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From YouTube: 8/16/2022 - Legislative Committee on Senior Citizens, Veterans and Adults With Special Needs
Description
This is the fourth and final meeting and work session of the 2021-2022 Interim. Please see agenda and work session document for details.
For agenda and additional meeting information: https://www.leg.state.nv.us/App/Calendar/A/
Videos of archived meetings are made available as a courtesy of the Nevada Legislature.
The videos are part of an ongoing effort to keep the public informed of and involved in the legislative process.
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Closed Captioning is Auto-Generated and is not an official representation of what is being spoken.
A
Welcome
to
the
fourth
and
final
meeting,
the
legislative
committee
on
senior
citizens,
veterans
and
adults
with
special
needs
for
the
2021-22
legislative
interim
for
members
attending
virtually.
Would
you
please
turn
on
your
camera
and
respond
when
you
hear
your
name,
madam
secretary,
please
call
the
roll
senator.
B
C
B
A
And
here,
thank
you,
madam
secretary,
and
please
indicate
senator
scheibel
and
assemblyman
mcluther
are
excused
some
housekeeping
items
before
we
begin,
I
would
like
to
take
a
moment
to
go
over
some
basic
housekeeping
keeping
items.
First,
please
silence
all
your
electronic
devices,
especially
cell
phones
and
laptops
during
the
meeting.
A
As
a
reminder,
meeting
materials
can
be
accessed
on
the
committee's
webpage.
Anyone
who
would
like
to
receive
electronic
notification
of
and
access
to
the
committee's
agendas
minutes
and
final
report
can
do
so
by
signing
up
on
the
nevada
legislators
website
and
that
is
leg.state
state
dot,
n-v
dot
u-s
and
with
that
we're
going
to
get
started.
A
In
addition
to
testifying
in
person,
members
of
the
public
may
provide
public
comment
in
four
different
ways,
all
of
which
are
listed
on
the
agenda
when
witnesses
who
wish
to
provide
members
with
additional
information
or
have
their
complete
testimony
or
handouts
included
in
the
permanent
record
should
provide
a
paper
or
electronic
copy
to
the
secretary.
You
can
find
the
contact
information
on
the
committee's
web
page
members.
There
is
public
comment
that
was
emailed
to
the
committee,
which
is
available
on
committee's
meeting
page
madam
secretary.
A
Please
ensure
that
these
comments
are
included
in
the
record
of
the
meeting
with
that
we
will
move
on
to
public
comment
and
we
will
start
with
those
in
the
physical
location
and
then
move
on
to
anyone
who
has
called
in
when
testifying.
Please
remember
to
turn
on
your
microphone
and
clearly
state
your
name
and
the
entity
you
represent
at
the
beginning
of
your
testimony.
A
B
B
Okay,
proceed!
Okay!
Good
morning,
madam
chair
members
of
the
committee
for
the
record,
my
name
is
michelle
rose.
Thank
you
for
the
opportunity
to
share
my
family's
story
and
what
I
believe
has
become
an
emergency
in
the
state
of
nevada.
The
issue
I
will
be
speaking
about
is
medicated
home
and
community
based
provider
rates.
B
I
come
before
you
as
a
parent
of
a
severely
handicapped
33
year
old,
adult
that
has
a
caregiver.
I
struggle
to
keep
her
as
my
son's
caregiver,
because
her
wages
are
so
low.
Medicaid
provider
rates
in
the
state
of
nevada
are
currently
insufficient
to
cover
the
hourly
wages
for
direct
support
professionals
or
professional
care
attendants.
B
B
This
puts
our
most
valuable
people
in
society
at
risk.
Without
providers,
families
cannot
go
to
work.
We
must
provide
care
for
our
loved
ones
at
home.
This
further
exacerbates
the
support
system.
This
has
become
a
systemic
issue
across
the
state.
There
are
hundreds
of
families
with
loved
ones
sitting
at
home,
not
being
able
to
get
into
a
program
because
provider
organizations
cannot
hire
the
support
staff
that
is
needed.
The
waiting
list
for
services
grows
regularly.
B
One
parent
or
family
member
has
not
gone
back
to
work
because
their
child,
their
parent,
must
stay
at
home
with
their
child.
I
try
very
hard
to
keep
my
son
in
my
home.
This
is
beneficial
for
him
and
the
state,
since
the
residential
housing
cost
is
three
times
more
money
than
providing
caregivers
in
my
home,
with
the
provider
rate
as
low
as
it
is,
it's
becoming
increasingly
difficult.
B
If
I
fail
at
caring
for
my
son,
it
will
cost
the
state
more
money.
Please
help
me
and
other
families
like
mine.
Please
find
a
way
to
increase
medicaid
provider
rates
to
make
sure
our
family
members
can
get
the
services
that
they
need.
Thank
you
for
considering
this
very
important
issue
that
I
have
brought
before
you
today.
A
F
Richard,
I
am
a
home
care
worker
of
nevada
and
I've
been
a
home
care
worker
for
over
16
years.
I
have
to
say
I
agree
a
lot
with
the
young
lady
that
just
came
up
here.
I
thank
her.
She
cheated
on
a
lot
of
a
lot
of
a
lot
of
points
here
that
we're
dealing
with
out
here,
I
like
to
represent
over
13
000
caregivers
out
here
in
nevada
period,
and
it
is
a
struggle,
the
hardships
that
I
go
through
day
to
day
being
a
caregiver
from
the
gas
from
the
groceries
to
utilities.
F
You
know
we
have
to
everyone
at
this
table.
Everyone
in
this
room
is
going
to
end
up
with
a
we're
needed,
we're
essential.
You
know
you
got
everyone
in
this
room
is
going
to
have
a
person
in
their
family.
That
needs
one
of
us.
It's
it's
we're
essential
we're
needed
out
here.
This
is
necessary
as
well
as
that
second
500
round
payment
that
that
that
hasn't
came
up
either.
You
know
it
doesn't
make
any
sense,
and
I'm
here
to
represent
the
caregivers
in
nevada.
I've
been
a
caregiver
over
15-16
years
out.
Here
we
are
essential.
F
We
are
needed
as
well
as
the
increases
it's
needed.
I
struggle
with
gas.
I
struggle
with
bills.
I
struggle
with
groceries.
It's
it's
real
and
it's
rough,
so
I
just
want
to
get
up
here
and
speak
on
behalf
of
that
and
speak
as
far
as
the
increases.
As
far
as
you
know,
we're
needed
out
here.
You
know
families
need
us,
so
I
thank
you
and
you
guys
have
a
good
day.
Thank
you
for
listening
to
me
today.
A
A
Seeing
none
is
there
anyone
on
the
phone
who
would
like
to
comment
for
public
comment.
G
H
Good
morning,
chair
garlow
and
committee
members,
I'm
lisa
foster,
and
I
represent
snap.
The
state
of
nevada
association
of
providers
licensed
by
the
aging
and
disability
services
division
and
funded
by
medicaid
snap
members
provide
residential
services
also
known
as
supportive
living
arrangements
and
jobs
and
day
training
services
to
adults
with
intellectual
disabilities
throughout
the
state.
You've
heard
a
parent
testify
about
their
frustration
with
maintaining
consistent
services
for
their
adult
child.
These
parents
cannot
count
on
maintaining
employment
themselves
due
to
the
uncertainty
of
whether
their
child
will
be
able
to
receive
services
from
day
to
day.
H
H
On
an
annualized
basis,
the
state
has
used
arpa
funds
to
increase
wages
through
2022,
but
this
increase
only
allows
providers
to
offer
a
starting
wage
of
just
over
thirteen
dollars
an
hour
fast.
Food
has
always
been
snap's
biggest
competitor,
with
starting
wages
listed
at
fifteen
dollars
an
hour
on
in-n-out's
website.
Yesterday,
these
skills
required
for
that
job
and
those
needed
to
care
for
an
intellectually
disabled
person
do
not
compare
we're
asking
the
legislature
to
approve
a
budget
that
will
pay
a
wage
that
stabilizes
the
workforce.
That
cares
for
these
nevadans.
H
The
wages
need
to
not
be
behind
the
fast
food
industry
or
even
a
hair
in
front
of
it.
They
need
to
be
wages
that
will
attract
caring,
consistent
workers,
who
will
strive
to
assure
all
nevadans,
especially
the
thousands
with
intellectual
and
developmental
disabilities,
receive
the
support
they
need
and
deserve.
G
I
I
Okay,
thank
you.
Thank
you.
So
much
so
I
do
want
you
to
bring
your
attention
the
slogan
without
us
about
us
without
us.
Please
consider
that,
as
you
make
recommendations
to
the
personal
care
attendant,
my
son
does
work
and
he
makes
more
than
what
these
important
people
are
doing.
I
You
know
taking
care
of
the
disabled
community.
He
makes
twenty
dollars
and
I
wish
we
would
hire
these
folks
at
25
an
hour
just
enough
to
pay
rent
and
all
the
expenses
that's
gone
up.
So
please
keep
that
in
mind
that
we
are
the
disabled
community
and
I've
always
said
this
are
always
first
to
be
forgotten
and
last
to
be
considered.
I
So
I
know
that
nevada
is
well
known
for
including
people
with
disability.
I
mean
we
started
with
the
right
to
parents,
act
2019
sponsored
by
assemblywoman
cohen,
and
everybody
voted
for
it.
Thank
you
for
that
and
last
year
the
ab121
people
with
disability
and
underlining
health
issues
are
able
to
vote
comfortably
at
home
with
access
with
this
awesome,
accessible
voting
platform,
that's
secured,
so
please
keep
that
in
mind,
and
and
and
let's,
let's
make
it
nevada
home
home
means
nevada.
Thank
you
so
much
and
have
a
great
morning
take
care.
A
G
A
Well,
thank
you
very
much
seeing
there
no
more
calls
we'll
move
on
to
our
first
order
of
business
agenda.
Item
number
three
approval
of
the
minutes
for
the
meeting
held
on
june
28th,
all
members
had
access
to
the
draft
minutes
which
are
posted
on
the
committee's
web
page,
along
with
other
documents
for
this
meeting
committee
members.
Are
there
any
questions
regarding
the
minutes
from
the
previous
meeting.
A
A
A
J
J
I
am
very
pleased
to
report
that
the
committee
is
operating
as
intended
for
the
first
time
in
the
state's
history.
This
legislation
has
brought
together
representatives
of
home
care
providers,
recipients
and
employees
to
discuss
and
find
solutions
for
the
myriad
of
issues
that
have
contributed
to
the
low
wages,
poor
working
conditions
and
the
chronic
shortage
of
home
care
workers
in
nevada,
and
you
have
heard
firsthand
this
morning
from
some
witnesses
who
have
direct
experience
with
these
problems.
J
To
compound
an
already
simmering
public
policy
time
bomb
elders
count
indicates,
nevada
has
been
and
will
continue
to
experience.
An
aging
tsunami
to
compound
nevada's
population
has
increased
by
11.42,
while
the
65
and
older
population
increased
by
40
percent.
Nevada's
growth
rate
for
age,
85
and
older
is
double
the
national
rate.
J
J
Home
care
workers
play
a
critical
role
in
keeping
seniors
and
adults
with
disabilities
out
of
expensive
and
less
desirable
care
settings.
For
example,
nevada
saves
an
average
of
seventy
thousand
dollars
a
year
for
every
senior
who
has
served
through
the
frail
elderly
and
community-based
waiver
program
instead
of
a
nursing
facility.
J
Lastly,
the
vast
majority
of
home
care
in
nevada
and
nationally
is
delivered
through
medicaid.
Most
individuals
needing
care
cannot
afford
to
pay
out
of
pocket
as
such.
The
state,
through
its
role
of
setting
reimbursement
rates
and
other
medicaid
policies,
is
responsible
for
setting
unemployment
and
working
conditions
for
the
home
care
industry
at
large,
and
it
is
absolutely
critical,
as
you
will
hear,
one
of
the
recommendations
is
to
increase
the
rate
reimbursement
to
providers
and
to
the
workers.
J
I
want
to
commend
you
and
the
2021
legislature
for
having
the
foresight
to
enact
legislation
sb
340,
to
immediately
address
this
critical
issue.
Deputy
administrator,
cody
finney
has
been
tasked
to
chair
this
home
care
employment
standards
board,
and
I
would
like
to
thank
and
commend
her
for
her
leadership
and
professionalism.
J
D
As
part
of
our
investigation,
the
board
has
reviewed
reports
from
the
labor
commissioner's
office
medicaid
and
the
bureau
of
healthcare
quality
and
compliance,
which
is
the
entity
responsible
for
licensing
home
care
agencies.
The
board
also
conducted
an
extensive
survey
of
home
care
workers
and
employers.
D
The
final
report
and
set
of
recommendations
from
the
board
are
due
to
the
director
of
the
department
of
health
and
human
services
at
the
end
of
this
year,
but
several
recommendations
have
already
been
approved
and
are
in
the
process
of
being
implemented,
I'm
going
to
go
through
those
with
a
little
bit
of
detail.
So
the
first
recommendation
that
we
worked
on
had
to
do
with
agencies
covering
the
cost
of
training
for
employees.
D
So,
due
to
some
ambiguous
excuse
me,
after
all
these
years,
I
still
get
nervous
due
to
some
ambiguity
in
the
regulations
for
personal
care
agencies.
Many
workers
reported
that
they
were
paying
for
the
state
mandated
training
out
of
pocket.
D
The
next
piece
of
our
recommendations
had
to
do
with
accountability
related
to
arpa
funding
that
was
made
available
to
improve
this
service.
As
part
of
that
arpa
funding
initiative,
nevada
medicaid
had
two
initiatives
to
support
home
care.
The
first
was
two
rounds
of
500
checks
to
home
care
workers
that
totaled
about
13
million
dollars.
The
workers
had
to
meet
certain
criteria,
be
serving
medicaid
patients
and
also
serving
during
particular
time
periods.
D
Unfortunately,
due
to
some
of
the
logistics
involved
with
that,
the
program
for
workers
was
voluntary,
for
the
employers
and
about
25
of
the
employers
did
not
apply
and
for
that
program,
and
so
anyone
employed
by
those
agencies
was
not
able
to
get
those
500
payments.
D
Those
payments
were
able
to
be
made
automatically
to
the
provider
agencies
based
on
what
they
had
built,
medicaid
for
and
but
this
program
did
not
include
a
lot
of
policy
on
how
the
funds
had
to
be
spent.
So
in
response
to
both
of
those
issues,
the
board
passed
recommendations
asking
medicaid
to
first
reopen
the
application
period
for
the
first
round
of
500
checks.
D
D
So
the
board
passed
a
recommendation
that
nevada
medicaid,
including
its
budget,
an
enhancement
to
increase
the
reimbursement
rate
for
personal
care
agencies,
to
25
dollars
an
hour
and
to
create
a
minimum
wage
of
15
an
hour
and
require
agencies
to
pay
at
least
15
an
hour
to
the
workers
providing
the
service.
D
Our
next
focus
was
on
worker
education
related
to
their
rights
as
employees.
D
We
have
referred
to
this
as
know
your
rights,
and
the
board
has
had
a
lot
of
discussion,
including
with
the
labor
commissioner's
office
and
our
employee
members.
I'm
sorry,
our
employer
members
who've
provided
valuable
information
on
this
around
compliance
with
existing
labor
law.
D
D
The
board
is
finalizing
language
for
a
know.
Your
rights
bulletin
that
is
designed
to
explain
in
plain
language
the
current
labor
laws
and
policies
around
home
care
workers,
rights
and
employers
obligations,
including
benefits
that
workers
are
entitled
to,
and
the
importance
of
not
being
misclassified
as
an
independent
contractor.
D
Finally,
the
board
has
created
a
subcommittee
on
systemic
racism
to
dive
deeper
into
that
issue
and
how
that
intersects
with
the
home
care
industry
as
you've
heard
most
of
the
workers
in
this
industry
are
women.
They
are
also
largely
people
of
color,
and
there
is
a
lot
of
intersection
here.
We've
heard
some
very
compelling
testimony
from
both
board
members
and
other
workers
and
some
employers
and
recipients
of
personal
care
services
regarding
this
issue,
so
those
recommendations
are
forthcoming,
as
that
subcommittee
continues
its
work.
D
A
G
D
Cody
finney
for
the
record.
My
understanding
is
that
that
second
hundred
second
round
of
five
hundred
dollars
has
not
yet
gone
out,
but
I
would
very
much
appreciate
the
opportunity
to
confirm
that
with
our
partners
at
medicaid
and
confirm
that,
for
you.
C
Good
morning,
chair
garlow,
I
can
proceed
if
you
like,
or
can
follow
up
with
answers.
Yes,
please
proceed.
Okay,
no
problem
good
morning,
kirsten
coulomb
for
the
record,
I'm
the
chief
of
the
long-term
services
and
supports
unit
with
nevada,
medicaid,
and
you
are
correct.
We
are
currently
working
on
issuing
a
second
round
of
applications
for
the
500
payment,
so
for
those
that
might
not
be
familiar,
nevada
medicaid
is
utilizing
american
rescue
plan
enhanced
funding
opportunity
through
section
9817.
C
So
it's
a
little
bit
different
than
some
other
american
rescue
plan
funding.
That
is
available,
for
example
like
through
the
governor's
office.
This
is
specific
to
home
and
community-based
services,
and
the
enhanced
federal
matching
does
allow
us
to
have
some
initiatives
specific
to
home
community-based
services.
C
Back
in
november,
we
once
we
see
received
cms
approval,
so
we
had
to
submit
a
spending
plan
first
receive
approval,
we
worked
on
applications,
had
providers
apply
and
then
were
able
to
issue
payments
in
march
and
then,
as
miss
vinnie
mentioned,
we
are
working
closely
with
the
board
to
receive
that
feedback
on
how
we
can
make
the
next
round
of
payments
either
a
better
process
for
the
recipients
and
just
really
reaching
out
to
the
providers
that
did
not
apply.
C
We
sent
out
a
survey
about
two
weeks
ago,
we'll
be
sending
it
out
one
more
time
to
solicit
feedback
on,
perhaps
why
the
providers
did
not
apply
in
nevada
medicaid.
We
might
have
a
list
of
enrolled
providers,
but
that
doesn't
mean
that
they're
always
actively
serving
medicaid
recipients
or
they
might
not
have
caregivers
available.
C
A
C
Kirsten
kuan
for
the
record-
thank
you.
I
probably
should
have
mentioned
that.
So
I
think
our
our
supplemental
payments
unit
that
works
on
those
reimbursements
is
concurrently
working
on
our
15
supplemental
payment.
I
think
we
are
it
was
august.
I
think
we
have
some
internal
challenges
with
some
vacancies,
but
our
goal
is
to
have
that
done
in
the
next
couple
of
weeks.
We
are
working
on
updating
that
application.
C
We
had
some
frequently
asked
questions
that
were
posted
on
our
website,
so
behind
the
scenes
we're
trying
to
get
that
documentation
up
on
our
website,
ready
to
go
so
that
when
we
do
send
out
notices
to
our
partners,
that
information
will
be
ready
because
we
did
pull
it
the
last
application
down
from
our
website.
We
didn't
want
to
confuse
anyone.
C
I
also
will
just
say
to
based
on
the
home
care
employment
standards
board
recommendations.
We
are
also
any
provider
that
responds
to
our
survey
or
that
reaches
out
to
us.
We
are
also
opening
up
that
first
round
of
500
payments
for
those
workers.
C
We
are
working
on
processing
those
if
providers
would
like
to
apply
now,
because
our
goal
is
to
make
sure
that
any
eligible
caregiver
that
would
be
able
to
receive
the
funds
and
has
that
their
employer
you
know
applies
on
their
behalf-
that
we
can
try
to
get
that
payment
to
them.
So
we
are
working
on
also
issuing
payments
for
the
first
round
too.
K
K
You
know
this
goes
back
to,
I
think
cody
you
and
you
all
you
and
miss
columb.
Were
there
when
I
chaired
hhs,
and
we
tried
for
17,
18
and
19
to
try
to
get
these
medicaid
reimbursement
rates
up
and,
as
I
remember,
it
really
came
down
to
a
matter
of
funding
in
terms
of
revenue
stream
with
the
state.
So
I'm
glad
to
see
that
we're
using
art.
But
what
I
want
to
do,
though
I
want
to
press
to
see
if
there
are
any
other
adjacent.
K
If
you
will
agencies
that
might
be
doing
something
where
there's
another
intersection
cody,
I
heard
you
talk
about
systemic
racism
and
the
intersection
between
mostly
women
and
people
of
color.
K
Those
are
the
ones
that
are
being
also
being
impacted
heavily
by
the
affordable
housing
crisis,
and
so
I
didn't
hear
I
didn't
hear
the
the
folks
who
the
ladies
who
spoke
at
the
beginning
during
public
comments
say
you
know
that
that
was
part
of
the
struggle.
I
did
hear
one
say:
you
know
it
was
gas
and
it
was
groceries
and
that
sort
of
thing,
but
I'm
wondering
if
there
are
any
other
resources
that
we
might
be
able
to
tap,
that
that
are
co-located.
K
If
you
will
in
this
in
this
dilemma,
that
will
help
us
maximize
those
dollars.
That's
number
one.
D
Thank
you,
senator
spearman,
cody
finney
for
the
record
through
chair
garlow
to
you.
I
appreciate
your
bringing
that
up.
We
have
heard
from
the
workers
on
the
board
and
other
workers
that
housing
prices
are
problematic
for
them
and
that
some
of
them
are
looking
for
housing.
D
D
Related
to
the
know,
your
rights
document
trying
to
connect
some
of
those
folks
with
other
agencies,
I'm
not
aware
of
a
large-scale
housing
effort
at
this
point
that
that
has
an
intersection
here.
But
we
are
more
than
happy
to
hear
to
make
those
connections
and
help
communicate
that
information
wherever
we
can
yeah.
K
And
but
I'm
sure,
if
I
just
follow
up
with
that,
what
comes
to
mind
is
possibly-
and
I'm
not
quite
sure
if
this
you
know-
crosses
boundaries,
but
nerf
may
have
some
information
and
some
of
the
other
social
justice
organizations
may
have
some
information
as
to
how
those
intersections
have
become
more
prominent
for
women
and
people
of
color.
K
And
if
we
can
look
at
where
that
bubble.
Is
there
a
lot
of
them
just
because
of
size
and
demographics
are
probably
down
here
in
southern
nevada,
but
if
we
could
take
a
look
at
that
and
then
make
the
case
for
more
dollars
from
other
tangential
agencies,
am
I
clear
to
to
make
sure
that
we
can
maximize
that,
because
I
cannot
imagine
someone
who
is
trying
to
make
it
on
11
to
13
an
hour?
I
I
cannot
imagine
you
know
the
struggles
that
they
they're
through,
so
we
can.
K
We
can
take
a
look
at
that
and
I'm
also
interested
in
in
the
systemic
racism
piece,
because
we
did
pass
several
bills
last
time
that
were
associated
with
concurrent
resolution
one.
I
think
it
was
in
the
2020
special
session
declaring
that
racism
is
a
public
health
crisis
in
nevada
and
it
was
senate
bill
341
that
that
changed
the
way
health
care
delivery
is
supposed
to
go
to
bipolar
communities.
K
So
I
want
to
take
a
look
at
that
and
maybe
there's
some
cross
analysis
that
can
be
done
with
tina,
dortch
and
the
office
of
minority
health
services.
I'm
I'm
curious
about
the
enforcement
piece.
You
said
we
need
an
enforcement
mechanism
and
maybe
I
didn't
catch
it,
but
I
was
trying
to
hear
what
the
recommendation
was
because
again
we
covered
this
in
16,
17
and
18,
and
I
believe
we
did
it
in
19
and
the
19
session.
So
what
is
it
that
we
need
to
be
doing
differently.
D
Thank
you
so
much
senator
spearman
to
you
through
chair
gorlo.
We
have
some
capabilities
for
enforcement,
with
healthcare
quality
and
compliance,
and
so
we
are
working
on
some
of
those
re.
Those
regulations
that
I
mentioned.
We
also
have
a
number
of
these
issues
that
are
related
to
enforcement
of
labor
laws,
and
we
have
heard
that
from
the
committee
members
and
also
other
workers
in
our
committee
meetings
that
the
labor
laws,
as
we
understand
them,
appear
to
not
be
applied
evenly
across
all
the
all
of
this
industry.
D
So
we
are
working
with
the
labor
commissioners
office,
very
hopeful
that
there
will
be
a
new
labor
commissioner
appointed
soon
and
we're
working
to
educate
one
educate
the
population
about
their
rights
and
make
sure
that
these
workers,
who
are
by
nature
of
the
business,
perhaps
somewhat
isolated
from
other
workers,
because
they're
working
in
people's
homes
that
they
have
that
information
on
what
their
rights
are
and
that
they
understand
and
are
making
informed
choices
about
being
an
employee
versus
being
an
independent
contractor
and
getting
those
benefits
that
are
afforded
to
employees.
D
So
again,
we're
the
board
is
working
closely
with
the
labor
commissioner's
office.
D
We've
explored,
and
I
will
say
the
staff
has
learned
a
great
deal,
particularly
hcqc
staff
has
learned
a
great
deal
about
some
of
these
other
pieces
that
are
not
in
chapter
449,
that
healthcare
quality
and
compliance
enforces
but
exist
in
labor
law
and
where
we
can
make
those
connections.
If
we
find
the
possibility
that
something
that
some
other
body
needs
to
enforce,
that
we
can
make
those
recommendations
and
referrals
and
and
improve
the
enforcement
overall.
In
that
way,
does
that
does
that
make
sense?
It.
K
K
K
So
there
are
probably
some
seniors
in
the
pool
of
healthcare
workers,
home
health
care
workers,
and
I
do
know
that
one
of
the
things
we
did
in
2017
was
to
to
give
enhanced
penalties
for
anyone
who
did
something
to
someone-
and
I
want
to
say
it
was
62,
maybe
64
years
old,
and
so
that
may
be
another
avenue
to
get
people's
attention
and
and
if
there
is
any
type
of
communication
that
you
can
put
up
on
the
website
or
maybe
a
newsletter
or
something
like
that
to
alert
folks
who
may
be
indulging
in
this,
perhaps
enhanced
penalties
and
what
that
may
be
might
get
their
attention
because
we're
at
a
critical
time
right
now
in
terms
of
people's
economic
stability
and
survivability
and
and
it
it
really
irks
me
to
no
end
to
know
that
there
are
people
who
are
providing
a
service
to
folks
who
really
need
it
and
and
are
being
taken
advantage
of
by
by
their
employer.
K
If
you
will
or
the
person
who
is
contracted
to
do
this.
So
so
take
a
look
at
what
the
what
the
ag's
office
can
do.
Look
what
the
dag
for
consumer
protection
might
be
able
to
do
and
we
may
find
we
might
find
some
remedies
there
and
and
if
possible,
let's
look
at
what
we
need
to
do.
If,
if
there
is
another
bdr
going
forward,
maybe
we
can
look
at
something
that
could
be
done
in
bdr.
A
Thank
you,
senator
spearman.
Are
there
any
other
questions
from
committee
members
nope?
I
do
want
to
take
a
moment
and
thank
the
home
health
care
workers
for
all
that
they
do
it
is.
It
is
an
essential
position.
I
know
how
important
it
was
to
my
mom
when
we
had
home
health
care
worker
taking
care
of
my
dad
before
he
passed
away.
So
thank
you
so
much
and
we'll
continue
this
conversation.
A
A
The
work
session
document
contains
a
list
of
proposed
recommendations
related
to
programs
to
assist
seniors
with
dementia
and
their
caregivers,
supportive
services
for
veterans
and
military
spouses,
proposals
to
assist
vulnerable
adults
proposal
to
update
guardianship,
laws,
support
for
telehealth
services
and
applications
and
continued
efforts
to
address
the
homelessness
of
seniors
veterans
and
adults
with
special
needs.
Ms
kalina
will
walk
us
through
the
document.
Thank
you
very
much.
E
Thank
you,
chair,
gorlo
and
good
morning
committee
members
for
the
record.
I
am
ashley
kalina
with
the
research
division
of
the
legislative
council
bureau
as
nonpartisan
staff
I
can
neither
advocate
for
or
against
a
measure
that
comes
before
the
forum.
With
that
I
will
provide
a
short
overview
of
the
work
session.
While
the
work
session
document
is
designed
to
assist
the
committee
in
determining
what
actions
it
wishes
to
take.
Each
item
in
this
document
may
be
subject
to
further
discussion,
refinement
or
action.
E
E
Also,
as
an
additional
note,
other
states
have
designated
that
percentage
of
the
per
diem
rate
anywhere
from
40
to
65
percent
and
in
discussions
with
chirogorlow,
she
recommended
that
the
percentage
be
set
at
65,
but
that
again
is
open
to
discussion
with
the
committee
members.
There
are
three
attachments:
labeled,
a
a1
and
a2
related
to
this
recommendation.
E
E
This
recommendation
was
proposed
by
charles
duarte,
the
nevada,
public
policy
and
advocacy
director
of
the
alzheimer's
association
and
mr
barry
gold,
the
director
of
government
relations
with
aarp
nevada,
based
on
information
and
testimony
provided
during
the
committee
meeting
on
march
22
2022
mr
duarte
is
participating
in
person
in
the
legislative
building
in
carson
city
and
miss
kirsten
colombe
with
the
division
of
healthcare.
Financing
policy
is
participating
via
zoom
and
they
are
both
available
for
any
questions
for
the
committee
from
the
committee.
K
I'm
sorry
I
just
this
is
just
a
comment.
One
of
the
things
that
that
has
been
proven
in
research
is
that
hearing
loss
for
seniors
is
connected
in
many
ways
to
the
advancement
of
dementia,
and
so
I
didn't
see
in
here.
K
Maybe
I
missed
it,
but
I
didn't
see
it
here
sometimes,
if
even
if
we
can't
cover
it
but
some
type
of
language
that
acknowledges,
we
need
to
make
sure
that
hearing
aids
in
some
form
through
medicaid
are
covered
for
for
seniors,
because
I
know
that
that
dementia
is
also
a
form
of
memory
loss.
A
L
L
I
am
the
public
policy
and
advocacy
director
for
the
nevada,
alzheimer's
association,
and
so
it's
a
pleasure
being
here-
and
I
much
appreciate
the
fact
that
you're
considering
a
couple
of
our
proposals
for
potential
bill
drafts
with
regard
to
hearing
loss,
senator
spearman
is
exactly
correct,
that
there
are
studies
that
show
that
it
can
exacerbate
or
advance
dementia
in
individuals
who
are
already
experiencing
the
early
early
stages
of
dementia,
and
so
it
can
exacerbate
that
and
quicken
it.
L
I
don't
think
this
addresses
it
directly,
whether
or
not
nevada
medicaid
covers
that
as
a
medical,
expense
or
even
medicare.
I
believe
medicare
does
not
cover
it,
but
if
medicaid
were
to
cover
for
individuals,
you
know
that
would
certainly
be
a
benefit
and
certainly
something
that
a
physician
could
could
recommend
to
prescribe.
K
Yeah,
I
know
that
I
think
was
last
year
that
congress
had
proposed
some
changes
to
medicare
and
it
did
include
hearing
aids,
so
perhaps
what
not
directly
associated
with
this
bill.
But
perhaps
we
might
look
at
some
type
of
resolution
urging
congress
to
go
back,
revisit
that
and
pass
funding
for
for
hearing
aids,
because
dementia
is
for
our
seniors
is
a
very
serious
issue
and
not
only
for
the
seniors,
but
also
for
their
caregivers
and
the
family
members
who
are
living
there
with
them.
K
So
if
we
can't
do
it
with
this
bdr,
then
maybe
there
can
be.
We
can
can
consider
some
type
of
concurrent
resolution
for
the
asking
our
federal
delegation
to
go
back
and
revisit
that
just
want
to
get
this
on
the
record.
A
You
senator
spearman,
I
agree.
Hearing
aids
are
very
expensive
and
definitely
a
necessity
for
our
elderly
population.
But
we're
going
to
have
a
motion
to
prove
I'm
going
to
request
a
motion
to
approve
the
recommendation
for
the
medicaid
structured
family,
caregiver
waiver.
So
do
I
have
a
motion
so
move
the
nurse?
A
Looks
like
we
will
write
a
letter
of
recommendation
to
our
congressional
delegation
as
senator
spearman
mentioned.
We
can
do
that.
So
we'll
include
that
in
with
the
medicaid
structure,
family
caregiver
waiver-
do
we
need
to
have
a
second
round
a
motion
on
that?
Yes,
okay,
so
I
will
rescind
the
last
motions
and
ask
for
a
new
motion
to
approve
with
that
letter
included.
E
Chair
gordo,
the
second
recommendation
is
to
draft
a
bill
to
require
the
department
of
health
and
human
services,
the
university
of
nevada,
reno,
school
of
medicine
and
the
university
of
nevada,
las
vegas
school
of
medicine,
to
establish
a
system
of
care
for
the
diagnosis
and
care
of
nevadans
with
dementia
called
the
nevada
memory
network.
In
establishing
the
program
these
entities
will
contract
for
the
services
of
memory
assessment.
Clinics
clinics
would
expand
capacity
by
hiring
or
contracting
with
neurologists
neuropsychologists
and
geriatricians
to
perform.
E
The
duties
described
in
the
request
to
diagnose
dementia
in
patients
referred
by
primary
care
providers,
create
plans
of
care
and
train
primary
care
care
providers
by
screening
for
and
treating
dementia
clinics
will
use
telehealth,
where
appropriate,
to
perform
these
duties
for
patients
and
providers
in
rural
nevada
and
employ
or
contract
with
four
community-based
dementia
care
navigators
to
perform.
The
duties
described
in
the
request
to
provide
care
coordination
and
referrals
to
community-based
services
and
in-home
care,
monitor
the
well-being
of
care,
provide
providers
and
provide
support
to
care
providers,
including
respite
care.
E
E
This
recommendation
was
made
by
mr
charles
duarte,
director
of
nevada,
public
policy
and
advocacy
for
the
alzheimer's
association
and
mr
barry
gold,
director
of
government
relations
for
aarp
nevada,
based
on
testimony
provided
in
the
committee
meeting
on
march
22
2022
again,
mr
duarte
is
available
in
the
legislative
building
in
carson
city,
and
he
is
here
to
answer
any
questions.
Thank
you.
A
K
Yes,
I
was
just
going
to
say
again
if
we
can
add
to
that:
the
quality
of
life
for
seniors
and
for
veterans.
I've
had
an
opportunity
to
speak
to
several
veterans
who
have
participated
in
the
adopt-a-vet
program,
and
it
has
been
an
invaluable
service.
If
we
could
only
expand
that,
I
think
we
could
serve
more
and
just
like
hearing
loss
for
seniors
when
there
are
dental
problems,
they
again
isolate
themselves
and
it
decreases
the
quality
of
life.
K
So
if
there
is
a
way
to
perhaps
add
a
amendment
to
encourage
our
federal
delegation
to
go
back
and
revisit
the
legislation
that
didn't
pass
one,
I
want
to
say
it
was
2021
with
the
legislation
that
didn't
pass
because
it
had
hearing
aids
and
it
had
dental
coverage
in
it.
A
A
Okay,
seeing
then
I'm
looking
for
a
motion
to
approve
the
recommendation
for
the
we're
calling
this.
A
A
H
L
E
The
next
recommendation
is
to
draft
a
bill
to
appropriate
state
general
funds
to
support
the
adopt-a-vet
dental
program
in
the
amount
of
five
hundred
thousand
dollars
for
northern
nevada,
with
an
additional
increase
of
five
hundred
thousand
dollars
for
southern
nevada.
For
a
total
of
one
million
dollars,
information
concerning
this
recommendation
can
be
found
in
attachment
c.
E
This
recommendation
was
made
by
dimitrio
gonzalez
executive
director
of
the
adopt-a-vet
dental
program
during
the
committee
meeting
on
april
12
2022,
mr
gonzalez,
is
attending
the
meeting
today
here
in
person
in
las
vegas,
and
he
is
available
to
answer
any
questions
from
the
committee
at
this
time.
Thank
you,
chair
gorlow,.
K
I'm
going
to
try
not
to
be
so
active,
no
I'm
not
yeah
and
again.
I
just
want
to
reiterate
the
comments
that
I
made
before
the
adoptive
vet.
Dental
program
is
an
essential
program
here
in
the
state,
one
of
the
things
that
I've
asked
asked
the
folks
who
associated
with
that.
K
If
they
could
look,
there
is
a
a
major
provider
of
implants
and,
to
my
knowledge
they
are
not
a
part
of
the
adopt-a-vet
program,
but
perhaps
there
is
a
way
that,
mr
gonzalez,
you
all
could
take
a
look
and
see
how
we
might
entice
them
to
become
a
part
of
this.
K
As
I
understand,
the
payment
or
the
other
payment
for
their
services
is
quite
expensive,
and
even
if
they
would
just
adopt
10
veterans
a
year
at
20
000
a
pop,
we
know
that
that
would
be
significant
and
they
can
buy
it
between
the
north
and
south
or,
however,
we
want
to
do
it,
but
I
think
I
think
there's
got
to
be
a
way
that
we
can
encourage
some
folks
who,
who
have
national
presence
with
potential
cosmetic
dentistry
to
become
a
part
of
this.
This
is
a
valuable
program.
M
Good
morning,
chair
and
and
committee
members,
thank
you
for
having
us
here.
We
really
appreciate
it.
Just
before
I
start
to
the
left
of
me.
I
have
my
assistant,
executive
director
and
chief
financial
officer
for
our
program
just
in
case
there's
any
budgetary
questions
that
are
there,
but,
yes,
senator
spearman.
M
We
we're
getting
into
the
partnership.
I
know
I
was
here
to
talk
about
some
of
the
partnerships
that
we've
made
here
in
the
south
and
that's
part
of
my
part
of
what
I'm
going
to
talk
about
today.
If
you
want
me
to
start
with
that
first
or
do
you
want
me
to
go
with
how
I
was
going
to
present
it?
It's
it's
up
to
you.
M
Okay,
if
you
don't
mind
senator
spearman
out,
if
I
can
start
from
the
beginning,
then
I'll
get
to
your
question
on
some
of
the
partnerships
that
we've
come
here
and
it's
specifically
one
of
it
was
going
to
be
to
the
question
that
you
asked
on
implants
and
we're
excited
about
that
as
well.
M
So
what
we
have
found
since
we've,
since
we've
expanded
to
the
south
is
obviously
the
number
of
veterans
are
doubled,
more
than
doubled
than
we
have
in
the
north
and
the
the
need
and
the
urgency,
but
also
the
types
of
cases
that
we're
seeing
we've
been
in
practice
in
nevada
for
12
years
and
we've
they've
done
such
a
great
job.
M
The
cases
that
we're
seeing
now
that
are
coming
into
the
program
are
just
so
much
more
difficult
and
so
much
more
extreme
than
the
cases
that
we're
seeing
in
lawrence's,
because
we
haven't
been
here
and
they
just
haven't,
been
able
to
see
dentist
also,
we've
been
able
to.
Since
we
know
we
know
this
problem.
We
knew
before
coming
to
the
south
that
this
would
be
an
issue
for
us
and
we
needed
to
think
differently
about
how
we
were
going
to
approach
it.
When
we
initially
started
in
the
north.
M
M
One
of
those
partnerships
was
with
dr
lydia
wyatt
who's,
the
dental
director
for
the
volunteers
in
medicine
here,
and
she
has
offered
up
her
clinic
to
do
the
same
thing
that
we
do
in
the
north
with
tmcc
and
that's
just
been
so
exciting
the
the
ability
to
go
ahead
and
start
that
right
now,
with
with
what
we
have
and
start
getting
a
retired
dentist
to
come
and
participate
in
our
program.
M
This
is
going
to
put
us
ahead
as
a
ahead
of
the
game.
When
we
first
started
using
tmcc,
we
were
in
what
year
I
think
we
were
in
our
ninth
year.
M
We
were
in
our
ninth
year
in
practice
as
a
dental
program
and
now
we're
going
into
our
first
our
second
year
and
we're
excited
to
see
that
that
can
be
a
possibility
working
with
dr
lydia
wyatt
as
a
director.
She
has
offered
a
space
for
us.
She
has
offered
the
dental
clinic
for
us.
The
only
the
only
items
that
we
would
need
to
procure
are
obviously
the
dental
equipment
that
we
would
need
would
be
hand,
pieces,
consumables,
things
that
we
use
normally
at
a
dental
clinic.
M
M
The
other
partnership
that
we
made
was
with
dr
thacker
from
roseman
rosemary
university
dental
school.
So
he
had.
They
have
a
dental
school
here
in
nevada.
It's
a
utah
dental
school,
but
they
do
have
a
charter
here
and
he's
a
he's.
A
navy
dentist
he
just
got
out
but
he's
offered
his
services
to
partner
up
with
us
as
well
to
see
veterans
and
also
do
more
sophisticated,
more
advanced
type
dentistry
for
our
dental,
for
our
more
severe
dental
veterans
that
we
have
but
he's
it's.
M
M
So
what
we've
done
is
we
partner
up
we've
partnered
up
with
eight
calvary,
chapels
throughout
the
the
southern
nevada
and
also
a
couple
of
baptist
churches,
and
what
they're
offering
us
is
their
business
centers
to
do
our
in
processing
all
through
nevada
and
and
the
surrounding
areas
of
nevada?
How
does
that
help
us
out?
It
lowers
our
costs.
We
don't
have
to
have
an
office
that
is
so
large
that
we
can
bring
all
these
people
in.
M
I
can
just
go
from
location
to
location
and,
however,
close
those
veterans
are
from
those
churches,
we
can
bring
them
in
there
do
the
in
processing.
We
don't
have
to
rent
a
space
to
do
that,
so
we've
been
able
to
lower
costs
with
that
the
other.
Now
we
do
eventually
want
to
get
some
type
of
office
here,
but
coming
here
last
year,
at
the
end
of
covid
was
really
not
the
time
to
do
that.
M
So
I
live
here
in
vegas
the
home
is
my
office
is
in
my
home,
and
so
I'm
kind
of
running
it
out
of
my
office
right
out
of
my
home
right
now,
which
is
fine,
but
eventually
we
do
want
to
have
an
office
where
we
can
have
a
central
location,
but
for
the
time
being,
because
we're
so
new,
we
wanted
to
minimize
the
cost,
because
we
have
not
increased
our
budget
and
our
cost
from
the
north.
Everything
we
did
last
year
was
just
trying
to
cut
every
cost.
M
We
possibly
could
to
make
up
the
difference
for
us
being
in
the
south.
The
other
area
that
we,
the
other
area
that
we
partnered
up
with,
is
lv
reach.
So
every
reach
is
an
organization
that
gives
education,
services
and
also
medical
services
to
low-income
veterans
and
civilian
sector
personnel,
just
individuals
in
the
city
of
las
vegas
and
surrounding
areas,
and
so
we're
able
to
partner
up
with
them,
use
their
facility
and
also
our
veterans
are
able
to
get
educational,
cert
education
services
from
that
from
that
area.
M
We
try
and
get
them
to
the
point
where
they
can
start
going
out
to
the
community,
face
the
community
not
be
embarrassed
about
what
their
teeth
look
like
and
so
adding
that
education
part
to
it,
getting
them
off
being
homeless,
partnering
up
with
hud
bash
and
getting
them
into
processes
that
that
get
them
involved
and
excited
to
live
again
rather
than
just
harming
and
being
in
their
homes,
not
coming
out
because
they're
so
embarrassed
to
not
get
seen
with
with
what
they
look
like,
but
lv
reaches
is
we've
we've
partnered
up
with
them
twice
already
since
I've
been
here
in
july,
and
it
was
very
successful,
they
were
able
to
get
in
contact
with
different
services
that
they
can
use
to
get
them
out
in
the
community
and
start
work,
which
is
the
ultimate
goal,
is
to
get
them
out
in
the
community
and
start
working,
get
off
of
homelessness
and
the
other.
M
So
dr
blasco,
now
dr
blasco
is
well
known
in
the
community.
Here
he's
he's
the
dentist
for
the
knights
and
for
the
for
many
sports
teams
here,
but
he
is
also
one
of
the
prominent
implants
dentist
here
in
the
state
of
nevada.
M
He
was
also
the
president
of
the
southern
nevada
board
of
dentistry
here
as
well,
and
he
holds
many
offices
throughout
for
the
dental
community,
but
he
has
partnered
up
with
us.
I
I
spoke
with
him
yesterday.
He's
excited
to
come
on
board.
His
whole
practice
is
built
around
implants
and
what
dr
blasco
also
does
is
he
does
training
and
continuing
education
courses
for
dentists
around
the
state
of
nevada,
and
that
can
only
help
our
program
out
more.
M
We
are
limited
on
on
the
the
amount
of
implants
that
we
do
and,
as
you
said,
senator
spearman
because
of
the
cost,
but
if
we're,
but
now
that
we're
partnering
up
with
dr
blasco,
this
is
a
great,
a
great
opportunity
for
us
to
cut
that
cost.
I
don't
ever
think
that
there
will.
M
It
will
be
a
point
where
it
won't
cost
something,
but
the
ability
to
cut
down
the
cost
is
is,
is
just
it's
a
promise
somewhere,
it's
something
that
we
can
look
forward
to
so,
but
that's
that's
the
partnerships
that
we've
made
so
far.
We
we
have.
We
have
been
able
to
do
that,
but
with
that
partnership,
the
ability
to
to
have
all
those
partners
there's
so
many
dentists
that
we
can't
approach,
because
the
cost
is
too
great.
M
So
with
the
22
dentists
that
we
have
now
with
the
budget
that
we
have
now
with
just
what
we
from
for
the
north,
we
can't
really
reach
out
to
any
more
dentists,
because
we
just
couldn't
afford
it.
We
pay
for
all
the
dental
laboratory
costs
that
associated
with
the
dental
care.
So
while
the
dentist
mace
may
see
the
patient
pro
bono
and
pay
for
all
the
services
that
way,
one
of
the
biggest
reasons
why
they
like
partner
partnering
with
us
is
we
do
all
the
administrative
work.
M
They
don't
add
that
whenever
they
take
a
patient,
they
don't
add
that
administrative
work
to
their
staff.
We
have
staff
members
that
do
that
they
from
the
time
they
come
into
the
program,
any
type
of
medical
issues
that
are
that
need
to
be
mitigated
prior
to
being
seen.
Our
staff
members
go
with
that
individual.
M
They
process
that
individual
all
the
way
through
until
they
start
their
treatment
and
throughout
the
treatment
into
the
into
treatment,
and
so
that's
why
they
like
working
with
us.
The
other
reason
is
because
we
pay
for
the
laboratory
cost,
which
the
laboratory
costs
are
pretty
significant
bridges
crowns
all
these
different
types
of
dentures
that
we
have
to
do.
Rpds,
replaceable,
partial
dentures
you
get
enough
of
those
going
and
the
cost
becomes
excess,
excessive
and
and
it's
hard
to
keep
up.
M
We
do
yearly
fund
ranges,
we
do
monthly
fundraisers
and
it
it
depletes
quickly
because
of
the
cost
of
these
associated
costs,
and
so,
but
as
far
as
the
implants
are
concerned,
we're
excited.
We
don't
know
what
that
looks
like
yet.
Dr
blasco
and
I
are
still
in
conversations
on
that,
but
hopefully
we'll
get
those
going.
A
E
This
letter
would
also
encourage
the
creation
of
a
state
coordinator
position
to
oversee
and
manage
the
program
and
to
facilitators
or
recruiters
within
the
department
to
collaborate
with
non-profit
organizations
and
state
local
state
and
federal
agencies
to
better
connect
veterans
to
available
k-12
employment
opportunities
throughout
nevada.
This
recommendation
was
proposed
by
assemblywoman
michelle
gorlow,
chair
of
the
legislative
committee
on
senior
citizens,
veterans
and
adults,
with
special
needs
in
consultation
with
lcb
staff
and
additional
communication
with
dr
george,
anne
rice,
representative
of
the
heroes
to
education
program
in
nevada.
E
K
Trying
to
try
not
to
say
anything,
this
is
just
such
a
comment
and
they
may
already
be
doing
it,
but
one
of
the
things
we
might
be
able
to
look
at
is
working
with
dod
or
specifically
nellis
to
see
if
they
have
any
incoming
service
members
who
might
fit
the
qualifications
for
the
heroes
education
work.
I
know
when
I
was
overseas.
K
I
used
to
get
a
lot
of
mail
once
once
I
was
getting
ready
to
come
back
home,
get
a
lot
of
mail
about
different
opportunities
and
things
of
that
nature,
so
that
might
be
that
might
be
some
place
where
we
might
be
able
to
get
additional
information
up
front
so
that
we
could
prepare
for
that.
The
next
thing
would
be
working
with
probably
the
the
blue
star,
moms
and
those
are
folks
who
have
family
members
who
are
deployed
overseas.
K
Some
of
them
may
fit
the
qualifications
for
that
or
their
loved
one
who's
overseas
might
do
that.
We
could
also
check
with
our
national
guards,
army
and
air
force,
to
see
if
there's
anybody
in
in
the
guard-
that's
not
full-time
see
if
they
fit
some
of
those
bills.
So
those
are
some
of
the
ways
that
we
might
be
able
to
expand
the
program
and
relatively
minimal
amount
of
additional
staffing.
H
Yes,
madam
chair
and
thank
you
vice
chair
spearman,
we
already
are
working
with
the
nevada
national
guard,
also
the
reserve
also
the
department
of
veterans
services
and
they
get
a
list
from
the
department
of
labor
every
single
month
of
the
people
who
are
leaving
the
service,
who
have
indicated
that
they're
moving
to
nevada
and
they
have
agreed
to
put
within
that
packet
information
about
jobs
in
public
education
that
are
available
in
the
areas
to
which
they're
moving.
H
We
also
have
talked
to
the
airmen
and
family
readiness
center
at
nellis,
also
we're
involving
even
community
groups,
for
example
like
the
las
vegas
chamber
of
commerce
military
affairs
committee.
So
anyone
who
has
connection
with
the
military
that
we've
been
able
to
think
of
we
have
involved
them
and
their
commitment
to
work
with
us
in
trying
to
staff
the
schools
of
the
17
school
districts,
plus
the
public
charters.
K
A
H
A
E
Recommendation
five
on
the
work
session
document
contains
two
recommendations
that
are
independent
from
one
another
but
are
proposed
together
so
that
if
the
members
decide
to
move
forward
with
both,
then
they
would
be
included
into
one
single
bdr
recommendation.
5A
is
to
draft
a
bill
to
create
a
vulnerable
adult
protection
order
under
chapter
33
of
nrs,
to
protect
vulnerable
adults
against
abuse,
neglect
or
exploitation.
E
This
would
be
a
redraft
of
the
assembly
bill,
407,
which
was
failed,
which
was
a
failed
measure
from
the
2022
or
sorry.
Excuse
me,
2021
legislative
session
with
proposed
amendments
which
can
be
found
on
attachment,
d2
and
or
recommendation
5b,
is
to
establish
an
independent
authority
for
adult
protective
services
to
apply
for
access
warrants
in
cases
of
suspected
abuse
and
or
neglect
of
vulnerable
adults.
E
These
provisions
would
ensure
aps
can
meet
independently
with
the
adult
suspected
of
being
abused
and
or
neglected.
Without
coercion
or
undue
influence,
more
information
concerning
recommendation
5b
is
available
in
attachment
d
and
d1,
which
contains
statutory
examples
from
arizona,
mississippi
and
missouri.
E
E
N
Good
morning,
madam
chair
and
members
of
the
committee
jennifer
richards
chief
rights
attorney
aging
disability
services,
division
for
the
record.
Thank
you
for
the
opportunity
to
be
in
front
of
this
committee
again
I'll,
be
brief.
We
did
a
comprehensive
presentation
to
this
committee.
Previously,
the
protected
protection
order
is
substantively
the
same.
We
incorporated
the
recommendations
from
the
public
defender's
office
that
we
received
last
session.
N
Oh,
the
pages
aren't
marked
in
the
work
session,
it's
it's
highlighted
and
italicized,
and
it
addresses
financial
institutions
freezing
assets
and
joint
accounts.
N
So
I
went
ahead
and
added
that
language.
Otherwise,
the
protection
order
is
substantively
the
same
as
it
was
in
2021
with
those
additions
regarding
the
access
warrant.
That
is
a
new
proposal
this
session
and
as
we
presented
to
the
committee,
we're
trying
to
address
adult
maltreatment
across
the
system
and
so
we're
looking
at
preventative
measures
through
the
protection
order
and
in
improving
outcomes
at
the
investigation
stage
of
the
case
as
well,
and
so
the
access
warrant
will
allow
us
to
intervene
earlier
and
assess
the
situation
of
these
adults
when
it's
bad.
N
It's
been
very
bad
for,
for
some
of
the
cases
that
we've
had
and
individuals
are
coming
out
on
a
stretcher
or
they're
they're
not
coming
out
of
the
situation,
so
I
don't
want
to
belabor
the
topics.
I'd
like
to
answer
any
questions
that
the
committee
may
have
on
either
of
these
initiatives.
A
N
Jennifer
richards
chief
rights
attorney
aging
disability
services
division
through
you,
madam
chair
to
senator
spearman.
I
heard
the
question
of:
are
there
enhanced
penalties
for
violation
of
the
protection
order?
Is
that
correct.
K
Yes,
ma'am
throughout
the
throughout
the
whole
bill,
just
enhance
penalties
so
that
so
that,
wherever
the
people
who
are
perpetrating
this
type
of
insidious
act
on
seniors
to
make
sure
that
we
get
their
attention.
N
A
A
E
The
next
recommendation
recommendation
6
at
the
top
of
page
4
of
the
work
session
document,
is
to
draft
a
bill
to
establish
a
baseline
of
eviction.
Protections
for
all
individuals
in
residential
facilities
for
group
residents
that
mirrors
federal
regulations
complies
with
the
requirements
of
the
settings.
Rule
incorporates
a
notification
process
to
alert
the
long-term
care
ombudsman
program
of
the
agent
and
disability
services.
Division
within
30
days
of
a
proposed
eviction
provides
for
penalties
for
facilities
that
do
not
follow
the
process
with
enforcement
mechanisms
and
designates
a
forum
to
adjudicate
eviction
disputes
according
to
adsd.
E
The
department
of
administration
is
the
current
forum
for
skilled
nursing
appeal
hearings.
Federal
regulations
provide
a
method
and
guidance
for
appeals
officers
to
follow.
Proponents
of
this
recommendation
note
that
illinois
compiled
statutes
should
be
considered,
especially
the
essential
contract
requirements
which
would
mirror
nevada's
existing
landlord
tenant
law
under
chapter
118.
A
of
nrs
information
concerning
provisions
enacted
in
illinois
are
located
on
page
60
of
the
pdf
in
attachment
e1.
E
E
A
E
E
A
E
In
response
to
testimony
provided
during
the
meeting
on
june
28
2022,
dr
packham
is
available
via
zoom,
along
with
dr
gerald
ackerman,
troy
jorgesen
and
dr
mordecai
lavi
for
their
for
any
questions
from
the
committee.
Thank
you,
chair,
gorlo,.
A
E
Information
concerning
nevada's
homelessness
is
included
in
attachments,
h1,
h2
and
h3.
This
recommendation
was
developed
by
chair
gorlo
in
consultation
with
lcb
staff
and
additional
communication
with
ms
nyani
cooper
manager
of
the
homeless,
to
housing
program,
social
and
social
services
manager
and
of
the
division
of
welfare
and
supportive
services
of
dhhs.
E
K
Reliable
to
ask
questions
or
make
comments,
I
just
want
to
include
in
the
record
a
a
72
year
old,
called
me
a
few
weeks
ago,
a
couple
of
months
ago,
actually
and
in
tears
that
her
social
security
income
was
only
1600
and
her
rent
that
used
to
be
that
was
900
for
several
years.
She
just
received
a
a
letter
from
her
landlord
that
the
rent
was
going
up
1400,
and
I
think
this
is
a
very
timely
recommendation.
K
I
guess
what
I
want
to
know
is
there
anything
that
we
can
do
between
now
and
the
first
monday
in
february,
when
the
legislature
reconvenes,
to
make
sure
that
our
seniors
are
not
pushed
out
because
of
increased
rates?
And
when
I
talked
to
this
lady,
there
had
been
no
improvements
made
in
the
property.
There
had
been
not
no
paint,
no
painting,
no
carpet
refurbishing,
no,
nothing.
K
The
only
thing
was
just
that
the
rent
was
was
going
up,
so
I
don't
know
what
can
be
done
in
terms
of
you
know
the
working
with
interagency
folks,
but
certainly
we
need
some
relief
for
them
right
now.
Thank
you.
G
Nianni
cooper,
the
manager
for
our
homeless,
housing
under
division
of
welfare
and
supportive
services.
That
exact
question
has
been
raised
by
not
only
the
council
but
our
three
cocs
for
the
northern
rural
and
southern.
That
is
also
continuously
being
worked
on
and
updated
in
the
nevada
state
strategic
plan
for
homelessness.
A
A
A
We
will
start
with
the
public
comment
from
those
in
the
physical
locations
and
then
move
to
public
comment
for
anyone
who
is
called
in.
Please
remember
to
clearly
state
and
spell
your
name
and
for
the
record
and
limit
your
comments
to
three
minutes.
Staff
will
be
timing.
Each
speaker
during
public
comment
to
ensure
everyone
is
given
a
fair
opportunity
to
speak
so
we'll
start
in
carson
city.
Is
there
anyone
who
would
like
to
provide
public
comment
at
this
time.
A
O
Hello,
my
name
is
shanika
cooper.
I
am
a
home
care
worker
here
in
las
vegas
nevada.
I
am
also
a
member
of
the
healthcare
standards
board
and
the
systemic
racism
committee,
I'm
here
today,
because
I
am
a
worker
that
is
displaced.
I
recently
reached
out
to
miss
pat
spearman
and
some
of
the
other
colleagues
that
I
know
I
am
struggling.
O
As
you
guys
may
know,
the
cost
11
has
gone
up
here
and
as
a
home
care
worker
that
does
take
care
of
my
disabled
son.
I
don't
make
enough
money,
we
are
asking
for
15
an
hour,
but
even
at
15
an
hour
is
not
enough.
O
I
can
only
imagine
how
they
feel
to
not
have
anybody
to
call
on
or
to
go
to,
and
I
just
want
to
ask
for
there
has
to
be
something
that
has
to
be
done
in
my
situation.
The
owner
does
not
live
here.
He
lives
out
of
he
lives
somewhere
else.
He
doesn't
live
in
the
state.
O
O
It's
it's
a
crisis
and
it's
a
scary
thing,
and
I'm
just
here
in
support
of
of
others
and
myself,
to
try
to
see
what
we
can
do
to
get
help
here
in
this
state.
It's
it's
gone
up.
They
asked
for
three
times
the
rent
and
we
don't
make
the
rent,
and
so
I'm
just
asking
for
some
kind
of
help
from
the
state
to
help
people
like
myself
and
elderly
people.
O
But
I
am
hopeful
that
something
is
going
to
be
done
and
I
just
want
to
say
that
it's
a
great
state
of
nevada,
but
it's
kind
of
scary
situation.
Right
now
with
the
housing
crisis-
and
you
know
the
things
that
are
going
on
here,
so
thank
you.
A
A
G
G
Share
the
public
line:
oh
just
one
moment,
we
just
had
a
hand
raised
just
one
moment.
I
I
Good
morning
this
is
dora
martinez,
the
nevada
disability,
peer
action
coalition
activist.
I
just
want
to
agree
with
the
brave
and
courageous
young
lady
that
made
the
public
comment.
Please
please,
I
hope
it's
possible
instead
of
15
or
17
for
the
pca
to
make
it
25.
I
I
I
train
disabled
people
and
people
who
are
elderly,
who
are
hard
of
hearing
or
visually
impaired.
I
go
to
their
home
and
I
teach
them.
You
know
how
to
use
their
iphone
or
android
tablet
pc
and
while
I
was
there,
her
pca
came
in
and
was
hungry,
she
didn't
have
enough
money
to
get
groceries.
I
I
Luckily,
I
don't
drive,
I
used
to
public
transportation,
and
even
that
is
sparse
in
in
here
in
reno,
nevada
and
and
I'm
my
coalition
is
trying
to
I'm
jumping
to
another
topic,
because
I
know
I'm
limited
and
my
coalitions
were
trying
for
to
for
the
rtc
here.
I
Excuse
me
washel
to
subsidize
a
bus
fare
for
people
because
three
dollars
per
ticket
for
paratransit
riders,
it's
just
simply
hard
for
people
that
need
that
goes
to
dialysis.
They
got
to
choose
if
they
gonna
pay
for
groceries
or
go
to
doctor's
office.
So
we're
trying
to
work
to
see
if
you
know
rtc
can
subsidize
that
and
I'm
sorry
I'm
jumping
around.
I
just
know
that
I'm
timed-
and
I
know
you
guys-
are
probably
hungry,
but
thank
you
so
much
for
all
that
you
do.
A
K
Chair
spearman
yeah,
it's
just
just
going
to
say
I
just
want
to
take
this
time
to
thank
you
for
your
leadership
during
some
rather
tremendous
times,
and
the
timely
recommendations
that
you
and
the
members
of
the
committee
have
come
up
with
for
those
persons
that
we
are
tasked
with
assisting.
K
So
thank
you
for
that
to
chair
to
the
members
and
to
our
staff,
who
have
done
a
yeoman's
job,
especially
at
and
making
sure
that
those
of
us
who
had
to
participate
remotely
were
able
to
do
so
and
want
to
also
thank
the
community
for
their
comments,
because
I
think
it's
the
public
comments
that
help
us
help,
make
us
better
and
more
precise
and
the
work
that
we
do
for
those
who
elected
us
and
for
whom
have
this.
We
have
the
sacred
trust.
So
thank
you.
A
Thank
you
vice
chair
spearman,
and
you
kind
of
beat
me
to
it.
I
also
would
like
to
thank
everybody
who
has
made
this
interim
committee
really
special
and
productive
and
all
the
commitments
and
contributions
everyone
has
made
from
our
committee
members
staff.
Thank
you.
Thank
you.
Thank
you.
I
could
not
have
done
it
without
them.
They
have
been
absolutely
truly
amazing.