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A
Spearman
and
chairman
ready
here
and
please
mark
senator
spearman
here
as
she
arrives-
well
hello,
everyone.
We
have
a
busy
agenda
here
in
the
senate
hhs
today,
so
we're
at
this
new
interesting
time
in
session,
where
some
of
you
are
participating
remotely
and
some
of
you
are
participating
in
person
if
you're
watching
us
on
the
video.
A
A
A
As
always,
life
is
what
happens
while
you're
making
plans,
and
so
that's
our
intent.
But
if
we
are
needing
to
move
around
some
schedules
based
on
the
availability
of
presenters,
we
will
make
those
decisions
as
we
go
with
that,
I'm
going
to
go
ahead
and
open
up
the
hearing
on
ab344
and
invite
assemblywoman
thomas
to
present
her
bill.
C
C
C
C
If
adsd
creates
this
type
of
program,
it
must
provide
for
collaboration
between
the
hospital
staff
who
are
responsible
for
discharging
these
individuals.
As
well
as
the
individuals
and
their
caregivers,
it
must
also
facilitate
the
coordination
of
health
care
and
social
services
to
support
these
individuals
and
their
caregivers.
C
C
It
authorizes
the
division
to
accept
gifts,
grants
and
donation
in
order
to
establish
and
operate
the
program
and
to
use
other
available
options
to
fund
it,
including
billing
third
party
payers,
such
as
health
insurance
for
services
provided
by
the
program
subsection
3
of
section
1
of
the
bill
defines
older
person
to
mean
an
individual
who
is
60
years
of
age
or
older.
It
defines
the
term
third
party
to
include
various
health
insurers
and
it
defines
vulnerable
person.
C
At
this
point,
with
your
permission,
madam
chair,
I
would
like
to
turn
my
time
over
to
mr
jeff
jeffrey
jeffrey
klein.
President
ceo
of
nevada
senior
services
incorporated
mr
klein's
organization,
currently
has
a
pilot
program
hospital
to
home.
That
is
doing
this
type
of
work,
which
has
been
extremely
effective.
D
First
and
foremost,
let
me
thank
assemblywoman
thomas
for
bringing
this
forward
very
often
it's
from
our
own
personal
experiences
that
we
fully
appreciate
the
impact
of
the
healthcare
delivery
system
and
the
challenges
it
presents
to
some
of
our
most
vulnerable
citizens,
particularly
seniors
and
those
who
are
have
a
disability.
D
So
it's
my
my
pleasure
to
be
here
with
you
today,
quick
word
about
nevada
senior
services.
We
are
a
not-for-profit
located
in
the
greater
las
vegas
valley.
We
have
two
adult
day:
health
care
centers
in
home
respite.
We
provide
home
modifications,
geriatric
assessments
and
a
variety
of
evidence-based
programs,
and
we
are
the
aging
and
disability
resource
center.
The
nevada
care
connection
resource
center
for
lincoln
nye
is
morel
than
the
majority
of
clark
county.
D
As
the
committee
knows,
that
is
one
of
the
fastest
growing
states
in
the
united
states,
with
respect
to
the
elderly
and
our
65
plus
population,
particularly
those
with
the
dementia,
have
been
dramatically
increasing.
The
issue
that
that
presents
for
us
when
you
look
at
a
55.3
percent
growth
curve
in
aging.
D
Is
that
also
a
big
slice
of
this
asian
community
falls
in
some
of
the
most
vulnerable,
older
population
groups,
and
we
know
that,
for
instance,
with
respect
to
dementia,
that
the
rate
of
dementia
increase
from
alzheimer's
alone
has
increased
261
percent
261
261
percent
since
2000.
It's
the
sixth
leading
cause
of
death
in
nevada
and
the.
D
Numbers
reported
really
are
we
believe,
as
they
are
nationally
an
understatement
of
the
impact
as
seniors
are
poor
reporters
and
dementias
very
rarely
fully
diagnosed.
The
problem
that
presents
itself
is
that
persons
with
dementia,
frail
elderly
and
their
care
partners
experience
enormous
challenges
when
they're
receiving
health
care
services
in
our
communities.
D
We
know
that
dementia
increases
the
burden
on
acute
care
delivery
systems.
It
creates
excessive
resource
consumption
from
a
health
care
perspective
that
this
population
has
much
higher
complication
rates
and
poor
outcomes.
Complications
and
poor
outcomes
are
frequently
increased
in
this
population.
D
Persons
with
dementia
are
three
times
more
likely
to
be
hospitalized
and
other
members
of
the
65
plus
community
and,
on
average,
about
25
of
all
hospital
patients,
age
65
plus
have
dementia
hospital
rates
for
persons
with
dementia
are
twice
with
the
cognitively
healthy
and
more
education
about
the
medications
that
are
unique
to
the
dementia
population
is
very
vital.
D
That
said,
when
we
look
at
readmissions
and
readmissions
in
nevada
in
particular,
one
third
of
all,
hospitalized
persons
with
alzheimer's
disease
average
one
and
a
half
to
two
hospital
stays
in
a
given
year.
D
One
in
four
of
their
care
partners
enter
the
hospital
which
presents
a
huge
issue
as
frequently
there's
no
one
to
take
care
of
persons
with
dementia
when
the
person
who
they
live
with
enters
the
hospital
people
with
dementia
comprised
40
percent
of
the
total
under
30
day
readmissions
nationally,
and
just
to
give
you
an
idea
in
nevada,
the
southern
nevada.
D
The
readmission
rate
for
medicare
is
about
35
of
the
total
readmissions
home
alone,
with
dementia
or
unsafe
discharges
is
a
huge
problem
and
hospitals
struggle
with
the
problem
of
discharging
particularly
homo
loans
back
into
their
homes,
if
they
believe,
even
though
they
may
not
have
a
diagnosis
that
may
represent
an
unsafe
discharge
due
to
a
cognitive
impairment
and,
as
I
mentioned,
clark
county
has
a
readmission
rate
of
over
35.
D
That
said,
hospital
patients
with
dementia
are
more
significantly
likely
to
have
problems
where
they
spin
down
post-discharge
and
the
example
I
frequently
give
people
is
that
a
25
year
old
breaks,
a
leg
ends
up
in
the
hospital
ends
up
at
a
cast,
ends
up
immobile
and
loses
an
enormous
amount
of
muscle,
strength
and
gets
out
of
the
hospital
starts
exercising
and
is
back
to
normal.
D
A
senior
in
the
hospital
begins
to
lose
functional,
adls
and
frequently,
even
year
after
discharge
not
really
recovered
either
they're
physical
or
their
cognitive
capacities
they're
two
to
four
times
more
likely
than
other
older
patients
to
be
discharged
to
a
nursing
home,
and
I
I
need
not
tell
the
committee
what
implications
discharge
to
long-term
care
has,
particularly
in
the
covered
world
that
we
live
in
and
three
times
to
seven
times
more
likely
to
be
living
in
a
nursing
home
after
discharge.
D
So
that
brings
us
around
to
the
pilot
initiative
about
five
years
ago.
Adsd
brought
to
us
the
idea
of
creating
a
dementia
friendly
approach
to
hospital
care
transitions,
and
we
initiated
an
effort
to
create
a
pilot
program.
Interestingly
enough,
when
most
of
the
care
transitions
programs
were
developed
some
years
back-
and
I
was
a
hospital
administrator
in
those
days
and
very
very
attuned
to
this
at
the
time.
D
All
of
them
virtually
excluded
people
with
long-term
chronic
conditions,
particularly
those
with
the
dementia.
And
so
when
we
went
to
create
a
model.
We
quickly
discovered
that
all
seven
of
the
nationally
reputed
models
excluded
dementia
and
we
had
to
create
one.
So,
with
the
help
of
a
a
phenomenal
consultant
mike
explained
from
cognitive
solutions,
we
kind
of
shopped
the
market.
D
That
model
was
incredibly
successful
and
led
us
to
moving
forward
with
a
submission
to
the
administration
for
community
living
in
washington,
which
resulted
in
a
million-dollar
three-year
grant
to
really
develop
the
program
and
see
if
we
could
not
prove
the
value
of
this.
The
target
populations
of
the
grant
included
people
who
had
a
diagnosis
or
were
self-diagnosed
with
alzheimer's
or
other
dementias.
D
Individuals
in
with
intellectual
or
developmental
disorder
disabilities,
which
we
are
are
very
aware,
are
at
high
risk
for
dementias
as
they
age.
The
frail
elderly
who
are
currently
hospitalized
for
any
condition,
live
alones
and
subsequently,
as
covet
hit.
Anyone
with
a
covert
related
admission
and
we're
ready
to
be
district
from
hospital
to
home.
D
D
Program
was
designed
to
deliver
this
the
bridge
model,
as
I
mentioned,
it,
was
developed
by
rush,
which
is
social
work
based.
D
We
developed
it
in
conjunction
with
the
valley
health
system
and
with
the
active
support
of
the
nevada
hospital
association,
I'm
glad
to
say,
and
with
the
championship
of
the
director
for
care
management
for
all
of
the
valley
health
system.
It
was
designed
as
a
collaboration
with
the
hospitals
to
make
sure
that
there
was
a
seamless
continuum
of
care.
D
So
this
is
the
point
where
the
health
care
delivery
system
and
the
community-based
system
meet
up
with
the
idea
that
there's
a
30-day
time
frame
that
is
critical,
post-discharge
to
transition
the
family
into
a
longer-term,
stable
set
of
services
and
supports,
but
also
to
decompress,
very
often
a
totally
wiped
out
family
caregiver
and
to
deliver
it
a
you
know,
wraparound
model
delivery
can
be
in
person
or
telephonic
and,
frankly,
with
covid19,
we
have
learned
to
deliver
major
sections
of
the
program
electronically.
D
D
We
know
that
the
post
care
transition
plan
is
a
driver
throughout
this
whole
process
that
frequently
lives
for
six
or
seven
or
eight
months
beyond
the
actual
program.
We
also
introduced
a
new
model.
We
call
it
respite,
coaching
think
about
it
as
a
personal
coach
who
works
in
conjunction
with
the
case
manager
or
social
worker
and
is
in
home,
particularly
during
the
first
30
days,
to
not
only
provide
the
family
caregiver
a
break
in
the
action,
but
to
coach
the
family
caregiver
on
dealing
with
mr.
A
A
D
We
are
okay,
so
the
results
in
in
the
first
three
years
we
saw
363
people,
there
were
no
readmissions
for
the
state
by
to
the
same
diagnostic,
related
group.
This
is
a
national
record.
I
might
add,
it's
been
touted
by
the
administration
for
community
living.
We've
only
had
16
admissions
for
different
diagnosis.
D
You
can
see
the
number
of
assistances
in
terms
of
insufficient
support
at
home,
being
a
critical
identification
factor
and
then
caregiver
support
and
respite
care
being
the
two
most
critical
post
service
referrals,
and
with
that
said,
the
only
other
thing
I
I
would
add
is
that
this
person-centered
model,
in
addition
to
being
enormously
successful
in
terms
of
preventing
readmissions,
has
been
enormously
successful
in
reducing
demonstrated
family
burden,
as
demonstrated
by
evidence-based
testing
and
the
evidence-based
models
of
bridge
plus
the
models
we
created,
as
I
say,
have
been
highly
successful
and
are
now
being
replicated
in
other
states.
C
A
A
I
guess
my
fundamental
question
is:
it
sounds
like
the.
It
was
an
amazing
pilot
with
some
really
good
work
done
with
some
really
good
results.
I
guess
my
fundamental
question
is:
if
we
were
able
to
do
the
pilot,
what
what's
missing
that
requires
there
to
be
a
change
to
nrs?
Why
do
we
need
the
bill.
E
F
I
Insurance
issue,
when
it
talks
about
other
options
available
to
fund
the
program,
including
without
limitation
building
billing
third
parties
for
the
services
provided
by
the
program
two
persons
currently
covered
by
the
third
parties.
When
I
looked
at
the
word
or
the
work
session
document,
it
use
the
phrase
for
by
the
program
for
current
plan
members
only,
and
I
I'm
trying
to
figure
out
if
that
was
currently
covered
by
third
party
of
other
insurances
or
just
this
insurance
and
then
asking
the
further
question.
I
The
third
party
on
c
3c
below
that
for
employees
who
provides
coverage
for
services
and
care
at
the
hospital.
So
in
other
words,
could
insurance
companies
be
billed
for
this
without
limitation?
Or
is
this
something
that's
already
covered
in
the
insurance
plan
that
a
patient
would
have.
C
Thank
you
senator
and
assemblywoman
claire
thomas
for
the
record
and
mr
duncan
again,
if
you
could
answer
this
question,
I
have
a
relative.
F
This
is
jeff
for
the
record.
Well,
I'm
not
a
insurance
expert
by
any
means.
E
I
I
don't
know
what's
currently
happening.
I
might
ask
mr
klein
to
speak
to
his
pilot
to
see
if
he
could
provide
more
detail
on
your
question.
D
For
the
record
jeffrey
klein,
a
number
of
insurances
do
pay
for
different
types
of
care
transitions.
Some
of
the
components
of
the
care
transitions
programs
are
individually
billable.
So,
for
instance,
the
respite
coach
may
be
billable
as
a
personal
care
service,
the
social
work
components
the
counseling
components
can
be
built,
but
there
are
insurances
who
who
pay
for
care
transitions
and
also,
I,
I
might
add,
that
self
insurance
frequently
pay
for
care
transitions
and
approve
those
payments.
I
So
this
would
not
be
adding
another
burden
to
insurances
that
are
already
where
this
is
already
covered.
Is
that
the
impression
I
get.
D
For
the
record,
jeff
klein
that's
correct,
and
what
it
would
do,
however,
is
potentially
encourage
the
kinds
of
changes
that
would
make
that
process
much
less
difficult
and
and
challenging
because
of
some
of
the
impediments
that
are
sometimes
seen
in
regulation.
Frankly
by
insurance
companies
to
whether
or
not
they
should
or
shouldn't
do
something.
H
C
D
For
the
record
jeffrey
klein,
thank
you
for
the
question.
We
have
been
working
both
in
both
pilots
to
coordinate
transportation,
on
the
medicaid
and
and
on
the
medic
on
the
waiver
side.
We
organized
transportation
paid
for
by
those
vehicles
and
in
some
instances,
through
other
grantees
of
the
aging
disability
services
division
who
provide
transportation.
D
In
some
instances
we
coordinate
with
family
caregivers
for
private
transportation,
but
in
all
instances
we
we
provide
a
mechanism
for
transportation,
coordinated
transportation
resources
by
the
case
manager
to
ensure
people
have
access
to
everything,
from
food,
nutrition,
to
medications,
to
doctors,
appointments
and
any
other
follow-up
care
that
they
need.
H
You
know
because
I
asked
that,
because
I
know
if
there's
any
opportunity
for
collaboration,
it
may
stretch
the
dollars
further
and
I
do
know
that
the
va
has
individual
rides
and
they
also
have
a
bus
that
goes
around
and
picks
up
people
that
may
not
be
good
for
dementia
persons,
but
but
the
individual
rides
would
probably
be
that
way,
and
there
may
be
some
things
that,
during
this
pilot,
that
the
va
is
doing
or
knows
about
that
civilians
don't
quite
know
about,
and
the
other
piece
of
that
is
because
of
kovitz.
H
Some
of
the
hospitals
have
been
strained,
and
I
know
when,
when
I
had
covert
I
was
I
was
rushed
to
the
va
hospital,
because
the
civilian
hospitals
didn't
have
room
so
there's
an
opportunity
for
collaboration
there,
and
I
don't
know
if
you
had
thought
about
it,
but
it
may
be.
It
may
be
good
because
I
said
there
may
be
some
some
things
that
they're
doing
and
I'm
curious
to
know.
H
You
mentioned
that
there's
I
think
I
saw
in
here
there's
a
30
day,
35
25
30
day
under
30
day
readmission,
I
don't
know,
may
have
had
that.
But
I
know
cms
at
one
time
would
not
pay
if
the
readmission
was
under
30
days.
So
how
are
you
getting
around
that.
D
For
the
record
jeffrey
klein,
thank
you
for
your
question.
Vice
chair
experiment,
we've
really
had
welcome
arms
from
the
hospitals.
I
I
I
I
must
say
they've
been
partners
in
this
from
day
one
and
as
a
former
hospital
ceo,
you
know
the
original
hurdle
that
you
relate
to
about
hospitals
and
and
readmissions
is
really
the
environment,
for
that
has
changed
dramatically.
D
Hospitals
are
very
anxious
not
to
have
frail
people
who
are
high
resource,
utilizers,
come
back
into
their
facilities,
and-
and
so
this
has
really
been
very
much
a
welcome
development
for
the
hospitals,
which
is
why
it's
had
such
strong
support
from
right
right
now,
we're
working
with
over
10
hospitals,
the
entire
valley,
health
system,
some
of
the
hospitals
like
mountain
view
and
the
university
umc
university
medical
center,
and
and
we
are
actually
actively
working
with
clark
county
now
to
expand
it
inside
the
county
system.
D
So
it's
been,
it's
been
a
change
of
sea
change,
I
think
in
in
the
attitude
of
the
hospitals,
but
particularly
towards
this
population,
because
this
is
very
high
risk.
These
are
frail
people
who
are
likely
to
be
very
resource
consuming
if
they
get
back
into
the
hospital
and
the
other
problem
they
have
is
they
start
bouncing
around
between
post-acute
and
acute
and
going
back
and
forth,
and
we
have
prevented
an
enormous
number
of
those
readmissions
as
well
and
in
covid,
that
is,
that
is
safe.
H
So
let's
be
my
last
question,
I
saw
in
the
in
the
material
that
you
handed
out
that
you
mentioned
dementia
and
alzheimer's
and
I
hope
I
got
this
right,
but
there
is
a
new
strain
if
I
can
use
that
term
for
dementia
lewy
bodies-
and
it's
very,
very
rare
so
in
this
pilot
program,
would
you
all
be
including
some
of
the
more
rare
forms
of
dementia
or
are
we
talking
about?
Just
you
know?
D
Jeffrey
klein
for
the
record.
Thank
you
vice
chair
spearman
for
the
question.
When
we
started
out
the
original
pilot,
we
tried
to
limit
it
to
people
who
had
a.
D
A
defined
dementia
diagnosis
or
were
self-identified
as
the
program
progressed,
we
widened
it
out
to
cognitive
impairment
and
the
current
program
is
really
quite
broad
and
it
encompasses
not
only
lewy
body
but
frontal
lobe,
but
also
some
of
the
vascular
dementias
things
that
people
think
about
in
the
aging
process.
D
That
may
not
technically
be
in
some
of
the
dementia
categories,
and
even
now,
aphasia's
and
and
people
forget
that
people,
for
instance,
have
had
strokes
and
don't
fully
recover
and
may
end
up
with
a
receptive
or
an
expressive
aphasia
while
not
not
having
a
dimension,
the
classical
sense,
they
have
a
lot
of
the
affect
of
a
cognitive
impairment,
and
so
the
impact
for
management
of
the
case
is
is
quite
the
same.
So
the
program
is
really
widened
out
diagnostically
and
that's
one
of
the
things.
D
H
Thank
you
just
for
questions
committee,
don't
see
any
so
assemblyman
thomas.
Do
you
have
anyone
else
that's
going
to
present
or
that
you
know
is
in
support.
C
Thank
you,
madame
vaishtir.
No,
this
is
our
presentation
and,
in
closing
I
would
really
respectfully
ask
the
committee
to
take
in
consideration
this
viable
program
for
our
fellow
countrymen.
Our
elder
community.
C
H
Thank
you.
Is
there
anyone
here
in
the
building
in
the
room
that
wants
to
testify
and
support
senate
bill
340?
I'm
sorry
assembly
bill,
344.,
okay,
broadcast.
I
don't
see
anyone
in
the
room,
so
you
can
go
to
the
phones
and
we
will
be
in
support.
J
J
E
Yes,
madam
vice
chair
and
members
of
the
committee
for
the
record,
my
name
is
barry
gold,
b-a-r-r-y-g-o-l-d
and
I'm
the
director
of
government
relations
for
aarp
nevada
in
2015.
The
nevada
legislature
passed
the
care
act
unanimously
in
both
houses,
which
assisted
and
helped
support
family
caregivers.
E
But
it
was
just
the
first
step
it
just
provided
them
with
information
and
notification
that
someone
was
going
to
be
discharged
and
what
they
might
need
to
be
doing
when
they
go
home,
but
it
didn't
involve
any
wrap
around
services
or
any
anything
to
help
them
once
they
were
home
as
terms
of
a
actual
program
to
help
them
stay
home.
This
is
really
the
next
step
in
a
very,
very
needed
step.
E
So
it's
really
important
that
we
get
this
done,
because
we
really
don't
want
people
to
go
back
to
the
hospital
where
they
don't
want
to
be,
spend
more
money
and
it's
a
great
help
both
to
the
people
themselves
and
to
support
family
caregivers.
So,
for
those
reasons,
aarp
on
behalf
of
our
345
000
people
across
the
state
strongly
support
ab344
and
urge
you
to
pass
it,
and
also
mary
liberati
is
on
the
line
and
she'd
like
to
on
a
separate
line
and
she'd
like
to
tell
your
personal
story
why
this
is
so
important.
J
E
E
Has
been
a
nurse
for
over
35
years,
and
I
was
a
social
worker
for
40
years,
which
we
made
a
pretty
good
team.
On
one
occasion
my
dad
was
discharged
with
wound
care,
which
was
quite
complicated
to
take
care
and
took
several
weeks
for
us
to
try
to
get
that
under
control.
J
J
J
A
J
J
A
J
A
C
I
appreciate
that
claire
thomas
assemblyman,
clara
thomas
for
the
record,
and
thank
you
cheer
ready.
I
appreciate
the
time
that
you've
allowed
me
to
speak
to
the
committee.
Thank
you
so
much.
A
A
A
E
Of
the
committee
for
the
record,
I
am
assemblywoman
susie
martinez
and
I
represent
assembly
district
12
and
I'm
introducing
assembly
bill
138,
which
revises
provisions
governing
the
eligibility
of
certain
convicted
persons
for
public
assistance.
With
me
today
is
shane
paccini
from
the
food
bank
of
northern
nevada.
L
L
Take
you
back
in
time
the
the
restrictions
on
access
to
snap
antenna
for
people
with
a
substance,
abuse
conviction
was
offered
up
as
an
amendment
to
the
person
on
responsibility
and
work
was
the
personal
responsibility
and
work
reconciliation
act
of
1996
that
was
passed
by
the
us
congress
and
what
the
amendment
did
was
it
prohibited
anybody
with
a
drug
related
felony
from
re
receiving
either
federally
funded
cash
assistance
or
tameth
or
food
stamps
through
the
snap
program,
but
effectively
what
the
what
the
amendment
did
was
it
cut
off
the
resources
that
people
need
through
the
snap
and
through
the
tanf
programs
in
order
to
get
the
recovery
assistance
that
are
required,
and
I
just
want
to
say
you
know
also
that
the
substance
abuse
felonies
are
the
only
criminal
convictions
that
are
barred
from
snap
and
tanf
access.
L
So
you
know
why
it
matters
is
a
question
that
I
get
a
lot
and
it's
because,
when
individuals
with
drug
convections
are
denied
food,
stamps
are
the
cash
benefits
or
any
type
of
benefit
that
are
offered
in
tanf,
which
is
primarily
designed
to
help
families
with
children
correct
to
help
re-establish
their
economic
stability.
It
becomes
more
difficult
which
in
turn,
then
makes
their
recovery
more
complicated.
L
By
providing
assistance
through
the
tanf
program
and
through
the
snap
program,
we
are
actually
giving
the
people
an
opportunity
to
re-enter
society,
and
you
know
help
them
build
a
more
stable
future,
and
I
also
just
want
to
say
that
in
nevada
I
have
heard
over
and
over
again
in
the
years
that
I've
been
working
either
in
policy
or
at
the
food
bank.
Is
that
actually
trying
to
find
access
to
treatment?
Programs
is
impossible
that
the
demand
has
has
always
from
the
beginning
in
1996
has
always
outstripped
the
availability
of
the
programs.
L
L
The
united
states
is
the
world's
leader
of
people
of
incarcerated
populations
with
about
2.2
million
people
in
in
prison,
and
that
has
probably
increased
by
about
500
over
the
last
four
years.
Changes
in
sentencing,
law
and
policy,
and
not
the
changes
in
the
crime
rates,
explain
most
of
this
increase.
L
So
really
it's
policy,
and
not
you
know,
typically
what
we
would
consider
criminal
activity
that
has
has
driven
up
the
prison
population,
so
in
2017,
14
of
the
total
population
for
state
and
federal
prisons
was
were
people
that
were
convicted
of
a
substance,
abuse
felony
that
has
disproportionately
impacted
communities
of
color.
L
A
number
of
parents
with
children
who
need
to
be
reunited
with
their
families
have
been
impacted
by
this,
and
this
this
bill
will
help
make
those
reunifications
possible.
There
are
a
number
of
people
who
are
survivors
of
trauma
who
have
been
using
drugs
to
man
as
a
way
to
cope.
L
You
know
through
their
trauma,
and
that
is
also
due
in
part
to
the
lack
of
counseling
that's
available
for
mental
health
services,
which
again
we
all
know
in
nevada,
there's
just
not
a
lot
of
that
available
right
now
and
then
finally,
veterans
and
survivors
of
sexual
abuse
and
domestic
violence
have
also
been
disproportionately
impacted
by
the
drug
found
by
the
ban
in
the
1996
law.
So
we're
hoping
to
correct
that
too.
L
So
what
our
bill
does
really
is
just
two
things:
it
removes
the
prohibition
in
the
in
nevada
law
to
allow
the
communities
that
have
been
impacted
by
a
substance,
abuse
felony
to
get
access
to
snap
and
tanf,
which
is
really
one
of
the
last
barriers
that
people
in
need
of
food
assistance.
You
know
that
they
face,
and
I
just
want
to
say
that
you
know
governor
siselak
said
something
this
afternoon
that
really
resonated
with
me
when
he
was
rolling
out
his
initiative
to
help
people
with
substance.
L
A
A
How
about
that?
No
questions
all
right.
Well,
we
are
going
to
go
ahead
and
open
up
the.
So
if
at
least
one
of
you
would
step
back
to
create
space
for
somebody
to
testify.
L
A
M
M
M
The
ban
currently
promotes
food
insecurity
and
malnutrition
for
ex-offenders,
and
their
families
poses
a
barrier
for
reintegration
into
the
community
and
has
a
disparate
impact
on
african-american
people,
women
and
survivors
of
domestic
violence,
samples
created
to
prevent
food
insecurity
and
male
nutrition
in
low-income
households
by
raising
food
expenditures
and
improving
nutrient
availability
from
the
dates
of
july
2019
through
december
2020,
over
300
or
3
800
individuals
in
nevada
have
been
disqualified
for
snap.
Due
to
this,
that
is
thousands
of
families
going
hungry,
and
that
is
unacceptable.
M
A
N
N
Let's
talk
about
who
we're
talking
about,
it
is
one
felony
and
it
is
not
felonies
that
are
related
to
drugs.
This
does
not
mean
that
if
somebody
who
is
addicted
to
drugs
commits
a
violent
felony
but
does
not
have
drugs
on
them
that
they
have
to,
they
fall
under
this
law.
No,
it
has
to
be
a
drug
felony.
This
can
even
be
possession.
We
could
have
somebody
that
is
moving
drugs,
but
is
not
addicted
to
drugs.
Now
has
to
do
a
30-day
treatment
program.
N
When
I
worked
at
the
public
defender's
office,
we
had
to
find
people
treatment,
programs
that
were
we
had
an
average
of
less
than
one
bed
available
in
northern
nevada.
The
best
way
to
get
into
a
drug
treatment
program
was
to
hope
that
your
social
worker
had
a
personal
relationship
with
somebody
in
these
treatment
programs.
Now
you
have
to
hold
on
to
some
kind
of
proof
of
that
for
20
plus
years
this,
the
law
as
it
stands,
it
just
doesn't
make
sense.
N
It
does
not
help
people
with
drug
addiction,
it
criminalizes
people
beyond
them,
paying
their
dues
and
it
disproportionately
affects
people
of
color,
especially
black
single
mothers,
who
have
a
difficult
time
supporting
their
children
and
often
can
lose
their
children.
This
is
common
sense
policy
and
we
urge
you
to
support
it.
Thank
you
very
much.
Thank.
A
J
J
E
Ben
ennis,
that
is
b-e-n-I-n-e-s-s
and
I'm
a
social
work
intern
with
progressive
leadership
alliance
of
nevada
here
in
support
of
ab138.
Ultimately,
the
current
modified
ban
creates
three
specific
challenges
that
negatively
impact
public
health
in
our
community.
It
promotes
food
insecurity
and
malnutrition
for
persons
with
a
felony
drug
conviction
and
their
families.
It
poses
a
barrier
to
reintegrate
reintegration
into
the
community
and
has
a
disproportionate
impact
on
people
of
color
who
are
unjustly
targeted
in
the
war
on
drugs.
E
According
to
the
drug
policy
alliance,
nearly
80
percent
of
people
in
federal
prison
and
almost
60
percent
of
people
in
state
prison
for
drug
defenses
are
black
or
latino,
and
limiting
access
to
food
for
someone
in
their
family
is
a
cruel
way
to
encourage
treatment.
A
recent
study
by
clemson
university
found
that
food
insecurity
leads
instead
to
an
increase
in
crime
rates.
By
removing
this
antiquated
and
punitive
restriction,
we
allow
more
nevadans
access
to
food
assistance
while
working
toward
increasing
equity
and
ending
food
insecurity
in
our
state.
We
urge
you
that
you
support
this
bill.
J
E
E
We
wholeheartedly
believe
federal
nutrition
programs,
such
as
the
supplemental
nutrition
assistance
program,
should
be
made
available
to
all
eligible
applicants,
especially
applicants
from
vulnerable
populations,
who
are
essentially
shut
out
of
housing
options
and
have
extremely
limited
employment
opportunities.
Three
square
believes:
removing
this
barrier
will
reduce
food
insecurity
while
helping
people
recover
and
successively
reintegrate
back
into
society.
J
K
We
also
know
that
having
access
to
social
services
has
been
shown
to
be
an
effective
tool
in
reducing
risk
factors
for
future
violence,
as
with
any
community
victim,
survivors
of
violence
can
have
convictions
of
drug
abuse,
and
they
are
just
as
deserving
of
social
support.
We
are
so
appreciative
of
this
another
measure
to
reduce
barriers
in
accessing
snap
and
tanf
benefits.
Everybody
deserves
access
to
food
and
everybody
deserves
access
to
these
truly
life-saving
programs.
Thank
you.
K
A
E
Good
afternoon
again,
and
thank
you
chair
ready,
my
name
is
julian
block-
that's
g-I-l-l-I-a-n,
b-l-o-c-k
speaking
in
support
of
ab-138
on
behalf
of
the
nevada
coalition
of
legal
service
providers.
I'd
like
to
echo
much
of
what
has
already
been
said
here
today.
E
You
know
snap
and
tanf
programs
provide
a
critical
safety
net
to
low-income
individuals
and
individuals
with
felony
convictions
already
face
significant
barriers
as
they
ran
our
society.
These
barriers
are
particularly
steep
for
people
of
color
who
are
convicted
of
drug
offenses
at
much
higher
rates
than
white
people.
Although
studies
have
shown
that
actual
drug
usage
rates
are
roughly
the
same,
the
current
law
is
a
roadblock
which
promotes
food
insecurity
and
negatively
affects
the
health
and
economic
security
of
people
with
a
drug-related
felony
conviction
and
their
families.
E
J
E
K-E-N-D-R-A-B-E-R-T-S-D-H-Y
with
the
washoe
county
public
defender's
office
this
afternoon,
I'm
testifying
on
behalf
of
my
office
as
well
as
the
clark
county
public
defender's
office.
We
want
to
thank
the
assemblywoman
for
bringing
forward
this
important
legislation
that
we
believe
will
help
reduce
recidivism.
E
J
J
J
A
J
J
A
E
Of
the
committee
for
your
the
privilege
of
your
time
and
your
consideration
for
assembly
bill
138.
A
P
P
We
are
hoping
that
this
will
be
a
very
quick
bill
presentation
as
we
believe
that
the
change
is
very
necessary
and
an
easy
one
to
move
forward
for
the
record.
My
name
is
assemblywoman
tracy
brownmay
and
I
represent
assembly
district
42
in
the
central
clark
county
in
las
vegas
co-presenting.
Today,
on
zoom,
I
have
both
jessica
adams,
who
is
our
deputy
administrator
with
the
division
of
aging
and
disability
services
and
ace
patrick
who
is
the
chair
of
the
nevada,
statewide
independent
living
council.
P
This
bill
originated
in
the
interim
and
is
thanks
to
the
good
work
for
this
of
the
statewide
independent
living
council,
where
they
first
identified
that
we
still
have
in
nevada,
revised
statutes
some
negative
terminology
that
can
be
eliminated,
so
the
bill's
focus
is
to
remove
outdated
and
offensive
language.
Specifically,
this
bill
removes
a
reference
to
an
association
for
citizens
that
no
longer
exists
in
nevada,
and
it
should
be
a
very
easy
walk
through.
E
E
As
the
assemblywoman
mentioned,
ab430
does
revise
obsolete
terms
and
phrases
within
nrs
435
regarding
the
care
and
services
provided
to
persons
with
intellectual
and
developmental
disabilities.
The
proposed
changes
will
align
the
language
used
in
nrs
435
with
the
language
and
phrases
commonly
used
already
by
developmental
services.
E
I
will
quickly
walk
through
the
bill.
Section
1
revises
nrs
435.060
to
describe
the
transition
of
persons
residing
in
a
residential
facility
for
groups
to
a
non-facility
setting
from
being
able
to
live
in
a
more
normal
situation
to
being
able
to
reside
in
an
appropriate
community-based
setting.
That
is
not
a
facility
section
two
revises
nrs
435.115
to
remove
the
reference
to
the
state
association
of
citizens
and
the
board,
as
this
organization
no
longer
exists
in
nevada.
E
This
bill
has
no
fiscal
note
again.
All
of
these
changes
already
align
with
the
terms
and
phrases
that
we
already
use
day
to
day
and
do
represent
the
current
terminology
in
the
in
the
field,
as
well
as
the
respectful
language
that
are
there
that
is
deserved
by
all
of
the
people
that
we
serve.
A
Q
Good
afternoon
my
name
is
ace,
patrick
and
I
am
the
chair
of
the
nevada,
statewide
independent
living
council.
Thank
you,
madam
chair
ratti
and
committee
members,
for
the
opportunity
to
provide
some
background
information
about
the
importance
of
our
words.
Since
the
late
60s,
there
has
been
an
evolving
movement
toward
person.
First
language.
Q
The
most
important
thing
to
remember
when
considering
person
first
language
is
that
it
replaces
some
very
antiquated
and
offensive
terminology
that
has
no
business
in
nevada
language
words
do
matter.
In
my
experience,
I
can
testify
to
the
fact
that
for
years
I
felt
like
a
farm
animal
being
hurted
by
doctors,
psychiatrists
and
institutions,
while
they
used
my
diagnosis
as
labels
to
push
me
through
the
next
provider.
Q
My
life
changed
dramatically
when
professionals
began
to
address
me
about
my
diagnosis
and
not
talk
to
each
other,
about
my
diagnosis
as
if
I
didn't
even
exist,
it
may
not
seem
like
it
matters
to
people
who
have
never
had
to
remind
others
that
they
are
in
the
room,
but
I
can
tell
you
it
has
made
an
enormous
impact
on
the
quality
of
my
life.
I
am
a
person
with
disabilities
and
I
support
these
important
changes
proposed
in
assembly
bill
430..
P
J
J
K
Thank
you,
chair
ratty
committee
members
for
allowing
me
to
speak
in
support
of
the
support
bill.
I'm
lisa
foster
that's
a
fos
ter
and
I
represent
snap.
The
state
of
nevada
association
of
providers,
snap
organizations
partner
with
the
state
to
provide
supportive
living
arrangements,
jobs
and
day
training,
services
and
related
supportive
programs
throughout
nevada.
K
Lastly,
we
support
the
change
in
section
3,
as
it
pertains
to
the
goal
of
the
services
offered
by
the
state
and
its
direct
providers
to
the
term
increased
independence.
Current
language
is
antiquated
and
not
respectful.
We
greatly
appreciate
assemblywoman
brown
bank
for
bringing
this
legislation
forward
and
encourage
your.
J
E
A
J
J
J
E
Afternoon,
madam,
thank
you
so
much
good
afternoon,
madam
chair
and
the
committee
members.
My
name
is
dora
martinez
d-r-a-m-a-r-t-I-n-e-d.
I
represent
the
nevada
disability
action
coalition.
J
J
A
J
J
A
J
A
P
Thank
you,
chair
for
the
record
tracy
brown
may
assembly
district
42..
I
just
would
like
to
thank
the
committee
for
taking
the
time
to
hear
this
bill.
I'd
like
to
thank
the
advocates
and
the
members
of
the
community
of
people
with
diverse
abilities
for
weighing
in
and
for
always
participating
in
the
legislative
process
to
make
sure
that
we
are
respectful
of
all
of
our
citizens.
Thank
you.
A
Thank
you
all
right,
we'll
go
ahead
and
close
the
hearing
on
ab430
and
thank
the
presenters
for
coming
and
presenting
the
bill
and
telling
their
story,
and
we
will
move
on
to
ab197
assemblyman
watts.
If
you
want
to
come
up
and
do
some
sanitizing
and
hand
sanitizing
for
yourself
there
we'll
give
you
a
minute.
R
Thank
you
very
much,
madam
chair
and
members
of
the
committee
for
the
record.
I
am
howard
watts
representing
assembly
district
15
in
clark
county
with
me
today
to
present
assembly
bill.
197
are
arashka
fourie
with
the
nevada
partnership
for
homeless,
youth
and
tavon
jenkins
after
providing
a
brief
overview
I'll
turn
it
over
to
them
and
after
they
finish
I'll,
give
you
a
brief
walkthrough
of
the
bills.
Language,
youth.
Homelessness
is
a
crisis
here
in
the
state
of
nevada.
R
On
any
given
night,
it's
estimated
that
312
youth
aged
18
or
under
in
our
state
are
living
on
their
own
in
shelters
or
on
the
streets
over
the
2018-19
school
year,
school
districts
across
nevada
identified
more
than
1
000,
school-aged,
unaccompanied
homeless,
youth
and
the
problem
is
as
prevalent
in
our
rural
communities
as
it
is
in
our
urban
areas.
Touching
every
corner
of
our
state
av-197
seeks
to
eliminate
barriers
that
can
prevent
these
youth
from
accessing
the
critical
health
care
services
and
documents
needed
to
exit
homelessness.
G
Have
thank
you,
chairwoman,
roddy
committee
members.
It's
an
honor
and
privilege
to
be
here
today.
My
name
is
arash
kapoori
and
I'm
the
executive
director
of
nevada
partnership
for
homeless
youth,
while
every
as
assembly
as
assemblyman
watts
just
mentioned.
Youth
homelessness
is
a
serious
and
significant
problem
nevada,
while
every
young
person's
story
is
unique.
Youth
often
experience
homelessness
on
their
own
as
a
result
of
family
instability,
including
abuse,
neglect
or
abandonment,
structural
issues
and
economic
instability.
G
Additionally,
homeless,
youth
experience
significantly
higher
rates
of
mental
illness
homeless.
Teenagers
are
7.2
times
more
likely
to
attempt
suicide
than
their
house
teenagers.
Consequently,
increasing
access
to
health
care
for
minors
experiencing
homelessness
is
paramount
to
the
health
of
vulnerable
young
people
and
to
the
wellness
of
our
entire
state.
In
my
10
years,
at
nevada
partnership
from
this
youth,
south
nevada's,
most
comprehensive
service
provider
for
young
people
experiencing
homelessness,
I've
seen
countless
young
people
present
with
health
issues
ranging
from
minor
to
severe
in
order
to
ensure
that
young
people
can
access
the
care
they
need.
G
Mphy
has
partnered
with
many
fantastic
healthcare
organizations,
including
nevada
health,
centers,
the
unov
school
of
nursing,
the
unlv
dental
clinic
south
nevada,
adult
mental
health,
lions,
kids
site
usa
foundation
and
many
others.
However,
many
of
our
healthcare
partners
have
faced
barriers
in
providing
services
to
unaccompanied
homeless
minors
due
to
limiting
and
unclear
language
in
existing
nevada
law.
Current
law
only
allows
medical
providers
to
serve
unaccompanied
youth
once
they've
been
homeless
for
four
months
or
more
and
doesn't
clearly
explain
how
providers
can
determine
which
youth
qualify.
G
Accordingly,
mphy
has
worked
with
many
healthcare
providers
who
truly
want
to
serve
youth
in
need,
but
feel
unsure
how
to
implement
the
correct.
The
the
current
law
correctly
ap197
addresses
this
by
establishing
a
simple
and
proven
process
to
verify
that
a
minor
is
covered
by
this
law.
The
verification
process
proposed
in
this
bill
is
modeled
on
the
federal
financial
aid
process,
which
nevada
public
schools,
universities
and
service
providers
have
been
implementing
since
2008..
G
This
same
verification
process
is
also
utilized
in
a
similar
healthcare
access
law
for
minors
in
maine
and
in
the
california
law,
helping
minors
access
vital
documents.
Ab197
also
allows
unaccompanied
homeless
miners
access
care
right
away
when
it's
needed.
This
timing
is
extremely
important,
as
a
lack
of
immediate
care
can
lead
to
routine
problems
becoming
dangerous
and
even
lead
to
death
by
suicide
overdose
or
unrelated
illness
in
a
population
that
is
already
prone
to
heightened
health
risks.
G
Additionally,
current
law
allows
unaccompanied
minors
to
access
treatment
from
a
physician
or
hospital.
However,
many
of
the
providers
who
are
able
to
provide
care
for
our
young
people
include
nurses
and
nurse
practitioners,
physicians,
assistants,
dental
hygienists
and
other
licensed
professionals
who
aren't
clearly
covered
under
the
existing
law.
Furthermore,
many
of
the
young
people
we
serve
have
urgent
and
important
health
care
needs
that
aren't
appropriately
met
by
physicians
or
hospitals,
but
rather
by
behavioral
mental
health
and
dental
health
professionals.
G
Ab197
takes
care
of
this
clarifying
that
unaccompanied
minors
can
access
not
only
healthcare
services
provided
by
a
physician
or
hospital,
but
also
mental
and
behavioral
health,
dental
and
other
critical
services
provided
by
all
providers
of
health
care,
a
category
already
defined
by
nevada
law.
This
will
ensure
that
homeless,
youth
can
receive
health
care
services
that
meet
their
varied
needs.
This
bill
will
improve
existing
law
and
help
youth
access
essential
care,
while
strengthening
the
ability
of
organizations
like
nphy
and
healthcare
providers
to
meet
young
people's
fundamental
needs.
G
Currently,
30
states
allow
unaccompanied
youth
to
access
basic
health
and
behavioral
health
services
without
a
parent.
The
american
academy
of
pediatrics
also
supports
these
measures.
This
bill
will
simply
clarify
and
fortify
nevada's
existing
law,
ensuring
that
unaccompanied
youth
have
access
to
the
basic
health
services.
They
need
to
stay
safe,
healthy
and
able
to
succeed
in
work
and
school,
empowering
them
to
ultimately
transition
out
of
homelessness.
G
Additionally,
by
provider
by
by
providing
minors
access
to
physical,
mental
and
behavioral
health
care.
Now
we
can
prevent
more
long-term
chronic
health
issues
from
occurring
saving
nevada,
millions
of
dollars
in
future
costs.
Now
more
than
ever
assembly
bill
197
is
a
simple
and
smart
step
to
support
vulnerable
young
people
on
their
journeys
beyond
the
streets
to
healthy
and
sustainable
adulthoods.
G
G
G
When
I
was
just
12
years
old,
I
experienced
homelessness
for
the
first
time
with
my
family.
After
that,
my
homelessness
was
often
only
due
to
conflict
within
my
family
and
my
mother's
health
problems.
I
was
first
introduced
to
mphy
through
their
field
goal
friday,
outreach
event.
When
I
was
12
years
old
there
I
got
food
and
other
supplies
every
week.
G
Eventually
I
came
to
the
drop-in
center,
where
I
got
help
getting
my
id
food
clothes,
school
supplies,
hygiene
supplies
and
much
more
by
the
time
I
was
17
years
old.
I
reached
a
breaking
point
with
my
homelessness
situation
and
there
came
a
time
and
place
where
I
had
no
other
place
to
go
about
mphy.
G
G
G
Accordingly,
I've
gotten
to
know
a
lot
of
young
people
experiencing
homelessness
over
the
years.
Just
recently,
there's
been
there
have
been
youth
who
haven't
been
able
to
seek
medical
care
for
chest,
pains
who
couldn't
seek
physical
therapy
after
a
gunshot
wound
limit
the
mobility
and
who
could
get
treatment
for
a
serious
mental
health
crisis
due
to
them
being
unable
to
obtain
parental
consent
for
unaccompanied
minors.
G
I've
also
known
of
you
who
couldn't
access,
important
preventative
health
care
services
by
mphy
partners,
including
dental
cleanings,
physical
health,
checkups
and
vision
tests,
because
they
couldn't
consent
to
these
services
themselves
as
unaccompanied
minors.
This
is
especially
important
right
now,
with
kobe,
as
homeless,
miners
have
been
turned
away
from
kova
testings,
because
they
have
been
unable
to
obtain
guardian
consent,
putting
not
only
themselves
but
also
other
youth
and
staff
at
risk.
G
G
Thank
you,
we'll
we'll
go
ahead
and
pass
it
back
to
assembly
and
watch
your
woman
riding.
R
Thank
you
very
much,
mr
gafori
and
mr
jenkins
with
that
I'll
just
walk
you
briefly
through
the
language
of
the
bill
and
then
we'll
be
glad
to
take
any
questions
that
you
have.
A
I
have
one
and
it
if
I
was
better
at
reading
nrs.
I
could
answer
it
myself,
but
I've
never
been
able
to
really
master
that.
So
I'm
curious
about
the
definition
of
a
custodian,
and
so
I
don't
know
if
you
can
answer
that
assemblyman
wants
or
if
that
might
be
something
that
mr
robbins,
because
I
know
there's
a
link
in
the
bill,
but
the
language
isn't
there.
R
Thank
you
for
the
question
chair,
ratty
howard
watts,
for
the
record.
A
term
custodian
particularly
applies,
and
this
this
language
came
about
in
conversations
with
clark
county.
So
when
youth
enter
the.
R
State
and
local
government
systems.
They
are
technically
not
a
guardian
for
the
youth,
but
are
a
custodian,
and
so
that
is
the
the
definition
that
is
referenced
in
statute
and
the
goal
of
an
amendment
that
we
incorporated
in
the
assembly
was
to
just
include
every
type
of
relationship
between
a
child
and
their
caretaker.
R
I
I
R
Thank
you
for
the
question
senator
hardy
for
the
record
howard
watts.
R
A
legal
opinion
was
actually
requested
about
this
in
the
on
the
assembly
side
and
I
can
send
the
analysis
that
was
compiled
to
all
of
you,
since
I
don't
have
it
in
front
of
me
I'll
be
paraphrasing,
but
essentially
our
parental
notification
laws
that
are
currently
on
the
books
are
unconstitutional,
so
there
is
no
consent
requirement
currently,
so
this
bill
does
nothing
to
move
that
backwards
or
forwards
in
any
way,
as
you
noted,
the
bill
is,
is
silent
on
that
issue
and
again
part
of
it
has
to
do
with
the
fact
that
those
other
statutes
are
on
the
books
and
are
currently
unconstitutional.
A
H
Thank
you
manager,
so
someone
wants
I
just
if
there
were
a
requirement
for
the
emancipated
child
to
get
permission
from
their
parents,
how
easy
and
or
difficult
might
it
be,
and
I'm
thinking
about
the
testimony
that
mr
jenkins
gave
is,
is
it
feasible?
I
guess
that's
really
what
I'm
asking.
R
Thank
you
for
the
question.
Senator
spearman
howard
watts
for
the
record
and
I'd
actually
turn
it
over.
Probably
to
mr
gafori
to
speak
to
some
of
the
logistical
hurdles
that
youth
currently
face
and
we
didn't
touch
on
it.
It
is
pretty
clear
within
the
statute,
but
currently
all
that
we
have
is
a
requirement
that
an
unaccompanied
youth
must
be
homeless
for
four
months
in
order
to
access
care,
and
we
don't
provide
any
guidance
on
how
a
provider
would
make
that
determination
before
rendering
care.
R
So
the
whole
point
of
this
bill
is
to
a
take
away
that
time
barrier,
but
also
to
lay
out
a
very
clear
process
that
assists
both
service
providers
as
well
as
health
care
providers
and
making
sure
that
that
these
miners
can
get
access
to
the
care
that
they
need
and
with
that
I'd
turn
it
over
to
mr
gafori
to
speak
to
some
of
the
the
issues
that
unaccompanied
homeless
youth
have
in
gaining
parental
or
guardian
consent.
G
Thank
you
senator
for
the
question.
Thank
you
some
watts.
G
So
the
issue,
really,
I
mean,
there's
definitely
barriers
for
youth
experiencing
homelessness,
accessing
medical
care,
but
luckily,
with
this
law,
we're
introducing
a
third
party
verification
that
we've
already
used
since
since
it
was
allowed
in
2008,
as
well
as
public
schools
and
other
organizations
in
our
state
that
allow
us
to
easily
verify
two
medical
providers,
and
I
think
that's
really
where
the
issue
is,
is
that
even
when
unaccompanied
youth
are
experiencing
medical
situations
and
maybe
with
mphy
or
another
agency,
there's
still
very
much
a
difficulty
in
advocating
to
medical
providers
to
actually
have
them
honor
the
law
and
accept
the
law
and
treat
these
youth
and
often
medical
providers
are
afraid
to
do
so
for
fear
of
liability.
G
Therefore,
this
very
much
ap
197
very
much
cleans
this
up
by
having
a
clean
third
party
verification,
because
that's
usually
where
the
issue
lies
in
terms
of
youth
accessing
care
when
they're,
unaccompanied
and
homeless.
This
is
a
huge
problem,
which
is
why
we're
constantly
out
there,
with
the
community,
doing
outreach
trying
to
get
youth
connected
to
social
workers
case
managers
etc.
So
we
can
do
that
advocacy
and
get
them
that
psychosocial
well-being,
complete
holistic
health
overview
and
assessment
and
anything
that
we
can
do
to
help
them
connect
to
those
resources
as
well.
R
Some
have
been
kicked
out
of
their
homes
and
so
in
either
of
those
situations
even
for
the
most
basic
medical
care,
as
you
heard
at
asthma
treatment,
other
things
getting
in
contact
with
that
parent
in
order
to
get
them
to
sign
off
on
on
that
health
care
can
be
incredibly
difficult,
and
so
that's
why
we
need
to
have
a
clear
statutory
framework
that
allows
them
to
access
these
medical
services
without
obtaining
parental
consent.
First.
H
Thank
you,
and
I
was
asking
that
because
one
of
the
things
that
was
said
during
testimony
of
138,
it
mentioned
women
who
are
leaving
domestic
violence
situations,
and
I
know
that
there's
a
lot
of
work
being
done
around
children
being
molested
by
parents,
and
so
they
leave,
because
that's
what
happened
and
thinking
thinking
now
about
a
about
a
case
in
kentucky
where
an
uncle
was
molesting,
a
young
lady
and
she
was
trying
to
get
away.
She
wanted
to
tell
somebody
and
four
months
later
they
found
her
in
a
barn.
A
Thank
you
vice
chair,
any
additional
questions
from
the
committee
all
right
scene
we're
going
to
go
ahead
and
open
up
public
testimony
on
assembly
bill
197..
If
you'd
like
to
testify
in
support
of
assembly
bill
197,
please
make
your
way
to
the
dyess.
M
Good
afternoon
again,
chair
and
members
of
the
committee
for
the
record,
my
name
is
annette
magnus
and
I
am
the
executive
director
of
battleborn
progress.
We
are
in
full
support
of
ab197.
Youth.
Homelessness
is
a
crisis
we
have
to
deal
with
in
nevada.
Ab197
is
a
good
step
to
do
that,
making
it
easier
for
unaccompanied
homeless.
Youth
to
access
health
care
is
crucial
in
ensuring
their
health
and
safety,
especially
during
a
global
pandemic.
M
N
Next,
hello-
and
thank
you
again,
chair
and
committee
members-
this
is
nick
chipak
with
the
aclu
of
nevada.
I'll,
be
brief,
I
think
mr
jenkins
summed
it
up
pretty
well.
This
is
an
important
bill
as
someone
with
a
master's
degree
in
social
work.
It
is
a
pleasure
to
be
here
in
this
committee
and
hear
so
many
wonderful
bills.
We
need
to
do
everything
we
can
to
ensure
that
our
homeless
youth
have
access
to
all
the
things
they
need
to
succeed
and
health
care
is
right
there
on
the
bottom
rung.
N
A
J
J
J
P
P
P-A-M-E-L-A-G-I-R-G-I-S,
I
am
a
pediatric
nurse
practitioner
and
medical
provider
for
children's
health
funds
and
nevada
health,
center's
mobile
medical
ban
that
serves
homeless,
sex
trafficked
and
refugee
children
and
youth
in
las
vegas.
Since
2018,
our
team
has
been
providing
free
health
care
to
homeless,
youth
and
partnership
with
without
a
partnership
for
homeless
youth.
Many
of
the
homeless
youth
we
see
on
a
weekly
basis
are.
S
P
To
access
health
care
services
due
to
the
restrictions
and
wait
time
on
consent,
laws
for
homeless
youth,
in
particular,
I've
seen
many
homeless,
youth
unable
to
access
behavioral
and
mental
health
care
services.
Many
homeless
youth
have
depression
and
have
survived
multiple
traumas.
They
are
7.2
times
higher
risk
of
committing
suicide
restriction.
Access
to
care
increases
the
risk
of
suicide
and
potential
harm
to
these
youth.
With
current
restrictions,
these
are
also
often
unable
to
access
specialty
healthcare
services.
P
P
Another
example
is,
we
recently
had
a
homeless
youth
with
uncontrolled
type
1
diabetes.
He
was
in
desperate
need
of
referral
and
care
of
endocrinology
for
an
insulin
pump
and
better
control
and
titration
of
his
insulin
because
of
the
four
months
full
care
was
delayed
and
resulted
in
multiple
hospitalizations
for
this
youth
risky
life.
The
delay
also
risks
and
resulted
in
him
missing
work
in
school,
causing
him
to
lose
his
job.
Setting
him
further
back.
P
This
story
is
one
of
the
many
we
see
on
a
weekly
basis
of
how
restrictions
negatively
impact
the
health
and
livelihood
of
the
youth
we
care
for,
on
the
contrary,
by
being
able
to
provide
essential
health
care
services
weekly
to
homeless,
youth,
I've
seen
countless
stories
of
success
for
basic
health
care
services
to
treat
asthma,
depression,
diabetes
and
other
conditions
has
given
las
vegas
youth
hope
and
a
new
lease
on
life.
I
urge
you
to
consider
eliminating
the
four-month
wait
period
and
broadening
the
language
on
who
can
provide
care
for
homeless.
P
P
I
appreciate
your
time
and
thank
you
for
considering
giving
unaccompanied
homeless
youth
the
chance
for
health
success
and
life
by
eliminating
the
consent,
while
delay
and
barriers
to
all
health
services,
including,
but
not
limited
to
dental
mental
health
and
other
health
care
services,
your
consideration
can
be
life
or
death
to
the
many
homeless,
youth
of
las
vegas.
Thank
you
again
for
your
time.
P
J
J
K
E
And
welfare
policy
with
the
children's
advocacy
alliance,
the
children's
galaxy
alliance
stands
in
support
of
ab197.
We
believe
this
bill
is
essential
and
it
is
a
no-brainer
brain
or
legislation.
K
J
E
Good
afternoon,
chair
ratty
members
of
the
committee
for
the
record,
my
name
is
katie
ryan
k-a-t-I-e-r-y-a-n
and
I'm
the
system,
director
of
nevada
government
relations
for
dignity,
health,
st
rose
dominican
and
a
member
of
the
policy
council
on
homelessness
through
the
nevada
homeless
alliance.
I'm
here
today
to
voice
our
support
on
the
record
for
ab197
we're
glad
this
oversight
will
hopefully
be
remedied
by
the
passage
of
this
bill
and
wanted
to
thank
the
nevada
partnership
for
homeless,
youth
and
assemblyman
watts
for
advocating
on
this
important
issue.
Thank
you.
A
J
K
Thank
you
for
this
opportunity.
My
name
is
leanne
mcallister
l-e-a-n-n-m-c
capital
a-l-l-I-s-t-e-r.
I
am
the
executive
director
of
the
nevada
chapter
of
the
american
academy
of
pediatrics.
Today
I
offer
support
on
behalf
of
the
nevada
aap
in
favor
of
bill
ab197
homeless.
Youth
deserve
timely
access
to
health
care
to
get
and
stay
healthy.
The
nevada
aap
currently
has
more
than
260
members,
most
of
whom
are
board
certified
pediatricians.
K
Both
primary
and
specialty
care
members
also
include
pediatric
nurse
practitioners,
physician
assistants,
pediatric
residents
and
medical
students,
all
of
whom
live
and
work
in
nevada
and
have
dedicated
their
professional
lives,
the
health
of
all
children.
Our
chapter
members
are
available
to
nevada
legislators.
To
answer
any
questions
you
have
about
caring
for
homeless,
youth
or
any
health
concern
that
impacts,
children,
adolescents
and
young
adults
in
nevada.
A
J
K
Good
evening
taradium
members
of
the
committee
joanna
jacobs,
j-o-a-n-n-a-j-a-c-o-b,
I'm
clark
county
government
affairs
manager.
We
are
in
support
of
the
bill
as
amended.
I
want
to
thank
assemblyman
watts
and
mr
kaffori
for
the
work
that
we
did
together
in
the
assembly
on
the
amendment
and
clark
county
is
in
support
of
this
legislation
that
will
help
to,
as
the
previous
caller
said,
help
homeless,
youth
really
get
timely
access
to
health
care.
K
A
J
K
K
J-U-L-I-A-N-E-L-L-E
with
school
schoolhouse
connection,
I'm
very
pleased
to
have
the
opportunity
to
testify
in
support
of
ab197
this
evening.
Schoolhouse
connection
has
worked
on
bills
similar
to
ab197
in
a
number
of
states.
However,
I
don't
think
I've
ever
seen
a
bill
like
this.
That
strikes
such
a
sensitive
and
smart
balance
among
the
urgent
needs
of
youth,
the
rights
of
caring
parents
and
the
professional
needs
of
health
care
providers.
K
When
this
bill
becomes
law,
I
definitely
will
use
it
as
a
model.
In
my
work
in
other
states,
other
witnesses
have
described
the
crisis
of
youth
homelessness
in
nevada
and
the
extremely
serious
health
and
mental
health
risks
faced
by
homeless
youth.
I
just
would
like
to
speak
briefly
about
why
I
support
this
bill
so
strongly
from
a
technical
perspective.
K
K
Second,
it
allows
you
to
receive
care
from
a
variety
of
a
licensed
health
and
behavioral
health
care
providers
and
third,
it
creates
a
clear
objective
process
for
youth
to
prove
their
eligibility
so
that
only
those
youth
who
are
truly
intended
to
be
the
beneficiaries
of
this
law
can
actually
avail
themselves
of
it.
That
process
also
will
ensure
that
youth
who
are
still
living
with
their
parents
remain
subject
to
parental
consent
requirements.
K
I've
been
working
personally
on
minor
consent
issues
for
over
a
decade
and
I'm
not
aware
of
any
legal
issues
or
unintended
unintended
consequences
of
the
policy
in
ab9197
in
any
state.
On
the
contrary,
schools
and
service
providers
report
to
me
that
allowing
a
company
views
to
access
health
services
keeps
them
safe,
healthy
and
able
to
attend
school
and
work
so
that
they
can
end
their
homelessness.
K
Q
Q
I'm
I'm
testifying
today,
as
a
parent
and
a
parent's
heart
is
broken
every
time
a
child
is
in
need
and
our
homeless
youth
are,
they
need
to
have
access
to
medical
medical
medical
procedures
as
quickly
as
they
can,
but
I
would
just
encourage
the
the
committee
to
also
keep
in
mind
parental
rights,
and
that
is
that
is
my
only
concern
with
this
it
in
writing
this
and
just
the
general
parent.
Q
Are
they
going
to
be
impacted?
Is
the
child
that
has
a
loving
mom
and
dad
or
a
loving
parent
or
guardian
at
home?
Will
they
still
have
that
that
adult
that
loving
adult
involved,
and
so
that
is
my
only
concern,
and
I
just
have
to
say
what
challenging
decisions
you
all
have
to
make.
So
thank
you
for
being
here
and
thank
you
for
doing
it.
A
I
just
have
to
take
a
moment
of
indulgence
in
the
chair
and
hearing
these
issues,
and
support
and
opposition
in
this
committee
in
person
just
makes
it
feel
like
we're
getting
back
to
a
little
bit
of
normal.
So
for
what
that's
worth,
I
I
actually
appreciate
that
anybody
on
the
phone
who
would
like
to
testify
in
opposition.
J
J
B
My
name
is
mary,
fetchner,
f
e
c,
h,
n
e
r,
and
I
am
representing
myself-
and
I
am
speaking
in
opposition
only
because
I
am
concerned
about
the
issues
senator
hardy
brought
up
about
minor
children
who
do
not
have
a
parent
relationship
or
a
safe
relationship,
and
they
come
to
a
hospital
pregnant
and
want
to
request
an
abortion.
B
B
Situation
where
they
send
her
to
an
operating
room
because
she
has
requested
it.
That
is
my
concern
that
young
children
who
have
come
to
the
hospital
seeking
some
help
that
they
would
get
adult
help.
That
really
is
caring
for
their
mental
as
well
as
physical
situation,
and
that
they
would
have
caring
and
wise
counseling
available
to
them
prior
to
surgery.
J
J
J
J
E
A-L-E-X-I-S-T-U-C-E-Y,
deputy
administrator
with
the
division
of
child
and
family
services,
I'm
testifying
in
neutral
today
on
ab197,
but
would
definitely
like
to
express
gratitude
and
appreciation
for
the
sponsors
and
members
that
have
assisted
on
these
amendments
and
moving
this
forward
and
addressing
the
transitional
age.
Youth
population,
as
well
as
the
homeless
youth
population,
as
this
tends
to
be
a
very
challenging
population
to
serve
with
our
various
services.
So
again,
just
testifying
in
neutral
today
for
ab197
and
again
appreciate
everyone's
support
and
working
through
the
amendments.
Thank
you
so
much.
A
R
Thank
you,
chair
and
members
of
the
committee
again
for
the
record,
howard
watts.
Just
very
briefly
I'd
note,
a
few
things
one
I've
distributed
to
via
email
to
the
members
and
staff
of
the
committee,
the
legal
opinion
related
to
the
questions
that
were
brought
up
previously.
R
I
would
also
just
say
in
response
to
the
opposition.
First
of
all,
this
bill
is
very
narrowly
tailored
so
to
the
concept
that
youth
would
somehow
use
this
as
a
as
a
workaround
when
they
have
loving
supportive
parents
in
their
homes.
Actually,
the
current
statutory
language
that
we
have
is
more
broad
and
vague
about.
How
do
we
prove
that
somebody
has
been
unaccompanied
for
four
months
than
this,
and
so
I
would
just
direct
all
of
the
opposition
to
read
section
1,
subsection
2
of
the
bill.
R
I
know
that
you
all
did,
and
so
I
won't
do
the
walk
through,
but
it
is
very
clear
and
precise
in
laying
out
how
a
youth
would
demonstrate
this
and
the
service
providers
or
school
staff
that
are
particularly
assigned
to
homeless
youth,
who
would
help
them
access
this
care
without
consent,
and
then
the
last
thing
I'll
say
is
you
know
this
is
this
is
not
a
bill
about
abortion?
R
I
know
that
I
and
others
have
disagreements
about
that,
and
if
there
is
a
bill
that
wants
to
make
a
broad
parental
consent
law
that
is
constitutional,
then
that's
a
debate
that
we
can
have
separately.
This
is
about
ensuring
that
homeless,
youth
that
are
unaccompanied
in
this
state
can
get
access
to
the
care
that
we
need.
So
if
that's
something
that
you
believe
in,
I
would
urge
your
support
for
assembly
bill
197.
Thank
you.
A
R
Thank
you
very
much
again,
madam
chair
members
of
the
committee
for
the
record
howard
watts,
representing
assembly
district
15
in
clark
county,
I'm
glad
to
present
assembly
bill
399
for
your
consideration
today.
Hopefully,
on
a
lighter
note,
this
bill
seeks
to
ensure
that
eggs
produced
or
sold
in
the
state
of
nevada
meet
certain
standards
of
humane
treatment
for
laying
hens,
often
referred
to
as
cage-free
housing.
R
R
I
have
several
folks
joining
me
to
help
present
the
bill
and
I
believe
warren
hardy
will
help
m.c
the
presentation
we'll
try
and
keep
it
very
brief
for
you
out
of
respect
for
your
time
and
we'll
avoid
doing
a
walk,
a
section
by
section
walkthrough
of
the
bill,
as
somebody
who
tends
a
flock
of
six
hens
in
my
own
backyard,
the
well-being
of
chickens
is,
is
important
to
me
personally,
and
it's
also
crucial
for
the
health
men,
both
mental
and
physical,
of
laying
hands
that
they
have
enough
space
to
move
that
they
have
appropriate
nest,
boxes,
scratching
areas,
bathing
areas
and
access
to
perches.
R
Unfortunately,
for
decades,
we
increasingly
moved
to
an
industrial
model
that
put
efficiency
first,
resulting
in
some
pretty
horrific
conditions
in
certain
facilities
with
battery
cages
in
these
facilities,
chickens
spend
their
entire
lives,
confined
to
a
space
with
a
floor
that
is
smaller
than
a
piece
of
letter-sized
paper.
However,
more
and
more
consumers
are
demanding
that
their
products
be
raised
more
humanely
and
large
food
buyers,
such
as
restaurant
and
grocery
store
chains,
and
even
major
gaming
companies
have
pledged
to
use
exclusively
cage-free
eggs.
R
In
brief,
ab-9399
requires
that
eggs
sold
offered
for
sale
or
transported
for
the
purpose
of
selling
within
nevada
be
produced
in
a
cage-free
housing
system.
It
does
this,
by
having
the
farm
owner
operator,
go
through
a
cage-free
certification
through
our
state
department
of
agriculture
as
part
of
their
existing
inspection
processes,
it
does
not
increase
fees
or
expand.
The
number
of
farms
that
need
to
be
certified
and
with
the
proposed
amendment
makes
it
clear
that
our
local
small
producers,
which
basically
already
meet
cage-free
standards
anyway,
are
exempt
from
the
provisions
of
this
bill.
O
O
This
is
one
of
those
I
I
call
it
a
happy
occasion
when
we've
been
able
to
get
the
animal
welfare
advocates
and
the
industry
themselves
together
to
move
forward
in
a
positive
direction.
That's
what
this
legislation
is.
It's
a
collaborative
effort
between
the
humane
societies
of
the
united
states
and
those
who
provide
egg
production
for
the
state
of
nevada.
O
Since
the
assembly
hearing,
we
had
some
concerns
raised
at
that
hearing
about
the
from
the
retail
association,
the
chamber
of
commerce
and
about
our
restaurant
association
regarding
the
the
need
for
a
phase-in
approach
that
was
adopted
in
the
event
that
is
adopted
in
the
amendment
before
you,
and
I
believe,
with
that
amendment,
we've
been
able
to
address
the
concerns
and
gain
the
support
of
those
organizations,
also
had
some
conversations
with
the
cattlemen's
association
and
the
farm
bureau,
nevada
farm
bureau
relative
to
the
small
hen
farms,
as
assemblyman
watts
indicated.
O
Those
are
all
essentially
what
we
would
define
as
free-range
chickens
anyway,
but
just
to
provide
some
additional
clarity.
We've
adopted
an
amendment
that
makes
the
provisions
of
this
bill
not
apply
to
any
farm
with
hens
with
less
than
3
000
hands,
so
that
should
take
care
of
all
of
our
small
producers
in
the
state
of
nevada
that
provide
eggs
at
county
fairs
and
that
farmers,
markets
and
those
sorts
of
things.
So
I
would
just
say
I'm
sure
I
don't
want
in
the
interest
of
brevity.
O
I
would
just
say
this
is,
as
I
said,
one
of
those
happy
occasions
when
the
industry
and
the
advocates
for
animals
have
been
able
to
get
together
and
what
we
think
is
a
very
solid
piece
of
legislation
and
with
that
I'll
I'll
turn
it
over.
If
it's
okay,
madam
chair,
to
jeff
dixon
from
the
humane
society
of
the
united
states,
and
then
we've
got
two
representatives
of
the
the
egg
producing
industry
here
and
then
we'll
be
happy
to
have
it
happy
to
open
it
to
questions.
O
Thank
you,
warren
am
I
on.
O
Okay,
thank
you,
madam
chair
vice
chair
members
of
the
committee.
I
am
jeff
dixon,
I'm
the
nevada
state
director
for
the
humane
society
of
the
united
states,
and
I
thank
you
for
the
opportunity
to
speak
in
support
of
ab399.
O
As
the
sponsor
said,
ab
399
is
the
result
of
nevada's
egg
suppliers
and
humane
advocates
coming
together
for
a
more
economically
viable
and
humane
future.
I
mean
in
particular
we
at
the
hsus
would
like
to
thank
jerry,
wilkins
and
jerry
wilkins
and
jim
van
gorkum,
who
will
be
speaking
after
me
and
the
other
egg
suppliers
for
being
such
terrific
partners.
In
this
effort,
millions
of
egg-laying
chickens
in
the
u.s
are
confined
in
cages,
the
industry
terms
as
battery
cages.
O
In
those
cages,
each
chicken
is
provided
with
roughly
67
square
inches
of
floor
space
to
live
her
entire
life.
That
is
smaller
than
the
dimensions
of
a
sheet
of
paper.
If
you
want
to
look
at
the
bill
that
this
is
printed
on
or
the
paper
that
is
printed
on,
that's
what
a
chicken
has
to
stand
on
for
her
entire
life
ab399
will
get
these
egg
laying
chickens
out
of
these
barren
wire
cages
and
into
cage-free
systems
improving
their
lives
by
providing
freedom
of
movement.
O
What
that
means,
they'll
have
key
enrichments
for
the
birds
that
include
perches
dust
bathing
and
scratching
areas
and
nest
boxes
to
the
egg
suppliers
credit
due
to
public
concern
for
animal
welfare.
Food
companies
demand
for
cage-free
products
and
legislative
momentum
around
the
u.s.
They
believe
that
the
future
of
the
egg
industry
is
cage
free
and
we
agree
more
than
200
of
the
world's
top
grocery
fast
food
and
restaurant
chains
are
switching
to
100.
O
O
Finally,
the
the
cage-free
standard
in
this
bill
promotes
food
safety
because
it
reduces
the
risk
for
zoonotic
disease
transmission
by
providing
requirements
for
a
minimum
stocking
density,
meaning
the
birds
simply
have
more
room
and
when
they're
confined
that's
what
leads
to
health
issues
as
well
nest
boxes
for
hens
to
lay
their
eggs,
so
the
eggs
aren't
laid
on
the
ground
which
substantially
increases
food
safety
risks.
So
with
that,
thank
you
for
considering
this
farmer
in
animal
friendly
legislation
and
I'll
pass
it
on
to
not
sure
which,
but
jim
or
jerry,
but
yeah.
F
J-I-M-V-A-N-G-O-R-K-O-M,
I'm
vice
president
of
new
cal
foods
and
agricultural
cooperative
of
family
egg
farmers.
These
families
that
I
represent
are
all
multi-generation
farmers
and
they
have
supplied
fresh
shell
eggs
to
nevada
for
decades
from
their
farms
in
california
and
utah.
I'd
first
like
to
thank
the
senate
health
and
services
committee.
Human
services.
Excuse
me
as
well
as
if
someone
walks
for
your
interest
in
this
bill,
so
consumers,
businesses,
animal
advocacy
groups
and
egg
farmers
all
value
the
importance
of
treating
animals
well
as
egg
farmers.
F
Consumer
sentiment
shows
very
strong
support
for
this,
as
seen
in
nevada
polling
nearby
ballot
initiatives
and
double-digit
annual
sales,
growth,
nevada,
grocers
and
businesses
such
as
smith,
starbucks
and
hilton,
just
to
name
a
few
have
committed
to
using
only
cage-free
eggs
as
the
minimum
standard,
some
now
and
others
soon.
So
ab-399
continues
to
offer
consumer
choice.
There
are
and
will
be
many
types
of
eggs
available
on
grocery
store
shelves
and
to
restaurants.
F
F
It
falls
under
the
current
procedures
and
practices
of
the
nevada
department
of
agriculture,
as
it
is
limited
to
the
commercial
egg
laying
industry
it
has
no
reach
into
other
animal
species,
and,
with
the
amendment
discussed
today,
it
does
not
affect
nevada's
small
egg
farms
or
backyard
flux,
so
the
egg
industry
in
total
is
shifting
towards
cage-free
operations
to
meet
the
demands
of
nevadans
other
western
states
and
much
of
the
nation.
So
this
legislation
brings
nevada
into
alignment
with
where
the
marketplace
is
moving.
F
It
also
aligns
nevada
with
states
throughout
the
region
that
already
have
nearly
identical
standards
in
place
and
those
were
listed
previously.
So,
with
these
nearby
states
enacting
similar
requirements,
it's
important
that
we
have
consistency
on
a
regional
basis,
rather
than
be
forced
to
comply
with
multiple
standards
across
state
lines.
F
These
cage-free
requirements
that
are
proposed
in
this
bill
are
standards.
The
egg
industry
has
already
endorsed
as
best
practices
to
produce
cage-free
eggs
and
in
a
manner
which
we
can
meet
the
shared
goals
of
giving
hands,
the
ability
to
exhibit
natural
behaviors
and
also
the
economic
viability
of
large-scale
egg
production.
F
So
passage
of
ab399
will
provide
clarity
and
certainty
for
these
nearby
farms
that
supply
fresh
eggs
to
nevada.
It
addresses
the
valid
concern
for
the
humane
treatment
of
animals
is
responsive
to
the
desire
of
the
marketplace
for
cage-free
eggs
and
the
egg
farmers
of
our
agricultural
cooperative
believe
this
bill
is
good
for
egg
farmers,
animal
agriculture
and
nevadans
and
support
ab399.
S
Good
afternoon,
madame
charity
and
committee
members,
my
name
is
jerry:
wilkins,
j
e
r,
r
y
I
and
I'm
the
sales
and
marketing
director
for
morningfresh
farms,
a
colorado
family,
owned
egg
farm.
We
produce
farm,
fresh
eggs
that
are
distributed
throughout
the
western
united
states,
including
nevada
committee.
You
may
ask
why
so-called
out-of-state
interests
are
supporting
ab399
to
be
clear.
There
are
no
commercial
egg
producers
in
the
state,
so
nevada
businesses
must
source
eggs
from
many
regional
farms,
such
as
morning
fresh
farms.
S
S
Although
our
family
farm
believes
in
free
markets,
there
are
multiple
reasons
why
ab-399
is
necessary,
as
k-tree
becomes
the
norm
first
to
create
a
more
stable
egg
supply.
This
legislation
creates
one
statewide
standard.
In
fact,
this
will
help
create
a
level
playing
field
with
one
regional
standard
for
undisrupted,
interstate
commerce,
in
the
southwest
keeping
production
and
distribution
costs
in
line
and
eggs
affordable.
S
S
In
conclusion,
this
bill
offers
a
balance
between
prudent,
science-based
animal
husbandry
standards
and
the
cost-effective
commercial
production
and
sale
of
fresh
eggs
in
nevada.
This
is
why
our
family
farm
supports
ab399,
as
amended
and
respectfully
asked
that
the
senate
health
and
humane
human
services
committee
for
the
same
consideration.
Thank
you.
Madam
chair
and
committee.
A
A
A
I
have
questions
so
my
first
question
is:
there's
no
fiscal
note,
which
would
then
imply
that
there's
no
significant
increase
in
the
need
for
inspections
or
anything
along
those
lines,
and
so
how
do
we
know?
I
mean
I
read
the
bill
and
it
shows
that
there
there's
the
opportunity
for
attestation
and
some
inspection.
A
R
Thank
you
for
the
question
chair,
ratty,
howard
watts,
for
the
record,
and
we
may
have
the
department
of
agriculture
available
to
testify
in
neutral,
I'm
not
sure.
If
they're
they're
joining
for
this
particular
hearing,
we
worked
with
the
department
in
crafting
the
bill
and
essentially
what
it
does.
R
Is
it
integrates
this
into
existing
procedures
that
our
state
department
of
agriculture
already
has
to
guarantee
food
safety,
including
particularly
for
eggs,
so
whether
the
producer
is
physically
located
here
in
nevada
or
is
bringing
products
into
the
state,
they
already
have
a
procedure
laid
out,
and
so
ab399
essentially
adds
a
layer
into
this.
It's
it's
now
considered
an
endorsement
as
part
of
their
certification
that
the
the
the
production
of
those
eggs
is
cage
free.
A
And
so
I
think,
the
testimony
that
we
heard
is
we
really
don't
have
any
in-state
producers,
so
that
would
make
sense.
Why
not
a
lot
of
fiscal
note
for
our
state?
But
how
does
that
interstate
commerce
piece
work
and
how
are
we
knowing
that
eggs
that
are
coming
really
from
anywhere
in
the
country
meet
these
standards.
R
R
So
the
the
bill
was
designed
to
work
in
the
existing
process
that
the
department
of
ag
already
has
so
that
it's
just
an
additional
kind
of
check
mark
and
that's
why
it
doesn't
create
any
additional
fiscal
cost,
because
it
can
be
integrated
into
the
existing
workflow
with
an
existing
number
of
certifications
that
are
happening
on
an
annual
basis.
F
Here
randy,
this
is
jim
van
gorkum
for
the
record.
There
are
multiple
certifying
agencies
across
the
country
that
are
currently
used
by
egg
producers.
There
are
we
have
customers
that
require
different
types
of
audits,
so
the
the
processes
are
already
in
place.
For
example,
one
organization
called
humane
farm
animal
care.
They
they
certify
farms.
So
that's
just
one
of
many
organizations
that
exist
within
the
egg
industry
today,
specifically
for
this
purpose
of
an
audit
trail
and
verification
and
process
verification.
F
A
Okay-
and
I
think
that
leads
to
my
next
question-
which
is
a
lot
of
that
work
has
been
done
around
labeling
and
public
education,
and
so
are
those
the
same
third
party
certification
bodies
that
are
leading
to
the
ability
for
an
egg
producer
to
put
a
logo
on
their
box.
That
says
this
is
pasture
raised,
or
this
is
organic,
or
this
is
cage
free
and
does
this
bill
align
with
those
current
labeling
standards.
F
F
There
are
usda
definitions
for
most
of
these
egg
types.
I
think
I'll
accept
the
word
natural,
which
is
pretty
vague,
so
these
certifying
companies
and
applicable
logos
which
are
optional
other
than
the
usda's
organic
circle
could
be
again
a
way
for
a
consumer
or
business
to
see
on
the
package
that
it
meets
these
standards.
H
R
Thank
you
for
the
question
senator
vice
chair,
spearman,
howard
watts,
for
the
record.
I
I
need
to
double
check,
or
perhaps
legal
can
advise
what
the
penalties
that
are
referenced
in
that
particular
chapter
are
as
it's
in
chapter
583.
R
A
Well,
we
haven't
thrown
mr
robbins
a
ball
for
a
while.
So
mr
robbins,
you
want
to
help
us
out.
R
Sure
so,
according
to
nrs
583.,
which
is
a
civil
penalty
statute,
reference
in
the
bill,
first
violation
penalty
would
be
250.
Second,
violation
penalty
would
be
500
and
each
subsequent
violation
would
be
one
thousand
dollars.
R
Thank
you
for
the
question
vice
chair,
howard
watts,
for
the
record.
Yes,
I
do
we,
we
brought
some
up
when
we
came
up
here
for
the
legislative
session
and
actually
hoping
to
get
some
some
more
from
my
my
backyard
flock.
So
I
am
lucky
not
to
I
pay
for
chicken
food
instead
of
eggs
these
days,
but
hopefully
everyone
will
be
able
to
to
access
these
higher
quality
eggs
when
we
pass
this
bill.
A
N
Hello
and
thank
you
one
last
time
my
name
is
nick
shibak.
I
am
a
now
a
constituent
from
senate
district
13..
The
aclu
does
not
take
a
position
on
this
bill.
However,
my
big
boss,
my
partner
at
home,
does-
and
so
I
am
here
on
behalf
of
the
both
of
us-
to
say
that
as
egg
lovers
and
members
of
this
fine
state,
knowing
that
our
eggs
will
always
be
cage
free
is
something
we
look
very
forward
to,
and
we
urge
you
to
pass
this
bill
for
all
chickens
and
all
people.
A
J
E
E
A
Thank
you,
mr
busselman,
for
that
testimony
and
I'm
going
to
just
use
you
as
a
little
bit
of
an
example.
So
I
apologize
for
that,
but
in
the
senate,
and
particularly
in
this
committee,
we
do
not
have
that
rule
folks.
Actually
for
some
reason,
the
word
got
out
this
session
that
that
rule
exists,
but
you
can
testify
in
whatever
lane
you
feel
like.
You
are
most
authentically
in
in
terms
of
your
position
on
this
bill.
A
So
would
you
like
to
be
listed
under
opposition,
or
would
you
like
to
be
listed
under
support,
given
the
amendment.
A
Okay,
great,
thank
you
all
right
and
I'll.
Just
use
that
to
spread
the
word
to
folks,
people
tie
themselves
in
nuts
and
pretzels
trying
to
get
into
the
right
place
and
in
this
committee
we
really
just
want
to
know
where
you
stand
on
the
bill.
So
thank
you.
Thank.
I
A
All
right
so
with
that
anybody
else
who
would
like
to
testify
in
opposition.
J
E
Good
evening,
chair
members
of
the
committee,
my
name
is
alexandria,
dazlich
d-a-z-l-I-c-h
and
I'm
the
director
of
government
affairs
for
the
nevada
restaurant
association,
the
nevada
restaurant
association
is
here
today
in
neutral
to
av
399
with
concerns.
We
appreciate
the
intent
behind
the
bill
and
understand
that
the
industry
is
moving
in
the
direction
of
greater
access
to
cage-free
eggs.
However,
we
are
concerned
about
the
precedent
it
sets
in
mandating
consumer
choice,
as
well
as
increasing
the
price
of
a
staple
food.
E
As
you're
aware,
the
restaurant
industry
has
been
greatly
devastated
by
the
pandemic
and
will
need
time
to
recover
as
we
continue
to
operate
at
limited
capacity.
Therefore,
instituting
this
level
of
change
in
the
distribution
and
supply
chain
of
a
staple
food
will
likely
have
negative
effects
on
our
members.
We
appreciate
your
time.
A
F
The
these
fatty
acids
can
be
added
to
the
chicken
feed
and
the
hen's
body
absorbs
that
and
passes
along
a
certain
amount
of
it
into
the
egg
itself.
So
where
you
do
see
an
egg
listed
with
an
omega-3
enhancement,
it
should
also
tell
you
a
numerical
value.
So,
yes,
it
is
a
real
thing.
F
Chair
ready,
jim
van
gaal
for
the
record,
they
are
not
exclusive,
because
even
a
pasture-raised
egg
is
still
given
milled
feed,
regular
chicken
feed
to
supplement
its
natural
grass
diet,
so
whether
it's
a
cage-free
egg
or
an
organic
or
pasture-raised.
Theoretically,
this
omega
additive
could
be
added
to
the
feed
of
any
of
those.
R
Thank
you
very
much,
madam
chair
members
of
the
committee
for
your
time
and
attention.
Thank
you
chair
for
your
excellent
questions,
and
I
would
just
note
you
know
in
relation
to
some
of
the
concerns
that
were
expressed,
that
I
just
want
to
reiterate
the
fact
that
many
major
restaurant
chains
are
already
moving
in
this
direction.
R
Major
gaming
companies
based
right
here
in
the
state
of
nevada,
have
already
made
this
commitment,
and
in
listening
to
those
stakeholders,
we
did
create
a
longer
phase-in
timeline,
so
that
allows
both
the
producers,
as
well
as
those
that
are
obtaining
eggs,
especially
in
those
commercial
enterprises
to
to
do
this
in
a
way
that
works
and
is
doesn't
create
any
pain
points.
So
again,
I
thank
you
all
for
your
time
and
urge
your
support
for
ab399.
Thank
you.
A
Thank
you,
assemblyman
watts,
miss
mallet,
make
sure
that
you
put
that
as
excellent
in
the
minutes
and,
let's
see
if
we
can
get
that
through
the
proofreaders,
all
right
that
closes
the
hearing
on
ab399.
A
We
have
one
more
additional
item
of
business
we
received.
While
we
were
in
this
hearing,
another
bdr
that
needs
to
be
introduced.
This
is
bdr40101
40-1107.
A
It
is
an
act
relating
to
public
health,
creating
the
public
health
resource
office
within
the
division
of
public
and
behavioral
health
of
the
department
of
health
and
human
services,
providing
for
the
appointment
of
the
public
health
resource
officer,
prescribing
the
duties
of
the
office
and
providing
other
matters
properly
relating
there
to.
I
need
a
motion
from
the
committee
to
introduce
the
bill
motion
from
senator
spearman.
Second
from
senator
harris.
A
Any
discussion,
as
always
a
vote
to
introduce,
is
not
necessarily
an
indication
of
how
you
will
land
on
the
bill
once
it
is
heard
with
that.
Any
discussion
see
none
all
those
in
favor
signify
by
saying
aye
aye.
Any
opposed
motion
passes
unanimously
with
that
just
one
last
item
of
business:
let's
go
ahead
and
open
up
public
public
comment.
Anybody
in
here
like
to
make
public
comment:
okay,
we'll
go
to
the
phone
lines
bps.
Do
we
have
anybody
who'd
like
to
make
public
comment.
J
J
A
A
Our
next
meeting
is
scheduled
for
thursday
april
29th
and
once
again,
we're
going
to
be
efficient
but
productive
with
our
time.
They'll
be
hearing
five
bills,
ab-177
ab-178,
ab-181,
ab-228
and
ab-345,
and
we
also
intend
to
have
a
work
session
so
we'll
get
that
agenda
posted.
So
you
know
it's
coming
with
that.
We
are
adjourned.
Thank
you.
Everyone,
thanks
to
staff
bps
everybody
here
today.
You
guys
all
have
a
good.