The provisions of this chapter apply to all mental health centers of the Division of Public and Behavioral Health 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; 2013, 3013)
As used in this chapter, unless the context otherwise requires, the words and terms defined in NRS 433A.012 to 433A.0194, inclusive, have the meanings ascribed to them in those sections.  (Added to NRS by 1993, 2720; A 2013, 3488; 2019, 348; 2021, 3077)
"Administrative officer" means a person with overall executive and administrative responsibility for those state or nonstate facilities for mental health designated by the Administrator.  (Added to NRS by 1993, 2720; A 2013, 668, 3014)
"Administrator" means:  1. Except as otherwise provided in subsection 2, the Administrator of the Division of Public and Behavioral Health of the Department.  2. Regarding the provision of services for the mental health of children pursuant to chapter 433B of NRS, the Administrator of the Division of Child and Family Services of the Department.  (Added to NRS by 1993, 2720; A 1999, 101)
"Assisted outpatient treatment" means outpatient services provided pursuant to a court order to a person with a mental illness for the purpose of treating the mental illness, assisting the person to live and function in the community or to prevent a relapse or deterioration that may reasonably be predicted to result in harm to the person or another person if the person with a mental illness is not treated. The term does not include services provided to residents of a mental health facility.  (Added to NRS by 2013, 3486; A 2021, 3077)(Substituted in revision for NRS 433A.019)
"Consumer" means any person who, whether voluntarily or involuntarily, seeks and can benefit from care, treatment and training:  1. In a public or private mental health facility or other public or private facility offering mental health services; or  2. From a person professionally qualified in the field of psychiatric mental health who provides assisted outpatient treatment.  (Added to NRS by 2021, 3067)
"Division" means:  1. Except as otherwise provided in subsection 2, the Division of Public and Behavioral Health of the Department.  2. Regarding the provision of services for the mental health of children pursuant to chapter 433B of NRS, the Division of Child and Family Services of the Department.  (Added to NRS by 1993, 2720; A 1999, 102; 2013, 3014)
"Division facility" means:  1. Except as otherwise provided in subsection 2, any unit or subunit operated by the Division of Public and Behavioral Health of the Department for the care, treatment and training of consumers.  2. Any unit or subunit operated by the Division of Child and Family Services of the Department pursuant to chapter 433B of NRS.  (Added to NRS by 1993, 2721; A 1999, 102; 2011, 425)
"Emergency admission" means the involuntary admission of a person who has been placed on a mental health crisis hold to a public or private mental health facility or hospital pursuant to NRS 433A.162.  (Added to NRS by 2021, 3067)
"Involuntary court-ordered admission" means the admission of a person in a mental health crisis to a public or private mental health facility ordered by a court pursuant to NRS 433A.200 to 433A.330, inclusive.  (Added to NRS by 2021, 3067)
"Medical director" means the medical officer in charge of any program of the Division of Public and Behavioral Health of the Department.  (Added to NRS by 1993, 2721; A 1999, 102; 2013, 3014)
"Mental health crisis hold" means the detention of a person alleged to be a person in a mental health crisis for transport, assessment, evaluation, intervention and treatment pursuant to NRS 433A.160.  (Added to NRS by 2021, 3067)
  1. "Person in a mental health crisis" means any person:  (a) Who has a mental illness; and  (b) Whose capacity to exercise self-control, judgment and discretion in the conduct of the persons affairs and social relations or to care for his or her personal needs is diminished, as a result of the mental illness, to the extent that the person presents a substantial likelihood of serious harm to himself or herself or others, as determined pursuant to NRS 433A.0195.  2. The term does not include any person in whom that capacity is diminished by epilepsy, intellectual disability, dementia, delirium, brief periods of intoxication caused by alcohol or drugs, or dependence upon or addiction to alcohol or other substances, unless a mental illness that can be diagnosed is also present which contributes to the diminished capacity of the person.  (Added to NRS by 1985, 2268; A 1989, 1757; 1997, 3493; 2009, 333; 2013, 668, 3488; 2017, 1644; 2019, 348, 2618)(Substituted in revision for NRS 433A.115)
"Person professionally qualified in the field of psychiatric mental health" means:  1. A psychiatrist licensed to practice medicine in this State;  2. A psychologist licensed to practice in this State;  3. A social worker who holds a masters degree in social work and is licensed by the State as a clinical social worker;  4. A registered nurse who:  (a) Is licensed to practice professional nursing in this State; and  (b) Holds a masters degree in the field of psychiatric nursing;  5. A marriage and family therapist licensed pursuant to chapter 641A of NRS; or  6. A clinical professional counselor licensed pursuant to chapter 641A of NRS.  (Added to NRS by 1993, 2721; A 2007, 3086; 2021, 3077)
[Replaced in revision by NRS 433A.0135.]
"Supporter" has the meaning ascribed to it in NRS 162C.090.  (Added to NRS by 2021, 3067)
"Voluntary admission" means the admission of a person to a public or private mental health facility or a division facility pursuant to NRS 433A.140 as a voluntary consumer for the purposes of observation, diagnosis, care and treatment.  (Added to NRS by 2021, 3067)
For the purposes of this chapter, a person shall be deemed to present a substantial likelihood of serious harm to himself or herself or others if, without care or treatment, the person is at serious risk of:  1. Attempting suicide or homicide;  2. Causing bodily injury to himself or herself or others, including, without limitation, death, unconsciousness, extreme physical pain, protracted and obvious disfigurement or a protracted loss or impairment of a body part, organ or mental functioning; or  3. Incurring a serious injury, illness or death resulting from complete neglect of basic needs for food, clothing, shelter or personal safety.  (Added to NRS by 2019, 347)
The administrative officer of a facility of the Division must:  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, public health 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 persons in a mental health crisis.  (Added to NRS by 1975, 1599; A 1979, 813; 1981, 1685; 1983, 642; 1985, 2268; 1999, 2594; 2013, 668, 3014)
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 or her duties, the care and treatment of consumers 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 or her 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 or her orders or the enforcement of the provisions of this chapter and chapters 433, 433B and 433C of NRS 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 consumers if that responsibility has not been delegated.  (Added to NRS by 1975, 1600; A 1979, 813; 2011, 425; 2013, 3014)
Except as otherwise provided in NRS 284.143, an administrative officer shall devote his or her entire time to the duties of his or her position and shall have no other gainful employment or occupation, but the administrative officer may attend seminars, act as a consultant and give lectures relating to his or her 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. The coordinator of medical programs:  (a) 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.  (b) May be a psychiatrist or pediatrician in private practice under contract to the Division.  (c) Must have such additional qualifications as are in accordance with criteria prescribed by the Division of Human Resource Management of the Department of Administration 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 consumers, and administer or have administered the accepted and appropriate medical treatments to all consumers under his or her care, and may, by delegation of the administrative officer, be responsible for the nonmedical care and treatment of consumers; and  (c) Undertake any diagnostic, medical or surgical procedure in the interest of the consumer, 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; 2011, 425)
All applications, certificates and other forms for the detainment, evaluation, admission, treatment and conditional release of any person in the State of Nevada 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; A 2013, 3489; 2021, 3078)(Substituted in revision for NRS 433A.130)
There is hereby created a Revolving Account for Northern Nevada Adult Mental Health Services in the sum of $7,500, which may be used for the payment of bills requiring immediate payment and for no other purpose. The Administrative Officer 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 money appropriated for Northern Nevada Adult Mental Health Services as other claims against the State are paid.  (Added to NRS by 1975, 1612; A 1979, 815; 1991, 206; 1999, 1497; 2001, 1116)
  1. A gift account in the Department of Health and Human Services 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)
  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 consumers 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 consumers canteen privileges, and to provide for such other expenditures benefiting the consumers 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 consumers.  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; 2011, 426)
There are three types of admission to mental health facilities in the State of Nevada:  1. Voluntary admission;  2. Emergency admission; and  3. Involuntary court-ordered admission.  (Added to NRS by 1975, 1602)
[Replaced in revision by NRS 433A.085.]
  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 consumer 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 or her behalf by the persons 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 consumer if an examination by personnel of the facility qualified to make such a determination reveals that the person needs and may benefit from services offered by the mental health facility.  3. Any person admitted to a public or private mental health facility as a voluntary consumer must be released immediately after the filing of a written request for release with the responsible physician or that physicians designee within the normal working day, unless 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 consumer 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 consumer has recovered or has improved to such an extent that the consumer is not considered a danger to himself or herself or others and that the services of that facility are no longer beneficial to the consumer 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 the person 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 assisted outpatient treatment.  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; 2011, 426; 2019, 349; 2021, 3078)
  1. If a person in a mental health crisis is admitted to a public or private mental health facility or hospital as a voluntary consumer, the facility or hospital shall not change the status of the person to an emergency admission unless:  (a) A person described in NRS 433A.160 places the person on a mental health crisis hold; and   (b) The requirements prescribed by NRS 433A.162 have been met.  2. Except as otherwise provided in subsection 3, a person whose status is changed pursuant to subsection 1 must not be detained in excess of 72 hours, including weekends and holidays, after the person is placed on a mental health crisis hold pursuant to NRS 433A.160 unless, before the close of the business day on which the 72 hours expires, a written petition for an involuntary court-ordered admission to a mental health facility is filed with the clerk of the district court pursuant to NRS 433A.200, including, without limitation, the documents required pursuant to NRS 433A.210.  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; A 2009, 333; 2011, 427; 2015, 2990; 2019, 350; 2021, 3079)
  1. A person alleged to be a person in a mental health crisis who is placed on a mental health crisis hold pursuant to NRS 433A.160 may, subject to the provisions of subsection 2, be detained in a public or private mental health facility or hospital for assessment, evaluation, intervention and treatment, regardless of whether any parent or legal guardian of the person has consented to the mental health crisis hold.  2. Except as otherwise provided in subsection 3, a person detained pursuant to subsection 1 must be released within 72 hours, including weekends and holidays, after the person is placed on a mental health crisis hold pursuant to NRS 433A.160 unless, before the close of the business day on which the 72 hours expires, a written petition for an involuntary court-ordered admission to a mental health facility is filed with the clerk of the district court pursuant to NRS 433A.200, including, without limitation, the documents required pursuant to NRS 433A.210, or the status of the person is changed to a voluntary admission.  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 1975, 1602; A 1985, 2269; 1989, 1758; 2001, 3041; 2003, 1944; 2009, 334; 2013, 3489; 2019, 350, 2619; 2021, 3079)
  1. A person listed in subsection 2 may petition a district court for an order requiring any peace officer to place a person alleged to be in a mental health crisis on a mental health crisis hold pursuant to NRS 433A.160.  2. A petition pursuant to subsection 1 may be made by:  (a) An officer authorized to make arrests in the State of Nevada;  (b) A physician, physician assistant, psychologist, marriage and family therapist, clinical professional counselor, social worker or registered nurse;  (c) The spouse, parent, adult child or legal guardian of a person alleged to be a person in a mental health crisis;   (d) A person who is providing case management, support and supervision to a person who has been conditionally released pursuant to NRS 433A.380, including, without limitation, a member of the staff of a community treatment program, social services agency, mobile crisis team or multi-disciplinary team that is providing case management, support and supervision to the person who is the subject of the petition; or  (e) Any other person who has a legitimate interest in a person alleged to be a person in a mental health crisis.   3. The district court may issue an order to place a person alleged to be in a mental health crisis on a mental health crisis hold only if it is satisfied that there is probable cause to believe that the person who is the subject of the petition is a person in a mental health crisis. If the district court issues such an order, the court shall ensure the delivery of the order to the sheriff of the county. The sheriff shall:  (a) Provide the order to the public or private mental health facility or hospital to which the person placed on a mental health crisis hold is transported; or   (b) Arrange for the person who transports the person placed on a mental health crisis hold to a public or private mental health facility or hospital to provide the order to the facility or hospital.  (Added to NRS by 2021, 3067)
  1. An officer authorized to make arrests in the State of Nevada or a physician, physician assistant, psychologist, marriage and family therapist, clinical professional counselor, social worker or registered nurse who, based on his or her personal observation of a person or the issuance of a court order pursuant to NRS 433A.155, has probable cause to believe that the person is a person in a mental health crisis, may place the person on a mental health crisis hold by:  (a) Taking the person into custody without a warrant for assessment, evaluation, intervention and treatment at a public or private mental health facility or hospital; and  (b) Completing and providing to the public or private mental health facility or hospital the form prescribed pursuant to NRS 433A.085 for the placement of a person on a mental health crisis hold. The form must set forth the circumstances under which the person was taken into custody and the reasons therefor.  2. A person who places another person on a mental health crisis hold pursuant to subsection 1 may transport that person to a public or private mental health facility or hospital or arrange for the person to be transported by:  (a) A local law enforcement agency;  (b) A system for the nonemergency medical transportation of persons whose operation is authorized by the Nevada Transportation Authority;  (c) An entity that is exempt pursuant to NRS 706.745 from the provisions of NRS 706.386 or 706.421;  (d) An accredited agent of the Division;  (e) A provider of nonemergency secure behavioral health transport services licensed under the regulations adopted pursuant to NRS 433.3317; or  (f) If medically necessary, an ambulance service that holds a permit issued pursuant to the provisions of chapter 450B of NRS.  3. To the extent practicable, a person described in subsection 1 shall attempt to obtain the consent of the parent or guardian of an unemancipated person who is less than 18 years of age before placing the person on a mental health crisis hold. The person who places an unemancipated person who is less than 18 years of age on a mental health crisis hold or, if the person is acting within the scope of his or her employment, the employer of the person, shall maintain documentation of each such attempt until the person who is placed on a mental health crisis hold reaches at least 23 years of age.  4. The State Board of Health shall adopt regulations governing the manner in which:  (a) A person may apply to become an accredited agent of the Division; and  (b) Accredited agents of the Division will be monitored and disciplined for professional misconduct.  5. As used in this section, "an accredited agent of the Division" means any person authorized by the Division to transport to a mental health facility pursuant to paragraph (d) of subsection 2 those persons being placed on a mental health crisis hold.  (Added to NRS by 1975, 1603; A 1983, 506; 1985, 2269; 1989, 1759; 1997, 3494; 2001, 1017, 3042; 2005, 967; 2007, 3087; 2015, 2990; 2017, 1748; 2019, 351, 1924, 2619; 2021, 3080)
  1. A public or private mental health facility or hospital may admit a person who has been placed on a mental health crisis hold under an emergency admission if:  (a) After conducting an examination pursuant to NRS 433A.165, a physician, physician assistant or advanced practice registered nurse determines that the person does not have a medical condition, other than a psychiatric condition, which requires immediate treatment;  (b) A psychologist, a physician, a physician assistant under the supervision of a psychiatrist, a clinical social worker who has the psychiatric training and experience prescribed by the Board of Examiners for Social Workers pursuant to NRS 641B.160 or an advanced practice registered nurse who has the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120, who is employed by the public or private mental health facility or hospital completes a certificate pursuant to NRS 433A.170;  (c) A psychiatrist or a psychologist or, if a psychiatrist or a psychologist is not available, a physician or an advanced practice registered nurse who has the training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120, evaluates the person at the time of admission and determines that the person is a person in a mental health crisis; and  (d) A psychiatrist approves the admission.  2. The provisions of subsections 2 and 3 of NRS 433A.150 continue to apply to a person who is admitted to a public or private mental health facility or hospital under an emergency admission pursuant to this section.  (Added to NRS by 2021, 3068)
  1. Before a person alleged to be a person in a mental health crisis may be admitted to a public or private mental health facility or hospital under an emergency admission pursuant to NRS 433A.162, the person must:  (a) First be examined by a licensed physician or physician assistant licensed pursuant to chapter 630 or 633 of NRS or an advanced practice registered nurse licensed pursuant to NRS 632.237 at any location where such a physician, physician assistant or advanced practice registered nurse is authorized to conduct such an examination to determine whether the person has a medical condition, other than a psychiatric condition, which requires immediate treatment; and  (b) If such treatment is required, be admitted for the appropriate medical care:  (1) To a hospital if the person is in need of emergency services or care; or  (2) To another appropriate medical facility if the person is not in need of emergency services or care.  2. If a person alleged to be a person in a mental health crisis has a medical condition in addition to a psychiatric condition which requires medical treatment that requires more than 72 hours to complete, the licensed physician, physician assistant or advanced practice registered nurse who examined the person must:  (a) On the first business day after determining that such medical treatment is necessary, file with the clerk of the district court a written petition for the involuntary court-ordered admission of the person to a public or private mental health facility pursuant to NRS 433A.200 after the medical treatment has been completed. The petition must:  (1) Include, without limitation, the medical condition of the person and the purpose for continuing the medical treatment of the person; and  (2) Be accompanied by a copy of:  (I) The form for the placement of a person on a mental health crisis hold completed pursuant to NRS 433A.160; and   (II) The certificate completed pursuant to NRS 433A.170, unless the medical condition prevents the completion of such a certificate.  (b) Seven days after filing a petition pursuant to paragraph (a) and every 7 days thereafter, file with the clerk of the district court an update on the medical condition and treatment of the person.  3. The examination and any transfer of the person from a facility when the person has an emergency medical condition and has not been stabilized must be conducted in compliance with:  (a) The requirements of 42 U.S.C.  1395dd and any regulations adopted pursuant thereto, and must involve a person authorized pursuant to federal law to conduct such an examination or certify such a transfer; and  (b) The provisions of NRS 439B.410.  4. The cost of the examination must be paid by the county in which the person alleged to be a person in a mental health crisis resides if services are provided at a county hospital located in that county or a hospital or other medical facility designated by that county, unless the cost is voluntarily paid by the person alleged to be a person in a mental health crisis or, on the persons behalf, by his or her insurer or by a state or federal program of medical assistance.  5. 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.  6. The cost of treatment, including hospitalization, for a person who is indigent must be paid pursuant to NRS 428.010 by the county in which the person alleged to be a person in a mental health crisis resides.  7. The provisions of this section do not require the Division to provide examinations required pursuant to subsection 1 at a division facility if the Division does not have the:  (a) Appropriate staffing levels of physicians, physician assistants, advanced practice registered nurses or other appropriate staff available at the facility as the Division determines is necessary to provide such examinations; or  (b) Appropriate medical laboratories as the Division determines is necessary to provide such examinations.  8. The State Board of Health shall adopt regulations to carry out the provisions of this section, including, without limitation, regulations that:  (a) Define "emergency services or care" as that term is used in this section;  (b) Prescribe a procedure to ensure that an examination is performed pursuant to paragraph (a) of subsection 1; and  (c) Prescribe the type of medical facility that a person may be admitted to pursuant to subparagraph (2) of paragraph (b) of subsection 1.  9. As used in this section, "medical facility" has the meaning ascribed to it in NRS 449.0151.  (Added to NRS by 1987, 1445; A 1991, 2209; 1993, 908; 2001, 1018; 2003, 1453, 1944; 2007, 1855; 2009, 334; 2013, 2080; 2019, 352; 2021, 3082)
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 a person for an emergency admission under NRS 433A.162 unless a psychologist, a physician, a physician assistant under the supervision of a psychiatrist, a clinical social worker who has the psychiatric training and experience prescribed by the Board of Examiners for Social Workers pursuant to NRS 641B.160 or an advanced practice registered nurse who has the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120 completes a certificate stating that he or she has examined the person alleged to be a person in a mental health crisis and that he or she has concluded that the person is a person in a mental health crisis. The certificate required by this section may be obtained from a psychologist, physician, physician assistant, clinical social worker or advanced practice registered nurse who is employed by the public or private mental health facility or hospital to which the person alleged to be a person in a mental health crisis is to be admitted.  (Added to NRS by 1975, 1603; A 1985, 2270; 1989, 1550, 1759; 1997, 3495; 2001, 3043; 2015, 2991; 2019, 354; 2021, 3083)
As soon as practicable but not more than 8 hours after an unemancipated person who is under 18 years of age is placed on a mental health crisis hold, the administrative officer of the public or private mental health facility or hospital in which the person is being held or his or her designee shall attempt to give notice of the mental health crisis hold in person, by telephone or facsimile and by certified mail to the parent or legal guardian of that person and shall maintain documentation of each such attempt until the person who is placed on a mental health crisis hold reaches at least 23 years of age.  (Added to NRS by 2019, 2617; A 2021, 3084)
  1. The administrative officer of a public or private mental health facility or hospital shall ensure that, within 24 hours of the emergency admission of a person alleged to be a person in a mental health crisis who is at least 18 years of age, the person is asked to give permission to provide notice of the emergency admission to a family member, friend or other person identified by the person.  2. If a person alleged to be a person in a mental health crisis who is at least 18 years of age gives permission to notify a family member, friend or other person of the emergency admission, the administrative officer shall ensure that:  (a) The permission is recorded in the medical record of the person; and  (b) Notice of the admission is promptly provided to the family member, friend or other person in person or by telephone, facsimile, other electronic communication or certified mail.  3. Except as otherwise provided in subsections 4 and 5, if a person alleged to be a person in a mental health crisis who is at least 18 years of age does not give permission to notify a family member, friend or other person of the emergency admission of the person, notice of the emergency admission must not be provided until permission is obtained.  4. If a person alleged to be a person in a mental health crisis who is at least 18 years of age is not able to give or refuse permission to notify a family member, friend or other person of the emergency admission, the administrative officer of the mental health facility or hospital may cause notice as described in paragraph (b) of subsection 2 to be provided if the administrative officer determines that it is in the best interest of the person in a mental health crisis.  5. If a guardian has been appointed for a person alleged to be a person in a mental health crisis who is at least 18 years of age or the person has executed a durable power of attorney for health care pursuant to NRS 162A.700 to 162A.870, inclusive, or appointed an attorney-in-fact using an advance directive for psychiatric care pursuant to NRS 449A.600 to 449A.645, inclusive, the administrative officer of the mental health facility or hospital must ensure that the guardian, agent designated by the durable power of attorney or the attorney-in-fact, as applicable, is promptly notified of the admission as described in paragraph (b) of subsection 2, regardless of whether the person alleged to be a person in a mental health crisis has given permission to the notification.  (Added to NRS by 1975, 1604; A 1993, 2114; 2009, 1667; 2019, 354, 2621; 2021, 3084)
  1. A licensed physician on the medical staff of a facility operated by the Division or of any other public or private mental health facility or hospital may release a person from a mental health crisis hold upon completion of a certificate which meets the requirements of NRS 433A.197 signed by a licensed physician on the medical staff of the facility or hospital, a physician assistant under the supervision of a psychiatrist, psychologist, a clinical social worker who has the psychiatric training and experience prescribed by the Board of Examiners for Social Workers pursuant to NRS 641B.160 or an advanced practice registered nurse who has the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120 stating that he or she has personally observed and examined the person and that he or she has concluded that the person is not a person in a mental health crisis.  2. A psychologist, a physician, a physician assistant under the supervision of a psychiatrist, a clinical social worker who has the psychiatric training and experience prescribed by the Board of Examiners for Social Workers pursuant to NRS 641B.160 or an advanced practice registered nurse who has the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120 on the medical staff of a facility operated by the Division or of any other public or private mental health facility or hospital who has personally assessed an unemancipated person who is less than 18 years of age after the person was placed on a mental health crisis hold may release the person from the hold if the parent or guardian of the person agrees to treatment or accepts physical custody of the person.  (Added to NRS by 2009, 332; A 2015, 2992; 2019, 355; 2021, 3085)
  1. A form or certificate authorized under subsection 1 of NRS 433A.160 or NRS 433A.170 or 433A.195 must not be accepted or considered if made by a psychologist, physician, physician assistant, clinical social worker or advanced practice registered nurse who is related by blood or marriage within the second degree of consanguinity or affinity to the person alleged to be a person in a mental health crisis, or who is financially interested in the facility in which the person alleged to be a person in a mental health crisis is to be detained.  2. An application or certificate of any examining person authorized under NRS 433A.170 must not be considered unless it is based on personal observation and examination of the person alleged to be a person in a mental health crisis made by such examining person not more than 72 hours prior to the making of the application or certificate. The certificate required pursuant to NRS 433A.170 must set forth in detail the facts and reasons on which the examining person based his or her opinions and conclusions.  3. A certificate authorized pursuant to NRS 433A.195 must not be considered unless it is based on personal observation and examination of the person alleged to be a person in a mental health crisis made by the examining physician, physician assistant, psychologist, clinical social worker or advanced practice registered nurse. The certificate authorized pursuant to NRS 433A.195 must describe in detail the facts and reasons on which the examining physician, physician assistant, psychologist, clinical social worker or advanced practice registered nurse based his or her opinions and conclusions.  (Added to NRS by 1975, 1603; A 1989, 1550; 2009, 336; 2015, 2992; 2019, 355; 2021, 3085)
  1. Except as otherwise provided in NRS 432B.6075, a proceeding for an involuntary court-ordered admission of any person in the State of Nevada may be commenced by the filing of a petition for the involuntary admission to a mental health facility with the clerk of the district court of the county where the person who is to be treated resides or the county where a mental health facility that is willing to admit the person is located. The petition may be filed by any physician, physician assistant, psychologist, social worker or registered nurse or by any officer authorized to make arrests in the State of Nevada. The petition must be accompanied:  (a) By a certificate of a physician, a psychologist, a physician assistant under the supervision of a psychiatrist, a clinical social worker who has the psychiatric training and experience prescribed by the Board of Examiners for Social Workers pursuant to NRS 641B.160 or an advanced practice registered nurse who has the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120 stating that he or she has examined the person alleged to be a person in a mental health crisis and has concluded that the person is a person in a mental health crisis; or  (b) By a sworn written statement by the petitioner that:  (1) The petitioner has, based upon the petitioners personal observation of the person alleged to be a person in a mental health crisis, probable cause to believe that the person is a person in a mental health crisis and the person alleged to be a person in a mental health crisis has refused to submit to examination or treatment by a physician, psychiatrist, psychologist or advanced practice registered nurse who has the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120; or  (2) The person alleged to be a person in a mental health crisis has been placed on a mental health crisis hold pursuant to NRS 433A.160 and the physician, physician assistant or advanced practice registered nurse who examined the person alleged to be a person with a mental health crisis pursuant to NRS 433A.165 determined that the person has a medical condition, other than a psychiatric condition, which requires immediate treatment.  2. Except as otherwise provided in NRS 432B.6075, if the person to be treated is an unemancipated minor and the petitioner is a person other than a parent or guardian of the minor, a petition submitted pursuant to subsection 1 must, in addition to the certificate or statement required by that subsection, include a statement signed by a parent or guardian of the minor that the parent or guardian does not object to the filing of the petition.  (Added to NRS by 1975, 1604; A 1985, 54, 2270; 1989, 1551, 1760; 1995, 2413; 2001, 3044; 2005, 1322; 2013, 3489; 2015, 2993; 2017, 1749, 3004; 2019, 356; 2021, 3086)
In addition to the requirements of NRS 433A.200, a petition filed pursuant to that section with the clerk of the district court to commence proceedings for involuntary court-ordered admission of a person pursuant to NRS 433A.145 or 433A.150 must include documentation of the results of the medical examination conducted pursuant to NRS 433A.165 and a copy of:  1. The form for the placement of the person on a mental health crisis hold pursuant to NRS 433A.160; and  2. A petition executed by a psychiatrist, psychologist, physician or advanced practice registered nurse who has the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120, including, without limitation, a sworn statement that:  (a) He or she has examined the person alleged to be a person in a mental health crisis;  (b) In his or her opinion, there is a reasonable degree of certainty that the person alleged to be a person in a mental health crisis suffers from a mental illness;  (c) Based on his or her personal observation of the person alleged to be a person in a mental health crisis and other facts set forth in the petition, the person presents a substantial risk of serious harm to himself or herself or others, as determined pursuant to NRS 433A.0195; and  (d) In his or her opinion, involuntary admission of the person alleged to be a person in a mental health crisis to a mental health facility or hospital is medically necessary to prevent the person from harming himself or herself or others.  (Added to NRS by 1975, 1604; A 1985, 2270; 1989, 1551, 1760; 1995, 2414; 2001, 3044; 2017, 1750; 2019, 357; 2021, 3087)
If an application for a writ of habeas corpus is made by, or on behalf of, a person in a mental health crisis or who is alleged to be a person in a mental health crisis before the initial hearing on a petition for the involuntary court-ordered admission of the person to a mental health facility, the court must conduct a hearing on the application as soon as practicable.  (Added to NRS by 2017, 1644; A 2021, 3087)
  1. Immediately after the clerk of the district court receives any petition filed pursuant to NRS 433A.200 and 433A.210, the clerk shall transmit the petition to the appropriate district judge, who shall set a time, date and place for its hearing. The date must be within 6 judicial days after the date on which the petition is received by the clerk unless otherwise stipulated by an attorney representing the person alleged to be a person in a mental health crisis and the district attorney. If the Chief Judge, if any, of the district court has assigned a district court judge or hearing master to preside over such hearings, that judge or hearing master must preside over the hearing.  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 or her attorney, if known, the persons legal guardian, 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 in a mental health crisis and the administrative office of any public or private mental health facility or hospital in which the subject of the petition is detained.  3. The provisions of this section do not preclude a facility or hospital from discharging a person before the time set pursuant to this section for the hearing concerning the person, if appropriate. If the person has a legal guardian, the facility or hospital shall notify the guardian prior to discharging the person from the facility or hospital. The legal guardian has discretion to determine where the person will be released, taking into consideration any discharge plan proposed by the facility or hospital assessment team. If the legal guardian does not inform the facility or hospital as to where the person will be released within 3 days after the date of notification, the facility or hospital shall discharge the person according to its proposed discharge plan. Notification of a guardian pursuant to this subsection must be provided:  (a) In person or by telephone; or  (b) If the mental health facility is not able to contact the guardian in person or by telephone, by facsimile, electronic mail or certified mail.  4. If the person who is the subject of the petition is currently admitted to a mental health facility or hospital and is transferred to another mental health facility or hospital, the petitioner must notify the court before the next scheduled hearing related to the petition and not more than 24 hours after the transfer.  5. If the person who is the subject of the petition is currently on conditional release pursuant to NRS 433A.380:  (a) The court may provide information on the conditional release to any public or private mental health facility or hospital in which the person is receiving treatment; and  (b) The court may, with the consent of the parties, set a hearing before or concurrent with the hearing scheduled pursuant to subsection 1 to determine whether conditional release remains appropriate. If the court sets a hearing to resolve the conditional release, the parties may stipulate to continue the matter of the petition for involuntary court-ordered admission pending resolution of the conditional release. If the court determines by clear and convincing evidence that conditional release is no longer appropriate, the court may order the admission of the person to a mental health facility or hospital pending the resolution of the petition for involuntary court-ordered admission.  (Added to NRS by 1975, 1604; A 1989, 1760; 1993, 2114; 1995, 2414; 1997, 3495; 2001, 3045; 2009, 1667; 2017, 3005; 2019, 357; 2021, 3087)
The court in its discretion may require any petitioner under NRS 433A.200, except 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 a person in a mental health crisis 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; A 2019, 358)
  1. After the filing of a petition to commence proceedings for the involuntary court-ordered admission of a person pursuant to NRS 433A.200 and 433A.210, the court shall promptly cause two or more physicians, psychologists or advanced practice registered nurses who have the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120, one of whom must always be a physician, to examine the person alleged to be a person in a mental health crisis, or request an evaluation by an evaluation team from the Division of the person alleged to be a person in a mental health crisis.  2. Subject to the provisions in subsection 1, the judge assigned to hear a proceeding brought pursuant to NRS 433A.200 to 433A.330, inclusive, shall have complete discretion in selecting the medical professionals to conduct the examination required pursuant to subsection 1.  3. To conduct the examination of a person who is not being detained at a mental health facility or hospital under a mental health crisis hold pursuant to NRS 433A.160, the court may order a peace officer to take the person into protective custody and transport the person to a mental health facility or hospital where the person may be detained until a hearing is had upon the petition or motion, as applicable.  4. If the person is not being detained under a mental health crisis hold pursuant to NRS 433A.160, the person may be allowed to remain in his or her home or other place of residence pending an ordered examination or examinations and to return to his or her home or other place of residence upon completion of the examination or examinations. The person may be accompanied by one or more of his or her relations or friends to the place of examination.  5. Each physician, psychologist and advanced practice registered nurse who examines a person pursuant to subsection 1 shall, in conducting such an examination, consider the least restrictive treatment appropriate for the person.  6. Each physician, psychologist and advanced practice registered nurse who examines a person pursuant to subsection 1 shall, not later than 24 hours before the hearing set pursuant to subsection 1 of NRS 433A.220, submit to the court in writing a summary of his or her findings and evaluation regarding the person alleged to be a person in a mental health crisis.  (Added to NRS by 1975, 1604; A 1983, 507; 1989, 1760; 1995, 2414; 2001, 3045; 2013, 3490; 2017, 1645, 1750, 3005; 2021, 3088)
  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; 2013, 3491; 2021, 3089)
  1. If a petition is filed pursuant to NRS 433A.200 with the clerk of the district court in a county where the examining personnel required pursuant to NRS 433A.240 are not available, the district court must transfer the case to the nearest county having such examining personnel available before any hearing on the petition and not later than 1 judicial day after the petition was filed. Not later than 6 days after a case is transferred to a district court pursuant to this subsection, that district court shall:  (a) Set a time, date and place for its hearing in accordance with NRS 433A.220; and  (b) Appoint counsel for the person, if required by NRS 433A.270.  2. The entire expense of proceedings for involuntary court-ordered admission shall be paid by the county where the person to be admitted resides.  (Added to NRS by 1975, 1605; A 2021, 3089)
  1. The person alleged to be a person in a mental health crisis or any relative or friend on the persons behalf is entitled to retain counsel to represent the person in any proceeding before the district court relating to involuntary court-ordered admission, and if he or she fails or refuses to obtain counsel, the court must advise the person and the persons guardian or next of kin, if known, of such right to counsel and shall appoint counsel.  2. The court shall award any counsel appointed pursuant to subsection 1 compensation for his or her services in an amount determined by it to be fair and reasonable. The compensation must be charged against the estate of the person for whom the counsel was appointed or, if the person is indigent, against the county where the person alleged to be a person in a mental health crisis last resided.  3. The court shall, at the request of counsel representing the person alleged to be a person in a mental health crisis in proceedings before the court relating to involuntary court-ordered admission, grant a recess in the proceedings for the shortest time possible, but for not more than 5 days, to give the counsel an opportunity to prepare his or her case.  4. Each district attorney or his or her deputy shall appear and represent the State in all involuntary court-ordered admission proceedings in the district attorneys 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 and 433A.210.  (Added to NRS by 1975, 1605; A 2001, 3046; 2013, 3491; 2021, 2271, 3090)
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 a person in a mental health crisis and the certificates of physicians, certified psychologists or advanced practice registered nurses accompanying the petition, if applicable. The court may consider testimony relating to any past actions of the person alleged to be a person in a mental health crisis if such testimony is probative of the question of whether the person is presently a person in a mental health crisis.  (Added to NRS by 1975, 1606; A 1999, 120; 2017, 1751, 3006; 2019, 358)
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)
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. Except as otherwise provided in NRS 432B.6076 and 432B.6077, if the district court finds, after proceedings for the involuntary court-ordered admission of a person:  (a) That there is not clear and convincing evidence that the person with respect to whom the hearing was held is a person in a mental health crisis, the court must enter its finding to that effect and the person must not be involuntarily admitted to a public or private mental health facility. If the person has been detained in a public or private mental health facility or hospital under a mental health crisis hold pursuant to NRS 433A.160, including, without limitation, where the person has been admitted under an emergency admission pursuant to NRS 433A.162, the court must issue a written order requiring the facility or hospital to release the person not later than 24 hours after the court issues the order, unless the person applies for admission as a voluntary consumer pursuant to NRS 433A.140.  (b) That there is clear and convincing evidence that the person with respect to whom the hearing was held is a person in a mental health crisis, the court may order the involuntary admission of the person to a public or private mental health facility. 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. Except as otherwise provided in NRS 432B.608, 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 after a determination by the physician primarily responsible for treating the patient, a psychiatrist or an advanced practice registered nurse as provided for in subsection 3 of NRS 433A.390. Except as otherwise provided in NRS 432B.608, at the end of the involuntary court-ordered admission, the Division or any mental health facility that is not operated by the Division may petition to renew the involuntary admission of the person for additional periods not to exceed 6 months each. For each renewal, the petition must include evidence which meets the same standard set forth in subsection 1 that was required for the initial period of admission of the person to a public or private mental health facility.  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, including assisted outpatient treatment, 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.  4. If the court issues an order involuntarily admitting a person to a public or private mental health facility pursuant to this section, the court must, notwithstanding the provisions of NRS 433A.715, cause, within 5 business days after the order becomes final pursuant to this section, on a form prescribed by the Department of Public Safety, a record of the order to be transmitted to:  (a) The Central Repository for Nevada Records of Criminal History, along with a statement indicating that the record is being transmitted for inclusion in each appropriate database of the National Instant Criminal Background Check System; and  (b) Each law enforcement agency of this State with which the court has entered into an agreement for such transmission, along with a statement indicating that the record is being transmitted for inclusion in each of this States appropriate databases of information relating to crimes.  5. After issuing an order pursuant to this section, a court shall not transfer the case to another court.  6. A public or private mental health facility to which a person is involuntarily admitted pursuant to this section shall notify the court and the counsel for the person if the person is transferred to another facility.  7. As used in this section, "National Instant Criminal Background Check System" has the meaning ascribed to it in NRS 179A.062.  (Added to NRS by 1975, 1606; A 1981, 1134; 1983, 508; 1989, 1761; 1993, 2115; 2001, 3046; 2005, 1323; 2009, 2491; 2013, 3492; 2015, 1815; 2017, 1646, 3006; 2021, 3090)
Repealed. (See chapter 481, Statutes of Nevada 2021, at page 3116.)
The order for involuntary court-ordered admission of any person to a public or private mental health facility must 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; A 2013, 3493; 2021, 3093)
Repealed. (See chapter 481, Statutes of Nevada 2021, at page 3116.)
Repealed. (See chapter 481, Statutes of Nevada 2021, at page 3116.)
When an involuntary court admission to a mental health facility is ordered under the provisions of this chapter, the involuntarily admitted person, together with the court orders and certificates of the physicians, certified psychologists, advanced practice registered nurses 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, must be delivered to the sheriff of the county who shall:  1. Transport the person; or  2. Arrange for the person to be transported by:  (a) A system for the nonemergency medical transportation of persons whose operation is authorized by the Nevada Transportation Authority;  (b) A provider of nonemergency secure behavioral health transport services licensed under the regulations adopted pursuant to NRS 433.3317; or  (c) If medically necessary, an ambulance service that holds a permit issued pursuant to the provisions of chapter 450B of NRS,  to the appropriate public or private mental health facility.  (Added to NRS by 1975, 1607; A 2001, 1018; 2013, 3493; 2017, 1751; 2019, 361, 1925)
  1. A proceeding for an order requiring any person in the State of Nevada to receive assisted outpatient treatment may be commenced by the filing of a petition for such an order with the clerk of the district court of the county where the person who is to be treated is present. The petition may be filed by:  (a) Any person who is at least 18 years of age and resides with the person to be treated;  (b) The spouse, parent, adult sibling, adult child or legal guardian of the person to be treated;  (c) A physician, physician assistant, psychologist, social worker or registered nurse who is providing care to the person to be treated;  (d) The Administrator or his or her designee; or  (e) The medical director of a division facility in which the person is receiving treatment or the designee of the medical director of such a division facility.  2. A proceeding to require a person who is the defendant in a criminal proceeding in the district court to receive assisted outpatient treatment may be commenced by the district court, on its own motion, or by motion of the defendant or the district attorney if:  (a) The defendant has been examined in accordance with NRS 178.415;  (b) The defendant is not eligible for commitment to the custody of the Administrator pursuant to NRS 178.461; and  (c) The Division makes a clinical determination that assisted outpatient treatment is appropriate.  3. A petition filed pursuant to subsection 1 or a motion made pursuant to subsection 2 must allege the following concerning the person to be treated:  (a) The person is at least 18 years of age.  (b) The person has a mental illness.  (c) The person has a history of poor compliance with treatment for his or her mental illness that has resulted in at least one of the following circumstances:  (1) At least twice during the immediately preceding 48 months, poor compliance with mental health treatment has been a significant factor in causing the person to be hospitalized or receive services in the behavioral health unit of a detention facility or correctional facility. The 48-month period described in this subparagraph must be extended by any amount of time that the person has been hospitalized, incarcerated or detained during that period.  (2) Poor compliance with mental health treatment has been a significant factor in causing the person to commit, attempt to commit or threaten to commit serious physical harm to himself or herself or others during the immediately preceding 48 months. The 48-month period described in this subparagraph must be extended by any amount of time that the person has been hospitalized, incarcerated or detained during that period.  (3) Poor compliance with mental health treatment has resulted in the person being hospitalized, incarcerated or detained for a cumulative period of at least 6 months and the person:  (I) Is scheduled to be discharged or released from such hospitalization, incarceration or detention during the 30 days immediately following the date of the petition; or  (II) Has been discharged or released from such hospitalization, incarceration or detention during the 60 days immediately preceding the date of the petition.   (d) Because of his or her mental illness, the person is unwilling or unlikely to voluntarily participate in outpatient treatment that would enable the person to live safely in the community without the supervision of the court.  (e) Assisted outpatient treatment is the least restrictive appropriate means to prevent further disability or deterioration that would result in the person becoming a person in a mental health crisis.  4. A petition filed pursuant to subsection 1 or a motion made pursuant to subsection 2 must be accompanied by:  (a) A sworn statement or a declaration that complies with the provisions of NRS 53.045 by a physician, a psychologist, a physician assistant under the supervision of a psychiatrist, a clinical social worker who has the psychiatric training and experience prescribed by the Board of Examiners for Social Workers pursuant to NRS 641B.160 or an advanced practice registered nurse who has the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120, stating that he or she:  (1) Evaluated the person who is the subject of the petition or motion not earlier than 10 days before the filing of the petition or making of the motion;  (2) Recommends that the person be ordered to receive assisted outpatient treatment; and  (3) Is willing and able to testify at a hearing on the petition or motion; and  (b) A sworn statement or a declaration that complies with the provisions of NRS 53.045 from a person professionally qualified in the field of psychiatric mental health stating that he or she is willing to provide assisted outpatient treatment for the person in the county where the person resides.  5. A copy of the petition filed pursuant to subsection 1 or the motion made pursuant to subsection 2 must be served upon the person who is the subject of the petition or motion or his or her counsel and, if applicable, his or her legal guardian.  (Added to NRS by 2021, 3068)
  1. Immediately after the clerk of the district court receives a petition filed pursuant to subsection 1 of NRS 433A.335 or NRS 433A.345, the clerk shall transmit the petition to the appropriate district judge, who shall set a time, date and place for its hearing. Immediately after a motion is made pursuant to subsection 2 of NRS 433A.335, the district judge shall set a time, date and place for its hearing. The date must be:  (a) Within 30 judicial days after the date on which the petition is received by the clerk or the motion is made, as applicable; or  (b) If the person who is the subject of the petition or motion is hospitalized at the time of the petition or motion, before that person is to be discharged and within a sufficient time to arrange for a continuous transition from inpatient treatment to assisted outpatient treatment.  2. If the Chief Judge, if any, of the district court has assigned a district court judge or hearing master to preside over hearings pursuant to this section, that judge or hearing master must preside over the hearing.  3. The court shall give notice of the petition or motion and of the time, date and place of any proceedings thereon to the person who is the subject of the petition or motion, his or her attorney, if known, the persons legal guardian, the petitioner, if applicable, the district attorney of the county in which the court has its principal office, the local office of an agency or organization that receives money from the Federal Government pursuant to 42 U.S.C.  10801 et seq. to protect and advocate the rights of persons with a mental illness and the administrative office of any public or private mental health facility or hospital in which the subject of the petition or motion is detained.  (Added to NRS by 2021, 3070)
  1. Before the date of a hearing on a petition or motion for assisted outpatient treatment, the person who made the sworn statement or declaration pursuant to paragraph (a) of subsection 4 of NRS 433A.335, the personnel of the Division who made the clinical determination concerning the appropriateness of assisted outpatient treatment pursuant to paragraph (c) of subsection 2 of NRS 433A.335 or the person or entity who submitted the petition pursuant to NRS 433A.345, as applicable, shall submit to the court a proposed written treatment plan created by a person professionally qualified in the field of psychiatric mental health who is familiar with the person who is the subject of the petition or motion, as applicable. The proposed written treatment plan must set forth:   (a) The services and treatment recommended for the person who is the subject of the petition or motion; and  (b) The person who will provide such services and treatment and his or her qualifications.   2. Services and treatment set forth in a proposed written treatment plan must include, without limitation:  (a) Case management services to coordinate the assisted outpatient treatment recommended pursuant to paragraph (b); and   (b) Assisted outpatient treatment which may include, without limitation:  (1) Medication;  (2) Periodic blood or urine testing to determine whether the person is receiving such medication;  (3) Individual or group therapy;  (4) Full-day or partial-day programming activities;  (5) Educational activities;  (6) Vocational training;  (7) Treatment and counseling for a substance use disorder;  (8) If the person has a history of substance use, periodic blood or urine testing for the presence of alcohol or other recreational drugs;  (9) Supervised living arrangements; and  (10) Any other services determined necessary to treat the mental illness of the person, assist the person in living or functioning in the community or prevent a deterioration of the mental or physical condition of the person.  3. A person professionally qualified in the field of psychiatric mental health who is creating a proposed written treatment plan pursuant to subsection 1 shall:  (a) Consider any wishes expressed by the person who is to be treated in an advance directive for psychiatric care executed pursuant to NRS 449A.600 to 449A.645, inclusive; and  (b) Consult with the person who is to be treated, any providers of health care who are currently treating the person, any supporter or legal guardian of the person, and, upon the request of the person, any other person concerned with his or her welfare, including, without limitation, a relative or friend.  4. If a proposed written treatment plan includes medication, the plan must specify the type and class of the medication and state whether the medication is to be self-administered or administered by a specific provider of health care. A proposed written treatment plan must not recommend the use of physical force or restraints to administer medication.  5. If a proposed written treatment plan includes periodic blood or urine testing for the presence of alcohol or other recreational drugs, the plan must set forth sufficient facts to support a clinical determination that the person who is to be treated has a history of substance use disorder.  6. If the person who is to be treated has executed an advance directive for psychiatric care pursuant to NRS 449A.600 to 449A.645, inclusive, a copy of the advance directive must be attached to the proposed written treatment plan.   7. As used in this section, "provider of health care" has the meaning ascribed to it in NRS 629.031.  (Added to NRS by 2021, 3071)
  1. The person who is the subject of a petition filed or motion made pursuant to NRS 433A.335 or 433A.345 or any relative or friend on the persons behalf is entitled to retain counsel to represent the person in any proceeding before the district court relating to assisted outpatient treatment. If he or she fails or refuses to obtain counsel, the court must advise the person and his or her guardian or next of kin, if known, of such right to counsel and must appoint counsel, who may be the public defender or his or her deputy. The person must be represented by counsel at all stages of the proceedings.  2. The court shall award compensation to any counsel appointed pursuant to subsection 1 for his or her services in an amount determined by the court to be fair and reasonable. The compensation must be charged against the estate of the person for whom the counsel was appointed or, if the person is indigent, against the county where the person who is the subject of the petition or motion last resided.  3. The court shall, at the request of counsel representing the subject of the petition or motion in proceedings before the court relating to assisted outpatient treatment, grant a recess in the proceedings for the shortest time possible, but for not more than 7 days, to give the counsel an opportunity to prepare his or her case.  4. If the person who is the subject of the petition or motion is ordered to receive assisted outpatient treatment, counsel must continue to represent the person until the person is released from the program. The court shall serve notice upon such counsel of any action that is taken involving the person while the person is required by the order to receive assisted outpatient treatment.  (Added to NRS by 2021, 3072)
  1. The district attorney of a county in which a petition is filed or motion is made pursuant to NRS 433A.335 or 433A.345 or his or her deputy:  (a) Must appear and represent the State in the proceedings for assisted outpatient treatment if:  (1) The proceedings were initiated by:  (I) A petition filed pursuant to subsection 1 of NRS 433A.335 or NRS 433A.345 by the Administrator or his or her designee or the medical director of a division facility or his or her designee; or  (II) A motion made pursuant to subsection 2 of NRS 433A.335; and  (2) The district attorney determines that there is clear and convincing evidence that the criteria prescribed in subsection 3 of NRS 433A.335 or subsection 1 of NRS 433A.345, as applicable, are met.  (b) May appear and represent the State in the proceedings for assisted outpatient treatment in any other case where the district attorney determines that there is clear and convincing evidence that the criteria prescribed in subsection 3 of NRS 433A.335 or subsection 1 of NRS 433A.345, as applicable, are met.  2. If the district attorney does not appear and represent the State in a proceeding for assisted outpatient treatment, the petitioner is responsible for presenting the case in support of the petition.  (Added to NRS by 2021, 3072)
  1. In proceedings for assisted outpatient treatment, the court shall hear and consider all relevant testimony, including, without limitation:  (a) The testimony of the person who made a sworn statement or declaration pursuant to paragraph (a) of subsection 4 of NRS 433A.335, any personnel of the Division responsible for a clinical determination made pursuant to paragraph (c) of subsection 2 of NRS 433A.335 or the person or entity responsible for the decision to submit a petition pursuant to NRS 433A.345, as applicable;  (b) The testimony of any supporter or legal guardian of the person who is the subject of the proceedings, if that person wishes to testify; and  (c) If the proposed written treatment plan submitted pursuant to NRS 433A.337 recommends medication and the person who is the subject of the petition or motion objects to the recommendation, the testimony of the person professionally qualified in the field of psychiatric mental health who prescribed the recommendation.  2. The court may consider testimony relating to any past actions of the person who is the subject of the petition or motion if such testimony is probative of the question of whether the person currently meets the criteria prescribed by subsection 3 of NRS 433A.335 or subsection 1 of NRS 433A.345, as applicable.  (Added to NRS by 2021, 3073)
  1. Except as otherwise provided in subsection 2, the person who is the subject of a petition or motion for assisted outpatient treatment must be present at the proceedings on the petition or motion, as applicable, and may, at the discretion of the court, testify.  2. The court may conduct the hearing on a petition or motion for assisted outpatient treatment in the absence of the person who is the subject of the petition or motion if:  (a) The person has waived his or her right to attend the hearing after receiving notice pursuant to NRS 433A.336 and being advised of his or her right to be present and the potential consequences of failing to attend; and  (b) The counsel for the person is present.  (Added to NRS by 2021, 3073)
  1. If the district court finds, after proceedings for the assisted outpatient treatment of a person:  (a) That the person professionally qualified in the field of psychiatric mental health who made the sworn statement or declaration pursuant to paragraph (b) of subsection 4 of NRS 433A.335 or submitted the petition pursuant to NRS 433A.345, as applicable, is not able to provide treatment to the person who is the subject of the proceedings in the county where he or she resides or that there is not clear and convincing evidence that the person who is the subject of the proceedings meets the criteria prescribed in subsection 3 of NRS 433A.335 or subsection 1 of NRS 433A.345, as applicable, the court must enter its finding to that effect and the person must not be ordered to receive assisted outpatient treatment.  (b) That the person professionally qualified in the field of psychiatric mental health who made the sworn statement or declaration pursuant to paragraph (b) of subsection 4 of NRS 433A.335 or submitted the petition pursuant to NRS 433A.345, as applicable, is able to provide treatment to the person who is the subject of the proceedings in the county where he or she resides and that there is clear and convincing evidence that the person who is the subject of the proceedings meets the criteria prescribed in subsection 3 of NRS 433A.335 or subsection 1 of NRS 433A.345, as applicable, the court may order the person to receive assisted outpatient treatment. The order of the court must be interlocutory and must not become final if, within 30 days after the issuance of the order, the person is unconditionally released pursuant to NRS 433A.390.   2. If the district court finds, after proceedings for the assisted outpatient treatment of a defendant in a criminal proceeding pursuant to subsection 2 of NRS 433A.335:  (a) That the person professionally qualified in the field of psychiatric mental health who made the sworn statement or declaration pursuant to paragraph (b) of subsection 4 of NRS 433A.335 or submitted the petition pursuant to NRS 433A.345, as applicable, is not able to provide treatment to the defendant in the county where he or she resides or that there is not clear and convincing evidence that the defendant meets the criteria prescribed in subsection 3 of NRS 433A.335 or subsection 1 of NRS 433A.345, as applicable, the court must enter its finding to that effect and the defendant must not be ordered to receive assisted outpatient treatment.   (b) That the person professionally qualified in the field of psychiatric mental health who made the sworn statement or declaration pursuant to paragraph (b) of subsection 4 of NRS 433A.335 or submitted the petition pursuant to NRS 433A.345, as applicable, is able to provide treatment to the defendant in the county where he or she resides and that there is clear and convincing evidence that the defendant meets the criteria prescribed in subsection 3 of NRS 433A.335 or subsection 1 of NRS 433A.345, as applicable, except as otherwise provided in this paragraph, the court must order the defendant to receive assisted outpatient treatment and suspend further proceedings in the criminal proceeding against the defendant until the defendant completes the treatment or the treatment is terminated. If the offense allegedly committed by the defendant is a category A or B felony or involved the use or threatened use of force or violence, the court must not order the defendant to receive assisted outpatient treatment pursuant to this paragraph unless the prosecuting attorney stipulates to the assignment. The order of the court must be interlocutory and must not become final if, within 30 days after the issuance of the order, the person is unconditionally released pursuant to NRS 433A.390. If the defendant successfully completes the assisted outpatient treatment to the satisfaction of the court, the court must dismiss the criminal charges against the defendant with prejudice.  3. An order for a person to receive assisted outpatient treatment must:  (a) Provide for a period of assisted outpatient treatment that does not exceed 6 months unless the order is renewed or extended pursuant to NRS 433A.345;  (b) Specify the services that the person who is to be treated must receive; and  (c) Direct the person professionally qualified in the field of psychiatric mental health who made the sworn statement or declaration pursuant to paragraph (b) of subsection 4 of NRS 433A.335 or submitted the petition pursuant to NRS 433A.345, as applicable, to provide the services pursuant to paragraph (b) for the duration of the order.  4. If an order for a person to receive assisted outpatient treatment requires the administration of medication, the order must state the classes of medication and the reasons for ordering the medication, which must be based on the proposed written treatment plan submitted pursuant to NRS 433A.337. The order may require the person who is to be treated to self-administer the medication or accept the administration of the medication by a specified person. The court shall not order the use of physical force or restraints to administer medication.  5. An order for a person to receive assisted outpatient treatment must not prescribe treatment that is not recommended by the person professionally qualified in the field of psychiatric mental health who made the sworn statement or declaration pursuant to paragraph (b) of subsection 4 of NRS 433A.335 or submitted the petition pursuant to NRS 433A.345, as applicable.  6. If the court issues an order requiring a person to receive assisted outpatient treatment, the court must, notwithstanding the provisions of NRS 433A.715, cause, within 5 business days after the order becomes final pursuant to this section, on a form prescribed by the Department of Public Safety, a record of the order to be transmitted to:  (a) The Central Repository for Nevada Records of Criminal History, along with a statement indicating that the record is being transmitted for inclusion in each appropriate database of the National Instant Criminal Background Check System; and  (b) Each law enforcement agency of this State with which the court has entered into an agreement for such transmission, along with a statement indicating that the record is being transmitted for inclusion in each of this States appropriate databases of information relating to crimes.  7. A court may periodically review an order for a person to receive assisted outpatient treatment to determine whether there is an available alternative treatment that is the least restrictive treatment that is appropriate for the person, is in the best interest of the person and will not be detrimental to the public welfare. If the court determines that such a treatment is available, the court must amend the order to require such treatment.  8. As used in this section, "National Instant Criminal Background Check System" has the meaning ascribed to it in NRS 179A.062.  (Added to NRS by 2021, 3074)
  1. A person professionally qualified in the field of psychiatric mental health who is responsible for providing assisted outpatient treatment to a person ordered by a court to receive assisted outpatient treatment pursuant to NRS 433A.343 may petition the court to issue an order requiring a peace officer to take into custody and deliver the person to an appropriate location for a prompt evaluation by the professional to determine whether the person is a person in a mental health crisis if:  (a) The person who is the subject of the petition has failed to comply with the plan of assisted outpatient treatment ordered pursuant to NRS 433A.343;   (b) The petitioner has made reasonable efforts to solicit such compliance; and  (c) The failure to comply with the plan of assisted outpatient treatment may cause the person who is the subject of the petition to harm himself or herself or others.  2. A petition pursuant to subsection 1 must set forth:  (a) The specific provisions of the plan of assisted outpatient treatment which the subject of the petition has failed to carry out;  (b) The efforts made by the petitioner to solicit compliance; and  (c) The basis for the petitioners belief that the failure to comply with the plan of assisted outpatient treatment may cause the subject of the petition to harm himself or herself or others.  3. If the court determines that there is probable cause to believe that the conditions described in paragraphs (a), (b) and (c) of subsection 1 have been satisfied, the court may issue an order requiring a peace officer to take into custody and deliver the person who is the subject of the petition to an appropriate location for a prompt evaluation by the petitioner to determine whether the person is a person in a mental health crisis.  4. As used in this section, "appropriate location" means any location identified by a petitioner but does not include a jail or prison.  (Added to NRS by 2021, 3076)
  1. Not later than 7 judicial days before the end of a period of assisted outpatient treatment ordered by a court pursuant to NRS 433A.343, the Administrator or his or her designee, the medical director of a division facility through which the person who is the subject of the order is receiving assisted outpatient treatment or his or her designee or another person professionally qualified in the field of psychiatric mental health responsible for providing the assisted outpatient treatment may petition to renew the order for assisted outpatient treatment for an additional period that does not exceed 6 months. The petition for renewal must allege that:   (a) Because of his or her mental illness, the person to be treated is unwilling or unlikely to voluntarily participate in outpatient treatment that would enable the person to live safely in the community without the supervision of the court; and  (b) Assisted outpatient treatment is the least restrictive appropriate means to prevent further disability or deterioration that would result in the person to be treated becoming a person in a mental health crisis.  2. A copy of a petition filed pursuant to subsection 1 must be served upon the person who is the subject of the petition or his or her counsel and, if applicable, his or her legal guardian.  3. Upon receiving a petition filed pursuant to subsection 1, the court shall schedule a hearing on the petition pursuant to NRS 433A.336. If the order for assisted outpatient treatment that is effective at the time of the petition is scheduled to expire before the hearing, the order is extended and remains in effect until the date of the hearing.  (Added to NRS by 2021, 3076)
  1. Upon admission to any public or private mental health facility or to assisted outpatient treatment, each consumer and the consumers spouse and legal guardian, if any, must receive a written statement outlining in simple, nontechnical language all procedures for release provided by this chapter, setting out all rights accorded to such a consumer by this chapter and chapters 433 and 433B of NRS and, if the consumer has no legal guardian, describing procedures provided by law for adjudication of incapacity and appointment of a guardian for the consumer.  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 in a mental health crisis must be posted in each public and private mental health facility and in each location in which assisted outpatient treatment is provided and must be provided to each consumer upon admission.  (Added to NRS by 1975, 1610; A 1993, 2115, 2722; 1995, 676; 2011, 427; 2013, 3494; 2021, 3093)
  1. A clinical record for each consumer must be diligently maintained by any division facility, private institution, facility offering mental health services or person professionally qualified in the field of psychiatric mental health responsible for providing assisted outpatient treatment. The record must include information pertaining to the consumers 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 as otherwise provided in subsection 2 or except:  (a) If the release is authorized or required pursuant to NRS 439.538.  (b) The record must be released to physicians, advanced practice registered nurses, attorneys and social agencies as specifically authorized in writing by the consumer, the consumers parent, guardian or attorney.  (c) The record must be released to persons authorized by the order of a court of competent jurisdiction.  (d) The record or any part thereof may be disclosed to a qualified member of the staff of a division facility, an employee of the Division or a member of the staff of an agency in Nevada which has been established pursuant to the Developmental Disabilities Assistance and Bill of Rights Act of 2000, 42 U.S.C.  15001 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 consumer.  (e) 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 consumers.  (f) To the extent necessary for a consumer to make a claim, or for a claim to be made on behalf of a consumer for aid, insurance or medical assistance to which the consumer may be entitled, information from the records may be released with the written authorization of the consumer or the consumers guardian.  (g) 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.  15001 et seq. or 42 U.S.C.  10801 et seq. if:  (1) The consumer is a consumer of that office and the consumer or the consumers legal representative or guardian authorizes the release of the record; or  (2) A complaint regarding a consumer was received by the office or there is probable cause to believe that the consumer has been abused or neglected and the consumer:  (I) Is unable to authorize the release of the record because of the consumers mental or physical condition; and  (II) Does not have a guardian or other legal representative or is a ward of the State.  (h) The record must be released as provided in NRS 433.332 or 433B.200 and in chapter 629 of NRS.  2. A division facility, private institution, facility offering mental health services or person professionally qualified in the field of psychiatric mental health responsible for providing assisted outpatient treatment and any other person or entity having information concerning a consumer, including, without limitation, a clinical record, any part thereof or any information contained therein, may disclose such information to a provider of health care to assist with treatment provided to the consumer.  3. As used in this section, "provider of health care" has the meaning ascribed to it in NRS 629.031.  (Added to NRS by 1975, 1611; A 1987, 746, 1197; 1989, 2056; 1991, 2351; 1993, 2722; 2003, 1945; 2007, 1981; 2011, 428; 2013, 3494; 2017, 1752; 2019, 362; 2021, 3093)
  1. When a consumer committed by a court to a division facility on or before June 30, 1975, or a consumer who is judicially admitted on or after July 1, 1975, or a person who is involuntarily detained pursuant to NRS 433A.145 to 433A.300, inclusive, escapes from any division facility, or when a judicially admitted consumer has not returned to a division facility from conditional release after the administrative officer of the facility has ordered the consumer to do so, any peace officer shall, upon written request of the administrative officer or the administrative officers 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; 2001, 3047; 2011, 429)
  1. 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:  (a) The conditional release is in the best interest of the person, will provide the least restrictive treatment that is appropriate for the person and will not be detrimental to the public welfare;  (b) A community treatment program, social services agency, mobile crisis team or multi-disciplinary team has agreed to provide case management, support and supervision to the person to ensure his or her compliance with the conditions of the release; and  (c) The person qualifies to receive case management, support and supervision from the community treatment program, social services agency, mobile crisis team or multi-disciplinary team.  2. The medical director of the facility or the medical directors designee shall prescribe the period for which the conditional release is effective. The period must not extend beyond the last day of the court-ordered period of admission pursuant to NRS 433A.310. If the person has a legal guardian, the facility must notify the guardian at least 3 days before discharging the person from the facility or, if the person will be released in less than 3 days, as soon as practicable. Notification of the legal guardian must be provided:  (a) In person or by telephone; or  (b) If the facility is not able to contact the guardian in person or by telephone, by facsimile, electronic mail or certified mail.  3. The legal guardian has discretion to determine where the person will be released, taking into consideration any discharge plan proposed by the facility assessment team. If the legal guardian does not inform the facility as to where the person will be released within 3 days after the date of notification, the facility must discharge the person according to its proposed discharge plan.  4. Before conditionally releasing a person from a public or private mental health facility pursuant to this section, the medical director of the facility must notify the court that ordered the involuntary admission. The court may periodically review the appropriateness of the conditional release and the terms thereof, but the court may not terminate the conditional release except through proceedings for involuntary admission pursuant to NRS 433A.200 to 433A.330, inclusive.  5. When a person is conditionally released pursuant to this section, 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.  6. When a person who has been adjudicated by a court to be incapacitated 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 incapacitated persons rehabilitation. If the person has a legal guardian, the petition must be filed with the court having jurisdiction over the guardianship.  (Added to NRS by 1975, 1608; A 1981, 1661; 1999, 867; 2009, 1667; 2019, 363; 2021, 3095)
  1. When a consumer, involuntarily admitted to a mental health facility or required to receive assisted outpatient treatment by court order, is released at the end of the period specified pursuant to NRS 433A.310 or 433A.343, as applicable, written notice must be given to the court that issued the order not later than 3 judicial days after the release of the consumer. The consumer may be released without requiring further orders of the court. If the consumer has a legal guardian, the facility or the person professionally qualified in the field of psychiatric mental health responsible for providing the assisted outpatient treatment shall notify the guardian in the manner prescribed by subsection 6 at least 3 days before discharging the consumer from the facility or treatment or, if the consumer will be released in less than 3 days, as soon as practicable.   2. The legal guardian of a consumer involuntarily admitted to a mental health facility, if applicable, has discretion to determine where the consumer will be released pursuant to subsection 1, taking into consideration any discharge plan proposed by the facility assessment team. If the legal guardian does not inform the facility as to where the consumer will be released within 3 days after the date of notification, the facility must discharge the consumer according to its proposed discharge plan.  3. A consumer who is involuntarily admitted to a mental health facility may be unconditionally released before the period specified in NRS 433A.310 when the physician primarily responsible for treating the patient, a psychiatrist or an advanced practice registered nurse who has the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120 determines that the consumer is no longer a person in a mental health crisis. If the consumer has a legal guardian, the facility shall notify the guardian in the manner prescribed by subsection 6 at least 3 days before discharging the consumer from the facility or, if the consumer will be released in less than 3 days, as soon as practicable. The legal guardian, if applicable, has discretion to determine where the consumer will be released, taking into consideration any discharge plan proposed by the facility assessment team. If the legal guardian does not inform the facility as to where the consumer will be released within 3 days after the date of notification, the facility shall discharge the consumer according to its proposed discharge plan.  4. A consumer who is required to receive assisted outpatient treatment may be unconditionally released before the period specified in NRS 433A.343 when the person professionally qualified in the field of psychiatric mental health responsible for providing the assisted outpatient treatment for the consumer determines that:  (a) The consumer no longer requires assisted outpatient treatment to prevent further disability or deterioration that would result in the person becoming a person in a mental health crisis;  (b) The consumer is willing and likely to voluntarily participate in outpatient treatment that enables the person to live safely in the community without the supervision of the court; or  (c) After the order for assisted outpatient treatment has been effective for at least 30 days, the assisted outpatient treatment is not meeting the needs of the consumer.  5. If a consumer who will be released from assisted outpatient treatment pursuant to subsection 4 has a legal guardian, the person professionally qualified in the field of psychiatric mental health responsible for providing the assisted outpatient treatment to the consumer shall notify the guardian in the manner prescribed by subsection 6 at least 3 days before discharging the consumer from the treatment or, if the consumer will be released in less than 3 days, as soon as practicable.   6. Notification of a guardian pursuant to subsection 1, 3 or 5 must be provided:  (a) In person or by telephone; or  (b) If the mental health facility or the person professionally qualified in the field of psychiatric mental health, as applicable, is not able to contact the guardian in person or by telephone, by facsimile, electronic mail or certified mail.  7. A mental health facility or a person professionally qualified in the field of psychiatric mental health responsible for providing treatment to a consumer shall provide written notice to the court that issued the order not later than 3 judicial days after unconditionally releasing a consumer pursuant to subsection 3 or 4.  (Added to NRS by 1975, 1607; A 1983, 508; 1989, 1762; 1997, 3496; 1999, 868; 2009, 1668; 2011, 429; 2013, 3495; 2019, 364; 2021, 3096)
  1. An indigent resident of this state discharged as having been determined to no longer be a person in a mental health crisis, but having a residual medical or surgical disability which prevents him or her from obtaining or holding remunerative employment, must be returned to the county of his or her last residence, except as otherwise provided pursuant to subsections 2 and 3. A nonresident indigent with such disabilities must be returned to the county from which he or she was involuntarily court-admitted, except as otherwise provided in subsections 2 and 3. The administrative officer of the mental health facility shall first give notice in writing, not less than 10 days before discharge, to the board of county commissioners of the county to which the person will be returned and to the persons legal guardian.  2. Delivery of the indigent person must be made to an individual or agency authorized to provide further care. If the person has a legal guardian, the facility shall notify the guardian before discharging the person from the facility. The legal guardian has discretion to determine where the person will be released, taking into consideration any discharge plan proposed by the facility assessment team. If the legal guardian does not inform the facility as to where the person will be released within 3 days after the date of notification, the facility shall discharge the person according to its proposed discharge plan. Notification of a guardian pursuant to this subsection must be provided:  (a) In person or by telephone; or  (b) If the mental health facility is not able to contact the guardian in person or by telephone, by facsimile, electronic mail or certified mail.  3. An indigent person may be delivered to a state that is a party to the Interstate Compact on Mental Health ratified and enacted in NRS 433.4543 regardless of residency in the manner provided in the Compact.  4. This section does not authorize the release of any person held upon an order of a court or judge having criminal jurisdiction arising out of a criminal offense.  (Added to NRS by 1975, 1607; A 2009, 1669; 2015, 1036; 2021, 3098)
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 consumer eligible for treatment therein. If the consumer 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 consumers 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; 2011, 430)
  1. Whenever the Administrator determines that division facilities within the State are inadequate for the care of any person in a mental health crisis, the Administrator may designate two physicians, licensed under the provisions of chapter 630 or 633 of NRS and familiar with the field of psychiatry, or advanced practice registered nurses who have the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120, to examine that person. If the two physicians or advanced practice registered nurses concur with the opinion of the Administrator, the Administrator may:  (a) Transfer the person to a state that is a party to the Interstate Compact on Mental Health ratified and enacted in NRS 433.4543 in the manner provided in the Compact; or  (b) Contract with appropriate corresponding authorities in any other state of the United States that is not a party to the Compact and has 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 or advanced practice registered nurses so designated are entitled to a reasonable fee for their services which must be paid by the county of the persons 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; 2003, 1177; 2015, 1036; 2017, 1753)
  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, the person may be transferred to the state of his or her residence pursuant to NRS 433.444, and, if applicable, the Interstate Compact on Mental Health ratified and enacted in NRS 433.4543, if an appropriate institution of that state is willing to accept the person.  2. The approval of the Administrator of the Division of Public and Behavioral Health 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; 2015, 1037)
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 Corrections is a person in a mental health crisis, the Director of the Department of Corrections shall apply to the Administrator for the offenders 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 the Administrator deems necessary, consultation and other appropriate services for the offender at the place where the offender is confined. It is the Directors decision whether to accept such services.  (Added to NRS by 1975, 1609; A 1977, 871; 1983, 509; 2001, 240)
No person admitted to a public or private mental health facility or who receives assisted outpatient treatment pursuant to this chapter shall, by reason of such admission or treatment, be denied the right to dispose of property, marry, execute instruments, make purchases, enter into contractual relationships, vote and hold a drivers license, unless such person has been specifically adjudicated incapacitated by a court of competent jurisdiction and has not been restored to legal capacity.  (Added to NRS by 1975, 1610; A 2013, 3496; 2021, 3099)
A person adjudicated by a court to be incapacitated who is 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 persons adjudicated incapacitated 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 consumer remains unable to exercise rights to dispose of property, marry, execute instruments, make purchases, enter into contractual relationships, vote or hold a drivers license.  2. If the medical director has sufficient reason to believe that the consumer remains unable to exercise these rights, such information shall be documented in the consumers treatment record.  3. If there is no such reason to believe the consumer is unable to exercise these rights, the medical director shall immediately initiate proper action to cause to have the consumer restored to legal capacity.  (Added to NRS by 1975, 1610; A 2011, 430)
Any person in the State of Nevada who, by reason of a judicial decree ordering the persons hospitalization entered prior to July 1, 1975, is considered to be incapacitated and is denied the right to dispose of property, marry, execute instruments, make purchases, enter into contractual relationships, vote or hold a drivers 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 incapacitated by a court of competent jurisdiction.  (Added to NRS by 1975, 1610)
No person may be admitted or transferred to a private hospital or a division mental health facility, ordered to receive assisted outpatient treatment or transferred to a different person professionally qualified in the field of psychiatric mental health to provide assisted outpatient treatment pursuant to the provisions of this chapter unless mutually agreeable financial arrangements relating to the costs of treatment are made between the private hospital, division facility or person professionally qualified in the field of psychiatric mental health responsible for providing assisted outpatient treatment and the consumer or person requesting his or her admission.  (Added to NRS by 1975, 1614; A 2011, 430; 2013, 3496; 2021, 3099)
  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 consumer for the class of consumer care provided.  3. The fee schedule must allow for a consumer to pay a portion of the actual cost if it is determined that the consumer and his or her 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 consumer 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; 2011, 430)
  1. A person who is admitted to a division facility or who receives assisted outpatient treatment operated by the Division and not determined to be indigent and every responsible relative pursuant to NRS 433A.610 of the person shall be charged for the cost of treatment and is liable for that cost. If after demand is made for payment the person or his or her responsible relative fails to pay that cost, the administrative officer or person professionally qualified in the field of psychiatric mental health responsible for providing the assisted outpatient treatment, as applicable, may recover the amount due by civil action.  2. All sums received pursuant to subsection 1 must be deposited in the State Treasury and may be expended by the Division for the support of that facility or of assisted outpatient treatment 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; 2013, 3496; 2021, 3099)
  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 person in a mental health crisis who is a minor or the spouse of a person in a mental health crisis, if of sufficient ability, and the estate of the person in a mental health crisis, if the estate is sufficient for the purpose, shall pay the cost of the maintenance for the person in a mental health crisis, 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; 2017, 790)
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 persons estate if there is a likelihood of such persons recovery or release from such facility and payment will reduce the persons estate to such an extent that he or she is likely to become a burden on the community in the event of his or her 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 consumers who are adjudicated incapacitated for subsistence, care or other expenses of such consumers. 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 consumer may, from time to time, pay money to the division facility for the future personal needs of the consumer who is incapacitated and for the consumers burial expenses. Money paid pursuant to this subsection must be credited to the consumer in the consumers personal deposit fund established pursuant to NRS 433.539.  (Added to NRS by 1975, 1615; A 1993, 1240; 2011, 430)
  1. Once a court has ordered the admission of a person to a division facility, the administrative officer must make an investigation, pursuant to the provisions of this chapter, to determine whether the person or his or her responsible relatives pursuant to NRS 433A.610 are capable of paying for all or a portion of the costs that will be incurred during the period of admission.  2. If a person is admitted to a division facility or required to receive assisted outpatient treatment pursuant to a court order, that person and his or her responsible relatives are responsible for the payment of the actual cost of the treatment and services rendered during his or her admission to the division facility or while he or she is receiving assisted outpatient treatment unless the investigation reveals that the person and his or her responsible relatives are not capable of paying the full amount of the costs.  3. Once a court has ordered a person to receive assisted outpatient treatment operated by the Division, the person professionally qualified in the field of psychiatric mental health responsible for providing the assisted outpatient treatment must make an investigation, pursuant to the provisions of this chapter, to determine whether the person receiving the treatment or his or her responsible relatives pursuant to NRS 433A.610 are capable of paying for all or a portion of the costs that will be incurred during the period of treatment.  (Added to NRS by 1975, 1614; A 1993, 1241; 2013, 3497; 2021, 3099)
Determination of ability to pay pursuant to NRS 433A.640 must include investigation of whether the consumer has benefits due and owing to the consumer for the cost of his or her treatment from third-party sources, such as Medicare, Medicaid, social security, medical insurance benefits, retirement programs, annuity plans, government benefits or any other financially responsible third parties. The administrative officer of a division mental health facility or person professionally qualified in the field of psychiatric mental health responsible for providing the assisted outpatient treatment may accept payment for the cost of a consumers treatment from the consumers insurance company, Medicare or Medicaid and other similar third parties.  (Added to NRS by 1975, 1614; A 2011, 431; 2013, 3497; 2021, 3100)
  1. If the consumer, his or her responsible relative pursuant to NRS 433A.610, guardian or the estate neglects or refuses to pay the cost of treatment to the division facility or to the person professionally qualified in the field of psychiatric mental health responsible for providing the assisted outpatient treatment operated by the Division rendering service pursuant to the fee schedule established under NRS 433.404 or 433B.250, as appropriate, the State is entitled to recover by appropriate legal action all sums due, plus interest.  2. Before initiating such legal action, the division facility or person professionally qualified in the field of psychiatric mental health responsible for providing the assisted outpatient treatment, as applicable, 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; 2011, 431; 2013, 3497; 2021, 3100)
The expense of diagnostic, medical and surgical services furnished to a consumer admitted to a division facility by a person not on the staff of the facility, whether rendered while the consumer is in a hospital, an outpatient of a hospital or treated outside any hospital, must be paid by the consumer, the guardian or relatives responsible pursuant to NRS 433A.610 for the consumers care. In the case of an indigent consumer or a consumer 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 consumer 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 consumer is admitted payment should be made for nonresident indigent consumers 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; 2011, 431; 2019, 2646)
Claims by a division mental health facility against the estates of deceased consumers 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 persons death.  (Added to NRS by 1975, 1617; A 2011, 432)
  1. Each public or private mental health facility and hospital in this State shall, in the manner and time prescribed by regulation of the State Board of Health, report to the Division:  (a) The number of persons placed on a mental health crisis hold at the mental health facility or hospital pursuant to NRS 433A.160 during the immediately preceding quarter; and  (b) Any other information prescribed by regulation of the State Board of Health.  2. The State Board of Health may adopt regulations that require a public or private mental health facility or hospital to adopt a plan for the discharge of a person admitted to the facility or hospital in accordance with the provisions of this chapter and that prescribe the contents of such a plan.  (Added to NRS by 2019, 348; A 2021, 3100)
  1. A court shall seal all court records relating to proceedings under this chapter.  2. Except as otherwise provided in subsections 4, 5 and 6, a person or governmental entity that wishes to inspect records that are sealed pursuant to this section must file a petition with the court that sealed the records. Upon the filing of a petition, the court shall fix a time for a hearing on the matter. The petitioner must provide notice of the hearing and a copy of the petition to the person who is the subject of the records. If the person who is the subject of the records wishes to oppose the petition, the person must appear before the court at the hearing. If the person appears before the court at the hearing, the court must provide the person an opportunity to be heard on the matter.  3. After the hearing described in subsection 2, the court may order the inspection of records that are sealed pursuant to this section if:  (a) A law enforcement agency must obtain or maintain information concerning persons who have been admitted to a public or private hospital or a mental health facility or received assisted outpatient treatment in this State pursuant to state or federal law;  (b) A prosecuting attorney or an attorney who is representing the person who is the subject of the records in a criminal action requests to inspect the records; or  (c) The person who is the subject of the records petitions the court to permit the inspection of the records by a person named in the petition.  4. A governmental entity is entitled to inspect court records that are sealed pursuant to this section without following the procedure described in subsection 2 if:  (a) The governmental entity has made a conditional offer of employment to the person who is the subject of the records;  (b) The position of employment conditionally offered to the person concerns public safety, including, without limitation, employment as a firefighter or peace officer;  (c) The governmental entity is required by law, rule, regulation or policy to obtain the mental health records of each individual conditionally offered the position of employment; and  (d) An authorized representative of the governmental entity presents to the court a written authorization signed by the person who is the subject of the records and notarized by a notary public or judicial officer in which the person who is the subject of the records consents to the inspection of the records.  5. Upon the request of a public or private hospital or a mental health facility to which a person has been admitted in this State, the court shall:  (a) Authorize the release of a copy of any order which was entered by the court pursuant to paragraph (b) of subsection 1 of NRS 433A.310 or paragraph (b) of subsection 1 of NRS 433A.343 if:  (1) The request is in writing and includes the name and date of birth of the person who is the subject of the requested order; and  (2) The hospital or facility certifies that:  (I) The person who is the subject of the requested order is, at the time of the request, admitted to the hospital or facility and is being treated for an alleged mental illness; and  (II) The requested order is necessary to improve the care which is being provided to the person who is the subject of the order.  (b) Place the request in the record under seal.  6. Upon its own order, any court of this State may inspect court records that are sealed pursuant to this section without following the procedure described in subsection 2 if the records are necessary and relevant for the disposition of a matter pending before the court. The court may allow a party in the matter to inspect the records without following the procedure described in subsection 2 if the court deems such inspection necessary and appropriate.  7. Following the sealing of records pursuant to this section, the admission of the person who is the subject of the records to the public or private hospital or mental health facility or the assisted outpatient treatment of the person who is the subject of the records is deemed never to have occurred, and the person may answer accordingly any question related to its occurrence, except in connection with:  (a) An application for a permit to carry a concealed firearm pursuant to the provisions of NRS 202.3653 to 202.369, inclusive;  (b) A transfer of a firearm; or  (c) An application for a position of employment described in subsection 4.  8. A court may disclose information contained in a record sealed pursuant to this section to a provider of health care to assist with treatment provided to the consumer.  9. As used in this section:  (a) "Firefighter" means a person who is a salaried employee of a fire-fighting agency and whose principal duties are to control, extinguish, prevent and suppress fires. As used in this paragraph, "fire-fighting agency" means a public fire department, fire protection district or other agency of this State or a political subdivision of this State, the primary functions of which are to control, extinguish, prevent and suppress fires.  (b) "Peace officer" has the meaning ascribed to it in NRS 289.010.  (c) "Provider of health care" has the meaning ascribed to it in NRS 629.031.  (d) "Seal" means placing records in a separate file or other repository not accessible to the general public.  (Added to NRS by 2007, 1521; A 2013, 3498; 2017, 1647; 2019, 365; 2021, 3101)
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 or her 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 is a person in a mental health crisis 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 the person 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 or 3, 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 or the commencement or termination of assisted outpatient treatment is guilty of a gross misdemeanor.  3. A person who, without probable cause for believing another person is a person in a mental health crisis, executes a petition, application or certificate pursuant to this chapter, by which the person secures or attempts to secure the apprehension, hospitalization, detention, admission or restraint of the person alleged to be a person in a mental health crisis, or any physician, psychiatrist, psychologist, advanced practice registered nurse or other person professionally qualified in the field of psychiatric mental health who knowingly makes any false certificate or application pursuant to this chapter as to the mental condition of any person is guilty of a category D felony and shall be punished as provided in NRS 193.130.  (Added to NRS by 1975, 1608; A 1989, 1552; 1993, 2116; 1995, 1277; 2013, 3499; 2017, 1753; 2019, 367; 2021, 3102)