Existing law defines the term “chemical restraint” to mean the administration of drugs for the specific and exclusive purpose of controlling an acute or episodic aggressive behavior when alternative intervention techniques have failed to limit or control the behavior. (NRS 388.476, 394.355, 433.5456, 449A.206) Existing law prescribes the conditions under which a medical facility, facility for the dependent, psychiatric hospital or psychiatric unit of a hospital or public or private school may use a chemical restraint on a person with a disability and prohibits the use of a chemical restraint on such a person under certain circumstances. (NRS 388.473, 388.497, 394.354, 394.366, 433.5486, 433.549, 433.5503, 449A.236, 449A.245, 449A.248) Sections 2, 65, 66 and 68 of this bill redefine the term “chemical restraint” for those purposes. Existing law uses the term “consumer” to describe persons who receive various mental health services. (Chapter 433A of NRS) Section 3.5 of this bill specifically defines that term to mean any person who voluntarily or involuntarily seeks and may benefit from certain mental health services. Existing law authorizes an officer authorized to make arrests in this State, certain providers of health care, or the spouse, parent, adult child or legal guardian of a person alleged to be a person in a mental health crisis to apply for the emergency admission of a person alleged to be a person in a mental health crisis to a mental health facility or hospital. (NRS 433A.160) Existing law requires the release of a person admitted under an emergency admission within 72 hours after the submission of the application for emergency admission unless: (1) a petition is filed for the involuntary court-ordered admission of the person; or (2) the admission is changed to a voluntary admission. (NRS 433A.145, 433A.150, 433A.200) Section 6 of this bill defines the term “mental health crisis hold” to mean the detention of a person alleged to be a person in a mental health crisis for transport to, and assessment, evaluation, intervention and treatment at, a public or private mental health facility or hospital. Section 4 of this bill defines the term “emergency admission” to mean the involuntary admission of a person who has been placed on a mental health crisis hold to a public or private mental health facility or a hospital. Sections 9, 10 and 28-35 of this bill prescribe separate processes for the detention of a person on a mental health crisis hold and the emergency admission of such a person. Specifically, section 30 of this bill authorizes an officer authorized to make arrests in this State or certain providers of health care to place a person alleged to be a person who is in a mental health crisis on a mental health crisis hold. Section 9 of this bill authorizes such an officer or provider of health care, certain family members, a person who is providing case management, support and supervision to a person who has been conditionally released from a mental health facility or any other person with a legitimate interest in a person alleged to be a person in a mental health crisis to petition for a court order to place a person alleged to be a person with a mental illness on a mental health crisis hold. Section 29 of this bill prescribes the conditions under which a person may be detained if the person is placed on a mental health crisis hold. Section 35 of this bill prescribes the requirements for releasing a person from a mental health crisis hold. Sections 10, 28, 31 and 32 of this bill prescribe the procedure for admitting a person to a mental health facility or hospital under an emergency admission. Sections 10, 28 and 29 require the release of a person placed on a mental health crisis hold within 72 hours after the initiation of the hold, regardless of whether the person is admitted under an emergency admission, unless: (1) a petition is filed for the involuntary court-ordered admission of the person; or (2) the admission is changed to a voluntary admission. Sections 1, 23, 37, 40, 55, 64, 67 and 70-72 of this bill make conforming changes. Existing law establishes a procedure for the involuntary court-ordered admission of a person to a mental health facility or a program of community-based or outpatient services. (NRS 433A.200-433A.330) Section 24 of this bill replaces the term “program of community-based or outpatient services” with the term “assisted outpatient treatment,” which is defined to mean outpatient services provided pursuant to a court order to a person with a mental illness for the purpose of treating the mental illness, assisting the person to live and function in the community or prevent a relapse or deterioration. Sections 11-21 of this bill prescribe a separate process for the issuance of a court order requiring a person to receive assisted outpatient treatment. Specifically, section 11 of this bill authorizes: (1) the Administrator of the Division of Public and Behavioral Health of the Department of Health and Human Services, certain providers of health care and certain persons who have an interest in a person to petition the district court to commence a proceeding for the issuance of a court order requiring assisted outpatient treatment of the person; and (2) a criminal defendant or the district attorney to make a motion to the district court to commence a proceeding for the issuance of a court order requiring assisted outpatient treatment of the defendant or the district court to commence such a proceeding on its own motion. Section 11 prescribes the criteria for determining whether a person may be ordered to receive assisted outpatient treatment. Section 13 of this bill requires certain persons who have evaluated a person who is the subject of a petition or motion for assisted outpatient treatment to submit to the court a recommended treatment plan for the person. Section 14 of this bill requires a person who is the subject of a petition or motion for assisted outpatient treatment to be represented by counsel at all stages of the proceedings. Section 18 of this bill authorizes a court to order a person to receive assisted outpatient treatment if: (1) at the conclusion of the proceedings, there is clear and convincing evidence that the person to be treated meets the applicable criteria for the initiation or renewal of such treatment; and (2) a person professionally qualified in the field of psychiatric mental health is able to treat the person in the county where the person to receive the treatment resides. If a person who has been ordered to receive assisted outpatient treatment fails to comply with the order after reasonable efforts to solicit compliance and, as a result, may harm himself or herself or others, section 20.5 of this bill authorizes the person responsible for providing the outpatient treatment to submit a petition for a court to order that the person be taken into custody to determine whether he or she is a person in a mental health crisis. Section 21 of this bill prescribes a procedure for renewing an order for assisted outpatient treatment. Section 23.5 of this bill revises the definition of “person professionally qualified in the field of psychiatric mental health” for purposes relating to eligibility to provide assisted outpatient treatment and certain other purposes. Sections 1, 27, 38, 41, 44, 45, 49, 51-54, 57-63, 69 and 72-75 of this bill make conforming changes. Section 26 of this bill requires the Division and the Attorney General to approve all forms for the detainment, evaluation, treatment and conditional release of any person under chapter 433A of NRS and furnish the forms to the clerks of district courts in each county. Section 36 of this bill revises requirements governing a petition for involuntary court-ordered admission. Section 39 of this bill requires a person who submits such a petition to notify the court if the subject of the petition is currently admitted to a mental health facility or hospital and is transferred to another mental health facility or hospital. Existing law: (1) requires the transfer of proceedings for the involuntary admission of a person if professionals who are qualified to examine the person are not available in the county where the petition is filed; and (2) provides that the expense of proceedings for involuntary admission are to be paid by the county where the petition is filed or, if the subject of the petition does not reside in that county, the county of the State where he or she last resided. (NRS 433A.260) Section 41.5 of this bill imposes specific requirements for the transfer of proceedings from a county where qualified professionals are not available to conduct the examination to a county where qualified professionals are available. Section 41.5 also revises requirements governing the payment of the cost of proceedings for involuntary admission to require such cost to be paid by the county in which the subject of the petition resides. Section 42 of this bill removes a requirement that the same counsel must continue to represent a person who is involuntarily admitted to a program of community-based or outpatient services until the person is unconditionally released. Section 43 of this bill provides that, once a person is involuntarily admitted to a mental health facility: (1) the admitting court is prohibited from transferring the case; and (2) the mental health facility is required to notify the court if the person is transferred. Section 50 of this bill prohibits the transfer of a consumer who has been admitted to a mental health facility or required to receive assisted outpatient treatment to another facility or provider of treatment, as applicable, unless arrangements relating to the costs of treatment are made between the facility or provider and the consumer or the person who requested the admission or treatment. Section 47 of this bill: (1) requires the notification of the court when a person who has been involuntarily admitted to a mental health facility is conditionally released; (2) revises the criteria for determining whether such a person may be conditionally released; and (3) authorizes the court to periodically review the terms of the conditional release. Sections 39 and 47 of this bill revise the procedure for admitting a person who has been conditionally released to a mental health facility or hospital when conditional release is no longer appropriate. Section 48 of this bill: (1) abolishes a requirement that an evaluation team evaluate a person who is involuntarily admitted by court order to a mental health facility or required to receive assisted outpatient treatment before the person may be unconditionally released before the expiration of the order; and (2) makes certain other minor revisions concerning unconditional release. Sections 39, 47, 48 and 48.5 of this bill impose specific requirements concerning notification of the guardian of a person who is released from a mental health facility or assisted outpatient treatment under certain circumstances. Existing law requires a court to seal all records related to the admission and treatment of any person admitted to a mental health facility or a program of community-based or outpatient services. (NRS 433A.715) Section 56 of this bill additionally requires a court to seal records governing any other proceedings conducted under chapter 433A of NRS.

Statutes affected:
As Introduced: 433.4295, 433.5456, 433A.011, 433A.019, 433A.0195, 433A.130, 433A.140, 433A.145, 433A.150, 433A.160, 433A.165, 433A.170, 433A.185, 433A.190, 433A.195, 433A.200, 433A.210, 433A.215, 433A.220, 433A.240, 433A.250, 433A.270, 433A.310, 433A.320, 433A.350, 433A.360, 433A.380, 433A.390, 433A.460, 433A.580, 433A.600, 433A.640, 433A.650, 433A.660, 433A.713, 433A.715, 433A.750, 3.0105, 3.223, 178.460, 179A.163, 179A.165, 179A.167, 388.253, 388.476, 394.355, 449.0915, 449A.206, 449A.636, 450.470, 629.550, 632.120, 641B.160
Reprint 1: 433.4295, 433.5456, 433A.011, 433A.018, 433A.019, 433A.130, 433A.140, 433A.145, 433A.150, 433A.160, 433A.165, 433A.170, 433A.185, 433A.190, 433A.195, 433A.200, 433A.210, 433A.215, 433A.220, 433A.240, 433A.250, 433A.260, 433A.270, 433A.310, 433A.320, 433A.350, 433A.360, 433A.380, 433A.390, 433A.460, 433A.580, 433A.600, 433A.640, 433A.650, 433A.660, 433A.713, 433A.715, 433A.750, 3.0105, 3.223, 178.460, 179A.163, 179A.165, 179A.167, 388.253, 388.476, 394.355, 449.0915, 449A.206, 449A.636, 450.470, 629.550, 632.120, 641B.160
Reprint 2: 433.4295, 433.5456, 433A.011, 433A.018, 433A.019, 433A.130, 433A.140, 433A.145, 433A.150, 433A.160, 433A.165, 433A.170, 433A.185, 433A.190, 433A.195, 433A.197, 433A.200, 433A.210, 433A.215, 433A.220, 433A.240, 433A.250, 433A.260, 433A.270, 433A.310, 433A.320, 433A.350, 433A.360, 433A.380, 433A.390, 433A.400, 433A.460, 433A.580, 433A.600, 433A.640, 433A.650, 433A.660, 433A.713, 433A.715, 433A.750, 3.0105, 3.223, 178.460, 179A.163, 179A.165, 179A.167, 388.253, 388.476, 394.355, 449.0915, 449A.206, 449A.636, 450.470, 629.550, 632.120, 641B.160
As Enrolled: 433.4295, 433.5456, 433A.011, 433A.018, 433A.019, 433A.130, 433A.140, 433A.145, 433A.150, 433A.160, 433A.165, 433A.170, 433A.185, 433A.190, 433A.195, 433A.197, 433A.200, 433A.210, 433A.215, 433A.220, 433A.240, 433A.250, 433A.260, 433A.270, 433A.310, 433A.320, 433A.350, 433A.360, 433A.380, 433A.390, 433A.400, 433A.460, 433A.580, 433A.600, 433A.640, 433A.650, 433A.660, 433A.713, 433A.715, 433A.750, 3.0105, 3.223, 178.460, 179A.163, 179A.165, 179A.167, 388.253, 388.476, 394.355, 449.0915, 449A.206, 449A.636, 450.470, 629.550, 632.120, 641B.160