S.B.

228

SENATE BILL NO. 228COMMITTEE ON

HEALTH AND HUMAN SERVICES

FEBRUARY 28, 2017

____________

Referred to Committee on Judiciary

SUMMARYRevises provisions relating to registry identification
cards and letters of approval. (BDR 40-576)
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 the medical use of marijuana; authorizing the

issuance of a registry identification card or letter of
approval to engage in the medical use of marijuana for
certain patients who suffer from opioid addiction;
authorizing additional providers of health care to provide
the written documentation necessary for such a patient to
obtain a registry identification card or letter of approval;
and providing other matters properly relating thereto.
Legislative Counsels Digest:
1 Existing law exempts a person who holds a valid registry identification card
2 from state prosecution for possession, delivery and production of marijuana. (NRS
3 453A.200) Existing law requires a person who wishes to obtain a registry
4 identification card or letter of approval to obtain written documentation from his or
5 her attending physician stating that: (1) he or she has been diagnosed with a chronic
6 or debilitating medical condition; (2) the medical use of marijuana may mitigate the
7 symptoms or effects of that condition; and (3) the attending physician has explained
8 the possible risks and benefits of the medical use of marijuana. (NRS 453A.210)
9 Section 2 of this bill includes opioid addiction within the definition of chronic or
10 debilitating medical condition. Section 1 of this bill includes licensed advanced
11 practice registered nurses, psychologists, clinical professional counselors, clinical
12 social workers, alcohol and drug abuse counselors and clinical alcohol and drug
13 abuse counselors who have responsibility for the care and treatment of a person
14 diagnosed with opioid addiction as attending providers of health care who may
15 provide written documentation to a patient for obtaining a registry identification
16 card or letter of approval. Sections 3-9, 11, 17 and 18 of this bill make conforming
17 changes.
18 Existing law prohibits the Board of Medical Examiners or the State Board of
19 Osteopathic Medicine from taking disciplinary action against an attending

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20 physician on the basis of the attending physician engaging in certain acts relating to
21 the medical use of marijuana. (NRS 453A.500, 630.3066, 633.521) Sections 10
22 and 12-16 of this bill similarly prohibit the State Board of Nursing, Board of
23 Psychological Examiners, Board of Examiners for Marriage and Family Therapists
24 and Clinical Professional Counselors, Board of Examiners for Social Workers and
25 Board of Examiners for Alcohol, Drug and Gambling Counselors from taking
26 disciplinary action against an attending provider of health care.

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN

SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

1 Section 1. NRS 453A.030 is hereby amended to read as

2 follows:
3 453A.030 Attending [physician] provider of health care
4 means [a] :
5 1. A physician who:
6 [1.] (a) Is licensed to practice:
7 [(a)] (1) Medicine pursuant to the provisions of chapter 630 of
8 NRS; or
9 [(b)] (2) Osteopathic medicine pursuant to the provisions of
10 chapter 633 of NRS; and
11 [2.] (b) Has responsibility for the care and treatment of a person
12 diagnosed with a chronic or debilitating medical condition.
13 2. A person who:
14 (a) Is licensed to practice as:
15 (1) An advanced practice registered nurse pursuant to the
16 provisions of chapter 632 of NRS;
17 (2) A psychologist pursuant to the provisions of chapter 641
18 of NRS;
19 (3) A clinical professional counselor pursuant to the
20 provisions of chapter 641A of NRS;
21 (4) A clinical social worker pursuant to the provisions of
22 chapter 641B of NRS; or
23 (5) An alcohol and drug abuse counselor or a clinical
24 alcohol and drug abuse counselor pursuant to the provisions of
25 chapter 641C of NRS; and
26 (b) Has responsibility for the care and treatment of a person
27 diagnosed with opioid addiction.
28 Sec. 2. NRS 453A.050 is hereby amended to read as follows:
29 453A.050 Chronic or debilitating medical condition means:
30 1. Acquired immune deficiency syndrome;
31 2. Cancer;
32 3. Glaucoma;
33 4. Opioid addiction;

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1 5. A medical condition or treatment for a medical condition

2 that produces, for a specific patient, one or more of the following:
3 (a) Cachexia;
4 (b) Persistent muscle spasms, including, without limitation,
5 spasms caused by multiple sclerosis;
6 (c) Seizures, including, without limitation, seizures caused by
7 epilepsy;
8 (d) Severe nausea; or
9 (e) Severe pain; or
10 [5.] 6. Any other medical condition or treatment for a medical
11 condition that is:
12 (a) Classified as a chronic or debilitating medical condition by
13 regulation of the Division; or
14 (b) Approved as a chronic or debilitating medical condition
15 pursuant to a petition submitted in accordance with NRS 453A.710.
16 Sec. 3. NRS 453A.080 is hereby amended to read as follows:
17 453A.080 1. Designated primary caregiver means a person
18 who:
19 (a) Is 18 years of age or older;
20 (b) Has significant responsibility for managing the well-being of
21 a person diagnosed with a chronic or debilitating medical condition;
22 and
23 (c) Is designated as such in the manner required pursuant to
24 NRS 453A.250.
25 2. The term does not include the attending [physician] provider
26 of health care of a person diagnosed with a chronic or debilitating
27 medical condition.
28 Sec. 4. NRS 453A.170 is hereby amended to read as follows:
29 453A.170 Written documentation means:
30 1. A statement signed by the attending [physician] provider of
31 health care of a person diagnosed with a chronic or debilitating
32 medical condition; or
33 2. Copies of the relevant medical records of a person diagnosed
34 with a chronic or debilitating medical condition.
35 Sec. 5. NRS 453A.210 is hereby amended to read as follows:
36 453A.210 1. The Division shall establish and maintain a
37 program for the issuance of registry identification cards and letters
38 of approval to persons who meet the requirements of this section.
39 2. Except as otherwise provided in subsections 3 and 5 and
40 NRS 453A.225, the Division or its designee shall issue a registry
41 identification card to a person who is a resident of this State and
42 who submits an application on a form prescribed by the Division
43 accompanied by the following:
44 (a) Valid, written documentation from the persons attending
45 [physician] provider of health care stating that:

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1 (1) The person has been diagnosed with a chronic or

2 debilitating medical condition;
3 (2) The medical use of marijuana may mitigate the symptoms
4 or effects of that condition; and
5 (3) The attending [physician] provider of health care has
6 explained the possible risks and benefits of the medical use of
7 marijuana;
8 (b) The name, address, telephone number, social security
9 number and date of birth of the person;
10 (c) Proof satisfactory to the Division that the person is a resident
11 of this State;
12 (d) The name, address and telephone number of the persons
13 attending [physician;] provider of health care;
14 (e) If the person elects to designate a primary caregiver at the
15 time of application:
16 (1) The name, address, telephone number and social security
17 number of the designated primary caregiver; and
18 (2) A written, signed statement from the persons attending
19 [physician] provider of health care in which the attending
20 [physician] provider of health care approves of the designation of
21 the primary caregiver; and
22 (f) If the person elects to designate a medical marijuana
23 dispensary at the time of application, the name of the medical
24 marijuana dispensary.
25 3. The Division or its designee shall issue a registry
26 identification card to a person who is at least 10 years of age but less
27 than 18 years of age or a letter of approval to a person who is less
28 than 10 years of age if:
29 (a) The person submits the materials required pursuant to
30 subsection 2; and
31 (b) The custodial parent or legal guardian with responsibility for
32 health care decisions for the person under 18 years of age signs a
33 written statement setting forth that:
34 (1) The attending [physician] provider of health care of the
35 person under 18 years of age has explained to that person and to the
36 custodial parent or legal guardian with responsibility for health care
37 decisions for the person under 18 years of age the possible risks and
38 benefits of the medical use of marijuana;
39 (2) The custodial parent or legal guardian with responsibility
40 for health care decisions for the person under 18 years of age
41 consents to the use of marijuana by the person under 18 years of age
42 for medical purposes;
43 (3) The custodial parent or legal guardian with responsibility
44 for health care decisions for the person under 18 years of age agrees

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1 to serve as the designated primary caregiver for the person under 18

2 years of age; and
3 (4) The custodial parent or legal guardian with responsibility
4 for health care decisions for the person under 18 years of age agrees
5 to control the acquisition of marijuana and the dosage and frequency
6 of use by the person under 18 years of age.
7 4. The form prescribed by the Division to be used by a person
8 applying for a registry identification card or letter of approval
9 pursuant to this section must be a form that is in quintuplicate. Upon
10 receipt of an application that is completed and submitted pursuant to
11 this section, the Division shall:
12 (a) Record on the application the date on which it was received;
13 (b) Retain one copy of the application for the records of the
14 Division; and
15 (c) Distribute the other four copies of the application in the
16 following manner:
17 (1) One copy to the person who submitted the application;
18 (2) One copy to the applicants designated primary caregiver,
19 if any;
20 (3) One copy to the Central Repository for Nevada Records
21 of Criminal History; and
22 (4) One copy to:
23 (I) If the attending [physician] provider of health care of
24 the applicant is licensed to practice medicine pursuant to the
25 provisions of chapter 630 of NRS, the Board of Medical Examiners;
26 [or]
27 (II) If the attending provider of health care of the
28 applicant is licensed as an advanced practice registered nurse
29 pursuant to the provisions of chapter 632 of NRS, the State Board
30 of Nursing;
31 (III) If the attending [physician] provider of health care
32 of the applicant is licensed to practice osteopathic medicine pursuant
33 to the provisions of chapter 633 of NRS, the State Board of
34 Osteopathic Medicine [.] ;
35 (IV) If the attending provider of health care of the
36 applicant is licensed as a psychologist pursuant to the provisions
37 of chapter 641 of NRS, the Board of Psychological Examiners;
38 (V) If the attending provider of health care of the
39 applicant is licensed as a clinical professional counselor pursuant
40 to the provisions of chapter 641A of NRS, the Board of Examiners
41 for Marriage and Family Therapists and Clinical Professional
42 Counselors;
43 (VI) If the attending provider of health care of the
44 applicant is licensed as a clinical social worker pursuant to the

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1 provisions of chapter 641B of NRS, the Board of Examiners for

2 Social Workers; or
3 (VII) If the attending provider of health care of the
4 applicant is licensed as an alcohol and drug abuse counselor or a
5 clinical alcohol and drug abuse counselor pursuant to the
6 provisions of chapter 641C of NRS, the Board of Examiners for
7 Alcohol, Drug and Gambling Counselors.
8 The Central Repository for Nevada Records of Criminal History
9 shall report to the Division its findings as to the criminal history, if
10 any, of an applicant within 15 days after receiving a copy of an
11 application pursuant to subparagraph (3) of paragraph (c). The
12 [Board of Medical Examiners or the State Board of Osteopathic
13 Medicine, as] applicable [,] state professional board shall report to
14 the Division its findings as to the licensure and standing of the
15 applicants attending [physician] provider of health care within 15
16 days after receiving a copy of an application pursuant to
17 subparagraph (4) of paragraph (c).
18 5. The Division shall verify the information contained in an
19 application submitted pursuant to this section and shall approve or
20 deny an application within 30 days after receiving the application.
21 The Division may contact an applicant, the applicants attending
22 [physician] provider of health care and designated primary
23 caregiver, if any, by telephone to determine that the information
24 provided on or accompanying the application is accurate. The
25 Division may deny an application only on the following grounds:
26 (a) The applicant failed to provide the information required
27 pursuant to subsections 2 and 3 to:
28 (1) Establish the applicants chronic or debilitating medical
29 condition; or
30 (2) Document the applicants consultation with an attending
31 [physician] provider of health care regarding the medical use of
32 marijuana in connection with that condition;
33 (b) The applicant failed to comply with regulations adopted by
34 the Division, including, without limitation, the regulations adopted
35 by the Administrator pursuant to NRS 453A.740;
36 (c) The Division determines that the information provided by
37 the applicant was falsified;
38 (d) The Division determines that the attending [physician]
39 provider of health care of the applicant is not licensed [to practice
40 medicine or osteopathic medicine] in this State or is not in good
41 standing, as reported by the [Board of Medical Examiners or the
42 State Board of Osteopathic Medicine, as] applicable [;] state
43 professional board.

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1 (e) The Division determines that the applicant, or the applicants

2 designated primary caregiver, if applicable, has been convicted of
3 knowingly or intentionally selling a controlled substance;
4 (f) The Division has prohibited the applicant from obtaining or
5 using a registry identification card or letter of approval pursuant to
6 subsection 2 of NRS 453A.300;
7 (g) The Division determines that the applicant, or the applicants
8 designated primary caregiver, if applicable, has had a registry
9 identification card or letter of approval revoked pursuant to NRS
10 453A.225; or
11 (h) In the case of a person under 18 years of age, the custodial
12 parent or legal guardian with responsibility for health care decisions
13 for the person has not signed the written statement required pursuant
14 to paragraph (b) of subsection 3.
15 6. The decision of the Division to deny an application for a
16 registry identification card or letter of approval is a final decision for
17 the purposes of judicial review. Only the person whose application
18 has been denied or, in the case of a person under 18 years of age
19 whose application has been denied, the persons parent or legal
20 guardian, has standing to contest the determination of the Division.
21 A judicial review authorized pursuant to this subsection must be
22 limited to a determination of whether the denial was arbitrary,
23 capricious or otherwise characterized by an abuse of discretion and
24 must be conducted in accordance with the procedures set forth in
25 chapter 233B of NRS for reviewing a final decision of an agency.
26 7. A person whose application has been denied may not
27 reapply for 6 months after the date of the denial, unless the Division
28 or a court of competent jurisdiction authorizes reapplication in a
29 shorter time.
30 8. Except as otherwise provided in this subsection, if a person
31 has applied for a registry identification card or letter of approval
32 pursuant to this section and the Division has not yet approved or
33 denied the application, the person, and the persons designated
34 primary caregiver, if any, shall be deemed to hold a registry
35 identification card or letter of approval upon the presentation to a
36 law enforcement officer of the copy of the application provided to
37 him or her pursuant to subsection 4.
38 9. As used in this section, resident has the meaning ascribed
39 to it in NRS 483.141.
40 Sec. 6. NRS 453A.230 is hereby amended to read as follows:
41 453A.230 1. A person to whom the Division or its designee
42 has issued a registry identification card or letter of approval
43 pursuant to paragraph (a) of subsection 1 of NRS 453A.220 shall, in
44 accordance with regulations adopted by the Division:

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1 (a) Notify the Division of any change in the persons name,

2 address, telephone number, designated medical marijuana
3 dispensary, attending [physician] provider of health care or
4 designated primary caregiver, if any; and
5 (b) Submit annually to the Division:
6 (1) Updated written documentation from the persons
7 attending [physician] provider of health care in which the attending
8 [physician] provider of health care sets forth that:
9 (I) The person continues to suffer from a chronic or
10 debilitating medical condition;
11 (II) The medical use of marijuana may mitigate the
12 symptoms or effects of that condition; and
13 (III) The attending [physician] provider of health care
14 has explained to the person the possible risks and benefits of the
15 medical use of marijuana; and
16 (2) If the person elects to designate a primary caregiver for
17 the subsequent year and the primary caregiver so designated was not
18 the persons designated primary caregiver during the previous year:
19 (I) The name, address, telephone number and social
20 security number of the designated primary caregiver; and
21 (II) A written, signed statement from the persons
22 attending [physician] provider of health care in which the attending
23 [physician] provider of health care approves of the designation of
24 the primary caregiver.
25 2. A person to whom the Division or its designee has issued a
26 registry identification card pursuant to paragraph (b) of subsection 1
27 of NRS 453A.220 or pursuant to NRS 453A.250 shall, in
28 accordance with regulations adopted by the Division, notify the
29 Division of any change in the persons name, address, telephone
30 number, designated medical marijuana dispensary or the identity of
31 the person for whom he or she acts as designated primary caregiver.
32 3. If a person fails to comply with the provisions of subsection
33 1 or 2, the registry identification card or letter of approval issued to
34 the person shall be deemed expired. If the registry identification
35 card or letter of approval of a person to whom the Division or its
36 designee issued the card or letter pursuant to paragraph (a) of
37 subsection 1 of NRS 453A.220 is deemed expired pursuant to this
38 subsection, a registry identification card issued to the persons
39 designated primary caregiver, if any, shall also be deemed expired.
40 Upon the deemed expiration of a registry identification card or letter
41 of approval pursuant to this subsection:
42 (a) The Division shall send, by certified mail, return receipt
43 requested, notice to the person whose registry identification card or
44 letter of approval has been deemed expired, advising the person of
45 the requirements of paragraph (b); and

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1 (b) The person shall return his or her registry identification card
2 or letter of approval to the Division within 7 days after receiving the
3 notice sent pursuant to paragraph (a).
4 Sec. 7. NRS 453A.240 is hereby amended to read as follows:
5 453A.240 If a person to whom the Division or its designee has
6 issued a registry identification card or letter of approval pursuant to
7 paragraph (a) of subsection 1 of NRS 453A.220 is diagnosed by the
8 persons attending [physician] provider of health care as no longer
9 having a chronic or debilitating medical condition, the person shall
10 return his or her registry identification card or letter of approval and
11 his or her designated primary caregiver, if any, shall return his or
12 her registry identification card to the Division within 7 days after
13 notification of the diagnosis.
14 Sec. 8. NRS 453A.310 is hereby amended to read as follows:
15 453A.310 1. Except as otherwise provided in this section and
16 NRS 453A.300, it is an affirmative defense to a criminal charge of
17 possession, delivery or production of marijuana, or any other
18 criminal offense in which possession, delivery or production of
19 marijuana is an element, that the person charged with the offense:
20 (a) Is a person who:
21 (1) Has been diagnosed with a chronic or debilitating
22 medical condition within the 12-month period preceding his or her
23 arrest and has been advised by his or her attending [physician]
24 provider of health care that the medical use of marijuana may
25 mitigate the symptoms or effects of that chronic or debilitating
26 medical condition;
27 (2) Is engaged in the medical use of marijuana; and
28 (3) Possesses, delivers or produces marijuana only in the
29 amount described in paragraph (b) of subsection 3 of NRS
30 453A.200 or in excess of that amount if the person proves by a
31 preponderance of the evidence that the greater amount is medically
32 necessary as determined by the persons attending [physician]
33 provider of health care to mitigate the symptoms or effects of the
34 persons chronic or debilitating medical condition; or
35 (b) Is a person who:
36 (1) Is assisting a person described in paragraph (a) in the
37 medical use of marijuana; and
38 (2) Possesses, delivers or produces marijuana only in the
39 amount described in paragraph (b) of subsection 3 of NRS
40 453A.200 or in excess of that amount if the person proves by a
41 preponderance of the evidence that the greater amount is medically
42 necessary as determined by the assisted persons attending
43 [physician] provider of health care to mitigate the symptoms or
44 effects of the assisted persons chronic or debilitating medical
45 condition.

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1 2. A person need not hold a registry identification card or letter

2 of approval issued to the person by the Division or its designee
3 pursuant to NRS 453A.220 or 453A.250 to assert an affirmative
4 defense described in this section.
5 3. Except as otherwise provided in this section and in addition
6 to the affirmative defense described in subsection 1, a person
7 engaged or assisting in the medical use of marijuana who is charged
8 with a crime pertaining to the medical use of marijuana is not
9 precluded from:
10 (a) Asserting a defense of medical necessity; or
11 (b) Presenting evidence supporting the necessity of marijuana
12 for treatment of a specific disease or medical condition,
13 if the amount of marijuana at issue is not greater than the amount
14 described in paragraph (b) of subsection 3 of NRS 453A.200 and the
15 person has taken steps to comply substantially with the provisions of
16 this chapter.
17 4. A defendant who intends to offer an affirmative defense
18 described in this section shall, not less than 5 days before trial or at
19 such other time as the court directs, file and serve upon the
20 prosecuting attorney a written notice of the defendants intent to
21 claim the affirmative defense. The written notice must:
22 (a) State specifically why the defendant believes he or she is
23 entitled to assert the affirmative defense; and
24 (b) Set forth the factual basis for the affirmative defense.
25 A defendant who fails to provide notice of his or her intent to
26 claim an affirmative defense as required pursuant to this subsection
27 may not assert the affirmative defense at trial unless the court, for
28 good cause shown, orders otherwise.
29 Sec. 9. NRS 453A.370 is hereby amended to read as follows:
30 453A.370 The Division shall adopt such regulations as it
31 determines to be necessary or advisable to carry out the provisions
32 of NRS 453A.320 to 453A.370, inclusive. Such regulations are in
33 addition to any requirements set forth in statute and must, without
34 limitation:
35 1. Prescribe the form and any additional required content of
36 registration and renewal applications submitted pursuant to NRS
37 453A.322 and 453A.332.
38 2. Set forth rules pertaining to the safe and healthful operation
39 of medical marijuana establishments, including, without limitation:
40 (a) The manner of protecting against diversion and theft without
41 imposing an undue burden on medical marijuana establishments or
42 compromising the confidentiality of the holders of registry
43 identification cards and letters of approval.
44 (b) Minimum requirements for the oversight of medical
45 marijuana establishments.

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1 (c) Minimum requirements for the keeping of records by

2 medical marijuana establishments.
3 (d) Provisions for the security of medical marijuana
4 establishments, including, without limitation, requirements for the
5 protection by a fully operational security alarm system of each
6 medical marijuana establishment.
7 (e) Procedures pursuant to which medical marijuana
8 dispensaries must use the services of an independent testing
9 laboratory to ensure that any marijuana, edible marijuana products
10 and marijuana-infused products sold by the dispensaries to end users
11 are tested for content, quality and potency in accordance with
12 standards established by the Division.
13 (f) Procedures pursuant to which a medical marijuana
14 dispensary will be notified by the Division if a patient who holds a
15 valid registry identification card or letter of approval has chosen the
16 dispensary as his or her designated medical marijuana dispensary, as
17 described in NRS 453A.366.
18 3. Establish circumstances and procedures pursuant to which
19 the maximum fees set forth in NRS 453A.344 may be reduced over
20 time:
21 (a) To ensure that the fees imposed pursuant to NRS 453A.344
22 are, insofar as may be practicable, revenue neutral; and
23 (b) To reflect gifts and grants received by the Division pursuant
24 to NRS 453A.720.
25 4. Set forth the amount of usable marijuana that a medical
26 marijuana dispensary may dispense to a person who holds a valid
27 registry identification card, including, without limitation, a
28 designated primary caregiver, in any one 14-day period. Such an
29 amount must not exceed the limits set forth in NRS 453A.200.
30 5. As far as possible while maintaining accountability, protect
31 the identity and personal identifying information of each person who
32 receives, facilitates or delivers services in accordance with this
33 chapter.
34 6. In cooperation with the Board of Medical Examiners [and] ,
35 the State Board of Nursing, the State Board of Osteopathic
36 Medicine, the Board of Psychological Examiners, the Board of
37 Examiners for Marriage and Family Therapists and Clinical
38 Professional Counselors, the Board of Examiners for Social
39 Workers and the Board of Examiners for Alcohol, Drug and
40 Gambling Counselors, establish a system to:
41 (a) Register and track attending [physicians] providers of health
42 care who advise their patients that the medical use of marijuana may
43 mitigate the symptoms or effects of the patients medical condition;

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1 (b) Insofar as is possible, track and quantify the number of times

2 an attending [physician] provider of health care described in
3 paragraph (a) makes such an advisement; and
4 (c) Provide for the progressive discipline of attending
5 [physicians] providers of health care who advise the medical use of
6 marijuana at a rate at which the Division and Board determine and
7 agree to be unreasonably high.
8 7. Establish different categories of medical marijuana
9 establishment agent registration cards, including, without limitation,
10 criteria for training and certification, for each of the different types
11 of medical marijuana establishments at which such an agent may be
12 employed or volunteer or provide labor as a medical marijuana
13 establishment agent.
14 8. Provide for the maintenance of a log by the Division of each
15 person who is authorized to cultivate, grow or produce marijuana
16 pursuant to subsection 6 of NRS 453A.200. The Division shall
17 ensure that the contents of the log are available for verification by
18 law enforcement personnel 24 hours a day.
19 9. Address such other matters as may assist in implementing
20 the program of dispensation contemplated by NRS 453A.320 to
21 453A.370, inclusive.
22 Sec. 10. NRS 453A.500 is hereby amended to read as follows:
23 453A.500 The Board of Medical Examiners [or] , the State
24 Board of Nursing, the State Board of Osteopathic Medicine, the
25 Board of Psychological Examiners, the Board of Examiners for
26 Marriage and Family Therapists and Clinical Professional
27 Counselors, the Board of Examiners for Social Workers or the
28 Board of Examiners for Alcohol, Drug and Gambling Counselors,
29 as applicable, shall not take any disciplinary action against an
30 attending [physician] provider of health care on the basis that the
31 attending [physician:] provider of health care:
32 1. Advised a person whom the attending [physician] provider
33 of health care has diagnosed as having a chronic or debilitating
34 medical condition, or a person whom the attending [physician]
35 provider of health care knows has been so diagnosed by another
36 [physician] provider of health care licensed [to practice medicine]
37 pursuant to the provisions of chapter 630 , 632, 633, 641A, 641B or
38 641C of NRS : [or licensed to practice osteopathic medicine
39 pursuant to the provisions of chapter 633 of NRS:]
40 (a) About the possible risks and benefits of the medical use of
41 marijuana; or
42 (b) That the medical use of marijuana may mitigate the
43 symptoms or effects of the persons chronic or debilitating medical
44 condition,

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1 if the advice is based on the attending [physicians] provider of

2 health cares personal assessment of the persons medical history
3 and current medical condition.
4 2. Provided the written documentation required pursuant to
5 paragraph (a) of subsection 2 of NRS 453A.210 for the issuance of a
6 registry identification card or letter of approval or pursuant to
7 subparagraph (1) of paragraph (b) of subsection 1 of NRS 453A.230
8 for the renewal of a registry identification card or letter of approval
9 if:
10 (a) Such documentation is based on the attending [physicians]
11 provider of health cares personal assessment of the persons
12 medical history and current medical condition; and
13 (b) The [physician] attending provider of health care has
14 advised the person about the possible risks and benefits of the
15 medical use of marijuana.
16 Sec. 11. NRS 453A.700 is hereby amended to read as follows:
17 453A.700 1. Except as otherwise provided in this section,
18 NRS 239.0115 and subsection 4 of NRS 453A.210, the Division
19 shall not disclose:
20 (a) The contents of any tool used by the Division to evaluate an
21 applicant or its affiliate.
22 (b) Any information, documents or communications provided to
23 the Division by an applicant or its affiliate pursuant to the provisions
24 of this chapter, without the prior written consent of the applicant or
25 affiliate or pursuant to a lawful court order after timely notice of the
26 proceedings has been given to the applicant or affiliate.
27 (c) The name or any other identifying information of:
28 (1) An attending [physician;] provider of health care; or
29 (2) A person who has applied for or to whom the Division or
30 its designee has issued a registry identification card or letter of
31 approval.
32 Except as otherwise provided in NRS 239.0115, the items of
33 information described in this subsection are confidential, not subject
34 to subpoena or discovery and not subject to inspection by the
35 general public.
36 2. Notwithstanding the provisions of subsection 1, the Division
37 or its designee may release the name and other identifying
38 information of a person to whom the Division or its designee has
39 issued a registry identification card or letter of approval to:
40 (a) Authorized employees of the Division or its designee as
41 necessary to perform official duties of the Division; and
42 (b) Authorized employees of state and local law enforcement
43 agencies, only as necessary to verify that a person is the lawful
44 holder of a registry identification card or letter of approval issued to
45 him or her pursuant to NRS 453A.220 or 453A.250.

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1 Sec. 12. Chapter 632 of NRS is hereby amended by adding

2 thereto a new section to read as follows:
3 An advanced practice registered nurse is not subject to
4 disciplinary action solely for engaging in any activity in
5 accordance with the provisions of chapter 453A of NRS.
6 Sec. 13. Chapter 641 of NRS is hereby amended by adding
7 thereto a new section to read as follows:
8 A psychologist is not subject to disciplinary action solely for
9 engaging in any activity in accordance with the provisions of
10 chapter 453A of NRS.
11 Sec. 14. Chapter 641A of NRS is hereby amended by adding
12 thereto a new section to read as follows:
13 A clinical professional counselor is not subject to disciplinary
14 action solely for engaging in any activity in accordance with the
15 provisions of chapter 453A of NRS.
16 Sec. 15. Chapter 641B of NRS is hereby amended by adding
17 thereto a new section to read as follows:
18 A clinical social worker is not subject to disciplinary action
19 solely for engaging in any activity in accordance with the
20 provisions of chapter 453A of NRS.
21 Sec. 16. Chapter 641C of NRS is hereby amended by adding
22 thereto a new section to read as follows:
23 A licensed alcohol and drug abuse counselor or clinical
24 alcohol and drug abuse counselor is not subject to disciplinary
25 action solely for engaging in any activity in accordance with the
26 provisions of chapter 453A of NRS.
27 Sec. 17. NRS 641C.065 is hereby amended to read as follows:
28 641C.065 1. Clinical practice of counseling alcohol and
29 drug abusers means:
30 (a) The application of counseling to reduce or eliminate the
31 habitual use of alcohol or other drugs, other than any maintenance
32 dosage of a narcotic or habit-forming drug administered pursuant to
33 chapter 453 of NRS [;] or marijuana administered pursuant to
34 chapter 453A of NRS; and
35 (b) The identification, evaluation and diagnosis of and treatment
36 for a mental illness when a person with mental illness is also an
37 alcoholic or abuser of drugs.
38 2. The term does not include:
39 (a) The diagnosis or treatment of a psychotic disorder; or
40 (b) The use of a psychological or psychometric assessment test
41 to determine intelligence, personality, aptitude and interests.
42 Sec. 18. NRS 641C.100 is hereby amended to read as follows:
43 641C.100 Practice of counseling alcohol and drug abusers
44 means the application of counseling to reduce or eliminate the
45 habitual use of alcohol or other drugs, other than any maintenance

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1 dosage of a narcotic or habit-forming drug administered pursuant to

2 chapter 453 of NRS [.] or marijuana administered pursuant to
3 chapter 453A of NRS.
4 Sec. 19. This act becomes effective:
5 1. Upon passage and approval for the purpose of adopting
6 regulations or performing any other preparatory administrative tasks
7 that are necessary to carry out the provisions of this act; and
8 2. On July 1, 2017, for all other purposes.
H

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