By: Allen, et al. (Senate Sponsor - Nelson) H.B. No. 1483
(In the Senate - Received from the House May 9, 2003;
May 13, 2003, read first time and referred to Committee on Health
and Human Services; May 23, 2003, reported adversely, with
favorable Committee Substitute by the following vote: Yeas 9,
Nays 0; May 23, 2003, sent to printer.)
COMMITTEE SUBSTITUTE FOR H.B. No. 1483 By: Nelson
A BILL TO BE ENTITLED
AN ACT
relating to the regulation of the practice of nursing by the Board
of Nurse Examiners and to the abolition of the Board of Vocational
Nurse Examiners and the transfer of the functions of that agency to
the Board of Nurse Examiners.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
ARTICLE 1. SINGLE NURSING BOARD
SECTION 1.001. The heading to Chapter 301, Occupations
Code, is amended to read as follows:
CHAPTER 301. [REGISTERED] NURSES
SECTION 1.002. Section 301.002, Occupations Code, is
amended by adding Subdivisions (3), (4), and (5) to read as follows:
(3) "Nurse" means a person required to be licensed
under this chapter to engage in professional or vocational nursing.
(4) "Nursing" means professional or vocational
nursing.
(5) "Vocational nursing" means nursing, other than
professional nursing, that generally requires experience and
education in biological, physical, and social sciences sufficient
to qualify as a licensed vocational nurse.
SECTION 1.003. Section 301.003, Occupations Code, is
amended to read as follows:
Sec. 301.003. APPLICATION OF SUNSET ACT. The Board of Nurse
Examiners is subject to Chapter 325, Government Code (Texas Sunset
Act). Unless continued in existence as provided by that chapter,
the board is abolished September 1, 2007 [2005].
SECTION 1.004. Section 301.004(a), Occupations Code, is
amended to read as follows:
(a) This chapter does not apply to:
(1) gratuitous nursing care of the sick that is
provided by a friend;
(2) [nursing care by a licensed vocational nurse
licensed under Chapter 302;
[(3)] nursing care provided during a disaster under
the state emergency management plan adopted under Section 418.042,
Government Code, if the person providing the care does not hold the
person out as a [registered or professional] nurse unless the
person is licensed in another state;
(3) [(4)] nursing care in which treatment is solely by
prayer or spiritual means;
(4) [(5)] an act performed by a person under the
delegated authority [control or supervision or at the instruction]
of a person licensed by the Texas State Board of Medical Examiners;
(5) [(6)] an act performed by a person licensed by
another state agency if the act is authorized by the statute under
which the person is licensed;
(6) [(7)] the practice of nursing that is incidental
to a program of study by a student enrolled in a board-approved
[board-accredited] nursing education program leading to an initial
license as a [professional] nurse; or
(7) [(8)] the practice of nursing by a person
[registered nurse] licensed in another state who is in this state on
a nonroutine basis for a period not to exceed 72 hours to:
(A) provide care to a patient being transported
into, out of, or through this state;
(B) provide [professional] nursing consulting
services; or
(C) attend or present a continuing nursing
education program.
SECTION 1.005. Subchapter A, Chapter 301, Occupations Code,
is amended by adding Section 301.005 to read as follows:
Sec. 301.005. OCCUPATION TAX AND FEE EXEMPTION. A
vocational nurse organization that operates a nonprofit registry to
enroll members to provide nursing to the public is not liable for
the payment of an occupation tax or license fee unless the law
imposing the tax or fee specifically imposes the tax or fee on
vocational nurse organizations that operate nonprofit registries.
SECTION 1.006. Section 301.051(a), Occupations Code, is
amended to read as follows:
(a) The Board of Nurse Examiners consists of 13 [nine]
members appointed by the governor with the advice and consent of the
senate as follows:
(1) six [registered] nurse members, including:
(A) one advanced practice nurse;
(B) two registered nurses who are not advanced
practice nurses or members of a nurse faculty; and
(C) three vocational nurses who are not members
of a nurse faculty;
(2) three members who are nurse faculty members of
schools of nursing:
(A) one of whom is a nurse faculty member of a
school of nursing offering a [the] baccalaureate degree program in
preparing registered nurses;
(B) one of whom is a nurse faculty member of a
school of nursing offering an [the] associate degree program in
preparing registered nurses; and
(C) one of whom is a nurse faculty member of a
[graduate] school of nursing at an institution of higher education
preparing vocational [advanced practice] nurses; and
(3) four [(2) three] members who represent the
public.
SECTION 1.007. Section 301.052(a), Occupations Code, is
amended to read as follows:
(a) A person is not eligible for appointment as a registered
nurse or vocational nurse member of the board unless the person has
practiced [engaged in the] nursing in the role for which the member
was appointed [profession] for at least three of the five years
preceding the date of appointment.
SECTION 1.008. Section 301.054, Occupations Code, is
amended to read as follows:
Sec. 301.054. TERMS. Members of the board serve staggered
six-year terms, with the terms of as near to one-third of the
members as possible [one member who is a practicing registered
nurse, one member who is a registered nurse engaged in nurse
education, and one member who is a representative of the public]
expiring on January 31 of each odd-numbered year.
SECTION 1.009. Section 301.151, Occupations Code, is
amended to read as follows:
Sec. 301.151. GENERAL RULEMAKING AUTHORITY. The board may
adopt and enforce rules consistent with this chapter and necessary
to:
(1) perform its duties and conduct proceedings before
the board;
(2) regulate the practice of professional nursing and
vocational nursing;
(3) establish standards of professional conduct for
license holders under this chapter; and
(4) determine whether an act constitutes the practice
of professional nursing or vocational nursing.
SECTION 1.010. Section 301.154(a), Occupations Code, is
amended to read as follows:
(a) The board may recommend to the Texas State Board of
Medical Examiners the adoption of rules relating to the delegation
by physicians of medical acts to registered nurses and vocational
nurses licensed by the board. In making a recommendation, the board
may distinguish between nurses on the basis of special training and
education.
SECTION 1.011. The heading to Section 301.157, Occupations
Code, is amended to read as follows:
Sec. 301.157. PROGRAMS OF STUDY AND APPROVAL
[ACCREDITATION].
SECTION 1.012. Sections 301.157(b), (c), and (d),
Occupations Code, are amended to read as follows:
(b) The board shall:
(1) prescribe two programs of study to prepare
vocational nurses as follows:
(A) a program conducted by an educational unit in
nursing within the structure of a school, including a college,
university, or proprietary school; and
(B) a program conducted by a hospital;
(2) prescribe and publish the minimum requirements and
standards for a course of study in each program that prepares
registered nurses or vocational [professional] nurses;
(3) [(2)] prescribe other rules as necessary to
conduct approved [accredited] schools of nursing and educational
programs for the preparation of registered nurses or vocational
[professional] nurses;
(4) approve [(3) accredit] schools of nursing and
educational programs that meet the board's requirements; and
(5) [(4)] deny or withdraw approval [accreditation]
from a school of nursing or educational program that fails to meet
the prescribed course of study or other standard.
(c) A program approved to prepare registered nurses [The
board] may not be [require a program that is composed of] less than
two academic years or more than four calendar years.
(d) A person may not be certified as a graduate of any school
of nursing or educational program unless the person has completed
the requirements of the prescribed course of study, including
clinical practice, of an approved [accredited] school of nursing or
educational program.
SECTION 1.013. Section 301.158, Occupations Code, is
amended to read as follows:
Sec. 301.158. DISSEMINATION OF INFORMATION. The board
shall disseminate, at least twice a year and at other times the
board determines necessary, information that is of significant
interest to [professional] nurses and employers of [professional]
nurses in this state, including summaries of final disciplinary
action taken against [registered] nurses by the board since its
last dissemination of information.
SECTION 1.014. Section 301.251, Occupations Code, is
amended to read as follows:
Sec. 301.251. LICENSE REQUIRED. (a) A person may not
practice or offer to practice professional nursing or vocational
nursing in this state unless the person is licensed as provided by
this chapter.
(b) Unless the person holds a license under this chapter, a
person may not use, in connection with the person's name:
(1) the title "Registered Nurse," "Professional
Nurse," "Licensed Vocational Nurse," "Vocational Nurse," "Licensed
Practical Nurse," "Practical Nurse," or "Graduate Nurse";
(2) the abbreviation "R.N.," "L.V.N.," "V.N.,"
"L.P.N.," or "P.N."; or
(3) any other designation tending to imply that the
person is a licensed registered nurse or vocational nurse.
(c) This section does not apply to a person entitled to
practice professional nursing or vocational nursing in this state
under Chapter 304, as added by Chapter 1420, Acts of the 77th
Legislature, Regular Session, 2001.
SECTION 1.015. Section 301.252, Occupations Code, is
amended to read as follows:
Sec. 301.252. LICENSE APPLICATION. (a) Each applicant for
a registered nurse license or a vocational nurse license must
submit to the board a sworn application that demonstrates the
applicant's qualifications under this chapter, accompanied by
evidence that the applicant [has]:
(1) has good professional character; and
(2) has successfully completed an approved
[accredited] program of professional or vocational nursing
education.
(b) The board may waive the requirement of Subsection (a)(2)
for a vocational nurse applicant if the applicant provides
satisfactory sworn evidence that the applicant has completed an
acceptable level of education in:
(1) a professional nursing school approved by the
board; or
(2) a school of professional nurse education located
in another state or a foreign country.
(c) The board by rule shall determine acceptable levels of
education under Subsection (b).
SECTION 1.016. Section 301.253(c), Occupations Code, is
amended to read as follows:
(c) The examination shall be designed to determine the
fitness of the applicant to practice professional nursing or
vocational nursing.
SECTION 1.017. Section 301.256, Occupations Code, is
amended to read as follows:
Sec. 301.256. ISSUANCE OF LICENSE. If the results of an
examination taken under Section 301.253 or 301.255 satisfy the
criteria established by the board under that section, the board
shall issue to the applicant a license to practice professional
nursing or vocational nursing in this state. The license must be
signed by the board's presiding officer and the executive director
and attested by the board's seal.
SECTION 1.018. Sections 301.257(a) and (g), Occupations
Code, are amended to read as follows:
(a) A person may petition the board for a declaratory order
as to the person's eligibility for a license under this chapter if
the person:
(1) is enrolled or planning to enroll in an
educational program that prepares a person for an initial license
as a registered nurse or vocational nurse; and
(2) has reason to believe that the person is
ineligible for the license.
(g) The board may require an individual accepted for
enrollment or enrolled in an educational program preparing a
student for initial licensure as a registered nurse or vocational
nurse to submit information to the board to permit the board to
determine whether the person is aware of the conditions that may
disqualify the person from licensure as a registered nurse or
vocational nurse on graduation and of the person's right to
petition the board for a declaratory order under this section.
Instead of requiring the person to submit the information, the
board may require the educational program to collect and submit the
information on each person accepted for enrollment or enrolled in
the program.
SECTION 1.019. Sections 301.258(a), (d), and (f),
Occupations Code, are amended to read as follows:
(a) Pending the results of a licensing examination, the
board may issue to an applicant who is a graduate of an approved
educational program a permit to practice professional nursing under
the direct supervision of a registered nurse or to practice
vocational nursing under the direct supervision of a registered
nurse or vocational nurse.
(d) The board may issue a temporary permit to practice
professional nursing or vocational nursing for the limited purpose
of allowing a nurse to satisfy a requirement imposed by the board
necessary for:
(1) renewal of an expired license;
(2) reactivation of an inactive license; or
(3) reissuance of a suspended, revoked, or surrendered
license.
(f) A person who holds a temporary permit issued under this
section is considered to be a licensed registered nurse or
vocational nurse for all purposes except to the extent of any
stipulation or limitation on practice imposed by the board as a
condition of issuing the permit.
SECTION 1.020. Section 301.259, Occupations Code, is
amended to read as follows:
Sec. 301.259. RECIPROCAL LICENSE BY ENDORSEMENT FOR CERTAIN
FOREIGN APPLICANTS. On payment of a fee established by the board,
the board may issue a license to practice as a registered nurse or
vocational nurse in this state by endorsement without examination
to an applicant who holds a registration certificate as a
registered nurse or vocational nurse, as applicable, issued by a
territory or possession of the United States or a foreign country if
the board determines that the issuing agency of the territory or
possession of the United States or foreign country required in its
examination the same general degree of fitness required by this
state.
SECTION 1.021. Section 301.260(a), Occupations Code, is
amended to read as follows:
(a) An applicant for a license under this chapter who is
licensed as a registered nurse or vocational nurse by another state
may qualify for a temporary license by endorsement to practice as a
registered nurse or vocational nurse, as applicable, by submitting
to the board:
(1) an endorsement fee as determined by the board and a
completed sworn application in the form prescribed by the board;
(2) evidence that the person possessed, at the time of
initial licensing as a [registered] nurse, the other qualifications
necessary at that time to have been eligible for licensing in this
state; and
(3) proof of initial licensing by examination and
proof that the license and any other license issued to the applicant
by another state have not been suspended, revoked, canceled,
surrendered, or otherwise restricted.
SECTION 1.022. Sections 301.261(a), (c), and (e),
Occupations Code, are amended to read as follows:
(a) The board may place on inactive status the license of a
person under this chapter who is not actively engaged in the
practice of professional nursing or vocational nursing if the
person submits a written request to the board in the form and manner
determined by the board. The inactive status begins on the
expiration date of the person's license.
(c) A person whose license is on inactive status may not
perform any professional nursing or vocational nursing service or
work.
(e) The board by rule shall permit a person whose license is
on inactive status and who is 65 years or older to use, as
applicable, the title "Registered Nurse Retired," [or] "R.N.
Retired," "Licensed Vocational Nurse Retired," "Vocational Nurse
Retired," "L.V.N. Retired," or "V.N. Retired."
SECTION 1.023. Section 301.301(f), Occupations Code, is
amended to read as follows:
(f) A registered nurse who practices professional nursing
or a vocational nurse who practices vocational nursing after the
expiration of the nurse's license is an illegal practitioner whose
license may be revoked or suspended.
SECTION 1.024. Section 301.302(a), Occupations Code, is
amended to read as follows:
(a) The board may renew without examination the expired
license of a person who was licensed to practice professional
nursing or vocational nursing in this state, moved to another
state, and is currently licensed and has been in practice in the
other state for the two years preceding application.
SECTION 1.025. Section 301.304(a), Occupations Code, is
amended to read as follows:
(a) As part of any continuing education requirements under
Section 301.303, a registered nurse [license holder] shall
participate in not less than two hours of continuing education
relating to hepatitis C. This subsection applies only to a
registered nurse [license holder] who renews a license on or after
June 1, 2002.
SECTION 1.026. Subchapter G, Chapter 301, Occupations Code,
is amended by adding Section 301.305 to read as follows:
Sec. 301.305. BIOTERRORISM RESPONSE COMPONENT IN
CONTINUING EDUCATION. (a) As part of continuing education
requirements under Section 301.303, a license holder shall
participate during each two-year licensing period in at least two
hours of continuing education relating to preparing for, reporting
medical events resulting from, and responding to the consequences
of an incident of bioterrorism.
(b) The continuing education required under Subsection (a)
must be part of a program approved under Section 301.303(c).
(c) A license holder who does not comply with the continuing
education required under Subsection (a) is subject only to one or
both of the following sanctions:
(1) completion of the instruction in a period set by
the board of 30 days or less; or
(2) an administrative penalty imposed under
Subchapter K.
(d) A license holder who fails to comply with a sanction
imposed under Subsection (c) is subject to any sanction imposed
under Section 301.453 or Subchapter K.
(e) The board, in consultation with the Texas Department of
Health, shall adopt rules establishing the content of the
continuing education required under Subsection (a). The board may
adopt other rules to implement this section, including rules under
Section 301.303(c) for the approval of education programs and
providers.
(f) The board may divide the content of the continuing
education required under Subsection (a) into one-hour segments and
may require that those segments be taken in a certain sequence.
(g) This section expires September 1, 2007.
SECTION 1.027. Section 301.351, Occupations Code, is
amended to read as follows:
Sec. 301.351. DESIGNATIONS. (a) A person who holds a
license as a registered nurse under this chapter:
(1) is referred to as a registered nurse; and
(2) may use the abbreviation "R.N."
(b) A person who holds a license as a vocational nurse under
this chapter:
(1) is referred to as a licensed vocational nurse or
vocational nurse; and
(2) may use the abbreviation "L.V.N." or "V.N."
(c) While on duty providing direct care to a patient, each
licensed registered nurse shall wear an insignia identifying the
nurse as a registered nurse and each licensed vocational nurse
shall wear an insignia identifying the nurse as a vocational nurse.
SECTION 1.028. Sections 301.352(a) and (c), Occupations
Code, are amended to read as follows:
(a) A person may not suspend, terminate, or otherwise
discipline or discriminate against a [registered] nurse who refuses
to engage in an act or omission relating to patient care that would
constitute grounds for reporting the nurse to the board under
Subchapter I if the nurse notifies the person at the time of the
refusal that the reason for refusing is that the act or omission:
(1) constitutes grounds for reporting the nurse to the
board; or
(2) is a violation of this chapter or a rule of the
board.
(c) A [registered] nurse's rights under this section may not
be nullified by a contract.
SECTION 1.029. Section 301.401, Occupations Code, is
amended to read as follows:
Sec. 301.401. GROUNDS FOR REPORTING [REGISTERED] NURSE.
The following are grounds for reporting a [registered] nurse under
Section 301.402, 301.403, 301.405, or 301.407:
(1) unnecessary or likely exposure by the [registered]
nurse of a patient or other person to a risk of harm;
(2) unprofessional conduct by the [registered] nurse;
(3) failure by the [registered] nurse to adequately
care for a patient;
(4) failure by the [registered] nurse to conform to
the minimum standards of acceptable professional nursing practice;
or
(5) impairment or likely impairment of the
[registered] nurse's practice by chemical dependency.
SECTION 1.030. Section 301.402, Occupations Code, is
amended to read as follows:
Sec. 301.402. DUTY OF [REGISTERED] NURSE TO REPORT. (a) In
this section:
(1) "Nursing [Professional nursing] educational
program" means a board-approved [board-accredited] educational
program leading to initial licensure as a registered nurse or
vocational nurse.
(2) "Nursing [Professional nursing] student" means an
individual who is enrolled in a professional nursing or vocational
nursing educational program.
(b) A [registered] nurse shall report to the board in the
manner prescribed under Subsection (d) if the nurse has reasonable
cause to suspect that:
(1) another [registered] nurse is subject to a ground
for reporting under Section 301.401; or
(2) the ability of a [professional] nursing student to
perform the services of the nursing profession would be, or would
reasonably be expected to be, impaired by chemical dependency.
(c) In a written, signed report to the appropriate licensing
board, a [registered] nurse may report a licensed health care
practitioner, agency, or facility that the nurse has reasonable
cause to believe has exposed a patient to substantial risk of harm
as a result of failing to provide patient care that conforms to the
minimum standards of acceptable and prevailing nursing
[professional] practice.
(d) A report by a [registered] nurse under Subsection (b)
must:
(1) be written and signed; and
(2) include the identity of the [registered] nurse or
student and any additional information required by the board.
(e) A [registered] nurse may make a report required under
Subsection (b)(2) to the [professional] nursing educational
program in which the student is enrolled instead of reporting to the
board.
SECTION 1.031. Section 301.403, Occupations Code, is
amended to read as follows:
Sec. 301.403. DUTY OF PEER REVIEW COMMITTEE TO REPORT. A
[professional] nursing peer review committee operating under
Chapter 303 that has a ground for reporting a [registered] nurse
under Section 301.401 shall file with the board a written, signed
report that includes:
(1) the identity of the nurse;
(2) a description of any corrective action taken
against the nurse;
(3) a statement whether the [professional] nursing
peer review committee recommends that the board take formal
disciplinary action against the nurse; and
(4) any additional information the board requires.
SECTION 1.032. Section 301.404, Occupations Code, is
amended to read as follows:
Sec. 301.404. DUTY OF NURSING EDUCATIONAL PROGRAM TO
REPORT. (a) In this section, "[professional] nursing educational
program" and "[professional] nursing student" have the meanings
assigned by Section 301.402(a).
(b) A [professional] nursing educational program that has
reasonable cause to suspect that the ability of a [professional]
nursing student to perform the services of the nursing profession
would be, or would reasonably be expected to be, impaired by
chemical dependency shall file with the board a written, signed
report that includes the identity of the student and any additional
information the board requires.
SECTION 1.033. Section 301.405, Occupations Code, is
amended to read as follows:
Sec. 301.405. DUTY OF PERSON EMPLOYING [REGISTERED] NURSE
TO REPORT. (a) This section applies only to a person who employs,
hires, or contracts for the services of a [registered] nurse,
including:
(1) a health care facility, including a hospital,
health science center, nursing home, or home health agency;
(2) a state agency;
(3) a political subdivision;
(4) a school of [professional] nursing; and
(5) a temporary nursing service.
(b) A person that terminates, suspends for more than seven
days, or takes other substantive disciplinary action, as defined by
the board, against a [registered] nurse because a ground under
Section 301.401 exists to report the nurse shall report in writing
to the board the identity of the nurse and any additional
information the board requires.
(c) Except as provided by Subsection (g), each [Each] person
subject to this section that regularly employs, hires, or otherwise
contracts for the services of 10 or more [registered] nurses shall
develop a written plan for identifying and reporting a [registered]
nurse in its service against whom a ground under Section 301.401
exists. The plan must include an appropriate process for the review
by a [professional] nursing peer review committee established and
operated under Chapter 303 of any incident reportable under this
section and for the affected nurse to submit rebuttal information
to that committee. Review by the committee is only advisory.
(d) The review by the peer review committee must include a
determination as to whether a ground under Section 301.401 exists
to report the [registered] nurse undergoing review. The peer
review committee's determination must be included in the report
made to the board under Subsection (b).
(e) The requirement that a report to the board be reviewed
by a [professional] nursing peer review committee:
(1) applies only to a required report; and
(2) does not subject a person's administrative
decision to discipline a [registered] nurse to the peer review
process or prevent a person from taking disciplinary action before
review by the peer review committee is conducted.
(f) The board shall enter into memoranda of understanding
with each state agency that licenses, registers, or certifies a
health care facility or agency or surveys that facility or agency
with respect to [professional] nursing care as to how that state
agency can promote compliance with Subsection (c).
(g) A person is not required to develop a written plan under
Subsection (c) for peer review of:
(1) a registered nurse, unless the person regularly
employs, hires, or otherwise contracts for the services of at least
five registered nurses; or
(2) a vocational nurse, unless the person regularly
employs, hires, or otherwise contracts for the services of at least
five vocational nurses.
SECTION 1.034. Section 301.406, Occupations Code, is
amended to read as follows:
Sec. 301.406. DUTY OF CERTAIN PROFESSIONAL ASSOCIATIONS AND
ORGANIZATIONS TO REPORT. A professional association of
[registered] nurses or an organization that conducts a
certification or accreditation program for [registered] nurses and
that expels, decertifies, or takes any other substantive
disciplinary action, as defined by the board, against a
[registered] nurse as a result of the nurse's failure to conform to
the minimum standards of acceptable [professional] nursing
practice shall report in writing to the board the identity of the
nurse and any additional information the board requires.
SECTION 1.035. Section 301.407, Occupations Code, is
amended to read as follows:
Sec. 301.407. DUTY OF STATE AGENCY TO REPORT. (a) This
section applies only to a state agency that:
(1) licenses, registers, or certifies:
(A) a hospital;
(B) a nursing home;
(C) a health science center;
(D) a home health agency; or
(E) another health care facility or agency; or
(2) surveys a facility or agency listed in Subdivision
(1) regarding the quality of [professional] nursing care provided
by the facility or agency.
(b) Unless expressly prohibited by state or federal law, a
state agency that has reason to believe a ground for reporting a
[registered] nurse exists under Section 301.401 shall report in
writing to the board the identity of that [registered] nurse.
SECTION 1.036. Section 301.408, Occupations Code, is
amended to read as follows:
Sec. 301.408. DUTY OF [PROFESSIONAL] LIABILITY INSURER TO
REPORT. (a) Each insurer that provides to a [registered] nurse
[professional] liability insurance that covers claims arising from
providing or failing to provide [professional] nursing care shall
submit to the board the report or data required by this section at
the time prescribed.
(b) The report or data must be provided for:
(1) a complaint filed in court against a [registered]
nurse that seeks damages related to the nurse's conduct in
providing or failing to provide [professional] nursing care; and
(2) a settlement of a claim or lawsuit made on behalf
of a nurse.
(c) Not later than the 30th day after the date the insurer
receives a complaint subject to Subsection (b), the insurer shall
provide to the board:
(1) the name of the [registered] nurse against whom
the claim is filed;
(2) the policy number;
(3) the policy limits;
(4) a copy of the petition;
(5) a copy of the answer; and
(6) other relevant information known by the insurer,
as required by the board.
(d) Not later than the 30th day after the date of a judgment,
dismissal, or settlement of a suit involving an insured
[registered] nurse or settlement of a claim on behalf of the nurse
without the filing of a lawsuit, the insurer shall provide to the
board information regarding the date of the judgment, dismissal, or
settlement and, if appropriate:
(1) whether an appeal has been taken from the judgment
and by which party;
(2) the amount of the settlement or judgment against
the nurse; and
(3) other relevant information known by the insurer,
as required by the board.
(e) A [registered] nurse shall report the information
required to be reported under this section if the nurse is named as
a defendant in a claim arising from providing or failing to provide
[professional] nursing care and the nurse:
(1) does not carry or is not covered by [professional]
liability insurance; or
(2) is insured by a nonadmitted carrier.
SECTION 1.037. Section 301.409(a), Occupations Code, is
amended to read as follows:
(a) The attorney representing the state shall cause the
clerk of the court of record in which the conviction, adjudication,
or finding is entered to prepare and forward to the board a
certified true and correct abstract of the court record of the case
not later than the 30th day after the date:
(1) a person known to be a [registered] nurse who is
licensed, otherwise lawfully practicing in this state, or applying
to be licensed to practice is convicted of:
(A) a felony;
(B) a misdemeanor involving moral turpitude;
(C) a violation of a state or federal narcotics
or controlled substance law; or
(D) an offense involving fraud or abuse under the
Medicare or Medicaid program; or
(2) a court finds that a [registered] nurse is
mentally ill or mentally incompetent.
SECTION 1.038. Section 301.410, Occupations Code, is
amended to read as follows:
Sec. 301.410. REPORT REGARDING IMPAIRMENT BY CHEMICAL
DEPENDENCY OR MENTAL ILLNESS. A person who is required to report a
[registered] nurse under this subchapter because the nurse is
impaired or suspected of being impaired by chemical dependency or
mental illness may report to a peer assistance program approved by
the board under Chapter 467, Health and Safety Code, instead of
reporting to the board or requesting review by a [professional]
nursing peer review committee.
SECTION 1.039. Section 301.414, Occupations Code, is
amended to read as follows:
Sec. 301.414. NOTICE AND REVIEW OF REPORT. (a) The board
shall notify each [registered] nurse who is reported to the board
under Section 301.402, 301.403, 301.405, 301.406, 301.407,
301.408, or 301.409 of the filing of the report unless the
notification would jeopardize an active investigation.
(b) The [registered] nurse or the nurse's authorized
representative is entitled on request to review any report
submitted to the board under a section specified under Subsection
(a) unless doing so would jeopardize an active investigation. The
board may not reveal the identity of the person making or signing
the report.
SECTION 1.040. Section 301.415(a), Occupations Code, is
amended to read as follows:
(a) A [registered] nurse who is entitled to receive notice
under Section 301.414 or the authorized representative of the nurse
may file with the board a statement of reasonable length containing
the nurse's rebuttal of any information in the report to the board.
SECTION 1.041. Section 301.416(b), Occupations Code, is
amended to read as follows:
(b) If the board determines that the reported conduct does
not indicate that the continued practice of [professional] nursing
by the nurse poses a risk of harm to a client or other person, the
board, with the written consent of the nurse and the person making
the report, may elect not to proceed with an investigation or to
file formal charges. The board shall:
(1) maintain a record of the report; and
(2) investigate the report if it receives two or more
reports involving separate incidents regarding the nurse in any
five-year period.
SECTION 1.042. Sections 301.418(b) and (c), Occupations
Code, are amended to read as follows:
(b) A report or information submitted as required or
authorized by this subchapter arising out of the provision or
failure to provide [professional] nursing services may not be made
available in a liability action for:
(1) discovery;
(2) court subpoena; or
(3) introduction into evidence.
(c) A person is not prevented from taking disciplinary
action against a [registered] nurse by:
(1) the filing of a report under this subchapter with
the board;
(2) an investigation by the board; or
(3) the disposition of a matter by the board.
SECTION 1.043. Sections 301.419(a), (c), and (d),
Occupations Code, are amended to read as follows:
(a) In this section, "minor incident" means conduct that
does not indicate that the continuing practice of [professional]
nursing by an affected nurse poses a risk of harm to a client or
other person.
(c) If the board determines that a report submitted under
this subchapter is without merit, the board shall expunge the
report from the [registered] nurse's file.
(d) The board shall inform, in the manner the board
determines appropriate, [registered] nurses, facilities, agencies,
and other persons of their duty to report under this subchapter.
SECTION 1.044. Section 301.451, Occupations Code, is
amended to read as follows:
Sec. 301.451. CERTAIN PROHIBITED PRACTICES. A person may
not:
(1) sell, fraudulently obtain, or fraudulently
furnish a nursing diploma, license, renewal license, or record;
(2) assist another person in selling, fraudulently
obtaining, or fraudulently furnishing a nursing diploma, license,
renewal license, or record;
(3) practice [professional] nursing under a diploma,
license, or record that was:
(A) obtained unlawfully or fraudulently; or
(B) signed or issued unlawfully or under false
representation; or
(4) practice [professional] nursing in a period in
which the person's license is suspended or revoked.
SECTION 1.045. Sections 301.452(a) and (b), Occupations
Code, are amended to read as follows:
(a) In this section, "intemperate use" includes practicing
[professional] nursing or being on duty or on call while under the
influence of alcohol or drugs.
(b) A person is subject to denial of a license or to
disciplinary action under this subchapter for:
(1) a violation of this chapter, a rule or regulation
not inconsistent with this chapter, or an order issued under this
chapter;
(2) fraud or deceit in procuring or attempting to
procure a license to practice professional nursing or vocational
nursing;
(3) a conviction for a felony or for a misdemeanor
involving moral turpitude;
(4) conduct that results in the revocation of
probation imposed because of conviction for a felony or for a
misdemeanor involving moral turpitude;
(5) use of a nursing license, diploma, or permit, or
the transcript of such a document, that has been fraudulently
purchased, issued, counterfeited, or materially altered;
(6) impersonating or acting as a proxy for another
person in the licensing examination required under Section 301.253
or 301.255;
(7) directly or indirectly aiding or abetting an
unlicensed person in connection with the unauthorized practice of
[professional] nursing;
(8) revocation, suspension, or denial of, or any other
action relating to, the person's license or privilege to practice
nursing in another jurisdiction;
(9) intemperate use of alcohol or drugs that the board
determines endangers or could endanger a patient;
(10) unprofessional or dishonorable conduct that, in
the board's opinion, is likely to deceive, defraud, or injure a
patient or the public;
(11) adjudication of mental incompetency;
(12) lack of fitness to practice because of a mental or
physical health condition that could result in injury to a patient
or the public; or
(13) failure to care adequately for a patient or to
conform to the minimum standards of acceptable [professional]
nursing practice in a manner that, in the board's opinion, exposes a
patient or other person unnecessarily to risk of harm.
SECTION 1.046. Sections 301.453(a), (b), and (c),
Occupations Code, are amended to read as follows:
(a) If the board determines that a person has committed an
act listed in Section 301.452(b), the board shall enter an order
imposing one or more of the following:
(1) denial of the person's application for a license,
license renewal, or temporary permit;
(2) issuance of a written warning;
(3) administration of a public reprimand;
(4) limitation or restriction of the person's license,
including:
(A) limiting to or excluding from the person's
practice one or more specified activities of [professional]
nursing; or
(B) stipulating periodic board review;
(5) suspension of the person's license for a period not
to exceed five years;
(6) revocation of the person's license; or
(7) assessment of a fine.
(b) In addition to or instead of an action under Subsection
(a), the board, by order, may require the person to:
(1) submit to care, counseling, or treatment by a
health provider designated by the board as a condition for the
issuance or renewal of a license;
(2) participate in a program of education or
counseling prescribed by the board;
(3) practice for a specified period under the
direction of a registered nurse or vocational nurse designated by
the board; or
(4) perform public service the board considers
appropriate.
(c) The board may probate any penalty imposed on a
[registered] nurse and may accept the voluntary surrender of a
license. The board may not reinstate a surrendered license unless
it determines that the person is competent to resume practice.
SECTION 1.047. Section 301.455(a), Occupations Code, is
amended to read as follows:
(a) The license of a [registered] nurse shall be temporarily
suspended on a determination by a majority of the board or a
three-member committee of board members designated by the board
that, from the evidence or information presented, the continued
practice of the [registered] nurse would constitute a continuing
and imminent threat to the public welfare.
SECTION 1.048. Section 301.457, Occupations Code, is
amended to read as follows:
Sec. 301.457. COMPLAINT AND INVESTIGATION. (a) The board
or any person may initiate a proceeding under this subchapter by
filing with the board a complaint against a [registered] nurse. The
complaint must be in writing and signed by the complainant.
(b) Except as otherwise provided by this section, the board
or a person authorized by the board shall conduct each
investigation. Each complaint against a [registered] nurse that
requires a determination of [professional] nursing competency
shall be reviewed by a board member, consultant, or employee with a
[professional] nursing background the board considers sufficient.
(c) On the filing of a complaint, the board:
(1) may conduct a preliminary investigation into the
identity of the [registered] nurse named or described in the
complaint;
(2) shall make a timely and appropriate preliminary
investigation of the complaint; and
(3) may issue a warning or reprimand to the
[registered] nurse.
(d) After any preliminary investigation to determine the
identity of the subject of the complaint, unless it would
jeopardize an investigation, the board shall notify the
[registered] nurse that a complaint has been filed and the nature of
the complaint. If the investigation reveals probable cause to take
further disciplinary action, the board shall either attempt an
informal disposition of the complaint or file a formal charge
against the [registered] nurse stating the provision of this
chapter or board rule that is alleged to have been violated and a
brief description of each act or omission that constitutes the
violation.
(e) The board shall conduct an investigation of the
complaint to determine:
(1) whether the [registered] nurse's continued
practice of [professional] nursing poses a risk of harm to clients
or other persons; and
(2) whether probable cause exists that a [registered]
nurse committed an act listed in Section 301.452(b) or that
violates other law.
SECTION 1.049. Sections 301.458(a) and (c), Occupations
Code, are amended to read as follows:
(a) Unless there is an agreed disposition of the complaint
under Section 301.463, and if probable cause is found under Section
301.457(e)(2), the board or the board's authorized representative
shall initiate proceedings by filing formal charges against the
[registered] nurse.
(c) A copy of the formal charge shall be served on the
[registered] nurse or the nurse's counsel of record.
SECTION 1.050. Section 301.459(b), Occupations Code, is
amended to read as follows:
(b) In any hearing under this section, a [registered] nurse
is entitled to appear in person or by counsel.
SECTION 1.051. Section 301.462, Occupations Code, is
amended to read as follows:
Sec. 301.462. VOLUNTARY SURRENDER OF LICENSE. The board
may revoke a [registered] nurse's license without formal charges,
notice, or opportunity of hearing if the nurse voluntarily
surrenders the nurse's license to the board and executes a sworn
statement that the nurse does not desire to be licensed.
SECTION 1.052. Section 301.463(b), Occupations Code, is
amended to read as follows:
(b) An agreed disposition of a complaint is considered to be
a disciplinary order for purposes of reporting under this chapter
and an administrative hearing and proceeding by a state or federal
regulatory agency regarding the practice of [professional]
nursing.
SECTION 1.053. Section 301.466, Occupations Code, is
amended to read as follows:
Sec. 301.466. CONFIDENTIALITY. (a) A complaint and
investigation concerning a [registered] nurse under this
subchapter and all information and material compiled by the board
in connection with the complaint and investigation are:
(1) confidential and not subject to disclosure under
Chapter 552, Government Code; and
(2) not subject to disclosure, discovery, subpoena, or
other means of legal compulsion for release to anyone other than the
board or a board employee or agent involved in license holder
discipline.
(b) Notwithstanding Subsection (a), information regarding a
complaint and an investigation may be disclosed to:
(1) a person involved with the board in a disciplinary
action against the nurse;
(2) a [professional] nursing licensing or
disciplinary board in another jurisdiction;
(3) a peer assistance program approved by the board
under Chapter 467, Health and Safety Code;
(4) a law enforcement agency; or
(5) a person engaged in bona fide research, if all
information identifying a specific individual has been deleted.
(c) The filing of formal charges against a [registered]
nurse by the board, the nature of those charges, disciplinary
proceedings of the board, and final disciplinary actions, including
warnings and reprimands, by the board are not confidential and are
subject to disclosure in accordance with Chapter 552, Government
Code.
SECTION 1.054. Section 301.467(a), Occupations Code, is
amended to read as follows:
(a) On application, the board may reinstate a license to
practice professional nursing or vocational nursing to a person
whose license has been revoked, suspended, or surrendered.
SECTION 1.055. Section 301.468(a), Occupations Code, is
amended to read as follows:
(a) The board may determine that an order denying a license
application or suspending a license be probated. A person subject
to a probation order shall conform to each condition the board sets
as the terms of probation, including a condition:
(1) limiting the practice of the person to, or
excluding, one or more specified activities of professional nursing
or vocational nursing; or
(2) requiring the person to submit to supervision,
care, counseling, or treatment by a practitioner designated by the
board.
SECTION 1.056. Section 301.469, Occupations Code, is
amended to read as follows:
Sec. 301.469. NOTICE OF FINAL ACTION. If the board takes a
final disciplinary action, including a warning or reprimand,
against a [registered] nurse under this subchapter, the board shall
immediately send a copy of the board's final order to the nurse and
to the last known employer of the nurse.
ARTICLE 2. CONFORMING AMENDMENTS
SECTION 2.001. Section 84.003(5), Civil Practice and
Remedies Code, is amended to read as follows:
(5) "Volunteer health care provider" means an
individual who voluntarily provides health care services without
compensation or expectation of compensation and who is:
(A) an individual who is licensed to practice
medicine under Subtitle B, Title 3, Occupations Code;
(B) a retired physician who is eligible to
provide health care services, including a retired physician who is
licensed but exempt from paying the required annual registration
fee under Section 156.002, Occupations Code;
(C) a physician assistant licensed under Chapter
204, Occupations Code, or a retired physician assistant who is
eligible to provide health care services under the law of this
state;
(D) a registered nurse, including an advanced
nurse practitioner, or vocational nurse, licensed under Chapter
301, Occupations Code, or a retired vocational nurse or registered
nurse, including a retired advanced nurse practitioner, who is
eligible to provide health care services under the law of this
state;
(E) [a licensed vocational nurse licensed under
Chapter 302, Occupations Code, or a retired licensed vocational
nurse who is eligible to provide health care services under the law
of this state;
[(F)] a pharmacist licensed under Subtitle J,
Title 3, Occupations Code, or a retired pharmacist who is eligible
to provide health care services under the law of this state;
(F) [(G)] a podiatrist licensed under Chapter
202, Occupations Code, or a retired podiatrist who is eligible to
provide health care services under the law of this state;
(G) [(H)] a dentist licensed under Subtitle D,
Title 3, Occupations Code, or a retired dentist who is eligible to
provide health care services under the law of this state;
(H) [(I)] a dental hygienist licensed under
Subtitle D, Title 3, Occupations Code, or a retired dental
hygienist who is eligible to provide health care services under the
law of this state; or
(I) [(J)] an optometrist or therapeutic
optometrist licensed under Chapter 351, Occupations Code, or a
retired optometrist or therapeutic optometrist who is eligible to
provide health care services under the law of this state.
SECTION 2.002. Section 61.657(b), Education Code, is
amended to read as follows:
(b) The board shall appoint an eight-member advisory
committee to advise the board concerning assistance provided under
this subchapter to vocational nursing students. The advisory
committee consists of:
(1) a chair named by the board;
(2) one representative named by the Licensed
Vocational Nurses Association of Texas;
(3) one representative named by the Texas Organization
of Nurse Executives;
(4) one representative named by the Board of
[Vocational] Nurse Examiners;
(5) two representatives of vocational nursing
educational programs named by the Texas Association of Vocational
Nurse Educators;
(6) one representative named by the Texas Health Care
Association; and
(7) one representative named by the Texas Association
of Homes for the Aging.
SECTION 2.003. Section 232.002, Family Code, is amended to
read as follows:
Sec. 232.002. LICENSING AUTHORITIES SUBJECT TO CHAPTER.
The following are licensing authorities subject to this chapter:
(1) Department of Agriculture;
(2) Texas Commission on Alcohol and Drug Abuse;
(3) Texas Alcoholic Beverage Commission;
(4) Texas Appraiser Licensing and Certification
Board;
(5) Texas Board of Architectural Examiners;
(6) State Board of Barber Examiners;
(7) Texas Board of Chiropractic Examiners;
(8) Comptroller of Public Accounts;
(9) Texas Cosmetology Commission;
(10) Court Reporters Certification Board;
(11) State Board of Dental Examiners;
(12) Texas State Board of Examiners of Dietitians;
(13) Texas Funeral Service Commission;
(14) Texas Department of Health;
(15) Texas Department of Human Services;
(16) Texas Board of Professional Land Surveying;
(17) Texas Department of Licensing and Regulation;
(18) Texas State Board of Examiners of Marriage and
Family Therapists;
(19) Texas State Board of Medical Examiners;
(20) Midwifery Board;
(21) Texas Commission on Environmental Quality
[Natural Resource Conservation Commission];
(22) Board of Nurse Examiners;
(23) Texas Board of Occupational Therapy Examiners;
(24) Texas Optometry Board;
(25) Parks and Wildlife Department;
(26) Texas State Board of Examiners of Perfusionists;
(27) Texas State Board of Pharmacy;
(28) Texas Board of Physical Therapy Examiners;
(29) Texas State Board of Plumbing Examiners;
(30) Texas State Board of Podiatric Medical Examiners;
(31) Polygraph Examiners Board;
(32) Texas Commission on Private Security;
(33) Texas State Board of Examiners of Professional
Counselors;
(34) Texas Board of Professional Engineers;
(35) Department of Protective and Regulatory
Services;
(36) Texas State Board of Examiners of Psychologists;
(37) Texas State Board of Public Accountancy;
(38) Department of Public Safety of the State of
Texas;
(39) Public Utility Commission of Texas;
(40) Railroad Commission of Texas;
(41) Texas Real Estate Commission;
(42) State Bar of Texas;
(43) Texas State Board of Social Worker Examiners;
(44) State Board of Examiners for Speech-Language
Pathology and Audiology;
(45) Texas Structural Pest Control Board;
(46) Board of Tax Professional Examiners;
(47) Secretary of State;
(48) Supreme Court of Texas;
(49) Texas Transportation Commission;
(50) State Board of Veterinary Medical Examiners;
(51) [Board of Vocational Nurse Examiners;
[(52)] Texas Ethics Commission;
(52) [(53)] Advisory Board of Athletic Trainers;
(53) [(54)] State Committee of Examiners in the
Fitting and Dispensing of Hearing Instruments;
(54) [(55)] Texas Board of Licensure for Professional
Medical Physicists;
(55) [(56)] Texas Department of Insurance;
(56) [(57)] Texas Board of Orthotics and Prosthetics;
(57) [(58)] savings and loan commissioner;
(58) [(59)] Texas Juvenile Probation Commission; and
(59) [(60)] Texas Lottery Commission under Chapter
466, Government Code.
SECTION 2.004. Section 487.101(3), Government Code, is
amended to read as follows:
(3) "Postsecondary educational institution" means:
(A) an institution of higher education, as
defined by Section 61.003, Education Code;
(B) a nonprofit, independent institution
approved under Section 61.222, Education Code; or
(C) a nonprofit, health-related school or
program accredited by the Southern Association of Colleges and
Schools, the Liaison Committee on Medical Education, the American
Osteopathic Association, the Board of Nurse Examiners, [the Board
of Vocational Nurse Examiners,] or, in the case of allied health, an
accrediting body recognized by the United States Department of
Education.
SECTION 2.005. Section 487.151(2), Government Code, is
amended to read as follows:
(2) "Postsecondary educational institution" means:
(A) an institution of higher education, as
defined by Section 61.003, Education Code;
(B) a nonprofit, independent institution
approved under Section 61.222, Education Code; or
(C) a nonprofit, health-related school or
program accredited by the Southern Association of Colleges and
Schools, the Liaison Committee on Medical Education, the American
Osteopathic Association, the Board of Nurse Examiners, [the Board
of Vocational Nurse Examiners,] or, in the case of allied health, an
accrediting body recognized by the United States Department of
Education.
SECTION 2.006. Section 531.051(f), Government Code, is
amended to read as follows:
(f) Section 301.251(a), Occupations Code, does not apply to
delivery of a service for which payment is provided under the
voucher payment program developed under this section if:
(1) the person who delivers the service:
(A) has not been denied a license under Chapter
301 [or 302], Occupations Code;
(B) has not been issued a license under Chapter
301, Occupations Code, that is revoked or suspended; and
(C) provides a service listed under Subsection
(h); and
(2) the consumer who receives the service:
(A) has a functional disability and the service
would have been performed by the consumer, or the parent or guardian
for the consumer, except for that disability; and
(B) if:
(i) the consumer is capable of training the
person in the proper performance of the service, the consumer
directs the person to deliver the service; or
(ii) the consumer is not capable of
training the person in the proper performance of the service, the
consumer's parent or guardian is capable of training the person in
the proper performance of the service and directs the person to
deliver the service.
SECTION 2.007. Section 2054.252(a), Government Code, as
added by Chapter 353, Acts of the 77th Legislature, Regular
Session, 2001, is amended to read as follows:
(a) The following licensing authorities shall participate
in the system established under Section 2054.253, as added by
Chapter 353, Acts of the 77th Legislature, Regular Session, 2001:
(1) State Board of Barber Examiners;
(2) Texas Board of Chiropractic Examiners;
(3) Texas Cosmetology Commission;
(4) Court Reporters Certification Board;
(5) State Board of Dental Examiners;
(6) Texas Funeral Service Commission;
(7) Texas Board of Professional Land Surveying;
(8) Texas State Board of Medical Examiners;
(9) Board of Nurse Examiners;
(10) [Board of Vocational Nurse Examiners;
[(11)] Texas Optometry Board;
(11) [(12)] Texas Structural Pest Control Board;
(12) [(13)] Texas State Board of Pharmacy;
(13) [(14)] Executive Council of Physical Therapy and
Occupational Therapy Examiners;
(14) [(15)] Texas State Board of Plumbing Examiners;
(15) [(16)] Texas State Board of Podiatric Medical
Examiners;
(16) [(17)] Board of Tax Professional Examiners;
(17) [(18)] Polygraph Examiners Board;
(18) [(19)] Texas State Board of Examiners of
Psychologists;
(19) [(20)] State Board of Veterinary Medical
Examiners;
(20) [(21)] Texas Real Estate Commission;
(21) [(22)] Texas Appraiser Licensing and
Certification Board; and
(22) [(23)] Texas Department of Licensing and
Regulation.
SECTION 2.008. Section 81.010(c), Health and Safety Code,
is amended to read as follows:
(c) The council consists of one representative from each of
the following agencies appointed by the executive director or
commissioner of each agency:
(1) the department;
(2) the Texas Department of Mental Health and Mental
Retardation;
(3) the Texas Department of Human Services;
(4) the Texas Commission on Alcohol and Drug Abuse;
(5) the Texas Rehabilitation Commission;
(6) the Texas Youth Commission;
(7) the Texas Department of Criminal Justice;
(8) the Texas Juvenile Probation Commission;
(9) the Texas Commission for the Blind;
(10) the Texas Commission for the Deaf and Hard of
Hearing;
(11) the Department of Protective and Regulatory
Services;
(12) the Texas Education Agency;
(13) the Texas State Board of Medical Examiners;
(14) the Board of Nurse Examiners;
(15) [the Board of Vocational Nurse Examiners;
[(16)] the State Board of Dental Examiners;
(16) [(17)] the Health and Human Services Commission;
(17) [(18)] the Texas Department on Aging; and
(18) [(19)] the Texas Workforce Commission.
SECTION 2.009. Section 142.022, Health and Safety Code, is
amended to read as follows:
Sec. 142.022. EXEMPTIONS FOR NURSING STUDENTS AND
MEDICATION AIDE TRAINEES. (a) Sections 142.021 and 142.029 do not
apply to:
(1) a graduate nurse holding a temporary permit issued
by the Board of Nurse Examiners;
(2) a student enrolled in an accredited school of
nursing or program for the education of registered nurses who is
administering medications as part of the student's clinical
experience;
(3) a graduate vocational nurse holding a temporary
permit issued by the Board of [Vocational] Nurse Examiners;
(4) a student enrolled in an accredited school of
vocational nursing or program for the education of vocational
nurses who is administering medications as part of the student's
clinical experience; or
(5) a trainee in a medication aide training program
approved by the department under Section 142.024 who is
administering medications as part of the trainee's clinical
experience.
(b) The administration of medications by persons exempted
under Subdivisions (1) through (4) of Subsection (a) is governed by
the terms of the memorandum of understanding executed by the
department and the Board of Nurse Examiners [or the department and
the Board of Vocational Nurse Examiners, as appropriate].
SECTION 2.010. Section 164.003(6), Health and Safety Code,
is amended to read as follows:
(6) "Mental health professional" means a:
(A) "physician" as defined by Section 571.003;
(B) "licensed professional counselor" as defined
by Section 503.002, Occupations Code;
(C) "chemical dependency counselor" as defined
by Section 504.001, Occupations Code;
(D) "psychologist" offering "psychological
services" as defined by Section 501.003, Occupations Code;
(E) "registered nurse" licensed under Chapter
301, Occupations Code;
(F) "[licensed] vocational nurse" licensed under
Chapter 301 [as defined by Section 302.001], Occupations Code;
(G) "licensed marriage and family therapist" as
defined by Section 502.002, Occupations Code; and
(H) "social worker" as defined by Section
505.002, Occupations Code.
SECTION 2.011. Section 242.607, Health and Safety Code, is
amended to read as follows:
Sec. 242.607. EXEMPTIONS FOR NURSING STUDENTS AND
MEDICATION AIDE TRAINEES. (a) Sections 242.606 and 242.614 do not
apply to:
(1) a graduate nurse holding a temporary permit issued
by the Board of Nurse Examiners;
(2) a student enrolled in an accredited school of
nursing or program for the education of registered nurses who is
administering medications as part of the student's clinical
experience;
(3) a graduate vocational nurse holding a temporary
permit issued by the Board of [Vocational] Nurse Examiners;
(4) a student enrolled in an accredited school of
vocational nursing or program for the education of vocational
nurses who is administering medications as part of the student's
clinical experience; or
(5) a trainee in a medication aide training program
approved by the department under this subchapter who is
administering medications as part of the trainee's clinical
experience.
(b) The administration of medications by persons exempted
under Subdivisions (1) through (4) of Subsection (a) is governed by
the terms of the memorandum of understanding executed by the
department and the Board of Nurse Examiners [or the department and
the Board of Vocational Nurse Examiners, as appropriate].
SECTION 2.012. Section 36.132(a)(2), Human Resources Code,
is amended to read as follows:
(2) "Licensing authority" means:
(A) the Texas State Board of Medical Examiners;
(B) the State Board of Dental Examiners;
(C) the Texas State Board of Examiners of
Psychologists;
(D) the Texas State Board of Social Worker
Examiners;
(E) the Board of Nurse Examiners;
(F) [the Board of Vocational Nurse Examiners;
[(G)] the Texas Board of Physical Therapy
Examiners;
(G) [(H)] the Texas Board of Occupational
Therapy Examiners; or
(H) [(I)] another state agency authorized to
regulate a provider who receives or is eligible to receive payment
for a health care service under the Medicaid program.
SECTION 2.013. Section 101.002, Occupations Code, is
amended to read as follows:
Sec. 101.002. COMPOSITION OF COUNCIL. The council consists
of 14 [15] members, with one member appointed by each of the
following:
(1) the Texas Board of Chiropractic Examiners;
(2) the State Board of Dental Examiners;
(3) the Texas Optometry Board;
(4) the Texas State Board of Pharmacy;
(5) the Texas State Board of Podiatric Medical
Examiners;
(6) the State Board of Veterinary Medical Examiners;
(7) the Texas State Board of Medical Examiners;
(8) the Board of Nurse Examiners;
(9) the Texas State Board of Examiners of
Psychologists;
(10) [the Board of Vocational Nurse Examiners;
[(11)] the Texas Funeral Service Commission;
(11) [(12)] the entity that regulates the practice of
physical therapy;
(12) [(13)] the entity that regulates the practice of
occupational therapy;
(13) [(14)] the health licensing division of the Texas
Department of Health; and
(14) [(15)] the governor's office.
SECTION 2.014. Section 201.003(a), Occupations Code, is
amended to read as follows:
(a) This chapter does not apply to a registered nurse
licensed under Chapter 301, a vocational nurse licensed under
Chapter 301 [302], a person who provides spinal screening services
as authorized by Chapter 37, Health and Safety Code, a physical
therapist licensed under Chapter 453, or a massage therapist or a
massage therapy instructor qualified and registered under Chapter
455 if:
(1) the person does not represent to the public that
the person is a chiropractor or use the term "chiropractor,"
"chiropractic," "doctor of chiropractic," "D.C.," or any
derivative of those terms or initials in connection with the
person's name or practice; and
(2) the person practices strictly within the scope of
the license or registration held in compliance with all laws
relating to the license and registration.
SECTION 2.015. Section 203.402, Occupations Code, is
amended to read as follows:
Sec. 203.402. PROHIBITED REPRESENTATION. A midwife may
not:
(1) except as provided by Section 203.403, use in
connection with the midwife's name a title, abbreviation, or
designation tending to imply that the midwife is a "registered" or
"certified" midwife as opposed to one who is documented under this
chapter;
(2) advertise or represent that the midwife is a
physician or a graduate of a medical school unless the midwife is
licensed to practice medicine by the Texas State Board of Medical
Examiners;
(3) use advertising or an identification statement
that is false, misleading, or deceptive; or
(4) except as authorized by rules adopted by the Board
of Nurse Examiners [and the Board of Vocational Nurse Examiners],
use in combination with the term "midwife" the term "nurse" or
another title, initial, or designation that implies that the
midwife is licensed as a registered nurse or [licensed] vocational
nurse.
SECTION 2.016. Section 206.253(a), Occupations Code, is
amended to read as follows:
(a) This chapter does not authorize a person who holds a
license issued under this chapter to engage in the practice of:
(1) medicine, as defined by Subtitle B[, Title 3,
Occupations Code]; or
(2) [professional] nursing, as defined by Chapter
301[, Occupations Code; or
[(3) nursing, as defined by Chapter 302, Occupations
Code].
SECTION 2.017. Section 22.011(c)(3), Penal Code, is amended
to read as follows:
(3) "Health care services provider" means:
(A) a physician licensed under Subtitle B, Title
3, Occupations Code;
(B) a chiropractor licensed under Chapter 201,
Occupations Code;
(C) [a licensed vocational nurse licensed under
Chapter 302, Occupations Code;
[(D)] a physical therapist licensed under
Chapter 453, Occupations Code;
(D) [(E)] a physician assistant licensed under
Chapter 204, Occupations Code; or
(E) [(F)] a registered nurse, a vocational
nurse, or an advanced practice nurse licensed under Chapter 301,
Occupations Code.
SECTION 2.018. Sections 303.001(2) and (3), Occupations
Code, are amended to read as follows:
(2) "Nurse" means a registered nurse [licensed under
Chapter 301] or a [licensed] vocational nurse licensed under
Chapter 301 [302].
(3) "Nursing" has the meaning assigned by Section
301.002 [means professional nursing as defined by Chapter 301 or
vocational nursing as defined by Chapter 302].
SECTION 2.019. Section 303.002(b), Occupations Code, is
amended to read as follows:
(b) The board shall enter into a memorandum of understanding
with each state agency that licenses, registers, or certifies a
facility required by law to have a nursing [registered nurse] peer
review committee. The memorandum of understanding must:
(1) state the actions the board and agency are to take
to encourage compliance with the requirement to have a nursing
[registered nurse] peer review committee; and
(2) be adopted as a rule of the board and the agency.
SECTION 2.020. Sections 303.003(b) and (c), Occupations
Code, are amended to read as follows:
(b) A nursing peer review committee that conducts a peer
review that involves only the practice of vocational nursing must
have registered nurses and [licensed] vocational nurses as
three-fourths of its members, to the extent feasible must include
[licensed] vocational nurses as members, and may have only
registered nurses and [licensed] vocational nurses as voting
members.
(c) A nursing peer review committee that conducts a peer
review that involves the practice of both professional nursing and
[licensed] vocational nursing:
(1) must have registered nurses and [licensed]
vocational nurses as four-fifths of its members, with registered
nurses as three-fifths of its members;
(2) to the extent feasible must include [licensed]
vocational nurses as members; and
(3) may have only:
(A) registered nurses and [licensed] vocational
nurses as voting members when a [licensed] vocational nurse is
being reviewed; and
(B) registered nurses as voting members when a
registered nurse is being reviewed.
SECTION 2.021. Section 303.005, Occupations Code, is
amended by amending Subsections (a), (b), (c), (d), and (f) and
adding Subsection (h) to read as follows:
(a) In this section, "duty to a patient" means conduct
required by standards of practice or professional conduct adopted
by the board for nurses. The term includes administrative
decisions directly affecting a [registered] nurse's ability to
comply with that duty.
(b) If a person who regularly employs, hires, or otherwise
contracts for the services of at least 10 [registered] nurses
requests one of those nurses to engage in conduct that the nurse
believes violates a [registered] nurse's duty to a patient, the
nurse may request, on a form produced by the board, a determination
by a nursing peer review committee under this chapter of whether the
conduct violates a [registered] nurse's duty to a patient.
(c) A [registered] nurse who in good faith requests a peer
review determination under Subsection (b):
(1) may not be disciplined or discriminated against
for making the request;
(2) may engage in the requested conduct pending the
peer review;
(3) is not subject to the reporting requirement under
Subchapter I, Chapter 301; and
(4) may not be disciplined by the board for engaging in
that conduct while the peer review is pending.
(d) The determinations of the peer review committee shall be
considered in a decision to discipline the nurse, but the
determinations are not binding if a [registered] nurse
administrator believes in good faith that the peer review committee
has incorrectly determined a [registered] nurse's duty.
(f) A [registered] nurse's rights under this section may not
be nullified by a contract.
(h) A person is not required to provide a peer review
determination under this section for a request made by:
(1) a registered nurse, unless the person regularly
employs, hires, or otherwise contracts for the services of at least
five registered nurses; or
(2) a vocational nurse, unless the person regularly
employs, hires, or otherwise contracts for the services of at least
five vocational nurses.
SECTION 2.022. Section 304.002, Occupations Code, as added
by Chapter 1420, Acts of the 77th Legislature, Regular Session,
2001, is amended to read as follows:
Sec. 304.002. ADMINISTRATION OF COMPACT. The executive
director [directors] of the Board of Nurse Examiners is [and the
Board of Vocational Nurse Examiners are] the Nurse Licensure
Compact administrator [administrators] for this state. [The
executive director of the Board of Nurse Examiners is responsible
for administering matters relating to registered nurses. The
executive director of the Board of Vocational Nurse Examiners is
responsible for administering matters relating to licensed
vocational nurses.]
SECTION 2.023. Section 304.003, Occupations Code, as added
by Chapter 1420, Acts of the 77th Legislature, Regular Session,
2001, is amended to read as follows:
Sec. 304.003. RULES. The Board of Nurse Examiners [and the
Board of Vocational Nurse Examiners] may adopt rules necessary to
implement this chapter.
SECTION 2.024. Sections 304.004(b) and (c), Occupations
Code, as added by Chapter 1420, Acts of the 77th Legislature,
Regular Session, 2001, are amended to read as follows:
(b) Unless the context indicates otherwise or doing so would
be inconsistent with the Nurse Licensure Compact, nurses practicing
in this state under a license issued by a state that is a party to
the Nurse Licensure Compact have the same rights and obligations as
imposed by the laws of this state on license holders of the Board of
Nurse Examiners [or the Board of Vocational Nurse Examiners].
(c) The Board of Nurse Examiners has [and the Board of
Vocational Nurse Examiners have] the authority to determine whether
a right or obligation imposed on license holders applies to nurses
practicing in this state under a license issued by a state that is a
party to the Nurse Licensure Compact unless that determination is
inconsistent with the Nurse Licensure Compact.
SECTION 2.025. Section 304.005, Occupations Code, as added
by Chapter 1420, Acts of the 77th Legislature, Regular Session,
2001, is amended to read as follows:
Sec. 304.005. ENFORCEMENT. The Board of Nurse Examiners is
[and the Board of Vocational Nurse Examiners are] the state agency
[agencies] responsible for taking action against registered and
vocational nurses practicing in this state under a license issued
by a state that is a party to the Nurse Licensure Compact as
authorized by the Nurse Licensure Compact. The action shall be
taken in accordance with the same procedures for taking action
against registered and vocational nurses licensed by this state.
SECTION 2.026. Section 304.006(a), Occupations Code, as
added by Chapter 1420, Acts of the 77th Legislature, Regular
Session, 2001, is amended to read as follows:
(a) On request and payment of a reasonable fee, the Board of
Nurse Examiners [and the Board of Vocational Nurse Examiners] shall
provide a registered or vocational nurse licensed by this state
with a copy of information regarding the nurse maintained by the
coordinated licensure information system under Article 7 of the
Nurse Licensure Compact.
SECTION 2.027. Section 304.007, Occupations Code, as added
by Chapter 1420, Acts of the 77th Legislature, Regular Session,
2001, is amended to read as follows:
Sec. 304.007. ACCESS TO PRACTICE-RELATED INFORMATION.
Practice-related information provided by the Board of Nurse
Examiners [or the Board of Vocational Nurse Examiners] to
registered or vocational nurses licensed by this state shall be
made available by the board [boards] on request and at a reasonable
cost to nurses practicing in this state under a license issued by a
state that is a party to the Nurse Licensure Compact.
SECTION 2.028. Section 304.008(a), Occupations Code, as
added by Chapter 1420, Acts of the 77th Legislature, Regular
Session, 2001, is amended to read as follows:
(a) In reporting information to the coordinated licensure
information system under Article 7 of the Nurse Licensure Compact,
the Board of Nurse Examiners [and the Board of Vocational Nurse
Examiners] may disclose personally identifiable information about
the nurse, including social security number.
SECTION 2.029. Section 304.009, Occupations Code, as added
by Chapter 1420, Acts of the 77th Legislature, Regular Session,
2001, is amended to read as follows:
Sec. 304.009. WITHDRAWAL FROM COMPACT. (a) The governor
may withdraw this state from the Nurse Licensure Compact if the
Board of Nurse Examiners [or the Board of Vocational Nurse
Examiners] notifies the governor that a state that is party to the
compact changed, after January 1, 1999, the state's requirements
for licensing a nurse and that the state's requirements, as
changed, are substantially lower than the requirements for
licensing a nurse in this state.
(b) The governor may completely withdraw this state from the
Nurse Licensure Compact or may limit withdrawal to the application
of the compact to registered nurses or [licensed] vocational
nurses.
SECTION 2.030. Section 304.001(3), Occupations Code, as
added by Chapter 1489, Acts of the 77th Legislature, Regular
Session, 2001, is amended to read as follows:
(3) "Nurse" means a registered nurse or a [licensed]
vocational nurse.
ARTICLE 3. REPEALER; TRANSITION; EFFECTIVE DATE
SECTION 3.001. On February 1, 2004, the following laws are
repealed:
(1) Chapter 302, Occupations Code; and
(2) Section 303.002(a), Occupations Code.
SECTION 3.002. (a) This section provides for the
appointment of members to the Board of Nurse Examiners for terms
beginning February 1, 2004, to establish the staggering of members'
terms in accordance with Sections 301.051 and 301.054, Occupations
Code, as amended by this Act.
(b) The term of one of two registered nurse members of the
Board of Nurse Examiners scheduled to expire in 2007 expires
January 31, 2004. Those members shall agree or draw lots to
determine whose term expires on that date. Effective February 1,
2004, the governor shall appoint one person who is a nurse faculty
member of a school of nursing offering vocational nurse training to
fill that vacancy and to serve a term expiring January 31, 2007.
(c) Effective February 1, 2004, the governor shall appoint
one person who shall serve as a public member of the Board of Nurse
Examiners with a term expiring January 31, 2009, as provided under
Section 301.051, Occupations Code, as amended by this Act.
(d) Effective February 1, 2004, the governor shall appoint
three additional members to the Board of Nurse Examiners to serve in
the position of vocational nurse, as provided under Section
301.051, Occupations Code, as amended by this Act. In appointing
those members, the governor shall appoint one person to a term
expiring January 31, 2005, one to a term expiring January 31, 2007,
and one to a term expiring January 31, 2009.
SECTION 3.003. (a) On February 1, 2004:
(1) all functions and activities performed by the
Board of Vocational Nurse Examiners immediately before that date
are transferred to the Board of Nurse Examiners;
(2) a rule or form adopted by the Board of Vocational
Nurse Examiners is a rule or form of the Board of Nurse Examiners
and remains in effect until amended or replaced by that board;
(3) a reference in law or an administrative rule to the
Board of Vocational Nurse Examiners means the Board of Nurse
Examiners;
(4) a complaint, investigation, or other proceeding
before the Board of Vocational Nurse Examiners is transferred
without change in status to the Board of Nurse Examiners, and the
Board of Nurse Examiners assumes, as appropriate and without a
change in status, the position of the Board of Vocational Nurse
Examiners in an action or proceeding to which the Board of
Vocational Nurse Examiners is a party;
(5) all money, contracts, leases, property, and
obligations of the Board of Vocational Nurse Examiners are
transferred to the Board of Nurse Examiners;
(6) a license issued by the Board of Vocational Nurse
Examiners is a license of the Board of Nurse Examiners;
(7) an employee of the Board of Vocational Nurse
Examiners, except for the Board of Vocational Nurse Examiners'
executive director, becomes an employee of the Board of Nurse
Examiners; and
(8) the unexpended and unobligated balance of any
money appropriated by the legislature for the Board of Vocational
Nurse Examiners is transferred to the Board of Nurse Examiners.
(b) Before February 1, 2004, the Board of Vocational Nurse
Examiners may agree with the Board of Nurse Examiners to transfer
any property of the Board of Vocational Nurse Examiners to the Board
of Nurse Examiners to implement the transfer required by this
section.
(c) In the period beginning on the effective date of this
Act and ending on January 31, 2004, the Board of Vocational Nurse
Examiners shall continue to perform functions and activities under
Chapter 302, Occupations Code, or other law as if that chapter had
not been repealed or other law had not been amended by this Act, and
the former law is continued in effect for that purpose.
SECTION 3.004. (a) Not later than June 1, 2004, the Board
of Nurse Examiners shall adopt the rules required by Section
301.305, Occupations Code, as added by this Act.
(b) A license holder may not be required to complete the
continuing education requirements imposed by Section 301.305,
Occupations Code, as added by this Act, before June 1, 2006.
(c) As part of the next review conducted under Section
301.003, Occupations Code, as amended by this Act, the Sunset
Advisory Commission shall evaluate the necessity and effectiveness
of mandating continuing education courses for nurses on specific
topics.
SECTION 3.005. In the event of a conflict between a
provision of this Act and another Act passed by the 78th
Legislature, Regular Session, 2003, that becomes law, this Act
prevails and controls regardless of the relative dates of
enactment.
SECTION 3.006. (a) Except as provided by Subsection (b) of
this section, this Act takes effect September 1, 2003.
(b) Article 2 of this Act takes effect February 1, 2004.
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