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A
Okay,
good
afternoon,
everyone
I'd
like
to
call
to
order
the
senate
committee
on
health
and
human
services
for
march
11th
at
3
31
p.m.
We
were
close
I'll,
go
ahead
and
start
with
a
roll
call
and
note
that
myself,
senator
spearman
vice
chair,
spearman,
senator
harris
and
senator
kikeber
are
present
and
that
senator
hardy
is
presenting
a
bill
in
another
committee,
but
will
join
us
shortly.
So
please
do
mark
him
present
when
he
arrives.
A
Just
as
a
reminder:
we've
been
in
virtual
world
for
a
while.
Now
we
are
still
have
a
building
close
to
protect
the
safety
of
the
public
and
our
staff,
but
there
are
lots
of
ways
to
participate.
So
if
you
haven't
been
able
to
access
that
information,
yet
please,
google,
nevada
legislature,
that'll,
get
you
onto
our
website
and
there's
a
help
bar
on
our
website.
A
A
Of
course,
we
care
about
children
for
17
weeks
long
and
even
perhaps
when
we're
not
in
session,
but
we
did
want
to
highlight
these
bills
this
week
during
children's
week
and
want
to
thank
all
of
the
advocates
who
have
been
doing
a
lot
of
work
to
raise
awareness
about
issues
that
face
children
during
during
this
legislative
session.
So
with
that,
I
am
going
to
go
ahead
and
open
the
hearing
on
sb
146
and
invite
senator
orange
all
to
the
virtual
diets
to
present
senate
bill
146.
B
Thank
you
very
much
chair
ready
and
members
of
the
senate,
health
and
human
services
committee
appreciate
you
hearing
both
these
measures
this
afternoon.
For
the
record,
my
name
is
james
orenshaw.
I
represent
state
senate
district
21,
that's
parts
of
henderson
and
unincorporated
clark
county
with
me
today.
I
have
amy
honeydel,
a
children's
advocacy
attorney
at
the
legal
aid
center
of
southern
nevada,
I'm
privileged
to
know
amy
and
actually
work
with
her.
We
have
both
represented
the
same
clients
at
different
times
in
juvenile
court.
Also.
B
I
have
bailey
bortolin
with
the
coalition
of
legal
service
providers.
With
your
permission,
chair
ratty,
I
will
give
some
brief
opening
remarks
and
then
ms
honadell
will
tell
you
more
about
the
need
for
this
legislation.
B
We
have
some
experts
with
us
today
who
can
help
answer
questions
senate
bill
146,
seeks
to
codify
best
practices
for
coordination
and
communication
when
practicable
between
the
treating
team
or
youth's
mental
health
and
the
receiving
team
that
is
treating
the
child.
If
and
when
that
child
is
in
a
temporary
crisis.
B
Unfortunately,
sometimes
things
can
get
worse
and
a
child
experiences
a
temporary
crisis
and
unfortunately,
that
information
is
not
always
relayed
as
to
past
treatment
plans
and,
what's
already
in
place,
what
might
have
helped
talk
the
child
down
or
inform
the
care
and
treatment
plan
of
the
child
may
be
left
out
of
the
conversation
when
that
child
is
released
from
a
facility
oftentimes,
there
are
new
diagnoses,
medications
and
plans
that
are
different
and
possibly
in
conflict
with
the
original
treatment
plan.
B
The
intent
of
this
legislation
is
not
to
hamstring
providers
or
reduce
access
to
emergency
care.
In
any
way,
we
want
children
to
receive
the
treatment
they
need
and
we
trust
the
professionals
that
are
treating
them.
But
we
believe
that
codifying
the
best
practices
of
an
informed
and
warm
handoff
and
consultation
could
make
a
world
of
difference
for
these
kids
with
that
and
with
your
permission,
chair
addy,
I'd
like
to
turn
it
over
to
amy
hanadahl
to
share
some
of
her
experiences
as
a
children's
advocacy
attorney
around
this.
C
Thank
you,
chair
ratty
and
members
of
the
committee
for
allowing
me
to
speak
on
senate
bill
146,
and
the
amendment
that
is
being
put
forth.
I
am
amy
hanadel
last
name
is
spelled
h-o-n-o-t-e-l.
C
I
am
a
staff
attorney
with
legal
aid
center
of
southern
nevada
in
the
children's
attorneys
project
I
represent
about
100
foster
kids
at
any
given
time.
So
this
issue
is
near
and
dear
to
my
heart
as
well
as
to
my
clients,
I
submitted
a
written
statement
in
support
of
senate
bill
146,
but
I
would
like
to
outline
the
bill
with
the
amendments
for
the
committee.
C
Briefly,
the
first
section
section
one
is
requiring
admitting
staff
at
a
locked
mental
health
facility
to
reach
out
to
a
child
a
foster
child,
a
main,
treating
main
mental
health
treating
provider
after
asking.
Whoever
brings
that
child
in
if
they
have
a
treating
psychiatrist
or
a
main
treating
provider.
C
In
the
time
that
I
have
been
representing
children,
what
has
become
quickly
apparent
to
me
from
a
qualitative
observational
standpoint
as
well
as
in
my
education,
on
child
welfare
law
and
practice,
is
that
number
one
youth
in
foster
care
have
a
significantly
higher
rate
of
diagnosis
of
mental
health
care
problems
than
our
general
population,
and
I
was
reading
an
article
recently
that
said,
80
percent
of
the
foster
care
population
has
mental
health
care
issues
that
need
treatment
versus
18
to
22
percent
of
the
general
population.
C
We
have
a
child
welfare
worker,
we
have
attorneys
and
we
have
the
court
overseeing
what
happens
to
this
child.
So
it
makes
care
coordination
particularly
difficult,
and
this
bill
is
not
intended
to
undercut
what
you
know.
The
mental
health
providers
we
have
here
in
nevada
do.
Rather
it's
really
to
get
them
to
start
coordinating
care
when
the
care
is
better
coordinated,
then
the
outcomes
are
better
for
our
foster
youth
and
we,
I
think
many
of
us
will
agree
that
we
need
to
improve
the
outcomes
for
these
kids.
They
are
at
significant
disadvantages.
C
So
I
want
to
tell
you
two
stories,
and
these
are
the
stories
that
are
set
forth
in
my
written
statement
that
are
submitted
about
the
clients
I
currently
have
on
my
caseloads,
I'm
using
pseudonyms
for
them
they're
younger
kids,
one
is
caden
and
caden
is
a
ten-year-old.
I
wasn't
his
original
attorney,
but
this
kid
is
smart
as
a
whip
and
can
beat
me
legitimately
at
several
games,
including
connect
four,
but
kayden's
been
in
care
for
about
four
years.
He
came
in
with
four
siblings.
C
His
siblings
are
in
their
forever
home.
Caden
is
not.
Let
me
tell
you
why
he's
not
in
his
forever
home
he
has
intense
anger
and
when
he
has
an
outburst
he
will.
He
will
try
to
hit
and
kick
things
he'll
knock
over
furniture.
He
will
yell
and
scream,
and
it
can
be
scary-
and
it's
definitely
memorable
as
I
have
seen
them,
but
when
these
occur
he's
ten
he's
not
that
big.
C
But
it's
enough
that,
under
our
child
welfare
law,
nevada
statute,
chapter
432b,
that
kaden
can
be
admitted
to
one
of
these
locked
facilities
and
I
think
he's
been
admitted
more
than
ten
times
since
he's
been
in
care.
C
But
when
he
goes
to
those
facilities,
they're,
scary,
okay,
he
doesn't
get
to
take
his
own
clothes
and
if
he
does
have
his
own
clothes,
he
doesn't
get
to
take
anything
with
strings
or
wires.
It's
a
strange
bed,
strange
people,
it's
noisy
and
he'll,
see
a
doctor
and
it's
usually
not
his
doctor
that
he's
had
since
the
beginning.
One
thing
I
can
say
about
cadence
treatment
team
is
that
involves
a
person
who
diagnoses
medicare.
Excuse
me
prescribes
medication.
C
He
is
a
therapist
who
is
very
invested
in
his
well-being
and
is
trying
everything
within
his
means
to
help
aid
or
kaden
be
able
to
make
it
through
these
outbursts
without
hurting
anyone.
He
had
myself
and
a
couple.
Other
workers
were
really
dedicated
to
him,
but
when
he's
in
this
hospital,
none
of
us
are
there
with
him.
C
Caden
had
an
outburst
he
was
admitted
and
when
he
was
discharged
he
was
given
a
new
prescription
by
the
doctor
inside
the
hospital,
and
that
was
not
communicated
or
transmitted
to
the
rest
of
the
team.
So
he
left
essentially
without
medication
that
he
had
been
taking
while
he
was
in,
and
this
disruption
in
his
care
actually
led
to
a
more
intense
outburst
at
which
time
the
uncle
said.
I
can't
take
them.
C
I
can't
adopt
them
so
right
now,
caden
is
in
a
congregate
care
facility
without
an
adoptive
resource
at
age
10,
and
it
seems
that
in
the
only
way
that
this
young
man,
this
boy
will
find
permanency
is
if
we
can
get
the
care
addressed
now.
On
the
flip
side,
I
have
another
client,
sarah
and
who
is
very
close
to
being
in
her
forever
home.
So
this
is
a
good
story
for
her,
but
at
one
point
in
time
she
was
with
a
relative
placement
and
did
not
want
to
visit
with
her
biological
father.
C
She
I
she
threatened
to
cut
herself,
and
that
is
you
know.
While
it's
not
a
suicide
attempt,
it
is
enough
to
get
her
admitted
to
one
of
these
inpatient
facilities.
C
Now,
in
this
particular
case,
I
had
been
coordinating
with
her
therapist
the
person
she
sees
on
a
regular
basis
about
this
visit
with
a
dad,
and
when
I
heard
that
law
enforcement
was
on
their
way
out
to
sarah's
placement
to
take
her
through
the
system
to
be
admitted,
I
reached
out
to
the
therapist
and
said:
hey,
I.
I
don't
think
this
is
serious.
I
think
this
is
some
influence
from
some
adults.
C
Can
you
please
get
involved,
and
the
good
news
is
that
there
was
not
admitted
you
know
between
the
therapist
advocacy
that
the
emergency
doctors
who
were
looking
at
her,
they
decided
that
this
was
more
of
a
statement
of
an
11
year
old,
being
dramatic
and
not
a
threat
of
self-harm.
So
the
good
news
was,
she
did
go
to
go
to
that
visit.
She
wasn't
admitted
to
one
of
these
facilities.
C
C
They
have
a
case
worker
and
sometimes
it
might
be
an
on-call
worker.
It
might
be
a
foster
parent
who
doesn't
know
them.
So
we
want
the
medical
professionals
to
start
communicating
to
work
together
so
that
we
can
get
really
good
outcomes
for
these
youth
in
the
least
restrictive
settings.
It's
not
in
any
way
intended
to
undermine
or
any
way
limit
the
hospital.
You
just
want
to
bridge
a
gap,
and
I
thank
you
for
allowing
me
to
address.
A
This
thank
you
very
much
for
sharing
your
testimony.
Senator
orrinshaw
is
there
additional
presentation
of
the
bill.
B
D
Thank
you,
bailey
portland,
for
the
record,
with
nevada
coalition
of
legal
service
providers.
I'm
just
here
to
answer
questions
as
well,
and
I
would
note
that
dcfs
is
with
us
on
the
zoom,
including
dr
raven,
from
public
and
behavioral
health,
who
has
helped
drop
this
language
and
can
speak
to
some
of
the
medical
terms
of
art
in
it.
Should
you
have
questions
around
that?
D
I
was
looking
forward
to
having
him
here
for
dr
hardy's
questions,
but
maybe
he'll
join
us
during
and
then
bridget
duffy
is
also
here
with
the
department
of
family
services.
So
I
think
our
conversations
have
led
to
what
looks
like
a
scary
amendment,
but
is
really
good
language,
that
everyone
agrees,
fixes
a
problem
and
codifies
a
best
practice
that
could
make
a
big
difference
for
our
kids.
So
thanks.
A
Okay,
great
I'll,
go
ahead
and
open
it
up
to
the
committee
first
for
questions
you
can
use
your
virtual
hand
or
just
wave
at
me.
I
can
see
you
all
right
now.
A
All
right,
I
see
no
virtual
hands
or
ravings,
but
I
I
do
have
a
couple
questions
that
I'd
like
to
get
on
the
record
just
to
make
sure
they're
clear.
So,
first
of
all,
could
you
comment
on
whether
it
sounds
like
from
your
testimony
that
this
is
intended
to
only
be
or
inpatient
admitting?
So
not
necessarily
if
I
have
an
outpatient
plan
of
care
or
an
intensive
outpatient
plan
of
care
or
anything
along
those
lines.
So
is
that
that
accurate?
A
C
Thank
you
chair
again
for
the
record.
This
is
amy
hanadel.
Yes,
it's
only
to
be
used
for
inpatient
admission
into
a
large
facility,
and
while
I
don't
see
the
wording
in
there
for
emergency
or
unplanned,
I
would
submit
to
the
committee
that
that
would
be
the
only
time
it
would
be
used
when
we
do
have
planned
admissions.
We
have
a
separate,
separate
procedure
in
nrs
432b
to
make
a
request
to
the
court
for
court
ordered
admission,
so
this
would
be
for
those
times
when
it's
exigent
circumstances.
A
Narrowly
tailored
to
an
emergency
or
unplanned
admittance
into
an
inpatient
facility,
correct
great
thank
you
and
that
was
amy
honeydel
for
the
record
and
then
other
just
for
the
record
question
when
we
say
other
health
care
providers,
it
looks
like
there's
some
narrowing
language
where,
in
the
subsection
one
it's
in
section
one,
it
says,
or
another
health
care
provider
authorized
to
diagnose
and
treat
mental
disorders.
But
could
we
be
very
clear
about
what
health
care
providers
were
talking
about.
C
Thank
you
chair.
This
is
amy
hanadel
again.
I
wanted
to
defer
this
to
dr
ravin
from
dcfs,
but
from
the
legal
advocacy
standpoint.
This
would
be
someone
who
is
qualified
to
diagnose
a
child
with
either
an
emotional
disturbance
or
mental
health
disorder.
So
we're
looking
at
psychiatrists
psychologists
to
the
extent
that
certain
levels
of
therapists,
depending
on
their
training,
can
make
or
suggest
a
diagnosis.
C
We
would
include
them,
but
this
wouldn't
be
the
social
work
interns
working
under
supervision.
We're
looking
for
someone
who
has
a
rapport
with
the
child
who's
familiar
with
the
treatment
has
a
requisite
education
and
licensure.
To
do
that.
Thank.
A
You
could
be
like
it
and
perhaps
doctor
even
you'll
comment
on
this,
but
an
aprn
with
a
emphasis
in
behavioral
health.
Perhaps.
C
A
E
Good
evening,
oh
good
afternoon,
chair
ready
and
members
of
the
committee
for
the
record,
this
is
dr
leon.
Raven
spelled
l-e-o-n.
E
I
am
statewide
psychiatric
medical
director
for
the
division
of
public
and
behavioral
health.
Thank
you
for
the
opportunity
to
consult
on
the
language
of
this
bill
and
to
your
question.
Senator
radi.
E
The
scope
of
the
individuals
who
could
provide
input
to
the
inpatient
treatment
team
should
include
all
the
professionals
who
are
primarily
responsible
for
diagnosing
and
treating
of
the
child
in
our
patients.
Setting
so
most
commonly
there
would
be
a
psychiatrist,
but
also
we
have
to
recognize
that
a
number
of
children
receive
care
from
up
providers
like
advanced
practice
registered
nurses,
since
they
received
their
legal
right
to
practice
as
a
licensed
independent
providers
without
supervision
or
collaboration.
E
They,
though
it
is
my
understanding
that,
with
the
permission
of
nursing
board,
they
can
practice
when
the
the
scope
of
psychiatric
mental
health,
when
they
have
appropriate
credentials
and
qualifications.
In
addition
to
that,
that
could
be
a
physician
assistant,
for
example,
who
practices
under
the
supervision
of
a
psychiatrist.
E
It
could
be
a
primary
care
provider
because
we
do
need
to
recognize
that
many
individuals
receive
help
for
their
psychiatric
needs
are
from
primary
care,
family
physicians,
so
those
could
be
included
as
well
and
in
cases
when
a
child
is
not
in
need
of
psychotropic
medications,
so
it
is
foreseeable
or
that
a
psychologist
would
be
the
primary
health
care
provider
for
the
child
for
his
or
her
mental
health
needs.
A
So
I
heard
thank
you
for
the
answer,
so
I
heard
psychiatrists,
aprns,
physicians,
assistants,
primary
care,
doctors,
psychologists,
what
about
licensed
clinical
social
workers
or
family
licensed
family
therapists.
E
Thank
you,
senator
wright
for
this
question.
Again.
It's
that
leon
raven
for
the
record.
I
can
only
comment
for
the
scope
of
the
disciplines
that
are
authorized
to
prescribe
medications,
so
I
cannot
speak
on
behalf
of
the
mental
or
mft,
so
marriage,
family,
therapies
or
other
clinic
licensed
clinical
counselors.
E
However,
I
would
like
to
emphasize
that,
since
of
the
professionals,
I
expected
to
provide
substantive
input
onto
the
inpatient
treatment
team
to
the
extent
of
need
for
inpatient
hospitalization.
E
I
imagine
that
that
should
be
professionals
who
are
typically
authorized
to
have
admitting
privileges
to
impatient
psychiatric
services,
and
usually
there
would
be
either
physicians
or
physician
assistants
or
advanced
practice.
Registered
nurses.
A
Okay,
so
we're
going
to
have
to
drill
that
down
and
really
make
sure
what
we're
understanding
that
the
amendment
wants
to
include.
So,
if
it
is
just
people
who
have
a
bidding
privileges
or
if
it
is
any
behavioral
health
care,
professional
who's
already
connected
to
this
child,
who
might
have
input
if
we
could
get
some
feedback
on
the
intent
of
where,
where
you
really
want
that
to
land,
I
think
we'll
we'll
need
some
help.
A
I
think
our
challenge
is
that
other
another
health
care
provider
authorized
to
diagnose
and
treat
treat
could
be
psychologists
and
licensed
marriage,
family
therapist
licensed
clinical
social
worker.
So
I'm
not
sure
if
anybody
else
is
able
to
comment
on
the
intent,
but
before
we
work
session,
while.
E
We
want
to
do
that.
If
I
may
add,
this
is
again
liam
raven
for
the
record.
I
do
think
that
it
may
make
sense
to
split
the
professions
into
two
categories,
since
section
two
primarily
focuses
on
determining
the
level
of
care
for
the
child,
which
is
whether
or
not
toward
being
the
child
to
the
most
restrictive
settings
of
inpatient
treatment
facility
or
continue
treating
the
child
in
outpatient
settings.
E
That's
where
you
may
need
a
professional
who
is
at
the
level
of
qualifying
for
having
admitting
privileges
to
the
hospital,
but
for
the
ongoing
coordination
of
care
and
discharge
planning
or
any
mental
health
professional
who
is
primarily
involved
in
treating
a
child
for
mental
or
behavioral
health
issues
should
be
included.
So
no,
I
certainly
foresee
possibility
of
splitting
that
into
two
categories.
Thank
you.
A
F
Thank
you,
chair,
ready.
No
apologies
needed.
I
was
a
little
late
getting
to
the
reactions
button,
so
I
I
have
a
couple
of
questions.
If
that's
okay,
my
first
question
is
that
all
right,
chair.
F
Questions,
thank
you
so
much
so.
My
first
question
is:
why
are
we
limiting
this
to
to
children
juveniles
who
are
under
the
jurisdiction
of
the
juvenile
court?
I
know
that
those
are
the
children
that
legal
aid
often
interacts
with,
but
are
we
seeing
this
gap
with
other
children
as
well.
D
Bailey
bortland
for
the
record,
so
that's
a
great
question
senator
when
we
first
started
having
these
conversations
with
some
of
the
treating
doctors
that
we
often
work
with
in
the
b
context,
and
we
were
identifying
the
problem
right
of
our
kids
already
have
diagnoses,
they
already
have
medications
and
they
come
out
with
a
whole
different
set.
And
could
we
try
to
coordinate
that
care?
D
We
were
told
well,
yeah,
that's
a
best
practice,
that's
the
best
practice
that
should
be
happening,
and
so,
when
we
were
told
it
was
the
best
practice.
We
thought
that
the
gap
was
probably
specific
to
432b,
and
so
we
wanted
to
solve
the
problem
for
our
clients.
D
I
can't
with
any
first-hand
knowledge
speak
to
what
is
happening
in
other
places,
but
I
will
say
in
the
last
day
or
two
we've
gotten
some
feedback
that
it
may
make
sense
to
broaden
this,
and
that
just
wasn't
the
angle
we
were
coming
from
and
I
think
dr
raven
could
speak
to
that
as
well.
If
you'd
like
to.
E
Thank
you
senator
harris
for
this
question.
I'll
throw
chair,
write
it
to
you.
E
I
do
agree
that
the
same
level
of
collaboration
constitutes
good
clinical
practice
across
all
ages
and
overall,
as
a
practicing
physician
well
practicing
physicians,
who
should
not
be
making
the
determination
on
the
scope
of
care
provided
or
the
level
of
coordination
just
based
on
whether
or
not
the
child
has
parents
or
is
in
foster
care,
or
is
it
any
other
facilities
as
well
as,
even
if
the
person
is
an
adult,
we
still
should
strive
to
maintain
the
best
collaboration
between
inpatient
and
outpatient
providers.
B
B
Certainly
when
we
look
at
trying
to
fix
a
problem-
and
you
know
I
think
the
the
question
comes
as
to
you
know
the
the
scope
we're
going
to
look
at
with
the
legislation,
but
in
my
experience
practicing
in
the
delinquency
courts,
not
in
the
abuse
of
neglect
sphere.
Certainly,
I've
heard
from
parents
who
felt
frustrated
when
a
child
was
let's
say
committed
to
a
state
correctional
facility.
They'd
had
a
treating
psychiatrist
before
here
in
the
community
and
felt
that
you
know.
B
Maybe
there
was
a
real
disconnect
between
the
the
care
plan
prior
to
the
child
being
committed
not
not
to
a
mental
health
facility
but
to
a
correctional
facility.
So
I'm
that's
anecdotal.
You
know
I
don't
have
studies
as
to
whether
that's
an
issue
but
anecdotally.
I
certainly
have
have
observed
that
in
terms
of
continuity
of
care
and
whether
the
the
treatment
at
the
facility,
even
if
it's
not
a
mental
health
facility,
is
really
if
there's
a
disconnect
between
the
treatment
plan
before.
F
Well,
I
would,
I
would
certainly
support
helping
as
many
children
as
we
can
with
this
bill.
If
that's
something
you
all
are
interested
in
in
taking
on
so.
My
next
question
is
about
the
language
in
subsection,
one
versus
the
language
and
subsection
three,
and
this
may
just
be
a
a
minor
drafting
in
subsection
one.
F
You
know
congruent
or,
if
there's
a
reason
why
it's
a
bit
more
broader
in
subsection,
one
than
in
subsection
three.
D
Bailey
bordelin
for
the
record.
Thank
you
senator
you
are
right
and
drafting
and
your
lovely,
wonderful
committee
staff
has
noticed
that
issue
as
well,
but
that
just
got
lost
in
translation
of
all
of
the
stakeholder
rounds.
We
went
through
on
this
amendment,
so
the
department
of
family
services
park
county
requested
that
section
three
narrowing
to
to
inpatient
psychiatric
treatment
facility,
and
we
would.
We
would
now
go
back
and
mirror
that
in
section
one
and
just
missed
that.
A
F
A
D
I'm
going
to
defer
the
question
to
amy
to
speak
to
if
both
types
are
used
in
432b.
I
can't
answer
that.
C
All
right,
thank
you,
chair
for
the
record.
This
is
amy
hanadel
answering
this
question.
It's
intended
to
apply
to
both,
which
may
be
the
reason
for
the
conflicting
language
are
youth
down
in
clark.
County
are
admitted
both
to
state
facilities,
and
we
have
a
few
private
facilities
that
are
taking
them
on
an
inpatient
basis.
A
F
Okay,
I
promise
this
is
the
last
one
in
subsection,
one
there's
a
change
from
before
to
when.
Can
you
tell
me
a
little
bit
about
why
that
change
was
made
and
what,
when
means,
if
not
before,.
D
Bailey
bortlin
for
the
record.
I
will
let
bridget
duffy
jump
in
here
as
well
if
she
wants
to,
but
some
of
the
concerns
was
just
from
a
practical
standpoint.
I
think
legally,
we
agree
with
you,
but
practically
speaking,
we
thought
before
had
more
of
a
connotation
of
you
can't
do
this
unless
and
we
wanted
to
make
it
abundantly
clear
that
this
was
a
when
practicable
but
should
not
be
seen
as
a
basis
for
denial
and
bridget
I'll.
Let
you
jump
in
if
that
didn't
quite
cover
it.
G
Yes,
good
afternoon,
chair
ready
and
members
of
the
committee,
I
am
bridget
duffy.
It
is
b-r-I-g-I-d
d-u-f-f-y,
I'm
the
chief
of
the
juvenile
division
for
the
clark
county
district
attorney's
office,
and
I'm
here
today
on
behalf
of
clark
county
department
of
family
services.
That
is
like
a
super
long
title,
senator
harris
it
was
the
department
of
family
services
request
to
change
the
before
to
when,
specifically
for
what
ms
borderlin
had
expressed,
we
sometimes
have
difficulty
when
our
children
are
continually
cycling
into
these
acute
episodes
for
emergency
treatment.
G
G
We
couldn't
reach
the
treating
health
care
provider,
so
we
cannot
admit
this
child
for
this
emergency
treatment
because
we
were
unable
to
admit
we
were
afraid
of
how
that
might
be
interpreted
at
three
o'clock
in
the
morning
by
a
staff
of
a
hospital,
and
so
we
thought
that
it
would
be
much
more
clear
for
everybody
to
understand
that
when
you
are
admitting
a
child,
you
need
to
make
those
reasonable
efforts
to
contact
that
healthcare
provider.
F
And
miss
duffy
is
there
some
type
of
I
guess
a
time
limit,
that's
reasonable.
You
know
within
48
hours
or
you
know,
I've
noticed
the
change
at
the
bottom,
where
it
says,
make
reasonable
effort,
and
so
that
alone
seems
like
it
would
address
your
concerns
even
without
changing
from
when
to
before.
But
you
know
is
there
something
where
we
could
put
a
you
know
an
actual
requirement
that
this
reasonable
effort
be
made
within
a
certain
amount
of
time,
as
opposed
to,
I
guess,
leaving
it
kind
of
open.
G
Yes,
richard
duffy
for
the
record.
Thank
you
senator
harris
for
that
question.
Actually
I
I
don't
disagree
with
you.
I
think
that
the
reasonable
efforts
was
the
recommended
language
of
dcfs
and-
and
I
I
honestly
had
put
some
time
frames
on
there.
I
don't
know
if
I
put
the
best
time
frame
on
there,
but
I
I
like
you.
I
agree
that
there
should
be
some
sort
of
no
later
then,
but
again
we
all
we're
all
working
to
compromise
to
come
up
with
the
best
bill
possible.
G
I
don't
work
in
the
field
of
of
psychiatric
treatment,
so
I
was
going
with
the
experts
that
from
our
dcfs
partners,
but
I
I
do
understand
your
concern.
E
E
Making
efforts,
as
opposed
to
not
to
the
considerations,
are
that
if
a
child
is
a
brought
to
the
facility
on
friday
night,
then
the
outpatient
provider
may
not
be
available
for
his
or
her
input
until
monday
morning,
and
if
we
say
that
the
inpatient
treatment
team
should
seek
that
input
no
later
than
24
hours.
E
Let's
say
no
later
than
12
hours
from
the
time
of
the
admission
of
the
child,
then
we
are
risking
a
possibility
that
they
will
try
to
seek
that
input
only
for
the
duration
of
time
outlined
in
the
language
of
the
bill
and
after
that,
they'll
just
put
an
entry
in
the
charge
saying
that
they
tried
and
they
got
no
response,
and
at
that
point
that
would
be
the
end
of
their
efforts
from
the
clinical
care
perspective.
A
A
H
A
I
H
I
H
Desean
jackson,
d-a-s-h-u-n
j-a-c-k-s-o-n
good
afternoon,
chairwoman,
rowdy
and
community
members,
my
name
is
desean
jackson
and
I
currently
serve
as
the
director
of
children's
safety
and
policy
with
the
children's
advocacy
alliance.
The
children's
advocacy
alliance
supports
senate
bill
146.
We
believe
this
bill
promotes
the
mental
and
emotional
health
of
a
child.
H
The
children's
dog
client
also
recognizes
the
trauma
a
child
goes
through
when
they
are
placed
into
a
facility
and
removed
from
their
home.
This
bill
allows
the
continuity
continuity
of
care,
while
preventing
a
child
from
being
over
medicated
and
reducing
the
trauma
caused
to
the
child.
Lastly,
this
also
allows
and
promotes
youth
having
a
voice.
Thank
you
all.
So.
I
J
Good
afternoon,
chair
ratty
and
members
of
the
committee,
this
is
kendra
burchie
k-e-n-d-r-a
b-e-r-t-s-c-h-y,
with
the
washoe
county
public
defender's
office.
My
office
represents
parents
in
those
432-b
actions
and
we
support
this
bill.
We
appreciate
the
senator
for
bringing
forward
this
important
issue
to
ensure
that
there
is
continuity
of
care
for
children.
J
I'll
just
add
that
I
previously
worked
as
a
children's
attorney
as
well
as
handling
the
docket
specifically
for
child
commitment
hearings,
and
I
would
agree
with
the
statements
that
this
can
be
extremely
traumatic
and
we
are
preventing
potentially
future
harm
on
these
children
by
allowing
for
there
to
be
that
continuity
of
care.
Thank
you.
I
H
A
Another
ready,
sorry
interrupt.
I
think
bridget
duffy
would
like
to
testify
and
support
as
well.
Oh,
I
apologize
bridget
go
ahead.
I'm
sorry,
miss
duffy
go
ahead.
You
are
on
mute,
mister.
G
Oh,
thank
you,
chair,
ready
and
members
of
the
committee.
I
understand
I
I
was
called
in
before
I
got
to
put
my
official
support
on
the
record
on
behalf
of
the
clark
county
department
of
family
services.
I
will
spare
you
my
long
title
again,
but
I'd
like
to
thank
senator
orrinshaw
legal
aid
services
and
dr
ravin
from
dcfs
for
working
with
the
child
welfare
agencies
to
address
our
concerns
with
the
original
language.
We
support
the
policy
of
ensuring
that
we
are
coordinating
mental
health
care
for
our
children
in
foster
care.
G
Our
children
often
come
with
complex
levels
of
trauma
and
are
in
need
of
consistent
treatment
when
times
occur,
that
a
child
has
an
acute
episode
and
needs
an
emergency
placement
in
a
psychiatric
treatment
facility.
It
is
important
that
the
people
on
the
outside
or
the
ongoing
health
care
providers,
who
have
an
established
relationship
with
our
children
and
the
acute
inpatient
psychiatric
care
provider,
are
communicating.
It
is
best
practice
and
is
in
our
children's
best
interest
senator
harris.
I
also
want
to
say
I
loved
your
question.
G
A
I
I
A
Is
there
now
we'll
go
ahead
and
open
up
testimony
in
neutral?
Do
I
have
anybody
on
the
zoom
who
needed
to
testify
in.
A
A
Okay,
I
don't
see
anybody
so
going.
Let's
bps,
let's
go
ahead
and
open
up
the
phone
line
for
anybody.
Who'd
like
to
testify
in.
I
I
A
B
Secretary
members
of
committee,
thank
you
for
hearing
the
bill.
I
really
appreciate
all
the
support,
all
the
stakeholders
working
together
on
this
measure.
I
have
taken
to
heart
this
committee's
suggestions
in
terms
of
trying
to
come
up
with
a
little
more
detail
as
to
definition
of
healthcare
provider
and
to
senator
harris's
comments
about
whether
the
idea
here
should
be
expanded
for
other
children
and
I'll
go
back
to
the
stakeholders,
I'm
working
with
and
see.
If,
if
we
can
work
on
those
issues,
thank
you
for
hearing
the
bill.
A
Okay
committee,
any
additional
clarifying
questions
before
we
close
this
hearing.
B
Thank
you
very
much
chair
ratty
members
of
the
committee
for
hearing
senate
bill
158,
I'm
still
james
orenshall.
I
still
represent
state
senate
district
21
parts
of
henderson
unincorporated
clark
county
and
during
the
last
interim
I
was
very
very
lucky
to
chair
the
interim
committee
on
child
welfare
and
juvenile
justice.
It
was
a
great
honor
and
a
privilege,
and
I
certainly
want
to
thank
majority
leader
of
the
assistant
majority
leader
legislative
commission,
for
giving
me
that
opportunity.
B
We
were
able
to
have
eight
meetings.
We
had
two
in-person
meetings
before
the
pandemic
and
then
our
remaining
six
meetings
were
all
held.
Virtually
we
came
up
with
many
recommendations.
We
we
did.
A
lot
of
work
really
commend
the
members
and
the
staff
tremendous
work
went
into
this
committee.
The
interim
we
came
out
with
10
recommendations
for
legislation.
B
I
believe
they
either
all
passed
with
bipartisan,
unanimous
support
or
or
nearly
all
past
there
might
have
been-
might
have
been
a
couple
where
we
didn't,
but
I
thought
that
we
we
really
could
came
to
con
concur
on
many
of
these
issues
and
senate
bill.
58
is
one
of
those
builder
after
quests
and
I'm
lucky
to
have
some
experts
here
who
work
in
this
area
from
legal
aid
center
and,
with
your
permission,
chair
ratty,
I'd
like
to
turn
it
over.
B
I
believe
to
mr
patrick
hirsch,
representing
legal
aid
center
of
southern
nevada
and
bailey
bortolin
coalition
legal
service
providers
to
discuss
this
legislation
and
the
kinship
guardianship
assistance
program.
There
is
an
amendment
which
should
be
on
nellis.
We've
worked
with
ross
armstrong
of
the
state
of
nevada
and
other
stakeholders
on
that,
and
I
I
believe
that
we've
we've
got
something
that
will
be
beneficial
for
the
state
and
for
our
children
and,
with
your
permission,
chair
I'd
like
to
turn
it
over
to
them
and
then
answer
any
questions
after
they're
done.
K
Thank
you
senator
and
good
afternoon,
chair
ready
and
committee
members.
I've
submitted
a
written
statement
supporting
sb
158
and
I
don't
want
to
belabor
those
points
here,
but
I
would
like
to
highlight
one
particular
issue
that
this
bill
addresses
and
then
provide
a
little
context
for
the
bill.
Overall,
the
issue
I'd
like
to
highlight
is
the
way
our
current
laws
eliminate
the
ability
of
our
child
welfare
agencies
to
use
their
discretion.
K
The
way
nevada's
law
is
currently
written.
It
completely
disregards
the
professional
opinion
of
our
child
welfare
caseworkers,
the
ones
that
we
entrust
with
the
welfare
of
nevada's
children.
Currently
it
doesn't
matter
if
the
responsible
child
welfare
agency
is
recommending
guardianship
as
the
best
possible
outcome
for
the
child.
K
To
illustrate
a
little
bit
more
about
the
need
for
this
bill.
Please
let
me
tell
you
about
a
client,
I'm
currently
representing
I'll
call
him
tommy
tommy.
His
father
has
never
really
been
a
part
of
his
life.
We
don't
really
know
where
he
is
tommy's
been
raised
by
his
mother
and
they
are
very
closely
bonded.
But
tommy's
mother
is
an
alcoholic.
K
She's
been
in
recovery
for
almost
a
decade,
but
recently
she
had
a
relapse
she's
trying,
but
she
hasn't
been
able
to
get
her
sobriety
back
yet
now,
tommy's
only
12
years
old
and
in
nevada.
That's
not
old
enough
to
have
the
right
to
consent
to
or
withhold
consent
to
his
own
adoption,
but
he
does
not
want
to
be
adopted
and
he'll.
Tell
anyone
who
asks
he's
made
that
very
clear.
K
It's
his
therapist
professional
opinion
that
an
adoption
would
probably
not
be
in
his
best
interests
right
now.
Tommy's
living
with
his
maternal
grandparents,
his
mom's
parents
and
all
of
them
are
holding
out
hope
that
mom
will
get
her
sobriety
back.
The
grandparents
could
adopt
tommy,
but
they
don't
want
to.
K
If
they
did,
they
would
have
to
terminate
their
own
daughter's
rights
and
take
her
place
in
doing
so
seems
to
close
the
door
on
her
instead
of
offering
the
hope
and
the
help
that
they
want
to
now
under
nevada's
current
laws.
The
fact
that
they
could
adopt
means
that
tommy's
grandparents
are
not
eligible
for
a
guardianship
through
the
kin
gap
program.
K
It
doesn't
matter
that
tommy
doesn't
want
to
be
adopted.
It
doesn't
matter
that
they
don't
want
to
adopt
him.
It
doesn't
matter
that
an
adoption
will
probably
cause
harm
to
tommy's
well-being,
and
it
doesn't
even
matter
that
the
responsible
child
welfare
agency
is
recommending
guardianship
instead
of
adoption,
because
an
adoption
is
possible
in
this
case.
The
kinggap
program
is
not
available
to
tommy's
families
and
the
consequences
of
that
are
very
real.
K
K
K
D
Comments,
I
can
always
talk
bailey
forward.
Looking
for
the
record,
thank
you.
I
think
you
all
see
before
you
it's
a
very
short
and
simple
bill.
The
the
language
that's
being
put
in
in
the
amendment
mirrors
the
federal
requirement,
so
that's
a
literal
mirror
to
what's
required
by
the
federal
statutes
to
use
the
federal
funding
in
this
situation.
So
we
have
the
agency
representatives
on
again
as
well.
D
If
you
have
any
questions
for
them,
but
this
is
not
change,
changing
anything
about
the
way
that
the
program
should
work,
we're
just
kind
of
getting
rid
of
a
situation
and,
to
be
very
frank,
this
is
mostly
a
problem
in
clark
county,
the
way
that
the
systems
are
interpreting
the
statutes,
but
we're
having
a
lot
of
conversations
when
all
stakeholders
agree
in
the
child's
life
guardianship
is
in
the
best
interest
of
the
child
is
the
most
appropriate
placement.
D
Let's
move
forward
with
guardianship
we're
having
trouble
getting
that
funding
in
some
cases,
just
around
a
legal
impossibility
question:
is
it
legally
impossible
that,
in
10
years,
someone
might
prefer
to
adopt
this
child
and
do
what's
in
the
best
interest
today?
So
that's
we're.
Just
trying
to
work
through
that
statute
a
little
bit.
A
All
right,
I
do
not
believe
we
have
any
questions
on
this
bill
right,
we'll
go
ahead
and
is
there
anybody
on
the
line
who
would
like
to
testify
and
support?
G
Yes,
good
afternoon
again,
chair
ready
and
members
of
the
committee,
I
am
bridget
duffy
from
the
clark
county
district
attorney's
office
appearing
on
behalf
of
the
department
of
family
services
and
again
it
is
b-r-I-g-I-d
d-u-f-f-y
I'd
like
to
thank
the
interim
committee
on
child
welfare
and
juvenile
justice
and
the
legal
aid
representatives
for
bringing
forth
sb
158
and
for
working
with
the
child
welfare
agencies
to
come
to
an
agreement
on
the
amendments
that
align
us
with
federal
language
and
will
not
impact
our
federal
funding.
It
is
very
important.
G
G
The
proposed
amendment
changes
the
original
language
drafted
that
was
restrictive
and
the
proposed
amendment
will
move
us
to
a
federally
approved
language
that
will
open
up
king
guardianship
for
more
children
and
families
and
not
impact
funding
to
the
state
of
nevada.
Thank
you
very
much
for
the
opportunity
to
testify
today
in
support
of
this
bill.
I
I
I
L
L
We
support
the
bill
with
the
proposed
amendment
because
it
provides
a
minor
correction
of
the
nrs
to
be
in
line
with
the
federal
statute,
which
will
allow
child
welfare
agencies
to
more
appropriately
utilize
king
gap
as
a
permanency
option
for
children
to
exit
foster
care
to
their
kinship
caregiver,
who
maybe
does
not
want
adoption,
but
is
willing
to
be
the
permanent
home
for
the
child.
Therefore,
providing
access
to
more
support
for
the
child
post-foster
care
case
closure.
I've
also
provided
a
more
thorough
explanation
in
my
letter
of
support
submitted
to
the
committee
secretary.
I
H
Good
afternoon
desean
jackson,
d-a-s-h-u-n
j-a-c-k-s-o-n,
with
the
children's
advocacy
alliance.
Again
I
stand
and
support
the
children's
advocacy
alliance
stands
in
support
of
senate
bill
158.
We
believe
that
this
bill
will
provide
the
support
that
foster
kinship
families
need
and
would
help
with
retaining
kinship
families.
Thank
you
so
much
committee.
I
J
J
J
I
I
L
K-A-T-H-R-Y-N-R-O-O-S-E,
I'm
here
in
a
neutral
position,
to
thank
the
sponsors
for
bringing
attention
to
this
issue
and
working
to
support
kim
guardians.
Dcf
has
submitted
a
fiscal
note
based
on
the
original
version
of
this
bill,
and
I
just
want
to
get
on
the
record
that
we
will
remove
it
with
the
amended
language.
A
A
I
I
A
B
Chair
ready
members
committee,
thank
you
for
hearing
senate
bill
158.
I
want
to
thank
mrs
bortolin
and
mr
hirsch
administrator
armstrong.
Ms
duffy,
all
the
other
stakeholders
worked
together
on
this
bill.
I
I
do
believe
this
bill
would
would
be
positive
for
the
state
and
for
our
children
that
are
under
that
jurisdiction.
I
hope
the
committee
consider
processing
it.
Thank
you
for
your
time.
A
Thank
you
and
one
last
shot
for
the
committee.
Any
clarifying
questions
is
anybody
that
outstanding.
A
I
I
A
Thank
you
all
right
for
the
chair
and
for
everybody
else's
information.
A
Our
next
scheduled
meeting
would
be
on
the
16th
of
march
and
we
are
going
to
cancel
that
meeting,
but
we
will
be
meeting
again
on
the
18th,
so
I
look
forward
to
seeing
you
all
a
week
from
today
enjoy
your
weekend
and
thank
you
everybody
for
your
participation
today.
This
meeting
is.