AB 85 — Revises provisions governing mental health. (BDR 39-443)

Chapter 433A of NRS is hereby amended by adding theSec.thereto the provisions set forth as sections 4 and 5 of this act.

4.eSec. pFor the purposes of this chapter, a person shall be.

deemed4. to present a substantial likelihood of serious harm to person is at serious risk of:if, without care or treatment, the 1.

For the purposes of this chapter, a person shall be deemed to present a substantial likelihood of serious harm to himself or herself or others if, without care or treatment, the person is at serious risk of:

1.

and (b) Any other information prescribed by regulation of the State Board of Health.

-information *AB85_R1*prescribed –by 5regulation –of the State 2.

As used in NRS 433A.115 to 433A.330, inclusive, unless the context otherwise requires, “person with] 1.- 80th Session (2019) – 5 – person [whose] :in a mental [illness”] health crisis” means any (a) Who has a mental illness;

“Personand (b) Whose capacity to exercise self-control, judgment and discretion in the conduct of the person’s affairs and social relations or to care for his or her personal needs is diminished, as a result of [a] the mental [illness”]illness, healthto crisis”the meansextent anythat the person [whose]presents :a [clear and present danger] substantial likelihood of serious harm to himself or herself or others, [but] as determined pursuant to section of this act.

(a)2. Who has a mental illness;

andThe (b)term Whosedoes capacitynot toinclude exerciseany self-control,person judgment and discretion in thewhom conductthat ofcapacity theis person’sdiminished affairsby andepilepsy, socialintellectual relationsdisability, ordementia, todelirium, carebrief forperiods hisof orintoxication hercaused personalby needsalcohol isor diminished,drugs, asor adependence resultupon ofor [a]addiction the mental illness, to thealcohol extentor thatdrugs, theunless person presents a [clearmental andillness presentthat danger]can substantialbe likelihooddiagnosed ofis seriousalso harmpresent towhich himselfcontributes or herself or others, [but] as determined pursuant to sectionthe 4diminished capacity of thisthe act.person.

is diminished by epilepsy, intellectual disability, dementia, delirium, brief periods of intoxication caused by alcohol or drugs, or illness that can be diagnosed is also present which contributes to the diminished capacity of the person.

A person presents a clear and present danger of harm to himselfperson orhas, herselfas if,a withinresult theof immediatelya mental illness:y preceding 30 days, the person(a) has,Acted asin a resultmanner from which it may reasonably be inferred that, without the care, supervision or continued assistance of others, the person will be unable to satisfy his or her need for nourishment, personal or medical care, shelter, self-protection or safety, and if there exists a reasonable probability that the person’s death, serious bodily injury or physical debilitation will occur within the next following 30 days unless he or she is admitted to a mental illness:health facility or required to participate in a program of community-based or outpatient services pursuant to the provisions of NRS 433A.115 to 433A.330, inclusive, and adequate treatment is provided to the person;

(a)(b) ActedAttempted in a manner from which it may reasonably be inferred that, without the care, supervision or continuedthreatened assistance of others, the person will be unable to satisfycommit hissuicide or hercommitted needacts forin nourishment,furtherance personalof ora medicalthreat care,to shelter,commit self-protectionsuicide, or safety, and if there exists a reasonable probability that the person’sperson death, serious bodily injury or physical debilitation will occurcommit withinsuicide the next following 30 days unless he or she is admitted to a mental health facility or required to participate in a program of community-based or outpatient services pursuant to the provisions of NRS 433A.115 to 433A.330, inclusive, and adequate treatment is provided to the person;

(b)or Attempted(c) Mutilated himself or herself, attempted or threatened to commitmutilate suicidehimself or herself or committed acts in furtherance of a threat to commitmutilate suicide,himself or herself, and if there exists a - *AB85_R1* – 6 – reasonable probability that thehe personor she will commitmutilate suicidehimself unlessor heherself orunless shethe person is admitted to a mental health facility or required to participate in a program of community-based or outpatient services - 80th Session (2019) – 6 – pursuant to the provisions of NRS 433A.115 to 433A.330, inclusive, and adequate treatment is provided to the person;person.

or (c) Mutilated himself or herself, attempted or threatened to mutilate himself or herself or committed acts in furtherance of a threat to mutilate himself or herself, and if there exists a reasonable probability that he or she will mutilate himself or herself unless the person is admitted to a mental health facility or required to participate in a program of community-based or outpatient services pursuant to the provisions of NRS 433A.115 to 433A.330, inclusive, and adequate treatment is provided to the person.

A person presents a clear and present danger of harm to others if, within the immediately preceding 30 days, the person has, as a result of a mental illness, inflicted or attempted to inflict serious bodily harm on any other person, or made threats to inflict harm andanderious committed acts in furtherance of those threats, and if there exists a reasonable probability that he or she will do so again unless the person is admitted to a mental health facility or required to participate in a program of community-based or outpatient services pursuant to the provisions of NRS 433A.115 to 433A.330, inclusive, and adequate treatment is provided to him or her.] 433A.140Sec. NR1.

Any8. person may apply to:d to read as follows:

(a)NRS A433A.140 publicis orhereby privateamended mental health facility in the State of Nev(b) A division facility to receiveread care, treatment or training provided by the Division,  as afollows: voluntary consumer for the purposes of observation, diagnosis, care and treatment.

433A.140 1.

Any person may apply to:

(a) A public or private mental health facility in the State of Nevada for admission to the facility;

or (b) A division facility to receive care, treatment or training provided by the Division,  as a voluntary consumer for the purposes of observation, diagnosis, care and treatment.

If the application is for admission to a division facility, or for care, treatment or training provided by the Division, the applicant must be admitted or provided such services as a voluntary consumer if an examination by personnel of the facility qualified to make such a determination reveals that the person needs and may benefit from services offered by the mental health facility.facility.may 3.

3.Any person admitted to a public or private mental health facility as a voluntary consumer must be released immediately after the filing of a written request for release with the responsible physician or that physician’s designee within the normal working day, unless [, within 24 hours after the request,] the facility changes the status of the person to an emergency admission pursuant to NRS 433A.145.

Any person admitted to a public or private mental health facility as a voluntary consumer must be released immediately after the filing of a written request for release with the responsible physician or that physician’s designee within the normal working day, unless [, within 24 hours after the request,] the facility changes - *AB85_R1* – 7 – the status of the person to an emergency admission pursuant to NRS 433A.145.

Any person admitted to a public or private mental health facility as a voluntary consumer who has not requested release may nonetheless be released by the medical director of the facility when examining personnel at the facility determine that the consumer has - 80th Session (2019) – 7 – recovered or has improved to such an extent that the consumer is not considered a danger to himself or herself or others and that the services of that facility are no longer beneficial to the consumer or advisable.

5.Division pursuant to this section must be evaluated by the personnel of the Division to determine whether the person is eligible for the services offered by the Division.

A person who requests care, treatment or training from the Division pursuant to this section must be evaluated by the personnel of the Division to determine whether the person is eligible for the services offered by the Division.

This section does not preclude a public facility from making moneydecisions, madepolicies, availableprocedures toand thepractices facility.ractices within the limits of the Sec.money made available to the facility.

Sec.

crisis433A.145 is1. admitted to a public or private mental health facility or hospital as a voluntary consumer, the facility or hospital shall not change the status of the person to an emergency admission unless the hospital or facility receives, before the change in status is made, an application for an emergency admission pursuant to NRS 433A.160 and the certificate of a psychiatrist, psychologist, physician, physician assistant, clinical social worker [,] or advanced practice registered nurse [or accredited agent of the Department] pursuant to NRS 433A.170.

2.If a person [with] in a mental [illness] health crisis is admitted to a public or private mental health facility or hospital as a voluntary consumer, the facility or hospital shall not change the status of the person to an emergency admission unless the hospital or facility receives, before the change in status is made, an application for an emergency admission pursuant to NRS 433A.160 and the certificate of a psychiatrist, psychologist, physician, physician assistant, clinical social worker [,] or advanced practice registered nurse [or accredited agent of the Department] pursuant to NRS 433A.170.

A person whose status is changed pursuant to subsection 1 must not be detained in excess of [48] 72 hours after the change in status is made unless, before the close of the business day on which the [48] 72 hours expires, a written petition is filed with the clerk of the district court pursuant to NRS 433A.200.

- *AB85_R1* – 8 – Sec.

2.- 80th Session (2019) – 8 – detained pursuant to subsection 1 must be released within 72 hours, including weekends and holidays, after the [certificate required pursuant to NRS 433A.170 and the examination required by paragraph (a) of subsection 1 of NRS 433A.165 have been completed, if such an examination is required, or within 72 hours, including weekends and holidays, after the person arrives at the mental health facility or hospital, if an examination is not required by paragraph (a) of subsection 1 of NRS 433A.165,] application for emergency admission or any part of such an application is made pursuant to NRS 433A.160 unless, before the close of the business day on which the 72 hours expires, a written petition for an involuntary court-ordered admission to a mental health facility is filed with the clerk of the district court pursuant to NRS 433A.200, including, without limitation, the documents required pursuant to NRS 433A.210, or the status of the person is changed to a voluntary admission.

Exceptwhich as otherwise provided in subsection 3, a person detained pursuant to subsection 1 must be released within 72 hours, including weekends and holidays, after the [certificateoffice requiredof pursuant to NRS 433A.170 and the examinationclerk required by paragraph (a) of subsection 1 of NRS 433A.165 have been completed, if such an examination is required, or within 72 hours, including weekends and holidays, after the persondistrict arrivescourt at the mental health facility or hospital, if an examination is not requiredopen, by paragraph (a) of subsection 1 of NRS 433A.165,] application for emergency admission or any part of such an application is made pursuant to NRS 433A.160 unless, before the close of the business day on which the 72 hours expires, a written petition formust anbe involuntary court-ordered admission to a mental health facility is filed withon the clerk of the district court pursuant to NRS 433A.200, including, without limitation, the documents required pursuant to NRS 433A.210, or thebefore status of the personclose is changed to a voluntary adm3.sioIf the period specified in subsection 2 expires on a day on which the office of the clerkbusiness of the district court is not open, the day next following the expiration of that period.loseperiod. of the business Sec.

Sec.

(1) Take a person alleged to be a person [with] in a mental [illness] health crisis into custody to apply for the emergencyemergencytal admission of the person for evaluation, observation and treatment;

and - *AB85_R1* – 9 – (2) Transport the person alleged to be a person [with] in a mental [illness] health crisis to a public or private mental health facility or hospital for that purpose, or arrange for the person to be transported by:

- 80th Session (2019) – 9 – (II) A system for the nonemergency medical transportation of persons whose operation is authorized by the Nevada Transportation Authority;

(III) An entity that is exempt pursuant to NRS 706.745 from the provisionsp(IV) ofAn NRSaccredited 706.386agent orof 706.421;the Division;

[or] (IV) An accredited agent of the Division;

(1) Any peace officer to take a person alleged to be a person [with] in a mental [illness] health crisis into custody to allow the applicant for the order to apply for the emergency admission of the person(2) Any agency, system , agent or service described in subparagraph (2) of paragraph (a) to transport the person allegedfor toevaluation, beobservation aand persontreatment; [with] in a mental [illness] health crisis to a public or private mental health facility or hospital for that purpose.

and The(2) districtAny courtagency, maysystem issue, suchagent anor orderservice onlydescribed ifin itsubparagraph is(2) satisfiedof thatparagraph there(a) is probable cause to believetransport that the person [hasalleged ato mentalbe illnessa and,person because[with] ofin thata illness,mental is[illness] likelyhealth crisis to harma himselfpublic or herselfprivate ormental othershealth iffacility allowed his or herhospital liberty.]for isthat apurpose. person in a mental health crisis.

 The district court may issue such an order only if it is satisfied illness and, because of that illness, is likely to harm himself ortal herself or others if allowed his or her liberty.] is a person in a mental health crisis.

- *AB85_R1* – 10 – 3.

The application for the emergency admission of a person alleged to be a person [with] in a mental [illness] health crisis for evaluation, observation and treatment must reveal the circumstances - 80th Session (2019) – 10 – under which the person was taken into custody and the reasons therefor.

Except as otherwise provided in this subsection, each person admitted to a public or private mental health facility or hospital under an emergency admission must be evaluated at the time of admission by a psychiatrist or a psychologist.

As used in this section, “an accredited agent of the [Department”] Division” means any person [appointed or designated] authorized by the [Director of the Department] Division to [take into custody and] transport to a mental health facility pursuant to [subsections] subparagraph 2 of paragraph (a) oflityof subsection 1 [and 2] those persons in need of emergency admission.

433A.165Sec. NRS1.

Before12. a person alleged to be a person [with] in a mental [illness] health crisis may be admitted to a public or private mental health facility pursuant to NRS 433A.160, the person must:

(a) First be examined by a licensed physician or physician assistant licensed pursuant to chapter 630 or 633 of NRS or433A.165 an advanced practice registered nurse licensed pursuant to NRS 632.237 at any location where such a physician, physician assistant or advanced practice registered nurse is authorizedhereby toamended conduct such an examination to determineread whetheras thefollows: person has a medical [problem,] condition, other than a psychiatric [problem,] condition, which requires immediate treatment;

433A.165 1.

Before a person alleged to be a person [with] in a mental [illness] health crisis may be admitted to a public or private mental health facility pursuant to NRS 433A.160, the person mus(a) First be examined by a licensed physician or physician assistant licensed pursuant to chapter 630 or 633 of NRS or an advanced practice registered nurse licensed pursuant to NRS 632.237 at any location where such a physician, physician assistant or advanced practice registered nurse is authorized to conduct such an examination to determine whether the person has a medical [problem,] condition, other than a psychiatric [problem,] condition, which requires immediate treatment;

- *AB85_R1*80th Session (2019) – 11 – 2.medical [problem] condition in addition to a psychiatric [problem] a condition which requires medical treatment that requires more than hours to complete, the licensed physician, physician assistant or advanced practice registered nurse who examined the person must:

If a person [with] in a mental [illness] health crisis has a medical [problem] condition in addition to a psychiatric [problem] condition which requires medical treatment that requires more than 72 hours to complete, the licensed physician, physician assistant or advanced practice registered nurse who examined the person must:

(b) Seven days after filing a petition pursuant to paragraph (a) and every 7 days thereafter, file with the clerk of the district court an update on the medical condition and treatment of the person.person.rict court an 3.

3.

§ 1395dd and any regulations adopted pursuant thereto, and must involve a person authorized pursuant to federal law to conduct such an examination or certify such a transfer;

and 4.(b) The provisions of NRS 439B.410.

The4. cost of the examination must be paid by the county in which the person alleged to be a person [with] in a mental [illness] health crisis resides if services are provided at a county hospital located in that county or a hospital or other medical facility designated by that county, unless the cost is voluntarily paid by the person alleged to be a person [with] in a mental [illness] health crisis or, on the person’s behalf, by his or her insurer or by a state or federal program of medical assistance.

The cost of the examination must be paid by the county in which the person alleged to be a person [with] in a mental [illness] health crisis resides if services are provided at a county hospital located in that county or a hospital or other medical facility designated by that county, unless the cost is voluntarily paid by the person alleged to be a person [with] in a mental [illness] health federal program of medical assistance.his or her insurer or by a state or 5.

The cost of treatment, including hospitalization, for a person who is indigent must be paid pursuant to NRS 428.010 by the - 80th Session (2019) – 12 – county in which the person alleged to be a person [with] in a mental [illness] health crisis resides.

- *AB85_R1* – 12 – 7.

The provisions of this section do not require the Division to provide examinations required pursuant to subsection 1 at a division fac(a) Appropriatevisistaffingnotlevelstheof physicians, physician assistants, advanced practice registered nurses or other appropriate staff available at the facility ifas the Division doesdetermines notis havenecessary the:to provide such examinations;

(a) Appropriate staffing levels of physicians, physician assistants, advanced practice registered nurses or other appropriate staff available at the facility as the Division determines is necessary to provide such examinations;

433A.170 Except as otherwise provided in this section, the administrative officer of a facility operated by the Division or of any other public or private mental health facility or hospital shall notanynot accept433A.160 anunless that application foris anaccompanied emergencyby admissiona undercertificate NRSof a licensed psychologist, a physician, a physician assistant under the supervision of a psychiatrist, a clinical social worker who has the psychiatric training and experience prescribed by the Board of Examiners for Social Workers pursuant to NRS 641B.160 [,] or an advanced practice registered nurse who has the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120 [or an accredited agent of the Department] stating that he or she has examined the person alleged to be a person [with] in a mental [illness] health crisis and that he or she has concluded that the person [has] is a person in a mental [illness and, because of that illness, is likely to harm himself or herself or others if allowed his or her liberty.] health crisis.

The certificate required by this section may be obtained from a licensed psychologist, physician, physician assistant, clinical social worker [,] or advanced practice registered - 80th Session (2019) – 13 – nurse [or accredited agent of the Department] who is employed by the public or private mental health facility or hospital to which the application is made.

- *AB85_R1* – 13 – Sec.

433A.1901.3A.The [Within]administrative 1.officer of a public or private mental health facility shall ensure that, within 24 hours of [a person’s admission under] the emergency admission [,] of a person alleged to be a person in a mental health crisis pursuant to NRS 433A.150, the [administrative officer of a public or private mental health facility] person is asked to give permission to provide notice of the emergency admission to a family member, friend or other person identified by the person.

The administrative officer of a public or private mental health facility shall ensure that, within 24 hours of [a person’s admission under] the emergency admission [,] of a person alleged to be a person in a mental health crisis pursuant to NRS 433A.150, the [administrative officer of a public or private mental health facility] person is asked to give permission to provide notice of the emergency admission to a family member, friend or other person identified by the person.

Except as otherwise provided in subsections 4 and 5, if a person alleged to be a person in a mental health crisis does not give permission to notify a family member, friend or other person of the emergency admission mustof the person, notice of the emergency adm4.sioIf a person alleged to be a person in a mental health crisis is not able to give or refuse permission to notify a family member, friend or other person of the emergency admission, the administrative officer of the mental health facility may cause notice as described in paragraph (b) of subsection 2 to be provided untilif permissionthe administrative officer determines that it is obtained.gencyin 4.the best interest of the person in a mental health crisis.

If a person alleged to be a person in a mental health crisis friend or other person of the emergency admission, theamily member, administrative officer of the mental health facility may cause notice as described in paragraph (b) of subsection 2 to be provided if the administrative officer determines that it is in the best interest of the person in a mental health crisis.

If a guardian has been appointed for a person alleged to be a person in a mental health crisis or the person has executed a durable power of attorney for health care pursuant to NRS 162A.700 to 162A.865, inclusive, or appointed an attorney-in-fact using an advance directive for psychiatric care pursuant to NRS 449A.600 to 449A.645, inclusive, the administrative officer of the mental health facility must ensure that the guardian, agent designated by the durable power of attorney or the attorney-in- - 80th Session (2019) – 14 – fact, as applicable, is promptly notified of the admission as described in paragraph (b) of subsection 2, regardless of whether the person alleged to be a person in a mental health crisis has given permission to the notification.

-433A.195 *AB85_R1*NRSA –licensed 14physician –on Sec.the medical staff of a:

15.facility operated by the Division or of any other public or private mental health facility or hospital may release a person admitted pursuant to NRS 433A.160 upon completion of a certificate which meets the requirements of NRS 433A.197 signed by a licensed physician on the medical staff of the facility or hospital, a physician assistant under the supervision of a psychiatrist, psychologist, a clinical social worker who has the psychiatric training and experience prescribed by the Board of Examiners for Social Workers pursuant to NRS 641B.160 [,] or an advanced practice registered nurse who has the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120 [or an accredited agent of the Department] stating that he or she has personally observed and examined the person and that he or she has concluded that the person is not a person [with] in a mental [illness.] health crisis.

NRS 433A.195 is hereby amended to read as follows:

433A.195 A licensed physician on the medical staff of a facility operated by the Division or of any other public or private mental health facility or hospital may release a person admitted pursuant to NRS 433A.160 upon completion of a certificate which meets the requirements of NRS 433A.197 signed by a licensed physician on the medical staff of the facility or hospital, a physician assistant under the supervision of a psychiatrist, psychologist, a clinical social worker who has the psychiatric training and experience prescribed by the Board of Examiners for Social Workers pursuant to NRS 641B.160 [,] or an advanced practice registered nurse who has the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120 [or an accredited agent of the Department] stating that he or she has personally observed and examined the person and that he or she has concluded that the person is not a person [with] in a mental [illness.] health crisis.

An application or certificate authorized under subsection 1 of NRS 433A.160 or NRS 433A.170 or 433A.195 must not be considered if made by a psychologist, physician, physician assistant, clinical social worker [,] or advanced practice registered nurse [or accredited agent of the Department] who is related by affinity to the person alleged to be a person [with] in a mental [illness,] health crisis, or who is financially interested in the facility in which the person alleged to be a person [with] in a mental [illness] health crisis is to be detained.

[with] in a mental 2.

A certificate authorized pursuant to NRS 433A.195 must not be considered unless it is based on personal observation and examination- of80th theSession person(2019) alleged– to15 be– a person [with] in a mental [illness] health crisis made by the examining physician, physicianphysicianl assistant, psychologist, clinical social worker [,] or advanced practice registered nurse .

[or accredited agent of the Department.] The certificate authorized pursuant to NRS 433A.195 must describe in detail the facts and reasons on which the examining physician, - *AB85_R1* – 15 – physician assistant, psychologist, clinical social worker [,] or advanced practice registered nurse [or accredited agent of the Department] based his or her opinions and conclusions.

The petition may be filed by the spouse, parent, adult children or legal guardian of the person to be treated or by any physician, physician assistant, psychologist, social worker or registered nurse [, by an accredited agent of the Department] or by any officer authorized to make arrests in the State of Nevada.

(a) By a certificate of a physician, a licensed psychologist, a physician assistant under the supervision of a psychiatrist, a clinical social worker who has the psychiatric training and experience prescribed by the Board of Examiners for Social Workers pursuant to NRS 641B.160 [,] or an advanced practice registered nurse who has the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120 [or an accredited agent of the Department] stating that he or she has examined the person alleged to be a person [with] in a mental [illness] health crisis and has concluded that the person [has] is a person in a mental [illness othersand, ifbecause allowedof histhat orillness, heris libertylikely orto ifharm nothimself requiredor toherself participateor in a program of community-based or outpatient services;] healthhealtharticipate in crisis;

(1) The petitioner has, based upon the petitioner’s personal observation of the person alleged to be a person [with] in a mental [illness,] health crisis, probable cause to believe that the person [has] is a person in a mental [illness and, because of that illness, is likely to harm himself or herself or others if allowed his or her liberty- or80th ifSession not(2019) required– to16 participate– in a program of community- based or outpatient services;] health crisis;

andandogram of community- (2) The person alleged to be a person [with] in a mental [illness] health crisis has refused to submit to examination or treatment by a physician, psychiatrist, licensed psychologist or advanced practice registered nurse who has the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120.

- *AB85_R1* – 16 – 2.

A proceeding for the involuntary court-ordered admission of a person who is the defendant in a criminal proceeding in the district court to a program of community-based or outpatient services may be commenced by the district court, on its own motion, or by motion of the defendant or the district attorney if:

433A.210 In addition to the requirements of NRS 433A.200, a petition filed pursuant to that section with the clerk of the district court to commence proceedings for involuntary court-ordered includeadmission of a certifiedperson copypursuant of:nt to NRS 433A.145 or 433A.150 must 1.include a certified copy of:

Themade application for the emergency admission of the person mad2.purA petition executed by a psychiatrist, licensed psychologist, physician or advanced practice registered nurse who has the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120,433A.160; including, without limitation, a sworn statement that:

andgency admission of the person 2.

A petition executed by a psychiatrist, licensed psychologist, physician or advanced practice registered nurse who has the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120, including, without limitation, a sworn statement that:

(b)- In80th hisSession or(2019) her– opinion,17 there– is a reasonable degree of certainty that the person alleged to be a person [with] in a mental [illness][illness]inty health crisis suffers from a mental illness;

and (d) In his or her opinion, involuntary admission of the person alleged to be a person [with] in a mental [illness] health crisis to a - *AB85_R1* – 17 – mental health facility or hospital is medically necessary to prevent the person from harming himself or herself or others.

Immediately after a motion is made pursuant to subsection 3 of NRS 433A.200, the district judge shall set a time, date and place for its hearing.

§§ 10801 et seq., to protect and health crisis and the administrative office of any public or private mental health facility in which the subject of the petition or motion is 3.detained.

3.

The legal guardian has discretion to determine where the person will be released, taking - 80th Session (2019) – 18 – into consideration any discharge plan proposed by the facility assessment team.

If the legal guardian does not inform the facility as to where the person will be released within 3 days after the date of notification, the facility shall discharge the person according to its proposedproSec. discharge plan.

Sec.

433A.230 The court in its discretion may require any petitioner under NRS 433A.200, except [any duly accredited agent of the Department or] any officer authorized to make arrests in the State of Nevada, to file an undertaking with surety to be approved by the court in the amount the court deems proper, conditioned to save harmless the person alleged to be [mentally ill] a person in a mental - *AB85_R1* – 18 – health crisis by reason of costs incurred, including attorney fees, if any, and damages suffered by the person as a result of such action.

The court may consider testimony relating to any past actions of the person alleged to be a person [with] in a mental [illness] health crisis if such testimony is probative of the question of whether the person is presently [mentally ill and presents a clear and present danger of harm to himself or herself or others.] a person in a mental health crisis.criSec.

Sec.

(a) That there is not clear and convincing evidence that the person with respect to whom the hearing was held [has a mental illness or exhibits observable behavior such that the person is likely to harm himself or herself or others if allowed his or her liberty or if not required to participate in a program of community-based or outpatient services,] is a person in a mental health crisis, the court shall enter its finding to that effect and the person must not becourtbe involuntarily admitted to a public or private mental health facility or to a program of community-based or outpatient services.

If the person has been admitted to a public or private mental health facility- or80th hospitalSession pursuant(2019) to– NRS19 433A.160,– the court must issue a written order requiring the facility or hospital to release the person not later than 24 hours after the court issues the order, unless the person applies for admission as a voluntary consumer pursuant to NRS 433A.140.

(b) That there is clear and convincing evidence that the person with respect to whom the hearing was held [has a mental illness and, because of that illness, is likely to harm himself or herself or others if allowed his or her liberty or if not required to participate in a program of community-based or outpatient services,] is a person in a mental health crisis, the court may order the involuntary admission of the person for the most appropriate course of treatment, including, without limitation, admission to a public or private mental health facility or participation in a program of - *AB85_R1* – 19 – community-based or outpatient services.

The order of the court must be interlocutory and must not become final if, within 30 days after the involuntary admission, the person is unconditionally released pur2.antIf the district court finds, after proceedings for the involuntary court-ordered admission of a defendant in a criminal proceeding pursuant to subsection 3 of NRS 433A.390.433A.200:

2.

If the district court finds, after proceedings for the involuntary court-ordered admission of a defendant in a criminal proceeding pursuant to subsection 3 of NRS 433A.200:

(b) That there is clear and convincing evidence that the defendant with respect to whom the hearing was held [has a mental illness and, because of that illness, is likely to harm himself or herself or others if allowed his or her liberty or if not required to participate in a program of community-based or outpatient services,]services,]o is a person in a mental health crisis, except as otherwise provided in this paragraph, the court shall order the involuntary admission of the defendant for participation in a program of community-based or outpatient services and suspend further proceedings in the criminal proceeding against the defendant until the defendant completes or is theremoved defendantfrom is a category A or B felony or involved the useprogram. or threatened use of force or violence, the court may not order the involuntary admission of the defendant for participation in a program pursuant to this paragraph unless the prosecuting attorney stipulates to the assignment.

If the offense allegedly committed by the defendant is a category A or B felony or involved the use or threatened use of force or violence, the court may not order the - 80th Session (2019) – 20 – program pursuant to this paragraph unless the prosecuting attorney stipulates to the assignment.

If, pursuant to NRS 176A.400, the district court issues an order granting probation to a defendant in a criminal proceeding with a condition that the defendant submit to mental health treatment and comply with instructions, admission to a program of community-based or outpatient services may be used to satisfy such a condition if the Division makes a clinical determination that - *AB85_R1* – 20 – placement in a program of community-based or outpatient services is appropriate.

4.based or outpatient services unless:rson to a program of community- (a) A program of community-based or outpatient services is available in the community in which the person resides or is otherwise made available to the person;

A court shall not admit a person to a program of community- based or outpatient services unless:

(a) A program of community-based or outpatient services is available in the community in which the person resides or is otherwise made available to the person;

(e) The court determines that, based on the person’s history of treatment for mental illness, the person needs to be admitted to a program of community-based or outpatient services to prevent further disability or deterioration of the person which [is likely to result in] presents a substantial likelihood of serious harm to himself or herself or others [;] , as determined pursuant to section 4 of this(f) act;The current mental status of the person or the nature of the person’s illness limits or negates his or her ability to make an informed decision to seek treatment for mental illness voluntarily or to comply with recommended treatment for mental illness;

(f)(g) The currentprogram mental status of thecommunity-based person or theoutpatient natureservices ofis the person’sleast illnessrestrictive limits or negates his or her ability to make an informed decision to seek treatment forwhich mentalis illnessin voluntarilythe orbest tointerest complyof withthe recommendedperson; treatment for mental illness;

theand least(h) restrictiveThe treatmentcourt whichhas isapproved ina theplan bestof interesttreatment ofdeveloped for the person;person pursuant to NRS 433A.315.

and- person80th Session (2019) – 21 – involuntary admission pursuant to NRSparagraph 433A.315.plan(b) of treatmentsubsection developed1 or paragraph (b) of subsection 2 automatically expires at the end of 6 months if not terminated previously by the medical director of the public or private mental health facility as provided for in subsection of NRS 433A.390 or by the 5.professional responsible for providing or coordinating the program of community-based or outpatient services as provided for in subsection 3 of NRS 433A.390.

Except as otherwise provided in NRS 432B.608, an involuntary admission pursuant to paragraph (b) of subsection 1 or paragraph (b) of subsection 2 automatically expires at the end of 6 months if not terminated previously by the medical director of the public or private mental health facility as provided for in subsection 2 of NRS 433A.390 or by the professional responsible for providing or coordinating the program of community-based or outpatient services as provided for in subsection 3 of NRS 433A.390.

For each renewal, the petition must include evidence which meets the same standard set forth in subsection 1 or 2 that was required for the initial period of admission of the person to a - *AB85_R1* – 21 – public or private mental health facility or to a program of com6.nitBefore issuing an order for involuntary admission or a renewal thereof, the court shall explore other alternative courses of treatment within the least restrictive appropriate environment, including involuntary admission to a program of community-based or outpatient services.services, as suggested by the evaluation team who evaluated the person, or other persons professionally qualified in the field of psychiatric mental health, which the court believes may be in the best interests of the person.

6.

Before issuing an order for involuntary admission or a renewal thereof, the court shall explore other alternative courses of treatment within the least restrictive appropriate environment, including involuntary admission to a program of community-based or outpatient services, as suggested by the evaluation team who evaluated the person, or other persons professionally qualified in the field of psychiatric mental health, which the court believes may be in the best interests of the person.

(a) The Central Repository for Nevada Records of Criminal History, along with a statement indicating that the record is being transmitted for inclusion in each appropriate database of the National Instant Criminal Background Check System;

and (b) Each law enforcement agency of this State with which the court has entered into an agreement for such transmission, along with a statement indicating that the record is being transmitted for inclusion in each of this State’s appropriate databases of information relating to crimes.

Background- Check80th System”Session has(2019) the– meaning22 ascribed– to8. it inl NRS 179A.062.

As used in this section, “National Instant Criminal Background Check System” has the meaning ascribed to it in NRS 179A.062.

433A.327any 1.person involuntarily admitted to a program of community-based or outpatient services may be conditionally released from the program when, in the judgment of the professional responsible for providing or coordinating the program of community-based or outpatient services, the person does not present a [danger] substantial likelihood of serious harm to himself or herself or others.

Except as otherwise provided in subsection 3, any person involuntarily admitted to a program of community-based or outpatient services may be conditionally released from the program when, in the judgment of the professional responsible for providing or coordinating the program of community-based or outpatient services, the person does not present a [danger] substantial likelihood of serious harm to himself or herself or others.

When a person is conditionally released pursuant to subsection 1, the State of Nevada, the agents and employees of the - *AB85_R1* – 22 – State or a mental health facility, the professionals responsible for providing or coordinating programs of community-based or outpatient services and any other professionals providing mental health services are not liable for any debts or contractual obligations incurred, medical or otherwise, or damages caused by the actions of the person who is released.

A person who is involuntarily admitted to a program of community-based or outpatient services may be conditionally released only if, at the time of the release, written notice is given to the court which ordered the person to participate in the program, ton to the attorney of the person and to the district attorney of the county in which the proceedings for admission were held.

Except as otherwise provided in this subsection, the professional responsible for providing or coordinating the program of community-based or outpatient services shall, at least 3 days before the issuance of the order to resume - 80th Session (2019) – 23 – participation, give written notice of the order to the court that admitted the person to the program.

If an emergency exists in which the person presents [an imminent threat of danger] a substantial likelihood of serious harm to himself or herself or others, the order mustorder beis submittedissued.d to the court not later than 1 business day after the order5. is issued.

5.

433A.330 [1.] When an involuntary court admission to a mental health facility is ordered under the provisions of this chapter, - *AB85_R1* – 23 – the involuntarily admitted person, together with the court orders and certificates of the physicians, certified psychologists, advanced practice registered nurses or 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 county who shall:

[(a)][(b)] 1.2.

Transport the person;

or [(b)] 2.

A clinical record for each consumer must be diligently maintained by any division facility, private institution, facility- offering80th mentalSession health(2019) services– or24 program– ofbased community-or pertainingoutpatient toservices. the consumer’s admission, legal status, treatment and individualized plan for habilitation.

The clinical record ismust notinclude ainformation otherwisepertaining providedto in subsection 2 or except:ed, except [:] as (a) If the releaseconsumer’s isadmission, authorizedlegal orstatus, requiredtreatment pursuantand toindividualized NRSplan 439.538.for habilitation.

The clinical record is not a public record and no part of it may be released, except [:] as otherwise provided in subsection 2 or except:

(a) If the release is authorized or required pursuant to NRS 439.538.

(d) The record or any part thereof may be disclosed to a qualified member of the staff of a division facility, an employee of the Division or a member of the staff of an agency in Nevada which has been established pursuant to the Developmental Disabilities Assistance and Bill of Rights Act of 2000, 42 U.S.C.

- *AB85_R1* – 24 – (e) Information from the clinical records may be used for statistical and evaluative purposes if the information is abstracted in such a way as to protect the identity of individual consumers.

if:i(1) The consumer is a consumer of that office and the consumer or the consumer’s legal representative or guardian authorizes the release of the record;

(1) The consumer is a consumer of that office and the consumer or the consumer’s legal representative or guardian authorizes the release of the record;

and (II)- Does80th notSession have(2019) – 25 – or is a ward of the State.ve a guardian or other legal representative (h) The record must be released as provided in NRS 433.332 or is433B.200 aand wardin ofchapter the629 State.of NRS.

(h)2. The record must be released as provided in NRS 433.332 or 4332.200A division facility, private institution, facility offering mental health services or program of community-based or information concerning a consumer, including, without limitation, a clinical record, any part thereof or any information contained therein, may disclose such information to a provider of health care to assist with treatment provided to the consumer.

A division facility, private institution, facility offering mental health services or program of community-based or outpatient services and any other person or entity having information concerning a consumer, including, without limitation, a clinical record, any part thereof or any information contained therein, may disclose such information to a provider of health care to assist with treatment provided to the consumer.

(a) “Consumer” includes any person who seeks, on the person’s own or others’ initiative, and can benefit from, care, treatment and training in a private institution or facility offering mental health services, from treatment to competency in a private institution or facility offering mental health services, or from a program of community-basedcom(b) or“Provider outpatientof services.health care” has the meaning ascribed to it in NRS 629.031.

(b) “Provider of health care” has the meaning ascribed to it in NRS 629.031.

Except as otherwise provided in subsection 4, any person involuntarily admitted by a court may be conditionally released from a public or private mental health facility when, in the judgment of the medical director of the facility, the conditional - *AB85_R1* – 25 – release is in the best interest of the person and will not be detrimental to the public welfare.

The legal guardian has discretion to determine where the person will be released, taking into consideration any discharge plan proposed by the facility assessment team.

If the legal guardian doesdoesn not inform the facility as to where the person will be released within 3 days after the date of notification, the facility shall discharge the person according to its proposed discharge plan.

3.- 80th Session (2019) – 26 – incapacitated is conditionally released from a mental health facility, the administrative officer of the mental health facility shall petition the court for restoration of full civil and legal rights as deemed necessary to facilitate the incapacitated person’s rehabilitation.

WhenIf athe person who has been adjudicated by a courtlegal toguardian, be incapacitated is conditionally released from a mental health facility, the administrativepetition officermust ofbe thefiled mentalwith health facility shall petition the court forhaving restorationjurisdiction ofover full civil and legal rights as deemed necessary to facilitate the incapacitatedguardianship. person’s rehabilitation.

If4. the person has a legal guardian, the petition must be filed with the court hav4.g jA person who was involuntarily admitted by a court because he or she was likely to present a substantial likelihood of serious , as determined pursuant to section 4 of this act, may ben at liberty] conditionally released only if, at the time of the release, written notice is given to the court which admitted him or her, to the person’s legal guardian and to the district attorney of the county in which the proceedings for admission were held.

A person who was involuntarily admitted by a court because he or she was likely to present a substantial likelihood of serious harm to himself or herself or others [if allowed to remain at liberty] , as determined pursuant to section 4 of this act, may be conditionally released only if, at the time of the release, written notice is given to the court which admitted him or her, to the person’s legal guardian and to the district attorney of the county in which the proceedings for admission were held.

Except as otherwise provided in subsection 7, the administrative officer of a public or private mental health facility or the administrative officer’s designee shall order a person who is conditionally released from that facility pursuant to this section to return to the facility if a psychiatrist and a member of that person’s treatment team who is professionally qualified in the field of psychiatric mental health determine [, pursuant to NRS 433A.115,] that the conditional release is no longer appropriate because that person presents a [clear and present danger] substantial likelihood of serious harm to himself or herself or others [.] , as determined pursuant to section 4 of this act.

Except as otherwise provided in this subsection, the administrative officer or the designee shall, at least 3 days before the issuance of the order to return, give written - *AB85_R1* – 26 – notice of the order to the court that admitted the person to the facility and to the person’s legal guardian.

If an emergency exists in which the person presents [an imminent threat of danger] a substantial likelihood of harm to himself or herself or others, as determined pursuant to section 4 of this act, the order must be submittedbusiness today theafter court and the legalorder guardianis issued.ardian not later than 1 business6. day after the order is issued.

6.

The administrative officer or the administrative officer’s designee shall give written notice to the person who was ordered to return to the facility, to the person’s legal- guardian80th andSession to(2019) the– person’s27 attorney,– if known, of the time, date and place of the hearing and of the facts necessitating thatthate, person’s return to the facility.

When a consumer, involuntarily admitted to a mental health facility or to a program of community-based or outpatient services by court order, is released at the end of the period specified pursuant to NRS 433A.310, written notice must be given to the admitting court and to the consumer’s legal guardian at thenleast be10 releaseddays withoutbefore requiringthe furtherrelease orders of the court.consumer.

The consumer may then be released without requiring further orders of the court.

The legal guardian has discretion to determine where the consumer will be released, taking into consideration any discharge plan proposed by the facility assessment team or the professional responsible for providing or coordinating the program of community-based or outpatient services.

(a) An evaluation team established under NRS 433A.250 or two persons professionally qualified in the field of psychiatric mental - *AB85_R1* – 27 – health, at least one of them being a physician, determines that the consumer [has recovered from his or her mental illness or has improved to such an extent that the consumer is no longer considered to present a clear and present danger of harm to himself or herself or others;] is no longer a person in a mental healthhealthself crisis;

and (b) Under advisement from the evaluation team or two persons professionally qualified in the field of psychiatric mental health, at least one of them being a physician, the medical director of the mental health facility authorizes the release and gives written notice to the admitting court and to the consumer’s legal guardian at least 10 days before the release of the consumer.

If the consumer has a legal guardian, the facility shall notify the guardian before discharging- 80th Session (2019) – 28 – discretion to determine where the consumer fromwill be released, taking into consideration any discharge plan proposed by the facility.facility assessment team.

The legal guardian has discretion to determine where the consumer will be released, taking into consideration any discharge plan proposed by the facility assessment team.

(a) The professional responsible for providing or coordinating the program of community-based or outpatient services for thetingthe consumer determines that the consumer [has recovered from his or her mental illness or has improved to such an extent that the consumer is no longer considered to present a clear and present danger of harm to himself or herself or others;] is no longer a person in a mental health crisis;

and (b) Under advisement from an evaluation team established under NRS 433A.250 or two persons professionally qualified in the field of psychiatric mental health, at least one of them being a physician, the professional responsible for providing or coordinating the program of community-based or outpatient services for the consumer authorizes the release and gives written notice to the admitting court at least 10 days before the release of the consumer from the program.

- *AB85_R1* – 28 – 2.

Except as otherwise provided in subsections 4, 5 and 6, a person or governmental entity that wishes to inspect records that are sealed pursuant to this section must file a petition with the court that sealed the records.

3.- 80th Session (2019) – 29 – order the inspection of records that are sealed pursuant to thisay section if:

After the hearing described in subsection 2, the court may order the inspection of records that are sealed pursuant to this section if:

or (c) The person who is the subject of the records petitions the thecourt petition.itto permit the inspection of the records by a person named in 4.the petition.

A4. governmental entity is entitled to inspect court records procedure described in subsection 2 if:n without following the (a) The governmental entity has made a conditional offer of employment to the person who is the subject of the records;

(b)A Thegovernmental positionentity ofis employmententitled conditionallyto offeredinspect tocourt therecords personthat concernsare publicsealed safety,pursuant including,to this section without limitation,following employmentthe asprocedure adescribed firefighterin orsubsection peace2 officer;if:

employment to the person who is the subject of the records;

of (b) The position of employment conditionally offered to the person concerns public safety, including, without limitation, employment as a firefighter or peace officer;

- *AB85_R1* – 29 – (a) Authorize the release of a copy of any order which was entered by the court pursuant to paragraph (b) of subsection 1 of NRS 433A.310 if:

and - 80th Session (2019) – 30 – (II) The requested order is necessary to improve the care which is being provided to the person who is the subject of the order.

6.records that are sealed pursuant to this section without following the procedure described in subsection 2 if the records are necessary and relevant for the disposition of a matter pending before the court.

Upon its own order, any court of this State may inspect court records that are sealed pursuant to this section without following the procedure described in subsection 2 if the records are necessary and relevant for the disposition of a matter pending before the court.

Following the sealing of records pursuant to this section, the admission of the person who is the subject of the records to the public or private hospital, mental health facility or program of community-based or outpatient services, is deemed never to have occurred, and the person may answer accordingly any questionavequestion related to its occurrence, except in connection with:

(a) An application for a permit to carry a concealed firearm pursuant to the provisions of NRS 202.3653 to 202.369, inclusive;

(a) “Firefighter” means a person who is a salaried employee of a fire-fighting agency and whose principal duties are to control, extinguish, prevent and suppress fires.

- *AB85_R1* – 30 – (c) “Provider of health care” has the meaning ascribed to it in NRS 629.031.

(a) Without probable cause for believing a person [to be mentally ill] is a person in a mental health crisis causes or conspires- with80th orSession assists(2019) another– to31 cause– the involuntary court- ordered admission of the person under this chapter;

orortary court- (b) Causes or conspires with or assists another to cause the denial to any person of any right accorded to the person under this chapter,  is guilty of a category D felony and shall be punished as provided in NRS 193.130.

A person who, without probable cause for believing another person [to be mentally ill,] is a person in a mental health crisis, executes a petition, application or certificate pursuant to this chapter, by which the person secures or attempts to secure theisthe apprehension,the hospitalization,person detention,alleged admissionto orbe restraint[mentally ofill,] a person in a mental health crisis, or any physician, psychiatrist, licensed psychologist,healthpsychologist, advanced practice registered nurse or other person professionally qualified in the field of psychiatric mental health who knowingly makes any false certificate or application pursuant to this chapter as to the mental condition of any person is guilty of a category D felony and shall be punished as provided in NRS 193.130.

(c)restraint;emergency An emergency exists that necessitates the use of chemical restraint;(d) A medical order authorizing the use of chemical restraint is obtained from the patient’s attending physician, psychiatrist or advanced practice registered nurse;

- *AB85_R1* – 31 – (d) A medical order authorizing the use of chemical restraint is obtained from the patient’s attending physician, psychiatrist or advanced practice registered nurse;

and - 80th Session (2019) – 32 – (f) The chemical restraint is administered by a person licensed to administer medication.

If chemical restraint is used on a person with a disability who is a patient, the use of the procedure must be reported as a denial of rights pursuant to NRS 449A.263, regardless of whether the use of the procedure is authorized by statute.

Sec.approval.3.

33.This act becomes effective upon passage and ~~~~~ 19 - 80th Session (2019)

This act becomes effective upon passage and approval.

H - *AB85_R1*