US Laws, Codes, Statutes & Cases

OCCUPATIONS CODE

SUBTITLE E. REGULATION OF NURSING

CHAPTER 301. NURSES

SUBCHAPTER A. GENERAL PROVISIONS


	§ 301.001. SHORT TITLE.  This chapter may be cited as the 
Nursing Practice Act.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.002. DEFINITIONS.  In this chapter:                                   
		(1)  "Board" means the Board of Nurse Examiners.                              
		(2)  "Professional nursing" means the performance of an 
act that requires substantial specialized judgment and skill, the 
proper performance of which is based on knowledge and application 
of the principles of biological, physical, and social science as 
acquired by a completed course in an approved school of 
professional nursing.  The term does not include acts of medical 
diagnosis or the prescription of therapeutic or corrective 
measures.  Professional nursing involves:
			(A)  the observation, assessment, intervention, 
evaluation, rehabilitation, care and counsel, or health teachings 
of a person who is ill, injured, infirm, or experiencing a change in 
normal health processes;
			(B)  the maintenance of health or prevention of 
illness;                   
			(C)  the administration of a medication or 
treatment as ordered by a physician, podiatrist, or dentist;
			(D)  the supervision or teaching of nursing;                                 
			(E)  the administration, supervision, and 
evaluation of nursing practices, policies, and procedures;
			(F)  the requesting, receiving, signing for, and 
distribution of prescription drug samples to patients at sites in 
which a registered nurse is authorized to sign prescription drug 
orders as provided by Subchapter B, Chapter 157;
			(G)  the performance of an act delegated by a 
physician under Section 157. 052, 157.053, 157.054, 157.0541, 
157.0542, 157.058, or 157.059;  and
			(H)  the development of the nursing care plan.                               
		(3)  "Nurse" means a person required to be licensed 
under this chapter to engage in professional or vocational nursing.
		(4)  "Nursing" means professional or vocational 
nursing.                    
		(5)  "Vocational nursing" means a directed scope of 
nursing practice, including the performance of an act that requires 
specialized judgment and skill, the proper performance of which is 
based on knowledge and application of the principles of biological, 
physical, and social science as acquired by a completed course in an 
approved school of vocational nursing.  The term does not include 
acts of medical diagnosis or the prescription of therapeutic or 
corrective measures.  Vocational nursing involves:
			(A)  collecting data and performing focused 
nursing assessments of the health status of an individual;
			(B)  participating in the planning of the nursing 
care needs of an individual;
			(C)  participating in the development and 
modification of the nursing care plan;
			(D)  participating in health teaching and 
counseling to promote, attain, and maintain the optimum health 
level of an individual;
			(E)  assisting in the evaluation of an 
individual's response to a nursing intervention and the 
identification of an individual's needs;  and
			(F)  engaging in other acts that require education 
and training, as prescribed by board rules and policies, 
commensurate with the nurse's experience, continuing education, 
and demonstrated competency.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2001, 77th Leg., ch. 112, § 4, eff. May 11, 2001;  Acts 
2003, 78th Leg., ch. 553, § 1.002, eff. Sept. 1, 2003;  Acts 
2005, 79th Leg., ch. 113, § 3, eff. May 20, 2005.


	§ 301.003. APPLICATION OF SUNSET ACT.  The Board of Nurse 
Examiners is subject to Chapter 325, Government Code (Texas Sunset 
Act). Unless continued in existence as provided by that chapter, 
the board is abolished September 1, 2007.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.003, eff. Sept. 1, 2003.


	§ 301.004. APPLICATION OF CHAPTER.  (a) This chapter does 
not apply to:   
		(1)  gratuitous nursing care of the sick that is 
provided by a friend;      
		(2)  nursing care provided during a disaster under the 
state emergency management plan adopted under Section 418.042, 
Government Code, if the person providing the care does not hold the 
person out as a nurse unless the person is licensed in another 
state;
		(3)  nursing care in which treatment is solely by 
prayer or spiritual means;
		(4)  an act performed by a person under the delegated 
authority of a person licensed by the Texas State Board of Medical 
Examiners;
		(5)  an act performed by a person licensed by another 
state agency if the act is authorized by the statute under which the 
person is licensed;
		(6)  the practice of nursing that is incidental to a 
program of study by a student enrolled in a board-approved nursing 
education program leading to an initial license as a nurse;  or
		(7)  the practice of nursing by a person licensed in 
another state who is in this state on a nonroutine basis for a 
period not to exceed 72 hours to:
			(A)  provide care to a patient being transported 
into, out of, or through this state;
			(B)  provide nursing consulting services;  or                                
			(C)  attend or present a continuing nursing 
education program.             
	(b)  This chapter does not authorize the practice of medicine 
as defined by Chapter 151.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.004, eff. Sept. 1, 2003.

SUBCHAPTER B. BOARD OF NURSE EXAMINERS


	§ 301.051. BOARD MEMBERSHIP.  (a) The Board of Nurse 
Examiners consists of 13 members appointed by the governor with the 
advice and consent of the senate as follows:
		(1)  six nurse members, including:                                            
			(A)  one advanced practice nurse;                                            
			(B)  two registered nurses who are not advanced 
practice nurses or members of a nurse faculty;  and
			(C)  three vocational nurses who are not members 
of a nurse faculty;       
		(2)  three members who are nurse faculty members of 
schools of nursing:     
			(A)  one of whom is a nurse faculty member of a 
school of nursing offering a baccalaureate degree program in 
preparing registered nurses;
			(B)  one of whom is a nurse faculty member of a 
school of nursing offering an associate degree program in preparing 
registered nurses;  and
			(C)  one of whom is a nurse faculty member of a 
school of nursing at an institution of higher education preparing 
vocational nurses;  and
		(3)  four members who represent the public.                                   
	(b)  Appointments to the board shall be made without regard 
to the race, color, disability, sex, religion, age, or national 
origin of the appointee.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.006, eff. Sept. 1, 2003.


	§ 301.052. MEMBER ELIGIBILITY.  (a) A person is not 
eligible for appointment as a registered nurse or vocational nurse 
member of the board unless the person has practiced nursing in the 
role for which the member was appointed for at least three of the 
five years preceding the date of appointment.
	(b)  A person is not eligible for appointment as a public 
member of the board if the person or the person's spouse:
		(1)  is licensed by an occupational regulatory agency 
in the field of health care;
		(2)  is employed by or participates in the management 
of a business entity or other organization that:
			(A)  provides health care services;  or                                      
			(B)  sells, manufactures, or distributes health 
care supplies or equipment;
		(3)  owns or controls, directly or indirectly, more 
than a 10 percent interest in a business entity or other 
organization that:
			(A)  provides health care services;  or                                      
			(B)  sells, manufactures, or distributes health 
care supplies or equipment;  or
		(4)  uses or receives a substantial amount of tangible 
goods, services, or funds from the board, other than compensation 
or reimbursement authorized by law for board membership, 
attendance, or expenses.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.007, eff. Sept. 1, 2003.


	§ 301.053. MEMBERSHIP AND EMPLOYEE RESTRICTIONS.  (a) In 
this section, "Texas trade association" means a nonprofit, 
cooperative, and voluntarily joined association of business or 
professional competitors in this state designed to assist its 
members and its industry or profession in dealing with mutual 
business or professional problems and in promoting their common 
interest.
	(b)  An officer, employee, or paid consultant of a Texas 
trade association in the field of health care may not be a member of 
the board and may not be an employee of the board who is exempt from 
the state's position classification plan or is compensated at or 
above the amount prescribed by the General Appropriations Act for 
step 1, salary group A17, of the position classification salary 
schedule.
	(c)  A person who is the spouse of an officer, manager, or 
paid consultant of a Texas trade association in the field of health 
care may not be a member of the board and may not be an employee of 
the board who is exempt from the state's position classification 
plan or is compensated at or above the amount prescribed by the 
General Appropriations Act for step 1, salary group A17, of the 
position classification salary schedule.
	(d)  A person may not serve as a board member or act as the 
general counsel to the board if the person is required to register 
as a lobbyist under Chapter 305, Government Code, because of the 
person's activities for compensation on behalf of a profession 
related to the board's operation.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.054. TERMS.  Members of the board serve staggered 
six-year terms, with the terms of as near to one-third of the 
members as possible expiring on January 31 of each odd-numbered 
year.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.008, eff. Sept. 1, 2003.


	§ 301.055. GROUNDS FOR REMOVAL.  (a) It is a ground for 
removal from the board that a member:
		(1)  does not have at the time of appointment the 
qualifications required by Section 301.051(a);
		(2)  does not maintain during service on the board the 
qualifications required by Section 301.051(a);
		(3)  violates a prohibition established by Section 
301.053;                 
		(4)  cannot, because of illness or disability, 
discharge the member's duties for a substantial part of the member's 
term;  or
		(5)  is absent from more than half of the regularly 
scheduled board meetings that the member is eligible to attend 
during a calendar year unless the absence is excused by majority 
vote of the board.
	(b)  The validity of an action of the board is not affected by 
the fact that the action is taken when a ground for removal of a 
board member exists.
	(c)  If the executive director has knowledge that a potential 
ground for removal exists, the executive director shall notify the 
presiding officer of the board of the potential ground.  The 
presiding officer shall then notify the governor that a potential 
ground for removal exists.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.056. PER DIEM;  REIMBURSEMENT.  (a) Each board 
member is entitled to receive a per diem as set by the General 
Appropriations Act for each day the member engages in the business 
of the board.
	(b)  A board member is not entitled to reimbursement for 
travel expenses, including expenses for meals and lodging, other 
than transportation expenses.  A member is entitled to 
reimbursement for transportation expenses as provided by the 
General Appropriations Act.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.057. OFFICERS.  (a) The governor shall designate a 
member of the board as presiding officer to serve in that capacity 
at the pleasure of the governor.
	(b)  The board shall elect other officers from its members.                    

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.058. MEETINGS.  The presiding officer shall call a 
special board meeting on the written request of at least two board 
members.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.059. TRAINING.  (a) Before a board member may 
assume the member's duties and before the member may be confirmed by 
the senate, the member must complete at least one course of a 
training program established by the board under this section.
	(b)  The training program shall provide information to a 
participant regarding:
		(1)  this chapter;                                                            
		(2)  the programs operated by the board;                                      
		(3)  the role and functions of the board;                                     
		(4)  the rules of the board, with an emphasis on the 
rules that relate to disciplinary and investigatory authority;
		(5)  the current budget for the board;                                        
		(6)  the results of the most recent formal audit of the 
board;              
		(7)  the requirements of Chapters 551, 552, 2001, and 
2002, Government Code;
		(8)  the requirements of the conflict of interest laws 
and other laws relating to public officials;  and
		(9)  any applicable ethics policies adopted by the 
board or the Texas Ethics Commission.
	(c)  In developing the training program, the board shall 
consult with the governor's office, the attorney general's office, 
and the Texas Ethics Commission.
	(d)  If another state agency or entity is given the authority 
to establish the training requirements for board members, the board 
shall allow that training instead of developing its own program.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    

SUBCHAPTER C. EXECUTIVE DIRECTOR AND PERSONNEL


	§ 301.101. EXECUTIVE DIRECTOR.  (a) The board shall 
employ an executive director.  The executive director may not be a 
member of the board.
	(b)  Under the direction of the board, the executive director 
shall perform the duties required by this chapter or designated by 
the board.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.103. PUBLIC RECORDS;  REGISTRY.  (a) The executive 
director shall keep:
		(1)  a record of each meeting of the board;  and                              
		(2)  a registry of the name of each nurse registered 
under this chapter.    
	(b)  Information maintained under this section is open to 
public inspection at all times.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.104. PERSONNEL;  EMPLOYMENT PRACTICES.  The board 
shall employ persons as necessary to carry on the work of the board.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.105. DIVISION OF RESPONSIBILITIES.  (a) The board 
shall develop and implement policies that clearly define the 
respective responsibilities of the board and the staff of the 
board.
	(b)  The board shall determine the salaries and compensation 
to be paid to employees and persons retained by the board.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.106. QUALIFICATIONS AND STANDARDS OF CONDUCT 
INFORMATION.  The board shall provide, as often as necessary, to 
its members and employees information regarding their:
		(1)  qualifications for office or employment under this 
chapter;  and       
		(2)  responsibilities under applicable laws relating 
to standards of conduct for state officers or employees.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.107. CAREER LADDER PROGRAM;  PERFORMANCE 
EVALUATIONS.  (a) The executive director or the executive 
director's designee shall develop an intra-agency career ladder 
program.  The program must require intra-agency posting of all 
nonentry level positions concurrently with any public posting.
	(b)  The executive director or the executive director's 
designee shall develop a system of annual performance evaluations 
based on measurable job tasks.  All merit pay for board employees 
must be based on the system established under this subsection.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.108. EQUAL EMPLOYMENT OPPORTUNITY POLICY;  
REPORT.  (a) The executive director or the executive director's 
designee shall prepare and maintain a written policy statement to 
ensure implementation of an equal employment opportunity program 
under which all personnel transactions are made without regard to 
race, color, disability, sex, religion, age, or national origin.  
The policy statement must include:
		(1)  personnel policies, including policies relating 
to recruitment, evaluation, selection, application, training, and 
promotion of personnel that are in compliance with the requirements 
of Chapter 21, Labor Code;
		(2)  a comprehensive analysis of the board workforce 
that meets federal and state guidelines;
		(3)  procedures by which a determination can be made of 
significant underuse in the board workforce of all persons for whom 
federal or state guidelines encourage a more equitable balance;  
and
		(4)  reasonable methods to appropriately address those 
areas of underuse.   
	(b)  A policy statement prepared under Subsection (a) must:                    
		(1)  cover an annual period;                                                  
		(2)  be updated annually;                                                     
		(3)  be reviewed by the Commission on Human Rights for 
compliance with Subsection (a)(1);  and
		(4)  be filed with the governor.                                              
	(c)  The governor shall deliver a biennial report to the 
legislature based on the information received under Subsection (b).  
The report may be made separately or as part of other biennial 
reports to the legislature.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    

SUBCHAPTER D. GENERAL POWERS AND DUTIES OF BOARD


	§ 301.151. GENERAL RULEMAKING AUTHORITY.  The board may 
adopt and enforce rules consistent with this chapter and necessary 
to:
		(1)  perform its duties and conduct proceedings before 
the board;           
		(2)  regulate the practice of professional nursing and 
vocational nursing;  
		(3)  establish standards of professional conduct for 
license holders under this chapter;  and
		(4)  determine whether an act constitutes the practice 
of professional nursing or vocational nursing.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.009, eff. Sept. 1, 2003.


	§ 301.152. RULES REGARDING SPECIALIZED TRAINING.  (a) In 
this section, "advanced practice nurse" means a registered nurse 
approved by the board to practice as an advanced practice nurse on 
the basis of completion of an advanced educational program.  The 
term includes a nurse practitioner, nurse midwife, nurse 
anesthetist, and clinical nurse specialist.  The term is synonymous 
with "advanced nurse practitioner."
	(b)  The board shall adopt rules to:                                           
		(1)  establish:                                                               
			(A)  any specialized education or training, 
including pharmacology, that a registered nurse must have to carry 
out a prescription drug order under Section 157.052;  and
			(B)  a system for assigning an identification 
number to a registered nurse who provides the board with evidence of 
completing the specialized education and training requirement 
under Subdivision (1)(A);
		(2)  approve a registered nurse as an advanced practice 
nurse;  and         
		(3)  initially approve and biennially renew an advanced 
practice nurse's authority to carry out or sign a prescription drug 
order under Chapter 157.
	(c)  At a minimum, the rules adopted under Subsection (b)(3) 
must:           
		(1)  require completion of pharmacology and related 
pathology education for initial approval;
		(2)  require continuing education in clinical 
pharmacology and related pathology in addition to any continuing 
education otherwise required under Section 301.303;  and
		(3)  provide for the issuance of a prescription 
authorization number to an advanced practice nurse approved under 
this section.
	(d)  The signature of an advanced practice nurse attesting to 
the provision of a legally authorized service by the advanced 
practice nurse satisfies any documentation requirement for that 
service established by a state agency.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2001, 77th Leg., ch. 1420, § 14.121(a), eff. Sept. 1, 
2001.


	§ 301.153. RULES REGARDING ADVERTISING AND COMPETITIVE 
BIDDING.  (a) The board may not adopt rules restricting advertising 
or competitive bidding by a person except to prohibit false, 
misleading, or deceptive practices by the person.
	(b)  The board may not include in its rules to prohibit 
false, misleading, or deceptive practices by a person regulated by 
the board a rule that:
		(1)  restricts the person's use of any medium for 
advertising;              
		(2)  restricts the person's personal appearance or use 
of the person's voice in an advertisement;
		(3)  relates to the size or duration of an 
advertisement by the person;  or 
		(4)  restricts the use of a trade name in advertising by 
the person.        

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.154. RULES REGARDING DELEGATION OF CERTAIN MEDICAL 
ACTS.  (a) The board may recommend to the Texas State Board of 
Medical Examiners the adoption of rules relating to the delegation 
by physicians of medical acts to registered nurses and vocational 
nurses licensed by the board.  In making a recommendation, the board 
may distinguish between nurses on the basis of special training and 
education.
	(b)  A recommendation under Subsection (a) shall be treated 
in the same manner as a petition for the adoption of a rule by an 
interested party under Chapter 2001, Government Code.
	(c)  The board in recommending a rule and the Texas State 
Board of Medical Examiners in acting on a recommended rule shall, to 
the extent allowable under state and federal statutes, rules, and 
regulations, act to enable the state to obtain its fair share of the 
federal funds available for the delivery of health care in this 
state.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.010, eff. Sept. 1, 2003.


	§ 301.155. FEES.  (a) The board by rule shall establish 
fees in amounts reasonable and necessary to cover the costs of 
administering this chapter.  The board may not set a fee that 
existed on September 1, 1993, in an amount less than the amount of 
that fee on that date.
	(b)  The board may adopt a fee in an amount necessary for a 
periodic newsletter to produce and disseminate to license holders 
the information required under Section 301.158.
	(c)  The board shall assess a $3 surcharge for a registered 
nurse and a $2 surcharge for a vocational nurse to the fee 
established by the board under Subsection (a) for a license holder 
to renew a license under this chapter.  The board may use nine cents 
of the registered nurse surcharge and six cents of the vocational 
nurse surcharge to cover the administrative costs of collecting and 
depositing the surcharge.  The board quarterly shall transmit the 
remainder of each surcharge to the Department of State Health 
Services to be used only to implement the nursing resource section 
under Section 105.002, Health and Safety Code.  The board is not 
required to collect the surcharge if the board determines the funds 
collected are not appropriated for the purpose of funding the 
nursing resource section.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 728, § 12, eff. June 20, 2003;  Acts 
2005, 79th Leg., ch. 113, § 4, eff. May 20, 2005.


	§ 301.156. GIFTS AND GRANTS.  The board may receive 
gifts, grants, or other funds or assets.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.157. PROGRAMS OF STUDY AND APPROVAL.  (a) The board 
shall prescribe three programs of study to prepare registered 
nurses as follows:
		(1)  a baccalaureate degree program that is conducted 
by an educational unit in nursing that is a part of a senior college 
or university and that leads to a baccalaureate degree in nursing;
		(2)  an associate degree program that is conducted by 
an educational unit in nursing within the structure of a college or 
a university and that leads to an associate degree in nursing;  and
		(3)  a diploma program that is conducted by a 
single-purpose school, usually under the control of a hospital, and 
that leads to a diploma in nursing.
	(b)  The board shall:                                                          
		(1)  prescribe two programs of study to prepare 
vocational nurses as follows:
			(A)  a program conducted by an educational unit in 
nursing within the structure of a school, including a college, 
university, or proprietary school;  and
			(B)  a program conducted by a hospital;                                      
		(2)  prescribe and publish the minimum requirements and 
standards for a course of study in each program that prepares 
registered nurses or vocational nurses;
		(3)  prescribe other rules as necessary to conduct 
approved schools of nursing and educational programs for the 
preparation of registered nurses or vocational nurses;
		(4)  approve schools of nursing and educational 
programs that meet the board's requirements;  and
		(5)  deny or withdraw approval from a school of nursing 
or educational program that fails to meet the prescribed course of 
study or other standard.
	(c)  A program approved to prepare registered nurses may not 
be less than two academic years or more than four calendar years.
	(d)  A person may not be certified as a graduate of any school 
of nursing or educational program unless the person has completed 
the requirements of the prescribed course of study, including 
clinical practice, of an approved school of nursing or educational 
program.
	(e)  The board shall give each person, including an 
organization, affected by an order or decision of the board under 
this section reasonable notice of not less than 20 days and an 
opportunity to appear and be heard regarding the order or decision.  
The board shall hear each protest or complaint from a person 
affected by a rule or decision regarding:
		(1)  the inadequacy or unreasonableness of any rule or 
order the board adopts;  or
		(2)  the injustice of any order or decision of the 
board.                   
	(f)  Not later than the 30th day after the date an order is 
entered and approved by the board, a person is entitled to bring an 
action against the board in a district court of Travis County to 
have the rule or order vacated or modified, if that person:
		(1)  is affected by the order or decision;                                    
		(2)  is dissatisfied with any rule or order of the 
board;  and              
		(3)  sets forth in a petition the principal grounds of 
objection to the rule or order.
	(g)  An appeal under this section shall be tried de novo as if 
it were an appeal from a justice court to a county court.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.011, 1.012, eff. Sept. 1, 
2003.


	§ 301.158. DISSEMINATION OF INFORMATION.  The board shall 
disseminate, at least twice a year and at other times the board 
determines necessary, information that is of significant interest 
to nurses and employers of nurses in this state, including 
summaries of final disciplinary action taken against nurses by the 
board since its last dissemination of information.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.013, eff. Sept. 1, 2003.


	§ 301.1581. INFORMATION PROVIDED TO LICENSE HOLDERS.  At 
least once each biennium, the board shall provide to license 
holders information on:
		(1)  prescribing and dispensing pain medications, with 
particular emphasis on Schedule II and Schedule III controlled 
substances;
		(2)  abusive and addictive behavior of certain persons 
who use prescription pain medications;
		(3)  common diversion strategies employed by certain 
persons who use prescription pain medications, including 
fraudulent prescription patterns;  and
		(4)  the appropriate use of pain medications and the 
differences between addiction, pseudo-addiction, tolerance, and 
physical dependence.

Added by Acts 2003, 78th Leg., ch. 1163, § 4, eff. Sept. 1, 2003.          


	§ 301.1582. POISON CONTROL CENTER INFORMATION.  The board 
shall provide to license holders information regarding the services 
provided by poison control centers.

Added by Acts 2003, 78th Leg., ch. 1163, § 4, eff. Sept. 1, 2003.          


	§ 301.159. BOARD DUTIES REGARDING COMPLAINTS.  (a) The 
board by rule shall:
		(1)  adopt a form to standardize information concerning 
complaints made to the board;  and
		(2)  prescribe information to be provided to a person 
when the person files a complaint with the board.
	(b)  The board shall provide reasonable assistance to a 
person who wishes to file a complaint with the board.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.160. PILOT PROGRAMS.  (a) In this section:                            
		(1)  "Proactive nursing peer review" means peer review 
that is not initiated to determine culpability with respect to a 
particular incident.
		(2)  "Targeted continuing nursing education" means 
continuing education focusing on a skill that would likely benefit 
a significant proportion of registered nurses in a particular 
practice area.
	(b)  The board may develop pilot programs to evaluate the 
effectiveness of mechanisms, including proactive nursing peer 
review and targeted continuing nursing education, for maintenance 
of the clinical competency of a registered nurse in the nurse's area 
of practice and the understanding by registered nurses of the laws, 
including regulations, governing the practice of professional 
nursing.
	(c)  A pilot program under Subsection (b) must be designed to 
test the effectiveness of a variety of mechanisms in a variety of 
practice settings.
	(d)  The board may approve a pilot program under Subsection 
(b) that is to be conducted by a person other than the board.
	(e)  The board may spend funds to develop or fund a pilot 
program and may contract with, make grants to, or make other 
arrangements with an agency, professional association, 
institution, individual, or other person to implement this section.
	(f)  In developing, administering, approving, and funding a 
pilot program, the board shall consult with:
		(1)  the Competency Advisory Committee on matters 
relating to ensuring the maintenance of continued competency of 
registered nurses;  and
		(2)  the Laws and Regulations Advisory Committee on 
matters relating to ensuring that registered nurses understand the 
laws, including regulations, governing the practice of 
professional nursing.
	(g)  The Competency Advisory Committee is appointed by the 
board and consists of the following members:
		(1)  a representative from the Texas Nurses 
Association;                    
		(2)  a representative from the Texas Nurses Foundation;                       
		(3)  a representative from the Texas Organization of 
Nurse Executives;      
		(4)  a registered nurse representative from the Texas 
Hospital Association; 
		(5)  a registered nurse representative from the Texas 
Health Care Association;
		(6)  a registered nurse representative from the Texas 
Association of Homes and Services for the Aging;
		(7)  a registered nurse representative from the Texas 
Association for Home Care;
		(8)  a professional nursing educator;                                         
		(9)  a representative from the Consumers Union;                               
		(10)  a representative from the Texas Department of 
Mental Health and Mental Retardation;  and
		(11)  any other person appointed by the board.                                
	(h)  The Laws and Regulations Advisory Committee is 
appointed by the board and consists of the following members:
		(1)  a representative of the Texas Nurses Association;                        
		(2)  a representative of the Texas League for Nursing;                        
		(3)  a representative of the Texas Chapter of the 
American Association of Nurse Attorneys;
		(4)  a representative of the Texas Organization of 
Baccalaureate and Graduate Nursing Educators;
		(5)  a representative of the Texas Organization for 
Associate Degree Nursing;
		(6)  a representative of the Texas Organization of 
Nurse Executives;        
		(7)  a representative of the American Association of 
Retired Persons;       
		(8)  a registered nurse researcher;  and                                      
		(9)  any other person appointed by the board.                                 
	(i)  Except as provided by this subsection, in developing or 
approving a pilot program under this section the board may exempt 
the program from rules adopted under this chapter.  Subchapter I and 
Chapter 303 apply to pilot programs, except that Sections 
303.002(e), 303.003, and 303.008(b) do not apply to a pilot program 
using proactive peer review.  The board may establish alternative 
criteria for nursing peer review committees conducting proactive 
peer review.
	(j)  The board shall issue an annual report regarding any 
pilot programs developed or approved and a status report on those 
programs, including preliminary or final findings concerning their 
effectiveness.  The board shall mail the report to statewide 
associations of registered nurses, registered nurse educators, and 
employers of registered nurses that request a copy.  The board shall 
issue a final report not later than September 1, 2000.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.1605. PILOT PROGRAMS FOR INNOVATIVE 
APPLICATIONS.  (a) The board may approve and adopt rules regarding 
pilot programs for innovative applications in the practice and 
regulation of professional nursing.
	(b)  The board shall specify the procedures to be followed in 
applying for approval of a pilot program.  The board may condition 
approval of a program on compliance with this section and rules 
adopted under this section. 
	(c)  In approving a pilot program, the board may grant the 
program an exception to the mandatory reporting requirements of 
Sections 301.401-301.409 or to a rule adopted under this chapter or 
Chapter 303 that relates to the practice of professional nursing, 
including education and reporting requirements for registered 
nurses.  The board may not grant an exception to:
		(1)  the education requirements of this chapter unless 
the program includes alternate but substantially equivalent 
requirements;  or
		(2)  the mandatory reporting requirements unless the 
program:               
			(A)  is designed to evaluate the efficiency of 
alternative reporting methods;  and
			(B)  provides consumers adequate protection from 
registered nurses whose continued practice is a threat to public 
safety.

Added by Acts 2003, 78th Leg., ch. 876, § 1, eff. June 20, 2003.           


	§ 301.1606. PILOT PROGRAMS ON NURSE REPORTING 
SYSTEMS.  (a) Before January 1, 2004, the board shall solicit 
proposals for pilot programs designed to evaluate the efficacy and 
effect on protection of the public of reporting systems designed to 
encourage identification of system errors.
	(b)  The board may grant a pilot program approved under this 
section an exception to the mandatory reporting requirements of 
Sections 301.401-301.409 or to a rule adopted under this chapter or 
Chapter 303 that relates to the practice of professional nursing, 
including education and reporting requirements for registered 
nurses.  If the board grants an exception, the board may require 
that the program:
		(1)  provide for the remediation of the deficiencies of 
a registered nurse who has knowledge or skill deficiencies that 
unless corrected may result in an unreasonable risk to public 
safety;
		(2)  provide for supervision of the nurse during 
remediation of deficiencies under Subdivision (1);
		(3)  require reporting to the board of a registered 
nurse:                  
			(A)  who fails to satisfactorily complete 
remediation, or who does not make satisfactory progress in 
remediation, under Subdivision (1);
			(B)  whose incompetence in the practice of 
professional nursing would pose a continued risk of harm to the 
public;  or
			(C)  whose error contributed to a patient death or 
serious patient injury;  or
		(4)  provide for a nursing peer review committee to 
review whether a registered nurse is appropriate for remediation 
under Subdivision (1).
	(c)  The board may require that the entity conducting a pilot 
program under this section reimburse the board for the cost of 
monitoring and evaluating the pilot program.
	(d)  The board may contract with a third party to perform the 
monitoring and evaluation.
	(e)  The board may limit the number of pilot programs that it 
approves under this section.

Added by Acts 2003, 78th Leg., ch. 876, § 1, eff. June 20, 2003.           


	§ 301.161. ENFORCEMENT.  (a) The board shall aid in the 
enforcement of this chapter.
	(b)  The board may:                                                            
		(1)  issue a subpoena;                                                        
		(2)  compel the attendance of a witness;                                      
		(3)  administer an oath to a person giving testimony at 
hearings;  and      
		(4)  cause the prosecution of each person violating 
this chapter.           
	(c)  The attorney general shall provide legal assistance 
necessary to enforce this chapter.  This subsection does not 
relieve a local prosecuting officer of any duty under the law.
	(d)  The board may establish a criminal investigations unit 
to investigate suspected criminal acts relating to the practice of 
nursing as authorized by this chapter.
	(e)  The board may assist federal, state, or local law 
enforcement agencies in the investigation and prosecution of crimes 
related to the practice of nursing.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2005, 79th Leg., ch. 1058, § 1, eff. Sept. 1, 2005.


	§ 301.1615. OBTAINING CRIMINAL HISTORY RECORD 
INFORMATION;  HEARING.  (a) In addition to the information to which 
the board is entitled under Section 411.125, Government Code, the 
board may request and receive criminal history record information 
from the Federal Bureau of Investigation as provided by Section 
411.087, Government Code.
	(b)  Criminal history record information received by the 
board may be used only by the board and is privileged.  The 
information may not be disclosed to any person other than:
		(1)  as required under a court order;  or                                     
		(2)  to a nursing board that is a member of the nurse 
licensure compact under Chapter 304.
	(c)  If, on the basis of criminal history record information 
obtained by the board, the board proposes to deny an application for 
a license, refuse to renew a license, or suspend or revoke a license 
or temporary permit, the applicant or license holder is entitled to 
a hearing under Section 301.454.

Added by Acts 2003, 78th Leg., ch. 1102, § 1, eff. Sept. 1, 2003.          


	§ 301.162. LEGAL COUNSEL.  The board may retain legal 
counsel to represent the board if first:
		(1)  the board requests the attorney general to 
represent the board;  and   
		(2)  the attorney general certifies to the board that 
the attorney general cannot provide those services.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.163. RECORD OF PROCEEDINGS;  REPORT.  The board 
shall keep a record of its proceedings under this chapter and make 
an annual report to the governor.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.164. ASSISTANCE OF PROSECUTOR.  A board member may 
present to a prosecuting officer a complaint relating to a 
violation of this chapter.  The board, through its members, 
officers, counsel, or agents, shall assist in the trial of a case 
involving an alleged violation of this chapter, subject to the 
control of the prosecuting officers.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.165. ANNUAL REPORT.  (a) The board shall file 
annually with the governor and the presiding officer of each house 
of the legislature a complete and detailed written report 
accounting for all funds received and disbursed by the board during 
the preceding fiscal year.
	(b)  The report must be in the form and reported in the time 
provided by the General Appropriations Act.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    

SUBCHAPTER E. PUBLIC INTEREST INFORMATION AND COMPLAINT PROCEDURES


	§ 301.201. PUBLIC INTEREST INFORMATION.  (a) The board 
shall prepare information of public interest describing the 
functions of the board and the procedures by which complaints are 
filed with and resolved by the board.
	(b)  The board shall make the information available to the 
public and appropriate state agencies.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.202. COMPLAINTS.  (a) The board by rule shall 
establish methods by which consumers and service recipients are 
notified of the name, mailing address, and telephone number of the 
board for the purpose of directing complaints to the board.  The 
board may provide for that notice:
		(1)  on each registration form, application, or written 
contract for services of a person regulated by the board;
		(2)  on a sign prominently displayed in the place of 
business of each person regulated by the board;  or
		(3)  in a bill for service provided by a person 
regulated by the board.     
	(b)  The board shall enter into a memorandum of understanding 
with each state agency that licenses health care facilities or 
agencies to coordinate the notification requirement under 
Subsection (a) with notification requirements that may be imposed 
on the health care facility or agency by that state agency.
	(c)  The board shall list with its regular telephone number 
any toll-free telephone number established under other state law 
that may be called to present a complaint about a health 
professional.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.203. RECORDS OF COMPLAINTS.  (a) The board shall 
keep an information file about each complaint filed with the board.  
The information file must be kept current and must contain a record 
for each complaint of:
		(1)  each person contacted in relation to the 
complaint;                    
		(2)  a summary of findings made at each step of the 
complaint process;      
		(3)  an explanation of the legal basis and reason for a 
complaint that is dismissed;
		(4)  the schedule required under Section 301.204 and a 
notation of any change in the schedule;  and
		(5)  other relevant information.                                              
	(b)  If a written complaint is filed with the board that the 
board has authority to resolve, the board, at least quarterly and 
until final disposition of the complaint, shall notify the parties 
to the complaint of the status of the complaint unless notice would 
jeopardize an undercover investigation.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.204. GENERAL RULES REGARDING COMPLAINT 
INVESTIGATION AND DISPOSITION.  (a) The board shall adopt rules 
concerning the investigation of a complaint filed with the board.  
The rules adopted under this subsection must:
		(1)  distinguish between categories of complaints;                            
		(2)  ensure that complaints are not dismissed without 
appropriate consideration;
		(3)  require that the board be advised of a complaint 
that is dismissed and that a letter be sent to the person who filed 
the complaint explaining the action taken on the dismissed 
complaint;
		(4)  ensure that the person who filed the complaint has 
an opportunity to explain the allegations made in the complaint;  
and
		(5)  prescribe guidelines concerning the categories of 
complaints that require the use of a private investigator and the 
procedures for the board to obtain the services of a private 
investigator.
	(b)  The board shall:                                                          
		(1)  dispose of all complaints in a timely manner;  and                       
		(2)  establish a schedule for conducting each phase of 
a complaint that is under the control of the board not later than 
the 30th day after the date the board receives the complaint.
	(c)  The board shall notify the parties of the projected time 
requirements for pursuing the complaint.
	(d)  The board shall notify the parties to the complaint of 
any change in the schedule not later than the seventh day after the 
date the change is made.
	(e)  The executive director of the board shall notify the 
board of a complaint that is unresolved after the time prescribed by 
the board for resolving the complaint so that the board may take 
necessary action on the complaint.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.205. PUBLIC PARTICIPATION.  (a) The board shall 
develop and implement policies that provide the public with a 
reasonable opportunity to appear before the board and to speak on 
any issue under the board's jurisdiction.
	(b)  The board shall prepare and maintain a written plan that 
describes how a person who does not speak English can be provided 
reasonable access to the board's programs.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    

SUBCHAPTER F. LICENSE REQUIREMENTS


	§ 301.251. LICENSE REQUIRED.  (a) A person may not 
practice or offer to practice professional nursing or vocational 
nursing in this state unless the person is licensed as provided by 
this chapter.
	(b)  Unless the person holds a license under this chapter, a 
person may not use, in connection with the person's name:
		(1)  the title "Registered Nurse," "Professional 
Nurse," "Licensed Vocational Nurse," "Vocational Nurse," "Licensed 
Practical Nurse," "Practical Nurse," or "Graduate Nurse";
		(2)  the abbreviation "R.N.," "L.V.N.," "V.N.," 
"L.P.N.," or "P.N.";  or    
		(3)  any other designation tending to imply that the 
person is a licensed registered nurse or vocational nurse.
	(c)  This section does not apply to a person entitled to 
practice nursing in this state under Chapter 304.
	(d)  Unless the person holds a license under this chapter, a 
person may not use, in connection with the person's name:
		(1)  the title "nurse";  or                                                   
		(2)  any other designation tending to imply that the 
person is licensed to provide nursing care.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2001, 77th Leg., ch. 1420, § 14.122(a), eff. Sept. 1, 
2001;  Acts 2003, 78th Leg., ch. 553, § 1.014, eff. Sept. 1, 
2003;  Acts 2003, 78th Leg., ch. 876, § 2, eff. June 20, 2003;  
Acts 2005, 79th Leg., ch. 113, § 5, eff. May 20, 2005.


	§ 301.2511. CRIMINAL HISTORY RECORD INFORMATION FOR 
LICENSE APPLICANTS.  (a) An applicant for a registered nurse 
license must submit to the board, in addition to satisfying the 
other requirements of this subchapter, a complete and legible set 
of fingerprints, on a form prescribed by the board, for the purpose 
of obtaining criminal history record information from the 
Department of Public Safety and the Federal Bureau of 
Investigation.
	(b)  The board may deny a license to an applicant who does not 
comply with the requirement of Subsection (a).  Issuance of a 
license by the board is conditioned on the board obtaining the 
applicant's criminal history record information under this 
section.
	(c)  The board by rule may develop a system for initiating 
the process of obtaining criminal history record information for 
applicants for a license under this chapter by requiring persons 
who enroll or plan to enroll in an educational program that prepares 
a person for a license as a registered nurse to submit to the board a 
set of fingerprints that meets the requirements of Subsection (a).  
The board may require payment of a fee by a person who is required to 
submit a set of fingerprints under this subsection. 

Added by Acts 2003, 78th Leg., ch. 1102, § 2, eff. Sept. 1, 2003.          


	§ 301.252. LICENSE APPLICATION.  (a) Each applicant for a 
registered nurse license or a vocational nurse license must submit 
to the board a sworn application that demonstrates the applicant's 
qualifications under this chapter, accompanied by evidence that the 
applicant:
		(1)  has good professional character;  and                                    
		(2)  has successfully completed an approved program of 
professional or vocational nursing education.
	(b)  The board may waive the requirement of Subsection (a)(2) 
for a vocational nurse applicant if the applicant provides 
satisfactory sworn evidence that the applicant has completed an 
acceptable level of education in:
		(1)  a professional nursing school approved by the 
board;  or               
		(2)  a school of professional nurse education located 
in another state or a foreign country.
	(c)  The board by rule shall determine acceptable levels of 
education under Subsection (b).

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.015, eff. Sept. 1, 2003.


	§ 301.253. EXAMINATION.  (a) Except as provided by 
Section 301.452, an applicant is entitled to take the examination 
prescribed by the board if:
		(1)  the board determines that the applicant meets the 
qualifications required by Section 301.252;  and
		(2)  the applicant pays the fees required by the board.                       
	(b)  The board shall give the examination in various cities 
throughout the state.
	(c)  The examination shall be designed to determine the 
fitness of the applicant to practice professional nursing or 
vocational nursing.
	(d)  The board shall determine the criteria that determine a 
passing score on the examination.  The criteria may not exceed those 
required by the majority of the states.
	(e)  A written examination prepared, approved, or offered by 
the board, including a standardized national examination, must be 
validated by an independent testing professional.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.016, eff. Sept. 1, 2003.


	§ 301.254. EXAMINATION RESULTS.  (a) The board shall 
notify each examinee of the results of the examination not later 
than the 30th day after the date the examination is administered.  
If an examination is graded or reviewed by a national testing 
service, the board shall notify each examinee of the results of the 
examination not later than the 14th day after the date the board 
receives the results from the testing service.
	(b)  If the notice of the examination results graded or 
reviewed by a national testing service will be delayed for longer 
than 90 days after the examination date, the board shall notify each 
examinee of the reason for the delay before the 90th day.
	(c)  If requested in writing by a person who fails an 
examination, the board shall provide to the person an analysis of 
the person's performance on the examination.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.255. REEXAMINATION.  The board by rule shall 
establish conditions under which an applicant who fails an 
examination may retake the examination.  For an applicant who fails 
the examination two or more times, the board may:
		(1)  require the applicant to fulfill additional 
educational requirements;  or
		(2)  deny the applicant the opportunity to retake the 
examination.          

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.256. ISSUANCE OF LICENSE.  If the results of an 
examination taken under Section 301.253 or 301.255 satisfy the 
criteria established by the board under that section, the board 
shall issue to the applicant a license to practice professional 
nursing or vocational nursing in this state.  The license must be 
signed by the board's presiding officer and the executive director 
and attested by the board's seal.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.017, eff. Sept. 1, 2003.


	§ 301.257. DECLARATORY ORDER OF LICENSE ELIGIBILITY.  (a) 
A person may petition the board for a declaratory order as to the 
person's eligibility for a license under this chapter if the 
person:
		(1)  is enrolled or planning to enroll in an 
educational program that prepares a person for an initial license 
as a registered nurse or vocational nurse;  and
		(2)  has reason to believe that the person is 
ineligible for the license.   
	(b)  The petition must state the basis for the person's 
potential ineligibility.
	(c)  The board has the same powers to investigate the 
petition and the person's eligibility that it has to investigate a 
person applying for a license.
	(d)  The petitioner or the board may amend the petition to 
include additional grounds for potential ineligibility at any time 
before a final determination is made.
	(e)  If the board determines that a ground for ineligibility 
does not exist, instead of issuing an order, the board shall notify 
the petitioner in writing of the board's determination on each 
ground of potential ineligibility.  If the board proposes to find 
that the petitioner is ineligible for a license, the petitioner is 
entitled to a hearing before the State Office of Administrative 
Hearings.
	(f)  The board's order must set out each basis for potential 
ineligibility and the board's determination as to eligibility.  In 
the absence of new evidence known to but not disclosed by the 
petitioner or not reasonably available to the board at the time the 
order is issued, the board's ruling on the petition determines the 
person's eligibility with respect to the grounds for potential 
ineligibility set out in the written notice or order.
	(g)  The board may require an individual accepted for 
enrollment or enrolled in an educational program preparing a 
student for initial licensure as a registered nurse or vocational 
nurse to submit information to the board to permit the board to 
determine whether the person is aware of the conditions that may 
disqualify the person from licensure as a registered nurse or 
vocational nurse on graduation and of the person's right to 
petition the board for a declaratory order under this section.  
Instead of requiring the person to submit the information, the 
board may require the educational program to collect and submit the 
information on each person accepted for enrollment or enrolled in 
the program.
	(h)  The information required under Subsection (g) must be 
submitted in a form approved by the board.
	(i)  If, as a result of information provided under Subsection 
(g), the board determines that a person may not be eligible for a 
license on graduation, the board shall notify the educational 
program of its determination.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2001, 77th Leg., ch. 1420, § 14.123(a), eff. Sept. 1, 
2001;  Acts 2003, 78th Leg., ch. 553, § 1.018, eff. Sept. 1, 
2003.


	§ 301.258. TEMPORARY PERMIT.  (a) Pending the results of 
a licensing examination, the board may issue to an applicant who is 
a graduate of an approved educational program a permit to practice 
professional nursing under the direct supervision of a registered 
nurse or to practice vocational nursing under the direct 
supervision of a registered nurse or vocational nurse.
	(b)  The board may not issue a permit under this section to an 
applicant who has previously failed an examination administered by 
the board or another state.
	(c)  A permit issued under Subsection (a) expires on the date 
of receipt of: 
		(1)  a permanent license;  or                                                 
		(2)  a notice from the board that the permit holder has 
failed the examination.
	(d)  The board may issue a temporary permit to practice 
professional nursing or vocational nursing for the limited purpose 
of allowing a nurse to satisfy a requirement imposed by the board 
necessary for:
		(1)  renewal of an expired license;                                           
		(2)  reactivation of an inactive license;  or                                 
		(3)  reissuance of a suspended, revoked, or surrendered 
license.            
	(e)  A permit issued under Subsection (d) expires on the 
earlier of:         
		(1)  the date of receipt of a permanent license;  or                          
		(2)  six months after the date the permit is issued.                          
	(f)  A person who holds a temporary permit issued under this 
section is considered to be a licensed registered nurse or 
vocational nurse for all purposes except to the extent of any 
stipulation or limitation on practice imposed by the board as a 
condition of issuing the permit.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.019, eff. Sept. 1, 2003.


	§ 301.259. RECIPROCAL LICENSE BY ENDORSEMENT FOR CERTAIN 
FOREIGN APPLICANTS.  On payment of a fee established by the board, 
the board may issue a license to practice as a registered nurse or 
vocational nurse in this state by endorsement without examination 
to an applicant who holds a registration certificate as a 
registered nurse or vocational nurse, as applicable, issued by a 
territory or possession of the United States or a foreign country if 
the board determines that the issuing agency of the territory or 
possession of the United States or foreign country required in its 
examination the same general degree of fitness required by this 
state.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.020, eff. Sept. 1, 2003.


	§ 301.260. TEMPORARY LICENSE BY ENDORSEMENT.  (a) An 
applicant for a license under this chapter who is licensed as a 
registered nurse or vocational nurse by another state may qualify 
for a temporary license by endorsement to practice as a registered 
nurse or vocational nurse, as applicable, by submitting to the 
board:
		(1)  an endorsement fee as determined by the board and a 
completed sworn application in the form prescribed by the board;
		(2)  evidence that the person possessed, at the time of 
initial licensing as a nurse, the other qualifications necessary at 
that time to have been eligible for licensing in this state;  and
		(3)  proof of initial licensing by examination and 
proof that the license and any other license issued to the applicant 
by another state have not been suspended, revoked, canceled, 
surrendered, or otherwise restricted.
	(b)  A holder of a temporary license under this section is 
entitled to receive a permanent license if the applicant:
		(1)  verifies the applicant's academic and professional 
credentials;  and   
		(2)  satisfies any other requirement established by 
statute.                
	(c)  The board shall grant or deny an application for a 
permanent license not later than the 180th day after the date the 
board receives all required forms or information.  The board may 
extend that deadline to allow for the receipt and tabulation of 
examination results.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.021, eff. Sept. 1, 2003.


	§ 301.261. INACTIVE STATUS.  (a) The board may place on 
inactive status the license of a person under this chapter who is 
not actively engaged in the practice of professional nursing or 
vocational nursing if the person submits a written request to the 
board in the form and manner determined by the board.  The inactive 
status begins on the expiration date of the person's license.
	(b)  The board shall maintain a list of each person whose 
license is on inactive status.
	(c)  A person whose license is on inactive status may not 
perform any professional nursing or vocational nursing service or 
work.
	(d)  The board shall remove a person's license from inactive 
status if the person:
		(1)  requests that the board remove the person's 
license from inactive status;
		(2)  pays each appropriate fee;  and                                          
		(3)  meets the requirements determined by the board.                          
	(e)  The board by rule shall permit a person whose license is 
on inactive status and who is 65 years or older to use, as 
applicable, the title "Registered Nurse Retired," "R.N. Retired," 
"Licensed Vocational Nurse Retired," "Vocational Nurse Retired," 
"L.V.N. Retired," or "V.N. Retired."

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.022, eff. Sept. 1, 2003.

SUBCHAPTER G. LICENSE RENEWAL


	§ 301.301. LICENSE RENEWAL.  (a) The board by rule may 
adopt a system under which licenses expire on various dates during 
the year.
	(b)  A person may renew an unexpired license issued under 
this chapter on payment of the required renewal fee, payment of any 
costs assessed under Section 301.461, and compliance with any other 
renewal requirements adopted by the board.
	(c)  A person whose license has been expired for 90 days or 
less may renew the license by paying to the board the required 
renewal fee and a fee that is equal to one-half the amount charged 
for examination for the license.  If a license has been expired for 
more than 90 days but less than one year, the person may renew the 
license by paying to the board all unpaid renewal fees and a fee 
that is equal to the amount charged for examination for the license.
	(d)  The board by rule shall set a length of time beyond which 
an expired license may not be renewed.  The board by rule may 
establish additional requirements that apply to the renewal of a 
license that has been expired for more than one year but less than 
the time limit set by the board beyond which a license may not be 
renewed.  The person may obtain a new license by submitting to 
reexamination and complying with the requirements and procedures 
for obtaining an original license.
	(e)  At least 30 days before the expiration of the person's 
license, the board shall send written notice of the impending 
license expiration to the person at the person's last known address 
according to the records of the board.
	(f)  A registered nurse who practices professional nursing 
or a vocational nurse who practices vocational nursing after the 
expiration of the nurse's license is an illegal practitioner whose 
license may be revoked or suspended.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.023, eff. Sept. 1, 2003;  
Acts 2005, 79th Leg., ch. 1058, § 2, eff. Sept. 1, 2005.


	§ 301.3011. CRIMINAL HISTORY RECORD INFORMATION 
REQUIREMENT FOR RENEWAL.  (a) The board may require that an 
applicant for renewal of an unexpired license submit to the board, 
in addition to satisfying any other requirements for license 
renewal, a complete and legible set of fingerprints, on a form 
prescribed by the board, for the purpose of obtaining criminal 
history record information from the Department of Public Safety and 
the Federal Bureau of Investigation.
	(b)  The board may refuse to renew the license of a person who 
does not comply with the requirement of Subsection (a).  Renewal of 
a license by the board is conditioned on the board obtaining the 
person's criminal history record information under this section.

Added by Acts 2003, 78th Leg., ch. 1102, § 3, eff. Sept. 1, 2003.          


	§ 301.302. RENEWAL OF EXPIRED LICENSE BY OUT-OF-STATE 
PRACTITIONER.  (a) The board may renew without examination the 
expired license of a person who was licensed to practice 
professional nursing or vocational nursing in this state, moved to 
another state, and is currently licensed and has been in practice in 
the other state for the two years preceding application.
	(b)  The person must pay to the board a fee that is equal to 
the amount of the initial fee for the license and the renewal fee.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.024, eff. Sept. 1, 2003.


	§ 301.303. CONTINUING COMPETENCY.  (a) The board may 
recognize, prepare, or implement continuing competency programs 
for license holders under this chapter and may require 
participation in continuing competency programs as a condition of 
renewal of a license.  The programs may allow a license holder to 
demonstrate competency through various methods, including:
		(1)  completion of targeted continuing education 
programs;  and             
		(2)  consideration of a license holder's professional 
portfolio, including certifications held by the license holder.
	(b)  The board may not require participation in more than a 
total of 20 hours of continuing education in a two-year licensing 
period and may not require that more than 10 hours of the continuing 
education consist of classroom instruction in approved programs.  
The remaining hours of continuing education may consist of any 
combination of:
		(1)  classroom instruction;                                                   
		(2)  institutional-based instruction;  or                                     
		(3)  individualized study.                                                    
	(c)  If the board requires participation in continuing 
education programs as a condition of license renewal, the board by 
rule shall establish a system for the approval of programs and 
providers of continuing education.
	(d)  In adopting rules under Subsection (c), the board shall 
consider, but is not obligated to approve:
		(1)  a program or provider approved or accredited 
through the American Nurses Credentialing Center;  and
		(2)  a nurse in-service program offered by a hospital 
that is:              
			(A)  accredited by the Joint Commission on 
Accreditation of Healthcare Organizations;
			(B)  certified by Medicare;  or                                              
			(C)  maintained or operated by the federal 
government or the state.        
	(e)  The board may adopt other rules as necessary to 
implement this section. 
	(f)  The board may assess each program and provider under 
this section a fee in an amount that is reasonable and necessary to 
defray the costs incurred in approving programs and providers.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 876, § 3, 4, eff. June 20, 2003.


	§ 301.305. BIOTERRORISM RESPONSE COMPONENT IN CONTINUING 
EDUCATION.       

Text of section effective until September 1, 2007
	(a)  As part of continuing education requirements under 
Section 301.303, a license holder shall participate during each 
two-year licensing period in at least two hours of continuing 
education relating to preparing for, reporting medical events 
resulting from, and responding to the consequences of an incident 
of bioterrorism.
	(b)  The continuing education required under Subsection (a) 
must be part of a program approved under Section 301.303(c).
	(c)  A license holder who does not comply with the continuing 
education required under Subsection (a) is subject only to one or 
both of the following sanctions:
		(1)  completion of the instruction in a period set by 
the board of 30 days or less;  or
		(2)  an administrative penalty imposed under 
Subchapter K.                  
	(d)  A license holder who fails to comply with a sanction 
imposed under Subsection (c) is subject to any sanction imposed 
under Section 301.453 or Subchapter K.
	(e)  The board, in consultation with the Texas Department of 
Health, shall adopt rules establishing the content of the 
continuing education required under Subsection (a).  The board may 
adopt other rules to implement this section, including rules under 
Section 301.303(c) for the approval of education programs and 
providers.
	(f)  The board may divide the content of the continuing 
education required under Subsection (a) into one-hour segments and 
may require that those segments be taken in a certain sequence.
	(g)  This section expires September 1, 2007.                                   

Added by Acts 2003, 78th Leg., ch. 553, § 1.026, eff. Sept. 1, 
2003.     


	§ 301.306. FORENSIC EVIDENCE COLLECTION COMPONENT IN 
CONTINUING EDUCATION.  (a) As part of continuing education 
requirements under Section 301.303, a license holder who is 
employed to work in an emergency room setting and who is required 
under board rules to comply with this section shall complete at 
least two hours of continuing education relating to forensic 
evidence collection not later than:
		(1)  September 1, 2008;  or                                                   
		(2)  the second anniversary of the initial issuance of 
a license under this chapter to the license holder.
	(b)  The continuing education required under Subsection (a) 
must be part of a program approved under Section 301.303(c).
	(c)  The board shall adopt rules to identify the license 
holders who are required to complete continuing education under 
Subsection (a) and to establish the content of that continuing 
education.  The board may adopt other rules to implement this 
section, including rules under Section 301.303(c) for the approval 
of education programs and providers.

Added by Acts 2005, 79th Leg., ch. 782, § 2, eff. Sept. 1, 2005.           

SUBCHAPTER H. PRACTICE BY LICENSE HOLDER


	§ 301.351. DESIGNATIONS.  (a) A person who holds a 
license as a registered nurse under this chapter:
		(1)  is referred to as a registered nurse;  and                               
		(2)  may use the abbreviation "R.N."                                          
	(b)  A person who holds a license as a vocational nurse under 
this chapter:  
		(1)  is referred to as a licensed vocational nurse or 
vocational nurse;  and
		(2)  may use the abbreviation "L.V.N." or "V.N."                              
	(c)  While interacting with the public in a nursing role, 
each nurse shall wear a clearly legible insignia identifying the 
nurse as a registered or vocational nurse.  The insignia may not 
contain information other than:
		(1)  the registered or vocational nurse designation;                          
		(2)  the nurse's name, certifications, academic 
degrees, or practice position;
		(3)  the name of the employing facility or agency, or 
other employer;       
		(4)  a picture of the nurse;  or                                              
		(5)  any other information authorized by the board.                           
	(d)  The board may adopt rules establishing specifications 
for the insignia. 

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.027, eff. Sept. 1, 2003;  
Acts 2005, 79th Leg., ch. 113, § 6, eff. May 20, 2005;  Acts 2005, 
79th Leg., ch. 728, § 23.001(73), eff. Sept. 1, 2005. 


	§ 301.352. PROTECTION FOR REFUSAL TO ENGAGE IN CERTAIN 
CONDUCT.  (a) A person may not suspend, terminate, or otherwise 
discipline or discriminate against a nurse who refuses to engage in 
an act or omission relating to patient care that would constitute 
grounds for reporting the nurse to the board under Subchapter I, 
that constitutes a minor incident, or that violates this chapter or 
a board rule if the nurse notifies the person at the time of the 
refusal that the reason for refusing is that the act or omission:
		(1)  constitutes grounds for reporting the nurse to the 
board;  or          
		(2)  is a violation of this chapter or a rule of the 
board.                 
	(b)  An act by a person under Subsection (a) does not 
constitute a violation of this section if a nursing peer review 
committee under Chapter 303 determines:
		(1)  that the act or omission the nurse refused to 
engage in was:           
			(A)  not conduct reportable to the board under 
Section 301.403;            
			(B)  a minor incident;  or                                                   
			(C)  a violation of this chapter or a board rule;  
or                      
		(2)  that:                                                                    
			(A)  the act or omission in which the nurse 
refused to engage was conduct reportable to the board, a minor 
incident, or a violation of this chapter or a board rule;  and
			(B)  the person:                                                             
				(i)  rescinds any disciplinary or 
discriminatory action taken against the nurse;
				(ii)  compensates the nurse for lost wages;  
and                          
				(iii)  restores to the nurse any lost 
benefits.                           
	(c)  A nurse's rights under this section may not be nullified 
by a contract. 
	(d)  An appropriate licensing agency may take action against 
a person who violates this section.
	(e)  In this section, "minor incident" has the meaning 
assigned by Section 301.419.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.028, eff. Sept. 1, 2003;  
Acts 2005, 79th Leg., ch. 113, § 7, eff. May 20, 2005.


	§ 301.353. SUPERVISION OF VOCATIONAL NURSE.                                 

Text of section as added by Acts 2005, 79th Leg., ch. 113, § 8
	The practice of vocational nursing must be performed under 
the supervision of a registered nurse, physician, physician 
assistant, podiatrist, or dentist.

Added by Acts 2005, 79th Leg., ch. 113, § 8, eff. May 20, 2005.            

For text of section as added by Acts 2005, 79th Leg., ch. 966, § 
1, see § 301.353, post.


	§ 301.353. NURSE FIRST ASSISTANTS;  ASSISTING AT SURGERY 
BY OTHER NURSES.  

Text of section as added by Acts 2005, 79th Leg., ch. 966, § 1
	(a)  In this section, "nurse first assistant" means a 
registered nurse who:  
		(1)  has completed a nurse first assistant educational 
program approved or recognized by an organization recognized by the 
board;  and
		(2)  is either:                                                               
			(A)  certified in perioperative nursing by an 
organization recognized by the board;  or
			(B)  recognized by the board as an advanced 
practice nurse and qualified by education, training, or experience 
to perform the tasks involved in perioperative nursing.
	(b)  Unless the person is a nurse first assistant, the person 
may not use:   
		(1)  the title "nurse first assistant" or "registered 
nurse first assistant";
		(2)  the abbreviation "R.N.F.A.";  or                                         
		(3)  any other title or abbreviation that implies to 
the public that the person is qualified as a nurse first assistant 
under this section.
	(c)  A health maintenance organization or an insurer, 
including an insurer offering a preferred provider benefit plan, 
may not, by contract or any other method, require a physician to use 
the services of a nurse first assistant.
	(d)  A nurse who is not a nurse first assistant may assist a 
physician, podiatrist, or dentist in the performance of surgery if 
the nurse:
		(1)  assists under the direct personal supervision and 
in the physical presence of the physician, podiatrist, or dentist;
		(2)  is in the same sterile field as the physician, 
podiatrist, or dentist; 
		(3)  is employed by:                                                          
			(A)  the physician, podiatrist, or dentist;                                  
			(B)  a group to which the physician, podiatrist, 
or dentist belongs;  or   
			(C)  a hospital licensed or owned by the state;  
and                       
		(4)  is qualified by education, training, or experience 
to perform the tasks assigned to the nurse.
	(e)  A patient or third-party insurer may not be billed 
separately for the services performed by a nurse described by 
Subsection (d).

Added by Acts 2005, 79th Leg., ch. 966, § 1, eff. Sept. 1, 2005.           

For text of section as added by Acts 2005, 79th Leg., ch. 113, § 
8, see § 301.353, ante.

SUBCHAPTER I. DUTY TO REPORT VIOLATION


	§ 301.401. GROUNDS FOR REPORTING NURSE.  (a) Except as 
provided by Subsection (b), the following are grounds for reporting 
a nurse under Section 301.402, 301.403, 301.405, or 301.407:
		(1)  likely exposure by the nurse of a patient or other 
person to an unnecessary risk of harm;
		(2)  unprofessional conduct by the nurse;                                     
		(3)  failure by the nurse to adequately care for a 
patient;                 
		(4)  failure by the nurse to conform to the minimum 
standards of acceptable nursing practice;  or
		(5)  impairment or likely impairment of the nurse's 
practice by chemical dependency.
	(b)  Subsection (a) does not apply to a minor incident, as 
defined by Section 301.419, if the incident is not required to be 
reported under a rule adopted under Section 301.419.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.029, eff. Sept. 1, 2003;  
Acts 2003, 78th Leg., ch. 876, § 6, eff. June 20, 2003;  Acts 
2005, 79th Leg., ch. 113, § 9, eff. May 20, 2005.


	§ 301.402. DUTY OF NURSE TO REPORT.  (a) In this section:                   
		(1)  "Nursing educational program" means a 
board-approved educational program leading to initial licensure as 
a registered nurse or vocational nurse.
		(2)  "Nursing student" means an individual who is 
enrolled in a professional nursing or vocational nursing 
educational program.
	(b)  A nurse shall report to the board in the manner 
prescribed under Subsection (d) if the nurse has reasonable cause 
to suspect that:
		(1)  another nurse is subject to a ground for reporting 
under Section 301.401;  or
		(2)  the ability of a nursing student to perform the 
services of the nursing profession would be, or would reasonably be 
expected to be, impaired by chemical dependency.
	(c)  In a written, signed report to the appropriate licensing 
board or accrediting body, a nurse may report a licensed health care 
practitioner, agency, or facility that the nurse has reasonable 
cause to believe has exposed a patient to substantial risk of harm 
as a result of failing to provide patient care that conforms to the:
		(1)  minimum standards of acceptable and prevailing 
professional practice, for a report made regarding a practitioner;  
or
		(2)  statutory, regulatory, or accreditation 
standards, for a report made regarding an agency or facility.
	(d)  A report by a nurse under Subsection (b) must:                            
		(1)  be written and signed;  and                                              
		(2)  include the identity of the nurse or student and 
any additional information required by the board.
	(e)  A nurse may make a report required under Subsection 
(b)(2) to the nursing educational program in which the student is 
enrolled instead of reporting to the board.
	(f)  A nurse may report to the nurse's employer or another 
entity at which the nurse is authorized to practice any situation 
that the nurse has reasonable cause to believe exposes a patient to 
substantial risk of harm as a result of a failure to provide patient 
care that conforms to minimum standards of acceptable and 
prevailing professional practice or to statutory, regulatory, or 
accreditation standards.  For purposes of this subsection, the 
employer or entity includes an employee or agent of the employer or 
entity.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.030, eff. Sept. 1, 2003;  
Acts 2003, 78th Leg., ch. 876, § 7, eff. June 20, 2003;  Acts 
2005, 79th Leg., ch. 113, § 10, eff. May 20, 2005.


	§ 301.403. DUTY OF PEER REVIEW COMMITTEE TO REPORT.  A 
nursing peer review committee operating under Chapter 303 that has 
a ground for reporting a nurse under Section 301.401 shall file with 
the board a written, signed report that includes:
		(1)  the identity of the nurse;                                               
		(2)  a description of any corrective action taken 
against the nurse;        
		(3)  a statement whether the nursing peer review 
committee recommends that the board take formal disciplinary action 
against the nurse;
		(4)  a description of the ground for reporting;                               
		(5)  the extent to which any deficiency in care 
provided by the reported nurse was the result of a factor beyond the 
nurse's control rather than a deficiency in the nurse's judgment, 
knowledge, training, or skill;  and
		(6)  any additional information the board requires.                           

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.031, eff. Sept. 1, 2003;  
Acts 2005, 79th Leg., ch. 113, § 11, eff. May 20, 2005.


	§ 301.404. DUTY OF NURSING EDUCATIONAL PROGRAM TO 
REPORT.  (a) In this section, "nursing educational program" and 
"nursing student" have the meanings assigned by Section 301.402(a).
	(b)  A nursing educational program that has reasonable cause 
to suspect that the ability of a nursing student to perform the 
services of the nursing profession would be, or would reasonably be 
expected to be, impaired by chemical dependency shall file with the 
board a written, signed report that includes the identity of the 
student and any additional information the board requires.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.032, eff. Sept. 1, 2003.


	§ 301.405. DUTY OF PERSON EMPLOYING NURSE TO REPORT.  (a) 
This section applies only to a person who employs, hires, or 
contracts for the services of a nurse, including:
		(1)  a health care facility, including a hospital, 
health science center, nursing home, or home health agency;
		(2)  a state agency;                                                          
		(3)  a political subdivision;                                                 
		(4)  a school of nursing;  and                                                
		(5)  a temporary nursing service.                                             
	(b)  A person that terminates, suspends for more than seven 
days, or takes other substantive disciplinary action, as defined by 
the board, against a nurse, or a substantially equivalent action 
against a nurse who is a staffing agency nurse, because a ground 
under Section 301.401 exists to report the nurse shall report in 
writing to the board:
		(1)  the identity of the nurse;                                               
		(2)  the ground that preceded the termination, 
suspension, or other substantive disciplinary action or 
substantially equivalent action;  and
		(3)  any additional information the board requires.                           
	(c)  Except as provided by Subsection (g), each person 
subject to this section that regularly employs, hires, or otherwise 
contracts for the services of 10 or more nurses shall develop a 
written plan for identifying and reporting a nurse under Section 
301.401(a).  The plan must provide for the review of the nurse and 
the incident by a nursing peer review committee established and 
operated under Chapter 303.  Review by the committee is only 
advisory, but is required, even if the nurse is voluntarily or 
involuntarily terminated.
	(d)  The nursing peer review committee shall submit a report 
to the board that contains the information required by Section 
301.403.  A report is not required under this subsection if the 
nurse was terminated, either voluntarily or involuntarily, and 
elected not to participate in peer review.
	(e)  The requirement under Subsection (c) that a nursing peer 
review committee review the nurse and the incident does not subject 
a person's administrative decision to discipline a nurse to the 
peer review process or prevent a person from taking disciplinary 
action before review by the peer review committee is conducted.
	(f)  The board shall enter into memoranda of understanding 
with each state agency that licenses, registers, or certifies a 
health care facility or agency or surveys that facility or agency 
with respect to nursing care as to how that state agency can promote 
compliance with Subsection (c).
	(g)  A person is not required to develop a written plan under 
Subsection (c) for peer review of a registered nurse, unless the 
person regularly employs, hires, or otherwise contracts for the 
services of at least five registered nurses.
	(h)  A plan developed under Subsection (c) must provide that 
a nurse who has been terminated, either voluntarily or 
involuntarily, shall have the opportunity to participate in peer 
review.  If the nurse elects to not participate in peer review, the 
nurse waives any right to procedural due process under Section 
303.002.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.033, eff. Sept. 1, 2003;  
Acts 2005, 79th Leg., ch. 113, § 12, eff. May 20, 2005.


	§ 301.406. DUTY OF CERTAIN PROFESSIONAL ASSOCIATIONS AND 
ORGANIZATIONS TO REPORT.  A professional association of nurses or 
an organization that conducts a certification or accreditation 
program for nurses and that expels, decertifies, or takes any other 
substantive disciplinary action, as defined by the board, against a 
nurse as a result of the nurse's failure to conform to the minimum 
standards of acceptable nursing practice shall report in writing to 
the board the identity of the nurse and any additional information 
the board requires.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.034, eff. Sept. 1, 2003.


	§ 301.407. DUTY OF STATE AGENCY TO REPORT.  (a) This 
section applies only to a state agency that:
		(1)  licenses, registers, or certifies:                                       
			(A)  a hospital;                                                             
			(B)  a nursing home;                                                         
			(C)  a health science center;                                                
			(D)  a home health agency;  or                                               
			(E)  another health care facility or agency;  or                             
		(2)  surveys a facility or agency listed in Subdivision 
(1) regarding the quality of nursing care provided by the facility 
or agency.
	(b)  Unless expressly prohibited by state or federal law, a 
state agency that has reason to believe a ground for reporting a 
nurse exists under Section 301.401 shall report in writing to the 
board the identity of that nurse.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.035, eff. Sept. 1, 2003.


	§ 301.408. DUTY OF LIABILITY INSURER TO REPORT.  (a) Each 
insurer that provides to a nurse liability insurance that covers 
claims arising from providing or failing to provide nursing care 
shall submit to the board the report or data required by this 
section at the time prescribed.
	(b)  The report or data must be provided for:                                  
		(1)  a complaint filed in court against a nurse that 
seeks damages related to the nurse's conduct in providing or 
failing to provide nursing care;  and
		(2)  a settlement of a claim or lawsuit made on behalf 
of a nurse.          
	(c)  Not later than the 30th day after the date the insurer 
receives a complaint subject to Subsection (b), the insurer shall 
provide to the board:
		(1)  the name of the nurse against whom the claim is 
filed;                 
		(2)  the policy number;                                                       
		(3)  the policy limits;                                                       
		(4)  a copy of the petition;                                                  
		(5)  a copy of the answer;  and                                               
		(6)  other relevant information known by the insurer, 
as required by the board.
	(d)  Not later than the 30th day after the date of a judgment, 
dismissal, or settlement of a suit involving an insured nurse or 
settlement of a claim on behalf of the nurse without the filing of a 
lawsuit, the insurer shall provide to the board information 
regarding the date of the judgment, dismissal, or settlement and, 
if appropriate:
		(1)  whether an appeal has been taken from the judgment 
and by which party; 
		(2)  the amount of the settlement or judgment against 
the nurse;  and       
		(3)  other relevant information known by the insurer, 
as required by the board.
	(e)  A nurse shall report the information required to be 
reported under this section if the nurse is named as a defendant in 
a claim arising from providing or failing to provide nursing care 
and the nurse:
		(1)  does not carry or is not covered by liability 
insurance;  or           
		(2)  is insured by a nonadmitted carrier.                                     

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.036, eff. Sept. 1, 2003.


	§ 301.409. DUTY OF PROSECUTING ATTORNEY TO REPORT.  (a) 
The attorney representing the state shall cause the clerk of the 
court of record in which the conviction, adjudication, or finding 
is entered to prepare and forward to the board a certified true and 
correct abstract of the court record of the case not later than the 
30th day after the date:
		(1)  a person known to be a nurse who is licensed, 
otherwise lawfully practicing in this state, or applying to be 
licensed to practice is convicted of:
			(A)  a felony;                                                               
			(B)  a misdemeanor involving moral turpitude;                                
			(C)  a violation of a state or federal narcotics 
or controlled substance law;  or
			(D)  an offense involving fraud or abuse under the 
Medicare or Medicaid program;  or
		(2)  a court finds that a nurse is mentally ill or 
mentally incompetent.    
	(b)  A prosecuting attorney shall comply with Subsection (a) 
even if the conviction, adjudication, or finding is entered, 
withheld, or appealed under the laws of this state.
	(c)  The abstract required under Subsection (a) must 
include:                
		(1)  the name and address of the nurse or applicant;                          
		(2)  a description of the nature of the offense 
committed, if any;          
		(3)  the sentence, if any;  and                                               
		(4)  the judgment of the court.                                               
	(d)  The board shall prepare the form of the abstract and 
distribute a copy to each district attorney and county attorney in 
this state with appropriate instructions for preparation and 
filing.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.037, eff. Sept. 1, 2003.


	§ 301.410. REPORT REGARDING IMPAIRMENT BY CHEMICAL 
DEPENDENCY OR MENTAL ILLNESS.  A person who is required to report a 
nurse under this subchapter because the nurse is impaired or 
suspected of being impaired by chemical dependency or mental 
illness may report to a peer assistance program approved by the 
board under Chapter 467, Health and Safety Code, instead of 
reporting to the board or requesting review by a nursing peer review 
committee.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.038, eff. Sept. 1, 2003.


	§ 301.411. EFFECT OF FAILURE TO REPORT.  (a) A person is 
not liable in a civil action for failure to file a report required 
by this subchapter.
	(b)  The appropriate state licensing agency may take action 
against a person regulated by the agency for a failure to report as 
required by this subchapter.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.412. REPORTING IMMUNITY.  A person who, without 
malice, makes a report required or authorized, or reasonably 
believed to be required or authorized, under this subchapter:
		(1)  is immune from civil liability;  and                                     
		(2)  may not be subjected to other retaliatory action 
as a result of making the report.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.413. RETALIATORY ACTION.  (a) A person named as a 
defendant in a civil action or subjected to other retaliatory 
action as a result of filing a report required, authorized, or 
reasonably believed to be required or authorized under this 
subchapter may file a counterclaim in the pending action or prove a 
cause of action in a subsequent suit to recover defense costs, 
including reasonable attorney's fees and actual and punitive 
damages, if the suit or retaliatory action is determined to be 
frivolous, unreasonable, or taken in bad faith.
	(b)  A person may not suspend or terminate the employment of, 
or otherwise discipline or discriminate against, a person who 
reports, without malice, under this subchapter.
	(c)  A person who reports under this subchapter has a cause 
of action against a person who violates Subsection (b), and may 
recover:
		(1)  the greater of:                                                          
			(A)  actual damages, including damages for mental 
anguish even if no other injury is shown;  or
			(B)  $1,000;                                                                 
		(2)  exemplary damages;                                                       
		(3)  court costs;  and                                                        
		(4)  reasonable attorney's fees.                                              
	(d)  In addition to the amount recovered under Subsection 
(c), a person whose employment is suspended or terminated in 
violation of this section is entitled to:
		(1)  reinstatement in the employee's former position or 
severance pay in an amount equal to three months of the employee's 
most recent salary;  and
		(2)  compensation for wages lost during the period of 
suspension or termination.
	(e)  A person who brings an action under this section has the 
burden of proof.  It is a rebuttable presumption that the person's 
employment was suspended or terminated for reporting under this 
subchapter if:
		(1)  the person was suspended or terminated within 60 
days after the date the report was made;  and
		(2)  the board or a court determines that the report 
that is the subject of the cause of action was:
			(A)  authorized or required under Section 
301.402, 301.403, 301.405, 301.406, 301.407, 301.408, 301.409, or 
301.410;  and
			(B)  made without malice.                                                    
	(f)  An action under this section may be brought in a 
district court of the county in which:
		(1)  the plaintiff resides;                                                   
		(2)  the plaintiff was employed by the defendant;  or                         
		(3)  the defendant conducts business.                                         

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.414. NOTICE AND REVIEW OF REPORT.  (a) The board 
shall notify each nurse who is reported to the board under Section 
301.402, 301.403, 301.405, 301.406, 301.407, 301.408, or 301.409 of 
the filing of the report unless the notification would jeopardize 
an active investigation.
	(b)  The nurse or the nurse's authorized representative is 
entitled on request to review any report submitted to the board 
under a section specified under Subsection (a) unless doing so 
would jeopardize an active investigation.  The board may not reveal 
the identity of the person making or signing the report.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.039, eff. Sept. 1, 2003.


	§ 301.415. REBUTTAL STATEMENT.  (a) A nurse who is 
entitled to receive notice under Section 301.414 or the authorized 
representative of the nurse may file with the board a statement of 
reasonable length containing the nurse's rebuttal of any 
information in the report to the board.
	(b)  The statement made under Subsection (a) must accompany 
the part of the report being rebutted.
	(c)  In investigating the report, the board shall:                             
		(1)  review the statement made under Subsection (a);  
and                   
		(2)  evaluate each reason asserted by the nurse to 
justify the nurse's conduct.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.040, eff. Sept. 1, 2003.


	§ 301.416. INVESTIGATION.  (a) Except as provided by 
Subsections (b) and (c), a report under this subchapter shall be 
treated as a complaint under Section 301.457.
	(b)  If the board determines that the reported conduct does 
not indicate that the continued practice of nursing by the nurse 
poses a risk of harm to a client or other person, the board, with the 
written consent of the nurse and the person making the report, may 
elect not to proceed with an investigation or to file formal 
charges.  The board shall:
		(1)  maintain a record of the report;  and                                    
		(2)  investigate the report if it receives two or more 
reports involving separate incidents regarding the nurse in any 
five-year period.
	(c)  The board is not required to investigate a report filed 
by an insurer under Section 301.408, but shall:
		(1)  maintain a record of the report;  and                                    
		(2)  investigate the report if it receives two or more 
reports involving separate incidents regarding the nurse in any 
five-year period.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.041, eff. Sept. 1, 2003.


	§ 301.417. CONFIDENTIALITY REQUIREMENTS;  DISCLOSURE OF 
INFORMATION.  (a) A report required or authorized under this 
subchapter and the identity of the person making the report are 
confidential and may not be disclosed except as provided by this 
section and Section 301.414.
	(b)  The board may disclose the information to the same 
extent that the board may disclose information relating to a 
complaint under Section 301.466.
	(c)  Repealed by Acts 2005, 79th Leg., ch. 113, § 18.                       
	(d)  In addition to the other authorizations of this section, 
the information may be disclosed in:
		(1)  a civil action in which a reporting person is named 
as a defendant as a result of making the report;  or
		(2)  the prosecution of a cause of action based on a 
claim that the reporting person was subject to retaliatory action 
as a result of making the report.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2005, 79th Leg., ch. 113, § 13, 18, eff. May 20, 2005.


	§ 301.418. DISCLOSURE OF CHARGES OR DISCIPLINARY 
ACTION.  (a) This subchapter does not prevent disclosure under 
Section 301.466 of formal charges filed by the board or a final 
disciplinary action taken by the board as a result, in whole or in 
part, of submission of a report under this subchapter.
	(b)  A report or information submitted as required or 
authorized by this subchapter arising out of the provision or 
failure to provide nursing services may not be made available in a 
liability action for:
		(1)  discovery;                                                               
		(2)  court subpoena;  or                                                      
		(3)  introduction into evidence.                                              
	(c)  A person is not prevented from taking disciplinary 
action against a nurse by:
		(1)  the filing of a report under this subchapter with 
the board;           
		(2)  an investigation by the board;  or                                       
		(3)  the disposition of a matter by the board.                                

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.042, eff. Sept. 1, 2003.


	§ 301.419. GENERAL PROVISIONS REGARDING DUTY TO REPORT;  
MINOR INCIDENTS.  (a) In this section, "minor incident" means 
conduct that does not indicate that the continuing practice of 
nursing by an affected nurse poses a risk of harm to a client or 
other person.
	(b)  The board shall adopt rules governing reporting 
required under this subchapter to minimize:
		(1)  unnecessary duplicative reporting;  and                                  
		(2)  the reporting of a minor incident.                                       
	(c)  If the board determines that a report submitted under 
this subchapter is without merit, the board shall expunge the 
report from the nurse's file.
	(d)  The board shall inform, in the manner the board 
determines appropriate, nurses, facilities, agencies, and other 
persons of their duty to report under this subchapter.
	(e)  The reporting required under this subchapter does not 
constitute state action on behalf of the person reporting.
	(f)  The duty to report or any other requirement of this 
subchapter may not be nullified by a contract.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.043, eff. Sept. 1, 2003.

SUBCHAPTER J. PROHIBITED PRACTICES AND DISCIPLINARY ACTIONS


	§ 301.451. CERTAIN PROHIBITED PRACTICES.  A person may 
not:               
		(1)  sell, fraudulently obtain, or fraudulently 
furnish a nursing diploma, license, renewal license, or record;
		(2)  assist another person in selling, fraudulently 
obtaining, or fraudulently furnishing a nursing diploma, license, 
renewal license, or record;
		(3)  practice nursing under a diploma, license, or 
record that was:         
			(A)  obtained unlawfully or fraudulently;  or                                
			(B)  signed or issued unlawfully or under false 
representation;  or        
		(4)  practice nursing in a period in which the person's 
license is suspended or revoked.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.044, eff. Sept. 1, 2003.


	§ 301.4515. USE OF CERTAIN NURSING TITLES.  Unless the 
person is practicing under the delegated authority of a registered 
nurse or is otherwise authorized by state or federal law, a person 
may not use, in connection with the person's name:
		(1)  the title "nurse aide," "nurse assistant," or 
"nurse technician";  or  
		(2)  any other similar title.                                                 

Added by Acts 2003, 78th Leg., ch. 876, § 8, eff. June 20, 2003.           


	§ 301.452. GROUNDS FOR DISCIPLINARY ACTION.  (a) In this 
section, "intemperate use" includes practicing nursing or being on 
duty or on call while under the influence of alcohol or drugs.
	(b)  A person is subject to denial of a license or to 
disciplinary action under this subchapter for:
		(1)  a violation of this chapter, a rule or regulation 
not inconsistent with this chapter, or an order issued under this 
chapter;
		(2)  fraud or deceit in procuring or attempting to 
procure a license to practice professional nursing or vocational 
nursing;
		(3)  a conviction for, or placement on deferred 
adjudication community supervision or deferred disposition for, a 
felony or for a misdemeanor involving moral turpitude;
		(4)  conduct that results in the revocation of 
probation imposed because of conviction for a felony or for a 
misdemeanor involving moral turpitude;
		(5)  use of a nursing license, diploma, or permit, or 
the transcript of such a document, that has been fraudulently 
purchased, issued, counterfeited, or materially altered;
		(6)  impersonating or acting as a proxy for another 
person in the licensing examination required under Section 301.253 
or 301.255;
		(7)  directly or indirectly aiding or abetting an 
unlicensed person in connection with the unauthorized practice of 
nursing;
		(8)  revocation, suspension, or denial of, or any other 
action relating to, the person's license or privilege to practice 
nursing in another jurisdiction;
		(9)  intemperate use of alcohol or drugs that the board 
determines endangers or could endanger a patient;
		(10)  unprofessional or dishonorable conduct that, in 
the board's opinion, is likely to deceive, defraud, or injure a 
patient or the public;
		(11)  adjudication of mental incompetency;                                    
		(12)  lack of fitness to practice because of a mental or 
physical health condition that could result in injury to a patient 
or the public;  or
		(13)  failure to care adequately for a patient or to 
conform to the minimum standards of acceptable nursing practice in 
a manner that, in the board's opinion, exposes a patient or other 
person unnecessarily to risk of harm.
	(c)  The board may refuse to admit a person to a licensing 
examination for a ground described under Subsection (b).

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2001, 77th Leg., ch. 1420, § 14.124(a), eff. Sept. 1, 
2001;  Acts 2003, 78th Leg., ch. 553, § 1.045, eff. Sept. 1, 
2003;  Acts 2005, 79th Leg., ch. 1058, § 3, eff. Sept. 1, 2005.


	§ 301.453. DISCIPLINARY AUTHORITY OF BOARD;  METHODS OF 
DISCIPLINE.  (a) If the board determines that a person has 
committed an act listed in Section 301.452(b), the board shall 
enter an order imposing one or more of the following:
		(1)  denial of the person's application for a license, 
license renewal, or temporary permit;
		(2)  issuance of a written warning;                                           
		(3)  administration of a public reprimand;                                    
		(4)  limitation or restriction of the person's license, 
including:          
			(A)  limiting to or excluding from the person's 
practice one or more specified activities of nursing;  or
			(B)  stipulating periodic board review;                                      
		(5)  suspension of the person's license for a period not 
to exceed five years;
		(6)  revocation of the person's license;  or                                  
		(7)  assessment of a fine.                                                    
	(b)  In addition to or instead of an action under Subsection 
(a), the board, by order, may require the person to:
		(1)  submit to care, counseling, or treatment by a 
health provider designated by the board as a condition for the 
issuance or renewal of a license;
		(2)  participate in a program of education or 
counseling prescribed by the board;
		(3)  practice for a specified period under the 
direction of a registered nurse or vocational nurse designated by 
the board;  or
		(4)  perform public service the board considers 
appropriate.                
	(c)  The board may probate any penalty imposed on a nurse and 
may accept the voluntary surrender of a license.  The board may not 
reinstate a surrendered license unless it determines that the 
person is competent to resume practice.
	(d)  If the board suspends, revokes, or accepts surrender of 
a license, the board may impose conditions for reinstatement that 
the person must satisfy before the board may issue an unrestricted 
license.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.046, eff. Sept. 1, 2003.


	§ 301.4535. REQUIRED SUSPENSION, REVOCATION, OR REFUSAL 
OF LICENSE FOR CERTAIN OFFENSES.  (a) The board shall suspend a 
nurse's license or refuse to issue a license to an applicant on 
proof that the nurse or applicant has been initially convicted of:
		(1)  murder under Section 19.02, Penal Code, capital 
murder under Section 19.03, Penal Code, or manslaughter under 
Section 19.04, Penal Code;
		(2)  kidnapping or unlawful restraint under Chapter 20, 
Penal Code, and the offense was punished as a felony or state jail 
felony;
		(3)  sexual assault under Section 22.011, Penal Code;                         
		(4)  aggravated sexual assault under Section 22.021, 
Penal Code;            
		(5)  indecency with a child under Section 21.11, Penal 
Code;                
		(6)  aggravated assault under Section 22.02, Penal 
Code;                    
		(7)  intentionally, knowingly, or recklessly injuring 
a child, elderly individual, or disabled individual under Section 
22.04, Penal Code;
		(8)  intentionally, knowingly, or recklessly 
abandoning or endangering a child under Section 22.041, Penal Code;
		(9)  aiding suicide under Section 22.08, Penal Code, 
and the offense was punished as a state jail felony;
		(10)  an offense under Section 25.07, Penal Code, 
punished as a felony;     
		(11)  an offense under Section 25.071, Penal Code, 
punished as a felony;    
		(12)  an agreement to abduct a child from custody under 
Section 25.031, Penal Code;
		(13)  the sale or purchase of a child under Section 
25.08, Penal Code;      
		(14)  robbery under Section 29.02, Penal Code;                                
		(15)  aggravated robbery under Section 29.03, Penal 
Code;                   
		(16)  an offense for which a defendant is required to 
register as a sex offender under Chapter 62, Code of Criminal 
Procedure;  or
		(17)  an offense under the law of another state, 
federal law, or the Uniform Code of Military Justice that contains 
elements that are substantially similar to the elements of an 
offense listed in this subsection.
	(b)  On final conviction or a plea of guilty or nolo 
contendere for an offense listed in Subsection (a), the board, as 
appropriate, may not issue a license to an applicant, shall refuse 
to renew a license, or shall revoke a license if the applicant or 
license holder did not previously disclose the conviction or plea 
and the fifth anniversary of the date the person successfully 
completed community supervision or parole has not occurred.
	(c)  A person is not eligible for an initial license or for 
reinstatement or endorsement of a license to practice nursing in 
this state before the fifth anniversary of the date the person 
successfully completed and was dismissed from community 
supervision or parole for an offense described by Subsection (a).

Added by Acts 2005, 79th Leg., ch. 1058, § 4, eff. Sept. 1, 2005.          


	§ 301.454. NOTICE AND HEARING.  (a) Except in the case of 
a temporary suspension authorized under Section 301.455 or an 
action taken in accordance with an agreement between the board and a 
license holder, the board may not initiate a disciplinary action 
relating to a license unless:
		(1)  the board has served notice to the license holder 
of the facts or conduct alleged to warrant the intended action;  and
		(2)  the license holder has been given an opportunity, 
in writing or through an informal meeting, to show compliance with 
all requirements of law for the retention of the license.
	(b)  If an informal meeting is held, a board member, staff 
member, or board representative who attends the meeting is 
considered to have participated in the hearing of the case for the 
purposes of ex parte communications under Section 2001.061, 
Government Code.
	(c)  A person is entitled to a hearing conducted by the State 
Office of Administrative Hearings if the board proposes to:
		(1)  refuse to admit the person to examination;                               
		(2)  refuse to issue a license or temporary permit;                           
		(3)  refuse to renew a license;  or                                           
		(4)  suspend or revoke the person's license or permit.                        
	(d)  The State Office of Administrative Hearings shall use 
the schedule of sanctions adopted by the board for any sanction 
imposed as the result of a hearing conducted by that office.
	(e)  Notwithstanding Subsection (a), a person is not 
entitled to a hearing on a refusal to renew a license if the person:
		(1)  fails to submit a renewal application;  or                               
		(2)  submits an application that:                                             
			(A)  is incomplete;                                                          
			(B)  shows on its face that the person does not 
meet the renewal requirements;  or
			(C)  is not accompanied by the correct fee.                                  

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.                    


	§ 301.455. TEMPORARY LICENSE SUSPENSION OR 
RESTRICTION.  (a) The license of a nurse shall be temporarily 
suspended or restricted on a determination by a majority of the 
board or a three-member committee of board members designated by 
the board that, from the evidence or information presented, the 
continued practice of the nurse would constitute a continuing and 
imminent threat to the public welfare.
	(b)  A license may be temporarily suspended or restricted 
under this section without notice or hearing on the complaint if:
		(1)  institution of proceedings for a hearing before 
the State Office of Administrative Hearings is initiated 
simultaneously with the temporary suspension or determination to 
restrict;  and
		(2)  a hearing is held as soon as possible under this 
chapter and Chapter 2001, Government Code.
	(c)  The State Office of Administrative Hearings shall hold a 
preliminary hearing not later than the 14th day after the date of 
the temporary suspension or restriction to determine whether 
probable cause exists that a continuing and imminent threat to the 
public welfare exists.  The probable cause hearing shall be 
conducted as a de novo hearing.
	(d)  A final hearing on the matter shall be held not later 
than the 61st day after the date of the temporary suspension or 
restriction.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.047, eff. Sept. 1, 2003;  
Acts 2005, 79th Leg., ch. 1058, § 5, eff. Sept. 1, 2005.


	§ 301.456. EVIDENCE.  A certified copy of the order of the 
denial, suspension, or revocation or other action under Section 
301.452(b)(8) is conclusive evidence of that action.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2001, 77th Leg., ch. 1420, § 14.124(b), eff. Sept. 1, 
2001.


	§ 301.457. COMPLAINT AND INVESTIGATION.  (a) The board or 
any person may initiate a proceeding under this subchapter by 
filing with the board a complaint against a nurse.  The complaint 
must be in writing and signed by the complainant.
	(b)  Except as otherwise provided by this section, the board 
or a person authorized by the board shall conduct each 
investigation.  Each complaint against a nurse that requires a 
determination of nursing competency shall be reviewed by a board 
member, consultant, or employee with a nursing background the board 
considers sufficient.
	(c)  On the filing of a complaint, the board:                                  
		(1)  may conduct a preliminary investigation into the 
identity of the nurse named or described in the complaint;
		(2)  shall make a timely and appropriate preliminary 
investigation of the complaint;  and
		(3)  may issue a warning or reprimand to the nurse.                           
	(d)  After any preliminary investigation to determine the 
identity of the subject of the complaint, unless it would 
jeopardize an investigation, the board shall notify the nurse that 
a complaint has been filed and the nature of the complaint.  If the 
investigation reveals probable cause to take further disciplinary 
action, the board shall either attempt an informal disposition of 
the complaint or file a formal charge against the nurse stating the 
provision of this chapter or board rule that is alleged to have been 
violated and a brief description of each act or omission that 
constitutes the violation.
	(e)  The board shall conduct an investigation of the 
complaint to determine: 
		(1)  whether the nurse's continued practice of nursing 
poses a risk of harm to clients or other persons;  and
		(2)  whether probable cause exists that a nurse 
committed an act listed in Section 301.452(b) or that violates 
other law.
	(f)  In making a determination under Subsection (e), the 
board shall review the evidence to determine the extent to which a 
deficiency in care by the registered nurse was the result of 
deficiencies in the registered nurse's judgment, knowledge, 
training, or skill rather than other factors beyond the nurse's 
control.  A determination that a deficiency in care is attributable 
to a registered nurse must be based on the extent to which the 
registered nurse's conduct was the result of a deficiency in the 
registered nurse's judgment, knowledge, training, or skill.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.048, eff. Sept. 1, 2003;  
Acts 2003, 78th Leg., ch. 876, § 9, eff. June 20, 2003.


	§ 301.458. INITIATION OF FORMAL CHARGES;  DISCOVERY.  (a) 
Unless there is an agreed disposition of the complaint under 
Section 301.463, and if probable cause is found under Section 
301.457(e)(2), the board or the board's authorized representative 
shall initiate proceedings by filing formal charges against the 
nurse.
	(b)  A formal charge must:                                                     
		(1)  be written;                                                              
		(2)  be specific enough to enable a person of common 
understanding to know what is meant by the formal charge;  and
		(3)  contain a degree of certainty that gives the 
person who is the subject of the formal charge notice of each 
particular act alleged to violate a specific statute, board rule, 
or board order.
	(c)  A copy of the formal charge shall be served on the nurse 
or the nurse's counsel of record.
	(d)  The board shall adopt reasonable rules to promote 
discovery by each party to a contested case.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.049, eff. Sept. 1, 2003.


	§ 301.459. FORMAL HEARING.  (a) The board by rule shall 
adopt procedures under Chapter 2001, Government Code, governing 
formal disposition of a contested case.  The State Office of 
Administrative Hearings shall conduct a formal hearing.
	(b)  In any hearing under this section, a nurse is entitled 
to appear in person or by counsel.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 553, § 1.050, eff. Sept. 1, 2003.


	§ 301.460. ACCESS TO INFORMATION.  (a) Except for good 
cause shown for delay and subject to any other privilege or 
restriction set forth by statute, rule, or legal precedent, the 
board shall, not later than the 30th day after the date the board 
receives a written request from a license holder who is the subject 
of a formal charge filed under Section 301.458 or from the license 
holder's counsel of record, provide the license holder with access 
to:
		(1)  all known exculpatory information in the board's 
possession;  and      
		(2)  information in the board's possession that the 
board intends to offer into evidence in presenting its case in chief 
at the contested hearing on the complaint.
	(b)  The board is not required to provide:                                     
		(1)  board investigative reports or investigative 
memoranda;