[Rev. 1/31/2018 2:21:05 PM]

[NAC-433 Revised Date: 2-18]

CHAPTER 433 - ADMINISTRATION OF MENTAL HEALTH AND INTELLECTUAL AND DEVELOPMENTAL DISABILITY PROGRAMS

GENERAL PROVISIONS

433.001              Definitions.

433.003              “Cemetery” defined.

433.004              “Cemetery authority” defined.

433.005              “Director” defined.

433.010              “Division” defined.

433.013              “Removal” defined.

433.040              “Adult with a serious mental illness” and “child with a serious emotional disturbance” defined for counting purposes.

433.050              Adoption of Manual by reference.

EDUCATION AND CERTIFICATION OF MENTAL HEALTH TECHNICIANS

433.060              Requirements for certification.

433.070              Purposes of vocational and educational program.

433.080              Compensation for participation in vocational and educational program; requirements to repeat failed courses.

433.090              Renewal of certification.

433.100              Designation of certification.

433.110              Vocational and educational program requirements for new employees, permanent employees and promotions; allowance for partial attendance and lack of available courses.

BURIAL PARK AT NORTHERN NEVADA ADULT MENTAL HEALTH SERVICES

433.130              Order by cemetery authority to disinter and remove remains.

433.140              Notice of removal.

433.150              Disposition of remains from removal; request for removal by family member or tribe.

REPORTING THE ABUSE AND NEGLECT OF CONSUMERS

433.200              “Abuse” and “neglect” interpreted.

433.210              Requirements.

COMMUNITY-BASED LIVING ARRANGEMENT SERVICES

General Provisions

433.300              Definitions.

433.303              “Certificate” defined.

433.306              “Community-based living arrangement services” or “services” defined.

433.309              “Individual support team” defined.

433.312              “Individualized plan” defined.

433.315              “Mental illness” defined.

433.318              “Provider” defined.

433.321              “Provisional certificate” defined.

433.324              “Quality assurance review” defined.

Issuance and Renewal of Provisional Certificates and Certificates

433.327              Provisional certificate or certificate required to provide services; exception.

433.330              Contents of application for provisional certificate.

433.333              Review of application for provisional certificate; actions upon determination that application is incomplete.

433.336              Interview of applicant; training; issuance and validity of provisional certificate.

433.339              Grounds for denial of application for provisional certificate; notice of denial.

433.342              Request for quality assurance review; revocation or extension of provisional certificate; issuance of certificate.

433.345              Renewal of certificate.

Operation of Provider

433.348              Duties of provider.

433.351              Policies and procedures of governmental or organizational provider.

433.354              Arrangements for services from specially trained persons; determination of need for such services.

433.357              Financial plan; financial records; financial report.

433.360              Assessment of need for services; maintenance of findings of assessment; establishment of individualized support team and permanent individual plan; acceptance of person before assessment.

433.363              Contract for provision of services.

433.366              Training concerning administration of medication; persons authorized to administer medication.

433.369              Record regarding recipient of services: Contents and availability for review.

433.372              Record regarding recipient of services: Retention; availability for review by representatives of Department.

433.375              Rights of recipient of services.

Quality Assurance Reviews and Discipline

433.378              Quality assurance review.

433.381              Authorized actions of Division upon determination of deficiencies; grounds for sanctions; authorized sanctions.

433.384              Grounds for revocation of provisional certificate or certificate.

433.387              Notice of intent to revoke provisional certificate or certificate.

433.390              Immediate termination of provision of services.

433.393              Appeal.

 

 

GENERAL PROVISIONS

     NAC 433.001  Definitions. (NRS 451.080)  As used in this chapter, unless the context otherwise requires, the words and terms defined in NAC 433.003 to 433.013, inclusive, have the meanings ascribed to them in those sections.

     (Added to NAC by Div. of Men. Health & Dev. Services by R031-09, eff. 10-27-2009)

     NAC 433.003  “Cemetery” defined. (NRS 451.080)  “Cemetery” means the nonfunctioning burial park located on the grounds of Northern Nevada Adult Mental Health Services at 480 Galletti Way, Sparks, Nevada 89431.

     (Added to NAC by Div. of Men. Health & Dev. Services by R031-09, eff. 10-27-2009)

     NAC 433.004  “Cemetery authority” defined. (NRS 451.080)  “Cemetery authority” means the Administrator of the Division.

     (Added to NAC by Div. of Men. Health & Dev. Services by R031-09, eff. 10-27-2009)

     NAC 433.005  “Director” defined. (NRS 435.070)  “Director” means the director of the service for which a mental health technician performs his or her duties.

     (Added to NAC by Men. Hygiene & Men. Retardation Div., eff. 7-5-94; A by Div. of Men. Health & Dev. Services by R031-09, 10-27-2009)

     NAC 433.010  “Division” defined.  “Division” means the Division of Mental Health and Developmental Services of the Department of Health and Human Services.

     (Supplied in codification)

     NAC 433.013  “Removal” defined. (NRS 451.080)  “Removal” means the disinterment and removal of human remains from a grave in the cemetery.

     (Added to NAC by Div. of Men. Health & Dev. Services by R031-09, eff. 10-27-2009)

     NAC 433.040  “Adult with a serious mental illness” and “child with a serious emotional disturbance” defined for counting purposes. (NRS 433.324)  Each division facility shall use the following definitions to count the number of persons in this State who are adults with a serious mental illness or children with a serious emotional disturbance:

     1.  “Adult with a serious mental illness” means a person who is at least 18 years old and has been diagnosed within the immediately preceding 12 months as having a mental, behavioral or emotional disorder as defined in the Diagnostic and Statistical Manual of Mental Disorders, as adopted by reference in NAC 433.050, other than an addictive disorder, intellectual or developmental disability, irreversible dementia or a disorder caused by an abuse of alcohol or drugs, which interferes with or limits one or more major life activities of the adult.

     2.  “Child with a serious emotional disturbance” means a person who is less than 18 years old and has been diagnosed within the immediately preceding 12 months as having a mental, behavioral or emotional disorder as defined in the Diagnostic and Statistical Manual of Mental Disorders, as adopted by reference in NAC 433.050, other than a mental disorder designated as a Code V disorder in the Manual, a developmental disorder or a disorder caused by an abuse of alcohol or drugs, which substantially interferes with or limits the child from developing social, behavioral, cognitive, communicative or adaptive skills or his or her activities relating to family, school or community. The term does not include a child with a disorder which is temporary or is an expected response to stressful events.

     (Added to NAC by Comm’n on Men. Health & Men. Retardation, eff. 8-24-88; A 11-19-90; R128-97, 11-14-97)

     NAC 433.050  Adoption of Manual by reference. (NRS 433.324)  The Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Revised 1994, published by the American Psychiatric Association, Washington, D.C., and commonly referred to as “DSM,” is hereby adopted by reference. This Manual may be obtained from the American Psychiatric Press, Inc., 1400 K Street, N.W., Washington, D.C. 20005, for the price of $45, plus $7.50 for shipping and handling.

     (Added to NAC by Comm’n on Men. Health & Men. Retardation, eff. 8-24-88; A by R128-97, 11-14-97)

EDUCATION AND CERTIFICATION OF MENTAL HEALTH TECHNICIANS

     NAC 433.060  Requirements for certification. (NRS 433.279)

     1.  The Division will certify a mental health technician who is initially employed by the Division in that position on or after July 5, 1994, if he or she:

     (a) Is at least 18 years of age;

     (b) Is a citizen of the United States or is lawfully entitled to remain and work in the United States; and

     (c) Has successfully completed the vocational and educational program established pursuant to NRS 433.279.

     2.  The Division will certify a mental health technician who is initially employed by the Division in that position before July 5, 1994, if he or she has passed the final examination for each course offered in the vocational and educational program established pursuant to NRS 433.279.

     (Added to NAC by Men. Hygiene & Men. Retardation Div., eff. 7-5-94)

     NAC 433.070  Purposes of vocational and educational program. (NRS 433.279)

     1.  The vocational and educational program established by the Division pursuant to NRS 433.279 will be designed to provide the training necessary for a mental health technician to:

     (a) Obtain certification from the Division;

     (b) Attain the status of a permanent employee; and

     (c) Receive a promotion.

     2.  The Division will not approve a course or program for credit toward certification if it determines that the course or program is not appropriate for the purposes stated in subsection 1.

     (Added to NAC by Men. Hygiene & Men. Retardation Div., eff. 7-5-94)

     NAC 433.080  Compensation for participation in vocational and educational program; requirements to repeat failed courses. (NRS 433.279)

     1.  Except as otherwise provided in subsection 2, if a mental health technician must participate in a vocational and educational program, the Division will grant him or her a related amount of administrative leave with pay or, when applicable, compensation for overtime in the form of pay or leave.

     2.  The Division will not permit a mental health technician who fails to complete successfully a course at the appropriate level to take that course again with pay unless he or she:

     (a) Demonstrates good cause for the failure to complete the course successfully; and

     (b) Obtains the approval of the director.

     (Added to NAC by Men. Hygiene & Men. Retardation Div., eff. 7-5-94)

     NAC 433.090  Renewal of certification. (NRS 433.279)

     1.  Unless renewed, a certificate expires 2 years after the date on which it was issued. A mental health technician shall apply for renewal of his or her certificate on or before the date of expiration. The application for renewal must be:

     (a) On a form prescribed by the Division; and

     (b) Accompanied by evidence that he or she has completed 20 hours of continuing education during the preceding 2 years in one or more courses or programs approved by the Division.

     2.  A certificate of renewal becomes effective on the date on which the Division approves the application for renewal.

     3.  If a mental health technician attends only part of a course or program approved by the Division, the Division may determine the number of hours of credit, if any, that the technician may receive for continuing education.

     (Added to NAC by Men. Hygiene & Men. Retardation Div., eff. 7-5-94)

     NAC 433.100  Designation of certification. (NRS 433.279)  A person who is certified by the Division may place the words or appropriate initials for the words “certified mental health technician” or “certified forensic technician” as applicable, after his or her name.

     (Added to NAC by Men. Hygiene & Men. Retardation Div., eff. 7-5-94)

     NAC 433.110  Vocational and educational program requirements for new employees, permanent employees and promotions; allowance for partial attendance and lack of available courses. (NRS 433.279)

     1.  For each mental health technician who is initially employed by the Division in that position on or after July 5, 1994, the director shall require the technician to complete the vocational and educational program established pursuant to NRS 433.279.

     2.  If a mental health technician attends only part of a course or program approved by the Division, the Division may determine the number of hours of credit, if any, that the technician may receive toward certification.

     3.  Except as otherwise provided in subsection 4, for each mental health technician who is initially employed by the Division in that position on or after July 5, 1994, the director shall, in determining whether to grant the technician the status of a permanent employee, consider whether the technician has completed 5 hours of credit.

     4.  The provisions of subsection 3 do not apply if the technician is not able to complete the required hours because of the failure of the Division or the Nevada System of Higher Education to offer the courses necessary for the technician to complete the required hours of credit.

     5.  Except as otherwise provided in subsection 6, for each mental health technician who is initially employed by the Division in that position on or after July 5, 1994, the director shall not consider the technician as eligible for promotion unless the technician has successfully completed at least 5 additional hours of credit at the appropriate level of the vocational and educational program established pursuant to NRS 433.279.

     6.  The provisions of subsection 5 do not apply if the technician is not able to complete the additional hours of credit because of the failure of the Division or the Nevada System of Higher Education to offer the courses necessary for the technician to complete the additional hours of credit.

     7.  If a mental health technician has completed the 5 additional hours of credit necessary for promotion and is subsequently demoted, the director shall determine whether it is necessary for the technician to take additional courses before he or she may be considered for any future promotion. If the director determines that the technician must take additional courses, the director shall notify the technician in the same document which notifies the technician of the demotion.

     8.  For the purposes of this section, “5 hours of credit” means 75 hours of participation in one or more courses or programs approved by the Division for the vocational and educational program pursuant to NAC 433.070.

     (Added to NAC by Men. Hygiene & Men. Retardation Div., eff. 7-5-94)

BURIAL PARK AT NORTHERN NEVADA ADULT MENTAL HEALTH SERVICES

     NAC 433.130  Order by cemetery authority to disinter and remove remains. (NRS 451.080)

     1.  The cemetery authority may order the disinterment and removal of human remains interred in all or any part of the cemetery if the cemetery authority determines that the further maintenance of all or part of the cemetery as a burial place for the human dead is not in accordance with the health, safety, comfort or welfare of the public.

     2.  The cemetery authority will prescribe a reasonable time of not less than 1 year after which the cemetery authority may proceed with a removal.

     (Added to NAC by Div. of Men. Health & Dev. Services by R031-09, eff. 10-27-2009)

     NAC 433.140  Notice of removal. (NRS 451.080)

     1.  If the cemetery authority determines that removal is necessary, the cemetery authority will provide notice of the removal in accordance with the provisions of NRS 451.110, 451.130 and 451.140.

     2.  If the cemetery authority determines that any of the remains subject to removal may belong to a Native American tribe, notice must be sent to the tribal council of that tribe.

     (Added to NAC by Div. of Men. Health & Dev. Services by R031-09, eff. 10-27-2009)

     NAC 433.150  Disposition of remains from removal; request for removal by family member or tribe. (NRS 451.080)

     1.  Except as otherwise provided in this section, the human remains from a removal will be subject to cremation and inurnment or reinterment elsewhere at the discretion of the cemetery authority.

     2.  Upon the written request to the cemetery authority by a family member or the Native American tribe of the person whose remains are interred in the cemetery, the cemetery authority will allow for the removal by the family member or the Native American tribe. All documentation verifying the familial or tribal relationship must be attached to the written request, and the costs related to the removal must be paid by the family member or tribe.

     3.  Any removal must be conducted in accordance with the laws and ordinances of the constituted authorities of the city, county and State.

     4.  As used in this section:

     (a) “Cremation” means the technical process that reduces human remains to bone fragments by using heat and evaporation.

     (b) “Inurnment” means the disposition of cremated human remains by inserting the remains in an urn and placing the urn in a crypt or niche.

     (Added to NAC by Div. of Men. Health & Dev. Services by R031-09, eff. 10-27-2009)

REPORTING THE ABUSE AND NEGLECT OF CONSUMERS

     NAC 433.200  “Abuse” and “neglect” interpreted. (NRS 433.331)

     1.  As used in NRS 433.554, the term:

     (a) “Abuse” includes, without limitation, physical abuse, sexual abuse, verbal and mental abuse, and financial exploitation.

     (b) “Neglect” includes, without limitation:

          (1) Failure to provide the degree of care or other service to a consumer that a person is legally required or contractually obligated to provide, which may include, without limitation, the provision of adequate medical care, nutrition, hydration, clothing or assistance with personal hygiene; and

          (2) Failure to act to prevent another person from abusing or neglecting a consumer.

     2.  As used in this section:

     (a) “Financial exploitation” means the illegal or improper use of the money, property or other assets of a consumer. The term includes, without limitation:

          (1) Using a consumer’s social security number to obtain a benefit or other financial gain for a person other than the consumer; and

          (2) Diverting money or property that is intended to be used for the benefit of the consumer, including, without limitation, money provided by the State.

     (b) “Physical abuse” includes, without limitation, intentionally causing physical pain to a consumer, whether or not the action results in an observable injury to the consumer, by burning, cutting, hitting, kicking, punching, pushing, scratching, slapping, or pulling the hair of the consumer.

     (c) “Sexual abuse” includes, without limitation:

          (1) Engaging or attempting to engage in sexual conduct with a consumer, including, without limitation, the intimate touching or fondling of a consumer;

          (2) Encouraging a consumer or another person to engage in sexual conduct with a consumer;

          (3) Encouraging a consumer to solicit for, or engage in, prostitution;

          (4) Exposing a person’s genitals to a consumer or encouraging a consumer to expose his or her genitals to another person;

          (5) Encouraging a consumer to view obscene or pornographic materials; and

          (6) Using sexually degrading language or gestures toward a consumer.

     (d) “Verbal and mental abuse” includes, without limitation:

          (1) Cursing, insulting, mocking, ridiculing or taunting a consumer;

          (2) Threatening a consumer with any kind of harm or with the deprivation of any right, privilege or benefit;

          (3) Making a hostile or offensive gesture toward a consumer; and

          (4) Engaging in any action that is intended to humiliate a consumer,

Ê whether or not the consumer understands the meaning of the words, gestures or actions.

     (Added to NAC by Div. of Men. Health & Dev. Services by R063-10, eff. 12-16-2010)

     NAC 433.210  Requirements. (NRS 433.331)

     1.  An employee or contractor who knows or reasonably believes that a consumer has been or is being abused or neglected shall report the abuse or neglect of the consumer:

     (a) Verbally, not later than 1 hour after the employee or contractor becomes aware of the abuse or neglect; and

     (b) In writing, not later than 24 hours after the employee or contractor becomes aware of the abuse or neglect.

     2.  A report required pursuant to subsection 1 must be made to the person and in the manner prescribed by the Administrator.

     3.  An employee or contractor may reasonably believe that a consumer has been or is being abused or neglected based solely on the statement of a consumer.

     4.  As used in this section:

     (a) “Contractor” means a person who provides care or other services to a consumer pursuant to a contract with the Division.

     (b) “Employee” means an employee of the Division.

     (Added to NAC by Div. of Men. Health & Dev. Services by R063-10, eff. 12-16-2010)

COMMUNITY-BASED LIVING ARRANGEMENT SERVICES

General Provisions

     NAC 433.300  Definitions. (NRS 433.324, 433.609)  As used in NAC 433.300 to 433.393, inclusive, unless the context otherwise requires, the words and terms defined in NAC 433.303 to 433.324, inclusive, have the meanings ascribed to them in those sections.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

     NAC 433.303  “Certificate” defined. (NRS 433.324, 433.607, 433.609)  “Certificate” has the meaning ascribed to it in NRS 433.603.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

     NAC 433.306  “Community-based living arrangement services” or “services” defined. (NRS 433.324, 433.609)  “Community-based living arrangement services” or “services” has the meaning ascribed to it in NRS 433.605.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

     NAC 433.309  “Individual support team” defined. (NRS 433.324, 433.609)  “Individual support team” means a team of persons, other than a provider, who provide health care and perform other duties for the benefit of a person with a mental illness.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

     NAC 433.312  “Individualized plan” defined. (NRS 433.324, 433.609)  “Individualized plan” means a plan prescribing the services that will be provided to a person with mental illness, the frequency with which the services will be provided and the manner in which those services will be provided.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

     NAC 433.315  “Mental illness” defined. (NRS 433.324, 433.609)  “Mental illness” has the meaning ascribed to it in NRS 433.164.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

     NAC 433.318  “Provider” defined. (NRS 433.324, 433.609)  “Provider” means a natural person or a partnership, firm, corporation, association, state or local government or agency thereof that is issued a provisional certificate or certificate.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

     NAC 433.321  “Provisional certificate” defined. (NRS 433.324, 433.609)  “Provisional certificate” means a temporary certificate to provide services that is issued pursuant to NAC 433.336.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

     NAC 433.324  “Quality assurance review” defined. (NRS 433.324, 433.609)  “Quality assurance review” means a review of the provision of services conducted by the Division pursuant to NAC 433.378.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

Issuance and Renewal of Provisional Certificates and Certificates

     NAC 433.327  Provisional certificate or certificate required to provide services; exception. (NRS 433.324, 433.607, 433.609)  Except as otherwise provided in NRS 433.607, a person or governmental entity must hold a provisional certificate or certificate to provide services or receive payment from the Division for services.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

     NAC 433.330  Contents of application for provisional certificate. (NRS 433.324, 433.607, 433.609)  An application for a provisional certificate must be submitted to the Division on a form furnished by the Division and must include:

     1.  For an applicant who is a natural person:

     (a) Three or more letters of professional reference;

     (b) A certification, signed by the applicant, that the applicant will maintain the confidentiality of information relating to any person who receives services;

     (c) Proof that the applicant has successfully completed a course in cardiopulmonary resuscitation according to the guidelines of the American Red Cross or American Heart Association;

     (d) Proof that the applicant is currently certified in standard first aid through a course from the American Red Cross or American Heart Association or, if the applicant submits proof that the course meets or exceeds the requirements of the American Red Cross or the American Heart Association, an equivalent course in standard first aid;

     (e) Written verification, on a form prescribed by the Division, that the fingerprints of the applicant were taken and forwarded electronically or by another means directly to the Central Repository for Nevada Records of Criminal History and that the applicant has given written permission to the law enforcement agency or other authorized entity taking the fingerprints to submit the fingerprints to the Central Repository for submission to the Federal Bureau of Investigation and to such other law enforcement agencies as the Division deems necessary for reports on the applicant’s background to the Division and the applicant;

     (f) A copy of the social security card of the applicant;

     (g) Proof that the applicant has sufficient working capital to provide services for at least 3 months without compensation;

     (h) If applicable, a copy of the applicant’s state business license and a copy of the current business license issued for the applicant’s business by the county, city or town in which the applicant’s business is located or written verification that the applicant is exempt from any requirement to obtain a business license; and

     (i) Any other information required by the Division.

     2.  For an applicant other than a natural person:

     (a) If applicable, a copy of the state business license of the organization and a copy of the current business license issued for the applicant’s business by the county, city or town in which the applicant’s business is located or written verification that the applicant is exempt from any requirement to obtain a business license;

     (b) The federal tax identification number of the organization;

     (c) A copy of the bylaws, articles of incorporation, articles of association, articles of organization, partnership agreement, constitution and any other substantially equivalent documents of the applicant, and any amendments thereto;

     (d) A list of the members of the governing body of the applicant;

     (e) If the applicant is an association or a corporation:

          (1) The name, title and principal business address of each officer and member of its governing body;

          (2) The signature of the chief executive officer or an authorized representative; and

          (3) If the applicant is a corporation, the name and address of each person holding more than 10 percent of its stock;

     (f) For each member of the governing body:

          (1) Three or more letters of professional reference; and

          (2) Written verification, on a form prescribed by the Division, that the fingerprints of the member of the governing body were taken and forwarded electronically or by another means directly to the Central Repository for Nevada Records of Criminal History and that the member of the governing body has given written permission to the law enforcement agency or other authorized entity taking the fingerprints to submit the fingerprints to the Central Repository for submission to the Federal Bureau of Investigation and to such other law enforcement agencies as the Division deems necessary for reports on the member’s background to the Division and the applicant;

     (g) Proof that the applicant has sufficient working capital to provide services for at least 3 months without compensation;

     (h) Copies of any policies and procedures of the applicant relating to the provision of services; and

     (i) Such other information as may be required by the Division.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

     NAC 433.333  Review of application for provisional certificate; actions upon determination that application is incomplete. (NRS 433.324, 433.607, 433.609)

     1.  The Division shall review each application for a provisional certificate to determine whether the application is complete.

     2.  If the Division determines that an application for a provisional certificate is incomplete, the Division shall notify the applicant that the application is incomplete and authorize the applicant to submit any required information or documentation to complete the application. The applicant must submit any additional information or documentation not later than 30 calendar days after receipt of the notice. The Division may deny the application if the applicant does not submit any required information or documentation in accordance with this subsection. If the application is denied pursuant to this subsection, the applicant may not resubmit an application for a provisional certificate for at least 12 months after receipt of the notice of the denial given pursuant to NAC 433.339.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

     NAC 433.336  Interview of applicant; training; issuance and validity of provisional certificate. (NRS 433.324, 433.607, 433.609)

     1.  If the Division determines that an application for a provisional certificate is complete, the Division shall establish a screening panel composed of employees of the Division to interview the applicant and determine whether the applicant is qualified to participate in the training required by subsection 2.

     2.  Except as otherwise provided in this subsection, if the screening panel determines that an applicant is qualified to obtain a provisional certificate, the applicant must complete 16 hours of training provided by the Division concerning the provision of services. The training must be completed not later than 3 months after the date on which the screening panel makes its determination. If the applicant is not a natural person, each officer or employee of the applicant who will oversee the provision of services by the applicant must complete the training required by this subsection.

     3.  Upon successful completion of the training required by subsection 2, the Division shall issue a provisional certificate to the applicant.

     4.  A provisional certificate is valid until the Division completes the initial quality assurance review required by NAC 433.342.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

     NAC 433.339  Grounds for denial of application for provisional certificate; notice of denial. (NRS 433.324, 433.607, 433.609)

     1.  Each of the following constitutes a ground for denial of an application for a provisional certificate:

     (a) Failure by the applicant to submit a complete application for a provisional certificate within the time required by NAC 433.333.

     (b) Inability of the applicant to provide proper care for the number and types of intended recipients of services.

     (c) Misrepresentation or failure by the applicant to disclose any material fact in the application submitted to the Division or in any financial record or other document requested by the Division.

     (d) Conviction of the applicant, an officer or employee of the applicant or an independent contractor of the applicant who oversees the provision of services of a crime relevant to any aspect of the provision of services, including, without limitation:

          (1) Murder, voluntary manslaughter or mayhem;

          (2) Assault or battery with intent to kill or to commit sexual assault or mayhem;

          (3) Sexual assault, statutory sexual seduction, incest or lewdness or indecent exposure that is punished as a felony, or any other sexually related felony;

          (4) A felony involving domestic violence;

          (5) A misdemeanor involving domestic violence, within the immediately preceding 7 years;

          (6) A misdemeanor involving assault or battery, within the immediately preceding 7 years;

          (7) Abuse or neglect of a child or contributory delinquency;

          (8) A violation of any federal or state law regulating the possession, distribution or use of any controlled substance or any dangerous drug as defined in chapter 454 of NRS, within the immediately preceding 7 years;

          (9) Abuse, neglect, exploitation, isolation or abandonment of an older person or vulnerable person, including, without limitation, a violation of any provision of NRS 200.5091 to 200.50995, inclusive, or a law of any other jurisdiction that prohibits the same or similar conduct;

          (10) A violation of any law relating to the State Plan for Medicaid or a law of any other jurisdiction that prohibits the same or similar conduct, within the immediately preceding 7 years;

          (11) A violation of any provision of NRS 422.450 to 422.590, inclusive;

          (12) A criminal offense under the laws governing Medicaid or Medicare, within the immediately preceding 7 years;

          (13) Any offense involving fraud, theft, embezzlement, burglary, robbery, fraudulent conversion or misappropriation of property, within the immediately preceding 7 years;

          (14) Any felony involving the use or threatened use of force or violence against the victim or the use of a firearm or other deadly weapon; or

          (15) An attempt or conspiracy to commit any of the offenses listed in this paragraph, within the immediately preceding 7 years.

     (e) Exclusion of the applicant, an officer or employee of the applicant or an independent contractor of the applicant who oversees the provision of services from participation in Medicare, Medicaid or any other federal health care program pursuant to federal law.

     (f) The existence of any major deficiency in the proposed services to be provided by the applicant which would preclude compliance with NAC 433.300 to 433.393, inclusive.

     2.  If an application is denied, the Division shall give the applicant a written notice of the denial in the manner provided by NAC 439.345.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

     NAC 433.342  Request for quality assurance review; revocation or extension of provisional certificate; issuance of certificate. (NRS 433.324, 433.607, 433.609, 433.613)

     1.  Within 6 months after the issuance of a provisional certificate, the holder of the provisional certificate shall request the Division to conduct a quality assurance review as provided in NAC 433.378. If no timely request is made or the Division determines as the result of the quality assurance review that the holder of the provisional certificate is not in full compliance with the standards for the provision of services set forth in NAC 433.300 to 433.393, inclusive, the Division may revoke or extend the term of the provisional certificate. The Division may extend the term of the provisional certificate for any period not to exceed 6 months.

     2.  If the Division extends the term of a provisional certificate pursuant to subsection 1, the holder of the provisional certificate shall, before the expiration of the extended term, request the Division to conduct another quality assurance review. If no timely request is made or the Division determines as the result of the quality assurance review that the holder of the provisional certificate is not in full compliance with the standards described in subsection 1, the Division shall revoke the provisional certificate.

     3.  If the Division determines as the result of a quality assurance review conducted pursuant to subsection 1 or 2 that the holder of a provisional certificate is in full compliance with the standards described in subsection 1, the Division shall issue a certificate to the holder of the provisional certificate. The Division may issue a certificate to a provider for any period not to exceed 2 years.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

     NAC 433.345  Renewal of certificate. (NRS 433.324, 433.607, 433.609, 433.613)  Upon the expiration of a certificate, the Division may renew the certificate of the provider for any period not to exceed 2 years if the Division conducts a quality assurance review as provided in NAC 433.378 and determines that the provider is in compliance with the standards for the provision of services set forth in NAC 433.300 to 433.393, inclusive.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

Operation of Provider

     NAC 433.348  Duties of provider. (NRS 433.324, 433.609)  A provider shall:

     1.  Comply with any state or federal statute or regulation as required for the Division to receive state or federal money for the provision of services, including, without limitation, any standard of care set forth in:

     (a) The State Plan for Medicaid; and

     (b) The Medicaid Services Manual established by the Division of Health Care Financing and Policy of the Department of Health and Human Services.

     2.  Comply with all applicable state or federal requirements concerning fiscal management, reporting and employment.

     3.  Comply with the individualized plan prepared pursuant to NAC 433.360 for each person who receives services.

     4.  Assure the health and welfare of persons receiving services. Any assessment by the Division of a provider’s compliance with the requirements of this subsection must be based upon the self-reporting of persons receiving services from the provider, the observations of members of the staff of the Division and any other information available to the Division.

     5.  Establish internal procedures for quality assurance.

     6.  Promptly report to the Division any change in the officers or ownership of the provider.

     7.  Cooperate with any investigation by the Division.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

     NAC 433.351  Policies and procedures of governmental or organizational provider. (NRS 433.324, 433.609)  If a provider is a governmental entity or an organization, it shall, in conformance with NAC 433.300 to 433.393, inclusive, establish policies and procedures for the provision of services and the welfare of the persons it serves.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

     NAC 433.354  Arrangements for services from specially trained persons; determination of need for such services. (NRS 433.324, 433.609)

     1.  A provider shall make arrangements for obtaining services from persons professionally qualified in the field of psychiatric mental health or other specially trained persons, as needed, to assist in planning, carrying out and reviewing the provision of services. Evidence of any use of such services must be on file with the provider.

     2.  The need for such services must be determined initially by the individual support team established pursuant to NAC 433.360 for the person receiving services and be reviewed by the team on a regular basis, at least annually.

     3.  As used in this section, “person professionally qualified in the field of psychiatric mental health” has the meaning ascribed to it in NRS 433.209.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

     NAC 433.357  Financial plan; financial records; financial report. (NRS 433.324, 433.609)  A provider shall:

     1.  Develop and maintain a financial plan which ensures that there are sufficient resources to meet the costs for care of the persons receiving services from the provider;

     2.  Maintain financial records adequate to determine whether the provider meets all the requirements of NAC 433.300 to 433.393, inclusive, related to finances; and

     3.  Submit to the Division any financial report:

     (a) Which the Division requests in writing; and

     (b) The need for which is explained by the Division.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

     NAC 433.360  Assessment of need for services; maintenance of findings of assessment; establishment of individualized support team and permanent individual plan; acceptance of person before assessment. (NRS 433.324, 433.609, 433.806)

     1.  Except as otherwise provided in subsection 4, a provider may not provide services to a person until there has been an assessment of the need for services for the person.

     2.  The assessment must be performed or approved by the Division. As part of the assessment, the Division or other entity that performs the assessment must establish an interim individualized plan.

     3.  Following the assessment, if the person is accepted by the provider:

     (a) The findings of the assessment must be maintained by the Division and entered into the person’s record kept and maintained by the provider as provided in NAC 433.369; and

     (b) The Division shall establish an individual support team for the person and, in collaboration with the individual support team, establish a permanent individualized plan.

     4.  In an urgent situation and with the approval of the Division, a provider may accept a person for the provision of services for a period of not more than 5 working days before an assessment is performed.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

     NAC 433.363  Contract for provision of services. (NRS 433.324, 433.609)  A provider shall enter into a written contract for the provision of services with each person who will receive services or his or her parent or guardian, if applicable, and the Division. The contract must prescribe the services that will be provided to the person and the payment that the provider will receive from the Division for those services.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

     NAC 433.366  Training concerning administration of medication; persons authorized to administer medication. (NRS 433.324, 433.609)

     1.  Each member of the direct support staff of a provider must successfully complete a program, approved by the Division, concerning the administration of medication.

     2.  A person who is receiving services may have his or her medication administered by:

     (a) A provider of health care; or

     (b) A member of the direct support staff of the provider if:

          (1) The member of the direct support staff is a personal assistant who is authorized to administer medication by a provider of health care pursuant to NRS 629.091;

          (2) The person or his or her parent or guardian, as applicable, provides written authorization to receive medication from a member of the direct support staff of the provider in accordance with NRS 453.375 and 454.213; and

          (3) The person submits to a physical examination by his or her provider of health care on an annual basis and the provider of health care determines that the person is medically cleared to receive medication from the member of the direct support staff.

     3.  As used in this section, “provider of health care” has the meaning ascribed to it in NRS 629.031.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

     NAC 433.369  Record regarding recipient of services: Contents and availability for review. (NRS 433.324, 433.609)  A provider shall keep a separate record regarding each person for whom services are provided. Each such record must include the information needed for providing services, to substantiate billing and for the planning and periodic reevaluation of the needs of the person who is receiving services. The record must be available for review by the person who is receiving services or his or her guardian, if applicable, and the Division.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

     NAC 433.372  Record regarding recipient of services: Retention; availability for review by representatives of Department. (NRS 433.324, 433.609)

     1.  A provider shall retain the original records of each person who receives services from the provider as provided in NAC 433.369, or photographic reproductions of such records, for at least 3 years after the provider ceases to provide services to the person.

     2.  All such records must be complete, current and readily available for review by representatives of the Department.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

     NAC 433.375  Rights of recipient of services. (NRS 433.324, 433.609)

     1.  Any person who receives services has the same rights that are afforded to a consumer by chapter 433 of NRS and any regulations adopted pursuant thereto.

     2.  A person has the right to file a complaint with the Division against a provider.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

Quality Assurance Reviews and Discipline

     NAC 433.378  Quality assurance review. (NRS 433.324, 433.609, 433.613)

     1.  The Division:

     (a) Shall conduct a quality assurance review upon a request made pursuant to NAC 433.342 and before renewing a certificate pursuant to NAC 433.345; and

     (b) May conduct a quality assurance review at any time during the certification of a provider if there is a complaint of abuse, neglect or exploitation or a concern related to the health or welfare of a person who receives services from the provider.

     2.  In conducting a quality assurance review, the Division may:

     (a) Obtain any information or otherwise review any aspect of the provider’s system of delivery of services, including, without limitation, any:

          (1) Policies and procedures of the provider;

          (2) Personnel or clinical records maintained by the provider;

          (3) Documentation regarding any administrative or personnel matter directly related to the health and welfare of any person who is receiving services;

          (4) Financial information concerning the provider or any person receiving services; and

          (5) Information concerning the quality of care provided to any person receiving services;

     (b) Interview or otherwise solicit information from any person receiving services, any employee or independent contractor of any provider or any other agency with knowledge of any person receiving services, and any member of the family or any guardian, friend or advocate of any person receiving services; and

     (c) Observe the services provided to any person receiving services.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

     NAC 433.381  Authorized actions of Division upon determination of deficiencies; grounds for sanctions; authorized sanctions. (NRS 433.324, 433.609, 433.613)

     1.  If the Division determines pursuant to a quality assurance review that there are any deficiencies in the provision of services by a provider related to the health or welfare of a person receiving such services, the Division may:

     (a) Deny, suspend or revoke the provisional certificate or certificate of the provider;

     (b) Require the provider to prepare and submit to the Division a written plan of correction, which must be approved by the Division; or

     (c) Require changes concerning the provision of services by the provider before the Division issues, renews or reinstates a provisional certificate or certificate.

     2.  The Division may impose any sanction described in subsection 3 upon a provider for:

     (a) Any aspect of the provision of services by the provider which poses a probable risk of harm to the health or welfare of a person receiving services;

     (b) Any refusal by the provider to participate in any aspect of a quality assurance review; or

     (c) The failure or refusal of the provider to implement or maintain any action required by the Division to correct a deficiency identified during a quality assurance review.

     3.  As a sanction imposed pursuant to subsection 2, the Division may, without limitation:

     (a) Require the provider to:

          (1) Participate in training concerning the provision of services;

          (2) Comply with additional measures of accountability concerning the provision of services;

          (3) Comply with additional measures of review by the Division; or

          (4) Comply with additional performance requirements concerning the provision of services;

     (b) Terminate or amend any contract that the Division has with the provider; or

     (c) Suspend or reduce any payment otherwise owed by the Division to the provider.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

     NAC 433.384  Grounds for revocation of provisional certificate or certificate. (NRS 433.324, 433.609)  Each of the following acts and omissions is a ground for revocation of a provisional certificate or certificate:

     1.  Any misrepresentation of or failure to disclose any material fact in the application for the provisional certificate or in any financial record or other document requested by the Division.

     2.  A lack of personnel in sufficient numbers or qualifications to provide proper care and support for the persons receiving services.

     3.  Conviction of the provider or any employee or independent contractor of the provider of a crime relevant to any aspect of the provision of services.

     4.  Any deficiency of the provider relating to the provision of services that poses an imminent or probable risk of harm to the health or welfare of any person receiving services.

     5.  Any violation of any requirement set forth in NAC 433.300 to 433.393, inclusive.

     6.  Any accumulation or pattern of minor violations of the provisions of NAC 433.300 to 433.393, inclusive, if the violations taken as a whole endanger the health or welfare of any person who is receiving services.

     7.  Any fraudulent activity by the provider or an employee or independent contractor of the provider, including, without limitation, any fraudulent billing, falsification of records or misuse or misappropriation of the property of a person who is receiving services.

     8.  Failure to comply with any obligation set forth in the contract entered into pursuant to NAC 433.363.

     9.  Any refusal to participate in any aspect of a quality assurance review or any other review or investigation by the Division.

     10.  The failure or refusal of the provider to implement or maintain any action required by the Division to correct a deficiency identified during a quality assurance review or any other review or investigation by the Division.

     11.  Abuse, neglect, exploitation or coercion of a person who is receiving services.

     12.  Harassing, coercive, intimidating, insulting, abusive or disruptive language or behavior directed at an employee of the Division, an employee or independent contractor of the provider, another provider or a person or entity providing services other than community-based living arrangement services, a person who is receiving services or a family member or guardian of such a person.

     13.  Exclusion of the provider, an officer or employee of the provider or an independent contractor of the provider who oversees the provision of services from participation in Medicare, Medicaid or any other federal health care program pursuant to federal law.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

     NAC 433.387  Notice of intent to revoke provisional certificate or certificate. (NRS 433.324, 433.609)  The Division shall give a provider written notice of any intended action to revoke the provisional certificate or certificate of the provider as prescribed by NAC 439.345.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

     NAC 433.390  Immediate termination of provision of services. (NRS 433.324, 433.609)  If a revocation of the provisional certificate or the certificate of a provider is pending and the Division determines that the grounds for the revocation place any person at an imminent or probable risk of harm, the Division may immediately terminate the provision of services by the provider.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)

     NAC 433.393  Appeal. (NRS 433.324, 433.609)

     1.  If a provider is aggrieved by any sanction imposed pursuant to NAC 433.381 or any decision concerning the denial, suspension or revocation of a provisional certificate or certificate, the provider may submit a request for an appeal to the Administrator of the Division pursuant to the procedures set forth in NAC 439.300 to 439.395, inclusive.

     2.  Except in the case of an immediate termination of the provision of services pursuant to NAC 433.390, the effective date of a revocation is stayed upon receipt of a request for appeal until the hearing officer renders a decision regarding the appeal.

     (Added to NAC by Bd. of Health by R090-16, 6-21-2017, eff. 7-1-2017)