HBA-RBT H.B. 224 76(R) BILL ANALYSIS Office of House Bill AnalysisH.B. 224 By: Naishtat Human Services 2/6/1999 Introduced BACKGROUND AND PURPOSE Under federal law, the Department of Human Services (DHS) is required to maintain a Nurse Aide Registry for nurse aides employed in Texas nursing facilities. There are training and examination requirements for a nurse aide to be placed on the registry, but the registry only tracks nurse aides working in nursing facilities. There are 100,000 nurse aides in Texas and only 35,000 work in nursing facilities. H.B. 224 grants DHS the authority to regulate nurse aides working in any type of facility in the long-term care industry. The bill establishes standards of practice, sets fees, and provides for investigation of complaints, continuing education, criminal penalties for violations, and due process standards for disciplinary hearings. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that rulemaking authority is expressly delegated to the Texas Board of Human Services in SECTION 1 (Sections 148.004 and 148.007) of this bill. SECTION BY SECTION ANALYSIS SECTION 1. Amends Subtitle G, Title 2, Health and Safety Code, by adding Chapter 148, as follows: CHAPTER 148. NURSE AIDE CERTIFICATION Sec. 148.001. DEFINITIONS. Defines "board" as the Texas Board of Human Services, "department" as the Texas Department of Human Services, and "nurse aide" as an individual who provides nursing or nursing-related services to residents in a facility regulated by the department who is not licensed or otherwise authorized to practice as a health care professional, is not a registered dietitian, nor a volunteer who provides the services without pay. Sec. 148.002. CERTIFICATE OF REGISTRATION REQUIRED. Prohibits a person from acting as a nurse aide unless the person holds a certificate of registration issued by the department, and is listed in the nurse aide registry. Sec. 148.003. EXEMPTIONS. Provides that this chapter does not apply to a registered nurse licensed by the Board of Nurse Examiners, a student enrolled in an accredited school of nursing or program for the education of registered nurses who is providing services as part of the student's clinical experience, a graduate vocational nurse licensed by the Board of Vocational Nurse Examiners, or a student enrolled in an accredited school of vocational nursing or program for the education of vocational nurses who is providing services as part of the student's clinical experience. Sec. 148.004. RULES; STANDARDS. Requires the board to adopt rules to implement this chapter. Requires the board to adopt standards for the performance of personal care services by a nurse aide. Provides that the standards must meet any requirements for nurse aides adopted under 42 U.S.C. Section 1395i-3 (Requirements for, and Assuring Quality of Care in, Skilled Nursing Facilities). Provides that the standards must include minimum requirements for the issuance, denial, renewal, suspension, emergency suspension, and revocation of a certificate of registration to a nurse aide, curricula to train a nurse aide, minimum standards for the approval of nurse aide training programs and for rescinding approval, the acts and practices that are allowed or prohibited to a holder of a certificate of registration, and minimum standards for on-site supervision of a nurse aide by appropriate licensed personnel. Sec. 148.005. NURSE AIDE TRAINING PROGRAMS. Provides that an application for the approval of a nurse aide training program must be made to the department on a form and under rules prescribed by the board. Requires the department to approve a nurse aide training program that meets the minimum standards adopted under Section 148.004. Authorizes the department to review the approval each year. Sec. 148.006. ISSUANCE AND RENEWAL OF NURSE AIDE CERTIFICATE OF REGISTRATION. Requires an applicant for a nurse aide certificate of registration or renewal certificate to apply to the department on a form prescribed by the board. Requires the department to prepare and conduct an examination for the issuance of a certificate of registration. Requires the department to require a holder of a certificate of registration to satisfactorily complete an approved continuing education course for renewal of the certificate. Requires the department to issue a certificate of registration or to renew a certificate for an applicant who meets the minimum requirements under Section 148.004, successfully completes the examination or continuing education requirements, and pays a nonrefundable application fee. Provides that a certificate of registration is valid for one year and is not transferable. Sec. 148.007. FEES. Requires the board by rule to adopt fees for filing an application and for the issuance and renewal of a nurse aide certificate of registration. Requires the board to set the fees in amounts reasonable and necessary to administer its functions under this chapter. Sets forth the maximum amount of certain fees. Provides that the fee for a combined certificate application and examination fee may not exceed $25. Provides that the fee for a renewal certificate application fee may not exceed $15. Sec. 148.008. DISCIPLINARY ACTIONS. Authorizes the department to deny, suspend, revoke, or refuse to renew a certificate of registration, suspend a certificate in an emergency, or rescind training program approval for a violation of this chapter or of a rule adopted under this chapter. Provides that except in an emergency suspension under Section 148.009, the procedure for a disciplinary action and its appeal is governed by the department's rules far a formal hearing and by Chapter 2001, Government Code (Administrative Procedure). Sec. 148.009. EMERGENCY SUSPENSION OF NURSE AIDE CERTIFICATE OF REGISTRATION. Requires the board to suspend a certificate of registration if the department has reasonable cause to believe that the conduct of the certificate holder creates an imminent danger to the public health or safety. Provides that an emergency suspension is effective immediately without a hearing on notice to the certificate holder. Requires the department to conduct a hearing to continue, modify, or rescind the emergency suspension if requested to do so in writing by a certificate holder whose license has been suspended. Provides that the hearing must be held within thirty days after the hearing request is received. Provides that the procedure for the hearing and any appeal arising from it are governed by the department's rules for a formal hearing and by Chapter 2001, Government Code (Administrative Procedure). Sec. 148.010. CRIMINAL PENALTY. Provides that a person commits an offense if the person knowingly acts as a nurse aide for compensation in violation of this chapter or a rule adopted under this chapter. Provides that an offense under this chapter is a Class B misdemeanor. SECTION 2. Effective date: Sections 148.002 and 148.010 take effect January 1, 2000. All other sections take effect September 1, 1999. SECTION 3. Emergency clause.