AB 66 — Revises provisions relating to mental health. (BDR 40-486)

On or before February 1 of each odd-numbered year, the Division shall submit to the Director of the Legislative Counsel BureauBur(a) aAny writtencomplaints reportincluded settingin forth,the forlog themaintained previousby biennium:thennium:

(a) Any complaints included in the log maintained by the Division pursuant to subsection 3;

and - *AB66_R2* – 7 – (b) Any disciplinary actions taken by the Division pursuant to subsection 2.

In addition to the payment of the amount required by NRS 449.0308, if a medical facility, facility for the dependent or facility which is required by the regulations adopted by the Board pursuant to NRS 449.0303 to be licensed violates any provision related to its licensure, including any provision of NRS 439B.410 or 449.029 to 449.2428, inclusive, and section 1 of this act or any condition, standard or regulation adopted by the Board, the - 80th Session (2019) – 7 – Division, in accordance with the regulations adopted pursuant to NRS 449.165, may:

(c) If the license of the facility limits the occupancy of the facility and the facility has exceeded the approved occupancy, requirefacility thethat facility,is atlicensed;ts its own expense, to move patients to another facility(d) thatImpose isan licensed;administrative penalty of not more than $5,000 per day for each violation, together with interest thereon at a rate not to exceed 10 percent per annum;

(d)and Impose an administrative penalty of not more than $5,000 per day for each violation, together with interest thereon at a rate not to (e) Appoint temporary management to oversee the operation of the facility and to ensure the health and safety of the patients of the facili(1)facility, Ituntil: determines that the facility has corrected the violation and has management which is capable of ensuring continued compliance with the applicable statutes, conditions, standards and regulations;

(1) It determines that the facility has corrected the violation and has management which is capable of ensuring continued compliance with the applicable statutes, conditions, standards and regulations;

The Division may require any facility that violates any provision of NRS 439B.410 or 449.029 to 449.2428, inclusive, and section 1 of this act or any condition, standard or regulation adopted by the Board to make any improvements necessary to correct the violation.

Any money collected as administrative penalties pursuant to paragraph (d) of subsection 1 must be accounted for separately and - *AB66_R2* – 8 – used to administer and carry out the provisions of NRS 449.001 to 449.430, inclusive, and section 1 of this act, 449.435 to 449.531, inclusive, and chapter 449A of NRS to protect the health, safety, well-being and property of the patients and residents of facilities in accordance with applicable state and federal standards or for any other purpose authorized by the Legislature.

- 80th Session (2019) – 8 – Sec.

(a) Shall appoint, with the consent of the Governor, administrators of the divisions of the Department, who are respectivelyrespec(1) designatedThe asAdministrator follows:of the Aging and Disability Services Division;

(1) The Administrator of the Aging and Disability Services Division;

(4) The Administrator of the Division of Health Care Financ(5)Financing The Administrator of the Division of Public and BehavioralPolicy; Health.

the provisions of chapters 63, 424, 425, 427A, 432A to 442,tment, inclusive, 446 to 450, inclusive, 458A and 656A(5) ofThe NRS,Administrator NRS 127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and section 9 of this act, 422.580, 432.010 to 432.133, inclusive, 432B.621 to 432B.626, inclusive, 444.002 to 444.430, inclusive, and 445A.010 to 445A.055, inclusive, and all other provisions of law relating to the functions of the divisions of the Department, but is not responsible for the clinical activities of the Division of Public and Behavioral HealthHealth. or the professional line activities of the other divisions.

(b) Shall administer, through the divisions of the Department, the provisions of chapters 63, 424, 425, 427A, 432A to 442, inclusive, 446 to 450, inclusive, 458A and 656A of NRS, NRS 127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and section 9 of this act, 422.580, 432.010 to 432.133, inclusive, 432B.621 to 432B.626, inclusive, 444.002 to 444.430, inclusive, and 445A.010 to 445A.055, inclusive, and all other provisions of law relating to the functions of the divisions of the Department, but is not responsible for the clinical activities of the Division of Public divisions.oral Health or the professional line activities of the other (c) Shall administer any state program for persons with developmental disabilities established pursuant to the Developmental Disabilities Assistance and Bill of Rights Act of 2000, 42 U.S.C.

The Director shall revise the plan biennially and deliver a - *AB66_R2* – 9 – copy of the plan to the Governor and the Legislature at the beginning of each regular session.

- 80th Session (2019) – 9 – (1) Identify and assess the plans and programs of the Department for the provision of human services, and any duplication of those services by federal, state and local agencies;

(5) Set forth sufficient information to assist the Department in providing those services and in the planning and budgeting for the future provision of those services;

(e) May, by regulation, require nonprofit organizations and state and local governmental agencies to provide information regarding the programs of those organizations and agencies, excluding detailed information relating to their budgets and payrolls, which the uponDirector himdeems ornecessary herfor pursuantthe toperformance this section.nce of the duties imposed (f)upon Hashim suchor otherher powerspursuant andto dutiesthis assection. are provided by law.

the(f) Director’sHas designee,such isother responsiblepowers for appointing and removingrduties subordinateas officersare andprovided employeesby oflaw. the Department, other than the State Public Defender of the Office of State Public Defender who is appointed pursuant to NRS 180.010.

2.

Notwithstanding any other provision of law, the Director, or the Director’s designee, is responsible for appointing and removing subordinate officers and employees of the Department, other than the State Public Defender of the Office of State Public Defender who is appointed pursuant to NRS 180.010.

thereto a new section to read as follows:

amended by adding The Department shall take any action necessary to ensure that crisis stabilization services provided at a psychiatric hospital established pursuant to section 1 of this act are reimbursable under Medicaid to the same extent as if the services were provided in another covered facility.

9.

Chapter 422 of NRS is hereby amended by adding thereto a new section to read as follows:

The Department shall take any action necessary to ensure that crisis stabilization services provided at a psychiatric hospital established pursuant to section 1 of this act are reimbursable under Medicaid to the same extent as if the services were provided in another covered facility.

Sec.

- *AB66_R2*80th Session (2019) – 10 – 2.

and (b) Prevents the person being transported from escaping from the vehicle or accessing the driver or the means of controlling the vehicle.vehSec.

Sec.

(1) Take a person alleged to be a person with mental illness into custody to apply for the emergency admission of the person for evaluation, observation and treatment;

andmissionand of the person for (2) Transport the person alleged to be a person with mental illness to a public or private mental health facility or hospital for that purpose, or arrange for the person to be transported by:italby: for (I) A local law enforcement agency;

(II)(I) A systemlocal forlaw theenforcement nonemergencyagency; medical transportation of persons whose operation is authorized by the Nevada Transportation Authority;

transportation of persons whose operation is authorized by theedical Nevada Transportation Authority;

or (V) If medically necessary, an ambulance service that holds a permit issued pursuant to the provisions of chapter 450B of NRS,  only if the agent, officer, physician, physician assistant, psychologist, marriage and family therapist, clinical professional counselor, social worker or registered nurse has, based upon his or - 80th Session (2019) – 11 – her personal observation of the person alleged to be a person with mental illness, probable cause to believe that the person has a - *AB66_R2* – 11 – mental illness and, because of that illness, is likely to harm himself or herself or others if allowed his or her liberty.

and (2) Any agency, system , provider or service described in subparagraph (2) of paragraph (a) to transport the person alleged to be a person with mental illness to a public or private mental health facility or hospital for that purpose.

The application for the emergency admission of a person alleged to be a person with mental illness for evaluation, observation and treatment must reveal the circumstances under which the persontionperson was taken into custody and the reasons therefor.

admitted4. to a public or private mental health facility or hospitalon under an emergency admission must be evaluated at the time of admission by a psychiatrist or a psychologist.

Except as otherwise provided in this subsection, each person under an emergency admission must be evaluated at the time ofpital admission by a psychiatrist or a psychologist.

- 80th Session (2019) – 12 – Sec.

When an involuntary court admission to a mental health facility is ordered under the provisions of this chapter, the involuntarily admitted person, together with the court orders and certificates of the physicians, certified psychologists, advanced - *AB66_R2* – 12 – 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) TransportArrange for the person;person to be transported by:

or (b) Arrange for the person to be transported by:

A health maintenance organization that provides health care services to recipients of Medicaid under the State Plan for InsuranceMedicaid Programor insurance pursuant to a contract with the DivisionChildren’s ofHealth Health Care Financing and Policy of the Department of HealthHealthf and Human Services shall negotiate in good faith to enter into a contract with a psychiatric hospital with an endorsement as ao a crisis stabilization center pursuant to section 1 of this act to include the psychiatric hospital in the network of providers under contract with the health maintenance organization to provide services to recipients of Medicaid or enrollees in the Children’s Health Insurance Program, as applicable.

- 80th Session (2019) – 13 – (a) The health maintenance organization is operating significantly in contravention of its basic organizational document, its health care plan or in a manner contrary to that described in and reasonably inferred from any other information submitted pursuant to NRS 695C.060, 695C.070 and 695C.140, unless any amendments to those submissions have been filed with and approved by the Commissioner;

- *AB66_R2* – 13 – (b) The health maintenance organization issues evidence of coverage or uses a schedule of charges for health care services which do not comply with the requirements of NRS 695C.1691 to 695C.200, inclusive, and section 13 of this act, or 695C.207;

(1) Resolving complaints in a manner reasonably to dispose of validval(2) complaints;Conducting external reviews of adverse determinations that comply with the provisions of NRS 695G.241 to 695G.310, inclusive;

and(h) thatThe complyhealth withmaintenance theorganization provisionsor ofany NRSperson 695G.241on toits 695G.310,onsbehalf inclusive;has advertised or merchandised its services in an untrue, misrepresentative, misleading, deceptive or unfair manner;

behalf has advertised or merchandised its services in an untrue, misrepresentative, misleading, deceptive or unfair manner;

- 80th Session (2019) – 14 – 2.

If the certificate of authority of a health maintenance organization is revoked, the organization shall proceed, immediately - *AB66_R2* – 14 – following the effective date of the order of revocation, to wind up its affairs and shall conduct no further business except as may be essential to the orderly conclusion of the affairs of the organization.

Chapter 695G of NRS is hereby amended by adding theretotheA managed care organization that provides health care services to recipients of Medicaid under the State Plan for Medicaid or insurance pursuant to the Children’s Health Insurance Program pursuant to a newcontract with the Division of Health Care Financing and Policy of the Department of Health and Human Services shall negotiate in good faith to enter into a contract with a psychiatric hospital with an endorsement as a crisis stabilization center pursuant to section 1 of this act to readinclude the psychiatric hospital in the network of providers under contract with the managed care organization to provide services to recipients of Medicaid or insureds in the Children’s Health Insurance Program, as follows:applicable.

A managed care organization that provides health care services to recipients of Medicaid under the State Plan for Medicaid or insurance pursuant to the Children’s Health Insurance Program pursuant to a contract with the Division of Health Care Financing and Policy of the Department of Health and Human Services shall negotiate in good faith to enter into a contract with a psychiatric hospital with an endorsement as a crisis stabilization center pursuant to section 1 of this act to include the psychiatric hospital in the network of providers under contract with the managed care organization to provide services to recipients of Medicaid or insureds in the Children’s Health Insurance Program, as applicable.

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