AN ACT
1-1 relating to the practice and conduct of registered nurses.
1-2 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-3 SECTION 1. Article 4518, Revised Statutes, is amended by
1-4 adding Section 8 to read as follows:
1-5 Sec. 8. (a) In this section:
1-6 (1) "Pilot program" means a pilot program developed or
1-7 approved under this section.
1-8 (2) "Proactive nursing peer review" means peer review
1-9 that is not initiated for the purpose of determining culpability
1-10 with respect to a particular incident.
1-11 (3) "Targeted continuing nursing education" means
1-12 continuing education focusing on a competency identified as one
1-13 that a significant portion of registered nurses in a particular
1-14 practice area would likely benefit from taking.
1-15 (b) The Board may develop pilot programs to evaluate the
1-16 effectiveness of mechanisms for assuring: (1) maintenance of
1-17 clinical competency by registered nurses in their area of practice,
1-18 including the use of proactive nursing peer review and targeted
1-19 continuing nursing education; and (2) that registered nurses
1-20 understand the laws and regulations governing the practice of
1-21 professional nursing. The pilot programs shall be designed to test
1-22 the effectiveness of a variety of mechanisms in a variety of
1-23 practice settings. The Board may approve pilot programs to be
2-1 conducted by persons other than the Board.
2-2 (c) Subject to appropriations by the legislature, the Board
2-3 may expend funds to develop or fund pilot programs. The Board may
2-4 contract with, make grants to, or make other arrangements with an
2-5 agency, professional association, institution, individual, or other
2-6 person to implement this section.
2-7 (d) In developing, administering, approving, and funding
2-8 pilot programs, the Board shall consult with the Competency
2-9 Advisory Committee on matters relating to ensuring the maintenance
2-10 of continued competency of registered nurses and with the Laws and
2-11 Regulations Advisory Committee on matters relating to ensuring that
2-12 registered nurses understand the laws and regulations governing
2-13 the practice of professional nursing.
2-14 (e) The Competency Advisory Committee is composed of the
2-15 following members appointed by the Board:
2-16 (1) a representative from the Texas Nurses
2-17 Association;
2-18 (2) a representative from the Texas Nurses Foundation;
2-19 (3) a representative from the Texas Organization of
2-20 Nurse Executives;
2-21 (4) a registered nurse representative from the Texas
2-22 Hospital Association;
2-23 (5) a registered nurse representative from the Texas
2-24 Health Care Association;
2-25 (6) a registered nurse representative from the Texas
3-1 Association of Homes and Services for the Aging;
3-2 (7) a registered nurse representative from the Texas
3-3 Association for Home Care;
3-4 (8) a professional nursing educator;
3-5 (9) a representative from the Consumers Union;
3-6 (10) a representative from the Texas Department of
3-7 Mental Health and Mental Retardation; and
3-8 (11) any other persons appointed by the Board.
3-9 (f) The Laws and Regulations Advisory Committee is composed
3-10 of the following members appointed by the Board:
3-11 (1) a representative of the Texas Nurses Association;
3-12 (2) a representative of the Texas League for Nursing;
3-13 (3) a representative of the Texas Chapter of the
3-14 American Association of Nurse Attorneys;
3-15 (4) a representative of the Texas Organization of
3-16 Baccalaureate and Graduate Nursing Educators;
3-17 (5) a representative of the Texas Organization for
3-18 Associate Degree Nursing;
3-19 (6) a representative of the Texas Organization of
3-20 Nurse Executives;
3-21 (7) a representative of the American Association of
3-22 Retired Persons;
3-23 (8) a registered nurse researcher; and
3-24 (9) any other persons appointed by the Board.
3-25 (g) Except as provided in this subsection, the Board, in
4-1 developing or approving a pilot program, may exempt the program
4-2 from rules adopted under this chapter. Provisions of this chapter
4-3 relating to mandatory reporting and peer review shall apply to
4-4 pilot programs except that Section 1A, Article 4525b, Revised
4-5 Statutes, shall not apply to programs utilizing proactive peer
4-6 review. The Board may establish alternative criteria for nursing
4-7 peer review committees conducting proactive peer review.
4-8 (h) Beginning November 1, 1998, the Board shall issue an
4-9 annual report of any pilot programs developed or approved and a
4-10 status report on those programs, including any preliminary or final
4-11 findings concerning their effectiveness. The report shall be
4-12 mailed to statewide associations of registered nurses, registered
4-13 nurse educators, and employers of registered nurses that have
4-14 requested a copy. A final report shall be issued by the Board not
4-15 later than September 1, 2000.
4-16 SECTION 2. Section 1, Article 4513, Revised Statutes, is
4-17 amended to read as follows:
4-18 Sec. 1. Composition of Board; Programs of Study. The Board
4-19 of Nurse Examiners is composed of nine members appointed by the
4-20 governor with the advice and consent of the senate. Appointments
4-21 to the board shall be made without regard to the race, color,
4-22 disability, sex, religion, age, or national origin of the
4-23 appointees. The board shall prescribe three programs of study to
4-24 prepare professional nurse practitioners, to wit: (1) The
4-25 Baccalaureate Degree Program--A program leading to a baccalaureate
5-1 degree in nursing conducted by an educational unit in nursing
5-2 (department, division, school, or college) which is a part of a
5-3 senior college or university; (2) The Associate Degree Program--A
5-4 program leading to an associate degree in nursing conducted by an
5-5 educational unit in nursing within the structure of a college or a
5-6 university; and (3) The Diploma Program--A program leading to a
5-7 diploma in nursing conducted by a single purpose school usually
5-8 under the control of a hospital. Six of the board members must be
5-9 Registered Nurses, three of whom shall be engaged in professional
5-10 nurse education [and shall be representative of said three
5-11 programs] in that one shall be a nurse faculty member in a school
5-12 of nursing pursuing the Baccalaureate Degree Program; one shall be
5-13 a nurse faculty member in a school of nursing pursuing the
5-14 Associate Degree Program; and one shall be a nurse faculty member
5-15 in a graduate school of nursing preparing Advanced Practice Nurses
5-16 [pursuing the Diploma Program]. Three members must be members of
5-17 the general public.
5-18 SECTION 3. Article 4519a, Revised Statutes, is amended to
5-19 read as follows:
5-20 Art. 4519a. Declaratory orders of eligibility for license.
5-21 Sec. 1. (a) An individual enrolled or planning to enroll in
5-22 an educational program that prepares an individual for an initial
5-23 license as a registered nurse who has reason to believe that the
5-24 individual is ineligible for the license may petition the board for
5-25 a declaratory order as to the individual's eligibility. The
6-1 petition must state the basis for the individual's potential
6-2 ineligibility. The board shall have the same powers to investigate
6-3 the petition and the individual's eligibility that it has to
6-4 investigate a person applying for a license. The petitioning
6-5 individual or the board may amend the petition at any time before a
6-6 final determination is made to include additional grounds for
6-7 potential ineligibility.
6-8 (b) If the board proposes to find the petitioner ineligible
6-9 for a license, the petitioner is entitled to a hearing before the
6-10 board in accordance with Subsection (a) [(b)], Article 4525,
6-11 Revised Statutes, as amended by Section 8, Chapter 840, Acts of the
6-12 73rd Legislature, 1993. The board's order must set out each basis
6-13 for potential ineligibility and the board's determination as to
6-14 eligibility. In the absence of new evidence known to but not
6-15 disclosed by the petitioner or not reasonably available to the
6-16 board at the time the order is issued, the board's ruling on the
6-17 petition determines the individual's eligibility with respect to
6-18 the basis for potential ineligibility set out in the order.
6-19 Sec. 2. (a) The board may require individuals accepted for
6-20 enrollment or enrolled in an educational program preparing students
6-21 for initial licensure as registered nurses to submit information to
6-22 the board that will permit it to determine whether the individual
6-23 is aware of the conditions that may disqualify the individual from
6-24 licensure as a professional nurse on graduation and of the
6-25 individual's right to petition the board for a declaratory order of
7-1 eligibility for licensure under Section 1 of this article. In lieu
7-2 of requiring the individual to submit the information, the board
7-3 may require the educational program to collect and submit the
7-4 information on individuals accepted for enrollment or enrolled in
7-5 the program. The information shall be submitted in a form approved
7-6 by the board.
7-7 (b) If the board determines that an individual may not be
7-8 eligible for licensure on graduation, the board shall notify the
7-9 educational program of its determination.
7-10 SECTION 4. Article 4525, Revised Statutes, is amended by
7-11 adding Subsection (a-1) to read as follows:
7-12 (a-1) Notwithstanding Subsection (a) of this article, as
7-13 amended by Section 8, Chapter 840, Acts of the 73rd Legislature,
7-14 1993, a person is not entitled to a hearing on a refusal to renew a
7-15 license if the person:
7-16 (1) fails to submit an application for renewal; or
7-17 (2) submits an application that:
7-18 (A) is incomplete;
7-19 (B) shows on its face that the person does not
7-20 meet the requirements for renewal; or
7-21 (C) is not accompanied by the correct fee.
7-22 SECTION 5. This Act takes effect September 1, 1997, except
7-23 that Section 2 of this Act takes effect January 31, 1999.
7-24 SECTION 6. The importance of this legislation and the
7-25 crowded condition of the calendars in both houses create an
8-1 emergency and an imperative public necessity that the
8-2 constitutional rule requiring bills to be read on three several
8-3 days in each house be suspended, and this rule is hereby suspended.
_______________________________ _______________________________
President of the Senate Speaker of the House
I hereby certify that S.B. No. 617 passed the Senate on
March 20, 1997, by a viva-voce vote; and that the Senate concurred
in House amendment on May 24, 1997, by a viva-voce vote.
_______________________________
Secretary of the Senate
I hereby certify that S.B. No. 617 passed the House, with
amendment, on May 21, 1997, by a non-record vote.
_______________________________
Chief Clerk of the House
Approved:
_______________________________
Date
_______________________________
Governor