[Rev. 6/29/2024 4:05:01 PM--2023]
TITLE 39 - MENTAL HEALTH
CHAPTER 433 - GENERAL PROVISIONS
DECLARATION OF INTENT FOR CHAPTERS 433 TO 433C, INCLUSIVE, OF NRS
NRS 433.003 Declaration of legislative intent.
DEFINITIONS FOR CHAPTERS 433 TO 433C, INCLUSIVE, OF NRS
NRS 433.005 Definitions.
NRS 433.014 “Administrative officer” defined.
NRS 433.024 “Administrator” defined.
NRS 433.047 “Commission” defined.
NRS 433.064 “Department” defined.
NRS 433.069 “Developmental disability” defined.
NRS 433.074 “Director of the Department” defined.
NRS 433.084 “Division” defined.
NRS 433.094 “Division facility” defined.
NRS 433.099 “Intellectual disability” defined.
NRS 433.134 “Medical director” defined.
NRS 433.144 “Mental health center” defined.
NRS 433.164 “Mental illness” defined.
NRS 433.209 “Person professionally qualified in the field of psychiatric mental health” defined.
NRS 433.224 “Treatment” defined.
NRS 433.227 “Treatment to competency” defined.
DIVISION OF PUBLIC AND BEHAVIORAL HEALTH
Facilities of Division
NRS 433.233 Designation.
NRS 433.2335 Hours of operation for mobile units.
Personnel of Division
NRS 433.234 Administration of facilities of Division.
NRS 433.244 Administrator: Qualifications; classification.
NRS 433.254 Administrator: Powers and duties.
NRS 433.259 Administrator: Delegation of power, duty or function.
NRS 433.262 Medical director responsible to Chief Medical Officer.
NRS 433.264 Physicians: Employment; qualifications; compensation; duties.
NRS 433.265 Licensing or certification of certain employees of Division.
NRS 433.267 Limitation on time for certification of psychiatrist employed by Division.
NRS 433.269 Proficiency in English language required of certain employees.
NRS 433.279 Program for certification of mental health technicians.
Commission on Behavioral Health
NRS 433.314 Duties.
NRS 433.316 Powers.
NRS 433.317 Appointment of subcommittee on the mental health of children; duties; compensation to extent of available funding.
NRS 433.318 Appointment of subcommittee or advisory committee; member qualifications; duties; compensation to extent of available funding.
NRS 433.324 Regulations.
NRS 433.325 Inspection of facility.
NRS 433.327 Right of certain employees of Department to submit information or requests to Commission or appear before Commission.
Powers and Duties
NRS 433.331 Adoption of regulations concerning abuse and neglect of consumers.
NRS 433.3315 Adoption of regulations concerning consumers.
NRS 433.3317 Licensure and regulation of providers of nonemergency secure behavioral health transport services; regulations by State Board of Health.
NRS 433.332 Division facility required to forward patient’s medical records upon transfer of patient from facility.
NRS 433.334 Contract with hospital or other institution for care of consumers.
NRS 433.344 Contracts with persons professionally qualified in field of psychiatric mental health for care of persons.
NRS 433.354 Contracts for cooperation with governmental entities and others; effect of payments to Division for such cooperation; immunity from and limitations on liability not waived.
NRS 433.359 Grants for addressing disparities in behavioral health care and outcomes; selection of lead partner to ensure services supported by grant are provided equitably; establishment of advisory committee; report.
NRS 433.364 Involuntary court-ordered admission to private institution not precluded.
NRS 433.374 State not responsible for payment of costs of care and treatment at other facility; exceptions.
Finance
NRS 433.384 Legislative appropriations; payment of claims.
NRS 433.394 Acceptance by Department of money from other sources.
NRS 433.395 Acceptance by Administrator of donations, gifts and grants for disbursement to certain programs; contract for services for evaluation and recommendation of recipients for disbursements.
NRS 433.404 Schedule of fees for services rendered through programs supported by State; disposition of receipts; amount of fee for services of facility.
NRS 433.414 Fees of physicians and other professionally qualified employees of facility.
NRS 433.424 Mental health center revolving accounts.
REGIONAL BEHAVIORAL HEALTH POLICY BOARDS
NRS 433.425 Definitions.
NRS 433.426 “Behavioral health region” defined.
NRS 433.427 “Policy board” defined.
NRS 433.428 Designation of behavioral health regions.
NRS 433.429 Creation; membership; terms; meetings; Chair.
NRS 433.4295 Duties.
CONSUMERS
Residence
NRS 433.431 Definitions.
NRS 433.434 Determination of residence.
NRS 433.444 Reciprocal agreement for returning consumers to legal residence; investigation and report concerning residence.
NRS 433.454 Expenses of returning consumer to legal residence.
Interstate Compact on Mental Health
NRS 433.4543 Text of Compact.
NRS 433.4545 Administrator to serve as Compact Administrator; duties; regulations.
NRS 433.4547 Construction.
Consumers’ Rights
NRS 433.456 Definitions.
NRS 433.458 “Administrative officer” defined.
NRS 433.461 “Facility” defined.
NRS 433.462 “Rights” defined.
NRS 433.464 Right to habeas corpus unimpaired.
NRS 433.471 Rights concerning admission and discharge of consumers.
NRS 433.472 Rights concerning involuntary commitment.
NRS 433.482 Personal rights.
NRS 433.484 Rights concerning care, treatment and training.
NRS 433.494 Individualized plan of services for consumer.
NRS 433.496 Basis for decisions, policies, procedures and practices regarding emergency admissions and involuntary court-ordered admissions.
NRS 433.504 Right to information; inspection and copying of records.
NRS 433.514 Medication: Responsibility of psychiatrist and physician; review of methods for administration and custody.
NRS 433.524 Labor by consumer: Conditions; compensation.
NRS 433.531 Rights concerning suspension or violation of rights.
NRS 433.533 Document reflecting receipt of list of rights and explanation of rights.
NRS 433.534 Denial of rights prohibited; exceptions; report; investigation and action by Commission; closure of meeting in certain circumstances.
NRS 433.536 Retaliation by officer, director or employee of facility prohibited.
Safekeeping of Consumer’s Money and Other Personal Property
NRS 433.538 Definitions.
NRS 433.539 Personal deposit funds for consumers.
NRS 433.541 Disposition of personal property of consumer upon death.
NRS 433.542 Disposition of unclaimed personal property of consumer worth more than $100.
NRS 433.543 Disposition of unclaimed personal property of minimal value.
Deaths and Burials
NRS 433.544 Notification of death of consumer; burial.
USE OF RESTRAINTS AND INTERVENTIONS
NRS 433.545 Definitions.
NRS 433.5453 “Aversive intervention” defined.
NRS 433.5456 “Chemical restraint” defined.
NRS 433.546 “Corporal punishment” defined.
NRS 433.5463 “Electric shock” defined.
NRS 433.5466 “Emergency” defined.
NRS 433.547 “Mechanical restraint” defined.
NRS 433.5473 “Person with a disability” defined.
NRS 433.5476 “Physical restraint” defined.
NRS 433.548 “Verbal and mental abuse” defined.
NRS 433.5483 Use of aversive intervention on consumer prohibited.
NRS 433.5486 Use of physical, mechanical or chemical restraint on consumer by facility authorized in certain circumstances.
NRS 433.549 Use of physical, mechanical or chemical restraint on consumer by person employed by facility prohibited; exceptions.
NRS 433.5493 Use of physical restraint on consumer; requirements; exceptions; report as denial of rights.
NRS 433.5496 Use of mechanical restraint on consumer other than consumer of forensic facility; requirements; exceptions; report as denial of rights.
NRS 433.5499 Use of mechanical restraint on consumer of forensic facility; requirements; exceptions; report as denial of rights.
NRS 433.5503 Use of chemical restraint on consumer; requirements; report as denial of rights.
NRS 433.5506 Facility required to develop program of education in positive behavioral interventions and supports; facility required to train certain members of staff to use physical, mechanical and chemical restraint.
NRS 433.551 Facility required to report violations to Division and to develop corrective plan; Division required to forward corrective plan to Director of Department; power of Department to withhold funding.
UNLAWFUL ACTS
NRS 433.554 Abuse of consumer; failure to report abuse; possession or use of intoxicating beverage or controlled substance; transaction with consumer; aiding escape of consumer; penalties.
NRS 433.564 Unlawful sale or transfer of intoxicating beverage on grounds of division facility.
PEER RECOVERY SUPPORT SERVICES
General Provisions
NRS 433.622 Definitions.
NRS 433.623 “Adult” defined.
NRS 433.624 “Board” defined.
NRS 433.625 “Certificate” defined. [Effective on the date on which the Nevada Certification Board, or its successor organization, ceases certifying peer recovery support specialists or peer recovery support specialist supervisors.]
NRS 433.626 “Peer recovery support services” defined.
NRS 433.627 “Peer recovery support specialist” defined.
NRS 433.628 “Peer recovery support specialist intern” defined.
NRS 433.629 “Peer recovery support specialist supervisor” defined.
Certification
NRS 433.631 Certificate required to provide or supervise provision of peer recovery support services; exception for interns; civil penalty. [Effective until the date on which the Nevada Certification Board, or its successor organization, ceases certifying peer recovery support specialists or peer recovery support specialist supervisors.]
NRS 433.631 Certificate required to provide or supervise provision of peer recovery support services; exception for interns; civil penalty. [Effective on the date on which the Nevada Certification Board, or its successor organization, ceases certifying peer recovery support specialists or peer recovery support specialist supervisors.]
NRS 433.632 Regulations; fees. [Effective on the date on which the Nevada Certification Board, or its successor organization, ceases certifying peer recovery support specialists or peer recovery support specialist supervisors.]
NRS 433.633 Statement concerning obligation for child support required for issuance or renewal of certificate. [Effective on the date on which the Nevada Certification Board, or its successor organization, ceases certifying peer recovery support specialists or peer recovery support specialist supervisors, and until the date of the repeal of 42 U.S.C. § 666, the federal law requiring each state to establish procedures for withholding, suspending and restricting the professional, occupational and recreational licenses for child support arrearages and for noncompliance with certain processes relating to paternity or child support proceedings.]
NRS 433.634 Suspension of certificate for failure to pay child support or comply with certain subpoenas or warrants; reinstatement of certificate. [Effective on the date on which the Nevada Certification Board, or its successor organization, ceases certifying peer recovery support specialists or peer recovery support specialist supervisors, and until the date of the repeal of 42 U.S.C. § 666, the federal law requiring each state to establish procedures for withholding, suspending and restricting the professional, occupational and recreational licenses for child support arrearages and for noncompliance with certain processes relating to paternity or child support proceedings.]
NRS 433.635 Expedited certificate by endorsement: Requirements; procedure for issuance. [Effective on the date on which the Nevada Certification Board, or its successor organization, ceases certifying peer recovery support specialists or peer recovery support specialist supervisors.]
NRS 433.636 Expedited certificate by endorsement for active member of Armed Forces, member’s spouse, veteran or veteran’s surviving spouse: Requirements; procedure for issuance; provisional certificate pending application. [Effective on the date on which the Nevada Certification Board, or its successor organization, ceases certifying peer recovery support specialists or peer recovery support specialist supervisors.]
NRS 433.637 Application for renewal of certificate to include information relating to state business license; denial of renewal for unpaid debt assigned to State Controller for collection. [Effective on the date on which the Nevada Certification Board, or its successor organization, ceases certifying peer recovery support specialists or peer recovery support specialist supervisors.]
NRS 433.638 Injunction.
Requirements Concerning Certain Persons Who Have Contact With Minors
NRS 433.639 Child abuse and neglect screening; termination upon receipt of substantiated report; opportunity to correct information; review; regulations; civil penalties.
NRS 433.641 Maintenance of records.
SUICIDE PREVENTION LIFELINE PROGRAM
NRS 433.702 “National Suicide Prevention Lifeline program” defined.
NRS 433.704 Implementation of hotline; immunity from liability for telecommunications provider.
NRS 433.706 Requirements for and duties of support center.
NRS 433.708 Surcharge on certain communications lines; Crisis Response Account; use of money in Account; acceptance of gifts, grants and donations; report.
NRS 433.710 Reports.
ADMINISTRATION OF CERTAIN PROCEEDS FROM LITIGATION CONCERNING OPIOIDS
General Provisions
NRS 433.712 Definitions.
NRS 433.714 “Advisory Committee” defined.
NRS 433.716 “Agency which provides child welfare services” defined.
NRS 433.718 “Fund” defined.
NRS 433.720 “Office” defined.
NRS 433.722 “Special population” defined.
NRS 433.724 “Substance use disorder prevention coalition” defined.
Advisory Committee for a Resilient Nevada
NRS 433.726 Creation; appointment, qualifications, terms and compensation of members.
NRS 433.728 Chair; meetings; quorum; staff assistance.
NRS 433.730 Reports.
Administration and Allocation of Funds
NRS 433.732 Fund for a Resilient Nevada: Creation and administration; appropriation and expenditure of money in Fund; acceptance of gifts, grants and donations.
NRS 433.734 Statewide needs assessment; statewide plan to allocate money; report; regulations.
NRS 433.736 Requirements and procedure for statewide needs assessment.
NRS 433.738 Requirements for statewide plan to allocate money from Fund; authorized uses of money; revision of statewide plan without needs assessment.
NRS 433.740 Procedure for awarding grants; administrative expenses of grantee; annual report; recovery of money from certain grantees.
NRS 433.742 Requirements and procedure for regional, county, local or tribal needs assessment.
NRS 433.744 Requirements for regional, county, local or tribal plan for use of grant; authorized uses of grant money.
MISCELLANEOUS PROVISIONS
NRS 433.801 Return of prescription drug to dispensing pharmacy for reissuance or transfer of drug; reissuance or transfer of drug by dispensing pharmacy; regulations.
NRS 433.806 Required considerations before placing person with mental illness or person with developmental disability.
_________
DECLARATION OF INTENT FOR CHAPTERS 433 TO 433C, INCLUSIVE, OF NRS
NRS 433.003 Declaration of legislative intent. The Legislature hereby declares that it is the intent of chapters 433 to 433C, inclusive, of NRS:
1. To eliminate the forfeiture of any civil and legal rights of any person and the imposition of any legal disability on any person, based on an allegation of mental illness, by any method other than a separate judicial proceeding resulting in a determination of incapacity, wherein the civil and legal rights forfeited and the legal disabilities imposed are specifically stated; and
2. To charge the Division of Public and Behavioral Health, and the Division of Child and Family Services, of the Department with recognizing their duty to act in the best interests of their respective consumers by placing them in the least restrictive environment.
(Added to NRS by 1975, 1589; A 1993, 2715; 1999, 97, 2589; 2011, 410; 2013, 662, 3003)
DEFINITIONS FOR CHAPTERS 433 TO 433C, INCLUSIVE, OF NRS
NRS 433.005 Definitions. As used in chapters 433 to 433C, inclusive, of NRS, unless the context otherwise requires, or except as otherwise defined by specific statute, the words and terms defined in NRS 433.014 to 433.227, inclusive, have the meanings ascribed to them in those sections.
(Added to NRS by 1969, 1060; A 1971, 1987; 1973, 256, 1220; 1975, 1589; 1979, 811; 1985, 2264; 1989, 1755; 1999, 2590; 2003, 1941; 2013, 3003; 2017, 2804)
NRS 433.014 “Administrative officer” defined. “Administrative officer” means a person with overall executive and administrative responsibility for those state or nonstate mental health centers designated by the Administrator.
(Added to NRS by 1975, 1590; A 1979, 811; 2013, 662, 3003)
NRS 433.024 “Administrator” defined. “Administrator” means the Administrator of the Division.
(Added to NRS by 1973, 256; A 1999, 97)
NRS 433.047 “Commission” defined. “Commission” means the Commission on Behavioral Health.
(Added to NRS by 1985, 2262; A 1999, 97; 2013, 3003)
NRS 433.064 “Department” defined. “Department” means the Department of Health and Human Services.
(Added to NRS by 1975, 1590)
NRS 433.069 “Developmental disability” defined. “Developmental disability” has the meaning ascribed to it in NRS 435.007.
(Added to NRS by 2017, 2804)
NRS 433.074 “Director of the Department” defined. “Director of the Department” means the administrative head of the Department.
(Added to NRS by 1975, 1590)
NRS 433.084 “Division” defined. “Division” means the Division of Public and Behavioral Health of the Department.
(Added to NRS by 1969, 1060; A 1973, 1406; 1975, 1590; 1999, 97; 2013, 3003)
NRS 433.094 “Division facility” defined. “Division facility” means any unit or subunit operated by the Division for the care, treatment and training of consumers.
(Added to NRS by 1973, 256; A 1975, 1590; 1981, 275; 2011, 410)
NRS 433.099 “Intellectual disability” defined. “Intellectual disability” means significantly subaverage general intellectual functioning existing concurrently with deficits in adaptive behavior and manifested during the developmental period.
(Added to NRS by 1975, 1591; A 2013, 662)
NRS 433.134 “Medical director” defined. “Medical director” means the medical officer in charge of any division mental health program.
(Added to NRS by 1973, 1220; A 1975, 1591; 2013, 662, 3003)
NRS 433.144 “Mental health center” defined. “Mental health center” means any of the state comprehensive mental health centers, including rural clinics.
(Added to NRS by 1969, 1060; A 1973, 98; 1975, 1591)
NRS 433.164 “Mental illness” defined. “Mental illness” means a clinically significant disorder of thought, mood, perception, orientation, memory or behavior which seriously limits the capacity of a person to function in the primary aspects of daily living, including, without limitation, personal relations, living arrangements, employment and recreation. The term does not include other mental disorders that result in diminished capacity, including, without limitation, epilepsy, intellectual disability, dementia, delirium, brief periods of intoxication caused by alcohol or other substances or dependence upon or addiction to alcohol or other substances.
(Added to NRS by 1975, 1591; A 2003, 1941; 2017, 431)
NRS 433.209 “Person professionally qualified in the field of psychiatric mental health” defined. “Person professionally qualified in the field of psychiatric mental health” means:
1. A psychiatrist licensed to practice medicine in the State of Nevada and 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 master’s degree in social work, 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;
(b) Holds a master’s 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.
(Added to NRS by 1975, 1591; A 1983, 506; 1985, 2044; 1987, 527, 1124, 2133, 2134; 1989, 1550; 2007, 3086)
NRS 433.224 “Treatment” defined. “Treatment” means any combination of procedures or activities, of whatever level of intensity and whatever duration, ranging from occasional counseling sessions to full-time admission to a residential facility.
(Added to NRS by 1975, 1592)
NRS 433.227 “Treatment to competency” defined. “Treatment to competency” means treatment provided to a person who is a defendant in a criminal action or proceeding to attempt to cause the person to attain competency to stand trial or receive pronouncement of judgment.
(Added to NRS by 2003, 1941)
DIVISION OF PUBLIC AND BEHAVIORAL HEALTH
Facilities of Division
1. The division facilities providing mental health services are designated as:
(a) Northern Nevada Adult Mental Health Services;
(b) Southern Nevada Adult Mental Health Services;
(c) Rural clinics; and
(d) Lakes Crossing Center.
2. Division facilities established after July 1, 1981, must be named by the Administrator, subject to the approval of the Director of the Department.
(Added to NRS by 1981, 274; A 1993, 2715; 1999, 97, 2590; 2001, 1115; 2013, 663, 3003)
NRS 433.2335 Hours of operation for mobile units. If a division facility provides mental health services using a mobile unit in a county whose population is 100,000 or more, the mobile unit must be available to provide such services from 8 a.m. or earlier to 12 a.m. or later, 7 days a week, including holidays.
(Added to NRS by 2017, 2927)
Personnel of Division
NRS 433.234 Administration of facilities of Division. The provisions of chapters 433 to 433C, inclusive, of NRS pertaining to division facilities must be administered by the respective administrative officers of the division facilities, subject to administrative supervision by the Administrator.
(Added to NRS by 1975, 1592; A 1993, 2715; 2013, 3004)
NRS 433.244 Administrator: Qualifications; classification.
1. The Administrator must be selected on the basis of his or her education, training, experience, leadership qualities, demonstrated abilities and interest in the field of behavioral health or public health.
2. The Administrator is in the unclassified service of the State.
(Added to NRS by 1975, 1592; A 1981, 1281, 1685; 1983, 641; 1985, 2264; 1999, 2590; 2009, 270; 2013, 663, 3004)
NRS 433.254 Administrator: Powers and duties.
1. The Administrator serves at the pleasure of the Director of the Department and shall:
(a) Serve as the Executive Officer of the Division;
(b) Administer the Division in accordance with the policies established by the Commission;
(c) Make an annual report to the Director of the Department on the condition and operation of the Division, and such other reports as the Director may prescribe; and
(d) Employ, within the limits of available money, the assistants and employees necessary to the efficient operation of the Division.
2. The Administrator may:
(a) Appoint the administrative personnel necessary to operate the programs of the Division.
(b) Delegate to the administrative officers the power to appoint medical, technical, clerical and operational staff necessary for the operation of the facilities of the Division.
3. If the Administrator finds that it is necessary or desirable that any employee reside at a facility operated by the Division or receive meals at such a facility, perquisites granted or charges for services rendered to that person are at the discretion of the Director of the Department.
(Added to NRS by 1975, 1592; A 1979, 811; 1985, 423, 2264; 1989, 429; 2009, 271; 2019, 4464)
NRS 433.259 Administrator: Delegation of power, duty or function.
1. The Administrator may delegate to any officer, deputy or employee of the Division the exercise or discharge in the name of the Administrator of any power, duty or function vested in or imposed upon the Administrator.
2. The official act of any such person acting in the name of the Administrator and by his or her authority shall be deemed an official act of the Administrator.
(Added to NRS by 2013, 3003)
NRS 433.262 Medical director responsible to Chief Medical Officer. The medical director or other person in charge of any division facility or any other facility or center established pursuant to chapters 433 to 433C, inclusive, of NRS:
1. Is subject to the oversight of the Chief Medical Officer; and
2. Shall report to the Chief Medical Officer any information concerning the facility or center upon the request of the Chief Medical Officer.
(Added to NRS by 2013, 3003)
NRS 433.264 Physicians: Employment; qualifications; compensation; duties.
1. Physicians shall be employed within the various division facilities as are necessary for the operation of the facilities. They shall hold degrees of doctor of medicine or doctor of osteopathic medicine from accredited medical schools and they shall be licensed to practice medicine or osteopathic medicine in Nevada as provided by law.
2. Except as otherwise provided by law, their only compensation shall be annual salaries, fixed in accordance with the pay plan adopted pursuant to the provisions of NRS 284.175.
3. The physicians shall perform such duties pertaining to the care and treatment of consumers as may be required.
(Added to NRS by 1975, 1592; A 2011, 410; 2013, 3004)
NRS 433.265 Licensing or certification of certain employees of Division. Any person employed by the Division as a psychiatrist, psychologist, marriage and family therapist, clinical professional counselor, registered nurse or social worker must be licensed or certified by the appropriate state licensing board for his or her respective profession.
(Added to NRS by 1985, 2044; A 1987, 527, 1122, 2133, 2134; 2007, 3086)
NRS 433.267 Limitation on time for certification of psychiatrist employed by Division. Any psychiatrist who is employed by the Division must be certified by the American Board of Psychiatry and Neurology within 5 years after the psychiatrist’s first date of employment with the Division. The Administrator shall terminate the employment of any psychiatrist who fails to receive such certification.
(Added to NRS by 1985, 2044; A 1989, 683)
NRS 433.269 Proficiency in English language required of certain employees. The Administrator shall not employ any psychiatrist, psychologist, social worker or registered nurse who holds a master’s degree in the field of psychiatric nursing who is unable to demonstrate proficiency in the oral and written expression of the English language.
(Added to NRS by 1985, 2044)
NRS 433.279 Program for certification of mental health technicians.
1. The Division shall carry out a vocational and educational program for the certification of mental health technicians, including forensic technicians:
(a) Employed by the Division, or other employees of the Division who perform similar duties, but are classified differently.
(b) Employed by the Division of Child and Family Services of the Department.
Ê The program must be carried out in cooperation with the Nevada System of Higher Education.
2. A mental health technician is responsible to the director of the service in which his or her duties are performed. The director of a service may be a licensed physician, dentist, podiatric physician, psychiatrist, psychologist, rehabilitation therapist, social worker, registered nurse or other professionally qualified person. This section does not authorize a mental health technician to perform duties which require the specialized knowledge and skill of a professionally qualified person.
3. The Division shall adopt regulations to carry out the provisions of this section.
4. As used in this section, “mental health technician” means an employee of the Division of Public and Behavioral Services or the Division of Child and Family Services who, for compensation or personal profit, carries out procedures and techniques which involve cause and effect and which are used in the care, treatment and rehabilitation of persons with mental illness and persons who are emotionally disturbed, and who has direct responsibility for:
(a) Administering or carrying out specific therapeutic procedures, techniques or treatments, excluding medical interventions, to enable consumers to make optimal use of their therapeutic regime, their social and personal resources, and their residential care; or
(b) The application of interpersonal and technical skills in the observation and recognition of symptoms and reactions of consumers, for the accurate recording of such symptoms and reactions, and for carrying out treatments authorized by members of the interdisciplinary team that determines the treatment of the consumers.
(Added to NRS by 1989, 428; A 1993, 402, 2230; 1995, 805; 1999, 98, 2591; 2011, 410; 2013, 663, 3004)
Commission on Behavioral Health
1. The Commission shall:
(a) Establish policies to ensure adequate development and administration of services for persons with mental illness, persons with intellectual disabilities, persons with developmental disabilities, persons with substance use disorders or persons with co-occurring disorders, including services to prevent mental illness, intellectual disabilities, developmental disabilities, substance use disorders and co-occurring disorders, and services provided without admission to a facility or institution;
(b) Set policies for the care and treatment of persons with mental illness, persons with intellectual disabilities, persons with developmental disabilities, persons with substance use disorders or persons with co-occurring disorders provided by all state agencies;
(c) If a data dashboard is established pursuant to NRS 439.245, use the data dashboard to review access by different groups and populations in this State to behavioral health services provided through telehealth, as defined in NRS 629.515, and evaluate policies to make such access more equitable;
(d) Review the programs and finances of the Division;
(e) Report at the beginning of each year to the Governor and at the beginning of each odd-numbered year to the Legislature:
(1) Information concerning the quality of the care and treatment provided for persons with mental illness, persons with intellectual disabilities, persons with developmental disabilities, persons with substance use disorders or persons with co-occurring disorders in this State and on any progress made toward improving the quality of that care and treatment; and
(2) In coordination with the Department, any recommendations from the regional behavioral health policy boards created pursuant to NRS 433.429. The report must include, without limitation:
(I) The epidemiologic profiles of substance use disorders, addictive disorders related to gambling and suicide;
(II) Relevant behavioral health prevalence data for each behavioral health region created by NRS 433.428; and
(III) The health priorities set for each behavioral health region; and
(f) Review and make recommendations concerning regulations submitted to the Commission for review pursuant to NRS 641.100, 641A.160, 641B.160 and 641C.200.
2. The Commission may employ an administrative assistant and a data analyst to assist the regional behavioral health policy boards created by NRS 433.429 in carrying out their duties.
(Added to NRS by 1975, 1593; A 1985, 2265; 1999, 2591; 2009, 662; 2013, 664, 3005; 2017, 2247, 2248, 2805, 2993; 2019, 2043; 2021, 3012)
NRS 433.316 Powers. The Commission may:
1. Collect and disseminate information pertaining to mental health, intellectual disabilities, developmental disabilities, substance use disorders and co-occurring disorders.
2. Request legislation pertaining to mental health, intellectual disabilities, developmental disabilities, substance use disorders and co-occurring disorders.
3. Review findings of investigations of complaints about the care of any person in a public facility for the treatment of persons with mental illness, persons with intellectual disabilities, persons with developmental disabilities, persons with substance use disorders or persons with co-occurring disorders.
4. Accept, as authorized by the Legislature, gifts and grants of money and property.
5. Take appropriate steps to increase the availability of and to enhance the quality of the care and treatment of persons with mental illness, persons with intellectual disabilities, persons with developmental disabilities, persons with substance use disorders or persons with co-occurring disorders provided through private nonprofit organizations, governmental entities, hospitals and clinics.
6. Promote programs for the treatment of persons with mental illness, persons with intellectual disabilities, persons with developmental disabilities, persons with substance use disorders or persons with co-occurring disorders and participate in and promote the development of facilities for training persons to provide services for persons with mental illness, persons with intellectual disabilities, persons with developmental disabilities, persons with substance use disorders or persons with co-occurring disorders.
7. Create a plan to coordinate the services for the treatment of persons with mental illness, persons with intellectual disabilities, persons with developmental disabilities, persons with substance use disorders or persons with co-occurring disorders provided in this State and to provide continuity in the care and treatment provided.
8. Establish and maintain an appropriate program which provides information to the general public concerning mental illness, intellectual disabilities, developmental disabilities, substance use disorders and co-occurring disorders and consider ways to involve the general public in the decisions concerning the policy on mental illness, intellectual disabilities, developmental disabilities, substance use disorders and co-occurring disorders.
9. Compile statistics on mental illness and study the cause, pathology and prevention of that illness.
10. Establish programs to prevent or postpone the commitment of residents of this State to facilities for the treatment of persons with mental illness, persons with intellectual disabilities, persons with developmental disabilities, persons with substance use disorders or persons with co-occurring disorders.
11. Evaluate the future needs of this State concerning the treatment of mental illness, intellectual disabilities, developmental disabilities, substance use disorders and co-occurring disorders and develop ways to improve the treatment already provided.
12. Take any other action necessary to promote mental health in this State.
(Added to NRS by 1985, 2263; A 1999, 2592; 2009, 663; 2013, 665, 3006; 2017, 2805)
NRS 433.317 Appointment of subcommittee on the mental health of children; duties; compensation to extent of available funding.
1. The Commission shall appoint a subcommittee on the mental health of children to review the findings and recommendations of each mental health consortium submitted pursuant to NRS 433B.335 and to create a statewide plan for the provision of mental health services to children.
2. The members of the subcommittee appointed pursuant to this section serve at the pleasure of the Commission. The members serve without compensation, except that each member is entitled, while engaged in the business of the subcommittee, to the per diem allowance and travel expenses provided for state officers and employees generally if funding is available for this purpose.
(Added to NRS by 2009, 662)
NRS 433.318 Appointment of subcommittee or advisory committee; member qualifications; duties; compensation to extent of available funding.
1. The Commission may appoint a subcommittee or an advisory committee composed of members who have experience and knowledge of matters relating to persons with mental illness, persons with intellectual disabilities, persons with developmental disabilities, persons with substance use disorders or persons with co-occurring disorders and who, to the extent practicable, represent the ethnic and geographic diversity of this State.
2. A subcommittee or advisory committee appointed pursuant to this section shall consider specific issues and advise the Commission on matters related to the duties of the Commission.
3. The members of a subcommittee or advisory committee appointed pursuant to this section serve at the pleasure of the Commission. The members serve without compensation, except that each member is entitled, while engaged in the business of the subcommittee or advisory committee, to the per diem allowance and travel expenses provided for state officers and employees generally if funding is available for this purpose.
(Added to NRS by 2009, 662; A 2013, 665, 3007; 2017, 2806)
1. The State Board of Health shall adopt regulations:
(a) For the care and treatment of persons with mental illness, persons with substance use disorders or persons with co-occurring disorders by all state agencies and facilities, and their referral to private facilities, including, without limitation, regulations governing the procedure for the involuntary administration of medication to persons with mental illness;
(b) To ensure continuity in the care and treatment provided to persons with mental illness, persons with substance use disorders or persons with co-occurring disorders in this State; and
(c) Necessary for the proper and efficient operation of the facilities of the Division.
2. The State Board of Health may adopt regulations to promote programs relating to mental health, substance use disorders and co-occurring disorders.
(Added to NRS by 1975, 1594; A 1985, 368, 2265; 1999, 2592; 2009, 664; 2013, 666, 3007; 2019, 347)
NRS 433.325 Inspection of facility. The Commission or its designated agent may inspect any state facility providing services for persons with mental illness, persons with intellectual disabilities, persons with developmental disabilities, persons with substance use disorders or persons with co-occurring disorders to determine if the facility is in compliance with the provisions of this title and any regulations adopted pursuant thereto.
(Added to NRS by 1985, 2263; A 1993, 2715; 1999, 2593; 2009, 664; 2013, 666, 3007; 2017, 2806)
NRS 433.327 Right of certain employees of Department to submit information or requests to Commission or appear before Commission. Every employee of the Division, and every person employed by the Division of Child and Family Services of the Department pursuant to chapter 433B of NRS is entitled to submit written information or requests directly to the Commission or its individual members, or appear before it with its permission, but the Commission shall not interfere with the procedures for resolving the grievances of employees in the classified service of the State.
(Added to NRS by 1985, 2263; A 1993, 2716)
Powers and Duties
NRS 433.331 Adoption of regulations concerning abuse and neglect of consumers. The Division shall adopt regulations to:
1. Provide for a more detailed definition of abuse of a consumer of the Division, consistent with the general definition given in NRS 433.554;
2. Provide for a more detailed definition of neglect of a consumer of the Division, consistent with the general definition given in NRS 433.554; and
3. Establish policies and procedures for reporting the abuse or neglect of a consumer of the Division.
(Added to NRS by 1989, 642; A 2011, 411)
NRS 433.3315 Adoption of regulations concerning consumers. The Division shall adopt regulations:
1. To define the term “consumer” for the purposes of chapters 433 to 433C, inclusive, of NRS.
2. To specify the circumstances under which a consumer is eligible to receive services from the Division pursuant to chapters 433 to 433C, inclusive, of NRS, including, but not limited to, care, treatment, treatment to competency and training. Regulations adopted pursuant to this subsection must:
(a) Prescribe a system to categorize a recipient of community-based living arrangement services by the scope of services needed by the recipient; and
(b) Specify that a consumer is eligible to receive services only if the consumer:
(1) Has a documented diagnosis of a mental disorder based on the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association; and
(2) Except as otherwise provided in the regulations adopted pursuant to subsection 3, is not eligible to receive services through another public or private entity.
3. To specify the circumstances under which the provisions of subparagraph (2) of paragraph (b) of subsection 2 do not apply, including, without limitation, when the copay or other payment required to obtain services through another public or private entity is prohibitively high.
4. To establish policies and procedures for the referral of each consumer who needs services that the Division is unable to provide to the most appropriate organization or resource who is able to provide the needed services to that consumer.
5. To establish procedures by which a recipient of community-based living arrangement services with which the Division has entered into a contract may appeal a decision of the Division concerning eligibility for or authorization of services.
6. As used in this section, “community-based living arrangement services” has the meaning ascribed to it in NRS 449.0026.
(Added to NRS by 2011, 409; A 2013, 3008; 2019, 1779)
NRS 433.3317 Licensure and regulation of providers of nonemergency secure behavioral health transport services; regulations by State Board of Health.
1. The State Board of Health shall adopt regulations providing for the licensure and regulation of providers of nonemergency secure behavioral health transport services by the Division.
2. As used in this section, “nonemergency secure behavioral health transport services” means the use of a motor vehicle, other than an ambulance, as defined in NRS 450B.040, or other emergency response vehicle, that is specifically designed, equipped and staffed to transport a person with a mental illness or other behavioral health condition in a manner that:
(a) Allows observation of the person being transported; and
(b) Prevents the person being transported from escaping from the vehicle or accessing the driver or the means of controlling the vehicle.
(Added to NRS by 2019, 1923)
NRS 433.332 Division facility required to forward patient’s medical records upon transfer of patient from facility.
1. If a patient in a division facility is transferred to another division facility or to a medical facility, a facility for the dependent or a physician licensed to practice medicine, the division facility shall forward a copy of the medical records of the patient, on or before the date the patient is transferred, to the facility or physician. Except as otherwise required by 42 U.S.C. §§ 290dd, 290dd-1 or 290dd-2 or NRS 439.591 or 439.597, the division facility is not required to obtain the oral or written consent of the patient to forward a copy of the medical records.
2. As used in this section, “medical records” includes a medical history of the patient, a summary of the current physical condition of the patient and a discharge summary which contains the information necessary for the proper treatment of the patient.
(Added to NRS by 1991, 2351; A 1993, 145; 2007, 1980; 2011, 1761)
NRS 433.334 Contract with hospital or other institution for care of consumers. The Division may, by contract with hospitals or other institutions having adequate facilities in the State of Nevada, provide for inpatient care of consumers with mental illness.
(Added to NRS by 1975, 1594; A 1999, 2593; 2011, 411; 2013, 666, 3008; 2019, 2645)
NRS 433.344 Contracts with persons professionally qualified in field of psychiatric mental health for care of persons. The Division may contract with appropriate persons professionally qualified in the field of psychiatric mental health to provide inpatient and outpatient care for persons with mental illness when it appears that they can be treated best in that manner.
(Added to NRS by 1975, 1594; A 1983, 506; 1999, 2593; 2013, 666)
NRS 433.354 Contracts for cooperation with governmental entities and others; effect of payments to Division for such cooperation; immunity from and limitations on liability not waived.
1. For the purposes of chapters 433 to 433C, inclusive, of NRS, the Department through the Division may cooperate, financially or otherwise, and execute contracts or agreements with the Federal Government, any federal department or agency, any other state department or agency, a county, a city, a public district or any political subdivision of this state, a public or private corporation, an individual or a group of individuals. Such contracts or agreements may include provisions whereby the Division will provide staff, services or other resources, or any combination thereof, without payment, to further the purposes of the contract or agreement. If the contract or agreement includes a provision whereby the Division is paid for the provision of staff, services or other resources, the payment will be reimbursed directly to the Division’s budget. Cooperation pursuant to this section does not of itself relieve any person, department, agency or political subdivision of any responsibility or liability existing under any provision of law.
2. If the Administrator or the Administrator’s designee enters into a contract or agreement pursuant to subsection 1 with a private nonprofit corporation, the contract or agreement may allow:
(a) The Division to enter and inspect any premises that are related to services provided under the contract or agreement and to inspect any records that are related to services provided under the contract or agreement to ensure the welfare of any consumer served by the private nonprofit corporation under the contract or agreement;
(b) The Division and the private nonprofit corporation to share confidential information concerning any consumer served by the private nonprofit corporation under the contract or agreement; and
(c) The private nonprofit corporation to assign rights and obligations of the private nonprofit corporation under the contract or agreement to the Division.
3. The State, Department and Division do not waive any immunity from liability or limitation on liability provided by law by entering into a contract or agreement pursuant to this section and any such contract or agreement must include a provision to that effect.
(Added to NRS by 1975, 1594; A 1993, 2716; 2013, 313, 3008)
NRS 433.359 Grants for addressing disparities in behavioral health care and outcomes; selection of lead partner to ensure services supported by grant are provided equitably; establishment of advisory committee; report.
1. The Division may apply for grants available from the Federal Government and other sources which have the express purpose of addressing disparities in behavioral health care and behavioral health outcomes based on race, color, ancestry, national origin, disability, familial status, sex, sexual orientation, gender identity or expression, immigration status, primary language or income level.
2. To the extent authorized by the terms of a grant obtained pursuant to subsection 1, the Division may:
(a) Use a competitive process to select and award a grant of money to a nonprofit organization to serve as a lead partner to ensure that services supported by a grant obtained pursuant to subsection 1 are funded and allocated in an equitable manner. The lead partner must:
(1) Be based in the community to which the services are to be provided; and
(2) Have demonstrated experience serving that community.
(b) Establish and consult with an advisory committee to ensure that services supported by a grant obtained pursuant to subsection 1 are provided in a culturally competent manner. The advisory committee must be composed of representatives of nonprofit organizations that have demonstrated experience serving the community to which the services are to be provided.
3. On or before February 1 of each year, the Department shall:
(a) Compile a report that includes, without limitation:
(1) The amount of money allocated by the Department during the immediately preceding calendar year to support the provision of behavioral health services or other services to promote emotional well-being in communities with higher risk of behavioral health problems, decreased access to or usage of behavioral health services or worse behavioral health outcomes or emotional well-being than the general population based on race, color, ancestry, national origin, disability, familial status, sex, sexual orientation, gender identity or expression, immigration status, primary language or income level;
(2) A description of the services described in subparagraph (1) that were provided during the immediately preceding calendar year and the efforts made by the Department during the immediately preceding calendar year to locate persons in need of such services and provide such services to those persons;
(3) The number of persons who received the services described in subparagraph (1) and, to the extent available, information regarding the income level, age, race and ethnicity of those persons; and
(4) Any community-based organizations with which the Department collaborated to provide those services; and
(b) Submit the report to the Director of the Legislative Counsel Bureau for transmittal to:
(1) In even-numbered years, the Legislative Commission and the Joint Interim Standing Committee on Health and Human Services; and
(2) In odd-numbered years, the next regular session of the Legislature.
(Added to NRS by 2021, 2706)
NRS 433.364 Involuntary court-ordered admission to private institution not precluded. Nothing in chapters 433 to 433C, inclusive, of NRS precludes the involuntary court-ordered admission of a person with mental illness to a private institution where such admission is authorized by law.
(Added to NRS by 1975, 1594; A 2013, 3008)
NRS 433.374 State not responsible for payment of costs of care and treatment at other facility; exceptions. The State is not responsible for payment of the costs of care and treatment of persons admitted to a facility not operated by the Division except as otherwise provided in NRS 433B.230 or where, before admission, the Administrator or the Administrator’s designee authorizes the expenditure of state money for such purpose.
(Added to NRS by 1975, 1594; A 1993, 2716)
Finance
NRS 433.384 Legislative appropriations; payment of claims. Money to carry out the provisions of chapters 433 to 433C, inclusive, of NRS must be provided by legislative appropriation from the State General Fund, and paid out on claims as other claims against the State are paid. All claims relating to a division facility individually must be approved by the administrative officer of such facility before they are paid.
(Added to NRS by 1975, 1594; A 1993, 2716; 2013, 3008)
NRS 433.394 Acceptance by Department of money from other sources. For the purposes of chapters 433 to 433C, inclusive, of NRS, the Department may accept:
1. Moneys appropriated and made available by any act of the Congress of the United States;
2. Moneys and contributions made available by a county, a city, a public district or any political subdivision of this state; and
3. Moneys and contributions made available by a public or private corporation, a private foundation, an individual or a group of individuals.
(Added to NRS by 1975, 1595; A 2013, 3009)
NRS 433.395 Acceptance by Administrator of donations, gifts and grants for disbursement to certain programs; contract for services for evaluation and recommendation of recipients for disbursements.
1. Upon approval of the Director of the Department, the Administrator may accept:
(a) Donations of money and gifts of real or personal property; and
(b) Grants of money from the Federal Government,
Ê for use in public or private programs that provide services to persons in this State with mental illness.
2. The Administrator shall disburse any donations, gifts and grants received pursuant to this section to programs that provide services to persons with mental illness in a manner that supports the plan to coordinate services created by the Commission pursuant to subsection 7 of NRS 433.316. In the absence of a plan to coordinate services, the Administrator shall make disbursements to programs that will maximize the benefit provided to persons with mental illness in consideration of the nature and value of the donation, gift or grant.
3. Within limits of legislative appropriations or other available money, the Administrator may enter into a contract for services related to the evaluation and recommendation of recipients for the disbursements required by this section.
(Added to NRS by 1997, 3231; A 1999, 2593; 2013, 666, 3009)
NRS 433.404 Schedule of fees for services rendered through programs supported by State; disposition of receipts; amount of fee for services of facility.
1. The Division shall establish a fee schedule for services rendered through any program supported by the State pursuant to the provisions of chapters 433 to 433C, inclusive, of NRS. The schedule must be submitted to the Commission and the Director of the Department for joint approval before enforcement. The fees collected by facilities operated by the Division pursuant to this schedule must be deposited in the State Treasury to the credit of the State General Fund, except as otherwise provided in NRS 433.354 for fees collected pursuant to contract or agreement.
2. For a facility providing services for the treatment of persons with mental illness, the fee established must approximate the cost of providing the service, but if a consumer is unable to pay in full the fee established pursuant to this section, the Division may collect any amount the consumer is able to pay.
(Added to NRS by 1975, 1594; A 1985, 2265; 1993, 2716; 1999, 2593; 2011, 411; 2013, 667, 3009)
NRS 433.414 Fees of physicians and other professionally qualified employees of facility.
1. Physicians and other professional staff employed within any division facility shall receive a reasonable fee for evaluations, examinations or court testimony when directed by the court to perform such services, singularly or as a member of an evaluation team established pursuant to the provisions of chapter 433A of NRS.
2. If such evaluation or testimony is provided while the physician or other professional person is acting as an employee of a division facility, the fee shall be received by the division facility at which he or she is employed.
(Added to NRS by 1975, 1595)
NRS 433.424 Mental health center revolving accounts. A mental health center revolving account up to the amount of $5,000 is hereby created for each division mental health center, and may be used for the payment of mental health center bills requiring immediate payment and for no other purposes. The respective administrative officers shall deposit the money for the respective revolving accounts in one or more banks or credit unions of reputable standing. Payments made from each account must be promptly reimbursed from appropriated money of the respective mental health centers on claims as other claims against the State are paid.
(Added to NRS by 1975, 1595; A 1979, 812; 1983, 395; 1999, 1496; 2013, 667, 3009)
REGIONAL BEHAVIORAL HEALTH POLICY BOARDS
NRS 433.425 Definitions. As used in NRS 433.425 to 433.4295, inclusive, unless the context otherwise requires, the words and terms defined in NRS 433.426 and 433.427 have the meanings ascribed to them in those sections.
(Added to NRS by 2017, 2991)
NRS 433.426 “Behavioral health region” defined. “Behavioral health region” means a behavioral health region created by NRS 433.428.
(Added to NRS by 2017, 2991)
NRS 433.427 “Policy board” defined. “Policy board” means a regional behavioral health policy board created by NRS 433.429.
(Added to NRS by 2017, 2991)
NRS 433.428 Designation of behavioral health regions. Five behavioral health regions are hereby created as follows:
1. The Northern Behavioral Health Region consisting of Carson City and the counties of Churchill, Douglas, Lyon and Storey;
2. The Washoe Behavioral Health Region consisting of the county of Washoe;
3. The Rural Behavioral Health Region consisting of the counties of Elko, Eureka, Humboldt, Lander, Pershing and White Pine;
4. The Southern Behavioral Health Region consisting of the counties of Esmeralda, Lincoln and Mineral and the portion of the county of Nye that is north of the 38th parallel of north latitude; and
5. The Clark Behavioral Health Region consisting of the county of Clark and the portion of the county of Nye that is south of the 38th parallel of north latitude.
(Added to NRS by 2017, 2991; A 2019, 2044)
NRS 433.429 Creation; membership; terms; meetings; Chair.
1. A regional behavioral health policy board is hereby created for each behavioral health region.
2. Each policy board consists of not less than 7 members and not more than 13 members appointed pursuant to this section.
3. The Speaker of the Assembly shall appoint to each policy board one member who represents the criminal justice system.
4. The Majority Leader of the Senate shall appoint to each policy board one member who represents law enforcement agencies and who has experience with and knowledge of matters relating to persons in need of behavioral health services.
5. The Governor shall appoint to each policy board one member who has extensive experience in the delivery of social services in the field of behavioral health, including, without limitation, directors or officers of social service agencies in the behavioral health region.
6. The Legislative Commission shall appoint to each policy board one member who is a Legislator.
7. The Administrator shall appoint to each policy board:
(a) One member who represents the interests of hospitals, residential long-term care facilities or facilities that provide acute inpatient behavioral health services;
(b) One member who represents the interests of administrators or counselors who are employed at facilities for the treatment of alcohol or other substance use disorders; and
(c) One member who represents providers of emergency medical services or fire services and who has experience providing emergency services to behavioral health patients, which may include, without limitation, a paramedic or physician.
8. The members appointed to a policy board pursuant to subsections 2 to 7, inclusive, may appoint to the policy board:
(a) One member who represents the interests of community-based organizations which provide behavioral health services.
(b) One member who represents the interests of owners or administrators of residential treatment facilities, transitional housing or other housing for persons with a mental illness or persons who have an alcohol or other substance use disorder.
(c) One member who is a health officer of a county or who holds a position with similar duties or, if no such person is available, an employee of a city, county or Indian tribe who has experience in the field of public health.
(d) One member who is a psychiatrist or a psychologist who holds the degree of doctor of psychology, has clinical experience and is licensed to practice in this State or, if no such person is available, a provider of health care, as defined in NRS 629.031, who has experience working with persons with a mental illness or persons who have an alcohol or other substance use disorder.
(e) One member who represents private or public insurers who offer coverage for behavioral health services or, if no such person is available, another person who has experience in the field of insurance or working with insurers.
(f) One member who has received behavioral health services in this State, including, without limitation, services for substance use disorders, or a family member of such a person or, if such a person is not available, a person who represents the interests of behavioral health patients or the families of behavioral health patients.
9. If the members of a policy board described in subsections 2 to 7, inclusive, appoint both a member described in paragraph (a) of subsection 8 and a member described in paragraph (b) of subsection 8, at least one of those members must be a behavioral health professional who has experience in evaluating and treating children.
10. In making appointments, preference must be given to persons who reside in the behavioral health region served by the policy board.
11. Each member of the policy board serves without compensation for a term of 2 years and may be reappointed. The appointing authority may remove a member from the policy board if the appointing authority determines the member has neglected his or her duties.
12. If a vacancy occurs during the term of:
(a) A member who was appointed pursuant to subsection 2, 3, 4, 5 or 6, the vacancy must be filled in the same manner as the original appointment for the remainder of the unexpired term.
(b) A member who was appointed pursuant to subsection 7, the policy board shall, by majority vote, appoint a member to fill the vacancy for the remainder of the unexpired term.
(c) A member who was appointed pursuant to subsection 8, the policy board may, by majority vote, appoint a member to fill the vacancy for the remainder of the unexpired term.
13. Each policy board shall meet not later than 60 days after all appointments to such board have been made and elect one member of the policy board to act as the Chair for the biennium. The Director of the Department or his or her designee shall preside over the election of the Chair for each policy board at each board’s first meeting. Except as otherwise provided in subsection 14, each policy board shall thereafter meet at least quarterly at the call of the Chair.
14. A policy board is not required to meet during any legislative session. If a policy board meets during a legislative session, the member of the policy board who is a Legislator is excused from attendance.
15. As used in this section, “social services agency” means any public agency or organization that provides social services in this State, including, without limitation, welfare and health care services.
(Added to NRS by 2017, 2991; A 2019, 2045)
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;
(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.162, persons admitted to mental health facilities 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 NRS 433A.335 to 433A.345, inclusive, 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) If a data dashboard is established pursuant to NRS 439.245, use the data dashboard to review access by different groups and populations in this State to behavioral health services provided through telehealth, as defined in NRS 629.515, and evaluate policies to make such access more equitable.
(h) 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.
(i) 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;
(3) A description of the manner in which the policy board has carried out the requirements of paragraphs (c) and (h) 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 (i) 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.
(Added to NRS by 2017, 2992; A 2019, 2047; 2021, 3013, 3065)
CONSUMERS
Residence
NRS 433.431 Definitions. As used in NRS 433.431 to 433.454, inclusive, unless the context otherwise requires, “division facility” means any unit or subunit operated by:
1. The Division of Public and Behavioral Health of the Department for the care, treatment and training of consumers; or
2. The Division of Child and Family Services of the Department pursuant to chapter 433B of NRS.
(Added to NRS by 1993, 2714; A 1999, 99; 2003, 1942; 2011, 411)
NRS 433.434 Determination of residence. For purposes of chapters 433 to 433C, inclusive, of NRS, the residence of a person is:
1. The domicile of such person;
2. If the domicile of the person cannot be ascertained, the place where the person was last employed; or
3. If the domicile of the person cannot be ascertained and he or she is not or was not employed, the place where the person made his or her home or headquarters.
(Added to NRS by 1975, 1595; A 2013, 3010)
NRS 433.444 Reciprocal agreement for returning consumers to legal residence; investigation and report concerning residence.
1. For the purpose of facilitating the return of nonresident consumers to the state in which they have legal residence, the Administrator may enter into reciprocal agreements with the proper boards, commissioners or officers of other states for the mutual exchange of consumers confined in, admitted or committed to a mental health facility in one state whose legal residence is in the other. Such reciprocal agreements must be consistent with the provisions of chapters 433 to 433C, inclusive, of NRS, including, if applicable, the Interstate Compact on Mental Health ratified and enacted in NRS 433.4543.
2. The Administrator may give written permission for the return and admission to a division facility of any resident of this state when such permission is conformable to the provisions of chapters 433 to 433C, inclusive, of NRS governing admissions to a division facility, including, if applicable, the Interstate Compact on Mental Health ratified and enacted in NRS 433.4543.
3. The county clerk and board of county commissioners of each county, upon receiving notice from the Administrator that an application for the return of an alleged resident of this state has been received, shall promptly investigate and report to the Administrator their findings as to the legal residence of the consumer.
(Added to NRS by 1975, 1595; A 2011, 412; 2013, 667, 3010; 2015, 1035)
NRS 433.454 Expenses of returning consumer to legal residence.
1. All expenses incurred for the purpose of returning a consumer to the state in which the consumer has legal residence shall be paid from the moneys of the consumer or by the relatives or other persons responsible for the consumer’s care and treatment under his or her commitment or admission.
2. In the case of indigent consumers whose relatives cannot pay the costs and expenses of returning such consumers to the state in which they have residence, the costs may be assumed by the State. These costs shall be advanced from moneys appropriated for the general support of the division facility wherein the consumer was receiving care, treatment or training, if such consumer was committed to a division facility at the time of the transfer, and shall be paid out on claims as other claims against the State are paid.
(Added to NRS by 1975, 1596; A 2011, 412)
Interstate Compact on Mental Health
NRS 433.4543 Text of Compact. The Interstate Compact on Mental Health is hereby ratified, enacted into law and entered into with all jurisdictions legally joining in the Compact, in substantially the form set forth in this section:
INTERSTATE COMPACT ON MENTAL HEALTH
The contracting states solemnly agree that:
ARTICLE I.
The party states find that the proper and expeditious treatment of persons with mental illness and mental deficiencies can be facilitated by cooperative action, to the benefit of the patients, their families and society as a whole. Further, the party states find that the necessity of and desirability for furnishing such care and treatment bears no primary relation to the residence or citizenship of the patient but that, on the contrary, the controlling factors of community safety and humanitarianism require that facilities and services be made available for all who are in need of them. Consequently, it is the purpose of this Compact and of the party states to provide the necessary legal basis for the institutionalization or other appropriate care and treatment of the mentally ill and mentally deficient under a system that recognizes the paramount importance of patient welfare and to establish the responsibilities of the party states in terms of such welfare.
ARTICLE II.
As used in this Compact:
(a) “Aftercare” means care, treatment and services provided to a patient on convalescent status or conditional release.
(b) “Institution” means any hospital or other facility maintained by a party state or political subdivision thereof for the care and treatment of mental illness or mental deficiency.
(c) “Mental deficiency” means mental deficiency as defined by appropriate clinical authorities to such extent that a person so afflicted is incapable of managing himself or herself and his or her affairs, but does not include mental illness as defined herein.
(d) “Mental illness” means mental disease to such extent that a person so afflicted requires care and treatment for his or her own welfare, or the welfare of others, or of the community.
(e) “Patient” means any person subject to or eligible as determined by the laws of the sending state, for institutionalization or other care, treatment or supervision pursuant to the provisions of this Compact.
(f) “Receiving state” means a party state to which a patient is transported pursuant to the provisions of the Compact or to which it is contemplated that a patient may be so sent.
(g) “Sending state” means a party state from which a patient is transported pursuant to the provisions of the Compact or from which it is contemplated that a patient may be so sent.
(h) “State” means any state, territory or possession of the United States, the District of Columbia and the Commonwealth of Puerto Rico.
ARTICLE III.
(a) Whenever a person physically present in any party state is in need of institutionalization by reason of mental illness or mental deficiency, he or she is eligible for care and treatment in an institution in that state irrespective of his or her residence, settlement or citizenship qualifications.
(b) The provisions of paragraph (a) of this Article to the contrary notwithstanding, any patient may be transferred to an institution in another state whenever there are factors based upon clinical determinations indicating that the care and treatment of said patient would be facilitated or improved thereby. Any such institutionalization may be for the entire period of care and treatment or for any portion or portions thereof. The factors referred to in this paragraph include the patient’s full record with due regard for the location of the patient’s family, character of the illness and probable duration thereof and such other factors as are considered appropriate.
(c) No state is obliged to receive any patient pursuant to the provisions of paragraph (b) of this Article unless the sending state has given advance notice of its intention to send the patient, furnished all available medical and other pertinent records concerning the patient and given the qualified medical or other appropriate clinical authorities of the receiving state an opportunity to examine the patient if said authorities so wish and the receiving state agrees to accept the patient.
(d) In the event that the laws of the receiving state establish a system of priorities for the admission of patients, an interstate patient under this Compact must receive the same priority as a local patient and must be taken in the same order and at the same time that he or she would be taken if he or she were a local patient.
(e) Pursuant to this Compact, the determination as to the suitable place of institutionalization for a patient may be reviewed at any time and such further transfer of the patient may be made as seems likely to be in the best interest of the patient.
ARTICLE IV.
(a) Whenever, pursuant to the laws of the state in which a patient is physically present, it is determined that the patient should receive aftercare or supervision, such care or supervision may be provided in a receiving state. If the medical or other appropriate clinical authorities having responsibility for the care and treatment of the patient in the sending state have reason to believe that aftercare in another state would be in the best interest of the patient and would not jeopardize the public safety, they shall request the appropriate authorities in the receiving state to investigate the desirability of affording the patient such aftercare in said receiving state, and such investigation must be made with all reasonable speed. The request for investigation must be accompanied by complete information concerning the patient’s intended place of residence and the identity of the person in whose charge it is proposed to place the patient, the complete medical history of the patient and such other documents as may be pertinent.
(b) If the medical or other appropriate clinical authorities having responsibility for the care and treatment of the patient in the sending state and the appropriate authorities in the receiving state find that the best interest of the patient would be served thereby, and if the public safety would not be jeopardized thereby, the patient may receive aftercare or supervision in the receiving state.
(c) In supervising, treating or caring for a patient on aftercare pursuant to the terms of this Article, a receiving state shall employ the same standards of visitation, examination, care and treatment that it employs for similar local patients.
ARTICLE V.
Whenever a dangerous or potentially dangerous patient escapes from an institution in any party state, that state shall promptly notify all appropriate authorities within and without the jurisdiction of the escape in a manner reasonably calculated to facilitate the speedy apprehension of the escapee. Immediately upon the apprehension and identification of any such dangerous or potentially dangerous patient, he or she must be detained in the state where found pending disposition in accordance with law.
ARTICLE VI.
The duly accredited officers of any state party to this Compact, upon the establishment of their authority and the identity of the patient, must be permitted to transport any patient being moved pursuant to this Compact through any and all states party to this Compact, without interference.
ARTICLE VII.
(a) No person shall be deemed a patient of more than one institution at any given time. Completion of transfer of any patient to an institution in a receiving state has the effect of making the person a patient of the institution in the receiving state.
(b) The sending state shall pay all costs of and incidental to the transportation of any patient pursuant to this Compact, but any two or more party states may, by making a specific agreement for that purpose, arrange for a different allocation of costs as among themselves.
(c) No provision of this Compact shall be construed to alter or affect any internal relationships among the departments, agencies and officers of and in the government of a party state, or between a party state and its subdivisions, as to the payment of costs or responsibilities therefor.
(d) Nothing in this Compact shall be construed to prevent any party state or subdivision thereof from asserting any right against any person, agency or other entity in regard to costs for which such party state or subdivision thereof may be responsible pursuant to any provision of this Compact.
(e) Nothing in this Compact shall be construed to invalidate any reciprocal agreement between a party state and a nonparty state relating to institutionalization, care or treatment of the mentally ill or mentally deficient, or any statutory authority pursuant to which such agreements may be made.
ARTICLE VIII.
(a) Except as otherwise provided in paragraph (b) of this Article, nothing in this Compact shall be construed to abridge, diminish or in any way impair the rights, duties and responsibilities of any patient’s guardian on his or her own behalf or in respect of any patient for whom he or she may serve.
(b) Except as otherwise provided in paragraph (c) of this Article, where the transfer of any patient to another jurisdiction makes advisable the appointment of a supplemental or substitute guardian, any court of competent jurisdiction in the receiving state may make such supplemental or substitute appointment and the court which appointed the previous guardian shall, upon being duly advised of the new appointment and upon the satisfactory completion of such accounting and other acts as such court may by law require, relieve the previous guardian of power and responsibility to whatever extent is appropriate in the circumstances.
(c) In the case of any patient having settlement in the sending state, the court of competent jurisdiction in the sending state has the sole discretion to relieve a guardian appointed by it or continue his or her power and responsibility, whichever it deems advisable. The court in the receiving state may, in its discretion, confirm or reappoint the person or persons previously serving as guardian in the sending state in lieu of making a supplemental or substitute appointment.
(d) The term “guardian” as used in paragraphs (a), (b) and (c) of this Article includes any guardian, trustee, legal committee, conservator or other person or agency, however denominated, who is charged by law with power to act for or responsibility for the person or property of a patient.
ARTICLE IX.
(a) No provision of this Compact except Article V applies to any person institutionalized while under sentence in a penal or correctional institution or while subject to trial on a criminal charge, or whose institutionalization is due to the commission of an offense for which, in the absence of mental illness or mental deficiency, said person would be subject to incarceration in a penal or correctional institution.
(b) To every extent possible, it is the policy of states party to this Compact that no patient shall be placed or detained in any prison, jail or lockup, but such patient must, with all expedition, be taken to a suitable institutional facility for mental illness or mental deficiency.
ARTICLE X.
(a) Each party state shall appoint a Compact Administrator who, on behalf of his or her state, shall act as general coordinator of activities under the Compact in his or her state and who shall receive copies of all reports, correspondence and other documents relating to any patient processed under the Compact by his or her state either in the capacity of sending or receiving state. The Compact Administrator or his or her duly designated representative is the official with whom other party states shall deal in any matter relating to the Compact or any patient processed thereunder.
(b) The Compact Administrators of the respective party states have power to promulgate reasonable rules and regulations to carry out more effectively the terms and provisions of this Compact.
ARTICLE XI.
The duly constituted administrative authorities of any two or more party states may enter into supplementary agreements for the provision of any service or facility or for the maintenance of any institution on a joint or cooperative basis whenever the states concerned find that such agreements will improve services, facilities or institutional care and treatment in the fields of mental illness or mental deficiency. No such supplementary agreement shall be construed so as to relieve any party state of any obligation which it otherwise would have under other provisions of this Compact.
ARTICLE XII.
This Compact enters into full force and effect as to any state when enacted by it into law and such state shall thereafter be a party thereto with any and all states legally joining therein.
ARTICLE XIII.
(a) A state party to this Compact may withdraw therefrom by enacting a statute repealing the same. Such withdrawal takes effect 1 year after notice thereof has been communicated officially and in writing to the Governors and Compact Administrators of all other party states. However, the withdrawal of any state does not change the status of any patient who has been sent to said state or sent out of said state pursuant to the provisions of the Compact.
(b) Withdrawal from any agreement permitted by paragraph (b) of Article VII as to costs or from any supplementary agreement made pursuant to Article XI must be in accordance with the terms of such agreement.
ARTICLE XIV.
This Compact shall be liberally construed so as to effectuate the purposes thereof. The provisions of this Compact are severable and if any phrase, clause, sentence or provision of this Compact is declared to be contrary to the constitution of any party state or of the United States or the applicability thereof to any government, agency, person or circumstance is held invalid, the validity of the remainder of this Compact and the applicability thereof to any government, agency, person or circumstance will not be affected thereby. If this Compact is held contrary to the constitution of any state party thereto, the Compact remains in full force and effect as to the remaining states and in full force and effect as to the state affected as to all severable matters.
(Added to NRS by 2015, 1030)
NRS 433.4545 Administrator to serve as Compact Administrator; duties; regulations. The Administrator shall serve as the Compact Administrator of the Interstate Compact on Mental Health. The Compact Administrator shall:
1. Cooperate with all departments, agencies and officers of and in the government of this State and its subdivisions in facilitating the proper administration of the Compact or of any supplementary agreement entered into by this State under the Compact.
2. Enter into supplementary agreements with appropriate officials of other states pursuant to the Compact. If a supplementary agreement requires or contemplates the use of any institution or facility of this State or the provision of any service by this State, the supplementary agreement has no force or effect until approved by the head of the department or agency under whose jurisdiction the institution or facility is operated or whose department or agency will be charged with the rendering of the service.
3. Adopt any regulations necessary or convenient to carry out the Compact.
(Added to NRS by 2015, 1035)
1. To the extent possible, the provisions of the Interstate Compact on Mental Health are intended to supplement other statutory provisions governing the treatment and transfer of persons with mental illness and persons with intellectual disabilities and the return of such persons to their place of residence must be given effect to the extent that those provisions do not conflict with the provisions of the Compact.
2. Except as provided in subsection 3, if there is a conflict between the provisions of the Compact and any other provisions of NRS, the provisions of the Compact prevail.
3. Nothing in the Compact shall be construed to restrict any rights of a consumer as provided in NRS 433.456 to 433.536, inclusive.
(Added to NRS by 2015, 1035)
Consumers’ Rights
NRS 433.456 Definitions. As used in NRS 433.456 to 433.536, inclusive, unless the context otherwise requires, the words and terms defined in NRS 433.458, 433.461 and 433.462 have the meanings ascribed to them in those sections.
(Added to NRS by 1989, 1755; A 1997, 3491; 2011, 412)
NRS 433.458 “Administrative officer” defined. “Administrative officer” means a person with overall executive and administrative responsibility for a facility that provides services relating to mental health and that is operated by any public or private entity.
(Added to NRS by 1989, 1755; A 1999, 2594; 2013, 668, 3010)
NRS 433.461 “Facility” defined. “Facility” means any:
1. Unit or subunit operated by the Division of Public and Behavioral Health of the Department for the care, treatment and training of consumers.
2. Unit or subunit operated by the Division of Child and Family Services of the Department pursuant to chapter 433B of NRS.
3. Hospital, clinic or other institution operated by any public or private entity, for the care, treatment and training of consumers.
(Added to NRS by 1989, 1755; A 1993, 2716; 1999, 99; 2011, 412)
NRS 433.462 “Rights” defined. “Rights” includes, without limitation, all rights provided to a consumer pursuant to NRS 433.456 to 433.536, inclusive, and any regulations adopted pursuant thereto.
(Added to NRS by 1997, 3490; A 2011, 413)
NRS 433.464 Right to habeas corpus unimpaired. The provisions of chapters 433 to 433C, inclusive, of NRS do not limit the right of any person detained hereunder to a writ of habeas corpus upon a proper application made at any time by such person or any other person on his or her behalf.
(Added to NRS by 1975, 1596; A 2013, 3010)
NRS 433.471 Rights concerning admission and discharge of consumers.
1. Each consumer admitted for evaluation, treatment or training to a facility has the following rights concerning admission to the facility, a list of which must be prominently posted in all facilities providing those services and must be otherwise brought to the attention of the consumer by such additional means as prescribed by regulation:
(a) The right not to be admitted to the facility under false pretenses or as a result of any improper, unethical or unlawful conduct by a staff member of the facility to collect money from the insurance company of the consumer or for any other financial purpose.
(b) The right to receive a copy, on request, of the criteria upon which the facility makes its decision to admit or discharge a consumer from the facility. Such criteria must not, for emergency admissions or involuntary court-ordered admissions, be based on the availability of insurance coverage or any other financial considerations.
2. As used in this section, “improper conduct” means a violation of the rules, policies or procedures of the facility.
(Added to NRS by 1997, 3490; A 1999, 866; 2011, 413)
NRS 433.472 Rights concerning involuntary commitment.
1. Each consumer admitted for evaluation, treatment or training to a facility has the following rights concerning involuntary commitment to the facility, a list of which must be prominently posted in all facilities providing those services and must be otherwise brought to the attention of the consumer by such additional means as prescribed by regulation:
(a) To request and receive a second evaluation by a psychiatrist or psychologist who does not have a contractual relationship with or financial interest in the facility. The evaluation must:
(1) Include, without limitation, a recommendation of whether the consumer should be involuntarily committed to the facility; and
(2) Be paid for by the consumer if the insurance carrier of the consumer refuses to pay for the evaluation.
(b) To receive a copy of the procedure of the facility regarding involuntary commitment and treatment.
(c) To receive a list of the consumer’s rights concerning involuntary commitment or treatment.
2. If the results of an evaluation conducted by a psychiatrist or psychologist pursuant to subsection 1 conflict in any manner with the results of an evaluation conducted by the facility, the facility may request and receive a third evaluation of the consumer to resolve the conflicting portions of the previous evaluations.
(Added to NRS by 1997, 3490; A 1999, 1040; 2011, 413)
NRS 433.482 Personal rights. Each consumer admitted for evaluation, treatment or training to a facility has the following personal rights, a list of which must be prominently posted in all facilities providing those services and must be otherwise brought to the attention of the consumer by such additional means as prescribed by regulation:
1. To wear the consumer’s own clothing, to keep and use his or her own personal possessions, including toilet articles, unless those articles may be used to endanger the consumer’s life or others’ lives, and to keep and be allowed to spend a reasonable sum of the consumer’s own money for expenses and small purchases.
2. To have access to individual space for storage for his or her private use.
3. To see visitors each day.
4. To have reasonable access to telephones, both to make and receive confidential calls.
5. To have ready access to materials for writing letters, including stamps, and to mail and receive unopened correspondence, but:
(a) For the purposes of this subsection, packages are not considered as correspondence; and
(b) Correspondence identified as containing a check payable to a consumer may be subject to control and safekeeping by the administrative officer of that facility or the administrative officer’s designee, so long as the consumer’s record of treatment documents the action.
6. To have reasonable access to an interpreter if the consumer does not speak English or is hearing impaired.
7. To designate a person who must be kept informed by the facility of the consumer’s medical and mental condition, if the consumer signs a release allowing the facility to provide such information to the person.
8. Except as otherwise provided in NRS 439.597, to have access to the consumer’s medical records denied to any person other than:
(a) A member of the staff of the facility or related medical personnel, as appropriate;
(b) A person who obtains a waiver by the consumer of his or her right to keep the medical records confidential; or
(c) A person who obtains a court order authorizing the access.
9. Other personal rights as specified by regulation of the Commission.
(Added to NRS by 1981, 892; A 1985, 2266; 1989, 1755; 1997, 3492; 2007, 1980; 2011, 413)
NRS 433.484 Rights concerning care, treatment and training. Each consumer admitted for evaluation, treatment or training to a facility has the following rights concerning care, treatment and training, a list of which must be prominently posted in all facilities providing those services and must be otherwise brought to the attention of the consumer by such additional means as prescribed by regulation:
1. To medical, psychosocial and rehabilitative care, treatment and training including prompt and appropriate medical treatment and care for physical and mental ailments and for the prevention of any illness or disability. All of that care, treatment and training must be consistent with standards of practice of the respective professions in the community and is subject to the following conditions:
(a) Before instituting a plan of care, treatment or training or carrying out any necessary surgical procedure, express and informed consent must be obtained in writing from:
(1) The consumer if he or she is 18 years of age or over or legally emancipated and has the capacity to give that consent, and from the consumer’s legal guardian, if any;
(2) The parent or guardian of a consumer under 18 years of age and not legally emancipated; or
(3) The legal guardian of a consumer of any age who has been adjudicated mentally incompetent;
(b) An informed consent requires that the person whose consent is sought be adequately informed as to:
(1) The nature and consequences of the procedure;
(2) The reasonable risks, benefits and purposes of the procedure; and
(3) Alternative procedures available;
(c) The consent of a consumer as provided in paragraph (b) may be withdrawn by the consumer in writing at any time with or without cause;
(d) Even in the absence of express and informed consent, a licensed and qualified physician may render emergency medical care or treatment to any consumer who has been injured in an accident or motor vehicle crash or who is suffering from an acute illness, disease or condition, if within a reasonable degree of medical certainty, delay in the initiation of emergency medical care or treatment would endanger the health of the consumer and if the treatment is immediately entered into the consumer’s record of treatment, subject to the provisions of paragraph (e); and
(e) If the proposed emergency medical care or treatment is deemed by the chief medical officer of the facility to be unusual, experimental or generally occurring infrequently in routine medical practice, the chief medical officer shall request consultation from other physicians or practitioners of healing arts who have knowledge of the proposed care or treatment.
2. To be free from abuse, neglect and aversive intervention.
3. To consent to the consumer’s transfer from one facility to another, except that the Administrator of the Division of Public and Behavioral Health of the Department or the Administrator’s designee, or the Administrator of the Division of Child and Family Services of the Department or the Administrator’s designee, may order a transfer to be made whenever conditions concerning care, treatment or training warrant it. If the consumer in any manner objects to the transfer, the person ordering it must enter the objection and a written justification of the transfer in the consumer’s record of treatment and immediately forward a notice of the objection to the Administrator who ordered the transfer, and the Commission shall review the transfer pursuant to subsection 3 of NRS 433.534.
4. Other rights concerning care, treatment and training as may be specified by regulation of the Commission.
(Added to NRS by 1975, 1596; A 1981, 893; 1985, 2266; 1989, 1756; 1993, 2717; 1999, 99, 3233; 2011, 414; 2015, 1675)
NRS 433.494 Individualized plan of services for consumer.
1. An individualized written plan of mental health services must be developed for each consumer of each facility. The plan must:
(a) Provide for the least restrictive treatment procedure that may reasonably be expected to benefit the consumer; and
(b) Be developed with the input and participation of:
(1) The consumer, to the extent that he or she is able to provide input and participate; and
(2) To the extent that the consumer is unable to provide input and participate, the parent or guardian of the consumer if the consumer is under 18 years of age and is not legally emancipated, or the legal guardian of a consumer who has been adjudicated incapacitated.
2. The plan must be kept current and must be modified, with the input and participation of the consumer, the parent or guardian of the consumer or the legal guardian of the consumer, as appropriate, when indicated. The plan must be thoroughly reviewed at least once every 3 months.
3. The person in charge of implementing the plan of services must be designated in the plan.
(Added to NRS by 1975, 1597; A 1989, 1757; 1999, 2594; 2005, 307; 2011, 415; 2013, 668, 3010)
NRS 433.496 Basis for decisions, policies, procedures and practices regarding emergency admissions and involuntary court-ordered admissions.
1. Each facility shall make all of its decisions, policies, procedures and practices regarding emergency admissions or involuntary court-ordered admissions based upon clinical efficiency rather than cost containment.
2. 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.
(Added to NRS by 1997, 3491)
NRS 433.504 Right to information; inspection and copying of records.
1. A consumer or the consumer’s legal guardian must be:
(a) Permitted to inspect the consumer’s records; and
(b) Informed of the consumer’s clinical status and progress at reasonable intervals of no longer than 3 months in a manner appropriate to his or her clinical condition.
2. Unless a psychiatrist has made a specific entry to the contrary in a consumer’s records, a consumer or the consumer’s legal guardian is entitled to obtain a copy of the consumer’s records at any time upon notice to the administrative officer of the facility and payment of the cost of reproducing the records.
(Added to NRS by 1975, 1597; A 1987, 2221; 2009, 1666; 2011, 416)
NRS 433.514 Medication: Responsibility of psychiatrist and physician; review of methods for administration and custody.
1. The attending psychiatrist or physician shall be responsible for all medication given or administered to a consumer.
2. Each administrative officer shall establish a policy for the review of the administration, storage and handling of medications by nurses and nonprofessional personnel.
(Added to NRS by 1975, 1597; A 2011, 416)
NRS 433.524 Labor by consumer: Conditions; compensation.
1. A consumer may perform labor which contributes to the operation and maintenance of the facility for which the facility would otherwise employ someone only if:
(a) The consumer voluntarily agrees to perform the labor;
(b) Engaging in the labor is not inconsistent with and does not interfere with the plan of services for the consumer;
(c) The person responsible for the consumer’s treatment agrees to the plan of labor; and
(d) The amount of time or effort necessary to perform the labor is not excessive.
Ê In no event may discharge or privileges be conditioned upon the performance of such labor.
2. A consumer who performs labor which contributes to the operation and maintenance of the facility for which the facility would otherwise employ someone must be adequately compensated and the compensation must be in accordance with applicable state and federal labor laws.
3. A consumer who performs labor other than that described in subsection 2 must be compensated an adequate amount if an economic benefit to another person or agency results from the consumer’s labor.
4. The administrative officer of the facility may provide for compensation of a resident when the resident performs labor not governed by subsection 2 or 3.
5. This section does not apply to labor of a personal housekeeping nature or to labor performed as a condition of residence in a small group living arrangement.
6. One-half of any compensation paid to a consumer pursuant to this section is exempt from collection or retention as payment for services rendered by the Division of Public and Behavioral Health of the Department or its facilities, or by the Division of Child and Family Services of the Department or its facilities. Such an amount is also exempt from levy, execution, attachment, garnishment or any other remedies provided by law for the collection of debts.
(Added to NRS by 1975, 1598; A 1993, 2718; 1999, 100; 2011, 416)
NRS 433.531 Rights concerning suspension or violation of rights. Each consumer admitted for evaluation, treatment or training to a facility has the following rights concerning the suspension or violation of his or her rights, a list of which must be prominently posted in all facilities providing those services and must be otherwise brought to the attention of the consumer by such additional means as prescribed by regulation:
1. To receive a list of the consumer’s rights.
2. To receive a copy of the policy of the facility that sets forth the clinical or medical circumstances under which the consumer’s rights may be suspended or violated.
3. To receive a list of the clinically appropriate options available to the consumer or the consumer’s family to remedy an actual or a suspected suspension or violation of his or her rights.
4. To have all policies of the facility regarding the rights of consumers prominently posted in the facility.
(Added to NRS by 1997, 3491; A 2011, 417)
NRS 433.533 Document reflecting receipt of list of rights and explanation of rights. Each facility shall, within a reasonable time after a consumer is admitted to the facility for evaluation, treatment or training, ask the consumer to sign a document that reflects that the consumer has received a list of the consumer’s rights and has had those rights explained to him or her.
(Added to NRS by 1997, 3491; A 2011, 417)
NRS 433.534 Denial of rights prohibited; exceptions; report; investigation and action by Commission; closure of meeting in certain circumstances.
1. The rights of a consumer enumerated in this chapter must not be denied except to protect the consumer’s health and safety or to protect the health and safety of others, or both. Any denial of those rights in any facility must be entered in the consumer’s record of treatment, and notice of the denial must be forwarded to the administrative officer of the facility. Failure to report denial of rights by an employee may be grounds for dismissal.
2. If the administrative officer of a facility receives notice of a denial of rights as provided in subsection 1, the officer shall cause a full report to be prepared which must set forth in detail the factual circumstances surrounding the denial. Except as otherwise provided in NRS 239.0115, such a report is confidential and must not be disclosed. A copy of the report must be sent to the Commission.
3. The Commission:
(a) Shall receive reports of and may investigate apparent violations of the rights guaranteed by this chapter;
(b) May act to resolve disputes relating to apparent violations;
(c) May act on behalf of consumers to obtain remedies for any apparent violations; and
(d) Shall otherwise endeavor to safeguard the rights guaranteed by this chapter.
4. Pursuant to NRS 241.030, the Commission may close any portion of a meeting in which it considers the character, alleged misconduct or professional competence of a person in relation to:
(a) The denial of the rights of a consumer; or
(b) The care and treatment of a consumer.
Ê The provisions of this subsection do not require a meeting of the Commission to be closed to the public.
(Added to NRS by 1975, 1598; A 1979, 812; 1985, 2268; 1989, 1757; 1993, 2112, 2719; 1995, 676, 1735; 2007, 2106; 2011, 417)
NRS 433.536 Retaliation by officer, director or employee of facility prohibited. An officer, director or employee of a facility shall not retaliate against any person for having:
1. Reported any violation of law; or
2. Provided information regarding a violation of law,
Ê by the facility or a staff member of the facility.
(Added to NRS by 1997, 3491)
Safekeeping of Consumer’s Money and Other Personal Property
NRS 433.538 Definitions. As used in NRS 433.538 to 433.543, inclusive, unless the context otherwise requires:
1. “Administrative officer” means a person with overall executive and administrative responsibility for a division facility.
2. “Division facility” means any unit or subunit operated by:
(a) The Division of Public and Behavioral Health of the Department for the care, treatment and training of consumers; or
(b) The Division of Child and Family Services of the Department pursuant to chapter 433B of NRS.
(Added to NRS by 1993, 2714; A 1999, 101; 2003, 1943; 2011, 418)
NRS 433.539 Personal deposit funds for consumers.
1. There may be maintained as a trust fund at each division facility a consumers’ personal deposit fund.
2. Money coming into the possession of the administrative officer of a division facility which belongs to a consumer must be credited in the fund in the name of that consumer.
3. When practicable, individual credits in the fund must not exceed the sum of $300.
4. Any amounts to the credit of a consumer may be used for purchasing personal necessities, for expenses of burial or may be turned over to the consumer upon the consumer’s demand, except that when the consumer is adjudicated incapacitated the guardian of the consumer’s estate has the right to demand and receive the money.
5. An amount accepted for the benefit of a consumer for a special purpose must be reserved for that purpose regardless of the total amount to the credit of the consumer.
6. Except as otherwise provided in subsection 7, the administrative officers shall deposit any money received for the funds of their respective facilities in commercial accounts with one or more banks or credit unions of reputable standing. When deposits in a commercial account exceed $15,000, the administrative officer may deposit the excess in a savings account paying interest in any reputable commercial bank, or in any credit union, savings and loan association or savings bank within this state that is federally insured or insured by a private insurer approved pursuant to NRS 672.755. The savings account must be in the name of the fund. Interest paid on deposits in the savings account may be used for recreational purposes at the division facility.
7. The administrative officers may maintain at their respective division facilities petty cash of not more than $400 of the money in the consumers’ personal deposit fund to enable consumers to withdraw small sums from their accounts.
(Added to NRS by 1979, 252; A 1979, 1894; 1983, 395; 1999, 1497; 2011, 418)
NRS 433.541 Disposition of personal property of consumer upon death. Whenever any person admitted to a division facility dies, the administrative officer shall send written notice to the decedent’s legally appointed representative, listing the personal property remaining in the custody or possession of the facility. If there is no demand made upon the administrative officer of the facility by the decedent’s legally appointed representative, all personal property of the decedent remaining in the custody or possession of the administrative officer must be held by the officer for a period of 1 year from the date of the decedent’s death for the benefit of the heirs, legatees or successors of the decedent. At the end of this period, another notice must be sent to the decedent’s representative, listing the property and specifying the manner in which the property will be disposed of if not claimed within 15 business days. After 15 business days, all personal property and documents of the decedent, other than cash, remaining unclaimed in the possession of the administrative officer must be disposed of as follows:
1. All documents must be filed by the administrative officer with:
(a) The public administrator of the county from which the consumer was admitted; or
(b) If the office of public administrator has been abolished pursuant to NRS 253.125, the person employed or contracted with pursuant to NRS 253.125 to carry out the duties and responsibilities of chapter 253 of NRS in the county from which the consumer was admitted,
Ê as applicable.
2. All other personal property must be sold at a public auction or by sealed bids. The proceeds of the sale must be applied to the decedent’s unpaid balance for costs incurred at the division facility.
(Added to NRS by 1979, 253; A 2011, 419; 2019, 1550)
NRS 433.542 Disposition of unclaimed personal property of consumer worth more than $100. If a person admitted to a division facility is discharged or leaves and the person fails to recover personal property worth more than $100 in the custody of the administrative officer of the facility, the administrative officer shall notify the former consumer or the consumer’s legal representative in writing that personal property remains in the custody of the facility. The property must be held in safekeeping for the consumer for a period of 1 year from the date of discharge. If upon the expiration of the 1-year period no claim has been made upon the administrative officer by the person or the person’s legal representative, another notice must be sent to the person or the person’s legal representative, stating the fact that personal property remains in the custody of the facility, and specifying the manner in which the property will be disposed of if not claimed within 15 business days. After 15 business days, the property may be considered unclaimed property and be disposed of in the manner provided for unclaimed property of deceased persons under the provisions of NRS 433.541.
(Added to NRS by 1979, 253; A 2011, 419)
NRS 433.543 Disposition of unclaimed personal property of minimal value. If, upon the death or release of a person admitted to a division facility, the value of unclaimed personal property in the possession of the administrative officer of the facility is so minimal that it cannot be sold at public auction or by sealed bid and if the property, either in its present condition or in an improved condition, cannot be used by the division facility, the administrative officer may order the personal property destroyed.
(Added to NRS by 1979, 253)
Deaths and Burials
NRS 433.544 Notification of death of consumer; burial.
1. Upon the death of a consumer, any known relatives or friends of the consumer shall be notified immediately of the fact of death.
2. The Administrator or the Administrator’s designee shall cause a decent burial to be provided for the consumer outside division facility grounds. The Administrator or the designee may enter into a contract with any person or persons, including governmental agencies or other instrumentalities, as the Administrator or the designee deems proper, for a decent burial. Where there are known relatives, and they are financially able, the cost of burial shall be borne by the relatives. Where there are no known relatives, the cost of burial shall be a charge against the State of Nevada, but the cost thereof shall not exceed the amount charged for the burial of indigents in the county in which the burial takes place.
3. When a consumer has income from a pension payable through a division facility, and has no guardian, the Division may obligate operating funds for funeral expenses in the amount due under the pension benefits.
(Added to NRS by 1975, 1599; A 2011, 419)
USE OF RESTRAINTS AND INTERVENTIONS
NRS 433.545 Definitions. As used in NRS 433.545 to 433.551, inclusive, unless the context otherwise requires, the words and terms defined in NRS 433.5453 to 433.548, inclusive, have the meanings ascribed to them in those sections.
(Added to NRS by 1999, 3229; A 2001, 2744)
NRS 433.5453 “Aversive intervention” defined. “Aversive intervention” means any of the following actions if the action is used to punish a person with a disability or to eliminate, reduce or discourage maladaptive behavior of a person with a disability:
1. The use of noxious odors and tastes;
2. The use of water and other mists or sprays;
3. The use of blasts of air;
4. The use of corporal punishment;
5. The use of verbal and mental abuse;
6. The use of electric shock;
7. Requiring a person to perform exercise under forced conditions if the:
(a) Person is required to perform the exercise because the person exhibited a behavior that is related to his or her disability;
(b) Exercise is harmful to the health of the person because of his or her disability; or
(c) Nature of the person’s disability prevents the person from engaging in the exercise;
8. Any intervention, technique or procedure that deprives a person of the use of one or more of his or her senses, regardless of the length of the deprivation, including, without limitation, the use of sensory screens; or
9. The deprivation of necessities needed to sustain the health of a person, regardless of the length of the deprivation, including, without limitation, the denial or unreasonable delay in the provision of:
(a) Food or liquid at a time when it is customarily served; or
(b) Medication.
(Added to NRS by 1999, 3229)
NRS 433.5456 “Chemical restraint” defined. “Chemical restraint” means the administration of drugs to a person for the specific and exclusive purpose of controlling an acute or episodic 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 prescribed by a physician, physician assistant or advanced practice registered nurse as standard treatment for the mental or physical condition of the person.
(Added to NRS by 1999, 3230; A 2021, 3067)
NRS 433.546 “Corporal punishment” defined. “Corporal punishment” means the intentional infliction of physical pain, including, without limitation, hitting, pinching or striking.
(Added to NRS by 1999, 3230)
NRS 433.5463 “Electric shock” defined. “Electric shock” means the application of electric current to a person’s skin or body. The term does not include electroconvulsive therapy.
(Added to NRS by 1999, 3230)
NRS 433.5466 “Emergency” defined. “Emergency” means a situation in which immediate intervention is necessary to protect the physical safety of a person or others from an immediate threat of physical injury or to protect against an immediate threat of severe property damage.
(Added to NRS by 1999, 3230)
NRS 433.547 “Mechanical restraint” defined. “Mechanical restraint” means the use of devices, including, without limitation, mittens, straps, restraint chairs, handcuffs, belly chains and four-point restraints to limit a person’s movement or hold a person immobile.
(Added to NRS by 1999, 3230; A 2001, 2744)
NRS 433.5473 “Person with a disability” defined. “Person with a disability” means a person who:
1. Has a physical or mental impairment that substantially limits one or more of the major life activities of the person;
2. Has a record of such an impairment; or
3. Is regarded as having such an impairment.
(Added to NRS by 1999, 3230)
NRS 433.5476 “Physical restraint” defined. “Physical restraint” means the use of physical contact to limit a person’s movement or hold a person immobile.
(Added to NRS by 1999, 3230)
NRS 433.548 “Verbal and mental abuse” defined. “Verbal and mental abuse” means verbal intimidation or coercion of a person without a redeeming purpose.
(Added to NRS by 1999, 3230)
NRS 433.5483 Use of aversive intervention on consumer prohibited. A person employed by a facility or any other person shall not use any aversive intervention on a person with a disability who is a consumer.
(Added to NRS by 1999, 3230; A 2011, 420)
NRS 433.5486 Use of physical, mechanical or chemical restraint on consumer by facility authorized in certain circumstances. Notwithstanding the provisions of NRS 433.549 to 433.5503, inclusive, to the contrary, a facility may use or authorize the use of physical restraint, mechanical restraint or chemical restraint on a person with a disability who is a consumer if the facility is:
1. Accredited by a nationally recognized accreditation association or agency; or
2. Certified for participation in the Medicaid or Medicare Program,
Ê only to the extent that the accreditation or certification allows the use of such restraint.
(Added to NRS by 1999, 3230; A 2011, 420)
NRS 433.549 Use of physical, mechanical or chemical restraint on consumer by person employed by facility prohibited; exceptions. A person employed by a facility or any other person shall not:
1. Except as otherwise provided in NRS 433.5493, use physical restraint on a person with a disability who is a consumer.
2. Except as otherwise provided in NRS 433.5496 and 433.5499, use mechanical restraint on a person with a disability who is a consumer.
3. Except as otherwise provided in NRS 433.5503, use chemical restraint on a person with a disability who is a consumer.
(Added to NRS by 1999, 3231; A 2001, 2744; 2011, 420)
NRS 433.5493 Use of physical restraint on consumer; requirements; exceptions; report as denial of rights.
1. Except as otherwise provided in subsection 2, physical restraint may be used on a person with a disability who is a consumer only if:
(a) An emergency exists that necessitates the use of physical restraint;
(b) The physical restraint is used only for the period that is necessary to contain the behavior of the consumer so that the consumer is no longer an immediate threat of causing physical injury to himself or herself or others or causing severe property damage; and
(c) The use of force in the application of physical restraint does not exceed the force that is reasonable and necessary under the circumstances precipitating the use of physical restraint.
2. Physical restraint may be used on a person with a disability who is a consumer and the provisions of subsection 1 do not apply if the physical restraint is used to:
(a) Assist the consumer in completing a task or response if the consumer does not resist the application of physical restraint or if the consumer’s resistance is minimal in intensity and duration;
(b) Escort or carry a consumer to safety if the consumer is in danger in his or her present location; or
(c) Conduct medical examinations or treatments on the consumer that are necessary.
3. If physical restraint is used on a person with a disability who is a consumer in an emergency, the use of the procedure must be reported as a denial of rights pursuant to NRS 433.534 or 435.610, as applicable, regardless of whether the use of the procedure is authorized by statute. The report must be made not later than 1 working day after the procedure is used.
(Added to NRS by 1999, 3231; A 2011, 420; 2013, 3011)
NRS 433.5496 Use of mechanical restraint on consumer other than consumer of forensic facility; requirements; exceptions; report as denial of rights.
1. Except as otherwise provided in subsections 2 and 4, mechanical restraint may be used on a person with a disability who is a consumer only if:
(a) An emergency exists that necessitates the use of mechanical restraint;
(b) A medical order authorizing the use of mechanical restraint is obtained from the consumer’s treating physician or advanced practice registered nurse before the application of the mechanical restraint or not later than 15 minutes after the application of the mechanical restraint;
(c) The physician or advanced practice registered nurse who signed the order required pursuant to paragraph (b) or the attending physician or attending advanced practice registered nurse examines the consumer not later than 1 working day immediately after the application of the mechanical restraint;
(d) The mechanical restraint is applied by a member of the staff of the facility who is trained and qualified to apply mechanical restraint;
(e) The consumer is given the opportunity to move and exercise the parts of his or her body that are restrained at least 10 minutes per every 60 minutes of restraint;
(f) A member of the staff of the facility lessens or discontinues the restraint every 15 minutes to determine whether the consumer will stop or control his or her inappropriate behavior without the use of the restraint;
(g) The record of the consumer contains a notation that includes the time of day that the restraint was lessened or discontinued pursuant to paragraph (f), the response of the consumer and the response of the member of the staff of the facility who applied the mechanical restraint;
(h) A member of the staff of the facility continuously monitors the consumer during the time that mechanical restraint is used on the consumer; and
(i) The mechanical restraint is used only for the period that is necessary to contain the behavior of the consumer so that the consumer is no longer an immediate threat of causing physical injury to himself or herself or others or causing severe property damage.
2. Mechanical restraint may be used on a person with a disability who is a consumer and the provisions of subsection 1 do not apply if the mechanical restraint is used to:
(a) Treat the medical needs of a consumer;
(b) Protect a consumer who is known to be at risk of injury to himself or herself because the consumer lacks coordination or suffers from frequent loss of consciousness;
(c) Provide proper body alignment to a consumer; or
(d) Position a consumer who has physical disabilities in a manner prescribed in the consumer’s plan of services.
3. If mechanical restraint is used on a person with a disability who is a consumer in an emergency, the use of the procedure must be reported as a denial of rights pursuant to NRS 433.534 or 435.610, as applicable, regardless of whether the use of the procedure is authorized by statute. The report must be made not later than 1 working day after the procedure is used.
4. The provisions of this section do not apply to a forensic facility, as that term is defined in subsection 5 of NRS 433.5499.
(Added to NRS by 1999, 3231; A 2001, 2744; 2011, 421; 2013, 3011; 2017, 1746)
NRS 433.5499 Use of mechanical restraint on consumer of forensic facility; requirements; exceptions; report as denial of rights.
1. Except as otherwise provided in subsection 3, mechanical restraint may be used on a person with a disability who is a consumer of a forensic facility only if:
(a) An emergency exists that necessitates the use of the mechanical restraint;
(b) The consumer’s behavior presents an imminent threat of causing physical injury to himself or herself or to others or causing severe property damage and less restrictive measures have failed to modify the consumer’s behavior;
(c) The consumer is in the care of the facility but not on the premises of the facility and mechanical restraint is necessary to ensure security; or
(d) The consumer is in the process of being transported to another location and mechanical restraint is necessary to ensure security.
2. If mechanical restraint is used pursuant to subsection 1, the forensic facility shall ensure that:
(a) The mechanical restraint is applied by a member of the staff of the facility who is trained and qualified to apply mechanical restraint;
(b) A member of the staff of the facility continuously monitors the consumer during the time that mechanical restraint is used on the consumer;
(c) The record of the consumer contains a notation that indicates the time period during which the restraint was used and the circumstances warranting the restraint; and
(d) The mechanical restraint is used only for the period that is necessary.
3. Mechanical restraint may be used on a person with a disability who is a consumer of a forensic facility, and the provisions of subsections 1 and 2 do not apply if the mechanical restraint is used to:
(a) Treat the medical needs of a consumer;
(b) Protect a consumer who is known to be at risk of injury to himself or herself because the consumer lacks coordination or suffers from frequent loss of consciousness;
(c) Provide proper body alignment to a consumer; or
(d) Position a consumer who has physical disabilities in a manner prescribed in the consumer’s plan of services.
4. If mechanical restraint is used in an emergency on a person with a disability who is a consumer of a forensic facility, the use of the procedure must be reported as a denial of rights pursuant to NRS 433.534 or 435.610, as applicable, regardless of whether the use of the procedure is authorized by statute. The report must be made not later than 1 working day after the procedure is used.
5. As used in this section, “forensic facility” means a secure facility of the Division for offenders and defendants with a mental disorder who are ordered to the facility pursuant to chapter 178 of NRS.
(Added to NRS by 2001, 2743; A 2011, 422; 2013, 3012)
NRS 433.5503 Use of chemical restraint on consumer; requirements; report as denial of rights.
1. Chemical restraint may only be used on a person with a disability who is a consumer if:
(a) The consumer has been deemed to be a person in a mental health crisis, as defined in NRS 433A.0175, and is receiving mental health services from a facility;
(b) The chemical restraint is administered to the consumer while he or she is under the care of the facility;
(c) An emergency exists that necessitates the use of chemical restraint;
(d) A medical order authorizing the use of chemical restraint is obtained from the consumer’s attending physician, psychiatrist or advanced practice registered nurse;
(e) The physician, psychiatrist or advanced practice registered nurse who signed the order required pursuant to paragraph (d) examines the consumer not later than 1 working day immediately after the administration of the chemical restraint; and
(f) The chemical restraint is administered by a person licensed to administer medication.
2. If chemical restraint is used on a person with a disability who is a consumer, the use of the procedure must be reported as a denial of rights pursuant to NRS 433.534 or 435.610, as applicable, regardless of whether the use of the procedure is authorized by statute. The report must be made not later than 1 working day after the procedure is used.
(Added to NRS by 1999, 3232; A 2011, 422; 2013, 3013; 2017, 1747; 2019, 347)
NRS 433.5506 Facility required to develop program of education in positive behavioral interventions and supports; facility required to train certain members of staff to use physical, mechanical and chemical restraint.
1. Each facility shall develop a program of education for the members of the staff of the facility to provide instruction in positive behavioral interventions and positive behavioral supports that:
(a) Includes positive methods to modify the environment of consumers to promote adaptive behavior and reduce the occurrence of inappropriate behavior;
(b) Includes methods to teach skills to consumers so that consumers can replace inappropriate behavior with adaptive behavior;
(c) Includes methods to enhance a consumer’s independence and quality of life;
(d) Includes the use of the least intrusive methods to respond to and reinforce the behavior of consumers; and
(e) Offers a process for designing interventions based upon the consumer that are focused on promoting appropriate changes in behavior as well as enhancing the overall quality of life for the consumer.
2. Each facility shall provide appropriate training for the members of the staff of the facility who are authorized to carry out and monitor physical restraint, mechanical restraint and chemical restraint to ensure that those members of the staff are competent and qualified to carry out the procedures in accordance with NRS 433.545 to 433.551, inclusive.
(Added to NRS by 1999, 3233; A 2011, 423)
NRS 433.551 Facility required to report violations to Division and to develop corrective plan; Division required to forward corrective plan to Director of Department; power of Department to withhold funding.
1. A facility where a violation of the provisions of NRS 433.545 to 433.551, inclusive, occurs shall:
(a) Not later than 24 hours after a violation occurs, or as soon thereafter as the violation is discovered, report the violation to the Division; and
(b) Develop, in cooperation with the Division, a corrective plan to ensure that within 30 calendar days after the violation occurred, appropriate action is taken by the facility to prevent future violations.
2. The Division shall forward the plan to the Director of the Department. The Director or the Director’s designee shall review the plan to ensure that it complies with applicable federal law and the statutes and regulations of this state. The Director or the designee may require appropriate revision of the plan to ensure compliance.
3. If the facility where the violation occurred does not meet the requirements of the plan to the satisfaction of the Director or the designee, the Department may withhold funding for the facility until the facility meets the requirements of the plan.
(Added to NRS by 1999, 3233)
UNLAWFUL ACTS
NRS 433.554 Abuse of consumer; failure to report abuse; possession or use of intoxicating beverage or controlled substance; transaction with consumer; aiding escape of consumer; penalties.
1. An employee of a public or private mental health facility or any other person, except a consumer, who:
(a) Has reason to believe that a consumer of the Division or of a private facility offering mental health services has been or is being abused or neglected and fails to report it;
(b) Brings intoxicating beverages or a controlled substance into any division facility occupied by consumers unless specifically authorized to do so by the administrative officer or a staff physician of the facility;
(c) Is under the influence of liquor or a controlled substance while employed in contact with consumers, unless in accordance with a lawfully issued prescription;
(d) Enters into any transaction with a consumer involving the transfer of money or property for personal use or gain at the expense of the consumer; or
(e) Contrives the escape, elopement or absence of a consumer,
Ê is guilty of a misdemeanor, in addition to any other penalties provided by law.
2. In addition to any other penalties provided by law, an employee of a public or private mental health facility or any other person, except a consumer, who willfully abuses or neglects a consumer:
(a) For a first violation that does not result in substantial bodily harm to the consumer, is guilty of a gross misdemeanor.
(b) For a first violation that results in substantial bodily harm to the consumer, is guilty of a category B felony.
(c) For a second or subsequent violation, is guilty of a category B felony.
Ê A person convicted of a category B felony pursuant to this section shall be punished by imprisonment in the state prison for a minimum term of not less than 1 year and a maximum term of not more than 6 years, or by a fine of not more than $5,000, or by both fine and imprisonment.
3. A person who is convicted pursuant to this section is ineligible for 5 years for appointment to or employment in a position in the state service and, if the person is an officer or employee of the State, the person forfeits his or her office or position.
4. A conviction pursuant to this section is, when applicable, grounds for disciplinary action against the person so convicted and the facility where the violation occurred. The Division may recommend to the appropriate agency or board the suspension or revocation of the professional license, registration, certificate or permit of a person convicted pursuant to this section.
5. For the purposes of this section:
(a) “Abuse” means any willful and unjustified infliction of pain, injury or mental anguish upon a consumer, including, but not limited to:
(1) The rape, sexual assault or sexual exploitation of the consumer;
(2) The use of any type of aversive intervention;
(3) Except as otherwise provided in NRS 433.5486, a violation of NRS 433.549; and
(4) The use of physical, chemical or mechanical restraints or the use of seclusion in violation of federal law.
Ê Any act which meets the standard of practice for care and treatment does not constitute abuse.
(b) “Consumer” includes any person who seeks, on the person’s own or others’ initiative, and can benefit from, care, treatment and training in a public or private institution or facility offering mental health services, or from treatment to competency in a public or private institution or facility offering mental health services. The term includes a consumer of the Division of Child and Family Services of the Department.
(c) “Neglect” means any omission to act which causes injury to a consumer or which places the consumer at risk of injury, including, but not limited to, the failure to follow:
(1) An appropriate plan of treatment to which the consumer has consented; and
(2) The policies of the facility for the care and treatment of consumers.
Ê Any omission to act which meets the standard of practice for care and treatment does not constitute neglect.
(d) “Standard of practice” means the skill and care ordinarily exercised by prudent professional personnel engaged in health care.
(Added to NRS by 1975, 1599; A 1983, 933; 1987, 1196, 1551; 1989, 642; 1993, 2112, 2231, 2719; 1995, 676, 1276, 1715; 1997, 542; 1999, 3235; 2003, 1942; 2011, 423)
NRS 433.564 Unlawful sale or transfer of intoxicating beverage on grounds of division facility.
1. Any person who, on the grounds of a division facility, sells, barters, exchanges or in any manner disposes of any spirituous or malt liquor or beverage to any person lawfully confined in the division facility is guilty of a gross misdemeanor.
2. This section does not apply to any physician prescribing or furnishing liquor to the person when the liquor is prescribed or furnished for medicinal purposes only.
(Added to NRS by 1975, 1599)
PEER RECOVERY SUPPORT SERVICES
General Provisions
NRS 433.622 Definitions. As used in NRS 433.622 to 433.641, inclusive, unless the context otherwise requires, the words and terms defined in NRS 433.623 to 433.629, inclusive, have the meanings ascribed to them in those sections.
(Added to NRS by 2021, 2810)
NRS 433.623 “Adult” defined. “Adult” means a natural person who is 18 years of age or older.
(Added to NRS by 2021, 2810)
NRS 433.624 “Board” defined. “Board” means the State Board of Health.
(Added to NRS by 2021, 2810)
NRS 433.625 “Certificate” defined. [Effective on the date on which the Nevada Certification Board, or its successor organization, ceases certifying peer recovery support specialists or peer recovery support specialist supervisors.] “Certificate” means a certificate issued by the Division that authorizes the holder to provide or supervise the provision of peer recovery support services, as applicable.
(Added to NRS by 2021, 2810, effective on the date on which the Nevada Certification Board, or its successor organization, ceases certifying peer recovery support specialists or peer recovery support specialist supervisors)
NRS 433.626 “Peer recovery support services” defined. “Peer recovery support services” means nonclinical supportive services that use lived experience in recovery from a substance use disorder or other behavioral health disorder to promote recovery in another person with a substance use disorder or other behavioral health disorder by advocating, mentoring, educating, offering hope and providing assistance in navigating systems.
(Added to NRS by 2021, 2810)
NRS 433.627 “Peer recovery support specialist” defined. “Peer recovery support specialist” means an adult who is authorized under the provisions of NRS 433.631 to provide peer recovery support services for compensation as a regular part of his or her job duties. The term does not include a peer recovery support specialist intern.
(Added to NRS by 2021, 2810)
NRS 433.628 “Peer recovery support specialist intern” defined. “Peer recovery support specialist intern” means an adult who is authorized under the provisions of NRS 433.631 to provide peer recovery support services for compensation as a regular part of his or her job duties while the adult is acquiring the experience necessary for certification as a peer recovery support specialist.
(Added to NRS by 2021, 2810)
NRS 433.629 “Peer recovery support specialist supervisor” defined. “Peer recovery support specialist supervisor” means an adult who is authorized under the provisions of NRS 433.631 to supervise the provision of peer recovery support services for compensation as a regular part of his or her job duties.
(Added to NRS by 2021, 2810)
Certification
NRS 433.631 Certificate required to provide or supervise provision of peer recovery support services; exception for interns; civil penalty. [Effective until the date on which the Nevada Certification Board, or its successor organization, ceases certifying peer recovery support specialists or peer recovery support specialist supervisors.]
1. Except as authorized by subsection 2, an adult shall not:
(a) Provide peer recovery support services for compensation as a regular part of his or her job duties or hold himself or herself out as authorized to provide peer recovery support services unless he or she holds a valid certificate as a peer recovery support specialist issued by the Nevada Certification Board or its successor organization.
(b) Supervise the provision of peer recovery support services for compensation as a regular part of his or her job duties or hold himself or herself out as authorized to supervise the provision of peer recovery support services unless he or she holds a valid certificate as a peer recovery support specialist supervisor issued by the Nevada Certification Board or its successor organization.
2. If the Nevada Certification Board or its successor organization establishes conditions governing the provision of peer recovery support services by a person who is not certified as a peer recovery support specialist while the person is acquiring the experience necessary for certification as a peer recovery support specialist, an adult who is not certified as a peer recovery support specialist may:
(a) Provide peer recovery support services for compensation as a regular part of his or her job duties under those conditions; and
(b) Use the title of “peer recovery support specialist intern” while providing peer recovery support services under those conditions.
3. The Division may impose upon an adult who violates this section a civil penalty in an amount prescribed by regulation of the Board.
(Added to NRS by 2021, 2810)
NRS 433.631 Certificate required to provide or supervise provision of peer recovery support services; exception for interns; civil penalty. [Effective on the date on which the Nevada Certification Board, or its successor organization, ceases certifying peer recovery support specialists or peer recovery support specialist supervisors.]
1. Except as authorized by subsection 2, an adult shall not:
(a) Provide peer recovery support services for compensation as a regular part of his or her job duties or hold himself or herself out as authorized to provide peer recovery support services unless he or she holds a valid certificate as a peer recovery support specialist issued by the Division.
(b) Supervise the provision of peer recovery support services for compensation as a regular part of his or her job duties or hold himself or herself out as authorized to supervise the provision of peer recovery support services unless he or she holds a valid certificate as a peer recovery support specialist supervisor issued by the Division.
2. The Division may adopt regulations establishing conditions under which an adult who is not certified as a peer recovery support specialist may:
(a) Provide peer recovery support services for compensation as a regular part of his or her job duties while acquiring the experience necessary for certification; and
(b) Use the title of “peer recovery support specialist intern.”
3. The Division may impose upon an adult who violates this section a civil penalty in an amount prescribed by regulation of the Board.
(Added to NRS by 2021, 2810; A 2021, 2834, effective on the date on which the Nevada Certification Board, or its successor organization, ceases certifying peer recovery support specialists or peer recovery support specialist supervisors)
NRS 433.632 Regulations; fees. [Effective on the date on which the Nevada Certification Board, or its successor organization, ceases certifying peer recovery support specialists or peer recovery support specialist supervisors.]
1. The Board shall adopt regulations governing the provision of peer recovery support services. The regulations must prescribe:
(a) The requirements for the issuance and renewal of a certificate as a peer recovery support specialist or peer recovery support specialist supervisor, which must include, without limitation, required training and experience for peer recovery support specialists and peer recovery support specialist supervisors.
(b) Requirements governing the supervision of peer recovery support specialists by peer recovery support specialist supervisors.
(c) Procedures for the Division to investigate misconduct by a peer recovery support specialist or peer recovery support specialist supervisor and to impose disciplinary action for such misconduct.
(d) The forms of disciplinary action that the Division may impose against a peer recovery support specialist or peer recovery support specialist supervisor.
2. The Board may, by regulation, prescribe a fee for:
(a) The issuance of a certificate; and
(b) The renewal of a certificate.
3. Any fee prescribed pursuant to subsection 2 must be calculated to produce the revenue estimated to cover the costs related to the issuance and renewal of certificates, but in no case may the fee for the issuance or renewal of a certificate exceed the actual cost to the Division of issuing or renewing the certificate, as applicable.
4. The regulations adopted pursuant to this section may establish exemptions from the provisions of NRS 433.631.
(Added to NRS by 2021, 2811, effective on the date on which the Nevada Certification Board, or its successor organization, ceases certifying peer recovery support specialists or peer recovery support specialist supervisors)
NRS 433.633 Statement concerning obligation for child support required for issuance or renewal of certificate. [Effective on the date on which the Nevada Certification Board, or its successor organization, ceases certifying peer recovery support specialists or peer recovery support specialist supervisors, and until the date of the repeal of 42 U.S.C. § 666, the federal law requiring each state to establish procedures for withholding, suspending and restricting the professional, occupational and recreational licenses for child support arrearages and for noncompliance with certain processes relating to paternity or child support proceedings.]
1. A person who applies for the issuance or renewal of a certificate must:
(a) Include the social security number of the applicant in the application submitted to the Division.
(b) Submit to the Division the statement prescribed by the Division of Welfare and Supportive Services of the Department pursuant to NRS 425.520. The statement must be completed and signed by the applicant.
2. The Division shall include the statement required pursuant to subsection 1 in:
(a) The application or any other forms that must be submitted for the issuance or renewal of the certificate; or
(b) A separate form prescribed by the Division.
3. A certificate may not be issued or renewed by the Division if the applicant:
(a) Fails to submit the statement required pursuant to subsection 1; or
(b) Indicates on the statement submitted pursuant to subsection 1 that the applicant is subject to a court order for the support of a child and is not in compliance with the order or a plan approved by the district attorney or other public agency enforcing the order for the repayment of the amount owed pursuant to the order.
4. If an applicant indicates on the statement submitted pursuant to subsection 1 that the applicant is subject to a court order for the support of a child and is not in compliance with the order or a plan approved by the district attorney or other public agency enforcing the order for the repayment of the amount owed pursuant to the order, the Division shall advise the applicant to contact the district attorney or other public agency enforcing the order to determine the actions that the applicant may take to satisfy the arrearage.
(Added to NRS by 2021, 2811, effective on the date on which the Nevada Certification Board, or its successor organization, ceases certifying peer recovery support specialists or peer recovery support specialist supervisors)
NRS 433.634 Suspension of certificate for failure to pay child support or comply with certain subpoenas or warrants; reinstatement of certificate. [Effective on the date on which the Nevada Certification Board, or its successor organization, ceases certifying peer recovery support specialists or peer recovery support specialist supervisors, and until the date of the repeal of 42 U.S.C. § 666, the federal law requiring each state to establish procedures for withholding, suspending and restricting the professional, occupational and recreational licenses for child support arrearages and for noncompliance with certain processes relating to paternity or child support proceedings.]
1. If the Division receives a copy of a court order issued pursuant to NRS 425.540 that provides for the suspension of all professional, occupational and recreational licenses, certificates and permits issued to a natural person who is the holder of a certificate, the Division shall deem the certificate issued to that person to be suspended at the end of the 30th day after the date the court order was issued unless the Division receives a letter issued to the holder of the certificate by the district attorney or other public agency pursuant to NRS 425.550 stating that the holder of the certificate has complied with the subpoena or warrant or has satisfied the arrearage pursuant to NRS 425.560.
2. The Division shall reinstate a certificate that has been suspended by a district court pursuant to NRS 425.540 if the Division receives a letter issued by the district attorney or other public agency pursuant to NRS 425.550 to the person whose certificate was suspended stating that the person whose certificate was suspended has complied with the subpoena or warrant or has satisfied the arrearage pursuant to NRS 425.560.
(Added to NRS by 2021, 2812, effective on the date on which the Nevada Certification Board, or its successor organization, ceases certifying peer recovery support specialists or peer recovery support specialist supervisors)
NRS 433.635 Expedited certificate by endorsement: Requirements; procedure for issuance. [Effective on the date on which the Nevada Certification Board, or its successor organization, ceases certifying peer recovery support specialists or peer recovery support specialist supervisors.]
1. The Division may issue a certificate by endorsement as a peer recovery support specialist or peer recovery support specialist supervisor to an applicant who meets the requirements set forth in this section. An applicant may submit to the Division an application for such a certificate if the applicant holds a corresponding valid and unrestricted license, certificate or other credential as a peer recovery support specialist or peer recovery support specialist supervisor, as applicable, in the District of Columbia or any state or territory of the United States.
2. An applicant for a certificate by endorsement pursuant to this section must submit to the Division with his or her application:
(a) Proof satisfactory to the Division that the applicant:
(1) Satisfies the requirements of subsection 1;
(2) Has not been disciplined or investigated by the corresponding regulatory authority of the District of Columbia or any state or territory in which the applicant currently holds or has held a license, certificate or other credential as a peer recovery support specialist or peer recovery support specialist supervisor, as applicable; and
(3) Has not been held civilly or criminally liable for malpractice in the District of Columbia or any state or territory of the United States;
(b) An affidavit stating that the information contained in the application and any accompanying material is true and correct;
(c) The fee prescribed by the Board in the regulations adopted pursuant to NRS 433.632; and
(d) Any other information required by the Division.
3. Not later than 15 business days after the Division receives an application for a certificate by endorsement as a peer recovery support specialist or peer recovery support specialist supervisor pursuant to this section, the Division shall provide written notice to the applicant of any additional information required by the Division to consider the application. Unless the Division denies the application for good cause, the Division shall approve the application and issue a certificate by endorsement as a peer recovery support specialist or peer recovery support specialist supervisor, as applicable, to the applicant not later than 45 days after receiving the application.
(Added to NRS by 2021, 2812, effective on the date on which the Nevada Certification Board, or its successor organization, ceases certifying peer recovery support specialists or peer recovery support specialist supervisors)
NRS 433.636 Expedited certificate by endorsement for active member of Armed Forces, member’s spouse, veteran or veteran’s surviving spouse: Requirements; procedure for issuance; provisional certificate pending application. [Effective on the date on which the Nevada Certification Board, or its successor organization, ceases certifying peer recovery support specialists or peer recovery support specialist supervisors.]
1. The Division may issue a certificate by endorsement as a peer recovery support specialist or peer recovery support specialist supervisor to an applicant who meets the requirements set forth in this section. An applicant may submit to the Division an application for such a certificate if the applicant:
(a) Holds a corresponding valid and unrestricted license, certificate or other credential as a peer recovery support specialist or peer recovery support specialist supervisor, as applicable, in the District of Columbia or any state or territory of the United States; and
(b) Is an active member of, or the spouse of an active member of, the Armed Forces of the United States, a veteran or the spouse, widow or widower of a veteran.
2. An applicant for a certificate by endorsement pursuant to this section must submit to the Division with his or her application:
(a) Proof satisfactory to the Division that the applicant:
(1) Satisfies the requirements of subsection 1;
(2) Has not been disciplined or investigated by the corresponding regulatory authority of the District of Columbia or any state or territory in which the applicant currently holds or has held a license, certificate or other credential as a peer recovery support specialist or peer recovery support specialist supervisor, as applicable; and
(3) Has not been held civilly or criminally liable for malpractice in the District of Columbia or any state or territory of the United States;
(b) An affidavit stating that the information contained in the application and any accompanying material is true and correct;
(c) The fee prescribed by the Board in the regulations adopted pursuant to NRS 433.632; and
(d) Any other information required by the Division.
3. Not later than 15 business days after the Division receives an application for a certificate by endorsement as a peer recovery support specialist or peer recovery support specialist supervisor pursuant to this section, the Division shall provide written notice to the applicant of any additional information required by the Division to consider the application. Unless the Division denies the application for good cause, the Division shall approve the application and issue a certificate by endorsement as a peer recovery support specialist or peer recovery support specialist supervisor, as applicable, to the applicant not later than 45 days after receiving all the additional information required by the Division to complete the application.
4. At any time before making a final decision on an application for a certificate by endorsement pursuant to this section, the Division may grant a provisional certificate authorizing an applicant to practice as a peer recovery support specialist or peer recovery support specialist supervisor, as applicable, in accordance with regulations adopted by the Board.
5. As used in this section, “veteran” has the meaning ascribed to it in NRS 417.005.
(Added to NRS by 2021, 2813, effective on the date on which the Nevada Certification Board, or its successor organization, ceases certifying peer recovery support specialists or peer recovery support specialist supervisors)
NRS 433.637 Application for renewal of certificate to include information relating to state business license; denial of renewal for unpaid debt assigned to State Controller for collection. [Effective on the date on which the Nevada Certification Board, or its successor organization, ceases certifying peer recovery support specialists or peer recovery support specialist supervisors.]
1. In addition to any other requirements set forth in NRS 433.622 to 433.641, inclusive, an applicant for the renewal of a certificate as a recovery support specialist or recovery support specialist supervisor must indicate in the application submitted to the Division whether the applicant has a state business license. If the applicant has a state business license, the applicant must include in the application the business identification number assigned by the Secretary of State upon compliance with the provisions of chapter 76 of NRS.
2. A certificate may not be renewed if:
(a) The applicant fails to submit the information required by subsection 1; or
(b) The State Controller has informed the Division pursuant to subsection 5 of NRS 353C.1965 that the applicant owes a debt to an agency that has been assigned to the State Controller for collection and the applicant has not:
(1) Satisfied the debt;
(2) Entered into an agreement for the payment of the debt pursuant to NRS 353C.130; or
(3) Demonstrated that the debt is not valid.
3. As used in this section:
(a) “Agency” has the meaning ascribed to it in NRS 353C.020.
(b) “Debt” has the meaning ascribed to it in NRS 353C.040.
(Added to NRS by 2021, 2814, effective on the date on which the Nevada Certification Board, or its successor organization, ceases certifying peer recovery support specialists or peer recovery support specialist supervisors)
1. The Division may bring an action in the name of the State of Nevada to enjoin any adult from engaging in conduct that violates the provisions of NRS 433.631.
2. It is sufficient in such an action to allege that the defendant did, on a certain date and in a certain place, engage in conduct for which a certificate is required by NRS 433.631 without a valid certificate.
(Added to NRS by 2021, 2814)
Requirements Concerning Certain Persons Who Have Contact With Minors
NRS 433.639 Child abuse and neglect screening; termination upon receipt of substantiated report; opportunity to correct information; review; regulations; civil penalties.
1. Not later than 3 days after employing a person to provide or supervise the provision of peer recovery support services in a position where the person has regular and substantial contact with minors or retaining a person as an independent contractor to provide or supervise the provision of peer recovery support services in such a position and every 5 years thereafter, an employer, or person or entity who retained the independent contractor, shall:
(a) Obtain from the employee or independent contractor written authorization for the release of any information that may be available from the Statewide Central Registry for the Collection of Information Concerning the Abuse or Neglect of a Child established pursuant to NRS 432.100; and
(b) Complete a child abuse and neglect screening through the Central Registry to determine whether there has been a substantiated report of child abuse or neglect or a violation of NRS 201.540, 201.553, 201.560, 392.4633 or 394.366 made against the person.
2. Except as otherwise provided in any regulations adopted pursuant to subsection 4, upon receiving information pursuant to subsection 1 from the Central Registry or from any other source that an employee or independent contractor described in subsection 1 has, within the immediately preceding 5 years, had a substantiated report of child abuse or neglect or a violation of NRS 201.540, 201.553, 201.560, 392.4633 or 394.366 made against him or her, the employer or person or entity who retained the independent contractor shall terminate the employment or contract of the employee or independent contractor, as applicable, after allowing the employee or independent contractor time to correct the information as required pursuant to subsection 3.
3. If an employee or independent contractor described in subsection 1 believes that the information provided to the employer or person or entity who retained the independent contractor pursuant to subsection 2 is incorrect, the employee or independent contractor must inform the employer, person or entity immediately. The employer, person or entity shall give any such employee or independent contractor 30 days to correct the information.
4. The Division, in consultation with each agency which provides child welfare services, may establish by regulation a process by which it may review evidence upon request to determine whether an employee or independent contractor described in subsection 1 who has, within the immediately preceding 5 years, had a substantiated report of child abuse or neglect or a violation of NRS 201.540, 201.553, 201.560, 392.4633 or 394.366 made against him or her may continue to provide or supervise the provision of peer recovery support services and have regular and substantial contact with minors despite the report. Any such review must be conducted in a manner which does not discriminate against a person in violation of 42 U.S.C. §§ 2000e et seq.
5. If a process for review is established pursuant to subsection 4, an employee or independent contractor described in subsection 1 may request such a review in the manner established by the Division. Any determination made by the Division is final for purposes of judicial review.
6. During any period in which an employee or independent contractor seeks to correct information pursuant to subsection 3 or requests a review of information pursuant to subsection 5, it is within the discretion of the employer or person or entity who retained the independent contractor whether to allow the employee or independent contractor to continue to work for the employer, person or entity, as applicable, except that the employee or independent contractor shall not have regular and substantial contact with minors without supervision during such a period.
7. The Division shall adopt regulations to establish civil penalties to be imposed against any person or entity that fails to comply with the requirements of this section.
8. As used in this section, “agency which provides child welfare services” has the meaning ascribed to it in NRS 424.011.
(Added to NRS by 2021, 2814; A 2023, 2491)
NRS 433.641 Maintenance of records.
1. A person or entity that employs a person or retains an independent contractor for the purpose of providing or supervising the provision of peer recovery support services in a position where the person has regular and substantial contact with minors shall maintain records of the information concerning such employees and independent contractors that is collected pursuant to NRS 433.639, including, without limitation, the written authorization for the release of information from the Statewide Central Registry for the Collection of Information Concerning the Abuse or Neglect of a Child established pursuant to NRS 432.100.
2. The records maintained pursuant to subsection 1 must be:
(a) Maintained for the period that the employee or independent contractor has regular and substantial contact with minors; and
(b) Made available for inspection by the Division at any reasonable time and copies thereof must be furnished to the Division upon request.
(Added to NRS by 2021, 2815)
SUICIDE PREVENTION LIFELINE PROGRAM
NRS 433.702 “National Suicide Prevention Lifeline program” defined. As used in NRS 433.702 to 433.710, inclusive, unless the context otherwise requires, “National Suicide Prevention Lifeline program” means the National Suicide Prevention Lifeline program established by 42 U.S.C. § 290bb-36c.
(Added to NRS by 2021, 2841)
NRS 433.704 Implementation of hotline; immunity from liability for telecommunications provider.
1. The Division shall support the implementation of a hotline for persons who are considering suicide or otherwise in a behavioral health crisis that may be accessed by dialing the digits 9-8-8 by:
(a) Establishing at least one support center that meets the requirements of NRS 433.706 to answer calls to the hotline and coordinate the response to persons who access the hotline;
(b) Encouraging the establishment of and, to the extent that money is available, establishing mobile crisis teams to provide community-based intervention, including, without limitation, de-escalation and stabilization, for persons who are considering suicide or otherwise in a behavioral health crisis and access the hotline;
(c) Participating in any collection of information by the Federal Government concerning the National Suicide Prevention Lifeline program;
(d) Collaborating with the National Suicide Prevention Lifeline program and the Veterans Crisis Line program established pursuant to 38 U.S.C. § 1720F(h) to ensure consistent messaging to the public about the hotline;
(e) Supporting the provision of crisis stabilization services at hospitals that hold endorsements as crisis stabilization centers pursuant to NRS 449.0915; and
(f) Adopting any regulations necessary to carry out the provisions of NRS 433.702 to 433.710, inclusive, including, without limitation:
(1) Regulations establishing the qualifications of providers of services who are involved in responding to persons who are considering suicide or are otherwise in a behavioral health crisis and access the hotline;
(2) Any regulations necessary to allow for communication and sharing of information between persons and entities involved in responding to crises and emergencies in this State to facilitate the coordination of care for persons who are considering suicide or are otherwise in a behavioral health crisis and access the hotline; and
(3) Regulations defining the term “person professionally qualified in the field of behavioral health” for the purposes of this section.
2. A mobile crisis team established pursuant to paragraph (b) of subsection 1 must be:
(a) A team based in the jurisdiction that it serves which includes persons professionally qualified in the field of behavioral health and providers of peer recovery support services;
(b) A team established by a provider of emergency medical services that includes persons professionally qualified in the field of behavioral health and providers of peer recovery support services; or
(c) A team established by a law enforcement agency that includes law enforcement officers, persons professionally qualified in the field of psychiatric mental health and providers of peer recovery support services.
3. A telecommunications provider and its employees, agents, subcontractors and suppliers are not liable for damages that directly or indirectly result from the installation, maintenance or provision of service in relation to the hotline implemented pursuant to this section, including, without limitation, the total or partial failure of any transmission to a support center, unless willful conduct or gross negligence is proven.
4. As used in this section, “peer recovery support services” means nonclinical supportive services that use lived experience in recovery from a substance use disorder or other behavioral health disorder to promote recovery in another person with a substance use disorder or other behavioral health disorder by advocating, mentoring, educating, offering hope and providing assistance in navigating systems.
(Added to NRS by 2021, 2842; A 2023, 1482)
NRS 433.706 Requirements for and duties of support center.
1. Any support center established pursuant to NRS 433.704 must:
(a) Meet the requirements established for participation in the National Suicide Prevention Lifeline program including, without limitation, requirements established by the National Suicide Prevention Lifeline program for serving lesbian, gay, bisexual, transgender and questioning persons, persons with substance use disorders or persons with co-occurring disorders, Native Americans and other high-risk and specialized populations identified by the Substance Abuse and Mental Health Services Administration of the United States Health and Human Services. Such requirements include, without limitation, requirements for training staff to respond to callers who are members of specialized populations and transferring such callers to an appropriate specialized center or subnetwork.
(b) Use technology that is interoperable between systems for responding to crises and emergencies across this State, including, without limitation:
(1) Systems used to provide emergency 911 service;
(2) Systems used by providers of emergency medical services; and
(3) Registries of beds available for persons who require inpatient psychiatric treatment.
2. A support center shall:
(a) Enter into an agreement with the National Suicide Prevention Lifeline program to participate in the network of local crisis support centers established by that program;
(b) Implement the operational and clinical standards and best practices prescribed by the National Suicide Prevention Lifeline program for a local crisis support center;
(c) Share information with other persons and entities in this State responsible for providing services to persons in a behavioral health crisis to facilitate performance of the duties described in paragraph (d);
(d) Coordinate and deploy necessary services, including, without limitation, crisis stabilization services and mobile crisis teams, for persons who are considering suicide or otherwise in a behavioral health crisis and access the hotline established pursuant to NRS 433.704; and
(e) Provide follow-up services for persons who are considering suicide or otherwise in a behavioral health crisis and access the hotline established pursuant to NRS 433.704.
3. As used in this section, “crisis stabilization services” has the meaning ascribed to it in NRS 449.0915.
(Added to NRS by 2021, 2843)
NRS 433.708 Surcharge on certain communications lines; Crisis Response Account; use of money in Account; acceptance of gifts, grants and donations; report.
1. The State Board of Health shall impose a surcharge of 35 cents for each line on:
(a) Each access line of each customer of a company that provides commercial mobile communication services or IP-enabled voice services in this State in accordance with 47 U.S.C. § 251a; and
(b) Each access line or trunk line of each customer to the local exchange of any telecommunications provider providing those lines in this State.
2. The companies and providers described in subsection 1 shall:
(a) Collect the surcharge described in subsection 1 from their customers; and
(b) Transfer the money collected to the Division on or before the last day of the month immediately following the month to which the surcharge applies.
3. The Crisis Response Account is hereby created in the State General Fund. Any money collected from the surcharge imposed pursuant to subsection 1 must be deposited in the State Treasury for credit to the Account. The Division shall administer the Account. The money in the Account:
(a) Must be used by the Division to carry out the provisions of NRS 433.702 to 433.710, inclusive, to the extent authorized by 47 U.S.C. § 251a; and
(b) Must not be used to supplant existing methods of funding that are available for those purposes.
4. The interest and income earned on the money in the Account, after deducting any applicable charges, must be credited to the Account.
5. Any money remaining in the Account at the end of each fiscal year does not revert to the State General Fund but must be carried over into the next fiscal year.
6. The Division may accept gifts, grants and donations for the purpose of carrying out the provisions of NRS 433.702 to 433.710, inclusive.
7. On or before April 1 of each year, the companies and providers described in subsection 1 shall report to the Division the average number of access lines and trunk lines in service which were subject to the surcharge imposed pursuant to subsection 1 for each calendar month of the immediately preceding year. Such information shall be deemed proprietary information regarding a trade secret which is subject to the provisions of NRS 333.333.
8. As used in this section:
(a) “Access line” means any voice connection between a customer and a carrier that provides the customer with access to telecommunication in this State and allows a customer to access the hotline described in NRS 433.704 by dialing the digits 9-8-8.
(b) “Commercial mobile communication service” means commercial mobile service, as that term is defined in 47 U.S.C. § 251a, which is provided to a customer within this State as determined by the place of primary use, as that term is defined in 4 U.S.C. § 124.
(c) “IP-enabled voice service” has the meaning ascribed to it in 47 U.S.C. § 251a.
(d) “Trunk line” means a line which provides a channel between a switchboard owned by a customer of a telecommunications provider and the local exchange of the telecommunications provider.
(Added to NRS by 2021, 2843; A 2023, 1483)
NRS 433.710 Reports. On or before December 31 of each year, the Division shall compile:
1. A report concerning the usage of the hotline established pursuant to NRS 433.704 and the services provided to persons who are considering suicide or otherwise in a behavioral health crisis and access the hotline and submit the report to:
(a) The Commission on Behavioral Health;
(b) Each regional behavioral health policy board created by NRS 433.429; and
(c) The Director of the Legislative Counsel Bureau for transmittal to:
(1) In odd-numbered years, the Joint Interim Standing Committee on Health and Human Services and the Legislative Committee on Senior Citizens, Veterans and Adults With Special Needs created by NRS 218E.750; and
(2) In even-numbered years, the next regular session of the Legislature.
2. A report concerning the revenue generated by the surcharge imposed pursuant to NRS 433.708 and deposits and expenditures from the Account created by that section and submit the report to the Director of the Legislative Counsel Bureau for transmittal to:
(a) In odd-numbered years, the Interim Finance Committee; and
(b) In even-numbered years, the next regular session of the Legislature.
(Added to NRS by 2021, 2844)
ADMINISTRATION OF CERTAIN PROCEEDS FROM LITIGATION CONCERNING OPIOIDS
General Provisions
NRS 433.712 Definitions. As used in NRS 433.712 to 433.744, inclusive, unless the context otherwise requires, the words and terms defined in NRS 433.714 to 433.724, inclusive, have the meanings ascribed to them in those sections.
(Added to NRS by 2021, 2844)
NRS 433.714 “Advisory Committee” defined. “Advisory Committee” means the Advisory Committee for a Resilient Nevada created by NRS 433.726.
(Added to NRS by 2021, 2844)
NRS 433.716 “Agency which provides child welfare services” defined. “Agency which provides child welfare services” has the meaning ascribed to it in NRS 432B.030.
(Added to NRS by 2021, 2844)
NRS 433.718 “Fund” defined. “Fund” means the Fund for a Resilient Nevada created by NRS 433.732.
(Added to NRS by 2021, 2844)
NRS 433.720 “Office” defined. “Office” means the Office of Minority Health and Equity of the Department created by NRS 232.474.
(Added to NRS by 2021, 2844)
NRS 433.722 “Special population” defined. “Special population” means a population uniquely affected by substance use or substance use disorder. The term includes, without limitation:
1. Veterans;
2. Persons who are pregnant;
3. Parents of dependent children;
4. Youth;
5. Persons who are lesbian, gay, bisexual, transgender and questioning; and
6. Persons and families involved in the criminal justice system, juvenile justice system and child welfare system.
(Added to NRS by 2021, 2844)
NRS 433.724 “Substance use disorder prevention coalition” defined. “Substance use disorder prevention coalition” means a coalition of persons and entities who possess knowledge and experience related to the prevention of substance use and substance use disorders in a region of this State.
(Added to NRS by 2021, 2845)
Advisory Committee for a Resilient Nevada
NRS 433.726 Creation; appointment, qualifications, terms and compensation of members.
1. The Advisory Committee for a Resilient Nevada is hereby created within the Department.
2. The Attorney General shall appoint to the Advisory Committee:
(a) One member who possesses knowledge, skills and experience working with youth in the juvenile justice system;
(b) One member who possesses knowledge, skills and experience working with persons in the criminal justice system;
(c) One member who possesses knowledge, skills and experience in the surveillance of overdoses; and
(d) One member who:
(1) Resides in a county other than Clark or Washoe County; and
(2) Has experience having a substance use disorder or having a family member who has a substance use disorder.
3. The Office shall appoint to the Advisory Committee:
(a) One member who:
(1) Resides in Clark County; and
(2) Has experience having a substance use disorder or having a family member who has a substance use disorder;
(b) One member who possesses knowledge, skills and experience in public health;
(c) One member who is the director of an agency which provides child welfare services or his or her designee;
(d) One member who represents a program that specializes in the prevention of substance use by youth;
(e) One member who represents a faith-based organization that specializes in recovery from substance use disorders; and
(f) One member who represents a program for substance use disorders that is operated by a nonprofit organization and certified pursuant to NRS 458.025.
4. The Director of the Department shall appoint to the Advisory Committee:
(a) One member who:
(1) Resides in Washoe County; and
(2) Has experience having a substance use disorder or having a family member who has a substance use disorder;
(b) One member who is a physician certified in the field of addiction medicine by the American Board of Addiction Medicine or its successor organization;
(c) One member who represents a nonprofit, community-oriented organization that specializes in peer-led recovery from substance use disorders;
(d) One member who has survived an opioid overdose;
(e) One member who represents a program to prevent overdoses or otherwise reduce the harm caused by the use of substances;
(f) One member who represents an organization that specializes in housing; and
(g) One member who possesses knowledge, skills and experience with the education of pupils in kindergarten through 12th grade.
5. In appointing the members of the Advisory Committee pursuant to subsections 2, 3 and 4, the appointing authorities shall coordinate the appointments when practicable so that the members of the Advisory Committee represent the diversity of:
(a) This State; and
(b) The communities within this State that are disproportionately affected by opioid use disorder and disparities in access to care and health outcomes.
6. The term of each member of the Advisory Committee is 2 years. A member may be reappointed for an additional term of 2 years in the same manner as the original appointment. A vacancy occurring in the membership of the Advisory Committee must be filled in the same manner as the original appointment.
7. To the extent that money is available for these purposes:
(a) Each member of the Advisory Committee who is not an officer or employee of this State is entitled to receive a salary of not more than $80, as fixed by the Department, for each day or portion of a day spent on the business of the Advisory Committee.
(b) Each member of the Advisory Committee is entitled to receive the per diem allowance and travel expenses provided for state officers and employees generally while engaged in the business of the Advisory Committee.
8. A member of the Advisory Committee who is an officer or employee of this State or a political subdivision of this State must be relieved from his or her duties without loss of regular compensation to prepare for and attend meetings of the Advisory Committee and perform any work necessary to carry out the duties of the Advisory Committee in the most timely manner practicable. A state agency or political subdivision of this State shall not require an officer or employee who is a member of the Advisory Committee to:
(a) Make up the time he or she is absent from work to carry out his or her duties as a member of the Advisory Committee; or
(b) Take annual leave or compensatory time for the absence.
(Added to NRS by 2021, 2845)
NRS 433.728 Chair; meetings; quorum; staff assistance.
1. At the first meeting of each calendar year, the Advisory Committee shall elect from its members a Chair.
2. The Advisory Committee shall meet at least twice annually at the call of the Chair or a majority of its members.
3. A majority of the members of the Advisory Committee constitutes a quorum for the transaction of business, and a majority of a quorum present at any meeting is sufficient for any official action taken by the Advisory Committee.
4. The Department shall provide staff assistance to the Advisory Committee.
(Added to NRS by 2021, 2846)
1. On or before June 30 of each even-numbered year, the Advisory Committee shall submit to the Director of the Department a report of recommendations concerning:
(a) The statewide needs assessment conducted pursuant to paragraph (a) of subsection 1 of NRS 433.734, including, without limitation, the establishment of priorities pursuant to paragraph (e) of subsection 1 of NRS 433.736; and
(b) The statewide plan to allocate money from the Fund developed pursuant to paragraph (b) of subsection 1 of NRS 433.734.
2. When developing recommendations to be included in the report pursuant to subsection 1, the Advisory Committee shall consider:
(a) Health equity and identifying relevant disparities among racial and ethnic populations, geographic regions and special populations in this State; and
(b) The need to prevent overdoses, address disparities in access to health care and prevent substance use among youth.
3. When developing recommendations concerning the establishment of priorities pursuant to paragraph (e) of subsection 1 of NRS 433.736, the Advisory Committee shall use an objective method to define the potential positive and negative impacts of a priority on the health of the affected communities with an emphasis on disproportionate impacts to any population targeted by the priority.
4. Before finalizing a report of recommendations pursuant to subsection 1, the Advisory Committee must hold at least one public meeting to solicit comments from the public concerning the recommendations and make any revisions to the recommendations determined, as a result of the public comment received, to be necessary.
(Added to NRS by 2021, 2846)
Administration and Allocation of Funds
NRS 433.732 Fund for a Resilient Nevada: Creation and administration; appropriation and expenditure of money in Fund; acceptance of gifts, grants and donations.
1. The Fund for a Resilient Nevada is hereby created in the State Treasury. Unless otherwise required by the applicable judgment or settlement, the Attorney General shall, after deducting any fees and costs imposed pursuant to an applicable contingent fee contract as described in NRS 228.111, deposit in the Fund all money received by this State pursuant to any judgment received or settlement entered into by the State of Nevada as a result of litigation concerning the manufacture, distribution, sale or marketing of opioids conducted in accordance with the declaration of findings issued by the Governor and the Attorney General pursuant to paragraph (a) of subsection 1 of NRS 228.1111 on January 24, 2019.
2. The Director of the Department shall administer the Fund.
3. The interest and income earned on the money in the Fund must, after deducting any applicable charges, be credited to the Fund. All claims against the Fund must be paid as other claims against the State are paid.
4. To the extent authorized by the terms of any judgment or settlement described in subsection 1, the Director of the Department may submit to the Interim Finance Committee a request for an allocation for administrative expenses from the Fund pursuant to this section. Except as otherwise limited by this subsection, the Interim Finance Committee may allocate all or part of the money so requested. The annual allocation for administrative expenses from the Fund must not exceed 8 percent of the money deposited into the Fund. For the purposes of this subsection, expenses directly related to conducting a statewide needs assessment pursuant to paragraph (a) of subsection 1 of NRS 433.734, developing the statewide plan to allocate money from the Fund pursuant to paragraph (b) of subsection 1 of NRS 433.734 and allocating money from the Fund in accordance with that statewide plan do not constitute administrative expenses.
5. The money in the Fund remains in the Fund and does not revert to the State General Fund at the end of any fiscal year.
6. Except as otherwise provided in subsection 4, all money that is deposited or paid into the Fund is hereby appropriated to the Department to be used, subject to the provisions of chapter 353 of NRS, to carry out the provisions of NRS 433.734 to 433.740, inclusive.
7. Money expended from the Fund must not be used to supplant existing methods of funding that are available to state, regional, local or tribal agencies.
8. The Department may accept and deposit into the Fund gifts, grants, donations and appropriations to support the activities described in NRS 433.734 to 433.740, inclusive.
(Added to NRS by 2021, 2847)
NRS 433.734 Statewide needs assessment; statewide plan to allocate money; report; regulations.
1. At least once every 4 years, the Department, in consultation with the Office, shall:
(a) Conduct a statewide needs assessment in accordance with NRS 433.736; and
(b) Based on the statewide needs assessment, develop or revise, as applicable, a statewide plan to allocate the money in the Fund in accordance with NRS 433.738.
2. When performing the duties described in subsection 1, the Department and the Office shall consider:
(a) The recommendations provided by the Advisory Committee in the report submitted pursuant to NRS 433.730; and
(b) The recommendations of state, regional, local and tribal governmental entities in this State whose work relates to opioid use disorder and other substance use disorders.
3. On or before January 31 of each year, the Department shall transmit a report concerning all findings and recommendations made and money expended pursuant to NRS 433.734 to 433.740, inclusive, to:
(a) The Governor;
(b) The Director of the Legislative Counsel Bureau for transmittal to:
(1) In odd-numbered years, the next regular session of the Legislature; and
(2) In even-numbered years, the Joint Interim Standing Committee on Health and Human Services and the Interim Finance Committee;
(c) The Commission;
(d) Each regional behavioral health policy board created by NRS 433.429;
(e) The Office of the Attorney General; and
(f) Any other committees or commissions the Director of the Department deems appropriate.
4. The Department may adopt any regulations or take such other actions as are necessary to carry out its duties pursuant to NRS 433.712 to 433.744, inclusive.
(Added to NRS by 2021, 2848)
NRS 433.736 Requirements and procedure for statewide needs assessment.
1. A statewide needs assessment conducted by the Department, in consultation with the Office, pursuant to paragraph (a) of subsection 1 of NRS 433.734 must:
(a) Be evidence-based and use information from damages reports created by experts as part of the litigation described in subsection 1 of NRS 433.732.
(b) Include an analysis of the impacts of opioid use and opioid use disorder on this State that uses quantitative and qualitative data concerning this State and the regions, counties and Native American tribes in this State to determine the risk factors that contribute to opioid use, the use of substances and the rates of opioid use disorder, other substance use disorders and co-occurring disorders among residents of this State.
(c) Focus on health equity and identifying disparities across all racial and ethnic populations, geographic regions and special populations in this State.
(d) Take into account the resources of state, regional, local and tribal agencies and nonprofit organizations, including, without limitation, any money recovered or anticipated to be recovered by county, local or tribal governmental agencies through judgments or settlements resulting from litigation concerning the manufacture, distribution, sale or marketing of opioids, and the programs currently existing in each geographic region of this State to address opioid use disorder and other substance use disorders.
(e) Based on the information and analyses described in paragraphs (a) to (d), inclusive, establish priorities for the use of the funds described in subsection 1 of NRS 433.732. Such priorities must include, without limitation, priorities related to the prevention of overdoses, addressing disparities in access to health care and the prevention of substance use among youth.
2. When conducting a needs assessment, the Department, in consultation with the Office, shall:
(a) Use community-based participatory research methods or similar methods to conduct outreach to groups impacted by the use of opioids, opioid use disorder and other substance use disorders, including, without limitation:
(1) Persons and families impacted by the use of opioids and other substances;
(2) Providers of treatment for opioid use disorder and other substance use disorders;
(3) Substance use disorder prevention coalitions;
(4) Communities of persons in recovery from opioid use disorder and other substance use disorders;
(5) Providers of services to reduce the harms caused by opioid use disorder and other substance use disorders;
(6) Persons involved in the child welfare system;
(7) Providers of social services;
(8) Faith-based organizations;
(9) Providers of health care and entities that provide health care services; and
(10) Members of diverse communities disproportionately impacted by opioid use and opioid use disorder; and
(b) Conduct outreach to governmental agencies who interact with persons or groups impacted by the use of opioids, opioid use disorder and other substance use disorders, including, without limitation:
(1) The Office of the Attorney General, the Department of Public Safety, the Department of Corrections, courts, juvenile justice agencies and other governmental agencies involved in law enforcement or criminal justice;
(2) Agencies which provide child welfare services and other governmental agencies involved in the child welfare system; and
(3) Public health agencies.
(Added to NRS by 2021, 2848)
NRS 433.738 Requirements for statewide plan to allocate money from Fund; authorized uses of money; revision of statewide plan without needs assessment.
1. The statewide plan to allocate money from the Fund established by the Department, in consultation with the Office, pursuant to paragraph (b) of subsection 1 of NRS 433.734 must:
(a) Establish policies and procedures for the administration and distribution of money from the Fund;
(b) Allocate the money in the Fund for the purposes described in subsection 2; and
(c) Establish requirements governing the use of money allocated from the Fund.
2. The statewide plan may allocate money to:
(a) Statewide projects, which may include, without limitation:
(1) Expanding access to evidence-based prevention of substance use disorders, early intervention for persons at risk of a substance use disorder, treatment for substance use disorders and support for persons in recovery from substance use disorders;
(2) Programs to reduce the incidence and severity of neonatal abstinence syndrome;
(3) Prevention of adverse childhood experiences and early intervention for children who have undergone adverse childhood experiences and the families of such children;
(4) Services to reduce the harm caused by substance use;
(5) Prevention and treatment of infectious diseases in persons with substance use disorders;
(6) Services for children and other persons in a behavioral health crisis and the families of such persons;
(7) Housing for persons who have or are in recovery from substance use disorders;
(8) Campaigns to educate and increase awareness of the public concerning substance use and substance use disorders;
(9) Programs for persons involved in the criminal justice or juvenile justice system and the families of such persons, including, without limitation, programs that are administered by courts;
(10) The evaluation of existing programs relating to substance use and substance use disorders;
(11) Development of the workforce of providers of services relating to substance use and substance use disorders;
(12) The collection and analysis of data relating to substance use and substance use disorders;
(13) Capital projects relating to substance use and substance use disorders, including, without limitation, construction, purchasing and remodeling; and
(14) Implementing the hotline for persons who are considering suicide or otherwise in a behavioral health crisis and providing services to persons who access that hotline in accordance with the provisions of NRS 433.702 to 433.710, inclusive.
(b) Grants to regional, county, local and tribal agencies and private-sector organizations whose work relates to opioid use disorder and other substance use disorders.
3. The projects described in paragraph (a) of subsection 2 may include, without limitation, projects to maximize expenditures through federal, local and private matching contributions.
4. The Department, in consultation with the Office, may revise the statewide plan to allocate money from the Fund as necessary without conducting a statewide needs assessment pursuant to paragraph (a) of subsection 1 of NRS 433.734 so long as a needs assessment is conducted at the intervals required by that subsection.
(Added to NRS by 2021, 2849)
NRS 433.740 Procedure for awarding grants; administrative expenses of grantee; annual report; recovery of money from certain grantees.
1. If the Department awards grants pursuant to paragraph (b) of subsection 2 of NRS 433.738, the Department, in consultation with the Office, must:
(a) Develop, solicit and accept applications for those grants. An application submitted by a regional, local or tribal governmental entity must include, without limitation:
(1) The results of a needs assessment that meets the requirements of NRS 433.742; and
(2) A plan for the use of the grant that meets the requirements of NRS 433.744.
(b) Coordinate with and provide support to regional, local and tribal governmental entities in conducting needs assessments and developing plans pursuant to paragraph (a).
(c) Consider any money recovered or anticipated to be recovered by county, local or tribal governmental agencies through judgments received or settlements entered into as a result of litigation concerning the manufacture, distribution, sale or marketing of opioids.
(d) Conduct annual evaluations of programs to which grants have been awarded.
2. To the extent authorized by the terms of any judgment or settlement described in subsection 1 of NRS 433.732, the recipient of a grant pursuant to paragraph (b) of subsection 2 of NRS 433.738 may use not more than 8 percent of the grant for administrative expenses related to the grant or the projects supported by the grant.
3. The recipient of a grant pursuant to paragraph (b) of subsection 2 of NRS 433.738 shall annually submit to the Department a report concerning the expenditure of the money that was received and the outcomes of the projects on which that money was spent.
4. If a regional, local or tribal governmental entity that receives a grant pursuant to paragraph (b) of subsection 2 of NRS 433.738 later recovers money through a judgment or a settlement resulting from litigation concerning the manufacture, distribution, sale or marketing of opioids:
(a) The regional, local or tribal governmental entity must immediately notify the Department; and
(b) The Department may recover from the governmental entity an amount not to exceed the amount of the grant or the amount of the recovery, whichever is less.
5. A regional, local or tribal governmental entity that receives a grant pursuant to paragraph (b) of subsection 2 of NRS 433.738 shall conduct a new needs assessment and update its plan for the use of the grant at intervals prescribed by regulation of the Department, which must be not less than every 4 years.
(Added to NRS by 2021, 2850)
NRS 433.742 Requirements and procedure for regional, county, local or tribal needs assessment.
1. A needs assessment conducted pursuant to subparagraph (1) of paragraph (a) of subsection 1 of NRS 433.740 by a regional, local or tribal governmental entity applying for a grant must:
(a) Be evidence-based.
(b) Include an analysis of the impacts of opioid use and opioid use disorder on the area under the jurisdiction of the applicant that uses quantitative and qualitative data to determine the risk factors that contribute to opioid use, the use of substances and the rates of opioid use disorder, other substance use disorders and co-occurring disorders among residents of the area.
(c) Focus on health equity and identifying disparities across all racial and ethnic populations, geographic regions and special populations in the area under the jurisdiction of the applicant.
(d) Take into account the resources of the applicant and the programs currently existing in the area under the jurisdiction of the applicant to address opioid use disorder and other substance use disorders.
(e) Based on the information and analyses described in paragraphs (a) to (d), inclusive, establish priorities for the use of the funds for which the applicant is applying.
2. When conducting a needs assessment, a regional, local or tribal governmental entity applying for a grant shall:
(a) Use community-based participatory research methods or similar methods to conduct outreach to groups impacted by the use of opioids, opioid use disorder and other substance use disorders, including, without limitation:
(1) Persons and families impacted by the use of opioids and other substances;
(2) Providers of treatment for opioid use disorder and other substance use disorders;
(3) Substance use disorder prevention coalitions;
(4) Communities of persons in recovery from opioid use disorder and other substance use disorders;
(5) Providers of services to reduce the harms caused by opioid use disorder and other substance use disorders;
(6) Persons involved in the child welfare system;
(7) Providers of social services;
(8) Faith-based organizations;
(9) Providers of health care and entities that provide health care services; and
(10) Members of diverse communities disproportionately impacted by opioid use and opioid use disorder; and
(b) Conduct outreach to governmental agencies that interact with persons or groups impacted by the use of opioids, opioid use disorder and other substance use disorders, including, without limitation:
(1) Courts, juvenile justice agencies and other governmental agencies involved in law enforcement or criminal justice;
(2) Agencies which provide child welfare services and other governmental agencies involved in the child welfare system; and
(3) Public health agencies.
(Added to NRS by 2021, 2851)
NRS 433.744 Requirements for regional, county, local or tribal plan for use of grant; authorized uses of grant money.
1. A plan for the use of grant money by a state, local or tribal governmental entity developed pursuant to subparagraph (2) of paragraph (a) of subsection 1 of NRS 433.740 must:
(a) Establish policies and procedures for the administration and distribution of the grant money for which the governmental entity is applying;
(b) Describe the projects to which the governmental entity is proposing to allocate grant money; and
(c) Establish requirements governing the use of the grant money.
2. A plan for the use of grant money by a state, local or tribal governmental entity may allocate money pursuant to paragraph (b) of subsection 1 to:
(a) Projects and programs to:
(1) Expand access to evidence-based prevention of substance use disorders, early intervention for persons at risk of a substance use disorder, treatment for substance use disorders and support for persons in recovery from substance use disorders;
(2) Reduce the incidence and severity of neonatal abstinence syndrome;
(3) Prevent incidents of adverse childhood experiences and increase early intervention for children who have undergone adverse childhood experiences and the families of such children;
(4) Reduce the harm caused by substance use;
(5) Prevent and treat infectious diseases in persons with substance use disorders;
(6) Provide services for children and other persons in a behavioral health crisis and the families of such persons; and
(7) Provide housing for persons who have or are in recovery from substance use disorders;
(b) Campaigns to educate and increase awareness of the public concerning substance use and substance use disorders;
(c) Programs for persons involved in the criminal justice or juvenile justice system and the families of such persons, including, without limitation, programs that are administered by courts;
(d) Evaluation of existing programs relating to substance use and substance use disorders;
(e) Development of the workforce of providers of services relating to substance use and substance use disorders;
(f) The collection and analysis of data relating to substance use and substance use disorders; and
(g) Capital projects relating to substance use and substance use disorders, including, without limitation, construction, purchasing and remodeling.
3. The projects described in subsection 2 may include, without limitation, projects to maximize expenditures through federal, local and private matching contributions.
(Added to NRS by 2021, 2852)
MISCELLANEOUS PROVISIONS
NRS 433.801 Return of prescription drug to dispensing pharmacy for reissuance or transfer of drug; reissuance or transfer of drug by dispensing pharmacy; regulations.
1. A public or private mental health facility may return a prescription drug that is dispensed to a patient of the facility, but will not be used by that patient, to the dispensing pharmacy for the purpose of reissuing the drug to fill other prescriptions for patients in that facility or for the purpose of transferring the drug to a nonprofit pharmacy designated by the State Board of Pharmacy pursuant to NRS 639.2676 if:
(a) The drug is not a controlled substance;
(b) The drug is dispensed in a unit dose, in individually sealed doses or in a bottle that is sealed by the manufacturer of the drug;
(c) The drug is returned unopened and sealed in the original manufacturer’s packaging or bottle;
(d) The usefulness of the drug has not expired;
(e) The packaging or bottle contains the expiration date of the usefulness of the drug; and
(f) The name of the patient for whom the drug was originally prescribed, the prescription number and any other identifying marks are obliterated from the packaging or bottle before the return of the drug.
2. A dispensing pharmacy to which a drug is returned pursuant to this section may:
(a) Reissue the drug to fill other prescriptions for patients in the same facility if the registered pharmacist of the pharmacy determines that the drug is suitable for that purpose in accordance with standards adopted by the State Board of Pharmacy pursuant to subsection 5; or
(b) Transfer the drug to a nonprofit pharmacy designated by the State Board of Pharmacy pursuant to NRS 639.2676.
3. No drug that is returned to a dispensing pharmacy pursuant to this section may be used to fill other prescriptions more than one time.
4. A mental health facility shall adopt written procedures for returning drugs to a dispensing pharmacy pursuant to this section. The procedures must:
(a) Provide appropriate safeguards for ensuring that the drugs are not compromised or illegally diverted during their return.
(b) Require the maintenance and retention of such records relating to the return of such drugs as are required by the State Board of Pharmacy.
(c) Be approved by the State Board of Pharmacy.
5. The State Board of Pharmacy shall adopt such regulations as are necessary to carry out the provisions of this section, including, without limitation, requirements for:
(a) Returning and reissuing such drugs pursuant to the provisions of this section.
(b) Transferring drugs to a nonprofit pharmacy pursuant to the provisions of this section and NRS 639.2676.
(c) Maintaining records relating to the return and the use of such drugs to fill other prescriptions.
(Added to NRS by 2003, 1371; A 2009, 1087)
NRS 433.806 Required considerations before placing person with mental illness or person with developmental disability.
1. Any person or entity, including, without limitation, the Division, that determines the placement of a person with a mental illness or a person with a developmental disability in a mental health facility, medical facility, facility for the dependent or any other placement shall, when making such a determination, consider whether the mental health facility, medical facility, facility for the dependent or other placement is capable of:
(a) Adequately addressing the needs of the person for care and services, including, without limitation, the administration of medication; and
(b) Ensuring the safety of the person in the event of a fire or other emergency.
2. As used in this section:
(a) “Facility for the dependent” has the meaning ascribed to it in NRS 449.0045.
(b) “Medical facility” has the meaning ascribed to it in NRS 449.0151.
(Added to NRS by 2017, 1408; A 2019, 252)