Text of NV SB 171 (2025)

S.B. 171 - *SB171* SENATE BILL NO. 171–SENATOR OHRENSCHALL PREFILED FEBRUARY 3, 2025 ____________ Referred to Committee on Commerce and Labor SUMMARY—Enacts a shield law to protect the transgender community. (BDR 54-12) FISCAL NOTE: Effect on Local Government: No. Effect on the State: No. ~ EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. AN ACT relating to health care; prohibiting health care licensing boards from disqualifying from licensure or disciplining a person for providing or assisting in the provision of medically necessary gender-affirming health care services; prohibiting in certain circumstances the Governor from extraditing a person who is charged with a crime in another state related to medically necessary gender-affirming health care services; prohibiting state agencies from assisting in certain investigations and proceedings initiated in other states related to medically necessary gender-affirming health care services; requiring certain health care licensing boards to examine the feasibility of reciprocal licensure for health care providers who provide gender-affirming health care services in other states; and providing other matters properly relating thereto. Legislative Counsel’s Digest: Existing law regulates the licensing, certification and registration of various 1 providers of health care in this State. (Chapters 630-637B and 639-641D of NRS) 2 Existing law prohibits a health care licensing board from disqualifying from 3 licensure or subjecting a person to discipline solely: (1) for providing reproductive 4 health care services that are lawful and consistent with the practice of the relevant 5 profession in this State; or (2) as a consequence of certain adverse actions 6 threatened or imposed in another jurisdiction for the provision of such reproductive 7 health care services. (NRS 629.250) Section 1 of this bill additionally prohibits a 8 health care licensing board from taking similar actions against a person for 9 providing or assisting in the provision of medically necessary gender-affirming 10 health care services that are lawful in this State. Section 4 of this bill requires each 11 – 2 – - *SB171* health care licensing board that licenses providers of health care who provide 12 gender-affirming health care services to examine the feasibility of providing 13 reciprocal licensing to providers of health care in other states to facilitate the 14 provision of gender-affirming health care services to persons from other states who 15 seek such medically necessary services in this State. 16 In accordance with the Extradition Clause of Section 2 of Article IV of the 17 United States Constitution, existing state law requires the Governor to extradite to 18 another state any person charged in that state with a crime, who is found in this 19 State. (NRS 179.181) Under existing law, the Governor is also authorized, but not 20 required, to extradite to another state any person in this State charged in the other 21 state with committing an act in this State intentionally resulting in a crime in the 22 state demanding extradition. (NRS 179.189) Existing law, with certain exceptions, 23 prohibits the Governor from extraditing any person in this State who is charged 24 with a crime in another state if the crime alleged involves the provision or receipt of 25 or assistance with reproductive health care services. (NRS 179.540) Section 2 of 26 this bill similarly prohibits the Governor from extraditing a person in this State who 27 is charged with a crime in another state if the crime involves the provision or 28 receipt of or assistance with medically necessary gender-affirming health care 29 services, unless the crime charged in the other state would also be a crime in this 30 State. Section 2, as an exception to this prohibition, authorizes the extradition of a 31 person who was physically present in the other state at the time of the commission 32 of the alleged offense. 33 Existing law prohibits a state agency from providing any information or 34 expending or using any resources in furtherance of any investigation or proceeding 35 initiated in or by another state that seeks to impose civil or criminal liability or 36 professional sanction on a person or entity for providing, securing, receiving, 37 making an inquiry concerning or providing certain assistance concerning 38 reproductive health care services that are legal in this State, except under certain 39 limited circumstances. (NRS 232.0088) Section 3 of this bill prohibits state 40 agencies in the Executive Department of the State Government from providing 41 information or expending any resources of the State in furtherance of such an 42 investigation or proceeding concerning medically necessary gender-affirming 43 health care services, except under certain limited circumstances. 44 THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS: Section 1. Chapter 629 of NRS is hereby amended by adding 1 thereto a new section to read as follows: 2 1. A health care licensing board shall not disqualify a person 3 from licensure or subject any person to discipline solely: 4 (a) For providing or assisting in the provision of medically 5 necessary gender-affirming health care services; or 6 (b) As a consequence of any judgment, discipline or other 7 sanction threatened or imposed under the laws of the District of 8 Columbia or any state or territory of the United States for 9 providing or assisting in the provision of medically necessary 10 gender-affirming health care services, 11  if the gender-affirming health care services were provided with 12 parental consent, unless the minor would have been expressly 13 – 3 – - *SB171* authorized to consent to the services under the laws of this State, 1 and the services, as provided, would have been lawful in this State. 2 2. As used in this section: 3 (a) “Gender-affirming health care services”: 4 (1) Means medical, surgical, counseling or referral services 5 that respect the gender identity or expression of the patient and 6 are found by a competent medical professional to be appropriate 7 based upon the wishes of a patient and in accordance with the 8 laws of this State, including, without limitation: 9 (I) Interventions to suppress the development of 10 endogenous secondary sex characteristics; 11 (II) Interventions to align the appearance or physical 12 body of the patient with the gender identity or expression of the 13 patient; 14 (III) Interventions to alleviate symptoms of clinically 15 significant distress resulting from gender dysphoria, as defined in 16 the most recent edition of the Diagnostic and Statistical Manual of 17 Mental Disorders published by the American Psychiatric 18 Association; and 19 (IV) Developmentally appropriate exploration and 20 integration of identity, reduction of distress, adaptive coping and 21 strategies to increase family acceptance. 22 (2) Does not include conversion therapy, as defined in 23 NRS 629.600. 24 (b) “Health care licensing board” means: 25 (1) A board created pursuant to chapter 630, 630A, 631, 26 632, 633, 634, 634A, 634B, 635, 636, 637, 637B, 639, 640, 640A, 27 640B, 640C, 640D, 640E, 641, 641A, 641B, 641C or 641D of NRS. 28 (2) The Division of Public and Behavioral Health of the 29 Department of Health and Human Services. 30 (c) “Medically necessary” means health care services or 31 products that a prudent provider of health care would provide to a 32 patient to prevent, diagnose or treat an illness, injury or disease, or 33 any symptoms thereof, that are necessary and: 34 (1) Provided in accordance with generally accepted 35 standards of medical practice; 36 (2) Clinically appropriate with regard to type, frequency, 37 extent, location and duration; 38 (3) Not provided primarily for the convenience of the 39 patient or provider of health care; 40 (4) Required to improve a specific health condition of a 41 patient or to preserve the existing state of health of the patient; 42 and 43 (5) The most clinically appropriate level of health care that 44 may be safely provided to the patient. 45 – 4 – - *SB171*  A provider of health care prescribing, ordering, recommending 1 or approving a health care service or product does not, by itself, 2 make that health care service or product medically necessary. 3 Sec. 2. Chapter 179 of NRS is hereby amended by adding 4 thereto a new section to read as follows: 5 1. Notwithstanding the provisions of NRS 179.177 to 179.235, 6 inclusive, the Governor shall not surrender, or issue a warrant 7 pursuant to NRS 179.191 for the arrest of, any person in this State 8 who is charged in another state with a criminal violation of the 9 laws of that other state if the violation alleged involves the 10 provision or receipt of or assistance with medically necessary 11 gender-affirming health care services, unless the acts forming the 12 basis of the prosecution of the crime charged would constitute a 13 criminal offense under the laws of the State of Nevada. 14 2. The provisions of this section do not apply in the 15 circumstance where a demand for the extradition of a person 16 charged with a crime in another state is made in accordance with 17 NRS 179.183, and the person who is the subject of the demand 18 was physically present in the demanding state at the time of the 19 commission of the alleged offense and thereafter fled from that 20 state. 21 3. The provisions of this section shall not be construed to 22 apply to the provision of medically necessary gender-affirming 23 health care services without parental consent unless the minor is 24 authorized to consent to those services under the laws of this State. 25 4. As used in this section: 26 (a) “Gender-affirming health care services”: 27 (1) Means medical, surgical, counseling or referral services 28 that respect the gender identity or expression of the patient and 29 are found by a competent medical professional to be appropriate 30 based upon the wishes of a patient and in accordance with the 31 laws of this State, including, without limitation: 32 (I) Interventions to suppress the development of 33 endogenous secondary sex characteristics; 34 (II) Interventions to align the appearance or physical 35 body of the patient with the gender identity or expression of the 36 patient; 37 (III) Interventions to alleviate symptoms of clinically 38 significant distress resulting from gender dysphoria, as defined in 39 the most recent edition of the Diagnostic and Statistical Manual of 40 Mental Disorders published by the American Psychiatric 41 Association; and 42 (IV) Developmentally appropriate exploration and 43 integration of identity, reduction of distress, adaptive coping and 44 strategies to increase family acceptance. 45 – 5 – - *SB171* (2) Does not include conversion therapy, as defined in 1 NRS 629.600. 2 (b) “Medically necessary” means health care services or 3 products that a prudent provider of health care would provide to a 4 patient to prevent, diagnose or treat an illness, injury or disease, or 5 any symptoms thereof, that are necessary and: 6 (1) Provided in accordance with generally accepted 7 standards of medical practice; 8 (2) Clinically appropriate with regard to type, frequency, 9 extent, location and duration; 10 (3) Not provided primarily for the convenience of the 11 patient or provider of health care; 12 (4) Required to improve a specific health condition of a 13 patient or to preserve the existing state of health of the patient; 14 and 15 (5) The most clinically appropriate level of health care that 16 may be safely provided to the patient. 17  A provider of health care prescribing, ordering, recommending 18 or approving a health care service or product does not, by itself, 19 make that health care service or product medically necessary. 20 (c) “Provider of health care” has the meaning ascribed to it in 21 NRS 629.031. 22 (d) The words and terms defined in NRS 179.179 have the 23 meanings ascribed to them in that section. 24 Sec. 3. Chapter 232 of NRS is hereby amended by adding 25 thereto a new section to read as follows: 26 1. Except as otherwise required by the order of a court of 27 competent jurisdiction, a state agency shall not provide any 28 information or expend or use time, money, facilities, property, 29 equipment, personnel or other resources of the State in 30 furtherance of any investigation or proceeding initiated in or by 31 another state that seeks to impose civil or criminal liability or 32 professional sanction upon a person or entity for: 33 (a) The provision, securing or receiving of, or any inquiry 34 concerning, medically necessary gender-affirming health care 35 services that are legal in this State; or 36 (b) Any assistance given to any person or entity that relates to 37 the provision, securing or receiving of, or any inquiry concerning, 38 medically necessary gender-affirming health care services that are 39 legal in this State. 40 2. The provisions of subsection 1 do not apply to any 41 investigation or proceeding where the conduct that is subject to 42 potential liability under the investigation or proceeding initiated in 43 or by the other state would be subject to civil or criminal liability 44 – 6 – - *SB171* or professional sanction under the laws of the State of Nevada, if 1 committed in this State. 2 3. Notwithstanding the provisions of this section, a state 3 agency or an employee, appointee, officer or other person acting 4 on behalf of a state agency may provide information or assistance 5 in connection with such an investigation or proceeding in 6 response to a written request by the person who is the subject of 7 the investigation or proceeding. 8 4. The provisions of this section shall not be construed to 9 apply to the provision, securing or receipt of medically necessary 10 gender-affirming health care services without parental consent, 11 unless the minor is authorized to consent to those services under 12 the laws of this State. 13 5. As used in this section: 14 (a) “Gender-affirming health care services”: 15 (1) Means medical, surgical, counseling or referral services 16 that respect the gender identity or expression of the patient and 17 are found by a competent medical professional to be appropriate 18 based upon the wishes of a patient and in accordance with the 19 laws of this State, including, without limitation: 20 (I) Interventions to suppress the development of 21 endogenous secondary sex characteristics; 22 (II) Interventions to align the appearance or physical 23 body of the patient with the gender identity or expression of the 24 patient; 25 (III) Interventions to alleviate symptoms of clinically 26 significant distress resulting from gender dysphoria, as defined in 27 the most recent edition of the Diagnostic and Statistical Manual of 28 Mental Disorders published by the American Psychiatric 29 Association; and 30 (IV) Developmentally appropriate exploration and 31 integration of identity, reduction of distress, adaptive coping and 32 strategies to increase family acceptance. 33 (2) Does not include conversion therapy, as defined in 34 NRS 629.600. 35 (b) “Medically necessary” means health care services or 36 products that a prudent provider of health care would provide to a 37 patient to prevent, diagnose or treat an illness, injury or disease, or 38 any symptoms thereof, that are necessary and: 39 (1) Provided in accordance with generally accepted 40 standards of medical practice; 41 (2) Clinically appropriate with regard to type, frequency, 42 extent, location and duration; 43 (3) Not provided primarily for the convenience of the 44 patient or provider of health care; 45 – 7 – - *SB171* (4) Required to improve a specific health condition of a 1 patient or to preserve the existing state of health of the patient; 2 and 3 (5) The most clinically appropriate level of health care that 4 may be safely provided to the patient. 5  A provider of health care prescribing, ordering, recommending 6 or approving a health care service or product does not, by itself, 7 make that health care service or product medically necessary. 8 (c) “Provider of health care” has the meaning ascribed to it in 9 NRS 629.031. 10 (d) “State agency” means an agency, bureau, board, 11 commission, department, division, officer, employee, appointee or 12 agent or any other unit of the Executive Department of the State 13 Government. 14 Sec. 4. 1. Each health care licensing board that licenses 15 providers of health care who provide gender-affirming health care 16 services shall examine the feasibility of providing opportunities for 17 reciprocity of licensure to providers of health care who provide 18 gender-affirming health care services in other states to facilitate the 19 provision of quality gender-affirming health care services to persons 20 from other states who seek medically necessary gender-affirming 21 health care services in this State. 22 2. As used in this section: 23 (a) “Gender-affirming health care services” has the meaning 24 ascribed to it in section 1 of this act. 25 (b) “Health care licensing board” has the meaning ascribed to it 26 in section 1 of this act. 27 (c) “Medically necessary” has the meaning ascribed to it in 28 section 1 of this act. 29 (d) “Provider of health care” has the meaning ascribed to it in 30 NRS 629.031. 31 Sec. 5. This act becomes effective upon passage and approval. 32 H