Part 4.
TEXAS COSMETOLOGY COMMISSION
Chapter 83.
SANITARY RULINGS
22 TAC §83.14
The Texas Cosmetology Commission proposes an amendment to §83.14,
concerning Disinfection Practices and Procedures, by adding subsection (j).
Subsection (j) specifies the procedure and frequency in which a licensed cosmetologist
or manicurist must disinfect a "whirlpool footspa" or "spa." The amendment
is proposed as a result of a need to protect the public from potential infection
due to use of an improperly sanitized "whirlpool footspa" or "spa."
Antoinette Humphrey, Executive Director, Texas Cosmetology Commission,
has determined that for the first five-year period the amendment is in effect,
there will be no fiscal implications for state or local government as a result
of enforcing or administering the amended section.
Ms. Humphrey has also determined that for each year of the first five years
the amendment is in effect, the public benefit anticipated as a result of
enforcing the amended section will be to better ensure that the public is
protected from harmful contaminants that can be present and spread in a whirlpool
footspa if they are not properly and regularly cleaned and disinfected. There
will be no effect on small businesses. There are no anticipated economic costs
to persons who are required to comply with the amendment as proposed.
Comments on the proposed amendment may be submitted to Virgil Seals, Texas
Cosmetology Commission, P.O. Box 26700, Austin, Texas 78755-0700. Comments
may also be submitted electronically to virgil.seals@txcc.state.tx.us or faxed
to (512) 454-0339.
The amendment is proposed under Texas Occupations Code, Chapter
1602, §1602.151, which provides the commission with the authority to
"adopt rules consistent with this chapter," to protect the public's health
and safety.
There are no other statutes affected by this proposed amendment.
§83.14.Disinfection Practices and Procedures.
(a) - (i)
(No change.)
(j)
Cleaning and Disinfecting Whirlpool Footspas.
(1)
As used in this section, "whirlpool footspa" or "spa" is
defined as any basin using circulating water.
(2)
Before use upon each patron, each whirlpool footspa shall
be cleaned and disinfected in the following manner:
(A)
All water shall be drained and all debris shall be removed
from the spa basin.
(B)
The spa basin must be cleaned with soap or detergent and
water.
(C)
The spa basin must be disinfected with an EPA--registered
disinfectant with demonstrated bactericidal, fungicidal, and virucidal activity
which must be used according to manufacturer's instructions.
(D)
The spa basin must be wiped dry with a clean towel.
(3)
At the end of each day, each whirlpool footspa shall be
cleaned and disinfected in the following manner:
(A)
The screen shall be removed, all debris trapped behind
the screen shall be removed, and the screen and the inlet shall be washed
with soap and water or detergent and water.
(B)
Before replacing the screen, one of the following procedures
shall be performed:
(i)
The screen shall be washed with a chlorine bleach solution
of one teaspoon of 5% chlorine bleach to one (1) gallon of water, or
(ii)
The screen shall be totally immersed in an EPA--registered
disinfectant with demonstrated bactericidal, fungicidal, and virucidal activity
which must be used according to manufacturer's instructions.
(C)
The spa system shall be flushed with low sudsing soap and
warm water for at least ten (10) minutes, after which the spa shall be rinsed
and drained.
(4)
Every other week (bi-weekly), after cleaning and disinfecting
as provided in subsection (c) of this section, each whirlpool footspa shall
be cleaned and disinfected in the following manner:
(A)
The spa basin shall be filled completely with water and
one (1) teaspoon of 5% bleach for each one (1) gallon of water.
(B)
The spa system shall be flushed with the bleach and water
solution for 5 to 10 minutes and allowed to sit for 6 to 10 hours.
(C)
The spa system shall be drained and flushed with water
before use upon a patron.
(i)
A record shall be made of the date and time of each cleaning
and disinfecting as required by paragraphs (2) and (3) of this subsection
indicate whether the cleaning was a daily or bi-weekly cleaning. This record
shall be made at or near the time of cleaning and disinfecting. Cleaning and
disinfecting records shall be made available upon request by either a patron
or a Texas Cosmetology Commission representative.
(ii)
A violation of this section may result in an administrative
fine and/or disciplinary action. Each footspa not in compliance with this
section may result in a separate violation.
This agency hereby certifies that the proposal
has been reviewed by legal counsel and found to be within the agency's legal
authority to adopt.
Filed with the Office of
the Secretary of State on May 3, 2004.
TRD-200402990
Antoinette Humphrey
Executive Director
Texas Cosmetology Commission
Earliest possible date of adoption: June 13, 2004
For further information, please call: (512) 380-7644
22 TAC §89.1
The Texas Cosmetology Commission proposes amendment to §89.1(b)
of the Commission's schedule of fines by adding subsection (j) concerning
failure to sanitize Whirlpool Footspas (each foot spa) and §89.1(b) of
the Commission's schedule of fines by adding subsection 1602.267 concerning
Shampoo Apprentice Permit.
Ms. Antoinette Humphrey, Executive Director, Texas Cosmetology Commission,
has determined that for the first five-year period the rule is in effect,
there will be no fiscal implications for state or local government as a result
of enforcing or administering rule 89.1 (j) concerning failure to sanitize
Whirlpool Footspas (each foot spa).
Ms. Humphrey has also determined that for each year of the first five years
this rule is in effect, the public benefit anticipated as a result of enforcing
the rule will be to better ensure that the public is protected from harmful
contaminants that can be present and spread in a whirlpool footspa if they
are not properly and regularly cleaned and disinfected. There will be no effect
on small businesses. There are no anticipated economic costs to persons who
are required to comply with the rule as proposed.
Ms. Antoinette Humphrey, Executive Director, Texas Cosmetology Commission,
has determined that for the first five-year period the rule is in effect there
will be a fiscal impact of $15,000 per year to state government concerning
the implementation of the Shampoo Apprentice Permit.
Ms. Humphrey has also determined that for each year of the first five years
the Shampoo Apprentice Permit rule is in effect, the public benefit will be
that persons interested in pursuing a career in cosmetology would receive
training in a salon prior to becoming licensed in Texas. Any cost to small
businesses associated with this rule will be as a result of hiring a shampoo
apprentice to work in the business. There are no anticipated economic costs
to persons who are required to comply with the rule as proposed.
These sections specify the actual civil penalties the commission shall
assess for 1st, 2nd and 3rd violations.
Comments on these proposed rules may be submitted to Mr. Virgil Seals,
Texas Cosmetology Commission, P.O. Box 26700, Austin, Texas 78755-0700. Comments
may also be submitted electronically to virgil.seals@txcc.state.tx.us or faxed
to 512-454-0339.
The amended sections are proposed under Texas Occupations Code,
Chapter 1602, 1602.151, which provides the commission with the authority to
"adopt rules consistent with this chapter", to protect the public's health
and safety.
§89.1.Schedule of fines.
(a)
(No change.)
(b) Schedule of fines: In accordance with Chapter 1602, Title
9, Occupations Code, the commission shall adopt the following fine schedules
for the 1st, 2nd and 3rd violation of the following practitioner, facility,
and independent contractor licensing rules. For the 4th and subsequent offenses,
the provisions of Chapter 1602, Occupations Code, will apply.
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of the Secretary of State on May 3, 2004.
TRD-200402968
Antoinette Humphrey
Executive Director
Texas Cosmetology Commission
Earliest possible date of adoption: June 13, 2004
For further information, please call: (512) 380-7644
22 TAC §89.15
The Texas Cosmetology Commission proposes an amendment to §89.15,
concerning apprenticeship permits for shampoo technicians, by adding subsection
(l). Subsection (l) specifies that the commission as of January 1, 2004, may
issue a Shampoo Apprentice Permit to an applicant who is at least 16 years
of age. The amendment is proposed as a result of House Bill 653, Shampoo Apprentice
Permit enacted by the 78th Texas Legislature.
Antoinette Humphrey, Executive Director, Texas Cosmetology Commission,
has determined that for the first five-year period the amendment is in effect
there will be a fiscal impact of $15,000 per year to state government. There
will be no fiscal implications for local government as a result of enforcing
or administering the amended section.
Ms. Humphrey has also determined that for each year of the first five years
the amendment is in effect, the public benefit for the first five year period
will be that persons interested in pursuing a career in cosmetology would
receive training in a salon prior to becoming licensed. Any cost to small
businesses associated with this amendment will be as a result of hiring a
shampoo apprentice to work in the business. There are no anticipated economic
costs to persons who are required to comply with the amendment as proposed.
Comments on the proposed amendment may be submitted to Virgil Seals, Texas
Cosmetology Commission, P.O. Box 26700, Austin, Texas 78755-0700. Comments
may also be submitted electronically to virgil.seals@txcc.state.tx.us or faxed
to (512) 454-0339.
The amendment is proposed under Texas Occupations Code, Chapter
1602, §1602.151, which provides the commission with the authority to
"adopt rules consistent with this chapter," to protect the public's health
and safety.
There are no other statutes affected by this proposed amendment.
§89.15.Definitions of License Authorizations.
(a) - (k)
(No change.)
(l)
Effective January 1, 2004, the commission
may issue a Shampoo Apprentice Permit to an applicant who is at least 16 years
of age.
(1)
Effective January 1, 2004, the commission shall not:
(A)
require payment of a fee for said permit,
(B)
require prior completion of instruction at a cosmetology
program as a prerequisite for the issuance of a shampoo apprentice permit,
(C)
renew said permit once the initial twelve (12) month period
has expired for each permit holder,
(D)
grant school hours toward credit for a license through
an approved TxCC accredited facility/school as a result of time spent while
holding a Shampoo Apprentice Permit.
(2)
The Shampoo Apprentice Permit holder:
(A)
shall perform only the practice of cosmetology as defined
in
§1602.002(3) shampooing and conditioning
a person's hair
,
(B)
shall be restricted to working in a facility licensed under
this chapter.
(m)
[
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of
the Secretary of State on May 3, 2004.
TRD-200402989
Antoinette Humphrey
Executive Director
Texas Cosmetology Commission
Earliest possible date of adoption: June 13, 2004
For further information, please call: (512) 380-7644
Chapter 163.
LICENSURE
22 TAC §163.1
The Texas State Board of Medical Examiners proposes an amendment
to §163.1, concerning Definitions. The proposal adds new definitions
concerning Telemedicine.
Michele Shackelford, General Counsel, Texas State Board of Medical Examiners,
has determined that for the first five-year period the proposed rule is in
effect, there will be no fiscal implications to state or local government
as a result of enforcing the rule as proposed.
Ms. Shackelford also has determined that for each year of the first five
years the rule as proposed is in effect the public benefit anticipated as
a result of enforcing the section will be an updated rule. There will be no
effect on small or micro businesses. There will be no effect to individuals
required to comply with the section as proposed.
Comments on the proposal may be submitted to Colleen Klein, P.O. Box 2018,
Austin, Texas 78768-2018. A public hearing will be held at a later date.
The amendment is proposed under the authority of the Occupations
Code Annotated, §153.001, which provides the Texas State Board of Medical
Examiners to adopt rules and bylaws as necessary to: govern its own proceedings;
perform its duties; regulate the practice of medicine in this state; and enforce
this subtitle.
The following are affected by the proposed rule: Texas Occupations Code
Annotated, §§151.002, 151.056, 155.001, 155.002, 155.003, 155.0031,
155.004, 155.005, 155.007, 155.008, 155.051, 155.0511, 155.052, 155.053, 155.054,
155.055, 155.056, 155.057, 155.058, 155.104.
§163.1.Definitions.
(a)
The following words and terms,
(concerning
General Definitions)
when used in this chapter, shall have the following
meanings, unless the context clearly indicate otherwise.
(1)
Acceptable approved medical school--A medical school or
college located in the United States or Canada that has been accredited by
the Liaison Committee on Medical Education or the American Osteopathic Association
Bureau of Professional Education.
(2)
Acceptable unapproved medical school--A school or college
located outside the United States or Canada that:
(A)
is substantially equivalent to a Texas medical school;
and
(B)
has not been disapproved by another state physician licensing
agency unless the applicant can provide evidence that the disapproval was
unfounded.
(3)
Affiliated hospital--Affiliation status of a hospital with
a medical school as defined by the Liaison Committee on Medical Education
and documented by the medical school in its application for accreditation.
(4)
Applicant--One who files an application as defined in this
section.
(5)
Application--An application is all documents and information
necessary to complete an applicant's request for licensure including the following:
(A)
forms furnished by the board, completed by the applicant:
(i)
all forms and addenda requiring a written response must
be typed or printed in ink;
(ii)
photographs must meet United States Government passport
standards;
(B)
all documents required under section 163.5 of this title
(relating to Licensure Documentation); and
(C)
the required fee, payable by check through a United States
bank.
(6)
Board--Texas State Board of Medical Examiners
(7)
Continuous--12 month periods of uninterrupted postgraduate
training with no absences greater than 21 days, unless such absences have
been approved by the training program.
(8)
Eligible for licensure in country of graduation--An applicant
must be eligible for licensure in the country in which the medical school
is located except for any citizenship requirements.
(9)
Examinations accepted by the board for licensure.
(A)
United States Medical Licensing Examination (USMLE), with
a score of 75 or better, or a passing grade if applicable, on each step, with
all steps passed within seven years;
(B)
Federation Licensing Examination (FLEX), on or after July
1, 1985, passage of both components within seven years with a score of 75
or better on each component;
(C)
Federation Licensing Examination (FLEX), before July 1,
1985, with a FLEX weighted average of 75 or better in one sitting;
(D)
National Board of Medical Examiners Examination (NBME)
or its successor with all steps passed within seven years;
(E)
National Board of Osteopathic Medical Examiners Examination
(NBOME) or its successor with all steps passed within seven years;
(F)
Medical Council of Canada Examination (LMCC) or its successor,
with all steps passed within seven years;
(G)
State board licensing examination, passed before January
1, 1977, (with the exception of Virgin Islands, Guam, Tennessee Osteopathic
Board or Puerto Rico then the exams must be passed before July 1, 1963); or
(H)
One of the following examination combinations with a score
of 75 or better on each part, level, component, or step, all parts, levels,
components, or steps must be passed within seven years:
(i)
FLEX I plus USMLE 3;
(ii)
USMLE 1 and USMLE 2 (including passage of the clinical
skills component if applicable), plus FLEX II;
(iii)
NBME I or USMLE 1, plus NBME II or USMLE 2 (including
passage of the clinical skills component if applicable), plus NBME III or
USMLE 3;
(iv)
NBME I or USMLE 1, plus NBME II or USMLE 2 (including
passage of the clinical skills component if applicable), plus FLEX II;
(v)
NBOME I, plus NBOME II, plus FLEX II;
(vi)
the NBOME Part I or COMLEX Level I and NBOME Part II or
COMLEX Level II and NBOME Part III or COMLEX Level III.
(I)
An applicant must pass each part of an examination within
three attempts, except that an applicant who has passed all but one part of
an examination within three attempts may take the remaining part of the examination
one additional time.
(J)
Notwithstanding subparagraph (I) of this paragraph, an
applicant is considered to have satisfied the requirements of this section
if the applicant:
(i)
passed all but one part of an examination approved by the
board within three attempts and passed the remaining part of the examination
within five attempts;
(ii)
is specialty board certified by a specialty board that:
(I)
is a member of the American Board of Medical Specialties;
or
(II)
is a member of the Bureau of Osteopathic Specialists;
and
(iii)
completed in this state an additional two years of postgraduate
medical training approved by the board.
(K)
An applicant who has not passed an examination for licensure
in a ten-year period prior to the filing date of the application must:
(i)
pass a monitored specialty certification examination or
formal evaluation, a monitored recertification examination or formal evaluation,
or a monitored examination of continued demonstration of qualifications by
a board that is a member of the American Board of Medical Specialties or the
Bureau of Osteopathic Specialists within the preceding ten years;
(ii)
obtain through extraordinary circumstances, unique training
equal to the training required for specialty certification as determined by
a committee of the board and approved by the board, including but not limited
to participation for at least six months in a training program approved by
the board within twelve months prior to the application for licensure; or
(iii)
pass the Special Purpose Examination (SPEX) within the
preceding ten years.
(10)
Good professional character--An applicant for licensure
must not be in violation of or committed any act described in the Medical
Practice Act, Tex. Occ. Code Ann. §§164.051-.053.
(11)
One-year training program--a program that is one continuous
year of postgraduate training approved by the board that is:
(A)
accepted for certification by a specialty board that is
a member of the American Board of Medical Specialties or the Bureau of Osteopathic
Specialists; or
(B)
accredited by one of the following:
(i)
the Accreditation Council for Graduate Medical Education,
or its predecessor;
(ii)
the American Osteopathic Association;
(iii)
the Committee on Accreditation of Preregistration Physician
Training Programs, Federation of Provincial Medical Licensing Authorities
of Canada;
(iv)
the Royal College of Physicians and Surgeons of Canada;
or
(v)
the College of Family Physicians of Canada; or
(C)
a postresidency program, usually called a fellowship, performed
in the U.S. or Canada and approved by the board for additional training in
a medical specialty or subspecialty.
(12)
Sixty (60) semester hours of college courses--60 semester
hours of college courses other than in medical school that are acceptable
to The University of Texas at Austin for credit on a bachelor of arts degree
or a bachelor of science degree; the entire primary, secondary, and premedical
education required in the country of medical school graduation, if the medical
school is located outside the United States or Canada; or substantially equivalent
courses as determined by the board.
(13)
Substantially equivalent to a Texas medical school--A
medical school or college that is an institution of higher learning designed
to select and educate medical students; provide students with the opportunity
to acquire a sound basic medical education through training in basic sciences
and clinical sciences; provide advancement of knowledge through research;
develop programs of graduate medical education to produce practitioners, teachers,
and researchers; and afford opportunity for postgraduate and continuing medical
education. The school must provide resources, including faculty and facilities,
sufficient to support a curriculum offered in an intellectual environment
that enables the program to meet these standards. The faculty of the school
shall actively contribute to the development and transmission of new knowledge.
The medical school shall contribute to the advancement of knowledge and to
the intellectual growth of its students and faculty through scholarly activity,
including research. The medical school shall include, but not be limited to,
the following characteristics:
(A)
The facilities for basic sciences and clinical training
(i.e., laboratories, hospitals, library, etc.) shall be adequate to ensure
opportunity for proper education.
(B)
The admissions standards shall be substantially equivalent
to a Texas medical school.
(C)
The basic sciences curriculum shall include the contemporary
content of those expanded disciplines that have been traditionally titled
gross anatomy, biochemistry, biology, histology, physiology, microbiology,
immunology, pathology, pharmacology and neuroscience, as defined by the Texas
Higher Education Coordinating Board.
(D)
The fundamental clinical subjects, which shall be offered
in the form of required patient-related clerkships, are internal medicine,
obstetrics and gynecology, pediatrics, psychiatry, neurology, family practice,
introduction to patient/physical examination, and surgery, as defined by the
Texas Higher Education Coordinating Board.
(E)
The curriculum shall be of at least 130 weeks in duration.
(F)
The school shall provide advancement of knowledge through
research.
(G)
The school shall develop programs of graduate medical education
to produce practitioners, teachers, and researchers.
(H)
The school shall provide opportunity for postgraduate and
continuing medical education.
(I)
Medical education courses must be centrally organized,
integrated and controlled into a continuous program which was conducted, monitored
and approved by the medical school which issues the degree.
(14)
Texas Medical Jurisprudence Examination (JP exam): the
ethics examination administered by the board for licensure that must be passed
by an applicant for licensure within three attempts with a score 75 or better.
(15)
Three-year training program--three continuous years of
postgraduate training in the United States or Canada, progressive in nature
and acceptable for specialty board certification in one specialty area that
is:
(A)
accredited by one of the following:
(i)
the Accreditation Council for Graduate Medical Education;
(ii)
the American Osteopathic Association;
(iii)
the Committee on Accreditation of Preregistration Physician
Training Programs, Federation of Provincial Medical Licensing Authorities
of Canada;
(iv)
the Royal College of Physicians and Surgeons of Canada;
(v)
the College of Family Physicians of Canada; or
(vi)
all programs approved by the board after August 25, 1984;
or
(B)
a board-approved program for which a Faculty Temporary
Permit was issued; or
(C)
a postresidency program, usually called a fellowship, for
additional training in a medical specialty or subspecialty, approved by the
Texas State Board of Medical Examiners.
(b)
The following words and terms,
(concerning Telemedicine Definitions) when used in this chapter shall have
the following meanings unless the context indicates otherwise.
(1)
Act that is part of patient care service--Any
diagnosis, assessment, or treatment including the taking of diagnostic imaging
studies as well as the preparation of pathological material for examination.
(2)
Episodic consultation--Consultation on an irregular
or infrequent basis involving no more than 24 patients of a physician's diagnostic
or therapeutic practice per calendar year. Multiple consultations may be performed
for one or more patients up to 24 patients per calendar year.
(3)
Informal consultation--Consultation performed
outside the context of a contractual relationship and on an irregular or infrequent
basis without the expectation of or exchange of direct or indirect compensation.
(4)
Patient care service initiated in this state--Any
act constituting the practice of medicine as defined in this chapter in which
the patient is physically located in Texas at the time of diagnosis, treatment,
or testing.
(5)
Person--An individual unless otherwise expressly
made applicable to a partnership, association, or corporation.
(6)
Practice of medicine--A person shall be considered
to be practicing medicine under any of the following circumstances listed
in subparagraphs (A) - (D) of this paragraph. This definition does not negate
the responsibility of applicants to demonstrate engagement in the active practice
of medicine as set forth in section 163.11 of this title (relating to Active
Practice of Medicine).
(A)
the person publicly professes to be a physician
or surgeon and diagnoses, treats, or offers to treat any mental or physical
disease or disorder, or any physical deformity or injury by any system or
method or to effect cures thereof;
(B)
the person diagnoses, treats or offers to treat
any mental or physical disease or disorder, or any physical deformity or injury
by any system or method and to effect cures thereof and charges therefor,
directly or indirectly, money or other compensation;
(C)
the person exercises medical judgment, renders
an opinion, or gives advice concerning the diagnosis or treatment of a patient,
or makes any determination regarding the appropriate or necessary medical
response to a particular patient's medical condition; or
(D)
the person is physically located in another
jurisdiction, other than the state of Texas, and through any medium performs
an act that is part of patient care service initiated in this state that would
affect the diagnosis or treatment of the patient.
(7)
State--Any state, territory, or insular possession
of the United States and the District of Columbia.
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State on May 3, 2004.
TRD-200402961
Donald W. Patrick, MD, JD
Executive Director
Texas State Board of Medical Examiners
Earliest possible date of adoption: June 13, 2004
For further information, please call: (512) 305-7016
Chapter 217.
LICENSURE, PEER ASSISTANCE AND PRACTICE
22 TAC §§217.1, 217.3, 217.6 - 217.10, 217.13, 217.15, 217.16, 217.19, 217.20
The Board of Nurse Examiners proposes amendments to 22 TAC §§217.1,
217.3, 217.6 - 217.10, 217.13, 217.15, 217.16, 217.19, and 217.20, concerning
Licensure, Peer Assistance, and Practice. Effective February 1, 2004, the
Board of Nurse Examiners and Board of Vocational Nurse Examiners were merged
into one agency, Board of Nurse Examiners. House Bill 1483, passed by the
78th Regular Legislative Session, was the legislative action that implemented
the consolidation. These proposed amendments implement HB 1483 and the make-
up and function of the new Board of Nurse Examiners. Any change in the rule
language merely tracks the statutory language or includes "licensed vocational
nurses" with "professional" or "registered nurses."
The proposed amendments are primarily for the purpose of providing consistent
licensing processes to all nurses. Section 217.1 addresses the definitions
to be used by the combined board. It includes some of the definitions used
by the former Board of Vocational Nurse Examiners, and attempts to clarify
some of the Board of Nurse Examiners' definitions by using more appropriate
terminology and including language inclusive of licensed vocational nursing
practice. Section 217.3 is broadened to include licensed vocational nurses
and to apply the same temporary permit process to all nurses. Sections 217.6,
217.7, 217.8, and 217.15 are broadened to include all nurses in the same license
renewal, change of address, credentialing, and copying of license requirements.
Section 217.9, Inactive Status, and §217.10 reflect the statutory language
of Texas Occupations Code §§301.261 (§217.9) and 301.351, 301.251,
301.4515 (§217.10) respectively, and the titles applicable to all nurses.
This language does not include "LVN, Emeritus" as the statute did not provide
for such title; therefore, "LVN, Emeritus" is brought under the title of "LVN,
Retired." Sections 217.13 (Peer Assistance Programs), 217.16 (Minor Incidents),
and 217.19 (Incident-Based Nursing Peer Review) were similar processes used
by both boards which are being brought under one umbrella of rules. The issues
addressed in these rules are also statutorily addressed. Rule 217.20 (Safe
Harbor Peer Review) includes a new protection to licensed vocational nurses
(LVNs) which did not exist until the boards were consolidated. Licensed vocational
nurses are now statutorily (§301.352) and by rule provided the right
to invoke safe harbor when they feel that they are put in a situation which
would be in violation of the Nursing Practice Act or a Board rule. The existing
Board of Vocational Nurse Examiners' rules which are in conflict which these
proposed amendments are concurrently being proposed for repeal.
Katherine Thomas, executive director, has determined that for the first
five-year period the proposed amendments are adopted there will be no fiscal
implications for state or local government as a result of implementing the
proposed amendments.
Katherine Thomas, executive director, has determined that for each year
of the first five years the proposed amendments are adopted, the public benefit
will be that the legislative intent of consolidating the boards and fiscal
austerity will be accomplished. There will be no effect on small businesses.
There is no anticipated additional economic cost to persons who are required
to comply with the proposed amendments.
Written comments on the proposal may be submitted to Katherine A. Thomas,
MN, RN, Executive Director, Board of Nurse Examiners, 333 Guadalupe, Suite
3-460, Austin, Texas 78701.
The proposed adoption of amendments to these sections is pursuant
to the authority of Texas Occupations Code §§301.151 and 301.152
which authorizes the Board of Nurse Examiners to adopt, enforce, and repeal
rules consistent with its legislative authority under the Nursing Practice
Act. The adoption of the proposed amendments implement section §§301.251,
301.258, 301.261, 301.351, 301.352, 301.419, and 301.4515 of the Texas Occupations
Code.
§217.1.Definitions.
The following words and terms, when used in this chapter, shall have
the following meanings, unless the context clearly indicates otherwise:
(1)
Academic course--A specific set of learning experiences
offered in an accredited school, college or university. Academic credit will
convert on the following basis: One academic quarter hour = 10 contact hours;
one academic semester hour = 15 contact hours.
[
(2)
[
(3)
[
(4)
[
(5)
Approved/Accredited nursing
program--A school, department, or division of nursing approved/accredited
by a nursing board or other licensing authority which has jurisdiction over
approval/accreditation of nursing programs.
(6)
Board--The Board of Nurse Examiners for the State of Texas.
(7)
Commission on Graduates of Foreign Nursing Schools (CGFNS)
Certificate--Documentation that verifies the educational credentials and
/or
CGFNS examination results of graduates of foreign nursing schools.
(8)
Declaratory order--An order issued by the Board pursuant
to
Texas Occupations Code §301.257,
[
(9)
Delinquent
[
(10)
Direct supervision--Requires a [
(11)
Eligibility order--An order, issued by the Board pursuant
to
Texas Occupations Code §§301.256, 301.257 and 301.259
[
(12)
Endorsement--The process of issuing a permanent license
without further examination to a [
(13)
First level, general nurse--Refers to the International
Council of Nurses (ICN) classification of nurses. A first-level nurse is called
a registered or professional nurse in most countries. A general nurse has
studied theory and had clinical practice in a variety of nursing areas. [
(14)
Graduate of a foreign nursing school--An individual who
graduated from a post-secondary nursing education program that prepares [
(15)
Graduate nurse (GN)--Graduates
of approved professional nursing programs who are issued a permit to practice
for a specific time period until they successfully meet all licensure requirements.
(16)
Graduate vocational nurse
(GVN)--Graduates of approved vocational nursing programs who are issued a
permit to practice for a specific time period until they successfully meet
all licensure requirements.
(17)
[
(18)
Indirect supervision--Requires
a nurse to be readily available if needed for consultation to coordinate,
direct, and observe another individual for whom the nurse is responsible.
(19)
[
(20)
Licensed Vocational Nurse--See
Vocational Nurse.
(21)
[
(22)
National Council Licensure
Examination for Practical Nurses (NCLEX-PN)--The test used by the board to
measure minimal competence for licensure as a vocational nurse.
(23)
[
(24)
Nurse--a person required to
be licensed under Texas Occupations Code chapter 301 to engage in professional
or vocational nursing.
(25)
[
(26)
[
(27)
[
(28)
[
(29)
[
(30)
[
(A)
medical-
[
(B)
maternal
/child
[
(C)
pediatric
nursing
;
[
(D)
[
(31)
[
(32)
[
(33)
[
(34)
[
(35)
[
(36)
[
(37)
[
(38)
[
(39)
Second level nurses--Refers
to the International Council of Nurses (ICN) classification of nurses. Second
level nurses are called enrolled, vocational, or practical nurses or nurse
assistants in most countries. Those nurses who have specialized in one area
without being educated and registered/licensed as a general nurse (for instance,
midwife, pediatric nurse, or psychiatric nurse) are not eligible to take the
CGFNS qualifying exam.
(40)
[
(41)
Should--Denotes recommendations.
(42)
[
(43)
[
(44)
[
(45)
[
(46)
Vocational nurse--A person
currently licensed by the board to practice vocational nursing.
(47)
Vocational nurse, retired--An
individual on inactive status, 65 or older, who has met the requirements for
using the title as stated in §217.9(b) of this title (relating to Inactive
Status); includes individuals formerly classified as Vocational nurse, emeritus.
(48)
Vocational Nursing--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.
(49)
Vocational Nursing Education
Program--A comprehensive system of education which provides instruction in
biological, physical, social, behavioral and nursing sciences, with correlated
theory, to include clinical practice in nursing care of children, maternity
nursing, nursing care of the aged, nursing care of adults and nursing care
of individuals with mental health problems.
(50)
Vocational Nursing Practice--The
performance of services for compensation appropriate for Licensed Vocational
Nurses employed in roles which fall within the scope of the definition of
vocational nursing.
§217.3.Temporary Authorization to Practice/Temporary Permit.
(a)
A new graduate who completes an accredited basic nursing
education program within the United States, its Territories or Possessions
and who applies for initial licensure by examination in Texas may be temporarily
authorized to practice [
(1)
In order to receive temporary authorization to practice
as a GN
or GVN
and obtain a [
(A)
file a completed application, including verification of
completion of graduation requirements and the non-refundable application processing
fee (see §217.2(a)(1)-(2) of this title [
(B)
have no outstanding eligibility issues (see §213.30
of this title (relating to Declaratory Order of Eligibility for Licensure),
and Texas Occupations Code §301.257);
[
(C)
have never taken the
NCLEX-PN or
NCLEX-RN .
Temporary authorization to practice as a GN will not be issued to any applicant
who has previously failed the licensing examination; and
(D)
have registered to take the
NCLEX-PN or
NCLEX-RN
with the examination administration service.
(2)
The temporary authorization to practice as a GN
or
GVN
, which is not renewable, is valid for
75
[
(3)
The new graduate who has been authorized to practice [
(4)
The nurse administrator of facilities that employ Graduate
Nurses
or Graduate Vocational Nurses
must ensure that the GN
or GVN
has a valid temporary authorization to practice as a GN
or GVN
pending the results of the licensing examination, has scheduled
a date to take the
NCLEX-PN or
NCLEX-RN , and does not continue
to practice after expiration of the
75
[
(b)
A [
(c)
A [
§217.6.Failure to Renew License.
(a)
A [
(b)
A [
(1)
complete a board
-
approved refresher course,
extensive orientation to the practice of [
(2)
submit evidence of the successful completion of the requirements
of paragraph (1) of this subsection;
(3)
submit a completed reactivation application;
(4)
submit the current non-refundable licensure fee, plus a
late fee and any applicable fines which are not refundable; and
(5)
submit evidence of completion of 20 contact hours of acceptable
continuing education within the previous two years.
(c)
A [
(d)
The issuance of a license renewal may be refused to an
individual who:
(1)
fails to submit an application for renewal; or
(2)
submits an application which:
(A)
is incomplete;
(B)
does not show that the person meets the requirements for
renewal; or
(C)
is not accompanied by the correct fee(s).
(e)
The refusal to renew the license for reasons in subsection
(d)(1) and (2) of this section does not entitle the individual to a hearing.
(f)
The individual refused a license renewal who wishes to
reactivate his or her license will be required to:
(1)
correctly complete the reactivation application form;
(2)
show evidence of meeting all current requirements for licensure,
including 20 contact hours of continuing education according to requirements
in Chapter 216 of this title (relating to Continuing Education); and
(3)
submit payment of the correct non-refundable reactivation
fee as follows:
(A)
if the license has been delinquent less than 90 days, the
required fee will equal the renewal fee plus one-half the examination fee
(see §223.1[
(B)
if the license has been delinquent for more than 90 days,
the required fee will equal the renewal fee plus the full examination fee
(see §223.1[
§217.7.Change of Name and/or Address.
(a)
A [
(b)
A [
§217.8.Duplicate or Substitute Credentials.
(a)
A [
(b)
A [
(1)
a duly executed affidavit;
(2)
the required non-refundable fee;
and
(3)
a
copy of the
legal document reflecting this
name change
.
[
[(4)
the original certificate of registration
if the requested change is for the original certificate.]
§217.9.Inactive Status.
(a)
A [
(1)
submit a written request to the board prior to the expiration
of his/her license;
(2)
designate "inactive" on the renewal form if at the time
of renewal.
(b)
A [
(1)
a written request to use the title; and
(2)
the required, non-refundable fee.
(c)
An individual who is permitted under
section 301.261
[
(d)
A [
(e)
A [
(1)
a reactivation application form;
(2)
verification of completion of a refresher course, extensive
orientation to the practice of [
(3)
evidence of completion of 20 contact hours of CE in compliance
with Chapter 216 (relating to Continuing Education);
(4)
the required reactivation fee plus the current licensure
fee, which are non-refundable.
(f)
A [
(1)
an application for a six month temporary permit to be used
only for completion of a refresher course, extensive orientation to the practice
of [
(2)
the required six-month temporary permit fee which is non-refundable.
(g)
A [
(h)
Upon completion of the refresher course, extensive orientation
to the practice of [
§217.10.Restrictions to Use of Designations for Licensed Vocational or Registered Nurse.
(a)
Use of title
(1)
A person who holds a valid
current license as a registered nurse under this chapter:
(A)
is referred to as a registered nurse; and
(B)
may use the abbreviation "R.N."
(2)
A person who holds a valid current license
as a vocational nurse under this chapter:
(A)
is referred to as a licensed vocational
nurse or vocational nurse; and
(B)
may use the abbreviation "L.V.N." or "V.N."
[
(3)
[
(4)
An applicant for initial licensure
by examination in Texas who has valid temporary authorization to practice
vocational nursing as a graduate vocational nurse pending the results of the
licensing examination may use the initials "GVN" or the title "graduate vocational
nurse."
(5)
[
(6)
A person who is eligible for
licensure by endorsement in Texas, holding a valid Texas temporary license
to engage in vocational nursing practice, may use the title "licensed vocational
nurse," "vocational nurse," "LVN," and "VN."
(7)
[
(8)
[
(9)
[
(10)
Unless the person is practicing
under the delegated authority of a registered nurse or is otherwise authorized
by state or federal law, a person may not use, in connection with the person's
name:
(A)
the title "nurse aide," "nurse assistant," or
"nurse technician" or any other similar title; and
(B)
may not abbreviate the title to "nurse."
(b)
Display of Designations.
(1)
While interacting with the public in a nursing
role, each licensed nurse shall wear a clearly legible insignia that:
(A)
displays the nurse's name, but the manner in
which the name appears, in reference to use of first name and/or last name,
is the nurse's preference in accordance with facility policy, if applicable;
and
(B)
identifies the nurse as a registered nurse or
vocational nurse according to licensure.
(2)
Although the board does not require the inclusion
of any other designations, with the exception of the specific authorization
of advanced practice nurses, the insignia may not contain information other
than:
(A)
the registered nurse or licensed vocational
nurse designation;
(B)
the nurse's name, certifications, academic degrees,
or practice position;
(C)
the name of the employing facility or agency,
or other employer; or
(D)
a picture of the nurse.
(c)
Duty to Document Designations.
While functioning in a nursing role, each licensed nurse shall document in
his/her written communications:
(1)
the nurse's name, but the manner in which the
name appears, in reference to use of first name and/or last name, is the nurse's
preference in accordance with facility policy, if applicable; and
(2)
the nurse's designation as a registered nurse
or vocational nurse according to licensure.
§217.13.Peer Assistance Programs.
A peer assistance program for [
(1)
Additional criteria.
(A)
The program will provide statewide peer advocacy services
available to all [
(B)
The program shall have a statewide monitoring system that
will be able to track the nurse while preserving confidentiality.
(C)
The program shall have a network of trained peer volunteer
advocates located throughout the state.
(D)
The program shall have a written plan for the education
and training of volunteer advocates and other program personnel.
(E)
The program shall have a written plan for the education
of [
(F)
The program shall have a mechanism for documenting program
compliance and for timely reporting of noncompliance to the board. Reports
of noncompliance shall include information regarding [
(G)
The program shall demonstrate financial stability and funding
sufficient to operate the program.
(H)
The program shall collect and make available to the board
and other appropriate persons data relating to program operations and participant
outcomes.
(I)
The program shall have a written plan for a systematic
total program evaluation.
(J)
The program shall be subject to periodic evaluation by
the board or its designee.
(K)
Counselors utilized by the peer assistance program shall
meet the minimum criteria for counselors as established by the board or its
designee.
(L)
The program shall establish a plan to verify previous disciplinary
action relative to impairment prior to admitting a nurse to the peer assistance
program.
(M)
If there has been any prior disciplinary action by the
board within five years or if the program determines that the nurse most likely
has impaired practice but is inappropriate for the program due to other reasons,
the program may report the nurse to the board.
(2)
Contractual agreement. The approved program(s) will enter
into a contractual agreement with the board to provide peer assistance services.
Said contract can be withdrawn for noncompliance and is subject to annual
review and renewal.
§217.15.Copying the License/Permit/Permanent Certificate of a Licensed Vocational Nurse/ Registered Nurse/Graduate Nurse/Advanced Practice Nurse.
(a)
The licensee or permit holder has the responsibility to
protect his or her license/permit/permanent certificate from loss and potential
fraudulent or unlawful use.
(b)
A licensee or permit holder shall only allow his or her
license/permit certificate to be copied for the purpose of licensure verification
by employers, licensing boards, professional organizations, nursing programs,
and third party payors for credentialing and reimbursement purposes. Other
persons and/or agencies may contact the board's office in writing or by phone
to verify licensure.
§217.16.Minor Incidents.
(a)
The Board believes protection of the public is not enhanced
by the reporting of every minor incident that may be a violation of the Texas
Nursing Practice Act. This is particularly true when there are mechanisms
in place in the
nurse's
[
(b)
A "minor incident" is defined by Texas Occupations Code §301.419(a)
as "conduct that does not indicate that the continuing practice of [
(1)
the potential risk of physical, emotional or financial
harm to the client due to the incident is very low;
(2)
the incident is a singular event with no pattern indicating
the
nurse's
[
(3)
the
nurse
[
(4)
the
nurse
[
(c)
Other factors which may be considered in determining whether
a minor incident should be reported to the Board are:
(1)
the significance of the
nurse's
[
(2)
the presence of contributing or mitigating circumstances,
including systems issues, in relation to the
nurse's
[
(d)
A single minor incident need not be reported to the Board
or the Peer Review Committee. When a decision is made that the incident is
minor, the following steps are required:
(1)
an incident/variance report shall be completed according
to the facility's policy;
(2)
a record shall be maintained of each minor incident;
(3)
the incident/variance report shall contain a complete description
of the incident, patient record number, witnesses,
nurse
[
(4)
In practice settings where a Peer Review Committee exists,
the nurse manager or supervisor shall report a
nurse
[
(5)
the Peer Review Committee shall review the three minor
incidents and make a determination as to whether a report to the Board is
warranted in accordance with Texas Occupations Code Annotated §301.403
(NPA). The committee need not report to the Board when they determine that:
(A)
The nurse's actions in the three incidents considered together
continue to meet the criteria of subsection (b)(1) - (4) of this section,
relating to criteria for "minor incidents; and
(B)
the committee determines remediation and monitoring of
the
nurse's
[
(6)
If additional practice related errors are committed by
the
nurse
[
(7)
In practice settings where no Peer Review Committee exists,
the nurse manager or supervisor shall review minor incidents involving those
nurses
[
(e)
Nothing in this rule is intended to prevent reporting of
a potential violation directly to the Board.
(f)
Failure to classify an event appropriately in order to
avoid reporting may result in violation of the mandatory reporting statute.
§217.19.Incident-Based Nursing Peer Review.
(a)
Minimum Due Process
(1)
The provisions of this subsection (a) apply:
(A)
to peer review for both registered nurses (RNs) and licensed
vocational nurses (LVNs). Any reference to "nurse" is a reference to both
RNs and LVNs. See Texas Occupations Code §303.001(1-3).
(B)
only to peer review conducted for purpose of evaluating
if a RN or LVN has engaged in unacceptable nursing practice.
(2)
Texas Occupations Code §303.001(5), states, "
'
Peer review
'
means the evaluation of nursing services, the
qualifications of
a nurse,
[
(3)
A facility conducting peer review shall have written policies
and procedures that, at a minimum, address:
(A)
level of participation of nurse or nurse's representative
at peer review proceeding beyond that required by Subsection (a)(4)(F) of
these rules (e.g., nurse's or representative's ability to question witnesses);
(B)
confidentiality and safeguards to prevent impermissible
disclosures including written agreement by all parties to abide by Texas Occupations
Code §§303.006 and 303.007;
(C)
handling of cases involving nurses suspected of having
problems with chemical dependency or mental illness in accordance with the
Texas Occupations Code §301.410;
(D)
reporting of nurses to
the
Board of Nurse Examiners
[
(E)
effective date of changes to the policies which in no event
shall apply to peer review proceedings initiated before the change was adopted
unless agreed in writing by the nurse being reviewed.
(4)
In order to meet the minimum due process required by the
Texas Occupations Code chapter 303, the Nursing Peer Review Committee must:
(A)
comply with the membership and voting requirements as set
forth in Texas Occupations Code §303.003(a) - (d);
(B)
exclude from the committee any person or persons with administrative
authority for personnel decisions directly relating to the nurse;
(C)
provide written notice to the nurse in person or by certified
mail at the last known address the nurse has on file with the facility that
his/her practice is being evaluated, that the peer review committee will meet
on a specified date not sooner than 21 calendar days and not more than 45
calendar days from date of notice , unless otherwise agreed upon by the nurse
and peer review committee. Said notice must include a written copy of the
peer review plan, policies and procedures;
(D)
include in the written notice:
(i)
a description of the event(s) to be evaluated in sufficient
detail to inform the nurse of the incident, circumstances and conduct (error
or omission), including date(s), time(s), location(s), and individual(s) involved.
The patient/client shall be identified by initials or number to the extent
possible to protect confidentiality but the nurse shall be provided the name
of the patient/client;
(ii)
name, address, telephone number of contact person to receive
the nurse's response; and
(iii)
a copy of this rule (
§
217.19) and a
copy of the facility's peer review plan, policies and procedures.
(E)
provide the nurse the opportunity to review, in person
or by attorney, the documents concerning the event under review, at least
15 calendar days prior to appearing before the committee;
(F)
provide the nurse the opportunity to:
(i)
submit a written statement regarding the event under review;
(ii)
call witnesses, question witnesses, and be present when
testimony or evidence is being presented;
(iii)
be provided copies of the witness list and written testimony
or evidence at least 48 hours in advance of proceeding;
(iv)
make an opening statement to the committee;
(v)
ask questions of the committee and respond to questions
of the committee; and
(vi)
make a closing statement to the committee after all evidence
is presented;
(G)
conclude its review no more than fourteen (14) calendar
days from the peer review proceeding;
(H)
provide written notice to the nurse in person or by certified
mail at the last known address the nurse has on file with the facility of
the findings of the committee within ten (10) calendar days of when the committee's
review has been completed; and
(I)
permit the nurse to file a written rebuttal statement within
ten (10) calendar days of the notice of the committee's findings and make
the statement a permanent part of the peer review record to be included whenever
the committee's findings are disclosed.
(5)
Nurse's Right To Representation. A nurse shall have a right
of representation as set out in this section. The rights set out in this section
are minimum requirements and a facility may allow the nurse more representation.
The peer review process is not a legal proceeding; therefore, rules governing
legal proceedings and admissibility of evidence do not apply and the presence
of attorneys is not required. The nurse has the right to be accompanied to
the hearing by a nurse peer or an attorney. Representatives attending the
peer review hearing must comply with the facility's peer review policies and
procedures regarding participation beyond conferring with the nurse. If either
the facility or nurse will have an attorney or representative present at the
peer review hearing in any capacity, the facility or nurse must notify the
other at least seven (7) calendar days before the hearing that they will have
an attorney or representative attending the hearing and in what capacity.
Notwithstanding any other provisions of these rules, if an attorney representing
the facility or peer review committee is present at the peer review hearing
in any capacity, including serving as a member of the peer review committee,
the nurse is entitled to "parity of participation of counsel." "Parity of
participation of counsel" means that the nurse's attorney is able to participate
to the same extent and level as the facility's attorney; e.g., if the facility's
attorney can question witnesses, the nurse's attorney must have the same right.
(6)
Confidentiality of information presented to and/or considered
by the peer review committee shall be maintained and not disclosed except
as provided by Texas Occupations Code §§303.006 and 303.007. Disclosure/discussion
by a nurse with the nurse's attorney is proper because the attorney is bound
to the same confidentiality requirements as the nurse.
(7)
In evaluating a nurse's conduct, the committee shall review
the evidence to determine the extent to which any deficiency in care by the
nurse was the result of deficiencies in the nurse's judgment, knowledge, training,
or skill rather than other factors beyond the nurse's control. A determination
that a deficiency in care is attributable to a nurse must be based on the
extent to which the nurse's conduct was the result of a deficiency in the
nurse's judgment, knowledge, training, or skill.
(8)
If a peer review committee finds that a nurse has engaged
in conduct reportable to the Board of Nurse Examiners [
(A)
a description of any corrective action taken against the
nurse and
(B)
a statement as to whether the committee recommends that
formal disciplinary action be taken against the nurse.
(9)
Texas Occupations Code chapter 303, requires that peer
review be conducted in good faith. A nurse who knowingly participates in peer
review in bad faith is subject to disciplinary action by the Board under the
Texas Occupations Code §301.452(b). Examples of bad faith are taking
action against a nurse without providing the nurse the rights provided by
these rules or taking action based on personal animosity towards the nurse.
(10)
A nurse whose practice is being evaluated may properly
choose not to participate in the proceeding after the nurse has been notified
under rule 217.19(a)(4)(C). Texas Occupations Code §303.002(d) prohibits
nullifying by contract any right a nurse has under the peer review process.
(11)
The Chief Nursing Officer (CNO) of a facility is responsible
for knowing the requirements of this Rule and for taking reasonable steps
to assure that peer review is implemented and conducted in compliance with
this Rule. The CNO is the registered nurse who is administratively responsible
for nursing services.
(b)
Effect of
Nurse
[
(1)
The peer review committee shall report the nurse to the
Board, if it finds the nurse engaged in reportable conduct. If the peer review
committee finds that the conduct constitutes a minor incident as defined by
rule 217.16 (relating to reporting of minor incidents), it shall report in
accordance with the requirements of that rule;
(2)
The reporting nurse shall be notified of the peer review
committee's findings and shall be subject to Texas Occupations Code §303.006;
and
(3)
the reporting nurse accepts in good faith the findings
of the peer review committee.
§217.20.Safe Harbor Peer Review for Nurses . [
(a)
Texas Occupations Code §303.005 requires a person
who regularly employs, hires or contracts for the services of at least ten
(10)
nurses
[
(b)
Minimum Due Process. The minimum due process requirements
of rule 217.19 do not apply to Safe Harbor Peer Review except in those circumstances
outlined in rule 217.20(e)(2). The peer review committee shall exclude from
the committee any persons or person with administrative authority for personnel
decisions directly affecting the nurse. The
nurse
[
(1)
appear before the committee;
(2)
ask questions and respond to questions of the committee;
and
(3)
make a verbal and/or written statement to explain why he
or she believes the requested conduct would have violated a
nurse's
[
(c)
Safe Harbor Protections. To activate protections outlined
in Texas Occupations Code §303.005, the
nurse
[
(1)
Invoke Safe Harbor in good faith. "Good faith" means that
the
nurse
[
(2)
At the time the
nurse
[
(3)
At the time of supervisor notification, also submit a written
request for Safe Harbor utilizing the Safe Harbor form provided on the Board's
web site or on a form that includes a minimum of the following information:
(A)
the conduct assigned or requested, including the name and
title of the person making the assignment or request;
(B)
a description of the practice setting (e.g., the
nurse's
[
(C)
a detailed description of how the conduct would have violated
the
nurse's
[
(D)
any other copies of pertinent documentation available at
the time. Additional documents may be submitted to the committee when available
at a later time; and
(E)
the
nurse's
[
(4)
If the
nurse
[
(d)
Safe Harbor Processes
(1)
The following timelines shall be followed:
(A)
the peer review committee shall complete its review and
notify the nurse administrator within 14 days of when the
nurse
[
(B)
within 48 hours of receiving the committee's determination,
the nurse administrator shall review these findings and notify the
nurse
[
(2)
If Safe Harbor was invoked to question the medical reasonableness
of a physician's order, the medical staff or medical director shall determine
whether the order was reasonable. Consideration for patient safety should
contribute to the time line for implementing a decision, but shall not exceed
the time limits specified in this section.
(3)
The
nurse
[
(e)
Exclusions to Safe Harbor Protections
(1)
The protections provided under subsection (c) do not apply
to the
nurse
[
(2)
In addition to consideration of the
nurse's
[
(3)
If the peer review committee determines that a
nurse's
[
(f)
The Chief Nursing Officer (CNO) of a facility is responsible
for knowing the requirements of the Rule and for taking reasonable steps to
assure that peer review is implemented and conducted in compliance with this
Rule. The CNO is the [
(g)
Texas Occupations Code chapter 303, requires that peer
review be conducted in good faith. A nurse who knowingly participates in peer
review in bad faith is subject to disciplinary action by the Board under the
Texas Occupations Code §301.452(b).
(h)
The peer review committee and participants shall comply
with the confidentiality requirements of Texas Occupations Code §§303.006
and 303.007 relating to confidentiality and limited disclosure of peer review
information.
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of
the Secretary of State on May 3, 2004.
TRD-200402987
Katherine Thomas
Executive Director
Board of Nurse Examiners
Earliest possible date of adoption: June 13, 2004
For further information, please call: (512) 305-6823
22 TAC §223.1, §223.2
The Board of Nurse Examiners proposes amendments to 22 TAC
Chapter 223, Fees, §223.1 and §223.2. The sections establish the
fees necessary for the administration of the Board's functions. Effective
February 1, 2004, the Board of Nurse Examiners and the Board of Vocational
Nurse Examiners were merged into one agency, the Board of Nurse Examiners.
The Board of Vocational Nurse Examiners ceased to exist as an agency. House
Bill 1483, passed by the 78th Regular Legislative Session, was the legislative
action that implemented the consolidation. The proposed amendments implement
House Bill 1483 and the make-up and function of the new Board of Nurse Examiners.
Chapter 223, Fees, addresses the agency's fee structure. Section 223.1, Fees,
establishes the fees necessary for the administration of the Board's functions.
Section 223.2, Charges for Public Records, is being proposed for amendment
due to the change in law allowed for the charges imposed by agencies for public
information. Those fees are now set by the Texas Building and Procurement
Commission.
The proposed amended fees attempt to provide consistency. The new Nursing
Practice Act does not provide for a LVN, Emeritus, so this title will now
be included in the LVN, Retired, status (§223.1(18)). The LVN initial
licensure fee will be maintained at the present level until September 1, 2004
(the beginning of the next fiscal year) so that confusion will hopefully be
alleviated for the present LVN students preparing to graduate. In September,
however, the LVN initial licensure fee will be reduced to provide consistency
with the costs incurred by other nurses.
Section 223.1(13) is being updated to conform to the language contained
in §217.6(f)(3), Failure to Renew License. In addition, a new monitoring
fee is being included which was the practice of the Board of Vocational Nursing,
which is continuing to be collected, and which may be incorporated into future
board orders. Section 223.1(10), verification of licensure, imposes a fee
to encourage people seeking to verify a nurse's license to do it online due
to the staffing time necessary to verify licensure manually and provide written
verification. The fee for returned checks was updated to the fee allowed by
the Texas Business and Commerce Code. The remaining changes are non-substantive
and for the purpose of removing unnecessary verbiage.
Katherine Thomas, Executive Director, has determined that for the first
five-year period the proposed amendments are in effect there will be no fiscal
implications for state or local government as a result of implementing the
proposed amendments.
Ms. Thomas also has determined that for each year of the first five years
the proposed amendments are in effect, the public benefit will be that all
nurses will be subject to a more consistent fee process involving their licensure.
There will be no effect on small businesses. There is no anticipated additional
cost to affected individuals as a result of these proposed amendments except
as addressed above.
Written comments on the proposal may be submitted to Katherine A. Thomas,
MN, RN, Executive Director, Board of Nurse Examiners, 333 Guadalupe, Suite
3-460, Austin, Texas 78701.
The amendments are proposed pursuant to the authority of Texas
Occupations Code §301.151 and §301.152 which authorizes the Board
of Nurse Examiners to adopt, enforce, and repeal rules consistent with its
legislative authority under the Nursing Practice Act.
No other rules, codes, or statutes will be affected by the proposed amendments.
§223.1.Fees.
(a)
The Board of Nurse Examiners has established reasonable
and necessary fees for the administration of its functions.
(1)
initial licensure fee
:
[
(A)
Registered nurse $70;
(B)
Licensed vocational nurse $93; effective
September 1, 2004, $70;
(2)
duplicate or substitute license--$20; [
(3)
duplicate or substitute permanent certificate--$20; [
(4)
duplicate permit--
$5
[
(5)
endorsement--[
(6)
licensure
renewal
(each biennium)--[
(7)
issuance of a temporary permit under §301.258--$15
;
[
(8)
reactivating from inactive status:
(A)
less than four years--
$5 plus current renewal fee
[
(B)
more than four years--$10
plus current renewal fee
; [
(9)
accreditation of new schools and programs--$150; [
(10)
verification of licensure--$5;
[(10)
filing of affidavits in re-change of
name--no charge; (11/85)]
(11)
verification of records--$20; [
(12)
bad checks--
$30;
[
(13)
late fee for
reactivation from delinquent status
[
(A)
less than 90 days--
$35 plus current licensure renewal
fee;
[
(B)
more than 90 days--
$70 plus current licensure renewal
fee;
[
(14)
Advanced Practice Nurse--initial credentials--$75; [
(15)
declaratory order of eligibility--$150; [
(16)
eligibility determination--$150; [
(17)
docketing fee in non disciplinary matters--$600; [
(18)
Licensed Vocational Nurse, Retired, or
Registered
Nurse, Retired--$10; [
(19)
Advanced Practice Nurse renewal--$52; [
(20)
Initial Prescriptive Authority--$25; [
(21)
outpatient anesthesia registry renewal--$35; [
(22)
outpatient anesthesia inspection and advisory opinion--$625;
[
(23)
Federal Bureau of Investigations (FBI) and Department
of Public Safety (DPS) criminal background check for initial licensure applicants
and endorsement applicants--$39
; and
[
(24)
Disciplinary monitoring fees as stated
in a Board order.
(b)
all fees are non-refundable. [
§223.2.Charges for Public Records.
In accordance with the Act,
76th
[
[(1)
Definitions. The following words and
terms, when used in this section, shall have the following meaning, unless
the context clearly indicates otherwise.]
[(A)
Standard-size copy--A printed impression on one side of
a piece of paper that measures up to 8-1/2 by 14 inches. Each side of the
paper on which an impression is made is counted as a single copy. A piece
of paper printed on both sides is counted as two copies.]
[(B)
Copy charge--A charge for costs incurred in copying standard-size
paper copies reproduced by an office machine copier or a computer printer.]
[(C)
Postage and shipping charge--A charge for costs incurred
in sending information to a requester, such as cost of postage, envelope,
or long-distance phone call for facsimile transmission.]
[(D)
Personnel charge--A charge imposed for costs incurred
for personnel time expended in processing a request for public information.
This charge may include the time any employee spends reading/reviewing the
initial request for records, making copies of records, conducting a file search,
conducting a computer search, preparing and reviewing the response to the
records request (administrative oversight/review), and any other type of personnel
time necessary to respond to the request.]
[(E)
Overhead charge--A charge for direct and indirect costs
incurred in addition to the personnel charge. This charge covers such costs
as depreciation of capital assets, rent, maintenance and repair, and utilities.]
[(F)
Microfiche and microfilm charge--A charge for costs incurred
for making a copy of microfiche or microfilm.]
[(G)
Remote document retrieval charge--A charge for costs incurred
in obtaining information not in current use in remote storage locations.]
[(H)
Computer resource charge--A charge for costs incurred
in obtaining information on computers based on the amortized cost of acquisition,
lease, operation, and maintenance of computer resources. This charge may also
include programming time if a request requires a programmer to enter data
in order to execute an existing program or create a new program so that requested
information may be accessed.]
[(I)
Readily available information--Information that is readily
available may include any information that does not fall under the "Not readily
available information" defined as follows.]
[(J)
Not readily available information--Information that is
not readily available includes information that requires personnel to locate
and retrieve a specific file, review the file to locate the record, and replace
the file after the record has been located. Information that is not readily
available also includes information that requires personnel review to determine
if the information is what the requestor has asked for, or a review to determine
if the records contain information confidential under the Nursing Practice
Act or other law.]
[(2)
Charges.]
[(A)
For one to 50 standard-size copies of readily available
information the charge shall be $.10 per page.]
[(B)
For 51 pages or more of readily available information,
or any quantity of not readily available information, the charge shall be
the sum of the following:]
[(i)
$.10 per page;]
[(ii)
personnel charge in an amount reflecting the average
hourly cost for classified state employees as determined from time to time
by the General Services Commission;]
[(iii)
overhead charge in an amount to be determined in accordance
with the guidelines of the General Services Commission;]
[(iv)
microfiche and microfilm charge (if applicable) in an
amount equal to the actual cost to the agency of the reproduction, or in accordance
with General Services Commission guidelines;]
[(v)
remote document retrieval charge (if applicable) in an
amount equal to the actual cost to the agency of the retrieval or in accordance
with General Services Commission guidelines;]
[(vi)
computer resource charge (if applicable), including any
programming time, in an amount equal to the cost to the agency, or in accordance
with General Services Commission guidelines; and]
[(vii)
actual cost of miscellaneous supplies (if applicable)
in an amount equal to the actual cost to the agency.]
[(C)
If a particular request may involve considerable time
and resources to process, the agency may advise the requesting party of what
may be involved and provide an estimate of date of completion and the charges
that may result.]
[(D)
Payment for charges must be received by the Board of Nurse
Examiners from requestor before copies will be released.]
This agency hereby certifies that the proposal
has been reviewed by legal counsel and found to be within the agency's legal
authority to adopt.
Filed with the Office of
the Secretary of State on April 28, 2004.
TRD-200402858
Katherine Thomas
Executive Director
Board of Nurse Examiners
Earliest possible date of adoption: June 13, 2004
For further information, please call: (512) 305-6823
Chapter 235.
LICENSING
Subchapter A. APPLICATION FOR LICENSURE
22 TAC §235.1, §235.17
(Editor's note: The text of the following sections proposed for
repeal will not be published. The sections may be examined in the offices
of the Board of Nurse Examiners or in the Texas Register office, Room 245,
James Earl Rudder Building, 1019 Brazos Street, Austin.)
The Board of Nurse Examiners proposes the repeal
of 22 Texas Administrative Code, Chapter 235, Licensing, Subchapter A, Application
for Licensure, §235.1 and §235.17. Effective February 1, 2004, the
Board of Nurse Examiners and the Board of Vocational Nurse Examiners were
merged into one agency, the Board of Nurse Examiners. The Board of Vocational
Nurse Examiners ceased to exist as an agency. House Bill 1483, passed by the
78th Regular Legislative Session, was the legislative action that implemented
the consolidation. The proposed repeal implements House Bill 1483 and the
make-up and function of the new Board of Nurse Examiners. Concurrent with
the proposed repeal are the proposed amendments to 22 Texas Administrative
Code Chapter 217, Licensure, Peer Assistance and Practice, which incorporate
Licensed Vocational Nurses into the Board of Nurse Examiners' licensing rules.
This proposed repeal is for the purpose of preventing conflicting rules and
to provide consistency in the nurse licensing process.
Katherine Thomas, Executive Director, has determined that for the first
five-year period the proposed repeal is in effect there will be no fiscal
implications for state or local government as a result of implementing the
proposed repeal.
Ms. Thomas also has determined that for each year of the first five years
the proposed repeal is in effect, the public benefit will be that all nurses
will be subject to a more consistent licensing process. The proposed repeal
will also prevent conflicting rules. There will be no effect on small businesses.
There is no anticipated cost to affected individuals as a result of this proposed
repeal.
Written comments on the proposal may be submitted to Katherine A. Thomas,
MN, RN, Executive Director, Board of Nurse Examiners, 333 Guadalupe, Suite
3-460, Austin, Texas 78701.
The repeal is proposed pursuant to the authority of Texas Occupations
Code §301.151 and §301.152 which authorizes the Board of Nurse Examiners
to adopt, enforce, and repeal rules consistent with its legislative authority
under the Nursing Practice Act.
The proposed repeal will not affect any existing statute.
§235.1.Authority.
§235.17.Temporary Permits.
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State on April 28, 2004.
TRD-200402859
Katherine Thomas
Executive Director
Board of Nurse Examiners
Earliest possible date of adoption: June 13, 2004
For further information, please call: (512) 305-6823
22 TAC §235.31, §235.32
(Editor's note: The text of the following sections proposed for
repeal will not be published. The sections may be examined in the offices
of the Board of Nurse Examiners or in the Texas Register office, Room 245,
James Earl Rudder Building, 1019 Brazos Street, Austin.)
The Board of Nurse Examiners proposes the repeal
of 22 Texas Administrative Code, Chapter 235, Licensing, Subchapter C, Examination, §235.31
and §235.32. Effective February 1, 2004, the Board of Nurse Examiners
and the Board of Vocational Nurse Examiners were merged into one agency, the
Board of Nurse Examiners. The Board of Vocational Nurse Examiners ceased to
exist as an agency. House Bill 1483, passed by the 78th Regular Legislative
Session, was the legislative action that implemented the consolidation. The
proposed repeal implements House Bill 1483 and the make-up and function of
the new Board of Nurse Examiners. Concurrent with the proposed repeal are
the proposed amendments to 22 Texas Administrative Code Chapter 217, Licensure,
Peer Assistance and Practice, which incorporate Licensed Vocational Nurses
into the Board of Nurse Examiners' licensing rules. This proposed repeal is
for the purpose of preventing conflicting rules and to provide consistency
in the nurse licensing process.
Katherine Thomas, Executive Director, has determined that for the first
five-year period the proposed repeal is in effect there will be no fiscal
implications for state or local government as a result of implementing the
proposed repeal.
Ms. Thomas also has determined that for each year of the first five years
the proposed repeal is in effect, the public benefit will be that all nurses
will be subject to a more consistent licensing process. The proposed repeal
will also prevent conflicting rules. There will be no effect on small businesses.
There is no anticipated cost to affected individuals as a result of this proposed
repeal.
Written comments on the proposal may be submitted to Katherine A. Thomas,
MN, RN, Executive Director, Board of Nurse Examiners, 333 Guadalupe, Suite
3-460, Austin, Texas 78701.
The repeal is proposed pursuant to the authority of Texas Occupations
Code §301.151 and §301.152 which authorizes the Board of Nurse Examiners
to adopt, enforce, and repeal rules consistent with its legislative authority
under the Nursing Practice Act.
The proposed repeal will not affect any existing statute.
§235.31.Applicability.
§235.32.Notification of Examination Results.
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State on April 28, 2004.
TRD-200402860
Katherine Thomas
Executive Director
Board of Nurse Examiners
Earliest possible date of adoption: June 13, 2004
For further information, please call: (512) 305-6823
22 TAC §§235.41 - 235.52
(Editor's note: The text of the following sections proposed for
repeal will not be published. The sections may be examined in the offices
of the Board of Nurse Examiners or in the Texas Register office, Room 245,
James Earl Rudder Building, 1019 Brazos Street, Austin.)
The Board of Nurse Examiners proposes the repeal
of 22 Texas Administrative Code, chapter 235 (Licensing), Subchapter D (Issuance
of Licenses), §§235.41 - 235.52. Effective February 1, 2004, the
Board of Nurse Examiners and the Board of Vocational Nurse Examiners were
merged into one agency, the Board of Nurse Examiners. The Board of Vocational
Nurse Examiners ceased to exist as an agency. House Bill 1483, passed by the
78th Regular Legislative Session, was the legislative action that implemented
the consolidation. These proposed repeals implement HB 1483 and the make-up
and function of the new Board of Nurse Examiners. Concurrent with these proposed
repeals are the proposed amendments to 22 Texas Administrative Code chapter
217 (Licensure, Peer Assistance and Practice) which incorporate Licensed Vocational
Nurses into the Board of Nurse Examiners' licensing rules and chapter 223
which consolidates the fee structure of the agency. This proposed repeal is
for the purpose of preventing conflicting rules and to provide consistency
in the nurse licensing and fee process.
Katherine Thomas, executive director, has determined that for the first
five-year period the proposed repeals are adopted there will be no fiscal
implications for state or local government as a result of implementing the
proposed repeal.
Katherine Thomas, executive director, has determined that for each year
of the first five years the proposed repeal is adopted, the public benefit
will be that all nurses will be subject to a more consistent licensing and
fee process. The proposed repeal will also prevent conflicting rules. There
will be no effect on small businesses. There is no anticipated cost to affected
individuals as a result of this proposed repeal.
Written comments on the proposal may be submitted to Katherine A. Thomas,
MN, RN, Executive Director, Board of Nurse Examiners, 333 Guadalupe, Suite
3-460, Austin, Texas 78701.
The proposed repeal of these sections is pursuant to the authority
of Texas Occupations Code §§301.151 and 301.152 which authorizes
the Board of Nurse Examiners to adopt, enforce, and repeal rules consistent
with its legislative authority under the Nursing Practice Act. The adoption
of the proposed repeal will not affect any existing statute.
§235.41.Issuance of Certificate of Licensure.
§235.42.License.
§235.43.Application for Renewal of License.
§235.44.Expirations and Renewals.
§235.45.Duplicate License or Temporary Permit.
§235.46.Notification of Change of Name or Address.
§235.47.Inactive License.
§235.48.Reactivation of a License.
§235.49.Emeritus License.
§235.50.Active License.
§235.51.Traveling Nurses.
§235.52.Licensure Status Fee Schedule.
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State on April 29, 2004.
TRD-200402861
Katherine Thomas
Executive Director
Board of Nurse Examiners
Earliest possible date of adoption: June 13, 2004
For further information, please call: (512) 305-6823
Subchapter A. DEFINITIONS
22 TAC §236.1
(Editor's note: The text of the following section proposed for
repeal will not be published. The section may be examined in the offices of
the Board of Nurse Examiners or in the Texas Register office, Room 245, James
Earl Rudder Building, 1019 Brazos Street, Austin.)
The Board of Nurse Examiners proposes the repeal
of 22 Texas Administrative Code Chapter 236, Nurse Licensure Compact, Subchapter
A, Definitions, §236.1. Subchapter B, Issuance of a License by a Compact
Party State, is being proposed for repeal concurrently with this subchapter.
Effective February 1, 2004, the Board of Nurse Examiners and the Board of
Vocational Nurse Examiners were merged into one agency, the Board of Nurse
Examiners. The Board of Vocational Nurse Examiners ceased to exist as an agency.
House Bill 1483, passed by the 78th Regular Legislative Session, was the legislative
action that implemented the consolidation. The proposed repeal implements
House Bill 1483 and the make-up and function of the new Board of Nurse Examiners.
22 Texas Administrative Code Chapter 220, Nurse Licensure Compact, also contains
rules addressing the nurse licensure compact and includes all nurses. This
proposed repeal is for the purpose of preventing repetitious rules.
Katherine Thomas, Executive Director, has determined that for the first
five-year period the proposed repeal is in effect there will be no fiscal
implications for state or local government as a result of implementing the
proposed repeal.
Ms. Thomas also has determined that for each year of the first five years
the proposed repeal is in effect, the public benefit will be that all nurses
will be subject to the same disciplinary and procedural process which will
be a more consistent process. There will be no effect on small businesses.
There is no anticipated cost to affected individuals as a result of the proposed
repeal.
Written comments on the proposal may be submitted to Katherine A. Thomas,
MN, RN, Executive Director, Board of Nurse Examiners, 333 Guadalupe, Suite
3-460, Austin, Texas 78701.
The repeal is proposed pursuant to the authority of Texas Occupations
Code §301.151 and §301.152 which authorizes the Board of Nurse Examiners
to adopt, enforce, and repeal rules consistent with its legislative authority
under the Nursing Practice Act.
The proposed repeal will affect Chapter 304 of the Texas Occupations Code
which is entitled Nurse Licensure Compact.
§236.1.Definitions.
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State on April 28, 2004.
TRD-200402851
Katherine Thomas
Executive Director
Board of Nurse Examiners
Earliest possible date of adoption: June 13, 2004
For further information, please call: (512) 305-6823
22 TAC §§236.11 - 236.13
(Editor's note: The text of the following sections proposed for
repeal will not be published. The sections may be examined in the offices
of the Board of Nurse Examiners or in the Texas Register office, Room 245,
James Earl Rudder Building, 1019 Brazos Street, Austin.)
The Board of Nurse Examiners proposes the repeal
of 22 Texas Administrative Code Chapter 236, Nurse Licensure Compact, Subchapter
B, Issuance of a License by a Compact Party State, §§236.11 - 236.13.
Subchapter A, Definitions, is being proposed for repeal concurrently with
this subchapter. Effective February 1, 2004, the Board of Nurse Examiners
and the Board of Vocational Nurse Examiners were merged into one agency, the
Board of Nurse Examiners. The Board of Vocational Nurse Examiners ceased to
exist as an agency. House Bill 1483, passed by the 78th Regular Legislative
Session, was the legislative action that implemented the consolidation. The
proposed repeal implements House Bill 1483 and the make-up and function of
the new Board of Nurse Examiners. 22 Texas Administrative Code Chapter 220,
Nurse Licensure Compact, also contains rules addressing the nurse licensure
compact and includes all nurses. This proposed repeal is for the purpose of
preventing repetitious rules.
Katherine Thomas, Executive Director, has determined that for the first
five-year period the proposed repeal is in effect there will be no fiscal
implications for state or local government as a result of implementing the
proposed repeal.
Ms. Thomas also has determined that for each year of the first five years
the proposed repeal is in effect, the public benefit will be that all nurses
will be subject to a more consistent process involving their multistate licensure
privilege. There will be no effect on small businesses. There is no anticipated
cost to affected individuals as a result of the proposed repeal.
Written comments on the proposal may be submitted to Katherine A. Thomas,
MN, RN, Executive Director, Board of Nurse Examiners, 333 Guadalupe, Suite
3-460, Austin, Texas 78701.
The repeal is proposed pursuant to the authority of Texas Occupations
Code §301.151 and §301.152 which authorizes the Board of Nurse Examiners
to adopt, enforce, and repeal rules consistent with its legislative authority
under the Nursing Practice Act.
The proposed repeal will affect Chapter 304 of the Texas Occupations Code
which is entitled Nurse Licensure Compact.
§236.11.For the Purpose of This Compact.
§236.12.Limitations on Multistate Licensure Privilege.
§236.13.Information System.
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State on April 28, 2004.
TRD-200402852
Katherine Thomas
Executive Director
Board of Nurse Examiners
Earliest possible date of adoption: June 13, 2004
For further information, please call: (512) 305-6823
Subchapter A. DEFINITIONS
22 TAC §239.1
(Editor's note: The text of the following section proposed for
repeal will not be published. The section may be examined in the offices of
the Board of Nurse Examiners or in the Texas Register office, Room 245, James
Earl Rudder Building, 1019 Brazos Street, Austin.)
The Board of Nurse Examiners proposes the repeal
of 22 Texas Administrative Code, chapter 239 (Contested Case Procedure), Subchapter
A (Definitions), §239.1. Effective February 1, 2004, the Board of Nurse
Examiners and the Board of Vocational Nurse Examiners were merged into one
agency, the Board of Nurse Examiners. The Board of Vocational Nurse Examiners
ceased to exist as an agency. House Bill 1483, passed by the 78th Regular
Legislative Session, was the legislative action that implemented the consolidation.
These proposed repeals implement HB 1483 and the make-up and function of the
new Board of Nurse Examiners. Concurrent with these proposed repeals are the
proposed amendments to 22 Texas Administrative Code chapter 217 (Licensure,
Peer Assistance and Practice) which incorporate Licensed Vocational Nurses
into the Board of Nurse Examiners' licensing rules. This proposed repeal is
for the purpose of preventing conflicting definitions.
Katherine Thomas, executive director, has determined that for the first
five-year period the proposed repeals are adopted there will be no fiscal
implications for state or local government as a result of implementing the
proposed repeal.
Katherine Thomas, executive director, has determined that for each year
of the first five years the proposed repeals are adopted, the public benefit
will be that all nurses will be subject to a more consistent licensing process.
The proposed repeal will also prevent conflicting rules. There will be no
effect on small businesses. There is no anticipated cost to affected individuals
as a result of this proposed repeal.
Written comments on the proposal may be submitted to Katherine A. Thomas,
MN, RN, Executive Director, Board of Nurse Examiners, 333 Guadalupe, Suite
3-460, Austin, Texas 78701.
The proposed repeal of this section is pursuant to the authority
of Texas Occupations Code §§ 301.151 and 301.152 which authorizes
the Board of Nurse Examiners to adopt, enforce, and repeal rules consistent
with its legislative authority under the Nursing Practice Act. The adoption
of the proposed repeal will not affect any existing statute.
§239.1.Definitions.
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State on April 29, 2004.
TRD-200402862
Katherine Thomas
Executive Director
Board of Nurse Examiners
Earliest possible date of adoption: June 13, 2004
For further information, please call: (512) 305-6823
22 TAC §239.16, §239.20
(Editor's note: The text of the following sections proposed for
repeal will not be published. The sections may be examined in the offices
of the Board of Nurse Examiners or in the Texas Register office, Room 245,
James Earl Rudder Building, 1019 Brazos Street, Austin.)
The Board of Nurse Examiners proposes the repeal
of 22 Texas Administrative Code, chapter 239 (Contested Case Procedure), Subchapter
B (Enforcement), §§ 239.16 and 239.20. Effective February 1, 2004,
the Board of Nurse Examiners and the Board of Vocational Nurse Examiners were
merged into one agency, the Board of Nurse Examiners. The Board of Vocational
Nurse Examiners ceased to exist as an agency. House Bill 1483, passed by the
78th Regular Legislative Session, was the legislative action that implemented
the consolidation. These proposed repeals implement HB 1483 and the make-up
and function of the new Board of Nurse Examiners. Concurrent with these proposed
repeals are the proposed amendments to 22 Texas Administrative Code chapter
217 (Licensure, Peer Assistance and Practice) which incorporate Licensed Vocational
Nurses into the Board of Nurse Examiners' licensing and peer assistance rules
and chapter 223 which consolidates the fee structure of the agency. This proposed
repeal is for the purpose of preventing conflicting rules and to provide consistency
in the nurse peer assistance and fee process.
Katherine Thomas, executive director, has determined that for the first
five-year period the proposed repeals are adopted there will be no fiscal
implications for state or local government as a result of implementing the
proposed repeal.
Katherine Thomas, executive director, has determined that for each year
of the first five years the proposed repeals are adopted, the public benefit
will be that all nurses will be subject to the same disciplinary and procedural
process which will be a more consistent process. The proposed repeal will
also prevent conflicting rules. There will be no effect on small businesses.
There is no anticipated cost to affected individuals as a result of this proposed
repeal.
Written comments on the proposal may be submitted to Katherine A. Thomas,
MN, RN, Executive Director, Board of Nurse Examiners, 333 Guadalupe, Suite
3-460, Austin, Texas 78701.
The proposed repeal of this section is pursuant to the authority
of Texas Occupations Code §§ 301.151 and 301.152 which authorizes
the Board of Nurse Examiners to adopt, enforce, and repeal rules consistent
with its legislative authority under the Nursing Practice Act. The adoption
of the proposed repeal will not affect any existing statute.
§239.16.Peer Assistance Programs.
§239.20.Schedule of Fees.
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State on April 29, 2004.
TRD-200402863
Katherine Thomas
Executive Director
Board of Nurse Examiners
Earliest possible date of adoption: June 13, 2004
For further information, please call: (512) 305-6823
22 TAC §§239.61 - 239.64
(Editor's note: The text of the following sections proposed for
repeal will not be published. The sections may be examined in the offices
of the Board of Nurse Examiners or in the Texas Register office, Room 245,
James Earl Rudder Building, 1019 Brazos Street, Austin.)
The Board of Nurse Examiners proposes the repeal
of 22 Texas Administrative Code, chapter 239 (Contested Case Procedure), Subchapter
E (Reinstatement Process), §§239.61 - 239.64. Effective February
1, 2004, the Board of Nurse Examiners and the Board of Vocational Nurse Examiners
were merged into one agency, the Board of Nurse Examiners. The Board of Vocational
Nurse Examiners ceased to exist as an agency. House Bill 1483, passed by the
78th Regular Legislative Session, was the legislative action that implemented
the consolidation. These proposed repeals implement HB 1483 and the make-up
and function of the new Board of Nurse Examiners. Concurrent with these proposed
repeals are the proposed amendments to 22 Texas Administrative Code chapter
217 (Licensure, Peer Assistance and Practice) which incorporate Licensed Vocational
Nurses into the Board of Nurse Examiners' reinstatement process. This proposed
repeal is for the purpose of preventing conflicting rules and to provide consistency
in the reinstatement process.
Katherine Thomas, executive director, has determined that for the first
five-year period the proposed repeals are adopted there will be no fiscal
implications for state or local government as a result of implementing the
proposed repeal.
Katherine Thomas, executive director, has determined that for each year
of the first five years the proposed repeals are adopted, the public benefit
will be that all nurses will be subject to the same procedural process which
will be a more consistent process. The proposed repeal will also prevent conflicting
rules. There will be no effect on small businesses. There is no anticipated
cost to affected individuals as a result of this proposed repeal.
Written comments on the proposal may be submitted to Katherine A. Thomas,
MN, RN, Executive Director, Board of Nurse Examiners, 333 Guadalupe, Suite
3-460, Austin, Texas 78701.
The proposed repeal of this section is pursuant to the authority
of Texas Occupations Code §§301.151 and 301.152 which authorizes
the Board of Nurse Examiners to adopt, enforce, and repeal rules consistent
with its legislative authority under the Nursing Practice Act. The adoption
of the proposed repeal will not affect any existing statute.
§239.61.Application for Reinstatement of License.
§239.62.Evaluation for Reinstatement.
§239.63.Process Upon Request for Reinstatement.
§239.64.Board Action Possible Upon Reinstatement.
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State on April 29, 2004.
TRD-200402865
Katherine Thomas
Executive Director
Board of Nurse Examiners
Earliest possible date of adoption: June 13, 2004
For further information, please call: (512) 305-6823
Chapter 89.
GENERAL RULES AND REGULATIONS
(l)
] Corporate License or Permit
Application: General. Each corporate applicant for any license or permit must
certify, before the license or permit is issued, that its state franchise
taxes are current. Corporations exempt from the payment of the franchise tax
and out-of-state corporations must certify that they are exempt and specify
the reason.
Part 9.
TEXAS STATE BOARD OF MEDICAL EXAMINERS
Part 11.
BOARD OF NURSE EXAMINERS
(2)
Accredited nursing program--A
school, department, or division of nursing accredited/approved by a nursing
board or other licensing authority which has jurisdiction over accreditation/approval
of nursing programs.]
(3)
]
Advanced practice nurse
(APN)--A registered nurse, currently licensed in the State of Texas, who has
been approved by the board to practice as an advanced practice nurse based
on completing an advanced educational program of study acceptable to the board.
The term includes a nurse practitioner, nurse-midwife, nurse anesthetist,
and a clinical nurse specialist.
[
Advanced Practice Nurse (APN)
A professional nurse, currently licensed in the State of Texas, who is prepared
for advanced nursing practice by virtue of knowledge and skills obtained in
an advanced educational program of study acceptable to the board, who meets
requirements of Rule 221 and/or Rule 222, and has received authorization to
practice as an APN in Texas.
]
(4)
] Applicant--An individual who
has
met the eligibility requirements and applied to take the National
Council Licensure Examination for Practical Nurses (NCLEX-PN ) or
completed
an accredited nursing program and has applied to take the National Council
Licensure Examination for Registered Nurses (NCLEX-RN ), or an individual
who has applied for Temporary Licensure/Endorsement into Texas.
(5)
] Approved--Recognized as having
met established standards and predetermined criteria of the credentialing
agencies recognized by the board. Applies to providers and programs.
Texas Civil Statutes,
Article 4519a,
] determining the eligibility of an individual for initial
licensure as a
licensed vocational or
registered nurse and setting
forth both the basis for potential ineligibility and the Board's determination
of the disclosed eligibility issues.
Deliquent
] license--A
license lapsed due to failure to renew the certificate of re
-
registration.
registered professional
] nurse to be immediately available to coordinate, direct, and observe
at firsthand another individual for whom the
nurse
[
RN
]
is responsible.
Texas Civil Statutes, Article 4519, 4519a, or 4521(a)
] determining the
eligibility of an individual for licensure.
registered
] nurse from another
jurisdiction or licensing authority after determination is made that the applicant
meets the same standards as those required of Texas [
registered
]
nurses.
Second level nurses, who may be called enrolled, vocational, or practical
nurses or nurse assistants, and those nurses who have specialized in one area
without being educated and registered/licensed as a general nurse (for instance,
midwife, pediatric nurse, or psychiatric nurse) are not eligible to take the
CGFNS qualifying exam.
]
professional
] nurse generalists
or enrolled nurses
for licensure
and is
approved/
accredited by a governmental authority.
(15)
] Impaired practice--Practice
in which the nurse's ability to perform the essential functions of a [
registered
] nurse is impaired by chemical dependency on drugs and/or
alcohol or by mental illness.
(16)
] Jurisdiction--A state or
territory of the United States using the National Council Licensure Examination
for Registered Nurses (NCLEX-RN )
and the National Council Licensure
Examination for Practical Nurses (NCLEX-PN )
as the licensing examination.
(17)
] Licensing authority--A legislated
or governmentally appointed agency which approves, accredits or otherwise
regulates legally defined behaviors of institutions or individuals.
(18)
] National Council Licensure
Examination for Registered Nurses (NCLEX- RN)--The test used by the board
to measure minimal competence for licensure as a registered professional nurse.
(19)
] Nursing curriculum--The equivalent
of all nursing courses in the program of study within an
approved/
accredited
nursing program.
(20)
] Nursing program--The equivalent
of all non-nursing and nursing courses in the program of study within an
approved/
accredited program.
(21)
] Peer assistance program--An
approved program designed for [
registered
] nurses whose nursing
practice is or may be impaired by chemical dependency on drugs and/or alcohol
or certain mental illnesses and which meets the minimum criteria established
by the Texas Commission on Alcohol and Drug Abuse and the additional criteria
established by the Board of Nurse Examiners for the State of Texas.
(22)
] Practitioner--As related
to radiology practice, a doctor of medicine, osteopathy, podiatry, dentistry,
or chiropractic who is licensed under the laws of Texas and who prescribes
radiologic procedures for other persons (See 25 TAC §143.2).
(23)
] Professional boundaries--
The appropriate limits which should be established by the nurse in the nurse/client
relationship due to the nurse's power and the patient's vulnerability.
Refers
to the provision of [
professional
] nursing services within the
limits of the nurse/client relationship which promote the client's dignity,
independence and best interests and refrain from inappropriate involvement
in the client's personal relationships and
/or
the obtainment of
the nurse's personal gain at the client's expense.
(24)
] Professional nursing education
program (general)--Post-secondary general nursing program of at least two
academic years in length that provides both theory and clinical instruction
in
:
[
nursing care of:
]
the adult to include both medical
and
] surgical nursing;
infant
] nursing;
care of children;
] and
psychiatric/
]mental health nursing
.
(25)
] Professional nursing practice--
The performance for compensation of an act that requires substantial specialized
judgment and skill, the proper performance of which is based on knowledge
and application of the principles of biological, physical, and social science
as acquired by a completed course in an approved school of professional nursing.
[
The performance of services for compensation appropriate for
RNs employed in clinical practice, administration, education, research or
other practices within the scope of the definition of professional nursing.
]
(26)
] Program of study--The courses
and learning experiences that constitute the requirements for completion of
a basic nursing
education
program (
vocational nursing education
program,
associate degree
nursing education
program, baccalaureate
degree
nursing education
program, master's degree
nursing
education
program, or diploma
nursing education
program)
or a post-licensure nursing
education
program.
(27)
] Radiologic procedure--Any
procedure or article used with clients, including diagnostic x-rays or nuclear
medicine procedures, through the emission of ionizing radiation as stated
in 25 TAC §143.2.
(28)
] Reactivation--The process
of making a license current when a [
registered
] nurse has allowed
his or her license to become delinquent and/or is in inactive/retired status.
(29)
] Refresher course--A program
designed to update knowledge of current nursing theory and clinical practice
consisting of didactic and clinical components to ensure entry level competencies
into
vocational,
professional
, or advanced
nursing practice.
Refresher courses are not accepted for continuing education credit
and
must meet current board requirements
.
(30)
] Registered nurse--A person
currently licensed by the board to practice professional nursing.
(31)
] Registered nurse, retired--An
individual on inactive status, 65 or older, who has met the requirements for
using the title as stated in §217.9(b) of this title (relating to Inactive
Status).
(32)
] Renewal period--Two-year
period determined by the licensee's birth month and year.
Specific time
frame for renewal may vary from six months to 29 months as determined by board
policies.
(33)
] Shall, will and must--Mandatory
requirements.
(34)
] State Board Test Pool Examination
(SBTPE)--The test formerly used by the board prior to the NCLEX-RN to measure
minimal competence for licensure as a registered nurse.
(35)
] Temporary authorization--An
authorization to practice
vocational or
professional nursing for
a specified period of time.
(36)
] Temporary license--A license
that authorizes an individual licensed as a [
registered
] nurse
in other jurisdictions to practice [
professional
] nursing in Texas
for a specified period of time.
(37)
] Temporary permit--A permit
issued to a [
registered
] nurse for a specific period of time which
allows the
nurse
[
RN
] to complete specific requirements
in order for the license to be reissued.
professional
] nursing as a graduate nurse
(GN)
or graduate vocational nurse (GVN)
pending the results of
the licensing examination.
Graduate Nurse
] Permit,
the new graduate must:
(
] relating to Licensure
by Examination for Graduates of Basic Nursing Education Programs Within the
United States, its Territories or Possessions [
)
]);
Texas Civil Statutes,
Article 4519a);
]
60
]
days from the date of eligibility, receipt of permanent license, or upon receipt
of a notice of failing the examination from the Board, whichever date is the
earliest. The GN
or GVN
must immediately inform employers of receipt
of notification of failing the examination and cease [
professional
]
nursing practice.
professional
] nursing as a GN
or GVN
pending the results
of the licensing examination must work under the direct supervision of
either a licensed vocational or
a registered professional nurse
if a GVN or a registered professional nurse only if a GN,
who is physically
present in the facility or practice setting and who is readily available to
the GN
or GVN
for consultation and assistance. If the facility
is organized into multiple units that are geographically distanced from each
other, then the supervising
nurse
[
RN
] must be working
on the same unit to which the GN
or GVN
is assigned. The GN
or GVN
shall not be placed in supervisory or charge positions and shall
not work in independent practice settings.
60
] days of
eligibility or receipt of a notice of failing the examination from the Board,
whichever date is earlier.
registered
] nurse who has not practiced nursing
for four or more years may be issued a temporary permit for the limited purpose
of completing a refresher course, extensive orientation to the practice of
professional
or vocational
nursing
, whichever is applicable,
or academic course. The permit is valid for six months and is nonrenewable.
registered
] nurse whose license has been
suspended, revoked, or surrendered through action by the board, may be issued
a temporary permit for the limited purpose of meeting any requirement(s) imposed
by the board in order for the nurse's license to be reissued. The permit is
valid for six months and is nonrenewable.
registered
] nurse who is not practicing [
professional
] nursing in Texas and who fails to maintain a current Texas
license for a period of time less than four years may bring his or her license
up-to-date by filing such forms as the board may require, showing evidence
of having completed 20 contact hours of acceptable continuing education within
two years immediately preceding the application for relicensure, and paying
the current licensure fee plus a late fee and any applicable fines, which
are not refundable.
registered
] nurse who is not practicing [
professional
] nursing and who fails to maintain a current license from
any licensing authority for four or more years will be required to:
professional
] nursing,
or completion of a nursing program of study. The applicant will submit an
application for temporary permit for the limited purpose of completing a refresher
course, extensive orientation to the practice of [
professional
]
nursing, or program of study;
registered
] nurse who fails to maintain a
current Texas license for four years or more and who is licensed and has practiced
in another state a minimum of two of the previous four years preceding the
application for relicensure in Texas, shall be exempt from requirements of
subsection (b)(1) and (2) of this section.
(13)(A)
]), plus any applicable fines; or
(13)(B)
]), plus any applicable fines.
registered
] nurse/applicant for licensure
shall notify the board in writing within ten days of a change of name by submitting
a legal document reflecting this name change.
registered
] nurse/applicant for licensure
shall notify the board in writing within 10 days of a change of address, providing
the new address and his or her license number.
registered
] nurse whose original certificate
of registration or wallet
-sized
[
size
] license is lost
or destroyed may obtain a duplicate by filing a form containing identifying
information, notarized affidavit, and paying a non-refundable fee.
registered
] nurse who wants to change his/her
name on the original certificate of registration or current wallet
-sized
[
size
] license must submit:
; and
]
registered
] nurse who elects to change from
active licensure status to inactive status must:
registered
] nurse on inactive status, who
is 65 or older, and requests to use the title
"Licensed Vocational Nurse,
Retired," "LVN, Retired," "Vocational Nurse, Retired," "VN, Retired,"
"Registered
Nurse, Retired," or "RN, Retired
,
" must submit the following:
Article 4526b
] to use the title
"Licensed Vocational
Nurse, Retired," "LVN, Retired," "Vocational Nurse, Retired," "VN, Retired,"
"Registered Nurse, Retired
,
" or "R.N., Retired
,"
[
",
] may not use that title to practice as a [
professional registered
] nurse for compensation.
registered
] nurse who has not practiced [
professional
] nursing and whose license has been in an inactive status
for less than four years may reactivate the license by completing the reactivation
application form, paying the required reactivation fee and the current licensure
fee which are non-refundable, and submitting verification of completion of
20 contact hours of continuing education in compliance with Chapter 216 of
this title (relating to Continuing Education).
registered
] nurse who has not practiced professional
nursing in Texas and whose license has been in an inactive status for more
than four years must submit:
professional
] nursing or program
of study which meets the board's requirements and was completed within the
last year;
registered
] nurse who has not practiced [
professional
] nursing in Texas or another jurisdiction within the last
four years and has not participated in a refresher course within the last
year must submit:
professional
] nursing or program of study which meets the board's
requirements; and
registered
] nurse completing refresher course
requirements in another jurisdiction is exempt from requirements of subsection
(f)(1) and (2) of this section.
professional
] nursing, or program of study
which meets the board's requirements, the nurse shall then comply with subsection
(e) of this section.
A person who holds a valid current license issued by the Board
of Nurse Examiners for the State of Texas may use the title registered nurse
or RN.
]
(b)
] An applicant for initial licensure
by examination in Texas who has valid temporary authorizations to practice
professional nursing as a graduate nurse pending the results of the licensing
examination may use the initials
"
GN
"
or the title
"
graduate nurse.
"
(c)
] A person who is eligible for
licensure by endorsement in Texas, holding a valid Texas temporary license
to engage in professional nursing practice,
may use the title
"registered nurse" or "RN."
[
registered nurse or RN.
]
(d)
] No other person, other than
designated in
paragraphs (1) - (6)
[
subsections (a), (b) and
(c)
] of this section, may use, where applicable, titles or abbreviations
with the word "nurse"
such as
office nurse,
staff nurse,
head nurse, charge nurse,
school nurse,
supervisor of nursing or
nurses, or any other title tending to imply to the public that the person
holds a license to practice [
professional
] nursing in Texas.
(e)
] Any person other than as permitted
by law or rule who uses any of the above titles or abbreviations deemed by
the board misleading or implying that the individual is a licensed [
professional
] nurse may be subject to potential violation or prosecution
under the applicable law.
(f)
] If a [
registered
]
nurse holds herself or himself out to the public as being engaged in the practice
of [
professional
] nursing, or uses the
designations
[
term
]
"licensed vocational nurse," "vocational nurse," "LVN," "VN,"
"registered nurse," or "RN"
[
registered nurse or "RN"
] or
any combination or variation of those terms and abbreviations, alone or in
combination with any other terms, then they must practice in accordance with
the Nursing Practice Act and the Rules and Regulations Relating to [
Professional
] Nurse Education, Licensure and Practice.
registered
] nurses will identify,
assist, and monitor professional colleagues experiencing mental health, alcohol,
or drug problems that are or are likely to be job- impairing so that they
may return to practice safe nursing.
registered
] nurses licensed to practice in Texas
whose practice may be impaired by chemical dependency or certain mental illness.
registered
] nurses, other practitioners, and employers.
registered
]
nurses who have been reported in accordance with the requirements of
Texas Occupations Code §301.410.
[
Texas Civil Statutes, Article
4525a.
]
RN's
] practice setting to take
corrective action, remediate deficits and detect patterns of behavior. This
rule is intended to clarify both what constitutes a minor incident and when
a minor incident need not be reported to the board.
professional
] nursing by an affected nurse poses a risk of harm to
a
[
the
] client or other person." A
nurse
[
RN
] involved in an incident which is determined to be minor need not
be reported to the Board or the Peer Review Committee if all of the following
factors exist:
RN's
] continuing practice would pose a
risk of harm to clients or others;
RN
] exhibits a conscientious
approach to and accountability for his/her practice; and
RN
] appears to have the
knowledge and skill to practice safely.
RN's
]
conduct in the particular practice setting; and
RN's
] conduct.
RN
] involved, and the action taken to correct or remedy the problem;
RN
]
to the Peer Review Committee if three minor incidents involving the
nurse
[
RN
] are documented within a one-year (any 12 consecutive
month) time period; and
RN's
] knowledge and/or skills can be accomplished
without referral to the Board.
RN
] after peer review is conducted, the information
on the first three errors shall be given new consideration in combination
with subsequent incidents occurring after this initial review process.
RNs
] under his/her supervision and keep the same
reports as required in paragraphs (1) - (3) of this subsection. A nurse manager
or supervisor shall report any
nurse
[
RN
] involved in
three minor incidents within one year to the Board.
nurses,
] the quality of
patient care rendered by
a nurse
[
nurses
], the merits
of
a complaint
[
complaints
] concerning
a nurse
or
[
nurses and
] nursing care, and
a determination
[
determinations
] or
recommendation
[
recommendations
]
regarding
a complaint."
[
complaints".
] The peer review
process is one of fact finding, analysis and study of events by nurses in
a climate of collegial problem solving focused on obtaining all relevant information
about an event. Once a decision is made that a nurse is subject to peer review,
Texas Occupations Code §303.002(e) provides that the nurse is entitled
to minimum due process. The purpose of
this rule
[
rule 217.19
] is to define minimum due process, to provide guidance to facilities
in developing peer review plans, to assure that nurses have knowledge of the
plan, and to provide guidance to the peer review committee in its fact finding
process.
and Board of Vocational Nurse Examiners
] by peer review committee
in accordance with the Texas Occupations Code §301.403; and
or Board of Vocational
Nurse Examiners
], the committee's report shall include:
RN
] Reporting to
Peer Review Committee. If a [
registered
] nurse reports a nurse
to a nursing peer review committee for conduct that the
reporting
nurse
has a duty to report to the Board, the report to the committee will satisfy
the nurse's duty to report to the Board provided that the following conditions
are met:
RNs. ]
RNs
] to permit a
nurse
[
RN
] to request Peer Review when requested to engage in conduct that
the
nurse
[
RN
] believes is in violation of his/her duty
to a patient. "Duty to a patient" means conduct, including administrative
decisions directly affecting a
nurse's
[
RN's
] ability
to comply with that duty, required by standards of practice or professional
conduct adopted by the Board. A
nurse
[
RN
] requesting
safe harbor in compliance with § 303.005 and these rules is afforded
the protections outlined in §303.005(c).
RN
]
requesting safe harbor shall be permitted to:
RN's
] duty to a patient.
RN
]
shall:
RN
] believes that the requested conduct violates
a
nurse's
[
RN's
] duty to a patient and that belief is
one a reasonable
nurse
[
RN
] could hold.
RN
] is requested
to engage in the activity, notify the supervisor making the assignment that
the
nurse
[
RN
] is invoking Safe Harbor.
RN's
] responsibilities, resources available, extenuating
or contributing circumstances impacting the situation);
RN's
] duty to a patient or any other provision
of the Nursing Practice Act and Board Rules. If possible, reference the specific
standard (Rule 217.11) or other section of the Nursing Practice Act and/or
Board rules the
nurse
[
RN
] believes would have been
violated;
RN's
] name, title, and
relationship to the supervisor making the assignment or request.
RN
] does not submit
the initial request for Safe Harbor using the form on the BNE web site, the
facility and
nurse
[
RN
] shall adhere to the Safe Harbor
process as outlined on the BNE form.
RN
] requested Safe Harbor;
RN
] requesting peer review of both the committee's determination
and whether the administrator believes in good faith that the committee's
findings are correct or incorrect.
RN
] invoking Safe Harbor
is responsible for keeping a copy of the request for Safe Harbor, and shall
be given a copy of the committee's determination and the nurse administrator's
review, if separate from the Safe Harbor form.
RN
] who invokes Safe Harbor in bad faith,
or engages in activity unrelated to the reason for the request for Safe Harbor
and that constitutes reportable misconduct of a [
professional
]
nurse, even if this activity occurs during the time a peer review committee
is considering the
nurse's
[
RN's
] request for Safe Harbor.
RN's
] request for Safe Harbor, the peer review committee may consider
whether an exclusion to Safe Harbor peer review applies, and evaluate whether
a [
professional
] nurse has engaged in reportable misconduct provided
such review is conducted in accordance with the requirements of rule 217.19.
RN's
] conduct was not related to the
nurse's
[
RN's
] request for Safe Harbor and would otherwise constitute misconduct
reportable to the Board, the committee shall report the
nurse
[
RN
] to the Board as required in Texas Occupations Code §301.403.
registered
] nurse who is administratively
responsible for nursing services.
Chapter 223.
FEES
--$65; effective
January 1, 2004, $70; (10/03)
]
(2/99)
]
(2/99)
]
$5.00
]; [
(11/85)
]
$125; effective January 1, 2004,
]
$130; [
(10/03)
]
$51;
effective January 1, 2004,
] $53; [
(10/03)
]
(5/86)
]
$5.00;
];
(11/85)
]
(11/85)
]
(2/99)
]
$15; (11/85)
]
re-registration
]:
$45; (11/90)
]
$90; (11/90)
]
(5/02)
]
(5/02)
]
(5/02)
]
(12/93)
]
(12/93)
]
(5/02)
]
(10/97)
]
(9/00)
]
(9/00)
]
.
]
(2/99)
]
73rd
] Legislature,
Regular Session
(1999), Chapter 1319, §16,
[
(1993), Chapter
428, §5,
] the [
following specifies the charges the
]
Board of Nurse Examiners will make [
for
] copies of public records
and charge the fees established by the Texas Building and Procurement Commission
. [
These charges are based on the full cost to the agency for providing
the copies.
]
Part 12.
BOARD OF VOCATIONAL NURSE EXAMINERS
Subchapter C. EXAMINATION
Subchapter D. ISSUANCE OF LICENSES
Chapter 236.
NURSE LICENSURE COMPACT
Subchapter B. ISSUANCE OF A LICENSE BY A COMPACT PARTY STATE
Chapter 239.
CONTESTED CASE PROCEDURE
Subchapter B. ENFORCEMENT
Subchapter E. REINSTATEMENT PROCESS
Chapter 240.
PEER REVIEW AND REPORTING