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Advocacy: Legislative Update
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TNA Provides the Latest Legislative News

Wrap-up of 84th Legislative Session

After 140 days of what to the untrained eye appears to be complete chaos, the Texas Legislature has concluded the business of the 84th session. The Texas Nurses Association was active throughout, working to ensure that you and your patients are protected. TNA is proud to represent you, and your government affairs staff looks forward to working throughout the next 18 months preparing for the 2017 session!


Nurse Day at the Capitol 2015Special thanks to the hundreds of Texas nurses who attended Nurse Day at the Capitol, visited legislative offices, and wrote or called your legislator. Your efforts made a huge difference!


All TNA members who submit their names will be considered for the Policy Council as well as specific issue-based task forces, and will at a minimum be added to our list of Expert Advisors for comments and direction on policy moving forward. We appreciate your support and leadership!


Below is general information about this year’s session as well as specifics on the bills followed by TNA.


Overall Landscape


The 2015 legislative session was significant for many reasons, most notably because it was the first session after Gov. Rick Perry left office. The impact of his departure was a reshuffling of offices — all major statewide offices changed hands as elected officials traded up, with the dominoes falling through the Senate and House as well.


When the smoke cleared, the legislature looked like this:


House – 19% freshman

Republicans 98 seats out of 150

Democrats – 52 seats out of 150

Senate – 35% freshman

Republicans - 20 seats out of 31

Democrats – 11 seats out of 31


What did this mean for TNA and the nursing agenda? We had to do significantly more education on nursing issues for legislators who were not aware of the problems out there!


Here are the final numbers for this session (pending Governor veto):


6,276 bills filed - 7% increase from the 2013 session.

1,323 bills passed – 8% decrease from the 2013 session

21% passage rate


TNA worked overtime to ensure that elected officials could filter through the noise and understand the nursing issues that were front and center.


Here are the biggest and most directly influential nursing bills that TNA worked on this session on your behalf and, pending Gov. Abbott’s approval, will be written into law by September of this year.

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Budget Items


HB 1 by Rep. Otto

  • The only bill that the legislature actually must pass, the budget, passed and narrowly avoided a standoff which would have resulted in a 30-day overtime special session.

  • In the budget, there were a few appropriations related to nursing, including:
  • $33.75 million for the Professional Nursing Shortage Reduction Program to increase RN graduates
  • $822,000 for the Texas Center for Nursing Workforce Studies
  • $4.5 million for trauma fellowships for emergency physicians and nurses
  • The Nursing Faculty Loan Repayment Program, originally passed last session, was continued through this session as well, allowing for any excess, unspent funds to rollover to this budget.


HB 495 by Rep. Howard – Nursing Shortage Funds

  • This bill ensures that the tobacco lawsuit settlement funds continue to be dedicated to the Texas Higher Education Coordinating Board for the Nursing Education Innovative Grant Program.

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Workplace Safety


HB 2696 by Rep. Howard – Workplace Violence Study

  • This bill provides the authority for the Center for Nursing Workforce Studies within the Dept. of State Health Services to conduct two studies, to be completed prior to the 2017 legislative session.

  • The first study will be of healthcare facilities to gather data on the instances and likelihood of violence against nurses in the workplace, with the second study consisting of nurses themselves to gain data from their perspective as well.

  • Currently no Texas-specific data exists on the occurrence of violence in the workplace against nurses. This data is necessary to accurately assess the problem in Texas and address it.


HB 1403 by Rep. Sheets – Medical Malpractice Claims

  • Because of the medical malpractice reforms of 2003, certain requirements and limitations are part of filing a medical malpractice claim. A plaintiff must file an expert report within a certain amount of time and all damages are limited to $250,000 regardless of the injury.

  • Unfortunately, one unintended consequence of the reform was that it limits claims by nurses (and others) who might slip and fall at work by classifying their lawsuits as medical malpractice claims even though they have nothing to do with care to a patient!

  • This bill makes a necessary clarification to exclude lawsuits by employees against employers from the definition of a medical malpractice claim.

  • While the bill does not cover all potential working situations where nurses provide care to patients, it is a needed first step to make sure that if you are hurt on the job, you are not unnecessarily limited by restrictions that have nothing to do with your injury. TNA staff worked hard to ensure that this bill passed to protect you in the workplace!

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Immunization Registry


HB 2171 by Rep. Sheffield – ImmTrac 18-26

  • Currently, after consent is obtained by a parent for a child’s immunization information to be included in the ImmTrac registry, the consent is valid until the child is 18 unless consent is withdrawn. This bill simply tracks Obamacare language by increasing the validity of consent until the child is 26 years old.

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Nursing Curriculum


HB 3078 by Rep. Darby – Pre-nursing Curriculum Advisory Committee

  • Creates an advisory committee, appointed by the Texas Higher Education Coordinating Board, to develop and make recommendations on a uniform pre-nursing curriculum for undergraduate professional nursing programs offered by higher education institutions. The committee will submit a report on their findings by December 1, 2016.

  • Since two of the appointments are required to be from professional nursing associations, TNA is hopeful that we will have a voice on the committee.

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Hospital Identification


SB 1753 by Sen. Campbell – Identification Requirements

  • This bill is a “clean-up” of 2013 legislation which was not implemented in way the bill author intended. DSHS’s rule permitted nametags to include only credentials such as “RN,” “OD,” “DC,” etc. rather than “registered nurse,” “optometrist,” “chiropractor,” etc. This bill sets out the specific wording that must be on practitioners’ nametags in hospitals other than public hospitals and psych hospitals. Hospitals have until September 1, 2019, to implement the requirement.
  • The wording required on nurses’ nametags is “licensed vocational nurse,” “registered nurse,” “nurse practitioner,” “nurse midwife,” “nurse anesthetist,” or “clinical nurse specialists.” This requirement is in addition to current NPA requirements for how nurses must identify themselves, and all nurses must continue to comply with those NPA requirements and BON rules.

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Nursing on the Defensive


HB 2267 by Rep. S. Davis – Anesthesiology Assistants Licensing

  • This bill would have required anesthesiologist assistants to be licensed by the Texas Medical Board with education and training requirements. The bill would have encroached on the scope of practice of nurse anesthetists and benefitted only 200 or so practitioners in the state of Texas.

  • In a dramatic turn of events, with the cooperation of multiple nursing organizations, the bill was defeated on an up and down vote not once, but twice on the House floor in as many days. This was a huge win for nursing this session in fighting back an attack on our nurses’ scope of practice!


HB 179/SB 1813 by Rep. Zedler and Sen. Kolkhorst, respectively – Texas Medical Board Complaint Confidentiality

  • Another session, another bill seeking to undo whistleblower protection and bring back cases like Winkler County! These bills would have required the Texas Medical Board to provide a copy of a complaint to the physician being complained against, either wholly unredacted or with only the name redacted.

  • After weeks of educating members on both sides of the capitol, a concerted lobby effort by TNA and over 1,000 emails and calls from TNA members, neither bill made it out of their respective chamber.

  • This is another BIG win for nursing, and we made our presence known in a big way on this issue. In fact, TNA staff was approached at one point and told that they heard nurses were “firebombing” the capitol about the bills. We appreciate everything you did to help defeat these terrible bills!

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Near Misses


HB 80 by Rep. Craddick – Texting While Driving Ban

  • This bill would have prohibited the use of a “portable wireless communication device” to read, write, or send a text-based communication while operating a motor vehicle, with certain exceptions. The bill made it all the way to the Senate floor and apparently only lacked one vote to bring it up and pass it out of the Senate, but failed to do so prior to a key deadline. As such, local ordinances around the state will continue to operate independently of state law.


HB 2323 by Rep. Blanco – Scoliosis Screenings

  • This bill would have implemented recommendations by multiple nationwide orthopaedic associations to screen male students in grade 8 or 9 and screen female students in grades 5 and 7 (to account for differences in development). This bill died on the House calendar among many others due to stall tactics to avoid an abortion debate.

NOTE: After the conclusion of the 84th session, the Texas Department of State Health Services determined that flexibility exists in the current rule language to allow schools to screen students in grades sixth and ninth or in grades fifth and eighth.


HB 2602 by Rep. Coleman – APRN CSII

  • The only advanced practice bill to make it out of committee, HB 2602 would have allowed APRN’s to write discharge prescriptions to patients in treatment receiving palliative care or by psychiatric mental health APRN’s. It also would have allowed for delegated prescription of Schedule II controlled substances.

  • This bill was heavily opposed by other health care groups, but managed to make it out of the Public Health Committee anyway, although it ultimately died in calendars.


HB 2474 by Rep. Sheffield – Epidemiological Reports

  • This bill would have required the Dept. of State Health Services to prepare a biennial report of 1) the outbreaks of vaccine preventable diseases in Texas and 2) immunization exemption information to identify the number of people claiming an exemption from immunizations.


SB 69 by Sen. Ellis – School Nurse Notification

  • Would have required a school district to notify parents if a school did not have a school nurse on duty. This bill died early on, but the language made it onto a separate bill that was inches from passage. Unfortunately, it was stripped out of the bill at the last minute.

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