Legislative Summary: 88th Texas Legislative Session

Legislative Summary: 88th Texas Legislative Session

The following is a summary of bills relating to the practice of nursing in Texas reported on in the Legislative Report on the 88th Regular Texas Legislative Session at the July 2023 Board of Nursing (BON) Board Meeting. The link to the report can be found at https://www.bon.texas.gov/meetings_board_meetings_2023_July.asp.html For the full text of the bills included in this summary, visit www. capitol.state.tx.us.

Bills Amending the Nursing Practice Act

House Bill (HB) 2187 by Representative Yvonne Davis

Relates to increased penalties for conviction for abandoning or endangering of elderly or disabled individuals. HB 2187 amends the Nursing Practice Act (NPA), Subchapter G, Chapter 301, Occupations Code, Section 301.4535(a).

HB 4123 by Representative Ryan Guillen

Relates to the dissemination of criminal history record information by the Department of Public Safety. HB 4123 amends the NPA, Subchapter G, Chapter 301, Occupations Code, Sections 301.2511(a), and (c).

Senate Bill (SB) 1343 by Senator Morgan Lamantia

Amends Section 301.051 of the Occupations Code to increase the size of the Board to 15 members. The two new positions on the Board will include an additional Advanced Practice Registered Nurse (APRN) representative and an additional consumer representative. Requires the Board to adopt rules to appoint APRNs to review and assist with complaints and investigations related to alleged standard of care violations by APRNs. The APRN reviewer must practice within the same role and population focus and must provide for the report of the expert reviewer to be included with notice of informal proceedings. The rules required by this section must be adopted no later than February 1, 2024.

SB 1429 by Senator Chuy Hinojosa

Prohibits the use of a standardized examination as a graduation requirement or to deny students an affidavit of graduation. Lists acceptable uses of standardized examinations. Requires rules related to the use of standardized exams to be adopted as soon as practicable after the effective date. SB 1429 adds new Section 301.1571 to the NPA.

SB 1659 by Senator Charles Schwertner

SB 1659 amends Sec. 301.003 to postpone review of the Board of Nursing and other agencies by the Sunset Advisory Commission from the 20282029 review cycle to the 2032-2033 review cycle.

Other Bills Relating to Nursing

HB 44 by Representative Valoree Swanson

Under HB 44, a provider who participates in Medicaid or the child health plan program may not refuse to provide health care services to a Medicaid recipient or child health plan program enrollee based solely on the recipient’s or enrollee’s refusal or failure to obtain a vaccine or immunization for a particular infectious or communicable disease.

HB 49 by Representative Stephanie Klick

Amendments to the Health and Safety Code will now require public access to certain hospital investigation information and materials.

HB 473 by Representative Lacey Hull

Before a school’s Threat Assessment and Safe and Supportive School Team can conduct a threat assessment of a student the team must notify a parent or other person standing in parental relation and provide them with the opportunity to participate. Following completion of the assessment the parent or other person shall be given the findings and conclusions of the assessment. School nurses working in support of these teams will need to be aware of the requirements of this bill to ensure compliance.

HB 617 by Representative Drew Darby

HB 617 establishes a pilot program for emergency telemedicine services in rural areas. Aims to provide emergency medical services instruction via telemedicine to healthcare and EMS providers in rural areas.

HB 755 by Representative Julie Johnson

HB 755 amends Chapter 1369 of the Insurance Code to prohibit most health benefit plans that provide prescription drug benefits from requiring an enrollee to receive more than one prior authorization annually for prescription drugs used to treat an autoimmune disease, hemophilia, or Von Willebrand disease. Some exceptions apply. APRNs who prescribe these drugs and nurses who work with patients who take these drugs should be aware.

HB 852 by Representative Shawn Thierry

HB 852 amends Chapter 34 of the Health and Safety Code to expand the membership of the Texas Maternal Mortality and Morbidity Review Committee to include additional members whose areas of expertise are not currently represented. There was no change to the existing nursing representation on this committee.

HB 916 by Representative Claudia Ordaz

HB 916 amends Chapter 1369 of the Insurance Code to require most health benefit plans that provide benefits for prescription contraceptive drugs to provide for an enrollee to obtain up to a three-month supply at one time the first time the enrollee obtains the drug and a 12-month supply at one time each subsequent time the enrollee obtains the drug. APRNs who prescribe these drugs and nurses who work with patients who take these drugs should be aware.

HB 1106 by Representative Vikki Goodwin

Following passage of HB 1106, the Texas Medical Board may set the training and certification process for an acudetox specialist to provide acupuncture services.

HB 1211 by Representative Ryan Guillen

HB 1211 relates to repayment of certain mental health professional education loans, including APRNs, who hold a nationally recognized board certification in psychiatric or mental health nursing.

HB 1337 by Representative Lacey Hull

Amends Chapter 1369 of the Insurance Code to limit the authority of health benefit plans to require enrollees who are 18 years or older and diagnosed with serious mental illness to complete step therapy protocols before the insurer will provide coverage for certain prescription drugs. Health benefit plans may implement a step therapy protocol to require the trial of a generic or pharmaceutical equivalent of a prescribed prescription drug only once in a plan year and only if the generic or pharmaceutical equivalent drug is added to the plan’s drug formulary. APRNs who diagnose and treat serious mental illness and nurses who work with these patients should be aware of the changes.

HB 1488 by Representative Toni Rose

The Health and Safety Code will outline the establishment of the sickle cell task force and the work to be accomplished to improve health care relating to sickle cell disease.

HB 1647 by Representative Cody Harris

HB 1647 amends Chapter 1369 of the Insurance Code to prohibit most health benefit plans from requiring enrollees with chronic, complex, rare, or life-threatening medical conditions to obtain clinician-administered drugs dispensed only by certain pharmacies or only by pharmacies participating in the health benefit plan issuer’s network or to limit or exclude coverage for such drugs based on the enrollee’s choice of pharmacy. Additionally, the health benefit plan cannot require a provider to bill for reimbursement for delivery and administration of the clinician-administered drug under the pharmacy benefit rather than the medical benefit without informed written consent of the patient and a written attestation from the provider that a delay in the drug’s administration will not place the patient at increased health risk. Additionally, the enrollee cannot be required to pay additional fees or higher copays, or other price based on the enrollee’s choice of pharmacy if certain criteria are met. APRNs and nurses who practice in settings in which these patients are administered these drugs should be aware.

HB 1673 by Representative Giovanni Capriglione

Nurses, including nurse managers and direct care staff members, who work in assisted living facilities that provide care to residents with Alzheimer’s disease and related disorders are required to complete training and receive annual continuing education training on Alzheimer’s disease, related disorders, and care of residents with these conditions. HB 1673 only applies to assisted living facilities that do not hold a license classified under section 247.029 Facilities for Persons with Alzheimer’s Disease of the Texas Health & Safety Code. The Texas Health and Human Services Commission (HHSC) will implement new rules to meet the requirements outlined in the bill. Staff do not have to complete training until December 31, 2024.

HB 1890 by Representative Jacey Jetton

Amends the Health and Safety Code, creating an application, approval process, and minimum standards for the operation of a hospital at home program by certain hospitals, authorizing a fee.

HB 2727 by Representative Four Price

HB 2727 establishes Medicaid reimbursement for telemonitoring services for individuals with certain conditions: pregnancy, diabetes, heart disease, cancer, COPD, hypertension, congestive heart failure, asthma, myocardial infarction, stroke, end stage renal disease and/or mental illness. These individuals must have at least one of the qualifying risk factors. The information gathered has to be gathered by a qualifying entity.

HB 3009 by Representative Gary VanDeaver

Amends Chapter 1101 of the Estates Code to permit an APRN to conduct examinations and issue letters or certificates of incapacitation of an adult for purposes of guardianship. The APRN must have delegated authority from the physician to provide this service, and the delegating physician must co-sign the letter or certificate issued by the APRN.

HB 3162 by Representative Stephanie Klick

Nurses who are involved in direct patient care and care coordination should be aware of what happens when an attending physician refuses to honor advance directives or a patient’s healthcare/treatment decision. HB 3162 includes updates to this process which involves review of the refusal by ethics or medical committee and care coordination among the physician, healthcare team, patient, and family to resolve disagreements about patient care and treatment decisions.

3286 by Representative Stephanie Klick

HB 3286 amends Chapter 531 of the Government Code adds protections for exceptions to the Texas Medicaid prescription drug formulary that will give Medicaid patients exceptions under certain conditions. Will allow patients who are stable on a drug to obtain an exception if a change in the drug would be expected to be ineffective or to cause harm to the patient. The bill also creates a database for providers to determine if drugs are on the state’s preferred drug list. APRNs who prescribe drugs to Medicaid patients and nurses working with these patients need to be aware of this change. The database will provide an additional resource for nurses at all levels of licensure who work with these patients.

HB 4375 by Representative Gary VanDeaver

A school district or open-enrollment charter school shall provide instruction to students in grades 7 through 12 in cardiopulmonary resuscitation and the use of an automated external defibrillator.

4696 by Representative Candy Noble

Nurses working in long-term care facilities licensed by or in contract with HHSC should be aware of updated reporting requirements related to reports of abuse, neglect, or exploitation of residents or patients, including the reporting of suspected abuse, neglect or exploitation. These reports must be made directly to the commission, instead of to the Department of Family and Protective Services.

HB 4888 by Representative Cole Hefner

HB 4888 amends Chapter 32 of the Human Resources Code to permit providers who provide non-opioid treatment services to include drugs or biological products to be reimbursed separately under Medicaid to the extent permitted under federal law. Non-opioid treatment is defined to mean a drug or biological product that is indicated to produce analgesia without acting on the body’s opioid receptors. APRNs who provide such services need to be aware.

SB 24 by Senator Lois Kolkhorst

Transfer of powers and duties of various programs from the Department of Family and Protective Services to Health and Human Services Commission, including the Nurse-Family Partnership competitive grant program and the Texas Home Visiting Program.

SB 25 by Senator Lois Kolkhorst

SB 25 amends Section 61.651(1), Education Code: Provides funding for an initial or an advanced degree in professional nursing in the form of scholarships and loan repayment. Specific criteria are set forth for eligibility to receive the funds. Part-time and full-time nursing program faculty are eligible to apply for these funds. This bill is meant to assist with the nursing and nursing faculty shortage.

SB 240 by Senator Donna Campbell

Facilities, as defined by the bill, to include home and community support services agencies, hospitals, nursing facilities employing at least two registered nurses, ambulatory surgical centers, freestanding emergency medical care facilities, and mental hospitals, shall establish a workplace violence prevention committee or authorize an existing committee to develop a workplace violence prevention plan. A facility shall adopt, implement, and enforce a written workplace violence prevention policy and plan to protect health care providers and employees from violent behavior and threats of violent behavior occurring at the facility. The committee must include at least one RN that provides direct care to patients of the facility.

SB 294 by Senator Nathan Johnson

Changes references in the education code relating to the use of unassigned asthma medication and the use of “medication for respiratory distress.” Public and private schools may adopt and implement a policy regarding the training of staff and the maintenance, administration, and disposal of medication for respiratory distress. Nurses working in school settings that will implement such policies should be aware of the requirements of this bill.

SB 401 by Senator Lois Kolkhorst

SB 401 prohibits price gouging by a medical staffing service during a designated public health disaster period.

SB 629 by Senator Jose Menendez

Public and private schools serving students in grades 6 through 12 shall adopt and implement policies regarding the training of staff and the maintenance, administration, and disposal of opioid antagonists. Schools serving students in a grade level below grade 6 may adopt such policies. Nurses working in school settings that will implement such policies should be aware of the requirements of this bill.

SB 745 by Senator Lois Kolkhorst

SB 745 amends Chapter 36 of the Human Resources Code to expand the scope of the Texas Medicaid Fraud Prevention Act and authorize the Office of the Attorney General to investigate and pursue civil enforcement actions to deter fraudulent conduct and recover funds from providers committing unlawful acts associated with health care programs funded by the state. Such programs include Medicaid, the Children’s Health Insurance Program (CHIP), and the Healthy Texas Women program. Nurses who may be found to have engaged in such conduct may be reported to the BON for enforcement action. This has the potential to result in additional complaints and investigations if nurses are found to be involved.

SB 840 by Senator Royce West

Deters and punishes violence against healthcare workers in the workplace by enhancing the penalty for assault from a Class A misdemeanor to a third-degree felony if the victim is a hospital employee on hospital property.

SB 867 by Senator Royce West

The Opioid Antagonist Program, operated by the executive commissioner of the Health and Human Services Commission, may provide opioid antagonist under the program to institutions of higher education as defined by Section 481.134.

989 by Senator Joan Huffman

SB 989 adds Chapter 1372 to the Insurance Code to require certain health benefit plans to provide coverage for biomarker testing for the purpose of diagnosis, treatment, appropriate management, or ongoing monitoring of an enrollee’s disease or condition to guide treatment when that test is supported by certain medical and scientific evidence as described in the Chapter. Nurses who work in settings in which biomarker testing is offered and meets the parameters set forth in the statute should be aware.

SB 1319 by Senator Joan Huffman

Following passage of SB 1319, emergency medical service personnel must report certain overdose information, including a registered nurse, or other health care practitioners licensed by this state, that staff an emergency medical services vehicle regularly.

SB 1506 by Senator Bryan Hughes

The parent of guardian of a student may seek care for the student’s seizures while at school or participating in a school activity by submitting a seizure management and treatment plan developed by themselves in collaboration with the physician responsible for the student’s seizure treatment. The plan must be on a form meeting the requirements specified in the bill. The Texas Education Agency shall adopt and post on the agency ’s Internet website the form required under Section 38.032(b), Education Code, as amended by this Act. Significant for school nurses.

SB 2133 by Senator Borris Miles

SB 2133 requires that each applicable emergency medical services provider have a plan for providing a dialysis patient who places an emergency 9-1-1 telephone call during a declared disaster an alternative mode of transportation directly to and from an outpatient end stage renal disease facility if the patient’s normal and alternative modes of transportation cannot be used during the disaster.

SB 2193 by Senator Morgan Lamantia

SB 2193 outlines details of the federally qualified health center primary care access program that provides primary care access to certain employees.

SB 2479 by Senator Judith Zaffirini

SB 2479 makes amendments to procedures concerning persons who are or may be persons with a mental illness or intellectual disability.

Sale of Computerized Lists Discontinued in Response to Changes to the Public Information Act

The Texas Board of Nursing (BON or Board) no longer offers for purchase computerized lists including Registered Nurses, Licensed Vocational Nurses, and Advanced Practice Registered Nurses. These lists were provided under the authority of the Public Information Act, Texas Government Code, Chapter 522, which requires release of public information pursuant to a lawful request from the public. On September 1, 2023, section 552.11765 of the Public Information Act was amended to prohibit release of certain information for all occupational licensees throughout the state. Changes to the Public Information Act make all license applications, home addresses, home phone numbers, email addresses, driver license numbers, passport numbers, and contact information restricted from public disclosure. The Board will make an announcement concerning what information will be offered through the BON website and how it will be provided in the next few months.