As used in this chapter, unless the
context otherwise requires, the words and terms defined in NRS 441A.020
to 441A.115 , inclusive, have the meanings ascribed to
them in those sections.
(Added to NRS by 1989, 294; A 2003, 2206 )
“Board” means the State Board of
Health.
(Added to NRS by 1989, 294)
“Child care facility”
has the meaning ascribed to it in NRS 432A.024 .
(Added to NRS by 1989, 294; A 1991, 2310)
“Communicable
disease” means a disease which is caused by a specific infectious agent
or its toxic products, and which can be transmitted, either directly or
indirectly, from a reservoir of infectious agents to a susceptible host
organism.
(Added to NRS by 1989, 294)
“Health authority” means
the district health officer in a district, or his designee, or, if none,
the State Health Officer, or his designee.
(Added to NRS by 1989, 294)
“Health Division” means
the Health Division of the Department of Health and Human Services.
(Added to NRS by 1989, 294)
“Isolation” means the physical
separation and confinement of a person or a group of persons infected or
reasonably believed by a health authority to be infected with a
communicable disease from persons who are not infected with and have not
been exposed to the communicable disease, to limit the transmission of
the communicable disease to persons who are not infected with and have
not been exposed to the communicable disease.
(Added to NRS by 2003, 2196 )
“Laboratory director”
has the meaning ascribed to it in NRS 652.050 .
(Added to NRS by 1989, 294)
“Medical facility” has
the meaning ascribed to it in NRS 449.0151 .
(Added to NRS by 1989, 294)
“Medical laboratory”
has the meaning ascribed to it in NRS 652.060 .
(Added to NRS by 1989, 294)
“Physician” is limited to a
person licensed to practice medicine pursuant to chapter 630 or 633 of NRS.
(Added to NRS by 1989, 294)
“Provider of
health care” means a physician, nurse, physician assistant or
veterinarian licensed in accordance with state law.
(Added to NRS by 1989, 294; A 2001, 781 )
“Quarantine” means the
physical separation and confinement of a person or a group of persons
exposed to or reasonably believed by a health authority to have been
exposed to a communicable disease who do not yet show any signs or
symptoms of being infected with the communicable disease from persons who
are not infected with and have not been exposed to the communicable
disease, to limit the transmission of the communicable disease to persons
who are not infected with and have not been exposed to the communicable
disease.
(Added to NRS by 2003, 2196 )
The Board
shall adopt regulations governing the control of communicable diseases in
this State, including regulations specifically relating to the control of
such diseases in educational, medical and correctional institutions. The
regulations must specify:
1. The diseases which are known to be communicable.
2. The communicable diseases which are known to be sexually
transmitted.
3. The procedures for investigating and reporting cases or
suspected cases of communicable diseases, including the time within which
these actions must be taken.
4. For each communicable disease, the procedures for testing,
treating, isolating and quarantining a person or group of persons who
have been exposed to or have or are suspected of having the disease.
5. A method for ensuring that any testing, treatment, isolation or
quarantine of a person or a group of persons pursuant to this chapter is
carried out in the least restrictive manner or environment that is
appropriate and acceptable under current medical and public health
practices.
(Added to NRS by 1989, 294; A 2003, 2206 )
1. The Board shall develop a system which provides for syndromic
reporting and active surveillance to monitor public health in this state
during major events or when determined appropriate and necessary by a
health authority.
2. The Board shall adopt regulations concerning the system it
develops pursuant to this section, including, without limitation:
(a) The manner in which and situations during which the system
actively gathers information;
(b) The persons who are required to report information to the
system; and
(c) The procedures for reporting required information to the system.
(Added to NRS by 2003, 2205 )
The State Health Officer shall inform
each local health officer of the regulations adopted by the Board and the
procedures established for investigating and reporting cases or suspected
cases of communicable diseases.
(Added to NRS by 1989, 295)
The Health Division may receive any financial aid made
available by any grant or other source and shall use the aid, in
cooperation with the health authority, to carry out the provisions of
this chapter.
(Added to NRS by 1989, 299)
1. A provider of health care who knows of, or provides services
to, a person who has or is suspected of having a communicable disease
shall report that fact to the health authority in the manner prescribed
by the regulations of the Board. If no provider of health care is
providing services, each person having knowledge that another person has
a communicable disease shall report that fact to the health authority in
the manner prescribed by the regulations of the Board.
2. A medical facility in which more than one provider of health
care may know of, or provide services to, a person who has or is
suspected of having a communicable disease shall establish administrative
procedures to ensure that the health authority is notified.
3. A laboratory director shall, in the manner prescribed by the
Board, notify the health authority of the identification by his medical
laboratory of the presence of any communicable disease in the
jurisdiction of that health authority. The health authority shall not
presume a diagnosis of a communicable disease on the basis of the
notification received from the laboratory director.
4. If more than one medical laboratory is involved in testing a
specimen, the laboratory that is responsible for reporting the results of
the testing directly to the provider of health care for the patient shall
also be responsible for reporting to the health authority.
(Added to NRS by 1989, 295)
1. A health authority who knows, suspects or is informed of the
existence within his jurisdiction of any communicable disease shall
immediately investigate the matter and all circumstances connected with
it, and shall take such measures for the prevention, suppression and
control of the disease as are required by the regulations of the Board or
a local board of health.
2. A health authority may:
(a) Enter private property at reasonable hours to investigate any
case or suspected case of a communicable disease.
(b) Order any person whom he reasonably suspects has a communicable
disease in an infectious state to submit to any medical examination or
test which he believes is necessary to verify the presence of the
disease. The order must be in writing and specify the name of the person
to be examined and the time and place of the examination and testing, and
may include such terms and conditions as the health authority believes
are necessary to protect the public health.
(c) Except as otherwise provided in subsection 5 and NRS 441A.210
, issue an order requiring the
isolation, quarantine or treatment of any person or group of persons if
he believes that such action is necessary to protect the public health.
The order must be in writing and specify the person or group of persons
to be isolated or quarantined, the time during which the order is
effective, the place of isolation or quarantine and other terms and
conditions which the health authority believes are necessary to protect
the public health, except that no isolation or quarantine may take place
if the health authority determines that such action may endanger the life
of a person who is isolated or quarantined.
3. Each order issued pursuant to this section must be served upon
each person named in the order by delivering a copy to him.
4. If a health authority issues an order to isolate or quarantine
a person with a communicable or infectious disease in a medical facility,
the health authority must isolate or quarantine the person in the manner
set forth in NRS 441A.500 to 441A.720
, inclusive.
5. Except as otherwise provided in NRS 441A.310 and 441A.380 , a health authority may not issue an order
requiring the involuntary treatment of a person without a court order
requiring the person to submit to treatment.
(Added to NRS by 1989, 295; A 2003, 2206 )
Each health
authority shall report each week to the State Health Officer the number
and types of cases or suspected cases of communicable disease reported to
him, and any other information required by the regulations of the Board.
(Added to NRS by 1989, 299)
1. A person who has a communicable disease in an infectious state
shall not conduct himself in any manner likely to expose others to the
disease or engage in any occupation in which it is likely that the
disease will be transmitted to others.
2. A health authority who has reason to believe that a person is
in violation of subsection 1 shall issue a warning to him, in writing,
informing him of the behavior which constitutes the violation and of the
precautions that he must take to avoid exposing others to the disease.
The warning must be served upon the person by delivering a copy to him.
3. A person who violates the provisions of subsection 1 after
service upon him of a warning from a health authority is guilty of a
misdemeanor.
(Added to NRS by 1989, 296)
1. Except as otherwise provided in this subsection, a health
authority who knows of the presence of a communicable disease within a
school, child care facility, medical facility or correctional facility
shall notify the principal, director or other person in charge of the
school, child care facility, medical facility or correctional facility of
that fact and direct what action, if any, must be taken to prevent the
spread of the disease. A health authority who knows of the presence of
the human immunodeficiency virus within a school shall notify the
superintendent of the school district of that fact and direct what
action, if any, must be taken to prevent the spread of the virus.
2. Except as otherwise provided in this subsection, the principal,
director or other person in charge of a school, child care facility,
medical facility or correctional facility who knows of or suspects the
presence of a communicable disease within the school, child care
facility, medical facility or correctional facility, shall notify the
health authority pursuant to the regulations of the Board. If a principal
of a school knows of the presence of the human immunodeficiency virus
within the school, he shall notify the superintendent of the school
district of that fact. A superintendent of a school district who is
notified of or knows of the presence of the human immunodeficiency virus
within a school in the school district shall notify the health authority
of that fact. The health authority shall investigate a report received
pursuant to this subsection to determine whether a communicable disease
or the human immunodeficiency virus is present and direct what action, if
any, must be taken to prevent the spread of the disease or virus.
3. A parent, guardian or person having custody of a child who has
a communicable disease shall not knowingly permit the child to attend
school or a child care facility if the Board, by regulation, has
determined that the disease requires exclusion from school or a child
care facility.
(Added to NRS by 1989, 296; A 1991, 1340)
1. A law enforcement officer, correctional officer, emergency
medical attendant, firefighter or any other person who is employed by an
agency of criminal justice who may have been exposed to a contagious
disease while performing his official duties, or the employer of such a
person, may petition a court for an order requiring the testing of a
person for exposure to the human immunodeficiency virus and the hepatitis
B surface antigen if the person may have exposed the officer, medical
attendant, firefighter or other person employed by an agency of criminal
justice to a contagious disease.
2. When possible, before filing a petition pursuant to subsection
1, the person or employer petitioning shall submit information concerning
the possible exposure to a contagious disease to the designated health
care officer for the employer, or if there is no designated health care
officer, the person designated by the employer to document and verify
possible exposure to contagious diseases, for verification that there was
substantial exposure. Each designated health care officer or person
designated by an employer to document and verify possible exposure to
contagious diseases shall establish guidelines based on current
scientific information to determine substantial exposure.
3. A court shall promptly hear a petition filed pursuant to
subsection 1 and determine whether there is probable cause to believe
that a possible transfer of blood or other bodily fluids occurred between
the person who filed the petition or on whose behalf the petition was
filed and the person who possibly exposed him to a contagious disease. If
the court determines that probable cause exists to believe that a
possible transfer of blood or other bodily fluids occurred, the court
shall order the person who possibly exposed the petitioner to a
contagious disease to submit two specimens of blood to a local hospital
or medical laboratory for testing for exposure to the human
immunodeficiency virus and the hepatitis B surface antigen. The local
hospital or medical laboratory shall perform the test in accordance with
generally accepted medical practices and shall disclose the results of
the test in the manner set forth in NRS 629.069 .
4. The employer of a person who files a petition or on whose
behalf a petition is filed pursuant to this section or the insurer of the
employer shall pay the cost of performing the test pursuant to subsection
3.
5. As used in this section:
(a) “Agency of criminal justice” has the meaning ascribed to it in
NRS 179A.030 .
(b) “Emergency medical attendant” means a person licensed as an
attendant or certified as an emergency medical technician, intermediate
emergency medical technician or advanced emergency medical technician
pursuant to chapter 450B of NRS.
(Added to NRS by 1999, 1122 ; A 2005, 328 )
This chapter does
not empower or authorize the health authority or any other person to
interfere in any manner with the right of a person to receive approved
treatment for a communicable disease from any physician, clinic or other
person of his choice, but the Board has the power to prescribe the
approved method of treatment to be used by the physician, clinic or other
person.
(Added to NRS by 1989, 298)
A person who has a communicable disease and
depends exclusively on prayer for healing in accordance with the tenets
and precepts of any recognized religious sect, denomination or
organization is not required to submit to any medical treatment required
by the provisions of this chapter, but may be isolated or quarantined in
his home or other place of his choice acceptable to the health authority,
and shall comply with all applicable rules, regulations and orders issued
by the health authority.
(Added to NRS by 1989, 298)
All information of a personal nature about any person
provided by any other person reporting a case or suspected case of a
communicable disease, or by any person who has a communicable disease, or
as determined by investigation of the health authority, is confidential
medical information and must not be disclosed to any person under any
circumstances, including pursuant to any subpoena, search warrant or
discovery proceeding, except as follows:
1. For statistical purposes, provided that the identity of the
person is not discernible from the information disclosed.
2. In a prosecution for a violation of this chapter.
3. In a proceeding for an injunction brought pursuant to this
chapter.
4. In reporting the actual or suspected abuse or neglect of a
child or elderly person.
5. To any person who has a medical need to know the information
for his own protection or for the well-being of a patient or dependent
person, as determined by the health authority in accordance with
regulations of the Board.
6. If the person who is the subject of the information consents in
writing to the disclosure.
7. Pursuant to subsection 2 of NRS 441A.320 or NRS 629.069 .
8. If the disclosure is made to the Department of Health and Human
Services and the person about whom the disclosure is made has been
diagnosed as having acquired immunodeficiency syndrome or an illness
related to the human immunodeficiency virus and is a recipient of or an
applicant for Medicaid.
9. To a firefighter, police officer or person providing emergency
medical services if the Board has determined that the information relates
to a communicable disease significantly related to that occupation. The
information must be disclosed in the manner prescribed by the Board.
10. If the disclosure is authorized or required by specific
statute.
(Added to NRS by 1989, 299; A 1989, 1476; 1997, 1254; 1999, 1123
, 2238 , 2245 ; 2005, 329 )
Except as otherwise provided in this chapter, a person shall
not make public the name of, or other personal identifying information
about, a person infected with a communicable disease who has been
investigated by the health authority pursuant to this chapter, without
the consent of the person.
(Added to NRS by 1989, 300)
SEXUALLY TRANSMITTED DISEASES
1. The Health Division shall control, prevent, treat and, whenever
possible, ensure the cure of sexually transmitted diseases.
2. The Health Division shall provide the materials and curriculum
necessary to conduct the educational program provided for in NRS 209.385
and establish a program for the
certification of persons qualified to provide instruction for the program.
(Added to NRS by 1989, 296; A 1989, 1476)
The Health Division may establish and provide financial or
other support to such clinics and dispensaries as it believes are
reasonably necessary for the prevention, control, treatment or cure of
sexually transmitted diseases.
(Added to NRS by 1989, 296)
If a person in this state who has a
sexually transmitted disease is, in the discretion of the Health
Division, unable to afford approved treatment for the disease, the Health
Division may provide medical supplies or direct financial aid to any
physician, clinic or dispensary in this state, within the limits of the
available appropriations and any other resources, to be used in his
treatment. A physician, clinic or dispensary that accepts supplies or aid
pursuant to this section shall comply with all conditions prescribed by
the Board relating to the use of the supplies or aid.
(Added to NRS by 1989, 296)
A physician, clinic or dispensary providing treatment to a
person who has a sexually transmitted disease shall instruct him in the
methods of preventing the spread of the disease and in the necessity of
systematic and prolonged treatment.
(Added to NRS by 1989, 296)
A physician who, or clinic or dispensary which,
determines that a person has a sexually transmitted disease shall
encourage and, if necessary, attempt to persuade him to submit to medical
treatment. Except as otherwise provided in NRS 441A.210 , if the person does not submit to treatment,
or does not complete the prescribed course of treatment, the physician,
clinic or dispensary shall notify the health authority who shall take
action to ensure that the person receives adequate treatment for the
disease.
(Added to NRS by 1989, 297)
A
person who has a sexually transmitted disease shall, upon request, inform
the health authority of the source or possible source of the infection.
(Added to NRS by 1989, 297)
A person who is diagnosed as having
acquired immunodeficiency syndrome who fails to comply with a written
order of a health authority, or who engages in behavior through which the
disease may be spread to others, is, in addition to any other penalty
imposed pursuant to this chapter, subject to confinement by order of a
court of competent jurisdiction.
(Added to NRS by 1989, 297)
Except as otherwise provided in NRS 441A.210 , when any minor is suspected of having or is
found to have a sexually transmitted disease, the health authority may
require the minor to undergo examination and treatment, regardless of
whether the minor or either of his parents consents to the examination
and treatment.
(Added to NRS by 1989, 297)
1. As soon as practicable after:
(a) A person is arrested for the commission of a crime; or
(b) A minor is detained for the commission of an act which, if
committed by a person other than a minor would have constituted a crime,
Ê which the victim or a witness alleges involved the sexual penetration
of the victim’s body, the health authority shall test a specimen obtained
from the arrested person or detained minor for exposure to the human
immunodeficiency virus and any commonly contracted sexually transmitted
disease, regardless of whether he or, if a detained minor, his parent or
guardian consents to providing the specimen. The agency that has custody
of the arrested person or detained minor shall obtain the specimen and
submit it to the health authority for testing. The health authority shall
perform the test in accordance with generally accepted medical practices.
2. The health authority shall disclose the results of all tests
performed pursuant to subsection 1 to:
(a) The victim or to the victim’s parent or guardian if the victim
is a minor; and
(b) The arrested person and, if a minor is detained, to his parent
or guardian.
3. If the health authority determines, from the results of a test
performed pursuant to subsection 1, that a victim of sexual assault may
have been exposed to the human immunodeficiency virus or any commonly
contracted sexually transmitted disease, it shall, at the request of the
victim, provide him with:
(a) An examination for exposure to the human immunodeficiency virus
and any commonly contracted sexually transmitted disease to which the
health authority determines he may have been exposed;
(b) Counseling regarding the human immunodeficiency virus and any
commonly contracted sexually transmitted disease to which the health
authority determines he may have been exposed; and
(c) A referral for health care and other assistance,
Ê as appropriate.
4. If the court in:
(a) A criminal proceeding determines that a person has committed a
crime; or
(b) A proceeding conducted pursuant to title 5 of NRS determines
that a minor has committed an act which, if committed by a person other
than a minor, would have constituted a crime,
Ê involving the sexual penetration of a victim’s body, the court shall,
upon application by the health authority, order that minor or other
person to pay any expenses incurred in carrying out this section with
regard to that minor or other person and that victim.
5. The Board shall adopt regulations identifying, for the purposes
of this section, sexually transmitted diseases which are commonly
contracted.
6. As used in this section:
(a) “Sexual assault” means a violation of NRS 200.366 .
(b) “Sexual penetration” has the meaning ascribed to it in NRS
200.364 .
(Added to NRS by 1989, 297; A 1993, 1208; 2003, 1150 )
The Health Division may establish such dispensaries, pharmacies
or clinics for outpatient care as it believes are necessary for the care
and treatment of persons who have acquired immune deficiency syndrome or
a human immunodeficiency virus related disease, and provide those
institutions with financial or other assistance. Dispensaries, pharmacies
or clinics which accept financial or other assistance pursuant to this
section shall comply with all conditions prescribed by the Board relating
to the use of that assistance.
(Added to NRS by 1989, 297)
TUBERCULOSIS
The Health Division shall
control, prevent the spread of, and ensure the treatment and cure of
tuberculosis.
(Added to NRS by 1989, 297)
The Health
Division may establish such clinics as it believes are necessary for the
prevention and control of, and for the treatment and cure of, persons who
have tuberculosis and provide those clinics with financial or other
assistance within the limits of the available appropriations and any
other resources.
(Added to NRS by 1989, 297)
If a person in this state who has
tuberculosis is, in the discretion of the Health Division, unable to
afford approved treatment for the disease, the Health Division may
provide medical supplies or direct financial aid, within the limits of
the available appropriations, to be used in his treatment, to any
physician, clinic, dispensary or medical facility. A physician, clinic,
dispensary or medical facility that accepts supplies or aid pursuant to
this section shall comply with all conditions prescribed by the board
relating to the use of the supplies or aid.
(Added to NRS by 1989, 298)
1. The Health Division shall, by contract with hospitals, clinics
or other institutions in the State, provide for the diagnostic
examination of, and inpatient and outpatient care for, persons who have
tuberculosis.
2. If adequate facilities for examination and care are not
available in the State, the Health Division may contract with hospitals,
clinics or other institutions in other states which do have adequate
facilities.
(Added to NRS by 1989, 298)
Except as otherwise provided in
NRS 441A.210 , a person who has
tuberculosis and is confined to a hospital or other institution pursuant
to the provisions of this chapter must be treated for tuberculosis and
any related condition, and may be treated for any other condition which
the Health Division determines is detrimental to his health and the
treatment of which is necessary for the effective control of tuberculosis.
(Added to NRS by 1989, 298)
The Health Division may contract with
any private physician to provide outpatient care in those rural areas of
the State where, in its determination, patients can best be treated in
that manner.
(Added to NRS by 1989, 298)
The Health Division may inspect and must be given access to all
records of every institution and clinic, both public and private, where
patients who have tuberculosis are treated at public expense.
(Added to NRS by 1989, 298)
MISCELLANEOUS DISEASES
The Board shall adopt regulations
governing the control of rabies. The regulations must provide for:
1. The periodic inoculation of animals with approved vaccines.
2. The impoundment of animals suspected of having rabies and the
disposition of those animals upon verification of the presence of the
disease.
3. Procedures for the treatment of persons who have been, or are
suspected of having been, exposed to rabies.
(Added to NRS by 1989, 298)
ISOLATION AND QUARANTINE OF PERSON OR GROUP OF PERSONS
General Provisions
As used in NRS 441A.500
to 441A.720 , inclusive, unless the context otherwise
requires, “health authority” means:
1. The officers and agents of the Health Division;
2. The officers and agents of a health district; or
3. The district health officer in a district, or his designee, or,
if none, the State Health Officer, or his designee.
(Added to NRS by 2003, 2196 )
1. If a health authority isolates, quarantines or treats a person
or group of persons infected with, exposed to, or reasonably believed by
a health authority to have been infected with or exposed to a
communicable disease, the authority must isolate, quarantine or treat the
person or group of persons in the manner set forth in NRS 441A.500 to 441A.720 , inclusive.
2. A health authority shall provide each person whom it isolates
or quarantines pursuant to NRS 441A.500 to 441A.720 , inclusive, with a document informing the
person of his rights. The Board shall adopt regulations:
(a) Setting forth the rights of a person who is isolated or
quarantined that must be included in the document provided pursuant to
this subsection; and
(b) Specifying the time and manner in which the document must be
provided pursuant to this subsection.
(Added to NRS by 2003, 2196 )
1. A person who is isolated or quarantined pursuant to NRS
441A.500 to 441A.720 , inclusive, has the right:
(a) To make a reasonable number of completed telephone calls from
the place where he is isolated or quarantined as soon as reasonably
possible after his isolation or quarantine; and
(b) To possess and use a cellular phone or any other similar means
of communication to make and receive calls in the place where he is
isolated or quarantined.
2. If a person who is isolated or quarantined pursuant to NRS
441A.500 to 441A.720 , inclusive, is unconscious or otherwise
unable to communicate because of mental or physical incapacity, the
health authority that isolated or quarantined the person must notify the
spouse or legal guardian of the person by telephone and certified mail.
If a person described in this subsection is isolated or quarantined in a
medical facility and the health authority did not provide the notice
required by this subsection, the medical facility must provide the
notice. If the case of a person described in this subsection is before a
court and the health authority, and medical facility, if any, did not
provide the notice required by this subsection, the court must provide
the notice.
(Added to NRS by 2003, 2197 )
A person who is isolated or
quarantined pursuant to NRS 441A.500
to 441A.720 , inclusive, has the right
to refuse treatment and may not be required to submit to involuntary
treatment unless a court issues an order requiring the person to submit
to treatment.
(Added to NRS by 2003, 2197 )
Emergency Isolation or Quarantine
1. If a person infected with or exposed to a communicable disease
is voluntarily isolated or quarantined in a public or private medical
facility, the facility shall not change the status of the person to an
emergency isolation or quarantine unless, before the change in status is
made:
(a) The facility provides:
(1) An application to a health authority for an emergency
isolation or quarantine pursuant to NRS 441A.560 ; and
(2) The certificate of a health authority, physician,
licensed physician assistant or registered nurse to a health authority
pursuant to NRS 441A.570 ; or
(b) The facility receives an order for isolation or quarantine
issued by a health authority.
2. A person whose status is changed to an emergency isolation or
quarantine pursuant to subsection 1:
(a) Must not be detained in excess of 48 hours after the change in
status is made, unless within that period a written petition is filed by
a health authority with the clerk of the district court pursuant to NRS
441A.600 ; and
(b) May, immediately after his status is changed, seek an
injunction or other appropriate process in district court challenging his
detention.
3. If the period specified in subsection 2 expires on a day on
which the office of the clerk of the district court is not open, the
written petition must be filed on or before the close of the business day
next following the expiration of that period.
4. Nothing in this section limits the actions that a public or
private medical facility may take to prevent or limit the transmission of
communicable diseases within the medical facility, including, without
limitation, practices for the control of infections.
(Added to NRS by 2003, 2197 )
1. Any person or group of persons alleged to have been infected
with or exposed to a communicable disease may be detained in a public or
private medical facility, a residence or other safe location under
emergency isolation or quarantine for testing, examination, observation
and the provision of or arrangement for the provision of consensual
medical treatment in the manner set forth in NRS 441A.500 to 441A.720 , inclusive, and subject to the provisions of
subsection 2:
(a) Upon application to a health authority pursuant to NRS 441A.560
;
(b) Upon order of a health authority; or
(c) Upon voluntary consent of the person, parent of a minor person
or legal guardian of the person.
2. Except as otherwise provided in subsection 3, 4 or 5, a person
voluntarily or involuntarily isolated or quarantined under subsection 1
must be released within 72 hours, including weekends and holidays, from
the time of his admission to a medical facility or isolation or
quarantine in a residence or other safe location, unless within that
period:
(a) The additional voluntary consent of the person, the parent of a
minor person or a legal guardian of the person is obtained;
(b) A written petition for an involuntary court-ordered isolation
or quarantine is filed with the clerk of the district court pursuant to
NRS 441A.600 , including, without
limitation, the documents required pursuant to NRS 441A.610 ; or
(c) The status of the person is changed to a voluntary isolation or
quarantine.
3. A person who is involuntarily isolated or quarantined under
subsection 1 may, immediately after he is isolated or quarantined, seek
an injunction or other appropriate process in district court challenging
his detention.
4. If the period specified in subsection 2 expires on a day on
which the office of the clerk of the district court is not open, the
written petition must be filed on or before the close of the business day
next following the expiration of that period.
5. During a state of emergency or declaration of disaster
regarding public health proclaimed by the Governor or the Legislature
pursuant to NRS 414.070 , a health
authority may, before the expiration of the period of 72 hours set forth
in subsection 2, petition, with affidavits supporting its request, a
district court for an order finding that a reasonably foreseeable
immediate threat to the health of the public requires the 72-hour period
of time to be extended for no longer than the court deems necessary for
available governmental resources to investigate, file and prosecute the
relevant written petitions for involuntary court-ordered isolation or
quarantine pursuant to NRS 441A.500
to 441A.720 , inclusive.
(Added to NRS by 2003, 2198 )
1. An application to a health authority for an order of emergency
isolation or quarantine of a person or a group of persons alleged to have
been infected with or exposed to a communicable disease may only be made
by another health authority, a physician, a licensed physician assistant,
a registered nurse or a medical facility by submitting the certificate
required by NRS 441A.570 . Within its
jurisdiction, upon application or on its own, subject to the provisions
of NRS 441A.500 to 441A.720 , inclusive, a health authority may:
(a) Pursuant to its own order and without a warrant:
(1) Take a person or group of persons alleged to and
reasonably believed by the health authority to have been infected with or
exposed to a communicable disease into custody in any safe location under
emergency isolation or quarantine for testing, examination, observation
and the provision of or arrangement for the provision of consensual
medical treatment; and
(2) Transport the person or group of persons alleged to and
reasonably believed by the health authority to have been infected with or
exposed to a communicable disease to a public or private medical
facility, a residence or other safe location for that purpose, or arrange
for the person or group of persons to be transported for that purpose by:
(I) A local law enforcement agency;
(II) A system for the nonemergency medical
transportation of persons whose operation is authorized by the
Transportation Services Authority; or
(III) If medically necessary, an ambulance service
that holds a permit issued pursuant to the provisions of chapter 450B
of NRS,
Ê only if the health authority acting in good faith has, based upon
personal observation, its own epidemiological investigation or an
epidemiological investigation by another health authority, a physician, a
licensed physician assistant or a registered nurse as stated in a
certificate submitted pursuant to NRS 441A.570 , if such a certificate was submitted, of the
person or group of persons alleged to have been infected with or exposed
to a communicable disease, a reasonable factual and medical basis to
believe that the person or group of persons has been infected with or
exposed to a communicable disease, and that because of the risks of that
disease, the person or group of persons is likely to be an immediate
threat to the health of members of the public who have not been infected
with or exposed to the communicable disease.
(b) Petition a district court for an emergency order requiring:
(1) Any health authority or peace officer to take a person
or group of persons alleged to have been infected with or exposed to a
communicable disease into custody to allow the health authority to
investigate, file and prosecute a petition for the involuntary
court-ordered isolation or quarantine of the person or group of persons
alleged to have been infected with or exposed to a communicable disease
in the manner set forth in NRS 441A.500 to 441A.720 , inclusive; and
(2) Any agency, system or service described in subparagraph
(2) of paragraph (a) to transport, in accordance with such court order,
the person or group of persons alleged to have been infected with or
exposed to a communicable disease to a public or private medical
facility, a residence or other safe location for that purpose.
2. The district court may issue an emergency order for isolation
or quarantine pursuant to paragraph (b) of subsection 1:
(a) Only for the time deemed necessary by the court to allow a
health authority to investigate, file and prosecute each petition for
involuntary court-ordered isolation or quarantine pursuant to NRS
441A.500 to 441A.720 , inclusive; and
(b) Only if it is satisfied that there is probable cause to believe
that the person or group of persons alleged to have been infected with or
exposed to a communicable disease has been infected with or exposed to a
communicable disease, and that because of the risks of that disease, the
person or group of persons is likely to be an immediate threat to the
health of the public.
(Added to NRS by 2003, 2198 )
A health
authority shall not accept an application for an emergency isolation or
quarantine under NRS 441A.560 unless
that application is accompanied by a certificate of another health
authority or a physician, licensed physician assistant or registered
nurse stating that he has examined the person or group of persons alleged
to have been infected with or exposed to a communicable disease or has
investigated the circumstances of potential infection or exposure
regarding the person or group of persons alleged to have been infected
with or exposed to a communicable disease and that he has concluded that
the person or group of persons has been infected with or exposed to a
communicable disease, and that because of the risks of that disease, the
person or group of persons is likely to be an immediate threat to the
health of the public. The certificate required by this section may be
obtained from a physician, licensed physician assistant or registered
nurse who is employed by the public or private medical facility in which
the person or group of persons is admitted or detained and from the
facility from which the application is made.
(Added to NRS by 2003, 2200 )
1. No application or certificate authorized under NRS 441A.560
or 441A.570 may be considered if made by a person on
behalf of a medical facility or by a health authority, physician,
licensed physician assistant or registered nurse who is related by blood
or marriage to the person alleged to have been infected with or exposed
to a communicable disease, or who is financially interested, in a manner
that would be prohibited pursuant to NRS 439B.425 if the application or certificate were
deemed a referral, in a medical facility in which the person alleged to
have been infected with or exposed to a communicable disease is to be
detained.
2. No application or certificate of any health authority or person
authorized under NRS 441A.560 or
441A.570 may be considered unless it
is based on personal observation, examination or epidemiological
investigation of the person or group of persons alleged to have been
infected with or exposed to a communicable disease made by such health
authority or person not more than 72 hours before the making of the
application or certificate. The certificate must set forth in detail the
facts and reasons on which the health authority or person who submitted
the certificate pursuant to NRS 441A.570 based his opinions and conclusions.
(Added to NRS by 2003, 2200 )
In
addition to any notice required pursuant to NRS 441A.520 , within 24 hours after a person’s
involuntary admission into a public or private medical facility under
emergency isolation or quarantine, the administrative officer of the
public or private medical facility shall reasonably attempt to ascertain
the identification and location of the spouse or legal guardian of that
person and, if reasonably possible, mail notice of the admission by
certified mail to the spouse or legal guardian of that person.
(Added to NRS by 2003, 2200 )
Involuntary Court-Ordered Isolation or Quarantine
A proceeding for an
involuntary court-ordered isolation or quarantine of any person in this
state may be commenced by a health authority filing a petition with the
clerk of the district court of the county where the person is to be
isolated or quarantined. The petition may be pled in the alternative for
both isolation and quarantine, if required by developing or changing
facts, and must be accompanied:
1. By a certificate of a health authority or a physician, a
licensed physician assistant or a registered nurse stating that he has
examined the person alleged to have been infected with or exposed to a
communicable disease or has investigated the circumstances of potential
infection or exposure regarding the person alleged to have been infected
with or exposed to a communicable disease and has concluded that the
person has been infected with or exposed to a communicable disease, and
that because of the risks of that disease, the person is likely to be an
immediate threat to the health of the public; or
2. By a sworn written statement by the health authority that:
(a) The health authority has, based upon its personal observation
of the person alleged to have been infected with or exposed to a
communicable disease, or its epidemiological investigation of the
circumstances of potential infection or exposure regarding the person
alleged to have been infected with or exposed to a communicable disease,
a reasonable factual and medical basis to believe that the person has
been infected with or exposed to a communicable disease and, that because
of the risks of that disease, the person is likely to be an immediate
threat to the health of the public; and
(b) The person alleged to have been infected with or exposed to a
communicable disease has refused to submit to voluntary isolation or
quarantine, examination, testing, or treatment known to control or
resolve the transmission of the communicable disease.
(Added to NRS by 2003, 2200 )
In addition to the requirements of
NRS 441A.600 , a petition filed
pursuant to that section with the clerk of the district court to commence
proceedings for involuntary court-ordered isolation or quarantine of a
person pursuant to NRS 441A.540 or
441A.550 must include a certified
copy of:
1. If an application for an order of emergency isolation or
quarantine of the person was made pursuant to NRS 441A.560 , the application for the emergency isolation
or quarantine of the person made to the petitioning health authority
pursuant to NRS 441A.560 ; and
2. A petition executed by a health authority, including, without
limitation, a sworn statement that:
(a) The health authority or a physician, licensed physician
assistant or registered nurse who submitted a certificate pursuant to NRS
441A.570 , if such a certificate was
submitted, has examined the person alleged to have been infected with or
exposed to a communicable disease;
(b) In the opinion of the health authority, there is a reasonable
degree of certainty that the person alleged to have been infected with or
exposed to a communicable disease is currently capable of transmitting
the disease, or is likely to become capable of transmitting the disease
in the near future;
(c) Based on either the health authority’s personal observation of
the person alleged to have been infected with or exposed to the
communicable disease or the health authority’s epidemiological
investigation of the circumstances of potential infection or exposure
regarding the person alleged to have been infected with or exposed to the
communicable disease, and on other facts set forth in the petition, the
person likely poses an immediate threat to the health of the public; and
(d) In the opinion of the health authority, involuntary isolation
or quarantine of the person alleged to have been infected with or exposed
to a communicable disease to a public or private medical facility,
residence or other safe location is necessary to prevent the person from
immediately threatening the health of the public.
(Added to NRS by 2003, 2201 )
1. Immediately after he receives any petition filed pursuant to
NRS 441A.600 or 441A.610 , the clerk of the district court shall
transmit the petition to the appropriate district judge, who shall set a
time, date and place for its hearing. The date must be within 5 judicial
days after the date on which the petition is received by the clerk.
2. The court shall give notice of the petition and of the time,
date and place of any proceedings thereon to the subject of the petition,
his attorney, if known, the petitioner and the administrative office of
any public or private medical facility in which the subject of the
petition is detained.
3. The provisions of this section do not preclude a health
authority from ordering the release from isolation or quarantine of a
person before the time set pursuant to this section for the hearing
concerning the person, if appropriate.
4. After the filing of a petition pursuant to NRS 441A.600 or 441A.610 and before any court-ordered involuntary
isolation or quarantine, a health authority shall file notice with the
court of any order of the health authority issued after the petition was
filed to release the person from emergency isolation or quarantine, upon
which the court may dismiss the petition without prejudice.
(Added to NRS by 2003, 2202 )
1. After the filing of a petition to commence proceedings for the
involuntary court-ordered isolation or quarantine of a person pursuant to
NRS 441A.600 or 441A.610 , the court shall promptly cause two or more
physicians or licensed physician assistants, at least one of whom must
always be a physician, to either examine the person alleged to have been
infected with or exposed to a communicable disease or assess the
likelihood that the person alleged to have been infected with or exposed
to a communicable disease has been so infected or exposed.
2. To conduct the examination or assessment of a person who is not
being detained at a public or private medical facility, residence or
other safe location under emergency isolation or quarantine pursuant to
the emergency order of a health authority or court made pursuant to NRS
441A.550 or 441A.560 , the court may order a peace officer to take
the person into protective custody and transport him to a public or
private medical facility, residence or other safe location where he may
be detained until a hearing is held upon the petition.
3. If the person is being detained at his home or other place of
residence under an emergency order of a health authority or court
pursuant to NRS 441A.550 or 441A.560
, he may be allowed to remain in his
home or other place of residence pending an ordered assessment,
examination or examinations and to return to his home or other place of
residence upon completion of the assessment, examination or examinations
if such remaining or returning would not constitute an immediate threat
to others residing in his home or place of residence.
4. Each physician and licensed physician assistant who examines or
assesses a person pursuant to subsection 1 shall, not later than 24 hours
before the hearing set pursuant to NRS 441A.620 , submit to the court in writing a summary of
his findings and evaluation regarding the person alleged to have been
infected with or exposed to a communicable disease.
(Added to NRS by 2003, 2202 )
1. The Health Division shall establish such evaluation teams as
are necessary to aid the courts under NRS 441A.630 and 441A.700 .
2. Each team must be composed of at least two physicians, or at
least one physician and one physician assistant.
3. Fees for the evaluations must be established and collected as
set forth in NRS 441A.650 .
(Added to NRS by 2003, 2203 )
1. In counties where the examining personnel required pursuant to
NRS 441A.630 are not available,
proceedings for involuntary court-ordered isolation or quarantine shall
be conducted in the nearest county having such examining personnel
available in order that there be minimum delay.
2. The entire expense of proceedings for involuntary court-ordered
isolation or quarantine shall be paid by the county in which the
application is filed.
(Added to NRS by 2003, 2203 )
1. The person alleged to have been infected with or exposed to a
communicable disease, or any relative or friend on his behalf, is
entitled to retain counsel to represent him in any proceeding before the
district court relating to involuntary court-ordered isolation or
quarantine, and if he fails or refuses to obtain counsel, the court shall
advise him and his guardian or next of kin, if known, of the right to
counsel and shall appoint counsel, who may be the public defender or his
deputy.
2. Any counsel appointed pursuant to subsection 1 must be awarded
compensation by the court for his services in an amount determined by the
court to be fair and reasonable. Except as otherwise provided in this
subsection, the compensation must be charged against the estate of the
person for whom the counsel was appointed or, if the person is indigent,
against the county in which the application for involuntary court-ordered
isolation or quarantine was filed. In any proceeding before the district
court relating to involuntary court-ordered isolation or quarantine, if
the person for whom counsel was appointed is challenging his isolation or
quarantine or any condition of his isolation or quarantine and the person
succeeds in his challenge, the compensation must be charged against the
county in which the application for involuntary court-ordered isolation
or quarantine was filed.
3. The court shall, at the request of counsel representing the
person alleged to have been infected with or exposed to a communicable
disease in proceedings before the court relating to involuntary
court-ordered isolation or quarantine, grant a recess in the proceedings
for the shortest time possible, but for not more than 5 days, to give the
counsel an opportunity to prepare his case.
4. Each district attorney or his deputy shall appear and represent
the State in all involuntary court-ordered isolation or quarantine
proceedings in his county. The district attorney is responsible for the
presentation of evidence, if any, in support of the involuntary
court-ordered isolation or quarantine of a person to a medical facility,
residence or other safe location in proceedings held pursuant to NRS
441A.600 or 441A.610 .
(Added to NRS by 2003, 2203 )
In proceedings for involuntary
court-ordered isolation or quarantine, the court shall hear and consider
all relevant testimony, including, but not limited to, the testimony of
examining personnel who participated in the evaluation of the person
alleged to have been infected with or exposed to a communicable disease
and the certificates, if any, of a health authority or a physician,
licensed physician assistant or registered nurse accompanying the
petition.
(Added to NRS by 2003, 2203 )
1. In proceedings for an involuntary court-ordered isolation or
quarantine, the person with respect to whom the proceedings are held has
the right:
(a) To be present by live telephonic conferencing or
videoconferencing; and
(b) To testify in his own behalf, to the extent that the court
determines he is able to do so without endangering the health of others.
2. A person who is alleged to have been infected with or exposed
to a communicable disease does not have the right to be physically
present during the proceedings if such person, if present in the
courtroom, would likely pose an immediate threat to the health of the
judge or the staff or officers of the court.
(Added to NRS by 2003, 2204 )
Witnesses subpoenaed
under the provisions of NRS 441A.500
to 441A.720 , inclusive, shall be paid
the same fees and mileage as are paid to witnesses in the courts of the
State of Nevada.
(Added to NRS by 2003, 2204 )
1. If the district court finds, after proceedings for the
involuntary court-ordered isolation or quarantine of a person to a public
or private medical facility, residence or other safe location:
(a) That there is not clear and convincing evidence that the person
with respect to whom the hearing was held has been infected with or
exposed to a communicable disease or is likely to be an immediate threat
to the health of the public, the court shall enter its finding to that
effect and the person must not be involuntarily detained in such a
facility, residence or other safe location.
(b) That there is clear and convincing evidence that the person
with respect to whom the hearing was held has been infected with or
exposed to a communicable disease and, because of that disease, is likely
to be an immediate threat to the health of the public, the court may
order the involuntary isolation or quarantine of the person and may order
the most appropriate course of treatment after considering the rights of
the person and the desires of the person concerning treatment and
vaccination, including, without limitation, the tenets of the person’s
religion and the tenets of any group or organization of which the person
is a member, the rights set forth in NRS 441A.210 , the rights set forth in NRS 441A.520 , the right to counsel set forth in NRS
441A.660 , and the right of a person
to challenge his isolation or quarantine or any condition of his
isolation or quarantine. The order of the court must be interlocutory and
must not become final if, within 14 days after the court orders the
involuntary isolation or quarantine, the person is unconditionally
released by a health authority from the medical facility, residence or
other safe location.
2. An involuntary isolation or quarantine pursuant to paragraph
(b) of subsection 1 automatically expires at the end of 30 days if not
terminated previously by a health authority. At the end of the
court-ordered period of isolation or quarantine, the health authority may
petition to renew the detention of the person for additional periods
which each must not exceed the shorter of 120 days or either, if the
person is isolated, the period of time which the health authority expects
the person will be infectious with the communicable disease or, if the
person is quarantined, the period of time which the health authority
determines is necessary to determine whether the person has been infected
with the communicable disease. For each renewal, the petition must set
forth to the court specific reasons why further isolation or quarantine
is appropriate and that the person likely poses an ongoing immediate
threat to the health of the public. If the court finds in considering a
petition for renewal that the person is noncompliant with a court-ordered
measure to control or resolve the risk of transmitting the communicable
disease, it may order the continued isolation and treatment of the person
for any period of time the court deems necessary to resolve the immediate
and ongoing risk of the person transmitting the disease.
3. Before issuing an order for involuntary isolation or quarantine
or a renewal thereof, the court shall explore other alternative courses
of isolation, quarantine and treatment within the least restrictive
appropriate environment as suggested by the evaluation team who evaluated
the person, or other persons professionally qualified in the field of
communicable diseases, which the court believes may be in the best
interests of the person.
(Added to NRS by 2003, 2204 )
The order for
involuntary court isolation or quarantine of any person to a medical
facility, public or private, must be accompanied by a clinical abstract,
including a history of illness, diagnosis and treatment, and the names of
relatives or correspondents.
(Added to NRS by 2003, 2205 )
When any involuntary court isolation
or quarantine is ordered under the provisions of NRS 441A.500 to 441A.720 , inclusive, the involuntarily isolated or
quarantined person, together with the court orders, any certificates of
the health authorities, physicians, licensed physician assistants or
registered nurses, the written summary of the evaluation team and a full
and complete transcript of the notes of the official reporter made at the
examination of such person before the court, must be delivered to the
sheriff of the appropriate county who must be ordered to:
1. Transport the person; or
2. Arrange for the person to be transported by:
(a) A system for the nonemergency medical transportation of persons
whose operation is authorized by the Transportation Services Authority; or
(b) If medically necessary, an ambulance service that holds a
permit issued pursuant to the provisions of chapter 450B of NRS,
Ê to the appropriate public or private medical facility, residence or
other safe location.
(Added to NRS by 2003, 2205 )
ENFORCEMENT
1. A person who refuses to:
(a) Comply with any regulation of the Board relating to the control
of a communicable disease;
(b) Comply with any provision of this chapter;
(c) Submit to approved treatment or examination required or
authorized by this chapter;
(d) Provide any information required by this chapter; or
(e) Perform any duty imposed by this chapter,
Ê may be enjoined by a court of competent jurisdiction.
2. An action for an injunction pursuant to this section must be
prosecuted by the Attorney General, any district attorney or any private
legal counsel retained by a local board of health in the name of and upon
the complaint of the health authority.
3. The court in which an injunction is sought may make any order
reasonably necessary to carry out the purpose or intent of any provision
of this chapter or to compel compliance with any regulation of the Board
or order of the health authority relating to the control of a
communicable disease.
(Added to NRS by 1989, 299)—(Substituted in revision for NRS
441A.420)
Except as
otherwise provided, every person who violates any provision of this
chapter is guilty of a misdemeanor.
(Added to NRS by 1989, 300)—(Substituted in revision for NRS
441A.430)
Every provider of
health care, medical facility or medical laboratory that willfully fails,
neglects or refuses to comply with any regulation of the Board relating
to the reporting of a communicable disease or any requirement of this
chapter is guilty of a misdemeanor and, in addition, may be subject to an
administrative fine of $1,000 for each violation, as determined by the
Board.
(Added to NRS by 1989, 300)—(Substituted in revision for NRS
441A.440)
The
district attorney of the county in which any violation of this chapter
occurs shall prosecute the person responsible for the violation.
(Added to NRS by 1989, 300)—(Substituted in revision for NRS
441A.450)
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