SB165 - Establishes provisions relating to behavioral health. (BDR 54-145)

- 83rd Session (2025) Senate Bill No. 165–Senators Nguyen; Buck and Steinbeck CHAPTER.......... AN ACT relating to behavioral health; providing for the licensure and regulation of behavioral health and wellness practitioners; requiring the establishment of a Behavioral Health and Wellness Practitioner Advisory Group; authorizing the Board of Psychological Examiners to investigate and impose discipline on a behavioral health and wellness practitioner; prohibiting the unlicensed practice of behavioral health promotion and prevention; establishing a privilege for certain confidential communications between a patient and a behavioral health and wellness practitioner under certain circumstances; requiring Medicaid to cover behavioral health promotion and prevention services provided by a behavioral health and wellness practitioner; providing penalties; requiring certain allocations and transfers of money and authorizing certain expenditures; and providing other matters properly relating thereto. Legislative Counsel’s Digest: Existing law provides for the licensure of psychologists by the Board of Psychological Examiners. (NRS 641.160, 641.170, 641.196) The Board also registers psychological assistants, psychological interns and psychological trainees. (NRS 641.226) Section 10 of this bill defines “behavioral health and wellness practitioner” to mean a person who is licensed to practice behavioral health promotion and prevention. Section 11 of this bill defines “behavioral health promotion and prevention” to mean the supervised clinical use of prevention and intervention strategies relating to mental and behavioral health. Section 20 of this bill applies those definitions to the provisions of existing law governing licensure by the Board. Sections 13-19 and 21-49 of this bill provide for the licensure and regulation of behavioral health and wellness practitioners by the Board. Section 13: (1) requires the Board to adopt certain regulations governing behavioral health and wellness practitioners; and (2) authorizes the Board to accept gifts, grants, donations and other funds to assist in carrying out the provisions relating to behavioral health and wellness practitioners. Section 28 authorizes the Board to adopt additional regulations governing the practice of behavioral health promotion and prevention. Section 14 requires the Board to establish a Behavioral Health and Wellness Practitioner Advisory Group to provide the Board with expertise and assistance relating to the regulation of behavioral health and wellness practitioners. Section 83 eliminates the Advisory Group on December 31, 2028. Section 37.5 of this bill makes a conforming change to remove a reference to the Advisory Group after it ceases to exist. Section 15 prescribes the required qualifications to obtain a license as a behavioral health and wellness practitioner, and section 30 requires an applicant for such a license to undergo a fingerprint-based background check. Sections 16 and 17 prescribe procedures relating to the expiration and renewal of such a license. Section 18 authorizes certain providers of health care, including an advanced practice registered nurse who has psychiatric training and experience, to supervise a behavioral health and wellness practitioner. Section 5 of this bill – 2 – - 83rd Session (2025) requires the State Board of Nursing to adopt regulations establishing the psychiatric training and experience necessary for an advanced practice registered nurse to provide such supervision. Section 33 establishes the maximum fees for the issuance or renewal of a license to practice behavioral health promotion and prevention. Sections 21-23, 25 and 35-47 make the procedures for the investigation and discipline of psychologists and the grounds for disciplinary action against psychologists also apply to behavioral health and wellness practitioners. Section 48: (1) prohibits a person from representing himself or herself as a behavioral health and wellness practitioner unless he or she is licensed as a behavioral health and wellness practitioner; and (2) authorizes certain persons in a course of study to practice behavioral health promotion and prevention to engage in the supervised practice of behavioral health promotion and prevention without a license. Section 49 makes the practice of behavioral health promotion and prevention without a license or under a false or assumed name a gross misdemeanor. Section 12 of this bill provides that provisions governing psychologists and persons who provide behavioral health promotion and prevention services do not apply to certain government employees. Section 59 of this bill provides that any privilege for communications between a patient and the supervisor of a behavioral health and wellness practitioner also applies to communications between the patient and the behavioral health and wellness practitioner and other persons involved in the provision of behavioral health promotion and prevention services under the supervision of the behavioral health and wellness practitioner. Sections 19, 24, 26, 31 and 32 make conforming changes to include behavioral health and wellness practitioners within existing provisions where appropriate and exclude behavioral health and wellness practitioners from existing provisions that apply only to psychologists. Sections 1-4, 6, 34, 50, 52, 54, 56-58 and 60-62 of this bill make various revisions to treat behavioral health and wellness practitioners in the same manner as other similar providers of health care in certain circumstances. Section 7 of this bill clarifies that a music therapist is not authorized to practice behavioral health promotion and prevention. Sections 8, 51, 53 and 55 of this bill provide that a behavioral health and wellness practitioner acting within his or her scope of practice is not violating provisions governing certain other providers of health care. Existing law requires the Department of Health and Human Services to develop and administer a State Plan for Medicaid which includes a list of specific medical services required to be provided to Medicaid recipients. (NRS 422.063, 422.270) Section 66 of this bill requires Medicaid to include coverage for behavioral health promotion and prevention services provided by a behavioral health and wellness practitioner. Section 63 of this bill makes a conforming change to require the Director of the Department to administer the provisions of section 66 in the same manner as other provisions relating to Medicaid. To carry out the purposes of section 66, section 79.5 of this bill requires the transfer of money from the Account to Improve Health Care Quality and Access in the State General Fund to the Nevada Medicaid budget account and authorizes the expenditure of certain federal funding. Existing law: (1) creates the Account to Improve Health Care Quality and Access to hold the revenue collected from assessments and penalties imposed in certain circumstances against an operator of an agency to provide personal care services in the home or a medical facility that is required to obtain a license; and (2) requires the Division of Health Care Financing and Policy of the Department of Health and Human Services to administer the Account. (NRS 422.3791-422.3795) Existing law: (1) creates the Fund for a Resilient Nevada to hold the proceeds of certain litigation by this State concerning the manufacture, distribution, sale or marketing of opioids; and (2) requires the Director of the Department of Health and – 3 – - 83rd Session (2025) Human Services to administer the Fund. (NRS 433.732-433.740) Section 80 of this bill requires the Director to make allocations, as reimbursement during the 2025- 2027 biennium from the Fund, to the Nevada System of Higher Education and certain institutions within the System for the costs of the establishment of: (1) programs for the education and training of behavioral health and wellness practitioners; (2) an accredited internship program for psychologists with an emphasis in child psychology; and (3) scholarships for students enrolled in programs for the education and training of providers of health care who may supervise behavioral health and wellness practitioners. 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 629.031 is hereby amended to read as follows: 629.031 Except as otherwise provided by a specific statute: 1. “Provider of health care” means: (a) A physician licensed pursuant to chapter 630, 630A or 633 of NRS; (b) A physician assistant; (c) An anesthesiologist assistant; (d) A dentist; (e) A dental therapist; (f) A dental hygienist; (g) A licensed nurse; (h) A person who holds a license as an attendant or who is certified as an emergency medical technician, advanced emergency medical technician or paramedic pursuant to chapter 450B of NRS or authorized to practice as an emergency medical technician, advanced emergency medical technician or paramedic in this State under the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact ratified by NRS 450B.145; (i) A dispensing optician; (j) An optometrist; (k) A speech-language pathologist; (l) An audiologist; (m) A practitioner of respiratory care; (n) A licensed physical therapist; (o) An occupational therapist; (p) A podiatric physician; (q) A licensed psychologist; (r) A licensed marriage and family therapist; (s) A licensed clinical professional counselor; (t) A music therapist; – 4 – - 83rd Session (2025) (u) A chiropractic physician; (v) An athletic trainer; (w) A perfusionist; (x) A doctor of Oriental medicine in any form; (y) A medical laboratory director or technician; (z) A pharmacist; (aa) A licensed dietitian; (bb) An associate in social work, a social worker, a master social worker, an independent social worker or a clinical social worker licensed pursuant to chapter 641B of NRS; (cc) An alcohol and drug counselor or a problem gambling counselor who is certified pursuant to chapter 641C of NRS; (dd) An alcohol and drug counselor or a clinical alcohol and drug counselor who is licensed pursuant to chapter 641C of NRS; (ee) A behavior analyst, assistant behavior analyst or registered behavior technician; (ff) A naprapath; [or] (gg) A behavioral health and wellness practitioner; or (hh) A medical facility as the employer of any person specified in this subsection. 2. For the purposes of NRS 629.400 to 629.490, inclusive, the term includes a person who holds a current license or certificate to practice his or her respective discipline pursuant to the applicable provisions of law of another state or territory of the United States. Sec. 2. NRS 629.550 is hereby amended to read as follows: 629.550 1. If a patient communicates to a mental health professional an explicit threat of imminent serious physical harm or death to a clearly identified or identifiable person and, in the judgment of the mental health professional, the patient has the intent and ability to carry out the threat, the mental health professional shall place the patient on a mental health crisis hold pursuant to NRS 433A.160, petition for a court to order the placement of the patient on a mental health crisis hold pursuant to NRS 433A.155 or make a reasonable effort to communicate the threat in a timely manner to: (a) The person who is the subject of the threat; (b) The law enforcement agency with the closest physical location to the residence of the person; and (c) If the person is a minor, the parent or guardian of the person. 2. A mental health professional shall be deemed to have made a reasonable effort to communicate a threat pursuant to subsection 1 if: – 5 – - 83rd Session (2025) (a) The mental health professional actually communicates the threat in a timely manner; or (b) The mental health professional makes a good faith attempt to communicate the threat in a timely manner and the failure to actually communicate the threat in a timely manner does not result from the negligence or recklessness of the mental health professional. 3. A mental health professional who exercises reasonable care in determining that he or she: (a) Has a duty to take an action described in subsection 1 is not subject to civil or criminal liability or disciplinary action by a professional licensing board for disclosing confidential or privileged information. (b) Does not have a duty to take an action described in subsection 1 is not subject to civil or criminal liability or disciplinary action by a professional licensing board for any damages caused by the actions of a patient. 4. The provisions of this section do not: (a) Limit or affect the duty of the mental health professional to report child abuse or neglect pursuant to NRS 432B.220 or the commercial sexual exploitation of a child pursuant to NRS 432C.110; or (b) Modify any duty of a mental health professional to take precautions to prevent harm by a patient: (1) Who is in the custody of a hospital or other facility where the mental health professional is employed; or (2) Who is being discharged from such a facility. 5. As used in this section, “mental health professional” includes: (a) A physician or psychiatrist licensed to practice medicine in this State pursuant to chapter 630 or 633 of NRS; (b) A psychologist who is licensed to practice psychology pursuant to chapter 641 of NRS or authorized to practice psychology in this State pursuant to the Psychology Interjurisdictional Compact enacted in NRS 641.227; (c) A behavioral health and wellness practitioner licensed to practice behavioral health promotion and prevention pursuant to chapter 641 of NRS; (d) A social worker who: (1) Holds a master’s degree in social work; (2) Is licensed as a clinical social worker pursuant to chapter 641B of NRS; and – 6 – - 83rd Session (2025) (3) Is employed by the Division of Public and Behavioral Health of the Department of Health and Human Services; [(d)] (e) A registered nurse who: (1) Is licensed to practice professional nursing pursuant to chapter 632 of NRS; and (2) Holds a master’s degree in psychiatric nursing or a related field; [(e)] (f) A marriage and family therapist licensed pursuant to chapter 641A of NRS; [(f)] (g) A clinical professional counselor licensed pursuant to chapter 641A of NRS; and [(g)] (h) A person who is worki [Text truncated for display. 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