EXEMPT
S.B. 445
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SENATE BILL NO. 445–COMMITTEE ON FINANCE
(ON BEHALF OF THE OFFICE OF FINANCE
IN THE OFFICE OF THE GOVERNOR)
APRIL 3, 2023
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Referred to Committee on Health and Human Services
SUMMARY—Revises provisions governing emergency medical
services. (BDR 40-1071)
FISCAL NOTE: Effect on Local Government: No.
Effect on the State: Executive Budget.
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EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.
AN ACT relating to emergency medical services; authorizing the
use of certain money to create and maintain an
information system containing the records of persons who
have completed certain training programs; providing that
money collected from certain fees must be accounted for
separately and does not revert to the State General Fund at
the end of any fiscal year; and providing other matters
properly relating thereto.
Legislative Counsel’s Digest:
Existing law provides for the licensure and regulation of emergency medical 1
services personnel, including ambulance attendants and firefighters, by: (1) in a 2
county whose population is 700,000 or more (currently Clark County), the district 3
board of health; and (2) in all other counties, the Division of Public and Behavioral 4
Health of the Department of Health and Human Services. (NRS 450B.077, 5
450B.160) Existing law authorizes the Division to impose an administrative penalty 6
against any person who violates a provision of law governing emergency medical 7
services. (NRS 450B.900) Existing law requires the Division to use money 8
generated from such administrative penalties, fees from the issuance or renewal of a 9
license as an ambulance attendant or a firefighter or certain Legislative 10
appropriations to carry out certain training programs. (NRS 450B.1505) Section 1 11
of this bill additionally authorizes the Division to use such money to create and 12
maintain an information system containing the records of persons who have 13
completed the training program. 14
Existing law authorizes the Division or the district board of health, as 15
applicable, to issue annual permits and provisional permits for the operation of an 16
ambulance, an air ambulance or certain vehicles of a fire-fighting agency. Existing 17
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law requires the State Board of Health or district board of health, as applicable, to 18
establish fees for such annual and provisional permits. (NRS 450B.200, 450B.210) 19
Sections 2 and 3 of this bill provide that revenue from such fees collected by the 20
Division of Public and Behavioral Health must be accounted for separately and 21
does not revert to the State General Fund at the end of any fiscal year. 22
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. NRS 450B.1505 is hereby amended to read as 1
follows: 2
450B.1505 1. Any money the Division receives from a fee 3
set by the State Board of Health pursuant to NRS 439.150 for the 4
issuance or renewal of a license pursuant to NRS 450B.160, an 5
administrative penalty imposed pursuant to NRS 450B.900 or an 6
appropriation made by the Legislature for the purposes of training 7
related to emergency medical services: 8
(a) Must be deposited in the State Treasury and accounted for 9
separately in the State General Fund; 10
(b) May be used [only] to [carry] : 11
(1) Carry out a training program for emergency medical 12
services personnel who work for a volunteer ambulance service or 13
firefighting agency, including, without limitation, equipment for use 14
in the training; and 15
(2) Create and maintain a system containing the records of 16
persons who have completed such a training program; and 17
(c) Does not revert to the State General Fund at the end of any 18
fiscal year. 19
2. Any interest or income earned on the money in the account 20
must be credited to the account. Any claims against the account 21
must be paid in the manner that other claims against the State are 22
paid. 23
3. The Administrator of the Division shall administer the 24
account. 25
Sec. 2. NRS 450B.200 is hereby amended to read as follows: 26
450B.200 1. The health authority may issue a permit for: 27
(a) The operation of an ambulance or an air ambulance; or 28
(b) The operation of a vehicle of a fire-fighting agency: 29
(1) At the scene of an emergency; and 30
(2) To provide community paramedicine services, but only if 31
the holder of the permit has obtained an endorsement on the permit 32
to provide such services pursuant to NRS 450B.1993. 33
2. Each permit must be evidenced by a card issued to the 34
holder of the permit. 35
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3. No permit may be issued unless the applicant is qualified 1
pursuant to the regulations of the board. 2
4. An application for a permit must be made upon forms 3
prescribed by the board and in accordance with procedures 4
established by the board, and must contain the following: 5
(a) The name and address of the owner of the ambulance or air 6
ambulance or of the fire-fighting agency; 7
(b) The name under which the applicant is doing business or 8
proposes to do business, if applicable; 9
(c) A description of each ambulance, air ambulance or vehicle of 10
a fire-fighting agency, including the make, year of manufacture and 11
chassis number, and the color scheme, insigne, name, monogram or 12
other distinguishing characteristics to be used to designate the 13
applicant’s ambulance, air ambulance or vehicle; 14
(d) The location and description of the places from which the 15
ambulance, air ambulance or fire-fighting agency intends to operate; 16
and 17
(e) Such other information as the board deems reasonable and 18
necessary to a fair determination of compliance with the provisions 19
of this chapter. 20
5. The board shall establish a reasonable fee for annual 21
permits. Revenue from such fees collected by the Division must be 22
accounted for separately and does not revert to the State General 23
Fund at the end of any fiscal year. 24
6. All permits expire on July 1 following the date of issue, and 25
are renewable annually thereafter upon payment of the fee required 26
by subsection 5 at least 30 days before the expiration date. 27
7. The health authority shall: 28
(a) Revoke, suspend or refuse to renew any permit issued 29
pursuant to this section for violation of any provision of this chapter 30
or of any regulation adopted by the board; or 31
(b) Bring an action in any court for violation of this chapter or 32
the regulations adopted pursuant to this chapter, 33
only after the holder of a permit is afforded an opportunity for a 34
public hearing pursuant to regulations adopted by the board. 35
8. The health authority may suspend a permit if the holder is 36
using an ambulance, air ambulance or vehicle of a fire-fighting 37
agency which does not meet the minimum requirements for 38
equipment as established by the board pursuant to this chapter. 39
9. In determining whether to issue a permit for the operation of 40
an air ambulance pursuant to this section, the health authority: 41
(a) Except as otherwise provided in paragraph (b), may consider 42
the medical aspects of the operation of an air ambulance, including, 43
without limitation, aspects related to patient care; and 44
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(b) Shall not consider economic factors, including, without 1
limitation, factors related to the prices, routes or nonmedical 2
services of an air ambulance. 3
10. The issuance of a permit pursuant to this section or NRS 4
450B.210 does not authorize any person or governmental entity to 5
provide those services or to operate any ambulance, air ambulance 6
or vehicle of a fire-fighting agency not in conformity with any 7
ordinance or regulation enacted by any county, municipality or 8
special purpose district. 9
11. A permit issued pursuant to this section is valid throughout 10
the State, whether issued by the Division or a district board of 11
health. An ambulance, air ambulance or vehicle of a fire-fighting 12
agency which has received a permit from the district board of health 13
in a county whose population is 700,000 or more is not required to 14
obtain a permit from the Division, even if the ambulance, air 15
ambulance or vehicle of a fire-fighting agency has routine 16
operations outside the county. 17
12. The Division shall maintain a central registry of all permits 18
issued pursuant to this section, whether issued by the Division or a 19
district board of health. 20
13. The board shall adopt such regulations as are necessary to 21
carry out the provisions of this section. 22
Sec. 3. NRS 450B.210 is hereby amended to read as follows: 23
450B.210 1. The board may issue provisional permits limited 24
as to time, place and purpose, based on the need therefor. No 25
provisional permit may be issued for a period of longer than 6 26
months. The board may establish a reasonable fee for such 27
provisional permits. Revenue from such fees collected by the 28
Division must be accounted for separately and does not revert to 29
the State General Fund at the end of any fiscal year. 30
2. Unless otherwise limited in the permit, a provisional permit 31
issued pursuant to this section is valid for providing emergency 32
services throughout the State, whether issued by the Division or a 33
district board of health. 34
3. In determining whether to issue a permit for the operation of 35
an air ambulance pursuant to this section, the health authority: 36
(a) Except as otherwise provided in paragraph (b), may consider 37
the medical aspects of the operation of an air ambulance, including, 38
without limitation, aspects related to patient care; and 39
(b) Shall not consider economic factors, including, without 40
limitation, factors related to the prices, routes or nonmedical 41
services of an air ambulance. 42
Sec. 4. This act becomes effective on July 1, 2023. 43
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