By:  Moncrief                                          S.B. No. 572
         2001S0162/2                            
                                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.  (a)  An institution of higher education may
 4-7     permit a registered nurse authorized to practice professional
 4-8     nursing in Texas to register by paying the tuition fees and other
 4-9     fees or charges required for Texas residents under Section 54.051,
4-10     without regard to the length of time the registered nurse has
4-11     resided in 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           (b)  The institution may set additional qualifications and
4-17     conditions that a registered nurse must meet to qualify for tuition
4-18     and fees at the resident tuition rate under this section,
4-19     including:
4-20                 (1)  the minimum length of time required to teach in
4-21     Texas; and
4-22                 (2)  repayment of any reduction in tuition received
4-23     under this section if the person fails to teach for the length of
4-24     time required.
4-25           SECTION 5.  Subdivision (1), Section 61.651, Education Code,
4-26     is amended to read as follows:
 5-1                 (1)  "Professional nursing student" means a student
 5-2     enrolled in an institution of higher education or a private or
 5-3     independent institution of higher education in a course of study
 5-4     leading to an initial or an advanced degree in professional
 5-5     nursing.
 5-6           SECTION 6.  Section 61.653, Education Code, is amended to
 5-7     read as follows:
 5-8           Sec. 61.653.  [Employer] MATCHING FUND PROGRAM.  The board
 5-9     shall establish and administer, using funds appropriated for that
5-10     purpose and in accordance with this subchapter and board rules, a
5-11     matching fund program under which a person [an employer] may
5-12     sponsor a professional nursing student or a vocational nursing
5-13     student by contributing to the costs of the student's education and
5-14     having that contribution matched in whole or in part by state funds
5-15     appropriated for that purpose.
5-16           SECTION 7.  Section 61.655, Education Code, is amended to
5-17     read as follows:
5-18           Sec. 61.655.  PURPOSE; ELIGIBILITY.  (a)  A scholarship
5-19     program, matching fund program, or loan repayment program
5-20     established under this subchapter shall be established and
5-21     administered in a manner that the board determines best promotes
5-22     the health care and educational needs of this state.
5-23           (b)  The board may establish multiple categories of persons
5-24     to receive scholarships, matching funds, and loan repayments.  The
5-25     board may include faculty with master's degrees or doctorates in
5-26     nursing from professional nursing programs among the categories of
 6-1     persons authorized to receive loan repayments.
 6-2           (c)  Each year funds are available, the board shall establish
 6-3     the categories of persons eligible to receive scholarships,
 6-4     matching funds, and loan repayments and the criteria for selecting
 6-5     persons to be assisted under each category.  The criteria:
 6-6                 (1)  must include [In determining what best promotes
 6-7     the health care and educational needs of this state, the board
 6-8     shall consider at a minimum the following factors relating to each
 6-9     person being assisted]:
6-10                       (A) [(1)  ethnic or racial minority status;]
6-11                 [(2)]  scholastic ability and performance; and
6-12                       (B) [(3)  geographical area of nursing practice;]
6-13                 [(4)]  financial need; and
6-14                 (2)  may include:
6-15                       (A)  the geographical area in which the person is
6-16     likely to practice;
6-17                       (B) [(5)]  whether the person receives Aid to
6-18     Families with Dependent Children or participates in another public
6-19     welfare program;
6-20                       (C) [(6)]  employment by a state agency;
6-21                       (D) [(7)]  employment on a nursing school faculty
6-22     or a person's intention to seek employment on a nursing school
6-23     faculty; [and]
6-24                       (E) [(8)]  whether the person [at the time of
6-25     application to participate in the scholarship program, matching
6-26     fund program, or loan repayment program under this subchapter] is
 7-1     [a] practicing [nurse] in a geographical area, a practice setting,
 7-2     or an area of practice with an acute nursing shortage or is likely
 7-3     to practice in such an area;
 7-4                       (F)  the type of certificate or academic degree
 7-5     held or pursued; or
 7-6                       (G)  any additional factors the board considers
 7-7     relevant to promoting the health care and educational needs of the
 7-8     state.
 7-9           SECTION 8.  Subsections (c), (d), and (e), Section 61.656,
7-10     Education Code, are amended to read as follows:
7-11           (c)  The board shall adopt rules relating to the
7-12     establishment and administration of the matching fund program under
7-13     Section 61.653 [of this code], including rules providing:
7-14                 (1)  eligibility criteria for sponsors [sponsoring
7-15     employers] and for students;
7-16                 (2)  the minimum and maximum sponsor [employer]
7-17     contributions that will be matched;
7-18                 (3)  conflict resolution procedures for resolving
7-19     disputes between the sponsor [sponsoring employer] and the student;
7-20     and
7-21                 (4)  a standard agreement for use by the sponsor and
7-22     the student [the form and manner in which the sponsoring employer
7-23     must make its contribution, including whether the contribution will
7-24     be made in a lump-sum payment at the beginning of a semester or
7-25     whether the contribution will be made in several payments over a
7-26     period of time;]
 8-1                 [(5)  conditions under which a student may be required
 8-2     to repay funds received under the matching fund program because of
 8-3     inability to fulfill obligations under the program;]
 8-4                 [(6)  conditions under which a sponsoring employer
 8-5     would be returned any unexpended portion of the employer's
 8-6     contribution;]
 8-7                 [(7)  conditions under which the coordinating board
 8-8     could cancel an agreement entered into under Subsection (d) of this
 8-9     section between the student and the sponsoring employer; and]
8-10                 [(8)  a procedure for the disbursement of funds that
8-11     provides for participation by a variety of employers consistent
8-12     with the purposes established under this subchapter].
8-13           (d)  [A student and the student's sponsoring employer shall
8-14     enter into a standard agreement as provided by board rules adopted
8-15     under this subsection.  The board shall adopt rules providing for a
8-16     standard agreement for use in connection with the matching fund
8-17     program under Section 61.653 of this code, which agreement must
8-18     include provisions:]
8-19                 [(1)  requiring the sponsoring employer to employ the
8-20     student while in school and to provide a work schedule that
8-21     accommodates the student's class schedule;]
8-22                 [(2)  requiring the student to remain in the employ of
8-23     the sponsoring employer for at least one year after graduation;]
8-24                 [(3)  requiring the student to repay funds received if
8-25     the student fails to fulfill his or her responsibilities under the
8-26     matching fund program, except for specified reasons;]
 9-1                 [(4)  providing for forfeiture of any funds contributed
 9-2     by the sponsoring employer if the employer fails to fulfill its
 9-3     obligations under the matching fund program, except for specified
 9-4     reasons;]
 9-5                 [(5)  requiring the student and sponsoring employer to
 9-6     submit any dispute relating to responsibilities under the matching
 9-7     fund program to be resolved under the dispute resolution procedures
 9-8     established by the board; and]
 9-9                 [(6)  granting authority to the board to cancel an
9-10     agreement entered into by a student and the student's sponsoring
9-11     employer if certain specified conditions are not met.]
9-12           [(e)]  The board shall distribute [adopt rules providing for
9-13     the distribution of] information about the scholarship program,
9-14     matching fund program, and loan repayment program established under
9-15     this subchapter to:
9-16                 (1)  employers of registered nurses or licensed
9-17     vocational nurses;
9-18                 (2)  associations of employers;
9-19                 (3)  schools and educational programs for registered
9-20     nurses or licensed vocational nurses; and
9-21                 (4)  professional associations of registered nurses or
9-22     licensed vocational nurses.
9-23           SECTION 9.  Section 61.658, Education Code, is amended by
9-24     adding Subsection (b) to read as follows:
9-25           (b)  The board may structure the scholarship program, the
9-26     matching fund program, and the loan repayment program established
 10-1    under this subchapter to secure funds available under federal
 10-2    matching programs.
 10-3          SECTION 10.  Subchapter L, Chapter 61, Education Code, is
 10-4    amended by adding Section 61.659 to read as follows:
 10-5          Sec. 61.659.  ADMINISTRATIVE COSTS.  A reasonable amount, not
 10-6    to exceed 10 percent, of the funds appropriated by the legislature
 10-7    to fund the programs established under this subchapter, may be used
 10-8    by the board to pay administrative costs of operating the programs.
 10-9          SECTION 11.  Subtitle E, Title 3, Occupations Code, is
10-10    amended by adding Chapter 304 to read as follows:
10-11                CHAPTER 304.  NURSING WORKFORCE DATA CENTER
10-12          Sec. 304.001.  DEFINITIONS.  In this chapter:
10-13                (1)  "Board" means the Board of Nurse Examiners.
10-14                (2)  "Center" means the nursing workforce data center
10-15    established under this chapter.
10-16                (3)  "Nurse" means a registered nurse or a licensed
10-17    vocational nurse.
10-18                (4)  "Nursing" means professional or vocational
10-19    nursing.
10-20                (5)  "Nursing personnel" means nurses, nurse aides, and
10-21    other licensed and unlicensed personnel providing nursing services.
10-22          Sec. 304.002.  ESTABLISHMENT.  (a)  The board shall establish
10-23    a nursing workforce data center to address issues of supply and
10-24    demand for nursing.
10-25          (b)  The board may contract with public or private entities
10-26    to establish and perform the responsibilities of the center.
 11-1          Sec. 304.003.  EXECUTIVE COMMITTEE.  (a)  The board shall
 11-2    appoint an executive committee to be the policymaking body for the
 11-3    center.  A majority of the members of the executive committee must
 11-4    be representatives designated by associations that represent
 11-5    nurses, associations that represent employers of nurses, and
 11-6    associations that represent educators of nurses.  At least
 11-7    one-third of the members must be representatives of the general
 11-8    public.  Other members may include nurse researchers, nurses,
 11-9    consumers, and other appropriate individuals.  Members shall serve
11-10    two-year staggered terms, with the terms of one-half of the members
11-11    expiring February 1 of each year.
11-12          (b)  The executive committee shall:
11-13                (1)  elect a chair and other officers from its
11-14    membership;
11-15                (2)  set priorities for the center;
11-16                (3)  develop and oversee long-term and short-term
11-17    strategic plans for the center;
11-18                (4)  provide for review of reports prepared by the
11-19    center prior to publication; and
11-20                (5)  appoint advisory committees as needed.
11-21          (c)  A member of the executive committee is entitled to
11-22    receive a per diem as set by the General Appropriations Act for
11-23    each day a member engages in the business of the center.  A member
11-24    is not entitled to reimbursement for travel expenses, including
11-25    expenses for meals and lodging, other than transportation expenses.
11-26    A member is entitled to reimbursement for transportation expenses
 12-1    as provided by the General Appropriations Act.
 12-2          Sec. 304.004.  EXECUTIVE DIRECTOR.  The operations of the
 12-3    center shall be administered by an executive director, who shall be
 12-4    a registered nurse.  The executive director shall make periodic
 12-5    reports to the executive committee concerning the operation of the
 12-6    center.
 12-7          Sec. 304.005.  DATA COLLECTION AND ANALYSIS.  The center
 12-8    shall:
 12-9                (1)  collect data on nurses and other nursing
12-10    personnel, including demographics, areas of practice, supply,
12-11    demand, and migration.  To the extent possible, the center shall
12-12    collect data:
12-13                      (A)  from existing sources that the center
12-14    determines are credible, but may take steps to collect additional
12-15    data, including conducting surveys; and
12-16                      (B)  on a county or other appropriate regional
12-17    basis;
12-18                (2)  analyze data on nursing personnel to identify
12-19    trends relating to numbers and geographical distribution, practice
12-20    setting, and area of practice and, to the extent possible, compare
12-21    those trends with corresponding national trends; and
12-22                (3)  predict supply and demand for nursing personnel in
12-23    Texas, including the development of a supply and demand model
12-24    appropriate for Texas.
12-25          Sec. 304.006.  COORDINATION OF ACTIVITIES.  The center shall
12-26    coordinate its activities with the Texas Higher Education
 13-1    Coordinating Board, the statewide health coordinating council, the
 13-2    Texas Workforce Commission, and other public entities to minimize
 13-3    duplication of collection of data and to promote the sharing of
 13-4    data.
 13-5          Sec. 304.007.  REPORTS.  The center shall use the data
 13-6    collected and analyzed under this chapter to publish reports
 13-7    regarding:
 13-8                (1)  the educational and employment trends for nursing
 13-9    personnel;
13-10                (2)  the supply of and demand for nursing personnel;
13-11    and
13-12                (3)  other issues, as necessary, concerning nursing in
13-13    the state.
13-14          Sec. 304.008.  RECRUITMENT.  The center may develop programs
13-15    relating to the recruitment of persons into nursing, including the
13-16    collection of data relating to career satisfaction for nurses.
13-17          Sec. 304.009.  CLEARINGHOUSE.  The center may establish a
13-18    clearinghouse for nursing education programs and health care
13-19    providers to identify sites available to nursing education programs
13-20    for providing clinical experiences for students.
13-21          Sec. 304.010.  RULES.  The board may adopt rules to implement
13-22    this chapter.
13-23          Sec. 304.011.  FEES.  The center may establish and charge
13-24    reasonable fees for nursing workforce data, reports produced, and
13-25    statistical and other services.
13-26          Sec. 304.012.  FUNDING.  In addition to funds appropriated by
 14-1    the legislature, the center may solicit, receive, and spend grants,
 14-2    gifts, and donations from public or private sources for the
 14-3    purposes of this chapter.
 14-4          Sec. 304.013.  ADMINISTRATIVE COSTS.  A reasonable amount of
 14-5    the funds appropriated by the legislature to fund the center
 14-6    established under this chapter, not to exceed five percent of the
 14-7    amount of such funds, may be used by the board to pay
 14-8    administrative costs of implementing this chapter.
 14-9          SECTION 12.  In appointing the initial members of the
14-10    executive committee of the nursing workforce data center, the Board
14-11    of Nurse Examiners shall appoint one-half of the members to terms
14-12    expiring February 1, 2003, and one-half of the members to terms
14-13    expiring February 1, 2005.
14-14          SECTION 13.  (a)  This Act takes effect September 1, 2001.
14-15          (b)  The Texas Higher Education Coordinating Board is
14-16    required to implement Subchapter U, Chapter 61, Education Code, as
14-17    added by this Act, only if the legislature appropriates money for
14-18    the professional nursing shortage reduction program established
14-19    under that subchapter.