With state Sen. Joe Hardy (R-Boulder City) termed out, two Republican Assembly members are eyeing his seat, with one of them already openly campaigning.
At a Fourth of July parade in Boulder City on Sunday, Assemblyman Glen Leavitt (R-Boulder City) broadcast his intention to run for the open seat with a banner attached to a pickup truck and handshakes with parade attendees. First-term Assemblywoman Annie Black (R-Mesquite) indicated in an interview that she is considering running for the seat as well.
Leavitt, first elected in 2018, told The Nevada Independent in a brief interview on Tuesday that he decided to run for the state Senate seat after Hardy approached him and asked if he would be willing to do so.
“A lot of the constituents in the district have said that they would prefer to have me there and continue to serve that district, the same way that I’ve been serving as an assemblyman,” Leavitt said. “So it was a kind of a natural organic progression, it wasn’t something that I pre-planned, but when it came about I was willing to accept that challenge and opportunity.”
Hardy confirmed that he had spoken with Leavitt and had endorsed him some time ago.
“I feel like [Leavitt] is capable, and not only capable but experienced too,” Hardy told The Nevada Independent. “I look forward to watching someone else in the campaign.”
Black said she is thinking about running for the same seat, but is waiting to see how redistricting later this year affects district lines.
The COVID-19 pandemic caused delays in 2020 Census operations, meaning lawmakers were unable to complete the redistricting process during the 2021 session and thus will need to draw new congressional and legislative district boundaries during a yet-to-be-announced special legislative session sometime this fall.
Should the district boundaries fall along similar lines, Black said that she would “most likely” run.
Both Leavitt and Black represent Assembly districts that are nestled within Hardy’s Senate District 12, which encompasses Boulder City, Mesquite and rural portions of Clark County that border Lake Mead, Arizona and California.
Leavitt and Black are not the only two Republican Assembly members looking to move to the Senate. Assemblymembers Jim Wheeler (R-Minden) and Robin Titus (R-Wellington) have also confirmed plans to run for the seat of termed-out state Sen. James Settelmeyer (R-Minden).
Despite potential changes that could come in the redistricting process, Leavitt said he is planning to campaign for the seat and will continue to advocate for small businesses and economic growth.
“My messaging platform will stay consistent with how it’s what it’s always been,” Leavitt said. “There’s no big platform message at this moment, just to continue to serve.”
This story was updated on Wednesday, June 7, 2021 at 2:48 p.m. to include comments from Sen. Joe Hardy.
When lawmakers kicked off their 120-day legislative session in February, the state was still recovering from a brutal winter surge of COVID-19, which saw a thousand new cases of the virus reported across the state each day.
Lawmakers early in the session came forward with some modest proposals to address the pandemic — including a bill to give workers paid time off to get vaccinated — but it was unclear at that point what COVID-19’s trajectory in the Silver State would be. With an influx of federal financial support boosting the state’s pandemic response, it wasn’t always easy to tell where lawmakers could be of most help. With sessions slated for only 120 days every other year, it also wasn’t clear they could craft policy responsive enough to the ever-changing needs created by the pandemic.
Instead, lawmakers generally focused on a host of other important, but perhaps less high-profile, health care proposals, from legislation to support the provision of telehealth services in the state, which became all the more popular during the pandemic, to a bill that would provide for Medicaid coverage of community health workers. They also honed in on data transparency, hearing bills that would make changes to the state’s drug pricing transparency program and establish an all-payer claims database in an effort to better understand the health care landscape in the state.
Lawmakers also took up a last-minute bill to establish a state-managed public health insurance option in Nevada, the second-ever to be approved in the nation. Despite reservations from Republican lawmakers — and even from some Democrats — the Legislature introduced and approved the bill in just a little more than a month with some strong-arming by Senate Majority Leader Nicole Cannizzaro (D-Las Vegas), who spearheaded the legislation.
Behind the scenes, there were frustrations, though, among health care lobbyists. Industry lobbyists, for instance, were caught off guard that Cannizzaro hadn’t involved them in the process of developing the public option bill and dropped the proposal on them in the final weeks of the session.
“I can tell you that when there are very challenging things that occur within health care, when you lock us all in a room, we tend to find solutions,” Tom Clark, lobbyist for the Nevada Association of Health Plans, said during the bill’s first hearing.
Bobbette Bond, policy director for the Culinary Health Fund, also said it was difficult to craft good policy in a legislative environment so heavily shaped by the pandemic. For much of the session, the legislative building was closed to the public and committee meetings were only able to be attended virtually.
“It was hard to get revisions made. It was hard to have good conversations about what could be done. It was hard to build stakeholders,” Bond said. “It was hard to communicate, and I think the policy suffered for that.”
Bond also expressed dismay in the two-thirds requirement for passing tax increases, on the grounds that it has prevented lawmakers from tackling more ambitious health care legislation. Because there isn’t more funding to go around, including to support health care, she said lawmakers have turned to putting mandates on industry.
“The mandates … end up substituting for actual public health policy,” Bond said.
The Culinary Health Fund, which is the health insurance arm of the politically powerful and Democratic-aligned Culinary Union, did, however, continue to play a significant role in shaping health care policy this session with Democrats remaining in control of both chambers of the Legislature. Other industry representatives, who often work collaboratively with Democratic lawmakers but more often align with Republicans on business priorities, had less of an upper hand.
Mike Hillerby, a longtime lobbyist on health care issues in the state, said Nevada loses “a lot of subtlety in the public policy debate” when the discussion is “driven by the relationship between a couple of unions and a couple of hospital chains.”
“That drives so much of what we do, and it's so contentious. Look at balance billing from 2019. Look at some of the stuff this time, and everything's driven by that. That's not indicative of the market and the rest of Nevada. That's not indicative of what's happening with providers and patients and payers in rural Nevada, in the Reno area, and yet so much of it is driven by that and that financial reality, that bargaining relationship, those contractual relationships,” Hillerby said. “We just lose a lot of the subtlety and the ability to make better decisions.”
Here’s a look at some of the health policies that passed this session and others that didn’t.
The highest-profile piece of health care legislation to pass this year, SB420 — Nevada’s public option bill — was introduced with just a little more than a month left in the legislative session by Cannizzaro, the Senate majority leader. Proponents were quiet about the legislation for the first couple of months of the session until Cannizzaro was asked by a reporter in mid-April about the proposal and health care lobbyists started receiving briefings from consultants on the concept.
The bill, which builds upon previous public option proposals introduced in Nevada in 2017 and 2019, aims to leverage the state’s purchasing power with Medicaid managed care organizations — private insurance companies that contract with the state to provide coverage to the state’s low-income population — to get insurers to also offer public option plans. The plans will resemble existing qualified health plans on the state’s health insurance exchange, though they will be required to be offered at a 5 percent markdown with the goal of reducing the plans’ premium costs by 15 percent over four years. The plans won’t be offered for sale on the exchange until 2026.
The proposal cleared both the Senate and Assembly on party line votes and was signed into law in early June by Gov. Steve Sisolak, making Nevada the second state in the nation after Washington to enact a state-based public health insurance option into law. Colorado became the third state to establish such a policy in mid-June.
Though the legislation was heavily opposed by the health insurance industry — with some groups running ads and sending mailers opposing the proposal — Cannizzaro muscled the bill through the Legislature as the clock counted down to the end of the 120-day session. The bill easily cleared the Senate — where Cannizzaro, as majority leader, controls which bills come to the floor — and Democratic leaders in the Assembly threw their support behind the bill shortly thereafter, setting aside concerns about whether the bill can accomplish its goals of improving health care access and affordability.
“It's not a secret I have been skeptical of this bill from the very beginning, but I've seen the amendments, and I have talked to a number of the different proponents of the bill and opponents of the bill on it,” Assembly Ways and Means Chair Maggie Carlton (D-Las Vegas) said in late May, shortly before allowing the bill to be voted out of her committee. “I feel much more comfortable knowing that, in the future, the people that are in this building now that do come back are well aware of what's going on, and I trust them to make the best decisions they can to protect the constituents of this state.”
In her remarks, Carlton was referring to the long runway the bill establishes before the public option actually goes into effect, leaving time for the state to conduct an actuarial study to figure out whether the bill actually accomplishes the goals it sets out to and two legislative session in 2023 and 2025 for lawmakers to make any tweaks to the policy as necessary.
Heather Korbulic, who as head of the state’s health insurance exchange will have a key role in shaping the policy’s implementation, has said she plans to bring stakeholders together to “outline the actuarial study and conduct a meaningful analysis of the public option as it relates to every aspect of health care throughout the state.”
Richard Whitley, director of the Department of Health and Human Services, said in an interview earlier this month that the public option isn’t “a single solution” but “does definitely enhance the opportunity for individuals to gain access to health care.”
“I think of this as an option for coverage,” Whitley said. “It definitely enhances that overall framework of health care coverage.”
Transparency and data efforts
For the last two legislative sessions, lawmakers have focused on prescription drug cost transparency, passing a first-in-the-nation diabetes drug transparency law in 2017 and expanding that law to include asthma drugs in 2019. This year, lawmakers built upon those transparency efforts by passing legislation requiring transparency from more portions of the health care industry.
This year, lawmakers approved a bill, SB40, to establish what’s known as an all-payer claims database — a state database of claims of medical, dental and pharmacy services provided in the state. The law requires all public and private insurers regulated under state law to submit their claims to the database and authorizes insurers governed by federal law — such as the Culinary Health Fund — to submit their claims to the database. A similar bill proposed during the 2019 legislative session failed to move forward in the final minutes of that session, though the concept was revived by the Patient Protection Commission, which brought SB40 forward this session.
The bill, however, required extensive work when it got to the Legislature, with state Sen. Julia Ratti (D-Sparks) taking the bill under her wing as chair of the Senate Health and Human Services Committee and working with industry advocates — including the Nevada Association of Health Plans, the Nevada State Medical Association and the Nevada Hospital Association — to finalize the legislation.
“We knew the bill was going to pass, at some level ... so we wanted to make sure that the information that was going to be collected was accurate, was consistent with what was required in other states that had all-payer claims databases and also to learn from what those other states had done so we wouldn’t make the same mistakes,” Clark, the Nevada Association of Health Plans lobbyist, said. “Fortunately, Senator Ratti and others were good to work with and we’re comfortable with the way the bill passed.”
The legislation additionally makes data contained in the all-payer claims database confidential, meaning that it is not a public record or subject to subpoena, and specifies how the information contained in it can be disclosed. It can be shared in de-aggregated form to state or federal government entities, including the Nevada System of Higher Education, and any entity that submits data to the database. Anyone else looking to obtain the data can only receive it in aggregated form by submitting a request to the Department of Health and Human Services.
Lawmakers also built upon the diabetes and asthma drug transparency bills passed in 2017 and 2019, respectively, by expanding the universe of drugs the state imposes transparency requirements on. SB380, which was proposed by an interim committee created during the 2019 session to study prescription drug costs, requires the state to compile a list of prescription drugs with a list price that is more than $40 for a course of therapy that has undergone a 10 percent price increase in the preceding year or a 20 percent increase in the two prior years.
The legislation requires drug manufacturers to submit a report to the state explaining the reason for the price increase and explaining the factors that contributed to the price increase. Meanwhile, pharmacy benefit managers, or PBMs, the middlemen in the drug pricing process, are required to submit their own reports with certain data about the drugs, including rebates negotiated with manufacturers and the amount of the rebates retained by the PBM.
The state’s drug transparency program will also, for the first time, have funding behind it, utilizing dollars that have been collected in the form of fines paid by companies for not complying with the state’s drug transparency law. The Department of Health and Human Services put a $780,000 fiscal note on the bill to allow state health officials to transfer the existing drug transparency database to the state’s Enterprise Information Technology Services Division and hire a pharmacist and management analyst to manage the drug transparency program.
SB380 was, however, only one of two bills put forward by the interim prescription drug committee to pass this session. The other was SB396, which allows the state to establish intra- and interstate drug purchasing coalitions with private entities.
The three bills that did not pass were:
SB201, which would have licensed pharmaceutical sales representatives
SB378, which would have required at least half of the health plans offered in the state by private insurers to provide prescription drug coverage with no deductible and a fixed copayment and limit the total amount of copayments insured individuals are required to pay in a year
SB392, which would have licensed PBMs and created additional rules for how PBMs can operate.
Nick McGee, senior director of public affairs for PhRMA, the drug industry advocacy organization, in an email expressed disappointment that lawmakers pursued SB380 this session while not advancing the other proposals out of the interim committee. PhRMA did, however, in the end testify in neutral on SB380.
“We are disappointed that the legislature overlooked this opportunity to address patients’ concerns related to their ability to afford and access the medicines they need,” McGee said. “Instead, lawmakers pursued onerous reporting and unnecessary registration requirements that won’t do anything to help patients afford their medicines and fail to provide transparency into why insurers are shifting more and more costs on to patients.”
Bond, the policy director for the Culinary Health Fund, which played a key role in bringing the 2017 bill to fruition, described SB380 as a “step forward,” though she said the bill didn’t end up “as strong as we would have liked.”
“It’s incremental, and it’s progress,” she said.
Lawmakers did not advance SB171, sponsored by state Sen. Joe Hardy (R-Boulder City), which would have barred most insurance companies from implementing copayment accumulator programs for any drug for which there is not a less expensive alternative or generic drug. Such programs prevent drug manufacturer coupons from applying toward patients’ deductibles and maximum out-of-pocket costs.
The Legislature additionally made a budgetary change to boost transparency, approving a request from the Department of Health and Human Services to centralize its data analysis efforts within the office of Data Analytics within the Director’s Office, while the Patient Protection Commission, which is focusing on health care spending and costs, was transferred from the governor’s office to Director’s Office as well.
Whitley, the department’s director, framed the reshuffling as an effort to bring together disparate health data collection and analysis efforts, adding that the pandemic showed the kind of real-time data the department could provide, as in the case of its COVID-19 dashboard, among other dashboards it now maintains.
“Usually people go, ‘We need more money.” Well, in government sometimes what you need is organizational structure,” Whitley said. “Putting data analytics all in one unit in my office … was really because of seeing all of the benefits that were coming out of monitoring the pandemic. That really served to inform what we could be doing.”
The Legislature also made a significant change to the Patient Protection Commission this session, transforming it from a largely industry-focused body to one instead made up largely of non-profit health industry representatives and patient advocates. AB348, sponsored by Carlton, requires the commission be made up of:
two patient advocates
one for-profit health care provider
one registered nurse who practices as a nonprofit hospital
one physician or registered nurse who practices at a federally qualified health center
one pharmacist not affiliated with any retail chain pharmacy, or a patient advocate
one public nonprofit hospital representative
one private nonprofit health insurer representative
one member with expertise advocating for the uninsured
one member with expertise advocating for people with special health care needs
one member who has expertise in health information technology and works with the Department of Health and Human Services
one representative of the general public.
The bill also makes the Patient Protection Commission the sole state agency responsible for administering and coordinating the state’s involvement in the Peterson-Milbank Program for Sustainable Health Care Costs, a program that provides technical assistance to states developing targets for statewide health care spending trends.
Health care industry representatives have, however, chafed at the reduction — or in the case of the drug industry, removal — of their representation on the commission. McGee, from PhRMA, said the change “[undermines] the ability of the commission to provide a comprehensive perspective.”
But Bond, a commission member whose ability to serve will be unaffected by the policy shift, said the change would give patients and consumers more of a voice.
“I understand the concerns about losing representation from the industry, but I also believe that industry has other places where they get represented,” Bond said. “They have the Nevada Hospital Association, the pharmaceutical industry has PhRMA. They get well represented in their core arena. Patients really don't have a core arena they can go to.”
The Patient Protection Commission’s other bill this session, SB5, also was approved by lawmakers, making a number of changes to telehealth in the state. That bill also contains a data transparency component, requiring the Department of Health and Human Services, to the extent money is available, to establish a data dashboard allowing for the analysis of data relating to telehealth access.
Another big bill that tried to tackle health care costs this session, AB347, sponsored by Assemblyman David Orentlicher (D-Las Vegas), died without receiving a vote. The ambitious bill, among other provisions, proposed establishing a rate-setting commission “to cover reasonable costs of providing health care services” while ensuring providers “earn a fair and reasonable profit.” The bill also would have raised Medicaid payments to Medicare levels via a provider tax.
Antitrust in health care
Lawmakers approved two antitrust in health care bills this session. The first one, AB47, requires parties to certain reportable health care or health carrier transactions to submit a notification to the attorney general with information about the transaction at least 30 days before it is finalized. Reportable transactions include material changes to the business or corporate structure of a group practice or health carrier that results in a group practice or health carrier providing 50 percent or more of services within a geographic market.
The bill, which was presented by the attorney general’s office, also prohibits employers from bringing court actions to restrict former employees from providing services to former customers or clients under certain circumstances and bars noncompete agreements from applying to employees that are paid on an hourly wage basis.
The bill attracted opposition from the Nevada Hospital Association and the Nevada State Medical Association. During a May hearing on the bill, Jesse Wadhams, a hospital association lobbyist, thanked the attorney general’s office for working with them on the bill but said the association still could not support the legislation.
“We believe the policy itself comes from a faulty premise,” Wadhams said. “We believe policies should promote more physicians, more access to care and more investment in the health care community.”
Another bill, SB329, requires hospitals to notify the Department of Health and Human Services of any merger, acquisition or similar transaction. It also requires physician group practices to report similar transactions if the practice represents at least 20 percent of the physicians in that specialty in a service area and if the practice represents the largest number of physicians of any practice in the transaction. The legislation, sponsored by state Sen. Roberta Lange (D-Las Vegas) and pushed for by the Culinary Health Fund, requires the department to publish that information online and write an annual report on that information.
Another section of the bill allows the attorney general or other individuals to bring a civil action against a health care provider that “willfully” enters into or solicits a contract that bars insurance companies from steering insured individuals to certain health care providers, putting health care providers in tiers or otherwise restricting insurers. It also makes such an action, known as “anti-tiering” or “anti-steering,” a misdemeanor. (A final amendment to the bill reduced the penalty from a felony to a misdemeanor.)
“I think this is one of the early steps in what will probably be a national trend,” Bond, of the Culinary Health Fund, said in an interview. “I think contract provisions are going to become more and more antitrust looking.”
The bill was opposed by the Nevada Hospital Association and individual Nevada hospital systems and hospitals.
“The technical elements of this and eliminating antitrust provisions by themselves are not the problem we have with this bill — it is making sure that it doesn’t impede the open contracting that occurs otherwise in this highly competitive environment,” Jim Wadhams, a lobbyist for the hospital association, said during a May hearing on the bill.
In perhaps the most substantial victory for health care providers this session, lawmakers rolled back a 6 percent Medicaid rate decrease approved by the Legislature during a budget-slashing special session last summer.
Legislative fiscal analysts projected the move would restore about $300 million in Medicaid funding both in the current fiscal year and in the upcoming biennium, including about $110 million in general fund spending.
“Nevada faced an unprecedented state budget crisis,” Bill Welch, CEO of the Nevada Hospital Association, and Jaron Hildebrand, executive director of the Nevada State Medical Association, wrote in a letter to the governor in May. “The work you did alongside the Nevada Legislature to restore funding to hospitals and providers will be instrumental in safeguarding the health care available to many Nevadans.”
Lawmakers made a number of other changes to Medicaid services as well, providing for coverage of doula services in AB256 and community health workers in AB191. The public option bill, SB420, also contained several Medicaid provisions, including one section providing that pregnant women are considered presumptively eligible for Medicaid without submitting an application for enrollment and another prohibiting pregnant women who are otherwise eligible for Medicaid to be barred from coverage for not having resided in the United States long enough to qualify.
On the mental health front, SB154 requires the state to apply for a waiver to receive federal funding to cover substance use disorder and mental health treatment inside what are known as institutions of mental disease — or psychiatric hospitals or residential treatment facilities with more than 16 beds. Medicaid has long been barred from paying for care in such facilities, but states were recently given the ability to apply to the federal government to cover these services through Medicaid via a federal waiver.
Lawmakers also approved AB358, sponsored by Assembly Speaker Jason Frierson (D-Las Vegas), which will allow for a more seamless transition of incarcerated people to Medicaid upon release from prison. The bill requires a person’s Medicaid eligibility to only be suspended, rather than terminated, when they are incarcerated and specifies that individuals who were not previously on Medicaid should be allowed to apply for enrollment in the program up to six months before their scheduled release date. The bill also requires eligibility for and coverage under Medicaid to be reinstated as soon as possible upon an individual’s release.
In a major victory for families of children with autism, lawmakers passed SB96, which boosts reimbursement rates for autism services.
Lawmakers, by and large, did not spend much time tackling the COVID-19 pandemic head on during their legislative session, likely a byproduct of how rapidly the situation has evolved over the last six months.
Legislators did, however, approve SB209, sponsored by state Sen. Fabian Doñate (D-Las Vegas), which requires employers to provide paid leave to employees to receive the COVID-19 vaccine and requires the Legislative Committee on Health Care to conduct a study during the 2021-2022 interim about the state’s response to the COVID-19 pandemic and make recommendations to the governor and lawmakers for the next legislative session in 2023.
They also passed SB318, also sponsored by Doñate, requiring public health information provided by the state and local health districts to “take reasonable measures” to ensure that people with limited English proficiency have “meaningful and timely access to services to restrain the spread of COVID-19.”
Beyond COVID, the Legislature passed a number of other public-health related measures this session, including, notably, establishing a public health resource office within the governor’s office through SB424, with the goal of taking a holistic, multidisciplinary approach to public health in the state.
Lawmakers also approved SB461, which requires the state to disburse $20.9 million of American Rescue Plan dollars to specifically to address needs spotlighted by the public health emergency including “mental health treatment, substance use disorder treatment and other behavioral health services, construction costs and other capital improvements in public facilities to meet COVID-19-related operational needs and expenses relating to establishing and enhancing public health data systems.”
The Legislature additionally passed a few tobacco-related pieces of legislation including AB59, sponsored by the attorney general’s office, officially raising the tobacco purchase age in the state to 21 — the federal Tobacco 21 law went into effect in December 2019 — and AB360, sponsored by Assemblyman Greg Hafen (R-Pahrump), which prohibits people from selling, distributing or offering to sell cigarettes or other tobacco products to a person under 40 without first conducting age verification. Additionally, SB460, the budget appropriations bill, allocates $5 million for vaping prevention activities.
Lawmakers also approved SB233, sponsored by state Sen. Joe Hardy (R-Boulder City), which appropriates $500,000 to the Nevada Health Services Corps, a state loan repayment program for physicians and other health practitioners aimed at encouraging providers to practice in underserved areas of the state. The Legislature also approved SB379, a health workforce data collection bill that proponents say is critical for the state’s health professional shortage area designation.
“It’s kind of nerdy, wonky data stuff, but those designations are really critical for Nevada, for loan repayment, for health service corps, for [federally qualified health center] and community health center designation and reimbursement and all sorts of stuff,” said John Packham, co-director of the Nevada Health Workforce Research Center at the University of Nevada, Reno. “We just need better data, period, on the workforce.”
While mental health advocates have become accustomed to making slim gains each legislative session, Robin Reedy, executive director of NAMI Nevada, believes 2021 was a good session for mental health.
“For once, it’s a long list. It’s just so amazing,” Reedy said of the mental health bills that passed this session. “Everything has just been an uphill climb constantly … but this year, oh my God.”
In addition to SB154, mentioned above, key mental health bills passed this session hone in on mental health parity (AB181), implement the 9-8-8 National Suicide Prevention Hotline (SB390), bolster crisis stabilization services in the state (SB156) and remove stigmatizing language from state law referring to people with mental illness (AB421).
Lawmakers also approved bills put forward by the regional behavioral health policy boards established during the 2017 legislative session, including SB44, which aims to smooth the licensure process to boost the number of behavioral health providers in the state, and SB70, which makes changes to the state’s mental health crisis hold procedures.
Reedy attributed the increased focus on mental health this session to a “perfect storm of things coming together.”
“I think it's incredibly sad that it took a pandemic for people to actually look more at mental health — when everyone was going through some form of anxiety or depression from being isolated, from not knowing what the future held, from it being just really untenable, and everyone has different levels of acceptance of those things, and living through those things, different levels of resilience,” Reedy said. “Suddenly it's like, ‘Mental health.’ We've been working on this forever. Finally.”
But Reedy said there’s still a long way to go. For instance, she wishes that SB390, which authorizes the state to impose a surcharge on certain mobile communication services, IP-enabled voice services and landline telephone services to fund the 9-8-8 line, would have capped that charge at 50 cents instead of 35 cents. She believes had the session been a regular session and had mental health advocates been able to pack the committee room with patients, they would have been able to get that fee cap increased.
“I just don't think 35 cents is going to be enough … We’re 51st in the nation [for mental health],” Reedy said. “I know telecommunications does not want to pay to fill the hole, but that means crisis lines are going to be busy.”
Other health care bills
In addition to reigning in drug pricing costs, lawmakers passed several bills making changes to how Nevadans can access certain kinds of prescription drugs. SB190, sponsored by Cannizzaro, will allow pharmacists to dispense certain kinds of hormonal birth control directly to patients. SB325, sponsored by Senate Minority Leader James Settelmeyer (R-Minden), similarly allowed pharmacists to dispense preventative HIV medication, including PrEP.
Other prescription-drug focused bills passed this session include AB178, a bill sponsored by Assemblywoman Melissa Hardy (R-Henderson) requiring insurers to waive restrictions on the time period in which a prescription can be refilled during a state of emergency or disaster declaration, and AB177, a bill from Assemblywoman Teresa Benitez-Thompson (D-Reno) aiming to expand access to prescription drugs in people’s preferred language.
Lawmakers also passed a number of other health care related bills including:
SB275, sponsored by state Sen. Dallas Harris (D-Las Vegas), modernizes state laws on HIV by treating the virus the same way as other communicable diseases
SB342, sponsored by the Senate Education Committee, puts the legislative stamp of approval on a major partnership between the UNR School of Medicine and Renown Health
SB290, sponsored by state Sen. Roberta Lange (D-Las Vegas), makes it easier for certain stage 3 and 4 cancer patients to receive prescription drug treatment by allowing them to apply for an exemption from step therapy, which requires patients to approve that certain drugs are ineffective before insurance will cover a higher-cost drug
SB340, sponsored by state Sen. Dina Neal (D-Las Vegas), provides for the establishment of a home care employment standards board
SB251, sponsored by state Sen. Heidi Seevers Gansert (R-Reno), requires primary care providers to conduct or refer patients for screening, genetic counseling and genetic testing in accordance with federal recommendations around BRCA genes, which influence someone’s chance of developing breast cancer
Several health care bills also died with the end of the legislative session, including AB351, which would have allowed terminally ill patients to self-administer life-ending medication, and AB387, a midwife licensure bill.
Democrats controlled both houses of the Legislature during the 2021 session, and hundreds of high-profile Democratic measures sailed through the Assembly and Senate while a vast majority of Republican-backed measures failed to make much headway in the legislative process.
Out of 605 bills introduced and sponsored by a lawmaker this session, Democratic legislators had 63 percent of their bills and resolutions pass out of the Legislature, compared to just 18 percent for Republicans. Those in the majority party were able to pass priority measures, including bills establishing the “Right to Return,” a public health insurance option and permanent expanded mail voting, while many priorities for Republicans, such as a voter ID law, were killed without so much as a hearing.
Which lawmakers had the most success passing their bills? Which lawmakers were least successful? How did Assembly members fare compared to senators?
The Nevada Independent analyzed all bills and resolutions that were both introduced and primarily sponsored by a lawmaker and examined which of those bills passed out of the Legislature and which ones died. Of those 605 bills, 267 (44 percent) were approved by members of the Assembly and Senate, while the remaining 338 (56 percent) were left in the graveyard of the legislative session.
Those 605 measures make up only a portion of the 1,035 bills and resolutions introduced during the session — others were sponsored by committees, constitutional officers such as the secretary of state or governor, or helped implement the state budget. The 2021 session also saw fewer measures introduced than previous sessions, as the 2019 and 2017 sessions each saw closer to 1,200 bills and resolutions introduced.
State law limits the number of bills that can be introduced by any individual lawmaker — incumbent senators and Assembly members can request 20 and 10 bill draft requests, respectively, while newly-elected legislators are limited to six bills in the Assembly and 12 in the Senate. Legislative leadership for both the majority and minority parties are also allowed to introduce additional bills beyond the normal limits.
The analysis revealed that Assemblywoman Sandra Jauregui (D-Las Vegas) and Sen. Chris Brooks (D-Las Vegas) led their caucuses with the highest rate of bill passage, while Assembly members Jill Tolles (R-Reno) and P.K. O'Neill (R-Carson City) were the only Republicans who had more than half of their bills passed out of the Legislature. Eight Republican legislators ended the session with zero bills passed.
A previous analysis of votes during the 2021 session revealed that most bills passed with bipartisan support, as more than half of all votes included no opposition. But that trend was largely driven by Democrats in the majority passing their priorities while not advancing nearly as many Republican bills, with 175 more Democrat-backed measures passing out of the Legislature than measures introduced by Republicans.
The guide below explores the results of our analysis, examining the successes and failures of both parties and of individual lawmakers this session.
We’ve double-checked our work to make sure we’ve counted every vote and hearing, but if you spot something off or think a bill was missed or improperly noted, feel free to email firstname.lastname@example.org.
How did Democrat-sponsored legislation fare? Did any Republican lawmakers find success?
Though hundreds of the more than 1,000 bills and resolutions introduced during the session were sponsored by Democrat-controlled committees, there were only 350 measures specifically sponsored and introduced by a lawmaker from the majority party.
Many were headline-grabbing progressive bills that drew staunch Republican opposition, including expanding permanent mail-in voting (AB321) and setting up Nevada to become one of the first states to have a public health insurance option starting in 2026 (SB420).
Of the 350 bills from Democratic lawmakers, 221 (63.1 percent) passed out of both houses. However, Assembly Democrats fared slightly better than their Senate counterparts, with 65 percent of their bills passing compared with 60 percent for those in the Senate Democratic Caucus.
The success rate of bills introduced by Republican lawmakers was dismal in comparison.
Members of the Assembly Republican caucus had 27 of their 126 introduced measures (21 percent) pass out of both houses, while Senate Republicans had 19 of their 129 (15 percent) pass out of the Legislature. The majority of Republican-backed measures were not even given a chance by the majority party, as 56 percent of 255 bills and resolutions introduced by Republican legislators never received an initial committee hearing.
Failed Republican-backed bills included an effort to create a bipartisan redistricting commission (SB462), a measure requiring voters to provide proof of identity (SB225) and a bill that aimed to limit the number of legislative actions allowed per session (AB98).
Among the 46 Republican-sponsored measures that passed out of the Legislature were a variety of health care-related bills, including legislation from Sen. Joe Hardy (R-Boulder City) that appropriated state funds to the Nevada Health Service Corps for encouraging certain medical and dental practitioners to practice in underserved areas (SB233). Lawmakers also approved a measure from Assembly Minority Leader Robin Titus (R-Wellington) authorizing the Board of Regents to waive fees for family members of National Guard members who reenlist (AB156).
While Republicans fared far worse, Democratic lawmakers still had more than a third of their bills fall victim to the legislative process.
Some bills were overwhelmed by backlash, such as SB452, a bill that aimed to grant casino resorts greater authority to ban firearms on their premises but was opposed by a broad coalition of Republicans, gun right advocates and criminal justice reform organizations and failed to advance out of the Assembly.
Other bills were watered down or axed after lawmakers deemed there was not enough time to consider the effects of a measure. Such was the case for AB161, a bill that started as a ban on the state’s “summary eviction” process, then was amended into a legislative study on the process but still never received a floor vote. Some measures fell just shy of the support they needed, including AB387, an attempt to license midwives that fell one vote shy of a two-thirds majority in the Senate on the final day of the session.
Which lawmakers were most prolific? Which lawmakers introduced the fewest bills?
Although Democratic lawmakers significantly outpaced Republican lawmakers in getting their bills passed out of both houses of the Legislature, the number of bills introduced by each legislator remained similar between the two parties.
On average, lawmakers from the majority party introduced 9.2 measures during the 2021 session, compared to 10.2 for lawmakers in the minority party.
Those who led their parties in introductions were typically house leaders or more experienced lawmakers.
In the Assembly, Speaker Jason Frierson (D-Las Vegas) topped the rest of his party with 18 bills introduced and sponsored, while Minority Floor Leader Titus had the most bills introduced and sponsored of anyone in the Assembly Republican caucus with 14.
Minority Leader James Settelmeyer (R-Minden) introduced and sponsored 25 bills, which was the most of any legislator during the session.
Four other Senators also stood above the pack: Sen. Dallas Harris (D-Las Vegas) led Democrats with 23 introductions, while Sen. Pat Spearman (D-North Las Vegas) and two Republican senators, Hardy and Keith Pickard (R-Henderson), rounded out the top with 20 bills each.
Assemblywoman Tracy Brown-May (D-Las Vegas), who was appointed by the Clark County Commission on Feb. 2, 2021 to fill the seat of Democratic former Assemblyman Alex Assefa, who resigned amid an investigation into whether he met residency requirements, was the only lawmaker who did not introduce a single piece of legislation this session.
The others at the bottom of the list — Assembly members Elaine Marzola (D-Henderson), Maggie Carlton (D-Las Vegas) and Richard McArthur (R-Las Vegas), and Sens. Fabian Doñate (D-Las Vegas) and Ira Hansen (R-Sparks) — introduced three bills each. Doñate was appointed to fill the seat of former Sen. Yvanna Cancela (D-Las Vegas), and introduced three of her bill draft requests submitted prior to the start of the session.
Which legislators had the most success with their bills?
Assemblywoman Sandra Jauregui (D-Las Vegas) had more success getting her bills passed than any Nevada lawmaker during the 2021 session, as all eight bills that she introduced and sponsored passed out of both houses of the Legislature.
Jauregui had one bill that was passed only with the support of her own party members in both houses. AB286, which bans so-called “ghost guns” and other firearm assembly kits that don’t come equipped with serial numbers, passed through the Assembly and Senate along party lines.
Other bills Jauregui introduced included measures focused on the environment and residential properties, as well as AB123, which increases fees on special Vegas Golden Knights license plates to help give more funds to charities.
Five other Assembly Democrats, all based out of Southern Nevada, had at least 80 percent of their measures pass out of both houses, including Assembly Speaker Frierson. Frierson, who saw 15 of his 18 sponsored measures pass, introduced several high-profile Democratic measures, including a pair of big election bills: AB126, which moves the state to a presidential primary system instead of a caucus-based system, and AB321, which permanently expands mail-in voting.
Other bills introduced by the Assembly leader that passed out of the Legislature included a measure requiring a three-day grace period before landlords can charge late fees for overdue rent (AB308) and a bill allowing college athletes to profit off of their name and likeness (AB254). Frierson was also the primary sponsor of AB484, which authorizes the Department of Employment, Training and Rehabilitation (DETR) to use $54 million in federal funds to modernize the state’s outdated unemployment insurance system.
Frierson had only three bills that did not pass out of the Legislature, including a controversial measure that would have allowed for the Washoe and Clark County school boards to be partially appointed (AB255).
Other lawmakers to have at least 80 percent of their measures pass out of both houses were Assembly members Venicia Considine (D-Las Vegas), Steve Yeager (D-Las Vegas), Daniele Monroe-Moreno (D-North Las Vegas) and Howard Watts (D-Las Vegas).
Considine had five of her six introduced measures pass both houses with significant bipartisan support, including a measure that replaces the gendered language for crimes of sexual assault with gender-neutral language (AB214).
Yeager saw eight of ten introduced bills pass, including AB341, which authorizes the licensing of cannabis consumption lounges, though he also presented several other, sometimes controversial, measures as chair of the Assembly Judiciary Committee. He presented AB400, a bill that removes “per se” limits on non-felony DUIs involving marijuana and that passed along party lines out of the Assembly. And he presented AB395, the death penalty bill that was scrapped by Democratic lawmakers in the Senate.
Though Monroe-Moreno had four of her five introduced bills pass out of both houses, including a measure that reduces the criminal penalties for minors found in possession of alcohol or small amounts of marijuana (AB158), she was also the sponsor of one of the few measures to fail to advance out of the Legislature because it failed to achieve a needed two-thirds majority. Her bill AB387, which would have established a midwifery licensure board, fell one vote shy of the two-thirds majority in the Senate.
Watts, a second-term assemblyman, sparked a variety of partisan disagreements throughout the session, as six of his ten introduced bills passed out of the Assembly with zero Republican support (Watts had eight bills pass out of both chambers). Those measures ranged broadly from a pair of environment-focused measures to a bill that bans offensive or racially discriminatory language and imagery, names, logos or mascots in Nevada schools (AB88).
In the Senate, only three legislators had more than two-thirds of their introduced measures pass out of both houses: Chris Brooks (D-Las Vegas), Roberta Lange (D-Las Vegas) and Majority Leader Nicole Cannizzaro (D-Las Vegas).
Brooks was the most successful of the bunch, getting five of his six introduced bills passed, including SB448, an omnibus energy bill expanding the state’s transmission infrastructure that was passed out of the Assembly on the final day of the session. With a larger number of introductions (13), Lange had twice as many bills passed as Brooks (10), covering a wide range of topics from health care to employment to a bill permanently authorizing curbside pickup at dispensaries (SB168).
The majority leader also succeeded in passing a higher percentage of her bills than most of her Senate colleagues, as 12 different Cannizzaro-sponsored bills made their way to the governor’s office. Those measures were met with varying degrees of bipartisan support, as a bill requiring data brokers to allow consumers to make requests to not sell their information passed with no opposition (SB260), while a bill barring the suspension of driver’s licenses for the nonpayment of fees received mixed support from Republicans in both chambers (SB219). Another bill, SB420, which enacts a state-managed public health insurance option, passed along party lines in both the Senate and Assembly.
A few Assembly Republicans stood above the pack, as Assembly members Jill Tolles (R-Reno), P.K. O’Neill (R-Carson City), Lisa Krasner (R-Reno) and Tom Roberts (R-Las Vegas) were the only members of their party to have at least half of their bills pass out of both houses.
Tolles, who was more likely to side with Democrats on close votes during the session than any other Republican lawmaker, found the most success of the group, as four of the six bills she introduced and sponsored were sent to the governor. Those bills that passed were met with broad bipartisan support, such as AB374 — that measure, which establishes a statewide working group in the attorney general’s office aimed at preventing and reducing substance use, passed unanimously out of both houses. The third-term legislator did introduce some bills that were killed by Democrats, such as AB248, which sought to allow "partisan observers" to watch over elections at polling places.
Four of O’Neill’s seven bills were sent to the governor. One allows the Stewart Indian School Cultural Center and Museum to designate certain buildings and grounds of the former boarding school for Native children for special events and authorizes the sale and consumption of alcoholic beverages at such events (AB270). O’Neill was the only Republican present at a bill signing event for Native-focused legislation, after many of those bills passed with bipartisan support.
Half of Krasner and Roberts’ bills passed out of the Legislature, with each lawmaker introducing and sponsoring eight measures during the session.
Nearly all four of Krasner’s bills that made it out of both chambers attracted unanimous votes, including AB143, which creates a statewide human trafficking task force and a plan for resources and services delivered to victims. Another well-received bill, AB251, seals juvenile criminal records automatically at age 18 and allows offenders to petition the court for the expungement or destruction of their juvenile records for misdemeanors. Both AB143 and AB251 have been signed by the governor.
Roberts, who was among the Republicans most likely to cross party lines and vote contrary to the majority of his caucus, had several bills sent to the governor with strong bipartisan support, including AB319, which establishes a pilot program for high school students to take dual credit courses at the College of Southern Nevada. Another of his four successful bills was AB326, which is aimed at curbing the illicit cannabis market.
Success for Republican senators in passing bills was more rare.
Sen. Ira Hansen (R-Sparks) had one bill sent to the governor and two bills killed without a hearing, giving him a higher percentage of bills passed (33 percent) than any other member of his caucus. Hansen’s one successful measure, SB112, aligns Nevada law with federal law regarding the administration of certain products for livestock. One of Hansen’s failed bills included an attempt to prohibit police officers from using surveillance devices without a warrant, unless there were pressing circumstances that presented danger to someone’s safety (SB213).
Sen. Ben Kieckhefer (R-Reno) was the second most successful member of his caucus in terms of getting bills passed, as three of the 14 measures (21 percent) he introduced passed out of both houses, including a measure establishing an esports advisory committee within the Gaming Control Board (SB165). But many of the measures introduced by Kieckhefer still failed, including a resolution to create an independent redistricting commission to conduct the reapportionment of districts (SJR9).
Only three other members of the Senate Republican caucus, including Minority Leader Settelmeyer, Hardy and Pete Goicoechea (R-Eureka), had at least 20 percent of their introduced measures pass fully out of the Legislature.
Which legislators had the least success with their bills?
Despite Democrats controlling both legislative chambers, a handful of Democratic lawmakers still had less than half of their sponsored measures sent off to the governor’s office.
In the Assembly, five members of the Democratic caucus failed to have 50 percent of their bills advance out of both houses, including Assemblywoman Michelle Gorelow (D-Las Vegas), who rounded out the bottom of the list as just one of her eight introduced bills passing out of the Legislature. Though that one successful bill — AB189, which establishes presumptive eligibility for pregnant women for Medicaid — garnered bipartisan support, many of Gorelow’s introduced measures failed to even receive an initial committee vote. Those failed bills included multiple more health care-focused measures, including an effort to require certain health plans to cover fertility preservation services (AB274).
The others in the caucus to have more than half of their bills fail were Assembly members Bea Duran (D-Las Vegas), David Orentlicher (D-Las Vegas), Edgar Flores (D-Las Vegas) and Cecelia Gonzalez (D-Las Vegas), who each had between 33 and 43 percent of their bills passed.
Duran found mixed success with her bills, getting three of her seven introduced measures passed, including a bill that requires all public middle schools, junior high schools and high schools to offer free menstrual products in bathrooms (AB224), but seeing four others fail, including one requiring public schools implement a survey about sexual misconduct (AB353).
One of Orentlicher’s five bills was among a small group that failed to advance at a mid-May deadline for second committee passage. The measure, AB243, would have required courts to consider whether a defendant is younger than 21 when deciding a sentence and failed to clear the deadline after previously passing out of the Assembly along party lines. Orentlicher introduced five bills, but only two passed out of both chambers.
While Flores introduced several measures that received broad unanimous support throughout the session, such as a measure that established a new, simpler Miranda warning for children (AB132), he also proposed several controversial measures that failed to advance out of the Assembly. One of those bills, AB351, would have allowed terminally ill patients to self-administer life-ending medication, and another, AB131, would have required all uniformed police officers to wear body cameras when interacting with the public. Only four of Flores’s ten introduced bills passed out of both legislative chambers.
Gonzalez, a freshman, had four of her six introduced bills die at different times over the course of the session. Two of her bills died without ever being heard. Another bill she introduced (AB151) was never voted on by the Assembly because a Cannizzaro-sponsored bill took almost the same approach in barring the suspension of driver’s licenses for the nonpayment of fees.
Gonzalez even had one piece of legislation, AB201, fail in its second house. That bill, which would have required more tracking and reporting on use of criminal informants, failed to advance out of a Senate committee after passing out of the Assembly along party lines.
Sen. James Ohrenschall (D-Las Vegas) was the only member of his caucus to have more than half of his bills fail. Though seven of his sponsored measures passed out of the Legislature, eleven other bills and resolutions from Ohrenschall failed to advance. Those bills often focused on the criminal justice system, including a measure that aimed to eliminate the death penalty for people who are convicted of first degree murder (SB228), though some stretched beyond that scope, such as an attempt to make Nevada the first state with an opt-out organ donation system (SB134) that failed to be voted out of committee.
Across the Senate and Assembly, eight Republican lawmakers had zero bills pass out of the Legislature. Those eight were Assembly members Alexis Hansen (R-Sparks), Annie Black (R-Mesquite), Andy Matthews (R-Las Vegas), Jill Dickman (R-Sparks), Jim Wheeler (R-Minden) and Richard McArthur (R-Las Vegas) and Sens. Carrie Buck (R-Henderson) and Pickard.
All eight of those Republicans were also among the least likely in their party to break from the majority of their caucus and vote with Democrats on legislation.
Those eight legislators introduced 70 measures combined, of which 58 died without ever receiving a committee hearing. Pickard was particularly unsuccessful, as he introduced 20 bills, and only one received a committee hearing before failing to advance past the first committee passage deadline in early April. The Henderson-based senator was previously derided by Democratic lawmakers, after backing out of a deal with Senate Democrats centered on a mining tax during one of the 2020 special sessions.
When were bills heard and when did they pass?
Throughout the session, lawmakers often waited until the latest possible days to complete the work needed for certain legislative deadlines.
In the week leading up to the first major deadline — bills and resolutions without an exemption were required to have passed out of their first committee by April 9 — lawmakers voted 336 bills out of committee. In the roughly nine weeks prior to that, only 236 bills were passed out of their first committee.
The other deadlines of the legislative session followed a similar pattern.
In the week leading up to and the week including the first house passage deadline (April 20), 340 bills received a vote in their first house, while just 71 bills were voted out of their first house in the 10 previous weeks.
The busiest week of the session was the week ending May 21, which included the second house passage deadline (May 20). During that week, 337 bills and resolutions were voted out of their second house, while a couple hundred more measures were acted on in some other way, including committee hearings, committee votes and first house votes.
The final shortened weekend of the session, stretching from May 29 through May 31, was also chock-full of legislative action, as lawmakers passed more than 150 bills out of their second house during those three final days.
From permanent expanded mail voting to the state public health option, the 2021 legislative session saw no shortage of headline-grabbing partisan disagreements — but a look at actual vote totals reveals that the vast majority of bills were passed with at least some bipartisan buy-in.
Out of nearly 1,200 votes on bills and resolutions during the 120-day session, 625 (53 percent) were passed with no lawmakers in opposition, and a small minority of 52 votes (4 percent) included just one “nay” vote. Meanwhile, roughly 100 votes (8 percent) happened strictly along party lines.
But there was a fourth, significant group of votes: on more than 150 votes, a minority of Republican lawmakers broke with their caucus and voted with Democrats, helping to pass bills ranging from marijuana DUI reform to expanded environmental protections.
So which Republicans were the most likely to side with Democrats?
The Nevada Independent analyzed and tallied every bill that received a recorded vote in at least one house where less than half of Republican caucus members supported the measure — a tally that includes 49 votes in the Senate and 104 in the Assembly. The analysis included any bill that received four or fewer votes from the nine-member Senate Republican Caucus and any bill that received seven or fewer votes from the 16-member Assembly Republican Caucus.
Instead of looking more broadly at all votes taken during the legislative session, focusing the analysis on the roughly 150 votes where less than half of Republican caucus members voted in favor of a particular bill offers a better view of which individual Republican lawmakers were most likely to cross party lines.
Because Democrats control both the Assembly and state Senate, no Republican-sponsored bills with even a whiff of partisanship made it to a full floor vote, though a handful of Democratic lawmakers proved willing to buck their party on a smaller number of votes.
The analysis reveals that Sens. Ben Kieckhefer (R-Reno) and Heidi Seevers Gansert (R-Reno) were the most likely to break with their caucus and vote with Democrats in the state Senate. On the Assembly side, Jill Tolles (R-Reno), Tom Roberts (R-Las Vegas) and Melissa Hardy (R-Henderson) most often broke with the rest of their caucus and sided with Democrats.
The guide below aims to take a look at what kinds of issues were at play when Republicans chose to break with the majority of their caucus on a particular issue — including high-profile votes on a new mining tax and a Democrat-backed effort to change Nevada to a presidential primary state.
We’ve double-checked our work to make sure we’ve counted every vote, but if you spot something off or think a vote wasn’t counted, feel free to email email@example.com.
Ben Kieckhefer: 36
Heidi Seevers Gansert: 33
Kieckhefer and Seevers Gansert voted with Democrats and against the majority of the Republican caucus 30 times, including eight times as the only two Republicans joining Democrats in support of a measure. Kieckhefer is termed out after the 2021 session and cannot run for re-election, and Seevers Gansert will not face voters until 2024 after winning her re-election race last year.
Both lawmakers broke party lines to join all Democrats in favor of AB115, allowing multiple parents to adopt a child, and AB181, a bill aimed at improving mental health parity and reporting on cases of attempted suicide.
Kieckhefer and Seevers Gansert were also among four Republican senators who voted with Democrats in favor of AB495, a bill that creates a new excise tax on the gross revenues of gold and silver companies, estimated to bring in an extra $150 million to $170 million a biennium for education. As the measure passed in the waning days of the session, Kieckhefer said the benefits of the bill outweighed the drawbacks, and Seevers Gansert pointed to the enhanced education funding as reason for voting in favor. The bill required a two-thirds majority to pass, as it created a new tax.
Seevers Gansert and Kieckhefer rarely broke from each other when crossing party lines to vote with Democrats. In one instance, Seevers Gansert was the lone Republican who sided with Democrats on SB237, a bill aimed at giving more support to LGBTQ-owned businesses, while no other Republicans did so. Kieckhefer had no such votes.
Pete Goicoechea: 20
Goicoechea joined Democrats as the lone Republican in support of AB148, which revises the application requirements for obtaining a permit to engage in an exploration project or mining operation.
He joined Kieckhefer and Seevers Gansert as the only members of their caucus to vote in support of AB126, which eliminates Nevada’s presidential caucus and replaces it with a primary election, and also aims to make the state first in the presidential primary calendar — ahead of New Hampshire and Iowa.
Goicoechea also broke from the majority of the Republican caucus to vote with Democrats in support of a few environment-related measures, including AB146, which expands efforts to mitigate water pollution, and AB71, which makes rare plant and animal locations confidential. The Eureka Republican is in his final term of office after winning re-election in 2020, and cannot run again in 2024.
Joe Hardy: 17
Hardy, who is termed out after this session, voted as the lone Republican in support of bills in the Senate more often than any other member of his caucus.
The Boulder City-based lawmaker joined Democrats as the only Republican in favor of SB61, which creates the Nevada Committee of Vendors Who Are Blind, as well as three other Democrat-sponsored bills — including a measure backed by Assembly Speaker Jason Frierson (D-Las Vegas), AB308, which requires a three-day grace period before landlords can charge late fees for overdue rent.
Hardy was one of three Republicans in the Senate who voted in favor of AB400, which removes “per se” limits on the amount of marijuana metabolite that can be in a person’s blood to trigger a DUI, though the limits remain when someone is facing a felony charge. He was also one of two Republicans in the caucus to back another marijuana-related bill, SB122, which requires occupational training for employees of cannabis establishments.
Scott Hammond: 14
The northwest Las Vegas Valley lawmaker was one of four Republican senators who voted in support of a new tax on the mining industry. Hammond previously said he would vote in support of the bill, AB495, “for all of our state’s students.”
Hammond also joined Democrats in voting in favor of AB296, which allows victims of ‘doxing’ to bring a civil action to recover damages, and SB450, which allows school districts to use excess revenue from existing tax rates to fund “pay as you go” capital improvement projects, such as remodels and needed facility upgrades.
Keith Pickard: 6
Along with Kieckhefer, Seevers Gansert and Hammond, Pickard voted in favor of the new excise tax on the mining industry through AB495, also citing increased education funding as reason for his support.
Pickard was also one of three Republican senators who voted in favor of removing “per se” limits on non-felony DUIs involving marijuana (AB400), and the Henderson-based legislator joined Kieckhefer and Seevers Gansert in voting in favor of raising the minimum age to buy tobacco products from 18 to 21, in line with federal law (AB59).
Ira Hansen: 5
Hansen was one of two Republican senators (along with Hardy) to record votes as the sole GOP member siding with Democrats on multiple votes.
Hansen was the only Republican who voted in favor of protecting the Spring Valley population of Rocky Mountain junipers, known as “swamp cedars” (AB171). Prior to the vote, Hansen had angered some Native advocates when he rebutted the historical accuracy of testimony shared by tribal leaders and elders.
He also was also the only member of his caucus to support SB349, which would have allowed unpackaged produce to be sold in farmers markets, but the legislation failed to advance in the Assembly.
Carrie Buck: 3
The freshman legislator rarely broke from the majority of the Republican caucus, only doing so to support an extension on school use of excess revenue for facility upgrades (SB450), cage-free eggs (AB399) and a clarification on registration requirements for lobbyists (AB110).
James Settelmeyer: 2
The Senate minority leader broke from the majority of his party less than any other Republican senator, only joining Democrats in support of two measures.
Settelmeyer joined Hardy and Pickard in support of removing “per se” limits on non-felony DUIs involving marijuana (AB400) and voted with Kieckhefer, Pickard and Seevers Gansert in support of a measure revising the issuance of orders for protection against high-risk behavior (SB6).
Jill Tolles: 92
Tom Roberts: 90
Among Assembly Republicans, Tolles and Roberts were the most likely to cross party lines and vote contrary to the majority of their caucus.
Out of the 104 votes in which a minority of the 16 Republican Assembly members joined Democrats in support, Tolles and Roberts voted together with Democrats 85 times, though only six of those votes featured no other Republicans in support.
Tolles and Roberts were the only two Republicans in the Assembly to vote in favor of the new mining tax (AB495) — giving the bill enough Republican votes to overcome the required two-thirds majority needed for a tax increase. Prior to the vote, both lawmakers spoke with The Nevada Independent about their rationale for the votes, stressing that they had gained concessions in exchange for their support and had an opportunity to improve education funding.
They were additionally the only members of their party to support other education-related measures, including an expansion of the core subjects contained within social studies in K-12 education (AB19) and a Democrat-sponsored bill to create the Task Force on Sexual Misconduct at Institutions of Higher Education (SB347).
Tolles and Roberts supported a wide range of Democrat-backed legislation, including measures focused on the economy, state government and criminal justice. The duo voted in support of a ban on race-based discrimination against certain hairstyles (SB327), a Frierson-backed effort to establish the Office of Small Business Advocacy (AB184) and a measure that doubles the fee on marriage licenses from $25 to $50 to better support sexual violence and domestic violence victim services in all counties (SB177).
Tolles has a history of voting more moderately than others in the Assembly Republican Caucus, and she was the only caucus member to join Democrats in support of legislation on multiple occasions. She was the only Assembly Republican to vote in favor of AB47, which gives the attorney general greater powers over mergers within the health care industry, and for AB382, an effort to license student loan servicers (that failed to receive a two-thirds majority).
Though he was not joined by Tolles, Roberts (who has said he plans to run for Clark County sheriff in 2022) voted with several other Republicans in favor of bills authorizing the licensing of cannabis consumption lounges (AB341) and a resolution to remove the Board of Regents’ constitutional protection (SJR7).
Melissa Hardy: 82
The Henderson-based assemblywoman was the lone member of the Republican caucus who voted in favor of AB85, which authorizes the State Quarantine Officer to declare any weed to be noxious by regulation.
Hardy also backed a wide range of Democrat-backed efforts, including a variety of bills sponsored by Frierson including a bill that eliminates Nevada’s presidential caucus and replaces it with a primary election (AB126).
In dissenting from the majority of the Assembly Republican Caucus, Hardy voted the same as both Tolles and Roberts 46 times, including when all three — along with Assemblyman Glen Leavitt (R-Boulder City) — joined Democrats in support of AB486, which is meant to ensure more tenants are connected with rental assistance as eviction protections expire.
Glen Leavitt: 55
Though Leavitt sided with Democrats more frequently than most other Assembly Republicans, he rarely did so without support from several other caucus members. There was only one instance in which Leavitt joined Democrats without at least three other Republicans in support of the measure.
In that case, just two other Republicans joined Leavitt and Assembly Democrats in favor of a bill allowing the State Board of Cosmetology to license a new group of people designated as “advanced estheticians” (SB291).
Additionally, Leavitt was among a minority group of seven Republicans who supported a pair of education measures from Sen. Marilyn Dondero Loop (D-Las Vegas), including SB173, also referred to as the “Back on Track Act,” which calls on districts to create learning loss prevention plans and set up summer school programs, and SB151, which is aimed at improving teacher-to-student ratios.
Heidi Kasama: 52
The freshman assemblywoman from Las Vegas was the only Republican in either house who voted in support of a Department of Employment, Training and Rehabilitation-backed measure, SB75, that makes technical changes to the regular unemployment system, such as allowing more flexibility on when claimants are eligible for benefit extensions. Other Republicans voiced concerns that the bill did not go far enough in addressing issues with the system.
Kasama and Hardy were also the only Republicans who voted in favor of banning the declawing of cats, though the measure, AB209, failed to advance through the Senate.
Lisa Krasner: 36
Krasner voted with a minority of her Republican colleagues on mostly Democrat-supported measures on three dozen occasions, including joining Tolles and Roberts in support of measures protecting swamp cedars in Spring Valley, AB171 and AJR4.
The Reno-based lawmaker also joined Tolles, Roberts, Hardy, Leavitt and Kasama in supporting SB448, an omnibus energy bill expanding the state’s transmission infrastructure that was passed out of the Assembly on the final day of the session.
Gregory Hafen: 30
The second-term legislator representing portions of Clark, Lincoln and Nye counties was one of only three Assembly Republicans who voted in favor of massively increasing fines for violating certain regulations from the Public Utilities Commission (SB18).
Hafen was also part of a limited group of Republicans who supported a change to the Live Entertainment Tax to exclude events held on behalf of a governmental entity (SB367) and a ban on race-based discrimination against certain hairstyles (SB327).
Alexis Hansen: 18
When Assemblywoman Alexis Hansen broke from her party majority and sided with Democrats, the Sparks-based lawmaker supported a wide range of measures, covering topics from health care to criminal justice to state government. Although she rarely joined fewer than four other party members in her dissent from the caucus, she was one of only two Republicans in the Assembly who voted to pass SB77, which exempts certain environmental impact reviews and discussions from the state’s open meeting law.
Robin Titus: 5
The minority floor leader rarely voted against the majority of her caucus, but Titus did join Democrats and several of her Republican colleagues in support of five bills, including a bill requiring state Medicaid plan coverage for doula services (AB256) and an appropriation of $5.4 million for upgrades to the Gaming Control Board’s IT systems (SB413).
Annie Black: 3
Though she was absent or not voting for more than 100 votes after being censured by other members of the Assembly for violating COVID-19 protocols, Black was one of the least likely to side with Democrats on a bill. She was, however, one of four Republicans in the Assembly who voted in favor of authorizing the licensing of cannabis consumption lounges (AB341).
The Nevada Legislative Freedom Caucus
At the beginning of the session, six Republican Assembly members announced the formation of the Nevada Legislative Freedom Caucus, a coalition of state legislators dedicated to the values of constitutional conservatism. Those six lawmakers — Jill Dickman, John Ellison, Andy Matthews, Richard McArthur, P.K. O’Neill and Jim Wheeler — rarely sided with Democrats.
P.K. O’Neill: 19
One member of the Freedom Caucus sided with Democrats significantly more often than any other, as O’Neill was one of just four Assembly Republicans who supported a measure requiring employers to allow people to use sick leave to care for ill family members (AB190).
The Carson City-based assemblyman also backed several Democrat-sponsored bills, including SB166, which clarifies that a crime does not need to be committed by someone with different characteristics than the victim to be considered a hate crime, and SB177, which doubles the fee on marriage licenses from $25 to $50 to better support sexual violence and domestic violence victim services in all the counties.
Jim Wheeler: 6
Jill Dickman: 6
Andy Matthews: 5
John Ellison: 3
Richard McArthur: 3
Almost every member of the Freedom Caucus was among the list of Republicans least likely to side with Democrats, though some threw support behind a few high-profile measures.
Dickman and Matthews were among four Assembly Republicans who voted in favor of authorizing the licensing of cannabis consumption lounges (AB341). McArthur supported a bill aimed at increasing the availability of peer support counseling for emergency response employees (AB96). Wheeler voted to pass a measure that increases fees on special Vegas Golden Knights license plates to help give more funds to charities (AB123).
Which Republicans broke up unanimous votes?
While votes throughout the legislative session were dominated by unanimous vote counts and instances of mixed support and opposition from Republicans, nearly 5 percent of all votes included just one lawmaker in opposition.
In the Senate, Hansen stood above the pack, providing the only “nay” vote 15 times out of 26 such votes in that chamber. Hansen was the lone opponent in the Senate against measures authorizing curbside pickup at dispensaries (SB168), banning race-based discrimination against certain hairstyles (SB327), decriminalizing traffic tickets (AB116) and requiring employees within the juvenile justice system to complete implicit bias training (SB108).
The other Senate Republicans who provided the only vote against a bill were Buck, who did so six times, Pickard, who did so twice, and Kieckhefer, who did so once. Buck was the only member of the caucus to not support a bill authorizing the sealing of someone’s criminal record after an unconditional pardon (AB219), and Pickard was the only Senate Republican to vote against an appropriation of $25 million for the UNLV Medical School (SB434).
In the Assembly, there were 26 votes that included a single “nay” vote. Ellison led the Republican caucus with 10, including votes against bills requiring the Board of Regents to waive tuition and fees for Native students attending Nevada public colleges and universities (AB262), prohibiting law enforcement agencies from having arrest or ticket quotas (AB186) and expanding the continuing education courses that law enforcement officers are required to take to include crisis intervention (AB304).
Other Assembly Republicans who stood alone in their opposition included Black, who provided the only “nay” vote on a bill five times, and McArthur, who did so twice. Hafen and Kasama were each the lone Assembly opponent to a bill once.
Which Democrats dissented from their party?
While disagreement among Republicans was far more common in the Democrat-controlled Legislature, a few Democrats in both houses were more likely to depart from the caucus consensus than their colleagues from the same party.
Sen. Dina Neal (D-North Las Vegas) was more likely to vote differently from the rest of the Senate Democrats than any other member of her party. Neal was the lone opposition vote to AB435, which expands a Commerce Tax exemption to include trade shows, and SB150, which requires local governments to authorize tiny houses in certain zoning districts. She previously expressed concerns that tiny homes might depreciate housing values or exacerbate zoning disparities.
Neal also dissented from the Senate Democratic Caucus to vote with her Republican colleagues at least three times, including voting against a bill that would have granted casino resorts greater authority to ban firearms on their premises (SB452).
Sens. Pat Spearman (D-North Las Vegas) and Mo Denis (D-Las Vegas) each disagreed with their fellow caucus members at least once. Spearman was the only Democrat who voted against a bill raising the minimum age to buy tobacco products from 18 to 21 (AB59), and Denis was the lone member of his party to not support an effort to license midwives (AB387). With Denis voting no, the bill fell one vote shy of the two-thirds majority it needed to pass.
In the Assembly, Brittney Miller (D-Las Vegas) was among the Democrats most likely to dissent from the majority position of the caucus. Miller was the lone opponent to a bill during two votes, including voting against SB172, which requires school districts and charter schools to develop programs for dual credits. Miller also joined a majority of Assembly Republicans in opposing a bill that prohibits homeowner associations from circumventing local ordinances when determining when construction can start in residential areas (AB249).
Assembly Ways and Means Committee Chair Maggie Carlton (D-Las Vegas) was the only Assembly member to oppose AB258, which clarifies existing law by requiring the trustees of the Clark County Library District to appoint an executive director, and AB477, which abolishes the DMV’s Revolving Account for the Assistance of the Department. She also joined the majority of the Assembly Republican Caucus in voting against SB190, which allows women to receive birth control through a pharmacy without a doctor’s visit.
Assembly Majority Floor Leader Teresa Benitez-Thompson (D-Reno) additionally dissented from her caucus on more than one occasion, as she provided the lone “nay” vote to AB435, which expands a Commerce Tax exemption to include trade shows. She was also joined by Assemblywoman Selena Torres (D-Las Vegas) in voting with a majority of Assembly Republicans against SB287, which formally recognizes UNLV and the Desert Research Institute (DRI) as land-grant institutions alongside UNR.
Crunch time has finally arrived for the Legislature, with lawmakers planning to work steadily through Sunday to work out compromises and pass scores of bills with less than a day and a half left in the 120-day session.
Much attention has been paid to negotiations over the long anticipated AB495 — the measure implementing a new excise tax on mining and various other education and health care changes, up for its first hearing on Sunday evening. But many other high-profile measures are finally approaching the finish line — including final votes on “Right to Return” legislation, as well as last-minute appropriations and amendments.
Here’s a look at some of the latest developments in Carson City on the penultimate day of session.
Physician aid in dying legislation will not advance
A deeply divisive bill that would have allowed terminally ill patients to self-administer life-ending medication is not moving forward.
Bill sponsor Edgar Flores (D-Las Vegas) told The Nevada Independent on Sunday that there was no consensus on AB351 and the bill would not receive any further hearings or a floor vote.
“I've lost all hope,” Flores said. “The position of the leadership is just, we don’t think the votes are there.”
Similar legislation divided Republicans and Democrats in 2017, when it passed 11-10 in the Senate. Democrats largely supported the measure, but the bill never made it to a final vote after it died in an Assembly committee. A 2019 measure sponsored by then Sen. David Parks (D-Las Vegas) also never received a floor vote after passing through its first committee.
Flores chalked the death of the bill up to ethical dilemmas and hesitancy to pass such a contentious piece of legislation. But he hopes to continue the dialogue in future sessions.
“It's funny how … there's very contested bills and then one session it just comes in and it goes right through,” Flores said. “And I think it's a lot of just that education component, and then kind of holding out, just being consistent.”
“There's an obvious trend where states are recognizing that there's folk who need it, and should have a right to request it if they want it,” Flores said. “So I think we'll come back in two years and do this whole thing again.”
— Tabitha Mueller
Assembly approves ‘Right to Return’ legislation, bill heads back to the Senate for final vote
The Assembly gave quick party-line approval to legislation that would guarantee the rights of laid-off gaming and tourism industry workers to return to their jobs.
The 26 Democratic Assembly members outvoted 16 Republicans to send SB386 back to the Senate for final concurrence on an amendment. The Senate voted along party lines last Wednesday to approve the legislation.
Lawmakers on Friday evening adopted an amendment that exempts small businesses — ones that prior to the pandemic employed 30 or fewer workers — from being affected by the so-called “Right to Return” legislation. The amendment likely exempts small restaurants and vendors operating in casinos from having to comply with the hiring requirements in the bill.
Assemblywoman Heidi Kasama (R-Las Vegas) urged lawmakers to vote against the legislation, saying its passage would hurt small businesses and 30 “seemed like an arbitrary number.”
However, Assemblywoman Maggie Carlton (D-Las Vegas) called SB386 a bill that “protects the people that built this state. They are the economic engine of Las Vegas.”
Carlton said the 78-day shutdown of the gaming industry in an effort to slow the spread of the pandemic a year ago March, “was done for the right reasons. This is also the right thing to do. This protects everyone.”
Gaming interests and the Culinary Union struck a deal on the high-profile legislation earlier last week, agreeing to limit the scope of the bill and exempting certain employee classes including managers and stage performers. The Nevada Resort Association agreed to take a neutral position on the bill in return for those concessions, though not all casino operators are on board with the proposed legislation.
SB386 would allow workers in the gaming and travel sectors the right to return to their jobs, covering those workers laid off after March 12, 2020, and who were employed for at least six months in the year before the governor’s first COVID-19 emergency declaration.
— Howard Stutz
Amendments to a bill pushing citations, rather than arrests, for minor crimes
A bill directing law enforcement to issue citations in lieu of arresting people for misdemeanor crimes, AB440, passed out of a conference committee Sunday morning with two amendments, one proposed by Sen. James Settelmeyer (R-Minden) and the other from Sen. Dallas Harris (D-Las Vegas).
Settelmeyer’s amendment establishes requirements for candidates running for county sheriff in rural Nevada counties. Specifically, the amendment lowers the population threshold for required qualifications from 100,000 to 30,000 and stipulates that a candidate running for county sheriff must have accumulated at least five years of service as a law enforcement officer and have been certified by the state or a federal law enforcement training program.
The other amendment gives law enforcement officials time to implement the measure, specifying that provisions within the act do not apply until the Division of Parole and Probation has sufficient resources to carry out the measure.
The bill passed out of the Assembly and Senate on party-line votes with Republicans in opposition.
— Tabitha Mueller
Gender-neutral bathrooms bill gets messy
A discussion over a bill requiring that single-stall bathrooms be designated as gender neutral going forward turned into a discussion about whether more urine ends up on the floor in men’s rooms.
Sen. Keith Pickard (R-Henderson) said he would oppose the bill — AB280 from Assemblywoman Sarah Peters (D-Reno) — because he doesn’t think there should be mandates on businesses to make their restrooms unisex. He also argued that “women have more sensitive sensibilities as a whole.”
“By doing this, we're going to be making all the restrooms men's rooms, and that will create problems for a good number of women in society,” Pickard said.
Sen. Joe Hardy (R-Boulder City), a doctor, also offered an anatomical explanation for why the floor of men’s rooms might be dirtier.
“So, it sounds to me like men are the problem, and they could work on that, but in the meantime, I think the bill is fine,” concluded Sen. Melanie Scheible (D-Las Vegas).
The committee ended up passing the bill — which “grandparents” in existing restrooms but governs future builds — with Republicans opposed.
— Michelle Rindels
$1 million to Immunize Nevada in AB355
AB355, a bill that already includes a variety of allocations for nonprofits, has a new proposed addition — $1 million for the statewide nonprofit Immunize Nevada.
Sen. Julia Ratti said the organization has seen a deluge of support for the COVID-19 vaccination effort, but much of that is strictly limited to the pandemic. Ratti said she doesn’t want the group to be shortchanged in its normal work.
“This gives them the flexibility to make sure that we're not disrupting the regular programming that they do for flu, back to school,” she said.
So far, the bill includes: $750,000 for the “Expanding the Leaderverse” initiative at UNLV’s International Gaming Institute, $350,000 for the “We the People” civics program in schools, more than $3 million for the Lou Ruvo Center for Brain Health, $1 million for the Nevada Blind Children’s Foundation and $2 million for the Springs Preserve in Las Vegas to develop an ethnobotanical garden for teaching indigenous farming techniques.
Assembly Ways and Means Chairwoman Maggie Carlton (D-Las Vegas) has said that nonprofits often approach the Legislature seeking allocations that they can leverage into further donations, and AB355 is a vehicle for such allocations.
When Gov. Steve Sisolak proposed establishing a Patient Protection Commission to conduct a top-to-bottom review of Nevada’s health care system, he told industry representatives that his goal was compromise — and that those not working toward that goal could lose their seats at the table.
Under a bill Sisolak put forward and the Legislature approved in 2019, the commission was established as an industry-heavy body, with a few patient and general public representatives added in, that would come together to address pressing health care issues in the state — in the vein of an industry working group that had successfully compromised on surprise emergency room billing legislation earlier that year.
Today, the commission’s representatives include two doctors, two hospital CEOs, one union health trust representative, one private insurance representative, one drug company executive, a regional behavioral health coordinator and two patient advocates.
But, if Assemblywoman Maggie Carlton (D-Las Vegas) has her way this session, the commission may soon see a shakeup of that membership.
A bill sponsored by Carlton, AB348, would overhaul the commission’s membership to instead center primarily around patient advocates and those who work in the nonprofit health care space.
Carlton, in presenting the bill to the Senate Health and Human Services Committee on Tuesday, lamented what she described as the commission’s “industry flavor,” suggesting it was at odds with the commission’s work, including with the Peterson-Milbank Program, which helps states set and implement health care cost growth targets.
“If we’re going to have real, honest, objective conversations, I believe the industry needs to step back and let other folks come forward and have those real conversations,” Carlton said. “This doesn’t say that the industry can’t participate, they just will not be voting members.”
In an email on Wednesday, Sisolak spokeswoman Meghin Delaney didn’t comment directly on the specifics of the legislation but said the governor supports “bringing more patient voices to the Commission and wants to ensure that all representatives of Nevada's health care community can participate in critical discussions about the future of care in our State.”
“Governor Sisolak is grateful to the members of the Patient Protection Commission who have spent the past year-and-a-half engaged in transparent and comprehensive dialogue about how to bring affordable and quality health care to Nevada’s residents,” she said.
Delaney also said the governor is “proud” of the commission’s acceptance into the Peterson-Milbank program and that he “looks forward to working closely with the Commission as they implement health care cost growth targets.”
AB348 would specifically require that the commission be made up of:
two patient advocates
one for-profit health care provider
one registered nurse who practices as a nonprofit hospital
one physician or registered nurse who practices at a federally qualified health center
one pharmacist not affiliated with any retail chain pharmacy, or a patient advocate
one public nonprofit hospital representative
one private nonprofit health insurer representative
one member with expertise advocating for the uninsured
one member with expertise advocating for people with special health care needs
one member who has expertise in health information technology and works with the Department of Health and Human Services
one representative of the general public
The bill also would transfer the Patient Protection Commission from the governor’s office to the director’s office in the Department of Health and Human Services. It also would require the commission to adopt bylaws and commission members to disclose conflicts of interest and abstain from votes when conflicts arise.
The Health Services Coalition, the Nevada State AFL-CIO and the Culinary Health Fund testified in support of the legislation on Tuesday.
While several industry representatives testified in favor of adding extra voices to the commission, they rebuffed the complete overhaul of the commission's membership as proposed by the bill, which would limit — or in the case of the pharmaceutical industry, entirely eliminate — their representation on the commission.
“We have no concern about the expansion of the commission but would request that the committee consider reinstating at least one more hospital to provide some of the diversity of that perspective and the cost drivers that go with that,” Jim Wadhams, a lobbyist for the Nevada Hospital Association, said during the Tuesday hearing.
But state Sen. Julia Ratti (D-Sparks), who chairs the Senate Health and Human Services Committee, was blunt in her assessment of the commission in its current form. During the hearing, Ratti said she has spent “significant” time working on the two bills that came out of the commission this session — a telehealth bill, SB5, and an all-payer claims database bill, SB40 — and that, in her view, the commission isn’t working.
Ratti praised the commission’s executive director, Sara Cholhagian, and said she believed there have been “good and sincere” efforts by the commission. But she also said she was “okay with trying something a little new.”
“I feel like I’ve been relatively engaged in this process, and I’ve tried to be a good, neutral player to continue to move things along,” Ratti said. “But I hope that, whether you have a seat on the board or not, that everybody stays engaged and we continue to try to figure out how to work together as people who care about advancing health care.”
Several members of the Patient Protection Commission, however, took issue with Ratti’s assessment of the commission during their Wednesday meeting, saying that it glossed over the hours of effort they put into building relationships with one another and trying to come to consensus.
“I am really disappointed, to say the least, about the opinion in the legislators’ minds that the commission is not working,” said Dr. Ikram Khan, the commission’s chair. “It may not be doing what the legislators, in their mind, thought should be happening, and there is always room for modifying the subjects to be addressed and brought to the commission.”
Members of the Senate Health and Human Services Committee voted on Tuesday evening on party lines to forward the bill to the Senate for a final vote. The committee’s two Republican members, Ben Kieckhefer (R-Reno) and Joe Hardy (R-Boulder City), voiced support for more industry representation on the commission and voted against the legislation.
The proposal passed out of the Assembly last week, also on party lines.
Disclosure: This story and all others about the Patient Protection Commission are edited by Managing Editor Elizabeth Thompson and/or Assistant Editor Michelle Rindels. Sara Cholhagian, the commission’s executive director, is in a relationship with Editor Jon Ralston.
Those included criminal justice reform measures that would have barred police from using deadly force if a subject appeared only to be a harm to themselves, a bill that would have created a treatment program option for people charged with misdemeanor domestic violence and another that would have promoted race-blind charging among prosecutors.
Other ideas — such as a bill relaxing rules around children playing without parent supervision, and one creating a “worksharing” program as an alternative to layoffs — also hit a wall after passing in their house of origin.
The next major legislative deadline comes Friday, when most bills not exempted from legislative rules have to pass out of their second chamber.
Below is a rundown of the bills that failed to move forward.
AB17: Sponsored by the state’s Division of Parole and Probation, this bill would have eliminated the distinction between an honorable and dishonorable discharge from parole or probation. It passed out of the Assembly on a party-line 26-16 vote, and was heard in the Senate Judiciary committee on April 27, but never came up for a vote before the deadline. It was opposed by the state district attorneys association.
AB129: This campaign finance transparency measure, sponsored by Assemblyman Tom Roberts (R-Las Vegas), would have required political action committees in the state to report their cash on hand totals when filing contribution and expenditure reports, similar to the requirement for political candidates. The bill passed unanimously out of the Assembly, but never received a hearing in the Senate.
AB160: Sponsored by Assemblywoman Selena Torres (D-Las Vegas), this bill would have required courts to allow credit for time served in confinement prior to a criminal conviction. The bill passed out of the Assembly on a 33-9 vote, but never received a hearing in the Senate Judiciary committee prior to the deadline.
AB180: A bill aimed at expanding supplemental policies attached to Medicare for people with disabilities failed to advance past the deadline after never receiving a hearing in the Senate Commerce and Labor committee. The measure was sponsored by Assemblywoman Alexis Hansen (R-Sparks) and passed out of the Assembly on a 40-2 vote.
AB201: Legislation sponsored by Assemblywoman Cecelia Gonzalez (D-Las Vegas) that aimed to require more tracking and reporting on use of criminal informants failed to advance out of committee by deadline. The bill, which was approved on a party-line 26-16 vote in the Assembly, was heard in the Senate on May 13 and was scheduled for a committee vote on Friday, but was pulled and never voted on.
AB209: Cats may have nine lives, but this bill from Assemblywoman Susie Martinez (D-Las Vegas) banning the practice of declawing a cat only had one life, which was snuffed out Friday without ever receiving a hearing in the Senate Natural Resources Committee. It previously passed out of the Assembly on a 28-14.
AB243: A bill that would have required courts to consider whether a defendant is younger than 21 when deciding a sentence failed to clear the deadline. The bill, whose primary sponsor was Assemblyman David Orentlicher (D-Las Vegas) would also authorize prosecutors to establish a system of race-blind charging when considering criminal charges or allegations of criminal delinquency against a child. The bill passed on party lines in the Assembly, with all Republicans opposed.
AB268: The Senate failed to advance a measure that would have required law enforcement agencies to post their use of force policies on their websites. It also would have prohibited police from using deadly force against a person solely based on the premise that the person is a danger to themselves, and if a reasonable peace officer would not consider that the person poses an imminent threat of death or serious harm to the officer or another person. The bill, whose lead sponsor was Assemblywoman Lisa Krasner (R-Reno), also had Democratic co-sponsors and passed unanimously out of the Assembly.
AB313: This bill would have adjusted the law for removing people from the executive board of a homeowners association, including allowing people voting by secret ballot to do so electronically. It was sponsored by Assemblywoman Alexis Hansen (R-Sparks) and passed in a 40-2 vote, with two Democrats against.
AB339: A bill allowing justice courts to create treatment programs for people convicted of misdemeanor battery that constitutes domestic violence did not survive a deadline. The measure would also have required a court to seal the record of a defendant who successfully completes the program, if it is at least seven years after the charge is conditionally dismissed. The bill, sponsored by Assemblywoman Rochelle Nguyen (D-Las Vegas), passed the Assembly with just one lawmaker opposed.
AB367: Nevada students will not see requirements for “disciplinary skills” in their American government instruction after this bill died. The measure sought to cultivate skills that help students discern the reliability of any given source, and was supported by the Clark County Education Association, which said it would help students tell the difference between information and misinformation. The bill passed with just two Democrats in the Assembly opposed.
AB384: This bill would have authorized a survey on sexual misconduct for students in the Nevada System of Higher Education and would have shaped a process for responding to reports of misconduct. It also would have required an annual report from the system on certain information about sexual misconduct. Sponsored by Assemblywoman Selena Torres (D-Las Vegas), the bill passed unanimously out of the Assembly.
AB395: This bill would have abolished the death penalty. Although it passed out of the Assembly on a party-line vote with Republicans opposed, Gov. Steve Sisolak announced the day before the deadline that the bill had no path forward in the Senate.
SB90: Members of the Assembly did not vote on this bill, which would have used different language to describe investigations of health care providers that turn out to be unsubstantiated. Rather than calling the regulatory probe an “investigation,” it would refer to it as a “review and evaluation” for purposes of employment, professional licensure or liability insurance. The bill, sponsored by Sen. Joe Hardy (R-Boulder City), passed unanimously in the Senate.
SB123: This bill would have relaxed the requirements for joining the Silver Haired Legislative Forum, which acts on issues of importance to seniors. It would have allowed people to be appointed to the forum as long as they had lived in Nevada for six months — down from five years — and would have reduced the residency requirement in the appointee’s senatorial district from three years to 30 days.
SB143: This so-called “Let Grow” bill with bipartisan sponsorship failed to clear Friday’s deadline. It would have spelled out that people aren’t abusing or neglecting a child just because they allow a child to do independent activities. It also explicitly stated that minorities and children living in poverty are disproportionately subject to intervention about their child-rearing practices and deserve equality under the law. Co-sponsored by Sen. Dallas Harris (D-Las Vegas) and Assemblywoman Alexis Hansen (R-Sparks), the bill passed unanimously out of the Senate.
SB218: Landlords would be required to disclose extra fees on the front page of a lease agreement, would not be allowed to assess late fees until three days after rent is due and would only be able to charge one prospective tenant at a time a fee for a rental application. The bill, sponsored by Sen. Julia Ratti (D-Sparks) passed the Senate on a 12-9 vote, with all Republicans opposed.
SB308: Assembly members did not vote on this bill, which would have required the Department of Employment, Training and Rehabilitation (DETR) to create a worksharing program through which employers could opt to reduce the hours of a group of employees instead of laying them off, and DETR would provide partial unemployment benefits to those workers. The measure, backed by Sen. Marilyn Dondero Loop (D-Las Vegas), passed the Senate in a 13-8 vote, with most Republicans opposed.
SB381: This bill, which aimed to modify and expand definitions in law around “service contracts” — defined as contracts where a provider agrees to repair, replace or perform maintenance on goods over a certain period of time — failed to advance out of the Assembly after passing unanimously in the Senate.
Members of the state Senate voted Wednesday to advance a trio of criminal justice reform bills sponsored by Sen. Dallas Harris (D-Las Vegas) that would add more limits on police use of deadly force, require additional recordkeeping on hate crimes and place rate caps on calls made to and from inmates.
The bills passed just as former police officer Derek Chauvin is on trial for the killing of George Floyd in Minneapolis — an incident that touched off a wave of protests last summer — and as protests continue over the death of Daunte Wright in Minnesota at the hands of police. But Harris said the national attention on police killings isn’t what is motivating her.
She remembers the 1992 Rodney King riots growing up. And as a Black woman, she says she’s conscious that she must be especially careful to keep her hands on the wheel and not make sudden movements when interacting with police.
“These are things that are ingrained in us growing up,” she said. “And so the imperative has always been there. I think other people are just kind of coming around to it, which is great.”
The three measures are among the 22 bills and resolutions passed out of both the Assembly and Senate on Wednesday, and part of the legislative rush ahead of the first house passage deadline next Tuesday.
Here’s a look at all three proposals, which now head to the Assembly.
Limits on police use of force
Members of the Senate voted along party lines to approve SB212, a bill that would put additional limits on police use of force, use of restraint chairs for people in police custody and police dispersal techniques during protests or demonstrations.
The bill requires police officers to use de-escalation techniques and other alternatives before resorting to higher levels of force to arrest an individual. It would also require police agencies to adopt use of force policies and training that take into account (before using deadly force) the potential threat posed by individuals not armed with a weapon, who are under 13 or over 70 years old, or are physically frail, mentally or physically disabled, pregnant, suffering from a mental health or behavioral health issue or experiencing a medical emergency.
The bill initially would have banned use of restraint chairs, but was amended to put limits on the practice including only using a restraint chair for persons who are physically violent, and if police get authorization from a higher-level officer to use the chair. The bill also limits use of the chair to no more than two hours unless authorized by a supervising officer. It would also ban use of a restraint chair for a person who is pregnant.
The measure also aims to put limits on police activities during protests or demonstrations, prohibiting officers from firing nonlethal rounds “indiscriminately” into a crowd or targeting a person’s head, pelvis or other vital areas. It also would require that police issue at least three orders to disperse and offer an egress route before firing chemical agents into a crowd (with some leeway in dangerous situations).
Some Republican lawmakers pushed back on the bill during a hearing and during the floor session Wednesday, saying statistics provided by bill advocates that showed Reno as having one of the highest rates of police killings of Black men were flawed and painted police in an unfairly negative light.
“This really boiled down to an attack,” Ira Hansen (R-Sparks) said about the bill in a floor speech.
Sen. Melanie Scheible (D-Las Vegas) said she works with police who are trying to serve honorably every day in her day job at the Clark County district attorney’s office.
“This bill perfectly hits on the places that it's necessary to have reform without imposing on the ability of an officer to utilize their good judgment and their training to effectuate their jobs adequately,” she said. “But it allows for better community trust, better community relationships, and for the progress and improvement of our law enforcement agencies moving forward.”
Recordkeeping on hate crimes
As written, SB148 would require that all state and local law enforcement agencies submit monthly records of all hate crimes to the state’s Central Repository for criminal history records. The bill would require hate crime statistics, including data on prosecution and sentencing, to be made available to the public.
The bill was approved on an 18-3 vote, with Republicans Scott Hammond, Ira Hansen and Joe Hardy all opposed. Hansen spoke against the principle of enhanced penalties for crimes committed based on a victim’s personal characteristics.
“The whole concept is flawed,” Hansen said. “I think we need to get back to the idea that all are equal in the eyes of the law, including all people that are victims of crime.”
Democrats, however, said the law is full of enhanced penalties, including for crimes against the elderly and against law enforcement.
“We are not yet perfect, but we are on our way to perfection,” said Sen. Pat Spearman (D-North Las Vegas). “And until we get there, then we will need these types of enhancements to make sure that those who break the law, pay.”
Rate caps on inmate calls
The state Public Utilities Commission (PUC) would be required to regulate and set rate caps on businesses that provide calling services for inmates under SB387.
The bill, which passed unanimously on Wednesday, would authorize the PUC to establish rate caps and charge limits on inmate calling services, and would require any competitive supplier of inmate calling services to both file their rates with the commission, and publish their rates, terms and conditions on its website for public view.
As it stands, a 15-minute call to or from a prison in the Nevada Department of Corrections costs $1.65 to $2.10.
“It’s not 1989 anymore, and the rates should be coming down,” Sen. Scott Hammond (R-Las Vegas) said ahead of the vote.
Harris said high calling costs prevent inmates from maintaining relationships with family, and that in turn could increase their chances of committing crime again when they leave prison. She also nodded to the multimillion dollar commissions that state prisons get from phone service companies — last session, the prison system estimated it would earn $10 million a biennium in commission from the phone service vendor.
“Can I necessarily be upset at agencies for wanting to get a little bit of additional funding where they can? No, not necessarily,” she said. “I just wish it didn't come on the backs of the folks who have the least.”
Hundreds of bills bit the dust on Friday, a deadline by which proposals needed to advance from their first committee or die, unless they have a special exemption.
Friday’s deadline day proved busy, with lawmakers passing out close to 120 bills or resolutions through marathon committee hearings, including measures abolishing capital punishment, imposing more gun control, allowing physicians to prescribe life-ending drugs to people with terminal illness and many others.
But when the frantic, all-day rush of virtual committee meetings finally ended, more than 280 measures had failed to meet the deadline — nearly a third of the roughly 925 bills and resolutions introduced so far this session. Casualties included a host of affordable housing measures, ticket taxes on major sports teams, paying inmates the minimum wage, Republican-backed election bills and a bevy of other dashed legislative dreams.
While the concepts could always reemerge as amendments to other bills or entirely new legislation in the remaining 52 days of the session, here’s a look at some of the ideas that appear to be in the legislative graveyard.
Raiders included in ticket tax
Tickets for Raiders and Golden Knights home games are exempt from a 9 percent Live Entertainment Tax on tickets, but an effort to bring them into the fold appears to be dead.
Sen. Dina Neal said she sponsored SB367 to create parity between those teams and other live events such as Cirque du Soleil shows. She said she doesn’t see a policy reason for the loophole, and argued it would only get harder to impose the tax on the teams’ tickets in the future as they started bringing in even more revenue.
But representatives from the teams argued that axing the exemption would violate the agreement on which the teams based their original moves to Nevada. They also speculated that subjecting teams to the tax would discourage more from relocating to the state.
More teeth in the public records act
In spite of a last-minute push from open government advocates, a bill to stiffen penalties for government agencies that violate the Nevada Public Records Act failed to survive the deadline.
The measure, AB276 from Assemblyman Andy Matthews (R-Las Vegas), would have allowed records requestors who prevail in a lawsuit be awarded twice the cost of their lawsuit. Local governments fiercely resisted the push, saying it would invite lawsuits.
"Even though this is disappointment ... I'm going to continue during my time here in the Legislature to continue to fight for that principle ... to make sure that our government is as open and accountable to the people as possible," Matthews said in an interview.
Minimum wage for inmates
Lawmakers failed to advance SB140, a bill from Sen. Dina Neal (D-Las Vegas) that would have required the state pay minimum wage to inmates.
During a hearing, former inmates testified that they sometimes made a dollar for an hour or even an entire day of work.
The bill also aimed to put inmates on a more solid footing ahead of their release. It would have limited deduction from prisoners’ wages to just family support and victim restitution and created an Offenders’ Release Fund so wages earned behind bars could be used when they leave.
COVID rule-free zones
A proposal to designate special zones within businesses for people who are vaccinated or recovered from COVID to mingle unbothered by government COVID-prevention rules failed to gain traction in the Legislature. The bill, SB323, was sponsored by Sen. James Settelmeyer (R-Minden).
The Nevada Association of Counties (NACO) brought forward SB10 to address local government shortfalls stemming from unexpected dips in property tax revenues.
Under current law, property taxes are capped at a certain percentage, with the goal of protecting property tax payers from burdensome increases year-over-year. Those caps can vary between zero and 3 percent for residential and zero and 8 percent for non-residential properties. The bill would have removed the ability for caps to drop below 3 percent and place a ceiling of 8 percent on tax caps for non-residential properties.
Opponents criticized the measure as an overstep of government authority in the wake of an economically devastating pandemic.
Three bills vehemently opposed by developers and development authorities quietly faded away after their first hearings.
Lauded by supporters as an opportunity to better understand Nevada’s rental market and take aim at bad-actor landlords, AB332, sponsored by Assemblywoman Sarah Peters (D-Reno), would have required the Housing Division of the Department of Business and Industry to establish a landlord registry containing a landlord's first and last name, information on rental units the landlord owns and rent prices.
AB331 and AB334, aimed at giving local governments the ability to raise money to support affordable housing projects, received heavy pushback from developers who said that the legislation would increase developers' fees and further negatively affect the market.
AB334, sponsored by Assemblywoman Shondra Summers Armstrong (D-Las Vegas), would have given local governments the option to require developers to follow inclusionary zoning policies. That means stipulating that a certain percentage of new construction has to be affordable for low-income households — or developers must pay a fee to avoid those requirements.
The bill would also have given municipalities the option to adopt fees referred to as linkage fees, ranging from $0.75 to $10 for each square foot of commercial or residential development.
Democratic Assemblywoman Elaine Marzola's AB331 asked larger cities and counties to establish five-year goals for preserving and producing affordable housing.
The bill, AB380, was heavily opposed by Southwest Gas and allies who claimed the bill would effectively end residential and commercial use of natural gas in the state.
Another bill requiring NV Energy to make a greater investment in energy efficiency programs, SB382, also failed to make it past the deadline. NV Energy opposed the bill, and said advocates should go through other avenues at the state Public Utilities Commission to accomplish their goals.
Bemoaned by development authorities, the bill would have limited the Governor's Office of Economic Development's suite of tax incentives and required that businesses receiving tax incentives make payments into a state fund for affordable housing.
It marked the latest effort by Benitez-Thompson and other legislative Democrats to improve the state's at-times criticized collection of incentives and abatements to businesses that meet certain capital investment, job creation or minimum hourly wage targets. Former Gov. Brian Sandoval set up most of the incentive programs, but some Democrats (and at times, Gov. Steve Sisolak) have criticized the office for being too generous with abatements.
Republican election bills fall flat
Entering the 2021 session, many Republican lawmakers said that one of their top priorities would be to shore up election security and undo many of the mail voting changes implemented ahead of the 2020 election.
But after Friday, the vast majority of those proposals lay in the scrap heap, with most not even receiving a hearing.
The casualties were numerous In the Assembly and included bills repealing expanded mail voting (AB134), requiring proof of identity before voting (AB137, AB163), requiring the registrar of voters in major counties be elected (AB297), and a proposal amending the Constitution to require the Legislature and not the Supreme Court canvass the vote (AJR13).
In the Senate, Republican-backed election bills not receiving a committee vote before the deadline included measures implementing voter ID requirements and ending ballot collection from non-family members (SB225), as well as a bill expanding mail-in voting but limiting deadlines more stringently than what Democratic lawmakers have proposed (SB301).
Right to repair
A “right to repair” bill that would have made it easier for independent repair shops to fix phones and laptops failed to make it past the deadline.
AB221, from Assemblywoman Selena Torres (D-Las Vegas), would have required manufacturers produce documentation and the parts and tools necessary to diagnose, maintain and repair electronic devices with values ranging from $100 to $5,000.
While environmentalists praised it as a way to reduce waste in landfills, technology companies argued it could create privacy risks and that an independent repair shop could do serious damage to a device even under the bill’s specifications.
Community college system
Even though the concept of breaking the Nevada System of Higher Education into two entities earned a mention in the governor’s State of the State address in January, a bill to carry out the concept never got a hearing.
Sen. James Settelmeyer (R-Minden) had carried the bill, SB321, that proposed a Nevada System of Community Colleges governed separately from the state’s universities.
Curbing governor’s emergency powers
Republicans were largely unsuccessful in their efforts to curb the governor’s emergency powers. AB93 and AB373, both of which would have made disaster declarations terminate after 15 days unless the Legislature extends them, failed to get hearings.
Members of the GOP have chafed against Gov. Steve Sisolak’s current state of emergency, which has lasted for more than a year.
The Democrat-controlled Legislature did not entertain AB176, a bill sponsored by Assemblywoman Alexis Hansen (R-Sparks) that would prohibits a doctor from performing an abortion on a minor until 48 hours after her parents or guardians were served a notice of the procedure in person or through certified mail.
Permanent Daylight Savings Time
A bill that would do away with sleep-disrupting time changes never got a hearing this session. SB153 from Sen. Joe Hardy (R-Boulder City) would have called for Nevada to stay on Daylight Savings Time year-round, although it was contingent on the state of California enacting similar legislation.
A legislative attempt to establish a state Division of Occupational Licensing brought together practitioners of oriental medicine, athletic trainers and cosmetologists on Thursday — all of whom oppose greater executive branch oversight.
The bill, SB335, would abolish five different occupational licensing boards — the Board of Homeopathic Medical Examiners, State Board of Oriental Medicine, State Board of Athletic Trainers, State Board of Massage Therapists and Board of Dental Examiners of Nevada — and bring those groups under the regulatory authority of a new division within the Department of Business and Industry. Combined, the five boards control more than 11,000 licenses across the state.
The bill would also allow for the appointment of advisory boards to assist in oversight of the occupations licensed by the division, including dentists, homeopathic medical examiners and athletic trainers. At least one member of the advisory board would have to hold a license in that profession, though the bill does not require any advisory boards to be appointed.
Opponents of the bill raised concerns that it would interfere with the practice of alternative medicine in the state, as the majority of those who testified in opposition during the hearing of the bill were members of the Oriental medicine board or advocates of homeopathic medicine. Oriental and homeopathic medicine can involve treatments such as acupuncture and herbal medicine.
“Abolishing the board and subsuming alternative medicine to allopathic medicine runs the risk of diluting the independence and legitimate effectiveness of this profession,” Lisa Grant, secretary-treasurer of the Oriental medicine board, said during the hearing.
Others in opposition expressed concerns that the new division would create unnecessary government oversight beyond the work of the Sunset Subcommittee, which reviews each state board and commission during the legislative interim and recommends which should be retired. And some bill opponents simply voiced general dismay.
“The board of athletic training recently progressed through the Sunset Subcommittee with a positive review,” Tedd Girouard, chair of the athletic trainers board, said during the hearing. “We are concerned that our board has been unjustly and unfairly, I guess, put into this situation to be abolished, and really don't understand what the metrics were that put us… in this bucket.”
Despite an overwhelming negative response to the bill — of 289 opinions filed on the bill so far, 284 are in opposition — the movement to overhaul the state’s occupational board system has been several years in the making.
In 2017, Sen. Keith Pickard (R-Henderson) sponsored a bill that he said during the Thursday hearing was aimed at addressing some of the “procedural and structural problems” of the occupational licensing boards. And a 2018 audit found that more than half of the boards were ignoring a 2010 directive on salary caps for state employees.
During the hearing, the bill’s sponsor, Sen. Joe Hardy (R-Boulder City), who also serves as a physician licensed by the state medical board, said the measure was aimed at ensuring that medical boards and practitioners within the state are adhering to the standards of care and are showing integrity.
The bill was primarily supported by members of the Nevada Dental Association, a branch of the American Dental Association that advocates for oral health care. In recent years, the state’s dental board, which licenses the dentists in the association, has dealt with resignations amid criticism from the governor, on top of issues with board operations and conflicts of interest that were revealed through a state audit.
“As many members of this committee are aware, the Nevada dental licensing board has had a history fraught with controversy and abuses,” Eddie Ableser, a lobbyist for the association, said during the hearing. “And the Nevada Dental Association stands with the efforts to change and reform boards across the state.”
Michael Brown, executive director of the Governor’s Office of Economic Development, explained that he and Terry Reynolds, director of the state’s business department, learned a lot from Utah’s occupational licensing division that informed the decision-making on introducing a similar division in Nevada.
Brown said that Utah has been able to reduce licensing barriers through the division, making it easier for professionals from other states to receive a license in a reasonable amount of time.
Previous attempts to overhaul the occupational boards have noted the potential high cost for establishing new oversight measures, such as the Division of Occupational Licensing, but no agency has yet submitted a fiscal note with an estimated price tag for the bill.
The measure does, however, call for 5 percent of fees received by various boards in the state — including the Board of Medical Examiners, State Board of Nursing and other health care licensing boards — to be deposited into an Occupational Licensing Account that would be used to fund the activities of the division.
Members of several boards that would not be abolished by the bill, including the Chiropractic Physicians' Board of Nevada and the Board of Osteopathic Medicine, testified in neutral during the hearing, calling for more conversations between the stakeholders and the sponsor of the bill.
“[The department’s] mission is the promotion of business and industry, which we are concerned might actually cause a lessening of consumer protection for Nevada's patients,” said Dan Musgrove, a lobbyist for the chiropractic board.
Thursday’s meeting marked the first hearing for the bill. The committee did not hold a vote on the measure.
Correction: This story has been updated at 3:35 p.m. on Friday, April 2 to reflectthat the Board of Homeopathic Medical Examiners did not testify in opposition to the bill and did testify in neutral.