The Legislature
hereby declares that it is the intent of this title:
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 or mental retardation or a
related condition, by any method other than a separate judicial
proceeding resulting in a determination of incompetency, wherein the
civil and legal rights forfeited and the legal disabilities imposed are
specifically stated; and
2. To charge the Division of Mental and Developmental Services,
and the Division of Child and Family Services, of the Department with
recognizing their duty to act in the best interests of their respective
clients by placing them in the least restrictive environment.
(Added to NRS by 1975, 1589; A 1993, 2715; 1999, 97 , 2589 )
DEFINITIONS FOR TITLE 39 OF NRS
As used in this title, 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 )
“Administrative
officer” means a person with overall executive and administrative
responsibility for those state or nonstate mental health or mental
retardation facilities designated by the Administrator.
(Added to NRS by 1975, 1590; A 1979, 811)
“Administrator” means the
Administrator of the Division.
(Added to NRS by 1973, 256; A 1999, 97 )
“Client” means any person who
seeks, on his own or another’s initiative, and can benefit from, care,
treatment and training provided by the Division, or from treatment to
competency provided by the Division.
(Added to NRS by 1975, 1590; A 1997, 3491; 2003, 1941 )
“Commission” means the
Commission on Mental Health and Developmental Services.
(Added to NRS by 1985, 2262; A 1999, 97 )
“Department” means the
Department of Health and Human Services.
(Added to NRS by 1975, 1590)
“Director of
the Department” means the administrative head of the Department.
(Added to NRS by 1975, 1590)
“Division” means the Division of
Mental Health and Developmental Services of the Department.
(Added to NRS by 1969, 1060; A 1973, 1406; 1975, 1590; 1999, 97
)
“Division facility”
means any unit or subunit operated by the Division for the care,
treatment and training of clients.
(Added to NRS by 1973, 256; A 1975, 1590; 1981, 275)
“Medical director” means
the chief medical officer of any division mental health or mental
retardation program.
(Added to NRS by 1973, 1220; A 1975, 1591)—(Substituted in revision
for NRS 433.0105)
“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)—(Substituted
in revision for NRS 433.011)
“Mental illness” means a
clinically significant disorder of thought, mood, perception,
orientation, memory or behavior which:
1. Is listed in the most recent edition of the clinical manual of
the International Classification of Diseases, ICD-9-CM, code range 295 to
302.9, inclusive, 306 to 309.9, inclusive, or 311 to 316, inclusive, or
the corresponding code in the most recent edition of the American
Psychiatric Association’s Diagnostic and Statistical Manual of Mental
Disorders, DSM-IV, Axis I; and
2. 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.
(Added to NRS by 1975, 1591; A 2003, 1941 )
“Mental retardation”
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)
“Mental
retardation center” means an organized program for providing appropriate
services and treatment to mentally retarded persons and persons with
related conditions. A mental retardation center may include facilities
for residential treatment and training.
(Added to NRS by 1975, 1591; A 1999, 2590 )
“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.
(Added to NRS by 1975, 1591; A 1983, 506; 1985, 2044; 1987, 527,
1124, 2133, 2134; 1989, 1550)
“Persons
with related conditions” means persons who have a severe, chronic
disability which:
1. Is attributable to:
(a) Cerebral palsy or epilepsy; or
(b) Any other condition, other than mental illness, found to be
closely related to mental retardation because the condition results in
impairment of general intellectual functioning or adaptive behavior
similar to that of a mentally retarded person and requires treatment or
services similar to those required by a mentally retarded person;
2. Is manifested before the person affected attains the age of 22
years;
3. Is likely to continue indefinitely; and
4. Results in substantial functional limitations in three or more
of the following areas of major life activity:
(a) Taking care of oneself;
(b) Understanding and use of language;
(c) Learning;
(d) Mobility;
(e) Self-direction; and
(f) Capacity for independent living.
(Added to NRS by 1999, 2589 )
“Training” means a program of
services directed primarily toward enhancing the health, welfare and
development of mentally retarded persons and persons with related
conditions through the process of providing those experiences that will
enable the individual to:
1. Develop his physical, intellectual, social and emotional
capacities to the fullest extent;
2. Live in an environment that is conducive to personal dignity;
and
3. Continue development of those skills, habits and attitudes
essential to adaptation in contemporary society.
(Added to NRS by 1975, 1591; A 1999, 2590 )
“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)
“Treatment to
competency” means treatment provided to a person who is a defendant in a
criminal action or proceeding to attempt to cause him to attain
competency to stand trial or receive pronouncement of judgment.
(Added to NRS by 2003, 1941 )
DIVISION OF MENTAL HEALTH AND DEVELOPMENTAL SERVICES
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. The division facilities providing services for mentally
retarded persons and persons with related conditions are designated as:
(a) Desert Regional Center;
(b) Sierra Regional Center; and
(c) Rural Regional Center.
3. 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 )
Personnel of Division
The
provisions of chapters 433 to 436 , 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)
1. The Administrator must:
(a) Have training and demonstrated administrative qualities of
leadership in any one of the professional fields of psychiatry, medicine,
psychology, social work, education or administration.
(b) Be appointed, from a list of three persons nominated by the
Commission, on the basis of merit as measured by administrative training
or experience in programs relating to mental health, including care,
treatment or training, or any combination thereof, of mentally ill and
mentally retarded persons and persons with related conditions.
(c) Have additional qualifications which are in accordance with
criteria prescribed by the Department of Personnel.
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 )
1. The Administrator serves at the pleasure of the Governor 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 shall appoint the administrative personnel
necessary to operate the programs of the Division, including an Associate
Administrator for Mental Retardation. The Commission must approve the
credentials, training and experience of deputy administrators and heads
of enumerated institutions. He shall 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 Governor.
4. The Administrator may accept persons referred to the Division
for treatment pursuant to the provisions of NRS 458.290 to 458.350 ,
inclusive.
(Added to NRS by 1975, 1592; A 1979, 811; 1985, 423, 2264; 1989,
429)
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 from accredited medical schools
and they shall be licensed to practice 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 clients as may be required.
(Added to NRS by 1975, 1592)
Any person employed by the Division as a psychiatrist,
psychologist, marriage and family therapist, registered nurse or social
worker must be licensed or certified by the appropriate state licensing
board for his respective profession.
(Added to NRS by 1985, 2044; A 1987, 527, 1122, 2133, 2134)
Any psychiatrist who is employed by the Division
must be certified by the American Board of Psychiatry and Neurology
within 5 years after his 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)
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)
An administrative
officer, with the approval of the Administrator, may designate an
employee to act as his deputy. In case of the absence or inability of the
administrative officer for any cause to discharge the duties of his
office, those duties devolve upon his deputy.
(Added to NRS by 1975, 1594; A 1979, 812)
1. The Division shall carry out a vocational and educational
program for the certification of mental health-mental retardation
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-mental retardation technician is responsible to
the director of the service in which his 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-mental retardation 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-mental retardation
technician” means an employee of the Division of Mental Health and
Developmental 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 mentally ill, emotionally disturbed or
mentally retarded persons or persons with related conditions, and who has
direct responsibility for:
(a) Administering or carrying out specific therapeutic procedures,
techniques or treatments, excluding medical interventions, to enable
clients 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 clients, 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 clients.
(Added to NRS by 1989, 428; A 1993, 402, 2230; 1995, 805; 1999, 98
, 2591 )
Commission on Mental Health and Developmental Services
The Commission shall:
1. Establish policies to ensure adequate development and
administration of services for the mentally ill and mentally retarded and
persons with related conditions, including services to prevent mental
illness and mental retardation and related conditions, and services
provided without admission to a facility or institution;
2. Set policies for the care and treatment of mentally ill and
mentally retarded persons and persons with related conditions provided by
all state agencies;
3. Review the programs and finances of the Division; and
4. Report at the beginning of each year to the Governor and at the
beginning of each odd-numbered year to the Legislature on the quality of
the care and treatment provided for mentally ill and mentally retarded
persons and persons with related conditions in this state and on any
progress made toward improving the quality of that care and treatment.
(Added to NRS by 1975, 1593; A 1985, 2265; 1999, 2591 )
The Commission may:
1. Collect and disseminate information pertaining to mental health
and mental retardation and related conditions.
2. Request legislation pertaining to mental health and mental
retardation and related conditions.
3. Investigate complaints about the care of any person in a public
facility for the treatment of the mentally ill or mentally retarded and
persons with related conditions.
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 the mentally ill and
mentally retarded and persons with related conditions provided through
state agencies, hospitals and clinics.
6. Promote programs for the treatment of the mentally ill and
mentally retarded and persons with related conditions and participate in
and promote the development of facilities for training persons to provide
services for the mentally ill and mentally retarded and persons with
related conditions.
7. Create a plan to coordinate the services for the treatment of
the mentally ill and the mentally retarded and persons with related
conditions 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 and mental
retardation and related conditions and consider ways to involve the
general public in the decisions concerning the policy on mental illness
and mental retardation and related conditions.
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 the mentally
ill and mentally retarded and persons with related conditions.
11. Evaluate the future needs of this state concerning the
treatment of mental illness and mental retardation and related conditions
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 )
1. The Commission shall adopt regulations:
(a) For the care and treatment of mentally ill and mentally
retarded persons and persons with related conditions by all state
agencies and facilities, and their referral to private facilities;
(b) To ensure continuity in the care and treatment provided to
mentally ill and mentally retarded persons and persons with related
conditions in this state; and
(c) Necessary for the proper and efficient operation of the
facilities of the Division.
2. The Commission may adopt regulations to promote programs
relating to mental health and mental retardation and related conditions.
(Added to NRS by 1975, 1594; A 1985, 368, 2265; 1999, 2592 )
The Commission or its
designated agent may inspect any state facility providing services for
the mentally ill or mentally retarded and persons with related conditions
to determine if the facility is in compliance with the provisions of this
title and any regulations adopted pursuant to those provisions.
(Added to NRS by 1985, 2263; A 1993, 2715; 1999, 2593 )
Every
employee of the Division, and every person employed by the Division of
Child and Family Services of the Department pursuant to NRS 433B.010
to 433B.350 , inclusive, 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
The Division shall adopt regulations to:
1. Provide for a more detailed definition of abuse of a client of
the Division, consistent with the general definition given in NRS 433.554
;
2. Provide for a more detailed definition of neglect of a client
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 client of the Division.
(Added to NRS by 1989, 642)
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-3 and 290ee-3, 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)
The Division may, by contract with general
hospitals or other institutions having adequate facilities in the State
of Nevada, provide for inpatient care of mentally ill and mentally
retarded clients and clients with related conditions.
(Added to NRS by 1975, 1594; A 1999, 2593 )
The Division may
contract with appropriate persons professionally qualified in the field
of psychiatric mental health to provide inpatient and outpatient care for
mentally ill and mentally retarded persons and persons with related
conditions when it appears that they can be treated best in that manner.
(Added to NRS by 1975, 1594; A 1983, 506; 1999, 2593 )
For the purposes of chapters 433
to 436 , 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 render services, the payment for which 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.
(Added to NRS by 1975, 1594; A 1993, 2716)
Nothing in this title precludes the
involuntary court-ordered admission of a mentally ill person to a private
institution where such admission is authorized by law.
(Added to NRS by 1975, 1594)
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 his designee authorizes the expenditure of state
money for such purpose.
(Added to NRS by 1975, 1594; A 1993, 2716)
Finance
Money
to carry out the provisions of chapters 433
to 436 , 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)
For the purposes of this title, 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)
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 who are mentally ill or mentally retarded and persons with
related conditions.
2. The Administrator shall disburse any donations, gifts and
grants received pursuant to this section to programs that provide
services to persons who are mentally ill or mentally retarded and persons
with related conditions 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 who are
mentally ill or mentally retarded and persons with related conditions 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 )
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 436 , 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 and in NRS 435.120 for fees collected for services to mentally
retarded clients and clients with related conditions.
2. For a facility providing services for the treatment of the
mentally ill or mentally retarded and persons with related conditions,
the fee established must approximate the cost of providing the service,
but if a client is unable to pay in full the fee established pursuant to
this section, the Division may collect any amount the client is able to
pay.
(Added to NRS by 1975, 1594; A 1985, 2265; 1993, 2716; 1999, 2593
)
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
is employed.
(Added to NRS by 1975, 1595)
A mental health and mental retardation center revolving
account up to the amount of $5,000 is hereby created for each division
mental health and mental retardation center, and may be used for the
payment of mental health or mental retardation 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 or mental
retardation centers on claims as other claims against the State are paid.
(Added to NRS by 1975, 1595; A 1979, 812; 1983, 395; 1999, 1496
)
CLIENTS
Residence
As used in NRS 433.431 to 433.454 ,
inclusive, unless the context otherwise requires:
1. “Client” means any person who seeks, on his own or another’s
initiative, and can benefit from, care, treatment, treatment to
competency or training in a division facility.
2. “Division facility” means any unit or subunit operated by:
(a) The Division of Mental Health and Developmental Services of the
Department for the care, treatment and training of clients; or
(b) The Division of Child and Family Services of the Department
pursuant to NRS 433B.010 to 433B.350
, inclusive.
(Added to NRS by 1993, 2714; A 1999, 99 ; 2003, 1942 )
For purposes of this
title, 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 he was last employed; or
3. If the domicile of the person cannot be ascertained and he is
not or was not employed, the place where he made his home or headquarters.
(Added to NRS by 1975, 1595)
1. For the purpose of facilitating the return of nonresident
clients to the state in which they have legal residence, the
Administrator may enter into reciprocal agreements, consistent with the
provisions of this title, with the proper boards, commissioners or
officers of other states for the mutual exchange of clients confined in,
admitted or committed to a mental health or mental retardation facility
in one state whose legal residence is in the other, and 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 this title governing admissions to a division facility.
2. 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 client.
(Added to NRS by 1975, 1595)
1. All expenses incurred for the purpose of returning a client to
the state in which he has legal residence shall be paid from the moneys
of the client or by the relatives or other persons responsible for his
care and treatment under his commitment or admission.
2. In the case of indigent clients whose relatives cannot pay the
costs and expenses of returning such clients 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 client was receiving care, treatment or
training, if such client 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)
Clients’ Rights
As used in NRS 433.456 to 433.536 ,
inclusive, unless the context otherwise requires, the words and terms
defined in NRS 433.458 to 433.462
, inclusive, have the meanings ascribed
to them in those sections.
(Added to NRS by 1989, 1755; A 1997, 3491)
“Administrative
officer” means a person with overall executive and administrative
responsibility for a facility that provides services relating to mental
health or mental retardation and related conditions and that is operated
by any public or private entity.
(Added to NRS by 1989, 1755; A 1999, 2594 )
“Client” means any person who
seeks, on his own or others’ initiative, and can benefit from, care,
treatment and training in any facility, or from treatment to competency
in any facility.
(Added to NRS by 1989, 1755; A 2003, 1943 )
“Facility” means any:
1. Unit or subunit operated by the Division of Mental Health and
Developmental Services of the Department for the care, treatment and
training of clients.
2. Unit or subunit operated by the Division of Child and Family
Services of the Department pursuant to NRS 433B.010 to 433B.350 , inclusive.
3. Hospital, clinic or other institution operated by any public or
private entity, for the care, treatment and training of clients.
(Added to NRS by 1989, 1755; A 1993, 2716; 1999, 99 )
“Rights” includes, without
limitation, all rights provided to a client pursuant to NRS 433.456
to 433.536 , inclusive, and any regulations adopted
pursuant thereto.
(Added to NRS by 1997, 3490)
This title does
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 behalf.
(Added to NRS by 1975, 1596)
Each client 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 client by
such additional means as prescribed by regulation:
1. 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 client or for any other financial purpose.
2. The right to receive a copy, on request, of the criteria upon
which the facility makes its decision to admit or discharge a client 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.
3. 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 )
1. Each client 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 client 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 client should be involuntarily committed to the facility; and
(2) Be paid for by the client if the insurance carrier of
the client 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 his rights concerning involuntary
commitment or treatment.
2. If the results of an evaluation conducted by a psychiatrist or
psychologist pursuant to subsection 1 conflicts in any manner with the
results of an evaluation conducted by the facility, the facility may
request and receive a third evaluation of the client to resolve the
conflicting portions of the previous evaluations.
(Added to NRS by 1997, 3490; A 1999, 1040 )
Each client 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
client by such additional means as prescribed by regulation:
1. To wear his own clothing, to keep and use his own personal
possessions, including his toilet articles, unless those articles may be
used to endanger his or others’ lives, and to keep and be allowed to
spend a reasonable sum of his own money for expenses and small purchases.
2. To have access to individual space for storage for his 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
client may be subject to control and safekeeping by the administrative
officer of that facility or his designee, so long as the client’s record
of treatment documents the action.
6. To have reasonable access to an interpreter if the client does
not speak English or is hearing impaired.
7. To designate a person who must be kept informed by the facility
of the client’s medical and mental condition, if the client signs a
release allowing the facility to provide such information to the person.
8. To have access to his 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 client of his 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)
Each
client 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 client 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 client if he is 18 years of age or over or legally
emancipated and competent to give that consent, and from his legal
guardian, if any;
(2) The parent or guardian of a client under 18 years of age
and not legally emancipated; or
(3) The legal guardian of a client 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 client as provided in paragraph (b) may be
withdrawn by the client 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 client who has been injured in an accident 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 client and if the treatment is
immediately entered into the client’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 his transfer from one facility to another, except
that the Administrator of the Division of Mental Health and Developmental
Services of the Department or his designee, or the Administrator of the
Division of Child and Family Services of the Department or his designee,
may order a transfer to be made whenever conditions concerning care,
treatment or training warrant it. If the client in any manner objects to
the transfer, the person ordering it must enter the objection and a
written justification of the transfer in the client’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 )
1. An individualized written plan of mental health or mental
retardation services or plan of services for a related condition must be
developed for each client of each facility. The plan must:
(a) Provide for the least restrictive treatment procedure that may
reasonably be expected to benefit the client; and
(b) Be developed with the input and participation of:
(1) The client, to the extent that he is able to provide
input and participate; and
(2) To the extent that the client is unable to provide input
and participate, the parent or guardian of the client if the client is
under 18 years of age and is not legally emancipated, or the legal
guardian of a client who has been adjudicated mentally incompetent.
2. The plan must be kept current and must be modified, with the
input and participation of the client, the parent or guardian of the
client or the legal guardian of the client, 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 )
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)
1. A client must be:
(a) Permitted to inspect his records; and
(b) Informed of his clinical status and progress at reasonable
intervals of no longer than 3 months in a manner appropriate to his
clinical condition.
2. Unless a psychiatrist has made a specific entry to the contrary
in a client’s records, a client is entitled to obtain a copy of his
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)
1. The attending psychiatrist or physician shall be responsible
for all medication given or administered to a client.
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)
1. A client 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 client 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 client;
(c) The person responsible for the client’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 client 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 client 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 his labor.
4. The administrative officer of the facility may provide for
compensation of a resident when he 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 client pursuant to this
section is exempt from collection or retention as payment for services
rendered by the Division of Mental Health and Developmental Services 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 )
Each client admitted for evaluation, treatment or training to a facility
has the following rights concerning the suspension or violation of his
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 client by such additional means as prescribed by regulation:
1. To receive a list of his rights.
2. To receive a copy of the policy of the facility that sets forth
the clinical or medical circumstances under which his rights may be
suspended or violated.
3. To receive a list of the clinically appropriate options
available to the client or his family to remedy an actual or a suspected
suspension or violation of his rights.
4. To have all policies of the facility regarding the rights of
clients prominently posted in the facility.
(Added to NRS by 1997, 3491)
Each facility shall, within a reasonable time
after a client is admitted to the facility for evaluation, treatment or
training, ask the client to sign a document that reflects that he has
received a list of his rights and has had those rights explained to him.
(Added to NRS by 1997, 3491)
1. The rights of a client enumerated in this chapter must not be
denied except to protect the client’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 client’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, he shall cause a full
report to be prepared which must set forth in detail the factual
circumstances surrounding the denial. 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 clients 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 client; or
(b) The care and treatment of a client.
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)
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 Client’s Money and Other Personal Property
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. “Client” means any person who seeks, on his own or another’s
initiative, and can benefit from, care, treatment, treatment to
competency or training in a division facility.
3. “Division facility” means any unit or subunit operated by:
(a) The Division of Mental Health and Developmental Services of the
Department for the care, treatment and training of clients; or
(b) The Division of Child and Family Services of the Department
pursuant to NRS 433B.010 to 433B.350
, inclusive.
(Added to NRS by 1993, 2714; A 1999, 101 ; 2003, 1943 )
1. There may be maintained as a trust fund at each division
facility a clients’ personal deposit fund.
2. Money coming into the possession of the administrative officer
of a division facility which belongs to a client must be credited in the
fund in the name of that client.
3. When practicable, individual credits in the fund must not
exceed the sum of $300.
4. Any amounts to the credit of a client may be used for
purchasing personal necessities, for expenses of burial or may be turned
over to the client upon his demand, except that when the client is
adjudicated mentally incompetent the guardian of his estate has the right
to demand and receive the money.
5. An amount accepted for the benefit of a client for a special
purpose must be reserved for that purpose regardless of the total amount
to the credit of the client.
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 or savings and loan association within this state
that is federally insured or insured by a private insurer approved
pursuant to NRS 678.755 . 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
clients’ personal deposit fund to enable clients to withdraw small sums
from their accounts.
(Added to NRS by 1979, 252; A 1979, 1894; 1983, 395; 1999, 1497
)
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 him 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
the public administrator of the county from which the client was admitted.
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)
If a person admitted to a division facility is
discharged or leaves and he 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 client or his legal
representative in writing that personal property remains in the custody
of the facility. The property must be held in safekeeping for the client
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 his legal representative, another notice must be
sent to the person or his 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)
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
1. Upon the death of a client, any known relatives or friends of
the client shall be notified immediately of the fact of death.
2. The Administrator or his designee shall cause a decent burial
to be provided for the client outside division facility grounds. The
Administrator or his designee may enter into a contract with any person
or persons, including governmental agencies or other instrumentalities,
as he 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 client 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)
USE OF RESTRAINTS AND INTERVENTIONS
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 )
“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 he exhibited
a behavior that is related to his disability;
(b) Exercise is harmful to the health of the person because of his
disability; or
(c) Nature of the person’s disability prevents him from engaging in
the exercise;
8. Any intervention, technique or procedure that deprives a person
of the use of one or more of his 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 )
“Chemical restraint”
means the administration of drugs for the specific and exclusive purpose
of controlling an acute or episodic aggressive behavior when alternative
intervention techniques have failed to limit or control the behavior. The
term does not include the administration of drugs on a regular basis, as
prescribed by a physician, to treat the symptoms of mental, physical,
emotional or behavioral disorders and for assisting a person in gaining
self-control over his impulses.
(Added to NRS by 1999, 3230 )
“Corporal punishment”
means the intentional infliction of physical pain, including, without
limitation, hitting, pinching or striking.
(Added to NRS by 1999, 3230 )
“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 )
“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 )
“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 )
“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 )
“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 )
“Verbal and mental
abuse” means verbal intimidation or coercion of a person without a
redeeming purpose.
(Added to NRS by 1999, 3230 )
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 client.
(Added to NRS by 1999, 3230 )
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
client 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 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 client.
2. Except as otherwise provided in NRS 433.5496 and 433.5499 , use mechanical restraint on a person with a
disability who is a client.
3. Except as otherwise provided in NRS 433.5503 , use chemical restraint on a person with a
disability who is a client.
(Added to NRS by 1999, 3231 ; A 2001, 2744 )
1. Except as otherwise provided in subsection 2, physical
restraint may be used on a person with a disability who is a client 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 client so that the client is no
longer an immediate threat of causing physical injury to himself 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 client and the provisions of subsection 1 do not apply if the
physical restraint is used to:
(a) Assist the client in completing a task or response if the
client does not resist the application of physical restraint or if his
resistance is minimal in intensity and duration;
(b) Escort or carry a client to safety if the client is in danger
in his present location; or
(c) Conduct medical examinations or treatments on the client that
are necessary.
3. If physical restraint is used on a person with a disability who
is a client in an emergency, the use of the procedure must be reported as
a denial of rights pursuant to NRS 433.534 , 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 )
1. Except as otherwise provided in subsections 2 and 4, mechanical
restraint may be used on a person with a disability who is a client 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 client’s treating physician before the application of
the mechanical restraint or not later than 15 minutes after the
application of the mechanical restraint;
(c) The physician who signed the order required pursuant to
paragraph (b) or the attending physician examines the client 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 client is given the opportunity to move and exercise the
parts of his 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 client will stop
or control his inappropriate behavior without the use of the restraint;
(g) The record of the client contains a notation that includes the
time of day that the restraint was lessened or discontinued pursuant to
paragraph (f), the response of the client 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
client during the time that mechanical restraint is used on the client;
and
(i) The mechanical restraint is used only for the period that is
necessary to contain the behavior of the client so that the client is no
longer an immediate threat of causing physical injury to himself or
others or causing severe property damage.
2. Mechanical restraint may be used on a person with a disability
who is a client and the provisions of subsection 1 do not apply if the
mechanical restraint is used to:
(a) Treat the medical needs of a client;
(b) Protect a client who is known to be at risk of injury to
himself because he lacks coordination or suffers from frequent loss of
consciousness;
(c) Provide proper body alignment to a client; or
(d) Position a client who has physical disabilities in a manner
prescribed in the client’s plan of services.
3. If mechanical restraint is used on a person with a disability
who is a client in an emergency, the use of the procedure must be
reported as a denial of rights pursuant to NRS 433.534 , 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 )
1. Except as otherwise provided in subsection 3, mechanical
restraint may be used on a person with a disability who is a client of a
forensic facility only if:
(a) An emergency exists that necessitates the use of the mechanical
restraint;
(b) The client’s behavior presents an imminent threat of causing
physical injury to himself or to others or causing severe property damage
and less restrictive measures have failed to modify the client’s behavior;
(c) The client 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 client 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
client during the time that mechanical restraint is used on the client;
(c) The record of the client 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 client 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 client;
(b) Protect a client who is known to be at risk of injury to
himself because he lacks coordination or suffers from frequent loss of
consciousness;
(c) Provide proper body alignment to a client; or
(d) Position a client who has physical disabilities in a manner
prescribed in the client’s plan of services.
4. If mechanical restraint is used in an emergency on a person
with a disability who is a client of a forensic facility, the use of the
procedure must be reported as a denial of rights pursuant to NRS 433.534
, 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 mentally disordered offenders and defendants
who are ordered to the facility pursuant to chapter 178 of NRS.
(Added to NRS by 2001, 2743 )
1. Chemical restraint may only be used on a person with a
disability who is a client if:
(a) The client has been diagnosed as mentally ill, as defined in
NRS 433A.115 , and is receiving mental
health services from a facility;
(b) The chemical restraint is administered to the client while he
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 client’s attending physician or psychiatrist;
(e) The physician or psychiatrist who signed the order required
pursuant to paragraph (d) examines the client 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 client, the use of the procedure must be reported as a denial of
rights pursuant to NRS 433.534 ,
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 )
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 clients
to promote adaptive behavior and reduce the occurrence of inappropriate
behavior;
(b) Includes methods to teach skills to clients so that clients can
replace inappropriate behavior with adaptive behavior;
(c) Includes methods to enhance a client’s independence and quality
of life;
(d) Includes the use of the least intrusive methods to respond to
and reinforce the behavior of clients; and
(e) Offers a process for designing interventions based upon the
client that are focused on promoting appropriate changes in behavior as
well as enhancing the overall quality of life for the client.
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 )
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 his 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 his 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 his
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
1. An employee of a public or private mental health facility or
any other person, except a client, who:
(a) Has reason to believe that a client 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 clients 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 clients, unless in accordance with a
lawfully issued prescription;
(d) Enters into any transaction with a client involving the
transfer of money or property for personal use or gain at the expense of
the client; or
(e) Contrives the escape, elopement or absence of a client,
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 client, who willfully abuses or neglects a client:
(a) For a first violation that does not result in substantial
bodily harm to the client, is guilty of a gross misdemeanor.
(b) For a first violation that results in substantial bodily harm
to the client, 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 he is an officer or employee of the State, he
forfeits his 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 client, including, but not limited to:
(1) The rape, sexual assault or sexual exploitation of the
client;
(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) “Client” includes any person who seeks, on his 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 client of the Division of Child and Family Services of the
Department.
(c) “Neglect” means any omission to act which causes injury to a
client or which places the client at risk of injury, including, but not
limited to, the failure to follow:
(1) An appropriate plan of treatment to which the client has
consented; and
(2) The policies of the facility for the care and treatment
of clients.
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 )
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)
MISCELLANEOUS PROVISIONS
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 if:
(a) The drug is not a schedule II drug specified in or pursuant to
chapter 453 of NRS;
(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 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.
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) Maintaining records relating to the return and the use of such
drugs to fill other prescriptions.
(Added to NRS by 2003, 1371 )
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