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From YouTube: 3/26/2021 - Senate Committee on Commerce and Labor
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A
C
B
C
A
A
Before
we
begin,
let's
go
over
some
housekeeping
items.
As
you
know,
the
legislative
building
is
currently
closed
as
a
public
safety
measure
to
reduce
the
spread
and
infection
rate
of
covet
19
to
the
public,
and
so
all
committee
meetings
will
be
held
virtually
meaning
committee
members
staff
and
everyone
else
will
participate
either
through
zoom
video
conference
or
by
telephone.
A
A
A
I
will
announce
the
time
frame.
That
is
how
many
minutes
for
each
response
for
against
and
neutral.
Before
we
begin,
it
will
be
helpful
that,
if
more
than
one
person
in
an
organization
wishes
to
comment,
remember
ditto
is
a
good
response.
When
someone
has
already
covered
your
points,
this
will
allow
more
people
to
comment
during
that
time
frame
when
you're
on
the
phone
line.
Please
pay
attention
to
which
bill
is
being
considered
and
follow.
A
A
Detailed
instructions
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participating
in
committee
meetings
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the
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nellis.
If
you
need
assistance
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or
if
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notification
of
the
committee's
agenda
and
minutes,
please
contact
our
committee
staff
at
the
email
listed
on
the
agenda.
A
Any
exhibits
for
the
committee
must
be
submitted
in
electronic
format
no
later
than
8
o'clock.
The
day
before
the
meeting
to
our
committee
staff
contact
information
may
be
found
on
the
committee
page
in
nellis.
In
addition,
any
person
proposing
an
amendment
to
be
heard
by
this
commitment
must
first
talk
to
the
sponsor
and
let
them
know
that
you
intend
to
submit
an
amendment.
A
I
will
not
entertain
any
amendments
if
the
sponsor
is
not
aware
of
that
amendment,
the
proposed
amendment
must
be
submitted
in
writing
24
hours
before
the
meeting,
and
please
include
the
bill,
number,
a
statement
of
intent
and
your
contact
information.
When
testifying.
Please
remember
to
unmute
your
voice
and
speak
clearly
and
please
project
your
voice,
so
that
people
who
are
listening
over
the
internet
can
hear
you
and
understand
you
a
reminder
to
all
those
who
are
testifying
pursuant
to
devised
nevada,
revised
statutes,
218e.085.
A
It
is
unlawful
for
a
person
to
knowingly
misrepresent
facts
when
testifying
before
a
legislative
committee.
A
person
who
knowingly
does
so
is
guilty
of
a
misdemeanor.
The
chair
and
any
members
may
request
any
testifier
to
submit
documentation
supporting
their
testimony
to
committee
members.
During
these
virtual
meetings,
when
an
agenda
calls
for
a
vote,
our
committee
will
be
using
a
roll
call
to
do
so.
When
the
committee
secretary
calls
your
name,
please
answer
with
a
yes
or
no,
so
that
there
is
no
confusion.
A
A
A
Okay,
I
have
a
second
from
senator
lang,
any
discussion.
E
F
C
A
G
Thank
you,
madam
chair,
for
the
record
of
cesar
mel
garejo
committee
policy.
Analyst,
our
first
bill
for
work
session
today
is
senate
bill
75
sponsored
by
this
committee
on
behalf
of
the
department
of
employment
security,
behalf
of
the
employment
security,
division
of
the
department
of
employment,
training
and
rehabilitation
senate
bill
75
makes
various
changes
to
the
administration
of
the
nevada
unemployment
compensation
program,
including
establishing
a
new
method
for
calculating
the
overall
employer
contribution
rate
to
the
employee
employment
compensation
fund.
G
There
are
several
amendments
attached
to
this
workstation
document.
The
first
two
amendments
delete
section:
one
and
its
entirety
have
established
the
new
employer
contribution
rate.
G
Third
amendment
men's
section:
fourth:
amendment
are
very
similar,
amends
section,
six
and
seven
to
delete
not-
and
this
is
in
order
to
clarify
that
an
educational
institution
will
have
the
benefits
paid
charged
against
the
educational
institutions
record
for
experience
rating
or
be
required
to
reimburse
the
unemployment
compensation
fund,
as
applicable.
G
The
fifth
amendment
is
delete
section
14
to
retain
existing
language
and
arrest,
requiring
the
administrator
to
prescribe
annually
a
contribution
rate
schedule
that
determines
how
each
employer
will
be
classified
next
amendment,
it's
a
men's
section
15.
to
provide
that
for
the
second
and
third
quarters
of
2020.
All
contributory
employee
units
will
not
have
benefits
charged
against
their
experience
rating
records.
Next
amendment
is
the
men's
section
15
to
provide
that
for
the
second
third.
Fourth
quarters
of
2020
reimbursements
in
lieu
of
contributions
will
be
reduced
by
up
to
the
amount
allowed
by
federal
law.
G
The
next
amendment
is
to
add
a
new
section
to
the
bill
to
amend
interest
612.655,
to
remove
the
three-year
limitation
currently
applicable
to
when
an
employer
may
limit
for
a
refund
relating
to
a
repayment
of
contributions,
forfeit
or
interest,
which
has
been
erroneously
collected
by
eesd.
G
The
pros
amendments
to
enter
at
612.65
also
specified
that
for
adjustments
as
opposed
to
refunds,
the
three-year
limitation
still
applies,
and
if
the
adjustments
relates
to
contributions
and
wages
which
have
been
included
in
the
determination
of
a
knowledgeable
claim
for
benefits.
The
fault
of
mistakes
must
be
entirely
that
of
the
division.
G
Add
anoth
another
section
to
the
bill
to
amend
interest
612.705
to
clarify
that
neither
the
state
of
nevada
or
a
person
claiming
benefits
may
be
charged
fees
of
any
kind
in
any
proceeding
concerning
the
employment
unemployment,
compensation
by
the
review
administrator
or
any
court
or
officer
thereof,
and
adds
another
section
to
the
bill
to
amend
nrs
612.377
to
allow
extended
benefits
to
be
paid
without
waiting.
14
weeks
between
extended
benefit
periods,
if
authorized
by
the
united
states
department
of
labor
and
adds
another
section
to
the
bill
to
amends
nrs
612
0.230.
G
To
allow
the
the
administrator
to
fill
other
attorney
positions
in
esd
outside
of
the
regis
registers
prepared
by
division
of
human
resources
and
finally
amends
the
effective
date
of
this
bill,
so
that
the
revisions
to
nrs
612.377
are
retroactive
to
december
27
2020.
This
will
allow
for
a
reduction
or
elimination
of
the
14-week
waiting
period
between
beginning
on
december
27
2020..
C
Pickard,
thank
you,
I'm
sure
what
I
don't
see
in
the
amendments,
and
I
just
want
to
make
sure
that
I'm
not
missing.
Something
are
the
the
things
that
we
pointed
out
during
the
hearing
that
they've
not
even
addressed
things
like
the
the
systems,
their
computer
systems,
they
need
to
update,
they
need
to
combine
them.
They
need
to
communicate
between
the
two
programs.
C
I
do
see
that
we've
got
some
things
like
the
elimination
of
the
14-week
wake
between,
if
authorized
by
the
department
of
labor,
that's
a
good
move,
but
I
also
don't
see
the
the
the
the
anyway
the
changes
that
we
had
pointed
out,
the
things
that
we
needed
to
fix
the
identification.
C
G
H
H
There
are
several
items
that
were
suggested
by
the
strikeforce
as
next
steps.
I
believe
we
have
shared
with
the
committee
the
full
list
of
strikeforce
recommendations
and
an
update
on
our
progress
in
implementing
those
items
in
terms
of
the
recommendation
for
a
modernized
computer
system
and
because
there
would
be
a
fairly
large
fiscal
note
with
that.
We
are
working
with
the
governor's
office
to
identify
a
way
forward,
particularly
if
there
are
federal
dollars
to
bring
those
into
the
state
and
modernize
the
system.
H
But
we
don't
need
to
change
our
nrs
statutes
in
order
to
do
that,
so
we
anticipate,
you
may
see
a
bill
later
in
the
session
to
address
that
the
same
goes
with
integrating
the
two
computer
systems.
We
don't
need
to
change
nrs
in
order
to
do
that,
it
is
definitely
on
our
our
immediate
next
steps
of
something
that
ultimately
needs
to
be
done,
but
it
doesn't
require
a
statutory
change
in
order
to
accomplish
that.
C
F
I
I
didn't
really
have
a
question
I
was.
I
was
just
going
to
say.
I
was
happy
that
the
I
was
looking
at
number
four
and
five
and
it
looks
like
you
guys,
found
a
way
to
deal
with
the
support
staff.
I
Yes,
thank
you
for
that
chair.
I
appreciate
it
on
four
and
five
by
adding
those
school
support
staff,
though
that
still
creates
a
pretty
big
fiscal
impact
to
the
counties
in
that
respect.
Is
there
a
fiscal
note
that
has
been
attached
to
this
from
those
counties,
so
I
know
how
much
you
know
offense
of
an
unintended
consequence
or
an
intended
consequence
of
a
hit
and
unfunded
mandate
that
we
would
be
putting
upon
those
school.
H
Sarah
spearman
to
you
drew
you
to
senator
settlement.
H
Thank
you.
This
is
alisa
caferetta,
the
director
of
dieter
to
clarify
what
what
the
amendment
to
the
bill
does
is
it
provides
clarifying
language
about
teachers
and
support
personnel,
and
it
keeps
the
existing
statute
in
terms
of
who
is
eligible
for
unemployment
benefits
and
who
is
not
currently
under
nevada
state
law,
for
teachers
and
for
education.
Support
personnel
who
have
a
certainty
of
getting
their
jobs
back,
cannot
apply
for
unemployment,
so
that
will
remain
the
statute.
As
this
amendment
is
written.
H
What
we
have
worked
on
with
the
the
nsea
is
that
their
concern
was
specific
to
this
summer
for
folks
who
might
have
spent
their
their
savings
and
just
didn't,
have
the
opportunity
to
build
back
up
their
savings
and
might
be
facing
unemployment
this
summer.
So
we
have
proposed
and,
and
the
governor
has
signed
emergency
regulations
that
will
cover
education
support
personnel
this
summer
only
because
it
is
very
specific
to
the
situation
in
this
pandemic.
H
Those
will
be
coming
to
the
legislative
commission
for
approval,
so
you'll
have
a
chance
to
look
at
them
and
comment.
If
you
want
to
what
is
unique
about
this
year.
Only
is
that,
under
the
american
rescue
plan,
we
are
allowed
to
waive
up
to
75
of
the
charges
for
reimbursable
employers
like
the
school
districts.
H
So
we
think
that
that
reduces
the
burden,
the
one
time,
one
summer,
burden
on
the
school
district
significantly
and
we
understand
you're
also
looking
at
legislation
and
support
that
will
allow
for
summer
school.
So
we
believe
many
of
these
support
personnel
will
also
be
returning
to
their
jobs
over
the
summer
and
won't
need
to
apply
for
unemployment.
So
we
we
work
with
the
school
district
to
find
the
lowest
impact
way
to
provide
some
support
to
these
these
employees
on
a
one-time
basis
and
that
that
is
the
proposed
solution.
I
Because
I
appreciate
that
answer
very
much
just
so
you
know
man,
I'm
sure,
I'm
going
to
be
a
no
for
now
until
I
have
the
chance
to
weigh
this
amendment,
since
this
is
the
first
time
I've
seen
it
and
I'd
like
to
get
feedback
from
the
counties,
I
represent
school
districts
to
make
sure
that
we're
not
doing
them
irreparable
harm.
Thank
you.
A
A
F
I'll
just
keep
testing
them
until
I
get
one
that
works.
I
am
I
am
with
somebody.
You
know.
One
of
the
things
that
was
really
important
to
me
is
we've
done
so
much
to
take
care
of
so
many
people
in
our
state
that
were
have
been
affected
by
the
pandemic
in
their
wages,
and
I
think
it's
so
important
that
we
help
the
support
staff
during
this
summer.
F
A
Okay,
seeing
none
madam
secretary,
please
do
a
roll
call
vote.
C
B
A
A
So
now
we
will
begin
work
session
on
senate
bill
145.
Mr
mayor
rejo,
please
walk
us
through
the
bill.
G
Thank
you.
Spearman
next
bill
is
senate
bill
145
sponsored
by
senator
spearman,
and
it
was
heard
by
this
committee
on
march
17th,
2021
senate
bill
145
requires
a
financial
institution
institution
subject
to
the
federal
community,
reinvestment
act
or
cra
of
1977
to
notify
the
commissioner
of
the
division
of
financial
institutions
from
the
department
of
business
industry
of
their
cra
rating.
As
soon
as
it
becomes
publicly
available.
G
Division
is
required
to
post
on
its
website
the
current
cra
rating
for
each
financial
institution
and
submit
an
annual
report
to
the
legislature
containing
the
names
of
each
financial
institution
and
their
most
current
cra
rating.
Senator
spearman
has
proposed
the
following
conceptual
amendments:
to
amend
subsection
3
of
section
1
to
change
the
frequency
of
the
report
submitted
by
the
commissioner
from
annually
to
bi-annually
in
an
even-numbered
year.
G
Second,
amendment
is
to
amend
the
bill
to
require
financial
institutions
operating
in
this
state
to
conduct
training
to
persons
and
organizations
in
the
community,
including
without
limitation,
faith-based
and
other
consumer
advocate
organizations
to
advocate
to
educate,
nevada's
residents
about
the
obligations
of
a
cra
and
report
to
the
commissioner.
The
number
of
training
sessions
conducted
each
year-
the
commissioner
must
include
in
their
biannual
report
the
number
of
training
sessions
conducted
by
each
finance
institution
in
those.
A
C
Madam
chair,
I'm
wondering
one
of
the
comments
that
I
got
repeatedly
after
the
hearing
was
that
this
bill
actually
only
covers
about
half
of
the
financial
institutions
in
the
state
and
that
they
felt
that
this
was
a
little
onerous
on
them
compared
to
what
will
be
required
from
others.
Is
there
a
way
to
I
mean
I
know,
and
that
had
to
do
with
who
the
cra
applied
to
it's
just
certain
banks
and
it
doesn't
touch
any
of
the
other
financial
institutions?
C
A
So,
thank
you.
Senator
pickard,
the
banks
that
are
covered
in
this
bill
are
the
ones
that
operate
in
the
state
of
nevada
and
that
fid
has.
I
don't
want
to
use
word
control,
but
has
interaction
with
those
that
only
operate
at
the
the
federal
level
are
not
a
part
of
this,
and
I
heard
that
I
heard
that
question
during
the
hearing
and
also
addressed
that
question
with
the
bankers
association.
A
This
will
not
cover
all
of
them,
but
I
don't
think
we
should
let
perfect
be
the
enemy
of
good.
The
cra
can
offer
a
lot
of
opportunities
for
community
organizations
that
are
trying
to
help
people
in
nevada
dig
their
way
out
of
the
vicissitudes
of
this
pandemic,
and
so
the
only
reason
the
others
aren't
is.
It's
not
my
call.
A
It's
the
difference
between
what
the
state
has
control
over
and
the
what
what
can
only
be
controlled
by
the
federal
government.
C
All
right-
and
that
makes
perfect
sense
I
just
because
this
doesn't
encompass
any
of
the
credit
unions
or
any
of
the
other
non-bank
financial
institutions.
The
banks
were
calling
me
and
saying
hey.
This
affects
us
disproportionately,
and,
and
so
I
was
just
wondering
if
there
was
a
way
to
make
it
fair
for
everyone
anyway.
Thank
you,
yeah
thank.
A
You
senator,
let
me
address
that
that
last
one
I'm
not
so
sure
what
would
be
onerous
about
it-
and
this
is
this
is
not.
A
Another
questionnaire,
they're
not
being
asked
to
do
anything
except
the
information
to
make
it
duplicative
and
and
send
it
as
well
to
fid
the
other
piece
of
that
is
partnering
with
communities,
organizations
and
and
trainings,
and
those
don't
have
to
be.
We
we've
learned
in
this
pandemic
that
everybody
doesn't
have
to
meet
in
person
or
the
media
to
be
effective,
and
so
the
only
thing
we're
doing
there
is
trying
to
make
sure
that
people
understand
what
is
available.
A
It
also
provides
those
banks
who
are
under
the
cera
act
make
sure
that
they
know
the
community
organizations
that
are
out
there
and
perhaps
they've
been
you
know,
trying
to
figure
out
well
who
can
who
needs
our
help?
Where
can
we
put
this
interest
and
that
provides
another
another
avenue
for
them?
So
whenever
and
I've
heard
some
people
say
that
to
me
and
I've,
given
them
the
same
response
what's
onerous
about
it,
I
mean
you
know.
C
Sure,
and
and
no
I
I
actually
agree
with
you-
I
think
it's
a
good
thing
to
to
make
sure
that
people
know
who,
which
banks
are
actually
providing
the
service,
because
that
should
draw
customers
to
them,
but
it's
the
requirement
for
them
to
post
a
rating
which
most
people
won't
understand
and
my
response
was
well,
I'm
not
sure
they
would
understand
the
rating
anyway,
whether
it's
positive
or
negative,
but
they
have
to
post
on
their
website
where
others
don't.
C
A
No
problem
and
for
those
who
may
be
concerned
that
they
won't
understand
the
rating,
the
ratings
are
satisfactory,
unsatisfactory
and
the
degrees
to
which
it
is
satisfactory,
or
the
degree
to
which
it
is
unsatisfactory,
really
determines
especially
unsatisf
unsatisfactory,
determines
how
often
they
have
to
send
the
report
to
the
federal
government.
So
unless
they
don't
understand
you
and
s,
I
don't
know
what
else
we
can
do.
C
No
reading
yeah
it
was
it
was
that
if
they
were
to
say
miss
a
report
and
they
got
an
unsatisfactory
rating.
You
know
everybody's
looking
at
yelp
these
days
right,
they're,
looking
at
the
ratings
and
they're
saying
oh,
it's
unsatisfactory,
and
that
would
give
them
a
a
a
a
negative
hit
that
maybe
they
were
actually
doing
well
in
the
marketplace
anyway.
I
I
don't
want
to
belabor
this
too
much.
I
appreciate
it.
Madam
chair,
thank.
I
Thank
you.
I
appreciate
the
opportunity
to
ask
a
question
so
in
the
original
concept,
their
cra
rating
they'd
have
to
put
on
their
website.
There
was
some
discussion
that
would
just
allow
a
financial
institution
or,
in
my
opinion,
we
should
be
doing
it
to
everybody
to
put
a
link
on
their
website
to
the
cra
rating,
in
other
words
redirecting
it
to
the
state,
and
then,
in
that
respect,
what
do
you
think
about
the
idea
that
we
just
put
it
on
everybody?
Not
just
the
ones
in
this
category?
I'd
have
no
problem
saying
you
know.
I
A
Thank
you
for
that
question.
Senator
settlemyre,
first
of
all,
requiring
every
bank
every
financial
institution
in
the
state,
especially
those
who
do
not
fall
under
the
provisions
of
community
reinvestment
act
requiring
all
of
them
to
do
that
when
we
do
not
have
oversight
on
them
would
be
like
me,
coming
to
you
and
saying
I
need
you
to
paint
your
living
room
purple.
A
I
have
no
say
in
in
the
way
you
you
run
your
household,
so
those
for
whom
fid
does
have
some
provisional
oversight.
Those
are
the
ones
with
respect
to
anyone
else
who
wants
to
put
the
link.
They
can
do
it
I
say
have
at
it.
I
think
it
would
be
a
great
idea
if
people
just
do
it
voluntarily
and
talking
with
with
phyllis
with
the
bankers
association.
A
According
to
her
all
the
banks
are
doing
very
well,
and
I
would
think
that
those
who,
for
whom
this
does
not
apply,
would
want
to
put
that
information
on
their
website
as
well,
because
it
would
then
tell
people
in
the
community
that
that
this
bank
that's
closer
to
them,
is
doing
as
well
as
the
bank.
A
That
is
not
as
close,
but
is
doing
well,
but
the
bank
that
is
farther
away
is
the
one
that
we
have
oversight
on
based
upon
the
cra,
so
those
for
whom
we
do
not
have
oversight
have
at
it
they're
they're.
More
than
welcome
more
than
welcome
to
do
it
and
I'm
not
willing
to
to
say
that
the
state
should
do
it
because
number
one.
That
would
add
a
fiscal
note
and
number
two.
The
community
reinvestment
act
is
closer
to
the
people
when
they
are
doing
it
along
with
community
organizations,
not
the
state.
I
I
appreciate
that
concept,
but
again
anybody
this
isn't
about
paying
somebody
else's
house.
This
is,
do
you
have
a
cra
rating?
If
you
have
a
cra
rating,
then
you
have
put
yourself
out
in
this
field
of
monetary
lending
and
in
that
respect
again
the
division
should
be
able
to
develop
this
in-house,
with
no
real
fiscal
impact,
because
again
it's
just
obtaining
which
I've
sat
there
and
viewed
the
cra,
you
you
know
youtubes
and
stuff.
They
give
a
pretty
good
explanation
of
it.
I
don't
know.
A
Thank
you
thank
you,
and
I
wish
we
could
put
it
on
everybody
you're,
exactly
right
that
we
don't
have
oversight
over
them.
So
rest
assured,
you
do
not
have
to
paint
your
living
room
purple.
F
F
A
G
Mr
spearman,
for
the
record
cesar
mcgregor
community
policy.
Analyst
next
bill
is
senate
bill
179
and
was
sponsored
by
this
committee
on
behalf
of
the
legislative
committee
and
senior
citizens,
veterans
and
adults
with
special
needs,
and
it
was
heard
on
march
19
2021
senate
bill
179
requires
a
person
who
engages
in
the
practice
of
sign
language
interpreting
in
an
educational
community
setting
to
register
as
an
interpreter.
The
bill
further
establishes
the
qualifications
to
register
or
provisional,
provisionally
registered,
to
engage
in
the
practice
of
sign
language,
interpreting,
division
of
aging
and
disability
services.
G
Division
of
the
department
of
health
and
human
services
is
required
to
adopt
regulations,
establishing
professional
classifications
to
the
practice
of
sign
language
interpreting
and
the
qualifications
for
professional
mentors
of
interpreters.
The
bill
also
removes
the
exception
that
persons
who
engage
in
the
practice
of
sign
language
interpreting
or
the
practice
of
real
type
captioning
solely
for
meetings
of
non-profits,
not
profit,
civic
organizations
from
registering
with
the
division.
E
C
I
A
A
We
will
now
do
our
work
session
on
senate
bill
181.
Mr
milorejo,
please
begin
when
you're
ready.
G
Thank
you,
chair
spearman,
for
the
record.
My
name
is
cesar
margaret
hope.
Community
policy
analyst
senate
bill
1881
is
sponsored
by
senator
gokuchiya,
hardy
pickard
buck
and
assembly
members,
titus,
hayfin
and
ellison,
and
it
was
heard
on
march
17th,
2021.
G
senate
bill
181
consolidates
the
postgraduate
counseling
program
requirements
for
licensure
as
a
clinical,
alcohol
and
drug
counselor
into
a
single
program
consisting
of
at
least
three
thousand
hours.
The
bill
authorizes
a
licensed
clinical
professional
counselor
who
meets
certain
requirements
to
be
licensed
in
a
to
license
as
a
clinical
alcohol
drug
counselor.
The
bill
also
reduces
from
four
thousand
to
three
thousand
hours,
the
minimum.
Our
requirement
of
supervision,
counseling
of
persons
with
alcohol
and
other
substances
use
disorders
to
be
licensed
as
an
alcohol,
drug
counselor.
G
Minimum
hours
of
postgraduate
counseling
of
persons
with
mental
illness
will
also
have
alcohol
and
other
substance
use
disorders,
and
second,
amendment
is
to
amend
subsection
one
c
of
section,
one
to
add
a
new
paragraph
to
include
that
an
application
for
licensure
as
a
clinical,
alcohol
and
drug
counselor
complete
an
additional
500
hours
of
postgraduate
counseling
of
persons
with
mental
health
illness
who
also
have
alcohol
or
other
substance
use,
disorders
of
or
persons
with
alcohol
and
other
substance
use
disorders.
And
those
are
all
the
amendments.
A
C
A
Hicker,
I
I
keep
trying
to
go
back
to
gallery,
so
I
can
see
everybody,
but
it
keeps
focusing
on
me
so
so
senator
pickard
has
second
further
discussion.
E
C
G
A
G
A
G
Ready
you
chair
spearman
for
the
record.
My
name
is
cesar
mcgregor
community
policy,
analyst
senate
bill
245
makes
changes
regarding
employment.
It
was
sponsored
by
senator
lang
senate
bill.
245
expands
the
definition
of
wages
to
include
the
amounts
due
to
a
discharged
employee
or
to
an
employee
who
resigns
or
quits
bill
authorizes
such
an
employee
who
believes
that
he
or
she
is
entitled
to
wages
of
or
compensation
from
a
former
employer
who
fails
to
pay
within
the
required
time
to
file
a
claim
or
complaint
with
the
nevada
labor.
G
A
Thank
you,
sir.
Any
questions,
committee.
C
I
have
a
question.
Thank
you
senator
pickert.
Thank
you.
I
raised
during
the
hearing
on
the
proposed
amendment
when
we
talk
about.
C
If
the
and
this
is
the
proposed
friendly
amendment
by
commissioner
chambers
in
the
second
paragraph,
it
says
if
in
the
or,
if
the
remedy
and
relief
provided
under
the
collective
bargaining
agreement
is
inadequate,
unavailable
or
non-binding,
the
commissioner
will
take
jurisdiction
and
on
I
asked
the
question:
if
we
could
define
who
gets
to
decide
if
it's
inadequate,
my
thought
was,
you
know
if
we
were
to
say
if,
in
the
sole
opinion
of
the
commissioner,
because
what
I
think
this
is
going
to
do
is
open
the
door
to
litigation.
C
If
the,
if
the
claimant
thinks
it's
inadequate
and
they
try
to
go
to
the
commissioner,
I
think
we're
exposing
ourselves.
Would
it
be
inappropriate
to
add
that
I
mean
I'm
gonna
be
going
to
be
a
yes,
but
I
think
we
need
to
strengthen
that
a
little
bit.
C
All
right,
then,
why
don't
I
just
I'll
be
a
yes
on
the
the
bill.
Madam
chair,
I
just
think
maybe
we
should
get
a
floor
amendment
to
clear
that
up.
I
just
think
we're
going
to
be
asking
for
for
additional
litigation
where
there
really
doesn't
need
to
be.
F
Sender,
madam
chair,
this
is
senator
lang,
senator
pickard.
I
will
talk
to
the
labor
commissioner,
and
we
will
see
if
we
need
to
do
something
on
the
floor
and
get
back
with
you.
C
Thank
you.
I
just
you
know.
This
is
something
that
there
are
enough
people
out
there
that
are
going
to
complain
about
what
the
commissioner
does.
I
think
we
should
put
this
solely
in
her
lap.
Let
her
make
that
determination
and
let
the
case
move
on
if
it's
going
to
litigate,
otherwise
we're
adding
a
step
and
that
can
be
avoided.
Thank
you,
madam
chair.
I
appreciate
your
indulgence.
I
A
C
C
A
F
A
Thank
you.
I
just
need
a
clarification.
There's
been
a
question
senator
hardy
on
181.
Did
you
vote
yes
or.
A
So
now
I
will
open
the
hearing
on
senate
bill
171
senator
hardy
dr
amber
fradizio
and
david
olson
senator
hardy.
Please
begin
when
you
are
ready.
E
Some
of
the
drugs
that
are
sent
by
mail
are
critical,
that
they
have
an
option
to
be
able
to
get
those
in
case
there
is
a
snafu
in
houston
with
snowstorms
or
if
there
is
a
problem,
someplace
elsewhere.
So
it's
a
bill
that
actually
allows
for
a
person
to
opt
to
get
their
prescription
locally,
even
though
maybe
the
routine
pharmacist
doesn't
carry
something
I
it
would
be
available
in
a
perhaps
different
way
than
just
the
local
corner
drugstore.
E
So
to
illustrate
this,
I've
asked
amber
to
present
her
opinions,
as
well
as
her
friendly
amendment
and
so
amber.
Frederico,
I
think,
is
on
the
line
and
willing
to
share
with
the
committee.
Thank
you,
madam
chair.
J
Thank
you
respected
members
of
the
committee
for
allowing
me
to
be
here
today.
My
name
is
amber
federizo
and
I
currently
chair
the
nevada,
rare
disease
advisory
council,
and
I
am
the
current
director
of
research
at
the
hemostasis
and
thrombosis
center
of
nevada.
Today,
I
reach
out
to
you
in
the
role
of
a
nurse
practitioner
who
has
covered
the
entirety
of
the
state
for
the
last
10
years,
treating
patients
with
rare
blood
disorders
and
as
a
resident
who
has
previously
lived
in
frontier
nevada.
J
The
hemostasis
and
thrombosis
center
of
nevada
holds
the
largest
on-site
inventory
of
factor
for
rare
blood
disorders
in
the
state,
no
contracted
pharmacies
with
which
all
of
the
major
pharmacy
benefits
managers
contract
with
hold
hemophilia
inventory
in
the
state
of
nevada.
Currently,
the
closest
distribution
centers
are
located
in
california,
the
most
common
distribution
centers
for
most
pharmacy
benefits.
Managers
which
operate
in
this
state
are
actually
located
in
lenexa
kansas.
J
The
country
was
recently
gripped
with
unexpected
severe
weather,
which
placed
all
mail
on
delay,
including
factor
and
vital
vaccine
shipments,
when
delays
such
as
this
occur
and
patients
are
required
to
utilize
only
male
order.
The
patient's
soul
access
becomes
the
more
costly
alternative
of
the
emergency
department.
This
should
be
the
avenue
of
last
resort.
More
so,
with
the
pandemic,
patients
should
not
have
to
risk
exposure
to
obtain
medications
that
can
easily
become
delayed
with
severe
weather.
Considering
the
shipping
distances
most
are
utilizing.
J
Additionally,
many
pbms
utilize,
the
same
distribution
sites.
Should
the
distribution
sites
be
shut
down,
face
a
power
outage
or
reprioritize
reprioritize
inventory.
It
can
leave
nevadans
with
no
local
access
to
factor
the
hemostasis
and
thrombosis
center
couriers
upon
notification
of
emergency
need
for
hospitals
throughout
the
state
and
for
patients
requiring
immediate
discharge.
They
are
couriered
factored
directly
from
our
office
to
their
home
if
they
are
unable
to
come
in
person.
Mail
is
an
option
for
convenience,
not
a
mandate
without
a
provision
to
protect
this
access.
J
Patients
would
not
be
able
to
obtain
factor
locally
and
be
dependent
on
out-of-state
resources.
The
hemostasis
and
thrombosis
center
of
nevada
has
the
only
pharmacy
in
the
state
that
you
can
walk
into
to
obtain
factor.
We
strongly
support
provisions
which
ensure
that
pharmacy
benefit
managers
do
not
restrict
local
direct
access
to
factor
that
is
not
dependent
on
mail.
If
a
patient
is
bleeding
today,
they
should
not
have
to
wait
for
shipping
or
pay
more
for
expeditious
shipping.
J
It
is
clear
that
the
administrators
of
pharmacy
benefit
managers
have
never
set
foot
on
tribal
land
or
understand
how
people
may
only
have
a
post
office
box
for
delivery
against
common
pbm
rules
that
they
must
have
a
home
address.
We
have
to
ship
to
hospitals,
or
sometimes
fire
houses,
to
make
these
things
work
and
also
drive
them
out
or
provide
direct
access.
It
is
also
clear
that
pbms
are
not
aware
of
what
resources
are
available
and
how
long
it
takes
for
such
delivery
delivery
methods
to
reach
frontier
nevada.
J
Most
of
us
complain
at
day
three
of
amazon,
prime
being
late.
Frontier
nevada
has
to
wait
sometimes
weeks
mail
order
requirements
may
have
a
cost
savings
in
urban
areas
that
can
support
it
for
common
conditions,
which
a
delay
may
not
impact
their
medical
condition
greatly
in
rare
disease,
especially
those
with
active,
bleeding
or
blood
clots.
Any
delay
can
be
problematic
and
erase
any
of
those
cost-saving
gains
in
mere
moments.
J
Additionally,
pharmacy
benefit
managers
and
insurers
are
more
commonly
implementing
co-payment
accumulator
programs
in
an
effort
to
reduce
costs
and
shift
patients
to
cheaper
generic
alternatives.
For
many,
this
is
an
option
for
patients
with
bleeding
disorders.
There
are
no
currently
available
generic
options
for
consideration.
J
Therefore,
the
implementation
of
co-payment
accumulator
programs
unfairly
penalizes
patients
with
no
choice
but
to
utilize
brand
name
medications.
Local
retail
pharmacies
do
not
stock
or
dispense
factor
with
us,
as
an
exception
factor
is
only
dispensed
through
specialty
pharmacies
due
to
the
exceedingly
high
cost
of
factor
approximately
twelve
thousand
dollars
per
month,
155
000
per
year.
We
do
not
have
any
families
that
have
voiced
ability
to
pay
cash
price
due
to
insurance,
mandating
specific
pbm
and
specialty
pharmacy
use.
Families
are
unable
to
shop
for
the
most
cost
efficient
choice.
J
They
must
pay
their
price
mandated
through
their
pbm
and
specialty
pharmacy
and
offer
the
formula
they
like
to
provide.
They
simply
do
not
have
a
choice.
It's
far
too
common
than
it
should
be
that
pbo
pbms
own
their
specialty
pharmacies
and
funds
paid
are
received
back
through
those
same
preparations.
J
J
That
brand
gives
her
a
card
to
help
her
buy
the
food
amber
thinks
she
will
then
have
the
card
applied
to
her
groceries,
but
she
is
wrong.
The
grocery
store
accepts
the
card
and
then
because
amber
did
not
directly
pay
herself.
She
will
still
have
to
pay
her
share
of
the
cost
to
obtain
the
brand.
If
amber,
chooses
another
product
off-brand,
it
will
apply.
There
are
no
off-brand
products
for
amber
to
buy
amber,
needs
this
brand
and
has
just
enough
this
time
the
grocery
store
pockets.
J
Unfortunately,
the
cost
of
this
therapy
is
beyond
the
control
of
anyone
who
requires
it.
Many
require
a
combination
of
support
services,
community-based
organization,
support,
manufacture,
assistance
and
national
assistance
programs
to
be
able
to
afford
their
medications
as
no
generic
alternative
is
available.
All
sources
should
be
accepted
for
this
exceptionally
rare
group,
as
applicable
to
all
costs,
including
deductibles
for
medications
which
no
generic
alternative
exists.
J
Pharmacy
benefit,
managers
and
payers
should
not
be
able
to
implement
co-payment
accumulated
programs,
or,
alternatively,
named
programs
nor
mandate
mail
as
the
only
option
on
behalf
of
the
more
than
19
organizations
who
have
signed
a
letter
of
support
for
this
bill,
representing
some
of
nevada's
most
vulnerable
patients.
I
thank
you
for
your
consideration
and
opportunity
to
share
with
you
today.
Thank
you.
A
E
No,
that
is
it,
I
would.
She
alluded
to
the
people,
the
nevada,
chronic
care
collaborative
that
you
have
a
copy
of
the
19.
Some
odd
organizations
that
are
in
favor
of
this
and
amber
in
essence
presented
the
proposed
conceptual
amendment
in
her
testimony
as
well.
E
J
A
Thank
you,
senator
pickard.
C
Thank
you,
madam
chair.
I
just
have
a
really
basic
question.
I
mean
this
is
about
as
simple
a
bill
as
we
can
get,
but
when
it
comes
to
the
conceptual
amendment
when
we're
talking
about
the
co-payment
accumulator,
this
is
only
on
pbms.
That
would
offer
that
as
the
only
option
where
there
may
be
under
the
the
employer's
plan,
other
options
for
that
it
wouldn't
apply
to
them.
Correct.
J
If
I,
if
I
understand
federico
for
the
record,
if
I
understand
your
question,
it
would
not
apply
to
individuals
who
have
chosen
another
plan
that
does
not
contain
a
co-payment
accumulator
or
they've
chosen
that
path.
This
would
only
apply
to
scenarios
where
no
generic
is
available
and
the
patient
does
not
have
the
option
to
utilize
a
generic
pathway
to
then
be
eligible
for
the
resources.
C
Okay,
thank
you.
I
think
this
is
a
great
bill.
It's
simple,
madam
chair,
if
you're
inclined,
I
would
be
willing
to
move
a
men
do
pass
and
move
this
out
with
the
other
bills.
A
Thank
you
for
your
suggestions,
senator
pickard.
However,
I
never
like
to
do
that
on
the
first
day,
the
first
time
that
it's
read
so
that
people
can
kind
of
listen
to
it,
think
about
it,
but
we'll
come
back,
but
it
will
be
on
work
session
very
soon.
Thank
you
for
the
suggestion
I
see
spicer
specially.
F
Thank
you,
madam
chair,
so,
dr
federico,
how
does
this
work
with
medicare
and
medicaid,
who
typically
push
you
to
the
generic?
I
I
see
the
conceptual
amendment,
but
just
talk
to
me
about
the
real
life
application
within
those
two
programs.
This
still.
J
So
the
real
life
application
would
mean
that,
unfortunately,
medicare
and
medicaid
patients
are
often
not
eligible
for
certain
co-payment
support
resources,
but
they
are
eligible
for
other
third-party
resources,
such
as
patient
services
or
foundational
support.
So
those
patients
would
still
have
access
to
that
support
and
it
would
still
apply
to
their
to
their
deductibles.
What
would
what
happens
right
now
is
many
of
the
commercial
payers.
J
They
implement
co-payment
accumulator
programs,
and
they
say
this
will
only
apply
for
this,
because
you're
choosing
a
tier
of
drug
that
is
brand
name
or
specialty,
and
so
for
many
patients.
They
can
choose
an
alternative
generic
therapy,
which
then
these
would
apply
and
they
would
ultimately
pay
very,
very
reduced
amounts,
but
for
these
patients
there's
no
generic
available
and
in
hemophilia
there
is
not
likely
to
become
generic
available
at
any
point
in
time.
The
cost
to
manufacture
this
drug
is
exceedingly
expensive.
J
D
F
Okay,
because,
what's
clicking
in
my
mind
right,
you
know
that
rx
that
rx
card
that
you
can
get
for
free
and
you
just
basically
go
on
the
rx
website-
you
download
it
and
then
you
take
it
to
the
pharmacy.
This,
then,
would
talk
to
me
about
that
card.
J
J
This
is
actually
a
good
rx
and
it's
actually
going
to
show
backwards,
probably
but
the
cost
of
the
medication
for
amino
capric
acid,
for
my
patient
to
take
that
coupon
over
to
the
drugstore
on
this
form
it
costs
nine
hundred
and
fifty
three
dollars
and
ninety
cents
and
that's
with
good
rx.
So
these
drugs
are
drugs
that
are
unaffordable
through
any
other
discount
mechanism
other
than
to
have
patient
support
systems.
Manufacturer
co-payment
assistance.
J
Without
these,
these
patients
are
often
encountering
a
twelve
thousand
dollar
deductible
at
the
beginning
of
every
year,
of
which
many
families
cannot
afford
on
an
ongoing
basis
and
co-payment
accumulators.
Basically,
they
spread
that
out
through
the
course
of
the
year
and
the
patient
never
meets
that
deductible,
so
they're
never
ever
able
to
actually
afford
it
on
an
ongoing
basis,
as
they
were
before
when
their
co-payments
were
accepted.
At
the
beginning
of
the
year,
their
twelve
thousand
dollars
was
met
and
then
they
were
able
to
afford
all
of
their
other
co-pays
throughout
the
year.
F
A
Not
a
problem,
thank
you.
Additional.
A
Questions,
I
don't
see
any
hands,
so
why
don't
we
move
now
to
public
comment
on
senate
bill
171
broadcast?
Can
you
open
up
the
phone
lines
please
and
we
will
have
15
minutes
for
this
portion
and
three
minutes
per
person,
and
please
remember
that
if
someone
has
already
covered
your
points,
you
can
come.
You
can
open
up
your
phone
and
say
ditto
we'd
like
to
get
as
many
people
through
as
possible.
K
F
Hi,
my
name
is
elizabeth
bittenberg
and
I
am
the
executive
director
of
the
nevada
chapter
of
the
national
hemophilia
foundation.
My
name
is
spelled
e
l,
I
z
a
b
e
t,
h
d.
I
t
t
e
n
b
e
r.
I
would
like
to
express
support
for
the
proposed
for
sb
171,
as
drafted
and
also
with
the
amendment.
F
The
mail
order
restriction
is
a
huge
barrier
to
families
that
require
drugs
on
a
prophylactic
or
timely
basis,
and
also
the
accumulator
adjuster
is
a
huge
threat
to
patients
who
require
their
medication
to
to
live
each
day,
and
it
is
a
a
huge
barrier.
We
have
many
families
that
have
approached
us
when
they
cannot
afford
their
medications
and
are
often
taken
by
surprise
by
this
policy.
So
I
really
encourage
the
committee
to
consider
the
amendment
and
consider
preventing
this
harmful
process.
Thank
you.
K
F
L-O-G-A-N-K-E-N-N-E-D-Y,
thank
you,
respected
members
of
the
committee,
our
story,
our
four-year-old
son
grayson,
has
severe
hemophilia
a
our
story
begins
a
few
hours
after
his
birth
when
he
started
having
symptoms
of
his
bleeding
disorder.
Grayson
was
bleeding
from
his
standard
newborn
screening
procedure
and
did
not
stop
for
another
36
hours.
His
incident,
along
with
several
other
prolonged
bleeding
episodes
one
resulting
in
emergency
surgery
when
he
was
just
three
weeks
old.
F
This
was
very
terrifying,
especially
as
being
first-time
parents.
However,
this
event
finally
led
to
his
diagnosis
of
severe
hemophilia
a
at
seven
weeks
old.
His
diagnosis
was
a
complete,
surprise
and
shock
to
us.
We
did
not
have
any
prior
family
history
of
the
condition
and
we
really
didn't
know
much
about
hemophilia.
At
the
time
we
jumped
right
in
with
both
feet
and
quickly
learned
how
to
care
and
managed
for
grayson's
bleeding
disorder.
Grayson
does
require
two
life-saving
medications:
every
four
weeks
to
prevent
any
spontaneous
or
injury
induced
bleeding
episodes.
F
L
L
Now,
luckily,
we
had
something
called
a
copay
assistance
program
that
helped
us
to
shoulder
the
cost
of
grayson's
medication,
so
he
is
able
to
live
a
normal
and
healthy
life.
However,
in
july
of
last
year,
we
were
informed
that
our
insurance
would
be
implementing
an
accumulator
adjuster
which
allows
them
to
dictate
that
those
copay
assistance
programs
will
not
be
used
towards
our
deductible
or
maxed
out
of
pocket
of
eight
hundred
and
fifty
dollars.
L
L
While
we
were
lucky
enough,
ultimately,
to
avoid
some
of
the
major
issues
of
this
policy,
what
about
those
individuals
who
are
not
lucky
enough
to
avoid
to
afford
their
life-saving
medication?
L
K
K
M
T-O-M-M-C-C-O-Y
nevada,
chronic
care
collaborative.
I
just
want
to
point
out
that
several
states
have
responded
to
this
evolving
co-pay
financial
challenge
by
enacting
legislation
similar
to
the
sb
171
amendment
and
other
legislatures
are
considering
comparable
bills
right
now.
The
nevada,
chronic
care
collaborative
has
applied
a
more
detailed
letter
for
the
committee
to
look
at,
but
we
support
the
amendment
and
ask
the
committee
to
move
sb
171
on
to
the
full
senate.
Thank
you.
A
Thank
you,
so
we
will
move
now
to
those
in
opposition
15
minutes
three
minutes
per
person.
Thank
you.
K
K
K
L
We
are
the
national
pbm
trade
association,
pbms
administer
prescription
drug
plans
for
more
than
266
million
americans
through
a
variety
of
health
care
sponsors,
commercial
plan,
self-insured
union
plans,
trust
medicare
and
medicaid,
including
medicaid,
and
the
employee
program
for
the
state
of
nevada.
L
Mail
order
is
a
planned
benefit.
Design
pbms
do
not
dictate
whether
or
not
mail
order
is
a
benefit
or
not.
That
is
decided
by
the
plan
sponsor.
I
think,
there's
a
misconception
that
pbms
are
imposing
mandates
or
requirements.
Pbm
simply
administer
plan
benefit
designs
and
the
reason
for
these
savings
is
that
mail
order
facilities
because
they
are
large,
are
able
to
purchase
from
wholesalers,
drugs
in
very
large
quantities
and
and
those
savings
from
those
purchases
are
passed
on
to
the
payer
and
to
the
patient.
L
So
that
is
the
reason
for
the
savings
mail
order.
Facilities
also
tend
to
have
higher
adherence
rates
because
mail-order
drugs
are
maintenance,
drugs,
typically
allergy
medications
or
medications
going
to
be
on
for
more
than
a
year
or
so
or
several
months
at
the
least.
So
we
are
in
opposition
to
that
provision.
L
You
don't
have
copay
coupons
for
on
the
medical
side,
because
they're
an
illegal
dosement
to
care
you
get
a
knee
surgery,
you
don't
get
a
coupon
for
that,
and
coupons
only
exists
when
there
are
competing
brands
in
the
same
therapeutic
class.
Sole
source
drugs
don't
offer
coupons
because
they
have
no
competition.
L
So
this
is
what-
and
this
is
how
it
ends
up-
raising
prices.
It
may
help
an
individual
patient
and
it's
hard
not
to
be
empathetic
to
that,
but
they
will
end
up
raising
the
cost
for
everybody
under
that
particular
health
plan.
So
for
these
reasons
we
oppose
both
the
underlying
bill
and
the
proposed
amendment.
L
I
would
like
to
take
a
second
to
thank
senator
hardy
for
his
time
and
speaking
to
us
about
the
bill
and
allowing
us
to
express
our
concerns
and
have
a
very
candid
and
good
conversation
and
grateful
for
that,
and
with
that
I
will
end
it
happy
to
answer
any
questions.
Thank
you,
madam
chair.
K
M
Good
morning
terrorist
family
members
of
the
committee,
my
name
is
tom
clark,
that's
t-o-m-c-l-a-r-k.
I
come
before
you
today
on
behalf
of
the
nevada
association
of
health
plans.
Our
association
is
made
up
of
the
private
insurance
carriers
in
the
state
and
we
currently
make
up
about
19
of
the
market.
M
M
It's
simply
not
realistic
to
think
that
retail
pharmacies,
especially
in
rural
nevada,
can
keep
many
of
these
important
medications
on
their
shelves,
whether
they're
sent
to
a
pharmacy
or
sent
to
a
patient's
home.
Prescriptions
arrived
by
some
kind
of
partial
delivery
company.
I
was
raised
in
rural
nevada
and
I
would
argue
that
it
is
more
likely
that
a
snowstorm
will
keep
a
patient
from
getting
to
the
pharmacy
than
that
package
being
delivered
to
their
house.
M
K
K
F
For
the
record,
laura
rich
l-a-u-r-a-r-I-c-h
executive
officer
of
the
public
employees
benefits
program-
I
am
testifying
today
in
the
neutral
position,
as
the
peb
board
has
not
had
an
opportunity
to
discuss
this
bill
or
take
a
position
on
it.
Yet
kev
has
determined
that
the
elimination
of
the
mail
order
requirement,
which
at
this
time
only
affects
specialty
medications,
would
result
in
reduced
discounts
and
rebates
to
the
plan.
Since
drug
pricing
and
rebates
are
not
as
favorable
through
retail
pharmacies
as
the
program
would
get
through,
the
pharmacy
benefit
manager.
F
The
potential
shift
to
retail
bills
modeled
by
pabst
pdm
estimates
about
a
318
thousand
dollar
annual
cost
impact
to
pebs.
There's
also
some
concern
that
the
cost
will
grow
as
members
who
currently
receive
their
drugs
by
mail
will
continue
to
do
so,
but
new
patients
might
be
more
likely
to
choose
a
retail
pharmacy
over
mail
order.
F
K
L
Good
morning,
chair
spearman
and
committee
members,
this
is
kent.
Irvin
k-e-n-t
e-r-v-I-n,
with
the
nevada
faculty
alliance
representing
the
the
independent
association
representing
the
faculty
at
nc
colleges
and
universities,
who
are
members
of
the
public
employees
benefits
program.
L
Many
of
our
participants
really
like
the
mail
delivery
of
you
know
it's
convenient
and
often
cheaper
than
going
to
the
retail
delivery.
However,
there
are
certain
cases
where
it's
very
problematic.
One
is
porch
security.
L
L
L
As
far
as
the
amendment,
we
need
more
information
how
this
would
affect
the
current
program
at
the
public
employees
benefits
program-
I
I
know
they
instituted
a
program
last
year
that
is
sort
of
a
compromise
between
the
status
quo
and
what
I
believe
this
bill
does
that
that
allows
a
certain
level
of
copays
for
each
specialty
to
be
counted
toward
accumulators,
but
without
following
up.
I
just
don't
have
enough
information
on
that
at
this
time,
but
I'm
afraid
that
this
amendment
might
interfere
with
that
program.
L
So
thank
you
very
much
and
hope
to
follow
up.
K
G
O
O
We
are
here
to
share
information
that
senate
bill,
171,
possibly
conflicts
with
the
intent
of
assembly
bill
3
from
the
31st
special
session,
which
provided
for
nevada
medicaid
to
set
up
a
specialty
pharmacy
program.
The
division
is
developing
a
specialty
pharmacy,
which
proposes
mailing
medications
to
recipients.
O
It
should
be
noted.
The
passage
of
this
bill
reduces
a
barrier
for
those
who
would
prefer
to
obtain
medications
through
a
pharmacy
or
have
difficulties
with
with
reliable
mail
service.
However,
mailing
drugs
is
a
tool
to
increase
access
to
prescription
drugs,
well
containing
costs,
and
the
passage
of
the
bill
has
written
would
limit
nevada
medicaid
from
establishing
a
specialty
pharmacy
program
as
a
means
to
contain
costs
for
the
state.
Thank
you.
A
E
Thank
you,
madam
chair.
I
I
think
basically
what
you're
hearing
is.
What
we
all
know
is
that
if
we
do
mail
order,
it
saves
money
for
everybody
except
those
people
who
cannot
afford
to
miss
what
they
need
to
have,
and
so
the
compelling
story
we've
had.
You
know
the
reality
of
those
people
who
need
to
have
their
literally
vital
medicines
become
very
critical,
and
I
I
am
not
opposed
to
mail-order
medicines,
and
I
think,
if
the
dhhs
looks
at
what
I
would
consider
a
very
friendly
amendment
to
recognize
that
not.
N
E
So
I
I
think
that
this
is
not
something
that
may
be
as
simple
as
it
looks
on
first
blush,
but
I
don't
think
it's
something
that
we
can't
figure
out
that
allows
the
state
not
to
have
to
worry
in
in
that
same
bubble,
the
va
and
those
other
people
who
have
challenges
with
this.
I
think
there's
room
to
save
children
and
protect
people
who
need
to
have
their
medicines.
C
Thank
you
and
I
don't
know
this
is
best
for
dr
federico
or
or
senator
hardy,
but
I
thought
it
was
an
interesting
point
that
was
raised
regarding
the
port
security
by
mr
irvin,
and
particularly
when
we're
talking
about
any
medications
that
might
need
to
be
refrigerated
or
protected
from
excessive
heat.
C
Has
your
experience
been
that
these,
the
the
patients
who
need
it,
know
this
and
take
steps
to
address
it
or
are
we
losing
a
significant
amount
of
of
these
mailed
pharmaceuticals
because
they're
left
out
on
the
porch
and
somebody
takes
them
or
or
they
spoil
do?
We
have
any
idea
even
anecdotally,
what's
happening
there.
E
Joe
hardy,
for
the
record-
I
I
don't
know
about
the
stealing
but
bill
head
and
paul
young
and
tom
clark
and
people
who
are
in
the
industry
even
here
in
las
vegas
area,
have
a
distribution
center,
that's
very
impressive
for
mail
order
and
they
will
make
the
point
of
the
protection
for
refrigeration
and
the
how
they
do
it.
E
And
if
there
is
a
hiccup
in
the
medicines
that
have
to
be
refrigerated
or
stolen,
they
have
capability
of
sending
things
literally
overnight
and
getting
deliveries
done
so
there.
There
are
not
perhaps
the
sitting
outside
on
the
porch
issues
as
much
as
the
theft.
And
you
know
this
is
a
theft
that
obviously
somebody
can't
get
rich
on
it,
because
they
can't
find
somebody
who's
got
hemophilia
down
the
street.
So
this
is
the
pbms,
the
insurance
people.
They
have
been
very
diligent.
E
Their
part
to
make
sure
that
people
who
get
their
mail
orders
get
them
and
if
they
don't
get
them,
they've
been
very
diligent
to
get
them.
The
problem
you
get
with
the
no.
E
And
very
expensive
and
subject
to
hiccups
in
the
delivery
system,
where
hemophilia
literally,
is
a
vital
thing,
and
you
can
understand
how
parents
feel
about
you
know
their
children
and
for
themselves
as
they
I
get
older.
Not
every
generation
has
had
these
opportunities
to
have
these
life-saving
measures
so
available.
E
So
I
think
there
are
things
that
the
pbms
and
the
insurance
people
and
the
planned
people
are
not
evil
people,
and
I
don't
think
that
I
don't
want
them
to
be
portrayed
as
such,
but
there
I
think,
there's
common
ground
that
we
can
reach
that
will
allow
those
things
that
are
generic,
very
expensive
things
to
be
delivered
in
such
a
way
that
there
are
not
the
potential
roadblocks
and
barriers
that
prevent
our
kids
from
getting
their
life-saving
medicines.
F
Thank
you,
chair
experiment.
This
is
actually
a
question
for
you.
I'm
wondering
I
think
it
was.
Mr
olson
said
that
this
bill
could
possibly
conflict
with
83
and
I'm
wondering
if
we
could
ask
legal
to.
Let
us
know
about
that,
because
that
would
be
an
important
piece
for
me
and
in
the
end,
as
I
decide,
rather
to
vote
for
the
bill
or.
A
Not
thank
you,
sir.
Yes,
we
can,
we
can
do
that.
We
can
do
that
and
I
don't
know
if
they
can
get
back
to
us
during
the
hearing,
but
we
can
certainly
do
that
and
get
the
information
to
the
committee
members.
Okay,
thank
you.
Okay.
Thank
you.
O
Chair
spearman
to
senator
pickard,
I
believe
it
was
the
31st
special
session.
J
Spearman,
may
I
make
a
comment.
Yes
in
regards
to
ab3,
we
have
worked
very
closely
with
dhhs
and
dchfp,
we're
actually
part
of
that
specialty
pharmacy
program.
Our
like
I
said
our
office
is
one
of
the
few
that
you
can
walk
into.
So
these
things
are
not
built
to
eliminate
male
as
an
option.
They
are
built
that
it
is
not
the
only
option
and
so
in
developing
that
specialty
program,
specifically
especially
for
hemophilia.
We
have
not
found
that
to
be
an
issue
that
they,
it
would
be
the
only
route
they
could
get.
A
Option:
okay,
thank
you,
dr
frederico.
Did
I
get
it
right?
I'm
going
right
before
you
leave
here.
Okay,
additional
questions.
E
No,
madam
chair,
I
think
dr
federico
has
summed
it
up
very
well.
Thank
you.
A
Thank
you,
so
we
will
close
the
hearing
on
senate
bill
171
and
before
we
go
into
the
next
bill,
we
have
a
bdr
introduction
that
we
need
to
do
and
please
keep
in
mind
that
voting
for
the
introduction
does
not
mean
that
you
are
locked
in
to
support
it.
It
simply
means
that
we're
voting
to
introduce
the
bill
and
that
it
can
be
heard.
Okay,
and
so
the
bdr
is
bdr.
A
E
C
I
A
Yes,
hey
the
motion
passes.
Thank
you
so
much
and
we'll
make
sure
to
get
this
down
to
the
desk
as
soon
as
possible.
The
other
item
of
business.
I
was
just
reminded
by
a
policy
analyst
that
during
the
discussion
on
senate
bill
75,
we
did
not
get
a
second,
so
go
back
and
reopen
the
hearing
for
senate
bill
75.
A
G
Spearman
for
the
record,
we
should
get
a
motion
as
well.
A
C
G
We
we
during
the
discussion,
we
didn't
catch
the
motion
on
the
second,
so
we
were
redoing
the
vote.
C
G
A
And
it's
okay,
you
don't
you
don't
have
to
change
your
vote.
We
just
need
to
make
sure
that
parliamentary
procedures
are
so
you
don't
there's
no
need
to
change
your
vote.
If
you
were
yes
before
you
can
be
a
yes
now,
if
you're
a
no
before
you
can
be
a
no
now,
unless
you
change
your
mind,
so
there's
no.
A
Okay,
so,
madam
secretary,
please
start
over
on.
A
Yes,
please
I
just
I
want
to
make
sure
that
that
everybody
is
counted
and
everyone
knows
you
don't
have
to
change
your
vote.
Thank
you.
So
much.
E
C
I
A
A
Okay,
so
everything
everything
will
stay
the
same
now
and
we've
just
made
sure
that
we
got
the
record
straight
for
from
the
standpoint
of
parliamentary
procedures,
so
I
will
now
open
the
hearing
on
senate
bill.
184
revises
provisions
relating
to
the
practice
of
medicine.
Senator
hardy.
Please
proceed
when
you
are.
Thank
you,
chair.
E
The
interesting
caveat
of
that
is
both
the
dos
and
the
mds
have
opportunities
to
have
a
license
started
and
given
before
they
actually
graduate
from
the
residency,
if
they're
in
residency
in
the
state
of
nevada
with
their
I'm,
not
going
to
say
their
life
signed
away,
but
their
obligation
to
stay
in
nevada
and
practice.
E
Now,
if
there
is
a
foreign
medical
graduate,
it's
still
the
three-year
residency
that's
required.
There
is
in
the
bill
an
opportunity
to
have
volunteer
license
in
regulation.
Physician
assistants
are,
you
are
able
to
be
used
without
direct
supervision
when
they
are
in
an
emergency
situation
or
faced
with
something
that
needs
somebody
to
do.
E
They
are
more
than
willing
and
able
to
step
in
and
help
do's
doctor
osteopathies
in
the
bill
now
are
going
to
be
allowed
as
md's
allopathic
physicians
can
decline
to
supervise
a
physician
assistant
and
if
they
do,
they
have
to
notify
the
board
they're
bored
in
writing
and
the
pa
likewise
needs
to
notify
the
board
in
writing
within
five
days,
and
then
the
pa
needs
to
notify
who
their
new
person
is.
That
is
their
physician
advisor
supervisor.
E
In
the
bill
we
are
mirroring
nrs
633
to
630,
for
what
supervision
means
we
are
talking
about.
Adopting
regulations
on
how
many
pas
would
be
the
maximum
that
a
physician
whether
do
or
md
can
supervise.
E
If
one
of
the
challenges
right
now
is
a
physician
assistant
works
for
a
group
or
in
a
group
there
are
dr
osteopathies
there's
dr
allopathies,
and
they
both
end
up
supervising
the
physician
assistant
at
one
time
or
another,
and
that
means
the
physician
assistant
has
to
pay
the
price
and
join
both
boards.
E
The
md
board
and
the
eo
board,
and
this
bill
proposes
that
there
be
a
simultaneous
licensing
of
nrs,
630
and
rs-633
and
then
split
the
fee
to
each
board
by
half
and
that
will
allow
a
seamless
way
for
a
pa
to
be
supervised
by
do
or
md
who
are
working
together.
E
It
allows
for
the
bill,
allows
for
an
inactive
status
or
physician
assistance
in
the
do
board,
or
the
md
board,
as
well
as
perfusionists
and
respiratory
care
people,
but
the
inactive
status
is
unique
in
that
I'm
no
longer
practicing,
and
then
there
are
no
fees
to
be
inactive
and
in
as
much
as
there
are
no
fees
to
be
inactive,
then
the
va
can
say
I'm
an
inactive
ea.
E
E
E
If
a
physician
assistant
is
working
with
a
supervising
physician,
then
he
she
should
stay
within
the
scope
of
the
supervising
position,
and
that
is
in
the
bill.
There
is.
E
There
are
some
questions
on
certification
and
endorsement
by
certification
for
the
specialty,
but
it's
not
required
in
as
much
as
physician
assistants.
Heretofore
haven't
had
exactly
the
same
certificate
of
specialization
that
some
have.
Having
said
all
that
that's
in
the
bill
and
in
a
I'll
call
it
a
somewhat
concerned
and
somewhat
friendly
amendment,
the
physician
assistance
organization,
the
nevada
association
or
the
nevada
academy
of
pas
have
suggested
amendments
that
they
have
talked
about.
E
Sections
that
are
quote
acceptable:
sections
where
they're
neutral
and
the
rest
of
the
sections
are
quote
unfavorable
or
they
have
questions,
and
they
will
provide
some
kind
of
summary
and
review
that
I
can
make
available
to
the
committee
and
of
those
sections
in
the
bill.
14
of
them
they
consider
unfavorable
or
they
have
questions
about
them,
and
so
the
amendments
are
not
ready
for
prime
time
and
I
apologize
because
you
know.
Obviously
we
got
our
bills
later
than
we
would
have
liked,
let
alone
the
opportunity
for
them
to
have
read
all
of
the
amendments.
E
So
I
am
not
opposed
to
the
amendments
that
they
are
bringing
forward
as
much
as
I
think
they
need
to
be
cooked
a
little
before
I
can
say.
Yes,
I'm
in
favor
of
everything
that
they're
suggesting-
and
I
know
that
is
somewhat
disjointed,
but
that's
the
bill
and
those
are
the
proposed
questions
and
they
only
have
questions
or
concerns
about
sections:
one
3
4
5,
10,
17,
18,
22,
23,
29,
34,
37,
40
and
41.
A
All
right,
so
we
will
now
go
to
questions
any
committee
members
questions.
F
I
run
the
risk
of
asking,
but
section
five
wasn't
mentioned,
so
I
I
wanted
to
because
in
section
five
it
includes
it
was
section
five
sub
eight.
It
includes
how
pas
function
within
a
federally
qualified
health
care
center.
So
I
just
want
to
get
clarification
on
the
record.
You
know
how
our
pas
used
and
whether
or
not
you
know
this
is
running
into
some
kind
of
issue
with.
E
If
I
may,
the
theory
is
a
physician
assistant
now
is
supervised
by
a
physician
and
the
physician
within
the
scope
of
the
physician.
The
physician
assistant
works
in
that
supervision.
That
is
one
of
the
sections
that
the
physician
assistants
would
like
to
cut
out
that
whole
section.
A
That's
quite
all
right,
that's
what
the
question
period
is
for
I'm
looking
and
I
don't
see
any
other
hands.
Did
I
miss
anyone
committee
member
for
questions?
A
Okay,
so
now
we
will
open
it
up
to
public
comment
and
we
will
go
first
with
those
in
support.
15
minutes
three
minutes
per
broadcast.
Please
open
the
phone
lines.
Thank
you.
K
L
N
L
Record
my
name
is
david
dazlich,
director
of
government
affairs
with
the
vegas
chamber,
that's
spelled
d-a-z-l-I-c-h.
I
want
to
thank
senator
hardy
for
bringing
this
bill.
L
The
long
work
of
the
southern
nevada
forum's
committee
on
healthcare
we'd
like
to
thank
dr
hardy
for
shepherding
that
process
along
and
bringing
this
bill
to
address
the
the
modest
goal
of
improving
access
to
care
and
care
providers
within
the
state
of
nevada.
We
appreciate
all
the
work
that
he's
done
with
the
stakeholders
so
far
and
look
forward
to
seeing
the
resolution
with
everyone
going
forward,
but
we'd
like
to
thank
the
senator
for
his
support
and
the
support
of
the
southern
nevada
forum.
We
would
urge
yes
vote.
Thank
you.
K
K
K
N
Thank
you,
madam
chair,
for
the
record
susan
fisher
s-u-s-a-n-f-I-s-h-e-r
with
mcdonald
carano,
representing
the
nevada
state
board
of
osteopathic
medicine.
We
are
neutral
with,
but
we
do
have
some
concerns.
I
have
spoken
with
the
bill's
sponsor
about
some
of
the
concerns
and
we're
working
to
get
what
hopefully,
will
be
viewed
as
a
friendly
amendment
to
him
soon.
I
appreciate,
or
we
appreciate,
the
intent
with
regard
to
eliminating
the
requirement
for
a
pa
to
have
to
register
and
pay
under
both
nrs
630
and
633.
That
would
be
the
allopathic
and
the
osteopathic
boards.
N
In
the
event
they
may
be
working
with
both
an
allopathic
and
an
osteopathic
physician
section.
29
is
a
concern
because
it
requires
a
supervising
physician
to
review
10
of
the
pa's
patient
charts
for
the
first
90
days
or
100
charts,
but
there's
no
requirement
for
further
review.
We
are
concerned
that
the
standard
of
care
may
drop
off
if
the
pa
knows
that
his
or
her
supervising
physician
isn't
reviewing
charts
anymore
section
43
allows
the
pa
to
be
put
on
inactive
status,
which
is
fine.
N
N
K
M
Good
morning,
madam
chair
members
of
the
committee,
this
is
keith
lee
keith
lee
lee.
I
represent
the
nevada
board
of
medical
examiners.
The
board
has
not
had
a
meeting
to
meet
and
take
a
position
on
sb
184,
so
I
appear
in
neutral,
but
we
do
have
a
question.
If
the
board
staff
is
correct
and
is
understanding
that
the
intention
of
section
2.1
trend
b
is
to
apply
to
graduates
of
foreign
medical
schools,
then
the
staff
believes
the
approving
authority
mentioned
in
that
section.
M
That
is,
the
approving
authority.
Is
the
liaison
committee
on
medical
education
or
the
lcme
is
not
accurate.
The
lcme
only
approves
medical
schools
in
the
united
states,
including
puerto
rico
and
canada.
It
does
not
approve
foreign
medical
schools
outside
of
canada
and
puerto
rico
and
for
your
convenience.
Madam
chair
members
of
committee,
as
part
of
the
testimony
I
submitted
in
writing
yesterday,
it's
on
nellis
right
now.
I
have
given
a
short
blurb
about
the
liaison
committee
on
medical
education.
So
you're
aware.
L
M
So
if
the
staff
reads
section
2.1
b
correctly,
what
it
does
it
limits,
rather
than
expands
the
universal
foreign
medical
school
graduates
who
may
be
eligible
for
licensure
in
nevada,
section
2.1a
also
changes
the
current
three-year
graduate
medical
education
requirement
or
36
months
as
a
statute
now
to
two
years.
That's
a
policy
decision.
The
board
takes
no
position
on
that.
M
However,
we
think
it's
instructive,
that
that
you're,
aware
of
the
fact
that
this
was
changed
in
1985
to
three
years
and
a
patch
for
your
convenience
and
information,
a
copy
of
the
legislative
history
on
sb
64
of
the
1985
legislature.
M
In
addition,
the
federation
of
state
medical
boards,
of
which
the
nevada
board
of
medical
examiners
and
member
recommends
that
all
states
require
the
successful
completion
of
a
three-year
minimum.
Three
years
of
graduate
major
education
with
that,
madam
chair
I'll,
be
happy
to
take
any
questions
offline
and
thank
you
for
your
time
and
consideration.
K
A
Thank
you.
Are
there
further
questions
by
committee
members.
A
So,
dr
hardy,
I
have
a
question
and
probably
a
comment
too
this.
This
is
really
brought
to
help
with
the
shortage
of
medical
providers
in
nevada.
A
We,
we
are
woefully
short
on
a
lot
of
medical
providers
woefully
short,
and
I'm
thinking
about
the
bill
that
she
had
last
night
was
designed
to
do
the
same
thing
and
I
sure
hope
we
can
come
to
some
type
of
agreement,
because
we
have
doctor
shortage
and
doctor
shortages
in
a
number,
the
area
for
pediatric
and
severe
diseases.
So.
A
If
what
if
what
those
in
opposition
are
saying,
how
do
we
get
to
the
place
where,
where
nevada
has
more
than-
and
this
is
just
euphemistic-
and
I
know
that
it's
more
than
that,
so
that
nevada
has
more
than
one
patient
for
one
doctor
for
every
300
patients
and
that
that's
not
that
that's
not
the
exact
ratio,
I'm
just
using
that
as
an
example,
because
we
don't
have
near
the
amount
of
people
here
that
we
need
in
nevada
north
of
three
million
people.
What
we
have
right
now,
you
know
is
shameful.
A
That's
my
comment.
My
question
is:
is
this
designed
to
improve
the
number
of
medical
providers
and
the
second
question
to
that
would
be
for
those
who
sign
on
to
this
but
fail
to
stay
in
nevada?
Are
there
any
penalties.
E
Thank
you,
madam
chair.
There
are
no
penalties.
If
you
don't,
if
you
don't
keep
your
word,
but
obviously,
if
you
don't
keep
your
word,
you
got
a
challenge
in
wherever
you
go
now.
You
have
perhaps
seen
one
of
the
exhibits
where
I
put
down
the
number
of
years
of
postgraduate
medical
training
required
to
obtain
a
license
as
a
physician
for
graduates
of
medical
school
in
the
united
states
and
canada,
and
I
I
find
that
we
as
physicians
have
created
this
shortage
ourselves
in
nevada
in
many
ways.
E
E
And
obviously
we
are
concerned
about
this
and
south
dakota
by
the
way
requires
a
residency
program,
successful
completion-
and
I
don't
know
any
residency
programs
that
are
actually
just
two
years,
so
that
would
in
essence
make
it
three
or
four
states:
california,
nevada,
new
jersey
and
south
dakota,
but,
as
I
alluded
to
before,
we
still
have
an
opportunity,
if
you're
doing
a
residency
to
get
a
license.
But
again
you
have
to
sign
on
your
life
that
you
are
going
to
come
to
nevada,
which
hasn't
been
very
productive.
E
A
D
All
right,
thank
you
for
having
me
here
in
the
senate
committee
on
commerce
and
labor.
I
hope
that
this
presentation
will
be
short
and
sweet
for
the
record.
My
name
is
melanie
scheibel.
I
represent
senate
district
nine
in
clark
county.
It's
my
pleasure
to
present
senate
bill
280,
which
aims
to
expand
the
membership
of
the
nevada
real
estate
commission
by
way
of
background
states,
exercise
broad
authority
for
professionals
to
protect
the
public
from
unethical
or
incompetent
practices.
D
In
doing
so,
states
are
uniquely
tasked
with
ensuring
that
occupational
licensing
policies
do
not
unduly
inhibit
economic
growth,
prevent
workforce
mobility
or
disproportionately
limit
opportunity
for
certain
individuals.
Unfortunately,
industry
domination
of
occupational
licensing
boards
is
a
problem
that
has
been
addressed
before
in
nevada.
D
In
the
north
carolina
case,
the
supreme
court
established
a
two-part
test
to
determine
whether
a
board
controlled
by
market
participants
is
immune
from
anti-trust
claims
to
claim
immunity
from
antitrust.
The
board's
composition
must
first
serve
a
state
policy
goal
and
two
given
the
board's
activities
must
be
subject
to
active
supervision
by
the
state
in
nevada.
83
of
occupational
licensing
boards
are
required
by
law
to
have
a
majority
of
members
who
are
licensed
holders
instead
of
monopolized
boards.
D
D
Therefore,
sb280
expands
the
makeup
of
the
real
estate
commission
to
include
an
advocate
for
the
rights
of
consumers
or
an
employer
of
an
organization
that
provides
affordable,
housing
or
an
employee
of
an
affordable
housing
entity.
As
most
of
us
know,
nevada
has
been
facing
an
affordable
housing
crisis
for
some
time.
D
According
to
the
united
states
census,
bureau
35
in
nevada
households
spend
more
than
30
percent
of
their
income
on
housing
and
are
considered
housing
cost
burden.
In
addition,
the
national
low
income
housing
coalition
estimates
that
in
nevada
80
of
extremely
low
income,
renters
are
severely
cost
burdened
by
including
a
consumer
advocate
and
a
housing
advocate
as
members
of
the
real
estate
commission.
Those
who
are
experiencing
a
critical
need
for
affordable
housing
will
be
provided
with
much
needed
representation
with
the
chairs
commission.
D
I
would
like
to
review
the
provisions
of
the
bill
I'm
going
to
discuss
the
bill
section
slightly
out
of
order,
beginning
with
sections
one
and
three
which
increase
from
five
to
seven.
The
number
of
members
appointed
to
the
real
estate
commissions.
One
of
the
new
members
must
be
representative
of
clark
county
and
the
other.
D
A
representative
of
washoe
county
section
5
requires
the
governor
to
appoint
the
two
new
members
to
the
commission
as
soon
as
practicable
after
july,
1st
of
2021.,
section
5
also
provides
the
length
of
the
term
of
the
new
appointments
and
that
these
terms
do
not
apply
to
computing.
The
year's
consecutive
service
cap
that
applies
to
members
of
the
commission,
section
2,
expands
the
qualifications
of
persons
appointed
to
the
commission.
This
section
allows
a
person
who
is
a
legal
resident
of
the
united
states
to
be
eligible,
not
just
a
person
who
is
a
citizen
section.
D
F
You
for
that,
okay
members,
senator
pickard.
C
Thank
you,
man.
Vice
chair,
senator
I'm
I'm
very
familiar
with
this
board.
Having
been
one
of
their
licensees
for
many
years,
is
it
do
I
understand
correctly,
then
that
the
reason
the
purpose
for
this
bill
is
because
the
board
has
done
a
poor
job
of
advocating
for
consumers
and
and
then
can
you
explain
how
the
board
has
any
interaction
when
it
comes
to
affordable
housing,
since
they
don't
tell
developers
what
to
develop.
D
Sure
for
the
record,
this
is
melanie
scheible
to
you,
senator
pickard,
through
vice
chair
neil,
and
the
purpose
of
this
bill
is
not
in
any
way
to
suggest
that
the
nevada
real
estate
commission
is
not
doing
a
fine
job
as
it
is,
which
of
course
begs
the
question
of
why
we
change
something
if
it
isn't
broken
and
for
me
this
is
simply
a
matter
of
making
good
policy
decisions
and
good
policy
practices.
D
D
This
is
an
area
where
it
was
brought
to
my
attention
that
the
real
estate
commission
is
entirely
regulated
by
people
who
hold
brokers,
brokers,
licenses
and
salespersons
licenses,
and
so
I
think
that
it
is
best
practice
and
the
consumer
federation
of
america
agrees
that
it
is
best
practice
that
every
regulatory
body
have
some
members
who
are
not
members
also
of
that
industry.
D
I
also
think
that
one
reason
that
it's
important
to
look
specifically
at
the
real
estate
commission
in
nevada,
as
opposed
to
any
of
the
other
commissions
in
nevada
that
might
be
facing
a
similar
problem
where
the
problem
is
simply
that
the
structure
needs
something
to
be
desired.
Not
necessarily
that
there's
been
a
problem
in
implementation
yet,
but
looking
at
the
real
estate
commission,
because
we
have
such
a
serious
housing
crisis
in
nevada
right
now,
both
renters
and
homeowners
have
been
affected
by
the
decrease
in
market
availability
and
the
increase
in
prices.
D
You
know
as
landlords
who
are
assisting
people
in
buying
homes
for
the
first
time,
are
responsible
and
accountable,
not
just
to
members
of
their
own
industry,
but
also
to
members
of
the
public,
so
that
any
member
of
the
public
who
has
a
problem
with
their
real
estate
broker
or
with
the
real
estate
broker.
On
the
other
side
of
an
interaction
that
they
have
or
a
deal,
that
they're
making
has
better
recourse
to
bring
that
to
the
attention
of
the
board
and
know
that
their
interests
are
being
represented
by
a
consumer
advocate.
C
All
right,
I
appreciate
that
I
guess
my
understanding
of
and
and
I
had
bill
in
17
and
19
dealing
with
title
54
boards,
the
direct
result
of
the
north
carolina
dental
board
case.
The
the
purpose
of
nevada's
boards
is
in
my
understanding,
is
to
protect
the
consumer.
That's
the
entire
purpose
of
of
the
board,
and
so
they
are
all
consumer
advocates.
C
I
mean
we've
been
changing
over
the
past
four
sessions.
To
my
knowledge,
we've
been
moving
towards
experts
on
these
boards,
as
opposed
to
non-experts,
and
the
north
carolina
dental
board
case
requires
only
that
the
state
supervised
when
it's
made
up
of
largely
market
participants.
C
So
I
we
seem
to
be
going
backwards
in
terms
of
getting
skilled
experts
in
those
positions
and,
as
you
said,
it's
not
a
broken
system.
So
if
we
do
this,
what
do
you
think
that
the
the
impact
the
real
impact
on
the
ground
is
going
to
be
by
changing
the
makeup
of
the
board?
Given
you
you've,
already
acknowledged,
they're
doing
a
great
job.
D
So
melanie
schreibel
for
the
record
and
through
your
vice
chair
neil
to
senator
pickard,
I
want
to
point
out
that
we
are
not
removing
any
current
members
of
the
board
or
the
broker
sales
people
who
stay
on
the
board.
We're
adding
two
additional
members,
because
I
think
that
having
experts
in
the
field
is
important
in
any
regulatory
body
and
those
experts
can
and
sometimes
will
be
participants
in
the
market.
But
it's
important
that
some
of
those
experts
are
also
not
participants
in
the
market.
D
That's
why
also
the
two
additional
seats
that
I
proposed
in
senate
bill
280
are
not
simply
members
at
large
or
members
of
the
public,
but
two
people
who
are
specifically
invested
in
regulatory
practice
of
the
real
estate
market.
One
of
them
is
a
consumer
advocate
somebody
who
has
experience
dealing
with
consumer
liability
issues
with
you
know,
citizen
complaints
and
consumer
policy
and
the
other
one
is
engaged
in
affordable
housing
because,
as
we
all
know,
affordable
housing
does
not
just
mean
government
subsidized
housing.
It
does
not
just
mean
you
know
public
or
private.
D
It
means
the
the
houses
that
people
are
buying
and
selling
every
day
in
their
neighborhood
and
that
apartments
that
people
are
renting
and
having
rented
it
in
their
neighborhood
every
single
day,
and
so
what
I
hope
the
impact
will
be
on
the
ground
is
actually
that
we
will
see
that
the
way
the
commission
has
been
operating
has
been
faithful
to
the
the
needs
of
the
consumer
and
that
they
have
been
prioritizing
the
needs
of
nevadans
and
that
nevadas
can
now
also
feel
confident
that
that
has
always
been
the
case
and
will
always
continue
to
be
the
case.
D
Even
as
the
makeup
of
the
particular
members
of
the
board
change.
They
always
know
that
the
specific
broker
sales
people
who
sit
on
that
board
don't
sit
on
that
board
alone
in
a
silo
in
a
vacuum
only
looking
out
for
the
the
interest
of
the
industry,
but
that
there
are
also
two
people
on
the
board
ensuring
that
their
expertise
is
utilized
to
hold
bad
actors
accountable
and
not
to
protect
them.
C
All
right
and-
and
I
I
guess
I
do
understand-
that
what
are
then-
and
this
is
my
final
question-
advice
to
neil-
what
are
the
qualifications
of
these
advocates?
Are
they
economists
that
understand
the
nature
of
affordable
housing,
because
the
board
has
nothing
to
do
with
what's
being
developed?
These
are
simply
the
people
that
are
selling
and
managing
these
things.
So
what
are
the
qualifications
for
these
people
that
you're
adding
on?
Do
we
have
any
idea,
or
is
it
just
someone
off
the
street?
C
You
know
where,
where
on
the
spectrum
do
they
fall
and
what
are
their
qualifications?
Are
there
minimum
qualifications?
They
need
to
meet
that
sort
of
thing.
D
Okay,
thank
you.
So,
first
of
all,
I
do
want
to
point
out
that,
while
the
real
estate
commission
doesn't
oversee
developers,
it
does
oversee
real
estate
brokers
and
sales
people
and
those
brokers
and
sales
people
should
be
involved
in
affordable
housing.
There
shouldn't
just
be
developers
who
create
affordable
housing
and
then
leave
it
to
run
itself.
D
We
want
every
real
estate
broker,
who
sells
homes
to
individuals
in
the
las
vegas
valley
or
the
pahrump
valley,
or
out
in
ely,
to
also
be
knowledgeable
in
the
area
of
affordable
housing
and
be
able
to
assist
somebody
who
is
utilizing,
affordable
housing.
I
think
it's
important
that
these
two
systems
be
integrated
and
not
siloed
and
separated
from
each
other.
D
But
to
answer
your
question
about
the
qualifications
of
the
two
new
individuals
who
will
be
added
to
the
real
estate
board,
the
there
are
requirements
set
out
in
sb
280
that
indicate
the
two
different
designations
for
the
two
different
people
who
would
be
added,
but
I
think
the
most
important
thing
is
that
they
have
to
be
appointed
by
the
governor.
Just
like
the
current
members
of
the
commission
have
to
be
appointed
by
the
governor,
so
the
and
I'm,
of
course
always
open
to
amendments
to
this
legislation.
A
A
A
So
one
of
the
things
we've
been
talking
a
lot
about
this
session
really
has
to
do
with
the
way.
A
Businesses
and
the
whole
economic
system
does
or
does
not
empower
systemic
racism,
and
we've
been
looking
at
ways
to
deconstruct
that.
So
that's
my
statement
is
it:
is
it
your
intent
to
have
someone
else
on
the
real
estate
board
as
a
way
to
look
through
the
lens
of
the
consumer?.
A
And
would
would
would
this?
Would
this
help
in
furthering
the
intent
intent
of
senate
committee
resolution?
You
know
concurrent
resolution
one
racism
is
a
public
health
crisis.
D
Again,
melanie
scheibel
for
the
record-
and
I
hope
so
that
would
be
the
highest
purpose
of
this
bill
if
it
could
contribute
to
dismantling
systemic
racism.
A
Now
so
I
guess-
and
I
don't
know
that
this
is
an
amendment,
but
if
there
is
a
way
to
bring
that
intent
into
more
clarity,
that
might
be
helpful,
sometimes
sometimes
we're
real
protectionist
about
what
we
do
and
you
know
preachers,
do
it
attorneys
do
it.
You
know
I
know
what's
best
and
you
don't
anyway,
so
let's
try
to
get.
Let's
try
to
get
there,
because
scr
one
is
is
probably
the
only
bill
during
the
second
first
or
second
session
that
everybody
in
the
building
voted.
A
A
Sorry,
yes,
I'm
sorry,
we
got.
We
have
public
comment,
I
got
it,
we
have
public
comment,
don't
don't
don't
tell
her,
but
senator
raddy
is
rubbing
off
on
me.
Okay,
so
let's
go
to
public
comment.
15
minutes
three
minutes
per
those
who
are
in
support
broadcast.
Please
open
the
phone.
A
K
K
M
M
I
am
a
recovering
attorney
and
a
licensed
real
estate
broker
in
nevada
and
california,
and
for
the
last
24
years
I've
been
a
real
estate,
educator
and
author
in
nevada.
I
teach
pre-licensing
education
at
truckee
meadows,
community
college
and
through
my
own
firm
post
licensing
and
continuing
education
in
the
spirit
of
full
disclosure.
M
M
M
Yet
nevada
is
one
of
only
four
real
estate
regulatory
bodies
in
the
nation.
Without
any
public
representation
within
nevada,
there
are
approximately
35
regulatory
bodies
and
the
real
estate
commission
is
one
of
only
three
that
has
no
public
representation
under
the
current
law.
All
five
members
of
the
nevada
real
estate
commission
must
be
real
estate
licensees.
M
M
M
M
K
O
Good
morning
my
name
is
paul:
kaffa,
that's
p-a-u-l-c-a-t-h-a
and
I'm
representing
the
culinary
workers
union
local
226.
The
culinary
union
supports
sb
280
because
having
advocates
for
consumer
rights
and
affordable
housing
on
the
real
estate,
commission
is
long
past.
Due
the
covet
19
pandemic
has
emphasized
that
housing
insecurity
is
a
major
problem
for
working
families.
When
economic
crises
occur,
having
a
consumer
rights
and
affordable
housing
advocate
on
the
commission
will
help
us
be
better
prepared
to
keep
working
families
in
their
homes.
When
the
next
economic
crisis
hits.
K
F
F
We
would
like
to
thank
senator
schreiber
for
bringing
this
bill
forward
and
for
recognizing
the
importance
of
expanding
the
real
estate
commission
to
ensure
that
it
reflects
all
facets
of
the
industry,
adding
in
adding
an
affordable
housing
expert
and
a
consumer
rights
advocate
to
the
commission,
diversifies
the
makeup
of
the
commission
helping
to
ensure
that
the
housing
needs
of
low-income
nevadans
are
prioritized
and
that
consumer
concerns
are
given
the
weight
they
deserve
again.
We
would
like
to
thank
senator
sharma
for
her
work
on
sb280.
Thank
you.
N
N
N
It's
important
to
make
sure
that
we
have
consumer
advocate
and
someone
knowledgeable
on
affordable
housing
on
this
commission
on
board.
We
want
to
make
sure
that
we
are.
We
have
someone
actually
advocating
for
consumers,
regardless
of
of
their
regardless
of
zip
code,
regardless
of
what
status
they
have
making
sure
that
they
have
someone
in
their
corner.
We
have
seen
even
before
the
covered
pandemic,
that
there
is
a
large
disparity
in
housing
and
affordable
housing
and
renters
and
tenants
rights,
and
this
will
help
make
sure
that
we
are
advocating
for
them.
K
A
D
K
F
K
K
K
L
Begin
good
morning,
members
of
the
commission,
madam
chair
sharat,
chandra
administrator
for
the
real
estate
division,
s-h-a-r-a-t-h
c-h-a-n-d-r-a,
just
here,
to
offer
any
help
and
answer
any
questions
the
community
may
have.
Thank
you.
K
A
Thank
you
senator
scheible
and
I
apologize
I've
been
kind
of
multitasking.
Maybe
you
mentioned
it.
Maybe
you
didn't,
but
what
is
the
if
you
look
at
the
diversity
of
the
real
estate
board
commission?
What
does
that
look
like.
D
You
know
I
don't
want
to
make
assumptions
about
the
the
members
of
the
commission
based
solely
on
their
names,
which
is
what's
available
on
the
website,
but
you
know
I
think
that
there's
always
an
opportunity
for
us
to
add
additional
voices
to
a
commission
like
the
real
estate
commission
and
in
this
case
adding
consumer
protected
consumer
protection
advocates
and
affordable
housing
advocates
is
just
one
avenue
for
doing
that.
A
Okay,
thank
you.
I
didn't
mean
to
put
you
on
the
spot,
but
that
too
is
a
is
a
is
an
issue
that
keeps
coming
up.
So
if
you
could
get
some
information
on
that,
I
certainly
would
appreciate
it.
Okay,
thank
you.
Committee
members,
additional
questions.
A
E
C
A
A
A
A
Thank
you,
so
we
will
go
with
what
we
have
and
that's
six
other
committee
members
who
voted
affirmatively
and
one
absent
an
excuse.
So
let
the
records
show
that
the
motion
does
pass.
Thank
you.
A
Now,
committee
members,
we
will
go
to
public
comment.
Public
comment.
K
K
M
M
We
also
want
to
express
our
appreciation
to
governor
sisolak
and
his
staff,
including
heather
corbuck,
as
well
as
members
of
our
team
chan
giles
from
esea,
fred
horvath
and
jason
dently
from
the
chancellor's
local
14
council
sue
mccaskill.
Finally,
a
special
thank
you
to
you,
the
members
of
this
committee
for
listening
to
educators
and
using
your
position
to
relieve
the
concern
of
thousands
of
lower
wage
workers
about
how
they
will
make
and
meet
this
summer.
Thank.
K
A
Thank
you,
and
I
know
that
we're
going
to
be
getting
several
we'll,
probably
get
some
more
bdrs
and
we
will
get
several
amendments
today
before
the
end
of
the
day
and
so
just
be
prepared
when
we
get
to
the
floor
for
a
meeting
of
the
committee
on
commerce
and
labor
and
we
will
handle
our
business
that
matter
as
expeditiously
as
we
possibly
can.
I
want
to
thank
everybody,
especially
those
who
are
in
broadcast
services,
looks
like
we
had
some
hiccups
today,
but
you
all
weathered
the
storm.
A
So
thank
you
so
much.
Thank
you
to
all
those
who
tuned
in
and
are
listening
provided
comments,
whether
yes,
no
or
neutral
your
voice
does
matter,
and
so,
with
that,
what
we
will
do
is
we
will
adjourn
and
we'll
be
right
back
here
on
monday.
Thank
you.
We
are
now.