AB102 - Revises provisions relating to emergency medical services. (BDR 40-345)

- 83rd Session (2025) Assembly Bill No. 102–Committee on Health and Human Services CHAPTER.......... AN ACT relating to emergency medical services; authorizing a district board of health in certain health districts to regulate emergency medical services within the district with certain exceptions; providing that certain persons are eligible for licensure as an attendant of an ambulance or air ambulance or certification as an emergency medical technician; revising provisions governing persons who are authorized to occupy an ambulance; and providing other matters properly relating thereto. Legislative Counsel’s Digest: Existing law: (1) creates a health district in each county whose population is 700,000 or more (currently only Clark County); and (2) authorizes the creation of a health district in counties whose population is less than 700,000 (currently all counties other than Clark County) under certain circumstances. (NRS 439.361, 439.362, 439.369, 439.370) Existing law provides for the licensure and regulation of emergency medical services by: (1) in a county whose population is 700,000 or more, the district board of health; and (2) in all other counties, the State Board of Health and the Division of Public and Behavioral Health of the Department of Health and Human Services. (NRS 450B.060, 450B.077, 450B.120, 450B.160) Sections 1-6, 9 and 10 of this bill authorize a district board of health in a health district that includes a county whose population is 100,000 or more but less than 700,000 (currently only Washoe County) to elect, by affirmative vote of a majority of all the members of the board, to regulate emergency medical services within the district in the same manner as a county whose population is 700,000 or more. However, section 10.5 of this bill prohibits a district board of health in a health district that elects to regulate emergency medical services from establishing a program for the treatment of trauma, thereby keeping the program for the treatment of trauma in such a health district under the authority of the State Board of Health. Existing law sets forth the requirements to obtain a license as an attendant of an ambulance or air ambulance or certification as an emergency medical technician. (NRS 450B.160, 450B.180, 450B.1905) Sections 7 and 8 of this bill provide that a person who is at least 16 years of age is eligible for such a license or certificate if he or she meets the qualifications prescribed by law. Existing law: (1) prohibits the owner of an ambulance from allowing a person to operate or use the ambulance if the person is not licensed as an attendant; and (2) requires an ambulance carrying a sick or injured patient to be occupied by a driver and attendant, both of whom must be licensed as attendants. (NRS 450B.260) Section 11 of this bill prohibits the State Board of Health or a district board of health from requiring that a person who is participating in a program of training for certification as an emergency medical technician, advanced emergency medical technician or paramedic be licensed as an attendant in order to occupy an ambulance that is providing care or transporting a sick or injured person so long as: (1) the ambulance is otherwise properly staffed; and (2) the person is not providing care to a sick or injured person or driving the ambulance. – 2 – - 83rd Session (2025) EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS: Section 1. NRS 439.410 is hereby amended to read as follows: 439.410 1. The district board of health has the powers, duties and authority of a county board of health in the health district. 2. The district health department has jurisdiction over all public health matters in the health district, except in matters concerning emergency medical services pursuant to the provisions of chapter 450B of NRS. 3. In addition to any other powers, duties and authority conferred on a district board of health by this section [, the] : (a) The district board of health may by affirmative vote of a majority of all the members of the board adopt regulations consistent with law, which must take effect immediately on their approval by the State Board of Health, to: [(a)] (1) Prevent and control nuisances; [(b)] (2) Regulate sanitation and sanitary practices in the interests of the public health; [(c)] (3) Provide for the sanitary protection of water and food supplies; and [(d)] (4) Protect and promote the public health generally in the geographical area subject to the jurisdiction of the health district. (b) The district board of health in a health district that includes a county whose population is 100,000 or more but less than 700,000 may, by affirmative vote of a majority of all the members of the board, elect to regulate emergency medical services within the district pursuant to chapter 450B of NRS. 4. Before the adoption, amendment or repeal of a regulation, the district board of health must give at least 30 days’ notice of its intended action. The notice must: (a) Include a statement of either the terms or substance of the proposal or a description of the subjects and issues involved, and of the time when, the place where and the manner in which interested persons may present their views thereon. (b) State each address at which the text of the proposal may be inspected and copied. (c) Be mailed to all persons who have requested in writing that they be placed on a mailing list, which must be kept by the district board for such purpose. – 3 – - 83rd Session (2025) 5. All interested persons must be afforded a reasonable opportunity to submit data, views or arguments, orally or in writing, on the intended action to adopt, amend or repeal the regulation. With respect to substantive regulations, the district board shall set a time and place for an oral public hearing, but if no one appears who will be directly affected by the proposal and requests an oral hearing, the district board may proceed immediately to act upon any written submissions. The district board shall consider fully all written and oral submissions respecting the proposal. 6. Each district board of health shall file a copy of all of its adopted regulations with the county clerk of each county in which it has jurisdiction. Sec. 2. Chapter 450B of NRS is hereby amended by adding thereto a new section to read as follows: “Regulating health district” means a health district: 1. In a county whose population is 700,000 or more; or 2. For which the district board of health has elected to regulate emergency medical services pursuant to NRS 439.410. Sec. 3. NRS 450B.020 is hereby amended to read as follows: 450B.020 As used in this chapter, unless the context otherwise requires, the words and terms defined in NRS 450B.025 to 450B.110, inclusive, and section 2 of this act have the meanings ascribed to them in those sections. Sec. 4. NRS 450B.060 is hereby amended to read as follows: 450B.060 “Board” means: 1. [In a county whose population is less than 700,000, the State Board of Health. 2.] In a [county whose population is 700,000 or more,] regulating health district, the district board of health. 2. In an area not described in subsection 1, the State Board of Health. Sec. 5. NRS 450B.077 is hereby amended to read as follows: 450B.077 “Health authority” means: 1. [In a county whose population is less than 700,000, the Division. 2.] In a [county whose population is 700,000 or more,] regulating health district, the district board of health. 2. In an area not described in subsection 1, the Division. Sec. 6. NRS 450B.082 is hereby amended to read as follows: 450B.082 “Health officer” means: 1. In a [county whose population is less than 700,000, the Chief Medical Officer. – 4 – - 83rd Session (2025) 2. In a county whose population is 700,000 or more,] regulating health district, the district health officer. 2. In an area not described in subsection 1, the Chief Medical Officer. Sec. 7. NRS 450B.160 is hereby amended to read as follows: 450B.160 1. The health authority may issue licenses to attendants and to firefighters employed by or serving as volunteers with a fire-fighting agency. A person is eligible for a license as an attendant if he or she: (a) Is at least 16 years of age; and (b) Possesses the qualifications required by this section and any regulations adopted by the board. 2. Each license must be evidenced by a card issued to the holder of the license, is valid for a period not to exceed 2 years and is renewable. 3. An applicant for a license must file with the health authority: (a) A current, valid certificate evidencing the applicant’s successful completion of a program of training as an emergency medical technician, advanced emergency medical technician or paramedic, if the applicant is applying for a license as an attendant, or, if a volunteer attendant, at a level of skill determined by the board. (b) A current valid certificate evidencing the applicant’s successful completion of a program of training as an emergency medical technician, advanced emergency medical technician or paramedic, if the applicant is applying for a license as a firefighter with a fire-fighting agency. (c) A signed statement showing: (1) The name and address of the applicant; (2) The name and address of the employer of the applicant; and (3) A description of the applicant’s duties. (d) Proof that the applicant has completed the training required by subsection 4. (e) Such other certificates for training and such other items as the board may specify. 4. In addition to the training required by subsection 3, each applicant for a license must complete training concerning identifying and interacting with persons with developmental disabilities. 5. The board shall adopt such regulations as it determines are necessary for the issuance, suspension, revocation and renewal of licenses. – 5 – - 83rd Session (2025) 6. Each operator of an ambulance or air ambulance and each fire-fighting agency shall annually file with the health authority a complete list of the licensed persons in its service. 7. Licensed physicians, registered nurses and licensed physician assistants may serve as attendants without being licensed under the provisions of this section. A registered nurse who performs emergency care in an ambulance or air ambulance shall perform the care in accordance with the regulations of the State Board of Nursing. A licensed physician assistant who performs emergency care in an ambulance or air ambulance shall perform the care in accordance with the regulations of the Board of Medical Examiners. 8. Each licensed physician, registered nurse and licensed physician assistant who serves as an attendant must have current certification of completion of training in: (a) Advanced life-support procedures for patients who require cardiac care; (b) Life-support procedures for pediatric patients who require cardiac care; and (c) Life-support procedures for patients with trauma that are administered before the arrival of those patients at a hospital.  The certification must be issued by the Board of Medical Examiners for a physician or licensed physician assistant or by the State Board of Nursing for a registered nurse. 9. The Board of Medical Examiners and the State Board of Nursing shall issue a certificate pursuant to subsection 8 if the licensed physician, licensed physician assistant or registered nurse attends: (a) A course offered by a national organization which is nationally recognized for issuing such certification; (b) Training conducted by the operator of an ambulance or air ambulance; or (c) Any other course or training,  approved by the Board of Medical Examiners or the State Board of Nursing, whichever is issuing the certification. 10. As used in this section, “developmental disability” has the meaning ascribed to it in NRS 435.007. Sec. 8. NRS 450B.180 is hereby amended to read as follows: 450B.180 1. Any person desiring certification as an emergency medical technician, advanced emergency medical technician or paramedic must apply to the health authority using forms prescribed by the health authority. A person is eligible for certification as an emergency medical technician if he or she is at – 6 – - 83rd Session (2025) least 16 years of age and is otherwise qualified pursuant to this chapter and the regulations adopted pursuant thereto. 2. The health authority, pursuant to regulations and procedures adopted by the board, shall make a determination of the applicant’s qualifications to be certified as an emergency medical technician, advanced emergency medical technician or paramedic and shall issue the appropriate certificate to each qualified applicant. 3. A certificate is valid for a period not exceeding 2 years and may be renewed if the holder of the certificate complies with the provisions of this chapter and meets the qualifications set forth in the regulations and standards established by the board pursuant to this chapter. The regulations and standards established by the board must provide for the completion of: (a) A course of instruction, within 2 years after initial certification, relating to the medical consequences of an act of terrorism that involves the use of a weapon of mass destruction. The course must provide at least 4 hours of instruction that includes instruction in the following subjects: (1) An overview of acts of terrorism and weapons of mass destruction; (2) Personal protective equipment required for acts of terrorism; (3) Common symptoms and methods of treatment associated with exposure to, or injuries caused by, chemical, biological, radioactive and nuclear agents; (4) Syndromic surveillance and reporting procedures for acts of terrorism that involve biological agents; and (5) An overview of the information available on, and the use of, the Health Alert Network.  The board may thereafter determine whether to establish regulations and standards requiring additional courses of instruction relating to the medical consequences of an act of terrorism that involves the use of a weapon of mass destruction. (b) Training before initial certification concerning identifying and interacting with persons with developmental disabilities. Training completed pursuant to this paragraph also satisfies the requirement for such training [Text truncated for display. Full text available on LegiScan.]