EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. Green numbers along left margin indicate location on the printed bill (e.g., 5-15 indicates page 5, line 15).

2-1 Section 1. Chapter 433 of NRS is hereby amended by adding thereto

2-2 the provisions set forth as sections 2 to 19, inclusive, of this act.

2-3 Sec. 2. As used in sections 2 to 19, inclusive, of this act, unless the

2-4 context otherwise requires, the words and terms defined in sections 3 to

2-5 11, inclusive, of this act have the meanings ascribed to them in those

2-6 sections.

2-7 Sec. 3. "Aversive intervention" means any of the following actions if

2-8 the action is used to punish a person with a disability or to eliminate,

2-9 reduce or discourage maladaptive behavior of a person with a disability:

2-10 1. The use of noxious odors and tastes;

2-11 2. The use of water and other mists or sprays;

2-12 3. The use of blasts of air;

2-13 4. The use of corporal punishment;

2-14 5. The use of verbal and mental abuse;

2-15 6. The use of electric shock;

2-16 7. Requiring a person to perform exercise under forced conditions if

2-17 the:

2-18 (a) Person is required to perform the exercise because he exhibited a

2-19 behavior that is related to his disability;

2-20 (b) Exercise is harmful to the health of the person because of his

2-21 disability; or

2-22 (c) Nature of the person’s disability prevents him from engaging in

2-23 the exercise;

2-24 8. Any intervention, technique or procedure that deprives a person of

2-25 the use of one or more of his senses, regardless of the length of the

2-26 deprivation, including, without limitation, the use of sensory screens; or

2-27 9. The deprivation of necessities needed to sustain the health of a

2-28 person, regardless of the length of the deprivation, including, without

2-29 limitation, the denial or unreasonable delay in the provision of:

2-30 (a) Food or liquid at a time when it is customarily served; or

2-31 (b) Medication.

2-32 Sec. 4. "Chemical restraint" means the administration of drugs for

2-33 the specific and exclusive purpose of controlling an acute or episodic

2-34 aggressive behavior when alternative intervention techniques have failed

2-35 to limit or control the behavior. The term does not include the

2-36 administration of drugs on a regular basis, as prescribed by a physician,

2-37 to treat the symptoms of mental, physical, emotional or behavioral

2-38 disorders and for assisting a person in gaining self-control over his

2-39 impulses.

3-1 Sec. 5. "Corporal punishment" means the intentional infliction of

3-2 physical pain, including, without limitation, hitting, pinching or striking.

3-3 Sec. 6. "Electric shock" means the application of electric current to

3-4 a person’s skin or body. The term does not include electroconvulsive

3-5 therapy.

3-6 Sec. 7. "Emergency" means a situation in which immediate

3-7 intervention is necessary to protect the physical safety of a person or

3-8 others from an immediate threat of physical injury or to protect against

3-9 an immediate threat of severe property damage.

3-10 Sec. 8. "Mechanical restraint" means the use of devices, including,

3-11 without limitation, mittens, straps and restraint chairs to limit a person’s

3-12 movement or hold a person immobile.

3-13 Sec. 9. "Person with a disability" means a person who:

3-14 1. Has a physical or mental impairment that substantially limits one

3-15 or more of the major life activities of the person;

3-16 2. Has a record of such an impairment; or

3-17 3. Is regarded as having such an impairment.

3-18 Sec. 10. "Physical restraint" means the use of physical contact to

3-19 limit a person’s movement or hold a person immobile.

3-20 Sec. 11. "Verbal and mental abuse" means verbal intimidation or

3-21 coercion of a person without a redeeming purpose.

3-22 Sec. 12. A person employed by a facility or any other person shall

3-23 not use any aversive intervention on a person with a disability who is a

3-24 client.

3-25 Sec. 13. Notwithstanding the provisions of sections 14 to 17,

3-26 inclusive, of this act to the contrary, a facility may use or authorize the

3-27 use of physical restraint, mechanical restraint or chemical restraint on a

3-28 person with a disability who is a client if the facility is:

3-29 1. Accredited by a nationally recognized accreditation association or

3-30 agency; or

3-31 2. Certified for participation in the Medicaid or Medicare
3-32 program,

3-33 only to the extent that the accreditation or certification allows the use of

3-34 such restraint.

3-35 Sec. 14. A person employed by a facility or any other person shall

3-36 not:

3-37 1. Except as otherwise provided in section 15 of this act, use physical

3-38 restraint on a person with a disability who is a client.

3-39 2. Except as otherwise provided in section 16 of this act, use

3-40 mechanical restraint on a person with a disability who is a client.

3-41 3. Except as otherwise provided in section 17 of this act, use

3-42 chemical restraint on a person with a disability who is client.

4-1 Sec. 15. 1. Except as otherwise provided in subsection 2, physical

4-2 restraint may be used on a person with a disability who is a client only if:

4-3 (a) An emergency exists that necessitates the use of physical restraint;

4-4 (b) The physical restraint is used only for the period that is necessary

4-5 to contain the behavior of the client so that the client is no longer an

4-6 immediate threat of causing physical injury to himself or others or

4-7 causing severe property damage; and

4-8 (c) The use of force in the application of physical restraint does not

4-9 exceed the force that is reasonable and necessary under the

4-10 circumstances precipitating the use of physical restraint.

4-11 2. Physical restraint may be used on a person with a disability who is

4-12 a client and the provisions of subsection 1 do not apply if the physical

4-13 restraint is used to:

4-14 (a) Assist the client in completing a task or response if the client does

4-15 not resist the application of physical restraint or if his resistance is

4-16 minimal in intensity and duration;

4-17 (b) Escort or carry a client to safety if the client is in danger in his

4-18 present location; or

4-19 (c) Conduct medical examinations or treatments on the client that are

4-20 necessary.

4-21 3. If physical restraint is used on a person with a disability who is a

4-22 client in an emergency, the use of the procedure must be reported as a

4-23 denial of rights pursuant to NRS 433.534, regardless of whether the use

4-24 of the procedure is authorized by statute. The report must be made not

4-25 later than 1 working day after the procedure is used.

4-26 Sec. 16. 1. Except as otherwise provided in subsection 2,

4-27 mechanical restraint may be used on a person with a disability who is a

4-28 client only if:

4-29 (a) An emergency exists that necessitates the use of mechanical

4-30 restraint;

4-31 (b) A medical order authorizing the use of mechanical restraint is

4-32 obtained from the client’s treating physician before the application of the

4-33 mechanical restraint or not later than 15 minutes after the application of

4-34 the mechanical restraint;

4-35 (c) The physician who signed the order required pursuant to

4-36 paragraph (b) or the attending physician examines the client not later

4-37 than 1 working day immediately after the application of the mechanical

4-38 restraint;

4-39 (d) The mechanical restraint is applied by a member of the staff of the

4-40 facility who is trained and qualified to apply mechanical restraint;

4-41 (e) The client is given the opportunity to move and exercise the parts

4-42 of his body that are restrained at least 10 minutes per every 60 minutes of

4-43 restraint;

5-1 (f) A member of the staff of the facility lessens or discontinues the

5-2 restraint every 15 minutes to determine whether the client will stop or

5-3 control his inappropriate behavior without the use of the restraint;

5-4 (g) The record of the client contains a notation that includes the time

5-5 of day that the restraint was lessened or discontinued pursuant to

5-6 paragraph (f), the response of the client and the response of the member

5-7 of the staff of the facility who applied the mechanical restraint;

5-8 (h) A member of the staff of the facility continuously monitors the

5-9 client during the time that mechanical restraint is used on the client; and

5-10 (i) The mechanical restraint is used only for the period that is

5-11 necessary to contain the behavior of the client so that the client is no

5-12 longer an immediate threat of causing physical injury to himself or

5-13 others or causing severe property damage.

5-14 2. Mechanical restraint may be used on a person with a disability

5-15 who is a client and the provisions of subsection 1 do not apply if the

5-16 mechanical restraint is used to:

5-17 (a) Treat the medical needs of a client;

5-18 (b) Protect a client who is known to be at risk of injury to himself

5-19 because he lacks coordination or suffers from frequent loss of

5-20 consciousness;

5-21 (c) Provide proper body alignment to a client; or

5-22 (d) Position a client who has physical disabilities in a manner

5-23 prescribed in the client’s plan of services.

5-24 3. If mechanical restraint is used on a person with a disability who is

5-25 a client in an emergency, the use of the procedure must be reported as a

5-26 denial of rights pursuant to NRS 433.534, regardless of whether the use

5-27 of the procedure is authorized by statute. The report must be made not

5-28 later than 1 working day after the procedure is used.

5-29 Sec. 17. 1. Chemical restraint may only be used on a person with a

5-30 disability who is a client if:

5-31 (a) The client has been diagnosed as mentally ill, as defined in NRS

5-32 433A.115, and is receiving mental health services from a facility;

5-33 (b) The chemical restraint is administered to the client while he is

5-34 under the care of the facility;

5-35 (c) An emergency exists that necessitates the use of chemical

5-36 restraint;

5-37 (d) A medical order authorizing the use of chemical restraint is

5-38 obtained from the client’s attending physician or psychiatrist;

5-39 (e) The physician or psychiatrist who signed the order required

5-40 pursuant to paragraph (d) examines the client not later than 1 working

5-41 day immediately after the administration of the chemical restraint; and

5-42 (f) The chemical restraint is administered by a person licensed to

5-43 administer medication.

6-1 2. If chemical restraint is used on a person with a disability who is a

6-2 client, the use of the procedure must be reported as a denial of rights

6-3 pursuant to NRS 433.534, regardless of whether the use of the procedure

6-4 is authorized by statute. The report must be made not later than 1

6-5 working day after the procedure is used.

6-6 Sec. 18. 1. Each facility shall develop a program of education for

6-7 the members of the staff of the facility to provide instruction in positive

6-8 behavioral interventions and positive behavioral supports that:

6-9 (a) Includes positive methods to modify the environment of clients to

6-10 promote adaptive behavior and reduce the occurrence of inappropriate

6-11 behavior;

6-12 (b) Includes methods to teach skills to clients so that clients can

6-13 replace inappropriate behavior with adaptive behavior;

6-14 (c) Includes methods to enhance a client’s independence and quality

6-15 of life;

6-16 (d) Includes the use of the least intrusive methods to respond to and

6-17 reinforce the behavior of clients; and

6-18 (e) Offers a process for designing interventions based upon the client

6-19 that are focused on promoting appropriate changes in behavior as well as

6-20 enhancing the overall quality of life for the client.

6-21 2. Each facility shall provide appropriate training for the members of

6-22 the staff of the facility who are authorized to carry out and monitor

6-23 physical restraint, mechanical restraint and chemical restraint to ensure

6-24 that those members of the staff are competent and qualified to carry out

6-25 the procedures in accordance with sections 2 to 19, inclusive, of this act.

6-26 Sec. 19. 1. A facility where a violation of the provisions of sections

6-27 2 to 19, inclusive, of this act occurs shall:

6-28 (a) Not later than 24 hours after a violation occurs, or as soon

6-29 thereafter as the violation is discovered, report the violation to the

6-30 division; and

6-31 (b) Develop, in cooperation with the division, a corrective plan to

6-32 ensure that within 30 calendar days after the violation occurred,

6-33 appropriate action is taken by the facility to prevent future violations.

6-34 2. The division shall forward the plan to the director of the

6-35 department. The director or his designee shall review the plan to ensure

6-36 that it complies with applicable federal law and the statutes and

6-37 regulations of this state. The director or his designee may require

6-38 appropriate revision of the plan to ensure compliance.

6-39 3. If the facility where the violation occurred does not meet the

6-40 requirements of the plan to the satisfaction of the director or his

6-41 designee, the department may withhold funding for the facility until the

6-42 facility meets the requirements of the plan.

7-1 Sec. 20. NRS 433.484 is hereby amended to read as follows:

7-2 433.484 Each client admitted for evaluation, treatment or training to a

7-42 treatment.

8-1 2. To be free from [the application of any mechanical restraint, except

8-2 if prescribed by a physician. If so prescribed, the restraint must be removed

8-3 whenever the condition justifying its use no longer exists, and any use of a

8-4 mechanical restraint, together with the reasons therefor, must be made a

8-5 part of the client’s record of treatment.] abuse, neglect and aversive

8-6 intervention.

8-7 3. To consent to his transfer from one facility to another, except that

8-8 the administrator of the division of mental health and developmental

8-9 services of the department or his designee, or the administrator of the

8-10 division of child and family services of the department or his designee, may

8-11 order a transfer to be made whenever conditions concerning care, treatment

8-12 or training warrant it. If the client in any manner objects to the transfer, the

8-13 person ordering it must enter the objection and a written justification of the

8-14 transfer in the client’s record of treatment and immediately forward a notice

8-15 of the objection to the administrator who ordered the transfer, and the

8-16 commission shall review the transfer pursuant to subsection 3 of NRS

8-17 433.534.

8-18 4. Other rights concerning care, treatment and training as may be

8-19 specified by regulation of the commission.

8-20 Sec. 21. NRS 433.554 is hereby amended to read as follows:

8-21 433.554 1. An employee of a public or private mental health facility

8-43 the client , [results,] is guilty of a category B felony . [and]

9-1 (c) For a second or subsequent violation, is guilty of a category B

9-2 felony.

9-3 A person convicted of a category B felony pursuant to this section shall

9-4 be punished by imprisonment in the state prison for a minimum term of not

9-5 less than 1 year and a maximum term of not more than 6 years, or by a fine

9-6 of not more than $5,000, or by both fine and imprisonment.

9-7 3. A person who is convicted pursuant to this section is ineligible for 5

9-8 years for appointment to or employment in a position in the state service

9-9 and, if he is an officer or employee of the state, he forfeits his office or

9-10 position.

9-11 4. A conviction pursuant to NRS 433.554 is, when applicable,

9-12 grounds for disciplinary action against the person so convicted and the

9-13 facility where the violation occurred. The division may recommend to the

9-14 appropriate agency or board the suspension or revocation of the

9-15 professional license, registration, certificate or permit of a person

9-16 convicted pursuant to NRS 433.554.

9-17 5. For the purposes of this section:

9-18 (a) "Abuse" means any willful and unjustified infliction of pain, injury

9-19 or mental anguish upon a client, including, but not limited to:

9-20 (1) The rape, sexual assault or sexual exploitation of the client;

9-21 (2) [Striking the client;

9-22 (3) Verbal intimidation or coercion of the client without a redeeming

9-23 purpose;

9-24 (4) The use of excessive force when placing the client in physical

9-25 restraints; and

9-26 (5)] The use of any type of aversive intervention;

9-27 (3) Except as otherwise provided in section 13 of this act, a

9-28 violation of section 14 of this act; and

9-29 (4) The use of physical , [or] chemical or mechanical restraints or

9-30 the use of seclusion in violation of [state or] federal law.

9-31 Any act which meets the standard of practice for care and treatment does

9-32 not constitute abuse.

9-33 (b) "Client" includes any person who seeks, on his own or others’

9-34 initiative, and can benefit from care , treatment and training in a public or

9-35 private institution or facility offering mental health services. The term [does

9-36 not include] includes a client of the division of child and family services of

9-37 the department.

9-38 (c) "Neglect" means any omission to act which causes injury to a client

9-39 or which places the client at risk of injury, including, but not limited to, the

9-40 failure to follow:

9-41 (1) An appropriate plan of treatment to which the client has

9-42 consented; and

9-43 (2) The policies of the facility for the care and treatment of clients.

10-1 Any omission to act which meets the standard of practice for care and

10-2 treatment does not constitute neglect.

10-3 (d) "Standard of practice" means the skill and care ordinarily exercised

10-4 by prudent professional personnel engaged in health care.

10-5 Sec. 22. NRS 435.350 is hereby amended to read as follows:

10-6 435.350 1. Each mentally retarded person or person with a related

10-24 of denial of rights as are enumerated in subsection 3 of NRS 433.534.

10-25 Sec. 23. Chapter 388 of NRS is hereby amended by adding thereto the

10-26 provisions set forth as sections 24 to 42, inclusive, of this act.

10-27 Sec. 24. As used in sections 24 to 42, inclusive, of this act, unless the

10-28 context otherwise requires, the words and terms defined in sections 25 to

10-29 33, inclusive, of this act have the meanings ascribed to them in those

10-30 sections.

10-31 Sec. 25. "Aversive intervention" means any of the following actions

10-32 if the action is used to punish a pupil with a disability or to eliminate,

10-33 reduce or discourage maladaptive behavior of a pupil with a disability:

10-34 1. The use of noxious odors and tastes;

10-35 2. The use of water and other mists or sprays;

10-36 3. The use of blasts of air;

10-37 4. The use of corporal punishment;

10-38 5. The use of verbal and mental abuse;

10-39 6. The use of electric shock;

10-40 7. The administration of chemical restraint to a person;

10-41 8. The placement of a person alone in a room where release from the

10-42 room is prohibited by a mechanism, including, without limitation, a lock,

11-1 device or object positioned to hold the door closed or otherwise prevent

11-2 the person from leaving the room;

11-3 9. Requiring a person to perform exercise under forced conditions if

11-4 the:

11-5 (a) Person is required to perform the exercise because he exhibited a

11-6 behavior that is related to his disability;

11-7 (b) Exercise is harmful to the health of the person because of his

11-8 disability; or

11-9 (c) Nature of the person’s disability prevents him from engaging in

11-10 the exercise; or

11-11 10. The deprivation of necessities needed to sustain the health of a

11-12 person, regardless of the length of the deprivation, including, without

11-13 limitation, the denial or unreasonable delay in the provision of:

11-14 (a) Food or liquid at a time when it is customarily served; or

11-15 (b) Medication.

11-16 Sec. 26. "Chemical restraint" means the administration of drugs for

11-17 the specific and exclusive purpose of controlling an acute or episodic

11-18 aggressive behavior when alternative intervention techniques have failed

11-19 to limit or control the behavior. The term does not include the

11-20 administration of drugs on a regular basis, as prescribed by a physician,

11-21 to treat the symptoms of mental, physical, emotional or behavioral

11-22 disorders and for assisting a person in gaining self-control over his

11-23 impulses.

11-24 Sec. 27. "Corporal punishment" means the intentional infliction of

11-25 physical pain, including, without limitation, hitting, pinching or striking.

11-26 Sec. 28. "Electric shock" means the application of electric current

11-27 to a person’s skin or body. The term does not include electroconvulsive

11-28 therapy.

11-29 Sec. 29. "Emergency" means a situation in which immediate

11-30 intervention is necessary to protect the physical safety of a person or

11-31 others from an immediate threat of physical injury or to protect against

11-32 an immediate threat of severe property damage.

11-33 Sec. 29.5. "Individualized education program" has the meaning

11-34 ascribed to it in 20 U.S.C. § 1414(d)(1)(A).

11-35 Sec. 30. "Individualized education program team" has the meaning

11-36 ascribed to it in 20 U.S.C. § 1414(d)(1)(B).

11-37 Sec. 31. "Mechanical restraint" means the use of devices, including,

11-38 without limitation, mittens, straps and restraint chairs to limit a person’s

11-39 movement or hold a person immobile.

11-40 Sec. 32. "Physical restraint" means the use of physical contact to

11-41 limit a person’s movement or hold a person immobile.

12-1 Sec. 33. "Verbal and mental abuse" means actions or utterances

12-2 that are intended to cause and actually cause severe emotional distress to

12-3 a person.

12-4 Sec. 34. A person employed by the board of trustees of a school

12-5 district or any other person shall not use any aversive intervention on a

12-6 pupil with a disability.

12-7 Sec. 35. A person employed by the board of trustees of a school

12-8 district or any other person shall not:

12-9 1. Except as otherwise provided in section 36 of this act, use physical

12-10 restraint on a pupil with a disability.

12-11 2. Except as otherwise provided in section 37 of this act, use

12-12 mechanical restraint on a pupil with a disability.

12-13 Sec. 36. 1. Except as otherwise provided in subsection 2, physical

12-14 restraint may be used on a pupil with a disability only if:

12-15 (a) An emergency exists that necessitates the use of physical restraint;

12-16 (b) The physical restraint is used only for the period that is necessary

12-17 to contain the behavior of the pupil so that the pupil is no longer an

12-18 immediate threat of causing physical injury to himself or others or

12-19 causing severe property damage; and

12-20 (c) The use of force in the application of physical restraint does not

12-21 exceed the force that is reasonable and necessary under the

12-22 circumstances precipitating the use of physical restraint.

12-23 2. Physical restraint may be used on a pupil with a disability and the

12-24 provisions of subsection 1 do not apply if the physical restraint is used to:

12-25 (a) Assist the pupil in completing a task or response if the pupil does

12-26 not resist the application of physical restraint or if his resistance is

12-27 minimal in intensity and duration;

12-28 (b) Escort or carry a pupil to safety if the pupil is in danger in his

12-29 present location; or

12-30 (c) Conduct medical examinations or treatments on the pupil that are

12-31 necessary.

12-32 3. If physical restraint is used on a pupil with a disability in an

12-33 emergency, the use of the procedure must be reported in the pupil’s

12-34 cumulative record and a confidential file maintained for the pupil not

12-35 later than 1 working day after the procedure is used. A copy of the report

12-36 must be provided to the board of trustees of the school district, the pupil’s

12-37 individualized education program team and the parent or guardian of the

12-38 pupil. If the board of trustees determines that a denial of the pupil’s

12-39 rights has occurred, the board of trustees may submit a report to the

12-40 department in accordance with section 42 of this act.

13-1 Sec. 37. 1. Except as otherwise provided in subsection 2,

13-2 mechanical restraint may be used on a pupil with a disability only if:

13-3 (a) An emergency exists that necessitates the use of mechanical

13-4 restraint;

13-5 (b) A medical order authorizing the use of mechanical restraint is

13-6 obtained from the pupil’s treating physician before the application of the

13-7 mechanical restraint or not later than 15 minutes after the application of

13-8 the mechanical restraint;

13-9 (c) The physician who signed the order required pursuant to

13-10 paragraph (b) or the attending physician examines the pupil as soon as

13-11 practicable;

13-12 (d) The mechanical restraint is applied by a member of the staff of the

13-13 school who is trained and qualified to apply mechanical restraint;

13-14 (e) The pupil is given the opportunity to move and exercise the parts

13-15 of his body that are restrained at least 10 minutes per every 60 minutes of

13-16 restraint, unless otherwise prescribed by the physician who signed the

13-17 order;

13-18 (f) A member of the staff of the school lessens or discontinues the

13-19 restraint every 15 minutes to determine whether the pupil will stop or

13-20 control his inappropriate behavior without the use of the restraint;

13-21 (g) The record of the pupil contains a notation that includes the time

13-22 of day that the restraint was lessened or discontinued pursuant to

13-23 paragraph (f), the response of the pupil and the response of the member

13-24 of the staff of the school who applied the mechanical restraint;

13-25 (h) A member of the staff of the school continuously monitors the

13-26 pupil during the time that mechanical restraint is used on the pupil; and

13-27 (i) The mechanical restraint is used only for the period that is

13-28 necessary to contain the behavior of the pupil so that the pupil is no

13-29 longer an immediate threat of causing physical injury to himself or

13-30 others or causing severe property damage.

13-31 2. Mechanical restraint may be used on a pupil with a disability and

13-32 the provisions of subsection 1 do not apply if the mechanical restraint is

13-33 used to:

13-34 (a) Treat the medical needs of the pupil;

13-35 (b) Protect a pupil who is known to be at risk of injury to himself

13-36 because he lacks coordination or suffers from frequent loss of

13-37 consciousness;

13-38 (c) Provide proper body alignment to a pupil; or

13-39 (d) Position a pupil who has physical disabilities in a manner

13-40 prescribed in the pupil’s individualized education program.

13-41 3. If mechanical restraint is used on a pupil with a disability in an

13-42 emergency, the use of the procedure must be reported in the pupil’s

13-43 cumulative record and a confidential file maintained for the pupil not

14-1 later than 1 working day after the procedure is used. A copy of the report

14-2 must be provided to the board of trustees of the school district, the pupil’s

14-3 individualized education program team and the parent or guardian of the

14-4 pupil. If the board of trustees determines that a denial of the pupil’s

14-5 rights has occurred, the board of trustees may submit a report to the

14-6 department in accordance with section 42 of this act.

14-7 Sec. 38. 1. The department shall develop a model program of

14-8 education for use by the school districts to train the members of the staff

14-9 of the schools within the school districts who are identified in the

14-10 individualized education programs of pupils with disabilities to provide

14-11 services to those pupils. The model program of education must provide

14-12 instruction in positive behavioral interventions and positive behavioral

14-13 supports that:

14-14 (a) Includes positive methods to modify the environment of pupils

14-15 with disabilities to promote adaptive behavior and reduce the occurrence

14-16 of inappropriate behavior;

14-17 (b) Includes methods to teach skills to pupils with disabilities so that

14-18 the pupils can replace inappropriate behavior with adaptive behavior;

14-19 (c) Includes methods to enhance the independence and quality of life

14-20 for pupils with disabilities;

14-21 (d) Includes the use of the least intrusive methods to respond to and

14-22 reinforce the behavior of pupils with disabilities; and

14-23 (e) Offers a process for designing interventions based upon the pupil

14-24 that are focused on promoting appropriate changes in behavior as well as

14-25 enhancing the overall quality of life for the pupil.

14-26 2. The board of trustees of each school district shall provide for

14-27 appropriate training for the members of the staff of the schools within

14-28 the school district who are authorized to carry out and monitor physical

14-29 restraint and mechanical restraint to ensure that those members of the

14-30 staff are qualified to carry out the procedures in accordance with

14-31 sections 24 to 42, inclusive, of this act.

14-32 Sec. 39. In addition to any penalty prescribed by specific statute, a

14-33 person who intentionally uses aversive intervention on a pupil with a

14-34 disability or intentionally violates section 35 of this act, is subject to

14-35 disciplinary action pursuant to NRS 391.312 or 391.330, or both.

14-36 Sec. 40. 1. A school where a violation of sections 24 to 42,

14-37 inclusive, of this act occurs shall report the violation to the board of

14-38 trustees of the school district not later than 24 hours after the violation

14-39 occurred, or as soon thereafter as the violation is discovered.

14-40 2. The board of trustees of the school district where the violation

14-41 occurred shall develop, in cooperation with the superintendent of schools

14-42 of the school district, a corrective plan to ensure that within 30 calendar

15-1 days after the violation occurred, appropriate action is taken by the

15-2 school and the board of trustees to prevent future violations.

15-3 3. The superintendent of schools of the school district shall submit

15-4 the plan to the department. The department shall review the plan to

15-5 ensure that it complies with applicable federal law and the statutes and

15-6 regulations of this state. The department may require appropriate

15-7 revision of the plan to ensure compliance.

15-8 4. If the school where the violation occurred does not meet the

15-9 requirements of the plan to the satisfaction of the department, the

15-10 department may appoint a licensed administrator to oversee the school to

15-11 ensure that the school meets the requirements of the plan. An

15-12 administrator serves at the pleasure of the superintendent of public

15-13 instruction and is entitled to receive such compensation as may be set by

15-14 the superintendent. A school district that contains a school for which an

15-15 administrator is appointed pursuant to this subsection shall reimburse

15-16 the department for any expenses incurred by the department pursuant to

15-17 this subsection.

15-18 Sec. 41. An officer, administrator or employee of a public school

15-19 shall not retaliate against any person for having:

15-20 1. Reported a violation of sections 24 to 42, inclusive, of this act; or

15-21 2. Provided information regarding a violation of sections 24 to 42,

15-22 inclusive, of this act,

15-23 by a public school or a member of the staff of the public school.

15-24 Sec. 42. 1. A denial of rights of a pupil with a disability pursuant

15-25 to sections 24 to 42, inclusive, of this act must be entered in the pupil’s

15-26 cumulative record and a confidential file maintained for that pupil.

15-27 Notice of the denial must be provided to the board of trustees of the

15-28 school district.

15-29 2. If the board of trustees of a school district receives notice of a

15-30 denial of rights pursuant to subsection 1, it shall cause a full report to be

15-31 prepared which must set forth in detail the factual circumstances

15-32 surrounding the denial. A copy of the report must be provided to the

15-33 department.

15-34 3. The department:

15-35 (a) Shall receive reports made pursuant to subsection 2;

15-36 (b) May investigate apparent violations of the rights of pupils with

15-37 disabilities; and

15-38 (c) May act to resolve disputes relating to apparent violations.

15-39 Sec. 43. NRS 388.440 is hereby amended to read as follows:

15-40 388.440 As used in NRS 388.440 to 388.520, inclusive [:] , and

15-43 who demonstrates such outstanding academic skills or aptitudes that he

16-1 cannot progress effectively in a regular school program and therefore needs

16-2 special instruction or special services.

16-3 2. "Pupil with a disability" means a person under the age of 22 years

16-4 who deviates either educationally, physically, socially or emotionally so

16-5 markedly from normal patterns that he cannot progress effectively in a

16-6 regular school program and therefore needs special instruction or special

16-7 services.

16-8 Sec. 44. NRS 391.312 is hereby amended to read as follows:

16-9 391.312 1. A teacher may be suspended, dismissed or not

16-42 special evaluation reports prepared in accordance with the policy of the

17-1 employing school district and to any written standards of performance

17-2 which may have been adopted by the board.

17-3 Sec. 45. NRS 391.330 is hereby amended to read as follows:

17-4 391.330 The state board may suspend or revoke the license of any

17-24 administered pursuant to NRS 389.015.

17-25 9. An intentional violation of section 34 or 35 of this act.

17-26 Sec. 46. Chapter 394 of NRS is hereby amended by adding thereto the

17-27 provisions set forth as sections 47 to 66, inclusive, of this act.

17-28 Sec. 47. As used in sections 47 to 66, inclusive, of this act, unless the

17-29 context otherwise requires, the words and terms defined in sections 48 to

17-30 57, inclusive, of this act have the meanings ascribed to them in those

17-31 sections.

17-32 Sec. 48. "Aversive intervention" means any of the following actions

17-33 if the action is used to punish a pupil with a disability or to eliminate,

17-34 reduce or discourage maladaptive behavior of a pupil with a disability:

17-35 1. The use of noxious odors and tastes;

17-36 2. The use of water and other mists or sprays;

17-37 3. The use of blasts of air;

17-38 4. The use of corporal punishment;

17-39 5. The use of verbal and mental abuse;

17-40 6. The use of electric shock;

17-41 7. The administration of chemical restraint to a person;

17-42 8. The placement of a person alone in a room where release from the

17-43 room is prohibited by a mechanism, including, without limitation, a lock,

18-1 device or object positioned to hold the door closed or otherwise prevent

18-2 the person from leaving the room;

18-3 9. Requiring a person to perform exercise under forced conditions if

18-4 the:

18-5 (a) Person is required to perform the exercise because he exhibited a

18-6 behavior that is related to his disability;

18-7 (b) Exercise is harmful to the health of the person because of his

18-8 disability; or

18-9 (c) Nature of the person’s disability prevents him from engaging in

18-10 the exercise; or

18-11 10. The deprivation of necessities needed to sustain the health of a

18-12 person, regardless of the length of the deprivation, including, without

18-13 limitation, the denial or unreasonable delay in the provision of:

18-14 (a) Food or liquid at a time when it is customarily served; or

18-15 (b) Medication.

18-16 Sec. 49. "Chemical restraint" means the administration of drugs for

18-17 the specific and exclusive purpose of controlling an acute or episodic

18-18 aggressive behavior when alternative intervention techniques have failed

18-19 to limit or control the behavior. The term does not include the

18-20 administration of drugs on a regular basis, as prescribed by a physician,

18-21 to treat the symptoms of mental, physical, emotional or behavioral

18-22 disorders and for assisting a person in gaining self-control over his

18-23 impulses.

18-24 Sec. 50. "Corporal punishment" means the intentional infliction of

18-25 physical pain, including, without limitation, hitting, pinching or striking.

18-26 Sec. 51. "Electric shock" means the application of electric current

18-27 to a person’s skin or body. The term does not include electroconvulsive

18-28 therapy.

18-29 Sec. 52. "Emergency" means a situation in which immediate

18-30 intervention is necessary to protect the physical safety of a person or

18-31 others from an immediate threat of physical injury or to protect against

18-32 an immediate threat of severe property damage.

18-33 Sec. 53. "Individualized education program team" has the meaning

18-34 ascribed to it in 20 U.S.C. § 1414(d)(1)(B).

18-35 Sec. 54. "Mechanical restraint" means the use of devices, including,

18-36 without limitation, mittens, straps and restraint chairs to limit a person’s

18-37 movement or hold a person immobile.

18-38 Sec. 55. "Physical restraint" means the use of physical contact to

18-39 limit a person’s movement or hold a person immobile.

18-40 Sec. 56. "Pupil with a disability" has the meaning ascribed to it in

18-41 NRS 388.440.

19-1 Sec. 57. "Verbal and mental abuse" means actions or utterances

19-2 that are intended to cause and actually cause severe emotional distress to

19-3 a person.

19-4 Sec. 58. A person employed by a private school or any other person

19-5 shall not use any aversive intervention on a pupil with a disability.

19-6 Sec. 59. A person employed by a private school or any other person

19-7 shall not:

19-8 1. Except as otherwise provided in section 60 of this act, use physical

19-9 restraint on a pupil with a disability.

19-10 2. Except as otherwise provided in section 61 of this act, use

19-11 mechanical restraint on a pupil with a disability.

19-12 Sec. 60. 1. Except as otherwise provided in subsection 2, physical

19-13 restraint may be used on a pupil with a disability only if:

19-14 (a) An emergency exists that necessitates the use of physical restraint;

19-15 (b) The physical restraint is used only for the period that is necessary

19-16 to contain the behavior of the pupil so that the pupil is no longer an

19-17 immediate threat of causing physical injury to himself or others or

19-18 causing severe property damage; and

19-19 (c) The use of force in the application of physical restraint does not

19-20 exceed the force that is reasonable and necessary under the

19-21 circumstances precipitating the use of physical restraint.

19-22 2. Physical restraint may be used on a pupil with a disability and the

19-23 provisions of subsection 1 do not apply if the physical restraint is used to:

19-24 (a) Assist the pupil in completing a task or response if the pupil does

19-25 not resist the application of physical restraint or if his resistance is

19-26 minimal in intensity and duration;

19-27 (b) Escort or carry a pupil to safety if the pupil is in danger in his

19-28 present location; or

19-29 (c) Conduct medical examinations or treatments on the pupil that are

19-30 necessary.

19-31 3. If physical restraint is used on a pupil with a disability in an

19-32 emergency, the use of the procedure must be reported in the pupil’s

19-33 cumulative record not later than 1 working day after the procedure is

19-34 used. A copy of the report must be provided to the superintendent, the

19-35 administrator of the private school, the pupil’s individualized education

19-36 program team, if applicable, and the parent or guardian of the pupil. If

19-37 the administrator of the private school determines that a denial of the

19-38 pupil’s rights has occurred, the administrator shall submit a report to the

19-39 superintendent in accordance with section 66 of this act.

19-40 Sec. 61. 1. Except as otherwise provided in subsection 2,

19-41 mechanical restraint may be used on a pupil with a disability only if:

19-42 (a) An emergency exists that necessitates the use of mechanical

19-43 restraint;

20-1 (b) A medical order authorizing the use of mechanical restraint is

20-2 obtained from the pupil’s treating physician before the application of the

20-3 mechanical restraint or not later than 15 minutes after the application of

20-4 the mechanical restraint;

20-5 (c) The physician who signed the order required pursuant to

20-6 paragraph (b) or the attending physician examines the pupil as soon as

20-7 practicable after the application of the mechanical restraint;

20-8 (d) The mechanical restraint is applied by a member of the staff of the

20-9 private school who is trained and qualified to apply mechanical restraint;

20-10 (e) The pupil is given the opportunity to move and exercise the parts

20-11 of his body that are restrained at least 10 minutes per every 60 minutes of

20-12 restraint, unless otherwise prescribed by the physician who signed the

20-13 order;

20-14 (f) A member of the staff of the private school lessens or discontinues

20-15 the restraint every 15 minutes to determine whether the pupil will stop or

20-16 control his inappropriate behavior without the use of the restraint;

20-17 (g) The record of the pupil contains a notation that includes the time

20-18 of day that the restraint was lessened or discontinued pursuant to

20-19 paragraph (f), the response of the pupil and the response of the member

20-20 of the staff of the private school who applied the mechanical restraint;

20-21 (h) A member of the staff of the private school continuously monitors

20-22 the pupil during the time that mechanical restraint is used on the pupil;

20-23 and

20-24 (i) The mechanical restraint is used only for the period that is

20-25 necessary to contain the behavior of the pupil so that the pupil is no

20-26 longer an immediate threat of causing physical injury to himself or

20-27 others or causing severe property damage.

20-28 2. Mechanical restraint may be used on a pupil with a disability and

20-29 the provisions of subsection 1 do not apply if the mechanical restraint is

20-30 used to:

20-31 (a) Treat the medical needs of the pupil;

20-32 (b) Protect a pupil who is known to be at risk of injury to himself

20-33 because he lacks coordination or suffers from frequent loss of

20-34 consciousness;

20-35 (c) Provide proper body alignment to a pupil; or

20-36 (d) Position a pupil who has physical disabilities in a manner

20-37 prescribed in the pupil’s service plan developed pursuant to 34 C.F.R. §

20-38 300.455 or the pupil’s individualized education program, whichever is

20-39 appropriate.

20-40 3. If mechanical restraint is used on a pupil with a disability in an

20-41 emergency, the use of the procedure must be reported in the pupil’s

20-42 cumulative record not later than 1 working day after the procedure is

20-43 used. A copy of the report must be provided to the superintendent, the

21-1 administrator of the private school, the pupil’s individualized education

21-2 program team, if applicable, and the parent or guardian of the pupil. If

21-3 the administrator of the private school determines that a denial of the

21-4 pupil’s rights has occurred, the administrator shall submit a report to the

21-5 superintendent in accordance with section 66 of this act.

21-6 4. As used in this section, "individualized education program" has

21-7 the meaning ascribed to it in 20 U.S.C. § 1414(d)(1)(A).

21-8 Sec. 62. 1. If a private school provides instruction to pupils with

21-9 disabilities, the school shall develop a program of education for the

21-10 members of the staff of the school who provide services to pupils with

21-11 disabilities. The program of education must provide instruction in

21-12 positive behavioral interventions and positive behavioral supports that:

21-13 (a) Includes positive methods to modify the environment of pupils

21-14 with disabilities to promote adaptive behavior and reduce the occurrence

21-15 of inappropriate behavior;

21-16 (b) Includes methods to teach skills to pupils with disabilities so that

21-17 the pupils can replace inappropriate behavior with adaptive behavior;

21-18 (c) Includes methods to enhance the independence and quality of life

21-19 for pupils with disabilities;

21-20 (d) Includes the use of the least intrusive methods to respond to and

21-21 reinforce the behavior of pupils with disabilities; and

21-22 (e) Offers a process for deigning interventions based upon the pupil

21-23 that are focused on promoting appropriate changes in behavior as well as

21-24 enhancing the overall quality of life for the pupil.

21-25 2. If a private school provides instruction to pupils with disabilities,

21-26 the school shall provide appropriate training for the members of the staff

21-27 of the school who are authorized to carry out and monitor physical

21-28 restraint and mechanical restraint to ensure that those members of the

21-29 staff are qualified to carry out the procedures in accordance with

21-30 sections 47 to 66, inclusive, of this act.

21-31 Sec. 63. In addition to any penalty prescribed by specific statute, a

21-32 person who intentionally uses aversive intervention on a pupil with a

21-33 disability or intentionally violates section 59 of this act, is subject to

21-34 appropriate disciplinary action by the private school that employs him.

21-35 Sec. 64. 1. A private school where a violation of sections 47 to 66,

21-36 inclusive, of this act occurs shall report the violation to the

21-37 superintendent not later than 24 hours after the violation occurred, or as

21-38 soon thereafter as the violation is discovered.

21-39 2. The private school where a violation occurred shall develop, in

21-40 cooperation with the superintendent, a corrective plan to ensure that

21-41 within 30 calendar days after the violation occurred, appropriate action

21-42 is taken by the private school to prevent future violations.

22-1 3. The superintendent shall submit the plan to the department. The

22-2 department shall review the plan to ensure that it complies with

22-3 applicable federal law and the statutes and regulations of this state. The

22-4 department may require appropriate revision of the plan to ensure

22-5 compliance.

22-6 Sec. 65. An officer, administrator or employee of a private school

22-7 shall not retaliate against any person for having:

22-8 1. Reported a violation of sections 47 to 66, inclusive, of this act; or

22-9 2. Provided information regarding a violation of sections 47 to 66,

22-10 inclusive, of this act,

22-11 by a private school or a member of the staff of the private school.

22-12 Sec. 66. 1. A denial of rights of a pupil with a disability pursuant

22-13 to sections 47 to 66, inclusive, of this act must be entered in the pupil’s

22-14 cumulative record. Notice of the denial must be provided to the

22-15 administrator of the private school.

22-16 2. If the administrator of a private school receives notice of a denial

22-17 of rights pursuant to subsection 1, he shall cause a full report to be

22-18 prepared which must set forth in detail the factual circumstances

22-19 surrounding the denial. A copy of the report must be provided to the

22-20 superintendent.

22-21 3. The superintendent:

22-22 (a) Shall receive reports made pursuant to subsection 2;

22-23 (b) May investigate apparent violations of the rights of pupils with

22-24 disabilities; and

22-25 (c) May act to resolve disputes relating to apparent violations.

22-26 Sec. 67. Chapter 449 of NRS is hereby amended by adding thereto the

22-27 provisions set forth as sections 68 to 86, inclusive, of this act.

22-28 Sec. 68. As used in sections 68 to 86, inclusive, of this act, unless the

22-29 context otherwise requires, the words and terms defined in sections 69 to

22-30 77, inclusive, of this act have the meanings ascribed to them in those

22-31 sections.

22-32 Sec. 69. "Aversive intervention" means any of the following actions

22-33 if the action is used to punish a person with a disability or to eliminate,

22-34 reduce or discourage maladaptive behavior of a person with a disability:

22-35 1. The use of noxious odors and tastes;

22-36 2. The use of water and other mists or sprays;

22-37 3. The use of blasts of air;

22-38 4. The use of corporal punishment;

22-39 5. The use of verbal and mental abuse;

22-40 6. The use of electric shock;

22-41 7. Requiring a person to perform exercise under forced conditions if

22-42 the:

23-1 (a) Person is required to perform the exercise because he exhibited a

23-2 behavior that is related to his disability;

23-3 (b) Exercise is harmful to the health of the person because of his

23-4 disability; or

23-5 (c) Nature of the person’s disability prevents him from engaging in

23-6 the exercise;

23-7 8. Any intervention, technique or procedure that deprives a person of

23-8 the use of one or more of his senses, regardless of the length of the

23-9 deprivation, including, without limitation, the use of sensory screens; or

23-10 9. The deprivation of necessities needed to sustain the health of a

23-11 person, regardless of the length of the deprivation, including, without

23-12 limitation, the denial or unreasonable delay in the provision of:

23-13 (a) Food or liquid at a time when it is customarily served; or

23-14 (b) Medication.

23-15 The term does not include the withholding or withdrawal of life-

23-16 sustaining treatment in accordance with NRS 449.626.

23-17 Sec. 69.5. "Chemical restraint" means the administration of drugs

23-18 for the specific and exclusive purpose of controlling an acute or episodic

23-19 aggressive behavior when alternative intervention techniques have failed

23-20 to limit or control the behavior. The term does not include the

23-21 administration of drugs on a regular basis, as prescribed by a physician,

23-22 to treat the symptoms of mental, physical, emotional or behavioral

23-23 disorders and for assisting a person in gaining self-control over his

23-24 impulses.

23-25 Sec. 70. "Corporal punishment" means the intentional infliction of

23-26 physical pain, including, without limitation, hitting, pinching or striking.

23-27 Sec. 71. "Electric shock" means the application of electric current

23-28 to a person’s skin or body. The term does not include electroconvulsive

23-29 therapy.

23-30 Sec. 72. "Emergency" means a situation in which immediate

23-31 intervention is necessary to protect the physical safety of a person or

23-32 others from an immediate threat of physical injury or to protect against

23-33 an immediate threat of severe property damage.

23-34 Sec. 73. "Facility" means a facility licensed pursuant to this chapter

23-35 that is a psychiatric hospital or a unit of a hospital that is specifically

23-36 designated to provide care and services to persons with psychiatric or

23-37 developmental disabilities.

23-38 Sec. 74. "Mechanical restraint" means the use of devices, including,

23-39 without limitation, mittens, straps and restraint chairs to limit a person’s

23-40 movement or hold a person immobile.

23-41 Sec. 75. "Person with a disability" means a person who:

23-42 1. Has a physical or mental impairment that substantially limits one

23-43 or more of the major life activities of the person;

24-1 2. Has a record of such an impairment; or

24-2 3. Is regarded as having such an impairment.

24-3 Sec. 76. "Physical restraint" means the use of physical contact to

24-4 limit a person’s movement or hold a person immobile.

24-5 Sec. 77. "Verbal and mental abuse" means actions or utterances

24-6 that are intended to cause and actually cause severe emotional distress to

24-7 a person.