Part 11. TEXAS BOARD OF NURSING
Chapter 214. VOCATIONAL NURSING EDUCATION
The Texas Board of Nursing (BON) adopts amendments to 22 Texas Administrative Code §214.2, concerning Definitions relating to Vocational Nursing Education, with changes to the proposed text as published in the November 9, 2007, issue of the Texas Register (32 TexReg 8083).
The Sunset Advisory Commission Report to the 80th Legislature, May 2007, Recommendations, Change in Statute and Management Action , made recommendations, and House Bill 2426 (Board's Sunset Bill), implemented those recommendations, resulting in changes to Chapter 301 of the Texas Occupations Code (Nursing Practice Act). The adopted amendments implement new §301.157(a-d) of the Nursing Practice Act.
The Texas Nurses Association (TNA) submitted comments in response to the proposed amendments.
Comment: The definition of Assistant Program Director in §214.2(4) is unclear about what it means to have director or coordinator assume responsibilities other than program: Is this temporary such as vacation, illness/teaching courses?
Response: Section 214.6(e)(2) adds clarification in the statement that "the director may have responsibilities other than the program provided that an assistant program coordinator/lead instructor is designated to assist with the program management." The definition describes the role of the individual designated as assistant program director. The intent in §214.6(e)(2) is to insure that the director has adequate time for administrative responsibilities for the program in question. Other responsibilities refers to other administrative responsibilities in the school setting since some directors administer several types of nursing programs or may hold other academic positions in the setting. The responsibilities in question are academic responsibilities or school responsibilities. Since this wording has not created confusion in the past, the Board recommends no change.
Comment: Inclusion of the word "employed" in the definition of faculty member in §214.2(21) needs clarification since some faculty may not be "employed"--they may be provided by a hospital without cost.
Board Response: This statement does not specify that the faculty member is hired by the school, but that all or a portion of their job responsibility is to teach for the program. The faculty member is then considered an employed member of the faculty, either full time or part time, and they are included in the faculty count. The salary of this individual may be paid by a hospital and their job description for the hospital would include their teaching duties. This distinguishes this individual from a preceptor who is employed by a health care facility but mentors the student in clinical experiences. The preceptor is not considered as one of the employed faculty. The Board recommends no change.
Comment: The definition for faculty waiver in §214.2(22) is not clear. The wording needs to include the temporary nature of the waiver rather than stating "for a specified period of time."
Board Response: The Board agrees and will change the language to include the year limitation on waivers in §214.2(22) and §215.2(19).
The amendments are adopted pursuant to the authority of Texas Occupations Code §301.151 and §301.152 which authorizes the BON to adopt, enforce, and repeal rules consistent with its legislative authority under the Nursing Practice Act.
§214.2.Definitions.
Words and terms, when used in this chapter, shall have the following meanings unless the context clearly indicates otherwise:
(1) Affidavit of Graduation--an official Board form containing an approved nursing educational program's curriculum components and hours, a statement attesting to an applicant's qualifications for vocational nurse licensure in Texas, the official school seal and the signature of the nursing program director/coordinator.
(2) Affiliating Agency or Clinical Facility--a health care facility or agency which provides learning experiences for students.
(3) Approved vocational nursing educational program--a vocational nursing educational program approved by the Texas Board of Nursing.
(4) Assistant Program Coordinator--a registered nurse faculty member in the vocational nursing educational program who is designated to assist with program management when the director or coordinator assumes responsibilities other than the program.
(5) Board--the Texas Board of Nursing composed of members appointed by the Governor for the State of Texas.
(6) Class Hours--those hours allocated to didactic instruction and testing in each subject.
(7) Clinical Conferences--scheduled presentations and discussions of aspects of client care experiences.
(8) Clinical Learning Experiences--faculty planned and guided learning activities designed to assist students to meet stated program and course outcomes and to safely apply knowledge and skills when providing nursing care to clients across the life span as appropriate to the role expectations of the graduates. These experiences occur in nursing skills and computer laboratories; in simulated clinical settings; in a variety of affiliating agencies or clinical practice settings including, but not limited to: acute care facilities, extended care facilities, clients' residences, and community agencies; and in associated clinical conferences.
(9) Clinical Practice Hours--hours spent in actual client care assignments, simulated laboratory experiences, observations, clinical conferences and clinical instruction.
(10) Clinical Preceptor--a licensed nurse who meets the minimum requirements in §214.10(l)(5) of this chapter (relating to Management of Clinical Learning Experiences and Resources), not paid as a faculty member by the controlling agency, and who directly supervises clinical learning experiences for no more than two students. A clinical preceptor facilitates student learning in a manner prescribed by a signed written agreement between the educational institution, preceptor, and affiliating agency (as applicable).
(11) Compliance Audit--a document required by the Board to be submitted at a specified time by the nursing educational program director or coordinator that serves as verification of the program's adherence to this chapter.
(12) Conceptual Framework--theories or concepts giving structure to the curriculum and enabling faculty to make consistent decisions about all aspects of curriculum development, implementation, and evaluation.
(13) Concurrent Theory and Skills Laboratory Experiences--planned experiences which coincide or operate at the same time to provide a common effect.
(14) Controlling Agency--institution that has direct authority and administrative responsibility for the operation of a board approved nursing educational program.
(15) Correlated Theory and Clinical Practice--didactic and clinical experiences which have a reciprocal relationship or mutually complement each other.
(16) Course--organized subject content and related activities, which may include didactic, laboratory and/or clinical experiences, planned to achieve specific objectives within a given time period.
(17) Curriculum--course offerings which, in aggregate, make up the total learning activities in a program of study.
(18) Differentiated Entry Level Competencies--the expected educational outcomes to be demonstrated by nursing students at the time of graduation as published in Differentiated Entry Level Competencies of Graduates of Texas Nursing Programs, Vocational (VN), Diploma/Associate Degree (Dip/ADN), Baccalaureate (BSN), September 2002.
(19) Director or Coordinator--denotes the nurse directly in charge chosen by the controlling agency, approved by the Board, and who is administratively responsible for the nursing educational program.
(20) Examination Year--the period beginning January 1 and ending December 31 used for the purposes of determining programs' NCLEX-PN™ examination pass rates.
(21) Faculty member--an individual employed to teach in the vocational nursing educational program who meets the requirements as stated in §214.7 of this chapter (relating to Faculty Qualifications and Faculty Organization).
(22) Faculty waiver--a waiver granted a director or coordinator of a vocational nursing educational program and submitted to the Board on a notarized notification form, or by the Board, as specified in §214.7(c)(2)(C) of this chapter, to an individual who is currently licensed as an LVN or RN, or has a privilege to practice, as appropriate, in Texas and who is approved to be employed as a faculty member which is valid for up to one year.
(23) Lead Instructor--a licensed nurse approved by the Board who has the delegated administrative authority for the program.
(24) Mobility--the ability to advance without educational barriers.
(25) Non-Nursing Faculty--instructors who teach non-nursing theory courses such as pharmacology, nutrition, and anatomy and physiology and who have educational preparation appropriate to the assigned teaching responsibilities.
(26) Objectives/Outcomes--clear statements of expected behaviors that are attainable and measurable.
(A) Program Objectives/Outcomes--broad statements used to direct overall student learning toward the achievement of expected program outcomes.
(B) Clinical Objectives/Outcomes--statements describing expected student behaviors throughout the curriculum and which represent progression of students' cognitive, affective and psychomotor achievement in clinical practice across the curriculum.
(C) Course Objectives/Outcomes--statements describing expected behavioral changes in the learner upon successful completion of specific curriculum content and which serve as the mechanism for evaluation of student progression.
(27) Observational experience--an assignment to a facility or unit where students observe activities within the facility and/or the role of nursing within the facility, but where students do not participate in patient/client care.
(28) Pass rate--the percentage of first-time candidates within one examination year who pass the National Council Licensure Examination for Vocational Nurses (NCLEX-PN™).
(29) Philosophy/Mission--statement of concepts expressing fundamental values and beliefs regarding human nature as they apply to nursing education and practice and upon which the curriculum is based.
(30) Program of Study--the courses and learning experiences that constitute the requirements for completion of a vocational nursing educational program.
(31) Proprietary Schools--educational entities defined by Texas Workforce Commission as "career schools and colleges."
(32) Recommendation--a suggestion based upon program assessment indirectly related to the rules to which the program must respond but in a method of their choosing.
(33) Requirement--mandatory criterion based on program assessment directly related to the rule that must be addressed in the manner prescribed.
(34) Shall--denotes mandatory requirements.
(35) Staff--Employees of the Texas Board of Nursing.
(36) Supervision--immediate availability of a faculty member or clinical preceptor to coordinate, direct, and observe first hand the practice of students.
(37) Survey Visit--an on-site visit to a vocational nursing educational program by a Board representative. The purpose of the visit is to evaluate the program of learning by gathering data to determine whether the program is meeting the Board's requirements as specified in §§214.2 - 214.13 of this chapter.
(38) Systematic Approach--the organized process in nursing which provides individualized, goal-directed nursing care which includes the vocational nurse's role in participating in data collection, assessment activities, planning and implementing client care, and evaluating the client's responses to nursing interventions and identification of client needs.
(39) Texas Higher Education Coordinating Board (THECB)--a state agency created by the Legislature to provide coordination for the Texas higher education system, institutions, and governing boards, through the efficient and effective utilization and concentration of all available resources and the elimination of costly duplication in program offerings, faculties, and physical plants (Texas Education Code, Title 3, Subtitle B, Chapter 61).
(40) Texas Workforce Commission (TWC)--the state agency charged with overseeing and providing workforce development services to employers and job seekers of Texas (Texas Labor Code, Title 4, Subtitle B, Chapter 301).
(41) Vocational Nursing Educational Program--a unit or entity within an educational setting which provides a program of study preparing graduates who are competent to practice safely and who are eligible to take the NCLEX-PN™ examination. Types of programs:
(A) Extension program--a site other than the program's main location where the program of study is provided, duplicating the current curriculum and teaching resources.
(B) MEEP--Multiple Entry Exit Program that offers mobility options for students.
(C) New program--a newly created program of study in which the curriculum, teaching resources, or program hours required to complete the program differs from that of the main location.
This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on January 30, 2008.
TRD-200800518
Katherine Thomas
Executive Director
Texas Board of Nursing
Effective date: February 19, 2008
Proposal publication date: November 9, 2007
For further information, please call: (512) 305-6823
The Texas Board of Nursing (BON) adopts amendments to 22 Texas Administrative Code §215.2, concerning Definitions; §215.3, concerning Program Development, Expansion, and Closure; and §215.4, concerning Approval, relating to Professional Nursing Education. Section 215.2 and §215.3 are adopted with changes to the proposed text as published in the November 9, 2007, issue of the Texas Register (32 TexReg 8088). Section 215.4 is adopted without changes to the proposed text and will not be republished.
The Sunset Advisory Commission Report to the 80th Legislature, May 2007, Recommendations, Change in Statute and Management Action, made recommendations, and House Bill 2426 (Board's Sunset Bill), implemented those recommendations, resulting in changes to Chapter 301 of the Texas Occupations Code (Nursing Practice Act). The adopted amendments implement new §301.157(a-d) of the Nursing Practice Act.
Comments to the proposed amendments were received from the Texas Nurses Association (TNA).
Comment: Definition for "faculty waivers" needs to include the temporary nature of the waiver rather than stating "for a specified period of time."
Response: The Board agrees and will change the language to include the year limitation on waivers in §215.2(19).
Comment: The wording in §215.3(a)(1)(B)(i) and (ii) is confusing. It says the process must precede, then it says only that the approval by THECB and TWC must precede. I think they are two different things. The flaw should be that the submission to all can be concurrent. THECB and TWC must complete their full approval processes and then the BON institutes its approval process.
Response: Board agrees that there is repetition and will delete §215.3(a)(1)(B)(i). Because the deletion of this clause leaves clause (ii) only, clause (ii) will be combined with the initial sentence in §215.3(a)(1)(B).
Comment: The wording in §215.3(a)(1)(G) says that there must be a "process in place by 2015 to ensure that. . . ." The board does not want a process, but wants a finalized plan so that by 2015 the graduates are entitled to a degree.
Response: House Bill 2426 states that "a diploma program of study in this state that leads to an initial license as a registered nurse under this chapter and that is completed on or after December 31, 2014, must entitle a student to receive a degree on the student's successful completion of a degree program of a public or private institution of higher education. . . ." Following deliberations with legislators and constituents, the consensus was that the intent was for diploma programs to establish a plan whereby their graduates would be entitled to an academic degree. This allows diploma programs the prerogative of determining how the awarding of degrees would occur. The outcome is the same, but there may be a difference in semantics. The Board does not plan to change the wording.
Comment: Is there an appeal process in §215.3(a)(1)(N)? Perhaps it is addressed elsewhere.
Response: There is no appeal process described in the rule. The program has an opportunity to answer questions and clarify issues at the Board meeting when the proposal is presented. If a program is denied, they may reapply after a twelve-month waiting period.
Comment: In §215.4(a)(2)(B) the sentence at the top suggests that the programs with full approval status may do certain things. . .on their own. Is that really the intent? Does the board mean that programs must have full accreditation status before they SEEK to initiate and SEEK to grant?
Response: This wording states that programs must have full approval status before they can branch out to extension sites or seek to use faculty who are not fully qualified (but require waivers). This means that new programs on initial approval (who have not had a first graduating class or have established an acceptable pass rate) or programs on warning or conditional approval (because of low pass rate) may not branch out to extension sites or use faculty who are not fully qualified (and require waivers). This puts a few more restrictions on new programs and on programs experiencing difficulties. Expansion to extension sites or using faculty who require additional mentoring would place additional challenges on new programs or programs experiencing difficulties. The Board does not plan to change the wording.
Comment: The statement in §215.4(c)(4)(B)(iii) seems to nullify the prior points that the board made about national accreditation. Why would the board accept (and thus have to review) another state's standards? Why not make the requirement that, like Texas schools, if the out of state school is accredited by a national nursing accrediting body. . . .
Response: This wording was taken from the statute: House Bill 2426, §301.157(b)(6)(C): "The board shall: deny or withdraw approval from a school of nursing or educational program that: fails to maintain the approval of the state board of nursing of another state and the board under which it was approved." The Board does not plan to change the wording.
Comment: Are there implications for Associate degree programs for accreditation? For example, if all ADN programs aren't accredited nationally, do these changes alter the BON workload? I think not and if that was part of the rationale for changes, the issue isn't fully addressed.
Response: The Board assumes that this question relates to §215.4(c)(4) which states that the "Texas Board of Nursing will select one or more national nursing accrediting agencies, recognized by the United States Department of Education and determined by the Board to have standards equivalent to the Board's ongoing approval standards." The question seems to ask if all ADN programs are required to have accreditation from a national nursing accrediting agency. No, they are not required to have this accreditation; it is voluntary. If programs hold national nursing accreditation from an agency determined by the Board to have standards equivalent to the Board's ongoing approval standards, maintain that accreditation and an acceptable pass rate, they will be exempt from Board rules that require ongoing approval. Programs not holding national nursing accreditation will be subject to Board rules for ongoing approval. These changes were not made to alter the BON workload. The Board does not think that changes need to be made in response to this comment.
One final change the Board makes is the addition of the trademark symbol in §215.2(28)(E) behind the word, NCLEX-PN.
The amendments are adopted pursuant to the authority of Texas Occupations Code §301.151 and §301.152 which authorizes the BON to adopt, enforce, and repeal rules consistent with its legislative authority under the Nursing Practice Act.
§215.2.Definitions.
Words and terms, when used in this chapter, shall have the following meanings unless the context clearly indicates otherwise:
(1) Accredited nursing educational program--a professional nursing educational program having voluntary accreditation by a Board-approved nursing accrediting body.
(2) Affiliating Agency or Clinical Facility--a health care facility or agency which provides learning experiences for students.
(3) Alternative practice settings--settings which provide opportunities for clinical learning experiences although their primary function is not the delivery of health care.
(4) Approved professional nursing educational program--a professional nursing educational program approved by the Texas Board of Nursing.
(5) Articulation--a planned process between two or more educational systems to assist students to make a smooth transition from one level of education to another without duplication in learning.
(6) Board--the Texas Board of Nursing composed of members appointed by the Governor for the State of Texas.
(7) Clinical learning experiences--faculty-planned and guided learning activities designed to assist students to meet stated program and course outcomes and to safely apply knowledge and skills when providing nursing care to clients across the life span as appropriate to the role expectations of the graduates. These experiences occur in nursing skills and computer laboratories; in simulated clinical settings; in a variety of affiliating agencies or clinical practice settings including, but not limited to: acute care facilities, extended care facilities, clients' residences, and community agencies; and in associated clinical conferences.
(8) Clinical preceptor--a registered nurse or other licensed health professional who meets the minimum requirements in §215.10(f)(5) of this chapter (relating to Management of Clinical Learning Experiences and Resources), not paid as a faculty member by the governing institution, and who directly supervises a student's clinical learning experience. A clinical preceptor facilitates student learning in a manner prescribed by a signed written agreement between the educational institution, preceptor, and affiliating agency (as applicable).
(9) Clinical teaching assistant--a registered nurse licensed in Texas, who is employed to assist in the clinical area and work under the supervision of a Master's or Doctorally prepared nursing faculty member and who meets the minimum requirements in §215.10(g)(4) of this chapter.
(10) Compliance Audit--a document required by the Board to be submitted at a specified time by the nursing educational program dean or director that serves as verification of the program's adherence to this chapter.
(11) Conceptual Framework--theories or concepts giving structure to the curriculum and enabling faculty to make consistent decisions about all aspects of curriculum development, implementation, and evaluation.
(12) Course--organized subject content and related activities, which may include didactic, laboratory and/or clinical experiences, planned to achieve specific objectives within a given time period.
(13) Curriculum--course offerings, which in aggregate, make up the total learning activities in a program of study.
(14) Dean or Director--a registered nurse who is accountable for administering a pre-licensure nursing educational program, who meets the requirements as stated in §215.6(f) of this chapter (relating to Administration and Organization), and is approved by the Board.
(15) Differentiated Entry Level Competencies--the expected educational outcomes to be demonstrated by nursing students at the time of graduation as published in Differentiated Entry Level Compentencies of Graduates of Texas Nursing Programs, Vocational (VN), Diploma/Associate Degree (Dip/ADN), Baccalaureate (BSN), September 2002.
(16) Examination year--the period beginning October 1 and ending September 30 used for the purposes of determining programs' NCLEX-RN™ examination pass rates.
(17) Extension Program--instruction provided by an approved professional pre-licensure nursing educational program providing a variety of instructional methods to any location(s) other than the program's main campus and where students are required to attend activities such as testing, group conferences, and/or campus laboratory. An extension program may offer the entire identical curriculum or may offer a single course or multiple courses.
(A) Complete program--provides the entire program of study at a site other than the program's main campus.
(B) Partial program--provides a course, or courses, from the program of study at a site other than the program's main campus.
(18) Faculty member--an individual employed to teach in the professional nursing educational program who meets the requirements as stated in §215.7 of this chapter (relating to Faculty Qualifications and Faculty Organization).
(19) Faculty waiver--a waiver granted by a dean or director of a professional nursing educational program and submitted to the Board on a notarized notification form, or by the Board, as specified in §215.7(c)(1)(E)(iii) of this chapter, to an individual who has a baccalaureate degree in nursing and is currently licensed in Texas, or has a privilege to practice, to be employed as a faculty member which is valid for up to one year.
(20) Governing institution--the entity with administrative and operational authority over a Board-approved professional nursing educational program.
(21) Health care professional--an individual other than a RN who holds at least a bachelor's degree in the health care field, including, but not limited to: respiratory therapists, physical therapists, occupational therapists, dieticians, pharmacists, physicians, social workers and psychologists.
(22) Mobility--the ability to advance without educational barriers.
(23) Non-Nursing Faculty--instructors who teach non-nursing theory courses such as pharmacology, pathophysiology, research, management and statistics, and who have educational preparation appropriate to the assigned teaching responsibilities.
(24) Objectives/Outcomes--clear statements of expected behaviors that are attainable and measurable.
(A) Program Objectives/Outcomes--broad statements used to direct the overall student learning toward the achievement of expected program outcomes.
(B) Clinical Objectives/Outcomes--statements describing expected student behaviors throughout the curriculum and which represent progression of students' cognitive, affective and psychomotor achievement in clinical practice across the curriculum.
(C) Course Objectives/Outcomes--statements describing expected behavioral changes in the learner upon successful completion of specific curriculum content and which serve as the mechanism for evaluation of student progression.
(25) Observational experience--an assignment to a facility or unit where students observe activities within the facility and/or the role of nursing within the facility, but where students do not participate in patient/client care.
(26) Pass rate--the percentage of first-time candidates within one examination year who pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN™).
(27) Philosophy/Mission--statement of concepts expressing fundamental values and beliefs regarding human nature as they apply to nursing education and practice and upon which the curriculum is based.
(28) Professional Nursing Educational Programs--an educational entity that offers the courses and learning experiences that prepares graduates who are competent to practice safely and who are eligible to take the NCLEX-RN™ examination and often referred to as a pre-licensure nursing program. Types of pre-licensure nursing programs:
(A) Associate degree nursing educational program--a program leading to an associate degree in nursing conducted by an educational unit in nursing within the structure of a college or university.
(B) Baccalaureate degree nursing educational program--a program leading to a bachelor's degree in nursing conducted by an educational unit in nursing which is a part of a senior college or university.
(C) Master's degree nursing educational program--a program leading to a master's degree, which is an individual's first professional degree in nursing, and conducted by an educational unit in nursing within the structure of a senior college or university.
(D) Diploma nursing educational program--a program leading to a diploma in nursing conducted by a single purpose school usually under the control of a hospital.
(E) MEEP--a Multiple Entry-Exit Program which allows students to challenge the NCLEX-PN™ examination when they have completed sufficient course work in a professional nursing educational program that will meet all requirements for the examination.
(29) Program of study--the courses and learning experiences that constitute the requirements for completion of a professional pre-licensure nursing educational program (associate degree nursing educational program, baccalaureate degree nursing educational program, master's degree nursing educational program, or diploma nursing educational program).
(30) Recommendation--a suggestion based upon program assessment indirectly related to the rules to which the program must respond but in a method of their choosing.
(31) Requirement--mandatory criterion based upon program assessment directly related to the rules that must be addressed in the manner prescribed.
(32) Shall--denotes mandatory requirements.
(33) Staff--employees of the Texas Board of Nursing.
(34) Supervision--immediate availability of a faculty member, clinical preceptor, or clinical teaching assistant to coordinate, direct, and observe first hand the practice of students.
(35) Survey Visit--an on-site visit to a professional nursing educational program by a Board representative. The purpose of the visit is to evaluate the program of learning by gathering data to determine whether the program is meeting the Board's requirements as specified in §§215.2 - 215.13 of this chapter.
(36) Systematic Approach--the organized process in nursing which provides individualized, goal-directed nursing care by performing comprehensive nursing assessments regarding the health status of the client, making nursing diagnoses that serve as the basis for the strategy of care, developing a plan of care based on the assessment and nursing diagnosis, implementing nursing care, and evaluating the client's responses to nursing interventions.
(37) Texas Higher Education Coordinating Board (THECB)--a state agency created by the Legislature to provide coordination for the Texas higher education system, institutions, and governing boards, through the efficient and effective utilization and concentration of all available resources and the elimination of costly duplication in program offerings, faculties, and physical plants (Texas Education Code, Title 3, Subtitle B, Chapter 61).
(38) Texas Workforce Commission (TWC)--the state agency charged with overseeing and providing workforce development services to employers and job seekers of Texas (Texas Labor Code, Title 4, Subtitle B, Chapter 301).
§215.3.Program Development, Expansion, and Closure.
(a) New Programs.
(1) Proposal to establish a new professional pre-licensure nursing educational program.
(A) The proposal to establish a professional nursing educational program may be submitted by:
(i) a college or university accredited by an agency recognized by the THECB or holding a certificate of authority from the THECB under provisions leading to accrediting of the institution in due course; or
(ii) a single-purpose school, such as a hospital, proposing a new diploma program.
(B) The new professional nursing educational program must be approved/licensed by the appropriate Texas agency, i.e., THECB, TWC, before approval can be granted by the Texas Board of Nursing for the program to be implemented. The proposal to establish a new professional nursing educational program may be submitted to the Board at the same time that an application is submitted to THECB or TWC, but the proposal cannot be approved by the Board until such time as the proposed program is approved by THECB or TWC.
(C) The process to establish a new professional nursing educational program shall be initiated with the Board office one year prior to the anticipated start of the program.
(D) The proposal shall be completed under the direction/consultation of a registered nurse who meets the approved qualifications for a program director according to §215.6 of this chapter (relating to Administration and Organization).
(E) Sufficient nursing faculty with appropriate expertise shall be in place for development of the curriculum component of the program.
(F) The proposal shall include information outlined in applicable Board guidelines.
(G) A proposal for a new diploma nursing educational program must include a written plan addressing the legislative mandate that all nursing diploma programs in Texas must have a process in place by 2015 to ensure that their graduates are entitled to receive a degree from a public or private institution of higher education accredited by an agency recognized by the THECB and. at a minimum, entitle a graduate of the diploma program to receive an associate degree in nursing.
(H) After the proposal is submitted and reviewed, a preliminary survey visit shall be conducted by Board staff prior to presentation to the Board.
(I) The proposal shall be considered by the Board following a public hearing at a regularly scheduled meeting of the Board. The Board may approve the proposal and grant initial approval to the new program, may defer action on the proposal, or may deny further consideration of the proposal.
(J) The program shall not admit students until the Board approves the proposal and grants initial approval.
(K) Prior to presentation of the proposal to the Board, evidence of approval from the appropriate regulatory/funding agencies shall be provided.
(L) After the proposal is approved, an initial approval fee shall be assessed per §223.1 of this title (relating to Fees).
(M) A proposal without action for one calendar year shall be inactivated.
(N) If the Board denies further consideration of a proposal, the educational unit in nursing within the structure of a school, including a college, university, or proprietary school (career school or college), or a hospital must wait a minimum of twelve calendar months from the date of the denial before submitting a new proposal to establish a professional pre-licensure nursing educational program.
(2) Survey visits shall be conducted, as necessary, by staff until full approval status is granted.
(b) Extension Program.
(1) Only nursing programs that have full approval are eligible to initiate or modify extension programs.
(2) Instruction provided for the extension program may include a variety of instructional methods, shall be congruent with the program's curriculum plan, and shall enable students to meet the goals, objectives, and competencies of the educational program and requirements of the Board as stated in §§215.2 - 215.13 of this chapter.
(3) A program intending to establish an extension program shall:
(A) Notify the Board office at least four (4) months prior to implementation of extension programs by any approved program;
(B) Submit required information according to Board-approved guidelines;
(C) Provide documentation of notification to the Regional Council of the governing institution about plans for establishment of extension programs to the Board office at least four (4) months prior to implementation, as appropriate; and
(D) Provide evidence of approval from the THECB, TWC and/or other regulating/accrediting bodies, as applicable, to the Board four (4) months prior to implementation, as appropriate.
(4) Extension programs of professional pre-licensure nursing educational programs which have been closed may be reactivated by submitting notification of reactivation to the Board at least four (4) months prior to reactivation, using the Board guidelines for initiating an extension program.
(5) A program intending to close an extension program shall:
(A) Notify the Board at least four (4) months prior to closure of the extension program; and
(B) Submit required information according to Board-approved guidelines including:
(i) reason for closing the program;
(ii) date of intended closure;
(iii) academic provisions for students; and
(iv) provisions made for access to and storage of vital school records.
(c) Transfer of Administrative Control by Governing Institutions. The authorities of the governing institution shall notify the Board office in writing of an intent to transfer the administrative authority of the program. This notification shall follow Board guidelines.
(d) Closing a Program.
(1) When the decision to close a program which provides the entire program of study has been made, the director must notify the Board and submit a written plan for closure which includes the following:
(A) reason for closing the program;
(B) date of intended closure;
(C) academic provisions for students;
(D) provisions made for access to and safe storage of vital school records, including transcripts of all graduates; and
(E) methods to be used to maintain requirements and standards until the program closes.
(2) The program shall continue within standards until all classes, which are enrolled at the time of the decision to close, have graduated. In the event this is not possible, a plan shall be developed whereby students may transfer to other approved programs.
(e) Approval of a Nursing Educational Program Outside Texas' Jurisdiction to Conduct Clinical Learning Experiences in Texas.
(1) The nursing educational program outside Texas' jurisdiction seeking approval to conduct clinical learning experiences in Texas should initiate the process with the Texas Board of Nursing two to three months prior to the anticipated start of the clinical learning experiences in Texas.
(2) A written request and the required supporting documentation shall be submitted to the Board office following Board guidelines.
(3) Evidence that the program has been approved/licensed by the appropriate Texas agency, i.e., THECB, to conduct business in the State of Texas must be obtained before approval can be granted by the Texas Board of Nursing for the program to conduct clinical learning experiences in Texas.
This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on January 30, 2008.
TRD-200800544
Katherine Thomas
Executive Director
Texas Board of Nursing
Effective date: February 19, 2008
Proposal publication date: November 9, 2007
For further information, please call: (512) 305-6823
The Texas Board of Nursing (BON) adopts the repeal of §217.13, concerning Peer Assistance Programs. The repeal is adopted without changes to the proposed text as published in the November 2, 2007, issue of the Texas Register (32 TexReg 7845).
House Bill 2426 (Sunset Bill) puts forth several requirements for a peer assistance program utilized by the BON that made it necessary to repeal the old rule and adopt a new rule addressing those requirements. Concurrent with this adopted repeal of the existing rule is an adopted new rule that implements those requirements listed in the Sunset Bill, amending §301.4106, Texas Occupations Code, of the Nursing Practice Act.
No comments were received in response to the proposed repeal.
The repeal is adopted pursuant to the authority of Texas Occupations Code §301.151 which authorizes the BON to adopt, enforce, and repeal rules consistent with its legislative authority under the Nursing Practice Act.
This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on January 29, 2008.
TRD-200800512
Katherine Thomas
Executive Director
Texas Board of Nursing
Effective date: February 18, 2008
Proposal publication date: November 2, 2007
For further information, please call: (512) 305-6823
The Texas Board of Nursing (BON) adopts §217.13 (Peer Assistance Programs) with changes to the proposed rule. The proposed rule was published in the November 2, 2007, edition of the Texas Register (32 TexReg 7845). Concurrent with this adopted new rule is the adopted repeal of the old rule.
House Bill 2426 (Sunset Bill) puts forth several requirements for a peer assistance program utilized by the BON. The Nursing Practice Act, Texas Occupations Code §301.4105 requires that the BON be notified when a nurse suspected of impaired behavior is alleged to have also committed a nursing practice violation. In addition, the BON is required in §301.4106 to adopt rules that develop guidelines for its peer assistance programs by: outlining the roles and responsibilities of the board and a peer assistance program; outlining the process for a peer assistance program to refer to the board complaints alleging a violation of the practice of nursing; establishing requirements for successfully completing a peer assistance program and for notifying the board of the successful completion by a nurse the board has ordered to attend or referred to the program; and establishing a procedure for evaluating the success of a peer assistance program established or approved by the board. The adopted new §217.13 implements these requirements.
The Board received two comments on the proposed new rule, from an individual and the Texas Nurses Association (TNA).
Comment: The TNA requests an editorial change in subsection (e)(2)(D) relating to minimum conditions associated with participation in the peer assistance contract and requests that it be amended to include the phrase "and for cause." TNA states that the edit is non-substantive.
Response: After review of TNA's comment, the Board agrees that the phrase "and for cause" will clarify the meaning intended by the use of "random drug screens" during program monitoring and that it is a non-substantive change.
Comment: The individual commenter does not suggest a particular amendment or change in §217.13. Rather, the comments express concerns that §217.13 requires the disclosure of personal health information with regard to mental health diagnosis and addiction to employers when there are no practice violations. The commenter believes such disclosures are in violation of Title II of the Americans with Disabilities Act and argues that persons with chemical dependency and mental illness are being singled out and treated differently because of their diagnosis. Additionally, the commenter states that a nurse's right to privacy over personal mental health information should not be compromised because of the disease of addiction or mental health diagnosis.
Response: The Board believes that proposed §217.13 is a lawful rule consistent with the Board's statutory authority and mission to protect the public welfare by ensuring that each person holding a license as a nurse in Texas is competent to practice safely. A legitimate concern to public safety exists regarding nurses whose practice is impaired or suspected of being impaired by chemical dependency, mental illness, or diminished mental capacity. The peer assistance program for nurses approved by the Board under chapter 467, Texas Health and Safety Code, will identify, monitor, and assist with locating appropriate treatment for those nurses whose practice is impaired or suspected of being impaired by chemical dependency, mental illness or diminished mental capacity so that they may return to practice safe nursing.
The proposal is pursuant to the authority of Texas Occupations Code §301.151 which authorizes the BON to adopt, enforce, and repeal rules consistent with its legislative authority under the Nursing Practice Act.
§217.13.Peer Assistance Program.
(a) A peer assistance program for nurses approved by the Board under chapter 467, Health and Safety Code, will identify, monitor, and assist with locating appropriate treatment for those nurses whose practice is impaired or suspected of being impaired by chemical dependency, mental illness or diminished mental capacity so that they may return to practice safe nursing.
(b) Role of the Board of Nursing and Peer Assistance Program.
(1) The Board of Nursing will retain the sole and exclusive authority to discipline a nurse who has committed a practice violation under §301.452(b) of the Nursing Practice Act regardless of whether such violation was influenced by chemical dependency, mental illness, or diminished mental capacity. The Board will balance the need to protect the public and the need to ensure the nurse seeks treatment in determining whether the nurse is appropriate for participation in an approved peer assistance program.
(2) The program shall report to the board, in accordance with policies adopted by the board, a nurse reported to the program who is impaired or suspected of being impaired for chemical dependency, mental illness, or diminished mental capacity if the nurse was reported to the program by third party. A third party report is a report concerning a nurse suspected of chemical dependency, mental illness, or diminished mental capacity that comes to the attention of the program through any source other than a self report.
(c) General Criteria for Approved Peer Assistance Program.
(1) The program will provide statewide peer advocacy services to all nurses licensed to practice in Texas whose practice may be impaired by chemical dependency, certain mental illnesses, or diminished mental capacity.
(2) The program shall have a statewide monitoring system that will be able to track the nurse while preserving confidentiality.
(3) The program shall have a network of trained peer volunteer advocates located throughout the state.
(4) The program shall have a written plan for the education and training of volunteer advocates and other program personnel.
(5) The program shall have a written plan for the education of nurses, other practitioners, and employers.
(6) The program shall demonstrate financial stability and funding sufficient to operate the program.
(7) The program shall have a mechanism for documenting program compliance and for timely reporting of noncompliance to the board.
(8) The program shall be subject to periodic evaluation by the board or its designee in order for the board to evaluate the success of the program.
(d) Evaluation of Peer Assistance Program.
(1) The program shall collect and make available to the board and other appropriate persons data relating to program operations and participant outcomes. At a minimum, the program shall submit the following statistical information quarterly to the Board for the purpose of evaluating the success of the program:
(A) Number and source of referral;
(B) Number of individuals who sign participation agreements;
(C) Type of participation agreement signed, i.e., Extended Evaluation Program; substance abuse or dependency, dual diagnosis, mental illness;
(D) Number of cases referred to program by Board of Nursing (this number should include all third party referrals that are reported to the board, but remain in participation pending board review);
(E) Number of participants referred to program by Board order;
(F) Number of self referred cases closed and reason(s) for closure;
(G) Number of active cases;
(H) Number of participants employed in nursing;
(I) Number of participants completing program;
(J) Number of participants who are reported back for failing to comply with the participation agreement;
(K) Monitoring activities, including number of drug screens requested, conducted and results of these tests;
(L) All applicable performance measures required by the Legislative Budget Board.
(2) The program shall have a written plan for a systematic total program evaluation. Such plan shall include at a minimum monthly reports of the programs activities showing compliance with this rule, quarterly reports of applicable LBB performance measure data and an annual report of program activities.
(3) The program shall be subject to periodic evaluation by the board or its designee in order for the board to evaluate the success of the program.
(e) Participants entering the approved peer assistance program for chemical dependency or chemical abuse must agree to the following minimum conditions:
(1) The nurse shall undergo, as appropriate, a physical and/or psychosocial evaluation before entering the approved monitoring program. This evaluation will be performed by health care professional(s) with expertise in chemical dependency.
(2) The nurse shall enter into a contract with the approved peer assistance program to comply with the requirements of the program which shall include, but not be limited to:
(A) The nurse will undergo recommended substance abuse treatment by an appropriate treatment facility or provider.
(B) The nurse will agree to remain free of all mind-altering substances including alcohol except for medications prescribed by an authorized prescriber for legitimate medical purposes and approved by the program.
(C) The nurse must complete the prescribed aftercare, if any, which may include individual and/or group psychotherapy.
(D) The nurse will submit to random and "for cause" drug screening as specified by the approved monitoring program.
(E) The nurse will attend support groups as specified by the contract.
(F) The nurse will comply with specified employment conditions and restrictions as defined by the contract.
(G) The nurse shall sign a waiver allowing the approved peer assistance program to release, to the extend permitted by federal or state law, information to the Board if the nurse does not comply with the requirements of this contract.
(3) The nurse may be subject to disciplinary action by the Board if the nurse does not participate in the approved peer assistance program, does not comply with specified employment restrictions, or does not successfully complete the program.
(f) Referral to Board of Noncompliance with Peer Assistance Program.
(1) A participant may be terminated from the program for the following causes:
(A) Noncompliance with any aspect of the program agreement;
(B) Receipt of information by the board which, after investigation, results in disciplinary action by the board; or
(C) Being unable to practice according to acceptable and prevailing standards of safe nursing care.
(2) The program shall contact the board in accordance with board policies if a nurse under contract fails to comply with the terms of the program agreement or evidences conduct that indicates an inability or unwillingness to comply with the program.
(g) Eligibility for Program Participation.
(1) The program shall contact the board if it receives a third-party referral for a nurse who may have been impaired or suspected of being impaired and who may have failed to comply with the minimum standards of nursing (22 TAC §217.11) and/or committed an act constituting unprofessional conduct (22 TAC §217.12). The program shall send that report to the Board. The Board will balance the need to protect the public and the need to ensure the impaired nurse seeks treatment in determining the whether the nurse is appropriate for participation in an approved peer assistance program.
(2) An individual may not participate in the program if the information reviewed in conjunction with the report indicates to the board that the individual's compliance with the program may not be effectively monitored while participating in the program. This information includes, but is not limited to, the following:
(A) The individual is not currently licensed as a registered nurse or licensed vocational nurse;
(B) The individual is currently using or being prescribed a drug normally associated with chemical dependency or abuse;
(C) The individual has a medical and/or psychiatric condition, diagnosis, or disorder, other than chemical dependency, in which the manifest symptoms are not adequately controlled;
(D) The individual has attempted or completed two or more chemical dependency monitoring programs as of the date of the application, notwithstanding the individual's current chemical dependency treatment plan and related treatment currently submitted for purposes of program eligibility;
(E) The board has taken action against the individual's license to practice nursing as either a registered nurse or a licensed practical nurse in Texas within the last 5 years;
(F) The individual has been convicted of a felony, placed on probation or received deferred adjudication relating to a felony, or felony charges are currently pending, or is currently being investigated for a felony; or
(G) The individual has been convicted or registered as a sex offender.
(h) Successful Completion of the Program. A participant successfully completes the program when the participant fully complies with all of the terms of the program agreement for the period as specified in the agreement. When a participant successfully completes the program, the program shall notify the participant of the successful completion in writing. Once the participant receives this written notification of successful completion of the program, the participant shall no longer be required to comply with the program agreement. The program shall notify the board when a nurse who the board has ordered to attend or referred to the program successfully completes the peer assistance contract.
This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on January 29, 2008.
TRD-200800513
Katherine Thomas
Executive Director
Texas Board of Nursing
Effective date: February 18, 2008
Proposal publication date: November 2, 2007
For further information, please call: (512) 305-6823
The Texas Board of Physical Therapy Examiners adopts amendments to §322.1, Provision of Services, without changes to the proposed text as published in the December 21, 2007, issue of the Texas Register (32 TexReg 9518). The amendment will clarify for licensees and the public what kind of instruction may be given by physical therapists to individuals who are asymptomatic relating to the instruction being given.
The amendment adds language clarifying that instruction of individuals who are asymptomatic relating to the instruction being given includes the provision of information on health, wellness and fitness.
Comments were received from one individual, who believes the public may be confused rather than helped by the addition of written information regarding the use of the title "doctor" by a physical therapist in a clinical setting.
The amendment is adopted under the Physical Therapy Practice Act, Title 3, Subtitle H, Chapter 453, Occupations Code, which provides the Texas Board of Physical Therapy Examiners with the authority to adopt rules consistent with this Act to carry out its duties in administering this Act.
This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on January 29, 2008.
TRD-200800515
John P. Maline
Executive Director
Texas Board of Physical Therapy Examiners
Effective date: February 18, 2008
Proposal publication date: December 21, 2007
For further information, please call: (512) 305-6900
Chapter 781. SOCIAL WORKER LICENSURE
The Texas State Board of Social Worker Examiners (board) adopts amendments to §§781.101, 781.102, 781.209, 781.215, 781.217, 781.301 - 781.304, 781.311, 781.314, 781.402 - 781.405, 781.409, 781.414, 781.502, 781.505, 781.509, 781.511, 781.512, 781.517, and 781.603; new §781.419, and the repeal of §781.609, concerning the licensure and regulation of social workers. The amendments to §§781.102, 781.303, and 781.402 are adopted with changes to the proposed text as published in the November 16, 2007, issue of the Texas Register (32 TexReg 8265). The amendments to §§781.101, 781.209, 781.215, 781.217, 781.301, 781.302, 781.304, 781.311, 781.314, 781.403 - 781.405, 781.409, 781.414, 781.502, 781.505, 781.509, 781.511, 781.512, 781.517; and 781.603; new §781.419; and the repeal of §781.609 are adopted without changes and, therefore, the sections will not be republished.
BACKGROUND AND PURPOSE
The adopted amendments, new rule, and repeal are necessary to implement Occupations Code, Chapter 505. The amended and new rules correct minor errors, improve the clarity of the rules, and ensure that the rules reflect current legal, policy, and operational considerations. Additionally, the repeal eliminates duplication of language.
SECTION-BY-SECTION SUMMARY
The amendments to §781.101 improve the description of the restriction in the Social Work Practice Act of the use of the social worker title.
The amendments to §781.102 improve the definitions of accredited university, Association of Social Work Boards, clinical social work, confidential information, detrimental to the client, direct practice, direct practice, dual relationship, exploitation, family systems, flagrant, fraud, full-time experience, group supervision, indirect practice, individual supervision, investigator, licensee, part-time experience, psychotherapy, social work practice, supportive counseling, supervision, telepractice, and termination; delete the definitions of exploitive behavior, pleading, reciprocity, sexual contact, and sexual exploitation; and, renumber the definitions accordingly.
The amendments to §781.209 clarify the types of committees that may be established by the board.
The amendments to §781.215 clarify what is displayed on the license certificate, add the requirements of a provisional license certificate, and reorder and renumber the section accordingly.
The amendments to §781.217 change the penalty fee for late renewal to one-fourth of the biennial license renewal fee (for late renewals from 1-90 days late); change the penalty fee for late renewal to one-half of the biennial license renewal fee (for late renewals from 91-365 days late); eliminate the student loan default reinstatement fee; and, renumber the section accordingly.
The amendments to §781.301 specify the academic requirements for licensure as a Licensed Clinical Social Worker to be consistent with the Occupations Code, §505; improve language, to establish a one time window between April 1, 2008 and March 31, 2010 during which LMSW licensees of the board may use clinical supervision which was on file with the board before the board established by rule change effective August 24, 2005 that clinical and non-clinical supervision expired after five years (After March 31, 2010, supervision toward clinical or non-clinical licensure or specialty recognition must have occurred within the previous five calendar years occurring from the date of application); remove the requirements of the advanced practice specialty recognition from subsection (a) and restore the requirements in subsection (b); add the requirements for independent non-clinical specialty recognition into subsection (b); remove language regarding the scope of practice in subsection (b) for placement in §781.402; remove language regarding the scope of practice in subsections (c), (d), and (e) for modification and placement in §781.402; and reorder and renumber the section accordingly.
The amendments to §781.302 remove provisions allowing licensees to obtain supervision toward licensure without a supervision plan; improve language, allow for a social worker to be under more than one supervision plan at the same time; and reorder and renumber the section accordingly.
The amendments to §781.303 improve language; delete language related to qualifications for independent practice recognition (note that the deleted language is added to §781.301); remove language in subsection (a) related to the application process for independent practice recognition; remove language in subsection (b) related to the initial one-time waive of the supervised experience requirement that expired August 31, 2007; remove language in subsection (f) that allowed for an LMSW or LBSW to practice independently until August 31, 2007; provide that an LMSW or LBSW may practice independently when the LMSW or LBSW holds the independent practice specialty recognition, is under application for the specialty recognition under the waiver of the supervised experience requirement, or when under a supervision plan for independent practice that has been approved by the board; and reorder and renumber the section accordingly.
Amendments to §781.304 improve language; specify that supervisors may supervise only supervisees providing professional services within the supervisor's own competency; establish the supervisor status renewal period is two years and to be renewed in conjunction with the license renewal; provide a process for a supervisor to surrender supervisory status; specify that any month of supervision under a supervision plan is not creditable unless the conditions of supervision specified in the section were met; forbid supervisors from providing supervision to a social worker who is practicing outside of the scope of the license; require a supervisor who believes a supervisee is practicing outside the scope of the license to make a report to the board; remove language that allows for supervision completed before the effective date of the chapter to be evaluated based on the rules that were in effect at the time the supervision plan or verification was submitted to the board; and reorder and renumber the section accordingly.
The amendment to §781.311 allows a temporarily licensed social worker who passes the licensing examination to be considered temporarily licensed until a regular license is issued by the board or the temporary license expires, whichever is first.
The amendments to §781.314 improve language and use updated terminology.
The amendments to §781.402 add language regarding the scope of practice removed from §781.301; to improve language; to include Current Procedural Terminology (CPT) Codes among identified diagnostic classification systems in assessment, diagnosis, treatment and other social work practice activities Licensed Clinical Social Workers are qualified to use; specify that a LMSW may provide clinical social work services under a contract with an agency when under a board approved clinical supervision plan; remove definitions of independent non-clinical practice and independent clinical practice since the definitions already appear in §781.102; and reorder and renumber the section accordingly.
The amendments to §781.403 improve language and add a general standard of practice for social workers to ensure that the client or a legally authorized person representing the client has signed a consent for services, when appropriate.
The amendments to §781.404 add "services to be provided" to the list of items that a social worker shall make known to a prospective client.
The amendments to §781.405 add a definition of sexual exploitation and improve language.
The amendments to §781.409 improve language; clarify the requirement that a social worker provide a written explanation of types of treatment and charges on a bill or statement to a client even if the bill is paid by a third party; and remove language that indicated that a social worker would be responsible for services rendered when providing approval by signature by another individual who may or may not be licensed.
The amendments to §781.414 improve language and specify that the board will provide consumer information on its web site.
New §781.419 provides that a social worker who is licensed as a sex offender treatment provider by the Council on Sex Offender Treatment is not subject to disciplinary action by the board in relation to the social worker's provision of sex offender treatment; specify that a social worker who is a sex offender treatment provider and who acts in conformance with the rules, policies, and procedures of the council is not subject to any administrative sanction by the board; and specify that if the Council on Sex Offender Treatment takes disciplinary action against a social worker who is a sex offender treatment provider, the board may consider the final order imposing such disciplinary action as grounds for disciplinary action by the board.
The amendments to §781.502 rename the section; reflect that licenses are renewed for a two-year term; and delete language that provided for prorated fees during the transition from renewal terms of one year to two years.
The amendments to §781.505 improve language; use the current terms of "expire" and "expiration" as opposed to the terms "lapse" and "lapsed"; specify the current process for placing a license on inactive status; and specify the process to reactivate a license that was placed on inactive status.
The amendment to §781.509 improves language.
The amendments to §781.511 add the expiration date of a continuing education provider's approved status to certificates of completion issued by the provider and specify that a program offered for continuing education in ethics shall meet the minimum course requirements for an ethics course approved by the board.
The amendments to §781.512 improve language.
The amendment to §781.517 requires that supervisory training courses approved by the board before September 8, 2007, must meet the requirements in §781.511 by August 31, 2008.
The amendments to §781.603 clarify the functions in the complaint procedure that are preformed by department staff; remove the requirement that the executive director make a sworn statement in order to open an anonymous complaint; more accurately describe the review process and decisions made by the executive director upon the receipt of a complaint relative to referral for investigation and notification of the respondent to a complaint; update the complaint procedure; update the range of information provided to the board's ethics committee regarding the status of open complaints; update references to timelines; and reorder and renumber the section accordingly.
Section 781.609 is repealed because language in current board rule §781.703 provides for appropriate default procedures.
COMMENTS
The board has reviewed and prepared responses to the comments received regarding the proposed rules during the comment period. The commenters were one individual, associations, and/or groups, including the following: Licensees representing the National Association of Social Workers--Texas Chapter, the Texas Society of Clinical Social Work, and one licensee of the board. The commenters were not against the rules in their entirety; however, the commenters suggested recommendations for change as discussed in the summary of comments. Commenters were generally in favor of the rules.
Comment: Concerning §781.102(11) and §781.102(47), the commenter indicated agreement with the proposed changes to §781.102(11). The commenter stated that the definition of clinical social work could be improved by making it clear who is restricted from practicing clinical social work and recommended adding the phrase, "The practice of Clinical social work is restricted to either: (A) a Licensed Clinical Social Worker; or (B) a Licensed Master Social Worker under clinical supervision." The commenter noted that there is currently an insufficient and unworkable delineation between the definitions of clinical and non-clinical social work. The commenter recommended adding language to the definition of non-clinical social work (§781.102(47)) to include direct practice elements of non-clinical social work, such as counseling, case management, interviewing, assessment, intervention, mediation, problem solving, treatment and evaluation. Supportive counseling was not on the list because it defined as non-clinical.
Response: The board agreed with the comment and amended the definition in §781.102(11) accordingly. The board noted that §781.102(47) was not open to substantive change and, therefore, could not act on the recommended change. The board noted that this issue would be referred to the rules committee for consideration in a future rule discussion.
Comment: Concerning §781.102(22), the commenter stated that the definition of "direct practice" should be clarified to limit a "client" to an individual or group who perceives themselves to be (or who are reasonably perceived by others) as social services seekers or recipients. The commenter recommended adding the words, "with those seeking social services," to the end of the current definition.
Response: The board disagreed with the comment because the current definition is generally accepted by the board. No change was made as a result of this comment.
Comment: Concerning §781.102(57), the commenter stated that the definition of "social work practice" is defined by focusing on what social work practice is, not by whom it is provided or whether it is for compensation. The commenter recommended deleting the words, "as an employee, independent practitioner, consultant, or volunteer for compensation or pro bono."
Response: The board disagreed with the comment because it should be clear that social work practice by a licensee in all settings, including unpaid volunteer work is under the jurisdiction of the board. No change was made as a result of this comment.
Comment: Concerning §781.102(60)(B), the commenter stated that the addition of definitions of specific types of supervision is necessary and useful in determining the purpose of the activity. Subparagraph (B) distinguishes what clinical supervision will not be acceptable to the board. The commenter recommended adding to subparagraph (B) the words, "non-approved supervisor" and deleting the words, "Licensed Masters Social Worker providing clinical services by a Licensed Professional Counselor, Licensed Psychologist, Licensed Marriage and Family Therapist, Licensed Clinical Social Worker or Psychiatrist."
Response: The board disagreed with the comment because subparagraph (B) clarifies the specific license holders who are authorized to provide clinical supervision to an LMSW under which a LMSW may practice clinical social work, as authorized by the license, but the supervision is not creditable toward the supervised clinical experience requirement for licensure as a LCSW. No change was made as a result of this comment.
Comment: Concerning §781.102(60)(C), the commenter recommended adding the words, "as a Licensed Clinical Social Worker" to the end of subparagraph (C) to clarify the definition.
Response: The board agreed with the comment and made the change.
Comment: Concerning §781.102(60)(D), the commenter recommended the addition of the words, "in independent practice or as a Licensed Master Social Worker--Advanced Practice" to the end of subparagraph (D) to clarify the definition.
Response: The board agreed with the comment and made the change.
Comment: Concerning §781.102(61), the commenter stated that the general definition of a meeting between a supervisor and supervisee needs not to be so narrowly defined. Other sections of the rules give directions as to the specific time requirements for different types of supervision acceptable to the board. The commenter recommended changing the definition of "supervision hour" to "supervisory session" and provided language to revise the definition.
Response: The board disagreed with the comment because the definition of "supervision hour" is useful for licensee accruing hours of supervision toward the necessary 100 hours for eligibility to examine for the LCSW license. No change was made as a result of this comment.
Comment: Concerning §781.301(a)(3), the commenter stated that, to her knowledge, a specific social work degree in colleges and universities did not exist prior to 1971 and that students interested in a social work career prior to 1971 obtained a degree in "Sociology." The commenter recommended changing the academic requirement for licensure as a Licensed Baccalaureate Social Worker (LBSW) to include a degree in Sociology, if the degree was obtained prior to 1971.
Response: The board disagreed with the comment because the Occupations Code, §505.353(b)(2), specifies that the academic requirement for licensure as a Licensed Baccalaureate Social Worker (LBSW) is a "baccalaureate degree" in social work from an educational program accredited by the Council on Social Work Education. No change was made as a result of this comment.
Comment: Concerning §781.302(b), the commenter recommended changing the word "upgrade" to "change."
Response: The board disagreed with the comment because the "change" from the license of LMSW to LCSW is an upgrade since the license authorizes the additional scope of practice of clinical social work without supervision. No change was made as a result of this comment.
Comment: Concerning §781.302(e), (f), and (g), the commenter stated that the subsections do not address the heading and recommended placement of the subsections in §781.610.
Response: The board disagreed with the comment because the subsections are appropriately placed. No change was made as a result of this comment.
Comment: Concerning §781.303, the commenter referred to previous comments on §781.102 regarding the definitions of clinical and non-clinical social work and that if recommended changes were not adopted in regard to the definitions, then the "non-clinical" qualifier of independent practice recognition should be stricken in all instances. The commenter further recommended that the board include contract clinical services under appropriate supervision as within the scope of an LMSW who holds the independent practice recognition.
Response: The board disagreed with the comment because the non-clinical qualifier is a relevant distinction. As noted above, the board agreed that the definition of non-clinical social work should be considered for amendment in the future since it was not opened for change with this adoption. The board disagreed with the comment regarding including contract clinical supervision under appropriate supervision as within the scope of an LMSW who holds the independent practice recognition because an LMSW with appropriate supervision may provide contract clinical services only under a board approved clinical supervision plan under the supervision of a board approved supervisor. The holding of independent practice recognition is not relevant to the validity of the relationship. No change was made as a result of this comment.
Comment: Concerning §781.303(b) the commenter recommended inserting the phrase, "for recognition of independent practice," in the first line after the words "An individual providing supervision" as well as in the second sentence.
Response: The board agreed with the comment and appropriate changes were made.
Comment: Concerning §781.304(8), the commenter recommended that the board accept any combination of face-to-face and web cam sessions as appropriate for approval (toward supervision hours), given geographical constraints, technological advancements, and precedents set in educational institutions and other disciplines for web-cam instruction and telemedicine.
Response: The board disagreed with the comment because the current rules allow for the approval of non-face-to face sessions by request and subsequent evaluation by the board or the executive director. No change was made as a result of this comment.
Comment: Concerning §781.402(a), the commenter stated that a reasonable licensee or stakeholder may interpret the language of the scopes of practice as authorizing all licensees to practice every form of practice listed for each respective category of licensure. The commenter recommended changing the language from "includes" to "may include."
Response: The board agreed with the comment and made a change similar to that recommended by the commenter.
Comment: Concerning §781.402(c), the commenter stated that a reasonable licensee or stakeholder may interpret the language of the scopes of practice as authorizing all licensees to practice every form of practice listed for each respective category of licensure. The commenter recommended changing the language from "includes" to "may include."
The commenter also stated that the proposed inclusion of "diagnosis" to the scope of practice for a Licensed Master Social Worker should be deleted. The commenter noted that the Association of Social Work Board's model act does not include diagnosis in the scope of a LMSW; the overwhelming majority of other states do not include diagnosis in the scope of a LMSW/equivalent license (with IOWA being the only exception).
Response: The board agreed with the comment and removed "diagnosis" from the scope of practice for a LMSW in renumbered subsection (b) of the section.
Comment: Concerning §781.603, the commenter stated that the proposed changes to the section do not support due process and accountability in regard to the delineation of responsibilities for the executive director versus the Department of State Health Services.
Response: The board disagreed with the comment because the duties of the executive director should be separated from those of the department per Occupations Code, §505.155. No change was made as a result of this comment.
Commenters also commented on the following rules which were not proposed for change: §781.102(35) and §781.304(1)(E), (17), (18), and (19). The board could not consider revising rules as a result of the comments, but did agree to review the comments during a future review of rules.
BOARD COMMENTS
Board members commented that every reference to the use of the language "Licensed Masters Social Worker" should be changed to "Licensed Master Social Worker." The board agreed to the following changes to clarify intent and improve accuracy of the sections.
Change: All references to Licensed Masters Social Worker in §781.102(60)(B) - (E) were changed as recommended.
Board members commented that §781.402(b) and (c) should be reversed in order. The board agreed to the following changes to clarify intent and improve accuracy of the sections.
Change: The order of §781.402(b) and (c) were changed.
Subchapter A. GENERAL PROVISIONS
STATUTORY AUTHORITY
The amendments are authorized by Occupations Code, §505.155, which requires the board to develop policies that clearly separate the policy-making responsibilities of the board and the management responsibilities of the executive director and staff of the department; by Occupations Code, §505.201, which authorizes the board to adopt rules necessary to perform the board's duties, to establish standards of conduct and ethics for license holders, to establish requirements for each type of license issued by the board, and to establish procedures for recognition of independent practice; by Occupations Code, §505.203, which authorizes the board to set fees; by Occupations Code, §505.254, which requires the board to adopt rules concerning an investigation of a complaint filed with the board; by Occupations Code, §505.303, which requires the board to establish a specialty area of clinical social work that is only available to a licensed master social worker who satisfies minimum supervised experience requirements and clinical examination as set by the board; and by Occupations Code, §505.404, which requires the board to establish mandatory continuing education requirements for license holders.
§781.102.Definitions.
The following words and terms, when used in this chapter, shall have the following meanings, unless the context clearly indicates otherwise.
(1) Accredited colleges or universities--An educational institution that is accredited by an accrediting agency recognized by the Council on Higher Education Accreditation.
(2) Act--The Social Work Practice Act, Occupations Code, Chapter 505.
(3) ALJ--A person within the State Office of Administrative Hearings who conducts hearings under this chapter on behalf of the board.
(4) Agency--A public or private employer, contractor or business entity providing social work services.
(5) AMEC--Alternative method of examining competency, as referenced in Occupations Code, §505.356(3).
(6) APA--The Administrative Procedure Act, Government Code, Chapter 2001.
(7) Association of Social Work Boards (ASWB)--The international organization which represents regulatory boards of social work and administers the national examinations utilized in the assessment for licensure.
(8) Board--Texas State Board of Social Worker Examiners.
(9) Case record--Any information related to a client and the services provided to that client, however recorded and stored.
(10) Client--An individual, family, couple, group or organization that seeks or receives social work services from a person identified as a social worker who is either licensed or unlicensed by the board. An individual, family, couple, group or organization remains a client until the formal termination of services.
(11) Clinical social work--A specialty within the practice of master social work that requires the application of social work theory, knowledge, methods, ethics, and the professional use of self to restore or enhance social, psychosocial, or biopsychosocial functioning of individuals, couples, families, groups, and/or persons who are adversely affected by social or psychosocial stress or health impairment. The practice of Clinical Social Work requires the application of specialized clinical knowledge and advanced clinical skills in the areas of assessment, diagnosis, and treatment of mental, emotional, and behavioral disorders, conditions and addictions, including severe mental illness in adults and serious emotional disturbances in adults, adolescents and children. Treatment methods include, but are not limited to, the provision of individual, marital, couple, family, and group psychotherapy. Clinical social workers are qualified to use the Diagnostic and Statistical Manual of Mental Disorders (DSM), the International Classification of Diseases (ICD), Current Procedural Terminology (CPT) codes, and other diagnostic classification systems in assessment, diagnosis, and other practice activities. The practice of clinical social work is restricted to either:
(A) a Licensed Clinical Social Worker; or
(B) a Licensed Master Social Worker under clinical supervision.
(12) Confidential information--Individually identifiable information relating to a client, including the client's identity, and demographic information that relates to the past, present, or future physical or mental health or condition of a client; the provision of social work services to a client; the past, present, or future payment for the provision of social work services to a client; and identifies the client or with respect to which there is a reasonable basis to believe the information can be used to identify the client which is not discloseable under applicable law or court rules of evidence. Client information is "confidential" if it is intended to be disclosed to third persons to further the interest of the client in the diagnosis, examination, assessment, evaluation, or treatment, or those reasonably necessary for the transmission of the communication, or those who are participating in the diagnosis, examination, assessment, evaluation, or treatment under the direction of the social worker, including members of the client's family.
(13) Completed application--The official social work application form, fees and all supporting documentation which meets the criteria set out in this chapter.
(14) Conditions of exchange--The setting of rates of reimbursement or fee structure and business rules or policies involving issues such as cancellation of appointments, office hours, and management of insurance claims.
(15) Contested case--A proceeding in accordance with the APA and this chapter, including, but not limited to, rule enforcement and licensing, in which the legal rights, duties, or privileges of a party are to be determined by the board after an opportunity for an adjudicative hearing.
(16) Counseling--A method used by social workers to assist individuals, couples, families or groups in learning how to solve problems and make decisions about personal, health, social, educational, vocational, financial, and other interpersonal concerns.
(17) Consultation--To provide advice, opinions and to confer with other professionals regarding social work practice.
(18) Continuing education--Formal or informal education or trainings, which are oriented to maintain, improve or enhance social work practice.
(19) Council on Social Work Education (CSWE)--The national organization that accredits social work education schools and programs.
(20) Department--Department of State Health Services.
(21) Detrimental to the client--An act or omission by a social worker that damages the physical, mental, financial, or societal status of a client.
(22) Direct practice--The provision of social work services to clients in which goals are reached through personal contact and immediate influence.
(23) Dual relationship--Dual or multiple relationships occur when social workers interact with clients in more than one capacity, whether it be before, during or after the professional, social, or business relationship. Dual relationships can occur simultaneously or consecutively.
(24) Endorsement--The process whereby the board reviews requirements for licensure completed while under the jurisdiction of a different regulatory board from another state. The board may accept, deny or grant partial credit for requirements completed in a different jurisdiction.
(25) Examination--A standardized test or examination of social work knowledge, skills and abilities, which has been approved by the board.
(26) Exploitation--The use of a pattern, practice or scheme of conduct that can reasonably be construed as being primarily for the purposes of meeting the needs or being to the benefit of the licensee rather than in the best interest of the client or at the expense of another practitioner. An unequal balance is inherent in the client/social worker relationship. The use of this power imbalance for the personal benefit of the social worker at the expense of the client or another practitioner is exploitation. Exploitation may take financial, business, emotional, sexual, verbal, religious and/or relational forms.
(27) Family systems--An on-going self-regulating social system.
(28) Formal hearing--A hearing or proceeding in accordance with this chapter, including a contested case as defined in this section to address the issues of a contested case.
(29) Flagrant--Conspicuously inconsistent with what is right or proper as to appear to be a flouting of law or morality.
(30) Fraud--Any misrepresentation or omission by a social worker related to qualifications, services, or related activities or information.
(31) Full-time experience--Providing social work services thirty or more hours per week.
(32) Group supervision for licensure--Supervision provided to a minimum of two and no more than six supervisees in a designated supervision session.
(33) Health care professional--A licensee or any other person licensed, certified, or registered by the State of Texas in a health related profession.
(34) Home study--A formal written evaluation or social study to determine what is the best interest of a minor child or other dependent person.
(35) Independent clinical practice--The provision of clinical social work in independent practice in which the social worker assumes responsibility and accountability for the nature and quality of the services provided to clients, pro bono or in exchange for direct payment or third party reimbursement.
(36) Independent non-clinical practice--The practice of non-clinical social work outside the jurisdiction of an organizational setting, after completion of all applicable supervision requirements, in which the social worker assumes responsibility and accountability for the nature and quality of the services provided to clients, pro bono or in exchange for direct payment or third party reimbursement.
(37) Independent practice--The practice of social work services outside the jurisdiction of an organizational setting, after completion of all applicable supervision requirements, in which the social worker assumes responsibility and accountability for the nature and quality of the services provided to clients, pro bono or in exchange for direct payment or third party reimbursement.
(38) Indirect practice--Providing social work services utilizing negotiation, education, advocacy, administration, research, policy development and resource location that does not have immediate or face-to-face contact with the clients being served.
(39) Individual supervision for licensure--Supervision provided to one supervisee during the designated supervision session.
(40) Investigator--An employee or contractor of the department utilized by the board in the investigation of allegations of professional misconduct.
(41) LBSW--Licensed Baccalaureate Social Worker.
(42) LCSW--Licensed Clinical Social Worker.
(43) License--A regular, provisional, or temporary license or recognition issued by the board unless the content of the rule indicates otherwise.
(44) Licensee--A person licensed by the board to practice social work.
(45) LMSW--Licensed Master Social Worker.
(46) LMSW-AP--Licensed master social worker-advanced practitioner.
(47) Non-clinical social work--The areas of social work practice that include community organization, planning, administration, teaching, research, administrative supervision, non-clinical consultation and other related social work activities.
(48) Part-time experience--Social work services provided for fewer than thirty hours per week.
(49) Party--Each person, governmental agency, or officer or employee of a governmental agency named by the ALJ as having a justiciable interest in the matter being considered, or any person, governmental agency, or officer or employee of a governmental agency meeting the requirements of a party as prescribed by applicable law.
(50) Persistently--Existing for a long or longer than usual time or continuously.
(51) Person--An individual, corporation, partnership, or other legal entity.
(52) Psychotherapy--Treatment utilizing a specialized, formal interaction with an individual, couple, family, or group by a social worker in which a therapeutic relationship is established, maintained and sustained to understand intrapersonal, interpersonal and psychosocial dynamics, and with a diagnosis and treatment of mental, emotional, and behavioral disorders, conditions and addictions.
(53) Recognition--Authorization from the board to engage in the independent or specialty practice of social work services.
(54) Rules--Provisions in this chapter specifying the implementation of statute and operations of the board and individuals affected by the Act.
(55) Social Work Case Management--The use of a biopsychosocial perspective to assess, evaluate, implement, monitor and advocate for services on behalf of and in collaboration with the identified client.
(56) Social worker--A person licensed under the Act.
(57) Social work practice--Services provided as an employee, independent practitioner, consultant, or volunteer for compensation or pro bono to effect changes in human behavior, a person's emotional responses, interpersonal relationships, and the social conditions of individuals, families, groups, organizations, and communities. The practice of social work is guided by specialized knowledge, acquired through formal social work education development and behavior within the context of the social environment, and methods to enhance the functioning of individuals, families, groups, communities, and social welfare organizations. Social work practice involves the disciplined application of social work values, principles, and methods, including, but not limited to, psychotherapy, marriage and family therapy, couples therapy, group therapy, mediation, case management, supervision of social work services and programs, counseling, assessment, diagnosis, treatment, and evaluation. Social work practice may also be referred to as social work services, social welfare policies and services, social welfare systems and resources, and human services.
(58) Supportive counseling--The methods used to help individuals create and maintain adaptive patterns. Such methods may include, but are not limited to, building community resources and networks, linking clients with services and resources, educating clients and informing the public, helping clients identify and build strengths, leading community groups, and providing reassurance and support. Supportive counseling is not considered clinical social work.
(59) Supervisor, board approved--A person meeting the requirements set out in §781.302 of this title (relating to Clinical Supervision for LCSW and Non-Clinical Supervision for LMSW-AP and Independent Practice Recognition), to supervise a licensee towards the LCSW, LMSW-AP or Independent Practice recognition.
(60) Supervision--Supervision includes:
(A) administrative or work related supervision of an employee, contractor or volunteer that is not related to qualification for licensure, practice recognition, a disciplinary order or a condition to new or continued licensure;
(B) clinical supervision of a Licensed Master Social Worker providing clinical services by a Licensed Professional Counselor, Licensed Psychologist, Licensed Marriage and Family Therapist, Licensed Clinical Social Worker or Psychiatrist that is not related to qualification for licensure, practice recognition, a disciplinary order or a condition to new or continued licensure;
(C) clinical supervision of a Licensed Master Social Worker providing clinical services by a Licensed Clinical Social Worker who is recognized by the board as a supervisor toward qualification for practice recognition as a Licensed Clinical Social Worker;
(D) non-clinical supervision of a Licensed Master Social Worker or Licensed Baccalaureate Social Worker providing non-clinical social work services by a licensed social worker who is recognized by the board as a supervisor toward qualification for practice recognition in independent practice or as a Licensed Master Social Worker;
(E) non-clinical supervision of a probationary Licensed Master Social Worker or Licensed Baccalaureate Social Worker providing clinical services by a licensed social worker who is recognized by the board as a supervisor toward licensure under the AMEC program; or
(F) supervision by an approved supervisor pursuant to a disciplinary order or as a condition of new or continued licensure.
(61) Supervision hour--A supervision hour is a minimum of 60 minutes in length.
(62) Telepractice--Providing social work services wherein the client and the practitioner are not in the same physical location.
(63) Termination--Ending social work services with a client.
(64) Texas Open Meetings Act--Government Code, Chapter 551.
(65) Texas Public Information Act--Government Code, Chapter 552.
(66) Waiver--The suspension of educational, professional, and/or examination requirements for applicants who meet the criteria for licensure under special conditions based on appeal to the board.
This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on February 1, 2008.
TRD-200800572
Jeannie McGuire, LBSW
Chair
Texas State Board of Social Worker Examiners
Effective date: February 21, 2008
Proposal publication date: November 16, 2007
For further information, please call: (512) 458-7111 x6972
22 TAC §§781.209, 781.215, 781.217
STATUTORY AUTHORITY
The amendments are authorized by Occupations Code, §505.155, which requires the board to develop policies that clearly separate the policy-making responsibilities of the board and the management responsibilities of the executive director and staff of the department; by Occupations Code, §505.201, which authorizes the board to adopt rules necessary to perform the board's duties, to establish standards of conduct and ethics for license holders, to establish requirements for each type of license issued by the board, and to establish procedures for recognition of independent practice; by Occupations Code, §505.203, which authorizes the board to set fees; by Occupations Code, §505.254, which requires the board to adopt rules concerning an investigation of a complaint filed with the board; by Occupations Code, §505.303, which requires the board to establish a specialty area of clinical social work that is only available to a licensed master social worker who satisfies minimum supervised experience requirements and clinical examination as set by the board; and by Occupations Code, §505.404, which requires the board to establish mandatory continuing education requirements for license holders.
This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on February 1, 2008.
TRD-200800573
Jeannie McGuire, LBSW
Chair
Texas State Board of Social Worker Examiners
Effective date: February 21, 2008
Proposal publication date: November 16, 2007
For further information, please call: (512) 458-7111 x6972
22 TAC §§781.301 - 781.304, 781.311, 781.314
STATUTORY AUTHORITY
The amendments are authorized by Occupations Code, §505.155, which requires the board to develop policies that clearly separate the policy-making responsibilities of the board and the management responsibilities of the executive director and staff of the department; by Occupations Code, §505.201, which authorizes the board to adopt rules necessary to perform the board's duties, to establish standards of conduct and ethics for license holders, to establish requirements for each type of license issued by the board, and to establish procedures for recognition of independent practice; by Occupations Code, §505.203, which authorizes the board to set fees; by Occupations Code, §505.254, which requires the board to adopt rules concerning an investigation of a complaint filed with the board; by Occupations Code, §505.303, which requires the board to establish a specialty area of clinical social work that is only available to a licensed master social worker who satisfies minimum supervised experience requirements and clinical examination as set by the board; and by Occupations Code, §505.404, which requires the board to establish mandatory continuing education requirements for license holders.
§781.303.Independent Practice Recognition (Non-Clinical).
(a) A LBSW or LMSW who seeks to obtain board approval for the recognition of independent non-clinical practice shall meet requirements and parameters set by the board in §781.301 of this title (relating to Qualifications for Licensure).
(b) An individual providing supervision for the recognition of independent non-clinical practice to a LBSW shall be a LBSW recognized for independent non-clinical practice, LMSW recognized for independent non-clinical practice, LMSW-AP or LCSW. An individual providing supervision for the recognition of independent non-clinical practice to a LMSW shall be a LMSW recognized for independent non-clinical practice, LMSW-AP or LCSW. In addition to the required licensure, the supervisor shall be board-approved and have attained the recognition of independent practice.
(c) A person who has obtained only the temporary license may not begin the supervision process until the issuance of the regular license.
(d) The board may use the twenty common law factors developed by the Internal Revenue Service (IRS) as part of their determination process regarding whether a worker is an independent contractor or an employee.
(1) No instructions to accomplish a job.
(2) No training by the hiring company.
(3) Others can be hired by the independent contractor (sub-contracting).
(4) Independent contractor's work is not essential to the company's success or continuation.
(5) No time clock.
(6) No permanent relationship between the contractor and company.
(7) Independent contractors control their own workers.
(8) Independent contractor should have enough time available to pursue other jobs.
(9) Independent contractor determines location of work.
(10) Independent contractor determines order of work.
(11) No interim reports.
(12) No hourly pay.
(13) Independent contractor often works for multiple firms.
(14) Independent contractor is often responsible for own business expenses.
(15) Own tools.
(16) Significant investment.
(17) Services available to the public by having an office and assistants; having business signs; having a business license; listing their services in a business directory; or advertising their services.
(18) Profit or loss possibilities.
(19) Can't be fired.
(20) No compensation if the job isn't done.
(e) A LBSW or LMSW who plans to apply for the recognition of non-clinical independent practice shall follow procedures set out in §781.302 of this title (relating to Clinical Supervision for LCSW and Non-Clinical Supervision for LMSW-AP and Independent Practice Recognition).
(f) A LBSW or LMSW may practice independently when the LMSW or LBSW holds the independent practice specialty recognition, is under application for the specialty recognition under the waiver of the supervised experience requirement, or when under a supervision plan for independent practice that has been approved by the board.
This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on February 1, 2008.
TRD-200800574
Jeannie McGuire, LBSW
Chair
Texas State Board of Social Worker Examiners
Effective date: February 21, 2008
Proposal publication date: November 16, 2007
For further information, please call: (512) 458-7111 x6972
22 TAC §§781.402 - 781.405, 781.409, 781.414, 781.419
STATUTORY AUTHORITY
The amendments and new section are authorized by Occupations Code, §505.155, which requires the board to develop policies that clearly separate the policy-making responsibilities of the board and the management responsibilities of the executive director and staff of the department; by Occupations Code, §505.201, which authorizes the board to adopt rules necessary to perform the board's duties, to establish standards of conduct and ethics for license holders, to establish requirements for each type of license issued by the board, and to establish procedures for recognition of independent practice; by Occupations Code, §505.203, which authorizes the board to set fees; by Occupations Code, §505.254, which requires the board to adopt rules concerning an investigation of a complaint filed with the board; by Occupations Code, §505.303, which requires the board to establish a specialty area of clinical social work that is only available to a licensed master social worker who satisfies minimum supervised experience requirements and clinical examination as set by the board; and by Occupations Code, §505.404, which requires the board to establish mandatory continuing education requirements for license holders.
§781.402.The Practice of Social Work.
(a) Practice of Baccalaureate Social Work--The application of social work theory, knowledge, methods, ethics and the professional use of self to restore or enhance social, psychosocial, or biopsychosocial functioning of individuals, couples, families, groups, organizations and communities. Baccalaureate Social Work is generalist practice may include interviewing, assessment, planning, intervention, evaluation, case management, mediation, counseling, supportive counseling, direct practice, information and referral, problem solving, supervision, consultation, education, advocacy, community organization and the development, implementation, and administration of policies, programs and activities. A LBSW recognized for independent practice may provide any non-clinical baccalaureate social work services in either an employment or an independent practice setting. A LBSW recognized for independent practice may work under contract, bill directly for services, and bill third parties for reimbursements for services. A LBSW recognized for independent practice must restrict his or her independent practice to the provision of non-clinical social work services.
(b) Practice of Master's Social Work--The application of social work theory, knowledge, methods and ethics and the professional use of self to restore or enhance social, psychosocial, or biopsychosocial functioning of individuals, couples, families, groups, organizations and communities. The Practice of Master's Social Work may include the Practice of Clinical Social Work in an agency employment setting under clinical supervision. A LMSW may practice clinical social work under contract with an agency when under a board approved clinical supervision plan. Master's Social Work practice may include applying specialized knowledge and advanced practice skills in assessment, treatment, planning, implementation and evaluation, case management, mediation, counseling, supportive counseling, direct practice, information and referral, supervision, consultation, education, research, advocacy, community organization and developing, implementing and administering policies, programs and activities. The practice of Master's Social Work acknowledges the practitioners ability to engage in Baccalaureate Social Work practice.
(c) Practice of Clinical Social Work--The practice of social work that requires the application of social work theory, knowledge, methods, ethics, and the professional use of self to restore or enhance social, psychosocial, or biopsychosocial functioning of individuals, couples, families, groups, and/or persons who are adversely affected by social or psychosocial stress or health impairment. The practice of Clinical Social Work requires applying specialized clinical knowledge and advanced clinical skills in assessment, diagnosis, and treatment of mental, emotional, and behavioral disorders, conditions and addictions, including severe mental illness in adults and serious emotional disturbances in children. The practice of Clinical Social Work acknowledges the practitioners ability to engage in Baccalaureate Social Work practice and Master's Social Work Practice. Treatment methods include but are not limited to providing individual, marital, couple, family, and group therapy mediation, counseling, supportive counseling, direct practice, and psychotherapy. Clinical social workers are qualified to use the Diagnostic and Statistical Manual of Mental Disorders (DSM), the International Classification of Diseases (ICD), Current Procedural Terminology (CPT) Codes, and other diagnostic classification systems in assessment, diagnosis, treatment and other practice activities. The practice of Clinical Social Work may include independent clinical practice and the provision of clinical supervision. A LCSW may provide any clinical or non-clinical social work services in either an employment or independent practice setting. A LCSW may work under contract, bill directly for services, and bill third parties for reimbursements for services. A LMSW recognized as an Advanced Practitioner (LMSW-AP) may provide any non-clinical social work services in either an employment or an independent practice setting. A LMSW-AP may work under contract, bill directly for services, and bill third parties for reimbursements for services. A LMSW recognized for independent practice may provide any non-clinical social work services in either an employment or an independent practice setting. A LMSW recognized for independent practice may work under contract, bill directly for services, and bill third parties for reimbursements for services. A LMSW recognized for independent practice and a LMSW-AP must restrict his or her independent practice to the provision of non-clinical social work services.
(d) A licensee who is not recognized for independent practice or working under supervision under the authority of a board approved non-clinical supervision plan must not engage in any independent practice that falls within the definition of social work practice in §781.102 of this title (relating to Definitions) without being licensed and recognized by the board unless the person is licensed in another profession and acting solely within the scope of that license. If engaged in professional practice under another license, the person may not use the titles "licensed clinical social worker," "licensed master social worker," "licensed social worker," "licensed baccalaureate social worker," or "social work associate" or any other title or initials that states or implies licensure or certification in social work unless one holds the appropriate license or independent practice recognition.
(e) An LBSW or LMSW who is not recognized for independent practice may not provide direct social work services to clients from a location that she or he owns or leases and that is not owned or leased by an employer or other legal entity with responsibility for the client. This does not preclude in home services such as in home health care or the use of telephones or other electronic media to provide services in an emergency.
(f) An LBSW or LMSW who is not recognized for independent practice may practice for remuneration in a direct employment or agency setting and can not work independently, bill directly to patients or to third party payers, unless the LBSW or LMSW is under a formal supervision plan approved by the board.
This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on February 1, 2008.
TRD-200800575
Jeannie McGuire, LBSW
Chair
Texas State Board of Social Worker Examiners
Effective date: February 21, 2008
Proposal publication date: November 16, 2007
For further information, please call: (512) 458-7111 x6972
22 TAC §§781.502, 781.505, 781.509, 781.511, 781.512, 781.517
STATUTORY AUTHORITY
The amendments are authorized by Occupations Code, §505.155, which requires the board to develop policies that clearly separate the policy-making responsibilities of the board and the management responsibilities of the executive director and staff of the department; by Occupations Code, §505.201, which authorizes the board to adopt rules necessary to perform the board's duties, to establish standards of conduct and ethics for license holders, to establish requirements for each type of license issued by the board, and to establish procedures for recognition of independent practice; by Occupations Code, §505.203, which authorizes the board to set fees; by Occupations Code, §505.254, which requires the board to adopt rules concerning an investigation of a complaint filed with the board; by Occupations Code, §505.303, which requires the board to establish a specialty area of clinical social work that is only available to a licensed master social worker who satisfies minimum supervised experience requirements and clinical examination as set by the board; and by Occupations Code, §505.404, which requires the board to establish mandatory continuing education requirements for license holders.
This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on February 1, 2008.
TRD-200800576
Jeannie McGuire, LBSW
Chair
Texas State Board of Social Worker Examiners
Effective date: February 21, 2008
Proposal publication date: November 16, 2007
For further information, please call: (512) 458-7111 x6972
STATUTORY AUTHORITY
The amendment is authorized by Occupations Code, §505.155, which requires the board to develop policies that clearly separate the policy-making responsibilities of the board and the management responsibilities of the executive director and staff of the department; by Occupations Code, §505.201, which authorizes the board to adopt rules necessary to perform the board's duties, to establish standards of conduct and ethics for license holders, to establish requirements for each type of license issued by the board, and to establish procedures for recognition of independent practice; by Occupations Code, §505.203, which authorizes the board to set fees; by Occupations Code, §505.254, which requires the board to adopt rules concerning an investigation of a complaint filed with the board; by Occupations Code, §505.303, which requires the board to establish a specialty area of clinical social work that is only available to a licensed master social worker who satisfies minimum supervised experience requirements and clinical examination as set by the board; and by Occupations Code, §505.404, which requires the board to establish mandatory continuing education requirements for license holders.
This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on February 1, 2008.
TRD-200800577
Jeannie McGuire, LBSW
Chair
Texas State Board of Social Worker Examiners
Effective date: February 21, 2008
Proposal publication date: November 16, 2007
For further information, please call: (512) 458-7111 x6972
STATUTORY AUTHORITY
The repeal is authorized by Occupations Code, §505.155, which requires the board to develop policies that clearly separate the policy-making responsibilities of the board and the management responsibilities of the executive director and staff of the department; by Occupations Code, §505.201, which authorizes the board to adopt rules necessary to perform the board's duties, to establish standards of conduct and ethics for license holders, to establish requirements for each type of license issued by the board, and to establish procedures for recognition of independent practice; by Occupations Code, §505.203, which authorizes the board to set fees; by Occupations Code, §505.254, which requires the board to adopt rules concerning an investigation of a complaint filed with the board; by Occupations Code, §505.303, which requires the board to establish a specialty area of clinical social work that is only available to a licensed master social worker who satisfies minimum supervised experience requirements and clinical examination as set by the board; and by Occupations Code, §505.404, which requires the board to establish mandatory continuing education requirements for license holders.
This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on February 1, 2008.
TRD-200800578
Jeannie McGuire, LBSW
Chair
Texas State Board of Social Worker Examiners
Effective date: February 21, 2008
Proposal publication date: November 16, 2007
For further information, please call: (512) 458-7111 x6972