By:  Moncrief, et al.                                  S.B. No. 572
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to the reduction of the shortage of registered nurses by
 1-3     establishing a program to increase enrollments in nursing education
 1-4     programs, increasing nursing faculty, and creating a nursing
 1-5     workforce data center.
 1-6           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-7           SECTION 1.  This Act may be cited as the Nursing Shortage
 1-8     Reduction Act of 2001.
 1-9           SECTION 2.  (a)  The legislature finds that:
1-10                 (1)  Texas is experiencing a significant shortage in
1-11     the registered nurses it needs;
1-12                 (2)  the health care needs of Texas' growing elderly
1-13     population create a need for more registered nurses;
1-14                 (3)  Texas' registered nurse workforce is aging, and as
1-15     registered nurses retire in increasing numbers, educating more
1-16     registered nurses is critical;
1-17                 (4)  the health care industry plays an important role
1-18     in the Texas economy and an adequate nursing workforce is an
1-19     essential component of the health care industry; and
1-20                 (5)  it is necessary to increase the number of
1-21     registered nurses in the state to protect the health, safety, and
1-22     welfare of the public.
1-23           (b)  It is the purpose of this Act to establish a program to
1-24     increase the ability of professional nursing educational programs
1-25     to prepare the registered nurses Texas needs, to encourage persons
 2-1     to enter the nursing profession or to teach in a nursing program,
 2-2     and to establish a nursing workforce data center to address issues
 2-3     of supply and demand in nursing.
 2-4           SECTION 3.  Chapter 61, Education Code, is amended by adding
 2-5     Subchapter U to read as follows:
 2-6                SUBCHAPTER U.  PROFESSIONAL NURSING SHORTAGE
 2-7                              REDUCTION PROGRAM
 2-8           Sec. 61.921.  DEFINITION.  In this subchapter, "professional
 2-9     nursing program" means an educational program for preparing
2-10     students for initial licensure as registered nurses.
2-11           Sec. 61.922.  PROGRAM.  A professional nursing shortage
2-12     reduction program is established.  The board shall administer the
2-13     professional nursing shortage reduction program to make grants to
2-14     professional nursing programs and other entities involved with a
2-15     professional nursing program in the preparation of students for
2-16     initial licensure as registered nurses in order to increase the
2-17     number and types of registered nurses to meet the needs for
2-18     registered nurses in the state.
2-19           Sec. 61.923.  GRANTS.  (a)  A grant from the professional
2-20     nursing shortage reduction program to a professional nursing
2-21     program or other entity involved with a professional nursing
2-22     program in the preparation of students for initial licensure as
2-23     registered nurses must be:
2-24                 (1)  expended exclusively on costs related to:
2-25                       (A)  enrolling additional students;
2-26                       (B)  assuring the retention of an adequate number
 3-1     of qualified faculty, including providing faculty salaries; or
 3-2                       (C)  encouraging innovation in the recruitment
 3-3     and retention of students;
 3-4                 (2)  contingent on the professional nursing program's
 3-5     having been approved as a professional nursing  program by the
 3-6     board or the Board of Nurse Examiners, as appropriate, by
 3-7     September 1, 2001;
 3-8                 (3)  contingent on the professional nursing program's
 3-9     not being on probation with the Board of Nurse Examiners or other
3-10     accrediting body; and
3-11                 (4)  if granted to increase enrollments, contingent on
3-12     the professional nursing program's ability to enroll additional
3-13     students, including having the necessary classroom space and
3-14     clinical slots.
3-15           (b)  Funds not expended on the costs described by Subsection
3-16     (a)(1) shall be returned to the board.
3-17           Sec. 61.924.  ADMINISTRATION.  The board shall adopt rules
3-18     and regulations for the administration of the professional nursing
3-19     shortage reduction program.  The board shall grant funds under
3-20     Sections 61.923(a)(1)(A) and (B) in an equitable manner among the
3-21     various types of professional nursing programs.  The board shall
3-22     grant funds under Section 61.923(a)(1)(C) in a manner that best
3-23     promotes innovation in the recruitment and retention of nursing
3-24     students.
3-25           Sec. 61.925.  GRANTS, GIFTS, AND DONATIONS.  In addition to
3-26     funds appropriated by the legislature, the board may solicit,
 4-1     receive, and spend grants, gifts, and donations from public or
 4-2     private sources for the purposes of this subchapter.
 4-3           SECTION 4.  Subchapter B, Chapter 54, Education Code, is
 4-4     amended by adding Section 54.069 to read as follows:
 4-5           Sec. 54.069.  REGISTERED NURSES IN POSTGRADUATE NURSING
 4-6     DEGREE PROGRAMS.  An institution of higher education may permit a
 4-7     registered nurse authorized to practice professional nursing in
 4-8     Texas to register by paying the tuition fees and other fees or
 4-9     charges required for Texas residents under Section 54.051, without
4-10     regard to the length of time the registered nurse has resided in
4-11     Texas, if the registered nurse:
4-12                 (1)  is enrolled in a program designed to lead to a
4-13     master's degree or other higher degree in nursing; and
4-14                 (2)  intends to teach in a program in Texas designed to
4-15     prepare students for licensure as registered nurses.
4-16           SECTION 5.  Subdivision (1), Section 61.651, Education Code,
4-17     is amended to read as follows:
4-18                 (1)  "Professional nursing student" means a student
4-19     enrolled in an institution of higher education or a private or
4-20     independent institution of higher education in a course of study
4-21     leading to an initial or an advanced degree in professional
4-22     nursing.
4-23           SECTION 6.  Section 61.653, Education Code, is amended to
4-24     read as follows:
4-25           Sec. 61.653.  [EMPLOYER] MATCHING FUND PROGRAM.  The board
4-26     shall establish and administer, using funds appropriated for that
 5-1     purpose and in accordance with this subchapter and board rules, a
 5-2     matching fund program under which a person [an employer] may
 5-3     sponsor a professional nursing student or a vocational nursing
 5-4     student by contributing to the costs of the student's education and
 5-5     having that contribution matched in whole or in part by state funds
 5-6     appropriated for that purpose.
 5-7           SECTION 7.  Section 61.655, Education Code, is amended to
 5-8     read as follows:
 5-9           Sec. 61.655.  PURPOSE; ELIGIBILITY.  (a)  A scholarship
5-10     program, matching fund program, or loan repayment program
5-11     established under this subchapter shall be established and
5-12     administered in a manner that the board determines best promotes
5-13     the health care and educational needs of this state.
5-14           (b)  The board may establish multiple categories of persons
5-15     to receive scholarships, matching funds, and loan repayments.  The
5-16     board may include faculty from professional nursing programs with
5-17     master's degrees or doctorates among the categories of persons
5-18     authorized to receive loan repayments.
5-19           (c)  Each year funds are available, the board shall establish
5-20     the categories of persons eligible to receive scholarships,
5-21     matching funds, and loan repayments and the criteria for selecting
5-22     persons to be assisted under each category.  The criteria may
5-23     include [In determining what best promotes the health care and
5-24     educational needs of this state, the board shall consider at a
5-25     minimum the following factors relating to each person being
5-26     assisted]:
 6-1                 (1)  [ethnic or racial minority status;]
 6-2                 [(2)]  scholastic ability and performance;
 6-3                 (2) [(3)  geographical area of nursing practice;]
 6-4                 [(4)]  financial need;
 6-5                 (3)  the geographical area in which the person is
 6-6     likely to practice;
 6-7                 (4) [(5)]  whether the person receives Aid to Families
 6-8     with Dependent Children or participates in another public welfare
 6-9     program;
6-10                 (5) [(6)]  employment by a state agency;
6-11                 (6) [(7)]  employment on a nursing school faculty or a
6-12     person's intention to seek employment on a nursing school faculty;
6-13     [and]
6-14                 (7) [(8)]  whether the person [at the time of
6-15     application to participate in the scholarship program, matching
6-16     fund program, or loan repayment program under this subchapter] is
6-17     [a] practicing [nurse] in a geographical area, a practice setting,
6-18     or an area of practice with an acute nursing shortage or is likely
6-19     to practice in such an area;
6-20                 (8)  the type of certificate or academic degree held or
6-21     pursued; or
6-22                 (9)  any additional factors the board considers
6-23     relevant to promoting the health care and educational needs of the
6-24     state.
6-25           SECTION 8.  Subsections (c), (d), and (e), Section 61.656,
6-26     Education Code, are amended to read as follows:
 7-1           (c)  The board shall adopt rules relating to the
 7-2     establishment and administration of the matching fund program under
 7-3     Section 61.653 [of this code], including rules providing:
 7-4                 (1)  eligibility criteria for sponsors [sponsoring
 7-5     employers] and for students;
 7-6                 (2)  the minimum and maximum sponsor [employer]
 7-7     contributions that will be matched;
 7-8                 (3)  conflict resolution procedures for resolving
 7-9     disputes between the sponsor [sponsoring employer] and the student;
7-10     and
7-11                 (4)  a standard agreement for use by the sponsor and
7-12     the student [the form and manner in which the sponsoring employer
7-13     must make its contribution, including whether the contribution will
7-14     be made in a lump-sum payment at the beginning of a semester or
7-15     whether the contribution will be made in several payments over a
7-16     period of time;]
7-17                 [(5)  conditions under which a student may be required
7-18     to repay funds received under the matching fund program because of
7-19     inability to fulfill obligations under the program;]
7-20                 [(6)  conditions under which a sponsoring employer
7-21     would be returned any unexpended portion of the employer's
7-22     contribution;]
7-23                 [(7)  conditions under which the coordinating board
7-24     could cancel an agreement entered into under Subsection (d) of this
7-25     section between the student and the sponsoring employer; and]
7-26                 [(8)  a procedure for the disbursement of funds that
 8-1     provides for participation by a variety of employers consistent
 8-2     with the purposes established under this subchapter].
 8-3           (d)  [A student and the student's sponsoring employer shall
 8-4     enter into a standard agreement as provided by board rules adopted
 8-5     under this subsection.  The board shall adopt rules providing for a
 8-6     standard agreement for use in connection with the matching fund
 8-7     program under Section 61.653 of this code, which agreement must
 8-8     include provisions:]
 8-9                 [(1)  requiring the sponsoring employer to employ the
8-10     student while in school and to provide a work schedule that
8-11     accommodates the student's class schedule;]
8-12                 [(2)  requiring the student to remain in the employ of
8-13     the sponsoring employer for at least one year after graduation;]
8-14                 [(3)  requiring the student to repay funds received if
8-15     the student fails to fulfill his or her responsibilities under the
8-16     matching fund program, except for specified reasons;]
8-17                 [(4)  providing for forfeiture of any funds contributed
8-18     by the sponsoring employer if the employer fails to fulfill its
8-19     obligations under the matching fund program, except for specified
8-20     reasons;]
8-21                 [(5)  requiring the student and sponsoring employer to
8-22     submit any dispute relating to responsibilities under the matching
8-23     fund program to be resolved under the dispute resolution procedures
8-24     established by the board; and]
8-25                 [(6)  granting authority to the board to cancel an
8-26     agreement entered into by a student and the student's sponsoring
 9-1     employer if certain specified conditions are not met.]
 9-2           [(e)]  The board shall distribute [adopt rules providing for
 9-3     the distribution of] information about the scholarship program,
 9-4     matching fund program, and loan repayment program established under
 9-5     this subchapter to:
 9-6                 (1)  employers of registered nurses or licensed
 9-7     vocational nurses;
 9-8                 (2)  associations of employers;
 9-9                 (3)  schools and educational programs for registered
9-10     nurses or licensed vocational nurses; and
9-11                 (4)  professional associations of registered nurses or
9-12     licensed vocational nurses.
9-13           SECTION 9.  Section 61.658, Education Code, is amended by
9-14     adding Subsection (b) to read as follows:
9-15           (b)  The board may structure the scholarship program, the
9-16     matching fund program, and the loan repayment program established
9-17     under this subchapter to secure funds available under federal
9-18     matching programs.
9-19           SECTION 10.  Subchapter L, Chapter 61, Education Code, is
9-20     amended by adding Section 61.659 to read as follows:
9-21           Sec. 61.659.  ADMINISTRATIVE COSTS.  A reasonable amount, not
9-22     to exceed 10 percent, of the funds appropriated by the legislature
9-23     to fund the programs established under this subchapter, may be used
9-24     by the board to pay administrative costs of operating the programs.
9-25           SECTION 11.  Subtitle E, Title 3, Occupations Code, is
9-26     amended by adding Chapter 304 to read as follows:
 10-1                CHAPTER 304.  NURSING WORKFORCE DATA CENTER
 10-2          Sec. 304.001.  DEFINITIONS.  In this chapter:
 10-3                (1)  "Board" means the Board of Nurse Examiners.
 10-4                (2)  "Center" means the nursing workforce data center
 10-5    established under this chapter.
 10-6                (3)  "Nurse" means a registered nurse or a licensed
 10-7    vocational nurse.
 10-8                (4)  "Nursing" means professional or vocational
 10-9    nursing.
10-10                (5)  "Nursing personnel" means nurses, nurse aides, and
10-11    other licensed and unlicensed personnel providing nursing services.
10-12          Sec. 304.002.  ESTABLISHMENT.  (a)  The board shall establish
10-13    a nursing workforce data center to address issues of supply and
10-14    demand for nursing.
10-15          (b)  The board may contract with public or private entities
10-16    to establish and perform the responsibilities of the center.
10-17          Sec. 304.003.  EXECUTIVE COMMITTEE.  (a)  The board shall
10-18    appoint an executive committee to be the policymaking body for the
10-19    center.  A majority of the members of the executive committee must
10-20    be representatives designated by associations that represent
10-21    nurses, associations that represent employers of nurses, and
10-22    associations that represent educators of nurses.  At least
10-23    one-third of the members must be representatives of the general
10-24    public.  Other members may include nurse researchers, nurses,
10-25    consumers, and other appropriate individuals.  Members shall serve
10-26    two-year staggered terms, with the terms of one-half of the members
 11-1    expiring February 1 of each year.
 11-2          (b)  The executive committee shall:
 11-3                (1)  elect a chair and other officers from its
 11-4    membership;
 11-5                (2)  set priorities for the center;
 11-6                (3)  develop and oversee long-term and short-term
 11-7    strategic plans for the center;
 11-8                (4)  provide for review of reports prepared by the
 11-9    center prior to publication; and
11-10                (5)  appoint advisory committees as needed.
11-11          (c)  A member of the executive committee is entitled to
11-12    receive a per diem as set by the General Appropriations Act for
11-13    each day a member engages in the business of the center.  A member
11-14    is not entitled to reimbursement for travel expenses, including
11-15    expenses for meals and lodging, other than transportation expenses.
11-16    A member is entitled to reimbursement for transportation expenses
11-17    as provided by the General Appropriations Act.
11-18          Sec. 304.004.  EXECUTIVE DIRECTOR.  The operations of the
11-19    center shall be administered by an executive director, who shall be
11-20    a registered nurse.  The executive director shall make periodic
11-21    reports to the executive committee concerning the operation of the
11-22    center.
11-23          Sec. 304.005.  DATA COLLECTION AND ANALYSIS.  The center
11-24    shall:
11-25                (1)  collect data on nurses and other nursing
11-26    personnel, including demographics, areas of practice, supply,
 12-1    demand, and migration.  To the extent possible, the center shall
 12-2    collect data:
 12-3                      (A)  from existing sources that the center
 12-4    determines are credible, including information submitted in
 12-5    aggregate by entities that collect similar data, but may take steps
 12-6    to collect additional data, including conducting surveys; and
 12-7                      (B)  on a county or other appropriate regional
 12-8    basis;
 12-9                (2)  analyze data on nursing personnel to identify
12-10    trends relating to numbers and geographical distribution, practice
12-11    setting, and area of practice and, to the extent possible, compare
12-12    those trends with corresponding national trends; and
12-13                (3)  predict supply and demand for nursing personnel in
12-14    Texas, including the development of a supply and demand model
12-15    appropriate for Texas.
12-16          Sec. 304.006.  CONFIDENTIALITY.  Reports, records, and
12-17    information obtained under this chapter are confidential and are
12-18    not subject to disclosure under Chapter 552, Government Code, or to
12-19    subpoena.
12-20          Sec. 304.007.  COORDINATION OF ACTIVITIES.  The center shall
12-21    coordinate its activities with the Texas Higher Education
12-22    Coordinating Board, the statewide health coordinating council, the
12-23    Texas Workforce Commission, and other public entities to minimize
12-24    duplication of collection of data and to promote the sharing of
12-25    data.
12-26          Sec. 304.008.  REPORTS.  (a)  The center shall use the data
 13-1    collected and analyzed under this chapter to publish reports
 13-2    regarding:
 13-3                (1)  the educational and employment trends for nursing
 13-4    personnel;
 13-5                (2)  the supply of and demand for nursing personnel;
 13-6    and
 13-7                (3)  other issues, as necessary, concerning nursing in
 13-8    the state.
 13-9          (b)  Reports, records, and information must be released in
13-10    the aggregate and may not contain employer-specific data.
13-11          Sec. 304.009.  RECRUITMENT.  The center may develop programs
13-12    relating to the recruitment of persons into nursing, including the
13-13    collection of data relating to career satisfaction for nurses.
13-14          Sec. 304.010.  CLEARINGHOUSE.  The center may establish a
13-15    clearinghouse for nursing education programs and health care
13-16    providers to identify sites available to nursing education programs
13-17    for providing clinical experiences for students.
13-18          Sec. 304.011.  RULES.  The board may adopt rules to implement
13-19    this chapter.
13-20          Sec. 304.012.  FEES.  The center may establish and charge
13-21    reasonable fees for nursing workforce data, reports produced, and
13-22    statistical and other services.
13-23          Sec. 304.013.  FUNDING.  In addition to funds appropriated by
13-24    the legislature, the center may solicit, receive, and spend grants,
13-25    gifts, and donations from public or private sources for the
13-26    purposes of this chapter.
 14-1          Sec. 304.014.  ADMINISTRATIVE COSTS.  A reasonable amount of
 14-2    the funds appropriated by the legislature to fund the center
 14-3    established under this chapter, not to exceed five percent of the
 14-4    amount of such funds, may be used by the board to pay
 14-5    administrative costs of implementing this chapter.
 14-6          SECTION 12.  In appointing the initial members of the
 14-7    executive committee of the nursing workforce data center, the Board
 14-8    of Nurse Examiners shall appoint one-half of the members to terms
 14-9    expiring February 1, 2003, and one-half of the members to terms
14-10    expiring February 1, 2005.
14-11          SECTION 13.  (a)  This Act takes effect September 1, 2001.
14-12          (b)  The Texas Higher Education Coordinating Board is
14-13    required to implement Subchapter U, Chapter 61, Education Code, as
14-14    added by this Act, only if the legislature appropriates money for
14-15    the professional nursing shortage reduction program established
14-16    under that subchapter.
14-17          (c)  The Board of Nurse Examiners is required to implement
14-18    Chapter 304, Occupations Code, as added by this Act, only if the
14-19    legislature appropriates money for the nursing workforce data
14-20    center established under that chapter.