1. Senate Bill No. 469–Committee on Human Resources

  1. and Facilities

CHAPTER........

AN ACT relating to persons with mental disabilities; extending certain governmental services

relating to mental retardation to persons with related conditions; and providing other

matters properly relating thereto.

 

 

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN

SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

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

new section to read as follows:

"Persons with related conditions" means persons who have a severe,

chronic disability which:

1. Is attributable to:

(a) Cerebral palsy or epilepsy; or

(b) Any other condition, other than mental illness, found to be closely

related to mental retardation because the condition results in impairment

of general intellectual functioning or adaptive behavior similar to that of

a mentally retarded person and requires treatment or services similar to

those required by a mentally retarded person;

2. Is manifested before the person affected attains the age of 22

years;

3. Is likely to continue indefinitely; and

4. Results in substantial functional limitations in three or more of

the following areas of major life activity:

(a) Taking care of oneself;

(b) Understanding and use of language;

(c) Learning;

(d) Mobility;

(e) Self-direction; and

(f) Capacity for independent living.

Sec. 2. NRS 433.003 is hereby amended to read as follows:

  1. 433.003 The legislature hereby declares that it is the intent of this
  1. Title:
  1. 1. To eliminate the forfeiture of any civil and legal rights of any person
  1. and the imposition of any legal disability on any person, based on an
  1. allegation of mental illness or mental retardation [,] or a related condition,
  1. by any method other than a separate judicial proceeding resulting in a
  1. determination of incompetency, wherein the civil and legal rights forfeited
  1. and the legal disabilities imposed are specifically stated; and
  1. 2. To charge the division of mental health and developmental services,
  1. and the division of child and family services, of the department with
  1. recognizing their duty to act in the best interests of their respective clients
  1. by placing them in the least restrictive environment.
  2. Sec. 3. NRS 433.005 is hereby amended to read as follows:
  1. 433.005 As used in this Title, unless the context otherwise requires, or
  1. except as otherwise defined by specific statute, the words and terms defined
  1. in NRS 433.014 to 433.224, inclusive, and section 1 of this act, have the
  1. meanings ascribed to them in those sections.

Sec. 4. NRS 433.184 is hereby amended to read as follows:

  1. 433.184 "Mental retardation center" means an organized program for
  1. providing appropriate services and treatment to mentally retarded persons
  1. [.] and persons with related conditions. A mental retardation center may
  1. include facilities for residential treatment and training.

Sec. 5. NRS 433.214 is hereby amended to read as follows:

  1. 433.214 "Training" means a program of services directed primarily
  1. toward enhancing the health, welfare and development of mentally retarded
  1. persons and persons with related conditions through the process of
  1. providing those experiences that will enable the individual to:
  1. 1. Develop his physical, intellectual, social and emotional capacities to
  1. the fullest extent;
  1. 2. Live in an environment that is conducive to personal dignity; and
  1. 3. Continue development of those skills, habits and attitudes essential
  1. to adaptation in contemporary society.

Sec. 6. NRS 433.233 is hereby amended to read as follows:

  1. 433.233 1. The division facilities providing mental health services
  1. are designated as:
  1. (a) Nevada mental health institute;

(b) Southern Nevada adult mental health services;

(c) Rural clinics; and

(d) Lakes Crossing center.

2. The division facilities providing services for mentally retarded

persons and persons with related conditions are designated as:

(a) Desert regional center;

(b) Sierra regional center; and

  1. (c) Rural regional center.

3. Division facilities established after July 1, 1981, must be named by

the administrator, subject to the approval of the director of the department.

Sec. 7. NRS 433.244 is hereby amended to read as follows:

  1. 433.244 1. The administrator must:
  1. (a) Have training and demonstrated administrative qualities of
  1. leadership in any one of the professional fields of psychiatry, medicine,
  1. psychology, social work, education or administration.
  1. (b) Be appointed, from a list of three persons nominated by the
  1. commission, on the basis of merit as measured by administrative training or
  1. experience in programs relating to mental health, including care, treatment
  1. or training, or any combination thereof, of mentally ill and mentally
  1. retarded persons [.] and persons with related conditions.
  1. (c) Have additional qualifications which are in accordance with criteria
  1. prescribed by the department of personnel.
  1. 2. The administrator is in the unclassified service of the state.

Sec. 8. NRS 433.279 is hereby amended to read as follows:

  1. 433.279 1. The division shall carry out a vocational and educational
  1. program for the certification of mental health-mental retardation
  1. technicians, including forensic technicians:
  1. (a) Employed by the division, or other employees of the division who
  1. perform similar duties, but are classified differently.
  1. (b) Employed by the division of child and family services of the
  1. department.
  1. The program must be carried out in cooperation with the University and
  1. Community College System of Nevada.
  1. 2. A mental health-mental retardation technician is responsible to the
  1. director of the service in which his duties are performed. The director of a
  1. service may be a licensed physician, dentist, podiatric physician,
  1. psychiatrist, psychologist, rehabilitation therapist, social worker, registered
  1. nurse or other professionally qualified person. This section does not
  1. authorize a mental health-mental retardation technician to perform duties
  1. which require the specialized knowledge and skill of a professionally
  1. qualified person.
  1. 3. The division shall adopt regulations to carry out the provisions of
  1. this section.
  1. 4. As used in this section, "mental health-mental retardation
  1. technician" means an employee of the division of mental health and
  1. developmental services or the division of child and family services who, for
  1. compensation or personal profit, carries out procedures and techniques
  1. which involve cause and effect and which are used in the care, treatment
  1. and rehabilitation of mentally ill, emotionally disturbed or mentally
  1. retarded persons [,] or persons with related conditions, and who has direct
  1. responsibility for:
  1. (a) Administering or carrying out specific therapeutic procedures,
  1. techniques or treatments, excluding medical interventions, to enable clients
  1. to make optimal use of their therapeutic regime, their social and personal
  1. resources, and their residential care; or

(b) The application of interpersonal and technical skills in the

observation and recognition of symptoms and reactions of clients, for the

accurate recording of such symptoms and reactions, and for carrying out

treatments authorized by members of the interdisciplinary team that

determines the treatment of the clients.

Sec. 9. NRS 433.314 is hereby amended to read as follows:

  1. 433.314 The commission shall:
  1. 1. Establish policies to ensure adequate development and
  1. administration of services for the mentally ill and mentally retarded [,] and
  1. persons with related conditions, including services to prevent mental
  2. illness and mental retardation and related conditions, and services
  1. provided without admission to a facility or institution;
  1. 2. Set policies for the care and treatment of mentally ill and mentally
  1. retarded persons and persons with related conditions provided by all state
  1. agencies;
  1. 3. Review the programs and finances of the division; and
  1. 4. Report at the beginning of each year to the governor and at the
  1. beginning of each odd-numbered year to the legislature on the quality of the
  1. care and treatment provided for mentally ill and mentally retarded persons
  1. and persons with related conditions in this state and on any progress made
  1. toward improving the quality of that care and treatment.

Sec. 10. NRS 433.316 is hereby amended to read as follows:

  1. 433.316 The commission may:

1. Collect and disseminate information pertaining to mental health and

mental retardation [.] and related conditions.

  1. 2. Request legislation pertaining to mental health and mental
  1. retardation [.] and related conditions.
  1. 3. Investigate complaints about the care of any person in a public
  1. facility for the treatment of the mentally ill or mentally retarded [.] and
  1. persons with related conditions.
  1. 4. Accept, as authorized by the legislature, gifts and grants of money
  1. and property.
  1. 5. Take appropriate steps to increase the availability of and to enhance
  1. the quality of the care and treatment of the mentally ill and mentally
  1. retarded and persons with related conditions provided through state
  1. agencies, hospitals and clinics.
  1. 6. Promote programs for the treatment of the mentally ill and mentally
  1. retarded and persons with related conditions and participate in and
  1. promote the development of facilities for training persons to provide
  1. services for the mentally ill and mentally retarded [.] and persons with
  1. related conditions.
  1. 7. Create a plan to coordinate the services for the treatment of the
  1. mentally ill and the mentally retarded and persons with related conditions
  1. provided in this state and to provide continuity in the care and treatment
  1. provided.
  1. 8. Establish and maintain an appropriate program which provides
  1. information to the general public concerning mental illness and mental
  1. retardation and related conditions and consider ways to involve the general
  1. public in the decisions concerning the policy on mental illness and mental
  1. retardation [.] and related conditions.
  1. 9. Compile statistics on mental illness and study the cause, pathology
  1. and prevention of that illness.
  1. 10. Establish programs to prevent or postpone the commitment of
  1. residents of this state to facilities for the treatment of the mentally ill and
  1. mentally retarded [.] and persons with related conditions.
  2. 11. Evaluate the future needs of this state concerning the treatment of
  1. mental illness and mental retardation and related conditions and develop
  1. ways to improve the treatment already provided.
  1. 12. Take any other action necessary to promote mental health in this
  1. state.

Sec. 11. NRS 433.324 is hereby amended to read as follows:

  1. 433.324 1. The commission shall adopt regulations:
  1. (a) For the care and treatment of mentally ill and mentally retarded
  1. persons and persons with related conditions by all state agencies and
  1. facilities, and their referral to private facilities;
  1. (b) To ensure continuity in the care and treatment provided to mentally
  1. ill and mentally retarded persons and persons with related conditions in
  1. this state; and
  1. (c) Necessary for the proper and efficient operation of the facilities of
  1. the division.
  1. 2. The commission may adopt regulations to promote programs
  1. relating to mental health and mental retardation [.] and related conditions.

Sec. 12. NRS 433.325 is hereby amended to read as follows:

  1. 433.325 The commission or its designated agent may inspect any state
  1. facility providing services for the mentally ill or mentally retarded and
  1. persons with related conditions to determine if the facility is in compliance
  1. with the provisions of this Title and any regulations adopted pursuant to
  1. those provisions.

Sec. 13. NRS 433.334 is hereby amended to read as follows:

  1. 433.334 The division may, by contract with general hospitals or other
  1. institutions having adequate facilities in the State of Nevada, provide for
  1. inpatient care of mentally ill and mentally retarded clients [.] and clients
  1. with related conditions.

Sec. 14. NRS 433.344 is hereby amended to read as follows:

  1. 433.344 The division may contract with appropriate persons
  1. professionally qualified in the field of psychiatric mental health to provide
  1. inpatient and outpatient care for mentally ill and mentally retarded persons
  1. and persons with related conditions when it appears that they can be
  1. treated best in that manner.

Sec. 15. NRS 433.395 is hereby amended to read as follows:

  1. 433.395 1. Upon approval of the director of the department, the
  1. administrator may accept:
  1. (a) Donations of money and gifts of real or personal property; and
  1. (b) Grants of money from the Federal Government,
  1. for use in public or private programs that provide services to persons in this
  1. state who are mentally ill or mentally retarded [.] and persons with related
  1. conditions.
  1. 2. The administrator shall disburse any donations, gifts and grants
  1. received pursuant to this section to programs that provide services to
  1. persons who are mentally ill or mentally retarded and persons with related
  1. conditions in a manner that supports the plan to coordinate services created
  2. by the commission pursuant to subsection 7 of NRS 433.316. In the
  1. absence of a plan to coordinate services, the administrator shall make
  1. disbursements to programs that will maximize the benefit provided to
  1. persons who are mentally ill or mentally retarded and persons with related
  1. conditions in consideration of the nature and value of the donation, gift or
  1. grant.
  1. 3. Within limits of legislative appropriations or other available money,
  1. the administrator may enter into a contract for services related to the
  1. evaluation and recommendation of recipients for the disbursements
  1. required by this section.

Sec. 16. NRS 433.404 is hereby amended to read as follows:

  1. 433.404 1. The division shall establish a fee schedule for services
  1. rendered through any program supported by the state pursuant to the
  1. provisions of chapters 433 to 436, inclusive, of NRS. The schedule must be
  1. submitted to the commission and the director of the department for joint
  1. approval before enforcement. The fees collected by facilities operated by
  1. the division pursuant to this schedule must be deposited in the state treasury
  1. to the credit of the state general fund, except as otherwise provided in NRS
  1. 433.354 for fees collected pursuant to contract or agreement and in NRS
  1. 435.120 for fees collected for services to mentally retarded clients [.] and
  1. clients with related conditions.
  1. 2. For a facility providing services for the treatment of the mentally ill
  1. or mentally retarded [,] and persons with related conditions, the fee
  1. established must approximate the cost of providing the service, but if a
  1. client is unable to pay in full the fee established pursuant to this section, the
  1. division may collect any amount the client is able to pay.

Sec. 17. NRS 433.458 is hereby amended to read as follows:

  1. 433.458 "Administrative officer" means a person with overall
  1. executive and administrative responsibility for a facility that provides
  1. services relating to mental health or mental retardation and related
  1. conditions and that is operated by any public or private entity.

Sec. 18. NRS 433.494 is hereby amended to read as follows:

  1. 433.494 1. An individualized written plan of mental health or mental
  1. retardation services or plan of services for a related condition must be
  1. developed for each client of each facility. The plan must provide for the
  1. least restrictive treatment procedure that may reasonably be expected to
  1. benefit the client.
  1. 2. The plan must be kept current and must be modified when indicated.
  1. The plan must be thoroughly reviewed at least once every 3 months.
  1. 3. The person in charge of implementing the plan of services must be
  1. designated in the plan.

Sec. 19. NRS 433A.020 is hereby amended to read as follows:

  1. 433A.020 The administrative officer of a facility of the division must:
  1. 1. Be selected on the basis of training and demonstrated administrative
  1. qualities of leadership in any one of the fields of psychiatry, medicine,
  1. psychology, social work, education or administration.
  2. 2. Be appointed on the basis of merit as measured by administrative
  1. training or experience in programs relating to mental health, including care
  1. and treatment of mentally ill and mentally retarded persons [.] and persons
  1. with related conditions.

3. Have additional qualifications which are in accordance with criteria

prescribed by the department of personnel.

Sec. 20. NRS 435.005 is hereby amended to read as follows:

  1. 435.005 Unless specifically excluded by law, the provisions of this
  1. chapter apply to all facilities within the division offering services to
  1. mentally retarded persons [.] and persons with related conditions.

Sec. 21. NRS 435.007 is hereby amended to read as follows:

  1. 435.007 As used in this chapter, unless the context otherwise requires:
  1. 1. "Child" means any person under the age of 18 years who may be
  1. eligible for mental retardation services [.] or services for a related
  1. condition.
  1. 2. "Residential facility for groups" means a structure similar to a
  1. private residence which will house a small number of persons in a homelike
  1. atmosphere.
  1. 3. "Parent" means the parent of a child. The term does not include the
  1. parent of a person who has attained the age of 18 years.
  1. 4. "Person" includes a child and any other mentally retarded client or
  1. client with a related condition who has attained the age of 18 years.

Sec. 22. NRS 435.010 is hereby amended to read as follows:

  1. 435.010 1. The boards of county commissioners of the various
  1. counties shall make provision for the support, education and care of the
  1. mentally retarded children and children with related conditions of their
  1. respective counties.
  1. 2. For that purpose they are empowered to make all necessary contracts
  1. and agreements to carry out the provisions of NRS 435.010 to 435.040,
  1. inclusive. Any such contract or agreement may be made with any
  1. responsible person or facility in or without the State of Nevada.
  1. 3. The provisions of NRS 435.010 to 435.040, inclusive, supplement
  1. the services which other political subdivisions or agencies of the state are
  1. required by law to provide, and do not supersede or relieve the
  1. responsibilities of such political subdivisions or agencies.

Sec. 23. NRS 435.020 is hereby amended to read as follows:

  1. 435.020 All mentally retarded children and children with related
  1. conditions are entitled to benefits under NRS 435.010 to 435.040,
  1. inclusive:
  1. 1. Who are unable to pay for their support and care;
  1. 2. Whose parents, relatives or guardians are unable to pay for their
  1. support and care; and
  1. 3. If division facilities are to be utilized, whom the division recognizes
  1. as proper subjects for services within such division facilities.

Sec. 24. NRS 435.030 is hereby amended to read as follows:

  1. 435.030 1. A parent, relative, guardian or nearest friend of any
  1. mentally retarded child [,] or a child with a related condition who is a
  1. resident of this state, may file with the board of county commissioners of
  1. the proper county an application under oath stating:
  1. (a) That the child meets the criteria set forth in NRS 435.020; and
  1. (b) That the child requires services not otherwise required by law to be
  1. provided to him by any other county, political subdivision or agency of this
  1. or any other state.
  1. 2. If the board of county commissioners is satisfied that the statements
  1. made in the application are true, the board shall issue a certificate to that
  1. effect.
  1. 3. The board of county commissioners shall make necessary
  1. arrangements for the transportation of a mentally retarded child or a child
  1. with a related condition to any responsible person or facility to be utilized
  1. pursuant to contract or agreement as designated in NRS 435.010 at the
  1. expense of the county.
  1. 4. A certificate of the board of county commissioners, when produced,
  1. shall be the authority of any responsible person or facility in or without the
  1. State of Nevada under contract with the board of county commissioners to
  1. receive any such mentally retarded child [.] or child with a related
  1. condition.

Sec. 25. NRS 435.040 is hereby amended to read as follows:

  1. 435.040 1. In case a resident of the northern Nevada children’s home
  1. or the southern Nevada children’s home is adjudged to be mentally retarded
  1. [,] or to have a related condition, a responsible person or facility as
  1. designated in NRS 435.010 may receive the resident from the
  1. superintendent of [such] the children’s home and shall make provision for
  1. [such] the child in the same manner as if received from a board of county
  1. commissioners.
  1. 2. The county of the child’s residence immediately preceding
  1. admission to the children’s home [shall] must bear the expense of
  1. transportation to the responsible person or facility and of the subsequent
  1. care.
  1. 3. If the child is a dependent child committed to the northern Nevada
  1. children’s home or the southern Nevada children’s home under the
  1. provisions of NRS 423.210, the county [shall be] is entitled to receive from
  1. the parent or parents, and to recover by appropriate legal action if
  1. necessary, all sums expended by the county under subsection 2 , [;] but the
  1. sum which the county may receive or recover [shall] must not exceed the
  1. amount which the district court has ordered [such] the parent or parents to
  1. pay under NRS 423.210.

Sec. 26. NRS 435.060 is hereby amended to read as follows:

  1. 435.060 The division may operate a residential facility for groups to
  1. care for and maintain mentally retarded persons and persons with related
  1. conditions until they can live in a more normal situation.
  2. Sec. 27. NRS 435.077 is hereby amended to read as follows:
  1. 435.077 1. The administrator shall [establish] adopt regulations for
  1. the transfer of mentally retarded persons and persons with related
  1. conditions from one facility to another facility operated by the division.
  1. 2. Subject to the provisions of subsection 3, when the associate
  1. administrator for mental retardation determines that it is in the best interest
  1. of the person, he may discharge, or place on convalescent leave, any
  1. mentally retarded person or person with a related condition in a facility
  1. operated by the division.
  1. 3. When a mentally retarded person or person with a related condition
  1. is committed to a division facility by court order, the committing court must
  1. be given 10 days’ notice before the discharge of that person.

Sec. 28. NRS 435.081 is hereby amended to read as follows:

  1. 435.081 1. The administrator or his designee may receive a mentally
  1. retarded person or person with a related condition of this state for services
  1. in a facility operated by the division if:
  1. (a) [He] The person is mentally retarded as defined in NRS 433.174 or
  1. is a person with a related condition and is in need of institutional training
  1. and treatment;
  1. (b) Space is available which is designed and equipped to provide
  1. appropriate care for [him;] the person;
  1. (c) The facility has or can provide an appropriate program of training
  1. and treatment for [him;] the person; and
  1. (d) There is written evidence that no less restrictive alternative is
  1. available in his community.
  1. 2. A mentally retarded person or person with a related condition may
  1. be accepted at a division facility for emergency evaluation when the
  1. evaluation is requested by a court. A person must not be retained pursuant
  1. to this subsection for more than 10 working days.
  1. 3. A court may order that a mentally retarded person or person with a
  1. related condition be admitted to a division facility if it finds that admission
  1. is necessary because of the death or sudden disability of the parent or
  1. guardian of the person. The person must not be retained pursuant to this
  1. subsection for more than 45 days. Before the expiration of the 45-day
  1. period the division shall report to the court its recommendations for
  1. placement or treatment of the person. If less restrictive alternatives are not
  1. available, the person may be admitted to the facility using the procedures
  1. for voluntary or involuntary admission, as appropriate.
  1. 4. A child may be received, cared for and examined at a division
  1. facility for the mentally retarded for not more than 10 working days without
  1. admission, if the examination is ordered by a court having jurisdiction of
  1. the minor in accordance with the provisions of paragraph (c) of subsection
  1. 1 of NRS 62.211 and subsection 1 of NRS 432B.560. At the end of the 10
  1. days, the administrator or his designee shall report the result of the
  1. examination to the court and shall detain the child until the further order of
  1. the court, but not to exceed 7 days after the administrator’s report.
  2. 5. The parent or guardian of a person believed to be mentally retarded
  1. or believed to have a related condition may apply to the administrative
  1. officer of a division facility to have the person evaluated by personnel of
  1. the division who are experienced in the diagnosis of mental retardation [.]
  1. and related conditions. The administrative officer may accept the person
  1. for evaluation without admission.
  1. 6. If, after the completion of an examination or evaluation pursuant to
  1. subsection 4 or 5, the administrative officer finds that the person meets the
  1. criteria set forth in subsection 1, the person may be admitted to the facility
  1. using the procedures for voluntary or involuntary admission, as
  1. appropriate.
  1. 7. If, at any time, the parent or guardian of a person admitted to a
  1. division facility on a voluntary basis, or the person himself if he has
  1. attained the age of 18 years, requests in writing that the person be
  1. discharged, the administrative officer shall discharge the person. If the
  1. administrative officer finds that discharge from the facility is not in the
  1. person’s best interests, he may initiate proceedings for involuntary
  1. admission, but the person must be discharged pending those proceedings.

Sec. 29. NRS 435.085 is hereby amended to read as follows:

  1. 435.085 The administrative officer of a division facility may authorize
  1. the transfer of a mentally retarded person or person with a related
  1. condition to a general hospital for necessary diagnostic, medical or surgical
  1. services not available within the division. All expenses incurred under this
  1. section [shall] must be paid as follows:
  1. 1. In the case of a judicially committed mentally retarded person [,
  1. such expenses shall] or person with a related condition, the expenses must
  1. be paid by his parents or guardian to the extent of their reasonable financial
  1. ability as determined by the administrator, and the remainder, if any, [shall
  1. be] is a charge upon the county of the last known residence of the mentally
  1. retarded [person’s last known residence;] person or person with a related
  1. condition;
  1. 2. In the case of a mentally retarded person or person with a related
  1. condition admitted to a division facility pursuant to NRS 435.010, 435.020
  1. and 435.030, [such expenses shall be] the expenses are a charge upon the
  1. county from which a certificate was issued pursuant to subsection 2 of NRS
  1. 435.030; and
  1. 3. In the case of a mentally retarded person or person with a related
  1. condition admitted to a division facility upon voluntary application as
  1. provided in NRS 435.081, [such expenses shall] the expenses must be paid
  1. by the parents or guardian to the extent of their reasonable financial ability
  1. as determined by the administrator, and for the remainder, if any, the
  1. administrator shall explore all reasonable alternative sources of payment.

Sec. 30. NRS 435.090 is hereby amended to read as follows:

  1. 435.090 1. When any mentally retarded child or child with a related
  1. condition is committed to a division facility by a court of competent
  1. jurisdiction, the court shall examine the parent, parents or guardian of
  2. [such] the child regarding the ability of [such] the parent, parents or
  1. guardian or the estate of the child to contribute to the care, support and
  1. maintenance of [such] the child while residing in [such] the facility.
  1. 2. If the court determines that the parent, parents or guardian of the
  1. child is able to contribute, it shall enter an order prescribing the amount to
  1. be contributed.
  1. 3. If the court determines that the estate of the child is able to
  1. contribute, it shall enter an order requiring that a guardian of the estate of
  1. the child be appointed, if there is none, and that the guardian of the estate
  1. contribute the amount prescribed by the court from [such] the estate.
  1. 4. If the parent, parents or guardian fail or refuse to comply with the
  1. order of the court, the division is entitled to recover from the parent,
  1. parents or guardian, by appropriate legal action, all sums due together with
  1. interest.

Sec. 31. NRS 435.100 is hereby amended to read as follows:

  1. 435.100 1. When any mentally retarded person or person with a
  1. related condition is transferred from one care facility operated by the
  1. division to another care facility operated by the division, the parent, parents
  1. or guardian shall continue to contribute [such] the amount for the care,
  1. support and maintenance of [such] the person as may have previously been
  1. ordered by the court of competent jurisdiction committing [such] the
  1. person.
  1. 2. If no such order was entered by the committing court, the division
  1. may petition [such] the court for an order requiring the parent, parents or
  1. guardian to contribute.
  1. 3. Any order for contribution entered under the provisions of
  1. subsection 2 [shall] must be entered in the same manner and [have] has the
  1. same effect as an order for contribution entered under the provisions of
  1. NRS 435.090.

Sec. 32. NRS 435.110 is hereby amended to read as follows:

  1. 435.110 1. When any mentally retarded child or child with a related
  1. condition is admitted to a facility operated by the division at the request of
  1. a parent, parents or guardian, [such] the parent, parents or guardian shall
  1. enter into an agreement with the division providing for the contribution of
  1. an amount for the care, support and maintenance of [such] the child as
  1. determined by the division to be reasonable. In determining the amount, the
  1. division shall give consideration to the ability of the parent, parents or
  1. guardian to make such a contribution, and may excuse the making of any
  1. contribution.
  1. 2. If the parent, parents or guardian fail or refuse to perform under the
  1. terms of the agreement, the division is entitled to recover from the parent,
  1. parents or guardian, by appropriate legal action, all sums due together with
  1. interest.
  1. 3. If the division determines that the parent, parents or guardian do not
  1. have the ability to contribute an amount sufficient to pay for the care,
  1. support and maintenance of [such] the child, but that the estate of [such]
  2. the child is able to contribute, the division may make application to a court
  1. of competent jurisdiction for the appointment of a guardian of the estate of
  1. [such] the child, if there is none, and for an order requiring [such] the
  1. guardian to contribute an amount as determined by the court.

Sec. 33. NRS 435.115 is hereby amended to read as follows:

  1. 435.115 The administrator shall establish a fee schedule, in
  1. consultation with the state association for retarded citizens and subject to
  1. the approval of the board and the director of the department, for services
  1. rendered to the mentally retarded and to persons with related conditions
  1. by the division.

Sec. 34. NRS 435.121 is hereby amended to read as follows:

  1. 435.121 1. There are two types of admissions of mentally retarded
  1. persons or persons with related conditions to a mental retardation center:
  1. (a) Voluntary admission.
  1. (b) Involuntary admission.
  1. 2. An application for admission of a mentally retarded person or
  1. person with a related condition to a mental retardation center must be
  1. made on a form approved by the division and the attorney general. The
  1. clerk of each district court in the state shall make the forms available to any
  1. person upon request.

Sec. 35. NRS 435.122 is hereby amended to read as follows:

  1. 435.122 1. Any mentally retarded person or person with a related
  1. condition may apply to any mental retardation center for admission as a
  1. voluntary client. His parent or guardian or another responsible person may
  1. submit the application on his behalf.
  1. 2. If the person or a responsible party on behalf of the person objects to
  1. voluntary admission, the procedure for involuntary admission may be
  1. followed.

Sec. 36. NRS 435.123 is hereby amended to read as follows:

  1. 435.123 Whenever a person is alleged to be mentally retarded or to
  1. have a related condition and is alleged to be a clear and present danger to
  1. himself or others, his parent or guardian or another responsible person may
  1. initiate proceedings for his involuntary admission to a mental retardation
  1. center by petitioning the district court of the county where the person
  1. resides. The petition must be accompanied by a certificate signed by a
  1. physician or licensed psychologist experienced in the diagnosis of mental
  1. retardation and related conditions stating that he has examined the person
  1. within the preceding 30 days and has concluded that the person is mentally
  1. retarded [,] or is a person with a related condition, has demonstrated that
  1. he is a clear and present danger to himself or others and is in need of
  1. institutional training and treatment.

Sec. 37. NRS 435.125 is hereby amended to read as follows:

  1. 435.125 1. After the petition is filed , the court may cause a
  1. physician or licensed psychologist promptly to examine the person who is
  1. the subject of the petition or request an evaluation from the mental
  1. retardation center to which it is proposed the person be admitted. Any
  2. physician or licensed psychologist requested by the court to conduct such
  1. an examination must be experienced in the diagnosis of mental retardation
  1. [.] and related conditions. The examination or evaluation must indicate
  1. whether the person is or is not mentally retarded or a person with a related
  1. condition and whether he is or is not in need of institutional training and
  1. treatment.
  1. 2. The court may allow the person alleged to be mentally retarded or to
  1. have a related condition to remain at his place of residence pending any
  1. ordered examination and to return upon completion of the examination.
  1. One or more of the person’s relatives or friends may accompany him to the
  1. place of examination.

Sec. 38. NRS 435.126 is hereby amended to read as follows:

  1. 435.126 1. The person alleged to be mentally retarded [,] or to have
  1. a related condition, or any relative or friend acting on his behalf, is entitled
  1. to retain counsel to represent him in any proceeding before the district
  1. court relating to his involuntary admission to a mental retardation center.
  1. 2. If [such] counsel has not been retained, the court, before proceeding,
  1. shall advise the person and his guardian, or closest living relative if such a
  1. relative can be located, of the person’s right to have counsel.
  1. 3. If the person fails or refuses to secure counsel, the court shall
  1. appoint counsel to represent him. If the person is indigent, the counsel
  1. appointed may be the public defender.
  1. 4. Any counsel appointed by the court is entitled to fair and reasonable
  1. compensation for his services. The compensation must be charged against
  1. the property of the person for whom he was appointed. If the person is
  1. indigent, the compensation must be charged against the county in which the
  1. person alleged to be mentally retarded or to have a related condition last
  1. resided.

Sec. 39. NRS 435.128 is hereby amended to read as follows:

  1. 435.128 1. Upon completion of the proceedings for involuntary
  1. admission of a person to a mental retardation center, if the court finds:
  1. (a) That the person is mentally retarded [,] or has a related condition,
  1. has demonstrated that he is a clear and present danger to himself or others
  1. and is in need of institutional training and treatment;
  1. (b) That appropriate space and programs are available at the mental
  1. retardation center to which it is proposed that the person be admitted; and
  1. (c) That there is no less restrictive alternative to admission to a mental
  1. retardation center which would be consistent with the best interests of the
  1. person,
  1. the court shall by written order certify that the person is eligible for
  1. involuntary admission to a mental retardation center.
  1. 2. A certificate of eligibility for involuntary admission expires 12
  1. months after the date of issuance if the client has not been discharged
  1. earlier by the procedure provided in NRS 435.129. At the end of the 12-
  1. month period, the administrative officer of the mental retardation center
  1. may petition the court to renew the certificate for an additional period of
  2. not more than 12 months. Each petition for renewal must set forth the
  1. specific reasons why further treatment is required. A certificate may be
  1. renewed more than once.

Sec. 40. NRS 435.130 is hereby amended to read as follows:

  1. 435.130 The intent of the legislature in the enactment of NRS 435.130
  1. to 435.320, inclusive, is to aid mentally or functionally retarded persons
  1. and persons with related conditions who are not served by existing
  1. programs to receive high quality care and training in an effort to help them
  1. become useful citizens.

Sec. 41. NRS 435.180 is hereby amended to read as follows:

435.180 "Enrollee" means any person enrolled in a center for care and

training because of mental or functional retardation [.] or a related

condition.

Sec. 42. NRS 435.230 is hereby amended to read as follows:

  1. 435.230 [In order to] To qualify for the aid provided for by NRS
  1. 435.130 to 435.320, inclusive, a center must:
  1. 1. File an application with the division for a certificate of qualification,
  1. which must include:
  1. (a) The name and address of the center.
  1. (b) The names, addresses and qualifications of the administrative
  1. personnel of the center.
  1. (c) An outline of the educational, occupational and therapeutic program
  1. to be offered.
  1. (d) The number of persons enrolled or expected.
  1. (e) An affidavit that the center is nonsectarian and a nonprofit
  1. organization under the Internal Revenue Code of 1954 as amended , [(] 26
  1. U.S.C. § 501(c)(3) . [).]
  1. (f) The number and qualifications of the staff.
  1. (g) A complete and detailed proposed financial statement for the
  1. operations for the coming year.
  1. (h) Any other information which the division may require.
  1. 2. Each year after the original application is made under subsection 1,
  1. file an application for renewal of the certificate of qualification, which must
  1. contain:
  1. (a) The information required by subsection 1.
  1. (b) The total number of members of the staff, persons enrolled, and days
  1. of care and training that the center provided during the previous year.
  1. (c) The number enrolled and days of care and training that the center
  1. provided during the previous year to those enrolled who qualify for aid
  1. under the terms of NRS 435.130 to 435.320, inclusive, and the standards
  1. established by the division.
  1. (d) A financial statement clearly showing all income received by the
  1. center during the previous year and the sources thereof.
  1. (e) Any other information that the division may require.
  1. 3. Be inspected by a member or authorized agent of the division to
  1. determine whether the center’s facilities are proper and adequate.
  2. 4. Keep accurate records of daily attendance and establish uniform
  1. financial statements and bookkeeping procedures as prescribed by the
  1. division.
  1. 5. Maintain standards not inconsistent with those required by NRS
  1. 435.130 to 435.320, inclusive, or established by the division to qualify for
  1. money from other sources, such as United Fund and United States
  1. Government programs.
  1. 6. Before certifying an applicant for enrollment as mentally retarded [,]
  1. or a person with a related condition, require:
  1. (a) A documentary history of retarded overall functioning [;] or the
  1. related condition; and
  1. (b) Substantiation, through evaluation by a qualified diagnostic team.

7. Meet all other standards set by the division.

Sec. 43. NRS 435.340 is hereby amended to read as follows:

  1. 435.340 Neither voluntary admission nor judicial commitment nor any
  1. other procedure provided in this chapter [shall] may be construed as
  1. depriving a mentally retarded person or person with a related condition of
  1. his full civil and legal rights by any method other than a separate judicial
  1. proceeding resulting in a determination of incompetency wherein the civil
  1. and legal rights forfeited and the legal disabilities imposed are specifically
  1. stated.

Sec. 44. NRS 435.350 is hereby amended to read as follows:

  1. 435.350 1. Each mentally retarded person or person with a related
  1. condition admitted to a division facility is entitled to all rights enumerated
  1. in NRS 433.482 and 433.484.
  1. 2. The administrator shall designate a person or persons to be
  1. responsible for establishment of regulations relating to denial of rights of
  1. mentally retarded persons [.] and persons with related conditions. The
  1. person designated shall file the regulations with the administrator.
  1. 3. Clients’ rights specified in NRS 433.482 and 433.484 may be denied
  1. only for cause. Any denial of such rights must be entered in the client’s
  1. treatment record, and notice of [such] the denial must be forwarded to the
  1. administrator’s designee or designees as provided in subsection 2. Failure
  1. to report denial of rights by an employee may be grounds for dismissal.
  1. 4. Upon receipt of notice of a denial of rights as provided in subsection
  1. 3, the administrator’s designee or designees shall cause a full report to be
  1. prepared which sets forth in detail the factual circumstances surrounding
  1. [such] the denial. A copy of the report must be sent to the administrator and
  1. the commission.
  1. 5. The commission has such powers and duties with respect to reports
  1. of denial of rights as are enumerated in subsection 3 of NRS 433.534.

Sec. 45. NRS 435.360 is hereby amended to read as follows:

  1. 435.360 1. The relatives of a mentally retarded client or client with a
  1. related condition who is 18 years of age or older are not responsible for the
  1. costs of his care and treatment within a division facility.
  2. 2. The client or his estate, when able, may be required to contribute a
  1. reasonable amount toward the costs of his care and treatment. Otherwise,
  1. the full costs of [such] the services must be borne by the state.

Sec. 46. NRS 435.365 is hereby amended to read as follows:

  1. 435.365 1. Whenever a person with mental retardation or a related
  1. condition is cared for by a parent or other relative with whom he lives, that
  1. parent or relative is eligible to receive assistance on a monthly basis from
  1. the division for each such person who lives and is cared for in the home if
  1. the division finds that:
  1. (a) The person with mental retardation or a related condition has been
  1. diagnosed as having profound or severe mental retardation or, if he is under
  1. 6 years of age, has developmental delays that require support that is
  1. equivalent to the support required by a person with profound or severe
  1. mental retardation [;] or a related condition;
  1. (b) The person with mental retardation or a related condition is
  1. receiving adequate care; and
  1. (c) The person with mental retardation or a related condition and the
  1. parent or other relative with whom he lives is not reasonably able to pay for
  1. his care and support.
  1. The amount of [such] the assistance must be established by legislative
  1. appropriation for each fiscal year.
  1. 2. The division shall adopt regulations:
  1. (a) Which establish a procedure of application for assistance;
  1. (b) For determining the eligibility of an applicant pursuant to subsection
  1. 1; and
  1. (c) For determining the amount of assistance to be provided to an
  1. eligible applicant.
  1. 3. The decision of the division regarding eligibility for assistance or the
  1. amount of assistance to be provided is a final administrative decision.

Sec. 47. NRS 435.370 is hereby amended to read as follows:

  1. 435.370 The division may make such rules and regulations and enter
  1. such agreements with public and private agencies as are deemed necessary
  1. to implement residential placement-foster family care programs for
  1. mentally retarded persons [.] and persons with related conditions.

Sec. 48. NRS 435.390 is hereby amended to read as follows:

  1. 435.390 1. The administrative officer of any division facility where
  1. mentally retarded persons or persons with related conditions reside may
  1. establish a canteen operated for the benefit of clients and employees of the
  1. facility. The administrative officer shall keep a record of transactions in the
  1. operation of the canteen.
  1. 2. Each canteen must be self-supporting. No money provided by the
  1. state may be used for its operation.
  1. 3. The respective administrative officers shall deposit the money used
  1. for the operation of the canteen in one or more banks of reputable standing,
  1. except that an appropriate sum may be maintained as petty cash at each
  1. canteen.
  2. Sec. 49. NRS 436.110 is hereby amended to read as follows:
  1. 436.110 The legislature declares that the purposes of this chapter are:
  1. 1. To encourage and provide financial assistance to counties in the
  1. establishment and development of mental health services, including
  1. services to the mentally retarded [,] and persons with related conditions,
  1. through locally controlled community mental health programs.

2. To promote the improvement and, if necessary, the expansion of

already existing services which help to conserve the mental health of the

people of Nevada. It is the intent of this chapter that services to individuals

[shall] be rendered only upon voluntary application.

Sec. 50. NRS 436.150 is hereby amended to read as follows:

  1. 436.150 The county board shall:
  1. 1. Review and evaluate communities’ needs, services, facilities and
  1. special problems in the fields of mental health and mental retardation [.]
  1. and related conditions.
  1. 2. Advise the governing body as to programs of community mental
  1. health services and facilities and services to the mentally retarded [,] and
  1. persons with related conditions, and, when requested by [such] the
  1. governing body, make recommendation regarding the appointment of a
  1. county director.

3. After adoption of a program, continue to act in an advisory capacity

to the county director.

Sec. 51. NRS 436.170 is hereby amended to read as follows:

  1. 436.170 The county director shall:
  1. 1. Serve as chief executive officer of the county program and be
  1. accountable to the county board.
  1. 2. Exercise administrative responsibility and authority over the county
  1. program and facilities furnished, operated or supported in connection
  1. therewith, and over services to the mentally retarded [,] and persons with
  1. related conditions, except as administrative responsibility is otherwise
  1. provided for in this Title.
  1. 3. Recommend to the governing body, after consultation with the
  1. county board, the providing of services, establishment of facilities,
  1. contracting for services or facilities and other matters necessary or
  1. desirable to accomplish the purposes of this chapter.
  1. 4. Submit an annual report to the governing body reporting all
  1. activities of the program, including a financial accounting of expenditures
  1. and a forecast of anticipated needs for the ensuing year.

5. Carry on such studies as may be appropriate for the discharge of his

duties, including the control and prevention of psychiatric disorders and the

treatment of mental retardation [.] and related conditions.

Sec. 52. NRS 436.230 is hereby amended to read as follows:

436.230 Expenditures made by counties for county programs,

including services to the mentally retarded [,] and persons with related

conditions, pursuant to this chapter, [shall] must be reimbursed by the state

pursuant to NRS 436.240 to 436.320, inclusive.

Sec. 53. NRS 436.240 is hereby amended to read as follows:

  1. 436.240 1. A service operated within a county program [shall] must
  1. be directed to at least one of the following mental health areas:
  1. (a) Mental illness;
  1. (b) Mental retardation [;] and related conditions;
  1. (c) Organic brain and other neurological impairment;
  1. (d) Alcoholism; and
  1. (e) Drug abuse.
  1. 2. A service is any of the following:
  1. (a) Diagnostic service;
  1. (b) Emergency service;
  1. (c) Inpatient service;
  1. (d) Outpatient or partial hospitalization service;
  1. (e) Residential, sheltered or protective care service;
  1. (f) Habilitation or rehabilitation service;
  1. (g) Prevention, consultation, collaboration, education or information
  1. service; and

(h) Any other service approved by the division.

Sec. 54. NRS 436.270 is hereby amended to read as follows:

  1. 436.270 1. [Moneys] Money provided by direct legislative
  1. appropriation for purposes of reimbursement as provided by NRS 436.230
  1. to 436.260, inclusive, [shall] must be allotted to the governing body as
  1. follows:
  1. (a) The state shall pay to each county a sum equal to 90 percent of the
  1. total proposed expenditures as reflected by the plan of proposed
  1. expenditures submitted pursuant to NRS 436.250 if the county has
  1. complied with the provisions of paragraph (b).
  1. (b) [Prior to] Before payment under this subsection, the governing body
  1. of a county must submit evidence to the administrator that 10 percent of the
  1. total proposed expenditures have been raised and budgeted by the county
  1. for the establishment or maintenance of a county program.

2. All state and federal moneys appropriated or authorized for the

promotion of mental health or for services to the mentally retarded and

persons with related conditions in the State of Nevada [shall] must be

disbursed through the division in accordance with the provisions of this

chapter and rules and regulations [promulgated] adopted in accordance

therewith.

Sec. 55. NRS 436.310 is hereby amended to read as follows:

436.310 Fees for mental health services, including services to the

mentally retarded [,] and persons with related conditions, rendered

pursuant to an approved county plan [shall] must be charged in accordance

with ability to pay, but not in excess of actual cost.

Sec. 56. This act becomes effective upon passage and approval.

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