Revises provisions relating to forensic medical examinations. (BDR 16-596)

A.B. 272

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ASSEMBLY BILL NO. 272–ASSEMBLYMEMBER HARDY

FEBRUARY 20, 2025
____________

Referred to Committee on Judiciary

SUMMARY—Revises provisions relating to forensic medical
examinations. (BDR 16-596)

FISCAL NOTE: Effect on Local Government: No.
Effect on the State: Yes.

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EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.

AN ACT relating to forensic medical examinations; repealing,
replacing and revising certain provisions relating to the
payment of and reimbursement for forensic medical
examinations of certain victims of crime; and providing
other matters properly relating thereto.
Legislative Counsel’s Digest:
Existing law: (1) requires a county in whose jurisdiction a sexual assault is 1
committed to pay any costs incurred by a hospital for a forensic medical 2
examination of the victim; and (2) provides that such costs must not be charged 3
directly to the victim. (NRS 217.300) Similarly, existing law: (1) requires a county 4
in whose jurisdiction a domestic violence battery by strangulation is committed to 5
pay any costs incurred by a hospital for a strangulation forensic medical 6
examination of the victim; and (2) provides that such costs must not be charged 7
directly to the victim. (NRS 217.405) 8
Sections 3 and 13 of this bill remove and repeal the provisions of existing law 9
requiring the costs incurred by a hospital for a forensic medical examination of a 10
victim of sexual assault or domestic violence battery by strangulation to be paid by 11
the county. Instead, section 1 of this bill establishes procedures by which a health 12
care facility may be reimbursed by the Depa rtment of Health and Human Services 13
for any costs incurred by the health care facility for the forensic medical 14
examination of a victim of sexual assault, domestic violence, battery which is 15
committed by strangulation or certain offenses related to human t rafficking. 16
Additionally, section 1 prohibits the health care facility from directly charging the 17
victims for the costs of such a forensic medical examinatio n. Sections 2 and 4-12 18
of this bill make conforming changes necessary to implement the new procedures 19
for reimbursement. 20

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THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

Section 1. Chapter 217 of NRS is hereby amended by adding 1
thereto a new section to read as follows: 2
1. Except as otherwise provided in subsection 2, a health care 3
facility that incurs any costs for a forensic medical examination 4
shall pay those costs and may not charge the costs directly to the 5
subject of the forensic medical examination. 6
2. A health care facility that incurs any costs for a forensic 7
medical examination may apply to the Department for 8
reimbursement in an amount determined by the Department for 9
each forensic medical examination. 10
3. An application for reimbursement must inclu de 11
documentation of the services rendered during the forensic 12
medical examination. 13
4. The Department shall reimburse a health care facility not 14
later than 60 days after receiving a completed application for 15
reimbursement. 16
5. The Department shall adopt regulations to establish: 17
(a) The procedures to be followed in the filing and review of 18
an application for reimbursement, which must co mply with all 19
laws concerning the privacy of information, including, without 20
limitation, the Health Insurance Portabilit y and Accountability 21
Act of 1996, Public Law 104 -191, as amended, and applicable 22
regulations; and 23
(b) The amount to be reimbursed for a forensic medical 24
examination, which must be reviewed annually by the Department. 25
6. The filing of a report with the appropriate law enforcement 26
agency must not be a prerequisite to qualify for a forensic medical 27
examination pursuant to this section. 28
7. As used in this section: 29
(a) “Department” means the Department of Health and 30
Human Services. 31
(b) “Forensic medical examination” means: 32
(1) An examination by a provider of health care to obtain 33
evidence from a victim of sexual assault; or 34
(2) An examination conducted by a provider of health care 35
for the purpose of assessing the health care needs of a victim of 36
domestic violence, a victim of strangulation or a victim of human 37
trafficking and coordinating the treatment of any injuries of the 38
victim. 39
(c) “Health care facility” has the meaning ascribed to it in 40
NRS 200.471. 41

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(d) “Victim of domestic violence” means a per son who is the 1
victim of the commission of any act described in NRS 33.018. 2
(e) “Victim of human trafficking” has the meaning ascribed to 3
it in NRS 217.520. 4
(f) “Victim of sexual assault” has the meaning ascribed to it in 5
NRS 217.280. 6
(g) “Victim of str angulation” means a person who is a victim 7
of a battery which is committed by strangulation as described in 8
NRS 200.481. 9
Sec. 2. NRS 217.160 is hereby amended to read as follows: 10
217.160 1. The compensation officer may order the payment 11
of compensation: 12
(a) To or for the benefit of the victim. 13
(b) If the victim has suffered personal injury, to any person 14
responsible for the maintenance of the victim who has suffered 15
pecuniary loss or incurred expenses as a result of the injury. 16
(c) If the victim dies, to or for the benefit of any one or more of 17
the dependents of the victim. 18
(d) To a minor who is a member of the household or immediate 19
family of a victim of a battery which constitutes domestic violence 20
pursuant to NRS 3 3.018 who needs an assessment, a psychological 21
evaluation or psychological counseling for emotional trauma 22
suffered by the minor as a result of the battery. 23
(e) To a member of the victim’s household or immediate family 24
for psychological counseling for emo tional trauma suffered by the 25
member as a result of the crime of murder as defined in 26
NRS 200.010. 27
[(f) To a county in whose jurisdiction a sexual assault was 28
committed for the reimbursement of costs associated with a forensic 29
medical examination of a vi ctim of sexual assault that are paid by 30
the county pursuant to NRS 217.300. A county may be reimbursed 31
pursuant to this paragraph in an amount equal to the cost of 10 32
forensic medical examinations or $10,000, whichever is less, each 33
fiscal year.] 34
2. As used in this section: 35
(a) “Battery” has the meaning ascribed to it in paragraph (a) of 36
subsection 1 of NRS 200.481. 37
(b) [“Forensic medical examination” has the meaning ascribed 38
to it in NRS 217.300. 39
(c)] “Household” means an association of persons who li ve in 40
the same home or dwelling and who: 41
(1) Have significant personal ties to the victim; or 42
(2) Are related by blood, adoption or marriage, within the 43
first degree of consanguinity or affinity. 44

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[(d)] (c) “Immediate family” means persons who are rela ted by 1
blood, adoption or marriage, within the first degree of consanguinity 2
or affinity. 3
[(e) “Victim of sexual assault” has the meaning ascribed to it in 4
NRS 217.280.] 5
Sec. 3. NRS 217.300 is hereby amended to read as follows: 6
217.300 1. The county in whose jurisdiction a sexual assault 7
is committed shall [: 8
(a) Pay] pay any costs incurred for medical care for any physical 9
injuries resulting from the sexual assault which is provided to the 10
victim not later than 72 h ours after the victim first arrives for 11
treatment. 12
[(b) Pay any costs incurred by a hospital for the forensic medical 13
examination of the victim.] 14
2. Any costs incurred pursuant to subsection 1: 15
(a) Must not be charged directly to the victim of sexual assault. 16
(b) Must be charged to the county in whose jurisdiction the 17
offense was committed. 18
[3. The filing of a report with the appropriate law enforcement 19
agency must not be a prerequisite to qualify for a forensic medical 20
examination pursuant to this section. 21
4. The costs associated with a forensic medical examination 22
must not be included in the costs for medical treatment pursuant to 23
NRS 217.310. 24
5. As used in this section, “forensic medical examination” 25
means an examination by a health care provi der to obtain evidence 26
from a victim of sexual assault.] 27
Sec. 4. NRS 217.310 is hereby amended to read as follows: 28
217.310 1. If any victim of sexual assault requires medical 29
treatment for physical injuries as a result o f the sexual assault, in 30
addition to any initial emergency medical care provided, or if any 31
victim or spouse of such a victim suffers emotional trauma as a 32
result of the sexual assault, the victim or spouse may, upon 33
submitting an affidavit as required by subsection 2, apply to the 34
board of county commissioners in the county where the sexual 35
assault occurred for treatment at county expense. 36
2. The board shall approve an application for treatment upon 37
receiving an affidavit from the applicant declaring that: 38
(a) The applicant is a victim of sexual assault or spouse of such 39
a victim; 40
(b) The sexual assault occurred in the county; and 41
(c) The victim requires medical treatment for physical injuries, 42
or the victim or spouse has suffered emotional trauma, as a result of 43
the sexual assault. 44

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3. A victim who has suffered emotional trauma may select a 1
relative or close friend to receive counseling with the victim if the 2
counselor agrees that such companionship will be helpful to the 3
victim. If the victim’s appli cation for treatment is approved, 4
counseling for the relative or friend must also be approved. 5
4. A victim must file a report with the appropriate law 6
enforcement agency or submit to a forensic medical examination 7
pursuant to [NRS 217.300] section 1 of this act as a prerequisite for 8
the victim or any other person eligible to qualify for treatment under 9
the provisions of this section. 10
5. Whenever cost s are incurred by a hospital for treatment 11
which has been approved by the board of county commissioners 12
pursuant to this section for the victim of a sexual assault and any 13
other person eligible for treatment, the costs of the treatment, not to 14
exceed $1,000, must be charged to the county which authorized the 15
treatment. Any remainder must be handled the same as other 16
hospital costs. 17
6. The costs associated with a forensic medical examination 18
must not be included in the costs for medical treatment under thi s 19
section. 20
7. As used in this section, “forensic medical examination” 21
means an examination by a provider of health care to obtain 22
evidence from a victim of sexual assault. 23
Sec. 5. NRS 178A.060 is hereby amended to read as follows: 24
178A.060 “Forensic medical examination” has the meaning 25
ascribed to it in NRS [217.300.] 217.310. 26
Sec. 6. NRS 178A.190 is hereby amended to read as follows: 27
178A.190 1. If a survivor requests a consultation w ith a 28
sexual assault victims’ advocate or an attendant to provide support 29
to the survivor pursuant to NRS 178A.170, the medical provider 30
shall summon the sexual assault victims’ advocate or attendant 31
before the commencement of the forensic medical examination. 32
2. If a sexual assault victims’ advocate or an attendant to 33
provide support to the survivor pursuant to NRS 178A.170 cannot 34
be summoned in a timely manner, the medical provider shall inform 35
the survivor of the ramifications of delaying the forensic medical 36
examination. 37
3. A survivor must not be required to pay any expense related 38
to a forensic medical examination pursuant to [NRS 217.300. ] 39
section 1 of this act. 40
4. After the forensic medical examination, the survivor has the 41
right to use a shower apparatus at no cost, unless a facility which 42
includes a shower apparatus is not available. 43
5. Before a medical provider commences a forensic medical 44
examination, the medical provider shall inform the survivor of his or 45

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her rights pursuant to the Sexual Assault Survivors’ Bill of Rights 1
and other relevant law by presenting a document developed by the 2
Office of the Attorney General pursuant to NRS 178A.270. 3
6. The person who presents to the survivor the document 4
developed by the Office of the Attorney General pursuant to NRS 5
178A.270 shall sign a written acknowledgment indicating that the 6
person presen ted the document to the survivor. The written 7
acknowledgment must be retained in the case file of the survivor. 8
Sec. 7. NRS 200.364 is hereby amended to read as follows: 9
200.364 As used in NRS 200.364 to 200.3788, inclusi ve, 10
unless the context otherwise requires: 11
1. “Forensic laboratory” has the meaning ascribed to it in 12
NRS 176.09117. 13
2. “Forensic medical examination” has the meaning ascribed to 14
it in NRS [217.300.] 217.310. 15
3. “Genetic marker analysis” has the meaning ascribed to it in 16
NRS 176.09118. 17
4. “Offense involving a pupil or child” means any of the 18
following offenses: 19
(a) Sexual conduct between certain employees of a school or 20
volunteers at a school and a pupil pursuant to NRS 201.540. 21
(b) Sexual con duct between certain employees of a college or 22
university and a student pursuant to NRS 201.550. 23
(c) Sexual conduct between certain employees or contractors of 24
or volunteers for an entity which provides services to children and a 25
person under the care, cu stody, control or supervision of the entity 26
pursuant to NRS 201.555. 27
5. “Perpetrator” means a person who commits a sexual offense, 28
an offense involving a pupil or child or sex trafficking. 29
6. “Sex trafficking” means a violation of subsection 2 of 30
NRS 201.300. 31
7. “Sexual assault forensic evidence kit” means the forensic 32
evidence obtained from a forensic medical examination. 33
8. “Sexual offense” means any of the following offenses: 34
(a) Sexual assault pursuant to NRS 200.366. 35
(b) Statutory sexual seduction pursuant to NRS 200.368. 36
9. “Sexual penetration” means cunnilingus, fellatio, or any 37
intrusion, however slight, of any part of a person’s body or any 38
object manipulated or inserted by a person into the genital or anal 39
openings of the body of anoth er, including sexual intercourse in its 40
ordinary meaning. The term does not include any such conduct for 41
medical purposes. 42
10. “Statutory sexual seduction” means ordinary sexual 43
intercourse, anal intercourse or sexual penetration committed by a 44

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person 18 years of age or older with a person who is 14 or 15 years 1
of age and who is at least 4 years younger than the perpetrator. 2
11. “Victim” means a person who is a victim of a sexual 3
offense, an offense involving a pupil or child or sex trafficking. 4
12. “Victim of sexual assault” has the meaning ascribed to it in 5
NRS 217.280. 6
Sec. 8. NRS 388.1347 is hereby amended to read as follows: 7
388.1347 1. The board of trustees of each school district shall 8
enter into a memorandum of understanding with a community-based 9
organization that assists victims of power -based violence. The 10
memorandum of understanding may, without limitation: 11
(a) Allow for cooperation and training between the school 12
district and the community-based organization that assists victims of 13
power-based violence to establish an understanding of the: 14
(1) Responsibilities that the school district and the 15
community-based organization that assists victims of power -based 16
violence have in responding to a report or disc losure of an alleged 17
incident of power-based violence; and 18
(2) Procedures of the school district for providing support 19
and services to pupils and employees. 20
(b) Require a community-based organization that assists victims 21
of power-based violence to: 22
(1) Assist with developing policies, programming or training 23
for the school district regarding power-based violence; 24
(2) Provide an alternative for a pupil or employee of the 25
school district to receive free counseling, advocacy or crisis services 26
related to an alleged incident of power -based violence, including, 27
without limitation, access to a health care provider who specializes 28
in forensic medical examinations; 29
(3) Assist with the development and implementation of 30
education and prevention programs fo r pupils enrolled at a public 31
school in the school district; and 32
(4) Assist with the development and implementation of 33
training and prevention curriculum for employees of the school 34
district. 35
(c) Include a fee structure for any services provided by the 36
community-based organization that assists victims of power -based 37
violence. 38
2. If a teacher or administrator is informed by a pupil that the 39
pupil has been a victim of power -based violence, the teacher or 40
administrator shall refer the pupil to the communi ty-based 41
organization that assists victims of power-based violence. 42
3. As used in this section: 43
(a) “Forensic medical examination” has the meaning ascribed to 44
it in NRS [217.300.] 217.310. 45

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(b) “Power-based violence” has the meaning ascribed to it in 1
NRS 396.1285. 2
Sec. 9. NRS 388A.3938 is hereby amended to read as follows: 3
388A.3938 1. The governing body of each charter school 4
shall enter into a memorandum of understanding with a community -5
based organization that assists victims of power-based violence. The 6
memorandum of understanding may, without limitation: 7
(a) Allow for cooperation and training between the charter 8
school and the community-based organization that assists victims of 9
power-based violence to establish an understanding of the: 10
(1) Responsibilities that the charter school and the 11
community-based organization that assists victims of power -based 12
violence have in responding to a report or disclosure of an alleged 13
incident of power-based violence; and 14
(2) Procedures of the charter school for providing support 15
and services to pupils and employees. 16
(b) Require a community-based organization that assists victims 17
of power-based violence to: 18
(1) Assist with developing policies, programming or training 19
for the charter school regarding power-based violence; 20
(2) Provide an alternative for a pupil or employee of the 21
charter school to receive free counseling, advocacy or crisis services 22
related to an alleged incident of power -based violence, including, 23
without limitation, access to a health care provider who specializes 24
in forensic medical examinations; 25
(3) Assist with the development and implementation of 26
education and prevention programs for pupils enrolled at the charter 27
school; and 28
(4) Assist with the dev elopment and implementation of 29
training and prevention curriculum for employees of the charter 30
school. 31
(c) Include a fee structure for any services provided by the 32
community-based organization that assists victims of power -based 33
violence. 34
2. If a teacher or administrator of the charter school is informed 35
by a pupil that the pupil has been a victim of power -based violence, 36
the teacher or administrator shall refer the pupil to the community -37
based organization that assists victims of power-based violence. 38
3. As used in this section: 39
(a) “Forensic medical examination” has the meaning ascribed to 40
it in NRS [217.300.] 217.310. 41
(b) “Power-based violence” has the meaning ascribed to it in 42
NRS 396.1285. 43

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Sec. 10. NRS 388C.160 is hereby amended to read as follows: 1
388C.160 1. The governing body of each university school 2
for profoundly gifted pupils shall enter into a memorandum of 3
understanding with a community -based organization that assists 4
victims of power -based violence. Th e memorandum of 5
understanding may, without limitation: 6
(a) Allow for cooperation and training between the university 7
school for profoundly gifted pupils and the community -based 8
organization that assists victims of power -based violence to 9
establish an understanding of the: 10
(1) Responsibilities that the university school for profoundly 11
gifted pupils and the community -based organization that assists 12
victims of power -based violence have in responding to a report or 13
disclosure of an alleged incident of power-based violence; and 14
(2) Procedures of the university school for profoundly gifted 15
pupils for providing support and services to pupils and employees. 16
(b) Require a community-based organization that assists victims 17
of power-based violence to: 18
(1) Assist with developing policies, programming or training 19
for the university school for profoundly gifted pupils regarding 20
power-based violence; 21
(2) Provide an alternative for a pupil or employee of the 22
university school for profoundly gifted pupils to re ceive free 23
counseling, advocacy or crisis services related to an alleged incident 24
of power-based violence, including, without limitation, access to a 25
health care provider who specializes in forensic medical 26
examinations; 27
(3) Assist with the development a nd implementation of 28
education and prevention programs for pupils enrolled at the 29
university school for profoundly gifted pupils; and 30
(4) Assist with the development and implementation of 31
training and prevention curriculum for employees of the university 32
school for profoundly gifted pupils. 33
(c) Include a fee structure for any services provided by the 34
community-based organization that assists victims of power -based 35
violence. 36
2. If a teacher or administrator of the university school for 37
profoundly gifted pupils is informed by a pupil that the pupil has 38
been a victim of power -based violence, the teacher or administrator 39
shall refer the pupil to the community-based organization that assists 40
victims of power-based violence. 41
3. As used in this section: 42
(a) “Forensic medical examination” has the meaning ascribed to 43
it in NRS [217.300.] 217.310. 44

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(b) “Power-based violence” has the meaning ascribed to it in 1
NRS 396.1285. 2
Sec. 11. NRS 396.147 is hereby amended to read as follows: 3
396.147 1. The Board of Regents may require a n institution 4
within the System to enter into a memorandum of understanding 5
with an organization that assists persons involved in power -based 6
violence. The memorandum of understanding may, without 7
limitation: 8
(a) Allow for cooperation and training between the institution 9
and the organization that assists persons involved in power -based 10
violence to establish an understanding of the: 11
(1) Responsibilities that the institution and organization that 12
assists persons involved in power-based violence have in responding 13
to a report or disclosure of an alleged incident of power -based 14
violence; and 15
(2) Procedures of the institution for providing support and 16
services to students and employees; 17
(b) Require an organi zation that assists persons involved in 18
power-based violence to: 19
(1) Assist with developing policies, programming or training 20
at the institution regarding power-based violence; 21
(2) Provide an alternative for a student or employee of the 22
institution to receive free and confidential counseling, advocacy or 23
crisis services related to an alleged incident of power-based violence 24
that are located on or off a campus of the institution, including, 25
without limitation: 26
(I) Access to a health care provider who specializes in 27
forensic medical examinations; and 28
(II) Confidential services; 29
(3) Assist with the development and implementation of 30
education and prevention programs for students of the institution; 31
and 32
(4) Assist with the development and implementation of 33
training and prevention curriculum for employees of the institution; 34
and 35
(c) Include a fee structure for any services provided by the 36
organization that assists persons involved in power-based violence. 37
2. As used in this section, “forensic medical examination” has 38
the meaning ascribed to it in NRS [217.300.] 217.310. 39
Sec. 12. NRS 629.085 is hereby amended to read as follows: 40
629.085 1. A provider of health care shall not: 41
(a) Perform or supervise the performance of a pelvic 42
examination that the provider of health care is not appropriately 43
licensed, certified or registered to perform or is not within the scope 44
of practice of the provider of health care; or 45

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(b) Perform a pelvic examination on an anesth etized or 1
unconscious patient or supervise the performance of a pelvic 2
examination on such a patient without first obtaining the informed 3
consent of the patient unless: 4
(1) The pelvic examination is within the scope of a surgical 5
procedure or diagnostic examination to which the patient has given 6
informed consent; or 7
(2) In the case of an unconscious patient: 8
(I) The pelvic examination is required for diagnostic 9
purposes and is medically necessary; or 10
(II) The patient is an alleged victim of a sexual assault 11
and the physician or physician assistant reasonably concludes that 12
exigent circumstances justify conducting a forensic medical 13
examination which requires the pelvic examination. 14
2. A person who is not licensed, certified or registered as a 15
provider of health care and is working under the supervision of a 16
provider of health care, including, without limitation, a student or 17
trainee, shall not: 18
(a) Perform or supervise the performance of any pelvic 19
examination that his or her supervising prov ider of health care is 20
prohibited by subsection 1 from supervising; or 21
(b) Supervise the performance of a pelvic examination by any 22
other person outside the immediate presence of his or her 23
supervising provider of health care. 24
3. As used in this section: 25
(a) “Forensic medical examination” has the meaning ascribed to 26
it in NRS [217.300.] 217.310. 27
(b) “Sexual assault” has the meaning ascribed to it in 28
NRS 200.366. 29
Sec. 13. NRS 217.405 is hereby repealed. 30
Sec. 14. 1. This section becomes effective upon passage and 31
approval. 32
2. Sections 1 to 13, inclusive, of this act become effective: 33
(a) Upon passage and approval for the purpose of adopting 34
regulations and performing other preparatory administrative tasks 35
that are necessary to carry out the provisions of this act; and 36
(b) On October 1, 2025, for all other purposes. 37

TEXT OF REPEALED SECTION

217.405 Payment of costs incurred by hospital for
strangulation forensic medical examination.

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1. The county in whose jurisdiction a domestic violence battery
by strangulation is committed shall pay any costs incurred by a
hospital for a strangulation forensic medical examination of the
victim.
2. Any costs incurred pursuant to subsection 1:
(a) Must not be charged directly to the victim.
(b) Must be charged to the county in whose jurisdiction the
offense was committed.
3. A county which pays costs related to a strangulation forensic
medical examination pursuant to subsection 1 may, to the extent that
money is available for that purpose fro m legislative appropriation,
receive reimbursement from the State.
4. The filing of a report with the appropriate law enforcement
agency must not be a prerequisite to qualify for a strangulation
forensic medical examination pursuant to this section.
5. Nothing in this section shall be construed to prohibit the use
of evidence obtained from a strangulation forensic medical
examination during the investigation or prosecution of a person for
domestic violence battery by strangulation.
6. As used in this section:
(a) “Domestic violence battery by strangulation” means a
battery which constitutes domestic violence pursuant to NRS 33.018
that is committed by strangulation as described in NRS 200.481.
(b) “Strangulation forensic medical examination” means a n
examination conducted by a health care provider for the purpose of
assessing the health care needs of a victim of a domestic violence
battery by strangulation and coordinating the treatment of any
injuries of the victim.

H