EXEMPT
(Reprinted with amendments adopted on June 4, 2023)
SECOND REPRINT A.B. 201
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ASSEMBLY BILL NO. 201–COMMITTEE ON
HEALTH AND HUMAN SERVICES
(ON BEHALF OF THE JOINT INTERIM STANDING COMMITTEE
ON HEALTH AND HUMAN SERVICES)
FEBRUARY 20, 2023
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Referred to Committee on Health and Human Services
SUMMARY—Revises provisions relating to planning for the
provision of behavioral health care. (BDR 39-325)
FISCAL NOTE: Effect on Local Government: May have Fiscal Impact.
Effect on the State: Yes.
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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 behavioral health; requiring the Department of
Health and Human Services to provide certain oversight
and make certain recommendations concerning the
children’s behavioral health system of care; adding
certain members to the subcommittee on the mental health
of children of the Commission on Behavioral Health;
prescribing certain duties of a regional behavioral health
policy board; requiring a mental health consortium to
submit certain documents to the Administrator of the
Division of Child and Family Services of the Department;
clarifying the authority of the State Board of Health to
require the licensing of certain facilities; requiring the
Legislative Committee on Senior Citizens, Veterans and
Adults With Special Needs to conduct a study of the
feasibility of formulating and operating a comprehensive
state plan to provide behavioral health services; and
providing other matters properly relating thereto.
Legislative Counsel’s Digest:
Existing law requires: (1) the Division of Public and Behavioral Health of the 1
Department of Health and Human Services to perform certain duties relating to the 2
provision of behavioral health services in this State; and (2) the Division of Child 3
and Family Services of the Department to administer provisions governing mental 4
health services for children. (NRS 433.331-433.374, chapter 433B of NRS) 5
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Section 2 of this bill requires the Department to: (1) track the spending of federal 6
and state money on the children’s behavioral health system of care, which consists 7
of certain behavioral health services for children and their families; (2) quantify and 8
track the costs avoided through such expenditures; and (3) perform certain duties to 9
provide oversight for and make recommendations concerning the reinvestment of 10
the money saved through such avoided costs in the children’s behavioral health 11
system of care. 12
Existing law establishes a regional behavioral health policy board for each of 13
the five behavioral health regions of this State. (NRS 433.428, 433.429) Existing 14
law requires each regional behavioral health policy board to: (1) advise the 15
Department, the Division of Public and Behavioral Health and the Commission on 16
Behavioral Health regarding certain matters relating to behavioral health in the 17
region; and (2) submit an annual report to the Commission concerning the 18
behavioral health needs of the region and certain duties of the policy board. (NRS 19
433.4295) Section 8 of this bill additionally requires each regional behavioral 20
health policy board to advise the Division of Child and Family Services regarding 21
behavioral health for children in the region over which the policy board has 22
jurisdiction. Section 8 also requires a regional behavioral health policy board to 23
additionally submit the annual report to the Division of Public and Behavioral 24
Health and the Division of Child and Family Services. 25
Existing law establishes a mental health consortium for each county whose 26
population is 100,000 or more (currently Clark and Washoe Counties) and another 27
behavioral health consortium for the jurisdiction consisting of all other counties in 28
this State. (NRS 433B.333) 29
Existing law requires each mental health consortium to: (1) prepare and submit 30
to the Director of the Department a long-term strategic plan for the provision of 31
mental health services to children with emotional disturbance in the jurisdiction of 32
the consortium; and (2) annually submit to the Director of the Department and the 33
Commission certain reports relating to the long-term strategic plan. (NRS 34
433B.335) Section 11 of this bill requires each mental health consortium to submit 35
the long-term strategic plan and the annual reports to the Administrator of the 36
Division of Child and Family Services. 37
Existing law requires the Commission to appoint a subcommittee on the mental 38
health of children to review each long-term strategic plan submitted by a mental 39
health consortium that represents a particular region. (NRS 433.317) Section 6 of 40
this bill requires that subcommittee to include two members recommended by and 41
upon agreement of the mental health consortia. 42
Existing law: (1) requires a medical facility or facility for the dependent to 43
obtain a license from the Division of Public and Behavioral Health; and (2) 44
authorizes the State Board of Health to adopt regulations requiring the licensing of 45
other types of facilities that provide any type of medical care or treatment. (NRS 46
449.030, 449.0303) Section 12.8 of this bill clarifies that the authority of the State 47
Board to require such licensing includes the authority to require the licensing of 48
facilities that provide behavioral health care or treatment. 49
Existing law requires the Division of Public and Behavioral Health to formulate 50
and operate a comprehensive state plan for programs for alcohol or other substance 51
use disorders. (NRS 458.025) Section 13.5 of this bill requires the Legislative 52
Committee on Senior Citizens, Veterans and Adults With Special Needs to study, 53
during the 2023-2024 interim, the feasibility of formulating and operating a similar 54
comprehensive state plan for the provision of behavioral health services in this 55
State. 56
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THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 433 of NRS is hereby amended by adding 1
thereto the provisions set forth as sections 2 and 3 of this act. 2
Sec. 2. 1. The Department shall: 3
(a) Track the spending of federal and state money on the 4
children’s behavioral health system of care; 5
(b) Quantify and track the costs avoided through the 6
expenditures described in paragraph (a) over time; 7
(c) Solicit, compile and analyze information and hold public 8
hearings concerning: 9
(1) The use of federal and state money spent on the 10
children’s behavioral health system of care; and 11
(2) Ways to reinvest the money saved through the avoided 12
costs quantified pursuant to paragraph (b) in the children’s 13
behavioral health system of care in a manner that addresses the 14
behavioral health needs of children in this State and reduces the 15
involvement of such children in the child welfare and juvenile 16
justice systems; 17
(d) On or before June 30 of every even-numbered year, present 18
at a meeting of the Joint Interim Standing Committee on Health 19
and Human Services concerning: 20
(1) The costs that are projected to be avoided through the 21
expenditure of federal and state money on the children’s 22
behavioral health system of care during the immediately following 23
2 years; and 24
(2) Recommendations for the reinvestment of such avoided 25
costs in accordance with subparagraph (2) of paragraph (c); and 26
(e) On or before December 31 of every even-numbered year, 27
submit a report of the information described in paragraph (d) to 28
the Governor and the Director of the Legislative Counsel Bureau 29
for transmittal to the Senate Standing Committee on Finance and 30
the Assembly Standing Committee on Ways and Means at the 31
beginning of the next regular session of the Legislature. 32
2. For the purposes of this section, the children’s behavioral 33
health system of care consists of: 34
(a) Respite care for families and caregivers; 35
(b) Community-based and in-home behavioral health services 36
for children; 37
(c) Services for children in a behavioral health crisis, 38
including, without limitation, mobile crisis services and services 39
for in-home stabilization; 40
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(d) Services to promote the coordination of behavioral health 1
care between families and providers, including, without limitation, 2
high fidelity wraparound; 3
(e) Family-to-family peer support services; 4
(f) Specialty services for children with an emotional 5
disturbance and dual diagnoses; 6
(g) Behavioral health services identified in the state plan for 7
foster care and adoption assistance established pursuant to 42 8
U.S.C. § 671; and 9
(h) Any other services prescribed by regulation of the Division 10
of Child and Family Services of the Department. 11
3. As used in this section: 12
(a) “Child with an emotional disturbance” has the meaning 13
ascribed to it in NRS 433B.045. 14
(b) “High fidelity wraparound” means an evidence-based, 15
structured and team-oriented process for developing and 16
implementing a plan to meet all of the behavioral health needs of 17
a child with complex behavioral health issues in collaboration 18
with the family of the child. 19
Sec. 3. (Deleted by amendment.) 20
Sec. 4. (Deleted by amendment.) 21
Sec. 5. (Deleted by amendment.) 22
Sec. 6. NRS 433.317 is hereby amended to read as follows: 23
433.317 1. The Commission shall appoint a subcommittee on 24
the mental health of children to review the findings and 25
recommendations of each mental health consortium submitted 26
pursuant to NRS 433B.335 and to create a statewide plan for the 27
provision of mental health services to children. The members of the 28
subcommittee must include, without limitation, two members 29
recommended by and upon agreement of the mental health 30
consortia established pursuant to NRS 433B.333. 31
2. The members of the subcommittee appointed pursuant to 32
this section serve at the pleasure of the Commission. The members 33
serve without compensation, except that each member is entitled, 34
while engaged in the business of the subcommittee, to the per diem 35
allowance and travel expenses provided for state officers and 36
employees generally if funding is available for this purpose. 37
Sec. 7. (Deleted by amendment.) 38
Sec. 8. NRS 433.4295 is hereby amended to read as follows: 39
433.4295 1. Each policy board shall: 40
(a) Advise the Department, the Division , the Division of Child 41
and Family Services and the Commission , as appropriate, 42
regarding: 43
(1) The behavioral health needs of adults and children in the 44
behavioral health region; 45
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(2) Any progress, problems or proposed plans relating to the 1
provision of behavioral health services and methods to improve the 2
provision of behavioral health services in the behavioral health 3
region; 4
(3) Identified gaps in the behavioral health services which 5
are available in the behavioral health region and any 6
recommendations or service enhancements to address those gaps; 7
(4) Any federal, state or local law or regulation that relates to 8
behavioral health which it determines is redundant, conflicts with 9
other laws or is obsolete and any recommendation to address any 10
such redundant, conflicting or obsolete law or regulation; and 11
(5) Priorities for allocating money to support and develop 12
behavioral health services in the behavioral health region. 13
(b) Promote improvements in the delivery of behavioral health 14
services in the behavioral health region. 15
(c) Coordinate and exchange information with the other policy 16
boards to provide unified and coordinated recommendations to the 17
Department, the Division , the Division of Child and Family 18
Services and the Commission regarding behavioral health services 19
in the behavioral health region. 20
(d) Review the collection and reporting standards of behavioral 21
health data to determine standards for such data collection and 22
reporting processes. 23
(e) To the extent feasible, establish an organized, sustainable 24
and accurate electronic repository of data and information 25
concerning behavioral health and behavioral health services in the 26
behavioral health region that is accessible to members of the public 27
on an Internet website maintained by the policy board. A policy 28
board may collaborate with an existing community-based 29
organization to establish the repository. 30
(f) To the extent feasible, track and compile data concerning 31
persons placed on a mental health crisis hold pursuant to NRS 32
433A.160, persons admitted to mental health facilities and hospitals 33
under an emergency admission pursuant to NRS 433A.162, persons 34
admitted to mental health facilities under an involuntary court-35
ordered admission pursuant to NRS 433A.200 to 433A.330, 36
inclusive, and persons ordered to receive assisted outpatient 37
treatment pursuant to NRS 433A.335 to 433A.345, inclusive, in the 38
behavioral health region, including, without limitation: 39
(1) The outcomes of treatment provided to such persons; and 40
(2) Measures taken upon and after the release of such 41
persons to address behavioral health issues and prevent future 42
mental health crisis holds and admissions. 43
(g) If a data dashboard is established pursuant to NRS 439.245, 44
use the data dashboard to review access by different groups and 45
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populations in this State to behavioral health services provided 1
through telehealth, as defined in NRS 629.515, and evaluate policies 2
to make such access more equitable. 3
(h) Identify and coordinate with other entities in the behavioral 4
health region and this State that address issues relating to behavioral 5
health to increase awareness of such issues and avoid duplication of 6
efforts. 7
(i) In coordination with existing entities in this State that address 8
issues relating to behavioral health services, submit an annual report 9
to the Commission , the Division and the Division of Child and 10
Family Services which includes, without limitation: 11
(1) The specific behavioral health needs of the behavioral 12
health region; 13
(2) A description of the methods used by the policy board to 14
collect and analyze data concerning the behavioral health needs and 15
problems of the behavioral health region and gaps in behavioral 16
health services which are available in the behavioral health region, 17
including, without limitation, a list of all sources of such data used 18
by the policy board; 19
(3) A description of the manner in which the policy board 20
has carried out the requirements of paragraphs (c) and (h) and the 21
results of those activities; and 22
(4) The data compiled pursuant to paragraph (f) and any 23
conclusions that the policy board has derived from such data. 24
2. A report described in paragraph (i) of subsection 1 may be 25
submitted more often than annually if the policy board determines 26
that a specific behavioral health issue requires an additional report . 27
[to the Commission.] 28
3. As used in this section, “Division of Child and Family 29
Services” means the Division of Child and Family Services of the 30
Department. 31
Sec. 9. (Deleted by amendment.) 32
Sec. 10. (Deleted by amendment.) 33
Sec. 10.5. (Deleted by amendment.) 34
Sec. 11. NRS 433B.335 is hereby amended to read as follows: 35
433B.335 1. Each mental health consortium established 36
pursuant to NRS 433B.333 shall prepare and submit to the Director 37
of the Department and the Administrator a long-term strategic plan 38
for the provision of mental health services to children with 39
emotional disturbance in the jurisdiction of the consortium. A plan 40
submitted pursuant to this section is valid for 10 years after the date 41
of submission, and each consortium shall submit a new plan upon its 42
expiration. 43
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2. In preparing the long-term strategic plan pursuant to 1
subsection 1, each mental health consortium must be guided by the 2
following principles: 3
(a) The system of mental health services set forth in the plan 4
should be centered on children with emotional disturbance and their 5
families, with the needs and strengths of those children and their 6
families dictating the types and mix of services provided. 7
(b) The families of children with emotional disturbance, 8
including, without limitation, foster parents, should be active 9
participants in all aspects of planning, selecting and delivering 10
mental health services at the local level. 11
(c) The system of mental health services should be community-12
based and flexible, with accountability and the focus of the services 13
at the local level. 14
(d) The system of mental health services should provide timely 15
access to a comprehensive array of cost-effective mental health 16
services. 17
(e) Children and their families who are in need of mental health 18
services should be identified as early as possible through screening, 19
assessment processes, treatment and systems of support. 20
(f) Comprehensive mental health services should be made 21
available in the least restrictive but clinically appropriate 22
environment. 23
(g) The family of a child with an emotional disturbance should 24
be eligible to receive mental health services from the system. 25
(h) Mental health services should be provided to children with 26
emotional disturbance in a sensitive manner that is responsive to 27
cultural and gender-based differences and the special needs of the 28
children. 29
3. The long-term strategic plan prepared pursuant to subsection 30
1 must include: 31
(a) An assessment of the need for mental health services in the 32
jurisdiction of the consortium; 33
(b) The long-term strategies and goals of the consortium for 34
providing mental health services to children with emotional 35
disturbance within the jurisdiction of the consortium; 36
(c) A description of the types of services to be offered to 37
children with emotional disturbance within the jurisdiction of the 38
consortium; 39
(d) Criteria for eligibility for those services; 40
(e) A description of the manner in which those services may be 41
obtained by eligible children; 42
(f) The manner in which the costs for those services will be 43
allocated; 44
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(g) The mechanisms to manage the money provided for those 1
services; 2
(h) Documentation of the number of children with emotional 3
disturbance who are not currently being provided services, the costs 4
to provide services to those children, the obstacles to providing 5
services to those children and recommendations for removing those 6
obstacles; 7
(i) Methods for obtaining additional money and services for 8
children with emotional disturbance from private and public entities; 9
and 10
(j) The manner in which family members of eligible children 11
and other persons may be involved in the treatment of the children. 12
4. On or before January 31 of each even-numbered year, each 13
mental health consortium shall submit to the Director of the 14
Department , the Administrator and the Commission: 15
(a) A list of the priorities of services necessary to implement the 16
long-term strategic plan submitted pursuant to subsection 1 and an 17
itemized list of the costs to provide those services; 18
(b) A description of any revisions to the long-term strategic plan 19
adopted by the consortium during the immediately preceding year; 20
and 21
(c) Any request for an allocation for administrative expenses of 22
the consortium. 23
5. In preparing the biennial budget request for the Department, 24
the Director of the Department shall consider the list of priorities 25
and any request for an allocation submitted pursuant to subsection 4 26
by each mental health consortium. On or before September 30 of 27
each even-numbered year, the Director of the Department shall 28
submit to each mental health consortium a report which includes a 29
description of: 30
(a) Each item on the list of priorities of the consortium that was 31
included in the biennial budget request for the Department; 32
(b) Each item on the list of priorities of the consortium that was 33
not included in the biennial budget request for the Department and 34
an explanation for the exclusion; and 35
(c) Any request for an allocation for administrative expenses of 36
the consortium that was included in the biennial budget request for 37
the Department. 38
6. On or before January 31 of each odd-numbered year, each 39
consortium shall submit to the Director of the Department , the 40
Administrator and the Commission: 41
(a) A report regarding the status of the long-term strategic plan 42
submitted pursuant to subsection 1, including, without limitation, 43
the status of the strategies, goals and services included in the plan; 44
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(b) A description of any revisions to the long-term strategic plan 1
adopted by the consortium during the immediately preceding year; 2
and 3
(c) A report of all expenditures made from an account 4
maintained pursuant to NRS 433B.339, if any. 5
Sec. 11.3. (Deleted by amendment.) 6
Sec. 11.6. (Deleted by amendment.) 7
Sec. 12. (Deleted by amendment.) 8
Sec. 12.3. (Deleted by amendment.) 9
Sec. 12.5. (Deleted by amendment.) 10
Sec. 12.8. NRS 449.0303 is hereby amended to read as 11
follows: 12
449.0303 The Board may adopt regulations requiring the 13
licensing of a facility other than those required to be licensed 14
pursuant to NRS 449.029 to 449.2428, inclusive, if the: 15
1. Facility provides any type of medical care or treatment [;] , 16
including, without limitation, behavioral health care or treatment; 17
and 18
2. Regulation is necessary to protect the health of the general 19
public. 20
Sec. 13. (Deleted by amendment.) 21
Sec. 13.5. 1. During the 2023-2024 interim, the Legislative 22
Committee on Senior Citizens, Veterans and Adults With Special 23
Needs created by NRS 218E.750 shall study the feasibility of 24
formulating and operating a comprehensive plan to provide 25
behavioral health services in this State. In conducting the study, the 26
Committee may collaborate with: 27
(a) The Commission on Behavioral Health; 28
(b) Personnel of the Department of Health and Human Services 29
or any division thereof; 30
(c) Any regional behavioral health policy board created by NRS 31
433.429; and 32
(d) Any other state or local governmental entity that provides or 33
performs duties relating to behavioral health services in this State. 34
2. On or before September 1, 2024, the Legislative Committee 35
on Senior Citizens, Veterans and Adults With Special Needs shall 36
submit a report of the results of the study conducted pursuant to 37
subsection 1 and recommendations for legislation resulting from the 38
study to: 39
(a) The Governor; and 40
(b) The Director of the Legislative Counsel Bureau for 41
transmittal to the 83rd Session of the Nevada Legislature. 42
Sec. 14. The provisions of subsection 1 of NRS 218D.380 do 43
not apply to any provision of this act which adds or revises a 44
requirement to submit a report to the Legislature. 45
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Sec. 15. (Deleted by amendment.) 1
Sec. 16. This act becomes effective on July 1, 2023. 2
H