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A
And
I
am
here.
Thank
you
all
for
being
here.
I
think
we've
got
everybody
a
couple
housekeeping
items
before
we
begin.
Please
remember
to
mute
your
electronic
devices
before
we
get
started,
so
we're
not
interrupting
folks,
as
they're
presenting
members
of
the
public
May
provide
testimony
in
a
variety
of
ways,
all
of
which
are
listed
on
the
agenda.
You
may
also
submit
public
comment
in
writing
either.
In
addition
to
testifying
or
in
lieu
thereof,
written
public
comment
may
be
submitted
before
during
or
up
to
24
hours
after
the
meeting
adjournment.
A
If
you
wish
to
testify
in
person
please
sign
in
by
the
door
and
leave
a
business
card,
so
we
have
an
accurate
record
of
your
name
and
contact
information.
If
you
do
not
testify,
you
may
also
want
to
sign
in
in
case
we
would
like
to
get
in
touch
with
you
regarding
a
particular
bill
to
ensure
an
orderly
flow
of
discussion.
All
comments,
questions
and
responses
must
go
through
me.
Also.
A
Committee
members
must
be
recognized
by
me
before
you
can
speak
additionally,
I
ask
our
presenters
on
Zoom
video
call
to
leave
your
cameras
off
and
microphones
muted
until
it's
your
turn
to
present
or
if
I
direct,
any
questions
to
you
when
testifying
in
person.
Please
turn
the
microphone
on
to
speak
and
off
to
listen,
so
we
can
avoid
a
Reverb
through
our
our
recording.
With
that
we'll
move
on
to
our
agenda,
we
have
three
bills
listed.
A
C
Thank
you.
My
name
is
Rochelle
Nguyen
I
represent
Senate
District
3
in
southern
Nevada
and
I
am
proud
to
present
Senate
bill.
280.
280
is
very
thick
and
I'm,
not
really
sure
why?
Because
it
only
does
a
couple
of
things
this
bill
came
to
me
in
my
conversations
with
Dr
Sandy
Koch.
She
is
a
local
OB
GYN
here
in
Carson
City
and
she
would
be
my
co-presenter
and
she
would
be
able
to
answer
all
those
doctor
type
questions
that
you
might
have
for
the
committee.
C
What
this
bill
is
is
I'm
going
to
refer
to
it,
because
it
is
a
long
acronym.
It
is
long-acting,
reversible
contraceptive
and
that
is
known
as
a
lark.
So
a
lark
for
all
the
women
and
men
in
this
committee
is
a
device
that
is
long-terming
a
lot
long-term
reproductive
contraceptive.
So
a
lot
of
times.
You
think
of
it
as
an
IUD.
C
What
Dr
Koch
had
learned
during
the
course
of
her
practice
over
the
past
I
think,
like
20
or
30
years,
as
an
OB
GYN
here,
working
outside
of
Carson,
City
and
also
in
our
rural
communities,
and
this
was
also
confirmed
by
Dr
Dr
Senator
Titus
in
the
Senate
side,
that
what
was
happening
is
women
would
come
in
and
have
children
and
give
birth,
and
then
they
would
request
a
lark
be
inserted,
and
at
this
time
they
were
not
able
to
do
so
because
they
didn't
have
some
of
those
devices
or
they
were
referred
to
come
back
and
have
the
procedure
done
at
a
later
time
in
an
outpatient
setting
because
it
was
either
cheaper,
and
so
we
were
seeing
a
drop
off
in
women
that
were
obtaining
these
types
of
contraceptive,
even
though
they
were
wanted
and
requested
after
birth.
C
Some
of
the
questions
that
came
up
and
that
I
can
preventatively,
maybe
ask-
is
some
people
asked?
Is
it
an
okay
time
to
get
one
of
these
iuds
inserted
upon
right
after
our
birth?
Would
your
body
naturally
expel
it?
Would
there
be
any
conditions
and
what
Dr
Koch
has
learned
in
her
research
and
in
her
practice
that
this
is
actually
a
very
good
time
to
do
this?
C
A
lot
of
you
have
heard
like
the
process
of
either
having
one
removed
in
an
outpatient,
setting
or
inserted,
and
sometimes
there
is
pain,
intolerable
pain
that
is
associated
with
the
removal
of
such
device
or
in
the
insertion
of
such
device
and
actually
post-pregnancy.
It
is
a
very
ideal
time
to
actually
insert
that,
and
so
this
would
allow
women
that
request
this
in
a
hospital
setting
to
be
able
to
do
just
that.
One
of
the
things
that
was
not
included
in
here
and
I
anticipate.
C
There
will
be
an
amendment
that
follows
and
I'm
continuing
working
with
different
stakeholders,
older
groups
on
what
that
might
look
like
is
in
talking
with
some
of
our
rural
communities
having
these
devices
on
hand
or
readily
available
in
a
hospital
setting,
isn't
always
isn't
always
workable,
and
so
we
wanted
to
expand
that
definition
to
also
include
like
shots
and
other
types
of
things
that
might
be
easier
to
administer
in
rural
settings.
C
So
there
are
lots
of
different
types
of
long
Larks
out
there,
including
iuds,
but
also
including
long-term
contraceptive
shots
that
can
be
given
and
administered
in
that
same
thing,
so
it
is
Our
intention
to
include
that.
I
know
that
this
was
one
of
the
things
that
Senator
Titus
was
concerned
and
wanted
to
make
sure
it
was
including
to
give
those
rural
hospitals,
in
particular
some
flexibility
to
provide
different
types
of
larks
in
their
facilities,
and
that
is
essentially
what
this
bill
does.
C
D
Thank
you,
madam
chair,
and
welcome
to
third
floor
so
yeah
my
Mike
question
and
concern
again
has
to
do
with
with
the
rurals
on
making
them
available.
D
C
Rochelle
went
for
the
record,
thank
you
for
that
question
and
that
concern.
That
is
something
that
we
are
continuing
to
work
on.
What
we
wanted
to
make
sure
is
that
people
were
not
charged
like
exorbitant
costs
because
they
were
having
this
procedure
in
a
hospital.
As
we
all
know,
if
you
have
an
Hospital
procedure
done,
it
tends
to
be
more
expensive
than
if
you
have
an
outpatient
procedure
done
in
like
a
medical
office,
and
we
wanted
to
ensure
that
that
was
that
we
were
protecting.
C
Patients
from
you
know
not
being
charged
a
ridiculous
amount
just
because
they
were
in
a
hospital
setting
as
opposed
to
coming
back.
You
know
four
or
five
six
weeks
later,
if
at
all
to
have
that
done
in
an
outpatient
setting.
So
there
is
some
protection
in
the
law.
We
are
continuing
to
fine-tune
that
what
that
looks
like
and
that's
part
of
the
reason
we
also
wanted
to
include
the
shot,
because
then
they
wouldn't
have
to
carry
those
devices
which
can
be
expensive.
A
At
the
same
time
as
that
cost
of
birth
is
being
incurred,
the
potential
cost
savings
nine
months
10
months,
15
months
down,
the
road
seems
to
offset
the
cost
of
inserting
a
500
IUD
for
that
can
last
up
to
12
years
or
so
I.
Just
it's
it's
funny
to
me
when
we
pinch
pennies
like
that,
but
we're
not
looking
at
the
cost
benefit,
and
maybe
it's
our
biennial,
our
biennial
budgets
that
keep
us
from
seeing
those
like
long-term
impacts
and
costs,
but
assembly
men
inhibits.
Please
go
ahead.
E
I
know
we're
not
a
money
committee,
but
is
policy
goes.
This
is
a
money
policy,
so
I'm
just
curious.
If
I
may
I'm
not
I
went
through
the
fiscal
impact
statements
on
the
fiscal
notes.
One
said
that
there
was
x
amount
of
dollars.
Another
from
the
similar
agency
in
a
different
County
said:
there's
no
fiscal
impact.
In
fact,
this
will
save
us
money
on
the
bill.
It
says,
may
have
fiscal
impact
and
says
contains
an
unfunded
mandate,
but
I'm,
not
understanding
where
that
comes
in.
Can
you
explain
that
by
any
chance.
C
Rochelle
went
for
the
record
I'm,
not
clear
on
that
as
well.
I
think
it
goes
to
the
point
that
your
chair
just
mentioned
that
the
cost
of
this
this
would
be
this.
These
are
covered
procedures.
This
isn't
a
procedure,
that's
not
covered
either
by
I,
don't
I
believe
it's
covered
by
Medicaid
and
it's
also
covered
by
most
private
insurance
and
I'm
sure
there
are
other
people
that
can
testify
as
to
that.
So
this
isn't
a
new
process
we're
not
requiring
something
new,
we're
just
requiring
a
new
location
for
it
to
be
covered
in.
C
So
you
can
have
this
done
in
a
hospital.
You
can
have
this
done
in
an
outpatient,
and
this
just
brings
that
Clarity.
So
people
when
they
are
requesting
it,
we
can
avoid
the
more
expensive
costs
of
an
unwanted
pregnancy
down
the
line,
and
so
you
know
to
the
chairs
point
that
the
long-term
cost
Savings
of
a
500
to
even
thousand
dollar
IUD
is
probably
actually
saves.
Us
money
as
a
state.
F
Yes,
Eric
Robbins,
LCB
legal,
so
basically
any
time
that
that
we
adjust
or
that
we
impose
requirements
relating
to
insurance
coverage
and
those
requirements
apply
to
local
governments
that
have
insurance
for
their
employees.
F
We,
we
do
put
an
unfunded
mandate
on
it
and
we
also
do
note
a
fiscal
effect
and
basically,
what
noting
the
fiscal
effect
does
is
it
requires
our
fiscal
division
to
go
out
and
solicit
those
fiscal
notes
from
the
agencies
that
will
know
better
as
to
whether
it
does
have
a
fiscal
effect
or
not,
and
then
the
unfunded
mandate
just
satisfies
the
constitute
or
the
legal
requirements
in
case
it
does.
But
just
because
those
are
noted
on
a
bill
doesn't
necessarily
mean
that
it
does
have
a
fiscal
impact
or
an
unfunded
mandate.
F
It
just
is
there
in
so
that
we
get
those
fiscal
notes
and
then,
if
one
comes
back
so
that
we're
covered
on
our
legal
basis.
C
And
Rochelle
win
for
the
record.
It
did
come
out
of
the
Senate
unanimously
and
it
did
not
get
taken
into
a
money
committee.
A
Thank
you,
I
have
assembly,
went
assembly,
woman,
newbie
next
and
then
assembly,
woman,
Taylor.
G
G
Having
had
kids
myself,
you
know
after
you
give
birth
you're
in
that
fog
for
some
time
afterwards,
and
and
child
care
is
hard
to
find
and
so
trying
to
find
the
time
to
go
and
get
the
all
of
the
exams
and
inserting-
and
everything
is
just
so
much
more
I
wonder
if
you
have
you
heard
from
women's
groups
about
that
and
about
that
aspect
of
you
know
just
carrying
on
with
women's
lives
after
they've,
given
birth
and
maybe
lightening
that
load.
C
Rochelle
win
for
the
record
I.
Definitely
that
was
part
of
the
motivation
to
bring
the
bill
is
as
a
mother
myself.
That
is
definitely
the
case
is
after
you
go
home,
and
you
have
this
new
child
that
you
have
to
take
care
of.
Sometimes
Women's
Health
and
women's
choices
get
put
to
the
Wayside
just
because
time
and
life
happens,
and
so
if
there
is
an
opportunity-
and
there
are
women
that
know
that
they
want
to
immediately
be
on
these
long-term.
You
know
these
Larks,
then
this
gives
them
the
opportunity
to
do
that.
A
I
was
like
listening
to
my
biography
right.
There
I
held
my
husband's
hands
six
months
pregnant
while
he
got
a
vasectomy
because
we
had
an
unexpected
pregnancy,
resulting
from
both
of
our
failures
to
follow
up
with
our
physicians,
she's,
wonderful,
I'm,
so
grateful
we
have
her,
but
that
was
definitely
a
decision.
We
had
to
make
that
cost
us
more
money
than
if
we
had
just
been
able
to
get
get
things
done
on
the
offset
assemblywoman
Taylor.
H
Thank
you,
madam
chair,
and
thank
you
senator
for
bringing
the
bill
and
again
welcome.
Welcome
back
Jessica
I
want
to
make
sure
I
I
understand
what
we're
attempting
to
get
our
arms
around
here,
because
it
certainly
seems
to
make
sense,
but
I
want
to
make
sure
that
I
get
it
so
really
what's
going
on
now.
H
Is
it's
difficult
for
women
to
have
an
IU
of
other
Larks
right
placed
during
the
time
when
they're
giving
birth,
and
this
bill
is
hoping
to
clear
that
up
and
to
make
that
possible
and
I
see
some
limitations
on
whether
third-party
ensure
you
know
with
Hospital
contrast,
if
they're,
probably
insuring
so
on
and
I,
certainly
understand
that
I'm
adding
the
shop
as
an
option
for
those
in
in
rural
Nevada
that
may
not
carry
these
devices
because
apparently
they're
pretty
expensive.
H
So
really,
is
this
really
it's
like
making
it
really
really
clear
that
this
can
happen
during
when,
when
they're,
when
they're
in
in
give
birth
when
they're
having
birth
and
that
really
we're
expecting
Insurance
to
be
a
part
of
helping
to
pay
for
this,
so
something
that
can
happen
during
that
time
and
do
I
have
to
kind
of
have
it
in
a
nutshell.
C
Rochelle
win
for
the
record.
That's
correct
assembly,
woman
Taylor
is
we
just
want
to
make
sure
that
it
is
an
option
for
women
while
they're
in
the
hospital
after
they
have
given
birth
before
they
go
home
that
they
can
have
one
of
these
inserted?
If
they
choose
to
ask
for
that,
and
they
don't
have
to
come
back
and
have
it
done
in
an
outpatient
setting,
they
can
have
it
done
when
they
are
there.
Okay,
follow.
H
Up
please
share.
Thank
you
thank
and
thank
you
Senator,
so
it
it
so
so
they
can
have
it.
Then
it
doesn't
have
to
happen.
It's
optional,
obviously,
and
they
don't
have
to
it's
not
to
say
that
you
have
to
have
it
during
the
time
like
the
baby
comes
out.
It's
not
like
right.
It
doesn't
have
to
happen
at
that,
but
it's
during
that
time.
If
that's
what
that
family
chooses,
that
they
want
to
do.
Rochelle.
C
Lynn,
that's
correct,
I,
don't
know
the
whole
medical
procedure
when
they
do
it,
but
usually
you're
in
the
hospital
for
a
little
time
after
you've
had
given
birth,
and
the
circumstances
obviously
differ
for
every
individual
to
speak
with
their
doctor
to
find
out.
If
that
is
the
appropriate
thing.
C
I
know
with
me,
I
had
I
had
had
a
cesarean
section
and
I
was
asked
if
I
wanted
to
have
my
tubes
tied
and
in
my
pregnancy
phase,
like
you
know,
brain
post
pregnancy
I
was
like
no
no
I
think
I
might
want
to
have
more
kids.
C
You
know
if
I
could
go
back,
but
it
made
it
more
fun
for
my
husband
to
have
a
procedure.
So
yes
and
I
made
him
follow
up.
Although
your
flower
is
beautiful,.
A
Thank
you.
I
have
assemblywoman
Thomas
next.
I
My
question
actually
has
to
do
with
history
and
push
back
the
reason
why
this
bill
is
being
pushed
or
being
brought
forward.
Is
it
because
of
the
the
pushback
that
you're
getting
from
the
hospitals,
because
I
would
think
that
doctors,
you
know
after
a
woman
has
a
baby
that
would
be
the
you
know,
the
optimum
time
to
insert
or
tubal
ligation
either
one
of
those
procedures.
So
is
there
a
pushback
on
this
bill.
C
Rochelle
win
for
the
record,
I
haven't
received
any
pushback
I
think
it's
just
a
policy
that
it's
good
to
put
it
in
place,
I
think
women
and
our
access
to
you
know
reproductive
contraception
is
something
that
is
timely.
It
like
I,
said
this
doesn't
create
new
things.
These
are
covered
in
the
hospital
they
are
covered
in
outpatient,
I,
think
it
is
something
we
just
want
to
make
sure
the
only
pushback
I've
had
and
we've
been
working
through
it
and
I'll
continue
to
listen
and
work
through.
C
It
is
to
just
make
sure
that
this
cost
piece
is
like
Equitable
for
not
only
the
insurers
but
also
the
hospitals.
You
know,
assemblyman
Koenig
had
brought
up
a
good
point.
We
don't
want
it
to
make
it
so
it's
like
a
free
device.
You
know
we
want
to
make
sure
that
the
cover
that
the
device
costs
are
covered
in
that
we
just
want
to
make
sure
that
patients
are
protected,
that
they're
not
charged
out
Hospital
prices
for
an
outpatient
procedure
in
this
limited
circumstance.
A
A
Thank
you,
I
am
we're
gonna
go
ahead
and
move
into
testimony.
Thank
you
so
much.
We
will
start
with
support
testimony
in
our
physical
locations
and
then
move
to
the
phone.
If
there's
anyone
who's
in
the
audience
in
Carson,
City
or
anyone
in
our
vacant
room
in
Las
Vegas.
Please
come
to
the
desk
to
for
support
testimony.
A
J
K
C-A-R-O-L-I-N-E-M-E-L-L-O-R-O-B-E-R-S-O-N
I'm
the
Southwest
Regional
director
for
nairal,
pro-choice
America
and
the
lead
staffer
here
in
Nevada
I
submitted
formal
comments.
I
wanted
to
speak
and
support.
We
have
48
000
members
in
the
state.
We're
really
proud
that
the
state
continues
to
advance
and
protect
reproductive
freedoms,
including
access
to
contraception.
K
I
will
note
I,
think
some
of
you
were
here
in
2017
when
we
voted
to
allow
for
no
co-pays
codified
in
the
state
law
for
iuds,
and
so
as
as
many
noted,
this
is
a
cost
that
will
will
pay
dividends
in
the
future,
allowing
people
that
access
I,
remember,
I,
myself
got
an
IUD
soon
after
giving
birth
and
I
one
of
the
best
decisions
I've
ever
made,
and
so
I
encourage
you
to
support
this
throughout
the
delay.
Thank
you
senator
for
bringing
this
forward
and
thank
you.
Dr
Koch
who's.
L
Chair
members
of
the
committee
Jessica
ferrado
here
today
on
behalf
of
the
American
College
of
Obstetricians
and
gynecologists,
we're
here
in
support
of
SB
280..
The
Affordable
Care
Act
requires
that
long-acting,
reversible
contraceptives,
including
iuds
implants
in
Depo-Provera,
are
covered
without
copays.
Unfortunately,
multiple
factors
inhibit
a
patient's
ability
to
obtain
these
in
a
hospital
setting
SB
280
attempts
to
remedy
some
of
these
barriers.
Most
importantly,
the
legislation
requires
a
device
to
be
available
if
a
patient
requests
such
a
device.
It's
important
for
long-acting,
reversible,
contraceptive
contraceptives
to
be
available
for
women,
especially
after
giving
birth.
A
N
Good
afternoon,
chair
and
members
of
the
committee
for
the
record,
my
name
is
Shelby
fourth
of
battleborn
progress,
I'm
calling
in
south
support
of
sc280,
because
our
hospitals
need
to
ensure
they
are
able
to
provide
iuds
to
any
patient
requesting
it
particularly
post
birth.
I
am
currently
pregnant
and
I'm
keenly
aware
of
how
necessary
birth
control
access
is
in
the
crucial
period
following
childbirth.
The
insertion
of
an
IUD
Post
delivery
can
provide
women
and
pregnant
people
with
crucial
Peace
of
Mind
during
the
intense
and
confusing
postpartum
period.
N
Some
people
are
actually
more
fertile
after
the
birth
of
a
child,
and
the
lack
of
access
to
birth
control
can
spell
disaster
for
a
new
parent
who
needs
to
focus
on
their
brand
new
baby.
We
know
that
access
to
Reliable,
effective
birth
control
is
liberating
for
individuals
and
helps
them
protect
their
bodily
economy.
That
is
why
I'm
calling
in
today
to
support
SB
280
and
to
urge
the
committee
to
support
this
Bill.
Thank
you.
O
Thank
you,
madam
chair
and
members
of
the
committee.
This
is
Matt
Robinson,
with
our
general
Partners,
testifying
on
behalf
of
Carson
Taco
help.
We
are
here
in
today
in
Strong's
sport
of
SB
280,
and
really
want
to
thank
Senator
Winn
for
working
with
us
on
language
that
includes
coverage
of
the
device,
as
well
as
the
procedure
and.
P
B-R-I-A-N-A-E-S-C-A-M-I-L-L-A
for
the
record
and
I'm
calling
on
behalf
of
Planned
Parenthood
votes,
Nevada,
and
we
are
in
strong
support
of
SB
280,
because
we
believe
that
all
people
deserve
to
have
accessible
and
reliable
birth
control
and
that
we
think
this
bill
will
help
move
us
in
that
direction,
and
we
strongly
support
this
bill
and
we
encourage
you
to
do
so
as
well.
Thank
you.
A
Q
Good
afternoon
my
name
is
Patrick
Kelly
with
the
Nevada
Hospital
Association.
We
do
not
oppose
the
primary
purpose
of
this
bill
as
Senator
Nguyen
indicated.
There
are
two
things
that
we
have
concerns
about.
One
are,
is
the
verbiage
related
to
payment,
and
the
second
is
allowing
rural
hospitals
to
have
injectables
as
an
option
under
the
bill,
so
we've
been
working
with
the
senator.
We
will
continue
to
work
with
her
and
we
appreciate
all
of
her
efforts
and
thank
you
for
your
time.
A
R
Good
afternoon
chair,
are
you
guys
able
to
hear
me.
R
Good
afternoon
to
you
and
your
committee,
this
is
Dora
Martinez
representing
the
Nevada
disability,
pre-action
Coalition,
Madame,
beautiful,
chair
I,
was
actually
calling
in
to
support
this
bill.
A
R
Okay,
thank
you.
Thank
you
to
Senator
Nguyen
for
bringing
sponsoring
this
bill
as
a
representative
of
people
with
disability
of
Nevada
disabled
population
of
Nevada.
This
is
one
of
those
things
that
falls
under
the
informative
choice,
so
we
are
very
thankful
for
her
to
support.
A
S
Thank
you,
madam
chair
members,
the
committee
Blaine
Osborne
Nevada
Rural
Hospital
partners
for
the
record,
we're
here
in
neutral
on
Senate
Bill
280.
Today,
we've
been
called
out
several
times
during
this
hearing
regarding
working
with
Senator
Nguyen
and
trying
to
get
that
language
correct
so
still
need
a
little
bit
more
time
to
get
that
figured
out
for
those
contraceptive
injections
as
well
as
working
on
those
payment
Provisions
in
subsection.
Four.
Thank
you.
A
A
Thank
you.
We
had
a
all
right,
I
think
they're
taking
it
offline
Senator.
Would
you
like
closing
remarks
today,
all
right,
we're
waving,
closing
remarks,
I'll
go
ahead
and
close
the
hearing
on
Senate
Bill
280
and
we
will
open
the
hearing
on
Senate
bill
298.,
which
revises
Provisions
governing
the
involuntary
discharge
of
a
resident
from
a
residential
facility
for
groups.
Welcome
Senator.
Thank
you
for
being
here.
It's
my
understanding
that
you
have
a
co-presenter-ish
on
Zoom
who
is
available
if
we
could
get
her
up
on
the
zoom.
A
T
T
When
people
are
in
a
specialized
facility,
they
don't
have
the
same
landlord-tenant
protections
that
the
rest
of
us
do,
who
rent
a
home
or
an
apartment
or
or
another
place
that
we
live,
and
so
the
purpose
of
SB
298
was
to
provide
some
kind
of
process
and
policy
for
those
individuals
who
might
be
being
removed
from
a
group
home
setting
to
ensure
that
they
have
some
due
process
before
they
are
ultimately
removed
and
sent
to
another
facility
and
really
I
am
not.
The
expert
on
this
Ms
Co
is
the
expert
on
this.
A
U
Thank
you,
chair
Peters,
my
name
is
Marie
Koh
I
am
the
state
Ombudsman
for
Nevada
I
have
the
pleasure
of
being
the
state
Ombudsman
and
representing
residents
who
live
in
care
facilities
throughout
Nevada.
This
bill
provides
increased
discharge
protections
for
residents,
along
with
consistent
criteria
for
providers
to
follow.
If
discharge
is
needed,
residents
have
been
discharged
into
our
communities
without
assistance
when
care
was
needed
and
without
ensuring
care
can
be
provided
at
another.
Setting,
promoting
transparency
for
the
reasons
residents
may
be
discharged
and
the
ability
for
advocacy
is
a
benefit
to
Residents
and
providers.
H
Okay,
thank
you,
chair
and
thank
you
Senator
for
being
here
and
for
bringing
for
bringing
this
important
bill.
I
want
to
make
sure
I
understand
the
the
problem
that
we're
trying
to
get
our
arms
around
here.
It
sounds
as
though
those
those
vulnerable
populations
that
you
mentioned,
sometimes
as
they're
getting
a
release
from
the
specialized
facilities
that
they're
they
don't.
They
don't
have
a
reason
why
or
they
don't
have
you
mentioned.
There
are
some
protections
that
they
don't
have
or
more
names.
T
Short
Melanie
scheibel
for
the
record,
we're
talking
about
people
who
live
in
a
residential
facility
for
groups
as
defined
in
the
NRS,
so
we're
not
talking
about
people
in
a
normal
apartment.
Setting
we're
talking
about
somebody
in
you
know
an
assistant,
Care,
Facility
or
perhaps
a
you
know,
a
a
Medical,
Care
Facility,
and
so
one
of
the
common
issues
that
we
were
trying
to
address
is
that
sometimes
these
people
are
discharged
or
removed
from
the
facility
because
of
because
the
either
the
facility
is
no
longer
the
right
fit
for
them.
T
They
need
a
higher
level
of
care.
They
need
a
lower
level
of
care,
or
sometimes
they
might
actually
be
their
disruptive,
behavior
and
they're
not
being
afforded
an
opportunity
to
rectify
the
behavior
or
being
informed
about
what
it
is
regarding
their
condition
or
their
particular
situation.
That
makes
them
a
bad
candidate
for
that
facility,
and
so
what
SB
298
does
is
it
requires
that
before
facility
serves
a
person
with
a
discharge
paperwork
that
says
you're
no
longer
you
know
a
you
know.
You
no
longer
require
the
services
of
our
facility.
U
Thank
you,
Mariko
for
the
record
again,
Senator
scheibel
was
correct
on
many
of
the
reasons
residents
have
been
leaving
these
facilities
residents
have
lacked
the
ability
to
dispute
the
reason,
and
so
this
gives
them
the
ability
to
ask
for
advocacy,
as
well
as
a
consistent
methodology
that
the
facility
providers
would
be
able
to
discharge.
This
is
similar
to
what
is
currently
happening
in
skilled
nursing
facilities
and
I
will
also
note
that
many
residents
are
having
care
needs
that
need
to
be
met.
A
V
I
very
familiar
in
this
Committee
of
asking
the
same
line
of
questions
so
I'm
very,
very
pleased
to
see
that
on
Section
11
of
your
bill
address
the
language
access,
so
I
really
want
to
command
you
on
behalf
of
you
know,
just
not
just
my
district,
but
also
the
district
that
you
serve,
that
language
access
is
one
of
the
critical
component
of
the
things
that
we're
trying
to
do
here
in
Carson,
City
I
just
have
a
a
small
question
for
the
Ombudsman
in
terms
of
the
number
of
cases
that
she
may
have
dealt
with
in
terms
of
language
access.
U
Thank
you,
Senator
Nguyen,
for
the
question
Marie
Koh
for
the
Wrecker.
We
currently
do
not
collect
data
regarding
language
access.
That
is
something
that
is
a
focus
without
within
the
department
and
I
am
pleased
to
tell
you
that
we
are
working
on
translation
services
of
of
a
lot
of
different
documents,
but
in
terms
of
cases
where
language
access
has
been
a
barrier,
we
don't
have
that
data
to
provide.
We
use
different
tools,
such
as
the
language
line,
to
be
able
to
communicate
with
people.
U
V
Quick
follow-up
chair,
thank
you,
so
I
just
want
to
make
sure
that
if
there
are
challenges
in
terms
of
the
issues
that
Arisen
out
of
these
cases,
that
obviously
your
office
is
the
stop
for
folks
who
have
challenges
that
they're
dealing
with
in
terms
of
language
access.
A
Oh
no
well
I
called
assemblyman
Watts
speaker
the
other
day,
so
you
know
we're
all
on
a
roll
in
a
session.
I
have
one
more
question
on
my
list:
assemblywoman
Thomas!
Please!
Let
me
know
if
I
missed
you.
I
Thank
you,
madam
chair,
and
thank
you
senator
for
bringing
this
forward.
My
question
actually
has
to
do
with
you
know
of
late
we've
seen
on
TV
and
in
the
paper
where
a
lot
of
people
that
do
not
have
Financial
access
are
being
turned
out
from
hospitals
and
or
this
bill
would
prevent
a
lot
of
that
from
happening
yes
or
no.
T
But
what
this
does
do
is
it
provides
them
with
the
right
to
have
that
information
shared
with
them
and
some
notification,
and
so
you
know
speaking
to
the
financial
situation
in
particular,
it's
important-
and
it
is
covered
in
this
bill-
that
if
a
facility
is
going
to
discharge
somebody
because
they
are
behind
on
their
payments,
they
have
to
give
them
the
opportunity
to
catch
up
on
those
payments
first
and
explain
to
them
what
payments
might
be
behind,
because
it's
not
always
as
simple
and
I
think
Ms
Coke
could
probably
speak
to
this
better.
T
A
G
Thank
you,
madam
chairwoman,
and
thank
you
for
bringing
this
bill
Senator
my
question.
You
know:
I
I've
been
in
a
number
of
different
group
homes
in
my
work
in
the
past,
with
the
public
Guardians
office
and
sometimes
they're
just
regular
homes,
with
a
couple
of
folks
living
there
and
so
I'm
wondering
you
know
if
one
of
the
residents
is
violent
or
develop
some
sort
of
behavior.
That
is
impacting
the
other
residents.
Does
this
bill
give
any
sort
of
cushion
for
those
residents?
I
I
know
it.
T
Melanie
scheibel
for
the
record,
this
ability
of
the
operator
of
that
group
home
to
remove
that
person
from
the
facility.
It
just
provides
that
they
have
to
be
given
notice,
and
it
also
provides
that
appeal
process
which
doesn't
necessarily
mean
that
they
can
appeal
the
process
and
remain
in
the
facility.
But
if
they
want
to
return
to
the
facility,
especially,
for
example,
if
they've
gone
and
received
treatment
at
the
hospital,
acute
treatment,
they've
gone
to
an
emergency
room
or
something
like
that,
and
they
want
to
come
back.
T
It
doesn't
guarantee
them
the
right
to
return,
but
it
provides
an
Avenue
for
them
to
contact
the
ombuds
person
and
explain
why
they
want
to
return
to
that
facility
and
opens
up
a
line
of
communication
to
make
that
you
know
to
make
it
possible,
doesn't
guarantee
it.
But
it
provides
them
with
an
Avenue
to
to
try
to
seek
that.
If
that
is
what
the
patient
or
the
resident
wants.
Does
that
answer
your
Ms
Co
might
be
able
to
better
explain
what
I'm
trying
to
say.
U
U
That
does
happen
on
occasion
and
if
the
resident
needed
to
receive
acute
treatment
to
resolve
the
behaviors,
then
a
conversation
could
be
had
about
returning
to
the
facility,
but
if
they
were
not
appropriate
anymore
and
needed
either
a
higher
level
or
a
behavioral
facility
than
the
provider
would
not
be
required
to
have
them
return.
A
Thank
you
so
much
for
the
questions
and
responses,
any
other
questions
from
the
committee.
Seeing
none.
We
will
go
ahead
and
move
into
testimony.
We
will
start
with
support,
support
testimony
in
our
physical
locations
and
then
move
to
the
phones.
Is
there
anyone
in
the
room
who'd
like
to
provide
support
testimony
on
Senate
bill
298.?
Please
remember
to
state
your
name
for
the
record.
You
may
begin
when
you're
ready,
chair.
W
Members
of
the
committee
Jonathan
Norman,
with
the
Nevada
Coalition
of
Legal
Service
Providers.
We
were
at
the
I
think
the
interim
committee,
where
this
was
presented
and
I
think
you
know
with
our
work
with
adults
and
guardianship
and
then
working
with
Miss
Co
and
then
Jennifer
Richards
at
adsd.
W
A
R
Good
afternoon,
chair
and
the
committee,
this
is
Dora
Martinez
with
the
Nevada
disability,
Action
Coalition
many
grateful
thanks
to
Senator
schaible.
You
are
awesome.
We
support
this
bill
and
thank
you.
A
Thank
you
BPS
other,
please
add
the
next
caller.
A
A
A
Here
we'll
close
out
the
hearing
on
Senate,
Bill
298
and
move
on
to
Senate
Bill
260.
welcome
Senator.
Thank
you.
So
much
for
being
here,
I
know
you're
running
around
in
the
assembly
today,
so
we
appreciate
you
making
making
time
in
your
schedule
for
us
as
well.
Please
remember
to
state
your
name
for
the
record.
Sb
260
revises
Provisions
relating
to
certain
persons
providing
referrals
to
group
housing
for
persons
who
are
aged.
X
Thank
you
very
much
Madam
chair
and
it's
a
pleasure
to
be
back
in
assembly
Health
and
Human
Services.
X
Section
2
defines
the
term
Senior
Living
Community
to
refer
to
certain
facilities
or
other
living
arrangements
for
people
who
are
aged,
including
residential
facilities.
Section
3
of
this
bill
defines
the
term
Senior
Living
Community
referral
agency.
As
a
person
who
refers
individuals
to
a
senior
living
community.
Section
4
of
this
bill
requires
that
all
unlicensed
Senior
Living
Community
referral
agencies
disclose
certain
information
to
a
person
that
is
aged
or
is
a
representative
of
that
individual
and
to
obtain
consent
before
a
referral
can
be
made.
X
Section
5
prohibits
an
unlicensed
Senior
Living
Community
referral
Agency
for
referring
a
person
who
is
aged
of
the
representative
of
such
a
person
under
certain
Provisions.
This
section
also
requires
an
unlicensed
Senior,
Living
Community
referral
agency
to
establish
a
policy
that
protects
the
privacy
of
an
aged
person
and
their
representatives
preventing
the
selling
of
their
personal
information.
X
Additionally,
this
section
requires
an
unlicensed
Senior,
Living
Community
referral
agency
to
stop
contact
and
or
referrals
for
an
age
person
or
their
representative
upon
request,
I'm
going
to
like
I,
said,
let
my
two
co-presenters
go
ahead
and
introduce
themselves
and
then
give
additional
informations
and
then
we'll
be
ready
for
questions.
Thank
you
very
much.
Y
You
good
afternoon,
chair
and
members
of
the
assembly
Health
and
Human
Services
committee,
Ashley
Cruz,
with
Corona
Nevada
for
the
record
I
just
want
to
thank
Senator
dondera
Loop
for
bringing
this
bill
forward
and
I
will
turn
it
over
to
Nana
Boyer,
who
is
here
with
us
from
A
Place
for
Mom
she's,
going
to
walk
through.
Why
we
think
this
bill
is
important
and
then
we'll
stand
for
questions.
Thank
you.
Z
Good
afternoon,
chair
Peters
members
of
the
assembly,
Health
Human
Services
committee,
Nana
Boyer
n-a-n-a-b-o-y-e-r,
for
the
record
I
Am
The
General
Counsel
for
A
Place
for
Mom,
which
is
a
nationwide
Senior
Living
referral
agency.
Z
Nevada
is
currently
the
only
state
in
the
United
States,
where
Senior
Living
referral
agencies
have
to
operate
on
a
subscription
model.
Senior
living
communities
have
to
subscribe
to
our
services
and
they
pay
a
set
subscription
fee,
regardless
of
whether
a
place
is
senior
in
the
community
or
not.
Z
This,
in
turn,
can
price
some
of
the
smaller
communities
out
of
using
our
services
altogether
and
those
smaller
communities
may
be
just
the
right
fit
for
the
families.
Z
The
goal
of
the
bill
before
the
committee
today
is
to
align
the
interest
of
all
three
parties
involved
in
the
process,
the
senior
and
their
family,
first
and
foremost,
the
referral
agencies
and
the
senior
living
communities.
So
we
ensure
that,
ultimately,
the
senior
moves
into
the
community
that
best
serves
their
needs
and
that
we,
as
a
referral
agency,
are
able
to
refer
them
to
that
community.
Z
Z
We
do
believe
that
this
change,
along
with
the
consumer
protections
that
the
senator
outlined
and
some
of
the
clarifications
of
the
duties
and
responsibilities
of
the
communities,
will
protect
our
most
vulnerable
populations
and
also
benefit
the
communities
which
they're
joining
happy.
To
answer
any
questions,
and
thank
you
for
your
attention.
A
E
Thank
you,
sir
I
might
be
missing.
It
I'm,
looking
to
see
what
the
penalty
is
for
violating
the
proposed
bill.
For
example,
let's
say
that
I'm
running
a
referral
agency
and
I
refer
the
aged
person
or
the
representative
to
my
brother,
who
runs
a
senior
living
facility.
That
would
be
a
violation
of
The
Proposal
of
this
bill.
Y
Thank
you,
I
do
not
have
that
off
the
top
of
my
head
and
it's
not
outlined
in
the
bill.
However,
we
are
happy
to
get
that
answer
for
you
and
and
get
it
back
to
you
unless
legal
has
another
answer.
V
Thank
you,
madam
chair.
This
is
just
a
curiosity
question
I
know
that
we
are
learning
terms
and
I'm
a
freshman,
so
I'm
learning
terms
as
I
go
because
we
have
so
many
new
vocabulary
here
in
this
building,
and
so
one
of
the
things
I'm
learning
is
now
I'm.
Learning
that
we're
not
talking
about
you
know
55
and
older
anymore,
we're
talking
about
55
and
better.
That's
a
new
term
I
learned
it's
better
55..
V
So
in
terms
of
the
senior
and
I
really
like
the
the
language,
this
person's
her
age,
like
wow,
you
learned
something
new
again
every
day.
Do
we
Define
that
age
somewhere
in
this
NRS
or
statue,
or
this
might
be
a
legal
question
as
well?
Is
that
when
we
talk
about
senior
living
communities,
is
there
a
a
minimum
in
terms
of
that
age
or
we're
just
going
to
Loosely
Define
it
and
kind
of
let
folk
figure
it
out?
Z
Its
own
criteria,
which
is
why
we're
not
looking
to
create
a
cut
off
of
The
Low
End
of
the
Age,
so
serving
different
kinds
of
senior
living
communities,
assisted,
independent
Memory,
Care
age.
Isn't
always
the
biggest
factor
in
the
communities
are
free
to
Define
what
their
population
is,
and
so
we
thought
that
was
not
necessary.
But
if
the
committee
feels
otherwise
we're
happy
to
discuss
that
as
well.
X
Marilyn
dondero
loot
for
the
record
I
can
speak
from
not
my
personal
experience,
but
my
sister-in-laws,
who
used
A
Place
for
Mom,
twice
and
one
time
with
her
mother
was
younger,
but
she'd
had
a
stroke.
So
she
needed
that
service
to
have
someone
help
the
family,
but
then,
when
she
used
it
with
her
father,
she
used
it
twice
because
her
father's
needs
changed.
V
Thanks
so
quick
follow-up
chair,
so
so
that
just
means
that
what
that
answer?
Thank
you
Senator.
So
they
don't
have
to
be
a
senior
to
use
a
service.
They
can
be
anyone.
X
Maryland
for
the
record,
this
is
just
sort
of
my
personal
opinion
as
being
a
better
person,
as
you
described
us,
I
would
tell
you
that
there
are
when
you
went
to
look
at
a
place
if
they
said
55
plus,
you
certainly
probably
wouldn't
go
in
there
as
a
45
year
old.
But
if
you
were
married,
for
example,
and
your
you
were
55
or
60
and
you
went
in
there
and
the
other
person
was
45
I
suppose
that
they
could
make
that
determination.
X
I,
don't
know
if
that
answers
your
question,
but
it's
it's
really
about
about
the
facility
More
Than
A
Place
for
Mom.
We.
A
Also
have
a
response
from
fiscal.
If
we
could
Mr
Robbins,
please
go
ahead.
F
Yes,
Eric
Robbins
LCB
legal
for
the
record,
so
the
original
question
was
about
what
what
constitutes
a
person
who
is
aged
for
the
the
purpose
of
this
bill,
and
that
was
not
not
included
in
the
bill.
There's
no
there's
no
specific
requirement
there
and
the
reason
that
wasn't
included
is
because
this
is
basically
putting
placing
requirements
on
Senior,
Living
Community
referral
agencies,
rather
than
you
know
what
constitutes
a
senior
living
community.
F
So
it's
more
about
what
these
types
of
agencies
do
as
their
business
rather
than
who
who
is
actually
living
in
these
communities.
So
we
we
didn't,
really
think
that
it
was
a
necessary
to
establish
a
specific
age
limit
here
and
a
would
just
be
be.
Anyone
who
I
would
think
would
be
advanced
in
age
and
need
Services
commonly
provided
to
persons
who
are
older.
A
Thank
you
for
the
question.
Our
next
question
comes
from
assemblywoman
Taylor.
Please
go
ahead.
Thank.
H
You
chair
and
thank
you
Senator
welcome
to
the
third
floor
and
and
what
we
do
here
and
thank
you
both
for
being
here
as
well
and
for
bringing
the
bill
I
have
a
my
mom
is
just
turned
80.,
yeah
and,
and
she
lives
with
me,
and
so
this
is
something
that's
really
important
important
to
me
in
the
event
that
she
can't
continue
to
stay
with
me.
I
want
to
make
sure
I
I
under
this
is
my
day.
I
think
I
didn't
have
enough
coffee,
because
this
is
my
idea.
H
Because
we're
the
only
state
where
facilities,
senior
facilities
have
to
pay
a
referral
right,
they
have
to
pay
the
facilities
have
to
pay
a
referral
fee
in
order
for
people
for
seniors
to
be
referred
to
them,
and
this
this
blocks
out
some
of
the
smaller
facilities
and
then
it
may
not,
which
may
not
give
the
seniors
their
family
members
may
not
open
up
as
many
options
as
possible,
so
they
can
find
the
right
place
for
them
am
I
getting
my
arms
around
this.
Z
Not
a
boy
for
the
record.
Thank
you
assembly.
Remember
that
question
almost
yes,
the
facilities
pay
a
referral
fee
in
any
in
in
all
of
the
states
in
all
of
the
states,
but
Nevada
they
pet
us
on
a
move-in
basis.
So
the
family
contacts
us,
we
identify
the
facility
only
if
they
move
in
and
stay
a
month.
Do
we
then
charge
the
facility
only
in
Nevada
We
collect
an
annual
subscription
fee,
so
we're
essentially
a
marketing
service.
Z
We
provide
the
information
of
the
families
that
may
be
interested
in
a
certain
Community
or
facility
and
the
family
that
goes
through
the
process
of
touring
and
moving
in.
So
there
is
little
incentive
for
referral
agencies
to
continue
to
provide
those
referrals
because,
regardless
of
whether
they
refer
one
family
or
a
hundred,
the
compensation
that
the
referral
agency
receives
is
the
same.
Z
So
the
expansion
of
the
of
our
Network
in
Nevada
and
agencies
like
ours
is
limited
just
by
the
fact
that
we
get
compensated
the
same
regardless
and
at
the
same
time,
as
you
mentioned,
some
of
the
smaller
facilities
for
home.
Z
You
know,
I,
don't
know,
500
might
be
too
much,
we'll
just
not
use
our
facility,
whereas
if
we
were
able
to
operate
on
a
per
movement
basis,
they
would
have
to
pay
us
nothing
until
they
got
a
paying
resident,
who
stayed
a
month,
paid
their
rent
and
care,
and
only
then
would
they
have
to
pay
us
anything,
and
we
would
have
the
incentive
to
refer.
Obviously,.
H
Thank
you
may
I
follow
up.
Please
share.
Thank
you.
It
sounds
as
though
it's
almost
aligning
it
as
as
someone
who's
looking
for
an
apartment
and
they
have
an
organization
that
helps
them
find
an
apartment
that
apartment
gets
paid.
Once
that
person
moves
in
and
pays
some
rent,
they
don't
pay
you
just
to
be
on
their
list
and
they
send
out
their
brochure
and
maybe
set
up
a
tour.
Z
Not
aboard
for
the
record,
that's
absolutely
correct.
There's
a
lot
of
analogy
to
Realtors
brokers
in
the
real
estate
business
here
and
the
as
I
mentioned.
The
families
never
pay
us
anything.
There's
no
contract,
there's
no
obligation
ever
the
communities
in
again.
Every
other
state
pay
us
nothing.
We
feature
them
on
our
website.
We
promote
them.
We
create
a
lot
of
visibility.
We
learn
a
lot
about
these
communities,
but
until
we
refer
a
family
that
moves
in
pays
a
month,
rent
and
care,
we
don't
get
paid
anything
well.
H
It
seems
like
if
I
may
just
close
this
with
the
comment
chair.
It
seems
as
though
that
that
bitter
serves
the
families,
because
they
get
all
of
the
options
that
are
available
to
them,
because
if,
in
the
event,
I
need
to
use
this
for
my
mom
or
anyone
else
who
may
have
or
or
Senator,
as
you
said,
your
sister-in-law
said
you
want
the
best
possible
option,
not
just
because
they
could
pay
the
fee
or
did
pay
the
fee
or
whatever.
The
case
may
be
so
I
appreciate
that.
Thank
you
so
much.
A
Thank
you
for
the
question.
Okay,
Mr
Robbins
has
a
response
to
the
Penalty
question.
Please
go
ahead.
All.
F
Right,
Eric,
Robbins,
LCB
legal
for
the
record,
so
the
answer
to
that
question
is
these
are
licensed
facilities
or
these
referral
agencies
are
licensed
entities
under
chapter
449,
so
if
they
did
not
comply
with
the
provisions
of
the
this
bill,
they
would
be
subject
to
actions
against
their
license
and
administrative
penalties
under
nrs449160
and
449-163,
and
the
the
monetary
penalties
would
would
be
an
administrative
penalty
of
not
more
than
five
thousand
dollars
per
day
of
each
violation
there.
There
are
not
criminal
penalties
attached
to
this,
but
they're.
F
E
Quick
follow-up
on
that
I'd
refer
you
to
section
10
of
the
bill,
NRS,
4490305
and
I'm,
not
sure
if
this
actually
applies
directly
or
not,
it
says
personally
violates
provisions
of
this
subsection
attorney
general
fine,
if
not
more
than
ten
thousand
dollars
subsequent
10
to
20
000.
F
Eric
Robbins
LCB
illegal
for
the
record,
no,
that
that
wouldn't
apply
to
the
new
portions
of
the
bill.
That
just
applies
to
subsection
4
here
that
prohibits
a
business
license
pursuant
to
this
particular
section
from
referring
or
from
violating
the
the
provisions
of
of
section
four
and
those
penalties
are
very
specific
to
that
subsection.
So
they
would
not
apply.
E
A
A
If
you
are
here
or
in
Las
Vegas
for
support
of
Senate
bill
260.,
seeing
no
one
come
up
to
the
desk,
we'll
move
to
the
phones,
BPS.
Is
there
anyone
on
the
public
line
for
support
testimony
on
Senate
bill
260.
A
A
A
All
right
would
you
like
closing
remarks
waving,
closing
remarks.
Thank
you
so
much
for
being
here.
Well,
that
will
close
the
hearing
on
Senate,
Bill,
260
and
move
on
to
our
last
agenda
item,
which
is
public
comment.
Is
there
anyone?
Sorry
public
comment
is
limited
to
two
minutes,
so
we
can
ensure
that
everyone
has
a
fair
opportunity
to
speak.
You
may
also
provide
written
testimony
if
you
would
like
or
written
public
comment,
and
we
will
start
in
our
physical
locations
and
move
to
the
phones.
A
A
All
right!
Well,
that
brings
us
to
the
end
of
our
agenda.
Today
we
have
what
is
today
Monday.
We
have
a
committee,
a
long
Committee
hearing
four
bills
on
Wednesday
that
we'll
have
to
squish
between
yeah
between
floor
and
our
afternoon
committees.
So
please
come
prepared
with
snacks,
an
appropriate
attire
with
that
we
are
adjourned.