AB 252 — Revises provisions relating to providers of community-based living arrangement services. (BDR 39-656)

(Deleted by amendment.) Sec.

and - 80th Session (2019) – 3 – 2.

3.living arrangement services may provide such services to anyd person with a primary diagnosis of a mental illness, including, without limitation, such a person who has a secondary diagnosis other than a mental illness.

The holder of a certificate to provide community-based living arrangement services may provide such services to any person with a primary diagnosis of a mental illness, including, without limitation, such a person who has a secondary diagnosis other than a mental illness.

8.8-9.

9.

(Deleted by amendment.) Sec.

Each person employed by a provider of community-based living arrangement services to supervise or provide support to - *AB252_R2* – 4 – recipients of such services must be able to communicate with the recipientsrec3.ieA tochild whomunder he18 oryears sheof isage tomust providenot services.reside in a building operated by a provider of community-based living arrangement services in which community-based living arrangement services are provided.

3.

A child under 18 years of age must not reside in a building operated by a provider of community-based living arrangement services in which community-based living arrangement services are provided.

and (b) Post prominently in any building operated by the provider of community-based living arrangement services in which community-based living arrangement services are provided a sign - 80th Session (2019) – 4 – with the telephone number that may be used to make a complaint to the Division concerning the provider.

provided(a) toA thedescription recipientof andthe acase designationmanagement ofservices thethat entity must be responsible for providing those services;

andandf the entity (b) The hours during which the provider of community-based living arrangement services must provide supervision and support to the recipient.

The holder of the license has refused or failed to reimburse any overpayment for community-based living arrangement services as required pursuant to subsection 3 of section 12 of this act;act2.orThe holder of the license has failed to correct any practice required by the Division to comply with state law or regulations or the requirements of a contract between the holder and the Division.

or - *AB252_R2* – 5 – 2.

The holder of the license has failed to correct any practice required by the Division to comply with state law or regulations or the requirements of a contract between the holder and the Division.

- 80th Session (2019) – 5 – 1.

Any medical facility, facility for the dependent or facility whichpursuant isto otherwiseNRS required449.0303 byto thebe regulationslicensed adoptedthat byis theoperated ande Board maintained by the United States Government or an agency thereof.

449.0302 1.

The Board shall adopt:

(d) Regulations establishing a procedure for the indemnification by the Division, from the amount of any surety bond or other obligation filed or deposited by a facility for refractive surgery pursuant to NRS 449.068 or 449.069, of a patient of the facility who has sustained any damages as a result of the bankruptcy of or anyanywho breach of contract by the facility.

- *AB252_R2* – 6 – (e) Any other regulations as it deems necessary or convenient to carry out the provisions of NRS 449.029 to 449.2428, inclusive [.] , and sections 11, 12 and 13 of this act.

- 80th Session (2019) – 6 – (b) The licensure of facilities for refractive surgery which take into consideration the unique factors of operating such a facility.

The Board shall require that the practices and policies of each medical facility or facility for the dependent provide adequately for the protection of the health, safety and physical, moral and mental well-being of each person accommodated in the facility.fac5.ityIn addition to the training requirements prescribed pursuant to NRS 449.093, the Board shall establish minimum qualifications for administrators and employees of residential facilities for groups.

5.In establishing the qualifications, the Board shall consider the related standards set by nationally recognized organizations which accredit such facilities.

In6. addition to the training requirements prescribed pursuant to NRS 449.093, the Board shall establish minimum qualifications In establishing the qualifications, the Board shall consider theroups.

related standards set by nationally recognized organizations which acc6.

(1) Addresses possession and assistance in the administration of the medication;(2) Includes a plan, which has been prepared under the supervision of a registered nurse or licensed pharmacist, for emergency intervention if an adverse condition results.

and(d) (2)Except Includesas aotherwise plan,authorized whichby has been prepared under the supervisionregulations ofadopted apursuant registeredto nurseNRS or449.0304, licensedthe pharmacist,prescribed formedication emergencyis interventionnot ifadministered anby adverseinjection conditionor results.intravenously.

- *AB252_R2* – 7 – (d) Except as otherwise authorized by the regulations adopted pursuant to NRS 449.0304, the prescribed medication is not administered by injection or intravenously.

The Board shall not allow the licensing of a facility as a residential facility for groups which - 80th Session (2019) – 7 – provides assisted living services and a residential facility for groups shall not claim that it provides “assisted living services” unless:

(1)toilet Exceptfacilities;as as otherwise provided in subsection 8, contain toilet(2) facilities;Contain a sleeping area or bedroom;

(2)and Contain(3) aAre sleepingshared areawith oranother bedroom;occupant only upon consent of both occupants.

and(c) (3) Are shared with another occupant only upon consent of bot(c) The facility provides personalized care to the residents of the facility and the general approach to operating the facility incorp(1)incorporates Thethese facilitycore isprinciples: designed to create a residential environment that actively supports and promotes each resident’s quality of life and right to privacy;

(1) The facility is designed to create a residential environment that actively supports and promotes each resident’s quality of life and right to privacy;

(4) The operation of the facility and its interaction with its residents supports, to the maximum extent possible, each resident’s needher forown autonomylife;nomy and the right to make decisions regarding his or her(5) ownThe life;operation of the facility is designed to foster a social climate that allows the resident to develop and maintain personal relationships with fellow residents and with persons in the general community;

(5)(6) The operation of the facility is designed to fosterminimize aand socialis climateoperated thatin allowsa manner which minimizes the residentneed for its residents to developmove andout maintainof personalthe relationshipsfacility withas fellowtheir residentsrespective physical and withmental personsconditions inchange theover generaltime; community;

- *AB252_R2* – 8 – (6) The facility is designed to minimize and is operated in a manner which minimizes the need for its residents to move out of the facility as their respective physical and mental conditions change over time;

- 80th Session (2019) – 8 – 8.

(1)any Causeresident substantialof detrimentthe facility;detriment to the health or welfare of any(2) residentResult ofin themore than two residents sharing a toilet facility;

(2) Result in more than two residents sharing a toilet facility;

The Board shall, if it determines necessary, adopt regulations and requirements to ensure that each residential facility for groups and its staff are prepared to respond to an emergency,lityemergency, including, without limitation:

(a) The adoption of plans to respond to a natural disaster and other types of emergency situations, including, without limitation, an emergency involving fire;

and (d) Posting the plans or a summary of the plans adopted pursuantresidential tofacility paragraphsfor (a)groups.b) and (b) in a conspicuous place in each residential10. facility for groups.

10.

- *AB252_R2* – 9 – (b) Facilities that provide or arrange for the provision of supportive services for residents of the facility to assist the residents with reintegration into the community, in addition to providing a housing and living environment;

and (c) Facilities that provide or arrange for the provision of alcohol and drug abuse programs, in addition to providing a housing and - 80th Session (2019) – 9 – living environment and providing or arranging for the provision of other supportive services.

(a) Except as otherwise provided in paragraph (b), require a natural person responsible for the operation of a provider of community-based living arrangement services and each employee of a provider of community-based living arrangement services who supervises or provides support to recipients of community-based living arrangement services to complete training concerning the provision of community-based living arrangement services to persons with mental illness and continuing education concerning the particular population served by the provider;

(b) Exempt a person licensed or certified pursuant to title 54 of NRS from the requirements prescribed pursuant to paragraph (a) if the Board determines that the person is required to receive training and continuing education substantially equivalent to that pre(c)prescribed Requirepursuant a natural person responsible for the operation of a provider of community-based living arrangement services to receivethat trainingparagraph; concerning the provisions of title 53 of NRS applicable to the provision of community-based living arrangement services;

and(c) (d) Require ana applicantnatural person responsible for athe licenseoperation toof providea community-provider basedof community-based living arrangement services to postreceive atraining suretyconcerning bond in an amount equal to the operatingprovisions expenses of thetitle applicant53 forof 2NRS months,applicable place that amount in escrow or take another action prescribed by the Division to ensure that, if the applicantprovision becomes insolvent, recipients of community-based living arrangement servicesservices; from the applicant may continue to receive community- based living arrangement services for 2 months at the expense of the applicant.

and (d) Require an applicant for a license to provide community- based living arrangement services to post a surety bond in an amount equal to the operating expenses of the applicant for 2 prescribed by the Division to ensure that, if the applicant becomes insolvent, recipients of community-based living arrangement services from the applicant may continue to receive community- based living arrangement services for 2 months at the expense of the applicant.

- *AB252_R2* – 10 – (a) Applicant is in full compliance with the provisions of NRS 449.029 to 449.2428, inclusive [;] , and sections 11, 12 and 13 of this act;

- 80th Session (2019) – 10 – (b) Applicant is in substantial compliance with the standards and regulations adopted by the Board;

Any investigation of an applicant for a license to provide community-based living arrangement services conducted pursuant to subsection 1 must include, without limitation, an inspection of any building operated by the applicant in which the applicant proposes to provide community-based living arrangement services.

Each license issued pursuant to NRS 449.029 to 449.2428, inclusive, and sections 11, 12 and 13 of this act expires on December 31 following its issuance and is renewable for 1 year upon reapplication and payment of all fees required pursuant to NRS 449.050 unless the Division finds, after an investigation, that the facility has not:

(a) Satisfactorily complied with the provisions of NRS 449.029 to 449.2428, inclusive, and sections 11, 12 and 13 of this act or the standards and regulations adopted by the Board;

or (c)2.) ConformedCEach reapplication for an agency to allprovide applicablepersonal localcare zoningservices regulations.in the home, an agency to provide nursing in the home, a community health worker pool, a facility for intermediate care, a facility for skilled nursing, a hospital described in 42 U.S.C.

2.

Each reapplication for an agency to provide personal care services in the home, an agency to provide nursing in the home, a community health worker pool, a facility for intermediate care, a facility for skilled nursing, a hospital described in 42 U.S.C.

§ - *AB252_R2* – 11 – 483.5, a hospital that provides swing-bed services as described in 42 - 80th Session (2019) – 11 – C.F.R.

Each reapplication for an agency to provide personal care services in the home, a community health worker pool, a facility for intermediate care, a facility for skilled nursing, a facility for the care of adults during the day, a peer support recovery organization, a residential facility for groups or a home for individual residential care must include, without limitation, a statement that the holder of the license to operate, and the administrator or other person in charge and employees of, the facility, agency, pool, organization or home are in compliance with the provisions of NRS 449.093.

The Division may deny an application for a license or may suspend or revoke any license issued under the provisions of NRS 449.029 to 449.2428, inclusive, and sections 11, 12 and 13 of this act upon any of the following grounds:

(a) Violation by the applicant or the licensee of any of the provisions of NRS 439B.410 or 449.029 to 449.245, inclusive, and orsections of11, the12 standards, rules and regulations13 adoptedof thereunder.sthis Stateact, (b) Aiding, abetting or permitting the commission of any illegalother act(c)law Conduct inimical to the public health, morals, welfare and safety of thethis people of the State ofor Nevada in the maintenance and operation of the premisesstandards, forrules whichand aregulations licenseadopted isthereunder. issued.

(d)(b) ConductAiding, orabetting practice detrimental to the health or safetypermitting of the occupantscommission or employees of theany facility.illegal act.

(e)(c) FailureConduct ofinimical to the applicantpublic tohealth, obtainmorals, writtenwelfare approvaland fromsafety of the Directorpeople of the DepartmentState of HealthNevada and Human Services as required by NRS 439A.100 or as provided in anythe regulationmaintenance adopted pursuant to NRS 449.001 to 449.430, inclusive, and sectionsoperation 11, 12 and 13 of thisthe actpremises andfor 449.435which toa 449.531,license inclusive, and chapter 449A of NRS if such approval is required.issued.

occupants or employees of the facility.to the health or safety of the (e) Failure of the applicant to obtain written approval from the Director of the Department of Health and Human Services as required by NRS 439A.100 or as provided in any regulation adopted pursuant to NRS 449.001 to 449.430, inclusive, and sections 11, 12 and 13 of this act and 449.435 to 449.531, inclusive, and chapter 449A of NRS if such approval is required.

- 80th Session (2019) – 12 – (a) Is convicted of violating any of the provisions of NRS 202.470;

- *AB252_R2* – 12 – (b) Is ordered to but fails to abate a nuisance pursuant to NRS 244.360, 244.3603 or 268.4124;

The Division shall maintain a log of any complaints that it receives relating to activities for which the Division may revoke the license to operate a facility for the dependent pursuant to subsection 2.

The Division shall provide to a facility for the care of adultsadultstion during the day:

and subsection(b) 2.sciplinaryAny disciplinary actions taken by the Division pursuant to Sec.subsection 2.

Sec.

by449.163 NRS1. 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 sections 11, 12 and 13 of this act or any condition, standard or regulation adopted by the Board, the Division, in accordance with the regulations adopted pursuant to NRS 449.165, may:

In addition to the payment of the amount required facility which is required by the regulations adopted by the Board or 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 sections 11, 12 and 13 of this act or any condition, standard or regulation adopted by the Board, the Division, in accordance with the regulations adopted pursuant to NRS 449.165, may:

- 80th Session (2019) – 13 – (c) If the license of the facility limits the occupancy of the facility and the facility has exceeded the approved occupancy, require the facility, at its own expense, to move patients to another facility that is licensed;

- *AB252_R2* – 13 – (d) Impose an 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;

and (e) Appoint temporary management to oversee the operation of the facility and to ensure the health and safety of the patients of the facility,facilit(1) until: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;

(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;

Any money collected as administrative penalties pursuant to paragraph (d) of subsection 1 must be accounted for separately and used to administer and carry out the provisions of NRS 449.001 todto 449.430,to 449.530, inclusive, and sections449.760 11, 12 and 13chapter 449A of thisNRS act,to49.435 449.435 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.

449.240 The district attorney of the county in which the facility is located shall, upon application by the Division, institute and conduct the prosecution of any action for violation of any provisions of NRS 449.029 to 449.245, inclusive [.] , and sections 11, 12 and 13 of this act.

The provisions of subsection 3 of section 12 of this act and section 13 of this act apply retroactively to any - 80th Session (2019) – 14 – overpayment by the Division of Public and Behavioral Health of the Department of Health and Human Services pursuant to any bill submitted to the Division by a provider of community-based living arrangement services on or after January 1, 2017.

- *AB252_R2* – 14 – 2.

2.January 1, 2020.

Sections 10 to 22, inclusive, of this act become effective on January~~~~~ 1,19 2020.- 80th Session (2019)

H - *AB252_R2*