Nv Business Health Insurance Small

							       Community Coalition for Oral Health
Community Coalition for Oral Health
Minutes – December 17, 2004
UNLV School of Dental Medicine
1001 Shadow Lane
Las Vegas, NV 89106

1. The Chair called the meeting to order at 1:05 P.M.

2. Roll call.

In attendance were:

Bob Anderson, Southern Nevada Dental Society
Sunny Ashabranner, GBPCA
Maury Astley, Nevada Dental Association
Sue Brooks, COW
Barbara Buckley, Nevada State Assembly
William Busch, Nevada State Board of Dental Examiners
Terri Chandler, Nevada State Health Division
Patty Craddock, Nevada Dental Association
Chris Forsch, State Health Division
Kathleen Kelly, Nevada State Board of Dental Examiners
Annette Lincicome, Huntridge Teen Clinic
Zakiya Moyenda, UNSOM, Pediatric Dental Residency Program
Dixie Rogers, 1 DAY Program
Michael Sanders, UNLV School of Dental Medicine
Jenney Sartin
Virginia Smith, Clark County School District
Nancy Whitman, Great Basin Primary Care Association
Cheri Ward, Miles for Smiles

3. Approve Minutes.

The minutes were approved as submitted by a unanimous vote.

4. Guest Speaker – Assemblywoman Barbara Buckely

Assemblywoman Buckley has lived in Nevada for 25 years. She graduated from UNLV in 1986
and then went to the University of Arizona for law school. She is a practicing attorney and the
Director of Clark County Legal Services. Clark County Legal Services has over 700 attorneys
who volunteer to provide pro bono legal services through their program so she is very familiar
with the population which the CCOH is trying to help. Assemblywoman Buckley has served in
the legislature since 1995. She became Majority Leader three sessions ago.

This year there are a lot of new faces in the legislature. They walk in as “blank slates”. The new
legislators care about health care issues but do not necessarily have a lot of knowledge about
specific issues. The Coalition should introduce itself to the new legislators and let them know
about the Coalition’s goals and objectives. Assemblywoman Buckley offered her assistance to
the Coalition and she also offered to introduce Coalition members to new legislators.
DRAFT

Assemblywoman Buckley has submitted a bill draft request (BDR 76) to create a program to
provide health care insurance for small business employees. The bill has come out of the
recommendations developed by the Legislative Committee on Health Care Subcommittee to
Study Health Insurance Expansion Options. The bill targets three populations: employees of
small businesses, pregnant women and the medically needy. Currently, employees of small
businesses in Nevada have the fourth highest uninsured rate in the nation. There is a direct
correlation between the size of a company and insurance coverage. Fewer small companies
provide health insurance than do large companies. The same correlation exists between low
wages and insurance coverage. Lower wage workers are less likely to have insurance coverage.

The bill would allow companies with fewer than 50 employees to purchase existing insurance
products. The employer would pay 50 percent of the cost of the coverage. The cost to the
employee would be subsidized by giving employees $100 a month to offset the cost of the
insurance. For pregnant women, the income level for Medicaid coverage would go from 133
percent of the federal poverty level, to 185 percent of the federal poverty level. Pregnant women
would have access to the full slate of Medicaid coverage for pregnant women (which has limited
dental). Finally, the bill would also provide individuals with a certain level of medical costs (>
$10,000 a year) with some kind of coverage.

According to Assemblywoman Buckley no new taxes will be needed to fund the program. The
State would apply for a federal Health Insurance Flexibility Act (HIFA) waiver. If granted, the
waiver would return approximately $95,000,000 of unused State Child Health Insurance Program
(SCHIP) dollars to Nevada. The State would have to match every federal dollar by 35 cents. Half
of the match would come from county indigent medical funds and half would come from existing
revenues. In addition, even if the HIFA waiver ended, the federal government would still provide
a 50 percent match.

In order to address concerns from the counties, representatives from University Medical Center in
Las Vegas and Washoe Medical Center in Reno were on the subcommittee that developed this
legislation. An analysis was done that showed that even if half of the county’s indigent medical
fund was used for the match, there would still be enough money to cover the costs of treating the
remaining uninsured.

Assemblywoman Buckley stated that this legislation is not going to solve all of the problems of
the uninsured but it is a step in the right direction. It is anticipated that in the first four years, the
program will provide coverage to 15,000 individuals who are currently uninsured.
When asked if the program would provide dental coverage, Assemblywoman Buckley stated that
small businesses would be able to purchase whatever coverage they wanted. Legislation
requiring “bare bones” coverage was passed in 1995. Requiring a minimum set of benefits in this
bill was nixed because it was felt that would be too controversial and it had the potential to kill
the entire bill. The Chamber of Commerce is looking at a minimum benefits bill and
Assemblywoman Buckley suggested the Coalition invite a representative from the Chamber to
speak to that bill.

When asked how this bill fits in with other bills to expand health care coverage that have been
introduced for the 2005 session, Assemblywoman Buckley stated that this bill is different from
the others. If the legislature tries to modify it too much, the partners will withdraw their support.
And if it gets changed too much, she herself will withdraw the bill.

Assemblywoman Buckley told members of the Coalition that if they want to support the bill they
should send a spokesperson to testify at the hearings. They should also contact members of the
DRAFT

Health Committee to express their support (Assemblywoman Sheila Leslie from Reno is the
Chair of the Assembly Health and Human Services Committee). In addition, supporters should
be vocal in voicing their opposition to a stripped down version of the bill.

In closing, Assemblywoman Buckley said that once it is developed, she will share a white paper
on the bill with Coalition members. Coalition members who wish to contact her can do so
through her main staff person, Alison Combs. In addition, Coalition members who need
assistance researching issues can do so by contacting the Legislative Council Bureau either
directly or through her office.

5. Verbal Announcement/Participating organization reports

      Secretary
           o This was the first month that participating organizations were asked to submit
               written reports to the secretary for compilation into a report to be distributed
               prior to the monthly meeting. It was quite successful, especially for being the
               first month this was tried, with nine organizations submitting written reports
           o Great Basin Primary Care Association has agreed to host a website for the
               CCOH. Patricia Durbin is in the process of setting it up.
           o The State Oral Health Program is continuing in efforts to secure additional
               funding for the 1DAY program.

      Treasurer
           o $1,100 has been collected in dues. $125 has been expended to set up the list
              serve.

      Coalition Coordinator
          o Melanie Azedor from Sunny radio in Las Vegas has indicated an interest in
               attending a coalition meeting. She would also like to attend the February Give
               Kids A Smile event so she can report on what happens during the clinic. (This
               information led to a discussion about forming a Public Relations Committee or
               Speakers Bureau. It was requested that this item be placed on the agenda for the
               January meeting).

6. The meeting adjourned at 2:00 p.m.

Next Meeting: The next CCOH meeting will be on Friday, January 14, 2005 at 1:00 p.m. at the
UNLV School of Dental Medicine campus located at 1001 Shadow Lane in Las Vegas.