2005 Nevada Revised Statutes - Chapter 433 — General Provisions

Title 39 - MENTAL HEALTH

CHAPTER 433 - GENERAL PROVISIONS

DECLARATION OF INTENT

NRS 433.003 Declarationof legislative intent.

DEFINITIONS FOR TITLE 39 OF NRS

NRS 433.005 Definitions.

NRS 433.014 Administrativeofficer defined.

NRS 433.024 Administratordefined.

NRS 433.044 Clientdefined.

NRS 433.047 Commissiondefined.

NRS 433.064 Departmentdefined.

NRS 433.074 Directorof the Department defined.

NRS 433.084 Divisiondefined.

NRS 433.094 Divisionfacility defined.

NRS 433.134 Medicaldirector defined.

NRS 433.144 Mentalhealth center defined.

NRS 433.164 Mentalillness defined.

NRS 433.174 Mentalretardation defined.

NRS 433.184 Mentalretardation center defined.

NRS 433.209 Personprofessionally qualified in the field of psychiatric mental health defined.

NRS 433.211 Personswith related conditions defined.

NRS 433.214 Trainingdefined.

NRS 433.224 Treatmentdefined.

NRS 433.227 Treatmentto competency defined.

DIVISION OF MENTAL HEALTH AND DEVELOPMENTAL SERVICES

Facilities of Division

NRS 433.233 Designation.

Personnel of Division

NRS 433.234 Administrationof facilities of Division.

NRS 433.244 Administrator:Qualifications; classification.

NRS 433.254 Administrator:Powers and duties.

NRS 433.264 Physicians:Employment; qualifications; compensation; duties.

NRS 433.265 Licensingor certification of certain employees of Division.

NRS 433.267 Limitationon time for certification of psychiatrist employed by Division.

NRS 433.269 Proficiencyin English language required of certain employees.

NRS 433.274 Deputyadministrative officer.

NRS 433.279 Programfor certification of mental health-mental retardation technicians.

Commission on Mental Health and DevelopmentalServices

NRS 433.314 Duties.

NRS 433.316 Powers.

NRS 433.324 Regulations.

NRS 433.325 Inspectionof facility.

NRS 433.327 Rightof certain employees of Department to submit information or requests toCommission or appear before Commission.

Powers and Duties

NRS 433.331 Adoptionof regulations concerning abuse and neglect of clients.

NRS 433.332 Divisionfacility required to forward patients medical records upon transfer of patientfrom facility.

NRS 433.334 Contractwith general hospital or other institution for care of clients.

NRS 433.344 Contractswith persons professionally qualified in field of psychiatric mental health forcare of persons.

NRS 433.354 Contractsfor cooperation with governmental agencies and others.

NRS 433.364 Involuntarycourt-ordered admission to private institution not precluded.

NRS 433.374 Statenot responsible for payment of costs of care and treatment at other facility;exceptions.

Finance

NRS 433.384 Legislativeappropriations; payment of claims.

NRS 433.394 Acceptanceby Department of money from other sources.

NRS 433.395 Acceptanceby Administrator of donations, gifts and grants for disbursement to certainprograms; contract for services for evaluation and recommendation of recipientsfor disbursements.

NRS 433.404 Scheduleof fees for services rendered through programs supported by State; dispositionof receipts; amount of fee for services of facility.

NRS 433.414 Feesof physicians and other professionally qualified employees of facility.

NRS 433.424 Mentalhealth and mental retardation center revolving accounts.

CLIENTS

Residence

NRS 433.431 Definitions.

NRS 433.434 Determinationof residence.

NRS 433.444 Reciprocalagreement for returning clients to legal residence; investigation and reportconcerning residence.

NRS 433.454 Expensesof returning client to legal residence.

Clients Rights

NRS 433.456 Definitions.

NRS 433.458 Administrativeofficer defined.

NRS 433.459 Clientdefined.

NRS 433.461 Facilitydefined.

NRS 433.462 Rightsdefined.

NRS 433.464 Rightto habeas corpus unimpaired.

NRS 433.471 Rightsconcerning admission and discharge of clients.

NRS 433.472 Rightsconcerning involuntary commitment.

NRS 433.482 Personalrights.

NRS 433.484 Rightsconcerning care, treatment and training.

NRS 433.494 Individualizedplan of services for client.

NRS 433.496 Basisfor decisions, policies, procedures and practices regarding emergencyadmissions and involuntary court-ordered admissions.

NRS 433.504 Rightto information; inspection and copying of records.

NRS 433.514 Medication:Responsibility of psychiatrist and physician; review of methods foradministration and custody.

NRS 433.524 Laborby client: Conditions; compensation.

NRS 433.531 Rightsconcerning suspension or violation of rights.

NRS 433.533 Documentreflecting receipt of list of rights and explanation of rights.

NRS 433.534 Denialof rights prohibited; exceptions; report; investigation and action byCommission; closure of meeting in certain circumstances.

NRS 433.536 Retaliationby officer, director or employee of facility prohibited.

Safekeeping of Clients Money and Other PersonalProperty

NRS 433.538 Definitions.

NRS 433.539 Personaldeposit funds for clients.

NRS 433.541 Dispositionof personal property of client upon death.

NRS 433.542 Dispositionof unclaimed personal property of client worth more than $100.

NRS 433.543 Dispositionof unclaimed personal property of minimal value.

Deaths and Burials

NRS 433.544 Notificationof death of client; burial.

USE OF RESTRAINTS AND INTERVENTIONS

NRS 433.545 Definitions.

NRS 433.5453 Aversiveintervention defined.

NRS 433.5456 Chemicalrestraint defined.

NRS 433.546 Corporalpunishment defined.

NRS 433.5463 Electricshock defined.

NRS 433.5466 Emergencydefined.

NRS 433.547 Mechanicalrestraint defined.

NRS 433.5473 Personwith a disability defined.

NRS 433.5476 Physicalrestraint defined.

NRS 433.548 Verbaland mental abuse defined.

NRS 433.5483 Useof aversive intervention on client prohibited.

NRS 433.5486 Useof physical, mechanical or chemical restraint on client by facility authorizedin certain circumstances.

NRS 433.549 Useof physical, mechanical or chemical restraint on client by person employed byfacility prohibited; exceptions.

NRS 433.5493 Useof physical restraint on client; requirements; exceptions; report as denial ofrights.

NRS 433.5496 Useof mechanical restraint on client other than client of forensic facility;requirements; exceptions; report as denial of rights.

NRS 433.5499 Useof mechanical restraint on client of forensic facility; requirements;exceptions; report as denial of rights.

NRS 433.5503 Useof chemical restraint on client; requirements; report as denial of rights.

NRS 433.5506 Facilityrequired to develop program of education in positive behavioral interventionsand supports; facility required to train certain members of staff to usephysical, mechanical and chemical restraint.

NRS 433.551 Facilityrequired to report violations to Division and to develop corrective plan;Division required to forward corrective plan to Director of Department; powerof Department to withhold funding.

UNLAWFUL ACTS

NRS 433.554 Abuseof client; failure to report abuse; possession or use of intoxicating beverageor controlled substance; transaction with client; aiding escape of client;penalties.

NRS 433.564 Unlawfulsale or transfer of intoxicating beverage to client; penalty.

MISCELLANEOUS PROVISIONS

NRS 433.801 Returnof prescription drug to dispensing pharmacy for reissuance of drug; reissuanceof drug by dispensing pharmacy; regulations.

_________

DECLARATION OF INTENT

NRS 433.003 Declarationof legislative intent. The Legislature herebydeclares that it is the intent of this title:

1. To eliminate the forfeiture of any civil and legalrights of any person and the imposition of any legal disability on any person,based on an allegation of mental illness or mental retardation or a relatedcondition, by any method other than a separate judicial proceeding resulting ina determination of incompetency, wherein the civil and legal rights forfeitedand the legal disabilities imposed are specifically stated; and

2. To charge the Division of Mental and DevelopmentalServices, and the Division of Child and Family Services, of the Department withrecognizing their duty to act in the best interests of their respective clientsby placing them in the least restrictive environment.

(Added to NRS by 1975, 1589; A 1993, 2715; 1999, 97, 2589)

DEFINITIONS FOR TITLE 39 OF NRS

NRS 433.005 Definitions. As used in this title, unless the context otherwiserequires, or except as otherwise defined by specific statute, the words andterms defined in NRS 433.014 to 433.227, inclusive, have the meaningsascribed to them in those sections.

(Added to NRS by 1969, 1060; A 1971, 1987; 1973, 256,1220; 1975, 1589; 1979, 811; 1985, 2264; 1989, 1755; 1999, 2590; 2003, 1941)

NRS 433.014 Administrativeofficer defined. Administrative officermeans a person with overall executive and administrative responsibility forthose state or nonstate mental health or mental retardation facilitiesdesignated by the Administrator.

(Added to NRS by 1975, 1590; A 1979, 811)

NRS 433.024 Administratordefined. Administrator means the Administratorof the Division.

(Added to NRS by 1973, 256; A 1999, 97)

NRS 433.044 Clientdefined. Client means any person who seeks,on his own or anothers initiative, and can benefit from, care, treatment andtraining provided by the Division, or from treatment to competency provided bythe Division.

(Added to NRS by 1975, 1590; A 1997, 3491; 2003, 1941)

NRS 433.047 Commissiondefined. Commission means the Commission onMental Health and Developmental Services.

(Added to NRS by 1985, 2262; A 1999, 97)

NRS 433.064 Departmentdefined. Department means the Department ofHealth and Human Services.

(Added to NRS by 1975, 1590)

NRS 433.074 Directorof the Department defined. Director of the Departmentmeans the administrative head of the Department.

(Added to NRS by 1975, 1590)

NRS 433.084 Divisiondefined. Division means the Division ofMental Health and Developmental Services of the Department.

(Added to NRS by 1969, 1060; A 1973, 1406; 1975,1590; 1999, 97)

NRS 433.094 Divisionfacility defined. Division facility meansany unit or subunit operated by the Division for the care, treatment andtraining of clients.

(Added to NRS by 1973, 256; A 1975, 1590; 1981, 275)

NRS 433.134 Medicaldirector defined. Medical director meansthe chief medical officer of any division mental health or mental retardationprogram.

(Added to NRS by 1973, 1220; A 1975,1591)(Substituted in revision for NRS 433.0105)

NRS 433.144 Mentalhealth center defined. Mental health centermeans any of the state comprehensive mental health centers, including ruralclinics.

(Added to NRS by 1969, 1060; A 1973, 98; 1975,1591)(Substituted in revision for NRS 433.011)

NRS 433.164 Mentalillness defined. Mental illness means aclinically significant disorder of thought, mood, perception, orientation,memory or behavior which:

1. Is listed in the most recent edition of theclinical manual of the International Classification of Diseases, ICD-9-CM,code range 295 to 302.9, inclusive, 306 to 309.9, inclusive, or 311 to 316,inclusive, or the corresponding code in the most recent edition of the AmericanPsychiatric Associations Diagnostic and Statistical Manual of MentalDisorders, DSM-IV, Axis I; and

2. Seriously limits the capacity of a person tofunction in the primary aspects of daily living, including, without limitation,personal relations, living arrangements, employment and recreation.

(Added to NRS by 1975, 1591; A 2003, 1941)

NRS 433.174 Mentalretardation defined. Mental retardationmeans significantly subaverage general intellectual functioning existingconcurrently with deficits in adaptive behavior and manifested during thedevelopmental period.

(Added to NRS by 1975, 1591)

NRS 433.184 Mentalretardation center defined. Mentalretardation center means an organized program for providing appropriateservices and treatment to mentally retarded persons and persons with relatedconditions. A mental retardation center may include facilities for residentialtreatment and training.

(Added to NRS by 1975, 1591; A 1999, 2590)

NRS 433.209 Personprofessionally qualified in the field of psychiatric mental health defined. Person professionally qualified in the field of psychiatricmental health means:

1. A psychiatrist licensed to practice medicine in theState of Nevada and certified by the American Board of Psychiatry andNeurology;

2. A psychologist licensed to practice in this State;

3. A social worker who holds a masters degree insocial work, is licensed by the State as a clinical social worker and isemployed by the Division;

4. A registered nurse who:

(a) Is licensed to practice professional nursing inthis State;

(b) Holds a masters degree in the field of psychiatricnursing; and

(c) Is employed by the Division.

5. A marriage and family therapist licensed pursuantto chapter 641A of NRS.

(Added to NRS by 1975, 1591; A 1983, 506; 1985, 2044;1987, 527, 1124, 2133, 2134; 1989, 1550)

NRS 433.211 Personswith related conditions defined. Persons with related conditionsmeans persons who have a severe, chronic disability which:

1. Is attributable to:

(a) Cerebral palsy or epilepsy; or

(b) Any other condition, other than mental illness,found to be closely related to mental retardation because the condition resultsin impairment of general intellectual functioning or adaptive behavior similarto that of a mentally retarded person and requires treatment or servicessimilar to those required by a mentally retarded person;

2. Is manifested before the person affected attainsthe age of 22 years;

3. Is likely to continue indefinitely; and

4. Results in substantial functional limitations inthree or more of the following areas of major life activity:

(a) Taking care of oneself;

(b) Understanding and use of language;

(c) Learning;

(d) Mobility;

(e) Self-direction; and

(f) Capacity for independent living.

(Added to NRS by 1999, 2589)

NRS 433.214 Trainingdefined. Training means a program ofservices directed primarily toward enhancing the health, welfare and developmentof mentally retarded persons and persons with related conditions through theprocess of providing those experiences that will enable the individual to:

1. Develop his physical, intellectual, social andemotional capacities to the fullest extent;

2. Live in an environment that is conducive topersonal dignity; and

3. Continue development of those skills, habits andattitudes essential to adaptation in contemporary society.

(Added to NRS by 1975, 1591; A 1999, 2590)

NRS 433.224 Treatmentdefined. Treatment means any combination ofprocedures or activities, of whatever level of intensity and whatever duration,ranging from occasional counseling sessions to full-time admission to aresidential facility.

(Added to NRS by 1975, 1592)

NRS 433.227 Treatmentto competency defined. Treatment to competencymeans treatment provided to a person who is a defendant in a criminal action orproceeding to attempt to cause him to attain competency to stand trial orreceive pronouncement of judgment.

(Added to NRS by 2003, 1941)

DIVISION OF MENTAL HEALTH AND DEVELOPMENTAL SERVICES

Facilities of Division

NRS 433.233 Designation.

1. The division facilities providing mental healthservices are designated as:

(a) Northern Nevada Adult Mental Health Services;

(b) Southern Nevada Adult Mental Health Services;

(c) Rural clinics; and

(d) Lakes Crossing Center.

2. The division facilities providing services formentally retarded persons and persons with related conditions are designatedas:

(a) Desert Regional Center;

(b) Sierra Regional Center; and

(c) Rural Regional Center.

3. Division facilities established after July 1, 1981,must be named by the Administrator, subject to the approval of the Director ofthe Department.

(Added to NRS by 1981, 274; A 1993, 2715; 1999, 97, 2590; 2001, 1115)

Personnel of Division

NRS 433.234 Administrationof facilities of Division. The provisions of chapters 433 to 436,inclusive, of NRS pertaining to division facilities must be administered by therespective administrative officers of the division facilities, subject toadministrative supervision by the Administrator.

(Added to NRS by 1975, 1592; A 1993, 2715)

NRS 433.244 Administrator:Qualifications; classification.

1. The Administrator must:

(a) Have training and demonstrated administrativequalities of leadership in any one of the professional fields of psychiatry,medicine, psychology, social work, education or administration.

(b) Be appointed, from a list of three personsnominated by the Commission, on the basis of merit as measured byadministrative training or experience in programs relating to mental health,including care, treatment or training, or any combination thereof, of mentallyill and mentally retarded persons and persons with related conditions.

(c) Have additional qualifications which are inaccordance with criteria prescribed by the Department of Personnel.

2. The Administrator is in the unclassified service ofthe State.

(Added to NRS by 1975, 1592; A 1981, 1281, 1685;1983, 641; 1985, 2264; 1999,2590)

NRS 433.254 Administrator:Powers and duties.

1. The Administrator serves at the pleasure of theGovernor and shall:

(a) Serve as the Executive Officer of the Division;

(b) Administer the Division in accordance with thepolicies established by the Commission;

(c) Make an annual report to the Director of theDepartment on the condition and operation of the Division, and such otherreports as the Director may prescribe; and

(d) Employ, within the limits of available money, theassistants and employees necessary to the efficient operation of the Division.

2. The Administrator shall appoint the administrativepersonnel necessary to operate the programs of the Division, including anAssociate Administrator for Mental Retardation. The Commission must approve thecredentials, training and experience of deputy administrators and heads ofenumerated institutions. He shall delegate to the administrative officers thepower to appoint medical, technical, clerical and operational staff necessaryfor the operation of the facilities of the Division.

3. If the Administrator finds that it is necessary ordesirable that any employee reside at a facility operated by the Division orreceive meals at such a facility, perquisites granted or charges for servicesrendered to that person are at the discretion of the Governor.

4. The Administrator may accept persons referred tothe Division for treatment pursuant to the provisions of NRS 458.290 to 458.350, inclusive.

(Added to NRS by 1975, 1592; A 1979, 811; 1985, 423,2264; 1989, 429)

NRS 433.264 Physicians:Employment; qualifications; compensation; duties.

1. Physicians shall be employed within the variousdivision facilities as are necessary for the operation of the facilities. Theyshall hold degrees of doctor of medicine from accredited medical schools andthey shall be licensed to practice medicine in Nevada as provided by law.

2. Except as otherwise provided by law, their onlycompensation shall be annual salaries, fixed in accordance with the pay planadopted pursuant to the provisions of NRS284.175.

3. The physicians shall perform such duties pertainingto the care and treatment of clients as may be required.

(Added to NRS by 1975, 1592)

NRS 433.265 Licensingor certification of certain employees of Division. Anyperson employed by the Division as a psychiatrist, psychologist, marriage andfamily therapist, registered nurse or social worker must be licensed orcertified by the appropriate state licensing board for his respectiveprofession.

(Added to NRS by 1985, 2044; A 1987, 527, 1122, 2133,2134)

NRS 433.267 Limitationon time for certification of psychiatrist employed by Division. Any psychiatrist who is employed by the Division must becertified by the American Board of Psychiatry and Neurology within 5 yearsafter his first date of employment with the Division. The Administrator shallterminate the employment of any psychiatrist who fails to receive suchcertification.

(Added to NRS by 1985, 2044; A 1989, 683)

NRS 433.269 Proficiencyin English language required of certain employees. TheAdministrator shall not employ any psychiatrist, psychologist, social worker orregistered nurse who holds a masters degree in the field of psychiatricnursing who is unable to demonstrate proficiency in the oral and writtenexpression of the English language.

(Added to NRS by 1985, 2044)

NRS 433.274 Deputyadministrative officer. An administrativeofficer, with the approval of the Administrator, may designate an employee toact as his deputy. In case of the absence or inability of the administrativeofficer for any cause to discharge the duties of his office, those dutiesdevolve upon his deputy.

(Added to NRS by 1975, 1594; A 1979, 812)

NRS 433.279 Programfor certification of mental health-mental retardation technicians.

1. The Division shall carry out a vocational andeducational program for the certification of mental health-mental retardationtechnicians, including forensic technicians:

(a) Employed by the Division, or other employees of theDivision who perform similar duties, but are classified differently.

(b) Employed by the Division of Child and FamilyServices of the Department.

The programmust be carried out in cooperation with the Nevada System of Higher Education.

2. A mental health-mental retardation technician isresponsible to the director of the service in which his duties are performed.The director of a service may be a licensed physician, dentist, podiatricphysician, psychiatrist, psychologist, rehabilitation therapist, social worker,registered nurse or other professionally qualified person. This section doesnot authorize a mental health-mental retardation technician to perform dutieswhich require the specialized knowledge and skill of a professionally qualifiedperson.

3. The Division shall adopt regulations to carry outthe provisions of this section.

4. As used in this section, mental health-mentalretardation technician means an employee of the Division of Mental Health andDevelopmental Services or the Division of Child and Family Services who, forcompensation or personal profit, carries out procedures and techniques whichinvolve cause and effect and which are used in the care, treatment andrehabilitation of mentally ill, emotionally disturbed or mentally retardedpersons or persons with related conditions, and who has direct responsibilityfor:

(a) Administering or carrying out specific therapeuticprocedures, techniques or treatments, excluding medical interventions, toenable clients to make optimal use of their therapeutic regime, their socialand personal resources, and their residential care; or

(b) The application of interpersonal and technicalskills in the observation and recognition of symptoms and reactions of clients,for the accurate recording of such symptoms and reactions, and for carrying outtreatments authorized by members of the interdisciplinary team that determinesthe treatment of the clients.

(Added to NRS by 1989, 428; A 1993, 402, 2230; 1995,805; 1999, 98, 2591)

Commission on Mental Health and Developmental Services

NRS 433.314 Duties. The Commission shall:

1. Establish policies to ensure adequate developmentand administration of services for the mentally ill and mentally retarded andpersons with related conditions, including services to prevent mental illnessand mental retardation and related conditions, and services provided withoutadmission to a facility or institution;

2. Set policies for the care and treatment of mentallyill and mentally retarded persons and persons with related conditions providedby all state agencies;

3. Review the programs and finances of the Division;and

4. Report at the beginning of each year to theGovernor and at the beginning of each odd-numbered year to the Legislature onthe quality of the care and treatment provided for mentally ill and mentallyretarded persons and persons with related conditions in this state and on anyprogress made toward improving the quality of that care and treatment.

(Added to NRS by 1975, 1593; A 1985, 2265; 1999, 2591)

NRS 433.316 Powers. The Commission may:

1. Collect and disseminate information pertaining tomental health and mental retardation and related conditions.

2. Request legislation pertaining to mental health andmental retardation and related conditions.

3. Investigate complaints about the care of any personin a public facility for the treatment of the mentally ill or mentally retardedand persons with related conditions.

4. Accept, as authorized by the Legislature, gifts andgrants of money and property.

5. Take appropriate steps to increase the availabilityof and to enhance the quality of the care and treatment of the mentally ill andmentally retarded and persons with related conditions provided through stateagencies, hospitals and clinics.

6. Promote programs for the treatment of the mentallyill and mentally retarded and persons with related conditions and participatein and promote the development of facilities for training persons to provideservices for the mentally ill and mentally retarded and persons with relatedconditions.

7. Create a plan to coordinate the services for thetreatment of the mentally ill and the mentally retarded and persons withrelated conditions provided in this state and to provide continuity in the careand treatment provided.

8. Establish and maintain an appropriate program whichprovides information to the general public concerning mental illness and mentalretardation and related conditions and consider ways to involve the generalpublic in the decisions concerning the policy on mental illness and mentalretardation and related conditions.

9. Compile statistics on mental illness and study thecause, pathology and prevention of that illness.

10. Establish programs to prevent or postpone thecommitment of residents of this state to facilities for the treatment of thementally ill and mentally retarded and persons with related conditions.

11. Evaluate the future needs of this state concerningthe treatment of mental illness and mental retardation and related conditionsand develop ways to improve the treatment already provided.

12. Take any other action necessary to promote mentalhealth in this state.

(Added to NRS by 1985, 2263; A 1999, 2592)

NRS 433.324 Regulations.

1. The Commission shall adopt regulations:

(a) For the care and treatment of mentally ill andmentally retarded persons and persons with related conditions by all stateagencies and facilities, and their referral to private facilities;

(b) To ensure continuity in the care and treatment providedto mentally ill and mentally retarded persons and persons with relatedconditions in this state; and

(c) Necessary for the proper and efficient operation ofthe facilities of the Division.

2. The Commission may adopt regulations to promoteprograms relating to mental health and mental retardation and relatedconditions.

(Added to NRS by 1975, 1594; A 1985, 368, 2265; 1999, 2592)

NRS 433.325 Inspectionof facility. The Commission or its designatedagent may inspect any state facility providing services for the mentally ill ormentally retarded and persons with related conditions to determine if thefacility is in compliance with the provisions of this title and any regulationsadopted pursuant to those provisions.

(Added to NRS by 1985, 2263; A 1993, 2715; 1999, 2593)

NRS 433.327 Rightof certain employees of Department to submit information or requests toCommission or appear before Commission. Everyemployee of the Division, and every person employed by the Division of Childand Family Services of the Department pursuant to NRS 433B.010 to 433B.350, inclusive, is entitled tosubmit written information or requests directly to the Commission or itsindividual members, or appear before it with its permission, but the Commissionshall not interfere with the procedures for resolving the grievances ofemployees in the classified service of the State.

(Added to NRS by 1985, 2263; A 1993, 2716)

Powers and Duties

NRS 433.331 Adoptionof regulations concerning abuse and neglect of clients. The Division shall adopt regulations to:

1. Provide for a more detailed definition of abuse ofa client of the Division, consistent with the general definition given in NRS 433.554;

2. Provide for a more detailed definition of neglectof a client of the Division, consistent with the general definition given in NRS 433.554; and

3. Establish policies and procedures for reporting theabuse or neglect of a client of the Division.

(Added to NRS by 1989, 642)

NRS 433.332 Divisionfacility required to forward patients medical records upon transfer of patientfrom facility.

1. If a patient in a division facility is transferredto another division facility or to a medical facility, a facility for thedependent or a physician licensed to practice medicine, the division facilityshall forward a copy of the medical records of the patient, on or before thedate the patient is transferred, to the facility or physician. Except asotherwise required by 42 U.S.C. 290dd-3 and 290ee-3, the division facilityis not required to obtain the oral or written consent of the patient to forwarda copy of the medical records.

2. As used in this section, medical records includesa medical history of the patient, a summary of the current physical conditionof the patient and a discharge summary which contains the information necessaryfor the proper treatment of the patient.

(Added to NRS by 1991, 2351; A 1993, 145)

NRS 433.334 Contractwith general hospital or other institution for care of clients. The Division may, by contract with general hospitals orother institutions having adequate facilities in the State of Nevada, providefor inpatient care of mentally ill and mentally retarded clients and clientswith related conditions.

(Added to NRS by 1975, 1594; A 1999, 2593)

NRS 433.344 Contractswith persons professionally qualified in field of psychiatric mental health forcare of persons. The Division may contractwith appropriate persons professionally qualified in the field of psychiatricmental health to provide inpatient and outpatient care for mentally ill andmentally retarded persons and persons with related conditions when it appearsthat they can be treated best in that manner.

(Added to NRS by 1975, 1594; A 1983, 506; 1999, 2593)

NRS 433.354 Contractsfor cooperation with governmental agencies and others.For the purposes of chapters 433 to 436, inclusive, of NRS, the Department throughthe Division may cooperate, financially or otherwise, and execute contracts oragreements with the Federal Government, any federal department or agency, anyother state department or agency, a county, a city, a public district or anypolitical subdivision of this state, a public or private corporation, anindividual or a group of individuals. Such contracts or agreements may includeprovisions whereby the Division will render services, the payment for whichwill be reimbursed directly to the Divisions budget. Cooperation pursuant tothis section does not of itself relieve any person, department, agency orpolitical subdivision of any responsibility or liability existing under anyprovision of law.

(Added to NRS by 1975, 1594; A 1993, 2716)

NRS 433.364 Involuntarycourt-ordered admission to private institution not precluded. Nothing in this title precludes the involuntarycourt-ordered admission of a mentally ill person to a private institution wheresuch admission is authorized by law.

(Added to NRS by 1975, 1594)

NRS 433.374 Statenot responsible for payment of costs of care and treatment at other facility;exceptions. The State is not responsible forpayment of the costs of care and treatment of persons admitted to a facilitynot operated by the Division except as otherwise provided in NRS 433B.230 or where, before admission,the Administrator or his designee authorizes the expenditure of state money forsuch purpose.

(Added to NRS by 1975, 1594; A 1993, 2716)

Finance

NRS 433.384 Legislativeappropriations; payment of claims. Money tocarry out the provisions of chapters 433 to 436, inclusive, of NRS must be provided bylegislative appropriation from the State General Fund, and paid out on claimsas other claims against the State are paid. All claims relating to a divisionfacility individually must be approved by the administrative officer of suchfacility before they are paid.

(Added to NRS by 1975, 1594; A 1993, 2716)

NRS 433.394 Acceptanceby Department of money from other sources. Forthe purposes of this title, the Department may accept:

1. Moneys appropriated and made available by any actof the Congress of the United States;

2. Moneys and contributions made available by acounty, a city, a public district or any political subdivision of this state;and

3. Moneys and contributions made available by a publicor private corporation, a private foundation, an individual or a group ofindividuals.

(Added to NRS by 1975, 1595)

NRS 433.395 Acceptanceby Administrator of donations, gifts and grants for disbursement to certainprograms; contract for services for evaluation and recommendation of recipientsfor disbursements.

1. Upon approval of the Director of the Department,the Administrator may accept:

(a) Donations of money and gifts of real or personalproperty; and

(b) Grants of money from the Federal Government,

for use inpublic or private programs that provide services to persons in this state whoare mentally ill or mentally retarded and persons with related conditions.

2. The Administrator shall disburse any donations,gifts and grants received pursuant to this section to programs that provideservices to persons who are mentally ill or mentally retarded and persons withrelated conditions in a manner that supports the plan to coordinate servicescreated by the Commission pursuant to subsection 7 of NRS 433.316. In the absence of a plan tocoordinate services, the Administrator shall make disbursements to programsthat will maximize the benefit provided to persons who are mentally ill ormentally retarded and persons with related conditions in consideration of thenature and value of the donation, gift or grant.

3. Within limits of legislative appropriations orother available money, the Administrator may enter into a contract for servicesrelated to the evaluation and recommendation of recipients for thedisbursements required by this section.

(Added to NRS by 1997, 3231; A 1999, 2593)

NRS 433.404 Scheduleof fees for services rendered through programs supported by State; dispositionof receipts; amount of fee for services of facility.

1. The Division shall establish a fee schedule forservices rendered through any program supported by the state pursuant to theprovisions of chapters 433 to 436, inclusive, of NRS. The schedule must besubmitted to the Commission and the Director of the Department for jointapproval before enforcement. The fees collected by facilities operated by theDivision pursuant to this schedule must be deposited in the State Treasury tothe credit of the State General Fund, except as otherwise provided in NRS 433.354 for fees collected pursuant tocontract or agreement and in NRS 435.120for fees collected for services to mentally retarded clients and clients withrelated conditions.

2. For a facility providing services for the treatmentof the mentally ill or mentally retarded and persons with related conditions,the fee established must approximate the cost of providing the service, but ifa client is unable to pay in full the fee established pursuant to this section,the Division may collect any amount the client is able to pay.

(Added to NRS by 1975, 1594; A 1985, 2265; 1993,2716; 1999, 2593)

NRS 433.414 Feesof physicians and other professionally qualified employees of facility.

1. Physicians and other professional staff employedwithin any division facility shall receive a reasonable fee for evaluations,examinations or court testimony when directed by the court to perform suchservices, singularly or as a member of an evaluation team established pursuantto the provisions of chapter 433A of NRS.

2. If such evaluation or testimony is provided whilethe physician or other professional person is acting as an employee of adivision facility, the fee shall be received by the division facility at whichhe is employed.

(Added to NRS by 1975, 1595)

NRS 433.424 Mentalhealth and mental retardation center revolving accounts. A mental health and mental retardation center revolvingaccount up to the amount of $5,000 is hereby created for each division mentalhealth and mental retardation center, and may be used for the payment of mentalhealth or mental retardation center bills requiring immediate payment and forno other purposes. The respective administrative officers shall deposit themoney for the respective revolving accounts in one or more banks or creditunions of reputable standing. Payments made from each account must be promptlyreimbursed from appropriated money of the respective mental health or mentalretardation centers on claims as other claims against the State are paid.

(Added to NRS by 1975, 1595; A 1979, 812; 1983, 395; 1999, 1496)

CLIENTS

Residence

NRS 433.431 Definitions. As used in NRS 433.431to 433.454, inclusive, unless thecontext otherwise requires:

1. Client means any person who seeks, on his own oranothers initiative, and can benefit from, care, treatment, treatment tocompetency or training in a division facility.

2. Division facility means any unit or subunitoperated by:

(a) The Division of Mental Health and DevelopmentalServices of the Department for the care, treatment and training of clients; or

(b) The Division of Child and Family Services of theDepartment pursuant to NRS 433B.010 to433B.350, inclusive.

(Added to NRS by 1993, 2714; A 1999, 99; 2003, 1942)

NRS 433.434 Determinationof residence. For purposes of this title, theresidence of a person is:

1. The domicile of such person;

2. If the domicile of the person cannot beascertained, the place where he was last employed; or

3. If the domicile of the person cannot be ascertainedand he is not or was not employed, the place where he made his home orheadquarters.

(Added to NRS by 1975, 1595)

NRS 433.444 Reciprocalagreement for returning clients to legal residence; investigation and reportconcerning residence.

1. For the purpose of facilitating the return ofnonresident clients to the state in which they have legal residence, theAdministrator may enter into reciprocal agreements, consistent with theprovisions of this title, with the proper boards, commissioners or officers ofother states for the mutual exchange of clients confined in, admitted orcommitted to a mental health or mental retardation facility in one state whoselegal residence is in the other, and may give written permission for the returnand admission to a division facility of any resident of this state when suchpermission is conformable to the provisions of this title governing admissionsto a division facility.

2. The county clerk and board of county commissionersof each county, upon receiving notice from the Administrator that anapplication for the return of an alleged resident of this state has beenreceived, shall promptly investigate and report to the Administrator theirfindings as to the legal residence of the client.

(Added to NRS by 1975, 1595)

NRS 433.454 Expensesof returning client to legal residence.

1. All expenses incurred for the purpose of returninga client to the state in which he has legal residence shall be paid from themoneys of the client or by the relatives or other persons responsible for hiscare and treatment under his commitment or admission.

2. In the case of indigent clients whose relativescannot pay the costs and expenses of returning such clients to the state inwhich they have residence, the costs may be assumed by the State. These costsshall be advanced from moneys appropriated for the general support of thedivision facility wherein the client was receiving care, treatment or training,if such client was committed to a division facility at the time of thetransfer, and shall be paid out on claims as other claims against the State arepaid.

(Added to NRS by 1975, 1596)

Clients Rights

NRS 433.456 Definitions. As used in NRS 433.456to 433.536, inclusive, unless thecontext otherwise requires, the words and terms defined in NRS 433.458 to 433.462, inclusive, have the meaningsascribed to them in those sections.

(Added to NRS by 1989, 1755; A 1997, 3491)

NRS 433.458 Administrativeofficer defined. Administrative officermeans a person with overall executive and administrative responsibility for afacility that provides services relating to mental health or mental retardationand related conditions and that is operated by any public or private entity.

(Added to NRS by 1989, 1755; A 1999, 2594)

NRS 433.459 Clientdefined. Client means any person who seeks,on his own or others initiative, and can benefit from, care, treatment andtraining in any facility, or from treatment to competency in any facility.

(Added to NRS by 1989, 1755; A 2003, 1943)

NRS 433.461 Facilitydefined. Facility means any:

1. Unit or subunit operated by the Division of MentalHealth and Developmental Services of the Department for the care, treatment andtraining of clients.

2. Unit or subunit operated by the Division of Childand Family Services of the Department pursuant to NRS 433B.010 to 433B.350, inclusive.

3. Hospital, clinic or other institution operated byany public or private entity, for the care, treatment and training of clients.

(Added to NRS by 1989, 1755; A 1993, 2716; 1999, 99)

NRS 433.462 Rightsdefined. Rights includes, withoutlimitation, all rights provided to a client pursuant to NRS 433.456 to 433.536, inclusive, and any regulationsadopted pursuant thereto.

(Added to NRS by 1997, 3490)

NRS 433.464 Rightto habeas corpus unimpaired. This title doesnot limit the right of any person detained hereunder to a writ of habeas corpusupon a proper application made at any time by such person or any other personon his behalf.

(Added to NRS by 1975, 1596)

NRS 433.471 Rightsconcerning admission and discharge of clients. Eachclient admitted for evaluation, treatment or training to a facility has the followingrights concerning admission to the facility, a list of which must beprominently posted in all facilities providing those services and must beotherwise brought to the attention of the client by such additional means asprescribed by regulation:

1. The right not to be admitted to the facility underfalse pretenses or as a result of any improper, unethical or unlawful conductby a staff member of the facility to collect money from the insurance companyof the client or for any other financial purpose.

2. The right to receive a copy, on request, of thecriteria upon which the facility makes its decision to admit or discharge aclient from the facility. Such criteria must not, for emergency admissions orinvoluntary court-ordered admissions, be based on the availability of insurancecoverage or any other financial considerations.

3. As used in this section, improper conduct means aviolation of the rules, policies or procedures of the facility.

(Added to NRS by 1997, 3490; A 1999, 866)

NRS 433.472 Rightsconcerning involuntary commitment.

1. Each client admitted for evaluation, treatment ortraining to a facility has the following rights concerning involuntary commitmentto the facility, a list of which must be prominently posted in all facilitiesproviding those services and must be otherwise brought to the attention of theclient by such additional means as prescribed by regulation:

(a) To request and receive a second evaluation by apsychiatrist or psychologist who does not have a contractual relationship withor financial interest in the facility. The evaluation must:

(1) Include, without limitation, arecommendation of whether the client should be involuntarily committed to thefacility; and

(2) Be paid for by the client if the insurancecarrier of the client refuses to pay for the evaluation.

(b) To receive a copy of the procedure of the facilityregarding involuntary commitment and treatment.

(c) To receive a list of his rights concerninginvoluntary commitment or treatment.

2. If the results of an evaluation conducted by apsychiatrist or psychologist pursuant to subsection 1 conflicts in any mannerwith the results of an evaluation conducted by the facility, the facility mayrequest and receive a third evaluation of the client to resolve the conflictingportions of the previous evaluations.

(Added to NRS by 1997, 3490; A 1999, 1040)

NRS 433.482 Personalrights. Each client admitted for evaluation,treatment or training to a facility has the following personal rights, a listof which must be prominently posted in all facilities providing those servicesand must be otherwise brought to the attention of the client by such additionalmeans as prescribed by regulation:

1. To wear his own clothing, to keep and use his ownpersonal possessions, including his toilet articles, unless those articles maybe used to endanger his or others lives, and to keep and be allowed to spend areasonable sum of his own money for expenses and small purchases.

2. To have access to individual space for storage forhis private use.

3. To see visitors each day.

4. To have reasonable access to telephones, both tomake and receive confidential calls.

5. To have ready access to materials for writingletters, including stamps, and to mail and receive unopened correspondence,but:

(a) For the purposes of this subsection, packages arenot considered as correspondence; and

(b) Correspondence identified as containing a checkpayable to a client may be subject to control and safekeeping by theadministrative officer of that facility or his designee, so long as theclients record of treatment documents the action.

6. To have reasonable access to an interpreter if theclient does not speak English or is hearing impaired.

7. To designate a person who must be kept informed bythe facility of the clients medical and mental condition, if the client signsa release allowing the facility to provide such information to the person.

8. To have access to his medical records denied to anyperson other than:

(a) A member of the staff of the facility or relatedmedical personnel, as appropriate;

(b) A person who obtains a waiver by the client of hisright to keep the medical records confidential; or

(c) A person who obtains a court order authorizing theaccess.

9. Other personal rights as specified by regulation ofthe Commission.

(Added to NRS by 1981, 892; A 1985, 2266; 1989, 1755;1997, 3492)

NRS 433.484 Rightsconcerning care, treatment and training. Eachclient admitted for evaluation, treatment or training to a facility has thefollowing rights concerning care, treatment and training, a list of which mustbe prominently posted in all facilities providing those services and must beotherwise brought to the attention of the client by such additional means asprescribed by regulation:

1. To medical, psychosocial and rehabilitative care,treatment and training including prompt and appropriate medical treatment andcare for physical and mental ailments and for the prevention of any illness ordisability. All of that care, treatment and training must be consistent withstandards of practice of the respective professions in the community and issubject to the following conditions:

(a) Before instituting a plan of care, treatment ortraining or carrying out any necessary surgical procedure, express and informedconsent must be obtained in writing from:

(1) The client if he is 18 years of age or overor legally emancipated and competent to give that consent, and from his legalguardian, if any;

(2) The parent or guardian of a client under 18years of age and not legally emancipated; or

(3) The legal guardian of a client of any agewho has been adjudicated mentally incompetent;

(b) An informed consent requires that the person whoseconsent is sought be adequately informed as to:

(1) The nature and consequences of theprocedure;

(2) The reasonable risks, benefits and purposesof the procedure; and

(3) Alternative procedures available;

(c) The consent of a client as provided in paragraph(b) may be withdrawn by the client in writing at any time with or withoutcause;

(d) Even in the absence of express and informedconsent, a licensed and qualified physician may render emergency medical careor treatment to any client who has been injured in an accident or who issuffering from an acute illness, disease or condition, if within a reasonabledegree of medical certainty, delay in the initiation of emergency medical careor treatment would endanger the health of the client and if the treatment isimmediately entered into the clients record of treatment, subject to theprovisions of paragraph (e); and

(e) If the proposed emergency medical care or treatmentis deemed by the chief medical officer of the facility to be unusual,experimental or generally occurring infrequently in routine medical practice,the chief medical officer shall request consultation from other physicians orpractitioners of healing arts who have knowledge of the proposed care ortreatment.

2. To be free from abuse, neglect and aversiveintervention.

3. To consent to his transfer from one facility toanother, except that the Administrator of the Division of Mental Health andDevelopmental Services of the Department or his designee, or the Administratorof the Division of Child and Family Services of the Department or his designee,may order a transfer to be made whenever conditions concerning care, treatmentor training warrant it. If the client in any manner objects to the transfer,the person ordering it must enter the objection and a written justification ofthe transfer in the clients record of treatment and immediately forward a noticeof the objection to the Administrator who ordered the transfer, and theCommission shall review the transfer pursuant to subsection 3 of NRS 433.534.

4. Other rights concerning care, treatment andtraining as may be specified by regulation of the Commission.

(Added to NRS by 1975, 1596; A 1981, 893; 1985, 2266;1989, 1756; 1993, 2717; 1999,99, 3233)

NRS 433.494 Individualizedplan of services for client.

1. An individualized written plan of mental health ormental retardation services or plan of services for a related condition must bedeveloped for each client of each facility. The plan must:

(a) Provide for the least restrictive treatmentprocedure that may reasonably be expected to benefit the client; and

(b) Be developed with the input and participation of:

(1) The client, to the extent that he is able toprovide input and participate; and

(2) To the extent that the client is unable toprovide input and participate, the parent or guardian of the client if theclient is under 18 years of age and is not legally emancipated, or the legalguardian of a client who has been adjudicated mentally incompetent.

2. The plan must be kept current and must be modified,with the input and participation of the client, the parent or guardian of theclient or the legal guardian of the client, as appropriate, when indicated. Theplan must be thoroughly reviewed at least once every 3 months.

3. The person in charge of implementing the plan ofservices must be designated in the plan.

(Added to NRS by 1975, 1597; A 1989, 1757; 1999, 2594; 2005, 307)

NRS 433.496 Basisfor decisions, policies, procedures and practices regarding emergencyadmissions and involuntary court-ordered admissions.

1. Each facility shall make all of its decisions,policies, procedures and practices regarding emergency admissions orinvoluntary court-ordered admissions based upon clinical efficiency rather thancost containment.

2. This section does not preclude a public facilityfrom making decisions, policies, procedures and practices within the limits ofthe money made available to the facility.

(Added to NRS by 1997, 3491)

NRS 433.504 Rightto information; inspection and copying of records.

1. A client must be:

(a) Permitted to inspect his records; and

(b) Informed of his clinical status and progress atreasonable intervals of no longer than 3 months in a manner appropriate to hisclinical condition.

2. Unless a psychiatrist has made a specific entry tothe contrary in a clients records, a client is entitled to obtain a copy ofhis records at any time upon notice to the administrative officer of thefacility and payment of the cost of reproducing the records.

(Added to NRS by 1975, 1597; A 1987, 2221)

NRS 433.514 Medication:Responsibility of psychiatrist and physician; review of methods foradministration and custody.

1. The attending psychiatrist or physician shall beresponsible for all medication given or administered to a client.

2. Each administrative officer shall establish apolicy for the review of the administration, storage and handling ofmedications by nurses and nonprofessional personnel.

(Added to NRS by 1975, 1597)

NRS 433.524 Laborby client: Conditions; compensation.

1. A client may perform labor which contributes to theoperation and maintenance of the facility for which the facility wouldotherwise employ someone only if:

(a) The client voluntarily agrees to perform the labor;

(b) Engaging in the labor is not inconsistent with anddoes not interfere with the plan of services for the client;

(c) The person responsible for the clients treatmentagrees to the plan of labor; and

(d) The amount of time or effort necessary to performthe labor is not excessive.

In no eventmay discharge or privileges be conditioned upon the performance of such labor.

2. A client who performs labor which contributes tothe operation and maintenance of the facility for which the facility wouldotherwise employ someone must be adequately compensated and the compensationmust be in accordance with applicable state and federal labor laws.

3. A client who performs labor other than thatdescribed in subsection 2 must be compensated an adequate amount if an economicbenefit to another person or agency results from his labor.

4. The administrative officer of the facility mayprovide for compensation of a resident when he performs labor not governed bysubsection 2 or 3.

5. This section does not apply to labor of a personalhousekeeping nature or to labor performed as a condition of residence in asmall group living arrangement.

6. One-half of any compensation paid to a clientpursuant to this section is exempt from collection or retention as payment forservices rendered by the Division of Mental Health and Developmental Servicesof the Department or its facilities, or by the Division of Child and FamilyServices of the Department or its facilities. Such an amount is also exemptfrom levy, execution, attachment, garnishment or any other remedies provided bylaw for the collection of debts.

(Added to NRS by 1975, 1598; A 1993, 2718; 1999, 100)

NRS 433.531 Rightsconcerning suspension or violation of rights. Eachclient admitted for evaluation, treatment or training to a facility has thefollowing rights concerning the suspension or violation of his rights, a listof which must be prominently posted in all facilities providing those servicesand must be otherwise brought to the attention of the client by such additionalmeans as prescribed by regulation:

1. To receive a list of his rights.

2. To receive a copy of the policy of the facilitythat sets forth the clinical or medical circumstances under which his rightsmay be suspended or violated.

3. To receive a list of the clinically appropriateoptions available to the client or his family to remedy an actual or asuspected suspension or violation of his rights.

4. To have all policies of the facility regarding therights of clients prominently posted in the facility.

(Added to NRS by 1997, 3491)

NRS 433.533 Documentreflecting receipt of list of rights and explanation of rights. Each facility shall, within a reasonable time after aclient is admitted to the facility for evaluation, treatment or training, askthe client to sign a document that reflects that he has received a list of hisrights and has had those rights explained to him.

(Added to NRS by 1997, 3491)

NRS 433.534 Denialof rights prohibited; exceptions; report; investigation and action byCommission; closure of meeting in certain circumstances.

1. The rights of a client enumerated in this chaptermust not be denied except to protect the clients health and safety or toprotect the health and safety of others, or both. Any denial of those rights inany facility must be entered in the clients record of treatment, and notice ofthe denial must be forwarded to the administrative officer of the facility.Failure to report denial of rights by an employee may be grounds for dismissal.

2. If the administrative officer of a facilityreceives notice of a denial of rights as provided in subsection 1, he shallcause a full report to be prepared which must set forth in detail the factualcircumstances surrounding the denial. Such a report is confidential and mustnot be disclosed. A copy of the report must be sent to the Commission.

3. The Commission:

(a) Shall receive reports of and may investigateapparent violations of the rights guaranteed by this chapter;

(b) May act to resolve disputes relating to apparentviolations;

(c) May act on behalf of clients to obtain remedies forany apparent violations; and

(d) Shall otherwise endeavor to safeguard the rightsguaranteed by this chapter.

4. Pursuant to NRS241.030, the Commission may close any portion of a meeting in which itconsiders the character, alleged misconduct or professional competence of aperson in relation to:

(a) The denial of the rights of a client; or

(b) The care and treatment of a client.

Theprovisions of this subsection do not require a meeting of the Commission to beclosed to the public.

(Added to NRS by 1975, 1598; A 1979, 812; 1985, 2268;1989, 1757; 1993, 2112, 2719; 1995, 676, 1735)

NRS 433.536 Retaliationby officer, director or employee of facility prohibited. An officer, director or employee of a facility shall notretaliate against any person for having:

1. Reported any violation of law; or

2. Provided information regarding a violation of law,

by thefacility or a staff member of the facility.

(Added to NRS by 1997, 3491)

Safekeeping of Clients Money and Other Personal Property

NRS 433.538 Definitions. As used in NRS 433.538to 433.543, inclusive, unless thecontext otherwise requires:

1. Administrative officer means a person withoverall executive and administrative responsibility for a division facility.

2. Client means any person who seeks, on his own oranothers initiative, and can benefit from, care, treatment, treatment tocompetency or training in a division facility.

3. Division facility means any unit or subunitoperated by:

(a) The Division of Mental Health and DevelopmentalServices of the Department for the care, treatment and training of clients; or

(b) The Division of Child and Family Services of theDepartment pursuant to NRS 433B.010 to433B.350, inclusive.

(Added to NRS by 1993, 2714; A 1999, 101; 2003, 1943)

NRS 433.539 Personaldeposit funds for clients.

1. There may be maintained as a trust fund at eachdivision facility a clients personal deposit fund.

2. Money coming into the possession of theadministrative officer of a division facility which belongs to a client must becredited in the fund in the name of that client.

3. When practicable, individual credits in the fundmust not exceed the sum of $300.

4. Any amounts to the credit of a client may be usedfor purchasing personal necessities, for expenses of burial or may be turnedover to the client upon his demand, except that when the client is adjudicatedmentally incompetent the guardian of his estate has the right to demand andreceive the money.

5. An amount accepted for the benefit of a client fora special purpose must be reserved for that purpose regardless of the totalamount to the credit of the client.

6. Except as otherwise provided in subsection 7, theadministrative officers shall deposit any money received for the funds of theirrespective facilities in commercial accounts with one or more banks or creditunions of reputable standing. When deposits in a commercial account exceed$15,000, the administrative officer may deposit the excess in a savings accountpaying interest in any reputable commercial bank, or in any credit union orsavings and loan association within this state that is federally insured orinsured by a private insurer approved pursuant to NRS 678.755. The savings account must be inthe name of the fund. Interest paid on deposits in the savings account may beused for recreational purposes at the division facility.

7. The administrative officers may maintain at theirrespective division facilities petty cash of not more than $400 of the money inthe clients personal deposit fund to enable clients to withdraw small sumsfrom their accounts.

(Added to NRS by 1979, 252; A 1979, 1894; 1983, 395; 1999, 1497)

NRS 433.541 Dispositionof personal property of client upon death.

Whenever any person admitted to a division facility dies, theadministrative officer shall send written notice to the decedents legallyappointed representative, listing the personal property remaining in thecustody or possession of the facility. If there is no demand made upon theadministrative officer of the facility by the decedents legally appointedrepresentative, all personal property of the decedent remaining in the custodyor possession of the administrative officer must be held by him for a period of1 year from the date of the decedents death for the benefit of the heirs,legatees or successors of the decedent. At the end of this period, anothernotice must be sent to the decedents representative, listing the property andspecifying the manner in which the property will be disposed of if not claimedwithin 15 business days. After 15 business days, all personal property anddocuments of the decedent, other than cash, remaining unclaimed in thepossession of the administrative officer must be disposed of as follows:

1. All documents must be filed by the administrativeofficer with the public administrator of the county from which the client wasadmitted.

2. All other personal property must be sold at apublic auction or by sealed bids. The proceeds of the sale must be applied tothe decedents unpaid balance for costs incurred at the division facility.

(Added to NRS by 1979, 253)

NRS 433.542 Dispositionof unclaimed personal property of client worth more than $100. If a person admitted to a division facility is dischargedor leaves and he fails to recover personal property worth more than $100 in thecustody of the administrative officer of the facility, the administrativeofficer shall notify the former client or his legal representative in writingthat personal property remains in the custody of the facility. The propertymust be held in safekeeping for the client for a period of 1 year from the dateof discharge. If upon the expiration of the 1-year period no claim has beenmade upon the administrative officer by the person or his legal representative,another notice must be sent to the person or his legal representative, statingthe fact that personal property remains in the custody of the facility, andspecifying the manner in which the property will be disposed of if not claimedwithin 15 business days. After 15 business days, the property may be consideredunclaimed property and be disposed of in the manner provided for unclaimedproperty of deceased persons under the provisions of NRS 433.541.

(Added to NRS by 1979, 253)

NRS 433.543 Dispositionof unclaimed personal property of minimal value. If,upon the death or release of a person admitted to a division facility, thevalue of unclaimed personal property in the possession of the administrativeofficer of the facility is so minimal that it cannot be sold at public auctionor by sealed bid and if the property, either in its present condition or in animproved condition, cannot be used by the division facility, the administrativeofficer may order the personal property destroyed.

(Added to NRS by 1979, 253)

Deaths and Burials

NRS 433.544 Notificationof death of client; burial.

1. Upon the death of a client, any known relatives orfriends of the client shall be notified immediately of the fact of death.

2. The Administrator or his designee shall cause adecent burial to be provided for the client outside division facility grounds.The Administrator or his designee may enter into a contract with any person orpersons, including governmental agencies or other instrumentalities, as hedeems proper, for a decent burial. Where there are known relatives, and theyare financially able, the cost of burial shall be borne by the relatives. Wherethere are no known relatives, the cost of burial shall be a charge against theState of Nevada, but the cost thereof shall not exceed the amount charged forthe burial of indigents in the county in which the burial takes place.

3. When a client has income from a pension payablethrough a division facility, and has no guardian, the Division may obligateoperating funds for funeral expenses in the amount due under the pensionbenefits.

(Added to NRS by 1975, 1599)

USE OF RESTRAINTS AND INTERVENTIONS

NRS 433.545 Definitions. As used in NRS 433.545to 433.551, inclusive, unless thecontext otherwise requires, the words and terms defined in NRS 433.5453 to 433.548, inclusive, have the meaningsascribed to them in those sections.

(Added to NRS by 1999, 3229; A 2001, 2744)

NRS 433.5453 Aversiveintervention defined. Aversive interventionmeans any of the following actions if the action is used to punish a personwith a disability or to eliminate, reduce or discourage maladaptive behavior ofa person with a disability:

1. The use of noxious odors and tastes;

2. The use of water and other mists or sprays;

3. The use of blasts of air;

4. The use of corporal punishment;

5. The use of verbal and mental abuse;

6. The use of electric shock;

7. Requiring a person to perform exercise under forcedconditions if the:

(a) Person is required to perform the exercise becausehe exhibited a behavior that is related to his disability;

(b) Exercise is harmful to the health of the personbecause of his disability; or

(c) Nature of the persons disability prevents him fromengaging in the exercise;

8. Any intervention, technique or procedure thatdeprives a person of the use of one or more of his senses, regardless of thelength of the deprivation, including, without limitation, the use of sensoryscreens; or

9. The deprivation of necessities needed to sustainthe health of a person, regardless of the length of the deprivation, including,without limitation, the denial or unreasonable delay in the provision of:

(a) Food or liquid at a time when it is customarilyserved; or

(b) Medication.

(Added to NRS by 1999, 3229)

NRS 433.5456 Chemicalrestraint defined. Chemical restraint meansthe administration of drugs for the specific and exclusive purpose ofcontrolling an acute or episodic aggressive behavior when alternativeintervention techniques have failed to limit or control the behavior. The termdoes not include the administration of drugs on a regular basis, as prescribedby a physician, to treat the symptoms of mental, physical, emotional orbehavioral disorders and for assisting a person in gaining self-control overhis impulses.

(Added to NRS by 1999, 3230)

NRS 433.546 Corporalpunishment defined. Corporal punishmentmeans the intentional infliction of physical pain, including, withoutlimitation, hitting, pinching or striking.

(Added to NRS by 1999, 3230)

NRS 433.5463 Electricshock defined. Electric shock means theapplication of electric current to a persons skin or body. The term does notinclude electroconvulsive therapy.

(Added to NRS by 1999, 3230)

NRS 433.5466 Emergencydefined. Emergency means a situation inwhich immediate intervention is necessary to protect the physical safety of aperson or others from an immediate threat of physical injury or to protectagainst an immediate threat of severe property damage.

(Added to NRS by 1999, 3230)

NRS 433.547 Mechanicalrestraint defined. Mechanical restraintmeans the use of devices, including, without limitation, mittens, straps,restraint chairs, handcuffs, belly chains and four-point restraints to limit apersons movement or hold a person immobile.

(Added to NRS by 1999, 3230; A 2001, 2744)

NRS 433.5473 Personwith a disability defined. Person with adisability means a person who:

1. Has a physical or mental impairment thatsubstantially limits one or more of the major life activities of the person;

2. Has a record of such an impairment; or

3. Is regarded as having such an impairment.

(Added to NRS by 1999, 3230)

NRS 433.5476 Physicalrestraint defined. Physical restraint meansthe use of physical contact to limit a persons movement or hold a personimmobile.

(Added to NRS by 1999, 3230)

NRS 433.548 Verbaland mental abuse defined. Verbal and mentalabuse means verbal intimidation or coercion of a person without a redeeming purpose.

(Added to NRS by 1999, 3230)

NRS 433.5483 Useof aversive intervention on client prohibited. Aperson employed by a facility or any other person shall not use any aversiveintervention on a person with a disability who is a client.

(Added to NRS by 1999, 3230)

NRS 433.5486 Useof physical, mechanical or chemical restraint on client by facility authorizedin certain circumstances. Notwithstanding theprovisions of NRS 433.549 to 433.5503, inclusive, to the contrary, afacility may use or authorize the use of physical restraint, mechanicalrestraint or chemical restraint on a person with a disability who is a clientif the facility is:

1. Accredited by a nationally recognized accreditationassociation or agency; or

2. Certified for participation in the Medicaid orMedicare Program,

only to theextent that the accreditation or certification allows the use of such restraint.

(Added to NRS by 1999, 3230)

NRS 433.549 Useof physical, mechanical or chemical restraint on client by person employed byfacility prohibited; exceptions. A personemployed by a facility or any other person shall not:

1. Except as otherwise provided in NRS 433.5493, use physical restraint on aperson with a disability who is a client.

2. Except as otherwise provided in NRS 433.5496 and 433.5499, use mechanical restraint on aperson with a disability who is a client.

3. Except as otherwise provided in NRS 433.5503, use chemical restraint on aperson with a disability who is a client.

(Added to NRS by 1999, 3231; A 2001, 2744)

NRS 433.5493 Useof physical restraint on client; requirements; exceptions; report as denial ofrights.

1. Except as otherwise provided in subsection 2,physical restraint may be used on a person with a disability who is a clientonly if:

(a) An emergency exists that necessitates the use ofphysical restraint;

(b) The physical restraint is used only for the periodthat is necessary to contain the behavior of the client so that the client isno longer an immediate threat of causing physical injury to himself or othersor causing severe property damage; and

(c) The use of force in the application of physicalrestraint does not exceed the force that is reasonable and necessary under thecircumstances precipitating the use of physical restraint.

2. Physical restraint may be used on a person with adisability who is a client and the provisions of subsection 1 do not apply ifthe physical restraint is used to:

(a) Assist the client in completing a task or responseif the client does not resist the application of physical restraint or if hisresistance is minimal in intensity and duration;

(b) Escort or carry a client to safety if the client isin danger in his present location; or

(c) Conduct medical examinations or treatments on theclient that are necessary.

3. If physical restraint is used on a person with adisability who is a client in an emergency, the use of the procedure must bereported as a denial of rights pursuant to NRS433.534, regardless of whether the use of the procedure is authorized bystatute. The report must be made not later than 1 working day after theprocedure is used.

(Added to NRS by 1999, 3231)

NRS 433.5496 Useof mechanical restraint on client other than client of forensic facility;requirements; exceptions; report as denial of rights.

1. Except as otherwise provided in subsections 2 and4, mechanical restraint may be used on a person with a disability who is aclient only if:

(a) An emergency exists that necessitates the use ofmechanical restraint;

(b) A medical order authorizing the use of mechanicalrestraint is obtained from the clients treating physician before theapplication of the mechanical restraint or not later than 15 minutes after theapplication of the mechanical restraint;

(c) The physician who signed the order requiredpursuant to paragraph (b) or the attending physician examines the client notlater than 1 working day immediately after the application of the mechanicalrestraint;

(d) The mechanical restraint is applied by a member ofthe staff of the facility who is trained and qualified to apply mechanicalrestraint;

(e) The client is given the opportunity to move andexercise the parts of his body that are restrained at least 10 minutes perevery 60 minutes of restraint;

(f) A member of the staff of the facility lessens ordiscontinues the restraint every 15 minutes to determine whether the clientwill stop or control his inappropriate behavior without the use of therestraint;

(g) The record of the client contains a notation thatincludes the time of day that the restraint was lessened or discontinuedpursuant to paragraph (f), the response of the client and the response of themember of the staff of the facility who applied the mechanical restraint;

(h) A member of the staff of the facility continuouslymonitors the client during the time that mechanical restraint is used on theclient; and

(i) The mechanical restraint is used only for theperiod that is necessary to contain the behavior of the client so that theclient is no longer an immediate threat of causing physical injury to himselfor others or causing severe property damage.

2. Mechanical restraint may be used on a person with adisability who is a client and the provisions of subsection 1 do not apply ifthe mechanical restraint is used to:

(a) Treat the medical needs of a client;

(b) Protect a client who is known to be at risk ofinjury to himself because he lacks coordination or suffers from frequent lossof consciousness;

(c) Provide proper body alignment to a client; or

(d) Position a client who has physical disabilities ina manner prescribed in the clients plan of services.

3. If mechanical restraint is used on a person with adisability who is a client in an emergency, the use of the procedure must bereported as a denial of rights pursuant to NRS433.534, regardless of whether the use of the procedure is authorized bystatute. The report must be made not later than 1 working day after theprocedure is used.

4. The provisions of this section do not apply to aforensic facility, as that term is defined in subsection 5 of NRS 433.5499.

(Added to NRS by 1999, 3231; A 2001, 2744)

NRS 433.5499 Useof mechanical restraint on client of forensic facility; requirements;exceptions; report as denial of rights.

1. Except as otherwise provided in subsection 3,mechanical restraint may be used on a person with a disability who is a clientof a forensic facility only if:

(a) An emergency exists that necessitates the use ofthe mechanical restraint;

(b) The clients behavior presents an imminent threatof causing physical injury to himself or to others or causing severe propertydamage and less restrictive measures have failed to modify the clientsbehavior;

(c) The client is in the care of the facility but noton the premises of the facility and mechanical restraint is necessary to ensuresecurity; or

(d) The client is in the process of being transportedto another location and mechanical restraint is necessary to ensure security.

2. If mechanical restraint is used pursuant tosubsection 1, the forensic facility shall ensure that:

(a) The mechanical restraint is applied by a member ofthe staff of the facility who is trained and qualified to apply mechanicalrestraint;

(b) A member of the staff of the facility continuouslymonitors the client during the time that mechanical restraint is used on theclient;

(c) The record of the client contains a notation thatindicates the time period during which the restraint was used and thecircumstances warranting the restraint; and

(d) The mechanical restraint is used only for theperiod that is necessary.

3. Mechanical restraint may be used on a person with adisability who is a client of a forensic facility, and the provisions ofsubsections 1 and 2 do not apply if the mechanical restraint is used to:

(a) Treat the medical needs of a client;

(b) Protect a client who is known to be at risk ofinjury to himself because he lacks coordination or suffers from frequent lossof consciousness;

(c) Provide proper body alignment to a client; or

(d) Position a client who has physical disabilities ina manner prescribed in the clients plan of services.

4. If mechanical restraint is used in an emergency ona person with a disability who is a client of a forensic facility, the use ofthe procedure must be reported as a denial of rights pursuant to NRS 433.534, regardless of whether the useof the procedure is authorized by statute. The report must be made not laterthan 1 working day after the procedure is used.

5. As used in this section, forensic facility meansa secure facility of the Division for mentally disordered offenders anddefendants who are ordered to the facility pursuant to chapter 178 of NRS.

(Added to NRS by 2001, 2743)

NRS 433.5503 Useof chemical restraint on client; requirements; report as denial of rights.

1. Chemical restraint may only be used on a personwith a disability who is a client if:

(a) The client has been diagnosed as mentally ill, asdefined in NRS 433A.115, and isreceiving mental health services from a facility;

(b) The chemical restraint is administered to theclient while he is under the care of the facility;

(c) An emergency exists that necessitates the use ofchemical restraint;

(d) A medical order authorizing the use of chemicalrestraint is obtained from the clients attending physician or psychiatrist;

(e) The physician or psychiatrist who signed the orderrequired pursuant to paragraph (d) examines the client not later than 1 workingday immediately after the administration of the chemical restraint; and

(f) The chemical restraint is administered by a personlicensed to administer medication.

2. If chemical restraint is used on a person with adisability who is a client, the use of the procedure must be reported as adenial of rights pursuant to NRS 433.534,regardless of whether the use of the procedure is authorized by statute. Thereport must be made not later than 1 working day after the procedure is used.

(Added to NRS by 1999, 3232)

NRS 433.5506 Facilityrequired to develop program of education in positive behavioral interventionsand supports; facility required to train certain members of staff to use physical,mechanical and chemical restraint.

1. Each facility shall develop a program of educationfor the members of the staff of the facility to provide instruction in positivebehavioral interventions and positive behavioral supports that:

(a) Includes positive methods to modify the environmentof clients to promote adaptive behavior and reduce the occurrence ofinappropriate behavior;

(b) Includes methods to teach skills to clients so thatclients can replace inappropriate behavior with adaptive behavior;

(c) Includes methods to enhance a clients independenceand quality of life;

(d) Includes the use of the least intrusive methods torespond to and reinforce the behavior of clients; and

(e) Offers a process for designing interventions basedupon the client that are focused on promoting appropriate changes in behavioras well as enhancing the overall quality of life for the client.

2. Each facility shall provide appropriate trainingfor the members of the staff of the facility who are authorized to carry outand monitor physical restraint, mechanical restraint and chemical restraint toensure that those members of the staff are competent and qualified to carry outthe procedures in accordance with NRS433.545 to 433.551, inclusive.

(Added to NRS by 1999, 3233)

NRS 433.551 Facilityrequired to report violations to Division and to develop corrective plan;Division required to forward corrective plan to Director of Department; powerof Department to withhold funding.

1. A facility where a violation of the provisions of NRS 433.545 to 433.551, inclusive, occurs shall:

(a) Not later than 24 hours after a violation occurs,or as soon thereafter as the violation is discovered, report the violation tothe Division; and

(b) Develop, in cooperation with the Division, acorrective plan to ensure that within 30 calendar days after the violationoccurred, appropriate action is taken by the facility to prevent future violations.

2. The Division shall forward the plan to the Directorof the Department. The Director or his designee shall review the plan to ensurethat it complies with applicable federal law and the statutes and regulationsof this state. The Director or his designee may require appropriate revision ofthe plan to ensure compliance.

3. If the facility where the violation occurred doesnot meet the requirements of the plan to the satisfaction of the Director orhis designee, the Department may withhold funding for the facility until thefacility meets the requirements of the plan.

(Added to NRS by 1999, 3233)

UNLAWFUL ACTS

NRS 433.554 Abuseof client; failure to report abuse; possession or use of intoxicating beverageor controlled substance; transaction with client; aiding escape of client;penalties.

1. An employee of a public or private mental healthfacility or any other person, except a client, who:

(a) Has reason to believe that a client of the Divisionor of a private facility offering mental health services has been or is beingabused or neglected and fails to report it;

(b) Brings intoxicating beverages or a controlledsubstance into any division facility occupied by clients unless specificallyauthorized to do so by the administrative officer or a staff physician of thefacility;

(c) Is under the influence of liquor or a controlledsubstance while employed in contact with clients, unless in accordance with alawfully issued prescription;

(d) Enters into any transaction with a client involvingthe transfer of money or property for personal use or gain at the expense ofthe client; or

(e) Contrives the escape, elopement or absence of aclient,

is guilty ofa misdemeanor, in addition to any other penalties provided by law.

2. In addition to any other penalties provided by law,an employee of a public or private mental health facility or any other person,except a client, who willfully abuses or neglects a client:

(a) For a first violation that does not result insubstantial bodily harm to the client, is guilty of a gross misdemeanor.

(b) For a first violation that results in substantialbodily harm to the client, is guilty of a category B felony.

(c) For a second or subsequent violation, is guilty ofa category B felony.

A personconvicted of a category B felony pursuant to this section shall be punished byimprisonment in the state prison for a minimum term of not less than 1 year anda maximum term of not more than 6 years, or by a fine of not more than $5,000,or by both fine and imprisonment.

3. A person who is convicted pursuant to this sectionis ineligible for 5 years for appointment to or employment in a position in thestate service and, if he is an officer or employee of the State, he forfeitshis office or position.

4. A conviction pursuant to this section is, whenapplicable, grounds for disciplinary action against the person so convicted andthe facility where the violation occurred. The Division may recommend to theappropriate agency or board the suspension or revocation of the professionallicense, registration, certificate or permit of a person convicted pursuant tothis section.

5. For the purposes of this section:

(a) Abuse means any willful and unjustifiedinfliction of pain, injury or mental anguish upon a client, including, but notlimited to:

(1) The rape, sexual assault or sexualexploitation of the client;

(2) The use of any type of aversiveintervention;

(3) Except as otherwise provided in NRS 433.5486, a violation of NRS 433.549; and

(4) The use of physical, chemical or mechanicalrestraints or the use of seclusion in violation of federal law.

Any actwhich meets the standard of practice for care and treatment does not constituteabuse.

(b) Client includes any person who seeks, on his ownor others initiative, and can benefit from, care, treatment and training in apublic or private institution or facility offering mental health services, orfrom treatment to competency in a public or private institution or facilityoffering mental health services. The term includes a client of the Division ofChild and Family Services of the Department.

(c) Neglect means any omission to act which causesinjury to a client or which places the client at risk of injury, including, butnot limited to, the failure to follow:

(1) An appropriate plan of treatment to whichthe client has consented; and

(2) The policies of the facility for the careand treatment of clients.

Any omissionto act which meets the standard of practice for care and treatment does notconstitute neglect.

(d) Standard of practice means the skill and careordinarily exercised by prudent professional personnel engaged in health care.

(Added to NRS by 1975, 1599; A 1983, 933; 1987, 1196,1551; 1989, 642; 1993, 2112, 2231, 2719; 1995, 676, 1276, 1715; 1997, 542; 1999, 3235; 2003, 1942)

NRS 433.564 Unlawfulsale or transfer of intoxicating beverage to client; penalty.

1. Any person who, on the grounds of a divisionfacility, sells, barters, exchanges or in any manner disposes of any spirituousor malt liquor or beverage to any person lawfully confined in the divisionfacility is guilty of a gross misdemeanor.

2. This section does not apply to any physicianprescribing or furnishing liquor to the person when the liquor is prescribed orfurnished for medicinal purposes only.

(Added to NRS by 1975, 1599)

MISCELLANEOUS PROVISIONS

NRS 433.801 Returnof prescription drug to dispensing pharmacy for reissuance of drug; reissuanceof drug by dispensing pharmacy; regulations.

1. A public or private mental health facility mayreturn a prescription drug that is dispensed to a patient of the facility, butwill not be used by that patient, to the dispensing pharmacy for the purpose ofreissuing the drug to fill other prescriptions for patients in that facilityif:

(a) The drug is not a schedule II drug specified in orpursuant to chapter 453 of NRS;

(b) The drug is dispensed in a unit dose, inindividually sealed doses or in a bottle that is sealed by the manufacturer ofthe drug;

(c) The drug is returned unopened and sealed in theoriginal manufacturers packaging or bottle;

(d) The usefulness of the drug has not expired;

(e) The packaging or bottle contains the expirationdate of the usefulness of the drug; and

(f) The name of the patient for whom the drug wasoriginally prescribed, the prescription number and any other identifying marksare obliterated from the packaging or bottle before the return of the drug.

2. A dispensing pharmacy to which a drug is returnedpursuant to this section may reissue the drug to fill other prescriptions forpatients in the same facility if the registered pharmacist of the pharmacydetermines that the drug is suitable for that purpose in accordance withstandards adopted by the State Board of Pharmacy pursuant to subsection 5.

3. No drug that is returned to a dispensing pharmacy pursuantto this section may be used to fill other prescriptions more than one time.

4. A mental health facility shall adopt writtenprocedures for returning drugs to a dispensing pharmacy pursuant to thissection. The procedures must:

(a) Provide appropriate safeguards for ensuring thatthe drugs are not compromised or illegally diverted during their return.

(b) Require the maintenance and retention of suchrecords relating to the return of such drugs as are required by the State Boardof Pharmacy.

(c) Be approved by the State Board of Pharmacy.

5. The State Board of Pharmacy shall adopt suchregulations as are necessary to carry out the provisions of this section,including, without limitation, requirements for:

(a) Returning and reissuing such drugs pursuant to theprovisions of this section.

(b) Maintaining records relating to the return and theuse of such drugs to fill other prescriptions.

(Added to NRS by 2003, 1371)

 

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