75R13415 GJH-F
By Moncrief S.B. No. 617
Substitute the following for S.B. No. 617:
By Berlanga C.S.S.B. No. 617
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the practice and conduct of registered nurses.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Article 4518, Revised Statutes, is amended by
1-5 adding Section 8 to read as follows:
1-6 Sec. 8. (a) In this section:
1-7 (1) "Pilot program" means a pilot program developed or
1-8 approved under this section.
1-9 (2) "Proactive nursing peer review" means peer review
1-10 that is not initiated for the purpose of determining culpability
1-11 with respect to a particular incident.
1-12 (3) "Targeted continuing nursing education" means
1-13 continuing education focusing on a competency identified as one
1-14 that a significant portion of registered nurses in a particular
1-15 practice area would likely benefit from taking.
1-16 (b) The Board may develop pilot programs to evaluate the
1-17 effectiveness of mechanisms for assuring: (1) maintenance of
1-18 clinical competency by registered nurses in their area of practice,
1-19 including the use of proactive nursing peer review and targeted
1-20 continuing nursing education; and (2) that registered nurses
1-21 understand the laws and regulations governing the practice of
1-22 professional nursing. The pilot programs shall be designed to test
1-23 the effectiveness of a variety of mechanisms in a variety of
1-24 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
2-26 Association of Homes and Services for the Aging;
2-27 (7) a registered nurse representative from the Texas
3-1 Association for Home Care;
3-2 (8) a professional nursing educator;
3-3 (9) a representative from the Consumers Union;
3-4 (10) a representative from the Texas Department of
3-5 Mental Health and Mental Retardation; and
3-6 (11) any other persons appointed by the Board.
3-7 (f) The Laws and Regulations Advisory Committee is composed
3-8 of the following members appointed by the Board:
3-9 (1) a representative of the Texas Nurses Association;
3-10 (2) a representative of the Texas League for Nursing;
3-11 (3) a representative of the Texas Chapter of the
3-12 American Association of Nurse Attorneys;
3-13 (4) a representative of the Texas Organization of
3-14 Baccalaureate and Graduate Nursing Educators;
3-15 (5) a representative of the Texas Organization for
3-16 Associate Degree Nursing;
3-17 (6) a representative of the Texas Organization of
3-18 Nurse Executives;
3-19 (7) a representative of the American Association of
3-20 Retired Persons;
3-21 (8) a registered nurse researcher; and
3-22 (9) any other persons appointed by the Board.
3-23 (g) Except as provided in this subsection, the Board, in
3-24 developing or approving a pilot program, may exempt the program
3-25 from rules adopted under this chapter. Provisions of this chapter
3-26 relating to mandatory reporting and peer review shall apply to
3-27 pilot programs except that Section 1A, Article 4525b, Revised
4-1 Statutes, shall not apply to programs utilizing proactive peer
4-2 review. The Board may establish alternative criteria for nursing
4-3 peer review committees conducting proactive peer review.
4-4 (h) Beginning November 1, 1998, the Board shall issue an
4-5 annual report of any pilot programs developed or approved and a
4-6 status report on those programs, including any preliminary or final
4-7 findings concerning their effectiveness. The report shall be
4-8 mailed to statewide associations of registered nurses, registered
4-9 nurse educators, and employers of registered nurses that have
4-10 requested a copy. A final report shall be issued by the Board not
4-11 later than September 1, 2000.
4-12 SECTION 2. Section 1, Article 4513, Revised Statutes, is
4-13 amended to read as follows:
4-14 Sec. 1. Composition of Board; Programs of Study. The Board
4-15 of Nurse Examiners is composed of nine members appointed by the
4-16 governor with the advice and consent of the senate. Appointments
4-17 to the board shall be made without regard to the race, color,
4-18 disability, sex, religion, age, or national origin of the
4-19 appointees. The board shall prescribe three programs of study to
4-20 prepare professional nurse practitioners, to wit: (1) The
4-21 Baccalaureate Degree Program--A program leading to a baccalaureate
4-22 degree in nursing conducted by an educational unit in nursing
4-23 (department, division, school, or college) which is a part of a
4-24 senior college or university; (2) The Associate Degree Program--A
4-25 program leading to an associate degree in nursing conducted by an
4-26 educational unit in nursing within the structure of a college or a
4-27 university; and (3) The Diploma Program--A program leading to a
5-1 diploma in nursing conducted by a single purpose school usually
5-2 under the control of a hospital. Six of the board members must be
5-3 Registered Nurses, three of whom shall be engaged in professional
5-4 nurse education [and shall be representative of said three
5-5 programs] in that one shall be a nurse faculty member in a school
5-6 of nursing pursuing the Baccalaureate Degree Program; one shall be
5-7 a nurse faculty member in a school of nursing pursuing the
5-8 Associate Degree Program; and one shall be a nurse faculty member
5-9 in a graduate school of nursing preparing Advanced Practice Nurses
5-10 [pursuing the Diploma Program]. Three members must be members of
5-11 the general public.
5-12 SECTION 3. Article 4519a, Revised Statutes, is amended to
5-13 read as follows:
5-14 Art. 4519a. Declaratory orders of eligibility for license.
5-15 Sec. 1. (a) An individual enrolled or planning to enroll in
5-16 an educational program that prepares an individual for an initial
5-17 license as a registered nurse who has reason to believe that the
5-18 individual is ineligible for the license may petition the board for
5-19 a declaratory order as to the individual's eligibility. The
5-20 petition must state the basis for the individual's potential
5-21 ineligibility. The board shall have the same powers to investigate
5-22 the petition and the individual's eligibility that it has to
5-23 investigate a person applying for a license. The petitioning
5-24 individual or the board may amend the petition at any time before a
5-25 final determination is made to include additional grounds for
5-26 potential ineligibility.
5-27 (b) If the board proposes to find the petitioner ineligible
6-1 for a license, the petitioner is entitled to a hearing before the
6-2 board in accordance with Subsection (a) [(b)], Article 4525,
6-3 Revised Statutes, as amended by Section 8, Chapter 840, Acts of the
6-4 73rd Legislature, 1993. The board's order must set out each basis
6-5 for potential ineligibility and the board's determination as to
6-6 eligibility. In the absence of new evidence known to but not
6-7 disclosed by the petitioner or not reasonably available to the
6-8 board at the time the order is issued, the board's ruling on the
6-9 petition determines the individual's eligibility with respect to
6-10 the basis for potential ineligibility set out in the order.
6-11 Sec. 2. (a) The board may require individuals accepted for
6-12 enrollment or enrolled in an educational program preparing students
6-13 for initial licensure as registered nurses to submit information to
6-14 the board that will permit it to determine whether the individual
6-15 is aware of the conditions that may disqualify the individual from
6-16 licensure as a professional nurse upon graduation and of the
6-17 individual's right to petition the board for a declaratory order of
6-18 eligibility for licensure under Section 1 of this article. In lieu
6-19 of requiring the individual to submit the information, the board
6-20 may require the educational program to collect and submit the
6-21 information on individuals accepted for enrollment or enrolled in
6-22 the program. The information shall be submitted in a form approved
6-23 by the board.
6-24 (b) If the board determines that an individual may not be
6-25 eligible for licensure upon graduation, the board shall notify the
6-26 educational program of its determination.
6-27 SECTION 4. Article 4525, Revised Statutes, is amended by
7-1 adding Subsection (a-1) to read as follows:
7-2 (a-1) Notwithstanding Subsection (a) of this section, a
7-3 person is not entitled to a hearing on a refusal to renew a license
7-4 if the person:
7-5 (1) fails to submit an application for renewal; or
7-6 (2) submits an application that:
7-7 (A) is incomplete;
7-8 (B) shows on its face that the person does not
7-9 meet the requirements for renewal; or
7-10 (C) is not accompanied by the correct fee.
7-11 SECTION 5. This Act takes effect September 1, 1997, except
7-12 that Section 2 takes effect January 31, 1999.
7-13 SECTION 6. The importance of this legislation and the
7-14 crowded condition of the calendars in both houses create an
7-15 emergency and an imperative public necessity that the
7-16 constitutional rule requiring bills to be read on three several
7-17 days in each house be suspended, and this rule is hereby suspended.