22 Tex. Admin. Code § 221.4 - Licensure as an APRN
(a) Application for
Initial Licensure as an APRN.
(1) An
applicant for licensure as an APRN in this state shall submit to the Board the
required fee specified in §
223.1 of this title (relating to
Fees), verification of licensure or privilege to practice as a registered nurse
in Texas, and a completed application that provides the following information:
(A) Graduation from an APRN graduate or
post-graduate program, as evidenced by official documentation received directly
from an APRN education program accredited by a nursing accrediting body that is
recognized by the Board and the U.S. Secretary of Education and/or the Council
for Higher Education Accreditation (CHEA), or its successor organization, as
recognized by the Board; and
(B)
Documentation of education shall verify the date of graduation; credential
conferred; number of clinical hours completed; completion of three separate
graduate level courses in advanced physiology and pathophysiology; advanced
health assessment; advanced pharmacology that includes pharmacodynamics,
pharmacokinetics, and pharmacotherapeutics of all broad categories of agents;
role and population focus area of the education program; and evidence of
meeting the standards of APRN education set forth in this rule.
(2) In order to be licensed in
this state, all APRN applicants must be currently licensed as a registered
nurse in Texas or hold a current privilege to practice as a registered nurse in
Texas.
(3) In order to be licensed
in this state, all APRN applicants must take and pass the appropriate APRN
national certification examination in the APRN role and population focus
congruent with the applicant's educational preparation. Only those national
certification examination(s) recognized by the Board for each APRN role and
population focus area shall be accepted. Certification must remain current at
all times.
(4) Identification of
any state, territory, or country in which the applicant holds or previously
held a professional license or credential, if applicable, must be provided.
Required information includes:
(A) The
number, type, and status of the license or credential; and
(B) The original state or country of
licensure or credentialing.
(5) An applicant must provide the date and
jurisdiction the applicant previously applied for a license in another
jurisdiction and either was denied a license, withdrew the application, or
allowed the application to expire, as applicable.
(6) An applicant must provide a detailed
explanation and supporting documentation for each affirmative answer to
questions regarding the applicant's eligibility for licensure.
(7) An individual who has reason to believe
that he or she may be ineligible for APRN licensure or prescriptive
authorization may petition the Board for a declaratory order as to his or her
eligibility by submitting a petition, on forms provided by the Board, and the
fee required in §
223.1 of this title (relating to
Fees).
(A) The petition shall include:
(i) a statement by the individual indicating
the reason(s) and basis of his/her potential ineligibility;
(ii) if the potential ineligibility is due to
the individual's criminal history, all court documents, including, but not
limited to: indictments, agreements for pre-trial diversion or deferred
prosecution, orders of deferred adjudication, judgments, probation records, and
evidence of completion of probation, as applicable;
(iii) if the potential ineligibility is due
to the individual's mental health condition or diminished capacity, verifiable
and reliable evidence of controlled behavior and consistent compliance with
recommended treatment, including compliance with a prescribed medication
regime, for a reasonable amount of time, as applicable;
(iv) if the potential ineligibility is due to
the individual's substance use disorder and/or the abuse/misuse of alcohol or
drugs, verifiable and reliable evidence of sobriety and abstinence from drugs
and alcohol, which may include evidence of the completion of inpatient,
outpatient, or aftercare treatment, random drug screens, individual or group
therapy, and/or support group attendance; and
(v) an evaluation that meets the criteria of
the Occupations Code §
301.4521 and §
213.33 of this title (relating to
Factors Considered for Imposition of Penalties/Sanctions), if
applicable.
(B) Once the
Board has received all necessary information, including the information
required by subparagraph (A) of this paragraph, an investigation shall be
conducted. The investigation will be based upon an evaluation of the
individualized factors of the case, the potential risk of harm the individual's
practice may pose to patients/clients and/or the public, and the individual's
ability to meet the requirements of §213.27 (relating to Good Professional
Character), §213.28 (relating to Licensure of Individuals with Criminal
History), and §
213.29(relating to Fitness to
Practice) of this title, as applicable. Based upon the individualized facts of
the case, the Board may approve licensure or prescriptive authorization without
encumbrance, impose probationary conditions or restrictions on the individual's
ability to practice advanced practice nursing in this state, or limit or deny
licensure or prescriptive authorization.
(C) If the Executive Director proposes to
find the individual ineligible for licensure or prescriptive authorization, the
individual may obtain a hearing before the State Office of Administrative
Hearings (SOAH). The Executive Director shall have discretion to set a hearing
and give notice of the hearing. The hearing shall be conducted in accordance
with §
213.22 of this title (relating to
Formal Proceedings) and the rules of SOAH. When in conflict, SOAH's rules of
procedure will prevail. The decision of the Board shall be rendered in
accordance with §
213.23 of this title (relating to
Decision of the Board).
(D) An
individual whose petition is denied may re-petition or seek licensure or
prescriptive authorization after the expiration of one year from the date of
the proposal to deny eligibility.
(8) An applicant must attest, on forms
provided by the Board, to having completed a minimum of 400 hours of current
practice with the last 24 calendar months in the APRN role and population focus
area for which the applicant is applying, unless the applicant has completed an
APRN education program in the advanced practice role and population focus area
within the last 24 calendar months.
(A) If
less than four years, but more than two years, have lapsed since completion of
the APRN education program, and/or the applicant does not have 400 hours of
current practice in the APRN role and population focus area during the previous
24 calendar months, the APRN shall be required to demonstrate proof of
completion of 400 hours of current practice obtained under the direct
supervision of a qualified preceptor who meets the requirements of §
221.10 of this chapter (relating
to Reactivation or Reinstatement of APRN Licensure).
(B) If more than four years have lapsed since
completion of the APRN education program, and/or the applicant has not
practiced in the APRN role during the previous four years, the applicant shall
successfully complete a refresher course or extensive orientation in the
appropriate APRN role and population focus area that includes a supervised
clinical component by a qualified preceptor who meets the requirements of
§
221.10 of this chapter.
(i) The course(s)/orientation shall be of
sufficient length to satisfy the learning needs of the applicant and to assure
that he/she meets the minimum standard for safe, competent care and include a
minimum of 400 hours of current practice as described in this paragraph. The
course(s)/orientation shall cover the entire scope of the authorized APRN role
and population focus area. Content shall comply with the requirements specified
in the form titled "Requirements for APRN Refresher Course or Extensive
Orientation", which is adopted by reference in §
221.10 of this chapter.
(ii) The preceptor must provide written
verification of satisfactory completion of the refresher course/extensive
orientation on forms provided by the Board and assurance that the individual
has reviewed current practice-related information pertinent to his/her APRN
role and population focus area.
(9) An applicant must attest, on forms
provided by the Board, to having obtained 20 contact hours of continuing
education within the last 24 calendar months appropriate for the APRN role and
population focus area for which the applicant is applying. Continuing education
in the APRN role and population focus area must meet the requirements of
Chapter 216 of this title (relating to Continuing Competency). The 20 contact
hours required for RN licensure may be met by the 20 hours required by this
paragraph.
(10) APRN applicants who
wish to practice in more than one role and/or population focus area shall
complete additional education in the desired area(s) of licensure in compliance
with the education requirements set forth in this chapter and meet all
requirements for licensure in each additional role or population focus area. To
apply for licensure for more than one role and/or population focus area, the
applicant shall submit a separate application and fee for each desired role
and/or population focus area. Additional licensure is required for those
licensed APRNs seeking to include an additional:
(A) APRN role and population focus
area;
(B) Population focus area
within the same APRN role; or
(C)
APRN role within the same population focus area.
(b) Licensure of an Internationally Educated
APRN.
(1) An internationally educated
applicant for licensure as an APRN in Texas shall:
(A) Graduate from a graduate or post-graduate
level APRN education program equivalent to an APRN education program in the
United States that is accepted by the Board. All curricular requirements set
forth in this rule must be met.
(B)
Submit documentation through an official transcript directly from the
international nursing education program and an original Credential Evaluation
Service (CES) Full Education course-by-course report, sent directly from an
approved organization for the license being sought.
(2) An internationally educated APRN
applicant shall meet all other licensure criteria required of applicants
educated in the United States.
(c) Application for Licensure by Endorsement.
(1) An applicant for licensure by endorsement
as an APRN in this state shall submit to the Board the required fee as
specified in §
223.1 of this title, verification
of licensure or privilege to practice as a registered nurse in Texas, and a
completed APRN application that provides the following information:
(A) Graduation from a graduate or
post-graduate level APRN education program, as evidenced by an official
transcript or other official documentation received directly from a graduate
program accredited by a nursing accrediting body that is recognized by the U.S.
Secretary of Education and/or Council for Higher Education Accreditation, or
its successor organization, as acceptable by the Board.
(B) Documentation of education shall verify
the date of graduation; credential conferred; number of clinical hours
completed; completion of three separate graduate level courses in advanced
physiology and pathophysiology, advanced health assessment, and advanced
pharmacology that includes pharmacodynamics, pharmacokinetics, and
pharmacotherapeutics of all broad categories of agents; role and population
focus area of the education program; and evidence of meeting the standards of
nursing education in this rule.
(2) An applicant must provide evidence of
current certification by a national certifying body in the APRN role and
population focus area appropriate to the APRN educational preparation. National
certifications accepted for APRN licensure shall meet the requirements for
national certification programs set forth in this rule. Primary source
verification of certification is required.
(3) An applicant must attest, on forms
provided by the Board, to having completed a minimum of 400 hours of current
practice within the last 24 calendar months in the APRN role and population
focus area for which the applicant is applying, unless the applicant has
completed an APRN education program in the APRN role and population focus area
within the last 24 calendar months.
(A) If
the applicant has not been in clinical practice in the APRN role and population
focus area for at least 400 hours within the past two years, the applicant
shall provide evidence of:
(i) Satisfactory
completion of 20 contact hours of continuing education within the two years
prior to applying for licensure; and
(ii) If less than four years but more than
two years have lapsed since completion of the APRN education program and/or the
applicant does not have 400 hours of current practice in the APRN and
population focus area during the previous 24 calendar months, the APRN shall be
required to demonstrate proof of completion of 400 hours of current practice
obtained under the direct supervision of a qualified preceptor who meets the
requirements of §
221.10 of this
chapter.
(B) If the
applicant has not been in clinical practice for more than the past four years,
the applicant shall provide evidence of satisfactory completion of 45 contact
hours of pharmacotherapeutics within the two years prior to application. The
applicant must also successfully complete a refresher course or an extensive
orientation in the appropriate APRN role and population focus area that
includes a supervised clinical component by a qualified preceptor who meets the
requirements of §
221.10 of this chapter.
(C) The course(s)/orientation shall be of
sufficient length to satisfy the learning needs of the applicant and to assure
that he/she meets the minimum standard for safe, competent care and include a
minimum of 400 hours of current practice as described in this paragraph. The
course(s)/orientation shall cover the entire scope of the authorized APRN role
and population focus area. Content shall comply with the requirements specified
in the form titled "Requirements for APRN Refresher Course or Extensive
Orientation", which is adopted by reference in §
221.10 of this chapter.
(D) The preceptor must provide written
verification of satisfactory completion of the refresher course/extensive
orientation on forms provided by the Board and assurance that the individual
has reviewed current practice-related information pertinent to his/her APRN
role and population focus area.
(4) Identification of any state, territory,
or country in which the applicant holds a professional license or credential,
if applicable, must be provided. Required information includes:
(A) The number, type, and status of the
license or credential; and
(B) The
original state or country of licensure or credentialing.
(5) An applicant must provide the date and
jurisdiction the applicant previously applied for a license in another
jurisdiction and either was denied a license, withdrew the application, or
allowed the application to expire, as applicable.
(6) An applicant must provide a detailed
explanation and supporting documentation for each affirmative answer to
questions regarding the applicant's eligibility for licensure.
(7) An individual who has reason to believe
that he or she may be ineligible for APRN licensure or prescriptive
authorization may petition the Board for a declaratory order as to his or her
eligibility by submitting a petition, on forms provided by the Board, and the
fee required in §
223.1 of this title (relating to
Fees).
(A) The petition shall include:
(i) a statement by the individual indicating
the reason(s) and basis of his/her potential ineligibility;
(ii) if the potential ineligibility is due to
the individual's criminal history, all court documents, including, but not
limited to: indictments, agreements for pre-trial diversion or deferred
prosecution, orders of deferred adjudication, judgments, probation records, and
evidence of completion of probation, as applicable;
(iii) if the potential ineligibility is due
to the individual's mental health condition or diminished capacity, verifiable
and reliable evidence of controlled behavior and consistent compliance with
recommended treatment, including compliance with a prescribed medication
regime, for a reasonable amount of time, as applicable;
(iv) if the potential ineligibility is due to
the individual's substance use disorder and/or the abuse/misuse of alcohol or
drugs, verifiable and reliable evidence of sobriety and abstinence from drugs
and alcohol, which may include evidence of the completion of inpatient,
outpatient, or aftercare treatment, random drug screens, individual or group
therapy, and/or support group attendance; and
(v) an evaluation that meets the criteria of
the Occupations Code §
301.4521 and §
213.33 of this chapter (relating
to Factors Considered for Imposition of Penalties/Sanctions), if
applicable.
(B) Once the
Board has received all necessary information, including the information
required by subparagraph (A) of this paragraph, an investigation shall be
conducted. The investigation will be based upon an evaluation of the
individualized factors of the case, the potential risk of harm the individual's
practice may pose to patients/clients and/or the public, and the individual's
ability to meet the requirements of §213.27 (relating to Good Professional
Character), §213.28 (relating to Licensure of Individuals with Criminal
History), and §
213.29(relating to Fitness to
Practice) of this title, as applicable. Based upon the individualized facts of
the case, the Board may approve licensure or prescriptive authorization without
encumbrance, impose probationary conditions or restrictions on the individual's
ability to practice advanced practice nursing in this state, or limit or deny
licensure or prescriptive authorization.
(C) If the Executive Director proposes to
find the individual ineligible for licensure or prescriptive authorization, the
individual may obtain a hearing before the State Office of Administrative
Hearings (SOAH). The Executive Director shall have discretion to set a hearing
and give notice of the hearing. The hearing shall be conducted in accordance
with §
213.22 of this title (relating to
Formal Proceedings) and the rules of SOAH. When in conflict, SOAH's rules of
procedure will prevail. The decision of the Board shall be rendered in
accordance with §
213.23 of this title (relating to
Decision of the Board).
(D) An
individual whose petition is denied may re-petition or seek licensure or
prescriptive authorization after the expiration of one year from the date of
the proposal to deny eligibility.
(8) APRN applicants who wish to practice in
more than one role and/or population focus area shall complete additional
education in the desired area(s) of licensure in compliance with the
educational requirements set forth in this chapter and meet all requirements
for licensure in each additional role or population focus area. To apply for
licensure for more than one role and/or population focus area, the applicant
shall submit a separate application and fee for each desired role and/or
population focus area. Addition licensure is required for those licensed APRNs
seeking to include an additional:
(A) APRN
role and population focus area;
(B)
Population focus area within the same APRN role; or
(C) APRN role within the same population
focus area.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.