C.S.H.B. 311 78(R)    BILL ANALYSIS

       
C.S.H.B. 311
By: Villarreal
Public Health
Committee Report (Substituted)
      

BACKGROUND AND PURPOSE 
Licensed Vocational Nurses (LVNs) are a vital component of our health care
delivery system.  These professionals provide direct basic health care in
clinics, hospitals, nursing homes, home health care settings and more.
Most health-care institutions could not function without LVNs, especially
in light of the shortage of Registered Nurses (RNs). As we rely more
heavily on this profession in increasingly varied settings, medical
directors and other administrators need frequent instruction from the
Board of Vocational Nurse Examiners (BVNE) to determine whether LVNs may
perform certain tasks in specific settings.  However, the BVNE may only
state what it believes is appropriate. There are no definitive answers
because LVNs are licensed under a "title control act" which simply
requires anyone calling themselves a Licensed Vocational Nurse to actually
be licensed.   

RULEMAKING AUTHORITY
It is the committee's authority that this bill does not expressly grant
any additional rulemaking authority to a state officer, department,
agency, or institution. 

ANALYSIS
CSHB 311 states that this bill may be cited as the Licensed Vocational
Nursing Practice Act and proceeds to clarify to whom the chapter applies.
The bill provides that the board may enforce and adopt rules necessary to
perform their duties, regulate the practice of vocational nursing,
establish standards of professional conduct, and determine whether an act
constitutes vocational nursing. The bill provides for the creation of a
practice advisory committee that will advise the Board of Vocational Nurse
Examiners on scope of practice issues.  The board will consist of a
combination of RNs, LVNs, and representatives from health care
associations, nursing educational institutions, and people appointed from
various state agencies.  The bill assures confidentiality of any complaint
or investigation taken by the BVNE concerning a LVN.  The bill provides
safe-harbor protection for LVNs.   Additionally, the peer review process
which has been available to RNs is now extended to LVNs in this bill. 

EFFECTIVE DATE
September 1, 2003


COMPARISON OF ORIGINAL TO SUBSTITUTE
The Committee Substitute differs from the original version by:
_eliminating reference to Avocational nursing consulting services@ in the
applicability chapter; 
_clarifying that vocational nurses may not delegate tasks to unlicensed
persons, but may continue to assign tasks already delegated by a
registered nurse or medical doctor; 
_stipulating that vocational nurses must continue to work under the
supervision of a registered nurse or medical doctor;  
_adding language requiring the formation of an advisory committee which
will consult with the Board of Vocational Nurse Examiners prior to
decisions that may impact the scope of practice or existing use of
vocational nurses in certain health-care settings; 
_replaces language pertaining to Asafe harbor@ and mandatory reporting
requirements with language that is consistent with similar sections within
the Nurse Practice Act; and 
_clarifies that the nurse practice act does not apply to services
delivered to certain disabled persons served by the voucher payment
program under Section 531.051 of the Government Code.