BG C.S.S.B. 617 75(R)    BILL ANALYSIS

C.S.S.B. 617
By: Moncrief (Maxey)
May 8, 1997
Committee Report (Substituted)


Currently, the Texas Board of Nurse Examiners (board) has no system in
place designed specifically to assess the clinical competency of its
registered nurses.  This legislation authorizes the board to develop a
pilot program to evaluate the mechanisms presently in place for assuring
high professional nursing standards, including targeted continuing
education and proactive peer review.  This bill also more closely outlines
the procedure regarding disqualification of individuals from licensure as
professional nurses upon graduation, and changes the composition of the
board to include an advanced practice program representative, rather than
a diploma program representative. 


C.S.S.B. 617 clarifies certain procedures regarding the licensure of
nurses and authorizes development of programs by the Board of Nurse
Examiners to assure high professional standards.  

It is the committee's opinion that this bill gives the Board of Nurse
Examiners the authority to exempt a pilot program from rules adopted under
this chapter in SECTION 1 (Sec. 8(g), Article 4518, Revised Statutes). 


SECTION 1. Amends Article 4518, Revised Statutes, by adding Section 8, as

Sec. 8.   (a) defines "pilot program," "proactive nursing peer review,"
and "targeted continuing nursing education."   

Subsection (b) authorizes the Board of Nurse Examiners (board) to develop
pilot programs to evaluate the effectiveness of mechanisms for assuring
maintenance of clinical competency as specified and assuring that
registered nurses understand the laws and regulations governing the
practice of professional nursing.  Requires that the pilot programs be
designed using a variety of mechanisms in a variety of practice settings.
Allows the board to approve pilot programs conducted by persons other than
the board. 

Subsection (c) allows the board to expend funds as specified, subject to
legislative appropriations, and to contract and make other arrangements
with entities and individuals to implement this section.  

Subsection (d) requires the board to consult with the Competency Advisory
Committee on matters as specified, and with the Laws and Regulations
Advisory Committee an matters as specified, in developing, administering,
approving and funding pilot programs.  

Subsection (e) sets forth the composition of the Competency Advisory

Subsection (f) sets forth the composition of the Laws and Regulations
Advisory Committee. 

Subsection (g) allows the board to exempt the program from rules adopted
under this chapter, except as provided by this subsection. Requires that
provisions relating to mandatory report and peer review apply to pilot
programs except as specified in programs utilizing proactive  peer review.
Allows the board to establish alternative criteria for nursing peer review
committees as specified. 

Subsection (h) requires the board to issue an annual report and status
report as specified beginning November 1, 1998. Requires the report to be
mailed to certain statewide associations and employers that have requested
a copy.  Requires a final report to be issued by the board by September 1,

SECTION 2. Amends Section 1, Article 4513, Revised Statutes, regarding the
board's composition to remove language specifying "and shall be
representative of said three programs" in reference to the six registered
nurse board members, three of whom are engaged in professional nurse
education. Adds  language to clarify that one board member is required to
be nurse faculty in a graduate school that prepares Advanced Practice
Nurses. Omits the words "pursuing the Diploma Program." 

SECTION 3. Amends Article 4519a, Revised Statutes, as follows:

Sec. 1.  Makes a conforming change and revises a statutory reference in
regards to a hearing on ineligibility as specified.   

Sec. 2.  Allows the board to require individuals accepted for enrollment
or enrolled in certain educational programs to submit certain information.
Allows the board to require the educational program to collect and submit
information on the individuals as specified in lieu of requiring the
individual to. Requires the information to be submitted in a board
approved form. Requires the board to notify the educational program of its
determination if an individual is determined as possibly not eligible for
licensure upon graduation. 

SECTION 4. Amends Article 4525, Revised Statutes, by adding Subsection
(a-1) to establish that notwithstanding Subsection (a) of this section, a
person is not entitled to a hearing on a license renewal refusal if the
person failed to submit an application as specified or submitted an
application that is incomplete, requirement deficient, or unaccompanied by
the correct fee. 

SECTION 5. Establishes that this Act takes effect on September 1, 1997,
except for SECTION 2 which takes effect on January 31, 1999. 

SECTION 6. Emergency clause.       


In SECTION 1 (Sec. 8(d), Article 4518, Revised Statutes), the original
bill provided for  an  advisory committee to be consult with on various
aspects of the pilot programs.  It has been divided into two separate
committees in the substitute bill, after concern had been expressed that a
single 16-member advisory committee was too large, and that some of the
members listed would be more appropriate for one rather than the other of
types of pilot programs. 

On recommendation from the Legislative Council, CSSB 617 makes a
nonsubstantive, technical change in SECTION 4.  Rather than amending the
current Subsection (a) of Article 4525, Revised Statutes as the original
bill had, the substitute bill adds a  new Subsection (a-1).