SB91_EN

Senate Bill No. 91–Committee on Commerce and Labor

CHAPTER..........

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:

Section 1. Chapter 630 of NRS is hereby amended by adding thereto

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

Sec. 2. “Practice of respiratory care” includes:

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

aerosols and the maintenance of associated apparatus;

2. The administration of drugs and medications to the

cardiopulmonary system;

3. The provision of ventilatory assistance and control;

4. Postural drainage and percussion, breathing exercises and other

respiratory rehabilitation procedures;

5. Cardiopulmonary resuscitation and maintenance of natural

airways and the insertion and maintenance of artificial airways;

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

certified registered nurse anesthetist or an advanced practitioner of

nursing relating to respiratory care;

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

and research related to respiratory care, including the measurement of

ventilatory volumes, pressures and flows, collection of blood and other

specimens, testing of pulmonary functions and hemodynamic and other

related physiological monitoring of the cardiopulmonary system; and

8. Training relating to the practice of respiratory care.

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

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

National Board for Respiratory Care or its successor organization; and

2. Licensed by the board.

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

diagnostic testing, control and care of persons with deficiencies and

abnormalities associated with the cardiopulmonary system. The term

includes inhalation and respiratory therapy.

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

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

patient is located at the time the act is performed.

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

direction of or pursuant to a prescription from a physician licensed to

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

the District of Columbia.

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

this state must:

(a) Have a high school diploma or general equivalency diploma;

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

been approved by the National Board for Respiratory Care or its

successor organization;

respiratory care administered by the National Board for Respiratory

Care or its successor organization;

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

successor organization; and

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

the required fee for licensure.

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

(a) Practice respiratory care; or

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

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

3. Any person who has completed the educational requirements set

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

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

respiratory care for not more than 12 months after completing those

educational requirements.

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

care must include the social security number of the applicant.

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

practitioners of respiratory care, including, without limitation:

1. Educational and other qualifications of applicants;

2. Required academic programs which applicants must successfully

complete;

3. Procedures for applying for and issuing licenses;

4. Tests or examinations of applicants by the board;

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

may perform, except that a practitioner of respiratory care may not

perform those specific functions and duties delegated or otherwise

restricted by specific statute to persons licensed as dentists,

chiropractors, podiatric physicians, optometrists, physicians, osteopathic

physicians or hearing aid specialists pursuant to this chapter or chapter

631, 633, 634, 635, 636 or 637A of NRS, as appropriate;

6. The duration, renewal and termination of licenses; and

7. The grounds and procedures for disciplinary actions against

practitioners of respiratory care.

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

630.003 The legislature finds and declares that it is among the

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

competent persons practice medicine and respiratory care within this

state. For this purpose, the legislature delegates to the board of medical

examiners the duty of determining the initial and continuing competence of

doctors of medicine , physician assistants and practitioners of respiratory

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

must be liberally construed to carry out this purpose.

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

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

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

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

sections.

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

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

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

general education, practical training and experience determined to be

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

the supervision of a supervising physician and who has been issued a

license by the board.

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

630.025 “Supervising physician” means an active physician licensed

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

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

physician assistant.

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

630.045 The purpose of licensing physicians [and physicians’] ,

physician assistants and practitioners of respiratory care is to protect the

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

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

holder of such a license acquires thereby any vested right.

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

630.047 1. This chapter does not apply to:

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

services or a medical officer or practitioner of respiratory care of any

division or department of the United States in the discharge of his official

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

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

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

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

reside;

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

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

who is licensed in this state; or

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

physicians licensed in this state; [and]

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

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

Christian Science[.] ;

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

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

recognized by a national organization which is approved by the board to

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

provides respiratory care only under the supervision of a practitioner of

respiratory care;

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

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

which has been approved by the board;

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

and

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

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

medical condition and a practitioner of respiratory care is not

immediately available to provide that care and the student is directed by

a physician to provide respiratory care under his supervision until a

practitioner or respiratory care is available;

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

gratuitous respiratory care provided to a friend or a member of a

person’s family if the provider of the care does not represent himself as

a practitioner of respiratory care;

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

surgeon or an anesthesiologist;

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

care under the supervision of that physician;

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

not attached to a patient; and

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

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

equipment if the person is trained to provide such services and is

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

authorized scope of his practice.

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

regulating or affecting any other healing art.

3. This chapter does not prohibit:

(a) Gratuitous services outside of a medical school or medical facility

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

respiratory care in cases of emergency.

(b) The domestic administration of family remedies.

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

630.120 1. The board shall procure a seal.

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

assistants and practitioners of respiratory care must bear the seal of the

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

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

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

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

practice.

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

may be issued to any person who:

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

work in the United States;

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

school:

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

American Medical Association and Association of American Medical

Colleges; or

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

that provided in medical schools in the United States approved by the

Liaison Committee on Medical Education;

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

Medical Examiners;

(2) All parts of the Federation Licensing Examination;

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

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

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

American Board of Medical Specialties;

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

Council of Canada; or

(6) Any combination of the examinations specified in subparagraphs

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

(d) Has completed [3 years of:

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

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

program approved by the board, the Accreditation Council for Graduate

Medical Education of the American Medical Association or the

Coordinating Council of Medical Education of the Canadian Medical

Association; or

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

the board or the Accreditation Council for Graduate Medical Education;

and

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

to practice medicine and provides the board with a description of the

clinical program completed demonstrating that the applicant’s clinical

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

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

630.164 1. A board of county commissioners may petition the board

of medical examiners to waive the [requirements] requirement of

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

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

term is defined by regulation by the [officer of rural health of the

University of Nevada School of Medicine.] board of medical examiners.

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

license if the applicant:

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

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

Council for Graduate Medical Education of the American Medical

Association or the Coordinating Council of Medical Education of the

Canadian Medical Association, respectively;

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

licensed allopathic physician or such other equivalent training as the board

deems appropriate; and

medicine.

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

license to practice medicine in this state restricted to practice in the

medically underserved area of the county which petitioned for the waiver

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

restricted license every 2 years after he is licensed.

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

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

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

an application for an unrestricted license pursuant to this subsection, the

board shall require the applicant to meet all statutory requirements for

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

requirement of paragraph (d) of subsection 2 of NRS 630.160.

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

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

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

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

the statement prescribed by the welfare division of the department of

human resources pursuant to NRS 425.520. The statement must be

completed and signed by the applicant.

2. The board shall include the statement required pursuant to

subsection 1 in:

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

issuance or renewal of the license; or

(b) A separate form prescribed by the board.

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

physician assistant or to practice as a practitioner of respiratory care

may not be issued or renewed by the board if the applicant:

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

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

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

compliance with the order or a plan approved by the district attorney or

other public agency enforcing the order for the repayment of the amount

owed pursuant to the order.

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

subsection 1 that he is subject to a court order for the support of a child

and is not in compliance with the order or a plan approved by the district

attorney or other public agency enforcing the order for the repayment of

the amount owed pursuant to the order, the board shall advise the applicant

to contact the district attorney or other public agency enforcing the order

to determine the actions that the applicant may take to satisfy the

arrearage.

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

630.253 The board shall, as a prerequisite for the:

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

2. Biennial registration of the holder of a license to practice

medicine,

require each holder to comply with the requirements for continuing

education adopted by the board. These requirements may provide for the

completion of one or more courses of instruction relating to risk

management in the performance of medical services.

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

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

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

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

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

state , who meets the requirements for licensure in this state and who is

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

enable an eligible physician to serve as a substitute for another physician

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

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

pursuant to the provisions of this paragraph is not renewable.

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

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

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

pursuant to the provisions of this paragraph is limited to the care of a

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

responsibility for the care of that patient.

applicant needs supervision or restriction.

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

licensed and in good standing in another state and meets the requirements

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

in order to provide medical services for a community without adequate

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

paragraph is not renewable.

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

state to permit the use of equipment that transfers information

concerning the medical condition of a patient in this state across state

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

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

state;

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

by any state or other jurisdiction; and

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

of NRS 630.160.

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

or modify any license issued pursuant to subsection 1.

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

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

state pursuant to the provisions of the license shall be deemed to have

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

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

inclusive.

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

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

may issue to a qualified applicant a limited license to practice medicine as

a resident physician in a graduate program approved by the Accreditation

Council for Graduate Medical Education if he is:

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

Canada; or

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

standard certificate of the Educational Commission for Foreign Medical

Graduates or a written statement from that commission that he passed the

examination given by it.

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

provide the board with written confirmation that the applicant has been

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

or lawfully entitled to remain and work in the United States. Such a

license remains valid only while the licensee is actively practicing

medicine in the residency program and is legally entitled to work and

remain in the United States.

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

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

the requirements set forth by the board by regulation.

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

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

as are approved by the director of the program and the board.

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

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

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

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

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

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

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

supervision and control of a] by his supervising physician.

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

[physician’s] physician assistant to prescribe controlled substances to

those schedules of controlled substances [which his] that the supervising

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

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

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

under the regulations of the board to perform medical services under the

supervision of a supervising physician. The application for a license as a

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

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

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

630.275 The board shall adopt regulations regarding the licensure of a

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

1. The educational and other qualifications of applicants.

2. The required academic program for applicants.

3. The procedures for applications for and the issuance of licenses.

4. The tests or examinations of applicants by the board.

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

perform, except that he may not perform those specific functions and

duties delegated or restricted by law to persons licensed as dentists,

chiropractors, podiatric physicians and optometrists under chapters 631,

634, 635 and 636, respectively, of NRS, or as hearing aid specialists.

6. The duration, renewal and termination of licenses.

7. The grounds and procedures respecting disciplinary actions against

[physicians’] physician assistants.

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

assistant by a supervising physician.

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

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

before July 1 of each alternate year:

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

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

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

physician is licensed.

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

registration and submit the statement required pursuant to NRS 630.197

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

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

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

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

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

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

reinstated to practice.

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

to notify a licensee:

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

required pursuant to NRS 630.197 are due; and

(b) That his license is suspended.

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

of the United States Department of Justice or its successor agency.

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

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

following fees:

For application for and issuance of a license [by written

examination, in addition to the actual cost to the board of

the examination] to practice as a physician. $600

For application for and issuance of a temporary, locum

tenens, limited, restricted , special or special purpose

license................................................ [300] 400

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

For application for and issuance of a license as a

[physician’s] physician assistant......... [300] 400

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

registration of a physician assistant... [300] 800

For biennial registration of a physician.......... 800

For application for and issuance of a license as a

practitioner of respiratory care................... 400

For biennial registration of a practitioner of respiratory

care............................................................ 600

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

on inactive status [or ~~not practicing medicine in Nevada............................................... 200]~~ 400

For written verification of licensure.................. 50

For a duplicate identification card.................... 25

For a duplicate license..................................... 50

For computer printouts or labels........... [300] 500

For verification of a listing of physicians, per hour.................................................................... 20

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

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

charge and collect[:

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

Licensing Examination; and

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

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

physician,] licensee, an institution, an organization, a state agency or an

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

the special meeting. Such a special meeting must not be called until the

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

sufficient to defray all expenses of the meeting.

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

630.301 The following acts, among others, constitute grounds for

initiating disciplinary action or denying licensure:

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

offense relating to the practice of medicine or the ability to practice

medicine. A plea of nolo contendere is a conviction for the purposes of

this subsection.

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

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

inclusive.

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

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

of the license or discontinuing the practice of medicine while under

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

Armed Services of the United States, an insurance company, an agency of

the Federal Government or an employer.

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

practitioner.

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

who is currently being treated by the practitioner.

6. Disruptive behavior with physicians, hospital personnel, patients,

members of the families of patients or any other persons if the behavior

interferes with patient care or has an adverse impact on the quality of

care rendered to a patient.

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

exploits the relationship between the physician and the patient for

financial or other personal gain.

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

inappropriate denials by organizations for managed care, to provide

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

such a failure occurs with the intent of positively influencing the

financial well-being of the practitioner or an insurer.

9. The engaging in conduct that brings the medical profession into

disrepute, including, without limitation, conduct that violates any

provision of a national code of ethics adopted by the board by

regulation.

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

other key persons related to a patient, including, without limitation, a

spouse, parent or legal guardian, which exploits the relationship

between the physician and the patient in a sexual manner.

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

630.3062 The following acts, among others, constitute grounds for

initiating disciplinary action or denying licensure:

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

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

2. Altering medical records of a patient.

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

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

or inducing another to obstruct such filing.

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

inspection and copying as provided in NRS 629.061.

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

against the licensee and the subsequent disposition thereof within 90 days

after the:

(a) Claim is filed; and

(b) Disposition of the claim.

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

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

the board.

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

630.3066 A physician is not subject to disciplinary action solely for

prescribing or administering to a patient under his care[:

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

use of the substance.

2. Procaine hydrochloride with preservatives and stabilizers (Gerovital

H3).

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

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

substance is lawfully prescribed or administered for the treatment of

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

medicine.] regulations adopted by the board.

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

630.307 1. Any person, medical school or medical facility that

becomes aware that a person practicing medicine or respiratory care in

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

constitutes grounds for initiating disciplinary action shall forthwith file a

written complaint with the board.

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

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

physician’s privileges to practice medicine while the physician is under

investigation and the outcome of any disciplinary action taken by that

facility or society against the physician concerning the care of a patient or

the competency of the physician.

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

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

physician assistant or practitioner of respiratory care:

(a) Is mentally ill;

(b) Is mentally incompetent;

substances or dangerous drugs;

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

providing medical assistance; or

(e) Is liable for damages for malpractice or negligence.

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

630.329 If the board issues an order suspending the license of a

physician , physician assistant or practitioner of respiratory care pending

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

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

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

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

may apply to any court of competent jurisdiction:

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

licensee which is harmful to the public;

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

practicing medicine[;] or respiratory care;

assistant or practitioner of respiratory care, or suspend his license to

practice ; [medicine;] or

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

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

or designate a person as a physician, physician assistant or practitioner

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

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

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

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

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

(b) Without relieving any person from criminal prosecution for

engaging in the practice of medicine without a license; and

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

630.336 1. Any proceeding of a committee of the board investigating

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

licensee under investigation requests that the proceeding be subject to

those requirements. Any deliberations conducted or vote taken by:

(a) The board or panel regarding its decision; or

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

ordering of a physician , physician assistant or practitioner of respiratory

care to undergo a physical or mental examination or any other

examination designated to assist the board or committee in determining

the fitness of a physician, physician assistant or practitioner of

respiratory care,

are not subject to the requirements of NRS 241.020.

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

license to practice medicine[,] or respiratory care, any charges filed by

the

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

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

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

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

following may be kept confidential:

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

support of or to verify the contents of an application;

(b) All investigations and records of investigations;

license to practice medicine[;] or respiratory care;

(d) Any communication between:

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

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

hearing officers, advisory members or consultants and counsel for the

board; and

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

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

communicating or cooperating with any other licensing board or agency or

any agency which is investigating a licensee, including a law enforcement

agency. Such cooperation may include , without limitation, providing the

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

examinations and the results of oral examinations.

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

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

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

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

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

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

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

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

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

newspaper widely distributed in that county.

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

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

board.

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

630.346 In any disciplinary hearing:

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

officer are not bound by formal rules of evidence and a witness must not

be barred from testifying solely because he was or is incompetent.

2. Proof of actual injury need not be established.

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

showing a conviction or plea of nolo contendere or the suspension,

revocation, limitation, modification, denial or surrender of a license to

practice medicine or respiratory care is conclusive evidence of its

occurrence.

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

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

member serving on a panel of the board hearing charges, may participate

in the final order of the board. If the board, after a formal hearing,

determines

from a preponderance of the evidence that a violation of the provisions of

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

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

findings and any sanctions.

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

dismiss the charges, in writing, and notify the physician that the charges

have been dismissed. If the disciplinary proceedings were instituted

against the physician as a result of a complaint filed against him, the board

may provide the physician with a copy of the complaint . [, including the

name of the person, if any, who filed the complaint.]

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

a violation has occurred, it may by order:

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

conditions specified in the order;

(b) Administer to him a public reprimand;

medicine from his practice;

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

the board;

(e) Revoke his license to practice medicine;

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

dependence or any other impairment;

(g) Require supervision of his practice;

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

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

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

examination testing his competence;

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

and

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

disciplinary proceedings.

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

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

or until further order of the board.

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

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

hearing officer or a panel of the board:

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

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

board;]

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

to obstruct the proceeding,

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

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

certification operates as a stay of all related disciplinary proceedings .

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

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

contempt.

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

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

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

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

imposed and the person may purge himself of the contempt in the same

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

of a civil action.

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

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

entitled to judicial review of the board’s order.

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

suspends or revokes a license] that imposes a sanction against a licensee

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

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

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

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

determination by the court.

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

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

given priority by law.

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

630.358 1. Any person:

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

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

(1) Suspended until further order; or

(2) Revoked,

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

limitation or restoration of his license.

2. In hearing the application, the board:

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

examination or an examination testing his competence to practice

medicine or respiratory care by physicians or practitioners of respiratory

care, as appropriate, or other examinations it designates and submit such

other evidence of changed conditions and of fitness as it deems proper;

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

application is reasonable; and

the evidence and the public safety warrants.

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

evidence that the requirements for restoration of the license or removal of

the limitation have been met.

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

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

final order of the board and that the person is capable of practicing

medicine or respiratory care in a safe manner.

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

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

had never been licensed under this chapter.

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

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

pursuant to NRS 425.540 that provides for the suspension of all

professional, occupational and recreational licenses, certificates and

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

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

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

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

after the date on which the court order was issued unless the board

receives a letter issued to the holder of the license by the district attorney

or other public agency pursuant to NRS 425.550 stating that the holder of

the license has complied with the subpoena or warrant or has satisfied the

arrearage pursuant to NRS 425.560.

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

practice as a [physician’s] physician assistant or to practice as a

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

pursuant to NRS 425.540 if the board receives a letter issued by the

district attorney or other public agency pursuant to NRS 425.550 to the

person whose license was suspended stating that the person whose license

was suspended has complied with the subpoena or warrant or has satisfied

the arrearage pursuant to NRS 425.560.

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

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

assistant,] physician assistant or practitioner of respiratory care, a

written complaint, specifying the charges, must be filed with the board by:

[(a) The board ;

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

investigate a complaint;

2. Any member of the board; or

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

constituting a ground for disciplinary action set forth in the regulations

adopted by the board.

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

physician’s assistant by his supervising physician or by an osteopathic

physician supervising the physician’s assistant pursuant to NRS 630.274,

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

complaint.

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

adopted by the board, the board finds that the charges in the complaint

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

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

the person, if any, who filed the complaint.]

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

630.390 In seeking injunctive relief against any person for an alleged

violation of this chapter by practicing medicine or respiratory care

without a license, it is sufficient to allege that he did, upon a certain day,

and in a certain county of this state, engage in the practice of medicine or

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

further or more particular facts concerning the same.

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

630.400 A person who:

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

of another;

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

3. Practices medicine or respiratory care under a false or assumed

name or falsely personates another licensee;

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

or respiratory care without being licensed under this chapter;

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

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

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

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

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

care without being licensed by the board; or

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

chapter, unless otherwise authorized by a specific statute,

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

193.130.

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

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

executive director of the board any conduct of a licensee or holder of a

certificate which constitutes a violation of the provisions of this chapter:

(a) Any physician, dentist, dental hygienist, chiropractor, optometrist,

podiatric physician, medical examiner, resident, intern, professional or

practical nurse, nursing assistant, [physician’s] physician assistant,

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

abuse counselor, driver of an ambulance, advanced emergency medical

technician or other person providing medical services licensed or certified

to practice in this state.

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

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

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

facility for the dependent upon notification by a member of the staff of the

facility.

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

nursing in the home.

(e) Any employee of the department of human resources.

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

protective services or an adult or juvenile probation officer.

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

establishment that provides care for older persons.

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

for an agency or service which advises persons regarding the abuse,

neglect or exploitation of an older person and refers them to persons and

agencies where their requests and needs can be met.

(i) Any social worker.

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

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

has engaged in conduct which constitutes grounds for the denial,

suspension or revocation of a certificate shall notify the superintendent,

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

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

subsection 1.

3. A report may be filed by any other person.

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

of this chapter to the executive director of the board pursuant to this

section is immune from civil liability for reporting the violation.

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

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

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

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

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

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

board of medical examiners and the supervising physician. The orders

must be cosigned by the supervising physician or another physician within

72 hours after treatment.

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

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

review by the nurse.

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

give orders for the administration of any controlled substance.

4. For the purposes of this section:

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

physician assistant licensed by the board of medical examiners pursuant to

chapter 630 of NRS who:

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

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

university recognized by the board of medical examiners; and

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

prescription of medication as a part of either his basic educational

qualifications or a program of continuing education approved by the board

of medical examiners.

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

management of specified medical conditions, including the drugs and

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

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

as a basis for their practice.

630.025.

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

639.0125 “Practitioner” means:

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

valid license to practice his profession in this state;

2. A hospital, pharmacy or other institution licensed, registered or

otherwise permitted to distribute, dispense, conduct research with respect

to or administer drugs in the course of professional practice or research in

this state;

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

prescribe poisons, dangerous drugs and devices; or

4. A physician assistant who:

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

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

dispense controlled substances, poisons, dangerous drugs or devices

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

5. An osteopathic physician’s assistant who:

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

certificate issued by the state board of osteopathic medicine; and

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

dispense controlled substances, poisons, dangerous drugs or devices under

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

chapter [630 or] 633 of NRS.

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

639.1373 1. A physician assistant or an osteopathic physician’s

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

dispense controlled substances, or possess, administer, prescribe or

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

his supervising physician only to the extent and subject to the limitations

specified in the registration certificate issued to the physician assistant or

osteopathic physician’s [assistant’s certificate as issued] assistant, as

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

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

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

the board of medical examiners or certificate issued by the state board of

osteopathic medicine to possess, administer, prescribe or dispense

controlled substances, or to possess, administer, prescribe or dispense

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

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

adopted by the board and pass an examination administered by the board

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

prescribe or dispense controlled substances, or possess, administer,

prescribe or dispense poisons, dangerous drugs or devices.

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

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

of medical examiners or the osteopathic physician’s assistant’s certificate

issued by the state board of osteopathic medicine authorizes the physician

assistant or osteopathic physician’s assistant , as appropriate, to possess,

administer, prescribe or dispense controlled substances, or to possess,

administer, prescribe or dispense poisons, dangerous drugs and devices:

(a) Refuse to issue a registration certificate;

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

assistant or osteopathic physician’s [assistant’s authority] assistant, as

appropriate, to possess, administer, prescribe or dispense controlled

substances, or to possess, administer, prescribe or dispense poisons,

dangerous drugs or devices, the area in which the physician assistant or

osteopathic physician’s assistant may possess controlled substances,

poisons, dangerous drugs and devices, or the kind and amount of

controlled substances, poisons, dangerous drugs and devices; or

restrictions which the board feels are necessary and required to protect the

health, safety and welfare of the public.

4. If the registration of the physician assistant or osteopathic

physician’s assistant is suspended or revoked, the physician’s controlled

substance registration may also be suspended or revoked.

5. The board shall adopt regulations controlling the maximum amount

to be administered, possessed and dispensed, and the storage, security,

recordkeeping and transportation of controlled substances and the

maximum amount to be administered, possessed, prescribed and dispensed

and the storage, security, recordkeeping and transportation of poisons,

dangerous drugs and devices by physician assistants and osteopathic

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

consider, but is not limited to, the following:

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

assistant is to operate;

(b) The population of that area;

osteopathic physician’s assistant;

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

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

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

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

physician” includes an employing osteopathic physician as defined in

chapter 633 of NRS.

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

652.210 No person other than a licensed physician, a licensed

optometrist, a licensed practical nurse, a registered nurse, a licensed [or]

physician assistant, a certified osteopathic physician’s assistant, a

certified intermediate emergency medical technician, a certified advanced

emergency medical technician or a licensed dentist may manipulate a

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

laboratory may collect blood, remove stomach contents, perform certain

diagnostic skin tests or field blood tests or collect material for smears and

cultures.

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

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

in his professional or occupational capacity, knows or has reasonable

cause to believe that an older person has been abused, neglected, exploited

or isolated shall:

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

neglect, exploitation or isolation of the older person to:

(1) The local office of the aging services division of the department

of human resources;

(2) A police department or sheriff’s office;

(3) The county’s office for protective services, if one exists in the

county where the suspected action occurred; or

(4) A toll-free telephone service designated by the aging services

division of the department of human resources; and

(b) Make such a report as soon as reasonably practicable but not later

than 24 hours after the person knows or has reasonable cause to believe

that the older person has been abused, neglected, exploited or isolated.

2. If a person who is required to make a report pursuant to subsection 1

knows or has reasonable cause to believe that the abuse, neglect,

exploitation or isolation of the older person involves an act or omission of

the aging services division, another division of the department of human

resources or a law enforcement agency, the person shall make the report to

an agency other than the one alleged to have committed the act or

omission.

3. Each agency, after reducing a report to writing, shall forward a copy

of the report to the aging services division of the department of human

resources.

4. A report must be made pursuant to subsection 1 by the following

persons:

(a) Every physician, dentist, dental hygienist, chiropractor, optometrist,

podiatric physician, medical examiner, resident, intern, professional or

practical nurse, [physician’s] physician assistant, psychiatrist,

psychologist, marriage and family therapist, alcohol or drug abuse

counselor, driver of an ambulance, advanced emergency medical

technician or other person providing medical services licensed or certified

to practice in this state, who examines, attends or treats an older person

who appears to have been abused, neglected, exploited or isolated.

(b) Any personnel of a hospital or similar institution engaged in the

admission, examination, care or treatment of persons or an administrator,

manager or other person in charge of a hospital or similar institution upon

notification of the suspected abuse, neglect, exploitation or isolation of an

older person by a member of the staff of the hospital.

(d) Every clergyman, practitioner of Christian Science or religious

healer, unless he acquired the knowledge of abuse, neglect, exploitation or

isolation of the older person from the offender during a confession.

(e) Every person who maintains or is employed by an agency to provide

nursing in the home.

(f) Every attorney, unless he has acquired the knowledge of abuse,

neglect, exploitation or isolation of the older person from a client who has

been or may be accused of such abuse, neglect, exploitation or isolation.

(g) Any employee of the department of human resources.

(h) Any employee of a law enforcement agency or a county’s office for

protective services or an adult or juvenile probation officer.

(i) Any person who maintains or is employed by a facility or

establishment that provides care for older persons.

(j) Any person who maintains, is employed by or serves as a volunteer

for an agency or service which advises persons regarding the abuse,

neglect, exploitation or isolation of an older person and refers them to

persons and agencies where their requests and needs can be met.

(k) Every social worker.

(l) Any person who owns or is employed by a funeral home or

mortuary.

5. A report may be made by any other person.

6. If a person who is required to make a report pursuant to subsection 1

knows or has reasonable cause to believe that an older person has died as a

result of abuse, neglect or isolation, the person shall, as soon as reasonably

practicable, report this belief to the appropriate medical examiner or

coroner, who shall investigate the cause of death of the older person and

submit to the appropriate local law enforcement agencies, the appropriate

prosecuting attorney and the aging services division of the department of

human resources his written findings. The written findings must include

the information required pursuant to the provisions of NRS 200.5094,

when possible.

7. A division, office or department which receives a report pursuant to

this section shall cause the investigation of the report to commence within

3 working days. A copy of the final report of the investigation conducted

by a division, office or department, other than the aging services division

of the department of human resources, must be forwarded to the aging

services division within 90 days after the completion of the report.

8. If the investigation of a report results in the belief that an older

person is abused, neglected, exploited or isolated, the aging services

division of the department of human resources or the county’s office for

protective services may provide protective services to the older person if

he is able and willing to accept them.

9. A person who knowingly and willfully violates any of the

provisions of this section is guilty of a misdemeanor.

Sec. 51. NRS 223.550 is hereby amended to read as follows:

223.550 1. The office for consumer health assistance is hereby

established in the office of the governor. The governor shall appoint the

director. The director must:

(a) Be:

(1) A physician, as that term is defined in NRS 0.040;

(2) A registered nurse, as that term is defined in NRS 632.019;

(3) An advanced practitioner of nursing, as that term is defined in

NRS 453.023; or

(4) A [physician’s] physician assistant, as that term is defined in NRS

630.015; and

(b) Have expertise and experience in the field of advocacy.

2. The cost of carrying out the provisions of NRS 223.500 to 223.580,

inclusive, must be paid as follows:

(a) That portion of the cost related to providing assistance to consumers

and injured employees concerning workers’ compensation must be paid

from the assessments levied pursuant to NRS 232.680.

(b) The remaining cost must be provided by direct legislative

appropriation from the state general fund and be paid out on claims as

other claims against the state are paid.

Sec. 52. NRS 244.1605 is hereby amended to read as follows:

244.1605 The boards of county commissioners may:

1. Establish, equip and maintain limited medical facilities in the

outlying areas of their respective counties to provide outpatient care and

emergency treatment to the residents of and those falling sick or being

injured or maimed in those areas.

2. Provide a full-time or part-time staff for the facilities which may

include a physician, a licensed [physician’s] physician assistant, a

registered nurse or a licensed practical nurse, a certified emergency

medical technician and such other personnel as the board deems necessary

or appropriate to ensure adequate staffing commensurate with the needs of

the area in which the facility is located.

3. Fix the charges for the medical and nursing care and medicine

furnished by the facility to those who are able to pay for them, and to

provide that care and medicine free of charge to those persons who qualify

as medical indigents under the county’s criteria of eligibility for medical

care.

4. Purchase, equip and maintain, either in connection with a limited

medical facility as authorized in this section or independent therefrom,

ambulances and ambulance services for the benefit of the residents of and

those falling sick or being injured or maimed in the outlying areas.

Sec. 53. NRS 244.382 is hereby amended to read as follows:

244.382 The legislature finds that:

1. Many of the less populous counties of the state have experienced

shortages of physicians, surgeons, anesthetists, dentists, other medical

professionals and [physicians’] physician assistants.

2. Some of the more populous counties of the state have also

experienced shortages of physicians, surgeons, anesthetists, dentists, other

medical professionals and [physicians’] physician assistants in their rural

communities.

3. By granting county scholarships to students in such medical

professions who will agree to return to the less populous counties or the

rural communities of the more populous counties for residence and

practice, these counties can alleviate the shortages to a degree and thereby

provide their people with needed health services.

Sec. 54. NRS 244.3821 is hereby amended to read as follows:

244.3821 1. In addition to the powers elsewhere conferred upon all

counties, except as otherwise provided in subsection 2, any county may

establish a medical scholarship program to induce students in the medical

professions to return to the county for practice.

2. Any county whose population is 100,000 or more may only

establish a medical scholarship program to induce students in the medical

professions to return to the less populous rural communities of the county

for practice.

3. Students in the medical professions for the purposes of NRS

244.382 to 244.3823, inclusive, include persons studying to be

[physicians’] physician assistants.

4. The board of county commissioners of a county that has established

a medical scholarship program may appropriate money from the general

fund of the county for medical scholarship funds and may accept private

contributions to augment the scholarship funds.

Sec. 55. NRS 397.0605 is hereby amended to read as follows:

397.0605 The provisions of NRS 397.0615, 397.0645 and 397.0653 to

the contrary notwithstanding, the Western Interstate Commission for

Higher Education may adopt regulations which require as a condition of

placement of a student in an educational program for [physicians’]

physician assistants and receipt of the related financial support that the

student submit to the director of the Western Interstate Commission for

Higher Education:

1. A written statement from a licensed provider of health care who

practices his profession in a rural area of this state that he agrees to

employ the student for the term necessary to fulfill the requirements of

NRS 397.0645 upon the completion of the student’s education,

examination and licensure.

2. A written statement from the student that in lieu of repayment of all

state contributions for the stipend he received he will practice his

profession in a rural area of this state in accordance with the schedule set

forth in subsection 1 of NRS 397.0645.

Sec. 56. NRS 397.0617 is hereby amended to read as follows:

397.0617 1. The provisions of this section apply only to support fees

received by a student on or after July 1, 1997.

2. The three commissioners from the State of Nevada, acting jointly,

may require a student who is certified to study to practice in a profession

which could benefit a medically underserved area of this state, as that term

is defined by the officer of rural health of the University of Nevada School

of Medicine, to practice in such an area or to practice in an area designated

by the Secretary of Health and Human Services:

(a) Pursuant to 42 U.S.C. § 254c, as containing a medically underserved

population; or

(b) Pursuant to 42 U.S.C. § 254e, as a health professional shortage

area,

as a condition to receiving a support fee.

3. If a person agrees to practice in a medically underserved area of this

state pursuant to subsection 2 for at least 2 years, the three commissioners

from the State of Nevada, acting jointly, may forgive the portion of the

support fee designated as the loan of the person.

4. If a person returns to this state but does not practice in a medically

underserved area of this state pursuant to subsection 2 for at least 2 years,

the three commissioners from the State of Nevada, acting jointly, shall

assess a default charge in an amount not less than three times the portion

of the support fee designated as the loan of the person, plus interest.

5. As used in this section, a “profession which could benefit a

medically underserved area of this state” includes, without limitation,

dentistry, physical therapy, pharmacy and practicing as a [physician’s]

physician assistant.

Sec. 57. NRS 432B.220 is hereby amended to read as follows:

432B.220 1. Any person who is described in subsection 3 and who,

in his professional or occupational capacity, knows or has reasonable

cause to believe that a child has been abused or neglected shall:

(a) Except as otherwise provided in subsection 2, report the abuse or

neglect of the child to an agency which provides protective services or to a

law enforcement agency; and

(b) Make such a report as soon as reasonably practicable but not later

than 24 hours after the person knows or has reasonable cause to believe

that the child has been abused or neglected.

2. If a person who is required to make a report pursuant to subsection 1

knows or has reasonable cause to believe that the abuse or neglect of the

child involves an act or omission of:

(a) A person directly responsible or serving as a volunteer for or an

employee of a public or private home, institution or facility where the

child is receiving child care outside of his home for a portion of the day,

the person shall make the report to a law enforcement agency.

(b) An agency which provides protective services or a law enforcement

agency, the person shall make the report to an agency other than the one

alleged to have committed the act or omission, and the investigation of the

abuse or neglect of the child must be made by an agency other than the

one alleged to have committed the act or omission.

3. A report must be made pursuant to subsection 1 by the following

persons:

(a) A physician, dentist, dental hygienist, chiropractor, optometrist,

podiatric physician, medical examiner, resident, intern, professional or

practical nurse, [physician’s] physician assistant, psychiatrist,

psychologist, marriage and family therapist, alcohol or drug abuse

counselor, advanced emergency medical technician or other person

providing medical services licensed or certified in this state;

(b) Any personnel of a hospital or similar institution engaged in the

admission, examination, care or treatment of persons or an administrator,

manager or other person in charge of a hospital or similar institution upon

notification of suspected abuse or neglect of a child by a member of the

staff of the hospital;

(d) A clergyman, practitioner of Christian Science or religious healer,

unless he has acquired the knowledge of the abuse or neglect from the

offender during a confession;

(e) A social worker and an administrator, teacher, librarian or counselor

of a school;

(f) Any person who maintains or is employed by a facility or

establishment that provides care for children, children’s camp or other

public or private facility, institution or agency furnishing care to a child;

(g) Any person licensed to conduct a foster home;

(h) Any officer or employee of a law enforcement agency or an adult or

juvenile probation officer;

(i) An attorney, unless he has acquired the knowledge of the abuse or

neglect from a client who is or may be accused of the abuse or neglect;

and

(j) Any person who maintains, is employed by or serves as a volunteer

for an agency or service which advises persons regarding abuse or neglect

of a child and refers them to persons and agencies where their requests and

needs can be met.

4. A report may be made by any other person.

5. If a person who is required to make a report pursuant to subsection 1

knows or has reasonable cause to believe that a child has died as a result of

abuse or neglect, the person shall, as soon as reasonably practicable, report

this belief to the appropriate medical examiner or coroner, who shall

investigate the report and submit to an agency which provides protective

services his written findings. The written findings must include, if

obtainable, the information required pursuant to the provisions of

subsection 2 of NRS 432B.230.

Sec. 58. NRS 441A.110 is hereby amended to read as follows:

441A.110 “Provider of health care” means a physician, nurse,

[physician’s] physician assistant or veterinarian licensed in accordance

with state law.

Sec. 59. NRS 442.003 is hereby amended to read as follows:

442.003 As used in this chapter, unless the context requires otherwise:

1. “Advisory board” means the advisory board on maternal and child

health.

2. “Department” means the department of human resources.

3. “Director” means the director of the department.

4. “Fetal alcohol syndrome” includes fetal alcohol effects.

5. “Health division” means the health division of the department.

6. “Obstetric center” has the meaning ascribed to it in NRS 449.0155.

7. “Provider of health care or other services” means:

(a) An alcohol and drug abuse counselor who is licensed or certified

pursuant to chapter 641C of NRS;

(b) A physician or a [physician’s] physician assistant who is licensed

pursuant to chapter 630 of NRS and who practices in the area of obstetrics

and gynecology, family practice, internal medicine, pediatrics or

psychiatry;

(d) A licensed psychologist;

(e) A licensed marriage and family therapist;

(f) A licensed social worker; or

(g) The holder of a certificate of registration as a pharmacist.

Sec. 60. NRS 442.119 is hereby amended to read as follows:

442.119 As used in NRS 442.119 to 442.1198, inclusive, unless the

context otherwise requires:

1. “Health officer” includes a local health officer, a city health officer,

a county health officer and a district health officer.

2. “Medicaid” has the meaning ascribed to it in NRS 439B.120.

3. “Medicare” has the meaning ascribed to it in NRS 439B.130.

4. “Provider of prenatal care” is limited to:

(a) A physician who is licensed in this state and certified in obstetrics

and gynecology, family practice, general practice or general surgery.

(b) A certified nurse midwife who is licensed by the state board of

nursing.

training in obstetrics or family nursing.

(d) A [physicians’] physician assistant who has specialized skills and

training in obstetrics or family practice.

Sec. 61. NRS 449.0175 is hereby amended to read as follows:

449.0175 “Rural clinic” means a facility located in an area that is not

designated as an urban area by the Bureau of the Census, where medical

services are provided by a [physician’s] physician assistant or an

advanced practitioner of nursing under the supervision of a licensed

physician.

Sec. 62. NRS 450B.160 is hereby amended to read as follows:

450B.160 1. The health authority may issue licenses to attendants

and to firemen employed by or serving as volunteers with a fire-fighting

agency.

2. Each license must be evidenced by a card issued to the holder of the

license, is valid for a period not to exceed 2 years and is renewable.

3. An applicant for a license must file with the health authority:

(a) A current, valid certificate evidencing his successful completion of a

program or course for training in emergency medical technology, if he is

applying for a license as an attendant, or, if a volunteer attendant, at a level

of skill determined by the board.

(b) A current valid certificate evidencing his successful completion of a

program for training as an intermediate emergency medical technician or

advanced emergency medical technician if he is applying for a license as a

fireman with a fire-fighting agency.

(1) His name and address;

(2) His employer’s name and address; and

(3) A description of his duties.

(d) Such other certificates for training and such other items as the board

may specify.

4. The board shall adopt such regulations as it determines are

necessary for the issuance, suspension, revocation and renewal of licenses.

5. Each operator of an ambulance or air ambulance and each fire

-fighting agency shall annually file with the health authority a complete list

of the licensed persons in its service.

6. Licensed physicians, registered nurses and licensed [physicians’]

physician assistants may serve as attendants without being licensed under

the provisions of this section. A registered nurse who performs advanced

emergency care in an ambulance or air ambulance must perform the care

in accordance with the regulations of the state board of nursing. A licensed

[physicians’] physician assistant who performs advanced emergency care

in an ambulance or air ambulance must perform the care in accordance

with the regulations of the [state] board of medical examiners.

7. Each licensed physician, registered nurse and licensed [physicians’]

physician assistant who serves as an attendant must have current

certification of completion of training in:

(a) Advanced life-support procedures for patients who require cardiac

care;

(b) Life-support procedures for pediatric patients who require cardiac

care; or

administered before the arrival of those patients at a hospital.

The certification must be issued by the board of medical examiners for a

physician or licensed [physician’s] physician assistant or by the state

board of nursing for a registered nurse.

8. The board of medical examiners and the state board of nursing shall

issue a certificate pursuant to subsection 7 if the licensed physician,

licensed [physician’s] physician assistant or registered nurse attends:

(a) A course offered by a national organization which is nationally

recognized for issuing such certification;

(b) Training conducted by the operator of an ambulance or air

ambulance; or

approved by the board of medical examiners or the state board of nursing,

whichever is issuing the certification. The board of medical examiners and

the state board of nursing may require certification of training in all three

areas set forth in subsection 7 for a licensed physician, licensed

[physician’s] physician assistant or registered nurse who primarily serves

as an attendant in a county whose population is 400,000 or more.

Sec. 63. NRS 453.038 is hereby amended to read as follows:

453.038 “Chart order” means an order entered on the chart of a

patient:

1. In a hospital, facility for intermediate care or facility for skilled

nursing which is licensed as such by the health division of the department;

2. Under emergency treatment in a hospital by a physician, dentist or

podiatric physician, or on the written or oral order of a physician,

[physician’s] physician assistant, dentist or podiatric physician authorizing

the administration of a drug to the patient.

Sec. 64. NRS 453.091 is hereby amended to read as follows:

453.091 1. “Manufacture” means the production, preparation,

propagation, compounding, conversion or processing of a substance, either

directly or indirectly by extraction from substances of natural origin, or

independently by means of chemical synthesis, or by a combination of

extraction and chemical synthesis, and includes any packaging or

repackaging of the substance or labeling or relabeling of its container.

2. “Manufacture” does not include the preparation or compounding of

a substance by a person for his own use or the preparation, compounding,

packaging or labeling of a substance by a physician, [physician’s]

physician assistant, dentist, podiatric physician or veterinarian:

(a) As an incident to his administering or dispensing of a substance in

the course of his professional practice; or

(b) By his authorized agent under his supervision, for the purpose of, or

as an incident to, research, teaching or chemical analysis and not for sale.

Sec. 65. NRS 453.126 is hereby amended to read as follows:

453.126 “Practitioner” means:

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

license to practice his profession in this state and is registered pursuant to

this chapter.

2. An advanced practitioner of nursing who holds a certificate from the

state board of nursing and a certificate from the state board of pharmacy

authorizing him to dispense controlled substances.

3. A scientific investigator or a pharmacy, hospital or other institution

licensed, registered or otherwise authorized in this state to distribute,

dispense, conduct research with respect to, to administer, or use in

teaching or chemical analysis, a controlled substance in the course of

professional practice or research.

4. A euthanasia technician who is licensed by the Nevada state board

of veterinary medical examiners and registered pursuant to this chapter,

while he possesses or administers sodium pentobarbital pursuant to his

license and registration.

5. A [physician’s] physician assistant who:

(a) Holds a license from the board of medical examiners ; [or a

certificate from the state board of osteopathic medicine;] and

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

dispense controlled substances under the supervision of a physician [or

osteopathic physician] as required by chapter 630 [or 633] of NRS.

6. An osteopathic physician’s assistant who:

(a) Holds a certificate from the state board of osteopathic medicine;

and

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

dispense controlled substances under the supervision of an osteopathic

physician as required by chapter 633 of NRS.

7. An optometrist who is certified by the Nevada state board of

optometry to prescribe and administer therapeutic pharmaceutical agents

pursuant to NRS 636.288, when he prescribes or administers therapeutic

pharmaceutical agents within the scope of his certification.

Sec. 66. NRS 453.128 is hereby amended to read as follows:

453.128 1. “Prescription” means:

(a) An order given individually for the person for whom prescribed,

directly from a physician, osteopathic physician’s assistant, physician

assistant, dentist, podiatric physician, optometrist or veterinarian, or his

agent, to a pharmacist or indirectly by means of an order signed by the

practitioner or an electronic transmission from the practitioner to a

pharmacist; or

(b) A chart order written for an inpatient specifying drugs which he is to

take home upon his discharge.

2. The term does not include a chart order written for an inpatient for

use while he is an inpatient.

Sec. 67. NRS 453.226 is hereby amended to read as follows:

453.226 1. Every practitioner or other person who dispenses any

controlled substance within this state or who proposes to engage in the

dispensing of any controlled substance within this state shall obtain

biennially a registration issued by the board in accordance with its

regulations.

2. A person registered by the board in accordance with the provisions

of NRS 453.011 to 453.552, inclusive, to dispense or conduct research

with controlled substances may possess, dispense or conduct research with

those substances to the extent authorized by the registration and in

conformity with the other provisions of those sections.

3. The following persons are not required to register and may lawfully

possess and distribute controlled substances pursuant to the provisions of

NRS 453.011 to 453.552, inclusive:

(a) An agent or employee of a registered dispenser of a controlled

substance if he is acting in the usual course of his business or employment;

(b) A common or contract carrier or warehouseman, or an employee

thereof, whose possession of any controlled substance is in the usual course

of business or employment;

substance pursuant to a lawful order of a physician, osteopathic

physician’s assistant, physician assistant, dentist, podiatric physician or

veterinarian or in lawful possession of a schedule V substance; or

(d) A physician who:

(1) Holds a locum tenens license issued by the board of medical

examiners or a temporary license issued by the state board of osteopathic

medicine; and

(2) Is registered with the Drug Enforcement Administration at a

location outside this state.

4. The board may waive the requirement for registration of certain

dispensers if it finds it consistent with the public health and safety.

5. A separate registration is required at each principal place of business

or professional practice where the applicant dispenses controlled

substances.

6. The board may inspect the establishment of a registrant or applicant

for registration in accordance with the board’s regulations.

Sec. 68. NRS 453.336 is hereby amended to read as follows:

453.336 1. A person shall not knowingly or intentionally possess a

controlled substance, unless the substance was obtained directly from, or

pursuant to, a prescription or order of a physician, osteopathic physician’s

assistant, physician assistant, dentist, podiatric physician, optometrist or

veterinarian while acting in the course of his professional practice, or

except as otherwise authorized by the provisions of NRS 453.011 to

453.552, inclusive.

2. Except as otherwise provided in subsections 3, 4 and 5 and in NRS

453.3363, and unless a greater penalty is provided in NRS 212.160,

453.3385, 453.339 or 453.3395, a person who violates this section shall be

punished:

(a) For the first or second offense, if the controlled substance is listed in

schedule I, II, III or IV, for a category E felony as provided in

NRS 193.130.

(b) For a third or subsequent offense, if the controlled substance is listed

in schedule I, II, III or IV, or if the offender has previously been convicted

two or more times in the aggregate of any violation of the law of the

United States or of any state, territory or district relating to a controlled

substance, for a category D felony as provided in NRS 193.130, and may

be further punished by a fine of not more than $20,000.

V, for a category E felony as provided in NRS 193.130.

(d) For a second or subsequent offense, if the controlled substance is

listed in schedule V, for a category D felony as provided in NRS 193.130.

3. Unless a greater penalty is provided in NRS 212.160, 453.337 or

453.3385, a person who is convicted of the possession of flunitrazepam or

gamma-hydroxybutyrate, or any substance for which flunitrazepam or

gamma-hydroxybutyrate is an immediate precursor, is guilty of a

category B felony and shall be punished by imprisonment in the state

prison for a minimum term of not less than 1 year and a maximum term of

not more than 6 years.

4. Unless a greater penalty is provided in NRS 212.160, a person who

is less than 21 years of age and is convicted of the possession of less than

1 ounce of marijuana:

(a) For the first and second offense, is guilty of a category E felony and

shall be punished as provided in NRS 193.130.

(b) For a third or subsequent offense, is guilty of a category D felony

and shall be punished as provided in NRS 193.130, and may be further

punished by a fine of not more than $20,000.

5. Before sentencing under the provisions of subsection 4 for a first

offense, the court shall require the parole and probation officer to submit a

presentencing report on the person convicted in accordance with the

provisions of NRS 176A.200. After the report is received but before

sentence is pronounced the court shall:

(a) Interview the person convicted and make a determination as to the

possibility of his rehabilitation; and

(b) Conduct a hearing at which evidence may be presented as to the

possibility of rehabilitation and any other relevant information.

6. As used in this section, “controlled substance” includes

flunitrazepam, gamma-hydroxybutyrate and each substance for which

flunitrazepam or gamma-hydroxybutyrate is an immediate precursor.

Sec. 69. NRS 453.371 is hereby amended to read as follows:

453.371 As used in NRS 453.371 to 453.552, inclusive:

1. “Medical intern” means a medical graduate acting as an assistant in

a hospital for the purpose of clinical training.

2. “Physician,” [“physician’s] “physician assistant,” “dentist,”

“podiatric physician,” “veterinarian,” “pharmacist” and “euthanasia

technician” mean persons authorized by a valid license to practice their

respective professions in this state who are registered with the board.

Sec. 70. NRS 453.375 is hereby amended to read as follows:

453.375 A controlled substance may be possessed and administered by

the following persons:

1. A practitioner.

2. A registered nurse licensed to practice professional nursing or

licensed practical nurse, at the direction of a physician, [physician’s]

physician assistant, dentist, podiatric physician or advanced practitioner of

nursing, or pursuant to a chart order, for administration to a patient at

another location.

3. An advanced emergency medical technician:

(a) As authorized by regulation of:

(1) The state board of health in a county whose population is less

than 100,000; or

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

is 100,000 or more; and

(b) In accordance with any applicable regulations of:

(1) The state board of health in a county whose population is less

than 100,000;

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

or more; or

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

county.

4. A respiratory therapist, at the direction of a physician or

[physician’s] physician assistant.

5. A medical student, student in training to become a [physician’s]

physician assistant or student nurse in the course of his studies at an

approved college of medicine or school of professional or practical

nursing, at the direction of a physician or [physician’s] physician assistant

and:

(a) In the presence of a physician, [physician’s] physician assistant or a

registered nurse; or

(b) Under the supervision of a physician, [physician’s] physician

assistant or a registered nurse if the student is authorized by the college or

school to administer the substance outside the presence of a physician,

[physician’s] physician assistant or nurse.

A medical student or student nurse may administer a controlled substance

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

the circumstances are such that the registered nurse would be authorized to

administer it personally.

6. An ultimate user or any person whom the ultimate user designates

pursuant to a written agreement.

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

8. A veterinary technician at the direction of his supervising

veterinarian.

9. In accordance with applicable regulations of the state board of

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

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

10. In accordance with applicable regulations of the state board of

pharmacy, an animal control officer, a wildlife biologist or an employee

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

include the control of domestic, wild and predatory animals.

Sec. 71. NRS 453.381 is hereby amended to read as follows:

453.381 1. In addition to the limitations imposed by NRS 453.256, a

physician, [physician’s] physician assistant, dentist or podiatric physician

may prescribe or administer controlled substances only for a legitimate

medical purpose and in the usual course of his professional practice, and

he shall not prescribe, administer or dispense a controlled substance listed

in schedule II for himself, his spouse or his children except in cases of

emergency.

2. A veterinarian, in the course of his professional practice only, and

not for use by a human being, may prescribe, possess and administer

controlled substances, and he may cause them to be administered by a

veterinary technician under his direction and supervision.

3. A euthanasia technician, within the scope of his license, and not for

use by a human being, may possess and administer sodium pentobarbital.

4. A pharmacist shall not fill an order which purports to be a

prescription if he has reason to believe that it was not issued in the usual

course of the professional practice of a physician, [physician’s] physician

assistant, dentist, podiatric physician or veterinarian.

5. Any person who has obtained from a physician, [physician’s]

physician assistant, dentist, podiatric physician or veterinarian any

controlled substance for administration to a patient during the absence of

the physician, [physician’s] physician assistant, dentist, podiatric

physician or veterinarian shall return to him any unused portion of the

substance when it is no longer required by the patient.

6. A manufacturer, wholesale supplier or other person legally able to

furnish or sell any controlled substance listed in schedule II shall not

provide samples of such a controlled substance to registrants.

7. A salesman of any manufacturer or wholesaler of pharmaceuticals

shall not possess, transport or furnish any controlled substance listed in

schedule II.

8. A person shall not dispense a controlled substance in violation of a

regulation adopted by the board.

Sec. 72. NRS 453.391 is hereby amended to read as follows:

453.391 A person shall not:

1. Unlawfully take, obtain or attempt to take or obtain a controlled

substance or a prescription for a controlled substance from a manufacturer,

wholesaler, pharmacist, physician, [physician’s] physician assistant,

dentist, veterinarian or any other person authorized to administer, dispense

or possess controlled substances.

2. While undergoing treatment and being supplied with any controlled

substance or a prescription for any controlled substance from one

practitioner, knowingly obtain any controlled substance or a prescription

for a controlled substance from another practitioner without disclosing this

fact to the second practitioner.

Sec. 73. NRS 454.00958 is hereby amended to read as follows:

454.00958 “Practitioner” means:

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

valid license to practice his profession in this state.

2. A pharmacy, hospital or other institution licensed or registered to

distribute, dispense, conduct research with respect to or to administer a

dangerous drug in the course of professional practice in this state.

3. When relating to the prescription of poisons, dangerous drugs and

devices:

(a) An advanced practitioner of nursing who holds a certificate from the

state board of nursing and a certificate from the state board of pharmacy

permitting him so to prescribe; or

(b) A [physician’s] physician assistant who holds a license from the

[state] board of medical examiners and a certificate from the state board of

pharmacy permitting him so to prescribe.

4. An optometrist who is certified to prescribe and administer

dangerous drugs pursuant to NRS 636.288 when he prescribes or

administers dangerous drugs which are within the scope of his

certification.

Sec. 74. NRS 454.213 is hereby amended to read as follows:

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

inclusive, may be possessed and administered by:

1. A practitioner.

2. A [physician’s] physician assistant at the direction of his

supervising physician or a licensed dental hygienist acting in the office of

and under the supervision of a dentist.

3. Except as otherwise provided in subsection 4, a registered nurse

licensed to practice professional nursing or licensed practical nurse, at the

direction of a prescribing physician, dentist, podiatric physician or

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

administration to a patient at another location.

4. In accordance with applicable regulations of the board, a registered

nurse licensed to practice professional nursing or licensed practical nurse

who is:

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

authorized to provide emergency care, or to respond to the immediate

needs of a patient, in the residence of the patient; and

(b) Acting under the direction of the medical director of that agency or

facility who works in this state.

5. An intermediate emergency medical technician or an advanced

emergency medical technician, as authorized by regulation of the state

board of pharmacy and in accordance with any applicable regulations of:

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

100,000;

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

more; or

county.

6. A respiratory therapist employed in a health care facility. The

therapist may possess and administer respiratory products only at the

direction of a physician.

7. A dialysis technician, under the direction or supervision of a

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

process of renal dialysis.

8. A medical student or student nurse in the course of his studies at an

approved college of medicine or school of professional or practical

nursing, at the direction of a physician and:

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

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

student is authorized by the college or school to administer the drug or

medicine outside the presence of a physician or nurse.

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

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

circumstances are such that the registered nurse would be authorized to

administer it personally.

9. Any person designated by the head of a correctional institution.

10. An ultimate user or any person designated by the ultimate user

pursuant to a written agreement.

11. A nuclear medicine technologist, at the direction of a physician

and in accordance with any conditions established by regulation of the

board.

12. A radiologic technologist, at the direction of a physician and in

accordance with any conditions established by regulation of the board.

13. A chiropractic physician, but only if the drug or medicine is a

topical drug used for cooling and stretching external tissue during

therapeutic treatments.

14. A physical therapist, but only if the drug or medicine is a topical

drug which is:

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

treatments; and

(b) Prescribed by a licensed physician for:

(1) Iontophoresis; or

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

15. In accordance with applicable regulations of the state board of

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

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

16. A veterinary technician at the direction of his supervising

veterinarian.

17. In accordance with applicable regulations of the board, a registered

pharmacist who:

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

immunization programs;

(b) Is authorized to administer immunizations pursuant to written

protocols from a physician; and

Immunization Practices” recommended and approved by the United States

Public Health Service Advisory Committee on Immunization Practices.

Sec. 75. NRS 454.215 is hereby amended to read as follows:

454.215 A dangerous drug may be dispensed by:

1. A registered pharmacist upon the legal prescription from a

practitioner or to a pharmacy in a correctional institution upon the written

order of the prescribing practitioner in charge;

2. A pharmacy in a correctional institution, in case of emergency, upon

a written order signed by the chief medical officer;

3. A practitioner, or a [physician’s] physician assistant if authorized by

the board;

4. A registered nurse, when the nurse is engaged in the performance of

any public health program approved by the board;

5. A medical intern in the course of his internship;

6. An advanced practitioner of nursing who holds a certificate from the

state board of nursing and a certificate from the state board of pharmacy

permitting him to dispense dangerous drugs;

7. A registered nurse employed at an institution of the department of

prisons to an offender in that institution; or

8. A registered pharmacist from an institutional pharmacy pursuant to

regulations adopted by the board,

except that no person may dispense a dangerous drug in violation of a

regulation adopted by the board.

Sec. 76. NRS 454.221 is hereby amended to read as follows:

454.221 1. A person who furnishes any dangerous drug except upon

the prescription of a practitioner is guilty of a category D felony and shall

be punished as provided in NRS 193.130, unless the dangerous drug was

obtained originally by a legal prescription.

2. The provisions of this section do not apply to the furnishing of any

dangerous drug by:

(a) A practitioner to his patients;

(b) A [physician’s] physician assistant if authorized by the board;

approved by the board, or an advanced practitioner of nursing who holds a

certificate from the state board of nursing and a certificate from the state

board of pharmacy permitting him to dispense dangerous drugs;

(d) A manufacturer or wholesaler or pharmacy to each other or to a

practitioner or to a laboratory under records of sales and purchases that

correctly give the date, the names and addresses of the supplier and the

buyer, the drug and its quantity;

(e) A hospital pharmacy or a pharmacy so designated by a county health

officer in a county whose population is 100,000 or more, or by a district

health officer in any county within its jurisdiction or, in the absence of

either, by the state health officer or his designated medical director of

emergency medical services, to a person or agency described in subsection

3 of NRS 639.268 to stock ambulances or other authorized vehicles or

replenish the stock; or

(f) A pharmacy in a correctional institution to a person designated by

the director of the department of prisons to administer a lethal injection to

a person who has been sentenced to death.

Sec. 77. NRS 484.393 is hereby amended to read as follows:

484.393 1. The results of any blood test administered under the

provisions of NRS 484.383 or 484.391 are not admissible in any hearing

or criminal action arising out of acts alleged to have been committed by a

person who was driving or in actual physical control of a vehicle while

under the influence of intoxicating liquor or a controlled substance or who

was engaging in any other conduct prohibited by NRS 484.379 or

484.3795 unless:

(a) The blood tested was withdrawn by a physician, [physician’s]

physician assistant, registered nurse, licensed practical nurse, emergency

medical technician or a technician, technologist or assistant employed in a

medical laboratory;

(b) The test was performed on whole blood, except if the sample was

clotted when it was received by the laboratory, the test may be performed

on blood serum or plasma; and

appropriate medical licensing or certifying agency.

2. The limitation contained in paragraph (a) of subsection 1 does not

apply to the taking of a chemical test of the urine, breath or other bodily

substance.

3. No person listed in paragraph (a) of subsection 1 incurs any civil or

criminal liability as a result of the administering of a blood test when

requested by a police officer or the person to be tested to administer the

test.

Sec. 78. Section 1 of Assembly Bill No. 78 of this session is hereby

amended to read as follows:

Section 1. NRS 632.017 is hereby amended to read as follows:

632.017 “Practice of practical nursing” means the performance of

selected acts in the care of the ill, injured or infirm under the

direction of a registered professional nurse, an advanced practitioner

of nursing, a licensed physician, a licensed physician assistant, a

licensed dentist or a licensed podiatric physician, not requiring the

substantial specialized skill, judgment and knowledge required in

professional nursing.

Sec. 79. Section 2 of Assembly Bill No. 78 of this session is hereby

amended to read as follows:

Sec. 2. NRS 632.018 is hereby amended to read as follows:

632.018 “Practice of professional nursing” means the

performance of any act in the observation, care and counsel of the ill,

injured or infirm, in the maintenance of health or prevention of illness

of others, in the supervision and teaching of other personnel, in the

administration of medications and treatments as prescribed by an

advanced practitioner of nursing, a licensed physician, a licensed

physician assistant, a licensed dentist or a licensed podiatric

physician, requiring substantial specialized judgment and skill based

on knowledge and application of the principles of biological, physical

and social science, but does not include acts of medical diagnosis or

prescription of therapeutic or corrective measures.

Sec. 80. Section 3 of Assembly Bill No. 78 of this session is hereby

amended to read as follows:

Sec. 3. NRS 454.213 is hereby amended to read as follows:

454.213 A drug or medicine referred to in NRS 454.181 to

454.371, inclusive, may be possessed and administered by:

1. A practitioner.

2. A physician assistant at the direction of his supervising

physician or a licensed dental hygienist acting in the office of and

under the supervision of a dentist.

3. Except as otherwise provided in subsection 4, a registered

nurse licensed to practice professional nursing or licensed practical

nurse, at the direction of a prescribing physician, physician assistant,

dentist, podiatric physician or advanced practitioner of nursing, or

pursuant to a chart order, for administration to a patient at another

location.

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

registered nurse licensed to practice professional nursing or licensed

practical nurse who is:

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

authorized to provide emergency care, or to respond to the immediate

needs of a patient, in the residence of the patient; and

(b) Acting under the direction of the medical director of that

agency or facility who works in this state.

5. An intermediate emergency medical technician or an advanced

emergency medical technician, as authorized by regulation of the state

board of pharmacy and in accordance with any applicable regulations

of:

(a) The state board of health in a county whose population is less

than 100,000;

(b) A county board of health in a county whose population is

100,000 or more; or

any county.

6. A respiratory therapist employed in a health care facility. The

therapist may possess and administer respiratory products only at the

direction of a physician.

7. A dialysis technician, under the direction or supervision of a

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

the process of renal dialysis.

8. A medical student or student nurse in the course of his studies

at an approved college of medicine or school of professional or

practical nursing, at the direction of a physician and:

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

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

student is authorized by the college or school to administer the drug

or medicine outside the presence of a physician or nurse.

A medical student or student nurse may administer a dangerous drug

in the presence or under the supervision of a registered nurse alone

only if the circumstances are such that the registered nurse would be

authorized to administer it personally.

9. Any person designated by the head of a correctional institution.

10. An ultimate user or any person designated by the ultimate

user pursuant to a written agreement.

11. A nuclear medicine technologist, at the direction of a

physician and in accordance with any conditions established by

regulation of the board.

12. A radiologic technologist, at the direction of a physician and

in accordance with any conditions established by regulation of the

board.

13. A chiropractic physician, but only if the drug or medicine is a

topical drug used for cooling and stretching external tissue during

therapeutic treatments.

14. A physical therapist, but only if the drug or medicine is a

topical drug which is:

(a) Used for cooling and stretching external tissue during

therapeutic treatments; and

(b) Prescribed by a licensed physician for:

(1) Iontophoresis; or

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

15. In accordance with applicable regulations of the state board of

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

NRS 449.017, pursuant to a written agreement entered into by the

ultimate user.

16. A veterinary technician at the direction of his supervising

veterinarian.

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

registered pharmacist who:

(a) Is trained in and certified to carry out standards and practices

for immunization programs;

(b) Is authorized to administer immunizations pursuant to written

protocols from a physician; and

of Immunization Practices” recommended and approved by the

United States Public Health Service Advisory Committee on

Immunization Practices.

Sec. 81. Section 2 of Senate Bill No. 52 of this session is hereby

amended to read as follows:

Sec. 2. NRS 639.0125 is hereby amended to read as follows:

639.0125 “Practitioner” means:

1. A physician, dentist, veterinarian or podiatric physician who

holds a [valid] license to practice his profession in this state;

2. A hospital, pharmacy or other institution licensed, registered or

otherwise permitted to distribute, dispense, conduct research with

respect to or administer drugs in the course of professional practice or

research in this state;

3. An advanced practitioner of nursing who has been authorized

to prescribe controlled substances, poisons, dangerous drugs and

devices; or

4. A physician assistant who:

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

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

dispense controlled substances, poisons, dangerous drugs or devices

under the supervision of a physician as required by chapter 630 of

NRS.

5. An osteopathic physician’s assistant who:

(a) Holds a certificate issued by the state board of osteopathic

medicine; and

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

dispense controlled substances, poisons, dangerous drugs or devices

under the supervision of an osteopathic physician as required by

chapter 633 of NRS.

Sec. 82. Section 4 of Senate Bill No. 52 of this session is hereby

amended to read as follows:

Sec. 4. NRS 453.038 is hereby amended to read as follows:

453.038 “Chart order” means an order entered on the chart of a

patient:

1. In a hospital, facility for intermediate care or facility for skilled

nursing which is licensed as such by the health division of the

department; or

2. Under emergency treatment in a hospital by a physician,

advanced practitioner of nursing, dentist or podiatric physician, or on

the written or oral order of a physician, physician assistant, advanced

practitioner of nursing, dentist or podiatric physician authorizing the

administration of a drug to the patient.

Sec. 83. Section 5 of Senate Bill No. 52 of this session is hereby

amended to read as follows:

Sec. 5. NRS 453.091 is hereby amended to read as follows:

453.091 1. “Manufacture” means the production, preparation,

propagation, compounding, conversion or processing of a substance,

either directly or indirectly by extraction from substances of natural

origin, or independently by means of chemical synthesis, or by a

combination of extraction and chemical synthesis, and includes any

packaging or repackaging of the substance or labeling or relabeling of

its container.

2. “Manufacture” does not include the preparation or

compounding of a substance by a person for his own use or the

preparation, compounding, packaging or labeling of a substance by a

physician, physician assistant, dentist, podiatric physician , advanced

practitioner of nursing or veterinarian:

(a) As an incident to his administering or dispensing of a substance

in the course of his professional practice; or

(b) By his authorized agent under his supervision, for the purpose

of, or as an incident to, research, teaching or chemical analysis and

not for sale.

Sec. 84. Section 6 of Senate Bill No. 52 of this session is hereby

amended to read as follows:

Sec. 6. NRS 453.126 is hereby amended to read as follows:

453.126 “Practitioner” means:

1. A physician, dentist, veterinarian or podiatric physician who

holds a license to practice his profession in this state and is registered

pursuant to this chapter.

2. An advanced practitioner of nursing who holds a certificate

from the state board of nursing and a certificate from the state board

of pharmacy authorizing him to dispense or to prescribe and

dispense controlled substances.

3. A scientific investigator or a pharmacy, hospital or other

institution licensed, registered or otherwise authorized in this state to

distribute, dispense, conduct research with respect to, to administer,

or use in teaching or chemical analysis, a controlled substance in the

course of professional practice or research.

4. A euthanasia technician who is licensed by the Nevada state

board of veterinary medical examiners and registered pursuant to this

chapter, while he possesses or administers sodium pentobarbital

pursuant to his license and registration.

5. A physician assistant who:

(a) Holds a license from the board of medical examiners; and

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

dispense controlled substances under the supervision of a physician

as required by chapter 630 of NRS.

6. An osteopathic physician’s assistant who:

(a) Holds a certificate from the state board of osteopathic

medicine; and

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

dispense controlled substances under the supervision of an

osteopathic physician as required by chapter 633 of NRS.

7. An optometrist who is certified by the Nevada state board of

optometry to prescribe and administer therapeutic pharmaceutical

agents pursuant to NRS 636.288, when he prescribes or administers

therapeutic pharmaceutical agents within the scope of his

certification.

Sec. 85. Section 7 of Senate Bill No. 52 of this session is hereby

amended to read as follows:

Sec. 7. NRS 453.128 is hereby amended to read as follows:

453.128 1. “Prescription” means:

(a) An order given individually for the person for whom

prescribed, directly from a physician, osteopathic physician’s

assistant, physician assistant, dentist, podiatric physician, optometrist

, advanced practitioner of nursing or veterinarian, or his agent, to a

pharmacist or indirectly by means of an order signed by the

practitioner or an electronic transmission from the practitioner to a

pharmacist; or

(b) A chart order written for an inpatient specifying drugs which he

is to take home upon his discharge.

2. The term does not include a chart order written for an inpatient

for use while he is an inpatient.

Sec. 86. Section 8 of Senate Bill No. 52 of this session is hereby

amended to read as follows:

Sec. 8. NRS 453.226 is hereby amended to read as follows:

453.226 1. Every practitioner or other person who dispenses

any controlled substance within this state or who proposes to engage

in the dispensing of any controlled substance within this state shall

obtain biennially a registration issued by the board in accordance

with its regulations.

2. A person registered by the board in accordance with the

provisions of NRS 453.011 to 453.552, inclusive, to dispense or

conduct research with controlled substances may possess, dispense or

conduct research with those substances to the extent authorized by

the registration and in conformity with the other provisions of those

sections.

3. The following persons are not required to register and may

lawfully possess and distribute controlled substances pursuant to the

provisions of NRS 453.011 to 453.552, inclusive:

(a) An agent or employee of a registered dispenser of a controlled

substance if he is acting in the usual course of his business or

employment;

(b) A common or contract carrier or warehouseman, or an

employee thereof, whose possession of any controlled substance is in

the usual course of business or employment;

substance pursuant to a lawful order of a physician, osteopathic

physician’s assistant, physician assistant, dentist, advanced

practitioner of nursing, podiatric physician or veterinarian or in

lawful possession of a schedule V substance; or

(d) A physician who:

(1) Holds a locum tenens license issued by the board of medical

examiners or a temporary license issued by the state board of

osteopathic medicine; and

(2) Is registered with the Drug Enforcement Administration at a

location outside this state.

4. The board may waive the requirement for registration of

certain dispensers if it finds it consistent with the public health and

safety.

5. A separate registration is required at each principal place of

business or professional practice where the applicant dispenses

controlled substances.

6. The board may inspect the establishment of a registrant or

applicant for registration in accordance with the board’s regulations.

Sec. 87. Section 9 of Senate Bill No. 52 of this session is hereby

amended to read as follows:

Sec. 9. NRS 453.336 is hereby amended to read as follows:

453.336 1. A person shall not knowingly or intentionally

possess a controlled substance, unless the substance was obtained

directly from, or pursuant to, a prescription or order of a physician,

osteopathic physician’s assistant, physician assistant, dentist,

podiatric physician, optometrist , advanced practitioner of nursing

or veterinarian while acting in the course of his professional practice,

or except as otherwise authorized by the provisions of NRS 453.011

to 453.552, inclusive.

2. Except as otherwise provided in subsections 3, 4 and 5 and in

NRS 453.3363, and unless a greater penalty is provided in NRS

212.160, 453.3385, 453.339 or 453.3395, a person who violates this

section shall be punished:

(a) For the first or second offense, if the controlled substance is

listed in schedule I, II, III or IV, for a category E felony as provided

in NRS 193.130.

(b) For a third or subsequent offense, if the controlled substance is

listed in schedule I, II, III or IV, or if the offender has previously

been convicted two or more times in the aggregate of any violation of

the law of the United States or of any state, territory or district

relating to a controlled substance, for a category D felony as provided

in NRS 193.130, and may be further punished by a fine of not more

than $20,000.

schedule V, for a category E felony as provided in NRS 193.130.

(d) For a second or subsequent offense, if the controlled substance

is listed in schedule V, for a category D felony as provided in NRS

193.130.

3. Unless a greater penalty is provided in NRS 212.160, 453.337

or 453.3385, a person who is convicted of the possession of

flunitrazepam or gamma-hydroxybutyrate, or any substance for

which

flunitrazepam or gamma-hydroxybutyrate is an immediate precursor,

is guilty of a category B felony and shall be punished by

imprisonment in the state prison for a minimum term of not less than

1 year and a maximum term of not more than 6 years.

4. Unless a greater penalty is provided in NRS 212.160, a person

who is less than 21 years of age and is convicted of the possession of

less than 1 ounce of marijuana:

(a) For the first and second offense, is guilty of a category E felony

and shall be punished as provided in NRS 193.130.

(b) For a third or subsequent offense, is guilty of a category D

felony and shall be punished as provided in NRS 193.130, and may

be further punished by a fine of not more than $20,000.

5. Before sentencing under the provisions of subsection 4 for a

first offense, the court shall require the parole and probation officer to

submit a presentencing report on the person convicted in accordance

with the provisions of NRS 176A.200. After the report is received but

before sentence is pronounced the court shall:

(a) Interview the person convicted and make a determination as to

the possibility of his rehabilitation; and

(b) Conduct a hearing at which evidence may be presented as to

the possibility of rehabilitation and any other relevant information.

6. As used in this section, “controlled substance” includes

flunitrazepam, gamma-hydroxybutyrate and each substance for which

flunitrazepam or gamma-hydroxybutyrate is an immediate precursor.

Sec. 88. Section 10 of Senate Bill No. 52 of this session is hereby

amended to read as follows:

Sec. 10. NRS 453.371 is hereby amended to read as follows:

453.371 As used in NRS 453.371 to 453.552, inclusive:

1. “Advanced practitioner of nursing” means a person who

holds a certificate of recognition granted pursuant to NRS 632.237

and is registered with the board.

2. “Medical intern” means a medical graduate acting as an

assistant in a hospital for the purpose of clinical training.

[2. “Physician,” “physician assistant,”]

3. “Pharmacist” means a person who holds a certificate of

registration issued pursuant to NRS 639.127 and is registered with

the board.

4. “Physician,” “dentist,” “podiatric physician,” [“veterinarian,”

“pharmacist”] “veterinarian” and “euthanasia technician” mean

persons authorized by a [valid] license to practice their respective

professions in this state who are registered with the board.

5. “Physician assistant” means a person who is registered with

the board and:

(a) Holds a license issued pursuant to NRS 630.273; or

(b) Holds a certificate issued pursuant to NRS 633.451.

Sec. 89. Section 12 of Senate Bill No. 52 of this session is hereby

amended to read as follows:

Sec. 12. NRS 453.381 is hereby amended to read as follows:

453.381 1. In addition to the limitations imposed by NRS

453.256, a physician, physician assistant, dentist , advanced

practitioner of nursing or podiatric physician may prescribe or

administer controlled substances only for a legitimate medical

purpose and in the usual course of his professional practice, and he

shall not prescribe, administer or dispense a controlled substance

listed in schedule II for himself, his spouse or his children except in

cases of emergency.

2. A veterinarian, in the course of his professional practice only,

and not for use by a human being, may prescribe, possess and

administer controlled substances, and he may cause them to be

administered by a veterinary technician under his direction and

supervision.

3. A euthanasia technician, within the scope of his license, and

not for use by a human being, may possess and administer sodium

pentobarbital.

4. A pharmacist shall not fill an order which purports to be a

prescription if he has reason to believe that it was not issued in the

usual course of the professional practice of a physician, physician

assistant, dentist, advanced practitioner of nursing, podiatric

physician or veterinarian.

5. Any person who has obtained from a physician, physician

assistant, dentist, advanced practitioner of nursing, podiatric

physician or veterinarian any controlled substance for administration

to a patient during the absence of the physician, physician assistant,

dentist, advanced practitioner of nursing, podiatric physician or

veterinarian shall return to him any unused portion of the substance

when it is no longer required by the patient.

6. A manufacturer, wholesale supplier or other person legally able

to furnish or sell any controlled substance listed in schedule II shall

not provide samples of such a controlled substance to registrants.

7. A salesman of any manufacturer or wholesaler of

pharmaceuticals shall not possess, transport or furnish any controlled

substance listed in schedule II.

8. A person shall not dispense a controlled substance in violation

of a regulation adopted by the board.

Sec. 90. Section 13 of Senate Bill No. 52 of this session is hereby

amended to read as follows:

Sec. 13. NRS 453.391 is hereby amended to read as follows:

453.391 A person shall not:

1. Unlawfully take, obtain or attempt to take or obtain a

controlled substance or a prescription for a controlled substance from

a manufacturer, wholesaler, pharmacist, physician, physician

assistant, dentist, advanced practitioner of nursing, veterinarian or

any other person authorized to administer, dispense or possess

controlled substances.

2. While undergoing treatment and being supplied with any

controlled substance or a prescription for any controlled substance

from one practitioner, knowingly obtain any controlled substance or a

prescription for a controlled substance from another practitioner

without disclosing this fact to the second practitioner.

Sec. 91. 1. NRS 630.272, 630.274, 640B.010, 640B.020, 640B.030,

640B.040, 640B.050, 640B.080, 640B.100, 640B.110 and 640B.150 are

hereby repealed.

2. NRS 630.256 is hereby repealed.

Sec. 92. A person who, on July 1, 2001, holds a license as a

physician’s assistant issued by the board of medical examiners shall be

deemed to hold a license as a physician assistant until his license as a

physician’s assistant is renewed as a license as a physician assistant,

expires or is revoked, whichever occurs first.

Sec. 93. Notwithstanding the amendatory provisions of section 44 of

this act to the contrary, a practitioner of respiratory care who, on July 1,

2001, is certified to practice respiratory care in this state pursuant to

chapter 640B of NRS may continue to practice respiratory care in this

state pursuant to the certification, but must obtain a license from the board

of medical examiners before January 1, 2002. On and after January 1,

2002, a person shall not practice respiratory care in this state unless he

holds a license issued by the board of medical examiners.

Sec. 94. 1. This section becomes effective upon passage and

approval.

2. Sections 1 to 90, inclusive, subsection 1 of section 91 and sections

92, 93 and 95 of this act become effective upon passage and approval for

the purpose of adopting regulations and taking such other actions as

necessary to regulate practitioners of respiratory care, and on July 1, 2001,

for all other purposes.

3. Subsection 2 of section 91 of this act becomes effective at 12:01

a.m. on July 1, 2001.

4. The amendatory provisions of sections 8, 19, 24, 26 and 41 of this

act expire by limitation on the date on which the provisions of 42 U.S.C. §

666 requiring each state to establish procedures under which the state has

authority to withhold or suspend, or to restrict the use of professional,

occupational and recreational licenses of persons who:

(a) Have failed to comply with a subpoena or warrant relating to a

proceeding to determine the paternity of a child or to establish or enforce

an obligation for the support of a child; or

(b) Are in arrears in the payment for the support of one or more

children,

are repealed by the Congress of the United States.

Sec. 95. 1. Except as otherwise provided in subsection 2, the

legislative counsel shall:

(a) In preparing the reprint and supplements to the Nevada Revised

Statutes, appropriately change any references to physician’s assistant or

any variation thereof, to physician assistant, or any appropriate variation

thereof.

(b) In preparing supplements to the Nevada Administrative Code,

appropriately change any references to physician’s assistant or any

variation thereof, to physician assistant, or any appropriate variation

thereof.

2. The legislative counsel shall not, pursuant to subsection 1, change

any references to osteopathic physician’s assistant or any variation thereof

that appear in the Nevada Revised Statutes or the Nevada Administrative

Code.

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