MINUTES OF THE MEETING OF THE ASSEMBLY COMMITTEE ON HEALTH AND HUMAN SERVICES Seventy-Ninth Session February 27, 2017 The Committee on Health and Human Services was called to order by Chairman Michael C. Sprinkle at 1:06 p.m. on Monday, February 27, 2017, in Room 3138 of the Legislative Building, 401 South Carson Street, Carson City, Nevada. The meeting was videoconferenced to Room 4401 of the Grant Sawyer State Office Building, 555 East Washington Avenue, Las Vegas, Nevada. Copies of the minutes, including the Agenda (Exhibit A), the Attendance Roster (Exhibit B), and other substantive exhibits, are available and on file in the Research Library of the Legislative Counsel Bureau and on the Nevada Legislature's website at www.leg.state.nv.us/App/NELIS/REL/79th2017. COMMITTEE MEMBERS PRESENT: Assemblyman Michael C. Sprinkle, Chairman Assemblywoman Amber Joiner, Vice Chair Assemblywoman Teresa Benitez-Thompson Assemblyman Richard Carrillo Assemblyman Chris Edwards Assemblyman John Hambrick Assemblyman William McCurdy II Assemblywoman Brittney Miller Assemblyman James Oscarson Assemblyman Tyrone Thompson Assemblywoman Robin L. Titus Assemblyman Steve Yeager COMMITTEE MEMBERS ABSENT: None GUEST LEGISLATORS PRESENT: Assemblywoman Ellen Spiegel, Assembly District No. 20 STAFF MEMBERS PRESENT: Marsheilah Lyons, Committee Policy Analyst Mike Morton, Committee Counsel Kailey Taylor, Committee Secretary Trinity Thom, Committee Assistant Minutes ID: 340 *CM340* Assembly Committee on Health and Human Services February 27, 2017 Page 2 OTHERS PRESENT: Shelley D. Blotter, Deputy Administrator, Division of Human Resource Management, Department of Administration Ryan Beaman, President, Clark County Firefighters, Union Local 1908 Suzie Owens, Lead Lactation Consultant, Dignity Health-St. Rose Dominican Hospitals Meghan Trahan, Private Citizen, Las Vegas, Nevada Autumn Wake, President, Southern Nevada Breastfeeding Coalition Rosemarie Casillas, Vice President, Southern Nevada Breastfeeding Coalition Tray Abney, Director of Government Relations, The Chamber, Reno-Sparks- Northern Nevada Paul Moradkhan, representing Las Vegas Metro Chamber of Commerce Jared Moser, Private Citizen, Reno, Nevada Marlene Lockard, representing Nevada Women's Lobby, Human Services Network, and Service Employees International Union Nevada 1107 Bryan Wachter, representing Retail Association of Nevada Lauren Klein, Private Citizen, Reno, Nevada Alexis Motarex, Government Affairs Coordinator, Associated General Contractors of America, Nevada Chapter Natha Anderson, President, Washoe Education Association and Nevada State Education Association Chris Daly, Deputy Executive Director of Government Relations, Nevada State Education Association Alanna Bondy, Intern, American Civil Liberties Union of Nevada Jared Busker, Policy Analyst, Children's Advocacy Alliance Randi Thompson, representing National Federation of Independent Business Craig M. Stevens, Director of Intergovernmental Relations, Government Affairs, Clark County School District Ed Gonzalez, Lobbyist and Policy Analyst, Clark County Education Association Lindsey Dermid-Gray, Statewide Breastfeeding Coordinator, Division of Public and Behavioral Health, Department of Health and Human Services Michael Hackett, representing the Nevada Public Health Association Mary Pierczynski, representing Nevada Association of School Superintendents and Nevada Association of School Administrators Dena Schmidt, Deputy Director, Director's Office, Department of Health and Human Services Janise Wiggins, Governor's Consumer Health Advocate, Office of Minority Health and Office for Consumer Health Assistance, Department of Health and Human Services Brenda Hernandez, Member, the Nevada Minority Health and Equity Coalition Will Rucker, Member, the Nevada Minority Health and Equity Coalition Delia Oliveri, Member, the Nevada Minority Health and Equity Coalition Erik Jimenez, representing Southern Nevada Health District Assembly Committee on Health and Human Services February 27, 2017 Page 3 Tom McCoy, Nevada Government Relations Director, American Cancer Society Cancer Action Network Tyson Falk, representing Aetna Eli Thompson, Private Citizen, Las Vegas, Nevada Micajah Daniels, Health and Education Committee Chair, National Association for the Advancement of Colored People Unit 1765, University of Nevada Las Vegas College Chapter Vilma Garre, Private Citizen, Las Vegas, Nevada Holly Welborn, Policy Director, American Civil Liberties Union of Nevada Steve Jimenez, Extern, Nevada Hispanic Legislative Caucus Elisa Cafferata, Director of Government Relations, Nevada Advocates for Planned Parenthood Affiliates José Melendrez, Executive Director of Community Partnerships, School of Community Health Sciences, University of Nevada, Las Vegas Katie Ryan, Director, Communications and Public Policy, Dignity Health-St. Rose Dominican Monique Normand, representing Progressive Leadership Alliance in Nevada Chairman Sprinkle: [Roll was called. Committee rules and protocol were explained.] I am going to mention this for a third time. It is our Committee policy that whenever amendments are going to be brought for any bill, you must first talk to the sponsor to see what they can do to work it out. I am not tolerant of amendments showing up without having first spoken with the sponsor. I am going to ask everyone from this point forward to work with the sponsor before making a change to the sponsor's bill. Is there any public comment here or in southern Nevada before we get started? [There was none.] We will open the hearing for Assembly Bill 113. Assembly Bill 113: Requires an employer to make certain accommodations for a nursing mother. (BDR 40-7) Assemblywoman Ellen Spiegel, Assembly District No. 20: I have had the pleasure of serving on our Maternal and Child Health Advisory Board during most of the past four years. In this capacity, I learned about a number of health issues, including breastfeeding. Through committee work and conference participation, I learned more about many health benefits associated with breast milk. For example, I have learned how a mother's milk provides a baby with its immune system's first benefits and offers additional benefits to both the child and the mother. Unfortunately, not all lactating employees are given breaks, and/or a clean place to express breast milk so that they can provide for their babies. The more I speak with hardworking Nevadans, the more I know how important this bill is to the health and welfare of our constituents. I am sharing the text of an email I received late last week from a Las Vegas Assembly Committee on Health and Human Services February 27, 2017 Page 4 twelfth grader whose mom was not able to breastfeed because there were no accommodations in her workplace. Dear Assemblywoman Spiegel, I am writing to you in regards to A.B. 113. This is a personal topic to me because my mother had me when she was 21 years old. She was a single mother who did not have support from anyone while raising me. That meant she had to work very hard to provide me with anything that I needed. She even returned to work only one week after giving birth and was unable to breastfeed me. Breast milk is essential to the development of babies. However, only 18.8 percent of babies in Nevada are breastfed for the recommended six months due to the mother's fear of being publicly criticized. Employers should provide nursing mothers with safe environments and conditions so that they can do so. This bill is necessary in order to improve the next generation's health by allowing working mothers to breastfeed their babies for at least six months. I ask that you vote yes on A.B. 113, not only because it is the right thing to do, but also because no woman should ever be afraid of feeding her baby. Sincerely, Nina. While there are now provisions in federal law that apply to private sector workers, those employees need to be covered by state law in case the federal law changes. It is my understanding that public sector employees have no such protections. It is up to us. I have had many public and private sector employees tell me that they have had to pump their milk in makeshift spots, often places that are lacking privacy or comfort, as well as in bathrooms. One teacher told me that her principal told her that she needed to pump her milk in the janitor's closet, and then she faced retaliation when she refused. I know you have the bill in front of you. I have some amendments (Exhibit C) that I have spoken about with folks. I just got the mock-up five minutes ago. With your indulgence, I will explain to the Committee what those amendments are, and then I will get the mock-up to everyone. The first is in section 2, subsection 3, paragraph (a). We changed it so that the complaints filed are done with the Employee-Management Committee instead of the Personnel Commission. In section 2, subsection 3, paragraph (d) we propose to change it so that instead of going to the Local Government Employee-Management Relations Board, it would go to the Local Board of Health. Additionally, in section 4, subsection 1, we are going to delete paragraph (h) that we originally added. In section 5, we will be adding an exemption for employees who work for rural contractors. If there is no building within three miles, there would be an exemption for those employees. I am putting forth those three changes in a mock-up amendment. I will get the completed mock-up to everyone with a cover note explaining a little better. To wrap up this portion of my presentation, I wanted to share some excerpts with you all from an article that I read in the Las Vegas Review-Journal on September 14, 2015, about the U.S. Army setting up a breastfeeding room at Fort Bliss: Assembly Committee on Health and Human Services February 27, 2017 Page 5 There were no lactation rooms or dedicated spaces for breastfeeding mothers when Tara Ruby was on active duty in the Air Force from 1997 to 2001. After her first son was born, Ruby remembers ducking into empty offices and bathrooms—anywhere she could find privacy for 20 to 30 minutes at a time to pump.