TAVNE Legislative Issues
 

[If the text is too small, size can be increased by holding the ctrl+scrolling the mouse.]

The next meeting of the Advisory Council on Education (ACE) at the Board of Nurse Examiners (BNE) is on December 1, 2006. TAVNE representatives who will be attending are Nancy Maebius (career schools), Beverly Skloss (hospital-based programs), and Kay Shaw (community college programs). The meetings are usually from 9:00 a.m. until 3:00 p.m. The agenda and actual hours will be posted here when available. The topics under discussion are included in the legislative report.

TAVNE Legislative Committee Report
Executive Board Meeting
San Antonio, Texas
Jan. 26, 2007

The Legislative Committee remains active via email.  Attention has been focused on the Sunset Review process and on establishing the nursing legislative agenda for the 2007 Legislative Session (80th Legislature).

During the Executive Board meeting, we need to discuss whether we want to continue our NLAC membership for the 2007-2008 years.  We also should discuss the nursing shortage, and  recommendations TAVNE may want to make regarding the shortage.

Sunset Commission Public Hearing on November 14, 2006  (Austin, Texas)
           
Jackie Morgan, Karen Malloy, and Nancy Maebius attended the Sunset Commission Public Hearing on November 14, 2007.  The Sunset Commission heard comments regarding the BNE and the recommendations of the Sunset staff. Gie Archer, Beverly Skloss, and Nancy Maebius submitted written testimony, which was included in the Sunset Commission minutes and listed  in the Sunset Commission Decision Material Book (December, 2006).  TAVNE did not submit any official position statements, but individual TAVNE members submitted comments during the last 6 months and were interviewed by Sunset staff regarding BNE advisory committees and the regulation of LVN educational programs. 

Sunset Commission Meeting on  Dec. 12, 2006  (Austin, Texas)

The Sunset Commission Decision Book was discussed by the Sunset Commission members, and the members adopted all of the recommended actions, adding three modifications to the Sunset Commission Decision Book report.

The final recommendations on the BNE adopted by the Sunset Advisory Commission on Dec. 12, 2006, will be handed out to Executive Board members. Some recommendations involve a “Change in Statute” and others involve “Management Action.” The Change in Statute recommendations require the Legislature to amend existing law.  These recommendations will be incorporated into the BNE Sunset Bill that will be filed by one of the legislator members of the Commission.  The Management Action recommendations can be implemented by the BNE without any change in existing law. The Sunset staff will monitor the BNE’s implementation of these recommendations. (NLAC Meeting Notebook, Jan. 13, 2007). 
           
Additional information about the hearings, including the audio/video of the hearing and meeting, is available at the Sunset web site:  http://www.sunset.state.tx.us/audioarchives.htm. 

Report of NLAC (Nursing Legislative Agenda Coalition) meeting on Jan. 13, 2007 (Austin, Texas)

Nancy Maebius attended the NLAC meeting. The following topics were discussed: 

  1. Overview of 2007 From Health Care Perspective and How to Have Effective Input — Anne Kimbol, JD, Senate Health & Human services Committee.
  2. Panel Discussion of Insights into the 2007 Session — Lobbyists Jennifer Banda, Mark Hanna and Jim Willmann
  3. Non-Punitive Review of Nursing Practice
  4. Patient Advocacy Protections and Mandatory CNE — Jim Willmann

Proposed amendment to require all CNE to be Type I

  1. BNE Sunset—Mary Beth Thomas, Jim Willmann
    1. Final Recommendations
    2. Transcription of Dialogue
    3. Peer Assistance Background Materials
    4. Final Decision Document of Sunset Commission (12/06)
  2. Advanced Practice Nursing
  3. Nursing Shortage—Clair Jordan, Elizabeth Sjoberg, Jim Willmann
    1. CNWS Recommendations (Center for Nursing Workforce Studies)
    2. THECB Recommendations (Texas Higher Education Coordinating Board)

Included in the CNWS report are recommendations regarding increasing the number of RN graduates; delaying the retirement of older, experienced nurses from the workforce; and increasing the capacity in professional nursing programs.  There is no mention of LVN education programs or LVN shortages. 

Included in the THECB report are completion and persistence rates findings of initial licensure RN programs. The statewide completion rate was 56%.  The statewide persistence rate was 13%.  (Completion rate is defined as completing the nursing curriculum within two years and persistence rate is defined has persistence in RN programs after two years).  About 31% of the original student cohort did not complete the nursing program during the two-year period, and was not enrolled in the program afte two years.  Once again, this study did not include LVN programs.  However, many of the problems in RN programs may be related to LVN programs.  In some areas, I believe the LVN programs are doing a very good job. 

  1. Allied Health Providers
    1. Draft Surgical Tech Bill
    2. Draft Lactation Consultant Bill
    3. THA Criteria for Evaluating Allied Health Bills
  2. Non-Legislative Issues
    1. BNE Draft Position Statement on Limiting Hours Nurses Work
    2. TDSHS Draft Revision/Update of Hospital Licensing Rules
    3. THA Memo on Proposed Rules

Additional Information.

  1. There are 2 new member of the 80th Legislature, Texas House, who are RNs.  They are:
    1. Donna Howard (D)        House District 48
    2. Susan King (R )            House District 71
  1. Tips on Advocating Issues before the Legislature and Guide to the 80th Legislature.  Handout for Executive Board members.  The Legislature convenes on Jan. 9, 2007, and adjourns on May 28, 2007.  Bills can be tracked as follows:

Texas Legislature Online – www.capitol.state.tx.us   Texas Senate Online – www.senate.state.ts.us. 

Please contact Nancy Maebius, who has a large notebook about the legislative agenda, if you would like more information.     

 

Advisory Committee on Education (ACE) Report
Board of Nurse Examiners

Dec. 1, 2006
9:50 a.m. – 4:15 p.m.

TAVNE member representatives present at this meeting were Nancy Maebius (representing career schools), Beverly Skloss (representing hospital-based programs), and Kay Shaw (representing community college programs).

The purpose of the BNE’s Advisory Committee for Education is to identify, review and analyze issues in the education and practice arenas that have or may have a significant impact upon the regulation of vocational and professional nursing education in Texas, including approval and evaluation of graduates for licensure.  The committee’s role is advisory, providing reports and recommendations for Board consideration.

Major points of discussion.

  1. Michael de Long and Virginia Bosman from Texas Workforce discussed  the purposes of Texas Workforce and the process for school approval.  TWC regulates schools, and the BNE approves nursing programs.  TWC approval is required prior to starting a new career program.
  2. Discussion followed related to approval of diploma programs by the TWC and the BNE.  A motion was passed suggesting the Board develop a process for diploma program approval.
  3. Discussion was held regarding the meaning of “Board-recognized accrediting body.”  In order for schools to develop a new RN program, the school must be approved by a “Board-recognized accrediting body.”  The BNE has historically deferred to the THECB, which recognizes SACS (regional accreditation).  A process of interim approval for programs while awaiting SACS accreditation was discussed.

Handouts were distributed and discussed related to accreditation requirements of states.

The next ACE meeting will be February 2, 2007.  The topic of “Simulation” will be discussed.  In addition, the committee is charged with reviewing rule language for clarity and consistency between Rule 214 and Rule 215 and making recommendations regarding Rule 219. 

 

OCT. 27, 2006
TAVNE LEGISLATIVE COMMITTEE REPORT

The Legislative Committee has been active via email during the interim time between legislative sessions.  Attention has been focused upon upcoming legislation through participation in the NLAC (Nursing Legislative Action Coalition).   In addition, TAVNE legislative activities have focused upon the Sunset Review of the Board of Nurse Examiners. 

The 80th Legislature will meet from January through May, 2007.  The Board of Nurse Examiners (BNE) is currently undergoing Sunset review, and the 80th legislature will take action regarding the continuance of the BNE.  In 1977, the Legislature created the Sunset Advisory Commission to identify and eliminate waste, duplication, and inefficiency in government agencies.  The 12-member Sunset Advisory Commission is a legislative body that reviews the policies and programs of more than 150 government agencies every 12 years. The Commission considers new and innovative changes to improve each agency’s operations and activities.  The Commission seeks public input through hearings on every agency under Sunset review and recommends actions on each agency to the full Legislature. The Legislature will decide to continue, modify, or abolish the BNE, after examining the recommendations from the Texas Sunset Advisory Commission and the public. The BNE is scheduled for Sunset review in 2007.

The Sunset Advisory Commission Staff Report was distributed in September, 2006. This report includes recommendations, which were developed following Sunset staff visits to the agency and following interviews with interest groups, stakeholders, and the BNE.  The BNE had previously submitted its own Self-Evaluation Report (SER). 

Eight issues and recommendations are presented in the Report. The full report can be found here. The following issues are included in the report.

Issue 1:  BNE’s Process of Approving Nursing Education Programs, Developed Without Clear Statutory Guidance, Could Contribute to the Nurse Shortage in Texas. 

The BNE has historically approved nursing education programs in Texas.  Since its approval process has lacked clear statutory direction, it duplicates efforts of other state agencies and national accrediting agencies “and exceeds what is necessary to ensure minimal competence to enter the profession…” 

Issue 2.  BNE Guidelines Do Not Ensure Consistent and Fair Consideration of Criminal History Information in Licensing and Disciplinary Decisions. 

Recommendations in the Report express the need for the BNE to more clearly identify which past criminal acitivitgy actually relate to the proactice of nursing, and to prioritize licensing and enforcement acrtivities in these areas. 

Issue 3.  The Board Has Not Defined the Purpose and Structure of Its Advisory Committees to Obtain from Them the Most Benefit. 

The three main advisory committees of the BNE are related to practice, education and disciplinary issues.  TAVNE has representatives on all three of the advisory committees.  The Report recommends that adding structure to the committees would increase their effectiveness.  In addition, the costs of reimbursing committee members are discussed.

Issue 4.  The Current Process of Authorizing Qualified Advanced Practice Nurses to Practice in Texas Does Not Promote Mobility Within the Profession. 

The Sunset Report recommends that the Advanced Practice Registered Nurse (APRN) Multistate Compact should be adopted into state law. 

Issue 5.  The Nursing Practice Act  Does Not Address Discipline for Impaired Nurses Who Commit Practice Violations. 

The Report recommends that clarity be brought to the working relationship between the BNE and its peer assistance provider, and to the practice violations by impaired nurses that must be reported. 

Issue 6.  Key Elements of the Board’s Licensing and Regulatory Functions Do Not Conform to Commonly Applied Licensing Practices.      

Issue 7.  Texas Has a Continuing Need for the Board of Nurse Examiners. 

The Report recommends that the BNE be continued for 10 years. 

Public Hearing on November 14-15, 2006.
The Sunset Commission will hear comments regarding the BNE and the recommendations of the Sunset staff beginning November 14, 2006.  Following this hearing, the Sunset Commission will make decisions about the recommendations for the consideration of the full Legislature when it convened in January, 2007. 

Sunset Advisory Commission

The 12-member Sunset Advisory Commission includes five members of the Senate and one public members appointed by the Lieutenant Governor, and five members of the House and one public member appointed by the Speaker. 

Members of the 2006-2007 Sunset Advisory Commission are:

Senator Kim Brimer, Chair
Representative Vicki Truitt, Vice Chair

Senator Robert Deuell, M.D.
Senator Craig Estes
Senator Eliot Shapleigh  
Senator John Whitmire
Howard Wolf, Public Member
 

 Representative Byron Cook
Representative Dan Flynn
Representative Lois Kolkhorst
Representative Ruth McClendon
Ike Sugg, Public Member

Oct. 29, 2006
ACE Committee Report

TAVNE members have attended 2 ACE (Advisory Council on Education) Committee meetings since our last Executive Board meeting.  In attendance at both meetings as representatives of TAVNE were Nancy Maebius (representing career schools), Beverly Skloss (representing hospital programs), and Kay Shaw (representing community college programs). 

Committee Charges:

The BNE Board issued the following charges to the ACE Committee at the April, 2006 meeting:

  1. Study the issues involved in the Board approving nursing education programs outside Texas’ jurisdiction currently operating in Texas or desiring to operate in Texas.
  2. Recommend new rules and regulations addressing Board approval of nursing education programs outside Texas’ jurisdiction currently operating in Texas or desiring to operate in Texas.
  3. Review rule language for clarity and consistency between Rule 214 and Rule 215 and making recommendations regarding Rule 219.

The Board added the following charges to the ACE Committee at the July, 2006 meeting:

  1. Review possible rule revision to clarify Board expectations in distance education for nursing education programs.
  2. Review rule revision to clarity the role of simulation in clinical learning experiences.
  3. Review recommendations on possible limitations or a revised process for re-submitting a proposal for a new nursing education program after the original proposal is denied by the Board.

The meeting of the ACE Committee on June 27, 2006, laid a foundation for the committee to study the issues involving the Board approving programs from out of state, programs presesented online and issues with board approval and accreditation.  The committee directed staff to collect additional data.

The second ACE meeting was held on October 6, 2006, to continue discussion and evaluation of the issues.

Major Points of Discussion

  1. Information presented by David Linkletter of the Texas Higher Education Coordinating Board (THECB) related to the THECB interim approval process (a program under Texas Education Code, Title 3, Chapter 7).
  2. Implications of Sunset recommendations.
  3. Current BNE Faculty waiver process.
  4. Regional versus national accreditation.
  5. Other states’ rules for regulation of out of state programs.

Action Taken:
The committee passed three motions.

  1. To concur with proposed changes to rule 214.7 (b) (2).  Faculty Qualifications and Faculty Organization related to faculty waivers and rule 215.7 (c) (E) Faculty Qualifications and Faculty Organization related to faculty waivers.  This was discussed at the Oct. BNE Board meeting.

Board staff was directed to

  1. Develop a plan to approve out of state programs’ clinicals to include, but not limited to, faculty ratio, clinical faculty qualifications and linking of lecture to clinical experiences.
  2. Develop an (approval) process that mirrors the process of THECB in providing interim/temporary approval of programs as described by chapter 7 of the THECB rules.

Board staff was directed to

    1. Invite a representative from the Texas Workforce Commission to provide information related to program approval.
    2. Research the number of states accepting national accreditation in lieu of regional accreditation
    3. Research language from other entities related to re-submission of a proposal after denial.

The next ACE Committee meeting will be Dec. 1, 2006.

All of the Advisory Council meetings are open meetings.   You are invited to attend any of our meetings, or, if you have comments about the regulation of education by the BNE, please feel free to contact Nancy Maebius, Beverly Skloss, or Kay Shaw.

Submitted by,
Nancy Maebius

TAVNE Legislative Committee
June 12, 2006

Report of ACE (Advisory Committee on Education)

There have been no meetings of the ACE Committee since February 24, 2005. Judy Farmer resigned from the committee. Beverly Skloss of Valley Baptist Medical Center in Harlingen will now represent hospital school LVN programs. Kay Shaw has been appointed to replace Sue Owns, who resigned also. Kay will represent community college LVN programs. Nancy Maebius represents LVN career schools.

This Committee does not meet on a regular basis but meets when called upon by the BNE. The next special called session of the ACE Committee will be held on Tuesday, June 27, in Austin from 10:00 AM to 3:00 PM. Nancy, Beverly and Kay will attend this meeting as TAVNE representatives. The agenda includes the following:
Move to issue a charge to ACE regarding Board approval of nursing education programs outside of Texas’ jurisdiction to include, but not limited to:

1. Studying the issues involved in the Board approving nursing education programs outside Texas’ jurisdiction currently operating in Texas or desiring to operate in Texas;
2. Recommending new rules and regulations addressing Board approval of nursing educating programs outside Texas’ jurisdiction currently operating in Texas or desiring to operate in Texas; and
3. Reviewing rule language for clarity and consistency between Rule 214 and Rule 215 and making recommendations regarding Rule 219.

Other issues to be considered in the present approval process include regional accreditation, online course delivery, teaching clinical courses in Texas, and approval of new diploma programs. Use of “simulations” will also be discussed.

If any TAVNE members have concerns related to the above agenda, please contact Beverly, Nancy or Kay.

_____________________________________________________

Report of NLAC (Nursing Legislative Agenda Coalition)

Nancy Maebius attended the NLAC meeting held in Austin on Saturday, March 25, 2006. The legislative agenda for the 2007 session was discussed. There is no nursing legislation directly impacting vocational nursing education. However, the BNE has submitted its Sunset Review Self-Evaluation Report to the Sunset Review staff, and it is available for review on the BNE and the Sunset web sites. Issues related to the BNE discussed at the NLAC meeting included changing the name of the BNE to Board of Nursing, BNE possibly assuming jurisdiction over unlicensed personnel, the BNE’s proposal to achieve “self-directed, semi independent (SDSI) status, BNE collection of administrative costs for hearings, removing targeted CNE requirements (such as bioterrorism, hepatitis C), criminal background checks for nursing students, and non-traditional nurse education program requirements. TNA is proposing a resolution on hours nurses should work, continued competency (and portfolios) for CE, and making mandatory reporting less punitive. (Nancy Maebius has additional hand-outs on these issues, if anyone would like to review them).

Nancy Maebius
Legislative Chair

TAVNE’S Legislative Chair person is Nancy Maebius,PhD, RN. She currently works for Galen Health Institute of San Antonio, San Antonio, TX. She keeps the Executive Board and its members appraised of important issues coming from the Texas legislature regarding nursing legislation.

Board of Nurse Examiners [BNE]

Texas Nurses Association [TNA]

Texas Registry