Senate Bill No. 91–Committee on Commerce and Labor

 

February 8, 2001

____________

 

Referred to Committee on Commerce and Labor

 

SUMMARY—Makes various changes to provisions governing practice of medicine and respiratory care. (BDR 54‑290)

 

FISCAL NOTE:            Effect on Local Government: No.

                                    Effect on the State: 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 medicine; changing the designation of physician’s assistant; revising the scope of authority and duties of the board of medical examiners; providing for the issuance of special purpose licenses; requiring the board of medical examiners to regulate the practice of respiratory care; requiring practitioners of respiratory care to be licensed by the board of medical examiners; revising the qualifications and requirements relating to licensure of physicians and physicians’ assistants; revising the duties and scope of authority of persons licensed by the board of medical examiners; making certain actions subject to disciplinary action by the board of medical examiners; revising provisions governing the imposition of disciplinary action against licensees; establishing and revising certain fees; increasing certain penalties; 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 630 of NRS is hereby amended by adding thereto

1-2  the provisions set forth as sections 2 to 9, inclusive, of this act.

1-3    Sec. 2.  “Practice of respiratory care” includes:

1-4    1.  Therapeutic and diagnostic use of medical gases, humidity and

1-5  aerosols and the maintenance of associated apparatus;

1-6    2.  The administration of drugs and medications to the

1-7  cardiopulmonary system;

1-8    3.  The provision of ventilatory assistance and control;

1-9    4.  Postural drainage and percussion, breathing exercises and other

1-10  respiratory rehabilitation procedures;

1-11    5.  Cardiopulmonary resuscitation and maintenance of natural

1-12  airways and the insertion and maintenance of artificial airways;

1-13    6.  Carrying out the written orders of a physician, physician assistant

1-14  or an advanced practitioner of nursing relating to respiratory care;


2-1    7.  Techniques for testing to assist in diagnosis, monitoring, treatment

2-2  and research related to respiratory care, including the measurement of

2-3  ventilatory volumes, pressures and flows, collection of blood and other

2-4  specimens, testing of pulmonary functions and hemodynamic and other

2-5  related physiological monitoring of the cardiopulmonary system; and

2-6    8.  Training relating to the practice of respiratory care.

2-7    Sec. 3.  “Practitioner of respiratory care” means a person who is:

2-8    1.  Certified to engage in the practice of respiratory care by the

2-9  National Board for Respiratory Care or its successor organization; and

2-10    2.  Licensed by the board.

2-11    Sec. 4.  “Respiratory care” means the treatment, management,

2-12  diagnostic testing, control and care of persons with deficiencies and

2-13  abnormalities associated with the cardiopulmonary system. The term

2-14  includes inhalation and respiratory therapy.

2-15    Sec. 5.  For the purposes of this chapter, any act that constitutes the

2-16  practice of medicine shall be deemed to occur at the place where the

2-17  patient is located at the time the act is performed.

2-18    Sec. 6.  The practice of respiratory care must be performed under the

2-19  direction of or pursuant to a prescription from a physician licensed to

2-20  practice in this state, any other state, any territory of the United States or

2-21  the District of Columbia.

2-22    Sec. 7.  1.  Every person who wishes to practice respiratory care in

2-23  this state must:

2-24    (a) Have a high school diploma or general equivalency diploma;

2-25    (b) Complete an educational program for respiratory care which has

2-26  been approved by the National Board for Respiratory Care or its

2-27  successor organization;

2-28    (c) Pass the examination as an entry-level or advanced practitioner of

2-29  respiratory care administered by the National Board for Respiratory Care

2-30  or its successor organization;

2-31    (d) Be certified by the National Board for Respiratory Care or its

2-32  successor organization; and

2-33    (e) Be licensed to practice respiratory care by the board and have paid

2-34  the required fee for licensure.

2-35    2.  Except as otherwise provided in subsection 3, a person shall not:

2-36    (a) Practice respiratory care; or

2-37    (b) Hold himself out as qualified to practice respiratory care,

2-38  in this state without complying with the provisions of subsection 1.

2-39    3.  Any person who has completed the educational requirements set

2-40  forth in paragraphs (a) and (b) of subsection 1 may practice respiratory

2-41  care pursuant to a program of practical training as an intern in

2-42  respiratory care for not more than 12 months after completing those

2-43  educational requirements.

2-44    Sec. 8.  An application for a license as a practitioner of respiratory

2-45  care must include the social security number of the applicant.

2-46    Sec. 9.  The board shall adopt regulations regarding the licensure of

2-47  practitioners of respiratory care, including, without limitation:

2-48    1.  Educational and other qualifications of applicants;


3-1    2.  Required academic programs which applicants must successfully

3-2  complete;

3-3    3.  Procedures for applying for and issuing licenses;

3-4    4.  Tests or examinations of applicants by the board;

3-5    5.  The types of medical services that a practitioner of respiratory care

3-6  may perform, except that a practitioner of respiratory care may not

3-7  perform those specific functions and duties delegated or otherwise

3-8  restricted by specific statute to persons licensed as dentists, chiropractors,

3-9  podiatric physicians, optometrists, physicians, osteopathic physicians or

3-10  hearing aid specialists pursuant to this chapter or chapter 631, 633, 634,

3-11  635, 636 or 637A of NRS, as appropriate;

3-12    6.  The duration, renewal and termination of licenses; and

3-13    7.  The grounds and procedures for disciplinary actions against

3-14  practitioners of respiratory care.

3-15    Sec. 10.  NRS 630.003 is hereby amended to read as follows:

3-16    630.003  The legislature finds and declares that it is among the

3-17  responsibilities of state government to ensure, as far as possible, that only

3-18  competent persons practice medicine and respiratory care within this state.

3-19  For this purpose, the legislature delegates to the board of medical

3-20  examiners the duty of determining the initial and continuing competence of

3-21  doctors of medicine , physician assistants and practitioners of respiratory

3-22  care in this state. The powers conferred upon the board by this chapter

3-23  must be liberally construed to carry out this purpose.

3-24    Sec. 11.  NRS 630.005 is hereby amended to read as follows:

3-25    630.005  As used in this chapter, unless the context otherwise requires,

3-26  the words and terms defined in NRS 630.010 to 630.025, inclusive, and

3-27  sections 2, 3 and 4 of this act have the meanings ascribed to them in those

3-28  sections.

3-29    Sec. 12.  NRS 630.015 is hereby amended to read as follows:

3-30    630.015  [“Physician’s] “Physician assistant” means a person who is a

3-31  graduate of an academic program approved by the board or who, by

3-32  general education, practical training and experience determined to be

3-33  satisfactory by the board, is qualified to perform medical services under the

3-34  supervision of a supervising physician and who has been issued a license

3-35  by the board.

3-36    Sec. 13.  NRS 630.025 is hereby amended to read as follows:

3-37    630.025  “Supervising physician” means an active physician licensed

3-38  in the State of Nevada [who cosigns the application for licensure of a

3-39  physician’s assistant and] who employs and supervises [the physician’s] a

3-40  physician assistant.

3-41    Sec. 14.  NRS 630.045 is hereby amended to read as follows:

3-42    630.045  The purpose of licensing physicians [and physicians’] ,

3-43  physician assistants and practitioners of respiratory care is to protect the

3-44  public health and safety and the general welfare of the people of this state.

3-45  Any license issued pursuant to this chapter is a revocable privilege and no

3-46  holder of such a license acquires thereby any vested right.

3-47    Sec. 15.  NRS 630.047 is hereby amended to read as follows:

3-48    630.047  1.  This chapter does not apply to:


4-1    (a) A medical officer or practitioner of respiratory care of the armed

4-2  services or a medical officer or practitioner of respiratory care of any

4-3  division or department of the United States in the discharge of his official

4-4  duties ; [for which a license is not required;]

4-5    (b) Physicians who are called into this state, other than on a regular

4-6  basis, for consultation with or assistance to a physician licensed in this

4-7  state, and who are legally qualified to practice in the state where they

4-8  reside;

4-9    (c) Physicians who are legally qualified to practice in the state where

4-10  they reside and come into this state on an irregular basis to:

4-11      (1) Obtain medical training approved by the board from a physician

4-12  who is licensed in this state; or

4-13      (2) Provide medical instruction or training approved by the board to

4-14  physicians licensed in this state; [and]

4-15    (d) Any person permitted to practice any other healing art under this

4-16  Title who does so within the scope of that authority, or healing by faith or

4-17  Christian Science [.] ;

4-18    (e) The practice of respiratory care by a student as part of a program

4-19  of study in respiratory care that is approved by the board, or is

4-20  recognized by a national organization which is approved by the board to

4-21  review such programs, if the student is enrolled in the program and

4-22  provides respiratory care only under the supervision of a practitioner of

4-23  respiratory care;

4-24    (f) The practice of respiratory care by a student who:

4-25      (1) Is enrolled in a clinical program of study in respiratory care

4-26  which has been approved by the board;

4-27      (2) Is employed by a medical facility, as defined in NRS 449.0151;

4-28  and

4-29      (3) Provides respiratory care to patients who are not in a critical

4-30  medical condition or, in an emergency, to patients who are in a critical

4-31  medical condition and a practitioner of respiratory care is not

4-32  immediately available to provide that care and the student is directed by a

4-33  physician to provide respiratory care under his supervision until a

4-34  practitioner or respiratory care is available;

4-35    (g) The practice of respiratory care by a person on himself or

4-36  gratuitous respiratory care provided to a friend or a member of a

4-37  person’s family if the provider of the care does not represent himself as a

4-38  practitioner of respiratory care;

4-39    (h) A cardiopulmonary perfusionist who is under the supervision of a

4-40  surgeon or an anesthesiologist;

4-41    (i) A person who is employed by a physician and provides respiratory

4-42  care under the supervision of that physician;

4-43    (j) The maintenance of medical equipment for respiratory care that is

4-44  not attached to a patient; and

4-45    (k) A person who installs medical equipment for respiratory care that

4-46  is used in the home and gives instructions regarding the use of that

4-47  equipment if the person is trained to provide such services and is

4-48  supervised by a provider of health care who is acting within the

4-49  authorized scope of his practice.


5-1    2.  This chapter does not repeal or affect any statute of Nevada

5-2  regulating or affecting any other healing art.

5-3    3.  This chapter does not prohibit:

5-4    (a) Gratuitous services outside of a medical school or medical facility

5-5  by a person who is not a physician , physician assistant or practitioner of

5-6  respiratory care in cases of emergency.

5-7    (b) The domestic administration of family remedies.

5-8    Sec. 16.  NRS 630.120 is hereby amended to read as follows:

5-9    630.120  1.  The board shall procure a seal.

5-10    2.  All licenses issued to physicians [and physicians’] , physician

5-11  assistants and practitioners of respiratory care must bear the seal of the

5-12  board and the signatures of its president and secretary-treasurer.

5-13    Sec. 17.  NRS 630.160 is hereby amended to read as follows:

5-14    630.160  1.  Every person desiring to practice medicine must, before

5-15  beginning to practice, procure from the board a license authorizing him to

5-16  practice.

5-17    2.  Except as otherwise provided in NRS 630.161 or 630.164, a license

5-18  may be issued to any person who:

5-19    (a) Is a citizen of the United States or is lawfully entitled to remain and

5-20  work in the United States;

5-21    (b) Has received the degree of Doctor of Medicine from a medical

5-22  school:

5-23      (1) Approved by the Liaison Committee on Medical Education of the

5-24  American Medical Association and Association of American Medical

5-25  Colleges; or

5-26      (2) Which provides a course of professional instruction equivalent to

5-27  that provided in medical schools in the United States approved by the

5-28  Liaison Committee on Medical Education;

5-29    (c) Has passed:

5-30      (1) All parts of the examination given by the National Board of

5-31  Medical Examiners;

5-32      (2) All parts of the Federation Licensing Examination;

5-33      (3) All parts of the United States Medical Licensing Examination;

5-34      (4) All parts of a licensing examination given by any state or territory

5-35  of the United States, if the applicant is certified by a specialty board of the

5-36  American Board of Medical Specialties;

5-37      (5) All parts of the examination to become a licentiate of the Medical

5-38  Council of Canada; or

5-39      (6) Any combination of the examinations specified in subparagraphs

5-40  (1), (2) and (3) that the board determined to be sufficient;

5-41    (d) Has completed [3 years of:

5-42      (1) Graduate education] 36 months of progressive postgraduate:

5-43      (1) Education as a resident in the United States or Canada in a

5-44  program approved by the board, the Accreditation Council for Graduate

5-45  Medical Education of the American Medical Association or the

5-46  Coordinating Council of Medical Education of the Canadian Medical

5-47  Association; or


6-1       (2) Fellowship training in the United States or Canada approved by

6-2  the board or the Accreditation Council for Graduate Medical Education;

6-3  and

6-4    (e) Passes a written or oral examination, or both, as to his qualifications

6-5  to practice medicine and provides the board with a description of the

6-6  clinical program completed demonstrating that the applicant’s clinical

6-7  training met the requirements of paragraph (b) of this subsection.

6-8    Sec. 18.  NRS 630.164 is hereby amended to read as follows:

6-9    630.164  1.  A board of county commissioners may petition the board

6-10  of medical examiners to waive the [requirements] requirement of

6-11  paragraph (d) of subsection 2 of NRS 630.160 for any applicant intending

6-12  to practice medicine in a medically underserved area of that county as that

6-13  term is defined by regulation by the [officer of rural health of the

6-14  University of Nevada School of Medicine.] board of medical examiners.

6-15  The board of medical examiners may waive that requirement and issue a

6-16  license if the applicant:

6-17    (a) Has completed at least 1 year of training as a resident in the United

6-18  States or Canada in a program approved by the board, the Accreditation

6-19  Council for Graduate Medical Education of the American Medical

6-20  Association or the Coordinating Council of Medical Education of the

6-21  Canadian Medical Association, respectively;

6-22    (b) Has a minimum of 5 years of practical medical experience as a

6-23  licensed allopathic physician or such other equivalent training as the board

6-24  deems appropriate; and

6-25    (c) Meets all other conditions and requirements for a license to practice

6-26  medicine.

6-27    2.  Any person licensed pursuant to subsection 1 must be issued a

6-28  license to practice medicine in this state restricted to practice in the

6-29  medically underserved area of the county which petitioned for the waiver

6-30  only. He may apply to the board of medical examiners for renewal of that

6-31  restricted license every 2 years after he is licensed.

6-32    3.  Any person holding a restricted license pursuant to subsection 1

6-33  who completes 3 years of [such] full-time practice under the restricted

6-34  license may apply to the board for an unrestricted license. In considering

6-35  an application for an unrestricted license pursuant to this subsection, the

6-36  board shall require the applicant to meet all statutory requirements for

6-37  licensure in effect at the time of application except the [requirements]

6-38  requirement of paragraph (d) of subsection 2 of NRS 630.160.

6-39    Sec. 19.  NRS 630.197 is hereby amended to read as follows:

6-40    630.197  1.  An applicant for the issuance or renewal of a license to

6-41  practice medicine , [or] to practice as a [physician’s] physician assistant or

6-42  to practice as a practitioner of respiratory care shall submit to the board

6-43  the statement prescribed by the welfare division of the department of

6-44  human resources pursuant to NRS 425.520. The statement must be

6-45  completed and signed by the applicant.

6-46    2.  The board shall include the statement required pursuant to

6-47  subsection 1 in:

6-48    (a) The application or any other forms that must be submitted for the

6-49  issuance or renewal of the license; or


7-1    (b) A separate form prescribed by the board.

7-2    3.  A license to practice medicine , [or] to practice as a [physician’s]

7-3  physician assistant or to practice as a practitioner of respiratory care may

7-4  not be issued or renewed by the board if the applicant:

7-5    (a) Fails to submit the statement required pursuant to subsection 1; or

7-6    (b) Indicates on the statement submitted pursuant to subsection 1 that he

7-7  is subject to a court order for the support of a child and is not in

7-8  compliance with the order or a plan approved by the district attorney or

7-9  other public agency enforcing the order for the repayment of the amount

7-10  owed pursuant to the order.

7-11    4.  If an applicant indicates on the statement submitted pursuant to

7-12  subsection 1 that he is subject to a court order for the support of a child and

7-13  is not in compliance with the order or a plan approved by the district

7-14  attorney or other public agency enforcing the order for the repayment of

7-15  the amount owed pursuant to the order, the board shall advise the applicant

7-16  to contact the district attorney or other public agency enforcing the order to

7-17  determine the actions that the applicant may take to satisfy the arrearage.

7-18    Sec. 20.  NRS 630.253 is hereby amended to read as follows:

7-19    630.253  The board shall, as a prerequisite for the:

7-20    1.  Renewal of a license as a [physician’s] physician assistant; or

7-21    2.  Biennial registration of the holder of a license to practice
medicine,

7-22  require each holder to comply with the requirements for continuing

7-23  education adopted by the board. These requirements may provide for the

7-24  completion of one or more courses of instruction relating to risk

7-25  management in the performance of medical services.

7-26    Sec. 21.  NRS 630.261 is hereby amended to read as follows:

7-27    630.261  1.  [The board may, unless] Except as otherwise provided in

7-28  [this section or] NRS 630.161, the board may issue : [, renew or modify:]

7-29    (a) A locum tenens license, to be effective not more than 3 months after

7-30  issuance, to any physician who is licensed and in good standing in another

7-31  state , who meets the requirements for licensure in this state and who is of

7-32  good moral character and reputation. The purpose of this license is to

7-33  enable an eligible physician to serve as a substitute for another physician

7-34  who is licensed to practice medicine in this state and who is absent from

7-35  his practice for reasons deemed sufficient by the board. A license issued

7-36  pursuant to the provisions of this paragraph is not renewable.

7-37    (b) A special license to a licensed physician of another state to come

7-38  into this state to care for or assist in the treatment of his own patient in

7-39  association with a physician licensed in this state. A special license issued

7-40  pursuant to the provisions of this paragraph is limited to the care of a

7-41  specific patient. The physician licensed in this state has the primary

7-42  responsibility for the care of that patient.

7-43    (c) A restricted license for a specified period if the board determines the

7-44  applicant needs supervision or restriction.

7-45    (d) A temporary license for a specified period if the physician is

7-46  licensed and in good standing in another state and meets the requirements

7-47  for licensure in this state, and if the board determines that it is necessary

7-48  in order to provide medical services for a community without adequate


8-1  medical care. A temporary license issued pursuant to the provisions of this

8-2  paragraph is not renewable.

8-3    (e) A special purpose license to a physician who is licensed in another

8-4  state to permit the use of equipment that transfers information

8-5  concerning the medical condition of a patient in this state across state

8-6  lines electronically, telephonically or by fiber optics if the physician:

8-7       (1) Holds a full and unrestricted license to practice medicine in that

8-8  state;

8-9       (2) Has not had any disciplinary or other action taken against him

8-10  by any state or other jurisdiction; and

8-11      (3) Meets the requirement set forth in paragraph (d) of subsection 2

8-12  of NRS 630.160.

8-13    2.  Except as otherwise provided in this section, the board may renew

8-14  or modify any license issued pursuant to subsection 1.

8-15    3.  Every physician who is licensed pursuant to [the provisions of]

8-16  subsection 1 and who accepts the privilege of practicing medicine in this

8-17  state pursuant to the provisions of the license shall be deemed to have

8-18  given his consent to the revocation of the license at any time by the board

8-19  for any of the grounds provided in NRS 630.161 or 630.301 to 630.3065,

8-20  inclusive.

8-21    Sec. 22.  NRS 630.265 is hereby amended to read as follows:

8-22    630.265  1.  Except as otherwise provided in NRS 630.161, the board

8-23  may issue to a qualified applicant a limited license to practice medicine as

8-24  a resident physician in a graduate program approved by the Accreditation

8-25  Council for Graduate Medical Education if he is:

8-26    (a) A graduate of an accredited medical school in the United States or

8-27  Canada; or

8-28    (b) A graduate of a foreign medical school and has received the

8-29  standard certificate of the Educational Commission for Foreign Medical

8-30  Graduates or a written statement from that commission that he passed the

8-31  examination given by it.

8-32    2.  The medical school or other institution sponsoring the program shall

8-33  provide the board with written confirmation that the applicant has been

8-34  appointed to a position in the program and is a citizen of the United States

8-35  or lawfully entitled to remain and work in the United States. Such a license

8-36  remains valid only while the licensee is actively practicing medicine in the

8-37  residency program and is legally entitled to work and remain in the United

8-38  States.

8-39    3.  The board may issue such a limited license for not more than 1 year

8-40  but may renew the license [.] if the applicant for the limited license meets

8-41  the requirements set forth by the board by regulation.

8-42    4.  The holder of a limited license may practice medicine only in

8-43  connection with his duties as a resident physician or under such conditions

8-44  as are approved by the director of the program and the board.

8-45    5.  [A] The holder of a limited license granted pursuant to this section

8-46  may be [revoked] disciplined by the board at any time for any of the

8-47  grounds provided in NRS 630.161 or 630.301 to 630.3065, inclusive.

 

 


9-1    Sec. 23.  NRS 630.271 is hereby amended to read as follows:

9-2    630.271  1.  A [physician’s] physician assistant may perform such

9-3  medical services as he is authorized to perform [pursuant to the terms of a

9-4  license issued to him by the board, if those services are rendered under the

9-5  supervision and control of a] by his supervising physician.

9-6    2.  The board and supervising physician shall limit the authority of a

9-7  [physician’s] physician assistant to prescribe controlled substances to those

9-8  schedules of controlled substances [which his] that the supervising

9-9  physician is authorized to prescribe pursuant to state and federal law.

9-10    Sec. 24.  NRS 630.273 is hereby amended to read as follows:

9-11    630.273  The board may issue a license to an applicant who is qualified

9-12  under the regulations of the board to perform medical services under the

9-13  supervision of a supervising physician. The application for a license as a

9-14  [physician’s] physician assistant must include the social security number

9-15  of the applicant . [and be cosigned by the supervising physician.]

9-16    Sec. 25.  NRS 630.275 is hereby amended to read as follows:

9-17    630.275  The board shall adopt regulations regarding the licensure of a

9-18  [physician’s] physician assistant, including, but not limited to:

9-19    1.  The educational and other qualifications of applicants.

9-20    2.  The required academic program for applicants.

9-21    3.  The procedures for applications for and the issuance of licenses.

9-22    4.  The tests or examinations of applicants by the board.

9-23    5.  The medical services which a [physician’s] physician assistant may

9-24  perform, except that he may not perform those specific functions and duties

9-25  delegated or restricted by law to persons licensed as dentists, chiropractors,

9-26  podiatric physicians and optometrists under chapters 631, 634, 635 and

9-27  636, respectively, of NRS, or as hearing aid specialists.

9-28    6.  The duration, renewal and termination of licenses.

9-29    7.  The grounds and procedures respecting disciplinary actions against

9-30  [physicians’] physician assistants.

9-31    8.  The supervision of medical services of a [physician’s] physician

9-32  assistant by a supervising physician.

9-33    Sec. 26.  NRS 630.288 is hereby amended to read as follows:

9-34    630.288  1.  Each holder of a license to practice medicine must, on or

9-35  before July 1 of each alternate year:

9-36    (a) Submit the statement required pursuant to NRS 630.197; and

9-37    (b) Pay to the secretary-treasurer of the board the applicable fee for

9-38  biennial registration. This fee must be collected for the period for which a

9-39  physician is licensed.

9-40    2.  When a holder of a license fails to pay the fee for biennial

9-41  registration and submit the statement required pursuant to NRS 630.197

9-42  after they become due, his license to practice medicine in this state is

9-43  automatically suspended. The holder may, within 2 years after the date his

9-44  license is suspended, upon payment of twice the amount of the current fee

9-45  for biennial registration to the secretary-treasurer and submission of the

9-46  statement required pursuant to NRS 630.197 and after he is found to be in

9-47  good standing and qualified under the provisions of this chapter, be

9-48  reinstated to practice.


10-1    3.  The board shall make such reasonable attempts as are practicable

10-2  to notify a licensee:

10-3    (a) At least once that his fee for biennial registration and the statement

10-4  required pursuant to NRS 630.197 are due; and

10-5    (b) That his license is suspended.

10-6  A copy of this notice must be sent to the Drug Enforcement Administration

10-7  of the United States Department of Justice or its successor agency.

10-8    Sec. 27.  NRS 630.290 is hereby amended to read as follows:

10-9    630.290  1.  The board shall charge and collect not more than the

10-10  following fees:

10-11  For application for and issuance of a license [by written

10-12  examination, in addition to the actual cost to the board of

10-13  the examination] to practice as a physician.............. $600

10-14  For application for and issuance of a temporary, locum

10-15  tenens, limited, restricted , special or special purpose

10-16  license................. [300] 400

10-17  For renewal of a limited, restricted or special license............................. [200] 400

10-18  For application for and issuance of a license as a

10-19  [physician’s] physician assistant................. [300] 400

10-20  For [renewal of a license as a physician’s] biennial

10-21  registration of a physician assistant................. [300] 800

10-22  For biennial registration of a physician........................ 800

10-23  For application for and issuance of a license as a

10-24  practitioner of respiratory care................................ 400

10-25  For biennial registration of a practitioner of respiratory

10-26  care.............................. 800

10-27  For biennial registration for a physician who is [retired,]

10-28  on inactive status [or not practicing medicine in Nevada............................... 200] 400

10-29  For written verification of licensure............................ 50

10-30  For a duplicate identification card.................................. 25

10-31  For a duplicate license..... 50

10-32  For computer printouts or labels..................... [300] 500

10-33  For verification of a listing of physicians, per hour.......... 20

10-34  For furnishing a list of new physicians................ [50] 100

10-35  2.  In addition to the fees prescribed in subsection 1, the board shall

10-36  charge and collect [:

10-37  (a) A fee to reimburse it for the cost of the United States Medical

10-38  Licensing Examination; and

10-39  (b) Necessary] necessary and reasonable fees for its other services.

10-40  3.  The cost of any special meeting called at the request of a [licensed

10-41  physician,] licensee, an institution, an organization, a state agency or an

10-42  applicant for licensure must be paid for by the person or entity requesting

10-43  the special meeting. Such a special meeting must not be called until the

10-44  person or entity requesting it has paid a cash deposit with the board

10-45  sufficient to defray all expenses of the meeting.

10-46  Sec. 28.  NRS 630.301 is hereby amended to read as follows:

10-47  630.301  The following acts, among others, constitute grounds for

10-48  initiating disciplinary action or denying licensure:


11-1    1.  Conviction of a felony, any offense involving moral turpitude or any

11-2  offense relating to the practice of medicine or the ability to practice

11-3  medicine. A plea of nolo contendere is a conviction for the purposes of this

11-4  subsection.

11-5    2.  Conviction of violating any of the provisions of NRS 616D.200,

11-6  616D.220, 616D.240, 616D.300, 616D.310, or 616D.350 to 616D.440,

11-7  inclusive.

11-8    3.  The revocation, suspension, modification or limitation of the license

11-9  to practice any type of medicine by any other jurisdiction or the surrender

11-10  of the license or discontinuing the practice of medicine while under

11-11  investigation by any licensing authority, a medical facility, a branch of the

11-12  Armed Services of the United States, an insurance company, an agency of

11-13  the Federal Government or an employer.

11-14  4.  Malpractice, which may be evidenced by claims settled against a

11-15  practitioner.

11-16  5.  The engaging by a practitioner in any sexual activity with a patient

11-17  who is currently being treated by the practitioner.

11-18  6.  Disruptive behavior or interaction with physicians, hospital

11-19  personnel, patients, members of the families of patients or any other

11-20  persons if the behavior or interaction interferes with patient care or

11-21  would be reasonably expected to have an adverse impact on the quality of

11-22  care rendered to the patients.

11-23  7.  The engaging in conduct that violates the trust of a patient and

11-24  exploits the relationship between the physician and the patient for

11-25  financial or other personal gain.

11-26  8.  The failure to offer appropriate procedures or studies, to protest

11-27  inappropriate denials by organizations for managed care, to provide

11-28  necessary services or to refer a patient to an appropriate provider, when

11-29  such a failure occurs for the sole purpose of positively influencing the

11-30  financial well-being of the practitioner or an insurer.

11-31  9.  The engaging in conduct calculated to bring, or having the effect

11-32  of bringing, the medical profession into disrepute, including, without

11-33  limitation, conduct that violates any provision of a national code of ethics

11-34  adopted by the board by regulation.

11-35  10.  The engaging in sexual contact with the surrogate of a patient or

11-36  other key persons related to a patient, including, without limitation, a

11-37  spouse, parent or legal guardian, which exploits the relationship between

11-38  the physician and the patient in a sexual manner.

11-39  Sec. 29.  NRS 630.3062 is hereby amended to read as follows:

11-40  630.3062  The following acts, among others, constitute grounds for

11-41  initiating disciplinary action or denying licensure:

11-42  1.  Failure to maintain timely, legible, accurate and complete medical

11-43  records relating to the diagnosis, treatment and care of a patient.

11-44  2.  Altering medical records of a patient.

11-45  3.  Making or filing a report which the licensee knows to be false,

11-46  failing to file a record or report as required by law or willfully obstructing

11-47  or inducing another to obstruct such filing.

11-48  4.  Failure to make the medical records of a patient available for

11-49  inspection and copying as provided in NRS 629.061.


12-1    5.  Failure to report any claim for malpractice or negligence filed

12-2  against the licensee and the subsequent disposition thereof within 90 days

12-3  after the:

12-4    (a) Claim is filed; and

12-5    (b) Disposition of the claim.

12-6    6.  Failure to report any person the licensee knows, or has reason to

12-7  know, is in violation of the provisions of this chapter or the regulations of

12-8  the board.

12-9    Sec. 30.  NRS 630.3066 is hereby amended to read as follows:

12-10  630.3066  A physician is not subject to disciplinary action solely for

12-11  prescribing or administering to a patient under his care [:

12-12  1.  Amygdalin (laetrile), if the patient has consented in writing to the

12-13  use of the substance.

12-14  2.  Procaine hydrochloride with preservatives and stabilizers (Gerovital

12-15  H3).

12-16  3.  A] a controlled substance which is listed in schedule II, III, IV or V

12-17  by the state board of pharmacy pursuant to NRS 453.146, if the controlled

12-18  substance is lawfully prescribed or administered for the treatment of

12-19  intractable pain in accordance with [accepted standards for the practice of

12-20  medicine.] regulations adopted by the board.

12-21  Sec. 31.  NRS 630.307 is hereby amended to read as follows:

12-22  630.307  1.  Any person, medical school or medical facility that

12-23  becomes aware that a person practicing medicine or respiratory care in

12-24  this state has, is or is about to become engaged in conduct which

12-25  constitutes grounds for initiating disciplinary action shall forthwith file a

12-26  written complaint with the board.

12-27  2.  Any hospital, clinic or other medical facility licensed in this state, or

12-28  medical society, shall forthwith report to the board any change in a

12-29  physician’s privileges to practice medicine while the physician is under

12-30  investigation and the outcome of any disciplinary action taken by that

12-31  facility or society against the physician concerning the care of a patient or

12-32  the competency of the physician.

12-33  3.  The clerk of every court shall forthwith report to the board any

12-34  finding, judgment or other determination of the court that a physician [:] ,

12-35  physician assistant or practitioner of respiratory care:

12-36  (a) Is mentally ill;

12-37  (b) Is mentally incompetent;

12-38  (c) Has been convicted of a felony or any law governing controlled

12-39  substances or dangerous drugs;

12-40  (d) Is guilty of abuse or fraud under any state or federal program

12-41  providing medical assistance; or

12-42  (e) Is liable for damages for malpractice or negligence.

12-43  Sec. 32.  NRS 630.329 is hereby amended to read as follows:

12-44  630.329  If the board issues an order suspending the license of a

12-45  physician , physician assistant or practitioner of respiratory care pending

12-46  proceedings for disciplinary action, the court shall not stay that order.

 

 

 


13-1    Sec. 33.  NRS 630.333 is hereby amended to read as follows:

13-2    630.333  1.  In addition to any other remedy provided by law, the

13-3  board, through its president or, secretary-treasurer or the attorney general,

13-4  may apply to any court of competent jurisdiction:

13-5    (a) To enjoin any prohibited act or other conduct of a [physician]

13-6  licensee which is harmful to the public;

13-7    (b) To enjoin any person who is not licensed under this chapter from

13-8  practicing medicine [;] or respiratory care;

13-9    (c) To limit the [physician’s] practice of a physician, physician

13-10  assistant or practitioner of respiratory care, or suspend his license to

13-11  practice ; [medicine;] or

13-12  (d) To enjoin the use of the title M.D. , P.A., P.A.-C, R.C.P. or any

13-13  other word, combination of letters or other designation intended to imply

13-14  or designate a person as a physician, physician assistant or practitioner

13-15  of respiratory care, when not licensed by the board pursuant to this

13-16  chapter, unless the use is otherwise authorized by a specific statute.

13-17  2.  The court in a proper case may issue a temporary restraining order

13-18  or a preliminary injunction for the purposes set forth in subsection 1:

13-19  (a) Without proof of actual damage sustained by any person;

13-20  (b) Without relieving any person from criminal prosecution for

13-21  engaging in the practice of medicine without a license; and

13-22  (c) Pending proceedings for disciplinary action by the board.

13-23  Sec. 34.  NRS 630.336 is hereby amended to read as follows:

13-24  630.336  1.  Any proceeding of a committee of the board investigating

13-25  complaints is not subject to the requirements of NRS 241.020, unless the

13-26  licensee under investigation requests that the proceeding be subject to those

13-27  requirements. Any deliberations conducted or vote taken by:

13-28  (a) The board or panel regarding its decision; or

13-29  (b) The board or any investigative committee of the board regarding its

13-30  ordering of a physician , physician assistant or practitioner of respiratory

13-31  care to undergo a physical or mental examination or any other examination

13-32  designated to assist the board or committee in determining the fitness of a

13-33  physician, physician assistant or practitioner of respiratory care,

13-34  are not subject to the requirements of NRS 241.020.

13-35  2.  Except as otherwise provided in subsection 3, all applications for a

13-36  license to practice medicine [,] or respiratory care, any charges filed by the

13-37  board, financial records of the board, formal hearings on any charges heard

13-38  by the board or a panel selected by the board, records of such hearings and

13-39  any order or decision of the board or panel must be open to the public.

13-40  3.  Except as otherwise provided in NRS 630.352 and 630.368, the

13-41  following may be kept confidential:

13-42  (a) Any statement, evidence, credential or other proof submitted in

13-43  support of or to verify the contents of an application;

13-44  (b) All investigations and records of investigations;

13-45  (c) Any report concerning the fitness of any person to receive or hold a

13-46  license to practice medicine [;] or respiratory care;

13-47  (d) Any communication between:

13-48     (1) The board and any of its committees or panels; and


14-1      (2) The board or its staff, investigators, experts, committees, panels,

14-2  hearing officers, advisory members or consultants and counsel for the

14-3  board; and

14-4    (e) Any other information or records in the possession of the board.

14-5    4.  This section does not prevent or prohibit the board from

14-6  communicating or cooperating with any other licensing board or agency or

14-7  any agency which is investigating a licensee, including a law enforcement

14-8  agency. Such cooperation may include , without limitation, providing the

14-9  board or agency with minutes of a closed meeting, transcripts of oral

14-10  examinations and the results of oral examinations.

14-11  Sec. 35.  NRS 630.344 is hereby amended to read as follows:

14-12  630.344  1.  Service of process [made] under this chapter must be

14-13  made on [the person] a licensee personally, or by registered or certified

14-14  mail with return receipt requested [,] addressed to the [physician] licensee

14-15  at his last known address. If personal service cannot be made and if notice

14-16  by mail is returned undelivered, the secretary-treasurer of the board shall

14-17  cause notice to be published once a week for 4 consecutive weeks in a

14-18  newspaper published in the county of the [physician’s] last known address

14-19  of the licensee or, if no newspaper is published in that county, then in a

14-20  newspaper widely distributed in that county.

14-21  2.  Proof of service of process or publication of notice made under this

14-22  chapter must be filed with the board and recorded in the minutes of the

14-23  board.

14-24  Sec. 36.  NRS 630.346 is hereby amended to read as follows:

14-25  630.346  In any disciplinary hearing:

14-26  1.  The board, a panel of the members of the board and a hearing

14-27  officer are not bound by formal rules of evidence and a witness must not be

14-28  barred from testifying solely because he was or is incompetent.

14-29  2.  Proof of actual injury need not be established.

14-30  3.  A certified copy of the record of a court or a licensing agency

14-31  showing a conviction or plea of nolo contendere or the suspension,

14-32  revocation, limitation, modification, denial or surrender of a license to

14-33  practice medicine or respiratory care is conclusive evidence of its

14-34  occurrence.

14-35  Sec. 37.  NRS 630.352 is hereby amended to read as follows:

14-36  630.352  1.  Any member of the board, except for an advisory

14-37  member serving on a panel of the board hearing charges, may participate in

14-38  the final order of the board. If the board, after a formal hearing, determines

14-39  from a preponderance of the evidence that a violation of the provisions of

14-40  this chapter or of the regulations of the board has occurred, it shall issue

14-41  and serve on the physician charged an order, in writing, containing its

14-42  findings and any sanctions.

14-43  2.  If the board determines that no violation has occurred, it shall

14-44  dismiss the charges, in writing, and notify the physician that the charges

14-45  have been dismissed. If the disciplinary proceedings were instituted against

14-46  the physician as a result of a complaint filed against him, the board may

14-47  provide the physician with a copy of the complaint . [, including the name

14-48  of the person, if any, who filed the complaint.]


15-1    3.  Except as otherwise provided in subsection 4, if the board finds that

15-2  a violation has occurred, it may by order:

15-3    (a) Place the person on probation for a specified period on any of the

15-4  conditions specified in the order;

15-5    (b) Administer to him a public reprimand;

15-6    (c) Limit his practice or exclude one or more specified branches of

15-7  medicine from his practice;

15-8    (d) Suspend his license for a specified period or until further order of

15-9  the board;

15-10  (e) Revoke his license to practice medicine;

15-11  (f) Require him to participate in a program to correct alcohol or drug

15-12  dependence or any other impairment;

15-13  (g) Require supervision of his practice;

15-14  (h) Impose a fine not to exceed $5,000;

15-15  (i) Require him to perform public service without compensation;

15-16  (j) Require him to take a physical or mental examination or an

15-17  examination testing his competence;

15-18  (k) Require him to fulfill certain training or educational requirements;

15-19  and

15-20  (l) Require him to pay all costs incurred by the board relating to his

15-21  disciplinary proceedings.

15-22  4.  If the board finds that the physician has violated the provisions of

15-23  NRS 439B.425, the board shall suspend his license for a specified period or

15-24  until further order of the board.

15-25  Sec. 38.  NRS 630.355 is hereby amended to read as follows:

15-26  630.355  1.  If a person, in a proceeding before the board [:] , a

15-27  hearing officer or a panel of the board:

15-28  (a) Disobeys or resists a lawful order ; [of the board;]

15-29  (b) Refuses to take an oath or affirmation as a witness ; [before the

15-30  board;]

15-31  (c) Refuses to be examined ; [before the board;] or

15-32  (d) Engages in conduct during a hearing or so near the place thereof as

15-33  to obstruct the proceeding,

15-34  the board , hearing officer or panel may certify the facts to the district

15-35  court of the county in which the proceeding is being conducted. Such a

15-36  certification operates as a stay of all related disciplinary proceedings .

15-37  [before the board.] The court shall issue an order directing the person to

15-38  appear before the court and show cause why he should not be held in

15-39  contempt.

15-40  2.  A copy of the statement of the board , hearing officer or panel, and

15-41  the order of the district court issued pursuant to subsection 1 must be

15-42  served on the person. Thereafter, the court has jurisdiction of the matter.

15-43  3.  The same proceedings must be had, the same penalties may be

15-44  imposed and the person may purge himself of the contempt in the same

15-45  way as in the case of a person who has committed a contempt in the trial of

15-46  a civil action.

15-47  Sec. 39.  NRS 630.356 is hereby amended to read as follows:

15-48  630.356  1.  Any person aggrieved by a final order of the board is

15-49  entitled to judicial review of the board’s order.


16-1    2.  Every order [of the board which limits the practice of medicine or

16-2  suspends or revokes a license] that imposes a sanction against a licensee

16-3  pursuant to subsection 3 or 4 of NRS 630.352 or any regulation of the

16-4  board is effective from the date the secretary-treasurer certifies the order

16-5  until the date the order is modified or reversed by a final judgment of the

16-6  court. The court shall not stay the order of the board pending a final

16-7  determination by the court.

16-8    3.  The district court shall give a petition for judicial review of the

16-9  board’s order priority over other civil matters which are not expressly

16-10  given priority by law.

16-11  Sec. 40.  NRS 630.358 is hereby amended to read as follows:

16-12  630.358  1.  Any person:

16-13  (a) Whose practice of medicine or respiratory care has been limited; or

16-14  (b) Whose license to practice medicine or respiratory care has been:

16-15     (1) Suspended until further order; or

16-16     (2) Revoked,

16-17  by an order of the board, may apply to the board for removal of the

16-18  limitation or restoration of his license.

16-19  2.  In hearing the application, the board:

16-20  (a) May require the person to submit to a mental or physical

16-21  examination or an examination testing his competence to practice medicine

16-22  or respiratory care by physicians or practitioners of respiratory care, as

16-23  appropriate, or other examinations it designates and submit such other

16-24  evidence of changed conditions and of fitness as it deems proper;

16-25  (b) Shall determine whether under all the circumstances the time of the

16-26  application is reasonable; and

16-27  (c) May deny the application or modify or rescind its order as it deems

16-28  the evidence and the public safety warrants.

16-29  3.  The licensee has the burden of proving by clear and convincing

16-30  evidence that the requirements for restoration of the license or removal of

16-31  the limitation have been met.

16-32  4.  The board shall not restore a license unless it is satisfied that the

16-33  person has complied with all of the terms and conditions set forth in the

16-34  final order of the board and that the person is capable of practicing

16-35  medicine or respiratory care in a safe manner.

16-36  5.  To restore a license that has been revoked by the board, the

16-37  applicant must apply for a license and take an examination as though he

16-38  had never been licensed under this chapter.

16-39  Sec. 41.  NRS 630.366 is hereby amended to read as follows:

16-40  630.366  1.  If the board receives a copy of a court order issued

16-41  pursuant to NRS 425.540 that provides for the suspension of all

16-42  professional, occupational and recreational licenses, certificates and

16-43  permits issued to a person who is the holder of a license to practice

16-44  medicine , [or] to practice as a [physician’s assistant,] physician assistant

16-45  or to practice as a practitioner of respiratory care, the board shall deem

16-46  the license issued to that person to be suspended at the end of the 30th day

16-47  after the date on which the court order was issued unless the board receives

16-48  a letter issued to the holder of the license by the district attorney or other

16-49  public agency pursuant to NRS 425.550 stating that the holder of the


17-1  license has complied with the subpoena or warrant or has satisfied the

17-2  arrearage pursuant to NRS 425.560.

17-3    2.  The board shall reinstate a license to practice medicine , [or] to

17-4  practice as a [physician’s] physician assistant or to practice as a

17-5  practitioner of respiratory care that has been suspended by a district court

17-6  pursuant to NRS 425.540 if the board receives a letter issued by the district

17-7  attorney or other public agency pursuant to NRS 425.550 to the person

17-8  whose license was suspended stating that the person whose license was

17-9  suspended has complied with the subpoena or warrant or has satisfied the

17-10  arrearage pursuant to NRS 425.560.

17-11  Sec. 42.  NRS 630.368 is hereby amended to read as follows:

17-12  630.368  [1.]  To institute a disciplinary action against a [physician’s

17-13  assistant,] physician assistant or practitioner of respiratory care, a written

17-14  complaint, specifying the charges, must be filed with the board by:

17-15  [(a) The board ;

17-16  (b)] 1.  The board or a committee designated by the board to

17-17  investigate a complaint;

17-18  2.  Any member of the board; or

17-19  [(c)] 3.  Any other person who is aware of any act or circumstance

17-20  constituting a ground for disciplinary action set forth in the regulations

17-21  adopted by the board.

17-22  [2.  Before taking any formal action on a complaint filed against a

17-23  physician’s assistant by his supervising physician or by an osteopathic

17-24  physician supervising the physician’s assistant pursuant to NRS 630.274,

17-25  the board shall provide the physician’s assistant with a copy of the

17-26  complaint.

17-27  3.  If, pursuant to disciplinary procedures set forth in the regulations

17-28  adopted by the board, the board finds that the charges in the complaint

17-29  against the physician’s assistant are false, the board may provide the

17-30  physician’s assistant with a copy of the complaint, including the name of

17-31  the person, if any, who filed the complaint.]

17-32  Sec. 43.  NRS 630.390 is hereby amended to read as follows:

17-33  630.390  In seeking injunctive relief against any person for an alleged

17-34  violation of this chapter by practicing medicine or respiratory care without

17-35  a license, it is sufficient to allege that he did, upon a certain day, and in a

17-36  certain county of this state, engage in the practice of medicine or

17-37  respiratory care without having a license to do so, without alleging any

17-38  further or more particular facts concerning the same.

17-39  Sec. 44.  NRS 630.400 is hereby amended to read as follows:

17-40  630.400  A person who:

17-41  1.  Presents to the board as his own the diploma, license or credentials

17-42  of another;

17-43  2.  Gives either false or forged evidence of any kind to the board;

17-44  3.  Practices medicine or respiratory care under a false or assumed

17-45  name or falsely personates another licensee;

17-46  4.  Except as otherwise provided by specific statute, practices medicine

17-47  or respiratory care without being licensed under this chapter;


18-1    5.  Holds himself out as a [physician’s] physician assistant or [who]

18-2  uses any other term indicating or implying that he is a [physician’s]

18-3  physician assistant without being licensed by the board; [or]

18-4    6.  Holds himself out as a practitioner of respiratory care or uses any

18-5  other term indicating or implying that he is a practitioner of respiratory

18-6  care without being licensed by the board; or

18-7    7.  Uses the title M.D., when not licensed by the board pursuant to this

18-8  chapter, unless otherwise authorized by a specific statute,

18-9  is guilty of a category D felony and shall be punished as provided in NRS

18-10  193.130.

18-11  Sec. 45.  NRS 632.472 is hereby amended to read as follows:

18-12  632.472  1.  The following persons shall report in writing to the

18-13  executive director of the board any conduct of a licensee or holder of a

18-14  certificate which constitutes a violation of the provisions of this chapter:

18-15  (a) Any physician, dentist, dental hygienist, chiropractor, optometrist,

18-16  podiatric physician, medical examiner, resident, intern, professional or

18-17  practical nurse, nursing assistant, [physician’s] physician assistant,

18-18  psychiatrist, psychologist, marriage and family therapist, alcohol or drug

18-19  abuse counselor, driver of an ambulance, advanced emergency medical

18-20  technician or other person providing medical services licensed or certified

18-21  to practice in this state.

18-22  (b) Any personnel of a medical facility or facility for the dependent

18-23  engaged in the admission, examination, care or treatment of persons or an

18-24  administrator, manager or other person in charge of a medical facility or

18-25  facility for the dependent upon notification by a member of the staff of the

18-26  facility.

18-27  (c) A coroner.

18-28  (d) Any person who maintains or is employed by an agency to provide

18-29  nursing in the home.

18-30  (e) Any employee of the department of human resources.

18-31  (f) Any employee of a law enforcement agency or a county’s office for

18-32  protective services or an adult or juvenile probation officer.

18-33  (g) Any person who maintains or is employed by a facility or

18-34  establishment that provides care for older persons.

18-35  (h) Any person who maintains, is employed by or serves as a volunteer

18-36  for an agency or service which advises persons regarding the abuse, neglect

18-37  or exploitation of an older person and refers them to persons and agencies

18-38  where their requests and needs can be met.

18-39  (i) Any social worker.

18-40  2.  Every physician who, as a member of the staff of a medical facility

18-41  or facility for the dependent, has reason to believe that a nursing assistant

18-42  has engaged in conduct which constitutes grounds for the denial,

18-43  suspension or revocation of a certificate shall notify the superintendent,

18-44  manager or other person in charge of the facility. The superintendent,

18-45  manager or other person in charge shall make a report as required in

18-46  subsection 1.

18-47  3.  A report may be filed by any other person.


19-1    4.  Any person who in good faith reports any violation of the provisions

19-2  of this chapter to the executive director of the board pursuant to this section

19-3  is immune from civil liability for reporting the violation.

19-4    Sec. 46.  NRS 632.473 is hereby amended to read as follows:

19-5    632.473  1.  A nurse licensed pursuant to the provisions of this

19-6  chapter, while working at an institution of the department of prisons, may

19-7  treat patients, including the administration of a dangerous drug, poison or

19-8  related device, pursuant to orders given by a [physician’s] physician

19-9  assistant if those orders are given pursuant to a protocol approved by the

19-10  board of medical examiners and the supervising physician. The orders must

19-11  be cosigned by the supervising physician or another physician within 72

19-12  hours after treatment.

19-13  2.  A copy of the protocol under which orders are given by a

19-14  [physician’s] physician assistant must be available at the institution for

19-15  review by the nurse.

19-16  3.  This section does not authorize a [physician’s] physician assistant to

19-17  give orders for the administration of any controlled substance.

19-18  4.  For the purposes of this section:

19-19  (a) [“Physician’s] “Physician assistant” means a [physician’s]

19-20  physician assistant licensed by the board of medical examiners pursuant to

19-21  chapter 630 of NRS who:

19-22     (1) Is employed at an institution of the department of prisons;

19-23     (2) Has been awarded a bachelor’s degree from a college or

19-24  university recognized by the board of medical examiners; and

19-25     (3) Has received at least 40 hours of instruction regarding the

19-26  prescription of medication as a part of either his basic educational

19-27  qualifications or a program of continuing education approved by the board

19-28  of medical examiners.

19-29  (b) “Protocol” means the written directions for the assessment and

19-30  management of specified medical conditions, including the drugs and

19-31  devices the [physician’s] physician assistant is authorized to order, which

19-32  the [physician’s] physician assistant and the supervision have agreed upon

19-33  as a basis for their practice.

19-34  (c) “Supervising physician” has the meaning ascribed to it in NRS

19-35  630.025.

19-36  Sec. 47.  NRS 639.0125 is hereby amended to read as follows:

19-37  639.0125  “Practitioner” means:

19-38  1.  A physician, dentist, veterinarian or podiatric physician who holds a

19-39  valid license to practice his profession in this state;

19-40  2.  A hospital, pharmacy or other institution licensed, registered or

19-41  otherwise permitted to distribute, dispense, conduct research with respect

19-42  to or administer drugs in the course of professional practice or research in

19-43  this state;

19-44  3.  An advanced practitioner of nursing who has been authorized to

19-45  prescribe poisons, dangerous drugs and devices; or

19-46  4.  A physician assistant who:

19-47  (a) Holds a license issued by the board of medical examiners; and


20-1    (b) Is authorized by the board to possess, administer, prescribe or

20-2  dispense controlled substances, poisons, dangerous drugs or devices

20-3  under the supervision of a physician as required by chapter 630 of NRS.

20-4    5.  An osteopathic physician’s assistant who:

20-5    (a) Holds a [license issued by the board of medical examiners or]

20-6  certificate issued by the state board of osteopathic medicine; and

20-7    (b) Is authorized by the board to possess, administer, prescribe or

20-8  dispense controlled substances, poisons, dangerous drugs or devices under

20-9  the supervision of [a physician or] an osteopathic physician as required by

20-10  chapter [630 or] 633 of NRS.

20-11  Sec. 48.  NRS 639.1373 is hereby amended to read as follows:

20-12  639.1373  1.  A physician assistant or an osteopathic physician’s

20-13  assistant may, if authorized by the board, possess, administer, prescribe or

20-14  dispense controlled substances, or possess, administer, prescribe or

20-15  dispense poisons, dangerous drugs or devices in or out of the presence of

20-16  his supervising physician only to the extent and subject to the limitations

20-17  specified in the registration certificate issued to the physician assistant or

20-18  osteopathic physician’s [assistant’s certificate as issued] assistant, as

20-19  appropriate, by the board [.] pursuant to this section.

20-20  2.  Each physician assistant and osteopathic physician’s assistant who

20-21  is authorized by his [physician’s] physician assistant’s license issued by

20-22  the board of medical examiners or certificate issued by the state board of

20-23  osteopathic medicine to possess, administer, prescribe or dispense

20-24  controlled substances, or to possess, administer, prescribe or dispense

20-25  poisons, dangerous drugs or devices must apply for and obtain a

20-26  registration certificate from the board, pay a fee to be set by regulations

20-27  adopted by the board and pass an examination administered by the board

20-28  on the law relating to pharmacy before he can possess, administer,

20-29  prescribe or dispense controlled substances, or possess, administer,

20-30  prescribe or dispense poisons, dangerous drugs or devices.

20-31  3.  The board shall consider each application separately and may, even

20-32  though the [physician’s] physician assistant’s license issued by the board

20-33  of medical examiners or the osteopathic physician’s assistant’s certificate

20-34  issued by the state board of osteopathic medicine authorizes the physician

20-35  assistant or osteopathic physician’s assistant , as appropriate, to possess,

20-36  administer, prescribe or dispense controlled substances, or to possess,

20-37  administer, prescribe or dispense poisons, dangerous drugs and devices:

20-38  (a) Refuse to issue a registration certificate;

20-39  (b) Issue a registration certificate limiting the authority of the physician

20-40  assistant or osteopathic physician’s [assistant’s authority] assistant, as

20-41  appropriate, to possess, administer, prescribe or dispense controlled

20-42  substances, or to possess, administer, prescribe or dispense poisons,

20-43  dangerous drugs or devices, the area in which the physician assistant or

20-44  osteopathic physician’s assistant may possess controlled substances,

20-45  poisons, dangerous drugs and devices, or the kind and amount of controlled

20-46  substances, poisons, dangerous drugs and devices; or

20-47  (c) Issue a registration certificate imposing other limitations or

20-48  restrictions which the board feels are necessary and required to protect the

20-49  health, safety and welfare of the public.


21-1    4.  If the registration of the physician assistant or osteopathic

21-2  physician’s assistant is suspended or revoked, the physician’s controlled

21-3  substance registration may also be suspended or revoked.

21-4    5.  The board shall adopt regulations controlling the maximum amount

21-5  to be administered, possessed and dispensed, and the storage, security,

21-6  recordkeeping and transportation of controlled substances and the

21-7  maximum amount to be administered, possessed, prescribed and dispensed

21-8  and the storage, security, recordkeeping and transportation of poisons,

21-9  dangerous drugs and devices by physician assistants and osteopathic

21-10  physicians’ assistants. In the adoption of those regulations, the board shall

21-11  consider, but is not limited to, the following:

21-12  (a) The area in which the physician assistant or osteopathic physician’s

21-13  assistant is to operate;

21-14  (b) The population of that area;

21-15  (c) The experience and training of the physician assistant or

21-16  osteopathic physician’s assistant;

21-17  (d) The distance to the nearest hospital and physician; and

21-18  (e) The effect on the health, safety and welfare of the public.

21-19  6.  For the purposes of this section, the term [“physician’s assistant”

21-20  includes an osteopathic physician’s assistant and the term] “supervising

21-21  physician” includes an employing osteopathic physician as defined in

21-22  chapter 633 of NRS.

21-23  Sec. 49.  NRS 652.210 is hereby amended to read as follows:

21-24  652.210  No person other than a licensed physician, a licensed

21-25  optometrist, a licensed practical nurse, a registered nurse, a licensed [or]

21-26  physician assistant, a certified osteopathic physician’s assistant, a certified

21-27  intermediate emergency medical technician, a certified advanced

21-28  emergency medical technician or a licensed dentist may manipulate a

21-29  person for the collection of specimens, except that technical personnel of a

21-30  laboratory may collect blood, remove stomach contents, perform certain

21-31  diagnostic skin tests or field blood tests or collect material for smears and

21-32  cultures.

21-33  Sec. 50.  NRS 200.5093 is hereby amended to read as follows:

21-34  200.5093  1.  Any person who is described in subsection 4 and who,

21-35  in his professional or occupational capacity, knows or has reasonable cause

21-36  to believe that an older person has been abused, neglected, exploited or

21-37  isolated shall:

21-38  (a) Except as otherwise provided in subsection 2, report the abuse,

21-39  neglect, exploitation or isolation of the older person to:

21-40     (1) The local office of the aging services division of the department

21-41  of human resources;

21-42     (2) A police department or sheriff’s office;

21-43     (3) The county’s office for protective services, if one exists in the

21-44  county where the suspected action occurred; or

21-45     (4) A toll-free telephone service designated by the aging services

21-46  division of the department of human resources; and

21-47  (b) Make such a report as soon as reasonably practicable but not later

21-48  than 24 hours after the person knows or has reasonable cause to believe

21-49  that the older person has been abused, neglected, exploited or isolated.


22-1    2.  If a person who is required to make a report pursuant to subsection 1

22-2  knows or has reasonable cause to believe that the abuse, neglect,

22-3  exploitation or isolation of the older person involves an act or omission of

22-4  the aging services division, another division of the department of human

22-5  resources or a law enforcement agency, the person shall make the report to

22-6  an agency other than the one alleged to have committed the act or

22-7  omission.

22-8    3.  Each agency, after reducing a report to writing, shall forward a copy

22-9  of the report to the aging services division of the department of human

22-10  resources.

22-11  4.  A report must be made pursuant to subsection 1 by the following

22-12  persons:

22-13  (a) Every physician, dentist, dental hygienist, chiropractor, optometrist,

22-14  podiatric physician, medical examiner, resident, intern, professional or

22-15  practical nurse, [physician’s] physician assistant, psychiatrist,

22-16  psychologist, marriage and family therapist, alcohol or drug abuse

22-17  counselor, driver of an ambulance, advanced emergency medical

22-18  technician or other person providing medical services licensed or certified

22-19  to practice in this state, who examines, attends or treats an older person

22-20  who appears to have been abused, neglected, exploited or isolated.

22-21  (b) Any personnel of a hospital or similar institution engaged in the

22-22  admission, examination, care or treatment of persons or an administrator,

22-23  manager or other person in charge of a hospital or similar institution upon

22-24  notification of the suspected abuse, neglect, exploitation or isolation of an

22-25  older person by a member of the staff of the hospital.

22-26  (c) A coroner.

22-27  (d) Every clergyman, practitioner of Christian Science or religious

22-28  healer, unless he acquired the knowledge of abuse, neglect, exploitation or

22-29  isolation of the older person from the offender during a confession.

22-30  (e) Every person who maintains or is employed by an agency to provide

22-31  nursing in the home.

22-32  (f) Every attorney, unless he has acquired the knowledge of abuse,

22-33  neglect, exploitation or isolation of the older person from a client who has

22-34  been or may be accused of such abuse, neglect, exploitation or isolation.

22-35  (g) Any employee of the department of human resources.

22-36  (h) Any employee of a law enforcement agency or a county’s office for

22-37  protective services or an adult or juvenile probation officer.

22-38  (i) Any person who maintains or is employed by a facility or

22-39  establishment that provides care for older persons.

22-40  (j) Any person who maintains, is employed by or serves as a volunteer

22-41  for an agency or service which advises persons regarding the abuse,

22-42  neglect, exploitation or isolation of an older person and refers them to

22-43  persons and agencies where their requests and needs can be met.

22-44  (k) Every social worker.

22-45  (l) Any person who owns or is employed by a funeral home or

22-46  mortuary.

22-47  5.  A report may be made by any other person.

22-48  6.  If a person who is required to make a report pursuant to subsection 1

22-49  knows or has reasonable cause to believe that an older person has died as a


23-1  result of abuse, neglect or isolation, the person shall, as soon as reasonably

23-2  practicable, report this belief to the appropriate medical examiner or

23-3  coroner, who shall investigate the cause of death of the older person and

23-4  submit to the appropriate local law enforcement agencies, the appropriate

23-5  prosecuting attorney and the aging services division of the department of

23-6  human resources his written findings. The written findings must include

23-7  the information required pursuant to the provisions of NRS 200.5094,

23-8  when possible.

23-9    7.  A division, office or department which receives a report pursuant to

23-10  this section shall cause the investigation of the report to commence within

23-11  3 working days. A copy of the final report of the investigation conducted

23-12  by a division, office or department, other than the aging services division

23-13  of the department of human resources, must be forwarded to the aging

23-14  services division within 90 days after the completion of the report.

23-15  8.  If the investigation of a report results in the belief that an older

23-16  person is abused, neglected, exploited or isolated, the aging services

23-17  division of the department of human resources or the county’s office for

23-18  protective services may provide protective services to the older person if he

23-19  is able and willing to accept them.

23-20  9.  A person who knowingly and willfully violates any of the

23-21  provisions of this section is guilty of a misdemeanor.

23-22  Sec. 51.  NRS 223.550 is hereby amended to read as follows:

23-23  223.550  1.  The office for consumer health assistance is hereby

23-24  established in the office of the governor. The governor shall appoint the

23-25  director. The director must:

23-26  (a) Be:

23-27     (1) A physician, as that term is defined in NRS 0.040;

23-28     (2) A registered nurse, as that term is defined in NRS 632.019;

23-29     (3) An advanced practitioner of nursing, as that term is defined in

23-30  NRS 453.023; or

23-31     (4) A [physician’s] physician assistant, as that term is defined in NRS

23-32  630.015; and

23-33  (b) Have expertise and experience in the field of advocacy.

23-34  2.  The cost of carrying out the provisions of NRS 223.500 to 223.580,

23-35  inclusive, must be paid as follows:

23-36  (a) That portion of the cost related to providing assistance to consumers

23-37  and injured employees concerning workers’ compensation must be paid

23-38  from the assessments levied pursuant to NRS 232.680.

23-39  (b) The remaining cost must be provided by direct legislative

23-40  appropriation from the state general fund and be paid out on claims as

23-41  other claims against the state are paid.

23-42  Sec. 52.  NRS 244.1605 is hereby amended to read as follows:

23-43  244.1605  The boards of county commissioners may:

23-44  1.  Establish, equip and maintain limited medical facilities in the

23-45  outlying areas of their respective counties to provide outpatient care and

23-46  emergency treatment to the residents of and those falling sick or being

23-47  injured or maimed in those areas.

23-48  2.  Provide a full-time or part-time staff for the facilities which may

23-49  include a physician, a licensed [physician’s] physician assistant, a


24-1  registered nurse or a licensed practical nurse, a certified emergency

24-2  medical technician and such other personnel as the board deems necessary

24-3  or appropriate to ensure adequate staffing commensurate with the needs of

24-4  the area in which the facility is located.

24-5    3.  Fix the charges for the medical and nursing care and medicine

24-6  furnished by the facility to those who are able to pay for them, and to

24-7  provide that care and medicine free of charge to those persons who qualify

24-8  as medical indigents under the county’s criteria of eligibility for medical

24-9  care.

24-10  4.  Purchase, equip and maintain, either in connection with a limited

24-11  medical facility as authorized in this section or independent therefrom,

24-12  ambulances and ambulance services for the benefit of the residents of and

24-13  those falling sick or being injured or maimed in the outlying areas.

24-14  Sec. 53.  NRS 244.382 is hereby amended to read as follows:

24-15  244.382  The legislature finds that:

24-16  1.  Many of the less populous counties of the state have experienced

24-17  shortages of physicians, surgeons, anesthetists, dentists, other medical

24-18  professionals and [physicians’] physician assistants.

24-19  2.  Some of the more populous counties of the state have also

24-20  experienced shortages of physicians, surgeons, anesthetists, dentists, other

24-21  medical professionals and [physicians’] physician assistants in their rural

24-22  communities.

24-23  3.  By granting county scholarships to students in such medical

24-24  professions who will agree to return to the less populous counties or the

24-25  rural communities of the more populous counties for residence and

24-26  practice, these counties can alleviate the shortages to a degree and thereby

24-27  provide their people with needed health services.

24-28  Sec. 54.  NRS 244.3821 is hereby amended to read as follows:

24-29  244.3821  1.  In addition to the powers elsewhere conferred upon all

24-30  counties, except as otherwise provided in subsection 2, any county may

24-31  establish a medical scholarship program to induce students in the medical

24-32  professions to return to the county for practice.

24-33  2.  Any county whose population is 100,000 or more may only

24-34  establish a medical scholarship program to induce students in the medical

24-35  professions to return to the less populous rural communities of the county

24-36  for practice.

24-37  3.  Students in the medical professions for the purposes of NRS

24-38  244.382 to 244.3823, inclusive, include persons studying to be

24-39  [physicians’] physician assistants.

24-40  4.  The board of county commissioners of a county that has established

24-41  a medical scholarship program may appropriate money from the general

24-42  fund of the county for medical scholarship funds and may accept private

24-43  contributions to augment the scholarship funds.

24-44  Sec. 55.  NRS 397.0605 is hereby amended to read as follows:

24-45  397.0605  The provisions of NRS 397.0615, 397.0645 and 397.0653 to

24-46  the contrary notwithstanding, the Western Interstate Commission for

24-47  Higher Education may adopt regulations which require as a condition of

24-48  placement of a student in an educational program for [physicians’]

24-49  physician assistants and receipt of the related financial support that the


25-1  student submit to the director of the Western Interstate Commission for

25-2  Higher Education:

25-3    1.  A written statement from a licensed provider of health care who

25-4  practices his profession in a rural area of this state that he agrees to employ

25-5  the student for the term necessary to fulfill the requirements of NRS

25-6  397.0645 upon the completion of the student’s education, examination and

25-7  licensure.

25-8    2.  A written statement from the student that in lieu of repayment of all

25-9  state contributions for the stipend he received he will practice his

25-10  profession in a rural area of this state in accordance with the schedule set

25-11  forth in subsection 1 of NRS 397.0645.

25-12  Sec. 56.  NRS 397.0617 is hereby amended to read as follows:

25-13  397.0617  1.  The provisions of this section apply only to support fees

25-14  received by a student on or after July 1, 1997.

25-15  2.  The three commissioners from the State of Nevada, acting jointly,

25-16  may require a student who is certified to study to practice in a profession

25-17  which could benefit a medically underserved area of this state, as that term

25-18  is defined by the officer of rural health of the University of Nevada School

25-19  of Medicine, to practice in such an area or to practice in an area designated

25-20  by the Secretary of Health and Human Services:

25-21  (a) Pursuant to 42 U.S.C. § 254c, as containing a medically underserved

25-22  population; or

25-23  (b) Pursuant to 42 U.S.C. § 254e, as a health professional shortage
area,

25-24  as a condition to receiving a support fee.

25-25  3.  If a person agrees to practice in a medically underserved area of this

25-26  state pursuant to subsection 2 for at least 2 years, the three commissioners

25-27  from the State of Nevada, acting jointly, may forgive the portion of the

25-28  support fee designated as the loan of the person.

25-29  4.  If a person returns to this state but does not practice in a medically

25-30  underserved area of this state pursuant to subsection 2 for at least 2 years,

25-31  the three commissioners from the State of Nevada, acting jointly, shall

25-32  assess a default charge in an amount not less than three times the portion of

25-33  the support fee designated as the loan of the person, plus interest.

25-34  5.  As used in this section, a “profession which could benefit a

25-35  medically underserved area of this state” includes, without limitation,

25-36  dentistry, physical therapy, pharmacy and practicing as a [physician’s]

25-37  physician assistant.

25-38  Sec. 57.  NRS 432B.220 is hereby amended to read as follows:

25-39  432B.220  1.  Any person who is described in subsection 3 and who,

25-40  in his professional or occupational capacity, knows or has reasonable cause

25-41  to believe that a child has been abused or neglected shall:

25-42  (a) Except as otherwise provided in subsection 2, report the abuse or

25-43  neglect of the child to an agency which provides protective services or to a

25-44  law enforcement agency; and

25-45  (b) Make such a report as soon as reasonably practicable but not later

25-46  than 24 hours after the person knows or has reasonable cause to believe

25-47  that the child has been abused or neglected.


26-1    2.  If a person who is required to make a report pursuant to subsection 1

26-2  knows or has reasonable cause to believe that the abuse or neglect of the

26-3  child involves an act or omission of:

26-4    (a) A person directly responsible or serving as a volunteer for or an

26-5  employee of a public or private home, institution or facility where the child

26-6  is receiving child care outside of his home for a portion of the day, the

26-7  person shall make the report to a law enforcement agency.

26-8    (b) An agency which provides protective services or a law enforcement

26-9  agency, the person shall make the report to an agency other than the one

26-10  alleged to have committed the act or omission, and the investigation of the

26-11  abuse or neglect of the child must be made by an agency other than the one

26-12  alleged to have committed the act or omission.

26-13  3.  A report must be made pursuant to subsection 1 by the following

26-14  persons:

26-15  (a) A physician, dentist, dental hygienist, chiropractor, optometrist,

26-16  podiatric physician, medical examiner, resident, intern, professional or

26-17  practical nurse, [physician’s] physician assistant, psychiatrist,

26-18  psychologist, marriage and family therapist, alcohol or drug abuse

26-19  counselor, advanced emergency medical technician or other person

26-20  providing medical services licensed or certified in this state;

26-21  (b) Any personnel of a hospital or similar institution engaged in the

26-22  admission, examination, care or treatment of persons or an administrator,

26-23  manager or other person in charge of a hospital or similar institution upon

26-24  notification of suspected abuse or neglect of a child by a member of the

26-25  staff of the hospital;

26-26  (c) A coroner;

26-27  (d) A clergyman, practitioner of Christian Science or religious healer,

26-28  unless he has acquired the knowledge of the abuse or neglect from the

26-29  offender during a confession;

26-30  (e) A social worker and an administrator, teacher, librarian or counselor

26-31  of a school;

26-32  (f) Any person who maintains or is employed by a facility or

26-33  establishment that provides care for children, children’s camp or other

26-34  public or private facility, institution or agency furnishing care to a child;

26-35  (g) Any person licensed to conduct a foster home;

26-36  (h) Any officer or employee of a law enforcement agency or an adult or

26-37  juvenile probation officer;

26-38  (i) An attorney, unless he has acquired the knowledge of the abuse or

26-39  neglect from a client who is or may be accused of the abuse or neglect; and

26-40  (j) Any person who maintains, is employed by or serves as a volunteer

26-41  for an agency or service which advises persons regarding abuse or neglect

26-42  of a child and refers them to persons and agencies where their requests and

26-43  needs can be met.

26-44  4.  A report may be made by any other person.

26-45  5.  If a person who is required to make a report pursuant to subsection 1

26-46  knows or has reasonable cause to believe that a child has died as a result of

26-47  abuse or neglect, the person shall, as soon as reasonably practicable, report

26-48  this belief to the appropriate medical examiner or coroner, who shall

26-49  investigate the report and submit to an agency which provides protective


27-1  services his written findings. The written findings must include, if

27-2  obtainable, the information required pursuant to the provisions of

27-3  subsection 2 of NRS 432B.230.

27-4    Sec. 58.  NRS 441A.110 is hereby amended to read as follows:

27-5  441A.110  Provider of health care” means a physician, nurse,

27-6  [physician’s] physician assistant or veterinarian licensed in accordance

27-7  with state law.

27-8    Sec. 59.  NRS 442.003 is hereby amended to read as follows:

27-9    442.003  As used in this chapter, unless the context requires otherwise:

27-10  1.  “Advisory board” means the advisory board on maternal and child

27-11  health.

27-12  2.  “Department” means the department of human resources.

27-13  3.  “Director” means the director of the department of human resources.

27-14  4.  “Fetal alcohol syndrome” includes fetal alcohol effects.

27-15  5.  “Health division” means the health division of the department of

27-16  human resources.

27-17  6.  “Obstetric center” has the meaning ascribed to it in NRS 449.0155.

27-18  7.  “Provider of health care or other services” means:

27-19  (a) A person who has been certified as a counselor or an administrator

27-20  of an alcohol and drug abuse program pursuant to chapter 458 of NRS;

27-21  (b) A physician or a [physician’s] physician assistant who is licensed

27-22  pursuant to chapter 630 of NRS and who practices in the area of obstetrics

27-23  and gynecology, family practice, internal medicine, pediatrics or

27-24  psychiatry;

27-25  (c) A licensed nurse;

27-26  (d) A licensed psychologist;

27-27  (e) A licensed marriage and family therapist;

27-28  (f) A licensed social worker; or

27-29  (g) A holder of a certificate of registration as a pharmacist.

27-30  Sec. 60.  NRS 442.119 is hereby amended to read as follows:

27-31  442.119  As used in NRS 442.119 to 442.1198, inclusive, unless the

27-32  context otherwise requires:

27-33  1.  “Health officer” includes a local health officer, a city health officer,

27-34  a county health officer and a district health officer.

27-35  2.  “Medicaid” has the meaning ascribed to it in NRS 439B.120.

27-36  3.  “Medicare” has the meaning ascribed to it in NRS 439B.130.

27-37  4.  “Provider of prenatal care” is limited to:

27-38  (a) A physician who is licensed in this state and certified in obstetrics

27-39  and gynecology, family practice, general practice or general surgery.

27-40  (b) A certified nurse midwife who is licensed by the state board of

27-41  nursing.

27-42  (c) An advanced practitioner of nursing who has specialized skills and

27-43  training in obstetrics or family nursing.

27-44  (d) A [physicians’] physician assistant who has specialized skills and

27-45  training in obstetrics or family practice.

27-46  Sec. 61.  NRS 449.0175 is hereby amended to read as follows:

27-47  449.0175  “Rural clinic” means a facility located in an area that is not

27-48  designated as an urban area by the Bureau of the Census, where medical


28-1  services are provided by a [physician’s] physician assistant or an advanced

28-2  practitioner of nursing under the supervision of a licensed physician.

28-3    Sec. 62.  NRS 450B.160 is hereby amended to read as follows:

28-4    450B.160  1.  The health authority may issue licenses to attendants

28-5  and to firemen employed by or serving as volunteers with a fire-fighting

28-6  agency.

28-7    2.  Each license must be evidenced by a card issued to the holder of the

28-8  license, is valid for a period not to exceed 2 years and is renewable.

28-9    3.  An applicant for a license must file with the health authority:

28-10  (a) A current, valid certificate evidencing his successful completion of a

28-11  program or course for training in emergency medical technology, if he is

28-12  applying for a license as an attendant, or, if a volunteer attendant, at a level

28-13  of skill determined by the board.

28-14  (b) A current valid certificate evidencing his successful completion of a

28-15  program for training as an intermediate emergency medical technician or

28-16  advanced emergency medical technician if he is applying for a license as a

28-17  fireman with a fire-fighting agency.

28-18  (c) A signed statement showing:

28-19     (1) His name and address;

28-20     (2) His employer’s name and address; and

28-21     (3) A description of his duties.

28-22  (d) Such other certificates for training and such other items as the board

28-23  may specify.

28-24  4.  The board shall adopt such regulations as it determines are

28-25  necessary for the issuance, suspension, revocation and renewal of licenses.

28-26  5.  Each operator of an ambulance or air ambulance and each fire-

28-27  fighting agency shall annually file with the health authority a complete list

28-28  of the licensed persons in its service.

28-29  6.  Licensed physicians, registered nurses and licensed [physicians’]

28-30  physician assistants may serve as attendants without being licensed under

28-31  the provisions of this section. A registered nurse who performs advanced

28-32  emergency care in an ambulance or air ambulance must perform the care in

28-33  accordance with the regulations of the state board of nursing. A licensed

28-34  [physicians’] physician assistant who performs advanced emergency care

28-35  in an ambulance or air ambulance must perform the care in accordance

28-36  with the regulations of the [state] board of medical examiners.

28-37  7.  Each licensed physician, registered nurse and licensed [physicians’]

28-38  physician assistant who serves as an attendant must have current

28-39  certification of completion of training in:

28-40  (a) Advanced life-support procedures for patients who require cardiac

28-41  care;

28-42  (b) Life-support procedures for pediatric patients who require cardiac

28-43  care; or

28-44  (c) Life-support procedures for patients with trauma that are

28-45  administered before the arrival of those patients at a hospital.

28-46  The certification must be issued by the board of medical examiners for a

28-47  physician or licensed [physician’s] physician assistant or by the state board

28-48  of nursing for a registered nurse.


29-1    8.  The board of medical examiners and the state board of nursing shall

29-2  issue a certificate pursuant to subsection 7 if the licensed physician,

29-3  licensed [physician’s] physician assistant or registered nurse attends:

29-4    (a) A course offered by a national organization which is nationally

29-5  recognized for issuing such certification;

29-6    (b) Training conducted by the operator of an ambulance or air

29-7  ambulance; or

29-8    (c) Any other course or training,

29-9  approved by the board of medical examiners or the state board of nursing,

29-10  whichever is issuing the certification. The board of medical examiners and

29-11  the state board of nursing may require certification of training in all three

29-12  areas set forth in subsection 7 for a licensed physician, licensed

29-13  [physician’s] physician assistant or registered nurse who primarily serves

29-14  as an attendant in a county whose population is 400,000 or more.

29-15  Sec. 63.  NRS 453.038 is hereby amended to read as follows:

29-16  453.038  “Chart order” means an order entered on the chart of a

29-17  patient:

29-18  1.  In a hospital, facility for intermediate care or facility for skilled

29-19  nursing which is licensed as such by the health division of the department;

29-20  or

29-21  2.  Under emergency treatment in a hospital by a physician, dentist or

29-22  podiatric physician, or on the written or oral order of a physician,

29-23  [physician’s] physician assistant, dentist or podiatric physician authorizing

29-24  the administration of a drug to the patient.

29-25  Sec. 64.  NRS 453.091 is hereby amended to read as follows:

29-26  453.091  1.  “Manufacture” means the production, preparation,

29-27  propagation, compounding, conversion or processing of a substance, either

29-28  directly or indirectly by extraction from substances of natural origin, or

29-29  independently by means of chemical synthesis, or by a combination of

29-30  extraction and chemical synthesis, and includes any packaging or

29-31  repackaging of the substance or labeling or relabeling of its container.

29-32  2.  “Manufacture” does not include the preparation or compounding of

29-33  a substance by a person for his own use or the preparation, compounding,

29-34  packaging or labeling of a substance by a physician, [physician’s]

29-35  physician assistant, dentist, podiatric physician or veterinarian:

29-36  (a) As an incident to his administering or dispensing of a substance in

29-37  the course of his professional practice; or

29-38  (b) By his authorized agent under his supervision, for the purpose of, or

29-39  as an incident to, research, teaching or chemical analysis and not for sale.

29-40  Sec. 65.  NRS 453.126 is hereby amended to read as follows:

29-41  453.126  Practitioner” means:

29-42  1.  A physician, dentist, veterinarian or podiatric physician who holds a

29-43  license to practice his profession in this state and is registered pursuant to

29-44  this chapter.

29-45  2.  An advanced practitioner of nursing who holds a certificate from the

29-46  state board of nursing and a certificate from the state board of pharmacy

29-47  authorizing him to dispense controlled substances.

29-48  3.  A scientific investigator or a pharmacy, hospital or other institution

29-49  licensed, registered or otherwise authorized in this state to distribute,


30-1  dispense, conduct research with respect to, to administer, or use in teaching

30-2  or chemical analysis, a controlled substance in the course of professional

30-3  practice or research.

30-4    4.  A euthanasia technician who is licensed by the Nevada state board

30-5  of veterinary medical examiners and registered pursuant to this chapter,

30-6  while he possesses or administers sodium pentobarbital pursuant to his

30-7  license and registration.

30-8    5.  A [physician’s] physician assistant who:

30-9    (a) Holds a license from the board of medical examiners ; [or a

30-10  certificate from the state board of osteopathic medicine;] and

30-11  (b) Is authorized by the board to possess, administer, prescribe or

30-12  dispense controlled substances under the supervision of a physician [or

30-13  osteopathic physician] as required by chapter 630 [or 633] of NRS.

30-14  6.  An osteopathic physician’s assistant who:

30-15  (a) Holds a certificate from the state board of osteopathic medicine;

30-16  and

30-17  (b) Is authorized by the board to possess, administer, prescribe or

30-18  dispense controlled substances under the supervision of an osteopathic

30-19  physician as required by chapter 633 of NRS.

30-20  7.  An optometrist who is certified by the Nevada state board of

30-21  optometry to prescribe and administer therapeutic pharmaceutical agents

30-22  pursuant to NRS 636.288, when he prescribes or administers therapeutic

30-23  pharmaceutical agents within the scope of his certification.

30-24  Sec. 66.  NRS 453.128 is hereby amended to read as follows:

30-25  453.128  1.  “Prescription” means:

30-26  (a) An order given individually for the person for whom prescribed,

30-27  directly from a physician, osteopathic physician’s assistant, physician

30-28  assistant, dentist, podiatric physician, optometrist or veterinarian, or his

30-29  agent, to a pharmacist or indirectly by means of an order signed by the

30-30  practitioner or an electronic transmission from the practitioner to a

30-31  pharmacist; or

30-32  (b) A chart order written for an inpatient specifying drugs which he is to

30-33  take home upon his discharge.

30-34  2.  The term does not include a chart order written for an inpatient for

30-35  use while he is an inpatient.

30-36  Sec. 67.  NRS 453.226 is hereby amended to read as follows:

30-37  453.226  1.  Every practitioner or other person who dispenses any

30-38  controlled substance within this state or who proposes to engage in the

30-39  dispensing of any controlled substance within this state shall obtain

30-40  biennially a registration issued by the board in accordance with its

30-41  regulations.

30-42  2.  A person registered by the board in accordance with the provisions

30-43  of NRS 453.011 to 453.552, inclusive, to dispense or conduct research with

30-44  controlled substances may possess, dispense or conduct research with those

30-45  substances to the extent authorized by the registration and in conformity

30-46  with the other provisions of those sections.

30-47  3.  The following persons are not required to register and may lawfully

30-48  possess and distribute controlled substances pursuant to the provisions of

30-49  NRS 453.011 to 453.552, inclusive:


31-1    (a) An agent or employee of a registered dispenser of a controlled

31-2  substance if he is acting in the usual course of his business or employment;

31-3    (b) A common or contract carrier or warehouseman, or an employee

31-4  thereof, whose possession of any controlled substance is in the usual course

31-5  of business or employment;

31-6    (c) An ultimate user or a person in possession of any controlled

31-7  substance pursuant to a lawful order of a physician, osteopathic

31-8  physician’s assistant, physician assistant, dentist, podiatric physician or

31-9  veterinarian or in lawful possession of a schedule V substance; or

31-10  (d) A physician who:

31-11     (1) Holds a locum tenens license issued by the board of medical

31-12  examiners or a temporary license issued by the state board of osteopathic

31-13  medicine; and

31-14     (2) Is registered with the Drug Enforcement Administration at a

31-15  location outside this state.

31-16  4.  The board may waive the requirement for registration of certain

31-17  dispensers if it finds it consistent with the public health and safety.

31-18  5.  A separate registration is required at each principal place of business

31-19  or professional practice where the applicant dispenses controlled

31-20  substances.

31-21  6.  The board may inspect the establishment of a registrant or applicant

31-22  for registration in accordance with the board’s regulations.

31-23  Sec. 68.  NRS 453.336 is hereby amended to read as follows:

31-24  453.336  1.  A person shall not knowingly or intentionally possess a

31-25  controlled substance, unless the substance was obtained directly from, or

31-26  pursuant to, a prescription or order of a physician, osteopathic physician’s

31-27  assistant, physician assistant, dentist, podiatric physician, optometrist or

31-28  veterinarian while acting in the course of his professional practice, or

31-29  except as otherwise authorized by the provisions of NRS 453.011 to

31-30  453.552, inclusive.

31-31  2.  Except as otherwise provided in subsections 3, 4 and 5 and in NRS

31-32  453.3363, and unless a greater penalty is provided in NRS 212.160,

31-33  453.3385, 453.339 or 453.3395, a person who violates this section shall be

31-34  punished:

31-35  (a) For the first or second offense, if the controlled substance is listed in

31-36  schedule I, II, III or IV, for a category E felony as provided in NRS

31-37  193.130.

31-38  (b) For a third or subsequent offense, if the controlled substance is listed

31-39  in schedule I, II, III or IV, or if the offender has previously been convicted

31-40  two or more times in the aggregate of any violation of the law of the

31-41  United States or of any state, territory or district relating to a controlled

31-42  substance, for a category D felony as provided in NRS 193.130, and may

31-43  be further punished by a fine of not more than $20,000.

31-44  (c) For the first offense, if the controlled substance is listed in schedule

31-45  V, for a category E felony as provided in NRS 193.130.

31-46  (d) For a second or subsequent offense, if the controlled substance is

31-47  listed in schedule V, for a category D felony as provided in NRS 193.130.

31-48  3.  Unless a greater penalty is provided in NRS 212.160, 453.337 or

31-49  453.3385, a person who is convicted of the possession of flunitrazepam or


32-1  gamma-hydroxybutyrate, or any substance for which flunitrazepam or

32-2  gamma-hydroxybutyrate is an immediate precursor, is guilty of a category

32-3  B felony and shall be punished by imprisonment in the state prison for a

32-4  minimum term of not less than 1 year and a maximum term of not more

32-5  than 6 years.

32-6    4.  Unless a greater penalty is provided in NRS 212.160, a person who

32-7  is less than 21 years of age and is convicted of the possession of less than 1

32-8  ounce of marijuana:

32-9    (a) For the first and second offense, is guilty of a category E felony and

32-10  shall be punished as provided in NRS 193.130.

32-11  (b) For a third or subsequent offense, is guilty of a category D felony

32-12  and shall be punished as provided in NRS 193.130, and may be further

32-13  punished by a fine of not more than $20,000.

32-14  5.  Before sentencing under the provisions of subsection 4 for a first

32-15  offense, the court shall require the parole and probation officer to submit a

32-16  presentencing report on the person convicted in accordance with the

32-17  provisions of NRS 176A.200. After the report is received but before

32-18  sentence is pronounced the court shall:

32-19  (a) Interview the person convicted and make a determination as to the

32-20  possibility of his rehabilitation; and

32-21  (b) Conduct a hearing at which evidence may be presented as to the

32-22  possibility of rehabilitation and any other relevant information.

32-23  6.  As used in this section, “controlled substance” includes

32-24  flunitrazepam, gamma-hydroxybutyrate and each substance for which

32-25  flunitrazepam or gamma-hydroxybutyrate is an immediate precursor.

32-26  Sec. 69.  NRS 453.371 is hereby amended to read as follows:

32-27  453.371  As used in NRS 453.371 to 453.552, inclusive:

32-28  1.  “Medical intern” means a medical graduate acting as an assistant in

32-29  a hospital for the purpose of clinical training.

32-30  2.  “Physician,” [“physician’s] “physician assistant,” “dentist,”

32-31  “podiatric physician,” “veterinarian,” “pharmacist” and “euthanasia

32-32  technician” mean persons authorized by a valid license to practice their

32-33  respective professions in this state who are registered with the board.

32-34  Sec. 70.  NRS 453.375 is hereby amended to read as follows:

32-35  453.375  A controlled substance may be possessed and administered by

32-36  the following persons:

32-37  1.  A practitioner.

32-38  2.  A registered nurse licensed to practice professional nursing or

32-39  licensed practical nurse, at the direction of a physician, [physician’s]

32-40  physician assistant, dentist, podiatric physician or advanced practitioner of

32-41  nursing, or pursuant to a chart order, for administration to a patient at

32-42  another location.

32-43  3.  An advanced emergency medical technician:

32-44  (a) As authorized by regulation of:

32-45     (1) The state board of health in a county whose population is less

32-46  than 100,000; or

32-47     (2) A county or district board of health in a county whose population

32-48  is 100,000 or more; and

32-49  (b) In accordance with any applicable regulations of:


33-1      (1) The state board of health in a county whose population is less

33-2  than 100,000;

33-3      (2) A county board of health in a county whose population is 100,000

33-4  or more; or

33-5      (3) A district board of health created pursuant to NRS 439.370 in any

33-6  county.

33-7    4.  A respiratory therapist, at the direction of a physician or

33-8  [physician’s] physician assistant.

33-9    5.  A medical student, student in training to become a [physician’s]

33-10  physician assistant or student nurse in the course of his studies at an

33-11  approved college of medicine or school of professional or practical

33-12  nursing, at the direction of a physician or [physician’s] physician assistant

33-13  and:

33-14  (a) In the presence of a physician, [physician’s] physician assistant or a

33-15  registered nurse; or

33-16  (b) Under the supervision of a physician, [physician’s] physician

33-17  assistant or a registered nurse if the student is authorized by the college or

33-18  school to administer the substance outside the presence of a physician,

33-19  [physician’s] physician assistant or nurse.

33-20  A medical student or student nurse may administer a controlled substance

33-21  in the presence or under the supervision of a registered nurse alone only if

33-22  the circumstances are such that the registered nurse would be authorized to

33-23  administer it personally.

33-24  6.  An ultimate user or any person whom the ultimate user designates

33-25  pursuant to a written agreement.

33-26  7.  Any person designated by the head of a correctional institution.

33-27  8.  A veterinary technician at the direction of his supervising

33-28  veterinarian.

33-29  9.  In accordance with applicable regulations of the state board of

33-30  health, an employee of a residential facility for groups, as defined in NRS

33-31  449.017, pursuant to a written agreement entered into by the ultimate user.

33-32  10.  In accordance with applicable regulations of the state board of

33-33  pharmacy, an animal control officer, a wildlife biologist or an employee

33-34  designated by a federal, state or local governmental agency whose duties

33-35  include the control of domestic, wild and predatory animals.

33-36  Sec. 71.  NRS 453.381 is hereby amended to read as follows:

33-37  453.381  1.  In addition to the limitations imposed by NRS 453.256, a

33-38  physician, [physician’s] physician assistant, dentist or podiatric physician

33-39  may prescribe or administer controlled substances only for a legitimate

33-40  medical purpose and in the usual course of his professional practice, and he

33-41  shall not prescribe, administer or dispense a controlled substance listed in

33-42  schedule II for himself, his spouse or his children except in cases of

33-43  emergency.

33-44  2.  A veterinarian, in the course of his professional practice only, and

33-45  not for use by a human being, may prescribe, possess and administer

33-46  controlled substances, and he may cause them to be administered by a

33-47  veterinary technician under his direction and supervision.

33-48  3.  A euthanasia technician, within the scope of his license, and not for

33-49  use by a human being, may possess and administer sodium pentobarbital.


34-1    4.  A pharmacist shall not fill an order which purports to be a

34-2  prescription if he has reason to believe that it was not issued in the usual

34-3  course of the professional practice of a physician, [physician’s] physician

34-4  assistant, dentist, podiatric physician or veterinarian.

34-5    5.  Any person who has obtained from a physician, [physician’s]

34-6  physician assistant, dentist, podiatric physician or veterinarian any

34-7  controlled substance for administration to a patient during the absence of

34-8  the physician, [physician’s] physician assistant, dentist, podiatric physician

34-9  or veterinarian shall return to him any unused portion of the substance

34-10  when it is no longer required by the patient.

34-11  6.  A manufacturer, wholesale supplier or other person legally able to

34-12  furnish or sell any controlled substance listed in schedule II shall not

34-13  provide samples of such a controlled substance to registrants.

34-14  7.  A salesman of any manufacturer or wholesaler of pharmaceuticals

34-15  shall not possess, transport or furnish any controlled substance listed in

34-16  schedule II.

34-17  8.  A person shall not dispense a controlled substance in violation of a

34-18  regulation adopted by the board.

34-19  Sec. 72.  NRS 453.391 is hereby amended to read as follows:

34-20  453.391  A person shall not:

34-21  1.  Unlawfully take, obtain or attempt to take or obtain a controlled

34-22  substance or a prescription for a controlled substance from a manufacturer,

34-23  wholesaler, pharmacist, physician, [physician’s] physician assistant,

34-24  dentist, veterinarian or any other person authorized to administer, dispense

34-25  or possess controlled substances.

34-26  2.  While undergoing treatment and being supplied with any controlled

34-27  substance or a prescription for any controlled substance from one

34-28  practitioner, knowingly obtain any controlled substance or a prescription

34-29  for a controlled substance from another practitioner without disclosing this

34-30  fact to the second practitioner.

34-31  Sec. 73.  NRS 454.00958 is hereby amended to read as follows:

34-32  454.00958  “Practitioner” means:

34-33  1.  A physician, dentist, veterinarian or podiatric physician who holds a

34-34  valid license to practice his profession in this state.

34-35  2.  A pharmacy, hospital or other institution licensed or registered to

34-36  distribute, dispense, conduct research with respect to or to administer a

34-37  dangerous drug in the course of professional practice in this state.

34-38  3.  When relating to the prescription of poisons, dangerous drugs and

34-39  devices:

34-40  (a) An advanced practitioner of nursing who holds a certificate from the

34-41  state board of nursing and a certificate from the state board of pharmacy

34-42  permitting him so to prescribe; or

34-43  (b) A [physician’s] physician assistant who holds a license from the

34-44  [state] board of medical examiners and a certificate from the state board of

34-45  pharmacy permitting him so to prescribe.

34-46  4.  An optometrist who is certified to prescribe and administer

34-47  dangerous drugs pursuant to NRS 636.288 when he prescribes or

34-48  administers dangerous drugs which are within the scope of his certification.

 


35-1    Sec. 74.  NRS 454.213 is hereby amended to read as follows:

35-2    454.213  A drug or medicine referred to in NRS 454.181 to 454.371,

35-3  inclusive, may be possessed and administered by:

35-4    1.  A practitioner.

35-5    2.  A [physician’s] physician assistant at the direction of his

35-6  supervising physician or a licensed dental hygienist acting in the office of

35-7  and under the supervision of a dentist.

35-8    3.  Except as otherwise provided in subsection 4, a registered nurse

35-9  licensed to practice professional nursing or licensed practical nurse, at the

35-10  direction of a prescribing physician, dentist, podiatric physician or

35-11  advanced practitioner of nursing, or pursuant to a chart order, for

35-12  administration to a patient at another location.

35-13  4.  In accordance with applicable regulations of the board, a registered

35-14  nurse licensed to practice professional nursing or licensed practical nurse

35-15  who is:

35-16  (a) Employed by a health care agency or health care facility that is

35-17  authorized to provide emergency care, or to respond to the immediate

35-18  needs of a patient, in the residence of the patient; and

35-19  (b) Acting under the direction of the medical director of that agency or

35-20  facility who works in this state.

35-21  5.  An intermediate emergency medical technician or an advanced

35-22  emergency medical technician, as authorized by regulation of the state

35-23  board of pharmacy and in accordance with any applicable regulations of:

35-24  (a) The state board of health in a county whose population is less than

35-25  100,000;

35-26  (b) A county board of health in a county whose population is 100,000 or

35-27  more; or

35-28  (c) A district board of health created pursuant to NRS 439.370 in any

35-29  county.

35-30   6.  A respiratory therapist employed in a health care facility. The

35-31  therapist may possess and administer respiratory products only at the

35-32  direction of a physician.

35-33  7.  A dialysis technician, under the direction or supervision of a

35-34  physician or registered nurse only if the drug or medicine is used for the

35-35  process of renal dialysis.

35-36  8.  A medical student or student nurse in the course of his studies at an

35-37  approved college of medicine or school of professional or practical

35-38  nursing, at the direction of a physician and:

35-39  (a) In the presence of a physician or a registered nurse; or

35-40  (b) Under the supervision of a physician or a registered nurse if the

35-41  student is authorized by the college or school to administer the drug or

35-42  medicine outside the presence of a physician or nurse.

35-43  A medical student or student nurse may administer a dangerous drug in the

35-44  presence or under the supervision of a registered nurse alone only if the

35-45  circumstances are such that the registered nurse would be authorized to

35-46  administer it personally.

35-47  9.  Any person designated by the head of a correctional institution.

35-48  10.  An ultimate user or any person designated by the ultimate user

35-49  pursuant to a written agreement.


36-1    11.  A nuclear medicine technologist, at the direction of a physician

36-2  and in accordance with any conditions established by regulation of the

36-3  board.

36-4    12.  A radiologic technologist, at the direction of a physician and in

36-5  accordance with any conditions established by regulation of the board.

36-6    13.  A chiropractic physician, but only if the drug or medicine is a

36-7  topical drug used for cooling and stretching external tissue during

36-8  therapeutic treatments.

36-9    14.  A physical therapist, but only if the drug or medicine is a topical

36-10  drug which is:

36-11  (a) Used for cooling and stretching external tissue during therapeutic

36-12  treatments; and

36-13  (b) Prescribed by a licensed physician for:

36-14     (1) Iontophoresis; or

36-15     (2) The transmission of drugs through the skin using ultrasound.

36-16  15.  In accordance with applicable regulations of the state board of

36-17  health, an employee of a residential facility for groups, as defined in NRS

36-18  449.017, pursuant to a written agreement entered into by the ultimate user.

36-19  16.  A veterinary technician at the direction of his supervising

36-20  veterinarian.

36-21  17.  In accordance with applicable regulations of the board, a registered

36-22  pharmacist who:

36-23  (a) Is trained in and certified to carry out standards and practices for

36-24  immunization programs;

36-25  (b) Is authorized to administer immunizations pursuant to written

36-26  protocols from a physician; and

36-27  (c) Administers immunizations in compliance with the “Standards of

36-28  Immunization Practices” recommended and approved by the United States

36-29  Public Health Service Advisory Committee on Immunization Practices.

36-30  Sec. 75.  NRS 454.215 is hereby amended to read as follows:

36-31  454.215  A dangerous drug may be dispensed by:

36-32  1.  A registered pharmacist upon the legal prescription from a

36-33  practitioner or to a pharmacy in a correctional institution upon the written

36-34  order of the prescribing practitioner in charge;

36-35  2.  A pharmacy in a correctional institution, in case of emergency, upon

36-36  a written order signed by the chief medical officer;

36-37  3.  A practitioner, or a [physician’s] physician assistant if authorized by

36-38  the board;

36-39  4.  A registered nurse, when the nurse is engaged in the performance of

36-40  any public health program approved by the board;

36-41  5.  A medical intern in the course of his internship;

36-42  6.  An advanced practitioner of nursing who holds a certificate from the

36-43  state board of nursing and a certificate from the state board of pharmacy

36-44  permitting him to dispense dangerous drugs;

36-45  7.  A registered nurse employed at an institution of the department of

36-46  prisons to an offender in that institution; or

36-47  8.  A registered pharmacist from an institutional pharmacy pursuant to

36-48  regulations adopted by the board,


37-1  except that no person may dispense a dangerous drug in violation of a

37-2  regulation adopted by the board.

37-3    Sec. 76.  NRS 454.221 is hereby amended to read as follows:

37-4    454.221  1.  A person who furnishes any dangerous drug except upon

37-5  the prescription of a practitioner is guilty of a category D felony and shall

37-6  be punished as provided in NRS 193.130, unless the dangerous drug was

37-7  obtained originally by a legal prescription.

37-8    2.  The provisions of this section do not apply to the furnishing of any

37-9  dangerous drug by:

37-10  (a) A practitioner to his patients;

37-11  (b) A [physician’s] physician assistant if authorized by the board;

37-12  (c) A registered nurse while participating in a public health program

37-13  approved by the board, or an advanced practitioner of nursing who holds a

37-14  certificate from the state board of nursing and a certificate from the state

37-15  board of pharmacy permitting him to dispense dangerous drugs;

37-16  (d) A manufacturer or wholesaler or pharmacy to each other or to a

37-17  practitioner or to a laboratory under records of sales and purchases that

37-18  correctly give the date, the names and addresses of the supplier and the

37-19  buyer, the drug and its quantity;

37-20  (e) A hospital pharmacy or a pharmacy so designated by a county health

37-21  officer in a county whose population is 100,000 or more, or by a district

37-22  health officer in any county within its jurisdiction or, in the absence of

37-23  either, by the state health officer or his designated medical director of

37-24  emergency medical services, to a person or agency described in subsection

37-25  3 of NRS 639.268 to stock ambulances or other authorized vehicles or

37-26  replenish the stock; or

37-27  (f) A pharmacy in a correctional institution to a person designated by

37-28  the director of the department of prisons to administer a lethal injection to a

37-29  person who has been sentenced to death.

37-30  Sec. 77.  NRS 484.393 is hereby amended to read as follows:

37-31  484.393  1.  The results of any blood test administered under the

37-32  provisions of NRS 484.383 or 484.391 are not admissible in any hearing or

37-33  criminal action arising out of acts alleged to have been committed by a

37-34  person who was driving or in actual physical control of a vehicle while

37-35  under the influence of intoxicating liquor or a controlled substance or who

37-36  was engaging in any other conduct prohibited by NRS 484.379 or

37-37  484.3795 unless:

37-38  (a) The blood tested was withdrawn by a physician, [physician’s]

37-39  physician assistant, registered nurse, licensed practical nurse, emergency

37-40  medical technician or a technician, technologist or assistant employed in a

37-41  medical laboratory;

37-42  (b) The test was performed on whole blood, except if the sample was

37-43  clotted when it was received by the laboratory, the test may be performed

37-44  on blood serum or plasma; and

37-45  (c) The person who withdrew the blood was authorized to do so by the

37-46  appropriate medical licensing or certifying agency.

37-47  2.  The limitation contained in paragraph (a) of subsection 1 does not

37-48  apply to the taking of a chemical test of the urine, breath or other bodily

37-49  substance.


38-1    3.  No person listed in paragraph (a) of subsection 1 incurs any civil or

38-2  criminal liability as a result of the administering of a blood test when

38-3  requested by a police officer or the person to be tested to administer the

38-4  test.

38-5    Sec. 78.  NRS 630.256, 630.272, 630.274 640B.010, 640B.020,

38-6  640B.030, 640B.040, 640B.050, 640B.080, 640B.100, 640B.110 and

38-7  640B.150 are hereby repealed.

38-8    Sec. 79.  A person who, on July 1, 2001, holds a license as a

38-9  physician’s assistant issued by the board of medical examiners shall be

38-10  deemed to hold a license as a physician assistant until his license as a

38-11  physician’s assistant is renewed as a license as a physician assistant,

38-12  expires or is revoked, whichever occurs first.

38-13  Sec. 80.  Notwithstanding the amendatory provisions of section 44 of

38-14  this act to the contrary, a practitioner of respiratory care who, on July 1,

38-15  2001, is certified to practice respiratory care in this state pursuant to

38-16  chapter 640B of NRS may continue to practice respiratory care in this state

38-17  pursuant to the certification, but must obtain a license from the board of

38-18  medical examiners before January 1, 2002. On and after January 1, 2002, a

38-19  person shall not practice respiratory care in this state unless he holds a

38-20  license issued by the board of medical examiners.

38-21  Sec. 81.  1.  This section becomes effective upon passage and

38-22  approval.

38-23  2.  Sections 1 to 80, inclusive, and 82 of this act become effective upon

38-24  passage and approval for the purpose of adopting regulations and taking

38-25  such other actions as necessary to regulate practitioners of respiratory care,

38-26  and on July 1, 2001, for all other purposes.

38-27  3.  The amendatory provisions of sections 8, 19, 24, 26 and 41 of this

38-28  act expire by limitation on the date on which the provisions of 42 U.S.C. §

38-29  666 requiring each state to establish procedures under which the state has

38-30  authority to withhold or suspend, or to restrict the use of professional,

38-31  occupational and recreational licenses of persons who:

38-32  (a) Have failed to comply with a subpoena or warrant relating to a

38-33  proceeding to determine the paternity of a child or to establish or enforce

38-34  an obligation for the support of a child; or

38-35  (b) Are in arrears in the payment for the support of one or more

38-36  children,

38-37  are repealed by the Congress of the United States.

38-38  Sec. 82.  1.  Except as otherwise provided in subsection 2, the

38-39  legislative counsel shall:

38-40  (a) In preparing the reprint and supplements to the Nevada Revised

38-41  Statutes, appropriately change any references to physician’s assistant or

38-42  any variation thereof, to physician assistant, or any appropriate variation

38-43  thereof.

38-44  (b) In preparing supplements to the Nevada Administrative Code,

38-45  appropriately change any references to physician’s assistant or any

38-46  variation thereof, to physician assistant, or any appropriate variation

38-47  thereof.

 


39-1    2.  The legislative counsel shall not, pursuant to subsection 1, change

39-2  any references to osteopathic physician’s assistant or any variation thereof

39-3  that appear in the Nevada Revised Statutes or the Nevada Administrative

39-4  Code.

 

 

39-5  LEADLINES OF REPEALED SECTIONS

 

 

39-6    630.256  Retired licensees: Duties; requirements for reinstatement.

39-7    630.272  Physician’s assistant employed at institution of

39-8  department of prisons: Authorized services.

39-9    630.274  Physician’s assistant: Supervision by osteopathic

39-10  physician.

39-11  640B.010  Legislative declaration.

39-12  640B.020  Definitions.

39-13  640B.030  “Practice of respiratory care” defined.

39-14  640B.040  “Practitioner of respiratory care” defined.

39-15  640B.050  “Respiratory care” defined.

39-16  640B.080  Applicability of chapter.

39-17  640B.100  Prescription required.

39-18  640B.110  Qualifications; certification required; prohibited acts;

39-19  practice as intern.

39-20  640B.150  Unlawful acts; penalty.

 

39-21  H