AB 387 — Revises provisions relating to midwives. (BDR 54-225)

The Division may accept gifts, grants and donations to pay the costs of performing its duties under the provisions of this chapter.

Sec.

(b) One voting member who is an advanced practice registered nurse, certified nurse-midwife or physician currently practicing in the area of obstetrics in this State;State and who has experience working in a home setting;

(c) One voting member who is a provider of health care, other than a provider of health care described in paragraph (a) or (b), who is currently providing neonatal or pediatric care in this State;

(d) Two voting members who are representatives of the general public and who have received care from a licensed certified professionalnurse-midwife; midwife;

- *AB387_R2* – 7 – Sec.

A majority of the voting members of the Board constitutes a quorum for the transaction of business, and a - *AB387_R1* – 7 – majority of a quorum present at any meeting is sufficient for any official action taken by the Board.

(b) Meet annuallyregularly at the call of the Chair;

To the extent that money is available, the Board may meet more frequently than required by paragraph (b) of subsection 2.

4.

(a) ARequirements listconcerning the approval by the Division of programs of training for licensed certified professional midwives and certified professional midwife birth assistantsassistants, approvedincluding, without limitation, the required training and instruction that must be provided by such a program and the Board.procedure for obtaining such approval.

The Division shall post the list on an Internet website maintained by the Division.

(1) The periodeducational forqualifications whichthat, aexcept licenseas isotherwise valid,provided whichin mustsection not19 exceedof 2this years.act and in addition to the qualifications prescribed by that section, are necessary to obtain a license pursuant to that section.

(2) AThe requirementperiod that an applicant for thewhich renewal of a license mustis havevalid. completed continuing education in cultural humility or the elimination of racism or bias.

(3) A requirement that an applicant for the renewal of a license must have completed continuing education in cultural humility or the elimination of racism or bias.

- *AB387_R1* – 8 – (f) Regulations governing the ordering, usage and administration of drugs, vaccines, chemicals, solutions and devices pursuant to section 26 of this act.

- *AB387_R2* – 8 – (g) Regulations concerning the management by a licensed certified professional midwife of a client who may have a condition that puts the client at a moderate or high risk of an adverse outcome for the client or the fetus or newborn infant of the client.

(j) AdministrativeAny penaltiesother thatrequirements thenecessary Divisionto mayoptimize imposeobstetrical uponand aneonatal certifiedoutcomes professionalfor midwifeclients student midwife who engages in the practice of licensed certified professional midwiferymidwives. without a preceptor.

(k)- Any*AB387_R1* other– requirements9 necessary– to2. optimize obstetrical and neonatal outcomes for clients of licensed certified professional midwives.

-The *AB387_R2*Board –may, 9by –regulation, 2.require an applicant for a license as a licensed certified professional midwife, including, without limitation, an applicant for a license by endorsement pursuant to section 20 of this act, to submit to the Division a complete set of his or her fingerprints and written permission authorizing the Division to forward the fingerprints to the Central Repository for Nevada Records of Criminal History for submission to the Federal Bureau of Investigation for its report.

The Board may, by regulation, require an applicant for a license as a licensed certified professional midwife to submit to the Division a complete set of his or her fingerprints and written permission authorizing the Division to forward the fingerprints to the Central Repository for Nevada Records of Criminal History for submission to the Federal Bureau of Investigation for its report.

An applicant for a license as a licensed certified professional midwifemidwife, other than a license by endorsement pursuant to section 20 of this act, must submit to the Division an application pursuant to this section in the form prescribed by the Division.

ToThe the extent that the implementation of such provisions will leave the Division with sufficient money to carry out its duties under this chapter, the State Board of Health shall establish by regulation a procedure through which:

(a) An applicant may petition the DivisionState Board to reduce the fees imposed pursuant to this section.

An applicant may qualify for such a reduction if the applicant demonstrates, to the satisfaction of the Division,State Board, that the fees imposed pursuant to this section are an economic hardship on the applicant.

(b) The DivisionState Board allocates a portion of the fees imposed and collected pursuant to this section to programs that promote applicants from marginalized identities through increasing the - *AB387_R2**AB387_R1* – 10 – numbers of such applicants and reducing barriers that such applicants face.

(Deleted1. by amendment.) Sec.

The Division shall issue a license by endorsement as a licensed certified professional midwife to an applicant who meets the requirements set forth in this section.

An applicant may submit to the Division an application for such a license if the applicant holds a corresponding valid and unrestricted license as a licensed certified professional midwife in the District of Columbia or any state or territory of the United States.

2.

An applicant for a license by endorsement pursuant to this section must submit to the Division with his or her application:

(a) Proof satisfactory to the Board that the applicant:

(1) Satisfies the requirements of subsection 1;

(2) Has not been disciplined or investigated by the corresponding regulatory authority of the District of Columbia or any state or territory in which the applicant currently holds or has held a license as a licensed certified professional midwife or any other type of midwife;

(3) Has not been held civilly or criminally liable for malpractice in the District of Columbia or any state or territory of the United States;

(4) Is certified as a certified professional midwife by the North American Registry of Midwives, or its successor organization;

and (5) Holds a Midwifery Bridge Certificate issued by the North American Registry of Midwives, or its successor organization, and has completed the Portfolio Evaluation Process prescribed by that organization or meets the educational requirements prescribed by the Board pursuant to section 18 of this act;

(b) An affidavit stating that the information contained in the application and any accompanying material is true and correct;

(c) The fee prescribed by the State Board of Health pursuant to NRS 439.150, which must not exceed $1,000;

and (d) Any other information required by the Division.

3.

Not later than 15 business days after receiving an application for a license by endorsement as a licensed certified professional midwife pursuant to this section, the Division shall provide written notice to the applicant of any additional - *AB387_R1* – 11 – information required by the Division to consider the application.

Unless the Division denies the application for good cause, the Division shall approve the application and issue a license by endorsement as a licensed certified professional midwife to the applicant not later than:

(a) Forty-five days after receiving the application;

or (b) If the Board requires the applicant to submit his or her fingerprints pursuant to section 18 of this act, 10 days after the Board receives a report on the applicant’s background based on the submission of the applicant’s fingerprints,  whichever occurs later.

Sec.

(Deleted1. by amendment.) Sec.

An applicant for a permit as a certified professional midwife student midwife must submit to the Division an application in the form prescribed by the Division.

The application must be accompanied by a fee of $100 and must include, without limitation:

(a) A copy of an agreement with at least one preceptor to supervise the applicant and proof that each preceptor meets the requirements of section 24 of this act;

and (b) Proof that the applicant is enrolled in a program of training for licensed certified professional midwives approved by the Division.

2.

A permit as a certified professional midwife student midwife is valid for 2 years after the date of issuance and may be renewed upon submission to the Division of:

(a) A renewal application in the form prescribed by the Division;

and (b) A renewal fee of $100.

3.

Upon approving an application for the issuance or renewal of a permit as a certified professional midwife student midwife, the Division shall provide to the applicant a written copy of the provisions of section 24 of this act and any regulations adopted pursuant to section 18 of this act that apply to certified professional midwife student midwives.

Sec.

(b) Have completed athe program of training for certified professional midwife birth assistants on the list of programs approved by the BoardDivision; pursuant to paragraph (a) of subsection 1 of section 18 of this act;

- *AB387_R1* – 12 – (c) Have completed training in cultural humility or the elimination of racism or bias;

(d) HaveHold completedcurrent trainingcertification in the techniques of administering neonatal resuscitation providedissued throughby thean Neonatalinstructor Resuscitationcertified Programby of the American Academy of Pediatrics, or anyits successor toorganization; that program;

ExceptA as otherwise provided in subsection 4, a certified professional midwife birth assistant may perform routine clinical tasks and procedures only under the direct supervision of a licensed certified professional midwife who is present on the premises and able to intervene if necessary.

(b) Providing medication, including, without limitation and to the extent applicable, any medication described in subsection 2 of - *AB387_R2* – 11 – section 26 of this act, to a patient to self-administer orally, sublingually, topically or rectally;

A certified professional midwife birth assistant may provide any necessary assistance in an emergency or when birth is imminent if his or her supervising licensed certified professional midwife is not present.

If a certified professional midwife birth assistant provides such assistance without supervision, the certified professional midwife birth assistant must contact a provider of emergency medical services to provide further assistance.

5.

(a) An applicant for the issuance of a license as a licensed certified professional midwife or a permit as a certified professional midwife student midwife in this State shall include the social security number of the applicant in the application submitted to the Division.

(b) An applicant for the issuance of a license as a licensed certified professional midwife or a permit as a certified - *AB387_R1* – 13 – professional midwife student midwife in this State shall submit to the Division of Public and Behavioral Health of the Department of Health and Human Services the statement prescribed by the Division of Welfare and Supportive Services of the Department of Health and Human Services pursuant to NRS 425.520.

(a) The application or any other forms that must be submitted for the issuance or renewal of the license;license or permit;

A license as a licensed certified professional midwife or a permit as a certified professional midwife student midwife may not be issued or renewed by the Division if the applicant:

or - *AB387_R2* – 12 – (b) Indicates on the statement submitted pursuant to subsection 1 that the applicant is subject to a court order for the support of a child and is not in compliance with the order or a plan approved by the district attorney or other public agency enforcing the order for the repayment of the amount owed pursuant to the order.

ExceptA as otherwise provided in subsection 5, a certified professional midwife student midwife may engage in the practice of certified professional midwifery, including, without limitation, by using or administering any drug, vaccine, device, chemical or solution described in subsection 1, 2 or 3 of section 26 of this act, only under the direct supervision of a preceptor who is present on the premises and able to intervene if necessary.

- *AB387_R1* – 14 – 3.

(a) NotifyProvide to each client in the form prescribed by the Division notice that a certified professional midwife student midwife may be involved in the care of the client;

and (c) Review and evaluate all care provided by a certified professional midwife student midwife under his or her supervision and attend every clinical encounter between the certified professional midwife student midwife and a client.

IfNot later than 10 days after the preceptor of a certified professional midwife student midwife ceases to serve as his or her preceptor and the certified professional midwife student midwife has no additional preceptor, the certified professional midwife student midwife mustshall ceasenotify engaging in the practiceDivision. of certified professional midwifery.

5.If the certified professional midwife student midwife has no additional preceptor, the certified professional midwife student midwife must cease engaging in the practice of certified professional midwifery until he or she submits to the Division a written agreement with a new preceptor who meets the requirements of this section.

A certified professional midwife student midwife may provide any necessary assistance in an emergency or when birth is - *AB387_R2* – 13 – imminent if his or her preceptor is not present.

If a certified professional midwife student midwife needs to provide such assistance and his or her preceptor is not present, the certified professional midwife student midwife must contact a provider of emergency medical services to provide further assistance.

AnyA midwife, including, without limitation, a licensed certified professional midwife and a certified nurse-midwife, shall provide the client with a Community Birth Disclosure.

- *AB387_R1* – 15 – (b) A description of the practice of certified professional midwifery as set forth in section 11 of this act and the limitations on the practice of a licensed certified professional midwife;

- *AB387_R2* – 14 – (f) A description of the procedures that will be used during the birth in the client’s chosen setting, the risks and benefits of birth in that setting and the conditions that may arise during delivery;

(b) Equipment for administering nitrous oxide, including, without limitation, scavenging systems, only in anthe obstetricsetting centerwhere licensedthe pursuantbirth tois chaptertaking 449place; of NRS;

- *AB387_R1* – 16 – (a) Oxytocin, misoprostol, methylergonovine, tranexamic acid, lidocaine, penicillin, ampicillin, cefazolin, clindamycin, epinephrine, diphenhydramine, ondansetron, phylloquinone, erythromycin ointment,ointment terbutaline and nitrous oxide;

(b) Influenza vaccine, hepatitis B vaccine, COVID-19 vaccine and diphtheria, tetanus and pertussis vaccine;

and (d) AnyTerbutaline otheronly drugsin orthe vaccinessetting authorizedwhere bythe regulationbirth ofis thetaking Board.place;

and (e) Any other drugs or vaccines authorized by regulation of the Board.

and - *AB387_R2* – 15 – (b) Any other chemicals or solutions authorized by regulation of the Board.

or - *AB387_R1* – 17 – (k) Any other condition or symptom which, in the judgment of the licensed certified professional midwife, could threaten the life of the client or the fetus or newborn infant of the client.

- *AB387_R2* – 16 – (b) The condition or symptom for which the recommendation was made;

A client may provide informed refusal to consent to consultation, co-management, referral or transfer in writing on a form prescribed by the Board.Division.

If the condition or symptom threatens the life or health of the client or the fetus or the newborn infant of the client during labor or delivery, the licensed - *AB387_R1* – 18 – certified professional midwife must call 911 and provide care until relieved by a qualified provider of health care.

(a) Subsection 1 exists and making a reasonable effort to arrange for consultation with, co-management of the condition or symptom with or referral of the client to a qualified provider of health care or the transfer of the client to an appropriate medical facility, a licensed certified professional midwife is unable to - *AB387_R2* – 17 – locate a qualified provider of health care who is willing to consult, co-manage or accept the referral or an appropriate medical facility willing to accept the transfer, the licensed certified professional midwife shall be deemed to be in compliance with the requirements of this section and is not liable for any damages resulting from the inability of the licensed certified professional midwife to consult, co-manage, refer or transfer.

Such a provider of health care is only liable for the damages resulting from his or her - *AB387_R1* – 19 – own acts or omissions in accordance with the standards of care governing his or her profession.

WithOn eachor applicationbefore forJanuary the31 renewal of hiseach oryear, her license, a licensed certified professional midwife shall submit to the Division a report that includes, for the immediately preceding licensurecalendar period:year:

- *AB387_R2* – 18 – (e) A brief description of any complications resulting in maternal or infant morbidity or mortality;

If the Division receives a copy of a court order issued pursuant to NRS 425.540 that provides for the suspension of all professional, occupational and recreational licenses, certificates and permits issued to a person who is the holder of a license or permit issued pursuant to this chapter, the Division shall deem the license or permit issued to that person to be suspended at the end of the 30th day after the date on which the court order was issued unless the Division receives a letter issued to the holder of the license by the district attorney or other public agency pursuant to NRS 425.550 stating that the holder of the license has complied with the subpoena or warrant or has satisfied the arrearage pursuant to NRS 425.560.

The Division shall reinstate a license or permit issued pursuant to this chapter that has been suspended by a district court pursuant to NRS 425.540 if:

(a) The Division receives a letter issued by the district attorney or other public agency pursuant to NRS 425.550 to the person whose license or permit was suspended stating that the person whose license or permit was suspended has complied with the - *AB387_R1* – 20 – subpoena or warrant or has satisfied the arrearage pursuant to NRS 425.560;

and (b) The person whose license or permit was suspended pays the appropriate fee required pursuant to this chapter.

Except as otherwise provided in this section and NRS 239.0115, a complaint filed with the Division, all documents and other information filed with the complaint and all documents and other information compiled as a result of an investigation conducted to determine whether to initiate disciplinary action against a person are confidential and privileged.privileged, unless the person submits a written statement to the Division requesting that such documents and information be made public records.

- *AB387_R2* – 19 – 4.

Except as otherwise provided in subsection 2, a person who is not licensed as a licensed certified professional midwife or does not hold a permit as a certified professional midwife student midwife or a person whose license as a licensed certified professional midwife or permit as a certified professional midwife student midwife has been suspended or revoked by the Division shall not:

(a) Use in connection with his or her name the words “licensed certified professional midwife,” “certified professional midwife,” “licensed midwife” or “certified professional midwife student midwife” or any other letters, words or insignia indicating or implying that he or she is licensed or holds a permit to engage in the practice of certified professional midwifery, or in any other way, orally, or in writing or print, or by sign, directly or by implication, represent himself or herself as licensed toor holding a permit engage in the practice of certified professional midwifery in this State;

or - *AB387_R1* – 21 – (b) List or cause to have listed in any directory, including, without limitation, a telephone directory, his or her name or the name of his or her company under the heading “licensed certified professional midwife,” “certified professional midwife,” “licensed midwife” or any other term that indicates or implies that he or she is licensed or holds a permit to engage in the practice of certified professional midwifery in this State.

A person who is not licensed as a licensed certified professional midwife or does not hold a permit as a certified professional midwife student midwife or a person whose license as a licensed certified professional midwife or permit as a certified professional midwife student midwife has been suspended or revoked by the Division may use or list the words or headings described in paragraph (a) or (b) of subsection 1 if the person is licensed or holds a permit in the District of Columbia or any state or territory of the United States.

If the person uses or lists the words or headings pursuant to this section, the person shall disclose the district, state or territory, as applicable, in which he or she is licensed.licensed or permitted.

A person who is licensed as a licensed certified professional midwife or holds a permit as a certified professional midwife student midwife and who is also licensed or holds a permit in the District of Columbia or any state or territory of the United States shall disclose each additional district, state or territory, as applicable, in which he or she is currently licensed or haspermitted ever been licensed in all circumstances described in paragraphs (a) and (b) of subsection 1.

A certified professional midwife student midwife shall not:not use in connection with his or her name the words “licensed certified professional midwife,” “certified professional midwife,” “licensed midwife” or any other letters, words or insignia indicating or implying that he or she is licensed to engage in the practice of certified professional midwifery without supervision, or in any other way, orally, or in writing or print, or by sign, directly or by implication, represent himself or herself as licensed to engage in the practice of certified professional midwifery without supervision in this State.

(a) Engage in midwifery except in circumstances authorized by this chapter;

or - *AB387_R2* – 20 – (b) Use in connection with his or her name the words “licensed certified professional midwife,” “certified professional midwife,” “licensed midwife” or any other letters, words or insignia indicating or implying that he or she is licensed to engage in the practice of certified professional midwifery without supervision, or in any other way, orally, or in writing or print, or by sign, directly or by implication, represent himself or herself as licensed to engage in the practice of certified professional midwifery without supervision in this State.

A person or entity shall not operate a program of training for licensed certified professional midwives or certified professional midwife birth assistants or advertise or otherwise represent that the person or entity is authorized to operate such a program unless the programperson isor includedentity onhas thebeen list of programs approved by the Board pursuant to paragraphoffer (a)such ofa subsectionprogram 1by ofthe sectionDivision. 18 of this act.

If the Division has reason to believe that a person has repeatedly violated any provision of this section or the Division - *AB387_R1* – 22 – has received complaints that a person has repeatedly violated any provision of this section, the Division may certify the facts to the Attorney General, or other appropriate enforcement officer, who may, in his or her discretion, cause appropriate proceedings to be brought.

7.

A person who violates any provision of this section is guilty of a misdemeanor.

Notwithstanding the provisions of NRS 623.225, 623A.185, 624.268, 625.387, 625A.105, 628.0345, 628B.320, 630.197, - *AB387_R2* – 21 – 630A.246, 631.225, 632.3446, 633.307, 634.095, 634A.115, 635.056, 636.159, 637.113, 637B.166, 638.103, 639.129, 640.095, 640A.145, 640B.340, 640C.430, 640D.120, 640E.200, 641.175, 641A.215, 641B.206, 641C.280, 642.0195, 643.095, 644A.485, 645.358, 645A.025, 645B.023, 645B.420, 645C.295, 645C.655, 645D.195, 645E.210, 645G.110, 645H.550, 648.085, 649.233, 652.075, 653.550, 654.145, 655.075 and 656.155, and section 23 of this act, an applicant for a license who does not have a social security number must provide an alternative personally identifying number, including, without limitation, his or her individual taxpayer identification number, when completing an application for a license.

A regulatory body shall not disclose to any person who is not employed by the regulatory body the social security number or alternative personally identifying number, including, without - *AB387_R1* – 23 – limitation, an individual taxpayer identification number, of an applicant for a license for any purpose except:

- *AB387_R2* – 22 – 3.

If the person seeks to practice as a licensed certified professional midwife in this State pursuant to sections 2 to 32, inclusive, of this act, the person must have been in practice for at least the 3 years immediately preceding the date on which the person submits an application for the issuance of a license - *AB387_R1* – 24 – pursuant to a reciprocal agreement entered into pursuant to subsection 1.

- *AB387_R2* – 23 – (e) 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;

- *AB387_R1* – 25 – (s) An athletic trainer;

(a) The practice of dentistry, chiropractic, Oriental medicine, podiatry, optometry, perfusion, respiratory care, faith or Christian - *AB387_R2* – 24 – Science healing, nursing, certified professional midwifery, veterinary medicine or fitting hearing aids.

- *AB387_R1* – 26 – (b) The domestic administration of family remedies.

- *AB387_R2* – 25 – (e) Any person who operates, who is employed by or who contracts to provide services for an intermediary service organization as defined in NRS 449.4304.

- *AB387_R1* – 27 – (l) Any person who operates or is employed by a community health worker pool or with whom a community health worker pool contracts to provide the services of a community health worker, as defined in NRS 449.0027.

- *AB387_R2* – 26 – (a) The practice of medicine or perfusion pursuant to chapter 630 of NRS, dentistry, chiropractic, podiatry, optometry, respiratory care, faith or Christian Science healing, nursing, certified professional midwifery, veterinary medicine or fitting hearing aids.

- *AB387_R1* – 28 – 2.

A hospital, pharmacy or other institution licensed, registered or otherwise permitted to distribute, dispense, conduct research with - *AB387_R2* – 27 – respect to or administer drugs in the course of professional practice or research in this State;

and - *AB387_R1* – 29 – (b) Is authorized by the Board to possess, administer, prescribe or dispense controlled substances, poisons, dangerous drugs or devices under the supervision of an osteopathic physician as required by chapter 633 of NRS;

A licensed certified professional midwife may administer drugs and devices ordered pursuant to section 26 of this act in - *AB387_R2* – 28 – accordance with the provisions of that section and any regulations adopted pursuant to section 18 of this act without obtaining a certificate from the Board.

- *AB387_R1* – 30 – 4.

(c) A person licensed or registered as an esthetician, esthetician’s apprentice, hair designer, hair designer’s apprentice, hair braider, shampoo technologist, cosmetologist or cosmetologist’s apprentice pursuant to chapter 644A of NRS if the person is massaging, cleansing or stimulating the scalp, face, neck or skin within the permissible scope of practice for an esthetician, - *AB387_R2* – 29 – esthetician’s apprentice, hair designer, hair designer’s apprentice, hair braider, shampoo technologist, cosmetologist or cosmetologist’s apprentice pursuant to that chapter.

- *AB387_R1* – 31 – (g) A person who practices massage therapy, reflexology or structural integration solely on members of his or her immediate family.

Except as otherwise expressly provided in a particular statute or required by the context, “licensed certified professional midwife” means a person licensed as a licensed certified professional midwife pursuant to section 19 or 20 of this act.

An attorney shall not contract for or collect a fee contingent on the amount of recovery for representing a person - *AB387_R2* – 30 – seeking damages in connection with an action for injury or death against a provider of health care based upon professional negligence in excess of:

For the purposes of this section, “recovered” means the net sum recovered by the plaintiff after deducting any disbursements or - *AB387_R1* – 32 – costs incurred in connection with the prosecution or settlement of the claim.

(a) “Person in a position of authority” means a parent, relative, household member, employer, supervisor, youth leader, scout leader, coach, mentor in a mentoring program, teacher, professor, counselor, school administrator, religious leader, doctor, nurse, - *AB387_R2* – 31 – licensed certified professional midwife, certified professional midwife student midwife, certified professional midwife birth assistant, psychologist, other health care provider, guardian ad litem, guardian, babysitter, police officer or other law enforcement officer or any other person who, by reason of his or her position, is able to exercise significant or undue influence over the victim.

Any person licensed under the provisions of chapter 630, 632 or 633 of NRS or sections 2 to 32, inclusive, of this act and any person who holds an equivalent license issued by another state, who renders emergency care or assistance, including, without limitation, emergency obstetrical care or assistance, in an - *AB387_R1* – 33 – emergency, gratuitously and in good faith, is not liable for any civil damages as a result of any act or omission, not amounting to gross negligence, by that person in rendering the emergency care or assistance or as a result of any failure to act, not amounting to gross negligence, to provide or arrange for further medical treatment for the injured or ill person.

- *AB387_R2* – 32 – 4.

and - *AB387_R1* – 34 – (c) The damages are reasonably related to or primarily caused by a lack of prenatal care received by the woman.

In an action for injury or death against a provider of health care based upon professional negligence, if the defendant so elects, the defendant may introduce evidence of any amount payable as a benefit to the plaintiff as a result of the injury or death pursuant to the United States Social Security Act, any state or federal income disability or worker’s compensation act, any health, sickness or income-disability insurance, accident insurance that provides health benefits or income-disability coverage, and any contract or agreement of any group, organization, partnership or - *AB387_R2* – 33 – corporation to provide, pay for or reimburse the cost of medical, hospital, dental or other health care services.

In an action for injury or death against a provider of health care based upon professional negligence, a district court shall, at the request of either party, enter a judgment ordering that money damages or its equivalent for future damages of the judgment - *AB387_R1* – 35 – creditor be paid in whole or in part by periodic payments rather than by a lump-sum payment if the award equals or exceeds $50,000 in future damages.

If the court finds that the judgment debtor has exhibited a continuing pattern of failing to make the periodic payments as - *AB387_R2* – 34 – specified pursuant to subsection 5, the court shall find the judgment debtor in contempt of court and, in addition to the required periodic payments, shall order the judgment debtor to pay the judgment creditor all damages caused by the failure to make such periodic payments, including, but not limited to, court costs and attorney’s fees.

- *AB387_R1* – 36 – (b) “Periodic payments” means the payment of money or delivery of other property to the judgment creditor at regular intervals.

- *AB387_R2* – 35 – Sec.

or - *AB387_R1* – 37 – (3) A toll-free telephone service designated by the Aging and Disability Services Division of the Department of Health and Human Services;

(a) Every physician, dentist, dental hygienist, chiropractor, optometrist, podiatric physician, medical examiner, resident, intern, professional or practical nurse, physician assistant licensed pursuant to chapter 630 or 633 of NRS, licensed certified professional midwife, perfusionist, psychiatrist, psychologist, marriage and family therapist, clinical professional counselor, clinical alcohol and drug counselor, alcohol and drug counselor, music therapist, athletic trainer, driver of an ambulance, paramedic, licensed dietitian, holder of a license or a limited license issued under the provisions of chapter 653 of NRS or other person providing medical services licensed or certified to practice in this State, who examines, attends - *AB387_R2* – 36 – or treats an older person or vulnerable person who appears to have been abused, neglected, exploited, isolated or abandoned.

- *AB387_R1* – 38 – (f) Every person who operates, who is employed by or who contracts to provide services for an intermediary service organization as defined in NRS 449.4304.

If a person who is required to make a report pursuant to subsection 1 knows or has reasonable cause to believe that an older person or vulnerable person has died as a result of abuse, neglect, - *AB387_R2* – 37 – isolation or abandonment, the person shall, as soon as reasonably practicable, report this belief to the appropriate medical examiner or coroner, who shall investigate the cause of death of the older person or vulnerable person and submit to the appropriate local law enforcement agencies, the appropriate prosecuting attorney, the Aging and Disability Services Division of the Department of Health and Human Services and the Unit for the Investigation and Prosecution of Crimes his or her written findings.

A copy of the final report of the - *AB387_R1* – 39 – investigation conducted by a division, office or department, other than the Aging and Disability Services Division of the Department of Health and Human Services, must be forwarded within 30 days after the completion of the report to the:

- *AB387_R2* – 38 – (a) Pursuant to a criminal prosecution;

- *AB387_R1* – 40 – (b) An agency responsible for or authorized to undertake the care, treatment and supervision of the older person or vulnerable person;

- *AB387_R2* – 39 – (k) An attorney appointed by a court to represent a protected person in a guardianship proceeding pursuant to NRS 159.0485, if:

or - *AB387_R1* – 41 – (l) The State Guardianship Compliance Office created by NRS 159.341.

If the person who is reported to have abused, neglected, exploited, isolated or abandoned an older person or a vulnerable person is the holder of a licenselicense, [,][or] certificate or certificatepermit issued pursuant to chapters 449, 630 to 641B, inclusive, 653 or 654 of NRS [,] or sections 2 to 32, inclusive, of this act, the information contained in the report must be submitted to the board that issued the license.

(b) If the revenue of the board from all sources is $200,000 or more for any fiscal year, or if the board is a regulatory body pursuant to NRS 622.060 and has failed to submit to the Director of - *AB387_R2* – 40 – the Legislative Counsel Bureau for each quarter of that fiscal year the information required by NRS 622.100, engage the services of a certified public accountant or public accountant, or firm of either of such accountants, to audit all its fiscal records for that fiscal year and file a report of the audit with the Legislative Auditor and the Chief of the Budget Division of the Office of Finance on or before December 1 following the end of that fiscal year.

In lieu of preparing a balance sheet or having an audit conducted for a single fiscal year, a board may engage the services of a certified public accountant or public accountant, or firm of - *AB387_R1* – 42 – either of such accountants, to audit all its fiscal records for a period covering two successive fiscal years.

The provisions of this subsection do not - *AB387_R2* – 41 – apply to a state officer who may be removed from office only by impeachment pursuant to Article 7 of the Nevada Constitution.

- *AB387_R1* – 43 – (3) The Administrator of the Division of Child and Family Services;

- *AB387_R2* – 42 – (4) Identify the sources of funding for services provided by the Department and the allocation of that funding;

- *AB387_R1* – 44 – (e) May, by regulation, require nonprofit organizations and state and local governmental agencies to provide information regarding the programs of those organizations and agencies, excluding detailed information relating to their budgets and payrolls, which the Director deems necessary for the performance of the duties imposed upon him or her pursuant to this section.

Except as otherwise provided in this section and NRS 1.4683, 1.4687, 1A.110, 3.2203, 41.071, 49.095, 49.293, 62D.420, 62D.440, 62E.516, 62E.620, 62H.025, 62H.030, 62H.170, 62H.220, 62H.320, 75A.100, 75A.150, 76.160, 78.152, 80.113, 81.850, 82.183, 86.246, 86.54615, 87.515, 87.5413, 87A.200, 87A.580, 87A.640, 88.3355, 88.5927, 88.6067, 88A.345, 88A.7345, 89.045, 89.251, 90.730, 91.160, 116.757, 116A.270, 116B.880, 118B.026, 119.260, 119.265, 119.267, 119.280, 119A.280, 119A.653, 119A.677, 119B.370, 119B.382, 120A.690, 125.130, 125B.140, 126.141, 126.161, 126.163, 126.730, 127.007, 127.057, 127.130, 127.140, 127.2817, 128.090, 130.312, 130.712, 136.050, 159.044, 159A.044, 172.075, 172.245, 176.01249, 176.015, 176.0625, 176.09129, 176.156, 176A.630, 178.39801, 178.4715, 178.5691, 179.495, 179A.070, 179A.165, 179D.160, 200.3771, 200.3772, 200.5095, 200.604, 202.3662, 205.4651, 209.392, 209.3923, 209.3925, 209.419, 209.429, 209.521, 211A.140, 213.010, 213.040, 213.095, 213.131, 217.105, 217.110, 217.464, 217.475, 218A.350, 218E.625, 218F.150, 218G.130, 218G.240, 218G.350, 226.300, 228.270, 228.450, 228.495, 228.570, 231.069, 231.1473, 233.190, 237.300, 239.0105, 239.0113, 239.014, 239B.030, 239B.040, 239B.050, 239C.140, 239C.210, 239C.230, 239C.250, 239C.270, 239C.420, 240.007, 241.020, 241.030, 241.039, 242.105, 244.264, 244.335, 247.540, 247.550, 247.560, 250.087, 250.130, 250.140, 250.150, 268.095, 268.0978, 268.490, - *AB387_R2* – 43 – 268.910, 269.174, 271A.105, 281.195, 281.805, 281A.350, 281A.680, 281A.685, 281A.750, 281A.755, 281A.780, 284.4068, 286.110, 286.118, 287.0438, 289.025, 289.080, 289.387, 289.830, 293.4855, 293.5002, 293.503, 293.504, 293.558, 293.5757, 293.870, 293.906, 293.908, 293.910, 293B.135, 293D.510, 331.110, 332.061, 332.351, 333.333, 333.335, 338.070, 338.1379, 338.1593, 338.1725, 338.1727, 348.420, 349.597, 349.775, 353.205, 353A.049, 353A.085, 353A.100, 353C.240, 360.240, 360.247, 360.255, 360.755, 361.044, 361.2242, 361.610, 365.138, 366.160, 368A.180, 370.257, 370.327, 372A.080, 378.290, 378.300, 379.0075, 379.008, - *AB387_R1* – 45 – 379.1495, 385A.830, 385B.100, 387.626, 387.631, 388.1455, 388.259, 388.501, 388.503, 388.513, 388.750, 388A.247, 388A.249, 391.033, 391.035, 391.0365, 391.120, 391.925, 392.029, 392.147, 392.264, 392.271, 392.315, 392.317, 392.325, 392.327, 392.335, 392.850, 393.045, 394.167, 394.16975, 394.1698, 394.447, 394.460, 394.465, 396.3295, 396.405, 396.525, 396.535, 396.9685, 398A.115, 408.3885, 408.3886, 408.3888, 408.5484, 412.153, 414.280, 416.070, 422.2749, 422.305, 422A.342, 422A.350, 425.400, 427A.1236, 427A.872, 432.028, 432.205, 432B.175, 432B.280, 432B.290, 432B.407, 432B.430, 432B.560, 432B.5902, 432C.140, 432C.150, 433.534, 433A.360, 437.145, 437.207, 439.4941, 439.840, 439.914, 439B.420, 439B.754, 439B.760, 440.170, 441A.195, 441A.220, 441A.230, 442.330, 442.395, 442.735, 442.774, 445A.665, 445B.570, 445B.7773, 447.345, 449.209, 449.245, 449.4315, 449A.112, 450.140, 450B.188, 453.164, 453.720, 453A.610, 453A.700, 458.055, 458.280, 459.050, 459.3866, 459.555, 459.7056, 459.846, 463.120, 463.15993, 463.240, 463.3403, 463.3407, 463.790, 467.1005, 480.535, 480.545, 480.935, 480.940, 481.063, 481.091, 481.093, 482.170, 482.5536, 483.340, 483.363, 483.575, 483.659, 483.800, 484A.469, 484E.070, 485.316, 501.344, 503.452, 522.040, 534A.031, 561.285, 571.160, 584.655, 587.877, 598.0964, 598.098, 598A.110, 599B.090, 603.070, 603A.210, 604A.303, 604A.710, 612.265, 616B.012, 616B.015, 616B.315, 616B.350, 618.341, 618.425, 622.238, 622.310, 623.131, 623A.137, 624.110, 624.265, 624.327, 625.425, 625A.185, 628.418, 628B.230, 628B.760, 629.047, 629.069, 630.133, 630.2673, 630.30665, 630.336, 630A.555, 631.368, 632.121, 632.125, 632.3415, 632.405, 633.283, 633.301, 633.4715, 633.524, 634.055, 634.214, 634A.185, 635.158, 636.107, 637.085, 637B.288, 638.087, 638.089, 639.2485, 639.570, 640.075, 640A.220, 640B.730, 640C.580, 640C.600, 640C.620, 640C.745, 640C.760, 640D.190, 640E.340, 641.090, 641.221, 641.325, 641A.191, 641A.262, 641A.289, 641B.170, 641B.282, 641B.460, 641C.760, 641C.800, 642.524, 643.189, 644A.870, 645.180, 645.625, 645A.050, 645A.082, 645B.060, 645B.092, 645C.220, - *AB387_R2* – 44 – 645C.225, 645D.130, 645D.135, 645G.510, 645H.320, 645H.330, 647.0945, 647.0947, 648.033, 648.197, 649.065, 649.067, 652.228, 653.900, 654.110, 656.105, 657A.510, 661.115, 665.130, 665.133, 669.275, 669.285, 669A.310, 671.170, 673.450, 673.480, 675.380, 676A.340, 676A.370, 677.243, 678A.470, 678C.710, 678C.800, 679B.122, 679B.124, 679B.152, 679B.159, 679B.190, 679B.285, 679B.690, 680A.270, 681A.440, 681B.260, 681B.410, 681B.540, 683A.0873, 685A.077, 686A.289, 686B.170, 686C.306, 687A.110, 687A.115, 687C.010, 688C.230, 688C.480, 688C.490, 689A.696, 692A.117, 692C.190, 692C.3507, 692C.3536, 692C.3538, - *AB387_R1* – 46 – 692C.354, 692C.420, 693A.480, 693A.615, 696B.550, 696C.120, 703.196, 704B.325, 706.1725, 706A.230, 710.159, 711.600, and section 30 of this act, sections 35, 38 and 41 of chapter 478, Statutes of Nevada 2011 and section 2 of chapter 391, Statutes of Nevada 2013 and unless otherwise declared by law to be confidential, all public books and public records of a governmental entity must be open at all times during office hours to inspection by any person, and may be fully copied or an abstract or memorandum may be prepared from those public books and public records.

or - *AB387_R2* – 45 – (b) Providing the public record in an electronic format or by means of an electronic medium would:

(a) Shall not refuse to provide a copy of that public record in the medium that is requested because the officer, employee or agent has - *AB387_R1* – 47 – already prepared or would prefer to provide the copy in a different medium.

Any board, commission, committee or council created in chapters 445C, 590, 623 to 625A, inclusive, 628, 630 to 644A, inclusive, 648, 652, 654 and 656 of NRS which contracts for the services of a person, shall require the contract for those services to - *AB387_R2* – 46 – be in writing.

- *AB387_R1* – 48 – Sec.

- *AB387_R2* – 47 – Sec.

On or before July 1 of each even-numbered year, the head of each agency shall report to the Director whether the agency’s - *AB387_R1* – 49 – system of internal accounting and administrative control is in compliance with the uniform system adopted pursuant to subsection 1 of NRS 353A.020.

The annual work - *AB387_R2* – 48 – plan must list the agencies to which the Division will provide training and assistance and be submitted to the Director for approval.

- *AB387_R1* – 50 – (d) The Housing Division of the Department of Business and Industry.

- *AB387_R2* – 49 – Sec.

- *AB387_R1* – 51 – (a) The medical device was ordered or prescribed by a provider of health care, within his or her scope of practice, for use by the person to whom it is provided;

and - *AB387_R2* – 50 – (c) The purchase of the medical device is made pursuant to a contract between the governmental entity that purchases the medical device and the person who sells the medical device to the governmental entity.

§§ 1396 et seq., to - *AB387_R1* – 52 – provide assistance for part or all of the cost of medical care rendered on behalf of indigent persons.

- *AB387_R2* – 51 – Sec.

- *AB387_R1* – 53 – (a) Except as otherwise provided in subsection 2, report the abuse or neglect of the child to an agency which provides child welfare services or to a law enforcement agency;

(a) A person providing services licensed or certified in this State pursuant to, without limitation, chapter 450B, 630, 630A, 631, 632, - *AB387_R2* – 52 – 633, 634, 634A, 635, 636, 637, 637B, 639, 640, 640A, 640B, 640C, 640D, 640E, 641, 641A, 641B, 641C or 653 of NRS [.] or sections 2 to 32, inclusive, of this act.

(b) Any personnel of a medical facility licensed pursuant to chapter 449 of NRS who are engaged in the admission, examination, - *AB387_R1* – 54 – care or treatment of persons or an administrator, manager or other person in charge of such a medical facility upon notification of suspected abuse or neglect of a child by a member of the staff of the medical facility.

If such a report is made to an agency which provides child welfare services, the agency which provides child welfare services shall - *AB387_R2* – 53 – notify the appropriate medical examiner or coroner of the report.

The medical examiner or coroner who is notified of a report pursuant to this subsection shall investigate the report and submit his or her written findings to the appropriate agency which provides child welfare services, the appropriate district attorney and a law - *AB387_R1* – 55 – enforcement agency.

and - *AB387_R2* – 54 – (c) Maintain a copy of the written acknowledgment or electronic record for as long as the person serves as a volunteer at the school.

- *AB387_R1* – 56 – (b) “Public school” has the meaning ascribed to it in NRS 385.007.

- *AB387_R2* – 55 – Sec.

As used in this chapter, “midwife” means any type of midwife, including, without limitation, a licensed certified professional midwife,midwife a certified nurse-midwife or any person who engages in the practice of certified professional midwifery.

- *AB387_R1* – 57 – Sec.

or (2) The mother and a person other than the mother’s spouse have signed a declaration for the voluntary acknowledgment of paternity developed by the Board pursuant to NRS 440.283 or a - *AB387_R2* – 56 – declaration for the voluntary acknowledgment of parentage developed by the Board pursuant to NRS 440.285.

- *AB387_R1* – 58 – (1) A court has issued an order establishing that a person other than the mother’s spouse at the time of conception is the other parent of the child;

- *AB387_R2* – 57 – Sec.

440.770 Any person who furnishes false information to a physician, advanced practice registered nurse, licensed certified professional midwife, funeral director, midwife or informant for the - *AB387_R1* – 59 – purpose of making incorrect certification of births or deaths shall be punished by a fine of not more than $250.

- *AB387_R2* – 58 – Sec.

- *AB387_R1* – 60 – 1.

or - *AB387_R2* – 59 – (b) A physician assistant who holds a license from the Board of Medical Examiners and a certificate from the State Board of Pharmacy permitting him or her so to prescribe.

- *AB387_R1* – 61 – 4.

(f) Except as otherwise provided in paragraph (g), an advanced emergency medical technician or a paramedic, as authorized by - *AB387_R2* – 60 – regulation of the State Board of Pharmacy and in accordance with any applicable regulations of:

- *AB387_R1* – 62 – (2) A county board of health in a county whose population is 100,000 or more;

- *AB387_R2* – 61 – (I) Iontophoresis;

- *AB387_R1* – 63 – (p) In accordance with applicable regulations of the State Board of Health, an employee of a residential facility for groups, as defined in NRS 449.017, pursuant to a written agreement entered into by the ultimate user.

- *AB387_R2* – 62 – (2) State Board of Osteopathic Medicine, at the direction of the prescribing physician and under the supervision of a physician or physician assistant.

(v) A certified professional midwife student midwife or certified professional midwife birth assistant who is administering - *AB387_R1* – 64 – the medicine or drug under the direct supervision of a licensed certified professional midwife as authorized by sections 2 to 32, inclusive, of this act and any regulations adopted pursuant thereto.

- *AB387_R2* – 63 – (2) Medical or dental malpractice of:

- *AB387_R1* – 65 – (II) A hospital or other health care facility;

- *AB387_R2* – 64 – Sec.

A physician, dentist, nurse, licensed certified professional midwife, dispensing optician, optometrist, physical therapist, - *AB387_R1* – 66 – podiatric physician, psychologist, chiropractor, doctor of Oriental medicine in any form, director or technician of a medical laboratory, pharmacist, person who holds a license to engage in radiation therapy and radiologic imaging or a limited license to engage in radiologic imaging pursuant to chapter 653 of NRS or other provider of health services who is authorized to engage in his or her occupation by the laws of this state or another state;

- *AB387_R2* – 65 – 2.

The Commissioner may not, by rule or otherwise, exempt an insurer from the provisions of NRS 686B.010 to 686B.1799, inclusive, with regard to insurance covering the liability of a practitioner licensed pursuant to chapter 630, 631, 632 or 633 of - *AB387_R1* – 67 – NRS or sections 2 to 32, inclusive, of this act for a breach of the practitioner’s professional duty toward a patient.

An insurer shall not contract with a provider of health care to provide health care to an insured unless the insurer uses the form - *AB387_R2* – 66 – prescribed by the Commissioner pursuant to NRS 629.095 to obtain any information related to the credentials of the provider of health care.

- *AB387_R1* – 68 – 3.

(b) Except as otherwise provided in this paragraph, by the insurer upon giving to the provider 45 days’ written notice of the - *AB387_R2* – 67 – modification of the insurer’s schedule of payments, including any changes to the fee schedule applicable to the provider’s practice.

If the provider fails to object in writing to the modification within the - *AB387_R1* – 69 – 45-day period, the modification becomes effective at the end of that period.

- *AB387_R2* – 68 – 4.

- *AB387_R1* – 70 – (a) If requested by the provider of health care at the time the contract is made, submit to the provider of health care the schedule of payments applicable to the provider of health care;

690B.270 If an insurer declines to issue to a practitioner licensed pursuant to chapter 630, 631, 632 or 633 of NRS or sections 2 to 32, inclusive, of this act a policy of professional liability insurance, the insurer shall, upon the request of the - *AB387_R2* – 69 – practitioner, disclose to the practitioner the reasons the insurer declined to issue the policy.

- *AB387_R1* – 71 – Sec.

If an insurer issues a policy of professional liability insurance to a practitioner licensed pursuant to chapter 630, 632 or 633 of NRS or sections 2 to 32, inclusive, of this act who delivers one or more babies per year, the insurer may set the premium for the policy at a rate that is different, based in whole or in part upon the number of babies delivered per year by the practitioner, from the rate set for such a policy issued by the insurer to any other practitioner licensed pursuant to chapter 630, 632 or 633 of NRS or - *AB387_R2* – 70 – sections 2 to 32, inclusive, of this act who delivers one or more babies per year if the insurer:

- *AB387_R1* – 72 – (a) Bases the difference upon actuarial and loss experience data available to the insurer;

(c) Disclose to the practitioner the portion of the premium attributable to funding the extended reporting endorsement offered at no additional cost to the practitioner in the event of the - *AB387_R2* – 71 – practitioner’s death, disability or retirement, if such a benefit is offered.

- *AB387_R1* – 73 – (d) Disclose to the practitioner the vesting requirements for the extended reporting endorsement offered at no additional cost to the practitioner in the event of the practitioner’s death or retirement, if such a benefit is offered.

or - *AB387_R2* – 72 – (c) Whose information collected pursuant to subsection 1 indicates a potentially adverse trend.

- *AB387_R1* – 74 – 3.

If - *AB387_R2* – 73 – the provider fails to object in writing to the modification within the 45-day period, the modification becomes effective at the end of that - *AB387_R1* – 75 – period.

- *AB387_R2**AB387_R1* – 7476 – (a) If requested by the provider of health care at the time the contract is made, submit to the provider of health care the schedule of payments applicable to the provider of health care;

- *AB387_R2**AB387_R1* – 7577 – 4.

(DeletedSection by18 amendment.)of Sec.this act is hereby amended to read as follows:

Sec.

18.

1.

The Board shall adopt any regulations necessary or convenient for carrying out the provisions of this chapter.

Those regulations must include, without limitation:

(a) Requirements concerning the approval by the Division of programs of training for licensed certified professional - *AB387_R1* – 78 – midwives and certified professional midwife birth assistants, including, without limitation, the required training and instruction that must be provided by such a program and the procedure for obtaining such approval.

(b) Requirements governing the issuance and renewal of a license as a licensed certified professional midwife, including, without limitation:

(1) The educational qualifications that, [except as otherwise provided in section 19 of this act and] in addition to the qualifications prescribed by [that] section [,] 19 of this act, are necessary to obtain a license pursuant to that section.

(2) The period for which a license is valid.

(3) A requirement that an applicant for the renewal of a license must have completed continuing education in cultural humility or the elimination of racism or bias.

(c) The procedure for filing a complaint with the Division concerning a licensed certified professional midwife or certified professional midwife student midwife.

(d) Grounds for the Division to impose disciplinary action against a licensed certified professional midwife or certified professional midwife student midwife and the procedure by which the Division will impose such disciplinary action.

(e) Requirements governing the reinstatement of a license that has been revoked, including, without limitation, the procedure to apply for reinstatement.

(f) Regulations governing the ordering, usage and administration of drugs, vaccines, chemicals, solutions and devices pursuant to section 26 of this act;

(g) Regulations concerning the management by a licensed certified professional midwife of a client who may have a condition that puts the client at a moderate or high risk of an adverse outcome for the client or the fetus or newborn infant of the client.

The regulations must, to the extent practicable, be guided by current, peer-reviewed scientific research and must include, without limitation:

(1) A list of conditions or symptoms associated with a risk of serious permanent harm or death to a client or the fetus or newborn infant of a client;

(2) A list of conditions or symptoms associated with a risk of greater than minimal harm to a client or the fetus or newborn infant of a client that do not pose a risk of serious permanent harm or death;

and (3) Specific requirements for each condition or symptom listed pursuant to subparagraphs (1) and (2) governing:

- *AB387_R1* – 79 – (I) The circumstances under which a licensed certified professional midwife must arrange for the client to consult with another provider of health care, co-manage the care of the client with another provider of health care, refer primary responsibility for the care of a client to another provider of health care or transfer the care of the client to a medical facility, procedures for such consultation, co- management, referral or transfer and requirements to ensure that a provider of health care who is consulted, with whom a client’s condition or symptom is co-managed or to whom primary responsibility for the care of a client is referred is appropriately qualified;

and (II) The information that must be included on the form for providing informed refusal to consent to consultation, co-management, referral or transfer pursuant to section 27 of this act and the management of a client who provides such informed refusal to consent.

(h) Requirements governing the screening of clients in accordance with chapter 442 of NRS and necessary measures for the prevention of communicable diseases.

(i) Requirements concerning the records of treatment and outcomes that must be kept by a licensed certified professional midwife.

(j) Any other requirements necessary to optimize obstetrical and neonatal outcomes for clients of licensed certified professional midwives.

2.

The Board may, by regulation, require an applicant for a license as a licensed certified professional midwife, including, without limitation, an applicant for a license by endorsement pursuant to section 20 of this act, to submit to the Division a complete set of his or her fingerprints and written permission authorizing the Division to forward the fingerprints to the Central Repository for Nevada Records of Criminal History for submission to the Federal Bureau of Investigation for its report.

Sec.

An applicant for a license as a licensed certified professional midwifemidwife, other than a license by endorsement pursuant to section 20 of this act, must submit to the Division an application pursuant to this section in the form prescribed by the Division.

The application must be accompanied by a fee - *AB387_R2* – 76 – in the amount prescribed by regulation of the State Board of Health pursuant to NRS 439.150, which must not exceed $1,000.

The application must include, - *AB387_R1* – 80 – without limitation, proof that the applicant [is]is :certified as a midwife by the North American Registry of Midwives, or its successor organization, and:

(a) Is[Has] certified as a midwife by the North American Registry of Midwives, or its successor organization [,] and [:] [(a) Has] (b) Except as otherwise provided in subsection 2, has completed an educational program accredited by the Midwifery Education Accreditation Council, or its successor organizationorganization; .

[;or (b) Holds a Midwifery Bridge Certificate issued by the North American Registry of Midwives, or its successor organization, and has completed the Portfolio Evaluation Process prescribed by that organization.

or (b) Holds a Midwifery Bridge Certificate issued by the North American Registry of Midwives, or its successor organization, and has completed the Portfolio Evaluation Process prescribed by that organization.] 2.

If the Division determines it to be necessary to address shortages in the number of midwives practicing in rural or underserved areas in this StateState, or barriers for applicants from marginalized identities, the Division may, on a case-by-case basis, exempt an applicant from complying with paragraph (b)(a) of subsection 1 if the applicant holdscomplies awith Midwiferyparagraph Bridge(b) certificate issued by the North American Registry of Midwives,subsection or1. its successor organization, and has completed the Portfolio Evaluation Process prescribed by that organization.

ToThe the extent that the implementation of such provisions will leave the Division with sufficient money to carry out its duties under this chapter, the State Board of Health shall establish by regulation a procedure through which:

(a) An applicant may petition the DivisionState Board to reduce the fees imposed pursuant to this section.

An applicant may qualify for such a reduction if the applicant demonstrates, to the satisfaction of the Division,State Board, that the fees imposed pursuant to this section are an economic hardship on the applicant.

- *AB387_R2* – 77 – (b) The DivisionState Board allocates a portion of the fees imposed and collected pursuant to this section to programs that promote applicants from marginalized identities through increasing the numbers of such applicants and reducing barriers that such applicants face.

- *AB387_R1* – 81 – Sec.

(a) An applicant for the issuance of a license as a licensed certified professional midwife or a permit as a student midwife in this State shall include the social security number of the applicant in the application submitted to the Division.

(b) An] , an applicant for the issuance of a license as a licensed certified professional midwife or a permit as a certified professional midwife student midwife in this State shall submit to the Division of Public and Behavioral Health of the Department of Health and Human Services the statement prescribed by the Division of Welfare and Supportive Services of the Department of Health and Human Services pursuant to NRS 425.520.

(a) The application or any other forms that must be submitted for the issuance or renewal of the license;license or permit;

A license as a licensed certified professional midwife or a permit as a certified professional midwife student midwife may not be issued or renewed by the Division if the applicant:

If an applicant indicates on the statement submitted pursuant to subsection 1 that the applicant is subject to a court - *AB387_R2* – 78 – order for the support of a child and is not in compliance with the order or a plan approved by the district attorney or other public agency enforcing the order for the repayment of the amount owed pursuant to the order, the Division shall advise the applicant to contact the district attorney or other public agency enforcing the order to determine the actions that the applicant may take to satisfy the arrearage.

- *AB387_R1* – 82 – Sec.

- *AB387_R2* – 79 – 3.

- *AB387_R1* – 83 – (c) Whether the client consented to the consultation, co- management, referral or transfer;

A client may provide informed refusal to consent to consultation, co-management, referral or transfer in writing on a form prescribed by the Board.Division.

[If the condition or symptom threatens the life or health of the client or the fetus or the newborn infant of the client during labor or delivery, the licensed certified professional midwife must call 911 and - *AB387_R2* – 80 – provide care until relieved by a qualified provider of health care.

- *AB387_R1* – 84 – (1) May continue to serve as the primary provider of health care for the client until the client provides such consent;

[(b) Subsection 2 exists and making a reasonable effort to arrange for consultation with, co-management of the condition or symptom with or referral of the client to a qualified provider of health care, a licensed certified professional midwife is unable to locate a qualified provider of health care who is willing to consult, co-manage or accept the referral, the licensed certified professional midwife shall be deemed to be in compliance with the requirements of this section and is not liable for any damages resulting from the inability of the licensed certified professional midwife to arrange for consultation, co-manage or refer.] - *AB387_R2* – 81 – 6.

Such a provider of health care is only - *AB387_R1* – 85 – liable for the damages resulting from his or her own acts or omissions in accordance with the standards of care governing his or her profession.

- *AB387_R2* – 82 – 3.

The Nevada Chapter of the National Association of Certified Professional Midwives, or its successor organization, in consultation with the Nevada Association of Professional Midwives, or its successor organization, shall appoint to the Workgroup four voting members who are midwives who reside and practice in Nevada.

To the extent practicable, two of those members must reside and practice in Northern Nevada and two of those members must practice in Southern Nevada.

- *AB387_R1* – 86 – 4.

Not later than July 1, 2022, the Workgroup or, if the Workgroup divides into subcommittees pursuant to subsection 8, each subcommittee of the Workgroup, shall make recommendations to the Board of Licensed Certified Professional Midwives created by section 16 of this act concerning the regulations required by paragraph (g) of subsection 1 of section 18 of this act governing the - *AB387_R2* – 83 – transfer of the client of a licensed certified professional midwife to a medical facility.

The Workgroup ceases to exist upon - *AB387_R1* – 87 – submission of those recommendations unless the Board requests that the Workgroup continue to meet.

Notwithstanding the provisions of section 16 of this act, on or before July 1, 2022, the Administrator of the Division of Public and Behavioral Health of the Department of Health and Human Services may appoint to the Board of Licensed Certified Professional Midwives created by that section:section four members pursuant to paragraph (a) of subsection 2 of that section who are not licensed pursuant to section 19 or 20 of this act and are certified as midwives by the North American Registry of Midwives, or its successor organization.

If such a member is not licensed as a licensed certified professional midwife pursuant to section 19 or 20 of this act on July 1, 2022:

FourHis membersor pursuanther toterm paragraphends (a)on of subsection 2 of that sectiondate; who are not licensed pursuant to section 19 of this act and are certified as midwives by the North American Registry of Midwives, or its successor organization.

Ifand such2. a member is not licensed as a licensed certified professional midwife pursuant to section 19 of this act on July 1, 2022:

(a)The HisAdministrator orshall herappoint terma endsperson onwho thatis date;so licensed to fill the vacancy.

and (b) The Administrator shall appoint a person who is so licensed to fill the vacancy.

2.

Two members pursuant to paragraph (d) of subsection 2 of section 16 of this act who have not received care from a licensed certified professional midwife licensed pursuant to section 19 of this act but who have received care from a midwife certified by the North American Registry of Midwives, or its successor organization.

Those members may serve until the expiration of the terms prescribed pursuant to subsection 5 of section 16 of this act.

- *AB387_R2* – 84 – Sec.

106.5.

Section 1.1 of Assembly Bill No.

287 of the current Legislative Session is hereby repealed.

§ 666 requiring each state to - *AB387_R1* – 88 – establish procedures under which the state has authority to withhold or suspend, or to restrict the use of professional, occupational and recreational licenses of persons who:

-(a) *AB387_R2*Have –failed 85to –comply with a subpoena or warrant relating to a proceeding to determine the paternity of a child or to establish or enforce an obligation for the support of a child;

TEXTH OF- REPEALED*AB387_R1* SECTION Section 1.1 of Assembly Bill No.

287 of the current Legislative Session:

Sec.

1.1.

Chapter 440 of NRS is hereby amended by adding thereto a new section to read as follows:

As used in this chapter, “midwife” means:

1.

A person certified as:

(a) A Certified Professional Midwife by the North American Registry of Midwives, or its successor organization;

or (b) A Certified Nurse-Midwife by the American Midwifery Certification Board, or its successor organization;

or 2.

Any other type of midwife.

H - *AB387_R2*