BG C.S.S.B. 617 75(R) BILL ANALYSIS PUBLIC HEALTH C.S.S.B. 617 By: Moncrief (Maxey) May 8, 1997 Committee Report (Substituted) BACKGROUND 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. PURPOSE 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. RULEMAKING AUTHORITY 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 BY SECTION ANALYSIS SECTION 1. Amends Article 4518, Revised Statutes, by adding Section 8, as follows: 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 Committee. 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, 2000. 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. COMPARISON OF ORIGINAL TO SUBSTITUTE 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).