AB 270 — Provides for the licensure and regulation of anesthesiologist assistants. (BDR 54-714)

An anesthesiologist assistant shall not prescribe any controlled substance or any dangerous drug, as defined in NRS 454.201.

(b) Has passed a certification examination administered by the National Commission for Certification of Anesthesiologist Assistants, its successor organization or other nationally assistants that has been reviewed and approved by the Board;ogist (c) Is certified by the National Commission for Certification of Anesthesiologist Assistants, its successor organization or other nationally recognized organization for the certification of anesthesiologist assistantsassistances that has been reviewed and approved by the Board;

(c)(d) IsSubmits certifiedan byapplication the National Commission for Certificationa oflicense Anesthesiologistas Assistants,an itsanesthesiologist successorassistant organizationin oraccordance otherwith nationallythe recognizedregulations organizationadopted forby the certificationBoard ofpursuant anesthesiologistto assistancessection that10 hasof beenthis reviewedact; and approved by the Board;

- *AB270_R1*82nd Session (2023) – 7 – (d)(e) SubmitsPays anthe application fee for the application for and issuance of a license as an anesthesiologist assistant inrequired accordance with the regulations adopted by theNRS Board630.268; pursuant to section 10 of this act;

(e)and Pays(f) Meets the applicationqualifications feeprescribed forby the applicationregulations forthe andpractice issuance of amedicine licenseunder asthe ansupervision anesthesiologistof assistanta requiredsupervisingst byin NRSanesthesiologist. 630.268;

and (f) Meets the qualifications prescribed by the regulations adopted by the Board pursuant to section 10 of this act to assist in the practice of medicine under the supervision of a supervising anesthesiologist.

An applicant for a temporary license to practice as an anesthesiologist assistant submitted pursuant to this section must includeapplication.the all the information required by the Board to complete the application.3.

3.

The Board shall adopt regulations establishing the requirements for the issuance of a license to practice as an anesthesiologist assistant pursuant to section 8 of this act and a - *AB270_R1*82nd Session (2023) – 8 – temporary license to practice as an anesthesiologist assistant pursuant to section 9 of this act, including, without limitation:

2.programs of study required of an applicant for such a license or temporary license;

The academic or educational certificates, credentials or programs of study required of an applicant for such a license or temporary license;

Sec.to section 8 or 9 of this act who is responding to a need forsuant medical care created by an emergency or disaster, as declared by a governmental agency, may render emergency care that is directly related to the emergency or disaster without the supervision of a supervising anesthesiologist as required by this chapter.

12.

1.

An anesthesiologist assistant licensed pursuant to section 8 or 9 of this act who is responding to a need for medical care created by an emergency or disaster, as declared by a governmental agency, may render emergency care that is directly related to the emergency or disaster without the supervision of a supervising anesthesiologist as required by this chapter.

A supervising anesthesiologist shall be immediately available in such proximity to an anesthesiologist assistant during the performance of his or her duties that the - 82nd Session (2023) – 9 – supervising anesthesiologist is able to effectively reestablish direct contact with the patient to meet the medical needs of the patient - *AB270_R1* – 9 – and intervene to address any urgent or emergent clinical problems.

2.anesthesiologist assistant in a manner consistent with anyvise an applicable federal rule or regulation for reimbursement for anesthesia services.

A supervising anesthesiologist shall supervise an anesthesiologist assistant in a manner consistent with any applicable federal rule or regulation for reimbursement for anesthesia services.

and (b) The State Board of Osteopathic Medicine pursuant to chapter 633 of NRS;

andandof Osteopathic Medicine pursuant to 3.

(a)- To82nd renewSession an(2023) anesthesiologist– assistant10 license– to the Board pursuant to this chapter;

andandlogist assistant license to the Board (b) For an anesthesiologist assistant license to the State Board of Osteopathic Medicine pursuant to chapter 633 of NRS;

and - *AB270_R1* – 10 – 3.

If a person licensed as an anesthesiologist assistant pursuant to the provisions of this chapter is not applying to renew his or her license and wishes to hold a simultaneous license as an anesthesiologist assistant pursuant to the provisions of chapter 633 of NRS, the person must:

and 2.(a) The fee for biennial simultaneous registration of anion:

Payanesthesiologist allassistant applicablepursuant fees,to including,NRS without630.268; limitation:

(a) The fee for biennial simultaneous registration of an anesthesiologist assistant pursuant to NRS 630.268;

(b) For the protection and benefit of the public, the Legislature delegates to the Board of Medical Examiners the power and duty to determine the initial and continuing competence of physicians, perfusionists, physician assistants , anesthesiologist assistants and practitioners of respiratory care who are subject to the provisions of this chapter;

and - 82nd Session (2023) – 11 – (e) The Board must encourage and allow for public input into its regulatory activities to further improve the quality of medical practice within this State.

The powers conferred upon the Board by this chapter must beand liberallybenefit construedof tothe carrypublic.carry out these purposes for the protection andSec. benefit of the public.

- *AB270_R1* – 11 – Sec.

Techniques for testing to assist in diagnosis, monitoring, treatment and research related to respiratory care, including the measurement of ventilatory volumes, pressures and flows, collection of blood and other specimens, testing of pulmonary functions and hemodynamic and other related physiological monitoring of the cardiopulmonary system;

(a)- A82nd medicalSession officer(2023) or– perfusionist12 or– practitioner of respiratory care of the Armed Forces or a medical officer or perfusionist or practitioner of respiratory care of any division or department of the United States in the discharge of his or her official duties, including, without limitation, providing medical care in a hospital in accordance with an agreement entered into pursuant to NRS 449.2455;

(b) Physicians who are called into this State, other than on a regular basis, for consultation with or assistance to a physician - *AB270_R1* – 12 – licensed in this State, and who are legally qualified to practice in the state where they reside;

(d) Physicians who are temporarily exempt from licensure pursuant to NRS 630.2665 and are practicing medicine within the scope of the exemption;

(2) Is employed by a medical facility, as defined in NRS 449.0151;449.015(3) Provides respiratory care to patients who are not in a critical medical condition or, in an emergency, to patients who are in a critical medical condition and a practitioner of respiratory care is not immediately available to provide that care and the student is directed by a physician to provide respiratory care under the supervision of the physician until a practitioner of respiratory care is available;

and(h) (3)The Providespractice of respiratory care toby patients who are not in a criticalperson medicalon conditionhimself or,or inherself anor emergency,gratuitous to patients who are in a critical medical condition and a practitioner of respiratory care isprovided not immediately available to providea thatfriend careor and the student is directed by a physician- to82nd provideSession respiratory(2023) care– under13 the– supervisionrepresent ofhimself theor physicianherself untilas a practitioner of respiratory carecare; is available;

(h) The practice of respiratory care by a person on himself or herself or gratuitous respiratory care provided to a friend or a member of a person’s family if the provider of the care does not represent himself or herself as a practitioner of respiratory care;

(k) A person who installs medical equipment for respiratory care that is used in the home and gives instructions regarding the use of that equipment if the person is trained to provide such services and - *AB270_R1* – 13 – is supervised by a provider of health care who is acting within the authorized scope of his or her practice;

and (m) A physician assistant of any division or department of the United States in the discharge of his or her official duties unless licensure by a state is required by the division or department of the United States.

630.075 The Board may, by majority vote, select physicians , anesthesiologist assistants and members of the public, who must meet the same qualifications as required for members of the Board, members may be designated by the Board to serveassist asa advisorycommittee of its members ofin an investigation as provided in NRS 630.311 but may not vote on any matter before the Board.committee.

One or more advisory members may be designated by the Board to assist a committee of its members in an investigation as provided in NRS 630.311 but may not vote on any matter before the committee.

- 82nd Session (2023) – 14 – 2.

Sec.630.137 1.RS 63Notwithstanding any other provision of law and except as otherwise provided in this section, the Board shall not adopt any regulations that prohibit or have the effect of prohibiting a physician, perfusionist, physician assistant , anesthesiologist assistant or practitioner of respiratory care from collaborating or consulting with another provider of health care.

26.

NRS 630.137 is hereby amended to read as follows:

630.137 1.

Notwithstanding any other provision of law and except as otherwise provided in this section, the Board shall not adopt any regulations that prohibit or have the effect of prohibiting a physician, perfusionist, physician assistant , anesthesiologist assistant or practitioner of respiratory care from collaborating or consulting with another provider of health care.

The provisions of this section do not prevent the Board from adopting regulations that prohibit a physician, perfusionist, - *AB270_R1* – 14 – physician assistant , anesthesiologist assistant or practitioner of respiratory care from aiding or abetting another person in the unlicensed practice of medicine or the unlicensed practice of perfusion or respiratory care.

In addition to any other requirements set forth in this chapter, each applicant for a license to practice medicine, including, without limitation, an expedited license pursuant to NRS 630.1606 or 630.1607 or chapter 629A of NRS, and each applicant for a license to practice as a perfusionist, to practice as a physician assistant , to practice as an anesthesiologist assistant or to practice respiratory care shall submit to the Board a complete set of fingerprints and written permission authorizing the Board to forward the fingerprints to the Central Repository for Nevada Records ofofward Criminal History for submission to the Federal Bureau of Investigation for its report.

(a)- An82nd applicantSession for(2023) the– issuance15 of– a license to practice medicine, to practice as a perfusionist, to practice as a physician assistant , to practice as an anesthesiologist assistant or to practice as a practitioner of respiratory care shall include the social security number of the applicant in the application submitted to the Board.

- *AB270_R1* – 15 – (a) The application or any other forms that must be submitted for the issuance or renewal of the license;

or (b)3.) AAA separatelicense formto prescribedpractice medicine, to practice as a perfusionist, to practice as a physician assistant , to practice as an anesthesiologist assistant or to practice as a practitioner of respiratory care may not be issued or renewed by the Board.Board if the applicant:

3.

A license to practice medicine, to practice as a perfusionist, to practice as a physician assistant , to practice as an anesthesiologist assistant or to practice as a practitioner of respiratory care may not be issued or renewed by the Board if the applicant:

or (b) Indicates on the statement submitted pursuant to subsection 1 that the applicant is subject to a court order for the support of a child and is not in compliance with the order or a plan approved by the district attorney or other public agency enforcing the order for the repayment of the amount owed pursuant to the order.

If an applicant indicates on the statement submitted pursuant to subsection 1 that the applicant is subject to a court order for the support of a child and is not in compliance with the order or a plan approved by the district attorney or other public agency enforcing the order for the repayment of the amount owed pursuant to thethecing order, the Board shall advise the applicant to contact the district attorney or other public agency enforcing the order to determine the actions that the applicant may take to satisfy the arrearage.

The Board shall not issue or renew a license to practice as a physician, physician assistant , anesthesiologist assistant or perfusionist unless the applicant for issuance or renewal of the license attests to knowledge of and compliance with the guidelines- of82nd theSession Centers(2023) for– Disease16 Control– and Prevention concerning the prevention of transmission of infectious agents through safe and appropriate injection practices.

or - *AB270_R1* – 16 – (c) Biennial registration of the holder of a license to practice medicine,  require each holder to submit evidence of compliance with the requirements for continuing education as set forth in regulations adopted by the Board.

(2) Personal protective equipment required for acts of terrorism;

Personal protective equipment required for acts of (3) Common symptoms and methods of treatment associated with exposure to, or injuries caused by, chemical, biological, radioactive and nuclear agents;

- 82nd Session (2023) – 17 – (c) Must provide for the completion by a holder of a license to practice medicine of a course of instruction within 2 years after initial licensure that provides at least 2 hours of instruction on evidence-based suicide prevention and awareness as described in subsectionsub(d) 6.Must provide for the completion of at least 2 hours of training in the screening, brief intervention and referral to treatment approach to substance use disorder within 2 years after initial licensure.

(d) Must provide for the completion of at least 2 hours of training in the screening, brief intervention and referral to treatment approach to substance use disorder within 2 years after initial licensure.

- *AB270_R1* – 17 – (3) Must address persons of different cultural backgrounds, including, without limitation:

(VI)(VII) PersonsPersonswith withawithtal aanlnessintellectual mentaldisability, illness;developmental disability or physical disability;

(VII) Persons with an intellectual disability, developmental disability or physical disability;

- 82nd Session (2023) – 18 – 4.

(a)aging Theissues;ills skills and knowledge that the licensee needs to address aging(b) issues;Approaches to providing health care to older persons, including both didactic and clinical approaches;

(b) Approaches to providing health care to older persons, including both didactic and clinical approaches;

- *AB270_R1* – 18 – 6.

(b) Approaches to engaging other professionals in suicide intervention;

and to engaging other professionals in suicide (c) The detection of suicidal thoughts and ideations and the prevention of suicide.

9.- 82nd Session (2023) – 19 – a license to practice medicine may substitute not more than 2 hours of continuing education credits in pain management, care for persons with an addictive disorder or the screening, brief intervention and referral to treatment approach to substance use disorder for the purposes of satisfying an equivalent requirement for continuing education in ethics.

Except as otherwise provided in NRS 630.2535, a holder of a license to practice medicine may substitute not more than 2 hours of continuing education credits in pain management, care for persons with an addictive disorder or the screening, brief intervention and referral to treatment approach to substance use disorder for the purposes of satisfying an equivalent requirement for continuing education in ethics.

(e) “Weapon of mass destruction” has the meaning ascribed to it in NRSSec. 202.4445.

Sec.

- *AB270_R1* – 19 – For application for and issuance of a license to practice as a physician, including a license by endorsement ................................................................$600 For application for and issuance of a temporary, locum tenens, limited, restricted, authorized facility, special, special purpose or special event license............................................................................400 For renewal of a limited, restricted, authorized facility or special license...............................................400 For application for and issuance of a license as a physician assistant, including a license by endorsement ..................................................................400 For application for and issuance of a simultaneoussimultaneous...............................400 license as a physician assistant......................................200 For biennial registration of a physician assistant................800 For biennial simultaneous registration of a physician assistant.........................................................400 For biennial registration of a physician..............................800 For application for and issuance of a license as a perfusionist or practitioner of respiratory care..............400 For biennial renewal of a license as a perfusionist.............600 - 82nd Session (2023) – 20 – For application for and issuance of a license or temporary license to practice as an anesthesiologist assistant .............................................400...........................................$400 For application for and initial issuance of a simultaneous license as an anesthesiologist assistant.........................................................................200 For biennial registration of an anesthesiologist assistant.........................................................................800 For biennial simultaneous registration of an anesthesiologist assistant .............................................400 For biennial registration of a practitioner of respiratory care..............................................................600 For biennial registration for a physician who is on inactive status................................................................400 For written verification of licensure.....................................50 For a duplicate identification card........................................25 For a duplicate license..........................................................50 For computer printouts or labels.........................................500 For verification of a listing of physicians, per hour .............20 For furnishing a list of new physicians...............................100 2.

Except as otherwise provided in subsections 4 and 5, in addition to the fees prescribed in subsection 1, the Board shall charge and collect necessary and reasonable fees for the expedited - *AB270_R1* – 20 – processing of a request or for any other incidental service the Board provides.

The cost of any special meeting called at the request of a licensee, an institution, an organization, a state agency or an applicant for licensure must be paid for by the person or entity requesting the special meeting.

(a) NRS 630.1607, and the applicant is an active member of, or the spouse of an active member of, the Armed Forces of the United States, a veteran or the surviving spouse of a veteran, the Board shall collect not more than one-half of the fee set forth in subsection 1 for the initial issuance of the license.

- 82nd Session (2023) – 21 – 5.

Sec.630.307 1.RS 63Except as otherwise provided in subsection 2, any person may file with the Board a complaint against a physician, perfusionist, physician assistant , anesthesiologist assistant or practitioner of respiratory care on a form provided by the Board.

32.

NRS 630.307 is hereby amended to read as follows:

630.307 1.

Except as otherwise provided in subsection 2, any person may file with the Board a complaint against a physician, perfusionist, physician assistant , anesthesiologist assistant or practitioner of respiratory care on a form provided by the Board.

Except as otherwise provided in subsection 4, any hospital, clinic or other medical facility licensed in this State, or medical society, shall report to the Board any change in the privileges of a physician, perfusionist, physician assistant , anesthesiologist assistant or practitioner of respiratory care to practice while the - *AB270_R1* – 21 – physician, perfusionist, physician assistant , anesthesiologist assistant or practitioner of respiratory care is under investigation and the outcome of any disciplinary action taken by that facility or society against the physician, perfusionist, physician assistant , anesthesiologist assistant or practitioner of respiratory care concerning the care of a patient or the competency of the physician, perfusionist, physician assistant , anesthesiologist assistant or practitioner of respiratory care within 30 days after the change in privileges is made or disciplinary action is taken.

or (b)- Suspected82nd orSession alleged(2023) substance– abuse22 in– any form by the physician, perfusionist, physician assistant , anesthesiologist assistant or practitioner of respiratory care.

The Board shall report any failure to comply with subsection 3 or 4 by a hospital, clinic or other medical facility licensed in this State to the Division of Public and Behavioral Health of the Department of Health and Human Services.

The clerk of every court shall report to the Board any finding, judgment or other determination of the court that a physician, perfusionist, physician assistant , anesthesiologist assistantass(a) orIs practitionermentally ill;er of respiratory care:

(a) Is mentally ill;

- *AB270_R1* – 22 – 7.

630.309 To institute a disciplinary action against a perfusionist, physician assistant , anesthesiologist assistant or practitioner of respiratory care, a written complaint, specifying the charges, must be filed with the Board by:

complaint, specifying the charges, must 1.

- 82nd Session (2023) – 23 – Sec.

If an investigation by the Board regarding a physician, perfusionist, physician assistant , anesthesiologist assistant or practitioner of respiratory care reasonably determines that the health, safety or welfare of the public or any patient served by the licensee is at risk of imminent or continued harm, the BoardBoardved may summarily suspend the license of the licensee pending the conclusion of a hearing to consider a formal complaint against the licensee.

If the Board or an investigative committee of the Board issues an order summarily suspending the license of a licensee pursuant to subsection 1 and the Board requires the licensee to submit to a mental or physical examination or an examination testing his or her competence to practice, the examination must be conductedorder andis theissued.e results obtained not later than 30 days after the orderSec. is issued.

- *AB270_R1* – 23 – Sec.

Any deliberations conducted or vote taken by the Board or any investigative committee of the Board regarding its ordering of a physician, perfusionist, physician assistant , anesthesiologist assistant or practitioner of respiratory care to undergo a physical or mental examination or any other examination designated to assist the Board or committee in determining the - 82nd Session (2023) – 24 – fitness of a physician, perfusionist, physician assistant , anesthesiologist assistant or practitioner of respiratory care are not subject to the requirements of NRS 241.020.

Except as otherwise provided in subsection 3 or 4, all applications for a license to practice medicine, perfusion or respiratory care, any charges filed by the Board, financial records of the Board, formal hearings on any charges heard by the Board or a panel selected by the Board, records of such hearings and any order or decision of the Board or panel must be open to the public.

5.to initiate disciplinary action and all documents and information considered by the Board when determining whether to impose discipline are public records.

The6. formal complaint or other document filed by the Board to initiate disciplinary action and all documents and information considered by the Board when determining whether to impose discipline are public records.

- *AB270_R1* – 24 – 6.

If the Board receives a copy of a court order issued pursuant to NRS 425.540 that provides for the suspension of all professional, occupational and recreational licenses, certificates and permits issued to a person who is the holder of a license to practice- medicine,82nd toSession practice(2023) as– a25 perfusionist,– to practice as a physician assistant , to practice as an anesthesiologist assistant or to practice as a practitioner of respiratory care, the Board shall deem the license issued to that person to be suspended at the end of the 30th day after the date on which the court order was issued unless the Board receives a letter issued to the holder of the license by the district attorney or other public agency pursuant to NRS 425.550 stating that the holder of the license has complied with the subpoena or warrant or has satisfied the arrearage pursuant to NRS 425.560.

The Board shall reinstate a license to practice medicine, to practice as a perfusionist, to practice as a physician assistant , to practice as an anesthesiologist assistant or to practice as a practitioner of respiratory care that has been suspended by a district court pursuant to NRS 425.540 if the Board receives a letter issued by the district attorney or other public agency pursuant to NRS 425.550 to the person whose license was suspended stating that the person whose license was suspended has complied with the subpoenaNRS or425.560.warrant warrant or has satisfied the arrearage pursuant to NRSSec. 425.560.

Sec.

(d) To enjoin the use of the title “P.A.,” “P.A.-C,” “C.A.A.,” “R.C.P.” or any other word, combination of letters or other designation intended to imply or designate a person as a physician - *AB270_R1* – 25 – assistant , anesthesiologist assistant or practitioner of respiratory care, when not licensed by the Board pursuant to this chapter, unless the use is otherwise authorized by a specific statute;

2.- 82nd Session (2023) – 26 – order or a preliminary injunction for the purposes set forth ining subsection 1:

The court in a proper case may issue a temporary restraining order or a preliminary injunction for the purposes set forth in subsection 1:

(d) Except as otherwise provided by a specific statute, practice medicine,this perfusionchapter;fusion or respiratory care without being licensed under this(e) chapter;Hold himself or herself out as a perfusionist or use any other term indicating or implying that he or she is a perfusionist without being licensed by the Board;

(e) Hold himself or herself out as a perfusionist or use any other term indicating or implying that he or she is a perfusionist without being licensed by the Board;

Unless a greater penalty is provided pursuant to NRS 200.830 or 200.840, a person who violates any provision of subsectionsub(a) 1:If no substantial bodily harm results, is guilty of a category D felony;

(a)or (b) If no substantial bodily harm results, is guilty of a category DC felony;felony,  and shall be punished as provided in NRS 193.130.

or - *AB270_R1* – 26 – (b) If substantial bodily harm results, is guilty of a category C felony,  and shall be punished as provided in NRS 193.130.

(a)- Issue82nd andSession serve(2023) on– the27 person– an order to cease and desist until the person obtains from the Board the proper license ororsist otherwise demonstrates that he or she is no longer in violation of subsection 1.

Sec.

40.

NRS 632.472 is hereby amended to read as follows:

(a) Any physician, dentist, dental hygienist, chiropractic physician, optometrist, podiatric physician, medical examiner, resident, intern, professional or practical nurse, nursing assistant, medication aide - certified, perfusionist, physician assistant licensed pursuant to chapter 630 or 633 of NRS, anesthesiologist assistant, psychiatrist, psychologist, marriage and family therapist, clinical professional counselor, alcohol or drug counselor, peer recovery support specialist, peer recovery support specialist supervisor, music therapist, holder of a license or limited license issued pursuant to chapter 653 of NRS, driver of an ambulance, paramedic or other person providing medical services licensed or certified to practice in thisthi(b) State.Any personnel of a medical facility or facility for the dependent engaged in the admission, examination, care or treatment of persons or an administrator, manager or other person in charge of a medical facility or facility for the dependent upon notification by a member of the staff of the facility.

(b)(c) AnyA personnelcoroner. of a medical facility or facility for the dependent engaged in the admission, examination, care or treatment of persons or an administrator, manager or other person in charge of a medical facility or facility for the dependent upon notification by a member of the staff of the facility.

- *AB270_R1* – 27 – (c) A coroner.

- 82nd Session (2023) – 28 – (e) Any person who operates, who is employed by or who contracts to provide services for an intermediary service organization as defined in NRS 449.4304.

(f) Any person who maintains or is employed by an agency to providepro(g) nursingAny inemployee of the home.Department of Health and Human Services.

(g) Any employee of the Department of Health and Human Services.

The superintendent, managersubsection or1.her other person in charge shall make a report as required in subsection3. 1.

3.

- *AB270_R1* – 28 – (d) “Peer recovery support specialist supervisor” has the meaning ascribed to it in NRS 433.629.

- 82nd Session (2023) – 29 – Sec.

“Anesthesiologist assistant” means a person who has been issued a license by the Board pursuant to section 47 or 48 of this act, as applicable, and is approved by the Board to assist in the practice of medicine under the supervision of a supervising osteopathic anesthesiologist.

An anesthesiologist assistant licensed under the provisions of this chapter may assist in the practice of medicine in accordance with the regulations adopted by the Board pursuant totoe in section 49 of this act and under the supervision of a supervising osteopathic anesthesiologist.

- *AB270_R1*82nd Session (2023) – 2930 – (d) Subject to the limitations for NRS 453.375, possessing and administering preoperative and perioperative medications, including, without limitation, controlled substances, administering anesthetic agents, related pharmaceutical agents, fluid and blood productsproduc(1) Maintaining and adjunctivealtering treatment,the forlevels purposesof of:anesthesia and providing continuity of anesthetic care into and during the postoperative recovery period;

(1) Maintaining and altering the levels of anesthesia and providing continuity of anesthetic care into and during the postoperative recovery period;

(i)(j) ImplementingEstablishing medicallymeairwayy acceptedacinterventionsrinandechnperforming monitoringventilatory support, including, without limitation, endotracheal intubation, laryngeal mask insertion and other advanced airway techniques;

(j) Establishing airway interventions and performing ventilatory support, including, without limitation, endotracheal intubation, laryngeal mask insertion and other advanced airway techniques;

- 82nd Session (2023) – 31 – (n) Conducting laboratory and other related studies, including, without limitation, taking blood samples and administering blood, blood products and supportive fluids;

- *AB270_R1* – 30 – (o) Performing, ordering and interpreting preoperative, point- of-care,procedures;traoperative intraoperative or postoperative diagnostic testing or procedures;(p) Monitoring the patient while in the preoperative suite, recovery area or labor suites and making postanesthesia rounds;

(p) Monitoring the patient while in the preoperative suite, recovery area or labor suites and making postanesthesia rounds;

The Board may issue a license to practice as an ane(a) Graduated from an anesthesiologist assistant toprogram anaccredited applicantby who:the Commission Accreditation of Allied Health Education Programs or its predecessor or successor organization;

(a) Graduated from an anesthesiologist assistant program accredited by the Commission Accreditation of Allied Health Education Programs or its predecessor or successor organization;

- 82nd Session (2023) – 32 – (d) Submits an application for a license as an anesthesiologist assistant in accordance with the regulations adopted by the Board pursuant to section 49 of this act;

(e) Pays the application fee for the application for and issuance of a license as an anesthesiologist assistant required by NRS 633.501;

andandcense -as *AB270_R1*an –anesthesiologist 31assistant –required by (f) Meets the qualifications prescribed by the regulations adopted by the Board pursuant to section 49 of this act to assist in the practice of medicine under the supervision of a supervising osteopathic anesthesiologist.

and (c)2.) PaysPAn theapplicant applicationfor feea temporary license to practice as an anesthesiologist assistant submitted pursuant to this section must include all the information required by NRSthe 633.501.Board to complete the application.

2.

An applicant for a temporary license to practice as an anesthesiologist assistant submitted pursuant to this section must include all the information required by the Board to complete the application.

The Board shall adopt regulations establishing the requirements for the issuance of a license to practice as an - 82nd Session (2023) – 33 – anesthesiologist assistant pursuant to section 47 of this act and a temporary license to practice as an anesthesiologist assistant pursuant to section 48 of this act, including, without limitation:

The required qualifications of an applicant for such a lic2.se The academic or educational certificates, credentials or programs of study required of an applicant for such a license or temporary license;licenses;

2.3.

The academic or educational certificates, credentials or programs of study required of an applicant for such a license or temporary licenses;

- *AB270_R1* – 32 – 3.

An anesthesiologist assistant licensed pursuant to section 47 or 48 of this act shall identify himself or herself as an anesthesiologist assistant when engaged in professional duties.duties.as an Sec.

Sec.

- 82nd Session (2023) – 34 – Sec.

A supervising osteopathic anesthesiologist shall be immediately available in such proximity to an anesthesiologist assistant during the performance of his or her duties that the supervising osteopathic anesthesiologist is able to effectively reestablish direct contact with the patient to meet the medical needs of the patient and intervene to address any urgent ororical emergent clinical problems.

- *AB270_R1* – 33 – Sec.

A person applying for a license to practice as an anesthesiologist assistant pursuant to the provisions of this chapter who wishes to hold a simultaneous license to practice as an anesthesiologist assistant pursuant to the provisions of chapter 630 of NRS must:

Indicate in the application that he or she wishes to hold a simultaneous license as an anesthesiologist assistant pursuant to thethe2.rovApply provisionsfor ofa chapterlicense 630to ofpractice NRS;as an anesthesiologist assistant to:

2.

Apply for a license to practice as an anesthesiologist assistant to:

and (b) The State Board of Medical Examiners pursuant to chapter 630 of NRS;

- 82nd Session (2023) – 35 – 1.

(a) To renew an anesthesiologist assistant license to the Board pursuant to this chapter;

andandlogist assistant license to the Board (b) For an anesthesiologist assistant license to the Board of Medical Examiners pursuant to chapter 630 of NRS;

- *AB270_R1* – 34 – Sec.

If a person licensed as an anesthesiologist assistant pursuant to the provisions of this chapter is not applying to renew his or her license and wishes to hold a simultaneous license as an anesthesiologist assistant pursuant to the provisions of chapter 630 of NRS, the person must:

On or before the last day of each quarter, the Board shall provide the Board of Medical Examiners a list of all anesthesiologistaneSec. assistants licensed by the Board.

Sec.

- 82nd Session (2023) – 36 – (a) Knowingly or willfully making a false or fraudulent statement or submitting a forged or false document in applying for a license to practice osteopathic medicine , [or] to practice as a physician assistant or to practice as an anesthesiologist assistant, or in applying for the renewal of a license to practice osteopathic medicine , [or] to practice as a physician assistant or to practice as an anesthesiologist assistant.

(c) Directly or indirectly giving to or receiving from any person, corporation or other business organization any fee, commission, rebate or other form of compensation for sending, referring or otherwise inducing a person to communicate with an osteopathic physician in his or her professional capacity or for any professional - *AB270_R1* – 35 – services not actually and personally rendered, except as otherwise provided in subsection 2.

(f) Engaging(1) inProfessional any:conduct which is intended to deceive or which the Board by regulation has determined is unethical;

(1) Professional conduct which is intended to deceive or which the Board by regulation has determined is unethical;

- 82nd Session (2023) – 37 – (j) Knowingly or willfully disclosing a communication privileged pursuant to a statute or court order.

(k) Knowingly or willfully disobeying regulations of the State Board of Health, the State Board of Pharmacy or the State Board of OsteopathicOst(l) Medicine.Violating or attempting to violate, directly or indirectly, or assisting in or abetting the violation of or conspiring to violate any prohibition made in this chapter.

(l) Violating or attempting to violate, directly or indirectly, or assisting in or abetting the violation of or conspiring to violate any prohibition made in this chapter.

- *AB270_R1* – 36 – (q) Failure of a licensee to make medical records of a patient available for inspection and copying as provided by NRS 629.061, if the licensee is the custodian of health care records with respect to those records.

(a) For persons holding valid licenses to practice osteopathic medicine issued pursuant to this chapter to practice osteopathic medicine in partnership under a partnership agreement or in a corporation or an association authorized by law, or to pool, share, divide or apportion the fees and money received by them or by the partnership, corporation or association in accordance with the partnership agreement or the policies of the board of directors of the corporation or association;

3.- 82nd Session (2023) – 38 – has the meaning ascribed to it in NRS 629.016.

As used in this section, “custodian of health care records” hasSec. the meaning ascribed to it in NRS 629.016.

Sec.

(b) Information reported to the Board during the previous biennium pursuant to NRS 633.526, 633.527, subsections 3 and 6 of NRS 633.533 and NRS 690B.250;

and - *AB270_R1* – 37 – (c) Information reported to the Board during the previous biennium pursuant to NRS 633.524, including, without limitation, the number and types of surgeries performed by each holder of a license to practice osteopathic medicine and the occurrence of sentinel events arising from such surgeries, if any.

Except as otherwise provided in this section, the record must be open to public inspection at all reasonable times and contain the name, known place of business and residence, and the date and number of the license of every osteopathic physician , [and every] physicianphysiciane assistant and anesthesiologist assistant licensed under this chapter.

Except as otherwise provided in this section and NRS 239.0115, a complaint filed with the Board, all documents and other information filed with the complaint and all documents and other information compiled as a result of an investigation conducted to determine whether to initiate disciplinary action against a person are confidential, unless the person submits a written statement to the Board- requesting82nd Session (2023) – 39 – public records.g that such documents and information be made public3. records.

3.

633.3619 The Board shall not issue or renew a license to practice osteopathic medicine or as a physician assistant or anesthesiologist assistant unless the applicant for issuance or renewal of the license attests to knowledge of and compliance with the guidelines of the Centers for Disease Control and Prevention concerning the prevention of transmission of infectious agents throughthrSec. safe and appropriate injection practices.

Sec.

Except as otherwise provided in subsection 14 and NRS 633.491, every holder of a license, except a physician assistant or an anesthesiologist assistant, issued under this chapter, - *AB270_R1* – 38 – except a temporary or a special license, may renew the license on or before January 1 of each calendar year after its issuance by:

(d) Subject to subsection 13, submitting evidence to the Board that in the year preceding the application for renewal the holder has attended courses or programs of continuing education approved by the Board in accordance with regulations adopted by the Board totaling a number of hours established by the Board which must not be less than 35 hours nor more than that set in the requirements for continuing medical education of the American Osteopathic Association;

3.- 82nd Session (2023) – 40 – completion of the required number of hours of continuing medical education annually from no fewer than one-third of the applicants for renewal of a license to practice osteopathic medicine or a license to practice as a physician assistant [.] or anesthesiologist assistant.

The Board shall request submission of verified evidence of completion of the required number of hours of continuing medical education annually from no fewer than one-third of the applicants for renewal of a license to practice osteopathic medicine or a license to practice as a physician assistant [.] or anesthesiologist assistant.

The Board shall require each holder of a license to practice osteopathic medicine to complete a course of instruction within 2 years after initial licensure that provides at least 2 hours of instruction on evidence-based suicide prevention and awareness as describeddes5. in subsection 9.

5.

- *AB270_R1* – 39 – 6.

and (b) Interpreting family history to determine whether such symptoms indicate a normal childhood illness or a condition that requiresreq7. additional examination.

7.

The continuing education requirements approved by the Board must allow the holder of a license as an osteopathic physician - 82nd Session (2023) – 41 – , [or] physician assistant or anesthesiologist assistant to receive credit toward the total amount of continuing education required by the Board for the completion of a course of instruction relating to genetic counseling and genetic testing.

9.osteopathic medicine to receive as a portion of his or her continuing education at least 2 hours of instruction every 4 years on evidence- based suicide prevention and awareness which may include, without limitation, instruction concerning:

The Board shall require each holder of a license to practice osteopathic medicine to receive as a portion of his or her continuing education at least 2 hours of instruction every 4 years on evidence- based suicide prevention and awareness which may include, without limitation, instruction concerning:

The Board shall require each psychiatrist or a physician assistant practicing under the supervision of a psychiatrist to - *AB270_R1* – 40 – biennially complete one or more courses of instruction that provide at least 2 hours of instruction relating to cultural competency and diversity, equity and inclusion.

- 82nd Session (2023) – 42 – (6) Persons with a mental illness;

and (8) Persons who are part of any other population that a psychiatrist or physician assistant practicing under the supervision of a psychiatrist may need to better understand, as determined by the Board.

(a) Application and initial license fee for an osteopathic physician..................................................................$800 (b) Annual license renewal fee for an osteopathic physician.......................................................................................500 (c) Temporary license fee.......................................................500 (d) Special or authorized facility license fee ..........................200 (e) Special event license fee ...................................................200 (f) Special or authorized facility license renewal fee .............200.............200..........200 - *AB270_R1* – 41 – (g) Reexamination fee ..........................................................$200............................................................200 (h) Late payment fee...............................................................300 (i) Application and initial license fee for a physician assistant.........................................................................................400 (j) Application and initial simultaneous license fee for a physician assistant......................................................................200 (k) Annual registration fee for a physician assistant...............400 (l) Annual simultaneous registration fee for a physician assistant.........................................................................200 (m) Inactive license fee...........................................................200 (n) Application and initial license fee for an anesthesiologist assistant.............................................................400 (o) Application and initial simultaneous license fee for an anesthesiologist assistant..................................................200 2.- 82nd Session (2023) – 43 – license issued pursuant to paragraph (a) or (i) of subsection 1 which expires less than 6 months after the date of issuance.

The Board may prorate the initial license fee for a new license issued pursuant to paragraph (a) or (i) of subsection 1 which expires less than 6 months after the date of issuance.

(a) NRS 633.399 or 633.400 and is an active member of, or the spouse of an active member of, the Armed Forces of the United States, a veteran or the surviving spouse of a veteran, the Board shall collect not more than one-half of the fee set forth in subsection 1 for the initial issuance of the license.

As used in this paragraph, “veteran”“ve(b) hasNRS 633.4336, the meaningBoard ascribedshall tocollect itnot more than one- half of the fee set forth in NRSsubsection 417.005.1 for the initial issuance of the license.

(b) NRS 633.4336, the Board shall collect not more than one- half of the fee set forth in subsection 1 for the initial issuance of the license.

- *AB270_R1* – 42 – (3) A violation of any of the provisions of NRS 616D.200, 616D.220, 616D.240 or 616D.300 to 616D.440, inclusive;

(4) Murder, voluntary manslaughter or mayhem;

(c)- The82nd suspensionSession of(2023) a– license44 to– practice osteopathic medicine or to practice as a physician assistant or anesthesiologist assistant by any other jurisdiction.

(j)NRS Failure633.322.re to comply with the provisions of subsection 2 of NRS(k) 633.322.Signing a blank prescription form.

(k) Signing a blank prescription form.

or -to *AB270_R1*a –patient 43pursuant –to (4)NRS Is630.3735 anor investigational633.6945.l drugproduct prescribed (m) Attempting, directly or biologicalindirectly, productby prescribedintimidation, coercion or deception, to obtain or retain a patient pursuantor to NRSdiscourage 630.3735the oruse 633.6945.of a second opinion.

(m) Attempting, directly or indirectly, by intimidation, coercion or deception, to obtain or retain a patient or to discourage the use of a second opinion.

(o) In addition to the provisions of subsection 3 of NRS 633.524, making or filing a report which the licensee knows to be false,- failing82nd toSession file(2023) a– record45 or– report that is required by law or knowingly or willfully obstructing or inducing another to obstructobstructor the making or filing of such a record or report.

(q) Failure by a licensee or applicant to report in writing, within 30 days, any criminal action taken or conviction obtained against the licensee or applicant, other than a minor traffic violation, in this State or any other state or by the Federal Government, a branch of the Armed Forces of the United States or any local or federal jurisdiction of a foreign country.

(t)to Failurethe toregulations superviseof adequatelythe Board.uately a medical assistant pursuant (u) Failure to theobtain regulationsany oftraining required by the Board.Board pursuant to NRS 633.473.

(u) Failure to obtain any training required by the Board pursuant to NRS 633.473.

(aa)examination Performingin orviolation supervisingof theNRS performance629.085.rformance of a pelvic examination2. in violation of NRS 629.085.

- *AB270_R1* – 44 – 2.

633.512 Any member or agent of the Board may enter any premises in this State where a person who holds a license issued pursuant to the provisions of this chapter practices osteopathic medicine or as a physician assistant or anesthesiologist assistant and- inspect82nd itSession to(2023) determine– whether46 a– violation of any provision of this chapter has occurred, including, without limitation:limitation:ovision of 1.

1.

(a) Any action for malpractice against the osteopathic physician , [or] physician assistant or anesthesiologist assistant not later than 45 days after the osteopathic physician , [or] physician assistant or anesthesiologist assistant receives service of a summons andandistant or complaint for the action;

The Board shall report any failure to comply with subsection 1 by an insurer licensed in this State to the Division of Insurance of the Department of Business and Industry.

If, after a hearing, the Division of Insurance determines that any such insurer failed to comply with the requirements of subsection 1, the Division may impose an administrative fine of not more than $10,000 against the insurernot forpaid eachwhen suchdue, failurethe tofine report.must be recovered in a civil actionfine is brought by the Attorney General on behalf of the Division.

IfSec. the administrative fine is not paid when due, the fine must be recovered in a civil action brought by the Attorney General on behalf of the Division.

- *AB270_R1* – 45 – Sec.

(a) Any action for malpractice against the osteopathic physician , [or] physician assistant or anesthesiologist assistant not later than 45 days after the osteopathic physician , [or] physician assistant or - 82nd Session (2023) – 47 – anesthesiologist assistant receives service of a summons and complaint for the action;

(b) Any claim for malpractice against the osteopathic physician , [or] physician assistant or anesthesiologist assistant that is submitted to arbitration or mediation not later than 45 days after the claim is submitted to arbitration or mediation;

than 45 days after the (c) Any settlement, award, judgment or other disposition of any action or claim described in paragraph (a) or (b) not later than 45 days after the settlement, award, judgment or other disposition;

633.528 If the Board receives a report pursuant to the provisions of NRS 633.526, 633.527 or 690B.250 indicating that a judgment has been rendered or an award has been made against an osteopathic physician , [or] physician assistant or anesthesiologist assistant regarding an action or claim for malpractice or that such an action or claim against the osteopathic physician , [or] physicianphysicianh an assistant or anesthesiologist assistant has been resolved by settlement, the Board shall conduct an investigation to determine whether to discipline the osteopathic physician , [or] physician assistant or anesthesiologist assistant regarding the action or claim, unless the Board has already commenced or completed such an investigation regarding the action or claim before it receives the report.

Notwithstanding the provisions of chapter 622A of NRS, if the Board or an investigative committee of the Board - *AB270_R1* – 46 – receives a report pursuant to the provisions of NRS 633.526, 633.527 or 690B.250 indicating that a judgment has been rendered or an award has been made against an osteopathic physician , [or] physician assistant or anesthesiologist assistant regarding an action or- claim82nd forSession malpractice,(2023) or– that48 such– an action or claim against the osteopathic physician , [or] physician assistant or anesthesiologistanesthesiologiste assistant has been resolved by settlement, the Board or committee may order the osteopathic physician , [or] physician assistant or anesthesiologist assistant to undergo a mental or physical examination or any other examination designated by the Board to test his or her competence to practice osteopathic medicine or to practice as a physician assistant [,] or an anesthesiologist assistant as applicable.

(a) An osteopathic physician , [or] physician assistant or anesthesiologist assistant who applies for a license or who holds a license under this chapter is deemed to have given consent to submit to a mental or physical examination or an examination testing his or her competence to practice osteopathic medicine or to practice as a physician assistant [,] or anesthesiologist assistant, as applicable, pursuantpur(b) toThe testimony or reports of a writtenperson orderwho byconducts an examination of an osteopathic physician , [or] physician assistant or anesthesiologist assistant on behalf of the Board.Board pursuant to this section are not privileged communications.

(b) The testimony or reports of a person who conducts an examination of an osteopathic physician , [or] physician assistant or anesthesiologist assistant on behalf of the Board pursuant to this section are not privileged communications.

Sec.633.533 1.RS 63Except as otherwise provided in subsection 2, any person may file with the Board a complaint against an osteopathic physician , [or] physician assistant or anesthesiologist assistant on a form provided by the Board.

74.

NRS 633.533 is hereby amended to read as follows:

633.533 1.

Except as otherwise provided in subsection 2, any person may file with the Board a complaint against an osteopathic physician , [or] physician assistant or anesthesiologist assistant on a form provided by the Board.

If a complaint is submitted anonymously, the Board may accept the complaint but may refuse to consider the complaint if the lack of the identity of the complainant makes - *AB270_R1* – 47 – processing the complaint impossible or unfair to the person who is the subject of the complaint.

- 82nd Session (2023) – 49 – 2.

Any licensee, medical school or medical facility that becomes aware that a person practicing osteopathic medicine or practicing as a physician assistant or anesthesiologist assistant in this State has, is or is about to become engaged in conduct which constitutes grounds for initiating disciplinary action shall file a written complaint with the Board within 30 days after becomingbecomingile a aware of the conduct.

or (b)the(b)osteopathicd Aophysician suspectedsub,tan[or]sephysician or alleged substance use disorder in anyassistantby form by the osteopathic physician , [or] physician assistant or anesthesiologist assistant.

The Board shall report any failure to comply with subsection 3 or 4 by a hospital, clinic or other medical facility licensed in this State to the Division of Public and Behavioral Health of the Department of Health and Human Services.

The clerk of every court shall report to the Board any finding, judgment or other determination of the court that an - *AB270_R1*82nd Session (2023) – 4850 – osteopathic physician , [or] physician assistant or anesthesiologist assistant:

(c)controlled Hassubstances beenor convicteddangerous ofdrugs;any alaw felonygoverning (d) Is guilty of abuse or fraud under any lawstate governingor controlledfederal substancesprogram orproviding dangerousmedical drugs;assistance;

(d) Is guilty of abuse or fraud under any state or federal program providing medical assistance;

Notwithstanding the provisions of chapter 622A of NRS, if the Board or a member of the Board designated to review a complaint pursuant to NRS 633.541 has reason to believe that the conduct of an osteopathic physician , [or] physician assistant or anesthesiologist assistant has raised a reasonable question as to his or her competence to practice osteopathic medicine or to practice as a physician assistant or anesthesiologist assistant, as applicable, with reasonable skill and safety to patients, the Board or the member designated by the Board may require the osteopathic physician , [or] physician assistant or anesthesiologist assistant to submit to aa[or] mental or physical examination conducted by physicians designated by the Board.

(a) An osteopathic physician , [or] physician assistant or anesthesiologist assistant who is licensed under this chapter and - 82nd Session (2023) – 51 – who accepts the privilege of practicing osteopathic medicine or practicing as a physician assistant or anesthesiologist assistant in - *AB270_R1* – 49 – this State is deemed to have given consent to submit to a mental or physical examination pursuant to a written order by the Board.

(b)physicians Theare testimonynot orprivileged examinationcommunications.f reports of the examining physicians3. are not privileged communications.

3.

If an investigation by the Board of an osteopathic physician , [or] physician assistant or anesthesiologist assistant reasonably determines that the health, safety or welfare of the public or any patient served by the osteopathic physician , [or] physician assistant or anesthesiologist assistant is at risk of imminent or continued harm, the Board may summarily suspend the license of the licensee pending the conclusion of a hearing to consider a formal complaint against the licensee.

If the Board or an investigative committee of the Board issues an order summarily suspending the license of a licensee pursuant to subsection 1, the Board shall hold a hearing not later than 60 days after the date on which the order is issued, unless the Board and the licensee mutually agree to a longer period, to determine whether a reasonable basis exists to continue the suspension of the license pending the conclusion of a hearing to consider- a82nd formalSession (2023) – 52 – complaint against the licensee is pending before the Board on the date on which a hearing is held pursuant to this section, the Board shall reinstate the license of the licensee.

If3. no formal complaint against the licensee is pending before the Board on the date on which a hearing is held pursuant to this section, the Board shall reinstate the license of the licensee.

- *AB270_R1* – 50 – 3.

633.591 Notwithstanding the provisions of chapter 622A of NRS, if the Board issues an order summarily suspending the license of an osteopathic physician , [or] physician assistant or anesthesiologist assistant pending proceedings for disciplinary action, including, without limitation, a summary suspension pursuant to NRS 233B.127, the court shall not stay that order unless the Board fails to institute and determine such proceedings as promptly as the requirements for investigation of the case reasonably allow.

2.order or a preliminary injunction for such purposes:ry restraining (a) Without proof of actual damage sustained by any person, this provision being a preventive as well as punitive measure;

The court in a proper case may issue a temporary restraining order or a preliminary injunction for such purposes:

(a) Without proof of actual damage sustained by any person, this provision being a preventive as well as punitive measure;

- 82nd Session (2023) – 53 – Sec.

Service of process made under this chapter must be either personal or by registered or certified mail with return receipt requested, addressed to the osteopathic physician , [or] physician assistant or anesthesiologist assistant at his or her last known address, as indicated in the records of the Board.

If personal service - *AB270_R1* – 51 – cannot be made and if mail notice is returned undelivered, the President or Secretary-Treasurer of the Board shall cause a notice of hearing to be published once a week for 4 consecutive weeks in a newspaper published in the county of the last known address of the osteopathic physician , [or] physician assistant or anesthesiologist assistant or, if no newspaper is published in that county, in a newspaper widely distributed in that county.

633.641 Notwithstanding the provisions of chapter 622A of NRS, in any disciplinary proceeding before the Board, a hearing officeroff1.erProof of actual injury need not be established where the formal complaint charges deceptive or aunethical panel:professional conduct or medical practice harmful to the public.

1.

Proof of actual injury need not be established where the formal complaint charges deceptive or unethical professional conduct or medical practice harmful to the public.

- 82nd Session (2023) – 54 – (c) Limit the practice of the person to, or by the exclusion of, one or more specified branches of osteopathic medicine.

(d) Suspend the license of the person to practice osteopathic medicine or to practice as a physician assistant or anesthesiologist assistantass(e) forRevoke athe specifiedlicense periodof orthe untilperson furtherto orderpractice ofosteopathicBoard. the Board.

(e) Revoke the license of the person to practice osteopathic medicine or to practice as a physician assistant or anesthesiologist assistant.

- *AB270_R1* – 52 – (h) Require the person to perform community service without compensation.

2.osteopathic medicine or the practice of a physician assistant or anesthesiologist assistant or suspends or revokes a license is effective from the date on which the order is issued by the Board until the date the order is modified or reversed by a final judgment of the court.

Every order of the Board which limits the practice of osteopathic medicine or the practice of a physician assistant or anesthesiologist assistant or suspends or revokes a license is effective from the date on which the order is issued by the Board until the date the order is modified or reversed by a final judgment of the court.

or - 82nd Session (2023) – 55 – (2) Revoked,  may apply to the Board after a reasonable period for removal of the limitation or suspension or may apply to the Board pursuant to the provisions of chapter 622A of NRS for reinstatement of the revokedrev2.ed license.In hearing the application, the Board:

2.

In hearing the application, the Board:

and - *AB270_R1* – 53 – (c) May deny the application or modify or rescind its order as it deems the evidence and the public safety warrants.

2.shall not commence an investigation, impose any disciplinary action or take any other adverse action against an osteopathic physician , [or] physician assistant or anesthesiologist assistant for:

Except as otherwise provided in subsection 3, the Board shall not commence an investigation, impose any disciplinary action or take any other adverse action against an osteopathic physician , [or] physician assistant or anesthesiologist assistant for:

An osteopathic physician , [or] physician assistant or anesthesiologist assistant who discloses information to or cooperates with a governmental entity pursuant to subsection 2 with respect to the violation of any law, rule or regulation by the osteopathic- physician82nd ,Session [or](2023) physician– assistant56 or– anesthesiologist assistant is subject to investigation and any other administrative or disciplinary action by the Board under the provisions of this chapter for such violation.

- *AB270_R1* – 54 – (d) A federal, state or local law enforcement agency or prosecutorial office, or any member or employee thereof, or police or peace officer;

and (e)employee Athereof, federal,or stategrand or localpetit judiciary,jury.y, or any member or employeeSec. thereof, or grand or petit jury.

Sec.

Sec.

88.

NRS 633.711 is hereby amended to read as follows:

- 82nd Session (2023) – 57 – 2.

(b)practicing Mustwithout not relieve such persona license.n from criminal prosecution for practicingSec. without such a license.

Sec.

- *AB270_R1* – 55 – (a) Except as otherwise provided in NRS 629.091, practice:

(c) Give either false or forged evidence of any kind to the Board or any of its members in connection with an application for a lic(d) File for record the license issued to another, falsely claiming himself or herself to be the person named in the license, or falsely claiming himself or herself to be the person entitled to the license;

(d) File for record the license issued to another, falsely claiming himself or herself to be the person named in the license, or falsely claiming himself or herself to be the person entitled to the license;

2.- 82nd Session (2023) – 58 – (a) If no substantial bodily harm results, is guilty of a category D felony;

A person who violates any provision of subsection 1:

(a) If no substantial bodily harm results, is guilty of a category D felony;

A citation issued pursuant to this paragraph must be in writing, describe with particularity the nature of the violation and inform the person of the provisions of - *AB270_R1* – 56 – this paragraph.

Each activity in which the person is engagedengagedons of constitutes a separate offense for which a separate citation may be issued.

Except as otherwise provided in subsection 2 and NRS 126.121 and 652.186, no person other than a licensed physician, a licensed optometrist, a licensed practical nurse, a registered nurse, a perfusionist, a physician assistant licensed pursuant to chapter 630 or 633 of NRS, a certified advanced emergency medical technician, a certified paramedic, a practitioner of respiratory care licensed pursuant to chapter 630 of NRS, aaioner licensed anesthesiologist assistant, a licensed dentist or a registered pharmacist may manipulate a person for the collection of specimens.

- 82nd Session (2023) – 59 – 2.

41.504anesthesiologist 1.assistant or registered nurse who in good faith , gives instruction or provides supervision to an emergency medical attendant, physician assistant , anesthesiologist assistant or registered nurse, at the scene of an emergency or while transporting an ill or injured person from the scene of an emergency, is not liable for any civil damages as a result of any act or omission, not amounting to gross negligence, in giving that instruction or providing that supervision.

Any physician, physician assistant , anesthesiologist assistant or registered nurse who in good faith gives instruction or provides supervision to an emergency medical attendant, physician assistant , anesthesiologist assistant or registered nurse, at the scene of an emergency or while transporting an ill or injured person from the scene of an emergency, is not liable for any civil damages as a result of any act or omission, not amounting to gross negligence, in giving that instruction or providing that supervision.

An emergency medical attendant, physician assistant, anesthesiologist assistant, registered nurse or licensed practical nurse who obeys an instruction given by a physician, physician assistant, anesthesiologist assistant, registered nurse or licensed practical nurse and thereby renders emergency care, at the scene of an emergency or while transporting an ill or injured person from the scene of an emergency, is not liable for any civil damages as a result - *AB270_R1* – 57 – of any act or omission, not amounting to gross negligence, in rendering that emergency care.

41.505chapter 1.630, 632 or 633 of NRS and any person who holds an equivalent license issued by another state, who renders emergency care or assistance, including, without limitation, emergency obstetrical care or assistance, in an emergency, gratuitously and in good faith, is not liable for any civil damages as a result of any act or omission, not amounting to gross negligence, by that person in rendering the emergency care or assistance or as a result of any failure to act, not amounting to gross negligence, to provide or arrange for further medical treatment for the injured or ill person.

Any person licensed under the provisions of chapter 630, 632 or 633 of NRS and any person who holds an equivalent license issued by another state, who renders emergency care or assistance, including, without limitation, emergency obstetrical care or assistance, in an emergency, gratuitously and in good faith, is not liable for any civil damages as a result of any act or omission, not amounting to gross negligence, by that person in rendering the emergency care or assistance or as a result of any failure to act, not amounting to gross negligence, to provide or arrange for further medical treatment for the injured or ill person.

- 82nd Session (2023) – 60 – 2.

Any person licensed under the provisions of chapter 630, 632 or 633 of NRS and any person who holds an equivalent license issued by another state who:

andand(b) (b) Gratuitously and in good faith, renders medical care within the scope of that person’s license to an indigent person,  is not liable for any civil damages as a result of any act or omission by that person, not amounting to gross negligence or reckless, willful or wanton conduct, in rendering that care.

- *AB270_R1* – 58 – Sec.

41A.017 “Provider of health care” means a physician licensed pursuant to chapter 630 or 633 of NRS, physician assistant, anesthesiologist assistant, dentist, licensed nurse, dispensing optician, optometrist, registered physical therapist, podiatric physician, licensed psychologist, chiropractic physician, doctor of Oriental medicine, holder of a license or a limited license issued under the provisions of chapter 653 of NRS, medical laboratorylaboratorysued director or technician, licensed dietitian or a licensed hospital, clinic, surgery center, physicians’ professional corporation or group practice that employs any such person and its employees.

(1)- A82nd personSession (2023) – 61 – peace officer;erson who possesses some or all of the powers of a peace(2) officer;A person employed in a full-time salaried occupation of fire fighting for the benefit or safety of the public;

(2) A person employed in a full-time salaried occupation of fire fighting for the benefit or safety of the public;

(8) A civilian employee or a volunteer of a law enforcement agency whosewho(I) officialInteract dutieswith require the public;e employee or volunteer to:

(I) Interact with the public;

- *AB270_R1* – 59 – (9) A civilian employee or a volunteer of a fire-fighting agency whose official duties require the employee or volunteer to:

or (10) A civilian employee or volunteer of this State or a political subdivision of this State whose official duties require the employee oro(I) volunteerInteract to:with the public;

(I) Interact with the public;

(d) “Provider of health care” means a physician, a medical student, a perfusionist , an anesthesiologist assistant or a physician assistant licensed pursuant to chapter 630 of NRS, a practitioner of respiratory care, a homeopathic physician, an advanced practitioner of- homeopathy,82nd aSession homeopathic(2023) assistant,– an62 osteopathic– physician, a physician assistant or anesthesiologist assistant licensed pursuant to chapter 633 of NRS, a podiatric physician, a podiatry hygienist, a physical therapist, a medical laboratory technician, an optometrist, a chiropractic physician, a chiropractic assistant, a doctor of Oriental medicine, a nurse, a student nurse, a certified nursing assistant, a nursing assistant trainee, a medication aide - certified, a dentist, a dental student, a dental hygienist, a dental hygienist student, a pharmacist, a pharmacy student, an intern pharmacist, an attendant on an ambulance or air ambulance, a psychologist, a social worker, a marriage and family therapist, a marriage and family therapist intern, a clinical professional counselor, a clinical professional counselor intern, a licensed dietitian, the holder of a license or a limited license issued under the provisions of chapter 653 of NRS, an emergency medical technician, an advanced emergency medical technician and a paramedic.

(e) “School employee” means a licensed or unlicensed person employed by a board of trustees of a school district pursuant to NRS 391.100 or 391.281.

of trustees of a school district pursuant to NRS (f) “Sporting event” has the meaning ascribed to it in NRS 41.630.

- *AB270_R1* – 60 – (j) “Transit operator” means a person who operates a bus or other vehicle as part of a public mass transportation system.

(b) If the assault is made with the use of a deadly weapon or the present ability to use a deadly weapon, for a category B felony by imprisonment in the state prison for a minimum term of not less by than 1 year and a maximum term of not more than 6 years, or by a fine of not more than $5,000, or by both fine and imprisonment.

(c) If paragraph (d) does not apply to the circumstances of the crime and if the assault is committed upon an officer, a provider of health care, a school employee, a taxicab driver or a transit operator who is performing his or her duty or upon a sports official based on the performance of his or her duties at a sporting event and the person charged knew or should have known that the victim was an officer,- a82nd providerSession of(2023) health– care,63 a– school employee, a taxicab driver, a transit operator or a sports official, for a grossgrossicab misdemeanor, unless the assault is made with the use of a deadly weapon or the present ability to use a deadly weapon, then for a category B felony by imprisonment in the state prison for a minimum term of not less than 1 year and a maximum term of not more than 6 years, or by a fine of not more than $5,000, or by both fine and imprisonment.

(d) If the assault is committed upon an officer, a provider of health care, a school employee, a taxicab driver or a transit operator who is performing his or her duty or upon a sports official based on the performance of his or her duties at a sporting event by a probationer, a prisoner who is in lawful custody or confinement or a parolee, and the probationer, prisoner or parolee charged knew or should have known that the victim was an officer, a provider of health care, a school employee, a taxicab driver, a transit operator or a sports official, for a category D felony as provided in NRS 193.130, unless the assault is made with the use of a deadly weapon or the present ability to use a deadly weapon, then for a category B felony by imprisonment in the state prison for a minimum term of not less than 1 year and a maximum term of not more than 6 years, or by a fine of not more than $5,000, or by both fine and imprisonment.

Any person who is described in subsection 4 and who, in a professional or occupational capacity, knows or has reasonable cause to believe that an older person or vulnerable - *AB270_R1* – 61 – person has been abused, neglected, exploited, isolated or abandoned shall:

(1) The local office of the Aging and Disability Services DivisionDivisi(2) ofA thepolice Departmentdepartment ofor Healthsheriff’s andoffice; Human Services;

(2)ores; A police department or sheriff’s office;

or (3) A toll-free telephone service designated by the Aging and Disability Services Division of the Department of Health and Human Services;

2.- 82nd Session (2023) – 64 – subsection 1 knows or has reasonable cause to believe that theto abuse, neglect, exploitation, isolation or abandonment of the older person or vulnerable person involves an act or omission of the Aging and Disability Services Division, another division of the Department of Health and Human Services or a law enforcement agency, the person shall make the report to an agency other than the one alleged to have committed the act or omission.

If a person who is required to make a report pursuant to subsection 1 knows or has reasonable cause to believe that the abuse, neglect, exploitation, isolation or abandonment of the older person or vulnerable person involves an act or omission of the Aging and Disability Services Division, another division of the Department of Health and Human Services or a law enforcement agency, the person shall make the report to an agency other than the one alleged to have committed the act or omission.

(a) Every physician, dentist, dental hygienist, chiropractic physician, optometrist, podiatric physician, medical examiner, resident, intern, professional or practical nurse, physician assistant licensed pursuant to chapter 630 or 633 of NRS, anesthesiologist assistant, perfusionist, psychiatrist, psychologist, marriage and family therapist, clinical professional counselor, clinical alcohol and drug counselor, alcohol and drug counselor, music therapist, athletic trainer, driver of an ambulance, paramedic, licensed dietitian, holder of a license or a limited license issued under the provisions of chapter 653 of NRS, behavior analyst, assistant behavior analyst, registered behavior technician, peer recovery support specialist, as defined in NRS 433.627, peer recovery support specialist supervisor, as defined in NRS 433.629, or other person providing medical services licensed or certified to practice in this State, who examines, attends or treats an older person or vulnerable person who - *AB270_R1* – 62 – appears to have been abused, neglected, exploited, isolated or abandoned.

(b) Any personnel of a hospital or similar institution engaged in the admission, examination, care or treatment of persons or an administrator, manager or other person in charge of a hospital or similar institution upon notification of the suspected abuse, neglect, exploitation, isolation or abandonment of an older person or vulnerable person by a member of the staff of the hospital.

(f)- Every82nd personSession who(2023) operates,– who65 is– employed by or who contracts to provide services for an intermediary serviceserviceho organization as defined in NRS 449.4304.

(g) Any employee of the Department of Health and Human Services, except the State Long-Term Care Ombudsman appointed pursuant to NRS 427A.125 and any of his or her advocates or volunteers where prohibited from making such a report pursuant to 45 C.F.R.

(j) Any person who maintains, is employed by or serves as a volunteer for an agency or service which advises persons regarding the abuse, neglect, exploitation, isolation or abandonment of an older person or vulnerable person and refers them to persons and agencies where their requests and needs can be met.met.o persons and (k) Every social worker.

(k) Every social worker.

- *AB270_R1* – 63 – 6.

If a person who is required to make a report pursuant to subsection 1 knows or has reasonable cause to believe that an older person or vulnerable person has died as a result of abuse, neglect, isolation or abandonment, the person shall, as soon as reasonablyreasonablyt, practicable, report this belief to the appropriate medical examiner or coroner, who shall investigate the cause of death of the older person or vulnerable person and submit to the appropriate local law enforcement agencies, the appropriate prosecuting attorney, the Aging and Disability Services Division of the Department of Health and Human Services and the Unit for the Investigation and Prosecution of Crimes his or her written findings.

The written - 82nd Session (2023) – 66 – findings must include the information required pursuant to the provisions of NRS 200.5094, when possible.

A division, office or department which receives a report pursuant to this section shall cause the investigation of the report to commenceinvestigation conducted by a division, office or department, other than the Aging and Disability Services Division of the Department of Health and Human Services, must be forwarded within 330 workingdays days.after the completion of the report to the:

A copy of the final report of the investigation conducted by a division, office or department, other than the Aging and Disability Services Division of the Department of Health and Human Services, must be forwarded within 30 days after the completion of the report to the:

As used in this section, “Unit for the Investigation and Prosecution of Crimes” means the Unit for the Investigation and Prosecution of Crimes Against Older Persons or Vulnerable Persons in the Office of the Attorney General created pursuant to NRSNRSSec. 228.265.

Sec.

Except as otherwise provided in this section and NRS 1.4683, 1.4687, 1A.110, 3.2203, 41.0397, 41.071, 49.095, 49.293, 62D.420, 62D.440, 62E.516, 62E.620, 62H.025, 62H.030, 62H.170, 62H.220, 62H.320, 75A.100, 75A.150, 76.160, 78.152, 80.113, 81.850, 82.183, 86.246, 86.54615, 87.515, 87.5413, - *AB270_R1* – 64 – 87A.200, 87A.580, 87A.640, 88.3355, 88.5927, 88.6067, 88A.345, 88A.7345, 89.045, 89.251, 90.730, 91.160, 116.757, 116A.270, 116B.880, 118B.026, 119.260, 119.265, 119.267, 119.280, 119A.280, 119A.653, 119A.677, 119B.370, 119B.382, 120A.640, 120A.690, 125.130, 125B.140, 126.141, 126.161, 126.163, 126.730, 127.007, 127.057, 127.130, 127.140, 127.2817, 128.090, 130.312, 130.712, 136.050, 159.044, 159A.044, 172.075, 172.245, 176.015, 176.0625, 176.09129, 176.156, 176A.630, 178.39801, 178.4715, 178.5691, 179.495, 179A.070, 179A.165, 179D.160, 200.3771, - 82nd Session (2023) – 67 – 200.3772, 200.5095, 200.604, 202.3662, 205.4651, 209.392, 209.3923, 209.3925, 209.419, 209.429, 209.521, 211A.140, 213.010, 213.040, 213.095, 213.131, 217.105, 217.110, 217.464, 217.475, 218A.350, 218E.625, 218F.150, 218G.130, 218G.240, 218G.350, 224.240, 226.300, 228.270, 228.450, 228.495, 228.570, 231.069, 231.1473, 232.1369, 233.190, 237.300, 239.0105,239.0105,28.570, 239.0113, 239.014, 239B.026, 239B.030, 239B.040, 239B.050, 239C.140, 239C.210, 239C.230, 239C.250, 239C.270, 239C.420, 240.007, 241.020, 241.030, 241.039, 242.105, 244.264, 244.335, 247.540, 247.550, 247.560, 250.087, 250.130, 250.140, 250.150, 268.095, 268.0978, 268.490, 268.910, 269.174, 271A.105, 281.195, 281.805, 281A.350, 281A.680, 281A.685, 281A.750, 281A.755, 281A.780, 284.4068, 284.4086, 286.110, 286.118, 287.0438, 289.025, 289.080, 289.387, 289.830, 293.4855, 293.5002, 293.503, 293.504, 293.558, 293.5757, 293.870, 293.906, 293.908, 293.910, 293B.135, 293D.510, 331.110, 332.061, 332.351, 333.333, 333.335, 338.070, 338.1379, 338.1593, 338.1725, 338.1727, 348.420, 349.597, 349.775, 353.205, 353A.049, 353A.085, 353A.100, 353C.240, 360.240, 360.247, 360.255, 360.755, 361.044, 361.2242, 361.610, 365.138, 366.160, 368A.180, 370.257, 370.327, 372A.080, 378.290, 378.300, 379.0075, 379.008, 379.1495, 385A.830, 385B.100, 387.626, 387.631, 388.1455, 388.259, 388.501, 388.503, 388.513, 388.750, 388A.247, 388A.249, 391.033, 391.035, 391.0365, 391.120, 391.925, 392.029, 392.147, 392.264, 392.271, 392.315, 392.317, 392.325, 392.327, 392.335, 392.850, 393.045, 394.167, 394.16975, 394.1698, 394.447, 394.460, 394.465, 396.1415, 396.1425, 396.143, 396.159, 396.3295, 396.405, 396.525, 396.535,408.5484,396412.153,98A414.280,8.3416.070,.3422.2749,388422.305, 396.9685, 398A.115, 408.3885, 408.3886, 408.3888, 408.5484, 412.153, 414.280, 416.070, 422.2749, 422.305, 422A.342, 422A.350, 425.400, 427A.1236, 427A.872, 432.028, 432.205, 432B.175, 432B.280, 432B.290, 432B.4018, 432B.407, 432B.430, 432B.560, 432B.5902, 432C.140, 432C.150, 433.534, 433A.360, 439.4941, 439.4988, 439.840, 439.914, 439A.116, 439A.124, 439B.420, 439B.754, 439B.760, 439B.845, 440.170, 441A.195, 441A.220, 441A.230, 442.330, 442.395, 442.735, 442.774, 445A.665, 445B.570, 445B.7773, 447.345, 449.209, - *AB270_R1* – 65 – 449.245, 449.4315, 449A.112, 450.140, 450B.188, 450B.805, 453.164, 453.720, 458.055, 458.280, 459.050, 459.3866, 459.555, 459.7056, 459.846, 463.120, 463.15993, 463.240, 463.3403, 463.3407, 463.790, 467.1005, 480.535, 480.545, 480.935, 480.940, 481.063, 481.091, 481.093, 482.170, 482.368, 482.5536, 483.340, 483.363, 483.575, 483.659, 483.800, 484A.469, 484B.830, 484B.833, 484E.070, 485.316, 501.344, 503.452, 522.040, - 82nd Session (2023) – 68 – 534A.031, 561.285, 571.160, 584.655, 587.877, 598.0964, 598.098, 598A.110, 598A.420, 599B.090, 603.070, 603A.210, 604A.303, 604A.710, 612.265, 616B.012, 616B.015, 616B.315, 616B.350, 618.341, 618.425, 622.238, 622.310, 623.131, 623A.137, 624.110, 624.265, 624.327, 625.425, 625A.185, 628.418, 628B.230, 628B.760, 629.047, 629.069, 630.133, 630.2671, 630.2672,630.2672,8B.230, 630.2673, 630.30665, 630.336, 630A.327, 630A.555, 631.332, 631.368, 632.121, 632.125, 632.3415, 632.3423, 632.405, 633.283, 633.301, 633.4715, 633.4716, 633.4717, 633.524, 634.055, 634.1303, 634.214, 634A.169, 634A.185, 635.111, 635.158, 636.262, 636.342, 637.085, 637.145, 637B.192, 637B.288, 638.087, 638.089, 639.183, 639.2485, 639.570, 640.075, 640.152, 640A.185, 640A.220, 640B.405, 640B.730, 640C.580, 640C.600, 640C.620, 640C.745, 640C.760, 640D.135, 640D.190, 640E.225, 640E.340, 641.090, 641.221, 641.2215, 641.325, 641A.191, 641A.217, 641A.262, 641B.170, 641B.281, 641B.282, 641C.455, 641C.760, 641D.260, 641D.320, 642.524, 643.189, 644A.870, 645.180, 645.625, 645A.050, 645A.082, 645B.060, 645B.092, 645C.220, 645C.225, 645D.130, 645D.135, 645G.510, 645H.320, 645H.330, 647.0945, 647.0947, 648.033, 648.197, 649.065, 649.067, 652.126, 652.228, 653.900, 654.110, 656.105, 657A.510, 661.115, 665.130, 665.133, 669.275, 669.285, 669A.310, 671.170, 673.450, 673.480, 675.380, 676A.340, 676A.370, 677.243, 678A.470, 678C.710, 678C.800, 679B.122, 679B.124, 679B.152, 679B.159, 679B.190, 679B.285, 679B.690, 680A.270, 681A.440, 681B.260, 681B.410, 681B.540, 683A.0873, 685A.077, 686A.289, 686B.170, 686C.306, 687A.060, 687A.115, 687B.404, 687C.010, 688C.230, 688C.480, 688C.490, 689A.696, 692A.117, 692C.190, 692C.3507, 692C.3536, 692C.3538, 692C.354, 692C.420, 693A.480, 693A.615, 696B.550,696B.550,, 696C.120, 703.196, 704B.325, 706.1725, 706A.230, 710.159, 711.600, and sections 14 and 53 of this act, sections 35, 38 and 41 of chapter 478, Statutes of Nevada 2011 and section 2 of chapter 391, Statutes of Nevada 2013 and unless otherwise declared by law to be confidential, all public books and public records of a governmental entity must be open at all times during office hours to inspection by any person, and may be fully copied or an abstract or memorandum may be prepared from those public books and public records.

Any such copies, abstracts or memoranda may be used to - *AB270_R1* – 66 – supply the general public with copies, abstracts or memoranda of the records or may be used in any other way to the advantage of the governmental entity or of the general public.

This section does not supersede or in any manner affect the federal laws governing copyrights or enlarge, diminish or affect in any other manner the - 82nd Session (2023) – 69 – rights of a person in any written book or record which is copyrighted pursuant to federal law.

3.public book or record shall not deny a request made pursuant to of a subsection 1 to inspect or copy or receive a copy of a public book or record on the basis that the requested public book or record contains information that is confidential if the governmental entity can redact, delete, conceal or separate, including, without limitation, electronically, the confidential information from the information included in the public book or record that is not otherwise confidential.

A governmental entity that has legal custody or control of a public book or record shall not deny a request made pursuant to subsection 1 to inspect or copy or receive a copy of a public book or record on the basis that the requested public book or record contains information that is confidential if the governmental entity can redact, delete, conceal or separate, including, without limitation, electronically, the confidential information from the information included in the public book or record that is not otherwise confidential.

5.has legal custody or control of a public record:nmental entity who (a) Shall not refuse to provide a copy of that public record in the medium that is requested because the officer, employee or agent has already prepared or would prefer to provide the copy in a different medium.

An officer, employee or agent of a governmental entity who has legal custody or control of a public record:

(a) Shall not refuse to provide a copy of that public record in the medium that is requested because the officer, employee or agent has already prepared or would prefer to provide the copy in a different medium.

- *AB270_R1* – 67 – 1.

- 82nd Session (2023) – 70 – 2.

Provide a full-time or part-time staff for the facilities which may include a physician, a physician assistant licensed pursuant to chapter 630 or 633 of NRS, an anesthesiologist assistant, a registered nurse or a licensed practical nurse, a certified emergency medical technician, advanced emergency medical technician or paramedic, and such other personnel as the board deems necessary or appropriate to ensure adequate staffing commensurate with the needs of the area in which the facility is located.

Some of the more populous counties of the State have also experienced shortages of physicians, surgeons, anesthetists, dentists, other medical professionals , [and] physician assistants and anesthesiologistane3.hesBy assistantsgranting county scholarships to students in theirsuch medical professions who will agree to return to the less populous counties or the rural communities.communities of the more populous counties for residence and practice, these counties can alleviate the shortages to a degree and thereby provide their people with needed health services.

3.

By granting county scholarships to students in such medical professions who will agree to return to the less populous counties or the rural communities of the more populous counties for residence and practice, these counties can alleviate the shortages to a degree and thereby provide their people with needed health services.

- *AB270_R1* – 68 – 2.

Any county whose population is 100,000 or more may only establish a medical scholarship program to induce students in the - 82nd Session (2023) – 71 – medical professions to return to the less populous rural communities of the county for practice.

Students in the medical professions for the purposes of NRS 244.382 to 244.3823, inclusive, include persons studying to be physician assistants licensed pursuant to chapter 630 or 633 of NRS [.] or anesthesiologist assistants licensed pursuant to chapters 630 and 633 of NRS.

453.038 “Chart order” means an order entered on the chart of a patient:pat1.nt:In a hospital, facility for intermediate care or facility for skilled nursing which is licensed as such by the Division of Public and Behavioral Health of the Department;

1.

In a hospital, facility for intermediate care or facility for skilled nursing which is licensed as such by the Division of Public and Behavioral Health of the Department;

(b) A registered nurse licensed to practice professional nursing or licensed practical nurse, at the direction of a physician, physician - *AB270_R1*82nd –Session 69(2023) – assistant,72 dentist,– podiatric physician or advanced practice registered nurse, or pursuant to a chart order, for administration to a patient at another location.

(d) A respiratory therapist, at the direction of a physician or physicianphy(e) assistant.An anesthesiologist assistant, at the direction of a supervising anesthesiologist or supervising osteopathic anesthesiologist.

(e) An anesthesiologist assistant, at the direction of a supervising anesthesiologist or supervising osteopathic anesthesiologist.

 A medical student or student nurse may administer a controlled substance in the presence or under the supervision of a registered nurse alone only if the circumstances are such that the registered nurse would be authorized to administer it personally.

[(i)]- (j)82nd InSession accordance(2023) with– applicable73 regulations– of the State Board of Health, an employee of a residential facility for groups, as - *AB270_R1* – 70 – defined in NRS 449.017, pursuant to a written agreement entered into by the ultimate user.

[(l)] (m) A registered pharmacist pursuant to written guidelines and protocols developed pursuant to NRS 639.2629 or aaten guidelines collaborative practice agreement, as defined in NRS 639.0052.

Except as otherwise provided in NRS 454.217, a drugmay orbe medicinepossessed referredand toadministered inby:54.181 NRS 454.181 to 454.371, inclusive, may(a) beA possessedpractitioner. and administered by:

(a) A practitioner.

- 82nd Session (2023) – 74 – (c) Except as otherwise provided in paragraph (d), a registered nurse licensed to practice professional nursing or licensed practical nurse, at the direction of a prescribing physician, physician assistant licensed pursuant to chapter 630 or 633 of NRS, dentist, podiatric - *AB270_R1* – 71 – physician or advanced practice registered nurse, or pursuant to a chart order, for administration to a patient at another location.

(2) A county board of health in a county whose population is 100,000100,000(3) A district board of health created pursuant to NRS 439.362 or more;439.370 in any county.

or (3) A district board of health created pursuant to NRS 439.362 or 439.370 in any county.

- 82nd Session (2023) – 75 – (1) In the presence of a physician or a registered nurse;

 A medical student or student nurse may administer a dangerous drug in the presence or under the supervision of a registered nurse - *AB270_R1* – 72 – alone only if the circumstances are such that the registered nurse would be authorized to administer it personally.

(p) In accordance with applicable regulations of the State Board of Health, an employee of a residential facility for groups, asasoard defined in NRS 449.017, pursuant to a written agreement entered into by the ultimate user.

- 82nd Session (2023) – 76 – (s) A registered pharmacist pursuant to written guidelines and protocols developed pursuant to NRS 639.2629 or a collaborative practice agreement, as defined in NRS 639.0052.

(t) A person who is enrolled in a training program to become a physician assistant or anesthesiologist assistant licensed pursuant to chapter 630 or 633 of NRS, dental hygienist, advanced emergency medical technician, paramedic, respiratory therapist, dialysis technician, physical therapist or veterinary technician or to obtain a - *AB270_R1* – 73 – license to engage in radiation therapy and radiologic imaging pursuant to chapter 653 of NRS if the person possesses and administers the drug or medicine in the same manner and under the same conditions that apply, respectively, to a physician assistant or anesthesiologist assistant licensed pursuant to chapter 630 or 633 of NRS, dental hygienist, advanced emergency medical technician, paramedic, respiratory therapist, dialysis technician, physical therapist, veterinary technician or person licensed to engage in radiation therapy and radiologic imaging who may possess and administer the drug or medicine, and under the direct supervision of a person licensed or registered to perform the respective medical art or (u)a Asupervisor medicalof assistant,such ina accordanceperson. with applicable regulations of the:

(u) A medical assistant, in accordance with applicable regulations of the:

H~~~~~ 23 - *AB270_R1*82nd Session (2023)