SB189 - Provides for the licensure and regulation of genetic counselors. (BDR 54-69)

- 83rd Session (2025) Senate Bill No. 189–Senators Lange; Cannizzaro, Cruz-Crawford, Daly, Flores, Neal, Ohrenschall, Pazina, Scheible and Taylor CHAPTER.......... AN ACT relating to genetic counseling; prescribing certain duties and authority of a genetic counselor; providing for the regulation of the practice of genetic counseling by the Board of Medical Examiners; requiring the appointment of the Genetic Counseling Advisory Council; prescribing the requirements for the issuance and renewal of a license as a genetic counselor; authorizing the Board to take certain actions to investigate and impose discipline against a genetic counselor; prohibiting the unlicensed practice of genetic counseling except in certain circumstances; establishing a privilege for certain confidential communications; providing penalties; and providing other matters properly relating thereto. Legislative Counsel’s Digest: Existing law provides for the licensure and regulation of physicians, physician assistants, anesthesiologist assistants, perfusionists and practitioners of respiratory care by the Board of Medical Examiners. (Chapter 630 of NRS) This bill additionally provides for the licensure and regulation of genetic counselors by the Board. Sections 4-5.6 of this bill define certain terms, and section 14 of this bill establishes the applicability of those definitions. Section 40 of this bill makes it a felony for a person to practice genetic counseling or hold himself or herself out as a genetic counselor without a license. Section 7 of this bill prescribes the requirements to obtain such a license, including obtaining certain education, passing certain examinations and obtaining certification from the American Board of Genetic Counseling. Section 8 of this bill authorizes the Board to issue a temporary license under which a person who has obtained the required education but has not yet passed the required examination or obtained the required certification may engage in the supervised practice of genetic counseling. Section 6 of this bill requires the Board to adopt certain other regulations regarding the licensure and practice of genetic counselors. Section 9 of this bill authorizes certain unlicensed persons to provide assistance or consulting services related to genetic counseling, and section 16 of this bill exempts a genetic counselor of the Federal Government and permitted practitioners of other healing arts who are authorized to provide genetic counseling from licensure and regulation by the Board. Section 9 also authorizes a physician or a physician assistant to engage in genetic counseling as part of his or her practice without obtaining a license as a genetic counselor. Section 10 of this bill prescribes the date on which a license as a genetic counselor expires and the requirements to renew such a license. Section 23 of this bill prescribes the maximum fees that the Board may charge for the issuance or renewal of a license or a temporary license as a genetic counselor. Section 11 of this bill prescribes the procedure for the voluntary surrender of such a license. Section 12 of this bill prescribes the grounds for disciplinary action against a genetic counselor. Sections 24, 25 and 27 of this bill apply to genetic counselors the existing process for the filing of a complaint with the Board concerning a – 2 – - 83rd Session (2025) licensee or notifying the Board of certain actions taken against a licensee. Sections 26, 28-33, 36 and 38 of this bill apply to genetic counselors: (1) existing procedures for the investigation of complaints and the imposition of disciplinary action against licensees; and (2) certain other existing procedures to address incompetence or misconduct by a licensee. Section 34 of this bill applies to genetic counselors the existing procedure to remove limitations that the Board has placed on a license or to restore a revoked license. Sections 36, 37, 39 and 40 of this bill authorize or require the Board to take certain actions against a person who is practicing genetic counseling or holding himself or herself out as a genetic counselor without a license. Sections 13, 15 and 19-21 of this bill make various conforming changes so that genetic counselors are treated similarly to other providers of health care licensed by the Board for certain purposes related to licensure and regulation. Section 17 of this bill deems any act that constitutes the practice of genetic counseling to occur where the patient is located at the time the act is performed. Section 5.9 of this bill requires the Board to appoint the Genetic Counseling Advisory Council to advise the Board concerning the regulation of genetic counseling until January 1, 2031. After that date, section 18 of this bill authorizes the Board to select genetic counselors to serve as advisory members of the Board. Sections 22 and 35 of this bill subject genetic counselors to certain provisions required by federal law for the enforcement of child support obligations. (42 U.S.C. § 666) Existing law defines the term “provider of health care” to mean a person who practices any of certain professions related to the provision of health care. (NRS 629.031) Existing law imposes certain requirements upon providers of health care, including requirements for billing, standards for advertisements and criminal penalties for acquiring certain debts. (NRS 629.071, 629.076, 629.078) Section 1 of this bill includes genetic counselors in the definition of “provider of health care,” thereby subjecting genetic counselors to those same requirements. Section 42 of this bill requires a genetic counselor to report misconduct by a person licensed or certified by the State Board of Nursing to the Executive Director of that Board. Existing law establishes a privilege for confidential communications between a patient and a physician, dentist or chiropractor or person participating in the diagnosis or treatment of the patient under the direction of such a provider. (NRS 49.215-49.245) Section 48 of this bill extends that same privilege to apply to confidential communications between a patient and a genetic counselor or a person under the direction of a genetic counselor. Existing law provides that: (1) assault is generally a misdemeanor, with certain exceptions; and (2) assault upon a provider of health care is a gross misdemeanor or felony, depending on the circumstances. (NRS 200.471) Section 51 of this bill includes a genetic counselor within the definition of “provider of health care” for that purpose, thereby making assault upon a genetic counselor a gross misdemeanor or felony, depending on the circumstances. Section 52 of this bill requires a genetic counselor to report the abuse, neglect, exploitation, isolation or abandonment of an older person or vulnerable person or the abuse or neglect of a child in the same manner as other providers of health care. A genetic counselor would also be required to report the abuse, neglect or commercial sexual exploitation of a child. (NRS 432B.220, 432C.110) Sections 41, 43 and 44 of this bill provide that a genetic counselor acting within his or her scope of practice is not violating provisions governing certain other providers of health care. Sections 2, 45-47, 49, 50 and 53-59 of this bill make revisions to treat genetic counselors in the same manner as other similar providers of health care in other certain respects. – 3 – - 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 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 genetic counselor; (e) A dentist; [(e)] (f) A dental therapist; [(f)] (g) A dental hygienist; [(g)] (h) A licensed nurse; [(h)] (i) 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)] (j) A dispensing optician; [(j)] (k) An optometrist; [(k)] (l) A speech-language pathologist; [(l)] (m) An audiologist; [(m)] (n) A practitioner of respiratory care; [(n)] (o) A licensed physical therapist; [(o)] (p) An occupational therapist; [(p)] (q) A podiatric physician; [(q)] (r) A licensed psychologist; [(r)] (s) A licensed marriage and family therapist; [(s)] (t) A licensed clinical professional counselor; [(t)] (u) A music therapist; [(u)] (v) A chiropractic physician; [(v)] (w) An athletic trainer; [(w)] (x) A perfusionist; [(x)] (y) A doctor of Oriental medicine in any form; [(y)] (z) A medical laboratory director or technician; [(z)] (aa) A pharmacist; [(aa)] (bb) A licensed dietitian; – 4 – - 83rd Session (2025) [(bb)] (cc) 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)] (dd) An alcohol and drug counselor or a problem gambling counselor who is certified pursuant to chapter 641C of NRS; [(dd)] (ee) An alcohol and drug counselor or a clinical alcohol and drug counselor who is licensed pursuant to chapter 641C of NRS; [(ee)] (ff) A behavior analyst, assistant behavior analyst or registered behavior technician; [(ff)] (gg) A naprapath; or [(gg)] (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 629.580 is hereby amended to read as follows: 629.580 1. A person who provides wellness services in accordance with this section, but who is not licensed, certified or registered in this State as a provider of health care, is not in violation of any law based on the unlicensed practice of health care services or a health care profession unless the person: (a) Performs surgery or any other procedure which punctures the skin of any person; (b) Sets a fracture of any bone of any person; (c) Prescribes or administers X-ray radiation to any person; (d) Prescribes or administers a prescription drug or device or a controlled substance to any person; (e) Recommends to a client that he or she discontinue or in any manner alter current medical treatment prescribed by a provider of health care licensed, certified or registered in this State; (f) Makes a diagnosis of a medical disease of any person; (g) Performs a manipulation or a chiropractic adjustment of the articulations of joints or the spine of any person; (h) Treats a person’s health condition in a manner that intentionally or recklessly causes that person recognizable and imminent risk of serious or permanent physical or mental harm; (i) Holds out, states, indicates, advertises or implies to any person that he or she is a provider of health care; (j) Engages in the practice of medicine or genetic counseling in violation of chapter 630 or 633 of NRS, the practice of homeopathic – 5 – - 83rd Session (2025) medicine in violation of chapter 630A of NRS, the practice of naprapathy in violation of chapter 634B of NRS or the practice of podiatry in violation of chapter 635 of NRS, unless otherwise expressly authorized by this section; (k) Performs massage therapy as that term is defined in NRS 640C.060, reflexology as that term is defined in NRS 640C.080 or structural integration as that term is defined in NRS 640C.085; (l) Provides mental health services that are exclusive to the scope of practice of a psychiatrist licensed pursuant to chapter 630 or 633 of NRS, or a psychologist licensed pursuant to chapter 641 of NRS; or (m) Engages in the practice of applied behavior analysis in violation of chapter 641D of NRS. 2. Any person providing wellness services in this State who is not licensed, certified or registered in this State as a provider of health care and who is advertising or charging a fee for wellness services shall, before providing those services, disclose to each client in a plainly worded written statement: (a) The person’s name, business address and telephone number; (b) The fact that he or she is not licensed, certified or registered as a provider of health care in this State; (c) The nature of the wellness services to be provided; (d) The degrees, training, experience, credentials and other qualifications of the person regarding the wellness services to be provided; and (e) A statement in substantially the following form: It is recommended that before beginning any wellness plan, you notify your primary care physician or other licensed providers of health care of your intention to use wellness services, the nature of the wellness services to be provided and any wellness plan that may be utilized. It is also recommended that you ask your primary care physician or other licensed providers of health care about any potential drug interactions, side effects, risks or conflicts between any medications or treatments prescribed by your primary care physician or other licensed providers of health care and the wellness services you intend to receive.  A person who provides wellness services shall obtain from each client a signed copy of the statement required by this subsection, provide the client with a copy of the signed statement at the time of – 6 – - 83rd Session (2025) service and retain a copy of the signed statement for a period of not less than 5 years. 3. A written copy of the statement required by subsection 2 must be posted in a prominent place in the treatment location of the person providing wellness services in at least 12-point font. Reasonable accommodations must be made for clients who: (a) Are unable to read; (b) Are blind or visually impaired; (c) Have communication impairments; or (d) Do not read or speak English or any other language in which the statement is written. 4. Any adv [Text truncated for display. Full text available on LegiScan.]