SB82_R1

Senate Bill No. 82–Committee on Human
Resources and Facilities

(On Behalf of the Legislative Committee on
Health Care (NRS 439B.200))

February 11, 2003

____________

Referred to Committee on Human Resources and Facilities

SUMMARY—Makes various changes concerning public health laws. (BDR 40‑677)

FISCAL NOTE: Effect on Local Government: Yes.

Effect on the State: Yes.

EXPLANATION – Matter in bolded italics is new; matter between brackets [~~omitted material]~~ is material to be omitted.

Green numbers along left margin indicate location on the printed bill (e.g., 5-15 indicates page 5, line 15).

AN ACT relating to public health; establishing procedures for the isolation or quarantine of a person with a communicable disease; authorizing public health officials to isolate and quarantine a group of persons; requiring the State Board of Health to develop a syndromic reporting and active surveillance system for monitoring public health; expanding the exclusive jurisdiction of the family court to include proceedings for an involuntary court-ordered isolation or quarantine; and providing other matters properly relating thereto.

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN

SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

1-1 Section 1. NRS 439.360 is hereby amended to read as follows:

1-2 439.360 The county board of health may:

1-3 1. Abate nuisances in accordance with law.

1-4 2. Establish and maintain an isolation hospital or quarantine

1-5 station when necessary[.] for the isolation or quarantine of a

1-6 person or a group of persons.

2-1 3. Restrain, quarantine and disinfect any person or group of

2-2 persons sick with or exposed to any contagious or infectious disease

2-3 that is dangerous to the public health.

2-4 4. Appoint quarantine officers when necessary to enforce a

2-5 quarantine, shall provide whatever medicines, disinfectants and

2-6 provisions which may be required, and shall arrange for the payment

2-7 of all debts or charges so incurred from any funds available, but

2-8 each patient shall, if he is able, pay for his food, medicine, clothes

2-9 and medical attendance.

2-10 5. Subject to the prior review and approval of the board of

2-11 county commissioners and except as otherwise provided in NRS

2-12 576.128, adopt a schedule of reasonable fees to be collected for

2-13 issuing or renewing any health permit or license required to be

2-14 obtained from the board pursuant to a law of this state or an

2-15 ordinance adopted by any political subdivision of this state. Such

2-16 fees must be for the sole purpose of defraying the costs and

2-17 expenses of the procedures for issuing licenses and permits, and

2-18 investigations related thereto, and not for the purposes of general

2-19 revenue.

2-20 Sec. 2. NRS 439.470 is hereby amended to read as follows:

2-21 439.470 The city board of health may:

2-22 1. Abate nuisances in accordance with law.

2-23 2. Establish a temporary isolation hospital or quarantine station

2-24 when an emergency demands[.] the isolation or quarantine of a

2-25 person or a group of persons.

2-26 3. Restrain, quarantine and disinfect any person or group of

2-27 persons sick with or exposed to any contagious or infectious disease

2-28 which is dangerous to the public health.

2-29 4. Appoint quarantine officers when necessary to enforce a

2-30 quarantine, and shall provide whatever medicines, disinfectants and

2-31 provisions which may be required. The city council shall pay all

2-32 debts or charges so incurred , [;] but each patient shall, if able, pay

2-33 for his food, medicine, clothes and medical attendance.

2-34 5. Subject to the prior review and approval of the governing

2-35 body of the city and except as otherwise provided in NRS 576.128,

2-36 adopt a schedule of reasonable fees to be collected for issuing or

2-37 renewing any health permit or license required to be obtained from

2-38 such board pursuant to state law or an ordinance adopted by any

2-39 political subdivision. Such fees must be for the sole purpose of

2-40 defraying the costs and expenses of the procedures for issuing

2-41 licenses and permits, and investigations related thereto, and not for

2-42 the purposes of general revenue.

3-1 Sec. 3. Chapter 441A of NRS is hereby amended by adding

3-2 thereto the provisions set forth as sections 4 to 27, inclusive, of this

3-3 act.

3-4 Sec. 4. “Isolation” means the physical separation and

3-5 confinement of a person or a group of persons infected or

3-6 reasonably believed by a health authority to be infected with a

3-7 communicable disease from persons who are not infected with and

3-8 have not been exposed to the communicable disease, to limit the

3-9 transmission of the communicable disease to persons who are not

3-10 infected with and have not been exposed to the communicable

3-11 disease.

3-12 Sec. 5. “Quarantine” means the physical separation and

3-13 confinement of a person or a group of persons exposed to or

3-14 reasonably believed by a health authority to have been exposed to

3-15 a communicable disease who do not yet show any signs or

3-16 symptoms of being infected with the communicable disease from

3-17 persons who are not infected with and have not been exposed to

3-18 the communicable disease, to limit the transmission of the

3-19 communicable disease to persons who are not infected with and

3-20 have not been exposed to the communicable disease.

3-21 Sec. 6. As used in sections 6 to 26, inclusive, of this act,

3-22 unless the context otherwise requires, “health authority” means:

3-23 1. The officers and agents of the Health Division;

3-24 2. The officers and agents of a health district; or

3-25 3. The district health officer in a district, or his designee, or,

3-26 if none, the State Health Officer, or his designee.

3-27 Sec. 7. If a health authority isolates or quarantines a person

3-28 or group of persons infected with, exposed to, or reasonably

3-29 believed by a health authority to have been infected with or

3-30 exposed to a communicable disease, the authority must isolate or

3-31 quarantine the person or group of persons in the manner set forth

3-32 in sections 6 to 26, inclusive, of this act.

3-33 Sec. 7.5. A person who is isolated or quarantined pursuant to

3-34 sections 6 to 26, inclusive, of this act has the right:

3-35 1. To make a reasonable number of completed telephone calls

3-36 from the place where he is isolated or quarantined as soon as

3-37 reasonably possible after his isolation or quarantine; and

3-38 2. To possess and use a cellular phone or any other similar

3-39 means of communication to make and receive calls in the place

3-40 where he is isolated or quarantined.

3-41 Sec. 8. 1. If a person infected with or exposed to a

3-42 communicable disease is voluntarily isolated or quarantined in a

3-43 public or private medical facility, the facility shall not change the

3-44 status of the person to an emergency isolation or quarantine

3-45 unless, before the change in status is made:

4-1 (a) The facility provides:

4-2 (1) An application to a health authority for an emergency

4-3 isolation or quarantine pursuant to section 10 of this act; and

4-4 (2) The certificate of a health authority, physician, licensed

4-5 physician assistant or registered nurse to a health authority

4-6 pursuant to section 11 of this act; or

4-7 (b) The facility receives an order for isolation or quarantine

4-8 issued by a health authority.

4-9 2. A person whose status is changed to an emergency

4-10 isolation or quarantine pursuant to subsection 1:

4-11 (a) Must not be detained in excess of 48 hours after the change

4-12 in status is made, unless within that period a written petition is

4-13 filed by a health authority with the clerk of the district court

4-14 pursuant to section 14 of this act.

4-15 act; and

4-16 (b) May, immediately after his status is changed, seek an

4-17 injunction or other appropriate process in district court

4-18 challenging his detention.

4-19 3. If the period specified in subsection 2 expires on a day on

4-20 which the office of the clerk of the district court is not open, the

4-21 written petition must be filed on or before the close of the business

4-22 day next following the expiration of that period.

4-23 4. Nothing in this section limits the actions that a public or

4-24 private medical facility may take to prevent or limit the

4-25 transmission of communicable diseases within the medical facility,

4-26 including, without limitation, practices for the control of

4-27 infections.

4-28 Sec. 9. 1. Any person or group of persons alleged to have

4-29 been infected with or exposed to a communicable disease may be

4-30 detained in a public or private medical facility, a residence or

4-31 other safe location under emergency isolation or quarantine for

4-32 testing, examination, observation and the provision of or

4-33 arrangement for the provision of consensual medical treatment in

4-34 the manner set forth in sections 6 to 26, inclusive, of this act, and

4-35 subject to the provisions of subsection 2:

4-36 (a) Upon application to a health authority pursuant to section

4-37 10 of this act;

4-38 (b) Upon order of a health authority; or

4-39 (c) Upon voluntary consent of the person, parent of a minor

4-40 person or legal guardian of the person.

4-41 2. Except as otherwise provided in subsection 3, 4 or 5, a

4-42 person voluntarily or involuntarily isolated or quarantined under

4-43 subsection 1 must be released within 72 hours, including

4-44 weekends and holidays, from the time of his admission to a

5-1 medical facility or isolation or quarantine in a residence or other

5-2 safe location, unless within that period:

5-3 (a) The additional voluntary consent of the person, the parent

5-4 of a minor person or a legal guardian of the person is obtained;

5-5 (b) A written petition for an involuntary court-ordered

5-6 isolation or quarantine is filed with the clerk of the district court

5-7 pursuant to section 14 of this act, including, without limitation,

5-8 the documents required pursuant to section 15 of this act; or

5-9 (c) The status of the person is changed to a voluntary isolation

5-10 or quarantine.

5-11 3. A person who is involuntarily isolated or quarantined

5-12 under subsection 1 may, immediately after he is isolated or

5-13 quarantined, seek an injunction or other appropriate process in

5-14 district court challenging his detention.

5-15 4. If the period specified in subsection 2 expires on a day on

5-16 which the office of the clerk of the district court is not open, the

5-17 written petition must be filed on or before the close of the business

5-18 day next following the expiration of that period.

5-19 5. During a state of emergency or declaration of disaster

5-20 regarding public health proclaimed by the Governor or the

5-21 Legislature pursuant to NRS 414.070, a health authority may,

5-22 before the expiration of the period of 72 hours set forth in

5-23 subsection 2, petition, with affidavits supporting its request, a

5-24 district court for an order finding that a reasonably foreseeable

5-25 immediate threat to the health of the public requires the 72-hour

5-26 period of time to be extended for no longer than the court deems

5-27 necessary for available governmental resources to investigate, file

5-28 and prosecute the relevant written petitions for involuntary court-

5-29 ordered isolation or quarantine pursuant to sections 6 to 26,

5-30 inclusive, of this act.

5-31 Sec. 10. 1. An application to a health authority for an order

5-32 of emergency isolation or quarantine of a person or a group of

5-33 persons alleged to have been infected with or exposed to a

5-34 communicable disease may only be made by another health

5-35 authority, a physician, a licensed physician assistant, a registered

5-36 nurse or a medical facility by submitting the certificate required by

5-37 section 11 of this act. Within its jurisdiction, upon application or

5-38 on its own, subject to the provisions of sections 6 to 26, inclusive, a

5-39 health authority may:

5-40 (a) Pursuant to its own order and without a warrant:

5-41 (1) Take a person or group of persons alleged to and

5-42 reasonably believed by the health authority to have been infected

5-43 with or exposed to a communicable disease into custody in any

5-44 safe location under emergency isolation or quarantine for testing,

6-1 examination, observation and the provision of or arrangement for

6-2 the provision of consensual medical treatment; and

6-3 (2) Transport the person or group of persons alleged to and

6-4 reasonably believed by the health authority to have been infected

6-5 with or exposed to a communicable disease to a public or private

6-6 medical facility, a residence or other safe location for that

6-7 purpose, or arrange for the person or group of persons to be

6-8 transported for that purpose by:

6-9 (I) A local law enforcement agency;

6-10 (II) A system for the nonemergency medical

6-11 transportation of persons whose operation is authorized by the

6-12 Transportation Services Authority; or

6-13 (III) If medically necessary, an ambulance service that

6-14 holds a permit issued pursuant to the provisions of chapter 450B

6-15 of NRS,

6-16 only if the health authority acting in good faith has, based upon

6-17 personal observation, its own epidemiological investigation or an

6-18 epidemiological investigation by another health authority, a

6-19 physician, a licensed physician assistant or a registered nurse as

6-20 stated in a certificate submitted pursuant to section 11 of this act,

6-21 if such a certificate was submitted, of the person or group of

6-22 persons alleged to have been infected with or exposed to a

6-23 communicable disease, a reasonable factual and medical basis to

6-24 believe that the person or group of persons has been infected with

6-25 or exposed to a communicable disease, and that because of the

6-26 risks of that disease the person or group of persons is likely to be

6-27 an immediate threat to the health of members of the public who

6-28 have not been infected with or exposed to the communicable

6-29 disease.

6-30 (b) Petition a district court for an emergency order requiring:

6-31 (1) Any health authority or peace officer to take a person or

6-32 group of persons alleged to have been infected with or exposed to

6-33 a communicable disease into custody to allow the health authority

6-34 to investigate, file and prosecute a petition for the involuntary

6-35 court-ordered isolation or quarantine of the person or group of

6-36 persons alleged to have been infected with or exposed to a

6-37 communicable disease in the manner set forth in sections 6 to 26,

6-38 inclusive, of this act; and

6-39 (2) Any agency, system or service described in

6-40 subparagraph (2) of paragraph (a) to transport, in accordance

6-41 with such court order, the person or group of persons alleged to

6-42 have been infected with or exposed to a communicable disease to a

6-43 public or private medical facility, a residence or other safe

6-44 location for that purpose.

7-1 2. The district court may issue an emergency order for

7-2 isolation or quarantine pursuant to paragraph (b) of subsection 1:

7-3 (a) Only for the time deemed necessary by the court to allow a

7-4 health authority to investigate, file and prosecute each petition for

7-5 involuntary court-ordered isolation or quarantine pursuant to

7-6 sections 6 to 26, inclusive, of this act; and

7-7 (b) Only if it is satisfied that there is probable cause to believe

7-8 that the person or group of persons alleged to have been infected

7-9 with or exposed to a communicable disease has been infected with

7-10 or exposed to a communicable disease, and that because of the

7-11 risks of that disease the person or group of persons is likely to be

7-12 an immediate threat to the health of the public.

7-13 Sec. 11. A health authority shall not accept an application

7-14 for an emergency isolation or quarantine under section 10 of this

7-15 act unless that application is accompanied by a certificate of

7-16 another health authority or a physician, licensed physician

7-17 assistant or registered nurse stating that he has examined the

7-18 person or group of persons alleged to have been infected with or

7-19 exposed to a communicable disease or has investigated the

7-20 circumstances of potential infection or exposure regarding the

7-21 person or group of persons alleged to have been infected with or

7-22 exposed to a communicable disease and that he has concluded that

7-23 the person or group of persons has been infected with or exposed

7-24 to a communicable disease, and that because of the risks of that

7-25 disease the person or group of persons is likely to be an immediate

7-26 threat to the health of the public. The certificate required by this

7-27 section may be obtained from a physician, licensed physician

7-28 assistant or registered nurse who is employed by the public or

7-29 private medical facility in which the person or group of persons is

7-30 admitted or detained and from the facility from which the

7-31 application is made.

7-32 Sec. 12. 1. No application or certificate authorized under

7-33 section 10 or 11 of this act may be considered if made by a person

7-34 on behalf of a medical facility or by a health authority, physician,

7-35 licensed physician assistant or registered nurse who is related by

7-36 blood or marriage to the person alleged to have been infected with

7-37 or exposed to a communicable disease, or who is financially

7-38 interested, in a manner that would be prohibited pursuant to NRS

7-39 439B.425 if the application or certificate were deemed a referral,

7-40 in a medical facility in which the person alleged to have been

7-41 infected with or exposed to a communicable disease is to be

7-42 detained.

7-43 2. No application or certificate of any health authority or

7-44 person authorized under section 10 or 11 of this act may be

7-45 considered unless it is based on personal observation, examination

8-1 or epidemiological investigation of the person or group of persons

8-2 alleged to have been infected with or exposed to a communicable

8-3 disease made by such health authority or person not more than 72

8-4 hours before the making of the application or certificate. The

8-5 certificate must set forth in detail the facts and reasons on which

8-6 the health authority or person who submitted the certificate

8-7 pursuant to section 11 of this act based his opinions and

8-8 conclusions.

8-9 Sec. 13. Within 24 hours after a person’s involuntary

8-10 admission into a public or private medical facility under

8-11 emergency isolation or quarantine, the administrative officer of

8-12 the public or private medical facility shall reasonably attempt to

8-13 ascertain the identification and location of the spouse or legal

8-14 guardian of that person and, if reasonably possible, mail notice of

8-15 the admission by certified mail to the spouse or legal guardian of

8-16 that person.

8-17 Sec. 14. A proceeding for an involuntary court-ordered

8-18 isolation or quarantine of any person in this state may be

8-19 commenced by a health authority filing a petition with the clerk of

8-20 the district court of the county where the person is to be isolated or

8-21 quarantined. The petition may be pled in the alternative for both

8-22 isolation and quarantine, if required by developing or changing

8-23 facts, and must be accompanied:

8-24 1. By a certificate of a health authority or a physician, a

8-25 licensed physician assistant or a registered nurse stating that he

8-26 has examined the person alleged to have been infected with or

8-27 exposed to a communicable disease or has investigated the

8-28 circumstances of potential infection or exposure regarding the

8-29 person alleged to have been infected with or exposed to a

8-30 communicable disease and has concluded that the person has

8-31 been infected with or exposed to a communicable disease, and that

8-32 because of the risks of that disease the person is likely to be an

8-33 immediate threat to the health of the public; or

8-34 2. By a sworn written statement by the health authority that:

8-35 (a) The health authority has, based upon its personal

8-36 observation of the person alleged to have been infected with or

8-37 exposed to a communicable disease, or its epidemiological

8-38 investigation of the circumstances of potential infection or

8-39 exposure regarding the person alleged to have been infected with

8-40 or exposed to a communicable disease, a reasonable factual and

8-41 medical basis to believe that the person has been infected with or

8-42 exposed to a communicable disease and, that because of the risks

8-43 of that disease the person is likely to be an immediate threat to the

8-44 health of the public; and

9-1 (b) The person alleged to have been infected with or exposed to

9-2 a communicable disease has refused to submit to voluntary

9-3 isolation or quarantine, examination, testing, or treatment known

9-4 to control or resolve the transmission of the communicable

9-5 disease.

9-6 Sec. 15. In addition to the requirements of section 14 of this

9-7 act, a petition filed pursuant to that section with the clerk of the

9-8 district court to commence proceedings for involuntary court-

9-9 ordered isolation or quarantine of a person pursuant to section 8

9-10 or 9 of this act must include a certified copy of:

9-11 1. If an application for an order of emergency isolation or

9-12 quarantine of the person was made pursuant to section 10 of this

9-13 act, the application for the emergency isolation or quarantine of

9-14 the person made to the petitioning health authority pursuant to

9-15 section 10 of this act; and

9-16 2. A petition executed by a health authority, including,

9-17 without limitation, a sworn statement that:

9-18 (a) The health authority or a physician, licensed physician

9-19 assistant or registered nurse who submitted a certificate pursuant

9-20 to section 11 of this act, if such a certificate was submitted, has

9-21 examined the person alleged to have been infected with or exposed

9-22 to a communicable disease;

9-23 (b) In the opinion of the health authority, there is a reasonable

9-24 degree of certainty that the person alleged to have been infected

9-25 with or exposed to a communicable disease is currently capable of

9-26 transmitting the disease, or is likely to become capable of

9-27 transmitting the disease in the near future;

9-28 (c) Based on either the health authority’s personal observation

9-29 of the person alleged to have been infected with or exposed to the

9-30 communicable disease or the health authority’s epidemiological

9-31 investigation of the circumstances of potential infection or

9-32 exposure regarding the person alleged to have been infected with

9-33 or exposed to the communicable disease, and on other facts set

9-34 forth in the petition, the person likely poses an immediate threat to

9-35 the health of the public; and

9-36 (d) In the opinion of the health authority, involuntary isolation

9-37 or quarantine of the person alleged to have been infected with or

9-38 exposed to a communicable disease to a public or private medical

9-39 facility, residence or other safe location is necessary to prevent the

9-40 person from immediately threatening the health of the public.

9-41 Sec. 16. 1. Immediately after he receives any petition filed

9-42 pursuant to section 14 or 15 of this act, the clerk of the district

9-43 court shall transmit the petition to the appropriate district judge,

9-44 who shall set a time, date and place for its hearing. The date must

10-1 be within 5 judicial days after the date on which the petition is

10-2 received by the clerk.

10-3 2. The court shall give notice of the petition and of the time,

10-4 date and place of any proceedings thereon to the subject of the

10-5 petition, his attorney, if known, the petitioner and the

10-6 administrative office of any public or private medical facility in

10-7 which the subject of the petition is detained.

10-8 3. The provisions of this section do not preclude a health

10-9 authority from ordering the release from isolation or quarantine

10-10 of a person before the time set pursuant to this section for the

10-11 hearing concerning the person, if appropriate.

10-12 4. After the filing of a petition pursuant to section 14 or 15 of

10-13 this act and before any court-ordered involuntary isolation or

10-14 quarantine, a health authority shall file notice with the court of

10-15 any order of the health authority issued after the petition was filed

10-16 to release the person from emergency isolation or quarantine,

10-17 upon which the court may dismiss the petition without prejudice.

10-18 Sec. 17. 1. After the filing of a petition to commence

10-19 proceedings for the involuntary court-ordered isolation or

10-20 quarantine of a person pursuant to section 14 or 15 of this act, the

10-21 court shall promptly cause two or more physicians or licensed

10-22 physician assistants, at least one of whom must always be a

10-23 physician, to either examine the person alleged to have been

10-24 infected with or exposed to a communicable disease or assess the

10-25 likelihood that the person alleged to have been infected with or

10-26 exposed to a communicable disease has been so infected or

10-27 exposed.

10-28 2. To conduct the examination or assessment of a person who

10-29 is not being detained at a public or private medical facility,

10-30 residence or other safe location under emergency isolation or

10-31 quarantine pursuant to the emergency order of a health authority

10-32 or court made pursuant to section 9 or 10 of this act, the court

10-33 may order a peace officer to take the person into protective custody

10-34 and transport him to a public or private medical facility, residence

10-35 or other safe location where he may be detained until a hearing is

10-36 held upon the petition.

10-37 3. If the person is being detained at his home or other place

10-38 of residence under an emergency order of a health authority or

10-39 court pursuant to section 9 or 10 of this act, he may be allowed to

10-40 remain in his home or other place of residence pending an

10-41 ordered assessment, examination or examinations and to return to

10-42 his home or other place of residence upon completion of the

10-43 assessment, examination or examinations if such remaining or

10-44 returning would not constitute an immediate threat to others

10-45 residing in his home or place of residence.

11-1 4. Each physician and licensed physician assistant who

11-2 examines or assesses a person pursuant to subsection 1 shall, not

11-3 later than 24 hours before the hearing set pursuant to section 16

11-4 of this act, submit to the court in writing a summary of his

11-5 findings and evaluation regarding the person alleged to have been

11-6 infected with or exposed to a communicable disease.

11-7 Sec. 18. 1. The Health Division shall establish such

11-8 evaluation teams as are necessary to aid the courts under sections

11-9 17 and 24 of this act.

11-10 2. Each team must be composed of at least two physicians, or

11-11 at least one physician and one physician assistant.

11-12 3. Fees for the evaluations must be established and collected

11-13 as set forth in section 19 of this act.

11-14 Sec. 19. 1. In counties where the examining personnel

11-15 required pursuant to section 17 of this act are not available,

11-16 proceedings for involuntary court-ordered isolation or quarantine

11-17 shall be conducted in the nearest county having such examining

11-18 personnel available in order that there be minimum delay.

11-19 2. The entire expense of proceedings for involuntary court-

11-20 ordered isolation or quarantine shall be paid by the county in

11-21 which the application is filed.

11-22 Sec. 20. 1. The person alleged to have been infected with or

11-23 exposed to a communicable disease, or any relative or friend on

11-24 his behalf, is entitled to retain counsel to represent him in any

11-25 proceeding before the district court relating to involuntary court-

11-26 ordered isolation or quarantine, and if he fails or refuses to obtain

11-27 counsel, the court shall advise him and his guardian or next of

11-28 kin, if known, of the right to counsel and shall appoint counsel,

11-29 who may be the public defender or his deputy.

11-30 2. Any counsel appointed pursuant to subsection 1 must be

11-31 awarded compensation by the court for his services in an amount

11-32 determined by the court to be fair and reasonable. Except as

11-33 otherwise provided in this subsection, the compensation must be

11-34 charged against the estate of the person for whom the counsel was

11-35 appointed or, if the person is indigent, against the county in which

11-36 the application for involuntary court-ordered isolation or

11-37 quarantine was filed. In any proceeding before the district court

11-38 relating to involuntary court-ordered isolation or quarantine, if

11-39 the person for whom counsel was appointed is challenging his

11-40 isolation or quarantine or any condition of his isolation or

11-41 quarantine and the person succeeds in his challenge, the

11-42 compensation must be charged against the county in which the

11-43 application for involuntary court-ordered isolation or quarantine

11-44 was filed.

12-1 3. The court shall, at the request of counsel representing the

12-2 person alleged to have been infected with or exposed to a

12-3 communicable disease in proceedings before the court relating to

12-4 involuntary court-ordered isolation or quarantine, grant a recess

12-5 in the proceedings for the shortest time possible, but for not more

12-6 than 5 days, to give the counsel an opportunity to prepare his case.

12-7 4. Each district attorney or his deputy shall appear and

12-8 represent the State in all involuntary court-ordered isolation or

12-9 quarantine proceedings in his county. The district attorney is

12-10 responsible for the presentation of evidence, if any, in support of

12-11 the involuntary court-ordered isolation or quarantine of a person

12-12 to a medical facility, residence or other safe location in

12-13 proceedings held pursuant to section 14 or 15 of this act.

12-14 Sec. 21. In proceedings for involuntary court-ordered

12-15 isolation or quarantine, the court shall hear and consider all

12-16 relevant testimony, including, but not limited to, the testimony of

12-17 examining personnel who participated in the evaluation of the

12-18 person alleged to have been infected with or exposed to a

12-19 communicable disease and the certificates, if any, of a health

12-20 authority or a physician, licensed physician assistant or registered

12-21 nurse accompanying the petition. The court may consider

12-22 testimony relating to any past actions of the person alleged to have

12-23 been infected with or exposed to a communicable disease if such

12-24 testimony is probative of the question of whether the person

12-25 presently has been infected with or exposed to a communicable

12-26 disease and is likely to present an immediate threat to the health of

12-27 the public.

12-28 Sec. 22. 1. In proceedings for an involuntary court-ordered

12-29 isolation or quarantine, the person with respect to whom the

12-30 proceedings are held has the right:

12-31 (a) To be present by live telephonic conferencing or

12-32 videoconferencing; and

12-33 (b) To testify in his own behalf, to the extent that the court

12-34 determines he is able to do so without endangering the health of

12-35 others.

12-36 2. A person who is alleged to have been infected with or

12-37 exposed to a communicable disease does not have the right to be

12-38 physically present during the proceedings if such person, if

12-39 present in the courtroom, would likely pose an immediate threat to

12-40 the health of the judge or the staff or officers of the court.

12-41 Sec. 23. Witnesses subpoenaed under the provisions of

12-42 sections 6 to 26, inclusive, of this act shall be paid the same fees

12-43 and mileage as are paid to witnesses in the courts of the State of

12-44 Nevada.

13-1 Sec. 24. 1. If the district court finds, after proceedings for

13-2 the involuntary court-ordered isolation or quarantine of a person

13-3 to a public or private medical facility, residence or other safe

13-4 location:

13-5 (a) That there is not clear and convincing evidence that the

13-6 person with respect to whom the hearing was held has been

13-7 infected with or exposed to a communicable disease or is likely to

13-8 be an immediate threat to the health of the public, the court shall

13-9 enter its finding to that effect and the person must not be

13-10 involuntarily detained in such a facility, residence or other safe

13-11 location.

13-12 (b) That there is clear and convincing evidence that the person

13-13 with respect to whom the hearing was held has been infected with

13-14 or exposed to a communicable disease and, because of that

13-15 disease, is likely to be an immediate threat to the health of the

13-16 public, the court may order the involuntary isolation or quarantine

13-17 of the person and may order the most appropriate course of

13-18 treatment after considering the rights of the person and the desires

13-19 of the person concerning treatment, including, without limitation,

13-20 the rights set forth in NRS 441A.210, the rights set forth in section

13-21 7.5 of this act, the right to counsel set forth in section 20 of this

13-22 act, and the right of a person to challenge his isolation or

13-23 quarantine or any condition of his isolation or quarantine. The

13-24 order of the court must be interlocutory and must not become final

13-25 if, within 14 days after the court orders the involuntary isolation

13-26 or quarantine, the person is unconditionally released by a health

13-27 authority from the medical facility, residence or other safe

13-28 location.

13-29 2. An involuntary isolation or quarantine pursuant to

13-30 paragraph (b) of subsection 1 automatically expires at the end of

13-31 30 days if not terminated previously by a health authority. At the

13-32 end of the court-ordered period of isolation or quarantine, the

13-33 health authority may petition to renew the detention of the person

13-34 for additional periods not to exceed 120 days each. For each

13-35 renewal, the petition must set forth to the court specific reasons

13-36 why further isolation or quarantine is appropriate and that the

13-37 person likely poses an ongoing immediate threat to the health of

13-38 the public. If the court finds in considering a petition for renewal

13-39 that the person is noncompliant with a court-ordered measure to

13-40 control or resolve the risk of transmitting the communicable

13-41 disease, it may order the continued isolation and treatment of the

13-42 person for any period of time the court deems necessary to resolve

13-43 the immediate and ongoing risk of the person transmitting the

13-44 disease.

14-1 3. Before issuing an order for involuntary isolation or

14-2 quarantine or a renewal thereof, the court shall explore other

14-3 alternative courses of isolation, quarantine and treatment within

14-4 the least restrictive appropriate environment as suggested by the

14-5 evaluation team who evaluated the person, or other persons

14-6 professionally qualified in the field of communicable diseases,

14-7 which the court believes may be in the best interests of the person.

14-8 Sec. 25. The order for involuntary court isolation or

14-9 quarantine of any person to a medical facility, public or private,

14-10 must be accompanied by a clinical abstract, including a history of

14-11 illness, diagnosis and treatment, and the names of relatives or

14-12 correspondents.

14-13 Sec. 26. When any involuntary court isolation or quarantine

14-14 is ordered under the provisions of sections 6 to 26, inclusive, of

14-15 this act, the involuntarily isolated or quarantined person, together

14-16 with the court orders, any certificates of the health authorities,

14-17 physicians, licensed physician assistants or registered nurses, the

14-18 written summary of the evaluation team and a full and complete

14-19 transcript of the notes of the official reporter made at the

14-20 examination of such person before the court, must be delivered to

14-21 the sheriff of the appropriate county who must be ordered to:

14-22 1. Transport the person; or

14-23 2. Arrange for the person to be transported by:

14-24 (a) A system for the nonemergency medical transportation of

14-25 persons whose operation is authorized by the Transportation

14-26 Services Authority; or

14-27 (b) If medically necessary, an ambulance service that holds a

14-28 permit issued pursuant to the provisions of chapter 450B of

14-29 NRS,

14-30 to the appropriate public or private medical facility, residence or

14-31 other safe location.

14-32 Sec. 27. 1. The Board shall develop a system which

14-33 provides for syndromic reporting and active surveillance to

14-34 monitor public health in this state during major events or when

14-35 determined appropriate and necessary by a health authority.

14-36 2. The Board shall adopt regulations concerning the system it

14-37 develops pursuant to this section, including, without limitation:

14-38 (a) The manner in which and situations during which the

14-39 system actively gathers information;

14-40 (b) The persons who are required to report information to the

14-41 system; and

14-42 (c) The procedures for reporting required information to the

14-43 system.

15-1 Sec. 28. NRS 441A.010 is hereby amended to read as follows:

15-2 441A.010 As used in this chapter, unless the context otherwise

15-3 requires, the words and terms defined in NRS 441A.020 to

15-4 441A.110, inclusive, and sections 4 and 5 of this act have the

15-5 meanings ascribed to them in those sections.

15-6 Sec. 29. NRS 441A.120 is hereby amended to read as follows:

15-7 441A.120 The Board shall adopt regulations governing the

15-8 control of communicable diseases in this state, including regulations

15-9 specifically relating to the control of such diseases in educational,

15-10 medical and correctional institutions. The regulations must specify:

15-11 1. The diseases which are known to be communicable.

15-12 2. The communicable diseases which are known to be sexually

15-13 transmitted.

15-14 3. The procedures for investigating and reporting cases or

15-15 suspected cases of communicable diseases, including the time

15-16 within which these actions must be taken.

15-17 4. For each communicable disease, the procedures for testing,

15-18 treating, isolating and quarantining a person or group of persons

15-19 who [has or is] have been exposed to or have or are suspected of

15-20 having the disease.

15-21 5. A method for ensuring that any testing, treatment, isolation

15-22 or quarantine of a person or a group of persons pursuant to this

15-23 chapter is carried out in the least restrictive manner or

15-24 environment that is appropriate and acceptable under current

15-25 medical and public health practices.

15-26 Sec. 30. NRS 441A.160 is hereby amended to read as follows:

15-27 441A.160 1. A health authority who knows, suspects or is

15-28 informed of the existence within his jurisdiction of any

15-29 communicable disease shall immediately investigate the matter and

15-30 all circumstances connected with it, and shall take such measures for

15-31 the prevention, suppression and control of the disease as are

15-32 required by the regulations of the Board or a local board of health.

15-33 2. A health authority may:

15-34 (a) Enter private property at reasonable hours to investigate any

15-35 case or suspected case of a communicable disease.

15-36 (b) Order any person whom he reasonably suspects has a

15-37 communicable disease in an infectious state to submit to any

15-38 medical examination or test which he believes is necessary to verify

15-39 the presence of the disease. The order must be in writing and specify

15-40 the name of the person to be examined and the time and place of the

15-41 examination and testing, and may include such terms and conditions

15-42 as the health authority believes are necessary to protect the public

15-43 health.

15-44 (c) Except as otherwise provided in NRS 441A.210, issue an

15-45 order requiring the isolation, quarantine or treatment of any person

16-1 or group of persons if he believes that such action is necessary to

16-2 protect the public health. The order must be in writing and specify

16-3 the person or group of persons to be isolated[,] or quarantined, the

16-4 time during which the order is effective, the place of isolation or

16-5 quarantine and other terms and conditions which the health authority

16-6 believes are necessary to protect the public health, except that no

16-7 isolation or quarantine may take place if the health authority

16-8 determines that such action may endanger the life of [the person .] a

16-9 person who is isolated or quarantined.

16-10 (d) Each order issued pursuant to this section must be served

16-11 upon each person named in the order by delivering a copy to him.

16-12 3. If a health authority issues an order to isolate or

16-13 quarantine a person with a communicable or infectious disease in

16-14 a medical facility, the health authority must isolate or quarantine

16-15 the person in the manner set forth in sections 6 to 26, inclusive, of

16-16 this act.

16-17 Sec. 31. NRS 3.223 is hereby amended to read as follows:

16-18 3.223 1. Except if the child involved is subject to the

16-19 jurisdiction of an Indian tribe pursuant to the Indian Child Welfare

16-20 Act of 1978 , [(]25 U.S.C. §§ 1901 et seq. , [),] in each judicial

16-21 district in which it is established, the family court has original,

16-22 exclusive jurisdiction in any proceeding:

16-23 (a) Brought pursuant to chapter 31A, 62, 123, 125, 125A, 125B,

16-24 125C, 126, 127, 128, 129, 130, 159, 425 or 432B of NRS, except to

16-25 the extent that a specific statute authorizes the use of any other

16-26 judicial or administrative procedure to facilitate the collection of an

16-27 obligation for support.

16-28 (b) Brought pursuant to NRS 442.255 and 442.2555 to request

16-29 the court to issue an order authorizing an abortion.

16-30 (c) For judicial approval of the marriage of a minor.

16-31 (d) Otherwise within the jurisdiction of the juvenile court.

16-32 (e) To establish the date of birth, place of birth or parentage of a

16-33 minor.

16-34 (f) To change the name of a minor.

16-35 (g) For a judicial declaration of the sanity of a minor.

16-36 (h) To approve the withholding or withdrawal of life-sustaining

16-37 procedures from a person as authorized by law.

16-38 (i) Brought pursuant to NRS 433A.200 to 433A.330, inclusive,

16-39 for an involuntary court-ordered admission to a mental health

16-40 facility.

16-41 (j) Brought pursuant to sections 6 to 26, inclusive, of this act

16-42 for an involuntary court-ordered isolation or quarantine.

16-43 2. The family court, where established, and the justices’ court

16-44 have concurrent jurisdiction over actions for the issuance of a

17-1 temporary or extended order for protection against domestic

17-2 violence.

17-3 3. The family court, where established, and the district court,

17-4 have concurrent jurisdiction over any action for damages brought

17-5 pursuant to NRS 41.134 by a person who suffered injury as the

17-6 proximate result of an act that constitutes domestic violence.

17-7 Sec. 32. This act becomes effective on July 1, 2003.

17-8 H