The 82nd Legislative Session in Review
Anita Wheeler, RN, MSN, CPN
Session Objectives
• Differentiate between laws, rules, standards and
guidelines.
• Describe 2 laws that were passed during the 82nd
The Legislative Process…..
Points of Interest
• Bill can be filed in House or Senate
• Bill is assigned to Committee for hearing
• Committee hears bill 3 times, 1st time is
public comment period
• Bill sent to the calendars and heard on the floor
• Bill sent to other body to go through the same hearing process
• Bill Enrolled (Final)
• Sent to Governor
Input by the public is accepted by email, phone calls, or letters. Public Comment
Bill Written and Filed
Tips to Consider When Providing
Testimony or Information on a Bill
• Know the Committee • Be Concise and Direct • General Rule of 3’s…
Say what you want to say: three times,
in three ways, in three minutes‖.
• Directly state you are ―in support‖ of or ―not in support of‖ the bill
• These tips apply to written and oral testimony
So Many Bills…. So Little Time….
*
1928
Senate Bills *
3865
House Bills
– Some bills are never even heard by the assigned committee
– Some bills are lost in committee and never voted out
– Some bills get substitute language
– The above list does not include resolutions, joint resolutions, etc.
On to the Governor…
• Three Actions the Governor can take:
– Sign the bill – Veto the bill
– Let the bill pass into law without signing it
• Governor has until 20th day after final
adjournment to sign or veto
– June 19, 2011 (this session)
• Bills that are not signed or vetoed go into effect on the 91st day following adjournment
Rules Process (TAC)
• Most bills assign responsibilities to a state agency to develop rules or guidelines.
• Rules carry the weight of law once they are approved and are located in the Texas
Administrative Code (TAC).
• Rules are developed utilizing subject matter experts, public input, research and best
practices.
• Public comment periods are woven throughout the rules process.
Examples of Rules*
• Texas School Health Advisory Committee
• School-based Health Center Rules
• Rodeo Rules
Other School Health Rules
• Vision, Hearing and Spinal Screening
• Immunization Rules
• Infectious Disease Rules
• Licensing Rules for Nurses
• Rules on Implementing Coordinated
School Health
In a Nut Shell…
• The law usually outlines who, what, when and where…. • The rules outline how the law is to be implemented.
• The Texas Administrative Code is a compilation of all state agencies rules.
• Rule development follows a specific process to allow for public comment.
• DSHS works closely with stakeholders
– SBHC-TASBHCs, current contractors, past contractors
– Rodeo- Rodeo associations, vendors, parents, school districts – TSHAC- TEA, TDA, parents, school nurses, PE and Health
Example of Law and Rules
Texas Administrative Code
TITLE 25 HEALTH SERVICES
PART 1
DEPARTMENT OF STATE HEALTH SERVICES CHAPTER 104
CHILDREN PARTICIPATING IN RODEOS Rules
• §104.1Purpose • §104.2Definitions
• §104.3Standards for Protective Vests and Bull Riding Helmets for Children Who Participate in Rodeos
• §104.4Requirements for an Educational Program on Safety
• §104.5Compliance Date of Rules
Health and Safety Code
SUBTITLE A. PUBLIC SAFETY
CHAPTER 768
CHILDREN PARTICIPATING IN RODEOS
Sec. 768.001. Definitions
Sec. 768.002. Protective Gear Required for Children Engaging in Certain Rodeo Activities
Sec. 768.003. RODEOS ASSOCIATED WITH SCHOOL
On To Guidelines….
•
Examples-– USDA Nutritional Guidelines – HB 984 Guidelines
– Practice Guidelines for Healthcare Professionals
• ―Instruction that shows or tells how something should be done — Usually based on research, expertise, and best practice.‖ (Dictionary.com)
Example-SB 27, 82
ndLegislative Session
• Relating to policies of school districts (and
charters) for the care of certain students at
risk for anaphylaxis.
– School Boards shall adopt and administer policy
– Policy shall be based on Guidelines (DSHS)
• Consulting with Ad Hoc Committee
– Districts with policy must review and align with Guidelines
Ad Hoc Committee
• Appointed by DSHS Commissioner by December 1, 2011
• Ad Hoc Committee members:
– One representative from: DSHS, Food Allergy Initiative, Food Allergy and Anaphylaxis Network, TSNO
– One of each: principal, classroom teacher, school board member, superintendent, physician from Academy of Allergy, Asthma and Immunnology – At least two parents (of public school students)
Guidelines Timeline
• May 1, 2012
Guidelines must be final and ready to post
• August 1, 2012
school boards must adopt policy based on the Guidelines
DSHS First Steps in Developing
Guidelines
• Develop criteria for parent member
selection
• Write letters to organizations listed in the
bill asking for representative
• Set up timeline in getting assignments
made and meetings set up
• Allowing time for the writing of the
Limitations on SB 27 Guidelines
• May not require
schools to purchase prescription
anaphylaxis
medication or require any other expenditure that would result in a negative fiscal impact.
• May not require the personnel of a district to administer
anaphylaxis meds to a student unless the anaphylaxis med is prescribed for the student.
Standards…
―Standards are authoritative statements by which the nursing profession describes the
responsibilities for which its practitioners are accountable. Standards reflect the values and priorities of the profession and provide direction for professional nursing practice and a
framework for the evaluation of this practice. They also define the nursing profession’s
accountability to the public and the outcomes for which registered nurses are responsible‖.
Standards of Practice
• General Nursing-ANA
• School Nursing-NASN
• Other Nursing
Standards of School Nursing Practice**
• Standard I. Assessment
– The school nurse collects comprehensive data pertinent to the client’s health or the situation.
• Standard II. Diagnosis
– The school nurse analyzes the assessment data to determine the diagnosis or issues.
• Standard III. Outcomes Identification
– The school nurse identifies expected outcomes for a plan individualized to the client or the situation.
• Standard IV. Planning
– The school nurse develops a plan that prescribes strategies and alternatives to attain expected outcomes.
• Standard V. Implementation
– The school nurse implements the identified plan.
Standard 5A: Coordination of Care
– The school nurse coordinates care delivery.
Standard 5B: Health Teaching and Health Promotion
– The school nurse provides health education and employs strategies to promote health and a safe environment.
Standard 5C: Consultation
– The school nurse provides consultation to influence the identified plan, enhance the abilities of others and effect change.
Standard 5D: Prescriptive Authority and Treatment
– The advanced practice registered nurse uses prescriptive authority, procedures, referrals, treatments and therapies in accordance with state and federal laws and regulations.
• Standard VI. Evaluation
• The school nurse evaluates progress towards achievement of outcomes.
Standards of School Nursing Professional Performance
• Standard VII. Quality of Practice
– The school nurse systematically enhances the quality and effectiveness of nursing practice.
• Standard VIII. Education
– The school nurse attains knowledge and competency that reflects current school nursing practice.
• Standard IX. Professional Practice Evaluation
– The school nurse evaluates ones own nursing practice in relation to professional standards and guidelines, relevant statutes, rules and regulations.
• Standard X. Collegiality
– The school nurse interacts with, and contributes to the professional development of peers and school personnel as colleagues.
• Standard XI. Collaboration
– The school nurse collaborates with the client, the family, school staff and others in the conduct of school nursing practice.
• Standard XII. Ethics
– The school nurse integrates ethical provisions in all areas of practice.
• Standard XIII. Research
– The school nurse integrates research findings into practice.
• Standard XIV. Resource Utilization
– The school nurse considers factors related to safety,
effectiveness, cost and impact on practice in the planning and delivery of school nursing services.
• Standard XV. Leadership
– The school nurse provides leadership in the professional practice setting and the profession.
• Standard XVI. Program Management
Other Tools for School Nurses
• Six-step Decision Making Tool
– Texas Board of Nursing
• Texas Guide to School Health Programs
– DSHS, School Health Program
• School Nursing: A Comprehensive Text
– Selekman, Janice, editor
• Clinical Guidelines for School Nurses
Scenarios Activity
• As a group, review the scenario that was handed to you.
• Utilizing your knowledge of the law, rules, guidelines and standards for school nursing
practice. Come up with the group answer to the question at the end of your scenario.
• Utilize your groups general experience and education as a baseline in determining the answer.
82
nd
Session in Brief
• Bills of Interest
– Bullying Bill(s)
• Too many to name them all
– School Health Bill(s)
• Not as many heard this session related to health and PE
• Bill(s) related to SHACs
