[Rev. 3/13/2024 9:51:07 AM]
κ2023 Statutes of Nevada, Page 2263κ
Assembly Bill No. 434Committee on Health and Human Services
CHAPTER 390
[Approved: June 12, 2023]
AN ACT relating to prescription drugs; prohibiting certain pharmacy benefit managers and health carriers from taking certain actions against entities that participate in a federal program to facilitate the discounted purchase of prescription drugs; prohibiting a program administered by the Department of Health and Human Services to provide therapeutics to persons with human immunodeficiency virus from taking similar actions; imposing certain limitations on the use of money available to administer the program to provide therapeutics to persons with human immunodeficiency virus; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Existing federal law creates a program, known as the 340B Program, by which certain hospitals and other facilities that provide health care to low-income patients are able to purchase certain drugs at discounted rates. (42 U.S.C. § 256b) Existing law prohibits a pharmacy benefit manger from prohibiting a pharmacist or pharmacy from taking certain actions to assist a person in obtaining a less expensive alternative or generic drug. (NRS 683A.179) Existing law imposes certain requirements relating to the operation of health carriers. (NRS 687B.470-687B.850) Sections 1, 3, 6 and 7 of this bill prohibit pharmacy benefit managers and health carriers, including governmental entities that provide coverage for employees, from: (1) discriminating against a covered entity that participates in the 340B Program to purchase drugs at a discounted rate or a pharmacy that contracts with such an entity with regard to reimbursement; (2) taking certain actions to limit the ability of such an entity or pharmacy to receive the full benefit of participating in that program; (3) excluding such an entity or pharmacy from an insurance network because the entity or pharmacy participates in that program; (4) restricting the ability of a person to receive a 340B drug; or (5) taking certain other actions to limit the participation of an entity or pharmacy in the Program. Section 1 exempts from those prohibitions a pharmacy benefit manager that manages prescription drug benefits under Medicaid. Sections 1 and 3 also provide that the provisions of those sections do not prohibit the Department of Health and Human Services, the Division of Health Care Financing and Policy of the Department of Health and Human Services or a Medicaid managed care organization from taking certain actions necessary to comply with federal law or ensure the financial stability of the Medicaid program. Sections 2, 4 and 5 of this bill make conforming changes to indicate the proper placement of sections 1 and 3 in the Nevada Revised Statutes.
Existing law authorizes the Department of Health and Human Services to administer a program pursuant to federal law to provide therapeutics to treat certain persons who have been diagnosed with the human immunodeficiency virus. (NRS 439.529) Section 9 of this bill prescribes certain limitations on the use of money allocated to the program. Section 8 of this bill requires the program to take certain actions and refrain from certain activity to ensure that a covered provider that participates in the 340B Program to purchase drugs at a discounted rate or a pharmacy that contracts with such a provider receives the full benefit of participating in the Program. Section 8 additionally prohibits the program administered by the Department from: (1) denying a request from such a covered provider or contract pharmacy to participate in the network of the program in certain circumstances; or (2) engaging in certain discrimination against a covered provider or contract pharmacy.
κ2023 Statutes of Nevada, Page 2264 (CHAPTER 390, AB 434)κ
EXPLANATION Matter in bolded italics is new; matter between
brackets [omitted material] is material to be
omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 683A of NRS is hereby amended by adding thereto a new section to read as follows:
1. A pharmacy benefit manager shall not:
(a) Discriminate against a covered entity, a contract pharmacy or a 340B drug in the amount of reimbursement for any item or service or the procedures for obtaining such reimbursement;
(b) Assess any fee, chargeback, clawback or adjustment against a covered entity or contract pharmacy on the basis that the covered entity or contract pharmacy dispenses a 340B drug or otherwise limit the ability of a covered entity or contract pharmacy to receive the full benefit of purchasing the 340B drug at or below the ceiling price, as calculated pursuant to 42 U.S.C. § 256b(a)(1);
(c) Exclude a covered entity or contract pharmacy from any network because the covered entity or contract pharmacy dispenses a 340B drug;
(d) Restrict the ability of a person to receive a 340B drug, including, without limitation, by imposing a copayment, coinsurance, deductible or other cost-sharing obligation on the drug that is different from a similar drug on the basis that the drug is a 340B drug;
(e) Restrict the methods by which a covered entity or contract pharmacy may dispense or deliver a 340B drug or the entity through which a covered entity may dispense or deliver such a drug in a manner that does not apply to drugs that are not 340B drugs; or
(f) Prohibit a covered entity or contract pharmacy from purchasing a 340B drug or interfere with the ability of a covered entity or contract pharmacy to purchase a 340B drug.
2. This section does not:
(a) Apply to a pharmacy benefit manager that has entered into a contract with the Department of Health and Human Services pursuant to NRS 422.4053 when the pharmacy benefit manager is managing prescription drug benefits under Medicaid, including, without limitation, where such benefits are delivered through a Medicaid managed care organization.
(b) Prohibit the Department of Health and Human Services, the Division of Health Care Financing and Policy of the Department of Health and Human Services or a Medicaid managed care organization from taking such actions as are necessary to:
(1) Prevent duplicate discounts or rebates where prohibited by 42 U.S.C. § 256b(a)(5)(A); or
(2) Ensure the financial stability of the Medicaid program, including, without limitation, by including or enforcing provisions in any contract with a pharmacy benefit manager entered into pursuant to NRS 422.4053.
3. As used in this section:
(a) 340B drug means a prescription drug that is purchased by a covered entity under the 340B Program.
κ2023 Statutes of Nevada, Page 2265 (CHAPTER 390, AB 434)κ
(b) 340B Program means the drug pricing program established by the United States Secretary of Health and Human Services pursuant to section 340B of the Public Health Service Act, 42 U.S.C. § 256b, as amended.
(c) Contract pharmacy means a pharmacy that enters into a contract with a covered entity to dispense 340B drugs and provide related pharmacy services to the patients of the covered entity.
(d) Covered entity has the meaning ascribed to it in 42 U.S.C. § 256b(a)(4).
(e) Medicaid managed care organization has the meaning ascribed to it in 42 U.S.C. § 1396b(m).
(f) Network means a defined set of providers of health care who are under contract with a pharmacy benefit manager or third party to provide health care services to covered persons.
Sec. 2. NRS 683A.171 is hereby amended to read as follows:
683A.171 As used in NRS 683A.171 to 683A.179, inclusive, and section 1 of this act, unless the context otherwise requires, the words and terms defined in NRS 683A.172 to 683A.176, inclusive, have the meanings ascribed to them in those sections.
Sec. 3. Chapter 687B of NRS is hereby amended by adding thereto a new section to read as follows:
1. A health carrier shall not:
(a) Discriminate against a covered entity, a contract pharmacy or a 340B drug in the amount of reimbursement for any item or service or the procedures for obtaining such reimbursement;
(b) Assess any fee, chargeback, clawback or adjustment against a covered entity or contract pharmacy on the basis that the covered entity or contract pharmacy dispenses a 340B drug or otherwise limit the ability of a covered entity or contract pharmacy to receive the full benefit of purchasing the 340B drug at or below the ceiling price, as calculated pursuant to 42 U.S.C. § 256b(a)(1);
(c) Exclude a covered entity or contract pharmacy from any network because the covered entity or contract pharmacy dispenses a 340B drug;
(d) Restrict the ability of a person to receive a 340B drug, including, without limitation, by imposing a copayment, coinsurance, deductible or other cost-sharing obligation on the drug that is different from a similar drug on the basis that the drug is a 340B drug;
(e) Restrict the methods by which a covered entity or contract pharmacy may dispense or deliver a 340B drug or the entity through which a covered entity may dispense or deliver such a drug in a manner that does not apply to drugs that are not 340B drugs; or
(f) Prohibit a covered entity or contract pharmacy from purchasing a 340B drug or interfere with the ability of a covered entity or contract pharmacy to purchase a 340B drug.
2. This section does not prohibit the Department of Health and Human Services, the Division of Health Care Financing and Policy of the Department of Health and Human Services or a Medicaid managed care organization from taking such actions as are necessary to:
(a) Prevent duplicate discounts or rebates where prohibited by 42 U.S.C. § 256b(a)(5)(A); or
(b) Ensure the financial stability of the Medicaid program, including, without limitation, by including or enforcing provisions in any relevant contract.
κ2023 Statutes of Nevada, Page 2266 (CHAPTER 390, AB 434)κ
3. As used in this section:
(a) 340B drug means a prescription drug that is purchased by a covered entity under the 340B Program.
(b) 340B Program means the drug pricing program established by the United States Secretary of Health and Human Services pursuant to section 340B of the Public Health Service Act, 42 U.S.C. § 256b, as amended.
(c) Contract pharmacy means a pharmacy that enters into a contract with a covered entity to dispense 340B drugs and provide related pharmacy services to the patients of the covered entity.
(d) Covered entity has the meaning ascribed to it in 42 U.S.C. § 256b(a)(4).
(e) Medicaid managed care organization has the meaning ascribed to it in 42 U.S.C. § 1396b(m).
Sec. 4. NRS 687B.600 is hereby amended to read as follows:
687B.600 As used in NRS 687B.600 to 687B.850, inclusive, and section 3 of this act, unless the context otherwise requires, the words and terms defined in NRS 687B.602 to 687B.665, inclusive, have the meanings ascribed to them in those sections.
Sec. 5. NRS 687B.670 is hereby amended to read as follows:
687B.670 If a health carrier offers or issues a network plan, the health carrier shall, with regard to that network plan:
1. Comply with all applicable requirements set forth in NRS 687B.600 to 687B.850, inclusive [;] , and section 3 of this act;
2. As applicable, ensure that each contract entered into for the purposes of the network plan between a participating provider of health care and the health carrier complies with the requirements set forth in NRS 687B.600 to 687B.850, inclusive [;] , and section 3 of this act; and
3. As applicable, ensure that the network plan complies with the requirements set forth in NRS 687B.600 to 687B.850, inclusive [.] , and section 3 of this act.
Sec. 6. NRS 287.010 is hereby amended to read as follows:
287.010 1. The governing body of any county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency of the State of Nevada may:
(a) Adopt and carry into effect a system of group life, accident or health insurance, or any combination thereof, for the benefit of its officers and employees, and the dependents of officers and employees who elect to accept the insurance and who, where necessary, have authorized the governing body to make deductions from their compensation for the payment of premiums on the insurance.
(b) Purchase group policies of life, accident or health insurance, or any combination thereof, for the benefit of such officers and employees, and the dependents of such officers and employees, as have authorized the purchase, from insurance companies authorized to transact the business of such insurance in the State of Nevada, and, where necessary, deduct from the compensation of officers and employees the premiums upon insurance and pay the deductions upon the premiums.
(c) Provide group life, accident or health coverage through a self-insurance reserve fund and, where necessary, deduct contributions to the maintenance of the fund from the compensation of officers and employees and pay the deductions into the fund. The money accumulated for this purpose through deductions from the compensation of officers and employees and contributions of the governing body must be maintained as an internal service fund as defined by NRS 354.543.
κ2023 Statutes of Nevada, Page 2267 (CHAPTER 390, AB 434)κ
employees and contributions of the governing body must be maintained as an internal service fund as defined by NRS 354.543. The money must be deposited in a state or national bank or credit union authorized to transact business in the State of Nevada. Any independent administrator of a fund created under this section is subject to the licensing requirements of chapter 683A of NRS, and must be a resident of this State. Any contract with an independent administrator must be approved by the Commissioner of Insurance as to the reasonableness of administrative charges in relation to contributions collected and benefits provided. The provisions of NRS 686A.135, 687B.352, 687B.408, 687B.723, 687B.725, 689B.030 to 689B.050, inclusive, 689B.265, 689B.287 and 689B.500 and section 3 of this act apply to coverage provided pursuant to this paragraph, except that the provisions of NRS 689B.0378, 689B.03785 and 689B.500 only apply to coverage for active officers and employees of the governing body, or the dependents of such officers and employees.
(d) Defray part or all of the cost of maintenance of a self-insurance fund or of the premiums upon insurance. The money for contributions must be budgeted for in accordance with the laws governing the county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency of the State of Nevada.
2. If a school district offers group insurance to its officers and employees pursuant to this section, members of the board of trustees of the school district must not be excluded from participating in the group insurance. If the amount of the deductions from compensation required to pay for the group insurance exceeds the compensation to which a trustee is entitled, the difference must be paid by the trustee.
3. In any county in which a legal services organization exists, the governing body of the county, or of any school district, municipal corporation, political subdivision, public corporation or other local governmental agency of the State of Nevada in the county, may enter into a contract with the legal services organization pursuant to which the officers and employees of the legal services organization, and the dependents of those officers and employees, are eligible for any life, accident or health insurance provided pursuant to this section to the officers and employees, and the dependents of the officers and employees, of the county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency.
4. If a contract is entered into pursuant to subsection 3, the officers and employees of the legal services organization:
(a) Shall be deemed, solely for the purposes of this section, to be officers and employees of the county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency with which the legal services organization has contracted; and
(b) Must be required by the contract to pay the premiums or contributions for all insurance which they elect to accept or of which they authorize the purchase.
5. A contract that is entered into pursuant to subsection 3:
(a) Must be submitted to the Commissioner of Insurance for approval not less than 30 days before the date on which the contract is to become effective.
(b) Does not become effective unless approved by the Commissioner.
(c) Shall be deemed to be approved if not disapproved by the Commissioner within 30 days after its submission.
κ2023 Statutes of Nevada, Page 2268 (CHAPTER 390, AB 434)κ
6. As used in this section, legal services organization means an organization that operates a program for legal aid and receives money pursuant to NRS 19.031.
Sec. 7. NRS 287.04335 is hereby amended to read as follows:
287.04335 If the Board provides health insurance through a plan of self-insurance, it shall comply with the provisions of NRS 686A.135, 687B.352, 687B.409, 687B.723, 687B.725, 689B.0353, 689B.255, 695C.1723, 695G.150, 695G.155, 695G.160, 695G.162, 695G.1635, 695G.164, 695G.1645, 695G.1665, 695G.167, 695G.1675, 695G.170 to 695G.174, inclusive, 695G.176, 695G.177, 695G.200 to 695G.230, inclusive, 695G.241 to 695G.310, inclusive, and 695G.405, and section 3 of this act, in the same manner as an insurer that is licensed pursuant to title 57 of NRS is required to comply with those provisions.
Sec. 8. Chapter 439 of NRS is hereby amended by adding thereto a new section to read as follows:
1. If the Department administers a program pursuant to NRS 439.529:
(a) The program may not prohibit or interfere with the ability of a covered provider or contract pharmacy to purchase, administer or dispense, as applicable, a 340B drug, regardless of whether the drug is dispensed or administered to a person participating in the program or whether the program pays all, part or none of the cost of the drug.
(b) When a covered provider or contract pharmacy dispenses or administers a drug that is eligible to be a 340B drug to a person participating in the program and the program pays the insurance premium of the person and the copayment, coinsurance, deductible or other cost-sharing obligation of the person, the program shall pay to the covered provider or contract pharmacy the full amount of the copayment, coinsurance, deductible or other cost-sharing obligation, regardless of whether the drug is a 340B drug.
(c) The program may not deny a request from a covered provider or contract pharmacy to be included in the network of the program if the covered provider or contract pharmacy:
(1) Meets the terms and conditions for participation in the network of the program; and
(2) Requests to participate in the network of the program.
(d) The program shall not treat a covered provider or contract pharmacy differently from an entity that does not participate in the 340B Program or a pharmacy that has contracted with a covered provider, as applicable, in any manner, including, without limitation:
(1) In any regulation, guidance, policy, procedure or contract;
(2) With regard to participation in the network of the program; or
(3) In any matter relating to the dispensing of drugs or billing and reimbursement for drugs.
2. As used in this section:
(a) 340B drug means a prescription drug that is purchased under the 340B Program.
(b) 340B Program means the drug pricing program established by the United States Secretary of Health and Human Services pursuant to section 340B of the Public Health Service Act, 42 U.S.C. § 256b, as amended.
κ2023 Statutes of Nevada, Page 2269 (CHAPTER 390, AB 434)κ
(c) Contract pharmacy means a pharmacy that enters into a contract with a covered provider to dispense 340B drugs and provide related pharmacy services to the patients of the covered provider.
(d) Covered entity has the meaning ascribed to it in 42 U.S.C. § 256b(a)(4).
(e) Covered provider means a covered entity other than the program established pursuant to NRS 439.529.
(f) Network means a defined set of providers of health care who are under contract with any program established pursuant to NRS 439.529 to provide health care services to persons who participate in the program.
Sec. 9. NRS 439.529 is hereby amended to read as follows:
439.529 1. The Department may, to the extent that money is available, administer a program pursuant to 42 U.S.C. §§ 300ff-21 et seq. to provide therapeutics to treat certain persons who have been diagnosed with the human immunodeficiency virus and to prevent the serious deterioration of the health of such persons. The program may include the provision of subsidies and pharmaceutical services.
2. The Director shall:
(a) Establish the criteria for eligibility for participation in the program administered pursuant to this section, which must be in accordance with the provisions of 42 U.S.C. §§ 300ff-21 et seq.; and
(b) Prescribe the manner in which the program will be administered and services will be provided.
3. The Department may use any other program administered by the Department to facilitate the provision of subsidies and services pursuant to this section, including, without limitation, the provision of subsidies for pharmaceutical services to senior citizens and persons with disabilities pursuant to NRS 439.635 to 439.690, inclusive. If the Department uses another program to facilitate the provision of subsidies and services pursuant to this section, the Department shall not commingle the money available to carry out the provisions of this section and the money available to carry out the other program.
4. Money available to carry out the provisions of this section must be accounted for separately by the Department. The Department shall use such money only to pay for or subsidize the cost of:
(a) Drugs approved by the United States Food and Drug Administration;
(b) Insurance premiums, deductibles, copayments, coinsurance or other cost-sharing obligations associated with private health insurance; and
(c) Services that improve access to, adherence to and monitoring of drug treatment.
Sec. 10. 1. This section becomes effective upon passage and approval.
2. Sections 1 to 9, inclusive, of this act become effective:
(a) Upon passage and approval for the purpose of adopting any regulations and performing any other preparatory administrative tasks that are necessary to carry out the provisions of this act; and
(b) On January 1, 2024, for all other purposes.
________
κ2023 Statutes of Nevada, Page 2270κ
Assembly Bill No. 158Assemblymen ONeill, Gray, Kasama; DeLong, Dickman, Gallant, Gurr, Hansen, Hibbetts and Koenig
CHAPTER 391
[Approved: June 12, 2023]
AN ACT relating to emergency medical services; ratifying the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact; making an appropriation; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Existing law generally provides for the certification and regulation of advanced emergency medical technicians, emergency medical technicians and paramedics in this State. (Chapter 450B of NRS) Section 2 of this bill ratifies the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact. The Compact authorizes: (1) emergency medical service personnel who are certified in this State to perform their professional duties in any other state that has ratified the Compact; and (2) emergency medical service personnel who are certified in another state that has ratified the Compact to perform their professional duties in this State. Sections 1, 3-7 and 9-21 of this bill make various changes to clarify that a person who is authorized to practice as an emergency medical technician, advanced emergency medical technician or paramedic under the Compact, including by serving as an attendant on an ambulance or air ambulance: (1) is not prohibited from doing so because he or she is not licensed or certified in this State; and (2) is legally equivalent to an emergency medical technician, advanced emergency medical technician or paramedic who is certified in this State for certain purposes. Section 8 of this bill provides that a person who is authorized to practice as an emergency medical technician, advanced emergency medical technician or paramedic under the Compact is not eligible for an endorsement to provide community paramedicine services. Section 21.5 of this bill makes an appropriation to the Division of Public and Behavioral Health of the Department of Health and Human Services to cover certain fees related to the coordinated database established under the Compact.
EXPLANATION Matter in bolded italics is new; matter between
brackets [omitted material] is material to be
omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. NRS 441A.195 is hereby amended to read as follows:
441A.195 1. Except as otherwise provided in NRS 259.047, a law enforcement officer, correctional officer, emergency medical attendant, firefighter, county coroner or medical examiner or any of their employees or volunteers, any other person who is employed by or is a volunteer for an agency of criminal justice or any other public employee or volunteer for a public agency who, in the course of his or her official duties, comes into contact with human blood or bodily fluids, or the employer of such a person or the public agency for which the person volunteers, may petition a court for an order requiring the testing of a person or decedent for exposure to a communicable disease if:
(a) The officer, emergency medical attendant, firefighter, county coroner or medical examiner or their employee or volunteer, other person employed by or volunteering for an agency of criminal justice or other public employee or volunteer for a public agency was likely exposed to a communicable disease; and
κ2023 Statutes of Nevada, Page 2271 (CHAPTER 391, AB 158)κ
by or volunteering for an agency of criminal justice or other public employee or volunteer for a public agency was likely exposed to a communicable disease; and
(b) Testing of the person or decedent is necessary to determine the appropriate treatment for the officer, emergency medical attendant, firefighter, county coroner, medical examiner, employee or volunteer.
2. When possible, before filing a petition pursuant to subsection 1, the person, employer or public agency for which the person volunteers, and who is petitioning shall submit information concerning the likely exposure to a communicable disease to the designated health care officer for the employer or public agency or, if there is no designated health care officer, the person designated by the employer or public agency to document and verify likely exposure to communicable diseases, for verification that there was substantial exposure. Each designated health care officer or person designated by an employer or public agency to document and verify likely exposure to communicable diseases shall establish guidelines based on current scientific information to determine substantial exposure.
3. A court shall promptly hear a petition filed pursuant to subsection 1 and determine whether there is probable cause to believe that a likely transfer of blood or other bodily fluids occurred between the person who filed the petition or on whose behalf the petition was filed and the person or decedent who likely exposed him or her to a communicable disease. If the court determines that such probable cause exists, the court shall:
(a) Order the person who likely exposed the petitioner, or the person on whose behalf the petition was filed, to a communicable disease to submit two appropriate specimens to a local hospital or medical laboratory for testing for exposure to a communicable disease; or
(b) Order that two appropriate specimens be taken from the decedent who likely exposed the petitioner, or the person on whose behalf the petition was filed, to a communicable disease and be submitted to a local hospital or medical laboratory for testing for exposure to the communicable disease.
Κ The local hospital or medical laboratory shall perform the test in accordance with generally accepted medical practices and shall disclose the results of the test in the manner set forth in NRS 629.069.
4. If a judge or a justice of the peace enters an order pursuant to this section, the judge or justice of the peace may authorize the designated health care officer or the person designated by the employer or public agency to document and verify likely exposure to a communicable disease to sign the name of the judge or justice of the peace on a duplicate order. Such a duplicate order shall be deemed to be an order of the court. As soon as practicable after the duplicate order is signed, the duplicate order must be returned to the judge or justice of the peace who authorized the signing of it and must indicate on its face the judge or justice of the peace to whom it is to be returned. The judge or justice of the peace, upon receiving the returned order, shall endorse the order with his or her name and enter the date on which the order was returned. Any failure of the judge or justice of the peace to make such an endorsement and entry does not in and of itself invalidate the order.
5. Except as otherwise provided in NRS 629.069, all records submitted to the court in connection with a petition filed pursuant to this section and any proceedings concerning the petition are confidential and the judge or justice of the peace shall order the records and any record of the proceedings to be sealed and to be opened for inspection only upon an order of the court for good cause shown.
κ2023 Statutes of Nevada, Page 2272 (CHAPTER 391, AB 158)κ
6. A court may establish rules to allow a judge or justice of the peace to conduct a hearing or issue an order pursuant to this section by electronic or telephonic means.
7. The employer of a person or the public agency for which the person volunteers, who files a petition or on whose behalf a petition is filed pursuant to this section or the insurer of the employer or public agency, shall pay the cost of performing the test pursuant to subsection 3.
8. As used in this section:
(a) Agency of criminal justice has the meaning ascribed to it in NRS 179A.030.
(b) Emergency medical attendant means a person [licensed] who is:
(1) Licensed as an attendant or certified as an emergency medical technician, advanced emergency medical technician or paramedic pursuant to chapter 450B of NRS [.] ; or
(2) Authorized to practice as an emergency medical technician, advanced emergency medical technician or paramedic in this State under the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact ratified by section 2 of this act.
Sec. 2. Chapter 450B of NRS is hereby amended by adding thereto a new section to read as follows:
The Recognition of Emergency Medical Services Personnel Licensure Interstate Compact is hereby ratified and entered into with all other jurisdictions legally joining the Compact, in substantially the form set forth in this section:
RECOGNITION OF EMERGENCY MEDICAL SERVICES PERSONNEL LICENSURE INTERSTATE COMPACT
SECTION 1. PURPOSE
In order to protect the public through verification of competency and ensure accountability for patient care related activities all states license emergency medical services (EMS) personnel, such as emergency medical technicians (EMTs), advanced EMTs and paramedics. This Compact is intended to facilitate the day-to-day movement of EMS personnel across state boundaries in the performance of their EMS duties as assigned by an appropriate authority and authorize state EMS offices to afford immediate legal recognition to EMS personnel licensed in a member state. This Compact recognizes that states have a vested interest in protecting the publics health and safety through their licensing and regulation of EMS personnel and that such state regulation shared among the member states will best protect public health and safety. This Compact is designed to achieve the following purposes and objectives:
1. Increase public access to EMS personnel;
2. Enhance the states ability to protect the publics health and safety, especially patient safety;
3. Encourage the cooperation of member states in the areas of EMS personnel licensure and regulation;
4. Support licensing of military members who are separating from an active duty tour and their spouses;
κ2023 Statutes of Nevada, Page 2273 (CHAPTER 391, AB 158)κ
5. Facilitate the exchange of information between member states regarding EMS personnel licensure, adverse action and significant investigatory information;
6. Promote compliance with the laws governing EMS personnel practice in each member state; and
7. Invest all member states with the authority to hold EMS personnel accountable through the mutual recognition of member state licenses.
SECTION 2. DEFINITIONS
In this Compact:
A. Advanced emergency medical technician (AEMT) means an individual licensed with cognitive knowledge and a scope of practice that corresponds to that level in the National EMS Education Standards and National EMS Scope of Practice Model.
B. Adverse action means any administrative, civil, equitable or criminal action permitted by a states laws which may be imposed against licensed EMS personnel by a state EMS authority or state court, including, but not limited to, actions against an individuals license such as revocation, suspension, probation, consent agreement, monitoring or other limitation or encumbrance on the individuals practice, letters of reprimand or admonition, fines, criminal convictions and state court judgments enforcing adverse actions by the state EMS authority.
C. Alternative program means a voluntary, nondisciplinary substance abuse recovery program approved by a state EMS authority.
D. Certification means the successful verification of entry-level cognitive and psychomotor competency using a reliable, validated and legally defensible examination.
E. Commission means the national administrative body of which all states that have enacted the Compact are members.
F. Emergency medical technician (EMT) means an individual licensed with cognitive knowledge and a scope of practice that corresponds to that level in the National EMS Education Standards and National EMS Scope of Practice Model.
G. Home state means a member state where an individual is licensed to practice emergency medical services.
H. License means the authorization by a state for an individual to practice as an EMT, AEMT, paramedic or a level in between EMT and paramedic.
I. Medical director means a physician licensed in a member state who is accountable for the care delivered by EMS personnel.
J. Member state means a state that has enacted this Compact.
K. Privilege to practice means an individuals authority to deliver emergency medical services in remote states as authorized under this Compact.
L. Paramedic means an individual licensed with cognitive knowledge and a scope of practice that corresponds to that level in the National EMS Education Standards and National EMS Scope of Practice Model.
M. Remote state means a member state in which an individual is not licensed.
N. Restricted means the outcome of an adverse action that limits a license or the privilege to practice.
κ2023 Statutes of Nevada, Page 2274 (CHAPTER 391, AB 158)κ
O. Rule means a written statement by the Commission promulgated pursuant to Section 12 of this Compact that is of general applicability, implements, interprets, or prescribes a policy or provision of the Compact, or is an organizational, procedural or practice requirement of the Commission and has the force and effect of statutory law in a member state and includes the amendment, repeal or suspension of an existing rule.
P. Scope of practice means defined parameters of various duties or services that may be provided by an individual with specific credentials. Whether regulated by rule, statute or court decision, it tends to represent the limits of services an individual may perform.
Q. Significant investigatory information means:
1. Investigative information that a state EMS authority, after a preliminary inquiry that includes notification and an opportunity to respond if required by state law, has reason to believe, if proved true, would result in the imposition of an adverse action on a license or privilege to practice; or
2. Investigative information that indicates that the individual represents an immediate threat to public health and safety regardless of whether the individual has been notified and had an opportunity to respond.
R. State means any state, commonwealth, district or territory of the United States.
S. State EMS authority means the board, office or other agency with the legislative mandate to license EMS personnel.
SECTION 3. HOME STATE LICENSURE
A. Any member state in which an individual holds a current license shall be deemed a home state for purposes of this Compact.
B. Any member state may require an individual to obtain and retain a license to be authorized to practice in the member state under circumstances not authorized by the privilege to practice under the terms of this Compact.
C. A home states license authorizes an individual to practice in a remote state under the privilege to practice only if the home state:
1. Currently requires the use of the National Registry of Emergency Medical Technicians (NREMT) examination as a condition of issuing initial licenses at the EMT and paramedic levels;
2. Has a mechanism in place for receiving and investigating complaints about individuals;
3. Notifies the Commission, in compliance with the terms herein, of any adverse action or significant investigatory information regarding an individual;
4. Not later than 5 years after activation of the Compact, requires a criminal background check of all applicants for initial licensure, including the use of the results of fingerprint or other biometric data checks compliant with the requirements of the Federal Bureau of Investigation with the exception of federal employees who have suitability determination in accordance with 5 C.F.R. § 731.202 and submit documentation of such as promulgated in the rules of the Commission; and
5. Complies with the rules of the Commission.
κ2023 Statutes of Nevada, Page 2275 (CHAPTER 391, AB 158)κ
SECTION 4. COMPACT PRIVILEGE TO PRACTICE
A. Member states shall recognize the privilege to practice of an individual licensed in another member state that is in conformance with Section 3.
B. To exercise the privilege to practice under the terms and provisions of this Compact, an individual must:
1. Be at least 18 years of age;
2. Possess a current unrestricted license in a member state as an EMT, AEMT, paramedic or state recognized and licensed level with a scope of practice and authority between EMT and paramedic; and
3. Practice under the supervision of a medical director.
C. An individual providing patient care in a remote state under the privilege to practice shall function within the scope of practice authorized by the home state unless and until modified by an appropriate authority in the remote state as may be defined in the rules of the Commission.
D. Except as provided in Section 4, subsection C, an individual practicing in a remote state will be subject to the remote states authority and laws. A remote state may, in accordance with due process and that states laws, restrict, suspend or revoke an individuals privilege to practice in the remote state and may take any other necessary actions to protect the health and safety of its citizens. If a remote state takes action it shall promptly notify the home state and the Commission.
E. If an individuals license in any home state is restricted or suspended, the individual shall not be eligible to practice in a remote state under the privilege to practice until the individuals home state license is restored.
F. If an individuals privilege to practice in any remote state is restricted, suspended or revoked the individual shall not be eligible to practice in any remote state until the individuals privilege to practice is restored.
SECTION 5. CONDITIONS OF PRACTICE IN A REMOTE STATE
An individual may practice in a remote state under a privilege to practice only in the performance of the individuals EMS duties as assigned by an appropriate authority, as defined in the rules of the Commission, and under the following circumstances:
1. The individual originates a patient transport in a home state and transports the patient to a remote state;
2. The individual originates in the home state and enters a remote state to pick up a patient and provide care and transport of the patient to the home state;
3. The individual enters a remote state to provide patient care and/or transport within that remote state;
4. The individual enters a remote state to pick up a patient and provide care and transport to a third member state; and
5. Other conditions as determined by rules promulgated by the Commission.
κ2023 Statutes of Nevada, Page 2276 (CHAPTER 391, AB 158)κ
SECTION 6. RELATIONSHIP TO EMERGENCY MANAGEMENT ASSISTANCE COMPACT
Upon a member states governors declaration of a state of emergency or disaster that activates the Emergency Management Assistance Compact (EMAC), all relevant terms and provisions of EMAC shall apply, and to the extent any terms or provisions of this Compact conflict with EMAC, the terms of EMAC shall prevail with respect to any individual practicing in the remote state in response to such declaration.
SECTION 7. VETERANS, SERVICE MEMBERS SEPARATING FROM ACTIVE DUTY MILITARY, AND THEIR SPOUSES
A. Member states shall consider a veteran, active military service member and member of the National Guard and Reserves separating from an active duty tour, and a spouse thereof, who holds a current valid and unrestricted NREMT certification at or above the level of the state license being sought as satisfying the minimum training and examination requirements for such licensure.
B. Member states shall expedite the processing of licensure applications submitted by veterans, active military service members, and members of the National Guard and Reserves separating from an active duty tour, and their spouses.
C. All individuals functioning with a privilege to practice under this Section remain subject to the adverse actions provisions of Section 8.
SECTION 8. ADVERSE ACTIONS
A. A home state shall have exclusive power to impose adverse action against an individuals license issued by the home state.
B. If an individuals license in any home state is restricted or suspended, the individual shall not be eligible to practice in a remote state under the privilege to practice until the individuals home state license is restored.
1. All home state adverse action orders shall include a statement that the individuals Compact privileges are inactive. The order may allow the individual to practice in remote states with prior written authorization from both the home state and remote states EMS authority.
2. An individual currently subject to adverse action in the home state shall not practice in any remote state without prior written authorization from both the home state and remote states EMS authority.
C. A member state shall report adverse actions and any occurrences that the individuals Compact privileges are restricted, suspended or revoked to the Commission in accordance with the rules of the Commission.
D. A remote state may take adverse action on an individuals privilege to practice within that state.
E. Any member state may take adverse action against an individuals privilege to practice in that state based on the factual findings of another member state, so long as each state follows its own procedures for imposing such adverse action.
κ2023 Statutes of Nevada, Page 2277 (CHAPTER 391, AB 158)κ
F. A home states EMS authority shall investigate and take appropriate action with respect to reported conduct in a remote state as it would if such conduct had occurred within the home state. In such cases, the home states law shall control in determining the appropriate adverse action.
G. Nothing in this Compact shall override a member states decision that participation in an alternative program may be used in lieu of adverse action and that such participation shall remain nonpublic if required by the member states laws. Member states must require individuals who enter any alternative programs to agree not to practice in any other member state during the term of the alternative program without prior authorization from such other member state.
SECTION 9. ADDITIONAL POWERS INVESTED IN A MEMBER STATES EMS AUTHORITY
A member states EMS authority, in addition to any other powers granted under state law, is authorized under this Compact to:
1. Issue subpoenas for both hearings and investigations that require the attendance and testimony of witnesses and the production of evidence. Subpoenas issued by a member states EMS authority for the attendance and testimony of witnesses and/or the production of evidence from another member state, shall be enforced in the remote state by any court of competent jurisdiction, according to that courts practice and procedure in considering subpoenas issued in its own proceedings. The issuing state EMS authority shall pay any witness fees, travel expenses, mileage and other fees required by the service statutes of the state where the witnesses and/or evidence are located; and
2. Issue cease and desist orders to restrict, suspend or revoke an individuals privilege to practice in the state.
SECTION 10. ESTABLISHMENT OF THE INTERSTATE COMMISSION FOR EMS PERSONNEL PRACTICE
A. The Compact states hereby create and establish a joint public agency known as the Interstate Commission for EMS Personnel Practice.
1. The Commission is a body politic and an instrumentality of the Compact states.
2. Venue is proper and judicial proceedings by or against the Commission shall be brought solely and exclusively in a court of competent jurisdiction where the principal office of the Commission is located. The Commission may waive venue and jurisdictional defenses to the extent it adopts or consents to participate in alternative dispute resolution proceedings.
3. Nothing in this Compact shall be construed to be a waiver of sovereign immunity.
B. Membership, Voting and Meetings
1. Each member state shall have and be limited to one delegate. The responsible official of the state EMS authority or his or her designee shall be the delegate to this Compact for each member state. Any delegate may be removed or suspended from office as provided by the law of the state from which the delegate is appointed. Any vacancy occurring in the Commission shall be filled in accordance with the laws of the member state in which the vacancy exists.
κ2023 Statutes of Nevada, Page 2278 (CHAPTER 391, AB 158)κ
Commission shall be filled in accordance with the laws of the member state in which the vacancy exists. In the event that more than one board, office or other agency with the legislative mandate to license EMS personnel at and above the level of EMT exists, the governor of the state will determine which entity will be responsible for assigning the delegate.
2. Each delegate shall be entitled to one vote with regard to the promulgation of rules and creation of bylaws and shall otherwise have an opportunity to participate in the business and affairs of the Commission. A delegate shall vote in person or by such other means as provided in the bylaws. The bylaws may provide for delegates participation in meetings by telephone or other means of communication.
3. The Commission shall meet at least once during each calendar year. Additional meetings shall be held as set forth in the bylaws.
4. All meetings shall be open to the public, and public notice of meetings shall be given in the same manner as required under the rulemaking provisions in Section 12.
5. The Commission may convene in a closed, nonpublic meeting if the Commission must discuss:
a. Noncompliance of a member state with its obligations under the Compact;
b. The employment, compensation, discipline or other personnel matters, practices or procedures related to specific employees or other matters related to the Commissions internal personnel practices and procedures;
c. Current, threatened or reasonably anticipated litigation;
d. Negotiation of contracts for the purchase or sale of goods, services or real estate;
e. Accusing any person of a crime or formally censuring any person;
f. Disclosure of trade secrets or commercial or financial information that is privileged or confidential;
g. Disclosure of information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy;
h. Disclosure of investigatory records compiled for law enforcement purposes;
i. Disclosure of information related to any investigatory reports prepared by or on behalf of or for use of the Commission or other committee charged with responsibility of investigation or determination of compliance issues pursuant to the Compact; or
j. Matters specifically exempted from disclosure by federal or member state statute.
6. If a meeting, or portion of a meeting, is closed pursuant to this provision, the Commissions legal counsel or designee shall certify that the meeting may be closed and shall reference each relevant exempting provision. The Commission shall keep minutes that fully and clearly describe all matters discussed in a meeting and shall provide a full and accurate summary of actions taken, and the reasons therefore, including a description of the views expressed. All documents considered in connection with an action shall be identified in such minutes. All minutes and documents of a closed meeting shall remain under seal, subject to release by a majority vote of the Commission or order of a court of competent jurisdiction.
κ2023 Statutes of Nevada, Page 2279 (CHAPTER 391, AB 158)κ
C. The Commission shall, by a majority vote of the delegates, prescribe bylaws and/or rules to govern its conduct as may be necessary or appropriate to carry out the purposes and exercise the powers of the Compact, including, but not limited to, bylaws and/or rules:
1. Establishing the fiscal year of the Commission;
2. Providing reasonable standards and procedures;
a. For the establishment and meetings of other committees; and
b. Governing any general or specific delegation of any authority or function of the Commission;
3. Providing reasonable procedures for calling and conducting meetings of the Commission, ensuring reasonable advance notice of all meetings and providing an opportunity for attendance of such meetings by interested parties, with enumerated exceptions designed to protect the publics interest, the privacy of individuals and proprietary information, including trade secrets. The Commission may meet in closed session only after a majority of the membership votes to close a meeting in whole or in part. As soon as practicable, the Commission must make public a copy of the vote to close the meeting revealing the vote of each member with no proxy votes allowed;
4. Establishing the titles, duties and authority, and reasonable procedures for the election of the officers of the Commission;
5. Providing reasonable standards and procedures for the establishment of the personnel policies and programs of the Commission. Notwithstanding any civil service or other similar laws of any member state, the bylaws shall exclusively govern the personnel policies and programs of the Commission;
6. Promulgating a code of ethics to address permissible and prohibited activities of Commission members and employees; and
7. Providing a mechanism for winding up the operations of the Commission and the equitable disposition of any surplus funds that may exist after the termination of the Compact after the payment and/or reserving of all of its debts and obligations.
D. The Commission shall publish its bylaws and file a copy thereof, and a copy of any amendment thereto, with the appropriate agency or officer in each of the member states, if any.
E. The Commission shall maintain its financial records in accordance with the bylaws.
F. The Commission shall meet and take such actions as are consistent with the provisions of this Compact and the bylaws.
G. The Commission shall have the following powers:
1. The authority to promulgate uniform rules to facilitate and coordinate implementation and administration of this Compact. The rules shall have the force and effect of law and shall be binding in all member states;
2. To bring and prosecute legal proceedings or actions in the name of the Commission, provided that the standing of any state EMS authority or other regulatory body responsible for EMS personnel licensure to sue or be sued under applicable law shall not be affected;
3. To purchase and maintain insurance and bonds;
4. To borrow, accept or contract for services of personnel, including, but not limited to, employees of a member state;
κ2023 Statutes of Nevada, Page 2280 (CHAPTER 391, AB 158)κ
5. To hire employees, elect or appoint officers, fix compensation, define duties, grant such individuals appropriate authority to carry out the purposes of the Compact, and to establish the Commissions personnel policies and programs relating to conflicts of interest, qualifications of personnel and other related personnel matters;
6. To accept any and all appropriate donations and grants of money, equipment, supplies, materials and services, and to receive, utilize and dispose of the same, provided that at all times the Commission shall strive to avoid any appearance of impropriety and/or conflict of interest;
7. To lease, purchase, accept appropriate gifts or donations of, or otherwise to own, hold, improve or use, any property, real, personal or mixed, provided that at all times the Commission shall strive to avoid any appearance of impropriety;
8. To sell, convey, mortgage, pledge, lease, exchange, abandon or otherwise dispose of any property, real, personal or mixed;
9. To establish a budget and make expenditures;
10. To borrow money;
11. To appoint committees, including advisory committees comprised of members, state regulators, state legislators or their representatives, and consumer representatives, and such other interested persons as may be designated in this Compact and the bylaws;
12. To provide and receive information from, and to cooperate with, law enforcement agencies;
13. To adopt and use an official seal; and
14. To perform such other functions as may be necessary or appropriate to achieve the purposes of this Compact consistent with the state regulation of EMS personnel licensure and practice.
H. Financing of the Commission
1. The Commission shall pay, or provide for the payment of, the reasonable expenses of its establishment, organization and ongoing activities.
2. The Commission may accept any and all appropriate revenue sources, donations and grants of money, equipment, supplies, materials and services.
3. The Commission may levy on and collect an annual assessment from each member state or impose fees on other parties to cover the cost of the operations and activities of the Commission and its staff, which must be in a total amount sufficient to cover its annual budget as approved each year for which revenue is not provided by other sources. The aggregate annual assessment amount shall be allocated based upon a formula to be determined by the Commission, which shall promulgate a rule binding upon all member states.
4. The Commission shall not incur obligations of any kind prior to securing the funds adequate to meet the same, nor shall the Commission pledge the credit of any of the member states, except by and with the authority of the member state.
5. The Commission shall keep accurate accounts of all receipts and disbursements. The receipts and disbursements of the Commission shall be subject to the audit and accounting procedures established under its bylaws. However, all receipts and disbursements of funds handled by the Commission shall be audited yearly by a certified or licensed public accountant, and the report of the audit shall be included in and become part of the annual report of the Commission.
κ2023 Statutes of Nevada, Page 2281 (CHAPTER 391, AB 158)κ
accountant, and the report of the audit shall be included in and become part of the annual report of the Commission.
I. Qualified Immunity, Defense and Indemnification
1. The members, officers, executive director, employees and representatives of the Commission shall be immune from suit and liability, either personally or in their official capacity, for any claim for damage to or loss of property or personal injury or other civil liability caused by or arising out of any actual or alleged act, error or omission that occurred, or that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of Commission employment, duties or responsibilities, provided that nothing in this paragraph shall be construed to protect any such person from suit and/or liability for any damage, loss, injury or liability caused by the intentional or willful or wanton misconduct of that person.
2. The Commission shall defend any member, officer, executive director, employee or representative of the Commission in any civil action seeking to impose liability arising out of any actual or alleged act, error or omission that occurred within the scope of Commission employment, duties or responsibilities, or that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of Commission employment, duties or responsibilities, provided that nothing herein shall be construed to prohibit that person from retaining his or her own counsel, and provided further, that the actual or alleged act, error or omission did not result from that persons intentional or willful or wanton misconduct.
3. The Commission shall indemnify and hold harmless any member, officer, executive director, employee or representative of the Commission for the amount of any settlement or judgment obtained against that person arising out of any actual or alleged act, error or omission that occurred within the scope of Commission employment, duties or responsibilities, or that such person had a reasonable basis for believing occurred within the scope of Commission employment, duties or responsibilities, provided that the actual or alleged act, error or omission did not result from the intentional or willful or wanton misconduct of that person.
SECTION 11. COORDINATED DATABASE
A. The Commission shall provide for the development and maintenance of a coordinated database and reporting system containing licensure, adverse action and significant investigatory information on all licensed individuals in member states.
B. Notwithstanding any other provision of state law to the contrary, a member state shall submit a uniform data set to the coordinated database on all individuals to whom this Compact is applicable as required by the rules of the Commission, including:
1. Identifying information;
2. Licensure data;
3. Significant investigatory information;
4. Adverse actions against an individuals license;
5. An indicator that an individuals privilege to practice is restricted, suspended or revoked;
κ2023 Statutes of Nevada, Page 2282 (CHAPTER 391, AB 158)κ
6. Nonconfidential information related to alternative program participation;
7. Any denial of application for licensure and the reasons for such denial; and
8. Other information that may facilitate the administration of this Compact, as determined by the rules of the Commission.
C. The coordinated database administrator shall promptly notify all member states of any adverse action taken against, or significant investigative information on, any individual in a member state.
D. Member states contributing information to the coordinated database may designate information that may not be shared with the public without the express permission of the contributing state.
E. Any information submitted to the coordinated database that is subsequently required to be expunged by the laws of the member state contributing the information shall be removed from the coordinated database.
SECTION 12. RULEMAKING
A. The Commission shall exercise its rulemaking powers pursuant to the criteria set forth in this Section and the rules adopted thereunder. Rules and amendments shall become binding as of the date specified in each rule or amendment.
B. If a majority of the legislatures of the member states rejects a rule, by enactment of a statute or resolution in the same manner used to adopt the Compact, then such rule shall have no further force and effect in any member state.
C. Rules or amendments to the rules shall be adopted at a regular or special meeting of the Commission.
D. Prior to promulgation and adoption of a final rule or rules by the Commission, and at least 60 days in advance of the meeting at which the rule will be considered and voted upon, the Commission shall file a Notice of Proposed Rulemaking:
1. On the website of the Commission; and
2. On the website of each member state EMS authority or the publication in which each state would otherwise publish proposed rules.
E. The Notice of Proposed Rulemaking shall include:
1. The proposed time, date and location of the meeting in which the rule will be considered and voted upon;
2. The text of the proposed rule or amendment and the reason for the proposed rule;
3. A request for comments on the proposed rule from any interested person; and
4. The manner in which interested persons may submit notice to the Commission of their intention to attend the public hearing and any written comments.
F. Prior to adoption of a proposed rule, the Commission shall allow persons to submit written data, facts, opinions and arguments, which shall be made available to the public.
G. The Commission shall grant an opportunity for a public hearing before it adopts a rule or amendment if a hearing is requested by:
κ2023 Statutes of Nevada, Page 2283 (CHAPTER 391, AB 158)κ
1. At least 25 persons;
2. A governmental subdivision or agency; or
3. An association having at least 25 members.
H. If a hearing is held on the proposed rule or amendment, the Commission shall publish the place, time and date of the scheduled public hearing.
1. All persons wishing to be heard at the hearing shall notify the executive director of the Commission or other designated member in writing of their desire to appear and testify at the hearing not less than 5 business days before the scheduled date of the hearing.
2. Hearings shall be conducted in a manner providing each person who wishes to comment a fair and reasonable opportunity to comment orally or in writing.
3. No transcript of the hearing is required, unless a written request for a transcript is made, in which case the person requesting the transcript shall bear the cost of producing the transcript. A recording may be made in lieu of a transcript under the same terms and conditions as a transcript. This subsection shall not preclude the Commission from making a transcript or recording of the hearing if it so chooses.
4. Nothing in this Section shall be construed as requiring a separate hearing on each rule. Rules may be grouped for the convenience of the Commission at hearings required by this Section.
I. Following the scheduled hearing date, or by the close of business on the scheduled hearing date if the hearing was not held, the Commission shall consider all written and oral comments received.
J. The Commission shall, by majority vote of all members, take final action on the proposed rule and shall determine the effective date of the rule, if any, based on the rulemaking record and the full text of the rule.
K. If no written notice of intent to attend the public hearing by interested parties is received, the Commission may proceed with promulgation of the proposed rule without a public hearing.
L. Upon determination that an emergency exists, the Commission may consider and adopt an emergency rule without prior notice, opportunity for comment or hearing, provided that the usual rulemaking procedures provided in the Compact and in this Section shall be retroactively applied to the rule as soon as reasonably possible, in no event later than 90 days after the effective date of the rule. For the purposes of this provision, an emergency rule is one that must be adopted immediately in order to:
1. Meet an imminent threat to public health, safety or welfare;
2. Prevent a loss of Commission member state funds;
3. Meet a deadline for the promulgation of an administrative rule that is established by federal law or rule; or
4. Protect public health and safety.
M. The Commission or an authorized committee of the Commission may direct revisions to a previously adopted rule or amendment for purposes of correcting typographical errors, errors in format, errors in consistency or grammatical errors. Public notice of any revisions shall be posted on the website of the Commission. The revision shall be subject to challenge by any person for a period of 30 days after posting. The revision may be challenged only on grounds that the revision results in a material change to a rule. A challenge shall be made in writing and delivered to the chair of the Commission prior to the end of the notice period.
κ2023 Statutes of Nevada, Page 2284 (CHAPTER 391, AB 158)κ
chair of the Commission prior to the end of the notice period. If no challenge is made, the revision will take effect without further action. If the revision is challenged, the revision may not take effect without the approval of the Commission.
SECTION 13. OVERSIGHT, DISPUTE RESOLUTION AND ENFORCEMENT
A. Oversight
1. The executive, legislative and judicial branches of state government in each member state shall enforce this Compact and take all actions necessary and appropriate to effectuate the Compacts purposes and intent. The provisions of this Compact and the rules promulgated hereunder shall have standing as statutory law.
2. All courts shall take judicial notice of the Compact and the rules in any judicial or administrative proceeding in a member state pertaining to the subject matter of this Compact which may affect the powers, responsibilities or actions of the Commission.
3. The Commission shall be entitled to receive service of process in any such proceeding, and shall have standing to intervene in such a proceeding for all purposes. Failure to provide service of process to the Commission shall render a judgment or order void as to the Commission, this Compact or promulgated rules.
B. Default, Technical Assistance and Termination
1. If the Commission determines that a member state has defaulted in the performance of its obligations or responsibilities under this Compact or the promulgated rules, the Commission shall:
a. Provide written notice to the defaulting state and other member states of the nature of the default, the proposed means of curing the default and/or any other action to be taken by the Commission; and
b. Provide remedial training and specific technical assistance regarding the default.
2. If a state in default fails to cure the default, the defaulting state may be terminated from the Compact upon an affirmative vote of a majority of the member states, and all rights, privileges and benefits conferred by this Compact may be terminated on the effective date of termination. A cure of the default does not relieve the offending state of obligations or liabilities incurred during the period of default.
3. Termination of membership in the Compact shall be imposed only after all other means of securing compliance have been exhausted. Notice of intent to suspend or terminate shall be given by the Commission to the governor and the majority and minority leaders of the defaulting states legislature, and each of the member states.
4. A state that has been terminated is responsible for all assessments, obligations and liabilities incurred through the effective date of termination, including obligations that extend beyond the effective date of termination.
5. The Commission shall not bear any costs related to a state that is found to be in default or that has been terminated from the Compact, unless agreed upon in writing between the Commission and the defaulting state.
κ2023 Statutes of Nevada, Page 2285 (CHAPTER 391, AB 158)κ
6. The defaulting state may appeal the action of the Commission by petitioning the United States District Court for the District of Columbia or the federal district where the Commission has its principal offices. The prevailing member shall be awarded all costs of such litigation, including reasonable attorneys fees.
C. Dispute Resolution
1. Upon request by a member state, the Commission shall attempt to resolve disputes related to the Compact that arise among member states and between member and nonmember states.
2. The Commission shall promulgate a rule providing for both mediation and binding dispute resolution for disputes as appropriate.
D. Enforcement
1. The Commission, in the reasonable exercise of its discretion, shall enforce the provisions and rules of this Compact.
2. By majority vote, the Commission may initiate legal action in the United States District Court for the District of Columbia or the federal district where the Commission has its principal offices against a member state in default to enforce compliance with the provisions of the Compact and its promulgated rules and bylaws. The relief sought may include both injunctive relief and damages. In the event judicial enforcement is necessary, the prevailing member shall be awarded all costs of such litigation, including reasonable attorneys fees.
3. The remedies herein shall not be the exclusive remedies of the Commission. The Commission may pursue any other remedies available under federal or state law.
SECTION 14. DATE OF IMPLEMENTATION OF THE INTERSTATE COMMISSION FOR EMS PERSONNEL PRACTICE AND ASSOCIATED RULES, WITHDRAWAL AND AMENDMENT
A. The Compact shall come into effect on the date on which the Compact statute is enacted into law in the tenth member state. The provisions, which become effective at that time, shall be limited to the powers granted to the Commission relating to assembly and the promulgation of rules. Thereafter, the Commission shall meet and exercise rulemaking powers necessary to the implementation and administration of the Compact.
B. Any state that joins the Compact subsequent to the Commissions initial adoption of the rules shall be subject to the rules as they exist on the date on which the Compact becomes law in that state. Any rule that has been previously adopted by the Commission shall have the full force and effect of law on the day the Compact becomes law in that state.
C. Any member state may withdraw from this Compact by enacting a statute repealing the same.
1. A member states withdrawal shall not take effect until 6 months after enactment of the repealing statute.
2. Withdrawal shall not affect the continuing requirement of the withdrawing states EMS authority to comply with the investigative and adverse action reporting requirements of this act prior to the effective date of withdrawal.
D. Nothing contained in this Compact shall be construed to invalidate or prevent any EMS personnel licensure agreement or other cooperative arrangement between a member state and a nonmember state that does not conflict with the provisions of this Compact.
κ2023 Statutes of Nevada, Page 2286 (CHAPTER 391, AB 158)κ
arrangement between a member state and a nonmember state that does not conflict with the provisions of this Compact.
E. This Compact may be amended by the member states. No amendment to this Compact shall become effective and binding upon any member state until it is enacted into the laws of all member states.
SECTION 15. CONSTRUCTION AND SEVERABILITY
This Compact shall be liberally construed so as to effectuate the purposes thereof. If this Compact shall be held contrary to the constitution of any state member thereto, the Compact shall remain in full force and effect as to the remaining member states. Nothing in this Compact supersedes state law or rules related to licensure of EMS agencies.
Sec. 3. NRS 450B.025 is hereby amended to read as follows:
450B.025 Advanced emergency medical technician means a person [certified] who is:
1. Certified by the health officer as having satisfactorily completed a program of training for certification as an advanced emergency medical technician pursuant to NRS 450B.191 [.] ; or
2. Practicing as an advanced emergency medical technician in this State under the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact ratified by section 2 of this act.
Sec. 4. NRS 450B.065 is hereby amended to read as follows:
450B.065 Emergency medical technician means a person [certified] who is:
1. Certified by the health officer as having satisfactorily completed a program of training for certification as an emergency medical technician pursuant to NRS 450B.1905 [.] ; or
2. Practicing as an emergency medical technician in this State under the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact ratified by section 2 of this act.
Sec. 5. NRS 450B.095 is hereby amended to read as follows:
450B.095 Paramedic means a person [certified] who is:
1. Certified by the health officer as having satisfactorily completed a program of training for certification as a paramedic pursuant to NRS 450B.195 [.] ; or
2. Practicing as a paramedic in this State under the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact ratified by section 2 of this act.
Sec. 6. NRS 450B.191 is hereby amended to read as follows:
450B.191 1. A program of training for certification as an advanced emergency medical technician must be supervised by a licensed physician and approved by the health authority.
2. A program of training for certification as an advanced emergency medical technician must include an approved curriculum in intravenous therapy and the management of a passage for air to the lungs. Only a certified emergency medical technician with experience as established by the board is eligible for this training.
3. In order to maintain certification, each advanced emergency medical technician must annually:
(a) Comply with the requirements established by the board for continuing medical education; and
κ2023 Statutes of Nevada, Page 2287 (CHAPTER 391, AB 158)κ
(b) Demonstrate his or her skills as required by regulation of the board.
4. The board may by regulation prescribe the curriculum and other requirements for training and maintaining certification as an advanced emergency medical technician. The curriculum must be at least equivalent to any curriculum or educational standards prepared by the United States Department of Transportation as a national standard for advanced emergency medical technicians.
5. A person shall not represent himself or herself to be an advanced emergency medical technician unless the person has on file with the health authority a currently valid certificate demonstrating successful completion of the program of training required by this section [.] or is practicing under the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact ratified by section 2 of this act.
6. Except as authorized by subsection 7 of NRS 450B.160 [,] and the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact ratified by section 2 of this act, an attendant or firefighter shall not perform, and the owner, operator, director or chief officer of an ambulance or a fire-fighting agency shall not offer, emergency care as an advanced emergency medical technician without fulfilling the requirements established by the board.
Sec. 7. NRS 450B.195 is hereby amended to read as follows:
450B.195 1. Only a certified emergency medical technician with experience as established by the board is eligible for training as a paramedic.
2. A program of training for certification as a paramedic must be supervised by a licensed physician and approved by the health authority.
3. To maintain certification, each paramedic must annually:
(a) Comply with the requirements established by the board for continuing medical education; and
(b) Demonstrate his or her skills as required by regulation of the board.
4. The board may by regulation prescribe the curriculum and other requirements for training and maintaining certification as a paramedic. The curriculum must be at least equivalent to any curriculum or educational standards prepared by the United States Department of Transportation as a national standard for paramedics.
5. A person shall not represent himself or herself to be a paramedic unless the person has on file with the health authority a currently valid certificate evidencing the persons successful completion of the program of training required by this section [.] or is practicing under the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact ratified by section 2 of this act.
6. Except as authorized by subsection 7 of NRS 450B.160 [,] and the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact ratified by section 2 of this act, an attendant or firefighter shall not perform, and the owner, operator, director or chief officer of an ambulance or a fire-fighting agency shall not offer, emergency care as a paramedic without fulfilling the requirements established by the board.
Sec. 8. NRS 450B.199 is hereby amended to read as follows:
450B.199 As used in this section and NRS 450B.1993 and 450B.1996, unless the context otherwise requires, emergency medical provider means an emergency medical technician, advanced emergency medical technician or paramedic [.] who is certified pursuant to this chapter.
κ2023 Statutes of Nevada, Page 2288 (CHAPTER 391, AB 158)κ
Sec. 9. NRS 450B.225 is hereby amended to read as follows:
450B.225 1. Except as otherwise provided in subsection 2 [,] or as otherwise authorized by the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact ratified by section 2 of this act, during any period in which an air ambulance is used to provide medical transportation services for which a permit is required, the air ambulance must be staffed with, at a minimum:
(a) One primary attendant who:
(1) Is an emergency medical services registered nurse who has at least 3 years of critical care nursing experience;
(2) Has successfully completed an air ambulance attendant course which includes didactic and clinical components and is approved or in compliance with requirements set by the board; and
(3) Has demonstrated proficiency in basic prehospital skills and advance procedures as specified by the board; and
(b) One secondary attendant who meets the same qualifications as a primary attendant pursuant to paragraph (a) or:
(1) Is certified as a paramedic;
(2) Has at least 3 years of field experience as a paramedic;
(3) Has successfully completed an air ambulance attendant course which includes didactic and clinical components and is approved or in compliance with requirements set by the board; and
(4) Has demonstrated proficiency in basic prehospital skills and advance procedures as specified by the board.
2. If, as determined by the pilot and medical director of the air ambulance, the weight of the secondary attendant could compromise the performance of the air ambulance, safety or patient care, an air ambulance providing medical transportation services may be staffed with only a primary attendant as described in paragraph (a) of subsection 1.
3. The board may adopt regulations specifying the acceptable documentation of the requirements set forth in paragraph (a) or (b) of subsection 1.
4. The health authority may issue a letter of endorsement and identification card to an emergency medical services registered nurse or paramedic who satisfies the requirements of paragraph (a) or (b) of subsection 1.
Sec. 10. NRS 450B.255 is hereby amended to read as follows:
450B.255 A person shall not represent himself or herself to be an emergency medical technician, advanced emergency medical technician or paramedic unless the person has been issued a currently valid certificate by the health authority [.] or is practicing under the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact ratified by section 2 of this act.
Sec. 11. NRS 450B.260 is hereby amended to read as follows:
450B.260 1. Except as otherwise provided in this section [,] or as authorized by the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact ratified by section 2 of this act, the public or private owner of an ambulance or air ambulance or a fire-fighting agency which owns a vehicle used in providing medical care to sick or injured persons at the scene of an emergency or while transporting those persons to a medical facility shall not permit its operation and use by any person not licensed under this chapter.
κ2023 Statutes of Nevada, Page 2289 (CHAPTER 391, AB 158)κ
2. An ambulance carrying a sick or injured patient must be occupied by a driver and an attendant, each of whom is licensed as an attendant pursuant to this chapter , [or] exempt from licensing pursuant to subsection 7 of NRS 450B.160 [,] or authorized to practice in this State under the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact ratified by section 2 of this act, except as otherwise provided in subsection 5 or in geographic areas which may be designated by the board and for which the board may prescribe lesser qualifications.
3. An air ambulance carrying a sick or injured patient must be occupied by a licensed attendant, [or] a person exempt from licensing pursuant to subsection 7 of NRS 450B.160 [,] or a person authorized to practice in this State under the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact ratified by section 2 of this act, in addition to the pilot of the aircraft.
4. The pilot of an air ambulance is not required to have a license under this chapter.
5. A person who operates or uses a vehicle owned by a fire-fighting agency is not required to be licensed under this chapter, except that such a vehicle may not be used to provide the level of medical care provided by an advanced emergency medical technician or paramedic to sick or injured persons:
(a) At the scene of an emergency unless at least one person in the vehicle is licensed to provide the care; or
(b) While transporting those persons to a medical facility unless at least two persons in the vehicle are licensed to provide the care.
6. Nothing in this section precludes the operation of an aircraft in this State in a manner other than as an air ambulance.
Sec. 12. NRS 450B.655 is hereby amended to read as follows:
450B.655 Dedicated advanced life support ambulance means an ambulance equipped to provide advanced life support that:
1. Is capable of transporting a patient from a special event to a hospital but, upon delivering the patient, immediately returns to the site of the special event; and
2. Is staffed by:
(a) At least one licensed attendant who is an emergency medical technician and one licensed attendant who is a paramedic; or
(b) At least two other attendants, each with an equivalent or a higher level of skill than the levels described in paragraph (a) and each of whom is licensed pursuant to this chapter , [or] exempt from licensure pursuant to subsection 7 of NRS 450B.160 [.] or authorized to practice in this State under the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact ratified by section 2 of this act.
Sec. 13. NRS 450B.660 is hereby amended to read as follows:
450B.660 First-aid station means a fixed location at the site of a special event that is staffed by:
1. At least one licensed attendant who is an emergency medical technician, advanced emergency medical technician or paramedic; or
2. A person with a higher level of skill than the levels described in subsection 1 who is capable of providing emergency medical care within his or her scope of practice and is licensed pursuant to this chapter , [or] exempt from licensure pursuant to subsection 7 of NRS 450B.160 [.] or authorized to practice in this State under the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact ratified by section 2 of this act.
κ2023 Statutes of Nevada, Page 2290 (CHAPTER 391, AB 158)κ
to practice in this State under the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact ratified by section 2 of this act.
Sec. 14. NRS 450B.670 is hereby amended to read as follows:
450B.670 Roving emergency medical technician team means a team at the site of a special event that:
1. Consists of two or more [licensed attendants who are] emergency medical technicians, advanced emergency medical technicians or paramedics [;] who are licensed attendants or authorized to serve as attendants under the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact ratified by section 2 of this act; and
2. Has the medical supplies necessary to provide emergency medical care.
Sec. 15. NRS 450B.675 is hereby amended to read as follows:
450B.675 Roving intermediate emergency medical technician team means a roving emergency medical team that consists of two or more [licensed attendants who are] advanced emergency medical technicians or paramedics [.] who are licensed attendants or authorized to serve as attendants under the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact ratified by section 2 of this act.
Sec. 16. NRS 450B.712 is hereby amended to read as follows:
450B.712 1. An authorized entity may obtain an order for auto-injectable epinephrine from a physician, osteopathic physician, physician assistant or advanced practice registered nurse, pursuant to NRS 630.374, 632.239 or 633.707 to be maintained by the authorized entity at any location under control of the authorized entity where allergens capable of causing anaphylaxis may be present. If a dose of auto-injectable epinephrine maintained by the authorized entity is used or expires, the authorized entity may obtain an additional dose of auto-injectable epinephrine to replace the used or expired dose.
2. Auto-injectable epinephrine maintained by an authorized entity pursuant to this section may be provided to a person for self-administration or may be administered to any person reasonably believed to be experiencing anaphylaxis by:
(a) An owner, employee or agent of the authorized entity who has received the training required pursuant to NRS 450B.714; or
(b) A person, other than an owner, employee or agent of the authorized entity, who is trained to recognize the symptoms of anaphylaxis and to administer auto-injectable epinephrine, who may include, without limitation, a provider of health care, a provider of emergency medical services, an athletic trainer or a family member of a person who suffers from allergies capable of causing anaphylaxis.
3. An authorized entity shall:
(a) Store auto-injectable epinephrine in a designated, secure location that is easily accessible and in compliance with the instructions provided by the manufacturer of the auto-injectable epinephrine and any requirements prescribed by the board; and
(b) Designate one or more employees or agents who have received the training described in NRS 450B.714 to be responsible for the storage, maintenance and oversight of the auto-injectable epinephrine maintained by the authorized entity.
4. Not later than 30 days after a dose of auto-injectable epinephrine maintained by an authorized entity is administered, the authorized entity shall report, on a form prescribed by the board, the circumstances surrounding such administration.
κ2023 Statutes of Nevada, Page 2291 (CHAPTER 391, AB 158)κ
shall report, on a form prescribed by the board, the circumstances surrounding such administration. The board shall publish an annual report summarizing and analyzing the information reported by authorized entities pursuant to this subsection.
5. As used in this section:
(a) Provider of emergency medical services means a person [licensed] who is:
(1) Licensed as an attendant or certified as an emergency medical technician, advanced emergency medical technician or paramedic pursuant to this chapter [.] ; or
(2) Authorized to practice as an emergency medical technician, advanced emergency medical technician or paramedic in this State under the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact ratified by section 2 of this act.
(b) Provider of health care means a physician, nurse or physician assistant registered or licensed in this State.
Sec. 17. NRS 41.139 is hereby amended to read as follows:
41.139 1. Except as otherwise provided in subsection 2, a peace officer, firefighter or emergency medical attendant may bring and maintain an action for damages for personal injury caused by the willful act of another person, or by another persons lack of ordinary care or skill in the management of the persons property, if the conduct causing the injury:
(a) Occurred after the person who caused the injury knew or should have known of the presence of the peace officer, firefighter or emergency medical attendant;
(b) Was intended to injure the peace officer, firefighter or emergency medical attendant;
(c) Violated a statute, ordinance or regulation:
(1) Intended to protect the peace officer, firefighter or emergency medical attendant; or
(2) Prohibiting resistance to or requiring compliance with an order of a peace officer or firefighter; or
(d) Was arson.
2. This section does not impose liability on the employer of the peace officer, firefighter or emergency medical attendant.
3. As used in this section:
(a) Emergency medical attendant means a person [licensed] who is:
(1) Licensed as an attendant or certified as an emergency medical technician, advanced emergency medical technician or paramedic pursuant to chapter 450B of NRS [.] ; or
(2) Authorized to practice as an emergency medical technician, advanced emergency medical technician or paramedic in this State under the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact ratified by section 2 of this act.
(b) Peace officer has the meaning ascribed to it in NRS 169.125.
Sec. 18. NRS 41.504 is hereby amended to read as follows:
41.504 1. Any physician, physician assistant or registered nurse who in good faith gives instruction or provides supervision to an emergency medical attendant, physician assistant or registered nurse, at the scene of an emergency or while transporting an ill or injured person from the scene of an emergency, is not liable for any civil damages as a result of any act or omission, not amounting to gross negligence, in giving that instruction or providing that supervision.
κ2023 Statutes of Nevada, Page 2292 (CHAPTER 391, AB 158)κ
2. An emergency medical attendant, physician assistant, registered nurse or licensed practical nurse who obeys an instruction given by a physician, physician assistant, registered nurse or licensed practical nurse and thereby renders emergency care, at the scene of an emergency or while transporting an ill or injured person from the scene of an emergency, is not liable for any civil damages as a result of any act or omission, not amounting to gross negligence, in rendering that emergency care.
3. As used in this section, emergency medical attendant means a person [licensed] who is:
(a) Licensed as an attendant or certified as an emergency medical technician, advanced emergency medical technician or paramedic pursuant to chapter 450B of NRS [.] ; or
(b) Authorized to practice as an emergency medical technician, advanced emergency medical technician or paramedic in this State under the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact ratified by section 2 of this act.
Sec. 19. NRS 432B.220 is hereby amended to read as follows:
432B.220 1. Any person who is described in subsection 4 and who, in his or her professional or occupational capacity, knows or has reasonable cause to believe that a child has been abused or neglected shall:
(a) Except as otherwise provided in subsection 2, report the abuse or neglect of the child to an agency which provides child welfare services or to a law enforcement agency; and
(b) Make such a report as soon as reasonably practicable but not later than 24 hours after the person knows or has reasonable cause to believe that the child has been abused or neglected.
2. If a person who is required to make a report pursuant to subsection 1 knows or has reasonable cause to believe that the abuse or neglect of the child involves an act or omission of:
(a) A person directly responsible or serving as a volunteer for or an employee of a public or private home, institution or facility where the child is receiving child care outside of the home for a portion of the day, the person shall make the report to a law enforcement agency.
(b) An agency which provides child welfare services or a law enforcement agency, the person shall make the report to an agency other than the one alleged to have committed the act or omission, and the investigation of the abuse or neglect of the child must be made by an agency other than the one alleged to have committed the act or omission.
3. Any person who is described in paragraph (a) of subsection 4 who delivers or provides medical services to a newborn infant and who, in his or her professional or occupational capacity, knows or has reasonable cause to believe that the newborn infant has been affected by a fetal alcohol spectrum disorder or prenatal substance use disorder or has withdrawal symptoms resulting from prenatal substance exposure shall, as soon as reasonably practicable but not later than 24 hours after the person knows or has reasonable cause to believe that the newborn infant is so affected or has such symptoms, notify an agency which provides child welfare services of the condition of the infant and refer each person who is responsible for the welfare of the infant to an agency which provides child welfare services for appropriate counseling, training or other services. A notification and referral to an agency which provides child welfare services pursuant to this subsection shall not be construed to require prosecution for any illegal action.
κ2023 Statutes of Nevada, Page 2293 (CHAPTER 391, AB 158)κ
4. A report must be made pursuant to subsection 1 by the following persons:
(a) A person providing services licensed or certified in this State pursuant to, without limitation, chapter 450B, 630, 630A, 631, 632, 633, 634, 634A, 635, 636, 637, 637B, 639, 640, 640A, 640B, 640C, 640D, 640E, 641, 641A, 641B, 641C, 641D or 653 of NRS [.] or practicing as an emergency medical technician, advanced emergency medical technician or paramedic in this State under the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact ratified by section 2 of this act.
(b) Any personnel of a medical facility licensed pursuant to chapter 449 of NRS who are engaged in the admission, examination, care or treatment of persons or an administrator, manager or other person in charge of such a medical facility upon notification of suspected abuse or neglect of a child by a member of the staff of the medical facility.
(c) A coroner.
(d) A member of the clergy, practitioner of Christian Science or religious healer, unless the person has acquired the knowledge of the abuse or neglect from the offender during a confession.
(e) A person employed by a public school or private school and any person who serves as a volunteer at such a school.
(f) Any person who maintains or is employed by a facility or establishment that provides care for children, childrens camp or other public or private facility, institution or agency furnishing care to a child.
(g) Any person licensed pursuant to chapter 424 of NRS to conduct a foster home.
(h) Any officer or employee of a law enforcement agency or an adult or juvenile probation officer.
(i) Except as otherwise provided in NRS 432B.225, an attorney.
(j) Any person who maintains, is employed by or serves as a volunteer for an agency or service which advises persons regarding abuse or neglect of a child and refers them to persons and agencies where their requests and needs can be met.
(k) Any person who is employed by or serves as a volunteer for a youth shelter. As used in this paragraph, youth shelter has the meaning ascribed to it in NRS 244.427.
(l) Any adult person who is employed by an entity that provides organized activities for children, including, without limitation, a person who is employed by a school district or public school.
(m) Any person who is enrolled with the Division of Health Care Financing and Policy of the Department of Health and Human Services to provide doula services to recipients of Medicaid pursuant to NRS 422.27177.
(n) A peer recovery support specialist, as defined in NRS 433.627, or peer recovery support specialist supervisor, as defined in NRS 433.629.
5. A report may be made by any other person.
6. If a person who is required to make a report pursuant to subsection 1 knows or has reasonable cause to believe that a child has died as a result of abuse or neglect, the person shall, as soon as reasonably practicable, report this belief to an agency which provides child welfare services or a law enforcement agency. If such a report is made to a law enforcement agency, the law enforcement agency shall notify an agency which provides child welfare services and the appropriate medical examiner or coroner of the report. If such a report is made to an agency which provides child welfare services, the agency which provides child welfare services shall notify the appropriate medical examiner or coroner of the report.
κ2023 Statutes of Nevada, Page 2294 (CHAPTER 391, AB 158)κ
appropriate medical examiner or coroner of the report. The medical examiner or coroner who is notified of a report pursuant to this subsection shall investigate the report and submit his or her written findings to the appropriate agency which provides child welfare services, the appropriate district attorney and a law enforcement agency. The written findings must include, if obtainable, the information required pursuant to the provisions of subsection 2 of NRS 432B.230.
7. The agency, board, bureau, commission, department, division or political subdivision of the State responsible for the licensure, certification or endorsement of a person who is described in subsection 4 and who is required in his or her professional or occupational capacity to be licensed, certified or endorsed in this State shall, at the time of initial licensure, certification or endorsement:
(a) Inform the person, in writing or by electronic communication, of his or her duty as a mandatory reporter pursuant to this section;
(b) Obtain a written acknowledgment or electronic record from the person that he or she has been informed of his or her duty pursuant to this section; and
(c) Maintain a copy of the written acknowledgment or electronic record for as long as the person is licensed, certified or endorsed in this State.
8. The employer of a person who is described in subsection 4 and who is not required in his or her professional or occupational capacity to be licensed, certified or endorsed in this State must, upon initial employment of the person:
(a) Inform the person, in writing or by electronic communication, of his or her duty as a mandatory reporter pursuant to this section;
(b) Obtain a written acknowledgment or electronic record from the person that he or she has been informed of his or her duty pursuant to this section; and
(c) Maintain a copy of the written acknowledgment or electronic record for as long as the person is employed by the employer.
9. Before a person may serve as a volunteer at a public school or private school, the school must:
(a) Inform the person, in writing or by electronic communication, of his or her duty as a mandatory reporter pursuant to this section and NRS 392.303;
(b) Obtain a written acknowledgment or electronic record from the person that he or she has been informed of his or her duty pursuant to this section and NRS 392.303; and
(c) Maintain a copy of the written acknowledgment or electronic record for as long as the person serves as a volunteer at the school.
10. The provisions of subsection 8 do not apply to the employer of a person practicing as an emergency medical technician, advanced emergency medical technician or paramedic in this State under the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact ratified by section 2 of this act.
11. As used in this section:
(a) Private school has the meaning ascribed to it in NRS 394.103.
(b) Public school has the meaning ascribed to it in NRS 385.007.
Sec. 20. NRS 484B.767 is hereby amended to read as follows:
484B.767 1. Except as otherwise provided in this section, a peace officer, a firefighter, an emergency medical technician, an advanced emergency medical technician or a paramedic certified pursuant to chapter 450B of NRS or authorized to practice in this State under the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact ratified by section 2 of this act or an employee of a pedestrian mall, who operates a bicycle, an electric bicycle or an electric scooter while on duty, is not required to comply with any provision of NRS or any ordinance of a local government relating to the operation of a bicycle, an electric bicycle or an electric scooter while on duty if he or she:
κ2023 Statutes of Nevada, Page 2295 (CHAPTER 391, AB 158)κ
emergency medical technician or a paramedic certified pursuant to chapter 450B of NRS or authorized to practice in this State under the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact ratified by section 2 of this act or an employee of a pedestrian mall, who operates a bicycle, an electric bicycle or an electric scooter while on duty, is not required to comply with any provision of NRS or any ordinance of a local government relating to the operation of a bicycle, an electric bicycle or an electric scooter while on duty if he or she:
(a) Is responding to an emergency call or the peace officer is in pursuit of a suspected violator of the law; or
(b) Determines that noncompliance with any such provision is necessary to carry out his or her duties.
2. The provisions of this section do not:
(a) Relieve a peace officer, firefighter, emergency medical technician, advanced emergency medical technician, paramedic or employee of a pedestrian mall from the duty to operate a bicycle, an electric bicycle or an electric scooter with due regard for the safety of others.
(b) Protect such a person from the consequences of the persons disregard for the safety of others.
3. As used in this section, pedestrian mall has the meaning ascribed to it in NRS 268.811.
Sec. 21. NRS 629.031 is hereby amended to read as follows:
629.031 Except as otherwise provided by a specific statute:
1. Provider of health care means:
(a) A physician licensed pursuant to chapter 630, 630A or 633 of NRS;
(b) A physician assistant;
(c) A dentist;
(d) A licensed nurse;
(e) A person who holds a license as an attendant or who is certified as an emergency medical technician, advanced emergency medical technician or paramedic pursuant to chapter 450B of NRS [;] or authorized to practice as an emergency medical technician, advanced emergency medical technician or paramedic in this State under the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact ratified by section 2 of this act;
(f) A dispensing optician;
(g) An optometrist;
(h) A speech-language pathologist;
(i) An audiologist;
(j) A practitioner of respiratory care;
(k) A licensed physical therapist;
(l) An occupational therapist;
(m) A podiatric physician;
(n) A licensed psychologist;
(o) A licensed marriage and family therapist;
(p) A licensed clinical professional counselor;
(q) A music therapist;
(r) A chiropractic physician;
(s) An athletic trainer;
(t) A perfusionist;
(u) A doctor of Oriental medicine in any form;
(v) A medical laboratory director or technician;
(w) A pharmacist;
κ2023 Statutes of Nevada, Page 2296 (CHAPTER 391, AB 158)κ
(x) A licensed dietitian;
(y) An associate in social work, a social worker, a master social worker, an independent social worker or a clinical social worker licensed pursuant to chapter 641B of NRS;
(z) An alcohol and drug counselor or a problem gambling counselor who is certified pursuant to chapter 641C of NRS;
(aa) An alcohol and drug counselor or a clinical alcohol and drug counselor who is licensed pursuant to chapter 641C of NRS;
(bb) A behavior analyst, assistant behavior analyst or registered behavior technician; or
(cc) A medical facility as the employer of any person specified in this subsection.
2. For the purposes of NRS 629.400 to 629.490, inclusive, the term includes:
(a) A person who holds a license or certificate issued pursuant to chapter 631 of NRS; and
(b) A person who holds a current license or certificate to practice his or her respective discipline pursuant to the applicable provisions of law of another state or territory of the United States.
Sec. 21.5. 1. There is hereby appropriated from the State General Fund to the Division of Public and Behavioral Health of the Department of Health and Human Services for maintenance fees and software licenses to connect to the coordinated database established under the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact the following sums:
For the Fiscal Year 2023-2024......................................................... $5,000
For the Fiscal Year 2024-2025......................................................... $5,000
2. Any balance of the sums appropriated by subsection 1 remaining at the end of the respective fiscal years must not be committed for expenditure after June 30 of the respective fiscal years by the entity to which the appropriation is made or any entity to which money from the appropriation is granted or otherwise transferred in any manner, and any portion of the appropriated money remaining must not be spent for any purpose after September 20, 2024, and September 19, 2025, respectively, by either the entity to which the money was appropriated or the entity to which the money was subsequently granted or transferred, and must be reverted to the State General Fund on or before September 20, 2024, and September 19, 2025, respectively.
Sec. 22. The provisions of NRS 354.599 do not apply to any additional expenses of a local government that are related to the provisions of this act.
Sec. 23. 1. This section becomes effective upon passage and approval.
2. Section 21.5 of this act becomes effective on July 1, 2023.
3. Sections 1 to 21, inclusive, and 22 of this act become effective:
(a) Upon passage and approval for the purpose of adopting any regulations and performing any other preparatory administrative tasks that are necessary to carry out the provisions of this act; and
(b) On October 1, 2023, for all other purposes.
________
κ2023 Statutes of Nevada, Page 2297κ
Assembly Bill No. 138Committee on Health and Human Services
CHAPTER 392
[Approved: June 12, 2023]
AN ACT relating to Medicaid; requiring the State Plan for Medicaid to include coverage for certain behavioral health integration services; making an appropriation and authorizing certain expenditures; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Existing law requires the Department of Health and Human Services to develop and administer a State Plan for Medicaid which includes a list of specific medical services required to be provided to Medicaid recipients. (NRS 422.063, 422.270; 42 U.S.C. § 1396a) Section 1 of this bill requires such covered medical services to include behavioral health services that are delivered through evidence-based, behavioral health integration models. Section 2 of this bill makes a conforming change to indicate that the provisions of section 1 will be administered in the same manner as the provisions of existing law governing the State Plan for Medicaid. Section 3 of this bill makes an appropriation to the Division of Health Care Financing and Policy of the Department and authorizes certain related expenditures to carry out the provisions of section 1.
EXPLANATION Matter in bolded italics is new; matter between
brackets [omitted material] is material to be
omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 422 of NRS is hereby amended by adding thereto a new section to read as follows:
1. The Director shall include in the State Plan for Medicaid a requirement that the State must pay the nonfederal share of expenditures incurred for behavioral health services, including, without limitation, mental health services and services for the treatment of a substance use disorder, that are delivered through evidence-based, behavioral health integration models, including, without limitation, collaborative care management services.
2. As used in this section:
(a) Behavioral health integration model means a model of delivering behavioral health services that integrates such services with primary care. The term includes, without limitation, the delivery of behavioral health services using collaborative care management services.
(b) Collaborative care management services means a combination of services and structured care management with regular assessments directed and provided by a team of providers of primary care and providers of behavioral health care.
κ2023 Statutes of Nevada, Page 2298 (CHAPTER 392, AB 138)κ
Sec. 2. NRS 232.320 is hereby amended to read as follows:
232.320 1. The Director:
(a) Shall appoint, with the consent of the Governor, administrators of the divisions of the Department, who are respectively designated as follows:
(1) The Administrator of the Aging and Disability Services Division;
(2) The Administrator of the Division of Welfare and Supportive Services;
(3) The Administrator of the Division of Child and Family Services;
(4) The Administrator of the Division of Health Care Financing and Policy; and
(5) The Administrator of the Division of Public and Behavioral Health.
(b) Shall administer, through the divisions of the Department, the provisions of chapters 63, 424, 425, 427A, 432A to 442, inclusive, 446 to 450, inclusive, 458A and 656A of NRS, NRS 127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and section 1 of this act, 422.580, 432.010 to 432.133, inclusive, 432B.6201 to 432B.626, inclusive, 444.002 to 444.430, inclusive, and 445A.010 to 445A.055, inclusive, and all other provisions of law relating to the functions of the divisions of the Department, but is not responsible for the clinical activities of the Division of Public and Behavioral Health or the professional line activities of the other divisions.
(c) Shall administer any state program for persons with developmental disabilities established pursuant to the Developmental Disabilities Assistance and Bill of Rights Act of 2000, 42 U.S.C. §§ 15001 et seq.
(d) Shall, after considering advice from agencies of local governments and nonprofit organizations which provide social services, adopt a master plan for the provision of human services in this State. The Director shall revise the plan biennially and deliver a copy of the plan to the Governor and the Legislature at the beginning of each regular session. The plan must:
(1) Identify and assess the plans and programs of the Department for the provision of human services, and any duplication of those services by federal, state and local agencies;
(2) Set forth priorities for the provision of those services;
(3) Provide for communication and the coordination of those services among nonprofit organizations, agencies of local government, the State and the Federal Government;
(4) Identify the sources of funding for services provided by the Department and the allocation of that funding;
(5) Set forth sufficient information to assist the Department in providing those services and in the planning and budgeting for the future provision of those services; and
(6) Contain any other information necessary for the Department to communicate effectively with the Federal Government concerning demographic trends, formulas for the distribution of federal money and any need for the modification of programs administered by the Department.
(e) May, by regulation, require nonprofit organizations and state and local governmental agencies to provide information regarding the programs of those organizations and agencies, excluding detailed information relating to their budgets and payrolls, which the Director deems necessary for the performance of the duties imposed upon him or her pursuant to this section.
κ2023 Statutes of Nevada, Page 2299 (CHAPTER 392, AB 138)κ
(f) Has such other powers and duties as are provided by law.
2. Notwithstanding any other provision of law, the Director, or the Directors designee, is responsible for appointing and removing subordinate officers and employees of the Department.
Sec. 3. 1. There is hereby appropriated from the State General Fund to the Division of Health Care Financing and Policy of the Department of Health and Human Services for system modifications and to pay the nonfederal share of expenditures incurred for the services described in section 1 of this act the following sums:
For the Fiscal Year 2023-2024......................................................... $4,760
For the Fiscal Year 2024-2025.................................................... $207,313
2. Any balance of the sums appropriated by subsection 1 remaining at the end of the respective fiscal years must not be committed for expenditure after June 30 of the respective fiscal years by the entity to which the appropriation is made or any entity to which money from the appropriation is granted or otherwise transferred in any manner, and any portion of the appropriated money remaining must not be spent for any purpose after September 20, 2024, and September 19, 2025, respectively, by either the entity to which the money was appropriated or the entity to which the money was subsequently granted or transferred, and must be reverted to the State General Fund on or before September 20, 2024, and September 19, 2025, respectively.
3. Expenditure of $14,280 not appropriated from the State General Fund or the State Highway Fund is hereby authorized during Fiscal Year 2023-2024 by the Division of Health Care Financing and Policy of the Department of Health and Human Services for the same purposes as set forth in subsection 1.
4. Expenditure of $428,275 not appropriated from the State General Fund or the State Highway Fund is hereby authorized during Fiscal Year 2024-2025 by the Division of Health Care Financing and Policy of the Department of Health and Human Services for the same purposes as set forth in subsection 1.
Sec. 4. 1. This section becomes effective upon passage and approval.
2. Section 3 of this act becomes effective on July 1, 2023.
3. Sections 1 and 2 of this act become effective:
(a) Upon passage and approval for the purpose of performing any preparatory administrative tasks that are necessary to carry out the provisions of this act; and
(b) On July 1, 2024, for all other purposes.
________
κ2023 Statutes of Nevada, Page 2300κ
Assembly Bill No. 519Committee on Ways and Means
CHAPTER 393
[Approved: June 13, 2023]
AN ACT relating to capital projects; requiring the board of county commissioners of certain counties to levy a property tax for capital projects of school districts; authorizing the board of county commissioners of certain counties to levy a property tax for capital projects of school districts for which a grant is available from the Fund to Assist Rural School Districts in Financing Capital Improvements; exempting that property tax from certain partial abatements during the first fiscal year in which the tax is imposed; exempting both property taxes from the statutory limitation on the total ad valorem tax levy; creating the Fund to Assist Rural School Districts in Financing Capital Improvements; requiring the board of county commissioners of certain counties to establish an oversight panel for school district capital improvement projects; making appropriations to the Fund; making an appropriation to the Elko County School District for the construction of a school on the Duck Valley Indian Reservation; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Existing law requires the board of trustees of each school district to establish a fund for capital projects. (NRS 387.328) Existing law also creates the Fund to Assist School Districts in Financing Capital Improvements from which a grant of money may be obtained if certain emergency conditions exist within the school district. (NRS 387.333, 387.3335)
Section 2 of this bill requires the board of county commissioners of a county whose population is 52,500 or more and less than 57,500 (currently Elko County), to levy a tax at a rate of not less than 1 cent and not more than 25 cents on each $100 of assessed valuation of taxable property within the county. Section 2 requires any money collected from such a tax to be deposited in the county treasury for credit to the fund for capital projects to be held and expended in the same manner as other money deposited in that fund. Section 6 of this bill authorizes the school district of a county where such a tax is imposed to pledge the proceeds of the tax, and the portion of the governmental services tax whose allocation to the school district is based on the amount of the property tax levy attributable to its debt service, to the payment of any bonds or other obligations the school district issued for capital projects. Section 8 of this bill provides that, if the board of county commissioners of a county which is required to levy such a tax does not adopt an ordinance levying the tax on or before June 30, 2024, the tax is levied at a rate of 25 cents on each $100 of assessed valuation of taxable property within the county.
Section 4 of this bill creates the Fund to Assist Rural School Districts in Financing Capital Improvements and requires the money in the Fund to be used to make grants to school districts in counties whose population is less than 100,000 (currently all counties other than Clark and Washoe Counties) for certain capital projects.
κ2023 Statutes of Nevada, Page 2301 (CHAPTER 393, AB 519)κ
Section 3 of this bill authorizes the board of county commissioners of a county whose population is less than 100,000, other than a board which is required to levy a tax pursuant to section 2, to levy a tax on all taxable property in the county for a capital project for which a grant may be obtained from the Fund. Section 3 requires the board of county commissioners to determine the amount of money required for the capital project, excluding any amount that the board anticipates will be covered by a grant from the Fund, and fix a rate of taxation which will raise that amount. Section 3 requires the revenue from the tax to be expended for: (1) a capital project for which a grant was made from the Fund; or (2) if the amount collected for a fiscal year exceeds the amount of the grant for that year, in the same manner as other money in the fund for capital projects established by the school district. Section 5.5 of this bill requires the board of county commissioners of a county which levies a tax pursuant to section 2 or 3 to establish an oversight panel for school district capital improvement projects.
Section 5 of this bill requires the board of trustees of a school district in a county which levies a tax pursuant to section 3 and authorizes the board of trustees of a school district in a county which levies a tax pursuant to section 2 during a fiscal year to apply to the Director of the Office of Finance in the Office of the Governor for a grant of money from the Fund. Section 5 requires the Director of the Office of Finance to make a grant of money from the Fund in an amount which is equal to: (1) the total amount of tax assessed pursuant to section 3 by the county for the capital project during the immediately preceding fiscal year; or (2) the amount of the proceeds of the tax imposed pursuant to section 2 for the immediately preceding fiscal year which the board of trustees of the school district has certified will be dedicated to the capital project.
Existing law, in general, limits the total amount of property taxes which may be imposed to $3.64 on each $100 of assessed valuation. (NRS 361.453) Sections 2 and 3 exempt the rates for the property taxes in those sections from this limitation. Section 7 of this bill makes a conforming change to indicate these exemptions from the limitation.
Existing law provides a partial abatement of the property taxes levied on property for which an assessed valuation has previously been established, a remainder parcel of real property, certain single-family residences and certain residential rental dwellings. (NRS 361.4722, 361.4723, 361.4724) With certain exceptions, existing law exempts new or increased property taxes from those partial abatements if a legislative act that became effective after April 6, 2005, imposed a duty on a taxing entity to levy the tax or increase the rate of the tax. (NRS 361.4726) Section 7.5 of this bill exempts any new property tax levied pursuant to section 2 or 3 from those partial tax abatements for the first fiscal year in which such a tax is imposed, but provides that such a tax is not exempt from those partial tax abatements for any fiscal year after the first fiscal year in which the tax is imposed.
Section 9 of this bill makes appropriations from the State General Fund to the Fund for grants to school districts in counties whose population is less than 100,000 (currently all counties other than Clark and Washoe Counties), including grants for capital projects for schools located on qualified tribal land. Section 10 of this bill makes an appropriation to the Elko County School District for the construction of a school on the Duck Valley Indian Reservation.
EXPLANATION Matter in bolded italics is new; matter between
brackets [omitted material] is material to be
omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 387 of NRS is hereby amended by adding thereto the provisions set forth as sections 2 to 5.5, inclusive, of this act.
Sec. 2. 1. The board of county commissioners of a county whose population is 52,500 or more and less than 57,500 shall, in addition to any taxes levied in accordance with NRS 387.195, levy a tax at a rate of not less than 1 cent and not more than 25 cents on each $100 of assessed valuation of taxable property within the county for capital projects of a school district, including, without limitation, capital projects for schools located on qualified tribal land.
κ2023 Statutes of Nevada, Page 2302 (CHAPTER 393, AB 519)κ
taxes levied in accordance with NRS 387.195, levy a tax at a rate of not less than 1 cent and not more than 25 cents on each $100 of assessed valuation of taxable property within the county for capital projects of a school district, including, without limitation, capital projects for schools located on qualified tribal land.
2. Any money collected pursuant to this section must be deposited in the county treasury for credit to the fund for capital projects established pursuant to NRS 387.328, to be held and expended in the same manner as other money deposited in that fund.
3. The rate of any tax levied pursuant to subsection 1 must not be included in the total ad valorem tax levy for the purposes of the application of the limitation in NRS 361.453.
4. As used in this section, qualified tribal land means any real property:
(a) For which legal title is vested in, or held in trust for the benefit of, an Indian tribe or an individual Native American, and which is subject to restrictions against alienation pursuant to federal law; and
(b) Over which an Indian tribe exercises governmental power.
Sec. 3. 1. Except for a board of county commissioners which is required to levy a tax pursuant to section 2 of this act, the board of county commissioners of a county whose population is less than 100,000, may, in addition to any taxes levied in accordance with NRS 387.195, levy a tax at a rate established by the board of county commissioners on all taxable property in the county for a capital project of the school district for which a grant may be obtained from the Fund to Assist Rural School Districts in Financing Capital Improvements created by section 4 of this act. The board of county commissioners shall determine the amount of money necessary, when combined with money anticipated to be received as a grant from the Fund, to pay the costs of the proposed capital project or the principal and interest on bonds or other obligations issued for one or more purposes set forth in subsection 5 of section 4 of this act, and shall fix a rate which, when levied upon every dollar of assessed valuation of taxable property in the district, will raise that amount.
2. Any money collected pursuant to this section must be deposited in the county treasury for credit to the fund for capital projects established pursuant to NRS 387.328, to be expended:
(a) For a capital project of a school district for which a grant to the school district was made from the Fund to Assist Rural School Districts in Financing Capital Improvements pursuant to section 5 of this act; or
(b) With respect to any money collected in excess of the amount of the grant made from the Fund to Assist Rural School Districts in Financing Capital Improvements for the fiscal year pursuant to section 5 of this act, in the same manner as other money deposited in the fund for capital projects.
3. The proceeds of the tax collected pursuant to this section may be pledged to the payment of principal and interest on bonds or other obligations issued for one or more of the purposes set forth in subsection 5 of section 4 of this act. The proceeds of such taxes so pledged may be treated as pledged revenues for the purposes of subsection 3 of NRS 350.020, and the board of trustees of the school district may issue bonds for those purposes in accordance with the provisions of chapter 350 of NRS.
κ2023 Statutes of Nevada, Page 2303 (CHAPTER 393, AB 519)κ
4. The rate of any tax levied pursuant to subsection 1 must not be included in the total ad valorem tax levy for the purposes of the application of the limitation in NRS 361.453.
Sec. 4. 1. The Fund to Assist Rural School Districts in Financing Capital Improvements is hereby created in the State Treasury, to be administered by the Director of the Office of Finance. All money received and held by the State Treasurer for the purpose of the Fund must be deposited in the Fund.
2. The Director of the Office of Finance may accept gifts and grants from any source for deposit in the Fund.
3. The money in the Fund must be invested as the money in other state funds is invested. All interest and income earned on the money in the Fund must be credited to the Fund.
4. Claims against the Fund must be paid as other claims against the State are paid.
5. Money in the Fund must be used to make grants to school districts in counties whose population is less than 100,000, for the following purposes:
(a) Construction, design or purchase of new buildings for schools, including, but not limited to, teacherages, dormitories, dining halls, gymnasiums and stadiums.
(b) Enlarging, remodeling or repairing existing buildings or grounds for schools, including, but not limited to, teacherages, dormitories, dining halls, gymnasiums and stadiums.
(c) Acquiring sites for building schools, or additional real property for necessary purposes related to schools, including, but not limited to, playgrounds, athletic fields and sites for stadiums.
Sec. 5. 1. Following any fiscal year in which a county levies a tax imposed pursuant to section 3 of this act, the board of trustees of the school district in the county shall apply to the Director of the Office of Finance for a grant of money from the Fund created pursuant to section 4 of this act on a form provided by the Director.
2. Following any fiscal year in which a county levies a tax imposed pursuant to section 2 of this act, the board of trustees of the school district in the county may apply to the Director of the Office of Finance for a grant of money from the Fund created pursuant to section 4 of this act on a form provided by the Director.
3. The application for a grant of money from the Fund submitted pursuant to this section must be accompanied by:
(a) A description of the capital project for which the grant is requested, which must be a capital project described by subsection 5 of section 4 of this act; and
(b) Either:
(1) Documentation of the amount of the tax assessed pursuant to section 3 of this act for the capital project for which the grant is requested in the immediately preceding fiscal year; or
(2) A statement by the board of trustees of the school district in a county which has levied a tax imposed pursuant to section 2 of this act certifying the amount of the proceeds of the tax imposed pursuant to section 2 of this act for the immediately preceding fiscal year which will be dedicated to the capital project.
κ2023 Statutes of Nevada, Page 2304 (CHAPTER 393, AB 519)κ
4. To the extent that money is available for that purpose in the Fund and if the Director of the Office of Finance determines that the capital project for which the grant is requested is a project for which a grant may be made from the Fund, the Director shall make a grant of money from the Fund to a school district that submits an application pursuant to subsection 1 or 2 in an amount that is equal to:
(a) The total amount of tax assessed by the county for the capital project pursuant to section 3 of this act in the immediately preceding fiscal year; or
(b) If the school district is located in a county which levies a tax imposed pursuant to section 2 of this act, the amount of the proceeds of the tax imposed pursuant to section 2 of this act for the immediately preceding fiscal year which the board of trustees of the school district has certified will be dedicated to the capital project.
5. The Director of the Office of Finance shall adopt regulations that prescribe the annual deadline for submission of an application to the Director by a school district pursuant to this section.
Sec. 5.5. 1. The board of county commissioners of a county whose population is less than 100,000 and which levies a tax pursuant to section 2 or 3 of this act shall establish an oversight panel for school district capital improvement projects, consisting of five members selected as follows:
(a) One member who is the chair of the board of county commissioners of the county, or his or her designee, who shall serve as the chair of the oversight panel;
(b) One member who is a member of the board of trustees of the school district in the county, appointed by the president of the board of trustees of the school district;
(c) One member who is a member of a federally recognized Indian tribe or nation located in whole or in part within the boundaries of the county, appointed by the executive head of the federally recognized Indian tribe or nation;
(d) One member who is a resident of the county and has experience in the building of school facilities, appointed by the president of the board of trustees of the school district in the county; and
(e) One member who is a resident of the county and has experience in the financing of public works projects, appointed by the chair of the board of county commissioners of the county.
2. After the initial terms, the term of each member of the oversight panel is 2 years. Members of the oversight panel are eligible for reappointment.
3. The oversight panel shall meet at least once each calendar quarter.
4. The oversight panel shall:
(a) Review all credits to and debits from the fund for capital projects established pursuant to NRS 387.328;
(b) Recommend future uses of the money raised by the county from levying a tax imposed pursuant to section 2 or 3 of this act;
(c) Review the amount of any appropriation, grant, gift or donation received by the county for the construction of school facilities located on qualified tribal land; and
κ2023 Statutes of Nevada, Page 2305 (CHAPTER 393, AB 519)κ
(d) Make a recommendation for the date of termination of a tax levied pursuant to section 2 or 3 of this act if the date of termination of the tax is not otherwise fixed.
Sec. 6. NRS 387.328 is hereby amended to read as follows:
387.328 1. The board of trustees of each school district shall establish a fund for capital projects for the purposes set forth in subsection 1 of NRS 387.335. The money in the fund for capital projects may be transferred to the debt service fund to pay the cost of the school districts debt service.
2. The board of trustees may accumulate money in the fund for capital projects for a period not to exceed 20 years.
3. That portion of the governmental services tax whose allocation to the school district pursuant to NRS 482.181 is based on the amount of the property tax levy attributable to its debt service must be deposited in the county treasury to the credit of the fund established under subsection 1 or the school districts debt service fund.
4. No money in the fund for capital projects at the end of the fiscal year may revert to the county school district fund, nor may the money be a surplus for any other purpose than those specified in subsection 1.
5. The proceeds of the taxes deposited in the fund for capital projects pursuant to NRS 244.3354, 268.0962, 375.070, 377C.110 and 387.3288 and section 2 of this act and, in a county whose population is 100,000 or more but less than 700,000, the portion of the governmental services tax whose allocation to the school district pursuant to NRS 482.181 is based on the amount of the property tax levy attributable to its debt service may be pledged to the payment of the principal and interest on bonds or other obligations issued for one or more of the purposes set forth in NRS 387.335. The proceeds of such taxes so pledged may be treated as pledged revenues for the purposes of subsection 3 of NRS 350.020, and the board of trustees of a school district may issue bonds for those purposes in accordance with the provisions of chapter 350 of NRS.
Sec. 7. NRS 361.453 is hereby amended to read as follows:
361.453 1. Except as otherwise provided in this section and NRS 354.705, 354.723, 387.3288 and 450.760, and sections 2 and 3 of this act, the total ad valorem tax levy for all public purposes must not exceed $3.64 on each $100 of assessed valuation, or a lesser or greater amount fixed by the State Board of Examiners if the State Board of Examiners is directed by law to fix a lesser or greater amount for that fiscal year.
2. Any levy imposed by the Legislature for the repayment of bonded indebtedness or the operating expenses of the State of Nevada and any levy imposed by the board of county commissioners pursuant to NRS 387.195 that is in excess of 50 cents on each $100 of assessed valuation of taxable property within the county must not be included in calculating the limitation set forth in subsection 1 on the total ad valorem tax levied within the boundaries of the county, city or unincorporated town, if, in a county whose population is less than 45,000, or in a city or unincorporated town located within that county:
(a) The combined tax rate certified by the Nevada Tax Commission was at least $3.50 on each $100 of assessed valuation on June 25, 1998;
κ2023 Statutes of Nevada, Page 2306 (CHAPTER 393, AB 519)κ
(b) The governing body of that county, city or unincorporated town proposes to its registered voters an additional levy ad valorem above the total ad valorem tax levy for all public purposes set forth in subsection 1;
(c) The proposal specifies the amount of money to be derived, the purpose for which it is to be expended and the duration of the levy; and
(d) The proposal is approved by a majority of the voters voting on the question at a general election or a special election called for that purpose.
3. The duration of the additional levy ad valorem levied pursuant to subsection 2 must not exceed 5 years. The governing body of the county, city or unincorporated town may discontinue the levy before it expires and may not thereafter reimpose it in whole or in part without following the procedure required for its original imposition set forth in subsection 2.
4. A special election may be held pursuant to subsection 2 only if the governing body of the county, city or unincorporated town determines, by a unanimous vote, that an emergency exists. The determination made by the governing body is conclusive unless it is shown that the governing body acted with fraud or a gross abuse of discretion. An action to challenge the determination made by the governing body must be commenced within 15 days after the governing bodys determination is final. As used in this subsection, emergency means any unexpected occurrence or combination of occurrences which requires immediate action by the governing body of the county, city or unincorporated town to prevent or mitigate a substantial financial loss to the county, city or unincorporated town or to enable the governing body to provide an essential service to the residents of the county, city or unincorporated town.
Sec. 7.5. NRS 361.4726 is hereby amended to read as follows:
361.4726 1. Except as otherwise provided by specific statute, if any legislative act which becomes effective after April 6, 2005, imposes a duty on a taxing entity to levy a new ad valorem tax or to increase the rate of an existing ad valorem tax, the amount of the new tax or increase in the rate of the existing tax is exempt from each partial abatement from taxation provided pursuant to NRS 361.4722, 361.4723 and 361.4724.
2. The amount of any tax imposed pursuant to NRS 354.705 and 387.3288 is exempt from each partial abatement from taxation provided pursuant to NRS 361.4722, 361.4723 and 361.4724.
3. The amount of any tax imposed pursuant to section 2 or 3 of this act is exempt from each partial abatement from taxation provided pursuant to NRS 361.4722, 361.4723 and 361.4724 during the first fiscal year that the tax is imposed and is not exempt from each such partial abatement during any fiscal year thereafter.
4. For the purposes of this section, taxing entity does not include the State.
Sec. 8. If the board of county commissioners of a county whose population is 52,500 or more and less than 57,500, has not adopted an ordinance levying the tax pursuant to section 2 of this act on or before June 30, 2024, a tax shall be levied pursuant to section 2 of this act at a rate of 25 cents on each $100 of assessed valuation of taxable property within the county. The tax shall be collected and administered in the same manner as though the board of county commissioners had adopted an ordinance levying the tax pursuant to section 2 of this act at that rate.
κ2023 Statutes of Nevada, Page 2307 (CHAPTER 393, AB 519)κ
Sec. 9. 1. There is hereby appropriated from the State General Fund to the Fund to Assist Rural School Districts in Financing Capital Improvements created by section 4 of this act the sum of $25,000,000, for grants to school districts, and the sum of $25,000,000, for grants to school districts for capital projects for schools located on qualified tribal land.
2. As used in this section, qualified tribal land means any real property:
(a) For which legal title is vested in, or held in trust for the benefit of, an Indian tribe or an individual Native American, and which is subject to restrictions against alienation pursuant to federal law; and
(b) Over which an Indian tribe exercises governmental power.
Sec. 10. 1. There is hereby appropriated from the State General Fund to the Elko County School District the sum of $64,500,000 for the construction of a school on the Duck Valley Indian Reservation to replace the Owyhee Combined School.
2. All money appropriated by subsection 1 must be used only for the purposes specified in subsection 1 and no portion of the money may be set aside, distributed or otherwise committed or used for any other purpose, including, without limitation, any costs related to other buildings or facilities.
3. Any remaining balance of the appropriation made by subsection 1 must not be committed for expenditure after June 30, 2028, by the entity to which the appropriation is made or any entity to which money from the appropriation is granted or otherwise transferred in any manner, and any portion of the appropriated money remaining must not be spent for any purpose after September 15, 2028, by either the entity to which the money was appropriated or the entity to which the money was subsequently granted or transferred, and must be reverted to the State General Fund on or before September 15, 2028.
Sec. 11. Notwithstanding the provisions of NRS 218D.430 and 218D.435, a committee may vote on this act before the expiration of the period prescribed for the return of a fiscal note in NRS 218D.475. This section applies retroactively from and after May 21, 2023.
Sec. 12. This act becomes effective on July 1, 2023.
________
κ2023 Statutes of Nevada, Page 2308κ
Senate Bill No. 413Committee on Judiciary
CHAPTER 394
[Approved: June 13, 2023]
AN ACT relating to sentencing; revising the method for determining credits to reduce the sentence of an offender; requiring the Director of the Department of Corrections to provide an offender with a list of certain programs; requiring the Director of the Department to submit a report to the Board of State Prison Commissioners which includes certain information concerning the institutional programming and placement of an offender under certain circumstances; requiring the Board of State Prison Commissioners to adopt regulations to carry out the revised method for determining credits to reduce the sentence of an offender; requiring the Department to share information with the Office of the Attorney General concerning actions taken to implement the revised method for determining credits to reduce the sentence of an offender; requiring the Department to report to the Interim Finance Committee concerning such actions; making appropriations; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Existing law allows an offender to earn certain credits to reduce his or her sentence of imprisonment. (NRS 209.432-209.453) For example, under existing law, an offender who is sentenced to prison for a crime committed on or after July 17, 1997, may, under certain circumstances, be allowed: (1) a deduction of 20 days from his or her sentence for each month the offender serves; (2) up to 10 days of credit each month for diligence in labor and study; (3) certain credits for educational achievement; (4) up to 10 days of credit each month for participation in a center for the purpose of making restitution, program for reentry of offenders and parolees into the community, conservation camp, program of work release or another program conducted outside of the prison; (5) up to 90 days of credit each year for exceptional meritorious service; and (6) if the Governor determines, by executive order, that it is necessary, a deduction of up to 5 days from his or her sentence for each month the offender serves. Existing law provides that such credits must be deducted from the maximum term or the maximum aggregate term imposed by the sentence, as applicable, and apply to eligibility for parole unless the offender was sentenced pursuant to a statute which specifies a minimum sentence that must be served before a person becomes eligible for parole. Existing law also provides that, unless an offender has been convicted of certain crimes, such credits must also be deducted from the minimum term or the minimum aggregate term imposed by the sentence, as applicable, until the offender becomes eligible for parole. (NRS 209.4465) Existing law also allows certain offenders to earn credit for: (1) being incarcerated during a state of emergency due to communicable or infectious disease; (2) completing a program of treatment for an alcohol or other substance use disorder; and (3) completing a vocational education and training or other program. (NRS 209.4477, 209.448, 209.449)
Existing law requires the Director of the Department of Corrections to administer a risk and needs assessment to each person in the custody of the Department to measure criminal risk factors and individual needs for the purpose of guiding institutional programming and placement. (NRS 209.341) Before a meeting to consider a prisoner for parole, existing law requires the Department to compile and provide to the State Board of Parole Commissioners data that will assist the Board in determining whether parole should be granted to the prisoner. (NRS 213.131)
κ2023 Statutes of Nevada, Page 2309 (CHAPTER 394, SB 413)κ
This bill provides a revised method for determining credits to reduce the sentence of an offender that applies to an offender sentenced to prison for a crime committed: (1) on or after July 1, 2025; or (2) before July 1, 2025, if the offender elects to be subject to the revised method.
Section 1 of this bill provides that an offender who complies with the programming and placement identified in the risk and needs assessment administered to the offender, as determined by the Director, must be allowed credit against the minimum term or minimum aggregate term, as applicable, of his or her sentence for good behavior in an amount of days that is equivalent to 35 percent of the minimum term or minimum aggregate term, as applicable, of the sentence of the offender. Section 1 does not apply to an offender who has been convicted of: (1) any crime that is punishable as a felony involving the use or threatened use of force or violence against the victim; (2) a sexual offense that is punishable as a felony; (3) certain offenses relating to driving under the influence of alcohol or a controlled substance that are punishable as a felony; or (4) a category A or B felony. Therefore, under section 1, an offender convicted of such an offense is not eligible for credit to reduce the minimum term or minimum aggregate term, as applicable, of his or her sentence.
Section 1 also provides for the allowance of credit against the maximum term or maximum aggregate term, as applicable, of the sentence of an offender. Under section 1, an offender who complies with the programming and placement identified in the risk and needs assessment administered to the offender, as determined by the Director, must be allowed credit against the maximum term or maximum aggregate term, as applicable, of his or her sentence for good behavior in an amount of days that is equivalent to 35 percent of the maximum term or maximum aggregate term, as applicable, of his or her sentence.
Section 1 requires the Director to provide each offender in the custody of the Department with a list that includes: (1) the programs identified in the risk and needs assessment administered to the offender, as determined by the Director; (2) the programs available at the institution or facility to which the offender has been assigned; and (3) which of the programs identified in the risk and needs assessment are available at the institution or facility to which the offender has been assigned. At the time the Department compiles and provides to the State Board of Parole Commissioners data that will assist the Board in determining whether parole should be granted to an offender, section 1 requires the Director to additionally submit to the Board a report that includes: (1) the list of programs provided to each offender in the custody of the Department; and (2) the programs the offender has successfully completed.
Section 2 of this bill makes a conforming change to indicate the proper placement of section 1 in the Nevada Revised Statutes. Sections 3-10 of this bill make conforming changes to include necessary references to section 1 and to reflect the changes in section 1.
Section 10.1 of this bill appropriates money to the Department to pay for the costs of upgrading its information technology system that is necessary to carry out the provisions of section 1. Section 10.3 of this bill appropriates money to the Department for personnel costs associated with carrying out the provisions of section 1.
Section 10.5 of this bill requires the Department to: (1) not later than December 31, 2024, report to the Interim Finance Committee on the actions taken by the Department to implement the provisions of this bill; and (2) share information with the Office of the Attorney General concerning the actions taken by the Department to implement the provisions of this bill.
κ2023 Statutes of Nevada, Page 2310 (CHAPTER 394, SB 413)κ
EXPLANATION Matter in bolded italics is new; matter between
brackets [omitted material] is material to be
omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 209 of NRS is hereby amended by adding thereto a new section to read as follows:
1. Except as otherwise provided in this subsection, an offender who complies with the programming and placement identified in the risk and needs assessment administered pursuant to NRS 209.341, as determined by the Director, must be allowed credit against the minimum term or minimum aggregate term, as applicable, of his or her sentence for good behavior in an amount of days that is equivalent to 35 percent of the minimum term or minimum aggregate term, as applicable, of the sentence of the offender. Any credit allowed pursuant to this subsection may reduce the minimum term or the minimum aggregate term imposed by the sentence, as applicable, by not more than 58 percent. Credit must be allowed for the period the offender is actually incarcerated pursuant to his or her sentence and applies to eligibility for parole, unless the offender was sentenced pursuant to a specific statute which specifies that a minimum sentence must be served before the offender becomes eligible for parole. Any forfeiture of credit pursuant to a specific statute must be applied after the credit allowed in this subsection. This subsection does not apply to an offender who has been convicted of:
(a) Any crime that is punishable as a felony involving the use or threatened use of force or violence against the victim.
(b) A sexual offense that is punishable as a felony.
(c) A violation of NRS 484C.110, 484C.120, 484C.130 or 484C.430 that is punishable as a felony.
(d) A category A or B felony.
2. Except as otherwise provided in this subsection, an offender who complies with the programming and placement identified in the risk and needs assessment administered pursuant to NRS 209.341, as determined by the Director, must be allowed credit against the maximum term or maximum aggregate term, as applicable, of his or her sentence for good behavior in an amount of days that is equivalent to 35 percent of the maximum term or maximum aggregate term, as applicable, of his or her sentence. Any forfeiture of credit pursuant to a specific statute must be applied after the credit allowed in this subsection. Credit allowed pursuant to this subsection:
(a) Must be allowed only for any period the offender is:
(1) Actually incarcerated pursuant to his or her sentence;
(2) In residential confinement; or
(3) In the custody of the Division of Parole and Probation of the Department of Public Safety pursuant to NRS 209.4886 or 209.4888.
(b) Is in addition to any credit allowed to reduce the sentence of the offender that is authorized pursuant to a specific statute.
3. An offender who is sentenced to prison for a crime committed before July 1, 2025, may irrevocably elect to be subject to the provisions of this section. The election by an offender to be subject to the provisions of this section must not:
κ2023 Statutes of Nevada, Page 2311 (CHAPTER 394, SB 413)κ
(a) Extend the sentence of the offender; or
(b) Otherwise reduce retroactively the amount of credit allowed to reduce the sentence of the offender under the laws of this State as those laws existed before July 1, 2025, if doing so would constitute a violation under the United States Constitution or the Nevada Constitution.
4. The Director shall:
(a) Provide each offender in the custody of the Department with a list that includes:
(1) The programs identified in the risk and needs assessment administered to the offender pursuant to NRS 209.341, as determined by the Director;
(2) The programs available at the institution or facility to which the offender has been assigned; and
(3) Which of the programs described in subparagraph (1) are available at the institution or facility to which the offender has been assigned; and
(b) At the time the Department compiles and provides to the State Board of Parole Commissioners data that will assist the Board in determining whether parole should be granted to the offender pursuant to NRS 213.131, submit a report to the Board that includes:
(1) The list of programs provided to the offender pursuant to paragraph (a); and
(2) The programs provided to the offender pursuant to paragraph (a) that the offender successfully completed.
5. The Board shall adopt regulations to carry out the provisions of this section.
Sec. 2. NRS 209.432 is hereby amended to read as follows:
209.432 As used in NRS 209.432 to 209.453, inclusive, and section 1 of this act, unless the context otherwise requires:
1. Offender includes:
(a) A person who is convicted of a felony under the laws of this State and sentenced, ordered or otherwise assigned to serve a term of residential confinement.
(b) A person who is convicted of a felony under the laws of this State and assigned to the custody of the Division of Parole and Probation of the Department of Public Safety pursuant to NRS 209.4886 or 209.4888.
2. Residential confinement means the confinement of a person convicted of a felony to his or her place of residence under the terms and conditions established pursuant to specific statute. The term does not include any confinement ordered pursuant to NRS 176A.540, 176A.550, 176A.560, 176A.660 to 176A.690, inclusive, 213.15105, 213.15193 or 213.152 to 213.1528, inclusive.
Sec. 3. NRS 209.4465 is hereby amended to read as follows:
209.4465 1. [An] Unless an offender has elected to be subject to the provisions of section 1 of this act, an offender who is sentenced to prison for a crime committed on or after July 17, 1997, but before July 1, 2025, who has no serious infraction of the regulations of the Department, the terms and conditions of his or her residential confinement or the laws of the State recorded against the offender, and who performs in a faithful, orderly and peaceable manner the duties assigned to the offender, must be allowed:
κ2023 Statutes of Nevada, Page 2312 (CHAPTER 394, SB 413)κ
(a) For the period the offender is actually incarcerated pursuant to his or her sentence;
(b) For the period the offender is in residential confinement; and
(c) For the period the offender is in the custody of the Division of Parole and Probation of the Department of Public Safety pursuant to NRS 209.4886 or 209.4888,
Κ a deduction of 20 days from his or her sentence for each month the offender serves.
2. In addition to the credits allowed pursuant to subsection 1, the Director may allow not more than 10 days of credit each month for an offender whose diligence in labor and study merits such credits. In addition to the credits allowed pursuant to this subsection, an offender is entitled to the following credits for educational achievement:
(a) For earning a general educational development certificate or an equivalent document, 60 days.
(b) For earning a high school diploma, 90 days.
(c) For earning his or her first associate degree, 120 days.
3. The Director may, in his or her discretion, authorize an offender to receive a maximum of 90 days of credit for each additional degree of higher education earned by the offender.
4. The Director may allow not more than 10 days of credit each month for an offender who participates in a diligent and responsible manner in a center for the purpose of making restitution, program for reentry of offenders and parolees into the community, conservation camp, program of work release or another program conducted outside of the prison. An offender who earns credit pursuant to this subsection is eligible to earn the entire 30 days of credit each month that is allowed pursuant to subsections 1 and 2.
5. The Director may allow not more than 90 days of credit each year for an offender who engages in exceptional meritorious service.
6. The Board shall adopt regulations governing the award, forfeiture and restoration of credits pursuant to this section.
7. Except as otherwise provided in subsections 8 and 9, credits earned pursuant to this section:
(a) Must be deducted from the maximum term or the maximum aggregate term imposed by the sentence, as applicable; and
(b) Apply to eligibility for parole unless the offender was sentenced pursuant to a statute which specifies a minimum sentence that must be served before a person becomes eligible for parole.
8. Credits earned pursuant to this section by an offender who has not been convicted of:
(a) Any crime that is punishable as a felony involving the use or threatened use of force or violence against the victim;
(b) A sexual offense that is punishable as a felony;
(c) A violation of NRS 484C.110, 484C.120, 484C.130 or 484C.430 that is punishable as a felony; or
(d) A category A or B felony,
Κ apply to eligibility for parole and, except as otherwise provided in subsection 9, must be deducted from the minimum term or the minimum aggregate term imposed by the sentence, as applicable, until the offender becomes eligible for parole and must be deducted from the maximum term or the maximum aggregate term imposed by the sentence, as applicable.
κ2023 Statutes of Nevada, Page 2313 (CHAPTER 394, SB 413)κ
9. Credits deducted pursuant to subsection 8 may reduce the minimum term or the minimum aggregate term imposed by the sentence, as applicable, by not more than 58 percent for an offender who:
(a) Is serving a sentence for an offense committed on or after July 1, 2014; or
(b) On or after July 1, 2014, makes an irrevocable election to have his or her consecutive sentences aggregated pursuant to NRS 213.1212.
10. In addition to the credits allowed pursuant to this section, if the Governor determines, by executive order, that it is necessary, the Governor may authorize the deduction of not more than 5 days from a sentence for each month an offender serves. This subsection must be uniformly applied to all offenders under a sentence at the time the Governor makes such a determination.
Sec. 4. NRS 209.4475 is hereby amended to read as follows:
209.4475 1. In addition to any credits earned pursuant to NRS 209.447 [,] and section 1 of this act, an offender who is on parole as of January 1, 2004, or who is released on parole on or after January 1, 2004, for a term less than life must be allowed for the period the offender is actually on parole a deduction of 20 days from the offenders sentence for each month the offender serves if:
(a) The offender is current with any fee to defray the costs of his or her supervision charged by the Division of Parole and Probation of the Department of Public Safety pursuant to NRS 213.1076; and
(b) The offender is current with any payment of restitution required by the State Board of Parole Commissioners pursuant to NRS 213.126.
2. An offender shall be deemed to be current with any fee and payment of restitution described in subsection 1 for any given month if, during that month, the offender makes at least the minimum monthly payment established by:
(a) The Division of Parole and Probation of the Department of Public Safety, if any; and
(b) The State Board of Parole Commissioners, if any.
3. In addition to any credits earned pursuant to subsection 1 , [and] NRS 209.447 [,] and section 1 of this act, the Director may allow not more than 10 days of credit each month for an offender:
(a) Who is on parole as of January 1, 2004, or who is released on parole on or after January 1, 2004, for a term less than life; and
(b) Whose diligence in labor or study merits such credits.
4. An offender is entitled to the deductions authorized by this section only if the offender satisfies the conditions of subsection 1 or 3, as determined by the Director. The Chief Parole and Probation Officer or other person responsible for the supervision of an offender shall report to the Director the failure of an offender to satisfy those conditions.
5. Credits earned pursuant to this section must, in addition to any credits earned pursuant to NRS 209.443, 209.446, 209.4465, 209.447, 209.448 and 209.449, and section 1 of this act, be deducted from the maximum term or the maximum aggregate term imposed by the sentence, as applicable.
κ2023 Statutes of Nevada, Page 2314 (CHAPTER 394, SB 413)κ
6. The Director shall maintain records of the credits to which each offender is entitled pursuant to this section.
Sec. 5. NRS 209.4477 is hereby amended to read as follows:
209.4477 1. [An] Unless an offender has elected to be subject to the provisions of section 1 of this act, an offender who is serving a sentence for a crime committed before July 1, 2025, and who is actually incarcerated in an institution or facility of the Department pursuant to his or her sentence during a period in which a state of emergency due to a communicable or infectious disease has been declared by the Governor and remains in effect must be allowed, in addition to the credits provided pursuant to NRS 209.433, 209.443, 209.446 or 209.4465, a deduction of 5 days from his or her sentence for each month the offender serves during the state of emergency. An offender shall not be allowed more than 60 days of credit pursuant to this section.
2. Credits earned pursuant to this section:
(a) Apply to eligibility for parole and must be deducted from the minimum term or the minimum aggregate term imposed by the sentence, as applicable, until the offender becomes eligible for parole, unless the offender was sentenced pursuant to a statute which specifies a minimum sentence which must be served before a person becomes eligible for parole; and
(b) Must be deducted from the maximum term or the maximum aggregate term imposed by the sentence, as applicable.
3. Not later than 60 days after a state of emergency due to a communicable or infectious disease has been declared by the Governor, the Director shall submit a report containing a list of the offenders who have received credits pursuant to this section to the Chief Justice of the Nevada Supreme Court, the State Public Defender, the Attorney General, the Executive Director of the Department of Sentencing Policy and the Director of the Legislative Counsel Bureau for transmittal to the Legislature or, if the Legislature is not in session, to the Joint Interim Standing Committee on the Judiciary.
4. As used in this section:
(a) Communicable disease means an infectious disease that can be transmitted from person to person, animal to person or insect to person.
(b) Infectious disease means a disease caused by a living organism or other pathogen, including a fungus, bacillus, parasite, protozoan or virus. An infectious disease may or may not be transmissible from person to person, animal to person or insect to person.
Sec. 6. NRS 209.448 is hereby amended to read as follows:
209.448 1. An offender who has no serious infraction of the regulations of the Department or the laws of the State recorded against the offender must be allowed, in addition to the credits provided pursuant to NRS 209.433, 209.443, 209.446 or 209.4465, a deduction of not more than 60 days from the maximum term or the maximum aggregate term of the offenders sentence, as applicable, for the successful completion of a program of treatment for an alcohol or other substance use disorder which is conducted jointly by the Department and a person who is licensed as a clinical alcohol and drug counselor, licensed or certified as an alcohol and drug counselor or certified as an alcohol and drug counselor intern or a clinical alcohol and drug counselor intern, pursuant to chapter 641C of NRS.
κ2023 Statutes of Nevada, Page 2315 (CHAPTER 394, SB 413)κ
2. [The] Unless an offender has elected to be subject to the provisions of section 1 of this act, the provisions of this section apply to any offender who is sentenced on or after October 1, 1991 [.] , for a crime committed before July 1, 2025.
Sec. 7. NRS 209.449 is hereby amended to read as follows:
209.449 1. [An] Unless an offender has elected to be subject to the provisions of section 1 of this act, an offender who is serving a sentence for a crime committed before July 1, 2025, and who has no serious infraction of the regulations of the Department, the terms and conditions of his or her residential confinement or the laws of the State recorded against the offender must be allowed, in addition to the credits provided pursuant to NRS 209.433, 209.443, 209.446 or 209.4465, a deduction of 60 days from the maximum term or the maximum aggregate term of the offenders sentence, as applicable, for the successful completion of:
(a) A program of vocational education and training; or
(b) Any other program approved by the Director.
2. If the offender completes such a program with meritorious or exceptional achievement, the Director may allow not more than 60 days of credit in addition to the 60 days allowed for completion of the program.
Sec. 8. NRS 209.4495 is hereby amended to read as follows:
209.4495 1. Notwithstanding any provision of NRS 209.432 to 209.453, inclusive, and section 1 of this act, which entitles an offender to receive credit or which authorizes the Director to allow credit for an offender, an offender may not earn more than the amount of credit required to expire his or her sentence.
2. Nothing in this section shall be construed to reduce retroactively the amount of credit earned by an offender if doing so would constitute a violation under the Constitution of the United States or the Constitution of the State of Nevada.
Sec. 9. NRS 213.120 is hereby amended to read as follows:
213.120 1. Except as otherwise provided in NRS 213.1213 or section 1 of this act and as limited by statute for certain specified offenses, a prisoner who was sentenced to prison for a crime committed before July 1, 1995, may be paroled when the prisoner has served one-third of the definite period of time for which the prisoner has been sentenced pursuant to NRS 176.033, less any credits earned to reduce his or her sentence pursuant to chapter 209 of NRS.
2. Except as otherwise provided in NRS 213.1213 and as limited by statute for certain specified offenses, a prisoner who was sentenced to prison for a crime committed on or after July 1, 1995, may be paroled when the prisoner has served the minimum term or minimum aggregate term of imprisonment imposed by the court. Except as otherwise provided in NRS 209.4465 [,] and section 1 of this act, any credits earned to reduce his or her sentence pursuant to chapter 209 of NRS while the prisoner serves the minimum term or minimum aggregate term of imprisonment may reduce only the maximum term or the maximum aggregate term of imprisonment imposed, as applicable, and must not reduce the minimum term or the minimum aggregate term of imprisonment, as applicable.
Sec. 10. NRS 213.1212 is hereby amended to read as follows:
213.1212 1. Notwithstanding any other provision of law, if a prisoner is sentenced pursuant to NRS 176.035 to serve two or more consecutive sentences, the terms of which have been aggregated:
κ2023 Statutes of Nevada, Page 2316 (CHAPTER 394, SB 413)κ
(a) The prisoner shall be deemed to be eligible for parole from all such sentences after serving the minimum aggregate term of imprisonment; and
(b) The Board is not required to consider the prisoner for parole until the prisoner has served the minimum aggregate term of imprisonment.
2. Except as otherwise provided in subsection 3, for purposes of determining parole eligibility, a prisoner whose sentences have been aggregated may earn credit pursuant to NRS 209.433 to 209.449, inclusive, and section 1 of this act, which must be deducted from the minimum aggregate term of imprisonment or the maximum aggregate term of imprisonment, as applicable. Such credits may be earned only to the extent that the credits would otherwise be earned had the sentences not been aggregated.
3. For purposes of determining parole eligibility, if the sentences of a prisoner are governed by different provisions of law concerning the earning of credits pursuant to NRS 209.433 to 209.4465, inclusive, and section 1 of this act, the Department of Corrections shall determine the minimum term of each sentence to be aggregated for the purpose of establishing a minimum aggregate term of imprisonment as follows:
(a) If the parole eligibility of a prisoner is based on credits earned pursuant to NRS 209.433 or 209.443, the Department of Corrections shall establish a fixed minimum term for that sentence based on the assumption that the prisoner will earn all future credits to reduce that sentence as provided in NRS 209.433 or 209.443, as applicable, except for credits earned for donating blood or for educational achievements in accordance with any regulations adopted by the Board pursuant to subsection 2 of NRS 209.433 or subsection 3 of NRS 209.443. Any such credits earned by a prisoner for donating blood or for educational achievements that are awarded after a minimum aggregate term of imprisonment is established must be applied only to the maximum aggregate term of imprisonment.
(b) If the parole eligibility of a prisoner is based on credits earned pursuant to NRS 209.446, the Department of Corrections shall establish a fixed minimum term for that sentence based on the assumption that the prisoner will earn all future credits to reduce that sentence as provided in NRS 209.446, except for credits earned for educational achievements pursuant to subsection 2 of NRS 209.446 or for meritorious service pursuant to subsection 4 of NRS 209.446. Any such credits earned for educational achievements or meritorious service that are awarded after a minimum aggregate term of imprisonment is established must be applied only to the maximum aggregate term of imprisonment.
(c) If a prisoner is eligible to earn a deduction from the minimum term of his or her sentence pursuant to subsection 8 of NRS 209.4465 [,] or section 1 of this act, the minimum term of the sentence to be aggregated must be the minimum term set by the court, and the provisions of subsection 9 of NRS 209.4465 or section 1 of this act, as applicable, must be applied to the aggregated sentence.
(d) If a prisoner is not eligible to earn a deduction from the minimum term of his or her sentence, the minimum term of the sentence to be aggregated must be the term set by the court or, if the court does not set the minimum term, the minimum term required by law.
κ2023 Statutes of Nevada, Page 2317 (CHAPTER 394, SB 413)κ
4. A prisoner whose sentences have been aggregated pursuant to subsection 3 may earn credits to reduce the maximum aggregate term of imprisonment, as already reduced by any presentence credits stipulated in the judgment of conviction or other applicable court order, pursuant to NRS 209.4465 or 209.4475 or section 1 of this act beginning on the date the prisoner elected to have the sentences aggregated or on the date of sentencing.
5. Except as otherwise provided in subsection 6 and subsection 3 of NRS 176.035, a prisoner who is serving consecutive sentences which have not been aggregated may, by submitting a written request to the Director of the Department of Corrections, make an irrevocable election to have the sentences aggregated. If the prisoner makes such an irrevocable election to have the sentences aggregated and:
(a) The prisoner has not been considered for parole on any of the sentences requested to be aggregated, the Department of Corrections shall aggregate the sentences in the manner set forth in this section and NRS 176.035 and the Board is not required to consider the prisoner for parole until the prisoner has served the minimum aggregate term of imprisonment.
(b) The prisoner has been considered for parole on one or more of the sentences requested to be aggregated, the Department of Corrections shall aggregate only the sentences for which parole has not been considered. The Board is not required to consider the prisoner for parole on the aggregated sentences until the prisoner has served the minimum aggregate term of imprisonment.
6. At the request of a prisoner, the Department of Corrections may disaggregate any aggregated sentences for which parole has not been considered for the purpose of aggregating such sentences with other sentences pursuant to this section or NRS 176.035.
7. Except as otherwise provided in subsection 3 of NRS 176.035, if the Department of Corrections aggregates sentences that are comprised of separate aggregated sentences, the Department of Corrections may aggregate all the consecutive sentences to create a single aggregated sentence.
8. The provisions of this section do not establish a basis for any cause of action by a prisoner against the State or its political subdivisions, agencies, boards, commissions, departments, officers or employees relating to any credits the prisoner might have earned if the sentences of the prisoner had not been aggregated.
Sec. 10.1. 1. There is hereby appropriated from the State General Fund to the Department of Corrections the sum of $300,000 for costs associated with upgrading the information technology system of the Department that is necessary to carry out the provisions of section 1 of this act.
2. Any remaining balance of the appropriation made by subsection 1 must not be committed for expenditure after June 30, 2025, by the entity to which the appropriation is made or any entity to which money from the appropriation is granted or otherwise transferred in any manner, and any portion of the appropriated money remaining must not be spent for any purpose after September 19, 2025, by either the entity to which the money was appropriated or the entity to which the money was subsequently granted or transferred, and must be reverted to the State General Fund on or before September 19, 2025.
κ2023 Statutes of Nevada, Page 2318 (CHAPTER 394, SB 413)κ
Sec. 10.3. 1. There is hereby appropriated from the State General Fund to the Department of Corrections for personnel costs to carry out the provisions of section 1 of this act the following sums:
For the Fiscal Year 2023-2024....................................................... $53,721
For the Fiscal Year 2024-2025....................................................... $74,198
2. Any balance of the sums appropriated by subsection 1 remaining at the end of the respective fiscal years must not be committed for expenditure after June 30 of the respective fiscal years by the entity to which the appropriation is made or any entity to which money from the appropriation is granted or otherwise transferred in any manner, and any portion of the appropriated money remaining must not be spent for any purpose after September 20, 2024, and September 19, 2025, respectively, by either the entity to which the money was appropriated or the entity to which the money was subsequently granted or transferred, and must be reverted to the State General Fund on or before September 20, 2024, and September 19, 2025, respectively.
Sec. 10.5. 1. Not later than December 31, 2024, the Department of Corrections shall report to the Interim Finance Committee concerning the actions taken by the Department to implement the provisions of this act, including, without limitation, the progress of the Department in programming the computer systems of the Department as necessary to carry out the provisions of this act.
2. In preparing to implement the provisions of this act, the Department of Corrections shall share information with the Office of the Attorney General concerning the actions taken by the Department to enable the Department to carry out the provisions of this act. If any information provided by the Department of Corrections to the Office of the Attorney General pursuant to this subsection is confidential or privileged, such information is confidential and privileged to the same extent that the information would be confidential and privileged if in the possession of the Department of Corrections.
Sec. 11. 1. This section and section 10.5 of this act become effective upon passage and approval.
2. Sections 10.1 and 10.3 of this act become effective on July 1, 2023.
3. Sections 1 to 10, inclusive, of this act become effective upon passage and approval for the purpose of adopting any regulations and performing any other preparatory administrative tasks that are necessary to carry out the provisions of this act and on July 1, 2025, for all other purposes.
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κ2023 Statutes of Nevada, Page 2319κ
Senate Bill No. 279Senator Spearman
Joint Sponsor: Assemblywoman Brown-May
CHAPTER 395
[Approved: June 13, 2023]
AN ACT relating to disabilities; establishing the State as a Model Employer Program in the Division of Human Resource Management of the Department of Administration; making an appropriation; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Existing law: (1) declares that it is the policy of this State that persons with disabilities must be afforded equal opportunities in employment by the State; and (2) requires full consideration to be given to the employment of a person with a disability for a position if the person is capable of performing the essential functions of the position with or without reasonable accommodations. (NRS 284.012, 284.317) Section 3 of this bill establishes the State as a Model Employer Program in the Division of Human Resource Management of the Department of Administration to ensure that each appointing authority design and proactively implement best, promising and emerging policies, practices and procedures relating to the hiring, promotion and retention of persons with disabilities. Section 3 further requires the Administrator of the Division, in coordination with the Rehabilitation Division of the Department of Employment, Training and Rehabilitation, to provide technical assistance and training to each appointing authority on such policies, practices and procedures.
Section 3.5 of this bill makes an appropriation to the Division of Human Resource Management of the Department of Administration for personnel, operating, equipment, travel and information services costs to carry out the State as a Model Employer Program established by section 3.
Section 2 of this bill provides that the Legislature finds and declares that: (1) it is the policy of this State to be a model for persons with disabilities; and (2) the intent of establishing the Program is to provide agencies in the Executive Department of the State Government a framework for recruiting, hiring, promoting and retaining qualified persons with disabilities.
EXPLANATION Matter in bolded italics is new; matter between
brackets [omitted material] is material to be
omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 284 of NRS is hereby amended by adding thereto the provisions set forth as sections 2 and 3 of this act.
Sec. 2. The Legislature finds and declares that:
1. It is the policy of this State to be a model employer for persons with disabilities.
2. The intent of establishing the State as a Model Employer Program pursuant to section 3 of this act is to provide agencies in the Executive Department of the State Government a framework for recruiting, hiring, promoting and retaining qualified persons with disabilities.
κ2023 Statutes of Nevada, Page 2320 (CHAPTER 395, SB 279)κ
Sec. 3. 1. The State as a Model Employer Program is hereby established in the Division of Human Resource Management of the Department of Administration, to be administered by the Administrator. The Program must ensure that each appointing authority design and proactively implement best, promising and emerging policies, practices and procedures relating to the hiring, promotion and retention of persons with disabilities.
2. The Administrator shall, in coordination with the Rehabilitation Division of the Department of Employment, Training and Rehabilitation, provide technical assistance and training to each appointing authority on best, promising and emerging policies, practices and procedures relating to the hiring, promotion and retention of persons with disabilities.
3. The Commission shall adopt any regulations necessary to carry out the Program.
Sec. 3.5. 1. There is hereby appropriated from the State General Fund to the Division of Human Resource Management of the Department of Administration for personnel, operating, equipment, travel and information services costs to carry out the State as a Model Employer Program established by section 3 of this act the following sums:
For the Fiscal Year 2023-2024....................................................... $80,195
For the Fiscal Year 2024-2025....................................................... $98,171
2. Any balance of the sums appropriated by subsection 1 remaining at the end of the respective fiscal years must not be committed for expenditure after June 30 of the respective fiscal years by the entity to which the appropriation is made or any entity to which money from the appropriation is granted or otherwise transferred in any manner, and any portion of the appropriated money remaining must not be spent for any purpose after September 20, 2024, and September 19, 2025, respectively, by either the entity to which the money was appropriated or the entity to which the money was subsequently granted or transferred, and must be reverted to the State General Fund on or before September 20, 2024, and September 19, 2025, respectively.
Sec. 4. 1. This section becomes effective upon passage and approval.
2. Section 3.5 of this act becomes effective on July 1, 2023.
3. Sections 1, 2 and 3 of this act become effective:
(a) Upon passage and approval for the purpose of adopting any regulations and performing any other preparatory administrative tasks that are necessary to carry out the provisions of this act; and
(b) On January 1, 2024, for all other purposes.
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κ2023 Statutes of Nevada, Page 2321κ
Senate Bill No. 339Senators Dondero Loop, Cannizzaro, Spearman; Daly, Donate, D. Harris, Lange, Neal, Nguyen, Ohrenschall, Pazina and Scheible
CHAPTER 396
[Approved: June 13, 2023]
AN ACT making an appropriation to the Department of Education for the creation of a grant program to allow certain teachers and specialized instructional support personnel to obtain certain supplies or materials for classrooms or school operations; and providing other matters properly relating thereto.
EXPLANATION Matter in bolded italics is new; matter between
brackets [omitted material] is material to be
omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Sections 1-5. (Deleted by amendment.)
Sec. 6. 1. There is hereby appropriated from the State General Fund to the Department of Education the sum of $10,000,000 for the Other State Education Programs budget account for the purpose of creating a grant program to allow teachers and specialized instructional support personnel to obtain necessary supplies and materials for their classrooms or school operations, respectively.
2. The Department shall enter into an agreement with one or more organizations to provide such organizations with a grant from the Department to administer a program whereby the organizations expend grant money to directly provide teachers and specialized instructional support personnel with necessary supplies and materials for their classrooms or school operations, respectively, in response to a request from such persons.
3. Except as otherwise provided in this subsection, an agreement made pursuant to subsection 2 shall require that an organization that receives grant money expend not more than $500 per individual teacher or specialized instructional support personnel following a request made pursuant to subsection 2. An individual teacher or specialized instructional support personnel may request the organization expend money in excess of $500 and, to the extent that money from a source other than the grant program established pursuant to this section is available, such a request may be fulfilled.
4. As used in this section, specialized instructional support personnel includes persons employed by a school to provide necessary services such as assessment, diagnosis, counseling, educational services, therapeutic services and related services, as defined in 20 U.S.C. § 1401(26), to pupils. Such persons employed by a school include, without limitation:
(a) A school counselor;
(b) A school psychologist;
(c) A school social worker;
(d) A school nurse;
(e) A speech-language pathologist;
(f) A school library media specialist; and
κ2023 Statutes of Nevada, Page 2322 (CHAPTER 396, SB 339)κ
(g) Any other qualified professional.
Sec. 6.5. Any remaining balance of the appropriation made by section 6 of this act must not be committed for expenditure after June 30, 2025, by the entity to which the appropriation is made or any entity to which money from the appropriation is granted or otherwise transferred in any manner, and any portion of the appropriated money remaining must not be spent for any purpose after September 19, 2025, by either the entity to which the money was appropriated or the entity to which the money was subsequently granted or transferred, and must be reverted to the State General Fund on or before September 19, 2025.
Sec. 7. This act becomes effective on July 1, 2023.
________
Assembly Bill No. 148Assemblywoman Marzola
CHAPTER 397
[Approved: June 14, 2023]
AN ACT relating to child welfare; providing for the appointment of a guardian ad litem for an incapacitated parent or other person responsible for the welfare of a child in certain child welfare proceedings; prescribing the procedure for the judicial review of the placement of a child who is in the custody of an agency which provides child welfare services in a qualified residential treatment program; revising the procedures governing the court-ordered admission of such a child who has an emotional disturbance to certain psychiatric facilities and the release of such a child from such a facility; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Upon the filing of a petition that a child is in need of protection, existing law requires the appointment of a guardian ad litem to represent and protect the best interests of the child during the child welfare proceedings. (NRS 432B.500) Sections 32 and 33 of this bill prescribe a procedure for the appointment of a guardian ad litem to represent the best interests of a parent or other person responsible for the welfare of a child who is incapacitated during a child welfare proceeding. Section 34 of this bill requires a guardian ad litem appointed for a parent or other person responsible for the welfare of a child to act in the best interests of the parent or other person after considering the wishes of the parent or other person. Section 34 additionally: (1) provides that communications between a parent or other person responsible for the welfare of a child and his or her guardian ad litem are privileged; and (2) prohibits a guardian ad litem from taking any action to relinquish parental rights, effectuate a termination of parental rights or consent to a specific adoption on behalf of the person for whom the guardian ad litem is appointed.
In general, existing law provides that information maintained by an agency which provides child welfare services is confidential and may only be disclosed under certain circumstances. (NRS 432B.290) Section 46 of this bill authorizes the disclosure of information maintained by an agency which provides child welfare services to the legal guardian of a child appointed pursuant to section 32 under certain circumstances.
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Existing law authorizes the placement of a child who is in need of protection in the protective custody of an agency which provides child welfare services under certain circumstances. (NRS 432B.390) If a court finds that such a child is in need of protection, existing law authorizes the court to place the child with certain entities, including a public agency or institution authorized to care for children. (NRS 432B.550) Existing law prescribes procedures governing the placement of a child who is in need of protection and requires such placement to be reviewed semiannually. (NRS 432B.450, 432B.580) Existing law also requires a court overseeing proceedings concerning such a child to hold an annual hearing concerning the permanent placement of the child. (NRS 432B.590) Existing federal law defines qualified residential treatment program to mean a program that: (1) provides trauma-informed treatment of children with serious emotional or behavioral disorders or disturbances; (2) has clinical staff available 24 hours a day and 7 days a week; and (3) meets certain other requirements. (42 U.S.C. § 672(k)(4)) Section 31 of this bill adopts that federal definition, and section 43 of this bill makes a conforming change to indicate the proper placement of section 31 in the Nevada Revised Statutes. Section 52 of this bill makes a conforming change to remove a definition of the term qualified residential treatment program that duplicates the definition prescribed in section 31. Sections 35, 50 and 51 of this bill require a court to review the appropriateness of the placement of a child who is in the custody of an agency which provides child welfare services in a qualified residential treatment program: (1) not later than 60 days after the beginning of the placement; (2) as part of each semiannual review concerning the temporary placement of the child; and (3) at each annual hearing concerning the permanent placement of the child. Sections 20, 45, 47 and 49 of this bill make conforming changes to indicate the proper placement of sections 32-35 in the Nevada Revised Statutes.
Existing law prescribes the procedure for: (1) placing a person who is in a mental health crisis on a mental health crisis hold for assessment, evaluation, intervention and treatment at a hospital or mental health facility; (2) the emergency admission of such a person to a mental health facility; and (3) the involuntary court-ordered admission of such a person to a mental health facility or assisted outpatient treatment. (NRS 433A.145-433A.345) Existing law prescribes a separate procedure for the involuntary court-ordered admission of a child with an emotional disturbance who is in the custody of an agency which provides child welfare services to certain psychiatric facilities. (NRS 432B.607-432B.6085) Sections 37-40 and 54-57 of this bill revise the latter procedure to provide separate procedures for: (1) the involuntary court-ordered admission of such a child for nonemergency mental health treatment; and (2) the continuation of the emergency admission of such a child for longer than 5 days. Sections 37, 39, 54 and 56 of this bill authorize a physician, a psychiatrist, a psychologist or an advanced practice registered nurse who possesses certain training to conduct certain examinations in the course of those procedures. Section 70 of this bill makes conforming changes to indicate the applicability of the training requirements for an advanced practice registered nurse.
Sections 38 and 55 of this bill authorize the court to order the nonemergency admission or continued emergency admission, respectively, of a child with an emotional disturbance who is in the custody of an agency which provides child welfare services if the court finds by clear and convincing evidence that the child presents a substantial likelihood of serious harm to himself or herself or others and certain other requirements are met. Section 36 of this bill prescribes the manner in which to determine whether a child presents a substantial likelihood of serious harm to himself or herself or others for those purposes. Sections 41 and 58 of this bill provide for the expiration and renewal of an order for nonemergency mental health treatment or to continue an emergency admission, as applicable. Sections 41 and 58 also authorize the release of a child who has been admitted to a facility under such an order under certain circumstances, and section 75 of this bill repeals: (1) existing provisions governing the release of a child with an emotional disturbance who is in the custody of an agency which provides child welfare services from a facility; and (2) additional provisions of existing law which are duplicative of the provisions of sections 37-40 and 54-57.
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Sections 42 and 59 of this bill require a facility to which a child who is in the custody of an agency which provides child welfare services is admitted under an involuntary court-ordered admission or a continued emergency admission to develop a written plan for the continued care or treatment of the child upon discharge from the facility. Sections 53 and 62 of this bill make conforming changes to indicate the proper placement of sections 35.3-42 in the Nevada Revised Statutes. Sections 27, 28, 60, 61 and 63-67 of this bill make other conforming changes to indicate the continued applicability of certain provisions of existing law to the procedures created by sections 37-40 and 54-57.
EXPLANATION Matter in bolded italics is new; matter between
brackets [omitted material] is material to be
omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Sections 1-19. (Deleted by amendment.)
Sec. 20. NRS 49.295 is hereby amended to read as follows:
49.295 1. Except as otherwise provided in subsections 2 and 3 and NRS 49.305:
(a) A married person cannot be examined as a witness for or against his or her spouse without his or her consent.
(b) No spouse can be examined, during the marriage or afterwards, without the consent of the other spouse, as to any communication made by one to the other during marriage.
2. The provisions of subsection 1 do not apply to a:
(a) Civil proceeding brought by or on behalf of one spouse against the other spouse;
(b) Proceeding to commit or otherwise place a spouse, the property of the spouse or both the spouse and the property of the spouse under the control of another because of the alleged mental or physical condition of the spouse;
(c) Proceeding brought by or on behalf of a spouse to establish his or her competence;
(d) Proceeding in the juvenile court or family court pursuant to title 5 of NRS or NRS 432B.410 to 432B.590, inclusive [;] , and sections 32 to 35, inclusive, of this act; or
(e) Criminal proceeding in which one spouse is charged with:
(1) A crime against the person or the property of the other spouse or of a child of either, or of a child in the custody or control of either, whether the crime was committed before or during marriage.
(2) Bigamy or incest.
(3) A crime related to abandonment of a child or nonsupport of the other spouse or child.
3. The provisions of subsection 1 do not apply in any criminal proceeding to events which took place before the spouses were married.
Secs. 21-26. (Deleted by amendment.)
Sec. 27. NRS 392.857 is hereby amended to read as follows:
392.857 1. If a pupil who is enrolled in a public school, including, without limitation, a university school for profoundly gifted pupils, is admitted by a court to a psychiatric hospital or facility which provides residential treatment for mental illness pursuant to NRS 432B.6076 [,] or section 38 of this act, the public school and, if applicable, the school district in which the pupil is enrolled, must:
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(a) If the pupil is admitted to a psychiatric hospital, participate in the development of a plan for the continued education of the pupil pursuant to NRS 432B.60847 and comply with the provisions of the plan; and
(b) If an individualized education program has been developed for the pupil, provide the individualized education program to the psychiatric hospital or facility.
2. As used in this section, individualized education program has the meaning ascribed to it in 20 U.S.C. § 1414(d)(1)(A).
Sec. 28. NRS 394.1998 is hereby amended to read as follows:
394.1998 1. If a pupil who is enrolled in a private school is admitted by a court to a psychiatric hospital pursuant to NRS 432B.6076 [,] or section 38 of this act, the private school must participate in the development of a plan for the continued education of the pupil pursuant to NRS 432B.60847 and comply with the provisions of the plan.
2. If a pupil who is enrolled in a private school is admitted by a court to a psychiatric hospital pursuant to NRS 432B.6076 or section 38 of this act and the school district within whose geographic boundaries the private school is located has developed a services plan for the child, the school district must:
(a) Participate in the development of a plan for the continued education of the pupil pursuant to NRS 432B.60847 and comply with the provisions of the plan; and
(b) Provide the services plan to the psychiatric hospital.
3. As used in this section, services plan has the meaning ascribed to it in 34 C.F.R. § 300.37.
Sec. 29. (Deleted by amendment.)
Sec. 30. Chapter 432B of NRS is hereby amended by adding thereto the provisions set forth as sections 31 to 42, inclusive, of this act.
Sec. 31. Qualified residential treatment program has the meaning ascribed to it in 42 U.S.C. § 672(k)(4).
Sec. 32. 1. If a parent or other person responsible for the welfare of a child who is the subject of proceedings under this section, NRS 432B.410 to 432B.590, inclusive, and sections 33, 34 and 35 of this act is less than 18 years of age and is not emancipated, the court shall hold a hearing to determine whether the parent or other person is incapacitated. If the court determines, by clear and convincing evidence, that the parent or other person is incapacitated, the court shall appoint a guardian ad litem for the parent or other person.
2. If the provisions of subsection 1 do not apply, a court may appoint a guardian ad litem for a parent or other person responsible for the welfare of a child who is the subject of proceedings under this section, NRS 432B.410 to 432B.590, inclusive, and sections 33, 34 and 35 of this act upon the motion of a party or its own motion if the court determines that the parent or other person is incapacitated. A party shall not make a motion pursuant to this subsection for the purpose of delay.
3. When determining whether the parent or other person responsible for the welfare of a child is incapacitated pursuant to subsection 1 or 2, a court shall consider:
(a) The ability of the parent or other person to:
(1) Appreciate the allegations against him or her;
(2) Understand the possible outcomes of the proceedings;
(3) Understand the nature of the legal process;
(4) Disclose to his or her attorney the facts relevant to the proceedings;
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(5) Display appropriate behavior in the courtroom; and
(6) Testify regarding issues relevant to the proceedings;
(b) Any findings in another legal proceeding that the parent or other person is incapacitated or incompetent;
(c) Any mental illness, intellectual disability or developmental disability that affects the capacity of the parent or other person;
(d) The results of any evaluation conducted pursuant to section 33 of this act; and
(e) Any other factor that affects the capacity of the parent or other person or evidence concerning such capacity.
4. A court may determine that a parent or other person responsible for the welfare of a child is incapacitated pursuant to this section only if it finds by clear and convincing evidence that the parent or other person is unable to:
(a) Understand the nature of the allegations against him or her;
(b) Understand the nature and purpose of the proceedings; or
(c) Aid and assist his or her attorney at any time during the proceedings with a reasonable degree of rational understanding.
5. If a court determines that a parent or other person responsible for the welfare of a child is incapacitated pursuant to this section, the court shall appoint a guardian ad litem for the parent or other person. The court may not appoint the attorney for the parent or other person as his or her guardian ad litem. When determining the person who will be appointed as the guardian ad litem, the court:
(a) Shall consider the wishes of the parent or other person for whom the guardian ad litem will be appointed;
(b) May consider any other relevant evidence; and
(c) May call additional witnesses.
6. The court shall, upon the request of a parent or other person responsible for the welfare of the child for whom a guardian ad litem will be appointed pursuant to this section, conduct the initial evaluation of a person who may be appointed as the guardian ad litem outside the presence of the other parties.
7. An order appointing a guardian ad litem pursuant to this section must be based upon clear and convincing evidence and set forth:
(a) Findings of fact regarding the determination of the court that the parent or other person responsible for the welfare of a child is incapacitated; and
(b) The authority and duties of the guardian ad litem.
8. Except as otherwise provided in this subsection, the court shall review an order appointing a guardian ad litem pursuant to this section upon the request of any party to determine whether the parent or other person responsible for the welfare of a child for whom the guardian ad litem was appointed remains incapacitated. The court must conduct such a review within 45 days after such a request is made.
9. If a court determines that a parent or other person responsible for the welfare of a child is incapacitated solely because of his or her age and appoints a guardian ad litem for the parent or other person, the appointment of the guardian ad litem must terminate on the 18th birthday of the parent or other person.
Sec. 33. 1. If a parent or other person responsible for the welfare of a child described in subsection 1 of section 32 of this act or a parent or other person responsible for the welfare of a child who is the subject of a motion pursuant to subsection 2 of section 32 of this act requests an evaluation and the court determines that the parent or other person might be incapacitated because he or she is not mentally competent, the court shall order the parent or other person to undergo an evaluation by a person professionally qualified in the field of psychiatric mental health.
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pursuant to subsection 2 of section 32 of this act requests an evaluation and the court determines that the parent or other person might be incapacitated because he or she is not mentally competent, the court shall order the parent or other person to undergo an evaluation by a person professionally qualified in the field of psychiatric mental health. In all other circumstances, the court may, upon the motion of a party or its own motion, order such an evaluation if it determines that the parent or other person might be incapacitated because he or she is not mentally competent.
2. If an evaluation is conducted pursuant to subsection 1 upon:
(a) The request of the parent or other person who is the subject of the evaluation or the motion of court, the court may, except as otherwise provided in subsection 3, pay the cost of the evaluation.
(b) The motion of a party, other than the parent or other person who is the subject of the evaluation, the moving party shall pay the cost of the evaluation.
3. The court shall pay the cost of an evaluation conducted pursuant to subsection 1 if:
(a) The evaluation is conducted upon the request of the parent or other person who is the subject of the evaluation or the motion of court;
(b) The evaluation is not covered by a third party or the third party that provides such coverage is unable or unwilling to pay for the evaluation in a timely manner; and
(c) The parent or other person who is the subject of the evaluation has a household income that is less than 200 percent of the federally designated level signifying poverty.
4. If the court pays the cost of an evaluation pursuant to subsection 3 and later determines that the parent or other person responsible for the welfare of a child who is the subject of the examination is financially able to pay all or part of the cost of the evaluation, the court may require the parent or other person to make such payment to the clerk of the court.
5. Any other party to the proceeding may make an oral or written motion for the person to be evaluated by a person professionally qualified in the field of psychiatric mental health, a psychologist or other appropriate professional retained by the party. The party seeking the additional evaluation shall pay the costs related to the evaluation.
6. As used in this section:
(a) Household means persons of the first degree of consanguinity or affinity who live in the same dwelling.
(b) Person professionally qualified in the field of psychiatric mental health has the meaning ascribed to it in NRS 433A.018.
(c) Third party means any insurer or organization providing health coverage or benefits in accordance with state or federal law.
Sec. 34. 1. In making decisions on behalf of a parent or other person responsible for the welfare of a child, a guardian ad litem appointed for the parent or other person responsible for the welfare of a child pursuant to section 32 of this act shall:
(a) Consider the wishes of the parent or other person and inform the court of those wishes; and
(b) Act in the best interests of the parent or other person, as determined by the guardian ad litem using his or her independent judgment.
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2. Communications between a parent or other person responsible for the welfare of a child and his or her guardian ad litem are privileged and confidential to the same extent as communications between the parent and his or her attorney.
3. A guardian ad litem appointed pursuant to section 32 of this act may not take any action to relinquish parental rights, effectuate a termination of parental rights or consent to a specific adoption on behalf of the person for whom the guardian ad litem is appointed.
Sec. 35. 1. Not later than 72 hours after an agency which provides child welfare services places a child who is in the custody of the agency which provides child welfare services in a qualified residential treatment program, the agency which provides child welfare services shall file written notice of the placement with the court and serve such notice upon each party to the proceedings concerning the child being conducted pursuant to this section, NRS 432B.410 to 432B.590, inclusive, and sections 32, 33 and 34 of this act.
2. Not later than 60 days after a child is placed in a qualified residential treatment program, the court shall conduct a hearing to review the status of the child and determine the appropriateness of the placement.
3. At the hearing held pursuant to subsection 2, as part of each review conducted pursuant to NRS 432B.580 and at each hearing held pursuant to 432B.590 for the duration of the placement in the qualified residential treatment program, the court shall:
(a) Review the assessment of the child; and
(b) Determine whether to approve or disapprove the placement.
4. A court may approve placement of a child in a qualified residential treatment program only if it finds by a preponderance of the evidence that placement in the qualified residential treatment program is:
(a) The least restrictive appropriate environment for the child, including, without limitation, that:
(1) Placement in a lower level of care is not capable of meeting the needs of the child; and
(2) The qualified residential treatment program provides the most effective care and appropriate care and treatment for the child; and
(b) Consistent with the short term and long term goals of the childs treatment.
5. After the court conducts a review pursuant to this section, the court shall issue a written determination concerning whether to approve the continued placement of the child in the qualified residential treatment program which must include, without limitation, written findings on each factor listed in subsection 4.
6. If a court disapproves the continued placement of a child in a qualified residential treatment program, the court:
(a) Shall order the agency which provides child welfare service to place the child in a less restrictive appropriate placement; and
(b) May make any other order that it determines to be in the best interest of the child.
Sec. 35.3. As used in sections 35.3 to 42, inclusive, of this act, unless the context otherwise requires, the words and terms defined in sections 35.5 and 35.7 of this act have the meanings ascribed to them in those sections.
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Sec. 35.5. Facility means a psychiatric hospital or facility which provides residential treatment for mental or behavioral health care to which a child with an emotional disturbance is or will be admitted to a locked unit that prevents the child from leaving the facility.
Sec. 35.7. Person professionally qualified in the field of psychiatric mental health has the meaning ascribed to it in NRS 433A.018 and includes the same professionals licensed in the state in which the child is placed.
Sec. 36. For the purposes of NRS 432B.607 to 432B.6085, inclusive, and sections 35.3 to 42, inclusive, of this act, a determination concerning whether a child presents a substantial likelihood of serious harm to himself or herself or others must be made as provided in NRS 433A.0195.
Sec. 37. 1. An agency which provides child welfare services shall not place a child in the custody of the agency in a facility for the purpose of receiving nonemergency mental health treatment unless the agency has petitioned the court for the placement and the court has ordered the placement, or except as provided in sections 35.3 to 42, inclusive, of this act.
2. A proceeding for the admission of a child alleged to be a child with an emotional disturbance who is in the custody of an agency which provides child welfare services to a facility for nonemergency mental health treatment may be commenced by the filing of a petition with the court which has jurisdiction in proceedings concerning the child. The petition may be filed by the agency which provides child welfare services without the consent of a parent of the child. The petition must be accompanied:
(a) By a certificate of a physician, a psychiatrist, a psychologist or an advanced practice registered nurse who has the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120 stating that the physician, psychiatrist, psychologist or advanced practice registered nurse has examined the child alleged to be a child with an emotional disturbance and has concluded that the child:
(1) Is a child with an emotional disturbance and, because of that condition, presents a substantial likelihood of serious harm to himself or herself or others if allowed liberty; and
(2) Cannot be safely and effectively treated in a less restrictive environment that is appropriate for the child; or
(b) By a sworn written statement by the petitioner that:
(1) The petitioner has, based upon personal observation of the child alleged to be a child with an emotional disturbance, probable cause to believe that the child:
(I) Is a child with an emotional disturbance and, because of that condition, presents a substantial likelihood of serious harm to himself or herself or others if allowed liberty; and
(II) Cannot be safely and effectively treated in a less restrictive environment that is appropriate for the child; and
(2) The child alleged to be a child with an emotional disturbance has refused to submit to examination or treatment by a person described in paragraph (a).
3. A child who is the subject of a petition filed pursuant to this section or the parent or guardian of such a child may oppose the petition:
(a) Orally at a hearing on the petition; or
(b) By filing a written opposition with the court.
Sec. 38. 1. A child who is the subject of a petition pursuant to section 37 of this act may, after conferring with his or her attorney, submit to the court written consent, or provide oral consent in the record of the court, to nonemergency mental health treatment.
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nonemergency mental health treatment. Upon receiving such consent, the court shall order the admission of the child to a facility for such treatment if it finds that the treatment is in the best interests of the child.
2. A court that receives a petition pursuant to section 37 of this act for the court-ordered admission of a child alleged to be a child with an emotional disturbance to a facility for nonemergency mental health treatment shall conduct a hearing on the petition, unless otherwise ordered by the court.
3. A court may order the admission of a child with respect to whom a petition was filed pursuant to section 37 of this act to a facility only if the court finds that there is clear and convincing evidence that the child:
(a) Is a child with an emotional disturbance;
(b) Because of that condition, presents a substantial likelihood of serious harm to himself or herself or others if allowed liberty; and
(c) Cannot be treated in a less restrictive environment that is appropriate for the child.
4. The court shall issue a written order on a petition submitted pursuant to section 37 of this act. The order must include, without limitation, specific findings concerning each factor prescribed by subsection 3. The order must be interlocutory and is subject to regular review pursuant to section 41 of this act.
Sec. 39. 1. A child or a parent or guardian of the child who opposes a petition for the admission of a child alleged to be a child with emotional disturbance to a facility for nonemergency mental health treatment pursuant to subsection 3 of section 37 of this act may petition the court to authorize a second examination. The court shall authorize such a second examination upon receiving such a petition. Except as otherwise ordered by the court, a second examination must be completed not later than 45 business days after the court authorizes the examination and before any evidentiary hearing is conducted.
2. If the court authorizes a second examination of the child, the examination must:
(a) Be conducted by an independent physician, psychiatrist, psychologist or advanced practice registered nurse who has the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120 who is not:
(1) The same physician, psychiatrist, psychologist or advanced practice registered nurse who completed a certificate pursuant to paragraph (a) of subsection 2 of section 37 of this act or a physician, psychologist, clinical social worker or advanced practice registered nurse who participated in the examination conducted pursuant to that paragraph; or
(2) Employed by, connected to or otherwise affiliated with:
(I) The person described in subparagraph (1) or any facility which employs that person; or
(II) Any facility into which the child may be placed;
(b) Include, without limitation:
(1) An evaluation of the diagnosis of the child, the risks of harm posed by the child to himself or herself or others and whether the child is capable of being safely and effectively treated in a less restrictive appropriate environment; and
(2) Recommendations concerning the placement of the child and the level of care required by the child; and
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(c) Be paid for by the governmental entity that is responsible for the agency which provides child welfare services, if such payment is not otherwise provided by the State Plan for Medicaid.
Sec. 40. In determining pursuant to sections 38 and 41 of this act whether to issue or renew an order for the admission of a child who is in the custody of an agency which provides child welfare services to a facility for nonemergency treatment, the court shall consider:
1. The reports of any examinations or evaluations of a child by any person professionally qualified in the field of psychiatric mental health;
2. Any information concerning the child provided by:
(a) A person professionally qualified in the field of psychiatric mental health;
(b) A representative of the agency which provides child welfare services;
(c) An adult caretaker who is knowledgeable about the child; or
(d) A guardian ad litem appointed for the child pursuant to NRS 432B.500;
3. The wishes of the child concerning care and treatment and placement in a facility;
4. The best interests of the child, including, without limitation, whether the court believes the child might experience any psychological trauma from court-ordered admission;
5. Any alternative care or treatment options; and
6. Any other information the court deems relevant concerning the child.
Sec. 41. 1. If the court issues an order for the admission of a child who is in the custody of an agency which provides child welfare services to a facility for nonemergency mental health treatment pursuant to section 38 of this act, the order automatically expires:
(a) At the end of 90 days if the facility does not release the child pursuant to subsection 4 before the expiration of the order; or
(b) If the facility releases the child pursuant to subsection 4 before the expiration of the order, on the date of the release.
2. Before the expiration of an order for nonemergency medical treatment pursuant to paragraph (a) of subsection 1, the agency which provides child welfare services, the Division of Child and Family Services or any facility may petition to renew the admission of the child for additional periods not to exceed 60 days each. Each petition for renewal must set forth the specific reasons why further treatment in the facility is in the best interest of the child.
3. To grant a petition filed pursuant to subsection 2, the court must find by clear and convincing evidence that the child cannot be safely and effectively treated in a less restrictive appropriate environment. If the court finds that the child can be safely and effectively treated in a less restrictive appropriate environment, the court must order the discharge of the child from the facility.
4. A facility may unconditionally release a child who is admitted to the facility for nonemergency mental health treatment pursuant to section 38 of this act without an order of the court upon the recommendation of the psychiatrist and other persons professionally qualified in the field of psychiatric mental health who are responsible for treating the child. At least 30 days before the anticipated discharge, the facility shall provide notice of the recommendation to all parties. Such notice must include, without limitation, an explanation of the reasons that:
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(a) The release is clinically appropriate; and
(b) The child can be safely and effectively treated in a less restrictive appropriate environment.
Sec. 42. A facility which provides care or treatment to a child who is in the custody of an agency which provides child welfare services and who is admitted to the facility pursuant to section 38 of this act shall develop a written plan, in consultation with the child, for the continued care or treatment of the child upon discharge from the facility. The plan must:
1. Be developed not later than 30 days after the child is admitted to the facility and be updated on an ongoing basis throughout the admission;
2. Be submitted to the court after each period of admission ordered by the court pursuant to section 38 of this act in the manner set forth in section 41 of this act; and
3. Include, without limitation:
(a) The anticipated length of treatment and the anticipated date of discharge of the child from the facility, if known;
(b) The name of any person professionally qualified in the field of psychiatric mental health who will provide care or treatment to the child after the child is discharged from the facility, if known;
(c) A plan for any appropriate care or treatment for the child for at least 60 days after the child is discharged from the facility; and
(d) The recommended type of placement of the child after the child is discharged from the facility.
Sec. 43. NRS 432B.010 is hereby amended to read as follows:
432B.010 As used in this chapter, unless the context otherwise requires, the words and terms defined in NRS 432B.020 to 432B.110, inclusive, and section 31 of this act have the meanings ascribed to them in those sections.
Sec. 44. (Deleted by amendment.)
Sec. 45. NRS 432B.250 is hereby amended to read as follows:
432B.250 Any person who is required to make a report pursuant to NRS 432B.220 may not invoke any of the privileges set forth in chapter 49 of NRS:
1. For failure to make a report pursuant to NRS 432B.220;
2. In cooperating with an agency which provides child welfare services or a guardian ad litem for a child; or
3. In any proceeding held pursuant to NRS 432B.410 to 432B.590, inclusive [.] , and sections 32 to 35, inclusive, of this act.
Sec. 46. NRS 432B.290 is hereby amended to read as follows:
432B.290 1. Information maintained by an agency which provides child welfare services must be maintained by the agency which provides child welfare services as required by federal law as a condition of the allocation of federal money to this State.
2. Except as otherwise provided in this section and NRS 432B.165, 432B.175 and 432B.513, information maintained by an agency which provides child welfare services may, at the discretion of the agency which provides child welfare services, be made available only to:
(a) A physician, if the physician has before him or her a child who the physician has reasonable cause to believe has been abused or neglected;
(b) A person authorized to place a child in protective custody, if the person has before him or her a child who the person has reasonable cause to believe has been abused or neglected and the person requires the information to determine whether to place the child in protective custody;
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(c) An agency, including, without limitation, an agency in another jurisdiction, responsible for or authorized to undertake the care, treatment or supervision of:
(1) The child; or
(2) The person responsible for the welfare of the child;
(d) A district attorney or other law enforcement officer who requires the information in connection with an investigation or prosecution of the abuse or neglect of a child;
(e) Except as otherwise provided in paragraph (f), a court other than a juvenile court, for in camera inspection only, unless the court determines that public disclosure of the information is necessary for the determination of an issue before it;
(f) A court, as defined in NRS 159A.015, to determine whether a guardian or successor guardian of a child should be appointed pursuant to chapter 159A of NRS or NRS 432B.466 to 432B.468, inclusive;
(g) A person engaged in bona fide research or an audit, but information identifying the subjects of a report must not be made available to the person;
(h) The attorney and the guardian ad litem of the child, if the information is reasonably necessary to promote the safety, permanency and well-being of the child;
(i) A person who files or intends to file a petition for the appointment of a guardian or successor guardian of a child pursuant to chapter 159A of NRS or NRS 432B.466 to 432B.468, inclusive, if the identity of the person responsible for reporting the abuse or neglect of the child to a public agency is kept confidential and the information is reasonably necessary to promote the safety, permanency and well-being of the child;
(j) The proposed guardian or proposed successor guardian of a child over whom a guardianship is sought pursuant to chapter 159A of NRS or NRS 432B.466 to 432B.468, inclusive, if the identity of the person responsible for reporting the abuse or neglect of the child to a public agency is kept confidential and the information is reasonably necessary to promote the safety, permanency and well-being of the child;
(k) A grand jury upon its determination that access to these records and the information is necessary in the conduct of its official business;
(l) A federal, state or local governmental entity, or an agency of such an entity, or a juvenile court, that needs access to the information to carry out its legal responsibilities to protect children from abuse and neglect;
(m) A person or an organization that has entered into a written agreement with an agency which provides child welfare services to provide assessments or services and that has been trained to make such assessments or provide such services;
(n) A team organized pursuant to NRS 432B.350 for the protection of a child;
(o) A team organized pursuant to NRS 432B.405 to review the death of a child;
(p) A multidisciplinary team, as defined in NRS 432B.4014;
(q) A parent or legal guardian of the child and an attorney of a parent or legal guardian of the child, including, without limitation, the parent or guardian of a child over whom a guardianship is sought pursuant to chapter 159A of NRS or NRS 432B.466 to 432B.468, inclusive, if the identity of the person responsible for reporting the abuse or neglect of the child to a public agency is kept confidential and the information is reasonably necessary to promote the safety, permanency and well-being of the child and is limited to information concerning that parent or guardian;
κ2023 Statutes of Nevada, Page 2334 (CHAPTER 397, AB 148)κ
promote the safety, permanency and well-being of the child and is limited to information concerning that parent or guardian;
(r) The child over whom a guardianship is sought pursuant to chapter 159A of NRS or NRS 432B.466 to 432B.468, inclusive, if:
(1) The child is 14 years of age or older; and
(2) The identity of the person responsible for reporting the abuse or neglect of the child to a public agency is kept confidential and the information is reasonably necessary to promote the safety, permanency and well-being of the child;
(s) The persons or agent of the persons who are the subject of a report, if the information is reasonably necessary to promote the safety, permanency and well-being of the child and is limited to information concerning those persons;
(t) An agency that is authorized by law to license foster homes or facilities for children or to investigate persons applying for approval to adopt a child, if the agency has before it an application for that license or is investigating an applicant to adopt a child;
(u) Upon written consent of the parent, any officer of this State or a city or county thereof or Legislator authorized by the agency or department having jurisdiction or by the Legislature, acting within its jurisdiction, to investigate the activities or programs of an agency which provides child welfare services if:
(1) The identity of the person making the report is kept confidential; and
(2) The officer, Legislator or a member of the family of the officer or Legislator is not the person alleged to have committed the abuse or neglect;
(v) The Division of Parole and Probation of the Department of Public Safety for use pursuant to NRS 176.135 in making a presentence investigation and report to the district court or pursuant to NRS 176.151 in making a general investigation and report;
(w) Any person who is required pursuant to NRS 432B.220 to make a report to an agency which provides child welfare services or to a law enforcement agency;
(x) A local advisory board to expedite proceedings for the placement of children created pursuant to NRS 432B.604;
(y) The panel established pursuant to NRS 432B.396 to evaluate agencies which provide child welfare services;
(z) An employer in accordance with subsection 3 of NRS 432.100;
(aa) A team organized or sponsored pursuant to NRS 217.475 or 228.495 to review the death of the victim of a crime that constitutes domestic violence;
(bb) The Committee on Domestic Violence appointed pursuant to NRS 228.470; or
(cc) The Committee to Review Suicide Fatalities created by NRS 439.5104.
3. An agency investigating a report of the abuse or neglect of a child shall, upon request, provide to a person named in the report as allegedly causing the abuse or neglect of the child:
(a) A copy of:
(1) Any statement made in writing to an investigator for the agency by the person named in the report as allegedly causing the abuse or neglect of the child; or
(2) Any recording made by the agency of any statement made orally to an investigator for the agency by the person named in the report as allegedly causing the abuse or neglect of the child; or
κ2023 Statutes of Nevada, Page 2335 (CHAPTER 397, AB 148)κ
(b) A written summary of the allegations made against the person who is named in the report as allegedly causing the abuse or neglect of the child. The summary must not identify the person responsible for reporting the alleged abuse or neglect or any collateral sources and reporting parties.
4. Except as otherwise provided by subsection 6, before releasing any information maintained by an agency which provides child welfare services pursuant to this section, an agency which provides child welfare services shall take whatever precautions it determines are reasonably necessary to protect the identity and safety of any person who reports child abuse or neglect and to protect any other person if the agency which provides child welfare services reasonably believes that disclosure of the information would cause a specific and material harm to an investigation of the alleged abuse or neglect of a child or the life or safety of any person.
5. The provisions of this section must not be construed to require an agency which provides child welfare services to disclose information maintained by the agency which provides child welfare services if, after consultation with the attorney who represents the agency, the agency determines that such disclosure would cause a specific and material harm to a criminal investigation.
6. A person who is the subject of a report of child abuse or neglect made pursuant to this chapter that is assigned a disposition other than substantiated pursuant to NRS 432B.305 and who believes that the report was made in bad faith or with malicious intent may petition a district court to order the agency which provides child welfare services to release information maintained by the agency which provides child welfare services. The petition must specifically set forth the reasons supporting the belief that the report was made in bad faith or with malicious intent. The petitioner shall provide notice to the agency which provides child welfare services so that the agency may participate in the action through its counsel. The district court shall review the information which the petitioner requests to be released and the petitioner shall be allowed to present evidence in support of the petition. If the court determines that there is a reasonable question of fact as to whether the report was made in bad faith or with malicious intent and that the disclosure of the identity of the person who made the report would not be likely to endanger the life or safety of the person who made the report, the court shall provide a copy of the information to the petitioner and the original information is subject to discovery in a subsequent civil action regarding the making of the report.
7. If an agency which provides child welfare services receives any information that is deemed confidential by law, the agency which provides child welfare services shall maintain the confidentiality of the information as prescribed by applicable law.
8. Pursuant to this section, a person may authorize the release of information maintained by an agency which provides child welfare services about himself or herself, but may not waive the confidentiality of such information concerning any other person.
9. An agency which provides child welfare services may provide a summary of the outcome of an investigation of the alleged abuse or neglect of a child to the person who reported the suspected abuse or neglect.
10. Except as otherwise provided in this subsection, any person who is provided with information maintained by an agency which provides child welfare services and who further disseminates the information or makes the information public is guilty of a gross misdemeanor. This subsection does not apply to:
κ2023 Statutes of Nevada, Page 2336 (CHAPTER 397, AB 148)κ
(a) A district attorney or other law enforcement officer who uses the information solely for the purpose of initiating legal proceedings;
(b) An employee of the Division of Parole and Probation of the Department of Public Safety making a presentence investigation and report to the district court pursuant to NRS 176.135 or making a general investigation and report pursuant to NRS 176.151; or
(c) An employee of a juvenile justice agency who provides the information to the juvenile court.
11. An agency which provides child welfare services may charge a fee for processing costs reasonably necessary to prepare information maintained by the agency which provides child welfare services for release pursuant to this section.
12. An agency which provides child welfare services shall adopt rules, policies or regulations to carry out the provisions of this section.
13. As used in this section, juvenile justice agency means the Youth Parole Bureau or a director of juvenile services.
Sec. 47. NRS 432B.420 is hereby amended to read as follows:
432B.420 1. A parent or other person responsible for the welfare of a child who is alleged to have abused or neglected the child may be represented by an attorney at all stages of any proceedings under NRS 432B.410 to 432B.590, inclusive [.] , and sections 32 to 35, inclusive, of this act. Except as otherwise provided in subsection 3, if the person is indigent, the court may appoint an attorney to represent the person.
2. A child who is alleged to have been abused or neglected shall be deemed to be a party to any proceedings under NRS 432B.410 to 432B.590, inclusive [.] , and sections 32 to 35, inclusive, of this act. The court shall appoint an attorney to represent the child. The child must be represented by an attorney at all stages of any proceedings held pursuant to NRS 432B.410 to 432B.590, inclusive [.] , and sections 32 to 35, inclusive, of this act. The attorney representing the child has the same authority and rights as an attorney representing any other party to the proceedings.
3. If the court determines that the parent of an Indian child for whom protective custody is sought is indigent, the court:
(a) Shall appoint an attorney to represent the parent; and
(b) May apply to the Secretary of the Interior for the payment of the fees and expenses of such an attorney,
Κ as provided in the Indian Child Welfare Act.
4. Each attorney, other than an attorney compensated through a program for legal aid described in NRS 19.031 and 247.305, if appointed under the provisions of subsection 1 or 2, is entitled to the same compensation and payment for expenses from the county as provided in NRS 7.125 and 7.135 for an attorney appointed to represent a person charged with a crime.
Sec. 48. (Deleted by amendment.)
Sec. 49. NRS 432B.4675 is hereby amended to read as follows:
432B.4675 Upon the entry of a final order by the court establishing a guardianship pursuant to NRS 432B.4665:
1. The custody of the child by the agency which has legal custody of the child is terminated;
2. The proceedings concerning the child conducted pursuant to NRS 432B.410 to 432B.590, inclusive, and sections 32 to 35, inclusive, of this act terminate; and
κ2023 Statutes of Nevada, Page 2337 (CHAPTER 397, AB 148)κ
3. Unless subsequently ordered by the court to assist the court, the following agencies and persons are excused from any responsibility to participate in the guardianship case:
(a) The agency which has legal custody of the child;
(b) Any counsel or guardian ad litem appointed by the court to assist in the proceedings conducted pursuant to NRS 432B.410 to 432B.590, inclusive [;] , and sections 32 to 35, inclusive, of this act; and
(c) Any person nominated or appointed as the person who is legally responsible for the psychiatric care of the child pursuant to NRS 432B.4684 or 432B.4685, respectively.
Sec. 50. NRS 432B.580 is hereby amended to read as follows:
432B.580 1. Except as otherwise provided in this section and NRS 432B.513, if a child is placed pursuant to NRS 432B.550 other than with a parent, the placement must be reviewed by the court at least semiannually, and within 90 days after a request by a party to any of the prior proceedings. Unless the parent, guardian or the custodian objects to the referral, the court may enter an order directing that the placement be reviewed by a panel appointed pursuant to NRS 432B.585.
2. An agency acting as the custodian of the child shall, before any hearing for review of the placement of a child, submit a report to the court, or to the panel if it has been designated to review the matter, which includes:
(a) An evaluation of the progress of the child and the family of the child and any recommendations for further supervision, treatment or rehabilitation.
(b) Information concerning the placement of the child in relation to the childs siblings, including, without limitation:
(1) Whether the child was placed together with the siblings;
(2) Any efforts made by the agency to have the child placed together with the siblings;
(3) Any actions taken by the agency to ensure that the child has contact with the siblings; and
(4) If the child is not placed together with the siblings:
(I) The reasons why the child is not placed together with the siblings; and
(II) A plan for the child to visit the siblings, which must be presented at the first hearing to occur after the siblings are separated and approved by the court. The plan for visitation must be updated as necessary to reflect any change in the placement of the child or a sibling, including, without limitation, any such change that occurs after the termination of parental rights to the child or a sibling or the adoption of a sibling.
(c) Information concerning the childs education, including:
(1) A copy of any academic plan or individual graduation plan developed for the child pursuant to NRS 388.155, 388.165, 388.205 or 388.227;
(2) The grade and school in which the child is enrolled;
(3) The name of each school the child attended before enrolling in the school in which he or she is currently enrolled and the corresponding dates of attendance;
(4) Whether the child has not completed or passed any course of instruction that the child should have completed or passed by the time the report is submitted, which has resulted in the child having a deficiency in credits;
(5) A copy of any individualized education program developed for the child;
κ2023 Statutes of Nevada, Page 2338 (CHAPTER 397, AB 148)κ
(6) A copy of any plan developed in accordance with section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794;
(7) A summary of any special education services received by the child;
(8) A copy of the most recent report card of the child;
(9) A statement of the number of credits earned by the child during the most recent semester, if applicable;
(10) A statement of the number of times the child has been absent from school during the current or most recent school year for which the child was enrolled in school;
(11) The scores the child received on any academic assessments or standardized examinations administered to the child;
(12) Any information provided by the educational decision maker appointed for the child pursuant to NRS 432B.462; and
(13) Whether a request that the child receive special education services has been made and, if so, the outcome of such a request.
(d) A copy of any explanations regarding medication that has been prescribed for the child that have been submitted by a foster home pursuant to NRS 424.0383.
3. Except as otherwise provided in this subsection, a copy of the report submitted pursuant to subsection 2 must be given to the parents, the guardian ad litem and the attorney, if any, representing the parent or the child. If the child was delivered to a provider of emergency services pursuant to NRS 432B.630 and the parent has not appeared in the action, the report need not be sent to that parent.
4. After a plan for visitation between a child and the siblings of the child submitted pursuant to subparagraph (4) of paragraph (b) of subsection 2 has been approved by the court, the agency which provides child welfare services must request the court to issue an order requiring the visitation set forth in the plan for visitation. Upon the issuance of such an order, the court shall provide each sibling of the child with the case number of the proceeding for the purpose of allowing the sibling to petition the court for visitation or enforcement of the order for visitation. If a person refuses to comply with or disobeys an order issued pursuant to this subsection, the person may be punished as for a contempt of court.
5. The court or the panel shall hold a hearing to review the placement, unless the parent, guardian or custodian files a motion with the court to dispense with the hearing. If the motion is granted, the court or panel may make its determination from any report, statement or other information submitted to it.
6. Except as otherwise provided in subsection 7 and subsection 5 of NRS 432B.520, notice of the hearing must be filed with the court and must be given by first-class mail or any other means agreed upon in writing between the agency which provides child welfare services and the recipient of the notice to:
(a) All the parties to any of the prior proceedings;
(b) Any persons planning to adopt the child;
(c) A sibling of the child, if known, who has been granted a right to visitation of the child pursuant to this section or NRS 127.171 and his or her attorney, if any;
(d) Any other relatives of the child or providers of foster care who are currently providing care to the child; and
(e) The educational decision maker appointed for the child pursuant to NRS 432B.462.
κ2023 Statutes of Nevada, Page 2339 (CHAPTER 397, AB 148)κ
7. The notice of the hearing required to be filed and given pursuant to subsection 6:
(a) Must include a statement indicating that if the child is placed for adoption the right to visitation of the child is subject to the provisions of NRS 127.171;
(b) Must not include any confidential information described in NRS 127.140;
(c) Need not be given to a parent whose rights have been terminated pursuant to chapter 128 of NRS or who has voluntarily relinquished the child for adoption pursuant to NRS 127.040; and
(d) Need not be given to a parent who delivered a child to a provider of emergency services pursuant to NRS 432B.630.
8. The court or panel may require the presence of the child at the hearing and shall provide to each person to whom notice was given pursuant to subsection 6 a right to be heard at the hearing.
9. The court or panel shall, after considering the report provided in subsection 2 and any other relevant evidence, determine based on a preponderance of the evidence:
(a) The continuing necessity for and appropriateness of the placement;
(b) The extent of compliance with the plan submitted pursuant to subsection 2 of NRS 432B.540;
(c) Any progress which has been made in alleviating the problem which resulted in the placement of the child;
(d) The date the child may be returned to, and safely maintained in, the home or placed for adoption or under a legal guardianship; and
(e) Whether the child is making adequate academic progress and receiving the educational services or supports necessary to ensure the academic success of the child.
10. If the child is placed in a qualified residential treatment program, the determination pursuant to paragraph (a) of subsection 9 must include, without limitation, a finding on each factor prescribed by subsection 4 of section 35 of this act.
11. The provision of notice and a right to be heard pursuant to this section does not cause any person planning to adopt the child, any sibling of the child or any other relative, any adoptive parent of a sibling of the child or a provider of foster care to become a party to the hearing.
[11.] 12. As used in this section, individualized education program has the meaning ascribed to it in 20 U.S.C. § 1414(d)(1)(A).
Sec. 51. NRS 432B.590 is hereby amended to read as follows:
432B.590 1. Except as otherwise provided in subsection 2 and NRS 432B.513, the court shall hold a hearing concerning the permanent placement of a child:
(a) Not later than 12 months after the initial removal of the child from the home of the child and annually thereafter.
(b) Within 30 days after making any of the findings set forth in subsection 3 of NRS 432B.393.
Κ Notice of this hearing must be filed with the court and must be given by first-class mail or any other means agreed upon in writing between the agency which provides child welfare services and the recipient of the notice to all the persons to whom notice must be given pursuant to subsection 6 of NRS 432B.580.
κ2023 Statutes of Nevada, Page 2340 (CHAPTER 397, AB 148)κ
2. A parent who delivered a child to a provider of emergency services pursuant to NRS 432B.630 shall be deemed to have waived any right to notice pursuant to this section.
3. The court may require the presence of the child at the hearing and shall provide to each person to whom notice was given pursuant to subsection 1 a right to be heard at the hearing.
4. At the hearing, the court shall review the report submitted by the agency which provides child welfare services pursuant to subsection 2 of NRS 432B.580, any plan for the permanent placement of the child adopted pursuant to NRS 432B.553 and any other relevant evidence and, if the goal of the plan is a permanent living arrangement other than reunification with his or her parents, placement for adoption, placement with a legal guardian or placement with a relative, ask the child about his or her desired permanent living arrangement. After doing so, the court must determine, based on a preponderance of the evidence:
(a) Whether the agency with legal custody of the child has made the reasonable efforts required by subsection 1 of NRS 432B.553;
(b) Whether, and if applicable when:
(1) The child should be returned to the parents of the child or placed with other relatives;
(2) It is in the best interests of the child to:
(I) Initiate proceedings to terminate parental rights pursuant to chapter 128 of NRS so that the child can be placed for adoption;
(II) Initiate proceedings to establish a guardianship pursuant to chapter 159A of NRS; or
(III) Establish a guardianship in accordance with NRS 432B.466 to 432B.468, inclusive; or
(3) The agency with legal custody of the child has produced documentation of its conclusion that there is a compelling reason for the placement of a child who has attained the age of 16 years in another permanent living arrangement;
(c) If the child will not be returned to the parents of the child, whether the agency with legal custody of the child fully considered placement options both within and outside of this State;
(d) If the child has attained the age of 14 years, whether the child will receive the services needed to assist the child in transitioning to independent living; and
(e) If the child has been placed outside of this State, whether the placement outside of this State continues to be appropriate for and in the best interests of the child.
5. The court shall prepare an explicit statement of the facts upon which each of its determinations is based pursuant to subsection 4. If the court determines that it is not in the best interests of the child to be returned to his or her parents, or to be placed for adoption, with a legal guardian or with a relative, the court must include compelling reasons for this determination and an explanation of those reasons in its statement of the facts.
6. If the court determines that it is in the best interests of the child to terminate parental rights, the court shall use its best efforts to ensure that the procedures required by chapter 128 of NRS are completed within 6 months after the date the court makes that determination, including, without limitation, appointing a private attorney to expedite the completion of the procedures.
κ2023 Statutes of Nevada, Page 2341 (CHAPTER 397, AB 148)κ
7. The provisions of this section do not limit the jurisdiction of the court to review any decisions of the agency with legal custody of the child regarding the permanent placement of the child.
8. If a child has been placed outside of the home and has resided outside of the home pursuant to that placement for 14 months of any 20 consecutive months, the best interests of the child must be presumed to be served by the termination of parental rights.
9. This hearing may take the place of the hearing for review required by NRS 432B.580.
10. If a hearing pursuant to this section concerns a child who has been placed in a qualified residential treatment program, the hearing must include, without limitation, a review of that placement conducted in the manner prescribed by section 35 of this act.
11. The provision of notice and a right to be heard pursuant to this section does not cause any person planning to adopt the child, any sibling of the child or any other relative, any adoptive parent of a sibling of the child or a provider of foster care to become a party to the hearing.
Sec. 52. NRS 432B.595 is hereby amended to read as follows:
432B.595 1. Upon the request of a young adult who satisfies the requirements of subsection 1 of NRS 432B.594 to participate in the Program, the agency which provides child welfare services shall develop a written extended youth support services plan to assist the young adult in transitioning to self-sufficiency. Such a plan must include, without limitation:
(a) The persons or entities that will receive payments from the agency which provides child welfare services and the manner in which such payments will be allocated. The agency which provides child welfare services may make payments to more than one person or entity authorized to receive payments pursuant to subsection 2.
(b) The goals set forth in subsection 3.
2. The plan developed pursuant to subsection 1 may provide for the agency which provides child welfare services to make direct payments to:
(a) A foster home.
(b) A qualified residential treatment program.
(c) A child care institution.
(d) A person or entity, including, without limitation, a relative or fictive kin, who provides a supervised arrangement for independent living where the participant resides.
(e) A landlord, property manager or other entity that collects rental payments for housing.
(f) A participant.
(g) Any combination of the persons or entities listed in paragraphs (a) to (f), inclusive.
3. The plan developed pursuant to subsection 1 must include, without limitation, the following goals:
(a) That the young adult save enough money to pay for his or her monthly expenses for at least 3 months;
(b) If the young adult has not graduated from high school or obtained a general equivalency diploma or an equivalent document, that the young adult obtain a high school diploma or general equivalency diploma;
(c) If the young adult has graduated from high school or obtained a general equivalency diploma or an equivalent document, that the young adult:
κ2023 Statutes of Nevada, Page 2342 (CHAPTER 397, AB 148)κ
(1) Complete a program of postsecondary or vocational education;
(2) Complete a program or activity designed to promote employment or remove obstacles to employment; or
(3) Be employed at least 80 hours per month;
(d) That the young adult secure housing;
(e) That the young adult have adequate income to meet his or her monthly expenses;
(f) That the young adult identify an adult who will be available to provide support to the young adult; and
(g) If applicable, that the young adult have established appropriate supportive services to address any mental health or developmental needs of the young adult.
4. If a young adult is not capable of achieving one or more of the goals set forth in paragraphs (a) to (g), inclusive, of subsection 3, the young adult must have goals which are appropriate for the young adult based upon the needs of the young adult.
5. Based upon the needs of a participant, the agency which provides child welfare services may, at any time, after consulting with the participant, revise:
(a) The persons or entities to whom a payment is made pursuant to subsection 2.
(b) The manner in which payments are allocated between persons or entities to whom payments are made pursuant to subsection 2.
6. The plan developed pursuant to subsection 1 must be annually reviewed and mutually agreed upon by the young adult and the agency which provides child welfare services at the hearing required by NRS 432B.601.
7. The agency which provides child welfare services shall:
(a) Monitor the plan developed pursuant to subsection 1 and adjust the plan as necessary;
(b) Contact the young adult by telephone at least once each month and in person at least quarterly;
(c) Ensure that the young adult meets with a person who will provide guidance to the young adult and make the young adult aware of the services which will be available to the young adult; and
(d) Conduct a meeting with the young adult at least 30 days, but not more than 45 days, before he or she reaches the age of 21 years to determine whether the young adult requires any additional guidance.
8. As used in this section:
(a) Child care institution has the meaning ascribed to it in NRS 432A.0245.
(b) Foster home has the meaning ascribed to it in NRS 424.014.
[(c) Qualified residential treatment program has the meaning ascribed to it in 42 U.S.C. § 672.]
Sec. 53. NRS 432B.607 is hereby amended to read as follows:
432B.607 As used in NRS 432B.607 to 432B.6085, inclusive, and sections 35.3 to 42, inclusive, of this act, unless the context otherwise requires, the words and terms defined in NRS 432B.6071 to 432B.6074, inclusive, have the meanings ascribed to them in those sections.
Sec. 54. NRS 432B.6075 is hereby amended to read as follows:
432B.6075 1. [A proceeding for a court-ordered admission of a child alleged to be] If a child with an emotional disturbance who is in the custody of an agency which provides child welfare services is admitted to a facility [may be commenced by the filing of] under an emergency admission and the child has not been released within 5 days after the admission, the agency which provides child welfare services shall file a petition to continue the emergency admission, not later than 5 days after the admission, with the clerk of the court which has jurisdiction in proceedings concerning the child.
κ2023 Statutes of Nevada, Page 2343 (CHAPTER 397, AB 148)κ
provides child welfare services shall file a petition to continue the emergency admission, not later than 5 days after the admission, with the clerk of the court which has jurisdiction in proceedings concerning the child. The petition may be filed by the agency which provides child welfare services without the consent of a parent or guardian of the child. The petition must be accompanied [:
(a) By] by a certificate of a physician, a psychiatrist [or licensed] , a psychologist [stating] or an advanced practice registered nurse who has the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120:
(a) Stating that the physician, psychiatrist , [or licensed] psychologist or advanced practice registered nurse has examined the child [alleged to be a child with an emotional disturbance] who is the subject of the petition and has concluded that the child [has] is a child with an emotional disturbance and, because of that condition, [is likely to harm himself or herself or others if allowed liberty; or
(b) By a sworn written statement by the petitioner that:
(1) The petitioner has, based upon personal observation of the child alleged to be a child with an emotional disturbance, probable cause to believe that the child has an emotional disturbance and, because of that condition, is likely to harm himself or herself or others if allowed liberty; and
(2) The child alleged to be a child with an emotional disturbance has refused to submit to examination or treatment by a physician, psychiatrist or licensed psychologist.] the child is a person in a mental health crisis, as defined in NRS 433A.0175, and presents a substantial likelihood of serious harm to himself or herself or others, as determined pursuant to NRS 433A.0195, if discharged to a less restrictive appropriate environment and includes, if available, the date on which the child will be discharged from the emergency admission to the facility; or
(b) By a sworn written statement by the petitioner that the child is:
(1) A person in a mental health crisis, as defined in NRS 433A.0175, and presents a substantial likelihood of serious harm to herself or himself or others, as determined pursuant to NRS 433A.0195, if discharged to a less restrictive appropriate environment; and
(2) Is alleged to be a child with an emotional disturbance and has refused to submit to examination or treatment by a physician, psychiatrist, psychologist or advanced practice registered nurse who has the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120.
2. [If a] A child who is the subject of a petition filed pursuant to this section [is to continue the placement of the child after an emergency admission, the petition must be filed not later than 5 days after the emergency admission or the child must be released.] or the parent or guardian of such a child may oppose the petition:
(a) Orally at a hearing on the petition; or
(b) By filing a written opposition with the court.
Sec. 55. NRS 432B.6076 is hereby amended to read as follows:
432B.6076 1. [Except as otherwise provided in NRS 432B.6077, if] A child who is the subject of a petition submitted pursuant to NRS 432B.6075 may, after conferring with his or her attorney, submit to the court written consent, or provide oral consent in the record of the court, to continue the emergency admission. Upon receiving such consent, the court may order the continuation of the emergency admission if it finds that continuing the emergency admission is in the best interests of the child.
κ2023 Statutes of Nevada, Page 2344 (CHAPTER 397, AB 148)κ
continuation of the emergency admission if it finds that continuing the emergency admission is in the best interests of the child.
2. A court that receives a petition submitted pursuant to NRS 432B.6075 to continue the emergency admission of a child alleged to be a child with an emotional disturbance to a facility shall conduct a hearing on the petition, unless otherwise ordered by the court.
3. Except as otherwise provided in subsection 1, a court may order the continuation of the emergency admission of a child with respect to whom a petition was filed pursuant to NRS 432B.6075 to a facility only if the court finds [, after proceedings for the court-ordered admission of a child alleged to be a child with an emotional disturbance who is in the custody of an agency which provides child welfare services to a facility, including, without limitation, an evidentiary hearing:
(a) That there is not clear and convincing evidence that the child with respect to whom the hearing was held exhibits observable behavior such that the child is likely to harm himself or herself or others if allowed liberty, the court shall enter its finding to that effect and the child must not be admitted to a facility.
(b) That there is] by clear and convincing evidence that the child [with respect to whom the hearing was held is in need of treatment in a facility and is likely to harm himself or herself or others if allowed liberty, the court may order the admission of the child for the most appropriate course of treatment. The order of the court must be interlocutory and must not become final if, within 30 days after the admission, the child is unconditionally released from the facility pursuant to NRS 432B.6084.
2. Before issuing an order for admission or a renewal thereof, the court shall explore other alternative courses of treatment within the least restrictive appropriate environment as suggested by the evaluation team who evaluated the child, or other persons professionally qualified in the field of psychiatric mental health, which the court believes may be in the best interests of the child.] :
(a) Is a child with an emotional disturbance; and
(b) Is a person in a mental health crisis, as defined in NRS 433A.0175, and presents a substantial likelihood of serious harm to himself or herself or others, as determined pursuant to NRS 433A.0195, if discharged to a less restrictive appropriate environment.
4. The court shall issue a written order on a petition submitted pursuant to NRS 432B.6075. If the court:
(a) Orders the continuation of the emergency admission, the order must include specific findings concerning each factor prescribed by subsection 3.
(b) Does not order the continuation of the emergency admission, the court must enter its findings to that effect and order the discharge of the child from the facility.
Sec. 56. NRS 432B.6078 is hereby amended to read as follows:
432B.6078 1. [Not later than 5 days after a child who is in the custody of an agency which provides child welfare services has been admitted to a facility pursuant to NRS 432B.6076, the agency which provides child welfare services shall inform the child of his or her legal rights and the provisions of NRS 432B.607 to 432B.6085, inclusive, 433.456 to 433.543, inclusive, and 433.545 to 433.551, inclusive, and chapters 433A and 433B of NRS and NRS 435.530 to 435.635, inclusive, and, if the child or the childs attorney desires, assist the child in requesting] A child or a parent or legal guardian of the child who opposes a petition to continue an emergency admission pursuant to subsection 2 of NRS 432B.6075 may petition the court to authorize a second examination [by an evaluation team that includes a physician, psychiatrist or licensed psychologist who are not employed by, connected to or otherwise affiliated with the facility other than a physician, psychiatrist or licensed psychologist who performed an original examination which authorized the court to order the admission of the child to the facility.]
κ2023 Statutes of Nevada, Page 2345 (CHAPTER 397, AB 148)κ
to subsection 2 of NRS 432B.6075 may petition the court to authorize a second examination [by an evaluation team that includes a physician, psychiatrist or licensed psychologist who are not employed by, connected to or otherwise affiliated with the facility other than a physician, psychiatrist or licensed psychologist who performed an original examination which authorized the court to order the admission of the child to the facility.] of any child examined pursuant to subsection 1 of NRS 432B.6075. The court shall authorize a second examination upon receiving such a petition. A second examination must be [conducted] completed not later than [5 business] 6 days after the court authorizes the examination.
2. If the court authorizes a second examination of the child, the examination must:
(a) Be conducted by a physician, psychiatrist, psychologist or advanced practice registered nurse who has the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120 who is not:
(1) The same physician, psychiatrist, psychologist or advanced practice registered nurse who completed the certificate pursuant to subsection 1 of NRS 432B.6075 or a physician, psychologist or advanced practice registered nurse who participated in the examination conducted pursuant to that subsection; or
(2) Employed by, connected to or otherwise affiliated with the facility where the child is admitted;
(b) Include, without limitation, an evaluation [concerning whether the child should remain in the facility and a recommendation concerning the appropriate placement of the child which must be provided to the facility;] of the diagnosis of the child, whether the child presents a substantial likelihood of serious harm to himself or herself or others, as determined pursuant to NRS 433A.0195, and whether the emergency admission should be continued; and
[(b)] (c) Be paid for by the governmental entity that is responsible for the agency which provides child welfare services, if such payment is not otherwise provided by the State Plan for Medicaid.
Sec. 57. NRS 432B.6079 is hereby amended to read as follows:
432B.6079 In determining pursuant to NRS 432B.6076 and 432B.608 whether to issue or renew an order [for] to continue the emergency admission of a child who is in the custody of an agency which provides child welfare services to a facility, the court shall consider:
1. The reports of any examinations or evaluations of a child by any [psychologist, psychiatrist or other physician;] person professionally qualified in the field of psychiatric mental health;
2. Any information concerning [the child provided to the court by a licensed clinical social worker or other professional or any adult caretaker who is knowledgeable about the child or a guardian ad litem appointed for the child pursuant to NRS 432B.500;] whether the child presents a substantial likelihood of serious harm to himself or herself or others provided by:
(a) A person professionally qualified in the field of psychiatric mental health;
(b) A representative of the agency which provides child welfare services;
(c) An adult caretaker who is knowledgeable about the child; or
(d) A guardian ad litem appointed for the child pursuant to NRS 432B.500;
κ2023 Statutes of Nevada, Page 2346 (CHAPTER 397, AB 148)κ
3. The wishes of the child concerning care, treatment [and training] and [placement in a] emergency admission to the facility;
4. The best interests of the child, including, without limitation, whether the court believes the child might experience any psychological trauma from [court-ordered] continued emergency admission;
5. Any alternative care [,] or treatment [or training] options; and
6. Any other information the court deems relevant concerning the child.
Sec. 58. NRS 432B.608 is hereby amended to read as follows:
432B.608 1. If the court issues an order [for] to continue the emergency admission to a facility of a child who is in the custody of an agency which provides child welfare services pursuant to NRS 432B.6076, the [admission automatically expires at the end of 90 days if not terminated previously by the facility as provided for in subsection 2 of NRS 432B.6084.
2. At the end of the court-ordered period of treatment, the agency which provides child welfare services, the Division of Child and Family Services or any facility may petition to renew the admission of the child for additional periods not to exceed 60 days each.
3. For each renewal, the petition must set forth the specific reasons why further treatment in the facility would be in the best interests of the child and the court shall apply the same standards when considering a petition to renew the admission of the child as were applied for the original petition for the court-ordered admission of the child.] order must be interlocutory, and the child must be discharged from the facility if the order is not renewed within 14 days after the order is issued.
2. A facility may unconditionally release a child who is admitted under an emergency admission that has been continued pursuant to NRS 432B.6076 without a prior order of the court upon the written recommendation of the psychiatrist and other person professionally qualified in the field of psychiatric mental health who are responsible for treating the child. Upon receipt of such a recommendation, the facility shall provide notice of the recommendation to the agency which provides child welfare services and the agency shall notify all parties and the court. Such notice must include, without limitation, an explanation of the reasons that:
(a) The release is clinically appropriate; and
(b) The child is capable of being safely and effectively treated in a less restrictive appropriate environment.
Sec. 59. NRS 432B.6081 is hereby amended to read as follows:
432B.6081 A facility which provides care [,] or treatment [or training] to a child who is in the custody of an agency which provides child welfare services and who is admitted to the facility under an emergency admission continued pursuant to NRS 432B.6076 shall develop a written plan, in consultation with the child, for the continued care [,] or treatment [and training] of the child upon discharge from the facility. The plan must:
1. Be developed [not later than 10 days after the child is admitted] at the time of the emergency admission of a child to the facility [;] and revised on an ongoing basis for the duration of the emergency admission based on the clinical status of the child;
2. Be submitted to the court after each period of admission ordered by the court pursuant to NRS 432B.6076 in the manner set forth in NRS 432B.608; and
κ2023 Statutes of Nevada, Page 2347 (CHAPTER 397, AB 148)κ
3. Include, without limitation:
(a) The anticipated date of discharge of the child from the facility;
(b) The name of any [psychiatrist or psychologist] person professionally qualified in the field of psychiatric mental health who will provide care [,] or treatment [or training] to the child after the child is discharged from the facility, if [appropriate;] known;
(c) A plan for any appropriate care [,] or treatment [or training] for the child for at least 30 days after the child is discharged from the facility; and
(d) The [suggested] recommended type of placement [of] for the child after the child is discharged from the facility.
Sec. 60. NRS 432B.60845 is hereby amended to read as follows:
432B.60845 A facility which provides care [,] or treatment [or training] to a child who is in the custody of an agency which provides child welfare services and who is admitted to the facility pursuant to NRS 432B.6076 or section 38 of this act shall:
1. Ensure that each employee of the facility who comes into direct contact with children at the facility receives, within 90 days after employment and annually thereafter, training that has been approved by the Division of Child and Family Services concerning working with lesbian, gay, bisexual, transgender and questioning children;
2. Ensure that each child who is placed in the facility is treated in all respects in accordance with the childs gender identity or expression; and
3. Follow the protocols prescribed in the regulations adopted pursuant to NRS 432B.172 when placing the child within the facility.
Sec. 61. NRS 432B.60847 is hereby amended to read as follows:
432B.60847 1. A psychiatric hospital to which a child who is in the custody of an agency which provides child welfare services is admitted pursuant to NRS 432B.6076 or section 38 of this act shall, in consultation with the public or private school in which the child was enrolled when he or she was admitted to the psychiatric hospital, any school district in which the child was enrolled or which was providing services to the child when he or she was admitted to the psychiatric hospital, the agency which provides child welfare services and any person responsible for the education of the child, develop a plan for the continued education of the child while the child remains enrolled in the public or private school or the school district yet is admitted to the psychiatric hospital. The plan must be:
(a) Provided to the child, the agency which provides child welfare services, the childs caseworker, if applicable, any person responsible for the education of the child, the school and, if applicable, the school district; and
(b) Submitted to the court after each period of admission ordered by the court pursuant to NRS 432B.6076 in the manner set forth in NRS 432B.608 [.] or section 38 of this act in the manner set forth in section 41 of this act.
2. A plan for the continued education of a child developed pursuant to subsection 1 must include, without limitation:
(a) The number of hours of instruction each week that must be provided to the child while the child is admitted to the psychiatric hospital;
(b) Provisions for the transfer of instructional materials to the psychiatric hospital from the school in which the child was enrolled when he or she was admitted to the psychiatric hospital;
(c) Procedures for monitoring the implementation of the plan and the appropriateness of the instruction being provided to the child;
(d) If an individualized education program or services plan has been developed for the child and provided to the psychiatric hospital pursuant to NRS 392.857 or 394.1998, provisions to ensure that the psychiatric hospital maintains compliance with the individualized education program or services plan, as applicable; and
κ2023 Statutes of Nevada, Page 2348 (CHAPTER 397, AB 148)κ
NRS 392.857 or 394.1998, provisions to ensure that the psychiatric hospital maintains compliance with the individualized education program or services plan, as applicable; and
(e) A plan for continuing the education of the child after he or she is discharged from the psychiatric hospital, including, without limitation, a plan for transitioning the child into a school or any other educational setting in which the child will receive instruction after discharge.
3. Before admission of a child who is in the custody of an agency which provides child welfare services to a facility which provides residential treatment for mental illness, the public or private school or any school district in which the child was enrolled or which was providing services to the child when he or she was admitted to the facility must:
(a) For a child who is a pupil with a disability, convene an individualized education program meeting to consider the appropriateness of a residential placement under federal law as it relates to the childs education needs;
(b) Convene a meeting of representatives of the public or private school in which the child was enrolled, the school district in which the child was enrolled, the agency which provides child welfare services, any person responsible for the education of the child and any other organization that provides support to the child, as appropriate, to consider, pursuant to the statewide framework for integrated student supports established pursuant to NRS 388.885, the appropriateness of a residential placement;
(c) Monitor the childs progress while the child is admitted to the facility; and
(d) Participate in discharge planning for transitioning the child into a school or any other educational setting in which the child will receive instruction after discharge. The Department of Education shall adopt regulations necessary to carry out the provisions of this paragraph.
4. As used in this section:
(a) Individualized education program has the meaning ascribed to it in 20 U.S.C. § 1414(d)(1)(A).
(b) Person responsible for the education of the child includes, without limitation, the parent or guardian of the child and any educational decision maker appointed for the child pursuant to NRS 432B.462.
(c) Private school has the meaning ascribed to it in NRS 394.103.
(d) Public school includes, without limitation, a university school for profoundly gifted pupils.
(e) Services plan has the meaning ascribed to it in 34 C.F.R. § 300.37.
Sec. 62. NRS 432B.6085 is hereby amended to read as follows:
432B.6085 1. Nothing in this chapter purports to deprive any person of any legal rights without due process of law.
2. Unless the context clearly indicates otherwise, the provisions of NRS 432B.607 to 432B.6085, inclusive, and sections 35.3 to 42, inclusive, of this act, 433.456 to 433.543, inclusive, and 433.545 to 433.551, inclusive, and chapters 433A and 433B of NRS and NRS 435.530 to 435.635, inclusive, apply to all children who are in the custody of an agency which provides child welfare services.
Sec. 63. NRS 433A.145 is hereby amended to read as follows:
433A.145 1. If a person in a mental health crisis is admitted to a public or private mental health facility or hospital as a voluntary consumer, the facility or hospital shall not change the status of the person to an emergency admission unless:
κ2023 Statutes of Nevada, Page 2349 (CHAPTER 397, AB 148)κ
(a) A person described in NRS 433A.160 places the person on a mental health crisis hold; and
(b) The requirements prescribed by NRS 433A.162 have been met.
2. Except as otherwise provided in subsection 3 [,] and NRS 432B.6075, a person whose status is changed pursuant to subsection 1 must not be detained in excess of 72 hours, including weekends and holidays, after the person is placed on a mental health crisis hold pursuant to NRS 433A.160 unless, before the close of the business day on which the 72 hours expires, a written petition for an involuntary court-ordered admission to a mental health facility is filed with the clerk of the district court pursuant to NRS 433A.200, including, without limitation, the documents required pursuant to NRS 433A.210.
3. If the period specified in subsection 2 expires on a day on which the office of the clerk of the district court is not open, the written petition must be filed on or before the close of the business day next following the expiration of that period.
Sec. 64. NRS 433A.150 is hereby amended to read as follows:
433A.150 1. A person alleged to be a person in a mental health crisis who is placed on a mental health crisis hold pursuant to NRS 433A.160 may, subject to the provisions of subsection 2, be detained in a public or private mental health facility or hospital for assessment, evaluation, intervention and treatment, regardless of whether any parent or legal guardian of the person has consented to the mental health crisis hold.
2. Except as otherwise provided in subsection 3 [,] and NRS 432B.6075, a person detained pursuant to subsection 1 must be released within 72 hours, including weekends and holidays, after the person is placed on a mental health crisis hold pursuant to NRS 433A.160 unless, before the close of the business day on which the 72 hours expires, a written petition for an involuntary court-ordered admission to a mental health facility is filed with the clerk of the district court pursuant to NRS 433A.200, including, without limitation, the documents required pursuant to NRS 433A.210, or the status of the person is changed to a voluntary admission.
3. If the period specified in subsection 2 expires on a day on which the office of the clerk of the district court is not open, the written petition must be filed on or before the close of the business day next following the expiration of that period.
Sec. 65. NRS 433A.200 is hereby amended to read as follows:
433A.200 1. Except as otherwise provided in NRS 432B.6075 [,] and section 37 of this act, a proceeding for an involuntary court-ordered admission of any person in the State of Nevada may be commenced by the filing of a petition for the involuntary admission to a mental health facility with the clerk of the district court of the county where the person who is to be treated resides or the county where a mental health facility that is willing to admit the person is located. The petition may be filed by any physician, physician assistant, psychologist, social worker or registered nurse or by any officer authorized to make arrests in the State of Nevada. The petition must be accompanied:
(a) By a certificate of a physician, a psychologist, a physician assistant under the supervision of a psychiatrist, a clinical social worker who has the psychiatric training and experience prescribed by the Board of Examiners for Social Workers pursuant to NRS 641B.160 or an advanced practice registered nurse who has the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120 stating that he or she has examined the person alleged to be a person in a mental health crisis and has concluded that the person is a person in a mental health crisis; or
κ2023 Statutes of Nevada, Page 2350 (CHAPTER 397, AB 148)κ
(b) By a sworn written statement by the petitioner that:
(1) The petitioner has, based upon the petitioners personal observation of the person alleged to be a person in a mental health crisis, probable cause to believe that the person is a person in a mental health crisis and the person alleged to be a person in a mental health crisis has refused to submit to examination or treatment by a physician, psychiatrist, psychologist or advanced practice registered nurse who has the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120; or
(2) The person alleged to be a person in a mental health crisis has been placed on a mental health crisis hold pursuant to NRS 433A.160 and the physician, physician assistant or advanced practice registered nurse who examined the person alleged to be a person with a mental health crisis pursuant to NRS 433A.165 determined that the person has a medical condition, other than a psychiatric condition, which requires immediate treatment.
2. Except as otherwise provided in NRS 432B.6075 [,] and section 37 of this act, if the person to be treated is an unemancipated minor and the petitioner is a person other than a parent or guardian of the minor, a petition submitted pursuant to subsection 1 must, in addition to the certificate or statement required by that subsection, include a statement signed by a parent or guardian of the minor that the parent or guardian does not object to the filing of the petition.
Sec. 66. NRS 433A.310 is hereby amended to read as follows:
433A.310 1. Except as otherwise provided in NRS 432B.6076 and [432B.6077,] section 38 of this act, if the district court finds, after proceedings for the involuntary court-ordered admission of a person:
(a) That there is not clear and convincing evidence that the person with respect to whom the hearing was held is a person in a mental health crisis, the court must enter its finding to that effect and the person must not be involuntarily admitted to a public or private mental health facility. If the person has been detained in a public or private mental health facility or hospital under a mental health crisis hold pursuant to NRS 433A.160, including, without limitation, where the person has been admitted under an emergency admission pursuant to NRS 433A.162, the court must issue a written order requiring the facility or hospital to release the person not later than 24 hours after the court issues the order, unless the person applies for admission as a voluntary consumer pursuant to NRS 433A.140.
(b) That there is clear and convincing evidence that the person with respect to whom the hearing was held is a person in a mental health crisis, the court may order the involuntary admission of the person to a public or private mental health facility. The order of the court must be interlocutory and must not become final if, within 30 days after the involuntary admission, the person is unconditionally released pursuant to NRS 433A.390.
2. Except as otherwise provided in NRS 432B.608 [,] and section 41 of this act, an involuntary admission pursuant to paragraph (b) of subsection 1 automatically expires at the end of 6 months if not terminated previously by the medical director of the public or private mental health facility after a determination by the physician primarily responsible for treating the patient, a psychiatrist or an advanced practice registered nurse as provided for in subsection 3 of NRS 433A.390. Except as otherwise provided in NRS 432B.608 [,] and section 41 of this act, at the end of the involuntary court-ordered admission, the Division or any mental health facility that is not operated by the Division may petition to renew the involuntary admission of the person for additional periods not to exceed 6 months each.
κ2023 Statutes of Nevada, Page 2351 (CHAPTER 397, AB 148)κ
the person for additional periods not to exceed 6 months each. For each renewal, the petition must include evidence which meets the same standard set forth in subsection 1 that was required for the initial period of admission of the person to a public or private mental health facility.
3. Before issuing an order for involuntary admission or a renewal thereof, the court shall explore other alternative courses of treatment within the least restrictive appropriate environment, including assisted outpatient treatment, as suggested by the evaluation team who evaluated the person, or other persons professionally qualified in the field of psychiatric mental health, which the court believes may be in the best interests of the person.
4. If the court issues an order involuntarily admitting a person to a public or private mental health facility pursuant to this section, the court must, notwithstanding the provisions of NRS 433A.715, cause, within 5 business days after the order becomes final pursuant to this section, on a form prescribed by the Department of Public Safety, a record of the order to be transmitted to:
(a) The Central Repository for Nevada Records of Criminal History, along with a statement indicating that the record is being transmitted for inclusion in each appropriate database of the National Instant Criminal Background Check System; and
(b) Each law enforcement agency of this State with which the court has entered into an agreement for such transmission, along with a statement indicating that the record is being transmitted for inclusion in each of this States appropriate databases of information relating to crimes.
5. After issuing an order pursuant to this section, a court shall not transfer the case to another court.
6. A public or private mental health facility to which a person is involuntarily admitted pursuant to this section shall notify the court and the counsel for the person if the person is transferred to another facility.
7. As used in this section, National Instant Criminal Background Check System has the meaning ascribed to it in NRS 179A.062.
Sec. 67. NRS 433A.390 is hereby amended to read as follows:
433A.390 1. When a consumer, involuntarily admitted to a mental health facility or required to receive assisted outpatient treatment by court order, is released at the end of the period specified pursuant to NRS 433A.310 or 433A.343, as applicable, written notice must be given to the court that issued the order not later than 3 judicial days after the release of the consumer. The consumer may be released without requiring further orders of the court. If the consumer has a legal guardian, the facility or the person professionally qualified in the field of psychiatric mental health responsible for providing the assisted outpatient treatment shall notify the guardian in the manner prescribed by subsection 6 at least 3 days before discharging the consumer from the facility or treatment or, if the consumer will be released in less than 3 days, as soon as practicable.
2. The legal guardian of a consumer involuntarily admitted to a mental health facility, if applicable, has discretion to determine where the consumer will be released pursuant to subsection 1, taking into consideration any discharge plan proposed by the facility assessment team. If the legal guardian does not inform the facility as to where the consumer will be released within 3 days after the date of notification, the facility must discharge the consumer according to its proposed discharge plan.
κ2023 Statutes of Nevada, Page 2352 (CHAPTER 397, AB 148)κ
3. [A] Except as otherwise provided in NRS 432B.608 and section 41 of this act, a consumer who is involuntarily admitted to a mental health facility may be unconditionally released before the period specified in NRS 433A.310 when the physician primarily responsible for treating the patient, a psychiatrist or an advanced practice registered nurse who has the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120 determines that the consumer is no longer a person in a mental health crisis. If the consumer has a legal guardian, the facility shall notify the guardian in the manner prescribed by subsection 6 at least 3 days before discharging the consumer from the facility or, if the consumer will be released in less than 3 days, as soon as practicable. The legal guardian, if applicable, has discretion to determine where the consumer will be released, taking into consideration any discharge plan proposed by the facility assessment team. If the legal guardian does not inform the facility as to where the consumer will be released within 3 days after the date of notification, the facility shall discharge the consumer according to its proposed discharge plan.
4. A consumer who is required to receive assisted outpatient treatment may be unconditionally released before the period specified in NRS 433A.343 when the person professionally qualified in the field of psychiatric mental health responsible for providing the assisted outpatient treatment for the consumer determines that:
(a) The consumer no longer requires assisted outpatient treatment to prevent further disability or deterioration that would result in the person becoming a person in a mental health crisis;
(b) The consumer is willing and likely to voluntarily participate in outpatient treatment that enables the person to live safely in the community without the supervision of the court; or
(c) After the order for assisted outpatient treatment has been effective for at least 30 days, the assisted outpatient treatment is not meeting the needs of the consumer.
5. If a consumer who will be released from assisted outpatient treatment pursuant to subsection 4 has a legal guardian, the person professionally qualified in the field of psychiatric mental health responsible for providing the assisted outpatient treatment to the consumer shall notify the guardian in the manner prescribed by subsection 6 at least 3 days before discharging the consumer from the treatment or, if the consumer will be released in less than 3 days, as soon as practicable.
6. Notification of a guardian pursuant to subsection 1, 3 or 5 must be provided:
(a) In person or by telephone; or
(b) If the mental health facility or the person professionally qualified in the field of psychiatric mental health, as applicable, is not able to contact the guardian in person or by telephone, by facsimile, electronic mail or certified mail.
7. A mental health facility or a person professionally qualified in the field of psychiatric mental health responsible for providing treatment to a consumer shall provide written notice to the court that issued the order not later than 3 judicial days after unconditionally releasing a consumer pursuant to subsection 3 or 4.
Secs. 68 and 69. (Deleted by amendment.)
κ2023 Statutes of Nevada, Page 2353 (CHAPTER 397, AB 148)κ
Sec. 70. NRS 632.120 is hereby amended to read as follows:
632.120 1. The Board shall:
(a) Adopt regulations establishing reasonable standards:
(1) For the denial, renewal, suspension and revocation of, and the placement of conditions, limitations and restrictions upon, a license to practice professional or practical nursing or a certificate to practice as a nursing assistant or medication aide - certified.
(2) Of professional conduct for the practice of nursing.
(3) For prescribing and dispensing controlled substances and dangerous drugs in accordance with applicable statutes.
(4) For the psychiatric training and experience necessary for an advanced practice registered nurse to be authorized to make the diagnoses, evaluations and examinations described in NRS 432B.6078, 433A.162, 433A.240, 433A.335, 433A.390, 433A.430, 484C.300, 484C.320, 484C.330, 484C.340 and 484C.350 [,] and section 39 of this act, the certifications described in NRS 432B.6075, 433A.170, 433A.195 and 433A.200 and section 37 of this act and the sworn statements or declarations described in NRS 433A.210 and 433A.335.
(b) Prepare and administer examinations for the issuance of a license or certificate under this chapter.
(c) Investigate and determine the eligibility of an applicant for a license or certificate under this chapter.
(d) Carry out and enforce the provisions of this chapter and the regulations adopted pursuant thereto.
(e) Develop and disseminate annually to each registered nurse who cares for children information concerning the signs and symptoms of pediatric cancer.
2. The Board may adopt regulations establishing reasonable:
(a) Qualifications for the issuance of a license or certificate under this chapter.
(b) Standards for the continuing professional competence of licensees or holders of a certificate. The Board may evaluate licensees or holders of a certificate periodically for compliance with those standards.
3. The Board may adopt regulations establishing a schedule of reasonable fees and charges, in addition to those set forth in NRS 632.345, for:
(a) Investigating licensees or holders of a certificate and applicants for a license or certificate under this chapter;
(b) Evaluating the professional competence of licensees or holders of a certificate;
(c) Conducting hearings pursuant to this chapter;
(d) Duplicating and verifying records of the Board; and
(e) Surveying, evaluating and approving schools of practical nursing, and schools and courses of professional nursing,
Κ and collect the fees established pursuant to this subsection.
4. For the purposes of this chapter, the Board shall, by regulation, define the term in the process of obtaining accreditation.
5. The Board may adopt such other regulations, not inconsistent with state or federal law, as may be necessary to carry out the provisions of this chapter relating to nursing assistant trainees, nursing assistants and medication aides - certified.
κ2023 Statutes of Nevada, Page 2354 (CHAPTER 397, AB 148)κ
6. The Board may adopt such other regulations, not inconsistent with state or federal law, as are necessary to enable it to administer the provisions of this chapter.
Secs. 71 and 71.5. (Deleted by amendment.)
Sec. 72. 1. The provisions of sections 32, 33 and 34 of this act apply to any proceedings to which those provisions would otherwise apply which are instituted before, on or after October 1, 2023.
2. The provisions of section 35 of this act apply to any child in the custody of an agency which provides child welfare services who is placed in a qualified residential treatment program before, on or after October 1, 2023.
3. The provisions of section 36 and 75 of this act apply to any child in the custody of an agency which provides child welfare services who has been admitted to a facility where the admission is effective on or after October 1, 2023.
4. The provisions of sections 37 to 42, inclusive, of this act apply to any child in the custody of an agency which provides child welfare services:
(a) Who has been admitted to a facility; and
(b) Whose status is not that of an emergency consumer on or after October 1, 2023, regardless of the date on which he or she was admitted.
5. The amendatory provisions of sections 54 to 59, inclusive, of this act apply to any child in the custody of an agency which provides child welfare services:
(a) Who has been admitted to a facility; and
(b) Whose status is that of an emergency consumer on or after October 1, 2023, regardless of the date on which he or she was admitted.
6. As used in this section:
(a) Agency which provides child welfare services has the meaning ascribed to it in NRS 432B.030.
(b) Facility has the meaning ascribed to it in NRS 432B.6072.
(c) Qualified residential treatment program has the meaning ascribed to it in section 31 of this act.
Sec. 73. The provisions of NRS 354.599 do not apply to any additional expenses of a local government that are related to the provisions of this act.
Sec. 74. (Deleted by amendment.)
Sec. 75. NRS 432B.6077, 432B.6083 and 432B.6084 are hereby repealed.
Sec. 76. 1. This section becomes effective upon passage and approval.
2. Sections 1 to 51, inclusive, and 53 to 75, inclusive, of this act become effective:
(a) Upon passage and approval for the purpose of adopting any regulations and performing any other preparatory administrative tasks that are necessary to carry out the provisions of this act; and
(b) On October 1, 2023, for all other purposes.
3. Section 52 of this act becomes effective on January 1, 2024.
________
κ2023 Statutes of Nevada, Page 2355κ
Assembly Bill No. 156Committee on Health and Human Services
CHAPTER 398
[Approved: June 14, 2023]
AN ACT relating to substance use disorders; providing for the separate accounting of certain money for the purchase of opioid antagonists; establishing the order in which a provider or program is required to prioritize persons for participation in certain publicly funded programs for the treatment of alcohol or other substance use disorders; authorizing a pharmacist to prescribe and dispense drugs for medication-assisted treatment of opioid use disorder and perform certain assessments under certain conditions; requiring certain health plans to include coverage for such drugs and assessments; prescribing certain requirements concerning the diagnosis and treatment of a patient with an opioid use disorder; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Existing law requires all gifts or grants of money for a program for alcohol or other substance use disorders which the Division of Public and Behavioral Health of the Department of Health and Human Services is authorized to accept to be deposited in the State Treasury for credit to the State Grant and Gift Account for Alcohol or Other Substance Use Disorders. (NRS 458.100) Sections 1.28 and 1.3 of this bill authorize the Division to accept and deposit into a separate account gifts, grants, donations, bequests or money from any other source for the purpose of funding the bulk purchase of opioid antagonists. Section 1.28 provides that such money is not subject to provisions of law governing budgeting by agencies of the State Government. Section 1.28 requires the Division to use the money in the account to fund the bulk purchase of opioid antagonists and the distribution of those opioid antagonists.
Existing federal regulations require programs funded by certain federal grants for injection drug users to prioritize persons for participation in such programs in the following order: (1) pregnant injecting drug users; (2) pregnant persons with a substance use disorder; (3) other injecting drug users; and (4) all others. (45 C.F.R. § 96.131) Section 1.7 of this bill requires any treatment provider, provider of health care or program for the treatment of alcohol or other substance use disorders to prioritize persons to receive services for the treatment of alcohol or other substance use disorders funded in whole or in part by federal or state money in that order, except that section 1.7 authorizes the State Board of Health to adopt regulations prioritizing additional categories of people for such services.
Existing law defines the term practice of pharmacy for the purpose of determining which activities require a person to be registered and regulated by the State Board of Pharmacy as a pharmacist. (NRS 639.0124) Section 12.3 of this bill requires the Board to prescribe a protocol to allow a pharmacist who registers with the Board to: (1) assess a patient to determine whether the patient has an opioid use disorder and medication-assisted treatment would be appropriate for the patient; and (2) prescribe and dispense a drug for medication-assisted treatment. Section 12.6 of this bill provides that the practice of pharmacy includes actions authorized by the protocol established in section 12.3. Sections 1-1.25 and 12.8 of this bill make additional changes necessary to authorize a pharmacist who registers with the Board to prescribe a drug for medication-assisted treatment. The Board would be authorized to suspend or revoke the registration of a pharmacist who orders or assesses a patient or prescribes or dispenses drugs under the protocol established pursuant to section 12.3 without complying with the provisions of the protocol. (NRS 639.210)
κ2023 Statutes of Nevada, Page 2356 (CHAPTER 398, AB 156)κ
Sections 3.5, 4.5, 16.1, 16.3, 16.4, 16.48-16.75 and 16.9 of this bill require public and private health plans, including Medicaid managed care organizations and health plans for state and local government employees, to: (1) cover drugs approved by the Food and Drug Administration for medication-assisted treatment; and (2) reimburse assessment, prescribing and dispensing by a pharmacist in accordance with section 12.3 at a rate equal to that provided to a physician, physician assistant or advanced practice registered nurse for similar services. Section 5.5 of this bill also requires Medicaid to reimburse those services at such a rate, regardless of whether the services are reimbursed directly or through managed care organizations. Sections 2.5 and 16.2 of this bill make conforming changes to indicate the proper placement of sections 5.5 and 16.1, respectively, of this bill in the Nevada Revised Statutes. Sections 6.5, 16.13, 16.16, 16.43 and 16.45 of this bill make conforming changes to indicate that the coverage required by sections 16.1, 16.3 and 16.4 is in addition to certain coverage for the treatment of substance use disorder that certain insurers are required by existing law to provide. Section 16.8 of this bill authorizes the Commissioner of Insurance to suspend or revoke the certificate of a health maintenance organization that fails to comply with the requirements of section 16.7 of this bill. The Commissioner would also be authorized to take such action against other health insurers who fail to comply with the requirements of sections 16.1, 16.3, 16.48-16.6 or 16.9 of this bill. (NRS 680A.200)
Existing law authorizes a physician, physician assistant or advanced practice registered nurse to prescribe controlled substances if he or she is registered with the State Board of Pharmacy. (NRS 453.126, 453.231, 630.271, 632.237, 633.432) Existing federal law requires a physician, physician assistant or advanced practice registered nurse who prescribes or dispenses narcotic drugs for the treatment of opioid use disorder to register with the Drug Enforcement Administration of the United States Department of Justice for the specific purpose of dispensing such drugs. (21 U.S.C. § 822(a)) Sections 10-12 and 13-16 of this bill require a physician, physician assistant, advanced practice registered nurse, osteopathic physician or certain providers of behavioral health care who diagnose a patient with an opioid use disorder to counsel and provide information to the patient concerning evidence-based treatment for opioid use disorder, including medication-assisted treatment. If the patient requests medication-assisted treatment: (1) sections 10-12 require a physician, physician assistant, advanced practice registered nurse or osteopathic physician who is authorized under federal and state law to prescribe such treatment to offer to issue such a prescription; and (2) sections 10-12 and 13-16 require all other physicians, physician assistants, advanced practice registered nurses, osteopathic physicians and certain providers of behavioral health care to refer the patient to a physician, physician assistant, advanced practice registered nurse, osteopathic physician or pharmacist who is authorized to issue such a prescription.
Existing law requires the Director of the Department of Corrections to establish one or more programs of treatment for offenders with substance use or co-occurring disorders who have been sentenced to imprisonment in the state prison. (NRS 209.4236, 209.425) Existing law additionally provides that the treatment of a prisoner in a local jail or detention facility who has a substance use disorder may include medication-assisted treatment. (NRS 211.140) Section 17.5 of this bill requires the Department of Corrections, in collaboration with the Department of Health and Human Services, and each county, city or town that maintains a jail or detention facility to study during the 2023-2024 interim certain issues relating to the provision of medication-assisted treatment to incarcerated persons.
κ2023 Statutes of Nevada, Page 2357 (CHAPTER 398, AB 156)κ
EXPLANATION Matter in bolded italics is new; matter between
brackets [omitted material] is material to be
omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. NRS 453.126 is hereby amended to read as follows:
453.126 Practitioner means:
1. A physician, dentist, veterinarian or podiatric physician who holds a license to practice his or her profession in this State and is registered pursuant to this chapter.
2. An advanced practice registered nurse who holds a certificate from the State Board of Pharmacy authorizing him or her to dispense or to prescribe and dispense controlled substances.
3. A scientific investigator or a pharmacy, hospital or other institution licensed, registered or otherwise authorized in this State to distribute, dispense, conduct research with respect to, to administer, or use in teaching or chemical analysis, a controlled substance in the course of professional practice or research.
4. A euthanasia technician who is licensed by the Nevada State Board of Veterinary Medical Examiners and registered pursuant to this chapter, while he or she possesses or administers sodium pentobarbital pursuant to his or her license and registration.
5. A physician assistant who:
(a) Holds a license from the Board of Medical Examiners; and
(b) Is authorized by the Board to possess, administer, prescribe or dispense controlled substances under the supervision of a physician as required by chapter 630 of NRS.
6. A physician assistant who:
(a) Holds a license from the State Board of Osteopathic Medicine; and
(b) Is authorized by the Board to possess, administer, prescribe or dispense controlled substances under the supervision of an osteopathic physician as required by chapter 633 of NRS.
7. An optometrist who is certified by the Nevada State Board of Optometry to prescribe and administer pharmaceutical agents pursuant to NRS 636.288, when the optometrist prescribes or administers pharmaceutical agents within the scope of his or her certification.
8. A pharmacist who is registered pursuant to section 12.3 of this act to prescribe and dispense drugs for medication-assisted treatment.
Sec. 1.05. NRS 453.128 is hereby amended to read as follows:
453.128 1. Prescription means:
(a) An order given individually for the person for whom prescribed, directly from a physician, physician assistant licensed pursuant to chapter 630 or 633 of NRS, dentist, podiatric physician, optometrist, advanced practice registered nurse , pharmacist registered pursuant to section 12.3 of this act or veterinarian, or his or her agent, to a pharmacist or indirectly by means of an order signed by the practitioner or an electronic transmission from the practitioner to a pharmacist; or
(b) A chart order written for an inpatient specifying drugs which he or she is to take home upon his or her discharge.
2. The term does not include a chart order written for an inpatient for use while he or she is an inpatient.
κ2023 Statutes of Nevada, Page 2358 (CHAPTER 398, AB 156)κ
Sec. 1.1. NRS 453.226 is hereby amended to read as follows:
453.226 1. Every practitioner or other person who dispenses any controlled substance within this State or who proposes to engage in the dispensing of any controlled substance within this State shall obtain biennially a registration issued by the Board in accordance with its regulations. A person must present proof that he or she is authorized to access the database of the program established pursuant to NRS 453.162 before the Board may issue or renew a registration.
2. A person registered by the Board in accordance with the provisions of NRS 453.011 to 453.552, inclusive, to dispense or conduct research with controlled substances may possess, dispense or conduct research with those substances to the extent authorized by the registration and in conformity with the other provisions of those sections.
3. The following persons are not required to register and may lawfully possess and distribute controlled substances pursuant to the provisions of NRS 453.011 to 453.552, inclusive:
(a) An agent or employee of a registered dispenser of a controlled substance if he or she is acting in the usual course of his or her business or employment;
(b) A common or contract carrier or warehouseman, or an employee thereof, whose possession of any controlled substance is in the usual course of business or employment;
(c) An ultimate user or a person in possession of any controlled substance pursuant to a lawful order of a physician, physician assistant licensed pursuant to chapter 630 or 633 of NRS, dentist, advanced practice registered nurse, podiatric physician , pharmacist registered pursuant to section 12.3 of this act or veterinarian or in lawful possession of a schedule V substance; or
(d) A physician who:
(1) Holds a locum tenens license issued by the Board of Medical Examiners or a temporary license issued by the State Board of Osteopathic Medicine; and
(2) Is registered with the Drug Enforcement Administration at a location outside this State.
4. The Board may waive the requirement for registration of certain dispensers if it finds it consistent with the public health and safety.
5. A separate registration is required at each principal place of business or professional practice where the applicant dispenses controlled substances.
6. The Board may inspect the establishment of a registrant or applicant for registration in accordance with the Boards regulations.
Sec. 1.15. NRS 453.336 is hereby amended to read as follows:
453.336 1. Except as otherwise provided in subsection 6, a person shall not knowingly or intentionally possess a controlled substance, unless the substance was obtained directly from, or pursuant to, a prescription or order of a physician, physician assistant licensed pursuant to chapter 630 or 633 of NRS, dentist, podiatric physician, optometrist, advanced practice registered nurse , pharmacist registered pursuant to section 12.3 of this act or veterinarian while acting in the course of his or her professional practice, or except as otherwise authorized by the provisions of NRS 453.005 to 453.552, inclusive.
κ2023 Statutes of Nevada, Page 2359 (CHAPTER 398, AB 156)κ
2. Except as otherwise provided in subsections 3, 4 and 5 and in NRS 453.3363, and unless a greater penalty is provided in NRS 212.160, 453.3385 or 453.339, a person who violates this section:
(a) For a first or second offense, if the controlled substance is listed in schedule I or II and the quantity possessed is less than 14 grams, or if the controlled substance is listed in schedule III, IV or V and the quantity possessed is less than 28 grams, is guilty of possession of a controlled substance and shall be punished for a category E felony as provided in NRS 193.130. In accordance with NRS 176.211, the court shall defer judgment upon the consent of the person.
(b) For a third or subsequent offense, if the controlled substance is listed in schedule I or II and the quantity possessed is less than 14 grams, or if the controlled substance is listed in schedule III, IV or V and the quantity possessed is less than 28 grams, or if the offender has previously been convicted two or more times in the aggregate of any violation of the law of the United States or of any state, territory or district relating to a controlled substance, is guilty of possession of a controlled substance and shall be punished for a category D felony as provided in NRS 193.130, and may be further punished by a fine of not more than $20,000.
(c) If the controlled substance is listed in schedule I or II and the quantity possessed is 14 grams or more, but less than 28 grams, or if the controlled substance is listed in schedule III, IV or V and the quantity possessed is 28 grams or more, but less than 200 grams, is guilty of low-level possession of a controlled substance and shall be punished for a category C felony as provided in NRS 193.130.
(d) If the controlled substance is listed in schedule I or II and the quantity possessed is 28 grams or more, but less than 42 grams, or if the controlled substance is listed in schedule III, IV or V and the quantity possessed is 200 grams or more, is guilty of mid-level possession of a controlled substance and shall be punished for a category B felony by imprisonment in the state prison for a minimum term of not less than 1 year and a maximum term of not more than 10 years and by a fine of not more than $50,000.
(e) If the controlled substance is listed in schedule I or II and the quantity possessed is 42 grams or more, but less than 100 grams, is guilty of high-level possession of a controlled substance and shall be punished for a category B felony by imprisonment in the state prison for a minimum term of not less than 2 years and a maximum term of not more than 15 years and by a fine of not more than $50,000.
3. Unless a greater penalty is provided in NRS 212.160, 453.337 or 453.3385, a person who is convicted of the possession of flunitrazepam or gamma-hydroxybutyrate, or any substance for which flunitrazepam or gamma-hydroxybutyrate is an immediate precursor, is guilty of a category B felony and shall be punished by imprisonment in the state prison for a minimum term of not less than 1 year and a maximum term of not more than 6 years.
4. Unless a greater penalty is provided pursuant to NRS 212.160, a person who is convicted of the possession of 1 ounce or less of marijuana is guilty of a misdemeanor and shall be punished by:
(a) Performing not more than 24 hours of community service;
(b) Attending the live meeting described in paragraph (a) of subsection 2 of NRS 484C.530 and complying with any other requirements set forth in that section; or
κ2023 Statutes of Nevada, Page 2360 (CHAPTER 398, AB 156)κ
(c) Being required to undergo an evaluation in accordance with subsection 1 of NRS 484C.350,
Κ or any combination thereof.
5. Unless a greater penalty is provided pursuant to NRS 212.160, a person who is convicted of the possession of more than 1 ounce, but less than 50 pounds, of marijuana or more than one-eighth of an ounce, but less than one pound, of concentrated cannabis is guilty of a category E felony and shall be punished as provided in NRS 193.130.
6. It is not a violation of this section if a person possesses a trace amount of a controlled substance and that trace amount is in or on a hypodermic device obtained from a sterile hypodermic device program pursuant to NRS 439.985 to 439.994, inclusive.
7. The court may grant probation to or suspend the sentence of a person convicted of violating this section.
8. If a person fulfills the terms and conditions imposed for a violation of subsection 4, the court shall, without a hearing, order sealed all documents, papers and exhibits in that persons record, minute book entries and entries on dockets, and other documents relating to the case in the custody of such other agencies and officers as are named in the courts order. The court shall cause a copy of the order to be sent to each agency or officer named in the order. Each such agency or officer shall notify the court in writing of its compliance with the order.
9. As used in this section:
(a) Controlled substance includes flunitrazepam, gamma-hydroxybutyrate and each substance for which flunitrazepam or gamma-hydroxybutyrate is an immediate precursor.
(b) Marijuana does not include concentrated cannabis.
(c) Sterile hypodermic device program has the meaning ascribed to it in NRS 439.986.
Sec. 1.2. NRS 453.381 is hereby amended to read as follows:
453.381 1. In addition to the limitations imposed by NRS 453.256 and 453.3611 to 453.3648, inclusive, a physician, physician assistant, dentist, advanced practice registered nurse , [or] podiatric physician or pharmacist registered pursuant to section 12.3 of this act may prescribe or administer controlled substances only for a legitimate medical purpose and in the usual course of his or her professional practice, and he or she shall not prescribe, administer or dispense a controlled substance listed in schedule II for himself or herself, his or her spouse or his or her children except in cases of emergency.
2. A veterinarian, in the course of his or her professional practice only, and not for use by a human being, may prescribe, possess and administer controlled substances, and the veterinarian may cause them to be administered by a veterinary technician under the direction and supervision of the veterinarian.
3. A euthanasia technician, within the scope of his or her license, and not for use by a human being, may possess and administer sodium pentobarbital.
4. A pharmacist shall not fill an order which purports to be a prescription if the pharmacist has reason to believe that it was not issued in the usual course of the professional practice of a physician, physician assistant, dentist, advanced practice registered nurse, podiatric physician , pharmacist registered pursuant to section 12.3 of this act or veterinarian.
κ2023 Statutes of Nevada, Page 2361 (CHAPTER 398, AB 156)κ
5. Any person who has obtained from a physician, physician assistant, dentist, advanced practice registered nurse, podiatric physician , pharmacist registered pursuant to section 12.3 of this act or veterinarian any controlled substance for administration to a patient during the absence of the physician, physician assistant, dentist, advanced practice registered nurse, podiatric physician , pharmacist or veterinarian shall return to him or her any unused portion of the substance when it is no longer required by the patient.
6. A manufacturer, wholesale supplier or other person legally able to furnish or sell any controlled substance listed in schedule II shall not provide samples of such a controlled substance to registrants.
7. A salesperson of any manufacturer or wholesaler of pharmaceuticals shall not possess, transport or furnish any controlled substance listed in schedule II.
8. A person shall not dispense a controlled substance in violation of a regulation adopted by the Board.
Sec. 1.25. NRS 454.00958 is hereby amended to read as follows:
454.00958 Practitioner means:
1. A physician, dentist, veterinarian or podiatric physician who holds a valid license to practice his or her profession in this State.
2. A pharmacy, hospital or other institution licensed or registered to distribute, dispense, conduct research with respect to or to administer a dangerous drug in the course of professional practice in this State.
3. When relating to the prescription of poisons, dangerous drugs and devices:
(a) An advanced practice registered nurse who holds a certificate from the State Board of Pharmacy permitting him or her so to prescribe; or
(b) A physician assistant who holds a license from the Board of Medical Examiners and a certificate from the State Board of Pharmacy permitting him or her so to prescribe.
4. An optometrist who is certified to prescribe and administer pharmaceutical agents pursuant to NRS 636.288 when the optometrist prescribes or administers dangerous drugs which are within the scope of his or her certification.
5. A pharmacist who is registered pursuant to section 12.3 of this act to prescribe and dispense drugs for medication-assisted treatment.
Sec. 1.28. Chapter 458 of NRS is hereby amended by adding thereto a new section to read as follows:
1. The Division may accept gifts, grants, donations, bequests or money from any other source for the purpose of funding the bulk purchase of opioid antagonists. Any money so received must be accounted for separately in the State General Fund.
2. Money accepted pursuant to subsection 1 or deposited into the account created pursuant to subsection 1 is not subject to the State Budget Act.
3. Interest and income earned on money in the account created pursuant to subsection 1 must be credited to the account. Any money remaining in the account at the end of a fiscal year does not revert to the State General Fund, and the balance in the account must be carried forward to the next fiscal year.
4. The money in the account created pursuant to subsection 1 must be used only to fund the bulk purchase of opioid antagonists and pay the costs of the Division to distribute those opioid antagonists.
κ2023 Statutes of Nevada, Page 2362 (CHAPTER 398, AB 156)κ
5. As used in this section, opioid antagonist has the meaning ascribed to it in NRS 453C.040.
Sec. 1.3. NRS 458.100 is hereby amended to read as follows:
458.100 1. [All] Except as otherwise provided in section 1.28 of this act, all gifts or grants of money for a program for alcohol or other substance use disorders which the Division is authorized to accept must be deposited in the State Treasury for credit to the State Grant and Gift Account for Alcohol or Other Substance Use Disorders which is hereby created in the Department of Health and Human Services Gift Fund.
2. Subject to the limitations set forth in NRS 458.094, money in the Account must be used to carry out the provisions of this chapter.
3. All claims must be approved by the Administrator before they are paid.
Sec. 1.7. NRS 458.103 is hereby amended to read as follows:
458.103 1. The Division may accept:
[1.] (a) Money appropriated and made available by any act of Congress for any program for alcohol or other substance use disorder administered by the Division as provided by law.
[2.] (b) Money appropriated and made available by the State of Nevada or by a county, a city, a public district or any political subdivision of this State for any program for alcohol or other substance use disorder administered by the Division as provided by law.
2. Except as otherwise provided in any regulations adopted pursuant to subsection 3, a treatment provider, provider of health care or program for alcohol or other substance use disorders shall prioritize persons to receive services for the treatment of alcohol or other substance use disorders funded in whole or in part by federal or state money in accordance with 45 C.F.R. § 96.131(a).
3. To the extent that such regulations do not conflict with federal law or impair an obligation under any existing grant, contract or other agreement, the State Board of Health may adopt regulations prioritizing categories of persons, in addition to the categories prescribed in 45 C.F.R. § 96.131(a), to receive services for the treatment of alcohol or other substance use disorders funded in whole or in part by federal or state money.
4. As used in this section, provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 2. (Deleted by amendment.)
Sec. 2.5. NRS 232.320 is hereby amended to read as follows:
232.320 1. The Director:
(a) Shall appoint, with the consent of the Governor, administrators of the divisions of the Department, who are respectively designated as follows:
(1) The Administrator of the Aging and Disability Services Division;
(2) The Administrator of the Division of Welfare and Supportive Services;
(3) The Administrator of the Division of Child and Family Services;
(4) The Administrator of the Division of Health Care Financing and Policy; and
(5) The Administrator of the Division of Public and Behavioral Health.
(b) Shall administer, through the divisions of the Department, the provisions of chapters 63, 424, 425, 427A, 432A to 442, inclusive, 446 to 450, inclusive, 458A and 656A of NRS, NRS 127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and section 5.5 of this act, 422.580, 432.010 to 432.133, inclusive, 432B.6201 to 432B.626, inclusive, 444.002 to 444.430, inclusive, and 445A.010 to 445A.055, inclusive, and all other provisions of law relating to the functions of the divisions of the Department, but is not responsible for the clinical activities of the Division of Public and Behavioral Health or the professional line activities of the other divisions.
κ2023 Statutes of Nevada, Page 2363 (CHAPTER 398, AB 156)κ
to 450, inclusive, 458A and 656A of NRS, NRS 127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and section 5.5 of this act, 422.580, 432.010 to 432.133, inclusive, 432B.6201 to 432B.626, inclusive, 444.002 to 444.430, inclusive, and 445A.010 to 445A.055, inclusive, and all other provisions of law relating to the functions of the divisions of the Department, but is not responsible for the clinical activities of the Division of Public and Behavioral Health or the professional line activities of the other divisions.
(c) Shall administer any state program for persons with developmental disabilities established pursuant to the Developmental Disabilities Assistance and Bill of Rights Act of 2000, 42 U.S.C. §§ 15001 et seq.
(d) Shall, after considering advice from agencies of local governments and nonprofit organizations which provide social services, adopt a master plan for the provision of human services in this State. The Director shall revise the plan biennially and deliver a copy of the plan to the Governor and the Legislature at the beginning of each regular session. The plan must:
(1) Identify and assess the plans and programs of the Department for the provision of human services, and any duplication of those services by federal, state and local agencies;
(2) Set forth priorities for the provision of those services;
(3) Provide for communication and the coordination of those services among nonprofit organizations, agencies of local government, the State and the Federal Government;
(4) Identify the sources of funding for services provided by the Department and the allocation of that funding;
(5) Set forth sufficient information to assist the Department in providing those services and in the planning and budgeting for the future provision of those services; and
(6) Contain any other information necessary for the Department to communicate effectively with the Federal Government concerning demographic trends, formulas for the distribution of federal money and any need for the modification of programs administered by the Department.
(e) May, by regulation, require nonprofit organizations and state and local governmental agencies to provide information regarding the programs of those organizations and agencies, excluding detailed information relating to their budgets and payrolls, which the Director deems necessary for the performance of the duties imposed upon him or her pursuant to this section.
(f) Has such other powers and duties as are provided by law.
2. Notwithstanding any other provision of law, the Director, or the Directors designee, is responsible for appointing and removing subordinate officers and employees of the Department.
Sec. 3. (Deleted by amendment.)
Sec. 3.5. NRS 287.010 is hereby amended to read as follows:
287.010 1. The governing body of any county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency of the State of Nevada may:
(a) Adopt and carry into effect a system of group life, accident or health insurance, or any combination thereof, for the benefit of its officers and employees, and the dependents of officers and employees who elect to accept the insurance and who, where necessary, have authorized the governing body to make deductions from their compensation for the payment of premiums on the insurance.
κ2023 Statutes of Nevada, Page 2364 (CHAPTER 398, AB 156)κ
(b) Purchase group policies of life, accident or health insurance, or any combination thereof, for the benefit of such officers and employees, and the dependents of such officers and employees, as have authorized the purchase, from insurance companies authorized to transact the business of such insurance in the State of Nevada, and, where necessary, deduct from the compensation of officers and employees the premiums upon insurance and pay the deductions upon the premiums.
(c) Provide group life, accident or health coverage through a self-insurance reserve fund and, where necessary, deduct contributions to the maintenance of the fund from the compensation of officers and employees and pay the deductions into the fund. The money accumulated for this purpose through deductions from the compensation of officers and employees and contributions of the governing body must be maintained as an internal service fund as defined by NRS 354.543. The money must be deposited in a state or national bank or credit union authorized to transact business in the State of Nevada. Any independent administrator of a fund created under this section is subject to the licensing requirements of chapter 683A of NRS, and must be a resident of this State. Any contract with an independent administrator must be approved by the Commissioner of Insurance as to the reasonableness of administrative charges in relation to contributions collected and benefits provided. The provisions of NRS 686A.135, 687B.352, 687B.408, 687B.723, 687B.725, 689B.030 to 689B.050, inclusive, and section 16.3 of this act, 689B.265, 689B.287 and 689B.500 apply to coverage provided pursuant to this paragraph, except that the provisions of NRS 689B.0378, 689B.03785 and 689B.500 only apply to coverage for active officers and employees of the governing body, or the dependents of such officers and employees.
(d) Defray part or all of the cost of maintenance of a self-insurance fund or of the premiums upon insurance. The money for contributions must be budgeted for in accordance with the laws governing the county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency of the State of Nevada.
2. If a school district offers group insurance to its officers and employees pursuant to this section, members of the board of trustees of the school district must not be excluded from participating in the group insurance. If the amount of the deductions from compensation required to pay for the group insurance exceeds the compensation to which a trustee is entitled, the difference must be paid by the trustee.
3. In any county in which a legal services organization exists, the governing body of the county, or of any school district, municipal corporation, political subdivision, public corporation or other local governmental agency of the State of Nevada in the county, may enter into a contract with the legal services organization pursuant to which the officers and employees of the legal services organization, and the dependents of those officers and employees, are eligible for any life, accident or health insurance provided pursuant to this section to the officers and employees, and the dependents of the officers and employees, of the county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency.
4. If a contract is entered into pursuant to subsection 3, the officers and employees of the legal services organization:
κ2023 Statutes of Nevada, Page 2365 (CHAPTER 398, AB 156)κ
(a) Shall be deemed, solely for the purposes of this section, to be officers and employees of the county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency with which the legal services organization has contracted; and
(b) Must be required by the contract to pay the premiums or contributions for all insurance which they elect to accept or of which they authorize the purchase.
5. A contract that is entered into pursuant to subsection 3:
(a) Must be submitted to the Commissioner of Insurance for approval not less than 30 days before the date on which the contract is to become effective.
(b) Does not become effective unless approved by the Commissioner.
(c) Shall be deemed to be approved if not disapproved by the Commissioner within 30 days after its submission.
6. As used in this section, legal services organization means an organization that operates a program for legal aid and receives money pursuant to NRS 19.031.
Sec. 4. (Deleted by amendment.)
Sec. 4.5. NRS 287.04335 is hereby amended to read as follows:
287.04335 If the Board provides health insurance through a plan of self-insurance, it shall comply with the provisions of NRS 686A.135, 687B.352, 687B.409, 687B.723, 687B.725, 689B.0353, 689B.255, 695C.1723, 695G.150, 695G.155, 695G.160, 695G.162, 695G.1635, 695G.164, 695G.1645, 695G.1665, 695G.167, 695G.1675, 695G.170 to 695G.174, inclusive, and section 16.9 of this act, 695G.176, 695G.177, 695G.200 to 695G.230, inclusive, 695G.241 to 695G.310, inclusive, and 695G.405, in the same manner as an insurer that is licensed pursuant to title 57 of NRS is required to comply with those provisions.
Sec. 5. (Deleted by amendment.)
Sec. 5.5. Chapter 422 of NRS is hereby amended by adding thereto a new section to read as follows:
1. The Director shall include in the State Plan for Medicaid a requirement that the State pay the nonfederal share of expenditures incurred for the services of a pharmacist described in section 12.3 of this act.
2. The State must provide reimbursement for the services of a pharmacist described in section 12.3 of this act at a rate equal to the rate of reimbursement provided to a physician, physician assistant or advanced practice registered nurse for similar services.
Secs. 5.8 and 6. (Deleted by amendment.)
Sec. 6.5. NRS 608.156 is hereby amended to read as follows:
608.156 1. [If] In addition to any benefits required by NRS 608.155, if an employer provides health benefits for his or her employees, the employer shall provide benefits for the expenses for the treatment of alcohol and substance use disorders. The annual benefits provided by the employer must [consist of:] include, without limitation:
(a) Treatment for withdrawal from the physiological effects of alcohol or drugs, with a maximum benefit of $1,500 per calendar year.
(b) Treatment for a patient admitted to a facility, with a maximum benefit of $9,000 per calendar year.
(c) Counseling for a person, group or family who is not admitted to a facility, with a maximum benefit of $2,500 per calendar year.
κ2023 Statutes of Nevada, Page 2366 (CHAPTER 398, AB 156)κ
2. The maximum amount which may be paid in the lifetime of the insured for any combination of the treatments listed in subsection 1 is $39,000.
3. Except as otherwise provided in NRS 687B.409, these benefits must be paid in the same manner as benefits for any other illness covered by the employer are paid.
4. The employee is entitled to these benefits if treatment is received in any:
(a) Program for the treatment of alcohol or substance use disorders which is certified by the Division of Public and Behavioral Health of the Department of Health and Human Services.
(b) Hospital or other medical facility or facility for the dependent which is licensed by the Division of Public and Behavioral Health of the Department of Health and Human Services, is accredited by The Joint Commission or CARF International and provides a program for the treatment of alcohol or substance use disorders as part of its accredited activities.
Secs. 7-9. (Deleted by amendment.)
Sec. 10. Chapter 630 of NRS is hereby amended by adding thereto a new section to read as follows:
1. Upon diagnosing a patient as having an opioid use disorder, a physician or physician assistant shall counsel and provide information to the patient concerning evidence-based treatment for opioid use disorders, including, without limitation, medication-assisted treatment.
2. If the patient requests medication-assisted treatment, the physician or physician assistant shall:
(a) If the physician or physician assistant is authorized under federal and state law to issue such a prescription, offer to prescribe an appropriate medication; or
(b) If the physician or physician assistant is not authorized under federal and state law to prescribe an appropriate medication, refer the patient to a physician, osteopathic physician, physician assistant licensed pursuant to this chapter or chapter 633 of NRS, advanced practice registered nurse or pharmacist who is authorized to issue the prescription.
3. As used in this section, medication-assisted treatment has the meaning ascribed to it in section 12.3 of this act.
Sec. 11. Chapter 632 of NRS is hereby amended by adding thereto a new section to read as follows:
1. Upon diagnosing a patient as having an opioid use disorder, an advanced practice registered nurse shall counsel and provide information to the patient concerning evidence-based treatment for opioid use disorders, including, without limitation, medication-assisted treatment.
2. If the patient requests medication-assisted treatment, the advanced practice registered nurse shall:
(a) If the advanced practice registered nurse is authorized under federal and state law to issue such a prescription, offer to prescribe an appropriate medication; or
(b) If the advanced practice registered nurse is not authorized under federal and state law to prescribe an appropriate medication, refer the patient to a physician, osteopathic physician, physician assistant licensed pursuant to chapter 630 or 633 of NRS, advanced practice registered nurse or pharmacist who is authorized to issue the prescription.
κ2023 Statutes of Nevada, Page 2367 (CHAPTER 398, AB 156)κ
3. As used in this section, medication-assisted treatment has the meaning ascribed to it in section 12.3 of this act.
Sec. 12. Chapter 633 of NRS is hereby amended by adding thereto a new section to read as follows:
1. Upon diagnosing a patient as having an opioid use disorder, an osteopathic physician or physician assistant shall counsel and provide information to the patient concerning evidence-based treatment for opioid use disorders, including, without limitation, medication-assisted treatment.
2. If the patient requests medication-assisted treatment, the osteopathic physician or physician assistant shall:
(a) If the osteopathic physician or physician assistant is authorized under federal and state law to issue such a prescription, offer to prescribe an appropriate medication; or
(b) If the osteopathic physician or physician assistant is not authorized under federal and state law to prescribe an appropriate medication, refer the patient to a physician, osteopathic physician, physician assistant licensed pursuant to this chapter or chapter 630 of NRS, advanced practice registered nurse or pharmacist who is authorized to issue the prescription.
3. As used in this section, medication-assisted treatment has the meaning ascribed to it in section 12.3 of this act.
Sec. 12.3. Chapter 639 of NRS is hereby amended by adding thereto a new section to read as follows:
1. To the extent authorized by federal law, a pharmacist who registers with the Board to engage in the activity authorized by this section may, in accordance with the requirements of the protocol prescribed pursuant to subsection 2:
(a) Assess a patient to determine whether:
(1) The patient has an opioid use disorder; and
(2) Medication-assisted treatment would be appropriate for the patient;
(b) Counsel and provide information to the patient concerning evidence-based treatment for opioid use disorders, including, without limitation, medication-assisted treatment; and
(c) Prescribe and dispense a drug for medication-assisted treatment.
2. The Board shall adopt regulations:
(a) Prescribing the requirements to register with the Board to engage in the activity authorized by this section; and
(b) Establishing a protocol for the actions authorized by this section.
3. As used in this section, medication-assisted treatment means treatment for an opioid use disorder using medication approved by the United States Food and Drug Administration for that purpose.
Sec. 12.6. NRS 639.0124 is hereby amended to read as follows:
639.0124 1. Practice of pharmacy includes, but is not limited to, the:
(a) Performance or supervision of activities associated with manufacturing, compounding, labeling, dispensing and distributing of a drug, including the receipt, handling and storage of prescriptions and other confidential information relating to patients.
(b) Interpretation and evaluation of prescriptions or orders for medicine.
(c) Participation in drug evaluation and drug research.
(d) Advising of the therapeutic value, reaction, drug interaction, hazard and use of a drug.
κ2023 Statutes of Nevada, Page 2368 (CHAPTER 398, AB 156)κ
(e) Selection of the source, storage and distribution of a drug.
(f) Maintenance of proper documentation of the source, storage and distribution of a drug.
(g) Interpretation of clinical data contained in a persons record of medication.
(h) Development of written guidelines and protocols in collaboration with a practitioner which authorize collaborative drug therapy management. The written guidelines and protocols must comply with NRS 639.2629.
(i) Implementation and modification of drug therapy, administering drugs and ordering and performing tests in accordance with a collaborative practice agreement.
(j) Prescribing, dispensing and administering of drugs for preventing the acquisition of human immunodeficiency virus and ordering and conducting laboratory tests necessary for therapy that uses such drugs pursuant to the protocol prescribed pursuant to NRS 639.28085.
(k) Dispensing a self-administered hormonal contraceptive pursuant to NRS 639.28078.
(l) Assessing a patient and prescribing and dispensing a drug for medication-assisted treatment in accordance with section 12.3 of this act.
2. The term does not include the changing of a prescription by a pharmacist or practitioner without the consent of the prescribing practitioner, except as otherwise provided in NRS 639.2583, 639.28078 and 639.28085.
Sec. 12.8. NRS 639.0125 is hereby amended to read as follows:
639.0125 Practitioner means:
1. A physician, dentist, veterinarian or podiatric physician who holds a license to practice his or her profession in this State;
2. A hospital, pharmacy or other institution licensed, registered or otherwise permitted to distribute, dispense, conduct research with respect to or administer drugs in the course of professional practice or research in this State;
3. An advanced practice registered nurse who has been authorized to prescribe controlled substances, poisons, dangerous drugs and devices;
4. A physician assistant who:
(a) Holds a license issued by the Board of Medical Examiners; and
(b) Is authorized by the Board to possess, administer, prescribe or dispense controlled substances, poisons, dangerous drugs or devices under the supervision of a physician as required by chapter 630 of NRS;
5. A physician assistant who:
(a) Holds a license issued by the State Board of Osteopathic Medicine; and
(b) Is authorized by the Board to possess, administer, prescribe or dispense controlled substances, poisons, dangerous drugs or devices under the supervision of an osteopathic physician as required by chapter 633 of NRS; or
6. An optometrist who is certified by the Nevada State Board of Optometry to prescribe and administer pharmaceutical agents pursuant to NRS 636.288, when the optometrist prescribes or administers pharmaceutical agents within the scope of his or her certification.
7. A pharmacist who is registered pursuant to section 12.3 of this act to prescribe and dispense drugs for medication-assisted treatment.
κ2023 Statutes of Nevada, Page 2369 (CHAPTER 398, AB 156)κ
Sec. 13. Chapter 641 of NRS is hereby amended by adding thereto a new section to read as follows:
1. Upon diagnosing a patient as having an opioid use disorder, a psychologist shall counsel and provide information to the patient concerning evidence-based treatment for opioid use disorders, including, without limitation, medication-assisted treatment.
2. If the patient requests medication-assisted treatment, the psychologist shall refer the patient to a physician, osteopathic physician, physician assistant licensed pursuant to chapter 630 or 633 of NRS, advanced practice registered nurse or pharmacist who is authorized under federal and state law to prescribe an appropriate medication.
3. As used in this section, medication-assisted treatment has the meaning ascribed to it in section 12.3 of this act.
Sec. 14. Chapter 641A of NRS is hereby amended by adding thereto a new section to read as follows:
1. Upon diagnosing a client as having an opioid use disorder, a marriage and family therapist or clinical professional counselor shall counsel and provide information to the client concerning evidence-based treatment for opioid use disorders, including, without limitation, medication-assisted treatment.
2. If the client requests medication-assisted treatment, the marriage and family therapist or clinical professional counselor shall refer the client to a physician, osteopathic physician, physician assistant licensed pursuant to chapter 630 or 633 of NRS, advanced practice registered nurse or pharmacist who is authorized under federal and state law to prescribe an appropriate medication.
3. As used in this section, medication-assisted treatment has the meaning ascribed to it in section 12.3 of this act.
Sec. 15. Chapter 641B of NRS is hereby amended by adding thereto a new section to read as follows:
1. Upon diagnosing a client as having an opioid use disorder, a clinical social worker shall counsel and provide information to the client concerning evidence-based treatment for opioid use disorders, including, without limitation, medication-assisted treatment.
2. If the client requests medication-assisted treatment, the clinical social worker shall refer the client to a physician, osteopathic physician, physician assistant licensed pursuant to chapter 630 or 633 of NRS, advanced practice registered nurse or pharmacist who is authorized under federal and state law to prescribe an appropriate medication.
3. As used in this section, medication-assisted treatment has the meaning ascribed to it in section 12.3 of this act.
Sec. 16. Chapter 641C of NRS is hereby amended by adding thereto a new section to read as follows:
1. Upon diagnosing a client as having an opioid use disorder, an alcohol and drug counselor, clinical alcohol and drug counselor or problem gambling counselor shall counsel and provide information to the client concerning evidence-based treatment for opioid use disorders, including, without limitation, medication-assisted treatment.
2. If the client requests medication-assisted treatment, the alcohol and drug counselor, clinical alcohol and drug counselor or problem gambling counselor shall refer the client to a physician, osteopathic physician, physician assistant licensed pursuant to chapter 630 or 633 of NRS, advanced practice registered nurse or pharmacist who is authorized under federal and state law to prescribe an appropriate medication.
κ2023 Statutes of Nevada, Page 2370 (CHAPTER 398, AB 156)κ
advanced practice registered nurse or pharmacist who is authorized under federal and state law to prescribe an appropriate medication.
3. As used in this section, medication-assisted treatment has the meaning ascribed to it in section 12.3 of this act.
Sec. 16.05. (Deleted by amendment.)
Sec. 16.1. Chapter 689A of NRS is hereby amended by adding thereto a new section to read as follows:
1. An insurer that offers or issues a policy of health insurance shall include in the policy coverage for:
(a) All drugs approved by the United States Food and Drug Administration to provide medication-assisted treatment for opioid use disorder, including, without limitation, buprenorphine, methadone and naltrexone; and
(b) The services described in section 12.3 of this act when provided by a pharmacist or pharmacy that participates in the network plan of the insurer. The Commissioner shall adopt regulations governing the provision of reimbursement for such services.
2. An insurer that offers or issues a policy of health insurance shall reimburse a pharmacist or pharmacy that participates in the network plan of the insurer for the services described in section 12.3 of this act at a rate equal to the rate of reimbursement provided to a physician, physician assistant or advanced practice registered nurse for similar services.
3. Except as otherwise provided in this subsection, an insurer shall not subject the benefits required by subsection 1 to medical management techniques, other than step therapy. An insurer may subject such benefits to other reasonable medical management techniques when the benefits are provided by a pharmacist in accordance with section 12.3 of this act.
4. An insurer shall ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the insurer.
5. A policy of health insurance subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the policy that conflicts with the provisions of this section is void.
6. As used in this section:
(a) Medical management technique means a practice which is used to control the cost or use of health care services or prescription drugs. The term includes, without limitation, the use of step therapy, prior authorization and categorizing drugs and devices based on cost, type or method of administration.
(b) Network plan means a policy of health insurance offered by an insurer under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the insurer. The term does not include an arrangement for the financing of premiums.
(c) Provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 16.13. NRS 689A.030 is hereby amended to read as follows:
689A.030 A policy of health insurance must not be delivered or issued for delivery to any person in this State unless it otherwise complies with this Code, and complies with the following:
κ2023 Statutes of Nevada, Page 2371 (CHAPTER 398, AB 156)κ
1. The entire money and other considerations for the policy must be expressed therein.
2. The time when the insurance takes effect and terminates must be expressed therein.
3. It must purport to insure only one person, except that a policy may insure, originally or by subsequent amendment, upon the application of an adult member of a family, who shall be deemed the policyholder, any two or more eligible members of that family, including the husband, wife, domestic partner as defined in NRS 122A.030, dependent children, from the time of birth, adoption or placement for the purpose of adoption as provided in NRS 689A.043, or any child on or before the last day of the month in which the child attains 26 years of age, and any other person dependent upon the policyholder.
4. The style, arrangement and overall appearance of the policy must not give undue prominence to any portion of the text, and every printed portion of the text of the policy and of any endorsements or attached papers must be plainly printed in light-faced type of a style in general use, the size of which must be uniform and not less than 10 points with a lowercase unspaced alphabet length not less than 120 points. Text includes all printed matter except the name and address of the insurer, the name or the title of the policy, the brief description, if any, and captions and subcaptions.
5. The exceptions and reductions of indemnity must be set forth in the policy and, other than those contained in NRS 689A.050 to 689A.290, inclusive, must be printed, at the insurers option, with the benefit provision to which they apply or under an appropriate caption such as Exceptions or Exceptions and Reductions, except that if an exception or reduction specifically applies only to a particular benefit of the policy, a statement of that exception or reduction must be included with the benefit provision to which it applies.
6. Each such form, including riders and endorsements, must be identified by a number in the lower left-hand corner of the first page thereof.
7. The policy must not contain any provision purporting to make any portion of the charter, rules, constitution or bylaws of the insurer a part of the policy unless that portion is set forth in full in the policy, except in the case of the incorporation of or reference to a statement of rates or classification of risks, or short-rate table filed with the Commissioner.
8. The policy must provide benefits for expense arising from care at home or health supportive services if that care or service was prescribed by a physician and would have been covered by the policy if performed in a medical facility or facility for the dependent as defined in chapter 449 of NRS.
9. [The] Except as otherwise provided by this subsection, the policy must provide [, at the option of the applicant,] benefits for expenses incurred for the treatment of alcohol or substance use disorder . [, unless] Except for the benefits required by section 16.1 of this act, such benefits must be provided:
(a) At the option of the applicant; and
(b) Unless the policy provides coverage only for a specified disease or provides for the payment of a specific amount of money if the insured is hospitalized or receiving health care in his or her home.
10. The policy must provide benefits for expense arising from hospice care.
κ2023 Statutes of Nevada, Page 2372 (CHAPTER 398, AB 156)κ
Sec. 16.16. NRS 689A.046 is hereby amended to read as follows:
689A.046 1. [The] In addition to the benefits required by section 16.1 of this act, the benefits provided by a policy for health insurance for treatment of alcohol or substance use disorder must [consist of:] include, without limitation:
(a) Treatment for withdrawal from the physiological effect of alcohol or drugs, with a minimum benefit of $1,500 per calendar year.
(b) Treatment for a patient admitted to a facility, with a minimum benefit of $9,000 per calendar year.
(c) Counseling for a person, group or family who is not admitted to a facility, with a minimum benefit of $2,500 per calendar year.
2. Except as otherwise provided in NRS 687B.409, these benefits must be paid in the same manner as benefits for any other illness covered by a similar policy are paid.
3. The insured person is entitled to these benefits if treatment is received in any:
(a) Facility for the treatment of alcohol or substance use disorder which is certified by the Division of Public and Behavioral Health of the Department of Health and Human Services.
(b) Hospital or other medical facility or facility for the dependent which is licensed by the Division of Public and Behavioral Health of the Department of Health and Human Services, accredited by The Joint Commission or CARF International and provides a program for the treatment of alcohol or substance use disorder as part of its accredited activities.
Sec. 16.2. NRS 689A.330 is hereby amended to read as follows:
689A.330 If any policy is issued by a domestic insurer for delivery to a person residing in another state, and if the insurance commissioner or corresponding public officer of that other state has informed the Commissioner that the policy is not subject to approval or disapproval by that officer, the Commissioner may by ruling require that the policy meet the standards set forth in NRS 689A.030 to 689A.320, inclusive [.] , and section 16.1 of this act.
Sec. 16.3. Chapter 689B of NRS is hereby amended by adding thereto a new section to read as follows:
1. An insurer that offers or issues a policy of group health insurance shall include in the policy coverage for:
(a) All drugs approved by the United States Food and Drug Administration to provide medication-assisted treatment for opioid use disorder, including, without limitation, buprenorphine, methadone and naltrexone; and
(b) The services described in section 12.3 of this act when provided by a pharmacist or pharmacy that participates in the network plan of the insurer. The Commissioner shall adopt regulations governing the provision of reimbursement for such services.
2. An insurer that offers or issues a policy of group health insurance shall reimburse a pharmacist or pharmacy that participates in the network plan of the insurer for the services described in section 12.3 of this act at a rate equal to the rate of reimbursement provided to a physician, physician assistant or advanced practice registered nurse for similar services.
3. Except as otherwise provided in this subsection, an insurer shall not subject the benefits required by subsection 1 to medical management techniques, other than step therapy. An insurer may subject such benefits to other reasonable medical management techniques when the benefits are provided by a pharmacist in accordance with section 12.3 of this act.
κ2023 Statutes of Nevada, Page 2373 (CHAPTER 398, AB 156)κ
to other reasonable medical management techniques when the benefits are provided by a pharmacist in accordance with section 12.3 of this act.
4. An insurer shall ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the insurer.
5. A policy of group health insurance subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the policy that conflicts with the provisions of this section is void.
6. As used in this section:
(a) Medical management technique means a practice which is used to control the cost or use of health care services or prescription drugs. The term includes, without limitation, the use of step therapy, prior authorization and categorizing drugs and devices based on cost, type or method of administration.
(b) Network plan means a policy of group health insurance offered by an insurer under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the insurer. The term does not include an arrangement for the financing of premiums.
(c) Provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 16.4. Chapter 689C of NRS is hereby amended by adding thereto a new section to read as follows:
1. A carrier that offers or issues a health benefit plan shall include in the plan coverage for:
(a) All drugs approved by the United States Food and Drug Administration to provide medication-assisted treatment for opioid use disorder, including, without limitation, buprenorphine, methadone and naltrexone; and
(b) The services described in section 12.3 of this act when provided by a pharmacist or pharmacy that participates in the network plan of the carrier. The Commissioner shall adopt regulations governing the provision of reimbursement for such services.
2. A carrier that offers or issues a health benefit plan shall reimburse a pharmacist or pharmacy that participates in the network plan of the carrier for the services described in section 12.3 of this act at a rate equal to the rate of reimbursement provided to a physician, physician assistant or advanced practice registered nurse for similar services.
3. Except as otherwise provided in this subsection, a carrier shall not subject the benefits required by subsection 1 to medical management techniques, other than step therapy. A carrier may subject such benefits to other reasonable medical management techniques when the benefits are provided by a pharmacist in accordance with section 12.3 of this act.
4. A carrier shall ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the carrier.
5. A health benefit plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the plan that conflicts with the provisions of this section is void.
κ2023 Statutes of Nevada, Page 2374 (CHAPTER 398, AB 156)κ
the legal effect of including the coverage required by subsection 1, and any provision of the plan that conflicts with the provisions of this section is void.
6. As used in this section:
(a) Medical management technique means a practice which is used to control the cost or use of health care services or prescription drugs. The term includes, without limitation, the use of step therapy, prior authorization and categorizing drugs and devices based on cost, type or method of administration.
(b) Network plan means a health benefit plan offered by a carrier under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the carrier. The term does not include an arrangement for the financing of premiums.
(c) Provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 16.43. NRS 689C.166 is hereby amended to read as follows:
689C.166 Each group health insurance policy must contain in substance a provision for benefits payable for expenses incurred for the treatment of alcohol or substance use disorder, as provided in NRS 689C.167 [.] and section 16.4 of this act.
Sec. 16.45. NRS 689C.167 is hereby amended to read as follows:
689C.167 1. [The] In addition to the benefits required by section 16.4 of this act, the benefits provided by a group policy for health insurance, as required by NRS 689C.166, for the treatment of alcohol or substance use disorders must [consist of:] include, without limitation:
(a) Treatment for withdrawal from the physiological effects of alcohol or drugs, with a minimum benefit of $1,500 per calendar year.
(b) Treatment for a patient admitted to a facility, with a minimum benefit of $9,000 per calendar year.
(c) Counseling for a person, group or family who is not admitted to a facility, with a minimum benefit of $2,500 per calendar year.
2. Except as otherwise provided in NRS 687B.409, these benefits must be paid in the same manner as benefits for any other illness covered by a similar policy are paid.
3. The insured person is entitled to these benefits if treatment is received in any:
(a) Facility for the treatment of alcohol or substance use disorders which is certified by the Division of Public and Behavioral Health of the Department of Health and Human Services.
(b) Hospital or other medical facility or facility for the dependent which is licensed by the Division of Public and Behavioral Health of the Department of Health and Human Services, is accredited by The Joint Commission or CARF International and provides a program for the treatment of alcohol or substance use disorders as part of its accredited activities.
Sec. 16.48. NRS 689C.425 is hereby amended to read as follows:
689C.425 A voluntary purchasing group and any contract issued to such a group pursuant to NRS 689C.360 to 689C.600, inclusive, are subject to the provisions of NRS 689C.015 to 689C.355, inclusive, and section 16.4 of this act, to the extent applicable and not in conflict with the express provisions of NRS 687B.408 and 689C.360 to 689C.600, inclusive.
κ2023 Statutes of Nevada, Page 2375 (CHAPTER 398, AB 156)κ
Sec. 16.5. Chapter 695A of NRS is hereby amended by adding thereto a new section to read as follows:
1. A society that offers or issues a benefit contract shall include in the contract coverage for:
(a) All drugs approved by the United States Food and Drug Administration to provide medication-assisted treatment for opioid use disorder, including, without limitation, buprenorphine, methadone and naltrexone; and
(b) The services described in section 12.3 of this act when provided by a pharmacist or pharmacy that participates in the network plan of the society. The Commissioner shall adopt regulations governing the provision of reimbursement for such services.
2. A society that offers or issues a benefit contract shall reimburse a pharmacist or pharmacy that participates in the network plan of the society for the services described in section 12.3 of this act at a rate equal to the rate of reimbursement provided to a physician, physician assistant or advanced practice registered nurse for similar services.
3. Except as otherwise provided in this subsection, a society shall not subject the benefits required by subsection 1 to medical management techniques, other than step therapy. A society may subject such benefits to other reasonable medical management techniques when the benefits are provided by a pharmacist in accordance with section 12.3 of this act.
4. A society shall ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the society.
5. A benefit contract subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the contract that conflicts with the provisions of this section is void.
6. As used in this section:
(a) Medical management technique means a practice which is used to control the cost or use of health care services or prescription drugs. The term includes, without limitation, the use of step therapy, prior authorization and categorizing drugs and devices based on cost, type or method of administration.
(b) Network plan means a benefit contract offered by a society under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the society. The term does not include an arrangement for the financing of premiums.
(c) Provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 16.6. Chapter 695B of NRS is hereby amended by adding thereto a new section to read as follows:
1. A hospital or medical services corporation that offers or issues a policy of health insurance shall include in the policy coverage for:
(a) All drugs approved by the United States Food and Drug Administration to provide medication-assisted treatment for opioid use disorder, including, without limitation, buprenorphine, methadone and naltrexone; and
κ2023 Statutes of Nevada, Page 2376 (CHAPTER 398, AB 156)κ
(b) The services described in section 12.3 of this act when provided by a pharmacist or pharmacy that participates in the network plan of the hospital or medical services corporation. The Commissioner shall adopt regulations governing the provision of reimbursement for such services.
2. A hospital or medical services corporation that offers or issues a policy of health insurance shall reimburse a pharmacist or pharmacy that participates in the network plan of the hospital or medical services corporation for the services described in section 12.3 of this act at a rate equal to the rate of reimbursement provided to a physician, physician assistant or advanced practice registered nurse for similar services.
3. Except as otherwise provided in this subsection, a hospital or medical services corporation shall not subject the benefits required by subsection 1 to medical management techniques, other than step therapy. A hospital or medical services corporation may subject such benefits to other reasonable medical management techniques when the benefits are provided by a pharmacist in accordance with section 12.3 of this act.
4. A hospital or medical services corporation shall ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the hospital or medical services corporation.
5. A policy of health insurance subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the policy that conflicts with the provisions of this section is void.
6. As used in this section:
(a) Medical management technique means a practice which is used to control the cost or use of health care services or prescription drugs. The term includes, without limitation, the use of step therapy, prior authorization and categorizing drugs and devices based on cost, type or method of administration.
(b) Network plan means a policy of health insurance offered by a hospital or medical services corporation under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the hospital or medical services corporation. The term does not include an arrangement for the financing of premiums.
(c) Provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 16.7. Chapter 695C of NRS is hereby amended by adding thereto a new section to read as follows:
1. A health maintenance organization that offers or issues a health care plan shall include in the plan coverage for:
(a) All drugs approved by the United States Food and Drug Administration to provide medication-assisted treatment for opioid use disorder, including, without limitation, buprenorphine, methadone and naltrexone; and
(b) The services described in section 12.3 of this act when provided by a pharmacist or pharmacy that participates in the network plan of the health maintenance organization. The Commissioner shall adopt regulations governing the provision of reimbursement for such services.
κ2023 Statutes of Nevada, Page 2377 (CHAPTER 398, AB 156)κ
2. A health maintenance organization that offers or issues a health care plan shall reimburse a pharmacist or pharmacy that participates in the network plan of the health maintenance organization for the services described in section 12.3 of this act at a rate equal to the rate of reimbursement provided to a physician, physician assistant or advanced practice registered nurse for similar services.
3. Except as otherwise provided in this subsection, health maintenance organization shall not subject the benefits required by subsection 1 to medical management techniques, other than step therapy. A health maintenance organization may subject such benefits to other reasonable medical management techniques when the benefits are provided by a pharmacist in accordance with section 12.3 of this act.
4. A health maintenance organization shall ensure that the benefits required by subsection 1 are made available to an enrollee through a provider of health care who participates in the network plan of the health maintenance organization.
5. A health care plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the plan that conflicts with the provisions of this section is void.
6. As used in this section:
(a) Medical management technique means a practice which is used to control the cost or use of health care services or prescription drugs. The term includes, without limitation, the use of step therapy, prior authorization and categorizing drugs and devices based on cost, type or method of administration.
(b) Network plan means a health care plan offered by a health maintenance organization under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the health maintenance organization. The term does not include an arrangement for the financing of premiums.
(c) Provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 16.75. NRS 695C.050 is hereby amended to read as follows:
695C.050 1. Except as otherwise provided in this chapter or in specific provisions of this title, the provisions of this title are not applicable to any health maintenance organization granted a certificate of authority under this chapter. This provision does not apply to an insurer licensed and regulated pursuant to this title except with respect to its activities as a health maintenance organization authorized and regulated pursuant to this chapter.
2. Solicitation of enrollees by a health maintenance organization granted a certificate of authority, or its representatives, must not be construed to violate any provision of law relating to solicitation or advertising by practitioners of a healing art.
3. Any health maintenance organization authorized under this chapter shall not be deemed to be practicing medicine and is exempt from the provisions of chapter 630 of NRS.
4. The provisions of NRS 695C.110, 695C.125, 695C.1691, 695C.1693, 695C.170, 695C.1703, 695C.1705, 695C.1709 to 695C.173, inclusive, 695C.1733, 695C.17335, 695C.1734, 695C.1751, 695C.1755, 695C.1759, 695C.176 to 695C.200, inclusive, and 695C.265 do not apply to a health maintenance organization that provides health care services through managed care to recipients of Medicaid under the State Plan for Medicaid or insurance pursuant to the Childrens Health Insurance Program pursuant to a contract with the Division of Health Care Financing and Policy of the Department of Health and Human Services.
κ2023 Statutes of Nevada, Page 2378 (CHAPTER 398, AB 156)κ
695C.1759, 695C.176 to 695C.200, inclusive, and 695C.265 do not apply to a health maintenance organization that provides health care services through managed care to recipients of Medicaid under the State Plan for Medicaid or insurance pursuant to the Childrens Health Insurance Program pursuant to a contract with the Division of Health Care Financing and Policy of the Department of Health and Human Services. This subsection does not exempt a health maintenance organization from any provision of this chapter for services provided pursuant to any other contract.
5. The provisions of NRS 695C.1694 to 695C.1698, inclusive, 695C.1701, 695C.1708, 695C.1728, 695C.1731, 695C.17333, 695C.17345, 695C.17347, 695C.1735, 695C.1737, 695C.1743, 695C.1745 and 695C.1757 and section 16.7 of this act apply to a health maintenance organization that provides health care services through managed care to recipients of Medicaid under the State Plan for Medicaid.
Sec. 16.8. NRS 695C.330 is hereby amended to read as follows:
695C.330 1. The Commissioner may suspend or revoke any certificate of authority issued to a health maintenance organization pursuant to the provisions of this chapter if the Commissioner finds that any of the following conditions exist:
(a) The health maintenance organization is operating significantly in contravention of its basic organizational document, its health care plan or in a manner contrary to that described in and reasonably inferred from any other information submitted pursuant to NRS 695C.060, 695C.070 and 695C.140, unless any amendments to those submissions have been filed with and approved by the Commissioner;
(b) The health maintenance organization issues evidence of coverage or uses a schedule of charges for health care services which do not comply with the requirements of NRS 695C.1691 to 695C.200, inclusive, or section 16.7 of this act, or 695C.207;
(c) The health care plan does not furnish comprehensive health care services as provided for in NRS 695C.060;
(d) The Commissioner certifies that the health maintenance organization:
(1) Does not meet the requirements of subsection 1 of NRS 695C.080; or
(2) Is unable to fulfill its obligations to furnish health care services as required under its health care plan;
(e) The health maintenance organization is no longer financially responsible and may reasonably be expected to be unable to meet its obligations to enrollees or prospective enrollees;
(f) The health maintenance organization has failed to put into effect a mechanism affording the enrollees an opportunity to participate in matters relating to the content of programs pursuant to NRS 695C.110;
(g) The health maintenance organization has failed to put into effect the system required by NRS 695C.260 for:
(1) Resolving complaints in a manner reasonably to dispose of valid complaints; and
(2) Conducting external reviews of adverse determinations that comply with the provisions of NRS 695G.241 to 695G.310, inclusive;
(h) The health maintenance organization or any person on its behalf has advertised or merchandised its services in an untrue, misrepresentative, misleading, deceptive or unfair manner;
κ2023 Statutes of Nevada, Page 2379 (CHAPTER 398, AB 156)κ
(i) The continued operation of the health maintenance organization would be hazardous to its enrollees or creditors or to the general public;
(j) The health maintenance organization fails to provide the coverage required by NRS 695C.1691; or
(k) The health maintenance organization has otherwise failed to comply substantially with the provisions of this chapter.
2. A certificate of authority must be suspended or revoked only after compliance with the requirements of NRS 695C.340.
3. If the certificate of authority of a health maintenance organization is suspended, the health maintenance organization shall not, during the period of that suspension, enroll any additional groups or new individual contracts, unless those groups or persons were contracted for before the date of suspension.
4. If the certificate of authority of a health maintenance organization is revoked, the organization shall proceed, immediately following the effective date of the order of revocation, to wind up its affairs and shall conduct no further business except as may be essential to the orderly conclusion of the affairs of the organization. It shall engage in no further advertising or solicitation of any kind. The Commissioner may, by written order, permit such further operation of the organization as the Commissioner may find to be in the best interest of enrollees to the end that enrollees are afforded the greatest practical opportunity to obtain continuing coverage for health care.
Sec. 16.9. Chapter 695G of NRS is hereby amended by adding thereto a new section to read as follows:
1. A managed care organization that offers or issues a health care plan shall include in the plan coverage for:
(a) All drugs approved by the United States Food and Drug Administration to provide medication-assisted treatment for opioid use disorder, including, without limitation, buprenorphine, methadone and naltrexone; and
(b) The services described in section 12.3 of this act when provided by a pharmacist or pharmacy that participates in the network plan of the managed care organization. The Commissioner shall adopt regulations governing the provision of reimbursement for such services.
2. A managed care organization that offers or issues a health care plan shall reimburse a pharmacist or pharmacy that participates in the network plan of the managed care organization for the services described in section 12.3 of this act at a rate equal to the rate of reimbursement provided to a physician, physician assistant or advanced practice registered nurse for similar services.
3. Except as otherwise provided in this subsection, managed care organization shall not subject the benefits required by subsection 1 to medical management techniques, other than step therapy. A managed care organization may subject such benefits to other reasonable medical management techniques when the benefits are provided by a pharmacist in accordance with section 12.3 of this act.
4. A managed care organization shall ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the managed care organization.
5. A health care plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the plan that conflicts with the provisions of this section is void.
κ2023 Statutes of Nevada, Page 2380 (CHAPTER 398, AB 156)κ
the legal effect of including the coverage required by subsection 1, and any provision of the plan that conflicts with the provisions of this section is void.
6. As used in this section:
(a) Medical management technique means a practice which is used to control the cost or use of health care services or prescription drugs. The term includes, without limitation, the use of step therapy, prior authorization and categorizing drugs and devices based on cost, type or method of administration.
(b) Network plan means a health care plan offered by a managed care organization under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the managed care organization. The term does not include an arrangement for the financing of premiums.
(c) Provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 17. 1. Notwithstanding the provisions of subsection 2 of NRS 458.103, as amended by section 1.7 of this act, a treatment provider, provider of health care or program for alcohol or substance use disorders is not, unless otherwise required by federal law, required to terminate services to which the provisions of that subsection would otherwise apply to a person who is receiving such services on or before October 1, 2023, from the treatment provider, provider of health care or program in order to provide such services to a person who would otherwise receive priority under that subsection.
2. The provisions of subsection 2 of NRS 458.103, as amended by section 1.7 of this act, do not apply to treatment for an alcohol or other substance use disorder provided under any grant, contract or other agreement accepted or entered into on or before October 1, 2023, but do apply to any such treatment provided under such a grant, contract or agreement that is renewed or extended.
3. As used in this section:
(a) Program for alcohol or other substance use disorders has the meaning ascribed to it in NRS 458.010.
(b) Provider of health care has the meaning ascribed to it in NRS 629.031.
(c) Treatment provider has the meaning ascribed to it in NRS 458.010.
Sec. 17.5. 1. During the 2023-2024 interim, the Department of Corrections, in collaboration with the Department of Health and Human Services, shall study the provision of medication-assisted treatment to offenders with opioid use disorder. The study must include, without limitation, an examination of:
(a) Barriers to accessing medication-assisted treatment at institutions and facilities of the Department of Corrections and private facilities and institutions, including, without limitation:
(1) A shortage of providers of health care who are authorized and willing to prescribe a drug for medication-assisted treatment to offenders; and
(2) Barriers relating to the licensure, credentialing and regulation of such providers of health care;
κ2023 Statutes of Nevada, Page 2381 (CHAPTER 398, AB 156)κ
(b) The feasibility of forming multidisciplinary review teams consisting of experts on behavioral health care and criminal justice to make informed decisions about the medication-assisted treatment provided to offenders;
(c) The feasibility of establishing medication-assisted treatment programs on the grounds of institutions and facilities of the Department of Corrections and private facilities and institutions to provide medication-assisted treatment to offenders with opioid use disorder to the same extent as other health care provided to offenders;
(d) The feasibility of forming partnerships with providers of health care and agencies, including, without limitation, the Department of Health and Human Services and local agencies that provide social services, to provide medication-assisted treatment inside or nearby institutions and facilities of the Department of Corrections and private facilities and institutions;
(e) The feasibility of forming partnerships with counties, cities and towns that maintain jails or detention facilities to provide medication-assisted treatment to prisoners in such jails or detention facilities;
(f) The feasibility of storing information concerning offenders who are receiving medication-assisted treatment and sharing such information with providers of treatment, providers of community-based services and other interested persons and entities;
(g) Strategies for facilitating the continuation of medication-assisted treatment by an offender upon release, including, without limitation:
(1) Affiliating with providers of community-based services or federally qualified health centers; and
(2) Obtaining a waiver pursuant to 42 U.S.C. § 1315 to provide coverage under Medicaid for services to offenders before they are released;
(h) The funding that would be needed to provide medication-assisted treatment to all offenders with opioid use disorder in each institution or facility of the Department of Corrections and each private facility or institution; and
(i) Opportunities to obtain federal and private funding to defray the costs described in paragraph (h).
2. During the 2023-2024 interim, each county, city or town that maintains a jail or detention facility shall study opioid use disorder among prisoners. Each study must include, without limitation:
(a) An examination of the current prevalence of opioid use disorder among prisoners in the jail or detention facility;
(b) An examination of the treatment prescribed for and provided to prisoners with opioid use disorder, including, without limitation, treatments provided by the staff of the jail or detention facility; and
(c) For a county whose population is 100,000 or more or any city or town within such a county, an examination of the feasibility of:
(1) Establishing a program to provide medication-assisted treatment for prisoners with opioid use disorder that meets national standards of care for the provision of medication-assisted treatment in a correctional setting, including, without limitation, with regard to personnel and funding; and
(2) Forming partnerships with providers of health care and agencies to provide medication-assisted treatment inside or nearby the jail or detention facility and facilitate the continuation of medication-assisted treatment after a prisoner is released.
3. A county whose population is less than 100,000 or a city or town within such a county that maintains a jail or detention facility may:
κ2023 Statutes of Nevada, Page 2382 (CHAPTER 398, AB 156)κ
(a) Conduct the examination described in paragraph (c) of subsection 2; and
(b) Cooperate with the regional behavioral health policy board created by NRS 433.429 for the behavioral health region established by NRS 433.428 in which the county is located for the purpose of conducting that examination.
4. On or before June 30, 2024, the Department of Corrections and each county, city or town that maintains a jail or detention facility shall:
(a) Submit a report of the findings of the study conducted pursuant to this section to the Director of the Legislative Counsel Bureau for transmittal to the Joint Interim Standing Committee on Health and Human Services and the Joint Interim Standing Committee on the Judiciary; and
(b) Present the findings of the study conducted pursuant to this section at meetings of the Joint Interim Standing Committee on Health and Human Services and the Joint Interim Standing Committee on the Judiciary.
5. As used in this section:
(a) Facility has the meaning ascribed to it in NRS 209.065.
(b) Federally-qualified health center has the meaning ascribed to it in 42 U.S.C. § 1396d(l)(2)(B).
(c) Institution has the meaning ascribed to it in NRS 209.071.
(d) Medication-assisted treatment has the meaning ascribed to it in section 12.3 of this act.
(e) Offender has the meaning ascribed to it in NRS 209.081.
(f) Private facility or institution has the meaning ascribed to it in NRS 209.083.
(g) Provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 18. The provisions of NRS 354.599 do not apply to any additional expenses of a local government that are related to the provisions of this act.
Sec. 19. 1. This section becomes effective upon passage and approval.
2. Sections 1.28, 1.3 and 17.5 of this act becomes effective on July 1, 2023.
3. Sections 1.7 and 17 of this act become effective on October 1, 2023.
4. Sections 1 to 1.25, inclusive, 2 to 16.9, inclusive, and 18 of this act become effective:
(a) Upon passage and approval for the purpose of adopting any regulations and performing any other preparatory administrative tasks that are necessary to carry out the provisions of this act; and
(b) On January 1, 2024, for all other purposes.
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