AB395 - Revises provisions relating to services to persons who are deaf or hard of hearing. (BDR 40-841)

EXEMPT (Reprinted with amendments adopted on April 21, 2025) FIRST REPRINT A.B. 395 - *AB395_R1* ASSEMBLY BILL NO. 395–ASSEMBLYMEMBERS ROTH AND BROWN-MAY MARCH 11, 2025 ____________ Referred to Committee on Health and Human Services SUMMARY—Revises provisions relating to services to persons who are deaf or hard of hearing. (BDR 40-841) FISCAL NOTE: Effect on Local Government: May have Fiscal Impact. Effect on the State: Yes. CONTAINS UNFUNDED MANDATE (§ 1) (NOT REQUESTED BY AFFECTED LOCAL GOVERNMENT) ~ EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. AN ACT relating to health care; requiring certain health facilities and providers of health care to provide qualified sign language interpreters to certain persons who are deaf or hard of hearing; prescribing the circumstances under which such qualified sign language interpreters may be provided remotely; establishing requirements for providing remotely such qualified sign language interpreters; requiring the Department of Health and Human Services to maintain a list of certain facilities that provide services specialized to persons who are deaf or hard of hearing; and providing other matters properly relating thereto. Legislative Counsel’s Digest: Existing federal regulations require providers of health care and health care 1 facilities that receive funding or certain other assistance from the Federal 2 Government to ensure that communications with persons with disabilities are as 3 effective as communications with persons who do not have disabilities. (45 C.F.R. 4 § 92.202) Those federal regulations: (1) prohibit such providers and facilities from 5 requiring a person with a disability to be accompanied by a person to interpret for 6 him or her; and (2) authorize such providers and facilities to provide qualified 7 interpreters through video remote interpreting services. (28 C.F.R. § 35.160, 45 8 C.F.R. § 92.202) 9 Sections 1 and 8 of this bill require a medical facility, a facility for the 10 dependent and certain other health facilities in a county whose population is 20,000 11 – 2 – - *AB395_R1* or more (currently Clark, Washoe, Lyon, Elko, Nye, Douglas and Churchill 12 Counties and Carson City) and a provider of health care who is providing services 13 in such a county, respectively, to ensure that each person who is deaf or hard of 14 hearing and seeks care or services at the facility or from the provider, as applicable, 15 is notified: (1) that a qualified sign language interpreter can be made available; (2) 16 that the person may request an in-person or remote sign language interpreter; and 17 (3) of any other accommodations that may be made available. If the person requests 18 an in-person qualified sign language interpreter, sections 1 and 8 require such a 19 health facility or provider of health care to: (1) provide the person with a qualified 20 sign language interpreter in person if the request is made at least 48 hours before a 21 prescheduled encounter or at least 2 hours after arriving at the health facility for an 22 unplanned inpatient hospitalization; or (2) make a good faith effort to provide the 23 person with a qualified sign language interpreter in person under all other 24 circumstances. If the health facility or provider of health care cannot provide an in- 25 person qualified sign language interpreter after making a good faith effort or if the 26 person requests a remote interpreter, sections 1 and 8 require the health facility or 27 provider of health care to provide a remote interpreter. Sections 1 and 8 prescribe 28 requirements governing the use of a remote interpreter. 29 Sections 2 and 3 of this bill make conforming changes to establish the 30 applicability of certain existing provisions to section 1. Sections 4-6 and 9 of this 31 bill prescribe various mechanisms for the enforcement of section 1, including the 32 imposition of administrative sanctions against a health facility that fails to comply 33 with those provisions. Section 8 authorizes professional discipline against a 34 provider of health care who fails to comply with that section. 35 Section 7 of this bill requires the Department of Health and Human Services to 36 maintain on an Internet website a list of assisted living facilities and senior living 37 communities that provide services specialized for persons who are deaf or hard of 38 hearing. 39 THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS: Section 1. Chapter 449 of NRS is hereby amended by adding 1 thereto a new section to read as follows: 2 1. A health facility that is located in a county whose 3 population is 20,000 or more shall notify each person who is deaf 4 or hard of hearing and seeks care or services at the health facility: 5 (a) That a qualified sign language interpreter can be made 6 available to assist the person; 7 (b) That the person may request an in-person or remote 8 qualified sign language interpreter; and 9 (c) Of any other specific accommodations that may be 10 available for the person. 11 2. If a person who is deaf or hard of hearing seeks health 12 care from a health facility that is located in a county whose 13 population is 20,000 or more and requests an in-person qualified 14 sign language interpreter: 15 (a) At least 48 hours before a prescheduled encounter at a 16 health facility or at least 2 hours after arriving at a health facility 17 – 3 – - *AB395_R1* that is a hospital for an unplanned inpatient hospitalization, the 1 health facility shall provide an in-person qualified sign language 2 interpreter. 3 (b) In circumstances other than those described in paragraph 4 (a), the health facility shall: 5 (1) Make a good faith effort to provide an in-person 6 qualified sign language interpreter; 7 (2) Provide an in-person qualified sign language 8 interpreter if the health facility is able to do so after making a 9 good faith effort; 10 (3) Provide a qualified sign language interpreter remotely 11 using audiovisual communication technology in a manner that 12 meets the requirements of subsections 4 and 5 if the health facility 13 is unable to provide an in-person qualified sign language 14 interpreter after making a good faith effort; and 15 (4) Maintain in the medical record of the person 16 documentation of the good faith effort made pursuant to 17 subparagraph (1), which must include, without limitation: 18 (I) A list of entities contacted to provide an in-person 19 qualified sign language interpreter and a statement of the manner 20 in which each such entity responded; 21 (II) A statement of whether the health facility provided 22 an in-person qualified sign language interpreter or provided a 23 qualified sign language interpreter remotely using audiovisual 24 communication technology; and 25 (III) If applicable, the time at which a qualified sign 26 language interpreter was available in person to assist the person. 27 3. If a person who is deaf or hard of hearing seeks health 28 care from a health facility that is located in a county whose 29 population is 20,000 or more and requests that the health facility 30 provide: 31 (a) A qualified sign language interpreter remotely using 32 audiovisual communication technology, the health facility shall 33 provide a qualified sign language interpreter remotely using 34 audiovisual communication technology in a manner that meets the 35 requirements of subsections 4 and 5. 36 (b) Any type of accommodation other than a qualified sign 37 language interpreter, the health facility may provide the 38 accommodation. 39 4. If a health facility that is located in a county whose 40 population is 20,000 or more provides a qualified sign language 41 interpreter remotely using audiovisual communication technology, 42 the audiovisual communication technology must: 43 (a) Provide clear transmission of audio and visuals; and 44 (b) Be capable of hands-free use. 45 – 4 – - *AB395_R1* 5. A qualified sign language interpreter who provides remote 1 sign language interpreting pursuant to this section must: 2 (a) Interpret from a dedicated secure call center that ensures 3 the privacy of the person who is deaf or hard of hearing; and 4 (b) Comply with the provisions of the Health Insurance 5 Portability and Accountability Act of 1996, Public Law 104-191, 6 and any regulations adopted pursuant thereto. 7 6. A health facility that is located in a county whose 8 population is 20,000 or more shall provide training to an 9 employee, a contractor or a volunteer who is involved in using 10 audiovisual communication technology to facilitate the use of a 11 remote qualified sign language interpreter. Such training must be 12 adequate to ensure that the employee, contractor or volunteer 13 operates the technology efficiently and effectively. 14 7. As used in this section: 15 (a) “Health facility” means a medical facility, a facility for the 16 dependent or a facility which is required by the regulations 17 adopted pursuant to NRS 449.0303 to be licensed. 18 (b) “Provider of health care” has the meaning ascribed to it in 19 NRS 629.031. 20 (c) “Qualified sign language interpreter” means a qualified 21 interpreter for an individual with a disability, as defined in 45 22 C.F.R. § 92.4, who is registered pursuant to NRS 656A.100 to 23 practice sign language interpreting in a community setting. 24 (d) “Secure call center” means a location with the physical 25 and technological capability to provide qualified sign language 26 interpreters remotely using audiovisual communication 27 technology in compliance with this section. 28 Sec. 2. NRS 449.029 is hereby amended to read as follows: 29 449.029 As used in NRS 449.029 to 449.240, inclusive, and 30 section 1 of this act, unless the context otherwise requires, “medical 31 facility” has the meaning ascribed to it in NRS 449.0151 and 32 includes a program of hospice care described in NRS 449.196. 33 Sec. 3. NRS 449.0301 is hereby amended to read as follows: 34 449.0301 The provisions of NRS 449.029 to 449.2428, 35 inclusive, and section 1 of this act do not apply to: 36 1. Any facility conducted by and for the adherents of any 37 church or religious denomination for the purpose of providing 38 facilities for the care and treatment of the sick who depend solely 39 upon spiritual means through prayer for healing in the practice of 40 the religion of the church or denomination, except that such a 41 facility shall comply with all regulations relative to sanitation and 42 safety applicable to other facilities of a similar category. 43 2. Foster homes as defined in NRS 424.014. 44 – 5 – - *AB395_R1* 3. Any medical facility, facility for the dependent or facility 1 which is otherwise required by the regulations adopted by the Board 2 pursuant to NRS 449.0303 to be licensed that is operated and 3 maintained by the United States Government or an agency thereof. 4 Sec. 4. NRS 449.160 is hereby amended to read as follows: 5 449.160 1. The Division may deny an application for a 6 license or may suspend or revoke any license issued under the 7 provisions of NRS 449.029 to 449.2428, inclusive, and section 1 of 8 this act upon any of the following grounds: 9 (a) Violation by the applicant or the licensee of any of the 10 provisions of NRS 439B.410, 449.029 to 449.245, inclusive, and 11 section 1 of this act or 449A.100 to 449A.124, inclusive, and 12 449A.270 to 449A.286, inclusive, or of any other law of this State 13 or of the standards, rules and regulations adopted thereunder. 14 (b) Aiding, abetting or permitting the commission of any illegal 15 act. 16 (c) Conduct inimical to the public health, morals, welfare and 17 safety of the people of the State of Nevada in the maintenance and 18 operation of the premises for which a license is issued. 19 (d) Conduct or practice detrimental to the health or safety of the 20 occupants or employees of the facility. 21 (e) Failure of the applicant to obtain written approval from the 22 Director of the Department of Health and Human Services as 23 required by NRS 439A.100 or 439A.102 or as provided in any 24 regulation adopted pursuant to NRS 449.001 to 449.430, inclusive, 25 and section 1 of this act and 449.435 to 449.531, inclusive, and 26 chapter 449A of NRS if such approval is required, including, 27 without limitation, the closure or conversion of any hospital in a 28 county whose population is 100,000 or more that is owned by the 29 licensee without approval pursuant to NRS 439A.102. 30 (f) Failure to comply with the provisions of NRS 441A.315 and 31 any regulations adopted pursuant thereto or NRS 449.2486. 32 (g) Violation of the provisions of NRS 458.112. 33 (h) Failure to comply with the provisions of NRS 449A.170 to 34 449A.192, inclusive, and any regulation adopted pursuant thereto. 35 (i) Violation of the provisions of NRS 629.260. 36 2. In addition to the provisions of subsection 1, the Division 37 may revoke a license to operate a facility for the dependent if, with 38 respect to that facility, the licensee that operates the facility, or an 39 agent or employee of the licensee: 40 (a) Is convicted of violating any of the provisions of 41 NRS 202.470; 42 (b) Is ordered to but fails to abate a nuisance pursuant to NRS 43 244.360, 244.3603 or 268.4124; or 44 – 6 – - *AB395_R1* (c) Is ordered by the appropriate governmental agency to correct 1 a violation of a building, safety or health code or regulation but fails 2 to correct the violation. 3 3. The Division shall maintain a log of any complaints that it 4 receives relating to activities for which the Division may revoke the 5 license to operate a facility for the dependent pursuant to subsection 6 2. The Division shall provide to a facility for the care of adults 7 during the day: 8 (a) A summary of a complaint against the facility if the 9 investigation of the complaint by the Division either substantiates 10 the complaint or is inconclusive; 11 (b) A report of any investigation conducted with respect to the 12 complaint; and 13 (c) A report of any disciplinary action taken against the facility. 14  The facility shall make the information available to the public 15 pursuant to NRS 449.2486. 16 4. On or before February 1 of each odd-nu [Text truncated for display. Full text available on LegiScan.]