RULES AND REGULATIONS
Title 49—PROFESSIONAL AND VOCATIONAL STANDARDS
STATE BOARD OF NURSING
[ 49 PA. CODE CH. 21 ]
Biennial Renewal Fees
[40 Pa.B. 4755]
[Saturday, August 21, 2010]The State Board of Nursing (Board) amends §§ 21.5, 21.147, 21.253 and 21.705. The final-form rulemaking provides for a new biennial renewal fee for licensed practical nurses (LPN), professional nurses (RN), certified registered nurse practitioners (CRNP) and licensed dietitian-nutritionists (LDN).
Effective Date
The final-form rulemaking will be effective upon publication in the Pennsylvania Bulletin.
Statutory Authority
Section 11.2 of the Professional Nursing Law (63 P. S. § 221.2) and section 17.5 of the Practical Nurse Law (63 P. S. § 667.5) require the Board to set fees sufficient to meet expenditures.
Response to Comments
The proposed rulemaking was published at 39 Pa.B. 7105 (December 19, 2009). The Board received comments from the Pennsylvania Association of Nurse Anesthetists (PANA), the Pennsylvania Health Care Association (PHCA), Judith Giannuzzi, R. N., the House Professional Licensure Committee (HPLC) and the Independent Regulatory Review Commission (IRRC). PANA wrote that it did not have an objection to the proposed rulemaking. PHCA, an organization representing approximately 324 long-term care and senior service providers, wrote in opposition to the proposed increase in biennial renewal fees. PHCA opined that the increase could create an impediment for individuals seeking to become and to work as nurses. Judith Giannuzzi objected to the proposed increase and asked what obligations the Board could not meet without the increase and whether other cost-cutting options had been explored.
The HPLC submitted three comments. First, the HPLC requested the rationale for the proposed 45%—50% increase after 9 years without increases and after having been notified of the need for increases in the fall of 2008. Second, the HPLC recommended a duplicate listing of the fee for examination and licensure be stricken. Third, the HPLC recommended that web site references be checked and questioned the wisdom of placing web site addresses in a regulation. IRRC echoed the HPLC's second comment, recommended that the web site link be corrected but remain in the regulation and requested that the Board submit a ''fee report form'' for the increases in the final-form rulemaking.
In determining that a fee increase was necessary, the Board considered both its operational expenses and the ability of its licensees to pay the increased fees. The majority of the Board's expenses arise from the investigation and prosecution of individuals who have violated the nursing practice acts. Individuals who violate the nursing practice acts place patients at risk. The Board's obligation to protect the public would be compromised if it did not have the funds necessary to investigate and prosecute violations of the nursing practice acts. The Department of State and the Bureau of Professional and Occupational Affairs have explored and implemented various cost-cutting measures over the past several years.
The HPLC requested the rationale for the amount of the increase after 9 years without increases and after having been notified of the need for an increase in the fall of 2008. The Board last increased biennial renewal fees in November 2000. The Board anticipates that the first implementation of the new fee will be in April 2011.
The Board is statutorily required to monitor revenues and expenditures and to increase fees when it appears that the Board's revenues will not meet its expenditures over a 2-year period. After monitoring revenues and expenses on a biennial basis, the Department's Bureau of Finance and Operations informed the Board, in late fall of 2008, that the Board's revenues were not projected to meet its expenses over a 2-year period. The Board began drafting its proposed rulemaking and submitted a draft for an incremental fee increase over the coming 10-year period for internal review in January 2009. The incremental increase was an approach that had been suggested by the HPLC in its review of other board's biennial renewal fee regulations, but that had not previously been adopted by another board.
Ongoing discussions ensued between the Board's regulatory officers and the Bureau of Finance and Operations regarding the uncertainty surrounding the approval of an incremental fee increase and the urgency of the Board's need to balance its budget. The Board decided to propose a traditional, one-time increase. The proposed rulemaking was published at 39 Pa.B. 7105. In accordance with the Regulatory Review Act (71 P. S. §§ 745.1—745.12), comment periods were provided for the public, the HPLC, the Senate Consumer Protection and Professional Licensure Committee (SCP/PLC) and IRRC. The Board considered the comments at its meeting on April 13, 2010, and finalized a draft of the final-form rulemaking package that day.
In determining the proposed biennial fee increases, the Board also reviewed nursing salary data compiled by the Department of Labor and Industry. This data shows the average salary in this Commonwealth for an LPN is $39,920, $61,390 for an RN and $44,420 for an LDN. Data from the United States Department of Labor, Bureau of Labor Statistics showed a median salary for CRNPs in 2007 was $82,590. The increases proposed by the Board would increase the licensure fees for LDNs, LPNs and RNs by $10 per year to $32.50 per year. The increase proposed by the Board would increase the licensure fee for CRNPs by $12.50 per year to $37.50 per year. These fees are significantly lower than the nurse licensure fees charged in most of the surrounding states. The Board does not anticipate that the increases will place an undue burden on licensees or on employers who pay the fees for their employees.
Regarding the web addresses in regulations, licensing boards within the Bureau began including web addresses in regulations at the suggestion of IRRC. Although the Board questioned, as does the HPLC, the advisability of publishing web addresses, which are subject to change, in regulations, the Board agreed with IRRC that its regulations should provide as much information as possible to licensees. The Legislative Reference Bureau has agreed to publish changes to web addresses without requiring the Board to promulgate a rulemaking to effectuate a change. On balance, therefore, it appears that the benefit to including web and e-mail addresses outweighs the possible negative effects when these addresses are changed. The Board corrected the web addresses for the Commission on Dietetic Registration and the Certification Board for Nutrition Specialists in the final-form rulemaking.
The Board deleted the repetitious provision in the fee schedule for RNs and provided the fee report forms as requested by IRRC.
Fiscal Impact and Paperwork Requirements
The final-form rulemaking will have a fiscal impact on nurses and LDNs in this Commonwealth in that the final-form rulemaking increases the biennial licensure renewal fees for these licensees. The final-form rulemaking will not otherwise have fiscal impact nor impose additional paperwork on the private sector, the general public, the Commonwealth or its political subdivisions.
Sunset Date
The Board continuously monitors the effectiveness of its regulations. Therefore, a sunset date has not been assigned.
Regulatory Review
Under section 5(a) of the Regulatory Review Act (71 P. S. § 745.5(a)), on December 7, 2009, the Board submitted a copy of the notice of proposed rulemaking, published at 39 Pa.B. 7105, to IRRC and the Chairpersons of the HPLC and the SCP/PLC for review and comment.
Under section 5(c) of the Regulatory Review Act, IRRC, the HPLC and the SCP/PLC were provided with copies of the comments received during the public comment period, as well as other documents when requested. In preparing the final-form rulemaking, the Board has considered all comments from IRRC, the HPLC, the SCP/PLC and the public.
Under section 5.1(j.2) of the Regulatory Review Act (71 P. S. § 745.5a(j.2)), on June 23, 2010, the final-form rulemaking was approved by the HPLC. On July 14, 2010, the final-form rulemaking was deemed approved by the SCP/PLC. Under section 5.1(e) of the Regulatory Review Act, IRRC met on July 15, 2010, and approved the final-form rulemaking.
Additional Information
Additional information may be obtained by writing to Ann Steffanic, Board Administrator, State Board of Nursing, P. O. Box 2649, Harrisburg, PA 17105-2649.
Findings
The Board finds that:
(1) Public notice of proposed rulemaking was given under sections 201 and 202 of the act of July 31, 1968 (P. L. 769, No. 240) and the regulations promulgated thereunder, 1 Pa. Code §§ 7.1 and 7.2.
(2) A public comment period was provided as required by law and all comments were considered in drafting this final-form rulemaking.
(3) The amendments made to the final-form rulemaking do not enlarge the purpose of the proposed rulemaking as published under section 201 of the act of July 31, 1968 (P. L. 769, No. 240) (45 P. S. § 1201).
(4) The amendments to the regulations of the Board are necessary and appropriate for the regulation of the practice of RNs in this Commonwealth.
Order
The Board orders that:
(a) The regulations of the Board, 49 Pa. Code Chapter 21, are amended by amending §§ 21.147 and 21.253 to read as set forth at 39 Pa.B. 7105 and by amending §§ 21.5 and 21.705 to read as set forth in Annex A.
(b) The Board shall submit a copy of 39 Pa.B. 7105 and Annex A to the Office of the Attorney General and the Office of General Counsel for approval as required by law.
(c) The Board shall certify this order, 39 Pa.B. 7105 and Annex A and deposit them with the Legislative Reference Bureau as required by law.
(d) The final-form rulemaking shall take effect upon publication in the Pennsylvania Bulletin.
ANN O'SULLIVAN, Ph.D., FAAN, CRNP,
Chairperson(Editor's Note: For the text of the order of the Independent Regulatory Review Commission relating to this document, see 40 Pa.B. 4359 (July 31, 2010).)
Fiscal Note: Fiscal Note 16A-5136 remains valid for the final adoption of the subject regulations.
Annex A
TITLE 49. PROFESSIONAL AND VOCATIONAL STANDARDS
PART I. DEPARTMENT OF STATE
Subpart A. PROFESSIONAL AND OCCUPATIONAL AFFAIRS
CHAPTER 21. STATE BOARD OF NURSING
Subchapter A. REGISTERED NURSES
GENERAL PROVISIONS § 21.5. Fees.
(a) The following fees are charged by the Board for services provided to licensees:
Examination and licensure ....................$35
Reexamination....................$30
Licensure by endorsement....................$100
Temporary permit....................$35
Extension of temporary permit....................$60
Fee for review and challenge of RN exams....................$170
Application fee for out-of-State graduates....................$100
Verification of licensure....................$15
Reactivation of license (after 5 years or longer)....................$50
Restoration after suspension or revocation....................$50
Certification of scores....................$25
Certification of license history....................$40
(b) The following fees are charged by the Board to support its operations:
Biennial renewal of license....................$65
(c) The following fees are charged by the Board for services provided to nursing education programs:
Application for approval of new nursing program....................$935
(d) The following fees related to continuing education are charged by the Board:
Request, under § 21.134(b) (relating to continuing education sources) by a provider of a continuing education activity not listed in § 21.134(a) or an individual seeking credit for a continuing education activity not pre-approved by the Board, for approval of each hour of continuing education for which credit is requested....................$75
(e) In addition to the examination and licensure fee prescribed in subsection (a), which is payable directly to the Board, a candidate for the registered nurse licensing examination shall also pay a fee to the National Council of the State Board of Nursing (www.ncsbn.org) to cover costs associated with the preparation and administration of the registered nurse licensing examination.
Subchapter G. DIETITIAN-NUTRITIONISTS
GENERAL PROVISIONS § 21.705. Fees.
(a) The following fees are charged by the Board for services to licensees:
Application for licensure....................$45
Reactivation of inactive or lapsed license....................$50
License verification fee....................$15
License certification fee....................$25
Restoration after suspension or revocation....................$50
(b) The following fees are charged by the Board to support its operations:
Biennial renewal of license....................$65
(c) In addition to the application fee prescribed in subsection (a), which is payable directly to the Board, a candidate for the Registration Examination for Registered Dietitians shall also pay an additional examination fee. A candidate may contact the Commission on Dietetic Registration, 120 South Riverside Plaza, Suite 2000, Chicago, IL 60606-6995, www.cdrnet.org for more information regarding the examination and examination fee.
(d) In addition to the application fee prescribed in subsection (a), which is payable directly to the Board, a candidate for the Certification Board for Nutrition Specialists examination for Certified Nutrition Specialists shall also pay an additional examination fee. A candidate may contact the Certification Board for Nutrition Specialists, 300 South Duncan Avenue, Suite 225, Clearwater, FL 33755, www.cbns.org for more information regarding the examination and examination fee.
[Pa.B. Doc. No. 10-1519. Filed for public inspection August 20, 2010, 9:00 a.m.]
No part of the information on this site may be reproduced for profit or sold for profit.This material has been drawn directly from the official Pennsylvania Bulletin full text database. Due to the limitations of HTML or differences in display capabilities of different browsers, this version may differ slightly from the official printed version.
