By:  Moncrief                                          S.B. No. 839
       73R4041 CAG-D
                                 A BILL TO BE ENTITLED
    1-1                                AN ACT
    1-2  relating to the regulation of the practice of nursing and to the
    1-3  creation of a new state board to replace the Board of Nurse
    1-4  Examiners and the Board of Vocational Nurse Examiners; providing
    1-5  penalties.
    1-6        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-7     ARTICLE 1.  STATE BOARD OF EXAMINERS FOR PROFESSIONAL NURSES
    1-8        SECTION 1.01.  Chapter 7, Title 71, Revised Statutes, is
    1-9  amended by adding Article 4513-1 to read as follows:
   1-10        Art. 4513-1.  STATE BOARD OF EXAMINERS FOR PROFESSIONAL
   1-11  NURSES
   1-12        Sec. 1.  STATE BOARD OF EXAMINERS FOR PROFESSIONAL NURSES.
   1-13  (a)  The State Board of Examiners for Professional Nurses consists
   1-14  of:
   1-15              (1)  four members licensed as registered nurses;
   1-16              (2)  four members licensed as licensed vocational
   1-17  nurses; and
   1-18              (3)  four members who represent the public.
   1-19        (b)  Members of the board are appointed by the governor with
   1-20  the advice and consent of the senate.  The governor shall designate
   1-21  the presiding officer of the board.
   1-22        (c)  Appointments to the board shall be made without regard
   1-23  to the race, color, disability, sex, religion, age, or national
   1-24  origin of the appointees.
    2-1        Sec. 2.  MEETINGS; COMPENSATION.  (a)  The board shall hold
    2-2  at least two regular meetings each year at which time an
    2-3  examination for a license under a law administered by the board
    2-4  shall be offered.  Additional meetings may be held on the call of
    2-5  the presiding officer or at the written request of three members of
    2-6  the board.
    2-7        (b)  A member of the board is entitled to a per diem as set
    2-8  by the General Appropriations Act for each day that the member
    2-9  engages in the business of the board.  A member may not receive any
   2-10  compensation for travel expenses, including expenses for meals and
   2-11  lodging, other than transportation expenses as provided by the
   2-12  General Appropriations Act.
   2-13        Sec. 3.  TERMS.  (a)  Members of the board are appointed for
   2-14  staggered six-year terms, with four members' terms expiring on
   2-15  February 1 of each odd-numbered year.
   2-16        (b)  A member appointed to fill a vacancy shall hold office
   2-17  for the remainder of that term.
   2-18        Sec. 4.  PUBLIC MEMBERSHIP RESTRICTION.  A person is not
   2-19  eligible for appointment as a public member of the board if the
   2-20  person or the person's spouse:
   2-21              (1)  is registered, certified, or licensed by an
   2-22  occupational regulatory agency in the field of health care;
   2-23              (2)  is employed by or participates in the management
   2-24  of a business entity or other organization regulated by the board
   2-25  or receiving funds from the board;
   2-26              (3)  owns or controls, directly or indirectly, more
   2-27  than 10 percent interest in a business entity or other organization
    3-1  regulated by the board or receiving funds from the board; 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. 5.  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 member or employee of the board
    3-9  who is exempt from the state's position classification plan or is
   3-10  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 and may not be an employee of the
   3-16  board who is exempt from the state's position classification plan
   3-17  or is 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. 6.  EFFECT OF LOBBYING ACTIVITY.  A person may not serve
   3-27  as a member of the board or act as the general counsel to the board
    4-1  if the person is required to register as a lobbyist under Chapter
    4-2  305, 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. 7.  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 4,
   4-12  5, or 6 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. 8.  STAFF.  (a)  The board shall employ an executive
    5-2  director and administrative and clerical employees as necessary to
    5-3  carry out the board's functions.
    5-4        (b)  The board shall develop and implement policies that
    5-5  clearly define the respective responsibilities of the board and the
    5-6  staff of the board.
    5-7        Sec. 9.  REGULATORY STATUTES ADMINISTERED.  The board shall
    5-8  administer and enforce:
    5-9              (1)  the law regulating registered nurses, Chapter 7,
   5-10  Title 71, Revised Statutes, and the chapter's subsequent
   5-11  amendments; and
   5-12              (2)  the law regulating licensed vocational nurses,
   5-13  Chapter 118, Acts of the 52nd Legislature, Regular Session, 1951
   5-14  (Article 4528c, Vernon's Texas Civil Statutes), and its subsequent
   5-15  amendments.
   5-16        Sec. 10.  SEPARATE LICENSES.  (a)  The board shall issue
   5-17  separate licenses for a registered nurse and a licensed vocational
   5-18  nurse.
   5-19        (b)  The board may issue more than one type of license to a
   5-20  person under a law regulated by the board if the person is
   5-21  qualified to hold each of the licenses issued.  The board shall
   5-22  adopt rules relating to the issuance of multiple licenses to a
   5-23  person under laws administered by the board.
   5-24        Sec. 11.  RULES.  (a)  The board may only adopt rules
   5-25  proposed to the board by a rules subcommittee established under
   5-26  Section 12 of this article.  This provision controls
   5-27  notwithstanding any conflicting provision of the law regulating
    6-1  registered nurses, Chapter 7, Title 71, Revised Statutes, and the
    6-2  chapter's subsequent amendments, or the law regulating licensed
    6-3  vocational nurses, Chapter 118, Acts of the 52nd Legislature,
    6-4  Regular Section, 1951 (Article 4528c, Vernon's Texas Civil
    6-5  Statutes), and its subsequent amendments.
    6-6        (b)  If the board does not approve a rule proposed by a rules
    6-7  subcommittee, the board shall indicate to the subcommittee the
    6-8  reasons that the board did not approve the rule and return the rule
    6-9  to the subcommittee for further development.
   6-10        Sec. 12.  RULES SUBCOMMITTEES.  (a)  Two rules subcommittees,
   6-11  each consisting of three members of the board, are established as
   6-12  follows:
   6-13              (1)  a rules subcommittee relating to the practice of
   6-14  registered nurses consisting of two board members who are
   6-15  registered nurses and one member who represents the public; and
   6-16              (2)  a rules subcommittee relating to the practice of
   6-17  licensed vocational nurses consisting of two board members who are
   6-18  licensed vocational nurses and one member who represents the
   6-19  public.
   6-20        (b)  A member of the board may not serve on more than one
   6-21  rules subcommittee.
   6-22        (c)  The presiding officer of the board shall designate the
   6-23  registered nurse board members, licensed vocational nurse board
   6-24  members, and public members of each rules subcommittee.
   6-25        (d)  A rules subcommittee shall develop and recommend to the
   6-26  board for approval rules that regulate the profession to which the
   6-27  subcommittee relates.  A rules subcommittee periodically shall
    7-1  review board rules relating to the profession to which the
    7-2  subcommittee relates and shall recommend changes in those rules to
    7-3  the board.  The authority of a rules subcommittee is not affected
    7-4  by Section 5(f), Administrative Procedure and Texas Register Act
    7-5  (Article 6252-13a, Vernon's Texas Civil Statutes), and its
    7-6  subsequent amendments.
    7-7        Sec. 13.  EXPENDITURES; AUDIT.  (a)  The board may authorize,
    7-8  from funds appropriated to it, all necessary disbursements to carry
    7-9  out:
   7-10              (1)  this article;
   7-11              (2)  the law regulating registered nurses, Chapter 7,
   7-12  Title 71, Revised Statutes, and the chapter's subsequent
   7-13  amendments; and
   7-14              (3)  the law regulating licensed vocational nurses,
   7-15  Chapter 118, Acts of the 52nd Legislature, Regular Session, 1951
   7-16  (Article 4528c, Vernon's Texas Civil Statutes), and its subsequent
   7-17  amendments.
   7-18        (b)  The financial transactions of the board are subject to
   7-19  audit by the state auditor in accordance with Chapter 321,
   7-20  Government Code, and its subsequent amendments.
   7-21        Sec. 14.  ANNUAL FINANCIAL REPORT.  The board shall file
   7-22  annually with the governor and the presiding officer of each house
   7-23  of the legislature a complete and detailed written report
   7-24  accounting for all funds received and disbursed by the board during
   7-25  the preceding fiscal year.  The annual report must be in the form
   7-26  and reported in the time provided by the General Appropriations
   7-27  Act.
    8-1        Sec. 15.  PERSONNEL POLICIES.  (a)  The executive director or
    8-2  the executive director's designee shall develop an intra-agency
    8-3  career ladder program.  The program shall require intra-agency
    8-4  posting of all nonentry level positions concurrently with any
    8-5  public posting.
    8-6        (b)  The executive director or the executive director's
    8-7  designee shall develop a system of annual performance evaluations
    8-8  based on measurable job tasks.  All merit pay for board employees
    8-9  must be based on the system established under this subsection.
   8-10        Sec. 16.  EQUAL EMPLOYMENT OPPORTUNITY POLICIES.  (a)  The
   8-11  executive director or the executive director's designee shall
   8-12  prepare and maintain a written policy statement to assure
   8-13  implementation of a program of equal employment opportunity under
   8-14  which all personnel transactions are made without regard to race,
   8-15  color, disability, sex, religion, age, or national origin.  The
   8-16  policy statement must include:
   8-17              (1)  personnel policies, including policies relating to
   8-18  recruitment, evaluation, selection, application, training, and
   8-19  promotion of personnel that are in compliance with the Commission
   8-20  on Human Rights Act (Article 5221k, Vernon's Texas Civil Statutes),
   8-21  and its subsequent amendments;
   8-22              (2)  a comprehensive analysis of the board workforce
   8-23  that meets federal and state guidelines;
   8-24              (3)  procedures by which a determination can be made of
   8-25  significant underuse in the board workforce of all persons for whom
   8-26  federal or state guidelines encourage a more equitable balance; and
   8-27              (4)  reasonable methods to appropriately address those
    9-1  areas of underuse.
    9-2        (b)  A policy statement prepared under Subsection (a) of this
    9-3  section must cover an annual period, be updated annually, be
    9-4  reviewed by the Commission on Human Rights for compliance with
    9-5  Subsection (a)(1) of this section, and be filed with the governor's
    9-6  office.
    9-7        (c)  The governor's office shall deliver a biennial report to
    9-8  the legislature based on the information received under Subsection
    9-9  (b)  of this section.  The report may be made separately or as part
   9-10  of other biennial reports to the legislature.
   9-11        Sec. 17.  PUBLIC INTEREST INFORMATION.  (a)  The board shall
   9-12  prepare information of public interest describing the functions of
   9-13  the board and the board's procedures by which complaints are filed
   9-14  with and resolved by the board.  The board shall make the
   9-15  information available to the public and appropriate state agencies.
   9-16        (b)  The board by rule shall establish methods by which
   9-17  consumers and service recipients are notified of the name, mailing
   9-18  address, and telephone number of the board for the purpose of
   9-19  directing complaints to the board.  The board may provide for that
   9-20  notification:
   9-21              (1)  on each registration form, application, or written
   9-22  contract for services of an individual or entity regulated by the
   9-23  board;
   9-24              (2)  on a sign prominently displayed in the place of
   9-25  business of each individual or entity regulated by the board; or
   9-26              (3)  in a bill for service provided by an individual or
   9-27  entity regulated by the board.
   10-1        (c)  The board shall list along with its regular telephone
   10-2  number the toll-free telephone number that may be called to present
   10-3  a complaint about a health professional if the toll-free number is
   10-4  established under other state law.
   10-5        Sec. 18.  PUBLIC PARTICIPATION IN BOARD HEARINGS.  The board
   10-6  shall develop and implement policies that provide the public with a
   10-7  reasonable opportunity to appear before the board and to speak on
   10-8  any issue under the jurisdiction of the board.
   10-9        Sec. 19.  PROGRAM ACCESSIBILITY.  The board shall prepare and
  10-10  maintain a written plan that describes how a person who does not
  10-11  speak English can be provided reasonable access to the board's
  10-12  programs.  The board shall also comply with federal and state laws
  10-13  for program and facility accessibility.
  10-14        Sec. 20.  TRAINING; STANDARDS OF CONDUCT INFORMATION.  (a)
  10-15  Each board member shall comply with the board member training
  10-16  requirements established by any other state agency that is given
  10-17  authority to establish the requirements for the board.
  10-18        (b)  The board shall provide to its members and employees, as
  10-19  often as necessary, information regarding their qualifications for
  10-20  office or employment under this article and their responsibilities
  10-21  under applicable laws relating to standards of conduct for state
  10-22  officers or employees.
  10-23        Sec. 21.  OPEN MEETINGS AND ADMINISTRATIVE PROCEDURE.  The
  10-24  board is subject to:
  10-25              (1)  the open meetings law, Chapter 271, Acts of the
  10-26  60th Legislature, Regular Session, 1967 (Article 6252-17, Vernon's
  10-27  Texas Civil Statutes), and its subsequent amendments; and
   11-1              (2)  the Administrative Procedure and Texas Register
   11-2  Act (Article 6252-13a, Vernon's Texas Civil Statutes) and its
   11-3  subsequent amendments.
   11-4        Sec. 22.  SUNSET PROVISION.  The State Board of Examiners for
   11-5  Professional Nurses is subject to Chapter 325, Government Code
   11-6  (Texas Sunset Act), and its subsequent amendments.  Unless
   11-7  continued in existence as provided by that chapter, the board is
   11-8  abolished and the following laws expire September 1, 2005:
   11-9              (1)  this article;
  11-10              (2)  the law regulating registered nurses, Chapter 7,
  11-11  Title 71, Revised Statutes, and the chapter's subsequent
  11-12  amendments; and
  11-13              (3)  the law regulating licensed vocational nurses,
  11-14  Chapter 118, Acts of the 52nd Legislature, Regular Session, 1951
  11-15  (Article 4528c, Vernon's Texas Civil Statutes), and its subsequent
  11-16  amendments.
  11-17                     ARTICLE 2.  REGISTERED NURSES
  11-18        SECTION 2.01.  Article 4514, Revised Statutes, is amended to
  11-19  read as follows:
  11-20        Art. 4514.  RULEMAKING AUTHORITY <Organization of board>
  11-21        Sec. 1.  <The members of the board shall elect from their
  11-22  number a president.  Special meetings of said board shall be called
  11-23  by the president acting upon the written request of any two
  11-24  members.  The board shall have the authority and power to make and
  11-25  enforce all rules and regulations necessary for the performance of
  11-26  its duties and conducting of proceedings before it, to establish
  11-27  standards of professional conduct for all persons licensed under
   12-1  the provisions of this law in keeping with its purpose and
   12-2  objectives, to regulate the practice of professional nursing and to
   12-3  determine whether or not an act constitutes the practice of
   12-4  professional nursing, not inconsistent with this Act.  Such rules
   12-5  and regulations shall not be inconsistent with the provisions of
   12-6  this law.>
   12-7        <Sec. 2.>  If the appropriate standing committees of both
   12-8  houses of the legislature acting under Subsection (g), Section 5,
   12-9  Administrative Procedure and Texas Register Act, as amended
  12-10  (Article 6252-13a, Vernon's Texas Civil Statutes), transmit to the
  12-11  board statements opposing adoption of a rule under that section,
  12-12  the rule may not take effect, or if the rule has already taken
  12-13  effect, the rule is repealed effective on the date the board
  12-14  receives the committee's statements.
  12-15        Sec. 2. <Sec. 3.>  The board may not promulgate rules
  12-16  restricting competitive bidding or advertising by licensees except
  12-17  to prohibit false, misleading, or deceptive practices by the
  12-18  person.  The board may not include in its rules to prohibit false,
  12-19  misleading, or deceptive practices by a person regulated by the
  12-20  board a rule that:
  12-21              (1)  restricts the person's use of any medium for
  12-22  advertising;
  12-23              (2)  restricts the person's personal appearance or use
  12-24  of the person's <his or her> voice in an advertisement;
  12-25              (3)  relates to the size or duration of an
  12-26  advertisement by the person; or
  12-27              (4)  restricts the person's advertisement under a trade
   13-1  name.
   13-2        <Sec. 4.  The executive secretary shall be required to keep a
   13-3  record of each meeting of said board, including a register of the
   13-4  names of all nurses registered under this law, which shall be at
   13-5  all times open to public inspection.  The board shall prepare
   13-6  information of consumer interest describing the regulatory
   13-7  functions of the board and the board's procedures by which consumer
   13-8  complaints are filed with and resolved by the board.  The board
   13-9  shall make the information available to the general public and
  13-10  appropriate state agencies.  Said board shall assist the proper
  13-11  legal authorities in the prosecution of all persons violating any
  13-12  provision of this law.  Nothing herein shall either expand or
  13-13  contract the board's present powers as they relate to the
  13-14  regulation of nursing education.>
  13-15        <Sec. 5.  The board is subject to the open meetings law,
  13-16  Chapter 271, Acts of the 60th Legislature, Regular Session, 1967,
  13-17  as amended (Article 6252-17, Vernon's Texas Civil Statutes), and
  13-18  the Administrative Procedure and Texas Register Act, as amended
  13-19  (Article 6252-13a, Vernon's Texas Civil Statutes).>
  13-20        Sec. 3. <Sec. 6.>  The board may recommend to the Texas State
  13-21  Board of Medical Examiners the adoption of rules relating to
  13-22  physician's delegating medical acts to persons licensed by the
  13-23  board.  The recommendations shall be acted on in the same manner as
  13-24  a petition for the adoption of a rule by an interested party under
  13-25  the Administrative Procedure and Texas Register Act, as amended
  13-26  (Article 6252-13a, Vernon's Texas Civil Statutes).  The board in
  13-27  making recommendations may distinguish between nurses on the basis
   14-1  of special training and education.  The board <Board of Nurse
   14-2  Examiners> in recommending rules and the Texas State Board of
   14-3  Medical Examiners in acting on recommended rules shall act, to the
   14-4  extent allowable under state and federal statutes and regulations,
   14-5  so as to permit the state to obtain its fair share of federal funds
   14-6  available for the delivery of health care in this state.
   14-7        Sec. 4. <Sec. 7.>  The board shall adopt rules establishing:
   14-8              (1)  any specialized education and training, including
   14-9  pharmacology, a registered nurse must have to carry out a
  14-10  prescription drug order pursuant to Subdivision (5), Subsection
  14-11  (d), Section 3.06, Medical Practice Act (Article 4495b, Vernon's
  14-12  Texas Civil Statutes); and
  14-13              (2)  a system for assigning an identification number to
  14-14  a registered nurse who provides the board with evidence of
  14-15  completing the required specialized education and training.
  14-16        SECTION 2.02.  Sections 1, 3, and 4, Article 4518, Revised
  14-17  Statutes, are amended to read as follows:
  14-18        Sec. 1.  It shall be the duty of the Board <of Nurse
  14-19  Examiners> to prescribe and publish the minimum requirements and
  14-20  standards for a course of study in programs which prepare
  14-21  professional nurse practitioners.  All other regulations necessary
  14-22  to conduct accredited schools of nursing and educational programs
  14-23  for the preparation of professional nurses shall be as prescribed
  14-24  by the Board, provided, however, that the minimum period of time
  14-25  that the Board may require shall be at least two (2) academic years
  14-26  and the maximum period of time shall not exceed four (4) calendar
  14-27  years.  The Board shall accredit such schools of nursing and
   15-1  educational programs as meet its requirements and shall deny or
   15-2  withdraw accreditation from schools of nursing and educational
   15-3  programs which fail to meet the prescribed course of study or other
   15-4  standards.
   15-5        The Board shall give those persons and organizations affected
   15-6  by its orders or decisions under this Article reasonable notice
   15-7  thereof, not less than twenty (20) days, and an opportunity to
   15-8  appear and be heard with respect to same.  The Board shall hear all
   15-9  protests or complaints from such persons and organizations affected
  15-10  by such rule, regulation or decision as to the inadequacy or
  15-11  unreasonableness of any rule, regulation or order promulgated or
  15-12  adopted by it, or the injustice of any order or decision by it.  If
  15-13  any person or organization which shall be affected by such order or
  15-14  decision shall be dissatisfied with any regulation, rule or order
  15-15  by such Board, such person or organization shall have the right,
  15-16  within thirty (30) days from the date such order is entered, to
  15-17  bring an action against said Board in the District Court of Travis
  15-18  County, Texas, to have such regulation, rule or order vacated or
  15-19  modified, and shall set forth in a petition therefor the principal
  15-20  grounds of objection to any or all of such rules, regulations or
  15-21  orders.  Such appeal as herein provided shall be de novo as that
  15-22  term is known and understood in appeals from the Justice Court to
  15-23  the County Court.
  15-24        Sec. 3.  Every applicant for registration under this law
  15-25  shall present to the Board <of Nurse Examiners> evidence of
  15-26  successful completion of an accredited program of professional
  15-27  nursing education and a sworn application and shall upon payment of
   16-1  required fees be entitled to take the examination prescribed by the
   16-2  Board.  Upon making a passing grade, the applicant shall be
   16-3  entitled to receive from said Board a certificate attested by the
   16-4  seal of said Board, entitling such person to practice as a
   16-5  registered nurse in the State of Texas.  The Board shall determine
   16-6  the score, not to exceed a score required by a majority of the
   16-7  states, that constitutes a passing grade on the examination.
   16-8        Sec. 4.  Any person practicing or offering to practice
   16-9  professional nursing in this state for compensation, shall
  16-10  hereafter be required to submit evidence to the Board <of Nurse
  16-11  Examiners> that the person <he or she> is qualified to practice and
  16-12  shall be registered as provided by this law.
  16-13        SECTION 2.03.  Sections 7(a), (b), and (c), Article 4518,
  16-14  Revised Statutes, are amended to read as follows:
  16-15        (a)  To renew a license to practice as a registered nurse or
  16-16  as a licensed vocational nurse, a licensee must demonstrate to the
  16-17  satisfaction of the Board completion of the requirement for
  16-18  continuing professional education <The Board may recognize,
  16-19  prepare, or implement continuing education programs for its
  16-20  licensees and may require participation in continuing education
  16-21  programs as a condition of renewal of a registration certificate>.
  16-22        (b)  The Board shall adopt rules relating to the operation of
  16-23  the mandatory continuing education programs.  In establishing the
  16-24  requirement for continuing education, the Board shall consider:
  16-25              (1)  factors that lead to the competent performance of
  16-26  professional duties; and
  16-27              (2)  the continuing education needs of licensees <The
   17-1  Board may not require more than a total of 20 hours of continuing
   17-2  education in a two-year registration period and may not require
   17-3  that more than 10 of those hours consist of classroom instruction
   17-4  in approved programs.  The remaining 10 hours may consist of any
   17-5  combination of classroom instruction, institutional-based
   17-6  instruction, or individualized study>.
   17-7        (c)  The Board shall adopt rules relating to the adoption or
   17-8  approval of mandatory continuing education programs and providers
   17-9  and shall adopt rules to evaluate the effectiveness of the programs
  17-10  and a licensee's participation and performance in the programs <If
  17-11  the Board requires participation in continuing education programs
  17-12  as a condition of renewal of a registration certificate, the Board
  17-13  shall by rule establish a system for the approval of programs and
  17-14  providers of continuing education.  In adopting the rules, the
  17-15  Board shall consider but is not obligated to approve programs or
  17-16  providers approved or accredited through the Board of Accreditation
  17-17  of the American Nurses' Association or the National Federation of
  17-18  Specialty Nursing Organizations and nurse in-service programs
  17-19  offered by hospitals accredited by the Joint Commission on
  17-20  Accreditation of Healthcare Organizations, certified by Medicare,
  17-21  or maintained or operated by the federal government or the State of
  17-22  Texas.  The Board may assess programs and providers a fee in an
  17-23  amount reasonable and necessary to defray the costs incurred in
  17-24  approving providers and programs.  The fee collected under this
  17-25  subsection shall be deposited in the Professional Nurse
  17-26  Registration Fund>.
  17-27        SECTION 2.04.  Article 4519, Revised Statutes, is amended to
   18-1  read as follows:
   18-2        Art. 4519.  Examination and fee.  (a)  Upon filing
   18-3  application with the intent to take the <for> examination, each
   18-4  applicant shall pay an examination fee which shall in no case be
   18-5  returned to the applicant.  If the applicant passes the
   18-6  examination, then no further fee shall be required for
   18-7  registration.  <Any applicant for registration who fails to
   18-8  successfully pass the examination herein provided for shall have
   18-9  the right to stand a second examination.>  The examination shall be
  18-10  given in various cities throughout the State and shall be of such
  18-11  character as to determine the fitness of the applicant to practice
  18-12  professional nursing.  A written examination prepared or offered by
  18-13  the board, including a standardized national examination, shall be
  18-14  validated by an independent testing professional.  Not later than
  18-15  the 30th day <Within 30 days> after the date on which a licensing
  18-16  examination is administered under this article, the board shall
  18-17  notify each examinee of the results of the examination.  However,
  18-18  if an examination is graded or reviewed by a national testing
  18-19  service, the board shall notify each examinee of the results of the
  18-20  examination not later than the 14th day <within two weeks> after
  18-21  the date the board receives the results from the testing service.
  18-22  If the notice of the examination results graded or reviewed by a
  18-23  national testing service will be delayed for more than 90 days
  18-24  after the examination date, the board shall notify each examinee of
  18-25  the reason for the delay before the 90th day.  If requested in
  18-26  writing by a person who fails the licensing examination, the board
  18-27  shall furnish the person with an analysis of the person's
   19-1  performance on the examination.  If the result of the examination
   19-2  be satisfactory to the board, a certificate shall be issued to the
   19-3  applicant, signed by the president and executive secretary and
   19-4  attested by the seal of said board, which certificate shall qualify
   19-5  the person receiving the same to practice professional nursing in
   19-6  this State.
   19-7        (b)  The board by rule shall establish the conditions under
   19-8  which an applicant who fails the licensing examination may retake
   19-9  the examination.  The board may require an applicant to fulfill
  19-10  additional educational requirements and may deny an applicant who
  19-11  failed the examination the opportunity to retake the examination.
  19-12        SECTION 2.05.  Article 4521, Revised Statutes, is amended to
  19-13  read as follows:
  19-14        Art. 4521.  LICENSING BY RECIPROCITY <Certificate from
  19-15  another state>.  (a)  To qualify for a temporary license to
  19-16  practice as a registered nurse by reciprocity, an applicant for
  19-17  licensing must:
  19-18              (1)  submit to the board a reciprocity fee as
  19-19  determined by the board and a completed application given under
  19-20  oath, in the form prescribed by the board;
  19-21              (2)  have possessed at the time of initial licensing as
  19-22  a registered nurse other qualifications necessary to have been
  19-23  eligible for licensing at that time in this state;
  19-24              (3)  have presented to the board proof of initial
  19-25  licensing by examination and proof that the license and other
  19-26  license or licenses granted to the applicant by any other state
  19-27  have not been suspended, revoked, canceled, surrendered, or
   20-1  otherwise restricted for any reason; and
   20-2              (4)  submit to the board a notice of sponsorship of the
   20-3  applicant by a licensee of the state under whom the applicant will
   20-4  practice.
   20-5        (b)  A holder of a temporary license under this section shall
   20-6  receive a permanent license if the applicant:
   20-7              (1)  has verified the academic and professional
   20-8  credentials of the applicant; and
   20-9              (2)  satisfies any other requirement set by statute.
  20-10        (c)  An applicant is not eligible for licensing by
  20-11  reciprocity unless the state in which the applicant was initially
  20-12  licensed as a registered nurse also grants reciprocal licensing to
  20-13  registered nurses licensed by examination in this state, under like
  20-14  circumstances and conditions.
  20-15        (d)  The board shall either grant or deny an application for
  20-16  a permanent license within 180 days after the date of the board's
  20-17  receipt of all required forms or information.
  20-18        (e)  The board shall adopt rules relating to the conditions
  20-19  of sponsorship under Subsection (a)(4) of this article, including
  20-20  waiver of the requirement in the event of a hardship.  <Any
  20-21  applicant who holds a registration certificate as a registered
  20-22  nurse from another state, district, territory or possession of the
  20-23  United States, or from a foreign country, may be issued a license
  20-24  to practice as a registered nurse in the State of Texas by
  20-25  endorsement and without examination upon the payment of a fee
  20-26  established by the board, provided in the opinion of the Board of
  20-27  Nurse Examiners such other board issuing such other certificate in
   21-1  its examination required the same general degree of fitness
   21-2  required by this state.>
   21-3        SECTION 2.06.  Chapter 7, Title 71, Revised Statutes, is
   21-4  amended by adding Articles 4524A-4524E to read as follows:
   21-5        Art. 4524A.  PUBLIC INTEREST INFORMATION AND COMPLAINTS;
   21-6  PUBLIC ACCESS TO BOARD FUNCTIONS.  (a)  The board shall prepare
   21-7  information of public interest describing the functions of the
   21-8  board and the board's procedures by which complaints are filed with
   21-9  and resolved by the board.  The board shall make the information
  21-10  available to the public and appropriate state agencies.
  21-11        (b)  The board by rule shall establish methods by which
  21-12  consumers and care recipients are notified of the name, mailing
  21-13  address, and telephone number of the board for the purpose of
  21-14  directing complaints to the board.  The board may provide for that
  21-15  notification:
  21-16              (1)  on each registration form, application, or written
  21-17  contract for services of an individual or entity regulated under
  21-18  this chapter;
  21-19              (2)  on a sign prominently displayed in the place of
  21-20  business of each individual or entity regulated under this chapter;
  21-21  or
  21-22              (3)  in a bill for service provided by an individual or
  21-23  entity regulated under this chapter.
  21-24        (c)  The board shall list along with its regular telephone
  21-25  number the toll-free telephone number that may be called to present
  21-26  a complaint about a health professional if the toll-free number is
  21-27  established under other state law.
   22-1        (d)  The board shall develop and implement policies that
   22-2  provide the public with a reasonable opportunity to appear before
   22-3  the board and to speak on any issue under the jurisdiction of the
   22-4  board.
   22-5        (e)  The board shall prepare and maintain a written plan that
   22-6  describes how a person who does not speak English can be provided
   22-7  reasonable access to the board's programs.  The board shall also
   22-8  comply with federal and state laws for program and facility
   22-9  accessibility.
  22-10        Art. 4524B.  RECORDS OF COMPLAINTS.  (a)  The board shall
  22-11  keep an information file about each complaint filed with the board.
  22-12  The board's information file shall be kept current and contain a
  22-13  record for each complaint of:
  22-14              (1)  all persons contacted in relation to the
  22-15  complaint;
  22-16              (2)  a summary of findings made at each step of the
  22-17  complaint process;
  22-18              (3)  an explanation of the legal basis and reason for a
  22-19  complaint that is dismissed; and
  22-20              (4)  other relevant information.
  22-21        (b)  If a written complaint is filed with the board that the
  22-22  board has authority to resolve, the board, at least as frequently
  22-23  as quarterly and until final disposition of the complaint, shall
  22-24  notify the parties to the complaint of the status of the complaint
  22-25  unless the notice would jeopardize an undercover investigation.
  22-26        (c)  The board by rule shall adopt a form to standardize
  22-27  information concerning complaints made to the board.  The board by
   23-1  rule shall prescribe information to be provided to a person when
   23-2  the person files a complaint with the board.
   23-3        (d)  The board shall provide reasonable assistance to a
   23-4  person who wishes to file a complaint with the board.
   23-5        Art. 4524C.  COMPLAINT INVESTIGATION AND DISPOSITION.  (a)
   23-6  The board shall adopt rules concerning the investigation of a
   23-7  complaint filed with the board.  The rules adopted under this
   23-8  subsection shall:
   23-9              (1)  distinguish between categories of complaints;
  23-10              (2)  ensure that complaints are not dismissed without
  23-11  appropriate consideration;
  23-12              (3)  require that the board be advised of a complaint
  23-13  that is dismissed and that a letter be sent to the person who filed
  23-14  the complaint explaining the action taken on the dismissed
  23-15  complaint;
  23-16              (4)  ensure that the person who filed the complaint has
  23-17  an opportunity to explain the allegations made in the complaint;
  23-18  and
  23-19              (5)  prescribe guidelines concerning the categories of
  23-20  complaints that require the use of a private investigator and the
  23-21  procedures for the board to obtain the services of a private
  23-22  investigator.
  23-23        (b)  The board shall dispose of all complaints in a timely
  23-24  manner.  The board shall establish a timeline for conducting each
  23-25  phase of a complaint that is under the control of the board not
  23-26  later than the 30th day after the date the complaint is received by
  23-27  the board.  The timeline shall be kept in the information file for
   24-1  the complaint and all parties shall be notified of the projected
   24-2  time requirements for pursuing the complaint.  A change in the
   24-3  timeline must be noted in the complaint information file and all
   24-4  parties to the complaint must be notified not later than the
   24-5  seventh day after the date the change is made.
   24-6        (c)  The executive director of the board shall notify the
   24-7  board of a complaint that extends beyond the time prescribed by the
   24-8  board for resolving the complaint so that the board may take
   24-9  necessary action on the complaint.
  24-10        Art. 4524D.  INFORMAL PROCEEDINGS.  (a)  The board by rule
  24-11  shall adopt procedures governing:
  24-12              (1)  informal disposition of a contested case under
  24-13  Section 13(e), Administrative Procedure and Texas Register Act
  24-14  (Article 6252-13a, Vernon's Texas Civil Statutes), and its
  24-15  subsequent amendments; and
  24-16              (2)  informal proceedings held in compliance with
  24-17  Section 18(c), Administrative Procedure and Texas Register Act
  24-18  (Article 6252-13a, Vernon's Texas Civil Statutes), and its
  24-19  subsequent amendments.
  24-20        (b)  Rules adopted under this article must provide the
  24-21  complainant and the licensee an opportunity to be heard and must
  24-22  require the presence of a representative of the office of the
  24-23  attorney general to advise the board or the board's employees.
  24-24        Art. 4524E.  MONITORING OF LICENSEE.  The board by rule shall
  24-25  develop a system for monitoring licensees' compliance with the
  24-26  requirements of this chapter.  Rules adopted under this article
  24-27  shall include procedures for monitoring a licensee who is ordered
   25-1  by the board to perform certain acts to ascertain that the licensee
   25-2  performs the required acts and to identify and monitor licensees
   25-3  who represent a risk to the public.
   25-4        SECTION 2.07.  Article 4525, Revised Statutes, is amended by
   25-5  amending Subsections (a), (b), and (e) and adding Subsection (k) to
   25-6  read as follows:
   25-7        (a)  The board <of nurse examiners> may refuse to admit
   25-8  persons to its examinations, may refuse to issue a license or
   25-9  certificate of registration or to issue a certificate of
  25-10  re-registration, may refuse to issue a temporary permit, may issue
  25-11  a warning or reprimand with or without stipulations, may suspend
  25-12  for any period not to exceed 5 years, or may revoke the license or
  25-13  certificate of any practitioner of professional nursing, for any of
  25-14  the following reasons:
  25-15              (1)  The violation of any of the provisions of this
  25-16  law, any rule, regulation not inconsistent with this law, or order
  25-17  issued hereinunder.
  25-18              (2)  Is guilty of fraud or deceit in procuring or
  25-19  attempting to procure a license to practice professional nursing.
  25-20              (3)  Conviction of a crime of the grade of felony, or a
  25-21  crime of lesser grade which involves moral turpitude, or any
  25-22  conduct resulting in the revocation of probation imposed pursuant
  25-23  to such conviction.
  25-24              (4)  The use of any nursing license, certificate,
  25-25  diploma or permit, or transcript of such license, certificate,
  25-26  diploma or permit, which has been fraudulently purchased, issued,
  25-27  counterfeited, or materially altered.
   26-1              (5)  The impersonation of, or the acting as a proxy
   26-2  for, another in any examination required by law to obtain a license
   26-3  to practice professional nursing.
   26-4              (6)  Aiding or abetting, directly or indirectly, or in
   26-5  any manner whatsoever, any unlicensed person in connection with the
   26-6  unauthorized practice of professional nursing.
   26-7              (7)  Revocation, suspension, or denial of or any other
   26-8  action relating to the license to practice nursing in another
   26-9  jurisdiction.  Certified copy of the order of denial, suspension,
  26-10  revocation, or any other action shall be conclusive evidence
  26-11  thereof.
  26-12              (8)  Intemperate use of alcohol or drugs that the board
  26-13  determines endangers or could endanger patients.  Intemperate use
  26-14  includes but is not limited to practicing professional nursing or
  26-15  being on duty or call while under the influence of alcohol or
  26-16  drugs.
  26-17              (9)  Unprofessional or dishonorable conduct which, in
  26-18  the opinion of the board, is likely to deceive, defraud, or injure
  26-19  patients or the public.
  26-20              (10)  Adjudication of mental incompetency.
  26-21              (11)  Lack of fitness to practice by reason of mental
  26-22  or physical health that could result in injury to patients or the
  26-23  public.
  26-24              (12)  Failing to care adequately for patients or to
  26-25  conform to the minimum standards of acceptable professional nursing
  26-26  practice that, in the opinion of the board, exposes a patient or
  26-27  other person unnecessarily to risk of harm.
   27-1        (b)  Proceedings under this article shall be begun by filing
   27-2  a written complaint with the board <of nurse examiners>.  Such
   27-3  complaint may be made by any person or filed by the board on its
   27-4  own initiative.  Unless it would jeopardize an investigation, the
   27-5  board shall notify the registered nurse that a complaint has been
   27-6  filed and the nature of the complaint after a determination of the
   27-7  identity of the subject of the complaint.  <An information file
   27-8  about each complaint filed relating to a licensee shall be
   27-9  maintained by the board.  If a written complaint is filed with the
  27-10  board relating to a licensee, the board at least as frequently as
  27-11  quarterly and until final disposition of the complaint, shall
  27-12  notify the party that filed the complaint of the status of the file
  27-13  unless notice would jeopardize an investigation.>  The board shall
  27-14  make a timely and appropriate preliminary investigation of the
  27-15  complaint and may issue a warning or reprimand to the person
  27-16  against whom the complaint was filed.  If the investigation reveals
  27-17  probable cause to take further disciplinary action, the board shall
  27-18  either attempt an informal disposition of the complaint or file
  27-19  formal charges against the registered nurse stating the provisions
  27-20  of this chapter or the board's rules that are alleged to have been
  27-21  violated and a brief description of the acts or omissions that
  27-22  constituted the violation.  If the board proposes to refuse to
  27-23  admit a person to its examination, to refuse to issue a temporary
  27-24  permit, license, certificate of registration, certificate of
  27-25  re-registration, or to suspend or revoke a person's permit,
  27-26  license, or certificate, the person is entitled to a hearing before
  27-27  the State Office of Administrative Hearings <board.  The hearing
   28-1  may be before a subcommittee of the board, a majority of which is
   28-2  composed of registered nurses.  The person shall on request be
   28-3  granted a hearing before the entire board>.  Proceedings for a
   28-4  disciplinary action are governed by the Administrative Procedure
   28-5  and Texas Register Act (Article 6252-13a, Vernon's Texas Civil
   28-6  Statutes).  The board may assess a person found to have violated
   28-7  any provision of this chapter the administrative costs of
   28-8  conducting a hearing to determine that violation.  If a licensed
   28-9  professional nurse voluntarily surrenders his or her license to the
  28-10  board and executes a sworn statement that he or she no longer
  28-11  desires to be licensed, the board may revoke his or her license
  28-12  without the necessity of formal charges, notice, or opportunity of
  28-13  hearing.
  28-14        (e)  The board <of nurse examiners> is charged with the duty
  28-15  of aiding in the enforcement of the provisions of this chapter, and
  28-16  may retain legal counsel to represent the board, but prior to
  28-17  retaining outside legal counsel, the board shall request the
  28-18  attorney general to perform such services and may only retain
  28-19  outside counsel if the attorney general so certifies to the board
  28-20  that the attorney general cannot provide such services.  The board
  28-21  shall have the power to issue subpoenas, compel the attendance of
  28-22  witnesses, administer oaths to persons giving testimony at
  28-23  hearings, and cause the prosecution of all persons violating any
  28-24  provisions of this chapter.  It shall keep a record of all its
  28-25  proceedings and make an annual report to the Governor.  Any member
  28-26  of the board may present to a prosecuting officer complaints
  28-27  relating to violations of any of the provisions of this chapter,
   29-1  and the board through its members, officers, counsel, or agents
   29-2  shall assist in the trial of any cases involving alleged violation
   29-3  of this chapter, subject to the control of the prosecuting
   29-4  officers.  The Attorney General is directed to render such legal
   29-5  assistance as may be necessary in enforcing and making effective
   29-6  the provisions of this chapter; provided that this shall not
   29-7  relieve the local prosecuting officers of any of their duties under
   29-8  the law as such.
   29-9        (k)  The schedule of sanctions adopted by the board by rule
  29-10  shall be used by the State Office of Administrative Hearings for
  29-11  any sanction imposed as the result of a hearing conducted by that
  29-12  office.
  29-13        SECTION 2.08.  Article 4525a, Revised Statutes, is amended by
  29-14  adding Section 16A to read as follows:
  29-15        Sec. 16A.  The board by rule shall define actions or
  29-16  omissions that must be reported and actions or omissions that are
  29-17  not required to be reported under this article.
  29-18        SECTION 2.09.  Chapter 7, Title 71, Revised Statutes, is
  29-19  amended by adding Article 4525c to read as follows:
  29-20        Art. 4525c.  MEMORANDUM OF UNDERSTANDING.  The board shall
  29-21  sign a memorandum of understanding with state agencies that license
  29-22  a facility required by law to have a registered nurse peer review
  29-23  committee.  The memorandum of understanding shall:
  29-24              (1)  state the actions the board and agency shall take
  29-25  to comply with the requirement to have a registered nurse peer
  29-26  review committee; and
  29-27              (2)  be adopted as a rule of the board and the agency.
   30-1        SECTION 2.10.  Chapter 7, Title 71, Revised Statutes, is
   30-2  amended by adding Article 4525d to read as follows:
   30-3        Art. 4525d.  LIMITED PRACTICE LICENSE.  (a)  The board may
   30-4  issue a limited license to practice nursing in a restricted manner.
   30-5  This licensure shall be issued if a nurse is unable to practice the
   30-6  full range of nursing safely due to a physical or mental
   30-7  disability.
   30-8        (b)  The board by rule may provide for the issuance of a
   30-9  temporary license.
  30-10        SECTION 2.11.  Chapter 7, Title 71, Revised Statutes, is
  30-11  amended by adding Article 4525e to read as follows:
  30-12        Art. 4525e.  TEMPORARY SUSPENSION OF LICENSE.  If the
  30-13  majority of the board or a three-member committee of board members
  30-14  designated by the board determines from the evidence or information
  30-15  presented to it that a registered nurse by continuation in practice
  30-16  would constitute a continuing and imminent threat to the public
  30-17  welfare, the board or the three-member committee shall temporarily
  30-18  suspend the license of the registered nurse.  The license may be
  30-19  suspended under this article without notice or hearing on the
  30-20  complaint, provided institution of proceedings for a hearing before
  30-21  the State Office of Administrative Hearings is initiated
  30-22  simultaneously with the temporary suspension and provided that a
  30-23  hearing is held as soon as can be accomplished under this chapter
  30-24  and the Administrative Procedure and Texas Register Act (Article
  30-25  6252-13a, Vernon's Texas Civil Statutes) and its subsequent
  30-26  amendments.  The State Office of Administrative Hearings shall hold
  30-27  a preliminary hearing not later than the 14th day after the date of
   31-1  the temporary suspension to determine if probable cause exists that
   31-2  a continuing and imminent threat to the public welfare still
   31-3  exists.  A final hearing on the matter shall be held not later than
   31-4  the 61st day after the date of temporary suspension.
   31-5        SECTION 2.12.  Article 4526, Revised Statutes, is amended to
   31-6  read as follows:
   31-7        Art. 4526.  LICENSE RENEWAL <Re-registration>.  The board by
   31-8  rule may <shall> adopt a system under which licenses expire on
   31-9  various dates during the year <issued by the board shall be renewed
  31-10  each biennium>.  For the year in which the license expiration date
  31-11  is changed, registration fees payable on or before March 31 shall
  31-12  be prorated on a monthly basis so that each registrant shall pay
  31-13  only that portion of the registration <re-registration> fee that is
  31-14  allocable to the months in which the registration is valid.  On
  31-15  renewal of the license on the new expiration date, the total
  31-16  license renewal <re-registration> fee is payable.  <The board shall
  31-17  notify each licensee at least 30 days in advance of the date of
  31-18  expiration of the license.  The application for re-registration
  31-19  shall be mailed by United States mail to the address shown in the
  31-20  board's records.  Any application received after the expiration
  31-21  date shall be charged a late fee.>  If a person's license has been
  31-22  expired for <not more than> 90 days or less, the person may renew
  31-23  the license by paying to the board the required renewal fee and a
  31-24  fee that is one-half the examination fee for the license.  If a
  31-25  license has been expired for <more than> 90 days but less than one
  31-26  year <two years>, the person may renew the license by paying to the
  31-27  board all unpaid renewal fees and a fee that is equal to the
   32-1  examination fee for the license.  If a license has been expired for
   32-2  one year or longer <two years or more>, the person may not renew
   32-3  the license <on meeting the requirements that the board considers
   32-4  necessary>.  The person may obtain a new license by submitting to
   32-5  reexamination and complying with the requirements and procedures
   32-6  for obtaining an original license.  However, the board may renew
   32-7  without reexamination an expired license of a person who was
   32-8  licensed in this state, moved to another state, and is currently
   32-9  licensed and has been in practice in the other state for the two
  32-10  years preceding application.  The person must pay to the board a
  32-11  fee that is equal to the examination fee for the license.  At least
  32-12  30 days before the expiration of the person's license, the board
  32-13  shall send written notice of the impending license expiration to
  32-14  the person at the person's last known address according to the
  32-15  records of the board.  If any registered nurse continues to
  32-16  practice professional nursing beyond the time for which the nurse
  32-17  is registered <or re-registered>, the nurse shall be considered to
  32-18  be an illegal practitioner and the license may be revoked or
  32-19  suspended.
  32-20        SECTION 2.13.  Article 4527, Revised Statutes, is amended to
  32-21  read as follows:
  32-22        Art. 4527.  Fees.
  32-23        Sec. 1.  The board by rule shall establish reasonable and
  32-24  necessary fees so that the fees, in the aggregate, produce
  32-25  sufficient revenue to cover the cost of administering this chapter.
  32-26  The board may not set a fee for an amount less than the amount of
  32-27  that fee on September 1, 1993.  <The Board of Nurse Examiners shall
   33-1  establish reasonable and necessary fees for the administration of
   33-2  its functions in amounts not to exceed:>
   33-3        <Admission fee to examination ......................... $200>
   33-4        <Duplicate or substitute of current certificate .......   25>
   33-5        <Duplicate or substitute of permanent certificate .....   25>
   33-6        <Duplicate permits ....................................   15>
   33-7        <Endorsement with or without examination ..............  150>
   33-8        <Re-registration ......................................   50>
   33-9        <Issuance of a temporary permit under Art. 4523 .......   25>
  33-10        <Reactivating from inactive status ....................   30>
  33-11        <Accreditation of new schools and programs ............  150>
  33-12        <Filing of affidavits in re-change of name ............   10>
  33-13        <Verification of records ..............................   50>
  33-14        <Bad checks ...........................................   25>
  33-15        <Advanced Nurse Practitioner-initial credentials ......   50>
  33-16        <Advanced Nurse Practitioner-renewal of credentials ...   25>
  33-17        <Issuance    of   declaratory   order   of  eligibility>
  33-18           <for license ........................................   25>
  33-19        Sec. 2.  The board may receive gifts, grants, or other funds
  33-20  or assets.  <The Board shall not maintain unnecessary fund
  33-21  balances, and fee amounts shall be set in accordance with this
  33-22  requirement.   The Board shall set and collect a sales charge for
  33-23  copies of any paper or record in the office of the Board and for
  33-24  any printed material published by the Board.  The charges are to be
  33-25  in an amount considered sufficient to reimburse the Board for its
  33-26  actual expenses.  All fees received by said Board under this law
  33-27  shall be placed in the State Treasury to the credit of a special
   34-1  fund to be known as the "Professional Nurse Registration Fund" and
   34-2  the Comptroller shall upon requisition of the Board from time to
   34-3  time draw warrants upon the State Treasurer for the amounts
   34-4  specified in such requisition; provided, however, all fees
   34-5  collected by the Board and deposited in the Professional Nurse
   34-6  Registration Fund shall be expended as specified by itemized
   34-7  appropriation in the General Appropriations Act and shall be used
   34-8  by the Board, and under its directions, only for purposes of
   34-9  carrying out this Act. The Board may use any of the fees and
  34-10  charges collected by it, as necessary, to retain, hire, or contract
  34-11  for additional prosecutors, hearing examiners, investigators, and
  34-12  support staff as necessary to aid in the investigation of
  34-13  complaints and the prosecution of persons subject to the Board's
  34-14  jurisdiction.  This provision shall apply to all fees of whatsoever
  34-15  nature as permitted by law.  The financial transactions of the
  34-16  Board are subject to audit by the state auditor in accordance with
  34-17  Chapter 321, Government Code.>
  34-18        SECTION 2.14.  Article 4527b, Revised Statutes, is amended to
  34-19  read as follows:
  34-20        Art. 4527b.  PENALTIES <Penalty>.  (a)  A person who violates
  34-21  any provision of Article 4527a, Revised Statutes, commits an
  34-22  offense.  Except as provided by this section, an offense under that
  34-23  article is a Class A misdemeanor.  If it is shown in the trial of a
  34-24  person allegedly in violation of that article that the person has
  34-25  once before been convicted of a violation of Article 4527a, on
  34-26  conviction the person shall be punished for a third degree felony.
  34-27  Each day of violation constitutes a separate offense.  On final
   35-1  conviction of an offense under that article, a person forfeits all
   35-2  rights and privileges conferred by virtue of licensure under this
   35-3  chapter.
   35-4        (b)  A person who violates Article 4527a, Revised Statutes,
   35-5  is liable to the state for a civil penalty that does not exceed
   35-6  $1,000 a day.  The civil penalty may be collected in a suit
   35-7  initiated by the board.
   35-8        SECTION 2.15.  Chapter 7, Title 71, Revised Statutes, is
   35-9  amended by adding Article 4527d to read as follows:
  35-10        Art. 4527d.  ADMINISTRATIVE PENALTIES.  (a) If a person
  35-11  licensed under this chapter violates a provision of this chapter or
  35-12  a rule or order adopted by the board under this chapter, the board
  35-13  may assess an administrative penalty against the person as provided
  35-14  by this article.
  35-15        (b)  The penalty for each violation may be in an amount not
  35-16  to exceed $2,500.  Each day a violation continues or occurs may be
  35-17  considered a separate violation for purposes of penalty
  35-18  assessments.
  35-19        (c)  In determining the amount of the penalty, the executive
  35-20  director shall consider:
  35-21              (1)  the seriousness of the violation, including but
  35-22  not limited to the nature, circumstances, extent, and gravity of
  35-23  the prohibited acts, and the hazard or potential hazard created to
  35-24  the health or safety of the public;
  35-25              (2)  the economic damage to property or the environment
  35-26  caused by the violation;
  35-27              (3)  the history of previous violations;
   36-1              (4)  the amount necessary to deter future violations;
   36-2              (5)  efforts to correct the violation; and
   36-3              (6)  any other matter that justice may require.
   36-4        (d)  If, after investigation of a possible violation and the
   36-5  facts surrounding that possible violation, the executive director
   36-6  determines that a violation has occurred, the executive director
   36-7  may issue a violation report stating the facts on which the
   36-8  conclusion that a violation occurred is based, recommending that an
   36-9  administrative penalty under this section be imposed on the person
  36-10  charged and recommending the amount of that proposed penalty.  The
  36-11  executive director shall base the recommended amount of the
  36-12  proposed penalty on the seriousness of the violation determined by
  36-13  consideration of the factors set forth in Subsection (c) of this
  36-14  article.
  36-15        (e)  Not later than the 14th day after the date on which the
  36-16  report is issued, the executive director shall give written notice
  36-17  of the report to the person charged.  The notice shall include a
  36-18  brief summary of the charges, a statement of the amount of the
  36-19  penalty recommended, and a statement of the right of the person
  36-20  charged to a hearing on the occurrence of the violation or the
  36-21  amount of the penalty, or both the occurrence of the violation and
  36-22  the amount of the penalty.
  36-23        (f)  Not later than the 20th day after the date on which
  36-24  notice is received, the person charged may accept the determination
  36-25  of the executive director made under Subsection (d) of this
  36-26  article, including the recommended penalty, or make a written
  36-27  request for a hearing on the determination.
   37-1        (g)  If the person charged with the violation accepts the
   37-2  determination of the executive director, the board shall issue an
   37-3  order approving the determination and ordering the payment of the
   37-4  recommended penalty.
   37-5        (h)  If the person charged requests a hearing or fails to
   37-6  timely respond to the notice, the executive director shall set a
   37-7  hearing and give notice of the hearing.  The hearing shall be held
   37-8  by the State  Office of Administrative Hearings.  The State Office
   37-9  of Administrative Hearings shall make findings of fact and
  37-10  conclusions of law and promptly issue to the board a proposal for
  37-11  decision as to the occurrence of the violation, including a
  37-12  recommendation as to the amount of the proposed penalty if a
  37-13  penalty is warranted.  Based on the findings of fact, conclusions
  37-14  of law, and recommendations of the hearing examiner, the board by
  37-15  order may find a violation has occurred and may assess a penalty or
  37-16  may find that no violation has occurred.  All proceedings under
  37-17  this subsection are subject to the Administrative Procedure and
  37-18  Texas Register Act (Article 6252-13a, Vernon's Texas Civil
  37-19  Statutes) and its subsequent amendments.
  37-20        (i)  The executive director shall give notice of the board's
  37-21  order to the person charged.  The notice shall include:
  37-22              (1)  the findings of fact and conclusions of law
  37-23  separately stated;
  37-24              (2)  the amount of the penalty ordered, if any;
  37-25              (3)  a statement of the right of the person charged to
  37-26  judicial review of the board's order, if any; and
  37-27              (4)  other information required by law.
   38-1        (j)  Within the 30-day period immediately following the day
   38-2  on which the order becomes final as provided by Section 16(c),
   38-3  Administrative Procedure and Texas Register Act (Article 6252-13a,
   38-4  Vernon's Texas Civil Statutes), and its subsequent amendments, the
   38-5  person charged with the penalty shall:
   38-6              (1)  pay the penalty in full; or
   38-7              (2)  if the person files a petition for judicial review
   38-8  contesting either the amount of the penalty or the fact of the
   38-9  violation or contesting both the fact of the violation and the
  38-10  amount of the penalty:
  38-11                    (A)  forward the amount to the executive director
  38-12  for placement in an escrow account; or
  38-13                    (B)  in lieu of payment into escrow, post with
  38-14  the executive director a supersedeas bond in a form approved by the
  38-15  executive director for the amount of the penalty, the bond to be
  38-16  effective until all judicial review of the order or decision is
  38-17  final.
  38-18        (k)  If a person charged is financially unable to either
  38-19  forward the amount of the penalty for placement in an escrow
  38-20  account or post a supersedeas bond for the amount of the penalty,
  38-21  the person may satisfy the requirements of Subsection (j)(2) of
  38-22  this section by filing with the executive director an affidavit
  38-23  sworn by the person charged, stating that the person is financially
  38-24  unable to either forward the amount of the penalty or post a bond.
  38-25        (l)  Failure to forward the money to or to post the bond or
  38-26  file the affidavit with the executive director within the time
  38-27  provided by Subsection (j) of this article results in a waiver of
   39-1  all legal rights to judicial review.  Also, if the person charged
   39-2  fails to pay the penalty in full as provided under Subsection
   39-3  (j)(1) of this article or forward the money, post the bond, or file
   39-4  the affidavit as provided by Subsection (j) or (k) of this article,
   39-5  the executive director may forward the matter to the attorney
   39-6  general for enforcement.
   39-7        (m)  Judicial review of the order or decision of the board
   39-8  assessing the penalty shall be under the substantial evidence rule
   39-9  and shall be instituted by filing a petition with a district court
  39-10  in Travis County, as provided by Section 19, Administrative
  39-11  Procedure and Texas Register Act (Article 6252-13a, Vernon's Texas
  39-12  Civil Statutes), and its subsequent amendments.
  39-13        (n)  If the penalty is reduced or not assessed by the court,
  39-14  the executive director shall remit to the person charged the
  39-15  appropriate amount plus accrued interest if the penalty has been
  39-16  paid or shall execute a release of the bond if a supersedeas bond
  39-17  has been posted.  The accrued interest on amounts remitted by the
  39-18  executive director under this subsection shall be paid at a rate
  39-19  equal to the rate charged on loans to depository institutions by
  39-20  the New York Federal Reserve Bank and shall be paid for the period
  39-21  beginning on the date the penalty is paid to the executive director
  39-22  under Subsection (j) of this article and ending on the date the
  39-23  penalty is remitted.
  39-24        (o)  A penalty collected under this section for a violation
  39-25  by a person licensed under this chapter shall be deposited in the
  39-26  general revenue fund.
  39-27                ARTICLE 3.  LICENSED VOCATIONAL NURSES
   40-1        SECTION 3.01.  Sections 1(a) and (b), Chapter 118, Acts of
   40-2  the 52nd Legislature, Regular Session, 1951 (Article 4528c,
   40-3  Vernon's Texas Civil Statutes), are amended to read as follows:
   40-4              (a)  "Board" means the State Board of <Vocational
   40-5  Nurse> Examiners for Professional Nurses.
   40-6              (b)  "Licensed Vocational Nurse" means a person who is
   40-7  licensed under this Act by the State Board of <Vocational Nurse>
   40-8  Examiners for Professional Nurses.
   40-9        SECTION 3.02.  Section 6, Chapter 118, Acts of the 52nd
  40-10  Legislature, Regular Session, 1951 (Article 4528c, Vernon's Texas
  40-11  Civil Statutes), is amended to read as follows:
  40-12        Sec. 6.  Examination and Licenses.  (a)  Except as provided
  40-13  in Section 7 of this Act, every person desiring to be licensed as a
  40-14  Licensed Vocational Nurse or use the abbreviation L.V.N. in the
  40-15  State of Texas, shall be required to pass the examination given by
  40-16  the State Board of <Vocational Nurse> Examiners for Professional
  40-17  Nurses <or its delegate>.  The applicant shall make application by
  40-18  presenting to <the secretary of> the Board, on forms furnished by
  40-19  the Board, satisfactory sworn evidence that the applicant has had
  40-20  at least two (2) years of high school education or its equivalent
  40-21  and has completed an approved course <of not less than twelve (12)
  40-22  months> in an approved school for educating vocational nurses.  An
  40-23  approved school as used herein shall mean one approved by the
  40-24  Board.  Application for examination by the Board or its delegate
  40-25  shall be made at least thirty (30) days prior to the date set for
  40-26  the examination.
  40-27        (b)  The Board in its discretion may waive the requirement in
   41-1  Subsection (a) of this section for completion of a course in an
   41-2  approved school for educating vocational or practical nurses upon
   41-3  presentation of satisfactory sworn evidence that the applicant has
   41-4  completed an acceptable level <at least two (2) years> of education
   41-5  in a nursing school approved by the State Board of <Nurse>
   41-6  Examiners for Professional Nurses <of Texas> or in some other
   41-7  school of professional nurse education located in another state,
   41-8  the District of Columbia, a possession of the United States, or a
   41-9  foreign country.  The Board by rule shall determine acceptable
  41-10  levels of education.  The Board shall have the written portion of
  41-11  the examination, if any, validated by an independent testing
  41-12  professional.  If the applicant received training in another state,
  41-13  the District of Columbia, a possession of the United States, or a
  41-14  foreign country, the applicant must present evidence satisfactory
  41-15  to the Board that the nursing education received is equivalent to
  41-16  that required for licensure as a vocational nurse in this state.
  41-17        (c)  Not later than the 30th day <Within 30 days> after the
  41-18  date a licensing examination is administered under this Act, the
  41-19  Board shall notify each examinee of the results of the examination.
  41-20  However, if an examination is graded or reviewed by a national
  41-21  testing service, the Board shall notify each examinee of the
  41-22  results of the examination within two weeks after the date the
  41-23  Board receives the results from the testing service.  If the notice
  41-24  of the examination results will be delayed for more than 90 days
  41-25  after the examination date, the Board shall notify each examinee of
  41-26  the reason for the delay before the 90th day.  If requested in
  41-27  writing by a person who fails the licensing examination
   42-1  administered under this Act, the Board shall furnish the person
   42-2  with an analysis of the person's performance on the examination or
   42-3  other information which the Board has available to it after the
   42-4  tests are scored.
   42-5        (d)  <If an applicant has graduated from an approved
   42-6  educational program in vocational nursing in this state, another
   42-7  state, or the District of Columbia, or successfully completed two
   42-8  years of an associate degree program or diploma program in
   42-9  professional nursing education in this state, another state, or the
  42-10  District of Columbia, the Board may issue to the applicant, pending
  42-11  the results of the licensing examination, a temporary permit to
  42-12  practice vocational nursing under the direct supervision of a
  42-13  licensed vocational nurse, registered professional nurse, or
  42-14  licensed physician.  A permit issued to an applicant who fails the
  42-15  examination expires on the date indicated on the permit.  A permit
  42-16  issued to an applicant who passes the examination expires on the
  42-17  applicant's receipt of a license from the Board.  A permit may not
  42-18  be issued to an applicant who has previously failed an examination
  42-19  administered by the Board or by another state.  The Board may issue
  42-20  a temporary permit to practice vocational nursing to an applicant
  42-21  who is a vocational or practical nurse who has graduated from an
  42-22  approved program for educating vocational or practical nurses,
  42-23  holds a license as a vocational or practical nurse from another
  42-24  state, the District of Columbia, or a possession of the United
  42-25  States, and has actually been engaged in the practice of vocational
  42-26  or practical nursing within the past five years.  Such an applicant
  42-27  must practice under the direct supervision of a licensed vocational
   43-1  nurse, registered professional nurse, or licensed physician.  A
   43-2  temporary permit issued to an applicant from another state, the
   43-3  District of Columbia, or a possession of the United States expires
   43-4  on receipt of a license from the Board or on the expiration of 90
   43-5  days, whichever occurs first.  The Board may, by mutual agreement,
   43-6  assign the function of physical distribution of the temporary
   43-7  permits to an agent designated by the Board to act on behalf of the
   43-8  Board.>
   43-9        <(e)>  Any nurse who is licensed under the provisions of this
  43-10  Act, when on duty in a public or private hospital, nursing home, or
  43-11  licensed health-care facility, shall wear identifying insignia on
  43-12  white caps or uniforms.
  43-13        SECTION 3.03.  Section 7, Chapter 118, Acts of the 52nd
  43-14  Legislature, Regular Session, 1951 (Article 4528c, Vernon's Texas
  43-15  Civil Statutes), is amended to read as follows:
  43-16        Sec. 7.  QUALIFICATION FOR LICENSING BY RECIPROCITY
  43-17  <Endorsement>.  (a)  To qualify for a temporary license to practice
  43-18  as a licensed vocational nurse by reciprocity, an applicant for
  43-19  licensing must:
  43-20              (1)  submit to the Board a reciprocity fee as
  43-21  determined by the Board and a completed application given under
  43-22  oath, in the form prescribed by the Board;
  43-23              (2)  have possessed at the time of initial licensing as
  43-24  a licensed vocational nurse the qualifications necessary to have
  43-25  been eligible for licensing at that time in this state;
  43-26              (3)  have presented to the Board proof of initial
  43-27  licensing by examination and proof that the license and other
   44-1  license or licenses granted to the applicant by any other state
   44-2  have not been suspended, revoked, canceled, surrendered, or
   44-3  otherwise restricted for any reason; and
   44-4              (4)  submit to the Board a notice of sponsorship of the
   44-5  applicant by a licensee of the state under whom the applicant will
   44-6  practice.
   44-7        (b)  A holder of a temporary license under this section shall
   44-8  receive a permanent license if the applicant:
   44-9              (1)  has verified the academic and professional
  44-10  credentials of the applicant; and
  44-11              (2)  satisfies any other requirement set by statute.
  44-12        (c)  An applicant is not eligible for licensing by
  44-13  reciprocity unless the state in which the applicant was initially
  44-14  licensed as a licensed vocational nurse also grants reciprocal
  44-15  licensing to licensed vocational nurses duly licensed by
  44-16  examination in this state, under like circumstances and conditions.
  44-17        (d)  The Board shall either grant or deny an application for
  44-18  a permanent license within 180 days after the date of the Board's
  44-19  receipt of all required forms or information.
  44-20        (e)  The Board shall adopt rules relating to the conditions
  44-21  of sponsorship under Subsection (a)(4) of this section, including
  44-22  waiver of the requirement in the event of a hardship.  <Any
  44-23  applicant who holds a license as a Vocational Nurse or Practical
  44-24  Nurse issued by the District of Columbia or another state whose
  44-25  requirements are equal to those of Texas, and whose individual
  44-26  qualifications shall be equivalent to those required by this law,
  44-27  may be granted a license to practice nursing as a Licensed
   45-1  Vocational Nurse in this State without examination provided the
   45-2  required fee is paid to the Board by such applicant.>
   45-3        SECTION 3.04.  Sections 8(a), (b), and (c), Chapter 118, Acts
   45-4  of the 52nd Legislature, Regular Session, 1951 (Article 4528c,
   45-5  Vernon's Texas Civil Statutes), are amended to read as follows:
   45-6        (a)  The Board <board> by rule shall adopt a system under
   45-7  which licenses expire on various dates during the year <every two
   45-8  years>.  For the year in which the license expiration date is
   45-9  changed, license fees payable on September 1 shall be prorated on a
  45-10  monthly basis so that each licensee shall pay only that portion of
  45-11  the license fee which is allocable to the number of months during
  45-12  which the license is valid.  On renewal of the license on the new
  45-13  expiration date, the total license renewal fee is payable.
  45-14        (b)  At <The Board shall notify each licensee about the
  45-15  expiration date of the person's license at> least 30 days before
  45-16  the expiration of a person's license, the Board <date.  The Board
  45-17  by United States mail> shall send written notice of the impending
  45-18  license expiration to the person, at the person's last known
  45-19  address according to the Board's records <with the notice an
  45-20  application for license renewal to the licensee's address contained
  45-21  in the Board's records.  A licensee whose completed application for
  45-22  renewal is received by the Board after the expiration date of the
  45-23  license shall be charged a late fee>.
  45-24        (c)  If a person's license has been expired for <not more
  45-25  than> 90 days or less, the person may renew the license by paying
  45-26  to the Board the required renewal fee and a fee that is one-half
  45-27  the examination fee for the license.  If a person's license has
   46-1  been expired for more than 90 days but less than one year <two
   46-2  years>, the person may renew the license by paying to the Board all
   46-3  unpaid renewal fees and a fee that is equal to the examination fee
   46-4  for the license.  If a person's license has been expired for one
   46-5  year or longer <two years or more>, the person may not renew the
   46-6  license <by complying with the requirements set forth in
   46-7  substantive rules adopted by the Board>.  The person may obtain a
   46-8  new license by submitting to reexamination and complying with the
   46-9  requirements and procedures for obtaining an original license.
  46-10  However, the Board may renew without examination an expired license
  46-11  of a person who was licensed in this state, moved to another state,
  46-12  and is currently licensed and has been in practice in the other
  46-13  state for the two years preceding application.  The person must pay
  46-14  to the Board a fee that is equal to the examination fee for the
  46-15  license.
  46-16        SECTION 3.05.  Chapter 118, Acts of the 52nd Legislature,
  46-17  Regular Session, 1951 (Article 4528c, Vernon's Texas Civil
  46-18  Statutes), is amended by adding Section 8A to read as follows:
  46-19        Sec. 8A.  MANDATORY CONTINUING EDUCATION REQUIREMENTS.
  46-20  (a)  To renew a license, a licensee must demonstrate to the
  46-21  satisfaction of the Board completion of the requirement for
  46-22  continuing professional education.
  46-23        (b)  The Board shall adopt rules relating to the operation of
  46-24  the mandatory continuing education programs.  In establishing the
  46-25  requirement for continuing education, the Board shall consider:
  46-26              (1)  factors that lead to the competent performance of
  46-27  professional duties; and
   47-1              (2)  the continuing education needs of licensees.
   47-2        (c)  The Board shall adopt rules relating to the adoption or
   47-3  approval of mandatory continuing education programs and providers
   47-4  and shall adopt rules to evaluate the effectiveness of the programs
   47-5  and a licensee's participation and performance in the programs.
   47-6        SECTION 3.06.  Section 9, Chapter 118, Acts of the 52nd
   47-7  Legislature, Regular Session, 1951 (Article 4528c, Vernon's Texas
   47-8  Civil Statutes), is amended to read as follows:
   47-9        Sec. 9.  Fees.  <(a)>  The Board by rule shall establish
  47-10  reasonable and necessary fees so that the fees, in the aggregate,
  47-11  produce sufficient revenue to cover the cost of administering this
  47-12  Act.  The fees set by the Board may be adjusted so that the total
  47-13  fees collected shall be sufficient to meet the expenses of
  47-14  administering this Act.  The Board may not set a fee for an amount
  47-15  less than the amount of that fee on September 1, 1993.  <for the
  47-16  administration of this Act in amounts not to exceed:>
  47-17              <(1)  examination and application fee:  $40;>
  47-18              <(2)  reexamination fee:  $40;>
  47-19              <(3)  renewal fee:  $20;>
  47-20              <(4)  endorsement fee:  $40;>
  47-21              <(5)  accreditation of new programs fee:  $75;>
  47-22              <(6)  duplicate temporary permit or license fee:  $10;>
  47-23              <(7)  filing of affidavits in rechange of name fee:
  47-24  $10;>
  47-25              <(8)  endorsement to another state fee:  $40; and>
  47-26              <(9)  reactivating from inactive status fee:  $30.>
  47-27  <The Board shall not maintain unnecessary fund balances, and fee
   48-1  amounts shall be set in accordance with this requirement.>
   48-2        <(b)  All expenses under this Act shall be paid from fees
   48-3  collected by the Board under this Act, and no expense incurred
   48-4  under this Act shall ever be charged against the funds of the State
   48-5  of Texas.>
   48-6        <(c)  On or before January 1 of each year, the Board shall
   48-7  make in writing to the Governor and the presiding officer of each
   48-8  house of the legislature a complete and detailed report accounting
   48-9  for all funds received and disbursed by the Board during the
  48-10  preceding year.>
  48-11        SECTION 3.07.  Chapter 118, Acts of the 52nd Legislature,
  48-12  Regular Session, 1951 (Article 4528c, Vernon's Texas Civil
  48-13  Statutes), is amended by adding Sections 10A-10G to read as
  48-14  follows:
  48-15        Sec. 10A.  PUBLIC INTEREST INFORMATION AND COMPLAINTS; PUBLIC
  48-16  ACCESS TO BOARD FUNCTIONS.  (a)  The Board shall prepare
  48-17  information of public interest describing the functions of the
  48-18  Board and the Board's procedures by which complaints are filed with
  48-19  and resolved by the Board.  The Board shall make the information
  48-20  available to the public and appropriate state agencies.
  48-21        (b)  The Board by rule shall establish methods by which
  48-22  consumers and service recipients are notified of the name, mailing
  48-23  address, and telephone number of the Board for the purpose of
  48-24  directing complaints to the Board.  The Board may provide for that
  48-25  notification:
  48-26              (1)  on each registration form, application, or written
  48-27  contract for services of an individual or entity regulated under
   49-1  this Act;
   49-2              (2)  on a sign prominently displayed in the place of
   49-3  business of each individual or entity regulated under this Act; or
   49-4              (3)  in a bill for service provided by an individual or
   49-5  entity regulated under this Act.
   49-6        (c)  The Board shall list along with its regular telephone
   49-7  number the toll-free telephone number that may be called to present
   49-8  a complaint about a health professional if the toll-free number is
   49-9  established under other state law.
  49-10        (d)  The Board shall develop and implement policies that
  49-11  provide the public with a reasonable opportunity to appear before
  49-12  the Board and to speak on any issue under the jurisdiction of the
  49-13  Board.
  49-14        (e)  The Board shall prepare and maintain a written plan that
  49-15  describes how a person who does not speak English can be provided
  49-16  reasonable access to the Board's programs.  The Board shall also
  49-17  comply with federal and state laws for program and facility
  49-18  accessibility.
  49-19        Sec. 10B.  RECORDS OF COMPLAINTS.  (a)  The Board shall keep
  49-20  an information file about each complaint filed with the Board.  The
  49-21  Board's information file shall be kept current and contain a record
  49-22  for each complaint of:
  49-23              (1)  all persons contacted in relation to the
  49-24  complaint;
  49-25              (2)  a summary of findings made at each step of the
  49-26  complaint process;
  49-27              (3)  an explanation of the legal basis and reason for a
   50-1  complaint that is dismissed; and
   50-2              (4)  other relevant information.
   50-3        (b)  If a written complaint is filed with the Board that the
   50-4  Board has authority to resolve, the Board, at least as frequently
   50-5  as quarterly and until final disposition of the complaint, shall
   50-6  notify the parties to the complaint of the status of the complaint
   50-7  unless the notice would jeopardize an undercover investigation.
   50-8        (c)  The Board by rule shall adopt a form to standardize
   50-9  information concerning complaints made to the Board.  The Board by
  50-10  rule shall prescribe information to be provided to a person when
  50-11  the person files a complaint with the Board.
  50-12        (d)  The Board shall provide reasonable assistance to a
  50-13  person who wishes to file a complaint with the Board.
  50-14        Sec. 10C.  COMPLAINT INVESTIGATION AND DISPOSITION.  (a)  The
  50-15  Board shall adopt rules concerning the investigation of a complaint
  50-16  filed with the Board.  The rules adopted under this subsection
  50-17  shall:
  50-18              (1)  distinguish between categories of complaints;
  50-19              (2)  ensure that complaints are not dismissed without
  50-20  appropriate consideration;
  50-21              (3)  require that the Board be advised of a complaint
  50-22  that is dismissed and that a letter be sent to the person who filed
  50-23  the complaint explaining the action taken on the dismissed
  50-24  complaint;
  50-25              (4)  ensure that the person who filed the complaint has
  50-26  an opportunity to explain the allegations made in the complaint;
  50-27  and
   51-1              (5)  prescribe guidelines concerning the categories of
   51-2  complaints that require the use of a private investigator and the
   51-3  procedures for the Board to obtain the services of a private
   51-4  investigator.
   51-5        (b)  The Board shall dispose of all complaints in a timely
   51-6  manner.  The Board shall establish a timeline for conducting each
   51-7  phase of a complaint that is under the control of the Board not
   51-8  later than the 30th day after the date the complaint is received by
   51-9  the Board.  The timeline shall be kept in the information file for
  51-10  the complaint and all parties shall be notified of the projected
  51-11  time requirements for pursuing the complaint.  A change in the
  51-12  timeline must be noted in the complaint information file and all
  51-13  parties to the complaint must be notified not later than the
  51-14  seventh day after the date the change is made.
  51-15        (c)  The executive director of the Board shall notify the
  51-16  Board of a complaint that extends beyond the time prescribed by the
  51-17  Board for resolving the complaint so that the Board may take
  51-18  necessary action on the complaint.
  51-19        Sec. 10D.  INFORMAL PROCEEDINGS.  (a)  The Board by rule
  51-20  shall adopt procedures governing:
  51-21              (1)  informal disposition of a contested case under
  51-22  Section 13(e), Administrative Procedure and Texas Register Act
  51-23  (Article 6252-13a, Vernon's Texas Civil Statutes), and its
  51-24  subsequent amendments; and
  51-25              (2)  informal proceedings held in compliance with
  51-26  Section 18(c), Administrative Procedure and Texas Register Act
  51-27  (Article 6252-13a, Vernon's Texas Civil Statutes), and its
   52-1  subsequent amendments.
   52-2        (b)  Rules adopted under this section must provide the
   52-3  complainant and the licensee an opportunity to be heard and must
   52-4  require the presence of a representative of the office of the
   52-5  attorney general to advise the Board or the Board's employees.
   52-6        Sec. 10E.  MONITORING OF LICENSEE.  The Board by rule shall
   52-7  develop a system for monitoring licensees' compliance with the
   52-8  requirements of this Act.  Rules adopted under this section shall
   52-9  include procedures for monitoring a licensee who is ordered by the
  52-10  Board to perform certain acts to ascertain that the licensee
  52-11  performs the required acts and to identify and monitor licensees
  52-12  who represent a risk to the public.
  52-13        Sec. 10F.  ADMINISTRATIVE PENALTIES.  (a) If a person
  52-14  licensed under this Act violates a provision of this Act or a rule
  52-15  or order adopted by the Board under this Act, the Board may assess
  52-16  an administrative penalty against the person as provided by this
  52-17  section.
  52-18        (b)  The penalty for each violation may be in an amount not
  52-19  to exceed $1,000.  Each day a violation continues or occurs may be
  52-20  considered a separate violation for purposes of penalty
  52-21  assessments.
  52-22        (c)  In determining the amount of the penalty, the executive
  52-23  director shall consider:
  52-24              (1)  the seriousness of the violation, including but
  52-25  not limited to the nature, circumstances, extent, and gravity of
  52-26  the prohibited acts, and the hazard or potential hazard created to
  52-27  the health or safety of the public;
   53-1              (2)  the economic damage to property or the environment
   53-2  caused by the violation;
   53-3              (3)  the history of previous violations;
   53-4              (4)  the amount necessary to deter future violations;
   53-5              (5)  efforts to correct the violation; and
   53-6              (6)  any other matter that justice may require.
   53-7        (d)  If, after investigation of a possible violation and the
   53-8  facts surrounding that possible violation, the executive director
   53-9  determines that a violation has occurred, the executive director
  53-10  may issue a violation report stating the facts on which the
  53-11  conclusion that a violation occurred is based, recommending that an
  53-12  administrative penalty under this section be imposed on the person
  53-13  charged, and recommending the amount of that proposed penalty.  The
  53-14  executive director shall base the recommended amount of the
  53-15  proposed penalty on the seriousness of the violation determined by
  53-16  consideration of the factors set forth in Subsection (c) of this
  53-17  section.
  53-18        (e)  Not later than the 14th day after the date on which the
  53-19  report is issued, the executive director shall give written notice
  53-20  of the report to the person charged.  The notice shall include a
  53-21  brief summary of the charges, a statement of the amount of the
  53-22  penalty recommended, and a statement of the right of the person
  53-23  charged to a hearing on the occurrence of the violation or the
  53-24  amount of the penalty, or both the occurrence of the violation and
  53-25  the amount of the penalty.
  53-26        (f)  Not later than the 20th day after the date on which
  53-27  notice is received, the person charged may accept the determination
   54-1  of the executive director made under Subsection (d) of this
   54-2  section, including the recommended penalty, or make a written
   54-3  request for a hearing on the determination.
   54-4        (g)  If the person charged with the violation accepts the
   54-5  determination of the executive director, the Board shall issue an
   54-6  order approving the determination and ordering the payment of the
   54-7  recommended penalty.
   54-8        (h)  If the person charged requests a hearing or fails to
   54-9  timely respond to the notice, the executive director shall set a
  54-10  hearing and give notice of the hearing.  The hearing shall be held
  54-11  by the State  Office of Administrative Hearings.  The State Office
  54-12  of Administrative Hearings shall make findings of fact and
  54-13  conclusions of law and promptly issue to the Board a proposal for
  54-14  decision as to the occurrence of the violation, including a
  54-15  recommendation as to the amount of the proposed penalty if a
  54-16  penalty is warranted.  Based on the findings of fact, conclusions
  54-17  of law, and recommendations of the hearing examiner, the Board by
  54-18  order may find a violation has occurred and may assess a penalty or
  54-19  may find that no violation has occurred.  All proceedings under
  54-20  this subsection are subject to the Administrative Procedure and
  54-21  Texas Register Act (Article 6252-13a, Vernon's Texas Civil
  54-22  Statutes) and its subsequent amendments.
  54-23        (i)  The executive director shall give notice of the Board's
  54-24  order to the person charged.  The notice shall include:
  54-25              (1)  the findings of fact and conclusions of law
  54-26  separately stated;
  54-27              (2)  the amount of the penalty ordered, if any;
   55-1              (3)  a statement of the right of the person charged to
   55-2  judicial review of the Board's order, if any; and
   55-3              (4)  other information required by law.
   55-4        (j)  Within the 30-day period immediately following the day
   55-5  on which the order becomes final as provided by Section 16(c),
   55-6  Administrative Procedure and Texas Register Act (Article 6252-13a,
   55-7  Vernon's Texas Civil Statutes), and its subsequent amendments, the
   55-8  person charged with the penalty shall:
   55-9              (1)  pay the penalty in full; or
  55-10              (2)  if the person files a petition for judicial review
  55-11  contesting either the amount of the penalty or the fact of the
  55-12  violation or contesting both the fact of the violation and the
  55-13  amount of the penalty:
  55-14                    (A)  forward the amount to the executive director
  55-15  for placement in an escrow account; or
  55-16                    (B)  in lieu of payment into escrow, post with
  55-17  the executive director a supersedeas bond in a form approved by the
  55-18  executive director for the amount of the penalty, the bond to be
  55-19  effective until all judicial review of the order or decision is
  55-20  final.
  55-21        (k)  If a person charged is financially unable to either
  55-22  forward the amount of the penalty for placement in an escrow
  55-23  account or post a supersedeas bond for the amount of the penalty,
  55-24  the person may satisfy the requirements of Subsection (j)(2) of
  55-25  this section by filing with the executive director an affidavit
  55-26  sworn by the person charged, stating that the person is financially
  55-27  unable to either forward the amount of the penalty or post a bond.
   56-1        (l)  Failure to forward the money to or to post the bond or
   56-2  file the affidavit with the executive director within the time
   56-3  provided by Subsection (j) of this section results in a waiver of
   56-4  all legal rights to judicial review.  Also, if the person charged
   56-5  fails to pay the penalty in full as provided under Subsection
   56-6  (j)(1) of this section or forward the money, post the bond, or file
   56-7  the affidavit as provided by Subsection (j) or (k) of this section,
   56-8  the executive director may forward the matter to the attorney
   56-9  general for enforcement.
  56-10        (m)  Judicial review of the order or decision of the Board
  56-11  assessing the penalty shall be under the substantial evidence rule
  56-12  and shall be instituted by filing a petition with a district court
  56-13  in Travis County, as provided by Section 19, Administrative
  56-14  Procedure and Texas Register Act (Article 6252-13a, Vernon's Texas
  56-15  Civil Statutes), and its subsequent amendments.
  56-16        (n)  If the penalty is reduced or not assessed by the court,
  56-17  the executive director shall remit to the person charged the
  56-18  appropriate amount plus accrued interest if the penalty has been
  56-19  paid or shall execute a release of the bond if a supersedeas bond
  56-20  has been posted.  The accrued interest on amounts remitted by the
  56-21  executive director under this subsection shall be paid at a rate
  56-22  equal to the rate charged on loans to depository institutions by
  56-23  the New York Federal Reserve Bank and shall be paid for the period
  56-24  beginning on the date the penalty is paid to the executive director
  56-25  under Subsection (j) of this section and ending on the date the
  56-26  penalty is remitted.
  56-27        (o)  A penalty collected under this section for a violation
   57-1  by a person licensed under this Act shall be deposited in the
   57-2  general revenue fund.
   57-3        Sec. 10G.  SCHEDULE OF SANCTIONS.  The schedule of sanctions
   57-4  adopted by the Board by rule shall be used by the State Office of
   57-5  Administrative Hearings for any sanction imposed as the result of a
   57-6  hearing conducted by that office.
   57-7        SECTION 3.08.  Section 11, Chapter 118, Acts of the 52nd
   57-8  Legislature, Regular Session, 1951 (Article 4528c, Vernon's Texas
   57-9  Civil Statutes), is amended by adding Subsection (c) to read as
  57-10  follows:
  57-11        (c)  A person who violates this Act is liable to the state
  57-12  for a civil penalty that does not exceed $1,000 a day.  The civil
  57-13  penalty may be collected in a suit initiated by the Board.
  57-14        SECTION 3.09.  Chapter 118, Acts of the 52nd Legislature,
  57-15  Regular Session, 1951 (Article 4528c, Vernon's Texas Civil
  57-16  Statutes), is amended by adding Section 14 to read as follows:
  57-17        Sec. 14.  COMPETITIVE BIDDING OR ADVERTISING.  The Board may
  57-18  not adopt rules restricting competitive bidding or advertising by a
  57-19  licensee of the Board except to prohibit false, misleading, or
  57-20  deceptive practices by the licensee.  The Board may not include in
  57-21  its rules to prohibit false, misleading, or deceptive practices by
  57-22  a licensee a rule that:
  57-23              (1)  restricts the licensee's use of any medium for
  57-24  advertising;
  57-25              (2)  restricts the licensee's personal appearance or
  57-26  use of the licensee's voice in an advertisement;
  57-27              (3)  relates to the size or duration of an
   58-1  advertisement by the licensee; or
   58-2              (4)  restricts the licensee's advertisement under a
   58-3  trade name.
   58-4        SECTION 3.10.  Chapter 118, Acts of the 52nd Legislature,
   58-5  Regular Session, 1951 (Article 4528c, Vernon's Texas Civil
   58-6  Statutes), is amended by adding Section 15 to read as follows:
   58-7        Sec. 15.  RESTRICTION ON RULEMAKING AUTHORITY.  If the
   58-8  appropriate standing committees of both houses of the legislature
   58-9  acting under Section 5(g), Administrative Procedure and Texas
  58-10  Register Act (Article 6252-13a, Vernon's Texas Civil Statutes), and
  58-11  its subsequent amendments transmit to the Board statements opposing
  58-12  adoption of a rule under that section, the rule may not take effect
  58-13  or, if the rule has already taken effect, the rule is repealed
  58-14  effective on the date the Board receives the committee's
  58-15  statements.
  58-16      ARTICLE 4.  TRANSITION; REPEALER; EFFECTIVE DATE; EMERGENCY
  58-17        SECTION 4.01.  (a)  As soon as possible after the effective
  58-18  date of this Act, the governor shall appoint the initial members of
  58-19  the State Board of Examiners for Professional Nurses in accordance
  58-20  with Article 4513-1, Revised Statutes, as added by this Act.  In
  58-21  making the initial appointments, the governor shall designate
  58-22  members to serve terms as follows:
  58-23              (1)  two members licensed as registered nurses, one
  58-24  member licensed as a licensed vocational nurse, and one public
  58-25  member serve for terms expiring February 1, 1995;
  58-26              (2)  one member licensed as a registered nurse, two
  58-27  members licensed as licensed vocational nurses, and one public
   59-1  member serve for terms expiring February 1, 1997; and
   59-2              (3)  one member licensed as a registered nurse, one
   59-3  member licensed as a licensed vocational nurse, and two public
   59-4  members serve for terms expiring February 1, 1999.
   59-5        (b)  The State Board of Examiners for Professional Nurses may
   59-6  not take any action and is not created until the day after the date
   59-7  that the last appointee to the initial board takes office.  On the
   59-8  date of its creation, the board assumes its functions and:
   59-9              (1)  the Board of Nurse Examiners and the Board of
  59-10  Vocational Nurse Examiners are abolished;
  59-11              (2)  the obligations, rights, contracts, records and
  59-12  other property, and personnel of, and unspent money appropriated to
  59-13  or for, the abolished boards are transferred to the State Board of
  59-14  Examiners for Professional Nurses;
  59-15              (3)  the rules of the abolished boards are continued in
  59-16  effect as rules of the State Board of Examiners for Professional
  59-17  Nurses until superseded by rule of the new board;
  59-18              (4)  the licenses in effect that were issued by the
  59-19  abolished boards are continued in effect as licenses of the State
  59-20  Board of Examiners for Professional Nurses;
  59-21              (5)  a complaint or investigation pending before an
  59-22  abolished board is transferred without change in status to the
  59-23  State Board of Examiners for Professional Nurses;
  59-24              (6)  a contested case pending before an abolished board
  59-25  is transferred to the State Office of Administrative Hearings and
  59-26  actions taken in the proceeding are treated as if taken by the
  59-27  State Office of Administrative Hearings; and
   60-1              (7)  any reference in a law to the abolished boards
   60-2  means the State Board of Examiners for Professional Nurses.
   60-3        (c)  Regardless of the changes in law made by this Act, until
   60-4  the date that the Board of Nurse Examiners and the Board of
   60-5  Vocational Nurse Examiners are abolished as provided by this
   60-6  section, the boards continue in existence and shall administer
   60-7  their functions under the laws that governed the boards before the
   60-8  effective date of this Act, and the prior laws are continued in
   60-9  effect for that purpose.
  60-10        (d)  The State Board of Examiners for Professional Nurses
  60-11  shall adopt rules under this Act not later than December 1, 1993.
  60-12        SECTION 4.02.  The following laws are repealed:
  60-13              (1)  Articles 4513, 4513a, 4515, 4516, and 4517,
  60-14  Revised Statutes; and
  60-15              (2)  Sections 5 and 10(f), Chapter 118, Acts of the
  60-16  52nd Legislature, Regular Session, 1951 (Article 4528c, Vernon's
  60-17  Texas Civil Statutes).
  60-18        SECTION 4.03.  This Act takes effect September 1, 1993.
  60-19        SECTION 4.04.  The importance of this legislation and the
  60-20  crowded condition of the calendars in both houses create an
  60-21  emergency and an imperative public necessity that the
  60-22  constitutional rule requiring bills to be read on three several
  60-23  days in each house be suspended, and this rule is hereby suspended.