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.