[Rev. 11/22/2013 9:07:42 AM--2013]

[NAC-458 Revised Date: 8-12]

CHAPTER 458 - ABUSE OF ALCOHOL AND DRUGS

GENERAL PROVISIONS

458.010            Definitions.

458.012            “Administrative program” defined.

458.017            “Bureau” defined.

458.019            “Client” defined.

458.0235          “Coalition program” defined.

458.0262          “Coordination of care” defined.

458.0265          “Counseling” defined.

458.028            “Criteria of the Health Division” defined.

458.029            “Detoxification” defined.

458.032            “Drug court program” defined.

458.034            “Evaluation center program” defined.

458.039            “Notice of subgrant award” defined.

458.043            “Operator” defined.

458.045            “Participant” defined.

458.049            “Prevention program” defined.

458.054            “Program” defined.

458.063            “Service” defined.

458.065            “Staff” defined.

458.069            “Substance-related disorder” defined.

458.077            “Treatment assessment” defined.

458.079            “Treatment program” defined.

458.087            “Volunteer” defined.

458.095            Adoption by reference of Diagnostic and Statistical Manual of Mental Disorders.

ALCOHOL AND DRUG ABUSE PROGRAMS

Certification of Programs

458.103            Certification required to receive funding from Health Division.

458.108            Applications for initial certification and recertification.

458.113            Duties of Health Division upon receipt of application; period of certification.

458.118            Criteria for certification and receipt of funding; amendment of criteria.

458.123            Notifications regarding changes affecting certification.

458.128            Addition of new service during period of certification.

458.133            Transferability of certification.

458.138            Fees of Health Division.

 

Operators and Staff of Programs

458.153            Operators: General requirements and duties.

458.158            Operators: Manual of policies, procedures and services.

458.163            Operators: Responsibilities concerning confidentiality and recordkeeping.

458.168            Operators: Records regarding members of staff.

458.173            Operators: Liability insurance.

458.177            Operators and staff: General ethical requirements.

458.183            Operators and staff: Responsibilities concerning clients and participants.

 

Information and Referral Services

458.193            General requirements.

 

Coalition Programs

458.203            Duties of operator.

 

Administrative Programs

458.213            Duties of operator; funding.

 

Prevention Programs

458.223            Purpose and scope of program.

458.228            Duties of operator.

 

Treatment Programs

458.241            Manual of policies and procedures.

458.246            Provision of services to clients.

458.252            Assessments for substance-related disorders and mental health disorders.

458.257            Provision of opioid maintenance therapy services.

458.262            Provision of counseling for groups.

458.267            Policies and procedures for provision of services using system of telecommunications.

458.272            Records regarding clients.

 

Drug Court Programs

458.291            Manual of policies and procedures.

458.296            Assessments of clients.

458.301            Provision of counseling for groups.

458.306            Records regarding clients.

 

Evaluation Center Programs

458.321            Manual of policies and procedures.

458.326            Assessments of clients.

458.331            Records regarding clients.

458.336            Restriction on area of operation.

 

Disciplinary Proceedings

458.361            Health Division: Acceptance of complaints; authority to inspect premises and request information.

458.366            Investigations: Duties of Health Division.

458.371            Investigations: Public disclosure of information and records.

458.376            Imposition of disciplinary action; recertification after revocation of certification.

MISCELLANEOUS PROVISIONS

458.401            Procedure for review of actions taken by Health Division; appeals.

 

GENERAL PROVISIONS

      NAC 458.010  Definitions. (NRS 458.025)  As used in this chapter, unless the context otherwise requires, the words and terms defined in NRS 458.010 and NAC 458.012 to 458.087, inclusive, have the meanings ascribed to them in those sections.

     (Supplied in codification; A by Bur. of Alcohol and Drug Abuse, 10-16-84; 11-30-87; 10-14-92; 4-27-94; R100-98, 11-3-98; A by Bd. of Health by R120-04, 10-5-2004)

      NAC 458.012  “Administrative program” defined. (NRS 458.025)  “Administrative program” means a program that provides services which support prevention programs and treatment programs, including, without limitation, a program which serves as a clearinghouse for information relating to the prevention or treatment of substance-related disorders, a program which provides services relating to training to assist persons with substance-related disorders and a program which provides information or support to assist in the recovery of a person with a substance-related disorder.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.017  “Bureau” defined. (NRS 458.025)  “Bureau” means the Bureau of Alcohol and Drug Abuse of the Health Division, or its successor.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.019  “Client” defined. (NRS 458.025)  “Client” means a person who meets the criteria of the Health Division for having a substance-related disorder and who is receiving a service from a program for that disorder.

     (Added to NAC by Bur. of Alcohol and Drug Abuse by R100-98, eff. 11-3-98; A by Bd. of Health by R120-04, 10-5-2004)

      NAC 458.0235  “Coalition program” defined. (NRS 458.025)  “Coalition program” means a program that is operated by a nonprofit organization consisting of individuals, organizations and agencies to develop strategies and identify programs which address the needs of a community or of a racial, ethnic, religious or social group regarding the use of, misuse of and dependence on alcohol and other drugs in that community or group.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.0262  “Coordination of care” defined. (NRS 458.025)  “Coordination of care” means the exchange of information between two or more parties providing a necessary service to a client to ensure that:

     1.  The client receives such service; and

     2.  The efforts of the parties are coordinated with one another in providing service to the client.

     (Added to NAC by Bur. of Alcohol and Drug Abuse by R100-98, eff. 11-3-98; A by Bd. of Health by R120-04, 10-5-2004)

      NAC 458.0265  “Counseling” defined. (NRS 458.025)  “Counseling” means interaction with a client to provide treatment for a substance-related disorder.

     (Added to NAC by Bur. of Alcohol and Drug Abuse, eff. 4-27-94; A by R100-98, 11-3-98; A by Bd. of Health by R120-04, 10-5-2004)

      NAC 458.028  “Criteria of the Health Division” defined. (NRS 458.025)  “Criteria of the Health Division” means the criteria adopted by the Health Division in the Administrative Manual of the Bureau for the prevention or treatment of a substance-related disorder, including, without limitation:

     1.  The policies and procedures established by the Health Division in the Administrative Manual to monitor compliance of programs with certification requirements; and

     2.  The criteria outlined in the current version of the Diagnostic and Statistical Manual of Mental Disorders, which is adopted by reference pursuant to NAC 458.095.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.029  “Detoxification” defined. (NRS 458.025)  “Detoxification” has the meaning ascribed to it in NAC 449.034.

     (Added to NAC by Bur. of Alcohol and Drug Abuse, eff. 4-27-94; A by R100-98, 11-3-98; A by Bd. of Health by R120-04, 10-5-2004)

      NAC 458.032  “Drug court program” defined. (NRS 458.025)  “Drug court program” means a program which provides treatment assessment services and referral services for persons assigned by a court to the program.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.034  “Evaluation center program” defined. (NRS 458.025, 484C.310)  “Evaluation center program” means a program which evaluates a person pursuant to NRS 484C.350 in a facility certified by the Health Division to determine whether the person is an abuser of alcohol or another drug through evaluations conducted by:

     1.  An alcohol and drug abuse counselor who is licensed or certified pursuant to chapter 641C of NRS to conduct such evaluations; or

     2.  A physician who is certified to conduct such evaluations by the Board of Medical Examiners.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.039  “Notice of subgrant award” defined. (NRS 458.025)  “Notice of subgrant award” means a written agreement signed by the Health Division and an operator which specifies the amount of any funding awarded to a program of the operator by the Health Division and any conditions on the funding which must be satisfied for the program to remain eligible to receive the funding.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.043  “Operator” defined. (NRS 458.025)  “Operator” means:

     1.  The owner of a private entity which operates a program;

     2.  The governing body of a corporation which operates a program;

     3.  The governing body of a nonprofit organization which is responsible for a program, or a designee authorized by the governing body in writing to be responsible for a program; or

     4.  A governmental entity which operates a program.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.045  “Participant” defined. (NRS 458.025)  “Participant” means a person who receives or participates in a service provided by a prevention program.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.049  “Prevention program” defined. (NRS 458.025)  “Prevention program” means a program that provides services, strategies and activities to the general public and to persons who are at a high risk of having a substance-related disorder which:

     1.  Are comprehensively structured to reduce individual or environmental risk factors for substance-related disorders;

     2.  Increase resiliency to substance-related disorders; and

     3.  Establish protections against substance-related disorders.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.054  “Program” defined. (NRS 458.025)  “Program” means any program certified by the Health Division to address substance-related disorders, including, without limitation:

     1.  An administrative program;

     2.  A coalition program;

     3.  A drug court program;

     4.  An evaluation center program;

     5.  A prevention program; and

     6.  A treatment program.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.063  “Service” defined. (NRS 458.025)  “Service” means an activity that is:

     1.  Directed toward the prevention, intervention or treatment of a substance-related disorder; and

     2.  Certified by the Health Division.

     (Added to NAC by Bur. of Alcohol and Drug Abuse by R100-98, eff. 11-3-98; A by Bd. of Health by R120-04, 10-5-2004)

      NAC 458.065  “Staff” defined. (NRS 458.025)  “Staff” means the:

     1.  Paid employees, including, without limitation, paid employees hired on a temporary basis;

     2.  Volunteers;

     3.  Independent contractors; and

     4.  Consultants,

Ê of a program.

     (Added to NAC by Bur. of Alcohol and Drug Abuse by R100-98, eff. 11-3-98; A by Bd. of Health by R120-04, 10-5-2004)

      NAC 458.069  “Substance-related disorder” defined. (NRS 458.025)  “Substance-related disorder” has the meaning ascribed to it in the Diagnostic and Statistical Manual of Mental Disorders, which is adopted by reference pursuant to NAC 458.095.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.077  “Treatment assessment” defined. (NRS 458.025)  “Treatment assessment” means a thorough collection of data concerning a client, including, without limitation, data concerning any life impairments of a client, to determine:

     1.  The existence of a substance-related disorder;

     2.  The appropriate services to be provided; and

     3.  The appropriate plan of treatment based on the criteria of the Health Division.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.079  “Treatment program” defined. (NRS 458.025)  “Treatment program” means a program that provides services for the treatment of a substance-related disorder in the manner set forth in the criteria of the Health Division, including, without limitation:

     1.  Comprehensive evaluations;

     2.  Early intervention services;

     3.  Outpatient counseling;

     4.  Intensive outpatient counseling;

     5.  Residential treatment;

     6.  Transitional housing;

     7.  Residential detoxification;

     8.  Civil protective custody; and

     9.  Opioid maintenance therapy.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.087  “Volunteer” defined. (NRS 458.025)  “Volunteer” means a person who, without compensation, provides a service or conducts a task similar to a service or task provided by a member of the staff.

     (Added to NAC by Bur. of Alcohol and Drug Abuse by R100-98, eff. 11-3-98; A by Bd. of Health by R120-04, 10-5-2004)—(Substituted in revision for NAC 458.068)

      NAC 458.095  Adoption by reference of Diagnostic and Statistical Manual of Mental Disorders. (NRS 458.025)  The Health Division hereby adopts by reference the Diagnostic and Statistical Manual of Mental Disorders, in the form most recently published by the American Psychiatric Association. A copy of the manual may be obtained from the American Psychiatric Association at 1000 Wilson Boulevard, Suite 1825, Arlington, Virginia 22209-3901, at the Internet address http://www.psych.org or by telephone at (800) 368-5777, for the price of $64, plus $9.95 for shipping and handling.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

ALCOHOL AND DRUG ABUSE PROGRAMS

Certification of Programs

      NAC 458.103  Certification required to receive funding from Health Division. (NRS 458.025)  A program must be certified by the Health Division to be eligible for any state or federal money for alcohol and drug abuse programs administered by the Health Division pursuant to chapter 458 of NRS for the prevention or treatment of substance-related disorders.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.108  Applications for initial certification and recertification. (NRS 458.025)

     1.  An operator may apply for the initial certification of a program by submitting to the Health Division:

     (a) A completed application for initial certification on a form provided by the Health Division;

     (b) Documentation evidencing that the applicant is in compliance with all applicable local, state and federal laws, regulations and ordinances;

     (c) All names used by the applicant in its operation of the program or practice of business;

     (d) A copy of the manual containing the policies and procedures of the program;

     (e) A nonrefundable fee in the amount set forth in NAC 458.138; and

     (f) A copy of the policy of insurance evidencing the insurance coverage required pursuant to NAC 458.173.

     2.  An operator may apply for recertification of the program by submitting to the Health Division, within 90 days before the expiration of the initial certification or any previous recertification:

     (a) A completed application for recertification on a form provided by the Health Division;

     (b) Documentation evidencing that the applicant is in compliance with all applicable local, state and federal laws, regulations and ordinances;

     (c) All names used by the applicant in the operation of the program or practice of business;

     (d) A copy of the manual containing the policies and procedures of the program, including, without limitation, documentation that:

          (1) Describes any changes to the manual which was submitted with the initial application for certification or any previous application for recertification and which were approved by the Health Division; and

          (2) Specifies in writing whether the changes were:

               (I) Made as a result of findings of the Health Division, including, without limitation, findings made before the expiration of the certification and findings made in any notice of revocation of certification by the Health Division;

               (II) Made as a result of findings of an agency or organization, other than an agency or organization owned or operated by the operator; or

               (III) Initiated by the operator;

     (e) A nonrefundable fee in the amount set forth in NAC 458.138; and

     (f) A copy of the policy of insurance evidencing the insurance coverage required pursuant to NAC 458.173.

     3.  If the certification of a program expires without recertification in accordance with the requirements set forth in subsection 2 and the operator wishes to certify the program, the operator must apply for initial certification of the program in the manner set forth in subsection 1.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.113  Duties of Health Division upon receipt of application; period of certification. (NRS 458.025)

     1.  Upon receipt of a completed application for initial certification or recertification of a program, the Health Division shall:

     (a) Review the application;

     (b) Schedule and perform an inspection of the program;

     (c) Review the services listed in the application to ensure compliance with the criteria of the Health Division; and

     (d) Provide a written report of the findings of the inspection to the applicant.

     2.  The Health Division shall return any incomplete application to the applicant.

     3.  If the Health Division finds that the program is in compliance with the requirements set forth in this chapter, the Health Division must issue a written initial certification or recertification of the program.

     4.  The Health Division may issue an initial certification or recertification of a program for a period not to exceed 2 years. The Health Division shall determine the period of each initial certification or recertification based upon the criteria for the length of certification set forth in the criteria of the Health Division.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.118  Criteria for certification and receipt of funding; amendment of criteria. (NRS 458.025)

     1.  Except as otherwise provided in subsection 5, the Health Division may only certify and provide funding for programs that provide services in accordance with the criteria of the Health Division.

     2.  The Health Division may amend the criteria of the Health Division if:

     (a) The staff of the Bureau submits a written proposed amendment to the Health Division to change the criteria of the Health Division based upon:

          (1) A review by the staff of the Bureau of any changes made to:

               (I) Any nationally recognized criteria for the prevention or treatment of substance-related disorders; and

               (II) The requirements for federal funding of programs; or

          (2) A request by the Advisory Board or any member of a provider group or the public for a change to the criteria of the Health Division;

     (b) The proposed amendment is placed on the agenda for the next scheduled meeting of the Advisory Board and heard in accordance with the requirements for meetings of state and local agencies set forth in chapter 241 of NRS;

     (c) The Advisory Board approves the amendment proposed by the staff of the Bureau and recommends to the Administrator that he or she amend the criteria of the Health Division; and

     (d) The Administrator approves the amendment recommended by the Advisory Board.

     3.  The staff of the Bureau shall send notice of a meeting of the Advisory Board to hear an amendment to the criteria of the Health Division to each known alcohol and drug abuse program which operates in this State for the prevention or treatment of substance-related disorders and to each person or organization requesting such notification.

     4.  If the Administrator of the Health Division approves any changes to the criteria of the Health Division, the changes must be:

     (a) Published in the Administrative Manual of the Bureau;

     (b) Posted on the Internet at http://health2k.state.nv.us/BADA/; and

     (c) Mailed to each certified alcohol and drug abuse program which operates in this State for the prevention or treatment of substance-related disorders.

     5.  If the Health Division amends the criteria of the Health Division in accordance with this section before an operator is required to recertify a program, the Health Division shall not require the operator to recertify the program to comply with the amended criteria of the Health Division before the date required for recertification of the program. The Health Division may require the operator to:

     (a) Revise the policies and procedures of the program to comply with the amended criteria of the Health Division before the operator is required to recertify the program; and

     (b) Submit to the Health Division a copy of the manual containing the revised policies and procedures.

     6.  As used in this section, “Advisory Board” means the board created by the Administrator to advise the Bureau.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.123  Notifications regarding changes affecting certification. (NRS 458.025)  An operator shall notify the Health Division of any anticipated change which will affect the certification of the program not later than 90 days before the change will occur or as soon as the operator is aware of the change if the operator is not aware of the change at least 90 days before the change will occur. The Health Division shall notify the operator of any actions the operator must take to maintain the certification of the program or whether the operator will be required to apply for a new certification as a result of the change.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.128  Addition of new service during period of certification. (NRS 458.025)

     1.  If, during the period of certification of a program, the operator wishes to provide a service that was not listed in the application for initial certification or recertification, the operator must submit to the Health Division:

     (a) A completed application for the addition of a new service on a form provided by the Health Division;

     (b) A copy of the manual containing the policies and procedures of the program, including, without limitation, a description of the operations of each new service and the procedures relating to each new service; and

     (c) A nonrefundable fee in the amount set forth in NAC 458.138 for each new service at each geographic location at which the service will be provided.

     2.  The Health Division may revise the certificate of the program to include the new service for a period not to exceed the time remaining in the period of certification established by the Health Division pursuant to subsection 4 of NAC 458.113.

     3.  If the operator wishes to continue the certification of the program with the new service after the period of certification, the operator must submit an application for recertification in accordance with the requirements set forth in subsection 2 of NAC 458.108 to maintain certification of the program with the new service. The Health Division shall determine the period of the recertification based upon the criteria for the length of certification set forth in the criteria of the Health Division.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.133  Transferability of certification. (NRS 458.025)  The certification of a program is not transferable and may not be used for any other program.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.138  Fees of Health Division. (NRS 458.025)  The Health Division shall charge and collect nonrefundable fees for the initial certification and recertification of programs and services in accordance with the following schedule:

 

     For each administrative program..................................................................................

              $100

     For each coalition program...........................................................................................

                100

     For each drug court program at each geographic location at which the drug court program will be provided........................................................................................

                100

     For each evaluation center program.............................................................................

                100

     For each prevention program.......................................................................................

                100

     For each service provided by a treatment program at each geographic location at which the service will be provided..........................................................................

                100

     For each service to be added to a program at each geographic location at which the service will be provided..........................................................................................

                100

 

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

Operators and Staff of Programs

      NAC 458.153  Operators: General requirements and duties. (NRS 458.025)

     1.  A program must have a specified operator who is responsible for the program. The operator may designate another responsible party to implement and supervise the responsibilities of the operator pursuant to this chapter. The operator remains responsible for any actions of his or her designee.

     2.  If the program is operated by a corporation, the governing body of the corporation must be the operator. The governing body shall:

     (a) Adopt written bylaws or policies that define any reimbursement to be provided to its members and the powers and duties of the governing body and its committees;

     (b) Meet at least quarterly and keep written minutes that indicate:

          (1) The date of the meeting;

          (2) The names of the persons present at the meeting;

          (3) Any decisions made by the governing body at the meeting; and

          (4) Any other actions taken by the governing body at the meeting; and

     (c) Make available for review by the Health Division the minutes of meetings, the articles of incorporation and the bylaws of the governing body.

     3.  An operator shall:

     (a) Develop and maintain a manual containing the policies and procedures of the program which meets the requirements set forth in NAC 458.158;

     (b) Review and approve any changes to the manual containing the policies and procedures of the program;

     (c) Comply with the provisions of the manual containing the policies and procedures of the program in operating the program;

     (d) Make a copy of the manual containing the policies and procedures of the program available for review to any person who requests to review it;

     (e) Notify the Health Division within 24 hours after the occurrence of an incident that may cause imminent danger to the health or safety of the clients, participants or staff of the program, or a visitor to the program;

     (f) Submit for review and approval by the Health Division a plan for improving the quality of the services provided by the program and for ensuring that the integrity of the program will be maintained;

     (g) After the Health Division approves the plan submitted pursuant to paragraph (f), implement the plan;

     (h) Maintain all licensure and certifications required by the Health Division and comply with all local, state and federal laws, regulations and ordinances;

     (i) Document that paid staff are on the premises where the program is providing services at all times when a client or participant is present on the premises;

     (j) Post a plan for evacuation of the premises where a program is providing services in a place where the plan can be easily viewed by clients, participants and staff; and

     (k) If the operator receives a report from a governmental agency or certifying agency relating to the program, the physical plant on the premises where the program is providing services or the operations of the program, provide a copy of the report to the Health Division not more than 30 days after the operator receives the report.

     4.  The Health Division shall report any known violation of any local, state or federal law, regulation or ordinance by an operator to the appropriate regulatory agencies which govern the licensure or certification of the program and to the appropriate agencies responsible for investigating the violation.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.158  Operators: Manual of policies, procedures and services. (NRS 458.025)  An operator shall maintain a manual containing the policies and procedures of the program and the services to be provided by the program, including, without limitation, the policies and procedures:

     1.  To be followed in the event of a medical emergency.

     2.  For the registration and disposition of complaints by clients, participants and staff and the right to appeal without threat of reprisal.

     3.  For the staff, including, without limitation, an accurate job description for each position held by an employee of the program that describes:

     (a) The title of the position;

     (b) The duties and responsibilities of the position; and

     (c) The qualifications for the position.

     4.  To be used by the operator to:

     (a) Claim funds or bill for services;

     (b) Receive and record funds;

     (c) Record expenditures;

     (d) Prepare financial reports;

     (e) Maintain information for the support of claims for funds or to bill for services; and

     (f) Implement internal controls and audits, as necessary.

     5.  To be used to maintain financial records of clients or participants when a client or participant is billed for services. The policies and procedures must include, without limitation, requirements that an operator shall:

     (a) Inform prospective clients and participants of financial arrangements concerning a service before providing the service;

     (b) Maintain accurate records of:

          (1) Any fees charged to a client or participant; and

          (2) Any payments made by a client or participant; and

     (c) Make the records required pursuant to paragraph (b) available to the client or participant for review upon request.

     6.  To be followed to meet the requirements set forth in this section and NAC 458.163 to 458.177, inclusive.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.163  Operators: Responsibilities concerning confidentiality and recordkeeping. (NRS 458.025, 458.055)  An operator shall ensure that:

     1.  The program complies with all applicable confidentiality and recordkeeping provisions set forth in 42 C.F.R. Part 2, 45 C.F.R. Parts 160, 162 and 164, NRS 458.055 and any other applicable confidentiality laws pertaining to the services provided by the program. In the event of a conflict in the confidentiality requirements set forth in 42 C.F.R. Part 2, 45 C.F.R. Parts 160, 162 and 164, NRS 458.055 and any other applicable confidentiality laws, the more restrictive law will apply.

     2.  A client or participant provides separate and explicit consent to allow the operator or a designee thereof to release information which identifies the client or participant and his or her human immunodeficiency virus seropositive status.

     3.  The program allows a consultant to have access to confidential information concerning clients or participants only if the confidentiality agreements required by 42 C.F.R. Part 2 and 45 C.F.R. Parts 160, 162 and 164 are satisfied. Such agreements must be maintained in the personnel file of the consultant.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.168  Operators: Records regarding members of staff. (NRS 458.025, 458.055)

     1.  An operator must establish a system for maintaining the records of the members of the staff which:

     (a) Maintains the confidentiality and safekeeping of the records.

     (b) Contains the application or resume of each member of the staff, any employment contract signed by a member of the staff and the operator or a designee thereof, and any document containing the job performance standards which is signed by a member of the staff and the operator or the designee.

     (c) Includes, for each member of the staff who serves clients who are under 16 years of age, documentation of the results of an inquiry made pursuant to NRS 179A.180 to 179A.240, inclusive.

     (d) Includes a copy of the certification, registration or license of each member of the staff who provides treatment or another service requiring certification, registration or licensure of the member of the staff.

     (e) Includes copies of documentation of any disciplinary action taken against a member of the staff.

     (f) Includes a verification signed by each member of the staff indicating that the member of the staff has participated in a course of orientation regarding the policies and procedures which govern the service that the member of the staff provides.

     (g) Includes copies of certificates of any training completed by each member of the staff.

     (h) Includes, for each member of the staff who is not a citizen of the United States, a copy of Form I-9, Employment Eligibility Verification, of the United States Citizenship and Immigration Services of the Department of Homeland Security, which verifies that the member of the staff is lawfully entitled to remain and work in the United States.

     (i) Includes a copy of any report of criminal history that is obtained pursuant to NRS 641C.260 or 641C.530 for each member of the staff working with any person who is less than 18 years of age.

     2.  If a record of a member of the staff includes an employment contract or a document containing job performance standards, the contract or standards must clearly specify the nature and amount of the service to be provided by the member of the staff.

     3.  A record of a member of the staff must be made available only to the member of the staff upon submission of a request to review the records and to persons who are:

     (a) Authorized by the policies and procedures of the program;

     (b) Inspecting the program; and

     (c) Authorized by the member of the staff.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.173  Operators: Liability insurance. (NRS 458.025)  An operator shall ensure that the program is insured:

     1.  For liability in an amount sufficient to protect the clients, participants and staff of the program, and the visitors to the program. The operator shall submit a copy of the policy of insurance to the Health Division with any application for initial certification or recertification. The policy of insurance must provide that notice be given to the Health Division not later than 30 days after cancellation of the policy or after an operator does not renew the policy. Upon request, an operator shall make a copy of the policy of insurance available to the Health Division for review.

     2.  For all liabilities arising out of the acts or omissions of a consultant while providing a service for the program. The insurance may be provided by the program or the consultant. If the insurance is provided by the consultant, the operator must obtain a copy of the policy and place the copy in the personnel file of the consultant.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.177  Operators and staff: General ethical requirements. (NRS 458.025)

     1.  An operator and the staff shall not knowingly provide false information to the Health Division or a representative of the Health Division.

     2.  An operator and the staff shall use information that is generally accepted in the field of prevention or treatment of substance-related disorders.

     3.  An operator shall supervise the staff to ensure that a member of the staff does not:

     (a) Become impaired in his or her ability to perform services; or

     (b) Perform activities which are unauthorized by his or her licensure or certification.

     4.  An operator shall not allow a client or participant to grant power of attorney to the operator or a member of the staff.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.183  Operators and staff: Responsibilities concerning clients and participants. (NRS 458.025)  An operator and the staff shall:

     1.  Upon the request of a client or participant, assist the client or participant in reporting any violation of any licensure or certification standard or requirement, or any violation of any law or regulation to the appropriate board or agency.

     2.  Act in the best interest of a client or participant.

     3.  Terminate the provision of a service to a client or participant if it is reasonably clear that the client or participant is not benefiting from the service.

     4.  Not give or receive any commission or any other form of remuneration for the referral of a client or participant from the entity to which the client or participant is referred.

     5.  Not use his or her relationship with a client or participant to promote his or her personal gain or profit.

     6.  Not enter into, or attempt to enter into, a financial relationship that is unrelated to services performed by the program with a current client or participant or a former client or participant, as required by the licensure or certification board of the operator or the member of the staff and for unlicensed or uncertified operators or staff, for at least 2 years after the client or participant is discharged from the program.

     7.  Enable all persons, regardless of ability to pay, especially persons with low or no income, to have access to necessary resources and services related to the prevention or treatment of a substance-related disorder.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

Information and Referral Services

      NAC 458.193  General requirements. (NRS 458.025)  An organization which provides information and referral services to persons with substance-related disorders must operate 24 hours each day and provide such persons with information regarding prevention programs and treatment programs for substance-related disorders. The organization shall maintain an updated record of all available prevention programs and treatment programs to provide specific information or referral services to assist persons with substance-related disorders.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

Coalition Programs

      NAC 458.203  Duties of operator. (NRS 458.025)  The operator of a coalition program shall:

     1.  Ensure that the governing body of the nonprofit organization which operates the coalition program meets at least quarterly, keeps minutes of the meetings and makes copies of the minutes available for review by the Health Division upon request.

     2.  Ensure that the nonprofit organization which operates the coalition program is comprised of individuals, organizations and agencies which broadly represent the community to be served by the coalition program.

     3.  At the request of the Health Division, develop a written comprehensive plan for the prevention of substance-related disorders in the community based upon:

     (a) An assessment of the risk factors and protective factors in the community;

     (b) An assessment of the resources available in the community to address the need for the prevention of substance-related disorders;

     (c) Research concerning the prevention of substance-related disorders; and

     (d) Any evidence-based programs which target risk factors and protective factors of substance-related disorders.

     4.  Make a good faith effort to include all providers of services relating to the prevention of substance-related disorders in:

     (a) Conducting the assessment of the risk factors, protective factors and resources available in the community; and

     (b) Developing and writing the comprehensive plan for the prevention of substance-related disorders in the community.

     5.  Submit all reports to the Health Division as may be required by the Health Division.

     6.  Ensure that all records of the coalition program are kept for at least 4 years, including, without limitation, fiscal records, information reported to the Health Division, records which substantiate any information reported to the Health Division and records which substantiate any claims for funds from the Health Division.

     7.  Meet all requirements as specified by the Health Division in the notice of subgrant award.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

Administrative Programs

      NAC 458.213  Duties of operator; funding. (NRS 458.025)

     1.  The operator of an administrative program shall:

     (a) Submit a request for funding to the Health Division to provide a service in the support of the prevention or treatment of a substance-related disorder.

     (b) Meet all the requirements as specified by the Health Division in the notice of subgrant award.

     (c) Keep all records required by the Health Division, and any documents to support those records, for at least 6 years after the end of the year in which a grant was awarded to the administrative program.

     2.  The Health Division shall group the requests for funding received pursuant to subsection 1 based on the services to be provided and determine which administrative program will be awarded money based on a competitive bidding process.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

Prevention Programs

      NAC 458.223  Purpose and scope of program. (NRS 458.025)  The operator of a prevention program shall ensure that the prevention program operates to prevent the initial onset of a substance-related disorder and to eliminate or reduce the harmful effects of alcohol, tobacco and other drugs in individuals, families and communities. The operator of a prevention program may direct the activities of the prevention program toward specific individuals, selected communities or the general public.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.228  Duties of operator. (NRS 458.025, 458.055)  The operator of a prevention program shall:

     1.  Submit to the Health Division a written statement signed by the operator of the prevention program assuring the Health Division that the prevention program promotes the message to minors not to use alcohol, tobacco or other drugs.

     2.  To satisfy federal requirements for the evaluation of a prevention program, include a requirement in the manual containing the policies and procedures of the prevention program that a minor and the parent or guardian of the minor wishing to participate in the prevention program must comply with the criteria of the Health Division regarding consent to participate in a prevention program.

     3.  If the prevention program includes an evaluation of the prevention program by the participants, maintain documentation that the operator made a good faith effort to obtain the consent required pursuant to subsection 2.

     4.  Maintain documentation of the consent required pursuant to subsection 2 and make the documentation available to the staff of the Health Division upon request.

     5.  If the prevention program is directed at a specific community:

     (a) Participate with any coalition program in that community which is funded by the Health Division to develop a comprehensive plan for the prevention of substance-related disorders in that community.

     (b) Submit quarterly reports to the Health Division which outline:

          (1) Specific activities of the prevention program with the coalition program; and

          (2) How the services of the prevention program:

               (I) Adhere to the goals and objectives of the comprehensive plan for the prevention of substance-related disorders;

               (II) Maintain fidelity to the appropriate evidence-based practices; and

               (III) Satisfy the goals of federal and state alcohol and drug abuse programs for the prevention or treatment of substance-related disorders.

     6.  Include in the manual containing the policies and procedures of the prevention program procedures for the staff to follow concerning the physical and computer records of a participant, including, without limitation, policies and procedures for:

     (a) Preventing the release of information concerning the participant without a signed consent form from the participant for the release of the information;

     (b) The conditions for release of information that would occur pursuant to 42 C.F.R. Part 2 and 45 C.F.R. Parts 160, 162 and 164;

     (c) Maintaining the records at the place of business of the operator or at a site designated by the operator working with an agency which has contracted with the Health Division to maintain the records; and

     (d) Maintaining physical records in a locked facility and computer records in a system which allows access to only those persons authorized by the operator.

     7.  Ensure that all records of the prevention program are kept for at least 4 years, including, without limitation, staff records, participant records, fiscal records, information reported to the Health Division, records which substantiate any information reported to the Health Division and records which substantiate any claims for funds from the Health Division.

     8.  If the operator is providing a service directed at specific participants, prepare records of the service, including, without limitation, records of attendance which include the date the service was provided, the name of each participant, the name and signature of the person who conducted the service and the location at which the service was provided.

     9.  Ensure that the staff are aware and knowledgeable of the theories, goals and methodologies used to successfully carry out the prevention program and the services of the program.

     10.  In accordance with the criteria of the Health Division, include in the manual containing the policies and procedures of the prevention program a written process for evaluating the outcomes of the program and for participating in an evaluation of the program.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

Treatment Programs

      NAC 458.241  Manual of policies and procedures. (NRS 458.025, 458.055)  The operator of a treatment program shall maintain a manual containing the policies and procedures of the treatment program which includes, without limitation, the policies and procedures required pursuant to NAC 458.158, and policies and procedures:

     1.  Concerning the control of infections, including, without limitation, communicable diseases, and concerning universal precautions against bloodborne pathogens.

     2.  Describing the manner in which the treatment program will satisfy the requirements set forth in NAC 458.246 and 458.272.

     3.  For releasing information about a client which satisfies the requirements set forth in 42 C.F.R. Part 2 and 45 C.F.R. Parts 160, 162 and 164 and which reveals:

     (a) That the client has abused or neglected a child or an elderly person;

     (b) That the client presents a danger to other people;

     (c) That the client has a communicable disease; or

     (d) The identity of the client and his or her human immunodeficiency virus seropositive status.

     4.  Describing the criteria which the treatment program will use to satisfy and comply with the criteria of the Health Division for admission, continued stay and discharge.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.246  Provision of services to clients. (NRS 458.025)  The operator of a treatment program shall:

     1.  Perform an assessment of each client or obtain the most recent assessment of the client which is found to be sufficient to:

     (a) Make a complete identification of any problems concerning the substance-related disorder of the client; and

     (b) Determine the appropriate level of service for the client pursuant to the criteria of the Health Division.

     2.  Identify the staff which provide the services set forth in subsection 1 and require such staff to develop a plan of treatment, not including detoxification, on or before the third contact of the client with the program or on or before the third day on which the client receives services from the program, whichever occurs first. For the purposes of this subsection, any contact that a client has with the program for the sole purpose of receiving medication does not constitute contact or receiving services. The plan of treatment must specify:

     (a) Behavioral objectives to be achieved by the client in response to the problems identified by the treatment assessment;

     (b) The services to be provided by the staff to facilitate the client in attaining the objectives of the plan; and

     (c) The member of the staff who is responsible for ensuring that the services specified pursuant to paragraph (b) are provided and that the client attains the objectives of the plan.

     3.  Review and revise the plan of treatment of a client:

     (a) If the client is receiving outpatient treatment services, whenever the condition of the client changes over the course of treatment or every 30 days, whichever occurs first; and

     (b) If the client is receiving residential treatment services, whenever the condition of the client changes over the course of treatment or every 14 days, whichever occurs first.

     4.  Provide the appropriate level of services determined pursuant to paragraph (b) of subsection 1 or refer the client to services which are the appropriate level and are otherwise available in the community.

     5.  Provide, when appropriate, a referral to, and coordination of care with, an employee assistance program or any other provider of a service related to the treatment of a substance-related disorder to address any identified problems of a client which cannot be resolved by a service provided by the treatment program.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.252  Assessments for substance-related disorders and mental health disorders. (NRS 458.025)  The operator of a treatment program which provides an assessment for substance-related disorders and mental health disorders shall:

     1.  Require that such an assessment be conducted by:

     (a) One person who is both:

          (1) Licensed or certified as an alcohol and drug abuse counselor pursuant to chapter 641C of NRS, or the intern of such a counselor; and

          (2) A mental health professional, or the intern of such a professional, who is licensed as a psychologist pursuant to chapter 641 of NRS, a marriage and family therapist pursuant to chapter 641A of NRS or a clinical social worker pursuant to chapter 641B of NRS, or who is a medical physician with a certification in addiction medicine from a nationally accepted board; or

     (b) Two persons:

          (1) One of whom is licensed or certified as an alcohol and drug abuse counselor pursuant to chapter 641C of NRS, or the intern of such a counselor; and

          (2) The other of whom is a mental health professional, or the intern of such a professional, who is licensed as a psychologist pursuant to chapter 641 of NRS, a marriage and family therapist pursuant to chapter 641A of NRS or a clinical social worker pursuant to chapter 641B of NRS, or who is a medical physician with a certification in addiction medicine from a nationally accepted board.

     2.  Determine whether the person being assessed has a co-occurring substance-related and mental health disorder and, if so, determine the appropriate treatment for the disorders.

     3.  Provide a comprehensive written report concerning such an assessment which includes, without limitation, the findings of each person who conducted the assessment.

     4.  If such an assessment is conducted by an intern, require that the assessment be supervised and reviewed by the appropriate licensed or certified alcohol and drug abuse counselor or mental health professional who is licensed as a psychologist pursuant to chapter 641 of NRS, a marriage and family therapist pursuant to chapter 641A of NRS or a clinical social worker pursuant to chapter 641B of NRS, or who is a medical physician with a certification in addiction medicine from a nationally accepted board.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.257  Provision of opioid maintenance therapy services. (NRS 458.025)  A treatment program which provides opioid maintenance therapy services must be certified to provide services for outpatients and ambulatory detoxification services. The facility at which the treatment program provides opioid maintenance therapy services must be licensed by the Health Division as a facility for treatment with narcotics pursuant to NAC 449.154 to 449.15485, inclusive.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.262  Provision of counseling for groups. (NRS 458.025)  If a treatment program provides counseling for groups, the operator shall ensure that any session for counseling for a group includes not more than 15 clients.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.267  Policies and procedures for provision of services using system of telecommunications. (NRS 458.025, 458.055)  The operator of a treatment program which offers services using a system of telecommunications shall submit the policies and procedures for the operation of the system to the Health Division for approval. The policies and procedures must provide for:

     1.  The confidentiality of the setting for clients and information concerning clients;

     2.  Actions the program will take in case of an emergency involving a client; and

     3.  The manner in which the dignity of clients will be maintained.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.272  Records regarding clients. (NRS 458.025, 458.055)  The operator of a treatment program shall:

     1.  Ensure that a record is maintained for each client. The record must include:

     (a) The name, age, gender, race, ethnicity and permanent address of the client.

     (b) If services are funded by the Health Division, an evaluation of the financial status of the client sufficient to determine eligibility for such services.

     (c) A statement from the client, signed within 24 hours after intake or upon enrollment in the treatment program, explaining that he or she is seeking service, unless the client is being provided a service related to civil protective custody.

     (d) A consent form for treatment services signed by the client or the parent or guardian of the client within 24 hours after intake or upon enrollment in the treatment program, unless the client is being provided a service related to civil protective custody.

     (e) Any consent to release information which satisfies the requirements set forth in 42 C.F.R. Part 2 and 45 C.F.R. Parts 160, 162 and 164.

     (f) The source of any referral to the treatment program.

     (g) Documentation of the treatment assessment performed by the operator or obtained by the operator pursuant to subsection 1 of NAC 458.246.

     (h) The history of treatment of the client.

     (i) Any sources of psychosocial stress affecting the client.

     (j) The original plan of care for the client and all revisions to the plan of care.

     (k) Any additional information that should be taken into consideration during the planning of treatment, determination of appropriate referrals and determination of any need for coordination of care.

     (l) Documentation of and justification for any referral to appropriate services pursuant to the criteria of the Health Division and any resulting coordination of care.

     (m) Documentation of any discussion with the client concerning the results of the treatment assessment, appropriate referrals and any barriers to treatment.

     (n) The date, type and duration of any contact with the client, and any services provided to the client.

     (o) Documentation of any:

          (1) Incident that may cause imminent danger to the health and safety of the client, other clients or staff, or persons outside the treatment program;

          (2) Problem involving the client;

          (3) Infraction of the rules of the treatment program by the client; and

          (4) Sign or symptom of illness or injury of the client.

     (p) Documentation in support of services that the treatment program provides to the client, including, without limitation, any:

          (1) Correspondence concerning the client; and

          (2) Results of a test conducted on the client, including, without limitation, any test conducted by a laboratory.

     (q) If the treatment program administers or dispenses medication to the client or makes medication available to the client to administer to himself or herself, documentation of all actions taken to comply with the requirements set forth in NAC 449.144.

     (r) If the client is transferred to a different location or provided a different service, including a service provided by the same operator, a copy of the case note made at the time of transfer which includes, without limitation:

          (1) Diagnosis of the client at the time of admission or intake;

          (2) The response of the client to treatment;

          (3) Diagnosis of the client at the time of transfer; and

          (4) Recommendations for persons who will be providing treatment to the client.

     (s) After the client is discharged from the treatment program:

          (1) Documentation that a copy of the plan for continuing care of the client, including, without limitation, any referrals given to the client, was provided to the client before discharge, if possible; and

          (2) Documentation that, not more than 5 business days after the client was discharged from the treatment program, a summary was completed which meets the criteria of the Health Division for the discharge of a client.

     (t) A copy of the notification, which is in the form approved by the Health Division and which was signed by the client, indicating:

          (1) The procedure for the client to register a complaint and to appeal a decision by the treatment program concerning a complaint;

          (2) The requirements for the confidentiality of client information set forth in 42 C.F.R. Part 2, 45 C.F.R. Parts 160, 162 and 164 and any other applicable federal or state laws governing the confidentiality of client information for the service provided; and

          (3) Any other rights of the client that are specified by the Health Division.

     (u) Documentation to support any claims for services or data reported to the Health Division.

     2.  Ensure that each client receives a copy of the notification required pursuant to paragraph (t) of subsection 1.

     3.  Ensure that the client records adhere to procedures for medical records.

     4.  Ensure that the case notes for each client accurately reflect the treatment and services needed by the client, as identified in the assessment and plan of treatment required pursuant to NAC 458.246.

     5.  Ensure that the staff readily has access to the client records to the extent authorized pursuant to 42 C.F.R. Part 2 and 45 C.F.R. Parts 160, 162 and 164.

     6.  Maintain a system for the maintenance and protection of client information which satisfies the requirements set forth in 42 C.F.R. Part 2 and 45 C.F.R. Parts 160, 162 and 164, including, without limitation, requirements for:

     (a) Adequate provisions to prevent unauthorized access or theft of any form of a record of a client;

     (b) The locked storage of paper records;

     (c) Adequate provisions for a system of backup of records maintained in a computer system in case of a failure of the primary system;

     (d) Retention of the records of each client for not less than 6 years after the client is discharged from the treatment program, to be made available as required pursuant to 45 C.F.R. Parts 160, 162 and 164; and

     (e) Appropriate methods to destroy records of clients as required by federal regulation.

     7.  Ensure that each client has access to their records as required pursuant to 42 C.F.R. Part 2 and 45 C.F.R. Parts 160, 162 and 164.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

Drug Court Programs

      NAC 458.291  Manual of policies and procedures. (NRS 458.025, 458.055)  The operator of a drug court program shall maintain a manual containing the policies and procedures of the drug court program which includes, without limitation, the policies and procedures required pursuant to NAC 458.158, and policies and procedures:

     1.  Concerning the control of infections, including, without limitation, communicable diseases, and concerning universal precautions against bloodborne pathogens.

     2.  Describing the manner in which the drug court program will satisfy the requirements set forth in NAC 458.296 and 458.306.

     3.  For releasing information about a client which satisfies the requirements set forth in 42 C.F.R. Part 2 and 45 C.F.R. Parts 160, 162 and 164 and which reveals:

     (a) That the client has abused or neglected a child or an elderly person;

     (b) That the client presents a danger to other people;

     (c) That the client has a communicable disease; or

     (d) The identity of the client and his or her human immunodeficiency virus seropositive status.

     4.  Describing the criteria which the drug court program will use to satisfy and comply with the criteria of the Health Division for admission, continued stay and discharge.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.296  Assessments of clients. (NRS 458.025)  The operator of a drug court program shall perform an assessment of each client or obtain the most recent assessment which is found to be sufficient to:

     1.  Make a complete identification of any problems related to the substance-related disorder of the client; and

     2.  Determine the appropriate level of service for the client pursuant to the criteria of the Health Division.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.301  Provision of counseling for groups. (NRS 458.025)  If a drug court program provides counseling for groups, the operator shall ensure that any session for counseling for a group includes not more than 15 clients.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.306  Records regarding clients. (NRS 458.025, 458.055)  The operator of a drug court program shall:

     1.  Ensure that a record is maintained for each client. The record must include:

     (a) The name, age, gender, race, ethnicity and permanent address of the client.

     (b) If services are funded by the Health Division, an evaluation of the financial status of the client sufficient to determine eligibility for such services.

     (c) A statement from the client, signed upon intake or enrollment in the drug court program, explaining that he or she is seeking service, unless the client is being provided a service related to civil protective custody.

     (d) A consent form for treatment services signed by the client or the parent or guardian of the client upon intake or enrollment in the drug court program, unless the client is being provided a service related to civil protective custody.

     (e) Any consent to release information which satisfies the requirements set forth in 42 C.F.R. Part 2 and 45 C.F.R. Parts 160, 162 and 164.

     (f) The source of any referral to the drug court which referred the client to the drug court program.

     (g) Documentation of the assessment performed by the operator or obtained by the operator pursuant to NAC 458.296.

     (h) The history of treatment of the client.

     (i) Any sources of psychosocial stress affecting the client.

     (j) Any additional information that should be taken into consideration during the planning of treatment, determination of appropriate referrals and determination of any need for coordination of care.

     (k) Documentation of and justification for any referral to appropriate services pursuant to the criteria of the Health Division and any resulting coordination of care.

     (l) Documentation of any discussion with the client concerning the results of the treatment assessment, appropriate referrals and any barriers to treatment.

     (m) The date, type and duration of any contact with the client, and any services provided to the client.

     (n) Documentation of any:

          (1) Incident that may cause imminent danger to the health and safety of the client, other clients or staff, or persons outside the drug court program;

          (2) Problem involving the client; and

          (3) Sign or symptom of illness or injury of the client.

     (o) Documentation in support of services that the drug court program provides to the client, including, without limitation, any:

          (1) Correspondence concerning the client; and

          (2) Results of a test conducted on the client, including, without limitation, any test conducted by a laboratory.

     (p) A copy of the notification, which is in the form approved by the Health Division and which was signed by the client, indicating:

          (1) The procedure for the client to register a complaint and to appeal a decision by the drug court program concerning a complaint;

          (2) The requirements for the confidentiality of client information set forth in 42 C.F.R. Part 2, 45 C.F.R. Parts 160, 162 and 164 and any other applicable federal or state laws governing the confidentiality of client information for the service provided; and

          (3) Any other rights of the client that are specified by the Health Division.

     (q) Documentation to support any claims for services or data reported to the Health Division.

     2.  Ensure that each client receives a copy of the notification required pursuant to paragraph (p) of subsection 1.

     3.  Ensure that the client records adhere to procedures for medical records.

     4.  Ensure that the case notes for each client accurately reflect the treatment and services needed by the client, as identified in the assessment required pursuant to NAC 458.296.

     5.  Ensure that the staff readily has access to the client records to the extent authorized pursuant to 42 C.F.R. Part 2 and 45 C.F.R. Parts 160, 162 and 164.

     6.  Maintain a system for the maintenance and protection of client information which satisfies the requirements set forth in 42 C.F.R. Part 2 and 45 C.F.R. Parts 160, 162 and 164, including, without limitation, requirements for:

     (a) Adequate provisions to prevent unauthorized access or theft of any form of a record of a client;

     (b) The locked storage of paper records;

     (c) Adequate provisions for a system of backup of records maintained in a computer system in case of a failure of the primary system;

     (d) Retention of the records of each client for not less than 6 years after the client is discharged from the drug court program, to be made available as required pursuant to 45 C.F.R. Parts 160, 162 and 164; and

     (e) Appropriate methods to destroy records of clients as required by federal regulation.

     7.  Ensure that each client has access to their records as required pursuant to 42 C.F.R. Part 2 and 45 C.F.R. Parts 160, 162 and 164.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

Evaluation Center Programs

      NAC 458.321  Manual of policies and procedures. (NRS 458.025, 458.055, 484C.310)  The operator of an evaluation center program shall maintain a manual containing the policies and procedures of the evaluation center program which includes, without limitation, the policies and procedures required pursuant to NAC 458.158, and policies and procedures:

     1.  Concerning the control of infections, including, without limitation, communicable diseases, and concerning universal precautions against bloodborne pathogens.

     2.  Describing the manner in which the evaluation center program will satisfy the requirements set forth in NAC 458.326 and 458.331.

     3.  For releasing information about a client which satisfies the requirements set forth in 42 C.F.R. Part 2 and 45 C.F.R. Parts 160, 162 and 164 and which reveals:

     (a) That the client has abused or neglected a child or an elderly person;

     (b) That the client presents a danger to other people;

     (c) That the client has a communicable disease; or

     (d) The identity of the client and his or her human immunodeficiency virus seropositive status.

     4.  Describing the criteria which the evaluation center program will use to satisfy and comply with the criteria of the Health Division for admission, continued stay and discharge.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.326  Assessments of clients. (NRS 458.025, 484C.310)  The operator of an evaluation center program shall perform an assessment of each client or obtain the most recent assessment which is found to be sufficient to:

     1.  Make a complete identification of any problems related to the substance-related disorder of the client; and

     2.  Determine the appropriate level of service for the client pursuant to the criteria of the Health Division.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.331  Records regarding clients. (NRS 458.025, 458.055, 484C.310)  The operator of an evaluation center program shall:

     1.  Ensure that a record is maintained for each client. The record must include:

     (a) The name, age, gender, race, ethnicity and permanent address of the client.

     (b) If services are funded by the Health Division, an evaluation of the financial status of the client sufficient to determine eligibility for such services.

     (c) A statement from the client, signed upon intake or enrollment in the evaluation center program, explaining that he or she is seeking service, unless the client is being provided a service related to civil protective custody.

     (d) A consent form for treatment services signed by the client or the parent or guardian of the client upon intake or enrollment in the evaluation center program, unless the client is being provided a service related to civil protective custody.

     (e) Any consent to release information which satisfies the requirements set forth in 42 C.F.R. Part 2 and 45 C.F.R. Parts 160, 162 and 164.

     (f) The source of any referral to the evaluation center program.

     (g) Documentation of the assessment performed by the operator or obtained by the operator pursuant to NAC 458.326.

     (h) The history of treatment of the client.

     (i) Any sources of psychosocial stress affecting the client.

     (j) Any additional information that should be taken into consideration during the planning of treatment, determination of appropriate referrals and determination of any need for coordination of care.

     (k) Documentation of and justification for any referral to appropriate services pursuant to the criteria of the Health Division and any resulting coordination of care.

     (l) Documentation of any discussion with the client concerning the results of the treatment assessment, appropriate referrals and any barriers to treatment.

     (m) The date, type and duration of any contact with the client, and any services provided to the client.

     (n) Documentation of any:

          (1) Incident that may cause imminent danger to the health and safety of the client, other clients or staff, or persons outside the evaluation center program;

          (2) Problem involving the client; and

          (3) Sign or symptom of illness or injury of the client.

     (o) Documentation in support of services that the evaluation center program provides to the client, including, without limitation, any:

          (1) Correspondence concerning the client; and

          (2) Results of a test conducted on the client, including, without limitation, any test conducted by a laboratory.

     (p) A copy of the notification, which is in the form approved by the Health Division and which was signed by the client, indicating:

          (1) The procedure for the client to register a complaint and to appeal a decision by the evaluation center program concerning a complaint;

          (2) The requirements for the confidentiality of client information set forth in 42 C.F.R. Part 2, 45 C.F.R. Parts 160, 162 and 164 and any other applicable federal or state laws governing the confidentiality of client information for the service provided; and

          (3) Any other rights of the client that are specified by the Health Division.

     (q) Documentation to support any claims for services or data reported to the Health Division.

     2.  Ensure that each client receives a copy of the notification required pursuant to paragraph (p) of subsection 1.

     3.  Ensure that the client records adhere to procedures for medical records.

     4.  Ensure that the case notes for each client accurately reflect the treatment and services needed by the client, as identified in the assessment required pursuant to NAC 458.326.

     5.  Ensure that the staff readily has access to the client records to the extent authorized pursuant to 42 C.F.R. Part 2 and 45 C.F.R. Parts 160, 162 and 164.

     6.  Maintain a system for the maintenance and protection of client information which satisfies the requirements set forth in 42 C.F.R. Part 2 and 45 C.F.R. Parts 160, 162 and 164, including, without limitation, requirements for:

     (a) Adequate provisions to prevent unauthorized access or theft of any form of a record of a client;

     (b) The locked storage of paper records;

     (c) Adequate provisions for a system of backup of records maintained in a computer system in case of a failure of the primary system;

     (d) Retention of the records of each client for not less than 6 years after the client is discharged from the evaluation center program, to be made available as required pursuant to 45 C.F.R. Parts 160, 162 and 164; and

     (e) Appropriate methods to destroy records of clients as required by federal regulation.

     7.  Ensure that each client has access to their records as required pursuant to 42 C.F.R. Part 2 and 45 C.F.R. Parts 160, 162 and 164.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.336  Restriction on area of operation. (NRS 458.025, 484C.310)  An evaluation center program must not be operated by an operator who operates or has a financial interest in a treatment program or any other organization which provides treatment for substance-related disorders in the same geographic area at which the evaluation center program will be provided if the evaluation center program is provided in a county whose population is 100,000 or more.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

Disciplinary Proceedings

      NAC 458.361  Health Division: Acceptance of complaints; authority to inspect premises and request information. (NRS 458.025)  The Health Division shall accept complaints against programs in person, in writing, over the phone or by electronic means. The Health Division may enter the premises of a program and inspect the premises or request additional information from the program at any time.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.366  Investigations: Duties of Health Division. (NRS 458.025, 458.055)  When investigating a complaint regarding a program, the Health Division shall:

     1.  Request that the person registering the complaint state in writing the substance of the complaint and the name of the person or program alleged to have violated a requirement of this chapter. An investigation will proceed whether or not the allegations are put in writing.

     2.  Conduct announced or unannounced inspections and any other investigation necessary to determine the validity of the complaint.

     3.  If the investigation is conducted on the premises where a program is providing services, inform the operator or a designee thereof of the presence of staff from the Health Division on the premises upon arrival.

     4.  Inform the operator or the designee of the nature of the complaint.

     5.  Except as otherwise provided in this subsection, keep all information gathered during the course of the investigation confidential while the investigation is proceeding. This subsection does not prohibit the Health Division from:

     (a) Communicating or cooperating with any agency or board that:

          (1) Is investigating a member of the staff who is under investigation;

          (2) Is investigating the same program as the Health Division; or

          (3) Regulates or has jurisdiction over the violations alleged in a complaint or found during the course of the investigation.

     (b) Communicating with the operator or the designee when a complaint against a person who is a member of the staff alleges a condition posing a significant hazard to the health or safety of the clients, participants or staff of the program, or a visitor to the program.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.371  Investigations: Public disclosure of information and records. (NRS 458.025, 458.055)  Except as otherwise provided in this section, if the Health Division imposes any disciplinary action against an operator, the information gathered during the course of an investigation conducted pursuant to NAC 458.361 or 458.366 and the records of the investigation become public after the Health Division completes the investigation. Any information required to be kept confidential pursuant to 42 C.F.R. Part 2 and 45 C.F.R. Parts 160, 162 and 164 may not be made public.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

      NAC 458.376  Imposition of disciplinary action; recertification after revocation of certification. (NRS 458.025)

     1.  The Health Division may revoke the certification of a program or deny the initial certification or recertification of a program based on the following grounds:

     (a) Diminished quality of the service from when the program was originally certified;

     (b) Major noncompliance with any local, state or federal law, regulation or ordinance;

     (c) Disseminating false or misleading information to the public, consumers or the Health Division;

     (d) Failure of the operator or the staff to comply with the requirements of this chapter;

     (e) A condition which poses a significant hazard to the health or safety of the clients, participants or staff of the program, or a visitor to the program;

     (f) Significant mismanagement of the program by the operator;

     (g) Significant fiscal mismanagement of the program by the operator;

     (h) Formal criminal charges or an investigative process being brought against the operator or any member of the staff;

     (i) A complaint against a program or a member of the staff made by a client, participant, entity or individual with knowledge of the program which alleges a violation of a requirement of this chapter and which has been substantiated by the Health Division after an investigation concerning the complaint; or

     (j) Failure to comply with the requirements for funding as specified in the notice of subgrant award.

     2.  The Health Division may deny the certification of any new service to a program and may suspend funding for any service of a program for the same grounds as set forth in subsection 1.

     3.  If the certification of a program has been revoked pursuant to this section, the operator may not apply for recertification for at least 6 months after the date of revocation of the certification.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)

MISCELLANEOUS PROVISIONS

      NAC 458.401  Procedure for review of actions taken by Health Division; appeals. (NRS 458.025)

     1.  A person who has reason to believe that an action taken by the Health Division pursuant to this chapter or chapter 458 of NRS is incorrect or based upon inadequate knowledge may, within 10 business days after receiving notice of the action, request an informal discussion with the employee of the Health Division responsible for the action and the immediate supervisor of the employee.

     2.  If the informal discussion does not resolve the problem, the aggrieved person may, within 10 business days after the date scheduled for the informal discussion, submit a written request to the Bureau for an informal conference. The informal conference must be scheduled for a date, time and place mutually agreed upon by the aggrieved person and the Bureau, except that the informal conference must be held not later than 60 days after the date on which the Bureau received the written request for the conference.

     3.  Except as otherwise provided in subsection 4, the determination of the Bureau resulting from the informal conference cannot be appealed and is the final remedy available to the aggrieved person.

     4.  An applicant for or holder of a certificate issued pursuant to this chapter or chapter 458 of NRS who is aggrieved by an action of the Health Division relating to the denial of initial certification or recertification of a program, the denial of certification of additional services to a program or the suspension of funding for services of a program may appeal that action in accordance with NAC 439.300 to 439.395, inclusive, after exhausting the informal procedures set forth in this section, except that the Bureau may waive the informal procedures, or any portion thereof, by giving written notice to the aggrieved person.

     (Added to NAC by Bd. of Health by R120-04, eff. 10-5-2004)