A.B. 467
- *AB467*
ASSEMBLY BILL NO. 467–ASSEMBLYMEMBERS ROTH AND YEAGER
MARCH 17, 2025
____________
JOINT SPONSOR: SENATOR NGUYEN
____________
Referred to Committee on Judiciary
SUMMARY—Revises provisions relating to forensic mental health.
(BDR 14-842)
FISCAL NOTE: Effect on Local Government: May have Fiscal Impact.
Effect on the State: Yes.
~
EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.
AN ACT relating to mental health; authorizing a court to order
involuntary court-ordered admission of a defendant to a
mental health facility in certain circumstances;
authorizing certain entities to request the records of such a
defendant; authorizing the creation of a facility for the
treatment of incompetent defendants within certain county
jails or detention facilities; requiring the Division of Child
and Family Services of the Department of Health and
Human Services to immediately accept placement of a
child in a division facility when a juvenile court orders
such acceptance of the child; exempting certain providers
of health care from compliance with an advance directive
for psychiatric care under certain circumstances; and
providing other matters properly relating thereto.
Legislative Counsel’s Digest:
Existing law prohibits a defendant from being tried or judgment pronounced for 1
a public offense while the defendant is incompetent. (NRS 178.400) Existing law 2
also requires a court to suspend criminal proceedings against a defendant if doubt 3
arises as to the competence of the defendant until the question of competence is 4
determined. (NRS 178.405) After a court determines that a defendant is 5
incompetent, existing law requires a judge to order the defendant into the custody 6
of the Administrator of the Division of Public and Behavioral Health of the 7
Department of Health and Human Services or the Administrator’s designee for 8
treatment at a secure mental health facility of the Division. (NRS 178.425) 9
– 2 –
- *AB467*
Section 5 of this bill authorizes a court to order the involuntary court-ordered 10
admission of a defendant to a public or private mental health facility if the court: 11
(1) finds that the defendant is a danger to himself or herself or to society; (2) finds 12
that commitment is required for a determination of the defendant’s ability to 13
receive treatment to competence and to attain competence; (3) explores other 14
alternative courses of treatment; and (4) receives an affirmation from the public or 15
private mental health facility that the facility will admit the defendant. Sections 2, 16
11 and 15 of this bill provide that a court that orders the involuntary admission of a 17
defendant to a mental health facility under those circumstances is not required to 18
follow the procedures established by existing law for the civil commitment of a 19
person to a public or private mental health facility. (NRS 433A.200-433A.330) 20
Section 2 prescribes certain required contents of an order for the involuntary 21
admission of a defendant to a public or private mental health facility. Section 6 of 22
this bill requires the county or city from which a defendant is sent to pay the cost of 23
transporting the defendant to the public or private mental health facility while 24
authorizing such a city or county to seek reimbursement from certain persons and 25
entities. 26
Section 7 of this bill requires the Administrator or the Administrator’s designee 27
to provide periodic evaluations and reports to the court if the defendant is 28
involuntarily admitted to a mental health facility. Sections 2 and 16 of this bill 29
require a mental health facility to provide clinical records of the defendant to the 30
court upon request. Sections 8 and 12 of this bill authorize certain entities involved 31
in the treatment of a defendant who is involuntarily admitted to a mental health 32
facility to request the records of the defendant from other such entities to assist in 33
the evaluation and treatment of the defendant. Section 2 prohibits the transfer of a 34
defendant who has been involuntarily admitted to a mental health facility without 35
the consent of the court that ordered the involuntary admission. Section 10 of this 36
bill updates an internal reference changed by section 5. Section 14 of this bill 37
requires each regional behavioral health policy board to track and compile data on 38
defendants who are involuntarily admitted to mental health facilities in the 39
behavioral health region. Sections 18 and 19 of this bill provide for the 40
compensation of a mental health facility to which a defendant is involuntarily 41
admitted pursuant to section 5 in the same manner as other persons who are 42
involuntarily admitted to mental health facilities. Section 17 of this bill requires a 43
peace officer, under certain circumstances, to apprehend a defendant who is 44
involuntarily admitted to, and later escapes from, a public or private mental health 45
facility. Section 21 of this bill provides that an attending provider of health care at 46
a mental health facility is not required to comply with the advance directive for 47
psychiatric care of a defendant who is involuntarily admitted to the facility. 48
Under certain circumstances, section 3 of this bill requires the Administrator to 49
seek to enter into a contract with an organization that provides mental health 50
services to the community to operate a facility for the treatment of defendants in a 51
county jail or detention facility in a county whose population is 100,000 or more 52
(currently Clark and Washoe Counties). Sections 3 and 5 authorize a court to 53
commit an incompetent defendant to such a facility under the same circumstances 54
where the court is authorized to commit an incompetent defendant to a division 55
facility. Section 9 of this bill requires a defendant who has attained competence 56
after being committed to a facility for the treatment of defendants established in a 57
county jail or detention facility to be discharged from the treatment facility within 58
the jail or detention facility. Section 13 of this bill applies the provisions of 59
sections 2 and 3 to persons who have been court-martialed for violations of the 60
Nevada Code of Military Justice. (NRS 412.196-412.584) Section 4 of this bill 61
applies certain definitions to sections 2 and 3. 62
Existing law authorizes a juvenile court that determines that a child in a case 63
before the court is incompetent to require a treatment facility of the Division of 64
– 3 –
- *AB467*
Child and Family Services of the Department to accept and provide services to the 65
child. (NRS 62D.180, 62D.185) If the administrative officer of the facility or the 66
administrative officer’s designee has determined that the treatment available at 67
the facility is not appropriate or necessary for the child, existing law requires the 68
administrative officer or the administrative officer’s designee to assist the court 69
with identifying a facility that has the appropriate or necessary treatment. (NRS 70
433B.320) If a court orders a treatment facility to accept and provide services to a 71
child, section 20 of this bill requires the administrative officer of the facility or the 72
administrative officer’s designee to: (1) accept placement of the child in the 73
facility; and (2) if the facility is not best situated to treat the child, to ensure that 74
the child receives treatment at the facility, within the capabilities of the facility, 75
while a more suitable facility is found. 76
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 178 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. An order for the involuntary court-ordered 3
admission of a defendant to a public or private mental health 4
facility may be issued pursuant to paragraph (b) of subsection 1 of 5
NRS 178.425 without: 6
(a) The filing of a petition pursuant to NRS 433A.200; or 7
(b) Any other procedure described in NRS 433A.200 to 8
433A.330, inclusive. 9
2. If a court orders a defendant involuntarily admitted to a 10
public or private mental health facility pursuant to paragraph (b) 11
of subsection 1 of NRS 178.425, the court shall order the sheriff to 12
convey the defendant forthwith into the custody of the 13
Administrator or the Administrator’s designee for transportation 14
to the public or private mental health facility. 15
3. An order for involuntary court-ordered admission issued 16
pursuant to paragraph (b) of subsection 1 of NRS 178.425 must 17
include, without limitation: 18
(a) The date on which the order expires, which must be not 19
more than 6 months after the date of the issuance of the order; 20
(b) A statement of the criminal charges against the defendant; 21
and 22
(c) Any procedure necessary to carry out the provisions of this 23
section and NRS 178.3981 to 178.4715, inclusive, and section 3 of 24
this act with respect to the defendant. 25
4. A public or private mental health facility shall not transfer 26
a defendant ordered involuntarily admitted to the facility pursuant 27
to paragraph (b) of subsection 1 of NRS 178.425 to another 28
facility without the consent of the court that ordered the 29
involuntary admission of the defendant. 30
– 4 –
- *AB467*
5. An order for the involuntary admission of a defendant to a 1
public or private mental health facility issued pursuant to 2
paragraph (b) of subsection 1 of NRS 178.425 may be renewed 3
under the circumstances prescribed in paragraph (b) of subsection 4
4 of NRS 178.460. 5
6. The provisions of NRS 433A.350 and 433A.380 to 6
433A.440, inclusive, do not apply to a defendant who is 7
involuntarily admitted to a public or private mental health facility 8
pursuant to paragraph (b) of subsection 1 of NRS 178.425 until 9
such time as the defendant is readmitted to the facility in 10
accordance with paragraph (d) of subsection 4 of NRS 178.460. 11
7. A public or private mental health facility to which a 12
defendant is involuntarily admitted pursuant to paragraph (b) of 13
subsection 1 of NRS 178.425 shall, upon the order of the court, 14
provide the clinical records of the defendant to the court. 15
Sec. 3. 1. The Administrator shall seek to enter into a 16
contract with an organization that provides mental health services 17
to the community to establish and operate a facility for the 18
treatment of defendants to competency within the county jail or 19
detention facility in a county whose population is 100,000 or more 20
if: 21
(a) Money is available to support the facility for the treatment 22
of defendants; 23
(b) There is a qualified organization that is willing and able to 24
operate the facility for the treatment of defendants; and 25
(c) The sheriff who is responsible for the county jail or 26
detention facility determines that the county jail or detention 27
facility is capable of hosting the facility for the treatment of 28
defendants without undue hardship. 29
2. An organization that enters into a contract pursuant to 30
subsection 1 may serve as an Administrator’s designee for the 31
purpose of this section and NRS 178.3981 to 178.4715, inclusive, 32
and section 2 of this act. The Administrator retains oversight over 33
the facility for the treatment of defendants and services provided at 34
the facility. 35
Sec. 4. NRS 178.3981 is hereby amended to read as follows: 36
178.3981 As used in NRS 178.3981 to 178.4715, inclusive, 37
and sections 2 and 3 of this act, unless the context otherwise 38
requires, the words and terms defined in NRS 178.3982 to 178.399, 39
inclusive, have the meanings ascribed to them in those sections. 40
Sec. 5. NRS 178.425 is hereby amended to read as follows: 41
178.425 1. If the court finds the defendant incompetent, and 42
dangerous to himself or herself or to society and that commitment is 43
required for a determination of the defendant’s ability to receive 44
– 5 –
- *AB467*
treatment to competency and to attain competence, the judge shall 1
[order] : 2
(a) Order the sheriff to convey the defendant forthwith, together 3
with a copy of the complaint, the commitment and the physicians’ 4
certificate, if any, into the custody of the Administrator or the 5
Administrator’s designee for detention and treatment at a division 6
facility that is secure [.] or a facility for the treatment of defendants 7
established within a county jail or detention facility pursuant to 8
section 3 of this act; or 9
(b) Order the involuntary court-ordered admission of a 10
defendant to a public or private mental health facility in 11
accordance with section 2 of this act, if the court additionally: 12
(1) Explores alternative courses of treatment and 13
determines that involuntary admission is in the best interests of the 14
defendant; and 15
(2) Receives confirmation from the public or private mental 16
health facility that the facility will admit the defendant. 17
2. The order issued pursuant to subsection 1 may include the 18
involuntary administration of medication if appropriate for treatment 19
to competency. 20
[2.] 3. The defendant must be held in [such] the custody of the 21
Administrator or the Administrator’s designee or a public or 22
private mental health facility, as applicable, pursuant to 23
subsection 1 until a court orders the defendant’s release or until the 24
defendant is returned for trial or judgment as provided in NRS 25
178.450, 178.455 and 178.460. 26
[3.] 4. If the court finds the defendant incompetent but not 27
dangerous to himself or herself or to society, and finds that 28
commitment is not required for a determination of the defendant’s 29
ability to receive treatment to competency and to attain competence, 30
the judge shall order the defendant to report to the Administrator or 31
the Administrator’s designee as an outpatient for treatment, if it 32
might be beneficial, and for a determination of the defendant’s 33
ability to receive treatment to competency and to attain competence. 34
The court may require the defendant to give bail for any periodic 35
appearances before the Administrator or the Administrator’s 36
designee. 37
[4.] 5. Except as otherwise provided in subsection [5,] 6, 38
proceedings against the defendant must be suspended until the 39
Administrator or the Administrator’s designee or, if the defendant is 40
charged with a misdemeanor, the judge finds the defendant capable 41
of standing trial or opposing pronouncement of judgment as 42
provided in NRS 178.400. 43
[5.] 6. Whenever the defendant has been found incompetent, 44
with no substantial probability of attaining competency in the 45
– 6 –
- *AB467*
foreseeable future, and released from custody or from obligations as 1
an outpatient pursuant to paragraph (d) of subsection 4 of NRS 2
178.460, the proceedings against the defendant which were 3
suspended must be dismissed. No new charge arising out of the 4
same circumstances may be brought except upon application by the 5
prosecuting attorney to the chief judge of the district court, or his or 6
her designee, and with leave of the court where: 7
(a) The State has a good faith belief, based on articulable facts, 8
that the defendant has attained competency; 9
(b) The State has a compelling interest in bringing charges 10
again; and 11
(c) The period, equal to the maximum time allowed by law for 12
commencing a criminal action for the crime with which the 13
defendant was charged, has not lapsed since the date of the alleged 14
offense. 15
The prosecuting attorney must give notice of an application made 16
pursuant to this subsection to the attorney for the defendant not less 17
than 24 hours before the hearing on the application. 18
[6.] 7. If a defendant is found incompetent pursuant to this 19
section, the court shall cause, within 5 business days after the 20
finding, on a form prescribed by the Department of Public Safety, a 21
record of that finding to be transmitted to the Central Repository for 22
Nevada Records of Criminal History, along with a statement 23
indicating that the record is being transmitted for inclusion in each 24
appropriate database of the National Instant Criminal Background 25
Check System. 26
[7.] 8. As used in this section, “National Instant Criminal 27
Background Check System” has the meaning ascribed to it in 28
NRS 179A.062. 29
Sec. 6. NRS 178.435 is hereby amended to read as follows: 30
178.435 The expenses of the examination and of the 31
transportation of the defendant to and from the custody of the 32
Administrator or the Administrator’s designee , or a public or 33
private mental health facility, are in the first instance chargeable to 34
the county or city from which the defendant has been sent. But the 35
county or city may recover the money from the estate of the 36
defendant, from a relative legally bound to care for the defendant or 37
from the county or city of which the defendant is a resident. 38
Sec. 7. NRS 178.450 is hereby amended to read as follows: 39
178.450 1. The Administrator or the Administrator’s 40
designee shall keep each defendant committed to the custody of the 41
Administrator, the Administrator’s designee or a public or private 42
mental health facility under NRS 178.425 or 178.460 under 43
observation and shall have each defendant who has been ordered to 44
– 7 –
- *AB467*
report to the Administrator as an outpatient under those sections 1
evaluated periodically. 2
2. The Administrator or the Administrator’s designee shall 3
report in writing to a judge of the court which committed the person 4
and the prosecuting attorney of the county or city to which the 5
person may be returned for further court action whether, in his or 6
her opinion, upon medical consultation, the defendant is of 7
sufficient mentality to be able to understand the nature of the 8
criminal charge against the defendant and, by reason thereof, is able 9
to aid and assist counsel in the defense interposed upon the trial or 10
against the pronouncement of the judgment thereafter. The 11
Administrator or the Administrator’s designee shall submit such a 12
report, in the case of a person charged or convicted of a 13
misdemeanor, within 3 months after the order for commitment or 14
treatment and evaluation as an outpatient or for recommitment 15
pursuant to paragraph (b) of subsection 4 of NRS 178.460, and at 16
monthly intervals thereafter. In all other cases, the initial report must 17
be submitted within 6 months after the order and at 6-month 18
intervals thereafter. If the opinion of the Administrator or the 19
Administrator’s designee is that the defendant is not of sufficient 20
mentality to understand the nature of the charge against the 21
defendant and assist in the defendant’s own defense, the 22
Administrator or the Administrator’s designee shall also include in 23
the report his or her opinion whether: 24
(a) There is a substantial probability that the defendant can 25
receive treatment to competency and will attain competency to stand 26
trial or receive pronouncement of judgment in the foreseeable 27
future; and 28
(b) The defendant is at that time a danger to himself or herself or 29
to society. 30
3. The report must contain: 31
(a) The name of the defendant and the county or city to which 32
the defendant may be returned for further court action. 33
(b) The circumstances under which the defendant was 34
committed to the custody of the Administrator , [or] the 35
Administrator’s designee or a public or private mental health 36
facility and the duration of the defendant’s hospitalization, or the 37
circumstances under which the defendant was ordered to report to 38
the Administrator or the Administrator’s designee as an outpatient. 39
Sec. 8. NRS 178.453 is hereby amended to read as follows: 40
178.453 1. The Administrator or the Administrator’s 41
designee or a public or private mental health facility may request 42
from the Department of Corrections access to any records in its 43
possession which contain information that may assist in evaluating 44
and treating a defendant who previously has served a term of 45
– 8 –
- *AB467*
imprisonment under the supervision of the Department of 1
Corrections and who is committed to the custody of or ordered to 2
report to the Administrator , [or] the Administrator’s designee or the 3
mental health facility pursuant to NRS 178.425, 178.460, 178.461 4
or 178.464. 5
2. Unless otherwise ordered by a court, upon request of the 6
Administrator , [or] the Administrator’s designee or a public or 7
private mental health facility for access to records of a defendant 8
pursuant to subsection 1, the Department of Corrections, through the 9
Medical Director, shall provide access to any such records, 10
including, without limitation, relevant medical and mental health 11
records, for the limited purpose of allowing the Administrator , [or] 12
the Administrator’s designee or the mental health facility, as 13
applicable, to evaluate and treat the defendant. 14
3. No oral or written consent of the defendant is required for 15
the Administrator , [or] the Administrator’s designee or a public or 16
private mental health facility to obtain access to records from the 17
Department of Corrections pursuant to this section. 18
4. As used in this section, “Medical Director” has the meaning 19
ascribed to it in NRS 209.077. 20
Sec. 9. NRS 178.460 is hereby amended to read as follows: 21
178.460 1. If requested by the district attorney or counsel for 22
the defendant within 10 days after the report by the Administrator or 23
the Administrator’s designee is sent to them, the judge shall hold a 24
hearing within 10 days after the request at which the district attorney 25
and the defense counsel may examine the members of the treatment 26
team on their report. 27
2. If the judge orders the appointment of a licensed psychiatrist 28
or psychologist who is not employed by the Division to perform an 29
additional evaluation and report concerning the defendant, the cost 30
of the additional evaluation and report is a charge against the 31
county. 32
3. Within 10 days after the hearing or 10 days after the report is 33
sent, if no hearing is requested, the judge shall make and enter a 34
finding of competence or incompetence, and if the judge finds the 35
defendant to be incompetent: 36
(a) Whether there is substantial probability that the defendant 37
can receive treatment to competency and will attain competency to 38
stand trial or receive pronouncement of judgment in the foreseeable 39
future; and 40
(b) Whether the defendant is at that time a danger to himself or 41
herself or to society. 42
4. If the judge finds the defendant: 43
(a) Competent, the judge shall, within 10 days, forward the 44
finding to the prosecuting attorney and counsel for the defendant. 45
– 9 –
- *AB467*
Upon receipt thereof, the prosecuting attorney shall notify the 1
sheriff of the county or chief of police of the city that the defendant 2
has been found competent and prearrange with the facility for the 3
return of the defendant to that county or city for trial upon the 4
offense there charged or the pronouncement of judgment, as the case 5
may be. If the defendant is receiving treatment through a facility 6
located within the county jail or detention facility pursuant to 7
subsection 2 of NRS 178.425, the judge shall order the defendant 8
discharged from the facility for treatment within the jail or 9
detention facility. 10
(b) Incompetent, but there is a substantial probability that the 11
defendant can receive treatment to competency and will attain 12
competency to stand trial or receive pronouncement of judgment in 13
the foreseeable future and finds that the defendant is dangerous to 14
himself or herself or to society, the judge shall recommit the 15
defendant and may order the involuntary administration of 16
medication for the purpose of treatment to competency. 17
(c) Incompetent, but there is a substantial probability that the 18
defendant can receive treatment to competency and will attain 19
competency to stand trial or receive pronouncement of judgment in 20
the foreseeable future and finds that the defendant is not dangerous 21
to himself or herself or to society, the judge shall order that the 22
defendant remain an outpatient or be transferred to the status of an 23
outpatient under the provisions of NRS 178.425. 24
(d) Incompetent, with no substantial probability of attaining 25
competency in the foreseeable future, the judge shall order the 26
defendant released from custody or, if the defendant is an outpatient, 27
released from any obligations as an outpatient if, within 10 judicial 28
days, the prosecuting attorney has not filed a motion pursuant to 29
NRS 178.461 or if, within 10 judicial days, a petition is not filed for 30
the involuntary court-ordered admission of the person to a mental 31
health facility pursuant to NRS 433A.200. After the initial 10 32
judicial days, the person may remain an outpatient or in custody 33
under the provisions of this chapter only as long as the motion or 34
petition is pending unless the person is committed to the custody of 35
the Administrator pursuant to NRS 178.461 or involuntarily 36
admitted to a mental health facility pursuant to chapter 433A of 37
NRS. 38
5. Except as otherwise provided in subsections 4 and 7 of NRS 39
178.461, no person who is committed under the provisions of this 40
chapter may be held in the custody of the Administrator or the 41
Administrator’s designee longer than the longest period of 42
incarceration provided for the crime or crimes with which the 43
person is charged or 10 years, whichever period is shorter. Upon 44
expiration of the applicable period provided in this section, 45
– 10 –
- *AB467*
subsection 4 or 7 of NRS 178.461 or subsection 4 of NRS 178.463, 1
the person must be returned to the committing court for a 2
determination as to whether or not involuntary commitment 3
pursuant to chapter 433A of NRS is required. 4
Sec. 10. NRS 178.461 is hereby amended to read as follows: 5
178.461 1. If the proceedings against a defendant who is 6
charged with any category A felony or a category B felony listed in 7
subsection 6 are dismissed pursuant to subsection [5] 6 of NRS 8
178.425, the prosecuting attorney may, within 10 judicial days after 9
the dismissal, file a motion with the court for a hearing to determine 10
whether to commit the person to the custody of the Administrator 11
pursuant to subsection 3. 12
2. If the prosecuting attorney files a motion pursuant to 13
subsection 1, the prosecuting attorney shall, not later than the date 14
on which the prosecuting attorney files the motion, request from the 15
Division a comprehensive risk assessment which indicates whether 16
the person requires the level of security provided by a forensic 17
facility. The Division shall, except as otherwise provided in this 18
subsection, complete the comprehensive risk assessment within 40 19
calendar days after receipt of the request and provide the 20
comprehensive risk assessment to the court, the prosecuting attorney 21
and counsel for the person. The court may grant the Division an 22
extension to complete the comprehensive risk assessment upon a 23
showing of good cause. Within 10 judicial days after receipt of the 24
comprehensive risk assessment, the court shall hold a hearing on the 25
motion. If the person was charged with any category A felony other 26
than murder or sexual assault or a category B felony listed in 27
subsection 6 and the comprehensive risk assessment indicates that 28
the person does not require the level of security provided by a 29
forensic facility, the court shall dismiss the motion. 30
3. At a hearing held pursuant to subsection 2, if the court finds 31
by clear and convincing evidence that the person has a mental 32
disorder, that the person is a danger to himself or herself or others 33
and that the person’s dangerousness is such that the person requires 34
placement at a forensic facility, the court may order: 35
(a) The sheriff to take the person into protective custody and 36
transport the person to a forensic facility; and 37
(b) That the person be committed to the custody of the 38
Administrator and kept under observation until the person is eligible 39
for conditional release pursuant to NRS 178.463 or until the 40
maximum length of commitment described in subsection 4 or 7 has 41
expired. 42
4. Except as otherwise provided in subsection 7, the length of 43
commitment of a person pursuant to subsection 3 must not exceed 44
– 11 –
- *AB467*
10 years, including any time that the person has been on conditional 1
release pursuant to NRS 178.463. 2
5. At least once every 12 months, the court shall review the 3
eligibility of the defendant for conditional release. 4
6. The provisions of subsection 1 apply to any of the following 5
category B felonies: 6
(a) Voluntary manslaughter pursuant to NRS 200.050; 7
(b) Mayhem pursuant to NRS 200.280; 8
(c) Kidnapping in the second degree pursuant to NRS 200.330; 9
(d) Assault with a deadly weapon pursuant to NRS 200.471; 10
(e) Battery with a deadly weapon pursuant to NRS 200.481; 11
(f) Aggravated stalking pursuant to NRS 200.575; 12
(g) First degree arson pursuant to NRS 205.010; 13
(h) Residential burglary with a deadly weapon pursuant to 14
NRS 205.060; 15
(i) Invasion of the home with a deadly weapon pursuant to 16
NRS 205.067; 17
(j) Any category B felony involving the use of a firearm; and 18
(k) Any attempt to commit a category A felony. 19
7. If a person is within 6 months of the maximum length of 20
commitment set forth in this subsection or subsection 4, as 21
applicable, and: 22
(a) Was charged with murder or sexual assault; and 23
(b) Was committed to the custody of the Administrator pursuant 24
to this subsection or subsection 3, 25
the Administrator may file a motion to request an extension of 26
the length of commitment for not more than 5 additional years. 27
8. The court may grant a motion for an extension of the length 28
of commitment pursuant to subsection 7 if, at a hearing conducted 29
on the motion, the court finds by clear and convincing evidence that 30
the person is a danger to himself or herself or others and that the 31
person’s dangerousness is such that the person requires placement at 32
a forensic facility. 33
9. At a hearing conducted pursuant to subsection 8, a person 34
who is committed has the right to be represented by counsel. If the 35
person does not have counsel, the court shall appoint an attorney to 36
represent the person. 37
Sec. 11. NRS 160.160 is hereby amended to read as follows: 38
160.160 1. In any proceeding under the laws of this State for 39
involuntary court-ordered admission of a person alleged to be 40
mentally ill or otherwise in need of confinement in a hospital or 41
other institution for his or her care, the court may order the 42
admission of that person to the Department of Veterans Affairs or 43
another agency of the Federal Government, whenever: 44
– 12 –
- *AB467*
(a) It is determined, after such adjudication of the status of that 1
person as may be required by chapter 433A of NRS, that 2
involuntary court-ordered admission to a hospital for mental disease 3
or another institution is necessary for safekeeping or treatment; and 4
(b) It appears that the person is eligible for care or treatment by 5
the Department of Veterans Affairs or any other agency that has 6
facilities available and that the person is eligible for care or 7
treatment therein. 8
2. [The] Except where involuntary admission is ordered 9
pursuant to NRS 178.425, the person whose involuntary court-10
ordered admission is sought must be personally served with notice 11
of the pending proceeding in the manner provided by chapter 433A 12
of NRS. This chapter does not affect that person’s right to appear 13
and be heard in the proceedings. 14
Sec. 12. NRS 209.3515 is hereby amended to read as follows: 15
209.3515 1. The Director, through the Medical Director, may 16
request from the Division of Public and Behavioral Health of the 17
Department of Health and Human Services access to any records in 18
its possession which contain information that may assist in 19
evaluating, caring for and providing treatment to an offender who 20
previously was committed to the custody of [or ordered to report to] 21
the Administrator or the Administrator’s designee or a public or 22
private mental health facility or ordered to report to the 23
Administrator or the Administrator’s designee pursuant to NRS 24
178.425 or 178.460. 25
2. Unless otherwise ordered by a court, upon a request for 26
access to records of an offender pursuant to subsection 1, the 27
Division of Public and Behavioral Health of the Department of 28
Health and Human Services shall provide access to any such 29
records, including, without limitation, relevant medical and mental 30
health records, for the limited purpose of allowing the Director or 31
the Medical Director to evaluate, care for and provide treatment to 32
the offender. 33
3. The Director, through the Medical Director, may provide to 34
the Division of Public and Behavioral Health of the Department of 35
Health and Human Services or to other community medical or 36
mental health care providers, relevant medical and mental health 37
records of an offender serving a term of imprisonment under the 38
custody of the Department of Corrections, for the purposes of 39
planning the discharge of the offender and assuring the continuity of 40
evaluation, care and treatment of the offender in the community 41
after release from incarceration. 42
4. No oral or written consent of the offender is required to 43
obtain access to records from the Division of Public and Behavioral 44
– 13 –
- *AB467*
Health of the Department of Health and Human Services or the 1
Department of Corrections pursuant to this section. 2
Sec. 13. NRS 412.4485 is hereby amended to read as follows: 3
412.4485 1. Unless otherwise stated in this section, in the 4
case of a person determined pursuant to NRS 412.2645 to be 5
incompetent, the provisions of NRS 178.3981 to 178.4715, 6
inclusive, and sections 2 and 3 of this act are applicable. 7
References to the court in NRS 178.3981 to 178.4715, inclusive, 8
and sections 2 and 3 of this act, and to the judge of such court, shall 9
be deemed to refer to the convening authority having authority to 10
convene a general court-martial for that person. However, if the 11
person is no longer subject to this Code at a time relevant to the 12
application to the person of the relevant provisions of NRS 13
178.3981 to 178.4715, inclusive, and sections 2 and 3 of this act, 14
the state trial court with felony jurisdiction in the county where the 15
person is committed or otherwise may be found retains the powers 16
specified in NRS 178.3981 to 178.4715, inclusive, and sections 2 17
and 3 of this act as if it were the court that ordered the commitment 18
of the person. 19
2. When the director of a facility in which a person is 20
hospitalized pursuant to the actions taken by the convening authority 21
having authority to convene a general court-martial for that person 22
determines that the person is able to understand the nature of the 23
proceedings against the person and to conduct or cooperate 24
intelligently in the defense of the case, the director shall promptly 25
transmit a notification of that determination to the convening 26
authority having authority to convene a general court-martial for the 27
person, the person’s counsel and the authority having custody of the 28
person. The authority having custody of the person may retain 29
custody of the person for not more than 30 days after receiving 30
notification that the person has recovered to such an extent that the 31
person is able to understand the nature of the proceedings against 32
the person and to conduct or cooperate intelligently in the defense of 33
the case. 34
3. Upon receipt of a notification pursuant to subsection 2, the 35
convening authority having authority to convene a general court-36
martial for the person shall promptly take custody of the person 37
unless the person to which the notification applies is no longer 38
subject to this Code. If the person is no longer subject to this Code, 39
the state trial court with felony jurisdiction in the county where the 40
person is committed or otherwise may be found may take any action 41
within the authority of that court that the court considers appropriate 42
regarding the person. 43
Sec. 14. NRS 433.4295 is hereby amended to read as follows: 44
433.4295 1. Each policy board shall: 45
– 14 –
- *AB467*
(a) Advise the Department, Division and Commission regarding: 1
(1) The behavioral health needs of adults and children in the 2
behavioral health region; 3
(2) Any progress, problems or proposed plans relating to the 4
provision of behavioral health services and methods to improve the 5
provision of behavioral health services in the behavioral health 6
region; 7
(3) Identified gaps in the behavioral health services which 8
are available in the behavioral health region and any 9
recommendations or service enhancements to address those gaps; 10
(4) Any federal, state or local law or regulation that relates to 11
behavioral health which it determines is redundant, conflicts with 12
other laws or is obsolete and any recommendation to address any 13
such redundant, conflicting or obsolete law or regulation; and 14
(5) Priorities for allocating money to support and develop 15
behavioral health services in the behavioral health region. 16
(b) Promote improvements in the delivery of behavioral health 17
services in the behavioral health region. 18
(c) Coordinate and exchange information with the other policy 19
boards to provide unified and coordinated recommendations to the 20
Department, Division and Commission regarding behavioral health 21
services in the behavioral health region. 22
(d) Review the collection and reporting standards of behavioral 23
health data to determine standards for such data collection and 24
reporting processes. 25
(e) To the extent feasible, establish an organized, sustainable 26
and accurate electronic repository of data and information 27
concerning behavioral health and behavioral health services in the 28
behavioral health region that is accessible to members of the public 29
on an Internet website maintained by the policy board. A policy 30
board may collaborate with an existing community-based 31
organization to establish the repository. 32
(f) To the extent feasible, track and compile data concerning 33
persons placed on a mental health crisis hold pursuant to NRS 34
433A.160, persons admitted to mental health facilities and hospitals 35
under an emergency admission pursuant to NRS 433A.162, persons 36
admitted to mental health facilities under an involuntary court-37
ordered admission pursuant to NRS 178.425 or 433A.200 to 38
433A.330, inclusive, and persons ordered to receive assisted 39
outpatient treatment pursuant to NRS 433A.335 to 433A.345, 40
inclusive, in the behavioral health region, including, without 41
limitation: 42
(1) The outcomes of treatment provided to such persons; and 43
– 15 –
- *AB467*
(2) Measures taken upon and after the release of such 1
persons to address behavioral health issues and prevent future 2
mental health crisis holds and admissions. 3
(g) If a data dashboard is established pursuant to NRS 439.245, 4
use the data dashboard to review access by different groups and 5
populations in this State to behavioral health services provided 6
through telehealth, as defined in NRS 629.515, and evaluate policies 7
to make such access more equitable. 8
(h) Identify and coordinate with other entities in the behavioral 9
health region and this State that address issues relating to behavioral 10
health to increase awareness of such issues and avoid duplication of 11
efforts. 12
(i) In coordination with existing entities in this State that address 13
issues relating to behavioral health services, submit an annual report 14
to the Commission which includes, without limitation: 15
(1) The specific behavioral health needs of the behavioral 16
health region; 17
(2) A description of the methods used by the policy board to 18
collect and analyze data concerning the behavioral health needs and 19
problems of the behavioral health region and gaps in behavioral 20
health services which are available in the behavioral health region, 21
including, without limitation, a list of all sources of such data used 22
by the policy board; 23
(3) A description of the manner in which the policy board 24
has carried out the requirements of paragraphs (c) and (h) and the 25
results of those activities; and 26
(4) The data compiled pursuant to paragraph (f) and any 27
conclusions that the policy board has derived from such data. 28
2. A report described in paragraph (i) of subsection 1 may be 29
submitted more often than annually if the policy board determines 30
that a specific behavioral health issue requires an additional report 31
to the Commission. 32
Sec. 15. NRS 433A.200 is hereby amended to read as follows: 33
433A.200 1. Except as otherwise provided in NRS 34
432B.6075 and 432B.60814 [,] and section 2 of this act, a 35
proceeding for an involuntary court-ordered admission of any 36
person in the State of Nevada may be commenced by the filing of a 37
petition for the involuntary admission to a mental health facility 38
with the clerk of the district court of the county where the person 39
who is to be treated resides or the county where a mental health 40
facility that is willing to admit the person is located. The petition 41
may be filed by any physician, physician assistant, psychologist, 42
social worker or registered nurse or by any officer authorized to 43
make arrests in the State of Nevada. The petition must be 44
accompanied: 45
– 16 –
- *AB467*
(a) By a certificate of a physician, a psychologist, a physician 1
assistant under the supervision of a psychiatrist, a clinical social 2
worker who has the psychiatric training and experience prescribed 3
by the Board of Examiners for Social Workers pursuant to NRS 4
641B.160 or an advanced practice registered nurse who has the 5
psychiatric training and experience prescribed by the State Board of 6
Nursing pursuant to NRS 632.120 stating that he or she has 7
examined the person alleged to be a person in a mental health crisis 8
and has concluded that the person is a person in a mental health 9
crisis; or 10
(b) By a sworn written statement by the petitioner that: 11
(1) The petitioner has, based upon the petitioner’s personal 12
observation of the person alleged to be a person in a mental health 13
crisis, probable cause to believe that the person is a person in a 14
mental health crisis and the person alleged to be a person in a mental 15
health crisis has refused to submit to examination or treatment by a 16
physician, psychiatrist, psychologist or advanced practice registered 17
nurse who has the psychiatric training and experience prescribed by 18
the State Board of Nursing pursuant to NRS 632.120; or 19
(2) The person alleged to be a person in a mental health crisis 20
has been placed on a mental health crisis hold pursuant to NRS 21
433A.160 and the physician, physician assistant or advanced 22
practice registered nurse who examined the person alleged to be a 23
person with a mental health crisis pursuant to NRS 433A.165 24
determined that the person has a medical condition, other than a 25
psychiatric condition, which requires immediate treatment. 26
2. Except as otherwise provided in NRS 432B.6075 and 27
432B.60814, if the person to be treated is an unemancipated minor 28
and the petitioner is a person other than a parent or guardian of the 29
minor, a petition submitted pursuant to subsection 1 must, in 30
addition to the certificate or statement required by that subsection, 31
include a statement signed by a parent or guardian of the minor that 32
the parent or guardian does not object to the filing of the petition. 33
Sec. 16. NRS 433A.360 is hereby amended to read as follows: 34
433A.360 1. A clinical record for each consumer must be 35
diligently maintained by any division facility, private institution, 36
facility offering mental health services or person professionally 37
qualified in the field of psychiatric mental health responsible for 38
providing assisted outpatient treatment. The record must include 39
information pertaining to the consumer’s admission, legal status, 40
treatment and individualized plan for habilitation. The clinical 41
record is not a public record and no part of it may be released, 42
except as otherwise provided in subsection 2 or except: 43
(a) If the release is authorized or required pursuant to NRS 44
209.3515 or 439.597. 45
– 17 –
- *AB467*
(b) The record must be released to physicians, advanced practice 1
registered nurses, attorneys and social agencies as specifically 2
authorized in writing by the consumer, the consumer’s parent, 3
guardian or attorney. 4
(c) The record must be released to persons authorized by the 5
order of a court of competent jurisdiction. 6
(d) The record or any part thereof may be disclosed to a 7
qualified member of the staff of a division facility, an employee of 8
the Division or a member of the staff of an agency in Nevada which 9
has been established pursuant to the Developmental Disabilities 10
Assistance and Bill of Rights Act of 2000, 42 U.S.C. §§ 15001 et 11
seq., or the Protection and Advocacy for Mentally Ill Individuals 12
Act of 1986, 42 U.S.C. §§ 10801 et seq., when the Administrator 13
deems it necessary for the proper care of the consumer. 14
(e) Information from the clinical records may be used for 15
statistical and evaluative purposes if the information is abstracted in 16
such a way as to protect the identity of individual consumers. 17
(f) To the extent necessary for a consumer to make a claim, or 18
for a claim to be made on behalf of a consumer for aid, insurance or 19
medical assistance to which the consumer may be entitled, 20
information from the records may be released with the written 21
authorization of the consumer or the consumer’s guardian. 22
(g) The record must be released without charge to any member 23
of the staff of an agency in Nevada which has been established 24
pursuant to 42 U.S.C. §§ 15001 et seq. or 42 U.S.C. §§ 10801 et 25
seq. if: 26
(1) The consumer is a consumer of that office and the 27
consumer or the consumer’s legal representative or guardian 28
authorizes the release of the record; or 29
(2) A complaint regarding a consumer was received by the 30
office or there is probable cause to believe that the consumer has 31
been abused or neglected and the consumer: 32
(I) Is unable to authorize the release of the record because 33
of the consumer’s mental or physical condition; and 34
(II) Does not have a guardian or other legal representative 35
or is a ward of the State. 36
(h) The record must be released as provided in NRS 433.332 or 37
433B.200 and in chapter 629 of NRS. 38
2. A division facility, private institution, facility offering 39
mental health services or person professionally qualified in the field 40
of psychiatric mental health responsible for providing assisted 41
outpatient treatment and any other person or entity having 42
information concerning a consumer, including, without limitation, a 43
clinical record, any part thereof or any information contained 44
– 18 –
- *AB467*
therein, may disclose such information to a provider of health care 1
to assist with treatment provided to the consumer. 2
3. As used in this section, “provider of health care” has the 3
meaning ascribed to it in NRS 629.031. 4
Sec. 17. NRS 433A.370 is hereby amended to read as follows: 5
433A.370 1. When a consumer committed by a court to a 6
division facility on or before June 30, 1975, or a consumer who is 7
judicially admitted on or after July 1, 1975, or a person who is 8
involuntarily detained pursuant to NRS 178.425 or 433A.145 to 9
433A.300, inclusive, escapes from any division facility, or when a 10
judicially admitted consumer has not returned to a division facility 11
from conditional release after the administrative officer of the 12
facility has ordered the consumer to do so, any peace officer shall, 13
upon written request of the administrative officer or the 14
administrative officer’s designee and without the necessity of a 15
warrant or court order, apprehend, take into custody and deliver the 16
person to such division facility or another state facility. 17
2. Any person appointed or designated by the Director of the 18
Department to take into custody and transport to a division facility 19
persons who have escaped or failed to return as described in 20
subsection 1 may participate in the apprehension and delivery of any 21
such person, but may not take the person into custody without a 22
warrant. 23
Sec. 18. NRS 433A.580 is hereby amended to read as follows: 24
433A.580 No person may be admitted or transferred to a 25
private hospital or a division mental health facility, ordered to 26
receive assisted outpatient treatment or transferred to a different 27
person professionally qualified in the field of psychiatric mental 28
health to provide assisted outpatient treatment pursuant to the 29
provisions of this chapter or NRS 178.425 unless mutually 30
agreeable financial arrangements relating to the costs of treatment 31
are made between the private hospital, division facility or person 32
professionally qualified in the field of psychiatric mental health 33
responsible for providing assisted outpatient treatment and the 34
consumer or person requesting his or her admission. 35
Sec. 19. NRS 433A.610 is hereby amended to read as follows: 36
433A.610 1. When a person is admitted to a division facility 37
or hospital under one of the various forms of admission prescribed 38
by law, the parent or legal guardian of a person in a mental health 39
crisis who is a minor or the spouse of a person in a mental health 40
crisis, if of sufficient ability, and the estate of the person in a mental 41
health crisis, if the estate is sufficient for the purpose, shall pay the 42
cost of the maintenance for the person in a mental health crisis, 43
including treatment and surgical operations, in any hospital in which 44
– 19 –
- *AB467*
the person is hospitalized under the provisions of this chapter [:] or 1
NRS 178.425: 2
(a) To the administrative officer if the person is admitted to a 3
division facility; or 4
(b) In all other cases, to the hospital rendering the service. 5
2. If a person or an estate liable for the care, maintenance and 6
support of a committed person neglects or refuses to pay the 7
administrative officer or the hospital rendering the service, the State 8
is entitled to recover, by appropriate legal action, all money owed to 9
a division facility or which the State has paid to a hospital for the 10
care of a committed person, plus interest at the rate established 11
pursuant to NRS 99.040. 12
Sec. 20. NRS 433B.320 is hereby amended to read as follows: 13
433B.320 1. In any case involving commitment by court 14
order, except a case where commitment was ordered by a juvenile 15
court pursuant to NRS 62D.180 or 62D.185, admission to a 16
treatment facility may be only after consultation with and approval 17
by the administrative officer of the facility or the administrative 18
officer’s designee, who shall determine whether the treatment 19
available at the facility is appropriate or necessary for the child’s 20
health and welfare. 21
2. In a case where commitment to a treatment facility was 22
ordered by a juvenile court pursuant to NRS 62D.180 or 62D.185, 23
[if] the administrative officer or the administrative officer’s 24
designee shall immediately accept placement of the child at the 25
treatment facility. If the administrative officer of the facility or the 26
administrative officer’s designee has determined that the treatment 27
available at the facility is not [appropriate or necessary for the 28
child’s health and welfare and for the protection of the community,] 29
best situated to treat the child, the administrative officer or the 30
administrative officer’s designee shall [assist] : 31
(a) Assist the court with identifying a facility that [has the 32
appropriate or necessary] is better situated to provide the necessary 33
treatment [.] ; and 34
(b) Ensure that the child receives treatment at the treatment 35
facility, within the capabilities of the treatment facility, until a 36
more suitable facility is found. 37
3. Except in a case where commitment was ordered by a 38
juvenile court pursuant to NRS 62D.180 or 62D.185, a child 39
committed by court order must not be released from a treatment 40
facility until the administrative officer determines that treatment in 41
the facility is no longer beneficial to the child. 42
Sec. 21. NRS 449A.636 is hereby amended to read as follows: 43
449A.636 1. When acting under the authority of an advance 44
directive for psychiatric care, an attending physician or other 45
– 20 –
- *AB467*
provider of health care shall comply with the advance directive 1
unless: 2
(a) Compliance, in the opinion of the attending physician or 3
other provider, is not consistent with generally accepted standards of 4
care for the provision of psychiatric care for the benefit of the 5
principal; 6
(b) Compliance is not consistent with the availability of 7
psychiatric care requested; 8
(c) Compliance is not consistent with applicable law; 9
(d) The principal is admitted to a mental health facility or 10
hospital pursuant to NRS 178A.425 or 433A.145 to 433A.330, 11
inclusive, or required to receive assisted outpatient treatment 12
pursuant to NRS 433A.335 to 433A.345, inclusive, and a course of 13
treatment is required pursuant to those provisions; or 14
(e) Compliance, in the opinion of the attending physician or 15
other provider, is not consistent with appropriate psychiatric care in 16
case of an emergency endangering the life or health of the principal 17
or another person. 18
2. In the event that one part of the advance directive is unable 19
to be followed because of any of the circumstances set forth in 20
subsection 1, all other parts of the advance directive must be 21
followed. 22
Sec. 22. 1. This section and section 20 of this act become 23
effective upon passage and approval. 24
2. Sections 1 to 19, inclusive, and 21 of this act become 25
effective: 26
(a) Upon passage and approval for the purpose of adopting any 27
regulations and performing any other preparatory administrative 28
tasks that are necessary to carry out the provisions of this act; and 29
(b) On January 1, 2026, for all other purposes. 30
H