[Rev. 9/10/2021 11:34:34 AM]
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Senate Bill No. 70Committee on Health and Human Services
CHAPTER 481
[Approved: June 4, 2021]
AN ACT relating to mental health; revising provisions governing the use of chemical restraints on persons with disabilities; establishing procedures for placing a person on and releasing a person from a mental health crisis hold; revising provisions governing the emergency admission of a person to a mental health facility or hospital; revising provisions governing involuntary court-ordered admission to a mental health facility and assisted outpatient treatment; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Existing law defines the term chemical restraint to mean the administration of drugs for the specific and exclusive purpose of controlling an acute or episodic aggressive behavior when alternative intervention techniques have failed to limit or control the behavior. (NRS 388.476, 394.355, 433.5456, 449A.206) Existing law prescribes the conditions under which a medical facility, facility for the dependent, psychiatric hospital or psychiatric unit of a hospital or public or private school may use a chemical restraint on a person with a disability and prohibits the use of a chemical restraint on such a person under certain circumstances. (NRS 388.473, 388.497, 394.354, 394.366, 433.5486, 433.549, 433.5503, 449A.236, 449A.245, 449A.248) Sections 2, 65, 66 and 68 of this bill redefine the term chemical restraint for those purposes.
Existing law uses the term consumer to describe persons who receive various mental health services. (Chapter 433A of NRS) Section 3.5 of this bill specifically defines that term to mean any person who voluntarily or involuntarily seeks and may benefit from certain mental health services.
Existing law authorizes an officer authorized to make arrests in this State, certain providers of health care, or the spouse, parent, adult child or legal guardian of a person alleged to be a person in a mental health crisis to apply for the emergency admission of a person alleged to be a person in a mental health crisis to a mental health facility or hospital. (NRS 433A.160) Existing law requires the release of a person admitted under an emergency admission within 72 hours after the submission of the application for emergency admission unless: (1) a petition is filed for the involuntary court-ordered admission of the person; or (2) the admission is changed to a voluntary admission. (NRS 433A.145, 433A.150, 433A.200)
Section 6 of this bill defines the term mental health crisis hold to mean the detention of a person alleged to be a person in a mental health crisis for transport to, and assessment, evaluation, intervention and treatment at, a public or private mental health facility or hospital. Section 4 of this bill defines the term emergency admission to mean the involuntary admission of a person who has been placed on a mental health crisis hold to a public or private mental health facility or a hospital. Sections 9, 10 and 28-35 of this bill prescribe separate processes for the detention of a person on a mental health crisis hold and the emergency admission of such a person. Specifically, section 30 of this bill authorizes an officer authorized to make arrests in this State or certain providers of health care to place a person alleged to be a person who is in a mental health crisis on a mental health crisis hold. Section 9 of this bill authorizes such an officer or provider of health care, certain family members, a person who is providing case management, support and supervision to a person who has been conditionally released from a mental health facility or any other person with a legitimate interest in a person alleged to be a person in a mental health crisis to petition for a court order to place a person alleged to be a person with a mental illness on a mental health crisis hold.
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on a mental health crisis hold. Section 29 of this bill prescribes the conditions under which a person may be detained if the person is placed on a mental health crisis hold. Section 35 of this bill prescribes the requirements for releasing a person from a mental health crisis hold. Sections 10, 28, 31 and 32 of this bill prescribe the procedure for admitting a person to a mental health facility or hospital under an emergency admission. Sections 10, 28 and 29 require the release of a person placed on a mental health crisis hold within 72 hours after the initiation of the hold, regardless of whether the person is admitted under an emergency admission, unless: (1) a petition is filed for the involuntary court-ordered admission of the person; or (2) the admission is changed to a voluntary admission. Sections 1, 23, 37, 40, 55, 64, 67 and 70-72 of this bill make conforming changes.
Existing law establishes a procedure for the involuntary court-ordered admission of a person to a mental health facility or a program of community-based or outpatient services. (NRS 433A.200-433A.330) Section 24 of this bill replaces the term program of community-based or outpatient services with the term assisted outpatient treatment, which is defined to mean outpatient services provided pursuant to a court order to a person with a mental illness for the purpose of treating the mental illness, assisting the person to live and function in the community or prevent a relapse or deterioration. Sections 11-21 of this bill prescribe a separate process for the issuance of a court order requiring a person to receive assisted outpatient treatment. Specifically, section 11 of this bill authorizes: (1) the Administrator of the Division of Public and Behavioral Health of the Department of Health and Human Services, certain providers of health care and certain persons who have an interest in a person to petition the district court to commence a proceeding for the issuance of a court order requiring assisted outpatient treatment of the person; and (2) a criminal defendant or the district attorney to make a motion to the district court to commence a proceeding for the issuance of a court order requiring assisted outpatient treatment of the defendant or the district court to commence such a proceeding on its own motion. Section 11 prescribes the criteria for determining whether a person may be ordered to receive assisted outpatient treatment. Section 13 of this bill requires certain persons who have evaluated a person who is the subject of a petition or motion for assisted outpatient treatment to submit to the court a recommended treatment plan for the person. Section 14 of this bill requires a person who is the subject of a petition or motion for assisted outpatient treatment to be represented by counsel at all stages of the proceedings. Section 18 of this bill authorizes a court to order a person to receive assisted outpatient treatment if: (1) at the conclusion of the proceedings, there is clear and convincing evidence that the person to be treated meets the applicable criteria for the initiation or renewal of such treatment; and (2) a person professionally qualified in the field of psychiatric mental health is able to treat the person in the county where the person to receive the treatment resides. If a person who has been ordered to receive assisted outpatient treatment fails to comply with the order after reasonable efforts to solicit compliance and, as a result, may harm himself or herself or others, section 20.5 of this bill authorizes the person responsible for providing the outpatient treatment to submit a petition for a court to order that the person be taken into custody to determine whether he or she is a person in a mental health crisis. Section 21 of this bill prescribes a procedure for renewing an order for assisted outpatient treatment. Section 23.5 of this bill revises the definition of person professionally qualified in the field of psychiatric mental health for purposes relating to eligibility to provide assisted outpatient treatment and certain other purposes. Sections 1, 27, 38, 41, 44, 45, 49, 51-54, 57-63, 69 and 72-75 of this bill make conforming changes.
Section 26 of this bill requires the Division and the Attorney General to approve all forms for the detainment, evaluation, treatment and conditional release of any person under chapter 433A of NRS and furnish the forms to the clerks of district courts in each county. Section 36 of this bill revises requirements governing a petition for involuntary court-ordered admission. Section 39 of this bill requires a person who submits such a petition to notify the court if the subject of the petition is currently admitted to a mental health facility or hospital and is transferred to another mental health facility or hospital.
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Existing law: (1) requires the transfer of proceedings for the involuntary admission of a person if professionals who are qualified to examine the person are not available in the county where the petition is filed; and (2) provides that the expense of proceedings for involuntary admission are to be paid by the county where the petition is filed or, if the subject of the petition does not reside in that county, the county of the State where he or she last resided. (NRS 433A.260) Section 41.5 of this bill imposes specific requirements for the transfer of proceedings from a county where qualified professionals are not available to conduct the examination to a county where qualified professionals are available. Section 41.5 also revises requirements governing the payment of the cost of proceedings for involuntary admission to require such cost to be paid by the county in which the subject of the petition resides. Section 42 of this bill removes a requirement that the same counsel must continue to represent a person who is involuntarily admitted to a program of community-based or outpatient services until the person is unconditionally released. Section 43 of this bill provides that, once a person is involuntarily admitted to a mental health facility: (1) the admitting court is prohibited from transferring the case; and (2) the mental health facility is required to notify the court if the person is transferred. Section 50 of this bill prohibits the transfer of a consumer who has been admitted to a mental health facility or required to receive assisted outpatient treatment to another facility or provider of treatment, as applicable, unless arrangements relating to the costs of treatment are made between the facility or provider and the consumer or the person who requested the admission or treatment.
Section 47 of this bill: (1) requires the notification of the court when a person who has been involuntarily admitted to a mental health facility is conditionally released; (2) revises the criteria for determining whether such a person may be conditionally released; and (3) authorizes the court to periodically review the terms of the conditional release. Sections 39 and 47 of this bill revise the procedure for admitting a person who has been conditionally released to a mental health facility or hospital when conditional release is no longer appropriate. Section 48 of this bill: (1) abolishes a requirement that an evaluation team evaluate a person who is involuntarily admitted by court order to a mental health facility or required to receive assisted outpatient treatment before the person may be unconditionally released before the expiration of the order; and (2) makes certain other minor revisions concerning unconditional release. Sections 39, 47, 48 and 48.5 of this bill impose specific requirements concerning notification of the guardian of a person who is released from a mental health facility or assisted outpatient treatment under certain circumstances.
Existing law requires a court to seal all records related to the admission and treatment of any person admitted to a mental health facility or a program of community-based or outpatient services. (NRS 433A.715) Section 56 of this bill additionally requires a court to seal records governing any other proceedings conducted under chapter 433A of NRS.
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 433.4295 is hereby amended to read as follows:
433.4295 1. Each policy board shall:
(a) Advise the Department, Division and Commission regarding:
(1) The behavioral health needs of adults and children in the behavioral health region;
(2) Any progress, problems or proposed plans relating to the provision of behavioral health services and methods to improve the provision of behavioral health services in the behavioral health region;
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(3) Identified gaps in the behavioral health services which are available in the behavioral health region and any recommendations or service enhancements to address those gaps;
(4) Any federal, state or local law or regulation that relates to behavioral health which it determines is redundant, conflicts with other laws or is obsolete and any recommendation to address any such redundant, conflicting or obsolete law or regulation; and
(5) Priorities for allocating money to support and develop behavioral health services in the behavioral health region.
(b) Promote improvements in the delivery of behavioral health services in the behavioral health region.
(c) Coordinate and exchange information with the other policy boards to provide unified and coordinated recommendations to the Department, Division and Commission regarding behavioral health services in the behavioral health region.
(d) Review the collection and reporting standards of behavioral health data to determine standards for such data collection and reporting processes.
(e) To the extent feasible, establish an organized, sustainable and accurate electronic repository of data and information concerning behavioral health and behavioral health services in the behavioral health region that is accessible to members of the public on an Internet website maintained by the policy board. A policy board may collaborate with an existing community-based organization to establish the repository.
(f) To the extent feasible, track and compile data concerning persons placed on a mental health crisis hold pursuant to NRS 433A.160, persons admitted to mental health facilities and hospitals under an emergency admission pursuant to [NRS 433A.145 to 433A.197, inclusive, and] section 10 of this act, persons admitted to mental health facilities [and programs of community-based or outpatient services] under an involuntary court-ordered admission pursuant to NRS 433A.200 to 433A.330, inclusive, and persons ordered to receive assisted outpatient treatment pursuant to sections 11 to 21, inclusive, of this act in the behavioral health region, including, without limitation:
(1) The outcomes of treatment provided to such persons; and
(2) Measures taken upon and after the release of such persons to address behavioral health issues and prevent future mental health crisis holds and admissions.
(g) Identify and coordinate with other entities in the behavioral health region and this State that address issues relating to behavioral health to increase awareness of such issues and avoid duplication of efforts.
(h) In coordination with existing entities in this State that address issues relating to behavioral health services, submit an annual report to the Commission which includes, without limitation:
(1) The specific behavioral health needs of the behavioral health region;
(2) A description of the methods used by the policy board to collect and analyze data concerning the behavioral health needs and problems of the behavioral health region and gaps in behavioral health services which are available in the behavioral health region, including, without limitation, a list of all sources of such data used by the policy board;
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(3) A description of the manner in which the policy board has carried out the requirements of paragraphs (c) and (g) of subsection 1 and the results of those activities; and
(4) The data compiled pursuant to paragraph (f) and any conclusions that the policy board has derived from such data.
2. A report described in paragraph (h) of subsection 1 may be submitted more often than annually if the policy board determines that a specific behavioral health issue requires an additional report to the Commission.
Sec. 2. NRS 433.5456 is hereby amended to read as follows:
433.5456 Chemical restraint means the administration of drugs to a person for the specific and exclusive purpose of controlling an acute or episodic [aggressive] behavior that places the person or others at a risk of harm when less restrictive alternative intervention techniques have failed to limit or control the behavior. The term does not include the administration of drugs [on a regular basis, as] prescribed by a physician, [to treat the symptoms of] physician assistant or advanced practice registered nurse as standard treatment for the mental [,] or physical [, emotional or behavioral disorders and for assisting a person in gaining self-control over his or her impulses.] condition of the person.
Sec. 3. Chapter 433A of NRS is hereby amended by adding thereto the provisions set forth as sections 3.5 to 22, inclusive, of this act.
Sec. 3.5. Consumer means any person who, whether voluntarily or involuntarily, seeks and can benefit from care, treatment and training:
1. In a public or private mental health facility or other public or private facility offering mental health services; or
2. From a person professionally qualified in the field of psychiatric mental health who provides assisted outpatient treatment.
Sec. 4. Emergency admission means the involuntary admission of a person who has been placed on a mental health crisis hold to a public or private mental health facility or hospital pursuant to section 10 of this act.
Sec. 5. Involuntary court-ordered admission means the admission of a person in a mental health crisis to a public or private mental health facility ordered by a court pursuant to NRS 433A.200 to 433A.330, inclusive.
Sec. 6. Mental health crisis hold means the detention of a person alleged to be a person in a mental health crisis for transport, assessment, evaluation, intervention and treatment pursuant to NRS 433A.160.
Sec. 7. Supporter has the meaning ascribed to it in NRS 162C.090.
Sec. 8. Voluntary admission means the admission of a person to a public or private mental health facility or a division facility pursuant to NRS 433A.140 as a voluntary consumer for the purposes of observation, diagnosis, care and treatment.
Sec. 9. 1. A person listed in subsection 2 may petition a district court for an order requiring any peace officer to place a person alleged to be in a mental health crisis on a mental health crisis hold pursuant to NRS 433A.160.
2. A petition pursuant to subsection 1 may be made by:
(a) An officer authorized to make arrests in the State of Nevada;
(b) A physician, physician assistant, psychologist, marriage and family therapist, clinical professional counselor, social worker or registered nurse;
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(c) The spouse, parent, adult child or legal guardian of a person alleged to be a person in a mental health crisis;
(d) A person who is providing case management, support and supervision to a person who has been conditionally released pursuant to NRS 433A.380, including, without limitation, a member of the staff of a community treatment program, social services agency, mobile crisis team or multi-disciplinary team that is providing case management, support and supervision to the person who is the subject of the petition; or
(e) Any other person who has a legitimate interest in a person alleged to be a person in a mental health crisis.
3. The district court may issue an order to place a person alleged to be in a mental health crisis on a mental health crisis hold only if it is satisfied that there is probable cause to believe that the person who is the subject of the petition is a person in a mental health crisis. If the district court issues such an order, the court shall ensure the delivery of the order to the sheriff of the county. The sheriff shall:
(a) Provide the order to the public or private mental health facility or hospital to which the person placed on a mental health crisis hold is transported; or
(b) Arrange for the person who transports the person placed on a mental health crisis hold to a public or private mental health facility or hospital to provide the order to the facility or hospital.
Sec. 10. 1. A public or private mental health facility or hospital may admit a person who has been placed on a mental health crisis hold under an emergency admission if:
(a) After conducting an examination pursuant to NRS 433A.165, a physician, physician assistant or advanced practice registered nurse determines that the person does not have a medical condition, other than a psychiatric condition, which requires immediate treatment;
(b) A psychologist, a physician, 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, who is employed by the public or private mental health facility or hospital completes a certificate pursuant to NRS 433A.170;
(c) A psychiatrist or a psychologist or, if a psychiatrist or a psychologist is not available, a physician or an advanced practice registered nurse who has the training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120, evaluates the person at the time of admission and determines that the person is a person in a mental health crisis; and
(d) A psychiatrist approves the admission.
2. The provisions of subsections 2 and 3 of NRS 433A.150 continue to apply to a person who is admitted to a public or private mental health facility or hospital under an emergency admission pursuant to this section.
Sec. 11. 1. A proceeding for an order requiring any person in the State of Nevada to receive assisted outpatient treatment may be commenced by the filing of a petition for such an order with the clerk of the district court of the county where the person who is to be treated is present. The petition may be filed by:
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(a) Any person who is at least 18 years of age and resides with the person to be treated;
(b) The spouse, parent, adult sibling, adult child or legal guardian of the person to be treated;
(c) A physician, physician assistant, psychologist, social worker or registered nurse who is providing care to the person to be treated;
(d) The Administrator or his or her designee; or
(e) The medical director of a division facility in which the person is receiving treatment or the designee of the medical director of such a division facility.
2. A proceeding to require a person who is the defendant in a criminal proceeding in the district court to receive assisted outpatient treatment may be commenced by the district court, on its own motion, or by motion of the defendant or the district attorney if:
(a) The defendant has been examined in accordance with NRS 178.415;
(b) The defendant is not eligible for commitment to the custody of the Administrator pursuant to NRS 178.461; and
(c) The Division makes a clinical determination that assisted outpatient treatment is appropriate.
3. A petition filed pursuant to subsection 1 or a motion made pursuant to subsection 2 must allege the following concerning the person to be treated:
(a) The person is at least 18 years of age.
(b) The person has a mental illness.
(c) The person has a history of poor compliance with treatment for his or her mental illness that has resulted in at least one of the following circumstances:
(1) At least twice during the immediately preceding 48 months, poor compliance with mental health treatment has been a significant factor in causing the person being hospitalized or receiving services in the behavioral health unit of a detention facility or correctional facility. The 48-month period described in this subparagraph must be extended by any amount of time that the person has been hospitalized, incarcerated or detained during that period.
(2) Poor compliance with mental health treatment has been a significant factor in causing the person to commit, attempt to commit or threaten to commit serious physical harm to himself or herself or others during the immediately preceding 48 months. The 48-month period described in this subparagraph must be extended by any amount of time that the person has been hospitalized, incarcerated or detained during that period.
(3) Poor compliance with mental health treatment has resulted in the person being hospitalized, incarcerated or detained for a cumulative period of at least 6 months and the person:
(I) Is scheduled to be discharged or released from such hospitalization, incarceration or detention during the 30 days immediately following the date of the petition; or
(II) Has been discharged or released from such hospitalization, incarceration or detention during the 60 days immediately preceding the date of the petition.
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(d) Because of his or her mental illness, the person is unwilling or unlikely to voluntarily participate in outpatient treatment that would enable the person to live safely in the community without the supervision of the court.
(e) Assisted outpatient treatment is the least restrictive appropriate means to prevent further disability or deterioration that would result in the person becoming a person in a mental health crisis.
4. A petition filed pursuant to subsection 1 or a motion made pursuant to subsection 2 must be accompanied by:
(a) A sworn statement or a declaration that complies with the provisions of NRS 53.045 by 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:
(1) Evaluated the person who is the subject of the petition or motion not earlier than 10 days before the filing of the petition or making of the motion;
(2) Recommends that the person be ordered to receive assisted outpatient treatment; and
(3) Is willing and able to testify at a hearing on the petition or motion; and
(b) A sworn statement or a declaration that complies with the provisions of NRS 53.045 from a person professionally qualified in the field of psychiatric mental health stating that he or she is willing to provide assisted outpatient treatment for the person in the county where the person resides.
5. A copy of the petition filed pursuant to subsection 1 or a motion made pursuant to subsection 2 must be served upon the person who is the subject of the petition or motion or his or her counsel and, if applicable, his or her legal guardian.
Sec. 12. 1. Immediately after the clerk of the district court receives a petition filed pursuant to subsection 1 of section 11 of this act or section 21 of this act, the clerk shall transmit the petition to the appropriate district judge, who shall set a time, date and place for its hearing. Immediately after a motion is made pursuant to subsection 2 of section 11 of this act, the district judge shall set a time, date and place for its hearing. The date must be:
(a) Within 30 judicial days after the date on which the petition is received by the clerk or the motion is made, as applicable; or
(b) If the person who is the subject of the petition or motion is hospitalized at the time of the petition or motion, before that person is to be discharged and within a sufficient time to arrange for a continuous transition from inpatient treatment to assisted outpatient treatment.
2. If the Chief Judge, if any, of the district court has assigned a district court judge or hearing master to preside over hearings pursuant to this section, that judge or hearing master must preside over the hearing.
3. The court shall give notice of the petition or motion and of the time, date and place of any proceedings thereon to the person who is the subject of the petition or motion, his or her attorney, if known, the persons legal guardian, the petitioner, if applicable, the district attorney of the county in which the court has its principal office, the local office of an agency or organization that receives money from the Federal Government pursuant to 42 U.S.C.
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legal guardian, the petitioner, if applicable, the district attorney of the county in which the court has its principal office, the local office of an agency or organization that receives money from the Federal Government pursuant to 42 U.S.C. §§ 10801 et seq., to protect and advocate the rights of persons with a mental illness and the administrative office of any public or private mental health facility or hospital in which the subject of the petition or motion is detained.
Sec. 13. 1. Before the date of a hearing on a petition or motion for assisted outpatient treatment, the person who made the sworn statement or declaration pursuant to paragraph (a) of subsection 4 of section 11 of this act, the personnel of the Division who made the clinical determination concerning the appropriateness of assisted outpatient treatment pursuant to paragraph (c) of subsection 2 of section 11 of this act or the person or entity who submitted the petition pursuant to section 21 of this act, as applicable, shall submit to the court a proposed written treatment plan created by a person professionally qualified in the field of psychiatric mental health who is familiar with the person who is the subject of the petition or motion, as applicable. The proposed written treatment plan must set forth:
(a) The services and treatment recommended for the person who is the subject of the petition or motion; and
(b) The person who will provide such services and treatment and his or her qualifications.
2. Services and treatment set forth in a proposed written treatment plan must include, without limitation:
(a) Case management services to coordinate the assisted outpatient treatment recommended pursuant to paragraph (b); and
(b) Assisted outpatient treatment which may include, without limitation:
(1) Medication;
(2) Periodic blood or urine testing to determine whether the person is receiving such medication;
(3) Individual or group therapy;
(4) Full-day or partial-day programming activities;
(5) Educational activities;
(6) Vocational training;
(7) Treatment and counseling for a substance use disorder;
(8) If the person has a history of substance use, periodic blood or urine testing for the presence of alcohol or other recreational drugs;
(9) Supervised living arrangements; and
(10) Any other services determined necessary to treat the mental illness of the person, assist the person in living or functioning in the community or prevent a deterioration of the mental or physical condition of the person.
3. A person professionally qualified in the field of psychiatric mental health who is creating a proposed written treatment plan pursuant to subsection 1 shall:
(a) Consider any wishes expressed by the person who is to be treated in an advance directive for psychiatric care executed pursuant to NRS 449A.600 to 449A.645, inclusive; and
(b) Consult with the person who is to be treated, any providers of health care who are currently treating the person, any supporter or legal guardian of the person, and, upon the request of the person, any other person concerned with his or her welfare, including, without limitation, a relative or friend.
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guardian of the person, and, upon the request of the person, any other person concerned with his or her welfare, including, without limitation, a relative or friend.
4. If a proposed written treatment plan includes medication, the plan must specify the type and class of the medication and state whether the medication is to be self-administered or administered by a specific provider of health care. A proposed written treatment plan must not recommend the use of physical force or restraints to administer medication.
5. If a proposed written treatment plan includes periodic blood or urine testing for the presence of alcohol or other recreational drugs, the plan must set forth sufficient facts to support a clinical determination that the person who is to be treated has a history of substance use disorder.
6. If the person who is to be treated has executed an advance directive for psychiatric care pursuant to NRS 449A.600 to 449A.645, inclusive, a copy of the advance directive must be attached to the proposed written treatment plan.
7. As used in this section, provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 14. 1. The person who is the subject of a petition filed or motion made pursuant to section 11 or 21 of this act or any relative or friend on the persons behalf is entitled to retain counsel to represent the person in any proceeding before the district court relating to assisted outpatient treatment. If he or she fails or refuses to obtain counsel, the court must advise the person and his or her guardian or next of kin, if known, of such right to counsel and must appoint counsel, who may be the public defender or his or her deputy. The person must be represented by counsel at all stages of the proceedings.
2. The court shall award compensation to any counsel appointed pursuant to subsection 1 for his or her services in an amount determined by the court to be fair and reasonable. The compensation must be charged against the estate of the person for whom the counsel was appointed or, if the person is indigent, against the county where the person who is the subject of the petition or motion last resided.
3. The court shall, at the request of counsel representing the subject of the petition or motion in proceedings before the court relating to assisted outpatient treatment, grant a recess in the proceedings for the shortest time possible, but for not more than 7 days, to give the counsel an opportunity to prepare his or her case.
4. If the person who is the subject of the petition or motion is ordered to receive assisted outpatient treatment, counsel must continue to represent the person until the person is released from the program. The court shall serve notice upon such counsel of any action that is taken involving the person while the person is required by the order to receive assisted outpatient treatment.
Sec. 15. 1. The district attorney of a county in which a petition is filed or motion is made pursuant to section 11 or 21 of this act or his or her deputy:
(a) Must appear and represent the State in the proceedings for assisted outpatient treatment if:
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(1) The proceedings were initiated by:
(I) A petition filed pursuant to subsection 1 of section 11 of this act or section 21 of this act by the Administrator or his or her designee or the medical director of a division facility or his or her designee; or
(II) A motion made pursuant to subsection 2 of section 11 of this act; and
(2) The district attorney determines that there is clear and convincing evidence that the criteria prescribed in subsection 3 of section 11 of this act or subsection 1 of section 21 of this act, as applicable, are met.
(b) May appear and represent the State in the proceedings for assisted outpatient treatment in any other case where the district attorney determines that there is clear and convincing evidence that the criteria prescribed in subsection 3 of section 11 of this act or subsection 1 of section 21 of this act, as applicable, are met.
2. If the district attorney does not appear and represent the State in a proceeding for assisted outpatient treatment, the petitioner is responsible for presenting the case in support of the petition.
Sec. 16. 1. In proceedings for assisted outpatient treatment, the court shall hear and consider all relevant testimony, including, without limitation:
(a) The testimony of the person who made a sworn statement or declaration pursuant to paragraph (a) of subsection 4 of section 11 of this act, any personnel of the Division responsible for a clinical determination made pursuant to paragraph (c) of subsection 2 of section 11 of this act or the person or entity responsible for the decision to submit a petition pursuant to section 21 of this act, as applicable;
(b) The testimony of any supporter or legal guardian of the person who is the subject of the proceedings, if that person wishes to testify; and
(c) If the proposed written treatment plan submitted pursuant to section 13 of this act recommends medication and the person who is the subject of the petition or motion objects to the recommendation, the testimony of the person professionally qualified in the field of psychiatric mental health who prescribed the recommendation.
2. The court may consider testimony relating to any past actions of the person who is the subject of the petition or motion if such testimony is probative of the question of whether the person currently meets the criteria prescribed by subsection 3 of section 11 of this act or subsection 1 of section 21 of this act, as applicable.
Sec. 17. 1. Except as otherwise provided in subsection 2, the person who is the subject of a petition or motion for assisted outpatient treatment must be present at the proceedings on the petition or motion, as applicable, and may, at the discretion of the court, testify.
2. The court may conduct the hearing on a petition or motion for assisted outpatient treatment in the absence of the person who is the subject of the petition or motion if:
(a) The person has waived his or her right to attend the hearing after receiving notice pursuant to section 12 of this act and being advised of his or her right to be present and the potential consequences of failing to attend; and
(b) The counsel for the person is present.
κ2021 Statutes of Nevada, Page 3074 (CHAPTER 481, SB 70)κ
Sec. 18. 1. If the district court finds, after proceedings for the assisted outpatient treatment of a person:
(a) That the person professionally qualified in the field of psychiatric mental health who made the sworn statement or declaration pursuant to paragraph (b) of subsection 4 of section 11 of this act or submitted the petition pursuant to section 21 of this act, as applicable, is not able to provide treatment to the person who is the subject of the proceedings in the county where he or she resides or that there is not clear and convincing evidence that the person who is the subject of the proceedings meets the criteria prescribed in subsection 3 of section 11 of this act or subsection 1 of section 21 of this act, as applicable, the court must enter its finding to that effect and the person must not be ordered to receive assisted outpatient treatment.
(b) That the person professionally qualified in the field of psychiatric mental health who made the sworn statement or declaration pursuant to paragraph (b) of subsection 4 of section 11 of this act or submitted the petition pursuant to section 21 of this act, as applicable, is able to provide treatment to the person who is the subject of the proceedings in the county where he or she resides and that there is clear and convincing evidence that the person who is the subject of the proceedings meets the criteria prescribed in subsection 3 of section 11 of this act or subsection 1 of section 21 of this act, as applicable, the court may order the person to receive assisted outpatient treatment. The order of the court must be interlocutory and must not become final if, within 30 days after the issuance of the order, the person is unconditionally released pursuant to NRS 433A.390.
2. If the district court finds, after proceedings for the assisted outpatient treatment of a defendant in a criminal proceeding pursuant to subsection 2 of section 11 of this act:
(a) That the person professionally qualified in the field of psychiatric mental health who made the sworn statement or declaration pursuant to paragraph (b) of subsection 4 of section 11 of this act or submitted the petition pursuant to section 21 of this act, as applicable, is not able to provide treatment to the defendant in the county where he or she resides or that there is not clear and convincing evidence that the defendant meets the criteria prescribed in subsection 3 of section 11 of this act or subsection 1 of section 21 of this act, as applicable, the court must enter its finding to that effect and the defendant must not be ordered to receive assisted outpatient treatment.
(b) That the person professionally qualified in the field of psychiatric mental health who made the sworn statement or declaration pursuant to paragraph (b) of subsection 4 of section 11 of this act or submitted the petition pursuant to section 21 of this act, as applicable, is able to provide treatment to the defendant in the county where he or she resides and that there is clear and convincing evidence that the defendant meets the criteria prescribed in subsection 3 of section 11 of this act or subsection 1 of section 21 of this act, as applicable, except as otherwise provided in this paragraph, the court must order the defendant to receive assisted outpatient treatment and suspend further proceedings in the criminal proceeding against the defendant until the defendant completes the treatment or the treatment is terminated. If the offense allegedly committed by the defendant is a category A or B felony or involved the use or threatened use of force or violence, the court must not order the defendant to receive assisted outpatient treatment pursuant to this paragraph unless the prosecuting attorney stipulates to the assignment.
κ2021 Statutes of Nevada, Page 3075 (CHAPTER 481, SB 70)κ
threatened use of force or violence, the court must not order the defendant to receive assisted outpatient treatment pursuant to this paragraph unless the prosecuting attorney stipulates to the assignment. The order of the court must be interlocutory and must not become final if, within 30 days after the issuance of the order, the person is unconditionally released pursuant to NRS 433A.390. If the defendant successfully completes the assisted outpatient treatment to the satisfaction of the court, the court must dismiss the criminal charges against the defendant with prejudice.
3. An order for a person to receive assisted outpatient treatment must:
(a) Provide for a period of assisted outpatient treatment that does not exceed 6 months unless the order is renewed or extended pursuant to section 21 of this act;
(b) Specify the services that the person who is to be treated must receive; and
(c) Direct the person professionally qualified in the field of psychiatric mental health who made the sworn statement or declaration pursuant to paragraph (b) of subsection 4 of section 11 of this act or submitted the petition pursuant to section 21 of this act, as applicable, to provide the services pursuant to paragraph (b) for the duration of the order.
4. If an order for a person to receive assisted outpatient treatment requires the administration of medication, the order must state the classes of medication and the reasons for ordering the medication, which must be based on the proposed written treatment plan submitted pursuant to section 13 of this act. The order may require the person who is to be treated to self-administer the medication or accept the administration of the medication by a specified person. The court shall not order the use of physical force or restraints to administer medication.
5. An order for a person to receive assisted outpatient treatment must not prescribe treatment that is not recommended by the person professionally qualified in the field of psychiatric mental health who made the sworn statement or declaration pursuant to paragraph (b) of subsection 4 of section 11 of this act or submitted the petition pursuant to section 21 of this act, as applicable.
6. If the court issues an order requiring a person to receive assisted outpatient treatment, 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.
7. A court may periodically review an order for a person to receive assisted outpatient treatment to determine whether there is an available alternative treatment that is the least restrictive treatment that is appropriate for the person, is in the best interest of the person and will not be detrimental to the public welfare.
κ2021 Statutes of Nevada, Page 3076 (CHAPTER 481, SB 70)κ
be detrimental to the public welfare. If the court determines that such a treatment is available, the court must amend the order to require such treatment.
8. As used in this section, National Instant Criminal Background Check System has the meaning ascribed to it in NRS 179A.062.
Secs. 19 and 20. (Deleted by amendment.)
Sec. 20.5. 1. A person professionally qualified in the field of psychiatric mental health who is responsible for providing assisted outpatient treatment to a person ordered by a court to receive assisted outpatient treatment pursuant to section 18 of this act may petition the court to issue an order requiring a peace officer to take into custody and deliver the person to an appropriate location for a prompt evaluation by the professional to determine whether the person is a person in a mental health crisis if:
(a) The person who is the subject of the petition has failed to comply with the plan of assisted outpatient treatment ordered pursuant to section 18 of this act;
(b) The petitioner has made reasonable efforts to solicit such compliance; and
(c) The failure to comply with the plan of assisted outpatient treatment may cause the person who is the subject of the petition to harm himself or herself or others.
2. A petition pursuant to subsection 1 must set forth:
(a) The specific provisions of the plan of assisted outpatient treatment which the subject of the petition has failed to carry out;
(b) The efforts made by the petitioner to solicit compliance; and
(c) The basis for the petitioners belief that the failure to comply with the plan of assisted outpatient treatment may cause the subject of the petition to harm himself or herself or others.
3. If the court determines that there is probable cause to believe that the conditions described in paragraphs (a), (b) and (c) of subsection 1 have been satisfied, the court may issue an order requiring a peace officer to take into custody and deliver the person who is the subject of the petition to an appropriate location for a prompt evaluation by the petitioner to determine whether the person is a person in a mental health crisis.
4. As used in this section, appropriate location means any location identified by a petitioner but does not include a jail or prison.
Sec. 21. 1. Not later than 7 judicial days before the end of a period of assisted outpatient treatment ordered by a court pursuant to section 18 of this act, the Administrator or his or her designee, the medical director of a division facility through which the person who is the subject of the order is receiving assisted outpatient treatment or his or her designee or another person professionally qualified in the field of psychiatric mental health responsible for providing the assisted outpatient treatment may petition to renew the order for assisted outpatient treatment for an additional period that does not exceed 6 months. The petition for renewal must allege that:
(a) Because of his or her mental illness, the person to be treated is unwilling or unlikely to voluntarily participate in outpatient treatment that would enable the person to live safely in the community without the supervision of the court; and
κ2021 Statutes of Nevada, Page 3077 (CHAPTER 481, SB 70)κ
(b) Assisted outpatient treatment is the least restrictive appropriate means to prevent further disability or deterioration that would result in the person to be treated becoming a person in a mental health crisis.
2. A copy of a petition filed pursuant to subsection 1 must be served upon the person who is the subject of the petition or his or her counsel and, if applicable, his or her legal guardian.
3. Upon receiving a petition filed pursuant to subsection 1, the court shall schedule a hearing on the petition pursuant to section 12 of this act. If the order for assisted outpatient treatment that is effective at the time of the petition is scheduled to expire before the hearing, the order is extended and remains in effect until the date of the hearing.
Sec. 22. (Deleted by amendment.)
Sec. 23. NRS 433A.011 is hereby amended to read as follows:
433A.011 As used in this chapter, unless the context otherwise requires, the words and terms defined in NRS 433A.012 to 433A.019, inclusive, and sections 3.5 to 8, inclusive, of this act have the meanings ascribed to them in those sections.
Sec. 23.5. NRS 433A.018 is hereby amended to read as follows:
433A.018 Person professionally qualified in the field of psychiatric mental health means:
1. A psychiatrist licensed to practice medicine in this State ; [who is certified by the American Board of Psychiatry and Neurology;]
2. A psychologist licensed to practice in this State;
3. A social worker who holds a masters degree in social work [,] and is licensed by the State as a clinical social worker ; [and is employed by the Division;]
4. A registered nurse who:
(a) Is licensed to practice professional nursing in this State; and
(b) Holds a masters degree in the field of psychiatric nursing; [and
(c) Is employed by the Division;]
5. A marriage and family therapist licensed pursuant to chapter 641A of NRS; or
6. A clinical professional counselor licensed pursuant to chapter 641A of NRS.
Sec. 24. NRS 433A.019 is hereby amended to read as follows:
433A.019 [Program of community-based or outpatient services] Assisted outpatient treatment means [care, treatment and training] outpatient services provided pursuant to a court order to [persons in a mental health crisis, including, without limitation:
1. A program or service for the treatment of alcohol or other substance use disorders;
2. A program of general education or vocational training;
3. A program or service that assists in the dispensing or monitoring of medication;
4. A program or service that provides counseling or therapy;
5. A service which provides screening tests to detect the presence of alcohol or drugs;
6. A program of supervised living; or
7. Any combination of programs and services for persons with mental illness.
Κ] a person with a mental illness for the purpose of treating the mental illness, assisting the person to live and function in the community or to prevent a relapse or deterioration that may reasonably be predicted to result in harm to the person or another person if the person with a mental illness is not treated.
κ2021 Statutes of Nevada, Page 3078 (CHAPTER 481, SB 70)κ
prevent a relapse or deterioration that may reasonably be predicted to result in harm to the person or another person if the person with a mental illness is not treated. The term does not include [care, treatment and training] services provided to residents of a mental health facility.
Sec. 25. (Deleted by amendment.)
Sec. 26. NRS 433A.130 is hereby amended to read as follows:
433A.130 All applications , [and] certificates and other forms for the detainment, evaluation, admission , treatment and conditional release of any person in the State of Nevada [to a mental health facility or to a program of community-based or outpatient services] under the provisions of this chapter shall be made on forms approved by the Division and the Office of the Attorney General and furnished by the clerks of the district courts in each county.
Sec. 27. NRS 433A.140 is hereby amended to read as follows:
433A.140 1. Any person may apply to:
(a) A public or private mental health facility in the State of Nevada for admission to the facility; or
(b) A division facility to receive care, treatment or training provided by the Division,
Κ as a voluntary consumer for the purposes of observation, diagnosis, care and treatment. In the case of a person who has not attained the age of majority, application for voluntary admission or care, treatment or training may be made on his or her behalf by the persons spouse, parent or legal guardian.
2. If the application is for admission to a division facility, or for care, treatment or training provided by the Division, the applicant must be admitted or provided such services as a voluntary consumer if an examination by personnel of the facility qualified to make such a determination reveals that the person needs and may benefit from services offered by the mental health facility.
3. Any person admitted to a public or private mental health facility as a voluntary consumer must be released immediately after the filing of a written request for release with the responsible physician or that physicians designee within the normal working day, unless the facility changes the status of the person to an emergency admission pursuant to NRS 433A.145. When a person is released pursuant to this subsection, the facility and its agents and employees are not liable for any debts or contractual obligations, medical or otherwise, incurred or damages caused by the actions of the person.
4. Any person admitted to a public or private mental health facility as a voluntary consumer who has not requested release may nonetheless be released by the medical director of the facility when examining personnel at the facility determine that the consumer has recovered or has improved to such an extent that the consumer is not considered a danger to himself or herself or others and that the services of that facility are no longer beneficial to the consumer or advisable.
5. A person who requests care, treatment or training from the Division pursuant to this section must be evaluated by the personnel of the Division to determine whether the person is eligible for the services offered by the Division. The evaluation must be conducted:
(a) Within 72 hours if the person has requested inpatient services; or
(b) Within 72 regular operating hours, excluding weekends and holidays, if the person has requested [community-based or outpatient services.] assisted outpatient treatment.
κ2021 Statutes of Nevada, Page 3079 (CHAPTER 481, SB 70)κ
6. This section does not preclude a public facility from making decisions, policies, procedures and practices within the limits of the money made available to the facility.
Sec. 28. 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 [the hospital or facility receives, before the change in status is made, an application for an emergency admission pursuant to] :
(a) A person described in NRS 433A.160 places the person in a mental health crisis hold; and [the certificate of a]
(b) [psychiatrist, psychologist, physician, physician assistant, clinical social worker or advanced practice registered nurse pursuant to NRS 433A.170.] The requirements prescribed by section 10 of this act have been met.
2. [A] Except as otherwise provided in subsection 3, 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 [change in status is made] 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. 29. NRS 433A.150 is hereby amended to read as follows:
433A.150 1. [Except as otherwise provided in this subsection, a] A person alleged to be a person in a mental health crisis [may, upon application] who is placed on a mental health crisis hold pursuant to NRS 433A.160 [and] may, subject to the provisions of subsection 2, be detained in a public or private mental health facility or hospital [under an emergency admission] for assessment, evaluation, [observation] intervention and treatment, regardless of whether any parent or legal guardian of the person has consented to the [admission.] mental health crisis hold.
2. Except as otherwise provided in subsection 3, a person detained pursuant to subsection 1 must be released within 72 hours, including weekends and holidays, after the [application for emergency admission or any part of such an application is made] 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.
κ2021 Statutes of Nevada, Page 3080 (CHAPTER 481, SB 70)κ
Sec. 30. NRS 433A.160 is hereby amended to read as follows:
433A.160 1. [Except as otherwise provided in subsection 2, an application for the emergency admission of a person alleged to be a person in a mental health crisis for evaluation, observation and treatment may only be made by an] An officer authorized to make arrests in the State of Nevada or a physician, physician assistant, psychologist, marriage and family therapist, clinical professional counselor, social worker or registered nurse [. The officer, physician, physician assistant, psychologist, marriage and family therapist, clinical professional counselor, social worker or registered nurse may:
(a) Without a warrant:
(1) Take] who, based on his or her personal observation of a person or the issuance of a court order pursuant to section 9 of this act, has probable cause to believe that the person is a person [alleged to be a person] in a mental health crisis , may place the person on a mental health crisis hold by:
(a) Taking the person into custody [to apply for the emergency admission of the person for evaluation, observation and treatment; and
(2) Transport the] without a warrant for assessment, evaluation, intervention and treatment at a public or private mental health facility or hospital; and
(b) Completing and providing to the public or private mental health facility or hospital the form prescribed pursuant to NRS 433A.130 for the placement of a person on a mental health crisis hold. The form must set forth the circumstances under which the person was taken into custody and the reasons therefor.
2. A person who places another person on a mental health crisis hold pursuant to subsection 1 may transport that person [alleged to be a person in a mental health crisis] to a public or private mental health facility or hospital [for that purpose,] or arrange for the person to be transported by:
[(I)] (a) A local law enforcement agency;
[(II)] (b) A system for the nonemergency medical transportation of persons whose operation is authorized by the Nevada Transportation Authority;
[(III)] (c) An entity that is exempt pursuant to NRS 706.745 from the provisions of NRS 706.386 or 706.421;
[(IV)] (d) An accredited agent of the Division;
[(V)] (e) A provider of nonemergency secure behavioral health transport services licensed under the regulations adopted pursuant to NRS 433.3317; or
[(VI)] (f) If medically necessary, an ambulance service that holds a permit issued pursuant to the provisions of chapter 450B of NRS . [,
Κ only if the officer, physician, physician assistant, psychologist, marriage and family therapist, clinical professional counselor, social worker or registered nurse, based upon his or her personal observation of the person, has probable cause to believe that the person is a person in a mental health crisis.
(b) Apply to a district court for an order requiring:
(1) Any peace officer to take a person alleged to be a person in a mental health crisis into custody to allow the applicant for the order to apply for the emergency admission of the person for evaluation, observation and treatment; and
κ2021 Statutes of Nevada, Page 3081 (CHAPTER 481, SB 70)κ
(2) Any agency, system, provider, agent or service described in subparagraph (2) of paragraph (a) to transport the person alleged to be a person in a mental health crisis to a public or private mental health facility or hospital for that purpose.
Κ The district court may issue such an order only if it is satisfied that there is probable cause to believe that the person is a person in a mental health crisis.
2. An application for the emergency admission of a person alleged to be a person in a mental health crisis for evaluation, observation and treatment may be made by a spouse, parent, adult child or legal guardian of the person. The spouse, parent, adult child or legal guardian and any other person who has a legitimate interest in the person alleged to be a person in a mental health crisis may apply to a district court for an order described in paragraph (b) of subsection 1.
3. The application for the emergency admission of a person alleged to be a person in a mental health crisis for evaluation, observation and treatment must reveal the circumstances under which the person was taken into custody and the reasons therefor.
4.] 3. To the extent practicable, a person [who applies for the emergency admission of a person who is less than 18 years of age to a public or private mental health facility or hospital, other than a parent or guardian,] described in subsection 1 shall attempt to obtain the consent of the parent or guardian of an unemancipated person who is less than 18 years of age before [making the application.] placing the person on a mental health crisis hold. The person who [applies for the emergency admission] places an unemancipated person who is less than 18 years of age on a mental health crisis hold or, if the person [makes the application] is acting within the scope of his or her employment, the employer of the person, shall maintain documentation of each such attempt until the person who is [the subject of the application] placed on a mental health crisis hold reaches at least 23 years of age.
[5. Except as otherwise provided in this subsection, each person admitted to a public or private mental health facility or hospital under an emergency admission must be evaluated at the time of admission by a psychiatrist or a psychologist. If a psychiatrist or a psychologist is not available to conduct an evaluation at the time of admission, a physician or an advanced practice registered nurse who has the training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120 may conduct the evaluation. Each such emergency admission must be approved by a psychiatrist.
6.] 4. The State Board of Health shall adopt regulations governing the manner in which:
(a) A person may apply to become an accredited agent of the Division; and
(b) Accredited agents of the Division will be monitored and disciplined for professional misconduct.
[7.] 5. As used in this section, an accredited agent of the Division means any person authorized by the Division to transport to a mental health facility pursuant to [subparagraph 2 of] paragraph [(a)] (d) of subsection [1] 2 those persons [in need of emergency admission.] being placed on a mental health crisis hold.
κ2021 Statutes of Nevada, Page 3082 (CHAPTER 481, SB 70)κ
Sec. 31. NRS 433A.165 is hereby amended to read as follows:
433A.165 1. Before a person alleged to be a person in a mental health crisis may be admitted to a public or private mental health facility or hospital under an emergency admission pursuant to [NRS 433A.160,] section 10 of this act, the person must:
(a) First be examined by a licensed physician or physician assistant licensed pursuant to chapter 630 or 633 of NRS or an advanced practice registered nurse licensed pursuant to NRS 632.237 at any location where such a physician, physician assistant or advanced practice registered nurse is authorized to conduct such an examination to determine whether the person has a medical condition, other than a psychiatric condition, which requires immediate treatment; and
(b) If such treatment is required, be admitted for the appropriate medical care:
(1) To a hospital if the person is in need of emergency services or care; or
(2) To another appropriate medical facility if the person is not in need of emergency services or care.
2. If a person alleged to be a person in a mental health crisis has a medical condition in addition to a psychiatric condition which requires medical treatment that requires more than 72 hours to complete, the licensed physician, physician assistant or advanced practice registered nurse who examined the person must:
(a) On the first business day after determining that such medical treatment is necessary, file with the clerk of the district court a written petition [to admit] for the involuntary court-ordered admission of the person to a public or private mental health facility pursuant to NRS [433A.160] 433A.200 after the medical treatment has been completed. The petition must:
(1) Include, without limitation, the medical condition of the person and the purpose for continuing the medical treatment of the person; and
(2) Be accompanied by a copy of [the application for the emergency admission of the person required] :
(I) The form for the placement of a person on a mental health crisis hold completed pursuant to NRS 433A.160 ; and [the]
(II) The certificate [required] completed pursuant to NRS 433A.170 [.] , unless the medical condition prevents the completion of such a certificate.
(b) Seven days after filing a petition pursuant to paragraph (a) and every 7 days thereafter, file with the clerk of the district court an update on the medical condition and treatment of the person.
3. The examination and any transfer of the person from a facility when the person has an emergency medical condition and has not been stabilized must be conducted in compliance with:
(a) The requirements of 42 U.S.C. § 1395dd and any regulations adopted pursuant thereto, and must involve a person authorized pursuant to federal law to conduct such an examination or certify such a transfer; and
(b) The provisions of NRS 439B.410.
4. The cost of the examination must be paid by the county in which the person alleged to be a person in a mental health crisis resides if services are provided at a county hospital located in that county or a hospital or other medical facility designated by that county, unless the cost is voluntarily paid by the person alleged to be a person in a mental health crisis or, on the persons behalf, by his or her insurer or by a state or federal program of medical assistance.
κ2021 Statutes of Nevada, Page 3083 (CHAPTER 481, SB 70)κ
by the person alleged to be a person in a mental health crisis or, on the persons behalf, by his or her insurer or by a state or federal program of medical assistance.
5. The county may recover all or any part of the expenses paid by it, in a civil action against:
(a) The person whose expenses were paid;
(b) The estate of that person; or
(c) A responsible relative as prescribed in NRS 433A.610, to the extent that financial ability is found to exist.
6. The cost of treatment, including hospitalization, for a person who is indigent must be paid pursuant to NRS 428.010 by the county in which the person alleged to be a person in a mental health crisis resides.
7. The provisions of this section do not require the Division to provide examinations required pursuant to subsection 1 at a division facility if the Division does not have the:
(a) Appropriate staffing levels of physicians, physician assistants, advanced practice registered nurses or other appropriate staff available at the facility as the Division determines is necessary to provide such examinations; or
(b) Appropriate medical laboratories as the Division determines is necessary to provide such examinations.
8. The State Board of Health shall adopt regulations to carry out the provisions of this section, including, without limitation, regulations that:
(a) Define emergency services or care as that term is used in this section;
(b) Prescribe a procedure to ensure that an examination is performed pursuant to paragraph (a) of subsection 1; and
(c) Prescribe the type of medical facility that a person may be admitted to pursuant to subparagraph (2) of paragraph (b) of subsection 1.
9. As used in this section, medical facility has the meaning ascribed to it in NRS 449.0151.
Sec. 32. NRS 433A.170 is hereby amended to read as follows:
433A.170 Except as otherwise provided in this section, the administrative officer of a facility operated by the Division or of any other public or private mental health facility or hospital shall not accept [an application] a person for an emergency admission under [NRS 433A.160] section 10 of this act unless [that application is accompanied by a certificate of] a [licensed] psychologist, a physician, 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 , completes a certificate stating that he or she has examined the person alleged to be a person in a mental health crisis and that he or she has concluded that the person is a person in a mental health crisis. The certificate required by this section may be obtained from a [licensed] psychologist, physician, physician assistant, clinical social worker or advanced practice registered nurse who is employed by the public or private mental health facility or hospital to which the [application is made.] person alleged to be a person in a mental health crisis is to be admitted.
κ2021 Statutes of Nevada, Page 3084 (CHAPTER 481, SB 70)κ
Sec. 33. NRS 433A.185 is hereby amended to read as follows:
433A.185 As soon as practicable but not more than [24] 8 hours after [the emergency admission of a person alleged to be a] an unemancipated person [in a mental health crisis] who is under 18 years of age [,] is placed on a mental health crisis hold, the administrative officer of the public or private mental health facility or hospital in which the person is being held or his or her designee shall attempt to give notice of [such admission] the mental health crisis hold in person, by telephone or facsimile and by certified mail to the parent or legal guardian of that person [.] and shall maintain documentation of each such attempt until the person who is placed on a mental health crisis hold reaches at least 23 years of age.
Sec. 34. NRS 433A.190 is hereby amended to read as follows:
433A.190 1. The administrative officer of a public or private mental health facility or hospital shall ensure that, within 24 hours of the emergency admission of a person alleged to be a person in a mental health crisis [pursuant to NRS 433A.150] who is at least 18 years of age, pursuant to section 10 of this act, the person is asked to give permission to provide notice of the emergency admission to a family member, friend or other person identified by the person.
2. If a person alleged to be a person in a mental health crisis who is at least 18 years of age gives permission to notify a family member, friend or other person of the emergency admission, the administrative officer shall ensure that:
(a) The permission is recorded in the medical record of the person; and
(b) Notice of the admission is promptly provided to the family member, friend or other person in person or by telephone, facsimile, other electronic communication or certified mail.
3. Except as otherwise provided in subsections 4 and 5, if a person alleged to be a person in a mental health crisis who is at least 18 years of age does not give permission to notify a family member, friend or other person of the emergency admission of the person, notice of the emergency admission must not be provided until permission is obtained.
4. If a person alleged to be a person in a mental health crisis who is at least 18 years of age is not able to give or refuse permission to notify a family member, friend or other person of the emergency admission, the administrative officer of the mental health facility or hospital may cause notice as described in paragraph (b) of subsection 2 to be provided if the administrative officer determines that it is in the best interest of the person in a mental health crisis.
5. If a guardian has been appointed for a person alleged to be a person in a mental health crisis who is at least 18 years of age or the person has executed a durable power of attorney for health care pursuant to NRS 162A.700 to 162A.870, inclusive, or appointed an attorney-in-fact using an advance directive for psychiatric care pursuant to NRS 449A.600 to 449A.645, inclusive, the administrative officer of the mental health facility or hospital must ensure that the guardian, agent designated by the durable power of attorney or the attorney-in-fact, as applicable, is promptly notified of the admission as described in paragraph (b) of subsection 2, regardless of whether the person alleged to be a person in a mental health crisis has given permission to the notification.
κ2021 Statutes of Nevada, Page 3085 (CHAPTER 481, SB 70)κ
Sec. 35. NRS 433A.195 is hereby amended to read as follows:
433A.195 1. A licensed physician on the medical staff of a facility operated by the Division or of any other public or private mental health facility or hospital may release a person [admitted pursuant to NRS 433A.160] from a mental health crisis hold upon completion of a certificate which meets the requirements of NRS 433A.197 signed by a licensed physician on the medical staff of the facility or hospital, a physician assistant under the supervision of a psychiatrist, psychologist, 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 personally observed and examined the person and that he or she has concluded that the person is not a person in a mental health crisis.
2. A psychologist, a physician, 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 on the medical staff of a facility operated by the Division or of any other public or private mental health facility or hospital who has personally assessed an unemancipated person who is less than 18 years of age after the person was placed on a mental health crisis hold may release the person from the hold if the parent or guardian of the person agrees to treatment or accepts physical custody of the person.
Sec. 35.5. NRS 433A.197 is hereby amended to read as follows:
433A.197 1. [An application] A form or certificate authorized under subsection 1 of NRS 433A.160 or NRS 433A.170 or 433A.195 must not be accepted or considered if made by a psychologist, physician, physician assistant, clinical social worker or advanced practice registered nurse who is related by blood or marriage within the second degree of consanguinity or affinity to the person alleged to be a person in a mental health crisis, or who is financially interested in the facility in which the person alleged to be a person in a mental health crisis is to be detained.
2. An application or certificate of any examining person authorized under NRS 433A.170 must not be considered unless it is based on personal observation and examination of the person alleged to be a person in a mental health crisis made by such examining person not more than 72 hours prior to the making of the application or certificate. The certificate required pursuant to NRS 433A.170 must set forth in detail the facts and reasons on which the examining person based his or her opinions and conclusions.
3. A certificate authorized pursuant to NRS 433A.195 must not be considered unless it is based on personal observation and examination of the person alleged to be a person in a mental health crisis made by the examining physician, physician assistant, psychologist, clinical social worker or advanced practice registered nurse. The certificate authorized pursuant to NRS 433A.195 must describe in detail the facts and reasons on which the examining physician, physician assistant, psychologist, clinical social worker or advanced practice registered nurse based his or her opinions and conclusions.
κ2021 Statutes of Nevada, Page 3086 (CHAPTER 481, SB 70)κ
Sec. 36. NRS 433A.200 is hereby amended to read as follows:
433A.200 1. Except as otherwise provided in [subsection 3 and] NRS 432B.6075, 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 [or to a program of community-based or outpatient services] 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 [the spouse, parent, adult children or legal guardian of the person to be treated or 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 [licensed] 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
(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
[(2) The] the person alleged to be a person in a mental health crisis has refused to submit to examination or treatment by a physician, psychiatrist, [licensed] 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, if the person to be treated is [a] 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.
[3. A proceeding for the involuntary court-ordered admission of a person who is the defendant in a criminal proceeding in the district court to a program of community-based or outpatient services may be commenced by the district court, on its own motion, or by motion of the defendant or the district attorney if:
(a) The defendant has been examined in accordance with NRS 178.415;
(b) The defendant is not eligible for commitment to the custody of the Administrator pursuant to NRS 178.461; and
κ2021 Statutes of Nevada, Page 3087 (CHAPTER 481, SB 70)κ
(c) The Division makes a clinical determination that placement in a program of community-based or outpatient services is appropriate.]
Sec. 37. NRS 433A.210 is hereby amended to read as follows:
433A.210 In addition to the requirements of NRS 433A.200, a petition filed pursuant to that section with the clerk of the district court to commence proceedings for involuntary court-ordered admission of a person pursuant to NRS 433A.145 or 433A.150 must include documentation of the results of the medical examination conducted pursuant to NRS 433A.165 and a [certified] copy of:
1. The [application for the emergency admission of the person made] form for the placement of the person on a mental health crisis hold pursuant to NRS 433A.160; and
2. A petition executed by a psychiatrist, [licensed] psychologist, physician or advanced practice registered nurse who has the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120, including, without limitation, a sworn statement that:
(a) He or she has examined the person alleged to be a person in a mental health crisis;
(b) In his or her opinion, there is a reasonable degree of certainty that the person alleged to be a person in a mental health crisis suffers from a mental illness;
(c) Based on his or her personal observation of the person alleged to be a person in a mental health crisis and other facts set forth in the petition, the person presents a substantial risk of serious harm to himself or herself or others, as determined pursuant to NRS 433A.0195; and
(d) In his or her opinion, involuntary admission of the person alleged to be a person in a mental health crisis to a mental health facility or hospital is medically necessary to prevent the person from harming himself or herself or others.
Sec. 38. NRS 433A.215 is hereby amended to read as follows:
433A.215 If an application for a writ of habeas corpus is made by, or on behalf of, a person in a mental health crisis or who is alleged to be a person in a mental health crisis before the initial hearing on a petition for the involuntary court-ordered admission of the person to a mental health facility , [or a program of community-based or outpatient services,] the court [shall] must conduct a hearing on the application as soon as practicable.
Sec. 39. NRS 433A.220 is hereby amended to read as follows:
433A.220 1. Immediately after the clerk of the district court receives any petition filed pursuant to NRS 433A.200 and 433A.210, the clerk shall transmit the petition to the appropriate district judge, who shall set a time, date and place for its hearing. [Immediately after a motion is made pursuant to subsection 3 of NRS 433A.200, the district judge shall set a time, date and place for its hearing.] The date must be within 6 judicial days after the date on which the petition is received by the clerk [or the motion is made, as applicable,] unless otherwise stipulated by an attorney representing the person alleged to be a person in a mental health crisis and the district attorney. If the Chief Judge, if any, of the district court has assigned a district court judge or hearing master to preside over such hearings, that judge or hearing master must preside over the hearing.
2. The court shall give notice of the petition [or motion] and of the time, date and place of any proceedings thereon to the subject of the petition , [or motion,] his or her attorney, if known, the persons legal guardian, the petitioner, [if applicable,] the district attorney of the county in which the court has its principal office, the local office of an agency or organization that receives money from the Federal Government pursuant to 42 U.S.C.
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petitioner, [if applicable,] the district attorney of the county in which the court has its principal office, the local office of an agency or organization that receives money from the Federal Government pursuant to 42 U.S.C. §§ 10801 et seq., to protect and advocate the rights of persons in a mental health crisis and the administrative office of any public or private mental health facility or hospital in which the subject of the petition [or motion] is detained.
3. The provisions of this section do not preclude a facility or hospital from discharging a person before the time set pursuant to this section for the hearing concerning the person, if appropriate. If the person has a legal guardian, the facility or hospital shall notify the guardian prior to discharging the person from the facility [.] or hospital. The legal guardian has discretion to determine where the person will be released, taking into consideration any discharge plan proposed by the facility or hospital assessment team. If the legal guardian does not inform the facility or hospital as to where the person will be released within 3 days after the date of notification, the facility or hospital shall discharge the person according to its proposed discharge plan. Notification of a guardian pursuant to this subsection must be provided:
(a) In person or by telephone; or
(b) If the mental health facility is not able to contact the guardian in person or by telephone, by facsimile, electronic mail or certified mail.
4. If the person who is the subject of the petition is currently admitted to a mental health facility or hospital and is transferred to another mental health facility or hospital, the petitioner must notify the court before the next scheduled hearing related to the petition and not more than 24 hours after the transfer.
5. If the person who is the subject of the petition is currently on conditional release pursuant to NRS 433A.380:
(a) The court may provide information on the conditional release to any public or private mental health facility or hospital in which the person is receiving treatment; and
(b) The court may, with the consent of the parties, set a hearing before or concurrent with the hearing scheduled pursuant to subsection 1 to determine whether conditional release remains appropriate. If the court sets a hearing to resolve the conditional release, the parties may stipulate to continue the matter of the petition for involuntary court-ordered admission pending resolution of the conditional release. If the court determines by clear and convincing evidence that conditional release is no longer appropriate, the court may order the admission of the person to a mental health facility or hospital pending the resolution of the petition for involuntary court-ordered admission.
Sec. 40. NRS 433A.240 is hereby amended to read as follows:
433A.240 1. After the filing of a petition to commence proceedings for the involuntary court-ordered admission of a person pursuant to NRS 433A.200 and 433A.210, the court shall promptly cause two or more physicians, [licensed] psychologists or advanced practice registered nurses who have the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120, one of whom must always be a physician, to examine the person alleged to be a person in a mental health crisis, or request an evaluation by an evaluation team from the Division of the person alleged to be a person in a mental health crisis.
κ2021 Statutes of Nevada, Page 3089 (CHAPTER 481, SB 70)κ
2. Subject to the provisions in subsection 1, the judge assigned to hear a proceeding brought pursuant to NRS 433A.200 to 433A.330, inclusive, shall have complete discretion in selecting the medical professionals to conduct the examination required pursuant to subsection 1.
3. [After the filing of a motion pursuant to subsection 3 of NRS 433A.200, the court shall promptly request an evaluation by an evaluation team from the Division of the person alleged to be a person in a mental health crisis.
4.] To conduct the examination of a person who is not being detained at a mental health facility or hospital under [emergency admission] a mental health crisis hold pursuant to [an application made pursuant to] NRS 433A.160, the court may order a peace officer to take the person into protective custody and transport the person to a mental health facility or hospital where the person may be detained until a hearing is had upon the petition or motion, as applicable.
[5.] 4. If the person is not being detained under [an emergency admission] a mental health crisis hold pursuant to [an application made pursuant to] NRS 433A.160, the person may be allowed to remain in his or her home or other place of residence pending an ordered examination or examinations and to return to his or her home or other place of residence upon completion of the examination or examinations. The person may be accompanied by one or more of his or her relations or friends to the place of examination.
[6.] 5. Each physician, [licensed] psychologist and advanced practice registered nurse who examines a person pursuant to subsection 1 [or 3] shall, in conducting such an examination, consider the least restrictive treatment appropriate for the person.
[7.] 6. Each physician, [licensed] psychologist and advanced practice registered nurse who examines a person pursuant to subsection 1 shall, not later than 24 hours before the hearing set pursuant to subsection 1 of NRS 433A.220, submit to the court in writing a summary of his or her findings and evaluation regarding the person alleged to be a person in a mental health crisis.
Sec. 41. NRS 433A.250 is hereby amended to read as follows:
433A.250 1. The Administrator shall establish such evaluation teams as are necessary to aid the courts under NRS 433A.240 [,] and 433A.310 . [, 433A.315 and 433A.323.]
2. Each team must be composed of a psychiatrist and other persons professionally qualified in the field of psychiatric mental health who are representative of the Division, selected from personnel in the Division.
3. Fees for the evaluations must be established and collected as set forth in NRS 433.414 or 433B.260, as appropriate.
Sec. 41.5. NRS 433A.260 is hereby amended to read as follows:
433A.260 1. [In counties] If a petition is filed pursuant NRS 433A.200 with the clerk of the district court in a county where the examining personnel required pursuant to NRS 433A.240 are not available, [proceedings for involuntary court-ordered admission shall be conducted in] the district court must transfer the case to the nearest county having such examining personnel available [in order that there be minimum delay.] before any hearing on the petition and not later than 1 judicial day after the petition was filed. Not later than 6 days after a case is transferred to a district court pursuant to this subsection, that district court shall:
κ2021 Statutes of Nevada, Page 3090 (CHAPTER 481, SB 70)κ
(a) Set a time, date and place for its hearing in accordance with NRS 433A.220; and
(b) Appoint counsel for the person, if required by NRS 433A.270.
2. The entire expense of proceedings for involuntary court-ordered admission shall be paid by the county [in which the application is filed, except that] where the person to be admitted [last resided in another county of the state the expense shall be charged to and payable by such county of residence.] resides.
Sec. 42. NRS 433A.270 is hereby amended to read as follows:
433A.270 1. The person alleged to be a person in a mental health crisis or any relative or friend on the persons behalf is entitled to retain counsel to represent the person in any proceeding before the district court relating to involuntary court-ordered admission, and if he or she fails or refuses to obtain counsel, the court [shall] must advise the person and the persons guardian or next of kin, if known, of such right to counsel and shall appoint counsel, who may be the public defender or his or her deputy.
2. [Any] The court shall award any counsel appointed pursuant to subsection 1 [must be awarded] compensation [by the court] for his or her services in an amount determined by it to be fair and reasonable. The compensation must be charged against the estate of the person for whom the counsel was appointed or, if the person is indigent, against the county where the person alleged to be a person in a mental health crisis last resided.
3. The court shall, at the request of counsel representing the person alleged to be a person in a mental health crisis in proceedings before the court relating to involuntary court-ordered admission, grant a recess in the proceedings for the shortest time possible, but for not more than 5 days, to give the counsel an opportunity to prepare his or her case.
4. [If the person alleged to be a person in a mental health crisis is involuntarily admitted to a program of community-based or outpatient services, counsel shall continue to represent the person until the person is released from the program. The court shall serve notice upon such counsel of any action that is taken involving the person while the person is admitted to the program of community-based or outpatient services.
5.] Each district attorney or his or her deputy shall appear and represent the State in all involuntary court-ordered admission proceedings in the district attorneys county. The district attorney is responsible for the presentation of evidence, if any, in support of the involuntary court-ordered admission of a person to a mental health facility [or to a program of community-based or outpatient services] in proceedings held pursuant to NRS 433A.200 and 433A.210.
Sec. 43. NRS 433A.310 is hereby amended to read as follows:
433A.310 1. Except as otherwise provided in [subsection 2 and] NRS 432B.6076 and 432B.6077, 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 [shall] must enter its finding to that effect and the person must not be involuntarily admitted to a public or private mental health facility . [or to a program of community-based or outpatient services.] If the person has been [admitted to] 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.160,] section 10 of this act, 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.
κ2021 Statutes of Nevada, Page 3091 (CHAPTER 481, SB 70)κ
emergency admission pursuant to [NRS 433A.160,] section 10 of this act, 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 [for the most appropriate course of treatment, including, without limitation, admission] to a public or private mental health facility . [or participation in a program of community-based or outpatient services.] 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. [If the district court finds, after proceedings for the involuntary court-ordered admission of a defendant in a criminal proceeding pursuant to subsection 3 of NRS 433A.200:
(a) That there is not clear and convincing evidence that the defendant with respect to whom the hearing was held is a person in a mental health crisis, the court shall enter its finding to that effect and the person must not be involuntarily admitted to a program of community-based or outpatient services.
(b) That there is clear and convincing evidence that the defendant with respect to whom the hearing was held is a person in a mental health crisis, except as otherwise provided in this paragraph, the court shall order the involuntary admission of the defendant for participation in a program of community-based or outpatient services and suspend further proceedings in the criminal proceeding against the defendant until the defendant completes or is removed from the program. If the offense allegedly committed by the defendant is a category A or B felony or involved the use or threatened use of force or violence, the court may not order the involuntary admission of the defendant for participation in a program pursuant to this paragraph unless the prosecuting attorney stipulates to the assignment. 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. If the defendant successfully completes a program of community-based or outpatient services to the satisfaction of the court, the court shall dismiss the criminal charges against the defendant with prejudice.
3. If, pursuant to NRS 176A.400, the district court issues an order granting probation to a defendant in a criminal proceeding with a condition that the defendant submit to mental health treatment and comply with instructions, admission to a program of community-based or outpatient services may be used to satisfy such a condition if the Division makes a clinical determination that placement in a program of community-based or outpatient services is appropriate.
4. A court shall not admit a person to a program of community-based or outpatient services unless:
(a) A program of community-based or outpatient services is available in the community in which the person resides or is otherwise made available to the person;
(b) The person is 18 years of age or older;
κ2021 Statutes of Nevada, Page 3092 (CHAPTER 481, SB 70)κ
(c) The person has a history of noncompliance with treatment for mental illness;
(d) The person is capable of surviving safely in the community in which he or she resides with available supervision;
(e) The court determines that, based on the persons history of treatment for mental illness, the person needs to be admitted to a program of community-based or outpatient services to prevent further disability or deterioration of the person which presents a substantial likelihood of serious harm to himself or herself or others, as determined pursuant to NRS 433A.0195;
(f) The current mental status of the person or the nature of the persons illness limits or negates his or her ability to make an informed decision to seek treatment for mental illness voluntarily or to comply with recommended treatment for mental illness;
(g) The program of community-based or outpatient services is the least restrictive treatment which is in the best interest of the person; and
(h) The court has approved a plan of treatment developed for the person pursuant to NRS 433A.315.
5.] Except as otherwise provided in NRS 432B.608, an involuntary admission pursuant to paragraph (b) of subsection 1 [or paragraph (b) of subsection 2] 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 [2] 3 of NRS 433A.390 . [or by the professional responsible for providing or coordinating the program of community-based or outpatient services as provided for in subsection 3 of NRS 433A.390.] Except as otherwise provided in NRS 432B.608, at the end of the involuntary court-ordered [period of treatment,] admission, the Division [,] or any mental health facility that is not operated by the Division [or a program of community-based or outpatient services] may petition to renew the involuntary admission of 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 [or 2] that was required for the initial period of admission of the person to a public or private mental health facility . [or to a program of community-based or outpatient services.
6.] 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 [involuntary admission to a program of community-based or outpatient services,] 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.
[7.] 4. If the court issues an order involuntarily admitting a person to a public or private mental health facility [or to a program of community-based or outpatient services] pursuant to this section, the court [shall,] 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:
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(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.
[8.] 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. 44. NRS 433A.320 is hereby amended to read as follows:
433A.320 The order for involuntary [court] court-ordered admission of any person to a public or private mental health facility [or to a program of community-based or outpatient services] must be accompanied by a clinical abstract, including a history of illness, diagnosis, treatment and the names of relatives or correspondents.
Sec. 45. NRS 433A.350 is hereby amended to read as follows:
433A.350 1. Upon admission to any public or private mental health facility or to [a program of community-based or outpatient services,] assisted outpatient treatment, each consumer and the consumers spouse and legal guardian, if any, must receive a written statement outlining in simple, nontechnical language all procedures for release provided by this chapter, setting out all rights accorded to such a consumer by this chapter and chapters 433 and 433B of NRS and, if the consumer has no legal guardian, describing procedures provided by law for adjudication of incapacity and appointment of a guardian for the consumer.
2. Written information regarding the services provided by and means of contacting the local office of an agency or organization that receives money from the Federal Government pursuant to 42 U.S.C. §§ 10801 et seq., to protect and advocate the rights of persons in a mental health crisis must be posted in each public and private mental health facility and in each location in which [a program of community-based or outpatient services] assisted outpatient treatment is provided and must be provided to each consumer upon admission.
Sec. 46. NRS 433A.360 is hereby amended to read as follows:
433A.360 1. A clinical record for each consumer must be diligently maintained by any division facility, private institution, facility offering mental health services or [program of community-based or outpatient services.] person professionally qualified in the field of psychiatric mental health responsible for providing assisted outpatient treatment. The record must include information pertaining to the consumers admission, legal status, treatment and individualized plan for habilitation. The clinical record is not a public record and no part of it may be released, except as otherwise provided in subsection 2 or except:
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(a) If the release is authorized or required pursuant to NRS 439.538.
(b) The record must be released to physicians, advanced practice registered nurses, attorneys and social agencies as specifically authorized in writing by the consumer, the consumers parent, guardian or attorney.
(c) The record must be released to persons authorized by the order of a court of competent jurisdiction.
(d) The record or any part thereof may be disclosed to a qualified member of the staff of a division facility, an employee of the Division or a member of the staff of an agency in Nevada which has been established pursuant to the Developmental Disabilities Assistance and Bill of Rights Act of 2000, 42 U.S.C. §§ 15001 et seq., or the Protection and Advocacy for Mentally Ill Individuals Act of 1986, 42 U.S.C. §§ 10801 et seq., when the Administrator deems it necessary for the proper care of the consumer.
(e) Information from the clinical records may be used for statistical and evaluative purposes if the information is abstracted in such a way as to protect the identity of individual consumers.
(f) To the extent necessary for a consumer to make a claim, or for a claim to be made on behalf of a consumer for aid, insurance or medical assistance to which the consumer may be entitled, information from the records may be released with the written authorization of the consumer or the consumers guardian.
(g) The record must be released without charge to any member of the staff of an agency in Nevada which has been established pursuant to 42 U.S.C. §§ 15001 et seq. or 42 U.S.C. §§ 10801 et seq. if:
(1) The consumer is a consumer of that office and the consumer or the consumers legal representative or guardian authorizes the release of the record; or
(2) A complaint regarding a consumer was received by the office or there is probable cause to believe that the consumer has been abused or neglected and the consumer:
(I) Is unable to authorize the release of the record because of the consumers mental or physical condition; and
(II) Does not have a guardian or other legal representative or is a ward of the State.
(h) The record must be released as provided in NRS 433.332 or 433B.200 and in chapter 629 of NRS.
2. A division facility, private institution, facility offering mental health services or [program of community-based or outpatient services] person professionally qualified in the field of psychiatric mental health responsible for providing assisted outpatient treatment and any other person or entity having information concerning a consumer, including, without limitation, a clinical record, any part thereof or any information contained therein, may disclose such information to a provider of health care to assist with treatment provided to the consumer.
3. As used in this section [:
(a) Consumer includes any person who seeks, on the persons own or others initiative, and can benefit from, care, treatment and training in a private institution or facility offering mental health services, from treatment to competency in a private institution or facility offering mental health services, or from a program of community-based or outpatient services.
(b) Provider] , provider of health care has the meaning ascribed to it in NRS 629.031.
κ2021 Statutes of Nevada, Page 3095 (CHAPTER 481, SB 70)κ
Sec. 47. NRS 433A.380 is hereby amended to read as follows:
433A.380 1. [Except as otherwise provided in subsection 4, any] Any person involuntarily admitted by a court may be conditionally released from a public or private mental health facility when, in the judgment of the medical director of the facility [, the] :
(a) The conditional release is in the best interest of the person , will provide the least restrictive treatment that is appropriate for the person and will not be detrimental to the public welfare [.] ;
(b) A community treatment program, social services agency, mobile crisis team or multi-disciplinary team has agreed to provide case management, support and supervision to the person to ensure his or her compliance with the conditions of the release; and
(c) The person qualifies to receive case management, support and supervision from the community treatment program, social services agency, mobile crisis team or multi-disciplinary team.
2. The medical director of the facility or the medical directors designee shall prescribe the period for which the conditional release is effective. The period must not extend beyond the last day of the court-ordered period of [treatment] admission pursuant to NRS 433A.310. If the person has a legal guardian, the facility [shall] must notify the guardian at least 3 days before discharging the person from the facility [.] or, if the person will be released in less than 3 days, as soon as practicable. Notification of the legal guardian must be provided:
(a) In person or by telephone; or
(b) If the facility is not able to contact the guardian in person or by telephone, by facsimile, electronic mail or certified mail.
3. The legal guardian has discretion to determine where the person 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 person will be released within 3 days after the date of notification, the facility [shall] must discharge the person according to its proposed discharge plan.
[2.] 4. Before conditionally releasing a person from a public or private mental health facility pursuant to this section, the medical director of the facility must notify the court that ordered the involuntary admission. The court may periodically review the appropriateness of the conditional release and the terms thereof, but the court may not terminate the conditional release except through proceedings for involuntary admission pursuant to NRS 433A.200 to 433A.330, inclusive.
5. When a person is conditionally released pursuant to [subsection 1,] this section, the State or any of its agents or employees are not liable for any debts or contractual obligations, medical or otherwise, incurred or damages caused by the actions of the person.
[3.] 6. When a person who has been adjudicated by a court to be incapacitated is conditionally released from a mental health facility, the administrative officer of the mental health facility shall petition the court for restoration of full civil and legal rights as deemed necessary to facilitate the incapacitated persons rehabilitation. If the person has a legal guardian, the petition must be filed with the court having jurisdiction over the guardianship.
[4. A person who was involuntarily admitted by a court because he or she was likely to present a substantial likelihood of serious harm to himself or herself or others, as determined pursuant to NRS 433A.0195, may be conditionally released only if, at the time of the release, written notice is given to the court which admitted him or her, to the persons legal guardian and to the district attorney of the county in which the proceedings for admission were held.
κ2021 Statutes of Nevada, Page 3096 (CHAPTER 481, SB 70)κ
or herself or others, as determined pursuant to NRS 433A.0195, may be conditionally released only if, at the time of the release, written notice is given to the court which admitted him or her, to the persons legal guardian and to the district attorney of the county in which the proceedings for admission were held.
5. Except as otherwise provided in subsection 7, the administrative officer of a public or private mental health facility or the administrative officers designee shall order a person who is conditionally released from that facility pursuant to this section to return to the facility if a psychiatrist and a member of that persons treatment team who is professionally qualified in the field of psychiatric mental health determine that the conditional release is no longer appropriate because that person presents a substantial likelihood of serious harm to himself or herself or others, as determined pursuant to NRS 433A.0195. Except as otherwise provided in this subsection, the administrative officer or the designee shall, at least 3 days before the issuance of the order to return, give written notice of the order to the court that admitted the person to the facility and to the persons legal guardian. If an emergency exists in which the person presents a substantial likelihood of harm to himself or herself or others, as determined pursuant to NRS 433A.0195, the order must be submitted to the court and the legal guardian not later than 1 business day after the order is issued.
6. The court shall review an order submitted pursuant to subsection 5 and the current condition of the person who was ordered to return to the facility at its next regularly scheduled hearing for the review of petitions for involuntary court-ordered admissions, but in no event later than 5 judicial days after the person is returned to the facility. The administrative officer or the administrative officers designee shall give written notice to the person who was ordered to return to the facility, to the persons legal guardian and to the persons attorney, if known, of the time, date and place of the hearing and of the facts necessitating that persons return to the facility.
7. The provisions of subsection 5 do not apply if the period of conditional release has expired.]
Sec. 48. NRS 433A.390 is hereby amended to read as follows:
433A.390 1. When a consumer, involuntarily admitted to a mental health facility or [to a program of community-based or outpatient services] required to receive assisted outpatient treatment by court order, is released at the end of the period specified pursuant to NRS 433A.310 [,] or section 18 of this act, as applicable, written notice must be given to the [admitting] court [and to the consumers legal guardian at least 10] that issued the order not later than 3 judicial days [before] after the release of the consumer. The consumer may [then] be released without requiring further orders of the court. If the consumer has a legal guardian, the facility or the [professional] person professionally qualified in the field of psychiatric mental health responsible for providing [or coordinating] the [program of community-based or outpatient services] 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 [program.] 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 .
κ2021 Statutes of Nevada, Page 3097 (CHAPTER 481, SB 70)κ
[or the professional responsible for providing or coordinating the program of community-based or outpatient services.] If the legal guardian does not inform the facility [or professional] as to where the consumer will be released within 3 days after the date of notification, the facility [or professional shall] must discharge the consumer according to its proposed discharge plan.
[2.] 3. A consumer who is involuntarily admitted to a mental health facility may be unconditionally released before the period specified in NRS 433A.310 when [:
(a) An evaluation team established under NRS 433A.250 or two persons professionally qualified in the field of psychiatric mental health, at least one of them being a] 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 . [; and
(b) Under advisement from the evaluation team or two persons professionally qualified in the field of psychiatric mental health, at least one of them being a physician, the medical director of the mental health facility authorizes the release and gives written notice to the admitting court and to the consumers legal guardian at least 10 days before the release of the consumer.] 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.
[3.] 4. A consumer who is [involuntarily admitted to a program of community-based or outpatient services] required to receive assisted outpatient treatment may be unconditionally released before the period specified in [NRS 433A.310] section 18 of this act when [:
(a) The professional] the person professionally qualified in the field of psychiatric mental health responsible for providing [or coordinating] the [program of community-based or outpatient services] assisted outpatient treatment for the consumer determines that [the consumer is no longer a person in a mental health crisis; and
(b) Under advisement from an evaluation team established under NRS 433A.250 or two persons professionally qualified in the field of psychiatric mental health, at least one of them being a physician, the professional responsible for providing or coordinating the program of community-based or outpatient services for the consumer authorizes the release and gives written notice to the admitting court at least 10 days before the release of the consumer from the program.] :
(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;
κ2021 Statutes of Nevada, Page 3098 (CHAPTER 481, SB 70)κ
(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.
Sec. 48.5. NRS 433A.400 is hereby amended to read as follows:
433A.400 1. An indigent resident of this state discharged as having been determined to no longer be a person in a mental health crisis, but having a residual medical or surgical disability which prevents him or her from obtaining or holding remunerative employment, must be returned to the county of his or her last residence, except as otherwise provided pursuant to subsections 2 and 3. A nonresident indigent with such disabilities must be returned to the county from which he or she was involuntarily court-admitted, except as otherwise provided in subsections 2 and 3. The administrative officer of the mental health facility shall first give notice in writing, not less than 10 days before discharge, to the board of county commissioners of the county to which the person will be returned and to the persons legal guardian.
2. Delivery of the indigent person must be made to an individual or agency authorized to provide further care. If the person has a legal guardian, the facility shall notify the guardian before discharging the person from the facility. The legal guardian has discretion to determine where the person 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 person will be released within 3 days after the date of notification, the facility shall discharge the person according to its proposed discharge plan. Notification of a guardian pursuant to this subsection must be provided:
(a) In person or by telephone; or
(b) If the mental health facility is not able to contact the guardian in person or by telephone, by facsimile, electronic mail or certified mail.
κ2021 Statutes of Nevada, Page 3099 (CHAPTER 481, SB 70)κ
3. An indigent person may be delivered to a state that is a party to the Interstate Compact on Mental Health ratified and enacted in NRS 433.4543 regardless of residency in the manner provided in the Compact.
4. This section does not authorize the release of any person held upon an order of a court or judge having criminal jurisdiction arising out of a criminal offense.
Sec. 49. NRS 433A.460 is hereby amended to read as follows:
433A.460 No person admitted to a public or private mental health facility or [to a program of community-based or outpatient services] who receives assisted outpatient treatment pursuant to this chapter shall, by reason of such admission [,] or treatment, be denied the right to dispose of property, marry, execute instruments, make purchases, enter into contractual relationships, vote and hold a drivers license, unless such person has been specifically adjudicated incapacitated by a court of competent jurisdiction and has not been restored to legal capacity.
Sec. 50. NRS 433A.580 is hereby amended to read as follows:
433A.580 No person may be admitted or transferred to a private hospital [,] or a division mental health facility [or a program of community-based or outpatient services] , ordered to receive assisted outpatient treatment or transferred to a different person professionally qualified in the field of psychiatric mental health to provide assisted outpatient treatment pursuant to the provisions of this chapter unless mutually agreeable financial arrangements relating to the costs of treatment are made between the private hospital, division facility or [professional] person professionally qualified in the field of psychiatric mental health responsible for providing [or coordinating a program of community-based or outpatient services] assisted outpatient treatment and the consumer or person requesting his or her admission.
Sec. 51. NRS 433A.600 is hereby amended to read as follows:
433A.600 1. A person who is admitted to a division facility or [to a program of community-based or outpatient services] who receives assisted outpatient treatment operated by the Division and not determined to be indigent and every responsible relative pursuant to NRS 433A.610 of the person shall be charged for the cost of treatment and is liable for that cost. If after demand is made for payment the person or his or her responsible relative fails to pay that cost, the administrative officer or [professional] person professionally qualified in the field of psychiatric mental health responsible for providing [or coordinating] the [program of community-based or outpatient services,] assisted outpatient treatment, as applicable, may recover the amount due by civil action.
2. All sums received pursuant to subsection 1 must be deposited in the State Treasury and may be expended by the Division for the support of that facility or [program] of assisted outpatient treatment in accordance with the allotment, transfer, work program and budget provisions of NRS 353.150 to 353.245, inclusive.
Sec. 52. NRS 433A.640 is hereby amended to read as follows:
433A.640 1. Once a court has ordered the admission of a person to a division facility, the administrative officer [shall] must make an investigation, pursuant to the provisions of this chapter, to determine whether the person or his or her responsible relatives pursuant to NRS 433A.610 are capable of paying for all or a portion of the costs that will be incurred during the period of admission.
κ2021 Statutes of Nevada, Page 3100 (CHAPTER 481, SB 70)κ
2. If a person is admitted to a division facility or [program of community-based or outpatient services] required to receive assisted outpatient treatment pursuant to a court order, that person and his or her responsible relatives are responsible for the payment of the actual cost of the treatment and services rendered during his or her admission to the division facility or [program] while he or she is receiving assisted outpatient treatment unless the investigation reveals that the person and his or her responsible relatives are not capable of paying the full amount of the costs.
3. Once a court has ordered [the admission of a person to a program of community-based or outpatient services] a person to receive assisted outpatient treatment operated by the Division, the [professional] person professionally qualified in the field of psychiatric mental health responsible for providing [or coordinating] the [program shall] assisted outpatient treatment must make an investigation, pursuant to the provisions of this chapter, to determine whether the person receiving the treatment or his or her responsible relatives pursuant to NRS 433A.610 are capable of paying for all or a portion of the costs that will be incurred during the period of [admission.] treatment.
Sec. 53. NRS 433A.650 is hereby amended to read as follows:
433A.650 Determination of ability to pay pursuant to NRS 433A.640 [shall] must include investigation of whether the consumer has benefits due and owing to the consumer for the cost of his or her treatment from third-party sources, such as Medicare, Medicaid, social security, medical insurance benefits, retirement programs, annuity plans, government benefits or any other financially responsible third parties. The administrative officer of a division mental health facility or [professional] person professionally qualified in the field of psychiatric mental health responsible for providing [or coordinating a program of community-based or outpatient services] the assisted outpatient treatment may accept payment for the cost of a consumers treatment from the consumers insurance company, Medicare or Medicaid and other similar third parties.
Sec. 54. NRS 433A.660 is hereby amended to read as follows:
433A.660 1. If the consumer, his or her responsible relative pursuant to NRS 433A.610, guardian or the estate neglects or refuses to pay the cost of treatment to the division facility or to the [program of community-based or outpatient services] person professionally qualified in the field of psychiatric mental health responsible for providing the assisted outpatient treatment operated by the Division rendering service pursuant to the fee schedule established under NRS 433.404 or 433B.250, as appropriate, the State is entitled to recover by appropriate legal action all sums due, plus interest.
2. Before initiating such legal action, the division facility or program, as applicable, shall demonstrate efforts at collection, which may include contractual arrangements for collection through a private collection agency.
Sec. 55. NRS 433A.713 is hereby amended to read as follows:
433A.713 1. Each public or private mental health facility and hospital in this State shall, in the manner and time prescribed by regulation of the State Board of Health, report to the Division:
(a) The number of [applications for emergency admission received by] persons placed on a mental health crisis hold at the mental health facility or hospital pursuant to NRS 433A.160 during the immediately preceding quarter; and
κ2021 Statutes of Nevada, Page 3101 (CHAPTER 481, SB 70)κ
(b) Any other information prescribed by regulation of the State Board of Health.
2. The State Board of Health may adopt regulations that require a public or private mental health facility or hospital to adopt a plan for the discharge of a person admitted to the facility or hospital in accordance with the provisions of this chapter and that prescribe the contents of such a plan.
Sec. 56. NRS 433A.715 is hereby amended to read as follows:
433A.715 1. A court shall seal all court records relating to [the admission and treatment of any person who was admitted, voluntarily or as the result of a noncriminal proceeding, to a public or private hospital, a mental health facility or a program of community-based or outpatient services in this State for the purpose of obtaining mental health treatment.] proceedings under this chapter.
2. Except as otherwise provided in subsections 4, 5 and 6, a person or governmental entity that wishes to inspect records that are sealed pursuant to this section must file a petition with the court that sealed the records. Upon the filing of a petition, the court shall fix a time for a hearing on the matter. The petitioner must provide notice of the hearing and a copy of the petition to the person who is the subject of the records. If the person who is the subject of the records wishes to oppose the petition, the person must appear before the court at the hearing. If the person appears before the court at the hearing, the court must provide the person an opportunity to be heard on the matter.
3. After the hearing described in subsection 2, the court may order the inspection of records that are sealed pursuant to this section if:
(a) A law enforcement agency must obtain or maintain information concerning persons who have been admitted to a public or private hospital [,] or a mental health facility or [a program of community-based or outpatient services] received assisted outpatient treatment in this State pursuant to state or federal law;
(b) A prosecuting attorney or an attorney who is representing the person who is the subject of the records in a criminal action requests to inspect the records; or
(c) The person who is the subject of the records petitions the court to permit the inspection of the records by a person named in the petition.
4. A governmental entity is entitled to inspect court records that are sealed pursuant to this section without following the procedure described in subsection 2 if:
(a) The governmental entity has made a conditional offer of employment to the person who is the subject of the records;
(b) The position of employment conditionally offered to the person concerns public safety, including, without limitation, employment as a firefighter or peace officer;
(c) The governmental entity is required by law, rule, regulation or policy to obtain the mental health records of each individual conditionally offered the position of employment; and
(d) An authorized representative of the governmental entity presents to the court a written authorization signed by the person who is the subject of the records and notarized by a notary public or judicial officer in which the person who is the subject of the records consents to the inspection of the records.
5. Upon the request of a public or private hospital or a mental health facility to which a person has been admitted in this State, the court shall:
κ2021 Statutes of Nevada, Page 3102 (CHAPTER 481, SB 70)κ
(a) Authorize the release of a copy of any order which was entered by the court pursuant to paragraph (b) of subsection 1 of NRS 433A.310 or paragraph (b) of subsection 1 of section 18 of this act if:
(1) The request is in writing and includes the name and date of birth of the person who is the subject of the requested order; and
(2) The hospital or facility certifies that:
(I) The person who is the subject of the requested order is, at the time of the request, admitted to the hospital or facility and is being treated for an alleged mental illness; and
(II) The requested order is necessary to improve the care which is being provided to the person who is the subject of the order.
(b) Place the request in the record under seal.
6. Upon its own order, any court of this State may inspect court records that are sealed pursuant to this section without following the procedure described in subsection 2 if the records are necessary and relevant for the disposition of a matter pending before the court. The court may allow a party in the matter to inspect the records without following the procedure described in subsection 2 if the court deems such inspection necessary and appropriate.
7. Following the sealing of records pursuant to this section, the admission of the person who is the subject of the records to the public or private hospital [,] or mental health facility or [program of community-based or outpatient services,] the assisted outpatient treatment of the person who is the subject of the records is deemed never to have occurred, and the person may answer accordingly any question related to its occurrence, except in connection with:
(a) An application for a permit to carry a concealed firearm pursuant to the provisions of NRS 202.3653 to 202.369, inclusive;
(b) A transfer of a firearm; or
(c) An application for a position of employment described in subsection 4.
8. A court may disclose information contained in a record sealed pursuant to this section to a provider of health care to assist with treatment provided to the consumer.
9. As used in this section:
(a) Firefighter means a person who is a salaried employee of a fire-fighting agency and whose principal duties are to control, extinguish, prevent and suppress fires. As used in this paragraph, fire-fighting agency means a public fire department, fire protection district or other agency of this State or a political subdivision of this State, the primary functions of which are to control, extinguish, prevent and suppress fires.
(b) Peace officer has the meaning ascribed to it in NRS 289.010.
(c) Provider of health care has the meaning ascribed to it in NRS 629.031.
(d) Seal means placing records in a separate file or other repository not accessible to the general public.
Sec. 57. NRS 433A.750 is hereby amended to read as follows:
433A.750 1. A person who:
(a) Without probable cause for believing a person is a person in a mental health crisis causes or conspires with or assists another to cause the involuntary court-ordered admission of the person under this chapter; or
κ2021 Statutes of Nevada, Page 3103 (CHAPTER 481, SB 70)κ
(b) Causes or conspires with or assists another to cause the denial to any person of any right accorded to the person under this chapter,
Κ is guilty of a category D felony and shall be punished as provided in NRS 193.130.
2. Unless a greater penalty is provided in subsection 1, a person who knowingly and willfully violates any provision of this chapter regarding the admission of a person to, or discharge of a person from, a public or private mental health facility or [a program of community-based or outpatient services] the commencement or termination of assisted outpatient treatment is guilty of a gross misdemeanor.
3. A person who, without probable cause for believing another person is a person in a mental health crisis, executes a petition, application or certificate pursuant to this chapter, by which the person secures or attempts to secure the apprehension, hospitalization, detention, admission or restraint of the person alleged to be a person in a mental health crisis, or any physician, psychiatrist, [licensed] psychologist, advanced practice registered nurse or other person professionally qualified in the field of psychiatric mental health who knowingly makes any false certificate or application pursuant to this chapter as to the mental condition of any person is guilty of a category D felony and shall be punished as provided in NRS 193.130.
Sec. 58. NRS 3.0105 is hereby amended to read as follows:
3.0105 1. There is hereby established, in each judicial district that includes a county whose population is 100,000 or more, a family court as a division of the district court.
2. If the caseload of the family court so requires, the Chief Judge may assign one or more district judges of the judicial district to act temporarily as judges of the family court.
3. If for any reason a judge of the family court is unable to act, any other district judge of the judicial district may be assigned as provided in subsection 2 to act temporarily as judge of the family court.
4. A district judge assigned to the family court pursuant to subsection 2 or 3 for a period of 90 or more days, except for a district judge or hearing master assigned to hear proceedings brought pursuant to NRS 433A.200 to 433A.330, inclusive, or sections 11 to 21, inclusive, of this act must attend the instruction required pursuant to subsection 1 of NRS 3.028. District judges must not be assigned to the family court pursuant to subsections 2 and 3 on a rotating basis.
Sec. 59. NRS 3.223 is hereby amended to read as follows:
3.223 1. Except if the child involved is subject to the jurisdiction of an Indian tribe pursuant to the Indian Child Welfare Act of 1978, 25 U.S.C. §§ 1901 et seq., in each judicial district in which it is established, the family court has original, exclusive jurisdiction in any proceeding:
(a) Brought pursuant to title 5 of NRS or chapter 31A, 123, 125, 125A, 125B, 125C, 126, 127, 128, 129, 130, 159A, 425 or 432B of NRS, except to the extent that a specific statute authorizes the use of any other judicial or administrative procedure to facilitate the collection of an obligation for support.
(b) Brought pursuant to NRS 442.255 and 442.2555 to request the court to issue an order authorizing an abortion.
(c) For judicial approval of the marriage of a minor.
(d) Otherwise within the jurisdiction of the juvenile court.
κ2021 Statutes of Nevada, Page 3104 (CHAPTER 481, SB 70)κ
(e) To establish the date of birth, place of birth or parentage of a minor.
(f) To change the name of a minor.
(g) For a judicial declaration of the sanity of a minor.
(h) To approve the withholding or withdrawal of life-sustaining procedures from a person as authorized by law.
(i) Brought pursuant to NRS 433A.200 to 433A.330, inclusive, for an involuntary court-ordered admission to a mental health facility.
(j) Brought pursuant to sections 11 to 21, inclusive, of this act to require a person to receive assisted outpatient treatment.
(k) Brought pursuant to NRS 441A.510 to 441A.720, inclusive, for an involuntary court-ordered isolation or quarantine.
2. The family court, where established and, except as otherwise provided in paragraph (m) of subsection 1 of NRS 4.370, the justice court have concurrent jurisdiction over actions for the issuance of a temporary or extended order for protection against domestic violence.
3. The family court, where established, and the district court have concurrent jurisdiction over any action for damages brought pursuant to NRS 41.134 by a person who suffered injury as the proximate result of an act that constitutes domestic violence.
Sec. 60. NRS 178.460 is hereby amended to read as follows:
178.460 1. If requested by the district attorney or counsel for the defendant within 10 days after the report by the Administrator or the Administrators designee is sent to them, the judge shall hold a hearing within 10 days after the request at which the district attorney and the defense counsel may examine the members of the treatment team on their report.
2. If the judge orders the appointment of a licensed psychiatrist or psychologist who is not employed by the Division to perform an additional evaluation and report concerning the defendant, the cost of the additional evaluation and report is a charge against the county.
3. Within 10 days after the hearing or 10 days after the report is sent, if no hearing is requested, the judge shall make and enter a finding of competence or incompetence, and if the judge finds the defendant to be incompetent:
(a) Whether there is substantial probability that the defendant can receive treatment to competency and will attain competency to stand trial or receive pronouncement of judgment in the foreseeable future; and
(b) Whether the defendant is at that time a danger to himself or herself or to society.
4. If the judge finds the defendant:
(a) Competent, the judge shall, within 10 days, forward the finding to the prosecuting attorney and counsel for the defendant. Upon receipt thereof, the prosecuting attorney shall notify the sheriff of the county or chief of police of the city that the defendant has been found competent and prearrange with the facility for the return of the defendant to that county or city for trial upon the offense there charged or the pronouncement of judgment, as the case may be.
(b) Incompetent, but there is a substantial probability that the defendant can receive treatment to competency and will attain competency to stand trial or receive pronouncement of judgment in the foreseeable future and finds that the defendant is dangerous to himself or herself or to society, the judge shall recommit the defendant and may order the involuntary administration of medication for the purpose of treatment to competency.
κ2021 Statutes of Nevada, Page 3105 (CHAPTER 481, SB 70)κ
shall recommit the defendant and may order the involuntary administration of medication for the purpose of treatment to competency.
(c) Incompetent, but there is a substantial probability that the defendant can receive treatment to competency and will attain competency to stand trial or receive pronouncement of judgment in the foreseeable future and finds that the defendant is not dangerous to himself or herself or to society, the judge shall order that the defendant remain an outpatient or be transferred to the status of an outpatient under the provisions of NRS 178.425.
(d) Incompetent, with no substantial probability of attaining competency in the foreseeable future, the judge shall order the defendant released from custody or, if the defendant is an outpatient, released from any obligations as an outpatient if, within 10 judicial days, the prosecuting attorney has not filed a motion pursuant to NRS 178.461 or if, within 10 judicial days, a petition is not filed [to commit] for the involuntary court-ordered admission of the person to a mental health facility pursuant to NRS 433A.200. After the initial 10 judicial days, the person may remain an outpatient or in custody under the provisions of this chapter only as long as the motion or petition is pending unless the person is committed to the custody of the Administrator pursuant to NRS 178.461 or involuntarily [committed] admitted to a mental health facility pursuant to chapter 433A of NRS.
5. Except as otherwise provided in subsections 4 and 7 of NRS 178.461, no person who is committed under the provisions of this chapter may be held in the custody of the Administrator or the Administrators designee longer than the longest period of incarceration provided for the crime or crimes with which the person is charged or 10 years, whichever period is shorter. Upon expiration of the applicable period provided in this section, subsection 4 or 7 of NRS 178.461 or subsection 4 of NRS 178.463, the person must be returned to the committing court for a determination as to whether or not involuntary commitment pursuant to chapter 433A of NRS is required.
Sec. 61. NRS 179A.163 is hereby amended to read as follows:
179A.163 1. Upon receiving a record transmitted pursuant to NRS 159.0593, 174.035, 175.533, 175.539, 178.425 or 433A.310 [,] or section 18 of this act, the Central Repository:
(a) Shall take reasonable steps to ensure that the information reported in the record is included in each appropriate database of the National Instant Criminal Background Check System; and
(b) May take reasonable steps to ensure that the information reported in the record is included in each appropriate database of the National Crime Information Center.
2. Except as otherwise provided in subsection 3, if the Central Repository receives a record described in subsection 1, the person who is the subject of the record may petition the court for an order declaring that:
(a) The basis for the adjudication reported in the record no longer exists;
(b) The adjudication reported in the record is deemed not to have occurred for purposes of 18 U.S.C. § 922(d)(4) and (g)(4) and NRS 202.360; and
(c) The information reported in the record must be removed from the National Instant Criminal Background Check System and the National Crime Information Center.
κ2021 Statutes of Nevada, Page 3106 (CHAPTER 481, SB 70)κ
3. To the extent authorized by federal law, if the record concerning the petitioner was transmitted to the Central Repository pursuant to NRS 159.0593, 174.035, 175.533, 175.539, 178.425 or 433A.310 [,] or section 18 of this act, the petitioner may not file a petition pursuant to subsection 2 until 3 years after the date of the order transmitting the record to the Central Repository.
4. A petition filed pursuant to subsection 2 must be:
(a) Filed in the court which made the adjudication or finding pursuant to NRS 159.0593, 174.035, 175.533, 175.539, 178.425 or 433A.310 [;] or section 18 of this act; and
(b) Served upon the district attorney for the county in which the court described in paragraph (a) is located.
5. The Nevada Rules of Civil Procedure govern all proceedings concerning a petition filed pursuant to subsection 2.
6. The court shall grant the petition and issue the order described in subsection 2 if the court finds that the petitioner has established that:
(a) The basis for the adjudication or finding made pursuant to NRS 159.0593, 174.035, 175.533, 175.539, 178.425 or 433A.310 or section 18 of this act concerning the petitioner no longer exists;
(b) The petitioners record and reputation indicate that the petitioner is not likely to act in a manner dangerous to public safety; and
(c) Granting the relief requested by the petitioner pursuant to subsection 2 is not contrary to the public interest.
7. Except as otherwise provided in this subsection, the petitioner must establish the provisions of subsection 6 by a preponderance of the evidence. If the adjudication or finding concerning the petitioner was made pursuant to NRS 159.0593 or 433A.310, the petitioner must establish the provisions of subsection 6 by clear and convincing evidence.
8. The court, upon entering an order pursuant to this section, shall cause, on a form prescribed by the Department of Public Safety, a record of the order to be transmitted to the Central Repository.
9. Within 5 business days after receiving a record of an order transmitted pursuant to subsection 8, the Central Repository shall take reasonable steps to ensure that information concerning the adjudication or finding made pursuant to NRS 159.0593, 174.035, 175.533, 175.539, 178.425 or 433A.310 or section 18 of this act is removed from the National Instant Criminal Background Check System and the National Crime Information Center, if applicable.
10. If the Central Repository fails to remove a record as provided in subsection 9, the petitioner may bring an action to compel the removal of the record. If the petitioner prevails in the action, the court may award the petitioner reasonable attorneys fees and costs incurred in bringing the action.
11. If a petition brought pursuant to subsection 2 is denied, the person who is the subject of the record may petition for a rehearing not sooner than 2 years after the date of the denial of the petition.
Sec. 62. NRS 179A.165 is hereby amended to read as follows:
179A.165 1. Any record described in NRS 179A.163 is confidential and is not a public book or record within the meaning of NRS 239.010. A person may not use the record for any purpose other than for a purpose related to criminal justice, including, without limitation, inclusion in the appropriate database of the National Instant Criminal Background Check System and the National Crime Information Center, if applicable.
κ2021 Statutes of Nevada, Page 3107 (CHAPTER 481, SB 70)κ
appropriate database of the National Instant Criminal Background Check System and the National Crime Information Center, if applicable. The Central Repository may disclose the record to any agency of criminal justice.
2. If a person or governmental entity is required to transmit, report or take any other action concerning a record pursuant to NRS 159.0593, 174.035, 175.533, 175.539, 178.425, 179A.163 or 433A.310 [,] or section 18 of this act, no action for damages may be brought against the person or governmental entity for:
(a) Transmitting or reporting the record or taking any other required action concerning the record;
(b) Failing to transmit or report the record or failing to take any other required action concerning the record;
(c) Delaying the transmission or reporting of the record or delaying in taking any other required action concerning the record; or
(d) Transmitting or reporting an inaccurate or incomplete version of the record or taking any other required action concerning an inaccurate or incomplete version of the record.
Sec. 63. NRS 179A.167 is hereby amended to read as follows:
179A.167 1. The Central Repository shall permit a person who is or believes he or she may be the subject of information relating to records of mental health held by the Central Repository to inspect and correct any information contained in such records.
2. The Central Repository shall adopt regulations and make available necessary forms to permit inspection, review and correction of information relating to records of mental health by those persons who are the subjects thereof. The regulations must specify:
(a) The requirements for proper identification of the persons seeking access to the records; and
(b) The reasonable charges or fees, if any, for inspecting records.
3. The Director of the Department shall adopt regulations governing:
(a) All challenges to the accuracy or sufficiency of information or records of mental health by the person who is the subject of the allegedly inaccurate or insufficient record;
(b) The correction of any information relating to records of mental health found by the Director to be inaccurate, insufficient or incomplete in any material respect;
(c) The dissemination of corrected information to those persons or agencies which have previously received inaccurate or incomplete information; and
(d) A reasonable time limit within which inaccurate or insufficient information relating to records of mental health must be corrected and the corrected information disseminated.
4. As used in this section, information relating to records of mental health means information contained in a record:
(a) Transmitted to the Central Repository pursuant to NRS 159.0593, 174.035, 175.533, 175.539, 178.425 or 433A.310 [;] or section 18 of this act; or
(b) Transmitted to the National Instant Criminal Background Check System or the National Crime Information Center pursuant to NRS 179A.163.
κ2021 Statutes of Nevada, Page 3108 (CHAPTER 481, SB 70)κ
Sec. 64. NRS 388.253 is hereby amended to read as follows:
388.253 1. The Department shall, with assistance from other state agencies, including, without limitation, the Division of Emergency Management, the Investigation Division, and the Nevada Highway Patrol Division of the Department of Public Safety, develop a model plan for the management of:
(a) A suicide; or
(b) A crisis or emergency that involves a public school or a private school and that requires immediate action.
2. The model plan must include, without limitation, a procedure for:
(a) In response to a crisis or emergency:
(1) Coordinating the resources of local, state and federal agencies, officers and employees, as appropriate;
(2) Accounting for all persons within a school;
(3) Assisting persons within a school in a school district, a charter school or a private school to communicate with each other;
(4) Assisting persons within a school in a school district, a charter school or a private school to communicate with persons located outside the school, including, without limitation, relatives of pupils and relatives of employees of such a school, the news media and persons from local, state or federal agencies that are responding to a crisis or an emergency;
(5) Assisting pupils of a school in the school district, a charter school or a private school, employees of such a school and relatives of such pupils and employees to move safely within and away from the school, including, without limitation, a procedure for evacuating the school and a procedure for securing the school;
(6) Reunifying a pupil with his or her parent or legal guardian;
(7) Providing any necessary medical assistance;
(8) Recovering from a crisis or emergency;
(9) Carrying out a lockdown at a school;
(10) Providing shelter in specific areas of a school; and
(11) Providing disaster behavioral health related to a crisis, emergency or suicide;
(b) Providing specific information relating to managing a crisis or emergency that is a result of:
(1) An incident involving hazardous materials;
(2) An incident involving mass casualties;
(3) An incident involving an active shooter;
(4) An incident involving a fire, explosion or other similar situation;
(5) An outbreak of disease;
(6) Any threat or hazard identified in the hazard mitigation plan of the county in which the school district is located, if such a plan exists; or
(7) Any other situation, threat or hazard deemed appropriate;
(c) Providing pupils and staff at a school that has experienced a crisis or emergency with access to counseling and other resources to assist in recovering from the crisis or emergency;
(d) Evacuating pupils and employees of a charter school to a designated space within an identified public middle school, junior high school or high school in a school district that is separate from the general population of the school and large enough to accommodate the charter school, and such a space may include, without limitation, a gymnasium or multipurpose room of the public school;
κ2021 Statutes of Nevada, Page 3109 (CHAPTER 481, SB 70)κ
school and large enough to accommodate the charter school, and such a space may include, without limitation, a gymnasium or multipurpose room of the public school;
(e) Selecting an assessment tool which assists in responding to a threat against the school by a pupil or pupils;
(f) On an annual basis, providing drills to instruct pupils in the appropriate procedures to be followed in response to a crisis or an emergency. Such drills must occur:
(1) At different times during normal school hours; and
(2) In cooperation with other state agencies, pursuant to this section.
(g) Responding to a suicide or attempted suicide to mitigate the effects of the suicide or attempted suicide on pupils and staff at the school, including, without limitation, by making counseling and other appropriate resources to assist in recovering from the suicide or attempted suicide available to pupils and staff;
(h) Providing counseling and other appropriate resources to pupils and school staff who have contemplated or attempted suicide;
(i) Outreach to persons and organizations located in the community in which a school that has had a suicide by a pupil, including, without limitation, religious and other nonprofit organizations, that may be able to assist with the response to the suicide;
(j) Addressing the needs of pupils at a school that has experienced a crisis, emergency or suicide who are at a high risk of suicide, including, without limitation, pupils who are members of the groups described in subsection 3 of NRS 388.256; and
(k) Responding to a pupil who is determined to be a person in mental health crisis, as defined in NRS 433A.0175, including, without limitation:
(1) Utilizing mobile mental health crisis response units, where available, before transporting the pupil to a public or private mental health facility pursuant to subparagraph (2); and
(2) Transporting the pupil to a public or private mental health facility or hospital for [admission] placement on a mental health crisis hold pursuant to NRS [433A.150.] 433A.160.
3. In developing the model plan, the Department shall consider the plans developed pursuant to NRS 388.243 and 394.1687 and updated pursuant to NRS 388.245 and 394.1688.
4. The Department shall require a school district to ensure that each public school in the school district identified pursuant to paragraph (d) of subsection 2 is prepared to allow a charter school to evacuate to the school when necessary in accordance with the procedure included in the model plan developed pursuant to subsection 1. A charter school shall hold harmless, indemnify and defend the school district to which it evacuates during a crisis or an emergency against any claim or liability arising from an act or omission by the school district or an employee or officer of the school district.
5. The Department may disseminate to any appropriate local, state or federal agency, officer or employee, as the Department determines is necessary:
(a) The model plan developed by the Department pursuant to subsection 1;
(b) A plan developed pursuant to NRS 388.243 or updated pursuant to NRS 388.245;
κ2021 Statutes of Nevada, Page 3110 (CHAPTER 481, SB 70)κ
(c) A plan developed pursuant to NRS 394.1687 or updated pursuant to NRS 394.1688; and
(d) A deviation approved pursuant to NRS 388.251 or 394.1692.
6. The Department shall, at least once each year, review and update as appropriate the model plan developed pursuant to subsection 1.
Sec. 65. NRS 388.476 is hereby amended to read as follows:
388.476 Chemical restraint means the administration of drugs to a person for the specific and exclusive purpose of controlling an acute or episodic [aggressive] behavior that places the person or others at a risk of harm when less restrictive alternative intervention techniques have failed to limit or control the behavior. The term does not include the administration of drugs [on a regular basis, as] prescribed by a physician, [to treat the symptoms of] physician assistant or advanced practice registered nurse as standard treatment for the mental [,] or physical [, emotional or behavioral disorders and for assisting a person in gaining self-control over his or her impulses.] condition of the person.
Sec. 66. NRS 394.355 is hereby amended to read as follows:
394.355 Chemical restraint means the administration of drugs to a person for the specific and exclusive purpose of controlling an acute or episodic [aggressive] behavior that places the person or others at a risk of harm when less restrictive alternative intervention techniques have failed to limit or control the behavior. The term does not include the administration of drugs [on a regular basis, as] prescribed by a physician, [to treat the symptoms of] physician assistant or advanced practice registered nurse as standard treatment for the mental [,] or physical [, emotional or behavioral disorders and for assisting a person in gaining self-control over his or her impulses.] condition of the person.
Sec. 67. NRS 449.0915 is hereby amended to read as follows:
449.0915 1. The Division may issue an endorsement as a crisis stabilization center to the holder of a license to operate a psychiatric hospital that meets the requirements of this section.
2. A psychiatric hospital that wishes to obtain an endorsement as a crisis stabilization center must submit an application in the form prescribed by the Division which must include, without limitation, proof that the applicant meets the requirements of subsection 3.
3. An endorsement as a crisis stabilization center may only be issued if the psychiatric hospital to which the endorsement will apply:
(a) Does not exceed a capacity of 16 beds or constitute an institution for mental diseases, as defined in 42 U.S.C. § 1396d;
(b) Operates in accordance with established administrative protocols, evidenced-based protocols for providing treatment and evidence-based standards for documenting information concerning services rendered and recipients of such services in accordance with best practices for providing crisis stabilization services;
(c) Delivers crisis stabilization services:
(1) To patients for not less than 24 hours in an area devoted to crisis stabilization or detoxification before releasing the patient into the community, referring the patient to another facility or transferring the patient to a bed within the hospital for short-term treatment, if the psychiatric hospital has such beds;
κ2021 Statutes of Nevada, Page 3111 (CHAPTER 481, SB 70)κ
(2) In accordance with best practices for the delivery of crisis stabilization services; and
(3) In a manner that promotes concepts that are integral to recovery for persons with mental illness, including, without limitation, hope, personal empowerment, respect, social connections, self-responsibility and self-determination;
(d) Employs qualified persons to provide peer support services, as defined in NRS 449.01566, when appropriate;
(e) Uses a data management tool to collect and maintain data relating to admissions, discharges, diagnoses and long-term outcomes for recipients of crisis stabilization services;
(f) Accepts all patients, without regard to:
(1) The race, ethnicity, gender, socioeconomic status, sexual orientation or place of residence of the patient;
(2) Any social conditions that affect the patient;
(3) The ability of the patient to pay; or
(4) Whether the patient is admitted voluntarily to the psychiatric hospital pursuant to NRS 433A.140 or admitted to the psychiatric hospital under an emergency admission pursuant to [NRS 433A.150;] section 10 of this act;
(g) Performs an initial assessment on any patient who presents at the psychiatric hospital, regardless of the severity of the behavioral health issues that the patient is experiencing;
(h) Has the equipment and personnel necessary to conduct a medical examination of a patient pursuant to NRS 433A.165; and
(i) Considers whether each patient would be better served by another facility and transfer a patient to another facility when appropriate.
4. Crisis stabilization services that may be provided pursuant to paragraph (c) of subsection 3 may include, without limitation:
(a) Case management services, including, without limitation, such services to assist patients to obtain housing, food, primary health care and other basic needs;
(b) Services to intervene effectively when a behavioral health crisis occurs and address underlying issues that lead to repeated behavioral health crises;
(c) Treatment specific to the diagnosis of a patient; and
(d) Coordination of aftercare for patients, including, without limitation, at least one follow-up contact with a patient not later than 72 hours after the patient is discharged.
5. An endorsement as a crisis stabilization center must be renewed at the same time as the license to which the endorsement applies. An application to renew an endorsement as a crisis stabilization center must include, without limitation:
(a) The information described in subsection 3; and
(b) Proof that the psychiatric hospital is accredited by the Commission on Accreditation of Rehabilitation Facilities, or its successor organization, or the Joint Commission, or its successor organization.
6. As used in this section, crisis stabilization services means behavioral health services designed to:
(a) De-escalate or stabilize a behavioral crisis, including, without limitation, a behavioral health crisis experienced by a person with a co-occurring substance use disorder; and
κ2021 Statutes of Nevada, Page 3112 (CHAPTER 481, SB 70)κ
(b) When appropriate, avoid admission of a patient to another inpatient mental health facility or hospital and connect the patient with providers of ongoing care as appropriate for the unique needs of the patient.
Sec. 68. NRS 449A.206 is hereby amended to read as follows:
449A.206 Chemical restraint means the administration of drugs to a person for the specific and exclusive purpose of controlling an acute or episodic [aggressive] behavior that places the person or others at a risk of harm when less restrictive alternative intervention techniques have failed to limit or control the behavior. The term does not include the administration of drugs [on a regular basis, as] prescribed by a physician, [to treat the symptoms of] physician assistant or advanced practice registered nurse as standard treatment for the mental [,] or physical [, emotional or behavioral disorders and for assisting a person in gaining self-control over his or her impulses.] condition of the person.
Sec. 69. NRS 449A.636 is hereby amended to read as follows:
449A.636 1. When acting under the authority of an advance directive for psychiatric care, an attending physician or other provider of health care shall comply with the advance directive unless:
(a) Compliance, in the opinion of the attending physician or other provider, is not consistent with generally accepted standards of care for the provision of psychiatric care for the benefit of the principal;
(b) Compliance is not consistent with the availability of psychiatric care requested;
(c) Compliance is not consistent with applicable law;
(d) The principal is admitted to a mental health facility or hospital pursuant to NRS 433A.145 to 433A.330, inclusive, or required to receive assisted outpatient treatment pursuant to sections 11 to 21, inclusive, of this act and a course of treatment is required pursuant to those provisions; or
(e) Compliance, in the opinion of the attending physician or other provider, is not consistent with appropriate psychiatric care in case of an emergency endangering the life or health of the principal or another person.
2. In the event that one part of the advance directive is unable to be followed because of any of the circumstances set forth in subsection 1, all other parts of the advance directive must be followed.
Sec. 70. NRS 450.470 is hereby amended to read as follows:
450.470 1. If the county hospital is located at the county seat, the board of hospital trustees shall, at all times, provide a suitable room that may be used for the examination of persons who are alleged to [have mental illness] be persons in a mental health crisis and who are to be brought before the judge of the district court for proceedings to determine the issue of involuntary court-ordered admission as provided in chapter 433A of NRS. This section does not prohibit or limit the examination of persons alleged to [have mental illness] be persons in a mental health crisis at a private hospital as provided in chapter 433A of NRS.
2. The board of trustees of such a county hospital, in cooperation with the local law enforcement agencies, may provide a suitable room that may be used for the custodial supervision of persons who are alleged to:
(a) [Have mental illness;] Be persons in a mental health crisis; or
(b) Be dangerous to themselves or others.
κ2021 Statutes of Nevada, Page 3113 (CHAPTER 481, SB 70)κ
Sec. 71. NRS 629.550 is hereby amended to read as follows:
629.550 1. If a patient communicates to a mental health professional an explicit threat of imminent serious physical harm or death to a clearly identified or identifiable person and, in the judgment of the mental health professional, the patient has the intent and ability to carry out the threat, the mental health professional shall [apply for the emergency admission of] place the patient [to a mental health facility] on a mental health crisis hold pursuant to NRS 433A.160 , petition for a court to order the placement of the patient on a mental health crisis hold pursuant to section 9 of this act or make a reasonable effort to communicate the threat in a timely manner to:
(a) The person who is the subject of the threat;
(b) The law enforcement agency with the closest physical location to the residence of the person; and
(c) If the person is a minor, the parent or guardian of the person.
2. A mental health professional shall be deemed to have made a reasonable effort to communicate a threat pursuant to subsection 1 if:
(a) The mental health professional actually communicates the threat in a timely manner; or
(b) The mental health professional makes a good faith attempt to communicate the threat in a timely manner and the failure to actually communicate the threat in a timely manner does not result from the negligence or recklessness of the mental health professional.
3. A mental health professional who exercises reasonable care in determining that he or she:
(a) Has a duty to take an action described in subsection 1 is not subject to civil or criminal liability or disciplinary action by a professional licensing board for disclosing confidential or privileged information.
(b) Does not have a duty to take an action described in subsection 1 is not subject to civil or criminal liability or disciplinary action by a professional licensing board for any damages caused by the actions of a patient.
4. The provisions of this section do not:
(a) Limit or affect the duty of the mental health professional to report child abuse or neglect pursuant to NRS 432B.220 or the commercial sexual exploitation of a child pursuant to NRS 432C.110; or
(b) Modify any duty of a mental health professional to take precautions to prevent harm by a patient:
(1) Who is in the custody of a hospital or other facility where the mental health professional is employed; or
(2) Who is being discharged from such a facility.
5. As used in this section, mental health professional includes:
(a) A physician or psychiatrist licensed to practice medicine in this State pursuant to chapter 630 or 633 of NRS;
(b) A psychologist who is licensed to practice psychology pursuant to chapter 641 of NRS or authorized to practice psychology in this State pursuant to the Psychology Interjurisdictional Compact enacted in NRS 641.227;
(c) A social worker who:
(1) Holds a masters degree in social work;
(2) Is licensed as a clinical social worker pursuant to chapter 641B of NRS; and
κ2021 Statutes of Nevada, Page 3114 (CHAPTER 481, SB 70)κ
(3) Is employed by the Division of Public and Behavioral Health of the Department of Health and Human Services;
(d) A registered nurse who:
(1) Is licensed to practice professional nursing pursuant to chapter 632 of NRS; and
(2) Holds a masters degree in psychiatric nursing or a related field;
(e) A marriage and family therapist licensed pursuant to chapter 641A of NRS;
(f) A clinical professional counselor licensed pursuant to chapter 641A of NRS; and
(g) A person who is working in this State within the scope of his or her employment by the Federal Government, including, without limitation, employment with the Department of Veterans Affairs, the military or the Indian Health Service, and is:
(1) Licensed or certified as a physician, psychologist, marriage and family therapist, clinical professional counselor, alcohol and drug counselor or clinical alcohol and drug counselor in another state;
(2) Licensed as a social worker in another state and holds a masters degree in social work; or
(3) Licensed to practice professional nursing in another state and holds a masters degree in psychiatric nursing or a related field.
Sec. 72. 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 [433A.160,] 433A.240, 433A.390, 433A.430, 484C.300, 484C.320, 484C.330, 484C.340 and 484C.350 and sections 10 and 11 of this act, the certifications described in NRS 433A.170, 433A.195 and 433A.200 [.] and the sworn statements or declarations described in NRS 433A.210 and section 11 of this act.
(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.
κ2021 Statutes of Nevada, Page 3115 (CHAPTER 481, SB 70)κ
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.
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.
Sec. 73. NRS 641B.160 is hereby amended to read as follows:
641B.160 1. The Board shall adopt:
(a) Such regulations as are necessary or desirable to enable it to carry out the provisions of this chapter;
(b) Regulations establishing reasonable standards for the psychiatric training and experience necessary for a clinical social worker to be authorized to make the certifications described in NRS 433A.170, 433A.195 and 433A.200 [;] and section 10 of this act, make a sworn statement or declaration described in NRS 433A.210 and section 11 of this act and perform an evaluation described in section 11 of this act;
(c) Regulations prescribing uniform standards concerning the locations at which interns provide services;
(d) Regulations prescribing standards concerning the electronic supervision of interns working at remote sites; and
(e) Regulations prescribing the manner by which the qualifications for the issuance or renewal of a license under the provisions of this chapter will be made available to the public such that those qualifications are clearly defined and easily understood.
2. On the date that the Board gives notice pursuant to NRS 233B.060 of its intent to adopt, amend or repeal a regulation, the Board shall submit the regulation to the Commission on Behavioral Health for review. The Commission shall review the regulation and make recommendations to the Board concerning the advisability of adopting, amending or repealing the regulation and any changes that the Commission deems advisable.
κ2021 Statutes of Nevada, Page 3116 (CHAPTER 481, SB 70)κ
Sec. 74. 1. The amendatory provisions of NRS 433A.145, as amended by section 28 of this act, apply to any person:
(a) Who has been admitted to a public or private mental facility; and
(b) Whose status is that of a voluntary consumer on or after October 1, 2021, regardless of the date on which he or she was admitted.
2. The amendatory provisions of NRS 433A.165, 433A.185, 433A.195, 433A.200 and 433A.310, as amended by sections 31, 33, 35, 36 and 43 of this act, respectively, apply to any person:
(a) Who has been admitted to a public or private mental facility or hospital; and
(b) Whose status is that of an emergency consumer on or after October 1, 2021, regardless of the date on which he or she was admitted.
3. Any person who was involuntarily admitted to a program of community-based or outpatient services before October 1, 2021, by a court order that remains effective on that date shall be deemed to have been ordered to receive assisted outpatient treatment pursuant to section 18 of this act.
4. The amendatory provisions of NRS 433A.380 and 433A.390, as amended by sections 47 and 48 of this act, respectively, apply to any person who has been admitted to a public or private mental health facility pursuant to a court order that is effective on October 1, 2021, regardless of the date on which he or she was admitted.
5. The amendatory provisions of NRS 433A.220 and 433A.380, as amended by sections 39 and 47 of this act, respectively, apply to any person who has been conditionally released from a public or private mental health facility where the conditional release is effective on October 1, 2021, regardless of the date on which he or she was conditionally released.
6. As used in this section, assisted outpatient treatment has the meaning ascribed to it in NRS 433A.019, as amended by section 24 of this act.
Sec. 75. NRS 433A.315, 433A.323 and 433A.327 are hereby repealed.
Sec. 76. 1. This section becomes effective upon passage and approval.
2. Sections 1 to 75, inclusive, of this act become effective:
(a) Upon passage and approval for the purpose of adopting regulations and performing any preparatory administrative tasks that are necessary to carry out the provisions of this act; and
(b) On October 1, 2021, for all other purposes.
________
κ2021 Statutes of Nevada, Page 3117κ
Senate Bill No. 158Committee on Health and Human Services
CHAPTER 482
[Approved: June 4, 2021]
AN ACT relating to public welfare; revising requirements for a relative of a child in foster care to be eligible for assistance from the Kinship Guardianship Assistance Program; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Existing law requires the Department of Health and Human Services to establish and administer the Kinship Guardianship Assistance Program to provide assistance to a relative who becomes the legal guardian of a child in foster care. (NRS 432B.6201-432B.626) Existing law sets forth various criteria that a child and a relative must satisfy in order for the relative to be eligible for assistance pursuant to the Program, including a requirement that the child must not be able to permanently return to his or her home or be adopted. (NRS 432B.623) This bill revises that requirement to require that, for a relative to be eligible for such assistance, an agency which provides child welfare services must determine that being returned home or adopted are not appropriate permanency options for the child.
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 432B.623 is hereby amended to read as follows:
432B.623 1. As a condition to the provision of assistance pursuant to the Program:
(a) A child must:
(1) Have been removed from his or her home:
(I) Pursuant to a written agreement voluntarily entered by the parent or guardian of the child and an agency which provides child welfare services; or
(II) By a court which has determined that it is in the best interests of the child for the child to remain in protective custody or to be placed in temporary or permanent custody outside his or her home;
(2) For not less than 6 consecutive months, have resided with a relative of the child;
(3) [Not have as an option for permanent placement the return to the home or the adoption of the child;
(4)] Demonstrate a strong attachment to the relative; and
[(5)] (4) If the child is 14 years of age or older, be consulted regarding the guardianship arrangement.
(b) A relative of the child must:
(1) Demonstrate a strong commitment to caring for the child permanently;
(2) Be a provider of foster care who is licensed by a licensing authority pursuant to NRS 424.030;
κ2021 Statutes of Nevada, Page 3118 (CHAPTER 482, SB 158)κ
(3) Enter into a written agreement for assistance with an agency which provides child welfare services before the relative is appointed as the legal guardian of the child; and
(4) Be appointed as the legal guardian of the child by a court of competent jurisdiction and comply with any requirements imposed by the court.
(c) An agency which provides child welfare services must determine that being returned home or adopted are not appropriate permanency options for the child.
2. If the sibling of a child who is eligible for assistance pursuant to the Program is not eligible for such assistance, the sibling may be placed with the child who is eligible for assistance upon approval of the agency which provides child welfare services and the relative. In such a case, payments may be made for the sibling so placed as if the sibling is eligible for the Program.
Sec. 2. This act becomes effective on July 1, 2021.
________
Senate Bill No. 164Senators Scheible, D. Harris and Ohrenschall
Joint Sponsors: Assemblymen Nguyen; Gonzαlez and Watts
CHAPTER 483
[Approved: June 4, 2021]
AN ACT relating to crimes; revising provisions relating to prostitution; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Existing law: (1) prohibits a person from engaging in prostitution or solicitation for prostitution except in a licensed house of prostitution; (2) provides that a prostitute who violates such a prohibition is guilty of a misdemeanor; and (3) provides that a customer who violates such a prohibition is guilty, in general, of a misdemeanor for the first offense and a gross misdemeanor for a subsequent offense. (NRS 201.354) Section 4 of this bill removes such a prohibition as it applies to prostitutes, thereby making the provisions of section 4 only applicable to customers, and section 2 of this bill adds the removed prohibition as a separate section applicable only to prostitutes.
Existing law requires a peace officer who detains, arrests or issues a citation to a prostitute for a violation of the prohibition against unlawfully engaging in prostitution or solicitation for prostitution to provide information relating to certain assistance for which the prostitute might be eligible. Existing law additionally requires a prosecuting attorney to dismiss the charge against a prostitute for such a violation if the prosecuting attorney has reason to believe that the prostitute is a victim of sex trafficking. (NRS 201.354) Section 4 removes such provisions and section 2 adds the removed provisions.
Section 3 of this bill makes a conforming change to indicate the placement of section 2 in the Nevada Revised Statutes. Sections 5, 6 and 9-13 of this bill make conforming changes to add references to section 2, thereby maintaining the applicability of those sections to the provisions of section 2. Sections 7 and 8 of this bill make conforming changes to indicate that, in accordance with section 4, those sections are applicable only to customers of prostitutes.
κ2021 Statutes of Nevada, Page 3119 (CHAPTER 483, SB 164)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. (Deleted by amendment.)
Sec. 2. Chapter 201 of NRS is hereby amended by adding thereto a new section to read as follows:
1. It is unlawful for a prostitute to engage in prostitution or solicitation therefor, except in a licensed house of prostitution.
2. A person who violates subsection 1 is guilty of a misdemeanor.
3. A peace officer who:
(a) Detains but does not arrest or issue a citation to a person for a violation of subsection 1 shall, before releasing the person, provide information regarding and opportunities for connecting with social service agencies that may provide assistance to the person. The Department of Health and Human Services shall assist law enforcement agencies in providing information regarding and opportunities for connecting with such social service agencies pursuant to this paragraph.
(b) Arrests or issues a citation to a person for a violation of subsection 1 shall, before the person is released from custody or cited:
(1) Inform the person that he or she may be eligible for assignment to a preprosecution diversion program established pursuant to NRS 174.032; and
(2) Provide the information regarding and opportunities for connecting with social service agencies described in paragraph (a).
4. If, at any time before the trial of a person charged with a violation of subsection 1, the prosecuting attorney has reason to believe that the person is a victim of sex trafficking, the prosecuting attorney shall dismiss the charge. As used in this subsection, sex trafficking means a violation of subsection 2 of NRS 201.300.
Sec. 3. NRS 201.295 is hereby amended to read as follows:
201.295 As used in NRS 201.295 to 201.440, inclusive, and section 2 of this act, unless the context otherwise requires:
1. Adult means a person 18 years of age or older.
2. Child means a person less than 18 years of age.
3. Induce means to persuade, encourage, inveigle or entice.
4. Prostitute means a male or female person who for a fee, monetary consideration or other thing of value engages in sexual intercourse, oral-genital contact or any touching of the sexual organs or other intimate parts of a person for the purpose of arousing or gratifying the sexual desire of either person.
5. Prostitution means engaging in sexual conduct with another person in return for a fee, monetary consideration or other thing of value.
6. Sexual conduct means any of the acts enumerated in subsection 4.
7. Transports means to transport or cause to be transported, by any means of conveyance, into, through or across this State, or to aid or assist in obtaining such transportation.
Sec. 4. NRS 201.354 is hereby amended to read as follows:
201.354 1. It is unlawful for [any person] a customer to engage in prostitution or solicitation therefor, except in a licensed house of prostitution.
2. Any person who violates subsection 1 by soliciting for prostitution:
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(a) A peace officer who is posing as a child; or
(b) A person who is assisting a peace officer by posing as a child,
Κ is guilty of soliciting a child for prostitution.
3. [A prostitute who violates subsection 1 is guilty of a misdemeanor. A peace officer who:
(a) Detains, but does not arrest or issue a citation to a prostitute for a violation of subsection 1 shall, before releasing the prostitute, provide information regarding and opportunities for connecting with social service agencies that may provide assistance to the prostitute. The Department of Health and Human Services shall assist law enforcement agencies in providing information regarding and opportunities for connecting with such social service agencies pursuant to this paragraph.
(b) Arrests or issues a citation to a prostitute for a violation of subsection 1 shall, before the prostitute is released from custody or cited:
(1) Inform the prostitute that he or she may be eligible for assignment to a preprosecution diversion program established pursuant to NRS 174.032; and
(2) Provide the information regarding and opportunities for connecting with social service agencies described in paragraph (a).
4.] Except as otherwise provided in subsection [6,] 5, a [customer] person who violates this section:
(a) For a first offense, is guilty of a misdemeanor and shall be punished as provided in NRS 193.150, and by a fine of not less than $400.
(b) For a second offense, is guilty of a gross misdemeanor and shall be punished as provided in NRS 193.140, and by a fine of not less than $800.
(c) For a third or subsequent offense, is guilty of a gross misdemeanor and shall be punished as provided in NRS 193.140, and by a fine of not less than $1,300.
[5.] 4. In addition to any other penalty imposed, the court shall order a person who violates subsection [4] 3 to pay a civil penalty of not less than $200 per offense. The civil penalty must be paid to the district attorney or city attorney of the jurisdiction in which the violation occurred. If the civil penalty imposed pursuant to this subsection:
(a) Is not within the persons present ability to pay, in lieu of paying the penalty, the court may allow the person to perform community service for a reasonable number of hours, the value of which would be commensurate with the civil penalty.
(b) Is not entirely within the persons present ability to pay, in lieu of paying the entire civil penalty, the court may allow the person to perform community service for a reasonable number of hours, the value of which would be commensurate with the amount of the reduction of the civil penalty.
[6.] 5. A [customer] person who violates this section by soliciting a child for prostitution:
(a) For a first offense, is guilty of a category D felony and shall be punished as provided in NRS 193.130, and by a fine of not more than $5,000.
(b) For a second offense, is guilty of a category C felony and shall be punished as provided in NRS 193.130.
(c) For a third or subsequent offense, 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 maximum term of not more than 6 years, and may be further punished by a fine of not more than $15,000.
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further punished by a fine of not more than $15,000. The court shall not grant probation to or suspend the sentence of a person punished pursuant to this paragraph.
[7.] 6. Any civil penalty collected by a district attorney or city attorney pursuant to subsection [5] 4 must be deposited in the county or city treasury, as applicable, to be used for:
(a) The enforcement of this section; and
(b) Programs of treatment for persons who solicit prostitution which are certified by the Division of Public and Behavioral Health of the Department of Health and Human Services.
Κ Not less than 50 percent of the money deposited in the county or city treasury, as applicable, pursuant to this subsection must be used for the enforcement of this section.
[8.] 7. If a person who violates subsection 1 is ordered pursuant to NRS 4.373 or 5.055 to participate in a program for the treatment of persons who solicit prostitution, upon fulfillment of the terms and conditions of the program, the court may discharge the person and dismiss the proceedings against the person. If the court discharges the person and dismisses the proceedings against the person, a nonpublic record of the discharge and dismissal must be transmitted to and retained by the Division of Parole and Probation of the Department of Public Safety solely for the use of the courts in determining whether, in later proceedings, the person qualifies under this section for participation in a program of treatment for persons who solicit prostitution. Except as otherwise provided in this subsection, discharge and dismissal under this subsection is without adjudication of guilt and is not a conviction for purposes of employment, civil rights or any statute or regulation or license or questionnaire or for any other public or private purpose, but is a conviction for the purpose of additional penalties imposed for a second or subsequent conviction or the setting of bail. Discharge and dismissal restores the person discharged, in the contemplation of the law, to the status occupied before the proceedings. The person may not be held thereafter under any law to be guilty of perjury or otherwise giving a false statement by reason of failure to recite or acknowledge the proceedings in response to an inquiry made of the person for any purpose. Discharge and dismissal under this subsection may occur only once with respect to any person. A professional licensing board may consider a proceeding under this subsection in determining suitability for a license or liability to discipline for misconduct. Such a board is entitled for those purposes to a truthful answer from the applicant or licensee concerning any such proceeding with respect to the applicant or licensee.
[9.] 8. Except as limited by subsection [10,] 9, if a person is discharged and the proceedings against the person are dismissed pursuant to subsection [8,] 7, 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.
[10.] 9. A professional licensing board is entitled, for the purpose of determining suitability for a license or liability to discipline for misconduct, to inspect and to copy from a record sealed pursuant to this section.
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[11. If, at any time before the trial of a prostitute charged with a violation of subsection 1, the prosecuting attorney has reason to believe that the prostitute is a victim of sex trafficking, the prosecuting attorney shall dismiss the charge. As used in this subsection, sex trafficking means a violation of subsection 2 of NRS 201.300.]
Sec. 5. NRS 201.358 is hereby amended to read as follows:
201.358 1. A person who:
(a) Violates NRS 201.354 [;] or section 2 of this act; or
(b) Works as a prostitute in a licensed house of prostitution,
Κ after testing positive in a test approved by the State Board of Health for exposure to the human immunodeficiency virus and receiving notice of that fact 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 2 years and a maximum term of not more than 10 years, or by a fine of not more than $10,000, or by both fine and imprisonment.
2. As used in this section, notice means:
(a) Actual notice; or
(b) Notice received pursuant to NRS 201.356.
Sec. 6. NRS 207.203 is hereby amended to read as follows:
207.203 1. Unless a greater penalty is provided pursuant to NRS 200.603, any person who commits a violation of NRS 207.200 by trespassing on the premises of a licensed gaming establishment and who has previously been convicted of three violations of NRS 201.354 or section 2 of this act within the immediately preceding 5 years is guilty of a misdemeanor and shall be punished by:
(a) A fine of $1,000;
(b) Imprisonment in the county jail for not more than 6 months; or
(c) Both fine and imprisonment.
Κ In lieu of all or a part of the punishment which may be imposed pursuant to this subsection, the person may be sentenced to perform a fixed period of community service pursuant to the conditions prescribed in NRS 176.087.
2. The court, without entering a judgment of conviction and with the consent of the accused, may suspend further proceedings and place the person on probation upon terms and conditions that must include attendance and successful completion of:
(a) A counseling or educational program; or
(b) In the case of a person dependent upon substances, a program of treatment and rehabilitation pursuant to NRS 176A.230 if the court determines that the person is eligible for participation in such a program.
3. Upon violation of a term or condition, the court may enter a judgment of conviction and punish the person as provided in subsection 1.
4. Upon fulfillment of the terms and conditions, the court shall discharge the accused and dismiss the proceedings against him or her.
5. Except as otherwise provided in subsection 6, discharge and dismissal under this section is without adjudication of guilt and is not a conviction for purposes of this section or for purposes of employment, civil rights or any statute or regulation or license or questionnaire or for any other public or private purpose, but is a conviction for the purpose of additional penalties imposed for second or subsequent convictions or the setting of bail. Discharge and dismissal restores the person discharged, in the contemplation of the law, to the status occupied before the arrest, indictment or information. The person may not be held thereafter under any law to be guilty of perjury or otherwise giving a false statement by reason of failure to recite or acknowledge that arrest, indictment, information or trial in response to an inquiry made of the person for any purpose.
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or otherwise giving a false statement by reason of failure to recite or acknowledge that arrest, indictment, information or trial in response to an inquiry made of the person for any purpose. Discharge and dismissal under this section may only occur once with respect to any person.
6. A professional licensing board may consider a proceeding under this section in determining suitability for a license or liability to discipline for misconduct. Such a board is entitled for those purposes to a truthful answer from the applicant or licensee concerning any such proceeding with respect to the applicant or licensee.
7. Before the court assigns a person to a program pursuant to this section, the person must agree to pay the cost of the program to which the person is assigned and the cost of any additional supervision required, to the extent of the financial resources of the person. If the person does not have the financial resources to pay all of the related costs, the court shall, to the extent practicable, arrange for the person to be assigned to a program at a facility that receives a sufficient amount of federal or state funding to offset the remainder of the costs.
8. As used in this section, licensed gaming establishment has the meaning ascribed to it in NRS 463.0169.
Sec. 7. NRS 4.373 is hereby amended to read as follows:
4.373 1. Except as otherwise provided in subsections 2 and 3, NRS 211A.127 or another specific statute, or unless the suspension of a sentence is expressly forbidden, a justice of the peace may suspend, for not more than 2 years, the sentence or a portion thereof of a person convicted of a misdemeanor. If the circumstances warrant, the justice of the peace may order as a condition of suspension, without limitation, that the offender:
(a) Make restitution to the owner of any property that is lost, damaged or destroyed as a result of the commission of the offense;
(b) Engage in a program of community service, for not more than 200 hours;
(c) Actively participate in a program of professional counseling at the expense of the offender;
(d) Abstain from the use of alcohol and controlled substances;
(e) Refrain from engaging in any criminal activity;
(f) Engage or refrain from engaging in any other conduct, or comply with any other condition, deemed appropriate by the justice of the peace;
(g) Submit to a search and seizure by the chief of a department of alternative sentencing, an assistant alternative sentencing officer or any other law enforcement officer at any time of the day or night without a search warrant; and
(h) Submit to periodic tests to determine whether the offender is using a controlled substance or consuming alcohol.
2. If a person is convicted of a misdemeanor that constitutes domestic violence pursuant to NRS 33.018, the justice of the peace may, after the person has served any mandatory minimum period of confinement, suspend the remainder of the sentence of the person for not more than 3 years upon the condition that the person actively participate in:
(a) A program of treatment for alcohol or drug use disorder, or both, which is certified by the Division of Public and Behavioral Health of the Department of Health and Human Services;
(b) A program for the treatment of persons who commit domestic violence that has been certified pursuant to NRS 439.258; or
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(c) The programs set forth in paragraphs (a) and (b),
Κ and that the person comply with any other condition of suspension ordered by the justice of the peace.
3. Except as otherwise provided in this subsection, if a [person] customer of a prostitute is convicted of a misdemeanor that constitutes solicitation for prostitution pursuant to NRS 201.354 or paragraph (b) of subsection 1 of NRS 207.030, the justice of the peace may suspend the sentence for not more than 2 years upon the condition that the person:
(a) Actively participate in a program for the treatment of persons who solicit prostitution which is certified by the Division of Public and Behavioral Health of the Department of Health and Human Services; and
(b) Comply with any other condition of suspension ordered by the justice of the peace.
Κ The justice of the peace may not suspend the sentence of a person pursuant to this subsection if the person has previously participated in a program for the treatment of persons who solicit prostitution which is certified by the Division of Public and Behavioral Health of the Department of Health and Human Services.
4. The justice of the peace may order reports from a person whose sentence is suspended at such times as the justice of the peace deems appropriate concerning the compliance of the offender with the conditions of suspension. If the offender complies with the conditions of suspension to the satisfaction of the justice of the peace, the sentence may be reduced to not less than the minimum period of confinement established for the offense.
5. The justice of the peace may issue a warrant for the arrest of an offender who violates or fails to fulfill a condition of suspension.
Sec. 8. NRS 5.055 is hereby amended to read as follows:
5.055 1. Except as otherwise provided in subsections 2 and 3, NRS 211A.127 or another specific statute, or unless the suspension of a sentence is expressly forbidden, a municipal judge may suspend, for not more than 2 years, the sentence or a portion thereof of a person convicted of a misdemeanor. If the circumstances warrant, the municipal judge may order as a condition of suspension, without limitation, that the offender:
(a) Make restitution to the owner of any property that is lost, damaged or destroyed as a result of the commission of the offense;
(b) Engage in a program of community service, for not more than 200 hours;
(c) Actively participate in a program of professional counseling at the expense of the offender;
(d) Abstain from the use of alcohol and controlled substances;
(e) Refrain from engaging in any criminal activity;
(f) Engage or refrain from engaging in any other conduct, or comply with any other condition, deemed appropriate by the municipal judge;
(g) Submit to a search and seizure by the chief of a department of alternative sentencing, an assistant alternative sentencing officer or any other law enforcement officer at any time of the day or night without a search warrant; and
(h) Submit to periodic tests to determine whether the offender is using any controlled substance or alcohol.
2. If a person is convicted of a misdemeanor that constitutes domestic violence pursuant to NRS 33.018, the municipal judge may, after the person has served any mandatory minimum period of confinement, suspend the remainder of the sentence of the person for not more than 3 years upon the condition that the person actively participate in:
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remainder of the sentence of the person for not more than 3 years upon the condition that the person actively participate in:
(a) A program of treatment for alcohol or drug use disorder, or both, which is certified by the Division of Public and Behavioral Health of the Department of Health and Human Services;
(b) A program for the treatment of persons who commit domestic violence that has been certified pursuant to NRS 439.258; or
(c) The programs set forth in paragraphs (a) and (b),
Κ and that the person comply with any other condition of suspension ordered by the municipal judge.
3. Except as otherwise provided in this subsection, if a [person] customer of a prostitute is convicted of a misdemeanor that constitutes solicitation for prostitution pursuant to NRS 201.354 or paragraph (b) of subsection 1 of NRS 207.030, the municipal judge may suspend the sentence for not more than 2 years upon the condition that the person:
(a) Actively participate in a program for the treatment of persons who solicit prostitution which is certified by the Division of Public and Behavioral Health of the Department of Health and Human Services; and
(b) Comply with any other condition of suspension ordered by the municipal judge.
Κ The municipal judge may not suspend the sentence of a person pursuant to this subsection if the person has previously participated in a program for the treatment of persons who solicit prostitution which is certified by the Division of Public and Behavioral Health of the Department of Health and Human Services.
4. The municipal judge may order reports from a person whose sentence is suspended at such times as the municipal judge deems appropriate concerning the compliance of the offender with the conditions of suspension. If the offender complies with the conditions of suspension to the satisfaction of the municipal judge, the sentence may be reduced to not less than the minimum period of confinement established for the offense.
5. The municipal judge may issue a warrant for the arrest of an offender who violates or fails to fulfill a condition of suspension.
Sec. 9. NRS 62C.015 is hereby amended to read as follows:
62C.015 1. A child must not be adjudicated as delinquent or in need of supervision for engaging in prostitution or solicitation for prostitution pursuant to NRS 201.354 or paragraph (b) of subsection 1 of NRS 207.030 [.] or section 2 of this act.
2. A child must not be placed in a state or local facility for the detention of children if:
(a) The child is alleged to have violated:
(1) The provisions of NRS 197.190, 207.200 or 463.350; or
(2) A county or municipal ordinance imposing a curfew on a child or prohibiting jaywalking or loitering for the purpose of solicitation for prostitution; and
(b) There is reasonable cause to believe that the child is a commercially sexually exploited child.
3. If a court finds that a child committed an act described in subsection 2 and that clear and convincing evidence exists that the child committed the act in connection with commercial sexual exploitation, the court shall not adjudicate the child as a delinquent child or a child in need of supervision based on that act.
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based on that act. Upon such a finding, the court shall report the commercial sexual exploitation of the child to an agency which provides child welfare services.
4. A juvenile justice agency that has reasonable cause to believe that a child in its custody is or has been a commercially sexually exploited child shall report the commercial sexual exploitation of the child to an agency which provides child welfare services.
5. As used in this section:
(a) Commercial sexual exploitation means the sex trafficking of a child in violation of NRS 201.300 or the sexual abuse or sexual exploitation of a child for the financial benefit of any person or in exchange for anything of value, including, without limitation, monetary or nonmonetary benefits given or received by any person.
(b) Commercially sexually exploited child has the meaning ascribed to it in NRS 424.0195.
(c) Juvenile justice agency means the Youth Parole Bureau or a director of juvenile services.
Sec. 10. NRS 62E.275 is hereby amended to read as follows:
62E.275 1. If a child has been adjudicated delinquent for an unlawful act listed in subsection 2, the child may petition the juvenile court for an order:
(a) Vacating the adjudication; and
(b) Sealing all records relating to the adjudication.
2. A child may file a petition pursuant to subsection 1 if the child was adjudicated delinquent for an unlawful act in violation of:
(a) NRS 201.354 [,] or section 2 of this act, for engaging in prostitution or solicitation for prostitution, provided that the child was not alleged to be a customer of a prostitute;
(b) NRS 207.200, for unlawful trespass;
(c) Paragraph (b) of subsection 1 of NRS 463.350, for loitering; or
(d) A county, city or town ordinance, for loitering for the purpose of solicitation or prostitution.
3. The juvenile court may grant a petition filed pursuant to subsection 1 if:
(a) The petitioner was adjudicated delinquent for an unlawful act described in subsection 2;
(b) The participation of the petitioner in the unlawful act was the result of the petitioner having been a victim of:
(1) Trafficking in persons as described in the Trafficking Victims Protection Act of 2000, 22 U.S.C. §§ 7101 et seq.; or
(2) Involuntary servitude as described in NRS 200.463 or 200.4631; and
(c) The petitioner files a petition pursuant to subsection 1 with due diligence after the petitioner has ceased being a victim of trafficking or involuntary servitude or has sought services for victims of such trafficking or involuntary servitude.
4. Before the court decides whether to grant a petition filed pursuant to subsection 1, the court shall:
(a) Notify the district attorney and the chief probation officer or the Chief of the Youth Parole Bureau and allow any person who has evidence that is relevant to consideration of the petition to testify at the hearing on the petition; and
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(b) Take into consideration any reasonable concerns for the safety of the petitioner, family members of the petitioner or other victims that may be jeopardized by the granting of the petition.
5. If the court grants a petition filed pursuant to subsection 1, the court shall:
(a) Vacate the adjudication and dismiss the accusatory pleading; and
(b) Order sealed all records relating to the adjudication.
6. If a petition filed pursuant to subsection 1 does not satisfy the requirements of NRS 62H.130 or the juvenile court determines that the petition is otherwise deficient with respect to the sealing of the petitioners record, the juvenile court may enter an order to vacate the adjudication and dismiss the accusatory pleading if the petitioner satisfies all requirements necessary for the adjudication to be vacated.
7. If the juvenile court enters an order pursuant to subsection 6, the court shall also order sealed all records of the petitioner which relate to the adjudication being vacated in accordance with paragraph (b) of subsection 5, regardless of whether any records relating to other adjudications are ineligible for sealing either by operation of law or because of a deficiency in the petition.
Sec. 11. NRS 179.247 is hereby amended to read as follows:
179.247 1. If a person has been convicted of any offense listed in subsection 2, the person may petition the court in which he or she was convicted or, if the person wishes to file more than one petition and would otherwise need to file a petition in more than one court, the district court, for an order:
(a) Vacating the judgment; and
(b) Sealing all documents, papers and exhibits in the 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.
2. A person may file a petition pursuant to subsection 1 if the person was convicted of:
(a) A violation of NRS 201.354 [,] or section 2 of this act, for engaging in prostitution or solicitation for prostitution, provided that the person was not alleged to be a customer of a prostitute;
(b) A crime under the laws of this State, other than a crime of violence; or
(c) A violation of a county, city or town ordinance, for loitering for the purpose of solicitation or prostitution.
3. A petition filed pursuant to subsection 1 must satisfy the requirements of NRS 179.245.
4. The court may grant a petition filed pursuant to subsection 1 if:
(a) The petitioner was convicted of a violation of an offense described in subsection 2;
(b) The participation of the petitioner in the offense was the result of the petitioner having been a victim of:
(1) Trafficking in persons as described in the Trafficking Victims Protection Act of 2000, 22 U.S.C. §§ 7101 et seq.; or
(2) Involuntary servitude as described in NRS 200.463 or 200.4631; and
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(c) The petitioner files a petition pursuant to subsection 1 with due diligence after the petitioner has ceased being a victim of trafficking or involuntary servitude or has sought services for victims of such trafficking or involuntary servitude.
5. Before the court decides whether to grant a petition filed pursuant to subsection 1, the court shall:
(a) Notify the Central Repository for Nevada Records of Criminal History, the Office of the Attorney General and each office of the district attorney and law enforcement agency in the county in which the petitioner was convicted and allow the prosecuting attorney who prosecuted the petitioner for the crime and any person to testify and present evidence on behalf of any such entity; and
(b) Take into consideration any reasonable concerns for the safety of the defendant, family members of the defendant or other victims that may be jeopardized by the granting of the petition.
6. If the prosecuting attorney who prosecuted the petitioner for the crime stipulates to vacating the judgment of the petitioner and sealing all documents, papers and exhibits related to the case after receiving notification pursuant to subsection 5 and the court makes the findings set forth in subsection 4, the court may vacate the judgment and seal all documents, papers and exhibits in accordance with subsection 7 without a hearing. If the prosecuting attorney does not stipulate to vacating the judgment and sealing the documents, papers and exhibits, a hearing on the petition must be conducted.
7. If the court grants a petition filed pursuant to subsection 1, the court shall:
(a) Vacate the judgment and dismiss the accusatory pleading; and
(b) Order sealed all documents, papers and exhibits in the petitioners 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.
8. If a petition filed pursuant to subsection 1 does not satisfy the requirements of NRS 179.245 or the court determines that the petition is otherwise deficient with respect to the sealing of the petitioners record, the court may enter an order to vacate the judgment and dismiss the accusatory pleading if the petitioner satisfies all requirements necessary for the judgment to be vacated.
9. If the court enters an order pursuant to subsection 8, the court shall also order sealed the records of the petitioner which relate to the judgment being vacated in accordance with paragraph (b) of subsection 7, regardless of whether any records relating to other convictions are ineligible for sealing either by operation of law or because of a deficiency in the petition.
10. As used in this section, crime of violence means:
(a) Any offense involving the use or threatened use of force or violence against the person or property of another; or
(b) Any felony for which there is a substantial risk that force or violence may be used against the person or property of another in the commission of the felony.
Sec. 12. NRS 644A.850 is hereby amended to read as follows:
644A.850 1. The following are grounds for disciplinary action by the Board:
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(a) Failure of an owner of an establishment for hair braiding, a cosmetological establishment, a licensed or registered, as applicable, esthetician, cosmetologist, hair designer, shampoo technologist, hair braider, electrologist, instructor, nail technologist, demonstrator of cosmetics, makeup artist or school of cosmetology to comply with the requirements of this chapter or the applicable regulations adopted by the Board.
(b) Failure of a cosmetologists apprentice, electrologists apprentice, estheticians apprentice, hair designers apprentice or nail technologists apprentice to comply with the requirements of this chapter or the applicable regulations adopted by the Board.
(c) Obtaining practice in cosmetology or any branch thereof, for money or any thing of value, by fraudulent misrepresentation.
(d) Gross malpractice.
(e) Continued practice by a person knowingly having an infectious or contagious disease.
(f) Drunkenness or the use or possession, or both, of a controlled substance or dangerous drug without a prescription, while engaged in the practice of cosmetology.
(g) Advertising in violation of any of the provisions of NRS 644A.800 or 644A.935.
(h) Permitting a license or certificate of registration to be used where the holder thereof is not personally, actively and continuously engaged in business.
(i) Failure to display the license or certificate of registration or a duplicate of the license or certificate of registration as provided in NRS 644A.530, 644A.535, 644A.615, 644A.665 and 644A.710.
(j) Entering, by a school of cosmetology, into an unconscionable contract with a student of cosmetology.
(k) Continued practice of cosmetology or operation of a cosmetological establishment or school of cosmetology after the license therefor has expired.
(l) Engaging in prostitution or solicitation for prostitution in violation of NRS 201.354 or section 2 of this act by the owner of a cosmetological establishment, an establishment for hair braiding or a facility in which threading is conducted, a licensee or a holder of a certificate of registration.
(m) Failure to comply with the provisions of NRS 454.217 or 629.086.
(n) Any other unfair or unjust practice, method or dealing which, in the judgment of the Board, may justify such action.
2. If the Board determines that a violation of this section has occurred, it may:
(a) Refuse to issue or renew a license or certificate of registration;
(b) Revoke or suspend a license or certificate of registration;
(c) Place the licensee or holder of a certificate of registration on probation for a specified period;
(d) Impose a fine not to exceed $2,000; or
(e) Take any combination of the actions authorized by paragraphs (a) to (d), inclusive.
3. An order that imposes discipline and the findings of fact and conclusions of law supporting that order are public records.
Sec. 13. NRS 644A.855 is hereby amended to read as follows:
644A.855 1. If the holder of a license or certificate of registration to operate a cosmetological establishment, an establishment for hair braiding or a facility in which threading is conducted or any other licensee or a holder of a certificate of registration issued pursuant to this chapter is charged with or cited for prostitution in violation of NRS 201.354 or section 2 of this act or any other sexual offense, the appropriate law enforcement agency shall report the charge or citation to the Executive Director of the Board.
κ2021 Statutes of Nevada, Page 3130 (CHAPTER 483, SB 164)κ
a certificate of registration issued pursuant to this chapter is charged with or cited for prostitution in violation of NRS 201.354 or section 2 of this act or any other sexual offense, the appropriate law enforcement agency shall report the charge or citation to the Executive Director of the Board. Upon receiving such a report, the Executive Director shall immediately forward the report to the Board or the Chair of the Board. The Board must meet as soon as practicable to consider the report. If the Board finds that the health, safety or welfare of the public imperatively require emergency action and issues a cease and desist order, the Executive Director shall immediately send the cease and desist order by certified mail to the licensee or holder of the certificate of registration. The temporary suspension of the license or certificate of registration is effective immediately after the licensee or holder of the certificate of registration receives notice of the cease and desist order and must not exceed 15 business days. The licensee or holder of the certificate of registration may file a written request for a hearing to challenge the necessity of the temporary suspension. The written request must be filed not later than 10 business days after the date on which the Executive Director mails the cease and desist order. If the licensee or holder of the certificate of registration:
(a) Files a timely written request for a hearing, the Board shall extend the temporary suspension until a hearing is held. The Board shall hold a hearing and render a final decision regarding the necessity of the temporary suspension as promptly as is practicable but not later than 15 business days after the date on which the Board receives the written request. After holding such a hearing, the Board may extend the period of the temporary suspension if the Board finds, for good cause shown, that such action is necessary to protect the health, safety or welfare of the public pending proceedings for disciplinary action.
(b) Does not file a timely written request for a hearing and the Board wants to consider extending the period of the temporary suspension, the Board shall schedule a hearing and notify the licensee or holder of the certificate of registration immediately by certified mail of the date of the hearing. The hearing must be held and a final decision rendered regarding whether to extend the period of the temporary suspension as promptly as is practicable but not later than 15 business days after the date on which the Executive Director mails the cease and desist order. After holding such a hearing, the Board may extend the period of the temporary suspension if the Board finds, for good cause shown, that such action is necessary to protect the health, safety or welfare of the public pending proceedings for disciplinary action.
2. For purposes of this section, a person is deemed to have notice of a temporary suspension of his or her license or certificate of registration:
(a) On the date on which the notice is personally delivered to the person; or
(b) If the notice is mailed, 3 days after the date on which the notice is mailed by certified mail to the last known business or residential address of the person.
Sec. 14. This act becomes effective on July 1, 2021.
________
κ2021 Statutes of Nevada, Page 3131κ
Senate Bill No. 175Senator Neal
CHAPTER 484
[Approved: June 4, 2021]
AN ACT relating to public health; requiring the Chief Medical Officer to establish and maintain a system for the reporting and analysis of certain information on lupus and its variants; authorizing administrative penalties for the failure to report certain information; requiring the Division of Public and Behavioral Health of the Department of Health and Human Services to report certain information on lupus and its variants; making an appropriation; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Existing law requires the Chief Medical Officer appointed by the Director of the Department of Health and Human Services to establish and maintain systems for the reporting of information on: (1) sickle cell disease and its variants, and (2) cancer and other neoplasms. (NRS 439.4929, 457.230) Existing law requires the chief administrative officer of each health care facility in this State to make available to the Chief Medical Officer or his or her representative the records of the health care facility for each reportable incidence of sickle cell disease or a variant thereof or cancer or another neoplasm. (NRS 439.4933, 457.250) Section 5 of this bill requires the Chief Medical Officer to establish and maintain a similar system for the reporting of information on lupus and its variants. Sections 5 and 6 of this bill require hospitals, medical laboratories, certain other facilities and providers of health care to report certain information prescribed by the State Board of Health concerning each case of lupus and its variants diagnosed or treated at the facility or by the provider, as applicable. Section 7 of this bill requires the chief administrative officer of each health care facility in this State to make available to the Chief Medical Officer or his or her representative the records of the health care facility for each case of lupus and its variants for abstraction by the Division of Public and Behavioral Health of the Department of Health and Human Services. Section 7 also provides for the imposition of an administrative penalty against a person that fails to make the records of the facility for each case of lupus and its variants available for abstraction. Sections 8 and 9 of this bill provide for analysis, reporting and research of the reported and abstracted information concerning cases of lupus and its variants. Section 10 of this bill requires the Division to apply for and accept gifts, grants and donations to carry out the provisions of sections 2-12 of this bill. Sections 6, 11 and 13 of this bill provide for the confidentiality of reported information concerning patients, physicians and facilities. Section 12 of this bill provides immunity from liability for any person or organization who discloses information in good faith to the Division in accordance with the requirements of sections 5-7. Section 14 of this bill makes an appropriation to the Department of Health and Human Services to pay for an employee to support the system for the reporting of information on lupus and its variants.
κ2021 Statutes of Nevada, Page 3132 (CHAPTER 484, SB 175)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 439 of NRS is hereby amended by adding thereto the provisions set forth as sections 2 to 12, inclusive, of this act.
Sec. 2. As used in sections 2 to 12, inclusive, of this act, unless context otherwise requires, the words and terms defined in sections 3 and 4 of this act have the meanings ascribed to them in those sections.
Sec. 3. Health care facility has the meaning ascribed to it in NRS 162A.740.
Sec. 4. Lupus and its variants means a chronic autoimmune disease that occurs when the immune system attacks tissues and organs which can cause inflammation and pain in any part of the body of the person with the disease.
Sec. 5. 1. The Chief Medical Officer shall, pursuant to regulations adopted by the State Board of Health pursuant to section 6 of this act, establish and maintain a system for the reporting of information on lupus and its variants. The Chief Medical Officer shall coordinate with the National Lupus Patient Registry of the Centers for Disease Control and Prevention of the United States Department of Health and Human Services, when establishing and maintaining the system.
2. The system established pursuant to subsection 1 must include a record of the cases of lupus and its variants which occur in this State along with such information concerning the cases as may be appropriate to form the basis for:
(a) Conducting comprehensive epidemiologic surveys of lupus and its variants in this State; and
(b) Evaluating the appropriateness of measures for the treatment of lupus and its variants.
3. Hospitals, medical laboratories and other facilities that provide screening, diagnostic or therapeutic services to patients with respect to lupus and its variants shall report the information prescribed by the State Board of Health pursuant to section 6 of this act to the system established pursuant to subsection 1.
4. Any provider of health care who diagnoses or provides treatment for lupus and its variants, except for cases directly referred to the provider or cases that have been previously admitted to a hospital, medical laboratory or other facility described in subsection 3, shall report the information prescribed by the State Board of Health pursuant to section 6 of this act to the system established pursuant to subsection 1.
5. As used in this section:
(a) Medical laboratory has the meaning ascribed to it in NRS 652.060.
(b) Provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 6. The State Board of Health shall by regulation:
1. Prescribe the form and manner in which information on cases of lupus and its variants must be reported;
2. Prescribe the information that must be included in each report, which must include, without limitation:
(a) The name, address, age and ethnicity of the patient;
(b) The variant of lupus with which the person has been diagnosed;
κ2021 Statutes of Nevada, Page 3133 (CHAPTER 484, SB 175)κ
(c) The method of treatment, including, without limitation, any opioid prescribed for the patient and whether the patient has adequate access to that opioid;
(d) Any other diseases from which the patient suffers;
(e) Information concerning the usage of and access to health care services by the patient; and
(f) If a patient diagnosed with lupus and its variants dies, his or her age at death; and
3. Establish a protocol for allowing appropriate access to and preserving the confidentiality of the records of patients needed for research into lupus and its variants.
Sec. 7. 1. The chief administrative officer of each health care facility in this State shall make available to the Chief Medical Officer or his or her representative the records of the health care facility for each case of lupus and its variants.
2. The Division shall abstract from the records of a health care facility or shall require a health care facility to abstract from the records of the health care facility such information as is required by the State Board of Health pursuant to section 6 of this act. The Division shall compile the information in a timely manner and not later than 6 months after the Division abstracts the information or receives the abstracted information from the health care facility.
3. Any person who violates this section is subject to an administrative penalty established by regulation by the State Board of Health.
Sec. 8. 1. The Division shall publish reports based upon the information obtained pursuant to sections 5, 6 and 7 of this act and make other appropriate uses of the information to report and assess trends in the usage of and access to health care services by patients with lupus and its variants in a particular area or population, advance research and education concerning lupus and its variants and improve the treatment of lupus and its variants and associated disorders. The reports must include, without limitation:
(a) Information concerning the locations in which patients diagnosed with lupus and its variants reside, the demographics of such patients and the utilization of health care services by such patients;
(b) The information described in paragraph (a), specific to patients diagnosed with lupus and its variants who are over 60 years of age; and
(c) The transition of patients diagnosed with lupus and its variants from pediatric to adult care upon reaching 18 years of age.
2. The Division shall provide any qualified researcher whom the Division determines is conducting valid scientific research with data from the information reported pursuant to sections 5, 6 and 7 of this act upon the researchers:
(a) Compliance with appropriate conditions as established pursuant to regulations of the State Board of Health; and
(b) Payment to the Division of a fee established by the Division by regulation to cover the cost of providing the data.
Sec. 9. 1. The Chief Medical Officer or a qualified person designated by the Administrator of the Division shall analyze the information obtained pursuant to sections 5, 6 and 7 of this act and the reports published pursuant to section 8 of this act to determine whether any trends exist in the usage of and access to health care services by patients with lupus and its variants in a particular area or population.
κ2021 Statutes of Nevada, Page 3134 (CHAPTER 484, SB 175)κ
2. If the Chief Medical Officer or the person designated pursuant to subsection 1 determines that a trend exists in the usage of and access to health care services by patients with lupus and its variants in a particular area or population, the Chief Medical Officer or the person designated pursuant to subsection 1 shall work with appropriate governmental, educational and research entities to investigate the trend, advance research in the trend and facilitate the treatment of lupus and its variants and associated disorders.
Sec. 10. The Division shall apply for and accept any gifts, grants and donations available to:
1. Carry out the provisions of sections 2 to 12, inclusive, of this act, including, without limitation, the provisions of subsection 1 of section 5 of this act requiring coordination with the National Lupus Patient Registry of the Centers for Disease Control and Prevention of the United States Department of Health and Human Services;
2. Coordinate and administer any other state programs relating to research concerning lupus and its variants or assistance to patients diagnosed with lupus and its variants;
3. Pay for research concerning lupus and its variants;
4. Provide education concerning lupus and its variants; and
5. Provide support to persons diagnosed with lupus and its variants.
Sec. 11. The Division shall not reveal the identity of any patient, physician or health care facility which is involved in the reporting required by section 7 of this act unless the patient, physician or health care facility gives prior written consent to such a disclosure.
Sec. 12. A person or governmental entity that provides information to the Division in accordance with sections 5, 6 and 7 of this act must not be held liable in a civil or criminal action for sharing confidential information unless the person or organization has done so in bad faith or with malicious purpose.
Sec. 13. NRS 239.010 is hereby amended to read as follows:
239.010 1. Except as otherwise provided in this section and NRS 1.4683, 1.4687, 1A.110, 3.2203, 41.071, 49.095, 49.293, 62D.420, 62D.440, 62E.516, 62E.620, 62H.025, 62H.030, 62H.170, 62H.220, 62H.320, 75A.100, 75A.150, 76.160, 78.152, 80.113, 81.850, 82.183, 86.246, 86.54615, 87.515, 87.5413, 87A.200, 87A.580, 87A.640, 88.3355, 88.5927, 88.6067, 88A.345, 88A.7345, 89.045, 89.251, 90.730, 91.160, 116.757, 116A.270, 116B.880, 118B.026, 119.260, 119.265, 119.267, 119.280, 119A.280, 119A.653, 119A.677, 119B.370, 119B.382, 120A.690, 125.130, 125B.140, 126.141, 126.161, 126.163, 126.730, 127.007, 127.057, 127.130, 127.140, 127.2817, 128.090, 130.312, 130.712, 136.050, 159.044, 159A.044, 172.075, 172.245, 176.01249, 176.015, 176.0625, 176.09129, 176.156, 176A.630, 178.39801, 178.4715, 178.5691, 179.495, 179A.070, 179A.165, 179D.160, 200.3771, 200.3772, 200.5095, 200.604, 202.3662, 205.4651, 209.392, 209.3923, 209.3925, 209.419, 209.429, 209.521, 211A.140, 213.010, 213.040, 213.095, 213.131, 217.105, 217.110, 217.464, 217.475, 218A.350, 218E.625, 218F.150, 218G.130, 218G.240, 218G.350, 226.300, 228.270, 228.450, 228.495, 228.570, 231.069, 231.1473, 233.190, 237.300, 239.0105, 239.0113, 239.014, 239B.030, 239B.040, 239B.050, 239C.140, 239C.210, 239C.230, 239C.250, 239C.270, 239C.420, 240.007, 241.020, 241.030, 241.039, 242.105, 244.264, 244.335, 247.540, 247.550, 247.560, 250.087, 250.130, 250.140, 250.150, 268.095, 268.0978, 268.490, 268.910, 269.174, 271A.105, 281.195, 281.805, 281A.350, 281A.680, 281A.685, 281A.750, 281A.755, 281A.780, 284.4068,
κ2021 Statutes of Nevada, Page 3135 (CHAPTER 484, SB 175)κ
286.110, 286.118, 287.0438, 289.025, 289.080, 289.387, 289.830, 293.4855, 293.5002, 293.503, 293.504, 293.558, 293.5757, 293.870, 293.906, 293.908, 293.910, 293B.135, 293D.510, 331.110, 332.061, 332.351, 333.333, 333.335, 338.070, 338.1379, 338.1593, 338.1725, 338.1727, 348.420, 349.597, 349.775, 353.205, 353A.049, 353A.085, 353A.100, 353C.240, 360.240, 360.247, 360.255, 360.755, 361.044, 361.2242, 361.610, 365.138, 366.160, 368A.180, 370.257, 370.327, 372A.080, 378.290, 378.300, 379.0075, 379.008, 379.1495, 385A.830, 385B.100, 387.626, 387.631, 388.1455, 388.259, 388.501, 388.503, 388.513, 388.750, 388A.247, 388A.249, 391.033, 391.035, 391.0365, 391.120, 391.925, 392.029, 392.147, 392.264, 392.271, 392.315, 392.317, 392.325, 392.327, 392.335, 392.850, 393.045, 394.167, 394.16975, 394.1698, 394.447, 394.460, 394.465, 396.3295, 396.405, 396.525, 396.535, 396.9685, 398A.115, 408.3885, 408.3886, 408.3888, 408.5484, 412.153, 414.280, 416.070, 422.2749, 422.305, 422A.342, 422A.350, 425.400, 427A.1236, 427A.872, 432.028, 432.205, 432B.175, 432B.280, 432B.290, 432B.407, 432B.430, 432B.560, 432B.5902, 432C.140, 432C.150, 433.534, 433A.360, 437.145, 437.207, 439.4941, 439.840, 439.914, 439B.420, 439B.754, 439B.760, 440.170, 441A.195, 441A.220, 441A.230, 442.330, 442.395, 442.735, 442.774, 445A.665, 445B.570, 445B.7773, 447.345, 449.209, 449.245, 449.4315, 449A.112, 450.140, 450B.188, 453.164, 453.720, 453A.610, 453A.700, 458.055, 458.280, 459.050, 459.3866, 459.555, 459.7056, 459.846, 463.120, 463.15993, 463.240, 463.3403, 463.3407, 463.790, 467.1005, 480.535, 480.545, 480.935, 480.940, 481.063, 481.091, 481.093, 482.170, 482.5536, 483.340, 483.363, 483.575, 483.659, 483.800, 484A.469, 484E.070, 485.316, 501.344, 503.452, 522.040, 534A.031, 561.285, 571.160, 584.655, 587.877, 598.0964, 598.098, 598A.110, 599B.090, 603.070, 603A.210, 604A.303, 604A.710, 612.265, 616B.012, 616B.015, 616B.315, 616B.350, 618.341, 618.425, 622.238, 622.310, 623.131, 623A.137, 624.110, 624.265, 624.327, 625.425, 625A.185, 628.418, 628B.230, 628B.760, 629.047, 629.069, 630.133, 630.2673, 630.30665, 630.336, 630A.555, 631.368, 632.121, 632.125, 632.3415, 632.405, 633.283, 633.301, 633.4715, 633.524, 634.055, 634.214, 634A.185, 635.158, 636.107, 637.085, 637B.288, 638.087, 638.089, 639.2485, 639.570, 640.075, 640A.220, 640B.730, 640C.580, 640C.600, 640C.620, 640C.745, 640C.760, 640D.190, 640E.340, 641.090, 641.221, 641.325, 641A.191, 641A.262, 641A.289, 641B.170, 641B.282, 641B.460, 641C.760, 641C.800, 642.524, 643.189, 644A.870, 645.180, 645.625, 645A.050, 645A.082, 645B.060, 645B.092, 645C.220, 645C.225, 645D.130, 645D.135, 645G.510, 645H.320, 645H.330, 647.0945, 647.0947, 648.033, 648.197, 649.065, 649.067, 652.228, 653.900, 654.110, 656.105, 657A.510, 661.115, 665.130, 665.133, 669.275, 669.285, 669A.310, 671.170, 673.450, 673.480, 675.380, 676A.340, 676A.370, 677.243, 678A.470, 678C.710, 678C.800, 679B.122, 679B.124, 679B.152, 679B.159, 679B.190, 679B.285, 679B.690, 680A.270, 681A.440, 681B.260, 681B.410, 681B.540, 683A.0873, 685A.077, 686A.289, 686B.170, 686C.306, 687A.110, 687A.115, 687C.010, 688C.230, 688C.480, 688C.490, 689A.696, 692A.117, 692C.190, 692C.3507, 692C.3536, 692C.3538, 692C.354, 692C.420, 693A.480, 693A.615, 696B.550, 696C.120, 703.196, 704B.325, 706.1725, 706A.230, 710.159, 711.600, and section 11 of this act, sections 35, 38 and 41 of chapter 478, Statutes of Nevada 2011 and section 2 of chapter 391, Statutes of Nevada 2013 and unless otherwise declared by law to be confidential, all public books and public records of a governmental entity must be open at all times during office hours to inspection by any person, and may be fully copied or an abstract or memorandum may be prepared from those public books and public records.
κ2021 Statutes of Nevada, Page 3136 (CHAPTER 484, SB 175)κ
records. Any such copies, abstracts or memoranda may be used to supply the general public with copies, abstracts or memoranda of the records or may be used in any other way to the advantage of the governmental entity or of the general public. This section does not supersede or in any manner affect the federal laws governing copyrights or enlarge, diminish or affect in any other manner the rights of a person in any written book or record which is copyrighted pursuant to federal law.
2. A governmental entity may not reject a book or record which is copyrighted solely because it is copyrighted.
3. A governmental entity that has legal custody or control of a public book or record shall not deny a request made pursuant to subsection 1 to inspect or copy or receive a copy of a public book or record on the basis that the requested public book or record contains information that is confidential if the governmental entity can redact, delete, conceal or separate, including, without limitation, electronically, the confidential information from the information included in the public book or record that is not otherwise confidential.
4. If requested, a governmental entity shall provide a copy of a public record in an electronic format by means of an electronic medium. Nothing in this subsection requires a governmental entity to provide a copy of a public record in an electronic format or by means of an electronic medium if:
(a) The public record:
(1) Was not created or prepared in an electronic format; and
(2) Is not available in an electronic format; or
(b) Providing the public record in an electronic format or by means of an electronic medium would:
(1) Give access to proprietary software; or
(2) Require the production of information that is confidential and that cannot be redacted, deleted, concealed or separated from information that is not otherwise confidential.
5. An officer, employee or agent of a governmental entity who has legal custody or control of a public record:
(a) Shall not refuse to provide a copy of that public record in the medium that is requested because the officer, employee or agent has already prepared or would prefer to provide the copy in a different medium.
(b) Except as otherwise provided in NRS 239.030, shall, upon request, prepare the copy of the public record and shall not require the person who has requested the copy to prepare the copy himself or herself.
Sec. 14. 1. There is hereby appropriated from the State General Fund to the Department of Health and Human Services to pay for one full-time staff position to support the system for the reporting of information on lupus and its variants established pursuant to section 5 of this act the following sums:
For the Fiscal Year 2021-2022........................................................ $87,593
For the Fiscal Year 2022-2023..................................................... $112,485
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 16, 2022, and September 15, 2023, 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 16, 2022, and September 15, 2023, respectively.
κ2021 Statutes of Nevada, Page 3137 (CHAPTER 484, SB 175)κ
transferred, and must be reverted to the State General Fund on or before September 16, 2022, and September 15, 2023, respectively.
Sec. 15. 1. This section and section 14 of this act become effective upon passage and approval.
2. Sections 1 to 13, inclusive, of this act become effective:
(a) Upon passage and approval for the purposes 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, 2021, for all other purposes.
________
Senate Bill No. 211Senators D. Harris, Hardy; Lange, Ohrenschall, Scheible and Spearman
CHAPTER 485
[Approved: June 4, 2021]
AN ACT relating to public health; requiring certain providers of emergency medical services in a hospital or primary care to consult with certain patients as to whether they wish to be tested for sexually transmitted diseases; requiring such a provider to test a patient who wishes to be tested or assist the patient in obtaining a test where practicable and medically indicated; requiring a hospital to ensure the performance of such consultation and testing under certain circumstances; authorizing the imposition of discipline against a hospital or provider for certain violations; making an appropriation; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Existing law establishes requirements concerning the control, prevention and treatment of the human immunodeficiency virus and other sexually transmitted diseases. (NRS 441A.240-441A.336) Section 1 of this bill requires, with certain exceptions, a physician, physician assistant, advanced practice registered nurse or midwife who provides or supervises the provision of emergency medical services in a hospital or primary care to a patient who is at least 15 years of age to: (1) consult with the patient to ascertain whether he or she wishes to be tested or assisted with obtaining testing for sexually transmitted diseases and to determine which tests, if any, are medically indicated; and (2) to the extent practicable and that testing is medically indicated, test a patient who wishes to be tested for sexually transmitted diseases or help such a patient obtain a test. Section 1 similarly requires a hospital that provides emergency medical service or primary care to a patient who is at least 15 years of age to ensure such consultation and the provision of such testing or assistance. A physician, physician assistant, advanced practice registered nurse, midwife or hospital is not required to comply with those requirements if the patient is being treated for a life-threatening emergency, has recently been offered or undergone such a test or lacks the capacity to consent to testing. Sections 1-6 of this bill provide that a hospital, physician, physician assistant, advanced practice registered nurse or midwife that fails to comply with the requirements of section 1 is not subject to a criminal penalty or an administrative fine imposed by the State Board of Health, but is subject to disciplinary action where applicable. Section 6.5 of this bill makes an appropriation to the Division of Health Care Financing and Policy of the Department of Health and Human Services for the costs of providing testing to persons who are covered by Medicaid.
κ2021 Statutes of Nevada, Page 3138 (CHAPTER 485, SB 211)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 441A of NRS is hereby amended by adding thereto a new section to read as follows:
1. Except as otherwise provided in subsection 3, a physician, physician assistant, advanced practice registered nurse or midwife who provides or supervises the provision of emergency medical services in a hospital or primary care to a patient who is 15 years of age or older shall, in accordance with the regulations adopted pursuant to subsection 4:
(a) Consult with the patient to ascertain whether he or she wishes to be tested for sexually transmitted diseases, including, without limitation, the human immunodeficiency virus, and to determine which tests, if any, are medically indicated for the patient; and
(b) If the patient wishes to be tested, conduct any test which is medically indicated for the patient or assist the patient with obtaining any such test, to the extent practicable for the physician, physician assistant, advance practice registered nurse or midwife.
2. Except as otherwise provided in subsection 3, a hospital that provides emergency medical services or primary care to a patient who is 15 years of age or older shall, in accordance with the regulations adopted pursuant to subsection 4:
(a) Ensure that the patient is consulted to ascertain whether he or she wishes to be tested for sexually transmitted diseases, including, without limitation, the human immunodeficiency virus, and to determine which tests, if any, are medically indicated for the patient; and
(b) If the patient wishes to be tested, ensure that any test which is medically indicated for the patient is conducted or that the patient is assisted with obtaining any such test, to the extent practicable for the hospital.
3. A physician, physician assistant, advanced practice registered nurse, midwife or hospital is not required to comply with the requirements of subsection 1 or 2 if the physician, physician assistant, advanced practice registered nurse or midwife or a provider of health care who provides emergency medical services or primary care to the patient at the hospital, as applicable, reasonably believes that the patient:
(a) Is being treated for a life-threatening emergency;
(b) Has recently been offered or has been the subject of a test for the human immunodeficiency virus or other sexually transmitted diseases; or
(c) Lacks capacity to consent to such testing.
4. The Board shall adopt regulations to ensure that:
(a) Any test which is administered to a patient or for which a patient is assisted in obtaining pursuant to this section is medically indicated for that patient; and
(b) Communications concerning testing pursuant to this section are made in a culturally competent manner and, to the extent practicable, in a language that is easily understood by the patient.
5. A physician, physician assistant, advanced practice registered nurse, midwife or hospital that fails to comply with the provisions of this section:
κ2021 Statutes of Nevada, Page 3139 (CHAPTER 485, SB 211)κ
(a) Is not subject to a criminal penalty or an administrative fine pursuant to this chapter; and
(b) Is subject to disciplinary action, where applicable.
6. As used in this section:
(a) Primary care means the practice of family medicine, pediatrics, internal medicine, obstetrics and gynecology and midwifery.
(b) Provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 2. NRS 441A.910 is hereby amended to read as follows:
441A.910 Except as otherwise provided [,] in section 1 of this act, every person who violates any provision of this chapter is guilty of a misdemeanor.
Sec. 3. NRS 441A.920 is hereby amended to read as follows:
441A.920 [Every] Except as otherwise provided in section 1 of this act, every provider of health care, medical facility or medical laboratory that willfully fails, neglects or refuses to comply with any regulation of the Board relating to the reporting of a communicable disease or drug overdose or any requirement of this chapter is guilty of a misdemeanor and, in addition, may be subject to an administrative fine of $1,000 for each violation, as determined by the Board.
Sec. 3.5. NRS 449.160 is hereby amended to read as follows:
449.160 1. The Division may deny an application for a license or may suspend or revoke any license issued under the provisions of NRS 449.029 to 449.2428, inclusive, upon any of the following grounds:
(a) Violation by the applicant or the licensee of any of the provisions of NRS 439B.410 or 449.029 to 449.245, inclusive, or of any other law of this State or of the standards, rules and regulations adopted thereunder.
(b) Aiding, abetting or permitting the commission of any illegal act.
(c) Conduct inimical to the public health, morals, welfare and safety of the people of the State of Nevada in the maintenance and operation of the premises for which a license is issued.
(d) Conduct or practice detrimental to the health or safety of the occupants or employees of the facility.
(e) Failure of the applicant to obtain written approval from the Director of the Department of Health and Human Services as required by NRS 439A.100 or as provided in any regulation adopted pursuant to NRS 449.001 to 449.430, inclusive, and 449.435 to 449.531, inclusive, and chapter 449A of NRS if such approval is required.
(f) Failure to comply with the provisions of NRS 449.2486 [.] or section 1 of this act and any regulations adopted pursuant thereto.
(g) Violation of the provisions of NRS 458.112.
2. In addition to the provisions of subsection 1, the Division may revoke a license to operate a facility for the dependent if, with respect to that facility, the licensee that operates the facility, or an agent or employee of the licensee:
(a) Is convicted of violating any of the provisions of NRS 202.470;
(b) Is ordered to but fails to abate a nuisance pursuant to NRS 244.360, 244.3603 or 268.4124; or
(c) Is ordered by the appropriate governmental agency to correct a violation of a building, safety or health code or regulation but fails to correct the violation.
κ2021 Statutes of Nevada, Page 3140 (CHAPTER 485, SB 211)κ
3. The Division shall maintain a log of any complaints that it receives relating to activities for which the Division may revoke the license to operate a facility for the dependent pursuant to subsection 2. The Division shall provide to a facility for the care of adults during the day:
(a) A summary of a complaint against the facility if the investigation of the complaint by the Division either substantiates the complaint or is inconclusive;
(b) A report of any investigation conducted with respect to the complaint; and
(c) A report of any disciplinary action taken against the facility.
Κ The facility shall make the information available to the public pursuant to NRS 449.2486.
4. On or before February 1 of each odd-numbered year, the Division shall submit to the Director of the Legislative Counsel Bureau a written report setting forth, for the previous biennium:
(a) Any complaints included in the log maintained by the Division pursuant to subsection 3; and
(b) Any disciplinary actions taken by the Division pursuant to subsection 2.
Sec. 4. NRS 630.306 is hereby amended to read as follows:
630.306 1. The following acts, among others, constitute grounds for initiating disciplinary action or denying licensure:
(a) Inability to practice medicine with reasonable skill and safety because of illness, a mental or physical condition or the use of alcohol, drugs, narcotics or any other substance.
(b) Engaging in any conduct:
(1) Which is intended to deceive;
(2) Which the Board has determined is a violation of the standards of practice established by regulation of the Board; or
(3) Which is in violation of a provision of chapter 639 of NRS, or a regulation adopted by the State Board of Pharmacy pursuant thereto, that is applicable to a licensee who is a practitioner, as defined in NRS 639.0125.
(c) Administering, dispensing or prescribing any controlled substance, or any dangerous drug as defined in chapter 454 of NRS, to or for himself or herself or to others except as authorized by law.
(d) Performing, assisting or advising the injection of any substance containing liquid silicone into the human body, except for the use of silicone oil to repair a retinal detachment.
(e) Practicing or offering to practice beyond the scope permitted by law or performing services which the licensee knows or has reason to know that he or she is not competent to perform or which are beyond the scope of his or her training.
(f) Performing, without first obtaining the informed consent of the patient or the patients family, any procedure or prescribing any therapy which by the current standards of the practice of medicine is experimental.
(g) Continual failure to exercise the skill or diligence or use the methods ordinarily exercised under the same circumstances by physicians in good standing practicing in the same specialty or field.
(h) Having an alcohol or other substance use disorder.
(i) Making or filing a report which the licensee or applicant knows to be false or failing to file a record or report as required by law or regulation.
(j) Failing to comply with the requirements of NRS 630.254.
κ2021 Statutes of Nevada, Page 3141 (CHAPTER 485, SB 211)κ
(k) Failure by a licensee or applicant to report in writing, within 30 days, any disciplinary action taken against the licensee or applicant by another state, the Federal Government or a foreign country, including, without limitation, the revocation, suspension or surrender of a license to practice medicine in another jurisdiction. The provisions of this paragraph do not apply to any disciplinary action taken by the Board or taken because of any disciplinary action taken by the Board.
(l) Failure by a licensee or applicant to report in writing, within 30 days, any criminal action taken or conviction obtained against the licensee or applicant, other than a minor traffic violation, in this State or any other state or by the Federal Government, a branch of the Armed Forces of the United States or any local or federal jurisdiction of a foreign country.
(m) Failure to be found competent to practice medicine as a result of an examination to determine medical competency pursuant to NRS 630.318.
(n) Operation of a medical facility at any time during which:
(1) The license of the facility is suspended or revoked; or
(2) An act or omission occurs which results in the suspension or revocation of the license pursuant to NRS 449.160.
Κ This paragraph applies to an owner or other principal responsible for the operation of the facility.
(o) Failure to comply with the requirements of NRS 630.373.
(p) Engaging in any act that is unsafe or unprofessional conduct in accordance with regulations adopted by the Board.
(q) Knowingly or willfully procuring or administering a controlled substance or a dangerous drug as defined in chapter 454 of NRS that is not approved by the United States Food and Drug Administration, unless the unapproved controlled substance or dangerous drug:
(1) Was procured through a retail pharmacy licensed pursuant to chapter 639 of NRS;
(2) Was procured through a Canadian pharmacy which is licensed pursuant to chapter 639 of NRS and which has been recommended by the State Board of Pharmacy pursuant to subsection 4 of NRS 639.2328;
(3) Is cannabis being used for medical purposes in accordance with chapter 678C of NRS; or
(4) Is an investigational drug or biological product prescribed to a patient pursuant to NRS 630.3735 or 633.6945.
(r) Failure to supervise adequately a medical assistant pursuant to the regulations of the Board.
(s) Failure to comply with the provisions of NRS 630.3745.
(t) Failure to obtain any training required by the Board pursuant to NRS 630.2535.
(u) Failure to comply with the provisions of NRS 454.217 or 629.086.
(v) Failure to comply with the provisions of section 1 of this act or any regulations adopted pursuant thereto.
2. As used in this section, investigational drug or biological product has the meaning ascribed to it in NRS 454.351.
Sec. 5. NRS 632.347 is hereby amended to read as follows:
632.347 1. The Board may deny, revoke or suspend any license or certificate applied for or issued pursuant to this chapter, or take other disciplinary action against a licensee or holder of a certificate, upon determining that the licensee or certificate holder:
κ2021 Statutes of Nevada, Page 3142 (CHAPTER 485, SB 211)κ
(a) Is guilty of fraud or deceit in procuring or attempting to procure a license or certificate pursuant to this chapter.
(b) Is guilty of any offense:
(1) Involving moral turpitude; or
(2) Related to the qualifications, functions or duties of a licensee or holder of a certificate,
Κ in which case the record of conviction is conclusive evidence thereof.
(c) Has been convicted of violating any of the provisions of NRS 616D.200, 616D.220, 616D.240 or 616D.300 to 616D.440, inclusive.
(d) Is unfit or incompetent by reason of gross negligence or recklessness in carrying out usual nursing functions.
(e) Uses any controlled substance, dangerous drug as defined in chapter 454 of NRS, or intoxicating liquor to an extent or in a manner which is dangerous or injurious to any other person or which impairs his or her ability to conduct the practice authorized by the license or certificate.
(f) Is a person with mental incompetence.
(g) Is guilty of unprofessional conduct, which includes, but is not limited to, the following:
(1) Conviction of practicing medicine without a license in violation of chapter 630 of NRS, in which case the record of conviction is conclusive evidence thereof.
(2) Impersonating any applicant or acting as proxy for an applicant in any examination required pursuant to this chapter for the issuance of a license or certificate.
(3) Impersonating another licensed practitioner or holder of a certificate.
(4) Permitting or allowing another person to use his or her license or certificate to practice as a licensed practical nurse, registered nurse, nursing assistant or medication aide - certified.
(5) Repeated malpractice, which may be evidenced by claims of malpractice settled against the licensee or certificate holder.
(6) Physical, verbal or psychological abuse of a patient.
(7) Conviction for the use or unlawful possession of a controlled substance or dangerous drug as defined in chapter 454 of NRS.
(h) Has willfully or repeatedly violated the provisions of this chapter. The voluntary surrender of a license or certificate issued pursuant to this chapter is prima facie evidence that the licensee or certificate holder has committed or expects to commit a violation of this chapter.
(i) Is guilty of aiding or abetting any person in a violation of this chapter.
(j) Has falsified an entry on a patients medical chart concerning a controlled substance.
(k) Has falsified information which was given to a physician, pharmacist, podiatric physician or dentist to obtain a controlled substance.
(l) Has knowingly procured or administered a controlled substance or a dangerous drug as defined in chapter 454 of NRS that is not approved by the United States Food and Drug Administration, unless the unapproved controlled substance or dangerous drug:
(1) Was procured through a retail pharmacy licensed pursuant to chapter 639 of NRS;
(2) Was procured through a Canadian pharmacy which is licensed pursuant to chapter 639 of NRS and which has been recommended by the State Board of Pharmacy pursuant to subsection 4 of NRS 639.2328;
κ2021 Statutes of Nevada, Page 3143 (CHAPTER 485, SB 211)κ
(3) Is cannabis being used for medical purposes in accordance with chapter 678C of NRS; or
(4) Is an investigational drug or biological product prescribed to a patient pursuant to NRS 630.3735 or 633.6945.
(m) Has been disciplined in another state in connection with a license to practice nursing or a certificate to practice as a nursing assistant or medication aide - certified, or has committed an act in another state which would constitute a violation of this chapter.
(n) Has engaged in conduct likely to deceive, defraud or endanger a patient or the general public.
(o) Has willfully failed to comply with a regulation, subpoena or order of the Board.
(p) Has operated a medical facility at any time during which:
(1) The license of the facility was suspended or revoked; or
(2) An act or omission occurred which resulted in the suspension or revocation of the license pursuant to NRS 449.160.
Κ This paragraph applies to an owner or other principal responsible for the operation of the facility.
(q) Is an advanced practice registered nurse who has failed to obtain any training required by the Board pursuant to NRS 632.2375.
(r) Is an advanced practice registered nurse who has failed to comply with the provisions of NRS 453.163, 453.164, 453.226, 639.23507, 639.23535 and 639.2391 to 639.23916, inclusive, and any regulations adopted by the State Board of Pharmacy pursuant thereto.
(s) Has engaged in the fraudulent, illegal, unauthorized or otherwise inappropriate prescribing, administering or dispensing of a controlled substance listed in schedule II, III or IV.
(t) Has violated the provisions of NRS 454.217 or 629.086.
(u) Has failed to comply with the provisions of section 1 of this act or any regulations adopted pursuant thereto.
2. For the purposes of this section, a plea or verdict of guilty or guilty but mentally ill or a plea of nolo contendere constitutes a conviction of an offense. The Board may take disciplinary action pending the appeal of a conviction.
3. A licensee or certificate holder is not subject to disciplinary action solely for administering auto-injectable epinephrine pursuant to a valid order issued pursuant to NRS 630.374 or 633.707.
4. As used in this section, investigational drug or biological product has the meaning ascribed to it in NRS 454.351.
Sec. 6. NRS 633.511 is hereby amended to read as follows:
633.511 1. The grounds for initiating disciplinary action pursuant to this chapter are:
(a) Unprofessional conduct.
(b) Conviction of:
(1) A violation of any federal or state law regulating the possession, distribution or use of any controlled substance or any dangerous drug as defined in chapter 454 of NRS;
(2) A felony relating to the practice of osteopathic medicine or practice as a physician assistant;
(3) A violation of any of the provisions of NRS 616D.200, 616D.220, 616D.240 or 616D.300 to 616D.440, inclusive;
(4) Murder, voluntary manslaughter or mayhem;
κ2021 Statutes of Nevada, Page 3144 (CHAPTER 485, SB 211)κ
(5) Any felony involving the use of a firearm or other deadly weapon;
(6) Assault with intent to kill or to commit sexual assault or mayhem;
(7) Sexual assault, statutory sexual seduction, incest, lewdness, indecent exposure or any other sexually related crime;
(8) Abuse or neglect of a child or contributory delinquency; or
(9) Any offense involving moral turpitude.
(c) The suspension of a license to practice osteopathic medicine or to practice as a physician assistant by any other jurisdiction.
(d) Malpractice or gross malpractice, which may be evidenced by a claim of malpractice settled against a licensee.
(e) Professional incompetence.
(f) Failure to comply with the requirements of NRS 633.527.
(g) Failure to comply with the requirements of subsection 3 of NRS 633.471.
(h) Failure to comply with the provisions of NRS 633.694.
(i) Operation of a medical facility, as defined in NRS 449.0151, at any time during which:
(1) The license of the facility is suspended or revoked; or
(2) An act or omission occurs which results in the suspension or revocation of the license pursuant to NRS 449.160.
Κ This paragraph applies to an owner or other principal responsible for the operation of the facility.
(j) Failure to comply with the provisions of subsection 2 of NRS 633.322.
(k) Signing a blank prescription form.
(l) Knowingly or willfully procuring or administering a controlled substance or a dangerous drug as defined in chapter 454 of NRS that is not approved by the United States Food and Drug Administration, unless the unapproved controlled substance or dangerous drug:
(1) Was procured through a retail pharmacy licensed pursuant to chapter 639 of NRS;
(2) Was procured through a Canadian pharmacy which is licensed pursuant to chapter 639 of NRS and which has been recommended by the State Board of Pharmacy pursuant to subsection 4 of NRS 639.2328;
(3) Is cannabis being used for medical purposes in accordance with chapter 678C of NRS; or
(4) Is an investigational drug or biological product prescribed to a patient pursuant to NRS 630.3735 or 633.6945.
(m) Attempting, directly or indirectly, by intimidation, coercion or deception, to obtain or retain a patient or to discourage the use of a second opinion.
(n) Terminating the medical care of a patient without adequate notice or without making other arrangements for the continued care of the patient.
(o) In addition to the provisions of subsection 3 of NRS 633.524, making or filing a report which the licensee knows to be false, failing to file a record or report that is required by law or knowingly or willfully obstructing or inducing another to obstruct the making or filing of such a record or report.
(p) Failure to report any person the licensee knows, or has reason to know, is in violation of the provisions of this chapter or the regulations of the Board within 30 days after the date the licensee knows or has reason to know of the violation.
κ2021 Statutes of Nevada, Page 3145 (CHAPTER 485, SB 211)κ
(q) Failure by a licensee or applicant to report in writing, within 30 days, any criminal action taken or conviction obtained against the licensee or applicant, other than a minor traffic violation, in this State or any other state or by the Federal Government, a branch of the Armed Forces of the United States or any local or federal jurisdiction of a foreign country.
(r) Engaging in any act that is unsafe in accordance with regulations adopted by the Board.
(s) Failure to comply with the provisions of NRS 629.515.
(t) Failure to supervise adequately a medical assistant pursuant to the regulations of the Board.
(u) Failure to obtain any training required by the Board pursuant to NRS 633.473.
(v) Failure to comply with the provisions of NRS 633.6955.
(w) Failure to comply with the provisions of NRS 453.163, 453.164, 453.226, 639.23507, 639.23535 and 639.2391 to 639.23916, inclusive, and any regulations adopted by the State Board of Pharmacy pursuant thereto.
(x) Fraudulent, illegal, unauthorized or otherwise inappropriate prescribing, administering or dispensing of a controlled substance listed in schedule II, III or IV.
(y) Failure to comply with the provisions of NRS 454.217 or 629.086.
(z) Failure to comply with the provisions of section 1 of this act or any regulations adopted pursuant thereto.
2. As used in this section, investigational drug or biological product has the meaning ascribed to it in NRS 454.351.
Sec. 6.5. 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 the costs of providing testing pursuant to the provisions of this act to persons who are covered by Medicaid the following sums:
For the Fiscal Year 2021-2022...................................................... $25,074
For the Fiscal Year 2022-2023...................................................... $21,431
2. The sums appropriated by subsection 1 are available for either fiscal year. Any remaining balance of those sums must not be committed for expenditure after June 30, 2023, 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, 2023, 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, 2023.
Sec. 7. This act becomes effective on July 1, 2021.
________
κ2021 Statutes of Nevada, Page 3146κ
Senate Bill No. 49Committee on Health and Human Services
CHAPTER 486
[Approved: June 4, 2021]
AN ACT relating to cannabis; prohibiting synthetic cannabinoids from being produced, sold or offered for sale in this State; authorizing the Cannabis Compliance Board to employ the services of persons the Board considers necessary for the purposes of hearing disciplinary proceedings; authorizing the Executive Director of the Board to serve a complaint on a respondent who is subject to a disciplinary proceeding; authorizing the Chair of the Board to grant one or more extensions to certain deadlines for holding a hearing; removing authorization for the Board to take testimony by deposition in hearings before the Board; revising provisions governing a regulatory waiver to the registration requirement for holders of an ownership interest of less than 5 percent in a cannabis establishment; changing the labeling requirement for cannabis products; revising provisions relating to cannabis; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Section 1 of this bill defines synthetic cannabinoid as a cannabinoid that is produced artificially and is not derived from a plant of the genus Cannabis. Sections 1.8, 3.1 and 3.6 of this bill prohibit the production, distribution, sale or offering for sale of a synthetic cannabinoid.
Existing law grants the Cannabis Compliance Board certain powers. (NRS 678A.440) Section 1.2 of this bill authorizes the Board to employ the services of such persons it considers necessary for the purposes of hearing disciplinary proceedings. Existing law requires the Board to serve the complaint upon a respondent that is subject to a disciplinary proceeding. (NRS 678A.520) Section 1.3 of this bill authorizes the Executive Director of the Board to serve the respondent with such a complaint. Existing law requires a disciplinary hearing to be held within 45 days after receiving the respondents answer to a complaint unless an expedited hearing is determined to be appropriate by the Board. (NRS 678A.520) Section 1.3 authorizes the Chair of the Board to grant one or more extensions to the 45-day requirement pursuant to a request of a party or an agreement by both parties.
Existing law allows for testimony provided by witnesses appearing at a hearing before the Board to be taken by deposition in the manner provided by the Nevada Rules of Civil Procedure. (NRS 678A.530) Section 1.7 of this bill removes the authorization for the Board to take the testimony of a witness by deposition in hearings before the Board.
Existing law requires a person who owns an ownership interest in a cannabis establishment of less than 5 percent to register with the Board. (NRS 678B.340) Existing law authorizes the Board to waive the registration requirement for such persons pursuant to policies and procedures adopted by regulation. (NRS 678A.450) Existing regulations of the Board establish the policies and procedures for waiving this requirement. (Nevada Cannabis Compliance Regulation 5.125) Section 2 of this bill clarifies existing law to reflect the authority of the Board to adopt policies and procedures that waive the registration requirement. (NRS 678A.450)
Existing law requires each cannabis establishment to ensure that all cannabis products offered for sale are labeled with the words THIS IS A MEDICAL CANNABIS PRODUCT or THIS IS A CANNABIS PRODUCT. (NRS 678B.520) Section 3 of this bill changes the labeling requirement to ensure that all cannabis products offered for sale are labeled with the words THIS PRODUCT CONTAINS CANNABIS.
κ2021 Statutes of Nevada, Page 3147 (CHAPTER 486, SB 49)κ
Existing law prohibits the THC concentration in hemp from exceeding the maximum THC concentration established by federal law for hemp. (NRS 557.160) Sections 3.7 and 3.9 of this bill instead require the State Department of Agriculture to establish the maximum THC concentration for hemp.
Existing law defines marijuana as: (1) all parts of any plant of the genus Cannabis, whether growing or not; (2) the seeds thereof; (3) the resin extracted from any part of the plant, including concentrated cannabis; and (4) every compound, manufacture, salt, derivative, mixture or preparation of the plant, its seeds or resin. (NRS 453.096) Section 3.3 of this bill adds to the definition of marijuana: (1) any commodity or product made using hemp which exceeds the maximum THC concentration established by the State Department of Agriculture; and (2) a product or commodity made from hemp and manufactured or sold by a cannabis establishment which exceeds the maximum THC concentration established by the Cannabis Compliance Board.
Existing law defines THC as: (1) delta-9-tetrahydrocannibinol; (2) delta-8-tetrahydrocannibinol; and (3) the optical isomers of such substances. (NRS 453.139) Section 3.5 of this bill revises the definition of THC as: (1) delta-9-tetrahydrocannabinol and any structural, optical or geometric isomer thereof; (2) delta-8-tetrahydrocannibinol; (3) delta-7-tetrahydrocannibinol; and (4) delta-10-tetrahydrocannibinol.
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 678A of NRS is hereby amended by adding thereto a new section to read as follows:
Synthetic cannabinoid means a cannabinoid that is:
1. Produced artificially, whether from chemicals or from recombinant biological agents, including, without limitation, yeast and algae; and
2. Is not derived from a plant of the genus Cannabis, including, without limitation, biosynthetic cannabinoids.
Sec. 1.1. NRS 678A.010 is hereby amended to read as follows:
678A.010 As used in this title, unless the context otherwise requires, the words and terms defined in NRS 678A.020 to 678A.240, inclusive, and section 1 of this act have the meanings ascribed to them in those sections.
Sec. 1.2. NRS 678A.440 is hereby amended to read as follows:
678A.440 In addition to any other powers granted by this title, the Board has the power to:
1. Enter into interlocal agreements pursuant to NRS 277.080 to 277.180, inclusive.
2. Establish and amend a plan of organization for the Board, including, without limitation, organizations of divisions or sections with leaders for such divisions or sections.
3. Appear on its own behalf before governmental agencies of the State or any of its political subdivisions.
4. Apply for and accept any gift, donation, bequest, grant or other source of money to carry out the provisions of this title.
5. Execute all instruments necessary or convenient for carrying out the provisions of this title.
6. Prepare, publish and distribute such studies, reports, bulletins and other materials as the Board deems appropriate.
7. Refer cases to the Attorney General for criminal prosecution.
8. Maintain an official Internet website for the Board.
κ2021 Statutes of Nevada, Page 3148 (CHAPTER 486, SB 49)κ
9. Monitor federal activity regarding cannabis and report its findings to the Legislature.
10. Employ the services of such persons the Board considers necessary for the purposes of hearing disciplinary proceedings.
Sec. 1.3. NRS 678A.520 is hereby amended to read as follows:
678A.520 1. If the Board proceeds with disciplinary action pursuant to NRS 678A.510, the Board or the Executive Director shall serve a complaint upon the respondent either personally, or by registered or certified mail at the address of the respondent that is on file with the Board. Such complaint must be a written statement of charges and must set forth in ordinary and concise language the acts or omissions with which the respondent is charged. The complaint must specify the statutes and regulations which the respondent is alleged to have violated, but must not consist merely of charges raised in the language of the statutes or regulations. The complaint must provide notice of the right of the respondent to request a hearing. The Chair of the Board may grant an extension to respond to the complaint for good cause.
2. Unless granted an extension, the respondent must answer within 20 days after the service of the complaint. In the answer the respondent:
(a) Must state in short and plain terms the defenses to each claim asserted.
(b) Must admit or deny the facts alleged in the complaint.
(c) Must state which allegations the respondent is without knowledge or information to form a belief as to their truth. Such allegations shall be deemed denied.
(d) Must affirmatively set forth any matter which constitutes an avoidance or affirmative defense.
(e) May demand a hearing. Failure to demand a hearing constitutes a waiver of the right to a hearing and to judicial review of any decision or order of the Board, but the Board may order a hearing even if the respondent so waives his or her right.
3. Failure to answer or to appear at the hearing constitutes an admission by the respondent of all facts alleged in the complaint. The Board may take action based on such an admission and on other evidence without further notice to the respondent. If the Board takes action based on such an admission, the Board shall include in the record which evidence was the basis for the action.
4. The Board shall determine the time and place of the hearing as soon as is reasonably practical after receiving the respondents answer. The Board shall deliver or send by registered or certified mail a notice of hearing to all parties at least 10 days before the hearing. The hearing must be held within 45 days after receiving the respondents answer unless an expedited hearing is determined to be appropriate by the Board, in which event the hearing must be held as soon as practicable. The Chair of the Board may grant one or more extensions to the 45-day requirement pursuant to a request of a party or an agreement by both parties.
Sec. 1.7. NRS 678A.530 is hereby amended to read as follows:
678A.530 [1.] Before a hearing before the Board, and during a hearing upon reasonable cause shown, the Board shall issue subpoenas and subpoenas duces tecum at the request of a party. All witnesses appearing pursuant to subpoena, other than parties, officers or employees of the State of Nevada or any political subdivision thereof, are entitled to receive fees and mileage in the same amounts and under the same circumstances as provided by law for witnesses in civil actions in the district courts.
κ2021 Statutes of Nevada, Page 3149 (CHAPTER 486, SB 49)κ
witnesses in civil actions in the district courts. Witnesses entitled to fees or mileage who attend hearings at points so far removed from their residences as to prohibit return thereto from day to day are entitled, in addition to witness fees and in lieu of mileage, to the per diem compensation for subsistence and transportation authorized for state officers and employees for each day of actual attendance and for each day necessarily occupied in traveling to and from the hearings. Fees, subsistence and transportation expenses must be paid by the party at whose request the witness is subpoenaed. The Board may award as costs the amount of all such expenses to the prevailing party.
[2. The testimony of any material witness residing within or without the State of Nevada may be taken by deposition in the manner provided by the Nevada Rules of Civil Procedure.]
Sec. 1.8. Chapter 678B of NRS is hereby amended by adding thereto a new section to read as follows:
The holder of a license or registration card issued pursuant to this chapter shall not produce, distribute, sell or offer to sell in this State any synthetic cannabinoid.
Sec. 2. NRS 678B.340 is hereby amended to read as follows:
678B.340 1. Except as otherwise provided in [this section,] any policies and procedures adopted by the Board pursuant to paragraph (e) of subsection 1 of NRS 678A.450, a person shall not hold an ownership interest in a cannabis establishment of less than 5 percent, volunteer or work at, contract to provide labor to or be employed by an independent contractor to provide labor to a cannabis establishment as a cannabis establishment agent unless the person is registered with the Board pursuant to this section.
2. A person who wishes to volunteer or work at a cannabis establishment shall submit to the Board an application on a form prescribed by the Board. The application must be accompanied by:
(a) The name, address and date of birth of the prospective cannabis establishment agent;
(b) A statement signed by the prospective cannabis establishment agent pledging not to dispense or otherwise divert cannabis to any person who is not authorized to possess cannabis in accordance with the provisions of this title;
(c) A statement signed by the prospective cannabis establishment agent asserting that he or she has not previously had a cannabis establishment agent registration card revoked;
(d) The application fee, as set forth in NRS 678B.390; and
(e) Such other information as the Board may require by regulation.
3. A person who wishes to contract to provide labor to or be employed by an independent contractor to provide labor to a cannabis establishment shall submit to the Board an application on a form prescribed by the Board for the registration of the independent contractor and each employee of the independent contractor who will provide labor as a cannabis establishment agent. The application must be accompanied by:
(a) The name, address and, if the prospective cannabis establishment agent has a state business license, the business identification number assigned by the Secretary of State upon compliance with the provisions of chapter 76 of NRS;
(b) The name, address and date of birth of each employee of the prospective cannabis establishment agent who will provide labor as a cannabis establishment agent;
κ2021 Statutes of Nevada, Page 3150 (CHAPTER 486, SB 49)κ
(c) A statement signed by the prospective cannabis establishment agent pledging not to dispense or otherwise divert cannabis to, or allow any of its employees to dispense or otherwise divert cannabis to, any person who is not authorized to possess cannabis in accordance with the provisions of this title;
(d) A statement signed by the prospective cannabis establishment agent asserting that it has not previously had a cannabis establishment agent registration card revoked and that none of its employees who will provide labor as a cannabis establishment agent have previously had a cannabis establishment agent registration card revoked;
(e) The application fee, as set forth in NRS 678B.390; and
(f) Such other information as the Board may require by regulation.
4. [A] Except as otherwise provided in any policies and procedures adopted by the Board pursuant to paragraph (e) of subsection 1 of NRS 678A.450, a person who wishes to hold an ownership interest in a cannabis establishment of less than 5 percent shall submit to the Board an application on a form prescribed by the Board. The application must be accompanied by:
(a) The name, address and date of birth of the prospective cannabis establishment agent;
(b) A statement signed by the prospective cannabis establishment agent pledging not to dispense or otherwise divert cannabis to any person who is not authorized to possess cannabis in accordance with the provisions of this title;
(c) A statement signed by the prospective cannabis establishment agent asserting that he or she has not previously had a cannabis establishment agent registration card revoked;
(d) Any information required by the Board to complete an investigation into the background of the prospective cannabis establishment agent, including, without limitation, financial records and other information relating to the business affairs of the prospective cannabis establishment agent;
(e) The application fee, as set forth in NRS 678B.390; and
(f) Such other information as the Board may require by regulation.
5. The Board may conduct any investigation of a prospective cannabis establishment agent and, for an independent contractor, each employee of the prospective cannabis establishment agent who will provide labor as a cannabis establishment agent, that the Board deems appropriate. In connection with such an investigation, the Board may:
(a) Conduct or accept any background check the Board determines to be reliable and expedient to determine the criminal history of the prospective cannabis establishment agent or the employee;
(b) Require a prospective cannabis establishment agent, if a natural person, and each employee of a prospective cannabis establishment agent who will provide labor as a cannabis establishment agent to submit to the Board a complete set of fingerprints and written permission authorizing the Board to forward the fingerprints to the Central Repository for Nevada Records of Criminal History for submission to the Federal Bureau of Investigation for its report; and
(c) If the Board imposes the requirement described in paragraph (b), submit the fingerprints of the prospective cannabis establishment agent and each employee of the prospective cannabis establishment agent who will provide labor as a cannabis establishment agent to the Central Repository for Nevada Records of Criminal History for submission to the Federal Bureau of Investigation for its report.
κ2021 Statutes of Nevada, Page 3151 (CHAPTER 486, SB 49)κ
6. A cannabis establishment shall notify the Board within 10 business days after a cannabis establishment agent ceases to hold an ownership interest in the cannabis establishment of less than 5 percent, be employed by, volunteer at or provide labor as a cannabis establishment agent to the cannabis establishment.
7. A person who:
(a) Has been convicted of an excluded felony offense;
(b) Is less than 21 years of age; or
(c) Is not qualified, in the determination of the Board pursuant to NRS 678B.200,
Κ shall not serve as a cannabis establishment agent.
8. The provisions of this section do not require a person who is an owner, officer or board member of a cannabis establishment to resubmit information already furnished to the Board at the time the establishment was licensed with the Board.
9. If an applicant for registration as a cannabis establishment agent satisfies the requirements of this section, is found to be qualified by the Board pursuant to NRS 678B.200 and is not disqualified from serving as such an agent pursuant to this section or any other applicable law, the Board shall issue to the person and, for an independent contractor, to each person identified in the independent contractors application for registration as an employee who will provide labor as a cannabis establishment agent, a cannabis establishment agent registration card. If the Board does not act upon an application for a cannabis establishment agent registration card within 45 days after the date on which the application is received, the application shall be deemed conditionally approved until such time as the Board acts upon the application. A cannabis establishment agent registration card expires 2 years after the date of issuance and may be renewed upon:
(a) Resubmission of the information set forth in this section; and
(b) Payment of the renewal fee set forth in NRS 678B.390.
10. A person to whom a cannabis establishment agent registration card is issued or for whom such a registration card is renewed shall submit to the Board on the date of the first anniversary of the issuance or renewal an affidavit attesting that in the preceding year there has been no change in the information previously provided to the Board which would subject the person to disciplinary action by the Board.
11. A cannabis establishment agent registration card issued pursuant to this section to an independent contractor or an employee of an independent contractor authorizes the independent contractor or employee to provide labor to any cannabis establishment in this State.
12. A cannabis establishment agent registration card issued pursuant to this section to a person who wishes to volunteer or work at a medical cannabis establishment authorizes the person to volunteer or work at any cannabis establishment in this State for which the category of the cannabis establishment agent registration card authorizes the person to volunteer or work.
13. Except as otherwise prescribed by regulation of the Board, an applicant for registration or renewal of registration as a cannabis establishment agent is deemed temporarily registered as a cannabis establishment agent on the date on which a complete application for registration or renewal of registration is submitted to the Board. A temporary registration as a cannabis establishment agent expires 45 days after the date upon which the application is received.
κ2021 Statutes of Nevada, Page 3152 (CHAPTER 486, SB 49)κ
Sec. 3. NRS 678B.520 is hereby amended to read as follows:
678B.520 1. Each cannabis establishment shall, in consultation with the Board, cooperate to ensure that all cannabis products offered for sale:
(a) Are labeled clearly and unambiguously:
(1) As cannabis [or medical cannabis] with the words [THIS IS A MEDICAL CANNABIS PRODUCT or THIS IS A CANNABIS PRODUCT, as applicable,] THIS PRODUCT CONTAINS CANNABIS in bold type; and
(2) As required by the provisions of this chapter and chapters 678C and 678D of NRS.
(b) Are not presented in packaging that contains an image of a cartoon character, mascot, action figure, balloon or toy, except that such an item may appear in the logo of the cannabis production facility which produced the product.
(c) Are regulated and sold on the basis of the concentration of THC in the products and not by weight.
(d) Are packaged and labeled in such a manner as to allow tracking by way of an inventory control system.
(e) Are not packaged and labeled in a manner which is modeled after a brand of products primarily consumed by or marketed to children.
(f) Are labeled in a manner which indicates the amount of THC in the product, measured in milligrams, and includes a statement that the product contains cannabis and its potency was tested with an allowable variance of the amount determined by the Board by regulation.
(g) Are not labeled or marketed as candy.
2. A cannabis production facility shall not produce cannabis products in any form that:
(a) Is or appears to be a lollipop.
(b) Bears the likeness or contains characteristics of a real or fictional person, animal or fruit, including, without limitation, a caricature, cartoon or artistic rendering.
(c) Is modeled after a brand of products primarily consumed by or marketed to children.
(d) Is made by applying concentrated cannabis, as defined in NRS 453.042, to a commercially available candy or snack food item other than dried fruit, nuts or granola.
3. A cannabis production facility shall:
(a) Seal any cannabis product that consists of cookies or brownies in a bag or other container which is not transparent.
(b) Affix a label to each cannabis product which includes without limitation, in a manner which must not mislead consumers, the following information:
(1) The words Keep out of reach of children;
(2) A list of all ingredients used in the cannabis product;
(3) A list of all allergens in the cannabis product; and
(4) The total content of THC measured in milligrams.
(c) Maintain a hand washing area with hot water, soap and disposable towels which is located away from any area in which cannabis products are cooked or otherwise prepared.
(d) Require each person who handles cannabis products to restrain his or her hair, wear clean clothing and keep his or her fingernails neatly trimmed.
(e) Package all cannabis products produced by the cannabis production facility on the premises of the cannabis production facility.
κ2021 Statutes of Nevada, Page 3153 (CHAPTER 486, SB 49)κ
4. A cannabis establishment shall not engage in advertising that in any way makes cannabis or cannabis products appeal to children, including, without limitation, advertising which uses an image of a cartoon character, mascot, action figure, balloon, fruit or toy.
5. Each cannabis sales facility shall offer for sale containers for the storage of cannabis and cannabis products which lock and are designed to prohibit children from unlocking and opening the container.
6. A cannabis sales facility shall:
(a) Include a written notification with each sale of cannabis or cannabis products which advises the purchaser:
(1) To keep cannabis and cannabis products out of the reach of children;
(2) That cannabis products can cause severe illness in children;
(3) That allowing children to ingest cannabis or cannabis products or storing cannabis or cannabis products in a location which is accessible to children may result in an investigation by an agency which provides child welfare services or criminal prosecution for child abuse or neglect;
(4) That the intoxicating effects of edible cannabis products may be delayed by 2 hours or more and users of edible cannabis products should initially ingest a small amount of the product, then wait at least 120 minutes before ingesting any additional amount of the product;
(5) That pregnant women should consult with a physician before ingesting cannabis or cannabis products;
(6) That ingesting cannabis or cannabis products with alcohol or other drugs, including prescription medication, may result in unpredictable levels of impairment and that a person should consult with a physician before doing so;
(7) That cannabis or cannabis products can impair concentration, coordination and judgment and a person should not operate a motor vehicle while under the influence of cannabis or cannabis products; and
(8) That ingestion of any amount of cannabis or cannabis products before driving may result in criminal prosecution for driving under the influence.
(b) Enclose all cannabis and cannabis products in opaque, child-resistant packaging upon sale.
7. A cannabis sales facility shall allow any person who is at least 21 years of age to enter the premises of the cannabis sales facility.
8. If the health authority, as defined in NRS 446.050, where a cannabis production facility or cannabis sales facility which sells edible cannabis products is located requires persons who handle food at a food establishment to obtain certification, the cannabis production facility or cannabis sales facility shall ensure that at least one employee maintains such certification.
9. A cannabis production facility may sell a commodity or product made using hemp, as defined in NRS 557.160, or containing cannabidiol to a cannabis sales facility.
10. In addition to any other product authorized by the provisions of this title, a cannabis sales facility may sell:
(a) Any commodity or product made using hemp, as defined in NRS 557.160;
(b) Any commodity or product containing cannabidiol with a THC concentration of not more than 0.3 percent; and
(c) Any other product specified by regulation of the Board.
11. A cannabis establishment:
κ2021 Statutes of Nevada, Page 3154 (CHAPTER 486, SB 49)κ
(a) Shall not engage in advertising which contains any statement or illustration that:
(1) Is false or misleading;
(2) Promotes overconsumption of cannabis or cannabis products;
(3) Depicts the actual consumption of cannabis or cannabis products; or
(4) Depicts a child or other person who is less than 21 years of age consuming cannabis or cannabis products or objects suggesting the presence of a child, including, without limitation, toys, characters or cartoons, or contains any other depiction which is designed in any manner to be appealing to or encourage consumption of cannabis or cannabis products by a person who is less than 21 years of age.
(b) Shall not advertise in any publication or on radio, television or any other medium if 30 percent or more of the audience of that medium is reasonably expected to be persons who are less than 21 years of age.
(c) Shall not place an advertisement:
(1) Within 1,000 feet of a public or private school, playground, public park or library, but may maintain such an advertisement if it was initially placed before the school, playground, public park or library was located within 1,000 feet of the location of the advertisement;
(2) On or inside of a motor vehicle used for public transportation or any shelter for public transportation;
(3) At a sports event to which persons who are less than 21 years of age are allowed entry; or
(4) At an entertainment event if it is reasonably estimated that 30 percent or more of the persons who will attend that event are less than 21 years of age.
(d) Shall not advertise or offer any cannabis or cannabis product as free or donated without a purchase.
(e) Shall ensure that all advertising by the cannabis establishment contains such warnings as may be prescribed by the Board, which must include, without limitation, the following words:
(1) Keep out of reach of children; and
(2) For use only by adults 21 years of age and older.
12. Nothing in subsection 11 shall be construed to prohibit a local government, pursuant to chapter 244, 268 or 278 of NRS, from adopting an ordinance for the regulation of advertising relating to cannabis which is more restrictive than the provisions of subsection 11 relating to:
(a) The number, location and size of signs, including, without limitation, any signs carried or displayed by a natural person;
(b) Handbills, pamphlets, cards or other types of advertisements that are distributed, excluding an advertisement placed in a newspaper of general circulation, trade publication or other form of print media;
(c) Any stationary or moving display that is located on or near the premises of a cannabis establishment; and
(d) The content of any advertisement used by a cannabis establishment if the ordinance sets forth specific prohibited content for such an advertisement.
13. If a cannabis establishment engages in advertising for which it is required to determine the percentage of persons who are less than 21 years of age and who may reasonably be expected to view or hear the advertisement, the cannabis establishment shall maintain documentation for not less than 5 years after the date on which the advertisement is first broadcasted, published or otherwise displayed that demonstrates the manner in which the cannabis establishment determined the reasonably expected age of the audience for that advertisement.
κ2021 Statutes of Nevada, Page 3155 (CHAPTER 486, SB 49)κ
manner in which the cannabis establishment determined the reasonably expected age of the audience for that advertisement.
14. In addition to any other penalties provided for by law, the Board may impose a civil penalty upon a cannabis establishment that violates the provisions of subsection 11 or 13 as follows:
(a) For the first violation in the immediately preceding 2 years, a civil penalty not to exceed $1,250.
(b) For the second violation in the immediately preceding 2 years, a civil penalty not to exceed $2,500.
(c) For the third violation in the immediately preceding 2 years, a civil penalty not to exceed $5,000.
(d) For the fourth violation in the immediately preceding 2 years, a civil penalty not to exceed $10,000.
15. As used in this section, motor vehicle used for public transportation does not include a taxicab, as defined in NRS 706.124.
Sec. 3.1. Chapter 453 of NRS is hereby amended by adding thereto a new section to read as follows:
1. A person shall not produce, distribute, sell or offer to sell in this State any synthetic cannabinoid.
2. As used in this section, synthetic cannabinoid has the meaning ascribed to it in section 1 of this act.
Sec. 3.3. NRS 453.096 is hereby amended to read as follows:
453.096 1. Marijuana means:
(a) All parts of any plant of the genus Cannabis, whether growing or not;
(b) The seeds thereof;
(c) The resin extracted from any part of the plant, including concentrated cannabis; [and]
(d) Every compound, manufacture, salt, derivative, mixture or preparation of the plant, its seeds or resin [.] ;
(e) Any commodity or product made using hemp which exceeds the maximum THC concentration established by the State Department of Agriculture for hemp; and
(f) Any product or commodity made from hemp which is manufactured or sold by a cannabis establishment which violates any regulation adopted by the Cannabis Compliance Board pursuant to paragraph (g) of subsection 1 of NRS 678A.450 relating to THC concentration.
2. Marijuana does not include:
(a) Hemp, as defined in NRS 557.160, which is grown or cultivated pursuant to the provisions of chapter 557 of NRS ; [or any commodity or product made using such hemp; or]
(b) The mature [stems] stalks of the plant, fiber produced from the [stems,] stalks, oil or cake made from the seeds of the plant, any other compound, manufacture, salt, derivative, mixture or preparation of the mature [stems] stalks (except the resin extracted therefrom), fiber, oil or cake, or the sterilized seed of the plant which is incapable of germination [.] ; or
(c) Any commodity or product made using hemp, as defined in NRS 557.160, which does not exceed the maximum THC concentration established by the State Department of Agriculture for hemp.
Sec. 3.5. NRS 453.139 is hereby amended to read as follows:
453.139 THC means [:
1. Delta-9-tetrahydrocannabinol;] delta-9-tetrahydrocannabinol and any structural, optical or geometric isomer thereof, including, without limitation:
κ2021 Statutes of Nevada, Page 3156 (CHAPTER 486, SB 49)κ
[2.] 1. Delta-8-tetrahydrocannabinol; [and
3. The optical isomers of such substances.]
2. Delta-7-tetrahydrocannabinol; and
3. Delta-10-tetrahydrocannabinol.
Sec. 3.6. Chapter 557 of NRS is hereby amended by adding thereto a new section to read as follows:
1. A grower or producer shall not produce, distribute, sell in or offer to sell in this State any synthetic cannabinoid.
2. As used in this section, synthetic cannabinoid has the meaning ascribed to it in section 1 of this act.
Sec. 3.7. NRS 557.160 is hereby amended to read as follows:
557.160 1. Hemp means any plant of the genus Cannabis sativa L. and any part of such a plant, including, without limitation, the seeds thereof and all derivatives, extracts, cannabinoids, isomers, acids, salts and salts of isomers, whether growing or not, with a THC concentration that does not exceed the maximum THC concentration established by [federal law] the State Department of Agriculture for hemp.
2. Hemp does not include any commodity or product made using hemp.
Sec. 3.9. NRS 557.260 is hereby amended to read as follows:
557.260 1. The Department may adopt regulations necessary to:
(a) Establish quality standards and requirements for the packaging and labeling of agricultural hemp seed;
(b) Provide for the certification and registration of sites used for growing, producing or handling hemp; and
(c) Comply with any requirement imposed by the United States Department of Agriculture, including, without limitation, any requirement related to reporting information regarding growers, handlers and producers.
2. The Department shall adopt regulations establishing the maximum THC concentration for hemp.
3. A producer shall comply with:
(a) Any regulation adopted by the Department pursuant to subsection 1 [;] or 2; and
(b) The provisions of NRS 587.015 to 587.123, inclusive, and any regulations adopted pursuant thereto.
[3.] 4. Any agricultural hemp seed which is obtained by a grower and was produced:
(a) In this State must be produced by a producer; and
(b) In another state must be produced by a person who is registered and approved to produce and sell agricultural hemp seed pursuant to the laws of that state.
[4.] 5. The Department shall provide adequate information to growers to identify producers from which a grower may purchase agricultural hemp seed.
[5.] 6. A handler may only obtain hemp from a grower and agricultural hemp seed for cleaning and future propagation from a producer.
Sec. 4. This act becomes effective upon passage and approval.
________
κ2021 Statutes of Nevada, Page 3157κ
Senate Bill No. 210Senator Dondero Loop
CHAPTER 487
[Approved: June 4, 2021]
AN ACT relating to child welfare; requiring the development of a plan for the education of certain children admitted by a court to a psychiatric hospital or facility which provides residential treatment for mental illness; requiring a school district providing services to such a child to submit certain programs and plans to the psychiatric hospital; requiring a school district providing services to a child admitted to a facility which provides residential treatment for mental illness to monitor the progress and participate in transition planning for the child; requiring a school district providing services to a child who is admitted to a facility which provides residential treatment for mental illness to convene certain meetings before the admission of the child to the facility; requiring the Department of Education to adopt regulations relating to the transition from a facility which provides residential treatment for mental illness to a school or other educational setting after discharge; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Existing law provides for the court-ordered admission of a child with an emotional disturbance who is in the custody of an agency which provides child welfare services to a psychiatric hospital or facility which provides residential treatment for mental illness. (NRS 432B.6076) Existing law provides that a child who is admitted to a psychiatric hospital or other facility under those conditions has the right to an education. (NRS 432B.6082) Section 1 of this bill requires a psychiatric hospital to which such a child is admitted to develop a plan for the continued education of the child in consultation with the public or private school in which the child was enrolled at the time of admission, any school district that was providing services to the child at the time of admission, the agency which provides child welfare services and any person responsible for the education of the child. Section 1 requires that before a child is admitted to a facility which provides residential treatment for mental illness, any school district in which the child was enrolled or which was providing services to the child when he or she was admitted must monitor the childs progress while the child is admitted to the facility and participate in the discharge planning for transitioning the child into a school or any other educational setting. Section 1 additionally requires that before a pupil with a disability is admitted to a facility which provides residential treatment for mental illness, the school district must convene an individualized education program meeting to consider the appropriateness of a residential placement. For any other child, section 1 instead requires that before the childs admission to such a facility, the school district convene a meeting of representatives from the childs school, the school district, the child welfare services agency, any person responsible for the education of the child and any other agency or organization that supports the child, to consider the appropriateness of a residential placement. Sections 2-4 of this bill make conforming changes to: (1) indicate the placement of section 1 in the Nevada Revised Statutes; and (2) clarify that a child who is admitted to a facility has the right to an education in accordance with the plan. Sections 5 and 6 of this bill require the public or private school in which the child was enrolled at the time of admission to the facility and the school district that was providing services to the child at the time of admission to the facility to participate in the development of and comply with the plan.
κ2021 Statutes of Nevada, Page 3158 (CHAPTER 487, SB 210)κ
Existing law requires that the treatment provided to a child with an emotional disturbance must be designed to facilitate the adjustment and effective functioning of the child in his or her present or anticipated situation in life, and includes certain services. (NRS 433B.300) Section 6.5 of this bill requires that a plan for the continued education of the child if the child is admitted to a psychiatric hospital or facility which provides residential treatment for mental illness is included in the required services. Existing law requires that when a child enters foster care, the agency which provides child welfare services to the child, in consultation with the local education agency and the educational decision maker, must consider certain factors in determining whether it is in the best interests of the child to remain in his or her school of origin. (NRS 388E.105) Section 4.5 of this bill requires that the consideration of a plan for the continued education of the child, if the child is admitted to a psychiatric hospital or facility which provides residential treatment for mental illness, be added to the list of factors considered when determining whether it is in the best interests of the child to remain in his or her school of origin.
Existing federal law requires a school district to develop an individualized education program for the education of a pupil with a disability who attends a public school in the district. (20 U.S.C. § 1414) Existing federal regulations also require a school district to develop a services plan to provide services to a pupil with a disability who attends a private school located within the geographic boundaries of the district. (34 C.F.R. §§ 300.132, 300.137-300.139) If a child for whom an individualized education program or services plan has been developed is in the custody of an agency which provides child welfare services and admitted by a court to a psychiatric hospital or other facility which provides residential treatment for mental illness, sections 5 and 6 require the school district to provide the individualized education program or services plan, as applicable, to the psychiatric hospital or other facility.
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 432B of NRS is hereby amended by adding thereto a new section to read as follows:
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 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.
2. A plan for the continued education of a child developed pursuant to subsection 1 must include, without limitation:
κ2021 Statutes of Nevada, Page 3159 (CHAPTER 487, SB 210)κ
(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 section 5 or 6 of this act, 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 subsection.
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.
κ2021 Statutes of Nevada, Page 3160 (CHAPTER 487, SB 210)κ
Sec. 2. NRS 432B.607 is hereby amended to read as follows:
432B.607 As used in NRS 432B.607 to 432B.6085, inclusive, and section 1 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. 3. NRS 432B.6082 is hereby amended to read as follows:
432B.6082 In addition to the personal rights set forth in NRS 432B.607 to 432B.6085, inclusive, and section 1 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, a child who is in the custody of an agency which provides child welfare services and who is admitted to a facility has the following personal rights, a list of which must be prominently posted in all facilities providing evaluation, treatment or training services to such children and must be otherwise brought to the attention of the child by such additional means as prescribed by regulation:
1. To receive an education in accordance with a plan developed pursuant to section 1 of this act as required by law; and
2. To receive an allowance from the agency which provides child welfare services in an amount equivalent to any allowance required to be provided to children who reside in foster homes.
Sec. 4. 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 section 1 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. 4.5. NRS 388E.105 is hereby amended to read as follows:
388E.105 1. When a child enters foster care or changes placement while in foster care, the agency which provides child welfare services to the child shall determine whether it is in the best interests of the child for the child to remain in his or her school of origin. In making this determination, there is a rebuttable presumption that it is in the best interests of the child to remain in his or her school of origin.
2. In determining whether it is in the best interests of a child in foster care to remain in his or her school of origin, the agency which provides child welfare services, in consultation with the local education agency and the educational decision maker appointed for the child pursuant to NRS 432B.462, must consider, without limitation:
(a) The wishes of the child;
(b) The educational success, stability and achievement of the child;
(c) Any individualized education program or academic plan developed for the child;
(d) Whether the child has been identified as an English learner;
(e) The health and safety of the child;
(f) The availability of necessary services for the child at the school of origin; [and]
(g) Whether the child has a sibling enrolled in the school of origin [.] ; and
κ2021 Statutes of Nevada, Page 3161 (CHAPTER 487, SB 210)κ
(h) A plan for the continued education of the child, developed pursuant to section 1 of this act, if the child is admitted to a psychiatric hospital or facility which provides residential treatment for mental illness.
Κ The costs of transporting the child to the school of origin must not be considered when determining whether it is in the best interests of the child to remain at his or her school of origin.
3. If the agency which provides child welfare services determines that it is in the best interests of a child in foster care to attend a public school other than the childs school of origin:
(a) The agency which provides child welfare services must:
(1) Provide written notice of its determination to every interested party as soon as practicable; and
(2) In collaboration with the local education agency, ensure that the child is immediately enrolled in that public school; and
(b) The public school may not refuse to the enroll the child on the basis that the public school does not have:
(1) A certificate stating that the child has been immunized and has received proper boosters for that immunization;
(2) A birth certificate or other document suitable as proof of the childs identity;
(3) A copy of the childs records from the school the child most recently attended; or
(4) Any other documentation required by a policy adopted by the public school or the local education agency.
Sec. 5. Chapter 392 of NRS is hereby amended by adding thereto a new section to read as follows:
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, the public school and, if applicable, the school district in which the child is enrolled, must:
(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 section 1 of this act 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. 6. Chapter 394 of NRS is hereby amended by adding thereto a new section to read as follows:
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, the private school must participate in the development of a plan for the continued education of the pupil pursuant to section 1 of this act 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 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:
κ2021 Statutes of Nevada, Page 3162 (CHAPTER 487, SB 210)κ
(a) Participate in the development of a plan for the continued education of the pupil pursuant to section 1 of this act 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. 6.5. NRS 433B.300 is hereby amended to read as follows:
433B.300 The treatment provided to a child with an emotional disturbance must be designed to facilitate the adjustment and effective functioning of that child in his or her present or anticipated situation in life, and includes:
1. Services provided without admission to a facility, such as:
(a) Counseling for the family;
(b) Therapy in a group for parents and children;
(c) Classes for parents in effective techniques for the management of children;
(d) Individual therapy for children; and
(e) Evaluation of the child, including personal assessments and studies of individual social environments;
2. Services for the care of children during the day, involving educational programs and therapy programs provided after school or for half a day;
3. Placement in transitional homes operated by professionally trained parents working in close consultation with the administrative officer and the staff of the administrative officer; [and]
4. Short-term residential services providing 24-hour supervision, evaluation and planning and intensive counseling for the family, therapy and educational evaluation and consultation [.] ; and
5. A plan for the continued education of the child if the child is admitted to a psychiatric hospital or a facility which provides residential treatment for mental illness, as applicable, developed pursuant to section 1 of this act, and the communication and coordination of that plan with the school district and the agency which provides child welfare services.
Sec. 7. 1. This section becomes effective upon passage and approval.
2. Sections 1 to 6, 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 July 1, 2021, for all other purposes.
________
κ2021 Statutes of Nevada, Page 3163κ
Senate Bill No. 77Committee on Government Affairs
CHAPTER 488
[Approved: June 2, 2021]
AN ACT relating to public bodies; exempting certain predecisional and deliberative meetings of public bodies from the requirements of the Open Meeting Law; and providing other matters properly relating thereto.
Legislative Counsels Digest:
The Open Meeting Law requires that meetings of public bodies be open to the public, with limited exceptions set forth specifically in statute. (NRS 241.020) Existing federal law exempts certain predecisional interagency or intraagency memorandums or letters that are part of the deliberative process from disclosure under the federal Freedom of Information Act. (5 U.S.C. § 552) Sections 1 and 2 of this bill exempt from the requirements of the Open Meeting Law certain meetings conducted by a public body for the purpose of engaging in predecisional and deliberative discussions relating to an action under the federal National Environmental Policy Act of 1969 (42 U.S.C. §§ 4321 et seq.), including, without limitation, the review and discussion of drafts of environmental impact statements describing the environmental effects of proposed actions within the jurisdiction of the public body.
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 241 of NRS is hereby amended by adding thereto a new section to read as follows:
1. A public body that has entered into a memorandum of understanding or other agreement with a federal agency for the purpose of engaging with the federal agency on an action under the National Environmental Policy Act of 1969, 42 U.S.C. §§ 4321 et seq., may hold a closed meeting to engage in predecisional and deliberative discussions on the subject of the memorandum or agreement. Any such discussions in a closed meeting must:
(a) Occur only during the period before the federal agency publicly releases the document addressing the action under the National Environmental Policy Act and begins the corresponding public comment period; and
(b) Be required by the federal agency to be kept confidential under the memorandum of understanding or other agreement.
2. If a public body holds a closed meeting pursuant to subsection 1, the public body shall not include any item in the discussions for the closed meeting other than the subject of the memorandum or agreement entered into with the federal agency.
Sec. 2. NRS 241.016 is hereby amended to read as follows:
241.016 1. The meetings of a public body that are quasi-judicial in nature are subject to the provisions of this chapter.
κ2021 Statutes of Nevada, Page 3164 (CHAPTER 488, SB 77)κ
2. The following are exempt from the requirements of this chapter:
(a) The Legislature of the State of Nevada.
(b) Judicial proceedings, including, without limitation, proceedings before the Commission on Judicial Selection and, except as otherwise provided in NRS 1.4687, the Commission on Judicial Discipline.
(c) Meetings of the State Board of Parole Commissioners when acting to grant, deny, continue or revoke the parole of a prisoner or to establish or modify the terms of the parole of a prisoner.
3. Any provision of law, including, without limitation, NRS 91.270, 219A.210, 228.495, 239C.140, 239C.420, 281A.350, 281A.690, 281A.735, 281A.760, 284.3629, 286.150, 287.0415, 287.04345, 287.338, 288.220, 288.590, 289.387, 295.121, 360.247, 388.261, 388A.495, 388C.150, 388D.355, 388G.710, 388G.730, 392.147, 392.467, 394.1699, 396.3295, 414.270, 422.405, 433.534, 435.610, 442.774, 463.110, 480.545, 622.320, 622.340, 630.311, 630.336, 631.3635, 639.050, 642.518, 642.557, 686B.170, 696B.550, 703.196 and 706.1725, and section 1 of this act, which:
(a) Provides that any meeting, hearing or other proceeding is not subject to the provisions of this chapter; or
(b) Otherwise authorizes or requires a closed meeting, hearing or proceeding,
Κ prevails over the general provisions of this chapter.
4. The exceptions provided to this chapter, and electronic communication, must not be used to circumvent the spirit or letter of this chapter to deliberate or act, outside of an open and public meeting, upon a matter over which the public body has supervision, control, jurisdiction or advisory powers.
Sec. 3. (Deleted by amendment.)
Sec. 4. This act becomes effective upon passage and approval.
________
κ2021 Statutes of Nevada, Page 3165κ
Senate Bill No. 109Senator Spearman
CHAPTER 489
[Approved: June 6, 2021]
AN ACT relating to governmental agencies; requiring governmental agencies to request from certain persons information related to sexual orientation and gender identity or expression; providing, with certain exceptions, that such information is confidential; requiring a governmental agency to annually report certain information related to sexual orientation and gender identity or expression to the Director of the Legislative Counsel Bureau; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Existing law authorizes certain governmental entities to collect certain personal information. (Chapter 239B of NRS) Section 3 of this bill makes certain legislative findings and declarations related to the collection by governmental agencies of information related to sexual orientation and gender identity or expression. Gender identity or expression means a gender-related identity, appearance, expression or behavior of a person, regardless of the persons assigned sex at birth. (NRS 0.034)
Section 2 of this bill defines governmental agency to include any unit of government of the State or a local government. Section 4 of this bill: (1) requires a governmental agency that requests from a person information related to the persons race or ethnicity to also request information related to the persons sexual orientation and gender identity or expression; (2) provides, with limited exception, that such information is confidential; and (3) authorizes the governmental agency to use such information only for certain purposes. Section 4 also provides that no person shall be required to provide to a governmental agency any information related to the persons sexual orientation or gender identity or expression or denied services or assistance for failure to provide such information. Section 4 further requires a governmental agency to submit an annual report to the Director of the Legislative Counsel Bureau that includes a summary of the information received related to sexual orientation and gender identity or expression.
Section 5 of this bill makes a conforming change relating to the confidentiality of the information collected by a governmental agency related to sexual orientation and gender identity or expression.
Section 5.5 of this bill provides that a governmental agency that does not have the financial resources to comply with the requirements of section 4 is not required to comply with the provisions of section 4 until January 1, 2024. Any such governmental agency must submit an annual report to the Director of the Legislative Counsel Bureau that includes: (1) the specific reasons that the governmental agency has not complied with the requirements of section 4; and (2) the specific actions that the governmental agency has taken in the immediately preceding year toward compliance with the requirements of section 4.
κ2021 Statutes of Nevada, Page 3166 (CHAPTER 489, SB 109)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 239B of NRS is hereby amended by adding thereto the provisions set forth as sections 2, 3 and 4 of this act.
Sec. 2. As used in sections 3 and 4 of this act, governmental agency means an officer, board, commission, department, division, bureau, district or any other unit of government of the State or a local government.
Sec. 3. The Legislature finds and declares that:
1. It is the intent of the Legislature that, in collecting information, governmental agencies must gather accurate information in order for the State and local governments to be able to enhance and improve public services to people in this State.
2. Various governmental agencies collect information on race and ethnicity but there is limited collection by governmental agencies of information related to sexual orientation and gender identity or expression.
3. Compared to the broader community, lesbian, gay, bisexual, transgender and questioning persons experience disparities in their health and welfare and disproportionately high rates of poverty, suicide, homelessness, isolation, substance use disorders and violence. These problems are more prevalent for youth and seniors, communities of color and immigrants.
4. It is in the best interests of the State to respect, embrace and understand the full diversity of residents by collecting accurate information to effectively implement and deliver critical services and programs.
Sec. 4. 1. A governmental agency that requests from a person information related to the persons race or ethnicity shall also request information related to the persons sexual orientation and gender identity or expression. Except as otherwise provided in this section, all information related to a persons sexual orientation or gender identity or expression that is received by a governmental agency is confidential.
2. No person shall be:
(a) Required to provide to a governmental agency any information related to the persons sexual orientation or gender identity or expression; or
(b) Denied services or assistance from a governmental agency for failure to provide to the governmental agency any information related to the persons sexual orientation or gender identity or expression.
3. A governmental agency that receives information related to a persons sexual orientation or gender identity or expression may only use such information for carrying out the duties of the governmental agency, demographic analysis, coordination of care and services, improvement of care and services, conducting research, fulfilling a reporting requirement pursuant to federal or state law or informing policy or funding decisions.
κ2021 Statutes of Nevada, Page 3167 (CHAPTER 489, SB 109)κ
4. On or before December 31 of each year, a governmental agency shall submit to the Director of the Legislative Counsel Bureau for transmittal to the Legislature or, if the Legislature is not in session, to the Legislative Commission, a summary of the information received by the governmental agency related to sexual orientation or gender identity or expression, including, without limitation, the number of people who identify as lesbian, gay, bisexual or transgender, according to race and gender. All information must be reported in the aggregate and must not include any personally identifiable information.
Sec. 5. NRS 239.010 is hereby amended to read as follows:
239.010 1. Except as otherwise provided in this section and NRS 1.4683, 1.4687, 1A.110, 3.2203, 41.071, 49.095, 49.293, 62D.420, 62D.440, 62E.516, 62E.620, 62H.025, 62H.030, 62H.170, 62H.220, 62H.320, 75A.100, 75A.150, 76.160, 78.152, 80.113, 81.850, 82.183, 86.246, 86.54615, 87.515, 87.5413, 87A.200, 87A.580, 87A.640, 88.3355, 88.5927, 88.6067, 88A.345, 88A.7345, 89.045, 89.251, 90.730, 91.160, 116.757, 116A.270, 116B.880, 118B.026, 119.260, 119.265, 119.267, 119.280, 119A.280, 119A.653, 119A.677, 119B.370, 119B.382, 120A.690, 125.130, 125B.140, 126.141, 126.161, 126.163, 126.730, 127.007, 127.057, 127.130, 127.140, 127.2817, 128.090, 130.312, 130.712, 136.050, 159.044, 159A.044, 172.075, 172.245, 176.01249, 176.015, 176.0625, 176.09129, 176.156, 176A.630, 178.39801, 178.4715, 178.5691, 179.495, 179A.070, 179A.165, 179D.160, 200.3771, 200.3772, 200.5095, 200.604, 202.3662, 205.4651, 209.392, 209.3923, 209.3925, 209.419, 209.429, 209.521, 211A.140, 213.010, 213.040, 213.095, 213.131, 217.105, 217.110, 217.464, 217.475, 218A.350, 218E.625, 218F.150, 218G.130, 218G.240, 218G.350, 226.300, 228.270, 228.450, 228.495, 228.570, 231.069, 231.1473, 233.190, 237.300, 239.0105, 239.0113, 239.014, 239B.030, 239B.040, 239B.050, 239C.140, 239C.210, 239C.230, 239C.250, 239C.270, 239C.420, 240.007, 241.020, 241.030, 241.039, 242.105, 244.264, 244.335, 247.540, 247.550, 247.560, 250.087, 250.130, 250.140, 250.150, 268.095, 268.0978, 268.490, 268.910, 269.174, 271A.105, 281.195, 281.805, 281A.350, 281A.680, 281A.685, 281A.750, 281A.755, 281A.780, 284.4068, 286.110, 286.118, 287.0438, 289.025, 289.080, 289.387, 289.830, 293.4855, 293.5002, 293.503, 293.504, 293.558, 293.5757, 293.870, 293.906, 293.908, 293.910, 293B.135, 293D.510, 331.110, 332.061, 332.351, 333.333, 333.335, 338.070, 338.1379, 338.1593, 338.1725, 338.1727, 348.420, 349.597, 349.775, 353.205, 353A.049, 353A.085, 353A.100, 353C.240, 360.240, 360.247, 360.255, 360.755, 361.044, 361.2242, 361.610, 365.138, 366.160, 368A.180, 370.257, 370.327, 372A.080, 378.290, 378.300, 379.0075, 379.008, 379.1495, 385A.830, 385B.100, 387.626, 387.631, 388.1455, 388.259, 388.501, 388.503, 388.513, 388.750, 388A.247, 388A.249, 391.033, 391.035, 391.0365, 391.120, 391.925, 392.029, 392.147, 392.264, 392.271, 392.315, 392.317, 392.325, 392.327, 392.335, 392.850, 393.045, 394.167, 394.16975, 394.1698, 394.447, 394.460, 394.465, 396.3295, 396.405, 396.525, 396.535, 396.9685, 398A.115, 408.3885, 408.3886, 408.3888, 408.5484, 412.153, 414.280, 416.070, 422.2749, 422.305, 422A.342, 422A.350, 425.400, 427A.1236, 427A.872, 432.028, 432.205, 432B.175, 432B.280, 432B.290, 432B.407, 432B.430, 432B.560, 432B.5902, 432C.140, 432C.150, 433.534, 433A.360, 437.145, 437.207, 439.4941, 439.840, 439.914, 439B.420, 439B.754, 439B.760, 440.170, 441A.195, 441A.220, 441A.230, 442.330, 442.395, 442.735, 442.774, 445A.665, 445B.570, 445B.7773, 447.345,
κ2021 Statutes of Nevada, Page 3168 (CHAPTER 489, SB 109)κ
449.209, 449.245, 449.4315, 449A.112, 450.140, 450B.188, 453.164, 453.720, 453A.610, 453A.700, 458.055, 458.280, 459.050, 459.3866, 459.555, 459.7056, 459.846, 463.120, 463.15993, 463.240, 463.3403, 463.3407, 463.790, 467.1005, 480.535, 480.545, 480.935, 480.940, 481.063, 481.091, 481.093, 482.170, 482.5536, 483.340, 483.363, 483.575, 483.659, 483.800, 484A.469, 484E.070, 485.316, 501.344, 503.452, 522.040, 534A.031, 561.285, 571.160, 584.655, 587.877, 598.0964, 598.098, 598A.110, 599B.090, 603.070, 603A.210, 604A.303, 604A.710, 612.265, 616B.012, 616B.015, 616B.315, 616B.350, 618.341, 618.425, 622.238, 622.310, 623.131, 623A.137, 624.110, 624.265, 624.327, 625.425, 625A.185, 628.418, 628B.230, 628B.760, 629.047, 629.069, 630.133, 630.2673, 630.30665, 630.336, 630A.555, 631.368, 632.121, 632.125, 632.3415, 632.405, 633.283, 633.301, 633.4715, 633.524, 634.055, 634.214, 634A.185, 635.158, 636.107, 637.085, 637B.288, 638.087, 638.089, 639.2485, 639.570, 640.075, 640A.220, 640B.730, 640C.580, 640C.600, 640C.620, 640C.745, 640C.760, 640D.190, 640E.340, 641.090, 641.221, 641.325, 641A.191, 641A.262, 641A.289, 641B.170, 641B.282, 641B.460, 641C.760, 641C.800, 642.524, 643.189, 644A.870, 645.180, 645.625, 645A.050, 645A.082, 645B.060, 645B.092, 645C.220, 645C.225, 645D.130, 645D.135, 645G.510, 645H.320, 645H.330, 647.0945, 647.0947, 648.033, 648.197, 649.065, 649.067, 652.228, 653.900, 654.110, 656.105, 657A.510, 661.115, 665.130, 665.133, 669.275, 669.285, 669A.310, 671.170, 673.450, 673.480, 675.380, 676A.340, 676A.370, 677.243, 678A.470, 678C.710, 678C.800, 679B.122, 679B.124, 679B.152, 679B.159, 679B.190, 679B.285, 679B.690, 680A.270, 681A.440, 681B.260, 681B.410, 681B.540, 683A.0873, 685A.077, 686A.289, 686B.170, 686C.306, 687A.110, 687A.115, 687C.010, 688C.230, 688C.480, 688C.490, 689A.696, 692A.117, 692C.190, 692C.3507, 692C.3536, 692C.3538, 692C.354, 692C.420, 693A.480, 693A.615, 696B.550, 696C.120, 703.196, 704B.325, 706.1725, 706A.230, 710.159, 711.600, and section 4 of this act, sections 35, 38 and 41 of chapter 478, Statutes of Nevada 2011 and section 2 of chapter 391, Statutes of Nevada 2013 and unless otherwise declared by law to be confidential, all public books and public records of a governmental entity must be open at all times during office hours to inspection by any person, and may be fully copied or an abstract or memorandum may be prepared from those public books and public records. Any such copies, abstracts or memoranda may be used to supply the general public with copies, abstracts or memoranda of the records or may be used in any other way to the advantage of the governmental entity or of the general public. This section does not supersede or in any manner affect the federal laws governing copyrights or enlarge, diminish or affect in any other manner the rights of a person in any written book or record which is copyrighted pursuant to federal law.
2. A governmental entity may not reject a book or record which is copyrighted solely because it is copyrighted.
3. A governmental entity that has legal custody or control of a public book or record shall not deny a request made pursuant to subsection 1 to inspect or copy or receive a copy of a public book or record on the basis that the requested public book or record contains information that is confidential if the governmental entity can redact, delete, conceal or separate, including, without limitation, electronically, the confidential information from the information included in the public book or record that is not otherwise confidential.
κ2021 Statutes of Nevada, Page 3169 (CHAPTER 489, SB 109)κ
if the governmental entity can redact, delete, conceal or separate, including, without limitation, electronically, the confidential information from the information included in the public book or record that is not otherwise confidential.
4. If requested, a governmental entity shall provide a copy of a public record in an electronic format by means of an electronic medium. Nothing in this subsection requires a governmental entity to provide a copy of a public record in an electronic format or by means of an electronic medium if:
(a) The public record:
(1) Was not created or prepared in an electronic format; and
(2) Is not available in an electronic format; or
(b) Providing the public record in an electronic format or by means of an electronic medium would:
(1) Give access to proprietary software; or
(2) Require the production of information that is confidential and that cannot be redacted, deleted, concealed or separated from information that is not otherwise confidential.
5. An officer, employee or agent of a governmental entity who has legal custody or control of a public record:
(a) Shall not refuse to provide a copy of that public record in the medium that is requested because the officer, employee or agent has already prepared or would prefer to provide the copy in a different medium.
(b) Except as otherwise provided in NRS 239.030, shall, upon request, prepare the copy of the public record and shall not require the person who has requested the copy to prepare the copy himself or herself.
Sec. 5.5. 1. Notwithstanding the provisions of section 4 of this act, if a governmental agency does not have sufficient financial resources to comply with the provisions of section 4 of this act, the governmental agency is not required to comply with the provisions of section 4 of this act until January 1, 2024. Any such governmental agency must, on or before January 1 of each year, starting on January 1, 2022, submit to the Director of the Legislative Counsel Bureau for transmittal to the Legislature or, if the Legislature is not in session, to the Legislative Commission, a report which indicates:
(a) The specific reasons that the governmental agency has not complied with the requirements of section 4 of this act; and
(b) The specific actions that the governmental agency has taken in the immediately preceding year toward compliance with the requirements of section 4 of this act.
2. As used in this section, governmental agency has the meaning ascribed to it in section 2 of this act.
Sec. 6. The provisions of subsection 1 of NRS 218D.380 do not apply to any provision of this act which adds or revises a requirement to submit a report to the Legislature.
Sec. 7. 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.
________
κ2021 Statutes of Nevada, Page 3170κ
Senate Bill No. 237Senators D. Harris, Scheible; and Spearman
CHAPTER 490
[Approved: June 6, 2021]
AN ACT relating to businesses; revising provisions relating to policies, programs and procedures intended to encourage and promote certain business enterprises to require such programs to include LGBTQ-owned businesses; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Existing law provides that a minority-owned business, woman-owned business or veteran-owned business is entitled, at the time of application for issuance or renewal of a state business license, to receive certain information through the state business portal regarding public and private programs to obtain financing for small businesses under state and federal laws and the process for obtaining certification as a disadvantaged business enterprise under federal law. (NRS 75A.350) Section 1 of this bill adds LGBTQ-owned businesses to the list of those entitled to receive such information.
Existing law requires the Office of Economic Development to develop and carry into effect a program under which a business certified as a small business enterprise, minority-owned business enterprise, woman-owned business enterprise or disadvantaged business enterprise may obtain a loan to finance the expansion of its business in this State. (NRS 231.1409) Section 2 of this bill requires the program to include businesses certified as LGBTQ-owned business enterprises.
Existing law sets forth certain legislative declarations concerning equal access to opportunities for business formation and business growth in this State in relation to the business of the Department of Transportation. (NRS 408.38722) Section 3 of this bill specifically declares that the elimination of discrimination against LGBTQ-owned businesses is important to the future welfare of this State. Existing law also requires the Department of Transportation to establish goals for the participation of disadvantaged business enterprises and local emerging small businesses in certain contracts relating to transportation projects. (NRS 408.38724) Section 4 of this bill revises these requirements to require the Department to establish goals for the awarding of contracts to: (1) disadvantaged business enterprises for projects that receive federal funding in accordance with applicable federal regulations; and (2) small business enterprises, local emerging small businesses and LGBTQ-owned businesses for certain transportation projects that do not receive federal funding. Section 4 requires that the goals established for the awarding of contracts for projects that do not receive federal funding be: (1) consistent with the goals required for similar projects that receive federal funding; and (2) based upon certain information relating to the market for which the goals are set and the most recent disparity study conducted by the Department.
Existing law creates the Cannabis Advisory Commission for the purposes of studying issues and making recommendations related to the regulation of cannabis in this State. (NRS 678A.300, 678A.310) Section 5 of this bill requires any subcommittee on market participation appointed by the Chair of the Commission to review and make recommendations on matters relating to LGBTQ-owned businesses in the cannabis industry in this State.
Existing law creates the Regional Business Development Advisory Council for Clark County and requires the Council to propose and implement policies, programs and procedures to encourage and promote the use of local businesses owned and operated by disadvantaged persons. (Sections 15 and 20 of chapter 7, Statutes of Nevada 2003, 20th Special Session, at pages 268-69) Section 6 of this bill includes a person who identifies as lesbian, gay, bisexual, transgender, queer or intersex or of any other nonheterosexual or noncisgender orientation or gender identity or expression in the definition of disadvantaged person.
κ2021 Statutes of Nevada, Page 3171 (CHAPTER 490, SB 237)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 75A.350 is hereby amended to read as follows:
75A.350 1. The Secretary of State shall ensure that the state business portal enables a person who applies through the state business portal for the issuance or renewal of a state business license pursuant to chapter 76 of NRS to indicate whether the applicant is a minority-owned business, a woman-owned business , [or] a veteran-owned business [.] or an LGBTQ-owned business.
2. If a person who applies through the state business portal for the issuance or renewal of a state business license pursuant to chapter 76 of NRS indicates that the business is a minority-owned business, a woman-owned business , [or] a veteran-owned business [,] or an LGBTQ-owned business, the Secretary of State shall provide the following information to the person in electronic form through the state business portal:
(a) Information concerning programs to provide financing for small businesses. The information must include, without limitation, information concerning:
(1) Grants or loans of money from the Catalyst Account created by NRS 231.1573;
(2) The issuance of revenue bonds for industrial development pursuant to NRS 349.400 to 349.670, inclusive;
(3) The Nevada Collateral Support Program pursuant to 12 U.S.C. §§ 5701 et seq.;
(4) The Nevada Microenterprise Initiative Program pursuant to 12 U.S.C. §§ 5701 et seq.;
(5) The Nevada New Markets Jobs Act pursuant to chapter 231A of NRS;
(6) The Nevada Silver State Opportunities Fund pursuant to NRS 355.275;
(7) Loans from the Small Business Administration pursuant to 15 U.S.C. §§ 631 et seq.; and
(8) Any other program to provide financing for small businesses designated by the Secretary of State.
(b) Information concerning the process by which the business may become certified as a disadvantaged business enterprise for the purposes of 49 C.F.R. § 26.5 or a program to provide financing for disadvantaged business enterprises.
3. The Secretary of State may adopt regulations as he or she deems necessary to carry out the provisions of this section.
4. As used in this section:
(a) LGBTQ means lesbian, gay, bisexual, transgender, queer or intersex or of any other nonheterosexual or noncisgender orientation or gender identity or expression.
(b) LGBTQ-owned business means a business that:
(1) Is owned by a natural person who identifies as LGBTQ; or
(2) Has at least 51 percent of its ownership interest held by one or more natural persons who identify as LGBTQ.
(c) Veteran has the meaning ascribed to it in NRS 417.005.
κ2021 Statutes of Nevada, Page 3172 (CHAPTER 490, SB 237)κ
[(b)] (d) Veteran-owned business means a business that:
(1) Is owned by a natural person who is a veteran; or
(2) Has at least 51 percent of its ownership interest held by one or more veterans.
Sec. 2. NRS 231.1409 is hereby amended to read as follows:
231.1409 1. The Office shall develop and carry into effect a program under which a business located in this State that is certified by an agency or entity approved by the Office as a small business enterprise, minority-owned business enterprise, woman-owned business enterprise , LGBTQ-owned business enterprise or disadvantaged business enterprise may obtain a loan of money distributed from the Account to finance the expansion of its business.
2. In carrying out the program, the Office may:
(a) Enter into an agreement with a person who operates a program in this State to provide loans to small business enterprises, minority-owned business enterprises, women-owned business enterprises , LGBTQ-owned business enterprises and disadvantaged business enterprises.
(b) Make grants of money from the Account to that person, which must be used by that person to make loans or participate with private lending institutions in the making of loans to finance the expansion of a business located in this State that is certified by an agency or entity approved by the Office as a small business enterprise, minority-owned business enterprise, woman-owned business enterprise , LGBTQ-owned business enterprise or disadvantaged business enterprise.
3. The Office shall establish the criteria which must be used by the program to determine whether to make a loan to a business described in subsection 1 and the criteria which such a business must meet to qualify for a loan under the program. In establishing such criteria, the Office shall consider, without limitation, whether the making of the loan will assist this State to:
(a) Diversify and expand the number and types of businesses and industries in this State;
(b) Encourage economic growth and maintain a stable economy;
(c) Expand employment opportunities or relieve unemployment or underemployment in any segments of the population of this State that traditionally have experienced the highest rates of unemployment and underemployment; and
(d) Encourage the formation and expansion of businesses located in this State that are certified by an agency or entity approved by the Office as a small business enterprise, minority-owned business enterprise, woman-owned business enterprise , LGBTQ-owned business enterprise or disadvantaged business enterprise.
4. The Office shall establish procedures for applying for a loan from the program. The procedures must require an applicant to submit an application for a loan that includes, without limitation:
(a) A statement of the proposed use of the loan;
(b) A business plan; and
(c) Such other information as the Office deems necessary to determine whether the making of the loan to the applicant satisfies the criteria established by the Office pursuant to subsection 3 and whether the applicant is qualified for the loan.
κ2021 Statutes of Nevada, Page 3173 (CHAPTER 490, SB 237)κ
5. A business located in this State that is certified by an agency or entity approved by the Office as a small business enterprise, minority-owned business enterprise, woman-owned business enterprise , LGBTQ-owned business enterprise or disadvantaged business enterprise may submit an application for a loan to the Office or the person with whom the Office has entered into an agreement to carry out the program.
6. The Office, or the person with whom the Office has entered into an agreement to carry out the program, may approve an application for a loan submitted pursuant to subsection 5 if the Office, or the person carrying out the program, finds that:
(a) The applicant operates a for-profit business in this State and has the capability to continue in operation in this State for a period prescribed by the Office;
(b) The applicant maintains its principal place of business in this State;
(c) The applicant is certified by an agency or entity approved by the Office as a small business enterprise, minority-owned business enterprise, woman-owned business enterprise , LGBTQ-owned business enterprise or disadvantaged business enterprise and is in compliance with all applicable licensing and registration requirements in this State;
(d) The loan will enable the business to acquire the capital equipment necessary to expand in this State and hire additional employees in this State;
(e) There is adequate assurance that the loan will be repaid; and
(f) The making of the loan satisfies the criteria established by the Office pursuant to subsection 3.
7. If the Office, or a person with whom the Office has entered into an agreement to carry out the program, approves an application for a loan pursuant to this section:
(a) The Office, or the person carrying out the program, and the applicant must execute a loan agreement that contains such terms as the Office or person deems necessary; and
(b) The Office, or the person carrying out the program, must fund the loan from the money in the Account.
8. The rate of interest on loans made pursuant to the program must be as low as practicable, but sufficient to pay the cost of the program.
9. After deducting the costs directly related to administering the program, payments of principal and interest on loans made to a small business enterprise, minority-owned business enterprise, woman-owned business enterprise , LGBTQ-owned business enterprise or disadvantaged business enterprise from money distributed from the Account must be deposited in the State General Fund for credit to the Account.
10. As used in this section [,] :
(a) Account means the Small Business Enterprise Loan Account created by NRS 231.14095.
(b) LGBTQ means lesbian, gay, bisexual, transgender, queer or intersex or of any other nonheterosexual or noncisgender orientation or gender identity or expression.
(c) LGBTQ-owned business enterprise means a business that:
(1) Is owned by a natural person who identifies as LGBTQ; or
(2) Has at least 51 percent of its ownership interest held by one or more natural persons who identify as LGBTQ.
κ2021 Statutes of Nevada, Page 3174 (CHAPTER 490, SB 237)κ
Sec. 3. NRS 408.38722 is hereby amended to read as follows:
408.38722 The Legislature hereby finds and declares that:
1. The State wishes to provide all of its citizens with equal access to opportunities for business formation and business growth.
2. The elimination of discrimination against disadvantaged business enterprises and LGBTQ-owned businesses is of paramount importance to the future welfare of this State.
3. The Legislature has received and carefully reviewed the Availability and Disparity Study commissioned by the Department and published on June 15, 2007, that this study provides a strong basis of evidence demonstrating persistent discrimination against businesses owned by women and minorities and that this study demonstrates that:
(a) Disparities exist in the utilization of businesses owned by women and minorities in the same geographic markets and industry categories in which the Department does business;
(b) The State would become a passive participant in private-sector racial, ethnic and gender discrimination if it ceased or curtailed its remedial efforts against such discrimination;
(c) An overall pattern of disparities exists in the utilization of all racial and ethnic groups and both minority and nonminority women combined in all Department contracts;
(d) Evidence exists that discrimination in the private sector has depressed the formation and growth of firms among minority and nonminority women entrepreneurs; and
(e) Evidence exists of discrimination against minority and nonminority women business owners in the Nevada marketplace.
4. The Department should continue to use race-neutral and gender-neutral efforts to eliminate discrimination to the maximum extent feasible and should use only race-conscious and gender-conscious measures where necessary to eliminate discrimination that was not alleviated by race-neutral and gender-neutral efforts, and only as allowed under federal law.
5. NRS 408.3872 to 408.38728, inclusive, continues and enhances efforts to ensure that the Department limits the burden on businesses which are not disadvantaged business enterprises or LGBTQ-owned businesses by ensuring flexibility in the operations of the Department.
6. Efforts by this State to support the development of businesses owned by women , [and] minorities and persons who identify as LGBTQ that are competitively viable will assist in reducing discrimination and creating jobs for all citizens of this State.
7. As used in this section:
(a) LGBTQ means lesbian, gay, bisexual, transgender, queer or intersex or of any other nonheterosexual or noncisgender orientation or gender identity or expression.
(b) LGBTQ-owned business means a business that:
(1) Is owned by a natural person who identifies as LGBTQ; or
(2) Has at least 51 percent of its ownership interest held by one or more natural persons who identify as LGBTQ.
Sec. 4. NRS 408.38724 is hereby amended to read as follows:
408.38724 1. The Department shall establish goals for the awarding of contracts to [disadvantaged] :
κ2021 Statutes of Nevada, Page 3175 (CHAPTER 490, SB 237)κ
(a) Disadvantaged business enterprises [and] for projects that receive federal funding in accordance with 49 C.F.R. Part 26.
(b) Small business enterprises, local emerging small businesses and LGBTQ-owned businesses for:
[(a)] (1) Highway construction, reconstruction, improvements and maintenance on projects estimated to cost $250,000 or more that do not receive federal funding; and
[(b)] (2) Architectural, engineering and planning services [.] for projects that do not receive federal funding.
2. The Department shall ensure that the goals established pursuant to paragraph (b) of subsection 1 are:
(a) Consistent with the goals required for similar projects that receive federal funding; and
(b) Based upon [information] :
(1) Information about the relevant market for which the goals are set [.] ; and
(2) The most recent disparity study conducted by the Department.
3. The Department shall include LGBTQ-owned businesses in each disparity study.
4. The Department shall adopt regulations to define the term local emerging small business for the purposes of NRS 408.3872 to 408.38728, inclusive. When adopting regulations pursuant to this subsection, the Department shall determine whether other state agencies have adopted related definitions for similar projects and, if so, coordinate with those state agencies in defining the term.
5. As used in this section:
(a) Disparity study means a study conducted by the Department to assist the Department with implementing the federal Disadvantaged Business Enterprise Program.
(b) LGBTQ means lesbian, gay, bisexual, transgender, queer or intersex or of any other nonheterosexual or noncisgender orientation or gender identity or expression.
(c) LGBTQ-owned business means a business that:
(1) Is owned by a natural person who identifies as LGBTQ; or
(2) Has at least 51 percent of its ownership interest held by one or more natural persons who identify as LGBTQ.
(d) Small business enterprise means a business meeting the Small Business Administration size eligibility standards established in 13 C.F.R. §§ 121.101 to 121.201, inclusive.
Sec. 4.5. NRS 408.38726 is hereby amended to read as follows:
408.38726 1. The Department shall regularly review information about the goals established pursuant to NRS 408.38724 and the markets for which these goals are set.
2. The Department shall prepare a biennial report for the Governor and the Legislature and submit the report on or before December 31 of each even-numbered year. The biennial report must include, without limitation:
(a) All goals established by the Department pursuant to NRS 408.38724;
(b) Whether each goal established by the Department has been achieved; and
κ2021 Statutes of Nevada, Page 3176 (CHAPTER 490, SB 237)κ
(c) For each goal established by the Department that has not been achieved, information on all efforts undertaken by the Department to achieve the goal.
3. If the Department determines that the information gathered pursuant to subsection 1 indicates that disparities no longer exist in the awarding of contracts to disadvantaged business enterprises and LGBTQ-owned businesses and a discontinuation of the goals required to be established by NRS 408.38724 would be in the best interest of this State, the Director shall transmit to the Governor and the Director of the Legislative Counsel Bureau for transmission to the Legislature a statement of that determination accompanied by a report detailing the findings of the Department which justify that determination.
4. As used in this section:
(a) LGBTQ means lesbian, gay, bisexual, transgender, queer or intersex or of any other nonheterosexual or noncisgender orientation or gender identity or expression.
(b) LGBTQ-owned business means a business that:
(1) Is owned by a natural person who identifies as LGBTQ; or
(2) Has at least 51 percent of its ownership interest held by one or more natural persons who identify as LGBTQ.
Sec. 5. NRS 678A.310 is hereby amended to read as follows:
678A.310 1. The Commission shall:
(a) Consider all matters submitted to it by the Board, the Governor or the Legislature;
(b) On its own initiative, recommend to the Board any guidelines, rules or regulations or any changes to existing guidelines, rules or regulations that the Commission considers important or necessary for the review and consideration of the Board;
(c) Advise the Board on the preparation of any regulations adopted pursuant to this title;
(d) Study the distribution of licenses, including, without limitation, the number of licenses authorized to be issued to cannabis establishments within the territory of each local government in this State, and recommend to the Board any statutory changes that the Commission determines to be appropriate; and
(e) Study the feasibility of the use of emerging technologies, including, without limitation, blockchain and systems that use a single source of truth, as a means of collecting data or efficiently and effectively handling transactions electronically to reduce or eliminate the handling of cash.
2. The Chair of the Commission may appoint:
(a) A subcommittee on public health to review and make recommendations on matters related to the labeling, packaging, marketing and advertising of cannabis and cannabis products, the potency of cannabis and cannabis products and any other issue related to the effect of cannabis and cannabis products on public health. Such recommendations may include, without limitation, maximum limits for individual servings of cannabis and cannabis products.
(b) A subcommittee on public safety and community mitigation to review and make recommendations on matters relating to the effects of cannabis on law enforcement, property, businesses and consumers.
κ2021 Statutes of Nevada, Page 3177 (CHAPTER 490, SB 237)κ
(c) A subcommittee on the cannabis industry to review and make recommendations on matters relating to the stability of the market for and the cultivation, processing, manufacturing, transportation, distribution and seed-to-sale tracking of cannabis and cannabis products.
(d) A subcommittee on market participation to review and make recommendations on matters relating to the participation of women-owned businesses, minority-owned businesses, veteran-owned businesses , LGBTQ-owned businesses and local agriculture in the cannabis industry in this State.
(e) A subcommittee on the prevention of unlicensed cannabis sales in this State to:
(1) Review the legal authority of state agencies and local governments to curtail the unlicensed sale of cannabis and cannabis products, including, without limitation, by use of Internet websites, sales centers or other buildings to evade the laws of this State relating to the licensing of cannabis establishments;
(2) Review the resources available to state agencies and local governments to prevent the unlicensed sale of cannabis and cannabis products;
(3) Examine gaps in the enforcement of the laws of this State, including, without limitation, the importation of cannabis and cannabis products from other states;
(4) Identify the extent of the unlicensed sale of cannabis and cannabis products in this State, including, without limitation, the number of operations engaging in the unlicensed sale of cannabis and cannabis products and the most common methods used to engage in such sales;
(5) Examine any other issues relating to the unlicensed sale of cannabis or cannabis products that the Commission determines to be appropriate; and
(6) Make recommendations for efficiently and effectively closing any gaps in legal authority or enforcement identified by the subcommittee.
(f) A subcommittee on local governments to review and make recommendations on matters relating to the role of local governments in the regulation of the cannabis industry. In addition to any member of the Commission appointed to a subcommittee created pursuant to this paragraph, the Chair of the Commission shall appoint to the subcommittee:
(1) One member recommended by the governing body of the Nevada League of Cities; and
(2) One member recommended by the Nevada Association of Counties.
(g) A subcommittee on testing and laboratories to review and make recommendations on matters relating to the testing of cannabis and cannabis products and the efficient and effective operations of independent testing laboratories. In addition to any member of the Commission appointed to a subcommittee created pursuant to this paragraph, the Chair of the Commission shall appoint to the subcommittee one member who serves on an advisory committee for laboratories established by the Board to provide recommendations regarding the testing of cannabis.
(h) Any other subcommittee the Chair deems necessary to expedite the work of the Board.
κ2021 Statutes of Nevada, Page 3178 (CHAPTER 490, SB 237)κ
3. If the Chair appoints a subcommittee pursuant to subsection 2, the subcommittee must:
(a) Contain not more than five members, who serve at the pleasure of the Chair; and
(b) Be chaired by the person selected as chair of the subcommittee by the Chair.
4. As used in this section:
(a) LGBTQ means lesbian, gay, bisexual, transgender, queer or intersex or of any other nonheterosexual or noncisgender orientation or gender identity or expression.
(b) LGBTQ-owned business means a business that:
(1) Is owned by a natural person who identifies as LGBTQ; or
(2) Has at least 51 percent of its ownership interest held by one or more natural persons who identify as LGBTQ.
Sec. 6. Section 13 of the Regional Business Development Advisory Council for Clark County Act, being chapter 7, Statutes of Nevada 2003, 20th Special Session, at page 267, is hereby amended to read as follows:
Sec. 13. Disadvantaged person means a person who [is] :
1. Is a member of a racial or ethnic minority, female or physically disabled [.] ; or
2. Identifies as lesbian, gay, bisexual, transgender, queer or intersex or of any other nonheterosexual or noncisgender orientation or gender identity or expression.
Sec. 6.5. The provisions of subsection 1 of NRS 218D.380 do not apply to any provision of this act which adds or revises a requirement to submit a report to the Legislature.
Sec. 7. 1. This section becomes effective upon passage and approval.
2. Sections 1 to 6.5, inclusive, of this act become effective on January 1, 2022.
3. Sections 3, 4 and 4.5 of this act expire by limitation on the earlier of:
(a) September 30, 2023; or
(b) The date that is 90 days after the date on which the Director of the Department of Transportation transmits to the Governor and the Director of the Legislative Counsel Bureau the statement and report required by subsection 3 of NRS 408.38726.
________
κ2021 Statutes of Nevada, Page 3179κ
Senate Bill No. 275Senator D. Harris
CHAPTER 491
[Approved: June 6, 2021]
AN ACT relating to public health; revising the procedures followed by a county or city board of health or a health authority when isolating, quarantining or treating certain persons; revising provisions governing the investigation of a case or suspected case of a communicable disease and an order for a person with a communicable disease to submit to examination and treatment; revising provisions concerning certain offenses relating to communicable diseases; revising provisions concerning court-ordered testing for a communicable disease; prohibiting the disclosure of information about certain persons investigated by the health authority; requiring the alleged victim of a crime involving sexual penetration to be provided with information concerning sexually transmitted diseases; revising certain terminology used to refer to the human immunodeficiency virus and related matters; reestablishing the Advisory Task Force on HIV Exposure Modernization; setting forth the duties of the Task Force; abolishing certain crimes relating to the human immunodeficiency virus; repealing certain additional provisions relating to communicable diseases; providing a penalty; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Existing law authorizes state and local health authorities to take certain actions to investigate and control the spread of communicable diseases, including ordering: (1) a person to undergo a medical examination to verify the presence of a disease; and (2) the isolation, quarantine or treatment of a person or group of persons. (NRS 439.360, 439.470, 441A.160) Sections 1, 2 and 5 of this bill: (1) require any such order to state the reasons that the actions prescribed by the order are the least restrictive means available to prevent, suppress or control a communicable disease; and (2) prescribe certain limitations on the circumstances under which a state or local health authority may take such actions, including a requirement that the communicable disease must pose a risk to the public health.
Existing law establishes procedures pursuant to which the Chief Medical Officer or a district health officer, or a designee thereof, may isolate, quarantine or treat persons who have been infected with or exposed to a communicable disease. (NRS 441A.510-441A.720) Those procedures: (1) require the Chief Medical Officer or district health officer, or a designee thereof, to provide each person quarantined with a statement of his or her rights; and (2) require a judicial proceeding if a person is to be quarantined involuntarily for longer than 72 hours. (NRS 441A.510, 441A.550) Sections 1, 2 and 3.6 of this bill require a city or county board of health to adhere to those procedures when isolating, quarantining or treating a person who has or has been exposed to a communicable disease. Sections 12.3-12.9 of this bill make conforming changes to clarify that a person isolated, quarantined or treated by a county or city board of health has the same rights as a person isolated, quarantined or treated by the Chief Medical Officer or a district health officer, or a designee thereof.
Existing law authorizes the Chief Medical Officer or a district health officer, or a designee thereof, to investigate a case of a communicable disease and order the person with the communicable disease to submit to examination or testing. (NRS 441A.160) Section 5 requires such an official to know or suspect that the communicable disease is in an infectious state and poses a risk to the health of the public before taking such action.
κ2021 Statutes of Nevada, Page 3180 (CHAPTER 491, SB 275)κ
public before taking such action. Section 5 also requires the State Board of Health and each district board of health to establish a process by which a person may appeal an order to submit to examination or testing.
Existing law, with certain exceptions, prohibits a health authority from ordering involuntary treatment without a court order. (NRS 441A.160) Section 5 prohibits a court from issuing such an order without clear and convincing evidence that the person: (1) has a communicable disease in an infectious state; and (2) is likely to pose a danger to the health of the public.
Existing law makes it a misdemeanor for a person who has a communicable disease in an infectious state to conduct himself or herself in any manner likely to expose others to the disease or engage in any occupation in which it is likely that the disease will be transmitted to others after receiving a written warning from a health authority. (NRS 441A.180) Section 3.3 of this bill sets forth legislative findings that the spread of communicable diseases is a public health matter that should not be addressed through criminalization. Section 6 of this bill prohibits a health authority from warning a person against engaging in an occupation or accessing a place of public accommodation if a similar order from an employer or the place of public accommodation would constitute prohibited discrimination against a person with a disability. Section 6 makes it a misdemeanor for a person to intentionally transmit a communicable disease to another person under certain circumstances, regardless of whether the person has received a warning from the health authority. Section 6 prohibits a person from being charged for any offense other than the offenses set forth in section 6 for exposing or attempting to expose another person to a communicable disease. Section 6 additionally prohibits the use of the fact that a person has a communicable disease to satisfy any element of an offense other than the offenses set forth in section 6. Section 6 creates an affirmative defense if the person exposed to a communicable disease through prohibited conduct: (1) knew the defendant had the communicable disease; (2) knew the conduct could result in transmission of the communicable disease; and (3) consented to engage in the conduct with that knowledge. Section 6 additionally provides an affirmative defense if the defendant used or attempted to use means to prevent the transmission of the communicable disease. Section 6 also prohibits a person from being charged with certain offenses for transmitting or exposing another person to a communicable disease through the donation of an organ, blood, sperm or tissue or through pregnancy. Section 24 of this bill repeals a separate provision making it a category B felony for a person who has tested positive for the human immunodeficiency virus to intentionally, knowingly or willfully engage in conduct in a manner that is intended or likely to transmit the disease. (NRS 201.205) Such a person would still be guilty of a misdemeanor if he or she transmitted the virus or engaged in such conduct after a warning from the health authority and the affirmative defenses established by section 6 do not apply.
Existing law authorizes a court to order a person or decedent to be tested for a communicable disease upon the petition of a law enforcement officer, correctional officer, emergency medical attendant, firefighter, county coroner or medical examiner or employee or volunteer thereof if the court determines that there is probable cause to believe that: (1) a transfer of bodily fluids occurred between the person and the petitioner; and (2) a positive result from the test for the presence of a communicable disease would require the petitioner to seek medical intervention. (NRS 441A.195) Section 7 of this bill revises these provisions to instead authorize a court to order such a test only if the court determines that there is probable cause to believe that the petitioner: (1) was likely exposed to a communicable disease; and (2) testing of the other person or decedent is necessary to determine the appropriate medical treatment of the petitioner.
Existing law prohibits a person from making public personal identifying information about a person infected with a communicable disease who has been investigated by the health authority without the consent of the person. (NRS 441A.230) Section 9 of this bill instead prohibits a person from making public such information about a person who has been diagnosed with or exposed to a communicable disease and investigated by the health authority without the consent of the person.
κ2021 Statutes of Nevada, Page 3181 (CHAPTER 491, SB 275)κ
If the alleged victim or a witness to a crime alleges that the crime involved the sexual penetration of the victims body, existing law requires the testing of the alleged perpetrator for the human immunodeficiency virus and other commonly contracted sexually transmitted diseases. (NRS 441A.320) Section 24 removes this requirement, and section 14.5 of this bill instead requires information concerning testing for sexually transmitted diseases to be included in the information provided to victims of sexual assault under the Sexual Assault Survivors Bill of Rights.
Section 17 of this bill requires the Legislative Counsel, to the extent practicable, to ensure that: (1) persons living with the human immunodeficiency virus are referred to in Nevada Revised Statutes using language that is commonly viewed as respectful and sentence structure that refers to the person before referring to his or her disorder; and (2) duplicative references to the human immunodeficiency virus and acquired immunodeficiency syndrome are avoided in Nevada Revised Statutes. Section 18 of this bill provides that it is the policy of this State that such persons are referred to in a similar manner in the Nevada Administrative Code. Sections 8, 11-14, 16 and 19-21 of this bill make various revisions to terminology referring to the human immunodeficiency virus, other communicable diseases and related matters.
Section 24 repeals provisions of existing law: (1) requiring a person arrested for prostitution or solicitation for prostitution and each offender in the custody of the Department of Corrections to be tested for the human immunodeficiency virus; (2) making it a category B felony to engage in prostitution after testing positive for the human immunodeficiency virus; (3) requiring the Director of the Department of Corrections to establish for inmates and employees of the Department an educational program regarding the human immunodeficiency virus; and (4) authorizing a court to order the confinement of a person who is diagnosed as having acquired immunodeficiency syndrome who fails to comply with a written order of a health authority, or who engages in behavior through which the disease may be spread to other persons. Sections 10 and 15 of this bill make conforming changes by removing references to the repealed sections.
Senate Bill No. 284 of the 2019 Legislative Session: (1) created the Advisory Task Force on HIV Exposure Modernization; and (2) required the Task Force to conduct a comprehensive examination during the 2019-2020 legislative interim of the statutes and regulations in this State related to the criminalization of exposing a person to the human immunodeficiency virus. (Section 1 of chapter 88, Statutes of Nevada 2019, at page 466) Section 22 of this bill reestablishes the Task Force for the 2021-2022 legislative interim.
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 439.360 is hereby amended to read as follows:
439.360 1. The county board of health may:
[1.] (a) Abate nuisances in accordance with law.
[2.] (b) Establish and maintain an isolation hospital or quarantine station when necessary for the isolation or quarantine of a person or a group of persons.
[3. Restrain, quarantine and disinfect]
(c) Isolate any person or group of persons [sick] with [or] a communicable disease that is in an infectious state and poses a risk to the public health.
(d) Quarantine any person or group of persons who has been exposed to any [contagious or infectious] communicable disease that is [dangerous] in an infectious state and poses a risk to the public health.
κ2021 Statutes of Nevada, Page 3182 (CHAPTER 491, SB 275)κ
[4.] (e) Treat any person or group of persons with a communicable disease that is in an infectious state and poses a risk to the public health or who has been exposed to such a communicable disease.
(f) Monitor and treat any person or group of persons with a communicable disease that poses a risk to the public health if there is a risk that the communicable disease will develop into:
(1) A progressed state that endangers the health of the person or persons; or
(2) An infectious state.
(g) Appoint quarantine officers when necessary to enforce a quarantine . [, shall provide whatever medicines, disinfectants and provisions which may be required, and shall arrange for the payment of all debts or charges so incurred from any funds available, but each patient shall, if the patient is able, pay for his or her food, medicine, clothes and medical attendance.
5.] (h) Subject to the prior review and approval of the board of county commissioners and except as otherwise provided in NRS 576.128, adopt a schedule of reasonable fees to be collected for issuing or renewing any health permit or license required to be obtained from the board pursuant to a law of this state or an ordinance adopted by any political subdivision of this state. Such fees must be for the sole purpose of defraying the costs and expenses of the procedures for issuing licenses and permits, and investigations related thereto, and not for the purposes of general revenue.
2. Any order issued to isolate, quarantine or treat a person or group of persons issued pursuant to subsection 1 must state the reasons that each of the actions prescribed by the order are the least restrictive means available to prevent, suppress or control the communicable disease. If a county board of health issues an order to isolate, quarantine or treat a person pursuant to subsection 1, the county board of health must:
(a) Isolate, quarantine or treat the person in the manner set forth in NRS 441A.510 to 441A.720, inclusive, and section 3.6 of this act.
(b) Provide whatever medicines, disinfectants and provisions may be required and arrange for the payment of all debts or charges so incurred from any funds available, but each patient shall, if the patient is able, pay for his or her food, medicine, clothes and medical attendance.
3. As used in this section, communicable disease has the meaning ascribed to it in NRS 441A.040.
Sec. 2. NRS 439.470 is hereby amended to read as follows:
439.470 1. The city board of health may:
[1.] (a) Abate nuisances in accordance with law.
[2.] (b) Establish a temporary isolation hospital or quarantine station when an emergency demands the isolation or quarantine of a person or a group of persons.
[3. Restrain, quarantine and disinfect]
(c) Isolate any person or a group of persons [sick] with [or] a communicable disease that is in an infectious state and poses a risk to the public health.
(d) Quarantine any person or group of persons who has been exposed to any [contagious or infectious] communicable disease [which is dangerous] that is in an infectious state and poses a risk to the public health.
κ2021 Statutes of Nevada, Page 3183 (CHAPTER 491, SB 275)κ
[4.] (e) Treat any person or group of persons with a communicable disease that is in an infectious state and poses a risk to the public health or who has been exposed to such a communicable disease.
(f) Monitor and treat any person or group of persons with a communicable disease that poses a risk to the public health if there is a risk that the communicable disease will develop into:
(1) A progressed state that endangers the health of the person or persons; or
(2) An infectious state.
(g) Appoint quarantine officers when necessary to enforce a quarantine . [, and shall provide whatever medicines, disinfectants and provisions which may be required. The city council shall pay all debts or charges so incurred, but each patient shall, if able, pay for his or her food, medicine, clothes and medical attendance.
5.] (h) Subject to the prior review and approval of the governing body of the city and except as otherwise provided in NRS 576.128, adopt a schedule of reasonable fees to be collected for issuing or renewing any health permit or license required to be obtained from such board pursuant to state law or an ordinance adopted by any political subdivision. Such fees must be for the sole purpose of defraying the costs and expenses of the procedures for issuing licenses and permits, and investigations related thereto, and not for the purposes of general revenue.
2. Any order issued to isolate, quarantine, or treat a person or group of persons issued pursuant to subsection 1 must state the reasons that each of the actions prescribed by the order are the least restrictive means available to prevent, suppress or control the communicable disease. If a city board of health issues an order to isolate, quarantine or treat a person pursuant to subsection 1, the city board of health must:
(a) Isolate, quarantine or treat the person in the manner set forth in NRS 441A.510 to 441A.720, inclusive, and section 3.6 of this act.
(b) Provide whatever medicines, disinfectants and provisions may be required. The city council shall pay all debts or charges so incurred from any funds available, but each patient shall, if the patient is able, pay for his or her food, medicine, clothes and medical attendance.
3. As used in this section, communicable disease has the meaning ascribed to it in NRS 441A.040.
Sec. 3. Chapter 441A of NRS is hereby amended by adding thereto the provisions set forth as sections 3.3 and 3.6 of this act.
Sec. 3.3. The Legislature hereby finds and declares that the spread of communicable diseases is best addressed through public health measures rather than criminalization.
Sec. 3.6. As used in this section and NRS 441A.510 to 441A.720, inclusive, unless the context otherwise requires, health authority has the meaning ascribed to it in NRS 441A.050 and includes a county or city board of health.
Sec. 4. (Deleted by amendment.)
Sec. 5. NRS 441A.160 is hereby amended to read as follows:
441A.160 1. A health authority who knows, suspects or is informed of the existence within the jurisdiction of the health authority of any communicable disease that poses a risk to the health of the public and is in an infectious state, at risk of developing into an infectious state or at risk of developing into a progressed state that endangers the health of the person with the communicable disease shall immediately investigate the matter and all circumstances connected with it, and shall take such measures for the prevention, suppression and control of the disease as are required by the regulations of the Board or a [local] district board of health.
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with the communicable disease shall immediately investigate the matter and all circumstances connected with it, and shall take such measures for the prevention, suppression and control of the disease as are required by the regulations of the Board or a [local] district board of health.
2. A health authority may:
(a) Enter private property at reasonable hours to investigate any case or suspected case of a communicable disease [.] to determine the danger posed by the case or suspected case to the public, including, without limitation, whether the communicable disease is in an infectious state.
(b) Order any person whom the health authority [reasonably suspects] has a reasonable factual and medical basis to suspect has a communicable disease that is in an infectious state and poses a risk to the health of the public to submit to any medical examination or test which the health authority [believes] determines is necessary to verify the presence of the disease. The order must be in writing and specify the name of the person to be examined or tested and the time and place of the examination and testing, and may [include such terms and conditions as the health authority believes are necessary to protect the public health.] require the person to take other actions that the health authority has determined are necessary to prevent the spread of the communicable disease.
(c) Except as otherwise provided in this paragraph, subsection [5] 6 and NRS 441A.210, issue an order requiring the isolation, quarantine or treatment of any person or group of persons if the health authority [believes] has a reasonable factual and medical basis to believe that such action is necessary to protect the public health. The order must be in writing and specify the person or group of persons to be isolated or quarantined, the time during which the order is effective [,] and the place of isolation or quarantine . [and other terms and conditions which] The order may direct the person or group of persons to take other actions that the health authority [believes] has determined are necessary to [protect the public health, except that no] prevent the spread of the communicable disease. The health authority shall not order isolation or quarantine [may take place] if the health authority determines that such action may [endanger] compromise the [life] health of a person who is isolated or quarantined.
3. Each order issued pursuant to this section must [be] :
(a) Be served upon each person named in the order by delivering a copy to [him or her.] the person; and
(b) State the reasons that each of the actions prescribed by the order are necessary and are the least restrictive means available to prevent, suppress or control the communicable disease.
4. The Board and each district board of health shall adopt regulations to establish a process by which a person may appeal to the health authority an order issued pursuant to paragraph (b) of subsection 2. The health authority shall provide to a person who receives such an order a document stating the rights of the person, including, without limitation, the right to appeal the order, at the time and in the manner prescribed by regulation of the Board or the district board of health, as applicable.
5. If a health authority issues an order to isolate or quarantine a person with a communicable or infectious disease in a medical facility, the health authority must isolate or quarantine the person in the manner set forth in NRS 441A.510 to 441A.720, inclusive [.
5.] , and section 3.6 of this act.
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6. Except as otherwise provided in NRS 441A.310 and 441A.380, a health authority may not issue an order requiring the involuntary treatment of a person without a court order requiring the person to submit to treatment. A court shall not order a person to submit to treatment unless the court finds that there is clear and convincing evidence that:
(a) The person has a communicable disease in an infectious state; and
(b) Because of that disease, the person is likely to pose a risk to the public health.
Sec. 6. NRS 441A.180 is hereby amended to read as follows:
441A.180 1. [A] Except as otherwise provided in this section, a person who has a communicable disease in an infectious state shall not [conduct] :
(a) Conduct himself or herself in any manner [likely to expose others] that has a high probability of transmitting the disease to another person; or [engage]
(b) Engage in any occupation in which [it is likely] there is a high probability that the disease will be transmitted to [others.] other persons.
2. [A] Except as otherwise provided in this section, a health authority who has reason to believe that a person is in violation of subsection 1 shall issue a warning to that person, in writing, informing the person of the behavior which constitutes the violation and of the precautions that the person must take to avoid exposing [others] another person to the disease. The warning must be served upon the person by delivering a copy to [him or her.] the person. The health authority shall not warn a person against:
(a) Engaging in an occupation if the employer of the person would be prohibited from preventing the person from engaging in that occupation by the Americans with Disabilities Act of 1990, 42 U.S.C. §§ 12101 et seq., or NRS 613.330.
(b) Accessing a place of public accommodation if the place of public accommodation would be prohibited from denying the person access to the place of public accommodation by the Americans with Disabilities Act of 1990, 42 U.S.C. §§ 12101 et seq., or NRS 651.050 to 621.120, inclusive.
3. [A] Except as otherwise provided in this section, a person who violates the provisions of subsection 1 after service upon [him or her] the person of a warning from a health authority in the manner prescribed by subsection 2 is guilty of a misdemeanor.
4. Except as otherwise provided in this section, any person who, after receiving notice that he or she has tested positive for a communicable disease, intentionally conducts himself or herself in a manner that is specifically intended to transmit the disease to another person and has a high probability of transmitting the disease to another person and, as a consequence, transmits the disease to another person is guilty of a misdemeanor. A person shall not be deemed to have acted intentionally solely because the person failed to use or attempt to use means to prevent transmission.
5. It is an affirmative defense to an offense charged pursuant to this section that a person who was subject to exposure to a communicable disease as a result of conduct prohibited by a warning issued pursuant to subsection 2 or conduct described in subsection 4:
(a) Knew the defendant had the communicable disease;
(b) Knew the conduct could result in the transmission of the communicable disease; and
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(c) Consented to engage in the conduct with that knowledge.
6. It is an affirmative defense to an offense charged pursuant to this section that the defendant used or attempted to use means to prevent the transmission of the communicable disease.
7. A person who has tested positive for a communicable disease is not in violation of subsection 1 or 4 because the person:
(a) Donates or attempts to donate an organ, blood, sperm or tissue and thereby exposes another person to the communicable disease or transmits the communicable disease; or
(b) Becomes pregnant and exposes the unborn child to the communicable disease or transmits the communicable disease to the unborn child.
8. Before imposing a fine or a sentence of imprisonment upon a person who violates subsection 3 or 4, a court must consider all alternative means to advance the public health.
9. A person must not be charged for any offense other than the offenses set forth in this section if the person is alleged to have exposed another person to a communicable disease or attempted to expose another person to a communicable disease. The fact that a person has a communicable disease must not be used to satisfy any element of an offense other than the offenses set forth in this section.
10. For the purposes of subsections 1 and 4, the likelihood of transmitting a communicable disease to another person must be determined using current medical or epidemiological evidence. The Board shall adopt regulations prescribing requirements for determining the sufficiency and legitimacy of medical or epidemiological evidence pursuant to this subsection.
11. As used in this section, means to prevent transmission means any method, device, behavior or activity scientifically demonstrated to measurably limit, reduce or eliminate the risk of transmitting a communicable disease.
Sec. 7. 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 [the person or decedent may have exposed the] :
(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
(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 [possible] 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 [possible] likely exposure to communicable diseases, for verification that there was substantial exposure.
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is petitioning shall submit information concerning the [possible] 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 [possible] 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 [possible] 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 [possible] 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 [possibly] likely exposed him or her to a communicable disease. If the court determines that such probable cause exists , [to believe that a possible transfer of blood or other bodily fluids occurred and, that a positive result from the test for the presence of a communicable disease would require the petitioner to seek medical intervention,] the court shall:
(a) Order the person who [possibly] 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 [possibly] 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 [possible] 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.
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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 as an attendant or certified as an emergency medical technician, advanced emergency medical technician or paramedic pursuant to chapter 450B of NRS.
Sec. 8. NRS 441A.220 is hereby amended to read as follows:
441A.220 All information of a personal nature about any person provided by any other person reporting a case or suspected case of a communicable disease or drug overdose, or by any person who has a communicable disease or has suffered a drug overdose, or as determined by investigation of the health authority, is confidential medical information and must not be disclosed to any person under any circumstances, including pursuant to any subpoena, search warrant or discovery proceeding, except:
1. As otherwise provided in NRS 439.538.
2. For statistical purposes, provided that the identity of the person is not discernible from the information disclosed.
3. In a prosecution for a violation of this chapter.
4. In a proceeding for an injunction brought pursuant to this chapter.
5. In reporting the actual or suspected abuse or neglect of a child or elderly person.
6. To any person who has a medical need to know the information for his or her own protection or for the well-being of a patient or dependent person, as determined by the health authority in accordance with regulations of the Board.
7. If the person who is the subject of the information consents in writing to the disclosure.
8. Pursuant to [subsection 4 of NRS 441A.320 or] NRS 629.069.
9. If the disclosure is made to the Department of Health and Human Services and the person about whom the disclosure is made has been diagnosed [as having acquired immunodeficiency syndrome or an illness related to] with the human immunodeficiency virus and is a recipient of or an applicant for Medicaid.
10. To a firefighter, police officer or person providing emergency medical services if the Board has determined that the information relates to a communicable disease significantly related to that occupation. The information must be disclosed in the manner prescribed by the Board.
11. If the disclosure is authorized or required by NRS 239.0115 or another specific statute.
Sec. 9. NRS 441A.230 is hereby amended to read as follows:
441A.230 Except as otherwise provided in this chapter and NRS 439.538, a person shall not make public the name of, or other personal identifying information about, a person [infected] who has been diagnosed with or exposed to a communicable disease [who has been] and investigated by the health authority pursuant to this chapter without the consent of the person.
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with or exposed to a communicable disease [who has been] and investigated by the health authority pursuant to this chapter without the consent of the person.
Sec. 10. NRS 441A.240 is hereby amended to read as follows:
441A.240 [1.] The health authority shall control, prevent, treat and, whenever possible, ensure the cure of sexually transmitted diseases.
[2. The health authority shall provide the materials and curriculum necessary to conduct the educational program provided for in NRS 209.385 and establish a program for the certification of persons qualified to provide instruction for the program.]
Sec. 11. (Deleted by amendment.)
Sec. 12. NRS 441A.330 is hereby amended to read as follows:
441A.330 The health authority may establish such dispensaries, pharmacies or clinics for outpatient care as it believes are necessary for the care and treatment of persons who have [acquired immune deficiency syndrome or a] been diagnosed with the human immunodeficiency virus , [related disease,] and provide those institutions with financial or other assistance. Dispensaries, pharmacies or clinics which accept financial or other assistance pursuant to this section shall comply with all conditions prescribed by the Board relating to the use of that assistance.
Sec. 12.3. NRS 441A.510 is hereby amended to read as follows:
441A.510 1. If a health authority isolates, quarantines or treats a person or group of persons infected with, exposed to, or reasonably believed by a health authority to have been infected with or exposed to a communicable disease, the authority must isolate, quarantine or treat the person or group of persons in the manner set forth in NRS 441A.510 to 441A.720, inclusive [.] , and section 3.6 of this act.
2. A health authority shall provide each person whom it isolates or quarantines pursuant to NRS 441A.510 to 441A.720, inclusive, and section 3.6 of this act with a document informing the person of his or her rights. The Board shall adopt regulations:
(a) Setting forth the rights of a person who is isolated or quarantined that must be included in the document provided pursuant to this subsection; and
(b) Specifying the time and manner in which the document must be provided pursuant to this subsection.
Sec. 12.6. NRS 441A.520 is hereby amended to read as follows:
441A.520 1. A person who is isolated or quarantined pursuant to NRS 441A.510 to 441A.720, inclusive, and section 3.6 of this act has the right:
(a) To make a reasonable number of completed telephone calls from the place where the person is isolated or quarantined as soon as reasonably possible after his or her isolation or quarantine; and
(b) To possess and use a cellular phone or any other similar means of communication to make and receive calls in the place where the person is isolated or quarantined.
2. If a person who is isolated or quarantined pursuant to NRS 441A.510 to 441A.720, inclusive, and section 3.6 of this act is unconscious or otherwise unable to communicate because of mental or physical incapacity, the health authority that isolated or quarantined the person must notify the spouse or legal guardian of the person by telephone and certified mail. If a person described in this subsection is isolated or quarantined in a medical facility and the health authority did not provide the notice required by this subsection, the medical facility must provide the notice.
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subsection, the medical facility must provide the notice. If the case of a person described in this subsection is before a court and the health authority, and medical facility, if any, did not provide the notice required by this subsection, the court must provide the notice.
Sec. 12.9. NRS 441A.530 is hereby amended to read as follows:
441A.530 A person who is isolated or quarantined pursuant to NRS 441A.510 to 441A.720, inclusive, and section 3.6 of this act has the right to refuse treatment and may not be required to submit to involuntary treatment unless a court issues an order requiring the person to submit to treatment.
Sec. 13. NRS 453A.050 is hereby amended to read as follows:
453A.050 Chronic or debilitating medical condition means:
1. [Acquired immune deficiency syndrome;
2.] An anxiety disorder;
[3.] 2. An autism spectrum disorder;
[4.] 3. An autoimmune disease;
[5.] 4. Cancer;
[6.] 5. Dependence upon or addiction to opioids;
[7.] 6. Glaucoma;
[8.] 7. A medical condition or treatment for a medical condition that produces, for a specific patient, one or more of the following:
(a) Anorexia or cachexia;
(b) Muscle spasms, including, without limitation, spasms caused by multiple sclerosis;
(c) Seizures, including, without limitation, seizures caused by epilepsy;
(d) Severe nausea; or
(e) Severe or chronic pain;
[9. A]
8. The human immunodeficiency virus and any medical condition related to [acquired immune deficiency syndrome or] the human immunodeficiency virus;
[10.] 9. A neuropathic condition, whether or not such condition causes seizures; or
[11.] 10. Any other medical condition or treatment for a medical condition that is:
(a) Classified as a chronic or debilitating medical condition by regulation of the Division; or
(b) Approved as a chronic or debilitating medical condition pursuant to a petition submitted in accordance with NRS 453A.710.
Sec. 14. NRS 40.770 is hereby amended to read as follows:
40.770 1. Except as otherwise provided in subsection 6, in any sale, lease or rental of real property, the fact that the property is or has been:
(a) The site of a homicide, suicide or death by any other cause, except a death that results from a condition of the property;
(b) The site of any crime punishable as a felony other than a crime that involves the manufacturing of any material, compound, mixture or preparation which contains any quantity of methamphetamine; or
(c) Occupied by a person exposed to [the human immunodeficiency virus] or suffering from [acquired immune deficiency syndrome or] any [other] disease that is not known to be transmitted through occupancy of the property,
Κ is not material to the transaction.
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2. In any sale, lease or rental of real property, the fact that a sex offender, as defined in NRS 179D.095, resides or is expected to reside in the community is not material to the transaction, and the seller, lessor or landlord or any agent of the seller, lessor or landlord does not have a duty to disclose such a fact to a buyer, lessee or tenant or any agent of a buyer, lessee or tenant.
3. In any sale, lease or rental of real property, the fact that a facility for transitional living for released offenders that is licensed pursuant to chapter 449 of NRS is located near the property being sold, leased or rented is not material to the transaction.
4. A seller, lessor or landlord or any agent of the seller, lessor or landlord is not liable to the buyer, lessee or tenant in any action at law or in equity because of the failure to disclose any fact described in subsection 1, 2 or 3 that is not material to the transaction or of which the seller, lessor or landlord or agent of the seller, lessor or landlord had no actual knowledge.
5. Except as otherwise provided in an agreement between a buyer, lessee or tenant and that persons agent, an agent of the buyer, lessee or tenant is not liable to the buyer, lessee or tenant in any action at law or in equity because of the failure to disclose any fact described in subsection 1, 2 or 3 that is not material to the transaction or of which the agent of the buyer, lessee or tenant had no actual knowledge.
6. For purposes of this section, the fact that the property is or has been the site of a crime that involves the manufacturing of any material, compound, mixture or preparation which contains any quantity of methamphetamine is not material to the transaction if:
(a) All materials and substances involving methamphetamine have been removed from or remediated on the property by an entity certified or licensed to do so; or
(b) The property has been deemed safe for habitation by the board of health.
7. As used in this section:
(a) Board of health has the meaning ascribed to it in NRS 439.4797.
(b) Facility for transitional living for released offenders has the meaning ascribed to it in NRS 449.0055.
Sec. 14.5. NRS 178A.270 is hereby amended to read as follows:
178A.270 1. The Office of the Attorney General shall:
(a) Develop a document that explains the rights of a survivor pursuant to the Sexual Assault Survivors Bill of Rights and other relevant law; and
(b) Make the document available to medical providers, law enforcement officials and prosecutors.
2. The document must be in clear language that is comprehensible to a person proficient in English at the reading level of a fifth grader, accessible to persons with visual disabilities and available in all major languages of this State.
3. The document must include, without limitation:
(a) A clear statement that the survivor is not required to participate in the criminal justice system or to receive a forensic medical examination in order to retain the rights provided by the Sexual Assault Survivors Bill of Rights and other relevant law;
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(b) Means of contacting, by telephone or Internet, nearby sexual assault victims advocates and centers for support for victims of sexual assault;
(c) Information about the availability of temporary and extended orders of protection pursuant to NRS 200.378;
(d) Instructions for requesting the results of the genetic marker analysis of the sexual assault forensic evidence kit of the survivor;
(e) Information concerning state and federal funds for compensation for medical and other costs associated with the sexual assault; [and]
(f) Information concerning any municipal, state or federal right to restitution for survivors in the event of a criminal trial [.] ; and
(g) Information concerning testing for the human immunodeficiency virus and other common sexually transmitted diseases.
Sec. 15. NRS 202.876 is hereby amended to read as follows:
202.876 Violent or sexual offense means any act that, if prosecuted in this State, would constitute any of the following offenses:
1. Murder or voluntary manslaughter pursuant to NRS 200.010 to 200.260, inclusive.
2. Mayhem pursuant to NRS 200.280.
3. Kidnapping pursuant to NRS 200.310 to 200.340, inclusive.
4. Sexual assault pursuant to NRS 200.366.
5. Robbery pursuant to NRS 200.380.
6. Administering poison or another noxious or destructive substance or liquid with intent to cause death pursuant to NRS 200.390.
7. Battery with intent to commit a crime pursuant to NRS 200.400.
8. Administering a drug or controlled substance to another person with the intent to enable or assist the commission of a felony or crime of violence pursuant to NRS 200.405 or 200.408.
9. False imprisonment pursuant to NRS 200.460 if the false imprisonment involves the use or threatened use of force or violence against the victim or the use or threatened use of a firearm or a deadly weapon.
10. Assault with a deadly weapon pursuant to NRS 200.471.
11. Battery which is committed with the use of a deadly weapon or which results in substantial bodily harm as described in NRS 200.481 or battery which is committed by strangulation as described in NRS 200.481 or 200.485.
12. An offense involving pornography and a minor pursuant to NRS 200.710 or 200.720.
13. [Intentional transmission of the human immunodeficiency virus pursuant to NRS 201.205.
14.] Open or gross lewdness pursuant to NRS 201.210.
[15.] 14. Lewdness with a child pursuant to NRS 201.230.
[16.] 15. An offense involving pandering or sex trafficking in violation of NRS 201.300, prostitution in violation of NRS 201.320 or advancing prostitution in violation of NRS 201.395.
[17.] 16. Coercion pursuant to NRS 207.190, if the coercion involves the use or threatened use of force or violence against the victim or the use or threatened use of a firearm or a deadly weapon.
[18.] 17. An attempt, conspiracy or solicitation to commit an offense listed in this section.
Sec. 16. NRS 213.1088 is hereby amended to read as follows:
213.1088 1. The Department of Public Safety in conjunction with the Department of Corrections shall establish a program of orientation that:
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(a) Each member of the Board shall attend upon appointment to a first term; and
(b) Each person named by the Board to the list of persons eligible to serve as a case hearing representative pursuant to NRS 213.135 shall attend upon being named to the list. A person named to the list may not serve as a case hearing representative until the person completes the program of orientation.
2. The program of orientation must include a minimum of 40 hours of training. The information presented during the program of orientation must include, but is not limited to:
(a) A historical perspective of parole, including the objectives of and reasons for using parole within the criminal justice system;
(b) The role and function of the Board within the criminal justice system;
(c) The responsibilities of members of the Board and case hearing representatives;
(d) The goals and objectives of the Board;
(e) The programs administered by the Board;
(f) The policies and procedures of the Board; and
(g) The laws and regulations governing parole, including the standards for granting, denying, revoking and continuing parole.
3. The Chair of the Board shall develop a written plan for the continuing education of members of the Board and case hearing representatives. The plan must require that:
(a) Each member of the Board shall attend not less than 16 hours of courses for continuing education during each year of the members term.
(b) Each case hearing representative shall attend not less than 16 hours of courses for continuing education during each year that the representative is on the list of persons eligible to serve as a case hearing representative.
4. A member of the Board or a case hearing representative may meet the requirement for continuing education by successfully completing courses in any combination of the following subjects:
(a) The role and function of the Board within the criminal justice system;
(b) Changes in the law, including judicial decisions affecting parole;
(c) Developing skills in communicating, making decisions and solving problems;
(d) The interpretation and use of research, data and reports;
(e) Correctional policies and programs, including programs for the treatment of prisoners and parolees;
(f) Alternative punishments for disobedience;
(g) The selection of prisoners for parole;
(h) The supervision of parolees;
(i) The designation of and programs for repeating or professional offenders;
(j) Problems related to gangs;
(k) Alcohol and other substance use disorders;
(l) The [acquired immune deficiency syndrome;] human immunodeficiency virus;
(m) Domestic violence; and
(n) Mental illness and intellectual disabilities.
5. The Board shall, within the limits of legislative appropriations, pay the expenses of members of the Board and case hearing representatives attending courses for continuing education.
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Sec. 17. NRS 220.125 is hereby amended to read as follows:
220.125 1. The Legislative Counsel shall, to the extent practicable, ensure that persons with physical, mental or cognitive disabilities are referred to in Nevada Revised Statutes using language that is commonly viewed as respectful and sentence structure that refers to the person before referring to his or her disability as follows:
(a) Words and terms that are preferred for use in Nevada Revised Statutes include, without limitation, persons with disabilities, persons with mental illness, persons with developmental disabilities, persons with intellectual disabilities and other words and terms that are structured in a similar manner.
(b) Words and terms that are not preferred for use in Nevada Revised Statutes include, without limitation, disabled, handicapped, mentally disabled, mentally ill, mentally retarded and other words and terms that tend to equate the disability with the person.
2. The Legislative Counsel shall, to the extent practicable, ensure that terms related to persons affected by addictive disorders are referred to in Nevada Revised Statutes using language that is commonly viewed as respectful and sentence structure that refers to the person before referring to his or her disorder as follows:
(a) Words and terms that are preferred for use in Nevada Revised Statutes include, without limitation, addictive disorder, persons with addictive disorders, person with an addictive disorder, person with an addictive disorder related to gambling and substance use disorder.
(b) Words and terms that are not preferred for use in Nevada Revised Statutes include, without limitation, addict, alcoholic, alcohol abuse, alcohol abuser, alcohol and drug abuser, drug abuse, drug addict, problem gambler, substance abuse and substance abuser.
3. The Legislative Counsel shall, to the extent practicable, ensure that:
(a) Terms related to persons living with the human immunodeficiency virus are referred to in Nevada Revised Statutes using language that is commonly viewed as respectful and sentence structure that refers to the person before referring to the human immunodeficiency virus as follows:
(1) Words and terms that are preferred for use in Nevada Revised Statutes include, without limitation, person living with the human immunodeficiency virus and person diagnosed with the human immunodeficiency virus.
(2) Words and terms that are not preferred for use in Nevada Revised Statutes include, without limitation, HIV positive and human immunodeficiency virus positive.
(b) The human immunodeficiency virus is referred to in Nevada Revised Statutes using language that refers only to the human immunodeficiency virus or HIV rather than using duplicative references to both the human immunodeficiency virus or HIV and acquired immunodeficiency syndrome, acquired immune deficiency syndrome or AIDS.
(c) Duplicative references to both communicable diseases and the human immunodeficiency virus or HIV are not used in Nevada Revised Statutes.
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Sec. 18. NRS 233B.062 is hereby amended to read as follows:
233B.062 1. It is the policy of this State that every regulation of an agency be made easily accessible to the public and expressed in clear and concise language. To assist in carrying out this policy:
(a) The Attorney General must develop guidelines for drafting regulations; and
(b) Every permanent regulation must be incorporated, excluding any forms used by the agency, any publication adopted by reference, the title, any signature and other formal parts, in the Nevada Administrative Code, and every emergency or temporary regulation must be distributed in the same manner as the Nevada Administrative Code.
2. It is the policy of this State that:
(a) Persons with physical, mental or cognitive disabilities and persons living with the human immunodeficiency virus are to be referred to in the Nevada Administrative Code using language that is commonly viewed as respectful and sentence structure that refers to the person before referring to the persons disability [; and] or the human immunodeficiency virus, as applicable;
(b) Terms related to persons affected by addictive disorders are referred to in the Nevada Administrative Code using language that is commonly viewed as respectful and sentence structure that refers to the person before referring to his or her disorder [,] ; and
(c) References to only the human immunodeficiency virus or HIV should be used in the Nevada Administrative Code instead of duplicative references to both human immunodeficiency virus or HIV and acquired immunodeficiency syndrome, acquired immune deficiency syndrome or AIDS,
Κ in the same manner as provided in NRS 220.125 for Nevada Revised Statutes.
3. The Legislative Counsel shall:
(a) Include each permanent regulation in the Nevada Administrative Code; and
(b) Distribute in the same manner as the Nevada Administrative Code each emergency or temporary regulation,
Κ that is required to be adopted pursuant to the provisions of this chapter and which is adopted by an entity other than an agency.
4. The Legislative Commission may authorize inclusion in the Nevada Administrative Code of the regulations of an agency otherwise exempted from the requirements of this chapter.
Sec. 19. NRS 389.036 is hereby amended to read as follows:
389.036 1. The board of trustees of a school district shall establish a course or unit of a course of:
(a) Factual instruction concerning [acquired immune deficiency syndrome;] the human immunodeficiency virus; and
(b) Instruction on the human reproductive system, related communicable diseases and sexual responsibility.
2. Each board of trustees shall appoint an advisory committee consisting of:
(a) Five parents of children who attend schools in the district; and
(b) Four representatives, one from each of four of the following professions or occupations:
κ2021 Statutes of Nevada, Page 3196 (CHAPTER 491, SB 275)κ
(1) Medicine or nursing;
(2) Counseling;
(3) Religion;
(4) Pupils who attend schools in the district; or
(5) Teaching.
Κ This committee shall advise the district concerning the content of and materials to be used in a course of instruction established pursuant to this section, and the recommended ages of the pupils to whom the course is offered. The final decision on these matters must be that of the board of trustees.
3. The subjects of the courses may be taught only by a teacher or school nurse whose qualifications have been previously approved by the board of trustees.
4. The parent or guardian of each pupil to whom a course is offered must first be furnished written notice that the course will be offered. The notice must be given in the usual manner used by the local district to transmit written material to parents, and must contain a form for the signature of the parent or guardian of the pupil consenting to the pupils attendance. Upon receipt of the written consent of the parent or guardian, the pupil may attend the course. If the written consent of the parent or guardian is not received, the pupil must be excused from such attendance without any penalty as to credits or academic standing. Any course offered pursuant to this section is not a requirement for graduation.
5. All instructional materials to be used in a course must be available for inspection by parents or guardians of pupils at reasonable times and locations before the course is taught, and appropriate written notice of the availability of the material must be furnished to all parents and guardians.
Sec. 20. NRS 422.4025 is hereby amended to read as follows:
422.4025 1. The Department shall:
(a) By regulation, develop a list of preferred prescription drugs to be used for the Medicaid program and the Childrens Health Insurance Program, and each public or nonprofit health benefit plan that elects to use the list of preferred prescription drugs as its formulary pursuant to NRS 287.012, 287.0433 or 687B.407; and
(b) Negotiate and enter into agreements to purchase the drugs included on the list of preferred prescription drugs on behalf of the health benefit plans described in paragraph (a) or enter into a contract pursuant to NRS 422.4053 with a pharmacy benefit manager or health maintenance organization, as appropriate, to negotiate such agreements.
2. The Department shall, by regulation, establish a list of prescription drugs which must be excluded from any restrictions that are imposed by the Medicaid program on drugs that are on the list of preferred prescription drugs established pursuant to subsection 1. The list established pursuant to this subsection must include, without limitation:
(a) Prescription drugs that are prescribed for the treatment of the human immunodeficiency virus , [or acquired immunodeficiency syndrome,] including, without limitation, [protease inhibitors and] antiretroviral medications;
(b) Antirejection medications for organ transplants;
(c) Antihemophilic medications; and
κ2021 Statutes of Nevada, Page 3197 (CHAPTER 491, SB 275)κ
(d) Any prescription drug which the Board identifies as appropriate for exclusion from any restrictions that are imposed by the Medicaid program on drugs that are on the list of preferred prescription drugs.
3. The regulations must provide that the Board makes the final determination of:
(a) Whether a class of therapeutic prescription drugs is included on the list of preferred prescription drugs and is excluded from any restrictions that are imposed by the Medicaid program on drugs that are on the list of preferred prescription drugs;
(b) Which therapeutically equivalent prescription drugs will be reviewed for inclusion on the list of preferred prescription drugs and for exclusion from any restrictions that are imposed by the Medicaid program on drugs that are on the list of preferred prescription drugs; and
(c) Which prescription drugs should be excluded from any restrictions that are imposed by the Medicaid program on drugs that are on the list of preferred prescription drugs based on continuity of care concerning a specific diagnosis, condition, class of therapeutic prescription drugs or medical specialty.
4. The list of preferred prescription drugs established pursuant to subsection 1 must include, without limitation, any prescription drug determined by the Board to be essential for treating sickle cell disease and its variants.
5. The regulations must provide that each new pharmaceutical product and each existing pharmaceutical product for which there is new clinical evidence supporting its inclusion on the list of preferred prescription drugs must be made available pursuant to the Medicaid program with prior authorization until the Board reviews the product or the evidence.
6. On or before February 1 of each year, the Department shall:
(a) Compile a report concerning the agreements negotiated pursuant to paragraph (b) of subsection 1 and contracts entered into pursuant to NRS 422.4053 which must include, without limitation, the financial effects of obtaining prescription drugs through those agreements and contracts, in total and aggregated separately for agreements negotiated by the Department, contracts with a pharmacy benefit manager and contracts with a health maintenance organization; and
(b) Post the report on an Internet website maintained by the Department and submit the report to the Director of the Legislative Counsel Bureau for transmittal to:
(1) In odd-numbered years, the Legislature; or
(2) In even-numbered years, the Legislative Commission.
Sec. 21. NRS 678C.030 is hereby amended to read as follows:
678C.030 Chronic or debilitating medical condition means:
1. [Acquired immune deficiency syndrome;
2.] An anxiety disorder;
[3.] 2. An autism spectrum disorder;
[4.] 3. An autoimmune disease;
[5.] 4. Anorexia nervosa;
[6.] 5. Cancer;
[7.] 6. Dependence upon or addiction to opioids;
[8.] 7. Glaucoma;
[9.] 8. A medical condition or treatment for a medical condition that produces, for a specific patient, one or more of the following:
κ2021 Statutes of Nevada, Page 3198 (CHAPTER 491, SB 275)κ
(a) Cachexia;
(b) Muscle spasms, including, without limitation, spasms caused by multiple sclerosis;
(c) Seizures, including, without limitation, seizures caused by epilepsy;
(d) Nausea; or
(e) Severe or chronic pain;
[10. A]
9. The human immunodeficiency virus and any medical condition related to the human immunodeficiency virus;
[11.] 10. A neuropathic condition, whether or not such condition causes seizures; or
[12.] 11. Any other medical condition or treatment for a medical condition that is:
(a) Classified as a chronic or debilitating medical condition by regulation of the Division; or
(b) Approved as a chronic or debilitating medical condition pursuant to a petition submitted in accordance with NRS 678C.810.
Sec. 22. 1. The Advisory Task Force on HIV Exposure Modernization created by section 1 of chapter 88, Statutes of Nevada 2019, at page 466, is hereby reestablished. The Task Force consists of not more than fifteen members appointed pursuant to subsection 2.
2. The Governor shall:
(a) To the extent practicable, reappoint to the Task Force the members appointed pursuant to section 1 of chapter 88, Statutes of Nevada 2019, at page 466;
(b) Solicit applications for additional appointments to the Task Force; and
(c) After considering each application received pursuant to this subsection, appoint additional members to the Task Force who are members of the lesbian, gay, bisexual, transgender, questioning and queer community, women, persons living with the human immunodeficiency virus (HIV) and sex workers.
3. At the first meeting of the Task Force after the effective date of this act, the members of the Task Force shall elect a Chair and a Vice Chair by majority vote.
4. A vacancy occurring in the appointed membership of the Task Force must be filled in the same manner as the original appointment.
5. The Task Force shall solicit input from persons and nongovernmental agencies with expertise in matters relevant to the Task Force in carrying out its duties pursuant to this section, including, without limitation, persons, organizations and communities that are directly affected by the current statutes and regulations of this State that criminalize exposure to HIV or mandate HIV testing or disclosure as part of any civil or criminal law, or are likely to be affected by any law or policy recommended by the Task Force.
6. The Department of Health and Human Services shall provide the Task Force with such staff as is necessary for the Task Force to carry out its duties pursuant to this section.
7. The members of the Task Force serve without compensation or per diem allowance. A member may receive reimbursement for travel expenses if sufficient money collected pursuant to subsection 8 for the Task Force to carry out its duties is available.
κ2021 Statutes of Nevada, Page 3199 (CHAPTER 491, SB 275)κ
8. The Task Force may apply for any available grants and accept any gifts, grants or donations to assist the Task Force in carrying out its duties pursuant to this section.
9. The Task Force shall:
(a) Research the implementation and impact of such statutes and regulations of this State that criminalize exposure to HIV, including, without limitation, quantifying their impact through the analysis of records, information and data relevant to this State to the extent possible;
(b) Identify any disparities in arrests, prosecutions or convictions under such statutes or regulations related to race, color, sex, sexual orientation, gender identity or expression, age or national origin;
(c) Evaluate current medical and scientific research with respect to the modes of HIV transmission implicated by such statutes and regulations; and
(d) Identify any court decisions enforcing or challenging such statutes and regulations.
10. The Task Force may make recommendations concerning any matter relating to the duties performed pursuant to subsection 9, including, without limitation, recommendations concerning proposed legislation, proposed regulations and policies.
11. The Task Force shall, on or before September 1, 2022, prepare and submit a report of the activities, findings and recommendations of the Task Force to:
(a) The Governor; and
(b) The Director of the Legislative Counsel Bureau for transmittal to the 82nd Session of the Nevada Legislature.
Sec. 23. The Legislative Counsel shall:
1. In preparing the reprint and supplements to the Nevada Revised Statutes in 2021, appropriately change any words and terms in the Nevada Revised Statutes in the manner that the Legislative Counsel determines necessary to conform those words and terms to the provisions of NRS 220.125, as amended by section 17 of this act.
2. In preparing supplements to the Nevada Administrative Code, appropriately change any words and terms in the Nevada Administrative Code in the manner that the Legislative Counsel determines necessary to conform those words and terms to the provisions of subsection 2 of NRS 233B.062, as amended by section 18 of this act.
Sec. 24. NRS 201.205, 201.356, 201.358, 209.385, 441A.300 and 441A.320 are hereby repealed.
Sec. 25. This act becomes effective upon passage and approval.
________
κ2021 Statutes of Nevada, Page 3200κ
Senate Bill No. 325Senator Settelmeyer
CHAPTER 492
[Approved: June 6, 2021]
AN ACT relating to health care; requiring the State Board of Pharmacy to prescribe a protocol authorizing a pharmacist to prescribe, dispense and administer drugs to prevent the acquisition of human immunodeficiency virus and perform certain laboratory tests; requiring certain health plans to include coverage for such drugs and testing; and providing other matters properly relating thereto.
Legislative Counsels Digest:
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 1 of this bill requires the State Board of Pharmacy to prescribe a protocol to allow a pharmacist to: (1) order any laboratory test necessary for therapy that uses a drug approved by the United States Food and Drug Administration for preventing the acquisition of human immunodeficiency virus; (2) conduct such tests as necessary for such therapy; and (3) prescribe, dispense and administer such drugs without a prescription from a practitioner. Section 1 authorizes a pharmacist who is covered by sufficient liability coverage, as defined by regulations adopted by the Board, to take the actions authorized by the protocol. Section 2 of this bill provides that the practice of pharmacy includes actions authorized by the protocol. Section 8.5 of this bill makes a conforming change to account for the provisions of section 1 authorizing a pharmacist to dispense a drug that has not been prescribed by a practitioner. The Board would be authorized to suspend or revoke the registration of a pharmacist who orders or conducts a laboratory test or prescribes, dispenses or administers drugs under the protocol issued pursuant to section 1 without complying with the provisions of the protocol. (NRS 639.210)
Sections 4-7, 10, 12, 13, 15-17 and 20 of this bill require public and private health plans, including Medicaid and health plans for state and local government employees, to: (1) provide coverage for drugs that prevent the acquisition of human immunodeficiency virus and any related laboratory or diagnostic procedures; and (2) reimburse laboratory testing, prescribing, dispensing and administering by a pharmacist in accordance with section 1 at a rate equal to that provided to a physician, physician assistant or advanced practice registered nurse for similar services. Sections 3, 11 and 14 of this bill make conforming changes to indicate the placement of sections 6, 10 and 13, respectively, of this bill in the Nevada Revised Statutes. Section 19 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 17 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 10, 12, 13, 15, 16 and 20 of this bill. (NRS 680A.200)
κ2021 Statutes of Nevada, Page 3201 (CHAPTER 492, SB 325)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 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 meets the requirements prescribed by the Board pursuant to subsection 2 may, in accordance with the requirements of the protocol prescribed pursuant to subsection 2:
(a) Order and perform laboratory tests that are necessary for therapy that uses a drug approved by the United States Food and Drug Administration for preventing the acquisition of human immunodeficiency virus; and
(b) Prescribe, dispense and administer any drug described in paragraph (a) to a patient.
2. The Board shall adopt regulations:
(a) Requiring a pharmacist who takes the actions authorized by this section to be covered by adequate liability insurance, as determined by the Board; and
(b) Establishing a protocol for the actions authorized by this section.
Sec. 2. NRS 639.0124 is hereby amended to read as follows:
639.0124 1. Practice of pharmacy includes, but is not limited to, the:
[1.] (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.
[2.] (b) Interpretation and evaluation of prescriptions or orders for medicine.
[3.] (c) Participation in drug evaluation and drug research.
[4.] (d) Advising of the therapeutic value, reaction, drug interaction, hazard and use of a drug.
[5.] (e) Selection of the source, storage and distribution of a drug.
[6.] (f) Maintenance of proper documentation of the source, storage and distribution of a drug.
[7.] (g) Interpretation of clinical data contained in a persons record of medication.
[8.] (h) Development of written guidelines and protocols in collaboration with a practitioner which are intended for a patient in a licensed medical facility or in a setting that is affiliated with a medical facility where the patient is receiving care and which authorize collaborative drug therapy management. The written guidelines and protocols must comply with NRS 639.2629.
[9.] (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 section 1 of this act.
κ2021 Statutes of Nevada, Page 3202 (CHAPTER 492, SB 325)κ
conducting laboratory tests necessary for therapy that uses such drugs pursuant to the protocol prescribed pursuant to section 1 of this act.
[Κ]
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 [.] and section 1 of this act.
Sec. 3. 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 6 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.
κ2021 Statutes of Nevada, Page 3203 (CHAPTER 492, SB 325)κ
(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. 4. 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. 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 687B.408, 689B.030 to 689B.050, inclusive, and section 12 of this act, 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.
κ2021 Statutes of Nevada, Page 3204 (CHAPTER 492, SB 325)κ
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.
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. 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 687B.409, 689B.255, 695G.150, 695G.155, 695G.160, 695G.162, 695G.164, 695G.1645, 695G.1665, 695G.167, 695G.170 to 695G.174, inclusive, 695G.177, 695G.200 to 695G.230, inclusive, 695G.241 to 695G.310, inclusive, and 695G.405, and section 20 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. 6. Chapter 422 of NRS is hereby amended by adding thereto a new section to read as follows:
The Director shall include in the State Plan for Medicaid a requirement that the State pay the nonfederal share of expenditures incurred for:
1. Any laboratory testing that is necessary for therapy that uses a drug approved by the United States Food and Drug Administration for preventing the acquisition of human immunodeficiency virus; and
2. The services of a pharmacist described in section 1 of this act. The State must provide reimbursement for such services at a rate equal to the rate of reimbursement provided to a physician, physician assistant or advanced practice registered nurse for similar services.
κ2021 Statutes of Nevada, Page 3205 (CHAPTER 492, SB 325)κ
rate of reimbursement provided to a physician, physician assistant or advanced practice registered nurse for similar services.
Sec. 7. NRS 422.4025 is hereby amended to read as follows:
422.4025 1. The Department shall:
(a) By regulation, develop a list of preferred prescription drugs to be used for the Medicaid program and the Childrens Health Insurance Program, and each public or nonprofit health benefit plan that elects to use the list of preferred prescription drugs as its formulary pursuant to NRS 287.012, 287.0433 or 687B.407; and
(b) Negotiate and enter into agreements to purchase the drugs included on the list of preferred prescription drugs on behalf of the health benefit plans described in paragraph (a) or enter into a contract pursuant to NRS 422.4053 with a pharmacy benefit manager or health maintenance organization, as appropriate, to negotiate such agreements.
2. The Department shall, by regulation, establish a list of prescription drugs which must be excluded from any restrictions that are imposed by the Medicaid program on drugs that are on the list of preferred prescription drugs established pursuant to subsection 1. The list established pursuant to this subsection must include, without limitation:
(a) Prescription drugs that are prescribed for the treatment of the human immunodeficiency virus or acquired immunodeficiency syndrome, including, without limitation, protease inhibitors and antiretroviral medications;
(b) Antirejection medications for organ transplants;
(c) Antihemophilic medications; and
(d) Any prescription drug which the Board identifies as appropriate for exclusion from any restrictions that are imposed by the Medicaid program on drugs that are on the list of preferred prescription drugs.
3. The regulations must provide that the Board makes the final determination of:
(a) Whether a class of therapeutic prescription drugs is included on the list of preferred prescription drugs and is excluded from any restrictions that are imposed by the Medicaid program on drugs that are on the list of preferred prescription drugs;
(b) Which therapeutically equivalent prescription drugs will be reviewed for inclusion on the list of preferred prescription drugs and for exclusion from any restrictions that are imposed by the Medicaid program on drugs that are on the list of preferred prescription drugs; and
(c) Which prescription drugs should be excluded from any restrictions that are imposed by the Medicaid program on drugs that are on the list of preferred prescription drugs based on continuity of care concerning a specific diagnosis, condition, class of therapeutic prescription drugs or medical specialty.
4. The list of preferred prescription drugs established pursuant to subsection 1 must include, without limitation [, any] :
(a) Any prescription drug determined by the Board to be essential for treating sickle cell disease and its variants [.] ; and
(b) Prescription drugs to prevent the acquisition of human immunodeficiency virus.
5. The regulations must provide that each new pharmaceutical product and each existing pharmaceutical product for which there is new clinical evidence supporting its inclusion on the list of preferred prescription drugs must be made available pursuant to the Medicaid program with prior authorization until the Board reviews the product or the evidence.
κ2021 Statutes of Nevada, Page 3206 (CHAPTER 492, SB 325)κ
must be made available pursuant to the Medicaid program with prior authorization until the Board reviews the product or the evidence.
6. On or before February 1 of each year, the Department shall:
(a) Compile a report concerning the agreements negotiated pursuant to paragraph (b) of subsection 1 and contracts entered into pursuant to NRS 422.4053 which must include, without limitation, the financial effects of obtaining prescription drugs through those agreements and contracts, in total and aggregated separately for agreements negotiated by the Department, contracts with a pharmacy benefit manager and contracts with a health maintenance organization; and
(b) Post the report on an Internet website maintained by the Department and submit the report to the Director of the Legislative Counsel Bureau for transmittal to:
(1) In odd-numbered years, the Legislature; or
(2) In even-numbered years, the Legislative Commission.
Sec. 8. (Deleted by amendment.)
Sec. 8.5. NRS 683A.179 is hereby amended to read as follows:
683A.179 1. A pharmacy benefit manager shall not:
(a) Prohibit a pharmacist or pharmacy from providing information to a covered person concerning:
(1) The amount of any copayment or coinsurance for a prescription drug; or
(2) The availability of a less expensive alternative or generic drug including, without limitation, information concerning clinical efficacy of such a drug;
(b) Penalize a pharmacist or pharmacy for providing the information described in paragraph (a) or selling a less expensive alternative or generic drug to a covered person;
(c) Prohibit a pharmacy from offering or providing delivery services directly to a covered person as an ancillary service of the pharmacy; or
(d) If the pharmacy benefit manager manages a pharmacy benefits plan that provides coverage through a network plan, charge a copayment or coinsurance for a prescription drug in an amount that is greater than the total amount paid to a pharmacy that is in the network of providers under contract with the third party.
2. The provisions of this section:
(a) Must not be construed to authorize a pharmacist to dispense a drug that has not been prescribed by a practitioner, as defined in NRS 639.0125 [.] , except to the extent authorized by section 1 of this act.
(b) Do not apply to an institutional pharmacy, as defined in NRS 639.0085, or a pharmacist working in such a pharmacy as an employee or independent contractor.
3. As used in this section, network plan means a health benefit plan offered by a health carrier under which the financing and delivery of medical care is 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.
Sec. 9. (Deleted by amendment.)
Sec. 10. 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:
κ2021 Statutes of Nevada, Page 3207 (CHAPTER 492, SB 325)κ
(a) Drugs approved by the United States Food and Drug Administration for preventing the acquisition of human immunodeficiency virus;
(b) Laboratory testing that is necessary for therapy that uses such a drug; and
(c) The services described in section 1 of this act, when provided by a pharmacist who participates in the network plan of the insurer.
2. An insurer that offers or issues a policy of health insurance shall reimburse a pharmacist who participates in the network plan of the insurer for the services described in section 1 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. An insurer may subject the benefits required by subsection 1 to reasonable medical management techniques.
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 October 1, 2021, 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. 11. 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 10 of this act.
Sec. 12. 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) Drugs approved by the United States Food and Drug Administration for preventing the acquisition of human immunodeficiency virus;
(b) Laboratory testing that is necessary for therapy that uses such a drug; and
κ2021 Statutes of Nevada, Page 3208 (CHAPTER 492, SB 325)κ
(c) The services described in section 1 of this act, when provided by a pharmacist who participates in the network plan of the insurer.
2. An insurer that offers or issues a policy of group health insurance shall reimburse a pharmacist who participates in the network plan of the insurer for the services described in section 1 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. An insurer may subject the benefits required by subsection 1 to reasonable medical management techniques.
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 October 1, 2021, 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. 13. 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) Drugs approved by the United States Food and Drug Administration for preventing the acquisition of human immunodeficiency virus;
(b) Laboratory testing that is necessary for therapy that uses such a drug; and
(c) The services described in section 1 of this act, when provided by a pharmacist who participates in the health benefit plan of the carrier.
2. A carrier that offers or issues a health benefit plan shall reimburse a pharmacist who participates in the health benefit plan of the carrier for the services described in section 1 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. A carrier may subject the benefits required by subsection 1 to reasonable medical management techniques.
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.
κ2021 Statutes of Nevada, Page 3209 (CHAPTER 492, SB 325)κ
5. A health benefit plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after October 1, 2021, 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 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. 14. 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 13 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.
Sec. 15. 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 benefit coverage for:
(a) Drugs approved by the United States Food and Drug Administration for preventing the acquisition of human immunodeficiency virus;
(b) Laboratory testing that is necessary for therapy that uses such a drug; and
(c) The services described in section 1 of this act, when provided by a pharmacist who participates in the network plan of the society.
2. A society that offers or issues a benefit contract shall reimburse a pharmacist who participates in the network plan of the society for the services described in section 1 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. A society may subject the benefits required by subsection 1 to reasonable medical management techniques.
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 October 1, 2021, 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:
κ2021 Statutes of Nevada, Page 3210 (CHAPTER 492, SB 325)κ
(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. 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) Drugs approved by the United States Food and Drug Administration for preventing the acquisition of human immunodeficiency virus;
(b) Laboratory testing that is necessary for therapy using such a drug; and
(c) The services described in section 1 of this act, when provided by a pharmacist who participates in the network plan of the hospital or medical services corporation.
2. A hospital or medical services corporation that offers or issues a policy of health insurance shall reimburse a pharmacist who participates in the network plan of the hospital or medical services corporation for the services described in section 1 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. A hospital or medical services corporation may subject the benefits required by subsection 1 to reasonable medical management techniques.
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 October 1, 2021, 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.
κ2021 Statutes of Nevada, Page 3211 (CHAPTER 492, SB 325)κ
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. 17. 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) Drugs approved by the United States Food and Drug Administration for preventing the acquisition of human immunodeficiency virus;
(b) Laboratory testing that is necessary for therapy that uses such a drug; and
(c) The services described in section 1 of this act, when provided by a pharmacist who participates in the network plan of the health maintenance organization.
2. A health maintenance organization that offers or issues a health care plan shall reimburse a pharmacist who participates in the network plan of the health maintenance organization for the services described in section 1 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. A health maintenance organization may subject the benefits required by subsection 1 to reasonable medical management techniques.
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 October 1, 2021, 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. 18. 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.
κ2021 Statutes of Nevada, Page 3212 (CHAPTER 492, SB 325)κ
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.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.17345, 695C.1735, 695C.1745 and 695C.1757 , and section 17 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. 19. 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 17 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;
κ2021 Statutes of Nevada, Page 3213 (CHAPTER 492, SB 325)κ
(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;
(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. 20. 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) Drugs approved by the United States Food and Drug Administration for preventing the acquisition of human immunodeficiency virus;
(b) Laboratory testing that is necessary for therapy that uses such a drug; and
(c) The services described in section 1 of this act, when provided by a pharmacist who participates in the network plan of the managed care organization.
2. A managed care organization that offers or issues a health care plan shall reimburse a pharmacist who participates in the network plan of the managed care organization for the services described in section 1 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.
κ2021 Statutes of Nevada, Page 3214 (CHAPTER 492, SB 325)κ
3. A managed care organization may subject the benefits required by subsection 1 to reasonable medical management techniques.
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 October 1, 2021, 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 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. 21. 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. 22. 1. This section becomes effective upon passage and approval.
2. Sections 1 to 21, 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, 2021, for all other purposes.
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