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Description
This is the second meeting of the 2021-2022 Interim. Please see the agenda for details.
For agenda and additional meeting information: https://www.leg.state.nv.us/App/Calendar/A/
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A
Telling
you
about
the
federal
position
on
these
overdose
prevention
sites,
and
that
is
to
say
there
is
only
a
handful
of
people
in
the
us
doing.
Research
on
these
sites
at
the
moment,
but
the
research
they're
doing
is
quite
robust
and
researchers
are
potentially
getting
some
signals
that
there
is
a
change
in
the
way
that
the
feds
are
thinking
about
these
things
and
there's
some
openness
to
considering
the
data.
A
So
I
think
that's
very
encouraging.
I'm
going
to
present
just
a
little
bit
of
data
locally
when
assemblyman
or
looker
approached
us
to
start
having
conversations
about
what
an
overdose
prevention
site
legislation
could
look
like
lisa,
and
I
seized
the
opportunity
to
do
some
data
collection,
both
in
reno
and
las
vegas,
with
people
who
use
drugs
to
get
their
perspectives
on
what
they
would
think
about
a
place
like
this,
because
it
is
a
priority
of
our
research
group
to
center
the
perspectives
of
those
for
whom
interventions
are
delivered.
A
So
lisa
and
I
in
may
2021
did
a
series
of
qualitative
interviews
with
people
who
use
drugs
that
we
recruited
mostly
through
convenience,
sampling
and
street
based
outreach.
We
asked
them
essentially,
have
you
ever
heard
of
an
overdose
prevention
site,
and
what
would
you
think
about
it?
How
would
you
like
it
to
run?
What
do
you
see
as
the
benefits?
What
are
your
concerns
and
how,
if
we
were
to
consider
something
like
this
in
your
community,
how
would
you
like
it
to
be
done,
so
this
is
just
a
quick
table
on
this
slide.
A
A
A
We
identified
three
big
kind
of
overarching
themes
in
the
stories
that
people
were
telling
us
people
when
we
asked
them.
What
do
you
think
about
an
overdose
prevention
site?
How
would
you
use
it?
What
would
be
the
benefits?
What
would
be
your
concerns
people's
opinions,
kind
of
grouped
into
three
groups?
They
talked
about
benefits
to
self,
they
talked
about
benefits
to
others,
and
they
talked
more
broadly
about
benefits
to
the
community.
A
This
person
said
I
have
people
asked
to
come
over.
This
is
a
house
person
saying
I
have
people
asked
to
come
over
here
to
my
house
to
fix
or
get
high.
I
don't
want
to.
Let
people
do
that,
but
I
let
people
do
it
here,
because
I
don't
want
them
to
do
it
in
the
street
and
that's
problematic.
I
had
one
person
overdose
on
me,
which
was
frightening
and
other
people
have
requested
to
fix
or
get
high
here,
and
I
tell
them
no
and
I
always
feel
bad,
but
I
just
can't
risk
it.
A
Other
people,
many
people,
didn't
think
they
would
use
the
site
themselves,
but
could
see
how
this
could
benefit.
Other
people
keep
people
from
having
to
do
this
stuff
in
public.
A
It
says
in
that
first
quote:
it
would
be
helpful.
People
are
talking
about
self
managing
their
mental
health,
their
mental
health
system.
So
in
the
second
quote,
on
the
right
hand,
side
it
would
definitely
be
helpful
because
sometimes
that's
why
we
use
this
to
get
rid
of
depression,
depression
and
anxiety.
A
Maybe
that
particular
person
might
not
need
heroin.
They
might
need
an
antidepressant
or
something,
and
it
would
be
a
window
to
adore
for
them
to
be
able
to
walk
into
a
space
that
would
meet
them
where
they
are,
allow
them
to
do
what
they
need
to
do
and
provide
the
opportunity
to
link
to
clinical
behavioral
health
care.
A
There
are
unique
issues
to
women,
women
who
are
using
drugs.
Women
who
are
living
on
the
street
and
women
who
are
seeking
services
so
being
a
woman
using
drugs
can
increase
vulnerability
in
certain
ways,
and
so
one
of
the
things
that
people
talked
about
was
running
a
space
where
there
would
be
women's
nights
so
that
women
could
come
together
and
be
protected
from
some
of
the
things
that
they
face,
but
also
have
opportunities
to
link
to
services
and
care.
A
And
finally,
people
talked
about
benefits
to
the
broader
community.
When
we
asked
people
what
would
be
the
benefit
of
opening
a
space
like
this,
they
talked
about
the
ability
of
a
space
like
this,
to
reduce
drug
use
in
public
spaces,
to
reduce
discarded
syringes
to
reduce
crime
and
to
reduce
stress
on
ems
and
emergency
responders.
A
The
biggest
thing
for
me
personally
is
that
you
wouldn't
walk
up
on
somebody
who
had
died
or
who
was
dying
and
if
they
were
just
able
to
go
to
this
place.
That
would
happen
less
the
only
place
for
that
horrible
stuff
to
happen
is
out
on
the
street
in
public.
Where
are
we
going
to
go?
We
don't
have
a
spot
to
go.
A
Many
overdoses
happen
in
these
overdose
prevention
sites,
but
not
a
single
person
has
died
from
an
overdose
that
they
have
experienced
at
an
overdose
prevention
site.
So
the
take
home
there
is
people
might
still
be
consuming
drugs
in
such
a
way
that
depresses
their
respiration
and
sends
them
into
an
overdose,
but
because
there
is
supervision
and
there's
medical
personnel
on
site.
Nobody
has
died
in
an
overdose
prevention
site
next
slide.
A
Nevada
at
the
moment
only
has
two
syringe
service
programs
track
b
that
you
heard
from
earlier
and
change
point
up
here
in
the
north
and
even
though
trek
b
is
expanding
their
services
through
harm
reduction,
vending
machines.
This
is
really
not
enough
to
meet
the
needs
of
the
state.
A
One
of
the
opportunities
that
we
see
moving
forward
is
to
really
make
sure
embracing
these
principles
of
harm
reduction.
That
people
who
use
drugs
are
engaged
in
the
decision
making
process
as
subject
matter
experts
when
we
are
thinking
about
policies
and
programs
and
services
to
address
drug
related
harms,
we
need
to
be
thinking
about
how
to
get
the
people
for
whom
those
services
are
intended
in
the
room
and
at
the
table
and
amplify
those
voices,
and
we
can
also
think
about
that
in
terms
of
funding
allocation.
A
A
Housing
first
initiatives
is
a
a
bullet
point
here
because,
as
you
all
know,
in
nevada
and
in
many
places,
housing,
affordability
and
housing.
Instability
is
a
major
problem
and
the
link
between
housing,
instability
and
drug
overdose,
death
and
drug
related
harms
is
really
really
tight.
They
are
intimately
connected
and
so
ensuring
housing
stability
is
a
step
towards
reducing
drug
overdoses
and
reducing
drug
related
harms
and
then,
finally,
for
a
lot
of
today,
you
heard
some
really
fantastic
data.
A
I
would
like
to
suggest
that
one
of
the
opportunities
we
have
is
to
complement
those
surveillance
efforts
with
more
granular
analysis
of
the
circumstances
of
deaths.
We
are
counting
deaths
in
our
mortality
and
morbidity
reports,
but
if
we
looked
more
closely
at
the
circumstances
surrounding
death
and
what
was
going
on
in
those
cases,
I
think
we
could
get
a
better
handle
on
where
to
place
our
resources
and
where
to
place
our
interventions.
A
You
also
heard
a
lot
today
about
upstream
interventions,
and
we
have
to
be
doing
all
of
it
and
investigating
a
death
record
is
too
late,
but
it
could
tell
us
where
to
intervene,
so
it
doesn't
happen
again
and
again.
I
would
emphasize
that
best
practices
in
terms
of
harm
reduction
research
suggests
that
even
in
our
surveillance
efforts,
we
incorporate
the
on
the
ground
perspectives
of
people
who
are
using
drugs,
and
with
that
I
think
I
will
end
and
we
can
take
questions.
B
Thank
you
so
much
so
much
information
out
there.
I
would
entertain
questions
from
the
committee.
I
have
senator
donate
first,
please
go
ahead.
C
Thank
you
so
much
chair,
peters
and,
of
course,
thank
you,
dr
wagner
and
lisa
for
your
presentations
today.
You
know
I
find
this
interesting
because
it's
at
the
forefront
of
public
health
innovation,
dr
wagner,
would
you
be
able
to
detail
what
has
been
the
feedback
that
you
have
gained
from
law
enforcement
regarding
these
sites
and
what
have
congress?
What
what
have
been
the?
What
is
the
substance
of
the
conversations
that
you've
had
with
them
in
terms
of
implementation,
since
the
session
ended
since
the
81st
session
ended?
A
Thank
you
for
that
question.
Carla
wagner
for
the
record.
I
can
tell
you
a
little
bit
about
kind
of
what's
happening
in
terms
of
how
we're
talking
about
these
things.
There
might
be
other
people
in
the
room
who
could
do
a
better
job,
answering
your
questions
specifically
about
conversations
we've
had
in
the
state,
but
what
I
can
say
is
that
you're
asking
about
overdose
prevention
sites
right.
B
A
A
So
addressing
the
crash,
the
crack
house
statute,
which
prohibits
the
intentional
operation
of
a
brick
and
mortar
establishment
where
people
knowingly
use
drugs,
is
an
opportunity
right
because,
on
the
law
enforcement
side,
they're
asked
to
enforce
that
standard.
On
the
public
health
side,
we're
saying
the
public
health
value
outweighs
the
enforcement
need.
A
The
other
concern-
and
I
think
the
thing
that
needs
to
get
resolved
is
that
there
has
to
be
some
kind
of
buffer
space
around
a
place
like
this
one
of
the
big
concerns
that
people
talked
about
when
we
asked
them.
What
would
you
worry
about
if
we
opened
a
space
like
this
is
how
am
I
going
to
get
to
and
from
if
every
law
enforcement
officer
in
the
community
knows
that
I'm
going
to
this
space
to
use
drugs,
they
know
that
I'm
going
to
be
carrying
drugs.
A
There's
going
to
be
problems
they're,
going
to
stop
me
on
my
way
in
or
out.
So
these
are
opportunities
where
we're
really
going
to
have
to
have
some
difficult
conversations,
but
I
think
the
idea
that
we
are
all
moving
in
the
same
direction
in
terms
of
minimizing
deaths
needs
to
kind
of
be
our
central
focus.
D
I
myself
have
not
had
conversations
with
law
enforcement
since
the
81st
session,
primarily
because
I
wanted
to
hear
with
the
people
who
use
drugs
for
which
these
sites
are
intended
for
have
to
say
and
what
their
concerns
are
just
because
they're,
the
ones
that
are
dying,
and
so
I
definitely
want
to
be
mindful
that
if
these
spaces
were
to
exist,
they
would
be
spaces
in
which
the
people
who
are
intended
to
be
there
would
actually
come
there,
I'm
not
sure
about
law
enforcement,
but,
as
dr
wagner
mentioned,
that
was
a
concern
that
came
up
time
and
time
again.
D
Another
concern
which
I
find
most
interesting
coming
from
the
child
welfare
perspective,
is
that
there
were
mothers
who
talked
about
their
current
practices
of
substance
use
now
that
really,
when
you
think
about
child
safety,
permanency
and
well-being,
they
are
legitimate
concerns
and
they
talked
about
how
spaces
like
this.
D
That
is
a
very
uncomfortable
conversation,
and
so
I
think
those
are
legitimate
concerns
and
those
were
the
things
I
picked
up
on
coming
from
the
child
welfare
perspective.
D
And
so
I
just
I
wanted
to
bring
that
up
in
this
forum.
B
Thank
you
so
much
for
that
insight.
Miss
lee
and
dr
wagner
really
appreciate
the
work
you
guys
have
put
in
on
this
particular
issue,
and
I
would
encourage
folks
who
are
interested
in
this
topic
to
reach
out
to
and
work
with,
assemblyman
oren
liquor,
as
he
has
continued
interest
in
this
particular
area,
and
we
can
see
what
we
can
do
as
we
go
into
the
next
legislative
session.
Assemblywoman
titus.
I
saw
you
turn
your
camera
on.
Do
you
have
a
comment
or
a
question.
E
I
actually
both
thank
you
very
much
very
interesting
as
someone
who
was
opposed
to
that
particular
bill
for
a
number
of
reasons.
First,
I'm
married
to
retired
sheriff,
and
so
you
can
imagine
the
conversations
we
had
in
our
home
regarding
this
particular
bill.
But
again
part
of
it
is
your
comments
and
all
well
intended,
and,
and
certainly
dr
arnold
licker,
his
again.
This
bill
was
well
intended.
He
brought
in
some
folks
from
international
folks
and
then
only
one
place
in
philadelphia,
and
I
think
I
think
the
concern
was
again.
E
The
newness
of
it
was
one
thing
and
that
it
really
hasn't
been
established,
and
how
do
you
know
what
the
outcomes
are?
If
you
don't
have
one
to
do
the
research
on
so
I
appreciate
that
aspect
of
it,
but
one
comment
that
you
made
was
that
folks
have
said
that
they
wouldn't
have
drugs
in
their
in
their
house,
but
but
our
concern
was-
or
my
concern
was
at
the
time
they're
still
getting
these
drugs
somewhere.
There's
you
know,
there's
some
supply
chain
problems
for
everything
else
we
have,
but
it
doesn't
seem.
E
There's
a
supply
chain
issue
for
illegal
drugs,
and
one
of
the
concerns
that
many
of
us
had
were:
where
are
they
still
going
to
get
these
drugs
they're
still
going
to
be
in
their
home
and
they're,
going
to
take
them
to
this
facility?
They're?
Still,
no
monitoring
of
what
drugs
are
taking,
and
that
was
some
of
our
concerns
to
to
watch
folks
sit
there
and
potentially
overdose
with
an
illegal
drug
that
they
have.
These
aren't
prescribed
drugs
from
a
provider
such
as
myself.
E
These
are
drugs
that
are
bought
illegally
on
the
street
from
some
you
know,
pusher
from
who
knows
where
or
what
these
things
are
laced
with,
and
so
I
have
you
know.
I
have
significant
concerns
regarding
that
aspect
of
it.
Yes,
I
I
certainly
hear
and
appreciate
what
you're
trying
to
do
for
the
the
the
people
that
are
the
the
users,
but
there
there's
this
whole
pyramid
effect
of
this
and
the
whole
other
concerns
and
so
happy
to
continue.
E
The
conversation
next
cycle
around
regarding
some
of
the
things
that
you
heard
testify
and
the
concern
that
that
many
of
us
had
regarding
these
type
of
facilities,
so
that
I
just
want
to
kind
of
go
on
record.
With
that
comment.
B
Highlighting
this
concerns
from
the
last
legislative
session,
I
think
it's
important,
especially
in
the
interim,
that
we
can
work
through
some
of
those
if
this
bill
is
going
to
make
it
back
into
the
legislative
session.
I
saw
both
dr
wagner
and
mrs
lee
raise
their
hand
in
response.
If
you
guys
would
like
to
trade
off
in
response,
we
do
have
a
little
bit
of
a
time
constraint
here
so
about
two
minutes.
If
you
may.
D
D
The
first
thing
that
came
to
my
mind
was
this
is
an
opportunity
for
additional
surveillance
to
really
see
what
people
are
taking
and
there's
an
opportunity
it,
and
it
was
suggested
much
earlier
in
the
day
about
checking
syringes
and
track
b
is
actually
doing
that
using
technology
down
in
las
vegas,
but
this
would
provide
an
additional
opportunity
to
really
see
what
kind
of
contaminants,
because
certainly
fentanyl,
is
one
of
many
we're,
also
seeing
drink
dope,
which
has
oh,
my
gosh
carla.
What
did
it?
What?
D
What
is
that
it's
too
late
in
the
day
for
me
to
it's
a
it's
a
bar,
it's
a
benzodiazepine
intended
for
animals,
that's
being
found
in
some
parts
of
the
country.
E
D
It's
not
and
I'll
get
back
to
you
with
that
on
dr
titus,
because
they'll
probably
remember
shortly,
but
there
are
other
contaminants,
and
I
think
that
this
offers
an
additional
space
in
which
to
really
get
that
ground
level.
Level.
Surveillance.
A
And
carla
wagner
for
the
record
just
very
quickly,
dr
titus,
I
think
what
you're
saying
is
exactly
right:
that
there
is
no
quality
control
in
terms
of
drugs
bought
on
the
street.
People,
don't
know
what
they're
getting,
and
that
is
exactly
the
argument
for
a
space
where
people
can
use
under
medical
supervision,
because
you
don't
know-
and
we
can't
control
that
side
of
it.
But
we
can
control
this
side
of
it.
B
I'd
like
to
thank
you
both
for
your
continued
work
in
this
area
and
the
presentation
on
this
issue,
and
we
hope
to
hear
from
you
again
as
we
move
through
this
and
around
and
kind
of
vet
out
some
more
of
this
issue
area
with
that
we're
going
to
move
on
to
our
next
agenda
item,
which
is
agenda,
item
12.,
I'm
pretty
sure
it's
12.
behavioral
and
mental
health
insurance
payment.
B
F
B
I
appreciate
you
asking
us
about:
we
have
approximately
30
minutes
set
up
aside
for
your
presentation
and
then
we
have
another
10
minutes
set
aside
for
questions
and
answers.
F
Okay,
well
everyone's
delight,
I
don't
think
I'll
take
the
entire
30
minutes.
I
know
it's
been
a
long
day,
so
I'm
going
to
share
my
screen
here
and
bring
up
my
slides.
F
Okay,
so
my
name
is
tim
clement,
I'm
with
the
american
psychiatric
association
and
I'm
going
to
give
a
presentation
today
about
mental
health
parity
and
don't
let
the
phrase
detract
from
the
fact
it's
about
its
mental
health
and
substance
use
disorder,
parity,
it's
just
as
much
about
substance,
use
disorders,
it's
about
mental
health
and
also
because
there
was
a
request,
I'm
going
to
just
throw
in
just
a
just
a
little
bit
of
information
about
telehealth
at
the
very
end,
just
a
few
slides,
but
but
the
just.
This
will
be
about
mental
health
parody.
F
Okay.
So
what
is
mental
health
parity
and,
as
I
said,
substance
use
disorder
is
just
as
much
a
part
of
it.
Well,
the
basics.
Are
it's
a
very
it's
a
very
simple
concept.
It's
the
insurance
coverage
for
mental
health
and
addiction
treatment
should
be
no
more
restrictive
than
coverage
for
other
medical
care.
That's
it
very
simple
and
it
doesn't
mean
that
treatment
has
to
be
the
same.
No,
no!
No!
It's
just
the
insurance
practices
for
mental
health
and
addiction
cannot
be
more
restrictive
than
what
they
are
for.
Other
medical
care,
all
right.
F
So,
given
that,
why
are
there
statement?
That's
a
simple
concept,
so
why
are
there
state
and
federal
laws
about
parity
well?
Historically,
insurance
coverage
for
mental
health
indication
was
much
more
restrictive
than
coverage
for
other
medical
care
and
what
this
looked
like
is
very
common
to
see
more
expensive,
co-pays
and
co-insurance
for
mental
health
and
addiction
care,
separate
deductibles
for
mental
health
care
for
medical
care
than
a
separate
deductible
for
medical
mental
health
care.
F
Then
a
separate
deductible
for
for
substance
use
disorder
care
and
those
deductibles
for
mental
health
and
addiction
would
be
much
higher
and
harder
to
reach
than
they
were
for
medical
hard
limits
on
inpatient
stays
20
visits
per
year,
then
you're
on
20
days,
beer,
then
you're
on
your
own
30
visits
per
year
for
outpatient
care.
Then
that's
it!
That's
all
you
get
so
then,
in
the
in
the
late
90s
and
early
2000s
states
started
passing
what,
as
you
see,
the
the
the
quotes
there
state
parity
laws.
F
However,
many
of
these
laws
were
well
below
the
standard
of
actual
parity,
as
in
they
still
made
it
explicitly
legal
to
have
more
restrictive
mental
health
and
addiction
coverage.
In
fact,
some
of
these
state
laws
actually
codified
more
restrictive
insurance
coverage
for
mental
health
and
addiction,
but
what
these
laws
generally
would
do
is
they'd
establish
a
minimum
number
of
inpatient
days
and
outpatient
visits,
so
you
get
at
least
you
know
45
days,
an
inpatient
facility
at
least
60
visits
outpatient.
You
know
whatever
they
vary
greatly
by
state.
They
establish
annual
and
lifetime
dollar
minimum.
F
So
you
got
to
provide
at
least
you
know,
five
thousand
dollars
worth
of
care
coverage
for
each
year
or
they
would
establish
a
list
of
serious
mental
illnesses
that
must
be
covered
and
then
other
other
conditions
were
considered
optional.
So
that
was
the
landscape
for
a
good
20
plus
years
or
so
states.
You
know
passing
a
patchwork
of
laws
and
of
course,
states
can't
do
anything
about
those
large
employer-sponsored
plans
that
that
that
aren't
regulated
by
the
by
by
state
regulators.
F
So
so
so
states
could
do
a
little
bit
and
they
and
they
have
been,
but
it
was
a
patchwork.
So
then,
in
2008
president
bush
signed
the
mental
health
periodic
negligence
into
law.
That's
what
we
call
the
federal
parity
law.
This
was
october.
2008
sponsored
by
patrick
kennedy
democrat,
so
you
got
a
dynastic
republican
family,
signing
the
law,
dynastic
democratic
family,
sponsoring
the
law
very
bipartisan.
It's
been
bipartisan
throughout.
So
what
the
federal
law
is?
F
It
supersedes
north
of
those
state
mental
health
addiction
coverage
laws,
for
example,
many
state
laws,
not
nevada,
still
have
from
some
provisions
on
the
books
that
are
that
codify.
Some
of
that.
You
know
more
restrictive
care.
Those
no
longer
have
effect
because
of
the
federal
law,
so
the
federal
parity
law
is
basically
it
sets
the
floor.
F
Okay,
but
there's
problems
still
on
the
concept
is
simple,
but
the
federal
parity
law
is
very
complex
and
I
warn
you
do
not
actually
read.
What's
written
there,
that
block
of
words,
it's
got
the
terms,
processes,
strategies,
evidentiary
standards
or
factors,
and
then
it
gets
repeated
again
later
in
in
the
same
block.
Don't
don't
read
it?
It's
it's
incredibly
complex
and
part
of
that
is
because
healthcare
is
very
complex,
and
that's
that's
because
of
this
unfortunate
reality
of
how
complex
the
law
is.
F
There's
been
problems
with
compliance
and
most
of
those
relate
to
the
insurers,
managed
care
practices
how
they
manage
the
benefits
prior
authorization.
Other
utilization
review,
like
concurrent
review
retrospective
view
step
therapy
how
they
design
their
formularies
provider,
network
design,
reimbursement
rate
setting.
You
know
the
the
law
doesn't
require.
The
reimbursement
rates
have
to
be
the
same,
but
how
you
go
about
setting
those
reimbursement
rates
has
to
be
comparable
and
no
more
stringent.
So
anyway,
that
block
of
words
above
sets
the
rules
for
insurers
manage
care
practices.
F
So
this
is
their
because
of
how
complex
is
there?
There
have
been
some
problems.
Well,
how
do
we
know?
There
are
problems
well
back
in
2017,
thanks
to
grant
funding
from
the
federal
government
or
the
trump
administration.
A
number
of
state
insurance
departments
began
looking
into
ensuring
compliance
with
the
federal
party
law,
so
2017
18
about
20
states
got
this
federal,
grant
money
and
started
digging
into
it,
and
basically
every
examination
found
that
insurers
were
not
compliant
with
the
law
as
it
related
to
those
managed
care
practices.
We
just
talked
about.
F
I
mean
and
there's
a
there's,
a
saying
among
state
insurance
regulators
that
have
looked
into
this.
If
you
look,
you
will
find
problems
and
it's
not
because
of
malfeasance.
It's
not
because
it's
just
you
know
the
insurance
industry
they've
struggled
with
the
complexity
and
they
they
might
not
have
taken
it
quite
as
seriously
as
they
need
it
to
until
recent
years.
When
there's
been
a
great
deal
of
action
and
also
federal
regulators,
when
they
were
looking
at
the
united
states
department
of
labor,
when
they
were
looking,
they
were
finding
problems
too.
F
Okay,
so
then,
beginning
in
2018
states
started
to
take
action,
passing
legislation
that
require
greater
transparency
and
accountability
from
insurers
in
terms
of
compliance,
so
they
make
requiring
insurers
to
do
these
compliance
analyses
and
submit
them
to
state
regulators,
and
you
see
here
we're
up
to
20
17
states
with
nevada
joining
the
party
last
year.
F
F
Congress
took
action
too,
so,
in
december,
of
2020
congress
amended
the
federal
parity
law
by
adding
language
that
was
identical,
that
was
in
all
those
state
laws
and
so
that
what
this
ended
up
doing
is
it
cleared
the
deck
so
for
all
50
states.
Now
in
every
state,
every
insurer
and
every
group
health
plan
in
america,
including
those
that
states
can't
regulate,
they
have
to
do
these
analyses
and
they
must
make
them
available
to
federal
and
state
regulators.
F
F
That's
because
you
need
the
legislate
legislation
to
formalize
this
process
to
make
sure
that
these
analyses
are
actually
submitted
and
looked
at
by
by
state
regulators.
Okay.
So
a
good
question
is
how
do
we
go
from
five
years
ago
today,
zero
states
and
the
federal
government
required
transparency
to
this
extent.
Now
everyone
every
every
insurer
in
america
and
every
group
helpline
has
to
be
transparent
in
this
uniform
fashion.
F
Well,
as
you
as
you
know,
many
people
are
dying
every
day
from
overdoses
and
suicides
and
that
that
statistic
there,
nearly
400
americans
each
say
that's
wrong.
Cdc
just
issued,
updated
overdose
data
and
that's
now
up
to
410
americans
die
every
day
from
an
overdose
of
suicide.
When
I
first
started
saying
that
in
2016
it
was
245,
americans
die
every
day,
so
we've
gotten
worse
by
about
155
people
in
the
last
you
know
six
years.
F
So
a
terrible
crisis
six
years
ago
has
gotten
that
much
worse,
so
things
things
are
really
bad
and
of
course,
a
lot
of
it
has
to
do
with
the
fentanyl.
Okay.
Another
reason
why
laws
pass
so
fast
is
usually
when
you
have
health,
insurance
and
you're
really
sick
insurance
covers
the
treatment
you
need
to
survive
and
get
better.
That's
a
pretty
common
commit
you're
sick
and
you
might
die
like
you
have.
You
know,
opioid
use
disorder,
and
you
know
you
you
overdose,
and
then
you
get
naloxone
you're
revived.
F
You
go
to
inpatient
treatment,
your
doc,
the
physician
or
the
provider
say
you
need
to
be
there
for
another
another,
three,
four
or
five
six
days
the
insurer
says.
No,
you
don't
we're
not
that
we're
going
to
contradict
the
the
recommendations
of
the
of
the
the
medical,
the
healthcare
professionals
and
say
you
don't
need
it.
That's
commonplace
and
behavioral
healthcare
so
for
other
medical
conditions
when
you're,
sick
and
you're
going
to
die.
F
Potentially,
insurance
covers
the
treatment
you
need
to
get
better
and
not
die
when
it
comes
to
mental
health
and
addiction
that
that
often
does
not
seem
to
be
the
case
and
also
another
reason.
These
laws
pass
the
fest
the
federal
law
is
fundamentally
comparative.
How
could
an
insurer
know
that
it
complies
with
this
law
unless
it
was
doing
comparative
analyses?
F
You
can't
there's
no
way.
You
could
know
whether
you
comply
with
this
law
without
doing
comparative
analyses
and
state
legislators
in
congress
found
this
argument
very
persuasive
and
that's
why
it
happened.
Okay,
so
all
this
action's
happened.
There's
a
lot
of
stuff
has
happened
at
the
state
level
over
the
last
four
years.
A
lot
of
stuff
happened
in
congress.
F
So
just
keep
that
in
mind
when
we
think
about
those
reports
that
are
going
to
come
in
here
in
nevada
when
they
gave
them
to
the
federal
government.
All
of
them
were
not
good
enough
initially
and
then,
when
they
asked
for
more
information
and
got
information,
they
found
all
kinds
of
violations.
It
was
a
really
bad
report.
In
fact,
that's
something
that
you
have
my
contact
information
at
the
end.
If
you
email
me,
I
can
send
you
the
report.
It's
it's.
It's
worth
a
read
anyway.
F
What
it
shows
is,
there's
still
a
lot
of
work
to
do
you
know,
that's
you
know
we,
you
know
the
reason.
A
lot
of
these
laws
passed
is
because
we
had
a
feeling
that
there
wasn't
full
compliance.
The
law,
and
now
it's
been
confirmed
that
that's
true.
We
do
have
problems
so
there's
there's
work
to
be
done
and
a
lot
of
that
has
to
happen.
You
know
both
the
legislative
level,
but
also
the
regulatory
level.
F
So
what
are
states
doing
now?
Well,
obviously,
some
states
are
pursuing
legislation
similar
to
ab181,
but
big
deal,
big
takeaway.
Here's
something,
I
think,
is
the
most
important
about
what
what
are
states
doing.
What
is
I
know,
this
falls
outside
of
the
legislative
arena,
but
32
states
have
joined
the
parity
working
group
for
the
national
association
of
insurance
commissioners
since
2020,
and
actually
it's
33
states.
I
just
checked
for
a
few
minutes
ago.
F
It's
actually
33
and
another
one
just
joined,
so
this
is
state
insurance
regulators
and
they
meet
regularly
and
they
share
best
practices
about
what's
what
they're
doing
on
parity,
so
some
really
good
states
that
have
been
doing
stuff
in
parity,
like
illinois,
has
been
doing
a
good
job.
Texas
has
been
doing
a
good
job.
Pennsylvania
is
doing
a
good
job,
oklahoma's,
getting
getting
really
good
these
guys.
They
have
a
lot
of
good
things
to
to
to
tell
their
their
regulator.
Colleagues
and
the
national
association
insurance
commissioners.
F
They
meet
all
the
time
they
meet
three
times
a
year
in
person.
I
always
go
there,
and
so
it's
a
great
opportunity
to
be
part
of
this
parity
working
group.
Now,
unfortunately-
and
I
don't
mean
this
as
a
dig
I'd
say
it's
an
opportunity
here-
the
nevada
division
of
insurance
does
not
yet
join
so
I
think
that'd
be
fabulous
if
the
division
of
insurance
joined
that
working
group,
I
think
they'd
learn
a
lot.
These
regulators
that
are
part
of
that
group.
F
They
really
want
to
share
what
they
know
with
their
colleagues,
and
so
I
think,
they'd
be
a
great
great
thing
for
the
the
division
to
join
that
group
and
some
other
the
legislative
angle.
Some
are
providing
funding
for
insurance
departments
to
designate
a
full-time
parity
specialist.
F
So
in
arizona
they
have
a
doctor,
lynette
hennigan,
who
has
been
hired
and
has
been
on
the
job
now
for
a
year
and
a
half
when
they
passed
their
parity
legislation
in
2020,
they
funded
a
full-time
person
for
for
a
number
of
years
to
be
on
top
of
parity
and
really
for
a
department
to
do
what
it
needs
to
do
in
terms
of
parity,
compliance
and
implementation.
You
probably
do
need
to
have
that
full-time
person.
F
Otherwise
it's
so
complicated
that
if
you
have
other
things
you
need
to
do,
you
got
to
worry
about
auto
insurance,
flood
casualty,
homeowners,
you're,
probably
not
going
to
get
on
top
of
this
complicated
law.
That's
why
it's
a
smart
thing
to
do
to
fund
a
full-time
person
and
also
right
now,
there's
congressional
legislation
that
would
actually
send
grant
funding
to
states
to
add
staff
to
to
do
do
some
of
this
work,
I'm
not
sure
how
the
status
that
will
be,
but
there's
something
that's
out
there.
F
Okay,
what
else
are
states
doing
on
mental
health
coverage?
Well,
a
few
states
passed
legislation
in
2021
that
requires
insurers
to
rely
on
non-profit,
especially
society
criteria
when
determined
if
mental
health
or
addiction
care
is
medically
necessary.
So,
for
example,
in
certain
in
these
three
states
you
see
them
listed
below
california,
illinois
and
oregon.
If
you're
making
substance
use,
disorder,
medical
necessity,
determinations
level
of
care
placement,
you
have
to
follow
the
criteria
of
the
american
society
of
addiction
medicine.
F
You
can't
use
your
own
in-house
criteria
that
you've
really
designed
just
to
you
know
maximize
to
suppress
costs,
and
the
reason
this
is
happening
is
because
a
major
court
case,
the
whit
v
united
behavioral
health,
found
that
a
major
insurer
was
making
decisions
about
mental
health
and
substance
disorder
care
on
in-house
criteria.
That
was
specifically
designed
to
suppress
costs.
F
For
instance,
when
the
when
the
the
medical
team,
the
behavior
health
medical
team,
wanted
to
go
to
the
american
society
of
addiction,
medicine
criteria,
they
wanted
to
adopt
that
they
were
overruled
by
the
corporate
office
because
of
the
presumed
cost
that
might
be
so
following
the
best
that
medicine
and
science
has
to
offer.
That
was
not
what
united
behavior
health
wanted
to
do.
They
wanted
to
keep
costs
down
at
a
certain
level,
and
that
leads
to
poorer
care
and
more
people
dying.
F
So
this
is
this
is
something
the
few
states
have
done
like
I
mentioned
california,
illinois
and
oregon,
and
also
georgia
is
pursuing
a
lighter
version
of
that
this
year.
So
it's
something
that
you
know
it's
a
pretty
comprehensive
piece
of
legislation,
and
it
is
it's
model
legislation
that
exists
out
there,
that's
created
by
an
organization.
It
was
the
kennedy
forum.
Kennedy
forum
is
run
by
former
congressman
patrick
kennedy,
who
was
the
sponsor
of
the
mental
health
parity
and
dictionary
act,
the
current
federal
parity
law,
okay.
F
So,
just
a
real
brief,
I'm
going
to
wrap
up
here
with
just
just
a
little
bit
on
telehealth
and
insurance
coverage.
This
is
not
about
the
delivery.
This
is
about
insurance
coverage.
This.
This
is
a
separate
issue,
but
it's
somewhat
related
because
a
lot
of
telehealth
happens
in
the
behavioral
health
realm.
So
so
anyway,
then
telehealth
covered
insurance
coverage
legislation.
This
is
not
a
new
thing.
Something's
been
going
on
for
many
many
years
and
before
the
pandemic,
the
main
issues
pursued
were
one.
F
You
insurance
cover,
telehealth
two,
the
reimbursement
would
be
the
same
rate
as
in
person
and
then
three
efforts
to
cover,
what's
called
asynchronous
telehealth.
What
that
means
is
the
patient?
Isn't
there
when
the
telehealth
occurs.
So
what
how's
that
possible?
What
that
could
look
like
is
a
patient
comes
into
a
a
primary
care.
Physician's
office.
The
primary
care
physician
asks
them.
Maybe
a
depression.
Screening
writes
down
his
answers
or
records.
It
records
the
encounter
and
asks
some
questions
about
potential
depression.
F
Anxiety
then
stores
it
and
then
sends
it
to
a
psychiatrist
who
looks
at
it
say
you
know
five
hours
later
and
then
renders
you
know
their
determination.
What
you
know
diagnosis
the
patient
might
have
so
anyway,
that's
what
was
going
on
before
the
pandemic
and
if
you
want
to
know
more
about
telehealth,
here's
a
great
resource
the
center
for
connected
health
policy.
F
You
see
that
link
there
if
it's
in
the
it's
in
the
slides
but
just
search
center
for
connected
health
policy,
you'll
see
what
what's
happening
all
over
the
country
when
it
comes
to
telehealth
and
not
just
coverage,
but
also
all
kinds
of
other
things
related
to
tele.
That's
that's
the
best
resource
in
america
on
telehealth.
So
I,
if
you
want
to
know
a
lot
about
telehealth,
go,
go
start
there.
Cchpca.Org.
F
F
legislative
efforts
to
expand
health
health
focused
on
the
previous
goals
that
we
just
talked
about,
but
also
coverage
of
audio
only
telehealth
under
certain
circumstances.
It's
always
you
really.
You
want
to
see
that
that
patient,
but
sometimes
it's
not
possible
because
of
broadband,
or
it
might
not
be
medically
advisable
due
to
maybe
symptoms
of
psychosis
or
something
like
that.
Maybe
the
person
will
not
get
on
camera
prohibiting
insurers
from
acquiring
that
only
a
certain
technology
platform
or
vendor
be
used.
F
That
can
be
very,
very
disruptive
to
care,
because
if
you
have
six
seven
eight
insurers
and
they
all
have
a
different
platform-
they
all
have
a
different
vendor.
That's
gonna
be
a
lot
of
money
for
providers
to
get
all
of
those
things
up
and
running,
so
that
that's
something
that
you
know
trying
to
prohibit
that
prohibiting
utilization
review.
That's
in
place
for
telos,
but
they
don't
do
it
for
in
person,
so
you
have
to
do
prior
authorization
for
telehealth
visit,
but
you
don't
have
to
do
prior
authorization
for
that
same
visit.
F
If
you
were
in
person
and
then
allowing
for
a
little
more
flexibility
where
the
patient
provider
can
be
located
during
the
telehealth
site,
which
is
known
as
the
originating
site
and
the
distance
site,
and
very
last
slide
here
of
content.
I'll
give
my
contact
information
on
the
next
slide.
F
We
at
the
american
psychiatrist,
we
actually
created
model
legislation
on
coverage,
insurance
coverage
of
telehealth,
that's
something
I
worked
with
our
telehealth
committee
and
put
together
the
model
legislation
and
addresses
the
issues
described
previously,
a
few
other
bells
and
whistles.
You
can
go
to
that
link
if
you
want
to.
If
you
want
to
look
more
or
search
into
google
american
psychiatric
association
model,
telehealth
legislation
now
two
good
case
studies
in
enacting
this
legislation
are
georgia
and
oklahoma.
F
So
in
2021,
georgia
passed
hb
307,
which
has
most
of
what's
in
that
model
legislation
and
so
did
oklahoma
with
sp
674.
So
it
shows
that
that
that
model
legislation
definitely
has
some
opportunities
to
to
pass
and
go
somewhere.
Okay.
So
with
that,
I
am
going
to
post
my
contact
information,
tim
clement,
director
of
legislative
development,
t
clement
psych.org.
F
If
you
have
any
questions
that
you
want
to
go
into
great
detail
about
anything,
but
what
I
went
over,
whether
it's
mental
health,
parity
or
telehealth,
please
send
me
an
email
and
with
that
I'm
going
to
stop
sharing
my
screen.
B
Thank
you
so
much
that
was
informative
and
helpful
nice
to
see
that
there's
some
bipartisan
effort
across
the
country
in
this
area,
looking
forward
to
seeing
what
we've
come
up
with
in
nevada
to
do
this.
Are
there
any
questions
from
the
committee.
B
I
have
questions
that
came
up,
but
mine
are
more
directed
for
our
department
or
a
division
of
insurance
rather
than
for
you,
but
we
really
appreciate
your
time
today
and
I
will
have
some
folks
follow
up
with
you.
I'd
like
to
get
my
hands
on
that
report.
You
were
talking
about
so
I'll.
Have
staff
email
you
for
that
if
they
can't
find
it
online.
B
Thank
you
cool,
so
we're
going
to
move
on
to
our
next
agenda
item
agenda
item
13.:
this
is
the
overview
of,
and
policy
considerations
related
to
assembly
bill
181
just
referenced
in
this
lab.
In
that
last
presentation.
This
bill
requires
certain
health
insurance,
insurers
to
demonstrate
mental
health,
parity
payment,
parity
and
addiction
equity
compliance.
B
We
have
nick
stosic
the
w
commissioner,
with
the
division
of
insurance
on
today,
to
tell
us
a
little
bit
about
this
this
bill
and
how
things
are
going.
G
G
Good
well,
chair,
peters
and
members
of
the
committee,
I
appreciate
the
opportunity
to
be
here,
as
you
indicated,
I'm
nick
stosic,
I'm
a
deputy
commissioner
with
the
division
of
insurance.
You'll,
also
see
the
name
of
jeremy
gladstone
who's
effectively
our
subject
matter,
expert
on
network
adequacy
and
mental
health
parity
and
unfortunately,
he
had
to
leave
the
office
at
2
30.
So
I
will
do
the
best.
I
can
to
answer
questions,
but
if
there
are
any,
I
can't
I
will
be
sure
and
get
back
to
you
as
quickly
as
we
can
also.
G
I
appreciate
mr
clement's
presentation
and
being
the
last
presentation
today
you'll
be
glad
to
know
I'll,
be
able
to
cut
out
some
of
my
slides
because
he
covered
some
of
the
subjects
that
I
would
have
been
covering
and
also
just
just
give
you
an
update
since
he
mentioned
us
in
his
presentation.
G
Although
we're
not
a
member
of
the
mental
health
parity
working
group
at
the
nevada.
Excuse
me,
national
association
of
insurance
commissioners.
Our
staff
does
participate
as
a
part
of
every
one
of
those
committee
meetings.
So
it's
something
that
we're
up
on
the
subject:
we're
just
not
an
official
member
of
that
committee.
G
At
this
point,
so
I
was
asked
today
to
present
on
ab-181
and
as
mr
clements
mentioned,
it's
it's
was
passed
in
2021
and
part
of
the
language
of
that
bill
is
directly
related
to
the
federal
paul,
wellstone
and
pete
domenici,
mental
health
parody
and
addiction,
equity
act
of
2008,
which
is
also
known
as
mapia
and
again
mr
clement
gave
you
a
pretty
good
overview
on
what
that
particular
bill
covered.
G
To
require
the
commissioner
of
insurance
to
perform
a
data
request
on
or
before
july,
1st
of
each
year
from
insurers
or
organizations
providing
health
care
to
solicit
information
necessary
to
evaluate
their
compliance
with
the
mental
health
parity
act.
The
information
needs
to
be
provided
to
the
division
by
october
1st
of
each
year
and
then
by
the
end
of
the
year.
G
The
commissioner
is
required
to
summarize
and
provide
a
report
to
the
patient
protection
commission,
the
governor
and
the
director
of
the
lcb
by
december
31st
of
each
year,
ab-181
was
effective
on
january
1st
of
2022,
so
our
first
data
call
will
occur
prior
to
this
july
and
our
report
compiling
the
information
will
be
submitted
by
the
end
of
this
year.
G
So
ab-181
allows
for
insurers
or
other
organizations
to
file
a
copy
of
that
federal
report
in
lieu
of
the
data
that
the
commissioner
is
asking
for.
However,
the
bill
does
allow
the
commissioner
to
request
supplemental
information
beyond
this
report
to
determine
whether
the
insurer
or
other
organization
is
in
compliance
with
federal
law,
and
I
assume
this
first
year
will
kind
of
be
interesting
for
us
to
see
what
type
of
information
is
provided
and
based
on
that.
G
So
that's
what
they
currently
are
required
to
do
when
we
go
forward
and
get
to
see
the
comparative
analysis
they'll
also
be
giving
additional
information
on
things
like
prior
authorization
requirements,
concurrent
reviews
for
in-network
and
out-of-network
inpatient
and
outpatient
services,
standards
for
provider
admissions
to
participate
in
networks,
including
reimbursement
rates,
formulary
designs
for
prescription
drugs
and
step
therapy
protocols.
So
we
will
obviously
be
getting
a
lot
more
information
this
year
than
we've
been
receiving
in
the
past.
G
Okay,
so
one
thing
I
wanted
to
share
with
you,
chair,
peters
and
the
rest
of
committee
members
is
the
division
of
insurance
was
recently
awarded
federal
funds
under
the
cycle
ii.
State
flexibility
grant
and
we'll
be
using
those
funds
to
contract
at
the
research
and
development
of
procedures
and
tools
that
can
be
used
by
our
division
staff
to
conduct
mapia
compliance
reviews
and
ensure
a
consistent
and
thorough
review
is
done
on
all
health
insurance
products.
G
It
will
be
going
out
to
to
bid
this
year,
so
I'm
assuming
that
it'll
be
later
in
this
year,
we'll
finally
be
starting
to
access
those
grant
funds
and
begin
this
review
and
then,
lastly,
I
did
want
to
review
two
nevada
statutes,
which
really
still
would
not
be
in
compliance
with
current
federal
mapia
law.
Mr
clement
had
addressed
this
issue
that
sometimes
there's
some
obsolete
limits
that
are
put
in
in
nevada.
Actually,
in
nrs689a,
046
and
687c167.
G
We
currently
have
limits
that,
for
example,
have
a
fifteen
hundred
dollar
per
calendar
a
year
for
the
treatment
of
withdrawal
from
drugs
and
alcohol,
nine
thousand
dollars
for
inpatient
treatment
and
twenty
five
hundred
dollars
for
outpatient,
counseling,
so
again
separate
from
federal
law.
These
are
the
requirements
that
technically
a
carrier
would
be
able
to
to
follow
and
be
in
compliance
with
state
law.
G
The
drug
and
alcohol
treatment
limits
were
added
to
nevada
statutes
during
the
1985
session.
So
it's
been
quite
a
while,
and
this
is
an
area
that
the
commit
committee
may
want
to
consider,
removing
these
limits
from
those
two
statutes
and
pointing
to
federal
law
to
ensure
that
carriers
are
in
compliance
with
mapia
making.
G
B
Thank
you
so
much
really
really
grateful
for
the
update.
I
am
what's
really
interesting,
invested
in
this
piece
of
legislation
last
session,
so
it's
nice
to
know
it's
being
applied
and
I'm
looking
forward
to
our
first
and
comparative
analysis
or
assessment.
That's
awesome!
B
B
Not
seeing
any
coming
up
right
away,
I'm
going
to
go
ahead
and
ask
mine
the
first
one
has
to
do
with,
and
you
kind
of
address
part
of
it
becoming
a
part
of
that
national
association
of
insurance.
Commissioners
parity
working
group
he
said,
participate
but
are
not
as
a
member.
What
does
it
take
to
become
a
member,
and
is
there
something
we
can
do
to
support
that.
G
Well,
chair,
peters,
really
to
become
a
member,
is
just
probably
a
matter
of
requesting
to
do
that.
There
are
about
200
different
naic
committees,
and
so
we
are
members
of
I
think
about
50
committees
right
now,
so
we
kind
of
spread
our
membership
around,
but
the
very
important
committees
we
are
not
members
of.
We
still
attend
every
meeting,
so
we're
still
involved
in
the
discussions.
G
If
you
would
like,
we
would
be
happy
to
go
forward
and
get
formal
membership,
but
but
I
can't
assure
you
that
we
are
attending
all
the
meetings
as
well
and
we're
notified
anytime.
A
meeting
is
being
held.
B
Of
course,
I
would
like
for
you
to
just
do
what's
best
for
nevada,
that
is
making
sure
that
you're
in
the
right
room
at
the
right
time,
then
that
is
what
that
is,
but
if
there
are
benefits
to
being
on
that
working
group
such
as
sharing
of
information
and
other
parts
and
pieces
of
making
sure
we're
doing
a
comparative
analysis,
that
is
whole.
That
would
be
great,
but
keep
us
posted
if
there's
anything
to
do.
B
G
B
Right,
I
think
that
leads
into
one
of
my
my
next
question,
which
is
related
to
the
potential
position
funding
that
mr
clement
mentioned.
There's
a
grant
fund
that
some
folks
are
using
specifically
for
this
comparative
analysis
and
data
collection
position,
and
I
was
wondering
if
you
guys
have
applied
for
that
grant
or
and
if
not,
if
there's
a
reason.
G
So
yeah
that
was
a
part
of
what
I
was
talking
about
when
I
had
mentioned
that
we
had
been
given
cycle
two
state
flexibility
grants
and
so
that,
as
a
part
of
that
grant,
we
are
going
to
be
hiring
contracting
out
to
have
the
the
process
on
researching
development
procedures
and
tools
from
appeared
being
done,
so
we
have
been
awarded
that
grant
and
again
the
the
funds
are
going
to
be
specific
to
this
particular
subject.
B
And
so
you're
you're
contracting
out
that
service
to
do
the
initial
determination
of
what
your
process
is
going
to
look
like
and
when
you
imagine
you'll
come
back
to
us
with.
Maybe
we
need
more
staff,
maybe
we
need
more
authority.
Do
you
think
you'll
come
back
to
us
with
some
of
those
recommendations.
G
Yeah,
I
would
have
to
say,
chair
peters.
I
really
expect
that
once
we
see
what
we
find
from
this
particular
grant
and
once
we
go
through
the
first
year
of
receiving
these
comparative
analysis
and
seeing
how
involved
the
amount
of
work
is
we're
going
to
have
a
much
better
understanding
if
it's
something
that
current
staff
can
handle
or
if
we
really
would
need
an
additional
position
in
order
to
do
an
adequate
job,
because
I'm
just
not
sure
I'm
not
envisioning,
it's
something.
That
would
be
a
year-round
full-time
position.
G
So
that's
why
you
know
it's
going
to
come
in
at
one
part
of
the
year,
be
analyzed
over
about
a
three
month
period,
and
so
that's
one
of
those
things
that
I
I
think
we
will
have
more
information
down
the
road
on
what
we're
going
to
need
in
terms
of
staffing.
B
Right
keep
us
posted
on
that
piece.
I
have
one
last
piece
and
hopefully
it's
a
quick
response.
I
don't
intend
this
to
be
a
large
base.
B
Conversation
on,
but
one
of
the
points
mentioned
by
mr
clements
was
that
the
the
bill
from
the
federal
bill
from
february
2021
authorized
states
to
request
information
from
all
hater
types,
including
the
self-funded
plans,
and
I'm
curious,
if
you
guys
believe
you
have
the
authority
to
ask
for
that
information,
despite
the
fact
that
we
can't
regulate
it
or
if
that
is
something
that
we
would
have
to
consider
for
legislation.
G
That's
one
of
those
questions
chair
that
I
would
have
to
look
into
generally,
since
we
have
no
regulatory
authority
over
providers.
I
would
say
typically
that's
not
something
we
would
be
able
to
do
and
again,
if
it's
granted
under
federal
law.
That
also
doesn't
necessarily
give
the
states
that
regulatory
authority,
but
that's
an
issue
we're
more
than
happy
to
research
and
find
out
more
what's
contained.
B
I
would
appreciate
that
and
and
some
follow-up
on
it,
not
that
we
want
to
regulate
them,
but
it's
important
that
we
can,
when
we
do
a
comparative
analysis
on
things
like
this,
that
we
are
comparing
across
the
board,
in
my
mind,
having
parity
and
consistency
of
care,
or
that
continuity
of
care
is
really
important,
whether
you're
bouncing
between
medicaid
and
pebb,
or
a
silver
state
plan
or
and
a
private
plan,
so
especially
for
mental
health
care
and
behavioral
health
care.
B
Wanting
to
make
sure
that
our
comparative
analysis
is
consistent
across
the
board
would
be
really
great.
So
let
me
know
what
you
find
on
that
absolutely
right.
Any
other
questions
from
the
committee
before
we
move
on
to
our
last
item
on
the
agenda
see
none.
Thank
you
so
much,
mr
stosic.
We
appreciate
your
time
here
today
and
your
efforts
on
this
bill
implementation.
Look
forward
to
your
report
in
december.
B
All
right,
so
we
had
agenda
item
14
up
next,
but
we
went
over
that
earlier
today
when
we
had
dr
kearns
with
us.
So
our
last
item
on
the
agenda
is
public
comment.
We're
going
to
take
a
short
break
to
allow
people
to
call
in
under
public
comment
again.
The
information
for
calling
in
is
on
the
agenda.
Today.
B
Mobile
is
going
to
take
like
a
two
minute
break
here:
real
quick.
While
we
get
people
on
the
line,
you
know
there's
a
little
bit
of
a
delay
and
then
we
will
hop
back
on
here
in
two
minutes
at
approximately
three
o'clock.
B
All
right,
it's
three
o'clock,
if
we
can
have
members,
turn
their
cameras
back
on
and
eps.
I'm
going
to
a
little
statement
then
ask
you
to
pull
up
the
first
person
on
the
line.
Public
comment,
please
remember
to
call
on
for
public
comments
to
clearly
state
and
spell
your
name
and
limit
your
comment
to
two
minutes.
Today,
staff
will
be
talking
to
each
speaker
during
public
comment
to
ensure
everyone
is
given
a
fair
opportunity
to
see
staff
in
our
broadcast
production
services.
C
B
Well,
that's
great,
thank
you,
so
I
much
want
to
mention
that
our
next
meeting
will
be
held
on
march
24th
at
9
00
a.m.
Thank
you
all
for
your
flexibility
on
that
I've
had
some
travel
schedule,
movement
for
march
23rd,
so
I'm
glad
we
were
able
to
move
that
to
a
time
when
we
cannot
be
there
and
I'm
going
to
go
ahead
and
adjourn
our
meeting
unless
there
are
some
other
comments
from
the
members.
E
B
Thank
you
for
that
feedback.
I
really
want
to
thank
staff
staff
worked
really
hard
with
with
our
department
of
health
and
services
to
come
up
with
some
great
solutions
and
options
and
folks
to
come
and
present
today.
So
I
think
we're
on
the
right
heading
the
right
direction
on
issues
related
to
this
behavioral
and
mental
health
care
area
in
nevada.
So
thank
you
for
that
feedback
and
thank
you
so
much
staff
for
all
of
your
efforts
as
well.
All
right
with
that,
we
will
adjourn
have
a
good
afternoon.
Y'all.