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A
A
And
if
we
can
Mark
chair
donate
present
when
he
arrives,
I
know
he
is
in
another
meeting
and
we
are
just
going
to
hopefully
start
this
process
on
these
hearings.
So
we
don't
have
to
have
you
guys
all
waiting
around
we're
going
to
go
a
little
bit
about
of
order
and
we're
going
to
start
with
assembly
Bill
215.
So
at
this
time
I
would
open
the
hearing
on
assembly,
Bill
215
and
welcome
to
the
table.
C
Good
afternoon
Madam
Vice,
chair
and
members
of
the
Health
Human
Service
committee,
I
am
assembly,
one
Michelle
gourlow
represent
Assembly
District
35,
and
we're
going
to
be
really
quick
today,
we're
here
on
assembly
Bill
215,
which
revises
residency
requirements
for
our
appointment
to
the
Nevada
silver
hair
legislative
forum
and
I'll
walk
you
through
the
bill.
We
changed
three-year
residency
to
one
year
residency.
There
you
go
you're
with
me,
is
Fran
almres
and
she's
going
to
explain
to
you
why
this
change
isn't
needed.
D
D
427A.340
a
person
must
meet
three
qualification
requirements
to
be
eligible
for
the
appointment
to
the
Forum.
First,
the
person
must
be
a
state
resident
for
five
years
immediately
before
their
appointment.
Second,
he
or
she
must
be
registered
voter
in
his
respective
Senate
District
for
three
years
immediately
prior
to
the
appointment.
Third,
he
or
she
must
be
at
least
60
years
of
age
on
the
day
they
are
appointed
assembly.
215
is
a
short
bill.
D
It
revises
the
residency
requirements
for
a
person
to
be
eligible
for
appointment
to
the
Forum
by
decreasing
from
three
years
to
one
year.
At
the
time,
a
person
is
required
to
have
a
registered
voter
in
a
Senate
District
of
the
senator
who
nominates
the
person
making.
This
change
opens
greater
prospects
for
well-qualified
seniors
to
be
appointed
to
the
Forum,
yet
still
provide
sufficient
time
to
get
to
know
their
state,
senator
Senate
District
and
the
challenges
and
opportunities
that
await
them.
D
I
think
you
have
a
paper
that
tells
you
who
the
the
appointees
are,
what
district
they
are
in
and
which
ones
because
of
redistricting
they
are
no
longer
in
the
district
they
were
appointed
for.
D
So
this
bill
changes
the
three
years
to
one
year
and
by
the
time
we
meet
our
next
meeting,
everyone
will
have
lived
in
their
district
for
one
year.
The
the
three-year
requirement
is
obsolete
because
of
redistricting
for
many
of
our
members.
D
E
Thank
you
for
this
just
for
clarification,
so
the
the
list
that
we
see
here
from
what
I
see
if
everybody
gets
to
nominate
from
each
district,
you
should
have
seven
team
members,
but
you
only
you
have
five
there's
or
is
these
just
the
ones
were
drawn
out
of
where
they
currently
lived.
The
list
that
you
gave
us,
you
have
seven,
you
should
have
17
members
if
each
Senator
gets
to
appoint
a
member.
Is
that
correct.
F
D
This
point
do
not
have
someone
representing
their
district
and
Senator
Titus.
Your
district
is
one
of
them,
so
I
was
going
to
come
talk
to
you
about
that.
Okay,
but
because
of
redistricting
you
can
see
on
that
paper
like
I,
was
a
appointed
by
Senator
donate
in
District
10.
because
of
redistricting
I,
think
I'm
now
in
21,
which
is
Senator
orenshaw.
So
that's
what
that
paper
shows
how
many
of
us
could
not
possibly
live
for
three
years
in
that
District,
but.
E
E
So
so
this
bill
won't
take
effect
until
it
says
a
bill
takes
effect
upon
Passage,
so
that
that's
my
question,
I
mean
I,
appreciate
what
you're
doing
and
I
have
no
issue
with
the
changing
it
from
one
three.
You
know
one
year
from
the
three
Year
to
one
year
and
I
was
thinking.
Every
County
got
one
person
versus
every
Senate
District,
but
so
every
Senate
District
gets
one
person
no
problem
with
that.
No
problem,
then
you
know
they
have
to
live
in
Nevada
for
five
years.
E
Even
if
they've
moved
around
that's
fine
in
one
district
for
a
year
is
fine
but
again
how,
if
it's
effective
upon
passage
when
folks
terms.
So
what's
the
average
term
when
you're
appointed,
is
it
just
a
two-year
term
or
because
it
doesn't
say
anything
in
the
bill
about
it?.
D
For
the
record
friend
almaraz,
yes
Senator,
it
is
a
two-year
term
and
in
those
districts
which
are
affected,
as
the
person
who
is
there
is
termed,
if
they
want
to
be
reappointed,
they
can.
But
if
the
senator,
who
has
that
district
has
someone
else
in
mind,
then
he
can
appoint
someone
else,
because
it's
only
the
one-year
residency
okay.
E
And
so,
and
this
bill
is
only
gonna,
even
though
it
starts
right
away
when
we,
when
we
at
time
of
Passage,
if
the
governor
says
signs
it,
it
doesn't
matter
really,
because
the
terms
aren't
expiring
will
have
no
effect
on
the
people
currently,
in
their
terms,
just
the
next
round
of
appointments
there'll
be
a
different
makeup
to
it.
E
D
A
You
do
we
have
any
other
questions
from
committee
members,
okay,
so
at
that
time
I
will
begin
testimony
in
support
of
ab215.
So
if
I
can
have
you
guys.
C
A
So
if
you
were
here
in
support,
please
come
up
to
the
table,
either
in
Las
Vegas
or
here
in
Carson
City,
seeing
no
one
coming
to
the
table,
both
here
in
Carson
City
and
in
Las
Vegas.
If
we
can
go
to
the
telephone
lines,
broadcast
services.
A
A
Thank
you.
Anyone
in
neutral
is
there
anyone
in
neutral,
seeing
no
one
here
and
no
one
in
Las
Vegas.
Anyone
on
the
lines
in
neutral.
A
A
24
24
yeah
here
we
go,
I
will
now
open
the
hearing
on
assembly,
Bill,
24
and
I
see
people
have
already
made
their
way
to
the
table,
so
I
will
go
ahead
and
begin
when
you're
ready.
H
Thank
you
very
much
chairwin
and
committee
members.
My
name
is
Cody
Finney
and
I
serve
as
the
Deputy
Administrator
of
the
division
of
public
and
behavioral
health
planning
and
Regulatory.
Section
and
I
really
appreciate
the
opportunity
to
be
here
today
to
share
with
you
assembly,
Bill
24..
The
purpose
of
this
bill
is
to
improve
the
representation
on
of
local
emergency
response
programs
on
the
EMS
Services
advisory
committee.
Some
tribes
in
the
state
run
their
own
emergency
medical
systems.
H
Last
year,
I
visited
some
of
those
leaders
and
it
was
clear
that
communication
between
them
and
the
state
EMS
program
could
be
improved.
This
program
has
a
particularly
active
advisory
committee
and
adding
tribal
representation
would
formalize
the
communication
in
a
way
that's
beneficial
to
the
program
and
the
regulated
communities
and
the
tribes
that
run
their
own
EMS
services.
H
As
the
bill
made
its
way
through
the
assembly,
we
received
a
request
to
amend
it,
to
include
one
member
who
is
employed
by
or
serves
as
a
volunteer
with
a
local
governmental
agency
that
provides
Emergency
Medical
Services,
but
which
is
not
part
of
a
firefighting
agency
or
law
enforcement
agency.
That
was
added
in
an
amendment
to
the
bill,
and
we
agree
that
that
would
also
improve
representation.
H
A
So
I'm
looking
around
I
know
that
moved
pretty
quickly.
Do
we
have
any
questions
from
the
committee
members?
A
Oh,
it
seems
very
straightforward.
So
I
appreciate
your
presentation.
At
this
time
we
will
move
to
testimony
in
support
of
assembly
bill
24
I'd
remind
everyone
to
please
state
your
name
clearly
for
the
record
and
spell
your
name
for
our
committee
staff.
I
know
I'm,
really
terrible
about
remembering
to
remind
everyone
that.
So,
if
you
could
do
that,
and
please
limit
your
testimony
to
two
minutes
and
begin
when
you're
ready.
I
J
Thank
you,
Alex
tanchik
a-l-e-x-t-a-n-c-h-e-k,
with
silver
state
government
relations
here
today
representing
the
Pyramid
Lake
Paiute
Tribe
duck
water,
Shoshone
tribe
of
the
duck
water
reservation
and
the
Shoshone
Paiute
tribes
of
the
duck.
Valley
Indian
reservation
also
here
in
support
of
the
bill,
and
thank
you
to
the
division
for
bringing
it
and
thank
you
to
the
committee
for
Harriet.
A
F
Hello,
my
name
is
Chris
McCann
EMS
Chief,
with
Elko
County
ambulance
service
in
Elko,
Nevada
I
just
wanted
to
vocalize
my
support
for
ab24.
The
amendment
that
was
adopted
in
the
assembly
allows
an
opportunity
for
Oklahoma,
County
ambulance
and
other
third
service
agencies
to
be
part
of
this
committee.
We've
never
had
that
opportunity
before
so
I'm
excited
to
to
voice
my
support
for
for
this
bill.
A
A
A
You
neutral
is
there
anyone
to
testify
in
neutral
I,
don't
see
anyone
here
in
Las
Vegas?
Is
there
anyone
online
in
neutral
or
on
the
phones.
A
Thank
you.
So
at
this
time
I
will.
Oh,
do
you
have
any
final
statements?
Okay,
we're
waving
that
I
see
that
waving
through
at
this
time,
I
will
close
the
bill.
Hearing
on
assembly,
Bill,
24
and
I
will
open
the
bill.
Hearing
on
assembly,
Bill
136
I
do
see
Miss
Jacobs
back
in
the
room
and
I
believe
she
has
a
co-presenter.
Are
they
online
or
in
Las
Vegas?
K
Vice
chairwin,
this
is
Joanna
Jacob,
Clark,
County,
government,
Affairs
manager
with
me
and
Grant.
Sawyer
today
is
Jill
Moreno,
our
director
of
the
Department
of
Family
Services
down
in
Clark
County.
So
she
is
here
to
just
give
me
technical
assist
if
there
are
any
questions
on
this
bill,
which
is
assembly
bill
136.,
so
coming
out
of
the
interim
HealthCare
and
Human
Health
and
Human
Services
committee.
Excuse
me:
I
apologize
I
was
in
another
hearing,
so
I
ran
over
here,
so
very
pleased
to
be
here
to
present
this
bill.
K
So
I'll
go
ahead
and
just
really
tell
you
why
we
are
proposing
this
bill,
which
is
we
had
submitted
this
request
to
the
Joint
Committee
last
summer
to
proposing
to
update
Nevada
statutes
to
align
with
guidance
that
we
had
received
from
the
federal
Children's
Bureau
on
the
implementation
of
the
2018
Families
First
Prevention
Services
act.
That
was
the
broad
Omnibus
Bill
that
had
updated,
foster
care
several
years
ago
and
had
shifted
the
model
for
foster
care
to
focus
more
on
Prevention,
Services
and
evidence-based
trauma-informed
care.
K
And
then
we
have
been
getting
federal
guidelines
on
this
implementation,
which
has
been
a
major
lift
for
States
and
counties
around
the
nation,
and
this
guidance
has
said
that
foster
care
group
homes
are
no
longer
reimbursable
under
the
federal
funding
source
for
E,
unless
the
home
is
a
qual,
is
a
family-based
setting,
except
under
very
limited
circumstances.
When
agencies
may
use
this
qrtp
model
for
placement,
it
was
actually
the
guideline
said
that
they,
because
it
was
intended
to
reduce,
congregate
care.
K
It
really
cuts
off
the
ability
to
use
that
Federal
funding
source
Beyond
14
days
unless
you
use
this
evidence-based
model,
and
that
is
why-
and
the
guidance
has
also
told
us-
that
they
must
be
licensed
literally
as
a
child
care
institution
under
a
federal
federal
definition.
That
definition
says
serving
I
guess
with
placement
up
to
25
children.
K
So
we've
been
working
with
the
state
and
with
Washoe
County,
and
that's
where
you
see
the
language
proposed
before
you
in
section
one
of
ab136,
which
we
are
taking
our
state
definition
of
child
care
institution
and
we
are
adding
the
reference
to
the
qualified
residential
treatment
program.
We
see
we
have
basically
Incorporated
the
federal
definition,
regardless
of
the
number
of
children
who
receive
care
and
shelter.
That
is
because
the
existing
definition
of
institution
you
can
see
right
there
in
subsection,
a
is,
was
really
limited
to
16
or
more
children,
so
we
are
actually
Clark.
K
County
is
really
looking
at
trying
to
do
smaller
models
under
this
qrtp
model
that
we
can
do
smaller
group
homes,
some
with
fewer
than
16
kids,
really,
though,
the
federal
definition
says
up
to
25,
and
so
that's
why
I
we
worked
together
with
Washoe
County
and
with
the
state
on
this
approach.
Consensus
approach,
I,
guess
on
how
they,
the
state,
would
like
to
see
this
done
and
so
that
they
would
be
able
to
work
with
us
on
this
licensing,
and
the
purpose
of
the
licensing
is
just
so
that
we
can.
K
We
can
bill
for
the
federal
funding
which
helps
to
support
foster
care.
So
that's
the
intent
of
the
bill.
I
I'll,
keep
it
pretty
short
there
and
Jill
Moreno
is
there.
She
has
been
working
on
this
implementation
on
those
plan.
If
the
committee
has
any
questions,
so
we'd
be
happy
to
stand
for
questions
right
now.
Thank
you.
I.
A
A
Okay
and
then
my
second
question
has
to
do
with
that
section
or
section
one
I
guess,
let's
see
it's
number
two
subsection
b,
where
it's
changed
from
who
have
been
diagnosed
to
just
with
an
emotional
disturbance.
A
What
was
the
basis
again
for
that?
Like
change
for
to
remove
that
diagnosis,
portion,
Joanna.
K
Jacob
for
the
record
Clark
County-
this
was
actually
something
that
came
out
in
the
Drafting
and
I
had
a
feeling
that
I
might
get
a
question
on
this.
So
I
I
actually
looked
this
up
right
before
the
hearing,
and
it
is
because
that
section
that
NRS
and
I
presume
I
miss
her,
maybe
Miss,
Cooper
or
Mr.
Robbins
is
not
here.
K
Legal
counsel,
but
433b
045
was
actually
updated
in
2013
and
was,
and
so
the
statute
actually
refers
to
children
with
an
emotional
disturbance
now,
instead
of
who
have
been
diagnosed
as
severely
emotionally
so
I,
this
is
oh
there's
Mr
Robbins.
It
is
actually
a
cleanup
and
I
if
I'm
misspeaking.
He
can
probably
tell
me.
L
Yes,
Eric
Robbins,
LCB
legal
yeah
Joanna
is
correct.
It's
just
because
the
the
term
was
changed
in
the
reference
statute,
so
we
updated
the
the
term
here.
E
Thank
you
and
I
appreciate
you
jumping
in
here
and
being
able
to
present
and
Johnny
on
the
spot.
I
I
need
some
clarification
so
currently
in
statute.
E
K
Joanna
Jacob
for
the
record.
Okay,
let
me
let
me
try
and
clarify
this
the
the
current
definition
of
child
care
institution
under
our
law
licensed
by
by
hcqc
in
our
state
right.
It
is
a
type
of
licensure
and
you
can
see
that
the
existing
language
said
16
or
more
children.
This
is
at
line
five
or
six
right.
K
So
we
we
and
we
put
in
language
regardless
of
the
number,
because
we're
incorporating
the
federal
definition
there
and
so
that
we
can
provide
for
smaller
homes
instead
of
changing
the
licensure
that
may
I
believe
and
I
will
have
to
defer
to
the
state,
but
I
believe
this
license
has
been
used
for
like
daycare
facilities
and
other
types
of
child
care
institutions,
and
they
we
didn't
want
to
make
a
larger
change
that
might
impact
those
facilities,
but
instead
allow
for
a
second
category
under
that
definition,
which
will
bring
us
into
alignment
with
the
federal
guidelines
that
we're
getting
is.
E
K
Joanna
Jacob
for
the
record
I
might
have
to
phone
a
friend
on
the
fee,
and
this
is
I
because
we're
going
to
provide
for
this
licensure
should
this
bill
pass,
we'll
be
working
with
the
state
on
creating
this
license
type.
So,
yes,
we
would
pick
how
we
would
be
I'll.
Give
you
an
example,
because
it's
actually
a
real-time
example
down
in
Clark,
County
and
Ms
Moreno
can
correct
me
to
or
offer
I'll
ask
her
to
pitch
in.
K
If,
if
there's
anything,
we
want
to
talk
about
what
we're
trying
to
do
in
Clark
County,
we
are
using
one
of
the
the
we
have
been
leasing,
one
of
the
state
buildings,
The
Oasis
Cottages
we
for
several
months
now
it
provides
for
beds
for
up
to
six
children.
So
that's
the
point
is
that
if
we
had
the
existing
definition
says
Child
Care
institution
is
more
than
16..
K
The
federal
definition
gave
us
some
flexibility
that
we
could
do
smaller
settings
and
there
is
actually
even
to
make
it
even
more
complicated
and
I'm
saying
it
like
that,
because
this
is
a
heavy
lift,
is
that
there
is
an
issue
on
Medicaid
reimbursement
right.
If
we
have
more
than
16
beds,
then
there
is
we're
running
into
the
IMD
exclusion
that
I
know
you're,
probably
familiar
with,
and
so
that's
why
we're
trying
to
transition
to
smaller
facilities.
So
this
would
allow
us
to.
K
M
True
Jill
Morano
for
the
record
director
of
Family,
Services,
m-a-r-a-n-o
and
yeah.
As
far
as
the
qualified
residential
treatment
program
goes
in
what
Clark
County's
plan
is
there?
Aren't
any
fees
associated
with
the
actual
license
or
certification
for
what
that?
For?
For
that
now,
I'm,
not
sure
when
the
state
licenses
Child
Care
institutions,
whether
or
not
they
charge
a
fee
but
internal
to
Clark,
County
and
sort
of
how
we
would
Envision
this
working
is.
M
As
Miss
Jacobs
stated,
we
have
a
six
bed
facility
in
Las
Vegas,
because
it's
a
staffed
facility,
it
doesn't
qualify
as
a
foster
care
as
a
foster
care
home
because
a
foster
home
has
to
have
parents
in
it.
So
this
would
be
a
staffed
facility.
They
they
would
work
through
us
with
the
licensing
process
or
maybe
a
certification
process
to
make
sure
that
they
meet
all
the
federal
requirements
of
a
qualified
residential
treatment
program,
the
responsibility
for
making
sure
that
they
meet
those
qrtp
requirements.
M
We
would
still
plan
to
address
on
the
Child
Welfare
side
of
the
house,
because
it's
a
child
welfare
program,
primarily
so
a
program
that
say
wanted
to
open,
maybe
17
or
18
beds
and
wasn't
going
to
be
a
qrtp,
might
be
something
like
a
training
school
or
something
like
that.
That
would
be
handled
outside
of
the
qrtp
process
and.
E
Okay,
so
that's
where
I
was
going
with
the
question,
because
I
number
one
I
understand
that
Clark
County
doesn't
have
a
fee,
but
this
is
going
to
be
a
Nevada
statute,
so
you're
affecting
Statewide
facilities
and
wondering
if
the
state
will
have
a
fee
for
a
licensure
and
how
will
the
state
Define
do
they
get
to
choose
what
they
want
to
be
the
QR
qrtp
program,
meaning
that
they're
going
to
have
up
to
25
kids
or
will
the
state
say?
No?
E
No,
you
have
more
than
16,
so
this
is
a
license
and
if
there's
a
different
fee,
this
bill
doesn't
really
Define
that
and
so
I
think
it's
pretty
like
okay
I
understand
that
Clark
County
has
this
figured
out
how
they
will
hounder
it,
but
this
is
going
to
be
direction
for
this
state
and
just
wondering
I
need
a
little
bit
more
clarification.
Joanna.
K
Jacob
for
the
record
from
Clark
County
and
we
have
been
working
with
the
state
because
you're
right,
we
we
will
have
this
provides
for
the
ability
for
the
state
licensure,
which
we
need
for
the
federal
reimbursement
and
I.
What,
in
my
discussion
with
the
state,
I
guess:
I
don't
want
to
speak
for
the
state,
but
in
my
discussion
with
the
state
on
this
bill,
it
is
contemplated
that
likely
there
may
be
some
regulation.
K
That
is
because,
when
you
know
the
hcqc
regs,
the
facility
ranks
that
are
promulgated
under
the
Board
of
Health
or
by
hcqc.
They
they
usually
set
the
standards
for
the
licensure
and
then
propose
the
fee
in
regulation
and
I
guess:
I
I
would
defer.
I
have
a
state
partner
here
with
me.
If
that
question
would
be
addressed
to
her
I,
don't
know
if
we
have
gone
that
far
in
the
process,
because
we're
providing
the
umbrella
under
NRS
and
then
prob
we're
going
to
continue
to
work
with
the
state
on
the
implementation
at
the
state.
K
Joanna
and
Joanna
Jacob
for
the
record
I
don't
know.
I
can't
speak
to
rates
of
reimbursement
for
the
existing
Child
Care
institutions.
On
the
we
hard-working,
we
are
trying
to
work
with
the
State
Medicaid
division
as
well
on
this
qrtp
model
and
with
the
state
DCFS.
The
state
has
a
policy
on
this
and
we're
working
with
both
of
those
agencies.
On
on
that
Ms
Moreno
has
been
involved
in
those
discussions
and
I
guess
can
maybe
speak
to
that
issue.
M
Jill
Moreno
for
the
record.
The
way
that
the
the
4E
reimbursement
would
work
is
it's
based
on
a
penetration
rate
as
determined
by
each
of
the
Child
Welfare
agencies.
So
those
are
typically
around
say,
40
percent,
so
how
it
would
work
would
be
something
like
if
we
charge
100.
If,
if
the
fee,
maybe
we're
going
to
reimburse
that
100
a
day
in
our
contract
we'd
be
able
to
build
back
to
the
feds
for
like
a
40.
M
L
I
can
answer
the
the
answer.
The
fee
question.
I
can't
really
talk,
speak
about
Medicaid
reimbursement
rates,
but
since
the
like,
since
these
facilities
are
being
licensed
by
the
by
the
state,
they
would
be,
they
would
be
subject
to
State
fees
and
under
basically
the
way
it
works
is
under
existing
law.
L
If
you
qualify
as
a
or
if
you're
a
there
are
kind
of
two
types
of
facilities,
there
are
child
care
facilities,
which
are
what
we
were
talking
talking
about
earlier
with
the
daycare
and
things
like
that,
and
then
there
are
child
care
institutions
which
are
what
you
see
defined
here
in
432a0245,
under
existing
law
and
the
child
care
facilities
that
are
not
Child,
Care
institutions.
L
They
have
to
be
licensed
by
either
the
state
or
a
local
government
and
the
child
care
institutions,
in
contrast,
have
to
be
licensed
by
the
state
and
so
yeah,
because
these
are
these
would
be
Child
Care
institutions.
They
would
be
new,
they
would
be
subject
to
State
Licensing
and
it
looks
like
the
fee
currently
established
under
existing
regulations
for
a
facility
under
well
under
25.
Kids
would
be
it's
20
to
100,
depending
on
the
size
of
the
facility.
N
E
Just
again,
this
the
reason
I'm
asking
these
rather
intently-
it's
just
been
recently
brought
to
my
attention
and
I
didn't
want.
In
my
district,
there
was
just
a
residential
behavioral
health
for
Kit
youth
in
Hawthorne.
That
was
is
in
jeopardy,
with
the
kids
there
and
I'm
just
wondering
about
again.
These
kind
of
state
laws
brought
by
good
intention.
E
Clark
County
may
be
affecting
some
there's
two
residential
housing
for
kids
that
are
not
in
compliance
and
apparently
one
in
Amargosa
Valley,
that's
being
shut
down
in
a
behavioral
health
residential
house
for
kids
in
Hawthorne
that
I
just
found
about
yesterday.
That's
in
Jeopardy
of
being
shut
down,
and
so
all
of
this
sounds
great,
but
I'm
just
wondering
process
of
registration
and
licensure
that
we're
doing
today
that
Clark
County
may
have
organized
understand,
what's
going
on,
impacts
the
rest
of
the
state
and
so
I'm
just
wondering
where
the
state
is
on
this.
K
Joanna
Jacob
for
the
record
and
I,
don't
see
anybody
from
DCFS
here,
but
I
will
phone
Miss
Finney
here
who
was
involved
with
us
in
this
and
you're
correct,
I?
Guess
as
she's
stepping
up
to
the
table
I'll
tell
you
we
did
try
to
work
with
Washoe
County
and
the
state,
because,
just
as
a
reminder,
Washoe
County,
we
we
have
foster
care
under
the
block,
grant
Washoe
and
Clark
administer
their
programs,
but
then
DCFS
handles
the
foster
care
for
all
the
kids
who
are
not
in
Washington
Clark.
K
So
we
tried
to
get
all
the
Child
Welfare
agencies
together,
that's
Washoe,
Clark
and
the
state
on
this
approach.
So
we
made
sure,
even
though
this
isn't
something
that
we're
trying
to
do
in
isolation
just
for
Clark
County,
because
we
know
it
impacts
our
kids
Statewide.
So
we
did
invite
the
state
to
the
table
and
I'll
hand
it
over
to
Ms
Finney
to
see
if
she
can
address
the
question.
H
For
the
record,
Deputy
Administrator
for
the
division
of
public
and
Behavioral
Health,
Regulatory
and
planning
section,
so
perhaps
it's
helpful
if
I
clarify
that
the
facilities
to
which
Senator
forgive
me,
Senator
daniate,
chair,
donate
through
you
to
Senator
Titus.
H
Perhaps
it's
helpful
if
I
clarify
the
facilities
that
Senator
Titus
is
speaking
of
are
currently
licensed
as
psychiatric
residential
treatment
facilities.
It's
my
understanding
that
this
qrtp
as
part
of
the
child
care
institutions
would
add
an
additional
choice
for
services
in
Nevada
and
an
additional
funding
source
for
services
in
Nevada
for
youth,
the
facilities
to
which
you're
referring
are
licensed.
As
I
said
as
psychiatric
residential
treatment
facilities.
We
do
have
that
as
a
specific
license.
Type
and
I'd
be
happy.
It's
helpful
to
provide
more
information
to
the
committee
about
those
differences
and
similarities.
H
E
D
L
Yeah
I
just
wanted
to
follow
up.
I
was
looking
at
the
definition
of
qualified
residential
treatment
program
under
federal
law,
and
it's
a
pretty
specific
definition.
I
think
that
you,
a
facility,
has
to
be
aiming
to
be
a
qualified
residential
treatment
program
and
meet
very
specific
Federal
requirements.
So,
to
the
extent
that
there's
a
concern
that
this
would
like
suck
in
other
types
of
facilities
accidentally
because
the
federal
definition
is
so
specific
I,
don't
think
that
is
likely.
N
Sounds
good!
Thank
you,
Eric
Mr
Robbins,
any
other
questions.
N
N
N
N
N
And
that
can
the
final
bill
that
we'll
hear
is
Senate
Bill
445,
so
I'll
go
ahead
and
open
the
hearing
on
this
bill.
This
bill
revises
Provisions
governing
Emergency,
Medical
Services,
and
so
we
will
call
our
folks
to
come
forward
and
please
begin
when
you're
ready.
H
Thank
you
very
much.
Chair
donate
and
committee
members.
I'll
try
to
speak
more
slowly.
This
time
my
name
is
Cody
Finney
and
I
serve
as
the
Deputy
Administrator
of
the
division
of
public
and
behavioral
health
planning
and
Regulatory
section
with
me.
Today.
I
have
Kitty
desocio
aso4,
with
the
division
to
provide
any
technical
budget.
Information
and
we'd
like
to
thank
you
for
your
attention
and
time
this
afternoon
on
Senate
bill
445..
H
H
H
The
program
is
also
partially
fee
funded,
and
these
fees
have
typically
been
set
to
prevent
undue
burden
to
some
of
the
smaller
agencies
that
provide
these
Services,
which
is
why
it's
only
partially
fee
funded
in
our
efforts
to
ensure
that
we're
using
the
available
funding
most
efficiently,
where
we
requested
this
bill
to
allow
the
fees
that
we
do
collect
to
be
kept
in
reserve
and
used
for
the
purpose
of
supporting
the
system.
Rather
than
reverting
those
funds.
Each
biennium
we're
very
happy
to
answer
any
questions
about
the
purpose
of
this
bill.
E
Thank
you
question.
So
what
percent
of
the
budget
is
General
funds
versus
fee
collection,
because
I
have
concerns
that,
if
you're
using
general
fund
money
to
for
the
program,
it
should
revert
back
to
the
general
fund,
if
you
don't
use
them
all
you're,
looking
at
keeping
the
revenue
from
such
fees,
but
but
you're,
also
supported
from
the
general
fund,
so
I
need
some
clarification.
E
H
You
I
appreciate
the
question
and
we
had
long
discussions
about
this
internally
as
well.
We
I
want
to
go
on
record
as
saying
we
are
absolutely
committed
to
doing
this
right.
We
want
to
make
sure
that
we
are
doing
this
right
I'm
going
to
let
Kitty
de
socio
speak
to
the
percentages,
but
your
point
is
well
taken.
We
want
to
make
sure
that
we're
that
we're
doing
this
appropriately
and
that
we're
spending
all
of
these
fees
appropriately
and
I,
hear
what
you're
saying
but
I'm
going
to.
O
So
Kitty
dissocio
for
the
record
share
Dante
through
you
to
the
senator
it's
approximately
for
23
24
and
24
25
about
three
quarters
of
the
budget,
the
general
fund.
E
No,
no,
so
three
quarters
of
your
funds
are
actually
from
the
general
fund,
so
one
quarter
are
supported
by
fees
and
these
fees
are
collected
by
the
individual,
EMS
Services,
who
use
these
the
system
to
to
do
their
uploading
of
the
runs
or
what
does?
Where
are
your
clicked
in
fees?
The.
H
The
individual
staff
people,
the
individual
licensed
service
providers,
EMS.
N
N
F
Hello,
Chris
McCann
again,
chief
of
EMS
and
Elko
County
ambulance
service
I
wanted
to
speak
in
support
of
this
bill.
Sb
445,
the
the
software
which
they're
talking
about,
has
been
very
beneficial
to
the
program.
The
EMS
program
has
been
working
to
find
efficiencies,
to
try
and
be
more
proactive
for
us
as
providers
and
the
software
that
they're
using
has
been
something
that
has
found
a
lot
of
efficiencies.
I
wholeheartedly
support
some
more
funding
or
the
fees
being
used
for
that.
F
N
Thank
you
so
much.
Anyone
in
opposition
to
this
bill,
please
come
forward.
Anyone
cards,
Las,
Vegas
and
anyone
virtually.
N
N
Thank
you
so
much
seeing
no
public
comment.
We
will
go
ahead
and
close
today's
meeting
and
we'll
see
everyone
next
Tuesday
meetings
adjourned.