SENATE BILL NO. 91 COMMITTEE ON COMMERCE AND LABOR
                                                                                   
                                                                       FEBRUARY 8, 2001
                                                                          ____________
                                                                                   
                                                       Referred to Committee on Commerce and Labor
                                                                                   
SUMMARY Makes various changes to provisions governing practice of medicine and respiratory care. (BDR
54?290)
 
FISCAL NOTE:            Effect on Local Government: No.
                                       Effect on the State: Yes.
                                                                                   
EXPLANATION   Matter in bolded italics is new; matter between brackets [omitted material] is material to be
omitted.
Green numbers along left margin indicate location on the printed bill (e.g., 5-15 indicates page 5, line 15).
                                                                                   
AN ACT relating to medicine; changing the designation of physician's assistant; revising the scope of authority and
duties of the board of medical examiners; providing for the issuance of special purpose licenses; requiring the board
of medical examiners to regulate the practice of respiratory care; requiring practitioners of respiratory care to be
licensed by the board of medical examiners; revising the qualifications and requirements relating to licensure of
physicians and physicians' assistants; revising the duties and scope of authority of persons licensed by the board of
medical examiners; making certain actions subject to disciplinary action by the board of medical examiners; revising
provisions governing the imposition of disciplinary action against licensees; establishing and revising certain fees;
increasing certain penalties; and providing other matters properly relating thereto.
                                                                                   
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT
AS FOLLOWS:
                                                                                   
1-1    Section 1.  Chapter 630 of NRS is hereby amended by adding thereto 
1-2  the provisions set forth as sections 2 to 9, inclusive, of this act.

1-3    Sec. 2.  "Practice of respiratory care" includes:
1-4    1.  Therapeutic and diagnostic use of medical gases, humidity and 
1-5  aerosols and the maintenance of associated apparatus;
1-6    2.  The administration of drugs and medications to the 
1-7  cardiopulmonary system;
1-8    3.  The provision of ventilatory assistance and control;
1-9    4.  Postural drainage and percussion, breathing exercises and other 
1-10  respiratory rehabilitation procedures;
1-11    5.  Cardiopulmonary resuscitation and maintenance of natural 
1-12  airways and the insertion and maintenance of artificial airways;
1-13    6.  Carrying out the written orders of a physician, physician assistant 
1-14  or an advanced practitioner of nursing relating to respiratory care;

2-1    7.  Techniques for testing to assist in diagnosis, monitoring, treatment 
2-2  and research related to respiratory care, including the measurement of 
2-3  ventilatory volumes, pressures and flows, collection of blood and other 
2-4  specimens, testing of pulmonary functions and hemodynamic and other 
2-5  related physiological monitoring of the cardiopulmonary system; and
2-6    8.  Training relating to the practice of respiratory care.

2-7    Sec. 3.  "Practitioner of respiratory care" means a person who is:
2-8    1.  Certified to engage in the practice of respiratory care by the 
2-9  National Board for Respiratory Care or its successor organization; and
2-10    2.  Licensed by the board.

2-11    Sec. 4.  "Respiratory care" means the treatment, management, 
2-12  diagnostic testing, control and care of persons with deficiencies and 
2-13  abnormalities associated with the cardiopulmonary system. The term 
2-14  includes inhalation and respiratory therapy.

2-15    Sec. 5.  For the purposes of this chapter, any act that constitutes the 
2-16  practice of medicine shall be deemed to occur at the place where the 
2-17  patient is located at the time the act is performed.

2-18    Sec. 6.  The practice of respiratory care must be performed under the 
2-19  direction of or pursuant to a prescription from a physician licensed to 
2-20  practice in this state, any other state, any territory of the United States or 
2-21  the District of Columbia.

2-22    Sec. 7.  1.  Every person who wishes to practice respiratory care in 
2-23  this state must:
2-24    (a) Have a high school diploma or general equivalency diploma;
2-25    (b) Complete an educational program for respiratory care which has 
2-26  been approved by the National Board for Respiratory Care or its 
2-27  successor organization;
2-28    (c) Pass the examination as an entry-level or advanced practitioner of 
2-29  respiratory care administered by the National Board for Respiratory Care 
2-30  or its successor organization;
2-31    (d) Be certified by the National Board for Respiratory Care or its 
2-32  successor organization; and
2-33    (e) Be licensed to practice respiratory care by the board and have paid 
2-34  the required fee for licensure.
2-35    2.  Except as otherwise provided in subsection 3, a person shall not:
2-36    (a) Practice respiratory care; or
2-37    (b) Hold himself out as qualified to practice respiratory care,
2-38  in this state without complying with the provisions of subsection 1.
2-39    3.  Any person who has completed the educational requirements set 
2-40  forth in paragraphs (a) and (b) of subsection 1 may practice respiratory 
2-41  care pursuant to a program of practical training as an intern in 
2-42  respiratory care for not more than 12 months after completing those 
2-43  educational requirements.

2-44    Sec. 8.  An application for a license as a practitioner of respiratory 
2-45  care must include the social security number of the applicant.

2-46    Sec. 9.  The board shall adopt regulations regarding the licensure of 
2-47  practitioners of respiratory care, including, without limitation:
2-48    1.  Educational and other qualifications of applicants;

3-1    2.  Required academic programs which applicants must successfully 
3-2  complete;
3-3    3.  Procedures for applying for and issuing licenses;
3-4    4.  Tests or examinations of applicants by the board;
3-5    5.  The types of medical services that a practitioner of respiratory care 
3-6  may perform, except that a practitioner of respiratory care may not 
3-7  perform those specific functions and duties delegated or otherwise 
3-8  restricted by specific statute to persons licensed as dentists, chiropractors, 
3-9  podiatric physicians, optometrists, physicians, osteopathic physicians or 
3-10  hearing aid specialists pursuant to this chapter or chapter 631, 633, 634, 
3-11  635, 636 or 637A of NRS, as appropriate;
3-12    6.  The duration, renewal and termination of licenses; and
3-13    7.  The grounds and procedures for disciplinary actions against 
3-14  practitioners of respiratory care.

3-15    Sec. 10.  NRS 630.003 is hereby amended to read as follows:
3-16    630.003  The legislature finds and declares that it is among the 
3-17  responsibilities of state government to ensure, as far as possible, that only 
3-18  competent persons practice medicine and respiratory care within this state. 
3-19  For this purpose, the legislature delegates to the board of medical 
3-20  examiners the duty of determining the initial and continuing competence of 
3-21  doctors of medicine , physician assistants and practitioners of respiratory 
3-22  care in this state. The powers conferred upon the board by this chapter 
3-23  must be liberally construed to carry out this purpose.

3-24    Sec. 11.  NRS 630.005 is hereby amended to read as follows:
3-25    630.005  As used in this chapter, unless the context otherwise requires, 
3-26  the words and terms defined in NRS 630.010 to 630.025, inclusive, and 
3-27  sections 2, 3 and 4 of this act have the meanings ascribed to them in those 
3-28  sections.

3-29    Sec. 12.  NRS 630.015 is hereby amended to read as follows:
3-30    630.015  ["Physician's] "Physician assistant" means a person who is a 
3-31  graduate of an academic program approved by the board or who, by 
3-32  general education, practical training and experience determined to be 
3-33  satisfactory by the board, is qualified to perform medical services under the 
3-34  supervision of a supervising physician and who has been issued a license 
3-35  by the board.

3-36    Sec. 13.  NRS 630.025 is hereby amended to read as follows:
3-37    630.025  "Supervising physician" means an active physician licensed 
3-38  in the State of Nevada [who cosigns the application for licensure of a 
3-39  physician's assistant and] who employs and supervises [the physician's] a 
3-40  physician assistant.

3-41    Sec. 14.  NRS 630.045 is hereby amended to read as follows:
3-42    630.045  The purpose of licensing physicians [and physicians'] , 
3-43  physician assistants and practitioners of respiratory care is to protect the 
3-44  public health and safety and the general welfare of the people of this state. 
3-45  Any license issued pursuant to this chapter is a revocable privilege and no 
3-46  holder of such a license acquires thereby any vested right.

3-47    Sec. 15.  NRS 630.047 is hereby amended to read as follows:
3-48    630.047  1.  This chapter does not apply to:

4-1    (a) A medical officer or practitioner of respiratory care of the armed 
4-2  services or a medical officer or practitioner of respiratory care of any 
4-3  division or department of the United States in the discharge of his official 
4-4  duties ; [for which a license is not required;]
4-5    (b) Physicians who are called into this state, other than on a regular 
4-6  basis, for consultation with or assistance to a physician licensed in this 
4-7  state, and who are legally qualified to practice in the state where they 
4-8  reside;
4-9    (c) Physicians who are legally qualified to practice in the state where 
4-10  they reside and come into this state on an irregular basis to:
4-11      (1) Obtain medical training approved by the board from a physician 
4-12  who is licensed in this state; or
4-13      (2) Provide medical instruction or training approved by the board to 
4-14  physicians licensed in this state; [and]
4-15    (d) Any person permitted to practice any other healing art under this 
4-16  Title who does so within the scope of that authority, or healing by faith or 
4-17  Christian Science [.] ;
4-18    (e) The practice of respiratory care by a student as part of a program 
4-19  of study in respiratory care that is approved by the board, or is 
4-20  recognized by a national organization which is approved by the board to 
4-21  review such programs, if the student is enrolled in the program and 
4-22  provides respiratory care only under the supervision of a practitioner of 
4-23  respiratory care;
4-24    (f) The practice of respiratory care by a student who:
4-25      (1) Is enrolled in a clinical program of study in respiratory care 
4-26  which has been approved by the board;
4-27      (2) Is employed by a medical facility, as defined in NRS 449.0151; 
4-28  and
4-29      (3) Provides respiratory care to patients who are not in a critical 
4-30  medical condition or, in an emergency, to patients who are in a critical 
4-31  medical condition and a practitioner of respiratory care is not 
4-32  immediately available to provide that care and the student is directed by a 
4-33  physician to provide respiratory care under his supervision until a 
4-34  practitioner or respiratory care is available;
4-35    (g) The practice of respiratory care by a person on himself or 
4-36  gratuitous respiratory care provided to a friend or a member of a 
4-37  person's family if the provider of the care does not represent himself as a 
4-38  practitioner of respiratory care;
4-39    (h) A cardiopulmonary perfusionist who is under the supervision of a 
4-40  surgeon or an anesthesiologist;
4-41    (i) A person who is employed by a physician and provides respiratory 
4-42  care under the supervision of that physician;
4-43    (j) The maintenance of medical equipment for respiratory care that is 
4-44  not attached to a patient; and
4-45    (k) A person who installs medical equipment for respiratory care that 
4-46  is used in the home and gives instructions regarding the use of that 
4-47  equipment if the person is trained to provide such services and is 
4-48  supervised by a provider of health care who is acting within the 
4-49  authorized scope of his practice.

5-1    2.  This chapter does not repeal or affect any statute of Nevada 
5-2  regulating or affecting any other healing art.
5-3    3.  This chapter does not prohibit:
5-4    (a) Gratuitous services outside of a medical school or medical facility 
5-5  by a person who is not a physician , physician assistant or practitioner of 
5-6  respiratory care in cases of emergency.
5-7    (b) The domestic administration of family remedies.

5-8    Sec. 16.  NRS 630.120 is hereby amended to read as follows:
5-9    630.120  1.  The board shall procure a seal.
5-10    2.  All licenses issued to physicians [and physicians'] , physician 
5-11  assistants and practitioners of respiratory care must bear the seal of the 
5-12  board and the signatures of its president and secretary-treasurer.

5-13    Sec. 17.  NRS 630.160 is hereby amended to read as follows:
5-14    630.160  1.  Every person desiring to practice medicine must, before 
5-15  beginning to practice, procure from the board a license authorizing him to 
5-16  practice.
5-17    2.  Except as otherwise provided in NRS 630.161 or 630.164, a license 
5-18  may be issued to any person who:
5-19    (a) Is a citizen of the United States or is lawfully entitled to remain and 
5-20  work in the United States;
5-21    (b) Has received the degree of Doctor of Medicine from a medical 
5-22  school:
5-23      (1) Approved by the Liaison Committee on Medical Education of the 
5-24  American Medical Association and Association of American Medical 
5-25  Colleges; or
5-26      (2) Which provides a course of professional instruction equivalent to 
5-27  that provided in medical schools in the United States approved by the 
5-28  Liaison Committee on Medical Education;
5-29    (c) Has passed:
5-30      (1) All parts of the examination given by the National Board of 
5-31  Medical Examiners;
5-32      (2) All parts of the Federation Licensing Examination;
5-33      (3) All parts of the United States Medical Licensing Examination;
5-34      (4) All parts of a licensing examination given by any state or territory 
5-35  of the United States, if the applicant is certified by a specialty board of the 
5-36  American Board of Medical Specialties;
5-37      (5) All parts of the examination to become a licentiate of the Medical 
5-38  Council of Canada; or
5-39      (6) Any combination of the examinations specified in subparagraphs 
5-40  (1), (2) and (3) that the board determined to be sufficient;
5-41    (d) Has completed [3 years of:
5-42      (1) Graduate education] 36 months of progressive postgraduate:
5-43      (1) Education as a resident in the United States or Canada in a 
5-44  program approved by the board, the Accreditation Council for Graduate 
5-45  Medical Education of the American Medical Association or the 
5-46  Coordinating Council of Medical Education of the Canadian Medical 
5-47  Association; or

6-1       (2) Fellowship training in the United States or Canada approved by 
6-2  the board or the Accreditation Council for Graduate Medical Education; 
6-3  and
6-4    (e) Passes a written or oral examination, or both, as to his qualifications 
6-5  to practice medicine and provides the board with a description of the 
6-6  clinical program completed demonstrating that the applicant's clinical 
6-7  training met the requirements of paragraph (b) of this subsection.

6-8    Sec. 18.  NRS 630.164 is hereby amended to read as follows:
6-9    630.164  1.  A board of county commissioners may petition the board 
6-10  of medical examiners to waive the [requirements] requirement of 
6-11  paragraph (d) of subsection 2 of NRS 630.160 for any applicant intending 
6-12  to practice medicine in a medically underserved area of that county as that 
6-13  term is defined by regulation by the [officer of rural health of the 
6-14  University of Nevada School of Medicine.] board of medical examiners. 
6-15  The board of medical examiners may waive that requirement and issue a 
6-16  license if the applicant:
6-17    (a) Has completed at least 1 year of training as a resident in the United 
6-18  States or Canada in a program approved by the board, the Accreditation 
6-19  Council for Graduate Medical Education of the American Medical 
6-20  Association or the Coordinating Council of Medical Education of the 
6-21  Canadian Medical Association, respectively;
6-22    (b) Has a minimum of 5 years of practical medical experience as a 
6-23  licensed allopathic physician or such other equivalent training as the board 
6-24  deems appropriate; and
6-25    (c) Meets all other conditions and requirements for a license to practice 
6-26  medicine.
6-27    2.  Any person licensed pursuant to subsection 1 must be issued a 
6-28  license to practice medicine in this state restricted to practice in the 
6-29  medically underserved area of the county which petitioned for the waiver 
6-30  only. He may apply to the board of medical examiners for renewal of that 
6-31  restricted license every 2 years after he is licensed.
6-32    3.  Any person holding a restricted license pursuant to subsection 1 
6-33  who completes 3 years of [such] full-time practice under the restricted 
6-34  license may apply to the board for an unrestricted license. In considering 
6-35  an application for an unrestricted license pursuant to this subsection, the 
6-36  board shall require the applicant to meet all statutory requirements for 
6-37  licensure in effect at the time of application except the [requirements] 
6-38  requirement of paragraph (d) of subsection 2 of NRS 630.160.

6-39    Sec. 19.  NRS 630.197 is hereby amended to read as follows:
6-40    630.197  1.  An applicant for the issuance or renewal of a license to 
6-41  practice medicine , [or] to practice as a [physician's] physician assistant or 
6-42  to practice as a practitioner of respiratory care shall submit to the board 
6-43  the statement prescribed by the welfare division of the department of 
6-44  human resources pursuant to NRS 425.520. The statement must be 
6-45  completed and signed by the applicant.
6-46    2.  The board shall include the statement required pursuant to 
6-47  subsection 1 in:
6-48    (a) The application or any other forms that must be submitted for the 
6-49  issuance or renewal of the license; or

7-1    (b) A separate form prescribed by the board.
7-2    3.  A license to practice medicine , [or] to practice as a [physician's] 
7-3  physician assistant or to practice as a practitioner of respiratory care may 
7-4  not be issued or renewed by the board if the applicant:
7-5    (a) Fails to submit the statement required pursuant to subsection 1; or
7-6    (b) Indicates on the statement submitted pursuant to subsection 1 that he 
7-7  is subject to a court order for the support of a child and is not in 
7-8  compliance with the order or a plan approved by the district attorney or 
7-9  other public agency enforcing the order for the repayment of the amount 
7-10  owed pursuant to the order.
7-11    4.  If an applicant indicates on the statement submitted pursuant to 
7-12  subsection 1 that he is subject to a court order for the support of a child and 
7-13  is not in compliance with the order or a plan approved by the district 
7-14  attorney or other public agency enforcing the order for the repayment of 
7-15  the amount owed pursuant to the order, the board shall advise the applicant 
7-16  to contact the district attorney or other public agency enforcing the order to 
7-17  determine the actions that the applicant may take to satisfy the arrearage.

7-18    Sec. 20.  NRS 630.253 is hereby amended to read as follows:
7-19    630.253  The board shall, as a prerequisite for the:
7-20    1.  Renewal of a license as a [physician's] physician assistant; or
7-21    2.  Biennial registration of the holder of a license to practice medicine,
7-22  require each holder to comply with the requirements for continuing 
7-23  education adopted by the board. These requirements may provide for the 
7-24  completion of one or more courses of instruction relating to risk 
7-25  management in the performance of medical services.

7-26    Sec. 21.  NRS 630.261 is hereby amended to read as follows:
7-27    630.261  1.  [The board may, unless] Except as otherwise provided in 
7-28  [this section or] NRS 630.161, the board may issue : [, renew or modify:]
7-29    (a) A locum tenens license, to be effective not more than 3 months after 
7-30  issuance, to any physician who is licensed and in good standing in another 
7-31  state , who meets the requirements for licensure in this state and who is of 
7-32  good moral character and reputation. The purpose of this license is to 
7-33  enable an eligible physician to serve as a substitute for another physician 
7-34  who is licensed to practice medicine in this state and who is absent from 
7-35  his practice for reasons deemed sufficient by the board. A license issued 
7-36  pursuant to the provisions of this paragraph is not renewable.
7-37    (b) A special license to a licensed physician of another state to come 
7-38  into this state to care for or assist in the treatment of his own patient in 
7-39  association with a physician licensed in this state. A special license issued 
7-40  pursuant to the provisions of this paragraph is limited to the care of a 
7-41  specific patient. The physician licensed in this state has the primary 
7-42  responsibility for the care of that patient.
7-43    (c) A restricted license for a specified period if the board determines the 
7-44  applicant needs supervision or restriction.
7-45    (d) A temporary license for a specified period if the physician is 
7-46  licensed and in good standing in another state and meets the requirements 
7-47  for licensure in this state, and if the board determines that it is necessary 
7-48  in order to provide medical services for a community without adequate 

8-1  medical care. A temporary license issued pursuant to the provisions of this 
8-2  paragraph is not renewable.
8-3    (e) A special purpose license to a physician who is licensed in another 
8-4  state to permit the use of equipment that transfers information 
8-5  concerning the medical condition of a patient in this state across state 
8-6  lines electronically, telephonically or by fiber optics if the physician:
8-7       (1) Holds a full and unrestricted license to practice medicine in that 
8-8  state;
8-9       (2) Has not had any disciplinary or other action taken against him 
8-10  by any state or other jurisdiction; and
8-11      (3) Meets the requirement set forth in paragraph (d) of subsection 2 
8-12  of NRS 630.160.
8-13    2.  Except as otherwise provided in this section, the board may renew 
8-14  or modify any license issued pursuant to subsection 1. 
8-15    3.  Every physician who is licensed pursuant to [the provisions of] 
8-16  subsection 1 and who accepts the privilege of practicing medicine in this 
8-17  state pursuant to the provisions of the license shall be deemed to have 
8-18  given his consent to the revocation of the license at any time by the board 
8-19  for any of the grounds provided in NRS 630.161 or 630.301 to 630.3065, 
8-20  inclusive.

8-21    Sec. 22.  NRS 630.265 is hereby amended to read as follows:
8-22    630.265  1.  Except as otherwise provided in NRS 630.161, the board 
8-23  may issue to a qualified applicant a limited license to practice medicine as 
8-24  a resident physician in a graduate program approved by the Accreditation 
8-25  Council for Graduate Medical Education if he is:
8-26    (a) A graduate of an accredited medical school in the United States or 
8-27  Canada; or
8-28    (b) A graduate of a foreign medical school and has received the 
8-29  standard certificate of the Educational Commission for Foreign Medical 
8-30  Graduates or a written statement from that commission that he passed the 
8-31  examination given by it.
8-32    2.  The medical school or other institution sponsoring the program shall 
8-33  provide the board with written confirmation that the applicant has been 
8-34  appointed to a position in the program and is a citizen of the United States 
8-35  or lawfully entitled to remain and work in the United States. Such a license 
8-36  remains valid only while the licensee is actively practicing medicine in the 
8-37  residency program and is legally entitled to work and remain in the United 
8-38  States.
8-39    3.  The board may issue such a limited license for not more than 1 year 
8-40  but may renew the license [.] if the applicant for the limited license meets 
8-41  the requirements set forth by the board by regulation.
8-42    4.  The holder of a limited license may practice medicine only in 
8-43  connection with his duties as a resident physician or under such conditions 
8-44  as are approved by the director of the program and the board.
8-45    5.  [A] The holder of a limited license granted pursuant to this section 
8-46  may be [revoked] disciplined by the board at any time for any of the 
8-47  grounds provided in NRS 630.161 or 630.301 to 630.3065, inclusive.

9-1    Sec. 23.  NRS 630.271 is hereby amended to read as follows:
9-2    630.271  1.  A [physician's] physician assistant may perform such 
9-3  medical services as he is authorized to perform [pursuant to the terms of a 
9-4  license issued to him by the board, if those services are rendered under the 
9-5  supervision and control of a] by his supervising physician.
9-6    2.  The board and supervising physician shall limit the authority of a 
9-7  [physician's] physician assistant to prescribe controlled substances to those 
9-8  schedules of controlled substances [which his] that the supervising 
9-9  physician is authorized to prescribe pursuant to state and federal law.

9-10    Sec. 24.  NRS 630.273 is hereby amended to read as follows:
9-11    630.273  The board may issue a license to an applicant who is qualified 
9-12  under the regulations of the board to perform medical services under the 
9-13  supervision of a supervising physician. The application for a license as a 
9-14  [physician's] physician assistant must include the social security number 
9-15  of the applicant . [and be cosigned by the supervising physician.]

9-16    Sec. 25.  NRS 630.275 is hereby amended to read as follows:
9-17    630.275  The board shall adopt regulations regarding the licensure of a 
9-18  [physician's] physician assistant, including, but not limited to:
9-19    1.  The educational and other qualifications of applicants.
9-20    2.  The required academic program for applicants.
9-21    3.  The procedures for applications for and the issuance of licenses.
9-22    4.  The tests or examinations of applicants by the board.
9-23    5.  The medical services which a [physician's] physician assistant may 
9-24  perform, except that he may not perform those specific functions and duties 
9-25  delegated or restricted by law to persons licensed as dentists, chiropractors, 
9-26  podiatric physicians and optometrists under chapters 631, 634, 635 and 
9-27  636, respectively, of NRS, or as hearing aid specialists.
9-28    6.  The duration, renewal and termination of licenses.
9-29    7.  The grounds and procedures respecting disciplinary actions against 
9-30  [physicians'] physician assistants.
9-31    8.  The supervision of medical services of a [physician's] physician 
9-32  assistant by a supervising physician.

9-33    Sec. 26.  NRS 630.288 is hereby amended to read as follows:
9-34    630.288  1.  Each holder of a license to practice medicine must, on or 
9-35  before July 1 of each alternate year:
9-36    (a) Submit the statement required pursuant to NRS 630.197; and
9-37    (b) Pay to the secretary-treasurer of the board the applicable fee for 
9-38  biennial registration. This fee must be collected for the period for which a 
9-39  physician is licensed.
9-40    2.  When a holder of a license fails to pay the fee for biennial 
9-41  registration and submit the statement required pursuant to NRS 630.197 
9-42  after they become due, his license to practice medicine in this state is 
9-43  automatically suspended. The holder may, within 2 years after the date his 
9-44  license is suspended, upon payment of twice the amount of the current fee 
9-45  for biennial registration to the secretary-treasurer and submission of the 
9-46  statement required pursuant to NRS 630.197 and after he is found to be in 
9-47  good standing and qualified under the provisions of this chapter, be 
9-48  reinstated to practice.

10-1    3.  The board shall make such reasonable attempts as are practicable 
10-2  to notify a licensee:
10-3    (a) At least once that his fee for biennial registration and the statement 
10-4  required pursuant to NRS 630.197 are due; and
10-5    (b) That his license is suspended.
10-6  A copy of this notice must be sent to the Drug Enforcement Administration 
10-7  of the United States Department of Justice or its successor agency.

10-8    Sec. 27.  NRS 630.290 is hereby amended to read as follows:
10-9    630.290  1.  The board shall charge and collect not more than the 
10-10  following fees:
     10-11  For application for and issuance of a license [by written 
     10-12  examination, in addition to the actual cost to the board of 
     10-13  the examination] to practice as a physician.............. $600
     10-14  For application for and issuance of a temporary, locum 
     10-15  tenens, limited, restricted , special or special purpose 
     10-16  license................. [300] 400
     10-17  For renewal of a limited, restricted or special license............................. [200] 400
     10-18  For application for and issuance of a license as a 
     10-19  [physician's] physician assistant................. [300] 400
     10-20  For [renewal of a license as a physician's] biennial 
     10-21  registration of a physician assistant................. [300] 800
     10-22  For biennial registration of a physician........................ 800
     10-23  For application for and issuance of a license as a 
     10-24  practitioner of respiratory care................................ 400
     10-25  For biennial registration of a practitioner of respiratory 
     10-26  care.............................. 800
     10-27  For biennial registration for a physician who is [retired,] 
     10-28  on inactive status [or not practicing medicine in Nevada............................... 200] 400
     10-29  For written verification of licensure............................ 50
     10-30  For a duplicate identification card.................................. 25
     10-31  For a duplicate license..... 50
     10-32  For computer printouts or labels..................... [300] 500
     10-33  For verification of a listing of physicians, per hour.......... 20
     10-34  For furnishing a list of new physicians................ [50] 100
10-35  2.  In addition to the fees prescribed in subsection 1, the board shall 
10-36  charge and collect [:
10-37  (a) A fee to reimburse it for the cost of the United States Medical 
10-38  Licensing Examination; and
10-39  (b) Necessary] necessary and reasonable fees for its other services.
10-40  3.  The cost of any special meeting called at the request of a [licensed 
10-41  physician,] licensee, an institution, an organization, a state agency or an 
10-42  applicant for licensure must be paid for by the person or entity requesting 
10-43  the special meeting. Such a special meeting must not be called until the 
10-44  person or entity requesting it has paid a cash deposit with the board 
10-45  sufficient to defray all expenses of the meeting.

10-46  Sec. 28.  NRS 630.301 is hereby amended to read as follows:
10-47  630.301  The following acts, among others, constitute grounds for 
10-48  initiating disciplinary action or denying licensure:



11-1    1.  Conviction of a felony, any offense involving moral turpitude or any 
11-2  offense relating to the practice of medicine or the ability to practice 
11-3  medicine. A plea of nolo contendere is a conviction for the purposes of this 
11-4  subsection.
11-5    2.  Conviction of violating any of the provisions of NRS 616D.200, 
11-6  616D.220, 616D.240, 616D.300, 616D.310, or 616D.350 to 616D.440, 
11-7  inclusive.
11-8    3.  The revocation, suspension, modification or limitation of the license 
11-9  to practice any type of medicine by any other jurisdiction or the surrender 
11-10  of the license or discontinuing the practice of medicine while under 
11-11  investigation by any licensing authority, a medical facility, a branch of the 
11-12  Armed Services of the United States, an insurance company, an agency of 
11-13  the Federal Government or an employer.
11-14  4.  Malpractice, which may be evidenced by claims settled against a 
11-15  practitioner.
11-16  5.  The engaging by a practitioner in any sexual activity with a patient 
11-17  who is currently being treated by the practitioner.
11-18  6.  Disruptive behavior or interaction with physicians, hospital 
11-19  personnel, patients, members of the families of patients or any other 
11-20  persons if the behavior or interaction interferes with patient care or 
11-21  would be reasonably expected to have an adverse impact on the quality of 
11-22  care rendered to the patients.
11-23  7.  The engaging in conduct that violates the trust of a patient and 
11-24  exploits the relationship between the physician and the patient for 
11-25  financial or other personal gain.
11-26  8.  The failure to offer appropriate procedures or studies, to protest 
11-27  inappropriate denials by organizations for managed care, to provide 
11-28  necessary services or to refer a patient to an appropriate provider, when 
11-29  such a failure occurs for the sole purpose of positively influencing the 
11-30  financial well-being of the practitioner or an insurer.
11-31  9.  The engaging in conduct calculated to bring, or having the effect 
11-32  of bringing, the medical profession into disrepute, including, without 
11-33  limitation, conduct that violates any provision of a national code of ethics 
11-34  adopted by the board by regulation.
11-35  10.  The engaging in sexual contact with the surrogate of a patient or 
11-36  other key persons related to a patient, including, without limitation, a 
11-37  spouse, parent or legal guardian, which exploits the relationship between 
11-38  the physician and the patient in a sexual manner.

11-39  Sec. 29.  NRS 630.3062 is hereby amended to read as follows:
11-40  630.3062  The following acts, among others, constitute grounds for 
11-41  initiating disciplinary action or denying licensure:
11-42  1.  Failure to maintain timely, legible, accurate and complete medical 
11-43  records relating to the diagnosis, treatment and care of a patient.
11-44  2.  Altering medical records of a patient.
11-45  3.  Making or filing a report which the licensee knows to be false, 
11-46  failing to file a record or report as required by law or willfully obstructing 
11-47  or inducing another to obstruct such filing.
11-48  4.  Failure to make the medical records of a patient available for 
11-49  inspection and copying as provided in NRS 629.061.

12-1    5.  Failure to report any claim for malpractice or negligence filed 
12-2  against the licensee and the subsequent disposition thereof within 90 days 
12-3  after the:
12-4    (a) Claim is filed; and
12-5    (b) Disposition of the claim.
12-6    6.  Failure to report any person the licensee knows, or has reason to 
12-7  know, is in violation of the provisions of this chapter or the regulations of 
12-8  the board.

12-9    Sec. 30.  NRS 630.3066 is hereby amended to read as follows:
12-10  630.3066  A physician is not subject to disciplinary action solely for 
12-11  prescribing or administering to a patient under his care [:
12-12  1.  Amygdalin (laetrile), if the patient has consented in writing to the 
12-13  use of the substance.
12-14  2.  Procaine hydrochloride with preservatives and stabilizers (Gerovital 
12-15  H3).
12-16  3.  A] a controlled substance which is listed in schedule II, III, IV or V 
12-17  by the state board of pharmacy pursuant to NRS 453.146, if the controlled 
12-18  substance is lawfully prescribed or administered for the treatment of 
12-19  intractable pain in accordance with [accepted standards for the practice of 
12-20  medicine.] regulations adopted by the board.

12-21  Sec. 31.  NRS 630.307 is hereby amended to read as follows:
12-22  630.307  1.  Any person, medical school or medical facility that 
12-23  becomes aware that a person practicing medicine or respiratory care in 
12-24  this state has, is or is about to become engaged in conduct which 
12-25  constitutes grounds for initiating disciplinary action shall forthwith file a 
12-26  written complaint with the board.
12-27  2.  Any hospital, clinic or other medical facility licensed in this state, or 
12-28  medical society, shall forthwith report to the board any change in a 
12-29  physician's privileges to practice medicine while the physician is under 
12-30  investigation and the outcome of any disciplinary action taken by that 
12-31  facility or society against the physician concerning the care of a patient or 
12-32  the competency of the physician.
12-33  3.  The clerk of every court shall forthwith report to the board any 
12-34  finding, judgment or other determination of the court that a physician [:] , 
12-35  physician assistant or practitioner of respiratory care:
12-36  (a) Is mentally ill;
12-37  (b) Is mentally incompetent;
12-38  (c) Has been convicted of a felony or any law governing controlled 
12-39  substances or dangerous drugs;
12-40  (d) Is guilty of abuse or fraud under any state or federal program 
12-41  providing medical assistance; or
12-42  (e) Is liable for damages for malpractice or negligence.

12-43  Sec. 32.  NRS 630.329 is hereby amended to read as follows:
12-44  630.329  If the board issues an order suspending the license of a 
12-45  physician , physician assistant or practitioner of respiratory care pending 
12-46  proceedings for disciplinary action, the court shall not stay that order.

13-1    Sec. 33.  NRS 630.333 is hereby amended to read as follows:
13-2    630.333  1.  In addition to any other remedy provided by law, the 
13-3  board, through its president or, secretary-treasurer or the attorney general, 
13-4  may apply to any court of competent jurisdiction:
13-5    (a) To enjoin any prohibited act or other conduct of a [physician] 
13-6  licensee which is harmful to the public;
13-7    (b) To enjoin any person who is not licensed under this chapter from 
13-8  practicing medicine [;] or respiratory care;
13-9    (c) To limit the [physician's] practice of a physician, physician 
13-10  assistant or practitioner of respiratory care, or suspend his license to 
13-11  practice ; [medicine;] or
13-12  (d) To enjoin the use of the title M.D. , P.A., P.A.-C, R.C.P. or any 
13-13  other word, combination of letters or other designation intended to imply 
13-14  or designate a person as a physician, physician assistant or practitioner 
13-15  of respiratory care, when not licensed by the board pursuant to this 
13-16  chapter, unless the use is otherwise authorized by a specific statute.
13-17  2.  The court in a proper case may issue a temporary restraining order 
13-18  or a preliminary injunction for the purposes set forth in subsection 1:
13-19  (a) Without proof of actual damage sustained by any person;
13-20  (b) Without relieving any person from criminal prosecution for 
13-21  engaging in the practice of medicine without a license; and
13-22  (c) Pending proceedings for disciplinary action by the board.

13-23  Sec. 34.  NRS 630.336 is hereby amended to read as follows:
13-24  630.336  1.  Any proceeding of a committee of the board investigating 
13-25  complaints is not subject to the requirements of NRS 241.020, unless the 
13-26  licensee under investigation requests that the proceeding be subject to those 
13-27  requirements. Any deliberations conducted or vote taken by:
13-28  (a) The board or panel regarding its decision; or
13-29  (b) The board or any investigative committee of the board regarding its 
13-30  ordering of a physician , physician assistant or practitioner of respiratory 
13-31  care to undergo a physical or mental examination or any other examination 
13-32  designated to assist the board or committee in determining the fitness of a 
13-33  physician, physician assistant or practitioner of respiratory care,
13-34  are not subject to the requirements of NRS 241.020.
13-35  2.  Except as otherwise provided in subsection 3, all applications for a 
13-36  license to practice medicine [,] or respiratory care, any charges filed by the 
13-37  board, financial records of the board, formal hearings on any charges heard 
13-38  by the board or a panel selected by the board, records of such hearings and 
13-39  any order or decision of the board or panel must be open to the public.
13-40  3.  Except as otherwise provided in NRS 630.352 and 630.368, the 
13-41  following may be kept confidential:
13-42  (a) Any statement, evidence, credential or other proof submitted in 
13-43  support of or to verify the contents of an application;
13-44  (b) All investigations and records of investigations;
13-45  (c) Any report concerning the fitness of any person to receive or hold a 
13-46  license to practice medicine [;] or respiratory care;
13-47  (d) Any communication between:
13-48     (1) The board and any of its committees or panels; and

14-1      (2) The board or its staff, investigators, experts, committees, panels, 
14-2  hearing officers, advisory members or consultants and counsel for the 
14-3  board; and
14-4    (e) Any other information or records in the possession of the board.
14-5    4.  This section does not prevent or prohibit the board from 
14-6  communicating or cooperating with any other licensing board or agency or 
14-7  any agency which is investigating a licensee, including a law enforcement 
14-8  agency. Such cooperation may include , without limitation, providing the 
14-9  board or agency with minutes of a closed meeting, transcripts of oral 
14-10  examinations and the results of oral examinations.

14-11  Sec. 35.  NRS 630.344 is hereby amended to read as follows:
14-12  630.344  1.  Service of process [made] under this chapter must be 
14-13  made on [the person] a licensee personally, or by registered or certified 
14-14  mail with return receipt requested [,] addressed to the [physician] licensee 
14-15  at his last known address. If personal service cannot be made and if notice 
14-16  by mail is returned undelivered, the secretary-treasurer of the board shall 
14-17  cause notice to be published once a week for 4 consecutive weeks in a 
14-18  newspaper published in the county of the [physician's] last known address 
14-19  of the licensee or, if no newspaper is published in that county, then in a 
14-20  newspaper widely distributed in that county.
14-21  2.  Proof of service of process or publication of notice made under this 
14-22  chapter must be filed with the board and recorded in the minutes of the 
14-23  board.

14-24  Sec. 36.  NRS 630.346 is hereby amended to read as follows:
14-25  630.346  In any disciplinary hearing:
14-26  1.  The board, a panel of the members of the board and a hearing 
14-27  officer are not bound by formal rules of evidence and a witness must not be 
14-28  barred from testifying solely because he was or is incompetent.
14-29  2.  Proof of actual injury need not be established.
14-30  3.  A certified copy of the record of a court or a licensing agency 
14-31  showing a conviction or plea of nolo contendere or the suspension, 
14-32  revocation, limitation, modification, denial or surrender of a license to 
14-33  practice medicine or respiratory care is conclusive evidence of its 
14-34  occurrence.

14-35  Sec. 37.  NRS 630.352 is hereby amended to read as follows:
14-36  630.352  1.  Any member of the board, except for an advisory 
14-37  member serving on a panel of the board hearing charges, may participate in 
14-38  the final order of the board. If the board, after a formal hearing, determines 
14-39  from a preponderance of the evidence that a violation of the provisions of 
14-40  this chapter or of the regulations of the board has occurred, it shall issue 
14-41  and serve on the physician charged an order, in writing, containing its 
14-42  findings and any sanctions.
14-43  2.  If the board determines that no violation has occurred, it shall 
14-44  dismiss the charges, in writing, and notify the physician that the charges 
14-45  have been dismissed. If the disciplinary proceedings were instituted against 
14-46  the physician as a result of a complaint filed against him, the board may 
14-47  provide the physician with a copy of the complaint . [, including the name 
14-48  of the person, if any, who filed the complaint.]

15-1    3.  Except as otherwise provided in subsection 4, if the board finds that 
15-2  a violation has occurred, it may by order:
15-3    (a) Place the person on probation for a specified period on any of the 
15-4  conditions specified in the order;
15-5    (b) Administer to him a public reprimand;
15-6    (c) Limit his practice or exclude one or more specified branches of 
15-7  medicine from his practice;
15-8    (d) Suspend his license for a specified period or until further order of 
15-9  the board;
15-10  (e) Revoke his license to practice medicine;
15-11  (f) Require him to participate in a program to correct alcohol or drug 
15-12  dependence or any other impairment;
15-13  (g) Require supervision of his practice;
15-14  (h) Impose a fine not to exceed $5,000;
15-15  (i) Require him to perform public service without compensation;
15-16  (j) Require him to take a physical or mental examination or an 
15-17  examination testing his competence;
15-18  (k) Require him to fulfill certain training or educational requirements; 
15-19  and
15-20  (l) Require him to pay all costs incurred by the board relating to his 
15-21  disciplinary proceedings.
15-22  4.  If the board finds that the physician has violated the provisions of 
15-23  NRS 439B.425, the board shall suspend his license for a specified period or 
15-24  until further order of the board.

15-25  Sec. 38.  NRS 630.355 is hereby amended to read as follows:
15-26  630.355  1.  If a person, in a proceeding before the board [:] , a 
15-27  hearing officer or a panel of the board:
15-28  (a) Disobeys or resists a lawful order ; [of the board;]
15-29  (b) Refuses to take an oath or affirmation as a witness ; [before the 
15-30  board;]
15-31  (c) Refuses to be examined ; [before the board;] or
15-32  (d) Engages in conduct during a hearing or so near the place thereof as 
15-33  to obstruct the proceeding,
15-34  the board , hearing officer or panel may certify the facts to the district 
15-35  court of the county in which the proceeding is being conducted. Such a 
15-36  certification operates as a stay of all related disciplinary proceedings . 
15-37  [before the board.] The court shall issue an order directing the person to 
15-38  appear before the court and show cause why he should not be held in 
15-39  contempt.
15-40  2.  A copy of the statement of the board , hearing officer or panel, and 
15-41  the order of the district court issued pursuant to subsection 1 must be 
15-42  served on the person. Thereafter, the court has jurisdiction of the matter.
15-43  3.  The same proceedings must be had, the same penalties may be 
15-44  imposed and the person may purge himself of the contempt in the same 
15-45  way as in the case of a person who has committed a contempt in the trial of 
15-46  a civil action.

15-47  Sec. 39.  NRS 630.356 is hereby amended to read as follows:
15-48  630.356  1.  Any person aggrieved by a final order of the board is 
15-49  entitled to judicial review of the board's order.

16-1    2.  Every order [of the board which limits the practice of medicine or 
16-2  suspends or revokes a license] that imposes a sanction against a licensee 
16-3  pursuant to subsection 3 or 4 of NRS 630.352 or any regulation of the 
16-4  board is effective from the date the secretary-treasurer certifies the order 
16-5  until the date the order is modified or reversed by a final judgment of the 
16-6  court. The court shall not stay the order of the board pending a final 
16-7  determination by the court.
16-8    3.  The district court shall give a petition for judicial review of the 
16-9  board's order priority over other civil matters which are not expressly 
16-10  given priority by law.

16-11  Sec. 40.  NRS 630.358 is hereby amended to read as follows:
16-12  630.358  1.  Any person:
16-13  (a) Whose practice of medicine or respiratory care has been limited; or
16-14  (b) Whose license to practice medicine or respiratory care has been:
16-15     (1) Suspended until further order; or
16-16     (2) Revoked,
16-17  by an order of the board, may apply to the board for removal of the 
16-18  limitation or restoration of his license.
16-19  2.  In hearing the application, the board:
16-20  (a) May require the person to submit to a mental or physical 
16-21  examination or an examination testing his competence to practice medicine 
16-22  or respiratory care by physicians or practitioners of respiratory care, as 
16-23  appropriate, or other examinations it designates and submit such other 
16-24  evidence of changed conditions and of fitness as it deems proper;
16-25  (b) Shall determine whether under all the circumstances the time of the 
16-26  application is reasonable; and
16-27  (c) May deny the application or modify or rescind its order as it deems 
16-28  the evidence and the public safety warrants.
16-29  3.  The licensee has the burden of proving by clear and convincing 
16-30  evidence that the requirements for restoration of the license or removal of 
16-31  the limitation have been met.
16-32  4.  The board shall not restore a license unless it is satisfied that the 
16-33  person has complied with all of the terms and conditions set forth in the 
16-34  final order of the board and that the person is capable of practicing 
16-35  medicine or respiratory care in a safe manner.
16-36  5.  To restore a license that has been revoked by the board, the 
16-37  applicant must apply for a license and take an examination as though he 
16-38  had never been licensed under this chapter.

16-39  Sec. 41.  NRS 630.366 is hereby amended to read as follows:
16-40  630.366  1.  If the board receives a copy of a court order issued 
16-41  pursuant to NRS 425.540 that provides for the suspension of all 
16-42  professional, occupational and recreational licenses, certificates and 
16-43  permits issued to a person who is the holder of a license to practice 
16-44  medicine , [or] to practice as a [physician's assistant,] physician assistant 
16-45  or to practice as a practitioner of respiratory care, the board shall deem 
16-46  the license issued to that person to be suspended at the end of the 30th day 
16-47  after the date on which the court order was issued unless the board receives 
16-48  a letter issued to the holder of the license by the district attorney or other 
16-49  public agency pursuant to NRS 425.550 stating that the holder of the 

17-1  license has complied with the subpoena or warrant or has satisfied the 
17-2  arrearage pursuant to NRS 425.560.
17-3    2.  The board shall reinstate a license to practice medicine , [or] to 
17-4  practice as a [physician's] physician assistant or to practice as a 
17-5  practitioner of respiratory care that has been suspended by a district court 
17-6  pursuant to NRS 425.540 if the board receives a letter issued by the district 
17-7  attorney or other public agency pursuant to NRS 425.550 to the person 
17-8  whose license was suspended stating that the person whose license was 
17-9  suspended has complied with the subpoena or warrant or has satisfied the 
17-10  arrearage pursuant to NRS 425.560.

17-11  Sec. 42.  NRS 630.368 is hereby amended to read as follows:
17-12  630.368  [1.]  To institute a disciplinary action against a [physician's 
17-13  assistant,] physician assistant or practitioner of respiratory care, a written 
17-14  complaint, specifying the charges, must be filed with the board by:
17-15  [(a) The board ;
17-16  (b)] 1.  The board or a committee designated by the board to 
17-17  investigate a complaint;
17-18  2.  Any member of the board; or
17-19  [(c)] 3.  Any other person who is aware of any act or circumstance 
17-20  constituting a ground for disciplinary action set forth in the regulations 
17-21  adopted by the board.
17-22  [2.  Before taking any formal action on a complaint filed against a 
17-23  physician's assistant by his supervising physician or by an osteopathic 
17-24  physician supervising the physician's assistant pursuant to NRS 630.274, 
17-25  the board shall provide the physician's assistant with a copy of the 
17-26  complaint.
17-27  3.  If, pursuant to disciplinary procedures set forth in the regulations 
17-28  adopted by the board, the board finds that the charges in the complaint 
17-29  against the physician's assistant are false, the board may provide the 
17-30  physician's assistant with a copy of the complaint, including the name of 
17-31  the person, if any, who filed the complaint.]

17-32  Sec. 43.  NRS 630.390 is hereby amended to read as follows:
17-33  630.390  In seeking injunctive relief against any person for an alleged 
17-34  violation of this chapter by practicing medicine or respiratory care without 
17-35  a license, it is sufficient to allege that he did, upon a certain day, and in a 
17-36  certain county of this state, engage in the practice of medicine or 
17-37  respiratory care without having a license to do so, without alleging any 
17-38  further or more particular facts concerning the same.

17-39  Sec. 44.  NRS 630.400 is hereby amended to read as follows:
17-40  630.400  A person who:
17-41  1.  Presents to the board as his own the diploma, license or credentials 
17-42  of another;
17-43  2.  Gives either false or forged evidence of any kind to the board;
17-44  3.  Practices medicine or respiratory care under a false or assumed 
17-45  name or falsely personates another licensee;
17-46  4.  Except as otherwise provided by specific statute, practices medicine 
17-47  or respiratory care without being licensed under this chapter;

18-1    5.  Holds himself out as a [physician's] physician assistant or [who] 
18-2  uses any other term indicating or implying that he is a [physician's] 
18-3  physician assistant without being licensed by the board; [or]
18-4    6.  Holds himself out as a practitioner of respiratory care or uses any 
18-5  other term indicating or implying that he is a practitioner of respiratory 
18-6  care without being licensed by the board; or
18-7    7.  Uses the title M.D., when not licensed by the board pursuant to this 
18-8  chapter, unless otherwise authorized by a specific statute,
18-9  is guilty of a category D felony and shall be punished as provided in NRS 
18-10  193.130.

18-11  Sec. 45.  NRS 632.472 is hereby amended to read as follows:
18-12  632.472  1.  The following persons shall report in writing to the 
18-13  executive director of the board any conduct of a licensee or holder of a 
18-14  certificate which constitutes a violation of the provisions of this chapter:
18-15  (a) Any physician, dentist, dental hygienist, chiropractor, optometrist, 
18-16  podiatric physician, medical examiner, resident, intern, professional or 
18-17  practical nurse, nursing assistant, [physician's] physician assistant, 
18-18  psychiatrist, psychologist, marriage and family therapist, alcohol or drug 
18-19  abuse counselor, driver of an ambulance, advanced emergency medical 
18-20  technician or other person providing medical services licensed or certified 
18-21  to practice in this state.
18-22  (b) Any personnel of a medical facility or facility for the dependent 
18-23  engaged in the admission, examination, care or treatment of persons or an 
18-24  administrator, manager or other person in charge of a medical facility or 
18-25  facility for the dependent upon notification by a member of the staff of the 
18-26  facility.
18-27  (c) A coroner.
18-28  (d) Any person who maintains or is employed by an agency to provide 
18-29  nursing in the home.
18-30  (e) Any employee of the department of human resources.
18-31  (f) Any employee of a law enforcement agency or a county's office for 
18-32  protective services or an adult or juvenile probation officer.
18-33  (g) Any person who maintains or is employed by a facility or 
18-34  establishment that provides care for older persons.
18-35  (h) Any person who maintains, is employed by or serves as a volunteer 
18-36  for an agency or service which advises persons regarding the abuse, neglect 
18-37  or exploitation of an older person and refers them to persons and agencies 
18-38  where their requests and needs can be met.
18-39  (i) Any social worker.
18-40  2.  Every physician who, as a member of the staff of a medical facility 
18-41  or facility for the dependent, has reason to believe that a nursing assistant 
18-42  has engaged in conduct which constitutes grounds for the denial, 
18-43  suspension or revocation of a certificate shall notify the superintendent, 
18-44  manager or other person in charge of the facility. The superintendent, 
18-45  manager or other person in charge shall make a report as required in 
18-46  subsection 1.
18-47  3.  A report may be filed by any other person.

19-1    4.  Any person who in good faith reports any violation of the provisions 
19-2  of this chapter to the executive director of the board pursuant to this section 
19-3  is immune from civil liability for reporting the violation.

19-4    Sec. 46.  NRS 632.473 is hereby amended to read as follows:
19-5    632.473  1.  A nurse licensed pursuant to the provisions of this 
19-6  chapter, while working at an institution of the department of prisons, may 
19-7  treat patients, including the administration of a dangerous drug, poison or 
19-8  related device, pursuant to orders given by a [physician's] physician 
19-9  assistant if those orders are given pursuant to a protocol approved by the 
19-10  board of medical examiners and the supervising physician. The orders must 
19-11  be cosigned by the supervising physician or another physician within 72 
19-12  hours after treatment.
19-13  2.  A copy of the protocol under which orders are given by a 
19-14  [physician's] physician assistant must be available at the institution for 
19-15  review by the nurse.
19-16  3.  This section does not authorize a [physician's] physician assistant to 
19-17  give orders for the administration of any controlled substance.
19-18  4.  For the purposes of this section:
19-19  (a) ["Physician's] "Physician assistant" means a [physician's] 
19-20  physician assistant licensed by the board of medical examiners pursuant to 
19-21  chapter 630 of NRS who:
19-22     (1) Is employed at an institution of the department of prisons;
19-23     (2) Has been awarded a bachelor's degree from a college or 
19-24  university recognized by the board of medical examiners; and
19-25     (3) Has received at least 40 hours of instruction regarding the 
19-26  prescription of medication as a part of either his basic educational 
19-27  qualifications or a program of continuing education approved by the board 
19-28  of medical examiners.
19-29  (b) "Protocol" means the written directions for the assessment and 
19-30  management of specified medical conditions, including the drugs and 
19-31  devices the [physician's] physician assistant is authorized to order, which 
19-32  the [physician's] physician assistant and the supervision have agreed upon 
19-33  as a basis for their practice.
19-34  (c) "Supervising physician" has the meaning ascribed to it in NRS 
19-35  630.025.

19-36  Sec. 47.  NRS 639.0125 is hereby amended to read as follows:
19-37  639.0125  "Practitioner" means:
19-38  1.  A physician, dentist, veterinarian or podiatric physician who holds a 
19-39  valid license to practice his profession in this state;
19-40  2.  A hospital, pharmacy or other institution licensed, registered or 
19-41  otherwise permitted to distribute, dispense, conduct research with respect 
19-42  to or administer drugs in the course of professional practice or research in 
19-43  this state;
19-44  3.  An advanced practitioner of nursing who has been authorized to 
19-45  prescribe poisons, dangerous drugs and devices; or
19-46  4.  A physician assistant who:
19-47  (a) Holds a license issued by the board of medical examiners; and

20-1    (b) Is authorized by the board to possess, administer, prescribe or 
20-2  dispense controlled substances, poisons, dangerous drugs or devices 
20-3  under the supervision of a physician as required by chapter 630 of NRS.
20-4    5.  An osteopathic physician's assistant who:
20-5    (a) Holds a [license issued by the board of medical examiners or] 
20-6  certificate issued by the state board of osteopathic medicine; and
20-7    (b) Is authorized by the board to possess, administer, prescribe or 
20-8  dispense controlled substances, poisons, dangerous drugs or devices under 
20-9  the supervision of [a physician or] an osteopathic physician as required by 
20-10  chapter [630 or] 633 of NRS.

20-11  Sec. 48.  NRS 639.1373 is hereby amended to read as follows:
20-12  639.1373  1.  A physician assistant or an osteopathic physician's 
20-13  assistant may, if authorized by the board, possess, administer, prescribe or 
20-14  dispense controlled substances, or possess, administer, prescribe or 
20-15  dispense poisons, dangerous drugs or devices in or out of the presence of 
20-16  his supervising physician only to the extent and subject to the limitations 
20-17  specified in the registration certificate issued to the physician assistant or 
20-18  osteopathic physician's [assistant's certificate as issued] assistant, as 
20-19  appropriate, by the board [.] pursuant to this section.
20-20  2.  Each physician assistant and osteopathic physician's assistant who 
20-21  is authorized by his [physician's] physician assistant's license issued by 
20-22  the board of medical examiners or certificate issued by the state board of 
20-23  osteopathic medicine to possess, administer, prescribe or dispense 
20-24  controlled substances, or to possess, administer, prescribe or dispense 
20-25  poisons, dangerous drugs or devices must apply for and obtain a 
20-26  registration certificate from the board, pay a fee to be set by regulations 
20-27  adopted by the board and pass an examination administered by the board 
20-28  on the law relating to pharmacy before he can possess, administer, 
20-29  prescribe or dispense controlled substances, or possess, administer, 
20-30  prescribe or dispense poisons, dangerous drugs or devices.
20-31  3.  The board shall consider each application separately and may, even 
20-32  though the [physician's] physician assistant's license issued by the board 
20-33  of medical examiners or the osteopathic physician's assistant's certificate 
20-34  issued by the state board of osteopathic medicine authorizes the physician 
20-35  assistant or osteopathic physician's assistant , as appropriate, to possess, 
20-36  administer, prescribe or dispense controlled substances, or to possess, 
20-37  administer, prescribe or dispense poisons, dangerous drugs and devices:
20-38  (a) Refuse to issue a registration certificate;
20-39  (b) Issue a registration certificate limiting the authority of the physician 
20-40  assistant or osteopathic physician's [assistant's authority] assistant, as 
20-41  appropriate, to possess, administer, prescribe or dispense controlled 
20-42  substances, or to possess, administer, prescribe or dispense poisons, 
20-43  dangerous drugs or devices, the area in which the physician assistant or 
20-44  osteopathic physician's assistant may possess controlled substances, 
20-45  poisons, dangerous drugs and devices, or the kind and amount of controlled 
20-46  substances, poisons, dangerous drugs and devices; or
20-47  (c) Issue a registration certificate imposing other limitations or 
20-48  restrictions which the board feels are necessary and required to protect the 
20-49  health, safety and welfare of the public.

21-1    4.  If the registration of the physician assistant or osteopathic 
21-2  physician's assistant is suspended or revoked, the physician's controlled 
21-3  substance registration may also be suspended or revoked.
21-4    5.  The board shall adopt regulations controlling the maximum amount 
21-5  to be administered, possessed and dispensed, and the storage, security, 
21-6  recordkeeping and transportation of controlled substances and the 
21-7  maximum amount to be administered, possessed, prescribed and dispensed 
21-8  and the storage, security, recordkeeping and transportation of poisons, 
21-9  dangerous drugs and devices by physician assistants and osteopathic 
21-10  physicians' assistants. In the adoption of those regulations, the board shall 
21-11  consider, but is not limited to, the following:
21-12  (a) The area in which the physician assistant or osteopathic physician's 
21-13  assistant is to operate;
21-14  (b) The population of that area;
21-15  (c) The experience and training of the physician assistant or 
21-16  osteopathic physician's assistant;
21-17  (d) The distance to the nearest hospital and physician; and
21-18  (e) The effect on the health, safety and welfare of the public.
21-19  6.  For the purposes of this section, the term ["physician's assistant" 
21-20  includes an osteopathic physician's assistant and the term] "supervising 
21-21  physician" includes an employing osteopathic physician as defined in 
21-22  chapter 633 of NRS.

21-23  Sec. 49.  NRS 652.210 is hereby amended to read as follows:
21-24  652.210  No person other than a licensed physician, a licensed 
21-25  optometrist, a licensed practical nurse, a registered nurse, a licensed [or] 
21-26  physician assistant, a certified osteopathic physician's assistant, a certified 
21-27  intermediate emergency medical technician, a certified advanced 
21-28  emergency medical technician or a licensed dentist may manipulate a 
21-29  person for the collection of specimens, except that technical personnel of a 
21-30  laboratory may collect blood, remove stomach contents, perform certain 
21-31  diagnostic skin tests or field blood tests or collect material for smears and 
21-32  cultures.

21-33  Sec. 50.  NRS 200.5093 is hereby amended to read as follows:
21-34  200.5093  1.  Any person who is described in subsection 4 and who, 
21-35  in his professional or occupational capacity, knows or has reasonable cause 
21-36  to believe that an older person has been abused, neglected, exploited or 
21-37  isolated shall:
21-38  (a) Except as otherwise provided in subsection 2, report the abuse, 
21-39  neglect, exploitation or isolation of the older person to:
21-40     (1) The local office of the aging services division of the department 
21-41  of human resources;
21-42     (2) A police department or sheriff's office; 
21-43     (3) The county's office for protective services, if one exists in the 
21-44  county where the suspected action occurred; or
21-45     (4) A toll-free telephone service designated by the aging services 
21-46  division of the department of human resources; and
21-47  (b) Make such a report as soon as reasonably practicable but not later 
21-48  than 24 hours after the person knows or has reasonable cause to believe 
21-49  that the older person has been abused, neglected, exploited or isolated.

22-1    2.  If a person who is required to make a report pursuant to subsection 1 
22-2  knows or has reasonable cause to believe that the abuse, neglect, 
22-3  exploitation or isolation of the older person involves an act or omission of 
22-4  the aging services division, another division of the department of human 
22-5  resources or a law enforcement agency, the person shall make the report to 
22-6  an agency other than the one alleged to have committed the act or 
22-7  omission.
22-8    3.  Each agency, after reducing a report to writing, shall forward a copy 
22-9  of the report to the aging services division of the department of human 
22-10  resources.
22-11  4.  A report must be made pursuant to subsection 1 by the following 
22-12  persons:
22-13  (a) Every physician, dentist, dental hygienist, chiropractor, optometrist, 
22-14  podiatric physician, medical examiner, resident, intern, professional or 
22-15  practical nurse, [physician's] physician assistant, psychiatrist, 
22-16  psychologist, marriage and family therapist, alcohol or drug abuse 
22-17  counselor, driver of an ambulance, advanced emergency medical 
22-18  technician or other person providing medical services licensed or certified 
22-19  to practice in this state, who examines, attends or treats an older person 
22-20  who appears to have been abused, neglected, exploited or isolated.
22-21  (b) Any personnel of a hospital or similar institution engaged in the 
22-22  admission, examination, care or treatment of persons or an administrator, 
22-23  manager or other person in charge of a hospital or similar institution upon 
22-24  notification of the suspected abuse, neglect, exploitation or isolation of an 
22-25  older person by a member of the staff of the hospital.
22-26  (c) A coroner.
22-27  (d) Every clergyman, practitioner of Christian Science or religious 
22-28  healer, unless he acquired the knowledge of abuse, neglect, exploitation or 
22-29  isolation of the older person from the offender during a confession.
22-30  (e) Every person who maintains or is employed by an agency to provide 
22-31  nursing in the home.
22-32  (f) Every attorney, unless he has acquired the knowledge of abuse, 
22-33  neglect, exploitation or isolation of the older person from a client who has 
22-34  been or may be accused of such abuse, neglect, exploitation or isolation.
22-35  (g) Any employee of the department of human resources.
22-36  (h) Any employee of a law enforcement agency or a county's office for 
22-37  protective services or an adult or juvenile probation officer.
22-38  (i) Any person who maintains or is employed by a facility or 
22-39  establishment that provides care for older persons.
22-40  (j) Any person who maintains, is employed by or serves as a volunteer 
22-41  for an agency or service which advises persons regarding the abuse, 
22-42  neglect, exploitation or isolation of an older person and refers them to 
22-43  persons and agencies where their requests and needs can be met.
22-44  (k) Every social worker.
22-45  (l) Any person who owns or is employed by a funeral home or 
22-46  mortuary.
22-47  5.  A report may be made by any other person.
22-48  6.  If a person who is required to make a report pursuant to subsection 1 
22-49  knows or has reasonable cause to believe that an older person has died as a 

23-1  result of abuse, neglect or isolation, the person shall, as soon as reasonably 
23-2  practicable, report this belief to the appropriate medical examiner or 
23-3  coroner, who shall investigate the cause of death of the older person and 
23-4  submit to the appropriate local law enforcement agencies, the appropriate 
23-5  prosecuting attorney and the aging services division of the department of 
23-6  human resources his written findings. The written findings must include 
23-7  the information required pursuant to the provisions of NRS 200.5094, 
23-8  when possible.
23-9    7.  A division, office or department which receives a report pursuant to 
23-10  this section shall cause the investigation of the report to commence within 
23-11  3 working days. A copy of the final report of the investigation conducted 
23-12  by a division, office or department, other than the aging services division 
23-13  of the department of human resources, must be forwarded to the aging 
23-14  services division within 90 days after the completion of the report.
23-15  8.  If the investigation of a report results in the belief that an older 
23-16  person is abused, neglected, exploited or isolated, the aging services 
23-17  division of the department of human resources or the county's office for 
23-18  protective services may provide protective services to the older person if he 
23-19  is able and willing to accept them.
23-20  9.  A person who knowingly and willfully violates any of the 
23-21  provisions of this section is guilty of a misdemeanor.

23-22  Sec. 51.  NRS 223.550 is hereby amended to read as follows:
23-23  223.550  1.  The office for consumer health assistance is hereby 
23-24  established in the office of the governor. The governor shall appoint the 
23-25  director. The director must:
23-26  (a) Be:
23-27     (1) A physician, as that term is defined in NRS 0.040;
23-28     (2) A registered nurse, as that term is defined in NRS 632.019;
23-29     (3) An advanced practitioner of nursing, as that term is defined in 
23-30  NRS 453.023; or
23-31     (4) A [physician's] physician assistant, as that term is defined in NRS 
23-32  630.015; and
23-33  (b) Have expertise and experience in the field of advocacy.
23-34  2.  The cost of carrying out the provisions of NRS 223.500 to 223.580, 
23-35  inclusive, must be paid as follows:
23-36  (a) That portion of the cost related to providing assistance to consumers 
23-37  and injured employees concerning workers' compensation must be paid 
23-38  from the assessments levied pursuant to NRS 232.680.
23-39  (b) The remaining cost must be provided by direct legislative 
23-40  appropriation from the state general fund and be paid out on claims as 
23-41  other claims against the state are paid.

23-42  Sec. 52.  NRS 244.1605 is hereby amended to read as follows:
23-43  244.1605  The boards of county commissioners may:
23-44  1.  Establish, equip and maintain limited medical facilities in the 
23-45  outlying areas of their respective counties to provide outpatient care and 
23-46  emergency treatment to the residents of and those falling sick or being 
23-47  injured or maimed in those areas.
23-48  2.  Provide a full-time or part-time staff for the facilities which may 
23-49  include a physician, a licensed [physician's] physician assistant, a 

24-1  registered nurse or a licensed practical nurse, a certified emergency 
24-2  medical technician and such other personnel as the board deems necessary 
24-3  or appropriate to ensure adequate staffing commensurate with the needs of 
24-4  the area in which the facility is located.
24-5    3.  Fix the charges for the medical and nursing care and medicine 
24-6  furnished by the facility to those who are able to pay for them, and to 
24-7  provide that care and medicine free of charge to those persons who qualify 
24-8  as medical indigents under the county's criteria of eligibility for medical 
24-9  care.
24-10  4.  Purchase, equip and maintain, either in connection with a limited 
24-11  medical facility as authorized in this section or independent therefrom, 
24-12  ambulances and ambulance services for the benefit of the residents of and 
24-13  those falling sick or being injured or maimed in the outlying areas.

24-14  Sec. 53.  NRS 244.382 is hereby amended to read as follows:
24-15  244.382  The legislature finds that:
24-16  1.  Many of the less populous counties of the state have experienced 
24-17  shortages of physicians, surgeons, anesthetists, dentists, other medical 
24-18  professionals and [physicians'] physician assistants.
24-19  2.  Some of the more populous counties of the state have also 
24-20  experienced shortages of physicians, surgeons, anesthetists, dentists, other 
24-21  medical professionals and [physicians'] physician assistants in their rural 
24-22  communities.
24-23  3.  By granting county scholarships to students in such medical 
24-24  professions who will agree to return to the less populous counties or the 
24-25  rural communities of the more populous counties for residence and 
24-26  practice, these counties can alleviate the shortages to a degree and thereby 
24-27  provide their people with needed health services.

24-28  Sec. 54.  NRS 244.3821 is hereby amended to read as follows:
24-29  244.3821  1.  In addition to the powers elsewhere conferred upon all 
24-30  counties, except as otherwise provided in subsection 2, any county may 
24-31  establish a medical scholarship program to induce students in the medical 
24-32  professions to return to the county for practice. 
24-33  2.  Any county whose population is 100,000 or more may only 
24-34  establish a medical scholarship program to induce students in the medical 
24-35  professions to return to the less populous rural communities of the county 
24-36  for practice. 
24-37  3.  Students in the medical professions for the purposes of NRS 
24-38  244.382 to 244.3823, inclusive, include persons studying to be 
24-39  [physicians'] physician assistants.
24-40  4.  The board of county commissioners of a county that has established 
24-41  a medical scholarship program may appropriate money from the general 
24-42  fund of the county for medical scholarship funds and may accept private 
24-43  contributions to augment the scholarship funds.

24-44  Sec. 55.  NRS 397.0605 is hereby amended to read as follows:
24-45  397.0605  The provisions of NRS 397.0615, 397.0645 and 397.0653 to 
24-46  the contrary notwithstanding, the Western Interstate Commission for 
24-47  Higher Education may adopt regulations which require as a condition of 
24-48  placement of a student in an educational program for [physicians'] 
24-49  physician assistants and receipt of the related financial support that the 

25-1  student submit to the director of the Western Interstate Commission for 
25-2  Higher Education:
25-3    1.  A written statement from a licensed provider of health care who 
25-4  practices his profession in a rural area of this state that he agrees to employ 
25-5  the student for the term necessary to fulfill the requirements of NRS 
25-6  397.0645 upon the completion of the student's education, examination and 
25-7  licensure.
25-8    2.  A written statement from the student that in lieu of repayment of all 
25-9  state contributions for the stipend he received he will practice his 
25-10  profession in a rural area of this state in accordance with the schedule set 
25-11  forth in subsection 1 of NRS 397.0645.

25-12  Sec. 56.  NRS 397.0617 is hereby amended to read as follows:
25-13  397.0617  1.  The provisions of this section apply only to support fees 
25-14  received by a student on or after July 1, 1997.
25-15  2.  The three commissioners from the State of Nevada, acting jointly, 
25-16  may require a student who is certified to study to practice in a profession 
25-17  which could benefit a medically underserved area of this state, as that term 
25-18  is defined by the officer of rural health of the University of Nevada School 
25-19  of Medicine, to practice in such an area or to practice in an area designated 
25-20  by the Secretary of Health and Human Services:
25-21  (a) Pursuant to 42 U.S.C.  254c, as containing a medically underserved 
25-22  population; or
25-23  (b) Pursuant to 42 U.S.C.  254e, as a health professional shortage area,
25-24  as a condition to receiving a support fee.
25-25  3.  If a person agrees to practice in a medically underserved area of this 
25-26  state pursuant to subsection 2 for at least 2 years, the three commissioners 
25-27  from the State of Nevada, acting jointly, may forgive the portion of the 
25-28  support fee designated as the loan of the person.
25-29  4.  If a person returns to this state but does not practice in a medically 
25-30  underserved area of this state pursuant to subsection 2 for at least 2 years, 
25-31  the three commissioners from the State of Nevada, acting jointly, shall 
25-32  assess a default charge in an amount not less than three times the portion of 
25-33  the support fee designated as the loan of the person, plus interest.
25-34  5.  As used in this section, a "profession which could benefit a 
25-35  medically underserved area of this state" includes, without limitation, 
25-36  dentistry, physical therapy, pharmacy and practicing as a [physician's] 
25-37  physician assistant.

25-38  Sec. 57.  NRS 432B.220 is hereby amended to read as follows:
25-39  432B.220  1.  Any person who is described in subsection 3 and who, 
25-40  in his professional or occupational capacity, knows or has reasonable cause 
25-41  to believe that a child has been abused or neglected shall:
25-42  (a) Except as otherwise provided in subsection 2, report the abuse or 
25-43  neglect of the child to an agency which provides protective services or to a 
25-44  law enforcement agency; and
25-45  (b) Make such a report as soon as reasonably practicable but not later 
25-46  than 24 hours after the person knows or has reasonable cause to believe 
25-47  that the child has been abused or neglected.

26-1    2.  If a person who is required to make a report pursuant to subsection 1 
26-2  knows or has reasonable cause to believe that the abuse or neglect of the 
26-3  child involves an act or omission of:
26-4    (a) A person directly responsible or serving as a volunteer for or an 
26-5  employee of a public or private home, institution or facility where the child 
26-6  is receiving child care outside of his home for a portion of the day, the 
26-7  person shall make the report to a law enforcement agency.
26-8    (b) An agency which provides protective services or a law enforcement 
26-9  agency, the person shall make the report to an agency other than the one 
26-10  alleged to have committed the act or omission, and the investigation of the 
26-11  abuse or neglect of the child must be made by an agency other than the one 
26-12  alleged to have committed the act or omission.
26-13  3.  A report must be made pursuant to subsection 1 by the following 
26-14  persons:
26-15  (a) A physician, dentist, dental hygienist, chiropractor, optometrist, 
26-16  podiatric physician, medical examiner, resident, intern, professional or 
26-17  practical nurse, [physician's] physician assistant, psychiatrist, 
26-18  psychologist, marriage and family therapist, alcohol or drug abuse 
26-19  counselor, advanced emergency medical technician or other person 
26-20  providing medical services licensed or certified in this state;
26-21  (b) Any personnel of a hospital or similar institution engaged in the 
26-22  admission, examination, care or treatment of persons or an administrator, 
26-23  manager or other person in charge of a hospital or similar institution upon 
26-24  notification of suspected abuse or neglect of a child by a member of the 
26-25  staff of the hospital;
26-26  (c) A coroner;
26-27  (d) A clergyman, practitioner of Christian Science or religious healer, 
26-28  unless he has acquired the knowledge of the abuse or neglect from the 
26-29  offender during a confession;
26-30  (e) A social worker and an administrator, teacher, librarian or counselor 
26-31  of a school;
26-32  (f) Any person who maintains or is employed by a facility or 
26-33  establishment that provides care for children, children's camp or other 
26-34  public or private facility, institution or agency furnishing care to a child;
26-35  (g) Any person licensed to conduct a foster home;
26-36  (h) Any officer or employee of a law enforcement agency or an adult or 
26-37  juvenile probation officer;
26-38  (i) An attorney, unless he has acquired the knowledge of the abuse or 
26-39  neglect from a client who is or may be accused of the abuse or neglect; and
26-40  (j) Any person who maintains, is employed by or serves as a volunteer 
26-41  for an agency or service which advises persons regarding abuse or neglect 
26-42  of a child and refers them to persons and agencies where their requests and 
26-43  needs can be met.
26-44  4.  A report may be made by any other person.
26-45  5.  If a person who is required to make a report pursuant to subsection 1 
26-46  knows or has reasonable cause to believe that a child has died as a result of 
26-47  abuse or neglect, the person shall, as soon as reasonably practicable, report 
26-48  this belief to the appropriate medical examiner or coroner, who shall 
26-49  investigate the report and submit to an agency which provides protective 

27-1  services his written findings. The written findings must include, if 
27-2  obtainable, the information required pursuant to the provisions of 
27-3  subsection 2 of NRS 432B.230.

27-4    Sec. 58.  NRS 441A.110 is hereby amended to read as follows:
27-5  441A.110  "Provider of health care" means a physician, nurse, 
27-6  [physician's] physician assistant or veterinarian licensed in accordance 
27-7  with state law.

27-8    Sec. 59.  NRS 442.003 is hereby amended to read as follows:
27-9    442.003  As used in this chapter, unless the context requires otherwise:
27-10  1.  "Advisory board" means the advisory board on maternal and child 
27-11  health.
27-12  2.  "Department" means the department of human resources.
27-13  3.  "Director" means the director of the department of human resources.
27-14  4.  "Fetal alcohol syndrome" includes fetal alcohol effects.
27-15  5.  "Health division" means the health division of the department of 
27-16  human resources.
27-17  6.  "Obstetric center" has the meaning ascribed to it in NRS 449.0155.
27-18  7.  "Provider of health care or other services" means:
27-19  (a) A person who has been certified as a counselor or an administrator 
27-20  of an alcohol and drug abuse program pursuant to chapter 458 of NRS;
27-21  (b) A physician or a [physician's] physician assistant who is licensed 
27-22  pursuant to chapter 630 of NRS and who practices in the area of obstetrics 
27-23  and gynecology, family practice, internal medicine, pediatrics or 
27-24  psychiatry;
27-25  (c) A licensed nurse;
27-26  (d) A licensed psychologist;
27-27  (e) A licensed marriage and family therapist;
27-28  (f) A licensed social worker; or
27-29  (g) A holder of a certificate of registration as a pharmacist.

27-30  Sec. 60.  NRS 442.119 is hereby amended to read as follows:
27-31  442.119  As used in NRS 442.119 to 442.1198, inclusive, unless the 
27-32  context otherwise requires:
27-33  1.  "Health officer" includes a local health officer, a city health officer, 
27-34  a county health officer and a district health officer.
27-35  2.  "Medicaid" has the meaning ascribed to it in NRS 439B.120.
27-36  3.  "Medicare" has the meaning ascribed to it in NRS 439B.130.
27-37  4.  "Provider of prenatal care" is limited to:
27-38  (a) A physician who is licensed in this state and certified in obstetrics 
27-39  and gynecology, family practice, general practice or general surgery.
27-40  (b) A certified nurse midwife who is licensed by the state board of 
27-41  nursing.
27-42  (c) An advanced practitioner of nursing who has specialized skills and 
27-43  training in obstetrics or family nursing.
27-44  (d) A [physicians'] physician assistant who has specialized skills and 
27-45  training in obstetrics or family practice.

27-46  Sec. 61.  NRS 449.0175 is hereby amended to read as follows:
27-47  449.0175  "Rural clinic" means a facility located in an area that is not 
27-48  designated as an urban area by the Bureau of the Census, where medical 

28-1  services are provided by a [physician's] physician assistant or an advanced 
28-2  practitioner of nursing under the supervision of a licensed physician.

28-3    Sec. 62.  NRS 450B.160 is hereby amended to read as follows:
28-4    450B.160  1.  The health authority may issue licenses to attendants 
28-5  and to firemen employed by or serving as volunteers with a fire-fighting 
28-6  agency.
28-7    2.  Each license must be evidenced by a card issued to the holder of the 
28-8  license, is valid for a period not to exceed 2 years and is renewable.
28-9    3.  An applicant for a license must file with the health authority:
28-10  (a) A current, valid certificate evidencing his successful completion of a 
28-11  program or course for training in emergency medical technology, if he is 
28-12  applying for a license as an attendant, or, if a volunteer attendant, at a level 
28-13  of skill determined by the board.
28-14  (b) A current valid certificate evidencing his successful completion of a 
28-15  program for training as an intermediate emergency medical technician or 
28-16  advanced emergency medical technician if he is applying for a license as a 
28-17  fireman with a fire-fighting agency.
28-18  (c) A signed statement showing:
28-19     (1) His name and address;
28-20     (2) His employer's name and address; and
28-21     (3) A description of his duties.
28-22  (d) Such other certificates for training and such other items as the board 
28-23  may specify.
28-24  4.  The board shall adopt such regulations as it determines are 
28-25  necessary for the issuance, suspension, revocation and renewal of licenses.
28-26  5.  Each operator of an ambulance or air ambulance and each fire-
28-27  fighting agency shall annually file with the health authority a complete list 
28-28  of the licensed persons in its service.
28-29  6.  Licensed physicians, registered nurses and licensed [physicians'] 
28-30  physician assistants may serve as attendants without being licensed under 
28-31  the provisions of this section. A registered nurse who performs advanced 
28-32  emergency care in an ambulance or air ambulance must perform the care in 
28-33  accordance with the regulations of the state board of nursing. A licensed 
28-34  [physicians'] physician assistant who performs advanced emergency care 
28-35  in an ambulance or air ambulance must perform the care in accordance 
28-36  with the regulations of the [state] board of medical examiners.
28-37  7.  Each licensed physician, registered nurse and licensed [physicians'] 
28-38  physician assistant who serves as an attendant must have current 
28-39  certification of completion of training in:
28-40  (a) Advanced life-support procedures for patients who require cardiac 
28-41  care;
28-42  (b) Life-support procedures for pediatric patients who require cardiac 
28-43  care; or
28-44  (c) Life-support procedures for patients with trauma that are 
28-45  administered before the arrival of those patients at a hospital.
28-46  The certification must be issued by the board of medical examiners for a 
28-47  physician or licensed [physician's] physician assistant or by the state board 
28-48  of nursing for a registered nurse.

29-1    8.  The board of medical examiners and the state board of nursing shall 
29-2  issue a certificate pursuant to subsection 7 if the licensed physician, 
29-3  licensed [physician's] physician assistant or registered nurse attends:
29-4    (a) A course offered by a national organization which is nationally 
29-5  recognized for issuing such certification;
29-6    (b) Training conducted by the operator of an ambulance or air 
29-7  ambulance; or
29-8    (c) Any other course or training,
29-9  approved by the board of medical examiners or the state board of nursing, 
29-10  whichever is issuing the certification. The board of medical examiners and 
29-11  the state board of nursing may require certification of training in all three 
29-12  areas set forth in subsection 7 for a licensed physician, licensed 
29-13  [physician's] physician assistant or registered nurse who primarily serves 
29-14  as an attendant in a county whose population is 400,000 or more.

29-15  Sec. 63.  NRS 453.038 is hereby amended to read as follows:
29-16  453.038  "Chart order" means an order entered on the chart of a 
29-17  patient:
29-18  1.  In a hospital, facility for intermediate care or facility for skilled 
29-19  nursing which is licensed as such by the health division of the department; 
29-20  or
29-21  2.  Under emergency treatment in a hospital by a physician, dentist or 
29-22  podiatric physician, or on the written or oral order of a physician, 
29-23  [physician's] physician assistant, dentist or podiatric physician authorizing 
29-24  the administration of a drug to the patient.

29-25  Sec. 64.  NRS 453.091 is hereby amended to read as follows:
29-26  453.091  1.  "Manufacture" means the production, preparation, 
29-27  propagation, compounding, conversion or processing of a substance, either 
29-28  directly or indirectly by extraction from substances of natural origin, or 
29-29  independently by means of chemical synthesis, or by a combination of 
29-30  extraction and chemical synthesis, and includes any packaging or 
29-31  repackaging of the substance or labeling or relabeling of its container.
29-32  2.  "Manufacture" does not include the preparation or compounding of 
29-33  a substance by a person for his own use or the preparation, compounding, 
29-34  packaging or labeling of a substance by a physician, [physician's] 
29-35  physician assistant, dentist, podiatric physician or veterinarian:
29-36  (a) As an incident to his administering or dispensing of a substance in 
29-37  the course of his professional practice; or
29-38  (b) By his authorized agent under his supervision, for the purpose of, or 
29-39  as an incident to, research, teaching or chemical analysis and not for sale.

29-40  Sec. 65.  NRS 453.126 is hereby amended to read as follows:
29-41  453.126  "Practitioner" means:
29-42  1.  A physician, dentist, veterinarian or podiatric physician who holds a 
29-43  license to practice his profession in this state and is registered pursuant to 
29-44  this chapter.
29-45  2.  An advanced practitioner of nursing who holds a certificate from the 
29-46  state board of nursing and a certificate from the state board of pharmacy 
29-47  authorizing him to dispense controlled substances.
29-48  3.  A scientific investigator or a pharmacy, hospital or other institution 
29-49  licensed, registered or otherwise authorized in this state to distribute, 

30-1  dispense, conduct research with respect to, to administer, or use in teaching 
30-2  or chemical analysis, a controlled substance in the course of professional 
30-3  practice or research.
30-4    4.  A euthanasia technician who is licensed by the Nevada state board 
30-5  of veterinary medical examiners and registered pursuant to this chapter, 
30-6  while he possesses or administers sodium pentobarbital pursuant to his 
30-7  license and registration.
30-8    5.  A [physician's] physician assistant who:
30-9    (a) Holds a license from the board of medical examiners ; [or a 
30-10  certificate from the state board of osteopathic medicine;] and
30-11  (b) Is authorized by the board to possess, administer, prescribe or 
30-12  dispense controlled substances under the supervision of a physician [or 
30-13  osteopathic physician] as required by chapter 630 [or 633] of NRS.
30-14  6.  An osteopathic physician's assistant who:
30-15  (a) Holds a certificate from the state board of osteopathic medicine; 
30-16  and
30-17  (b) Is authorized by the board to possess, administer, prescribe or 
30-18  dispense controlled substances under the supervision of an osteopathic 
30-19  physician as required by chapter 633 of NRS.
30-20  7.  An optometrist who is certified by the Nevada state board of 
30-21  optometry to prescribe and administer therapeutic pharmaceutical agents 
30-22  pursuant to NRS 636.288, when he prescribes or administers therapeutic 
30-23  pharmaceutical agents within the scope of his certification.

30-24  Sec. 66.  NRS 453.128 is hereby amended to read as follows:
30-25  453.128  1.  "Prescription" means:
30-26  (a) An order given individually for the person for whom prescribed, 
30-27  directly from a physician, osteopathic physician's assistant, physician 
30-28  assistant, dentist, podiatric physician, optometrist or veterinarian, or his 
30-29  agent, to a pharmacist or indirectly by means of an order signed by the 
30-30  practitioner or an electronic transmission from the practitioner to a 
30-31  pharmacist; or
30-32  (b) A chart order written for an inpatient specifying drugs which he is to 
30-33  take home upon his discharge.
30-34  2.  The term does not include a chart order written for an inpatient for 
30-35  use while he is an inpatient.

30-36  Sec. 67.  NRS 453.226 is hereby amended to read as follows:
30-37  453.226  1.  Every practitioner or other person who dispenses any 
30-38  controlled substance within this state or who proposes to engage in the 
30-39  dispensing of any controlled substance within this state shall obtain 
30-40  biennially a registration issued by the board in accordance with its 
30-41  regulations.
30-42  2.  A person registered by the board in accordance with the provisions 
30-43  of NRS 453.011 to 453.552, inclusive, to dispense or conduct research with 
30-44  controlled substances may possess, dispense or conduct research with those 
30-45  substances to the extent authorized by the registration and in conformity 
30-46  with the other provisions of those sections.
30-47  3.  The following persons are not required to register and may lawfully 
30-48  possess and distribute controlled substances pursuant to the provisions of 
30-49  NRS 453.011 to 453.552, inclusive:

31-1    (a) An agent or employee of a registered dispenser of a controlled 
31-2  substance if he is acting in the usual course of his business or employment;
31-3    (b) A common or contract carrier or warehouseman, or an employee 
31-4  thereof, whose possession of any controlled substance is in the usual course 
31-5  of business or employment;
31-6    (c) An ultimate user or a person in possession of any controlled 
31-7  substance pursuant to a lawful order of a physician, osteopathic 
31-8  physician's assistant, physician assistant, dentist, podiatric physician or 
31-9  veterinarian or in lawful possession of a schedule V substance; or
31-10  (d) A physician who:
31-11     (1) Holds a locum tenens license issued by the board of medical 
31-12  examiners or a temporary license issued by the state board of osteopathic 
31-13  medicine; and
31-14     (2) Is registered with the Drug Enforcement Administration at a 
31-15  location outside this state.
31-16  4.  The board may waive the requirement for registration of certain 
31-17  dispensers if it finds it consistent with the public health and safety.
31-18  5.  A separate registration is required at each principal place of business 
31-19  or professional practice where the applicant dispenses controlled 
31-20  substances.
31-21  6.  The board may inspect the establishment of a registrant or applicant 
31-22  for registration in accordance with the board's regulations.

31-23  Sec. 68.  NRS 453.336 is hereby amended to read as follows:
31-24  453.336  1.  A person shall not knowingly or intentionally possess a 
31-25  controlled substance, unless the substance was obtained directly from, or 
31-26  pursuant to, a prescription or order of a physician, osteopathic physician's 
31-27  assistant, physician assistant, dentist, podiatric physician, optometrist or 
31-28  veterinarian while acting in the course of his professional practice, or 
31-29  except as otherwise authorized by the provisions of NRS 453.011 to 
31-30  453.552, inclusive.
31-31  2.  Except as otherwise provided in subsections 3, 4 and 5 and in NRS 
31-32  453.3363, and unless a greater penalty is provided in NRS 212.160, 
31-33  453.3385, 453.339 or 453.3395, a person who violates this section shall be 
31-34  punished:
31-35  (a) For the first or second offense, if the controlled substance is listed in 
31-36  schedule I, II, III or IV, for a category E felony as provided in NRS 
31-37  193.130.
31-38  (b) For a third or subsequent offense, if the controlled substance is listed 
31-39  in schedule I, II, III or IV, or if the offender has previously been convicted 
31-40  two or more times in the aggregate of any violation of the law of the 
31-41  United States or of any state, territory or district relating to a controlled 
31-42  substance, for a category D felony as provided in NRS 193.130, and may 
31-43  be further punished by a fine of not more than $20,000.
31-44  (c) For the first offense, if the controlled substance is listed in schedule 
31-45  V, for a category E felony as provided in NRS 193.130.
31-46  (d) For a second or subsequent offense, if the controlled substance is 
31-47  listed in schedule V, for a category D felony as provided in NRS 193.130.
31-48  3.  Unless a greater penalty is provided in NRS 212.160, 453.337 or 
31-49  453.3385, a person who is convicted of the possession of flunitrazepam or 

32-1  gamma-hydroxybutyrate, or any substance for which flunitrazepam or 
32-2  gamma-hydroxybutyrate is an immediate precursor, is guilty of a category 
32-3  B felony and shall be punished by imprisonment in the state prison for a 
32-4  minimum term of not less than 1 year and a maximum term of not more 
32-5  than 6 years.
32-6    4.  Unless a greater penalty is provided in NRS 212.160, a person who 
32-7  is less than 21 years of age and is convicted of the possession of less than 1 
32-8  ounce of marijuana:
32-9    (a) For the first and second offense, is guilty of a category E felony and 
32-10  shall be punished as provided in NRS 193.130.
32-11  (b) For a third or subsequent offense, is guilty of a category D felony 
32-12  and shall be punished as provided in NRS 193.130, and may be further 
32-13  punished by a fine of not more than $20,000.
32-14  5.  Before sentencing under the provisions of subsection 4 for a first 
32-15  offense, the court shall require the parole and probation officer to submit a 
32-16  presentencing report on the person convicted in accordance with the 
32-17  provisions of NRS 176A.200. After the report is received but before 
32-18  sentence is pronounced the court shall:
32-19  (a) Interview the person convicted and make a determination as to the 
32-20  possibility of his rehabilitation; and
32-21  (b) Conduct a hearing at which evidence may be presented as to the 
32-22  possibility of rehabilitation and any other relevant information.
32-23  6.  As used in this section, "controlled substance" includes 
32-24  flunitrazepam, gamma-hydroxybutyrate and each substance for which 
32-25  flunitrazepam or gamma-hydroxybutyrate is an immediate precursor.

32-26  Sec. 69.  NRS 453.371 is hereby amended to read as follows:
32-27  453.371  As used in NRS 453.371 to 453.552, inclusive:
32-28  1.  "Medical intern" means a medical graduate acting as an assistant in 
32-29  a hospital for the purpose of clinical training.
32-30  2.  "Physician," ["physician's] "physician assistant," "dentist," 
32-31  "podiatric physician," "veterinarian," "pharmacist" and "euthanasia 
32-32  technician" mean persons authorized by a valid license to practice their 
32-33  respective professions in this state who are registered with the board.

32-34  Sec. 70.  NRS 453.375 is hereby amended to read as follows:
32-35  453.375  A controlled substance may be possessed and administered by 
32-36  the following persons:
32-37  1.  A practitioner.
32-38  2.  A registered nurse licensed to practice professional nursing or 
32-39  licensed practical nurse, at the direction of a physician, [physician's] 
32-40  physician assistant, dentist, podiatric physician or advanced practitioner of 
32-41  nursing, or pursuant to a chart order, for administration to a patient at 
32-42  another location.
32-43  3.  An advanced emergency medical technician:
32-44  (a) As authorized by regulation of:
32-45     (1) The state board of health in a county whose population is less 
32-46  than 100,000; or
32-47     (2) A county or district board of health in a county whose population 
32-48  is 100,000 or more; and
32-49  (b) In accordance with any applicable regulations of:

33-1      (1) The state board of health in a county whose population is less 
33-2  than 100,000;
33-3      (2) A county board of health in a county whose population is 100,000 
33-4  or more; or
33-5      (3) A district board of health created pursuant to NRS 439.370 in any 
33-6  county.
33-7    4.  A respiratory therapist, at the direction of a physician or 
33-8  [physician's] physician assistant.
33-9    5.  A medical student, student in training to become a [physician's] 
33-10  physician assistant or student nurse in the course of his studies at an 
33-11  approved college of medicine or school of professional or practical 
33-12  nursing, at the direction of a physician or [physician's] physician assistant 
33-13  and:
33-14  (a) In the presence of a physician, [physician's] physician assistant or a 
33-15  registered nurse; or
33-16  (b) Under the supervision of a physician, [physician's] physician 
33-17  assistant or a registered nurse if the student is authorized by the college or 
33-18  school to administer the substance outside the presence of a physician, 
33-19  [physician's] physician assistant or nurse.
33-20  A medical student or student nurse may administer a controlled substance 
33-21  in the presence or under the supervision of a registered nurse alone only if 
33-22  the circumstances are such that the registered nurse would be authorized to 
33-23  administer it personally.
33-24  6.  An ultimate user or any person whom the ultimate user designates 
33-25  pursuant to a written agreement.
33-26  7.  Any person designated by the head of a correctional institution.
33-27  8.  A veterinary technician at the direction of his supervising 
33-28  veterinarian.
33-29  9.  In accordance with applicable regulations of the state board of 
33-30  health, an employee of a residential facility for groups, as defined in NRS 
33-31  449.017, pursuant to a written agreement entered into by the ultimate user.
33-32  10.  In accordance with applicable regulations of the state board of 
33-33  pharmacy, an animal control officer, a wildlife biologist or an employee 
33-34  designated by a federal, state or local governmental agency whose duties 
33-35  include the control of domestic, wild and predatory animals.

33-36  Sec. 71.  NRS 453.381 is hereby amended to read as follows:
33-37  453.381  1.  In addition to the limitations imposed by NRS 453.256, a 
33-38  physician, [physician's] physician assistant, dentist or podiatric physician 
33-39  may prescribe or administer controlled substances only for a legitimate 
33-40  medical purpose and in the usual course of his professional practice, and he 
33-41  shall not prescribe, administer or dispense a controlled substance listed in 
33-42  schedule II for himself, his spouse or his children except in cases of 
33-43  emergency.
33-44  2.  A veterinarian, in the course of his professional practice only, and 
33-45  not for use by a human being, may prescribe, possess and administer 
33-46  controlled substances, and he may cause them to be administered by a 
33-47  veterinary technician under his direction and supervision.
33-48  3.  A euthanasia technician, within the scope of his license, and not for 
33-49  use by a human being, may possess and administer sodium pentobarbital.

34-1    4.  A pharmacist shall not fill an order which purports to be a 
34-2  prescription if he has reason to believe that it was not issued in the usual 
34-3  course of the professional practice of a physician, [physician's] physician 
34-4  assistant, dentist, podiatric physician or veterinarian.
34-5    5.  Any person who has obtained from a physician, [physician's] 
34-6  physician assistant, dentist, podiatric physician or veterinarian any 
34-7  controlled substance for administration to a patient during the absence of 
34-8  the physician, [physician's] physician assistant, dentist, podiatric physician 
34-9  or veterinarian shall return to him any unused portion of the substance 
34-10  when it is no longer required by the patient.
34-11  6.  A manufacturer, wholesale supplier or other person legally able to 
34-12  furnish or sell any controlled substance listed in schedule II shall not 
34-13  provide samples of such a controlled substance to registrants.
34-14  7.  A salesman of any manufacturer or wholesaler of pharmaceuticals 
34-15  shall not possess, transport or furnish any controlled substance listed in 
34-16  schedule II.
34-17  8.  A person shall not dispense a controlled substance in violation of a 
34-18  regulation adopted by the board.

34-19  Sec. 72.  NRS 453.391 is hereby amended to read as follows:
34-20  453.391  A person shall not:
34-21  1.  Unlawfully take, obtain or attempt to take or obtain a controlled 
34-22  substance or a prescription for a controlled substance from a manufacturer, 
34-23  wholesaler, pharmacist, physician, [physician's] physician assistant, 
34-24  dentist, veterinarian or any other person authorized to administer, dispense 
34-25  or possess controlled substances.
34-26  2.  While undergoing treatment and being supplied with any controlled 
34-27  substance or a prescription for any controlled substance from one 
34-28  practitioner, knowingly obtain any controlled substance or a prescription 
34-29  for a controlled substance from another practitioner without disclosing this 
34-30  fact to the second practitioner.

34-31  Sec. 73.  NRS 454.00958 is hereby amended to read as follows:
34-32  454.00958  "Practitioner" means:
34-33  1.  A physician, dentist, veterinarian or podiatric physician who holds a 
34-34  valid license to practice his profession in this state.
34-35  2.  A pharmacy, hospital or other institution licensed or registered to 
34-36  distribute, dispense, conduct research with respect to or to administer a 
34-37  dangerous drug in the course of professional practice in this state.
34-38  3.  When relating to the prescription of poisons, dangerous drugs and 
34-39  devices:
34-40  (a) An advanced practitioner of nursing who holds a certificate from the 
34-41  state board of nursing and a certificate from the state board of pharmacy 
34-42  permitting him so to prescribe; or
34-43  (b) A [physician's] physician assistant who holds a license from the 
34-44  [state] board of medical examiners and a certificate from the state board of 
34-45  pharmacy permitting him so to prescribe.
34-46  4.  An optometrist who is certified to prescribe and administer 
34-47  dangerous drugs pursuant to NRS 636.288 when he prescribes or 
34-48  administers dangerous drugs which are within the scope of his certification.

35-1    Sec. 74.  NRS 454.213 is hereby amended to read as follows:
35-2    454.213  A drug or medicine referred to in NRS 454.181 to 454.371, 
35-3  inclusive, may be possessed and administered by:
35-4    1.  A practitioner. 
35-5    2.  A [physician's] physician assistant at the direction of his 
35-6  supervising physician or a licensed dental hygienist acting in the office of 
35-7  and under the supervision of a dentist.
35-8    3.  Except as otherwise provided in subsection 4, a registered nurse 
35-9  licensed to practice professional nursing or licensed practical nurse, at the 
35-10  direction of a prescribing physician, dentist, podiatric physician or 
35-11  advanced practitioner of nursing, or pursuant to a chart order, for 
35-12  administration to a patient at another location.
35-13  4.  In accordance with applicable regulations of the board, a registered 
35-14  nurse licensed to practice professional nursing or licensed practical nurse 
35-15  who is:
35-16  (a) Employed by a health care agency or health care facility that is 
35-17  authorized to provide emergency care, or to respond to the immediate 
35-18  needs of a patient, in the residence of the patient; and
35-19  (b) Acting under the direction of the medical director of that agency or 
35-20  facility who works in this state.
35-21  5.  An intermediate emergency medical technician or an advanced 
35-22  emergency medical technician, as authorized by regulation of the state 
35-23  board of pharmacy and in accordance with any applicable regulations of:
35-24  (a) The state board of health in a county whose population is less than 
35-25  100,000;
35-26  (b) A county board of health in a county whose population is 100,000 or 
35-27  more; or
35-28  (c) A district board of health created pursuant to NRS 439.370 in any 
35-29  county.
35-30   6.  A respiratory therapist employed in a health care facility. The 
35-31  therapist may possess and administer respiratory products only at the 
35-32  direction of a physician.
35-33  7.  A dialysis technician, under the direction or supervision of a 
35-34  physician or registered nurse only if the drug or medicine is used for the 
35-35  process of renal dialysis.
35-36  8.  A medical student or student nurse in the course of his studies at an 
35-37  approved college of medicine or school of professional or practical 
35-38  nursing, at the direction of a physician and:
35-39  (a) In the presence of a physician or a registered nurse; or
35-40  (b) Under the supervision of a physician or a registered nurse if the 
35-41  student is authorized by the college or school to administer the drug or 
35-42  medicine outside the presence of a physician or nurse.
35-43  A medical student or student nurse may administer a dangerous drug in the 
35-44  presence or under the supervision of a registered nurse alone only if the 
35-45  circumstances are such that the registered nurse would be authorized to 
35-46  administer it personally.
35-47  9.  Any person designated by the head of a correctional institution.
35-48  10.  An ultimate user or any person designated by the ultimate user 
35-49  pursuant to a written agreement.

36-1    11.  A nuclear medicine technologist, at the direction of a physician 
36-2  and in accordance with any conditions established by regulation of the 
36-3  board.
36-4    12.  A radiologic technologist, at the direction of a physician and in 
36-5  accordance with any conditions established by regulation of the board.
36-6    13.  A chiropractic physician, but only if the drug or medicine is a 
36-7  topical drug used for cooling and stretching external tissue during 
36-8  therapeutic treatments.
36-9    14.  A physical therapist, but only if the drug or medicine is a topical 
36-10  drug which is:
36-11  (a) Used for cooling and stretching external tissue during therapeutic 
36-12  treatments; and
36-13  (b) Prescribed by a licensed physician for:
36-14     (1) Iontophoresis; or
36-15     (2) The transmission of drugs through the skin using ultrasound.
36-16  15.  In accordance with applicable regulations of the state board of 
36-17  health, an employee of a residential facility for groups, as defined in NRS 
36-18  449.017, pursuant to a written agreement entered into by the ultimate user.
36-19  16.  A veterinary technician at the direction of his supervising 
36-20  veterinarian.
36-21  17.  In accordance with applicable regulations of the board, a registered 
36-22  pharmacist who:
36-23  (a) Is trained in and certified to carry out standards and practices for 
36-24  immunization programs;
36-25  (b) Is authorized to administer immunizations pursuant to written 
36-26  protocols from a physician; and
36-27  (c) Administers immunizations in compliance with the "Standards of 
36-28  Immunization Practices" recommended and approved by the United States 
36-29  Public Health Service Advisory Committee on Immunization Practices.

36-30  Sec. 75.  NRS 454.215 is hereby amended to read as follows:
36-31  454.215  A dangerous drug may be dispensed by:
36-32  1.  A registered pharmacist upon the legal prescription from a 
36-33  practitioner or to a pharmacy in a correctional institution upon the written 
36-34  order of the prescribing practitioner in charge;
36-35  2.  A pharmacy in a correctional institution, in case of emergency, upon 
36-36  a written order signed by the chief medical officer;
36-37  3.  A practitioner, or a [physician's] physician assistant if authorized by 
36-38  the board;
36-39  4.  A registered nurse, when the nurse is engaged in the performance of 
36-40  any public health program approved by the board;
36-41  5.  A medical intern in the course of his internship;
36-42  6.  An advanced practitioner of nursing who holds a certificate from the 
36-43  state board of nursing and a certificate from the state board of pharmacy 
36-44  permitting him to dispense dangerous drugs;
36-45  7.  A registered nurse employed at an institution of the department of 
36-46  prisons to an offender in that institution; or
36-47  8.  A registered pharmacist from an institutional pharmacy pursuant to 
36-48  regulations adopted by the board,

37-1  except that no person may dispense a dangerous drug in violation of a 
37-2  regulation adopted by the board.

37-3    Sec. 76.  NRS 454.221 is hereby amended to read as follows:
37-4    454.221  1.  A person who furnishes any dangerous drug except upon 
37-5  the prescription of a practitioner is guilty of a category D felony and shall 
37-6  be punished as provided in NRS 193.130, unless the dangerous drug was 
37-7  obtained originally by a legal prescription.
37-8    2.  The provisions of this section do not apply to the furnishing of any 
37-9  dangerous drug by:
37-10  (a) A practitioner to his patients;
37-11  (b) A [physician's] physician assistant if authorized by the board;
37-12  (c) A registered nurse while participating in a public health program 
37-13  approved by the board, or an advanced practitioner of nursing who holds a 
37-14  certificate from the state board of nursing and a certificate from the state 
37-15  board of pharmacy permitting him to dispense dangerous drugs;
37-16  (d) A manufacturer or wholesaler or pharmacy to each other or to a 
37-17  practitioner or to a laboratory under records of sales and purchases that 
37-18  correctly give the date, the names and addresses of the supplier and the 
37-19  buyer, the drug and its quantity;
37-20  (e) A hospital pharmacy or a pharmacy so designated by a county health 
37-21  officer in a county whose population is 100,000 or more, or by a district 
37-22  health officer in any county within its jurisdiction or, in the absence of 
37-23  either, by the state health officer or his designated medical director of 
37-24  emergency medical services, to a person or agency described in subsection 
37-25  3 of NRS 639.268 to stock ambulances or other authorized vehicles or 
37-26  replenish the stock; or
37-27  (f) A pharmacy in a correctional institution to a person designated by 
37-28  the director of the department of prisons to administer a lethal injection to a 
37-29  person who has been sentenced to death.

37-30  Sec. 77.  NRS 484.393 is hereby amended to read as follows:
37-31  484.393  1.  The results of any blood test administered under the 
37-32  provisions of NRS 484.383 or 484.391 are not admissible in any hearing or 
37-33  criminal action arising out of acts alleged to have been committed by a 
37-34  person who was driving or in actual physical control of a vehicle while 
37-35  under the influence of intoxicating liquor or a controlled substance or who 
37-36  was engaging in any other conduct prohibited by NRS 484.379 or 
37-37  484.3795 unless:
37-38  (a) The blood tested was withdrawn by a physician, [physician's] 
37-39  physician assistant, registered nurse, licensed practical nurse, emergency 
37-40  medical technician or a technician, technologist or assistant employed in a 
37-41  medical laboratory;
37-42  (b) The test was performed on whole blood, except if the sample was 
37-43  clotted when it was received by the laboratory, the test may be performed 
37-44  on blood serum or plasma; and
37-45  (c) The person who withdrew the blood was authorized to do so by the 
37-46  appropriate medical licensing or certifying agency.
37-47  2.  The limitation contained in paragraph (a) of subsection 1 does not 
37-48  apply to the taking of a chemical test of the urine, breath or other bodily 
37-49  substance.

38-1    3.  No person listed in paragraph (a) of subsection 1 incurs any civil or 
38-2  criminal liability as a result of the administering of a blood test when 
38-3  requested by a police officer or the person to be tested to administer the 
38-4  test.

38-5    Sec. 78.  NRS 630.256, 630.272, 630.274 640B.010, 640B.020, 
38-6  640B.030, 640B.040, 640B.050, 640B.080, 640B.100, 640B.110 and 
38-7  640B.150 are hereby repealed.

38-8    Sec. 79.  A person who, on July 1, 2001, holds a license as a 
38-9  physician's assistant issued by the board of medical examiners shall be 
38-10  deemed to hold a license as a physician assistant until his license as a 
38-11  physician's assistant is renewed as a license as a physician assistant, 
38-12  expires or is revoked, whichever occurs first.

38-13  Sec. 80.  Notwithstanding the amendatory provisions of section 44 of 
38-14  this act to the contrary, a practitioner of respiratory care who, on July 1, 
38-15  2001, is certified to practice respiratory care in this state pursuant to 
38-16  chapter 640B of NRS may continue to practice respiratory care in this state 
38-17  pursuant to the certification, but must obtain a license from the board of 
38-18  medical examiners before January 1, 2002. On and after January 1, 2002, a 
38-19  person shall not practice respiratory care in this state unless he holds a 
38-20  license issued by the board of medical examiners.

38-21  Sec. 81.  1.  This section becomes effective upon passage and 
38-22  approval.
38-23  2.  Sections 1 to 80, inclusive, and 82 of this act become effective upon 
38-24  passage and approval for the purpose of adopting regulations and taking 
38-25  such other actions as necessary to regulate practitioners of respiratory care, 
38-26  and on July 1, 2001, for all other purposes.
38-27  3.  The amendatory provisions of sections 8, 19, 24, 26 and 41 of this 
38-28  act expire by limitation on the date on which the provisions of 42 U.S.C.  
38-29  666 requiring each state to establish procedures under which the state has 
38-30  authority to withhold or suspend, or to restrict the use of professional, 
38-31  occupational and recreational licenses of persons who:
38-32  (a) Have failed to comply with a subpoena or warrant relating to a 
38-33  proceeding to determine the paternity of a child or to establish or enforce 
38-34  an obligation for the support of a child; or
38-35  (b) Are in arrears in the payment for the support of one or more 
38-36  children,
38-37  are repealed by the Congress of the United States.

38-38  Sec. 82.  1.  Except as otherwise provided in subsection 2, the 
38-39  legislative counsel shall:
38-40  (a) In preparing the reprint and supplements to the Nevada Revised 
38-41  Statutes, appropriately change any references to physician's assistant or 
38-42  any variation thereof, to physician assistant, or any appropriate variation 
38-43  thereof.
38-44  (b) In preparing supplements to the Nevada Administrative Code, 
38-45  appropriately change any references to physician's assistant or any 
38-46  variation thereof, to physician assistant, or any appropriate variation 
38-47  thereof.
 
39-1    2.  The legislative counsel shall not, pursuant to subsection 1, change 
39-2  any references to osteopathic physician's assistant or any variation thereof 
39-3  that appear in the Nevada Revised Statutes or the Nevada Administrative 
39-4  Code.
39-5  LEADLINES OF REPEALED SECTIONS
39-6    630.256  Retired licensees: Duties; requirements for reinstatement.
39-7    630.272  Physician's assistant employed at institution of 
39-8  department of prisons: Authorized services.
39-9    630.274  Physician's assistant: Supervision by osteopathic 
39-10  physician.
39-11  640B.010  Legislative declaration.
39-12  640B.020  Definitions.
39-13  640B.030  "Practice of respiratory care" defined.
39-14  640B.040  "Practitioner of respiratory care" defined.
39-15  640B.050  "Respiratory care" defined.
39-16  640B.080  Applicability of chapter.
39-17  640B.100  Prescription required.
39-18  640B.110  Qualifications; certification required; prohibited acts; 
39-19  practice as intern.
39-20  640B.150  Unlawful acts; penalty.
                                                                                   
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