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).

1-1 Section 1. (Deleted by amendment.)

1-2 Sec. 2. NRS 453.375 is hereby amended to read as follows:

1-3 453.375 A controlled substance may be possessed and administered by

2-1 (2) A county or district board of health in a county whose population

2-2 is 100,000 or more; and

2-3 (b) In accordance with any applicable regulations of:

2-4 (1) The state board of health in a county whose population is less than

2-5 100,000;

2-6 (2) A county board of health in a county whose population is 100,000

2-7 or more; or

2-8 (3) A district board of health created pursuant to NRS 439.370 in any

2-9 county.

2-10 4. A respiratory therapist, at the direction of a physician or physician’s

2-11 assistant.

2-12 5. A medical student, student in training to become a physician’s

2-13 assistant or student nurse in the course of his studies at an approved college

2-14 of medicine or school of professional or practical nursing, at the direction

2-15 of a physician or physician’s assistant and:

2-16 (a) In the presence of a physician, physician’s assistant or a registered

2-17 nurse; or

2-18 (b) Under the supervision of a physician, physician’s assistant or a

2-19 registered nurse if the student is authorized by the college or school to

2-20 administer the substance outside the presence of a physician, physician’s

2-21 assistant or nurse.

2-22 A medical student or student nurse may administer a controlled substance

2-23 in the presence or under the supervision of a registered nurse alone only if

2-24 the circumstances are such that the registered nurse would be authorized to

2-25 administer it personally.

2-26 6. An ultimate user or any person whom the ultimate user designates

2-27 pursuant to a written agreement.

2-28 7. Any person designated by the head of a correctional institution.

2-29 8. A veterinary technician at the direction of his supervising

2-30 veterinarian.

2-31 9. In accordance with applicable regulations of the state board of

2-32 health, an employee of a residential facility for groups, as defined in NRS

2-33 449.017, pursuant to a written agreement entered into by the ultimate user.

2-34 10. In accordance with applicable regulations of the state board of

2-35 pharmacy, an animal control officer, a wildlife biologist or an employee

2-36 designated by a federal, state or local governmental agency whose duties

2-37 include the control of domestic, wild and predatory animals.

2-38 Sec. 3. (Deleted by amendment.)

2-39 Sec. 4. NRS 454.213 is hereby amended to read as follows:

2-40 454.213 A drug or medicine referred to in NRS 454.181 to 454.371,

2-42 1. A practitioner.

3-1 2. A physician’s assistant at the direction of his supervising physician

3-2 or a licensed dental hygienist acting in the office of and under the

3-3 supervision of a dentist.

3-4 3. [A] Except as otherwise provided in subsection 4, a registered

3-5 nurse licensed to practice professional nursing or licensed practical nurse,

3-6 at the direction of a prescribing physician, dentist, podiatric physician or

3-7 advanced practitioner of nursing, or pursuant to a chart order, for

3-8 administration to a patient at another location.

3-9 4. In accordance with applicable regulations of the board, a

3-10 registered nurse licensed to practice professional nursing or licensed

3-11 practical nurse who is:

3-12 (a) Employed by a health care agency or health care facility that is

3-13 authorized to provide emergency care, or to respond to the immediate

3-14 needs of a patient, in the residence of the patient; and

3-15 (b) Acting under the direction of the medical director of that agency

3-16 or facility who works in this state.

3-17 5. An intermediate emergency medical technician or an advanced

3-18 emergency medical technician, as authorized by regulation of the state

3-19 board of pharmacy and in accordance with any applicable regulations of:

3-20 (a) The state board of health in a county whose population is less than

3-21 100,000;

3-22 (b) A county board of health in a county whose population is 100,000 or

3-23 more; or

3-24 (c) A district board of health created pursuant to NRS 439.370 in any

3-25 county.

3-26 [5.] 6. A respiratory therapist employed in a health care facility. The

3-27 therapist may possess and administer respiratory products only at the

3-28 direction of a physician.

3-29 [6.] 7. A dialysis technician, under the direction or supervision of a

3-30 physician or registered nurse only if the drug or medicine is used for the

3-31 process of renal dialysis.

3-32 [7.] 8. A medical student or student nurse in the course of his studies

3-33 at an approved college of medicine or school of professional or practical

3-34 nursing, at the direction of a physician and:

3-35 (a) In the presence of a physician or a registered nurse; or

3-36 (b) Under the supervision of a physician or a registered nurse if the

3-37 student is authorized by the college or school to administer the drug or

3-38 medicine outside the presence of a physician or nurse.

3-39 A medical student or student nurse may administer a dangerous drug in the

3-40 presence or under the supervision of a registered nurse alone only if the

3-41 circumstances are such that the registered nurse would be authorized to

3-42 administer it personally.

4-1 [8.] 9. Any person designated by the head of a correctional institution.

4-2 [9.] 10. An ultimate user or any person designated by the ultimate user

4-3 pursuant to a written agreement.

4-4 [10.] 11. A nuclear medicine technologist, at the direction of a

4-5 physician and in accordance with any conditions established by regulation

4-6 of the board.

4-7 [11.] 12. A radiologic technologist, at the direction of a physician and

4-8 in accordance with any conditions established by regulation of the board.

4-9 [12.] 13. A chiropractic physician, but only if the drug or medicine is a

4-10 topical drug used for cooling and stretching external tissue during

4-11 therapeutic treatments.

4-12 [13.] 14. A physical therapist, but only if the drug or medicine is a

4-13 topical drug which is:

4-14 (a) Used for cooling and stretching external tissue during therapeutic

4-15 treatments; and

4-16 (b) Prescribed by a licensed physician for:

4-17 (1) Iontophoresis; or

4-18 (2) The transmission of drugs through the skin using ultrasound.

4-19 [14.] 15. In accordance with applicable regulations of the state board

4-20 of health, an employee of a residential facility for groups, as defined in

4-21 NRS 449.017, pursuant to a written agreement entered into by the ultimate

4-22 user.

4-23 [15.] 16. A veterinary technician at the direction of his supervising

4-24 veterinarian.

4-25 17. In accordance with applicable regulations of the board, a

4-26 registered pharmacist who:

4-27 (a) Is trained in and certified to carry out standards and practices for

4-28 immunization programs;

4-29 (b) Is authorized to administer immunizations pursuant to written

4-30 protocols from a physician; and

4-31 (c) Administers immunizations in compliance with the "Standards of

4-32 Immunization Practices" recommended and approved by the United

4-33 States Public Health Service Advisory Committee on Immunization

4-34 Practices.

4-35 Sec. 5. Chapter 639 of NRS is hereby amended by adding thereto a

4-36 new section to read as follows:

4-37 The board shall prepare an annual report concerning immunizations

4-38 administered by pharmacists that includes, without limitation, the

4-39 number of immunizations which were administered by pharmacists

4-40 during the previous year, any problems or complaints reported to the

4-41 board concerning immunizations administered by pharmacists and any

5-1 other information that the board determines would be useful in

5-2 determining whether pharmacists should continue to administer

5-3 immunizations in this state. The report must be available for public

5-4 inspection during regular business hours at the office of the board.