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Oregon Bulletin

January 1, 2011

 

Board of Nursing
Chapter 851

Rule Caption: Licensing Fee Increase for Nurses and Nursing Assistants.

Adm. Order No.: BN 16-2010

Filed with Sec. of State: 11-29-2010

Certified to be Effective: 11-29-10

Notice Publication Date: 10-1-2010

Rules Amended: 851-002-0010, 851-002-0040

Subject: These rules cover the agency fees. These rules amendments will increases the licensing renewal fee for nurses and nursing assistants.

Rules Coordinator: KC Cotton—(971) 673-0638

851-002-0010

RN/LPN Schedule of Fees

(1) License Renewal — $145.

(2) Delinquent Renewal — $12.

(3) Workforce Data Analysis Fund at Renewal — $5.

(4) License by Endorsement — $195.

(5) Licensure by Examination — $160.

(6) Written Verification of License — $12.

(7) Limited Licenses:

(a) License Memorandum — $25.

(b) Reentry — $95.

(c) Extension of Reentry — $25.

(8) Limited Licenses for Educational Experience:

(a) International Graduate Nursing Students — $65.

(b) Extension of International Graduate Nursing Students — $25.

(c) International RN in Short-Term Educational Experience — $35.

(d) International Exchange Students — $25.

(e) U.S. RNs in Distance Learning — $15.

(f) Extension of Distance Learning — $15.

(9) Reexamination for Licensure — $25.

(10) Reactivation — $160.

(11) Reinstatement by Reactivation — 160.

Stat. Auth.: ORS 678.150 & 678.410

Stats. Implemented: ORS 678.410

Hist.: NER 26(Temp), f. & ef. 12-11-75; NER 32, f. & ef. 5-4-76; NER 5-1981, f. & ef. 11-24-81; NER 2-1982, f. & ef. 8-25-82; NER 5-1983, f. 12-9-83, ef. 1-1-84; NER 5-1985, f. 7-30-85, ef. 10-1-85; NER 6-1986, f. & ef. 12-3-86; NB 5-1987, f. & ef. 7-1-87; NB 7-1987, f. & ef. 10-5-87; NB 1-1988, f. & cert. ef. 4-18-88; NB 2-1989, f. 6-22-89, cert. ef. 7-1-89; NB 2-1991, f. 6-14-91, cert. ef. 7-1-91; NB 3-1991, f. & cert. ef. 9-25-91; NB 5-1993, f. 6-15-93, cert. ef. 7-1-93; NB 7-1993, f. & cert. ef. 7-1-93; NB 13-1993, f. & cert. ef. 12-20-93; NB 5-1994 f. & cert. ef. 9-15-94; Renumbered from 851-020-0295; NB 8-1994, f. & cert. ef. 12-7-94; NB 7-1995(Temp), f. & cert. ef. 6-23-95; NB 2-1996, f. & cert. ef. 3-12-96; NB 9-1997, f. 7-22-97, cert. ef. 9-1-97; BN 6-1998(Temp), f. & cert. ef. 7-15-98 thru 12-31-98; Administrative correction 8-5-98; BN 10-1998, f. & cert. ef. 8-7-98; BN 11-1998, f. & cert. ef. 9-22-98; BN 4-1999, f. 5-21-99, cert. ef. 7-1-99, Renumbered from 851-031-0200; BN 11-1999, f. & cert. ef. 12-1-99; BN 6-2000, f. & cert. ef. 4-24-00; BN 17-2002, f. & cert. ef. 10-18-02; BN 6-2003, f. & cert. ef. 7-7-03; BN 5-2007, f. 5-4-07, cert. ef. 7-1-07; BN 5-2009, f. & cert. ef. 10-7-09; BN 6-2009, f. 12-17-09, cert. ef. 1-1-10; BN 7-2010, f. & cert. ef. 6-25-10; BN 16-2010, f. & cert. ef. 11-29-10

851-002-0040

Nursing Assistant Schedule of Fees

(1) Certification by Examination — $106.

(2) Certification by Endorsement — $60.

(3) Reexamination — Manual Skills — $45.

(4) Reexamination — Written — $25.

(5) Oral Administration of Written Examination — $35.

(6) Written Verification of Certification — $10.

(7) CNA Certificate Renewal — $60.

(8) CNA Reactivation Fee — $5.

(9) Workforce Data Analysis Fund at Renewal — $5.

(10) CNA Certification for RN or LPN — $60.

(11) CNA Certification for Student Nurses — $60.

(12) Initial Approval CNA Training Program — $100.

(13) Approval of Revised CNA Training Program — $75.

(14) Reapproval of CNA Training Program — $50.

(15) CNA Primary Instructor Approval — $10.

(16) Initial Approval of CNA Program Director — $25.

Stat. Auth.: ORS 678.150 & 678.410

Stats. Implemented: ORS 678.410

Hist.: NB 9-1989(Temp), f. & cert. ef. 11-24-89; NB 5-1990, f. & cert. ef. 5-7-90; NB 7-1990(Temp), f. & cert. ef. 7-11-90; NB 9-1990, f. & cert. ef. 10-9-90; NB 5-1991(Temp), f. & cert. ef. 10-15-91; NB 3-1992, f. & cert. ef. 2-13-92; NB 12-1992, f. 12-15-92, cert. ef. 1-1-93; NB 2-1993, f. 2-8-93, cert. ef. 2-16-93; NB 15-1993, f. 12-27-93, cert. ef. 6-1-94; NB 9-1997, f. 7-22-97, cert. ef. 9-1-97; BN 4-1999, f. 5-21-99, cert. ef. 7-1-99, Renumbered from 851-060-0300; BN 7-1999, f. 8-10-99, cert. ef. 11-1-99; BN 10-1999, f. & cert. ef. 12-1-99; BN 6-2003, f. & cert. ef. 7-7-03; BN 7-2004, f. & cert. ef. 2-26-04; BN 14-2004, f. & cert. ef. 10-26-04; BN 7-2007, f. 6-29-07, cert. ef. 1-1-08; BN 5-2009, f. & cert. ef. 10-7-09; BN 6-2009, f. 12-17-09, cert. ef. 1-1-10; BN 8-2010, f. & cert. ef. 6-25-10; BN 16-2010, f. & cert. ef. 11-29-10

 

Rule Caption: Nursing Education Rules Revised.

Adm. Order No.: BN 17-2010

Filed with Sec. of State: 11-29-2010

Certified to be Effective: 11-29-10

Notice Publication Date: 10-1-2010

Rules Amended: 851-021-0005, 851-021-0010, 851-021-0045, 851-021-0055, 851-021-0065, 851-021-0090

Subject: These rules cover the standards for the approval of educational programs in nursing, preparing candidates for licensure as practical or registered nurses. These amendments focus mainly on the steps for new program development and are part of a periodic rule review process.

Rules Coordinator: KC Cotton—(971) 673-0638

851-021-0005

Definitions

As used in these rules:

(1) “Accreditation” is a voluntary, non-governmental peer review process by the higher education community. For the purpose of these rules, institutional accreditation applies to the entire institution, whereas nursing program accreditation applies to program accreditation by the Commission on Collegiate Nursing Education (CCNE) or the National League for Nursing Accrediting Commission (NLNAC).

(2) “Accrediting agency” means a regional accrediting association or national accrediting agency approved by the U.S. Department of Education (US DOE) and/or the Council on Higher Education Accreditation (CHEA).

(3) “Approval” is synonymous with accreditation as authorized in ORS 678.150, and means the process by which the Board evaluates and grants official recognition and status to nursing education programs that meet Board established uniform and reasonable standards. The status assigned may be Developmental Approval, Initial Approval or Approval.

(4) “Approval by the office of Degree Authorization” means the approval, under ORS 348.606, to provide any part of a program leading to the award of college credit or to an academic degree.

(5) “Articulation” refers to the process of comparing or matching the coursework completed in one educational institution with the courses or requirements of another institution. For the purpose of these rules, articulation specifically relates to courses completed or required within a nursing education program.

(6) “Basic Master’s Program” —A graduate program in nursing leading to initial licensure.

(7) “Board” refers to the Oregon State Board of Nursing.

(8) “Clinical Lab Teaching Assistant” refers to a member of the nursing faculty whose primary responsibility is to assist with the clinical lab teaching under the direction of the nurse educator.

(9) “Clinical Teaching Associate” refers to a nurse who has undergone specific education/training to serve as a role model, resource and coach for nursing students. The clinical teaching associate functions under the direction of the nurse educator or nurse educator associate.

(10) “Community-based nursing” is nursing practice that takes place in the context of family and the community.

(11) “Competencies” mean the knowledge, values, attitudes, and interpersonal, clinical reasoning, and psychomotor skills expected for safe and effective nursing practice.

(12) “Controlling Body” is an accredited educational agency planning to conduct or conducting a program in nursing. For purposes of these rules, “institution,” “Educational institution,” or “governing institution” is synonymous with “controlling body.”

(13) “Developmental approval” means approval of an application for establishing a new program and authorization to proceed with its development.

(14) “Distance nursing education” means the provision of nursing course(s) to students in settings physically separate from the faculty and the campus-based setting. Distance nursing education includes on-line and web-based portals, video-streaming, interactive television, and use of other electronic course delivery methods.

(15) “Extended campus site” means any location of an institution, other than the main campus, at which the institution offers at least 50 percent of a nursing education curriculum.

(16) “Faculty” means the nursing faculty as a whole, functioning as a collective body.

(17) “Faculty member” means an individual nurse educator, nurse educator associate, or clinical lab teaching assistant.

(18) “Home Board” means the approval or accrediting authority by which a particular nursing program is approved and to which it is accountable.

(19) “Initial Approval” means authorization by the Board to accept students for admission in a new nursing program, or in an extended campus site, when the Board deems the extended campus site to be the equivalent of a new program. Initial approval status continues until the first class has graduated and the Board has taken final action on the application for approval.

(20) “Major curriculum change” means a change that results in a refocus of purpose and objectives, a substantive change in program structure or method of instructional delivery, or a change that modifies 10% or more of the credit hours in the curriculum.

(21) “May” indicates permission.

(22) “National accreditation” means accreditation granted by the National League for Nursing Accrediting Commission (NLNAC) or Commission on Collegiate Nursing Education (CCNE).

(23) “Nurse Administrator” refers to the registered nurse who is responsible and accountable for the nursing educational department, division or program, regardless of the official title assigned by any specific institution.

(24) “Nurse Educator” refers to a registered nurse who, as a member of the nursing faculty, is responsible for the development and/or implementation of the nursing program including curriculum, policies, student advising, and evaluation, mentoring and collaborating with nurse educator associates and clinical teaching associates. For the purpose of these rules, the term “nurse educator” includes all nurse faculty members regardless of rank who have responsibility for development and implementation of the program.

(25) “Nurse Educator Associate” refers to a registered nurse who may contribute to classroom and clinical instruction in collaboration with and under the direction of the nurse educator.

(26) “Nursing experience” means practice as a registered nurse. Specified years of nursing experience mean full time equivalence (FTE).

(27) “Organizing framework” means the mission, philosophy, and/or underlying assumptions upon which the curriculum is based.

(28) “Outcomes” are statements of the expected knowledge, skills, attitudes, values and abilities to be gained by students through completion of the nursing education program or a segment thereof.

(29) “Out-of-State Nursing Program” means a program in the United States that is approved or accredited by the licensing board for nurses in the particular state or U.S. territory, or the appropriate accrediting agency for that state or U.S. territory.

(30) “Population-focused nursing” is nursing practice that merges the body of knowledge from the public health sciences with nursing theories for the purpose of safeguarding and improving the health of populations.

(31) “Post-master’s certificate” means a certificate from an accredited graduate nursing education program that prepares licensed nurses who hold a master’s degree for an advanced nursing role.

(32) “Practice Site” is a location or situation in which nursing experience with actual patient/client individuals or groups is obtained.

(33) “Practicum” is a course or session in which a student obtains experience in nursing in either a laboratory or practice site.

(34) “Program” means a nursing education program that prepares graduates for licensure as registered or licensed practical nurses. The terms “nursing program,” or “nursing education program” as used in these rules, are synonymous with “Program.”

(35) “Representative of the Board” means the Education Consultant or Board designee qualified to perform the necessary responsibilities.

(36) “Shall” indicates a requirement.

(37) “Significant increase” means an increase of more than 10% in the enrolled nursing students or an increase of one or more clinical cohorts, whichever is greater.

(38) “Site Visit” means that representative(s) of the Board go to the location of a program for specified purpose(s) which may include a survey for approval.

(39) “Standards for Approval” — Authoritative statements that set expectations for a program to achieve and maintain for approval status. (OAR 851-021-0040 through 0070).

(40) “Statewide Need” — Assessment and documentation of the need for the nursing program in relation to plans for total state resources and the need for entry level nurses in the state.

(41) “Survey visit” means that representative(s) of the Board go to the location of a program to review the program for compliance with Standards for Approval, and to prepare a report and recommendation regarding approval status.

(42) “Units or Credits” — For programs on academic quarters, one unit or credit is defined as one academic clock hour per week for ten to twelve weeks or three academic clock hours of practicum per week for ten to twelve weeks. For programs on academic semesters, one unit or credit is defined as one academic clock hour per week for fourteen to sixteen weeks or three academic clock hours of practicum per week for fourteen to sixteen weeks.

Stat. Auth.: ORS 678.150

Stats. Implemented: ORS 678.150

Hist.: NER 9, f. 8-15-62; NER 15, f. 1-4-71, ef. 1-25-71; NER 30, f. & ef. 1-27-76; NER 37, f. & ef. 7-18-77; NER 2-1985, f. & ef. 4-5-85; NB 1-1990, f. & cert. ef. 4-2-90; Renumbered from 851-020-0005; NB 2-1996, f. & cert. ef. 3-12-96; NB 4-1996, f. & cert. ef. 9-3-96; BN 7-1998, f. & cert. ef. 7-16-98; BN 1-2001, f. & cert. ef. 2-21-01; BN 3-2008, f. & cert. ef. 6-24-08; BN 17-2010, f. & cert. ef. 11-29-10

851-021-0010

Approval of Nursing Education Programs

(1) Letter of Intent and Preliminary Application:

(a) An institution or consortium of accredited institutions wishing to establish a new program in nursing shall submit a letter of intent and preliminary application to develop the program to the Board in advance of anticipated opening date.

(b) The letter of intent and preliminary application shall address at least the following information:

(A) Purpose, size, and type of program proposed

(B) Studies documenting the statewide need for graduates of the program. The study should also specifically address the need for the program in relation to the nursing needs of the geographical area to be served;

(C) An analysis of potential impact on other nursing programs in the state including:

(i) An analysis of current usage of potential clinical sites in area(s) proposed for student placements including impact on other programs placing students in clinical sites; and

(ii) Projected number of faculty positions and availability of qualified faculty in the area(s) proposed for clinical placements.

(D) Evidence of administrative and financial support for development of a nursing program;

(E) Anticipated student enrollment and proposed date of enrollment;

(F) For consortium applicants, any charters, contracts and other documents that show:

(i) Relationships among member institutions;

(ii) Member institution commitment to the consortium and the proposed nursing program; and

(iii) Mechanisms within the consortium for attainment and maintenance of Board standards for nursing education programs.

(G) The applicant shall respond to any Board requests for additional information;

(H) The Board, after timely review and consideration of the information contained in the letter of intent and any supplementary information, shall either grant or deny permission to begin development of a nursing program, including rationale for the decision;

(I) The Board shall provide notice to the nurse administrator and academic administrator of all Oregon-approved nursing education program within 30 days of Board decision regarding approval to develop a nursing program;

(J) The nurse administrator and academic administrator of an Oregon-approved nursing education program shall have 30 days from notification of new program development to respond to the Board addressing potential adverse impact to their program;

(K) If the applicant is denied permission to begin development of a nursing program, the program may submit a revised letter of intent and preliminary application no sooner than six months from the previous submission;

(L) If the applicant is denied permission to begin development of a nursing program, a hearing before the Board may be requested and the provisions of the Administrative Procedures Act shall apply; and

(M) If the applicant does not submit a complete developmental approval application within twelve months after the date of the Board granting permission to proceed, the permission to begin program development shall expire.

(2) Application for Developmental Approval:

(a) An institution or consortium of accredited institutions that has received approval of their letter of intent to develop a nursing program may make application for developmental approval.

(b) The developmental approval application shall include at least the following:

(A) Evidence of accreditation of the institution, or of all member institutions in a consortium, by an appropriate regional or national accrediting association or agency; institutions seeking to establish a registered nursing program shall show evidence of;

(i) Approval as a degree-granting institution of higher education in Oregon; and

(ii) Accreditation by a regional association or national agency recognized by the Council on Higher Education Accreditation (CHEA).

(B) Letters of response from Oregon-approved nursing programs addressing specific concerns regarding adverse impact on current programs,

(C) Evidence of the appointment of a qualified nurse administrator and sufficient administrative support for program development;

(D) Administration and organizational plan delineating lines of authority and decision making impacting the nursing program;

(E) Description of proposed instructional modalities and resources to support these modalities with dates of availability;

(F) Availability of adequate practice sites for the program with supporting documentation from persons assigned to coordinate clinical placements for each facility;

(G) Availability of adequate educational facilities, services, and resources for the program;

(H) Evidence of financial resources adequate for planning, implementation and continuation of the program, including proposed operating costs;

(I) Tentative timetable for planning the program;

(J) Tentative start date for the program; and

(K) Current institution catalog(s).

(c) The applicant shall respond to the Board’s request(s) for additional information.

(d) If the Board, after timely review and consideration of the information contained in the application and any supplementary information, including response statements from other programs, shall either approve or deny the application and notify the applicant, including rationale for the decision.

(e) If developmental approval is denied, the program may submit a revised developmental application no sooner than six months from the previous submission.

(f) If developmental approval is denied, the applicant may request a hearing before the Board and the provisions of the Administrative Procedures Act shall apply; and

(g) If the applicant does not submit an application for initial approval within twelve months after the date designated for initiating the program in the approved plan, the developmental approval shall expire.

(3) Initial Approval:

(a) Initial approval status may be applied for when the following conditions have been met:

(A) Application as described in OAR 851-021-0010(2) has received Board approval;

(B) Evidence of approval for the new program has been obtained from the appropriate agencies or bodies that review and approve new programs for public and private educational institutions.

(i) An institution shall provide one copy of the report that was submitted to each agency and a copy of the letter(s) indicating that approval for the program have been granted;

(ii) A consortium shall provide documentation that each member institution has approved the program, as well as documentation of agency approval as above; and

(iii) An institution licensed by the Oregon Department of Education, Private Career Schools section shall provide documentation of current licensure.

(C) There are sufficient qualified nurse educators, other required educators and administrative support services to initiate the program a minimum of six months prior to the beginning of the courses;

(D) A tentative written proposed program plan, including curriculum developed in accordance with the Standards for Approval, has been submitted a minimum of three months prior to the offering of the first course to nursing students;

(E) There is evidence of readiness for admission of students in educational and clinical facilities including clinical placement sites for the maximum number of students enrolled at one time a minimum of three months prior to the offering of the first course to nursing students;

(F) Policies for admission and progression are in place a minimum of three months prior to the offering of the first course to nursing students;

(G) There is a comprehensive plan for evaluation of the nursing program that addresses key outcomes a minimum of three months prior to the offering of the first course to nursing students; and

(H) There is a signed agreement(s) for the articulation of program graduates into the next level of nursing education a minimum of three months prior to the offering of the first course to nursing students:

(i) Programs leading to a certificate or degree in practical nursing shall have an agreement with an Oregon-approved program preparing candidates for licensure as a registered nurse; and

(ii) Programs leading to an associate degree in nursing shall have an agreement with an Oregon-approved program leading to a baccalaureate or higher degree in nursing.

(b) Following Board receipt and review of the information required in OAR 851-021-0010(3)(a), the Board may grant or deny initial approval;

(c) A site visit may be conducted by a representative(s) of the Board;

(d) Initial approval must be received by a program prior to publication of the program and recruitment or acceptance of students for admission to the first class of nursing students;

(e) If initial approval is denied, the applicant may request a hearing before the Board and the provisions of the Administrative Procedures Act shall apply;

(f) Interim visits and/or progress reports may be requested by the Board at any time during the initial approval phase and/or following initial approval as deemed necessary by the Board; and

(g) If the institution or consortium does not admit a class within twelve months after the date designated for initiating the program the initial approval shall expire.

(4) Approval:

(a) Eligibility for approval occurs after the graduation of the first class of students;

(b) Within six months following graduation of the first class, the program shall submit a self study report addressing compliance with the Standards for Approval (OAR 851-021-0040 through OAR 851-021-0070) and a survey visit shall be made for consideration of approval of the program;

(c) The decision of the Board to grant or deny approval shall be based upon review of a self study report submitted by the program addressing compliance with Board standards, of the success rate of graduates on the national licensure examination, and of a survey report by a representative(s) of the Board; and

(d) If approval is denied, the applicant may request a hearing before the Board and the provisions of the Administrative Procedures Act shall apply.

Stat. Auth.: ORS 678.150, 678.340 & 678.360

Stats. Implemented: ORS 678.150 & 678.360

Hist.: NER 30, f. & ef. 1-27-76; NER 37, f. & ef. 7-18-77; NB 3-1988, f. & cert. ef. 7-5-88; NB 1-1990, f. & cert. ef. 4-2-90; Renumbered from 851-020-0021; NB 4-1996, f. & cert. ef. 9-3-96; BN 1-2001, f. & cert. ef. 2-21-01; BN 7-2003, f. & cert. ef. 7-7-03; BN 11-2003, f. & cert. ef. 12-9-03; BN 3-2008, f. & cert. ef. 6-24-08; BN 17-2010, f. & cert. ef. 11-29-10

851-021-0045

Standards for Approval: Nursing Faculty

(1) The faculty shall include a sufficient number of qualified nurse educators and nurse educator associates to meet the identified learning outcomes of the nursing education program.

(2) The nurse administrator and each nurse faculty member shall hold a current, unencumbered license to practice as a registered nurse in Oregon and be academically and experientially qualified for the position to which she/he is appointed.

(3) Faculty teaching in clinical settings shall also hold a registered nurse license to practice and meet requirements in the state in which the clinical experience is occurring.

(4) Each non-nurse faculty member shall be academically and experientially qualified for his/her responsibilities.

(5) The nurse administrator and each faculty member shall demonstrate professional competence and continued development in nursing, nursing education, and assigned teaching responsibilities.

(a) The nurse administrator and each faculty member shall periodically review assigned teaching responsibilities, evaluating and revising professional development plans as indicated; and

(b) The institution and nurse administrator shall support faculty in developing and maintaining competence in assigned teaching responsibilities.

(6) Qualifications for practical nurse programs:

(a) The nurse administrator shall:

(A) Hold at least a master’s degree in nursing with documentation of preparation and/or experience in curriculum and teaching; and

(B) Have at least four years of nursing experience, of which two years shall have been in a teaching or administrative position in a nursing education program.

(b) Each nurse educator shall:

(A) Hold at least a baccalaureate degree in nursing; and

(B) Have at least three years of nursing experience.

(c) Each nurse educator associate shall:

(A) Hold at least a baccalaureate degree in nursing; and

(B) Have at least two years of nursing experience.

(d) Each clinical lab teaching assistant shall:

(A) Hold a degree or certificate that is, at a minimum, equivalent to that for which students are being prepared; and

(B) Have at least two years of nursing experience.

(e) If the institutional program in practical nursing is embedded within a program in registered nursing, all faculty member appointments shall meet the qualifications required for registered nurse programs.

(7) Qualifications for registered nurse programs:

(a) The nurse administrator shall:

(A) Hold at least a master’s degree in nursing with documentation of preparation and/or experience in curriculum and teaching. In addition, for baccalaureate degree nursing programs, the nurse administrator shall hold an earned doctorate degree; and

(B) Have at least five years of nursing experience, of which three years shall have been in a nurse educator or administrative position in a nursing education program.

(b) Each nurse educator shall:

(A) Hold at least a master’s degree in nursing or a baccalaureate degree in nursing, and master’s in a related field with a post-master’s certificate in nursing from a program that is at least two semesters or three quarters in length; and

(B) Have at least three years of nursing experience.

(c) Each nurse educator associate shall hold at least a bachelor’s degree in nursing with no less than two years of nursing experience.

(d) Each clinical lab teaching assistant shall:

(A) Hold at least the educational level of preparation for which students are being taught; and

(B) Have at least two years of nursing experience.

(8) Any exceptions to subsections (6)(a), (b), (c), (d), (e) and (7)(a), (b), (c), (d) of this rule shall be submitted in writing to the Board and shall include rationale for the request. The Board may grant exceptions for any of the following circumstances:

(a) The education and experience qualifications are deemed equivalent to the requirements; or

(b) The individual has a baccalaureate in nursing, a masters or doctorate in a related field, and relevant nursing experience. The background of the individual is related to the teaching assignment and is complementary to the faculty mix, or

(c) Substantial effort has been made to recruit a qualified faculty member, and the appointed individual is pursuing the needed qualifications; or

(d) Substantial effort has been made to recruit a qualified faculty member, and the individual without full qualification is appointed for one year. The exception may be extended for one year with documentation of either continued and unsuccessful recruitment for a qualified replacement, or a plan to establish eligibility under exception (c) above.

(9) Special Provision for Nursing Faculty. Nurse administrators and faculty members employed as such in Oregon during the 1984 85 academic year may be appointed after September 1, 1985 without meeting new requirements under paragraphs 6(a)(A), (6)(b)(A), (7)(a)(A) and (7)(b)(A) of this rule.

(10) Faculty Member/Student Ratio:

(a) The number of faculty members appointed shall be not less than one faculty member to every eight students having experience in one or more practice sites at any given time. A lower ratio shall apply when nursing faculty determine that student/client safety and learning effectiveness warrant.

(b) Factors to be considered in determining the faculty member/student ratio shall be:

(A) Objectives to be achieved;

(B) Preparation and expertise of faculty member;

(C) Use of clinical teaching associates;

(D) Level of students;

(E) Number, type and condition of clients;

(F) Number, type, and location of practice sites; and

(G) Adequacy of the ratio for nurse faculty to:

(i) Assess students’ capability to function safely within the practice situation;

(ii) Select and guide student experience; and

(iii) Evaluate student performance.

(c) Clinical teaching associates may be used within the following guidelines:

(A) There shall be a written plan for the clinical learning experience consistent with these rules;

(B) Clinical teaching associates shall be selected according to written criteria developed by faculty, and agreed to by responsible person(s) in the practice site;

(C) A faculty member shall be available to the clinical teaching associate(s) while students are involved in a the clinical learning experience;

(D) The faculty member shall confer with each clinical teaching associate and student (individually or in groups) regularly during the clinical learning experience;

(E) Use of clinical teaching associates does not modify the requirement for faculty member/student ratio, except that the ratio may be modified for final practica.

(11) Principal responsibilities of the faculty shall be to:

(a) Develop, implement and evaluate the organizing framework and learning outcomes of the program;

(b) Construct, implement, evaluate and revise the curriculum;

(c) Develop, implement and evaluate policies and standards for the advising, selection, admission, advanced placement, progression and graduation of nursing students within the framework of the policies of the educational institution;

(d) Develop, integrate and evaluate student learning experiences including selection of learning activities, appropriate use of emerging teaching and learning methodologies, assessment and guidance of the student and evaluation of client and student safety;

(e) Develop, implement and evaluate policies for assessing student achievement in terms of course and program learning outcomes;

(f) Evaluate student learning and performance, assign grades for courses according to policies, determine student progression within the program, and recommend successful candidates for the degree or certificate;

(g) Develop, implement and evaluate policies and procedures necessary for the operation of the program;

(h) Provide for student evaluation of teaching effectiveness;

(i) Provide for evaluation of faculty members within the framework of the educational institution;

(j) Orient and provide on-going guidance for nurse educator associates, clinical teaching associates, and nursing staff in practice sites related to the program goals, learning outcomes and expected competencies of the students;

(k) Participate in review of the total nursing program;

(l) Participate in determining academic policies and procedures of the institution;

(m) Participate cooperatively with other nursing programs and agencies to develop appropriate and equitable access to practice sites; and

(n) Provide mechanisms for student input into and/or participation in decisions related to the nursing program.

(12) Faculty Organization shall be as follows:

(a) The nursing faculty shall participate through faculty meetings or other methods in developing, implementing and evaluating the program and curriculum and other responsibilities of the faculty;

(b) Minutes of faculty and committee meetings, including actions taken, shall be recorded and available for reference; and

(c) Faculty participation in decisions related to developing, implementing, and evaluating the curriculum, and to establishing or modifying nursing program policies shall be documented.

Stat. Auth.: ORS 678.150, 678.340 & 678.360

Stats. Implemented: ORS 678.150 & 678.360

Hist.: NER 30, f. & ef. 1-27-76; NER 37, f. & ef. 7-18-77; NER 3-1984, f. & ef. 10-4-84; NER 2-1985, f. & ef. 4-5-85; NER 4-1985, f. & ef. 7-10-85; NB 1-1990, f. & cert. ef. 4-2-90; Renumbered from 851-020-0061; NB 4-1996, f. & cert. ef. 9-3-96; BN 1-2001, f. & cert. ef. 2-21-01; BN 7-2001, f. & cert. ef. 7-9-01; BN 3-2008, f. & cert. ef. 6-24-08; BN 17-2010, f. & cert. ef. 11-29-10

851-021-0055

Standards for Approval: Students

The program in nursing is accountable to students by providing that:

(1) Admission, readmission, transfer, progression, retention, dismissal and graduation requirements are available to the students in written form and are consistent with those of the sponsoring institution. Where necessary, policies specific to nursing students may be adopted if justified by the nature and purposes of the nursing program.

(2) Students are admitted without discrimination as to age, race, religion, gender, sexual preference, national origin or marital status.

(3) Facilities and services of the program and its sponsoring institution are documented and available to students.

(4) Distance Nursing education programs are effectively supported through accessible modes of delivery, resources, and student support.

(5) Student rights and responsibilities are available in written form.

(6) Students are required to submit to a criminal background check to identify criminal convictions that may:

(a) Pose a risk to public safety;

(b) Preclude the ability to complete required clinical practica; or

(c) Result in Notice to Deny Licensure on application for initial licensure in Oregon.

(7) There is a signed agreement for the articulation or program graduates into the next level of nursing education as follows:

(a) Programs leading to a certificate or degree in practical nursing shall have an agreement with an Oregon-approved program preparing candidates for licensure as a registered nurse; or

(b) Programs leading to an associate degree in nursing shall have an agreement with an Oregon-approved program leading to a baccalaureate or higher degree in nursing.

Stat. Auth.: ORS 678.150, 678.340& 678.360

Stats. Implemented: ORS 678.150 & 678.360

Hist.: NB 1-1990, f. & cert. ef. 4-2-90; Renumbered from 851-020-0068; NB 4-1996, f. & cert. ef. 9-3-96; BN 3-2008, f. & cert. ef. 6-24-08; BN 17-2010, f. & cert. ef. 11-29-10

851-021-0065

Standards for Approval: Facilities and Services

(1) Educational facilities shall include:

(a) Classrooms, laboratories and conference rooms adequate in number, size and type according to the number of students and educational purposes for which the rooms are used;

(b) Offices and conference rooms available and adequate in number and size to meet faculty needs for individual student counseling and faculty meetings;

(c) Space provided for secretarial staff, files, storage and equipment; and

(d) Telephones, computers, equipment and support adequate in number and capacity to conduct program business.

(2) Educational services and resources shall include:

(a) Adequate secretarial services;

(b) Adequate library services, holdings, and electronic learning resources;

(c) Adequate student support services such as academic advising, financial aid advising, and academic bookstore services; and

(d) Adequate technology to support teaching and learning.

(3) Institutions offering distance nursing education programs shall provide ongoing and appropriate technical, design, and production support for faculty members and technical support services for students.

(4) Selection of practice sites shall be based on written criteria established by faculty.

(5) There is a written agreement that is in effect between the authorities responsible for the educational program and the nursing service or other relevant service of the practice site. The agreement shall include but not be limited to provisions that:

(a) Ensure that faculty members have authority and responsibility to select appropriate learning experiences in collaboration with practice site;

(b) Clearly specify whether or not clinical teaching associates will be provided by the site, and how they will be selected and function; and

(c) The practice sites shall be fully approved by the appropriate accreditation, evaluation or licensing bodies, if such exist.

Stat. Auth.: ORS 678.150 & 678.360

Stats. Implemented: ORS 678.150, 678.340 & 678.360

Hist.: NER 4-1985, f. & ef. 7-10-85; NB 1-1990, f. & cert. ef. 4-2-90; Renumbered from 851-020-0076; NB 4-1996, f. & cert. ef. 9-3-96; BN 1-2001, f. & cert. ef. 2-21-01; BN 3-2008, f. & cert. ef. 6-24-08; BN 17-2010, f. & cert. ef. 11-29-10

851-021-0090

Standards for Out-of-State Student Clinical Experience in Oregon

(1) Out-of-State Nursing Programs who seek to routinely send groups of students for clinical experience in Oregon

(a) The program shall petition the Board for approval to provide clinical experience in Oregon. The petition shall include:

(A) Justification or rationale for use of Oregon facilities;

(B) Documentation of home board approval including time frame and any recommendations which are outstanding;

(C) Evidence of accreditation by a regional accreditation body or national agency recognized by the council on Higher Education Accreditation (CHEA);

(D) Analysis of potential impact on nursing programs in areas where clinical placements are planned;

(E) Analysis of current usage of planned clinical sites in areas where clinical placements are planned;

(F) Anticipated student enrollment and proposed date of enrollment including the estimated number of students to be placed in Oregon clinical site(s);

(G) List of all faculty members with academic and licensure credentials;

(H) Evidence of availability of faculty in areas where clinical placements are planned;

(I) Evidence that faculty providing direct clinical supervision meet standards as established in OAR 851-021-0045(2, 6, 7, and 10);

(J) NCLEX pass rate, number of candidates and number passing for the past two years ending on the most recent September 30.

(K) The Board, after timely review and consideration of the petition and any supplemental information, shall either grant or deny the petition to place students in Oregon-based clinical experiences.

(b) The program shall provide an annual report on a form supplied by the Board to include at least the following information:            

(A) Curriculum change that affects the use of Oregon facilities for clinical experience;

(B) Plans for a significant increase in planned enrollment that may impact regional practice sites;

(C) Any change in provisions for client/student safety;

(D) List of all faculty members with academic and licensure credentials;

(E) Any change in approval/ accreditation status during the annum;

(F) Copy of progress reports (if any) to the home board during the annum; and

(G) NCLEX pass rate, number of candidates and number of candidates passing for the year ending September 30.

(c) The OSBN may conduct a complete visit to the program of nursing to determine its eligibility for approval at any time, or may accept all or part of the survey and findings on approval from the home state.

(2) Nursing programs with faculty and facilities located in Oregon and approved by another state as of April 1, 1998

(a) The program shall meet the reporting requirements established in OAR 851-021-0025 for Oregon approved nursing programs.

(b) In addition, the program shall:

(A) Report any change in approval/accreditation status within 30 days of such change;

(B) Report plans for a significant increase in planned enrollment that may impact regional practice sites including plans for provision of clinical placement(s) for additional student(s);

(C) Submit a copy of progress reports (if any) to the home board;

(D) Annually submit the NCLEX pass rate, number of candidates and number of candidates passing for the year ending September 30; and

(E) Demonstrate attainment of OSBN standards for approval through OSBN participation in the regular survey visit conducted by the home board and/or nursing specialty accreditation organization.

(c) The OSBN may conduct a complete visit to the program to determine its eligibility for approval at any time, or may accept all or part of the survey and findings on approval from the home state or nursing specialty accreditation organization.

(3) Nursing programs that do not regularly send clinical sections to Oregon sites, and that seek to place an individual student for precepted experience.

(a) The program shall petition the Board for approval to provide clinical experience in Oregon. The petition shall include:

(A) Justification or rationale for use of Oregon facilities including description of clinical sites and experiences and the provisions that will be used for client/student safety;

(B) Documentation of home board approval including time frame and any currently outstanding recommendations;

(C) Evidence of accreditation by a regional association or national agency recognized by the Council on Higher Education Accreditation (CHEA);

(D) Name and credentials of the contact faculty member;

(E) Name and credentials of a contact person within the Oregon clinical facility; and

(F) Evidence that faculty providing clinical supervision meet standards as established in OAR 851-021-0045(2, 6, 7, and 10).

(b) The program shall have a written agreement with the Oregon clinical facility including but not limited to:

(A) Learning objectives to guide the student experience;

(B) Provisions for client/student safety;

(C) Faculty member of record with provision for availability;

(D) Qualifications for selection of preceptor(s);

(E) Provision that the agency may unilaterally nullify the contract in the event of issues with client safety.

Stat. Auth.: ORS 678.031, 678.150, 678.340, 678.360

Stats. Implemented: ORS 678.031, 678.150, 678.340, 678.360

Hist.: BN 7-1998, f. & cert. ef. 7-16-98; BN 1-2001, f. & cert. ef. 2-21-01; BN 3-2008, f. & cert. ef. 6-24-08; BN 17-2010, f. & cert. ef. 11-29-10

 

Rule Caption: Modifications made for establishment of limited license to non-U.S. educated nurses.

Adm. Order No.: BN 18-2010

Filed with Sec. of State: 11-29-2010

Certified to be Effective: 11-29-10

Notice Publication Date: 10-1-2010

Rules Amended: 851-031-0045, 851-031-0070

Subject: These rules cover standards for licensure of registered nurses and licensed practical nurses. These rule amendments make modifications in order to allow for a limited license to be issued to non-U.S. educated nurses enrolled in Board-approved re-rentry programs for instructor-supervised clinical experiences within their program prior to passing NCLEX.

Rules Coordinator: KC Cotton—(971) 673-0638

851-031-0045

Limited License for Certain Students in Oregon Educational Programs

(1) RNs from other countries who enroll for graduate study in Oregon.

(a) Required licensure:

(A) When the nature of the graduate program includes no clinical component or a clinical component which requires no direct patient care, the international nurse is required to hold either a limited or full Oregon RN license.

(B) When the nature of the graduate program includes a clinical component with direct patient care experience (e.g. nurse practitioner programs) an Oregon RN license is required prior to clinical experience.

(b) Limited License Requirements:

(A) Completed application using forms and instructions provided by the Board and payment of appropriate fees established by the Board.

(B) Graduation from an educational program that is equivalent to nursing education in the United States documented by a Board approved credentials evaluation service.

(C) Demonstration of English language proficiency by one of the following methods:

(i) Pass an English language proficiency test that meets the standards as defined in OAR 851-031-0006(3)(f)(D)(ii) (iii) or (iv); or

(ii) Documentation of holding a Commission on Graduates of Foreign Nursing Schools (CGFNS) Certificate; or

(iii) Graduation from a school of nursing outside of the United States in which all classroom instruction was in English; and all nursing textbooks were in English; and the preponderance of clinical experience was in English; or

(iv) Documentation of practice as a registered nurse, in English, in another state in the United States, for at least 960 hours, in the two years preceding application for licensure.

(D) A passing score on the licensing examination as defined in OAR 851-031-0005(10) or on the Commission on Graduates of Foreign Nursing Schools (CGFNS) examination.

(c) Limited licenses issued under this section shall be valid for a period of two years from the date of issuance. After that period, the limited license may be extended annually for a one year period upon application by licensee, payment of the appropriate fee, and demonstration of continued enrollment in the graduate program.

(d) The limited license issued under this section is to be used only for study in the graduate program.

(2) RNs from other countries who seek short term educational experience in Oregon:

(a) Required licensure:

(A) When the nature of the short-term educational experience includes the practice of nursing, the international nurse is required to hold a limited RN license.

(B) When the nature of the short-term educational experience is observation only, the international nurse does not require an Oregon license. “Observation only” means that the individual is not responsible for nor a participant in any aspect of nursing practice.

(b) Limited license requirements:

(A) Completed application using forms and instructions provided by the Board and payment of appropriate fees.

(B) Demonstration of English language proficiency by one of the following methods:

(i) Pass an English language proficiency test that meets the standards as defined in OAR 851-031-0006(3)(f)(D)(ii) (iii) or (iv); or

(ii) Documentation of holding a Commission on Graduates of Foreign Nursing Schools (CGFNS) Certificate; or

(iii) Graduation from a school of nursing outside of the United States in which all classroom instruction was in English; and all nursing textbooks were in English; and the preponderance of clinical experience was in English; or

(iv) Documentation of practice as a registered nurse, in English, in another state in the United States, for at least 960 hours, in the two years preceding application for licensure.

(C) Graduation from an educational program that is equivalent to nursing education in the United States documented by a Board approved credentials evaluation service.

(D) A passing score on the licensing examination as defined in OAR 851-031-0005(10) or on the Commission on Graduates of Foreign Nursing Schools (CGFNS) examination.

(E) A contract with an organization or agency in Oregon for a planned learning experience including at least the planned learning outcomes, dates for the experience, and how the outcomes will be achieved.

(c) Limited licenses issued under this section shall be valid for practice only within the contracted learning experience, and shall be issued to the last date of the learning contract up to a maximum of six months.

(3) Students from other countries in established exchange programs with Oregon schools:

(a) When a nursing student from another country engages in clinical experience as part of an established exchange program, a limited license is required.

(b) Limited license requirements:

(A) Completed application using forms and instructions provided by the Board and payment of appropriate fees established by the Board;

(B) Enrollment in a pre-licensure nursing program in another country;

(C) Acceptance by an approved Oregon nursing program for exchange experience; and

(D) Demonstration of English language proficiency by one of the following methods:

(i) Pass an English language proficiency test that meets the standards as defined in OAR 851-031-0006(3)(f)(D)(ii) (iii) or (iv); or

(ii) Documentation of holding a Commission on Graduates of Foreign Nursing Schools (CGFNS) Certificate; or

(iii) Graduation from a school of nursing outside of the United States in which all classroom instruction was in English; and all nursing textbooks were in English; and the preponderance of clinical experience was in English; or

(iv) Documentation of practice as a registered nurse, in English, in another state in the United States, for at least 960 hours, in the two years preceding application for licensure.

(c) Limited licenses issued under this section shall be valid only for student experience within the exchange program, and shall be valid for the term of the exchange agreement up to a maximum of one year.

(4) RNs from other countries enrolled in Oregon-approved re-entry program for internationally-educated nurses

(a) Required licensure:

(A) When the nature of the educational experience includes the practice of nursing, the international nurse is required to hold an Oregon issued limited license.

(B) When the nature of the educational experience is classroom-based, skills/simulation laboratory-based, or observational only, the international nurse does not require an Oregon issued license.

(b) Limited license requirements:

(A) Completed application using forms and instructions provided by the Board and payment of applicable fees.

(B) Demonstration of English language proficiency as stated in OAR 851-031-0006(3)(f)

(C) Graduation from an educational program that is equivalent to nursing education in the United States documented by a Board approved credentials evaluation service.

(D) Evidence of current enrollment in a Board approved re-entry program for internationally-educated nurses.

(c) Limited licenses issued under this section shall be valid for practice only within the planned curriculum. The limited license expires on successful completion of the re-entry program, on withdrawal from the re-entry program, or in one year, whichever comes first. At the discretion of the Board, an extension of the limited license may be granted upon written request from the limited license holder or re-entry program director and submission of a fee.

Stat. Auth.: ORS 678.150

Stats. Implemented: ORS 678.040, 678.050, 678.101, 678.150 & 678.410

Hist.: BN 11-1999. f. & cert. ef. 12-1-99; BN 6-2000, f. & cert. ef. 4-24-00; BN 1-2003, f. & cert. ef. 3-6-03; BN 9-2005, f. & cert. ef. 12-21-05; BN 18-2010, f. & cert. ef. 11-29-10

851-031-0070

Re-entry into Nursing

(1) An applicant who has worked as a licensed or credentialed nurse and meets all standards of eligibility established in OAR 851-031-0006(1), (2) & (3) except OAR 851-031-0006(3)(d)(e) must complete an approved re-entry program or individualized plan and provide evidence of successful completion of the licensing examination, prior to issuance of a license to practice. The applicant shall:

(a) Provide documentation of having successfully completed within the two years preceding issuance of the license:

(A) A Board-approved re-entry program (as specified in OAR 851-031-0045, OAR 851-031-0080), or

(B) An individualized re-entry plan as specified in OAR 851-031-0070(4).

(b) Satisfactorily complete required supervised clinical practice as specified in OAR 851-031-0070(2).

(c) Provide documentation of successful completion of the licensing examination as defined in 851-031-0006(3)(d).

(2) Standards for supervised clinical practice. The nurse shall obtain a limited license to practice prior to engaging in supervised clinical practice.

(a) Supervised clinical practice for nursing re-entry shall be in the student role and unpaid.

(b) A nurse who has less than 960 hours of nursing practice in the five-year period immediately preceding application for licensure shall complete a re-entry program or individualized plan that includes a minimum of 160 hours of supervised clinical practice.

(c) Up to 160 additional hours of supervised clinical practice may be required when recommended to the Board by the re-entry program director, nurse preceptor or nurse manager/supervisor. Additional required supervised clinical practice is subject to the availability of a qualified preceptor, willingness of the facility to provide the experience, and availability of the program director to supervise/coordinate the experience.

(3) Standards for the limited license for re-entry.

(a) The limited license may be issued to a nurse who:

(A) Meets all requirements for licensure except for completion of the re-entry requirement;

(B) Submits verification of enrollment in an approved re-entry program; or

(C) Received Board approval of an individualized re-entry plan.

(b) A limited license issued under these rules is to be used only for completion of an approved re-entry program or individualized re-entry plan, and required supervised clinical practice for re-entry.

(c) The limited license expires on successful completion of the re-entry program or individualized plan, on withdrawal from an approved re-entry program or individualized plan, or in one year, whichever comes first. At the discretion of the Board, a one-year extension of the limited license may be granted on written request and submission of a fee.

(d) An applicant who fails to successfully complete the re-entry program or individualized re-entry plan and required supervised clinical experience may reapply for licensure, re-entry, and a limited license. The applicant is required to complete all requirements set forth in OAR 851-031-0070(1), (2).

(4) Standards for individualized re-entry plans. The nurse choosing to complete an individualized plan for re-entry shall submit, in writing, the following for Board approval:

(a) Summary of nursing education and practice with rationale for use of an individualized plan for re-entry into nursing practice;

(b) Anticipated timeframe for completing all required components, including acquisition/demonstration of current knowledge and required supervised clinical practice;

(c) Clinical competencies/outcomes to be achieved and the mechanism for evaluating competence in nursing practice on completion of the plan;

(d) Plan for obtaining and demonstrating knowledge/competence in nursing, as identified in OAR 851-031-0080(2)(c);

(e) Plan for obtaining required hours of supervised clinical practice as specified in OAR 851-031-0070(2). The plan shall identify:

(A) The agency or agencies and contact person(s) where required supervised clinical experience will be obtained. A signed contract/agreement with each agency is required. The contract/agreement shall include but is not limited to:

(i) Learning objectives/outcomes for the re-entry experience;

(ii) Provisions for client and re-entry nurse safety;

(iii) Unit(s) on which the experience is to occur with the name of the preceptor on each unit, if applicable;

(iv) A provision allowing the agency to nullify the contact/agreement in the event of client safety issues.

(B) The name and credentials of the registered nurse preceptor(s). Each nurse preceptor shall:

(i) Hold a current unencumbered registered nursing license in Oregon.

(ii) Agree to directly supervise and evaluate the re-entry nurse;

(iii) Have no less than two years of registered nursing experience, of which at least six months shall be in the setting in which the clinical experience is to occur; and

(iv) Be recommended by the nurse executive or immediate supervisor in that setting.

(f) Documentation of successful completion of the individualized re-entry plan shall be provided in writing, and shall include:

(A) Completion of program objectives/outcomes;

(B) Completion of required supervised clinical practice hours;

(C) Achievement of predetermined competencies;

(D) Recommendation for licensure by clinical preceptor and nurse manager.

Stat. Auth.: ORS 678.150

Stats. Implemented: ORS 678.113 & 678.150

Hist.: NER 25, f. 9-22-75, ef. 10-10-75; NER 2-1980, f. & ef. 3-3-80; NER 5-1981, f. & ef. 11-24-81; NER 6, 1983, f. & ef. 12-9-83; NB 5-1987, f. & ef. 7-1-87; NB 1-1994, f. & cert. ef. 4-1-94; Renumbered from 851-020-0187; NB 12-1997, f. & cert. ef. 9-29-97; BN 10-1998, f. & cert. ef. 8-7-98; BN 1-2003, f. & cert. ef. 3-6-03; BN 9-2003, f. & cert. ef. 10-2-03; BN 12-2006, f. & cert. ef. 10-5-06; BN 18-2010, f. & cert. ef. 11-29-10

 

Rule Caption: Rules for establishment of “Health Professional’ Services Program” as required by HB 2345 (Enrolled 2009 Session).

Adm. Order No.: BN 19-2010

Filed with Sec. of State: 12-2-2010

Certified to be Effective: 12-2-10

Notice Publication Date: 10-1-2010

Rules Adopted: 851-070-0000, 851-070-0005, 851-070-0010, 851-070-0020, 851-070-0030, 851-070-0040, 851-070-0050, 851-070-0060, 851-070-0070, 851-070-0080, 851-070-0090, 851-070-0100

Rules Repealed: 851-046-0000, 851-046-0005, 851-046-0010, 851-046-0020, 851-046-0030, 851-046-0040, 851-070-0000(T), 851-070-0005(T), 851-070-0010(T), 851-070-0020(T), 851-070-0030(T), 851-070-0040(T), 851-070-0050(T), 851-070-0060(T), 851-070-0070(T), 851-070-0080(T), 851-070-0090(T), 851-070-0100(T)

Subject: These rules cover the newly established “Health Professionals’ Services Program” (HPSP) and are specific to the Oregon State Board of Nursing. This program is being established by the Addictions & Mental Health (AMH) Division of the Department of Human Services as required by House Bill 2345 (Enrolled, 2009 Session). The Nurse Monitoring Program under the Oregon State Board of Nursing (OAR 851-045) has been eliminated.

Rules Coordinator: KC Cotton—(971) 673-0638

851-070-0000

Purpose, Intent and Scope

The Board believes that licensees who develop substance use disorders, mental health disorders, or both disorders can, with appropriate treatment, be assisted with recovery and return to the practice of nursing. It is the intent of the Board that a licensee with a substance use disorder, a mental health disorder or both types of disorders may have the opportunity to enter the Health Professionals’ Services Program (HPSP). Participation in the Health Professionals’ Services Program does not shield the licensee from disciplinary action.

Stat. Auth.: ORS 676.200

Stats. Implemented: ORS 676.200

Hist.: BN 6-2010(Temp), f. 6-23-10, cert. ef. 7-1-10 thru 12-28-10; BN 19-2010, f. & cert. ef. 12-2-10

851-070-0005

Definitions

The following definitions apply to OAR chapter 851, division 070, except as otherwise stated

in the definition:

(1) “Abstinence” means the avoidance of all intoxicating substances, including but not limited to prescription or over-the-counter drugs with a potential for abuse or dependence;

(2) “Assessment or evaluation” means the process an independent third-party evaluator uses to diagnose the licensee and to recommend treatment options for the licensee.

(3) “Board” means the Oregon State Board of Nursing.

(4) “Business day” means Monday through Friday, except legal holidays as defined in ORS 187.010 (or ORS 187.020).

(5) “Diagnosis” means the principal mental health or substance use diagnosis listed in the DSM. The diagnosis is determined through the assessment and any examinations, tests or consultations suggested by the assessment and is the medically appropriate reason for services.

(6) “Division” means the Department of Human Services, Addictions and Mental Health Division.

(7) “DSM” means the Diagnostic and Statistical Manual of Mental Disorders, commonly referred to as DSM-IV-TR published by the American Psychiatric Association.

(8) “Federal regulations” means:

(a) As used in ORS 676.190(1)(f)(D), a “positive toxicology test result as determined by federal regulations pertaining to drug testing” means test results meet or exceed the cutoff concentrations shown in 49 CFR § 40.87 (2009) must be reported as substantial non-compliance, but positive toxicology results for other drugs and for alcohol may also constitute and may be reported as substantial non-compliance.

(b) As used in ORS 676.190(4)(i), requiring a “licensee to submit to random drug or alcohol testing in accordance with federal regulations” means licensees are selected for random testing by a scientifically valid method, such as a random number table or a computer-based random number generator that is matched with licensees’ unique identification numbers or other comparable identifying numbers. Under the selection process used, each covered licensee shall have an equal chance of being tested each time selections are made, as described in 40 CFR § 199.105(c)(5) (2009). Random drug tests must be unannounced and the dates for administering random tests must be spread reasonably throughout the calendar year, as described in 40 CFR § 199.105(c)(7) (2009).

(9) “Fitness to practice evaluation” means the process a qualified, independent third-party evaluator uses to determine if the licensee can safely perform the essential functions of the licensee’s health practice.

(10) “Final enrollment” means a self-referred licensee has provided all documentation required by OAR 851-070-0040 and has met all eligibility requirements to participate in the HPSP.

(11) “Independent third-party evaluator” means an individual who is approved by a licensee’s Board to evaluate, diagnose, and offer treatment options for substance use disorders, mental health disorders or co-occurring disorders.

(12) “Individual service record” means the official permanent HPSP documentation, written or electronic, for each licensee, which contains all information required by these rules and maintained by the HPSP to demonstrate compliance with these rules.

(13) “Licensee” means a licensed practical nurse, registered nurse, or advanced practice registered nurse who is licensed or certified by the Oregon State Board of Nursing.

(14) “Mental health disorder” means a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress or disability or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom that is identified in the DSM. “Mental health disorder” includes gambling disorders.

(15) “Monitoring agreement” means an individualized agreement between a licensee and the vendor that meets the requirements for a diversion agreement set by ORS 676.190.

(16) “Monitoring Entity” means an independent third-party that monitors licensees’ HPSP enrollment status and monitoring agreement compliance.

(17) “Non-treatment compliance monitoring” means the non-medical, non-therapeutic services employed by the vendor to track and report the licensee’s compliance with the monitoring agreement.

(18) “Nurse Monitoring Program” (NMP) refers to the alternative to the Board of Nursing’s discipline program prior to July 1, 2010.

(19) “Self-referred licensee” means a licensee who seeks to participate in the program without a referral from the board

(20) “Peer” means another licensee currently enrolled in the program.

(21) “Provisional enrollment” means temporary enrollment, pending verification that a self-referred licensee meets all HPSP eligibility criteria.

(22) “Substance use disorder” means a disorder related to the taking of a drug of abuse (including alcohol); to the side effects of a medication; and to a toxin exposure, including: substance use disorders (substance dependence and substance abuse) and substance-induced disorders (including but not limited to substance intoxication, withdrawal, delirium, and dementia, as well as substance induced psychotic disorders and mood disorders), as defined in DSM criteria.

(23) “Substantial non-compliance” means that a licensee is in violation of the terms of his or her monitoring agreement in a way that gives rise to concerns about the licensee’s ability or willingness to participate in the HPSP. Substantial non-compliance and non-compliance include, but are not limited to, the factors listed in ORS 676.190(1)(f). Conduct that occurred before a licensee entered into a monitoring agreement does not violate the terms of that monitoring agreement.

(24) “Successful completion” means that for the period of service deemed necessary by the vendor or by the licensee’s Board by rule, the licensee has complied with the licensee’s monitoring agreement to the satisfaction of the HPSP.

(25) “Toxicology testing” means urine testing or alternative chemical monitoring including blood, saliva, breath or hair as conducted by a laboratory certified, accredited or licensed and approved for toxicology testing.

(26) “Treatment” means the planned, specific, individualized health and behavioral health procedures, activities, services and supports that a treatment provider uses to remediate symptoms of a substance use disorder, mental health disorder or both types of disorders.

(27) “Vendor” means the entity that has contracted with the Division to conduct the HPSP.

Stat. Auth.: ORS 676.200

Stats. Implemented: ORS 676.200

Hist.: BN 6-2010(Temp), f. 6-23-10, cert. ef. 7-1-10 thru 12-28-10; BN 19-2010, f. & cert. ef. 12-2-10

851-070-0010

Participation in Health Professionals’ Services Program

Effective July 1, 2010, the Board shall participate in the Health Professionals’ Services Program and may refer eligible nurses to the HPSP in lieu of or in addition to public discipline. Only licensed practical nurses, registered nurses, and advanced practice registered nurses who meet the eligibility criteria may be referred by the Board to the Health Professionals’ Services Program.

Stat. Auth.: ORS 676.200

Stats. Implemented: ORS 676.200

Hist.: BN 6-2010(Temp), f. 6-23-10, cert. ef. 7-1-10 thru 12-28-10; BN 19-2010, f. & cert. ef. 12-2-10

851-070-0020

Eligibility in Health Professionals Services Program

(1) Licensee must be evaluated by an independent, third-party evaluator approved by the Board. The evaluation must include a diagnosis of a substance use disorder, mental health disorder, or both types of disorders with the appropriate diagnostic code from the DSM, and treatment options.

(2) Licensee must provide a written statement agreeing to enter the HPSP in lieu of or in addition to discipline and agreeing to abide by all terms and conditions established by the Board.

(3) Licensee must enter into the “HPSP Monitoring Agreement.”

(4) Licensees who have successfully graduated from either the NMP or HPSP programs and who have had a relapse may be permitted a maximum of one additional admittance into the HPSP.

Stat. Auth.: ORS 676.200

Stats. Implemented: ORS 676.200

Hist.: BN 6-2010(Temp), f. 6-23-10, cert. ef. 7-1-10 thru 12-28-10; BN 19-2010, f. & cert. ef. 12-2-10

851-070-0030

Procedure for Board Referrals

(1) When a complaint is received involving a licensee who may have a substance use disorder, a mental disorder, or both types of disorders, the Board staff will investigate and complete a report to be presented at a Board meeting.

(2) The Board will review the report and determine if the licensee meets the eligibility criteria for the HPSP.

(3) If licensee meets eligibility criteria and the board approves entry into the HPSP, the Board will provide a written referral. The referral must include:

(a) A copy of the report from the independent, third-party evaluator who diagnosed the Licensee;

(b) The treatment options developed by the independent third-party evaluator;

(c) A statement that the Board has investigated the licensee’s professional practice and conduct, and has determined whether the licensee’s professional practice, while impaired, presents or has presented a danger to the public;

(d) A description of any restrictions recommended or imposed by the Board on the licensee’s professional practice; including those specific to prescribing and dispensing medications (for licensees with prescriptive authority).

(e) A written statement from the licensee agreeing to enter the HPSP in lieu of or in addition to discipline and agreeing to abide by all terms and conditions established by the vendor; and

(f) A statement that the licensee has agreed to report any arrest for or conviction of a misdemeanor or felony crime to the board within three business days after the licensee is arrested or convicted.

(4) A Board-referred licensee is enrolled in the program effective on the date the licensee signs the consents and the monitoring agreement required by ORS 676.190.

(5) Upon enrollment into the program, the vendor (or monitoring entity) will notify the Board and the Board will dismiss without prejudice the pending complaint at the next Board meeting.

Stat. Auth.: ORS 676.200

Stats. Implemented: ORS 676.200

Hist.: BN 6-2010(Temp), f. 6-23-10, cert. ef. 7-1-10 thru 12-28-10; BN 19-2010, f. & cert. ef. 12-2-10

851-070-0040

Procedure for Self- Referred Licensees

(1) Self-referred licensees may participate in the HPSP as permitted by ORS 676.190(5).

Provisional Enrollment. To be provisionally enrolled in the program, a self-referred licensee must:

(a) Sign a written consent allowing disclosure and exchange of information between the vendor, the monitoring entity, the licensee’s employer, independent third-party evaluators, and treatment providers, including other health care providers;

(b) Sign a written consent allowing disclosure and exchange of information between the vendor, the Board, the monitoring entity, the licensee’s employer, independent third-party evaluators and treatment providers in the event the vendor determines the licensee to be in substantial non-compliance with his or her monitoring agreement as defined in OAR 851-070-0090. The purpose of the disclosure is to permit the vendor and the monitoring entity to notify the Board if the vendor determines the licensee to be in substantial non-compliance with his or her monitoring agreement;

(c) Attest that the licensee is not, to the best of the licensee’s knowledge, under investigation by his or her Board; and

(d) Agree to and sign a monitoring agreement.

(2) Upon provisional enrollment, the vendor shall send to the monitoring entity copies of the signed consents and the monitoring agreement, described in section one of this rule.

(3) Final Enrollment: To move from provisional enrollment to final enrollment in the program, a self-referred licensee must:

(a) Obtain at the licensee’s own expense and provide to the vendor, an independent third-party evaluator’s written evaluation containing a DSM diagnosis and diagnostic code and treatment recommendations;

(b) Agree to cooperate with the vendor’s investigation to determine whether the licensee’s practice while impaired presents or has presented a danger to the public; and

(c) Enter into an amended monitoring agreement, if required by the vendor.

(4) Once a self-referred licensee seeks enrollment in the HPSP, failure to complete final enrollment may constitute substantial non-compliance and may be reported to the Board.

(5) Upon final enrollment of a self-referred licensee, the vendor shall send to the monitoring entity a copy of the written evaluation by the independent third-party evaluator and a copy of the amended monitoring agreement, if any.

Stat. Auth.: ORS 676.200

Stats. Implemented: ORS 676.200

Hist.: BN 6-2010(Temp), f. 6-23-10, cert. ef. 7-1-10 thru 12-28-10; BN 19-2010, f. & cert. ef. 12-2-10

851-070-0050

Disqualification Criteria

Licensees, either Board-referred or self-referred, may be disqualified from entering the HPSP for factors including, but not limited to:

(1) Licensee’s disciplinary history;

(2) Severity and duration of the licensee’s impairment;

(3) Extent to which licensee’s practice can be limited or managed to eliminate danger to the public;

(4) Likelihood that licensee’s impairment can be managed with treatment;

(5) Evidence of criminal history that involves injury or endangerment to others;

(6) A diagnosis requiring treatment because of sexual offenses or sexual misconduct;

(7) Evidence of non-compliance with a monitoring program from other state;

(8) Pending investigations with the Board or boards from other states;

(9) Previous Board investigations with findings of substantiated abuse or neglect; and

(10) Prior enrollment in, but failure to successfully complete, either the Nurse Monitoring Program or HPSP.

Stat. Auth.: ORS 676.200

Stats. Implemented: ORS 676.200

Hist.: BN 6-2010(Temp), f. 6-23-10, cert. ef. 7-1-10 thru 12-28-10; BN 19-2010, f. & cert. ef. 12-2-10

851-070-0060

Approval of Independent Third-Party Evaluators

(1) To be approved by the Board as an independent third-party evaluator, an evaluator must:

(a) Be licensed as required by the jurisdiction in which the evaluator works;

(b) Have a minimum of a Master’s Degree in a mental health discipline;

(c) Provide evidence of additional education and experience as shown by one of the following:

(i) Department of Transportation Substance Abuse Professional qualification;

(ii) Certified Alcohol and Drug Counselor II or III;

(iii) Board Certified in Addiction Medicine by either ASAM or American Board of Psychiatry and Neurology.

(d) Provide evidence of assessments at the licensure level of the licensee being evaluated

(e) The Board will not accept an evaluator as independent in a particular case if, in the Board’s judgment, the evaluator’s judgment is likely to be influenced by a personal or professional relationship with a licensee.

Stat. Auth.: ORS 676.200

Stats. Implemented: ORS 676.200

Hist.: BN 6-2010(Temp), f. 6-23-10, cert. ef. 7-1-10 thru 12-28-10; BN 19-2010, f. & cert. ef. 12-2-10

851-070-0070

Approval of Treatment Providers

(1) To be approved by the Board as a treatment provider, a provider must be:

(a) Licensed as required by the jurisdiction in which the provider works;

(b) Able to provide appropriate treatment considering licensee’s diagnosis, degree of impairment, level of licensure, and treatment options proposed by the independent third-party evaluator; and

(c) Able to obtain a urinalysis of the licensee at intake.

(2) The Board will not accept a provider as a treatment provider in a particular case if, in the Board’s judgment, the provider’s judgment is likely to be influenced by a personal or professional relationship with a licensee.

Stat. Auth.: ORS 676.200

Stats. Implemented: ORS 676.200

Hist.: BN 6-2010(Temp), f. 6-23-10, cert. ef. 7-1-10 thru 12-28-10; BN 19-2010, f. & cert. ef. 12-2-10

851-070-0080

Licensee Responsibilities

(1) All licensees must:

(a) Agree to report any arrest for or conviction of a misdemeanor or felony crime to the vendor and the Board within three business days after the licensee is arrested or convicted of the crime; and

(b) Comply continuously with his or her monitoring agreement, including any restrictions on his or her practice, for at least two years or longer, as specified by the Board by rule or order;

(c) Abstain from mind-altering or intoxicating substances or potentially addictive drugs, unless the drug is approved by the HPSP and prescribed for a documented medical condition by a person authorized by law to prescribe the drug to the licensee;

(d) Report use of mind-altering or intoxicating substances or potentially addictive drugs within 24 hours;

(e) Participate in a treatment plan approved by a third party;

(f) Limit practice as required by the HPSP;

(g) Cooperate with supervised monitoring of practice;

(h) Participate in a follow-up evaluation, when necessary, of licensee’s fitness to practice;

(i) Submit to random drug or alcohol testing;

(j) Report at least weekly to the HPSP regarding the licensee’s compliance with the monitoring agreement;

(k) Report at least weekly to the HPSP regarding the licensee’s compliance with the agreement;

(l) Report any arrest for or conviction of a misdemeanor or felony crime to the HPSP within three business days after the licensee is arrested or convicted;

(m) Report applications for licensure in other states, changes in employment and changes in practice setting;

(n) Agree to be responsible for the cost of evaluations, toxicology testing and treatment;

(o) Report to the HPSP any investigations or disciplinary action by any state or state agency, including Oregon;

(p) Participate in required meetings according to the treatment plan; and

(q) Maintain current license status.

(2) In addition to the requirements listed in section one of this rule, self-referred licensees must also provide to the HPSP a copy of a report of the licensee’s criminal history, at least once per calendar quarter or more often if required by the HPSP.

Stat. Auth.: ORS 676.200

Stats. Implemented: ORS 676.200

Hist.: BN 6-2010(Temp), f. 6-23-10, cert. ef. 7-1-10 thru 12-28-10; BN 19-2010, f. & cert. ef. 12-2-10

851-070-0090

Completion Requirements

(1) To successfully complete the Health Professionals’ Services Program, licensees with a substance use disorder, or with a mental health disorder and a substance use disorder, must have worked for at least two years in a monitored practice. Licensees must complete the required two years of monitored practice within four years of entering the Health Professionals’ Services Program.

(2) To successfully complete the Health Professionals’ Services Program, licensees with a mental health disorder, but no substance use disorder, must have worked for at least one year in a monitored practice. Licensees must complete the required year of monitored practice within two years of entering the Health Professionals’ Services Program.

(3) The Board may extend by one year the time within which a licensee must complete the monitored practice if the licensee has remained compliant with the program.

(4) A licensee who does not complete the required term of monitored practice will be discharged from the Health Professionals’ Services Program and may be subject to discipline.

(5) The time spent working in a monitored practice before transferring from the Nurse Monitoring Program to the Health Professionals’ Services Program effective July 1, 2010, will be counted toward the required term of monitored practice.

Stat. Auth.: ORS 676.200

Stats. Implemented: ORS 676.200

Hist.: BN 6-2010(Temp), f. 6-23-10, cert. ef. 7-1-10 thru 12-28-10; BN 19-2010, f. & cert. ef. 12-2-10

851-070-0100

Substantial Non-Compliance Criteria

(1) The HPSP or the monitoring entity will report substantial non-compliance with the diversion agreement within one business day after the HPSP learns of non-compliance, including but not limited to information that a licensee:

(a) Engaged in criminal behavior;

(b) Engaged in conduct that caused injury, death or harm to the public, including engaging in sexual impropriety with a patient;

(c) Was impaired in a health care setting in the course of the licensee’s employment;

(d) Received a positive toxicology test result as determined by federal regulations pertaining to drug testing;

(e) Violated a restriction on the licensee’s practice imposed by the HPSP or the licensee’s Board;

(f) Was admitted to the hospital for mental illness or adjudged to be mentally incompetent;

(g) Entered into a diversion agreement, but failed to participate in the HPSP;

(h) Was referred to the HPSP, but failed to enroll in the HPSP;

(i) Forged, tampered with, or modified a prescription;

(j) Violated any rules of prescriptive/dispensing authority;

(k) Violated any provisions of OAR 851-070-0080;

(l) Violated any terms of the diversion agreement; or

(m) Failed to complete the monitored practice requirements as stated in OAR 851-070-0090.

(2) The Board, upon being notified of a licensee’s substantial non-compliance will investigate and determine the appropriate sanction, which may include a limitation of licensee’s practice and any other sanction, up to and including termination from the HPSP and formal discipline.

Stat. Auth.: ORS 676.200

Stats. Implemented: ORS 676.200

Hist.: BN 6-2010(Temp), f. 6-23-10, cert. ef. 7-1-10 thru 12-28-10; BN 19-2010, f. & cert. ef. 12-2-10

Notes
1.) This online version of the OREGON BULLETIN is provided for convenience of reference and enhanced access. The official, record copy of this publication is contained in the original Administrative Orders and Rulemaking Notices filed with the Secretary of State, Archives Division. Discrepancies, if any, are satisfied in favor of the original versions. Use the OAR Revision Cumulative Index found in the Oregon Bulletin to access a numerical list of rulemaking actions after November 15, 2010.

2.) Copyright 2011 Oregon Secretary of State: Terms and Conditions of Use

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