have
limited
funding,
and
it
eliminates
exposure
for
those
with
weakened
immune
systems,
but
it's
a
tool
that
we
should
incorporate
into
our
practice
only
for
follow-up
visits.
After
initial
practice,
in-person
visit
has
been
done
by
the
veterinarian,
with
the
patient
and
the
client,
in
my
opinion,
as
a
veterinarian.
F
F
It's
absolutely
critical
to
me
that
we
introduce
veterinary
telemedicine
guidelines
into
the
nevada
veterinary
practice
act
and
give
authority
to
the
nevada
state
board
of
veterinary
medical
examiners
to
oversee
telemedicine
in
nevada.
The
implementation
of
these
guidelines
will
help
ensure
the
highest
level
of
protection
for
patients,
clients
and
veterinarians.
Thank
you.
E
Thank
you,
dr
costa,
and
now
dr
pannell.
Would
you
like
to
join.
G
G
G
The
avma
is
the
largest
veterinary
association
in
the
united
states
and
has
over
97
000
veterinarians.
As
members,
I'm
going
to
be
speaking
about
some
of
their
thoughts
on
the
establishment
of
the
bcpr,
the
avma
and
the
nevada
bma,
and
I
embrace
telemedicine.
As
dr
costa
said,
when
used
properly,
it
is
a
valuable
tool
that
is
used
extensively
by
veterinarians
on
a
daily
basis.
G
G
Both
the
policy
and
the
model
veterinary
practice
act
require
that
a
vcpr
be
first
established
by
an
in-person
physical
examination
and
may
not
be
established
by
telephonic
or
other
electronic
means
once
established,
it
may
be
maintained
electronically.
In
certain
circumstances,
the
passage
of
this
bill
will
also
follow
federal
law
on
the
establishment
of
the
vcpr,
as
miss
navworth
said,
we
believe
wholeheartedly
in
telemedicine.
G
I
have
many
examples
of
animals
hiding
illness,
but
one
one
quick
example
was
a
cocker.
Spaniel
was
dropped
off
at
my
hospital
for
boarding.
While
the
family
went
to
disneyland.
I
did
a
physical
exam
on
it.
It
was
pale
mucous
membranes.
I
palpated
the
abdomen.
There
was
a
mass
in
the
abdomen
that
was
bleeding.
G
G
G
Sure,
good
morning
my
name
is
dr
boyd
scratling,
v-o-y-d,
n
s-p-r-a-t-l-I-n-g.
I
am
a
rural
large
animal
veterinarian
serving
animal
agriculture
in
nevada,
since
1975.
G
telemedicine
is
and
has
for
a
long
time
been
an
essential
part
of
large
animal
practice.
The
very
nature
of
remote
location
of
nevada's
farms
and
ranches
require
assistance
given
traditionally
over
the
phone,
but
more
and
more
in
a
digital
format.
Almost
daily
I
receive
photos
of
affected
animals
or
situations
from
ranches
to
my
ipad.
Using
these,
I
can
determine
if
advice
can
be
given
via
telemedicine
or
if
a
ranch
call
is
required.
G
Trust
with
the
owner
is
solidified
concerns
over
antibiotic
resistance
have
been
front
and
center
in
recent
years.
Cooperation
among
ranchers
veterinarians,
government
agencies,
including
congressional
input
and
the
human
health
community,
have
mandated
that
prescribing
an
oversight
of
antibiotic
use
is
done
by
practicing
veterinarians
working
closely
with
individual
farms
and
ranchers
proper
use
of
drugs
for
the
benefit
of
the
animal
while
precluding
inappropriate
or
overuse
of
an
antibiotic
is
therefore
assured
key
to
the
success
of
planning
for
disease.
Prevention
is
for
disease
prevention,
thus
reducing
the
treatment
needs.
G
G
Distance
veterinarians,
who
have
never
set
foot
on
their
property,
who
are
allowed
to
prescribe
drugs
supported
only
by
a
digitally
structured
pcpr,
will
eviscerate
the
current
and
effective
curve.
Health
programs
that
are
so
essential
potential
for
mischief
is
also
achieved.
The
illegal
resale
of
prescription
drugs
by
an
operator
who
has
been
over
prescribed
would
remove
all
veterinary
oversight
and
control.
G
The
distant
veterinarian
would
have
no
idea
how
many
animals
are
actually
on
the
property
inflating.
That
number
would
be
very
simple.
This
telemedicine
discussion
raises
questions
as
to
the
availability
of
veterinary
service
to
nevada
agriculture.
Of
course,
there
could
be
closer
service.
Nevada
is
a
large
state,
but
in
today's
livestock
industry,
in
order
to
conduct
a
business
or
sell
animals
across
state
lines,
a
certificate
of
veterinary
inspection
must
be
issued
in
order
to
conduct
that
movement.
G
In
issuing
that
document,
the
veterinarian
has
to
have
visited
the
operation
and
seen
the
herd
within
a
specified
period
of
time.
In
spite
of
the
remote
location,
nevada's
veterinarians,
I
feel
like
that
means
have
been
formulated
for
a
long
time.
The
result
is
an
opportunity
for
a
person,
an
in-person
vcpr,
not
every
animal
needs
to
be
seen.
The
federal
definition
also
allows
the
veterinarian
to
have
been
on
the
premises
in
a
prior
appropriate
period
of
time.
G
In
addition,
an
in-person
vcpr
is
required
to
approve
a
veterinary
feed
directly.
This
provision
allows
feed
males
to
add
therapeutics
to
food.
Animal
feed
mixtures.
Bottom
line
bcprs
need
to
be
established
in
person
not
in
a
digital
atmosphere.
If
digital
obesity
birds
are
allowed
to
or
companion
animals,
that
practice
will
assuredly
jump
into
food.
Animal
prescriptions
thus
actually
endangering
animal
health
and,
more
importantly,
human
health.
Thank
you
for
your
opportunity
to
testify.
A
Thank
you,
miss
neighborhood
committee
members.
Any
questions.
H
Yep,
no
I'll
ask
him
when
I
have
him.
Thank
you
for
the
bill.
I
too
have
had
animals
most
of
my
life
from
horses
down
to
the
gerbils
that
we
would
bring
home
from
school,
and
I
certainly
appreciate
the
idea
of
both
telehealth
and
the
idea
of
a
a
physical
exam.
H
So
I
understand
that
and
then
now
we're
into
the
area
of
of
you
know,
covid
response
we're
trying
to
do
as
much
remotely
as
we
can.
So
I
understand
both
sides
of
that.
My
questions
have
to
do
actually
with
the
friendly
amendment.
H
I
can't
tell
what
sections
these
would
be,
but
it
would
be
under
the
first
page:
it's
the
change
to
638.017
sub
1.,
we're
deleting
personal
service.
H
That's
fine,
we're
deleting
or
I'm
sorry
we're
deleting
service
by
publication,
but
we're
not
inserting
service
by
alternative
means.
I
don't
know
if
this
is
going
to
change
the
rules
of
civil
procedure
at
all.
So
if
a
lawsuit
were
to
be
filed.
H
This
to
me
removes
the
ability
to
adequately
serve
and
where
this
is
under
622a,
which
is
the
due
process
section.
If
you
will
for
regulatory
boards,
I'm
really
concerned
that
we
are
removing
any
alternate
means
of
service
and
we
say
it's
personal
service
or
you
can't
to
move
forward.
That's
concerning
to
me:
can
you
explain
how
this
will
work.
I
Thank
you,
madam
chair,
and
senator
nina
laxat
for
the
record,
representing
the
nevada
state
board
of
veterinary
examiners.
If
I
could
defer
to
the
executive
director
who
is
online,
I'm
not
quite
sure
how
to
answer
that
question
and
I
believe
jennifer
pedego
is
online
and
can
re
respond
to
their
alternative
process.
A
And
if
there's
anyone
else
that
you
have
that's
going
to
answer
questions,
including
this
level,
you
can
make
sure
the
broadcast
has
information
and
you
can
pull
them
up
and
remove
it.
Okay,.
I
And
and
madam
chair
senator
pickard,
that
what
I
could
do
is
let
me
go
sit
back
and
and
try
to
get
on
a
text,
and
I
will
get
that
answer
for
you
so
that
we
don't
hold
up
this
process.
Okay,.
H
H
On
page
three,
these
aren't
numbered,
but
it's
the
change
to
100,
which
is
the
licensure
for
vets,
we're
deleting
the
what
I
assume
to
be
sub
7..
If
a
licensee
does
not
renew
his
or
her
license
and
is
licensed
to
practice
in
another
state
or
territory
of
the
united
states,
the
board
may
not
issue
the
license,
licensee
a
license
to
practice
by
reciprocity,
and
then
the
explanation
was
that
this
change
change.
H
The
changes
to
this
section
would
allow
licensed
veterinary
technicians
to
administer
zoonotic
vaccinations
such
as
rabies,
in
addition
to
veterinarians,
and
this
deletion
has
nothing
to
do
with
veterinary
texts.
So
to
me
it
seems
to
go
well
beyond,
and
and
so
we
are
eliminating.
If
someone
doesn't
renew
his
license,
they
are
no
longer
going
to
be
precluded
from
licensure
by
reciprocity
and
quite
often
we
see
licenses
surrendered
for
disciplinary
actions,
but
if
they
were
still
licensed
in
another
state
that
chose
not
to
also
remove
their
license.
H
I
D
Shannon
bilbray
for
the
record,
I
I
just
did
want
to
put
on
the
record
that
obviously
my
bill
is
ab200
and
I've
been
working
on
this
for
quite
a
while,
and
unfortunately,
the
the
boards
bill
missed
the
deadline.
D
So
I
think
the
aspects
that
you
see
in
the
friendly
amendment
are
the
things
that
they
believed
were
really
necessary
and
while
I
would
love
to
help
them
out-
and
that
is
my
intent-
the
what
I'm
really
bringing
to
you
today
is
ab200
and
I'm.
I
just
wanted
to
make
sure
that
was
on
the
record
and
if
hopefully,
we
can
work
out
the
amendment,
but
that's
just
one
to
get
that
on
the
record.
C
H
Follow
up
mrs
bilbray
axelrod,
I'm
assuming
that
or
assemblywoman.
I'm
sorry,
I'm
assuming
that
what
you're
saying
is
that
if
we
don't
have
a
if,
if
they're,
if
the
amendment
is
problematic,
you
are
willing
to
jettison
the
amendment
in
order
to
save
your
bill
is.
Is
that
what
I'm
hearing.
A
Okay,
let
me
let
me
ask
you
a
through
the
seminar,
so
a
simple
woman,
so
the
amendment
the
amendment
has
was
brought
to
you
when.
E
Chair
spearman,
alyssa
dave
worth
for
the
record.
The
the
amendment
that
is
presented
was
part
of
a
larger
piece
of
legislation
that
was
actually
heard
in
senate
natural
resources
in
the
beginning
of
the
session,
sponsored
by
senator
key
keffer.
That
bill
was
a
much
broader
bill.
It
included
a
number
of
controversial
portions
of
it
and
then
a
number
of
procedural
issues
that
the
board
felt
they
needed
to
be
able
to
do
their
job
between
2021
and
2023..
E
That
bill
failed
to
pass
muster
and
the
committee
and
died
the
board
then
approached
the
nvma
and
said
you
know.
We
do
believe
that
there
are
certain
aspects
of
the
bill
that
we
need
to
be
able
to
do
our
job
well
and
efficiently,
and
understanding
that
ab200
was
the
only
vehicle
available
left.
We
conferred
and
agreed
to
include
the
portions
of
the
bill
that
we
felt
were
largely
innocuous
and
that's
the
the
genesis
of
the
amendment.
J
Thank
you,
madam
chair
two
questions,
but
you
indicated
that
this
was
codification
of
knack
in
that
respect.
What
part
of
knack
is
this
codifying?
If
I
could
you
could
point
to
that?
So
I
could
go
look
that
up
and
just
understand
that.
E
Thank
you,
senator
selmeyer,
alyssa
dave
worth
for
the
record.
The
vcpr
requirement
is
a
codified
under
nac
638.0197
and
has
been
since
2001.
J
J
E
There
there
are
two
sections
again
for
the
record:
alyssa
navworth
to
you
senator
salmeyer.
There
are
two
sections
that
address
your
concern.
The
first
section
is
actually
section
two,
which
is
the
definition
of
veteran
telemedicine
and
specifically
lines
five
and
six.
It
says
on
site
to
another
via
electronic
communication
regarding
the
health
status
of
an
animal
or
a
group
of
animals
and
includes
without
limitation
communication
via
telephone,
etc,
etc.
E
That
was
amended
in
the
assembly
to
ensure
that
this
could
be
herd
medicine
in
addition
to
individual
small
animal
medicine
or
large
animal
medicine.
So,
in
the
example
that
you
were
giving,
you
know,
you
have
a
veterinarian
that
you
consult
with
at
your
ranch
or
in
your
business.
E
They
understand
and
have
examined
your
premises,
so
they
can
provide
you
with
proper
protocol
with
regarding
feed
and
also
maintenance
of
the
herd.
They
do
not
need
to
examine
every
member
of
your
heard
now,
nor
would
they
underneath
this
actual
bill.
Absolutely
not.
The
second
question
you
have
is
if
they
are
part
of
a
larger
practice,
can
it
be
that
the
one
doctor
within
the
practice
has
established
the
vcpr
and
then
can
another
doctor
within
the
practice,
then
can
do
continue
the
ongoing
care
via
telemedicine?
E
E
So,
for
example,
there
are
a
number
of
practices
in
southern
nevada
that
have
up
to
10
doctors
and
you've
established
the
vcpr
with
dr
a
but
dr
a
is
not
there
because
they
don't
work
seven
days
a
week
24
hours
a
day,
but
dr
c,
who
is
also
part
of
the
practice,
has
access
to
the
medical
records
and
can
consult
with
that
veterinarian
that
originally
established
the
vcpr.
That's
completely
fine
and
it's
meant
to
create.
Not
it's
not
meant
to
limit
access,
it's
meant
to
expand
access.
E
So,
if
the,
if
there
are
multiple
members
of
a
practice
and
they
have
access
to
the
medical
records
and
they
can
confer,
they
can
also
do
this.
Another
thing
that
ab200
does
is
it
allows
for
a
veterinarian
who
has
established
a
veterinary
client
patient,
a
relationship
in
a
physical
and
timely
means
to
have
their
their
technician?
Also,
do
you
know
what
is
allowed
under
the
veterinary
client
practice
act
and
the
act
governing
veteran
technicians
as
well?
So
there's
lots
of
different
ways
in
which
both
herds
and
individual
animals
can
be
seen.
D
Shannon
bilbrayak's
read
for
the
record,
and
I
do
have
that
section
senator.
It
is
in
section
three
sub
d,
it's
line
line.
It
starts
on
line
35,
continuing
medical
care
and
treatment
that
has
been
designated
by
the
veterinarian
to
be
provided
by
another
licensed
veteran,
who
one
has
access
to
medical
records
of
the
animal,
can
provide
reasonable
and
appropriate
medical
care
and
provide
oversight
of
treatment.
J
Now
do
such
as
simple
things
of
selenium
and
copper,
which,
in
an
area
that's
very
deficient,
animals,
actually
die
if
they
don't
get
it,
but
in
the
same
respect,
if
a
person
wants
to
give
too
much
of
it,
they
can
die
as
well.
So
I'm
just
making
sure
that
animal
feeds
will
still
be
allowed
to
be
done
through
your
veterinarian.
You
know
remotely
without
having
to
contact
every
and
touch
every
animal.
Thank
you.
Thank
you.
Chair.
L
Thank
you
and
thank
you
so
much
for
for
bringing
the
bill.
I
have
two
questions
and
the
first
one
I
think
I
may
actually
be
reading
this
a
little
bit
backwards
regarding
the
timeliness
of
the
visit
with
a
a
veterinarian,
because
I
had
read
that
to
imply
that,
in
an
emergency
situation,
the
physical
examination
could
happen
a
day
or
two
after
the
telemedicine
appointment
had
occurred
and
drugs
had
been
prescribed
or
you
know,
some
other
treatment
had
been
prescribed.
E
I'm
so
sorry
senator
schreibel,
can
you
tell
me
exactly
which
section
you're.
L
E
So
in
the
scenario
that
you
are
referencing,
if
an
animal
is
in
an
emergency
situation
and
calls
a
veterinarian
to
consult,
the
veterinarian
is
not
prohibited
under
ab200
from
providing
initial
medical
advice.
So
so
long
as
a
timely
physical
examination
can
be
had
within
a
reasonable
time
period.
So,
for
example,
a
dog
is
lethargic
or
convulsing.
E
L
I
think
so
I'm
imagining
or
not
imagining
you
know,
I'm
anticipating
a
situation
where,
like,
for
instance,
in
las
vegas,
you
know
I
go
to
my
one
veterinarian
who's,
not
an
emergency
veterinarian
right.
I
don't
have
a
vcpr
with
an
emergency
veterinarian,
but
if
I
did
need
you
know
an
emergency
prescription
for
my
animal,
would
I
be
able
to
get
that
prescription
and
then
take
her
to
my
regular
veterinarian
to
ensure
that
it's
the
right
course
of
action.
E
E
Is
it
defers
to
the
veteran
board
of
medical
examiners,
the
ability
to
regulate
what
is
timely
and
what
is
appropriate.
So
there
are
always
going
to
be
various
scenarios
in
which
an
animal
might
be
in
distress
and
a
veterinarian
provides
basic
or
initial
guidance
and
potentially
a
pharmaceutical
provision
in
advance
of
seeing
the
the
animal,
because,
in
your
scenario,
also
that
veterinarian
has
already
established,
has
examined
your
animal
multiple
times
so
understands
that
that
your
animal
might
be
50
pounds
versus
2
pounds
and
therefore
would
be
the
appropriate
amount
of
the
pharmaceutical.
E
They
might
understand
that
your
animal
is
diabetic
and
therefore
certain
not
extra
labeled
drug
use
can't
be
used
for
your
diabetic
animal,
but
they
have
a
history
with
that
animal,
so
that
would
be
an
appropriate
use.
But
again
this
defers
to
the
board
to
define
what
is
timely
and
what
is
appropriate,
and
we
felt
that
that
was
necessary
because
you
know
there
are
lots
of
different
times
where
veterinarians
have
to
use
their
discretion.
E
To
the
best
care
of
the
animals,
and
certainly
that
has
been
proven
true
during
the
corona
pandemic,
and
so
I
believe
that
in
that
scenario
that
that
would
be
appropriate
and
could
certainly
be
under
the
guidance
of
the
board.
M
So
I
have
a
question
on
the
amendment,
but
I'm
going
to
go.
Ask
a
question
on
the
bill
first,
so
I'm
in
section
three
at
the
back,
where
we're
talking
about.
I
think,
that's
sub
four,
and
it's
saying
that.
However,
once
a
veterinary
client
patient
relationship
may
be
maintained
via
veterinary
talent
medicine,
I
was
trying
to
understand
this
particular
provision,
because
I
was
reading
the
as
the
avma
dot
org
and
it
was
the
best
practices
or
I
guess
how
to
do
telemedicine.
But
they
said
without
an
established
vcpr.
M
The
veterinarian
may
provide
general
advice
which
I
do
see
in
the
bill,
but
then
it
also
said
they
may
be
able
to
triage,
but
just
must
stay
clear
of
diagnosing
providing
prognosis
for
treating
patients.
So
I
needed
to
get
an
understanding
of
triage
because
triage
was
not
spelled
out
in
this
bill,
but
yet
in
the
national
practices
they
mentioned
triage
being
available
without
an
established
vcpr.
E
Again
for
the
record,
alyssa
navworth
on
behalf
of
the
nevada,
veteran
medical
association,
and
I'm
also
going
to
ask
dr
john
pannell,
who
is
the
delegate
to
the
american
veteran
medical
association
and
the
past
president
of
the
veteran
board
of
medical
examiners,
to
follow
up
with
me
on
this
question.
But
this
thank
you
for
your
question.
Senator
neil.
This
goes
to
the
scenario
that
senator
schaible
was
just
speaking
to
so
an
animal
in
distress
calls
their
veterinarian
and
needs
to
be
triaged
in
an
emergency
care
situation.
E
The
avma's
guidance
is
that
the
the
veterinarian
can
triage
with
the
animal
but
needs
to
then
immediately
follow
up
with
a
diagnostic
exam.
So
in
this
scenario,
you've
established
a
relationship
with
your
a
veterinarian
has
examined
an
animal
senator
scheibel's
dog
and
has
known
the
dog
for
a
long
time,
but
the
dog
has
been
generally
healthy,
has
not
exhibited
any
new
manifestations.
E
E
The
other
question,
I
think
that
you
are
asking
too,
is
general
health
guidelines,
and
I
know
that
that
is
also
referenced
in
the
bill,
but
that's
the
distinction
that
the
avma
makes
between
telemedicine
and
telehealth.
So
telehealth
is
general
guidance
about
animal
care.
Generally,
telemedicine
is
diagnosting.
E
The
diagnosis
of
particular
problems
or
issues
associated
with
an
animal
or
herd
and
with
dr
pannell
can
I
call
on
you
to
follow
up
with
any
additional
thoughts
from
the
avma
perspective.
G
Thank
you,
john
pannell,
dr
john
muir,
the
avma
in
the
model
veterinary
practice
act
covers
a
lot
of
different
scenarios
and
and
nevada
did
go
through
our
bill
with
the
fine-tooth
comb
with
the
avma,
and
I
don't
have
the
bill
in
front
of
me.
I'm
sorry,
but
even
though
we
may
not
have
said
triage,
I
think
we
do
have
a
component
in
there
for
emergency
situations
and
miss
navworth
explained
it.
I
think
very
well.
Do
you
have
any
other
questions
on
that?
Or
did
she
cover
it?.
M
Well,
I
guess
my
the
question
is
tied
back
to
section
three
sub
one,
because
what
I
heard
in
the
explanation
was
that
certain
things
are
allowed
within
certain
parameters
right.
But
this
provision,
right
here
says
accept,
is
otherwise
in
section
two,
a
person
may
not
practice
veterinary
medicine
in
the
state,
except
within
the
context
of
the
client-patient
relationship,
and
so
it
seems
to
tie
the
client-patient
relationship
to
physical
presence
in
the
state
or
at
least
a
premise
or
affiliate
or
something
in
the
state.
And
so
I
was
wondering
how
the
triage
works.
M
E
Again,
alyssa
dave
worth
for
the
record
as
outlined
in
section
sub
one
it.
It
creates
an
exception
under
sub
two,
which
says
that
a
licensed
veterinarian
may
in
good
faith
and
without
the
establishment
of
the
vcpr,
provide
emergency
or
urgent
care
to
an
animal.
E
This
is
the
scenario
both
that
we
were
talking
with
regard
to
senator
scheible's
animal,
but
also
an
animal
that
is
hit
in
the
street
and
is
brought
in
by
a
good
samaritan
into
an
animal
hospital,
but
there's
no
there's
no
prior
record
of
that
animal,
so
that
allows
the
veterinarian
to
use
their
discretion
to
triage
consistent
with
the
avma
practice
act
and
without
legal
issues
associated
with
the
nevada
board
of
veterinary
medical
examiners.
M
E
M
E
Chair
spearman,
miss
locksaw
has
the
answers
to
senator
picker's
questions
and
may
have
the
answers
to
senator
niels.
Would
you
like
me
to
have
her
approach.
A
I
My
apologies
for
having
this
be
a
little
goofy,
but
I
have
my
executive
director
that
tried
to
be
president
hearing
and
thought
she
was
on
going
to
be
included
on
zoom.
So
she
is
on
the
phone.
But
if
I
could
vice
chair
I'll,
go
ahead
and
take
your
question
and.
M
See
what
I
can
do
thank
you
for
that.
So
it's
since
sub
five
and
it
was
dealing
with
the
strikeout
and
I
I
think
senator
pickard
asked.
But
I
I
had
a
different
thought
on
how
I
read
it
that
this
was
where,
if
a
licensed
seat
is
not
practiced
for
more
than
12
consecutive
months,
it
may
require
them
to
take
the
examination
to
determine
competency
within
that
year.
M
I
Madam
chair
vice
chair,
could
you
I'm
sorry?
I
had
the
wrong
document
in
front
of
me
if
you
could
just.
I
So
I'll
go
back
to
and
answer
everything
at
once
if
I
could
start
with
senator
pickards
too
and
just
go
through
the
first
section
that
was
questioned
about
taking
out
the
publishing
the
requirement
to
publish
in
the
newspaper.
I
The
response
I
got
from
the
board
is
that
that
is
seldom
if
ever
used
anymore
because
of
technology
and
with
emails
and
other
ways
of
finding
people,
the
personal
service
is
used
more
often
than
not,
and
so
that's
why
the
newspaper
publishing
section
was
removed.
It
was
outdated,
however,
with
that
said,
it
wouldn't
be
a
heartbreaker
to
put
that
in
it's
just
something:
that's
never
used,
so
they
thought
they
would
clean
that
up.
H
All
right,
if
I
can
jump
in
madam
vice
chair,
my
concern-
is
this:
under
the
nevada
rules
of
civil
procedure
we
have
recently
adopted
or
are
have
proposed,
an
adoption
of
alternate
means,
and
so
we
are
able
to
use
email,
even
facebook
and
social
media
under
certain
circumstances,
but
we've
not
added
that
in
so
under
this
deletion,
the
only
as
I'm
reading
it,
the
only
service
of
process
available
under
622,
a
or
I'm
sorry
under
638017
would
be
personal
service,
which
is
impractical
in
in
some
instances,
so
without
adding
language
that
would
allow,
for
other
electronic
alternative
means,
with
the
required
criteria
for
those.
H
I
think
this
deletion
would
be
significantly
problematic
if
we're
trying
to
litigate
an
important
issue.
I
I
I
It
would
be
six
three,
eight
one,
two
seven
one
and
the
original
would
be
six
okay.
M
And
then
my
next
question
is
it's
on
the
same
page,
which
is
on
the
consumer
complaints
piece,
and
I
was
looking
at
the
statutory
provision
because
it
seemed
like
I
guess
this
is
coming
from
638
1429
or
within
that
provision,
because
I
pulled
it
up,
but
it
seemed
that
the
licensees
that
investigations
are
very
different
than
a
consumer
complaint,
and
so
I
was
trying
to
understand
the
insertion
of
the
consumer
complaint
because
my
initial,
my
initial
review
was
it
was
you
know,
you
know
that
old
saying
where
the
the
hands
are
guarding
the
hen
house.
M
So
if
there's
a
consumer
plant
that
is
not
an
investigation
of
a
licensee,
but
it's
a
consumer
I
was
wondering:
did
those
go
to
another
body
such
as
like
bni
or
someone
else,
because
I
was
trying
to
understand
what
are
you
really
doing
with
the
insertion
here
and
have
they
typically
reviewed
consumer
complaints
and
made
recommendations
to
the
full
board?
Or
is
this
new?
I
know
it
says
streamline,
but
I
see
consumer
complaints
as
different
than
an
investigation
of
a
licensee.
I
Thank
you,
madam
chair,
madam
vice
chair,
to
explain
the
process.
As
I
know,
it
is
if,
if
the
board
gets
a
consumer
complaint
about
a
veterinarian
and
that
the
complaint
can
be
anything
from
their
charging
too
much
or
they
weren't
nice
to
me
whatever,
so
that
complaint,
if
determined
to
be
under
the
jurisdiction
of
the
license
of
the
veterinarian,
will
go
into
an
investigation
currently
with
the
veterinarian
board
that
investigation
and
is
assigned
to
investigator.
I
Who
then
brings
all
that
information
to
the
full
board
and
the
board
reviews
that
in
in
their
board
meetings,
what
this
was
intending
to
do
was
to
take
it
as
other
boards
do
take
it
to
a
small
investigation
board.
That
way.
You
know
they
can
look
it
over
kind
of
you
know
vetted
out
prior
and
then
that
group
would
then
take
it
to
the
full
board
and
that
and
then
that
happens
with
other
boards
as
well
and
in
the
meantime,
then
they
can
filter
out.
I
Without
all
these
investigations
going
full
force,
they
can
filter
out
those
that
are
real
complaints
that
need
to
be
deemed
by
the
board,
whether
they're,
just
a
disciplinary
or
a
you
know
smack
on
the
hand
or
a
letter
of
warning
or
whatever
else
it.
Just
it's
streamlining
the
process.
It
is
how
other
boards
do
their
investigation
so
that
it's
not
taking
up
the
time
of
the
full
board
with
every
single
complaint
and
investigation.
M
M
To
try
to
get
an
understanding
of
why
we're
not
trying
to
at
least
allow
an
individual
just
to
pay
the
fines
and
then
maybe
on
the
back
end,
do
the
money.
But
it's
like
what
are
you
getting
at
and
what
has
been
happening
in
the
space
where
you
wanted
to
insert
all
fines
and
money,
because
money
is
to
me
more
than,
and
so
I
needed
you
to
put
on
the
record.
M
What
are
you
getting
at
here
and
what
was
happening
in
this
in
in
in
the
board
space,
where
you
needed
to
make
sure
that
you
also
got
additional
money
owed,
because
that
could
be
a
lot
of
things.
And
I
need
you
to
delineate
what
is
money,
and
I
don't
mean
that
in
a
weird
way.
But
that
could
be.
That
could
be
was
a
court
case.
Maybe
there
was
something
between
the
entities
that
a
person
owes
some
civil
violation,
and
so
I
needed
to
understand
what
what
you're
doing.
I
Madam
chair,
madam
vice
chair,
I
see
your
point
on
that
as
well
and
we
can
define
that
and
I
believe
it
is
for
fees,
and
I
don't
know
whether
it's
for
court
cases,
because
that
would
be
a
larger
amount
clearly.
But
we
can
define.
M
H
Thank
you,
madam
chair,
and
miss
lax
I'll.
I
just
want
to
make
sure
I'm
clear
and
I
don't
want
to
yet
again
beat
a
dead
horse
here,
but
the
service
issues
under
622
a-
and
I
assume
when
you
when
you
said
they
were
in
622,
you
meant
622a.
H
They
only
require
service,
they
don't
actually
under
622
a
300
sub
1.
It
just
requires
service,
so
I
just
want
to
make
sure
the
record
is
clear
that
the
622a
does
not
define
the
process
of
service,
and
this
would
take
that
out.
So
I
think
we
should
probably
revisit
this,
and
I
can
work
with
you
if
you
want
to
come
up
with
maybe
language
that
would
better
suit
the
requirements
of
622a
and
due
process
or
I'm
sorry,
procedural
due
process
generally.
Thank
you.
Thank.
I
You
and
for
the
record,
nina
laxalt,
senator
pickard
and,
and
I
think,
you're
looking
at
the
newspaper
publishing
again,
that's
that's
perfectly
fine
and
we
don't
even
mind
leaving
the
original
language
in
so
it
says
status
quo
and
then
622
with
that
I
was
talking
about,
had
to
do
with
the
reciprocity.
I
A
Questions
so
I
just
have
a.
I
have
a
couple
and
that's
the
first
one,
a
sim
woman
bilbray
oxford
you
mentioned.
Was
it
applequa.
D
Yeah
assembly
woman
chain
of
bilbray
x
ride.
Yes,
that's
what
mia
is
on.
A
D
A
It's
okay!
Thank
you.
So,
on
a
more
serious
note,
I
have
a.
I
have
a
question
to
ask:
I'm
trying
to
understand
so
in
in
nevada.
Is
there
do
we
have
an
idea
about
how
many
veterinarians
we
have
in
the
state?
If
not
an
exact
number,
give
me
a
roundabout.
E
Chair
spearman,
it's
alyssa
navworth
again
for
the
record.
There
are
over
a
thousand
licensed
veterinarians
in
nevada.
E
Again,
this
is
a
an
estimate
elicit
a
worth
for
the
record
over
15
years
of
practice.
So,
for
example,
there
are
those
veterinarians
that
have
practiced.
You
know
upward
towards
40
to
50
years,
and
there
are
many
new
graduates
coming
to
nevada
every
year
that
are
just
starting
their
practice.
A
Okay,
all
right,
I
think
that's
that's
all,
unfortunately,
the
rest
of
them
answered
already
because
I
had
I
did
have
the
same
concern
that
senator
piglet
had
in
terms
of
notification.
N
N
Animals
can't
talk,
and
so
you
know,
veterinarians
have
special
skills
to
diagnose
animals,
and
I
you
know
I
I
have
four
dogs.
I
have
a.
I
have
a
wire-haired
german
pointer
who
is
my
bird
dog
and
he
will
do
anything
to
hunt
birds,
and
so
I
had.
I
had
taken
him
to
arizona
earlier
this
year
and
we
were
down
there
for
about
four
hours
and
he
just
loves
it.
He
nothing
wrong
with
him,
but
when
we
got
back
to
the
truck,
I
realized
that
he
had
cactus
spurs
in
all
four
of
his
paws.
N
He
didn't
act
like
anything
was
wrong
because
he
knew
that
if
something
was
wrong,
he
was
going
home
and
so
he
continued
to
hunt
birds
until
he
got
back
to
truck
and
then
he
was
limping
and
so
I
had
to
had
had
to
have
him
treated
now.
I
bought
him
a
pair
of
boots
to
wear,
but
animals
typically
hide
their
injuries
and
it's
not
uncommon,
not
just
because
he's
driven
he's
bred
to
hunt
birds
and
that's
the
only
thing
he
loves
to
do.
N
What's
wrong
with
them
and
it's
bred
into
them
in
some
cases
and
and
they
know
it
to
just
be-
you
know,
being
a
wild
animal,
and
so
I
don't
think
you
can
understate
the
importance
of
having
that
relationship,
and
I
think
this
bill
goes
a
long
ways
to
you
know
ensure
that
our
pets
and
our
animals
are
cared
for
properly,
and
I
think
it
goes
a
long
ways
to
protect
nevada
veterinarians
and
so
we're
in
full
support
of
the
bill.
Thank
you
very.
A
Seeing
none
broadcast,
let's
go
to
the
phones
and
we
will
go
start
with.
A
A
B
B
O
Hello,
this
is
lisa
levine,
I'm
calling
in
support
of
ab200.
Thank
you
to
alyssa,
nave
and
assemblywoman
bilbray
for
working
on
this.
My
partner
andrew
and
I
have
two
beloved
pets:
lacey
our
dog
and
samara.
Our
cat,
both
are
adopted
from
local
las
vegas
shelters.
Lacey
has
had
health
issues
since
we
got
her
about
10
years
ago
from
skin
allergies
to
more
recently
being
diagnosed
with
arthritis.
O
She
also
has
benign
tumors
and
has
had
to
have
blood
work
done
many
times
over
to
confirm
they
were
not
skin
cancer,
all
of
which
required
in-person
care.
So
we
know
firsthand
the
importance
of
veterinarian
care
for
the
health
and
safety
of
our
pets.
I'm
excited
about
telemedicine
and
will
definitely
use
it,
but
I
also
know
that
when
identifying
and
resolving
the
health
issues
our
pets
have
experienced,
it
requires
the
vet,
seeing
them
in
person
and
physically
examining
them
to
find
the
cause
of
their
discomfort.
O
B
O
Hi,
my
name
is
stacey
hosking
s-t-a-c-y
hosking,
h-o-s
k-I-n-g,
and
I
am
a
board-certified
veterinary
cardiologist
here
in
reno.
My
practice
is
nevada.
Veterinary
cardiology-
and
I
am
here
to
testify
in
support
of
av-200
telemedicine-
is
an
important
issue
specifically
in
veterinary
cardiology
because
of
the
ongoing
use
of
wearable
devices
that
we
can
place
on
patients
or
send
to
patients
to
have
them
attach
and
wear
at
home
generally
to
monitor
the
electrical
activity
of
the
heart,
and
these
have
proved
to
be
incredibly
useful
in
remote.
Patient
monitoring.
O
B
B
C
I
do
believe
that
telemedicine
is
a
great
tool
for
consultations
and
progress
reports,
but
it
should
not
be
used
to
initiate
a
veterinary
client
patient
relationship.
This
relationship
can
only
be
established
when
all
three
components
are
present
and
participating
as
a
veterinarian.
I
am
an
advocate
for
my
patients
because
they
they
cannot
speak.
They
can't
use
words
to
communicate
with
me
or
to
their
owners,
so
I
depend
on
information
gained
from
conversations
with
clients,
but
also
an
examination
of
the
patient.
C
C
Owners
at
times
are
are
incoherent
due
to
either
emotions
or
or
lack
of
information
and
patient
symptoms
may
at
times
be
ambiguous,
making
it
difficult
to
accurately
determine
the
next
best
step.
The
need
for
periodic
in
person
examination
to
manage
the
veterinary
client.
Patient
relationship
is
not
put
in
place
to
be
an
inconvenience,
but
to
ensure
that
we
are
providing
the
best
care
possible
for
the
patients
that
we
swore
to
care
for
and
protect
without
proper
regulation.
B
C
D-A-V-I-D-G-O-L-D-W-A-T-E-R,
thank
you,
chairwoman,
spearman,
and
thank
you
assemblywoman
bilbray
axelrod.
I
am
a
dog
father
to
blue
and
huckleberry.
I
appreciate
and
support
ab200.
C
You
know
when,
when
our
pets
are
sick,
we
are
at
our
worst
and
when
we're
at
our
worst,
our
judgment
is,
is
poor,
we're
vulnerable
to
people
that
can
prey
on
us
when,
when
we're
in
that
terrible
condition,
so
I
appreciate
the
fact
that,
when
our
pets
are
sick,
we
have
somebody
to
talk
to
somebody.
C
B
C
M-C-D-E-R-M-O-T-T,
I'm
a
veterinarian.
That's
been
practicing
in
las
vegas
for
about
15
years,
primarily
cats
and
dogs,
but
occasional
exotics
as
well.
I
just
want
to
offer
myself
or
encourage
my
support
for
ab200
and
reiterate
the
importance
of
the
physical
exam
performed
prior
to
telemedicine,
which
can
be
a
great
resource
in
vet
school.
C
They
tell
you
that,
once
you
become
a
veterinarian
you're
going
to
get
lots
of
phone
calls
and
texts
from
former
friends
and
family
members
asking
about
their
pets,
and
you
do
all
the
time
which
I
don't
mind,
but
I'm
always
very
cautious
what
I
volunteer,
because
at
least
daily
I
have
a
client
that
comes
in.
That
tells
me
what's
going
on
with
their
pet,
and
it's
not
actually
what's
going
on
with
their
pet,
so
perception
of
pain
or
perception
of
symptoms
is
often
not
linked
to
what
is
really
going
on.
C
Something
that
appears
to
be
belly.
Pain
can
actually
be
back
pain
so
that
physical
exam
and
knowing
that
pet
is
very
important.
We
want
to
provide
these
services
for
owners
who
need
telemedicine,
but
also
likes
to
do
it
in
a
safe
manner.
So
I
think
this
bill
addresses
that,
and
I
encourage
the
support.
Thank
you.
B
O
My
name
is
rosemary
stolzer,
r-o-s-e-m-a-r-y
s-t-o-l-z,
like
a
zebra
er.
I
have
been
a
veterinarian
in
northwest
las
vegas
for
about
10
years
now,
and
every
single
day
I
do
see.
Like
dr
mcdermott
said,
I
see
patients
that
think
their
pet
has
anxiety,
but
it's
pain
or
I've
seen
a
four-year-old
dog
come
in
with
seemingly
mild
diarrhea
that
turns
out
to
be
an
aggressive
form
of
lymphoma
and
that
dog
started
chemotherapy
immediately.
O
I
had
a
nine-year-old
cat
whose
only
presenting
complaint
was
pooping
outside
of
the
litter
box
twice,
but
then
returning
to
normal
that
cap
had
leukemia
and
also
went
to
see
the
oncologist,
and
these
are
cases
that
stand
out
to
me
because
they
wouldn't
have
gotten
the
care
that
their
owners
wanted.
Has
this
been
a
telemedicine
consult?
So
I
definitely
support
telemedicine.
I
support
bill
8200
because
I
think
it's
going
to
you
know
aid
me
in
helping
these
pets.
O
But
again
these
pets
can't
speak
for
themselves
and
the
number
of
times
I've
seen
a
suspected
kennel
cough
actually
be
congestive
heart
failure,
which
is
a
medical
emergency.
A
telehealth
doctor
can't
can't
fix
that
without
touching,
without
seeing
without
that
internal
spidey
sense
that
we
develop
as
veterinarians.
You
know
we
can
communicate
so
I
do.
I
do
severely
and
very
aggressively
support
ab200.
I
just
really
want
my
physical
exams
to
help
protect
these
kids.
B
O
Okay,
thank
you
perfecting
to
assemblywoman
billbarry
axelrod
alyssa
mays,
everybody
on
the
nevada,
memphis
doll
wagner
for
this
bill
ab200.
My
name
is
dr
jennifer
vittori
and
I
practice
here
for
southwest
veterinary
hospital.
I
have
been
a
small
animal
practitioner
11
years
and
I
very
enthusiastically
support
ab200
for
the
purpose
of
a
new
person,
physical
examination.
O
I
want
to
provide
one
example
that
stands
out
in
my
head
here
with
a
dog
who
presented
to
me
about
four
years
ago
and
physical
exam
itself,
as
well
as
routine
vaccination
updates.
This
dog
presented
with
a
side
note
from
the
client
of
and
so
upon,
physical
examination,
heart
and
lung
obstacle.
T.
O
O
However,
with
the
symptom
of
the
cough
in
this
particular
dog's
case,
a
cost
can
be
easily
misdiagnosed
as
far
as
underlying
causes
go
without
the
ability
to
listen,
feel
touch
and
use
all
of
our
senses
for
the
the
physical
appropriately
and
thus
a
misdiagnosis
made
occurring
without
the
in-person
exam
being
performed
as
well
as
treatment.
So
I
just
wanted
to
offer
that
experience.
I
wanted
to
make
sure
to
highlight
that
point
of
a
potential
way
that
telemedicine.
O
Physical
examination
and
I
wanted
to
thank
everybody
again
for
the
time
listening
to
everybody's
commentary
for
the
spill
and
just
insist
again
that
I
strongly
encourage
support
of
ab200
and
I'm
very
enthusiastic
about
it.
Thank
you
so
much
for
your
time.
B
C
Good
morning,
my
name
is
dennis
silknetter
diaz
and
dog
e-n-n-I-s:
silk
netter
s-I-l-k-n-I-t-t-e-r,
I'm
calling
today
in
support
of
ab-200,
which
regulates
telemedicine
for
animals,
I'm
a
local,
las
vegas
citizen,
I'm
a
big
dog
lover,
I'm
an
event
planner
and
I'm
actually
planning
a
dog
adoption
for
an
engagement
party
of
a
couple
that
met
at
a
dog
adoption.
So
it's
dog
life
and
pet
life
is
very
near
and
dear
to
my
heart
and
I'm
proud
owner
of
a
pekingese,
and
I
had
a
picnic
for
16
and
a
half
years.
C
So
this
resonates
deeply
to
me
that
it
was
a
very
emotional
vulnerable
time
going
through
losing
my
animal
at
any
rate,
keep
us
safe.
I
support
ab200
because
my
picnic
picnic
means
everything
to
me
and
I
want
her
to
be
safe
and
happy.
The
things
I
worry
about
with
telemedicine
for
pets
is
the
safety
of
a
diagnosis
and
a
prescription
online.
If
I
don't
know
the
doctor-
and
he
doesn't
know
my
pet,
I
would
feel
very
unsafe.
C
How
do
I
know
if
the
doctor
is
really
a
doctor?
How
do
I
know
what
state
they
are
in?
How
do
I
know
if
the
medicine
they
are
prescribing
is
safe
and
appropriate
with
ab200?
My
veterinarian
is
required
to
have
a
relationship
with
my
dog
in
order
to
use
telemedicine.
The
state
of
nevada
requires
that
relationship.
C
B
A
Yep
broadcast
yes,
yes,
we
are
down
to
three
minutes,
so
we'll
either
have
one
more
caller
or
if
everyone
else
was
holding
on,
if
they
just
want
to
say
ditto
that
allows
more
people
to
get
their
name
on
the
record,
because
we
only
have
three
minutes
left.
B
O
C
Happy
morning
to
you,
chairwoman,
spearman
and
you're
awesome
vice
chair,
neil
and
the
rest
of
the
committee.
This
is
dora
martinez,
d-o-r-a-m-I-r-d-I-n-e-z
and
I
support
the
nevada
disability
peer
action
coalition
and
as
a
service
dog
owner
who
is
blind.
I
truly
absolutely
am
very
grateful
to
the
sponsor
of
this
bill.
C
I
haven't
been
able
to
gone
to
my
veterinarian,
so
we've
been
doing
sort
of
like
a
tele
visiting
with
my
doctor,
and
it's
really
nice,
because
I
already
know
my
dog
and
I
he
gets
a
massage
every
day,
he's
pretty
pampered
for
a
service
dog,
and
I
thank
you
so
much
and
little
prior
callers.
Thank
you
have
a
great
day.
A
Let's,
let's
go
to
those
in
opposition
same
time,
frame,
20
minutes
three
minutes
per
individual
and
remember
ditto
is
a
good
response.
If
someone
has
already
made
your
point.
B
A
All
right,
let's
go
to
the
room
first
and
then
we'll
go
to
the
to
the
cell
phones.
Thank
you.
Thank
you.
Broadcast.
C
Thank
you,
madam
chair
john
assager,
for
the
record.
We
do
stand
in
opposition
to
the
bill
as
written,
and
I
hate
to
be
in
that
position,
because
we
do
actually
agree
with
the
majority
of
what
the
bill
does.
We
have
met
with
the
sponsor.
We
have
met
with
the
proponents.
P
And
so
we
have
proposed
an
amendment
and.
C
An
hour
and
a
half
now,
but
I
think,
there's
only
going
to
be
three
callers
against
and
those
are
the
ones
that
I
have
brought
to
the
table.
The
first
would
be
virginia
mimick
with
dutch
pet,
and
if
you
would
allow
her
just
a
few
extra
minutes,
I
think
we
could
be
done
in
15
minutes
with
all
three
of
these.
These
callers.
The
second
would
be
susan
riggs
with
the
aspca,
and
the
third
would
be
mark
cushing
with
the
vvca.
C
If
that
is
a
acceptable,
I
think
we
could.
We
could
knock
out
our
side
of
this
pretty
quickly.
A
H
B
B
Q
Thank
you
so
much.
My
name
is
virginia
mimac
v-I-r-g-I-n-I-a
mimac
m-I-m-m-a-c-k,
and
I
am
legal
counsel
for
dutch
pet.
Our
concern
with
the
current
version
of
ab200
is
that
it
does
not
allow
a
vcpr
to
be
created
remotely.
Q
Each
of
these
states
was
able
to
put
in
place
sufficient
guard
rails
to
ensure
vcprs
created
remotely
continue
to
meet
the
same
standard
of
care,
and
we
believe
nevada
can
do
the
same
as
currently
written.
The
only
veterinarians
that
can
take
advantage
of
the
many
benefits
of
telemedicine
are
those
veterinarians
that
already
have
a
brick
and
mortar
practice
in
nevada.
Q
The
bill
will
not
allow
greater
access
to
veterinary
care,
as
it
will
only
apply
to
pet
parents
that
already
have
a
relationship
with
a
brick-and-mortar
vet.
Therefore,
it
will
not
increase
access
to
care
to
those
that
need
it.
The
most
such
as
people
who
do
not
currently
have
a
vet
people
living
in
rural
areas,
pets
and
shelters,
pet
parents
that
do
not
have
easy
access
to
a
brick-and-mortar
practice
because
of
lack
of
transportation
or
mobility
issues
and
pet
parents
who
desire
to
seek
the
opinion
of
a
vet
specialist
that
lives
outside
their
area.
Q
Q
Every
day,
shelters
receive
new
dogs
that
need
to
be
vaccinated
for
rabies
and
other
diseases,
but
have
to
wait
for
a
vet
to
be
on
premises
before
they
can
perform
the
vaccinations
under
indirect
supervision.
This
can
sometimes
take
days
to
weeks.
However,
if
a
vcpr
could
be
established
remotely,
then
the
dogs
could
be
examined
using
appropriate
technology.
The
vet
could
review
the
dog's
available
data
and
medical
record
and,
if
deemed
appropriate
by
the
vet,
the
vet
could
give
permission
to
vaccinate
remotely
to
be
clear
after
the
virtual
exam.
Q
Q
This
is
because
the
pet
parent
will
be
able
to
share
data
with
the
vet
that
would
typically
not
be
shared
during
a
regular
vet
visit
and
could
continue
to
share
data
after
the
visit
to
track
the
progress
of
the
pet,
thus
allowing
for
a
remotely
created
vcpr
would
allow
pet
parents
to
access
vet
specialists
that
they
would
otherwise
not
be
able
to
see
to
be
clear.
We
are
not
suggesting
that
creating
a
vcpr
remotely
is
appropriate
in
most
circumstances,
but
we
believe
the
existing
evidence
and
data
confirms.
Q
There
are
some
circumstances
where
a
vcpr
can
be
formed
electronically,
and
we
urge
you
to
allow
veterinarians
to
use
their
discretion
to
determine
when
this
could
be
done.
Insistence
on
an
in-person
examination
in
every
case
is
not
supported
by
the
evidence
regarding
telemedicine
treatment
outcomes.
Q
We
have
listed
some
relevant
studies
in
the
materials
provided
to
the
committee,
but
we
wanted
to
highlight
one
study
published
in
october
of
2020
in
veterinary
telemedicine,
a
literature
review
which
stated
the
following
in
the
context
of
behavioral
health
services
that
were
provided
entirely
remotely
to
a
pet
population,
quote
the
studies
revealed
significant
improvement
in
the
treatment
of
both
owner-directed
aggression
and
separation.
Anxiety
and
further
show
that
there
were
no
significant
differences
in
the
results,
whether
the
consult
was
handled
remotely
or
in
person.
End
quote.
Q
Thus
we
urge
the
committee
to
reconsider,
allowing
vcprs
to
be
created
remotely
in
limited
circumstances,
as
many
other
states
have
successfully
done
along
these
lines.
The
proposed
amendment
contained
in
pages,
12
and
13
of
the
memo
we
submitted
will
allow
nevada
licensed
veterinarians
to
establish
a
veterinary
client
patient
relationship
electronically,
but
only
in
the
limited
circumstance
when
the
animal's
condition
is
one
that
would
allow
the
vet
to
provide
the
same
level
of
care
as
would
be
provided
in
person.
The
proposed
amendment
does
not
allow
a
vet
to
omit
an
examination
of
the
animal.
Q
An
examination
is
required
and
the
vet
must
assess
the
pet's
medical
history,
obtain
updated
medical
information
from
the
pet
owner
and
evaluate
the
pet's
condition,
either
through
a
live
video
visit
or
through
videos,
photos.
Recent
lab
tests
and
other
medical
data
that
the
pet
owner
must
provide
to
the
pet.
The
veterinary
board
will
still
retain
disciplinary
authority
over
the
vets,
just
the
same
as
if
the
services
were
performed
entirely
in
person
and
the
same
standard
of
care
would
apply.
Q
A
Thank
you
so
before
before
we
go
further,
I
want
to
open
it
up
for
any
of
the
committee
members
who
might
have
a
question.
M
Q
M
Q
And
yeah
and
dutch
pet
is
a
business
that
seeks
to
be
able
to
provide
telemedicine
to
pets
for
anxiety,
and
that
is
what
it
seeks
to
do.
But
we
don't
want
to
make
this
about
dutch
pet
or
any
one
particular
business.
We
just
want
to
make
it
about
what
that's
for
all
of
nevada
says.
K
Issue-
and
did
I
hear
you
correctly-
oh
madame
vice
chair
chair,
may
I
continue.
K
And
so
then
my
question
is
you
mentioned.
I
think
five
states
that
you're
that
have
veterinary
and
telemedicine,
like
you
suggest,
are
there
only
five
states.
Are
there
more
than
five
states?
Q
Q
I
I
cannot
say
that
they
are
the
only
states
that
allow
it.
Those
are
the
ones
that
I'm
the
most
familiar
with,
but,
as
you
know,
because
of
kovid
and
the
use
of
tele-veterinary
medicine
in
an
unprecedented
way,
many
states
are
revisiting
this
in
2021,
and
so
those
are
the
states
that
have
made
changes
so.
Q
L
I
do
thanks-
and
I
am
also
like
my
colleagues
a
little
bit
confused
about
dutch
pet
and
its
role
in
this
conversation,
because
I
did
have
a
meeting
with
your
lobbyist
last
week
or
earlier
this
week,
where
I
was
led
to
believe
that
the
nature
of
the
amendment
was
to
allow
for
emergency
care,
but
now
you're,
saying
that
you
want
to
be
clear.
So
let's
just
be
clear
on
the
record
that
your
amendment
allows
dutch
pet
to
come
into
nevada.
Q
I
I
think
that,
there's
more
to
our
amendment
than
just
dutch
pet,
I
think
that
our
amendment
would
allow
a
vcpr
to
be
created
remotely
in
several
circumstances
other
than
just
dutch
pets.
So
to
be
clear,
I
don't
think
this
is
really
just
about
dutch
pet,
but
why
we
are
testifying,
yes,
is
that
we
would
like
nevada,
licensed
vets
to
be
able
to
provide
care
to
nevada
patients
without
having
to
do
a
physical
exam
first
in
very
specific
circumstances,
and
so
we
wanted
to
leave
that
flexibility
in
this
bill
and
it's
currently
written.
Q
The
only
veterinarians
that
can
benefit
from
telemedicine
are
brick
and
mortar
vets
that
that
are
already
in
existence
and
along
those
lines.
We
heard
testimony
today
that
you
know
you
don't
have
to
physically
examine
every
member
of
a
herd
and
it's
okay,
if
it's
a
vet
other
than
the
vet.
That
performed
the
physical
examination
if
they're
in
the
same
practice,
and
so
we
were
just
pointing
out
that
there
are
times
when
it's
appropriate
for
a
nevada
vet.
A
Okay,
senator
picker.
H
Thank
you,
madam
chair.
I
want
to
just
ask
a
question:
miss
mimik
or
mimac.
I'm
sorry
about
the
substance
of
the
amendment
as
I'm
looking
at
section,
3,
sub,
1
and
then
and
that's
on
page
12
and
then
on
page
13,
sub
4.
H
Rather
than
mandatory,
and
so
as
I'm
reading
this,
wouldn't
this
invite
some
pressing
or
expansion
of
the
boundaries.
I
recognize
and
I
agree
that,
if
a
a
practitioner,
a
vet
in
a
practice
who
has
established
all
of
a
sudden,
I'm
losing
the
the
an
acronym
or
acronym
the
vcpr,
but
then
a
second
vet
in
the
practice
who
has
no
relationship
but
has
the
medical
history
and
and
the
like.
H
Those
are
similar
under
sub
4a.
H
But
wouldn't
this
really
invite,
particularly
when
we
look
at
the
strikeout
in
c,
and
we
look
at
the
permissive
language?
Wouldn't
this
invite
a
a
new
entrant,
for
example,
whomever
that
might
be
from
coming
in
and
providing
medications
on
a
non-emergency
basis
simply
because
they
had
a
motivation
to
do
so?
How?
How
is
in
other
words,
how
is
this
enforced?
How
is
this
enforceable.
Q
Yeah
great
question,
so,
to
your
first
point,
I
I
100
agree
that
our
editions
in
section
4
are
the
exact
same
as
a
vet.
That
is
not
the
vet
who
performs
the
physical
exam,
but
is
part
of
the
practice
seeing
seeing
the
pet
you're
right.
There's
nothing
allowed
in
section
four
that
already
wasn't
talked
about
today
to
your
point
in
section
three,
the
idea
was
that
there
are
certain
times
when
use
of
other
data
and
diagnostic
materials
that
are
appropriate,
for
that
condition
could
be
used
to
establish
the
vcpr,
and
I
think
that's.
Q
We
are
not
trying
to
suggest
that
a
different
standard
of
care
applies
or
that
there
are
certain
conditions
that
should
be
treated
without
a
physical
exam.
There
are
some
conditions
that
need
a
lab
test,
a
blood
test,
as
we've
heard
testimony
today
that
need
you
to
feel
the
abdomen.
But
there
are
some
conditions
where
that
is
not
always
the
case,
and
there
are
studies
to
back
that
up,
and
so
we
just
didn't
want
nevada
to
be
so
limited
in
in
its
ability
to
provide
care
to
pets.
And
so
I
I
think
this.
Q
The
idea
here
is:
do
you
trust
the
vets
in
your
community
to
use
their
discretion
to
provide
the
appropriate
standard
of
care?
And
if
you
do,
then
what
this
allows
them
to
do
is
use
other
diagnostic
images.
Videos
pictures
things
to
make
a
diagnosis.
Besides,
just
a
physical
exam
and,
like
I
said,
our
our
real
goal
in
making
sure
that
this
is
heard
is
that
this
will
hopefully
open
up
more
access
to
people
who
have
a
hard
time
getting
to
a
brick-and-mortar
vet.
Q
And
it
may
be
that
just
like,
if
you
were
to
call
in
urgent
care
as
a
human
that
what
they
say
to
you
is
you
need
to
go
and
see
a
vet
in
person.
That
is
what
you
need
to
go
and
do,
and
that
may
very
well
be
the
advice.
But
I
would
so
much
rather
for
someone
reach
out
and
talk
to
a
vet
and
find
out
that
that's
what
they
need
to
do
then
not
seek
medical
care
at
all,
because
they
don't
have
a
pre-established
relationship
with
a
brick
and
mortar
vet.
H
Well-
and
I
I
appreciate
that,
and
and
I
tend
to
favor
expanding
competition
and
opportunities,
you
know
access
to
care,
but
I
I
think
we're
talking
about
a
couple
of
different
things.
H
You
know
my
concern
is
that
the
in
the
press
to
get
the
the
appointment
over
a
vet,
and-
and
I
agree
we-
I
think
we
do
this
bill-
is
about
trusting
our
local
people,
but
we're
talking
about
people
from
outside
the
state
who
now
would
obtain
a
license
here,
but
they
they
aren't
here
and
the
concern
I
have
is
that
the
incentive
would
be
to
miss
what
we
heard
the
other
testimony.
H
You
know
really
missing
an
opportunity
to
find
the
proper
diagnosis,
because
there's
no
physical
exam.
Where,
if
we're
talking
about
the
local
practices
I
can
I'd,
I
tend
to
agree
that
if
they
had
the
ability
to
review
the
medical
history,
they
weren't
the
regular
practicing
vet.
But
they
had
the
ability
to
review
it
in
the
short
term
because
they
have
an
ongoing
relationship
that
mitigates
the
the
lack
of
physical
contact,
because
that
patient
will
eventually
come
back
into
the
office.
H
But
what
you're
talking
about
is
is
very
different
because
it's
it's
permissive,
I'm
I'm
struggling
a
little
bit,
but
you
didn't
address
the
strikeout
in
four.
If
you
could
just
touch
on
that
briefly
and
I
apologize
for
dragging
this
out
a
little
bit,
but
I
think
that's
important
to
see
that
we're
actually
striking
out
what
I
think
is
important
language.
But
if
you
could
just
address
that
and
then
I'll
be
done.
Q
Sure
yeah,
the
strikeout
in
four,
was
just
because
we
felt
like
it
was
already
addressed
above
where
we
say
you
know
after
established
through
other
means,
a
veterinary
client
patient
relationship
may
be
maintained
by
veterinary
telemets,
and
we
struck
that
out,
because
what
we're
saying
is
there
should
be
certain
circumstances,
limited
circumstances
under
which
you
could
just
form
the
vcpr
remotely.
So
in
our
amendment
we
didn't
think
that
language
was
needed.
Q
Q
It's
just
how
that
exam
is
done,
there's
a
little
bit
more
leeway
and
then
the
last
part
is
visits
within
a
period
of
time
that
they
are
appropriate
for
the
medical
issue
in
question
to
the
premises.
Again,
we
wouldn't
need
that
if
the
vcpr
could
be
formed
remotely
and
the
veterinarian
believes
that
the
standard
of
care
being
provided
would
be
the
same
as
in
person,
and
so
I
think
the
best
example
there
is
the
herd
example
we
heard
earlier
today.
Q
If
you
know
if
the
rancher
is
able
to
call
and
say
this
is
what's
going
on
with
my
pet
here's
a
picture
of
it.
This
is
how
I've
always
treated
this
particular
type
of
wound.
You
know
this
is
what
I
know
about
this
animal.
The
veterinarian
could
say.
Yes,
you
know,
even
without
a
physical
exam
based
on
the
data
you've.
Given
me
this,
you
can
treat
the
wound
that
way.
Q
The
last
thing
I'll
just
say,
taking
these
things
out
is.
We
do
not
believe
nor
want,
tell
the
veterinary
medicine
to
take
the
place
of
brick
and
mortar
vets
and
of
physical
exams
for
most
things
again,
I
think
we're
all
in
agreement
that
the
most
important
thing
is
the
standard
of
care
for
our
pets.
I've
heard
a
lot
of
other
people
say
it,
but
I
have
pets
that
I
love
very
much
too,
so
I
want
what's
best
for
pets.
Q
I
just
think
we're
trying
to
make
sure
there's
flexibility
for
those
people
who
may
not
be
able
to
access
a
brick
and
mortar
vet
or
who
want
to
see
a
specialist
who
is
not
in
any
way
close
to
them.
So
they
cannot
get
there
for
a
physical
exam,
but
there
may
be
a
way
for
them
to
get
that
higher
level
of
care,
so
that
that's
really
our
our
purpose
and
and
bringing
this
to
your
attention.
A
I
think
right,
you're,
new
you're
next.
M
M
The
answer
is
no
okay,
because
the
way
at
first
you
know
when
I
was
encountered
this
issue,
I
was
thinking.
Okay,
are
we
doing
a
bill
that
you
that
you
started
to
get
into
the
market
and
now
we're
changing
your
opportunities
because
you
were
already
playing
in
the
market
because
of
the
pandemic,
but
there
are
no
existing
client
relationships
in
nevada,
and
so
what
I'm
trying
to
understand?
Because
in
the
amendment
the
the
the
document
that
was
presented,
I'm
trying
to
understand.
M
How
exactly
because
it's
almost
like
you're
you!
You
want
to
discuss
the
rural
access
to
care
which
makes
sense,
but
why
do
you
care
I'm
just
gonna?
Why
do
you
care
if
you
have
no
clients
here
and
you
didn't
pick
up
any
clients
and
I'm
I'm
using
you
in
the
metaphorical
sense
during
the
pandemic?
M
So
because
I
did
ask
the
question:
if,
if
whether
or
not
in
the
original
version
of
the
bill,
whether
or
not
the
it
present
prevented
someone
from
from
becoming
actually
present
in
the
state
and
it
doesn't,
and
so
if
you're
going
to
establish
a
client
relationship,
that
would
be
just
the
first
key
for
you
to
be
able
to
operate
and
participate
in
the
nevada
market.
So
is
that
not?
Is
that
not
something
you
feel
is
appropriate?
M
Because
when
I
looked
at
the
national
standards
for
vet,
which
I
asked
on
first
in
the
sponsor
of
the
bill,
it
seemed
to
really
set
out
the
how
to
do
telemedicine
and
it
gave
the
options.
For
you
know,
if
you
are,
you
know
physically
present,
if
you're
not
physically
present,
and
so
what
are
the?
What
are
the
challenges
that
you're
facing
for
not
following
the
national
guidelines
or
practices
that
have
been
set
out
on
how
to
do
this?
Because
that's
not
clear
to
me.
Q
Well,
let
me
try
and
answer
that
question
by
first
telling
you
a
little
bit
about
what
I
think
dutch
pet
would
like
to
do,
but
then
also
explain
that
while
we
don't
currently
have
you
know
patients
in
nevada,
we
we
are,
you
know,
looking
we
were
looking
to
come
into
nevada
and
you
know
the
way
nevada's
law
was
written
before
it
was.
It
was
silent
on
telemedicine,
and
so
you
know
what's
interesting.
Q
But
before
when
this
issue
wasn't
was
silent,
you
know,
I
think
perhaps
our
business
could
have
come
into
nevada,
but
when
we
come
in
and
we
we
start
adding
restrictions
that
would
make
it
only
available
to
brick
and
mortar
vets.
I
think
that
was
what
was
concerning
to
us,
because
it
would
prevent
our
future
entrance.
So
I
I
think
that
we
can
be
concerned
about
a
law,
even
if
we're
not
in
the
state.
Q
Yet
if
it
was
our
intent
to
come
into
the
state
as
far
as
what
dutch
pet
would
like
to
do
on
a
very
general
level,
it
would
like
to
treat
anxiety
and
pets,
and
it
would
like
to
do
that
by
you
know,
connecting
pet
parents
with
behavioral
specialists
who
specialize
in
anxiety
so
again
not
providing
primary
care,
not
providing.
Q
You
know,
vaccinations
and
shots
or
anything
like
that,
but
to
address
a
very
specific
issue,
just
like
you
would
get
referred
to
a
specialist
if
your
pet
has
a
problem
and
so
connect
these
pet
patients
with
the
best
specialist
and
and
do
it
through
a
series
of
ongoing
videos.
Q
You
know
zoom
visits
and
other
things
that
we
believe,
and
we
have
many
many
veterinary
behavioral
specialists,
who
believe
would
be
a
sufficient
standard
of
care
and-
and
so
that
is
why
you
know
we
are
here
today-
is
that
we
think
that
this
law,
as
it's
currently
written,
would
prevent
our
entrance
into
the
market
and
would
also
have
sort
of
these
unintended
consequences
that
we
were
also
trying
to
bring
to
your
attention
about
the
way
it
would
affect
shelters
the
way
it
would
affect
anyone
from
seeing
a
specialist.
Q
You
know,
even
if
they
were
you
know,
in
their
vet's
office
and
the
vet
wanted
to
connect
them
with
a
specialist.
It
would
be
very
difficult
if
there's
never
an
exception
for
when
a
vcpr
can
be
established
remotely.
So
I
don't
know
if
that
if
that
helps
or
answers
your
question,
but
I
hope
it
does.
K
Thank
you.
So
we
were
talking
a
bit
ago
about
states
and
the
states
that
you
had
mentioned
and
I
had
a
chance
to
google
and
check
some
of
those
states
out,
and
I
noticed
actually
that
florida
has
rejected
this
language
and
that
arizona's
rejected
it
and
north
carolina
is
in
the
process
of
discussing
it.
And
it's
not
looking
like
it
has
a
favorable
outcome.
But
I
just
wanted
to
point
that
out.
I
thought
it
would
be
an
important
part
of
the
record.
Thank
you.
A
Oh,
thank
you
additional
questions.
A
You
don't
see
any
so
I
have
a
couple
because
I-
and
these
are
the
same
questions
that
I
asked
when
I
when
I
met
with
your
colleagues
last
week,
there
doesn't
appear
to
be
anything
in
200
that
prohibits
telemedicine
for
veterinarians.
A
The
only
requirement
unless
I
miss
something
is
to
establish
a
a
relationship
first,
but
I
keep
hearing
and
maybe
I'm
missing
it,
but
I
keep
hearing
you
say
you
know
we
just
want
to
do
this
and
and
there's
nothing
in
200
that
prohibits
that
the
requirement
is
to
first
have
a
a
relationship
with
the
with
the
animal.
Did
I
miss
something.
Q
Well,
I
think
the
way
ab
200
is
written.
The
way
we
read
it
is
it
would
require
an
in-person
exam
first
before
you
could
provide
telemedicine,
and
so
there
would
never
be
an
opportunity
for
a
vet
who
had
not
done
an
in-person
exam
to
see
to
you
know,
provide
care
to
a
pet,
and
so
so
the
way
we
were
reading
it
is
that
the
only
people
that
would
really
benefit
from
ab200
were
veterinarians
and
pet
parents
that
already
had
a
relationship.
Q
We
we
would
argue
that
there
are
circumstances,
for
example,
in
the
shelter,
is
a
good
example
of
when
it
would
be
appropriate
to
allow
a
virtual
exam
again
we're
not
suggesting
that
there's
not
an
exam
done.
It
would
just
be
a
virtual
exam
and
it
you
know
it
would
allow
the
veterinarian
to
ask
questions
to
see
the
animal
there.
You
know,
as
somebody
mentioned
earlier,
you
know
there
are
wearables,
there's
lots
of
different
ways.
Q
You
can
get
data
nowadays
and
so
in
certain
circumstances
we
would
suggest
that
a
vcpr
being
created
remotely
is
sufficient
and
is
the
same
standard
of
care
as
if
as
if
you
were
providing
the
care
in
person
again
not
all
circumstances,
and
that's
why
you
know
we're.
We
really
are
pushing
to
leave
it
up
to
the
veterinarian's
discretion,
because
again,
the
veterinarian,
at
the
end
of
the
day,
is
responsible
for
the
care
being
provided,
and
so,
if
they
provide
inadequate
care
because
they're
doing
it
remotely,
they
don't
get
a
path.
A
So
I
won't
belabor
the
point
I
I
get.
I
guess
for
me,
having
listened
to
the
those
who
called
in
in
support
and
talking
about
some
of
the
nuances,
I
here's
the
way
I
read
the
bill
and
if
I'm
incorrect,
then
I'm
going
to
ask
a
legal
counsel
from
lcb
to
correct
me,
but
here's
the
way
I
read
the
bill.
A
A
I
think
I
saw
dr
pennell
on,
but
so
shelters
right
now
are
not
deficient
when
they
need
to
get
veterinarian
advice
or
or
an
emergency
service.
So
if
they're
not
deficient
now
and
they
have
veterinarians,
who
are
here
in
nevada,
I'm
trying
to
understand
why
that
would
be
an
argument
for
veterinarians.
It
would
be
easier
for
them
if
they
already
have
an
established
relationship
and
dr
pinel
did
I
see
you
or
is
there
anyone
on
from
veterinarian
boy
that
can
answer
that
question?
A
What
kind
of
relationship
do
shelters
and
other
places
have,
and
the
other
questions
I
would
ask,
is
I've
heard
a
lot
about
those
persons
who
are
in
the
rules?
What
what
is
the?
A
What
is
the
procedure
now,
because
I,
I
would
think
a
significant
question
to
ask
and
to
have
answered
in
this
setting
in
this
hearing
would
be
what's
happening
right
now,
with
relationship
to
those
who
are
in
the
rules,
what's
happening
right
now,
with
relationship
to
shelters,
what's
happening
right
now
to
with
the
relationship
to
all
the
other
things
that
we've
described,
because
I'm
I'm
trying
to
understand
what
this
bill
says.
A
Some
things
very
specifically,
but
what
I'm
hearing
miss-
and
I
hope
I'm
pronouncing
your
name
correctly-
miss
mamrick
say-
is
that
there
are
some
questions
that
that
that
their
amendment
would
answer
so
help
me
out.
Help
me
understand
that.
G
G
I
think
different
shelters
vaccinate
the
animals
as
they're
being
adopted
out
in
relationship
to
her
question
about
the
rabies
and
and
one
a
couple
things
one
a
veterinarian
can
I
I
mean
I
can
offer
advice
to
somebody
without
diagnosing
and
treating
we're
we're
able
to
do
that
now,
but
I
can't
I
wish
I
could
speak
more
in
general
on
the
shelters,
but
even
the
smaller
rescue
groups
will
have
veterinarians.
They
bring
their
animals
into
us
all
the
time,
and
once
we
see
that
patient,
then
yes,
we
could.
G
What
if
it
has
ringworm
you
have
to
do
skin,
scrapes
and
fungal
cultures,
and
that
type
thing
in
many
cases.
Otherwise
you
can
misdiagnose
it
an
anxiety
to
see,
see
an
animal
at
home,
a
video
that
would
be
priceless.
But
what,
if
that
animal
anxiety
is
partially
caused
by
pain
or
other
other
things
so
again
back
to
the
original
promise,
is
that,
yes,
we
can
treat
animals
by
telemedicine.
We
don't
we
don't
doubt
that
at
all,
but
we
need
an
in-person,
vcpr
and
you're
exactly
correcting
your
interpretation.
A
Thank
you,
and
both
of
you
can
answer
this,
but
not
together,
so
miss
mamik.
You
I
hear
you
say
that
you
want
to
treat
anxiety
and
some
other
things.
Please
don't
hear
this
as
being
facetious.
I
just
don't
know,
but
does
that
mean
that
you
have
people
who
are
specifically
qualified
in
animal
psychiatry
and
if
there
is,
if
there
is
no
such
thing,
then
please
let
me
know,
because
I
don't
know.
Q
No
that's
an
excellent
question,
so
we
we
would
be
working
with
veterinarians,
who
have
specialized
training
in
behavioral
health
and
yes
in
in
the
mental
health
of
animals-
and
I
I
think
some
of
this
is
in
our
memo
that
we
submitted.
Q
But
studies
have
shown
that
I
think
it's
upwards
of
70
percent
of
dogs
can
have
anxiety,
and
so
it's
something
that
often
goes
untreated
by
people,
and
so
we
were
trying
to
make
it
easier
for
people
to
get
in
touch
with
a
real
specialist
in
the
area
and
someone
who
might
be
able
to
say
you
know.
Q
This
is
something
that
we
can
help
you
with
or-
and
this
is
to
dr
pennell's
point-
I
mean
sometimes
what
what
a
tele
medicine
visit
would
end
up
with
is
just
the
comment
that
actually
we
think
this
might
be
something
more
and
you
need
to
go
and
see
a
vet
in
person.
I
mean
a
lot
of
telemedicine
visits
end
up
with
that
being
the
response,
and
then
the
last
thing
I'll
say
is
just
to
your
question
about
the
shelters.
Q
A
I'm
I've
just
been
reminded.
We
haven't
gotten
to
nutria,
so
I
just
have
just
a
couple
more
questions
and
I
guess
we
can
pursue
this
after
the
hearing.
So
the
articles
of
incorporation
say
that
you
did
this
february
the
16th
of
2021
about
three
months
ago
four
months
ago.
A
Yes,
right
and
and-
and
I
guess
for
me-
here's
here's
the
issue
that
I
have.
I
have
no
problem
with
being
a
publicly
traded
company,
but
I've
not
been
able
to
find
anything
that
that
gives
me
a
a
sense
of
security
in
terms
of
dutch.
I
can't
I
mean
I
don't
know
about
that,
but
pet,
I
don't.
I
haven't
found
anything
that
suggests
there
is
some
type
of
a
record
longevity
that
that
this
company
has
been
operating
someplace
else
and
the
the
other
thing
that
I
would
say
is,
I
think
someone
brought
up.
A
It
might
have
been
you
and
it
may
have
been
mr
osagara,
but
that
you
know
you
don't
want
to
talk
about
dutch
pets.
But
but
we
are
talking
about
dutch
pets
because
you
all
are
the
avatar
and
and
if
the
bill
passes
with
the
amendments
that
you
all
suggest,
then
the
avatar
would
then
become
the
norm
and
I'll
just
be
honest
with
you.
That's
the
part
that
I
have
a
problem
with
okay.
So
so,
let's
let's
do
this?
Let's,
let's
go
to.
A
Let's
go
to
go
to
to
wait
a
minute.
We
were
just
talking
about
those
who
are
on
in
the
room
for
opposition.
Do
we
have
anybody
on
the
phones?
I'm
sorry!
I
just
got
lost
because
it's
like
this
is.
A
This
is
very
confusing
to
me
because
it
doesn't
the
bill
doesn't
say
you
can't
do
it.
The
bill
simply
sets
down
the
parameters.
It's
it's
like.
You
know
the
the
best
way
that
I
can
describe
it
is
you
know
when
you
come
up
on
this,
this
red
octagon
with
white
writing
on
it.
It
says:
stop
it
doesn't
say
you
have
to
stay
there.
It
simply
says
you
have
to
stop
before
you
move
forward.
So
it's
not
saying
it's
not
saying
you
can't
move
forward.
It
simply
says
you
have
to
stop
first
and
then
move
forward.
A
So
let's
go
to
let's
go
to
opposition
on
the
phones
and
I'm
not
listen,
I'm
not
trying
to
be
flippant.
I'm
really
trying
to
understand
this,
and
these
are,
I
think,
the
same
questions
that
I
raised
when
I
met
with
your
colleagues
last
week.
So
let's
go
to
go
to
the
phones
opposition.
B
B
O
Good
afternoon,
oh
I'm
sorry
jennifer
pedego
j-e-n-n-I-s-e-r-p-e-d-I-g-o,
I'm
the
executive
director
for
the
nevada
veterinary
board
and
I
apologize
to
the
committee
and
bill
sponsor
for
the
technology
issues
that
have
been
going
on.
O
I
just
wanted
to
express
my
appreciation
for
the
committee's
time
and
I
have
responded
in
writing
regarding
some
of
the
questions
that
were
raised
earlier
and
I
can
speak
to
any
other
questions.
I
know
this
is
testimony,
but
since
I
had
the
opportunity,
I
just
wanted
to
say
my
piece.
I
guess
so.
Thank
you
for
your
time.
A
Okay,
I'm
going
to
ask
if
the
sponsor
bill
can
come
back
to
the
table
and
again
my
questions,
weren't
designed
to
be
flippant.
It's
that
I
need
a
lot
more
information,
a
lot
more
clarification
than
what
I
heard
during
the
opposition,
because
it
it
it
appears
that
the
only
thing
is
well.
It
will
allow
us
to
do
but
the
but
the
bill
doesn't
say
you
can't
do
that.
It
simply
says
that
you
have
to
have
a
in-person
relationship
already
so
assemblywoman,
billboard,
axelrod.
D
Thank
you
chair
what
a
marathon
meeting
this
has
been,
so
I
think
senator
settlemyre
went
and
presented
another
bill
on
his
back.
So
I
just
want
to
say
a
few
things.
D
The
the
client
who
spoke
and
is
sort
of,
as
you
mentioned,
the
avatar
for
the
amendment
on
this
bill,
their
business
model
is,
is
pretty
simple.
The
way
I
can
deduce
it
we've
all
seen
ads
on
television,
for
you
can
call
and
talk
to
a
doctor
if
you
want
to
get
latisse
for
your
eyelashes
or
if
you
want
to
get
that
little
blue
pill
or
hair
loss
is
once
again
something
that
you
would
need
a
prescription
for.
You
would
call
you
would
talk
to
a
doctor.
D
As
dr
pernell
has
said,
I
talked
about
my
dog
mia
before
I
had
a
dog
named
pj
who
had
severe
anxiety,
and
it
was
only
through
working
with
our
veterinarian
that
we
realized
that
her
anxiety
was
actually
an
underlying
condition
that
she
needed
serious
medication
for,
and
it
wasn't
just
something
that
you
know
anxiety,
medicine
would
have.
Would
have
covered
so
I
just
want
to
make
sure
that
we
understand
that
that
is
so.
As
I
mentioned,
I
get
my
prescriptions
through
chewy.
It's
a
little
bit
less
expensive
than
getting
it
from
my
vet.
D
It's
ninety
dollars
a
month
for
my
vet.
Seventy
dollars
a
month
through
chewy,
but
I
go
to
my
vet.
My
vet
provides
a
prescription
to
chewy
because
they
are
the
vet
and
then
I
can
get
the
medication,
so
I
think
that's
sort
of
what
we're
missing
right
now
and
I
and
I-
and
I
hope,
maybe
that
clarifies
a
little
bit
just
trying
to
take
out
that
veterinarian
in
nevada.
So
I'll
leave
it
with
that.
This
is,
like
I
said,
I'll
been
a
marathon.
I
know.
E
Thank
you
for
the
record.
I've
been
asked
to
clarify.
My
name
is
alyssa
dave
worth.
I
forgot
that
already
it's
been
a
long
hearing,
I've
been
asked
to
clarify
a
number
of
points
and
I'll
be
very
quick
because
I
know
time
is
limited.
The
first
is
that
if
you
actually
review
the
amendment,
this
is
not
a
a
minor
amendment.
It's
a
major
amendment.
E
It
would
allow
for
the
amelioration
of
the
physical
exam
in
all
circumstances
of
veterinary
medicine,
and
we
wanted
to
make
that
point
a
number
of
the
veterinarians,
dr
pannell
and,
of
course,
the
sponsor
or
someone
billboard
axelrod
addressed
anxiety,
but
we
believe
anxiety
is
the
worst
example
of
the
use
of
telemedicine,
because
anxiety
is
oftentimes,
the
manifestation
of
physical
pain
in
an
animal
which
they
cannot
articulate
whether
or
not
you
listen
to
danny
thompson's
testimony
or
dr
carolina's
testimony
also,
as
senator
lang
pointed
out.
E
Oftentimes
people
speak
about
the
innovation
that
comes
from
the
corona
pandemic
and
all
these
wonderful
things
that
it
opened.
But
in
fact,
every
state
that
has
considered
whether
or
not
telemedicine
should
be
allowed
to
be
done
purely
telephonically
and
not
physically
has
rejected
that,
and
that
includes
florida,
arizona,
alaska
in
process
north
carolina
and,
most
recently,
two
weeks
ago,
as
I
said
florida,
that's
me
on.
E
We
talk
about
rural
medicine
and
the
fact
that
there's
a
drought
in
rural
nevada,
but
that
just
is
frankly
not
true.
Dr
gokuchiya
is
not
here
today
because
he
is
out
servicing
his
clients
he
drives
across
all
across
rural
nevada.
Dr
spratling
was
here
today
he
does
the
same
and
they
believe
that
telemedicine
in
the
rural
context,
particularly
with
birds,
is
an
extreme
danger
for
actually
the
food
chain
supply
here
in
nevada.
C
E
Agriculture,
and
with
that
I
will
say
that
nevada
has
not
been.
E
There's
the
ghost
in
the
machine
the
last.
The
last
thing
I
will
say
is
that
it
has
been
often
said
in
this
hearing
that
nevada
law
was
silent
with
regard
to
the
establishment
of
the
veterinary
client
patient
relationship,
and
I
just
want
to
reiterate,
for
the
last
time
that
for
20
years,
nevada
has
said
that
you
must
physically
and
timely,
examine
an
animal
to
establish
a
valid
veterinary
client,
patient
relationship
and
all
this
bill
does.
E
Is
it
elevates
it
into
the
the
statute
with
regard
to
the
practice
act,
I
am
so
grateful
for
this
committee's
attention
and
really
deep
analysis
of
this
very,
very
important
issue.
As
you
can
see
today,
this
is
an
issue:
that's
incredibly
important
to
nevada,
veterinarians,
nevada,
pet
owners,
nevada
consumers,
and
we
are
grateful
for
your
time.
L
You
have,
if
I
could,
I'm
I'm
sorry.
I
know
this
has
already
been
a
marathon
and
I
feel
like
we've
just
gotten
so
far
from
the
original
bill.
What
I
wanted
to
clarify,
because
assuming
women
billboard
axelrod,
you
just
went
to
an
excellent
example
of
how
you
get
prescriptions
for
your
dog
through
chewy,
and
so
what
I
understand
this
bill
to
do
is,
for
example,
while
you're
up
here
in
carson
city,
and
maybe
you
can't
go-
see
your
vet
in
las
vegas.
This
would
allow
you
to
say:
hey
vet.
L
L
I
can
get
mia's
prescriptions
from
chewy
tomorrow
and
not
have
to
fly
her
all
the
way
back
to
las
vegas
or
establish
a
new
veterinary
relationship
in
carson
city.
But
this
is
a
vet.
Who
knows
your
dog
knows
the
prescription
and
the
two
months
difference
or
one
month
difference
or
whatever
it
is,
is
still
a
timely
physical
exam.
A
Exactly
okay,
thank
you,
and
this
is
gonna,
be
homework
for
those
in
opposition.
I
need
to.
I
need
to
get
some
information.
We
don't
do
it
right
now,
but
I
need
to
get
some
information
number
one.
The
incorporation
of
dutch
pet
was
this
year
three
months
ago,
I'd
like
to
know
what
what,
if
any
track
record
there
there
is,
and
maybe
there's
maybe
there's
a
new
name.
A
Maybe
it
used
to
be
something
else,
but
I'd
like
to
know
what
that
is
as
well
and
would
like
to
know
more
about
the
folks
who
are
incorporating
to
see
what
the
to
see
what
the
background
is
in
terms
of
doing
veterinarian
practice
and
and
and
do
not
do
not
hear
that
is
being
overreaching.
I
just
I'm
not
clear
in
terms
of
what
of
what
the
qualifications
are
for
the
company
in
any
instance,
let
alone
telemedicine.
A
So
you
know,
mr
oscar,
if
you
and
your
colleagues
or
mrs
mamrick,
if
you
all,
can
put
together
something
like
that
and
send
it
to
me.
I
certainly
would
be
so
appreciative.
Okay,.
A
All
right,
so
we
will
close
the
hearing
now,
five
years
and
six
months
later,
we
will
close
the
hearing
now
on
assembly,
bill
200
and
we
will
open
the
bill
open.
Hearing
on
assembly
bill
47.,
mr
krueger
miss
miss
martin
and
mr
tucker
revises
provisions
relating
to
unfair
trade
practices.
So
mr
kruger
please
proceed
when
you
are
ready.
P
P
Ab-47
makes
amendments
to
the
nevada,
unfair
trade
practices
act,
nrs,
chapter
598-a,
otherwise
known
as
nevada's
anti-trust
laws.
Before
I
get
into
the
what
ab47
does
I
want
to
let
the
committee
know
that
our
office
has
worked
hard
with
over
30
stakeholders
to
get
us
to
where
we
are
and
we
thank
them.
We
believe
this
legislation
accomplishes
our
needs
without
creating
an
undue
burden
on
the
stakeholders.
P
Ab47
has
three
distinct
focuses
one.
It
allows
our
office
to
take
a
peek
at
consolidation
transactions
in
the
health
care
markets
in
nevada
two.
It
provides
clarification
and
cleanup
language
to
remedies
and
investigatory
authority
of
the
attorney
general's
office
and
three.
It
limits
the
applicability
of
non-competitive,
covenants
or
non-compete
agreements
by
prohibiting
them
from
being
applied
to
employees
paid
on
an
hourly
basis,
so
that
those
employees
are
not
limited
in
their
ability
to
get
a
new
job
when
they're
when
they
stop
working
for
a
particular
employer.
P
P
Our
first
focus
allows
the
antitrust
team
at
the
attorney
general's
office
an
opportunity
to
take
a
peek
at
the
transactions
that
may
very
well
affect
the
cost
of
health
care
in
nevada,
and
it
ensures
competition
in
the
healthcare
market
to
help
keep
lower
costs.
P
P
P
A
Thank
you,
mr
ruger.
Any
additional
presenters.
P
No,
I
have
two
people
available
for
answering
questions
if
necessary.
A
Okay,
thank
you
senator
picker.
Do
you
have
questions.
H
Yes,
madam
chair,
thank
you
as
to
the
first
section
I
I
recall
at
various
times
in
my
career,
having
hmos
or
different
plans
come
into
the
state
and
provide
access
to
care.
H
My
concern
is
by
by
really
clamping
down
on
this.
Doesn't
it
act
as
a
disincentive
to
the
large
providers
say?
I
know
health
plan
of
nevada,
for
example,
is
a
large
provider.
H
I
don't
have
any
idea
how
much
market
share
they
have,
but
if
say,
we
wanted
some
competition
and
somebody
wanted
to
come
in
and
provide.
You
know
a
large
operation,
particularly
in
rural
areas.
If
they
were
spread
out,
wouldn't
this
disincentivize
their
coming
in
since
they
would
have
to
get
approval
first.
P
Thank
you
senator
victor
mark
kruger
for
the
record
respectfully.
No,
it
should
not
disincentivize
any
company
from
coming
in
there's.
No,
I
think
it's
important
to
know
that
attorney
general's
office
already
has
the
authority
to
look
at
any
transaction
oftentimes.
We
don't
get
notice
of
the
transaction,
sometimes
up
until
the
cusp
of
when
it's
actually
going
to
be
consummated.
P
H
Well,
but
don't
you
actually
shift
the
the
burden,
not
the
burden,
the
the
operative
order?
In
that,
if
say,
someone
were
to
come
in,
they
wanted
to
purchase,
say
30
practices
across
the
street
the
state
or
enter
into
agreements
whereby
they
would
be
the
name
on
the
the
building.
H
But
right
now
they
are
essentially
having
to
or
the
the
right
now
the
ag's
office
would
come
in
and
say:
hey,
wait!
A
minute!
We've
got
a
concern
about
this.
We
want
you
to
justify,
or
we
want
you
to
explain
how
you're
going
to
operate,
that
this
isn't
a
competitive
in
some
way,
but
with
this
bill
it
would
say
now,
instead
of
us
being
reactive
as
law
enforcement.
H
Now
you
have
to
get
permission
to
to
do
this,
or
at
least
let
us
look
through
the
books
and
and
scrutinize
this
deal.
How
would
that
not
be
a
disincentive,
because
now
it's
asking
permission
instead
of
this
would
be
like
me
wanting
to
open
up
a
law
practice.
I
I'm
fully
able
to
do
it,
but
now
I
have
to
ask
the
bar
for
permission
to
start
working
out.
You
know,
even
though
I
have
a
medi
or
I
have
a
law
degree.
P
Services,
thank
you
senator
pickard
mark
ruger.
For
the
record.
We
believe
that
this
would
be
a
very
minor
transaction
in
that
they
would
have
to
give
us
a
report
just
to
say
here's
what
we
plan
on
doing
it
doesn't
take
that
level
of
scrutiny
that
we're
talking
about
unless
there's
a
concern,
that's
created
by
the
report
that
we
see.
So
we
believe
that,
with
that
information,
we
can
actually
look
to
make
sure
that
there
is
competition
in
the
health
care
market.
H
Practitioners
all
right.
I
appreciate
that.
I
I
I'm
not
sure
I
follow
the
logic
but
I'll.
Let
that
go
and
looking
at
section
10
and
the
thousand
dollar
a
day
violation.
It's
a
civil
penalty.
H
It
is
for
a
willful
violation,
so
that
would
have
to
be
proven,
but
I
can't
think
of
a
civil
penalty
outside
of
the
pucn
environment.
That's
more
than
a
few
hundred
dollars
a
thousand
dollars
a
day,
particularly
if
this
were
to
have
delayed
a
transaction.
H
My
guess
is
we're
talking
about
a
pretty
substantial
bill
to
an
industry.
That's
already
pretty
well.
P
A
No
excuse,
mr
kruger
either
somebody
in
your
office
who
posts
the
office
sounds
like
they
have
the
the
hearing
on,
but
I'm
getting
a
lot
of
feedback
every
everybody.
That's
on
the
line.
Please
meet
you
please
meet
with
microphones.
P
In,
in
short,
it
it,
we
worked
with
stakeholders
on
this
particular
provision.
We
added
the
word
willfully,
because
we
wanted
to
ensure
that
it
wasn't
excessive
and
that
we
only
are
going
to
see
that
the
imposition
of
the
full
amount
of
the
fine
of
a
thousand
dollars
in
those
cases
where
people
are
deliberately
and
intentionally
not
trying
to
comply
so
where
there
is
a
error
or
something
else.
The
word
willfully
helps
to
abrogate
the
full
impact
of
a
fine
or
even
a
fine
at
all.
In
those
particular
cases.
P
P
Thank
you
for
the
question
again
marker
for
the
record.
This
particular
enforcement
provision
would
be
more
in
in
tune
with
a
district
court
setting
and
not
necessarily
a
justice
court
setting
or
administrative
setting.
H
H
Without
you
know,
I
guess
they
would
have
to
petition
the
district
court
for
permission
to
file
the
action,
but
I
I
thought
it
was
interesting
that
you
said
that
this
this
section
makes
it.
This
only
applies
to
hourly
wages,
which
would
be
under
the
sub
3
insertion,
but
I
don't
see
any
language
that
restricts
this
to
hourly
wage.
H
P
Thank
you
senator
mark
kruger
for
the
record.
I
I'm
a
little
bit
confused
by
the
question
exactly
and
I'm
trying
to
look
at
the
bill
to
answer
it.
The
the
prohibition
is
is
drafted
in
such
a
way
through
this
amendment
to
prohibit
non-compete
agreements
to
be
used
with
hourly
employees.
P
H
You
know
provide
unless
these
prerequisites
are
met,
and
so
how
does
an
employer?
You
know
one
of
the
things,
and
this
is
let
me
just
kind
of
as
a
backdrop,
explain
why
I'm
hesitant
on
this
part.
One
of
the
things
that
we've
been
trying
to
do
since
I've
been
in
the
legislature
is
to
attract
innovative
businesses
to
nevada,
and
particularly
when
we're
talking
about
technology
businesses
we're
talking
about
businesses
that
rely
on
their
key
employees
to
bring
certain
technical
knowledge
to
bear
so
that
they
can
create
and
build
on
new
technology
and
new
ideas.
H
H
This
is
going
to
act
as
a
disincentive
to
the
kind
of
development
that
we've
been
trying
to.
You
know
do
over
the
last
six
or
eight
years
and
then
you
know
we
go
on
to
further
disincentivize
these.
By
awarding
reasonable
attorneys
fees
only
to
the
employee
not
to
the
employer,
we
don't
provide
a
commensurate
win
for
the
employer,
who
succeeds
in
the
litigation
so
but
under
sub
7
we
only
give
that
to
the
employees
and
then
in
sub
6.
We
we
put
this
undefined
undue
hardship.
H
P
Thank
you
senator
mark
kruger,
for
the
record.
I
I
will
address
it
just
briefly
and
then
I'm
going
to
ask
marie
martin
to
also
supplement
my
answer,
but
I
think
it's
important
to
remember
that
the
focus
of
this
prohibition
is
for
hourly
wage
employees
and
we're
talking
about,
and
we
got
examples
from
various
individuals
where
you
have
hourly
wage
nannies,
hourly
wage
wait,
staff,
those
types
of
people
who
are
an
hourly
wage
employee.
P
Certainly
it
does
not
apply
at
all
to
those
individuals
who
are
on
a
salary
and
and
the
the
brightline
rule
which
was
was
negotiated
with
the
stakeholders,
was
for
that
hourly
wage
employee
rather
than
setting
the
income
levels
and
things
like
that,
because
it
makes
sense-
and
it's
reasonable.
I'm
going
to
ask
marie
martin
to
supplement
my
my
answer
a
little
bit
with
some
additional
information
and
she
has
a
lot
of
expertise
in
this
area.
R
Okay,
great
so
the
section
22
of.
A
R
Hi
so
ab47
section
22
institutes
a
some
changes
to
nrs613195
now
nrs613195
allows
for
non-compete
agreements
that
are
reasonable
in
terms
of
time,
geographic
scope,
etc.
However,
the
first
change
that
mr
pickard
or
senator
pickard
addressed
is
to
section
sub
2.
now
section
sub
2
applies
to
employers
who
are
trying
to
institute
proceedings
against
former
employees,
who
do
a
certain
thing,
and
that
is
former
employees
who
are
going
to
provide
services
to
their
former
customers
or
clients.
R
What
this
addresses
is
a
situation,
for
example,
where
a
doctor
leaves
their
practice
and
their
former
clients
want
to
follow
them
now.
The
doctor,
doesn't,
you
know
otherwise
follows
the
requirements
of
sub
two
and
you
know,
doesn't
solicit
their
clients,
the
clients
just
say
I
want
my
doctor
as
it's
written.
Currently,
although
a
non-compete
agreement
is
not
allowed
to
prohibit
that
conduct,
that
doesn't
mean
the
employer
can't
use
an
otherwise
reasonable
non-compete
agreement
to
stop
that
doctor
from
providing
services
to
their
former
customers.
That's
all
those
words
where
we
say.
R
An
employer
may
not
bring
an
action
to
restrict.
That
is
what
that
is
entitled
to.
It
is
trying
to
capture
now,
there's
another
portion
to
the
amendments
to
nrs613195,
and
that
is
in
sub
sub
three,
I
believe
the
sub
three
is
it's
intended
to
cover
the
situations
that
we've
seen
where,
for
example,
a
nanny
is
being
prohibited.
R
An
employer
uses
a
non-complete
agreement
signed
with
a
nanny
to
stop
her
from
working
for
for
as
a
nanny
for
other
persons.
It's
entitled
to
encompass
the
jimmy
john's
situations
where
people
who
have
no
access
to
trade
cigarettes
who
would
not
have
any
valuable
information
or
proprietary
information
to
a
company
are
being
prohibited
from
moving
on
in
their
employment.
R
R
I
worked
in
tech
for
a
long
time
before
coming
to
the
attorney
general's
office,
when
we
put
together
a
non-compete
agreement
for
tech
employees,
you
really
want
to
cover
the
people
who
are
going
to
have
access
to
trade
secrets,
and
we
already
have
protections
for
trade
secrets
in
the
state
and
you
generally
don't
have
tech
employees,
your
higher
level
tech
employees
who
have
access
to
the
company's
trade
secrets
having
being
on
an
hourly
basis.
These
people
are
generally
very
well
paid
salaried
employees.
R
R
R
Now
in
terms
of
enforcing
nrs613195,
the
situation
where
that
would
arise
for
employees
if
they
is
when
they
are
subject
to
an
unreasonable,
non-compete
agreement
and
they
want
to
get
out
from
under
it
in
general.
Most
employees
are
not
going
to
be
enforcing
or
seeking
to
have
their
non-compete
agreements
overturned.
R
And
it
becomes
very
difficult
with
the
amount
of
attorney's
fees,
especially
that
intellectual
property
attorney's
charge,
which
I
used
to
be
before
joining
the
antitrust
division,
with
the
amount
of
fees
that
we
charge
even
very
well
paid
employees
have
a
very,
very
difficult
time,
challenging
employer,
responding
to
employer
lawsuits,
challenging
unenforceable
or
unreasonable
non-compete
agreements.
It's
just
something
that
you
don't
do
the
very
existence
of
the
non-compete
agreement,
disincentivizes
employees
from
challenging
them,
and
so
those
are
the
three
different
points.
I
think
that
you
covered.
H
Thank
you.
I
don't
want
to
overly
belabor
the
point,
but
if
we're
looking
at
22.5
sub
3
the
hourly
wage
piece,
I
don't
have
any
objection
to
that
because
I
agree
if
we're
talking
about
receptionists
waiters,
whatever
there's,
there's
no
need
to
restrict
their
their
activities,
but
sub
two
does
not
limit
the
prohibition
on
employers
bringing
an
action
to
restrict
wage
hourly
wage
employees.
H
There's
no
such
restriction,
and
so
my
concern
is
that
if
there
is
a
non-competition
covenant
in
a
contract,
an
employment
contract
for
a
salaried
employee,
now
they
have
to.
I
mean
that
this
says
they
cannot
bring
an
action
to
restrict
that
or
to
ultimately
to
enforce
that
covenant
unless
they
meet
prerequisites,
which
arguably
then
would
require
them
to
seek
a
pre-petition
request
to
the
district
court
to
determine
that
they
met
those
restrictions
or
be
subject
to
a
motion
for
summary
judgment
because
there's
an
argument
that
they
didn't.
H
But
this
now
adds
a
layer
of
obstacle
to
those
employers
who
are
trying
to
protect
their
intellectual
property
or
their
trade
secrets.
So
maybe
maybe
I'm
misreading
this.
Can
you
point
me
to
language
in
this
amendment
that
restricts
this
restriction
to
just
hourly
wage
basis,
because
there's
no
connection
between
two
and
three
that
I
see.
R
Okay,
so
currently
an
employer
cannot
sign
a
non-compete
agreement
with
an
employee
that
is
unreasonable.
That
is
the
current
language
of
our
nrs613195,
and
it
makes
sense-
and
it
is
consistent
with
existing
nevada
case
law.
What
this,
however,
the
current
language
of
nrs
613195
does
not
prevent
an
employer
from
bringing
a
lawsuit
against
an
employee
on
the
basis
of
a
non-compete
agreement
that
is
unreasonable.
R
That
is
what
sub
2
does.
Is
this
limited
to
hourly
employees?
No,
it
is
not.
It
is
currently
not
listed
limited
to
hourly
employees
and
the
amendment
which
would
disallow
employer
lawsuits
that
are
based
on
unreasonable
limitations
on
time,
geographic
scope
and,
I
think
believe
it
subject
matter.
It
would
also
not
allow
employers
to
bring
suits
against
employees
that
are
based
on
unreasonable
that
that
would
limit
an
employer's
ability
to
bring
suits.
H
H
Saying
that
not
only
do
we
not
allow
employers
to
restrict
former
employees
from
unreas,
you
know
in
unreasonable
ways
now
they
can't
even
bring
an
action
to
do
it
and
there's
no
language
that
suggests
how
a
an
employer
could
bring
an
action
under
any
circumstance.
H
In
other
words,
we
don't
define
that
there
needs
to
be
a
preliminary
petition
or
request
to
do
so.
This
essentially
throws
up
for
all
practical
purposes,
as
I
read
it,
a
bar
to
enforcing
these
restrictions-
and
I
object
to
that.
I
think
that
that's
going
that's
taking
nevada
in
the
wrong
direction
when
we're
trying
to
bring
these
innovation
companies
to
our
state
they
under
this
law.
I
think
they
would
read
this
as
a
bar
to
protecting
their
intellectual
property
rights.
R
I'm
sorry
I
in
terms
of
what
is
act
as
a
bar
to
employers
to
bringing
an
action
for
declaratory
relief.
Perhaps
I
do
not
believe
so.
Is
there
a
legal
term
for
what
is
reasonable?
You
know
what
is
reasonable
in
terms
of
time.
Geographic
scope
and
subject
matter
is
up
to
the
discretion
of
the
courts,
and
it
always
is
that
it
currently
is
so
and
and
also
in
terms
of
protecting
intellectual
property.
R
There
is
nothing
in
the
statute
that
would
be
able
to,
for
example,
override
federal
patent
law,
federal
copyright
law,
state
trade
secret
protections.
The
lanham
act
there's
nothing
in
here
which
would
affect
ip
rights.
So
thank
you
and-
and
I
do
appreciate
your
comments.
If
there's
you
know,
I,
I
think
that
there's
again,
there's
nothing
in
here
which
would
prevent
declaratory
relief.
H
Well-
and
I
appreciate
that-
I
I
guess
you
know
when
it
comes
to
the
landmark
you're
right-
we
can
protect
trade
secrets,
but
that's
usually
in
terms
of
damages
after
the
genie
is
out
of
the
bottle
and
the
non-competition
agreements
are
put
in
place
in
order
to
prevent
the
genie
from
getting
out
in
the
first
place.
A
Well,
you
know-
and
I
just
want
before
we
begin-
I
just
wanted
to
be
mindful
that
there
there
will
be
some
people
who
have
one
o'clock
committee
meetings
and
we
still
have
another
bill
to
be
heard.
So
I'm
going
to
make
a
request
of
the
committee
members.
Those
questions
that
you
know
are
directly
pertinent.
If
you
can
just
ask
those
and
if
there
are
some
that
need
for
clarification
or
whatever
you
can
work
on
that
offline,
I
don't.
A
I
want
to
make
sure
that
the
people
who
have
one
o'clock
committee
meetings
are
able
to
get
to
those
as
well.
Okay,
because
it's
11
o'clock
now
so
we've
been
at
this
three
hours
and
it's
okay,
it's
okay
to
vet
the
bill.
I
just
want
to
make
sure
that
we're
mindful
of
those
who
will
have
to
leave
this
committee
and
if
we,
if
we
go
to
12
30,
they
won't
have
time
to
take
care
of
some
other
business
before
the
one
o'clock
so
senator
hardy.
J
Thank
you,
madam
chair.
I
I
will
change
my
question
to
a
statement.
I'm
looking
at
sections
two
through
ten
and
I'm
considering
a
small
practice
with
two
or
more
physicians
are
going
to
have
to
hire
a
lawyer,
so
they
don't
have
to
pay
a
thousand
dollar.
J
Penalty
when
they
hire
a
new
physician,
they're
going
to
have
to
figure
out
what
they're
going
to
do
and
I'm
concerned
about
my
bypoc
community,
for
instance.
Well,
if
I
get
a
physician
who
hires
another
physician
now,
they're
two
physicians
in
a
community
of
need
and
the
trend
now
for
doctors
to
come
out
of
medical
school
residency
is
going
to
big
practices
and
discourage.
This
will
discourage
even
more
the
entrepreneurial
ship.
J
That
will
happen
that
I
need
to
have
happen
in
areas
that
aren't
getting
enough
care.
So
I'm
very
concerned
about
this:
the
implementation
of
that
two
or
more
physicians,
trying
to
open
up
a
shop
in
a
place
where
we
have
a
dearth
of
medical
practitioners.
I
don't
think
this
is
a
good
idea.
I
can't
say
it
any
more
bluntly
than
that.
Thank
you.
A
P
You,
chairman
senator,
thank
you
for
your
comment.
We
appreciate
it,
but
I
think
it
is
important
to
note
that
ab47
just
requires
a
simple
notification.
P
It
doesn't
necessarily
prohibit
anybody
from
consolidating
if
you
will
in
this
geographic
area,
but
it
does
say,
impose
upon
these
two
practices,
just
a
simple
one,
full
page
form
to
say:
here's
what
we
intend
to
do.
You
guys
have
any
problems
with
it.
You
already
have
the
authority
under
the
law.
If
you
do
have
a
problem
with
it
to
take
any
kind
of
action
to
prohibit
it.
That's
not
changing.
J
You
may
not
be
realizing
that
if
you
have
an
entrepreneurial
practice
in
an
area
of
need,
they're
going
to
have
multiple
times
where
they
contact
you
and
then
wait
for
the
approval
or
the
disavow
or
the.
Why
are
you
wanting
to
do
that?
I
think
it's
an
another
layer
of
bureaucracy,
that's
going
to
inhibit
and
discourage
people
from
going
in
a
bypoc
community.
Thank
you.
P
Madam
chair
senator,
if
I
have
a
moment
just
quickly
briefly
respond
as
well
to
senator's
point.
There
is
a
specific
exclusion
in
section
5.6
that
you
know
if
there's
already
an
existing
partnership
or
organization
that
wants
to
put
in
certain
assets,
they
are
permitted
to
do
so.
That's
not
a
reportable
transaction.
So
there's
it's
almost
as
if
you
have
to
meet
the
requirements
of
the
combination
of
these
two
practices,
but
also
once
they're
once
they're
combined
only
material
changes
then
apply
and
it's
all
defined
in
the
bill.
A
Okay,
thank
you.
Senator
lane.
K
K
The
one
thing-
and
maybe
I
missed
it
in
reading
the
bill-
I
don't
see
hospitals
in
here
and
what's
happening
in
las
vegas,
is
hospitals
are
buying
up
other
hospitals
and
then
they're
buying
doctors
practices
because
they
need
those
people
to
support
their
hospital
and
it's
causing
issues
of
steering
and
tearing
for
groups
that
are
working
to
get
insurance.
So
I'm
wondering
if
you
could
address
that.
P
The
bill
is
intended
to
capture
all
health
care
industries,
including
hospital
language.
K
So
would
you
be
amenable
I
mean
I
I
think
I
get
the
groups
and
and
as
I
read
that
section
I
read
about
groups
and
I
I
understand
the
definition
of
a
group,
but
I
don't,
I
think
a
hospital
is
different
and
I
think
it
would
be
really
great
if
we
could
insert
hospitals
in
there.
Thank
you.
P
And
and
thank
you
senator
mark
ruder
for
the
record-
and
you
did
point
me
to
the
right
direction
of
where
to
find
that
definition
is
in
section.
4.2
group
practice
would
include
two
or
more
practitioners
which
would
include
hospitals,
but
we
would
certainly
be
open
to
that
suggestion
and
we'll
we'll
work
with
the
bill
a
little
bit
later,.
K
A
Thank
you,
cine,
lying
bye.
Sure
thank
you.
M
Madam
chair,
so
it's
a
really
quick
question,
but
it's
on
section
five,
six,
but
it's
actually
line
eighteen.
So
I've
listened
to
the
bill,
but
I
really
want
to
know
who's
grandfathered
in
because
you
seem
to
have
created.
It
says,
have
a
contracting
relationship
that
was
established
before
october
1,
2021,
so
who's
out
of
this
bill,
because
somebody's
grandfathered.
P
Thank
you
senator
this
is
marker,
the
the
language
and
and
basically
the
exemptions.
We
wanted
to
make
sure
that
this
bill
was
prospected,
put
into
place
going
forward.
Anybody
that's
already
combined
and
consolidated.
It
wouldn't
apply
to
naturally,
and
the
language
was
added
to
make
sure
that
that
wasn't
captured.
A
I
don't
see
any
you
know
I
I
just
have
mr
crew.
I
just
have
one
if
you
were
going
to
explain
this
to
a
class
of
kindergartners,
can
you
please
explain
number
one
what
the
bill
does
and
why
it
is
important
and
what
issue
it
seeks
to
solve?
P
Okay,
thank
you,
madam
chair.
This
is
mark
kruger
for
the
record.
The
the
bill,
as
I
said,
really
breaks
into
three
three
different
sections
and
the
first
section
is
to
really
allow
or
require
certain
healthcare
transactions
to
make
a
report
very,
very
one-page,
often
one-page
report
to
the
attorney
general's
office
for
us
to
review
just
peak
a
review
at
the
transaction.
If
we
feel
we
need
more
information
again,
we
already
have
the
authority
under
nevada
law
under
our
antitrust
law,
to
request
more
information.
P
In
fact,
we
already
have
the
authority
that
we
could
issue
a
subpoena,
which
is
far
more
onerous
on
these
two
entities
trying
to
combine
than
it
is
for
them
to
simply
hey.
Let
us
know
with
a
simple
report.
This
is
what
we
intend
to
do,
and
so
it
really
while
it
creates
a
burden
to
send
a
report
to
the
attorney
general's
office.
P
P
Lastly,
third,
the
bill
really
seeks
to
create
a
prohibition
in
non-compete
agreements
for
hourly
wage
employees
and
it's
a
broad,
30
foot,
30
000
foot
level,
that's
as
simple
as
terms
as
I
can
go
into
it,
and
then
there's
obviously
within
each
of
those
nuances
and
not
just
spelled
out
in
the
bill.
A
Okay,
thank
you.
Sometimes
my
understanding
gets
clouded
with
all
the
legal
terms,
but
thank
you
for
that.
Any
additional
questions,
committee,
members
and
seeing
none
do
we
have
anyone
in
support
in
the
in
the
room.
Anyone
in
support
in
the
room.
B
B
C
I
do
want
to
first
begin
by
thanking
attorney
general
ford
and
his
team,
particularly
mr
krueger,
ms
martin
and
mr
tucker.
They
have
been
very,
very
thoughtful,
very
receptive
and
worked
with
us
extensively
at
this
point.
Ab47
is,
is
able
to
be
operationalized,
but
we
we
do
register
our
opposition,
because
we
believe
that
the
policy
itself
comes
from
a
a
faulty
premise.
C
Both
washington,
state
and
connecticut,
which
have
similar
reporting
concepts,
have
far
more
active
physicians
over
the
average
across
the
country.
Nevada,
however,
falls
far
below
that
average,
and
one
of
the
things
we
think
is
that
we
believe
policies
that
should
promote
more
physicians,
more
access
to
care
and
more
investment
in
the
health
care
community.
C
B
B
C
I
apologize
I
was
unable
to
get
on
mute
there.
My
name
is
good
morning,
chair
spearman
and
members
of
the
committee.
My
name
is
jaron
hildebrand
and
I
am
the
executive
director
of
the
nevada
state
medical
association.
Again,
I
would
like
to
echo
my
comments
from
after
the
comments
of
mr
wadhams
with
the
hospital
association.
C
The
attorney
general's
office
and
specifically
the
consumer
protection
bureau,
have
been
phenomenal
to
work
with
from
where
the
bill
started
into
now.
We
we
believe
it's
in
a
much
better
place
and
again
we
just.
I
would
like
to
express
the
same
concerns
that
mr
wadhams
and
the
hospital
association
expressed
again.
Thank
you
thank
you
to
mr
kruger
and
we
we
remain
opposed,
but
again
thank
you
for
for
all
the
work
that
they've
done
on
this
bill.
Thank
you.
A
Okay,
thank
you.
Let's
go
back
to
committee
members,
any
quick
questions
or
comments.
A
Saying
nine,
mr
gruger,
you
have
any
closing
remarks
you
or
your
colleagues.
P
A
Thank
you,
and
with
that
we
will
close
the
hearing
on
assembly,
bill,
47
and
open
the
hearing
on
assembly
bill
330
and
just
as
an
fyi,
we
have
pulled
391
and
we
will
hear
that
on
monday
on
monday
need
the
folks
to
get
together
and
figure
out
how
they're
going
to
get
you
go
also,
if
I
might
say,
for
semibill
47,
mr
kruger,
if
you
can
get
with
those
who
had
some
opposition
and
see
if
there's
any
way
to
work
through
it
and
if
so,
please,
let
me
know
I'd
like
to
make
sure
that
we
can
get
the
bills
that
have
come
to
this
committee
out
by
the
deadline
or
before
the
deadline
passes
next
friday.
A
Okay,
so
thank
you
all
assembly
bill
330..
I
think
that's
assemblyman
ellison
elliott,
mike
maylin
and
jeanette
bells.
We
are
ready
and
please
begin
when
you
are
ready.
A
S
S
This
measure
provides
that
a
person
who
receives
certificates,
careers
from
technical
training
in
high
school
or
in
post-secondary
institutions
unable
to
receive
equivalent
credit
toward
an
occupational
license
related
to
the
training
that
he
or
she
can
receive.
Today
I
have
elliot
malen
mpa
president
principal
of
em
inc,
and
I
will
provide
information
to
the
committee.
S
Occupational
license
required
a
worker
to
hold
a
credential
to
practice
or
operate
certain
operations
to
receive
occupational
license.
Applicants
must
meet
certain
criteria
in
the
form
of
education
or
training
fees,
testing
in
nevada
regulations
over
50
occupations,
which
is
mostly
contained
54
nevada,
revised
statute.
S
These
boards
and
commission
also
responsible
protecting
the
health
and
the
safety
of
the
consumer
and
ensure
high
levels
of
service.
Yet
licensing
regulations
can
create
unique
barriers
and
challenges
for
the
people
who
enter
the
labor
market,
especially
those
persons
with
high
school
diplomas
but
less
with
a
bachelor's
degree.
S
The
required
test
courses
and
fees
may
stop
youth
worked
from
essential
or
entering
those
occupations
to
overcome
these
challenges.
Nevada
has
helped
students
prepare
for
a
career
opportunities
may
of
which
end
in
a
certification
of
a
licensed
new
career
and
technical
education
cte
program,
which
is
offered
by
high
school
and
post-secondary
institution.
S
Some
boards
already
recognize
trainings
provided
in
this
pre-secondary
institution
as
high
school
of
this
bill
to
formalize
and
the
required
recognition
of
the
skills
our
students
students
obtain
with
preparing.
In
for
the
programs,
nevada
department
of
education
reported
during
2019
and
2020
year
school
year,
69
213
students,
roughly
14
percent,
were
entered
into
cte
programs.
S
Students
can
contain
a
college
career,
ready,
ccr,
high
school
diploma
and
a
career
ready
endorsement,
which
demonstrates
the
proficiency
of
the
career
readiness
associated
with
certain
cte
skills,
attainment,
certifications,
individu,
individual
recognized
credentials.
I'm
trying
to
go
to
as
fast
I
can
ma'am.
S
For
instance,
the
practical
nursing
program
provides
students
with
the
knowledge
the
skills
required
to
enter
into
the
field,
and
they
are
eligible
for
state
board
of
nursing
certificates,
exam
as
principal
practical
nurses,
then
the
2019
and
2020
academic
year,
the
nevada
system,
higher
education,
two-year
institute,
roughly
3
800
skill
certificates
and
certificates
of
achievement.
S
In
addition,
ab-330
would
have
a
positive
effect
in
rural
areas
in
the
state,
the
national
center
and
education
statistics
reported
in
2013
students
with
rural
towns,
earnings
with
the
cte
critics
that
their
cities
and
suburbs
counterparts
it
goes
to
show
that
that
they've
really
been
spent
a
lot
of
time
in
some
of
these
programs
mailman,
and
I
think
that
what
the
best
thing
is
is
I'm
hoping
this
expands
more
into
some
of
the
larger
universities
or
high
schools
like
in
las
vegas
or
washoe,
as
the
population
ages,
skilled
jobs
and
increase
going
unfilled
in
these
areas
of
our
state.
S
The
bill
summary
assembly
bill,
provides
a
person
who
receives
certificate,
career
and
technical
training
in
high
school
or
approach.
Post-Secondary
institution
is
eligible
to
receive
equivalent
credits
towards
an
occupational
license
relating
to
the
training
that
he
or
she
has
received.
S
We
have
a
amendment
for
the
committee
under
section
1,
subsection
4,
remove
the
language
of
coordination
with
the
department
of
education
and
the
nevada
system
of
higher
education
to
allow
respective
regulatory
governing
body
to
adopt
regulation,
to
officiate
the
purpose
of
this
section
and
allow
the
regulation
body
regulatory
body
to
complete
the
necessary
regulations
to
the
normal
process,
and
I
think
this
is
a
great
deal
and
it
was
a
great
amendment
to
come
in
and
actually
my
colleague
from
ways
and
means
brought
that
up
and
with
us
today
also
will
be
the
department
of
education.
S
But
if
I
can
give
you
a
little
background,
too
is
my
grandson.
In
idaho
hadn't
even
graduated
high
school
yet-
and
he
has
his
full
emt
certification
right
now
as
a
a
flight,
emt
medic
and
he's
he's
gonna
go
on
through
to
finish
the
high
school,
but
he's
he
got
offered
a
full
scholarship
for
to
be
a
doctor,
and
he
that's
not
what
he
wants.
S
So
he's
already
certified
and
he's
not
even
out
of
high
school,
and
I
thought
that
was
pretty
neat
that
that
these
kids
can
go
forward
and
know
what
they
want
and
and
finish
their
careers
what
they
want
to
do
and
and
how
they
want
to
go
for
the
future.
So
I
think
that's
a
great
deal
and
in
inclusion.
Madam
chair,
I
have
mr
mayland
with
provide
some
comments
to
the
committee.
Following
his
presentation
will
be
able
to
answer
any
questions
you
may
have.
T
Thank
you,
chair
spearman
and
members
of
the
senate
committee
on
commerce
and
labor
for
the
record.
My
name
is
elliott
malin
and
I'm
here
to
present
ab
330
alongside
assemblyman
ellison,
a
piece
of
legislation
that
continues
on
the
path
of
work
that
this
legislature
has
taken
over
the
past
few
sessions
to
reform
our
regulatory
licensing
agencies.
T
First,
I
want
to
thank
you
in
the
committee
for
allowing
me
the
opportunity
to
be
here
today.
I
also
want
to
thank
assemblywoman
ellison
for
bringing
this
legislation
forward
and
inviting
me
to
participate
alongside
him
and
remembering
my
passion
for
occupational
licensing
reforms.
I'm
not
here
today
on
behalf
of
any
client,
but
rather
because
I
have
a
passion
for
regulatory
reforms
that
can
improve
the
lives
of
nevadans
and
the
opportunity
that
nevadans
have
each
and
every
day.
T
T
Last
session,
I
was
honored
to
work
alongside
assemblywoman
tolls
on
ab319
a
bill
that
had
bipartisan
and
bicameral
sponsorship
that
passed
unanimously
and,
in
my
mind,
has
been
a
highlight
of
my
career
and
has
already
helped
countless
nevadans.
After
the
session,
we
had
the
opportunity
to
meet
with
truckee
meadows,
community
college
team
cc
faculty
and
students
about
the
legislation
and
listening
to
the
stories
of
those
who
the
bill
had
helped
and
listening
to
those
students
was
a
remarkable
experience
that
I
will
never
forget.
T
I
believe
that
this
bill
ab330,
is
a
natural
progression
of
that
legislation.
From
last
session
about
a
quarter
of
americans
require
a
license
to
work
per
study
by
the
national
conference
of
state
legislatures
educational
requirements
for
licensure
can
be
extremely
expensive
and
cause
it
be
cost
prohibitive,
especially
for
those
that
come
from
lower
income
socioeconomic
situations.
T
In
a
presentation
given
by
university
of
minnesota,
professor
morris
kleiner
and
a
webinar
hosted
by
arizona
state
university,
president
klanner
quote
found
that
in
some
cases,
occupational
licensee
was
actually
a
barrier
to
employment
because
of
costs
associated
with
required
exams
or
education.
End
quote
by
allowing
nevadans
to
apply
their
either
secondary
or
postsecondary
equivalent
education.
T
These
programs
will
allow
nevada
students
to
save
time
and
money
by
allowing
them
to
apply
their
existing
and
relevant
education
background
to
equivalent
standards
set
forth
by
the
regulatory
agencies
and
nevada
revived
statutes.
Titled
54.,
while
the
intent
of
occupational
licensure,
is
to
protect
the
public
with
public
safety
and
public
health
measures
and
to
protect
consumers.
We
also
have
to
ensure
that
the
barriers
that
people
face
to
get
in
the
workforce
is
not
detrimental
to
them
too.
T
This
legislation
would
work
hand
in
hand
to
keep
the
public
safe
educational
standards
uniform
and
to
help
people
get
in
the
workforce
are
in
a
higher
wage,
which
will
not
only
benefit
them,
but
the
state's
economic,
health
and
well-being
too.
What
this
legislation
does
not
do.
It
does
not
create
a
system
of
inferior
education
requirements
for
those
seeking
licensure
to
obtain
a
less
stringent
path
that
would
put
it
at
risk,
nevadans,
health
and
safety.
Instead,
it
allows
for
uniform
standards
that
exist
within
education
to
allow
nevadans
an
opportunity
to
get
ahead.
T
T
Lastly,
I
want
to
make
clear
that
we
want
to
work
with
any
stakeholders
to
make
this
bill
great.
The
last
thing
we
want
to
do
is
create
duplicative
efforts
or
confusion.
The
intent
of
this
bill
is
to
get
young
adults
into
good,
paying
jobs
faster,
and
I
appreciate
assemblyman
ellison
for
bringing
this
bill
forward,
as
well
as
all
the
stakeholders
that
have
talked
to
us
so
far
to
help
work
get
nevadans
ahead.
T
A
Okay,
thank
you.
You
have
anyone
else
in
the
in
the
room.
That's
part
of
your
presentation,
simon
ellison
or
mr
maylen,.
S
No
ma'am,
no
ma'am,
I
think
the
I
think
the
department
education
is
there
for
questions
if
it
need
to
be.
A
All
right,
I
just
have
one
question
and
then
we'll
go
to
support
so
senate
bill.
110
is
one
that
creates
a
task
force
within
vienna,
collaborating
with
to
look
at
emerging
technologies
and
innovations.
So
have
you
all
looked
at
number
one?
If
you
looked
at
that
legislation,
is
there
anything
that
you
might
be
able
to
glean
from
it?
That
would
help
in
terms
of
preparing
the
curriculum
for
those
who
are
in
high
school.
That
will
be
received.
Some
type
of
training.
T
Assemblyman
ellis-
and
I
can
take
that
if
you'd
like
yeah,
go
ahead
ellie.
Thank
you
senator
elliot
mellen
for
the
record.
I
have
not
yet
looked
at
sb
110,
I'm
happy
to
do
so,
but
I
think
it's
important
to
note
what
this
bill
does
with
education
standards
and
curriculum
is
that
it
doesn't
necessarily
require
the
implementation
of
curriculum.
A
Okay,
thank
you.
Thank
you,
so
with
that,
anyone
in
support
in
the
room.
A
Okay,
so
broadcast,
let's
go
to
the
phone
support
and
let's
take
15
minutes,
15
minutes
and
two
minutes
per
individual.
B
C
C
We
believe
that
this
legislation
works
to
ensure
workers
are
recognized
for
their
efforts
to
increase
their
skill,
and
we
agree
with
the
streamlining
purpose
of
this
bill
to
ensure
any
credits
toward
another
related
certification
are
also
given.
We
appreciate
the
ability
for
workers
to
appeal
for
equivalent
credits,
ensuring
those
that
who
have
already
completed
courses
receive
all
credits
due
and
for
all
boards
and
commissions
to
work
in
coordination
with
the
state
department
of
education
to
ensure
consistency
with
these
certificates.
C
Thank
you
for
thank
you
for
your
time.
We
urge
your
support
on
ab330.
A
Thank
you.
Anyone
in
the
room
who
is
in
opposition.
J
Chair
spearman,
there's
not.
A
S
Thank
you,
madam
chair
and
committee.
I
I
thank
you
for
allowing
me
to
be
here
and
testify
today
on
this
bill.
I
hope
you
take
this
for
consideration.
S
It's
a
good
deal
it's
for
students
and
I
think
we
need
the
workforce
development
out
there,
and
these
kids
are
smart
and
they're
they're
moving
forward
their
careers.
So
I
hope
you
support
330.
Thank
you.
T
A
B
A
In
a
couple
of
seconds,
just
in
case
someone's
having
technical
difficulty.
A
Okay,
so
with
that,
we
will
close
the
public
comment
and
thank
you
all
for
your
participation
for
those
who
were
able
to
hang
with
us
throughout
this
entire
meeting.
A
I
just
want
to
let
you
know
that
for
those
of
you
who
have
reached
the
age
of
retirement
since
we
started
8
o'clock
this
morning,
social
security
is
still
open,
so
you
can
submit
your
paperwork
feels
like
we've
been
in
here
for
about
20
years,
but
anyway,
I'm
glad
that
we
were
able
to
vet
these
bills
and
the
way
that
is
necessary
so
that
when
we
come
to
work
session,
we
have
all
of
the
at
least
most
answers
that
we
need
there
was.
A
There
were
a
couple
of
questions
that
were
that
were
raised
and
senator
hardy,
I'm
going
to
ask
if
you
will
get
with
mr
keen.
I've
asked
him
to
try
to
help
address
your
concerns,
there's
some
other
some
other
issues
with
ab47,
so
if
you're,
one
of
the
ones
that
had
some
more
questions
about
some
of
the
bills
that
you
will
get
with
the
necessary
parties
and
make
sure
we
get
it
ironed
out,
we
have
a
deadline
coming
up.
A
Next
friday
and
I'm
hoping
to
have
bills
heard
and
work
session
before
the
deadline
passes,
and
so
with
that
we
will
be
adjourned,
and
we
will
be
right
back
here
on
friday
morning
at
eight
o'clock.
Thank
you.
We
are.