Bill Text: HI SB2669 | 2024 | Regular Session | Introduced

Hawaii Senate Bill 2669

Introduced

Bill Title: Relating To Gender Affirming Care.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced) 2024-01-24 - Referred to HHS/CPN, WAM/JDC. [SB2669 Detail]

Download: Hawaii-2024-SB2669-Introduced.html

THE SENATE	S.B. NO.	2669
THIRTY-SECOND LEGISLATURE, 2024
STATE OF HAWAII

A BILL FOR AN ACT

relating to gender affirming care.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The legislature finds that the ability to access and make decisions about the full range of sexual and reproductive health care is essential to the health, well-being, and autonomy of Hawaii's people. In some instances, transgender and gender diverse persons have faced challenges with accessibility to gender affirming treatment, such as social support, mental health care, puberty blockers, gender affirming hormones and medications, and gender affirming procedures and surgeries. Ensuring that providers of sexual, reproductive, and gender affirming health care, including service providers who play a critical role in supporting individuals making important health care decisions, is essential to bodily autonomy of all people in the State.

The legislature also finds that transgender and gender diverse persons seeking gender affirming treatment with estrogen may access care through telehealth with any clinician licensed in the State, even if the provider is not physically present in the State. However, transgender and gender diverse persons seeking testosterone treatments are required to be seen physically for an in-person evaluation and have their provider physically present in the State, drastically limiting the availability of providers. While there is no clinical evidence for in-person requirements before a patient can access telehealth services, the Federation of State Medical Boards states that the provider-patient relationship is clearly established when the provider agrees to undertake diagnosis and treatment of the patient, and the patient agrees to be treated, whether there has been an encounter in-person between the provider and the patient. As the State is experiencing a chronic shortage of health care providers, in-person evaluations increase barriers and worsen health inequities. Therefore, increasing access and availability to health care providers and services through telehealth may improve patient and community outcomes.

The legislature further finds that the State has a history of being a leader nationwide in supporting gender affirming treatments and health care and accessibility to health care services through telehealth. The State has denounced discrimination, including transphobia and transphobic action, and recognized transphobia as a threat to public health. Additionally, the State has shown a commitment to expanding access to telehealth. Therefore, the State has an opportunity to continue ensuring that law and policy supports a provider's ability to provide quality services and an individual's ability to obtain the full range of care they need to affirm their gender identity.

Accordingly, the purpose of this Act is to:

(1) Provide that in-person consultation and examination requirements for the establishment of a provider-patient relationship shall not apply for the purposes of gender affirming treatment;

(2) Exempt certain in-person consultation requirements for providers to issue prescriptions for the purposes of gender affirming care;

(3) Prohibit certain boards from taking adverse action against individuals possessing or applying for a license to practice medicine and surgery or nursing for providing gender affirming treatments in the State in compliance with the laws of the State, or being disciplined by another state for providing gender affirming treatment;

(4) Prohibit certain insurers from taking adverse actions against health care providers for providing gender affirming treatment;

(5) Prohibit court clerks from issuing subpoenas in connection with out-of-state subpoenas related to gender affirming treatments that are provided in compliance with the laws of the State;

(6) Require the department of health to establish a public outreach and education campaign to inform the public of the availability and accessibility to gender affirming treatment providers and services; and

(7) Appropriate funds.

SECTION 2. Chapter 671, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§671- Professional liability insurance; gender affirming treatment. (a) No insurer providing professional liability insurance for health care providers shall take any adverse action against a health care provider, including denying or revoking coverage or imposing sanctions, fines, penalties, or rate increases; based on the health care provider providing, authorizing, recommending, aiding in, assisting in, referring for, or otherwise participating in gender affirming treatment, in violation of the laws of another state prohibiting the provision of gender affirming treatment either in that state or for a resident of that state, regardless of whether the violations have resulted in the revocation of, or any other adverse action taken against, the health care provider's license in that state.

(b) As used in this section:

"Gender affirming treatment" means a service or product that a health care provider prescribes to a two-spirit, transgender, nonbinary, or other gender-diverse individual to support and affirm the individual's gender identity. "Gender affirming treatment" includes treatment for gender dysphoria."

SECTION 3. Section 329-1, Hawaii Revised Statutes, is amended by amending the definition of "physician-patient-relationship" to read as follows:

""Physician-patient relationship" means the collaborative relationship between physicians and their patients. To establish this relationship, the treating physician or the physician's designated member of the health care team, at a minimum shall:

(1) Personally perform a face-to-face history and physical examination of the patient that is appropriate to the specialty training and experience of the physician or the designated member of the physician's health care team, make a diagnosis and formulate a therapeutic plan, or personally treat a specific injury or condition; provided that a face-to-face examination shall not be required for the purposes of gender affirming treatment;

(2) Discuss with the patient the diagnosis or treatment, including the benefits of other treatment options; and

(3) Ensure the availability of appropriate follow-up care.

For purposes of this definition, "gender affirming treatment" means a service or product that a health care provider prescribes to a two-spirit, transgender, nonbinary, or other gender-diverse individual to support and affirm the individual's gender identity. "Gender affirming treatment" includes treatment for gender dysphoria."

SECTION 4. Section 329-41, Hawaii Revised Statutes, is amended to read as follows:

"§329-41 Prohibited acts B--penalties. (a) It is unlawful for any person:

(1) Who is subject to part III to distribute, administer, prescribe, or dispense a controlled substance in violation of section 329-38 or rules authorized under section 329-31; however, a licensed manufacturer or wholesaler may sell or dispense a controlled substance to a master of a transpacific ship or a person in charge of a transpacific aircraft upon which no physician is regularly employed, for the actual medical needs of persons on board [~~such~~] the ship or aircraft when not in port; provided schedule I or II controlled substances shall be sold to the master of [~~such~~] the ship or person in charge of [~~such~~] the aircraft only in accordance with the provisions set forth in 21 Code of Federal Regulations, sections 1301, 1305, and 1307, adopted pursuant to Title 21, United States Code, section 821;

(2) Who is a registrant to manufacture a controlled substance not authorized by the registrant's registration or to distribute or dispense a controlled substance not authorized by the registrant's registration to another registrant or another authorized person;

(3) To refuse or fail to make available, keep, or furnish any record, notification, order form, prescription, statement, invoice, or information in patient charts relating to the administration, dispensing, or prescribing of controlled substances;

(4) To refuse any lawful entry into any premises for any inspection authorized by this chapter;

(5) Knowingly to keep or maintain any store, shop, warehouse, dwelling, building, vehicle, boat, aircraft, or other structure or place for the purpose of using these substances or which is used for keeping or selling them in violation of this chapter or chapter 712, part IV;

(6) Who is a practitioner or pharmacist to dispense a controlled substance to any individual not known to the practitioner or pharmacist, except under the following circumstances:

(A) When dispensing a controlled substance directly to an individual, the practitioner or pharmacist shall first obtain and document, in a log book or an electronic database, the full name, identification number, identification type, and signature, whether by actual signature or by electronic signature capture device, of the individual obtaining the controlled substance. If the individual does not have any form of proper identification, the pharmacist shall verify the validity of the prescription and identity of the patient with the prescriber, or their authorized agent, before dispensing the controlled substance; and

(B) For mail order prescriptions, the practitioner or pharmacist shall not be subject to subparagraph (A); provided that all other requirements of chapter 329 shall apply and that the practitioner or pharmacist, as part of the initial registration process of an individual in a mail order prescription drug plan and prior to the controlled substance being dispensed, shall obtain all identification information, including the full name, identification number, identification type, signature, and a photocopy of a form of proper identification of the individual obtaining the controlled substance. The practitioner or pharmacist shall also comply with other requirements set forth by rule.

For the purpose of this section, "proper identification" means government-issued identification containing the photograph, printed name, identification number, and signature of the individual obtaining the controlled substance;

(7) Who is a practitioner to predate or pre-sign prescriptions to facilitate the obtaining or attempted obtaining of controlled substances; or

(8) Who is a practitioner to facilitate the issuance or distribution of a written prescription or to issue an oral prescription for a controlled substance when not physically in the State[.]; provided that this paragraph shall not apply to gender affirming treatment.

(b) It shall be unlawful for any person subject to part III of this chapter except a pharmacist, to administer, prescribe, or dispense any controlled substance without a bona fide physician-patient relationship[.]; provided that this subsection shall not apply for the purposes of gender affirming treatment."

(d) For the purposes of this section, "gender affirming treatment" means a service or product that a health care provider prescribes to a two-spirit, transgender, nonbinary, or other gender-diverse individual to support and affirm the individual's gender identity. "Gender affirming treatment" includes treatment for gender dysphoria."

SECTION 5. Section 329-126, Hawaii Revised Statutes, is amended by amending subsection (b) to read as follows:

"(b) For purposes of this section[~~, a bona fide physician-patient relationship may be~~]:

"Bona fide physician-patient relationship" means a relationship established via telehealth, as defined in section 453-1.3(j), and a bona fide advanced practice registered nurse-patient relationship may be established via telehealth, as defined in section 457-2; provided that treatment recommendations that include certifying a patient for the medical use of cannabis via telehealth shall be allowed only after an initial in-person consultation between the certifying physician or advanced practice registered nurse and the patient[.]; provided that in-person consultation requirements shall not be required for the provision of gender affirming treatment.

SECTION 6. Section 453-1.3, Hawaii Revised Statutes, is amended by amending subsection (c) to read as follows:

"(c) Treatment recommendations made via telehealth, including issuing a prescription via electronic means, shall be held to the same standards of appropriate practice as those in traditional physician-patient settings that do not include [a] an in-person visit but in which prescribing is appropriate, including on-call telephone encounters and encounters for which a follow-up visit is arranged. Issuing a prescription based solely on an online questionnaire is not treatment for the purposes of this section and does not constitute an acceptable standard of care. For the purposes of prescribing opiates or certifying a patient for the medical use of cannabis, a physician-patient relationship shall only be established after an in-person consultation between the prescribing physician and the patient. This subsection shall not apply to the provision of gender affirming treatment.

For the purposes of this subsection, "gender affirming treatment" means a service or product that a health care provider prescribes to a two-spirit, transgender, nonbinary, or other gender-diverse individual to support and affirm the individual's gender identity. "Gender affirming treatment" includes treatment for gender dysphoria."

SECTION 7. Section 453-8, Hawaii Revised Statutes, is amended to read as follows:

"§453-8 Revocation, limitation, suspension, or denial of licenses. (a) In addition to any other actions authorized by law, any license to practice medicine and surgery may be revoked, limited, or suspended by the board at any time in a proceeding before the board, or may be denied, for any cause authorized by law, including but not limited to the following:

(1) Procuring, or aiding or abetting in procuring, an abortion or gender affirming treatment unlawful under the laws of this State if performed within this State;

(2) Employing any person to solicit patients for one's self;

(3) Engaging in false, fraudulent, or deceptive advertising, including but not limited to:

(A) Making excessive claims of expertise in one or more medical specialty fields;

(B) Assuring a permanent cure for an incurable disease; or

(4) Being habituated to the excessive use of drugs or alcohol; or being addicted to, dependent on, or a habitual user of a narcotic, barbiturate, amphetamine, hallucinogen, or other drug having similar effects;

(5) Practicing medicine while the ability to practice is impaired by alcohol, drugs, physical disability, or mental instability;

(6) Procuring a license through fraud, misrepresentation, or deceit, or knowingly permitting an unlicensed person to perform activities requiring a license;

(7) Professional misconduct, hazardous negligence causing bodily injury to another, or manifest incapacity in the practice of medicine or surgery;

(8) Incompetence or multiple instances of negligence, including but not limited to the consistent use of medical service, which is inappropriate or unnecessary;

(9) Conduct or practice contrary to recognized standards of ethics of the medical profession as adopted by the Hawaii Medical Association, the American Medical Association, the Hawaii Association of Osteopathic Physicians and Surgeons, or the American Osteopathic Association;

(10) Violation of the conditions or limitations upon which a limited or temporary license is issued;

(11) Revocation, suspension, or other disciplinary action by another state or federal agency of a license, certificate, or medical privilege, except when the revocation, suspension, or other disciplinary action was based on the provision or assistance in receipt or provision of medical, surgical, pharmaceutical, counseling, or referral services relating to the human reproductive system, including but not limited to services relating to pregnancy, contraception, or the termination of a pregnancy, or gender affirming treatment, so long as the provision or assistance in receipt or provision of the services was in accordance with the laws of this State or would have been in accordance with the laws of this State if it occurred within this State;

(12) Conviction, whether by nolo contendere or otherwise, of a penal offense substantially related to the qualifications, functions, or duties of a physician or osteopathic physician, notwithstanding any statutory provision to the contrary, except when the conviction was based on the provision or assistance in receipt or provision of medical, surgical, pharmaceutical, counseling, or referral services relating to the human reproductive system, including but not limited to services relating to pregnancy, contraception, or the termination of a pregnancy, or gender affirming treatment, so long as the provision or assistance in receipt or provision of the services was in accordance with the laws of this State or would have been in accordance with the laws of this State if it occurred within this State;

(13) Violation of chapter 329, the uniform controlled substances act, or any rule adopted thereunder except as provided in section 329-122;

(14) Failure to report to the board, in writing, any disciplinary decision issued against the licensee or the applicant in another jurisdiction within thirty days after the disciplinary decision is issued; or

(15) Submitting to or filing with the board any notice, statement, or other document required under this chapter, which is false or untrue or contains any material misstatement or omission of fact.

(b) If disciplinary action related to the practice of medicine has been taken against the applicant by another state or federal agency, or if the applicant reveals a physical or mental condition that would constitute a violation under this section, then the board may impose one or more of the following requirements as a condition for licensure:

(1) Physical and mental evaluation of the applicant by a licensed physician or osteopathic physician approved by the board;

(2) Probation, including conditions of probation as requiring observation of the licensee by an appropriate group or society of licensed physicians, osteopathic physicians, or surgeons;

(3) Limitation of the license by restricting the fields of practice in which the licensee may engage;

(4) Further education or training or proof of performance competency; and

(5) Limitation of the medical practice of the licensee in any reasonable manner to assure the safety and welfare of the consuming public; provided that the board shall not impose as a condition for licensure any of the requirements pursuant to this subsection if the disciplinary action related to the practice of medicine taken against the applicant was based on the provision or assistance in receipt or provision of medical, surgical, pharmaceutical, counseling, or referral services relating to the human reproductive system, including but not limited to services relating to pregnancy, contraception, or the termination of a pregnancy, or gender affirming treatment, so long as the provision or assistance in receipt or provision of the services was in accordance with the laws of this State or would have been in accordance with the laws of this State if it occurred within this State.

(c) Notwithstanding any other law to the contrary, the board may deny a license to any applicant who has been disciplined by another state or federal agency, except on the basis of discipline for the provision or assistance in receipt or provision of medical, surgical, pharmaceutical, counseling, or referral services relating to the human reproductive system, including but not limited to services relating to pregnancy, contraception, or the termination of a pregnancy, or gender affirming treatment, so long as the provision or assistance in receipt or provision of the services was in accordance with the laws of this State or would have been in accordance with the laws of this State if it occurred within this State. Any final order of discipline taken pursuant to this subsection shall be a matter of public record.

(d) Where the board has reasonable cause to believe that a licensee is or may be unable to practice medicine with reasonable skill and safety to protect patients, the board may order the licensee to submit to a mental or physical examination or any combination thereof, by a licensed practitioner approved by the board, at the licensee's expense. The examination may include biological fluid testing and other testing known to detect the presence of alcohol or other drugs. In addition:

(1) Any licensee shall be deemed to have consented to submit to a mental or physical examination when so directed by the board and to have waived all objection to the use or referral of information by the board to determine whether the licensee is able to practice medicine with reasonable skill and safety to protect patients;

(2) The board may seek to enforce an order directing a licensee to submit to a mental or physical examination in the circuit court in the county in which the licensee resides;

(3) Failure of a licensee to submit to an examination ordered under this subsection shall constitute grounds for summary suspension of the licensee's license; and

(4) The board may take any action authorized under this chapter based on information obtained under this subsection.

(e) Any person licensed by the board, including a physician, surgeon, or physician assistant, who provides information to the board indicating that a board licensee may be guilty of unprofessional conduct or may be impaired because of drug or alcohol abuse or mental illness shall not be liable for any damages in any civil action based on the communication. The immunity afforded by this section shall be in addition to any immunity afforded by section 663-1.7, if applicable, and shall not be construed to affect the availability of any absolute privilege under sections 663-1.7 and 671D-10.

(f) The board shall not revoke, suspend, penalize, refuse to issue or renew, or take any other adverse action against the license issued pursuant to this section based:

(1) Solely on the licensee providing, authorizing, recommending, aiding in, assisting in, referring for, or otherwise participating in gender affirming treatment provided in accordance with the laws of this State, regardless of the patient's resident state; or

(2) On the licensee's license being revoked or suspended, or the licensee being otherwise disciplined by another state, if that revocation, suspension, or other form of discipline was based solely on the licensee providing gender affirming treatment, regardless of the patient's resident state, in accordance with the laws of this State and within the accepted standard of care;

provided that the board may discipline a licensee for care provided that would otherwise constitute an actionable offense under this section.

(g) Any applicant seeking licensure to practice medicine and surgery under this chapter who has been subject to disciplinary action by a duly authorized professional disciplinary agency of another jurisdiction solely on the licensee's license being revoked or suspended, or the licensee being otherwise disciplined by another state, if that revocation, suspension, or other form of discipline was based solely on the licensee providing any gender affirming treatment, regardless of the patient's resident state, in accordance with the laws of this State and within the accepted standard of care, shall not be denied licensure to practice medicine and surgery under this chapter unless the board determines that the basis for disciplinary action in that jurisdiction constitutes professional misconduct in this State; provided that nothing in this subsection shall be construed as prohibiting the board from evaluating the conduct of the applicant and determining whether to deny the application for licensure to practice medicine and surgery under this chapter.

(h) As used in this section:

SECTION 8. Section 457-12, Hawaii Revised Statutes, is amended to read as follows:

"§457-12 Discipline; grounds; proceedings; hearings. (a) In addition to any other actions authorized by law, the board shall have the power to deny, revoke, limit, or suspend any license to practice nursing as a registered nurse or as a licensed practical nurse applied for or issued by the board in accordance with this chapter, and to fine or to otherwise discipline a licensee for any cause authorized by law, including but not limited to the following:

(1) Fraud or deceit in procuring or attempting to procure a license to practice nursing as a registered nurse or as a licensed practical nurse;

(2) Gross immorality;

(3) Unfitness or incompetence by reason of negligence, habits, or other causes;

(4) Habitual intemperance, addiction to, or dependency on alcohol or other habit-forming substances;

(5) Mental incompetence;

(6) Unprofessional conduct as defined by the board in accordance with its own rules;

(7) Wilful or repeated violation of any of the provisions of this chapter or any rule adopted by the board;

(8) [~~Revocation,~~] Except as otherwise provided in subsection (e), revocation, suspension, limitation, or other disciplinary action by another state of a nursing license, except when the revocation, suspension, limitation, or other disciplinary action by another state was based on the provision or assistance in receipt or provision of medical, surgical, pharmaceutical, counseling, or referral services relating to the human reproductive system, including but not limited to services relating to pregnancy, contraception, or the termination of a pregnancy, so long as the provision or assistance in receipt or provision of the services was in accordance with the laws of this State or would have been in accordance with the laws of this State if it occurred within this State;

(9) Conviction, whether by nolo contendere or otherwise, of a penal offense substantially related to the qualifications, functions, or duties of a nurse, notwithstanding any statutory provision to the contrary, except when the conviction was based on the provision or assistance in receipt or provision of medical, surgical, pharmaceutical, counseling, or referral services relating to the human reproductive system, including but not limited to services relating to pregnancy, contraception, or the termination of a pregnancy, so long as the provision or assistance in receipt or provision of the services was in accordance with the laws of this State or would have been in accordance with the laws of this State if it occurred within this State;

(10) Failure to report to the board any disciplinary action taken against the licensee in another jurisdiction within thirty days after the disciplinary action becomes final;

(11) Submitting to or filing with the board any notice, statement, or other document required under this chapter, which is false or untrue or contains any material misstatement of fact, including a false attestation of compliance with continuing competency requirements;

(12) Violation of the conditions or limitations upon which any license is issued; or

(13) Violation of chapter 329, the uniform controlled substances act, or any rule adopted thereunder except as provided in section 329-122.

(b) Notwithstanding any other law to the contrary, the board may deny a license to any applicant who has been disciplined by another state, except on the basis of discipline by another state for the provision or assistance in receipt or provision of medical, surgical, pharmaceutical, counseling, or referral services relating to the human reproductive system, including but not limited to services relating to pregnancy, contraception, or the termination of a pregnancy, so long as the provision or assistance in receipt or provision of the services was in accordance with the laws of this State or would have been in accordance with the laws of this State if it occurred within this State; provided that any applicant seeking an advanced practice registered nurse license under section 457-8.5 who has been subject to disciplinary action by a duly authorized professional disciplinary agency of another state based solely on the licensee providing any gender affirming treatment, regardless of the patient's resident state, in accordance with the laws of this State and within the accepted standard of care shall not be denied an advanced practice registered nurse license under section 457‑8.5 unless the board determines that the basis for disciplinary action in that jurisdiction constitutes professional misconduct in this State; provided further that nothing in this subsection shall be construed as prohibiting the board from evaluating the conduct of an applicant and determining whether to deny the application for an advanced practice registered nurse license under section 457-8.5. Any final order entered pursuant to this subsection shall be a matter of public record.

(c) Any fine imposed by the board after a hearing in accordance with chapter 91 shall be no less than $100 and no more than $1,000 for each violation.

(d) The remedies or penalties provided by this chapter are cumulative to each other and to the remedies or penalties available under all other laws of this State.

(e) The board shall not revoke, suspend, penalize, refuse to issue or renew, or take any other adverse action against a license issued pursuant to section 457-8.5 based:

provided that the board may discipline a licensee for care provided that would otherwise constitute an actionable offense under this section.

(f) As used in this section:

SECTION 9. Section 624D-3, Hawaii Revised Statutes, is amended by amending subsection (b) to read as follows:

"(b) When a party submits a foreign subpoena to a clerk of court in this State, the clerk, in accordance with that court's procedure, shall promptly issue a subpoena for service upon the person to which the foreign subpoena is directed[.]; provided that, notwithstanding any other law to contrary, no clerk of any court in this State shall issue a subpoena under this section in connection with a foreign subpoena for any proceedings relating to any gender affirming treatment provided in accordance with the laws of this State.

As used in this subsection, "gender affirming treatment" means a service or product that a health care provider prescribes to a two-spirit, transgender, nonbinary, or other gender-diverse individual to support and affirm the individual's gender identity. "Gender affirming treatment" includes treatment for gender dysphoria."

SECTION 10. The department of health shall conduct a public outreach and education campaign to inform the public about the availability and importance of access to gender affirming treatment. The department of health may use a portion of the funds collected in a given year for the public outreach and education campaign; provided that the department shall use not more than per cent per year or $ per year, whichever is greater, for the public outreach and education campaign. Outreach information shall be available in English and other languages spoken within the State.

SECTION 11. In accordance with section 9 of article VII of the Hawaii State Constitution and sections 37-91 and 37-93, Hawaii Revised Statutes, the legislature has determined that the appropriations contained in Act 164, Regular Session of 2023, and this Act will cause the state general fund expenditure ceiling for fiscal year 2024-2025 to be exceeded by $ or per cent. This current declaration takes into account general fund appropriations authorized for fiscal year 2024-2025 in Act 164, Regular Session of 2023, and this Act only. The reasons for exceeding the general fund expenditure ceiling are that:

(1) The appropriation made in this Act is necessary to serve the public interest; and

(2) The appropriation made in this Act meets the needs addressed by this Act.

SECTION 12. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2024-2025 for a public outreach and education campaign to inform the public of the availability to and accessibility of gender affirming treatment services and providers.

The sum appropriated shall be expended by the department of health for the purposes of this Act.

SECTION 13. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 14. This Act shall take effect on July 1, 2024.

INTRODUCED BY:	_____________________________

Report Title:

DOH; Gender Affirming Treatment; Telehealth; Provider-Patient Relationship; In-Person Requirements; Prescriptions; Licensure; Professional Liability Insurance; Foreign Subpoenas; Expenditure Ceiling; Appropriation

Description:

Excepts certain in-person consultation and examination requirements to establish a provider-patient relationship for the purposes of gender affirming treatment via telehealth. Excepts certain in-person consultation and examination requirements to establish a provider-patient relationship for issuing prescriptions for the purposes of gender affirming treatment. Prohibits certain boards from taking adverse action against individuals possessing or applying for a license to practice medicine and surgery or nursing for providing gender affirming treatments in the State in compliance with the laws of the State or being disciplined by another state for providing gender affirming treatments. Prohibits certain insurers from taking adverse actions against health care providers for providing gender affirming treatments. Prohibits court clerks from issuing subpoenas in connection with out-of-state subpoenas related to gender affirming treatments that are provided in compliance with the laws of the State. Requires the Department of Health to establish a public health campaign that educates the public on gender affirming treatment services statewide. Declares that the general fund expenditure ceiling is exceeded. Makes an appropriation.

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.