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From YouTube: 4/1/2021 - Senate Committee on Commerce and Labor
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A
F
G
A
So,
madam
secretary,
please:
well,
do
we
have
a
quorum
one,
two,
three
four
scheible's
not
on.
H
A
I'm
here,
okay,
so
so
then
we
have
a
quorum.
We
have
four
right.
So,
let's,
as
the
other
members
come
on,
mark
them
present,
but
we
need
to
go
ahead
and
get
started.
I
will
open
up
the
hearing
on
sv
290.
F
A
F
Thank
you,
madam
vice
chair
charity,
for
the
record,
I'm
going
to
focus
on
the
positive
on
sb
335,
the
rationale
for
why.
Oh,
we
need
confidence
in
our
medical
care
in
the
state
of
nevada.
F
We
need
to
have
faith
in
the
physicians
of
every
kind.
We
are
grateful
for
the
quality
of
care
and
we
need
to
have
that
gratitude.
We
need
to
have
a
commitment
to
serve.
We
the
caregivers,
the
commitment
to
serve
and
honor
those
who
are
sick
or
afflicted
have
the
ability
to
develop
that
self-sacrificing
for
the
good
of
our
neighbors.
F
F
F
This
is
actually
the
first
step
to
a
foundation
of
a
commitment
to
have
all
of
us
care
with
that.
I
would
like
to
have
the
director
of
department
of
business
and
industry
terry
reynolds
be
able
to
report
followed
by
the
executive
director
of
the
governor's
office
of
economic
development,
michael
brown,
if
that's
okay
with
you
meta
vice
chair.
D
Thank
you,
chair,
neal
and,
and
members
of
the
committee
good
morning,
I'm
terry
reynolds,
director
of
the
department
of
business
and
industry,
I'm
here
to
provide
testimony
in
regard
to
sb
335
concerning
occupational
licensing
boards
in
2018
and
2019.
Actually,
it
goes
back
to
2017.
D
The
executive
branch
audit
committee
took
a
comprehensive
look
at
occupational
licensing
boards
and
the
oversight
and
controls
of
those
entities.
Then,
director
matthew
and
I
worked
with
the
audit
committee
to
provide
an
internal
review
of
the
23
boards
and
commissions
that
the
department
of
business
and
industry
oversees.
D
The
executive
audit
committee
recommended
establishing
executive
branch
oversight,
nevada's
independent
licensing
boards
under
the
department
of
business
and
industry,
to
provide
the
executive
branch
awareness,
guidance
and
review
that
is
currently
lacking
and
would
enhance
public
and
licensed
confidence
in
board
activities.
Boards
are
subject
to
oversight
by
both
the
legislature
and
the
executive
branches.
According
to
the
office
of
attorney
general,
current
oversight
is
exercised
primarily
by
the
legislative
branch
to
the
subset
sunset
subcommittee,
review
and
approval
of
regulations
by
the
legislative
commission
and
other
reporting
requirements.
D
Last
interim
sunset
noted
many
concerns
with
the
board
practices
involving
hearing
officers,
training,
operating
reserve,
fines
and
fee
structures,
electronic
access
and
payments
use
of
outside
council
and
lobbyists,
and
centralized
coordination
of
expenditures.
Sunset
also
noted
instances
of
financial
irregularities
exec
existing
executive
branch
oversight
of
boards
is
lacking
as
far
back
as
1992.
D
The
study
of
the
structure
of
nevada's
government
recommended
boards
be
under
state
oversight.
Boards
are
exempt
from
certain
financial
personnel
and
internal
control,
statutes
that
govern
the
activities
of
other
state
agencies.
The
lack
of
executive
branch
oversight
allows
for
inconsistent
board
practices
that
may
not
comply
with
state
guidelines.
D
D
A
state
supervisor
should
be
designated
to
provide
active
supervision.
The
supervisor
may
be
an
extension
of
the
executive
branch
agency
or
official
that
oversees
regulatory
boards
and
who
is
not
an
active
market
participant
bni
is
one
of
the
largest
most
complex
executive
departments
with
23
regulatory
bodies
under
its
oversight
umbrella
and
currently
issues
approximately
265
000
licenses.
D
Bni
is
structured
to
provide
regulatory,
operational
facility
and
administrative
support
to
its
regulatory
bodies
and
could
expand
or
adapt
its
structure
to
support
boards.
The
best
first
step
for
establishing
bni
oversight
may
be
in
joining
a
semi-autonomous
relationship
by
which
boards
retain
authority
for
regulating
professions
under
their
practice,
acts
and
other
board
operations
fall
under
the
umbrella
oversight
of
business
and
industry.
D
D
Bni
can
provide
legislative
assistance,
reducing
board
expenditures
for
lobbying
activities.
Establishing
improved
oversight
by
the
boards
may
result
in
additional
costs.
However,
general
fund
appropriations
may
be
initially
be
necessary
to
offset
some
of
the
costs
for
personnel
and
other
resources.
Bni
may
require
an
ex
it's
expanded
executive
oversight,
role,
established
standards
for
regulatory
and
financial
administrative
operation
through
business
and
industry,
establishing
standards
that
business
industry
will
provide
for
executive
branch
awareness
guidance
and
review
of
the
boards
and
will
enhance
public
and
license
confidence
and
board
activities.
D
In
our
first
report,
we
were
noted
several
deficiencies
in
financial
and
administrative
practices
where
setting
standards
could
improve
oversight.
This
audit
identified
additional
con
areas
of
concern
where
setting
standards
could
provide
improved
oversight
by
the
executive
branch
hearing
officers,
fees,
fines,
penalties,
regulatory
authority,
administrative
cost,
recovery,
disciplinary
reporting,
board
training
and
records
retention
and
public
records
request.
D
As
a
follow-up
to
the
audit
board
recommendations,
the
department
of
business
and
industry
has
looked
at
several
state
occupational
and
professional
licensing
structures.
Two
western
states
stand
out
colorado
and
utah.
These
two
states
have
the
function
of
occupational
professional
as
well
as
division
under
the
department
of
commerce
or
business
regulation.
D
Their
occupational
license
structures
is
very
similar
to
the
structure
of
administration,
support
within
the
department
of
business
and
industry
for
licensing
functions
that
we
administer
with
that
I'd
like
to
turn
it
over
to
michael
brown
director
of
go
in.
I
would
also
indicate
that
I
will
give
to
the
committee
a
copy
of
the
executive
branch
audit
that
was
performed
in
their
latest
report
on
that.
Thank
you.
I
Thank
you
director
reynolds,
madam
chair
members
of
the
committee.
Following
that
report,
I
made
a
trip
over
to
utah
to
visit.
I
was
then
director
of
business
and
industry,
and
I
made
a
trip
to
utah
to
visit
with
my
counterpart,
the
director
of
the
secretary
department
of
commerce
in
utah,
to
learn
more
about
their
division
of
occupational
licensing.
I
Their
main
office
was
located
in
salt
lake
city
and
at
about
a
five
or
six
story.
Building
the
lobby
resembled
a
bank
where
people
that
needed
to
renew
occupational
licenses
could
go
in
and
conduct
and
transact
routine
business.
The
division
was
set
up
with
a
central
administration
of
their
occupational
licensing
boards.
It
had
a
centralized
or
a
very
robust
I.t
system
and
a
consolidated
accounting
and
financial
system.
I
They
had
a
independent
compliance
investigation
unit
that
had
approximately
30
investigators,
many
of
whom
were
had
recruited
as
retirees
from
the
state
highway
patrol
or
had
a
subject
matter
expert
in
their
areas,
and
then
they
could
rotate
these
through
it.
Within
each
occupational
area
they
had
a
bureau
chief
who
might
oversee
several
different
occupations
in
a
in
a
common
area.
They
had
a
standard
set
of
internal
controls.
I
They
had
co-located
at
that
facility.
Various
deputy
attorney
generals
that
supported
the
legal
work
on
that,
and
they
could
provide
consolidated
legal
support
across
all
their
different
occupational
licensing
boards.
The
policy
boards
don't
engage
in
the
day-to-day
management
of
the
boards,
they're
they're,
subject
matter:
experts,
the
employees
of
the
boards
were
civil
service
and
they
were
covered
under
the
budget
act
in
utah,
and
then
they
have
a
very
robust
web
page
for
the
utah
department
of
commerce,
division
of
occupational
and
professional
licensing,
very
user-friendly
standardized
across
all
the
different
occupations.
I
It
I
was,
I
left
there
truly
impressed
with
with
how
utah
is
is
managing
this.
The
area
of
occupational
licensing
is
one
area
that
sri
prioritized
in
the
economic
resiliency
program.
We
have
seen
some
of
our
competitive
states,
particularly
utah,
particularly
arizona,
reducing
the
barriers
to
make
it
easier
for
two
career
couples.
Where
one
couple
needs
an
occupational
licensing
needs
an
occupational
license
to
come
to
their
state
and
get
the
license
they
need
in
a
reasonable
amount
of
time.
I
The
expression
is
often
used.
I
think
the
expression
is
trailing
spouse,
and
so
anyway,
this
was
my
experience
in
my
field
trip
to
utah
on
this
and
director
reynolds,
and
I
were
involved
jointly
in
this
project
when
I
was
at
bni
and
something
I
continue
to
have
an
interest
in
as
head
of
economic
development.
With
that,
I
think
the
director
and
I'm
willing
to
answer
any
questions.
I
Oh,
I
will
michael
brown
director
of
governor's
office
of
economic
development.
Okay,
thank
you
for
that.
H
J
H
H
J
D
D
The
sunset
subcommittee
recommended
that
they
look
at
boards
that
did
not
have
about
a
robust
administrative
support
with
their
actual
setup
for
their
staff.
For
that,
and
I
think
that
probably
had
something
to
do
with
this.
D
But,
as
you
know,
the
boards
are
not
they're
all
created
equal,
some
are
have
a
very
good
administrative
support
and,
and
others
do
not,
and
so
I
think
any
kind
of
going
forward
with
this
type
of
legislation
and
this
type
of
administrative
control,
it's
really
going
to
have
to
be
broken
down
into
pieces
and
look
at
the
actual
individual
structure
in
terms
of
where
they're
at
net
today
and
where
they
should
be
going
forward.
D
So
I'm
not
here
to
basically
comment
on
how
the
current
legislation
of
structure
but
more
to
tell
you
what
the
recommendations
were
for
the
audit
subcommittee
and,
as
you
know,
senator
you've
been
involved
in
sunset
subcommittee
for
for
quite
some
time,
and
you
know
the
complexities
of
which
this
these
boards
and
commissions
present
and
how
they've
kind
of
grown
up
over
a
period
of
time.
D
So
I
think
there
needs
to
be
really
kind
of
a
an
overall
comprehensive
look
at
how
to
go
about
this
and
it
may
be
beyond
what
we
can
do
in
this
legislative
session
may
have
to
go
into
the
next
couple
sessions
to
be
able
to
determine
the
best
route.
For
this.
J
A
Okay,
thank
you
for
that.
Senator
picker.
H
Thank
you,
madam
vice
chair.
First,
by
way
of
just
background,
I've
been
on
the
sunset
subcommittee
since
I
entered
the
legislature,
and
so
I've
seen
in
fact,
even
before
that
I
was
working
with
former
assemblyman
lynn
stewart
on
what
became
ab328
in
the
2017
session,
where
we
actually
started
out.
H
Looking
at
this
very
concept,
we
were
working
with
the
governor's
office
and
and
several
of
the
boards,
because
we
had
a
significant
problem
both
with
at
the
time
it
was
the
dental
board
and
then,
with
the
result
of
the
supreme
court
case
in
the
the
north
carolina
dental
board
versus
ftc,
which
is
where
the
the
supreme
court
said.
States
need
to
do
a
much
better
job
of
managing
and
overseeing
boards
that
are
prime,
predominantly
made
up
by
market
participants,
and
so
rather
you
know
it
looked
like
we.
H
H
So,
at
the
end
of
the
day,
328
was
about
trying
to
standardize
some
of
the
hiring
and
and
support
practices,
limiting
attorneys
and
and
executive
directors
so
that
they
couldn't
represent
multiple
boards
all
at
the
same
time
and
trying
to
address
some
of
the
procedural
and
structural
problems
that
we
had.
H
But
the
thing
that
really
came
through
through
the
sunset
subcommittee
activities
was
that
some
of
the
boards
are
are
understaffed
under
supported
and,
frankly,
the
body
of
of
practitioners
was
so
small.
So,
for
example,
the
homeopathy
board.
There
were
only
like
60
members
and
they
can't
afford
to
pay
the
deputy
attorney
general,
the
bills
that
accrue
when
the
ag's
office
steps
in
to
help
it
just
didn't
make
sense
to
have
this.
This
regulatory
structure
over
only
a
few
people,
and
so
we
made
the
recommendation
for
the
actions
taken
here.
H
So
with
that
as
a
backdrop,
I
just
have
two
questions.
Well,
first,
after
looking
at
the
thickness
of
the
bill,
I
think
we
see
why
lcb
was
running
behind,
but
first,
why
don't
we
apply
this
to
all
boards,
because
streamlining
the
process
and
homogenizing
the
rules
and
and
procedures?
H
D
Structure,
senator
picker,
thank
you
for
that
type
of
question
and
I'm
going
to
also
allow
director
brown
to
get
involved
in
this.
But
one
of
the
things
I
think
that's
important
to
realize
is
that,
right
now,
if
you
look
at
the
comprehensive
audit
report,
the
statements
about
having
consistent
personnel
financial
records
financial
procedures,
you
know
it
really
encompasses
the
entire
operation
to
be
able
to
come
under
an
umbrella
for
administrative
control.
D
But
I
don't
like
to
really
use
administrative
control
on
this
point,
because
it's
really
setting
up
administrative
procedures,
legal
procedures,
administrative
procedures
to
be
able
to
look
across
the
board
at
all
of
these
entities,
and
so
I
think,
you're
correct.
In
terms
of
how
that
takes
place.
However,
I
will
note-
and,
as
you
probably
know,
there
has
been
other
states
that
have
accepted
out,
for
example,
the
contractor's
board
or
the
medical
board,
or
certain
boards
that
are
under
the
same
type
of
procedures,
but
they're
accepted
out
in
terms
of
having
common
administrative
control.
D
So
there
are
some
anomalies
across
the
united
states
in
terms
of
in
terms
of
what
happens,
but
generally
we
have
allowed
these
boards
to
develop
and
have
their
own
types
of
operations
and
controls
and
administrative
procedures,
and
so
now
to
bring
it
back
into
a
common
format
for
personnel
administration.
Financial
regulations
on
them
is
going
to
take
some
time
and
some
work
to
get
to
that
point,
and
so
you
know
this
as
well
as
I
do.
D
Senator
you've
been
very
involved
in
this,
and
actually
you
know
helped
to
get
this
to
where
it
is
today.
But
I
think
that
this
is
something
that
should
be
done
for
everything
all
the
boards
and
commissions
across
the
state.
They
should
all
be
under.
Essentially
uniform
financial
personnel
and
administrative
controls
within
the
state
makes
good
sense
makes
good
sense
from
a
standpoint
of
having
transparency
and
controls
in
their
operations,
and
it
also
makes
good
sense
to
make
sure
that
everybody's
operating
under
the
same
rules-
and
I
think
that's
extremely
important-.
I
Yes,
let
me
follow
up
michael
brown,
director
of
governor's
office
of
economic
development.
You
know,
I
think
it's
a
matter
of
scale
when
we
talked
to
some
folks
pre-pandemic
about
the
governor's
audit
recommendation
about
what
it
would
take.
Lcb
the
budget
process,
the
it
process.
It
was
simply
a
matter
of
scale
as
to
how
much
you
could
tackle
at
one
single
time.
H
All
right-
and
I
I
do
appreciate
that
I
I
had
envisioned
when
we
were
first
talking
about
this-
about
rolling
it
out
over
time
and
you
know,
have
different
sections
effective
at
later
dates,
particularly
since
we
had
immediate
issues
we
had
to
address.
Those
would
be
the
first
and
then
boards,
like
the
contractors
board,
which,
although
they
they
are
a
fight
them
unto
themselves,
they
do
a
pretty
good
job.
H
I
think
it's
well
run,
but
you
know
when
we
deal
particularly
when
the
lobbyists
come
up
and
and
not
just
the
contractor's
board,
but
a
few
other
boards,
they
feel
pretty
empowered
to
tell
us
what
we
should
be
doing,
not
the
other
way
around,
and
therein
lies,
I
think,
part
of
the
problem.
They
resist
oversight.
H
I
enjoyed
working
on
it
because
it
kind
of
exposes
some
of
these
defects
and
which
is
my
second
question,
which
is:
how
is
this
going
to
affect
the
role
of
the
sunset
subcommittee,
because
I
think
that
legislative
oversight
needs
to
remain
in
place,
but
it's
empowered
to
review
the
boards
as
it
the
oversight
for
the
state.
How
would
you
envision
the
the
sunset
subcommittee,
maintaining
its
its
position,
is
overseeing
boards
under
this
structure.
D
Senator
picker
this
is
director
reynolds
for
the
record.
I
think
there's
there's
actually
a
very
robust
role
for
the
sunset
subcommittee
you're
going
to
be
reviewing
as
you
as
you
do,
audits.
Continuing
on
of
these
these
boards,
there's
gonna,
be
ongoing
audits
because,
there's
you
know
multiple
boards
and
so
there's
going
to
be
continual
audits
over
of
the
boards.
D
There's
also
going
to
be
a
review
of
regulations
and
procedures
that
these
boards
have
over
time,
so
that
there
is
consistency
across
the
different
boards
and
commissions
that
you
will
be
aware
of
and
be
instrumental
in
making
sure
that
those
are
consistent
with
the
operational
procedures
that
you
would
like
to
see.
So
I
think
that
the
subset
subcommittee
will
still
have
a
very
active
role
over
time,
as
you
do
more
of
a
watchdog
in
terms
of
looking
at
the
audits
looking
at
regulations
looking
at
the
procedures
that
are
engaged
by
these
occupational
licensing
boards.
I
And
if
I
could
have
michael
brown
for
the
record
center,
I
think
is
a
very
valuable
role.
I
mean
this
is
a
system
that's
been
built
upon
itself
decade
over
decade.
I
It
would
be
useful,
I
believe,
for
that
committee,
to
consult
with
its
colleagues
in
utah
in
colorado
and
see
what
their
experience
is
and
perhaps
also
do
a
field
trip
to
see
how
they're
organized
there,
because
there
are
nuances
in
this,
the
contractor's
board
in
utah
has
a
very
different
function
than
the
contractors
board
in
nevada
and
one
regulates
the
plumber
one
regulates
the
company,
and,
and
so
there
are
nuances
there,
that
would
need
to
be
considered
carefully.
H
And
I
appreciate
that
having
had
licenses
in
both
states,
I
get
that
well,
and
I
appreciate
that.
I,
I
think,
probably
the
thing
that
excites
me
the
most
and
I
don't
want
to
jinx
the
bill
by
talking
too
much
about
it
from
my
own
perspective.
But
you
know
we.
H
One
of
the
things
I
noticed
in
senator
hardy's
amendment
was
to
delete
the
section
on
the
barber
board,
not
that
I'm
after
the
barber
board,
but
one
thing
that
we
learned
in
the
last
round
of
the
sunset
subcommittee
was
that
the
barber
board
is
using
antiquated
systems
and
they're
so
small
that
they
were
having
a
hard
time
keeping
up,
and
this
would
have
fixed
that
problem
that
would
have
allowed
them
to
have
a
current
technology
support
at
the
the
the
participant
level
so
that
we
they
could
walk
into
a
place
and
get
their
testing
done
and
turn
in
their
papers.
H
Instead
of
waiting
in
someone's
barber
shop
until
the
the
board
member
that
was
responsible
to
administer
the
test
finished
doing
somebody's
hair,
I
mean
it
was.
It
was
evident
that
they
were
just
too
small
and
underfunded
to
be
able
to
really
do
an
a
current
day,
modernized
review
and
and
licensing
system
that
this
bill
will
fix.
H
But
in
any
event
I
probably
said
more
than
I
need
to.
I
have
some
other
questions.
I
don't
want
to
monopolize
the
time
so
I'll
take
those
offline.
But
thank
you,
madam
vice
chair,
for
allowing
me
the
opportunity
to
ask
questions.
A
So
I
I
have
some
questions,
so
I'm
going
to
take
two
sections
together
because
I
think
they
kind
of
speak
to
each
other,
so
in
section
10
the
division,
which
is
now
this
created
division
when
you're
talking
about
determine
the
manner
in
which
applications
or
licenses
are
submitted.
Is
there
a
discussion
about
reformatting
this?
The
applications
that
the
existing
boards
have?
A
Because
when
I
looked
at
section
90
and
that's
why
I
said
I
was
taking
two
sections
together,
this
seems
to
talk
about
how
the
division
determines
what
the
application
that
an
application
is
sufficient,
and
so
I'm
wondering
what
is
the
reorganization
that
is
being
considered
in
terms
of
the
existing
work
applications
and
licensing
forms
that
have
already
been
created
by
these
bodies.
D
D
One
of
the
issues
is
to
really
try
to
standardize
the
format
for
applications
for
licensing,
so
that
the
so
that
they
can
use
common
platforms
for
it
platforms
and
be
able
to
be
able
to
have
these
online,
so
they
can
be
filled
out
online
and
that
we,
the
boards,
has
common
information
in
terms
of
updated
information
that
is
consistent
with
the
with
current
law,
in
terms
of
what
can
be
asked,
background,
information,
etc.
D
So
part
of
that
is
to
structure
the
occupational
licensing
applications
similar
to
what
is
happening
now
and
frankly,
right
now,
they're
all
different
they're,
all
non-similar
from
an
aspect
of
each
one
has
their
own
type
of
type
of
application,
and
some
of
those
are
are
very
sophisticated.
Current
and
others
are
not.
So
I
think
that
the
ability
was
to
be
able
to
have
a
common
platform
for
those,
and
so
that's
part
of
that.
D
So
it's
extremely
difficult
exercise
and
what
you
get
is
a
you
know,
basically,
a
two
hundred
some
seventy
some
page
bill
with
different
sections,
as
you
pointed
out
that
refer
to
other
areas,
because
it's
spread
out
in
the
current
of
nrs
and
nacs
to
be
able
to
do
that
and
each
board
has
their
own
section
within
the
administrative
code.
And
so
I
think
realistically,
what
we're
talking
about
is
to
be
able
to
take
and
create
common
platforms
for
applications
for
background
information
for
licensees,
so
that
they're
easily
discernible.
A
A
D
Terry
reynolds
for
the
record-
that
is
my
understanding,
I'll
defer
to
let's
say
council
on
in
terms
of
how
they
drafted
that.
But
it's
my
understanding
that
there
would
be
a
contribution
by
other
entities,
other
boards
toward
the
operation
of
that
and
as
we
go
forward
and
add,
potentially
add
additional
boards.
D
That
would
provide
a
base
funding
to
be
able
to
do
the
administrative
work
that
would
be
necessary
going
forward
to
add
those
additional
boards
in
for
funding.
But
I
can't
really
comment
on
the
how
that
was
structured
because
we
weren't,
like
I
said,
involved
in
the
in
this
bill
in
terms
of
putting
it
together.
B
A
Okay,
and
so
my
next
question's
on
section,
33
and
35,
but
I'm
33,
because
this
is
section
33.
Basically,
the
division
may
employ
the
attorneys
investigators,
hearing
officers,
experts
etc,
but
the
way
you
have
composed
or
not
you
but
the
way
this
bill
has
been
composed
and
all
of
the
boards
that
you're
taking
under
one
house.
A
How
is
it
exactly
because,
when
I
was
looking
at
how
the
members
are
selected
it
it
seems
that
we're
picking
and
choosing
the
members
that
are
selected
to
be
on
the
board.
So
how?
So?
How
will
this
the
experts,
consultants
and
everything
be
determined?
A
Is
that
expected
to
be
housed
in
in
under
the
expertise
of
one
individual
or
do
the
boards
who
are
now
being
taken
under
this
get
to
then
advise
on
who
they
have
used
and
and
and
the
proper
way
that
they
as
a
dental
board
or
as
a
medical
board,
been
able
to
handle
these
issues?
I'm
just
thinking
real
life.
D
Terry
reynolds
for
the
record,
chair
neal,
let
me
try
to
go
back
to
what
we
do
within
the
department
of
business
and
industry.
We
have
23
boards
commissions
13
of
those
are
our
policy
boards
and
licensing
boards
that
are
involved
in
that
we
use
a.
We
use
a
common
attorney
through
the
ag's
office
to
represent
us.
We
use
a
if
we
have
to
use
outside
counsel,
meaning
that
the
law
allows
for
that.
D
We
go
through
a
request
for
qualifications
process
and
we
hire
council
and
that
is
approved
by
the
board
of
examiners.
So
outside
counsel
is
approved
through
through
that
that
process
we
use
all
our
internal
I.t.
We
always
have
I.t
contracts
for
software
development
and
that
for
our
boards
and
commissions,
but
but
we
generally
have
that
done
internally,
and
so
we
are
and
would
envision
pulling
that
in
from
we
use
our
own
financial
people.
D
We
sign
management,
analysts
or
asos
agency
service
officers
to
go
in
and
be
able
to
review
the
budgets
and
make
recommendations
on
the
budget
and
work
with
the
entities
on
their
budget,
and
so
we
do
probably
90
percent
of
that
work
in-house
and
that's
what
I
would
recommend
for
this.
Obviously,
from
a
policy
standpoint.
A
Okay,
thank
you
for
that.
So
and
I'm
glad
you
said
the
administrative
hearing
process,
because
then
that
it
brings
me
to
my
next
question
now
this
is
this
is
a
two
for
one,
so
section,
35
and
section
127
so
section
35
is
where
the
division
will
hold
hearings,
conduct,
investigations
etc,
but
in
section
127
it
is
talking
about
how
all
the
money
received
by
the
division.
A
In
this
section-
and
this
section
seems
to
talk
about-
you-
know
the
refunds,
the
collection
of
fines
and
fees
associated
with
the
hearing,
panel,
etc,
etc,
and
so
I'm
trying
to
understand.
Okay
now
the
division
will
be
taking,
and
I
need
clarification
if
they
are
now
going
to
be
receiving
any
of
the
money
from
violations
fees,
because
typically
this
would
be
the
hearing
officer
and
the
board
would
deposit
the
money
collected
for
the
imposition
of
fees
etc,
and
there
was
a
state
board
of
examiner
element
there.
D
Jared
neal,
let
me
state
this
from
our
perspective
once
again,
through
business
and
industry,
all
fines
and
penalties
go
to
the
general
fund.
D
They
do
not
come
in
to
to
the
department,
we
do
hold
administrative
hearings
and
that
process
is
set
up
to
and
now
that
cost
for
those
hearings
and
the
cost
for
the
operation
of
the
different
policy
boards
are
set
up
in
different
budget
accounts
and
so
that
we
can
track
each
one
of
those
individual
policy
boards,
for
example
the
real
estate
commission
or
the
common
interest
community
commission
or
several
boards
that
we
have
with
insurance
or
emrb,
for
example,
the
board
that
makes
decisions
on
there.
D
Those
are
all
separate
budget
accounts
that
we
have,
and
so
we
keep
the
expenses
we
track
those
expenses
within
those
accounts
from
a
separate
standpoint,
so
we
don't
co-mingle
the
funds
from
all
of
our
boards
and
commissions
they're
all
handled
separately
and
then
penalties
on
that.
As
you
know,
they
don't
go
back
into
supporting
the
boards.
They
basically
are
accepted
out
and
go
to
the
the
general
fund
or
go
to
an
outside
fund.
D
So,
just
to
assure
you
that
we
follow
those
individual
processes
that
we
have
for
each
one
of
our
boards,
that
we
oversee,
whether
it
be
in
real
estate
or
insurance,
or
mortgage
lending
or
financial
institutions
or
real
estate.
A
And,
and
thank
you
for
saying
that,
because
the
strikeout
on
section
127
lines
30
through
36,
you
know
that
was
original
language,
which
basically
said
yes.
It
would
be
deposited
with
the
state
treasurer
for
credit
to
the
state
general
fund,
but
the
new
language
doesn't
say
for
credit
to
the
state
general
fund.
A
It
just
says
deposited
with
the
state
treasurer
for
credit
to
the
occupational
licensing
account
and
that's
why
I
want
a
clarification
because
it
yeah
in
the
original
language,
yes,
general
fund,
and
in
this
one
it
says
that
it
would
be
going
to
the
occupational
licensing
account
created
by
section
14
of
the
act.
So
it
struck
out
general
fund,
and
I
don't
know
if
that
was
an
error
if
we
were
still
playing
by
the
same
rules.
But
I
wanted
that
on
the
record.
A
Okay,
so
my
last
question
on
section
87,
where
the
strikeout
in
the
provision
is
dealing
with
the
salaries
that
the
members
of
the
boards
collect.
So
it
looks
like
no
more
salaries.
D
Once
again,
we
we
didn't
draft
the
language,
so
I
don't
know,
but
generally
what
we
do
for
our
board
members
is,
they
have
a
a
per
diem
rate
and
they
are
paid
for
by
the
meetings
that
they
have
and
that
is
consistent
across
the
all
of
our
boards
and
commissions
within
business
and
industry.
I
I
will
tell
you
that,
from
our
perspective,
they're,
not
all
equal,
some
board
members
put
in
a
tremendous
amount
of
time
the
qualifications
for
those
board
members.
D
D
So,
but
I
know
what
utah
does
is:
basically,
they
have
a
standardized
approach
in
terms
of
what
they
pay
their
board
and
commission
members
for
the
occupational
licensing
boards
and
most
states
have
that
it's
based
on
basically
a
a
per
diem
rate
when
they're
in
meetings
and
the
time
that
they
spend
preparing
for
the
meetings
for
the
hearings
that
they
have
and
that's
how
they're
paid
so.
K
Thank
you
vice
chair
neal,
for
the
record
will
keen
committee
council
with
regard
to
the
five
percent.
K
The
health
care
related
board,
such
as
the
board
of
medical
examiners,
will
be
paying
under
this
bill,
we'll
be
paying
five
percent
of
their
incoming
fees
into
the
newly
created
occupational
licensing
account,
and
that's
not
all
the
boards,
just
the
the
health
care
related
ones,
such
as
the
board
of
medical
examiners
and
with
regard
to
section
127
that
has
to
that
deals
with
the
dental
board,
and
perhaps
a
broader
statement
would
be
for
the
boards
that
are
being
abolished.
The
boards
are
actually
being
abolished.
K
But
for
the
most
part
the
boards
have
created
proceedings
where
their
fines
will
go
back
into
the
various
individual
accounts
of
the
boards.
Here
in
127,
the
money
would
go
into
the
new
occupational
licensing
account
because
the
division
is
essentially
acting
as
the
dental
board.
Under
this
section,
I
think.
A
Mr
keane,
since
the
ones
that
are
being
abolished,
they
go
away.
They're
built
I'm
assuming
their
building
goes
away
and
whatever
is
associated.
Was
there
any
was?
Is
there
any
bonding
or
anything
that
was
associated
with
these
boards,
that
we
have
to
be
worried
about
in
terms
of
because
they've
been
around
for
a
while,
where
maybe
they
bonded
for
their
building
or
is
that
is
that
an
issue
is
that?
Is
that
out
there
lingering
somewhere.
K
Once
again,
for
the
record
will
keen
community
council
for
the
boards
that
are
being
abolished,
the
division
is
simply
stepping
into
the
shoes
of
the
boards,
so
the
obligations
of
those
boards
will
be
taken
on
by
the
division.
I'm
not
a
I'm,
not
aware
of
any
bonding
that
was
done
by
particular
boards.
There's,
not
particular
provisions
about
that
in
the
particular
board
chapters,
but
the
division
would
step
in
and
take
on
the
obligations
of
these
boards.
A
F
Whatever
questions
the
committee
has
we'd
be
happy
to
answer
them.
If
terry
reynolds
and
michael
brown
are
still
around
it
wise
to
not
pick
their
brain
as
much
as
you
can,
you
have
to
leave.
B
L
L
A
dentist
here
in
las
vegas
nevada
and
I
am
a
delegate
for
the
nevada,
dental
association
and
we
are
calling
in
support
for
the
for
the
bill,
but
with
reservations,
and
we
do
look
forward
to
working
with
senator
hardy.
On
the
amendments
of
the
bill.
We
do
support
dentists,
overseeing
dental
licensure.
Thank
you.
B
J
Good
morning,
honorable
members
of
senate
commerce,
chair
vice
chair
neil,
this
is
eddie
ableiser,
edd
ie,
a
b
l
e
ser,
calling
on
behalf
of
the
nevada
dental
association.
This
morning
we
are
pleased
to
support
senate
bill
335
by
senator
hardy
and
the
work
that's
been
done
by
mr
reynolds
and
mr
brown
on
occupational
licensing
reform.
J
As
many
members
of
this
committee
are
aware,
the
nevada
dental
licensing
board
has
had
a
history
brought
with
controversy
and
abuses
and
the
nevada
dental
association
stands
with
the
efforts
to
change
and
reform
boards
across
the
state.
We
do
have
some
questions
and
concerns
that
we
have
priorly
offered
to
the
sponsor
and
look
forward
to
continually
engaging
with
him
on
possible
amendments
that
might
clarify
specifically
industry
focused
overview
and
involvement
in
the
development
of
of
licensing
and
discipline.
B
C
B-R-I-A-N-L-A-U-F
is
in
frank,
I'm
here,
testifying
in
support
of
senate
bill
335
as
the
president
of
the
nevada
academy
of
pas
for
a
little
background
information
on
myself
for
members
who
do
not
know
me,
I
completed
a
doctorate
of
medical
science
from
the
university
of
lynchburg.
I
am
the
founding
director
of
the
pa
program
at
the
university
of
nevada,
reno
school
of
medicine,
where
I
teach
and
continue
practicing
medicine
as
a
pa.
I
have
been
practicing
medicine
in
nevada
for
24
years.
Nevadans
are
excuse
me.
C
Napa's
goal
is
to
improve
access
to
quality
health
care
in
the
state
of
nevada
and
give
a
voice
to
the
pa
profession
through
education
and
advocacy,
with
over
1200
pas
working
in
every
facet
of
the
state's
health
care
industry.
We
are
committed
to
delivering
high
quality
health
care
to
all
nevadans
pas,
undergo
rigorous
training
at
the
graduate
level
to
include
on
average
126
credit
hours,
2,
000
plus
clinical
hours
in
multiple
medical
and
surgical
disciplines,
and
must
pass
a
national
certification
exam.
C
In
order
to
receive
a
license
to
maintain
our
license,
we
must
complete
over
40
hours
of
continuing
medical
education
every
two
years
on
top
of
staying
up
to
date
on
medical
innovations
and
best
practices
to
maintain
our
national
certification.
We
must
complete
100
hours
of
continuing
medical
education
every
two
years
and
pass
an
exam.
Every
10
years
pas
are
medical
providers
who
are
able
to
diagnose
and
treat
illness,
prescribe
medications
and
much
more.
We
believe
that
pa
should
be
leaders
of
the
medical
field
and
part
of
the
conversation
to
better
nevada's
health
care
system.
C
At
the
state
level,
we
would
like
to
have
meaningful
input
into
the
regulation
of
our
profession
and
offer
current
knowledge
of
the
pa
profession.
When
regulatory
boards
make
decisions
affecting
its
licensees
in
a
rapidly
growing
field,
we
believe
that
adding
apa
to
regulatory
bodies
is
essential
to
increasing
healthcare,
access
and
quality.
For
these
reasons,
we
are
specifically
in
support
of
sections
23,
24,
148
and
149
of
this
piece
of
legislation,
as
it
provides
pa
representation
in
the
licensing
and
oversight
of
our
profession.
C
B
M
M
This
bill
is
in
part
to
address
the
goals
of
the
southern
nevada
forum,
one
of
which
was
the
retention
and
ease
of
licensing
for
medical
caregivers
throughout
the
state.
Over
the
past
year,
we've
seen
the
need
for
an
increase
in
the
number
of
licensed
and
professional
care,
medical
caregivers
within
the
state
and
within
our
medical
markets.
We
believe
that
this
bill
will
do
a
lot
towards
the
ease
of
licensing
and
encouraging
the
retention
of
qualified
medical
professionals
throughout
the
state
of
nevada.
I'd
like
to
thank
you
and
urge
your
support
for
this
legislation.
B
B
N
Hi,
my
name
is
justin
mcitrado
for
the
record
last
name
m-I-c-a-t-r-o-t-t-o
in
support
of
335
minus
the
amendment
this
morning
that
excluded
the
barber
board.
My
name
is
justin
micatrado
and
I'm
the
franchise
partner
of
floyd's
99
cuts
and
colors.
We
opened
our
first
location
on
june
1st
in
the
midst
of
the
pandemic
and
demonstrations,
because
the
state
allowed
us
and,
more
importantly,
I
had
good
people
ready
to
work.
What
we
were
unable
to
do
was
open
under
the
same
name
as
our
franchise
partner,
floyd's
99
barbershop.
N
This
was
due
specifically
to
the
barriers
to
entry
placed
by
the
barber
board,
specifically
prohibiting
barbers
and
cosmetologists
from
working
side
by
side.
For
too
long,
the
state
aspiring
the
state
aspiring,
cosmetologists
and
barbers
are
held
to
the
difficulties
laid
in
place
by
the
barber
board
and
their
antiquated
practices
don't
deal
with
safety
and
sanitation,
namely
a
wall
and
separate
business
licenses.
This
is
not
a
change
of
what
makes
a
barbara
barber,
but
rather
to
be
like
48
other
states
in
this
country,
allowing
the
practice
of
barbering
and
cosmetology
side
by
side.
N
I
repeat:
48
other
states,
including
our
neighbors,
as
it
was
pointed
out
in
all
directions,
many
of
which
we
know
are
moving
to
nevada
and
droves.
The
simple
existence
of
a
separate
barber
board
makes
this
dynamic
impossible
from
the
perspective
of
floyds.
If
this
bill
isn't
passed,
we
will
likely
not
be
able
to
provide
a
place
for
five
to
ten
barbers
per
shops
and
the
shops
we
do
open.
I
have
plans
and
leases
and
hands
for
15
to
20.
N
Current
shops
developers
are
starved
for
new
tenants
and
if
the
choice
is
to
build
a
wall,
obtain
a
separate
license
and
adhere
to
the
scheduling
restrictions
placed
by
this
board
simply
to
justify
their
existence.
The
choice
is
easy.
I'll
continue
to
be
a
salon
operator
with
the
cosmetology
board
overseeing
us
and
150
to
200.
Barbers
will
have
to
find
another
place
to
work.
That's
about
15
percent
of
the
current
license
holders
in
our
state
and
my
previous
profession
profession
as
a
franchise
operator
of
raising
cain's
chicken
fingers.
N
N
This
needs
lebaton
nevada
with
two
choices,
and
I
won't
go
into
those
as
they
were
stated
simply
this.
This
bill
does
provide
that
option,
but,
more
importantly,
we
would
be
like
48
other
states
that
have
chosen
to
do
so.
We
don't
have
to
figure
this
out,
as
it
was
pointed
out
by
mr
brown.
There
is
a
great
example
to
our
north
I've
learned
in
the
past
year.
There
is
opposition
to
this
evolution
in
the
barber
community
and
as
someone
who
provides
jobs,
I
simply
don't
understand
why
this
narrative
exists.
N
The
ability
to
practice
both
of
these
licensed
professions
side
by
side
is
prohibiting
job
growth.
We
are
one
example
of
that,
since
I've
taken
up
enough
time,
I
only
want
to
share.
I
have
spoken
to
salon
owners
and
barbering
brands
in
other
states
that
are
that
are
avoiding
nevada,
specifically
because
of
the
existence
of
our
barb
report.
There
seems
to
be
a
culture
of
competition
that
isn't
welcome
in
the
barbering
community.
Perhaps
this
is
driven
by
the
myopic
narrative.
That
working
side
by
side
is
a
bad
thing,
rather
than
seeing
additional
venues.
B
B
B
B
J
My
name
is
dr
richard
a
dragon.
I
am
a
practicing
dentist
dragon
as
it
sounds
d.r.a,
I'm
a
practicing
dentist
in
douglas
county.
I
practice
here
since
1985..
J
I
am
the
immediate
past,
president
of
the
nevada,
dental
association,
I'm
co-chair
for
council
and
government
affairs
for
the
nevada,
dental
association,
and
I
am
a
previous
disciplinary
screen
officer
for
the
state
board
of
dental
examiners
2017-2018.
J
I
am
in
support
of
sp
335
with
amendment
which
we've
already
spoke
to
the
sponsor
too
he's
willing
to
agree.
He's
agreed
to
talk
to
us
about
such
an
amendment
and
with
the
current
state
of
our
existing
board,
the
previous
board,
the
overreaching,
the
inability
to
get
regulations
written
and
the
having
lack
of
understanding
or
the
regulatory
process
as
it
pertains
to
statute
has
become
a
major
issue
as
well
as
not
understanding
what
it
means
to
stay
in
their
lane.
J
A
Broadcast,
I
forgot
to
say
something
so
trying
to
follow
senator
spearman's
rules.
She
wanted
15
minutes
for
each
side
and
we
are
at.
We
have
time
for
one
more
caller
for
support,
and
then
I
need
to
move
to
opposition.
B
B
A
Okay,
thank
you
for
that.
So
members
who
are
public
who's,
calling
in
for
opposition,
I'm
going
to
limit
you
to
two
minutes:
we're
going
to
do
a
total
of
15
minutes
for
the
opposition.
So
we
have
time
for
neutral
and
time
to
get
to
our
second
bill
and
floor.
A
So
I
want
you
to
be
mindful
of
that.
Mr
milan,
milan
grow
will
cut
you
off
at
two
minutes
all
right.
Thank
you.
B
B
O
My
name
is
nancy
jones,
n-a-n-c-y
j-o-n-e-s,
and
I
am
in
opposition
to
this
bill.
It
sounds
like
there
are
dentists
and
pas
and
barbers
for
whom
it
would
serve
to
have
this
happen.
But
I
choose
to
use
homeopathic
physicians
and
oriental
medicine.
Practitioners,
and
I
have
spoken
with
them
and
from
my
own
family's
experience,
it
would
not
serve
us
or
those
industries
to
be
put
into
a
centralized
board.
I
also
am
opposed
to
this
from
the
stance
of
further
centralizing
bureaucracy.
B
J
J
B
L
Good
morning
this
is
janine
hanson
j,
a
n,
I
n
e
h,
a
n
s
e
n,
I'm
the
state
president
of
nevada
families
for
freedom.
Good
morning
we
like
the
object
of
sb
335,
to
reduce
and
consolidate
government
boards
and
improve
standards,
but
we
have
a
real
concern
that
if
the
homeopathy
board
is
placed
under
the
new
board,
it
will
soon
disappear,
like
the
naturopathic
board
did
previously.
L
This
is
because
there
is
a
natural
antagonism
between
allopathic
or
modern
medicine
and
other
more
traditional
forms
of
medicine
like
homeopathy,
the
governor
was
charged
with
appointing
boards
board
members
to
the
homeopathy
board.
However,
for
unknown
reasons,
he
has
refused
to
do
so.
He
has
received
a
dozen
applications
for
the
board.
Medical
choice
is
a
critical
freedom
and
we
need
you
to
protect
our
medical
choices
by
protecting
the
homeopathic
board.
Homeopathic
medicine
has
been
has
been
significant
in
maintaining
my
personal
and
my
family's
health.
L
B
E
Good
morning
my
name
is
bob
russo
and
I'm
just
going
to
keep
this
simple.
I
do
have
some
concerns
about
this
bill
that
will
undermine
the
homeopathic
industry
and
potentially
reduce
the
quality
of
service
that
people
get
like
janine,
I'm
also
a
recipient
of
homeopathic
and
integrative
medicinal
services.
E
B
P
P
P
Health
care
licensing
boards
are
subject
to
regulations
under
section
15.
Regarding
the
creation,
retention
and
public
disclosure
of
records.
Laws
about
these
topics
already
exist
in
nrs
239
public
records
and
nrs241
open
meeting
laws.
It
is
unclear
why
these
are
not
sufficient
and
further
clarification
is
needed
for
healthcare.
B
J
J
My
testimony
is
directed
to
sections
12
and
13
of
sb
335,
section
12
allows
the
newly
created
division
of
occupational
licensing
to
review
the
activities
of
any
title
54
board
by
inspecting
and
reviewing
records
reports
and
documents.
As
requested
and
section
13
allows
the
division
to
develop
recommendations
to
the
legislature
regarding
the
abolishment
of
any
title,
54
board
and
measures
to
improve
and
standardize
the
procedures
for
issuing
licenses.
J
My
concern
is
regarding
the
overlap
between
these
sections
and
the
responsibility
and
work
of
the
sunset
subcommittee
of
the
legislative
commission.
The
cosmetology
board
has
been
reviewed
by
the
subcommittee
twice
since
this
group
was
formed
and
in
both
instances
the
recommendation
was
of
the
board
continue
its
operation.
J
Our
board
has
also
been
subject
to
audits
by
the
executive
branch.
Audit
committee
has
have
other
boards.
The
oversight
of
our
operations
has
been
extensive
and
thorough,
and
we
do
not
understand
why
another
level
is
necessary
and
it
is
for
this
reason
that
we
oppose
that
senate
bill
to
be
35..
Thank
you.
B
L
Good
morning
my
name
is
dr
lisa
grant.
I
am
the
secretary
treasurer
of
the
nevada
board
of
oriental
medicine
and
I
have
been
a
licensed
practitioner
in
nevada
since
2009..
The
1973
regulation
that
established
oriental
medicine
as
a
regulated
profession
recognized
that
oriental
medicine
doctors
were
on
par
with
allopathic
doctors.
It
wanted
to
ensure
that
oriental
medicine
was
recognized
as
a
legal,
legitimate
and
effective
medical
profession
with
unique
modalities
and
treatments.
Abolishing
the
board
and
subsuming
alternative
medicine
to
allopathic
medicine
runs
the
risk
of
diluting
the
independent,
legitimate
effectiveness
of
this
profession.
L
Traditional
chinese
medicine,
utilizes,
unique
methods
of
diagnosis
and
treatments
based
on
acupuncture
and
herbs
are
different
from
western
medicine.
Understanding
the
legal
language
and
concepts
of
oriental
medicine
is
critical
to
ensuring
that
the
uniqueness
of
the
practice
translates
into
effective
regulation.
We
are
quickly
growing
as
a
profession
in
nevada.
As
a
result
of
the
efforts
of
the
current
board
to
align
to
national
standards
and
licensure
transparency.
L
The
legislation
we
introduced
in
the
last
session
aligned
all
of
our
licensing
processes
with
national
certification
and
educational
standards.
We
want
more
people
to
use
oriental
medicine
and
we
need
more
qualified
practitioners
and
we
are
working
hard
to
make
this
happen.
We
are
literally
in
the
final
stages
of
contracting
for
an
online
licensing
system
to
modernize
and
standardize
the
licensing
process
even
further.
L
We
oppose
this
bill
because
eliminating
the
board
will
eliminate
the
deep
level
of
expertise
necessary
to
ensure
that
public
safety
and
effective
regulation
on
a
governmental
level
are
created
by
eliminating
the
board
and
subsuming
all
of
the
functions
of
the
board,
to
independent
or
to
a
government
committee
that
doesn't
necessarily
understand
the
specifics
of
the
medication
really
does
run
the
risk
of
decreasing
public
safety
and
the
effective
regulation.
Thank
you
very
much.
B
A
Broadcast
we
have
six
minutes
left
in
opposition,
given
15
15
for
each
side,
and
so,
if
there
are
folks
calling
in-
and
you
know
that
someone
has
already
said
your
comments,
ditto
is
fine.
If
you
could
keep
it
shorter
to
allow
more
time
for
the
folks
behind
you,
I
think
we
roughly
have
eight
people
in
opposition.
A
B
E
E
Furthermore,
the
athletic
training
board
is
financially
self-sufficient,
with
appropriate
administrative
support,
as
the
athletic
training
board
has
a
co-working
arrangement
with
other
boards.
Our
executive
secretary
is
also
part
of
the
administrative
collaboration
to
take
advantage
of
more
experienced
executive
directors
for
best
practices.
Furthermore,
the
board
of
athletic
training
is
using
expedited
processes
for
licensing.
E
Also,
the
board
of
applied
training
recently
progressed
through
the
subset
subcommittee
with
a
positive
review.
So
to
summarize,
we
are
concerned
that
our
board
has
been
unjustly
and
unfairly.
I
guess
put
into
this
situation
to
be
abolished
and
really
don't
understand
what
the
metrics
were,
that
you
know
put
us
in
that
in
this
bucket.
Thank
you.
B
P
C-H-E-L-S-E-A-C-A-P-U-R-R-O
here,
on
behalf
of
the
nevada
state
board
of
oriental
medicine,
we're
here
today
in
opposition
to
this
bill
prior
to
the
release,
we
weren't
included
in
any
conversations
about
what
a
consolidation
or
elimination
of
our
board
might
look
like
not
only
for
our
licensees
but,
most
importantly,
what
this
would
look
like
for
the
safety
of
the
public.
While
we
understand
the
intent
of
this
bill,
we
cannot
support
something
that
has
not
taken
all
the
stakeholders
that
are
affecting
into
account.
P
I'll.
Be
brief,
because
a
lot
of
points
have
already
been
made,
but
I
will
just
say:
the
board
of
oriental
medicine
has
come
a
long
way
in
ensuring
public
safety
and
improving
standards
for
our
profession
as
well
as,
and
we
continue
to
update
the
statutes
and
regulations
to
ensure
that
professional
standards
are
maintained.
We
appreciate
the
purpose
of
this,
but
want
to
make
sure
that
we
are
taking
a
complete
look
at
this
and
part
of
the
solution.
P
A
Two
minutes
left,
so
we
have
time
for
one
one
or
two
callers
as
long
as
it's
going
to
be,
I'm
in
opposition.
B
P
My
name
is:
merle
walk,
m-e-r-l-e
l-o-k
and
I'm
the
executive
director
for
the
board
of
oriental
medicine.
I've
held
this
position
for
approximately
the
last
five
years
since
that
time,
I've
seen
our
licensees
grow
from
56
to
a
high
of
87,
while
maintaining
our
high
educational
standards
with
national
board
certification.
P
We
expect
to
welcome
three
more
new
licensees
after
the
state
exam
at
our
next
april
board
meeting
since
I've
been
the
executive
director,
I've
had
to
rely
on
the
expertise
of
our
board
members,
which
consist
of
four
licensees,
a
member
from
the
wangu
university
of
oriental
medicine,
which
is
nevada's
only
oriental
medical
school,
as
well
as
a
public
member.
They
constantly
review
and
update
our
statutes
and
regulations
to
make
sure
contemporary
issues
involving
oriental
medicine.
Oriental
medicine,
education
and
public
safety
are
being
addressed.
P
We
oppose
this
bill
because
this
expertise
and
deep
understanding
of
our
life
and
seats
and
the
practice
is
vital
to
make
sure
that
the
public
stays
safe.
It
does
not
make
sense
to
combine
these
boards,
while
some
may
think
that
oriental
medicine
doctors
are
a
small
group
of
licensees
and
it
may
be
more
efficient
if
we
were
part
of
a
generalized
occupational
licensing
division.
We
strongly
disagree.
The
board
of
oriental
medicine
needs
to
appear
independent
with
the
ability
to
meet
the
special
ongoing
challenges
that
appear
issues.
P
A
Thank
you,
and
so
that
was
that
has
to
be
our
last
caller
for
opposition.
I
understand
and
appreciate
everyone's
passion.
Occupational
licensing
forwards,
always
brings
out
some
level
of
passion,
and
I
would
suggest
that
you
send
in
your
written
testimony
to
the
committee
and
also
reach
out
to
the
sponsor
of
the
bill,
to
work
out.
If
he's
willing
any
additional
comments
or
amendments,
so
I
will
move
to
neutral
or
sb
335.
B
B
P
Good
morning,
vice
chair
neil
and
members
of
the
committee,
I'm
alex
conita
with
the
law
firm,
louis
rocha,
on
behalf
of
the
nevada
dental
board.
We
want
to
thank
senator
hardy
for
meeting
with
us
and
for
this
debate,
while
the
board
of
dental
examiners
has
not
yet
taken
an
official
position
on
this
bill,
we
do
have
general
concerns
about
such
a
concept.
We
understand
that
this
bill
is
an
attempt
to
find
better
methods
in
which
to
operate:
occupational
boards
and
commissions.
P
However,
most
states
don't
include
medical
and
health-related
boards
and
hybrid
models,
as
contemplated
by
this
bill.
The
expertise
our
doctors,
dentists
and
other
members
have
in
those
fields
cannot
be
replaced
by
the
layperson.
A
study
comparing
the
different
models
in
various
states
should
be
a
top
priority
to
determine
what
works
and
what
does
not.
I
certainly
don't
have
the
expertise
to
decide
whether
or
not
other
boards
should
be
included
or
excluded.
However,
for
public
safety
reasons,
it
may
be
prudent
for
this
committee
to
remove
the
dental
board
and
other
medical
and
health
related
boards.
B
B
E
E
I
want
to
thank
dr
hardy
senator
hardy
for
our
discussion
last
evening
and
while
we
absolutely
believe
that
his
intent
is
laudable
and
certainly
where
all
boards
should
be
leaning
towards,
we
are
one
of
those
boards
that,
for
the
last
actual
three
sessions,
have
bought
bills
to
this
legislature,
including
this
session,
to
try
to
lessen
the
barriers
for
our
chiropractors
to
make
it
easier
for
fun
for
folks
to
come
to
nevada
and
who
are
skilled
and
excellent
in
their
craft
to
practice
in
nevada,
and
we
have
certainly
worked
hand-in-hand
with
the
sunset
subcommittee
to
make
sure
that
we
are
a
responsive
and
fiscally
responsible
board.
E
Our
biggest
concern
is
that
moving
this
under
the
division
of
business
and
industry.
While
we
are
absolutely
you
know,
mr
reynolds
and
mr
brown
and
all
their
great
staff
are
excellent
at
what
they
do.
They
certainly
have
no
ability
or
no
expertise
in
state
healthcare
oversight.
I
mean
their
mission
is
the
promotion
of
business
and
industry,
which
we
are
concerned
might
actually
cause
a
lessening
of
consumer
protection
for
nevada's
patients,
those
that
seek
proper
health
care,
whether
it's
chiropractors
or
many
other
boards.
While
we
are
not
under
this
bill.
E
Currently
section
12
is
very
concerning
to
us
in
that
there
is
no
standard,
no
criteria
against
which
our
performance
will
be
judged
by
the
administrator
before
he
or
she
abolishes
our
border
any
other
board,
and
it
is
for
those
reasons
and
many
others.
I
will
try
to
be
quick
that
we
are
neutral
with
concerns,
and
we
thank
the
committee
for
the
opportunity
to
testify
thanks.
B
M
Good
morning,
vice
chair
neil
and
members
of
the
senate
committee
on
commerce
and
labor
for
the
record,
my
name
is
elliot:
mallon,
first
name
e-l-l-I-o-t
last
name
malin
m-a-l-I-n,
representing
the
nevada
board
of
homeopathic
medical
examiners.
Thank
you
for
the
opportunity
to
speak
with
you
today.
We
are
neutral
on
sb
335
and
has
communicated
with
senator
hardy
that
we
stand
ready
to
work
with
him
to
make
this
bill
work.
M
We
believe
these
are
reasonable
to
help
protect
nevadans,
while
forging
ahead
in
a
new
direction
that
will
create
a
more
efficient
and
effective
regulatory
body.
We
look
forward
to
continuing
to
work
with
the
sponsor
and
continue
our
conversations
on
this
bill.
I
stand
ready
to
answer
any
questions
and
I
thank
you
for
your
time
today.
B
B
O
Good
morning,
madam
vice
chair,
this
is
susan
fisher,
s-u-s-a-n
f-I-s-h-e-r,
with
mcdonald
carano,
testifying
this
morning
on
behalf
of
the
nevada
state
board
of
osteopathic
medicine.
We
are
neutral
with
concerns.
The
sections
of
the
bill
that
impact
us
are
sections
147,
148
and
150.
148
adds
a
new
board
member.
It
would
take
us
from
seven
to
eight
board
members
and,
it
would
add
a
physician
assistant.
O
O
We
have
invited
pas
to
sit
as
advisory
members
on
our
board
in
the
past
and
they
have
declined
to
do
so.
Fb
150
takes
five
percent
of
our
fees
to
help
fund
the
new
administration,
and
I
just
wonder
madam
vice
chair,
if
lcb
has
opined
on
whether
the
conversion
of
licensing
fees
to
the
general
fund
revenues
constitutes
a
new
tax
that
would
trigger
a
two-thirds
voting
requirement
as
written
our
licensees
are
losing
five
percent
of
their
dedicated
fees
for
the
use
of
other
professions
to
fund
a
new
general
fund
bureaucracy.
B
P
P
P
However,
as
written,
the
division
will
not
have
the
needed
authority
to
do
the
same
for
unlicensed
activity
as
the
statutes
of
640b
do
not
allow
the
nsbat
to
issue
citations
or
impose
fines
and
penalties.
I
wanted
to
make
the
new
division
aware
of
the
biggest
obstacle
that
the
board
contends
with,
which
is
unlicensed
activity.
This
issue
has,
unfortunately
escalated
in
response
to
the
covet
pandemic.
P
Institutions
that
have
athletic
trainers
on
their
staff
are
hiring
other
licensed
professionals
to
fill
the
position
of
a
licensed
athletic
trainer
to
the
potential
detriment
of
the
public,
which
in
some
instances
includes
athletes
that
are
minors.
For
instance,
a
physical
therapist
cannot
fill
the
position
of
an
athletic
trainer
or
vice
versa.
The
training
and
education
is
similar.
However,
their
practice
acts
are
different.
Neither
can
an
occupational
therapist,
a
nurse,
a
physician's
assistant,
a
massage
therapist,
a
chiropractor
or
other
such
licensed.
P
Medical
professional
as
written
nrs640b,
does
not
allow
the
nsbit
to
penalize
an
unlicensed
individual
that
is
practicing
or
holding
themselves
out
as
an
athletic
trainer
as
written,
the
new
division
will
be
powerless
to
stop
or
discourage
unlicensed
activity
as
well.
This
continues
to
be
a
problem
and
considering
that
athletic
programs
are
suffering
as
a
result
of
the
pandemic,
it
is
my
professional
opinion
that
unlicensed
activity
will
persist,
especially
as
professionals.
A
Alrighty,
thank
you
for
that.
So,
mr
keane,
he
would
he
I'm
going
to
have
him
comment
on
the
two-thirds
and
the
fee.
Mr
keane.
K
Thank
you
vice
chair
neal,
for
the
record
will
king
community
council,
the
two-thirds
issue
is
one
that
was
specifically
looked
at
by
lcb
legal
and,
if
there's
no
two-thirds
vote
required
here,
because
the
money
coming
into
the
government
is
the
same.
For
example,
if
the
boards
are
considered
to
be
the
same
as
the
executive
branch
for
purposes
of
two-thirds
calculation
and
the
money
coming
in
is
exactly
the
same
as
just
being
diverted
for
to
a
slightly
different
place.
Thank
you.
A
Thank
you
for
that.
Senator.
H
Yes,
madam
chair,
thank
you.
I
just
wanted
to
confirm
with
mr
reynolds
that
we're
when
we're
talking
about
it
seems
that
a
lot
of
the
opposition
had
to
do
with
abolishing
the
board
and
so
we're
going
to
lose
the
expertise.
H
As
I
read
section
nine,
it
allows
the
n8
for
that
matter,
but
section
nine
allows
the
administrator
to
maintain
experts
so
that
we
don't
lose
that
expertise
within
the
oversight
and
application
or
administration
of
these
boards.
Do
I
have
that
correctly
that
we're
not
losing
any
expertise,
we're
just
trying
to
homogenize
the
process
and
and
streamline
the
administration
of
these
boards.
F
So
yes,
this
is
not
something
that
is
going
to
happen
all
at
once
as
much
as
a
process,
and
I
guess
I'll
wait
for
closing
comments
when
the
vice
chair
allows
me.
F
Thank
you,
minimize
chair.
So
again
it's
no
increase
in
a
fee,
section
13..
It
goes
back
to
the
legislature
before
anything
is
done.
This
is
a
process.
I
called
up
utah
for
instance,
and
asked
them
about
how
they
did
it,
I'm
licensed
in
utah
and
arizona.
So
I'm
familiar
with
more
than
just
art
boards
and
they
said
well,
you
know
michael
brown.
F
Experts
will
still
be
involved
as
soon
as
this
happens.
As
soon
as
the
bill
happens,
it
opens
it
up
for
regulations,
but
all
of
the
present
members
of
every
board
goes
immediately
into
the
advisory
board.
So
the
advisory
board
is
in
a
position
then,
to
help
in
the
regulations
that
are
involved,
so
the
people
who
are
the
boards
that
are
involved
this
time
it
wasn't
meant
to
be
a
punishment.
F
This
is
an
opportunity,
as
I
look
at
it,
to
figure
out
how
we
can
do
better
with
our
boards,
and
so
we
have
a
big
board,
a
little
board
and
an
in-between
board,
and
this
will
be
an
opportunity
to
see
how
well
it
works.
I
suspect
it'll
work
well
and
we,
our
fears,
will
be
laid
when
we
see
it
how
it's
working.
A
A
G
Thank
you
so
much
vice
chair
and
committee
members
for
the
record,
I'm
roberta
lang
representing
senate
district
7
in
clark
county,
I'm
pleased
to
present
senate
bill
290,
which
seeks
to
allow
persons
diagnosed
with
stage
3
or
4
cancer
to
be
granted
an
exception
to
step
therapy
protocols.
G
J
G
Incidence
of
cancer
in
nevada
is
exacerbated
by
the
lifestyles
of
the
state's
population.
According
to
the
american
cancer
society,
approximately
sixteen
thousand
nine
hundred
and
seventy
thousand
nine
hundred
seventy
new
cancer
cases
will
be
diagnosed
in
nevada.
In
this
year
alone,
approximately
5
410
cancer
deaths
will
occur
in
the
state
in
the
year
2021
and
the
average
annual
adjusted
mortality
rate
for
cancer
deaths
per
100
000
persons
in
nevada
is
157
compared
to
the
national
rate
of
155.5,
from
2012
to
2016.
G
G
G
Let's
take
a
moment
to
talk
about
people
in
our
military.
Instant
rates
of
breast
cancer
and
prostate
cancer
are
significantly
higher
across
race
and
gender
and
breast
cancer
is
20
to
40
percent
higher
for
those
in
our
military
individuals
who
have
cancer
face
tremendous
financial
burdens
to
treat
the
disease.
G
G
In
fact,
the
united
health
foundation
reports
15
percent
of
our
state's
population,
avoid
seeking
care
due
to
the
cost
health
insurers
provide
coverage
for
health
related
services,
including
prescription
drugs,
that
patients
must
also
follow
certain
utilized
management
processes
before
coverage
or
service
begins.
These
practices
are
commonly
known
as
step
therapy
or
first
fail.
First
protocol
season,
generally
health
insurance
use
the
step
therapy
to
lower
costs,
while
healthcare
practitioners
tend
to
prescribe
the
most
effective
treatment
for
their
patients,
but
may
not
place
a
priority
on
prescribing
low-cost
treatments.
G
During
the
interim,
the
legislative
committee
to
conduct
the
legislative
committee
to
conduct
an
interim
study
concerning
the
cost
of
prescription
drugs
received
written
testimony
from
various
stakeholders,
demonstrating
that
step
therapy
causes
barriers
to
patients,
access
to
care
and
advocated
for
changes
to
the
current
policies.
Too.
Many
of
our
state's
residents
will
unfortunately
face
a
cancer
diagnosis
and
advocates
request
the
legislature
remove
any
unnecessary
barriers
for
the
cancer
drugs
they
need
on.
G
Vice
chair,
neil
I'll,
provide
the
committee
with
an
overview
of
the
substantive
bill
provisions
senate
bill
290
requires
health
insurers
to
grant
an
exemption
of
except
therapy
protocol
upon
receipt
of
an
application
from
an
insured
or
attending
practitioner
of
an
insured
who
has
been
diagnosed
with
stage
3
or
stage
4
cancer.
That
includes
supporting
clinical,
rational
and
documentation.
G
If
a
treatment
under
the
step
therapy
has
not
been
effective
at
treating
the
cancer
or
the
symptoms
of
the
insured,
a
delay
of
effective,
effective
treatment
would
have
severe
or
irreversible
consequences
for
the
insured,
and
the
treatment
under
the
step
therapy
is
not
reasonably
expected
to
be
effective.
A
treatment
under
the
step
therapy
is
contradicted
or
based.
Peer-Reviewed
clinical
evidence
will
likely
cause
an
adverse
reaction
or
other
physical
harm
to
the
insured
or
prevents
the
insured
from
performing
his
or
her
occupational
or
daily
activities.
G
The
insured
is
stable
under
treatment
of
the
prescription
drug
for
which
the
exemption
is
requested,
and
the
insured
has
previously
received
approval
for
coverage
of
that
drug
or
any
other
condition
for
exemption
is
met,
as
prescribed
in
regulations
adopted
by
the
insurance.
Commissioner,
health
insurers
must
respond
to
a
step
therapy
exemption
request
within
72
hours
of
the
request.
G
A
health
insurer
is
required
to
respond
within
24
hours
of
a
request.
If
the
attending
practitioner
determines
that
the
step
therapy
process
may
seriously
jeopardize
the
life
of
the
health
of
an
insured
health,
insurers
may
request
supporting
documentation
the
insurance
medical
records,
demonstrating
that
the
insurer
has
tried
other
drugs
included
in
the
step
therapy
protocol
without
success
or
demonstrates
the
insured
have
taken
the
request
for
the
drug
for
a
clinically
appropriate
amount
of
time
to
establish
stability
in
relation
to
the
cancer
health.
G
Insurers
are
required
to
provide
coverage
for
requested
prescription
drugs
in
accordance
with
the
terms
of
the
applicable
health
insurance
policy.
The
insurer
may
limit
limit
the
coverage
to
one
week
supply,
but
must
cover
the
drug
for
as
long
as
necessary
to
treat
the
insurer
if
the
attending
practitioner
determines
after
one
week
that
the
drug
is
effective.
G
Health
insurers
are
also
required
to
post
on
the
internet
website
the
procedures
and
prescribed
forms
that
apply
for
exemption
from
the
step
therapy
protocol,
and
I
might
add
that
we
have
accepted
an
amendment
on
this,
that
we
would
just
use
the
forms
that
they
already
have
on
their
website
to
have
a
drop
down
menu
and
that
the
form
would
be
accessible
to
patients
and
finally,
a
health
insurance
policy
issued
or
renewed
after
october.
G
G
It's
taken
me
a
lot
of
research
and
talking
to
people
to
understand
this,
so
I
hope
you'll
bear
with
me,
I'm
happy
to
expound
on
any
part
of
the
bill.
This
is
important
legislation.
It
will
support
many
medical
professions
and
I
urge
your
support
and
I'm
happy
to
answer
any
questions.
Okay,
thank.
A
It's
page
seven
and
it's
section
three
step
seven.
This
is
where,
if
the
insurer
approves
the
application
for
an
exemption
from
step
therapy,
then
the
insurer
must
cover
the
prescription
drug
okay.
So
I
wanted
to
get
an
understanding
on
like
the
cost
there
of
the
drug
and
what
the
insurers
had
to
say
about
that
particular
provision.
I
understand
what
you're
doing
I
just
wanted
to
know
like
the
real
life
application
of
that
one.
That's.
G
Yeah
I
appreciate
that
a
mountain
vice
chair,
so
we
before
we
even
wrote
the
bill.
G
We
met
with
all
the
stakeholders
and
we
have
sent
them
the
language
after
the
bill
was
printed
for
input,
and
this
section
actually
came
out
of
conversations
we
had
with
the
insurance
companies
and
see
the
situation
is-
and
I
don't
know
if
you
know
but
cancer
drugs
when
you
get
to
step
three
and
step
four
they're,
a
thousand
dollars
a
pill,
and
so
it's
thirty
thousand
dollars
a
month
for
those
medications,
and
so
sometimes
patients
take
the
medication
and
it
has
adverse
effect
for
them
and
instead
of
wasting
three
weeks
worth
of
medicine,
that's
worth
a
lot
of
money.
G
We
thought,
after
talking
to
the
insurance
companies,
it
would
be
better
to
prescribe
for
when
we
have
the
doctor
confirm
that
this
works
for
the
patient.
It's
doing
what
we
want
it
to
do
and
then
they
could
get
the
rest
of
the
prescription.
A
Okay
and
then,
if
the,
if
the-
and
I
know
you
have
the
process
at
the
beginning
of
section
three-
about
the
review
of
the
application,
if,
if
the
insurer
fails
to
approve
the
application-
and
maybe
I
missed
it,
does
the
patient
is
there,
an
appeal
is:
what's
what's
their
recourse
upon
denial.
G
I
think
in
most
insurance
policies
they
have
an
appeal
process
already.
So
that's
not
something
we
dealt
with
specifically
in
this
in
this
bill.
If,
if
the
committee
thinks
that
something,
we
should
add,
I'm
happy
to
do
that.
Yeah,
because.
A
I
was
just
wondering
because
you
know
sometimes
you're
already
sick
right,
there's,
probably
a
family
member,
that's
involved
and
then
the
process
of
going
back
through
the
insurance
and
battling
the
denial
exactly.
A
You
know
it's
harder
right
because,
and
so
I'm
just
wondering
if
you
were
thinking
about
trying
to
create
a
pathway
for
them
if
there
is
to
maybe
simplify
it
and
and
allow
them
a
quicker
response,
because
when
I,
when
I
saw
that
provision
immediately,
I
thought
about
like
if
this
was
medicare
and
man.
A
A
Okay
thanks
a
question:
senator
pickard.
H
Thank
you,
madam
vice
chair.
I'm
just
gonna
wait
and
see
if
this
came
up
in
opposition,
but
since
you
mentioned
senator
lang
that
you
had
spoken
to
the
stakeholders,
I
brought
a
bill
a
different
topic.
It
was
on
chronic
medications
but
similar
in
that
it
required
insurance
companies
and
providers
of
plans,
and
I
ran
into
some
opposition
because
they
said
you
know
the
pbm
community
was
opposed
to
it.
H
Pebb
was
opposed
to
it
because
they
kind
of
lose
control
and
it
adjusts
their
formularies
or
affects
their
formularies,
and-
and
I
was
surprised
at
how
quickly
the
opposition
mounted
have
they
expressed
to
you
similar
concerns
that
this
is
going
to
completely
blow
them
out
of
the
water,
make
them
ineffective.
The
kinds
of
things
that
I
heard
last
time
or
or
have
they
conceded
that
this
is
a
good
idea.
G
Well,
I
I
appreciate
that
that
question.
I
think
that
senator
parks
had
this
bill
and
before
he
when
he
was
in
office
and
had
some
trouble
with
it
as
well.
G
I
decided
that
early
on,
I
would
meet
with
all
the
stakeholders
and
before
I
crafted
the
bill,
I
would
listen
to
what
they
had
to
say
and
I
think
that
when
we
had
a
bill
just
for
step
therapy-
and
I
think
that
there
there
were
lots
of
concerns,
but
when
we
put
in
the
exceptions-
and
we
put
in
the
controls
around
the
exceptions,
it
was
more
palatable
for
the
stakeholders,
and
so
I
would
say
to
you,
I'm
not
familiar
with
your
bill,
but
I
would
just
say
that
we,
by
putting
in
some
of
the
controls,
I
think
it
eased
some
of
the
concern
that
stakeholders
had.
H
All
right-
that's
great
and-
and
I
had
several
conversations
with
senator
parks
on
his
bill
because
they
were
running
at
the
same
time,
mine
and
his
and
and
we
tried
to,
but
it
was
interesting
to
see
how
the
opposition
you
know
mounted
against
both
bills.
Frankly,
I
just
it's
it's
interesting
as
we
look
at
trying
to
make
medications
available
to
the
people
who
need
it,
and
particularly
in
this
instance,
where
we're
talking
about
people
that
are
looking
at
potentially
terminal
illness.
H
You
know
accelerating
to
the
more
potentially
effective.
Drugs
only
makes
sense,
and
it's
a
financial
decision
not
to
or
a
power
decision,
and
so
I
support
the
bill.
I'm
just
going
to
be
interested
to
see
what
they
have
to
say
and
I'm
glad
to
know
that
you
were
proactive
as
we
tried
to
be,
and
hopefully
we'll
be
able
to
get
this
through
this
time.
Thank
you.
G
Thanks
and
I
just
might
add
a
little
bit
more
senator
crickard-
I
think
that
you
know
a
lot
of
bills.
There
are
lots
of
things,
step
lots
of
illnesses,
that
step
therapies,
are
used
to
cure
those
illnesses
or
make
people
get
to
a
better
place
in
their
life.
In
this
bill,
I
decided
to
pair
that
back.
G
I
felt
like
it
was
too
much
to
go
after
everything
and
that
we
would
go
to
the
number
one
cause
of
death
or
the
number
two
cause
of
death
and
just
concentrate
on
cancer,
and
then
also
just
to
go
to
the
three
and
the
four
steps,
because
that's
when
people
are
really
sick
and
they
really
need
to
be
able
to
not
take
level
one
medicine,
they
need
to
get
right
to
level
three,
and
so
I
think
we
made
some
changes
and
made
the
circle
smaller.
B
B
P
P-A-I-G-E-B-A-R-N-E-S
with
crowley
and
verada
public
affairs-
I
am
here
today
representing
the
nevada
nurses
association.
We
are
here
in
support
of
sb290.
We
believe
that
patients
should
get
the
right
treatment
determined
by
the
provider
as
soon
as
possible.
This
bill
will
make
that
possible
for
patients
diagnosed
with
stage
3
and
stage
4
cancer,
as
senator
lang
highlighted
in
her
testimony.
This
will
especially
help
our
most
vulnerable
populations,
including
communities
of
color
and
military.
P
B
B
B
M
Hi,
my
name
is
jaren
hildebrand
good
morning,
madam
chair
and
members
of
the
committee,
my
name
is
jaren
hildebrand
and
I
am
the
executive
director
of
the
nevada
state
medical
association.
I'll
keep
my
comments
brief.
We
just
really
like
to
thank
senator
lang
for
bringing
this
bill
forward.
This
is
a
major
step,
no
pun
intended
in
the
right
direction
and
again
I
know
you've
had
a
long
hearing,
but
we
really
appreciate
all
appreciate
all
of
our
efforts
and
and
we
support
her
bill
wholeheartedly.
Thank
you.
B
A
Okay,
thank
you
for
that.
We
will
move
to
opposition.
B
B
B
J
B
A
Thank
you
for
that
senator
lang.
Any
closing
comments.
G
Thank
you.
I
would
just
post
by
saying
my
father
had
lymphoma
and
when
he
went
to
the
doctor
the
doctor,
we
knew
he
was
really
bad.
They
tried
to
get
him
the
medicines,
they
told
him.
He
wasn't
sick
enough
and
he
died
six
months
later
and
those
are
the
people
that
this
bill
will
help
the
people
that
go
to
the
doctor
and
they're
really
really
sick
and
they
need
help
and
they
need
to
jump
in
the
therapy
to
a
higher
level.
G
A
Okay,
thank
you
for
that.
So
we
will
go
ahead
and
close
the
hearing
for
sv2
before
we
go
and
open
up
for
public
comment.
A
Tomorrow
is
super
long.
I,
the
chair,
asked
me
to
bring
up.
We
have
four
bills
and
I
believe
we
have
nine
on
work
session,
so
it
will
be
a
very
long
hearing
there's
no
floor,
but
she
wanted
to
make
sure
that
everybody
was
aware,
review
the
work
session
documents
and
make
sure
that
you
are
prepared
for
tomorrow
morning
and
try
to
limit
your
questions
because
of
the
length
of
the
hearing
tomorrow,
and
so
I
will
open
up
the
lines
for
public
comment.
A
Bps
we
had
an
individual
who
was
a
part
of
opposition
on
sb
335
they're,
going
to
call
in
under
public
comment.
I
just
want
you
to
designate
them
positioned
under
sb
335,
but
the
rest
of
the
folks
calling
in
for
public
comment.
A
It
really
is
public
comment.
I
just
I
received
a
text
message
that
they
were
unable
to
get
on,
and
so
we're
just
going
to
take
that
testimony
and
then
the
rest
will
be
public
comment
on
other
items
that
are
not
related
to
the
two
bills
that
we
just
heard.
So
thank
you
for
your
time
and
attention.
Bps.
B
Absolutely
vice
chair,
if
you
logged
in
earlier
to
testify
in
opposition,
please
press
star
nine
now
to
take
your
place
in
the
queue.
B
O
Good
morning,
madam
chair
and
members
vice
chair
and
members
of
the
committee,
my
name
is
jeanette
bell:
j
e,
a
n
e
t,
t
e
b
e
l
z.
Thank
you
very
much,
madam
vice
chair,
for
allowing
me
this
opportunity
to
testify
in
opposition
to
sb
335.
O
Very
briefly,
we
are
in
concert
with
others
who
mentioned
their
opposition
to
sections
12
and
13.
O
in
regard
to
section
15
health
care
licensing
boards
are
subject
to
regulations
currently
regarding
creation
retention
and
public
disclosure
of
records.
Laws
about
these
topics
exist
in
nrs
239,
which
is
public
records
and
241,
which
is
open
meeting
law.
It
is
unclear
why
these
are
not
sufficient
and
further
clarification
is
needed
for
health
care
boards.
Only
section
190
requires
the
board
of
occupational
therapy
to
comply
with
these
new
regulations.
O
O
O
A
B
Yes
sure
I
will
make
an
announcement
to
testify
in
public
comment
or
to
speak
in
public
comment.
Please
press
star
9
now
to
take
your
place
in
the
queue.
A
Okay,
thank
you
for
that.
So
that
ends
our
business.
For
today,
the
work
session
doc
work
session
documents
will
come,
get
out
to
the
members
as
soon
as
possible,
so
that
you
are
prepared-
and
you
know
what's
in
the
amendments-
and
we
will
adjourn
senate
commerce
and.