Existing law establishes the State Fire Marshal Division in the Department of Public Safety, consisting of the Fire Protection and Control Section, the Fire Investigation Section, the Public Education Section, the Fire Service Training Section and the Fire Data Section. (NRS 477.010) Section 42 of this bill adds the Bureau of Emergency Medical Services to the State Fire Marshal Division. Section 43 of this bill requires the State Fire Marshal to appoint as Chief of the Bureau a person who has experience as a paramedic and has at least a bachelor's degree in some related field. Existing law regulates emergency medical services in this State. (Chapter 450B of NRS) Certain authority and duties relating to emergency medical services are given to the “board,” which means: (1) the State Board of Health in a county whose population is less than 700,000 (currently all counties other than Clark County); or (2) the district board of health in a county whose population is 700,000 or more (currently only Clark County). (NRS 450B.060) The authority and duties given to the board include: (1) establishing certain minimum standards and requirements for ambulances and air ambulances, for permits for the operation of air ambulances and for the certification or licensure of certain persons who provide emergency medical care; (2) approving certain training for emergency medical dispatchers; (3) issuing licenses to ambulance attendants and certain firefighters; (4) approving programs of training for certification as an emergency medical technician, advanced emergency medical technician or paramedic; (5) setting forth certain procedures that may be performed and drugs that may be administered by an advanced emergency medical technician or an attendant or a fire firefighter who is a paramedic; (6) determining eligibility for training as a paramedic; (7) setting forth certain provisions relating to the issuance of an endorsement on a permit which allows certain emergency medical providers to provide community paramedicine services; (8) setting forth qualifications for and issuing a permit to operate an ambulance, air ambulance or a vehicle of a fire-fighting agency and maintaining a registry of such permits; (9) issuing provisional permits to operate an ambulance, air ambulance or a vehicle of a fire-fighting agency; (10) adopting regulations specifying the acceptable documentation that staff of an air ambulance meet certain minimum qualifications; (11) setting forth the equipment required for an ambulance, air ambulance or vehicle used in providing emergency medical care; and (12) designating geographic areas in which an ambulance driver or attendant that meet certain lesser qualifications may transport a sick or injured person. (NRS 450B.120, 450B.130, 450B.140, 450B.155, 450B.160, 450B.180, 450B.1905, 450B.191, 450B.1915, 450B.195, 450B.197, 450B.1993, 450B.200, 450B.210, 450B.225, 450B.230, 450B.260) Sections 9, 12, 13 and 19-33 of this bill transfer from the State Board of Health to the Bureau such authority and duties in a county whose population is less than 700,000. (NRS 450B.077) Sections 7, 8 and 10 of this bill make conforming changes to amend the definition of “advanced emergency medical technician,” “emergency medical technician” and “paramedic” to clarify that the terms mean certain persons certified by the health authority. (NRS 450B.025, 450B.065, 450B.095) Section 1 of this bill makes a conforming change relating to the transfer of certain powers and duties to a health authority, as set forth in sections 12, 13 and 19-33, to create an exception to the provision that the State Board of Health is supreme in all nonadministrative health matters. (NRS 439.150) Existing law requires the board to establish and promulgate rules, regulations, standards and procedures as it determines are necessary to administer the provisions of the Nevada Revised Statutes relating to emergency medical services. (NRS 450B.120) Section 11 of this bill grants similar authority to a health authority. Section 5.5 of this bill requires any regulation adopted by the Bureau or Chief to be approved by the State Board of Health. Section 14 of this bill transfers from the State Board of Health to the Chief of the Bureau the requirement to establish by regulation: (1) a fee for the issuance or renewal of certain licenses, permits and certificates in a county whose population is less than 700,000; and (2) a schedule of fees for the services and regulatory activities performed by the Bureau. (NRS 439.150, 450B.200) Existing law provides that certain money received by the Division of Public and Behavioral Health of the Department of Health and Human Services must be accounted for separately, administered by the Administrator of the Division and used only to carry out a training program for emergency medical services personnel who work for a volunteer ambulance service or firefighting agency. (NRS 450B.1505) Section 14 provides instead that such money must be administered by the Chief of the Bureau. Existing law creates the Committee on Emergency Medical Services, consisting of nine members appointed by the State Board of Health, which has various duties relating to emergency medical services. (NRS 450B.151, 450B.153) Section 15 of this bill provides that the Director of the Department of Public Safety appoints the members of the Committee and revises the membership of the Committee. Section 16 of this bill makes a conforming change to provide that the per diem and travel expenses of members of the Committee are paid by the Bureau rather than the Division of Public and Behavioral Health of the Department of Health and Human Services. (NRS 450B.152) Section 17 of this bill revises the duties of the Committee to require the Committee to advise the Bureau rather than the Division of Public and Behavioral Health of the Department of Health and Human Services. (NRS 450B.153) Section 18 of this bill provides that the Bureau, rather than the Division, is required to provide administrative support and assistance to the Committee. Existing law sets forth certain authority for the health authority related to the issuance of do-not-resuscitate identification. (NRS 450B.400-450B.590) Because of the amendment to the definition of “health authority” in section 9, sections 34-38 of this bill amend these provisions so that such authority remains with the Division of Public and Behavioral Health of the Department of Health and Human Services in a county whose population is less than 700,000, and to the district board of health in a county whose population is 700,000 or more. Existing law requires the Division of Public and Behavioral Health of the Department of Health and Human Services to: (1) post on an Internet website maintained by the Division certain information about programs to provide peer support counseling to emergency response employees; (2) collect information, under certain circumstances, regarding suicide and attempted suicide among emergency response employees; and (3) report such information to the Chief Medical Officer. (NRS 450B.855) Section 39 of this bill provides instead that the Bureau shall: (1) post information about programs to provide peer support counseling to emergency response employees; (2) collect information, under certain circumstances, regarding suicide and attempted suicide among emergency response employees; and (3) report such information to the State Fire Marshal. Existing law authorizes the Division of Public and Behavioral Health of the Department of Health and Human Services to impose an administrative penalty against any person who violates any of the provisions of chapter 450B of NRS. (NRS 450B.900) Section 40 of this bill authorizes the Bureau to similarly impose an administrative penalty against a person who violates any provision of chapter 450B of NRS that is administered by the Bureau. Existing law requires the Department of Health and Human Services to provide to the Interagency Council on Veterans Affairs the total number of veterans who have applied for and received certification as an Emergency Medical Technician-B, Advanced Emergency Medical Technician and Paramedic through the State Emergency Medical Systems program. (NRS 417.0194) Section 41 of this bill requires instead that the Department of Public Safety provide such information to the Council. Sections 3-5 of this bill define the terms “Bureau,” “Chief” and “provider of emergency medical services,” respectively. Section 6 of this bill makes a conforming change to indicate the proper placement of sections 3-5 in the Nevada Revised Statutes.

Statutes affected:
As Introduced: 439.150, 450B.020, 450B.025, 450B.065, 450B.077, 450B.095, 450B.120, 450B.130, 450B.140, 450B.1505, 450B.151, 450B.152, 450B.153, 450B.154, 450B.155, 450B.160, 450B.180, 450B.190, 450B.1905, 450B.191, 450B.1915, 450B.195, 450B.197, 450B.1993, 450B.200, 450B.210, 450B.225, 450B.230, 450B.260, 450B.410, 450B.490, 450B.500, 450B.520, 450B.525, 450B.855, 450B.900, 417.0194, 477.010, 477.013
Reprint 1: 439.150, 450B.020, 450B.025, 450B.065, 450B.077, 450B.095, 450B.120, 450B.130, 450B.140, 450B.1505, 450B.151, 450B.152, 450B.153, 450B.154, 450B.155, 450B.160, 450B.180, 450B.190, 450B.1905, 450B.191, 450B.1915, 450B.195, 450B.197, 450B.1993, 450B.200, 450B.210, 450B.225, 450B.230, 450B.260, 450B.410, 450B.490, 450B.500, 450B.520, 450B.525, 450B.855, 450B.900, 417.0194, 477.010, 477.013
BDR: 439.150, 450B.020, 450B.025, 450B.065, 450B.077, 450B.095, 450B.120, 450B.130, 450B.140, 450B.1505, 450B.151, 450B.152, 450B.153, 450B.154, 450B.155, 450B.160, 450B.180, 450B.190, 450B.1905, 450B.191, 450B.1915, 450B.195, 450B.197, 450B.1993, 450B.200, 450B.210, 450B.225, 450B.230, 450B.260, 450B.410, 450B.490, 450B.500, 450B.520, 450B.525, 450B.855, 450B.900, 417.0194, 477.010, 477.013