Section 433A.165 - Examination required before emergency admission of person to facility; treatment of certain medical conditions required before emergency admission to facility; payment of costs; exceptions; regulations1. Before a person alleged to be a person in a mental health crisis may be admitted to a public or private mental health facility or hospital under an emergency admission pursuant to NRS 433A.162, the person must: (a) First be examined by a licensed physician or physician assistant licensed pursuant to chapter 630 or 633 of NRS or an advanced practice registered nurse licensed pursuant to NRS 632.237 at any location where such a physician, physician assistant or advanced practice registered nurse is authorized to conduct such an examination to determine whether the person has a medical condition, other than a psychiatric condition, which requires immediate treatment; and(b) If such treatment is required, be admitted for the appropriate medical care: (1) To a hospital if the person is in need of emergency services or care; or(2) To another appropriate medical facility if the person is not in need of emergency services or care.2. If a person alleged to be a person in a mental health crisis has a medical condition in addition to a psychiatric condition which requires medical treatment that requires more than 72 hours to complete, the licensed physician, physician assistant or advanced practice registered nurse who examined the person must: (a) On the first business day after determining that such medical treatment is necessary, file with the clerk of the district court a written petition for the involuntary court-ordered admission of the person to a public or private mental health facility pursuant to NRS 433A.200 after the medical treatment has been completed. The petition must:(1) Include, without limitation, the medical condition of the person and the purpose for continuing the medical treatment of the person; and(2) Be accompanied by a copy of: (I) The form for the placement of a person on a mental health crisis hold completed pursuant to NRS 433A.160; and (II) The certificate completed pursuant to NRS 433A.170, unless the medical condition prevents the completion of such a certificate.(b) Seven days after filing a petition pursuant to paragraph (a) and every 7 days thereafter, file with the clerk of the district court an update on the medical condition and treatment of the person.3. The examination and any transfer of the person from a facility when the person has an emergency medical condition and has not been stabilized must be conducted in compliance with:(a) The requirements of 42 U.S.C. § 1395dd and any regulations adopted pursuant thereto, and must involve a person authorized pursuant to federal law to conduct such an examination or certify such a transfer; and(b) The provisions of NRS 439B.410.4. The cost of the examination must be paid by the county in which the person alleged to be a person in a mental health crisis resides if services are provided at a county hospital located in that county or a hospital or other medical facility designated by that county, unless the cost is voluntarily paid by the person alleged to be a person in a mental health crisis or, on the person's behalf, by his or her insurer or by a state or federal program of medical assistance.5. The county may recover all or any part of the expenses paid by it, in a civil action against: (a) The person whose expenses were paid;(b) The estate of that person; or(c) A responsible relative as prescribed in NRS 433A.610, to the extent that financial ability is found to exist.6. The cost of treatment, including hospitalization, for a person who is indigent must be paid pursuant to NRS 428.010 by the county in which the person alleged to be a person in a mental health crisis resides.7. The provisions of this section do not require the Division to provide examinations required pursuant to subsection 1 at a division facility if the Division does not have the: (a) Appropriate staffing levels of physicians, physician assistants, advanced practice registered nurses or other appropriate staff available at the facility as the Division determines is necessary to provide such examinations; or(b) Appropriate medical laboratories as the Division determines is necessary to provide such examinations.8. The State Board of Health shall adopt regulations to carry out the provisions of this section, including, without limitation, regulations that:(a) Define "emergency services or care" as that term is used in this section;(b) Prescribe a procedure to ensure that an examination is performed pursuant to paragraph (a) of subsection 1; and(c) Prescribe the type of medical facility that a person may be admitted to pursuant to subparagraph (2) of paragraph (b) of subsection 1.9. As used in this section, "medical facility" has the meaning ascribed to it in NRS 449.0151.Added to NRS by 1987, 1445; A 1991, 2209; 1993, 908; 2001, 1018; 2003, 1453, 1944; 2007, 1855; 2009, 334; 2013, 2080; 2019, 352; 2021, 3082Amended by 2021, Ch. 481,§31, eff. 10/1/2021.Amended by 2019, Ch. 66,§12, eff. 5/15/2019.Amended by 2013, Ch. 383,§17, eff. 7/1/2013.Added to NRS by 1987, 1445; A 1991, 2209; 1993, 908; 2001, 1018; 2003, 1453, 1944; 2007, 1855; 2009, 334