AB 395 — Revises provisions relating to services to persons who are deaf or hard of hearing. (BDR 40-841)

or (3) The transportation of the person who is deaf or hard of hearing;

or (d) The communications are impeded by equipment failure or poor connectivity.

If a health facility that is located in a county whose population is 20,000 or more provides a qualified sign language interpreter remotely using audiovisual communication technology, the audiovisual communication technology mustmust: provide synchronous interaction with video over a high-speed, wide- bandwidth connection or wireless connection that:

(a) DoesProvide notclear producetransmission lagof oraudio irregularand pausesvisuals; in communication or images;

and (b) ProvidesBe transmissioncapable of voicehands-free thatuse. is clear and audible;

and- (c)*AB395_R1* Produces– a4 high-quality– video5. image that is not blurry or grainy and is large enough to display the face, arms, hands and finger of the qualified sign language interpreter and the person who is deaf or hard of hearing, regardless of body position.

5.

and (b) Comply with the provisions of the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, and any regulations adopted pursuant thereto,thereto. including, without limitation, entering into business associate agreements with each health facility for which the qualified sign language interpreter provides remote sign language interpreting;

and (c) Provide to the Division upon request copies of the business associate agreements into which the qualified sign language interpreter has entered.

A health facility that is located in a county whose population is 20,000 or more shall provide training to an employee, a contractor or a volunteer who is involved in using audiovisual communication technology to facilitate the use of a remote qualified sign language interpreter.

- *AB395* – 5 – (c) “Qualified sign language interpreter” means a qualified interpreter for an interpreter,individual with a disability, as defined in NRS45 656A.030,C.F.R. who:

(1)§ Has92.4, demonstratedwho proficiencyis inregistered thepursuant practiceto ofNRS sign656A.100 languageto interpreting,practice assign definedlanguage interpreting in NRSa 656A.060;community setting.

(2) Is able to interpret effectively,accurately and impartially, both receptively and expressively, using any necessary specialized vocabulary or terms without changes, omissions, or additions and while preserving the tone, sentiment and emotional level of the original statement;

and (3) Adheres to generally accepted ethical principles in the field of sign language interpreting, including, without limitation, client confidentiality.

- *AB395_R1* – 5 – 3.

(a) Violation by the applicant or the licensee of any of the provisions of NRS 439B.410, 449.029 to 449.245, inclusive, and section 1 of this act or 449A.100 to 449A.124, inclusive, and - *AB395* – 6 – 449A.270 to 449A.286, inclusive, or of any other law of this State or of the standards, rules and regulations adopted thereunder.

or - *AB395_R1* – 6 – (c) Is ordered by the appropriate governmental agency to correct a violation of a building, safety or health code or regulation but fails to correct the violation.

and - *AB395* – 7 – (c) A report of any disciplinary action taken against the facility.

(d) Except where a greater penalty is authorized by subsection 2, impose an administrative penalty of not more than $5,000 per day - *AB395_R1* – 7 – for each violation, together with interest thereon at a rate not to exceed 10 percent per annum;

If an off-campus location of a hospital fails to obtain a national provider identifier that is distinct from the national provider identifier used by the main campus and any other off-campus location of the hospital in violation of NRS 449.1818, the Division - *AB395* – 8 – may impose against the hospital an administrative penalty of not more than $10,000 for each day of such failure, together with interest thereon at a rate not to exceed 10 percent per annum, in addition to any other action authorized by this chapter.

- *AB395_R1* – 8 – Sec.

- *AB395* – 9 – (c) The manner in which a person may obtain information concerning whether the facility has ever been found to have violated the provisions of this chapter;

and - *AB395_R1* – 9 – (8) Services which ensure that the residents of the facility are safe, secure and adequately supervised.

A provider of health care who is providing care in a county whose population is 20,000 or more shall ensure that each person who is deaf or hard of hearing and seeks health care from the provider of health care:care is notified:

(a) IsThat notifieda that:qualified sign language interpreter can be made available to assist the person;

(1)(b) AThat qualifiedthe signperson languagemay interpreterrequest isan availablein-person toor assistremote thequalified person;sign language interpreter;

(2)and The(c) personOf mayany requestother anspecific in-personaccommodations orthat remotemay qualifiedbe signavailable languagefor interpreter;the person.

and - *AB395* – 10 – (3) If the provider of health care has determined in accordance with subsection 3 that the provision of a qualified sign language interpreter remotely using audiovisual communication technology is inadequate, the person who is deaf or hard of hearing must provide informed consent in order to receive sign language interpreting services from a remote qualified sign language interpreter;

and (b) Is provided with a qualified sign language interpreter in accordance with subsections 2 and 3 until the person ceases receiving health care from the provider of health care or it is determined that the person will not receive health care from the provider of health care.

AIf a person who is deaf or hard of hearing seeks health care from a provider of health care:care who is providing care in a county whose population is 20,000 or more and requests an in- person qualified sign language interpreter:

(a) ShallAt ensureleast that48 anhours in-personbefore qualifieda signprescheduled languageencounter interpreterwith isthe providedprovider toof ahealth personcare, whothe isprovider deaf or hard of hearing and seeks health care fromshall theprovide provideran ofin-person healthqualified caresign if:language interpreter.

(1)(b) TheIn personcircumstances requestsother anthan in-personthose qualifieddescribed signin languageparagraph interpreter;(a), the provider of health care shall:

or(1) (2)Make The provider of health care determines that the provision of a qualifiedgood signfaith languageeffort interpreterto remotely using audiovisual communication technology is inadequate in accordance with subsection 3 and the person does not provide informedan consentin-person to receive sign language interpreting services from a remote qualified sign language interpreter.interpreter;

(b)(2) ShallProvide ensurean thatin-person a qualified sign language interpreter isif providedthe toprovider a person who is deaf or hard of hearing and seeks health care fromis theable providerto remotelydo usingso audiovisualafter communicationmaking technologya if:good faith effort;

(1)(3) TheProvide persona requestsqualified sign language interpreter remotely using audiovisual communication technology in a remotemanner that meets the requirements of subsections 4 and 5 if the provider of health care is unable to provide an in-person qualified sign language interpreter;interpreter after making a good faith effort;

and (2)(4) IfMaintain the provider of health care has determined in accordance with subsection 3 that the provisionmedical record of a qualified sign language interpreter remotely using audiovisual communication technology is inadequate, the person providesdocumentation informedof consentthe togood receivingfaith signeffort languagemade interpretingpursuant servicesto fromsubparagraph a(1), remotewhich signmust languageinclude, interpreter.without limitation:

(c)(I) MayA providelist aof qualifiedentities signcontacted languageto interpreterprovide eitheran remotelyin-person usingqualified audiovisualsign communicationlanguage technologyinterpreter orand in person under circumstances where a personstatement who is deaf or hard of hearing seeks health care from the provider,manner other than those described in paragraphswhich (a)each andsuch (b).entity responded;

(II) A statement of whether the provider of health care provided an in-person qualified sign language interpreter or - *AB395_R1* – 10 – provided a qualified sign language interpreter remotely using audiovisual communication technology;

and (III) If applicable, the time at which a qualified sign language interpreter was available in person to assist the person.

AIf providera person who is deaf or hard of hearing seeks health care shallfrom determinea thatprovider theof provisionhealth ofcare who is providing care in a qualifiedcounty signwhose languagepopulation interpreteris remotely20,000 usingor audiovisualmore communicationand technologyrequests isthat inadequatethe if:provider of health care provide:

(a) TheA personqualified whosign islanguage deafinterpreter orremotely hardusing audiovisual communication technology, the provider of hearing:health care shall provide a qualified sign language interpreter remotely using audiovisual communication technology in a manner that meets the requirements of subsections 4 and 5.

-(b) *AB395*Any –type 11 – (1) Cannot easily see the audiovisual transmission because of restrictedaccommodation mobility,other than a secondaryqualified disabilitysign orlanguage becauseinterpreter, of the locationprovider whereof thehealth communicationcare ismay takingprovide place;the accommodation.

(2) Is heavily medicated or intoxicated;

(3) Has cognitive limitations;

(4) Is in surgery;

(5) Is giving birth;

or (6) Is in danger of imminent death;

or (7) Indicates through sigh, facial expression or other means that communication is not being achieved;

(b) The communications are highly sensitive, including, without limitation, the communication of a serious diagnosis;

(c) The communications occur during:

(1) An initial meeting with a specialist provider of health care;

(2) An eye examination;

or (3) The transportation of the person who is deaf or hard of hearing;

or (d) The communications are impeded by equipment failure or poor connectivity.

If a provider of health care who is providing care in a county whose population is 20,000 or more provides a qualified sign language interpreter remotely using audiovisual communication technology, the audiovisual communication technology mustmust: provide synchronous interaction with video over a high-speed, wide-bandwidth connection or wireless connection that:

(a) DoesProvide notclear producetransmission lagof oraudio irregularand pausesvisuals; in communication or images;

and (b) ProvidesBe transmissioncapable of voicehands-free thatuse. is clear and audible;

and (c) Produces a high-quality video image that is not blurry or grainy and is large enough to display the face, arms, hands and finger of the qualified sign language interpreter and the person who is deaf or hard of hearing, regardless of body position.

and (b) Comply with the provisions of the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, and any regulations adopted pursuant thereto,thereto. including, without limitation, entering into business associate agreements with each provider of health care for which the qualified sign language interpreter provides remote sign language interpreting;

and - *AB395* – 12 – (c) Provide upon request to the board, agency or other entity in this State by which the relevant provider of health care is licensed, certified or registered copies of the business associate agreements into which the qualified sign language interpreter has entered.

A provider of health care who is providing care in a county whose population is 20,000 or more shall provide training to an employee, a contractor or a volunteer who is involved in using audiovisual communication technology to facilitate the use of a remote qualified sign language interpreter.

The provisions of this section do not apply to a person who holds a license as an attendant or who is certified as an emergency medical technician, advanced emergency medical technician or - *AB395_R1* – 11 – paramedic pursuant to chapter 450B of NRS or authorized to practice as an emergency medical technician, advanced emergency medical technician or paramedic in this State under the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact ratified by NRS 450B.145.

9.

- *AB395* – 13 – 2.

Any person who is subpoenaed pursuant to this subsection may - *AB395_R1* – 12 – request the Board to modify the terms of the subpoena or grant additional time for compliance.

conclusions4. of law supporting that order are public records.fact and 5.

TheAn expiration of a license by operation of law or by order orthat decisionimposes ofdiscipline theand Board or a court, or the voluntaryfindings surrender of afact license,and doesconclusions not deprive the Board of jurisdictionlaw tosupporting proceedthat withorder anyare investigationpublic of,records. or action or disciplinary proceeding against, the licensee or to render a decision suspending or revoking the license.

or decision of the Board or a court, or the voluntary surrender of a license, does not deprive the Board of jurisdiction to proceed with any investigation of, or action or disciplinary proceeding against, the licensee or to render a decision suspending or revoking the license.

H - *AB395**AB395_R1*