1-1     By:  Maxey, et al. (Senate Sponsor - Moncrief)        H.B. No. 1342
 1-2           (In the Senate - Received from the House March 29, 1999;
 1-3     March 30, 1999, read first time and referred to Committee on Health
 1-4     Services; April 29, 1999, reported favorably, as amended, by the
 1-5     following vote:  Yeas 5, Nays 0; April 29, 1999, sent to printer.)
 1-6     COMMITTEE AMENDMENT NO. 1                             By:  Moncrief
 1-7     Amend H.B. 1342 as follows:
 1-8           1.  Amend Section 1 by adding (on page 7 between lines 54 and
 1-9     55) Secs. 8 and 9 to Article 4528b to read as follows and
1-10     renumbering remaining sections accordingly.
1-11           Sec. 8.  In reporting information to the Coordinated
1-12     Licensure Information System under Article 7 of the Nurse Licensure
1-13     Compact, the Board of Nurse Examiners and the Board of Vocational
1-14     Nurse Examiners may disclose personally identifiable information
1-15     about the nurse including social security number.  The Coordinated
1-16     Licensure Information System may not share personally identifying
1-17     information with a state not a party to the compact unless the
1-18     state agrees not to disclose that information to other persons.
1-19           Sec. 9.  (a)  The Governor may withdraw this state from the
1-20     Nurse Licensure Compact if the Board of Nurse Examiners or the
1-21     Board of Vocational Nurse Examiners notifies the governor that a
1-22     state that is party to the compact changed, after January 1, 1999,
1-23     the state's requirements for licensing a nurse and that the state's
1-24     requirements, as changed, are substantially lower than the
1-25     requirements for licensing a nurse in this state.
1-26           (b)  The governor may completely withdraw this state from the
1-27     Nurse Licensure Compact or may limit withdrawal to the application
1-28     of the compact to registered nurses or licensed vocational nurses.
1-29           2.  Add SECTION 8 to read as follows and renumber remaining
1-30     SECTIONS accordingly:
1-31           SECTION 8.  Section 12, Chapter 118, Acts of the 52nd
1-32     Legislature, Regular Session, 1951 (Article 4528c, Vernon's Texas
1-33     Civil Statutes), is amended to read as follows:
1-34           Sec. 12.  Approval of Vocational Nursing Programs.  (a)  Any
1-35     hospital in regular use for patients which has a registered nurse
1-36     in charge of nursing, and whose staff consists of one or more
1-37     licensed physicians licensed by the State Board of Medical
1-38     Examiners, may qualify as an approved hospital for Vocational Nurse
1-39     Education, provided it can and will meet requirements of the Board
1-40     for the education of Vocational Nurses.
1-41           (b)  Any institution which shall be qualified under Section
1-42     5, and under regulations promulgated by the Board to conduct a
1-43     course in Vocational Nursing shall apply to the Board and shall
1-44     accompany said application with evidence that it is prepared to
1-45     give a course [of not less than twelve (12) months] approved by the
1-46     Board for the education of Vocational Nurses; such application
1-47     shall be accompanied by the appropriate fee provided for in Section
1-48     9 of this Act; upon receipt of such application the Board shall
1-49     cause a survey of the institution making such application to be
1-50     made by a qualified representative of such Board.  If in the
1-51     opinion of a majority of the members of the Board, the requirements
1-52     for an approved course for Vocational Nursing are met by such
1-53     institution, such institution shall be placed on a list of such
1-54     institutions given for educating Vocational Nurses.  It shall
1-55     further be the duty of the Board, from time to time, to survey all
1-56     courses for such education of Vocational Nurses offered within the
1-57     State.  Written reports of such surveys shall be submitted to the
1-58     Board.  If the Board shall determine as a result of such surveys
1-59     that any school, hospital or institution heretofore approved as an
1-60     institution of Vocational Nursing is not maintaining the standards
1-61     required by law and by the rules and regulations promulgated by the
1-62     Board, notice thereof shall immediately be given to such school,
1-63     hospital or institution.  If the requirements of the Board are not
1-64     complied with within a reasonable time set by the Board in such
1-65     notices, such institution shall be removed from the list of
 2-1     approved schools, hospitals or institutions offering courses for
 2-2     Vocational Nurses in this State.
 2-3                            A BILL TO BE ENTITLED
 2-4                                   AN ACT
 2-5     relating to the practice of registered nurses and licensed
 2-6     vocational nurses, including the adoption of an interstate compact
 2-7     relating to licensing.
 2-8           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 2-9           SECTION 1.  Chapter 7, Title 71, Revised Statutes, is amended
2-10     by adding Article 4528b to read as follows:
2-11           Art. 4528b.  NURSE LICENSURE COMPACT
2-12           Sec. 1.  The Nurse Licensure Compact is enacted and entered
2-13     into with all other jurisdictions that legally join in the compact,
2-14     which is as follows:
2-15                           NURSE LICENSURE COMPACT
2-16           ARTICLE 1.  FINDINGS AND DECLARATION OF PURPOSE.  (a)  The
2-17     party states find that:
2-18                 (1)  the health and safety of the public are affected
2-19     by the degree of compliance with and the effectiveness of
2-20     enforcement activities related to state nurse licensing laws;
2-21                 (2)  violations of nurse licensing and other laws
2-22     regulating the practice of nursing may result in injury or harm to
2-23     the public;
2-24                 (3)  the expanded mobility of nurses and the use of
2-25     advanced communication technologies as part of our nation's health
2-26     care delivery system require greater coordination and cooperation
2-27     among states in the areas of nurse licensing and regulation;
2-28                 (4)  new practice modalities and technology make
2-29     compliance with each state nurse licensing laws difficult and
2-30     complex; and
2-31                 (5)  the current system of the duplicative licensing of
2-32     nurses practicing in multiple states is cumbersome and redundant to
2-33     both nurses and the states.
2-34           (b)  The general purposes of this compact are to:
2-35                 (1)  facilitate the states' responsibilities to protect
2-36     the public's health and safety;
2-37                 (2)  ensure and encourage the cooperation of party
2-38     states in the areas of nurse licensing and regulation;
2-39                 (3)  facilitate the exchange of information between
2-40     party states in the areas of nurse regulation, investigation, and
2-41     adverse action;
2-42                 (4)  promote compliance with the laws governing the
2-43     practice of nursing in each jurisdiction; and
2-44                 (5)  invest all party states with the authority to hold
2-45     a nurse accountable for meeting all state practice laws in the
2-46     state in which the patient is located at the time care is provided
2-47     through the mutual recognition of party state licenses.
2-48           ARTICLE 2.  DEFINITIONS.  In this compact:
2-49                 (a)  "Adverse action" means a home or remote state
2-50     action.
2-51                 (b)  "Alternative program" means a voluntary,
2-52     nondisciplinary monitoring program approved by a nurse licensing
2-53     board.
2-54                 (c)  "Coordinated licensure information system" means
2-55     an integrated process for collecting, storing, and sharing
2-56     information on nurse licensing and enforcement activities related
2-57     to nurse licensing laws, which is administered by a nonprofit
2-58     organization composed of and controlled by state nurse licensing
2-59     boards.
2-60                 (d)  "Current significant investigative information"
2-61     means:
2-62                       (1)  investigative information that a licensing
2-63     board, after a preliminary inquiry that includes notification and
2-64     an opportunity for the nurse to respond if required by state law,
2-65     has reason to believe is not groundless and, if  proved true, would
2-66     indicate more than a minor infraction; or
2-67                       (2)  investigative information that indicates
 3-1     that a nurse represents an immediate threat to public health and
 3-2     safety regardless of whether the nurse has been notified and had an
 3-3     opportunity to respond.
 3-4                 (e)  "Home state" means the party state that is the
 3-5     nurse's primary state of residence.
 3-6                 (f)  "Home state action" means any administrative,
 3-7     civil, equitable, or criminal action permitted by the home state's
 3-8     laws that are imposed on a nurse by the home state's licensing
 3-9     board or other authority, including actions against an individual's
3-10     license such as revocation, suspension, probation, or any other
3-11     action that affects a nurse's authorization to practice.
3-12                 (g)  "Licensing board" means a party state's regulatory
3-13     body responsible for issuing nurse licenses.
3-14                 (h)  "Multistate licensing privilege" means current,
3-15     official authority from a remote state permitting the practice of
3-16     nursing as a registered nurse, licensed practical nurse, or
3-17     licensed vocational nurse in the party state. All party states have
3-18     the authority, in accordance with existing state due process laws,
3-19     to take actions against the nurse's privilege, including
3-20     revocation, suspension, probation, or any other action that affects
3-21     a nurse's authorization to practice.
3-22                 (i)  "Nurse" means a registered nurse, licensed
3-23     practical nurse, or licensed vocational nurse as those terms are
3-24     defined by each party state's practice laws.
3-25                 (j)  "Party state" means any state that has enacted
3-26     this compact.
3-27                 (k)  "Remote state" means a party state, other than the
3-28     home state, in which:
3-29                       (1)  a patient is located at the time nursing
3-30     care is provided; or
3-31                       (2)  in the case of the practice of nursing not
3-32     involving a patient, the recipient of nursing practice is located.
3-33                 (l)  "Remote state action" means:
3-34                       (1)  an administrative, civil, equitable, or
3-35     criminal action permitted by a remote state's laws that are imposed
3-36     on a nurse by the remote state's licensing board or other
3-37     authority, including an action against an individual's multistate
3-38     licensing privilege to practice in the remote state; and
3-39                       (2)  a cease and desist order and other
3-40     injunctive or equitable orders issued by remote states or the
3-41     licensing boards of remote states.
3-42                 (m)  "State" means a state, territory, possession of
3-43     the United States, the District of Columbia, or the Commonwealth of
3-44     Puerto Rico.
3-45                 (n)  "State practice laws" means a party state's laws
3-46     and regulations that govern the practice of nursing, define the
3-47     scope of nursing practice, and create the methods and grounds for
3-48     imposing discipline. The term does not include the initial
3-49     qualifications for licensing or requirements necessary to obtain
3-50     and retain a license, except for qualifications or requirements of
3-51     the home state.
3-52           ARTICLE 3.  GENERAL PROVISIONS AND JURISDICTION.  (a)  A
3-53     license to practice registered nursing issued by a home state to a
3-54     resident in that state will be recognized by each party state as
3-55     authorizing a multistate licensing privilege to practice as a
3-56     registered nurse in the party state. A license to practice licensed
3-57     practical nursing or licensed vocational nursing issued by a home
3-58     state to a resident in that state will be recognized by each party
3-59     state as authorizing a multistate licensing privilege to practice
3-60     as a licensed practical nurse or vocational nurse in the party
3-61     state. To obtain or retain a license, an applicant must meet the
3-62     home state's qualifications for a license and license renewal as
3-63     well as all other applicable state laws.
3-64           (b)  A party state may, in accordance with state due process
3-65     laws, limit or revoke the multistate licensing privilege of any
3-66     nurse to practice in the party state and may take any other
3-67     necessary actions under the party state's applicable laws to
3-68     protect the health and safety of the party state's citizens. If a
3-69     party state takes this action, the party state shall promptly
 4-1     notify the administrator of the coordinated licensure information
 4-2     system. The administrator of the coordinated licensure information
 4-3     system shall promptly notify the home state of any such actions by
 4-4     remote states.
 4-5           (c)  A nurse practicing in a party state must comply with the
 4-6     state practice laws of the state in which the patient is located at
 4-7     the time care is provided.  The practice of nursing includes
 4-8     patient care and all nursing practice defined by the party state's
 4-9     practice laws. The practice of nursing will subject a nurse to the
4-10     jurisdiction of the nurse licensing board, the courts, and the laws
4-11     of the party state.
4-12           (d)  This compact does not affect additional requirements
4-13     imposed by states for advanced practice registered nursing.
4-14     However, a multistate licensing privilege to practice registered
4-15     nursing granted by a party state shall be recognized by another
4-16     party state as a license to practice registered nursing if the
4-17     state's law requires the license as a precondition for qualifying
4-18     for advanced practice registered nurse authorization.
4-19           (e)  Individuals not residing in a party state may apply for
4-20     a nurse license under the laws of a party state. However, the
4-21     license granted to these individuals will not be recognized as
4-22     granting the privilege to practice nursing in any other party state
4-23     unless explicitly agreed to by that party state.
4-24           ARTICLE 4.  APPLICATION FOR LICENSE IN A PARTY STATE.  (a)
4-25     Once an application for a license is submitted, the licensing board
4-26     in a party state shall ascertain, through the coordinated licensure
4-27     information system, whether:
4-28                 (1)  the applicant has held or is the holder of a
4-29     license issued by another state;
4-30                 (2)  a restriction exists on the multistate licensing
4-31     privilege; and
4-32                 (3)  any other adverse action by any state has been
4-33     taken against the license.
4-34           (b)  A nurse in a party state shall hold a license that is
4-35     issued by the home state in only one party state at a time.
4-36           (c)  A nurse who intends to change the nurse's primary state
4-37     of residence may apply for a license in the new home state in
4-38     advance of the change. However, a new license will not be issued by
4-39     a party state until a nurse provides satisfactory evidence to the
4-40     new home state's licensing board of a change in the nurse's primary
4-41     state of residence.
4-42           (d)  When a nurse changes the nurse's primary state of
4-43     residence by moving from:
4-44                 (1)  a party state to another party state and obtains a
4-45     license from the new home state, the license from the former home
4-46     state is no longer valid;
4-47                 (2)  a non-party state to a party state and obtains a
4-48     license from the new home state, the individual state license
4-49     issued by the non-party state is not affected and remains in full
4-50     force if provided by the laws of the non-party state; and
4-51                 (3)  a party state to a non-party state, the license
4-52     issued by the prior home state converts to a state license valid
4-53     only in the former home state and does not entitle the nurse to the
4-54     multistate licensing privilege to practice in other party states.
4-55           ARTICLE 5.  ADVERSE ACTIONS.  (a)  The licensing board of a
4-56     remote state shall promptly report to the administrator of the
4-57     coordinated licensure information system a remote state action and
4-58     the factual and legal basis for the action, if known. The licensing
4-59     board of a remote state shall promptly report any significant
4-60     current investigative information yet to result in a remote state
4-61     action.  The administrator of the coordinated licensure information
4-62     system shall promptly notify the home state of these reports.
4-63           (b)  The licensing board of a party state shall have the
4-64     authority to complete a pending investigation of a nurse who
4-65     changes the nurse's primary state of residence during the course of
4-66     the investigation and to take appropriate action.  The licensing
4-67     board shall promptly report the conclusions of the investigations
4-68     to the administrator of the coordinated licensure information
4-69     system. The administrator of the coordinated licensure information
 5-1     system shall promptly notify the new home state of any action.
 5-2           (c)  A remote state may take adverse action affecting the
 5-3     multistate licensing privilege to practice in that party state.
 5-4     However, only the home state has the power to impose adverse action
 5-5     against the license issued by the home state.
 5-6           (d)  For purposes of imposing adverse action, the licensing
 5-7     board of the home state shall give the same priority and effect to
 5-8     reported conduct received from a remote state as it would to
 5-9     conduct occurring in the home state. In so doing, the licensing
5-10     board shall apply its state laws to determine appropriate action.
5-11           (e)  The home state may take adverse action based on the
5-12     factual findings of the remote state only if each state follows its
5-13     own procedures for imposing the adverse action.
5-14           (f)  This compact does not affect a party state's decision
5-15     that participation in an alternative program may be used instead of
5-16     licensing action and that the participation shall remain non-public
5-17     if required by the party state's laws. Party states must require a
5-18     nurse who enters an alternative program to agree not to practice in
5-19     any other party state during the term of the alternative program
5-20     without prior authorization from the other party state.
5-21           ARTICLE 6.  ADDITIONAL AUTHORITIES OF PARTY STATE NURSE
5-22     LICENSING BOARDS.  (a)  Notwithstanding any other powers, party
5-23     state nurse licensing boards have the authority to:
5-24                 (1)  if otherwise permitted by state law, recover from
5-25     the affected nurse the costs of investigations and disposition of
5-26     cases resulting from any adverse action taken against the nurse;
5-27                 (2)  issue subpoenas for hearings and investigations
5-28     that require the attendance and testimony of witnesses and the
5-29     production of evidence;
5-30                 (3)  issue a cease and desist order to limit or revoke
5-31     a nurse's authority to practice in the state; and
5-32                 (4)  adopt uniform rules as provided under Article 8(c)
5-33     of this compact.
5-34           (b)  A subpoena issued by a nurse licensing board in a party
5-35     state for the attendance and testimony of witnesses or the
5-36     production of evidence from another party state shall be enforced
5-37     in the non-issuing party state by a court of competent jurisdiction
5-38     in accordance with the practice and procedure applicable to
5-39     subpoenas issued in proceedings pending before the court.  The
5-40     issuing authority shall pay any witness fees, travel expenses,
5-41     mileage, and other fees required by the service statutes of the
5-42     state in which a witness or evidence is located.
5-43           ARTICLE 7.  COORDINATED LICENSURE INFORMATION SYSTEM.  (a)
5-44     All party states shall participate in a cooperative effort to
5-45     create a coordinated database of all licensed registered nurses,
5-46     licensed practical nurses, and licensed vocational nurses. This
5-47     system will include information on the licensing and disciplinary
5-48     history of each nurse, as contributed by party states, to assist in
5-49     the coordination of nurse licensing and enforcement efforts.
5-50           (b)  Notwithstanding any other provision of law, all party
5-51     states' licensing boards shall promptly report to the coordinated
5-52     licensure information system adverse actions, actions against
5-53     multistate licensing privileges, any current significant
5-54     investigative information yet to result in adverse action, and
5-55     denials of applications and the reasons for the denials.
5-56           (c)  Current significant investigative information shall be
5-57     transmitted only to party state licensing boards through the
5-58     coordinated licensure information system.
5-59           (d)  Notwithstanding any other provision of law, all party
5-60     states' licensing boards that contribute information to the
5-61     coordinated licensure information system may designate information
5-62     that may not be shared with non-party states or disclosed to other
5-63     entities or individuals without the express permission of the
5-64     contributing state.
5-65           (e)  Any personally identifiable information obtained by a
5-66     party state's licensing board from the coordinated licensure
5-67     information system may not be shared with non-party states or
5-68     disclosed to other entities or individuals except to the extent
5-69     permitted by the laws of the party state contributing the
 6-1     information.
 6-2           (f)  Information contributed to the coordinated licensure
 6-3     information system that is subsequently required to be expunged by
 6-4     the laws of the party state contributing that information shall be
 6-5     expunged from the coordinated licensure information system.
 6-6           (g)  Each compact administrator shall act jointly and in
 6-7     consultation with the administrator of the coordinated licensure
 6-8     information system to formulate necessary and proper procedures for
 6-9     the identification, collection, and exchange of information under
6-10     this compact.
6-11           ARTICLE 8.  COMPACT ADMINISTRATION AND EXCHANGE OF
6-12     INFORMATION.  (a)  The presiding officer of the nurse licensing
6-13     board of a party state or the presiding officer's designee shall be
6-14     the administrator of this compact for the state.
6-15           (b)  The compact administrator of each party state shall
6-16     furnish to the compact administrator of each other party state
6-17     information and documents including a uniform data set of
6-18     investigations, identifying information, licensing data, and
6-19     disclosable alternative program participation information to
6-20     facilitate the administration of this compact.
6-21           (c)  Compact administrators have the authority to develop
6-22     uniform rules to facilitate and coordinate implementation of this
6-23     compact. The uniform rules shall be adopted by party states under
6-24     Article 6(a)(4) of this compact.
6-25           ARTICLE 9.  IMMUNITY.  A party state or an officer, employee,
6-26     or agent of a party state's nurse licensing board who acts in
6-27     accordance with the provisions of this compact is not liable for
6-28     any good faith act or omission that occurs  while the person is
6-29     performing the person's duties under this compact. Good faith in
6-30     this article does not include wilful misconduct, gross negligence,
6-31     or recklessness.
6-32           ARTICLE 10.  EFFECTIVE DATE, WITHDRAWAL, AND AMENDMENT.  (a)
6-33     This compact enters into force and takes effect for a state when
6-34     the state enacts this compact as law.  A party state may withdraw
6-35     from the compact by enacting a statute repealing the compact, but a
6-36     withdrawal takes effect six months after the date the withdrawing
6-37     state gives notice of the withdrawal to the executive heads of all
6-38     other party states.
6-39           (b)  No withdrawal shall affect the validity or applicability
6-40     by the licensing boards of states remaining party to the compact of
6-41     any report of adverse action occurring prior to the withdrawal.
6-42           (c)  This compact does not invalidate or prevent any nurse
6-43     licensing agreement or other cooperative arrangement between a
6-44     party state and a non-party state that is made in accordance with
6-45     the other provisions of this compact.
6-46           (d)  This compact may be amended by the party states. An
6-47     amendment to this compact is not effective or binding on the party
6-48     states unless and until all party states enact the amendment into
6-49     the law of each state.
6-50           ARTICLE 11.  CONSTRUCTION AND SEVERABILITY.  (a)  This
6-51     compact shall be liberally construed to effectuate the compact's
6-52     purposes.
6-53           (b)  This compact is severable.  If a phrase, clause,
6-54     sentence, or provision of this compact is declared to be contrary
6-55     to the constitution of a party state or the United States or the
6-56     applicability of this compact to a government, agency, person, or
6-57     circumstance is held invalid, the validity and applicability of the
6-58     remainder of the compact to a government, agency, person, or
6-59     circumstance is not affected. If this compact is held to be
6-60     contrary to the constitution of a party state, the compact remains
6-61     in full force and effect for the other party states and in full
6-62     force and effect for the party state affected for all severable
6-63     matters.
6-64           (c)  If the party states need to settle a dispute under the
6-65     compact the party states may submit the issues in dispute to an
6-66     arbitration panel comprised of:
6-67                 (A)  an individual appointed by the compact
6-68     administrator in the home state;
6-69                 (B)  an individual appointed by the compact
 7-1     administrator in each remote state involved; and
 7-2                 (C)  an individual mutually agreed upon by the compact
 7-3     administrators of each party state involved in the dispute.
 7-4           (d)  The decision of a majority of the arbitrators shall be
 7-5     final and binding.
 7-6           Sec. 2.  The executive directors of the Board of Nurse
 7-7     Examiners and the Board of Vocational Nurse Examiners are the nurse
 7-8     licensure compact administrators for this state.  The executive
 7-9     director of the Board of Nurse Examiners is responsible for
7-10     administering matters relating to registered nurses.  The executive
7-11     director of the Board of Vocational Nurse Examiners is responsible
7-12     for administering matters relating to licensed vocational nurses.
7-13           Sec. 3.  The Board of Nurse Examiners and the Board of
7-14     Vocational Nurse Examiners may adopt rules necessary to implement
7-15     this article.
7-16           Sec. 4.  The terms "nurse," "registered nurse," and
7-17     "vocational nurse" include nurses licensed as registered nurses or
7-18     vocational nurses by a state that is a party to the Nurse Licensure
7-19     Compact.  Unless the context indicates otherwise or doing so would
7-20     be inconsistent with the Nurse Licensure Compact, nurses practicing
7-21     in this state under a license issued by a state that is a party to
7-22     the Nurse Licensure Compact have the same rights and obligations as
7-23     imposed by the laws of this state on license holders of the Board
7-24     of Nurse Examiners or the Board of Vocational Nurse Examiners.  The
7-25     Board of Nurse Examiners and the Board of Vocational Nurse
7-26     Examiners have the authority to determine whether a right or
7-27     obligation imposed on license holders applies to nurses practicing
7-28     in this state under a license issued by a state that is a party to
7-29     the Nurse Licensure Compact unless that determination is
7-30     inconsistent with the Nurse Licensure Compact.
7-31           Sec. 5.  The Board of Nurse Examiners and the Board of
7-32     Vocational Nurse Examiners are the state agencies responsible for
7-33     taking action against registered and vocational nurses practicing
7-34     in this state under a license issued by a state that is a party to
7-35     the Nurse Licensure Compact as authorized by the Nurse Licensure
7-36     Compact.  The action shall be taken in accordance with the same
7-37     procedures for taking action against registered and vocational
7-38     nurses licensed by this state.
7-39           Sec. 6.  On request and payment of a reasonable fee, the
7-40     Board of Nurse Examiners and the Board of Vocational Nurse
7-41     Examiners shall provide a registered or vocational nurse licensed
7-42     by this state with a copy of information regarding the nurse
7-43     maintained by the Coordinated Licensure Information System under
7-44     Article 7 of the Nurse Licensure Compact.  A board is not obligated
7-45     to provide information not available to the board or information
7-46     that is not available to the nurse under the laws of the state
7-47     contributing the information to the Coordinated Licensure
7-48     Information System.
7-49           Sec. 7.  Practice-related information provided by the Board
7-50     of Nurse Examiners or the Board of Vocational Nurse Examiners to
7-51     registered or vocational nurses licensed by this state shall be
7-52     made available by the boards on request and at a reasonable cost to
7-53     nurses practicing in this state under a license issued by a state
7-54     that is a party to the Nurse Licensure Compact.
7-55           Sec. 8.  The Nurse Licensure Compact expires on December 31,
7-56     2005, unless this section is repealed or the expiration date is
7-57     extended.
7-58           SECTION 2.  Section 4, Article 4518, Revised Statutes, is
7-59     amended to read as follows:
7-60           Sec. 4.  Any person practicing or offering to practice
7-61     professional nursing in this state for compensation, shall
7-62     hereafter be required to submit evidence to the Board that the
7-63     person is qualified to practice and shall be registered as provided
7-64     by this law unless the person is entitled to practice in this state
7-65     under the Nurse Licensure Compact under Article 4528b, Revised
7-66     Statutes.
7-67           SECTION 3.  Section 1, Article 4519a, Revised Statutes, is
7-68     amended to read as follows:
7-69           Sec. 1.  (a)  An individual enrolled or planning to enroll in
 8-1     an educational program that prepares an individual for an initial
 8-2     license as a registered nurse who has reason to believe that the
 8-3     individual is ineligible for the license may petition the board for
 8-4     a declaratory order as to the individual's eligibility.   The
 8-5     petition must state the basis for the individual's potential
 8-6     ineligibility.  The board shall have the same powers to investigate
 8-7     the petition and the individual's eligibility that it has to
 8-8     investigate a person applying for a license.  The petitioning
 8-9     individual or the board may amend the petition at any time before a
8-10     final determination is made to include additional grounds for
8-11     potential ineligibility.
8-12           (b)  If the board finds that a ground for ineligibility does
8-13     not exist, the board, instead of issuing an order, shall notify the
8-14     petitioner in writing listing each ground of potential
8-15     ineligibility and the board's determination.
8-16           (c)  If the board proposes to find the petitioner ineligible
8-17     for a license, the petitioner is entitled to a hearing before the
8-18     board in accordance with Subsection (a), Article 4525, Revised
8-19     Statutes, as amended by Section 8, Chapter 840, Acts of the 73rd
8-20     Legislature, 1993.  The board's order must set out each basis for
8-21     potential ineligibility and the board's determination as to
8-22     eligibility.
8-23           (d)  In the absence of new evidence known to but not
8-24     disclosed by the petitioner or not reasonably available to the
8-25     board at the time the order is issued, the board's ruling on the
8-26     petition determines the individual's eligibility with respect to
8-27     the basis for potential ineligibility set out in the written notice
8-28     or order.
8-29           SECTION 4.  Chapter 7, Title 71, Revised Statutes, is amended
8-30     by adding Article 4525.01 to read as follows:
8-31           Art. 4525.01.  ADDITIONAL GROUNDS FOR DISCIPLINARY ACTION.
8-32     (a)  A person is subject to being refused admission to a licensing
8-33     examination, to denial of a license, or to disciplinary action by
8-34     the board if the person's privilege to practice nursing in another
8-35     jurisdiction is revoked, suspended, denied, or subjected to any
8-36     other disciplinary action.
8-37           (b)  A certified copy of the order of denial, suspension, or
8-38     revocation of the privilege or the other action by the jurisdiction
8-39     is conclusive evidence of that action.
8-40           SECTION 5.  Section 3, Article 4527a, Revised Statutes, is
8-41     amended to read as follows:
8-42           Sec. 3.  (a) No person, unless he or she is licensed under
8-43     this chapter, may practice professional nursing or use in
8-44     connection with his or her name the title "registered nurse,"
8-45     "professional nurse," or "graduate nurse," the abbreviation "R.N.,"
8-46     or any designation tending to imply that he or she is a licensed
8-47     registered nurse.
8-48           (b)  This section does not apply to a person practicing
8-49     professional nursing under the Nurse Licensure Compact under
8-50     Article 4528b, Revised Statutes.
8-51           SECTION 6.  Section 2(a), Chapter 118, Acts of the 52nd
8-52     Legislature, Regular Session, 1951 (Article 4528c, Vernon's Texas
8-53     Civil Statutes), is amended to read as follows:
8-54           (a)  A person may not use the designation Licensed Vocational
8-55     Nurse or the abbreviation L.V.N., unless such person shall hold a
8-56     license issued by the Board pursuant to the provisions of this Act.
8-57     This subsection does not apply to a person practicing vocational
8-58     nursing under the Nurse Licensure Compact under Article 4528b,
8-59     Revised Statutes.
8-60           SECTION 7.  Section 10(a), Chapter 118, Acts of the 52nd
8-61     Legislature, Regular Session, 1951 (Article 4528c, Vernon's Texas
8-62     Civil Statutes), is amended to read as follows:
8-63           (a)  The Board may refuse to admit persons to its
8-64     examinations, may refuse to issue or renew a license, may refuse to
8-65     issue a temporary permit, may issue a warning or reprimand, may
8-66     place on probation a person whose license has been suspended, or
8-67     may suspend or may revoke the license of any practitioner of
8-68     vocational nursing for any of the following reasons:
8-69                 (1)  violation of this Act or of any rule, regulation,
 9-1     or order issued under this Act;
 9-2                 (2)  commission of fraud or deceit in procuring or
 9-3     attempting to procure a license to practice vocational nursing;
 9-4                 (3)  conviction of a crime of the grade of felony or a
 9-5     crime of a lesser grade which involves moral turpitude;
 9-6                 (4)  use of any nursing license, certificate, diploma,
 9-7     or permit or transcript of the license, certificate, diploma, or
 9-8     permit, which has been fraudulently purchased, issued,
 9-9     counterfeited, or materially altered;
9-10                 (5)  impersonation of or the acting as a proxy for
9-11     another in any examination required by law to obtain a license to
9-12     practice vocational nursing;
9-13                 (6)  knowingly aiding or abetting any unlicensed person
9-14     in connection with the unauthorized practice of vocational nursing;
9-15                 (7)  revocation, suspension, or denial of a license to
9-16     practice vocational or practical nursing in another jurisdiction or
9-17     revocation, suspension, or denial of a license or a privilege to
9-18     practice professional nursing in this state or in another
9-19     jurisdiction;  certified copy of the order of denial, suspension,
9-20     or revocation shall be conclusive evidence of that fact;
9-21                 (8)  intemperate use of alcohol or drugs;
9-22                 (9)  unprofessional or dishonorable conduct that, in
9-23     the opinion of the Board, is likely to deceive, defraud, or injure
9-24     the public;
9-25                 (10)  adjudication of mental incompetency; or
9-26                 (11)  lack of fitness to practice by reason of mental
9-27     or physical health that may result in injury to patients or the
9-28     public.
9-29           SECTION 8.  (a)  Not later than January 1, 2000, the Board of
9-30     Nurse Examiners and the Board of Vocational Nurse Examiners shall
9-31     participate in a nurse licensure compact evaluation initiative
9-32     designed to evaluate the effectiveness and operability of the Nurse
9-33     Licensure Compact.
9-34           (b)  The evaluation initiative shall be conducted by a
9-35     qualified researcher.  A component of the evaluation initiative
9-36     shall be a state practice identification system through which
9-37     nurses designate the states in which they practice and that
9-38     provides for updating the information at the time of issuance and
9-39     renewal of licenses.
9-40           (c)  The evaluation initiative shall continue at least
9-41     through June 1, 2004, after which a report shall be produced and
9-42     submitted for comment by the Board of Nurse Examiners and the Board
9-43     of Vocational Nurse Examiners.
9-44           (d)  The report and the boards' comments shall be submitted
9-45     to the legislature not later than October 1, 2004, in the form of a
9-46     Nurse Licensure Compact evaluation report.
9-47           (e)  The boards may accept and spend money made available by
9-48     the federal or state government or by another public or private
9-49     source to fund participation in the evaluation initiative.
9-50           SECTION 9.  (a)  Except as provided by Subsection (b) of this
9-51     section, this Act takes effect January 1, 2000.
9-52           (b)  Article 4528b, Revised Statutes, as added by this Act,
9-53     takes effect January 1, 2000, unless the governor, on the
9-54     recommendation of the Board of Nurse Examiners and the Board of
9-55     Vocational Nurse Examiners, determines a later date would be in the
9-56     best interest of the state.
9-57           SECTION 10.  The importance of this legislation and the
9-58     crowded condition of the calendars in both houses create an
9-59     emergency and an imperative public necessity that the
9-60     constitutional rule requiring bills to be read on three several
9-61     days in each house be suspended, and this rule is hereby suspended.
9-62                                  * * * * *