The Texas Board of Nursing and the Sunset Process

This is the first part of a series in which we will discuss some of the changes to Texas Board of Nursing (BON) rules after its recent Sunset review. The Sunset process in Texas is a process that entails a review of state agencies by the Texas Sunset Advisory Commission and Texas Legislature. Approximately 140 Texas state agencies are subject to this process. An agency can expect to undergo Sunset review roughly every 12 years. Sunset starts with the basic question of whether or not the agency’s functions continue to be needed and continues with an analysis of how any necessary functions are performed. Recently, the BON was Sunsetted, and the BON has started to implement changes to several of its processes based on the Sunset review. The Sunset review stated that the Board of Nursing “is a shining example of a health licensing agency with experienced, capable staff that perform well.” However, the Sunset review noticed many problems that affect nurses, especially those that FosterDanowsky represents: “the board’s use of subjective standards to link most any mistake, even off-the-clock conduct, to nursing can result in harsh sanctions for nurses.”

The Sunset review made two recommendations regarding licensure enforcement by the BON:

  • Recommendation 2.1—Limit the use of subjective standards for licensure decisions by requiring the board to demonstrate a connection between a nurse’s conduct and the practice of nursing.
  • Recommendation 2.2—Direct the board to review its criminal conduct guidelines to limit disciplinary action to crimes directly related to the practice of nursing.

Additionally, the legislature proposed two additional recommendations:

  1. Remove public disciplinary information—Require the board to remove a nurse’s disciplinary action from the board’s website and the public coordinated licensure information system if the nurse and action meet certain criteria.
  2. Administrative hearings—Prohibit the board from charging a nurse for the administrative costs of conducting an administrative hearing and changing an administrative law judge’s findings of fact or conclusions of law in issuing a disciplinary order.

Since the Sunset review, the BON has made changes to its rule and procedures that make the investigative and sanctioning process less harsh and punitive. Over the next several blog posts, FosterDanowsky will review some of these changes and discuss how these will impact nurses under investigation and facing sanctions. If you would like to read about the Sunset process, you can do so at the Sunset website.