LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE
75th Regular Session
March 13, 1997
TO: Honorable Judith Zaffirini, Chair IN RE: Senate Bill No. 617, Committee Report 1st House, Substituted
Committee on Health & Human Services By: Moncrief
Senate
Austin, Texas
FROM: John Keel, Director
In response to your request for a Fiscal Note on SB617 ( Relating
to the licensure and regulation of nurses, including the development
of certain pilot programs by the Board of Nurse Examiners.)
this office has detemined the following:
Biennial Net Impact to General Revenue Funds by SB617-Committee Report 1st House, Substituted
Implementing the provisions of the bill would result in a net
positive impact of $12,260 to General Revenue Related Funds
through the biennium ending August 31, 1999.
The bill would make no appropriation but could provide the legal
basis for an appropriation of funds to implement the provisions
of the bill.
Fiscal Analysis
The bill would allow the Board of Nurse Examiners to develop
pilot programs to evaluate the effectiveness of mechanisms for
assuring: 1) maintenance of clinical competencies by registered
nurses, including proactive nursing peer review and targeted
continuing education; and 2) that registered nurses understand
laws and rules governing the practice of nursing. Should the
Board develop pilot programs, the bill would require the Board
to consult with an advisory committee of at least 16 individuals
on the development, administration and funding of pilot programs.
Beginning November 1, 1998, the Board shall issue an annual
report on pilot programs developed or approved and the programs'
effectiveness. Upon request, the report shall be mailed to
statewide associations of registered nurses, registered nurse
educators, and employers of nurses. The final report shall be
issued by September 1, 2000.
The bill would change the composition
of the Board of Nurse Examiners by replacing a faculty member
from a diploma program with a faculty member from a graduate
nursing program preparing Advanced Practice Nurses.
The
bill would allow the Board to require: 1) individuals accepted
into or enrolled in education programs preparing students for
initial licensure as registered nurses; or 2) these educational
programs; to collect and submit information to the Board that
would allow the Board to determine whether students are aware
of any conditions that would disqualify the student from licensure
as a professional nurse upon graduation. The Board must notify
the educational institution of individuals whom the Board has
determined may not be eligible for licensure upon graduation.
The
bill would exempt from the hearing process, individuals whose
license was not renewed by the board and who failed to submit
an application for renewal, or who submitted an incomplete application,
an application showing "on its face" that the individual does
not meet the renewal requirements, or an application not accompanied
by the correct fee.
Methodolgy
It is assumed that fiscal implications would result only from
the pilot projects.
The Board would hire a nursing consultant
at $45,420 per year for FY 1998-2000 to facilitate and monitor
the pilots and programs.
I. Methodology for Competencies
Pilots:
The methodology assumes that the Board or its designated
agent will use a contractor to measure and evaluate the continued
nursing competencies pilots. The estimated cost of $25,000 is
spread out over three years.
The Board would contract with
a maximum of 10 employers of registered nurses, schools, hospitals,
nurses in private practice or other entities in practice settings
to participate in the program. Grant amounts of $100 per registered
nurse in the pilot would be given to these entities for costs
incurred in the evaluation of RN competency. The total estimated
cost is $100,000. Grants would be made in FY 1999.
Pilots
would last for 12 months with 3 to 6 months of follow-up evaluation
in FY 2000.
II. Methodology for Legal and Regulatory Pilots:
The
Board would contract out for:
A) a legal review of state and
federal laws to be included in curriculum;
B) the development
of a review curriculum;
C) development and validation of a
jurisprudence examination.
Estimated cost for review and curriculum
development is $32,000 over three years. Estimated costs for
examination development and validation is $75,000 ($50,000 in
1999 and $25,000 in 2000).
III. Advisory Committee Costs
Advisory
committee costs would be limited to $500 per year for committee
support for postage, mailing and miscellaneous expenses, for
FY 1998-FY 2000, for a total of $1,500.
To cover costs of
the pilot programs, the Board would increase fees by $2 for
FY 1998 and FY 1999. The Board would adjust fees downward by
$1 in FY 2000, and by another $1 in 2001.
The probable fiscal implications of implementing the provisions
of the bill during each of the first five years following passage
is estimated as follows:
Five Year Impact:
Fiscal Year Probable Probable Revenue Change in Number
Savings/(Cost) Gain/(Loss) from of State
from General General Revenue Employees from
Revenue Fund Fund FY 1997
0001 0001
1998 ($93,370) $166,000 1.0
1998 (234,370) 174,000 1.0
2000 (95,370) 98,000 1.0
2001
2002
Net Impact on General Revenue Related Funds:
Fiscal Year Probable Net Postive/(Negative)
General Revenue Related Funds
Funds
1998 $72,630
1999 (60,370)
2000 2,630
2001 0
2002 0
No significant fiscal implication to units of local government
is anticipated.
The bill would allow the Board of Nurse Examiners
to require that educational programs collect and submit information
to the Board that will permit the Board to determine whether
enrollees or individuals accepted for enrollment are aware of
conditions that may disqualify individuals from qualifying for
licensure upon graduation. This may require additional administrative
activities for educational programs. These activities should
be absorbed by existing resources, and should not have significant
fiscal impact to local units of government.
Source: Agencies: 507 Board of Nurse Examiners
LBB Staff: JK ,BB ,MM