By: Moncrief S.B. No. 617
97S0414/1
A BILL TO BE ENTITLED
AN ACT
1-1 relating to the licensure and regulation of nurses, including the
1-2 development of certain pilot programs by the Board of Nurse
1-3 Examiners.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Article 4518, Revised Statutes, is amended by
1-6 adding Section 8 to read as follows:
1-7 Sec. 8. (a) In this section:
1-8 (1) "Pilot program" means a pilot program developed or
1-9 approved under this section.
1-10 (2) "Proactive nursing peer review" means peer review
1-11 that is not initiated for the purpose of determining culpability
1-12 with respect to a particular incident.
1-13 (3) "Targeted continuing nursing education" means
1-14 continuing education focusing on a competency identified as one
1-15 that a significant portion of registered nurses in a particular
1-16 practice area would likely benefit from taking.
1-17 (b) The Board may develop pilot programs to evaluate the
1-18 effectiveness of mechanisms for assuring: (1) maintenance of
1-19 clinical competency by registered nurses in their area of practice,
1-20 including the use of proactive nursing peer review and targeted
1-21 continuing nursing education; and (2) that registered nurses
1-22 understand the laws and regulations governing the practice of
1-23 professional nursing. The pilot programs shall be designed to test
2-1 the effectiveness of a variety of mechanisms in a variety of
2-2 practice settings. The Board may approve pilot programs to be
2-3 conducted by persons other than the Board.
2-4 (c) Subject to appropriations by the legislature, the Board
2-5 may expend funds to develop or fund pilot programs. The Board may
2-6 contract with, make grants to, or make other arrangements with an
2-7 agency, professional association, institution, individual, or other
2-8 person to implement this section.
2-9 (d) In developing, administering, approving, and funding
2-10 pilot programs, the Board shall consult with an advisory committee
2-11 consisting of:
2-12 (1) one representative each from the Texas Nurses
2-13 Association, Texas Nurses Foundation, Texas League for Nursing,
2-14 Texas Chapter of the American Association of Nurse Attorneys, Texas
2-15 Organization of Baccalaureate and Graduate Nursing Educators, Texas
2-16 Organization for Associate Degree Nursing, and Texas Organization
2-17 of Nurse Executives;
2-18 (2) one registered nurse representative each from the
2-19 Texas Hospital Association, Texas Health Care Association, Texas
2-20 Association of Homes and Services for the Aging, and Texas
2-21 Association for Home Care;
2-22 (3) one representative each from the American
2-23 Association of Retired Persons and Consumers Union;
2-24 (4) one representative each from the Texas Department
2-25 of Health and the Texas Department of Human Services who is
3-1 familiar with the facility or agency compliance survey process;
3-2 (5) one representative from the Texas Department of
3-3 Mental Health and Mental Retardation; and
3-4 (6) other persons appointed by the Board.
3-5 (e) Except as provided in this subsection, the Board, in
3-6 developing or approving a pilot program, may exempt the program
3-7 from rules adopted under this chapter. Provisions of this chapter
3-8 relating to mandatory reporting and peer review shall apply to
3-9 pilot programs except that Section 1A, Article 4525b, Revised
3-10 Statutes, shall not apply to programs utilizing proactive peer
3-11 review. The Board may establish alternate criteria for nursing
3-12 peer review committees conducting proactive peer review.
3-13 (f) Beginning November 1, 1998, the Board shall issue an
3-14 annual report of any pilot programs developed or approved and a
3-15 status report on those programs including any preliminary or final
3-16 findings concerning their effectiveness. The report shall be
3-17 mailed to statewide associations of registered nurses, registered
3-18 nurse educators, and employers of registered nurses that have
3-19 requested a copy. A final report shall be issued by the Board not
3-20 later than June 1, 2000.
3-21 SECTION 2. Section 1, Article 4513, Revised Statutes, is
3-22 amended to read as follows:
3-23 Sec. 1. Composition of Board; Programs of Study. The Board
3-24 of Nurse Examiners is composed of nine members appointed by the
3-25 governor with the advice and consent of the senate. Appointments
4-1 to the board shall be made without regard to the race, color,
4-2 disability, sex, religion, age, or national origin of the
4-3 appointees. The board shall prescribe three programs of study to
4-4 prepare professional nurse practitioners, to wit: (1) The
4-5 Baccalaureate Degree Program--A program leading to a baccalaureate
4-6 degree in nursing conducted by an educational unit in nursing
4-7 (department, division, school, or college) which is a part of a
4-8 senior college or university; (2) The Associate Degree Program--A
4-9 program leading to an associate degree in nursing conducted by an
4-10 educational unit in nursing within the structure of a college or a
4-11 university; and (3) The Diploma Program--A program leading to a
4-12 diploma in nursing conducted by a single purpose school usually
4-13 under the control of a hospital. Six of the board members must be
4-14 Registered Nurses, three of whom shall be engaged in professional
4-15 nurse education and shall be representative of said three programs
4-16 in that one shall be a nurse faculty member in a school of nursing
4-17 pursuing the Baccalaureate Degree Program; one shall be a nurse
4-18 faculty member in a school of nursing pursuing the Associate Degree
4-19 Program; and one shall be a nurse faculty member in a graduate
4-20 school of nursing preparing Advanced Practice Nurses [pursuing the
4-21 Diploma Program]. Three members must be members of the general
4-22 public.
4-23 SECTION 3. Article 4519a, Revised Statutes, is amended to
4-24 read as follows:
4-25 Art. 4519a. Declaratory orders of eligibility for license.
5-1 Sec. 1. (a) An individual enrolled or planning to enroll in
5-2 an educational program that prepares an individual for an initial
5-3 license as a registered nurse who has reason to believe that the
5-4 individual is ineligible for the license may petition the board for
5-5 a declaratory order as to the individual's eligibility. The
5-6 petition must state the basis for the individual's potential
5-7 ineligibility. The board shall have the same powers to investigate
5-8 the petition and the individual's eligibility that it has to
5-9 investigate a person applying for a license. The petitioning
5-10 individual or the board may amend the petition at any time before a
5-11 final determination is made to include additional grounds for
5-12 potential ineligibility.
5-13 (b) If the board proposes to find the petitioner ineligible
5-14 for a license, the petitioner is entitled to a hearing before the
5-15 board in accordance with Subsection (a) [(b)], Article 4525,
5-16 Revised Statutes, as amended by Section 8, Chapter 840, Acts of the
5-17 73rd Legislature, 1993. The board's order must set out each basis
5-18 for potential ineligibility and the board's determination as to
5-19 eligibility. In the absence of new evidence known to but not
5-20 disclosed by the petitioner or not reasonably available to the
5-21 board at the time the order is issued, the board's ruling on the
5-22 petition determines the individual's eligibility with respect to
5-23 the basis for potential ineligibility set out in the order.
5-24 Sec. 2. (a) The board may require individuals accepted for
5-25 enrollment or enrolled in an education program preparing students
6-1 for initial licensure as registered nurses to submit information to
6-2 the board that will permit it to determine whether the individual
6-3 is aware of the conditions that may disqualify the individual from
6-4 licensure as a professional nurse upon graduation and of the
6-5 individual's right to petition the board for a declaratory order of
6-6 eligibility for licensure under Section 1 of this article. In lieu
6-7 of requiring the individual to submit the information, the board
6-8 may require the educational program to collect and submit the
6-9 information on individuals accepted for enrollment or enrolled in
6-10 the program. The information shall be submitted in a form approved
6-11 by the board.
6-12 (b) If the board determines that an individual may not be
6-13 eligible for licensure upon graduation, the board shall notify the
6-14 educational program of its determination and that the individual
6-15 will need to resolve the issue of eligibility for licensure not
6-16 later than the end of the term or semester immediately following
6-17 the current term. The school shall not enroll the student beyond
6-18 the term or semester immediately following the current term or
6-19 semester without the board's written approval.
6-20 SECTION 4. Subsection (a), Article 4525, Revised Statutes,
6-21 as amended by Section 8, Chapter 840, Acts of the 73rd Legislature,
6-22 1993, is amended to read as follows:
6-23 (a) The board may refuse to admit persons to the licensing
6-24 examination, to issue or renew a license, or to issue a temporary
6-25 permit for any of the reasons for which the board may take
7-1 disciplinary action against a registered nurse under Subsection (b)
7-2 of this article. If the board proposes to refuse to admit a person
7-3 to the examination, to issue or renew a license, or to issue a
7-4 temporary permit, the board shall notify the person of the basis
7-5 for its decision. Except as provided in this subsection, a [A]
7-6 person who is refused admittance to the examination or the renewal
7-7 or issuance of a license or temporary permit is entitled to a
7-8 hearing before an administrative law judge of the State Office of
7-9 Administrative Hearings. A person is not entitled to a hearing on
7-10 a refusal to renew a license if the person: (1) fails to submit an
7-11 application for renewal; or (2) submits an application that is
7-12 incomplete, shows on its face that the person does not meet the
7-13 requirements for renewal, or is not accompanied by the correct fee.
7-14 SECTION 5. This Act takes effect September 1, 1997, except
7-15 that Section 2 takes effect January 31, 1999.
7-16 SECTION 6. The importance of this legislation and the
7-17 crowded condition of the calendars in both houses create an
7-18 emergency and an imperative public necessity that the
7-19 constitutional rule requiring bills to be read on three several
7-20 days in each house be suspended, and this rule is hereby suspended.