C.S.H.B. 1483 78(R)    BILL ANALYSIS


C.S.H.B. 1483
By: Allen
Public Health
Committee Report (Substituted)



BACKGROUND AND PURPOSE 

Texas is one of only 5 states in the country with separate boards and
licensing acts for registered nurses (RNs) and licensed vocational nurses
(LVNs).  (The other four states are California, Louisiana, Georgia, and
West Virginia). 

In Texas, the Board of Vocational Nurse Examiners regulates Licensed
Vocational Nurses (LVNs) under Chapter 302, Occupations Code, and the
Board of Nurse Examiners regulates Registered Nurses (RNs) and Advanced
Practice Nurses (Nurse Practitioners, Nurse Midwives, Nurse Anesthetists,
and Clinical Nurse Specialists) under Chapter 301, Occupations Code.   

Nursing practice is on a continuum from those duties performed by less
educated/experienced nurses to those performed by nurses with more
education and experience.  From a public policy perspective, it makes
sense that a single board and a single licensing act regulate nursing
practice across that continuum, which would provide for more consistency
in policy and regulation.   

CSHB 1483 combines the jurisdiction of the Board of Nurse Examiners and
the Board of Vocational Nurse Examiners and a creates a single licensing
act for RNs and LVNs.   

RULEMAKING AUTHORITY

It is the committee's  opinion that rulemaking authority is expressly
granted to the Texas Board of Nurse Examiners in SECTION 1.009 (Section
301.151, Occupations Code) and SECTION 1.012 (Sec 301.157, Occupations
Code) and SECTION 1.015 (Sec 301.252, Occupations Code) of this bill.  
ANALYSIS

CSHB 1483 accomplishes the combination of the BNE and the BVNE and the
creation of a single nursing licensing act by incorporating relevant
sections of the Vocational Nurse Act (Chapter 302, Occupations Code) into
the Nursing Practice Act (Chapter 301, Occupations Code). 

The bill states that the new combined Board of Nurse Examiners will be
comprised of 13 Board members.  Membership would consist of: 

_Six (6) nurse members, including:
 one advance practice nurse,
 two registered nurses who are not advanced practice nurses or members of
a nurse 
  faculty, and
 three licensed vocational nurses who are not members of a nurse faculty;

_Three (3) members of nurse faculty, including:
 one nurse faculty member from baccalaureate degree program,
 one nurse faculty member from associate degree program, and
 one nurse faculty member from vocational nurse program.

_Four (4) members who represent the public



 The bill makes conforming changes to the Nursing Peer Review Law (Chapter
303, Occupations Code) and the Nurse Multistate Compact (Chapter 304,
Occupations Code) to reflect a single board and to extend safe harbor peer
review to LVNs. 

The bill makes numerous conforming changes, including changing references
in the Nursing Practice Act to include RNs, LVNs, professional nursing,
and vocational nursing as appropriate. 

The bill repeals the Vocational Nurse Act and transfers all functions and
activities performed by the Board of Vocational Nurses to the Board of
Nurse Examiners effective February 1, 2004. 
 

EFFECTIVE DATE

SECTION 3.005(b) provides Article 2 of this Act takes effect February 1,
2004. All other sections of this Act take effect September 1, 2003. 

COMPARISON OF ORIGINAL TO SUBSTITUTE

The substitute modifies the original by creating not only a single board
to regulate nursing, but a single licensing act as well.