Why Are Rules & Regulations Important to APRNs?
Most APRNs understand why changing legislation to remove practice barriers is important, but far fewer understand the role that regulation plays in achieving this goal. Without regular participation in the regulatory process by APRNs and the organizations that represent them, state agencies often overlook APRNs as potential providers in the programs they operate. This includes important publicly-funded health insurance programs, such as Medicaid and CHIP, and regulation of private health insurance plans, health care facilities were APRNs practice, and Texas Universities where APRNs are educated. For these reasons, CNAP focuses on the regulatory process, acting as a watchdog for APRNs.
Differences Between Legislation and Regulation
Texans have the opportunity to change laws once every two years when the Texas Legislature meets in regular session. The bills that pass become part of Texas Statutes, and most statutes grant authority to state agencies to regulate specific programs, industries, or occupations. For instance, the Nursing Practice Act (NPA) is the statute that creates the Board of Nursing (BON) and directs it to license and regulate all nurses in Texas.
Statutes grant government officials and agencies rulemaking authority and direct them to pass certain rules. State officials and agencies cannot exceed their statutory rulemaking authority, but many aspects of day-to-day operations for any state program are within a state agency’s discretion.
Texas Rulemaking Process
While the Texas Legislature only amends statues once every two years, Texas state agencies are amending rules and regulations throughout the year. Each Friday, the Texas Secretary of State publishes the Texas Register containing the new rules or rule amendments being proposed.
Each issue of the Texas Register lists the state agencies proposing rule changes in alphabetical order with a link to the full text of each rule proposal. Each proposal includes a preamble that includes a summary of and reason for the changes. It also includes a paragraph labeled, PUBLIC COMMENT, identifying the accepted methods of commenting on the proposed rule and specifying the allowable comment period. Most agencies allow a 30-day comment period. The agency must consider each properly submitted comment received during the specified period, but may ignore comments submitted after the submission deadline (Tex. Gov’t. Code §2001.029).
The Texas Government Code requires state agencies to review their rules and regulations at least once every four years. Agencies cite the rules planned for review and include the period during which the public may comment on those existing rules and whether they should continue to exist (Tex. Gov’t. Code §2001.039).
APRNs Are Legally Required to Stay Up-To-Date
Commenting on proposed rules and regulations is not the only reason that CNAP reviews the Texas Register weekly. Another aspect of CNAP’s mission is educating APRNs about the current law. Rules and regulations are an essential part of that body of law.
The BON Rules and Regulations require nurses to follow all federal and state laws impacting their practices (BON Standards of Nursing Practice Rule). Check this website frequently for proposed rules requiring comment and new rules that APRNs must follow. CNAP members may access all the Texas Register Reports that CNAP produced since January 1, 2016. Readers may access announcements from state agencies & public meetings held by state agencies on CNAP’s Regulatory Updates page.
BON Standards of Nursing Practice Rule, 22 Tex. Admin. Code §217.11(1)(A).
Tex. Gov’t. Code, Chapter 2001.
Texas Secretary of State. (2016). State rules and open meetings.
Woolbert, L. (2000, December). A lesson from a mosquito. Advance for Nurse Practitioners, 8(12), 28.