(a) This section is authorized by Texas Occupations
Code §301.1605(a) and §301.453. Any pilot program approved
by the Board after the final adoption of this rule will continue for
a period not to exceed two years from the approval date. The pilot
program approved by the Board may be extended upon an approval of
a written application submitted to the Board.
(b) The purpose of this rule is to evaluate the effectiveness
of innovative remediation programs that are designed to target deficiencies
in nurse practice competencies of licensed practitioners and provide
effective and efficient remediation as an alternative method of discipline.
An applicant for approval is encouraged to develop a comprehensive
and individualized assessment of nurse practice competency based on
identified violations of the Nursing Practice Act (NPA) and targeted
remedial education to correct identified deficiencies in order to
ensure minimum competency. Additionally, the pilot program may wish
to develop an alternative extensive orientation program consistent
with §217.6(b) of this title (relating to Failure to Renew License)
and §217.9(g) of this title (relating to Inactive and Retired
Status) that will evaluate and remediate nurses who wish to re-enter
practice after prolonged absences. The design of any alternative extensive
orientation will focus on evidence-based assurance of minimum nurse
competency before returning to practice.
(c) Approval of the pilot program provider is within
discretion of the Executive Director and any provider must be able
to meet the requirements of this rule.
(d) Any order issued in association with an approved
pilot program will be considered a method of discipline pursuant to
Texas Occupations Code §301.453 or §301.6555 and will be
considered public information subject to all reporting requirements
of disciplinary actions under federal and state laws.
(e) Participation in an approved pilot program will
only be through an agreed order and the opportunity to enter into
a pilot program order is at the sole discretion of the Executive Director.
(f) Each nurse will be responsible for the entire cost
of participation in the pilot program. Each nurse subject to a pilot
program order must:
(1) enroll in the pilot program within 45 days of the
date of the order unless otherwise agreed;
(2) submit to an individualized assessment designed
to evaluate nurse practice competency and to support a targeted remediation
plan;
(3) follow all requirements within the remediation
plan if any;
(4) successfully complete the pilot program order within
one year from the effective date of the agreed order; and
(5) provide written proof of successful completion
of the pilot program to the Board.
(g) The pilot program provider approved under this
rule should be capable of meeting the following requirements:
(1) provide reasonable intake and assessment options
within 45 days of enrollment;
(2) perform an individualized comprehensive assessment
designed to evaluate nurse practice competency;
(3) develop a written individualized remediation plan
to ensure minimum competency that may include a period of monitoring
and follow-up;
(4) if requested by the Board, provide the remediation
plan to the Board for review and approval;
(5) provide the education, resources, tools and support
that the remediation plan requires; and
(6) provide a written report to the nurse and the Board
upon the successful completion of the remediation plan.
(h) Every pilot program order shall require the person
subject to the order to participate in a program of education and
study that will include a course in nursing jurisprudence and ethics.
(i) If the individualized assessment identifies further
violations of the Nursing Practice Act, including inability to practice
nursing safely, further disciplinary action may be taken based on
such results in the assessments.
(j) In order for a nurse to be eligible to participate
in a pilot program order, the individual shall have no prior disciplinary
history with the Board.
(k) A pilot program order will only be available:
(1) for violations of the NPA and/or Board rules that
are proposed for resolution through the issuance of a Warning, a Warning
with Stipulations, a Warning with Stipulations and a Fine, a Warning
with a Fine, Remedial Education, Remedial Education with a Fine, or
any deferred order issued pursuant to §213.34 of this title (relating
to Deferred Discipline);
(2) as a condition of settlement by agreement prior
to the initiation of proceedings before the State Office of Administrative
Hearings; and
(3) if the probationary stipulations outlined in the
pilot program are designed to address an individual's practice deficit,
knowledge deficit, or lack of situational awareness.
(l) Violations involving sexual misconduct, criminal
conduct, intentional acts, falsification, deception, chemical dependency,
or substance abuse will not be eligible for resolution through a pilot
program action under the pilot program.
(m) If an individual fails to comply with a probationary
stipulation required by the pilot program order or if a subsequent
complaint is filed against an individual during the pendency of the
pilot program order, the Board may treat the pilot program action
as prior disciplinary action when considering the imposition of a
disciplinary sanction.
(n) The outcome and effectiveness of any pilot program
will be monitored and evaluated by the Board to ensure compliance
with the criteria of this rule and obtain evidence that research goals
are being pursued.
(o) The Board may contract with a third party to perform
the monitoring and evaluation of any program approved under this rule.
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