Senate Bill No. 469–Committee on Human Resources
and Facilities

(On Behalf of Budget Division)

March 17, 1999

____________

Referred to Committee on Human Resources and Facilities

 

SUMMARY—Extends services related to mental retardation to persons with related conditions. (BDR 39-1579)

FISCAL NOTE: Effect on Local Government: Yes.

Effect on the State or on Industrial Insurance: Yes.

~

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).

 

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:

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

1-2 new section to read as follows:

1-3 "Persons with related conditions" means persons who have a severe,

1-4 chronic disability which:

1-5 1. Is attributable to:

1-6 (a) Cerebral palsy or epilepsy; or

1-7 (b) Any other condition, other than mental illness, found to be closely

1-8 related to mental retardation because the condition results in impairment

1-9 of general intellectual functioning or adaptive behavior similar to that of

1-10 a mentally retarded person and requires treatment or services similar to

1-11 those required by a mentally retarded person;

1-12 2. Is manifested before the person affected attains the age of 22

1-13 years;

1-14 3. Is likely to continue indefinitely; and

1-15 4. Results in substantial functional limitations in three or more of

1-16 the following areas of major life activity:

2-1 (a) Taking care of oneself;

2-2 (b) Understanding and use of language;

2-3 (c) Learning;

2-4 (d) Mobility;

2-5 (e) Self-direction; and

2-6 (f) Capacity for independent living.

2-7 Sec. 2. NRS 433.003 is hereby amended to read as follows:

2-8 433.003 The legislature hereby declares that it is the intent of this

2-9 Title:

2-10 1. To eliminate the forfeiture of any civil and legal rights of any person

2-11 and the imposition of any legal disability on any person, based on an

2-12 allegation of mental illness or mental retardation [,] or a related condition,

2-13 by any method other than a separate judicial proceeding resulting in a

2-14 determination of incompetency, wherein the civil and legal rights forfeited

2-15 and the legal disabilities imposed are specifically stated; and

2-16 2. To charge the division of mental health and developmental services,

2-17 and the division of child and family services, of the department with

2-18 recognizing their duty to act in the best interests of their respective clients

2-19 by placing them in the least restrictive environment.

2-20 Sec. 3. NRS 433.005 is hereby amended to read as follows:

2-21 433.005 As used in this Title, unless the context otherwise requires, or

2-22 except as otherwise defined by specific statute, the words and terms defined

2-23 in NRS 433.014 to 433.224, inclusive, and section 1 of this act, have the

2-24 meanings ascribed to them in those sections.

2-25 Sec. 4. NRS 433.184 is hereby amended to read as follows:

2-26 433.184 "Mental retardation center" means an organized program for

2-27 providing appropriate services and treatment to mentally retarded persons

2-28 [.] and persons with related conditions. A mental retardation center may

2-29 include facilities for residential treatment and training.

2-30 Sec. 5. NRS 433.214 is hereby amended to read as follows:

2-31 433.214 "Training" means a program of services directed primarily

2-32 toward enhancing the health, welfare and development of mentally retarded

2-33 persons and persons with related conditions through the process of

2-34 providing those experiences that will enable the individual to:

2-35 1. Develop his physical, intellectual, social and emotional capacities to

2-36 the fullest extent;

2-37 2. Live in an environment that is conducive to personal dignity; and

2-38 3. Continue development of those skills, habits and attitudes essential

2-39 to adaptation in contemporary society.

2-40 Sec. 6. NRS 433.233 is hereby amended to read as follows:

2-41 433.233 1. The division facilities providing mental health services

2-42 are designated as:

2-43 (a) Nevada mental health institute;

3-1 (b) Southern Nevada adult mental health services;

3-2 (c) Rural clinics; and

3-3 (d) Lakes Crossing center.

3-4 2. The division facilities providing services for mentally retarded

3-5 persons and persons with related conditions are designated as:

3-6 (a) Desert regional center;

3-7 (b) Sierra regional center; and

3-8 (c) Rural regional center.

3-9 3. Division facilities established after July 1, 1981, must be named by

3-10 the administrator, subject to the approval of the director of the department.

3-11 Sec. 7. NRS 433.244 is hereby amended to read as follows:

3-12 433.244 1. The administrator must:

3-13 (a) Have training and demonstrated administrative qualities of

3-14 leadership in any one of the professional fields of psychiatry, medicine,

3-15 psychology, social work, education or administration.

3-16 (b) Be appointed, from a list of three persons nominated by the

3-17 commission, on the basis of merit as measured by administrative training or

3-18 experience in programs relating to mental health, including care, treatment

3-19 or training, or any combination thereof, of mentally ill and mentally

3-20 retarded persons [.] and persons with related conditions.

3-21 (c) Have additional qualifications which are in accordance with criteria

3-22 prescribed by the department of personnel.

3-23 2. The administrator is in the unclassified service of the state.

3-24 Sec. 8. NRS 433.279 is hereby amended to read as follows:

3-25 433.279 1. The division shall carry out a vocational and educational

3-26 program for the certification of mental health-mental retardation

3-27 technicians, including forensic technicians:

3-28 (a) Employed by the division, or other employees of the division who

3-29 perform similar duties, but are classified differently.

3-30 (b) Employed by the division of child and family services of the

3-31 department.

3-32 The program must be carried out in cooperation with the University and

3-33 Community College System of Nevada.

3-34 2. A mental health-mental retardation technician is responsible to the

3-35 director of the service in which his duties are performed. The director of a

3-36 service may be a licensed physician, dentist, podiatric physician,

3-37 psychiatrist, psychologist, rehabilitation therapist, social worker, registered

3-38 nurse or other professionally qualified person. This section does not

3-39 authorize a mental health-mental retardation technician to perform duties

3-40 which require the specialized knowledge and skill of a professionally

3-41 qualified person.

3-42 3. The division shall adopt regulations to carry out the provisions of

3-43 this section.

4-1 4. As used in this section, "mental health-mental retardation

4-2 technician" means an employee of the division of mental health and

4-3 developmental services or the division of child and family services who, for

4-4 compensation or personal profit, carries out procedures and techniques

4-5 which involve cause and effect and which are used in the care, treatment

4-6 and rehabilitation of mentally ill, emotionally disturbed or mentally

4-7 retarded persons [,] or persons with related conditions, and who has direct

4-8 responsibility for:

4-9 (a) Administering or carrying out specific therapeutic procedures,

4-10 techniques or treatments, excluding medical interventions, to enable clients

4-11 to make optimal use of their therapeutic regime, their social and personal

4-12 resources, and their residential care; or

4-13 (b) The application of interpersonal and technical skills in the

4-14 observation and recognition of symptoms and reactions of clients, for the

4-15 accurate recording of such symptoms and reactions, and for carrying out

4-16 treatments authorized by members of the interdisciplinary team that

4-17 determines the treatment of the clients.

4-18 Sec. 9. NRS 433.314 is hereby amended to read as follows:

4-19 433.314 The commission shall:

4-20 1. Establish policies to ensure adequate development and

4-21 administration of services for the mentally ill and mentally retarded [,] and

4-22 persons with related conditions, including services to prevent mental

4-23 illness and mental retardation and related conditions, and services

4-24 provided without admission to a facility or institution;

4-25 2. Set policies for the care and treatment of mentally ill and mentally

4-26 retarded persons and persons with related conditions provided by all state

4-27 agencies;

4-28 3. Review the programs and finances of the division; and

4-29 4. Report at the beginning of each year to the governor and at the

4-30 beginning of each odd-numbered year to the legislature on the quality of the

4-31 care and treatment provided for mentally ill and mentally retarded persons

4-32 and persons with related conditions in this state and on any progress made

4-33 toward improving the quality of that care and treatment.

4-34 Sec. 10. NRS 433.316 is hereby amended to read as follows:

4-35 433.316 The commission may:

4-36 1. Collect and disseminate information pertaining to mental health and

4-37 mental retardation [.] and related conditions.

4-38 2. Request legislation pertaining to mental health and mental

4-39 retardation [.] and related conditions.

4-40 3. Investigate complaints about the care of any person in a public

4-41 facility for the treatment of the mentally ill or mentally retarded [.] and

4-42 persons with related conditions.

5-1 4. Accept, as authorized by the legislature, gifts and grants of money

5-2 and property.

5-3 5. Take appropriate steps to increase the availability of and to enhance

5-4 the quality of the care and treatment of the mentally ill and mentally

5-5 retarded and persons with related conditions provided through state

5-6 agencies, hospitals and clinics.

5-7 6. Promote programs for the treatment of the mentally ill and mentally

5-8 retarded and persons with related conditions and participate in and

5-9 promote the development of facilities for training persons to provide

5-10 services for the mentally ill and mentally retarded [.] and persons with

5-11 related conditions.

5-12 7. Create a plan to coordinate the services for the treatment of the

5-13 mentally ill and the mentally retarded and persons with related conditions

5-14 provided in this state and to provide continuity in the care and treatment

5-15 provided.

5-16 8. Establish and maintain an appropriate program which provides

5-17 information to the general public concerning mental illness and mental

5-18 retardation and related conditions and consider ways to involve the general

5-19 public in the decisions concerning the policy on mental illness and mental

5-20 retardation [.] and related conditions.

5-21 9. Compile statistics on mental illness and study the cause, pathology

5-22 and prevention of that illness.

5-23 10. Establish programs to prevent or postpone the commitment of

5-24 residents of this state to facilities for the treatment of the mentally ill and

5-25 mentally retarded [.] and persons with related conditions.

5-26 11. Evaluate the future needs of this state concerning the treatment of

5-27 mental illness and mental retardation and related conditions and develop

5-28 ways to improve the treatment already provided.

5-29 12. Take any other action necessary to promote mental health in this

5-30 state.

5-31 Sec. 11. NRS 433.324 is hereby amended to read as follows:

5-32 433.324 1. The commission shall adopt regulations:

5-33 (a) For the care and treatment of mentally ill and mentally retarded

5-34 persons and persons with related conditions by all state agencies and

5-35 facilities, and their referral to private facilities;

5-36 (b) To ensure continuity in the care and treatment provided to mentally

5-37 ill and mentally retarded persons and persons with related conditions in

5-38 this state; and

5-39 (c) Necessary for the proper and efficient operation of the facilities of

5-40 the division.

5-41 2. The commission may adopt regulations to promote programs

5-42 relating to mental health and mental retardation [.] and related conditions.

6-1 Sec. 12. NRS 433.325 is hereby amended to read as follows:

6-2 433.325 The commission or its designated agent may inspect any state

6-3 facility providing services for the mentally ill or mentally retarded and

6-4 persons with related conditions to determine if the facility is in compliance

6-5 with the provisions of this Title and any regulations adopted pursuant to

6-6 those provisions.

6-7 Sec. 13. NRS 433.334 is hereby amended to read as follows:

6-8 433.334 The division may, by contract with general hospitals or other

6-9 institutions having adequate facilities in the State of Nevada, provide for

6-10 inpatient care of mentally ill and mentally retarded clients [.] and clients

6-11 with related conditions.

6-12 Sec. 14. NRS 433.344 is hereby amended to read as follows:

6-13 433.344 The division may contract with appropriate persons

6-14 professionally qualified in the field of psychiatric mental health to provide

6-15 inpatient and outpatient care for mentally ill and mentally retarded persons

6-16 and persons with related conditions when it appears that they can be

6-17 treated best in that manner.

6-18 Sec. 15. NRS 433.395 is hereby amended to read as follows:

6-19 433.395 1. Upon approval of the director of the department, the

6-20 administrator may accept:

6-21 (a) Donations of money and gifts of real or personal property; and

6-22 (b) Grants of money from the Federal Government,

6-23 for use in public or private programs that provide services to persons in this

6-24 state who are mentally ill or mentally retarded [.] and persons with related

6-25 conditions.

6-26 2. The administrator shall disburse any donations, gifts and grants

6-27 received pursuant to this section to programs that provide services to

6-28 persons who are mentally ill or mentally retarded and persons with related

6-29 conditions in a manner that supports the plan to coordinate services created

6-30 by the commission pursuant to subsection 7 of NRS 433.316. In the

6-31 absence of a plan to coordinate services, the administrator shall make

6-32 disbursements to programs that will maximize the benefit provided to

6-33 persons who are mentally ill or mentally retarded and persons with related

6-34 conditions in consideration of the nature and value of the donation, gift or

6-35 grant.

6-36 3. Within limits of legislative appropriations or other available money,

6-37 the administrator may enter into a contract for services related to the

6-38 evaluation and recommendation of recipients for the disbursements

6-39 required by this section.

7-1 Sec. 16. NRS 433.404 is hereby amended to read as follows:

7-2 433.404 1. The division shall establish a fee schedule for services

7-3 rendered through any program supported by the state pursuant to the

7-4 provisions of chapters 433 to 436, inclusive, of NRS. The schedule must be

7-5 submitted to the commission and the director of the department for joint

7-6 approval before enforcement. The fees collected by facilities operated by

7-7 the division pursuant to this schedule must be deposited in the state treasury

7-8 to the credit of the state general fund, except as otherwise provided in NRS

7-9 433.354 for fees collected pursuant to contract or agreement and in NRS

7-10 435.120 for fees collected for services to mentally retarded clients [.] and

7-11 clients with related conditions.

7-12 2. For a facility providing services for the treatment of the mentally ill

7-13 or mentally retarded [,] and persons with related conditions, the fee

7-14 established must approximate the cost of providing the service, but if a

7-15 client is unable to pay in full the fee established pursuant to this section, the

7-16 division may collect any amount the client is able to pay.

7-17 Sec. 17. NRS 433.458 is hereby amended to read as follows:

7-18 433.458 "Administrative officer" means a person with overall

7-19 executive and administrative responsibility for a facility that provides

7-20 services relating to mental health or mental retardation and related

7-21 conditions and that is operated by any public or private entity.

7-22 Sec. 18. NRS 433.494 is hereby amended to read as follows:

7-23 433.494 1. An individualized written plan of mental health or mental

7-24 retardation services or plan of services for a related condition must be

7-25 developed for each client of each facility. The plan must provide for the

7-26 least restrictive treatment procedure that may reasonably be expected to

7-27 benefit the client.

7-28 2. The plan must be kept current and must be modified when indicated.

7-29 The plan must be thoroughly reviewed at least once every 3 months.

7-30 3. The person in charge of implementing the plan of services must be

7-31 designated in the plan.

7-32 Sec. 19. NRS 433A.020 is hereby amended to read as follows:

7-33 433A.020 The administrative officer of a facility of the division must:

7-34 1. Be selected on the basis of training and demonstrated administrative

7-35 qualities of leadership in any one of the fields of psychiatry, medicine,

7-36 psychology, social work, education or administration.

7-37 2. Be appointed on the basis of merit as measured by administrative

7-38 training or experience in programs relating to mental health, including care

7-39 and treatment of mentally ill and mentally retarded persons [.] and persons

7-40 with related conditions.

7-41 3. Have additional qualifications which are in accordance with criteria

7-42 prescribed by the department of personnel.

8-1 Sec. 20. NRS 435.005 is hereby amended to read as follows:

8-2 435.005 Unless specifically excluded by law, the provisions of this

8-3 chapter apply to all facilities within the division offering services to

8-4 mentally retarded persons [.] and persons with related conditions.

8-5 Sec. 21. NRS 435.007 is hereby amended to read as follows:

8-6 435.007 As used in this chapter, unless the context otherwise requires:

8-7 1. "Child" means any person under the age of 18 years who may be

8-8 eligible for mental retardation services [.] or services for a related

8-9 condition.

8-10 2. "Residential facility for groups" means a structure similar to a

8-11 private residence which will house a small number of persons in a homelike

8-12 atmosphere.

8-13 3. "Parent" means the parent of a child. The term does not include the

8-14 parent of a person who has attained the age of 18 years.

8-15 4. "Person" includes a child and any other mentally retarded client or

8-16 client with a related condition who has attained the age of 18 years.

8-17 Sec. 22. NRS 435.010 is hereby amended to read as follows:

8-18 435.010 1. The boards of county commissioners of the various

8-19 counties shall make provision for the support, education and care of the

8-20 mentally retarded children and children with related conditions of their

8-21 respective counties.

8-22 2. For that purpose they are empowered to make all necessary contracts

8-23 and agreements to carry out the provisions of NRS 435.010 to 435.040,

8-24 inclusive. Any such contract or agreement may be made with any

8-25 responsible person or facility in or without the State of Nevada.

8-26 3. The provisions of NRS 435.010 to 435.040, inclusive, supplement

8-27 the services which other political subdivisions or agencies of the state are

8-28 required by law to provide, and do not supersede or relieve the

8-29 responsibilities of such political subdivisions or agencies.

8-30 Sec. 23. NRS 435.020 is hereby amended to read as follows:

8-31 435.020 All mentally retarded children and children with related

8-32 conditions are entitled to benefits under NRS 435.010 to 435.040,

8-33 inclusive:

8-34 1. Who are unable to pay for their support and care;

8-35 2. Whose parents, relatives or guardians are unable to pay for their

8-36 support and care; and

8-37 3. If division facilities are to be utilized, whom the division recognizes

8-38 as proper subjects for services within such division facilities.

8-39 Sec. 24. NRS 435.030 is hereby amended to read as follows:

8-40 435.030 1. A parent, relative, guardian or nearest friend of any

8-41 mentally retarded child [,] or a child with a related condition who is a

8-42 resident of this state, may file with the board of county commissioners of

8-43 the proper county an application under oath stating:

9-1 (a) That the child meets the criteria set forth in NRS 435.020; and

9-2 (b) That the child requires services not otherwise required by law to be

9-3 provided to him by any other county, political subdivision or agency of this

9-4 or any other state.

9-5 2. If the board of county commissioners is satisfied that the statements

9-6 made in the application are true, the board shall issue a certificate to that

9-7 effect.

9-8 3. The board of county commissioners shall make necessary

9-9 arrangements for the transportation of a mentally retarded child or a child

9-10 with a related condition to any responsible person or facility to be utilized

9-11 pursuant to contract or agreement as designated in NRS 435.010 at the

9-12 expense of the county.

9-13 4. A certificate of the board of county commissioners, when produced,

9-14 shall be the authority of any responsible person or facility in or without the

9-15 State of Nevada under contract with the board of county commissioners to

9-16 receive any such mentally retarded child [.] or child with a related

9-17 condition.

9-18 Sec. 25. NRS 435.040 is hereby amended to read as follows:

9-19 435.040 1. In case a resident of the northern Nevada children’s home

9-20 or the southern Nevada children’s home is adjudged to be mentally retarded

9-21 [,] or to have a related condition, a responsible person or facility as

9-22 designated in NRS 435.010 may receive the resident from the

9-23 superintendent of [such] the children’s home and shall make provision for

9-24 [such] the child in the same manner as if received from a board of county

9-25 commissioners.

9-26 2. The county of the child’s residence immediately preceding

9-27 admission to the children’s home [shall] must bear the expense of

9-28 transportation to the responsible person or facility and of the subsequent

9-29 care.

9-30 3. If the child is a dependent child committed to the northern Nevada

9-31 children’s home or the southern Nevada children’s home under the

9-32 provisions of NRS 423.210, the county [shall be] is entitled to receive from

9-33 the parent or parents, and to recover by appropriate legal action if

9-34 necessary, all sums expended by the county under subsection 2 , [;] but the

9-35 sum which the county may receive or recover [shall] must not exceed the

9-36 amount which the district court has ordered [such] the parent or parents to

9-37 pay under NRS 423.210.

9-38 Sec. 26. NRS 435.060 is hereby amended to read as follows:

9-39 435.060 The division may operate a residential facility for groups to

9-40 care for and maintain mentally retarded persons and persons with related

9-41 conditions until they can live in a more normal situation.

10-1 Sec. 27. NRS 435.077 is hereby amended to read as follows:

10-2 435.077 1. The administrator shall [establish] adopt regulations for

10-3 the transfer of mentally retarded persons and persons with related

10-4 conditions from one facility to another facility operated by the division.

10-5 2. Subject to the provisions of subsection 3, when the associate

10-6 administrator for mental retardation determines that it is in the best interest

10-7 of the person, he may discharge, or place on convalescent leave, any

10-8 mentally retarded person or person with a related condition in a facility

10-9 operated by the division.

10-10 3. When a mentally retarded person or person with a related condition

10-11 is committed to a division facility by court order, the committing court must

10-12 be given 10 days’ notice before the discharge of that person.

10-13 Sec. 28. NRS 435.081 is hereby amended to read as follows:

10-14 435.081 1. The administrator or his designee may receive a mentally

10-15 retarded person or person with a related condition of this state for services

10-16 in a facility operated by the division if:

10-17 (a) [He] The person is mentally retarded as defined in NRS 433.174 or

10-18 is a person with a related condition and is in need of institutional training

10-19 and treatment;

10-20 (b) Space is available which is designed and equipped to provide

10-21 appropriate care for [him;] the person;

10-22 (c) The facility has or can provide an appropriate program of training

10-23 and treatment for [him;] the person; and

10-24 (d) There is written evidence that no less restrictive alternative is

10-25 available in his community.

10-26 2. A mentally retarded person or person with a related condition may

10-27 be accepted at a division facility for emergency evaluation when the

10-28 evaluation is requested by a court. A person must not be retained pursuant

10-29 to this subsection for more than 10 working days.

10-30 3. A court may order that a mentally retarded person or person with a

10-31 related condition be admitted to a division facility if it finds that admission

10-32 is necessary because of the death or sudden disability of the parent or

10-33 guardian of the person. The person must not be retained pursuant to this

10-34 subsection for more than 45 days. Before the expiration of the 45-day

10-35 period the division shall report to the court its recommendations for

10-36 placement or treatment of the person. If less restrictive alternatives are not

10-37 available, the person may be admitted to the facility using the procedures

10-38 for voluntary or involuntary admission, as appropriate.

10-39 4. A child may be received, cared for and examined at a division

10-40 facility for the mentally retarded for not more than 10 working days without

10-41 admission, if the examination is ordered by a court having jurisdiction of

10-42 the minor in accordance with the provisions of paragraph (c) of subsection

10-43 1 of NRS 62.211 and subsection 1 of NRS 432B.560. At the end of the 10

11-1 days, the administrator or his designee shall report the result of the

11-2 examination to the court and shall detain the child until the further order of

11-3 the court, but not to exceed 7 days after the administrator’s report.

11-4 5. The parent or guardian of a person believed to be mentally retarded

11-5 or believed to have a related condition may apply to the administrative

11-6 officer of a division facility to have the person evaluated by personnel of

11-7 the division who are experienced in the diagnosis of mental retardation [.]

11-8 and related conditions. The administrative officer may accept the person

11-9 for evaluation without admission.

11-10 6. If, after the completion of an examination or evaluation pursuant to

11-11 subsection 4 or 5, the administrative officer finds that the person meets the

11-12 criteria set forth in subsection 1, the person may be admitted to the facility

11-13 using the procedures for voluntary or involuntary admission, as

11-14 appropriate.

11-15 7. If, at any time, the parent or guardian of a person admitted to a

11-16 division facility on a voluntary basis, or the person himself if he has

11-17 attained the age of 18 years, requests in writing that the person be

11-18 discharged, the administrative officer shall discharge the person. If the

11-19 administrative officer finds that discharge from the facility is not in the

11-20 person’s best interests, he may initiate proceedings for involuntary

11-21 admission, but the person must be discharged pending those proceedings.

11-22 Sec. 29. NRS 435.085 is hereby amended to read as follows:

11-23 435.085 The administrative officer of a division facility may authorize

11-24 the transfer of a mentally retarded person or person with a related

11-25 condition to a general hospital for necessary diagnostic, medical or surgical

11-26 services not available within the division. All expenses incurred under this

11-27 section [shall] must be paid as follows:

11-28 1. In the case of a judicially committed mentally retarded person [,

11-29 such expenses shall] or person with a related condition, the expenses must

11-30 be paid by his parents or guardian to the extent of their reasonable financial

11-31 ability as determined by the administrator, and the remainder, if any, [shall

11-32 be] is a charge upon the county of the last known residence of the mentally

11-33 retarded [person’s last known residence;] person or person with a related

11-34 condition;

11-35 2. In the case of a mentally retarded person or person with a related

11-36 condition admitted to a division facility pursuant to NRS 435.010, 435.020

11-37 and 435.030, [such expenses shall be] the expenses are a charge upon the

11-38 county from which a certificate was issued pursuant to subsection 2 of NRS

11-39 435.030; and

11-40 3. In the case of a mentally retarded person or person with a related

11-41 condition admitted to a division facility upon voluntary application as

11-42 provided in NRS 435.081, [such expenses shall] the expenses must be paid

11-43 by the parents or guardian to the extent of their reasonable financial ability

12-1 as determined by the administrator, and for the remainder, if any, the

12-2 administrator shall explore all reasonable alternative sources of payment.

12-3 Sec. 30. NRS 435.090 is hereby amended to read as follows:

12-4 435.090 1. When any mentally retarded child or child with a related

12-5 condition is committed to a division facility by a court of competent

12-6 jurisdiction, the court shall examine the parent, parents or guardian of

12-7 [such] the child regarding the ability of [such] the parent, parents or

12-8 guardian or the estate of the child to contribute to the care, support and

12-9 maintenance of [such] the child while residing in [such] the facility.

12-10 2. If the court determines that the parent, parents or guardian of the

12-11 child is able to contribute, it shall enter an order prescribing the amount to

12-12 be contributed.

12-13 3. If the court determines that the estate of the child is able to

12-14 contribute, it shall enter an order requiring that a guardian of the estate of

12-15 the child be appointed, if there is none, and that the guardian of the estate

12-16 contribute the amount prescribed by the court from [such] the estate.

12-17 4. If the parent, parents or guardian fail or refuse to comply with the

12-18 order of the court, the division is entitled to recover from the parent,

12-19 parents or guardian, by appropriate legal action, all sums due together with

12-20 interest.

12-21 Sec. 31. NRS 435.100 is hereby amended to read as follows:

12-22 435.100 1. When any mentally retarded person or person with a

12-23 related condition is transferred from one care facility operated by the

12-24 division to another care facility operated by the division, the parent, parents

12-25 or guardian shall continue to contribute [such] the amount for the care,

12-26 support and maintenance of [such] the person as may have previously been

12-27 ordered by the court of competent jurisdiction committing [such] the

12-28 person.

12-29 2. If no such order was entered by the committing court, the division

12-30 may petition [such] the court for an order requiring the parent, parents or

12-31 guardian to contribute.

12-32 3. Any order for contribution entered under the provisions of

12-33 subsection 2 [shall] must be entered in the same manner and [have] has the

12-34 same effect as an order for contribution entered under the provisions of

12-35 NRS 435.090.

12-36 Sec. 32. NRS 435.110 is hereby amended to read as follows:

12-37 435.110 1. When any mentally retarded child or child with a related

12-38 condition is admitted to a facility operated by the division at the request of

12-39 a parent, parents or guardian, [such] the parent, parents or guardian shall

12-40 enter into an agreement with the division providing for the contribution of

12-41 an amount for the care, support and maintenance of [such] the child as

12-42 determined by the division to be reasonable. In determining the amount, the

12-43 division shall give consideration to the ability of the parent, parents or

13-1 guardian to make such a contribution, and may excuse the making of any

13-2 contribution.

13-3 2. If the parent, parents or guardian fail or refuse to perform under the

13-4 terms of the agreement, the division is entitled to recover from the parent,

13-5 parents or guardian, by appropriate legal action, all sums due together with

13-6 interest.

13-7 3. If the division determines that the parent, parents or guardian do not

13-8 have the ability to contribute an amount sufficient to pay for the care,

13-9 support and maintenance of [such] the child, but that the estate of [such]

13-10 the child is able to contribute, the division may make application to a court

13-11 of competent jurisdiction for the appointment of a guardian of the estate of

13-12 [such] the child, if there is none, and for an order requiring [such] the

13-13 guardian to contribute an amount as determined by the court.

13-14 Sec. 33. NRS 435.115 is hereby amended to read as follows:

13-15 435.115 The administrator shall establish a fee schedule, in

13-16 consultation with the state association for retarded citizens and subject to

13-17 the approval of the board and the director of the department, for services

13-18 rendered to the mentally retarded and to persons with related conditions

13-19 by the division.

13-20 Sec. 34. NRS 435.121 is hereby amended to read as follows:

13-21 435.121 1. There are two types of admissions of mentally retarded

13-22 persons or persons with related conditions to a mental retardation center:

13-23 (a) Voluntary admission.

13-24 (b) Involuntary admission.

13-25 2. An application for admission of a mentally retarded person or

13-26 person with a related condition to a mental retardation center must be

13-27 made on a form approved by the division and the attorney general. The

13-28 clerk of each district court in the state shall make the forms available to any

13-29 person upon request.

13-30 Sec. 35. NRS 435.122 is hereby amended to read as follows:

13-31 435.122 1. Any mentally retarded person or person with a related

13-32 condition may apply to any mental retardation center for admission as a

13-33 voluntary client. His parent or guardian or another responsible person may

13-34 submit the application on his behalf.

13-35 2. If the person or a responsible party on behalf of the person objects to

13-36 voluntary admission, the procedure for involuntary admission may be

13-37 followed.

13-38 Sec. 36. NRS 435.123 is hereby amended to read as follows:

13-39 435.123 Whenever a person is alleged to be mentally retarded or to

13-40 have a related condition and is alleged to be a clear and present danger to

13-41 himself or others, his parent or guardian or another responsible person may

13-42 initiate proceedings for his involuntary admission to a mental retardation

13-43 center by petitioning the district court of the county where the person

14-1 resides. The petition must be accompanied by a certificate signed by a

14-2 physician or licensed psychologist experienced in the diagnosis of mental

14-3 retardation and related conditions stating that he has examined the person

14-4 within the preceding 30 days and has concluded that the person is mentally

14-5 retarded [,] or is a person with a related condition, has demonstrated that

14-6 he is a clear and present danger to himself or others and is in need of

14-7 institutional training and treatment.

14-8 Sec. 37. NRS 435.125 is hereby amended to read as follows:

14-9 435.125 1. After the petition is filed , the court may cause a

14-10 physician or licensed psychologist promptly to examine the person who is

14-11 the subject of the petition or request an evaluation from the mental

14-12 retardation center to which it is proposed the person be admitted. Any

14-13 physician or licensed psychologist requested by the court to conduct such

14-14 an examination must be experienced in the diagnosis of mental retardation

14-15 [.] and related conditions. The examination or evaluation must indicate

14-16 whether the person is or is not mentally retarded or a person with a related

14-17 condition and whether he is or is not in need of institutional training and

14-18 treatment.

14-19 2. The court may allow the person alleged to be mentally retarded or to

14-20 have a related condition to remain at his place of residence pending any

14-21 ordered examination and to return upon completion of the examination.

14-22 One or more of the person’s relatives or friends may accompany him to the

14-23 place of examination.

14-24 Sec. 38. NRS 435.126 is hereby amended to read as follows:

14-25 435.126 1. The person alleged to be mentally retarded [,] or to have

14-26 a related condition, or any relative or friend acting on his behalf, is entitled

14-27 to retain counsel to represent him in any proceeding before the district

14-28 court relating to his involuntary admission to a mental retardation center.

14-29 2. If [such] counsel has not been retained, the court, before proceeding,

14-30 shall advise the person and his guardian, or closest living relative if such a

14-31 relative can be located, of the person’s right to have counsel.

14-32 3. If the person fails or refuses to secure counsel, the court shall

14-33 appoint counsel to represent him. If the person is indigent, the counsel

14-34 appointed may be the public defender.

14-35 4. Any counsel appointed by the court is entitled to fair and reasonable

14-36 compensation for his services. The compensation must be charged against

14-37 the property of the person for whom he was appointed. If the person is

14-38 indigent, the compensation must be charged against the county in which the

14-39 person alleged to be mentally retarded or to have a related condition last

14-40 resided.

14-41 Sec. 39. NRS 435.128 is hereby amended to read as follows:

14-42 435.128 1. Upon completion of the proceedings for involuntary

14-43 admission of a person to a mental retardation center, if the court finds:

15-1 (a) That the person is mentally retarded [,] or has a related condition,

15-2 has demonstrated that he is a clear and present danger to himself or others

15-3 and is in need of institutional training and treatment;

15-4 (b) That appropriate space and programs are available at the mental

15-5 retardation center to which it is proposed that the person be admitted; and

15-6 (c) That there is no less restrictive alternative to admission to a mental

15-7 retardation center which would be consistent with the best interests of the

15-8 person,

15-9 the court shall by written order certify that the person is eligible for

15-10 involuntary admission to a mental retardation center.

15-11 2. A certificate of eligibility for involuntary admission expires 12

15-12 months after the date of issuance if the client has not been discharged

15-13 earlier by the procedure provided in NRS 435.129. At the end of the 12-

15-14 month period, the administrative officer of the mental retardation center

15-15 may petition the court to renew the certificate for an additional period of

15-16 not more than 12 months. Each petition for renewal must set forth the

15-17 specific reasons why further treatment is required. A certificate may be

15-18 renewed more than once.

15-19 Sec. 40. NRS 435.130 is hereby amended to read as follows:

15-20 435.130 The intent of the legislature in the enactment of NRS 435.130

15-21 to 435.320, inclusive, is to aid mentally or functionally retarded persons

15-22 and persons with related conditions who are not served by existing

15-23 programs to receive high quality care and training in an effort to help them

15-24 become useful citizens.

15-25 Sec. 41. NRS 435.180 is hereby amended to read as follows:

15-26 435.180 "Enrollee" means any person enrolled in a center for care and

15-27 training because of mental or functional retardation [.] or a related

15-28 condition.

15-29 Sec. 42. NRS 435.230 is hereby amended to read as follows:

15-30 435.230 [In order to] To qualify for the aid provided for by NRS

15-31 435.130 to 435.320, inclusive, a center must:

15-32 1. File an application with the division for a certificate of qualification,

15-33 which must include:

15-34 (a) The name and address of the center.

15-35 (b) The names, addresses and qualifications of the administrative

15-36 personnel of the center.

15-37 (c) An outline of the educational, occupational and therapeutic program

15-38 to be offered.

15-39 (d) The number of persons enrolled or expected.

15-40 (e) An affidavit that the center is nonsectarian and a nonprofit

15-41 organization under the Internal Revenue Code of 1954 as amended , [(] 26

15-42 U.S.C. § 501(c)(3) . [).]

15-43 (f) The number and qualifications of the staff.

16-1 (g) A complete and detailed proposed financial statement for the

16-2 operations for the coming year.

16-3 (h) Any other information which the division may require.

16-4 2. Each year after the original application is made under subsection 1,

16-5 file an application for renewal of the certificate of qualification, which must

16-6 contain:

16-7 (a) The information required by subsection 1.

16-8 (b) The total number of members of the staff, persons enrolled, and days

16-9 of care and training that the center provided during the previous year.

16-10 (c) The number enrolled and days of care and training that the center

16-11 provided during the previous year to those enrolled who qualify for aid

16-12 under the terms of NRS 435.130 to 435.320, inclusive, and the standards

16-13 established by the division.

16-14 (d) A financial statement clearly showing all income received by the

16-15 center during the previous year and the sources thereof.

16-16 (e) Any other information that the division may require.

16-17 3. Be inspected by a member or authorized agent of the division to

16-18 determine whether the center’s facilities are proper and adequate.

16-19 4. Keep accurate records of daily attendance and establish uniform

16-20 financial statements and bookkeeping procedures as prescribed by the

16-21 division.

16-22 5. Maintain standards not inconsistent with those required by NRS

16-23 435.130 to 435.320, inclusive, or established by the division to qualify for

16-24 money from other sources, such as United Fund and United States

16-25 Government programs.

16-26 6. Before certifying an applicant for enrollment as mentally retarded [,]

16-27 or a person with a related condition, require:

16-28 (a) A documentary history of retarded overall functioning [;] or the

16-29 related condition; and

16-30 (b) Substantiation, through evaluation by a qualified diagnostic team.

16-31 7. Meet all other standards set by the division.

16-32 Sec. 43. NRS 435.340 is hereby amended to read as follows:

16-33 435.340 Neither voluntary admission nor judicial commitment nor any

16-34 other procedure provided in this chapter [shall] may be construed as

16-35 depriving a mentally retarded person or person with a related condition of

16-36 his full civil and legal rights by any method other than a separate judicial

16-37 proceeding resulting in a determination of incompetency wherein the civil

16-38 and legal rights forfeited and the legal disabilities imposed are specifically

16-39 stated.

16-40 Sec. 44. NRS 435.350 is hereby amended to read as follows:

16-41 435.350 1. Each mentally retarded person or person with a related

16-42 condition admitted to a division facility is entitled to all rights enumerated

16-43 in NRS 433.482 and 433.484.

17-1 2. The administrator shall designate a person or persons to be

17-2 responsible for establishment of regulations relating to denial of rights of

17-3 mentally retarded persons [.] and persons with related conditions. The

17-4 person designated shall file the regulations with the administrator.

17-5 3. Clients’ rights specified in NRS 433.482 and 433.484 may be denied

17-6 only for cause. Any denial of such rights must be entered in the client’s

17-7 treatment record, and notice of [such] the denial must be forwarded to the

17-8 administrator’s designee or designees as provided in subsection 2. Failure

17-9 to report denial of rights by an employee may be grounds for dismissal.

17-10 4. Upon receipt of notice of a denial of rights as provided in subsection

17-11 3, the administrator’s designee or designees shall cause a full report to be

17-12 prepared which sets forth in detail the factual circumstances surrounding

17-13 [such] the denial. A copy of the report must be sent to the administrator and

17-14 the commission.

17-15 5. The commission has such powers and duties with respect to reports

17-16 of denial of rights as are enumerated in subsection 3 of NRS 433.534.

17-17 Sec. 45. NRS 435.360 is hereby amended to read as follows:

17-18 435.360 1. The relatives of a mentally retarded client or client with a

17-19 related condition who is 18 years of age or older are not responsible for the

17-20 costs of his care and treatment within a division facility.

17-21 2. The client or his estate, when able, may be required to contribute a

17-22 reasonable amount toward the costs of his care and treatment. Otherwise,

17-23 the full costs of [such] the services must be borne by the state.

17-24 Sec. 46. NRS 435.365 is hereby amended to read as follows:

17-25 435.365 1. Whenever a person with mental retardation or a related

17-26 condition is cared for by a parent or other relative with whom he lives, that

17-27 parent or relative is eligible to receive assistance on a monthly basis from

17-28 the division for each such person who lives and is cared for in the home if

17-29 the division finds that:

17-30 (a) The person with mental retardation or a related condition has been

17-31 diagnosed as having profound or severe mental retardation or, if he is under

17-32 6 years of age, has developmental delays that require support that is

17-33 equivalent to the support required by a person with profound or severe

17-34 mental retardation [;] or a related condition;

17-35 (b) The person with mental retardation or a related condition is

17-36 receiving adequate care; and

17-37 (c) The person with mental retardation or a related condition and the

17-38 parent or other relative with whom he lives is not reasonably able to pay for

17-39 his care and support.

17-40 The amount of [such] the assistance must be established by legislative

17-41 appropriation for each fiscal year.

17-42 2. The division shall adopt regulations:

17-43 (a) Which establish a procedure of application for assistance;

18-1 (b) For determining the eligibility of an applicant pursuant to subsection

18-2 1; and

18-3 (c) For determining the amount of assistance to be provided to an

18-4 eligible applicant.

18-5 3. The decision of the division regarding eligibility for assistance or the

18-6 amount of assistance to be provided is a final administrative decision.

18-7 Sec. 47. NRS 435.370 is hereby amended to read as follows:

18-8 435.370 The division may make such rules and regulations and enter

18-9 such agreements with public and private agencies as are deemed necessary

18-10 to implement residential placement-foster family care programs for

18-11 mentally retarded persons [.] and persons with related conditions.

18-12 Sec. 48. NRS 435.390 is hereby amended to read as follows:

18-13 435.390 1. The administrative officer of any division facility where

18-14 mentally retarded persons or persons with related conditions reside may

18-15 establish a canteen operated for the benefit of clients and employees of the

18-16 facility. The administrative officer shall keep a record of transactions in the

18-17 operation of the canteen.

18-18 2. Each canteen must be self-supporting. No money provided by the

18-19 state may be used for its operation.

18-20 3. The respective administrative officers shall deposit the money used

18-21 for the operation of the canteen in one or more banks of reputable standing,

18-22 except that an appropriate sum may be maintained as petty cash at each

18-23 canteen.

18-24 Sec. 49. NRS 436.110 is hereby amended to read as follows:

18-25 436.110 The legislature declares that the purposes of this chapter are:

18-26 1. To encourage and provide financial assistance to counties in the

18-27 establishment and development of mental health services, including

18-28 services to the mentally retarded [,] and persons with related conditions,

18-29 through locally controlled community mental health programs.

18-30 2. To promote the improvement and, if necessary, the expansion of

18-31 already existing services which help to conserve the mental health of the

18-32 people of Nevada. It is the intent of this chapter that services to individuals

18-33 [shall] be rendered only upon voluntary application.

18-34 Sec. 50. NRS 436.150 is hereby amended to read as follows:

18-35 436.150 The county board shall:

18-36 1. Review and evaluate communities’ needs, services, facilities and

18-37 special problems in the fields of mental health and mental retardation [.]

18-38 and related conditions.

18-39 2. Advise the governing body as to programs of community mental

18-40 health services and facilities and services to the mentally retarded [,] and

18-41 persons with related conditions, and, when requested by [such] the

18-42 governing body, make recommendation regarding the appointment of a

18-43 county director.

19-1 3. After adoption of a program, continue to act in an advisory capacity

19-2 to the county director.

19-3 Sec. 51. NRS 436.170 is hereby amended to read as follows:

19-4 436.170 The county director shall:

19-5 1. Serve as chief executive officer of the county program and be

19-6 accountable to the county board.

19-7 2. Exercise administrative responsibility and authority over the county

19-8 program and facilities furnished, operated or supported in connection

19-9 therewith, and over services to the mentally retarded [,] and persons with

19-10 related conditions, except as administrative responsibility is otherwise

19-11 provided for in this Title.

19-12 3. Recommend to the governing body, after consultation with the

19-13 county board, the providing of services, establishment of facilities,

19-14 contracting for services or facilities and other matters necessary or

19-15 desirable to accomplish the purposes of this chapter.

19-16 4. Submit an annual report to the governing body reporting all

19-17 activities of the program, including a financial accounting of expenditures

19-18 and a forecast of anticipated needs for the ensuing year.

19-19 5. Carry on such studies as may be appropriate for the discharge of his

19-20 duties, including the control and prevention of psychiatric disorders and the

19-21 treatment of mental retardation [.] and related conditions.

19-22 Sec. 52. NRS 436.230 is hereby amended to read as follows:

19-23 436.230 Expenditures made by counties for county programs,

19-24 including services to the mentally retarded [,] and persons with related

19-25 conditions, pursuant to this chapter, [shall] must be reimbursed by the state

19-26 pursuant to NRS 436.240 to 436.320, inclusive.

19-27 Sec. 53. NRS 436.240 is hereby amended to read as follows:

19-28 436.240 1. A service operated within a county program [shall] must

19-29 be directed to at least one of the following mental health areas:

19-30 (a) Mental illness;

19-31 (b) Mental retardation [;] and related conditions;

19-32 (c) Organic brain and other neurological impairment;

19-33 (d) Alcoholism; and

19-34 (e) Drug abuse.

19-35 2. A service is any of the following:

19-36 (a) Diagnostic service;

19-37 (b) Emergency service;

19-38 (c) Inpatient service;

19-39 (d) Outpatient or partial hospitalization service;

19-40 (e) Residential, sheltered or protective care service;

19-41 (f) Habilitation or rehabilitation service;

20-1 (g) Prevention, consultation, collaboration, education or information

20-2 service; and

20-3 (h) Any other service approved by the division.

20-4 Sec. 54. NRS 436.270 is hereby amended to read as follows:

20-5 436.270 1. [Moneys] Money provided by direct legislative

20-6 appropriation for purposes of reimbursement as provided by NRS 436.230

20-7 to 436.260, inclusive, [shall] must be allotted to the governing body as

20-8 follows:

20-9 (a) The state shall pay to each county a sum equal to 90 percent of the

20-10 total proposed expenditures as reflected by the plan of proposed

20-11 expenditures submitted pursuant to NRS 436.250 if the county has

20-12 complied with the provisions of paragraph (b).

20-13 (b) [Prior to] Before payment under this subsection, the governing body

20-14 of a county must submit evidence to the administrator that 10 percent of the

20-15 total proposed expenditures have been raised and budgeted by the county

20-16 for the establishment or maintenance of a county program.

20-17 2. All state and federal moneys appropriated or authorized for the

20-18 promotion of mental health or for services to the mentally retarded and

20-19 persons with related conditions in the State of Nevada [shall] must be

20-20 disbursed through the division in accordance with the provisions of this

20-21 chapter and rules and regulations [promulgated] adopted in accordance

20-22 therewith.

20-23 Sec. 55. NRS 436.310 is hereby amended to read as follows:

20-24 436.310 Fees for mental health services, including services to the

20-25 mentally retarded [,] and persons with related conditions, rendered

20-26 pursuant to an approved county plan [shall] must be charged in accordance

20-27 with ability to pay, but not in excess of actual cost.

20-28 Sec. 56. This act becomes effective upon passage and approval.

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