SB 70 — Revises provisions governing mental health. (BDR 39-418)

matter between brackets [omitted material] is material to be omitted.

(1) The behavioral health needs of adults and children in the behavioral health region;

health needs of adults and children in the (2) Any progress, problems or proposed plans relating to the provision of behavioral health services and methods to improve the provision of behavioral health services in the behavioral health region;

- *SB70_R1* – 5 – (d) Review the collection and reporting standards of behavioral health data to determine standards for such data collection and reporting processes.

(f)- To81st theSession extent(2021) feasible,– track5 and– compile data concerning persons placed on a mental health crisis hold pursuant to NRSNRSing 433A.160, persons admitted to mental health facilities and hospitals under an emergency admission pursuant to [NRS 433A.145 to 433A.197, inclusive, and] section 10 of this act, persons admitted to mental health facilities [and programs of community-based or outpatient services] under an involuntary court-ordered admission pursuant to NRS 433A.200 to 433A.330, inclusive, and persons ordered to receive assisted outpatient treatment pursuant to sections 11 to 21, inclusive, of this act in the behavioral health region, including, without limitation:

(g) Identify and coordinate with other entities in the behavioral health region and this State that address issues relating to behavioral healthefforts.o to increase awareness of such issues and avoid duplication of efforts.(h) In coordination with existing entities in this State that address issues relating to behavioral health services, submit an annual report to the Commission which includes, without limitation:

(h) In coordination with existing entities in this State that address issues relating to behavioral health services, submit an annual report to the Commission which includes, without limitation:

and (4) The data compiled pursuant to paragraph (f) and any conclusions that the policy board has derived from such data.

- *SB70_R1* – 6 – 2.

433.5456 “Chemical restraint” means the administration of drugs to a person for the specific and exclusive purpose of controlling an acute or episodic [aggressive] behavior that places the- person81st orSession others(2021) at– a6 risk– of harm when less restrictive alternative intervention techniques have failed to limit or control the behavior.

From a person professionally qualified in the field of psychiatrictreatment.c mental health who provides assisted outpatient treatment.Sec.

Sec.

person to a public or private mental health facility or a division facility pursuant to NRS 433A.140 as a voluntary consumer for the purposes of observation, diagnosis, care and treatment.

8.

“Voluntary admission” means the admission of a person to a public or private mental health facility or a division facility pursuant to NRS 433A.140 as a voluntary consumer for the purposes of observation, diagnosis, care and treatment.

- *SB70_R1* – 7 – Sec.

(a)- An81st Session (2021) – 7 – Nevada;An officer authorized to make arrests in the State of Nevada;(b) A physician, physician assistant, psychologist, marriage and family therapist, clinical professional counselor, social worker or registered nurse;

(b) A physician, physician assistant, psychologist, marriage and family therapist, clinical professional counselor, social worker or registered nurse;

AThe petitiondistrict pursuantcourt tomay subsectionissue 1an thatorder concernsto place a person whohold only if it is receivingsatisfied assistedthat outpatientthere treatmentis orderedprobable pursuantcause to sectionbelieve 18that the person who is the subject of thisthe actpetition mustis bea accompaniedperson by:in a mental health crisis.

(a) A copy of the order for assisted outpatient treatment, including, without limitation, the list of services that the person has been ordered to receive;

and (b) A list of the provisions of the order with which the person has failed to comply, if any.

4.

The district court may issue an order to place a person alleged to be in a mental health crisis on a mental health crisis hold only if it is satisfied that there is probable cause to believe that the person who is the subject of the petition is a person in a mental health crisis.

- *SB70_R1* – 8 – (a) After conducting an examination pursuant to NRS 433A.165, a physician, physician assistant or advanced practice registered nurse determines that the person does not have aatice medical condition, other than a psychiatric condition, which requires immediate treatment;

(b) A 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- to81st NRSSession 632.120,(2021) who– is8 employed– by the public or private mental health facility or hospital completes a certificate pursuant to NRS 433A.170;

A proceeding for an order requiring any person in the State of Nevada to receive assisted outpatient treatment may be commenced by the filing of a petition for such an order with the clerk of the district court of the county where the person who is to be treated is present.

The petition may be filed by:by:person who is to (a) Any person who is at least 18 years of age and resides with the person to be treated;

(a) Any person who is at least 18 years of age and resides with the person to be treated;

A proceeding to require a person who is the defendant in a criminal proceeding in the district court to receive assisted outpatient treatment may be commenced by the district court, on -attorney *SB70_R1*if:on, – 9 – its own motion, or by motion of the defendant or the district attorney(a) if:The defendant has been examined in accordance with NRS 178.415;

(a) The defendant has been examined in accordance with NRS 178.415;

3.- 81st Session (2021) – 9 – pursuant to subsection 2 must allege the following concerning the person to be treated:

A petition filed pursuant to subsection 1 or a motion made pursuant to subsection 2 must allege the following concerning the person to be treated:

(1) At least twice during the immediately preceding 48 months, poor compliance with mental health treatment has been a significant factor in causing the person being hospitalized or receiving services in the behavioral health unit of a federaldetention orfacility state prison or acorrectional countyfacility. or city jail or detention center.

The 48-month period described in this subparagraph must be extended by theany amount of time that the person has been hospitalized, incarcerated or detained ifduring poorthat complianceperiod. with treatment for his or her mental illness was a significant factor in the person being hospitalized, incarcerated or detained.

(2) Poor compliance with mental health treatment has resultedbeen incommit at least one act of serious violence toward himself or herselfthreaten or others or threat or attempt to causecommit serious physical harm to himself or herself or others during the immediately preceding 48 monthsmonths. in which the person has not been hospitalized, incarcerated or detained.

The 48-month period described in this subparagraph must be extended by theany amount of time that the person has been hospitalized, incarcerated or detained ifduring poorthat complianceperiod. with treatment for his or her mental illness was a significant factor in the person being hospitalized, incarcerated or detained.

(3) Poor compliance with mental health treatment has resulted in the person being hospitalized, incarcerated or detained for a cumulative period of at least 6 months and the person:

- *SB70_R1* – 10 – (d) TheBecause person is capable of survivinghis in the community in which he or sheher residesmental withoutillness, presentingthe aperson substantialis likelihoodtreatment ofthat seriouswould harmenable tothe himselfperson or herself or others, as determined pursuant to NRSlive 433A.0195,safely ifin hethent orcommunity shewithout receivesthe assistedsupervision outpatientof treatment.the court.

(e) TheAssisted personoutpatient requirestreatment assistedis outpatientthe treatmentleast restrictive appropriate means to prevent further disability or deterioration that presentswould aresult substantialin likelihoodthe ofperson seriousbecoming harma toperson himselfin ora herselfmental orhealth others,crisis. as determined pursuant to NRS 433A.0195.

(a)- A81st swornSession statement(2021) or– a10 declaration– that complies with the provisions of NRS 53.045 by a physician, a psychologist, aath the 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, stating that he or she:

(1) AssessedEvaluated the person who is the subject of the petition or motion not earlier than 10 days before the filing of the petition or making of the motion;

and (b) A sworn statement or a declaration that complies with the provisions of NRS 53.045 from a person professionally qualified in the field of psychiatric mental health stating that he or she is willing to provide assisted outpatient treatment for the person in the county where the person resides.

(a) Within 30 judicial days after the date on which the petition is received(b) byIf the clerkperson orwho is the subject of the petition or motion is made,hospitalized asat applicable;the time of the petition or motion, before that person is to be discharged and within a sufficient time to arrange for a continuous transition from inpatient treatment to assisted outpatient treatment.

or - *SB70_R1* – 11 – (b) If the person who is the subject of the petition or motion is hospitalized at the time of the petition or motion, before that person is to be discharged and within a sufficient time to arrange for a continuous transition from inpatient treatment to assisted outpatient treatment.

- 81st Session (2021) – 11 – 3.

The court shall give notice of the petition or motion and of the time, date and place of any proceedings thereon to the person who is the subject of the petition or motion, his or her attorney, if known, the person’s legal guardian, the petitioner, if applicable, the district attorney of the county in which the court has its principal office, the local office of an agency or organization that receives money from the Federal Government pursuant to 42 U.S.C.

and (b) The person who will provide such services and treatment and2.is Services and histreatment orset herforth qualifications.in a proposed written treatment plan must include, without limitation:

2.

Services and treatment set forth in a proposed written treatment plan must include, without limitation:

- *SB70_R1* – 12 – (2) Periodic blood or urine testing to determine whether the person is receiving such medication;

- 81st Session (2021) – 12 – (8) If the person has a history of substance use, periodic blood or urine testing for the presence of alcohol or other recreational drugs;

and (10) Any other services determined necessary to treat the mental illness of the person, assist the person in living ororthe functioning in the community or prevent a deterioration of the mental or physical condition of the person.

If a proposed written treatment plan includes periodic blood or urine testing for the presence of alcohol or other recreational drugs, the plan must set forth sufficient facts to support a clinical determination that the person who is to bebeto treated has a history of substance use disorder.

The person who is the subject of a petition filed or motion made pursuant to section 11 or 21 of this act or any - *SB70_R1* – 13 – relative or friend on the person’s behalf is entitled to retain counsel to represent the person in any proceeding before the district court relating to assisted outpatient treatment.

If he or she fails or refuses to obtain counsel, the court must advise the person and his or her guardian or next of kin, if known, of such right to counsel- and81st mustSession appoint(2021) counsel,– who13 may– be the public defender or his or her deputy.

If the person who is the subject of the petition or motion is ordered to receive assisted outpatient treatment, counsel must continue to represent the person until the person is released from the program.

The court shall serve notice upon such counsel ofoffrom any action that is taken involving the person while the person is required by the order to receive assisted outpatient treatment.

or (II) A motion made pursuant to subsection 2 of section 11 of this act;

and (2) The district attorney determines that there is clear and convincing evidence that the criteria prescribed in subsection 3 of section 11 of this act or subsection 1 of section 21 of this act, as applicable, are met.

(b) May appear and represent the State in the proceedings for assisted outpatient treatment in any other case where the district attorney determines that there is clear and convincing evidence - *SB70_R1* – 14 – that the criteria prescribed in subsection 3 of section 11 of this act or subsection 1 of section 21 of this act, as applicable, are met.

2.- 81st Session (2021) – 14 – State in a proceeding for assisted outpatient treatment,resent the the petitioner is responsible for presenting the case in support of the petition.

If the district attorney does not appear and represent the State in a proceeding for assisted outpatient treatment, the petitioner is responsible for presenting the case in support of the petition.

(a) The testimony of the person who made a sworn statement or declaration pursuant to paragraph (a) of subsection 4 of section 11 of this act, any personnel of the Division responsible for a clinical determination made pursuant to paragraph (c) of subsection 2 of section 11 of this act or the person or entity responsible for the decision to submit a petition pursuant to section 21 of this act, as applicable;

and (c) If the proposed written treatment plan submitted pursuant to section 13 of this act recommends medication and the personpersonnt who is the subject of the petition or motion objects to the recommendation, the testimony of the person professionally qualified in the field of psychiatric mental health who prescribed the recommendation.

Except as otherwise provided in subsection 2, the person who is the subject of a petition or motion for assisted outpatient treatment must be present at the proceedings on the petition or motion, as applicable, and may, at the discretion of the court,cou2., testify.tThe court may conduct the hearing on a petition or motion for assisted outpatient treatment in the absence of the person who is the subject of the petition or motion if:

2.

The court may conduct the hearing on a petition or motion for assisted outpatient treatment in the absence of the person who is the subject of the petition or motion if:

- *SB70_R1*81st Session (2021) – 15 – Sec.the assisted outpatient treatment of a person:ter proceedings for (a) That the person professionally qualified in the field of psychiatric mental health who made the sworn statement or declaration pursuant to paragraph (b) of subsection 4 of section of this act or submitted the petition pursuant to section 21 of this act, as applicable, is not able to provide treatment to the person who is the subject of the proceedings in the county where he or she resides or that there is not clear and convincing evidence that the person who is the subject of the proceedings meets the criteria prescribed in subsection 3 of section 11 of this act or subsection 1 of section 21 of this act, as applicable, the court must enter its finding to that effect and the person must not be ordered to receive assisted outpatient treatment.

18.(b) That the person professionally qualified in the field of psychiatric mental health who made the sworn statement or declaration pursuant to paragraph (b) of subsection 4 of section this act, as applicable, is able to provide treatment to the person who is the subject of the proceedings in the county where he or she resides and that there is clear and convincing evidence that the person who is the subject of the proceedings meets the criteria prescribed in subsection 3 of section 11 of this act or subsection 1 of section 21 of this act, as applicable, the court may order the person to receive assisted outpatient treatment.

1.The order of the court must be interlocutory and must not become final if, within days after the issuance of the order, the person is unconditionally released pursuant to NRS 433A.390.

If the district court finds, after proceedings for the assisted outpatient treatment of a person:

(a) That the person professionally qualified in the field of psychiatric mental health who made the sworn statement or declaration pursuant to paragraph (b) of subsection 4 of section 11 of this act or submitted the petition pursuant to section 21 of this act, as applicable, is not able to provide treatment to the person who is the subject of the proceedings in the county where he or she resides or that there is not clear and convincing evidence that the person who is the subject of the proceedings meets the criteria prescribed in subsection 3 of section 11 of this act or subsection 1 of section 21 of this act, as applicable, the court must enter its finding to that effect and the person must not be ordered to receive assisted outpatient treatment.

(b) That the person professionally qualified in the field of psychiatric mental health who made the sworn statement or declaration pursuant to paragraph (b) of subsection 4 of section 11 of this act or submitted the petition pursuant to section 21 of this act, as applicable, is able to provide treatment to the person who is the subject of the proceedings in the county where he or she resides and that there is clear and convincing evidence that the person who is the subject of the proceedings meets the criteria prescribed in subsection 3 of section 11 of this act or subsection 1 of section 21 of this act, as applicable, the court may order the person to receive assisted outpatient treatment.

The order of the court must be interlocutory and must not become final if, within 30 days after the issuance of the order, the person is unconditionally released pursuant to NRS 433A.390.

(a) That the person professionally qualified in the field of psychiatric mental health who made the sworn statement or declaration pursuant to paragraph (b) of subsection 4 of section 11 of this act or submitted the petition pursuant to section 21 of this act, as applicable, is not able to provide treatment to the defendant in the county where he or she resides or that there is not clear and convincing evidence that the defendant meets the criteria prescribed in subsection 3 of section 11 of this act or subsection 1 of section 21 of this act, as applicable, the court must enter its finding to that effect and the defendant must not be ordered to receive assisted outpatient treatment.

(b)- That81st theSession person(2021) professionally– qualified16 in– the field of psychiatric mental health who made the sworn statement ororeld of declaration pursuant to paragraph (b) of subsection 4 of section - *SB70_R1* – 16 – 11 of this act or submitted the petition pursuant to section 21 of this act, as applicable, is able to provide treatment to the defendant in the county where he or she resides and that there is clear and convincing evidence that the defendant meets the criteria prescribed in subsection 3 of section 11 of this act or subsection 1 of section 21 of this act, as applicable, except as otherwise provided in this paragraph, the court must order the defendant to receive assisted outpatient treatment and suspend further proceedings in the criminal proceeding against the defendant until the defendant completes the treatment or the treatment is terminated.

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 must not order the defendant to receive assisted outpatient treatment pursuant to this paragraph unless the prosecutingcourt attorneymust stipulatesbe tointerlocutory and must not become final if, withinthe days after the assignment.issuance of the order, the person is unconditionally released pursuant to NRS 433A.390.

The order of the court must be interlocutory and must not become final if, within 30 days after the issuance of the order, the person is unconditionally released pursuant to NRS 433A.390.

and (c) Direct the person professionally qualified in the field of psychiatric mental health who made the sworn statement or declaration pursuant to paragraph (b) of subsection 4 of section 11 of this act or submitted the petition pursuant to section 21 of this act, as applicable, to provide the services pursuant to paragraph (b) for the duration of the order.

The order may require the person who is to be treated to self-- administer81st Session (2021) – 17 – self-administer the medication or accept the administration of the medication by a specified person.

An order for a person to receive assisted outpatient treatment must not prescribe treatment that is not recommended - *SB70_R1* – 17 – by the person professionally qualified in the field of psychiatric mental health who made the sworn statement or declaration pursuant to paragraph (b) of subsection 4 of section 11 of this act or submitted the petition pursuant to section 21 of this act, as applicable.

A court may periodically review an order for a person to receive assisted outpatient treatment to determine whether there is an available alternative treatment that is the least restrictive treatment that is appropriate for the person, is in the best interest of the person and will not be detrimental to the public welfare.

Sec.Secs.

19.19 and 20.

20.20.5.

(Deleted by amendment.) Sec.

21.

NotA laterperson thanprofessionally 7qualified judicialin days before the endfield of apsychiatric periodmental ofhealth who is responsible for providing assisted outpatient treatment to a person ordered by a court to receive assisted outpatient treatment pursuant to section 18 of this act,act may petition the Administratorcourt orto hisissue oran herorder designee,requiring thea medicalpeace directorofficer ofto atake divisioninto facilitycustody throughand whichdeliver the person whoto isan theappropriate subjectlocation offor thea orderprompt isevaluation receivingby assistedthe outpatientprofessional treatmentto or- his81st orSession her(2021) designee– or18 another– personif:ermine professionallywhether qualifiedthe inperson theis fielda ofperson psychiatricin a mental health responsiblecrisis for(a) providingThe theperson assistedwho outpatientis treatmentthe maysubject of the petition has failed to renewcomply with the orderplan forof assisted outpatient treatment forordered additionalpursuant periods not to exceedsection 618 monthsof each.this act;

For(b) eachThe renewal,petitioner thehas petitionmade mustreasonable allegeefforts that the person to besolicit treated:such compliance;

(a)and Is(c) capableThe offailure survivingto incomply with the communityplan inof whichassisted heoutpatient ortreatment shemay residescause withoutthe presentingperson awho substantialis likelihoodthe subject of seriousthe -petition *SB70_R1*to – 18 – harm to himself or herself or others,others. as determined pursuant to NRS 433A.0195, if he or she receives assisted outpatient treatment;

(b) Requires assisted outpatient treatment to prevent further disability or deterioration that presents a substantial likelihood of serious harm to himself or herself or others, as determined pursuant to NRS 433A.0195;

and (c) Has a limited ability to make an informed decision to voluntarily seek or comply with treatment for his or her mental illness as a result of his or her mental illness.

A copy of a petition filed pursuant to subsection 1 must beset servedforth: upon the person who is the subject of the petition or his or her counsel and, if applicable, his or her legal guardian.

(a) The specific provisions of the plan of assisted outpatient treatment which the subject of the petition has failed to carry out;

(b) The efforts made by the petitioner to solicit compliance;

and (c) The basis for the petitioner’s belief that the failure to comply with the plan of assisted outpatient treatment may cause the3.

If the court determines that there is probable cause toers.

believe that the conditions described in paragraphs (a), (b) and (c) of subsection 1 have been satisfied, the court may issue an order requiring a peace officer to take into custody and deliver the person who is the subject of the petition to an appropriate location for a prompt evaluation by the petitioner to determine whether the person is a person in a mental health crisis.

4.

As used in this section, “appropriate location” means any location identified by a petitioner but does not include a jail or prison.

Sec.

21.

1.

Not later than 7 judicial days before the end of a period of assisted outpatient treatment ordered by a court pursuant to section 18 of this act, the Administrator or his or her designee, the medical director of a division facility through which the person who is the subject of the order is receiving assisted outpatient qualified in the field of psychiatric mental health responsible for providing the assisted outpatient treatment may petition to renew the order for assisted outpatient treatment for an additional period that does not exceed 6 months.

The petition for renewal must allege that:

(a) Because of his or her mental illness, the person to be treated is unwilling or unlikely to voluntarily participate in outpatient treatment that would enable the person to live safely in the community without the supervision of the court;

and - 81st Session (2021) – 19 – (b) Assisted outpatient treatment is the least restrictive appropriate means to prevent further disability or deterioration that would result in the person to be treated becoming a person in a mental health crisis.

served upon the person who is the subject of the petition or his or her counsel and, if applicable, his or her legal guardian.

A psychiatrist licensed to practice medicine in this State who; is certified by the American Board of Psychiatry and Neurology;

[who is certified by the American Board of Psychiatry and Neurology;] 2.

3.[,] and is licensed by the State as a clinical social worker ;

A social worker who holds a master’s degree in social work [,] and is licensed by the State as a clinical social worker ;

- *SB70_R1* – 19 – Sec.

433A.019 [“Program of community-based or outpatient services”] “Assisted outpatient treatment” means [care, treatment - 81st Session (2021) – 20 – and training] outpatient services provided pursuant to a court order to [persons in a mental health crisis, including, without limitation:

2.

A program of general education or vocational training;

433A.130 All applications , [and] certificates and other forms for the detainment, evaluation, admission , treatment and conditional release of any person in the State of Nevada [to a mental health facility or to a program of community-based or outpatient services] under the provisions of this chapter shall be made on forms approved by the Division and the Office of the Attorney General and furnished by the clerks of the district courts in each county.

- *SB70_R1* – 20 – 2.

If the application is for admission to a division facility, or for care, treatment or training provided by the Division, the - 81st Session (2021) – 21 – 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.

3.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 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 the facility changes the status of the person to an emergency admission pursuant to NRS 433A.145.

(a) Within 72 hours if the person has requested inpatient services;ser(b) Within 72 regular operating hours, excluding weekends and holidays, if the person has requested [community-based or outpatient services.] assisted outpatient treatment.

or (b) Within 72 regular operating hours, excluding weekends and holidays, if the person has requested [community-based or outpatient services.] assisted outpatient treatment.

and [the certificate of a] - *SB70_R1*81st Session (2021) – 2122 – (b) [psychiatrist, psychologist, physician, physician assistant, clinical social worker or advanced practice registered nurse pursuant to NRS 433A.170.] The requirements prescribed by section 10 of this act have been met.

2.whose status is changed pursuant to subsection 1 must not beperson detained in excess of 72 hours , including weekends and holidays, after the [change in status is made] person is placed on a mental health crisis hold 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.

[A] Except as otherwise provided in subsection 3, a person whose status is changed pursuant to subsection 1 must not be detained in excess of 72 hours , including weekends and holidays, after the [change in status is made] person is placed on a mental health crisis hold 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.

[Except as otherwise provided in this subsection, a] A person alleged to be a person in a mental health crisis [may, upon application] who is placed on a mental health crisis hold pursuant to NRS 433A.160 [and] may, subject to the provisions of subsection 2, be detained in a public or private mental health facility or hospital [under an emergency admission] for assessment, evaluation, [observation] intervention and treatment, regardless of whether any parent or legal guardian of the person has consentedcon2.nteExcept 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 [admission.][application for emergency admission or any part of such an application is made] person is placed on a mental health crisis hold.hold pursuant to NRS 433A.160 unless, before the close of the business day on which the 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.

2.

Except 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 [application for emergency admission or any part of such an application is made] person is placed on a mental health crisis hold 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.

- *SB70_R1*81st Session (2021) – 2223 – Sec.433A.160 NRS1.

30.

NRS 433A.160 is hereby amended to read as follows:

433A.160 1.

(a) Taking the person into custody [to apply for the emergency admission of the person for evaluation, observation and treatment;

[(I)] (a) A local law enforcement agency;

or - *SB70_R1*81st –Session 23(2021) – [(VI)]24 (f)– If medically necessary, an ambulance service that holds a permit issued pursuant to the provisions of chapterchaptere 450B of NRS .

 The district court may issue such an order only if it is satisfied that there is probable cause to believe that the person is a person in a mental health crisis.

To the extent practicable, a person [who applies for the emergency admission of a person who is less than 18 years of age to a public or private mental health facility or hospital, other than a parent or guardian,] described in subsection 1 shall attempt to obtain the consent of the parent or guardian of an unemancipated person who is less than 18 years of age before [making the application.] placing the person on a mental health crisis hold.

The person who [applies for the emergency admission] places an unemancipated person who is less than 18 years of age on a mental health crisis hold or, if the person [makes the application] is acting within the scope of his or her employment, the employer of the- person,81st shallSession maintain(2021) documentation of each such attempt until - *SB70_R1* – 2425 – the person who is [the subject of the application] placed on aauntil mental health crisis hold reaches at least 23 years of age.

and (b) Accredited agents of the Division will be monitored and disciplined for professional misconduct.

will be monitored and [7.] 5.

(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 medicalmedicalct such condition, other than a psychiatric condition, which requires immediate treatment;

2.- 81st Session (2021) – 26 – has a medical condition in addition to a psychiatric 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:

If a person alleged to be a person in a mental health crisis has a medical condition in addition to a psychiatric condition which requires medical treatment that requires more than 72 hours to - *SB70_R1* – 25 – complete, the licensed physician, physician assistant or advanced practice registered nurse who examined the person must:

(I) The form for the placement of a person on a mental health crisiscri(II) holdThe certificate [required] completed pursuant to NRS 433A.160433A.170 ;[.] , unless the medical condition prevents the completion of such a certificate.

and [the] (II) The certificate [required] completed pursuant to NRS 433A.170 [.] , unless the medical condition prevents the completion of such a certificate.

The cost of the examination must be paid by the county in which the person alleged to be a person in a mental 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 in a mental health crisis or, on the person’s behalf, by his or her insurer or by a state or federal program of medical assistance.

- 81st Session (2021) – 27 – (b) The estate of that person;

The cost of treatment, including hospitalization, for a person who is indigent must be paid pursuant to NRS 428.010 by the - *SB70_R1* – 26 – county in which the person alleged to be a person in a mental health crisis resides.

As used in this section, “medical facility” has the meaning ascribedascSec. to it in NRS 449.0151.

Sec.

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 not accept [an application] a person for an emergency admission under [NRS 433A.160] section 10 of this act unless [that application is accompanied by a certificate of] 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 , completes a certificate stating that he or she has examined the person alleged to be a person in a mental health crisis and that he or she- has81st concludedSession that(2021) the– person28 is– a person in a mental health crisis.

- *SB70_R1* – 27 – Sec.

433A.185 As soon as practicable but not more than [24] 8 hours after [the emergency admission of a person alleged to be a] an unemancipated person [in a mental health crisis] who is under 18 years of age [,] is placed on a mental health crisis hold, the administrative officer of the public or private mental health facility or hospital in which the person is being held or his or her designee shall attempt to give notice of [such admission] the mental health crisis hold in person, by telephone or facsimile and by certified mail to the parent or legal guardian of that person [.] and shall maintain documentation of each such attempt until the person who is placed on a mental health crisis hold reaches at least 23 years of age.age.d Sec.

Sec.

and (b) Notice of the admission is promptly provided to the family member, friend or other person in person or by telephone, facsimile, other electronic communication or certified mail.

Except as otherwise provided in subsections 4 and 5, if a person alleged to be a person in a mental health crisis who is at least 18 years of age does not give permission to notify a family member, friend or other person of the emergency admission of the person, notice of the emergency admission must not be provided until permission is obtained.

- 81st Session (2021) – 29 – 4.

If a person alleged to be a person in a mental health crisis who is at least 18 years of age 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 or hospital may cause notice as described in paragraph (b) of subsection 2 to be provided if the administrative officerofficeraph (b) 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 who is at least 18 years of age or the - *SB70_R1* – 28 – person has executed a durable power of attorney for health care pursuant to NRS 162A.700 to 162A.870, 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 or hospital must ensure that the guardian, agent designated by the durable power of attorney or the attorney-in-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.

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] from a mental health crisis hold 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 thethen of a 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 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 in a mental health crisis.

A 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 on the medical staff of a facility - 81st Session (2021) – 30 – operated by the Division or of any other public or private mental health facility or hospital who has personally assessed an unemancipated person who is less than 18 years of age after the person was placed on a mental health crisis hold may release the person from the hold if the parent or guardian of the person agrees to treatment or accepts physical custody of the person.

35.5.

NRS 433A.197 is hereby amended to read as follows:

433A.197 1.

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

2.

An application or certificate of any examining person authorized under NRS 433A.170 must not be considered unless it is based on personal observation and examination of the person alleged to be a person in a mental health crisis made by such examining person not more than 72 hours prior to the making of the application or certificate.

The certificate required pursuant to NRS 433A.170 must set forth in detail the facts and reasons on which the examining person based his or her opinions and conclusions.

3.

A certificate authorized pursuant to NRS 433A.195 must not be considered unless it is based on personal observation and crisis made by the examining physician, physician assistant, health psychologist, clinical social worker or advanced practice registered nurse.

The certificate authorized pursuant to NRS 433A.195 must describe in detail the facts and reasons on which the examining physician, physician assistant, psychologist, clinical social worker or advanced practice registered nurse based his or her opinions and conclusions.

Sec.

Except as otherwise provided in [subsection 3 and] NRS 432B.6075, a proceeding for an involuntary court-ordered admission of any person in the State of Nevada may be commenced by the filing of a petition for the involuntary admission to a mental health facility [or to a program of community-based or outpatient - *SB70_R1* – 29 – services] with the clerk of the district court of the county where the person who is to be treated resides [.] or the county where a mental health- facility81st thatSession is(2021) willing– to31 admit– petition may be filed by [the spouse, parent, adult children or legal guardian of the person isto located.be treated or by] any physician, physician assistant, psychologist, social worker or registered nurse or by any officer authorized to make arrests in the State of Nevada.

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 or by any officer authorized to make arrests in the State of Nevada.

(1) The petitioner has, based upon the petitioner’s personal observation of the person alleged to be a person in a mental health crisis, probable cause to believe that the person is a person in a mental health crisis [;] and [(2) The] the person alleged to be a person in a mental 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 [.] ;

or (2) The person alleged to be a person in a mental health crisis has been placed on a mental health crisis hold pursuant to NRS 433A.160 and the physician, physician assistant or advanced practice registered nurse who examined the person alleged to be a person with a mental health crisis pursuant to NRS 433A.165 determined that the person has a medical condition, other than a psychiatricpsy2.iatExcept condition,as whichotherwise requiresprovided immediatein treatment.NRS 432B.6075, if the person to be treated is [a] an unemancipated minor and the petitioner is a person other than a parent or guardian of the minor, a petition submitted pursuant to subsection 1 must, in addition to the certificate or statement required by that subsection, include a statement signed by a parent or guardian of the minor that the parent or guardian does not object to the filing of the petition.

2.

Except as otherwise provided in NRS 432B.6075, if the person to be treated is [a] an unemancipated minor and the petitioner is a person other than a parent or guardian of the minor, a petition submitted pursuant to subsection 1 must, in addition to the certificate or statement required by that subsection, include a statement signed by a parent or guardian of the minor that the parent or guardian does not object to the filing of the petition.

A proceeding for the involuntary court-ordered admission of a person who is the defendant in a criminal proceeding in the - *SB70_R1*81st Session (2021) – 3032 – 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:

(a) The defendant has been examined in accordance with NRS(b) The defendant is not eligible for commitment to the custody of the Administrator pursuant to NRS 178.415;178.461;

(b) The defendant is not eligible for commitment to the custody of the Administrator pursuant to NRS 178.461;

(b) In his or her opinion, there is a reasonable degree of certainty that the person alleged to be a person in a mental health crisiscrisisrtainty suffers from a mental illness;

433A.215 If an application for a writ of habeas corpus is made by, or on behalf of, a person in a mental health crisis or who is alleged to be a person in a mental health crisis before the initial hearing- on81st aSession petition(2021) for– the33 involuntary– court-ordered admission of the person to a mental health facility , [or a program of community- - *SB70_R1* – 31 – based or outpatient services,] the court [shall] must conduct a hearing on the application as soon as practicable.

If the Chief Judge, if any, of the district court has assigned a district court judge or hearing master to preside over such hearings,hea2. that judge or hearing master must preside over the hearing.

2.The court shall give notice of the petition [or motion] and of.

The court shall give notice of the petition [or motion] and of the time, date and place of any proceedings thereon to the subject of the petition , [or motion,] his or her attorney, if known, the person’s legal guardian, the petitioner, [if applicable,] the district attorney of the county in which the court has its principal office, the local office of an agency or organization that receives money from the Federal Government pursuant to 42 U.S.C.

If the person has a legal guardian, the facility or hospital shall notify the guardian prior to discharging the person from the facility [.] or hospital.

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

Notification of a guardian pursuant to this subsection must be provided:

(a) In person or by telephone;

or - 81st Session (2021) – 34 – (b) If the mental health facility is not able to contact the guardian in person or by telephone, by facsimile, electronic mail or certified mail.

If the person who is the subject of the petition is currently admitted to a mental health facility or hospital and is transferred to another mental health facility or hospital, the petitioner mustmustd notify the court before the next scheduled hearing related to the petition and not more than 24 hours after the transfer.

- *SB70_R1* – 32 – 5.

After the filing of a petition to commence proceedings for the involuntary court-ordered admission of a person pursuant to NRS 433A.200 and 433A.210, the court shall promptly cause two or more physicians, [licensed] psychologists or advanced practice registered nurses who have the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120, one of whom must always be a physician, to examine the person alleged to be a person in a mental health crisis, or request an evaluation by an evaluation team from the Division of the person alleged to be a person in a mental health crisis.

[After the filing of a motion pursuant to subsection 3 of NRS 433A.200, the court shall promptly request an evaluation by an - 81st Session (2021) – 35 – evaluation team from the Division of the person alleged to be a person in a mental health crisis.

4.] To conduct the examination of a person who is not being detained at a mental health facility or hospital under [emergency admission] a mental health crisis hold pursuant to [an application made pursuant to] NRS 433A.160, the court may order a peacepeaceication officer to take the person into protective custody and transport the person to a mental health facility or hospital where the person may be detained until a hearing is had upon the petition or motion, as applicable.

- *SB70_R1* – 33 – [5.] 4.

Each physician, [licensed] psychologist and advanced practice registered nurse who examines a person pursuant to subsection 1 shall, not later than 24 hours before the hearing set pursuant to subsection 1 of NRS 433A.220, submit to the court in writing a summary of his or her findings and evaluation regarding the person alleged to be a person in a mental health crisis.crisis.rding Sec.

Sec.

[In counties] If a petition is filed pursuant NRS 433A.200 with the clerk of the district court in a county where the - 81st Session (2021) – 36 – examining personnel required pursuant to NRS 433A.240 are not available, [proceedings for involuntary court-ordered admission shall be conducted in] the district court must transfer the case to the nearest county having such examining personnel available [in order that there be minimum delay.] before any hearing on the petition and not later than 1 judicial day after the petition was filed.

- *SB70_R1* – 34 – 2.

[Any] The court shall award any counsel appointed pursuant to subsection 1 [must be awarded] compensation [by the court] for his or her services in an amount determined by it to be fair and reasonable.

The court shall serve - 81st Session (2021) – 37 – notice upon such counsel of any action that is taken involving the person while the person is admitted to the program of community- based or outpatient services.]services. 5.] Each district attorney or his or her deputy shall appear and represent the State in all involuntary court-ordered admission proceedings in the district attorney’s county.

5.] Each district attorney or his or her deputy shall appear and proceedings in the district attorney’s county.

Except as otherwise provided in [subsection 2 and] NRS 432B.6076 and 432B.6077, if the district court finds, after - *SB70_R1* – 35 – proceedings for the involuntary court-ordered admission of a person:

[or to a program of community- based or outpatient services.] If the person has been [admitted to] detained in a public or private mental health facility or hospital under a mental health crisis hold pursuant to NRS 433A.160, including, without limitation, where the person has been admitted under an emergency admission pursuant to [NRS 433A.160,] section 10 of this act, 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 ascourasissuea athevoluntarynlessconsumerson voluntaryapursuantor consumer pursuant to NRS 433A.140.

(a)- That81st thereSession is(2021) not– clear38 and– convincing evidence that the defendant with respect to whom the hearing was held is a person in a mental health crisis, the court shall enter its finding to that effect and the person must not be involuntarily admitted to a program of community-based or outpatient services.

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 - *SB70_R1* – 36 – involuntary admission of the defendant for participation in a program pursuant to this paragraph unless the prosecuting attorney stipulatesinterlocutory toand must not become final if, within 30 days after the assignment.involuntary admission, the person is unconditionally released pursuant to NRS 433A.390.

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 pursuant to NRS 433A.390.

A court shall not admit a person to a program of community- basedbas(a) A program of community-based or outpatient services unless:is available in the community in which the person resides or is otherwise made available to the person;

(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)- The81st courtSession determines(2021) that,– based39 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 presents a substantial likelihood of serious harm to himself or herself or others, as determined pursuant to NRS 433A.0195;

5.] Except as otherwise provided in NRS 432B.608, an involuntary admission pursuant to paragraph (b) of subsection 1 [or paragraphmonths (b)if ofnot subsectionterminated 2]previously automaticallyby expires at the endmedical director of the 6 -public *SB70_R1*or –private 37mental –health monthsfacility ifafter nota terminateddetermination previously by the medicalphysician directorprimarily ofresponsible for treating the publicpatient, a psychiatrist or privatean mentaladvanced healthpractice facilityregistered nurse as provided for in subsection [2] 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 public or private mental health facility .

[or to a program ofofson community-based or outpatient services.

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,] assisted outpatient treatment, as suggested by the evaluation team who evaluated the person, or other persons - 81st Session (2021) – 40 – professionally qualified in the field of psychiatric mental health, which the court believes may be in the best interests of the person.

If the court issues an order involuntarily admitting a person to a public or private mental health facility [or to a program of community-based or outpatient services] pursuant to this section, the court [shall,] must, notwithstanding the provisions ofofs section, NRS 433A.715, cause, within 5 business days after the order becomes final pursuant to this section, on a form prescribed by the Department of Public Safety, a record of the order to be transmitted to:

A public or private mental health facility to which a person is involuntarily admitted pursuant to this section shall notify the - *SB70_R1* – 38 – court and the counsel for the person if the person is transferred to another facility.

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

Sec.

Upon admission to any public or private mental health facility or to [a program of community-based or outpatient services,] assisted outpatient treatment, each consumer and the consumer’s spouse and legal guardian, if any, must receive a written statement outlining in simple, nontechnical language all procedures for release provided by this chapter, setting out all rights accorded to such a consumer by this chapter and chapters 433 and 433B of NRS and, if the consumer has no legal guardian, describing procedures provided- by81st lawSession (2021) – 41 – guardian for adjudicationthe consumer.cation of incapacity and appointment of a guardian2. for the consumer.

2.

A clinical record for each consumer must be diligently maintained by any division facility, private institution, facility offering mental health services or [program of community- based or outpatient services.] person professionally qualified in the field of psychiatric mental health responsible for providing assistedpertaining outpatientto treatment.the consumer’s admission, legal status, treatment and individualized plan for habilitation.

The record must include information pertaining to the consumer’s admission, legal status, treatment and individualized plan for habilitation.

- *SB70_R1* – 39 – (b) The record must be released to physicians, advanced practice registered nurses, attorneys and social agencies as specifically authorized in writing by the consumer, the consumer’s parent, guardian or attorney.

(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.

(f) To the extent necessary for a consumer to make a claim, or for a claim to be made on behalf of a consumer for aid, insurance or medical- assistance81st toSession which(2021) the– consumer42 may– be entitled, information from the records may be released with the written authorization of the consumer or the consumer’s guardian.

(h)433B.200 Theand recordin mustchapter be629 releasedof asNRS.as provided in NRS 433.332 or 433B.2002. and in chapter 629 of NRS.

2.A division facility, private institution, facility offering mental health services or [program of community-based or outpatient services] person professionally qualified in the field of psychiatric mental health responsible for providing assisted outpatient treatment 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 division facility, private institution, facility offering mental health services or [program of community-based or outpatient services] person professionally qualified in the field of psychiatric mental health responsible for providing assisted outpatient treatment and any other person or entity having information concerning a consumer, including, without limitation, a clinical record, any part thereof or any information contained - *SB70_R1* – 40 – 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 facilitycommunity-based offeringor mentaloutpatient healthservices.s, services, or from a program of community-based(b) or“Provider] outpatient, services.“provider of health care” has the meaning ascribed to it in NRS 629.031.

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

[Except as otherwise provided in subsection 4, any] 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] :

[,- the]81st (a)Session The(2021) conditional– release43 is– in the best interest of the person , will provide the least restrictive treatment that is appropriate for , the person and will not be detrimental to the public welfare [.] ;

If the person has a legal guardian, the facility [shall] must notify the guardian at least 3 days before discharging the person from the facility [.] or, if the person will be released in less thanguardian 3must days,be asprovided:acticable. soon as practicable.

Notification of the legal guardian(a) mustIn beperson provided:or by telephone;

(a) In person or by telephone;

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] must discharge the person according to its proposed discharge plan.

- *SB70_R1* – 41 – [2.] 4.

The court may periodically review the appropriateness of the conditional release and the terms thereof, but the court may not terminate the conditional release except through proceedings for involuntary admission pursuant to NRSNRSt 433A.200 to 433A.330, inclusive.

When a person who has been adjudicated by a court to be incapacitated is conditionally released from a mental health - 81st Session (2021) – 44 – 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 facilitatethefacilitate the incapacitated person’s rehabilitation.

If the person has a legal guardian, the petition must be filedfil[4.wiA withperson thewho courtwas havinginvoluntarily jurisdictionadmitted overby thea guardianship.courtship.

[4.because he or she was likely to present a substantial likelihood of serious harm to himself or herself or others, as determined pursuant to NRS 433A.0195, 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.

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, as determined pursuant to NRS 433A.0195, 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.

If an emergency exists in which the person presents a substantial likelihood of harm to himself or herself or others, as determined pursuant to NRS 433A.0195, the order must be submitted to the - *SB70_R1* – 42 – court and the legal guardian not later than 1 business day after the order is issued.

7.- 81st Session (2021) – 45 – conditional release has expired.]n 5 do not apply if the period of Sec.

The provisions of subsection 5 do not apply if the period of conditional release has expired.] Sec.

When a consumer, involuntarily admitted to a mental health facility or [to a program of community-based or outpatient services] required to receive assisted outpatient treatment by court order, is released at the end of the period specified pursuant to NRS 433A.310 [,] or section 18 of this act, as applicable, written notice must be given to the admitting[admitting] court [and to the consumer’s legal guardian at least 10] that issued the order not later than 3 judicial days [before] after the release of the consumer.

If the consumer has a legal guardian, the facility or the [professional] person professionally qualified in the field of psychiatric mental health responsible for providing [or coordinating] the [program of community-based or outpatient services] assisted outpatient treatment shall notify the guardian in the manner prescribed by subsection 6 at least 3 days before discharging the consumer from the facility or [program.] treatment or, if the consumer will be released in less than 3 days, as soon as practicable.

- *SB70_R1* – 43 – [2.] 3.

A consumer who is involuntarily admitted to a mental healthspecified facilityin mayNRS be433A.310 unconditionallywhen [:nally released before the period specified(a) 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] the physician [,] primarily responsible for treating the patient, a psychiatrist or an advanced practice registered nurse who has the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 433A.310632.120 whendetermines [:that the consumer is no longer a person in a mental health crisis .

(a) 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] the physician [,] primarily responsible for treating the patient, a psychiatrist 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 determines that the consumer is no longer a person in a mental health crisis .

and - 81st Session (2021) – 46 – (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 aast legal guardian, the facility shall notify the guardian in the manner prescribed by subsection 6 at least 3 days before discharging the consumer from the facility [.] or, if the consumer will be released in less than 3 days, as soon as practicable.

(a) The] the [professional] person professionally qualified in the field of psychiatric mental health responsible for providing [or coordinating] the [program of community-based or outpatient services] assisted outpatient treatment for the consumer determines that the[the consumer [is]is no longer [aa 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 - *SB70_R1* – 44 – admitting court at least 10 days before the release of the consumer from the program.] :

(a) RequiresThe consumer no longer requires assisted outpatient treatment to prevent further disability or deterioration that presentswould aresult substantialin likelihoodthe ofperson seriousbecoming harma toperson himselfin ora herselfmental orhealth others,crisis; as determined pursuant to NRS 433A.0195;

and (b) HasThe aconsumer limitedis abilitywilling toand makelikely an informed decision to voluntarily seekparticipate orin complyoutpatient with treatment forthat hisenables orthe herperson mentalto illnesslive assafely ain resultthe ofcommunity hiswithout orthe hersupervision mentalof illness.the court;

or - 81st Session (2021) – 47 – (c) After the order for assisted outpatient treatment has been effective for at least 30 days, the assisted outpatient treatment is not meeting the needs of the consumer.

If a consumer who will be released from assisted outpatient treatment pursuant to subsection 4 has a legal guardian, the person professionally qualified in the field of psychiatric mental health responsible for providing the assisted outpatient treatment to the consumer shall notify the guardian in the manner prescribed by subsection 6 at least 3 days before discharging the consumer from the treatment or, if the consumer will be released in less than 3 days, as soon as practicable.

A mental health facility or a person professionally qualified in the field of psychiatric mental health responsible for providing treatment to a consumer shall provide written notice to the admitting court that issued the order not later than 3 judicial days after unconditionally releasing a consumer pursuant to subsection 3 or 4.

48.5.

NRS 433A.400 is hereby amended to read as follows:

433A.400 1.

An indigent resident of this state discharged as crisis, but having a residual medical or surgical disability which prevents him or her from obtaining or holding remunerative employment, must be returned to the county of his or her last residence, except as otherwise provided pursuant to subsections 2 and 3.

A nonresident indigent with such disabilities must be returned to the county from which he or she was involuntarily court- admitted, except as otherwise provided in subsections 2 and 3.

The administrative officer of the mental health facility shall first give notice in writing, not less than 10 days before discharge, to the board of county commissioners of the county to which the person will be returned and to the person’s legal guardian.

2.

Delivery of the indigent person must be made to an individual or agency authorized to provide further care.

If the person has a legal guardian, the facility shall notify the guardian before discharging the person from the facility.

The legal guardian has - 81st Session (2021) – 48 – into consideration any discharge plan proposed by the facilitying 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 proposed discharge plan.

Notification of a guardian pursuant to this subsection must be provided:

(a) In person or by telephone;

or (b) If the mental health facility is not able to contact the guardian in person or by telephone, by facsimile, electronic mail or certified mail.

3.

An indigent person may be delivered to a state that is a party to the Interstate Compact on Mental Health ratified and enacted in NRS 433.4543 regardless of residency in the manner provided in the Compact.

4.

This section does not authorize the release of any person held upon an order of a court or judge having criminal jurisdiction ariSec.

433A.580 No person may be admitted or transferred to a private hospital [,] or a division mental health facility [or a program of community-based or outpatient services] , ordered to receive assisted outpatient treatment or transferred to a different person - *SB70_R1* – 45 – professionally qualified in the field of psychiatric mental health to provide assisted outpatient treatment pursuant to the provisions ofofto this chapter unless mutually agreeable financial arrangements relating to the costs of treatment are made between the private hospital, division facility or [professional] person professionally qualified in the field of psychiatric mental health responsible for providing [or coordinating a program of community-based or outpatient services] assisted outpatient treatment and the consumer or person requesting his or her admission.

- 81st Session (2021) – 49 – Sec.

A person who is admitted to a division facility or [to a program of community-based or outpatient services] who receives assisted outpatient treatment operated by the Division and not determined to be indigent and every responsible relative pursuant to NRS 433A.610 of the person shall be charged for the cost of treatment and is liable for that cost.

2.community-based or outpatient services] required to receiverogram of assisted outpatient treatment pursuant to a court order, that person and his or her responsible relatives are responsible for the payment of the actual cost of the treatment and services rendered during his or her admission to the division facility or [program] while he or she is receiving assisted outpatient treatment unless the investigation reveals that the person and his or her responsible relatives are not capable of paying the full amount of the costs.

If3. a person is admitted to a division facility or [program of community-based or outpatient services] required to receive assisted outpatient treatment pursuant to a court order, that person and his or her responsible relatives are responsible for the payment of the actual cost of the treatment and services rendered during his or her admission to the division facility or [program] while he or she is receiving assisted outpatient treatment unless the investigation reveals that the person and his or her responsible relatives are not capable of paying the full amount of the costs.

Once a court has ordered [the admission of a person to a program of community-based or outpatient services] a person to receive assisted outpatient treatment operated by the Division, the [professional] person professionally qualified in the field of psychiatric mental health responsible for providing [or coordinating] the [program shall] assisted outpatient treatment must make an investigation, pursuant to the provisions of this - *SB70_R1*81st Session (2021) – 4650 – 3.chapter, to determine whether the person receiving the treatment or his or her responsible relatives pursuant to NRS 433A.610 are capable of paying for all or a portion of the costs that will be incurred during the period of [admission.] treatment.

Once433A.650 aNRS courtDetermination has ordered [the admission of aability person to apay programpursuant of community-based or outpatient services] a person to receiveNRS assisted433A.640 outpatient[shall] treatmentmust operatedinclude byinvestigation the Division, the [professional] person professionally qualified in the field of psychiatricwhether mental health responsible for providing [or coordinating] the [programconsumer shall]has assistedbenefits outpatientdue treatmentand mustowing make an investigation, pursuant to the provisionsconsumer offor this chapter, to determine whether the personcost receivingof the treatment or his or her responsibletreatment relativesfrom pursuantthird-party tosources, NRSsuch 433A.610as areMedicare, capableMedicaid, ofsocial payingsecurity, formedical allinsurance orbenefits, aretirement portionprograms, ofannuity theplans, costsgovernment thatbenefits willor beany incurredother duringfinancially theresponsible periodthird ofparties. [admission.] treatment.

Sec.

53.

NRS 433A.650 is hereby amended to read as follows:

433A.650 Determination of ability to pay pursuant to NRS 433A.640 [shall] must include investigation of whether the consumer has benefits due and owing to the consumer for the cost of his or her treatment from third-party sources, such as Medicare, Medicaid, social security, medical insurance benefits, retirement programs, annuity plans, government benefits or any other financially responsible third parties.

If the consumer, his or her responsible relative pursuant to NRS 433A.610, guardian or the estate neglects or refuses to pay the cost of treatment to the division facility or to the [program of community-based or outpatient services] person professionally qualified in the field of psychiatric mental health responsible for providing the assisted outpatient treatment operated by the Division rendering service pursuant to the fee schedule established under NRS 433.404 or 433B.250, as appropriate, the State is entitled to recover by appropriate legal action all sums due, plus interest.

- *SB70_R1* – 47 – (a) The number of [applications for emergency admission received by] persons placed on a mental health crisis hold at the mental health facility or hospital pursuant to NRS 433A.160 during the immediately preceding quarter;

and - 81st Session (2021) – 51 – (b) Any other information prescribed by regulation of the State Board of Health.

The State Board of Health may adopt regulations that require a public or private mental health facility or hospital to adopt a plan for the discharge of a person admitted to the facility or hospital in accordance with the provisions of this chapter and that prescribe the contents of such a plan.

After the hearing described in subsection 2, the court may ordersection theif:nspection inspection of records that are sealed pursuant to this section(a) if:A law enforcement agency must obtain or maintain information concerning persons who have been admitted to a public or private hospital [,] or a mental health facility or [a program of community-based or outpatient services] received assisted outpatient treatment in this State pursuant to state or federal law;

(a) A law enforcement agency must obtain or maintain information concerning persons who have been admitted to a public or private hospital [,] or a mental health facility or [a program of community-based or outpatient services] received assisted outpatient treatment in this State pursuant to state or federal law;

- *SB70_R1* – 48 – 4.

(a)- The81st governmentalSession entity(2021) has– made52 a– conditional offer of 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;

(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 or paragraph (b) of subsection 1 of section 18 of of this act if:

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 relevantcourt formay theallow dispositiona ofparty ain the matter pendingto beforeinspect the court.records withouthe following the procedure described in subsection 2 if the court deems such inspection necessary and appropriate.

The court may allow a party in the matter to inspect the records without following the procedure described in subsection 2 if the court deems such inspection necessary and appropriate.

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 [,] or mental health facility or [program of community-based or outpatient services,] the assisted outpatient treatment of the person who is the subject of the records is deemed - *SB70_R1*81st Session (2021) – 4953 – neverquestion related to haveits occurred,occurrence, andexcept thein personconnection maywith:any answer(a) accordinglyAn anyapplication questionfor relateda permit to itscarry occurrence,a exceptconcealed infirearm connectionpursuant with:to the provisions of NRS 202.3653 to 202.369, inclusive;

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

As used in this paragraph, “fire-fighting agency” means a public fire department, fire protection district or other agency of this State or a political subdivision of this State, the primary functions of which are to control,con(b) extinguish,“Peace preventofficer” andhas suppressthe fires.meaning ascribed to it in NRS 289.010.

(b) “Peace officer” has the meaning ascribed to it in NRS 289.010.

or (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, in isNRS guilty193.130.a of a category D felony and shall be punished as provided in2. NRS 193.130.

2.

- 81st Session (2021) – 54 – 3.

A person who, without probable cause for believing another person is a person in a mental health crisis, executes a petition, application or certificate pursuant to this chapter, by which the - *SB70_R1* – 50 – person secures or attempts to secure the apprehension, hospitalization, detention, admission or restraint of the person alleged to be a person in a mental health crisis, or any physician, psychiatrist, [licensed] psychologist, 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.

A district judge assigned to the family court pursuant to subsection 2 or 3 for a period of 90 or more days, except for a district judge or hearing master assigned to hear proceedings brought pursuant to NRS 433A.200 to 433A.330, inclusive, or sections 11 to 21, inclusive, of this act must attend the instruction required pursuant to subsection 1 of NRS 3.028.

District judgesjudgesuction must not be assigned to the family court pursuant to subsections 2 and 3 on a rotating basis.

(b)- Brought81st pursuantSession to(2021) NRS– 442.25555 and– 442.2555 to request the court to issue an order authorizing an abortion.abortion.to request (c) For judicial approval of the marriage of a minor.

(c) For judicial approval of the marriage of a minor.

- *SB70_R1* – 51 – (f) To change the name of a minor.

2.provided in paragraph (m) of subsection 1 of NRS 4.370, the justice court have concurrent jurisdiction over actions for the issuance of a temporary or extended order for protection against domestic violence.

The family court, where established and, except as otherwise provided in paragraph (m) of subsection 1 of NRS 4.370, the justice court have concurrent jurisdiction over actions for the issuance of a temporary or extended order for protection against domestic violence.

2.or psychologist who is not employed by the Division to perform antrist additional evaluation and report concerning the defendant, the cost of the additional evaluation and report is a charge against the county.

If the judge orders the appointment of a licensed psychiatrist or psychologist who is not employed by the Division to perform an additional evaluation and report concerning the defendant, the cost of the additional evaluation and report is a charge against the county.

(a)- Whether81st thereSession is(2021) substantial– probability56 that– the defendant can receive treatment to competency and will attain competency totot stand trial or receive pronouncement of judgment in the foreseeable future;

- *SB70_R1* – 52 – Upon receipt thereof, the prosecuting attorney shall notify the sheriff of the county or chief of police of the city that the defendant has been found competent and prearrange with the facility for the return of the defendant to that county or city for trial upon the offense there charged or the pronouncement of judgment, as the case may be.

(b) Incompetent, but there is a substantial probability that the defendant can receive treatment to competency and will attain competency to stand trial or receive pronouncement of judgment in the foreseeable future and finds that the defendant is dangerous to himself or herself or to society, the judge shall recommit the defendant and may order the involuntary administration of medication for the purpose of treatment to competency.

(d) Incompetent, with no substantial probability of attaining competency in the foreseeable future, the judge shall order the defendant released from custody or, if the defendant is an outpatient, released from any obligations as an outpatient if, within 10 judicial days, the prosecuting attorney has not filed a motion pursuant to NRS 178.461 or if, within 10 judicial days, a petition is not filed [to commit] for the involuntary court-ordered admission of the person to a mental health facility pursuant to NRS 433A.200.

- 81st Session (2021) – 57 – 5.

Except as otherwise provided in subsections 4 and 7 of NRS 178.461, no person who is committed under the provisions of this chapter may be held in the custody of the Administrator or the Administrator’s designee longer than the longest period of incarceration provided for the crime or crimes with which the person is charged or 10 years, whichever period is shorter.

- *SB70_R1* – 53 – Sec.

(b) The adjudication reported in the record is deemed not to have occurred for purposes of 18 U.S.C.

and (b)- Served81st uponSession the(2021) district– attorney58 for– the county in which the court described in paragraph (a) is located.

the county in which the 5.

and - *SB70_R1* – 54 – (c) Granting the relief requested by the petitioner pursuant to subsection 2 is not contrary to the public interest.

Except as otherwise provided in this subsection, the petitioner must establish the provisions of subsection 6 by a preponderanceconcerning ofthe petitioner was made pursuant to NRS 159.0593 or 433A.310, the petitioner must establish the provisions of subsection by clear and convincing evidence.

If the adjudication or finding concerning the petitioner was made pursuant to NRS 159.0593 or 433A.310, the petitioner must establish the provisions of subsection 6 by clear and convincing evidence.

If the Central Repository fails to remove a record as provided in subsection 9, the petitioner may bring an action to compel the removal of the record.

Any record described in NRS 179A.163 is confidential and is not a public book or record within the meaning - 81st Session (2021) – 59 – other than for a purpose related to criminal justice, including, without limitation, inclusion in the appropriate database of NRSthe 239.010.National Instant Criminal Background Check System and the National Crime Information Center, if applicable.

A person may not use the record for any purpose other than for a purpose related to criminal justice, including, without limitation, inclusion in the appropriate database of the National Instant Criminal Background Check System and the National Crime Information Center, if applicable.

- *SB70_R1* – 55 – (b) Failing to transmit or report the record or failing to take any other required action concerning the record;

(c) Delaying the transmission or reporting of the record or delayingorlaying in taking any other required action concerning the record;

or (d) Transmitting or reporting an inaccurate or incomplete version of the record or taking any other required action concerning an inaccurate or incomplete version of the record.

(a) The requirements for proper identification of the persons seekingsee(b) accessThe toreasonable thecharges records;or fees, if any, for inspecting records.

and (b) The reasonable charges or fees, if any, for inspecting records.

(b)- The81st correctionSession of(2021) any– information60 relating– to records of mental health found by the Director to be inaccurate, insufficient or incomplete in any material respect;

- *SB70_R1* – 56 – Sec.

64.

NRS 388.253 is hereby amended to read as follows:

(3) Assisting persons within a school in a school district, a charter(4) Assisting persons within a school in a school district, a charter school or a private school to communicate with eachpersons other;located outside the school, including, without limitation, relatives of pupils and relatives of employees of such a school, the news media and persons from local, state or federal agencies that are responding to a crisis or an emergency;

(4)(5) Assisting personspupils withinof a school in athe school district, a charter school or a private schoolschool, toemployees communicateof withsuch personsa locatedschool outsideand therelatives school,of including,such withoutpupils limitation,and relativesemployees ofto pupilsmove safely within and relatives- of81st employeesSession of(2021) such– a61 school,– evacuating the newsschool media and personsa fromprocedure local,for statesecuring orthe federalschool;re agenciesfor that(6) areReunifying respondinga topupil awith crisishis or anher emergency;parent or legal guardian;

(5) Assisting pupils of a school in the school district, a charter school or a private school, employees of such a school and relatives of such pupils and employees to move safely within and away from the school, including, without limitation, a procedure for evacuating the school and a procedure for securing the school;

(6) Reunifying a pupil with his or her parent or legal guardian;

(5)(6) AnAny outbreakthreat or hazard identified in the hazard mitigation plan of disease;the county in which the school district is located, if such a plan exists;

- *SB70_R1* – 57 – (6) Any threat or hazard identified in the hazard mitigation plan of the county in which the school district is located, if such a plan exists;

(e) Selecting an assessment tool which assists in responding to a threatthr(f) againstOn an annual basis, providing drills to instruct pupils in the schoolappropriate byprocedures to be followed in response to a pupilcrisis or pupils;an emergency.

(f) On an annual basis, providing drills to instruct pupils in the appropriate procedures to be followed in response to a crisis or an emergency.

(g) Responding to a suicide or attempted suicide to mitigate the effects of the suicide or attempted suicide on pupils and staff at the school, including, without limitation, by making counseling and other- appropriate81st resourcesSession to(2021) assist– in62 recovering– from the suicide or attempted suicide available to pupils and staff;

from the suicide (h) Providing counseling and other appropriate resources to pupils and school staff who have contemplated or attempted suicide;

(1) Utilizing mobile mental health crisis response units, where available, before transporting the pupil to a public or private mental health facility pursuant to subparagraph (2);

andandic -or *SB70_R1*private – 58 – (2) Transporting the pupil to a public or private mental health facility or hospital for [admission] placement on a mental health crisis hold pursuant to NRS [433A.150.] 433A.160.

A charter school shall hold harmless, indemnify and defend the school district to which it evacuates during a crisis or an emergency against any claim or liability arising from an act or omission by the school district.school district or an employee or officer of the school5. district.

5.

(c)- A81st planSession developed(2021) pursuant– to63 NRS– 394.1687 or updated pursuant to NRS 394.1688;

andandant to NRS 394.1687 or updated (d) A deviation approved pursuant to NRS 388.251 or 394.1692.

The term does not include the administration of drugs [on a regular basis, as] prescribed by a physician, [to treat the symptoms of] physician assistant or advanced practice registered nurse as standard treatment for the mental [,] or physical [, emotional or behavioral disorders and for assisting a person in gaining self- controlconSec. over his or her impulses.] condition of the person.

Sec.

394.355 “Chemical restraint” means the administration of drugs to a person for the specific and exclusive purpose of controlling an acute or episodic [aggressive] behavior that places - *SB70_R1* – 59 – the person or others at a risk of harm when less restrictive alternative intervention techniques have failed to limit or control the behavior.

The Division may issue an endorsement as a crisis stabilization center to the holder of a license to operate a psy2.iatA psychiatric hospital that wishes to obtain an endorsement as a crisis stabilization center must submit an application in the form prescribed by the Division which must include, without limitation, proof that the applicant meets the requirements of thissubsection section.3.

2.

A psychiatric hospital that wishes to obtain an endorsement as a crisis stabilization center must submit an application in the form prescribed by the Division which must include, without limitation, proof that the applicant meets the requirements of subsection 3.

- 81st Session (2021) – 64 – (b) Operates in accordance with established administrative protocols, evidenced-based protocols for providing treatment and evidence-based standards for documenting information concerning services rendered and recipients of such services in accordance with bestbes(c) practicesDelivers for providing crisis stabilization services:ion services;

(c) Delivers crisis stabilization services:

- *SB70_R1* – 60 – (1) The race, ethnicity, gender, socioeconomic status, sexual orientation or place of residence of the patient;

or (4) Whether the patient is admitted voluntarily to the psychiatric hospital pursuant to NRS 433A.140 or admitted to the psychiatric hospital under an emergency admission pursuant to [NRS 433A.150;] section 10 of this act;

- 81st Session (2021) – 65 – (a) Case management services, including, without limitation, such services to assist patients to obtain housing, food, primary health care and other basic needs;

(b) Services to intervene effectively when a behavioral health crisis occurs and address underlying issues that lead to repeated behavioral health crises;

underlying issues that lead to repeated (c) Treatment specific to the diagnosis of a patient;

and (d) Coordination of aftercare for patients, including, without limitation, at least one follow-up contact with a patient not later than 72 hours after the patient is discharged.

and (b) When appropriate, avoid admission of a patient to another inpatient mental health facility or hospital and connect the patient - *SB70_R1* – 61 – with providers of ongoing care as appropriate for the unique needs of theSec. patient.

Sec.

When acting under the authority of an advance directive for psychiatric care, an attending physician or other provider- 81st Session (2021) – 66 – unless:r of health care shall comply with the advance directive unless:(a) Compliance, in the opinion of the attending physician or other provider, is not consistent with generally accepted standards of care for the provision of psychiatric care for the benefit of the principal;

(a) Compliance, in the opinion of the attending physician or other provider, is not consistent with generally accepted standards of care for the provision of psychiatric care for the benefit of the principal;

or (e) Compliance, in the opinion of the attending physician or other provider, is not consistent with appropriate psychiatric care in case of an emergency endangering the life or health of the principal or another2.othIn person.the event that one part of the advance directive is unable to be followed because of any of the circumstances set forth in subsection 1, all other parts of the advance directive must be followed.

2.

In the event that one part of the advance directive is unable to be followed because of any of the circumstances set forth in subsection 1, all other parts of the advance directive must be followed.

If the county hospital is located at the county seat, the board of hospital trustees shall, at all times, provide a suitable room that may be used for the examination of persons who are alleged to [have mental illness] be persons in a mental health crisis and who are to be brought before the judge of the district court for - *SB70_R1* – 62 – proceedings to determine the issue of involuntary court-ordered admission as provided in chapter 433A of NRS.

This section does not prohibit or limit the examination of persons alleged to have[have mental illnessillness] be persons in a mental health crisis at a private hospital as provided in chapter 433A of NRS.

2.cooperation with the local law enforcement agencies, may provide a suitable room that may be used for the custodial supervision of persons who are alleged to:

The board of trustees of such a county hospital, in cooperation with the local law enforcement agencies, may provide a suitable room that may be used for the custodial supervision of persons who are alleged to:

If a patient communicates to a mental health professional an explicit threat of imminent serious physical harm or death- to81st aSession clearly(2021) identified– or67 identifiable– person and, in the judgment of the mental health professional, the patient has the intent and ability to carry out the threat, the mental health professional shall [apply for the emergency admission of] place the patient [to a mental health facility] on a mental health crisis hold pursuant to NRS 433A.160 , petition for a court to order the placement of the patient on a mental health crisis hold pursuant to section 9 of this act or make a reasonable effort to communicate the threat in a timely manner to:

(a) The mental health professional actually communicates the thr(b) The mental health professional makes a good faith attempt to communicate the threat in a timely manner;manner and the failure to actually communicate the threat in a timely manner does not result from the negligence or recklessness of the mental health professional.

or (b) The mental health professional makes a good faith attempt to communicate the threat in a timely manner and the failure to actually communicate the threat in a timely manner does not result from the negligence or recklessness of the mental health professional.

- *SB70_R1* – 63 – (b) Does not have a duty to take an action described in subsection 1 is not subject to civil or criminal liability or disciplinary action by a professional licensing board for any damages caused by the actions of a patient.

4.

The provisions of this section do not:

- 81st Session (2021) – 68 – 5.

(b) A psychologist who is licensed to practice psychology pursuant to chapter 641 of NRS or authorized to practicepracticelogy psychology in this State pursuant to the Psychology Interjurisdictional Compact enacted in NRS 641.227;

(1) Licensed or certified as a physician, psychologist, marriage and family therapist, clinical professional counselor, alcohol and drug counselor or clinical alcohol and drug counselor in another state;

- *SB70_R1* – 64 – (2) Licensed as a social worker in another state and holds a master’s degree in social work;

(3)- For81st prescribingSession and(2021) dispensing– controlled69 substances– and dangerous drugs in accordance with applicable statutes.statutes.bstances and (4) For the psychiatric training and experience necessary for an advanced practice registered nurse to be authorized to make the diagnoses, evaluations and examinations described in NRS [433A.160,] 433A.240, 433A.390, 433A.430, 484C.300, 484C.320, 484C.330, 484C.340 and 484C.350 and sections 10 and 11 of this act, the certifications described in NRS 433A.170, 433A.195 and 433A.200 [.] and the sworn statements or declarations described in NRS 433A.210 and section 11 of this act.

(4) For the psychiatric training and experience necessary for an advanced practice registered nurse to be authorized to make the diagnoses, evaluations and examinations described in NRS [433A.160,] 433A.240, 433A.390, 433A.430, 484C.300, 484C.320, 484C.330, 484C.340 and 484C.350 and sections 10 and 11 of this act, the certifications described in NRS 433A.170, 433A.195 and 433A.200 [.] and the sworn statements or declarations described in NRS 433A.210 and section 11 of this act.

(e) Develop and disseminate annually to each registered nurse whosymptoms caresof forpediatric childrencancer.ation information concerning the signs and symptoms2. of pediatric cancer.

2.

- *SB70_R1* – 65 – (c) Conducting hearings pursuant to this chapter;

The Board may adopt such other regulations, not inconsistent with state or federal law, as may be necessary to carry - 81st Session (2021) – 70 – out the provisions of this chapter relating to nursing assistant trainees, nursing assistants and medication aides - certified.

The Board may adopt such other regulations, not inconsistent with state or federal law, as are necessary to enable it to administeradmSec. the provisions of this chapter.

Sec.

On the date that the Board gives notice pursuant to NRS 233B.060 of its intent to adopt, amend or repeal a regulation, the Board shall submit the regulation to the Commission on Behavioral Healthmake forrecommendations review.to the Board concerning the advisability ofd adopting, amending or repealing the regulation and any changes that the Commission deems advisable.

The Commission shall review the regulation and make recommendations to the Board concerning the advisability of adopting, amending or repealing the regulation and any changes that the Commission deems advisable.

and - *SB70_R1* – 66 – (b) Whose status is that of a voluntary consumer on or after October 1, 2021, regardless of the date on which he or she was admitted.

and - 81st Session (2021) – 71 – (b) Whose status is that of an emergency consumer on or after October 1, 2021, regardless of the date on which he or she was admitted.

The amendatory provisions of NRS 433A.380 and 433A.390, as amended by sections 47 and 48 of this act, respectively, apply to any person who has been admitted to a public or private mental health facility pursuant to a court order that is effective on October 1, 2021, regardless of the date on which he or she was admitted.

As used in this section, “assisted outpatient treatment” has the meaning ascribed to it in NRS 433A.019, as amended by section 24 of this act.

-~~~~~ *SB70_R1*21 –- 6781st –Session TEXT(2021) OF REPEALED SECTIONS treatment and program of community-based or outpatient of services.

If a court determines pursuant to NRS 433A.310 that a person should be involuntarily admitted to a program of community- based or outpatient services, the court shall promptly cause two or more persons professionally qualified in the field of psychiatric mental health, which may include the person who filed the petition for involuntary court-ordered admission pursuant to NRS 433A.200 if he or she is so qualified, in consultation with the person to be involuntarily admitted, to develop and submit to the court a written plan prescribing a course of treatment and enumerating the program of community-based or outpatient services for the person.

The plan mus1.incA description of the types of services in which the person will participate;

2.

The medications, if any, which the person must take and the manner in which those medications will be administered;

3.

The name of the person professionally qualified in the field of psychiatric mental health who is responsible for providing or coordinating the program of community-based or outpatient services;

and 4.

Any other requirements which the court deems necessary.

433A.323 Failure to participate in program or carry out plan of treatment:

Petition and order to take person into custody;

evaluation.

of community-based or outpatient services fails to participate in the program or otherwise fails to carry out the plan of treatment developed pursuant to NRS 433A.315, despite efforts by the professional responsible for providing or coordinating the program of community-based or outpatient services for the person to solicit the person’s compliance, the professional may petition the court to issue an order requiring a peace officer to take into custody and deliver the person to the appropriate location for an evaluation by an evaluation team from the Division pursuant to NRS 433A.240.

The petition must be accompanied by:

(a) A copy of the order for involuntary admission;

(b) A copy of the plan of treatment submitted to the court pursuant to NRS 433A.315;

- *SB70_R1* – 68 – (c) A list that sets forth the specific provisions of the plan of treatment which the person has failed to carry out;

and (d) A statement by the petitioner which explains how the person’s failure to participate in the program of community-based or outpatient services or failure to carry out the plan of treatment will likely cause the person to harm himself or herself or others.

2.

If the court determines that there is probable cause to believe that the person is likely to harm himself or herself or others if the person does not comply with the plan of treatment, the court may issue an order requiring a peace officer to take into custody and deliver the person to an appropriate location for an evaluation by an eva3.atiAs used in this section, “appropriate location” does not include a jail or prison.

433A.327 Conditional release of person in program:

When allowed;

no liability of State;

notice to court, district attorney and legal guardian;

order to resume participation in program;

judicial review of order to resume participation in program.

1.

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 substantial likelihood of responsible for providing or coordinating the program ofsional community-based or outpatient services shall prescribe the period for which the conditional release is effective.

The period must not extend beyond the last day of the court-ordered period of admission to a program of community-based or outpatient services pursuant to NRS 433A.310.

2.

When a person is conditionally released pursuant to subsection 1, the State of Nevada, the agents and employees of the 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 the person who is released.ise, or damages caused by the actions of 3.

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, to the attorney of the person and to the district attorney of the county in which the proceedings for admission were held.

- *SB70_R1* – 69 – 4.

Except as otherwise provided in subsection 6, the professional responsible for providing or coordinating the program of community-based or outpatient services shall order a person who is conditionally released pursuant to subsection 1 to resume participation in the program if the professional determines that the conditional release is no longer appropriate because that person presents a substantial likelihood of serious harm to himself or herself or others, as determined pursuant to NRS 433A.0195.

Except responsible for providing or coordinating the program ofal community-based or outpatient services shall, at least 3 days before the issuance of the order to resume 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 a substantial likelihood of serious harm to himself or herself or others, the order must be submitted to the court not later than 1 business day after the order is issued.

5.

The court shall review an order submitted pursuant to ordered to resume participation in a program of community-based or outpatient services at the next regularly scheduled hearing for the review of petitions for involuntary admissions, but in no event later than 5 judicial days after participation in the program is resumed.

The court shall serve notice on the person who was ordered to resume participation in the program and to his or her attorney of the time, date and place of the hearing and of the facts necessitating that the person resume participation in the program.

6.

The provisions of subsection 4 do not apply if the period of conditional release has expired.

H - *SB70_R1*