(a) A peer assistance program for nurses approved by the Board under chapter 467, Health and Safety Code, will identify, monitor, and assist with locating appropriate treatment for those nurses whose practice is impaired or suspected of being impaired by chemical dependency, mental illness or diminished mental capacity so that they may return to practice safe nursing.
(b) Role of the Board of Nursing and Peer Assistance Program.
(1) The Board of Nursing will retain the sole and exclusive authority to discipline a nurse who has committed a practice violation under §301.452(b) of the Nursing Practice Act regardless of whether such violation was influenced by chemical dependency, mental illness, or diminished mental capacity. The Board will balance the need to protect the public and the need to ensure the nurse seeks treatment in determining whether the nurse is appropriate for participation in an approved peer assistance program.
(2) The program shall report to the board, in accordance with policies adopted by the board, a nurse reported to the program who is impaired or suspected of being impaired for chemical dependency, mental illness, or diminished mental capacity if the nurse was reported to the program by third party. A third party report is a report concerning a nurse suspected of chemical dependency, mental illness, or diminished mental capacity that comes to the attention of the program through any source other than a self report.
(c) General Criteria for Approved Peer Assistance Program.
(1) The program will provide statewide peer advocacy services to all nurses licensed to practice in Texas whose practice may be impaired by chemical dependency, certain mental illnesses, or diminished mental capacity.
(2) The program shall have a statewide monitoring system that will be able to track the nurse while preserving confidentiality.
(3) The program shall have a network of trained peer volunteer advocates located throughout the state.
(4) The program shall have a written plan for the education and training of volunteer advocates and other program personnel.
(5) The program shall have a written plan for the education of nurses, other practitioners, and employers.
(6) The program shall demonstrate financial stability and funding sufficient to operate the program.
(7) The program shall have a mechanism for documenting program compliance and for timely reporting of noncompliance to the board.
(8) The program shall be subject to periodic evaluation by the board or its designee in order for the board to evaluate the success of the program.
(d) Evaluation of Peer Assistance Program.
(1) The program shall collect and make available to the board and other appropriate persons data relating to program operations and participant outcomes. At a minimum, the program shall submit the following statistical information quarterly to the Board for the purpose of evaluating the success of the program:
(2) The program shall have a written plan for a systematic total program evaluation. Such plan shall include at a minimum monthly reports of the programs activities showing compliance with this rule, quarterly reports of applicable LBB performance measure data and an annual report of program activities.
(3) The program shall be subject to periodic evaluation by the board or its designee in order for the board to evaluate the success of the program.
(e) Participants entering the approved peer assistance program for chemical dependency or chemical abuse must agree to the following minimum conditions:
(1) The nurse shall undergo, as appropriate, a physical and/or psychosocial evaluation before entering the approved monitoring program. This evaluation will be performed by health care professional(s) with expertise in chemical dependency.
(2) The nurse shall enter into a contract with the approved peer assistance program to comply with the requirements of the program which shall include, but not be limited to:
(3) The nurse may be subject to disciplinary action by the Board if the nurse does not participate in the approved peer assistance program, does not comply with specified employment restrictions, or does not successfully complete the program.
(f) Referral to Board of Noncompliance with Peer Assistance Program.
(1) A participant may be terminated from the program for the following causes:
(2) The program shall contact the board in accordance with board policies if a nurse under contract fails to comply with the terms of the program agreement or evidences conduct that indicates an inability or unwillingness to comply with the program.
(g) Eligibility for Program Participation.
(1) The program shall contact the board if it receives a third-party referral for a nurse who may have been impaired or suspected of being impaired and who may have failed to comply with the minimum standards of nursing (22 TAC §217.11) and/or committed an act constituting unprofessional conduct (22 TAC §217.12). The program shall send that report to the Board. The Board will balance the need to protect the public and the need to ensure the impaired nurse seeks treatment in determining whether the nurse is appropriate for participation in an approved peer assistance program.
(2) An individual may not participate in the program if the information reviewed in conjunction with the report indicates to the board that the individual's compliance with the program may not be effectively monitored while participating in the program. This information includes, but is not limited to, the following:
(h) Successful Completion of the Program. A participant successfully completes the program when the participant fully complies with all of the terms of the program agreement for the period as specified in the agreement. When a participant successfully completes the program, the program shall notify the participant of the successful completion in writing. Once the participant receives this written notification of successful completion of the program, the participant shall no longer be required to comply with the program agreement. The program shall notify the board when a nurse who the board has ordered to attend or referred to the program successfully completes the peer assistance contract.
(i) Re-evaluation of Participation in Peer Assistance Program.
(1) Each individual receiving an eligibility order requiring participation in a peer assistance program upon initial licensure shall be notified by the Board, upon the issuance of a nursing license, that he/she may request re-evaluation of his/her participation in the peer assistance program.
(2) If an individual wishes to have his/her participation in a peer assistance program re-evaluated by the Board, the individual must affirmatively request re-evaluation by the Board and provide the Board with relevant evidence supporting the individual's request.
(3) The following factors shall be considered when re-evaluating an individuals' required participation in a peer assistance program:
(4) An individual must comply with the terms of his/her eligibility order until the Board completes its review under this subsection and issues a decision.
(5) The Executive Director is authorized to:
Source Note: The provisions of this §217.13 adopted to be effective February 18, 2008, 33 TexReg 1333; amended to be effective November 18, 2018, 43 TexReg 7530