1 STATE OF OKLAHOMA
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2 1st Session of the 59th Legislature (2023)
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3 SENATE BILL 613 By: Daniels
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6 AS INTRODUCED
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7 An Act relating to health care; defining term;
7 prohibiting gender reassignment medical treatment for
8 minors; providing for administrative violation and
8 penalty; amending 59 O.S. 2021, Sections 509, 567.8,
9 and 637, which relate to healthcare provider
9 licensing; adding violations and penalties; providing
10 for codification; and declaring an emergency.
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13 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
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14 SECTION 1. NEW LAW A new section of law to be codified
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15 in the Oklahoma Statutes as Section 2607.1 of Title 63, unless there
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16 is created a duplication in numbering, reads as follows:
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17 A. As used in this section, “gender reassignment medical
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18 treatment” means any health care to facilitate the transitioning of
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19 a patient’s assigned gender identity on the patient’s birth
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20 certificate to the gender identity experienced and defined by the
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21 patient.
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22 1. The term includes:
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23 a. interventions to suppress the development of
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24 endogenous secondary sex characteristics,
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 1 b. interventions to align the patient’s appearance or
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2 physical body with the patient’s gender identity, and
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3 c. medical therapies and medical intervention used to
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4 treat gender dysphoria.
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5 2. The term shall not include:
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6 a. behavioral healthcare services or mental health
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7 counseling,
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8 b. medications to treat depression and anxiety,
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9 c. medications prescribed, dispensed, or administered
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10 specifically for the purpose of treating precocious
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11 puberty in that patient, or
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12 d. services provided to individuals born with ambiguous
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13 genitalia, incomplete genitalia, or both male and
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14 female anatomy, or biochemically verifiable disorder
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15 of sex development (DSD), including but not limited
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16 to: 46,XX DSD; 46,XY DSD; sex chromosomes DSDs; XX or
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17 XY sex reversal; and ovotesticular disorder.
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18 B. A physician or other healthcare professional shall not
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19 provide gender reassignment medical treatment to any individual
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20 under eighteen (18) years of age.
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21 C. A physician or other healthcare professional found to have
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22 knowingly provided gender reassignment medical treatment to an
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23 individual under eighteen (18) years of age shall, upon an adverse
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24 ruling by the appropriate licensing board, be guilty of
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 1 unprofessional conduct. Upon such adverse ruling, the appropriate
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2 licensing board shall immediately revoke the license or certificate
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3 of the physician or other healthcare professional.
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4 SECTION 2. AMENDATORY 59 O.S. 2021, Section 509, is
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5 amended to read as follows:
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6 Section 509. The words “unprofessional conduct” as used in
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7 Sections 481 through 518.1 of this title are hereby declared to
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8 include, but shall not be limited to, the following:
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9 1. Procuring, aiding or abetting a criminal operation;
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10 2. The obtaining of any fee or offering to accept any fee,
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11 present or other form of remuneration whatsoever, on the assurance
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12 or promise that a manifestly incurable disease can or will be cured;
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13 3. Willfully betraying a professional secret to the detriment
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14 of the patient;
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15 4. Habitual intemperance or the habitual use of habit-forming
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16 drugs;
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17 5. Conviction or confession of, or plea of guilty, nolo
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18 contendere, no contest or Alford plea to a felony or any offense
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19 involving moral turpitude;
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20 6. All advertising of medical business in which statements are
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21 made which are grossly untrue or improbable and calculated to
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22 mislead the public;
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 1 7. Conviction or confession of, or plea of guilty, nolo
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2 contendere, no contest or Alford plea to a crime involving violation
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3 of:
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4 a. the antinarcotic or prohibition laws and regulations
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5 of the federal government,
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6 b. the laws of this state,
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7 c. State Commissioner of Health rules, or
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8 d. a determination by a judge or jury;
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9 8. Dishonorable or immoral conduct which is likely to deceive,
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10 defraud, or harm the public;
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11 9. The commission of any act which is a violation of the
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12 criminal laws of any state when such act is connected with the
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13 physician’s practice of medicine. A complaint, indictment or
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14 confession of a criminal violation shall not be necessary for the
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15 enforcement of this provision. Proof of the commission of the act
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16 while in the practice of medicine or under the guise of the practice
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17 of medicine shall be unprofessional conduct;
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18 10. Failure to keep complete and accurate records of purchase
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19 and disposal of controlled drugs or of narcotic drugs;
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20 11. The writing of false or fictitious prescriptions for any
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21 drugs or narcotics declared by the laws of this state to be
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22 controlled or narcotic drugs;
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23 12. Prescribing or administering a drug or treatment without
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24 sufficient examination and the establishment of a valid physician-
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 1 patient relationship and not prescribing in a safe, medically
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2 accepted manner;
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3 13. The violation, or attempted violation, direct or indirect,
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4 of any of the provisions of the Oklahoma Allopathic Medical and
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5 Surgical Licensure and Supervision Act, either as a principal,
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6 accessory or accomplice;
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7 14. Aiding or abetting, directly or indirectly, the practice of
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8 medicine by any person not duly authorized under the laws of this
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9 state;
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10 15. The inability to practice medicine with reasonable skill
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11 and safety to patients by reason of age, illness, drunkenness,
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12 excessive use of drugs, narcotics, chemicals, or any other type of
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13 material or as a result of any mental or physical condition. In
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14 enforcing this section the State Board of Medical Licensure and
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15 Supervision may, upon probable cause, request a physician to submit
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16 to a mental or physical examination by physicians designated by it.
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17 If the physician refuses to submit to the examination, the Board
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18 shall issue an order requiring the physician to show cause why the
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19 physician will not submit to the examination and shall schedule a
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20 hearing on the order within thirty (30) days after notice is served
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21 on the physician, exclusive of the day of service. The physician
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22 shall be notified by either personal service or by certified mail
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23 with return receipt requested. At the hearing, the physician and
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24 the physician’s attorney are entitled to present any testimony and
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 1 other evidence to show why the physician should not be required to
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2 submit to the examination. After a complete hearing, the Board
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3 shall issue an order either requiring the physician to submit to the
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4 examination or withdrawing the request for examination. The medical
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5 license of a physician ordered to submit for examination may be
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6 suspended until the results of the examination are received and
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7 reviewed by the Board;
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8 16. a. Prescribing, dispensing or administering of controlled
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9 substances or narcotic drugs in excess of the amount
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10 considered good medical practice,
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11 b. Prescribing, dispensing or administering controlled
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12 substances or narcotic drugs without medical need in
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13 accordance with pertinent licensing board standards,
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14 or
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15 c. Prescribing, dispensing or administering opioid drugs
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16 in excess of the maximum limits authorized in Section
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17 2-309I of Title 63 of the Oklahoma Statutes;
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18 17. Engaging in physical conduct with a patient which is sexual
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19 in nature, or in any verbal behavior which is seductive or sexually
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20 demeaning to a patient;
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21 18. Failure to maintain an office record for each patient which
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22 accurately reflects the evaluation, treatment, and medical necessity
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23 of treatment of the patient;
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 1 19. Failure to provide necessary ongoing medical treatment when
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2 a doctor-patient relationship has been established, which
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3 relationship can be severed by either party providing a reasonable
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4 period of time is granted;
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5 20. Performance of an abortion as defined by Section 1-730 of
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6 Title 63 of the Oklahoma Statutes, except for an abortion necessary
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7 to prevent the death of the mother or to prevent substantial or
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8 irreversible physical impairment of the mother that substantially
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9 increases the risk of death. The performance of an abortion on the
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10 basis of the mental or emotional health of the mother shall be a
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11 violation of this paragraph, notwithstanding a claim or diagnosis
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12 that the woman may engage in conduct which she intends to result in
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13 her death. The Board shall impose a penalty as provided in Section
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14 509.1 of this title on a licensee who violates this paragraph. The
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15 penalty shall include, but not be limited to, suspension of the
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16 license for a period of not less than one (1) year; or
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17 21. Failure to provide a proper and safe medical facility
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18 setting and qualified assistive personnel for a recognized medical
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19 act, including but not limited to an initial in-person patient
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20 examination, office surgery, diagnostic service or any other medical
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21 procedure or treatment. Adequate medical records to support
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22 diagnosis, procedure, treatment or prescribed medications must be
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23 produced and maintained; or
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 1 22. Providing gender reassignment medical treatment as defined
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2 in Section 1 of this act to any individual under eighteen (18) years
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3 of age. Violation of this paragraph shall be grounds for the
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4 immediate revocation of a physician’s or physician assistant’s
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5 license.
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6 SECTION 3. AMENDATORY 59 O.S. 2021, Section 567.8, is
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7 amended to read as follows:
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8 Section 567.8. A. The Oklahoma Board of Nursing shall have the
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9 power to take any or all of the following actions:
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10 1. To deny, revoke or suspend any:
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11 a. licensure to practice as a Licensed Practical Nurse,
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12 single-state or multistate,
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13 b. licensure to practice as a Registered Nurse, single-
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14 state or multistate,
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15 c. multistate privilege to practice in Oklahoma,
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16 d. licensure to practice as an Advanced Practice
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17 Registered Nurse,
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18 e. certification to practice as an Advanced Unlicensed
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19 Assistant,
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20 f. authorization for prescriptive authority, or
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21 g. authority to order, select, obtain and administer
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22 drugs;
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23 2. To assess administrative penalties; and
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 1 3. To otherwise discipline applicants, licensees or Advanced
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2 Unlicensed Assistants.
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3 B. The Board shall impose a disciplinary action against the
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4 person pursuant to the provisions of subsection A of this section
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5 upon proof that the person:
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6 1. Is guilty of deceit or material misrepresentation in
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7 procuring or attempting to procure:
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8 a. a license to practice registered nursing, licensed
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9 practical nursing, or a license to practice advanced
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10 practice registered nursing with or without either
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11 prescriptive authority recognition or authorization to
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12 order, select, obtain and administer drugs, or
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13 b. certification as an Advanced Unlicensed Assistant;
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14 2. Is guilty of a felony, or any offense substantially related
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15 to the qualifications, functions or duties of any licensee or
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16 Advanced Unlicensed Assistant, or any offense an essential element
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17 of which is fraud, dishonesty, or an act of violence, whether or not
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18 sentence is imposed, or any conduct resulting in the revocation of a
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19 deferred or suspended sentence or probation imposed pursuant to such
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20 conviction. For the purposes of this paragraph, “substantially
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21 related” means the nature of criminal conduct for which the person
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22 was convicted has a direct bearing on the fitness or ability to
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23 perform one or more of the duties or responsibilities necessarily
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24 related to the occupation;
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 1 3. Fails to adequately care for patients or to conform to the
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2 minimum standards of acceptable nursing or Advanced Unlicensed
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3 Assistant practice that, in the opinion of the Board, unnecessarily
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4 exposes a patient or other person to risk of harm;
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5 4. Is intemperate in the use of alcohol or drugs, which use the
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6 Board determines endangers or could endanger patients;
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7 5. Exhibits through a pattern of practice or other behavior
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8 actual or potential inability to practice nursing with sufficient
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9 knowledge or reasonable skills and safety due to impairment caused
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10 by illness, use of alcohol, drugs, chemicals or any other substance,
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11 or as a result of any mental or physical condition, including
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12 deterioration through the aging process or loss of motor skills,
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13 mental illness, or disability that results in inability to practice
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14 with reasonable judgment, skill or safety; provided, however, the
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15 provisions of this paragraph shall not be utilized in a manner that
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16 conflicts with the provisions of the Americans with Disabilities
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17 Act;
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18 6. Has been adjudicated as mentally incompetent, mentally ill,
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19 chemically dependent or dangerous to the public or has been
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20 committed by a court of competent jurisdiction, within or without
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21 this state;
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22 7. Is guilty of unprofessional conduct as defined in the rules
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23 of the Board;
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 1 8. Is guilty of any act that jeopardizes a patient’s life,
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2 health or safety as defined in the rules of the Board;
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3 9. Violated a rule promulgated by the Board, an order of the
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4 Board, or a state or federal law relating to the practice of
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5 registered, practical or advanced practice registered nursing or
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6 advanced unlicensed assisting, or a state or federal narcotics or
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7 controlled dangerous substance law including, but not limited to
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8 prescribing, dispensing or administering opioid drugs in excess of
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9 the maximum limits authorized in Section 2-309I of Title 63 of the
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10 Oklahoma Statutes;
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11 10. Has had disciplinary actions taken against the individual’s
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12 registered or practical nursing lic