[Rev. 2/10/2015 5:29:38
PM--2014R2]
CHAPTER 441A - INFECTIOUS DISEASES; TOXIC
AGENTS
GENERAL PROVISIONS
NRS 441A.010 Definitions.
NRS 441A.020 “Board”
defined.
NRS 441A.030 “Child
care facility” defined.
NRS 441A.040 “Communicable
disease” defined.
NRS 441A.050 “Health
authority” defined.
NRS 441A.060 “Health
Division” defined. [Repealed.]
NRS 441A.063 “Infectious
disease” defined.
NRS 441A.065 “Isolation”
defined.
NRS 441A.070 “Laboratory
director” defined.
NRS 441A.080 “Medical
facility” defined.
NRS 441A.090 “Medical
laboratory” defined.
NRS 441A.100 “Physician”
defined.
NRS 441A.110 “Provider
of health care” defined.
NRS 441A.115 “Quarantine”
defined.
NRS 441A.120 Regulations
of State Board of Health; performance of duties set forth in regulations.
NRS 441A.125 Use
of syndromic reporting and active surveillance to monitor public health;
regulations.
NRS 441A.130 Chief
Medical Officer to inform local health officers of regulations and procedures.
NRS 441A.140 Authority
of Division of Public and Behavioral Health to receive and use financial aid.
REPORTING OF OCCURRENCES; INVESTIGATIONS; ACTIONS TO PROTECT
PUBLIC HEALTH AND SAFETY
NRS 441A.150 Reporting
occurrences of communicable diseases to health authority.
NRS 441A.160 Investigation:
Powers of health authority to conduct investigation of communicable disease;
order to require person to submit to examination; order of isolation,
quarantine or treatment.
NRS 441A.163 Investigation:
Powers of health authority to conduct investigation of infectious disease or
exposure to biological, radiological or chemical agent; reports; regulations.
NRS 441A.165 Investigation:
Powers of health authority to access medical records, laboratory records and
other information in possession of health care provider or medical facility;
payment of certain costs related to investigation.
NRS 441A.166 Investigation:
Subpoena to compel production of medical records, laboratory records and other
information; court order directing witness to appear for failure to produce.
NRS 441A.167 Investigation:
Law enforcement agencies and political subdivisions authorized to share certain
information and medical records with state and local health authorities.
NRS 441A.169 Investigation:
Powers of health authority to issue cease and desist order to health care
provider or medical facility; injunction.
NRS 441A.170 Weekly
reports to Chief Medical Officer.
NRS 441A.180 Contagious
person to prevent exposure to others; warning by health authority; penalty.
NRS 441A.190 Control
of disease within schools, child care facilities, medical facilities and
correctional facilities.
NRS 441A.195 Testing
of person or decedent who may have exposed law enforcement officer,
correctional officer, emergency medical attendant, firefighter, county coroner
or medical examiner, person employed by or volunteering for agency of criminal
justice or certain other public employees or volunteers to communicable
disease.
NRS 441A.200 Right
to receive treatment from physician or clinic of choice; Board may prescribe
method of treatment.
NRS 441A.210 Rights
and duties of person who depends exclusively on prayer for healing.
NRS 441A.220 Confidentiality
of information; permissible disclosure.
NRS 441A.230 Disclosure
of personal information prohibited without consent.
SEXUALLY TRANSMITTED DISEASES
NRS 441A.240 Duties
of health authority.
NRS 441A.250 Establishment
and support of clinics and dispensaries.
NRS 441A.260 Provision
of medical supplies and financial aid for treatment of indigent patients.
NRS 441A.270 Instruction
of patients on prevention and treatment of disease.
NRS 441A.280 Procedure
to ensure that infected person receives adequate treatment.
NRS 441A.290 Infected
person to report source of infection.
NRS 441A.300 Confinement
of person whose conduct may spread acquired immunodeficiency syndrome.
NRS 441A.310 Examination
and treatment of minor without consent.
NRS 441A.320 Testing
of person alleged to have committed sexual offense; disclosure of results of
test; assistance to victim; payment of expenses.
NRS 441A.330 Provision
of outpatient care to persons with acquired immune deficiency syndrome or human
immunodeficiency virus related disease.
SERVICES CONCERNING HUMAN IMMUNODEFICIENCY VIRUS
NRS 441A.334 “Provider
of health care” defined.
NRS 441A.335 Declaration
of legislative intent.
NRS 441A.336 Counseling
to be provided to person testing positive for human immunodeficiency virus;
topics to be addressed in counseling; referrals to be provided to person
testing positive for human immunodeficiency virus; regulations.
TUBERCULOSIS
NRS 441A.340 Duties
of health authority.
NRS 441A.350 Establishment
and support of clinics.
NRS 441A.360 Provision
of medical supplies and financial aid for treatment of indigent patients.
NRS 441A.370 Contracts
with hospitals, clinics and other institutions for examination and care of
patients.
NRS 441A.380 Treatment
of patient for condition related to or as necessary for control of
tuberculosis.
NRS 441A.390 Contracts
with private physicians to provide outpatient care in rural areas.
NRS 441A.400 Inspection
of records of facility where patients are treated.
MISCELLANEOUS DISEASES
NRS 441A.410 Control
of rabies.
ISOLATION AND QUARANTINE OF PERSON OR GROUP OF PERSONS
General Provisions
NRS 441A.510 Manner
of isolating, quarantining or treating by health authority; duty to inform
person of rights.
NRS 441A.520 Right
of person isolated or quarantined to make and receive telephone calls and to
possess cellular phone; duty to notify spouse or legal guardian under certain
circumstances.
NRS 441A.530 Right
to refuse treatment and not submit to involuntary treatment; exception.
Emergency Isolation or Quarantine
NRS 441A.540 Restrictions
on change of status from voluntary isolation or quarantine to emergency
isolation or quarantine; rights of person whose status is changed.
NRS 441A.550 Detention
for testing, examination, observation and consensual medical treatment;
limitation on time; rights of person detained; extension of time.
NRS 441A.560 Procedure
for isolation or quarantine.
NRS 441A.570 Certificate
of another health authority or physician, licensed physician assistant or
registered nurse required.
NRS 441A.580 Requirements
for and limitations on applications and certificates.
NRS 441A.590 Additional
notice to spouse or legal guardian.
Involuntary Court-Ordered Isolation or Quarantine
NRS 441A.600 Petition:
Filing; certificate or statement of alleged infection with or exposure to
communicable disease.
NRS 441A.610 Additional
requirements for petition that is filed after emergency isolation or
quarantine.
NRS 441A.620 Hearing
on petition; notice; release of person before hearing.
NRS 441A.630 Examination
or assessment of person alleged to be infected with or exposed to communicable
disease; protective custody pending hearing; written summary of findings and
evaluation concerning person alleged to be infected with or exposed to
communicable disease.
NRS 441A.640 Evaluation
teams: Establishment; composition; fees.
NRS 441A.650 Proceedings
held in county where persons to conduct examination are available; expense of
proceedings paid by county.
NRS 441A.660 Right
to counsel; compensation of counsel; recess; duties of district attorney.
NRS 441A.670 Testimony.
NRS 441A.680 Right
of person alleged to be infected with or exposed to communicable disease to be
present by telephonic conferencing or videoconferencing and to testify.
NRS 441A.690 Fees
and mileage for witnesses.
NRS 441A.700 Findings
and order; expiration and renewal of isolation or quarantine; alternative
courses of treatment.
NRS 441A.710 Clinical
abstract to accompany order.
NRS 441A.720 Transportation
to public or private medical facility, residence or other safe location.
ENFORCEMENT
NRS 441A.900 Injunction:
Grounds; responsibility for prosecution; authority of court.
NRS 441A.910 Criminal
penalty for violation of chapter.
NRS 441A.920 Criminal
penalty and administrative fine for failure to comply with regulations or
requirements of chapter.
NRS 441A.930 District
attorney to prosecute violators.
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GENERAL PROVISIONS
NRS 441A.010 Definitions. As
used in this chapter, unless the context otherwise requires, the words and
terms defined in NRS 441A.020 to 441A.115, inclusive, have the meanings ascribed to
them in those sections.
(Added to NRS by 1989, 294; A 2003, 2206; 2009, 557)
NRS 441A.020 “Board” defined. “Board”
means the State Board of Health.
(Added to NRS by 1989, 294)
NRS 441A.030 “Child care facility” defined.
1. “Child care facility” means:
(a) An establishment operated and maintained for
the purpose of furnishing care on a temporary or permanent basis, during the
day or overnight, to five or more children under 18 years of age, if
compensation is received for the care of any of those children;
(b) An on-site child care facility as defined in NRS 432A.0275;
(c) A child care institution as defined in NRS 432A.0245; or
(d) An outdoor youth program as defined in NRS 432A.028.
2. “Child care facility” does not include:
(a) The home of a natural parent or guardian,
foster home as defined in NRS 424.014
or maternity home;
(b) A home in which the only children received,
cared for and maintained are related within the third degree of consanguinity
or affinity by blood, adoption or marriage to the person operating the
facility; or
(c) A home in which a person provides care for
the children of a friend or neighbor for not more than 4 weeks if the person
who provides the care does not regularly engage in that activity.
(Added to NRS by 1989, 294; A 1991, 2310; 2011, 1998)
NRS 441A.040 “Communicable disease” defined. “Communicable
disease” means a disease which is caused by a specific infectious agent or its
toxic products, and which can be transmitted, either directly or indirectly,
from a reservoir of infectious agents to a susceptible host organism.
(Added to NRS by 1989, 294)
NRS 441A.050 “Health authority” defined. “Health
authority” means the district health officer in a district, or the district
health officer’s designee, or, if none, the Chief Medical Officer, or the Chief
Medical Officer’s designee.
(Added to NRS by 1989, 294)
NRS 441A.060 “Health Division” defined. Repealed.
(See chapter 489, Statutes of Nevada 2013, at page 3071.)
NRS 441A.063 “Infectious disease” defined. “Infectious
disease” means a disease which is caused by pathogenic microorganisms,
including, without limitation, bacteria, viruses, parasites or fungi, which
spread, either directly or indirectly, from one person to another. The term
includes a communicable disease.
(Added to NRS by 2009, 554)
NRS 441A.065 “Isolation” defined. “Isolation”
means the physical separation and confinement of a person or a group of persons
infected or reasonably believed by a health authority to be infected with a
communicable disease from persons who are not infected with and have not been
exposed to the communicable disease, to limit the transmission of the
communicable disease to persons who are not infected with and have not been
exposed to the communicable disease.
(Added to NRS by 2003, 2196)
NRS 441A.070 “Laboratory director” defined. “Laboratory
director” has the meaning ascribed to it in NRS
652.050.
(Added to NRS by 1989, 294)
NRS 441A.080 “Medical facility” defined. “Medical
facility” has the meaning ascribed to it in NRS
449.0151.
(Added to NRS by 1989, 294)
NRS 441A.090 “Medical laboratory” defined. “Medical
laboratory” has the meaning ascribed to it in NRS 652.060.
(Added to NRS by 1989, 294)
NRS 441A.100 “Physician” defined. “Physician”
is limited to a person licensed to practice medicine pursuant to chapter 630 or 633
of NRS.
(Added to NRS by 1989, 294)
NRS 441A.110 “Provider of health care” defined. “Provider
of health care” means a physician, nurse or veterinarian licensed in accordance
with state law or a physician assistant licensed pursuant to chapter 630 or 633
of NRS.
(Added to NRS by 1989, 294; A 2001, 781; 2007, 1856)
NRS 441A.115 “Quarantine” defined. “Quarantine”
means the physical separation and confinement of a person or a group of persons
exposed to or reasonably believed by a health authority to have been exposed to
a communicable disease who do not yet show any signs or symptoms of being
infected with the communicable disease from persons who are not infected with
and have not been exposed to the communicable disease, to limit the
transmission of the communicable disease to persons who are not infected with
and have not been exposed to the communicable disease.
(Added to NRS by 2003, 2196)
NRS 441A.120 Regulations of State Board of Health; performance of duties set
forth in regulations.
1. The Board shall adopt regulations
governing the control of communicable diseases in this State, including
regulations specifically relating to the control of such diseases in
educational, medical and correctional institutions. The regulations must
specify:
(a) The diseases which are known to be
communicable.
(b) The communicable diseases which are known to
be sexually transmitted.
(c) The procedures for investigating and
reporting cases or suspected cases of communicable diseases, including the time
within which these actions must be taken.
(d) For each communicable disease, the procedures
for testing, treating, isolating and quarantining a person or group of persons
who have been exposed to or have or are suspected of having the disease.
(e) A method for ensuring that any testing,
treatment, isolation or quarantine of a person or a group of persons pursuant
to this chapter is carried out in the least restrictive manner or environment
that is appropriate and acceptable under current medical and public health
practices.
2. The duties set forth in the regulations
adopted by the Board pursuant to this section must be performed by:
(a) In a district in which there is a district
health officer, the district health officer or the district health officer’s
designee; or
(b) In any other area of the State, the Chief
Medical Officer or the Chief Medical Officer’s designee.
(Added to NRS by 1989, 294; A 2003, 2206; 2011, 2506)
NRS 441A.125 Use of syndromic reporting and active surveillance to monitor
public health; regulations.
1. The Board shall develop a system which
provides for syndromic reporting and active surveillance to monitor public
health in this state during major events or when determined appropriate and
necessary by a health authority.
2. The Board shall adopt regulations
concerning the system it develops pursuant to this section, including, without
limitation:
(a) The manner in which and situations during which
the system actively gathers information;
(b) The persons who are required to report
information to the system; and
(c) The procedures for reporting required
information to the system.
(Added to NRS by 2003, 2205)
NRS 441A.130 Chief Medical Officer to inform local health officers of
regulations and procedures. The
Chief Medical Officer shall inform each local health officer of the regulations
adopted by the Board and the procedures established for investigating and
reporting cases or suspected cases of infectious diseases and cases or
suspected cases of exposure to biological, radiological or chemical agents pursuant
to this chapter.
(Added to NRS by 1989, 295; A 2009, 557)
NRS 441A.140 Authority of Division of Public and Behavioral Health to receive
and use financial aid. The
Division of Public and Behavioral Health of the Department of Health and Human
Services may receive any financial aid made available by any grant or other
source and shall use the aid, in cooperation with the health authority, to
carry out the provisions of this chapter.
(Added to NRS by 1989, 299; A 2013, 3047)
REPORTING OF OCCURRENCES; INVESTIGATIONS; ACTIONS TO
PROTECT PUBLIC HEALTH AND SAFETY
NRS 441A.150 Reporting occurrences of communicable diseases to health
authority.
1. A provider of health care who knows of,
or provides services to, a person who has or is suspected of having a
communicable disease shall report that fact to the health authority in the
manner prescribed by the regulations of the Board. If no provider of health
care is providing services, each person having knowledge that another person
has a communicable disease shall report that fact to the health authority in
the manner prescribed by the regulations of the Board.
2. A medical facility in which more than
one provider of health care may know of, or provide services to, a person who
has or is suspected of having a communicable disease shall establish
administrative procedures to ensure that the health authority is notified.
3. A laboratory director shall, in the
manner prescribed by the Board, notify the health authority of the
identification by his or her medical laboratory of the presence of any
communicable disease in the jurisdiction of that health authority. The health
authority shall not presume a diagnosis of a communicable disease on the basis
of the notification received from the laboratory director.
4. If more than one medical laboratory is
involved in testing a specimen, the laboratory that is responsible for
reporting the results of the testing directly to the provider of health care
for the patient shall also be responsible for reporting to the health
authority.
(Added to NRS by 1989, 295)
NRS 441A.160 Investigation: Powers of health authority to conduct
investigation of communicable disease; order to require person to submit to
examination; order of isolation, quarantine or treatment.
1. A health authority who knows, suspects
or is informed of the existence within the jurisdiction of the health authority
of any communicable disease shall immediately investigate the matter and all
circumstances connected with it, and shall take such measures for the
prevention, suppression and control of the disease as are required by the
regulations of the Board or a local board of health.
2. A health authority may:
(a) Enter private property at reasonable hours to
investigate any case or suspected case of a communicable disease.
(b) Order any person whom the health authority
reasonably suspects has a communicable disease in an infectious state to submit
to any medical examination or test which the health authority believes is
necessary to verify the presence of the disease. The order must be in writing
and specify the name of the person to be examined and the time and place of the
examination and testing, and may include such terms and conditions as the
health authority believes are necessary to protect the public health.
(c) Except as otherwise provided in subsection 5
and NRS 441A.210, issue an order requiring the
isolation, quarantine or treatment of any person or group of persons if the
health authority believes that such action is necessary to protect the public
health. The order must be in writing and specify the person or group of persons
to be isolated or quarantined, the time during which the order is effective,
the place of isolation or quarantine and other terms and conditions which the
health authority believes are necessary to protect the public health, except
that no isolation or quarantine may take place if the health authority
determines that such action may endanger the life of a person who is isolated
or quarantined.
3. Each order issued pursuant to this
section must be served upon each person named in the order by delivering a copy
to him or her.
4. If a health authority issues an order
to isolate or quarantine a person with a communicable or infectious disease in
a medical facility, the health authority must isolate or quarantine the person
in the manner set forth in NRS 441A.510 to 441A.720, inclusive.
5. Except as otherwise provided in NRS 441A.310 and 441A.380,
a health authority may not issue an order requiring the involuntary treatment
of a person without a court order requiring the person to submit to treatment.
(Added to NRS by 1989, 295; A 2003, 2206; 2011, 2507)
NRS 441A.163 Investigation: Powers of health authority to conduct
investigation of infectious disease or exposure to biological, radiological or
chemical agent; reports; regulations.
1. Except as otherwise required pursuant
to NRS 441A.160, a health authority may conduct an
investigation of a case or suspected case of:
(a) An infectious disease within its
jurisdiction; or
(b) Exposure to a biological, radiological or
chemical agent within its jurisdiction,
Ê which
significantly impairs the health, safety or welfare of the public within its
jurisdiction.
2. Each health authority shall:
(a) Except as otherwise required pursuant to NRS 441A.170, report each week to the Chief Medical
Officer the number and types of cases or suspected cases of infectious diseases
or cases or suspected cases of exposure to biological, radiological or chemical
agents which significantly impair the health, safety or welfare of the public
reported to the health authority, and any other information required by the
regulations of the Board.
(b) Report the results of an investigation
conducted pursuant to subsection 1 to the Chief Medical Officer within 30 days
after concluding the investigation.
3. The Board may adopt regulations to
carry out the provisions of NRS 441A.163 to 441A.169, inclusive.
(Added to NRS by 2009, 554)
NRS 441A.165 Investigation: Powers of health authority to access medical
records, laboratory records and other information in possession of health care
provider or medical facility; payment of certain costs related to
investigation.
1. A health authority which conducts an
investigation pursuant to NRS 441A.160 or 441A.163 shall, for the protection of the health,
safety and welfare of the public, have access to all medical records,
laboratory records and reports, books and papers relevant to the investigation
which are in the possession of a provider of health care or medical facility
being investigated or which are otherwise necessary to carry out the
investigation. The determination of what information is necessary to carry out
the investigation is at the discretion of the health authority.
2. If a health authority conducts an
investigation pursuant to NRS 441A.160 or 441A.163, the health authority may require a provider
of health care or medical facility being investigated to pay a proportionate
share of the actual cost of carrying out the investigation, including, without
limitation, the cost of notifying and testing patients who may have contracted
an infectious disease, been exposed to a biological, radiological or chemical
agent or otherwise been harmed.
(Added to NRS by 2009, 555)
NRS 441A.166 Investigation: Subpoena to compel production of medical records,
laboratory records and other information; court order directing witness to
appear for failure to produce.
1. Upon petition by a health authority to
the district court for the county in which an investigation is being conducted
by the health authority pursuant to NRS 441A.160
or 441A.163, the court may issue a subpoena to
compel the production of medical records, laboratory records and reports, books
and papers as set forth in NRS 441A.165.
2. If a witness refuses to produce any
medical records, laboratory records and reports, books or papers required by a
subpoena issued by a court pursuant to subsection 1, the court shall enter an
order directing the witness to appear before the court at a time and place to
be fixed by the court in its order, the time to be not more than 10 days after
the date of the order, and then and there show cause why the witness has not
produced the medical records, laboratory records and reports, books or papers
before the health authority. A certified copy of the order must be served upon
the witness. The court may enter an order that the witness appear before the
health authority at the time and place fixed in the order and produce the
required medical records, laboratory records and reports, books or papers, and
upon failure to obey the order, the witness must be dealt with as for contempt
of court.
(Added to NRS by 2009, 555)
NRS 441A.167 Investigation: Law enforcement agencies and political
subdivisions authorized to share certain information and medical records with
state and local health authorities.
1. A public agency, law enforcement agency
or political subdivision of this State which has information that is relevant
to an investigation relating to an infectious disease or exposure to a
biological, radiological or chemical agent which significantly impairs the
health, safety and welfare of the public shall share the information and any
medical records and reports with the appropriate state and local health
authorities if it is in the best interest of the public and as necessary to
further the investigation of the requesting health authority.
2. The Board shall adopt regulations to
carry out this section, including, without limitation:
(a) Identifying the public agencies and political
subdivisions with which the information set forth in subsection 1 may be
shared;
(b) Prescribing the circumstances and procedures
by which the information may be shared with those identified public agencies
and political subdivisions; and
(c) Ensuring the confidentiality of the
information if it is protected health information.
(Added to NRS by 2009, 556)
NRS 441A.169 Investigation: Powers of health authority to issue cease and
desist order to health care provider or medical facility; injunction.
1. During the course of or as a result of
an investigation concerning the case or suspected case of an infectious disease
or the case or suspected case of exposure to a biological, radiological or
chemical agent pursuant to NRS 441A.160 or 441A.163, a health authority may, upon finding that a
provider of health care or medical facility significantly contributed to a case
of an infectious disease or to a case of exposure to a biological, radiological
or chemical agent and that the public health imperatively requires:
(a) Issue a written order directing the provider
of health care or medical facility to cease and desist any act or conduct which
is harmful to the health, safety or welfare of the public; and
(b) Take any other action to reduce or eliminate
the harm to the health, safety or welfare of the public.
2. A written order directing a provider of
health care or medical facility to cease and desist issued pursuant to
subsection 1 must contain a statement of the:
(a) Provision of law or regulation which the
provider of health care or medical facility is violating; or
(b) Standard of care that the provider of health
care or medical facility is violating which led to the case of the infectious
disease or to the case of exposure to a biological, radiological or chemical
agent.
3. An order to cease and desist must be
served upon the person or an authorized representative of the facility directly
or by certified or registered mail, return receipt requested. The order becomes
effective upon service.
4. An order to cease and desist expires 30
days after the date of service unless the health authority institutes an action
in a court of competent jurisdiction seeking an injunction.
5. Upon a showing by the health authority
that a provider of health care or medical facility is committing or is about to
commit an act which is harmful to the health, safety or welfare of the public,
a court of competent jurisdiction may enjoin the provider of health care or
medical facility from committing the act.
(Added to NRS by 2009, 556)
NRS 441A.170 Weekly reports to Chief Medical Officer. Each health authority shall report each week
to the Chief Medical Officer the number and types of cases or suspected cases
of communicable disease reported to the health authority, and any other
information required by the regulations of the Board.
(Added to NRS by 1989, 299)
NRS 441A.180 Contagious person to prevent exposure to others; warning by
health authority; penalty.
1. A person who has a communicable disease
in an infectious state shall not conduct himself or herself in any manner
likely to expose others to the disease or engage in any occupation in which it
is likely that the disease will be transmitted to others.
2. A health authority who has reason to
believe that a person is in violation of subsection 1 shall issue a warning to
that person, in writing, informing the person of the behavior which constitutes
the violation and of the precautions that the person must take to avoid
exposing others to the disease. The warning must be served upon the person by
delivering a copy to him or her.
3. A person who violates the provisions of
subsection 1 after service upon him or her of a warning from a health authority
is guilty of a misdemeanor.
(Added to NRS by 1989, 296)
NRS 441A.190 Control of disease within schools, child care facilities,
medical facilities and correctional facilities.
1. Except as otherwise provided in this
subsection, a health authority who knows of the presence of a communicable
disease within a school, child care facility, medical facility or correctional
facility shall notify the principal, director or other person in charge of the
school, child care facility, medical facility or correctional facility of that
fact and direct what action, if any, must be taken to prevent the spread of the
disease. A health authority who knows of the presence of the human
immunodeficiency virus within a school shall notify the superintendent of the
school district of that fact and direct what action, if any, must be taken to
prevent the spread of the virus.
2. Except as otherwise provided in this
subsection, the principal, director or other person in charge of a school,
child care facility, medical facility or correctional facility who knows of or
suspects the presence of a communicable disease within the school, child care
facility, medical facility or correctional facility, shall notify the health
authority pursuant to the regulations of the Board. If a principal of a school
knows of the presence of the human immunodeficiency virus within the school,
the principal shall notify the superintendent of the school district of that
fact. A superintendent of a school district who is notified of or knows of the
presence of the human immunodeficiency virus within a school in the school
district shall notify the health authority of that fact. The health authority
shall investigate a report received pursuant to this subsection to determine
whether a communicable disease or the human immunodeficiency virus is present
and direct what action, if any, must be taken to prevent the spread of the
disease or virus.
3. A parent, guardian or person having
custody of a child who has a communicable disease shall not knowingly permit
the child to attend school or a child care facility if the Board, by
regulation, has determined that the disease requires exclusion from school or a
child care facility.
(Added to NRS by 1989, 296; A 1991, 1340)
NRS 441A.195 Testing of person or decedent who may have exposed law
enforcement officer, correctional officer, emergency medical attendant,
firefighter, county coroner or medical examiner, person employed by or
volunteering for agency of criminal justice or certain other public employees
or volunteers to communicable disease.
1. A law enforcement officer, correctional
officer, emergency medical attendant, firefighter, county coroner or medical
examiner or any of their employees or volunteers, any other person who is
employed by or is a volunteer for an agency of criminal justice or any other
public employee or volunteer for a public agency who, in the course of his or
her official duties, comes into contact with human blood or bodily fluids, or
the employer of such a person or the public agency for which the person
volunteers, may petition a court for an order requiring the testing of a person
or decedent for exposure to a communicable disease if the person or decedent
may have exposed the officer, emergency medical attendant, firefighter, county
coroner or medical examiner or their employee or volunteer, other person
employed by or volunteering for an agency of criminal justice or other public
employee or volunteer for a public agency to a communicable disease.
2. When possible, before filing a petition
pursuant to subsection 1, the person, employer or public agency for which the
person volunteers, and who is petitioning shall submit information concerning
the possible exposure to a communicable disease to the designated health care
officer for the employer or public agency or, if there is no designated health
care officer, the person designated by the employer or public agency to
document and verify possible exposure to communicable diseases, for
verification that there was substantial exposure. Each designated health care
officer or person designated by an employer or public agency to document and
verify possible exposure to communicable diseases shall establish guidelines
based on current scientific information to determine substantial exposure.
3. A court shall promptly hear a petition
filed pursuant to subsection 1 and determine whether there is probable cause to
believe that a possible transfer of blood or other bodily fluids occurred
between the person who filed the petition or on whose behalf the petition was
filed and the person or decedent who possibly exposed him or her to a
communicable disease. If the court determines that probable cause exists to
believe that a possible transfer of blood or other bodily fluids occurred and,
that a positive result from the test for the presence of a communicable disease
would require the petitioner to seek medical intervention, the court shall:
(a) Order the person who possibly exposed the
petitioner, or the person on whose behalf the petition was filed, to a
communicable disease to submit two appropriate specimens to a local hospital or
medical laboratory for testing for exposure to a communicable disease; or
(b) Order that two appropriate specimens be taken
from the decedent who possibly exposed the petitioner, or the person on whose
behalf the petition was filed, to a communicable disease and be submitted to a
local hospital or medical laboratory for testing for exposure to the
communicable disease.
Ê The local
hospital or medical laboratory shall perform the test in accordance with
generally accepted medical practices and shall disclose the results of the test
in the manner set forth in NRS 629.069.
4. If a judge or a justice of the peace
enters an order pursuant to this section, the judge or justice of the peace may
authorize the designated health care officer or the person designated by the
employer or public agency to document and verify possible exposure to a
communicable disease to sign the name of the judge or justice of the peace on a
duplicate order. Such a duplicate order shall be deemed to be an order of the
court. As soon as practicable after the duplicate order is signed, the
duplicate order must be returned to the judge or justice of the peace who
authorized the signing of it and must indicate on its face the judge or justice
of the peace to whom it is to be returned. The judge or justice of the peace,
upon receiving the returned order, shall endorse the order with his or her name
and enter the date on which the order was returned. Any failure of the judge or
justice of the peace to make such an endorsement and entry does not in and of
itself invalidate the order.
5. Except as otherwise provided in NRS 629.069, all records submitted to the
court in connection with a petition filed pursuant to this section and any
proceedings concerning the petition are confidential and the judge or justice
of the peace shall order the records and any record of the proceedings to be
sealed and to be opened for inspection only upon an order of the court for good
cause shown.
6. A court may establish rules to allow a
judge or justice of the peace to conduct a hearing or issue an order pursuant
to this section by electronic or telephonic means.
7. The employer of a person or the public
agency for which the person volunteers, who files a petition or on whose behalf
a petition is filed pursuant to this section or the insurer of the employer or
public agency, shall pay the cost of performing the test pursuant to subsection
3.
8. As used in this section:
(a) “Agency of criminal justice” has the meaning
ascribed to it in NRS 179A.030.
(b) “Emergency medical attendant” means a person
licensed as an attendant or certified as an emergency medical technician,
advanced emergency medical technician or paramedic pursuant to chapter 450B of NRS.
(Added to NRS by 1999, 1122; A 2005, 328; 2007, 88; 2013, 595, 936)
NRS 441A.200 Right to receive treatment from physician or clinic of choice;
Board may prescribe method of treatment. This
chapter does not empower or authorize the health authority or any other person
to interfere in any manner with the right of a person to receive approved
treatment for a communicable disease from any physician, clinic or other person
of his or her choice, but the Board has the power to prescribe the approved
method of treatment to be used by the physician, clinic or other person.
(Added to NRS by 1989, 298)
NRS 441A.210 Rights and duties of person who depends exclusively on prayer
for healing. A person who has a
communicable disease and depends exclusively on prayer for healing in
accordance with the tenets and precepts of any recognized religious sect,
denomination or organization is not required to submit to any medical treatment
required by the provisions of this chapter, but may be isolated or quarantined
in the person’s home or other place of the person’s choice acceptable to the
health authority, and shall comply with all applicable rules, regulations and
orders issued by the health authority.
(Added to NRS by 1989, 298)
NRS 441A.220 Confidentiality of information; permissible disclosure. All information of a personal nature about any
person provided by any other person reporting a case or suspected case of a
communicable disease, or by any person who has a communicable disease, or as
determined by investigation of the health authority, is confidential medical
information and must not be disclosed to any person under any circumstances,
including pursuant to any subpoena, search warrant or discovery proceeding,
except:
1. As otherwise provided in NRS 439.538.
2. For statistical purposes, provided that
the identity of the person is not discernible from the information disclosed.
3. In a prosecution for a violation of
this chapter.
4. In a proceeding for an injunction
brought pursuant to this chapter.
5. In reporting the actual or suspected
abuse or neglect of a child or elderly person.
6. To any person who has a medical need to
know the information for his or her own protection or for the well-being of a
patient or dependent person, as determined by the health authority in
accordance with regulations of the Board.
7. If the person who is the subject of the
information consents in writing to the disclosure.
8. Pursuant to subsection 4 of NRS 441A.320 or NRS
629.069.
9. If the disclosure is made to the
Department of Health and Human Services and the person about whom the
disclosure is made has been diagnosed as having acquired immunodeficiency
syndrome or an illness related to the human immunodeficiency virus and is a
recipient of or an applicant for Medicaid.
10. To a firefighter, police officer or
person providing emergency medical services if the Board has determined that
the information relates to a communicable disease significantly related to that
occupation. The information must be disclosed in the manner prescribed by the
Board.
11. If the disclosure is authorized or
required by NRS 239.0115 or another
specific statute.
(Added to NRS by 1989, 299; A 1989, 1476; 1997, 1254; 1999, 1123, 2238, 2245; 2005, 329; 2007, 1277, 1977, 2109)
NRS 441A.230 Disclosure of personal information prohibited without consent. Except as otherwise provided in this chapter
and NRS 439.538, a person shall not
make public the name of, or other personal identifying information about, a
person infected with a communicable disease who has been investigated by the
health authority pursuant to this chapter without the consent of the person.
(Added to NRS by 1989, 300; A 2007, 1978)
SEXUALLY TRANSMITTED DISEASES
NRS 441A.240 Duties of health authority.
1. The health authority shall control,
prevent, treat and, whenever possible, ensure the cure of sexually transmitted
diseases.
2. The health authority shall provide the
materials and curriculum necessary to conduct the educational program provided
for in NRS 209.385 and establish a
program for the certification of persons qualified to provide instruction for
the program.
(Added to NRS by 1989, 296; A 1989, 1476; 2011, 2508)
NRS 441A.250 Establishment and support of clinics and dispensaries. The health authority may establish and provide
financial or other support to such clinics and dispensaries as it believes are
reasonably necessary for the prevention, control, treatment or cure of sexually
transmitted diseases.
(Added to NRS by 1989, 296; A 2011, 2508)
NRS 441A.260 Provision of medical supplies and financial aid for treatment of
indigent patients. If a person in
this state who has a sexually transmitted disease is, in the discretion of the
health authority, unable to afford approved treatment for the disease, the
health authority may provide medical supplies or direct financial aid to any
physician, clinic or dispensary in this state, within the limits of the
available appropriations and any other resources, to be used in the person’s
treatment. A physician, clinic or dispensary that accepts supplies or aid
pursuant to this section shall comply with all conditions prescribed by the
Board relating to the use of the supplies or aid.
(Added to NRS by 1989, 296; A 2011, 2508)
NRS 441A.270 Instruction of patients on prevention and treatment of disease. A physician, clinic or dispensary providing
treatment to a person who has a sexually transmitted disease shall instruct the
person in the methods of preventing the spread of the disease and in the
necessity of systematic and prolonged treatment.
(Added to NRS by 1989, 296)
NRS 441A.280 Procedure to ensure that infected person receives adequate
treatment. A physician who, or
clinic or dispensary which, determines that a person has a sexually transmitted
disease shall encourage and, if necessary, attempt to persuade the person to
submit to medical treatment. Except as otherwise provided in NRS 441A.210, if the person does not submit to
treatment, or does not complete the prescribed course of treatment, the
physician, clinic or dispensary shall notify the health authority who shall
take action to ensure that the person receives adequate treatment for the
disease.
(Added to NRS by 1989, 297)
NRS 441A.290 Infected person to report source of infection. A person who has a sexually transmitted
disease shall, upon request, inform the health authority of the source or
possible source of the infection.
(Added to NRS by 1989, 297)
NRS 441A.300 Confinement of person whose conduct may spread acquired
immunodeficiency syndrome. A
person who is diagnosed as having acquired immunodeficiency syndrome who fails
to comply with a written order of a health authority, or who engages in
behavior through which the disease may be spread to others, is, in addition to
any other penalty imposed pursuant to this chapter, subject to confinement by
order of a court of competent jurisdiction.
(Added to NRS by 1989, 297)
NRS 441A.310 Examination and treatment of minor without consent. Except as otherwise provided in NRS 441A.210, when any minor is suspected of having
or is found to have a sexually transmitted disease, the health authority may
require the minor to undergo examination and treatment, regardless of whether
the minor or either of the minor’s parents consents to the examination and
treatment.
(Added to NRS by 1989, 297)
NRS 441A.320 Testing of person alleged to have committed sexual offense;
disclosure of results of test; assistance to victim; payment of expenses.
1. If the alleged victim or a witness to a
crime alleges that the crime involved the sexual penetration of the victim’s
body, the health authority shall perform the tests set forth in subsection 2 as
soon as practicable after the arrest of the person alleged to have committed
the crime, but not later than 48 hours after the person is charged with the
crime by indictment or information, unless the person alleged to have committed
the crime is a child who will be adjudicated in juvenile court and then not
later than 48 hours after the petition is filed with the juvenile court
alleging that the child is delinquent for committing such an act.
2. If the health authority is required to
perform tests pursuant to subsection 1, it must test a specimen obtained from
the arrested person for exposure to the human immunodeficiency virus and any
commonly contracted sexually transmitted disease, regardless of whether the
person or, if the person is a child, the parent or guardian of the child
consents to providing the specimen. The agency that has custody of the arrested
person shall obtain the specimen and submit it to the health authority for
testing. The health authority shall perform the test in accordance with
generally accepted medical practices.
3. In addition to the test performed
pursuant to subsection 2, the health authority shall perform such follow-up
tests for the human immunodeficiency virus as may be deemed medically
appropriate.
4. As soon as practicable, the health
authority shall disclose the results of all tests performed pursuant to
subsection 2 or 3 to:
(a) The victim or to the victim’s parent or
guardian if the victim is a child; and
(b) The arrested person and, if the person is a
child, to the parent or guardian of the child.
5. If the health authority determines,
from the results of a test performed pursuant to subsection 2 or 3, that a
victim of sexual assault may have been exposed to the human immunodeficiency
virus or any commonly contracted sexually transmitted disease, it shall, at the
request of the victim, provide him or her with:
(a) An examination for exposure to the human
immunodeficiency virus and any commonly contracted sexually transmitted disease
to which the health authority determines the victim may have been exposed;
(b) Counseling regarding the human
immunodeficiency virus and any commonly contracted sexually transmitted disease
to which the health authority determines the victim may have been exposed; and
(c) A referral for health care and other
assistance,
Ê as
appropriate.
6. If the court in:
(a) A criminal proceeding determines that a
person has committed a crime; or
(b) A proceeding conducted pursuant to title 5 of
NRS determines that a child has committed an act which, if committed by an
adult, would have constituted a crime,
Ê involving
the sexual penetration of a victim’s body, the court shall, upon application by
the health authority, order that child or other person to pay any expenses
incurred in carrying out this section with regard to that child or other person
and that victim.
7. The Board shall adopt regulations
identifying, for the purposes of this section, sexually transmitted diseases
which are commonly contracted.
8. As used in this section:
(a) “Sexual assault” means a violation of NRS 200.366.
(b) “Sexual penetration” has the meaning ascribed
to it in NRS 200.364.
(Added to NRS by 1989, 297; A 1993, 1208; 2003, 1150; 2007, 1278)
NRS 441A.330 Provision of outpatient care to persons with acquired immune
deficiency syndrome or human immunodeficiency virus related disease. The health authority may establish such
dispensaries, pharmacies or clinics for outpatient care as it believes are
necessary for the care and treatment of persons who have acquired immune
deficiency syndrome or a human immunodeficiency virus related disease, and
provide those institutions with financial or other assistance. Dispensaries, pharmacies
or clinics which accept financial or other assistance pursuant to this section
shall comply with all conditions prescribed by the Board relating to the use of
that assistance.
(Added to NRS by 1989, 297; A 2011, 2508)
SERVICES CONCERNING HUMAN IMMUNODEFICIENCY VIRUS
NRS 441A.334 “Provider of health care” defined. As
used in this section and NRS 441A.335 and 441A.336, “provider of health care” means a
physician, nurse or physician assistant licensed in accordance with state law.
(Added to NRS by 2007, 2174)
NRS 441A.335 Declaration of legislative intent. It
is the intent of the Legislature that:
1. The State Board of Health, the
Department of Health and Human Services, and all district, county and city
health departments, boards of health and health officers, medical facilities
and providers of health care work together in a collaborative manner to ensure
that testing for the human immunodeficiency virus and related counseling
services are offered in a culturally and linguistically appropriate manner.
2. Information pertaining to testing for
the human immunodeficiency virus be reported and maintained in accordance with
existing state and federal privacy laws.
3. Information pertaining to cases of the
human immunodeficiency virus not be used for any purpose other than public
health practices, including, without limitation, surveillance and epidemiology.
(Added to NRS by 2007, 2174)
NRS 441A.336 Counseling to be provided to person testing positive for human
immunodeficiency virus; topics to be addressed in counseling; referrals to be
provided to person testing positive for human immunodeficiency virus;
regulations.
1. Counties, providers of health care and
medical facilities that provide testing for the human immunodeficiency virus
shall provide, or ensure the provision of, to each person who tests positive
for the human immunodeficiency virus, a counseling session that is appropriate
and acceptable under current medical and public health practices, as
recommended by the Board.
2. Counseling required pursuant to this
section must address, without limitation:
(a) The meaning of the positive result of the
test;
(b) Any follow-up testing for the person;
(c) Methods for preventing the transmission of
the human immunodeficiency virus;
(d) Medical treatment available for the person;
(e) The confidentiality of the result of the
test; and
(f) Recommended testing for the human
immunodeficiency virus for sexual partners of the person.
3. Counties, providers of health care and
medical facilities that provide testing for the human immunodeficiency virus
shall offer to each person who tests positive for the human immunodeficiency
virus:
(a) Appropriate referrals for future services,
including, without limitation, medical care, mental health care and addiction
services; or
(b) If unable to provide referrals pursuant to
paragraph (a), referral to the local health authority for a subsequent referral
to providers within the community for future services, including, without
limitation, medical care, mental health care and addiction services.
4. The Director of the Department of
Health and Human Services may adopt regulations to carry out the provisions of
this section.
(Added to NRS by 2007, 2175)
TUBERCULOSIS
NRS 441A.340 Duties of health authority. The
health authority shall control, prevent the spread of, and ensure the treatment
and cure of tuberculosis.
(Added to NRS by 1989, 297; A 2011, 2508)
NRS 441A.350 Establishment and support of clinics. The
health authority may establish such clinics as it believes are necessary for
the prevention and control of, and for the treatment and cure of, persons who
have tuberculosis and provide those clinics with financial or other assistance
within the limits of the available appropriations and any other resources.
(Added to NRS by 1989, 297; A 2011, 2508)
NRS 441A.360 Provision of medical supplies and financial aid for treatment of
indigent patients. If a person in
this state who has tuberculosis is, in the discretion of the health authority,
unable to afford approved treatment for the disease, the health authority may
provide medical supplies or direct financial aid, within the limits of the
available appropriations and any other resources, to be used in the person’s
treatment, to any physician, clinic, dispensary or medical facility. A
physician, clinic, dispensary or medical facility that accepts supplies or aid
pursuant to this section shall comply with all conditions prescribed by the
board relating to the use of the supplies or aid.
(Added to NRS by 1989, 298; A 2011, 2508)
NRS 441A.370 Contracts with hospitals, clinics and other institutions for
examination and care of patients.
1. The health authority shall, by contract
with hospitals, clinics or other institutions in the State, provide for:
(a) The diagnostic examination, including,
without limitation, laboratory testing of persons who have tuberculosis; and
(b) Inpatient and outpatient care for persons who
have tuberculosis.
2. If adequate facilities for examination
and care are not available in the State, the health authority may contract with
hospitals, clinics or other institutions in other states which do have adequate
facilities.
(Added to NRS by 1989, 298; A 2011, 2509)
NRS 441A.380 Treatment of patient for condition related to or as necessary
for control of tuberculosis. Except
as otherwise provided in NRS 441A.210, a person
who has tuberculosis and is confined to a hospital or other institution
pursuant to the provisions of this chapter must be treated for tuberculosis and
any related condition, and may be treated for any other condition which the
health authority determines is detrimental to his or her health and the
treatment of which is necessary for the effective control of tuberculosis.
(Added to NRS by 1989, 298; A 2011, 2509)
NRS 441A.390 Contracts with private physicians to provide outpatient care in
rural areas. The health authority
may contract with any private physician to provide outpatient care in those
rural areas of the State where, in its determination, patients can best be
treated in that manner.
(Added to NRS by 1989, 298; A 2011, 2509)
NRS 441A.400 Inspection of records of facility where patients are treated. The health authority may inspect and must be
given access to all records of every institution and clinic, both public and
private, where patients who have tuberculosis are treated at public expense.
(Added to NRS by 1989, 298; A 2011, 2509)
MISCELLANEOUS DISEASES
NRS 441A.410 Control of rabies. The
Board shall adopt regulations governing the control of rabies. The regulations
must provide for:
1. The periodic inoculation of animals
with approved vaccines.
2. The impoundment of animals suspected of
having rabies and the disposition of those animals upon verification of the
presence of the disease.
3. Procedures for the treatment of persons
who have been, or are suspected of having been, exposed to rabies.
(Added to NRS by 1989, 298)
ISOLATION AND QUARANTINE OF PERSON OR GROUP OF PERSONS
General Provisions
NRS 441A.510 Manner of isolating, quarantining or treating by health
authority; duty to inform person of rights.
1. If a health authority isolates,
quarantines or treats a person or group of persons infected with, exposed to,
or reasonably believed by a health authority to have been infected with or
exposed to a communicable disease, the authority must isolate, quarantine or
treat the person or group of persons in the manner set forth in NRS 441A.510 to 441A.720,
inclusive.
2. A health authority shall provide each
person whom it isolates or quarantines pursuant to NRS
441A.510 to 441A.720, inclusive, with a
document informing the person of his or her rights. The Board shall adopt
regulations:
(a) Setting forth the rights of a person who is
isolated or quarantined that must be included in the document provided pursuant
to this subsection; and
(b) Specifying the time and manner in which the
document must be provided pursuant to this subsection.
(Added to NRS by 2003, 2196; A 2011, 2509)
NRS 441A.520 Right of person isolated or quarantined to make and receive
telephone calls and to possess cellular phone; duty to notify spouse or legal
guardian under certain circumstances.
1. A person who is isolated or quarantined
pursuant to NRS 441A.510 to 441A.720, inclusive, has the right:
(a) To make a reasonable number of completed
telephone calls from the place where the person is isolated or quarantined as
soon as reasonably possible after his or her isolation or quarantine; and
(b) To possess and use a cellular phone or any
other similar means of communication to make and receive calls in the place
where the person is isolated or quarantined.
2. If a person who is isolated or
quarantined pursuant to NRS 441A.510 to 441A.720, inclusive, is unconscious or otherwise
unable to communicate because of mental or physical incapacity, the health
authority that isolated or quarantined the person must notify the spouse or
legal guardian of the person by telephone and certified mail. If a person
described in this subsection is isolated or quarantined in a medical facility
and the health authority did not provide the notice required by this
subsection, the medical facility must provide the notice. If the case of a
person described in this subsection is before a court and the health authority,
and medical facility, if any, did not provide the notice required by this
subsection, the court must provide the notice.
(Added to NRS by 2003, 2197; A 2011, 2509)
NRS 441A.530 Right to refuse treatment and not submit to involuntary
treatment; exception. A person who
is isolated or quarantined pursuant to NRS 441A.510
to 441A.720, inclusive, has the right to refuse
treatment and may not be required to submit to involuntary treatment unless a
court issues an order requiring the person to submit to treatment.
(Added to NRS by 2003, 2197; A 2011, 2510)
Emergency Isolation or Quarantine
NRS 441A.540 Restrictions on change of status from voluntary isolation or
quarantine to emergency isolation or quarantine; rights of person whose status
is changed.
1. If a person infected with or exposed to
a communicable disease is voluntarily isolated or quarantined in a public or
private medical facility, the facility shall not change the status of the
person to an emergency isolation or quarantine unless, before the change in
status is made:
(a) The facility provides:
(1) An application to a health authority
for an emergency isolation or quarantine pursuant to NRS
441A.560; and
(2) The certificate of a health authority,
physician, physician assistant licensed pursuant to chapter 630 or 633
of NRS or registered nurse to a health authority pursuant to NRS 441A.570; or
(b) The facility receives an order for isolation
or quarantine issued by a health authority.
2. A person whose status is changed to an
emergency isolation or quarantine pursuant to subsection 1:
(a) Must not be detained in excess of 48 hours
after the change in status is made, unless within that period a written
petition is filed by a health authority with the clerk of the district court
pursuant to NRS 441A.600; and
(b) May, immediately after the person’s status is
changed, seek an injunction or other appropriate process in district court
challenging his or her detention.
3. If the period specified in subsection 2
expires on a day on which the office of the clerk of the district court is not
open, the written petition must be filed on or before the close of the business
day next following the expiration of that period.
4. Nothing in this section limits the
actions that a public or private medical facility may take to prevent or limit
the transmission of communicable diseases within the medical facility,
including, without limitation, practices for the control of infections.
(Added to NRS by 2003, 2197; A 2007, 1856)
NRS 441A.550 Detention for testing, examination, observation and consensual
medical treatment; limitation on time; rights of person detained; extension of
time.
1. Any person or group of persons alleged
to have been infected with or exposed to a communicable disease may be detained
in a public or private medical facility, a residence or other safe location
under emergency isolation or quarantine for testing, examination, observation
and the provision of or arrangement for the provision of consensual medical
treatment in the manner set forth in NRS 441A.510
to 441A.720, inclusive, and subject to the
provisions of subsection 2:
(a) Upon application to a health authority
pursuant to NRS 441A.560;
(b) Upon order of a health authority; or
(c) Upon voluntary consent of the person, parent
of a minor person or legal guardian of the person.
2. Except as otherwise provided in
subsection 3, 4 or 5, a person voluntarily or involuntarily isolated or
quarantined under subsection 1 must be released within 72 hours, including
weekends and holidays, from the time of the admission of the person to a
medical facility or isolation or quarantine in a residence or other safe
location, unless within that period:
(a) The additional voluntary consent of the
person, the parent of a minor person or a legal guardian of the person is
obtained;
(b) A written petition for an involuntary
court-ordered isolation or quarantine is filed with the clerk of the district
court pursuant to NRS 441A.600, including, without
limitation, the documents required pursuant to NRS
441A.610; or
(c) The status of the person is changed to a
voluntary isolation or quarantine.
3. A person who is involuntarily isolated
or quarantined under subsection 1 may, immediately after the person is isolated
or quarantined, seek an injunction or other appropriate process in district
court challenging his or her detention.
4. If the period specified in subsection 2
expires on a day on which the office of the clerk of the district court is not
open, the written petition must be filed on or before the close of the business
day next following the expiration of that period.
5. During a state of emergency or
declaration of disaster regarding public health proclaimed by the Governor or
the Legislature pursuant to NRS 414.070,
a health authority may, before the expiration of the period of 72 hours set
forth in subsection 2, petition, with affidavits supporting its request, a
district court for an order finding that a reasonably foreseeable immediate
threat to the health of the public requires the 72-hour period of time to be
extended for no longer than the court deems necessary for available
governmental resources to investigate, file and prosecute the relevant written
petitions for involuntary court-ordered isolation or quarantine pursuant to NRS 441A.510 to 441A.720,
inclusive.
(Added to NRS by 2003, 2198; A 2011, 2510)
NRS 441A.560 Procedure for isolation or quarantine.
1. An application to a health authority
for an order of emergency isolation or quarantine of a person or a group of
persons alleged to have been infected with or exposed to a communicable disease
may only be made by another health authority, a physician, a physician
assistant licensed pursuant to chapter 630 or
633 of NRS, a registered nurse or a medical
facility by submitting the certificate required by NRS
441A.570. Within its jurisdiction, upon application or on its own, subject
to the provisions of NRS 441A.510 to 441A.720, inclusive, a health authority may:
(a) Pursuant to its own order and without a
warrant:
(1) Take a person or group of persons
alleged to and reasonably believed by the health authority to have been
infected with or exposed to a communicable disease into custody in any safe
location under emergency isolation or quarantine for testing, examination,
observation and the provision of or arrangement for the provision of consensual
medical treatment; and
(2) Transport the person or group of
persons alleged to and reasonably believed by the health authority to have been
infected with or exposed to a communicable disease to a public or private
medical facility, a residence or other safe location for that purpose, or
arrange for the person or group of persons to be transported for that purpose
by:
(I) A local law enforcement agency;
(II) A system for the nonemergency
medical transportation of persons whose operation is authorized by the Nevada
Transportation Authority; or
(III) If medically necessary, an
ambulance service that holds a permit issued pursuant to the provisions of chapter 450B of NRS,
Ê only if the
health authority acting in good faith has, based upon personal observation, its
own epidemiological investigation or an epidemiological investigation by
another health authority, a physician, a physician assistant licensed pursuant
to chapter 630 or 633 of NRS or a registered nurse as stated in a
certificate submitted pursuant to NRS 441A.570, if
such a certificate was submitted, of the person or group of persons alleged to
have been infected with or exposed to a communicable disease, a reasonable
factual and medical basis to believe that the person or group of persons has
been infected with or exposed to a communicable disease, and that because of
the risks of that disease, the person or group of persons is likely to be an
immediate threat to the health of members of the public who have not been
infected with or exposed to the communicable disease.
(b) Petition a district court for an emergency
order requiring:
(1) Any health authority or peace officer
to take a person or group of persons alleged to have been infected with or
exposed to a communicable disease into custody to allow the health authority to
investigate, file and prosecute a petition for the involuntary court-ordered
isolation or quarantine of the person or group of persons alleged to have been
infected with or exposed to a communicable disease in the manner set forth in NRS 441A.510 to 441A.720,
inclusive; and
(2) Any agency, system or service
described in subparagraph (2) of paragraph (a) to transport, in accordance with
such court order, the person or group of persons alleged to have been infected
with or exposed to a communicable disease to a public or private medical
facility, a residence or other safe location for that purpose.
2. The district court may issue an
emergency order for isolation or quarantine pursuant to paragraph (b) of
subsection 1:
(a) Only for the time deemed necessary by the
court to allow a health authority to investigate, file and prosecute each
petition for involuntary court-ordered isolation or quarantine pursuant to NRS 441A.510 to 441A.720,
inclusive; and
(b) Only if it is satisfied that there is
probable cause to believe that the person or group of persons alleged to have
been infected with or exposed to a communicable disease has been infected with
or exposed to a communicable disease, and that because of the risks of that
disease, the person or group of persons is likely to be an immediate threat to
the health of the public.
(Added to NRS by 2003, 2198; A 2007, 1857; 2011, 2511)
NRS 441A.570 Certificate of another health authority or physician, licensed
physician assistant or registered nurse required. A
health authority shall not accept an application for an emergency isolation or
quarantine under NRS 441A.560 unless that
application is accompanied by a certificate of another health authority or a
physician, physician assistant licensed pursuant to chapter 630 or 633
of NRS or registered nurse stating that he or she has examined the person or
group of persons alleged to have been infected with or exposed to a
communicable disease or has investigated the circumstances of potential
infection or exposure regarding the person or group of persons alleged to have
been infected with or exposed to a communicable disease and that he or she has
concluded that the person or group of persons has been infected with or exposed
to a communicable disease, and that because of the risks of that disease, the
person or group of persons is likely to be an immediate threat to the health of
the public. The certificate required by this section may be obtained from a
physician, physician assistant licensed pursuant to chapter 630 or 633
of NRS or registered nurse who is employed by the public or private medical
facility in which the person or group of persons is admitted or detained and
from the facility from which the application is made.
(Added to NRS by 2003, 2200; A 2007, 1858)
NRS 441A.580 Requirements for and limitations on applications and
certificates.
1. No application or certificate
authorized under NRS 441A.560 or 441A.570 may be considered if made by a person on
behalf of a medical facility or by a health authority, physician, physician
assistant licensed pursuant to chapter 630 or
633 of NRS or registered nurse who is related
by blood or marriage to the person alleged to have been infected with or
exposed to a communicable disease, or who is financially interested, in a
manner that would be prohibited pursuant to NRS 439B.425 if the application or
certificate were deemed a referral, in a medical facility in which the person alleged
to have been infected with or exposed to a communicable disease is to be
detained.
2. No application or certificate of any
health authority or person authorized under NRS
441A.560 or 441A.570 may be considered unless
it is based on personal observation, examination or epidemiological
investigation of the person or group of persons alleged to have been infected
with or exposed to a communicable disease made by such health authority or
person not more than 72 hours before the making of the application or
certificate. The certificate must set forth in detail the facts and reasons on
which the health authority or person who submitted the certificate pursuant to NRS 441A.570 based his or her opinions and
conclusions.
(Added to NRS by 2003, 2200; A 2007, 1859)
NRS 441A.590 Additional notice to spouse or legal guardian. In addition to any notice required pursuant to
NRS 441A.520, within 24 hours after a person’s
involuntary admission into a public or private medical facility under emergency
isolation or quarantine, the administrative officer of the public or private
medical facility shall reasonably attempt to ascertain the identification and
location of the spouse or legal guardian of that person and, if reasonably possible,
mail notice of the admission by certified mail to the spouse or legal guardian
of that person.
(Added to NRS by 2003, 2200)
Involuntary Court-Ordered Isolation or Quarantine
NRS 441A.600 Petition: Filing; certificate or statement of alleged infection
with or exposure to communicable disease. A
proceeding for an involuntary court-ordered isolation or quarantine of any
person in this State may be commenced by a health authority filing a petition
with the clerk of the district court of the county where the person is to be
isolated or quarantined. The petition may be pled in the alternative for both
isolation and quarantine, if required by developing or changing facts, and must
be accompanied:
1. By a certificate of a health authority
or a physician, a physician assistant licensed pursuant to chapter 630 or 633
of NRS or a registered nurse stating that he or she has examined the person
alleged to have been infected with or exposed to a communicable disease or has
investigated the circumstances of potential infection or exposure regarding the
person alleged to have been infected with or exposed to a communicable disease
and has concluded that the person has been infected with or exposed to a
communicable disease, and that because of the risks of that disease, the person
is likely to be an immediate threat to the health of the public; or
2. By a sworn written statement by the
health authority that:
(a) The health authority has, based upon its
personal observation of the person alleged to have been infected with or
exposed to a communicable disease, or its epidemiological investigation of the
circumstances of potential infection or exposure regarding the person alleged
to have been infected with or exposed to a communicable disease, a reasonable
factual and medical basis to believe that the person has been infected with or
exposed to a communicable disease and, that because of the risks of that
disease, the person is likely to be an immediate threat to the health of the
public; and
(b) The person alleged to have been infected with
or exposed to a communicable disease has refused to submit to voluntary
isolation or quarantine, examination, testing, or treatment known to control or
resolve the transmission of the communicable disease.
(Added to NRS by 2003, 2200; A 2007, 1859)
NRS 441A.610 Additional requirements for petition that is filed after
emergency isolation or quarantine. In
addition to the requirements of NRS 441A.600, a
petition filed pursuant to that section with the clerk of the district court to
commence proceedings for involuntary court-ordered isolation or quarantine of a
person pursuant to NRS 441A.540 or 441A.550 must include a certified copy of:
1. If an application for an order of
emergency isolation or quarantine of the person was made pursuant to NRS 441A.560, the application for the emergency
isolation or quarantine of the person made to the petitioning health authority
pursuant to NRS 441A.560; and
2. A petition executed by a health
authority, including, without limitation, a sworn statement that:
(a) The health authority or a physician,
physician assistant licensed pursuant to chapter
630 or 633 of NRS or registered nurse who
submitted a certificate pursuant to NRS 441A.570,
if such a certificate was submitted, has examined the person alleged to have
been infected with or exposed to a communicable disease;
(b) In the opinion of the health authority, there
is a reasonable degree of certainty that the person alleged to have been
infected with or exposed to a communicable disease is currently capable of
transmitting the disease, or is likely to become capable of transmitting the
disease in the near future;
(c) Based on either the health authority’s
personal observation of the person alleged to have been infected with or
exposed to the communicable disease or the health authority’s epidemiological
investigation of the circumstances of potential infection or exposure regarding
the person alleged to have been infected with or exposed to the communicable
disease, and on other facts set forth in the petition, the person likely poses
an immediate threat to the health of the public; and
(d) In the opinion of the health authority,
involuntary isolation or quarantine of the person alleged to have been infected
with or exposed to a communicable disease to a public or private medical
facility, residence or other safe location is necessary to prevent the person
from immediately threatening the health of the public.
(Added to NRS by 2003, 2201; A 2007, 1859)
NRS 441A.620 Hearing on petition; notice; release of person before hearing.
1. Immediately after receiving any
petition filed pursuant to NRS 441A.600 or 441A.610, the clerk of the district court shall
transmit the petition to the appropriate district judge, who shall set a time,
date and place for its hearing. The date must be within 5 judicial days after
the date on which the petition is received by the clerk.
2. The court shall give notice of the
petition and of the time, date and place of any proceedings thereon to the
subject of the petition, his or her attorney, if known, the petitioner and the
administrative office of any public or private medical facility in which the
subject of the petition is detained.
3. The provisions of this section do not
preclude a health authority from ordering the release from isolation or
quarantine of a person before the time set pursuant to this section for the
hearing concerning the person, if appropriate.
4. After the filing of a petition pursuant
to NRS 441A.600 or 441A.610
and before any court-ordered involuntary isolation or quarantine, a health
authority shall file notice with the court of any order of the health authority
issued after the petition was filed to release the person from emergency
isolation or quarantine, upon which the court may dismiss the petition without
prejudice.
(Added to NRS by 2003, 2202)
NRS 441A.630 Examination or assessment of person alleged to be infected with
or exposed to communicable disease; protective custody pending hearing; written
summary of findings and evaluation concerning person alleged to be infected with
or exposed to communicable disease.
1. After the filing of a petition to
commence proceedings for the involuntary court-ordered isolation or quarantine
of a person pursuant to NRS 441A.600 or 441A.610, the court shall promptly cause two or more
physicians or physician assistants licensed pursuant to chapter 630 or 633
of NRS, at least one of whom must always be a physician, to either examine the
person alleged to have been infected with or exposed to a communicable disease
or assess the likelihood that the person alleged to have been infected with or
exposed to a communicable disease has been so infected or exposed.
2. To conduct the examination or
assessment of a person who is not being detained at a public or private medical
facility, residence or other safe location under emergency isolation or
quarantine pursuant to the emergency order of a health authority or court made
pursuant to NRS 441A.550 or 441A.560, the court may order a peace officer to take
the person into protective custody and transport the person to a public or
private medical facility, residence or other safe location where the person may
be detained until a hearing is held upon the petition.
3. If the person is being detained at his
or her home or other place of residence under an emergency order of a health
authority or court pursuant to NRS 441A.550 or 441A.560, the person may be allowed to remain in his
or her home or other place of residence pending an ordered assessment,
examination or examinations and to return to his or her home or other place of
residence upon completion of the assessment, examination or examinations if
such remaining or returning would not constitute an immediate threat to others
residing in his or her home or place of residence.
4. Each physician and physician assistant
licensed pursuant to chapter 630 or 633 of NRS who examines or assesses a person
pursuant to subsection 1 shall, not later than 24 hours before the hearing set
pursuant to NRS 441A.620, submit to the court in
writing a summary of his or her findings and evaluation regarding the person
alleged to have been infected with or exposed to a communicable disease.
(Added to NRS by 2003, 2202; A 2007, 1860)
NRS 441A.640 Evaluation teams: Establishment; composition; fees.
1. The health authority shall establish
such evaluation teams as are necessary to aid the courts under NRS 441A.630 and 441A.700.
2. Each team must be composed of at least
two physicians, or at least one physician and one physician assistant licensed
pursuant to chapter 630 or 633 of NRS.
3. Fees for the evaluations must be
established and collected as set forth in NRS 441A.650.
(Added to NRS by 2003, 2203; A 2007, 1861; 2011, 2512)
NRS 441A.650 Proceedings held in county where persons to conduct examination
are available; expense of proceedings paid by county.
1. In counties where the examining
personnel required pursuant to NRS 441A.630 are
not available, proceedings for involuntary court-ordered isolation or
quarantine shall be conducted in the nearest county having such examining
personnel available in order that there be minimum delay.
2. The entire expense of proceedings for
involuntary court-ordered isolation or quarantine shall be paid by the county
in which the application is filed.
(Added to NRS by 2003, 2203)
NRS 441A.660 Right to counsel; compensation of counsel; recess; duties of
district attorney.
1. The person alleged to have been
infected with or exposed to a communicable disease, or any relative or friend
on behalf of the person, is entitled to retain counsel to represent the person
in any proceeding before the district court relating to involuntary
court-ordered isolation or quarantine, and if the person fails or refuses to
obtain counsel, the court shall advise the person and his or her guardian or
next of kin, if known, of the right to counsel and shall appoint counsel, who
may be the public defender or his or her deputy.
2. Any counsel appointed pursuant to
subsection 1 must be awarded compensation by the court for his or her services
in an amount determined by the court to be fair and reasonable. Except as
otherwise provided in this subsection, the compensation must be charged against
the estate of the person for whom the counsel was appointed or, if the person
is indigent, against the county in which the application for involuntary
court-ordered isolation or quarantine was filed. In any proceeding before the district
court relating to involuntary court-ordered isolation or quarantine, if the
person for whom counsel was appointed is challenging his or her isolation or
quarantine or any condition of such isolation or quarantine and the person
succeeds in his or her challenge, the compensation must be charged against the
county in which the application for involuntary court-ordered isolation or
quarantine was filed.
3. The court shall, at the request of
counsel representing the person alleged to have been infected with or exposed
to a communicable disease in proceedings before the court relating to
involuntary court-ordered isolation or quarantine, grant a recess in the
proceedings for the shortest time possible, but for not more than 5 days, to
give the counsel an opportunity to prepare his or her case.
4. Each district attorney or his or her
deputy shall appear and represent the State in all involuntary court-ordered
isolation or quarantine proceedings in his or her county. The district attorney
is responsible for the presentation of evidence, if any, in support of the
involuntary court-ordered isolation or quarantine of a person to a medical
facility, residence or other safe location in proceedings held pursuant to NRS 441A.600 or 441A.610.
(Added to NRS by 2003, 2203)
NRS 441A.670 Testimony. In
proceedings for involuntary court-ordered isolation or quarantine, the court
shall hear and consider all relevant testimony, including, but not limited to,
the testimony of examining personnel who participated in the evaluation of the
person alleged to have been infected with or exposed to a communicable disease
and the certificates, if any, of a health authority or a physician, physician
assistant licensed pursuant to chapter 630 or
633 of NRS or registered nurse accompanying
the petition.
(Added to NRS by 2003, 2203; A 2007, 1861)
NRS 441A.680 Right of person alleged to be infected with or exposed to
communicable disease to be present by telephonic conferencing or
videoconferencing and to testify.
1. In proceedings for an involuntary
court-ordered isolation or quarantine, the person with respect to whom the
proceedings are held has the right:
(a) To be present by live telephonic conferencing
or videoconferencing; and
(b) To testify in his or her own behalf, to the
extent that the court determines that the person is able to do so without
endangering the health of others.
2. A person who is alleged to have been
infected with or exposed to a communicable disease does not have the right to
be physically present during the proceedings if such person, if present in the
courtroom, would likely pose an immediate threat to the health of the judge or
the staff or officers of the court.
(Added to NRS by 2003, 2204)
NRS 441A.690 Fees and mileage for witnesses. Witnesses
subpoenaed under the provisions of NRS 441A.510 to
441A.720, inclusive, shall be paid the same fees
and mileage as are paid to witnesses in the courts of the State of Nevada.
(Added to NRS by 2003, 2204; A 2011, 2512)
NRS 441A.700 Findings and order; expiration and renewal of isolation or
quarantine; alternative courses of treatment.
1. If the district court finds, after
proceedings for the involuntary court-ordered isolation or quarantine of a
person to a public or private medical facility, residence or other safe
location:
(a) That there is not clear and convincing evidence
that the person with respect to whom the hearing was held has been infected
with or exposed to a communicable disease or is likely to be an immediate
threat to the health of the public, the court shall enter its finding to that
effect and the person must not be involuntarily detained in such a facility,
residence or other safe location.
(b) That there is clear and convincing evidence
that the person with respect to whom the hearing was held has been infected
with or exposed to a communicable disease and, because of that disease, is
likely to be an immediate threat to the health of the public, the court may
order the involuntary isolation or quarantine of the person and may order the
most appropriate course of treatment after considering the rights of the person
and the desires of the person concerning treatment and vaccination, including,
without limitation, the tenets of the person’s religion and the tenets of any
group or organization of which the person is a member, the rights set forth in NRS 441A.210, the rights set forth in NRS 441A.520, the right to counsel set forth in NRS 441A.660, and the right of a person to challenge
his or her isolation or quarantine or any condition of such isolation or
quarantine. The order of the court must be interlocutory and must not become
final if, within 14 days after the court orders the involuntary isolation or
quarantine, the person is unconditionally released by a health authority from
the medical facility, residence or other safe location.
2. An involuntary isolation or quarantine
pursuant to paragraph (b) of subsection 1 automatically expires at the end of
30 days if not terminated previously by a health authority. At the end of the
court-ordered period of isolation or quarantine, the health authority may
petition to renew the detention of the person for additional periods which each
must not exceed the shorter of 120 days or either, if the person is isolated,
the period of time which the health authority expects the person will be
infectious with the communicable disease or, if the person is quarantined, the
period of time which the health authority determines is necessary to determine
whether the person has been infected with the communicable disease. For each
renewal, the petition must set forth to the court specific reasons why further
isolation or quarantine is appropriate and that the person likely poses an
ongoing immediate threat to the health of the public. If the court finds in
considering a petition for renewal that the person is noncompliant with a
court-ordered measure to control or resolve the risk of transmitting the
communicable disease, it may order the continued isolation and treatment of the
person for any period of time the court deems necessary to resolve the
immediate and ongoing risk of the person transmitting the disease.
3. Before issuing an order for involuntary
isolation or quarantine or a renewal thereof, the court shall explore other
alternative courses of isolation, quarantine and treatment within the least
restrictive appropriate environment as suggested by the evaluation team who
evaluated the person, or other persons professionally qualified in the field of
communicable diseases, which the court believes may be in the best interests of
the person.
(Added to NRS by 2003, 2204)
NRS 441A.710 Clinical abstract to accompany order. The
order for involuntary court isolation or quarantine of any person to a medical
facility, public or private, must be accompanied by a clinical abstract,
including a history of illness, diagnosis and treatment, and the names of
relatives or correspondents.
(Added to NRS by 2003, 2205)
NRS 441A.720 Transportation to public or private medical facility, residence
or other safe location. When any
involuntary court isolation or quarantine is ordered under the provisions of NRS 441A.510 to 441A.720,
inclusive, the involuntarily isolated or quarantined person, together with the
court orders, any certificates of the health authorities, physicians, physician
assistants licensed pursuant to chapter 630
or 633 of NRS or registered nurses, the written
summary of the evaluation team and a full and complete transcript of the notes
of the official reporter made at the examination of such person before the
court, must be delivered to the sheriff of the appropriate county who must be
ordered to:
1. Transport the person; or
2. Arrange for the person to be
transported by:
(a) A system for the nonemergency medical
transportation of persons whose operation is authorized by the Nevada
Transportation Authority; or
(b) If medically necessary, an ambulance service
that holds a permit issued pursuant to the provisions of chapter 450B of NRS,
Ê to the
appropriate public or private medical facility, residence or other safe
location.
(Added to NRS by 2003, 2205; A 2007, 1861; 2011, 2512)
ENFORCEMENT
NRS 441A.900 Injunction: Grounds; responsibility for prosecution; authority
of court.
1. A person who refuses to:
(a) Comply with any regulation of the Board
relating to the control of a communicable disease;
(b) Comply with any provision of this chapter;
(c) Submit to approved treatment or examination
required or authorized by this chapter;
(d) Provide any information required by this
chapter; or
(e) Perform any duty imposed by this chapter,
Ê may be
enjoined by a court of competent jurisdiction.
2. An action for an injunction pursuant to
this section must be prosecuted by the Attorney General, any district attorney
or any private legal counsel retained by a local board of health in the name of
and upon the complaint of the health authority.
3. The court in which an injunction is
sought may make any order reasonably necessary to carry out the purpose or
intent of any provision of this chapter or to compel compliance with any
regulation of the Board or order of the health authority relating to the
control of a communicable disease.
(Added to NRS by 1989, 299)—(Substituted
in revision for NRS 441A.420)
NRS 441A.910 Criminal penalty for violation of chapter. Except as otherwise provided, every person who
violates any provision of this chapter is guilty of a misdemeanor.
(Added to NRS by 1989, 300)—(Substituted
in revision for NRS 441A.430)
NRS 441A.920 Criminal penalty and administrative fine for failure to comply
with regulations or requirements of chapter. Every
provider of health care, medical facility or medical laboratory that willfully
fails, neglects or refuses to comply with any regulation of the Board relating
to the reporting of a communicable disease or any requirement of this chapter
is guilty of a misdemeanor and, in addition, may be subject to an administrative
fine of $1,000 for each violation, as determined by the Board.
(Added to NRS by 1989, 300)—(Substituted
in revision for NRS 441A.440)
NRS 441A.930 District attorney to prosecute violators. The district attorney of the county in which
any violation of this chapter occurs shall prosecute the person responsible for
the violation.
(Added to NRS by 1989, 300)—(Substituted
in revision for NRS 441A.450)