Anita Wheeler, RN, MSN, CPN DSHS School Health Coordinator/Nurse Consultant

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1 The 82 nd Legislative Session in Review Anita Wheeler, RN, MSN, CPN DSHS School Health Coordinator/Nurse Consultant

2 Session Objectives Differentiate between laws, rules, standards and guidelines. Describe 2 laws that were passed during the 82nd session that will have an impact on school health.

3 The Legislative Process.. Public Comment Input by the public is accepted by , phone calls, or letters. Points of Interest Bill can be filed in House or Senate Bill is assigned to Committee for hearing Committee hears bill 3 times, 1 st time is public comment period Bill sent to the calendars and heard on the floor Bill sent to other body to go through the same hearing process Bill Enrolled (Final) Sent to Governor

4 Bill Written and Filed Who can write a bill? Who influences a bill being written?

5 Tips to Consider When Providing Testimony or Information on a Bill Know the Committee Be Concise and Direct General Rule of 3 s Say what you want to say: three times, in three ways, in three minutes. Directly state you are in support of or not in support of the bill These tips apply to written and oral testimony

6 So Many Bills. So Little Time. * 1928 Senate Bills * 3865 House Bills Some bills are never even heard by the assigned committee Some bills are lost in committee and never voted out Some bills get substitute language The above list does not include resolutions, joint resolutions, etc.

7 On to the Governor Three Actions the Governor can take: Sign the bill Veto the bill Let the bill pass into law without signing it Governor has until 20 th day after final adjournment to sign or veto June 19, 2011 (this session) Bills that are not signed or vetoed go into effect on the 91 st day following adjournment August 29, 2011 (this session)

8 September 1 st

9 Rules Process (TAC) Most bills assign responsibilities to a state agency to develop rules or guidelines. Rules carry the weight of law once they are approved and are located in the Texas Administrative Code (TAC). Rules are developed utilizing subject matter experts, public input, research and best practices. Public comment periods are woven throughout the rules process.

10 Examples of Rules* Texas School Health Advisory Committee School-based Health Center Rules Rodeo Rules *These rules were developed in the School Health Program.

11 Other School Health Rules Vision, Hearing and Spinal Screening Immunization Rules Infectious Disease Rules Licensing Rules for Nurses Rules on Implementing Coordinated School Health

12 In a Nut Shell The law usually outlines who, what, when and where. The rules outline how the law is to be implemented. The Texas Administrative Code is a compilation of all state agencies rules. Rule development follows a specific process to allow for public comment. DSHS works closely with stakeholders SBHC-TASBHCs, current contractors, past contractors Rodeo- Rodeo associations, vendors, parents, school districts TSHAC- TEA, TDA, parents, school nurses, PE and Health teachers, child nutrition

13 Example of Law and Rules Health and Safety Code SUBTITLE A. PUBLIC SAFETY CHAPTER 768 CHILDREN PARTICIPATING IN RODEOS Sec Definitions Sec Protective Gear Required for Children Engaging in Certain Rodeo Activities Sec RODEOS ASSOCIATED WITH SCHOOL Sec RULES Texas Administrative Code TITLE 25 HEALTH SERVICES PART 1 DEPARTMENT OF STATE HEALTH SERVICES CHAPTER 104 CHILDREN PARTICIPATING IN RODEOS Rules Purpose Definitions Standards for Protective Vests and Bull Riding Helmets for Children Who Participate in Rodeos Requirements for an Educational Program on Safety Compliance Date of Rules

14 On To Guidelines. Instruction that shows or tells how something should be done Usually based on research, expertise, and best practice. (Dictionary.com) Examples- USDA Nutritional Guidelines HB 984 Guidelines Practice Guidelines for Healthcare Professionals

15 Example-SB 27, 82 nd Legislative Session Relating to policies of school districts (and charters) for the care of certain students at risk for anaphylaxis. School Boards shall adopt and administer policy Policy shall be based on Guidelines (DSHS) Consulting with Ad Hoc Committee Districts with policy must review and align with Guidelines

16 Ad Hoc Committee Appointed by DSHS Commissioner by December 1, 2011 Ad Hoc Committee members: One representative from: DSHS, Food Allergy Initiative, Food Allergy and Anaphylaxis Network, TSNO One of each: principal, classroom teacher, school board member, superintendent, physician from Academy of Allergy, Asthma and Immunnology At least two parents (of public school students) with children with diagnosed food allergies

17 Guidelines Timeline May 1, 2012 Guidelines must be final and ready to post August 1, 2012 school boards must adopt policy based on the Guidelines

18 DSHS First Steps in Developing Guidelines Develop criteria for parent member selection Write letters to organizations listed in the bill asking for representative Set up timeline in getting assignments made and meetings set up Allowing time for the writing of the Guidelines based on Committee input

19 Limitations on SB 27 Guidelines May not require schools to purchase prescription anaphylaxis medication or require any other expenditure that would result in a negative fiscal impact. May not require the personnel of a district to administer anaphylaxis meds to a student unless the anaphylaxis med is prescribed for the student.

20 Standards Standards are authoritative statements by which the nursing profession describes the responsibilities for which its practitioners are accountable. Standards reflect the values and priorities of the profession and provide direction for professional nursing practice and a framework for the evaluation of this practice. They also define the nursing profession s accountability to the public and the outcomes for which registered nurses are responsible. American Nurses Association-2011

21 Standards of Practice General Nursing- ANA School Nursing- NASN Other Nursing Standards- ANA

22 Standards of School Nursing Practice** Standard I. Assessment The school nurse collects comprehensive data pertinent to the client s health or the situation. Standard II. Diagnosis The school nurse analyzes the assessment data to determine the diagnosis or issues. Standard III. Outcomes Identification The school nurse identifies expected outcomes for a plan individualized to the client or the situation. Standard IV. Planning The school nurse develops a plan that prescribes strategies and alternatives to attain expected outcomes. **National Association of School Nurses

23 Standard V. Implementation The school nurse implements the identified plan. Standard 5A: Coordination of Care The school nurse coordinates care delivery. Standard 5B: Health Teaching and Health Promotion The school nurse provides health education and employs strategies to promote health and a safe environment. Standard 5C: Consultation The school nurse provides consultation to influence the identified plan, enhance the abilities of others and effect change. Standard 5D: Prescriptive Authority and Treatment The advanced practice registered nurse uses prescriptive authority, procedures, referrals, treatments and therapies in accordance with state and federal laws and regulations. Standard VI. Evaluation The school nurse evaluates progress towards achievement of outcomes.

24 Standards of School Nursing Professional Performance Standard VII. Quality of Practice The school nurse systematically enhances the quality and effectiveness of nursing practice. Standard VIII. Education The school nurse attains knowledge and competency that reflects current school nursing practice. Standard IX. Professional Practice Evaluation The school nurse evaluates ones own nursing practice in relation to professional standards and guidelines, relevant statutes, rules and regulations. Standard X. Collegiality The school nurse interacts with, and contributes to the professional development of peers and school personnel as colleagues. Standard XI. Collaboration The school nurse collaborates with the client, the family, school staff and others in the conduct of school nursing practice.

25 Standard XII. Ethics The school nurse integrates ethical provisions in all areas of practice. Standard XIII. Research The school nurse integrates research findings into practice. Standard XIV. Resource Utilization The school nurse considers factors related to safety, effectiveness, cost and impact on practice in the planning and delivery of school nursing services. Standard XV. Leadership The school nurse provides leadership in the professional practice setting and the profession. Standard XVI. Program Management The school nurse manages school health services

26 Other Tools for School Nurses Six-step Decision Making Tool Texas Board of Nursing Texas Guide to School Health Programs DSHS, School Health Program School Nursing: A Comprehensive Text Selekman, Janice, editor Clinical Guidelines for School Nurses Ozias, Jan, editor

27 Scenarios Activity As a group, review the scenario that was handed to you. Utilizing your knowledge of the law, rules, guidelines and standards for school nursing practice. Come up with the group answer to the question at the end of your scenario. Utilize your groups general experience and education as a baseline in determining the answer.

28 82 nd Session in Brief Bills of Interest Bullying Bill(s) Too many to name them all School Health Bill(s) Not as many heard this session related to health and PE Bill(s) related to SHACs Nursing Practice Related Bill(s)

29 Questions??

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