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From YouTube: 4/1/2021 - Senate Committee on Health and Human Services
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A
by
way
of
roll
call,
I
see
that
senator
harris,
senator
key
keffer
and
senator
hardy
are
here
along
with
myself
senator
reddy,
and
I
would
like
to
know
for
the
record
that
senator
spearman
is
excused
if
you're
following
along
and
want
to
know
how
to
participate.
Please,
google,
nevada
legislature
get
on
the
website,
there's
a
help,
tab
and
there's
all
the
different
ways
that
you
can
participate
in
this
hearing,
using
our
opinion
poll
sending
an
email
to
the
us
to
the
committee
to
have
it
part
of
the
record
or
registering
to
testify.
A
Today
we
are
going
to
go
in
order
with
the
exception
that
some
of
our
members
may
need
to
leave
to
present
in
other
committees,
and
so,
if
the
sponsor
that
I
need
isn't
here
when
their
bill
comes
up,
we'll
just
go
on
to
the
next
one
and
then
we'll
catch
them
when
they
come
back.
So
that
means
that
we
are
going
to
start
with
sb
275.
So
I'm
going
to
go
ahead
and
open
up
the
hearing
on
sb
275
and
invite
senator
harris
to
the
virtual
dies.
B
B
C
Thank
you,
chair,
ready
and
members
of
the
health
and
human
services
committee
good
afternoon
for
the
record,
I'm
david
parks.
During
the
80th
session
of
the
legislature.
I
was
successful
in
getting
past
senate
bill
284,
which
created
a
task
force
to
examine
and
make
recommendations
for
the
revision
of
existing
statutes
related
to
the
criminalization
of
hiv
and
aids.
These
statutes,
taken
under
review,
grew
out
of
recommendations
from
an
advisory
task
force
created
by
former
governor
richard
bryan
some
35
years
ago,
in
1986.
C
over
the
30
years
that
the
task
force
was
in
place.
I
was
a
member
of
that
task
force
during
the
early
years
of
hiv
infection
and
the
aids
epidemic
states,
including
nevada,
implemented
hiv
specific
criminal
exposure
laws.
These
laws
impose
criminal
penalties
on
people
living
with
hiv
knew
of
their
hiv
status
and
who
potentially
exposed
others
to
hiv
1990.
C
C
C
The
majority
of
these
laws
were
passed
before
antiretroviral
therapies
were
developed,
that
reduced
hiv
transmission
risk
to
zero.
Currently,
it's
possible
to
be
hiv
positive
and
have
no
detectable
presence
of
the
virus
as
a
person
who
helped
develop
nevada's
hiv
aids
statutes
and
regulations
in
the
late
1980s
early
1990s.
C
Over
the
years,
we
found
that
criminalization
laws
do
not
support
evidence-based
public
health
practices
reaching
those
that
are
at
high
risk
of
hiv
for
hiv
and
aids.
Data
indicated
people
that
are
at
high
risk.
C
At
a
high
risk
for
hiv
exposure
are
deterred
from
testing
which
facilitates
hiv
care
and
prevention
methods
that
will
stop.
The
transmission
of
hiv
here
are
being
charged
with
life-altering
felony
charges
prosecuted
for
living
with
hiv
and
not
disclosing
their
status,
injuries,
both
testing
and
seeking
out
care
with
the
passage
of
senate
bill
284
last
session,
a
coalition
of
social
service
and
health
care
professionals
from
across
the
state
and
nation
work
diligently
to
address
this
issue
and
develop
recommendations
for
consideration
by
the
legislature
in
senate
bill
275.
C
C
A
Good
afternoon
senator
parks,
it
is
beyond
good
to
see
your
face
and
to
have
you
here
today.
Thank
you
for
being
here.
Thank
you.
B
And
chair
ready
at
this
time,
with
your
permission,
I'd
like
to
turn
it
over
to
my
to
the
chair
of
the
hiv
modernization
task
force,
andre
wade
for
some
brief
remarks
and
emphasis
on
brief.
D
D
Equality,
nevada,
based
statewide,
lgbtq,
civil
rights
organization,
which
brings
the
voices
of
lgbtq
people
and
allies
to
the
institutions
of
power
in
nevada
and
across
the
united
states,
striving
to
create
a
world
that
is
healthy,
just
and
fully
equal
for
all
lgbtq
plus
people,
as
senator
harris
mentioned,
I'm
also
chair
of
the
governor's
task
force
and
hiv
modernization,
and
today,
I'm
speaking
on
behalf
of
service
data
quality,
as
senator
parks
mentioned
for
decades
now,
we've
had
laws
on
the
books
that
are
outdated,
ineffective
and
discriminatory,
and
they
do
more
harm
than
good.
D
So,
while
efforts
are
underway
to
end
the
hiv
epidemic
by
in
part,
developing
statewide
and
local
plans
to
address
people
getting
tested
to
know
their
status,
getting
people
in
care
and
to
stay
in
care,
these
plans
also
include
modernizing
our
laws
that
criminalize
otherwise
legal
behavior
or
increase
penalties
for
criminal
behavior
based
on
a
person's
hiv
status.
These
laws
stigmatize
people
living
with
hiv
and
go
against
the
very
public
health
efforts
to
end
the
hiv
epidemic
that
has
been
put
in
place
by
specifically
calling
out
hiv
in
the
law
when
other
chemical
diseases
are
not.
D
Moreover,
this
issue
at
hand
is
to
simply
treat
hiv
like
any
other
clinical
disease
and
not
require
students
enhancements.
This
effort
is
supported
by
the
u.s
center
for
disease
control,
the
national
institute
of
health
and
the
american
medical
association
and
the
u.s
office
of
infectious
disease
and
hiv
aids
policy.
Hiv
is
a
public
health
issue,
not
a
criminal
one.
Our
law
should
reflect
that.
Thank
you
in
advance
for
your
support
for
this
very
important
piece
of
legislation,
and
this
ends
my
remarks.
Thank
you
very
much.
B
Harris
and
with
your
further
very
very
short
indulgence,
I'd
like
to
turn
it
over
to
mrs
mr
cisneros
from
the
williams
institute
just
for
some
factual
data
that
I
think
would
be
helpful
for
the
committee.
E
E
E
We
count
76
individual
hiv-related
charges
across
67
arrest
cycles.
This
is
broadly
in
line
with
the
per
capita
rate
we've
seen
in
other
states,
and
it's
dozens
more
than
we
are
able
to
observe
in
either
press
reports
or
public
court
documents.
What
are
people
being
arrested
for
about?
Two-Thirds
of
those
individual
charges
are
for
sex
work
related
charges,
so
this
is
solicitation
or
engaging
in
prostitution
after
an
hiv.
A
positive
hiv
test,
the
other
third
are
for
what's
labeled
intentional
transmission
of
hiv,
either
intentional
transmission
attempted
or
conspiracy.
E
E
we
see
a
similar
trend
for
transmission
or
attempted
transmission,
in
fact
more
after
the
year
2013..
So
that's
the
time
trend.
E
Arrested
as
we
see
in
other
states,
the
data
revealed
that
hiv
crimes
disproportionately
impact
people
of
color
over
half
of
those
arrested
for
hiv
crimes
in
nevada
are
black.
However,
black
nevadans
make
up
just
nine
percent
of
the
state's
population
and
27
percent
of
nevada's
population
of
people
living
with
hiv.
E
E
What
about
outcomes?
We
see
that
30
of
all
charges
resulted
in
a
guilty
outcome
that
is
either
guilty
at
trial
or
the
individual
pled
guilty
again.
There's
a
racial
imbalance
in
these
guilty
outcomes.
The
overwhelming
majority
of
those
found
guilty
for
sex
work-related
crimes
are
black.
In
contrast,
all
of
the
individuals
found
guilty
of
transmission
related
crimes
worldwide
and
I'll
stop
there.
Thank
you.
B
Thank
you
so
much
and
chair
ready
at
this
time.
I
am
ready
to
do
a
section
by
section
summary,
but
if
you'd
like
to
just
jump
to
questions,
I'm
okay
with
that
as
well
up
to
you
chair.
A
B
B
One
two
and
five
require
orders
issued
by
state
and
local
health
authorities
requiring
a
person
to
undergo
medical
examination
to
verify
presence
of
a
communicable
disease
or
ordering
isolation,
quarantine
or
treatment
due
to
the
presence
of
exposure
to
such
a
disease,
to
also
state
the
reasons
that
the
action
prescribed
by
the
order
are
the
least
restrictive
course
necessary
to
prevent,
suppress
or
control
the
communicable
disease
section
for
the
length
of
the
of
the
section
4
language
proposed
to
be
added
to
441.8.040
in
the
original
bill
was
stricken
by
the
conceptual
amendment.
B
Section
three
sets
forth
legislative
findings
that
the
spread
of
communicable
disease
is
best
addressed
through
public
health
measures.
Not
criminalization
section
four
provides
an
exemption
for
creating
an
affirmative
defense
to
a
charge
under
441a
dot.
180.
B
Let's
see
section
6
also
states
how
to
determine
whether
a
person
acted
intentionally
under
subsection,
4,
section
24
of
the
bill.
This
is
a
biggie
for
us
repeals
a
provision
of
existing
law
that
makes
it
a
category
b,
felony
for
a
person,
who's
tested,
positive
for
hiv
to
intentionally,
knowingly
or
willfully,
engage
in
conduct,
and
then
that
would
refer
you
back
to
section
six,
where
they
would
instead
be
guilty
of
a
misdemeanor
section.
Seven
revises
conditions
under
which
a
court
may
order
a
person
to
be
tested
for
communicable
disease.
B
Section
seven
requires
court
to
determine
whether
it's
necessary
to
test
the
other
person
to
determine
the
appropriate
treatment
for
a
first
responder
county
coroner
or
medical
examiner,
section,
11
deals
with
alleged
victims
or
witness
to
a
crime
that
alleges
the
crime
involved.
Sexual
penetration
of
the
victim's
body.
The
health
authority
must
offer
to
test
the
person
for
carbon
sexually
transmitted
diseases,
section
seven
or
I'm
sorry.
B
17
requires
the
legislative
council
to
the
extent
practicable
to
ensure
that
people
living
with
hiv
are
referred
to
in
the
nevada,
revised
statutes
using
language,
that's
commonly
viewed
as
respectful,
and
that
refers
to
the
person
before
referring
to
the
disorder.
Section
18
clarifies
that
it's
the
policy
of
the
states
use
similar
practices
in
the
nevada.
B
Administrative
code
sections
8
9
11
through
14,
16
and
19-21,
revised
terminology
referring
to
hiv
other
communicable
diseases
and
other
related
issues,
section
24
repeals
existing
laws
that
require
a
person
arrested
for
prostitution
or
solicitation
for
prostitution
and
each
offender
in
the
custody
of
department
of
corrections
to
be
tested
for
hiv.
B
We've
repealed
the
the
provision
of
law
that
makes
a
category
b
felony
to
engage
in
prostitution
after
testing
positive
for
hiv
and
also
repealed
the
section
that
requires
the
director
of
the
department
of
corrections
to
establish
an
educational
program
related
to
hiv
for
inmates
and
employees
of
the
department.
B
Sections
10
and
15
make
informing
changes
to
remove
references
to
those
were
field
sections
and
section
22
of
the
bill.
Reestablishes
the
advisory
task
force
on
hiv
exposure,
modernization
from
the
2021-2022
interim,
which
again
was
originally
created
by
senate
bill
284
of
the
2019
legislative
session.
So,
as
you
can
see,
this
bill,
chair,
ratty,
is
extremely
comprehensive
and
truly
is
a
bill
that
seeks
to
modernize
our
hiv
laws
across
the
board.
G
Thank
you,
madam
chair,
so
I'm
going
to
try
to
summarize
what
I
think
I
heard
if
a
person
is
knows
himself
herself
to
be
hiv
positive
and
has
sex
or
shares
a
needle
with
somebody.
G
They
are
now
guilty
of
a
misdemeanor
and
not
a
felony.
Is
that
what
I
heard.
B
Senator
hardy
to
you
through
through
chair
ratty,
you
know
it
would,
it
would
depend
if
the
the
sharing
of
the
needle
is
a
kind
of
consensual
choice,
and
the
other
person
knows
that
that
person
has
hiv
and
chooses
to
engage
in
that
behavior,
whether
it
be
sex
or
or
sharing
a
needle,
then
they
would
not
be
guilty
of
the
misdemeanor
either.
B
I
think
it's
important
to
note
here
and-
and
you
know
I
can
kind
of
hear
this
in
the
basis
of
your
question.
Hiv
is
the
only
was
hopefully
after
passage
of
this
bill,
the
only
communicable
disease
where
that
felony
would
have
been
attached.
G
So
you
glossed
over
one
of
the
things,
so
the
person
who
knows
that
they
have
hiv
and
has
sex
with
somebody
is
now
potentially
guilty
of
a
misdemeanor,
not
a
felony.
B
To
you
senator
hardy
through
chair
ready,
you
are
correct
again.
I
just
wanted
to
note.
There
is
a
an
affirmative
defense
that
I
think
is
is
fairly
important,
that
if
those
relations
were
consensual,
they
would
not
be
guilty
of
the
misdemeanor.
G
G
B
In
your
scenario,
senator
hardy
dallas
hairs
for
the
record
you
are
describing
where
you
would
not
be
in
a
misdemeanor
because
it
fits
under
that
affirmative
defense.
G
Okay,
and
what
does
the
does
the
cdc
have
any
role
in
describing
this
affirmative
or
this
unaffirmative
transmission
frequency
or
what
it?
What
is
the
what's
the
science,
I
guess
cdc
weighed
in
on
this.
B
Senator
hardy
to
you
through
chair
ready,
if
I
think
I
understand
your
question
correctly
as
far
as
the
affirmative
defense
comes
in,
no
the
cdc
doesn't
play
a
role
in
that,
but
I
will
note
we
pulled
that
affirmative
defense
from
existing
nrs.
It
already
was
in
place
for
the
felony
that
we're
repealing
and
so
we're
moving
that
same
language.
Underneath
this
new
section.
D
This
is
andre
way:
superstate,
equality
for
the
record.
I
have
information
here
further.
Recent
research
shows
that
the
risk
of
hiv
transmission
through
sexual
intercourse
is
low,
even
if
people
are
not
using
condoms
or
taking
medications
that
reduce
risk.
The
cdc
estimates
that
the
per
act
risk
of
transmission
varies
from
close
to
zero
percent
to
a
maximum
average
of
1.38
depending
on
the
type
of
intercourse,
and
so
what
we
know
through
cdc
and
other
organizations,
is
that
the
actual
rate
of
transmission
is
very
low.
D
F
A
couple
of
questions
the
first
relates
to,
I
think,
the
definition
of
communica
urban
concern.
Well,
the
definition
of
communicable
disease
is
the
coronavirus,
a
communicable
disease.
B
Thank
you
for
the
the
question
senator
kikofer.
It
is
my
understanding
that,
yes,
the
coronal
virus
would
fit
under
the
definition.
F
F
All
right,
so
the
reason.
The
reason
I
ask
is
because
you
know
obviously
a
top
of
mind
subject,
but
it
also
begs
the
question
about
some
of
the
changes
in
section
two
relating
to
asking
people
to
isolate
ordering
people
to
isolate
quarantine
that
exposure.
You
have
to
have
been
in
a
an
infectious
state
in
order
to
get
people
to
isolate.
That
seems
counterintuitive
to
everything
we've
done
for
the
past
year
in
terms
of
social,
distancing
and
isolation
and
all
of
that
stuff.
H
D
Of
course,
hiv
is
communicable
disease.
I'm
not
well
versed
in
covet.
H
A
I
Senator
brady
this
is
kyrah
morgan
for
the
record.
I'm
the
state
biostatistician
for
the
department
of
health
and
human
services.
Cova
19
is
a
communicable
disease.
That's
correct!.
F
Thank
you
for
that.
I
appreciate
that
miss
morgan
and
jerry.
I
think
that
makes
I
think
we
need
to
explore
a
little
bit
what
some
of
the
changes
might
be
as
it
relates
to
powers
of
local
health
districts
to
get
people
to
isolate
under
broader
global
pandemic
type
conditions
under
these
changes
not
specifically
related
to
the
intent
of
the
bill.
F
I
know
that
so
sort
of
broader
issue
when
it
comes
to
section
sorry,
I'm
looking
back
into
the
amendment,
I
think
it's
section
7,
where
it
relates
to
testing
of
first
responders
and
and
public
health
officers,
who
believe
they've
had
an
exposure.
We're
worried
that
they've
had
an
exposure.
F
This
seems
to
make
a
significant
change
in
that
it
would
require
them
to
have
either
been
had
had
a
negative
test
before,
but
it
doesn't
really
say
when
and
and
or
specific
knowledge
that
the
person
who
potentially
exposed
them
was
infected.
Can
you
walk
through
that
section?
I
don't
really
understand
what
we're
trying
to
accomplish.
B
Sure
senator
kikifer,
thanks
for
the
question
I
will
say
just
off
bat.
This
section
was
developed
in
consultation
with
the
clark
county
fire
department's
input
as
well,
and
so
I
know
that
they
had
some
concerns,
and
so
what
you're
looking
at
is
actually
some
compromise
language
that
we
put
together
with
first
responders
themselves.
B
I
think
senator
kika
for
the
the
key
here
is
that
we
don't
want
to
subject
people
to
unnecessary
testing,
although
we
also
want
to
make
sure
we
keep
our
first
responders
safe
when
they
feel
that
they've
been
exposed,
and
this
language
accomplishes
those
dual
goals.
F
So,
under
under
this
language,
what
is
the
process
right?
So
if
a
if
a
police
officer
is
in
a
confrontation
and
has
you
know
bodily
fluid
expo,
you
know
exposed
to
them
in
one
way
or
another.
Under
what
conditions
are
they
allowed
to
test,
because
I
and
maybe
it'd,
be
helpful
for
me
to
understand
as
well?
What
is
the
sort
of
like
incubation
period,
all
those
sorts
of
things
for
contracting
some
communicable
diseases?
How
long
until
exposure
would
an
individual
actually
start?
Testing
positive-
and,
I
think
most
importantly,
are
there?
F
B
Thank
you
for
the
question
senator
kikifer.
The
way
that
I
read
section
seven
is
the
only
thing
that
you
need
in
order
to
get
the
testing
done.
Is
that
it'd
be
necessary
to
determine
an
appropriate
treatment
for
the
first
responder,
and
so,
if
that
prong
is
met,
then
the
testing
can
be
done
in,
in
conjunction,
of
course,
with
coming
into
contact
with
the
human
blood
or
or
bodily
fluids.
D
This
is
andre
wade
silverstein
just
for
the
the
record
just
so
we
can
dispel
some
myths
here.
There's
no
documented
evidence
that
there
has
been
a
transmission
of
hiv
through
biting
spitting,
scratching,
vital
leaflets,
those
sort
of
things,
and
so-
and
this
is
something
that
the
association
of
prosecuting
attorneys
and
general
hiv
loan
policy
et
cetera,
have
endorsed
and
done.
D
Research
on,
and
so
we
just
have
to
be
clear
that
a
lot
of
these
thoughts
about
the
way
hiv
is
transmitted
is
incorrect
and
so
we're
trying
to
make
sure
that
when
we
are
crafting
these
laws,
that
they
don't
provide
misinformation,
that's
out
of
stuff
with
science
and
is
stigmatizing,
and
so
the
way
that
you
described
it
wouldn't
transmit
hivs.
So
just
want
to
be
clear
on
the
record.
F
And
I
appreciate
that
and
thank
you,
mr
wade,
I
I'm
probably
guilty
of
some
of
those
assumptions
long
term
too,
but
I'll
point
out
that
this
is
about
all
communicative
diseases
and
I've
been
told
for
a
year
that
I
can't
breathe
on
people.
So
I
think
the
I
think
we
need
to
think
about
the
full
scope.
I
mean
I
know
you're
we're
trying
to
eliminate
stigma
and
criminalization
related
to
hiv,
but
communicable
disease
is
a
really
broad
term.
B
And
senator
kikofer,
I
I'd
also
note
that
section
seven
in
particular
already
has
the
kind
of
provision
that
you
have
to
come
in
contact
with
human
blood
or
bodily
fluids.
Right,
that's
that's
the
black
language,
and
so
this
section
wouldn't
really
address
someone
breathing
on
a
first
responder,
as
is.
F
And
if
I
read
paragraph
a
subsection
one
correctly,
I
think
there
either
has
to
have
been.
B
A
A
I
guess
my
question
is
is
broader
again,
because
the
so
understanding
what
you're
getting
at,
which
is,
the
very
real
stigma
and
misinformation
and
all
of
those
challenges
with
hiv
aids
and
then
understanding
also
that
this
bill
is
much
broader
than
that
and
is
all
communicable
diseases.
A
What
was
the
process
of
working
with
the
health
districts
to
get
to
a
point
where
this
is
that
they're
comfortable
with
this,
given
that
they
are
the
ones
who
are
protecting
us
all
from
the
outbreak
of
communicable
diseases?
When
that's
necessary-
and
I
don't
know
that
it's
actually
necessary,
but
I
will
disclose
that
I
am
currently
employed
by
the
health
district,
but
do
not
work
in
communicable
diseases
in
any
way
shape
or
form.
So
I'm
ignorant
to
these
these
pieces
of
it.
B
Thank
you
for
the
conversation
chair
ready.
I
think
there
are
two
parts,
so
the
first
was
the
hiv
modernization
task
force
where
we
had
a
health
district
experts
at
the
table
from
the
beginning
of
the
development
of
this
legislation.
B
The
second
piece
was,
as
we
actually
got
language,
and
I'm
sure,
mr
page
or
or
mr
wade
can
elaborate
a
little
bit
as
we
actually
got
language.
There
was
plenty
of
back
and
forth
between
hiv
advocates
and
and
the
health
districts
to
get
to
the
legislation
that
you
see
before
you
today,
for
that
exact
reason
that
that
the
bill
is
a
is
a
bit
broader
than
just
the
sections
that
only
call
out
hiv,
and
so
both
washoe
and
southern
nevada.
B
Health
districts
were
important
partners
in
getting
to
the
product
we
have
today.
A
All
right
seeing
none
we're
going
to
go
ahead
and
open
up
the
phone
for
public
testimony
if
you'd
like.
F
Okay,
guys
one
quick
question:
I'm
sorry.
We
heard
earlier
from
mrs
narrows
the
arrest
statistics
related
to
the
criminalization
provisions
that
we're
trying
to
eliminate.
E
This
is
nathan
cisneros,
the
data
that
we
have
come
from:
the
nevada
state,
oh
department
of
public
safety.
So
we
have
arrest
information
through
to
find
this
position.
D
A
Okay,
looking
around
again
not
seeing
anyone
all
right,
we're
going
to
go
ahead
and
open
the
lines
for
public
testimony
in
support
of
sb
275
public
testimony
will
be
limited
to
two
two
minutes
per
person
and
if
the
person
persons
who
have
testified
before
you
have
said,
essentially
what
you're
going
to
say
feel
free
to
just
say.
I
agree
with
the
prior
callers:
go
ahead
and
open
up
the
lines.
J
J
H
H
Q-U-E-N-T-I-N-S-A-V-W-O-I-R,
I'm
the
deputy
director
of
make
it
work,
nevada
and
I'm
also
a
member
of
the
advisory
task
force
on
hiv
exposure
and
modernization.
I
stand
in
support
of
sb
275
where
long
past,
due
for
modernizing
our
state
flaws
on
hiv,
such
laws
are
rooted
in
stigma
and
uncertainties
around
the
virus
that
are
no
longer
uncertain.
H
Furthermore,
current
laws
disproportionately
impact
black
communities
and
other
communities
of
color
that
are
more
likely
to
be
living
with
hiv.
During
the
special
session
of
2020,
this
body
passed
scr1
declaring
racism,
a
public
health
crisis.
This
measure
had
bipartisan
support
in
both
chambers.
This
bill,
sb
275,
is
in
alignment
with
the
intentions
of
this
senate
concurrent
resolution.
H
A
J
K
Good
afternoon
karate
and
members
of
the
committee,
my
name
is
roe
gill
r-o-g-I-l.
I
am
a
social
work
student
and
a
former
housing
case
manager
for
people
living
with
hiv.
I
am
here
in
support
of
sb
275
sb
275,
with
modernized
nevada's
hiv-related
laws
that
currently
perpetuate
stigma
against
people
living
with
hiv.
K
Throughout
my
career,
I
have
seen
the
impact
that
stigma
and
discrimination
has
had
on
people
living
with
hiv
or
aids,
to
name
a
few
clients
are
endured,
a
loss
of
hope
and
feeling
of
worthlessness,
addiction,
isolation
and
or
depression
and
loss
of
income
or
likelihood.
People
who
are
exposed
to
societal
stigma
often
undertake
internalized
stigma.
Internal
life
stigma
is
the
process
in
which
a
person
believes
the
negative
messaging
or
stereotypes
about
themselves.
As
we
can
imagine,
internalized
stigma
can
be
very
harmful
to
self
and
others.
K
H
K
Transmission
modernization
is
necessary
because
these
laws
not
only
are
not
only
failing
to
stop
the
spread
of
hiv
as
nevada
is
ranked
18th
in
the
nation
in
the
number
of
diagnosed
cases,
these
laws
are
also
continuing
to
negatively
impact
nevada
residents
and
their
families.
I'd
like
to
thank
thank
senators
harris
for
bringing
such
important
legislation
to
the
table
and
thank
the
committee
for
their
time.
A
J
L
D-A-W-N-C-H-R-I-S-T-E-N-S-E-N
vice
president
of
communications
and
corporate
responsibility
for
the
nevada
resort
association.
As
you
know,
nevada's
resort
industry
has
a
long-standing
commitment
to
corporate
social
responsibility
programs
and
initiatives
and
has
a
history
of
leadership
in
this
space.
The
key
pillars
of
most
csr
programs
are
philanthropy
environmental
sustainability
and
diversity,
equity
and
inclusion,
which
work
in
tandem
to
strengthen
our
community
and
create
better
outcomes
for
people
and
the
planet.
L
L
Sp275
seeks
to
change
that
by
modernizing
our
outdated
laws
that
treat
hiv
differently
from
every
other
communicable
communicable
disease.
We
hope
you
take
into
consideration
the
recommendations
presented
by
the
state's
hiv
modernization
task
force
that
helped
shape
this
bill.
I'd
like
to
thank
senator
dallas
harris
for
bringing
this
issue
forward
and
her
leadership
on
equality
and
equity
matters
also
like
to
thank
senator
parks
for
his
long
time,
dedication
for
the
lgbt
community
and
his
work
in
laying
the
foundation
for
this
bill.
L
J
M
Hi,
my
name
is
kimmy
cole.
That's
k-I-m-I-c-o-l-e
like
to
say
thank
you
to
chair
ratty
and
to
the
committee
there's
a
great
opportunity
here
to
accurately
and
effectively
recognize
scientific
understanding
of
the
human
immune
immunodeficiency
virus
and
to
pass
legislation
that
will
improve
public
health
while
sparing
taxpayers
the
unnecessary
burden
of
paying
for
onerous
and
ineffective
prosecutions,
laws
that
have
done
nothing
to
mitigate
issues
that
were
originally
and
erroneously
intended
to
help
protect
society
actually
accomplish
quite
the
opposite.
M
Outdated
laws
criminalize
an
affliction,
not
actions
that
cause
intentional
harm
to
others.
Understanding
of
hiv
long
ago,
passed
original
archaic,
inaccurate
understandings
of
an
affliction
that
can
be
effectively
monitored
and
treated
for
long-term
quality
of
life.
It's
time
to
correct
this
situation
and
move
on,
I
urge
your
support
of
senate
bill
275.
Thank
you
for
your
time.
J
K
Good
afternoon,
chair
robbie
and
senate
committee
on
health
and
human
services,
thank
you
for
this
time.
For
the
record,
my
name
is
jasmine,
marguerita
tobin,
jasmine,
j,
a
f
m,
I
n
margarita
and
tobin
tias,
and
tom
o
b.
As
in
boy,
oh
and
as
a
nancy
I
go
by
jazz.
I
am
an
organizer
with
planned
parenthood.
Boats,
nevada,
planned
parenthood,
both
to
nevada,
is
in
favor
of
sb
275.
K
Current
nevada
law
treats
the
hiv
epidemic
as
a
criminal
offense,
rather
than
a
public
health
crisis
with
science
and
with
knowledge
we
know
better,
and
so
this
this
is
our
opportunity
to
do
better.
Criminalization
is
not
the
answer,
and
ever
was.
Science
is
despite
advances
in
hiv
care
and
science
like
prep,
pre-exposure,
prophylaxis
and
undetectable
equals
untransmittable
or,
u
equals
view.
Nevada's
hiv
criminalization
laws
are
still
based
on
decades.
K
Old
science
criminalization
discourages
testing
treatment,
disclosure
and
results
in
stigma
and
preventable
deaths,
whether
it's
the
horribly
mismanaged
aids
epidemic
in
the
1990s
or
the
coronavirus
pandemic.
Bypac
and
lgbtq
plus
individuals
suffer
the
most
and
have
led
the
moment
for
justice
for
their
communities.
K
J
H
Thank
you,
madam
chair
and
members
of
the
committee.
This
is
john
piero
from
the
clark
county
public
defender's
office,
and
we
stand
with
our
community
partners
and
ask
you
to
pass
sb
275,
which
modernizes
our
laws
and
removes
some
of
the
outdated
and
discriminatory
laws
that
were
passed
during
a
time
when
we,
as
a
society,
used
hiv
to
destigmatize
and
discriminate
against
our
lgbtq
community.
Instead
of
dealing
with
hiv
as
it
is
a
public
health
issue,
nevada's
criminal
code
has
been
used
as
a
ineffective
hammer
to
solve
problems.
H
J
N
Yes,
thank
you
sharing
committee.
My
name
is
jada
hicks
j,
a
d
h
and
I'm
a
supervising
attorney
at
the
center
for
hiv
law
and
policy
or
chlp
for
short
chlp
hosts
the
positive
justice
project,
the
first
national
collaborative
network
of
people
living
with
hiv
and
people
living
with
viral
hepatitis
and
allies
working
to
end
criminalization
of
hiv
and
all
stigmatized
diseases.
N
N
There
are
currently
32
states
that
have
hiv
specific
laws
that
improve
and
post
criminal
liabilities.
These
laws
impose
either
misdemeanor
or
felony
punishment
and
explicitly
target
hiv
results
can
be
found
in
criminal
codes
or
public
health
codes,
and
some
of
these
laws
define
criminal
offenses
for
exposing
others
to
hiv.
N
Others
outline
harsher
penalties
for
people
living
with
hiv
for
acts
that
are
already
considered
criminal.
Hiv
criminalization
is
fueled
primarily
by
the
inaccurate
belief
that
hiv
is
easily
transmitted
and
fatal,
neither
of
which
is
true.
These
laws
conflict
with
public
health
goals.
The
laws
have
no
impact
on
risky
behavior,
no
impact
on
the
number
of
new
hiv
diagnoses.
A
A
J
H
We
are
a
non-partisan
organization
in
nevada
to
ensure
fairness
and
equal
and
equal
opportunity
to
succeed
for
all
nevadans
we're
speaking
in
support
of
sb
275.
Current
nevada
laws
regarding
hiv
criminalization
are
outdated,
ineffective
and
discriminatory.
These
laws
were
first
established
decades
ago,
during
the
height
of
the
hiv
aids
epidemic.
When
little
was
known
about
it,
this
led
to
disproportionate
marginalization
of
gender
and
sexual
minorities
and
communities
of
color.
We
cannot
punish
hiv
positive
nevadans
when
we
have
so
few
state
and
community
resources
available
to
them.
H
This
criminalization
fails
to
prevent
the
spread
of
hiv
by
discouraging
testing
treatment
and
disclosure.
We
support
sb
275
because
it
will
modernize,
nevada's,
outdated,
hiv
laws
to
eliminate
stigma
and
promote
public
health.
If
we
in
the
state
want
to
end
the
hiv
epidemic,
we
should
all
support.
Sb
275
we'd
like
to
thank
senator
harris
and
senator
parks
for
their
leadership
in
presenting
this
bill,
and
we
thank
members
of
the
committee
for
their
consideration.
J
H
H
I
want
to
say
ditto
to
the
other
policy
remarks
and
support
and
instead
focus
on
why
this
measure
is
so
important
to
me
personally
as
a
queer
man,
my
experience
has
been
that
discussions
about
hiv
and
aids
are
far
too
often
tangled
up
in
homophobia
and
transphobia,
and
my
sense
is
that
the
same
is
true
with
nevada's
current
criminalization
scheme
when
looking
at
the
group's
most
vulnerable
to
contracting
hiv.
It's
clear.
This
epidemic
is
also
tangled
up
with
racial
and
economic
justice
issues.
H
I'll
tell
you
some
of
the
first
volunteer
work
I
ever
did
back
in
my
early.
20S
was
hiv
prevention,
outreach
with
the
center
and
we
always
said,
get
tested
and
know
your
status
and
the
sad
truth
that
I
hope
you
see
now
is
that
criminalization
of
hiv
serves
as
a
major
obstacle
to
these
important
public
health
messages.
H
Thank
you
to
senator
harris
for
bringing
this
bill
and
thank
you
to
the
members
of
the
hiv
modernization
task
force
who
have
worked
so
hard
on
this.
This
is
a
great
opportunity
to
update
our
laws,
so
they
align
with
current
science
and,
like
I
said,
to
remove
the
stigma
that
gets
in
the
way
of
the
work
we
need
to
do
to
end
this
epidemic.
Please
send
sb
275
to
the
floor
and
on
to
the
assembly.
Thank
you.
H
A
J
I
I
agree
with
the
statements
from
the
callers
before
me
and
we
just
add
that
this
will
hopefully
allow
individuals
who
do
have
medical
and
issues
to
out
of
the
criminal
justice
system.
I've
had
a
handful
of
clients
who
indicated
that
they
became
involved
in
the
criminal
justice
system
because
of
the
stigma
associated
with
their
disease
that
led
to
them
using
alcohol
and
substances,
and
we
truly
believe
that
this
will
help
all
nevadans.
Thank
you.
J
N
Hello,
my
name
is
caitlin
t
l,
I
guin
g
w,
I
n
I'm
with
the
sex
worker
alliance
of
nevada,
and
we
believe
that
fd
275
will
improve
the
health
and
safety
of
those
who
engage
in
sex
work.
We
know
that
the
pattern
of
criminalization
only
makes
it
more
likely
that
folks
will
continue
in
this
work
and
make
it
harder
for
them
to
leave
the
industry
if
they
so
desire.
N
Criminal
records
make
it
harder
to
get
traditional
employment
and
signs
and
expenses
incurred
throughout
arrest
and
incarceration
make
folks
more
financially
vulnerable
and
therefore,
more
likely
to
you
guessed
it
engage
in
sex
work.
We
applaud
the
efforts
of
senator
harris
and
the
community
advocates,
and
we
thank
you
all
for
this
important
legislation.
Thank
you.
J
J
L
My
name
is
emily:
driscoll
e-m-I-l-y
d-r-I-s-c-o-l
from
assembly
district
10
senate
district
3.,
I'm
calling
to
represent
the
las
vegas
chapter
of
the
national
lawyers
guild.
The
las
vegas
energy
is
in
strong
support
of
of
fb275.
Hiv
is
currently
the
only
disease
that
criminalizes
people
just
for
having
it.
Current
law
does
not
protect
people.
L
In
fact,
it
puts
nevadans
at
risk
for
transmission,
currently
disincentivizes
people
from
getting
hiv
tests,
because
knowing
your
status
means
that
you're
more
likely
to
receive
felony
charges,
resultantly
nevada
laws
governing
hiv
have
put
vulnerable
nevadans
at
risk
for
criminalization
and
unnecessary
disease
spread.
These
laws
disproportionately
affect
members
of
the
gay
community,
trans
people
and
street-based
sex
workers,
all
of
whom
are
disproportionately
impacted
by
racism.
Sexual
impo
poverty,
if
275
were
to
be
passed,
nevadans
could
safely
seek
treatment
and
testing
for
hiv
and
remain
non-transmittable
without
having
to
worry
about
the
stigma
surrounding
the
virus.
L
To
those
who
oppose
275,
I
ask
who
do
you
wish
to
punish
for
having
hiv?
What
does
our
community
get
from
giving
people
felonies
for
having
hiv
existing
laws
come
from
fear
and
homophobic
campaigns
that
aim
to
harm
people?
Who
did
not
fit
the
framework
of
an
acceptable
citizen?
These
laws
disproportionately
impact
black
and
indigenous
people
of
color,
gay
people,
trans
people
and
poor
people,
energy
or
just
support
for
275
for
the
sake
of
public
safety
and
equality.
I
yield
my.
J
J
J
J
L
Okay,
thank
you.
My
name
is
connie
shear.
L
C-O-N-N-I-E-S-H-E-A-R-E-R
I'm
a
long-term
survivor
of
hiv
for
25
years,
I'm
one
of
the
founding
co-chairs
for
the
nevada,
hiv
modernization
coalition,
and
I'm
here
today
to
talk
about
why
we
should
all
care
about
reforming
the
outdated
hiv
criminalization
laws
in
nevada.
First,
I'd
like
to
thank
chair
woman,
ratty
and
the
health
and
human
services
for
their
time
today,
senator
david
parks
and
senator
dallas
harris
for
presenting
this
bill
and
championing
this
bill.
L
L
The
way
the
current
laws
are
written
are
preventing
people
from
getting
tested
out
of
fear
of
being
criminalized
and
getting
in,
and
it's
preventing
them
from
getting
into
treatment
treatment
that
we
now
know
prevents
the
spread
of
hiv.
We
are
not
going
to
criminalize
the
public
health
issue
away
so
because
of
that
daily
treatment
that
I
take,
it's
called
antiretroviral
therapy.
I
am
what
is
known
as
virally
suppressed.
L
That
means
the
virus
inside
my
body
is
unable
to
be
transmitted
to
someone
I'm
having
a
sexual
relationship
with
what
I
want
you
to
think
about
right
now
are
the
countless
more
like
me
who
were
exposed
and
acquired
hiv,
but
have
not
found
out.
That
means
they're
untested,
not
in
treatment,
too
afraid
to
go,
get
tested
and
possibly
being
told
by
their
doctor
that
their
symptoms
can't
be
hiv
because
they're
not
in
a
high
risk
group
or
because
they
don't
even
have
equity
access
to
treatment.
L
I'm
not
saying
they
should
be
criminalized.
We're
not
going
to
criminalize
a
public
health
issue
away.
I'm
here
today
to
ask
you
to
vote,
do
pass
on
sb
275
so
that
we
can
have
the
support
that
it
needs
to
be
adopted
into
law
so
that
our
state
can
ensure
that
we
begin
to
modernize
our
outdated
laws
that
are
stigmatizing
dangerous
and
are
not
in
line
with
science.
L
What
many
people
who
are
not
living
with
hiv
do
not
understand,
is
it's
not
just
the
actual
charges
that
ruin
people's
lives,
the
stigmatizing
language
used
by
the
media,
the
public
and
by
this
very
legislative
body
today
that
continues
to
perpetuate
outdated
myths
and
opinions?
There
is
language
in
this
bill
that
commits
to
modernizing
outdated
language,
and
I
thank
you
for
that.
So
very
much
senator
harris
that
that
commitment
means
so
much.
L
J
J
A
B
Ready
we
have
miss
jacob.
It
appears
from
from
clark
county
on
the
line,
I'm
not
sure
if
she
wants
to
testify
now
or
later
but
she's
on
on
the
video
and
was
going
to
be
in
the
neutral
position.
O
Miss
jacob
I
am
chair,
rowdy,
I
actually
had
called
in
on
the
phone,
because
I
wasn't
sure
logistically
how
to
do
this.
So
I
I
just
hung
up
the
phone.
Yes,
thank
you
senator
harris
for
good
for
letting
me
go
first.
My
name
is
joanna
jacob,
I'm
government
affairs
manager
on
behalf
of
clark,
county
j-o-a-n-n-a-j-a-c-o-b.
O
I
have
been
working
with
senator
harris
and
the
bill
proponents
on
this
bill
on
behalf
of
clark
county
fire.
Specifically
on
section
seven,
I
would
like
to
say
the
rest
of
the
bill.
We
are
in
support
of
the
stated
testimony
today
and
the
goals
of
the
task
force
and
everything
that
has
gone
into
modernizing
the
criminal
statutes
of
nevada
and
decriminalizing
potential
hiv
exposure.
O
The
concerns
with
section
7
that
we
had
on
behalf
of
our
fire
department
and
working
with
the
fire
unions,
who
are
going
to
testify
after
me,
I
believe
now
in
neutral,
is
that
the
the
changes
made
in
section
7,
as
in
the
original
bill,
we
felt
would
be
a
barrier,
and
we
consider
that
a
public
health
statute,
when
we
have
first
responders
going
in
to
in
response
to
an
emergency,
and
they
come
in
contact
with
the
public
if
they
are
exposed
to
a
communicable
disease.
O
It
is
the
position
of
clark
county
fire
that
we
always
have
to
err
on
the
side
of
safety
on
behalf
of
our
employees
and
get
them
tested
as
soon
as
possible
to
find
out
if
they
were
exposed.
So
we
are
going
to
continue
to
work
with
the
senator
and
the
bill
proponents
on
this
language.
The
amendment
that
was
presented
today,
I
was
has
been
the
product
of
a
lot
of
work,
and
we
thank
the
senator
and
the
bill
proponents
for
working
with
us.
O
We
are
still
have
some
concerns
about
the
fact
that
it's
shifting
the
burden
of
proof
in
a
public
health
statute,
and
this
is
not
a
criminal
statute,
and
so
that
is
our
concern
because
it
applies
to
all
communicable
diseases.
But
senator
harris
has
been
very
receptive
to
our
comments
and
will
continue
to
work
with
us,
and
so
we
are
neutral
today,
we'll
continue
to
participate.
So
thank
you.
O
J
J
M
J
K
Is
alisa
howard
I
was
trying
to
get
in
on
the
call
for
the
to
be
in
for
the
bill
not
for
neutral?
Is
it
still
possible
to
do
that.
K
I'm
sure
good
afternoon
my
name
is
alisa
howard,
a
l.
I
s
a
h
o
w
a
r
d
for
the
record
as
a
former
hiv
ryan
white
program
director
and
now
the
owner
of
minority
health.
K
O
K
State
data
shows
us
that
hiv
is
the
most
dangerous
infection
to
the
disease
aside
from
cover
19,
currently,
that
threatens
the
lives
of
minorities
to
include
african-americans,
latinx
community
and
the
lgbtq
communities
with
the
highest
amount
of
morbidity
and
mortality.
We're
asking
you
today
to
please
approve
this
bill
so
that
we
can
move
forward
in
our
laws
and
to
take
out
any
discriminatory
laws
that
affect
people
living
with
hiv.
Thank
you.
J
M
T-O-D-D-I-N-G-A-L-S-B-E-E
representing
the
professional
firefighters,
nevada,
I
just
want
to
ditto
the
comments
from
clark
county
joanne.
Regarding
section
seven,
I
totally
support
the
bill,
support
everything
it
it
does.
I
just
want
to
make
sure
that
my
members
are
protected.
We're
able
to
get
tested
our
patients
that
we're
transporting
and
we're
there
assisting
whether
it
be
an
intentional
or
accidental
exposure
for
any
disease
can
get
timely
tested.
So
we're
not
spreading
that
disease.
M
We
can
take
counter
medication
to
prevent
us
from
getting
the
disease
all
those
things,
but
again,
thanks
to
senator
harris
and
everybody
who's
been
willing
to
work
with
us
on
this
bill,
and
that's
it
we're
neutral
for
now,
but
looking
forward
to
getting
where
we
can
all
agree
and
get
this
legislation
passed.
Thank
you.
J
J
K
K
Also
thank
you
to
senator
parks
for
his
ongoing
leadership
and
support
of
hiv
efforts
and
human
rights
in
our
state.
I'm
the
sexual
health
program
coordinator
with
washer
county
health
district,
I'm
also
a
member
of
the
governor's
advisory
task
force
on
hiv,
modernization
and
the
public
health
co-chair
for
the
northern
nevada,
hiv
prevention
planning
group,
washa,
county
health
district
reports
modernizing
hiv-related
statutes
to
match
the
extraordinary
advances
in
hiv
care
and
prevention.
K
These
efforts
are
needed
to
end
the
hiv
epidemic,
which
is
within
our
graph.
Washoe
county
health
district
is
neutral
in
support
of
the
bill.
At
this
time
we
have
submitted
suggested
amendments
reflecting
the
collective
feedback
of
our
public
health
partner,
southern
nevada,
health
district
and
ongoing
community
discussion.
K
Some
items
continue
to
be
worked
through
and
we
greatly
appreciate
the
patience
and
support
of
senator
harris
and
our
community
partners
moving
hiv
into
the
public
health
realm
to
be
addressed.
The
same
as
other
communicable
diseases
assist
public
health
with
intervene,
intervening
in
proven
ways
by
expanding
access,
building,
trust
within
the
community
and
using
evidence-based
interventions
in
achieving
healthier
outcomes.
L
K
J
A
Thank
you
closing
comments.
Senator
harris.
B
Thank
you
so
much
chair,
ratty
I'll
spare
you
all
of
the
long
notes
that
I
had
in
closing
and
just
make
two
points.
If
I
can
one,
I
am
committed
to
continuing
to
work
with
clark
county,
the
professional
professional
firefighters
to
make
sure
that
we
get
this
right
as
well
as
our
health
district
partners.
This
has
been
a
labor
of
love
and
I
know
that
we
are
almost
there.
B
The
second
point
I'd
like
to
make,
while
he's
still
on
the
line,
is
that,
although
my
name
is
on
this
bill,
what
you
see
before
you
is
a
product
of
decades
of
work
by
senator
parks,
and
so,
as
always,
the
state
is
ever
grateful
to
to
your
endeavors,
and
I
I
appreciate
the
opportunity
to
to
kind
of
pick
up
the
mantle
on
this
issue.
Thank
you,
senator
parks,
and
with
that
chair,
ready,
I'm
ready
to
conclude.
A
A
good
to
see
you,
sir,
and
we
will
move
to
check
in
on
senator
orange
senator.
Do
you
have
the
presenters
that
you
need
for
sb.
A
A
A
Is
that
a
yes,
are
you
prepared
to
go
okay,
great,
so
we're
gonna
go
ahead
and
open
the
hearing
on
senate
bill
379,
and
I
invite
senator
hardy
to
present
this
bill
on
behalf
of
the
interim
committee
on.
G
Thank
you
again.
The
health
workforce
data
collection
in
nevada
through
licensure
renewal
process
was
a
group
of
stakeholders
who
came
to
the
legislative
committee
on
health
care
in
the
interim,
and
the
legislative,
health
care
and
committee
heard
their
report
and
said
we
should
do
something,
and
this
is
what
we
are
being
presented
with,
what
to
do
so.
G
This
talks
about
having
a
way
to
find
out
who
is
doing
what,
where,
when
and
how
in
the
field
of
health
care
and
so
asking
for
a
re
upon
renewal,
not
upon
the
initial
license,
but
upon
renewal
in
a
non-mandatory
way
to
have
a
survey
filled
out
that
took
me
four
minutes
to
do
when
I
saw
the
draft
of
it
and
it's
to
be
confidential
and
using
aggregate.
G
P
P
At
the
heart
of
our
ask
or
request
with
this
legislation
is
the
idea
that,
as
a
state
we're
leaving
money
on
the
table
when
we
do
not
accurately
establish
and
maintain
health
professional
shortage
area
designations,
which
funnel
into
a
lot
of
state
and
federal
reimbursement
for
professionals
serving
in
medically
underserved
areas,
and
that
again
licensure
renewal
provides
that
vehicle
or
mechanism
to
collect
data
better
than
we
currently
do
now.
G
Thank
you,
madam
chair.
I
think
this
could
be
typified
as
something
that
is
a
positive
going
forward
to
attract
people
to
not
only
come
to
nevada,
but
to
stay
in
nevada
that
look
like
the
people.
They
serve.
Look
like
the
people
they
and
sound
like
the
people
they
talk
to.
In
other
words,
we
have
special
groups
of
people
that
need
care
and
we
have
not
been
very
good
at
doing
it.
So
this
is
looking
at.
How
can
we
do
that?
G
How
can
we
deliver
care
to
the
people
who
need
it
and,
as
we've
pointed
out
many
times
in
the
bipolar
community,
we
need
to
get
people
their
immunizations.
We
need
to
get
them
their
screenings.
We
need
to
get
them
their
care.
We
need
to
develop
a
trust
factor,
a
confidence
factor,
and
this
survey
will
help
us
point
to
what
we
can
do
better,
who
we
need
to
recruit
so
section.
G
Six
of
the
bill
talks
about
the
director
shall
establish
a
health
care,
workforce,
working
group
and
then
proceeds
to
say
all
of
these
people
are
probably
going
to
be
those
that
are
interested
and
have
expertise,
including
members
of
the
state
employees,
and
it
lists
out
the
chapters
of
all
the
health
care
providers
that
this
would
go
to.
This
survey
would
go
to
upon
renewal
of
their
license,
so
we
don't
discourage
anybody
from
getting
their
license
but
upon
renewal
and
does
not
mandate
it.
Now.
G
One
of
the
things
that
we've
heard
from
more
than
one
person
is
how
do
we
keep
it
confidential
and
that's
where
I
say
I
fully
anticipate
a
group
of
people
working
together
to
come
up
with
language
keith
lee
dan
musgrove
susan
fisher
of
all
expressed
a
desire
to
come
up
with
language
that
keeps
the
the
aggregated
data
confidential,
so
that
people
can't
be
identified
individually
by
the
survey
results
and
that
in
essence,
madam
chair
is
the
bill.
We
want
to
do
something
and
move
forward.
H
F
Thank
you,
madam
chair,
so
the
all
of
the
is
all
of
the
data
collection
voluntary
on
the
part
of
the
providers.
That
is
that
what
I
heard
you
said
that's.
G
F
Okay-
and
it's
done
through
a
web
portal
that
is
now
being
directed
direct
straight
to
the
department
via
the
amendment
and
not
the
actual
licensing
boards.
P
G
P
I'll
be
happy
to
take
a
first
stab
at
that
again,
john
packham,
for
the
record.
The
idea
would
be
to
use
that
again
use
that
licensure
renewal.
So
let's
say
you
are
a
physician
or
nurse
you're
completing
your
renewal
online
through
that
application.
P
In
the
proposed
amendment,
there
would
be
a
link
that
would
take
you
to
the
dhhs
site,
where
you
would
complete
the
supplemental
questions
and
then
return
back
to
your
licensure
renewal
and
submit
that
again.
Those
questions
would
be
voluntary.
P
P
I
I
would
also
add
that
there
are
ways
to
streamline
this
so
that
two
years
from
now,
four
years
from
now,
you're
not
answering
the
same
questions
like
you
do
when
you
go
to
the
dentist
every
year,
and
they
ask
you
for
that
health
inventory
on
that
checklist.
It
would
be
nothing
like
that
you
would
simply
be
verifying
and
adding
any
any
changed
information.
P
F
P
F
I
appreciate
that
dr
peckham,
I
I
was
worried
a
little
bit
about
paragraphs,
maybe
j
and
k
talking
about
how
much
a
doctor
works
number
of
hours
a
week.
They
work
and
whether
they're
planning
on
retiring
anytime
in
the
next
five
years,
as
perhaps
disincentives
to
filling
out
any
of
this
data.
P
Yeah
again,
john
pack
them
for
the
record,
I'm
I'm
I'm
wary
of
any
question
that
compel
somebody
to
just
stop
in
their
tracks
and
not
complete
the
survey
and
whether
it's
retirement
plans,
whether
it's
race
and
ethnicity,
etc.
A
And
senator
because
we
are
referring
to
an
amendment,
I
think
it
perhaps
could
be
helpful
to
have
some
clarity,
because
there
were
multiple
amendments
that
were
submitted
as
exhibits
to
this.
I
just
want
to
acknowledge
that
this
is
one
of
the
bills
that
dropped
relatively
late.
That's
scheduled
with
a
relatively
short
turnaround,
and
so
there
are
amendments
from
dan,
musgrove,
nevada,
state
board
of
osteopathic
medicine,
the
nevada
board
of
medical
examiners.
G
A
Great
okay,
so
just
just
want
to
make
sure
everybody's
working
off
of
the
same
same
documents
for
the
purposes
of
this
hearing
today,.
J
J
H
Good
afternoon,
madam
chair
and
members
of
the
committee,
my
name
is
jaron
hildebrand
here
today
in
support
of
senate
bill
379
on
behalf
of
the
nevada
state
medical
association.
I
know
you
have
a
long
agenda
so
I'll
keep
my
remarks
brief.
Firstly,
we'd
just
like
to
thank
senator
ratty
senator
hardy
for
bringing
this
bill
forward.
I'd
also
like
to
thank
dr
pakkam
for
all
his
work
on
this
effort,
and
I
know
how
much
thought
and
his
willingness
to
meet
with
us
and
get
us
to
a
good
place
on
this
bill.
H
J
M
Hi
good
afternoon,
chair
ready
members
of
committee
bradley
mayer
again
from
our
gentleman
partners
for
the
record
here
today
on
behalf
of
the
southern
event:
health
district,
that's
e
y
m,
a
y
e
r
and
we
just
wanted
to
support
our
friend
dr
packham,
at
the
nevada
public
health
association
has
been
working
on
this
and
we
work
with
them
to
submit
this
to
the
interim
health
committee,
and
we
appreciate
this
bill
coming
forward
and
we
hope
we
converge
your
support.
Thank
you.
So
much.
J
N
I
am
the
ceo
of
the
nevada
primary
care
association
for
representing
the
state's
community
health
centers,
and
we
would
like
to
thank
the
committee
for
hearing
sb
379
and
urge
your
support
for
its
passage.
Community
health
centers
serve
geographically
isolated
and
traditionally
underserved
communities
in
rural
areas.
They
are
often
the
only
health
care
available
and
in
urban
areas
they
serve
medicaid
patients
and
uninsured,
who
are
have
no
other
access
to
services.
N
We
are
able
to
offer
federal
loan
repayment
assistance
providers
in
a
health
center
where
provider
shortage
is
documented,
and
this
is
a
critical
piece
of
the
health
center
business
model.
Chair
ready,
we
are
losing
the
data
raised
to
other
states.
We
have
already
seen
the
reno
sparks
area
fall
below
the
threshold
for
funding
loan
repayment
slots
for
behavioral
health
providers.
N
J
J
K
K
J
J
J
J
A
Thank
you,
let's
go
ahead
and
see.
Is
there
anybody
on
the
zoom
that
needs
to
testify
in
neutral.
A
I
Vinnie,
thank
you,
chair
ratty,
cody
finney
for
the
record,
p-h-I-n-n-e-y
I'll,
be
very
brief.
I
just
am
here
to
share
that.
I
It's
been
my
privilege
to
work
with
this
group
during
the
interim
with
dr
packham
on
on
the
what
started
as
a
governor's
association
project
and
became
this
with
other
states,
and
it's
been
very
enlightening,
and
the
department
of
health
and
human
services
is
convinced
that
this
would
would
allow
the
availability
of
this
data
would
be
beneficial
to
the
primary
care
office
and
their
efforts
toward
those
designations
for
health,
professional
shortage
areas
and
other
areas
of
the
department
are
certain
that
this
data,
the
availability
and
our
ability
to
analyze.
I
It
would
do
exactly
what
dr
hardy
described.
Allow
us
to
help
get
people
services
from
people
that
look
and
sound
like
them
in
a
much
better
way
than
we
can
currently.
So
I
just
wanted
to
say
thank
you
to
chair,
ratty
and
senator
hardy
for
for
their
work
on
this
and
dr
packham.
We've
got
the
office
of
analytics
on
board
as
well
to
help
with
any
privacy
about
the
concerns
about
the
data
privacy
and
we're
we're
on
standby
to
help.
As
we
can
with
any
amendment,
thank
you
very
much.
I
J
J
M
Good
evening,
madam
chair
members
of
the
committee,
this
is
dan
musgrove
on
behalf
of
the
chiropractic
physicians
board
of
nevada,
that's
d-a-n
capital
m-u-s-g-r-o-v-e,
we
are
in
neutral
today,
simply
appreciate
the
goals
of
senator
hardy
and
mr
packham
as
well
as
dcfs.
M
We
just
thought
that
it
would
be
appropriate,
as
dr
hardy
mentioned,
that,
because
everyone
is
interested
in
the
confidentiality
of
this
information
that
it
shouldn't
flow
through
the
individual
professional
boards.
I
think
there's
an
amendment
I've
offered.
I
think
susan
fisher
as
well.
It
has
a
similar
amendment.
M
We
just
think
it
should
go
directly
to
the
director
and
whatever
porthole
he
creates.
I
think
we
could
easily
figure
out
a
way
to
verify
that
any
applicants
or
current
members
of
our
boards
have
registered.
It
simply
takes
us
out
of
the
middle
and
further
protection,
for
you
know
very
important,
confidential
data
and
again
we're
here
in
neutral,
and
thank
you
for
the
opportunity
to
testify
this
evening.
A
A
J
L
This
is
joan
hall
h-a-l-l
and
chair
ratty,
I'm
actually
here
to
testify
in
support,
but
could
only
get
in
in
neutral.
So,
if
you'll
allow
me,
I
just
like
to
say
that
we
enrhp
are
in
support
of
sb
379,
as
you've
heard
from
dr
packham.
This
supports
workforce
that
we've
been
working
on
for
many
years
and,
as
ms
finney
said,
the
hipster
scores
are
very
important
and
this
data
will
help
underserved
areas
have
more
accurate
information
about
practice
locations
that
greatly.
J
J
Q
Good
afternoon,
madam
chair
committee,
members
for
the
record,
this
is
susan
fisher,
s-u-s-a-n,
space
f-I-s-h-e-r
with
mcdonald
carano,
calling
this
afternoon
on
behalf
of
nevada
state
board
of
osteopathic
medicine.
Our
board
is
neutral.
They
have
not
met
in
an
open
meeting
law
in
order
to
be
able
to
take
a
formal
position
on
this
bill.
Q
We
are
neutral,
but
we
do
propose
an
amendment,
as
mr
musgrove
said,
and
as
you
will
hear,
I
believe
from
board
of
medical
examiners
as
well.
We
don't
want
that
confidential
information,
because
it
could
cause
a
question
if
perhaps
a
provider
is
denied
a
license
because
of
something
that
perhaps
happened
in
their
background
some
criminal
behavior
or
whatever,
but
it
could.
It
could
just
raise
some
questions
that
we
just
don't
want
to
have.
Q
I
think
we'd
be
agnostic,
agnostic
on
the
language,
whether
you
use
ours
or
or
a
combination
thereof
from
the
chiropractic
board
or
bme.
So
I
thank
you
for
your
time.
We
did
submit
a
fiscal
note
on
this.
We
don't
know
what
it
will
cost
to
to
have
it
provide
that
link
for
us
and
staff
time
if
there
is
additional
staff
time
so
we'll
just
have
to
see
it
is
just
an
estimated
fiscal
note.
Thank
you.
A
J
R
Good
evening,
madam
chair
members
committee,
this
is
keith
lee
keith
last
name
lee
lee.
I
represent
the
board
of
medical
examiners.
I
have
previously
submitted
my
statement
in
neutral,
as
well
as
a
proposed
amendment
and
as
my
colleagues,
ms
schiffer
and
mrs
fisher
and
mr
musgrave
has,
as
indicated,
we
are
pretty
close
to
the
same
on
a
proposed
amendment
that
essentially
takes
our
respective
boards
out
of
being
the
recipient
or
the
middle
person.
R
If
you
will
in
in
the
the
exchange
of
information
between
our
licensee
and
dhhs,
I
can
tell
you
that
that
we
have
a
newly
installed
state-of-the-art,
electronic
licensing
and
re-licensing
system,
and
I've
spoken
with
our
people.
We
can
put
a
hyperlink
in
the
really
licensed
application
that
takes
them
directly
to
the
dhhs
questionnaire
and
that
then
we
can
follow
the
fact
that
they
have
clicked
on
that
questionnaire.
R
At
any
rate,
if
I
understand
dr
hardy
and
dr
packham's
testimony,
I
I
think
this
is
in
the
nature
of
friendly
amendment
and
we'll
be
pleased
to
work
with
with
both
of
them
as
well
as
mrs
fisher,
mr
musgrove
and
many
others,
including
miss
finney
and
her
folks.
R
At
the
dhhs
to
make
sure
this
happens,
that
essentially
gets
the
information
that
is
requested
to
dhhs
from
our
licensees,
while
removing
us
from
being
the
middle
recipient
of
it
that
could,
as
ms
fisher
said,
explosive
to
lawsuits
based
upon
the
knowledge
of
the
information
that
we've
received.
So
with
that,
madam
chair
look
forward
to
working
with
all
the
folks.
R
I
understand
that
we
have
a
short
short
time
frame
here,
as
you
anticipate
to
work
session
this
next
tuesday,
so
we
have
our
work
cut
out
for
us,
but
be
pleased
to
try
to
make
this
happen
as
quickly
as
possible.
Thank
you,
madam
chair.
If
there's
any
questions
be
happy
to
try
to
answer
them.
J
K
K
Let
me
first
begin
by
thanking
the
senate
committee
on
health
and
human
services
senator
hardy
and
dr
packham
for
initiating
this
discussion.
The
nevada
oral
health
program
is
committed
to
improving
the
oral
health
overall
health
and
well-being
of
nevadans
and
to
meet
this
goal.
The
program
puts
priority
on
the
current
and
future
needs
of
the
population
and
the
dental
profession.
K
A
J
J
G
Thank
you
chair.
I
appreciate
your
leadership
on
this
and
unpacking's
diligence
and
patience
and
perseverance
on
this
particular
bill
that
we
have
seen
before
as
it
were.
But,
most
importantly,
I
think
I
look
forward
to
having
the
various
and
sundry
amendment
proposed
languages
and
I
would
say,
have
them
to
me
at
804
or
not
805,
at
1105
tomorrow
and
then,
if
miss
finney
can
get
me
her
contact
information
with
the
secret
office
of
analytics
and
how
we
can
use
all
that
we
would
be
able
to
have
that
ready
for
you.
G
A
Right,
thank
you
senator
hardy.
I
would
like
to
express
my
gratitude
to
senator
hardy
for
really
kicking
off
this
effort.
Last
session.
Did
a
whole
lot
of
work
on
this
bill
with
dr
packham
didn't
quite
make
it
to
the
finish
line.
Both
senator
hardy
and
dr
packham
were
very
persistent
in
bringing
it
to
the
interim
committee
on
health
care,
cody
jumping
in
with
the
governor's
project,
and
so
a
lot
of
folks
have
been
working
on
this.
I'm
very
my
passion
comes
from.
Clearly.
A
We
need
to
know
more
about
our
providers
to
be
able
to
know
where
our
shortages
are,
and
particularly
that
issue
about.
We
are
losing
out
on
the
ability
to
do
some
that
relief
force
for
practitioners
who
are
willing
to
come
here
and
serve
underserved
communities,
because
we
don't
have
good
data
to
demonstrate
our
storage
areas.
So
thank
you,
dr
hardy,
for
jumping
in
and
picking
up
the
slack
on
this
one
and
being
willing
to
hit
those
deadlines,
so
we
can
hopefully
work
session
it
on
tuesday.
A
A
S
A
S
Thank
you
very
much
chair
ratty
members
of
the
senate,
health
and
human
services
committee.
I
know
the
hours
late
and
I
will
be
brief.
During
the
interim
I
was
very
lucky
to
chair
the
interim
committee
on
child
welfare
and
juvenile
justice.
We
had
six
meetings.
We
were
fortunate
to
have
two
in-person
meetings
before
the
pandemic,
with
a
meeting
at
the
grant,
sawyer
building
and
a
live
video
feed
up
here
to
the
legislative
building
in
carson
city
after
covet
hit.
S
We
were
you
know,
struggling
like
every
other
committee
to
figure
out
how
we
would
do
this
and
with
the
help
of
the
legislative
council
bureau,
we
were
able
to
have
four
virtual
meetings,
and
I
was
very
lucky
to
have
mr
patrick
guynan
and
julianne
king
from
the
research
division,
who
really
kept
everything
going
and
kept
this
committee
alive.
We
did
very
important
work.
We
came
up
with
recommendations
for
10
billdraft
requests,
as
well
as
letters
on
very
important
issues
affecting
nevada's
children.
S
Almost
all
of
our
recommendations
came
back
with
unanimous
votes
with
bipartisan
support.
I
was
very
proud
of
that.
One
of
the
recommendations
is
senate
bill.
376,
a
concern
was
brought
forth
to
the
committee
about
the
current
system
when
there
is
a
an
allegation
of
abuse
and
neglect
of
a
child
and
under
current
law.
It's
it's
like
a
one
and
a
zero.
S
The
outcome,
it's
either
substantiated
or
unsubstantiated,
and
many
of
the
men
and
women
who
are
tasked
with
protecting
our
children
in
nevada,
felt
that
that
really
didn't
tell
the
whole
story
in
terms
of
looking
at
what
might
have
happened
to
a
child
in
the
past
and
that
there
might
have
been
other
other
factors
that
the
the
person
who's
currently
evaluating
that
child
in
that
child's
circumstances,
needs
to
know
about.
S
O
Yep,
chair
ready
members
of
the
committee
joanna
jacob
j-o-a-n-n-a-j-s-a-c-o-p
government
affairs
manager,
I,
with
your
apologies.
We
did
put
together
a
short
presentation
just
for
ease
of
getting
through
the
bill,
we'll
go
through
it
super
fast,
as
as
senator
orrin
shaw
noted.
O
There
is
an
amendment
so
when
mr
burch
will
be
going
through
the
categories
that
we're
proposing
to
add
to
nevada
law,
we'll
be
working
from
the
amendment,
and
that
was
the
product
of
conversations
with
our
other
child
welfare
agency
partners,
and
that
is
the
language
that
we
came
to
consensus
on.
So
with
your
permission,
I
will
share
my
screen
and
then
hand
it
over
to
mr
burch,
who
should
be
bringing
his
video
up
right
now
and
we'll
get
going.
A
Absolutely
it
was
not
my
intent
to
scare
off
everybody
from
any
presentation,
just
keeping
it
to
the
most
critical
points.
T
Absolutely
madam
chair
and
members
of
the
committee,
thank
you
tim
burch,
human
services
administrator
for
clark,
county
nevada,
t-I-m-b-u-r-c-h.
I
will
keep
it
brief.
I
just
want
to
give
you
a
little
bit
of
scaffolding
to
to
hang
this
on.
So
you
understand
the
importance
of
the
proposed
changes,
so
joanna
will
be
advancing
slides
for
me.
Thank
you
very
much.
T
So
one
of
the
most
the
purpose
of
child
welfare
is
to
promote
the
safety,
permanency
and
well-being
of
children
and
to
help
make
sure
that
families
can
take
care
of
those
children
properly
and
when
they
can't
to
find
permanency
options
with
kin
or
through
adoption.
T
One
of
the
most
important
functions
that
we
can
serve
is
to
ensure
that
the
safety
of
children
is
done
properly
through
the
investigation
and
disposition
of
reports
of
child
abuse
and
neglect.
These
case
dispositions
help
us
in
several
ways
they
help
frame
the
interventions
that
we
perform
with
these
families
and
these
children.
They
help
inform
future
investigations
both
for
child
welfare
and
law
enforcement,
as
well
as
the
outcome
or
disposition
of
these
cases.
T
So
what
happens
when
a
child
abuse
and
neglect
reports
made
to
child
welfare
agency?
How
do
we
get
to
a
case
disposition
very
quickly
when
someone
suspects
child
abuse
and
neglect,
and
we
encourage
everyone
who
might
be
listening
if
you
suspect
make
the
call
see
something
say
say
something
when
those
calls
come
in
to
a
child
welfare
agency.
Typically
through
a
hotline
like
we
have
in
clark
county
or
through
our
online
reporting
function,
those
intake
callers
screen
those
calls
out
and
they
begin
to
look
for.
T
Can
we
collect
enough
information
to
make
a
determination
if
the
allegation
being
brought
to
us
meets
the
definition
of
abuse
or
neglect?
If
it
does,
we
make
a
screening
decision
and
we
route
that
out
for
investigation
to
the
appropriate
child
welfare
staff.
Those
investigations
are
then
conducted
and
if
you
go
ahead
and
go
to
the
next
slide,
you
can
see
here
just
as
an
approximation
for
you.
The
number
of
calls
that
we
get
into
the
hotline
averages
over
28
000
a
year.
We
were
slightly
down
getting
the
pandemic
so
for
2020
we're
about
25
000.
T
T
We
contact
the
reporter
if
necessary,
we
coordinate
with
law
enforcement
if
necessary,
and
we
go
through
and
complete
a
complete
initial
assessment.
We
interview
the
alleged
victims
that
reported
perpetrator,
any
pertinent
collateral
contacts
to
make
sure
that
we
do
the
best
job
possible
to
inform
that
safety
assessment.
T
This
information
is
used
to
determine
whether
or
not
that
neglect
or
abuse
actually
occurred
in
a
way
that
honors
the
safety
and
integrity
of
that
family
and
then,
as
we
wrap
that
assessment
up,
we
have
to
make
a
disposition
and,
according
to
our
practice,
model
in
state
of
nevada,
we
have
45
days
to
complete
those
safety
assessments
and
make
the
determination
whether
abuse
or
neglect
actually
occurred.
That
final
determination
is
called
a
disposition.
T
I
know
you
all
can
read,
but
I'll
just
really
quickly
frame
this,
for
you
substantiation
really
just
means
that
we
have
reasonable
cause
to
believe
that
abuse
or
neglect
occurred,
and
the
alleged
perpetrator
is
responsible
for
said.
Abuse
for
neglect
of
substantiation,
basically,
is
everything
else
at
this
point,
it
means
that
we
were
unable
to
make
that
determination
through
insufficient
evidence,
or
we
cannot
disposition
the
case
in
a
way
that
says
that
alleged
perpetrator
was
responsible
for
for
abuse
or
neglect.
T
The
next
two
slides
really
quickly.
You
can
go
through
this
one
and
get
the
next
one
joanna
and
just
jump
to
the
third
slide.
These
sides
are
just
to
show
you
other
states
and
the
approximate
amount
of
disposition
types
of
states
have
texas
has
about
five.
California's
got
three
new
hampshire
over
half
dozen
and
missouri.
T
Well,
over
a
dozen
types
of
disposition
cases
we
won't
walk
through
those
as
as
much
as
we
did
in
the
interim
next
slide
what
we
are
proposing
now.
So
that's
the
scaffolding
here.
Here's
what
we're
being
proposed
thanks
to
senator
orrinshaw
for
third,
three,
four
thirty,
two
three
b.3006
changes
we'd
like
to
be
able
to
add
the
following
case:
dispositions
to
our
our
tool
belt.
T
If
we
cannot
locate
that
family,
the
information
was
incorrect
or
that
family
has
fled
we're
unable
to
currently
do
a
proper
investigation
right
now
we
have
to
close
out
as
unsubstantiated
when,
in
fact
an
investigation
really
didn't
occur.
Did
we
just
get
us
that
disposition
type
so
unable
to
complete
would
cover
a
lot
of
those,
in
addition
to
the
fact
that
we
just
can't
collect
the
necessary
information
next
slide,
the
ministry
of
closure
is
really
to
help
us
where
we
don't
have.
T
The
authority
to
investigate
the
if
the
actions
were
not
conducted
by
adult
responsible
approximate
to
that
child,
or
it
is
actually
not
arising
to
child
abuse
and
neglect
when
we
actually
begin
to
to
look
at
it.
This
administrative
closure
lets
us
move
to
that
disposition
type
rather
than
unsubstantiated.
T
It's
clear
that
it
was
not
something
we
were
able
to
clearly
investigate.
We
get
calls
a
lot
where
you
have
example,
a
an
18
year
old
boyfriend
and
an
underage
girlfriend,
and
someone
calls
child
abuse
in
on
that
18
year
old.
Well,
that
18
year
old
boyfriend
is
not
a
responsible
adult
and
and
regarding
care
to
that
child
there
may
be
something
else
there.
T
O
Yeah
chair
ready,
if
I
might
just
add
joanna
jacob
government
affairs
manager
for
the
record,
I
realized,
as
we
were
walking
through
the
powerpoint,
that
I
just
wanted
to
note
on
the
amendment
that,
in
the
amendment
that
has
been
filed
on
nellis,
we
are
proposing
to
change
the
name
of
unable
to
complete,
to
locate,
unable,
to
locate
or
to
contact,
and
the
definition
of
unable
to
locate
or
to
contact
is
exactly
what
mr
burch
said.
But
that's
something
that
we
did
clean
up
with
the
rest
of
our
child.
O
Welfare
agencies
just
wanted
to
make
sure
that
that
was
clear
for
the
committee
members
and
I
will
turn
it
back
over
to
senator
orrinshaw.
A
One
does
seem
pretty
straightforward
key
kefir
all
right.
Please.
F
Sorry
I
know
so
look.
I
certainly
appreciate
the
effort
to
create
a
process
to
reflect
the
subtlety
that
goes
into
some
of
this
stuff
right,
and
I
was
wondering
if,
in
the
in
the
language
that's
being
struck,
particularly
the
unable
to
determine
category,
it
seemed
like
that
might
be
something
that
would
be
worth
having
on
a
file.
Is
there
a
reason
that
we're
not
proceeding
with
that.
S
And
chair
two
and
three
to
center
key
keffer
that
that
is
in
the
texas
statutory
scheme,
but
not
in
every
state,
hasn't
been
in
nevada's
before
that's
proposed
new
language
and
as
I
understand
it,
that's
the
consensus.
Amendment
was
not
to
go
with
that
that
language,
in
terms
of
trying
to
reach
consensus.
S
I
mean
it
was
part
of
the
original
recommendation
but,
as
you
know,
sometimes
there's
a
lot
of
give
and
take
on
bills,
even
even
though
it
did
come
out
unanimously
from
the
interim
committee,
but
we've
had
a
little
more
a
little
more
talks.
A
few
more
talks
on
this
bill.
F
A
All
right:
let's
go
ahead
and
open
up
the
testimony
for
senate
bill
376
with
those
who'd
like
to
testify
and
support
bps,
we'll
limit
it
to
two
minutes.
J
J
J
J
J
J
J
A
J
J
J
I
Good
evening,
for
the
record,
my
name
is
alexis
toosey
a-l-e-x-I-f
last
name
t-u-c-e-y,
I'm
a
deputy
administrator
with
the
division
of
child
and
family
services
here
to
testify
neutral
for
fb
376..
I
did
want
to
extend
a
great
thank
you
to
clark
county
for
continuing
to
collaborate
with
the
various
different
regions
within
for
this
particular
bill.
We
also
definitely
appreciate
the
thoughtful
changes
to
the
proposed
amendment
for
fb
376..
I
We
appreciate
the
changes
that
are
regarding
improvements
for
our
child
welfare
agencies
and
serving
the
populations
within
nevada
for
this
particular
group
and
being
able
to
utilize
this
information
to
pull
together
appropriate
information
for
agencies
to
be
able
to
look
at
changes
that
are
needed
and
to
see
what
the
true
picture
is
that
are
happening
with
these
youth.
So
again,
thank
you.
So
much.
A
J
J
I
Good
afternoon,
chair
ratty
and
members
of
the
senate
committee,
this
is
kendra
burchie
b-e-r-t-s-c-h-y
and
I'm
with
the
washoe
county
public
defender's
office.
For
those
of
you
on
the
committee
who
do
not
know
my
office
represents
parents
who
are
involved
in
these
432b
abuse
neglect
actions.
I
want
to
first
thank
senator
orrinshaw,
as
well
as
ms
jacobs
for
speaking
with
me,
especially
at
this
the
late
hour,
to
try
to
alleviate
all
the
concerns
that
my
office
had
regarding
this
bill.
We
are
in
neutral.
I
appreciate
the
intentions
of
this
bill.
I
Our
only
concern
left
is
just
to
ensure
that
the
new
designations
for
disposition
categories
will
not
be
reported
to
the
central
repository
we
want
to
ensure
that
only
as
in
current
law,
only
the
substantiated
designations
are
the
ones
that
are
reported,
because
these
do
have
significant
consequences
in
terms
of
obtaining
employment,
housing,
social
services,
and
so
it's
just
really
important
that
we
ensure
that
those
that
are
substantiated
are
the
only
ones
that
are
reported.
I
look
forward
to
continuing
the
conversation
and
it's
my
understanding
that
that
is
the
intention
of
this
bill.
I
Is
that
the
unsubstantiated,
unable
to
locate
or
contact
or
administrative
closure
will
not
have
a
legal
impact
on
parents,
and
we
just
want
to
make
sure
that
is
the
case.
So
again,
I
want
to
thank
all
the
members
and
sponsors
for
speaking
with
me
and
the
email
correspondence
to
ensure
that
they
were
able
to
alleviate
my
concerns.
Thank
you.
A
All
right,
thank
you,
bringing
it
back
to
you,
senator
any
closing
comments.
S
Thank
you,
chairman
members
of
the
committee
for
hearing
this
legislation.
I
appreciate
all
the
stakeholders
trying
to
work
with
us
to
address
their
concerns
and
I
hope
the
committee
will
consider
moving
forward
with
us.
S
You
know
it's
hard
to
be
100
sure
I
think
there
might
be
some
additional
language
coming
from
the
washington
county
public
defenders,
but
I'm
not
100
sure
that
is
or
not,
but
I'll.
O
Try
to,
if
I
might
add,
because
I
I
we
were
covering
for
senator
warren
shaw.
Well,
he
was
busy
with
his
legislative
work
today
and
we
did
engage
in
email
correspondence
and
talk
to
ms
burchie.
Today.
We
want
to
make
sure
her
concerns
are
alleviated
if
we
need
to
do
some
tightening
up
of
the
bill
to
alleviate
those
concerns,
I
think
we
can
do
that.
I
think
we
were
amenable
to
those
changes.
O
It
is
true
that
we
believe
that
under
existing
law,
only
substantiated
reports
are
are
put
into
the
central
registry.
If
we
need
to
tighten
it
up
to
alleviate
those
concerns,
I
think
ms
burchie's
sending
something
in
and
we're
amenable
to
that,
so
we
can
process
it
very
quickly.
Okay,
great.
A
Please
stay
in
touch
with
our
committee
staff
so
that
we
status
her
work
session
all
right.
Thank
you.
So
we're
going
to
go
ahead
and
close
the
hearing
on
sb
376.
A
B
A
I
don't
know
if
I
believe
that
and
just
making
sure
that
dr
capraro
is
here
and.
A
Ready
looks
like
we're
good
all
right,
I'd
like
to
turn
over
chair
of
the
meeting
to
senator
harris
for
the
last
bill.
B
All
right,
thank
you.
So
much
chair,
ratty,
I'll,
open
up
the
hearing
on
senate
bill
391
and
welcome
our
very
own
chair.
Please
begin
when
you're
ready.
A
My
name
is
senator
julia
ratty,
and
I
am
here
today,
on
behalf
of
the
interim
committee
on
health
care,
to
present
a
bill
that
was
one
of
the
10
bill
drafts
that
was
recommended
by
the
interim
committee.
This
interim
session
I
want
to
so
the
this
bill
has
been
on
a
journey
as
many
bills
have
in
the
course
of
their
life.
A
I
suppose
I'm
refraining
from
breaking
into
song
from
school
house
rock,
but
in
this
particular
bill,
dr
caprero
and
I
I
will
just
say,
join
hands
in
great
great
optimism
at
the
beginning
of
the
interim
to
say
that
the
status
of
oral
health
in
the
state
of
nevada
is
not
good
and
we
were
going
to
bring
forward
a
very
bold
agenda
and
try
to
find
out
if
there
was
a
couple
of
things
that
we
could
do
to
really
move
the
needle
on
oral
health.
That
was
back
in
september
of
would
be.
A
At
this
point,
and
by
the
time
it
came
time
to
make
the
present
and
and
dr
capuro
just
did-
and
I
take
the
time
to
tell
you
the
story,
because
dr
capraro
did
yeoman's
work
to
scour
best
practice,
look
at
what
other
states
were
doing
and
come
forward
with
a
number
of
ideas
of
how
we
could
move
the
needle
in
oral
health.
A
As
you
can
imagine,
some
of
those
ideas
cost
some
money
and
by
the
time
it
came
time
to
present
at
the
interim
committee,
we
were
needing
in
a
pandemic,
doing
virtual
meetings
and
the
impacts
of
the
budget
on
or
the
pandemic
on.
The
budget
were
starting
to
become
clear,
and
so
dr
capuro
and
I
took
a
couple
steps
back
looked
at
what
could
be
done
that
would
still
help
to.
We
believe,
strengthen
oral
health
in
the
state
of
nevada.
A
We
looked
at
three
significant
concepts.
One
was
an
insurance
concept,
dental
loss
ratio
and,
looking
at
how
do
we
make
sure
that
we
have
a
good,
balanced
approach
and
that
patients
were,
I
guess,
getting
the
most
from
their
insurance.
We
looked
at
particularly
with
the
lens
of
the
pandemic.
A
Were
we
well
situated
to
use
oral
health
providers
in
to
the
highest
and
best
of
their
ability
in
an
emergency
capacity,
and
did
we
have
the
infrastructure
built
around
that,
and
then
we
looked
at
teledentistry
and
what
was
the
state
of
nevada
law
when
it
came
to
teledentistry
and
in
the
end,
the
interim
committee
asked
that
we
move
forward
with
those
three
things
as
we've
gotten
into
session,
and
we've
been
able
to
have
some
more
conversations
about
the
bill.
A
I
will
just
say
that
the
insurance
piece
as
insurance
pieces
often
do
became
quite
complicated
and
at
this
late
date
in
the
session,
with
this
bill
being
one
of
the
later
ones
that
dropped,
we
have
decided
just
to
move
on
from
the
insurance
comp
conversation.
So
you
will
see
in
the
amendment
that
we
have
deleted
all
sections
of
the
bill
that
are
related
to
the
dental
loss
ratio.
A
So
the
bill
that
you
see
before
you
includes
teledentistry
emergency
providers
and
some
changes
to
the
licensing
requirements
for
our
top
oral
health
professionals
in
the
state.
So
with
that,
we
do
have
dr
caprero
here
and
what
I
would
like
to
do
since
she's.
The
subject
matter.
Expert
is
have
her
walk
you
through,
specifically
what
the
bill
accomplishes
in
terms
of
the
emergency
providers,
sections
and
the
tele-dentistry
sections
and
we'll
go
from
there.
Dr
capral
thank.
K
You
senator
reddy
well
good
evening,
senator
harris
honorable
members
of
the
committee
and
committee
staff.
My
name
is
dr
antonina
capero
and
I'm
the
state
dental
health
officer
overseeing
the
oral
health
program
within
the
department
of
health
and
human
services.
I'm
joined
this
evening
by
miss
jessica
woods,
our
interim
state
public
health,
dental
hygienist.
K
K
So
the
the
three
really
key
goals
here
are
to
sustain
the
dental
teledental
services
that
have
become
a
new
delivery
method
to
increase
access
to
care.
We
want
to
expand
the
health
care
workforce,
that's
available
as
a
surge
support
for
major
disasters,
pandemics
for
forensic
identification
and
admit
administrative
readiness
planning
and
then
also
to
prepare
for
any
kind
of
future
public
health,
emergency
or
disaster.
By
creating
the
committee
on
dental
emergency
management,
I
will
stop
there
and
hand
it
back
to
you
senator
ready.
A
So,
following
prior
guidance
in
this
meeting,
we're
we're
staying
relatively
concise
with
the
presentation
and
giving
you
the
opportunity,
hopefully
to
ask
all
the
questions
that
you'd
like
to
ask.
B
All
right,
thank
you,
we'll
open
it
up
to
questions
from
committee
members.
If
they
haven't,
should
I
practically
call
on
senator
kikupur.
A
Perhaps
well,
though,
it
was
always
hardy
before
so
I'm
a
little
confused,
but
let
me
just
add,
I
should
add
that
there
isn't
a
late
coming
amendment,
so
I
just
want
to
make
sure
that
everybody
has
it
and
it's
I've
been
submitted
by
jesse
wadhams
of
the
nevada
hospital
association,
and
I
did
just
want
to
note
it's
a
minor
amendment
to
how
we
get
information
out
to
patients
and
it
is
friendly.
The
the
sponsors
consider
it
friendly.
So
it
did
come
in
right
before
the
hearing.
That's
on
nellis,
considered
friendly.
G
With
that
gauntlet
thrown,
I
have
to
ask
the
question
so
with
this
beautiful
blue
print,
it
totally
replaces
the
bill.
Does
it
not
have
a
fiscal
note
at
all,
then
I
take
it.
A
K
Yes,
thank
you
for
the
question.
Senator
hardy,
the
division,
or
specifically
the
oral
health
program,
would
be
absorbing
any
costs
associated
with
the
committee
on
dental
emergency
management,
and
that
would
be
what
we
saw
as
the
only
cost
that
would
be
associated.
So
there
will
not
be
a
fiscal
note.
B
J
J
J
M
This
is
matt
robinson
m-a-t-t-r-o-b-I-n-s-o-n,
I'm
with
our
general
partners,
and
I'm
here
today
on
behalf
of
liberty,
dental
plan
liberty.
Dental
plan
is
the
current
state,
dental
benefits
administrator
for
children,
on
nevada,
medicaid
in
clark
and
washoe
counties.
We
also
provide
benefits
in
nevada
for
everyone
from
the
teamsters
and
other
labor
groups
to
mgm
to
las
vegas
sands.
M
We're
proud
to
employ
over
200
people
in
clark
county,
as
we
work
to
ensure
nevada
has
access
to
the
best
dental
care
possible.
We
very
much
appreciate
and
support
anything
that
helps
oral
health
in
nevada
and
our
goal
is
to
be
the
state's
partner
in
doing
that.
In
that
spirit,
we've
made
a
really
concerted
effort
to
mitigate
some
of
the
worst
impacts
of
the
pandemic
over
the
last
year.
M
That
includes
providing
nearly
6
000
dental
kits
to
children
in
washoe
and
clark
counties,
building
out
tele-dentistry
services
to
ensure
our
kids
didn't
fall
behind
on
their
oral
health,
which,
as
we
all
know,
is
the
gateway
to
overall
health.
We
chose
providers
over
profit
and
did
not
retroactively
bill
them
for
the
six
percent
rate
cut
that
was
mandated
by
the
summer
special
sessions.
M
M
J
L
L
L
This
is
in
addition
to
all
the
measures
we've
taken
during
the
pandemic
to
support
our
providers,
our
customers,
our
enrollees
and
the
community
through
substantial
financial
assistance.
We
thank
the
interim
committee,
dr
capuro,
and
youth
senator
raddy
for
bringing
this
legislation
forward
in
nevada
and
we
urge
its
passage.
Thank.
J
Q
It
also
defines
the
dental
home
as
dental
hygienists
and
high
dental
therapists
to
the
list
of
recognized
health
care
providers,
and
it
would
bring
nevada
statutes
up
to
date.
The
nevada
dental
hygienist
association
is
proud
to
say
that
we
have
worked
collaboratively
with
the
nevada,
dental
association
and
the
state
of
nevada
oral
health
program
on
many
key
initiatives.
This
session,
this
bill
plays
a
key
role
in
ensuring
nevadans
have
access
to
health
care
by
licensed
dental
practitioners
that
are
highly
educated,
trained
and
ready
to
serve
our
communities.
Q
J
J
M
M
Over
the
last
several
years
we
have
worked
with
partners,
including
liberty,
dental
plan,
the
nevada
state,
medicaid
program
and
local
dentists
as
well
to
help
create
and
deploy
a
solution
that
has
helped
countless
nevada,
medicaid
recipients
and
in
creating
and
then
deploying
a
platform
that
allows
for
an
affordable
method
of
increasing
access
to
care,
and
I
said
in
full
support
of
this
bill.
It
has,
it
has
been
an
absolute
honor
to
help
and
to
help
provide
this
platform
for
everybody
in
the
state.
Thank.
J
J
M
M
B
All
right,
thank
you
so
much.
Let's
go
ahead
and
move
on
to
those
who
like
to
testify
in
opposition.
J
B
Great,
let's
go
ahead
and
turn
to
those
who'd
like
to
testify
in.
J
Certainly
callers
if
you'd
like
to
testify
in
a
neutral
position
for
senate
bill
391,
please
press
star
9
now
to
enter
the
queue.
J
M
Vice
chair
harris
members
of
the
com
committee
on
health
and
human
services,
this
is
jesse
wadhams,
j-e-s-s-e
w-a-d-h-a-m-s,
with
the
law
firm
of
black
and
wadams,
representing
the
nevada
hospital
association
appreciate
dr
capro
and
senator
ratty
in
helping
address
our
concerns
with
the
legislation
has
written.
Obviously,
a
hospital
emergency
department
is
an
incredibly
busy
place
and
focused
on
emergent
care,
and
the
amendment
would
help
us
operationalize
the
the
goals
of
the
legislation.
J
J
B
A
B
Well
I'll,
say:
chair
ready
before
I
hand
it
back
over
to
you
was
nice
to
have
a
bunch
of
dentists
in
the
committee
and
to
not
have
them
drill
us.
But,
okay
back
to
you,.
A
All
right,
well
with
that
that
is
all
of
the
business
for
today
in
terms
of
hearing
bills,
let's
go
ahead
and
open
it
up
to
see.
If
there's
anybody
who
would
like
to
make
public
comment.
J
J
A
Great,
thank
you
so
just
a
couple
of
closing
remarks.
First,
just
would
like
to
say
with
the
pace
that
we're
going.
If
there's
anybody
who
is
submitting
written
comments
for
today's
hearing,
please,
let's
include
those
for
the
records
record.
Anything
that
comes
through
by
the
end
of
the
day
today
can
be
included
as
part
of
the
record
and
then
at
our
next
meeting,
which
is
tuesday
april
6th.
We
will
be
hearing
sb,
201,
sb,
380,
sb,
392
and
sb
396.
A
These
are
all
bills
that
came
out
of
the
inter
interim
committee
to
manage
the
high
cost
pharmaceuticals,
something
like
that.
That
might
not
be
exactly
the
name
of
the
committee,
but
it's
very
close.
It
was
the
pharmaceutical
costs
committee,
we'll
probably
we
will
also
be
having
an
extensive
work
session,
we're
a
little
backed
up
on
work
session.
We
haven't
had
all
of
our
committee
members
present,
so
it'll
be
a
quite
long
work
session.
A
So
long
meeting
on
the
sixth
and
then
our
last
meeting
before
the
committee
passage
deadline
will
be
on
the
8th
and
at
this
point
it's
looking
like
there
will
be
five
bills
on
that
meeting,
plus
a
work
session,
as
well
as
a
matter
of
process,
knowing
that
many
of
these
bills
came
out
relatively
later
in
the
session-
and
I
know
lots
of
folks
are
working
on
lots
of
things.
A
We
will
continue
to
send
amendments
to
the
committee
as
they
are
complete,
so
just
stay
in
touch
with
your
legislative
assistants
and
and
checking
your
emails
for
any
amendments,
because
we're
just
going
to
start
sending
to
them
to
you
now.
If
we
get
them
tomorrow,
we'll
send
them
to
you
if
we
get
them
over
the
weekend,
we'll
send
them
to
you
so
up
until
the
start
of
the
meeting
on
tuesday,
so
that
you
have
what
you
need
both
for
the
work
session
and
for
the
bill
hearings.