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RULE §213.35Targeted Assessment and Remediation Pilot Program

(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.

Source Note: The provisions of this §213.35 adopted to be effective July 30, 2014, 39 TexReg 5757; amended to be effective April 26, 2018, 43 TexReg 2412

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