73R10828 CAG-D
          By Moncrief                                            S.B. No. 839
          Substitute the following for S.B. No. 839:
          By Berlanga                                        C.S.S.B. No. 839
                                 A BILL TO BE ENTITLED
    1-1                                AN ACT
    1-2  relating to the regulation of the practice of vocational nursing
    1-3  and to the continuation of the Board of Vocational Nurse Examiners;
    1-4  providing penalties.
    1-5        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-6        SECTION 1.  Sections 1(a) and (b), Chapter 118, Acts of the
    1-7  52nd Legislature, Regular Session, 1951 (Article 4528c, Vernon's
    1-8  Texas Civil Statutes), are amended to read as follows:
    1-9              (a)  "Board" means the Board of Vocational Nurse
   1-10  Examiners.
   1-11              (b)  "Licensed Vocational Nurse" means a person who is
   1-12  licensed under this Act by the Board of Vocational Nurse Examiners.
   1-13        SECTION 2.  Section 5, Chapter 118, Acts of the 52nd
   1-14  Legislature, Regular Session, 1951 (Article 4528c, Vernon's Texas
   1-15  Civil Statutes), is amended to read as follows:
   1-16        Sec. 5.  TERM OF OFFICE, ORGANIZATION, MEETINGS OF BOARD<;
   1-17  CONTINUING EDUCATION>.  (a)  There is hereby created a board to be
   1-18  known as the Board of Vocational Nurse Examiners, consisting of 15
   1-19  <twelve (12)> members to be appointed by the Governor and confirmed
   1-20  by the State Senate.  Appointments to the Board shall be made
   1-21  without regard to the race, color, handicap <creed>, sex, religion,
   1-22  or national origin of the appointees.
   1-23        Seven (7) members of the Board must be Licensed Vocational
   1-24  Nurses who are graduates of approved schools of vocational nursing,
    2-1  who have been actively engaged in the practice of vocational
    2-2  nursing for five (5) years immediately preceding their
    2-3  appointments, and who are not licensed physicians, registered
    2-4  professional nurses, or hospital administrators.
    2-5        One (1) member of the Board must be a Registered Nurse
    2-6  licensed by the Board of Nurse Examiners who is actively engaged in
    2-7  a teaching, administrative, or supervisory capacity in a vocational
    2-8  nursing educational program and who is not a licensed physician,
    2-9  hospital administrator, or licensed vocational nurse.
   2-10        One (1) member of the Board must be a physician licensed by
   2-11  the Texas State Board of Medical Examiners who has been actively
   2-12  engaged in the practice of medicine for five (5) years immediately
   2-13  preceding appointment and who is not a hospital administrator,
   2-14  registered professional nurse, or licensed vocational nurse.
   2-15        One (1) member of the Board must be a hospital administrator
   2-16  who has been actively engaged in hospital administration for a
   2-17  period of five (5) years and who is not a licensed physician,
   2-18  registered professional nurse, or licensed vocational nurse.
   2-19        Five (5) <Two (2)> members of the Board must be
   2-20  representatives of the general public.  A person is not eligible
   2-21  for appointment as a public member of the Board if the person or
   2-22  the person's spouse:
   2-23              (1)  is registered, certified, or licensed by an
   2-24  occupational regulatory agency in the field of health care;
   2-25              (2)  is employed by or participates in the management
   2-26  of a business entity or other organization regulated by the Board
   2-27  or receiving funds from the Board;
    3-1              (3)  owns or controls, directly or indirectly, more
    3-2  than 10 percent interest in a business entity or other organization
    3-3  regulated by the Board or receiving funds from the Board; or
    3-4              (4)  uses or receives a substantial amount of tangible
    3-5  goods, services, or funds from the Board, other than compensation
    3-6  or reimbursement authorized by law for Board membership,
    3-7  attendance, or expenses.  <A person is not eligible for appointment
    3-8  as a public member if the person or the person's spouse is licensed
    3-9  by an occupational regulatory agency in the field of health care or
   3-10  is employed by, participates in the management of, or has, other
   3-11  than as a consumer, a financial interest in a business entity or
   3-12  other organization that provides health-care services or that
   3-13  sells, manufactures, or distributes health-care supplies or
   3-14  equipment.>
   3-15        (b)  The term of office of each member of the Board shall be
   3-16  six (6) years.  A member may not immediately succeed the member's
   3-17  term <himself (or herself)> in office.  In case of death,
   3-18  resignation or vacancy from any cause on the Board, the vacancy of
   3-19  the unexpired term shall be filled by the Governor within sixty
   3-20  (60) days after the occurrence of such vacancy.
   3-21        Each appointee to the Board <of Vocational Nurse Examiners>
   3-22  shall, within fifteen (15) days of the date of his appointment,
   3-23  qualify by taking the constitutional oath of office.
   3-24        (c)(1)  An officer, employee, or paid consultant of a Texas
   3-25  trade association in the field of health care may not be a Board
   3-26  member.
   3-27              (2)  A person who is the spouse of an officer, manager,
    4-1  or paid consultant of a Texas trade association in the field of
    4-2  health care may not be a Board member.
    4-3              (3)  For the purposes of this section, a Texas trade
    4-4  association is a nonprofit, cooperative, and voluntarily joined
    4-5  association of business or professional competitors in this state
    4-6  designed to assist its members and its industry or profession in
    4-7  dealing with mutual business or professional problems and in
    4-8  promoting their common interest.  <A member or employee of the
    4-9  Board may not be an officer, employee, or paid consultant of a
   4-10  national or state trade association in the vocational nursing
   4-11  field.>
   4-12        (d)  A person may not serve as a Board member if the person
   4-13  is required to register as a lobbyist under Chapter 305, Government
   4-14  Code, and its subsequent amendments, because of the person's
   4-15  activities for compensation on behalf of a profession related to
   4-16  the operation of the Board.  <A member or employee of the Board may
   4-17  not be related within the second degree by affinity or
   4-18  consanguinity, as determined under Article 5996h, Revised Statutes,
   4-19  to a person who is an officer, employee, or paid consultant of a
   4-20  national or state trade association in the vocational nursing
   4-21  field.>
   4-22        (e)(1)  It is a ground for removal from the Board if a
   4-23  member:
   4-24                    (A)  does not have at the time of appointment the
   4-25  qualifications required by Subsection (a) of this section;
   4-26                    (B)  does not maintain during service on the
   4-27  Board the qualifications required by Subsection (a) of this
    5-1  section;
    5-2                    (C)  violates a prohibition established by
    5-3  Subsections (c) and (d) of this section;
    5-4                    (D)  cannot discharge the member's term for a
    5-5  substantial part of the term for which the member is appointed
    5-6  because of illness or disability; or
    5-7                    (E)  is absent from more than half of the
    5-8  regularly scheduled Board meetings that the member is eligible to
    5-9  attend during a calendar year unless the absence is excused by
   5-10  majority vote of the Board.
   5-11              (2)  The validity of an action of the Board is not
   5-12  affected by the fact that it is taken when a ground for removal of
   5-13  a Board member exists.
   5-14              (3)  If the executive director has knowledge that a
   5-15  potential ground for removal exists, the executive director shall
   5-16  notify the presiding officer of the Board of the ground.  The
   5-17  presiding officer shall then notify the governor that a potential
   5-18  ground for removal exists.
   5-19              <(1)  does not have at the time of appointment the
   5-20  qualifications required by Subsection (a) of this section for
   5-21  appointment to the Board;>
   5-22              <(2)  does not maintain during his service on the Board
   5-23  the qualifications required by Subsection (a) of this section for
   5-24  appointment to the Board;>
   5-25              <(3)  violates a prohibition prescribed by Subsection
   5-26  (c) or (d) of this section; or>
   5-27              <(4)  fails to attend at least half of the regularly
    6-1  scheduled Board meetings held in a calendar year, excluding
    6-2  meetings held while the person was not a Board member.>
    6-3        (f)  The governor shall designate from the members of the
    6-4  Board the President of the Board.  The person designated as
    6-5  President serves in that capacity at the will of the governor.
    6-6  <The validity of an action of the Board is not affected by the fact
    6-7  that it was taken when a ground for removal of a member of the
    6-8  Board existed.>
    6-9        <(g)>  The Board shall elect a <President,> Vice-president<,>
   6-10  and Secretary-treasurer yearly at an annual meeting.  The Board may
   6-11  make such rules and regulations as may be necessary to govern its
   6-12  proceedings and to carry in effect the purposes of this law.  The
   6-13  Secretary-treasurer shall be required to keep minutes of each
   6-14  meeting of said Board, a register of the names of all nurses
   6-15  licensed under this law, and books of account of fees received and
   6-16  disbursements; and all minutes, the register of Licensed Vocational
   6-17  Nurses and books of account shall be at all times open to public
   6-18  inspection.  The financial transactions of this Board are subject
   6-19  to audit by the state auditor in accordance with Chapter 321,
   6-20  Government Code.  The Board shall employ a person other than a
   6-21  member of the Board as the executive director of the Board.  The
   6-22  executive director shall perform the administrative functions of
   6-23  the Board.  The Board shall employ other persons that it considers
   6-24  necessary in carrying out the provisions of this law.  The
   6-25  Secretary-treasurer shall be bonded by the Board in such amount as
   6-26  may be recommended by the State Auditor.
   6-27        <(h)  The executive director or his designee shall develop a
    7-1  system of annual performance evaluations based on measurable job
    7-2  tasks.  All merit pay authorized by the executive director must be
    7-3  based on the system established under this subsection.>
    7-4        (g) <(i)>  The Board shall employ a full-time Director of
    7-5  Education, who shall have had at least five (5) years experience in
    7-6  teaching nursing in an accredited school of nursing or an approved
    7-7  program in vocational nursing.  The Board may select either a
    7-8  Licensed Vocational Nurse or a Registered Nurse as the Director of
    7-9  Education.  The duties of the Director of Education shall be to
   7-10  visit and inspect all schools of vocational nursing to determine
   7-11  whether the Board's minimum requirements for vocational nursing
   7-12  programs are being met.  The Board, by rule, may establish a
   7-13  separate fee for the survey of approved programs.  The Board shall
   7-14  prescribe such methods and rules of visiting, and such methods of
   7-15  reporting <by the Director of Education> as may in its judgment be
   7-16  deemed proper.
   7-17        (h) <(j)>  Regular meetings of the Board shall be held at
   7-18  least twice a year, one of which shall be designated as an Annual
   7-19  Meeting for election of officers and the reading of auditors'
   7-20  reports.  At least twice each year the Board shall hold
   7-21  examinations in various cities in the state for qualified
   7-22  applicants for licensure.  Examinations may be held under the
   7-23  supervision of a Board member or such other person as the Board may
   7-24  specify.  Special <Not less than sixty (60) days notice of the
   7-25  holding of the examination shall be given by publication in at
   7-26  least three (3) daily newspapers of general circulation, to be
   7-27  selected by the Board; special> meetings shall be held upon request
    8-1  of five (5) <four (4)> members of the Board or upon the call of the
    8-2  president; eight (8) <six (6)> members of the Board shall
    8-3  constitute a quorum for the transaction of business, and should a
    8-4  quorum not be present on the day appointed for any meeting, those
    8-5  persons present may adjourn from day to day until a quorum shall be
    8-6  present, providing that such period shall not be longer than three
    8-7  (3) successive days; each member of said Board is entitled to a per
    8-8  diem set by legislative appropriation for each day that the member
    8-9  engages in the business of the Board.  A member may not receive any
   8-10  compensation for travel expenses, including expenses for meals and
   8-11  lodging, other than transportation expenses.  A member is entitled
   8-12  to compensation for transportation expenses as provided by the
   8-13  General Appropriations Act.
   8-14        (i) <(k)>  The Board may not adopt rules restricting
   8-15  competitive bidding or advertising by a licensee of the Board
   8-16  except to prohibit false, misleading, or deceptive practices by the
   8-17  licensee.  The Board may not include in its rules to prohibit
   8-18  false, misleading, or deceptive practices by a licensee a rule
   8-19  that:
   8-20              (1)  restricts the licensee's use of any medium for
   8-21  advertising;
   8-22              (2)  restricts the licensee's personal appearance or
   8-23  use of the person's <his> voice in an advertisement;
   8-24              (3)  relates to the size or duration of an
   8-25  advertisement by the licensee; or
   8-26              (4)  restricts the licensee's advertisement under a
   8-27  trade name.
    9-1        <(l)(1)  The Board may recognize, prepare, or implement
    9-2  continuing education programs for licensees and may require
    9-3  participation in continuing education programs as a condition of
    9-4  renewal of a license.>
    9-5              <(2)  The Board may not require more than a total of 20
    9-6  hours of continuing education in a two-year license period and may
    9-7  not require that more than 10 of those hours consist of classroom
    9-8  instruction in approved programs.  The remaining 10 hours may
    9-9  consist of any combination of classroom instruction,
   9-10  institutional-based instruction, or individualized study.>
   9-11              <(3)  If the Board requires participation in continuing
   9-12  education programs as a condition of renewal of a license, the
   9-13  Board shall by rule establish a system for the approval of programs
   9-14  and providers of continuing education.  In adopting the rules, the
   9-15  board shall consider but is not obligated to approve programs or
   9-16  providers approved or accredited through continuing education
   9-17  accreditation systems established by national or state associations
   9-18  of licensed vocational nurses and nurse in-service programs offered
   9-19  by hospitals accredited by the Joint Commission on Accreditation of
   9-20  Healthcare Organizations, certified by Medicare, or maintained or
   9-21  operated by the federal government or the State of Texas.  The
   9-22  Board may assess programs and providers a fee in an amount
   9-23  reasonable and necessary to defray the costs incurred in approving
   9-24  providers and programs.  The fee collected under this subsection
   9-25  shall be deposited in the Vocational Nurse Examiners Fund.>
   9-26              <(4)  The Board may adopt other rules as necessary to
   9-27  implement this section.>
   10-1        (j) <(m)  The Board shall prepare information of consumer
   10-2  interest describing the regulatory functions of the Board and the
   10-3  Board's procedures by which consumer complaints are filed with and
   10-4  resolved by the Board.  The Board shall make the information
   10-5  available to the general public and appropriate state agencies.>
   10-6        <(n)>  The Board shall enforce this Act.  The Board may
   10-7  retain outside legal counsel to represent the Board.  However,
   10-8  before the Board may retain outside counsel, the Board shall
   10-9  request the attorney general to perform the necessary services and
  10-10  may retain the outside counsel only if the attorney general
  10-11  certifies to the Board that the services cannot be performed.
  10-12        (k) <(o)  A person who is required to register as a lobbyist
  10-13  under Chapter 305, Government Code, may not serve as a member of
  10-14  the Board or act as the general counsel to the Board.>
  10-15        <(p)>  The Board of Vocational Nurse Examiners is subject to
  10-16  Chapter 325, Government Code (Texas Sunset Act).  Unless continued
  10-17  in existence as provided by that chapter, the board is abolished
  10-18  and this Act expires September 1, 2005 <1993>.
  10-19        (l) <(q)>  The Board is subject to the open meetings law,
  10-20  Chapter 271, Acts of the 60th Legislature, Regular Session, 1967,
  10-21  as amended (Article 6252-17, Vernon's Texas Civil Statutes), and
  10-22  the Administrative Procedure and Texas Register Act, as amended
  10-23  (Article 6252-13a, Vernon's Texas Civil Statutes).
  10-24        <(r)  If the appropriate standing committees of both houses
  10-25  of the legislature acting under Subsection (g), Section 5,
  10-26  Administrative Procedure and Texas Register Act, as amended
  10-27  (Article 6252-13a, Vernon's Texas Civil Statutes), transmit to the
   11-1  Board statements opposing adoption of a rule under that section,
   11-2  the rule may not take effect, or if the rule has already taken
   11-3  effect, the rule is repealed effective on the date the Board
   11-4  receives the committee's statements.>
   11-5        (m)(1)  The executive director or the executive director's
   11-6  designee shall develop an intra-agency career ladder program.  The
   11-7  program shall require intra-agency posting of all nonentry level
   11-8  positions concurrently with any public posting.
   11-9              (2)  The executive director or the executive director's
  11-10  designee shall develop a system of annual performance evaluations
  11-11  based on measurable job tasks.  All merit pay for Board employees
  11-12  must be based on the system established under this subsection.
  11-13        (n)(1)  The executive director or the executive director's
  11-14  designee shall prepare and maintain a written policy statement to
  11-15  assure implementation of a program of equal employment opportunity
  11-16  under which all personnel transactions are made without regard to
  11-17  race, color, disability, sex, religion, age, or national origin.
  11-18  The policy statement must include:
  11-19                    (A)  personnel policies, including policies
  11-20  relating to recruitment, evaluation, selection, application,
  11-21  training, and promotion of personnel that are in compliance with
  11-22  the Commission on Human Rights Act (Article 5221k, Vernon's Texas
  11-23  Civil Statutes), and its subsequent amendments;
  11-24                    (B)  a comprehensive analysis of the Board
  11-25  workforce that meets federal and state guidelines;
  11-26                    (C)  procedures by which a determination can be
  11-27  made of significant underuse in the Board workforce of all persons
   12-1  for whom federal or state guidelines encourage a more equitable
   12-2  balance; and
   12-3                    (D)  reasonable methods to appropriately address
   12-4  those areas of underuse.
   12-5              (2)  A policy statement prepared under Subdivision (1)
   12-6  of this subsection must cover an annual period, be updated
   12-7  annually, be reviewed by the Commission on Human Rights for
   12-8  compliance with Subdivision (1)(A) of this subsection, and be filed
   12-9  with the governor's office.
  12-10              (3)  The governor's office shall deliver a biennial
  12-11  report to the legislature based on the information received under
  12-12  Subdivision (2)  of this subsection.  The report may be made
  12-13  separately or as part of other biennial reports to the legislature.
  12-14        (o)(1)  The Board shall prepare information of public
  12-15  interest describing the functions of the Board and the Board's
  12-16  procedures by which complaints are filed with and resolved by the
  12-17  Board.  The Board shall make the information available to the
  12-18  public and appropriate state agencies.
  12-19              (2)  The Board by rule shall establish methods by which
  12-20  consumers and service recipients are notified of the name, mailing
  12-21  address, and telephone number of the Board for the purpose of
  12-22  directing complaints to the Board.  The Board may provide for that
  12-23  notification:
  12-24                    (A)  on each registration form, application, or
  12-25  written contract for services of an individual or entity regulated
  12-26  by the Board;
  12-27                    (B)  on a sign prominently displayed in the place
   13-1  of business of each individual or entity regulated by the Board; or
   13-2                    (C)  in a bill for service provided by an
   13-3  individual or entity regulated by the Board.
   13-4              (3)  The Board shall enter into memoranda of
   13-5  understanding with each state agency that licenses health care
   13-6  facilities or agencies for the purpose of coordinating any
   13-7  notification requirements under Subdivision (2) of this subsection
   13-8  with notification requirements that may be imposed on the health
   13-9  care facility or agency by any other state agency.
  13-10              (4)  The Board shall list along with its regular
  13-11  telephone number the toll-free telephone number that may be called
  13-12  to present a complaint about a health professional if the toll-free
  13-13  number is established under other state law.
  13-14        (p)  The Board shall develop and implement policies that
  13-15  provide the public with a reasonable opportunity to appear before
  13-16  the Board and to speak on any issue under the jurisdiction of the
  13-17  Board.
  13-18        (q)  The Board shall prepare and maintain a written plan that
  13-19  describes how a person who does not speak English can be provided
  13-20  reasonable access to the Board's programs.  The Board shall also
  13-21  comply with federal and state laws for program and facility
  13-22  accessibility.
  13-23        (r)(1)  The Board shall establish a training program for the
  13-24  members of the Board.
  13-25              (2)  Before a member of a Board may assume the member's
  13-26  duties, the member must complete at least one course of the
  13-27  training program established under this subsection, and before the
   14-1  member may be confirmed by the senate.
   14-2              (3)  A training program established under this
   14-3  subsection shall provide information to a participant regarding:
   14-4                    (A)  the enabling legislation that created the
   14-5  Board;
   14-6                    (B)  the programs operated by the Board;
   14-7                    (C)  the role and functions of the Board;
   14-8                    (D)  the rules of the Board with an emphasis on
   14-9  the rules that relate to disciplinary and investigatory authority;
  14-10                    (E)  the current budget for the Board;
  14-11                    (F)  the results of the most recent formal audit
  14-12  of the Board;
  14-13                    (G)  the requirements of the:
  14-14                          (i)  open meetings law, Chapter 271, Acts
  14-15  of the 60th Legislature, Regular Session, 1967 (Article 6252-17,
  14-16  Vernon's Texas Civil Statutes), and its subsequent amendments;
  14-17                          (ii)  open records law, Chapter 424, Acts
  14-18  of the 63rd Legislature, Regular Session, 1973 (Article 6252-17a,
  14-19  Vernon's Texas Civil Statutes), and its subsequent amendments; and
  14-20                          (iii)  Administrative Procedure and Texas
  14-21  Register Act (Article 6252-13a, Vernon's Texas Civil Statutes) and
  14-22  its subsequent amendments;
  14-23                    (H)  the requirements of the conflict of interest
  14-24  laws and other laws relating to public officials; and
  14-25                    (I)  any applicable ethics policies adopted by
  14-26  the Board or the Texas Ethics Commission.
  14-27              (4)  In developing the training requirements provided
   15-1  for in this subsection, the Board shall consult with the governor's
   15-2  office, the attorney general's office, and the Texas Ethics
   15-3  Commission.
   15-4              (5)  In the event that another state agency or entity
   15-5  is given the authority to establish the training requirements, the
   15-6  Board shall allow that training in lieu of developing its own
   15-7  program.
   15-8        (s)  The Board shall provide to its members and employees, as
   15-9  often as necessary, information regarding their qualifications for
  15-10  office or employment under this article and their responsibilities
  15-11  under applicable laws relating to standards of conduct for state
  15-12  officers or employees.
  15-13        (t)  The Board may enter interagency contracts for any
  15-14  purpose authorized by law.
  15-15        SECTION 3.  Section 6, Chapter 118, Acts of the 52nd
  15-16  Legislature, Regular Session, 1951 (Article 4528c, Vernon's Texas
  15-17  Civil Statutes), is amended to read as follows:
  15-18        Sec. 6.  Examination and Licenses.  (a)  Except as provided
  15-19  in Section 7 of this Act, every person desiring to be licensed as a
  15-20  Licensed Vocational Nurse or use the abbreviation L.V.N. in the
  15-21  State of Texas, shall be required to pass the examination approved
  15-22  <given> by the Board of Vocational Nurse Examiners <or its
  15-23  delegate>.  The applicant shall make application by presenting to
  15-24  <the secretary of> the Board, on forms furnished by the Board,
  15-25  satisfactory sworn evidence that the applicant has had at least two
  15-26  (2) years of high school education or its equivalent and has
  15-27  completed an approved course <of not less than twelve (12) months>
   16-1  in an approved school for educating vocational nurses.  An approved
   16-2  school as used herein shall mean one approved by the Board or by
   16-3  another state.  Application for examination by the Board or its
   16-4  delegate shall be made at least thirty (30) days prior to the date
   16-5  set for the examination.
   16-6        (b)  The Board in its discretion may waive the requirement in
   16-7  Subsection (a) of this section for completion of a course in an
   16-8  approved school for educating vocational or practical nurses upon
   16-9  presentation of satisfactory sworn evidence that the applicant has
  16-10  completed an acceptable level <at least two (2) years> of education
  16-11  in a nursing school approved by the State Board of Nurse Examiners
  16-12  of Texas or in some other school of professional nurse education
  16-13  located in another state, the District of Columbia, a possession of
  16-14  the United States, or a foreign country.  The Board by rule shall
  16-15  determine acceptable levels of education.  The Board shall have the
  16-16  written portion of the examination, if any, validated by an
  16-17  independent testing professional.  If the applicant received
  16-18  training in another state, the District of Columbia, a possession
  16-19  of the United States, or a foreign country, the applicant must
  16-20  present evidence satisfactory to the Board that the nursing
  16-21  education received is equivalent to that required for licensure as
  16-22  a vocational nurse in this state.
  16-23        (c)  Not later than the 30th day <Within 30 days> after the
  16-24  date a licensing examination is administered under this Act, the
  16-25  Board shall notify each examinee of the results of the examination.
  16-26  However, if an examination is graded or reviewed by a national
  16-27  testing service, the Board shall notify each examinee of the
   17-1  results of the examination within two weeks after the date the
   17-2  Board receives the results from the testing service.  If the notice
   17-3  of the examination results will be delayed for more than 90 days
   17-4  after the examination date, the Board shall notify each examinee of
   17-5  the reason for the delay before the 90th day.  If requested in
   17-6  writing by a person who fails the licensing examination
   17-7  administered under this Act, the Board shall furnish the person
   17-8  with an analysis of the person's performance on the examination or
   17-9  other information which the Board has available to it after the
  17-10  tests are scored.
  17-11        (d)  If an applicant has graduated from an approved
  17-12  educational program in vocational nursing in this state, another
  17-13  state, or the District of Columbia, or successfully completed an
  17-14  acceptable level of education in a professional nursing program
  17-15  <two years of an associate degree program or diploma program in
  17-16  professional nursing education> in this state, another state, or
  17-17  the District of Columbia, the Board may issue to the applicant,
  17-18  pending the results of the licensing examination, a temporary
  17-19  permit to practice vocational nursing under the direct supervision
  17-20  of a licensed vocational nurse, registered professional nurse, or
  17-21  licensed physician.  A permit issued to an applicant who fails the
  17-22  examination expires on the date indicated on the permit.  A permit
  17-23  issued to an applicant who passes the examination expires on the
  17-24  applicant's receipt of a license from the Board.  A permit may not
  17-25  be issued to an applicant who has previously failed an examination
  17-26  administered by the Board or by another state.  <The Board may
  17-27  issue a temporary permit to practice vocational nursing to an
   18-1  applicant who is a vocational or practical nurse who has graduated
   18-2  from an approved program for educating vocational or practical
   18-3  nurses, holds a license as a vocational or practical nurse from
   18-4  another state, the District of Columbia, or a possession of the
   18-5  United States, and has actually been engaged in the practice of
   18-6  vocational or practical nursing within the past five years.  Such
   18-7  an applicant must practice under the direct supervision of a
   18-8  licensed vocational nurse, registered professional nurse, or
   18-9  licensed physician.  A temporary permit issued to an applicant from
  18-10  another state, the District of Columbia, or a possession of the
  18-11  United States expires on receipt of a license from the Board or on
  18-12  the expiration of 90 days, whichever occurs first.  The Board may,
  18-13  by mutual agreement, assign the function of physical distribution
  18-14  of the temporary permits to an agent designated by the Board to act
  18-15  on behalf of the Board.>
  18-16        (e)  Any nurse who is licensed under the provisions of this
  18-17  Act, when on duty in a public or private hospital, nursing home, or
  18-18  licensed health-care facility, shall wear <identifying> insignia
  18-19  identifying the nurse as a licensed vocational nurse <on white caps
  18-20  or uniforms>.
  18-21        SECTION 4.  Section 7, Chapter 118, Acts of the 52nd
  18-22  Legislature, Regular Session, 1951 (Article 4528c, Vernon's Texas
  18-23  Civil Statutes), is amended to read as follows:
  18-24        Sec. 7.  QUALIFICATION FOR LICENSING BY ENDORSEMENT.  (a)  To
  18-25  qualify for a temporary license to practice as a licensed
  18-26  vocational nurse by endorsement, an applicant for licensing must:
  18-27              (1)  submit to the Board an application fee as
   19-1  determined by the Board and a completed application given under
   19-2  oath, in the form prescribed by the Board;
   19-3              (2)  have possessed at the time of initial licensing as
   19-4  a licensed vocational nurse the qualifications necessary to have
   19-5  been eligible for licensing at that time in this state;
   19-6              (3)  have presented to the Board proof of initial
   19-7  licensing by examination and proof that the current active license
   19-8  and other license or licenses granted to the applicant by any other
   19-9  state have not been suspended, revoked, canceled, surrendered, or
  19-10  otherwise restricted for any reason; and
  19-11              (4)  submit to the Board a notice of sponsorship of the
  19-12  applicant by the holder of a Texas health care professional license
  19-13  under whom the applicant will practice.
  19-14        (b)  A holder of a temporary license under this section shall
  19-15  receive a permanent license if the applicant:
  19-16              (1)  has submitted official verification of  the
  19-17  academic and professional credentials of the applicant; and
  19-18              (2)  satisfies any other requirement set by statute.
  19-19        (c)  The Board shall either grant or deny an application for
  19-20  a permanent license within 180 days after the date of the Board's
  19-21  receipt of all required forms or information.  The Board may extend
  19-22  the 180-day deadline to allow for the receipt and tabulation of
  19-23  pending examination results.
  19-24        (d)  The Board shall adopt rules relating to the conditions
  19-25  of sponsorship under Subsection (a)(4) of this section, including
  19-26  waiver of the requirement in the event of a hardship.  <Any
  19-27  applicant who holds a license as a Vocational Nurse or Practical
   20-1  Nurse issued by the District of Columbia or another state whose
   20-2  requirements are equal to those of Texas, and whose individual
   20-3  qualifications shall be equivalent to those required by this law,
   20-4  may be granted a license to practice nursing as a Licensed
   20-5  Vocational Nurse in this State without examination provided the
   20-6  required fee is paid to the Board by such applicant.>
   20-7        SECTION 5.  Sections 8(a), (b), and (c), Chapter 118, Acts of
   20-8  the 52nd Legislature, Regular Session, 1951 (Article 4528c,
   20-9  Vernon's Texas Civil Statutes), are amended to read as follows:
  20-10        (a)  The Board <board> by rule shall adopt a system under
  20-11  which licenses expire on various dates during the year <every two
  20-12  years>.  <For the year in which the expiration date is changed,
  20-13  license fees payable on September 1 shall be prorated on a monthly
  20-14  basis so that each licensee shall pay only that portion of the
  20-15  license fee which is allocable to the number of months during which
  20-16  the license is valid.  On renewal of the license on the new
  20-17  expiration date, the total license renewal fee is payable.>
  20-18        (b)  At <The Board shall notify each licensee about the
  20-19  expiration date of the person's license at> least 30 days before
  20-20  the expiration of a person's license, the Board <date.  The Board
  20-21  by United States mail> shall send written notice of the impending
  20-22  license expiration to the person, at the person's last known
  20-23  address according to the Board's records <with the notice an
  20-24  application for license renewal to the licensee's address contained
  20-25  in the Board's records.  A licensee whose completed application for
  20-26  renewal is received by the Board after the expiration date of the
  20-27  license shall be charged a late fee>.
   21-1        (c)  If a person's license has been expired for <not more
   21-2  than> 90 days or less, the person may renew the license by paying
   21-3  to the Board the required renewal fee and a fee that is one-half
   21-4  the examination fee for the license.  If a person's license has
   21-5  been expired for more than 90 days but less than one year <two
   21-6  years>, the person may renew the license by paying to the Board all
   21-7  unpaid renewal fees and a fee that is equal to the examination fee
   21-8  for the license.  The Board by rule shall set a length of time
   21-9  beyond which an expired license may not be renewed.  The Board by
  21-10  rule may establish additional requirements that apply to the
  21-11  renewal of a license that has been expired for more than one year
  21-12  but less than the period set by the Board beyond which a license
  21-13  may not be renewed <If a person's license has been expired for two
  21-14  years or more, the person may renew the license by complying with
  21-15  the requirements set forth in substantive rules adopted by the
  21-16  Board>.  The person may obtain a new license by submitting to
  21-17  reexamination and complying with the requirements and procedures
  21-18  for obtaining an original license.  However, the Board may renew
  21-19  without examination an expired license of a person who was licensed
  21-20  in this state, moved to another state, and is currently licensed
  21-21  and has been in practice in the other state for the two years
  21-22  preceding application.  The person must pay to the Board a fee that
  21-23  is equal to the examination fee for the license.
  21-24        SECTION 6.  Chapter 118, Acts of the 52nd Legislature,
  21-25  Regular Session, 1951 (Article 4528c, Vernon's Texas Civil
  21-26  Statutes), is amended by adding Section 8A to read as follows:
  21-27        Sec. 8A.  MANDATORY CONTINUING EDUCATION REQUIREMENTS.
   22-1  (a)  To renew a license, a licensee must demonstrate to the
   22-2  satisfaction of the Board completion of the requirement for
   22-3  continuing professional education.
   22-4        (b)  The Board shall adopt rules relating to the operation of
   22-5  the mandatory continuing education programs.  In establishing the
   22-6  requirement for continuing education, the Board shall consider:
   22-7              (1)  factors that lead to the competent performance of
   22-8  professional duties; and
   22-9              (2)  the continuing education needs of licensees.
  22-10        (c)  The Board shall adopt rules relating to the adoption or
  22-11  approval of mandatory continuing education programs and providers
  22-12  and shall adopt rules to evaluate the effectiveness of the programs
  22-13  and a licensee's participation and performance in the programs.
  22-14        SECTION 7.  Section 9, Chapter 118, Acts of the 52nd
  22-15  Legislature, Regular Session, 1951 (Article 4528c, Vernon's Texas
  22-16  Civil Statutes), is amended to read as follows:
  22-17        Sec. 9.  Fees.  (a)  The Board by rule shall establish
  22-18  reasonable and necessary fees so that the fees, in the aggregate,
  22-19  produce sufficient revenue to cover the cost of administering this
  22-20  Act.  The fees set by the Board may be adjusted so that the total
  22-21  fees collected shall be sufficient to meet the expenses of
  22-22  administering this Act.  The Board may not set a fee for an amount
  22-23  less than the amount of that fee on September 1, 1993  <for the
  22-24  administration of this Act in amounts not to exceed:>
  22-25              <(1)  examination and application fee:  $40;>
  22-26              <(2)  reexamination fee:  $40;>
  22-27              <(3)  renewal fee:  $20;>
   23-1              <(4)  endorsement fee:  $40;>
   23-2              <(5)  accreditation of new programs fee:  $75;>
   23-3              <(6)  duplicate temporary permit or license fee:  $10;>
   23-4              <(7)  filing of affidavits in rechange of name fee:
   23-5  $10;>
   23-6              <(8)  endorsement to another state fee:  $40; and>
   23-7              <(9)  reactivating from inactive status fee:  $30>.
   23-8  The Board shall not maintain unnecessary fund balances, and fee
   23-9  amounts shall be set in accordance with this requirement.
  23-10        (b)  All expenses under this Act shall be paid from fees
  23-11  collected by the Board under this Act, and no expense incurred
  23-12  under this Act shall ever be charged against the funds of the State
  23-13  of Texas.
  23-14        (c)  On or before January 1 of each year, the Board shall
  23-15  make in writing to the Governor and the presiding officer of each
  23-16  house of the legislature a complete and detailed report accounting
  23-17  for all funds received and disbursed by the Board during the
  23-18  preceding year.  The annual report must be in the form and reported
  23-19  in the time provided by the General Appropriations Act.
  23-20        SECTION 8.  Chapter 118, Acts of the 52nd Legislature,
  23-21  Regular Session, 1951 (Article 4528c, Vernon's Texas Civil
  23-22  Statutes), is amended by adding Sections 10A-10F to read as
  23-23  follows:
  23-24        Sec. 10A.  RECORDS OF COMPLAINTS.  (a)  The Board shall keep
  23-25  an information file about each complaint filed with the Board.  The
  23-26  Board's information file shall be kept current and contain a record
  23-27  for each complaint of:
   24-1              (1)  all persons contacted in relation to the
   24-2  complaint;
   24-3              (2)  a summary of findings made at each step of the
   24-4  complaint process;
   24-5              (3)  an explanation of the legal basis and reason for a
   24-6  complaint that is dismissed; and
   24-7              (4)  other relevant information.
   24-8        (b)  If a written complaint is filed with the Board that the
   24-9  Board has authority to resolve, the Board, at least as frequently
  24-10  as quarterly and until final disposition of the complaint, shall
  24-11  notify the parties to the complaint of the status of the complaint
  24-12  unless the notice would jeopardize an undercover investigation.
  24-13        (c)  The Board by rule shall adopt a form to standardize
  24-14  information concerning complaints made to the Board.  The Board by
  24-15  rule shall prescribe information to be provided to a person when
  24-16  the person files a complaint with the Board.
  24-17        (d)  The Board shall provide reasonable assistance to a
  24-18  person who wishes to file a complaint with the Board.
  24-19        Sec. 10B.  COMPLAINT INVESTIGATION AND DISPOSITION.  (a)  The
  24-20  Board shall adopt rules concerning the investigation of a complaint
  24-21  filed with the Board.  The rules adopted under this subsection
  24-22  shall:
  24-23              (1)  distinguish between categories of complaints;
  24-24              (2)  ensure that complaints are not dismissed without
  24-25  appropriate consideration;
  24-26              (3)  require that the Board be advised of a complaint
  24-27  that is dismissed and that a letter be sent to the person who filed
   25-1  the complaint explaining the action taken on the dismissed
   25-2  complaint;
   25-3              (4)  ensure that the person who filed the complaint has
   25-4  an opportunity to explain the allegations made in the complaint;
   25-5  and
   25-6              (5)  prescribe guidelines concerning the categories of
   25-7  complaints that require the use of a private investigator and the
   25-8  procedures for the Board to obtain the services of a private
   25-9  investigator.
  25-10        (b)  The Board shall dispose of all complaints in a timely
  25-11  manner.  The Board shall establish a timeline for conducting each
  25-12  phase of a complaint that is under the control of the Board not
  25-13  later than the 30th day after the date the complaint is received by
  25-14  the Board.  The timeline shall be kept in the information file for
  25-15  the complaint and all parties shall be notified of the projected
  25-16  time requirements for pursuing the complaint.  A change in the
  25-17  timeline must be noted in the complaint information file and all
  25-18  parties to the complaint must be notified not later than the
  25-19  seventh day after the date the change is made.
  25-20        (c)  The executive director shall notify the Board of a
  25-21  complaint that extends beyond the time prescribed by the Board for
  25-22  resolving the complaint so that the Board may take necessary action
  25-23  on the complaint.
  25-24        Sec. 10C.  INFORMAL PROCEEDINGS.  (a)  The Board by rule
  25-25  shall adopt procedures governing:
  25-26              (1)  informal disposition of a contested case under
  25-27  Section 13(e), Administrative Procedure and Texas Register Act
   26-1  (Article 6252-13a, Vernon's Texas Civil Statutes), and its
   26-2  subsequent amendments; and
   26-3              (2)  informal proceedings held in compliance with
   26-4  Section 18(c), Administrative Procedure and Texas Register Act
   26-5  (Article 6252-13a, Vernon's Texas Civil Statutes), and its
   26-6  subsequent amendments.
   26-7        (b)  Rules adopted under this section must provide the
   26-8  complainant and the licensee an opportunity to be heard and must
   26-9  require the presence of a representative of the Board's legal staff
  26-10  or of the office of the attorney general to advise the Board or the
  26-11  Board's employees.
  26-12        Sec. 10D.  MONITORING OF LICENSEE.  The Board by rule shall
  26-13  develop a system for monitoring licensees' compliance with the
  26-14  requirements of this Act.  Rules adopted under this section shall
  26-15  include procedures for monitoring a licensee who is ordered by the
  26-16  Board to perform certain acts to ascertain that the licensee
  26-17  performs the required acts and to identify and monitor licensees
  26-18  who represent a risk to the public.
  26-19        Sec. 10E.  ADMINISTRATIVE PENALTIES.  (a)  The Board may
  26-20  impose an administrative penalty against a person licensed or
  26-21  regulated under this Act who violates this Act or a rule or order
  26-22  adopted under this Act.
  26-23        (b)  The penalty for each violation may be in an amount not
  26-24  to exceed $1,000.  Each day a violation continues or occurs is a
  26-25  separate violation for purposes of imposing a penalty.
  26-26        (c)  The amount of the penalty shall be based on:
  26-27              (1)  the seriousness of the violation, including the
   27-1  nature, circumstances, extent, and gravity of any prohibited acts,
   27-2  and the hazard or potential hazard created to the health, safety,
   27-3  or economic welfare of the public;
   27-4              (2)  the economic harm to property or the environment
   27-5  caused by the violation;
   27-6              (3)  the history of previous violations;
   27-7              (4)  the amount necessary to deter future violations;
   27-8              (5)  efforts to correct the violation; and
   27-9              (6)  any other matter that justice may require.
  27-10        (d)  If the executive director determines that a violation
  27-11  has occurred, the executive director may issue to the Board a
  27-12  report that states the facts on which the determination is based
  27-13  and the executive director's recommendation on the imposition of a
  27-14  penalty, including a recommendation on the amount of the penalty.
  27-15        (e)  Within 14 days after the date the report is issued, the
  27-16  executive director shall give written notice of the report to the
  27-17  person.  The notice may be given by certified mail.  The notice
  27-18  must include a brief summary of the alleged violation and a
  27-19  statement of the amount of the recommended penalty and must inform
  27-20  the person that the person has a right to a hearing on the
  27-21  occurrence of the violation, the amount of the penalty, or both the
  27-22  occurrence of the violation and the amount of the penalty.
  27-23        (f)  Within 20 days after the date the person receives the
  27-24  notice, the person in writing may accept the determination and
  27-25  recommended penalty of the executive director or may make a written
  27-26  request for a hearing on the occurrence of the violation, the
  27-27  amount of the penalty, or both the occurrence of the violation and
   28-1  the amount of the penalty.
   28-2        (g)  If the person accepts the determination and recommended
   28-3  penalty of the executive director, the Board by order shall approve
   28-4  the determination and impose the recommended penalty.
   28-5        (h)  If the person requests a hearing or fails to respond
   28-6  timely to the notice, the executive director shall set a hearing
   28-7  and give notice of the hearing to the person.  The hearing shall be
   28-8  held by an administrative law judge of the State Office of
   28-9  Administrative Hearings.  The administrative law judge shall make
  28-10  findings of fact and conclusions of law.  The administrative law
  28-11  judge shall promptly issue to the Board a proposal for a decision
  28-12  about the occurrence of the violation and the amount of a proposed
  28-13  penalty.  Based on the findings of fact, conclusions of law, and
  28-14  proposal for a decision, the Board by order may find that a
  28-15  violation has occurred and impose a penalty or may find that no
  28-16  violation occurred.
  28-17        (i)  The notice of the Board's order given to the person
  28-18  under the Administrative Procedure and Texas Register Act (Article
  28-19  6252-13a, Vernon's Texas Civil Statutes) and its subsequent
  28-20  amendments must include a statement of the right of the person to
  28-21  judicial review of the order.
  28-22        (j)  Within 30 days after the date the Board's order is final
  28-23  as provided by Section 16(c), Administrative Procedure and Texas
  28-24  Register Act (Article 6252-13a, Vernon's Texas Civil Statutes), the
  28-25  person shall:
  28-26              (1)  pay the amount of the penalty;
  28-27              (2)  pay the amount of the penalty and file a petition
   29-1  for judicial review contesting the occurrence of the violation, the
   29-2  amount of the penalty, or both the occurrence of the violation and
   29-3  the amount of the penalty; or
   29-4              (3)  without paying the amount of the penalty, file a
   29-5  petition for judicial review contesting the occurrence of the
   29-6  violation, the amount of the penalty, or both the occurrence of the
   29-7  violation and the amount of the penalty.
   29-8        (k)  Within the 30-day period, a person who acts under
   29-9  Subsection (j)(3) of this section may:
  29-10              (1)  stay enforcement of the penalty by:
  29-11                    (A)  paying the amount of the penalty to the
  29-12  court for placement in an escrow account; or
  29-13                    (B)  giving to the court a supersedeas bond
  29-14  approved by the court for the amount of the penalty and that is
  29-15  effective until all judicial review of the Board's order is final;
  29-16  or
  29-17              (2)  request the court to stay enforcement of the
  29-18  penalty by:
  29-19                    (A)  filing with the court a sworn affidavit of
  29-20  the person stating that the person is financially unable to pay the
  29-21  amount of the penalty and is financially unable to give the
  29-22  supersedeas bond; and
  29-23                    (B)  giving a copy of the affidavit to the
  29-24  executive director by certified mail.
  29-25        (l)  An executive director who receives a copy of an
  29-26  affidavit under Subsection (k)(2) of this section may file with the
  29-27  court, within five days after the date the copy is received, a
   30-1  contest to the affidavit.  The court shall hold a hearing on the
   30-2  facts alleged in the affidavit as soon as practicable and shall
   30-3  stay the enforcement of the penalty on finding that the alleged
   30-4  facts are true.  The person who files an affidavit has the burden
   30-5  of proving that the person is financially unable to pay the amount
   30-6  of the penalty and to give a supersedeas bond.
   30-7        (m)  If the person does not pay the amount of the penalty and
   30-8  the enforcement of the penalty is not stayed, the executive
   30-9  director may refer the matter to the attorney general for
  30-10  collection of the amount of the penalty.
  30-11        (n)  Judicial review of the order of the Board:
  30-12              (1)  is instituted by filing a petition as provided by
  30-13  Section 19, Administrative Procedure and Texas Register Act
  30-14  (Article 6252-13a, Vernon's Texas Civil Statutes), and its
  30-15  subsequent amendments; and
  30-16              (2)  is under the substantial evidence rule.
  30-17        (o)  If the court sustains the occurrence of the violation,
  30-18  the court may uphold or reduce the amount of the penalty and order
  30-19  the person to pay the full or reduced amount of the penalty.  If
  30-20  the court does not sustain the occurrence of the violation, the
  30-21  court shall order that no penalty is owed.
  30-22        (p)  When the judgment of the court becomes final, the court
  30-23  shall proceed under this subsection.  If the person paid the amount
  30-24  of the penalty and if that amount is reduced or is not upheld by
  30-25  the court, the court shall order that the appropriate amount plus
  30-26  accrued interest be remitted to the person.  The rate of the
  30-27  interest is the rate charged on loans to depository institutions by
   31-1  the New York Federal Reserve Bank, and the interest shall be paid
   31-2  for the period beginning on the date the penalty was paid and
   31-3  ending on the date the penalty is remitted.  If the person gave a
   31-4  supersedeas bond and if the amount of the penalty is not upheld by
   31-5  the court, the court shall order the release of the bond.  If the
   31-6  person gave a supersedeas bond and if the amount of the penalty is
   31-7  reduced, the court shall order the release of the bond after the
   31-8  person pays the amount.
   31-9        (q)  A penalty collected under this section shall be remitted
  31-10  to the comptroller for deposit in the general revenue fund.
  31-11        (r)  All proceedings under this section are subject to the
  31-12  Administrative Procedure and Texas Register Act (Article 6252-13a,
  31-13  Vernon's Texas Civil Statutes) and its subsequent amendments.
  31-14        Sec. 10F.  SCHEDULE OF SANCTIONS.  The schedule of sanctions
  31-15  adopted by the Board by rule shall be used by the State Office of
  31-16  Administrative Hearings for any sanction imposed as the result of a
  31-17  hearing conducted by that office.
  31-18        SECTION 9.  Section 11, Chapter 118, Acts of the 52nd
  31-19  Legislature, Regular Session, 1951 (Article 4528c, Vernon's Texas
  31-20  Civil Statutes), is amended by adding Subsection (c) to read as
  31-21  follows:
  31-22        (c)  A person who violates this Act is liable to the state
  31-23  for a civil penalty that does not exceed $1,000 a day.  The civil
  31-24  penalty may be collected in a suit initiated by the Board.
  31-25        SECTION 10.  (a)  The changes in law made by this Act in the
  31-26  qualifications of members of the Board of Vocational Nurse
  31-27  Examiners do not affect the entitlement of a member appointed
   32-1  before September 1, 1993, to continue to hold office for the term
   32-2  for which the member was appointed.  The changes in the
   32-3  qualifications apply only to a member appointed on or after
   32-4  September 1, 1993.
   32-5        (b)  As soon as possible on or after September 1, 1993, the
   32-6  governor shall appoint three additional public members to the Board
   32-7  of Vocational Nurse Examiners.  In making the initial appointments
   32-8  of the new members, the governor shall designate one for a term
   32-9  expiring on the regular expiration date of board members in 1995,
  32-10  one for a term expiring on the regular expiration date of board
  32-11  members in 1997, and one for a term expiring on the regular
  32-12  expiration date of board members in 1999.
  32-13        SECTION 11.  This Act takes effect September 1, 1993.
  32-14        SECTION 12.  The importance of this legislation and the
  32-15  crowded condition of the calendars in both houses create an
  32-16  emergency and an imperative public necessity that the
  32-17  constitutional rule requiring bills to be read on three several
  32-18  days in each house be suspended, and this rule is hereby suspended.