PART 5. STATE BOARD OF DENTAL EXAMINERS
CHAPTER 115. EXTENSION OF DUTIES OF AUXILIARY PERSONNEL--DENTAL HYGIENE
The Texas State Board of Dental Examiners (Board) proposes new §115.6. The new section establishes a reference to the recordkeeping standard of care relating to dental hygiene practice.
Ms. Sherri Sanders Meek, Executive Director, Texas State Board of Dental Examiners, has determined that for each year of the first five-year period this section is in effect, there will be no fiscal implications for local or state government as a result of enforcing or administering this section.
Sherri Sanders Meek, Executive Director of the Texas State Board of Dental Examiners, has determined that the public benefit anticipated as a result of enforcing or administering this section will be to ensure that a patient record of dental hygiene treatments will be appropriately made, maintained and kept.
There is no anticipated impact on large, small or micro-businesses.
There is no anticipated economic cost to persons as a result of enforcing or administering this section.
Comments on the proposal may be submitted to Sherri Sanders Meek, Executive Director, Texas State Board of Dental Examiners, 333 Guadalupe, Tower 3, Suite 800, Austin, Texas 78701, (512) 463-6400. To be considered, all written comments must be received by the Texas State Board of Dental Examiners no later than 30 days from the date that this section is published in the Texas Register.
This section is proposed under Texas Government Code §2001.021 et seq., Texas Civil Statutes; the Occupations Code §254.001, which provides the Board with the authority to adopt and enforce rules necessary for it to perform its duties.
The proposed amendment affects Title 3, Subtitle D of the Occupations Code and Title 22, Texas Administrative Code, Chapter 101 - 125.
§115.6.Records.
A Texas dental hygiene licensee practicing dental hygiene in Texas shall record treatments delegated by a Texas licensed dentist and performed for and upon each dental patient for reference, identification, and protection of the patient, the dentist, and the dental hygienist. Such recordings shall be entered in the dental records maintained and kept by the delegating dentist.
This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of the Secretary of State on February 6, 2009.
TRD-200900450
Sherri Sanders Meek
Executive Director
State Board of Dental Examiners
Earliest possible date of adoption: March 22, 2009
For further information, please call: (512) 475-0972
CHAPTER 217. LICENSURE, PEER ASSISTANCE AND PRACTICE
The Texas Board of Nursing (Board) proposes amendments to §217.2, concerning Licensure by Examination for Graduates of Nursing Education Programs Within the United States, its Territories, or Possessions, and §217.4, concerning Requirements for Initial Licensure by Examination for Nurses Who Graduate from Nursing Education Programs Outside of United States' Jurisdiction.
Currently, §217.2(a)(4)(B) permits an applicant for vocational nurse licensure who has attended a (Texas-based) professional nursing education program to substitute completion of an acceptable level of a Board-approved professional nursing education program, as determined by the Board. Because students in professional education programs are prepared for the professional role and do not typically study the differentiation of professional versus vocational roles, this provision no longer has its intended effect. As such, the proposed amendment to §217.2(a)(4)(B) is necessary to eliminate this provision so that all licensed vocational nurse applicants must complete approved vocational education programs for initial licensure under §217.2.
Currently, §217.4(a)(1)(B) permits an applicant for vocational nurse licensure who was educated in a program outside of United States jurisdictions to substitute (i) completion of curriculum content comparable to the Texas curriculum requirements for graduates of approved vocational nursing education programs in lieu of (ii) completion of an approved vocational nursing education program. In essence, §217.4(a)(1)(B) allows licensed vocational nurse applicants to substitute the completion of a professional nursing education program for the completion of a vocational nursing education program for purposes of initial licensure under §217.4. Because the scopes of practice of vocational nurses and professional nurses are different, however, and because nursing education programs outside of United States jurisdictions do not address the vocational nursing role, this provision no longer has its intended effect. As such, the proposed amendment to §217.4(a)(1)(B) is necessary to eliminate this provision so that all licensed vocational nurse applicants must complete approved vocational education programs for initial licensure under §217.4. The proposed amendment to §217.4(e) is necessary to provide qualifying nurses the opportunity to participate in clinical experiences in Texas prior to taking an NCLEX exam. Specifically, the proposed amendment will allow certain nurses who have graduated from accredited nursing programs outside the United States to apply to the Board for a six month accustomation permit. This six month accustomation permit will allow a qualifying nurse to participate in nursing education courses and clinical experiences in Texas. Currently, a nurse who has graduated from an accredited nursing program outside the United States does not have access to education courses or clinical experiences designed to facilitate a transition to United States nursing practice. As a result, many of these nurses find it difficult to acclimate to the nuances of the United States healthcare system and to pass an NCLEX exam. The intended purpose of the proposed amendment is to ease the transition of these nurses into the United States healthcare system and to facilitate a higher passage rate of the NCLEX exam. In order for an applicant to be eligible for an accustomation permit, the applicant must have graduated from an accredited nursing program outside the United States, may not have taken the NCLEX-PN (applicants for vocational license) or the NCLEX-RN (applicants for professional license) prior to applying for the accustomation permit, and must successfully complete a credential evaluation service from one of the following Board approved credentialing agencies: (i) the Commission on Graduates of Foreign Nursing Schools; (ii) the Educational Records Evaluation Service; or (iii) the International Education Research Foundation. Additionally, certain restrictions are being proposed in order to ensure that the public is properly protected once an accustomation permit is approved. Upon receipt of the accustomation permit, the applicant may only participate in nursing education courses and clinical experiences under the direct supervision of a registered nurse who holds an unencumbered Texas license. Proposed amended §217.4(e) also makes clear that an applicant may not be left alone with a patient at any time. These limiting conditions are necessary to maintain a safe environment for patients and others and to ensure the highest quality of nursing care.
The following is a section-by-section overview of the proposal.
The proposed amendment to §217.2(a)(4)(B) eliminates subparagraph (B) in its entirety, which states "who have attended a professional nursing education program shall meet all of the requirements for licensure by examination as stated in this section, but may substitute completion of an acceptable level of a board-approved professional nursing education program as determined by the board". The remaining amendments to §217.2 re-designate the remaining subparagraph accordingly.
The proposed amendment to §217.4(a)(1)(B) removes the phrase "or curriculum content comparable to the Texas curriculum requirements for graduates of approved vocational nursing education programs" from subparagraph (B). The proposed amendment to §217.4(e)(1) permits an applicant who has graduated from an accredited nursing program outside the United States to apply to the Board for a six month accustomation permit by completing an application and paying a fee. Further, proposed amended §217.4(e)(1) permits an applicant holding an accustomation permit to participate in nursing education courses and clinical experiences. Proposed amended §217.4(e)(2) provides that an applicant is eligible to apply for an accustomation permit only if the applicant has: (i) graduated from an accredited nursing program outside the United States; (ii) never taken the NCLEX-PN (LVN applicants) or NCLEX-RN (RN applicants); and (iii) successfully completed a credential evaluation service from a board approved credentialing agency. Proposed amended §217.4(e)(3) requires an applicant holding an accustomation permit to participate in nursing education courses and clinical experiences under the direct supervision of a registered nurse who holds a current and unencumbered Texas license only. Finally, proposed amended §217.4(e)(3) prohibits an applicant from being left alone with a patient at any time. The remaining amendments to §217.4 re-designate the remaining subsections accordingly.
Katherine Thomas, Executive Director, has determined that for each year of the first five years the proposed amendments are in effect, there will be no additional fiscal implications for state or local government as a result of implementing the proposed amendments.
Ms. Thomas has also determined that for each year of the first five years the proposed amendments are in effect, the anticipated public benefits will be: (i) the removal of provisions that no longer yield their intended effect; and (ii) the opportunity for qualifying nurses who have graduated from an accredited nursing program outside the United States to participate in nursing education courses and clinical experiences prior to taking an NCLEX exam. It is anticipated that the participation in these educational courses and clinical experiences will assist qualifying nurses with the transition into the United States' healthcare system and will increase the passage rate of the NCLEX exam, ultimately resulting in additional qualified and trained nurses. Proposed amended §217.4(e) prescribes requirements for applicants applying for an accustomation permit. No person is required by law to apply for an accustomation permit. However, for those qualifying individuals who seek to participate in nursing education courses and clinical experiences prior to taking an NCLEX exam and who choose to apply for an accustomation permit under proposed amended §217.4(e), there will be associated costs of compliance with the proposal. Proposed amended §217.4(e) requires an applicant for an accustomation permit to submit an application to the Board. The total probable cost of completing and submitting an application to the Board should be less than $25. Further, each applicant is required to submit a $25 fee with each accustomation permit application. Finally, in order to be eligible for an accustomation permit under proposed amended §217.4(e), each applicant is required to complete a credential evaluation service from one of the following board approved credentialing agencies: (i) the Commission on Graduates of Foreign Nursing Schools; (ii) the Educational Records Evaluation Service; or (iii) the International Education Research Foundation. It is estimated that the completion of a credential evaluation from one of these credentialing agencies will cost between $200 - $300. However, each applicant is required to complete only one credential evaluation and each applicant is free to choose the credentialing agency he or she wishes to utilize. There will be no economic costs to any individual or Board regulated entity as a result of the eliminated language in proposed §217.2(a)(4)(B) and §217.4(a)(1)(B).
As required by the Government Code §2006.002(C), the Board has determined that the proposed amendments to §217.2 and §217.4 will not have an adverse economic effect on any individual or Board regulated entity because: (i) proposed amended §217.2(a)(4)(B) and §217.4(a)(1)(B) simply eliminate provisions that no longer yield their intended effect and do not impose any new requirements or costs with which small or micro businesses must comply; and (ii) no applicant subject to proposed amended §217.4(e) will meet the definition of a small business under the Government Code §2006.001(2). The Government Code §2006.001(2) defines a small business as a legal entity, including a corporation, partnership, or sole proprietorship, that: (i) is formed for the purpose of making a profit; (ii) is independently owned and operated; and (iii) has fewer than 100 employees or less than $6 million in annual gross receipts. Each of these elements must be met in order for an entity to qualify as a small business under this section. Because an applicant under proposed amended §217.4(e) will always be an individual and not a legal entity formed for the purpose of making a profit, no applicant will qualify as a small business under the Government Code §2006.001(2). Therefore, in accordance with the Government Code §2006.002(c), the Board is not required to prepare a regulatory flexibility analysis.
The Board has determined that no private real property interests are affected by this proposal and that this proposal does not restrict or limit an owner's right to property that would otherwise exist in the absence of government action and, therefore, does not constitute a taking or require a takings impact assessment under the Government Code §2007.043.
To be considered, written comments will be accepted within 30 days of publication of this proposal in the Texas Register to: James W. Johnston, General Counsel, Texas Board of Nursing, 333 Guadalupe, Suite 3-460, Austin, Texas 78701, or by e-mail to dusty.johnston@bon.state.tx.us, or faxed to (512) 305-8101. If a hearing is held, written and oral comments presented at the hearing will be considered.
The amendments are proposed pursuant to the authority of Texas Occupations Code §§301.157, 301.252, 301.259 and 301.151, which authorizes the Texas Board of Nursing to adopt, enforce, and repeal rules consistent with its legislative authority under the Nursing Practice Act.
Texas Occupations Code §§301.157, 301.252, 301.259 and 301.151 are affected by the proposal.
§217.2.Licensure by Examination for Graduates of Nursing Education Programs Within the United States, its Territories, or Possessions.
(a) All applicants for initial licensure by examination shall:
(1) file a complete application containing data required by the board attesting that all information contained in, or referenced by, the application is complete and accurate and is not false or misleading, and the required application processing fee which is not refundable;
(2) submit verification of completion of all requirements for graduation from an approved nursing education program, or certification from the nursing program director of completion of certificate/degree requirements. Prerequisites of an accredited master's degree program leading to a first degree in professional nursing must be approved by the board;
(3) pass the NCLEX-PN (LVN applicant) or NCLEX-RN (RN applicant);
(4) Licensed vocational nurse applicants:
(A) must hold a high school diploma issued by an accredited secondary school or equivalent educational credentials as established by the General Education Development Equivalency Test (GED);
[(B) who have attended
a professional nursing education program shall meet all of the requirements
for licensure by examination as stated in this section, but may substitute
completion of an acceptable level of a board-approved professional
nursing education program as determined by the board;]
(B) [(C)] who have graduated
from another U.S. jurisdiction's nursing education program must satisfactorily
have completed curriculum comparable to the curriculum requirements
for graduates of board-approved vocational nurse education programs.
[;]
(5) submit FBI fingerprint cards provided by the Board for a complete criminal background check; and
(6) pass the jurisprudence exam approved by the board, effective September 1, 2008.
(b) Should it be ascertained from the application filed, or from other sources, that the applicant should have had an eligibility issue determined by way of a Petition for Declaratory Order, (see §213.30 of this title relating to Declaratory Order of Eligibility for Licensure and Texas Occupations Code §301.257 relating to Declaratory Order of License Eligibility) then the application will be treated and processed as a Petition for Declaratory Order and the applicant will be required to pay the appropriate non-refundable fees for determination of eligibility. Should the Board in its final determination find that the individual is not eligible for licensure, then that individual is precluded from again petitioning, or applying to the Board for admission to the examination except when the impediment to eligibility has been removed. In no event, may an applicant repetition for a declaratory order before the first anniversary of the date of the Board's determination to deny eligibility. Any subsequent petition must be made in the manner and form the Board requires.
(c) An applicant for initial licensure by examination shall pass the NCLEX-PN or NCLEX-RN within four years of completion of requirements for graduation.
(d) An applicant who has not passed the NCLEX-PN or NCLEX-RN within four years from the date of completion of requirements for graduation must complete a board approved nursing education program in order to take or retake the examination.
(e) Upon initial licensure by examination, the license is issued for a period ranging from six months to 29 months depending on the birth month. Licensees born in even-numbered years shall renew their license in even-numbered years; licensees born in odd-numbered years shall renew their licenses in odd-numbered years.
(f) The U.S. Army Practical Nurse Course (formerly the 91C Clinical Specialist Course) is the only military program acceptable for vocational nurse licensure by examination.
§217.4.Requirements for Initial Licensure by Examination for Nurses Who Graduate from Nursing Education Programs Outside of United States' Jurisdiction.
(a) Nurse applicants for initial licensure applying under this section.
(1) A licensed vocational nurse applicant must:
(A) hold a high school diploma issued by an accredited secondary school or equivalent educational credentials as established by the General Education Development Equivalency Test (GED);
(B) have successfully completed an approved program
for educating vocational/practical (second level general nurses) nurses
[or curriculum content comparable to the Texas curriculum requirements
for graduates of approved vocational nursing education programs]
by providing a Credential Evaluation Service Full Education Course-by-Course
Report from the Commission on Graduates of Foreign Nursing Schools
(CGFNS), Educational Records Evaluation Service (ERES), or the International
Education Research Foundation (IERF); and
(C) have achieved an approved score on an English proficiency test acceptable to the Board.
(2) A registered nurse applicant must provide a Credential Evaluation Service Full Education Course-by-Course Report from the Commission on Graduates of Foreign Nursing Schools (CGFNS), Educational Records Evaluation Service (ERES), or the International Education Research Foundation (IERF) and an English proficiency test acceptable to the Board, or the equivalent which verifies that the applicant:
(A) has the educational credentials equivalent to graduation from a governmentally accredited/approved, post-secondary general nursing program of at least two academic years in length;
(B) received both theory and clinical education in each of the following: nursing care of the adult which includes both medical and surgical nursing, maternal/infant nursing, nursing care of children, and psychiatric/mental health nursing;
(C) received initial registration/license as a first-level, general nurse in the country where the applicant completed general nursing education;
(D) is currently registered/licensed as a first-level general nurse; and
(E) has achieved an approved score on an English proficiency test acceptable to the Board.
(3) all applicants must file a complete application for registration containing data required by the board attesting that all information contained in, or referenced by, the application is complete and accurate and is not false or misleading, and the required application processing fee which is not refundable;
(4) all applicants must pass the NCLEX-PN (LVN applicants) or NCLEX-RN (RN applicants) as a Texas applicant;
(A) within four years of completion of the requirements for graduation from the nursing education program if the applicant has not practiced as a second-level or first-level general nurse since completing the requirements for graduation; or
(B) within four years of the date of eligibility for the NCLEX-PN or NCLEX-RN if the applicant has practiced as a second-level or first-level general nurse at least two years since completing the requirements for graduation;
(5) all nurse applicants must submit FBI fingerprint cards provided by the Board for a complete criminal background check; and
(6) all nurse applicants must pass the jurisprudence exam approved by the board, effective September 1, 2008.
(b) An applicant who has completed the requirements for graduation and has practiced as a second-level or first-level general nurse for at least two years but has not practiced as a second-level or first-level general nurse within the four years immediately preceding the filing of an application for initial licensure will be issued a six month limited permit (temporary authorization) upon passing the NCLEX-PN or NCLEX-RN examination and must complete a nurse refresher course that meets the criteria defined by the Board in order to be eligible for licensure under this section.
(c) An applicant who has not passed the NCLEX-PN or NCLEX-RN within four years of completion of the requirements for graduation or within four years of the date of eligibility must complete an appropriate nursing education program in order to be eligible to take or retake the examination.
(d) Should it be ascertained from the application filed, or from other sources, that the applicant should have had an eligibility issue settled by way of a Petition for Declaratory Order, (see §213.30 of this title relating to Declaratory Order of Eligibility for Licensure and Texas Occupations Code §301.257 relating to Declaratory Order of License Eligibility) then the application will be treated and processed as a Petition for Declaratory Order and the applicant will be required to pay the appropriate non-refundable processing fees. Should the Board finally determine that the individual is not eligible to be admitted to the examination, then that individual is precluded from again petitioning, or applying to the Board for admission to the examination except when the impediment to eligibility for licensure has been removed. In no event, may an applicant re-petition for a declaratory order before the first anniversary of the date of the Board's determination to deny eligibility. Any subsequent petition must be made in the manner and form the Board requires.
(e) Accustomation Permit.
(1) An applicant who has graduated from an accredited nursing program outside the United States may apply to the Board for a six month accustomation permit by completing an application and paying a fee. An applicant holding an accustomation permit under this subsection may participate in nursing education courses and clinical experiences.
(2) An applicant is eligible to apply for an accustomation permit under this subsection only if the applicant has:
(A) graduated from an accredited nursing program outside the United States;
(B) never taken the NCLEX-PN (LVN applicants) or NCLEX-RN (RN applicants); and
(C) successfully completed a credential evaluation service from a board approved credentialing agency.
(3) An applicant holding an accustomation permit under this subsection may only participate in nursing education courses and clinical experiences under the direct supervision of a registered nurse who holds a current and unencumbered Texas license. For purposes of this subsection only, direct supervision requires a registered nurse to be working with the applicant at all times. At no time shall an applicant be left alone with a patient.
(f) [(e)] Upon initial licensure
by examination, the license is issued for a period ranging from six
months to 29 months depending on the birth month. Licensees born in
even-numbered years shall renew their licenses in even-numbered years;
licensees born in odd-numbered years shall renew their licenses in
odd-numbered years.
This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of the Secretary of State on February 9, 2009.
TRD-200900464
James W. Johnston
General Counsel
Texas Board of Nursing
Earliest possible date of adoption: March 22, 2009
For further information, please call: (512) 305-6811
The Texas Board of Nursing (Board) proposes amendments to §220.2 and §220.3, concerning the Nurse Licensure Compact (Compact). The Texas Occupations Code, Chapter 304 provides compact administrators with the authority to develop uniform rules to facilitate and coordinate implementation of the Compact. The proposed amendments to §220.2 and §220.3 are necessary in order to adopt certain policies of the member states of the Compact (party states). The adoption of these uniform rules will result in more consistent implementation of the Compact among the party states. Specifically, the proposed amendments to §220.2 are necessary for consistency and clarity among party states regarding the following issues: (i) documentation that may be requested in order to prove a nurse's primary state of residence; (ii) the option of a nurse on a visa to declare his or her country of origin or the party state as his or her primary state of residence; (iii) issuing a single state license to a nurse who declares a foreign country his or her primary state of residence; and (iv) designating when a license issued by one party state authorizes practice in all other party states and when a license issued by one party state does not authorize practice in other party states. It is important that these policies and procedures are adopted by the party states so that the treatment of compact license applications are consistent among the party states. Further, these proposed amendments are anticipated to result in a more efficient and streamlined compact application process in Texas. The proposed amendment to §220.3 is necessary to allow a nurse whose license has been revoked, suspended, or surrendered or whose application has been denied in the nurse's former state of primary residence to be eligible for issuance of a single state license in the nurse's new primary state of residence if the new primary state of residence deems it appropriate. However, the new primary state action will not provide a multistate privilege. This amendment is significant because a nurse may relocate to a new compact state and be unable to resolve the disciplinary past with the former state of residence. This amendment is anticipated to provide additional flexibility and opportunity to nurses under restricted licenses so that they may practice in a new state of primary residence, if that state of residence deems it appropriate, while resolving disciplinary actions with former states of residence.
The following is a section-by-section overview of the proposal.
Section 220.2. Issuance of a License by a Compact Party State. The proposed amendment to §220.2(b) provides that the following evidence may be requested in order to prove a nurse's primary state of residence: (i) Military Form Number 2058 - state of legal residence certificate; and (ii) W2 from US government of any bureau, division, or agency thereof indicating the declared state of residence. The proposed amendment to §220.2(c) provides that a nurse on a visa from another country applying for licensure in a party state may declare either the country of origin or the party state as the primary state of residence. Further, the proposed amendment to §220.2(c) provides that, if the foreign country is declared the primary state of residence, a single state license will be issued by the party state. The proposed amendment to §220.2(d) provides that a license issued by a party state is valid for practice in all other party states unless clearly designated as valid only in the state which issued the license. The proposed amendment to §220.2(e) states that when a party state issues a license authorizing practice only in that state and not authorizing practice in other party states (i.e. a single state license), the license shall be clearly marked with words indicating that it is valid only in the state of issuance. The remaining amendments to §220.2 re-designate the remaining subsections accordingly. The proposed amendment to §220.3(b) provides that an individual who had a license which was surrendered, revoked, suspended, or an application denied for cause in a prior state of primary residence may be issued a single state license in a new primary state of residence until such time as the individual would be eligible for an unrestricted license by the prior state(s) of adverse action. Further, the proposed amendment to §220.3(b) provides that, once eligible for licensure in the prior state(s), a multistate license may be issued. The remaining amendments to §220.3 re-designate the subsections accordingly.
Katherine Thomas, Executive Director, has determined that for each year of the first five years the proposed amendments are in effect, there will be no additional fiscal implications for state or local government as a result of implementing the proposed amendments.
Ms. Thomas has also determined that for each year of the first five years the proposed amendments are in effect, the anticipated public benefits will be more consistent implementation of the Compact among the party states, a more efficient and streamlined compact application process in Texas, and additional flexibility and opportunity for nurses under restricted licenses. There will be no economic costs to any individual or Board regulated entity as a result of the proposal.
ECONOMIC IMPACT STATEMENT AND REGULATORY FLEXIBILITY ANALYSIS FOR SMALL AND MICRO BUSINESSES. As required by the Government Code §2006.002(c), the Board has determined that proposed amended §220.2 and §220.3 will not have an adverse economic effect on any individual, Board regulated entity, or other entity because no entity subject to proposed amended §220.2 and §220.3 will meet the definition of a small business under the Government Code §2006.001(2). The Government Code §2006.001(2) defines a small business as a legal entity, including a corporation, partnership, or sole proprietorship, that: (i) is formed for the purpose of making a profit; (ii) is independently owned and operated; and (iii) has fewer than 100 employees or less than $6 million in annual gross receipts. Each of these elements must be met in order for an entity to qualify as a small business under this section. Because a nurse subject to proposed amended §220.2 or §220.3 will always be an individual and not a legal entity formed for the purpose of making a profit, no nurse will qualify as a small business under the Government Code §2006.001(2). Additionally, because no party state issuing a license under the Compact is formed for the purpose of a making a profit or is independently owned or operated, no party state will qualify as a small business under the Government Code §2006.001(2). Therefore, in accordance with the Government Code §2006.002(c), the Board is not required to prepare a regulatory flexibility analysis.
The Board has determined that no private real property interests are affected by this proposal and that this proposal does not restrict or limit an owner's right to property that would otherwise exist in the absence of government action and, therefore, does not constitute a taking or require a takings impact assessment under the Government Code §2007.043.
To be considered, written comments will be accepted within 30 days of publication of this proposal in the Texas Register to: James W. Johnston, General Counsel, Texas Board of Nursing, 333 Guadalupe, Suite 3-460, Austin, Texas 78701, or by e-mail to dusty.johnston@bon.state.tx.us, or faxed to (512) 305-8101. If a hearing is held, written and oral comments presented at the hearing will be considered.
The amendments are proposed pursuant to the authority of Texas Occupations Code, Chapter 304, which authorizes the Texas Board of Nursing to adopt, enforce, and repeal rules consistent with its legislative authority under the Nursing Practice Act.
Texas Occupations Code, Chapter 304 is affected by the proposal.
§220.2.Issuance of a License by a Compact Party State.
(a) As of July 1, 2005, no applicant for initial licensure will be issued a license granting a multistate privilege to practice unless the applicant first obtains a passing score on the applicable NCLEX examination or its predecessor examinations used for licensure.
(b) A nurse applying for a license in a home party state shall produce evidence of the nurse's primary state of residence. Such evidence shall include a declaration signed by the licensee. Further evidence that may be requested may include but are not limited to:
(1) a driver's license with a home address;
(2) voter registration card displaying a home address;[or]
(3) federal income tax return declaring the primary
state of residence;[.]
(4) Military Form No. 2058 - state of legal residence certificate; or
(5) W2 from US Government or any bureau, division or agency thereof indicating the declared state of residence.
(c) A nurse on a visa from another country applying for licensure in a party state may declare either the country of origin or the party state as the primary state of residence. If the foreign country is declared the primary state of residence, a single state license will be issued by the party state.
(d) A license issued by a party state is valid for practice in all other party states unless clearly designated as valid only in the state which issued the license.
(e) When a party state issues a license authorizing practice only in that state and not authorizing practice in other party states (i.e. a single state license), the license shall be clearly marked with words indicating that it is valid only in the state of issuance.
(f) [(c)] A nurse changing primary
state of residence, from one party state to another party state, may
continue to practice under the former home state license and multistate
licensure privilege during the processing of the nurse's licensure
application in the new home state for a period not to exceed thirty days.
(g) [(d)] The licensure application
in the new home state of a nurse under pending investigation by the
former home state shall be held in abeyance and the thirty day period
stated in subsection (f) [(c)] of this section
shall be stayed until resolution of the pending investigation.
(h) [(e)] The former home state
license shall no longer be valid upon the issuance of a new home state license.
(i) [(f)] If a decision is made
by the new home state denying licensure, the new home state shall
notify the former home state within ten business days and the former
home state may take action in accordance with that state's laws and rules.
§220.3.Limitations on Multistate Licensure Privilege--Discipline.
(a) All home state Board disciplinary orders, agreed or otherwise, which limit the scope of licensee's practice or require monitoring of the licensee as a condition of the order shall include the requirement that the licensee will limit his or her practice to the home state during the pendency of the order. This requirement may allow the licensee to practice in other party states with prior written authorization from both the home state and party state Boards.
(b) An individual who had a license which was surrendered, revoked, suspended, or an application denied for cause in a prior state of primary residence, may be issued a single state license in a new primary state of residence until such time as the individual would be eligible for an unrestricted license by the prior state(s) of adverse action. Once eligible for licensure in the prior state(s), a multistate license may be issued.
This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of the Secretary of State on February 9, 2009.
TRD-200900465
James W. Johnston
General Counsel
Texas Board of Nursing
Earliest possible date of adoption: March 22, 2009
For further information, please call: (512) 305-6811
The Texas Board of Nursing (Board) proposes amendments to §223.1, concerning Fees. The proposed amendments to §223.1(a)(8) are necessary to implement a new $25 fee for the issuance of accustomation permits. The Board is simultaneously proposing amendments to §217.4 (relating to Requirements For Initial Licensure By Examination for Nurses Who Graduate from Nursing Education Programs Outside of United States Jurisdictions) that permit certain nurses who have graduated from accredited nursing programs outside the United States to apply to the Board for a six-month accustomation permit. This six-month accustomation permit will authorize a qualifying nurse to participate in nursing education courses and clinical experiences in Texas. Further, the proposed amendments to §217.4 require an applicant to submit an accompanying fee to the Board with each accustomation permit application. These proposed amendments are also published in this edition of the Texas Register. The proposed new $25 fee in §223.1(a)(8) is reasonable and necessary to cover the costs of processing these accustomation permit applications. The proposed amendments to §223.1(a)(8) are also necessary to clarify that the existing fees for the issuance of a temporary permit for completing a refresher course and for the issuance of a temporary permit under §301.258 are also $25.
The following is a section-by-section overview of the proposal.
The proposed amendment to §223.1(a)(8) provides that the issuance of a temporary permit for completing a refresher course, a temporary permit under §301.258, or an accustomation permit is $25.
Katherine Thomas, Executive Director, has determined that for each year of the first five years the proposed amendment is in effect, there may be an approximate $2,500 total annual increase in revenue to state government as a result of the enforcement and administration of this proposal. This estimate is based on the following factors. The proposed amendments to §223.1(a)(8) impose a new $25 application filing fee on each applicant applying for an accustomation permit. The Board anticipates that it will receive 100 new applications for accustomation permits annually, resulting in an approximate $2,500 total annual increase in revenue to state government.
Ms. Thomas also has determined that for each year of the first five years the proposed amendment is in effect, the anticipated public benefits will be the opportunity for qualifying nurses who have graduated from an accredited nursing program outside the United States to participate in nursing education courses and clinical experiences prior to taking an NCLEX exam. It is anticipated that the participation in these educational courses and clinical experiences will assist qualifying nurses with the transition into the United States healthcare system and will increase the passage rate of the NCLEX exam, ultimately resulting in additional qualified and trained nurses.
Proposed amended §223.1(a)(8) prescribes a fee for applicants applying for an accustomation permit. No person is required by law to apply for an accustomation permit. However, for those qualifying individuals who seek to participate in nursing education courses and clinical experiences prior to taking an NCLEX exam and who choose to apply for an accustomation permit, there will be a $25 fee imposed on each applicant submitting an accustomation application to the Board.
ECONOMIC IMPACT STATEMENT AND REGULATORY FLEXIBILITY ANALYSIS FOR SMALL AND MICRO BUSINESSES. As required by the Government Code §2006.002(c), the Board has determined that proposed amended §223.1(a)(8) will not have an adverse economic effect on any individual applicant because no applicant will meet the definition of a small business under the Government Code §2006.001(2). The Government Code §2006.001(2) defines a small business as a legal entity, including a corporation, partnership, or sole proprietorship, that: (i) is formed for the purpose of making a profit; (ii) is independently owned and operated; and (iii) has fewer than 100 employees or less than $6 million in annual gross receipts. Each of these elements must be met in order for an entity to qualify as a small business under this section. Because an applicant who applies for an accustomation permit under proposed amended §217.4(e) and pays the accompanying fee of $25 under proposed amended §223.1(a)(8) will always be an individual and not a legal entity formed for the purpose of making a profit, no applicant will qualify as a small business under the Government Code §2006.001(2). Therefore, in accordance with the Government Code §2006.002(c), the Board is not required to prepare a regulatory flexibility analysis.
The Board has determined that no private real property interests are affected by this proposal and that this proposal does not restrict or limit an owner's right to property that would otherwise exist in the absence of government action and, therefore, does not constitute a taking or require a takings impact assessment under the Government Code §2007.043.
To be considered, written comments will be accepted within 30 days of publication of this proposal in the Texas Register to: James W. Johnston, General Counsel, Texas Board of Nursing, 333 Guadalupe, Suite 3-460, Austin, Texas 78701, or by e-mail to dusty.johnston@bon.state.tx.us, or faxed to (512) 305-8101. If a hearing is held, written and oral comments presented at the hearing will be considered.
The amendments are proposed pursuant to the authority of Texas Occupations Code §301.155 and §301.151, which authorizes the Texas Board of Nursing to adopt, enforce, and repeal rules consistent with its legislative authority under the Nursing Practice Act.
Texas Occupations Code, §301.155 and §301.151, are affected by this proposal.
§223.1.Fees.
(a) The Texas Board of Nursing has established reasonable and necessary fees for the administration of its functions.
(1) - (7) (No change.)
(8) issuance of a temporary permit for completing a refresher course, a temporary permit under §301.258, or an accustomation permit: $25;
(9) - (24) (No change.)
(b) (No change.)
This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of the Secretary of State on February 9, 2009.
TRD-200900466
James W. Johnston
General Counsel
Texas Board of Nursing
Earliest possible date of adoption: March 22, 2009
For further information, please call: (512) 305-6811
CHAPTER 871. ATHLETIC TRAINERS
SUBCHAPTER A. GENERAL GUIDELINES AND REQUIREMENTS
22 TAC §§871.4, 871.7 - 871.9, 871.14
The Advisory Board of Athletic Trainers (board) proposes amendments to §§871.4, 871.7, 871.8, 871.9, and 871.14 concerning the licensure and regulation of athletic trainers.
BACKGROUND AND PURPOSE
The amendments are being proposed in response to complaints and to application denials by clarifying and streamlining licensure requirements and procedures for persons who apply to become licensed athletic trainers in Texas. The proposed addition of a jurisprudence examination is designed to address and/or reduce complaints before the board and to insure the proper practice of licensed athletic trainers.
Proposed amendments remove the references to the board's mailing address; establish the requirement of a jurisprudence examination; restrict the setting at which a student athletic trainer shall accumulate apprenticeship hours; eliminate the requirement of an applicant to take the written and oral exams if the applicant has failed either portion three times; and set a time limit in which an applicant must apply for examination after the applicant's degree has been conferred.
SECTION-BY-SECTION SUMMARY
The amendment to §871.4 removes the reference to the board's mailing address, which has changed.
The amendment to §871.7 establishes the requirement that applicants for a license must complete a jurisprudence examination.
The amendment to §871.8 establishes the requirement that a student athletic trainer who has graduated cannot accumulate apprenticeship hours at the same setting where the student athletic trainer is employed.
Amendments to §871.9 remove the requirement of an applicant to take the written and oral exams if the applicant has failed either portion three times, and set a time limit in which an applicant must apply for examination after the applicant's degree has been conferred.
The amendment to §871.14 removes the reference to the board's mailing address, which has changed.
FISCAL NOTE
Stewart Myrick, Program Director, has determined that for each fiscal year of the first five years the sections are in effect, there will be no fiscal implications to the state as a result of enforcing or administering the sections as proposed. Implementation of the proposed sections will not result in any fiscal implications for local governments.
SMALL AND MICRO-BUSINESS IMPACT ANALYSIS
Mr. Myrick has also determined that there will be no adverse economic impact on small businesses or micro-businesses required to comply with the sections as proposed. This was determined by interpretation of the rules that small businesses and micro-businesses will not be required to alter their business practices in order to comply with the sections. There are no anticipated economic costs to persons who are required to comply with the sections as proposed. There is no anticipated negative impact on local employment.
PUBLIC BENEFIT
In addition, Mr. Myrick has also determined that for each year of the first five years the sections are in effect, the public will benefit from adoption of the sections. The public benefit anticipated as a result of enforcing or administering the sections is to continue to ensure public health and safety through the licensing and regulation of athletic trainers.
REGULATORY ANALYSIS
The board has determined that this proposal is not a "major environmental rule" as defined by Government Code, §2001.0225. "Major environmental rule" is defined to mean a rule the specific intent of which is to protect the environment or reduce risk to human health from environmental exposure and that may adversely affect, in a material way, the economy, a sector of the economy, productivity, competition, jobs, the environment or the public health and safety of a state or a sector of the state. This proposal is not specifically intended to protect the environment or reduce risks to human health from environmental exposure.
TAKINGS IMPACT ASSESSMENT
The board has determined that the proposed rules do not restrict or limit an owner's right to his or her property that would otherwise exist in the absence of government action and, therefore, do not constitute a taking under Government Code, §2007.043.
PUBLIC COMMENT
Comments on the proposal may be submitted to Stewart Myrick, Program Director, Advisory Board of Athletic Trainers, MC-1982, P.O. Box 149347, Austin, Texas 78714-9347, or by email to at@dshs.state.tx.us. When emailing comments, please indicate "Comments on Proposed Rules" in the subject line. Comments will be accepted for 30 days following publication of the proposal in the Texas Register.
STATUTORY AUTHORITY
The amendments are proposed under Occupations Code, §451.103, which authorizes the board to adopt rules necessary for the performance of its duties.
The amendments affect Occupations Code, Chapter 451.
§871.4.Petition for Rulemaking.
(a) (No change.)
(b) Submission of the petition.
(1) - (3) (No change.)
(4) The petition shall be mailed or delivered to the
board office [Executive Secretary, Advisory Board of Athletic
Trainers, 1100 West 49th Street, Austin, Texas 78756-3183].
(5) - (6) (No change.)
(c) (No change.)
§871.7.Qualifications.
(a) - (i) (No change.)
(j) Applicants for a license must complete the board's jurisprudence examination and submit proof of completion at the time of application. The jurisprudence examination must have been completed no more than six months prior to the date of application.
§871.8.Student Athletic Trainer Activities.
A student athletic trainer may perform the activities of an athletic trainer only under the following circumstances.
(1) - (3) (No change.)
(4) A student athletic trainer who has graduated shall not accumulate apprenticeship hours at the same college, university, high school, professional athletic team, or health care clinic at which the student athletic trainer is employed. In cases where a student athletic trainer is employed by a school, the student athletic trainer shall not accumulate apprenticeship hours at a setting within the same school.
§871.9.Examination for Licensure.
(a) - (h) (No change.)
(i) The following procedures relate to applicants who fail the examination prescribed by the board.
(1) - (2) (No change.)
[(3) An applicant who fails an examination
three times must take both the written examination and the practical
examination on the fourth examination attempt and on every fourth
examination attempt thereafter.]
(j) - (k) (No change.)
(l) A first-time applicant must apply for examination within five years from the date on which the applicant's qualifying degree was conferred or the apprenticeship was completed, whichever is later. An applicant may submit an application after this time period upon successful completion of remedial coursework or apprenticeship, as approved by the board.
§871.14.Violations, Complaints and Disciplinary Actions.
(a) (No change.)
(b) A person wishing to file a complaint against a
licensee or other person shall notify the department in writing.[
The initial notification of a complaint may be in writing, by
telephone, or by personal visit to the program director's office.
The mailing address is Advisory Board of Athletic Trainers, 1100 West
49th Street, Austin, Texas 78756-3183 and the phone number is (512)
834-6615.]
(c) - (h) (No change.)
This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of the Secretary of State on February 6, 2009.
TRD-200900451
David Weir
Chair
Advisory Board of Athletic Trainers
Earliest possible date of adoption: March 22, 2009
For further information, please call: (512) 458-7111 x6972