H.B. No. 2180
    1-1                                AN ACT
    1-2  relating to the regulation of the practice of registered nursing
    1-3  and to the continuation of the Board of Nurse Examiners; providing
    1-4  penalties.
    1-6        SECTION 1.  Article 4513, Revised Statutes, is amended to
    1-7  read as follows:
    1-8        Art. 4513.  BOARD OF NURSE EXAMINERS
    1-9        Sec. 1.  Composition of Board; Programs of Study.  The Board
   1-10  of Nurse Examiners is composed of nine members appointed by the
   1-11  governor with the advice and consent of the senate.  Appointments
   1-12  to the board shall be made without regard to the race, color
   1-13  <creed>, disability, sex, religion, age, or national origin of the
   1-14  appointees.  The board <Board of Nurse Examiners> shall prescribe
   1-15  three programs of study to prepare professional nurse
   1-16  practitioners, to wit:  (1) The Baccalaureate Degree Program--A
   1-17  program leading to a baccalaureate degree in nursing conducted by
   1-18  an educational unit in nursing (department, division, school, or
   1-19  college) which is a part of a senior college or university; (2) The
   1-20  Associate Degree Program--A program leading to an associate degree
   1-21  in nursing conducted by an educational unit in nursing within the
   1-22  structure of a college or a university; and (3) The Diploma
   1-23  Program--A program leading to a diploma in nursing conducted by a
   1-24  single purpose school usually under the control of a hospital.  Six
    2-1  of the board members must be Registered Nurses, three of whom shall
    2-2  be engaged in professional nurse education and shall be
    2-3  representative of said three programs in that one shall be a nurse
    2-4  faculty member in a school of nursing pursuing the Baccalaureate
    2-5  Degree Program; one shall be a nurse faculty member in a school of
    2-6  nursing pursuing the Associate Degree Program; and one shall be a
    2-7  nurse faculty member in a school of nursing pursuing the Diploma
    2-8  Program.  Three members must be members of the general public.
    2-9        Sec. 2.  Terms; Requirements of Professional Nurse Members
   2-10  and Public Members.  (a)  The members of the board shall hold
   2-11  office for staggered terms of six years, with the terms of one
   2-12  practicing registered nurse, one professional nurse engaged in
   2-13  nurse education, and one public member expiring on January 31 of
   2-14  odd-numbered years.  The professional nurse members must be
   2-15  actually employed in the nursing profession for at least three
   2-16  years before their appointment.
   2-17        (b)  A person is not eligible for appointment as a public
   2-18  member if the person or the person's spouse:
   2-19              (1)  is licensed by an occupational regulatory agency
   2-20  in the field of health care;
   2-21              (2)  is employed by or participates in the management
   2-22  of a business entity or other organization that provides
   2-23  health-care services or that sells, manufactures, or distributes
   2-24  health-care supplies or equipment; <or>
   2-25              (3)  owns, controls, or has, directly or indirectly,
   2-26  more than a 10 percent interest in a business entity or other
   2-27  organization that provides health-care services or that sells,
    3-1  manufactures, or distributes health-care supplies or equipment; or
    3-2              (4)  uses or receives a substantial amount of tangible
    3-3  goods, services, or funds from the board, other than compensation
    3-4  or reimbursement authorized by law for board membership,
    3-5  attendance, or expenses.
    3-6        Sec. 3.  CONFLICT OF INTEREST RESTRICTIONS.  (a)  An officer,
    3-7  employee, or paid consultant of a Texas trade association in the
    3-8  field of health care may not be a board member or employee of the
    3-9  board who is exempt from the state's position classification plan
   3-10  or is compensated at or above the amount prescribed by the General
   3-11  Appropriations Act for step 1, salary group 17, of the position
   3-12  classification salary schedule.
   3-13        (b)  A person who is the spouse of an officer, manager, or
   3-14  paid consultant of a Texas trade association in the field of health
   3-15  care may not be a board member or employee of the board who is
   3-16  exempt from the state's position classification plan or is
   3-17  compensated at or above the amount prescribed by the General
   3-18  Appropriations Act for step 1, salary group 17, of the position
   3-19  classification salary schedule.
   3-20        (c)  For the purposes of this section, a Texas trade
   3-21  association is a nonprofit, cooperative, and voluntarily joined
   3-22  association of business or professional competitors in this state
   3-23  designed to assist its members and its industry or profession in
   3-24  dealing with mutual business or professional problems and in
   3-25  promoting their common interest.
   3-26        Sec. 4.  EFFECT OF LOBBYING ACTIVITY.  A person may not serve
   3-27  as a board member or act as general counsel to the board if the
    4-1  person is required to register as a lobbyist under Chapter 305,
    4-2  Government Code, and its subsequent amendments, because of the
    4-3  person's activities for compensation on behalf of a profession
    4-4  related to the operation of the board.
    4-5        Sec. 5.  GROUNDS FOR REMOVAL FROM BOARD.  (a)  It is a ground
    4-6  for removal from the board if a member:
    4-7              (1)  does not have at the time of appointment the
    4-8  qualifications required by Section 1 of this article;
    4-9              (2)  does not maintain during service on the board the
   4-10  qualifications required by Section 1 of this article;
   4-11              (3)  violates a prohibition established by Section 3 or
   4-12  4 of this article;
   4-13              (4)  cannot discharge the member's term for a
   4-14  substantial part of the term for which the member is appointed
   4-15  because of illness or disability; or
   4-16              (5)  is absent from more than half of the regularly
   4-17  scheduled board meetings that the member is eligible to attend
   4-18  during a calendar year unless the absence is excused by majority
   4-19  vote of the board.
   4-20        (b)  The validity of an action of the board is not affected
   4-21  by the fact that it is taken when a ground for removal of a board
   4-22  member exists.
   4-23        (c)  If the executive director has knowledge that a potential
   4-24  ground for removal exists, the executive director shall notify the
   4-25  presiding officer of the board of the ground.  The presiding
   4-26  officer shall then notify the governor that a potential ground for
   4-27  removal exists.
    5-1        Sec. 6.  STANDARDS OF CONDUCT INFORMATION.  The board shall
    5-2  provide to its members and employees, as often as necessary,
    5-3  information regarding their qualifications for office or employment
    5-4  under this article and their responsibilities under applicable laws
    5-5  relating to standards of conduct for state officers or employees.
    5-6        Sec. 7.  STAFF.  The board shall develop and implement
    5-7  policies that clearly define the respective responsibilities of the
    5-8  board and the staff of the board.
    5-9        Sec. 8.  ANNUAL FINANCIAL REPORT.  The board shall file
   5-10  annually with the governor and the presiding officer of each house
   5-11  of the legislature a complete and detailed written report
   5-12  accounting for all funds received and disbursed by the board during
   5-13  the preceding fiscal year.  The annual report must be in the form
   5-14  and reported in the time provided by the General Appropriations
   5-15  Act.
   5-16        Sec. 9.  PERSONNEL POLICIES.  (a)  The executive director or
   5-17  the director's designee shall develop an intra-agency career ladder
   5-18  program.  The program shall require intra-agency posting of all
   5-19  nonentry level positions concurrently with any public posting.
   5-20        (b)  The executive director or the director's designee shall
   5-21  develop a system of annual performance evaluations based on
   5-22  measurable job tasks.  All merit pay for board employees must be
   5-23  based on the system established under this subsection.
   5-24        Sec. 10.  EQUAL EMPLOYMENT OPPORTUNITY POLICIES.  (a)  The
   5-25  executive director or the director's designee shall prepare and
   5-26  maintain a written policy statement to ensure implementation of a
   5-27  program of equal employment opportunity under which all personnel
    6-1  transactions are made without regard to race, color, disability,
    6-2  sex, religion, age, or national origin.  The policy statement must
    6-3  include:
    6-4              (1)  personnel policies, including policies relating to
    6-5  recruitment, evaluation, selection, application, training, and
    6-6  promotion of personnel that are in compliance with the Commission
    6-7  on Human Rights Act (Article 5221k, Vernon's Texas Civil Statutes)
    6-8  and its subsequent amendments;
    6-9              (2)  a comprehensive analysis of the board work force
   6-10  that meets federal and state guidelines;
   6-11              (3)  procedures by which a determination can be made of
   6-12  significant underuse in the board work force of all persons for
   6-13  whom federal or state guidelines encourage a more equitable
   6-14  balance; and
   6-15              (4)  reasonable methods to appropriately address those
   6-16  areas of underuse.
   6-17        (b)  A policy statement prepared under Subsection (a) of this
   6-18  section must cover an annual period, be updated annually, be
   6-19  reviewed by the Commission on Human Rights for compliance with
   6-20  Subsection (a)(1) of this section, and be filed with the governor's
   6-21  office.
   6-22        (c)  The governor's office shall deliver a biennial report to
   6-23  the legislature based on the information received under Subsection
   6-24  (b)  of this section.  The report may be made separately or as part
   6-25  of other biennial reports to the legislature.
   6-26        Sec. 11.  PUBLIC INTEREST INFORMATION.  (a)  The board shall
   6-27  prepare information of public interest describing the functions of
    7-1  the board and the procedures by which complaints are filed with and
    7-2  resolved by the board.  The board shall make the information
    7-3  available to the public and appropriate state agencies.
    7-4        (b)  The board by rule shall establish methods by which
    7-5  consumers and service recipients are notified of the name, mailing
    7-6  address, and telephone number of the board for the purpose of
    7-7  directing complaints to the board.  The board may provide for that
    7-8  notification:
    7-9              (1)  on each registration form, application, or written
   7-10  contract for services of an individual or entity regulated by the
   7-11  board;
   7-12              (2)  on a sign prominently displayed in the place of
   7-13  business of each individual or entity regulated by the board; or
   7-14              (3)  in a bill for service provided by an individual or
   7-15  entity regulated by the board.
   7-16        (c)  The board shall list along with its regular telephone
   7-17  number the toll-free telephone number that may be called to present
   7-18  a complaint about a health professional if the toll-free number is
   7-19  established under other state law.
   7-20        (d)  The board shall enter into memoranda of understanding
   7-21  with each state agency that licenses health-care facilities or
   7-22  agencies for the purpose of coordinating any posting or
   7-23  notification requirements under Subsection (b) of this section with
   7-24  posting or notification requirements that may be imposed on the
   7-25  health-care facility or agency by that state agency.
   7-26        Sec. 12.  PUBLIC PARTICIPATION IN BOARD HEARINGS.  The board
   7-27  shall develop and implement policies that provide the public with a
    8-1  reasonable opportunity to appear before the board and to speak on
    8-2  any issue under the jurisdiction of the board.
    8-3        Sec. 13.  PROGRAM ACCESSIBILITY.  The board shall prepare and
    8-4  maintain a written plan that describes how a person who does not
    8-5  speak English can be provided reasonable access to the board's
    8-6  programs.  The board shall also comply with federal and state laws
    8-7  for program and facility accessibility.
    8-9  (a)  The board shall establish a training program for the members
   8-10  of the board.
   8-11        (b)  Before a member of a board may assume the member's
   8-12  duties and before the member may be confirmed by the senate, the
   8-13  member must complete at least one course of the training program
   8-14  established under this section.
   8-15        (c)  A training program established under this section shall
   8-16  provide information to a participant regarding:
   8-17              (1)  the enabling legislation that created the board;
   8-18              (2)  the programs operated by the board;
   8-19              (3)  the role and functions of the board;
   8-20              (4)  the rules of the board with an emphasis on the
   8-21  rules that relate to disciplinary and investigatory authority;
   8-22              (5)  the current budget for the board;
   8-23              (6)  the results of the most recent formal audit of the
   8-24  board;
   8-25              (7)  the requirements of the:
   8-26                    (A)  open meetings law, Chapter 271, Acts of the
   8-27  60th Legislature, Regular Session, 1967 (Article 6252-17, Vernon's
    9-1  Texas Civil Statutes), and its subsequent amendments;
    9-2                    (B)  open records law, Chapter 424, Acts of the
    9-3  63rd Legislature, Regular Session, 1973 (Article 6252-17a, Vernon's
    9-4  Texas Civil Statutes), and its subsequent amendments; and
    9-5                    (C)  Administrative Procedure and Texas Register
    9-6  Act (Article 6252-13a, Vernon's Texas Civil Statutes) and its
    9-7  subsequent amendments;
    9-8              (8)  the requirements of the conflict of interest laws
    9-9  and other laws relating to public officials; and
   9-10              (9)  any applicable ethics policies adopted by that
   9-11  state agency or the Texas Ethics Commission.
   9-12        (d)  In developing the training requirements provided for in
   9-13  this section, the board shall consult with the governor's office,
   9-14  the attorney general's office, and the ethics commission.
   9-15        (e)  In the event that another state agency or entity is
   9-16  given the authority to establish the training requirements, the
   9-17  board shall allow that training in lieu of developing its own
   9-18  program.
   9-19        Sec. 15.  INTERAGENCY CONTRACTS.  The board may enter
   9-20  interagency contracts for any purpose authorized by law.
   9-22  or employee of the board may not be an officer, employee, or paid
   9-23  consultant of a national or statewide trade association in the
   9-24  health-care industry.  A member or employee of the board may not be
   9-25  related within the second degree by affinity or within the second
   9-26  degree by consanguinity, as determined under Article 5996h, Revised
   9-27  Statutes, to a person who is an officer, employee, or paid
   10-1  consultant of a national or statewide trade association in the
   10-2  regulated industry.  A person who is required to register as a
   10-3  lobbyist under Chapter 305, Government Code, by virtue of his
   10-4  activities on behalf of a national or statewide trade or
   10-5  professional association in a health-services industry may not
   10-6  serve as a member of the board or act as the general counsel to the
   10-7  board.>
   10-8        <Sec. 4.  GROUNDS FOR REMOVAL.  It is grounds for removal
   10-9  from the board if a member:>
  10-10              <(1)  does not have at the time of appointment the
  10-11  qualifications required for appointment to the board;>
  10-12              <(2)  does not maintain during the service on the board
  10-13  the qualifications for appointment to the board;>
  10-14              <(3)  violates a prohibition imposed on members of the
  10-15  board; or>
  10-16              <(4)  fails to attend at least half of the regularly
  10-17  scheduled board meetings held in a calendar year, excluding
  10-18  meetings held while the person was not a board member.>
  10-19        <Sec. 5.  VALIDITY OF ACTIONS.  The validity of an action of
  10-20  the board is not affected by the fact that it was taken when a
  10-21  ground for removal of a member of the board existed.>
  10-22        SECTION 2.  Article 4513a, Revised Statutes, is amended to
  10-23  read as follows:
  10-24        Art. 4513a.  SUNSET PROVISION.  The Board of Nurse Examiners
  10-25  is subject to Chapter 325, Government Code (Texas Sunset Act).
  10-26  Unless continued in existence as provided by that chapter, the
  10-27  board is abolished September 1, 2005 <1993>.
   11-1        SECTION 3.  Article 4514, Revised Statutes, is amended to
   11-2  read as follows:
   11-3        Art. 4514.  Organization of board
   11-4        Sec. 1.  President; Special Meetings; Powers.  The governor
   11-5  shall designate one of the members of the board as presiding
   11-6  officer to serve in that capacity at the pleasure of the governor.
   11-7  The members of the board shall elect other officers from their
   11-8  members <number a president>.  Special meetings of said board shall
   11-9  be called by the presiding officer <president> acting upon the
  11-10  written request of any two members.  The board shall have the
  11-11  authority and power to make and enforce all rules and regulations
  11-12  necessary for the performance of its duties and conducting of
  11-13  proceedings before it, to establish standards of professional
  11-14  conduct for all persons licensed under the provisions of this law
  11-15  in keeping with its purpose and objectives, to regulate the
  11-16  practice of professional nursing and to determine whether or not an
  11-17  act constitutes the practice of professional nursing, not
  11-18  inconsistent with this Act.  Such rules and regulations shall not
  11-19  be inconsistent with the provisions of this law.
  11-20        Sec. 2.  <LEGISLATIVE DISAPPROVAL OF RULES.  If the
  11-21  appropriate standing committees of both houses of the legislature
  11-22  acting under Subsection (g), Section 5, Administrative Procedure
  11-23  and Texas Register Act, as amended (Article 6252-13a, Vernon's
  11-24  Texas Civil Statutes), transmit to the board statements opposing
  11-25  adoption of a rule under that section, the rule may not take
  11-26  effect, or if the rule has already taken effect, the rule is
  11-27  repealed effective on the date the board receives the committee's
   12-1  statements.>
   12-2        <Sec. 3.>  Rules Restricting Competitive Bidding or
   12-3  Advertising Prohibited.  The board may not promulgate rules
   12-4  restricting competitive bidding or advertising by licensees except
   12-5  to prohibit false, misleading, or deceptive practices by the
   12-6  person.  The board may not include in its rules to prohibit false,
   12-7  misleading, or deceptive practices by a person regulated by the
   12-8  board a rule that:
   12-9              (1)  restricts the person's use of any medium for
  12-10  advertising;
  12-11              (2)  restricts the person's personal appearance or use
  12-12  of the person's <his or her> voice in an advertisement;
  12-13              (3)  relates to the size or duration of an
  12-14  advertisement by the person; or
  12-15              (4)  restricts the person's advertisement under a trade
  12-16  name.
  12-18  LEGAL AUTHORITIES.  The executive director <secretary> shall be
  12-19  required to keep a record of each meeting of said board, including
  12-20  a register of the names of all nurses registered under this law,
  12-21  which shall be at all times open to public inspection.  The <board
  12-22  shall prepare information of consumer interest describing the
  12-23  regulatory functions of the board and the board's procedures by
  12-24  which consumer complaints are filed with and resolved by the board.
  12-25  The board shall make the information available to the general
  12-26  public and appropriate state agencies.  Said> board shall assist
  12-27  the proper legal authorities in the prosecution of all persons
   13-1  violating any provision of this law.  Nothing herein shall either
   13-2  expand or contract the board's present powers as they relate to the
   13-3  regulation of nursing education.
   13-4        Sec. 4 <5>.  Open Meetings; Administrative Procedure.  The
   13-5  board is subject to the open meetings law, Chapter 271, Acts of the
   13-6  60th Legislature, Regular Session, 1967, as amended (Article
   13-7  6252-17, Vernon's Texas Civil Statutes), and the Administrative
   13-8  Procedure and Texas Register Act, as amended (Article 6252-13a,
   13-9  Vernon's Texas Civil Statutes).
  13-10        Sec. 5 <6>.  Recommendation of Rules Relating to Delegation
  13-11  of Medical Acts by Physicians.  The board may recommend to the
  13-12  Texas State Board of Medical Examiners the adoption of rules
  13-13  relating to physician's delegating medical acts to registered
  13-14  nurses <persons> licensed by the board.  The recommendations shall
  13-15  be acted on in the same manner as a petition for the adoption of a
  13-16  rule by an interested party under the Administrative Procedure and
  13-17  Texas Register Act, as amended (Article 6252-13a, Vernon's Texas
  13-18  Civil Statutes).  The board in making recommendations may
  13-19  distinguish between nurses on the basis of special training and
  13-20  education.  The board <Board of Nurse Examiners> in recommending
  13-21  rules and the Texas State Board of Medical Examiners in acting on
  13-22  recommended rules shall act, to the extent allowable under state
  13-23  and federal statutes and regulations, so as to permit the state to
  13-24  obtain its fair share of federal funds available for the delivery
  13-25  of health care in this state.
  13-26        Sec. 6 <7>.  Rules.  The board shall adopt rules
  13-27  establishing:
   14-1              (1)  any specialized education and training, including
   14-2  pharmacology, a registered nurse must have to carry out a
   14-3  prescription drug order pursuant to Subdivision (5), Subsection
   14-4  (d), Section 3.06, Medical Practice Act (Article 4495b, Vernon's
   14-5  Texas Civil Statutes); and
   14-6              (2)  a system for assigning an identification number to
   14-7  a registered nurse who provides the board with evidence of
   14-8  completing the required specialized education and training.
   14-9        Sec. 7.  NURSING PRACTICE ACT.  Articles 4513-4528, Revised
  14-10  Statutes, collectively may be referred to as the Nursing Practice
  14-11  Act.
  14-12        SECTION 4.  Article 4517, Revised Statutes, is amended to
  14-13  read as follows:
  14-15        <Sec. 1.>  The board shall employ a qualified executive
  14-16  director <secretary>, who shall not be a member of the board.
  14-17  Under the direction of the board, the executive director
  14-18  <secretary> shall perform duties required by this Act and duties
  14-19  designated by the board.  Also, the board shall employ all other
  14-20  persons necessary to carry on the work of the board.  The executive
  14-21  director <secretary> shall upon employment execute a bond in the
  14-22  sum of One Thousand Dollars payable to the Governor.  The bond is
  14-23  conditioned that the executive director <secretary> shall
  14-24  faithfully perform the duties of the <his or her> office and shall
  14-25  account for funds coming into the director's <his or her> hands as
  14-26  executive director <secretary>.  The bond shall be signed by two or
  14-27  more sufficient sureties or by a surety company authorized to do
   15-1  business in this state and approved by the president of the board.
   15-2        <Sec. 2.  The executive secretary or his designee shall
   15-3  develop a system of annual performance evaluations based on
   15-4  measurable job tasks.  All merit pay authorized by the executive
   15-5  secretary must be based on the system established under this
   15-6  section.>
   15-7        SECTION 5.  Sections 1, 3, and 4, Article 4518, Revised
   15-8  Statutes, are amended to read as follows:
   15-9        Sec. 1.  It shall be the duty of the Board <of Nurse
  15-10  Examiners> to prescribe and publish the minimum requirements and
  15-11  standards for a course of study in programs which prepare
  15-12  professional nurse practitioners.  All other regulations necessary
  15-13  to conduct accredited schools of nursing and educational programs
  15-14  for the preparation of professional nurses shall be as prescribed
  15-15  by the Board, provided, however, that the minimum period of time
  15-16  that the Board may require shall be at least two (2) academic years
  15-17  and the maximum period of time shall not exceed four (4) calendar
  15-18  years.  The Board shall accredit such schools of nursing and
  15-19  educational programs as meet its requirements and shall deny or
  15-20  withdraw accreditation from schools of nursing and educational
  15-21  programs which fail to meet the prescribed course of study or other
  15-22  standards.
  15-23        The Board shall give those persons and organizations affected
  15-24  by its orders or decisions under this Article reasonable notice
  15-25  thereof, not less than twenty (20) days, and an opportunity to
  15-26  appear and be heard with respect to same.  The Board shall hear all
  15-27  protests or complaints from such persons and organizations affected
   16-1  by such rule, regulation or decision as to the inadequacy or
   16-2  unreasonableness of any rule, regulation or order promulgated or
   16-3  adopted by it, or the injustice of any order or decision by it.  If
   16-4  any person or organization which shall be affected by such order or
   16-5  decision shall be dissatisfied with any regulation, rule or order
   16-6  by such Board, such person or organization shall have the right,
   16-7  within thirty (30) days from the date such order is entered and
   16-8  approved by the Board, to bring an action against said Board in the
   16-9  District Court of Travis County, Texas, to have such regulation,
  16-10  rule or order vacated or modified, and shall set forth in a
  16-11  petition therefor the principal grounds of objection to any or all
  16-12  of such rules, regulations or orders.  Such appeal as herein
  16-13  provided shall be de novo as that term is known and understood in
  16-14  appeals from the Justice Court to the County Court.
  16-15        Sec. 3.  Every applicant for registration as a registered
  16-16  nurse <under this law> shall present to the Board <of Nurse
  16-17  Examiners> evidence of successful completion of an accredited
  16-18  program of professional nursing education and a sworn application
  16-19  and shall upon payment of required fees be entitled to take the
  16-20  examination prescribed by the Board.  Upon <making a> passing the
  16-21  examination <grade>, the applicant shall be entitled to receive
  16-22  from said Board a certificate attested by the seal of said Board,
  16-23  entitling such person to practice as a registered nurse in the
  16-24  State of Texas.  The Board shall determine the criteria <score>,
  16-25  not to exceed the criteria <a score> required by a majority of the
  16-26  states, that constitutes <a> passing <grade on> the examination.
  16-27        Sec. 4.  Any person practicing or offering to practice
   17-1  professional nursing in this state for compensation, shall
   17-2  hereafter be required to submit evidence to the Board <of Nurse
   17-3  Examiners> that the person <he or she> is qualified to practice and
   17-4  shall be registered as provided by this law.
   17-5        SECTION 6.  Article 4519, Revised Statutes, is amended to
   17-6  read as follows:
   17-7        Art. 4519.  EXAMINATION <AND FEE>.  (a)  An applicant that
   17-8  wishes to take a licensing examination must submit to the board an
   17-9  application demonstrating the applicant's qualifications under this
  17-10  chapter.  If the board determines that the applicant meets the
  17-11  qualifications, the applicant may take the licensing examination
  17-12  <Upon filing application for examination each applicant shall pay
  17-13  an examination fee which shall in no case be returned to the
  17-14  applicant.  If the applicant passes the examination, then no
  17-15  further fee shall be required for registration.  Any applicant for
  17-16  registration who fails to successfully pass the examination herein
  17-17  provided for shall have the right to stand a second examination>.
  17-18        (b)  The examination shall be given in various cities
  17-19  throughout the State and shall be of such character as to determine
  17-20  the fitness of the applicant to practice professional nursing.  A
  17-21  written examination prepared, approved, or offered by the board,
  17-22  including a standardized national examination, shall be validated
  17-23  by an independent testing professional.  Not later than the 30th
  17-24  day <Within 30 days> after the date on which a licensing
  17-25  examination is administered under this article, the board shall
  17-26  notify each examinee of the results of the examination.  However,
  17-27  if an examination is graded or reviewed by a national testing
   18-1  service, the board shall notify each examinee of the results of the
   18-2  examination not later than the 14th day <within two weeks> after
   18-3  the date the board receives the results from the testing service.
   18-4  If the notice of the examination results graded or reviewed by a
   18-5  national testing service will be delayed for more than 90 days
   18-6  after the examination date, the board shall notify each examinee of
   18-7  the reason for the delay before the 90th day.  If requested in
   18-8  writing by a person who fails the licensing examination, the board
   18-9  shall furnish the person with an analysis of the person's
  18-10  performance on the examination.  If the result of the examination
  18-11  be satisfactory to the board, a certificate shall be issued to the
  18-12  applicant, signed by the president of the board, and executive
  18-13  director <secretary> and attested by the seal of said board, which
  18-14  certificate shall qualify the person receiving the same to practice
  18-15  professional nursing in this State.
  18-16        (c)  The board by rule shall establish the conditions under
  18-17  which an applicant who fails the licensing examination may retake
  18-18  the examination.  After twice failing the examination, the board
  18-19  may require an applicant to fulfill additional educational
  18-20  requirements and, after twice failing an examination,  may deny an
  18-21  applicant who failed the examination the opportunity to retake the
  18-22  examination.
  18-23        SECTION 7.  Article 4521, Revised Statutes, is amended to
  18-24  read as follows:
  18-26  ANOTHER STATE>.  (a)  To qualify for a temporary license to
  18-27  practice as a registered nurse by endorsement, an applicant for
   19-1  licensing must:
   19-2              (1)  submit to the board an endorsement fee as
   19-3  determined by the board and a completed application given under
   19-4  oath, in the form prescribed by the board;
   19-5              (2)  have possessed at the time of initial licensing as
   19-6  a registered nurse other qualifications necessary to have been
   19-7  eligible for licensing at that time in this state; and
   19-8              (3)  have presented to the board proof of initial
   19-9  licensing by examination and proof that the license and other
  19-10  license or licenses granted to the applicant by any other state
  19-11  have not been suspended, revoked, canceled, surrendered, or
  19-12  otherwise restricted for any reason.
  19-13        (b)  A holder of a temporary license under this section shall
  19-14  receive a permanent license if the applicant:
  19-15              (1)  has verified the academic and professional
  19-16  credentials of the applicant; and
  19-17              (2)  satisfies any other requirement set by statute.
  19-18        (c)  The board shall either grant or deny an application for
  19-19  a permanent license within 180 days after the date of the board's
  19-20  receipt of all required forms or information.  The board may extend
  19-21  the 180-day time limit to allow for the receipt and tabulation of
  19-22  examination results.
  19-23        (d)  Any applicant who holds a registration certificate as a
  19-24  registered nurse from a <another state, district,> territory or
  19-25  possession of the United States, or from a foreign country, may be
  19-26  issued a license to practice as a registered nurse in the State of
  19-27  Texas by endorsement and without examination upon the payment of a
   20-1  fee established by the board, provided in the opinion of the Board
   20-2  of Nurse Examiners such other board issuing such other certificate
   20-3  in its examination required the same general degree of fitness
   20-4  required by this state.
   20-5        SECTION 8.  Article 4523, Revised Statutes, is amended to
   20-6  read as follows:
   20-7        Art. 4523.  Temporary permit.  (a)  <Any nurse who has
   20-8  graduated from an accredited school of nursing, who holds a
   20-9  registration certificate as a Registered Nurse from another state
  20-10  or from a possession of the United States, and who is actually
  20-11  engaged in the pursuit of his or her profession, shall be permitted
  20-12  to practice in the state under a permit issued by the board of
  20-13  nurse examiners, upon the payment of a fee established by the
  20-14  board.>
  20-15        <(b)>  The board may issue a permit to practice professional
  20-16  nursing under the direct supervision of a Registered Nurse to
  20-17  graduates of approved educational programs pending the results of
  20-18  the licensing examination.  The permit expires on receipt of a
  20-19  permanent license or on receipt of a notice of failing the
  20-20  examination from the board.  The permit may not be issued to any
  20-21  applicant who has previously failed an examination administered by
  20-22  the board or by another state.
  20-23        (b) <(c)>  To allow a nurse to satisfy a requirement imposed
  20-24  under Article 4526, Revised Statutes, to renew an expired <a>
  20-25  license <expired for two years or more> or a requirement imposed
  20-26  under Article 4526b, Revised Statutes, to reactivate a nursing
  20-27  license from inactive status, the board may issue a temporary
   21-1  permit to practice professional nursing for the limited purpose of
   21-2  satisfying the requirement.  A permit issued under this subsection
   21-3  expires on the earlier of the receipt of a permanent license or six
   21-4  months from the date of issuance.
   21-5        (c) <(d)>  A person who holds a temporary permit under this
   21-6  article is a licensed professional registered nurse for all
   21-7  purposes except to the extent of any stipulations or limitations on
   21-8  practice imposed by the board as a condition of issuing the permit.
   21-9        SECTION 9.  Chapter 7, Title 71, Revised Statutes, is amended
  21-10  by adding Articles 4524A-4524D to read as follows:
  21-11        Art. 4524A.  RECORDS OF COMPLAINTS.  (a)  The board shall
  21-12  keep an information file about each complaint filed with the board.
  21-13  The board's information file shall be kept current and contain a
  21-14  record for each complaint of:
  21-15              (1)  all persons contacted in relation to the
  21-16  complaint;
  21-17              (2)  a summary of findings made at each step of the
  21-18  complaint process;
  21-19              (3)  an explanation of the legal basis and reason for a
  21-20  complaint that is dismissed; and
  21-21              (4)  other relevant information.
  21-22        (b)  If a written complaint is filed with the board that the
  21-23  board has authority to resolve, the board, at least as frequently
  21-24  as quarterly and until final disposition of the complaint, shall
  21-25  notify the parties to the complaint of the status of the complaint
  21-26  unless the notice would jeopardize an undercover investigation.
  21-27        (c)  The board by rule shall adopt a form to standardize
   22-1  information concerning complaints made to the board.  The board by
   22-2  rule shall prescribe information to be provided to a person when
   22-3  the person files a complaint with the board.
   22-4        (d)  The board shall provide reasonable assistance to a
   22-5  person who wishes to file a complaint with the board.
   22-7  (a)  The board shall adopt rules concerning the investigation of a
   22-8  complaint filed with the board.  The rules adopted under this
   22-9  subsection shall:
  22-10              (1)  distinguish between categories of complaints;
  22-11              (2)  ensure that complaints are not dismissed without
  22-12  appropriate consideration;
  22-13              (3)  require that the board be advised of a complaint
  22-14  that is dismissed and that a letter be sent to the person who filed
  22-15  the complaint explaining the action taken on the dismissed
  22-16  complaint;
  22-17              (4)  ensure that the person who filed the complaint has
  22-18  an opportunity to explain the allegations made in the complaint;
  22-19  and
  22-20              (5)  prescribe guidelines concerning the categories of
  22-21  complaints that require the use of a private investigator and the
  22-22  procedures for the board to obtain the services of a private
  22-23  investigator.
  22-24        (b)  The board shall dispose of all complaints in a timely
  22-25  manner.  The board shall establish a timeline for conducting each
  22-26  phase of a complaint that is under the control of the board not
  22-27  later than the 30th day after the date the complaint is received by
   23-1  the board.  The timeline shall be kept in the information file for
   23-2  the complaint and all parties shall be notified of the projected
   23-3  time requirements for pursuing the complaint.  A change in the
   23-4  timeline must be noted in the complaint information file and all
   23-5  parties to the complaint must be notified not later than the
   23-6  seventh day after the date the change is made.
   23-7        (c)  The executive director of the board shall notify the
   23-8  board of a complaint that extends beyond the time prescribed by the
   23-9  board for resolving the complaint so that the board may take
  23-10  necessary action on the complaint.
  23-11        Art. 4524C.  INFORMAL PROCEEDINGS.  (a)  The board by rule
  23-12  shall adopt procedures governing:
  23-13              (1)  informal disposition of a contested case under
  23-14  Section 13(e), Administrative Procedure and Texas Register Act
  23-15  (Article 6252-13a, Vernon's Texas Civil Statutes), and its
  23-16  subsequent amendments; and
  23-17              (2)  informal proceedings held in compliance with
  23-18  Section 18(c), Administrative Procedure and Texas Register Act
  23-19  (Article 6252-13a, Vernon's Texas Civil Statutes), and its
  23-20  subsequent amendments.
  23-21        (b)  Rules adopted under this article must provide the
  23-22  complainant and the licensee an opportunity to be heard and must
  23-23  require the presence of a representative of the board's legal staff
  23-24  or of the office of the attorney general to advise the board or the
  23-25  board's employees.
  23-26        Art. 4524D.  MONITORING OF LICENSEE.  The board by rule shall
  23-27  develop a system for monitoring licensees' compliance with the
   24-1  requirements of this chapter.  Rules adopted under this article
   24-2  shall include procedures for monitoring a licensee who is ordered
   24-3  by the board to perform certain acts to ascertain that the licensee
   24-4  performs the required acts and to identify and monitor licensees
   24-5  who represent a risk to the public.
   24-6        SECTION 10.  Article 4525, Revised Statutes, is amended by
   24-7  amending Subsections (a), (b), and (e) and adding Subsection (k) to
   24-8  read as follows:
   24-9        (a)  The board <of nurse examiners> may refuse to admit
  24-10  persons to its examinations, may refuse to issue a license or
  24-11  certificate of registration or to issue a certificate of renewal
  24-12  <re-registration>, may refuse to issue a temporary permit, license
  24-13  by endorsement, or license, may issue a warning or reprimand with
  24-14  or without stipulations, may suspend for any period not to exceed 5
  24-15  years, or may revoke the license or certificate of any practitioner
  24-16  of professional nursing, for any of the following reasons:
  24-17              (1)  The violation of any of the provisions of this
  24-18  law, any rule, regulation not inconsistent with this law, or order
  24-19  issued hereinunder.
  24-20              (2)  Is guilty of fraud or deceit in procuring or
  24-21  attempting to procure a license to practice professional nursing.
  24-22              (3)  Conviction of a crime of the grade of felony, or a
  24-23  crime of lesser grade which involves moral turpitude, or any
  24-24  conduct resulting in the revocation of probation imposed pursuant
  24-25  to such conviction.
  24-26              (4)  The use of any nursing license, certificate,
  24-27  diploma or permit, or transcript of such license, certificate,
   25-1  diploma or permit, which has been fraudulently purchased, issued,
   25-2  counterfeited, or materially altered.
   25-3              (5)  The impersonation of, or the acting as a proxy
   25-4  for, another in any examination required by law to obtain a license
   25-5  to practice professional nursing.
   25-6              (6)  Aiding or abetting, directly or indirectly, or in
   25-7  any manner whatsoever, any unlicensed person in connection with the
   25-8  unauthorized practice of professional nursing.
   25-9              (7)  Revocation, suspension, or denial of or any other
  25-10  action relating to the license to practice nursing in another
  25-11  jurisdiction.  Certified copy of the order of denial, suspension,
  25-12  revocation, or any other action shall be conclusive evidence
  25-13  thereof.
  25-14              (8)  Intemperate use of alcohol or drugs that the board
  25-15  determines endangers or could endanger patients.  Intemperate use
  25-16  includes but is not limited to practicing professional nursing or
  25-17  being on duty or call while under the influence of alcohol or
  25-18  drugs.
  25-19              (9)  Unprofessional or dishonorable conduct which, in
  25-20  the opinion of the board, is likely to deceive, defraud, or injure
  25-21  patients or the public.
  25-22              (10)  Adjudication of mental incompetency.
  25-23              (11)  Lack of fitness to practice by reason of mental
  25-24  or physical health that could result in injury to patients or the
  25-25  public.
  25-26              (12)  Failing to care adequately for patients or to
  25-27  conform to the minimum standards of acceptable professional nursing
   26-1  practice that, in the opinion of the board, exposes a patient or
   26-2  other person unnecessarily to risk of harm.
   26-3        (b)  Proceedings under this article shall be begun by filing
   26-4  a written complaint with the board <of nurse examiners>.  Such
   26-5  complaint may be made by any person or filed by the board on its
   26-6  own initiative.  Unless it would jeopardize an investigation, the
   26-7  board shall notify the registered nurse that a complaint has been
   26-8  filed and the nature of the complaint after a determination of the
   26-9  identity of the subject of the complaint.  <An information file
  26-10  about each complaint filed relating to a licensee shall be
  26-11  maintained by the board.  If a written complaint is filed with the
  26-12  board relating to a licensee, the board at least as frequently as
  26-13  quarterly and until final disposition of the complaint, shall
  26-14  notify the party that filed the complaint of the status of the file
  26-15  unless notice would jeopardize an investigation.>  The board shall
  26-16  make a timely and appropriate preliminary investigation of the
  26-17  complaint and may issue a warning or reprimand to the person
  26-18  against whom the complaint was filed.  If the investigation reveals
  26-19  probable cause to take further disciplinary action, the board shall
  26-20  either attempt an informal disposition of the complaint or file
  26-21  formal charges against the registered nurse stating the provisions
  26-22  of this chapter or the board's rules that are alleged to have been
  26-23  violated and a brief description of the acts or omissions that
  26-24  constituted the violation.  If the board proposes to refuse to
  26-25  admit a person to its examination, to refuse to issue a temporary
  26-26  permit, license, certificate of registration, certificate of
  26-27  re-registration, or to suspend or revoke a person's permit,
   27-1  license, or certificate, the person is entitled to a hearing before
   27-2  the State Office of Administrative Hearings <board.  The hearing
   27-3  may be before a subcommittee of the board, a majority of which is
   27-4  composed of registered nurses.  The person shall on request be
   27-5  granted a hearing before the entire board>.  Proceedings for a
   27-6  disciplinary action are governed by the Administrative Procedure
   27-7  and Texas Register Act (Article 6252-13a, Vernon's Texas Civil
   27-8  Statutes).  The board may assess a person found to have violated
   27-9  any provision of this chapter the administrative costs of
  27-10  conducting a hearing to determine that violation.  If a licensed
  27-11  professional nurse voluntarily surrenders his or her license to the
  27-12  board and executes a sworn statement that he or she no longer
  27-13  desires to be licensed, the board may revoke his or her license
  27-14  without the necessity of formal charges, notice, or opportunity of
  27-15  hearing.
  27-16        (e)  The board <of nurse examiners> is charged with the duty
  27-17  of aiding in the enforcement of the provisions of this chapter, and
  27-18  may retain legal counsel to represent the board, but prior to
  27-19  retaining outside legal counsel, the board shall request the
  27-20  attorney general to perform such services and may only retain
  27-21  outside counsel if the attorney general so certifies to the board
  27-22  that the attorney general cannot provide such services.  The board
  27-23  shall have the power to issue subpoenas, compel the attendance of
  27-24  witnesses, administer oaths to persons giving testimony at
  27-25  hearings, and cause the prosecution of all persons violating any
  27-26  provisions of this chapter.  It shall keep a record of all its
  27-27  proceedings and make an annual report to the Governor.  Any member
   28-1  of the board may present to a prosecuting officer complaints
   28-2  relating to violations of any of the provisions of this chapter,
   28-3  and the board through its members, officers, counsel, or agents
   28-4  shall assist in the trial of any cases involving alleged violation
   28-5  of this chapter, subject to the control of the prosecuting
   28-6  officers.  The Attorney General is directed to render such legal
   28-7  assistance as may be necessary in enforcing and making effective
   28-8  the provisions of this chapter; provided that this shall not
   28-9  relieve the local prosecuting officers of any of their duties under
  28-10  the law as such.
  28-11        (k)  The schedule of sanctions adopted by the board by rule
  28-12  shall be used by the State Office of Administrative Hearings for
  28-13  any sanction imposed as the result of a hearing conducted by that
  28-14  office.
  28-15        SECTION 11.  Section 1, Article 4525a, Revised Statutes, is
  28-16  amended to read as follows:
  28-18  (a)  Each registered nurse having reasonable cause to suspect that
  28-19  a registered nurse has exposed or is likely to expose a patient or
  28-20  other person unnecessarily to a risk of harm because of
  28-21  unprofessional conduct, failure to care adequately for a patient,
  28-22  failure to conform to the minimum standards of acceptable
  28-23  professional nursing practice, or impaired status shall report in a
  28-24  signed, written report to the board the name of the nurse
  28-25  committing the violation or suspected violation and any other
  28-26  pertinent information within the nurse's knowledge as the board may
  28-27  require.  A registered nurse without personal knowledge of the
   29-1  nurse's actions is not required to report under this section if she
   29-2  or he has reasonable cause to believe the nurse has already been
   29-3  reported.
   29-4        (b)  The board shall adopt rules governing reporting required
   29-5  under this article to minimize unnecessary duplicative reporting
   29-6  and the reporting of minor incidents.  A "minor incident" means
   29-7  conduct that does not indicate the nurse's continuing to practice
   29-8  professional nursing poses a risk of harm to a client or other
   29-9  person.
  29-10        SECTION 12.  Chapter 7, Title 71, Revised Statutes, is
  29-11  amended by adding Article 4525c to read as follows:
  29-12        Art. 4525c.  MEMORANDUM OF UNDERSTANDING.  The board shall
  29-13  sign a memorandum of understanding with state agencies that
  29-14  license, register, or certify a facility required by law to have a
  29-15  registered nurse peer review committee.  The memorandum of
  29-16  understanding shall:
  29-17              (1)  state the actions the board and agency shall take
  29-18  to encourage compliance with the requirement to have a registered
  29-19  nurse peer review committee; and
  29-20              (2)  be adopted as a rule of the board and the agency.
  29-21        SECTION 13.  Chapter 7, Title 71, Revised Statutes, is
  29-22  amended by adding Article 4525e to read as follows:
  29-23        Art. 4525e.  TEMPORARY SUSPENSION OF LICENSE.  If the
  29-24  majority of the board or a three-member committee of board members
  29-25  designated by the board determines from the evidence or information
  29-26  presented to it that a registered nurse by continuation in practice
  29-27  would constitute a continuing and imminent threat to the public
   30-1  welfare, the board or the three-member committee shall temporarily
   30-2  suspend the license of the registered nurse.  The license may be
   30-3  suspended under this article without notice or hearing on the
   30-4  complaint, provided institution of proceedings for a hearing before
   30-5  the State Office of Administrative Hearings is initiated
   30-6  simultaneously with the temporary suspension and provided that a
   30-7  hearing is held as soon as can be accomplished under this chapter
   30-8  and the Administrative Procedure and Texas Register Act (Article
   30-9  6252-13a, Vernon's Texas Civil Statutes) and its subsequent
  30-10  amendments.  The State Office of Administrative Hearings shall hold
  30-11  a preliminary hearing not later than the 14th day after the date of
  30-12  the temporary suspension to determine if probable cause exists that
  30-13  a continuing and imminent threat to the public welfare still
  30-14  exists.  A final hearing on the matter shall be held not later than
  30-15  the 61st day after the date of temporary suspension.
  30-16        SECTION 14.  Article 4526, Revised Statutes, is amended to
  30-17  read as follows:
  30-18        Art. 4526.  LICENSE RENEWAL <Re-registration>.  The board by
  30-19  rule may <shall> adopt a system under which licenses expire on
  30-20  various dates during the year <issued by the board shall be renewed
  30-21  each biennium>.  <For the year in which the  expiration date is
  30-22  changed, registration fees payable on or before March 31 shall be
  30-23  prorated on a monthly basis so that each registrant shall pay only
  30-24  that portion of the re-registration fee that is allocable to the
  30-25  months in which the registration is valid.  On the new expiration
  30-26  date, the total re-registration fee is payable.  The board shall
  30-27  notify each licensee at least 30 days in advance of the date of
   31-1  expiration of the license.  The application for re-registration
   31-2  shall be mailed by United States mail to the address shown in the
   31-3  board's records.  Any application received after the expiration
   31-4  date shall be charged a late fee.>  If a person's license has been
   31-5  expired for <not more than> 90 days or less, the person may renew
   31-6  the license by paying to the board the required renewal fee and a
   31-7  fee that is one-half the amount charged by the board or a designee
   31-8  for examination <fee> for the license.  If a license has been
   31-9  expired for <more than> 90 days but less than one year <two years>,
  31-10  the person may renew the license by paying to the board all unpaid
  31-11  renewal fees and a fee that is equal to the amount charged by the
  31-12  board or a designee for examination <fee> for the license.   The
  31-13  board shall by rule set a length of time beyond which an expired
  31-14  license may not be renewed.  The board may establish by rule
  31-15  additional requirements that shall apply to the renewal of a
  31-16  license that has been expired for more than one year but less than
  31-17  the time limit set by the board beyond which a license may not be
  31-18  renewed  <If a license has been expired for two years or more, the
  31-19  person may renew the license on meeting the requirements that the
  31-20  board considers necessary>.  The person may obtain a new license by
  31-21  submitting to reexamination and complying with the requirements and
  31-22  procedures for obtaining an original license.  However, the board
  31-23  may renew without reexamination an expired license of a person who
  31-24  was licensed in this state, moved to another state, and is
  31-25  currently licensed and has been in practice in the other state for
  31-26  the two years preceding application.  The person must pay to the
  31-27  board a fee that is equal to the initial fee for the license and
   32-1  the renewal fee.  At least 30 days before the expiration of the
   32-2  person's license, the board shall send written notice of the
   32-3  impending license expiration to the person at the person's last
   32-4  known address according to the records of the board.  If any
   32-5  registered nurse continues to practice professional nursing beyond
   32-6  the time for which the nurse is registered <or re-registered>, the
   32-7  nurse shall be considered to be an illegal practitioner and the
   32-8  license may be revoked or suspended.
   32-9        SECTION 15.  Article 4527, Revised Statutes, is amended to
  32-10  read as follows:
  32-11        Art. 4527.  Fees
  32-12        Sec. 1.  The board by rule shall establish reasonable and
  32-13  necessary fees so that the fees, in the aggregate, produce
  32-14  sufficient revenue to cover the cost of administering this chapter.
  32-15  The board may not set a fee for an amount less than the amount of
  32-16  that fee on September 1, 1993.  <The Board of Nurse Examiners shall
  32-17  establish reasonable and necessary fees for the administration of
  32-18  its functions in amounts not to exceed:>
  32-19        <Admission fee to examination ......................... $200>
  32-20        <Duplicate or substitute of current certificate .......   25>
  32-21        <Duplicate or substitute of permanent certificate .....   25>
  32-22        <Duplicate permits ....................................   15>
  32-23        <Endorsement with or without examination ..............  150>
  32-24        <Re-registration ......................................   50>
  32-25        <Issuance of a temporary permit under Art. 4523 .......   25>
  32-26        <Reactivating from inactive status ....................   30>
  32-27        <Accreditation of new schools and programs ............  150>
   33-1        <Filing of affidavits in re-change of name ............   10>
   33-2        <Verification of records ..............................   50>
   33-3        <Bad checks ...........................................   25>
   33-4        <Advanced Nurse Practitioner-initial credentials ......   50>
   33-5        <Advanced Nurse Practitioner-renewal of credentials ...   25>
   33-6        <Issuance    of   declaratory   order   of  eligibility>
   33-7           <for license ........................................   25>
   33-8        Sec. 2.  The board may receive gifts, grants, or other funds
   33-9  or assets  <The Board shall not maintain unnecessary fund balances,
  33-10  and fee amounts shall be set in accordance with this
  33-11  requirement.   The Board shall set and collect a sales charge for
  33-12  copies of any paper or record in the office of the Board and for
  33-13  any printed material published by the Board.  The charges are to be
  33-14  in an amount considered sufficient to reimburse the Board for its
  33-15  actual expenses>.
  33-16        Sec. 3.    All fees received by said Board under this law
  33-17  shall be placed in the State Treasury to the credit of a special
  33-18  fund to be known as the "Professional Nurse Registration Fund" and
  33-19  the Comptroller shall upon requisition of the Board from time to
  33-20  time draw warrants upon the State Treasurer for the amounts
  33-21  specified in such requisition; provided, however, all fees
  33-22  collected by the Board and deposited in the Professional Nurse
  33-23  Registration Fund shall be expended as specified by itemized
  33-24  appropriation in the General Appropriations Act and shall be used
  33-25  by the Board, and under its directions, only for purposes of
  33-26  carrying out this Act.  <The Board may use any of the fees and
  33-27  charges collected by it, as necessary, to retain, hire, or contract
   34-1  for additional prosecutors, hearing examiners, investigators, and
   34-2  support staff as necessary to aid in the investigation of
   34-3  complaints and the prosecution of persons subject to the Board's
   34-4  jurisdiction.  This provision shall apply to all fees of whatsoever
   34-5  nature as permitted by law.  The financial transactions of the
   34-6  Board are subject to audit by the state auditor in accordance with
   34-7  Chapter 321, Government Code.>
   34-8        SECTION 16.  Article 4527b, Revised Statutes, is amended to
   34-9  read as follows:
  34-10        Art. 4527b.  PENALTIES <Penalty>.  (a)  A person who violates
  34-11  any provision of Article 4527a, Revised Statutes, commits an
  34-12  offense.  Except as provided by this section, an offense under that
  34-13  article is a Class A misdemeanor.  If it is shown in the trial of a
  34-14  person allegedly in violation of that article that the person has
  34-15  once before been convicted of a violation of Article 4527a, on
  34-16  conviction the person shall be punished for a third degree felony.
  34-17  Each day of violation constitutes a separate offense.  On final
  34-18  conviction of an offense under that article, a person forfeits all
  34-19  rights and privileges conferred by virtue of licensure under this
  34-20  chapter.
  34-21        (b)  A person who violates Article 4527a, Revised Statutes,
  34-22  is liable to the state for a civil penalty that does not exceed
  34-23  $1,000 a day.  The civil penalty may be collected in a suit
  34-24  initiated by the board.
  34-25        SECTION 17.  Chapter 7, Title 71, Revised Statutes, is
  34-26  amended by adding Article 4527d to read as follows:
  34-27        Art. 4527d.  ADMINISTRATIVE PENALTIES.  (a)  The board may
   35-1  impose an administrative penalty against a person licensed or
   35-2  regulated under this article who violates this article or a rule or
   35-3  order adopted under this article.
   35-4        (b)  The penalty for each violation may be in an amount not
   35-5  to exceed $2,500.  Each day a violation continues or occurs is a
   35-6  separate violation for purposes of imposing a penalty.
   35-7        (c)  The amount of the penalty shall be based on:
   35-8              (1)  the seriousness of the violation, including the
   35-9  nature, circumstances, extent, and gravity of any prohibited acts,
  35-10  and the hazard or potential hazard created to the health, safety,
  35-11  or economic welfare of the public;
  35-12              (2)  the economic harm to property or the environment
  35-13  caused by the violation;
  35-14              (3)  the history of previous violations;
  35-15              (4)  the amount necessary to deter future violations;
  35-16              (5)  efforts to correct the violation; and
  35-17              (6)  any other matter that justice may require.
  35-18        (d)  The executive director who determines that a violation
  35-19  has occurred may issue to the board a report that states the facts
  35-20  on which the determination is based and the director's
  35-21  recommendation on the imposition of a penalty, including a
  35-22  recommendation on the amount of the penalty.
  35-23        (e)  Within 14 days after the date the report is issued, the
  35-24  executive director shall give written notice of the report to the
  35-25  person.  The notice may be given by certified mail.  The notice
  35-26  must include a brief summary of the alleged violation and a
  35-27  statement of the amount of the recommended penalty and must inform
   36-1  the person that the person has a right to a hearing on the
   36-2  occurrence of the violation, the amount of the penalty, or both the
   36-3  occurrence of the violation and the amount of the penalty.
   36-4        (f)  Within 20 days after the date the person receives the
   36-5  notice, the person in writing may accept the determination and
   36-6  recommended penalty of the executive director or may make a written
   36-7  request for a hearing on the occurrence of the violation, the
   36-8  amount of the penalty, or both the occurrence of the violation and
   36-9  the amount of the penalty.
  36-10        (g)  If the person accepts the determination and recommended
  36-11  penalty of the executive director, the board by order shall approve
  36-12  the determination and impose the recommended penalty.
  36-13        (h)  If the person requests a hearing or fails to respond
  36-14  timely to the notice, the executive director shall set a hearing
  36-15  and give notice of the hearing to the person.  The hearing shall be
  36-16  held by an administrative law judge of the State Office of
  36-17  Administrative Hearings.  The administrative law judge shall make
  36-18  findings of fact and conclusions of law.  The administrative law
  36-19  judge shall promptly issue to the board a proposal for a decision
  36-20  about the occurrence of the violation and the amount of a proposed
  36-21  penalty.  Based on the findings of fact, conclusions of law, and
  36-22  proposal for a decision, the board by order may find that a
  36-23  violation has occurred and impose a penalty or may find that no
  36-24  violation occurred.
  36-25        (i)  The notice of the board's order given to the person
  36-26  under the Administrative Procedure and Texas Register Act (Article
  36-27  6252-13a, Vernon's Texas Civil Statutes) and its subsequent
   37-1  amendments must include a statement of the right of the person to
   37-2  judicial review of the order.
   37-3        (j)  Within 30 days after the date the board's order is final
   37-4  as provided by Section 16(c), Administrative Procedure and Texas
   37-5  Register Act (Article 6252-13a, Vernon's Texas Civil Statutes), the
   37-6  person shall:
   37-7              (1)  pay the amount of the penalty;
   37-8              (2)  pay the amount of the penalty and file a petition
   37-9  for judicial review contesting the occurrence of the violation, the
  37-10  amount of the penalty, or both the occurrence of the violation and
  37-11  the amount of the penalty; or
  37-12              (3)  without paying the amount of the penalty, file a
  37-13  petition for judicial review contesting the occurrence of the
  37-14  violation, the amount of the penalty, or both the occurrence of the
  37-15  violation and the amount of the penalty.
  37-16        (k)  Within the 30-day period, a person who acts under
  37-17  Subsection (j)(3) of this section may:
  37-18              (1)  stay enforcement of the penalty by:
  37-19                    (A)  paying the amount of the penalty to the
  37-20  court for placement in an escrow account; or
  37-21                    (B)  giving to the court a supersedeas bond
  37-22  approved by the court for the amount of the penalty and that is
  37-23  effective until all judicial review of the board's order is final;
  37-24  or
  37-25              (2)  request the court to stay enforcement of the
  37-26  penalty by:
  37-27                    (A)  filing with the court a sworn affidavit of
   38-1  the person stating that the person is financially unable to pay the
   38-2  amount of the penalty and is financially unable to give the
   38-3  supersedeas bond; and
   38-4                    (B)  giving a copy of the affidavit to the
   38-5  executive director by certified mail.
   38-6        (l)  The executive director who receives a copy of an
   38-7  affidavit under Subsection (k)(2) of this section may file with the
   38-8  court, within five days after the date the copy is received, a
   38-9  contest to the affidavit.  The court shall hold a hearing on the
  38-10  facts alleged in the affidavit as soon as practicable and shall
  38-11  stay the enforcement of the penalty on finding that the alleged
  38-12  facts are true.  The person who files an affidavit has the burden
  38-13  of proving that the person is financially unable to pay the amount
  38-14  of the penalty and to give a supersedeas bond.
  38-15        (m)  If the person does not pay the amount of the penalty and
  38-16  the enforcement of the penalty is not stayed, the executive
  38-17  director may refer the matter to the attorney general for
  38-18  collection of the amount of the penalty.
  38-19        (n)  Judicial review of the order of the board:
  38-20              (1)  is instituted by filing a petition as provided by
  38-21  Section 19, Administrative Procedure and Texas Register Act
  38-22  (Article 6252-13a, Vernon's Texas Civil Statutes), and its
  38-23  subsequent amendments; and
  38-24              (2)  is under the substantial evidence rule.
  38-25        (o)  If the court sustains the occurrence of the violation,
  38-26  the court may uphold or reduce the amount of the penalty and order
  38-27  the person to pay the full or reduced amount of the penalty.  If
   39-1  the court does not sustain the occurrence of the violation, the
   39-2  court shall order that no penalty is owed.
   39-3        (p)  When the judgment of the court becomes final, the court
   39-4  shall proceed under this subsection.  If the person paid the amount
   39-5  of the penalty and if that amount is reduced or is not upheld by
   39-6  the court, the court shall order that the appropriate amount plus
   39-7  accrued interest be remitted to the person.  The rate of the
   39-8  interest is the rate charged on loans to depository institutions by
   39-9  the New York Federal Reserve Bank, and the interest shall be paid
  39-10  for the period beginning on the date the penalty was paid and
  39-11  ending on the date the penalty is remitted.  If the person gave a
  39-12  supersedeas bond and if the amount of the penalty is not upheld by
  39-13  the court, the court shall order the release of the bond.  If the
  39-14  person gave a supersedeas bond and if the amount of the penalty is
  39-15  reduced, the court shall order the release of the bond after the
  39-16  person pays the amount.
  39-17        (q)  A penalty collected under this section shall be remitted
  39-18  to the comptroller for deposit in the general revenue fund.
  39-19        (r)  All proceedings under this section are subject to the
  39-20  Administrative Procedure and Texas Register Act (Article 6252-13a,
  39-21  Vernon's Texas Civil Statutes) and its subsequent amendments.
  39-22        SECTION 18.  Article 4516, Revised Statutes, is repealed.
  39-23        SECTION 19.  The changes in law made by this Act in the
  39-24  qualifications of members of the Board of Nurse Examiners do not
  39-25  affect the entitlement of a member appointed before September 1,
  39-26  1993, to continue to hold office to the term to which the member
  39-27  was appointed.  The change in qualifications applies only to a
   40-1  member appointed on or after September 1, 1993.
   40-2        SECTION 20.  This Act takes effect September 1, 1993.
   40-3        SECTION 21.  The importance of this legislation and the
   40-4  crowded condition of the calendars in both houses create an
   40-5  emergency and an imperative public necessity that the
   40-6  constitutional rule requiring bills to be read on three several
   40-7  days in each house be suspended, and this rule is hereby suspended.