NRS 433.003 Declaration of legislative intent.

The legislature hereby declares that it is the intent of this Title:

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

2. To charge the mental hygiene and mental retardation division, and the division of child and family services, of the department with recognizing their duty to act in the best interests of their respective clients by placing them in the least restrictive environment.

NRS 433.005 Definitions.

As used in this Title, unless the context otherwise requires, or except as otherwise defined by specific statute, the words and terms defined in NRS 433.014 to 433.224, inclusive, have the meanings ascribed to them in those sections.

NRS 433.014 "Administrative officer" defined.

"Administrative officer" means a person with overall executive and administrative responsibility for those state or nonstate mental health or mental retardation facilities designated by the administrator.

"Administrator" means the administrator of the mental hygiene and mental retardation division.

NRS 433.044 "Client" defined.

"Client" means any person who seeks, on his own or another’s initiative, and can benefit from care, treatment and training provided by the division.

"Commission" means the commission on mental health and mental retardation.

"Department" means the department of human resources.

NRS 433.074 "Director of the department" defined.

"Director of the department" means the administrative head of the department of human resources.

NRS 433.084 "Division" defined.

"Division" means the mental hygiene and mental retardation division of the department.

"Division facility" means any unit or subunit operated by the division for the care, treatment and training of clients.

"Institute" means the Nevada mental health institute.

"Medical director" means the chief medical officer of any division mental health or mental retardation program.

"Mental health center" means any of the state comprehensive mental health centers, including rural clinics.

"Mental illness" means any mental disfunction leading to impaired ability to maintain oneself and function effectively in one’s life situation without external support.

"Mental retardation" means significantly subaverage general intellectual functioning existing concurrently with deficits in adaptive behavior and manifested during the developmental period.

NRS 433.184 "Mental retardation center" defined.

"Mental retardation center" means an organized program for providing appropriate services and treatment to mentally retarded persons. A mental retardation center may include facilities for residential treatment and training.

"Person professionally qualified in the field of psychiatric mental health" means:

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

2. A psychologist licensed to practice in this state;

3. A social worker who holds a master’s degree in social work, is licensed by the state as a clinical social worker and is employed by the division;

4. A registered nurse who:

(a) Is licensed to practice professional nursing in this state;
(b) Holds a master’s degree in the field of psychiatric nursing; and
(c) Is employed by the division.

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

NRS 433.214 "Training" defined.

"Training" means a program of services directed primarily toward enhancing the health, welfare and development of mentally retarded persons through the process of providing those experiences that will enable the individual to:

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

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

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

"Treatment" means any combination of procedures or activities, of whatever level of intensity and whatever duration, ranging from occasional counseling sessions to full-time admission to a residential facility.

NRS 433.456 Definitions.

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

NRS 433.458 "Administrative officer" defined.

"Administrative officer" means a person with overall executive and administrative responsibility for a facility that provides services relating to mental health or mental retardation and that is operated by any public or private entity.

NRS 433.459 "Client" defined.

"Client" means any person who seeks, on his own or others’ initiative, and can benefit from care, treatment and training in any facility.

NRS 433.461 "Facility" defined.

"Facility" means any:

1. Unit or subunit operated by the mental hygiene and mental retardation division of the department for the care, treatment and training of clients.

2. Unit or subunit operated by the division of child and family services of the department pursuant to NRS 433B.010 to 433B.350, inclusive.

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

NRS 433.462 "Rights" defined.

"Rights" includes, without limitation, all rights provided to a client pursuant to NRS 433.456 to 433.536, inclusive, and any regulations adopted pursuant thereto.

NRS 433.464 Right to habeas corpus unimpaired.

This Title does not limit the right of any person detained hereunder to a writ of habeas corpus upon a proper application made at any time by such person or any other person on his behalf.

NRS 433.471 Rights concerning admission and discharge of clients.

Each client admitted for evaluation, treatment or training to a facility has the following rights concerning admission to the facility, a list of which must be prominently posted in all facilities providing those services and must be otherwise brought to the attention of the client by such additional means as prescribed by regulation:

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

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

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

(a) To request and receive a second evaluation by a psychiatrist or psychologist who does not have a contractual or business relationship with the facility. The evaluation must:

(1) Include, without limitation, a recommendation of whether the client should be involuntarily committed to the facility; and
(2) Be paid for by the client if the insurance carrier of the client refuses to pay for the evaluation.

(b) To receive a copy of the procedure of the facility regarding involuntary commitment and treatment.
(c) To receive a list of his rights concerning involuntary commitment or treatment.

2. If the results of an evaluation conducted by a psychiatrist or psychologist pursuant to subsection 1 conflicts in any manner with the results of an evaluation conducted by the facility, the facility may request and receive a third evaluation of the client to resolve the conflicting portions of the previous evaluations.

NRS 433.482 Personal rights.

Each client admitted for evaluation, treatment or training to a facility has the following personal rights, a list of which must be prominently posted in all facilities providing those services and must be otherwise brought to the attention of the client by such additional means as prescribed by regulation:

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

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

3. To see visitors each day.

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

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

(a) For the purposes of this subsection, packages are not considered as correspondence; and
(b) Correspondence identified as containing a check payable to a client may be subject to control and safekeeping by the administrative officer of that facility or his designee, so long as the client’s record of treatment documents the action.

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

7. To designate a person who must be kept informed by the facility of the client’s medical and mental condition, if the client signs a release allowing the facility to provide such information to the person.

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

(a) A member of the staff of the facility or related medical personnel, as appropriate;
(b) A person who obtains a waiver by the client of his right to keep the medical records confidential; or
(c) A person who obtains a court order authorizing the access.

9. Other personal rights as specified by regulation of the commission.

NRS 433.484 Rights concerning care, treatment and training.

Each client admitted for evaluation, treatment or training to a facility has the following rights, concerning care, treatment and training, a list of which must be prominently posted in all facilities providing those services and must be otherwise brought to the attention of the client by such additional means as prescribed by regulation:

1. To medical, psychosocial and rehabilitative care, treatment and training including prompt and appropriate medical treatment and care for physical and mental ailments and for the prevention of any illness or disability. All of that care, treatment and training must be consistent with standards of practice of the respective professions in the community and is subject to the following conditions:

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

(1) The client if he is 18 years of age or over or legally emancipated and competent to give that consent, and from his legal guardian, if any;
(2) The parent or guardian of a client under 18 years of age and not legally emancipated; or
(3) The legal guardian of a client of any age who has been adjudicated mentally incompetent;

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

(1) The nature and consequences of the procedure;
(2) The reasonable risks, benefits and purposes of 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 without cause;

(d) Even in the absence of express and informed consent, a licensed and qualified physician may render emergency medical care or treatment to any client who has been injured in an accident or who is suffering from an acute illness, disease or condition, if within a reasonable degree of medical certainty, delay in initiation of emergency medical care or treatment would endanger the health of the client and if the treatment is immediately entered into the client’s record of treatment, subject to the provisions of paragraph (e); and

(e) If the proposed emergency medical care or treatment is 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 or practitioners of healing arts who have knowledge of the proposed care or treatment.

2. To be free from the application of any mechanical restraint, except if prescribed by a physician. If so prescribed, the restraint must be removed whenever the condition justifying its use no longer exists, and any use of a mechanical restraint, together with the reasons therefor, must be made a part of the client’s record of treatment.

3. To consent to his transfer from one facility to another, except that the administrator of the mental hygiene and mental retardation division of the department or his designee, or the administrator of the division of child and family services of the department or his designee, may order a transfer to be made whenever conditions concerning care, treatment or 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 of the transfer in the client’s record of treatment and immediately forward a notice of the objection to the administrator who ordered the transfer, and the commission shall review the transfer pursuant to subsection 3 of NRS 433.534.

4. Other rights concerning care, treatment and training as may be specified by regulation of the commission.

1. An individualized written plan of mental health or mental retardation services must be developed for each client of each facility. The plan must provide for the least restrictive treatment procedure that may reasonably be expected to benefit the client.

2. The plan must be kept current and must be modified when indicated. The plan must be thoroughly reviewed at least once every 3 months.

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

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

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

1. A client must be:

(a) Permitted to inspect his records; and
(b) Informed of his clinical status and progress at reasonable intervals of no longer than 3 months in a manner appropriate to his clinical condition.

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

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

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

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

(a) The client voluntarily agrees to perform the labor;
(b) Engaging in the labor is not inconsistent with and does not interfere with the plan of services for the client;
(c) The person responsible for the client’s treatment agrees to the plan of labor; and
(d) The amount of time or effort necessary to perform the labor is not excessive.

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

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

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

4. The administrative officer of the facility may provide for compensation of a resident when he performs labor not governed by subsection 2 or 3.

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

6. One-half of any compensation paid to a client pursuant to this section is exempt from collection or retention as payment for services rendered by the mental hygiene and mental retardation division of the department or its facilities, or by the division of child and family services of the department or its facilities. Such amount is also exempt from levy, execution, attachment, garnishment or any other remedies provided by law for the collection of debts.

NRS 433.531 Rights concerning suspension or violation of rights.

Each client admitted for evaluation, treatment or training to a facility has the following rights concerning the suspension or violation of his rights, a list of which must be prominently posted in all facilities providing those services and must be otherwise brought to the attention of the client by such additional means as prescribed by regulation:

1. To receive a list of his rights.

2. To receive a copy of the policy of the facility that sets forth the clinical or medical circumstances under which his rights may be suspended or violated.

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

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

NRS 433.533 Document reflecting receipt of list of rights and explanation of rights.

Each facility shall, within a reasonable time after a client is admitted to the facility for evaluation, treatment or training, ask the client to sign a document that reflects that he has received a list of his rights and has had those rights explained to him.

1. The rights of a client enumerated in this chapter must not be denied except to protect the client’s health and safety or to protect the health and safety of others, or both. Any denial of those rights in any facility must be entered in the client’s record of treatment, and notice of the 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 facility receives notice of a denial of rights as provided in subsection 1, he shall cause a full report to be prepared which must set forth in detail the factual circumstances surrounding the denial. Such a report is confidential and must not be disclosed. A copy of the report must be sent to the commission.

3. The commission:

(a) Shall receive reports of and may investigate apparent violations of the rights guaranteed by this chapter;
(b) May act to resolve disputes relating to apparent violations;
(c) May act on behalf of clients to obtain remedies for any apparent violations; and
(d) Shall otherwise endeavor to safeguard the rights guaranteed by this chapter.

4. Pursuant to NRS 241.030, the commission may close any portion of a meeting in which it considers the character, alleged misconduct or professional competence of a person in relation to:

(a) The denial of the rights of a client; or
(b) The care and treatment of a client.

The provisions of this subsection do not require a meeting of the commission to be closed to the public.

NRS 433.536 Retaliation by officer, director or employee of facility prohibited.

An officer, director or employee of a facility shall not retaliate against any person for having:
1. Reported any violation of law; or
2. Provided information regarding a violation of law,
by the facility or a staff member of the facility.

NRS 433A.010 Applicability of chapter.

The provisions of this chapter apply to all mental health centers of the division of mental health and developmental services of the department and of the division of child and family services of the department. Such provisions apply to private institutions and facilities offering mental health services only when specified in the context.
(Added to NRS by 1975, 1599; A 1993, 2721; 1999, 101)

NRS 433A.011 Definitions.

As used in this chapter, unless the context otherwise requires, the words and terms defined in NRS 433A.012 to 433A.018, inclusive, have the meanings ascribed to them in those sections.
(Added to NRS by 1993, 2720)

NRS 433A.012 "Administrative officer" defined.

"Administrative officer" means a person with overall executive and administrative responsibility for those state or nonstate facilities for mental health or mental retardation designated by the administrator.
(Added to NRS by 1993, 2720)

"Administrator" means:
1. Except as otherwise provided in subsection 2, the administrator of the division of mental health and developmental services of the department.
2. Regarding the provision of services for the mental health of children pursuant to NRS 433B.010 to 433B.350, inclusive, the administrator of the division of child and family services of the department.
(Added to NRS by 1993, 2720; A 1999, 101)

NRS 433A.014 "Client" defined.

"Client" means any person who seeks, on his own or another's initiative, and can benefit from care, treatment or training provided by the division.
(Added to NRS by 1993, 2720; A 1997, 3493)

NRS 433A.015 "Division" defined.

"Division" means:
1. Except as otherwise provided in subsection 2, the division of mental health and development services of the department.
2. Regarding the provision of services for the mental health of children pursuant to NRS 433B.010 to 433B.350, inclusive, the division of child and family services of the department.
(Added to NRS by 1993, 2720; A 1999, 102)

"Division facility" means:
1. Except as otherwise provided in subsection 2, any unit or subunit operated by the division of mental health and developmental services of the department for the care, treatment and training of clients.
2. Any unit or subunit operated by the division of child and family services of the department pursuant to NRS 433B.010 to 433B.350, inclusive.
(Added to NRS by 1993, 2721; A 1999, 102)

NRS 433A.017 "Medical director" defined.

"Medical director" means the chief medical officer of any program of the division of mental health and developmental services of the department.
(Added to NRS by 1993, 2721; A 1999, 102)

NRS 433A.018 "Person professionally qualified in the field of psychiatric mental health" defined.

"Person professionally qualified in the field of psychiatric mental health" means:

1. A psychiatrist licensed to practice medicine in this state who is certified by the American Board of Psychiatry and Neurology;
2. A psychologist licensed to practice in this state;
3. A social worker who holds a master's degree in social work, is licensed by the state as a clinical social worker and is employed by the division;
4. A registered nurse who:

(a) Is licensed to practice professional nursing in this state;
(b) Holds a master's degree in the field of psychiatric nursing; and
(c) Is employed by the division; or

5. A marriage and family therapist licensed pursuant to chapter 641A of NRS.
(Added to NRS by 1993, 2721)

1. Be selected on the basis of training and demonstrated administrative qualities of leadership in any one of the fields of psychiatry, medicine, psychology, social work, education or administration.

2. Be appointed on the basis of merit as measured by administrative training or experience in programs relating to mental health, including care and treatment of mentally ill and mentally retarded persons and persons with related conditions.

3. Have additional qualifications which are in accordance with criteria prescribed by the department of personnel.
(Added to NRS by 1975, 1599; A 1979, 813; 1981, 1685; 1983, 642; 1985, 2268; 1999, 2594)

NRS 433A.030 Administrative officer: Powers and duties.

The administrative officers have the following powers and duties, subject to the administrative supervision of the administrator:

1. To exercise general supervision of and establish regulations for the government of the facilities designated by the administrator;

2. To be responsible for and supervise the fiscal affairs and responsibilities of the facilities designated by the administrator;

3. To appoint such medical, technical, clerical and operational staff as the execution of his duties, the care and treatment of clients and the maintenance and operation of the facilities designated by the administrator may require;

4. To make reports to the administrator, and to supply the administrator with material on which to base proposed legislation;

5. To keep complete and accurate records of all proceedings, record and file all bonds and contracts, and assume responsibility for the custody and preservation of all papers and documents pertaining to his office;

6. To inform the public in regard to the activities and operation of the facilities;

7. To invoke any legal, equitable or special procedures for the enforcement of his orders or the enforcement of the provisions of this Title and other statutes governing the facilities;

8. To submit an annual report to the administrator on the condition, operation, functioning and anticipated needs of the facilities; and

9. To assume responsibility for the nonmedical care and treatment of clients if that responsibility has not been delegated.
(Added to NRS by 1975, 1600; A 1979, 813)

Other employment prohibited; exceptions. Except as otherwise provided in NRS 284.143, an administrative officer shall devote his entire time to the duties of his position and shall have no other gainful employment or occupation, but he may attend seminars, act as a consultant and give lectures relating to his profession and accept appropriate stipends for the seminars, consultations and lectures.
(Added to NRS by 1975, 1600; A 1979, 814; 1985, 423; 1995, 2314)

1. A coordinator of medical programs is the medical head of any division facility designated by the administrator. He must be a psychiatrist licensed to practice medicine or, in the case of a treatment facility authorized by paragraph (b) of subsection 1 of NRS 433B.290, a psychiatrist or a pediatrician licensed to practice medicine. He may be a psychiatrist or pediatrician in private practice under contract to the division. He must have such additional qualifications as are in accordance with criteria prescribed by the department of personnel and must be in the unclassified service of the state.

2. A coordinator of medical programs shall:

(a) Cause to be kept a fair and full account of all medical affairs;
(b) Have standard medical histories currently maintained on all clients, and administer or have administered the accepted and appropriate medical treatments to all clients under his care, and may, by delegation of the administrative officer, be responsible for the nonmedical care and treatment of clients; and
(c) Undertake any diagnostic, medical or surgical procedure in the interest of the client, but only in accordance with the provisions of subsection 1 of NRS 433.484.

(Added to NRS by 1975, 1601; A 1979, 814; 1981, 1686; 1983, 642; 1993, 2721)

There is hereby created a revolving account for the mental health institute in the sum of $7,500, which may be used for the payment of bills of the institute requiring immediate payment and for no other purpose. The administrative officer for the institute shall deposit the revolving account in one or more banks or credit unions of reputable standing. Payments made from the revolving account must be promptly reimbursed from appropriated money of the institute as other claims against the state are paid.
(Added to NRS by 1975, 1612; A 1979, 815; 1991, 206; 1999, 1497)

1. A gift account in the department of human resources' gift fund is hereby created for each division facility, and all gifts of money which the division is authorized to accept for the respective facilities must be deposited in the state treasury to the credit of the appropriate account. Amounts in the accounts must be used for division mental health facility purposes only and expended in accordance with the terms of the gift. All claims must be approved by the administrative officer before they are paid.

2. Gifts of property, other than money, may be sold or exchanged when it is deemed by the administrative officer and the administrator to be in the best interest of the division mental health facility. The sale price must be not less than 90 percent of the value determined by a qualified appraiser appointed by the administrative officer. All money realized from the sale must be deposited in the state treasury to the credit of the appropriate account and must be spent for division mental health facility purposes only.
(Added to NRS by 1975, 1613; A 1979, 622; 1981, 78)

NRS 433A.110 Canteen for facility of division: Establishment and operation.

1. The administrative officer of a division mental health facility which provides treatment for inpatients may cause to be established a canteen operated for the benefit of clients and employees of the facility. So far as practical within good business practices, the prices of commodities sold must approximate costs. The administrative officer shall cause to be kept a record of transactions in the operation of the canteen.

2. The administrator may designate money from budgeted resources in appropriate amounts to each such facility for the establishment and operation of canteens. The money must be used to supplement the financial operation of the canteens, if required, to provide money for needy clients' canteen privileges, and to provide for such other expenditures benefiting the clients of such division facilities as the respective administrative officers may deem necessary. All proceeds of sale collected must be deposited with the state treasurer for credit to the appropriate operating account of the mental health facility. The operating account must separately identify in the record of transactions the proceeds of sale collected, the amount of budgeted resources used, and the total amount expended for the operations of the canteen. All proceeds of sale collected must be used for the operation of the canteen. Proceeds of sale collected which exceed the amount necessary to maintain the operation of the canteens must be used to benefit the clients.

3. An appropriate sum may be maintained as petty cash at each canteen.

4. The respective administrative officers may cause to be appointed such staff as are necessary for the proper operation of the canteens.
(Added to NRS by 1975, 1613; A 1981, 263)

1. Voluntary admission;

2. Emergency admission; and

3. Involuntary court-ordered admission.

(Added to NRS by 1975, 1602)

NRS 433A.130 Forms for admission.

All applications and certificates for the admission of any person in the State of Nevada to a mental health facility under the provisions of this chapter shall be made on forms approved by the division and the office of the attorney general and furnished by the clerks of the district courts in each county.
(Added to NRS by 1975, 1608)

NRS 433A.140 Voluntary admission: Procedures for admission and release; effect of voluntary release.

1. Any person may apply to:

(a) A public or private mental health facility in the State of Nevada for admission to the facility; or
(b) A division facility to receive care, treatment or training provided by the division,

as a voluntary client for the purposes of observation, diagnosis, care and treatment. In the case of a person who has not attained the age of majority, application for voluntary admission or care, treatment or training may be made on his behalf by his spouse, parent or legal guardian.

2. If the application is for admission to a division facility, or for care, treatment or training provided by the division, the applicant must be admitted or provided such services as a voluntary client if an examination by personnel of the facility qualified to make such a determination reveals that the person needs and may benefit from services offered by the mental health facility.

3. Any person admitted to a public or private mental health facility as a voluntary client must be released immediately after the filing of a written request for release with the responsible physician or his designee within the normal working day, unless, within 24 hours after the request, the facility changes the status of the person to an emergency admission pursuant to NRS 433A.145. When a person is released pursuant to this subsection, the facility and its agents and employees are not liable for any debts or contractual obligations, medical or otherwise, incurred or damages caused by the actions of the person.

4. Any person admitted to a public or private mental health facility as a voluntary client who has not requested release may nonetheless be released by the medical director of the facility when examining personnel at the facility determine that the client has recovered or has improved to such an extent that he is not considered a danger to himself or others and that the services of that facility are no longer beneficial to him or advisable.

5. A person who requests care, treatment or training from the division pursuant to this section must be evaluated by the personnel of the division to determine whether he is eligible for the services offered by the division. The evaluation must be conducted:

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

6. This section does not preclude a public facility from making decisions, policies, procedures and practices within the limits of the money made available to the facility.
(Added to NRS by 1975, 1602; A 1993, 2114; 1997, 3494)

NRS 433A.145 Restrictions on change of status from voluntary client to emergency admission.

1. If a mentally ill person is admitted to a public or private mental health facility or hospital as a voluntary client, the facility or hospital shall not change the status of the person to an emergency admission unless the hospital or facility receives, before the change in status is made, an application for an emergency admission pursuant to NRS 433A.160 and the certificate of a psychiatrist, psychologist or physician pursuant to NRS 433A.170.

2. A person whose status is changed pursuant to subsection 1 must not be detained in excess of 48 hours after the change in status is made, unless within that period a written petition is filed with the clerk of the district court pursuant to NRS 433A.200.

3. If the period specified in subsection 2 expires on a day on which the office of the clerk of the district court is not open, the written petition must be filed on or before the close of the business day next following the expiration of that period.
(Added to NRS by 1997, 3492)

NRS 433A.150 Detention for evaluation, observation and treatment; limitation on time.

1. Any mentally ill person may be detained in a public or private mental health facility or hospital under an emergency admission for evaluation, observation and treatment subject to subsection 2.

2. Except as otherwise provided in subsection 3, a person admitted to a mental health facility or hospital under subsection 1 must not be detained in excess of 72 hours, including Saturdays and Sundays, from the time of his admission unless within that period a written petition for an involuntary court-ordered admission has been filed with the clerk of the district court pursuant to NRS 433A.200.

3. If the 72-hour period specified in subsection 2 expires on a day on which the office of the clerk of the district court is not open, the written petition must be filed on or before the close of the business day next preceding the expiration of that period, except that, if that business day is the same day as that upon which the person was admitted, the petition must be filed on or before the close of the business day next following the expiration of that period.
(Added to NRS by 1975, 1602; A 1985, 2269; 1989, 1758)

1. Application for an emergency admission of an allegedly mentally ill person for evaluation and observation may only be made by an accredited agent of the department, an officer authorized to make arrests in the State of Nevada or a physician, psychologist, marriage and family therapist, social worker or registered nurse. The agent, officer, physician, psychologist, marriage and family therapist, social worker or registered nurse may take an allegedly mentally ill person into custody without a warrant to apply for emergency admission for evaluation, observation and treatment under NRS 433A.150 and may transport the person or arrange the transportation for him with a local law enforcement agency to a public or private mental health facility for that purpose.

2. The application must reveal the circumstances under which the person was taken into custody and the reasons therefor.

3. For the purposes of subsection 1, "an accredited agent of the department" means any person appointed or designated by the director of the department to take into custody and transport to a mental health facility pursuant to subsections 1 and 2 those persons in need of emergency admission.

4. Any person who has reason to believe that another person is mentally ill may apply to the district attorney of the county where the allegedly mentally ill person is found, and the district attorney may, if satisfied that as a result of mental illness the person is likely to harm himself or others:

(a) Issue an order to any peace officer for the immediate apprehension of the person and his transportation to a public or private mental health facility; and
(b) Make application for the admission of the person under the emergency admission provisions of NRS 433A.150.

5. Except as otherwise provided in this subsection, each person admitted to a public or private mental health facility or hospital under an emergency admission must be evaluated at the time of admission by a psychiatrist or a psychologist. If a psychiatrist or a psychologist is not available to conduct an evaluation at the time of admission, a physician may conduct the evaluation. Each such emergency admission must be approved by a psychiatrist.
(Added to NRS by 1975, 1603; A 1983, 506; 1985, 2269; 1989, 1759; 1997, 3494)

NRS 433A.165 Examination required before transportation of person to mental health facility; payment of costs.

1. Before an allegedly mentally ill person may be transported to a public or private mental health facility pursuant to NRS 433A.160, he must:

(a) First be examined by a licensed physician to determine whether the person has a medical problem, other than a psychiatric problem, which requires immediate treatment; and
(b) If such treatment is required, be admitted to a hospital for the appropriate medical care.

2. The cost of the examination must be paid by the county in which the allegedly mentally ill person resides if services are provided at a county hospital located in that county or a hospital designated by that county, unless the cost is voluntarily paid by the allegedly mentally ill person or on his behalf, by his insurer or by a state or federal program of medical assistance.

3. The county may recover all or any part of the expenses paid by it, in a civil action against:

(a) The person whose expenses were paid;
(b) The estate of that person; or
(c) A responsible relative as prescribed in NRS 433A.610, to the extent that financial ability is found to exist.

4. The cost of treatment, including hospitalization, for an indigent must be paid pursuant to NRS 428.010 by the county in which the allegedly mentally ill person resides.
(Added to NRS by 1987, 1445; A 1991, 2209; 1993, 908)

NRS 433A.170 Certificate of psychiatrist, psychologist or physician required.

Except as otherwise provided in this section, the administrative officer of a facility operated by the division or of any other public or private mental health facility or hospital shall not accept an application for an emergency admission under NRS 433A.150 and 433A.160 unless that application is accompanied by a certificate of a psychiatrist or a licensed psychologist stating that he has examined the person alleged to be mentally ill and that he has concluded that as a result of mental illness the person is likely to harm himself or others. If a psychiatrist or licensed psychologist is not available to conduct an examination, a physician may conduct the examination. The certificate required by this section may be obtained from a psychiatrist, licensed psychologist or physician who is employed by the public or private mental health facility to which the application is made.
(Added to NRS by 1975, 1603; A 1985, 2270; 1989, 1550, 1759; 1997, 3495)

NRS 433A.180 Requirements for and limitations on applications and certificates.

No application or certificate authorized under NRS 433A.160 or 433A.170 may be considered if made by a psychiatrist, psychologist or physician who is related by blood or marriage to the allegedly mentally ill person, or who is financially interested in the facility in which the allegedly mentally ill person is to be detained. No application or certificate of any examining person authorized under NRS 433A.170 may be considered unless it is based on personal observation and examination of the allegedly mentally ill person made by such examining person not more than 72 hours prior to the making of the application or certificate. The certificate shall set forth in detail the facts and reasons on which the examining person based his opinions and conclusions.
(Added to NRS by 1975, 1603; A 1989, 1550)

NRS 433A.190 Notice to spouse or guardian.

Within 24 hours of a person's admission under emergency admission, the administrative officer of a public or private mental health facility shall give notice of such admission by certified mail to the spouse or legal guardian of that person.
(Added to NRS by 1975, 1604; A 1993, 2114)

1. A proceeding for an involuntary court-ordered admission of any person in the State of Nevada may be commenced by the filing of a petition with the clerk of the district court of the county where the person who is to be treated resides. The petition may be filed by the spouse, parent, adult children or legal guardian of the person to be treated or by any physician, psychologist, social worker or registered nurse, by an accredited agent of the department or by any officer authorized to make arrests in the State of Nevada. The petition must be accompanied:

(a) By a certificate of a physician or licensed psychologist stating that he has examined the person alleged to be mentally ill and has concluded that as a result of mental illness the person is likely to harm himself or others; or
(b) By a sworn written statement by the petitioner that:

(1) The petitioner has probable cause to believe that the person is mentally ill and, because of that illness is likely to harm himself or others; and
(2) The person has refused to submit to examination or treatment by a physician, psychiatrist or licensed psychologist.

2. If the person to be treated is a minor and the petitioner is a person other than a parent or guardian of the minor, the petition must, in addition to the certificate or statement required by subsection 1, include a statement signed by a parent or guardian of the minor that the parent or guardian does not object to the filing of the petition.
(Added to NRS by 1975, 1604; A 1985, 54, 2270; 1989, 1551, 1760; 1995, 2413)

NRS 433A.210 Petition following emergency admission.

A petition filed with the clerk of the district court to commence proceedings for involuntary court-ordered admission of a person pursuant to NRS 433A.150 must include:

1. A certified copy of the application made pursuant to NRS 433A.160 with respect to the person detained;

2. A petition executed by a psychiatrist, licensed psychologist or physician certifying that he has examined the person alleged to be mentally ill and has concluded that as a result of mental illness the person is likely to harm himself or others; and

3. If the person to be treated is a minor and the petitioner is a person other than a parent or guardian of the minor, a statement signed by a parent or guardian of the minor that the parent or guardian does not object to the filing of the petition.
(Added to NRS by 1975, 1604; A 1985, 2270; 1989, 1551, 1760; 1995, 2414)

1. Immediately after he receives any petition filed pursuant to NRS 433A.200 or 433A.210, the clerk of the district court shall transmit the petition to the appropriate district judge, who shall set a time, date and place for its hearing. The date must be:

(a) Within 14 calendar days after the date on which the petition is received by the clerk;
(b) If at the time the petition is received by the clerk the subject of the petition was admitted to a hospital or public or private mental health facility pursuant to NRS 433A.160, within 5 judicial days after the date on which the petition is received by the clerk; or
(c) If the district attorney filed a petition for the emergency admission of the subject of the petition, within 5 judicial days after the date on which the petition is received by the clerk.

2. The court shall give notice of the petition and of the time, date and place of any proceedings thereon to the subject of the petition, his attorney, if known, the petitioner, the district attorney of the county in which the court has its principal office, the local office of an agency or organization that receives money from the Federal Government pursuant to 42 U.S.C. §§ 10801 et seq., to protect and advocate the rights of persons with mental illnesses and the administrative office of any public or private mental health facility in which the subject of the petition is detained.
(Added to NRS by 1975, 1604; A 1989, 1760; 1993, 2114; 1995, 2414; 1997, 3495)

NRS 433A.230 Bond of petitioner.

The court in its discretion may require any petitioner under NRS 433A.200, except any duly accredited agent of the department or any officer authorized to make arrests in the State of Nevada, to file an undertaking with surety to be approved by the court in the amount the court deems proper, conditioned to save harmless the person alleged to be mentally ill by reason of costs incurred, including attorney fees, if any, and damages suffered by the person as a result of such action.
(Added to NRS by 1975, 1605)

1. After the filing of a petition to commence proceedings for involuntary court-ordered admission of a person pursuant to NRS 433A.200 or 433A.210, the court shall promptly cause two or more physicians or licensed psychologists, one of whom must always be a physician, to examine the person alleged to be mentally ill, or request an evaluation by an evaluation team from the division of the person alleged to be mentally ill.

2. To conduct the examination of a person who is not at a mental health facility under emergency admission pursuant to NRS 433A.150, the court may order a peace officer to take the person into protective custody and transport him to a mental health facility or hospital where he may be detained until a hearing is had upon the petition.

3. Unless the person is admitted under an emergency admission pursuant to NRS 433A.150, he may be allowed to remain in his home or other place of residence pending an ordered examination or examinations and to return to his home or other place of residence upon completion of the examination or examinations. The person may be accompanied by one or more of his relations or friends to the place of examination.

4. Except as otherwise provided in this subsection, each physician and licensed psychologist who examines a person pursuant to subsection 1 shall, not later than 48 hours before the hearing set pursuant to NRS 433A.220, submit to the court in writing a summary of his findings and evaluation regarding the person alleged to be mentally ill. If the person alleged to be mentally ill is admitted under an emergency admission pursuant to NRS 433A.150, the written findings and evaluation must be submitted to the court not later than 24 hours before the hearing set pursuant to paragraph (b) of subsection 1 of NRS 433A.220.
(Added to NRS by 1975, 1604; A 1983, 507; 1989, 1760; 1995, 2414)

NRS 433A.250 Evaluation team: Establishment; composition; fees.

1. The administrator shall establish such evaluation teams as are necessary to aid the courts under NRS 433A.240 and 433A.310.

2. Each team must be composed of a psychiatrist and other persons professionally qualified in the field of psychiatric mental health who are representative of the division, selected from personnel in the division.

3. Fees for the evaluations must be established and collected as set forth in NRS 433.414 or 433B.260, as appropriate.
(Added to NRS by 1975, 1605; A 1983, 507; 1985, 424; 1993, 2722)

1. In counties where the examining personnel required pursuant to NRS 433A.240 are not available, proceedings for involuntary court-ordered admission shall be conducted in the nearest county having such examining personnel available in order that there be minimum delay.

2. The entire expense of proceedings for involuntary court-ordered admission shall be paid by the county in which the application is filed, except that where the person to be admitted last resided in another county of the state the expense shall be charged to and payable by such county of residence.
(Added to NRS by 1975, 1605)

1. The allegedly mentally ill person or any relative or friend on his behalf is entitled to retain counsel to represent him in any proceeding before the district court relating to involuntary court-ordered admission, and if he fails or refuses to obtain counsel, the court shall advise him and his guardian or next of kin, if known, of such right to counsel and shall appoint counsel, who may be the public defender or his deputy.

2. Any counsel appointed pursuant to subsection 1 shall be awarded compensation by the court for his services in an amount determined by it to be fair and reasonable. The compensation shall be charged against the estate of the person for whom the counsel was appointed, or if the person is indigent, the compensation shall be charged against the county where the allegedly mentally ill person last resided.

3. The court shall, at the request of any counsel, grant a recess in the proceedings for not more than 5 days to give the counsel an opportunity to prepare his case.

4. Each district attorney or his deputy shall appear and represent the state in all involuntary court-ordered admission proceedings in his county. The district attorney is responsible for the presentation of evidence, if any, in support of the involuntary court-ordered admission of a person to a mental health facility in proceedings held pursuant to NRS 433A.200 or 433A.210.
(Added to NRS by 1975, 1605)

In proceedings for involuntary court-ordered admission, the court shall hear and consider all relevant testimony, including, but not limited to, the testimony of examining personnel who participated in the evaluation of the person alleged to be mentally ill and the certificates of physicians or certified psychologists accompanying the petition. The court may consider testimony relating to any past actions of the person alleged to be mentally ill if such testimony is probative of the question of whether the person is presently mentally ill and presents a clear and present danger of harm to himself or others.
(Added to NRS by 1975, 1606; A 1999, 120)

NRS 433A.290 Right of person alleged to be mentally ill to be present and testify.

In proceedings for an involuntary court-ordered admission, the person with respect to whom the proceedings are held shall be present and may, at the discretion of the court, testify.
(Added to NRS by 1975, 1606)

NRS 433A.300 Fees and mileage for witnesses.

Witnesses subpoenaed under the provisions of this chapter shall be paid the same fees and mileage as are paid to witnesses in the courts of the State of Nevada.
(Added to NRS by 1975, 1606)

1. If the district court finds, after proceedings for the involuntary court-ordered admission of a person to a public or private mental health facility:

(a) That there is not clear and convincing evidence that the person with respect to whom the hearing was held is mentally ill or exhibits observable behavior such that he is likely to harm himself or others if allowed to remain at liberty, the court shall enter its finding to that effect and the person must not be involuntarily detained in such a facility.
(b) That there is clear and convincing evidence that the person with respect to whom the hearing was held is mentally ill and, because of that illness, is likely to harm himself or others if allowed to remain at liberty, the court may order the involuntary admission of the person for the most appropriate course of treatment. The order of the court must be interlocutory and must not become final if, within 30 days after the involuntary admission, the person is unconditionally released pursuant to NRS 433A.390.

2. An involuntary admission pursuant to paragraph (b) of subsection 1 automatically expires at the end of 6 months if not terminated previously by the medical director of the public or private mental health facility as provided for in subsection 2 of NRS 433A.390. At the end of the court-ordered period of treatment, the division or any nondivision mental health facility may petition to renew the detention of the person for additional periods not to exceed 6 months each. For each renewal, the petition must set forth to the court specific reasons why further treatment would be in the person's own best interests.

3. Before issuing an order for involuntary admission or a renewal thereof, the court shall explore other alternative courses of treatment within the least restrictive appropriate environment as suggested by the evaluation team who evaluated the person, or other persons professionally qualified in the field of psychiatric mental health, which the court believes may be in the best interests of the person.
(Added to NRS by 1975, 1606; A 1981, 1134; 1983, 508; 1989, 1761; 1993, 2115)

NRS 433A.320 Clinical abstract to accompany order.

The order for involuntary court admission of any person to a mental health facility, public or private, shall be accompanied by a clinical abstract, including a history of illness, diagnosis, treatment and the names of relatives or correspondents.
(Added to NRS by 1975, 1607)

NRS 433A.330 Transportation to mental health facility.

1. When any involuntary court admission is ordered under the provisions of this chapter, the involuntarily admitted person, together with the court orders and certificates of the physicians, certified psychologists or evaluation team and a full and complete transcript of the notes of the official reporter made at the examination of such person before the court, shall be delivered to the sheriff of the county who shall convey the person to the appropriate public or private mental health facility.

2. No mentally ill person may be conveyed to the mental health facility without at least one attendant of the same sex or a relative in the first degree of consanguinity or affinity being in attendance.
(Added to NRS by 1975, 1607)

1. Upon admission to any public or private mental health facility, each client of the facility and the client's spouse and legal guardian, if any, must receive a written statement outlining in simple, nontechnical language all procedures for release provided by this chapter, setting out all rights accorded to such a client by this chapter and chapters 433 and 433B of NRS and, if the client has no legal guardian, describing procedures provided by law for adjudication of incompetency and appointment of a guardian for the client.

2. Written information regarding the services provided by and means of contacting the local office of an agency or organization that receives money from the Federal Government pursuant to 42 U.S.C. §§ 10801 et seq., to protect and advocate the rights of persons with mental illnesses must be posted in each public and private mental health facility and provided to each client of such a facility upon admission.
(Added to NRS by 1975, 1610; A 1993, 2115, 2722; 1995, 676)

1. A clinical record for each client must be diligently maintained by any division facility or private institution or facility offering mental health services. The record must include information pertaining to the client's admission, legal status, treatment and individualized plan for habilitation. The clinical record is not a public record and no part of it may be released, except:

(a) The record must be released to physicians, attorneys and social agencies as specifically authorized in writing by the client, his parent, guardian or attorney.
(b) The record must be released to persons authorized by the order of a court of competent jurisdiction.
(c) The record or any part thereof may be disclosed to a qualified member of the staff of a division facility, an employee of the division or a member of the staff of an agency in Nevada which has been established pursuant to the Developmental Disabilities Assistance and Bill of Rights Act (42 U.S.C. §§ 6041 et seq.) or the Protection and Advocacy for Mentally Ill Individuals Act of 1986 (42 U.S.C. §§ 10801 et seq.) when the administrator deems it necessary for the proper care of the client.
(d) Information from the clinical records may be used for statistical and evaluative purposes if the information is abstracted in such a way as to protect the identity of individual clients.
(e) To the extent necessary for a client to make a claim, or for a claim to be made on behalf of a client for aid, insurance or medical assistance to which he may be entitled, information from the records may be released with the written authorization of the client or his guardian.
(f) The record must be released without charge to any member of the staff of an agency in Nevada which has been established pursuant to 42 U.S.C. §§ 6041 et seq. or 42 U.S.C. §§ 10801 et seq. if:

(1) The client is a client of that office and he or his legal representative or guardian authorizes the release of the record; or
(2) A complaint regarding a client was received by the office or there is probable cause to believe that the client has been abused or neglected and the client:

(I) Is unable to authorize the release of the record because of his mental or physical condition; and
(II) Does not have a guardian or other legal representative or is a ward of the state.

(g) The record must be released as provided in NRS 433.332 or 433B.200 and in chapter 629 of NRS.

2. As used in this section, "client" includes any person who seeks, on his own or others' initiative, and can benefit from care, treatment and training in a private institution or facility offering mental health services.
(Added to NRS by 1975, 1611; A 1987, 746, 1197; 1989, 2056; 1991, 2351; 1993, 2722)

NRS 433A.370 Escape or absence without leave.

1. When a client committed by a court to a division facility on or before June 30, 1975, or a client who is judicially admitted on or after July 1, 1975, or a person who is involuntarily detained pursuant to NRS 433A.150 to 433A.300, inclusive, escapes from any division facility, or when a judicially admitted client has not returned to a division facility from conditional release after the administrative officer of the facility has ordered him to do so, any peace officer shall, upon written request of the administrative officer or his designee and without the necessity of a warrant or court order, apprehend, take into custody and deliver the person to such division facility or another state facility.

2. Any person appointed or designated by the director of the department to take into custody and transport to a division facility persons who have escaped or failed to return as described in subsection 1 may participate in the apprehension and delivery of any such person, but may not take the person into custody without a warrant.
(Added to NRS by 1975, 1609; A 1999, 867)

1. Except as otherwise provided in subsection 4, any person involuntarily admitted by a court may be conditionally released from a public or private mental health facility when, in the judgment of the medical director of the facility, the conditional release is in the best interest of the person and will not be detrimental to the public welfare. The medical director or his designee of the facility shall prescribe the period for which the conditional release is effective. The period must not extend beyond the last day of the court-ordered period of treatment pursuant to NRS 433A.310.

2. When a person is conditionally released pursuant to subsection 1, the state or any of its agents or employees are not liable for any debts or contractual obligations, medical or otherwise, incurred or damages caused by the actions of the person.

3. When a person who has been adjudicated by a court to be incompetent is conditionally released from a mental health facility, the administrative officer of the mental health facility shall petition the court for restoration of full civil and legal rights as deemed necessary to facilitate the incompetent person's rehabilitation.

4. A person who was involuntarily admitted by a court because he was likely to harm others if allowed to remain at liberty may be conditionally released only if, at the time of the release, written notice is given to the court which admitted him and to the district attorney of the county in which the proceedings for admission were held.

5. Except as otherwise provided in subsection 7, the administrative officer of a public or private mental health facility or his designee shall order a person who is conditionally released from that facility pursuant to this section to return to the facility if a psychiatrist and a member of that person's treatment team who is professionally qualified in the field of psychiatric mental health determine, pursuant to NRS 433A.115, that the conditional release is no longer appropriate because that person presents a clear and present danger of harm to himself or others. Except as otherwise provided in this subsection, the administrative officer or his designee shall, at least 3 days before the issuance of the order to return, give written notice of the order to the court that admitted the person to the facility. If an emergency exists in which the person presents an imminent threat of danger of harm to himself or others, the order must be submitted to the court not later than 1 business day after the order is issued.

6. The court shall review an order submitted pursuant to subsection 5 and the current condition of the person who was ordered to return to the facility at its next regularly scheduled hearing for the review of petitions for involuntary court-ordered admissions, but in no event later than 5 judicial days after the person is returned to the facility. The administrative officer or his designee shall give written notice to the person who was ordered to return to the facility and to his attorney, if known, of the time, date and place of the hearing and of the facts necessitating that person's return to the facility.

7. The provisions of subsection 5 do not apply if the period of conditional release has expired.
(Added to NRS by 1975, 1608; A 1981, 1661; 1999, 867)

NRS 433A.390 Release without further order of court; early release.

1. When a client, involuntarily admitted to a mental health facility by court order, is released at the end of the time specified pursuant to NRS 433A.310, written notice must be given to the admitting court at least 10 days before the release of the client. The client may then be released without requiring further orders of the court.

2. An involuntarily court-admitted client may be unconditionally released before the period specified in NRS 433A.310 when:

(a) An evaluation team established under NRS 433A.250 or two persons professionally qualified in the field of psychiatric mental health, at least one of them being a physician, determines that the client has recovered from his mental illness or has improved to such an extent that he is no longer considered to present a clear and present danger of harm to himself or others; and
(b) Under advisement from the evaluation team or two persons professionally qualified in the field of psychiatric mental health, at least one of them being a physician, the medical director of the mental health facility authorizes the release and gives written notice to the admitting court at least 10 days before the release of the client.

(Added to NRS by 1975, 1607; A 1983, 508; 1989, 1762; 1997, 3496; 1999, 868)

1. An indigent resident of this state discharged as having recovered from his mental illness, but having a residual medical or surgical disability which prevents him from obtaining or holding remunerative employment, shall be returned to the county of his last residence. A nonresident indigent with such disabilities shall be returned to the county from which he was involuntarily court-admitted. The administrative officer of the mental health facility shall first give notice in writing, not less than 10 days prior to discharge, to the board of county commissioners of the county to which the person will be returned.

2. Delivery of the indigent resident defined in subsection 1 shall be made to an individual or agency authorized to provide further care.

3. This section does not authorize the release of any person held upon an order of a court or judge having criminal jurisdiction arising out of a criminal offense.
(Added to NRS by 1975, 1607)

NRS 433A.420 Transfer to hospital of Department of Veterans Affairs or other facility; duties of medical director and commission upon objection of client.

The medical director of a division facility may order the transfer to a hospital of the Department of Veterans Affairs or other facility of the United States Government any admitted client eligible for treatment therein. If the client in any manner objects to the transfer, the medical director of the facility shall enter the objection and a written justification of the transfer in the client's record and forward a notice of the objection to the administrator, and the commission shall review the transfer pursuant to subsections 2 and 3 of NRS 433.534.
(Added to NRS by 1975, 1611; A 1981, 894; 1985, 2271; 1995, 1092)

1. Whenever the administrator determines that division facilities within the state are inadequate for the care of any mentally ill person, he may designate two physicians, licensed under the provisions of chapter 630 of NRS, and familiar with the field of psychiatry, to examine that person. If the two physicians concur with the opinion of the administrator, the administrator may contract with appropriate corresponding authorities in any other state of the United States having adequate facilities for such purposes for the reception, detention, care or treatment of that person, but if the person in any manner objects to the transfer, the procedures in subsection 3 of NRS 433.484 and subsections 2 and 3 of NRS 433.534 must be followed. The two physicians so designated are entitled to a reasonable fee for their services which must be paid by the county of the person's last known residence.

2. Money to carry out the provisions of this section must be provided by direct legislative appropriation.
(Added to NRS by 1975, 1609; A 1981, 895, 1527; 1999, 1826)

1. If any person involuntarily court-admitted to any division facility pursuant to NRS 433A.310 is found by the court not to be a resident of this state and to be a resident of another state, he may be transferred to the state of his residence pursuant to NRS 433.444 if an appropriate institution of that state is willing to accept him.

2. The approval of the administrator of the division of mental health and developmental services of the department must be obtained before any transfer is made pursuant to subsection 1.
(Added to NRS by 1975, 1607; A 1993, 2723; 1999, 102)

NRS 433A.450 Detention and treatment of mentally ill offender.

When a psychiatrist and one other person professionally qualified in the field of psychiatric mental health determines that an offender confined in an institution of the department of prisons is mentally ill, the director of the department of prisons shall apply to the administrator for the offender's detention and treatment at a division facility selected by the administrator. If the administrator determines that adequate security or treatment is not available in a division facility, the administrator shall provide, within the resources available to the division and as he deems necessary, consultation and other appropriate services for the offender at the place where he is confined. It is the director's decision whether to accept such services.
(Added to NRS by 1975, 1609; A 1977, 871; 1983, 509)

1. No person admitted to a public or private mental health facility pursuant to this chapter shall, by reason of such admission, be denied the right to dispose of property, marry, execute instruments, make purchases, enter into contractual relationships, vote and hold a driver's license, unless such person has been specifically adjudicated incompetent by a court of competent jurisdiction and has not been restored to legal capacity.

2. If the responsible physician of the mental health facility in which any person is detained is of the opinion that such person is unable to exercise any of the aforementioned rights, the responsible physician shall immediately notify the person and the person's attorney, legal guardian, spouse, parents or other nearest-known adult relative, and the district court of that fact.
(Added to NRS by 1975, 1610)

NRS 433A.470 Guardian may be appointed for person adjudicated incompetent.

A court-adjudicated mentally incompetent person admitted to a public or private mental health facility may have a guardian appointed either by the admitting court or by the district court of the county wherein the mental health facility is located, on the application of any interested person or, in the case of an indigent, on the application of the district attorney of the county wherein the mental health facility is located. The provisions of chapter 159 of NRS shall govern the appointment and administration of guardianships created pursuant to this chapter.
(Added to NRS by 1975, 1610)

1. The medical director of a division mental health facility shall have all adjudicated mentally incompetent persons of that facility automatically evaluated no less than once every 6 months to determine whether or not there is sufficient cause to believe that the client remains unable to exercise rights to dispose of property, marry, execute instruments, make purchases, enter into contractual relationships, vote or hold a driver's license.

2. If the medical director has sufficient reason to believe that the client remains unable to exercise these rights, such information shall be documented in the client's treatment record.

3. If there is no such reason to believe the client is unable to exercise these rights, the medical director shall immediately initiate proper action to cause to have the client restored to legal capacity.
(Added to NRS by 1975, 1610)

NRS 433A.490 Restoration of legal capacity of person previously adjudicated incompetent.

Any person in the State of Nevada who, by reason of a judicial decree ordering his hospitalization entered prior to July 1, 1975, is considered to be mentally incompetent and is denied the right to dispose of property, marry, execute instruments, make purchases, enter into contractual relationships, vote or hold a driver's license solely by reason of such decree shall, upon the expiration of the 6-month period immediately following such date, be deemed to have been restored to legal capacity unless, within such 6-month period, affirmative action is commenced to have the person adjudicated mentally incompetent by a court of competent jurisdiction.
(Added to NRS by 1975, 1610)

No person may be admitted to a private hospital or division mental health facility pursuant to the provisions of this chapter unless mutually agreeable financial arrangements relating to the costs of treatment are made between the private hospital or division facility and the client or person requesting his admission.
(Added to NRS by 1975, 1614)

1. Fees for the cost of treatment and services rendered through any division facility must be established pursuant to the fee schedule established under NRS 433.404 or 433B.250, as appropriate.

2. The maximum fee established by the schedule must approximate the actual cost per client for the class of client care provided.

3. The fee schedule must allow for a client to pay a portion of the actual cost if it is determined that he and his responsible relatives pursuant to NRS 433A.610 are unable to pay the full amount. That determination must be made pursuant to NRS 433A.640 and 433A.650.

4. Any reduction pursuant to subsection 3 of the amount owed must not be calculated until all of the benefits available to the client from third-party sources, other than Medicaid, have been applied to pay the actual cost for the care provided.
(Added to NRS by 1975, 1614; A 1993, 1239, 2723)

1. A person who is admitted to a facility operated by the division and not determined to be indigent and every responsible relative pursuant to NRS 433A.610 of the person shall be charged for the cost of treatment and is liable for that cost. If after demand is made for payment the person or his responsible relative fails to pay that cost, the administrative officer may recover the amount due by civil action.

2. All sums received by the administrative officer of a facility operated by the division pursuant to subsection 1 must be deposited in the state treasury and may be expended by the division for the support of that facility in accordance with the allotment, transfer, work program and budget provisions of NRS 353.150 to 353.245, inclusive.
(Added to NRS by 1975, 1615; A 1985, 2272; 1993, 1240)

1. When a person is admitted to a division facility or hospital under one of the various forms of admission prescribed by law, the parent or legal guardian of a mentally ill person who is a minor or the husband or wife of a mentally ill person, if of sufficient ability, and the estate of the mentally ill person, if the estate is sufficient for the purpose, shall pay the cost of the mentally ill person's maintenance, including treatment and surgical operations, in any hospital in which the person is hospitalized under the provisions of this chapter:

(a) To the administrative officer if the person is admitted to a division facility; or
(b) In all other cases, to the hospital rendering the service.

2. If a person or an estate liable for the care, maintenance and support of a committed person neglects or refuses to pay the administrative officer or the hospital rendering the service, the state is entitled to recover, by appropriate legal action, all money owed to a division facility or which the state has paid to a hospital for the care of a committed person, plus interest at the rate established pursuant to NRS 99.040.
(Added to NRS by 1975, 1614; A 1987, 1446; 1993, 1240)

Payment for the care, support, maintenance and other expenses of a person admitted to a division mental health facility shall not be exacted from such person's estate if there is a likelihood of such person's recovery or release from such facility and payment will reduce his estate to such an extent that he is likely to become a burden on the community in the event of his discharge from such facility.
(Added to NRS by 1975, 1615)

1. The administrative officers of the respective division facilities may enter into special agreements secured by properly executed bonds with the relatives, guardians or friends of clients who are adjudicated mentally incompetent for subsistence, care or other expenses of such clients. Each agreement and bond must be to the State of Nevada and any action to enforce the agreement or bond may be brought by the administrative officer.

2. Financially responsible relatives pursuant to NRS 433A.610 and the guardian of the estate of a client may, from time to time, pay money to the division facility for the future personal needs of the mentally incompetent client and for his burial expenses. Money paid pursuant to this subsection must be credited to the client in the clients' personal deposit fund established pursuant to NRS 433.539.
(Added to NRS by 1975, 1615; A 1993, 1240)

1. Once a court has ordered the admission of a person to a division facility, the administrative officer shall make an investigation, pursuant to the provisions of this chapter, to determine whether the person or his responsible relatives pursuant to NRS 433A.610 are capable of paying for all or a portion of the costs that will be incurred during the period of admission.

2. If a person is admitted to a division facility pursuant to a court order, that person and his responsible relatives are responsible for the payment of the actual cost of the treatment and services rendered during his admission to the division facility unless the investigation reveals that the person and his relatives are not capable of paying the full amount of the costs.
(Added to NRS by 1975, 1614; A 1993, 1241)

Determination of ability to pay pursuant to NRS 433A.640 shall include investigation of whether the client has benefits due and owing to him for the cost of his treatment from third party sources, such as Medicare, Medicaid, social security, medical insurance benefits, retirement programs, annuity plans, government benefits or any other financially responsible third parties. The administrative officer of a division mental health facility may accept payment for cost of a client's treatment from the client's insurance company, Medicare or Medicaid and other similar third parties.
(Added to NRS by 1975, 1614)

NRS 433A.660 Collection of fees by legal action and other methods.

1. If the client, his responsible relative pursuant to NRS 433A.610, guardian or the estate neglects or refuses to pay the cost of treatment to the division facility rendering service pursuant to the fee schedule established under NRS 433.404 or 433B.250, as appropriate, the state is entitled to recover by appropriate legal action all sums due, plus interest.

2. Before initiating such legal action, the division facility shall demonstrate efforts at collection, which may include contractual arrangements for collection through a private collection agency.
(Added to NRS by 1975, 1615; A 1993, 1241, 2723)

NRS 433A.680 Payment of costs of medical services rendered by person not on staff of facility of division.

The expense of diagnostic, medical and surgical services furnished to a client admitted to a division facility by a person not on the staff of the facility, whether rendered while the client is in a general hospital, an outpatient of a general hospital or treated outside any hospital, must be paid by the client, the guardian or relatives responsible pursuant to NRS 433A.610 for his care. In the case of an indigent client or a client whose estate is inadequate to pay the expenses, the expenses must be charged to the county from which the admission to the division facility was made, if the client had, before admission, been a resident of that county. The expense of such diagnostic, medical and surgical services must not in any case be a charge against or paid by the State of Nevada, except when in the opinion of the administrative officer of the division mental health facility to which the client is admitted payment should be made for nonresident indigent clients and money is authorized pursuant to NRS 433.374 or 433B.230 and the money is authorized in approved budgets.
(Added to NRS by 1975, 1617; A 1993, 1241, 1972, 2724; 1995, 664)

NRS 433A.690 Claim against estate of deceased client.

Claims by a division mental health facility against the estates of deceased clients may be presented to the executor or administrator in the manner required by law, and shall be paid as preferred claims equal to claims for expenses of last illness. When a deceased person has been maintained at a division mental health facility at a rate less than the maximum usually charged, or the facility has incurred other expenses for the benefit of the person for which full payment has not been made, the estate of the person shall be liable if the estate is discovered within 5 years after the person's death.
(Added to NRS by 1975, 1617)

NRS 433A.701 Definitions.

As used in NRS 433A.701 to 433A.711, inclusive:

1. "Seal" means placing records in a separate file or other repository not accessible to the general public.

2. "Substantial remission" means that a person professionally qualified in the field of psychiatric mental health has evaluated the client and found, for at least 2 years, no evidence of continuing mental illness which would indicate the client's need for psychiatric medication, psychotherapy or other services related to his mental health.
(Added to NRS by 1987, 745)

Any person who is admitted to a public or private hospital or mental health facility in this state either voluntarily or as the result of a noncriminal proceeding, and who has been released as recovered or with his illness in substantial remission, may file a verified petition for the sealing of all court and clinical records relating to his admission and treatment.
(Added to NRS by 1987, 745)

1. Be filed with the district court of the county where the petitioner resides or, if the petitioner's admission was involuntary, with the district court which ordered the admission.

2. Set forth the facts bringing the petitioner within the purview of that section.

3. Be accompanied by the affidavit of a psychiatrist, psychologist or physician qualified in the field of psychiatric mental health who has examined the petitioner. The affidavit must:

(a) Summarize the professional qualifications of the affiant;
(b) Set forth the date or dates on which he examined the petitioner; and
(c) State that, in the opinion of the affiant, the petitioner has recovered or his illness is in substantial remission.

(Added to NRS by 1987, 745; A 1989, 1551)

1. Upon the filing of a petition, the court shall fix a time, not less than 10 days nor more than 30 days thereafter, for the hearing of the matter. The court shall direct the clerk to issue a notice, reciting briefly the substance of the petition, stating the time and date set for the hearing, and requiring the person served with the notice to appear before the court at the hearing if he desires to oppose the petition.

2. A copy of the notice, together with a copy of the petition, must be served by the petitioner upon the medical director of each hospital or mental health facility to which the petitioner was admitted.
(Added to NRS by 1987, 746)

1. At the time stated in the notice, or at the earliest time thereafter to which the hearing is postponed, the court shall proceed to hear the petition.

2. If, after the hearing, the court is satisfied that the matters set forth in the petition and supporting affidavit are true, and no reason appears to the contrary, the court shall order all court and clinical records relating to the petitioner's admission and treatment sealed.

3. The clerk shall send a certified copy of the order to each facility and hospital named therein. Each recipient of the order shall, within 5 days after receipt of the order:

(a) Seal all records in its custody, as directed by the order.
(b) Advise the court of its compliance.
(c) Seal the copy of the order that it received.

(Added to NRS by 1987, 746)

NRS 433A.711 Effect of sealing records; inspection after sealing.

1. If the court orders records of admission and treatment sealed pursuant to NRS 433A.709, the petitioner's admission is deemed never to have occurred, and the petitioner may answer accordingly any question related to its occurrence.

2. If the records are sealed, the petitioner may thereafter petition the court to permit inspection of the records by a person named in the petition and the court may order the inspection.

3. The court may, upon the application of a district attorney or an attorney representing the petitioner in a criminal action, permit an inspection of the records.

4. If, after the sealing of the records, the petitioner is being treated by a physician or licensed psychologist, the physician or psychologist may obtain a copy of the petitioner's records from the hospital or facility. Any records so obtained must be used solely for the treatment of the petitioner.
(Added to NRS by 1987, 746; A 1989, 1551)

Any public officer or employee who transports or delivers or assists in transporting or delivering or detains or assists in detaining any person pursuant to the provisions of this chapter shall not be rendered civilly or criminally liable thereby unless it is shown that such officer or employee acted maliciously or in bad faith or that his negligence resulted in bodily harm to such person.
(Added to NRS by 1975, 1609)

1. A person who:

(a) Without probable cause for believing a person to be mentally ill causes or conspires with or assists another to cause the involuntary court-ordered admission of the person under this chapter; or
(b) Causes or conspires with or assists another to cause the denial to any person of any right accorded to him under this chapter,

is guilty of a category D felony and shall be punished as provided in NRS 193.130.

2. Unless a greater penalty is provided in subsection 1, a person who knowingly and willfully violates any provision of this chapter regarding the admission of a person to, or discharge of a person from, a public or private mental health facility is guilty of a gross misdemeanor.

3. A person who, without probable cause for believing another person to be mentally ill, executes a petition, application or certificate pursuant to this chapter, by which the person secures or attempts to secure the apprehension, hospitalization, detention or restraint of the person alleged to be mentally ill, or any physician, psychiatrist or licensed psychologist who knowingly makes any false certificate or application pursuant to this chapter as to the mental condition of any person is guilty of a category D felony and shall be punished as provided in NRS 193.130.
(Added to NRS by 1975, 1608; A 1989, 1552; 1993, 2116; 1995, 1277)