Text of NV SB 302 (2023)

S.B. 302 - *SB302* SENATE BILL NO. 302–SENATORS OHRENSCHALL, SCHEIBLE, SPEARMAN, D. HARRIS, FLORES; NEAL, NGUYEN AND PAZINA MARCH 16, 2023 ____________ Referred to Committee on Commerce and Labor SUMMARY—Revises provisions relating to health care. (BDR 54-55) 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. 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 services for gender-affirming services; prohibiting the Governor from surrendering, or issuing an arrest warrant for, a person who is charged in another state with a criminal violation related to gender-affirming services; prohibiting state agencies from assisting in certain investigations and proceedings initiated in other states related to gender-affirming services; requiring certain health care licensing boards to examine the feasibility of reciprocal licensure for health care providers who provide gender-affirming 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 Section 1 of this bill prohibits a health care licensing board from disqualifying a 3 person from licensure or subjecting a person to discipline because he or she 4 provided or assisted in providing gender-affirming services or was subject to 5 judgment, discipline or other sanction in another state for providing or assisting in 6 the provision of gender-affirming services if the gender-affirming services as 7 provided would have been lawful and consistent with standards for the practice of 8 the relevant profession in this State. Section 4 of this bill requires each health care 9 licensing board that licenses providers of health care who provide gender-affirming 10 services to examine the feasibility of providing reciprocal licensing to providers of 11 – 2 – - *SB302* health care in other states to facilitate the provision of gender-affirming services to 12 persons from other states who seek such services in this State. 13 In accordance with the Extradition Clause of Section 2 of Article IV of the 14 United States Constitution, existing state law provides that it is the duty of the 15 Governor to have arrested and delivered up to the executive authority of any other 16 state any person charged in that state with treason, felony or other crime, who has 17 fled from justice and is found in this State. (NRS 179.181) Under existing law, the 18 Governor is also authorized, but not required, to surrender, on demand of the 19 executive authority of any other state, any person in this State charged in the other 20 state with committing an act in this State, or in a third state, intentionally resulting 21 in a crime in the state whose executive authority is making the demand, even 22 though the accused was not in that state at the time of the commission of the crime, 23 and has not thereafter fled from that state. (NRS 179.189) Section 2 of this bill 24 prohibits the Governor from surrendering, or issuing a warrant of arrest for, a 25 person in this State who is charged in another state with a criminal violation of the 26 laws of that other state if the violation involves the provision or receipt of or 27 assistance with gender-affirming services, unless the acts forming the basis of the 28 prosecution of the crime would also constitute a criminal offense under the laws of 29 this State. Section 2 excludes from that prohibition circumstances in which the 30 executive authority of another state demands the surrender of a person who was 31 physically present in the demanding state at the time of the commission of the 32 alleged offense and thereafter fled from that state. 33 Section 3 of this bill prohibits state agencies in the Executive Department of 34 the State Government from providing information or expending or using time, 35 money, facilities, property, equipment, personnel or other resources of the State in 36 furtherance of an investigation or proceeding initiated in or by another state related 37 to the provision, securing or receiving of or any inquiry concerning gender- 38 affirming services, except under certain limited circumstances. 39 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 gender- 5 affirming 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 gender-affirming 10 services, 11  if the gender-affirming services as provided would have been 12 lawful and consistent with standards for the practice of the 13 relevant profession in this State. 14 2. As used in this section: 15 (a) “Gender-affirming services” means medical, surgical, 16 counseling or referral services that respect the gender identity or 17 – 3 – - *SB302* expression of the patient and are found by a competent medical 1 professional to be appropriate based upon the wishes of a patient 2 and in accordance with the laws of this State, including, without 3 limitation: 4 (1) Interventions to suppress the development of 5 endogenous secondary sex characteristics; 6 (2) Interventions to align the appearance or physical body 7 of the patient with the gender identity or expression of the patient; 8 (3) Interventions to alleviate symptoms of clinically 9 significant distress resulting from gender dysphoria, as defined in 10 the most recent edition of the Diagnostic and Statistical Manual of 11 Mental Disorders published by the American Psychiatric 12 Association; and 13 (4) Developmentally appropriate exploration and 14 integration of identity, reduction of distress, adaptive coping and 15 strategies to increase family acceptance. 16 (b) “Health care licensing board” means: 17 (1) A board created pursuant to chapter 630, 630A, 631, 18 632, 633, 634, 634A, 635, 636, 637, 637B, 639, 640, 640A, 640B, 19 640C, 640D, 640E, 641, 641A, 641B, 641C or 641D of NRS. 20 (2) The Division of Public and Behavioral Health of the 21 Department of Health and Human Services. 22 Sec. 2. Chapter 179 of NRS is hereby amended by adding 23 thereto a new section to read as follows: 24 1. Notwithstanding the provisions of NRS 179.177 to 179.235, 25 inclusive, the Governor shall not surrender, or issue a warrant 26 pursuant to NRS 179.191 for the arrest of, any person in this State 27 who is charged in another state with a criminal violation of the 28 laws of that other state if the violation alleged involves the 29 provision or receipt of or assistance with gender-affirming 30 services, unless the acts forming the basis of the prosecution of the 31 crime charged would constitute a criminal offense under the laws 32 of the State of Nevada. 33 2. The provisions of this section do not apply in the 34 circumstance where a demand for the extradition of a person 35 charged with a crime in another state is made in accordance with 36 NRS 179.183, and the person who is the subject of the demand 37 was physically present in the demanding state at the time of the 38 commission of the alleged offense and thereafter fled from that 39 state. 40 3. As used in this section: 41 (a) “Gender-affirming services” means medical, surgical, 42 counseling or referral services that respect the gender identity or 43 expression of the patient and are found by a competent medical 44 professional to be appropriate based upon the wishes of a patient 45 – 4 – - *SB302* and in accordance with the laws of this State, including, without 1 limitation: 2 (1) Interventions to suppress the development of 3 endogenous secondary sex characteristics; 4 (2) Interventions to align the appearance or physical body 5 of the patient with the gender identity or expression of the patient; 6 (3) Interventions to alleviate symptoms of clinically 7 significant distress resulting from gender dysphoria, as defined in 8 the most recent edition of the Diagnostic and Statistical Manual of 9 Mental Disorders published by the American Psychiatric 10 Association; and 11 (4) Developmentally appropriate exploration and 12 integration of identity, reduction of distress, adaptive coping and 13 strategies to increase family acceptance. 14 (b) The words and terms defined in NRS 179.179 have the 15 meanings ascribed to them in that section. 16 Sec. 3. Chapter 232 of NRS is hereby amended by adding 17 thereto a new section to read as follows: 18 1. Except as required by the order of a court of competent 19 jurisdiction, a state agency shall not provide any information or 20 expend or use time, money, facilities, property, equipment, 21 personnel or other resources of the State in furtherance of any 22 investigation or proceeding initiated in or by another state that 23 seeks to impose civil or criminal liability or professional sanction 24 upon a person or entity for: 25 (a) The provision, securing or receiving of, or any inquiry 26 concerning, gender-affirming services that are legal in this State; 27 or 28 (b) Any assistance given to any person or entity that relates to 29 the provision, securing or receiving of, or any inquiry concerning, 30 gender-affirming services that are legal in this State. 31 2. The provisions of subsection 1 do not apply to any 32 investigation or proceeding where the conduct that is subject to 33 potential liability under the investigation or proceeding initiated in 34 or by the other state would be subject to civil or criminal liability 35 or professional sanction under the laws of the State of Nevada, if 36 committed in this State. 37 3. Notwithstanding the provisions of this section, a state 38 agency or employee, appointee, officer or other person acting on 39 behalf of a state agency may provide information or assistance in 40 connection with such an investigation or proceeding in response 41 to a written request by the person who is the subject of the 42 investigation or proceeding. 43 4. As used in this section: 44 – 5 – - *SB302* (a) “Gender-affirming services” means medical, surgical, 1 counseling or referral services that respect the gender identity or 2 expression of the patient and are found by a competent medical 3 professional to be appropriate based upon the wishes of a patient 4 and in accordance with the laws of this State, including, without 5 limitation: 6 (1) Interventions to suppress the development of 7 endogenous secondary sex characteristics; 8 (2) Interventions to align the appearance or physical body 9 of the patient with the gender identity or expression of the patient; 10 (3) Interventions to alleviate symptoms of clinically 11 significant distress resulting from gender dysphoria, as defined in 12 the most recent edition of the Diagnostic and Statistical Manual of 13 Mental Disorders published by the American Psychiatric 14 Association; and 15 (4) Developmentally appropriate exploration and 16 integration of identity, reduction of distress, adaptive coping and 17 strategies to increase family acceptance. 18 (b) “State agency” means an agency, bureau, board, 19 commission, department, division, officer, employee, appointee or 20 agent or any other unit of the Executive Department of the State 21 Government. 22 Sec. 4. 1. Each health care licensing board that licenses 23 providers of health care who provide gender-affirming services shall 24 examine the feasibility of providing opportunities for reciprocity of 25 licensure to providers of health care who provide gender-affirming 26 services in other states to facilitate the provision of quality gender- 27 affirming services to persons from other states who seek gender- 28 affirming services in this State. 29 2. As used in this section: 30 (a) “Gender-affirming services” has the meaning ascribed to it in 31 section 1 of this act. 32 (b) “Health care licensing board” has the meaning ascribed to it 33 in section 1 of this act. 34 (c) “Provider of health care” has the meaning ascribed to it in 35 NRS 629.031. 36 Sec. 5. This act becomes effective upon passage and approval. 37 H