Agenda Item: 1.3 Prepared by: Bruce Holter/BON Staff

Meeting Date: July 20-21, 2017

Legislative Report – 85th Regular Texas Legislative Session

This report summarizes all bills followed by Board staff that were enacted by the Texas Legislature during the 2017 85th Texas Legislative Session. Bills included in the April 2017 Board Report (Item 1.3) which were not enacted by the legislature are not included in this report. There were two bills amending the Nursing Practice Act passed in the 85th Regular Legislative Session. Nursing, Legal and Operations staff member assistance was instrumental in following and reporting on the bills included in this report. Staff members who reported on the bills are listed by their initials in the first column of the report. This report is broken into four sections:

1. Bills amending the Nursing Practice Act; 2. Bills requiring rule making, development of frequently asked questions, that require consultation with our agency or some other

type of action; 3. All other bills relating to agency operations or nursing; and

4. The Sunset bills not passed, requiring initiation of a special session by Governor Abbott. Recommendation This item is for informational purposes only. No action is required.

Bills Amending the Nursing Practice Act

Bill Number

Bill Summary

Author(s)

Implications for BON/NPA

Effective Date

HB 2950

Sunset: Board of Nursing

MM

Relates to the continuation and functions of the Texas Board of Nursing and to the regulation of the practice of Nursing.

Representative Cindy Burkett

Amends the Texas Occupations Code relating to the continuation and functions of the Texas BON and the regulation of the practice of nursing. The bill continues the BON for twelve years until September 1, 2029.

Requires the BON to develop a path to initial licensure for graduates of out-of-state programs that are determined not to be substantially equivalent to Texas programs. Requires the BON, not later than March 1, 2019, to ensure that license denials and disciplinary actions are connected to the applicant's or license holder's conduct, and that the conduct is determined to affect the person's ability to practice nursing. The bill requires the Board to remove a nurse's disciplinary action from the Board's website if the nurse and action meet certain criteria: (1) the disciplinary action is the only disciplinary action taken against the nurse; (2) the disciplinary action was taken by the Board for a violation that is not related to the practice of nursing; (3) the disciplinary action did not result in the suspension or revocation of, or the probation of the suspension or revocation of the nurse's license;

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(4) the disciplinary action does not provide any indication that continued practice by the nurse may risk harm to a patient; and (5) the nurse has successfully completed the requirements imposed by the Board in the disciplinary order related to the disciplinary action. The bill prohibits the Board from charging a nurse for the administrative costs of conducting a hearing at the state office for administrative hearings. The BON is required to develop guidelines in rule to establish individualized requirements for participants in a peer assistance program, and to notify a person that they can request a re-evaluation of the requirement to participate in the peer assistance program. The bill also requires the BON to develop guidelines to establish meaningful performance goals for evaluating the success of the peer assistance program. Repeals the current Nurse Licensure Compact and replaces it with an updated version of the Compact. The new Compact will go into effect when 26 states have adopted it, or on December 31, 2018. Discontinues two reporting requirements regarding pilot programs and records of

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the Board's proceedings. Except as otherwise specified by the bill, the bill takes effect on September 1, 2017.

HB 3296

Nursing Peer Review

DJ/DB

Relating to persons required to establish nursing peer review committees. The minimum number of employed nurses required to establish nursing peer review has decreased from 10 to 8 and for RNs, 4 (instead of 5) of the nurses must be RNs to extend nursing peer review to RNs.

Representative Stephanie Klick

Amends NPA Section 303.0015. A nursing peer review committee is required to conduct peer review for LVNs if the person regularly hires, employs, or contracts for services for 8 or more nurses and for RNs, if the person regularly hires, employs, or contracts for services for 8 or more nurses, at least 4 of whom are RNs.

9/1/2017

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Bills Requiring Rule Making, Development of Frequently Asked Questions, or that

Require Consultation with BON Staff

Bill Number

Bill Summary

Author(s)

Implications for BON/NPA

Effective Date

HB 91

Criminal Background

DJ/TD

Relating to a review of occupational licensing requirements related to an applicant's criminal history.

Representative James White

No amendments to the NPA.

Not later than December 1, 2018, the Board must submit a report recommending retaining, repealing, or modifying the eligibility requirements related to an individual’s criminal history currently required for applicants for licensure.

6/12/2017

HB 280

Workplace Violence

SC

Relating to a grant program for reducing workplace violence against nurses. A recent study conducted by the Department of State Health Services found that workforce violence against nurses is a frequent occupational hazard, with approximately half of nurses experiencing physical violence over the course of their career. Based on its findings, the study recommended that healthcare facilities evaluate violent incidents and identify preventative measures that are facility-specific based on location, size, and the incidence of violence. HB 280 seeks to alleviate the trauma of

Representative Donna Howard

No amendments to the NPA. As soon as practicable after the effective date of this Act, the executive commissioner of the Health and Human Services Commission shall adopt the rules necessary to implement Section 105.011, Health and Safety Code, as added by this Act. Under Section 301.155, Occupations Code, to fund the grants authorized by this section, the nursing resource section may use money transferred to the department from the Texas Board of Nursing. This would require using existing revenue generated from nursing licensure renewal applications and would make no change to the statutory licensing renewal surcharge limit.

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workplace violence by providing grants to hospitals and other health facilities to implement innovative approaches unique to each facility and region to reduce the severity and frequency of these occurrences. These grants would be funded using existing revenue generated from nursing license and renewal applications, an approach widely supported by the nursing community. The bill would make no change to the statutory licensing renewal surcharge limit.

Health and Safety Code Chapter 105 is amended by adding Section 105.011

HB 1290

Adoption of Rules

DJ/JA

Relating to the required repeal of a state agency rule before adoption of a new state agency rule.

Representative Kevin Roberts

No amendments to the NPA. The Board may not adopt a rule with cost implications unless the Board first repeals a rule that costs as much or more than the proposed rule or amends a rule that results in a decrease in costs in an amount equal to or greater than the proposed rule. The Board must also include a government growth statement in its published rule proposals.

9/1/2017

HB 2561

Sunset: Pharmacy

Board

JZ

Relating to the continuation and functions of the Texas State Board of Pharmacy and the regulation of certain prescription drugs, prescription drug prescribers and dispensers, and colleges of pharmacy; authorizing a reduction in fees.

Representative Senfronia Thompson

No amendments to the NPA.

Each regulatory agency that issues a license, certification or registration to a prescriber must promulgate specific guidelines for prescribers regulated by that agency for the responsible prescribing of opioids, benzodiazepines, barbiturates, or carisoprodol. Clarifies

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The Texas State Board of Pharmacy (TSBP) is continued for 12 years. Pharmacists will be required to review the prescription monitoring program (PMP) prior to dispensing opioids, benzodiazepines, barbiturates or carisoprodol. Prescription drug wholesale distributors must submit information to the TSBP similar to what is shared with the US DEA. Requires electronic prescription records for controlled substances to be submitted to the TSBP within one day after dispensing the drug. Requires TSBP to identify prescriber and patient behaviors suggestive of drug diversion or abuse. Requires TSBP to notify a dispenser or prescriber if records suggest potential drug abuse or diversion and also notify the prescriber’s licensing board. Amends the Health and Safety Code to allow regulatory agencies to check the database and open investigations based on information discovered in periodic checks of the PMP. Removes good moral character requirement for licensure. Requires TSBP to create a graduated schedule of late renewal fees. Permits TSBP to

that BON and other regulatory agencies who regulate prescribers shall periodically access the information submitted to the PMP. BON will be required to develop such guidelines for APRN prescribers. APRNs prescribers are required to check the PMP prior to prescribing one of these categories of drugs unless the patient is a cancer patient. In patterns indicating potentially harmful practices, BON must consider the number of times a prescriber prescribes one of these categories of drugs and patterns of prescribing combinations of these drugs and other dangerous drug combinations. This has implications for non-therapeutic prescribing cases. BON is required to provide names and contact information for prescribers to the TSBP.

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refuse to renew a license if holder is in violation of a board order. Establishes program under the Health and Safety Code for donation of unused prescription drugs provided certain criteria are met. Prohibits adoption of rules and policies that would violate Civil Practice and Remedies Code, §110. Defines and establishes requirements for the practice of telepharmacy. Requires continuing education for pharmacy technicians.

SB 73

Employee Leave Policy

MM

Relating to leave policy and procedures for state employees.

Senator Jane Nelson

No amendment to the NPA. Limits the discretion of an agency head to grant emergency leave to employees who they believe in good faith will return to employment following that leave period; requires an agency report to the Texas comptroller of public accounts (comptroller) employees who were granted more than 32 hours of emergency leave during the previous fiscal year; requires each agency to adopt a policy governing leave for employees and that the policy be prominently posted on the agency's website; and instructs the comptroller to adopt a policy to include standardized accounting codes as a part of the centralized accounting and payroll system.

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SB 1107

Telemedicine

and Telehealth

Services

KB/SC

Relating to telemedicine and

teleservices.

Seeks to provide for a clear and

accountable regulatory

structure regarding the

establishment of a valid

practitioner-patient relationship

via telemedicine. The bill

subjects a health professional

providing a health care service

or procedure as a telemedicine

medical service or a telehealth

service to the standard of care

that would apply to the provision

of the same health care service

or procedure in an in-person

setting. The bill prohibits an

agency with regulatory authority

over a health professional from

adopting rules pertaining to

telemedicine medical services

or telehealth services that would

impose a higher standard of

care than the standard

described by the bill. The bill

expressly excludes mental

health services from statutory

provisions governing

telemedicine and telehealth.

Senator Charles

Schwertner No amendments to the NPA, however

amends Chapter 111, Texas

Occupations Code to require:

Coordinated rule making by the

Texas Medical Board (TMB),

BON, the Texas Physician

Assistant Board, and the Texas

State Board of Pharmacy to

establish determination of a valid

prescription in accordance with

practitioner-patient relationship

that meets statutory criteria;

Jointly developed responses to

frequently asked questions

related to determination of a valid

prescription issued while

telemedicine medical services

are provided among the

aforementioned agencies to be

published on each respective

agency’s website.

Clarifies regulatory structure and criteria

for establishment of a valid

practitioner-patient relationship via

telemedicine, specifically removing the

provision that allowed TMB to establish

rules requiring a face-to-face

consultation between a new patient and

a physician prior to a telemedicine

encounter. New definitions for

telemedicine, telehealth, and store and

9/1/17, except for

certain sections

amending the

Insurance Code

with a 1/1/2018

effective date.

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forward technology are established.

Requires the same standard of care for

telemedicine and in-person service and

prohibits an agency from requiring a

higher standard of care than set out in

bill language. Removes requirements

for health plans to include services

provided only by audio interaction or

facsimile in order to comply with

coverage mandates. Requires health

plans to publish policies and payment

practices for telemedicine and telehealth

on their websites.

SB 2118

Public Junior Colleges to

Offer Baccalaureate

Degree Programs

JH

Relating to authorization by the Texas Higher Education Coordinating Board for certain public junior colleges to offer baccalaureate degree programs.

Senator Kel Seliger

No amendments to the NPA. Will authorize community colleges that meet specific criteria to offer baccalaureate degree programs in areas that include nursing. THECB shall apply the same criteria and standards used to approve baccalaureate degree programs at general academic teaching institutions. THECB shall determine the ability of the community college to support the degree program with student enrollment considering many factors including evidence provided to THECB and the BON related to adequacy of clinical space. Since the BON is mentioned, it is expected that Board Staff may be involved in the approval process. (Analysis of bill implies programs must meet BON requirements for pre-licensure program

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approval.) Any community college seeking to establish a baccalaureate degree in nursing would need to receive approval of the degree status from SACSCOC and THECB.

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All Other Legislation

Bill Number

Bill Summary

Author(s)

Implications for BON/NPA

Effective Date

HB 8

Cyber Security

BR

Relating to cybersecurity for state agency information resources.

Representative Giovanni

Capriglione

No amendments to the NPA. Addresses several areas of agency security, including annual security plan updates, vulnerability/penetration testing guidelines, and reporting guidelines. Implementation steps to flow to agencies from DIR.

9/1/2017

HB 9

Cybercrime

BR

Relating to Cybercrime.

Representative Giovanni

Capriglione

No amendments to the NPA or direct implications for the BON. Sets up defined guidelines into what cybercrime and cybersecurity are defined as in relation to state government. Defines laws and penal codes that can be focused on in these types of offenses.

9/1/2017

HB 10

Mental Health and Substance Use Disorders:

Access & Benefits

DB

Relating to access to and benefits for mental health conditions and substance use disorders. Amends current law relating to access to and benefits for mental health conditions and substance use disorders. Creates a work group to increase understanding of benefits for mental health conditions and substance use disorders.

Representative Four Price

No amendments to the NPA or direct implications for the BON. Awareness of these resources may be useful to nurses providing care to those who may benefit.

9/1/2017

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HB 53

Claim Settlement

MM

Relates to settlement of claims and actions against a governmental unit.

Representative Ramon Romero

No amendments to the NPA. Prohibits an attorney representing a state or local governmental unit from entering into a settlement over $30,000 if a non-disclosure agreement is a condition of the settlement.

9/1/2017

HB 89

State Contracts/ Purchasing

MM

Relating to state contracts with and investments in companies that boycott Israel.

Representative Phil King

No amendments to the NPA. Prohibits state contracting with and/or investing in companies that boycott Israel.

9/1/2017

HB 239

TDCJ pregnant Inmates Report

KS

Relating to a report regarding the confinement of pregnant inmates by the Texas Department of Criminal Justice (TDCJ). TDCJ shall prepare a report by 12/1/18 on the confinement of pregnant inmates in facilities operated by or under contract with TDCJ between 9/1/17 and 9/1/18 to include: a description of policies and procedures implemented to provide adequate care to pregnant inmates while confined and any policies adopted regarding the placement of pregnant inmates in administrative segregation; information regarding the healthcare provided to pregnant

Representative Ana Hernandez

No amendments to the NPA or direct implications for the BON. Nurses in the TDCJ system will need to be aware of this report, as necessary, to comply with Board Rule 217.11(1)(A).

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inmates; and a detailed summary of pregnant inmate’s nutritional standards, work assignments, housing conditions, and situations in which restraints are used; and the number of miscarriages experienced by pregnant inmates.

HB 249

Investigation of Abuse,

Neglect, or Exploitation

by the Department of

Family and Protective Services

GV/JZ

Relating to investigations of child abuse, neglect, or exploitation and to child protective services functions of the Department of Family and Protective Services. Responsibility for investigating a complaint of abuse, neglect or exploitation of a child in a licensed child-care facility is moved to the Child Protective Services division (CPS) of the Department of Family and Protective Services from the Child Care Licensing division (CCL). CCL was permitted to investigate only actual harm to the child. The change will allow CPS to evaluate potential risk to the child as well as actual harm. CCL will continue to license child care facilities/providers.

Representative Ana Hernandez

No amendments to the NPA or direct implications for the BON. Pediatric nurses at all levels of licensure, including those who practice in or with child care facilities/providers, and forensic nurses will need to be aware of the new provisions.

9/1/2017

HB 257

Texas Workforce

Relating to a report by the Texas Workforce Commission (TWC) regarding the transition from military service to

Representative Ana Hernandez

No amendments to the NPA or direct implications for the BON. TWC report on military occupations may

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13

commission Report on

Transition from Military Service to Employment

LL

employment The Commission, in consultation with the Texas Coordinating Council for Veterans Services, shall submit to the Governor, Lieutenant Governor, Speaker of the House of Representatives, and chairs of the legislative committees with appropriate jurisdiction a report that identifies the five most common military occupational specialties of service members who are transitioning from military service to employment and the five occupations for which the military occupational specialties best offer transferable skills that meet the needs of employers.

include healthcare related specialties among occupations transferable to needs of employers. This may have future implications for nursing education and licensure.

HB 271

Veterans & Hyperbaric

Oxygen Treatment

LL

Relating to the establishment of the Veterans Recovery Pilot Program to provide certain veterans with hyperbaric oxygen treatment This bill would require the Health and Human Services Commission through existing resources to create & operate the Veterans Recovery Pilot Program. The program would provide diagnostic services, hyperbaric oxygen treatment, and support services to eligible

Representative Rick Miller

No amendments to the NPA or direct implications for the BON. May be of interest to nurses providing services to veterans.

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military veterans who have post-traumatic stress disorder or a traumatic brain injury.

HB 281

Evidence Tracking

System for Sex Offenses

JZ

Relating to establishing a statewide electronic tracking system for evidence of a sex offense. Provides victims of sexual assault or abuse with information regarding disclosure of evidence collected. Gives victims the right to information regarding analysis of evidence. Information included in the database is not subject to public disclosure.

Representative Donna Howard

No amendments to the NPA or direct implications for the BON. Forensic nurses who perform sexual assault exams will need to be aware of the new database and any requirements for them to enter information regarding evidence collected during an exam.

9/1/2017

HB 493

College Credit

for Heroes

VA

Relating to reporting requirements for the College Credit for Heroes program.

The College Credit for Heroes program was created in 2011 to help veterans transition more quickly into the workforce. Participating colleges can award credit hours based on prior training, education, or military experience.

HB 493 requires that the Texas Workforce Commission, in consultation with the Texas Higher Education Coordinating Board (THECB), report how many academic or workforce

Representative Mary Ann Perez

No amendments to the NPA or direct implications for the BON.

The outcome data should assist the Board Education Department to better understand the impact of veterans entering nursing education programs. Amends Section 302.0031(g), Labor Code.

1/1/2018

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credit hours are awarded each academic year.

HB 493 also requires that the report disaggregate credit hours awarded by subject matter. Additionally, THECB would report the number of transfer credit hours awarded.

The metrics provide baseline data and could provide insight on how the program could be improved.

HB 970

State Plan for Streptococcus Pneumoniae Education & Prevention

LL

Relating to the establishment of a state plan for Streptococcus pneumoniae education & prevention. This bill would require the Department of State Health Services to develop a state plan and an education and prevention program for diseases caused by Streptococcus pneumonia. The state plan would include strategies for prevention and treatment of diseases caused by Streptococcus pneumoniae in specific demographic groups that are disproportionately affected, including the elderly, children under two years old, those living in long-term care facilities, those with a chronic heart or lung disease, smokers,

Representative Philip Cortez

No amendments to the NPA or direct implications for the BON. Nurses may be called upon to provide feedback concerning the state plan relating to prevention and treatment of diseases caused by Streptococcus pneumoniae.

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and individuals with asplenia.

HB 1178

Theft of Controlled

Substances

TD

Relating to the punishment for burglary and theft of controlled substances. Amends the Penal Code to clarify that it is a third degree felony if a person enters or remains concealed in a commercial building in which controlled substances are stored if the person’s intent is to commit a theft of a controlled substance. It is also a third degree felony if a vehicle owned or operated by a wholesale distributor of prescription drugs is broken into or entered with the intent to commit theft of a controlled substance. In both cases, the value of the controlled substance must be less than $150,000.

Representative John Kuempel

No amendments to the NPA. The amendments to the Penal Code making this a felony offense could have implications for initial nursing licensure and for enforcement if licensed nurses engage in these behaviors.

9/1/2017

HB 1486

Peer services and peer

specialists under Medicaid

JZ

Relating to peer specialists, peer services, and the provision of those services under the medical assistance program.

Requires the Health and Human Services Commission (HHSC) to include peer services provided by certified peer specialists under Medicaid to the extent permitted under federal law. HHSC is required to develop training, certification

Representative Four Price

No amendments to the NPA or direct implications for the BON.

Nurses who work in mental health settings will need to be aware of this new provider type and maintain awareness regarding limitations on their scope of practice.

6/15/2017

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and supervision requirements as well as define scope of practice for peer specialists. Establishes a stakeholder workgroup under HHSC.

HB 1508

Eligibility for Occupational

License – Criminal

Conviction

TD

Relating to notice to applicants to and enrollees in certain educational programs regarding the consequences of a criminal conviction on eligibility for an occupational license. Amends Chapter 50 of the Occupations Code to require education programs that prepare individuals for licensure to notify each applicant to and enrollee in the program of the potential ineligibility due to previous criminal convictions and the right for the applicant or enrollee to request a criminal history evaluation. Programs must provide the information to all applicants and enrollees regardless of whether the applicant has been convicted of an offense. If a licensing authority determines the program failed to provide the required notice and the application for licensure is denied based on conviction of an offense, the licensing authority shall order the program to refund the amount of

Representative Helen Giddings

No amendments to the NPA. The BON already has a declaratory order process in place for programs offering entry level nursing education for vocational and registered nurses. Education programs will need to be aware of the consequences should they fail to provide this information to all applicants and enrollees. Education consultants will need to ensure deans and directors are aware. There may also be implications for enforcement should a determination be made that an individual is not eligible for licensure if that individual has paid fees to the education program, the BON and/or to Pearson Vue or any subsequent NCLEX vendors.

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any tuition paid by the applicant or enrollee in addition to the amount of any application fees paid to the licensing authority and examination fees paid to the licensing authority or examination provider approved by the licensing authority.

HB 1600

Mental Health Screenings: Texas Health

Steps

DB

Relating to certain mental health screenings under the Texas Health Steps program. Allows mental health screenings in children under the Texas Health Steps Program more than once per child but no more than once per year.

Representative Senfronia Thompson

No amendments to the NPA or implications for the BON. APRNs who provide Texas Health Steps evaluations need to be aware.

9/1/2017

HB 1638

Dual Credit Programs

JH

Relating to statewide goals for dual credit programs provided by school districts.

Representative Ryan Guillen

No amendments to the NPA or direct implications for the BON. Requires the Texas Education Agency and the Texas Higher Education Board to develop statewide goals for dual credit programs, including early college high school, career and technical education, and joint high school and college credit programs, to provide uniform standards for evaluating those programs. Does not specifically mention nursing but may impact with dual credit nursing programs.

5/23/2017

HB 1697

Pediatric Telemedicine

Relating to the establishment of a pediatric health electronic access in rural Texas grant program.

Representative Four Price

No amendments to the NPA or direct implications for the BON. May improve access to healthcare for

9/1/2017

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Grant Program for Rural Texas

GV

The Health and Human Services Commission shall establish and implement the pediatric health electronic access in rural Texas grant program authorized by Chapter 541, Government Code, as added by this Act.

rural pediatric patients.

HB 1787

Mental Health Treatment

Declaration

DB

Relating to the execution of a declaration for mental health treatment. Provides options for execution of a written Declaration for Mental Health Treatment: signed in front of two witnesses or the additional option of signed in front of a notary public.

Representative John Wray

No amendments to the NPA or direct implications for the BON. Nurses working with patients needing this document signed may benefit from knowing there are two options. .

9/1/2017

HB 1861

IT Security

BR

Relating to the confidentiality of certain information related to a computer security incident.

Representative Gary Elkins

No amendments to the NPA. Changes the classification of computer/network security audits to confidential. Allows the agency to redact any/all confidential findings from the computer/networks security audits. Redacted version could be published on agency website if deemed necessary information.

6/15/2017

HB 1974

Durable Powers of Attorney

Relating to durable powers of attorney. In an effort to reduce the need

Representative John Wray

No amendments to the NPA or direct implications for the BON. Nurses who provide care to patients

9/1/2017

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(DPOA)

SC

for guardianship proceedings, and to provide additional powers to the designated agents, H.B. 1974 makes important changes to the statute by: Providing for reasonable acceptance of DPOAs in a timely fashion so that guardianship can be avoided; Eliminating risk to persons who accept DPOAs by allowing them to rely on an agent's certification that the DPOA is valid for the purpose it is being presented or an opinion of the agent's counsel who is hired at the principal's expense; Giving the person who is asked to accept the DPOA numerous valid reasons to reject, some of which cannot be challenged by the principal or agent; and Providing a mechanism to have a court decide any disputes. Similar provisions have been enacted in 30 other states without issue.

with these documents need to be aware.

HB 1978

PAs providing care in

volunteer capacity

Relating to physician assistant services performed as volunteer care. Allows physician assistants (PAs) to perform medical tasks

Representative J.D. Sheffield

No amendments to the NPA or direct implications for the BON. Nurses at all levels of licensure are already named in this Act.

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JZ

as a volunteer for a charitable organization under their PA licenses for purposes of immunity under the provisions of the Texas Charitable Immunity and Liability Act of 1987 (found in the Civil Practice and Remedies Code, §84) that governs volunteer liability.

HB 2425

Hospital Aftercare

Instruction

LL

Relating to a requirement that a hospital allow a patient to designate a caregiver to receive aftercare instruction regarding the patient. On admission to a hospital or at the time the patient is discharged or transferred to another facility, the hospital shall provide the patient, the patient’s legal guardian, or the patient’s surrogate decision-maker the opportunity to designate a caregiver who will receive instructions regarding the patient’s care after discharge from the hospital.

Representative Four Price

No amendments to the NPA or direct implications for the BON. Nurses may need continuing education regarding the requirement for documentation in the medical record regarding the designation of a caregiver or if the patient declines to designate a caregiver. This is a hospital decision as to who will assume the responsibility of documentation in the medical record.

5/26/2017

HB 2466

Medicaid Coverage Related to Maternal

Depression

DB

Relating to the content of an application for Medicaid and coverage for certain services related to maternal depression under the Medicaid and child health plan programs. Promotes increased screening

Representative Sarah Davis

No amendments to the NPA or direct implications for the BON. Nurses who practice in women’s health and in mental health may wish to be aware of these benefits.

9/1/2017

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for postpartum depression by creating a postpartum depression screening benefit for the mothers of current Children's Health Insurance Plan and Medicaid enrollees. Amends current law relating to coverage for certain services related to maternal depression under the Medicaid and child health plan programs.

HB 2546

Work Status Reports Under

Workers’ Comp

JZ

Relating to completion of work status reports by a physician assistant under the workers' compensation system Allows a physician to delegate the authority to complete and sign a work status report regarding an injured employee’s ability to return to work to a physician assistant (PA). The legislation clarifies that the physician remains responsible for the acts of the PA who is delegated this authority.

Representative John Zerwas

No amendments to the NPA or direct implications for the BON. APRNs and their delegating physicians will need to be aware that this provision is applicable to PAs only.

6/9/2017

HB 2765

Physical Therapy

Licensure Compact

JZ

Relating to the Physical Therapy Licensure Compact; authorizing fees. Permits interstate practice of physical therapy (PT). Defines the practice to occur in the state where the patient is located at the time of the encounter.

Representative Travis Clardy

No amendments to the NPA or direct implications for the BON. There are some differences between the PT compact and the Nurse Licensure Compact that has been in effect in Texas since January 2000. There are also some differences between the PT compact and the Enhanced Nurse

9/1/2017

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Requires criminal background checks with FBI as a requirement for licensure. Compact privileges are only granted to physical therapists who have unencumbered licenses. States may charge a fee for granting a compact privilege. Compact privileges may not be granted if there was any adverse action against a license or privilege to practice in the previous two years. Loss of a compact privilege in any remote state results in loss of compact privileges in all other remote states. Compact licensees are required to meet any jurisprudence requirements in remote states in which they seek to practice. Allows military spouses to use permanent change of station to designate a home state. Allows member states to issue subpoenas for hearings and investigations in all party states and requires enforcement in the party state. States issuing the subpoena must pay witness fees, travel expenses required by the state where the witnesses or evidence are located. Establishes the PT Compact Commission and outlines its powers and duties. Requires

Licensure Compact passed by the 85th(R) Texas Legislature.

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establishment of a coordinated licensure database.

HB 2818

Marriage and Family

Therapy: “Diagnosis”

DB

Relating to the practice of marriage and family therapy. The practice of marriage and family therapy "includes the evaluation, diagnostic assessment, and remediation of mental, cognitive, affective, behavioral, or relations dysfunction, disease, or disorder in the context of marriage or family systems."

Representative Ramon Romero

No amendments to the NPA or direct implications for the BON. No direct implications for nurses.

6/9/2017

HB 2886

Provider Liability and

Newborn Prophylaxis of

Ophthalmia Neonatorum

JZ

Relating to limiting the liability of certain health care providers. Clarifies that health care providers in attendance at childbirth are not subject to criminal, civil or administrative liability or professional discipline if the provider is unable to apply prophylaxis for ophthalmia neonatorum due to the objection of a parent, managing conservator, or guardian of the newborn infant. Requires that the provider ensure that the objection is documented in the infant’s medical record.

Representative Stephanie Klick

No amendments to the NPA. This change to the Health and Safety Code will need to be considered should nurses be reported for failing to provide prophylaxis for this condition. Nurses who attend deliveries need to be aware of the requirement for documentation of any objections to newborn prophylaxis in the neonate’s medical record.

9/1/2017

HB 2937

Licensed Hospital Dual

Credit

Relating to the establishment of a pilot program under which a licensed hospital may offer dual credit courses to public high school students.

Representative Terry Canales

No amendments to the NPA. Medical Dual Credit Pilot Program: One licensed hospital will be selected to offer a pilot program with the goal of

6/9/2017

25

JH

preparing students for employment in the health care field. May impact the BON if students are prepared as nurses.

HB 3078

Sunset: TSBPE moved

to TDLR

JZ

Texas Commission of Licensing and Regulation and the Texas Department of Licensing and Regulation and the transfer of the regulation of podiatry to the Texas Department of Licensing and Regulation; authorizing a reduction in fees. Moves the regulation of podiatry to the Texas Department of Licensing and Regulation (TDLR). The Board of Podiatric Medical Examiners will cease to exist effective 9/1/2017.Establishes the Podiatric Medical Examiners Advisory Board to advise and make recommendations to TDLR. The advisory committee develops all rules related to scope of practice and podiatric standard of care subject to approval by TDLR. TDLR is granted authority to conduct DPS and FBI criminal background checks on applicants for licensure. Moves the Sunset review date for TDLR to 2021.

Representative Senfronia Thompson

No amendments to NPA or direct implications for BON. Questions related to podiatric practice and licensure will now be directed to TDLR.

9/1/2017

26

HB 3083

Repayment of Education Loans for

Mental Health Professionals

DB

Relating to repayment of certain mental health professional education loans. Licensed Chemical Dependence Counselors added to the mental health professionals potentially eligible for loan forgiveness. Amended Texas Education Code in relation to repayment assistance is “from the state” for mental health APRNs

Representative Four Price

No amendments to the NPA or direct implications for the BON. Mental Health APRNs are included in the mental health professionals who may be eligible for education repayment assistance.

9/1/2017

HB 3107

Public Information

JA

Relating to the production of public information under the public information law.

Representative Trenton Ashby

No amendments to the NPA. The Board may consider multiple open records requests submitted on the same day as one request for purposes of determining applicable costs. Further, the Board may establish monthly and yearly limits on the amount of time that staff is required to spend producing public information before the Board may recover costs for personnel time.

9/1/2017

HB 3152

Sexual Assault

SC

Relating to the care and transportation provided to a sexual assault survivor by a health care facility. If a sexual assault survivor arrives at a hospital without a Sexual Assault Forensic Examiner (SAFE) they may desire or be encouraged to transfer to a designated

Representative Sefronia

Thompson

Does not amend the NPA. Forensic nurses who provide sexual assault exams will need to be aware. Section 323.001, Health and Safety Code, is amended by amending Subdivision (3) and adding Subdivisions (3-a) and (4-a); Chapter 323, Health and Safety Code, is amended by adding Section 323.0015 and Section 323.0051

9/1/2017

27

hospital. HB 3152 would require the Department of State Health Services (DSHS) to develop an information sheet with information on hospitals that employ a SAFE, emergency rooms without a SAFE to provide the DSHS-developed information sheet to survivors of sexual assault, and, when transferring a sexual assault survivor/patient for a forensic medical exam, emergency rooms shall call ahead to confirm the presence of a SAFE at the receiving emergency room.

Sections 323.004(a-1) and (a-2), Section 323.0045(c), and Section 323.008 are amended. Section 323.001(1), Health and Safety Code, is repealed. Not later than January 1, 2018, the Department of State Health Services shall develop the information form required by Section 323.0051, Health and Safety Code, as added by this Act.

HB 3157

Vision Screening at Public and

Private Schools

SL

Relating to requirements for screenings in public or private schools to detect vision disorders of students This bill will allow the use of a photo-screening device in Texas schools to detect vision disorders.

Representative Dennis Bonnen

No amendments to the NPA or direct implications for the BON. There is concern that schools cannot use a photo-screening device to conduct the required vision screening of students and assert that this technology will provide an efficient alternative in detecting vision disorders. Bill allows the use of a photo-screening device in Texas schools to detect vision disorders. Health and Safety Code amended to require rules adopted by the Health and Human Services Commission. There may be implications for school nurses to conduct the screenings.

9/1/2017

28

HB 4007

Health licensing

functions at TDLR

JZ

Relating to the licensing and regulation of health-related occupations transferred to the Texas Department of Licensing and Regulation. Requires the Texas Department of Licensing and Regulation (TDLR) to post a list of licensed midwives on its website. Requires midwives in attendance at deliveries in which the parent, guardian or managing conservator objects to prophylactic treatment for ophthalmia neonatorum to document the objections in the child’s medical record. Requires administration of speech pathology and audiology licensure exam at least twice per year. Creates option for fitters and dispensers of hearing instruments to count publication of a book or article toward continuing education requirement. TDLR may approve dyslexia practitioner and therapy education programs without input from an advisory committee. Creates a massage therapy advisory board under TDLR. Permits approval of massage therapy education requirements and requires continuing education

Representative John Kuempel

No amendment to the NPA or direct implications for the BON. Nurses who work with these other types of providers need to be aware of the changes. Requirements for posting a list of licensed midwives on the TDLR’s website will help the BON more easily identify individuals who are licensed nurses and also licensed midwives when such is necessary.

9/1/2017

29

for licensure renewal. Adds enforcement provisions. Permits TDLR commissioner to appoint presiding officer of orthotists and prosthetists advisory board.

HCR 65

Stop the Bleed Program

LL

Recognizing the Stop the Bleed Campaign. Program established nationally in 2012 in the aftermath of mass shooting at Sandy Hook Elementary School. The program teaches citizens bleeding control methods and provides kits that include tourniquets, dressings, and topical hemostatic agents to help bystanders offer assistance at the scene of a mass casualty or other similar incident.

Representative Trenton Ashby

No amendment to the NPA or direct implications for the BON. Nurses may be involved with public awareness training relating to the Stop the Bleed Campaign.

2/22/2017

SB 1

Budget Bill

MM

General Appropriations Bill

Senate Bill 1 (SB 1) provides the revenue and spending parameters for all state entities.

Senator Jane Nelson

No amendment to the NPA.

The Texas Board of Nursing (BON or Board) received increased funding of appropriated receipts to cover workshops, webinars, newsletter and jurisprudence examination ($771,074) and also received funding for nursing salaries ($354,860), partial legal costs ($100,000) and increased funding for the peer assistance program ($263,800).

9/1/2017

SB 8

Relating to certain prohibited abortions and the treatment and

Senator Charles

Schwertner

No amendment to the NPA or direct implications for the BON.

9/1/2017

30

Abortion Ban & Treatment/

Disposition of Human

Embryonic & Fetal Tissue

Remains

KS

disposition of a human fetus, human fetal tissue, and embryonic and fetal tissue remains; creating a civil cause of action; imposing a civil penalty; creating criminal offenses. A ban on “partial birth abortion” was enacted by the US Congress in 2003 and upheld by the US Supreme Court in 2007. This law allows Texas to enforce the ban in state law. Additionally, federal statutes outline it is ‘unlawful to knowingly acquire, receive, or otherwise transfer any human fetal tissue for valuable consideration if the transfer affects interstate commerce,’ and this law allows enforceability at the State level. Key provisions: prohibits dismemberment abortions; prohibition of donation of human fetal tissue acquired via elective abortion; creates a criminal offense for receipt of any payment made in exchange for human fetal tissue; prohibits solicitation or acceptance of tissue from fetuses gestated for research purposes; increases criminal penalties for buying/selling human fetal

Nurses in settings where abortions take place will need to be aware of these updates to the Family Code and the Health and Safety Code, as necessary, to comply with Board Rule 217.11(1)(A).

31

tissue; prohibits offering of incentives to undergo abortions or donation of fetal tissue; clarifies facilities are only permitted to donate fetal tissue from non-elective abortion to accredited public higher education institutes for academic research purposes; development of a grant program using private donations to provide financial assistance for the costs associated with disposing of embryonic and fetal tissue remains; creates a reporting requirement for eligible entities to inform the Department of State Health Services (DSHS) about instances of fetal tissue donation; requires records maintenance for abortion providers for a period of seven years after consent was given, or if the woman is under 18 years of age, the later of the woman’s 23rd birthday or seven years after consent given; requires embryonic and fetal tissue remains be disposed of by interment, cremation, incineration followed by interment or steam disinfection followed by interment; establishes burial or cremation assistance registry; imposes a

32

$1,000 per violation civil penalty.

SB 11

Creating a “Community Based Care

Model” Contracting

with Nonprofits

GV

Relating to the administration of services provided by the Department of Family and Protective Services, including foster care, child protective, and prevention and early intervention services. Transfers certain case management services from the Department of Family and Protective Services (DFPS) to a qualified single source continuum contractor (SSCC) that would provide community-based foster care within a contracted area.

Senator Charles Schwertner

No amendments to the NPA or direct implications for the BON. Nurses who provide health care services for children in DFPS custody will need to be aware of requirements for medical and mental health screenings when the child initially is taken into custody, trauma screenings at 90 day intervals, and early periodic screening, diagnosis and treatment checkups. Nurses who work with managed care organizations under STAR health will need to be aware of requirements for screenings and checkups.

9/1/2017

SB 22

Pathways in Technology

Early College High School

JH

Relating to the establishment of a Pathways in Technology Early College High School (P-TECH) program and to the repeal of the tech-prep program.

Senator Larry Taylor

No amendment to the NPA or direct implications for the BON. Creates a work-based education program that provides a course of study enabling a participating student to combine high school and postsecondary courses. Students will be allowed six years to receive a high school diploma and an associate degree, a two-year postsecondary certificate, or industry certification. The program includes work-based training through an internship, apprenticeship, or other job-training program. Graduates would have first priority in interviewing for jobs

9/1/2017

33

with business partners. Participating agencies to develop pathways: Texas Education Agency and Texas Higher Education Coordinating Board (THECB). Does not mention nursing.

SB 27

Mental Health: Veterans

DB

Relating to the mental health program for veterans Allows for the addition of licensed mental health professionals at the local mental health authorities (LMHAs) to provide clinical interventions for veterans and their families. Amends current law relating to the mental health program for veterans and to the authority to establish a trauma affected veterans’ clinical care and research center at The University of Texas Health Science Center at San Antonio.

Senator Donna Campbell

No amendments to the NPA or direct implications for the BON. Nurse providing care to veterans with mental health care needs will need to be aware of these resources.

9/1/2017

SB 74

Managed Care: Behavioral

Health Services

DB

Relating to the provision of certain behavioral health services to children, adolescents, and their families under a contract with a managed care organization. Streamlines credentialing requirements for providers seeking to offer targeted case

Senator Jane Nelson

No amendments to the NPA or direct implications for the BON. Nurses involved in these settings will need to know and comply with provisions related to their role.

6/9/2017

34

management and rehabilitative services to children, adolescents, and their families. Also, clarifies that a non- local mental health authority provider entity may contract with a managed care organization to provide targeted case management and rehabilitative services to children, adolescents, and their families. Addresses third party provision of behavioral health and addresses sharing and integration of coordination and information between the managed care organization and the third party.

SB 78

State Surplus

MM

Relating to the disposition of certain state surplus or salvage data processing equipment.

Senator Jane Nelson

No amendments to the NPA. Adds Court Appointed Special Advocates (CASA) to the list of state entities eligible to receive used computers from the State of Texas. These computers will be available as a resource at CASA foster and group homes.

9/1/2017

SB 132

State Agency Savings Incentive Program

Relating to the savings incentive program for state agencies.

Senator Brandon

Creighton

No amendments to the NPA. Amends Chapter 2108, Government Code, to remove the one percent cap on funds allowed to be retained by an agency under the state agency savings

9/1/2017

35

MM

incentive program and allows the agency to retain one-half of the savings, with the other half being returned to general revenue. The bill also establishes a tiered bonus structure for agency employees that contribute to agency savings. The bill prohibits a state agency from providing such a bonus to employees of the agency who serve in an upper management position. The bill requires an agency to pay off its general obligation bonds prior to issuing bonuses.

SB 255

Staff Training Purchasing/ Contracts

MM

Relating to training for governmental entities and vendors, including purchasing and contract management training.

Senator Judith Zaffirini

No amendments to the NPA. Amends Subchapter C of Chapter 656 of the Government Code, regarding training for state officers and employees. Requires state agencies that spend more than $5,000 per fiscal year for training of any individual employee to submit certain agency training information to the Legislative Budget Board. Requires the Comptroller of Public Accounts to develop and provide a purchasing and contract management training program to meet the needs of state agencies. Authorizes the Comptroller to assess a fee for training in an amount not to exceed the costs incurred to provide the training. Authorizes state agencies, in consultation with the Comptroller, to develop agency-specific purchasing and contract management training programs to be administered by the agency to the

9/1/2017

36

agency's employees instead of or as a supplement to training programs developed by the Comptroller under the bill's provisions. Requires state agency personnel directly involved in contract negotiations for the purchase of information resources technologies to complete the training developed by the Department of Information Resources.

SB 304

Sunset: Chiropractic

Board

JZ

Relating to the continuation and functions of the Texas Board of Chiropractic Examiners; authorizing a reduction in fees. The Texas Board of Chiropractic Examiners (TBCE) is continued for 12 years. Restrictions related to raising licensure fees are removed. Requires DPS and FBI criminal background checks. TCBE is required to develop a process for expert review of chiropractic practice. TBCE is required to review national practitioner database for discipline or legal action prior to issuing or renewing a license. TCBE rules may extend licensure period for two or more years. The definition of chiropractic practice is amended to include diagnosis. Makes complaints to TBCE confidential and requires TBCE to protect Complainant’s confidentiality to the extent

Senator Van Taylor

No amendments to the NPA and no direct implications for the BON. There are a number of RNs and APRNs who are also licensed as chiropractors in Texas. Requirements for criminal background checks for chiropractors appear consistent with those already completed by the BON. There could be a slight increase in the number of complaints received by nurses who are also licensed chiropractors. It is notable that the definition of chiropractic was amended to include diagnosis of patients. For APRNs who are also chiropractors, there may be some issues related to role confusion as APRNs may only formulate medical diagnoses under the delegated authority of a physician. Notifying a licensee of the name and address of the complainant if the complainant is an insurance agent, insurer, pharmaceutical company, or third party administrator may be added to the NPA in the future. This requirement would be a departure from

9/1/2017

37

possible, unless the Complainant is an insurance agent, insurer, pharmaceutical company, or third party administrator. Within 15 days of the date a complaint is filed, TBCE is required to notify a licensee of the name and address of the insurance agent, insurer, pharmaceutical company or third party administrator who filed the complaint

current practice regarding maintaining the confidentiality of all complaints.

SB 313

Sunset: Dental Board

JZ

Relating to the continuation and functions of the State Board of Dental Examiners; imposing fees. The Board of Dental Examiners (TSBDE) is continued for 12 years. The number of Board members is reduced from 15 to 11. TSBDE must periodically review a national practitioner database for adverse actions against licensees. Dental anesthesia site inspections are required, and standards for dental anesthesia must be developed. Requires dental review committees to be established and participate in informal settlement conferences. Reduces the number of dental assistant certifications and allows the

Senator Charles Schwertner

No amendments to the NPA or direct implications for the BON. Issues may arise for CRNAs who provide anesthesia and anesthesia-related services in dental settings. Notifying a licensee of the name and address of the complainant if the complainant is an insurance agent, insurer, pharmaceutical company, or third party administrator may be added to the NPA in the future. This requirement would be a departure from current practice regarding maintaining the confidentiality of all complaints. Additionally, requirements to hold an informal settlement conference within 180 days of the date an investigation commenced is a new requirement for the TSBDE.

Various effective dates. Majority of the bill is effective 9/1/2017.

38

TSBDE to approve instruction courses and exams. Within 15 days of the date a complaint is filed, TSBDE is required to notify a licensee of the name and address of the insurance agent, insurer, pharmaceutical company or third party administrator who filed the complaint. TSBDE may refuse to renew a license for a license holder who is in violation of a board order. Dentists and hygienists required to complete CE. Requires TSBDE to develop more specific outpatient anesthesia rules. Requires dentists to have specific permits for each level of anesthesia services. Establishes advisory committee on dental anesthesia. Grants authority to require mental health or physical evaluations for cause. Requires TSBDE to conduct informal conferences within 180 days of the date an investigation commenced and provide a 45-day notice to Respondents. Copies of expert reports must be provided to Respondents. All Board members serving on 9/1/2017 will have their terms expire on that date. New members to be appointed by the Governor by

39

12/1/2017.

SB 314

Sunset:

Optometry

Board

JZ

Relating to the continuation and

functions of the Texas

Optometry Board; authorizing a

reduction in fees.

Continues the Texas Optometry

Board for 12 years. Permits the

board or an agent of the board

to request an individual submit

to mental or physical

examination by a physician or

other health care professional.

Guidelines must be adopted to

determine when such

examinations will be required.

Requires fingerprint criminal

background checks for

issuance of a new or renewed

license. Requires identity of

complainants to be protected as

Senator Charles

Schwertner No amendments to the NPA or direct

implications for the BON.

Requiring the optometry board to notify

a respondent within 15 days of receipt of

the complaint if the complainant is an

insurance agent, insurer,

pharmaceutical company or third party

administrator is a deviation from current

regulatory policy that bears watching.

9/1/2017

40

confidential unless the

complainant is an insurance

agent, insurer, pharmaceutical

company or third-party

administrator. If the complainant

is an insurance agent, insurer,

pharmaceutical company or

third-party administrator, the

board must notify the license

holder within 15 days after the

complaint is filed. Removes

requirements for applicants to

be of good moral character. The

board is required to review at

least one national practitioner

database prior to issuing or

renewing a license.

SB 315

Pain Clinic Regulation by Texas Medical

Board/ Guidelines for Certain Opioid

Prescribing

JZ

Relating to the enforcement of subpoenas, the regulation of pain management clinics, and the adoption of guidelines for prescribing certain opioids by the Texas Medical Board. Allows the Texas Medical Board (TMB) to inspect pain management facilities or clinics that are not certified to determine whether they were required be certified by the TMB as required by statute. Authorizes a process for the TMB to sue to enforce a subpoena in district court in

Senator Juan “Chuy” Hinojosa

No amendments to the NPA. Inspection of clinics that are not registered pain management facilities or clinics may result in an increased number of complaints to the BON if APRNs are found to be owners or operators of those clinics or appear to be in violation based on TMB observations. Nurses who practice in these settings will have to comply with subpoenas issued by the TMB for these purposes. Monitoring the TMB’s development of guidelines for prescription of opioid agonists is important as APRNs are now permitted by federal law to prescribe buprenorphine (suboxone) if they meet

9/1/2017

41

situations in which a person fails to comply with the subpoena. Includes a legislative finding that deaths resulting from the use of opioids or other controlled substances constitutes a public health crisis. Defines inappropriate prescribing to include nontherapeutic prescribing. Requires TMB to adopt guidelines for prescription of opioid antagonists. Of note, as passed, this legislation did not include continuation of the TMB as a state agency.

criteria set forth in federal law.

SB 317

Sunset: Physical and Occupational

Therapy

JZ

Relating to the continuation and functions of the Executive Council of Physical Therapy and Occupational Therapy Examiners, the Texas Board of Physical Therapy Examiners, and the Texas Board of Occupational Therapy Examiners; authorizing a fee. Continues the Board of Physical Therapy (PT) Examiners, Board of Occupational Therapy (OT) Examiners, and Executive Council of Physical Therapy and Occupational Therapy Examiners for 12 years. Eliminates the need for PT and OT facilities to register with their respective boards. Requires the

Senator Robert Nichols

No amendments to the NPA or direct implications for the BON. The requirement for the agency to develop a process to expunge certain types of disciplinary action bears some similarities to the requirement in the BON’s sunset bill that provides for removal of a nurse’s name from the BON website after five years for certain types of discipline. Differences between the NLC, eNLC, and the PT compact are notable as discussed under HB 2765.

9/1/2017

42

Board to develop a process to expunge records of disciplinary action taken against licensees who practiced in an unregistered facility. Requires fingerprint background checks for license holders. Includes provisions for licensure by endorsement for applicants from states with licensure standards substantially equivalent to Texas. Requires recognition of a national testing entity to administer the licensing exams. Requires the Board to adopt a schedule of sanctions for disciplinary purposes. Requires the development of policies that clearly delineate the responsibilities of the Council and each of the respective boards with regard to policymaking. Adopts the PT Compact (see discussion of HB 2765 for details of this compact).

SB 319

Sunset: Veterinary

Board

JZ

Relating to the continuation and functions of the State Board of Veterinary Medical Examiners; authorizing a reduction in fees; providing penalties. Continues the State Board of Veterinary Medical Examiners (BVME) until September 1, 2021. The BVME will undergo a

Senator Kirk Watson

No amendments to the NPA or direct implications for the BON.

It is notable that the BVME will now have access to the prescription monitoring program. It is also notable that the agency was only continued for four years rather than the usual 12 years.

9/1/2017

43

special purpose review for the 87th Legislature. Changes the composition of the board to include fewer veterinarians and add a veterinary tech. Allows licenses to be issued for one or two years, and requires the BVME to prorate licensure fees when changing the licensing period. Requires fingerprint criminal background checks for licensure. Prohibits disciplinary cases needing review by a veterinarian from being reviewed by BVME Board members. Provides for confidentiality of complaints. Requires development of sanction policies for disciplinary purposes. Allows the BVME to access the prescription monitoring program. Provides for onsite inspections for evaluation of practices related to controlled substances in a veterinary practice.

SB 507

Mediated settlement and balance billing

DB/JZ

Relating to mediation of the settlement of certain out-of-network health benefit claims involving balance billing. Extends mediated settlement option for out of network health benefit claims for enrollees receiving balance billing claims from facility-based providers or

Senator Kelly Hancock

Does not amend the NPA.

BON will have to evaluate the need for rules and data collection under this new language. The Texas Medical Board is named specifically as having to comply with these requirements as this provision has previously been in place for physicians. It is presumed other regulatory agencies includes the BON

9/1/2017

44

emergency care providers for claims greater than $500. The provider must be practicing in a preferred provider facility. Provider or the provider’s representative must participate in the mediation if such is requested by the patient. Except in case of emergency, a patient may request information and the provider must advise the patient if the provider does not have a contract with the patient’s health plan, disclose projected costs for which the patient may be responsible, and the circumstances under which the patient is responsible. Bills sent to patients by a facility-based or emergency care provider must include information regarding the mediation process if the claim is eligible for mediation. Mediator fees are split evenly and paid by the insurer and the provider. Patients not satisfied with the result of mediated agreements may file a complaint for improper billing with the appropriate regulatory agency. Mediators of an unsuccessful mediation are required to report the outcome of the mediation to the regulatory agency. Requires any appropriate regulatory

for care provided by APRNs in these settings. APRNs will need to be aware of this new provision if they engage in balance billing practices for out of network patients.

45

agency to adopt rules as necessary to implement their respective powers and duties under this chapter. This includes rules regulating the investigation and review of a complaint related to settlement of an out of network health benefit claim. Rules must give priority to allegations of delayed health or medical care and ensure that enrollees are aware of dispute mediation process. Appropriate regulatory agencies must maintain information on each complaint filed that concerns a claim or mediation and related to a claim that is the basis of an enrolled complaint, including the types of services that give rise to the dispute and the type and specialty of the provider who provided the services, the county or metropolitan area where the service was provided, whether the service was for emergency care, and anything else required by regulatory agency rule. Applies only to claims for services provided on or after January 1, 2018.

46

SB 532

IT Purchasing

BR

Relating to reports on and purchase of information technology by state agencies.

Senator Jane Nelson

No amendments to the NPA. Requires each agency to turn in budgeting items and plans in relation to cybersecurity functions to DIR and LBB by November 15 of each even numbered year.

9/1/2017

SB 533

IT Contracting

BR

Relating to state agency contracting.

Senator Jane Nelson

No amendments to the NPA. Requires that each agency that has major projects that are over $50K go through DIR for approval and governing. Agency will be required to use a bid posting system requiring additional time for responses.

9/1/2017

SB 564

IT Security Practices

BR

Relating to the applicability of open meetings requirements to certain meetings of a governing body relating to information technology security practices.

Senator Donna Campbell

No amendments to the NPA. Amends the code to put the requirements for network security during open meetings on the agency instead of on DIR.

9/1/2017

SB 579

Epinephrine Auto-Injectors Use on Private

School Campuses

SL

Relating to the use of epinephrine auto-injectors on private school campuses and at or in transit to or from off-campus school events. Amends the Education Code to make statutory provisions relating to the use, maintenance, administration, & disposal of epinephrine auto-injectors on the campus of

Senator Van Taylor

No amendments to the NPA or direct implications for the BON. May be of interest to school nurses at private school campuses.

5/22/17

47

a public school district or an open-enrollment charter school and at or in transit to or from off-campus school events applicable to a private school.

SB 584

Prescribing

Opioid

Antagonists

JZ

Relating to guidelines for prescribing opioid antagonists. Requires the Texas Medical Board (TMB) to develop guidelines for prescription of opioid antagonists that address: prescribing an opioid antagonist to a patient to whom opioids have been prescribed and identifying patients at risk for opioid-related drug overdose and prescribing the drug to that person or to a person who is in a position to administer the drug to that patient. TMB is required to consult the Pharmacy Board and also consult materials published by the Substance Abuse and Mental Health Services Administration. Certain protections are provided for physician prescribers who prescribe or fail to prescribe an opioid antagonist and from outcomes associated with administration of the opioid antagonist.

Senator Royce

West No amendments to the NPA or direct

implications for BON.

It will be important to follow the

development of guidelines for

prescription of opioid antagonists as

APRNs may be asked to prescribe

these as well. It is notable that

protections are only extended to

physician prescribers.

9/1/2017

SB 589

Licensure for

Relating to the licensing and regulation of behavior analysts and assistant behavior analysts;

Senator Eddie Lucio

No amendments to the NPA or direct implications for the BON.

9/1/2017

48

Behavior Analysts and

Assistant Behavior Analysts

JZ

requiring an occupational license; imposing fees. Beginning 9/1/2018, behavior analysts and assistant behavior analysts will be required to be licensed. Texas Department of Licensing and Regulation (TDLR) will administer the licensure program. Establishes a behavior analyst advisory board to advise TDLR on issues related to behavior analyst licensing. TDLR may only adopt rules regarding behavior analysis scope of practice or health-related standards of care that are proposed by the program advisory board. Defines the practice of applied behavior analysis.

Nurses who work in behavioral health settings or with individuals with behavioral health issues need to be aware of the new requirements.

SB 654

Advanced

Practice

Registered

Nurses as a

primary care or

network

provider

KB

Relating to the participation of

an advanced practice registered

nurse (APRN) as a primary care

or network provider for certain

governmental and other health

benefit plans.

Senator Kel

Seliger No amendments to the NPA or direct

implications for the BON.

Amends Government Code, Health and

Safety Code, and Human Resources

code to clarify that an APRN may be

included as a network primary care

provider for a managed care

organization that contracts with the

Health and Human Services

Commission (HHSC) regardless of

whether or not the APRN’s supervising

physician is a network provider. The

networks affected are the Medicaid

9/1/2017

49

managed care and the Children’s Health

Insurance Program.

SB 674

Expedited licensing

process for psychiatrist

JZ

Relating to licensing for certain health professions, including an expedited process for certain physicians specializing in psychiatry; authorizing a fee. Requires the Texas Medical Board (TMB) to create an expedited licensing process for physicians who hold unrestricted licensure to practice medicine in another state, are board certified in psychiatry by the American Board of Psychiatry and Neurology or the American Osteopathic Board of Neurology and Psychiatry and meet all other requirements for medical licensure. TMB may establish a fee for the expedited licensure process. The process must be implemented by January 1, 2018, and the provisions of the bill will expire on January 1, 2022. Clarifies that limitations on the number of attempts to pass the medical licensure exam do not apply to the Texas medical jurisprudence exam. Permits TMB to refuse to renew a license if the license holder is in violation of a board order.

Senator Charles Schwertner

No amendments to the NPA or direct implications for BON. Additional physicians who specialize in psychiatry may help meet the demand for services. Registered nurses are already required to register with the BON if performing radiologic procedures.

9/1/02017

50

Requires individuals who perform radiologic procedures under the delegation of a dentist to register with the dental board unless that individual is a registered nurse.

SB 679

Business

partnership for

Chiropractor

JZ

Relating to the authority of chiropractors to form certain business entities with certain other professions. Allows chiropractors to form jointly owned businesses with licensed medical doctors, doctors of osteopathy, or podiatrists. The authority of chiropractors would be limited by the scope of their practice.

Senator Kelly

Hancock No amendment to the NPA or direct

implications for the BON.

It is important to note that there are

some FNPs in the state of Texas who

are also licensed chiropractors and may

result in additional questions regarding

business practices.

6/1/2017

SB 680

Step Therapy Protocols/

Health Benefit Plans

DB

Relating to step therapy protocols required by a health benefit plan in connection with prescription drug coverage. Step therapy protocols require an enrolled patient to use a prescription drug or sequence of prescription drugs other than the drug recommended by the patient’s provider before the health benefit plan provides coverage for the recommended drug. Evidence based protocols must be developed by a panel of experts, and a process for exception requests must be developed by the carrier.

Senator Kelly Hancock

No amendments to the NPA or direct implications for the BON. APRN prescribers need to be aware of the new requirements and provisions for appeal when providing care for their patients.

9/1/2017

51

Carriers must grant the exception if certain criteria are demonstrated. Denials of exceptions qualify for expedited appeal. Timelines for reviews of requests for exceptions are established. Applies to benefit plans issued or renewed on or after January 1, 2018.

SB 705

Board Appointee

Public Information

MM

Relating to an exception from disclosure under the public information law for certain personal information of an applicant for an appointment by the governor.

Senator Brian Birdwell

No amendments to the NPA. Requires that the following information obtained by the governor or senate in connection with an applicant for an appointment by the governor is excepted from the requirements of public information requests:

the applicant's home address; the applicant's home telephone

number; the applicant's social security

number; and information regarding a member

of the applicant's family.

5/29/2017

SB 706

CCG Agency Purchasing

MM/KL

Relating to the abolishment of the State Council on Competitive Government and the transfer of its functions to the comptroller.

Senator Brian Birdwell

No amendments to the NPA or direct implications for the BON. Abolishes the State Council on Competitive Government and the transfer of its functions to the comptroller. Agency to revert to using a bid posting system requiring additional time for responses.

9/1/2017

SB 802

Course

Relating to a study and report regarding best practices in the transfer of course credit

Senator Kel Seliger

No amendments to the NPA. Requires THECB to conduct a study to

5/29/2017

52

Transferal Between Public

Institutions of Higher

Education

JH

between public institutions of higher education.

identify best practices to ensure that courses transferred to an institution of higher education (including courses for dual credit) apply toward a degree.

SB 919

Authority to

Sign a Death

Certificate in

Limited

Situations

KB

Relating to the authority of an

advanced practice registered

nurse or physician assistant to

sign a death certificate in limited

situations.

Senator Jose

Rodriguez No amendments to the NPA or direct

implications for the BON.

Amends Health and Safety Code to

allow advanced practice registered

nurses (APRNs) and physician

assistants to sign death certificates in

limited situations. Clarifies that APRNs

are among those in current statute who

are authorized to determine and

pronounce death in certain situations

with liability protections from civil

damages and criminal prosecution for

determination of death in accordance

with Health and Safety Code.

6/1/2017

SB 922

Telehealth

DB

Relating to the reimbursement of certain providers under the Medicaid program for the provision of telehealth services. Medicaid reimbursement provided to a public school district or open enrollment charter school for some telehealth services provided through the district or charter school by certain providers

Senator Dawn Buckingham

No amendments to the NPA or implications for the BON. Nurses who practice in school settings and who provide telehealth services need to be aware.

9/1/2017

53

under Medicaid with consent prior to the service.

SB 1091

Dual Credit Limitations

JH

Relating to limitations on courses that may be offered for dual credit by school districts and public institutions of higher education.

Senator Kel Seliger

No amendments to the NPA. Provides specific criteria for the awarding of college credit for dual credit courses offered in high school. Does not specifically mention nursing but important since there is growing interest in dual credit courses in nursing.

6/12/2017

SB 1148

Physician

Certification

for Licensure

JZ

Relating to maintenance of certification by a physician or an applicant for a license to practice medicine in this state. Prohibits certain hospitals, health facilities, and managed care plans from differentiating between physicians based on whether the physician maintained board certification through periodic recertification. Limited exceptions apply. The Texas Medical Board (TMB) is prohibited from requiring certification maintenance as a condition for physician licensure. TMB is required to study whether to recognize an entity to provide maintenance of certification for Texas physicians in consultation with state agencies and groups chosen by the TMB. If the study finds the TMB should recognize

Senator Dawn

Buckingham No amendment to the NPA or direct

implications for the BON.

Requiring the TMB to study certification

for physicians and prohibiting TMB from

requiring certification for physician

licensure may have implications for

other regulatory agencies in the future.

1/1/2018

54

an entity to provide certification maintenance, TMB is authorized to develop and implement a program to recognize such entities.

SB 1367

Epinephrine Auto-Injectors

on Higher Education Campuses

SL

Relating to policies and training regarding the use of epinephrine auto-injectors by public institutions of higher education; providing immunity. Anaphylactic shock can cause life-threatening symptoms, which make it vital to respond quickly. The quickest and most effective way is with epinephrine auto injectors. The 84th Texas Legislature authorized school districts and charter schools to implement policies regarding the use of auto-injectors for anaphylaxis. SB 1367 authorizes institutions of higher education to develop and implement policies to use epinephrine auto-injectors on campus and at campus-related events. The auto-injectors will be prescribed to the school and training will be required for personnel to learn to correctly administer auto-injectors.

Senator Jose Menendez

No amendments to the NPA or direct implications for the BON. May be of interest to nurses working on college campuses. SB 1367 grants immunity from civil or criminal liability for the use of epinephrine auto-injectors by university personnel.

9/1/2017

SB 1440

Open Meetings

Relating to the attendance by a quorum of a governmental body at certain candidate

Senator Donna Campbell

No amendments to the NPA. The requirements of the Open Meetings Act do not apply to the gathering of a

9/1/2017

55

JA events under the open meetings law.

quorum of the Board at a candidate forum, appearance, or debate to inform the electorate if formal action is not taken and any discussion of public business incidental to the forum, appearance, or debate.

SB 1446

Contested Cases

DJ/JA

Relating to contested cases conducted under the Administrative Procedures Act

Senator Craig Estes

No amendments to the NPA. A notice of hearing may include an attachment that incorporates by reference the factual matters asserted in the complaint or petition. An agency’s failure to comply with the due process requirements of the Administrative Procedures Act will be deemed to constitute substantial prejudice to the rights of the license holder unless the license holder waived the opportunity to show compliance with the requirements of law for the retention of the license. The Board may provide its decision(s) or order(s) to the license holder by personal service, email, or fax, or by another method specified in the Board’s rules. A request for extension of time to file a motion for rehearing must show that the license holder exercised due diligence by keeping the Board apprised of the license holder’s address and that the license holder did not do anything to impede receipt of notice of the Board’s signed order or decision.

9/1/2017

SB 1533

Mental Health: First Aid

Relating to mental health first aid training for university employees

Senator Jose Rodriguez

No amendments to the NPA or direct implications for the BON. Mental health first aid training may be

5/19/2017

56

Training

DB

Provides grants for voluntary, no-cost approved mental health first aid training to university employees, school district employees, and school resource officers.

provided to nurses who work in specified settings.

SB 1565

Medical and Dental

Services in Certain State

Facilities

JZ

Relating to the procedure for ordering medical or dental services for certain persons admitted to or committed to care at certain state facilities. When residents of certain state facilities need medical or dental treatment and the consenter does not respond within the appropriate time frame or no one is available to consent, the superintendent may order: medical services on the advice and consent of three primary care providers at least two of whom are physicians licensed in Texas, and dental services based on the advice of two dentists and one physician. An APRN or PA may serve as the third primary care provider who advises regarding medical services.

Senator Lois Kolkhorst

No amendment to the NPA or direct implications for the BON. APRNs who practice in these settings need to be familiar with the additional process for obtaining consents for services in these settings.

9/1/2017

SB 1599

Maternal

Mortality

Reporting and

Investigation

Relating to maternal mortality reporting and investigation information. Requires the Department of State Health Services (DSHS)

Senator Borris

Miles No amendments to the NPA or direct

implications for the BON.

Nurse-midwives need to be aware of the

requirements

9/1/2017

57

JZ to post information on its website regarding protocol for pregnancy-related death investigations and reporting the death to the medical examiner or justice of the peace as applicable in the specific county. The information must include guidelines for: when comprehensive toxicology screening is required in pregnancy-related deaths, determining when pregnancy-related deaths should be reported to or investigated by the medical examiner or justice of the peace, and correct completion of a birth certificate for a pregnancy related death.

SB 1625

Sunset:

Physician

Assistant

Board

JZ

Relating to the Texas Physician Assistant Board and the licensing and regulation of physician assistants. Provides protections for physician assistants (PAs) who refuse to engage in acts or omissions that would violate their licensing rules or Act. Provides a process for medical peer review of the PA’s conduct. Eliminates the requirement for the PA licensure applicant to be of good moral character. Creates

Senator Carlos

Uresti No amendment to the NPA or direct

implications for the BON.

Many changes included in this bill are

similar to those included in the BON’s

Sunset bill. It is notable that there are

changes to physician delegation of

prescriptive authority to PAs that did not

include APRNs. This may lead to

confusion in practice sites in which both

APRNs and PAs are practicing using a

prescriptive authority agreement.

9/1/2017

58

a requirement for fingerprint background checks. Grants authority for PA Board to hold executive sessions as permitted. Requires a PA to be a participant on the committee for informal settlement conferences. Changes the face to face meetings for prescriptive authority to periodic meetings between the physician and PA. Does not modify the requirement for APRNs. The Board may refuse to renew a license for a PA who has violated a board order.

SB 1633

Telehealth and Tele-pharmacy

SC

Relating to the provision of pharmacy services through a tele-pharmacy system; establishing a remote dispensing site license. In small communities, there are no local pharmacies because the demand for filling prescriptions in those areas is too low to support a pharmacy staffed by a pharmacist. S.B. 1633 seeks to address this issue by providing for remote dispensing sites for prescription drugs and devices. S.B. 1633 amends the Occupations Code to expand the locations at which a tele pharmacy system may be located to include a remote

Senator Charles Perry

No amendments to the NPA or direct implications for the BON. Nurses working in small communities may wish to be aware of these provisions. Rulemaking authority is expressly granted to the Texas State Board of Pharmacy in SECTION 1 of this bill. Occupations Code Sections n 562.110 Subsections (a), (b), (d), (e), and (f) are amended and adding Subsections (g), (h), and (i).

9/1/2017

The Texas State Board of

Pharmacy shall adopt rules under Section 562.110,

Occupations Code, as

amended by this Act, not later than January 1, 2018.

59

dispensing site, defined by the bill as a location licensed as a tele pharmacy that is authorized by a Class A provider pharmacy through a tele pharmacy system to store and dispense prescription drugs and devices, including dangerous drugs and controlled substances. The bill prohibits a tele pharmacy system located at a remote dispensing site from dispensing a controlled substance listed in Schedule II as established by the commissioner of state health services under the Texas Controlled Substances Act and from being located within 25 miles by road of a Class A pharmacy.

SB 1680

Border Health Task Force

SL

Relating to a task force of border health officials. Because of the proximity along the border to Mexico, public health and health care needs are more challenging than other Texas regions. There is a higher risk of communicable diseases such as tuberculosis, Zika, and the Chikungunya virus. A specialized task force focused on border issues to assist the Texas Department of State Health Services will be allowed to continue.

Senator Eddie Lucio

No amendments to the NPA or direct implications for the BON. May be of interest to public health nurses working in the border region.

9/1/2017

60

SB 1781

Financial Stability:

Institutions of Higher

Education

JH

Relating to the regulation of certain degree-granting secondary educational institutions by the Texas Higher Education Coordinating Board.

Senator Royce West

No amendments to the NPA or direct implications for the BON. This bill will protect students’ financial situation by assuring the for-profit institution has financial stability. The analysis indicates that “The bill authorizes the coordinating board by rule to require an exempt institution or person, or an institution operating or seeking to operate under a certificate of authority, to ensure that the financial resources and financial stability of the institution or person, as applicable, are adequate to provide education of a good quality and to fulfill the institution's or person's commitments to its enrolled students and to require the institution or person to provide to the coordinating board documentation of the institution's or person's compliance with those requirements.” This will help protect nursing students enrolled in for-profit programs if the program fails. It will not require changes in BON rules.

9/1/2017

SB 1813

Admission Forms:

Institutions of Higher

Education

JH

Relating to common admission application forms for institutions of higher education.

Senator Dawn Buckingham

No amendments to the NPA or direct implications for the BON. The adoption of a common admission form will be cost-effective for nursing schools.

6/15/2017

61

SB 1910

Agency IT Security

Online Apps

MM/BR

Relating to state agency information security plans, information technology employees, and online and mobile applications.

Senator Judith Zaffirini

No amendments to the NPA. Requires each state agency have on staff a chief information security officer or information security officer to ensure that within the agency's organizational structure the officer is independent from and not subordinate to the agency's information technology operations. Requires that before launching a new website or application that the agency has a security plan in place and DIR tests before deployment.

9/1/2017

Sunset Bills Not Passed During the Legislative Session

Bill Number

Agency Under Review Last Action

HB 3040 Texas Medical Board House Committee report sent to Calendars on 5/6/2017

HB 2898 Texas State Board of Social Worker Examiners, Texas State Board of Examiners of Marriage and Family Therapists, Texas State Board of Examiners of Psychologists, and Texas State Board of Examiners of Professional Counselors

Placed on House General State Calendar on 5/11/2017

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