C.S.H.B. 2131 78(R)    BILL ANALYSIS


C.S.H.B. 2131
By: Zedler
Public Health
Committee Report (Substituted)



BACKGROUND AND PURPOSE 
The 77th Legislature amended the Nursing Practice Act  by adding section
301.1525.  The Board of Nurse Practitioners was authorized to develop and
enact rules governing Registered Nurse First Assistant (RNFA) practice.
It was the  understanding of some nurses  that the Nursing Practice Act
was amended to allow for reimbursement of those functioning in the
capacity as a RNFA.  The wording of the legislation provided a definition
of a nurse first assistant that was not limited only to those seeking
reimbursement.  As a result there are some nurses that will be ineligible
to continue preforming the  duties  they have preformed for several years,
unless they complete the training and other requirements to become a RNFA. 

The legislation established a time limit by which nurses had to complete
training to become a RNFA or stop functioning in that role.  Some nurses
employed by doctors, hospitals, or physicians group that have been
assisting doctors in the operating room for many years do not want to be
reimbursed for the duties they preform and therefore do not want to go
through the process to become an RNFA. 


RULEMAKING AUTHORITY

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

ANALYSIS

This bill allows those nurses that have 2500 hours of experience under the
supervision of a physician in an operating room that do not wish to either
be reimbursed  or  use the title of Registered Nurse First Assistant to
continue doing the job that they have been doing without having to go
through the RNFA certification process 

EFFECTIVE DATE

September 1, 2003

COMPARISON OF ORIGINAL TO SUBSTITUTE
The substitute spells out what a nurse covered by this bill can and cannot
do in the operating room  while dealing with the issues covered by RNFA
rules.  

The first section covers nurses that have been preforming the task covered
in this bill for at least 2500 hours prior to September 1, 2003.  It
covers nurses working directly for hospitals, physicians, physician
groups,  podiatrist or dentist.  They also must be working under the
direct supervision of the doctor. The first section is sunsetted on
January 1, 2007, at this time the grandfather for these nurses will
expire.  The second section covers the exact same items as the first but
applies to nurses working for small hospitals (100 beds or less)  and does
not have a sunset provision.