HBA-LJP C.S.H.B. 1361 77(R) BILL ANALYSIS Office of House Bill AnalysisC.S.H.B. 1361 By: Gray Higher Education 4/4/2001 Committee Report (Substituted) BACKGROUND AND PURPOSE Texas, like the entire United States, is facing a shortage of registered nurses. According to the 2000 report "2001-2002 Texas State Health Plan Update: Ensuring a Quality Health Care Workforce for Texas" by the Texas Department of Health, there were 595 registered nurses per 100,000 people in Texas in 1999, which is considerably lower than the national ratio. Unfortunately, Texas nursing education programs have had to turn away approximately 3000 qualified applicants in the fall semesters of 1998 and 1999 because of the limited number of budgeted faculty positions. The report contends that an aging registered nurse workforce, the large youth and elderly population in Texas, and medical technology requiring a specially trained workforce are the demographic and market causes of the nursing shortage. C.S.H.B. 1361 establishes the Nursing Shortage Reduction Act of 2001 to provide incentives to increase enrollment in and faculty of professional nursing programs. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that rulemaking authority is expressly delegated to the Texas Higher Education Coordinating Board in SECTION 3 (Section 61.924, Education Code) and in SECTION 8 (Section 61.656, Education Code), and to the Board of Nurse Examiners in SECTION 11 (Section 304.011, Occupations Code) of this bill. ANALYSIS C.S.H.B. 1361 amends the Education Code to establish the professional nursing shortage reduction program (program) to increase the number and preparation of professional nurses in public, private, or independent institutions of higher education (institution) if the legislature appropriates money for the program (Sec. 61.922 and SECTION 13). The bill requires the Texas Higher Education Coordinating Board (THECB) to adopt rules and regulations for the administration of the program (Sec. 61.924). The bill authorizes THECB to solicit, receive, and spend donations or grants from public or private sources to administer the program. The bill requires THECB to make grants to professional nursing programs and other entities involved with a professional nursing program for the enrollment and retention of nursing students and to encourage innovation in enrollment and retention. The bill sets forth provisions regulating the expenditures of the program's grants and requires professional nursing programs and other entities to return any unexpended funds from the grant to THECB (Secs. 61.921-61.925). The bill authorizes an institution to permit a registered nurse to register in a postgraduate nursing degree program by paying the tuition and other fee charges required of Texas residents if the registered nurse: _is authorized to practice professional nursing in Texas; _is enrolled in a program designed to lead to a master's degree or other higher degree in nursing; and _intends to teach in a program in Texas designed to prepare a student for licensure as registered nurse (Sec. 54.069). The bill authorizes THECB to establish multiple categories of persons to receive scholarships, matching funds, and loan repayments through financial aid programs for professional and vocational nursing students, and to appropriate not more than ten percent of the legislative funds for administrative costs of operating these financial assistance programs. The bill repeals the requirement that THECB include ethnic or racial minority status in the criteria for the financial assistance and authorizes THECB to include in the existing criteria a person's intention to seek employment in a nursing school faculty, and the geographical area in which the person is likely to practice (Secs. 61.655 and 61.659). The bill repeals certain rules which THECB is required to adopt to establish and administer the employer matching fund program and requires THECB to adopt rules to provide a standard agreement for a sponsoring employer and the student. The bill requires THECB to distribute information about the different nursing financial aid programs to certain entities and persons (Sec. 61.656). The bill authorizes THECB to structure the nursing financial aid programs to secure funds available under federal matching programs (Sec. 61.658). The bill amends the Occupations Code to require the Board of Nurse Examiners to adopt rules to establish and implement the nursing workforce data center (center) to address issues of supply and demand for nursing if the legislature appropriates money for the center. The bill authorizes the Board of Nurse Examiners to contract with public or private entities to establish and to perform the responsibilities of the center (Secs. 304.002, 304.010, and SECTION 13). The center is authorized to establish and charge reasonable fees for certain services, to solicit, receive, and spend certain donations, and to appropriate not more than five percent of the legislative funds for administrative costs (Secs. 304.012 - 304.014). The bill requires the center to collect and analyze the specified data on nursing, predict supply and demand for nursing personnel in Texas, develop a nursing personnel supply and demand model appropriate for Texas, and publish certain reports with the collected data. The bill provides that reports, records, and information obtained from the center are confidential and are not subject to public disclosure, or to subpoena (Sec. 304.006). The bill authorizes the center to develop programs relating to the recruitment of nurses, including the collection of data on the career satisfaction of nurses (Sec. 304.009). In order to minimize the duplication of the collection of data and to promote the sharing of data, the bill requires the center to coordinate its activities with THECB, the statewide health coordinating council, the Texas Workforce Commission, and other public entities (Sec. 304.007). The bill also authorizes the center to establish a clearinghouse for nursing education programs and health care providers to identify sites available to nursing education programs to provide clinical experience for students (Sec. 304.010). The bill requires the Board of Nurse Examiners to appoint an executive committee and sets forth provisions regarding the appointment and composition, powers and duties, reimbursement, and administration of the executive committee by a qualified executive director (Secs. 304.003 and 304.004 and SECTION 12). EFFECTIVE DATE September 1, 2001. COMPARISON OF ORIGINAL TO SUBSTITUTE C.S.H.B. 1361 modifies the original to remove the additional qualifications that an institution of higher education is authorized to require a registered nurse to meet in order to qualify for the Texas resident rate of tuition and fees (Sec. 54.069, Education Code). The substitute clarifies that the establishment of the nursing workforce data center (center) occurs only if the legislature appropriates money for the center (SECTION 13). The substitute provides for the inclusion of information submitted in aggregate by entities that collect similar data in the required collected data and published reports of the center. C.S.H.B. 1361 provides that reports, records, and information from the center must be released in the aggregate and prohibits these documents from containing employer-specific data (Secs. 304.005 and 304.008, Occupations Code). The substitute provides that reports, records, and information obtained from the center are confidential and are not subject to public disclosure or to subpoena (Sec. 304.006, Occupations Code).