SECTION 221.7. Petitions for Waiver and Exemptions

(a) A registered nurse who submits a request for waiver from requirements of this rule must submit documentation as required by the Board to support his or her petition and assure the Board that he or she possesses the knowledge, skills, and abilities appropriate for the role and population focus area of licensure desired. Those petitioners who are under investigation or current Board order are not eligible for waiver.

(b) Petitions for waiver from the program accreditation requirements set forth in this chapter may be granted by the Board for individuals who completed their APRN programs before January 1, 1996. Petitioners must meet the length of academic program requirements set forth in this chapter and provide evidence of current national certification in the APRN role and population focus area.

(c) Petitions for waiver from the current certification requirements of this chapter may be granted by the Board as follows;

(1) Applicants who completed their APRN education programs prior to January 1, 1996 may be granted an exemption from the national certification requirement, provided the program was accredited by a national nursing education 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 acceptable to the Board at the time the applicant completed the program.

(2) Under this section, only those petitioners who completed their APRN education program on or after January 1, 1996 for whom no national certification examination within the advanced role and population focus area or a related advanced specialty exists will be considered for waiver by the Board. The Board reserved the right to determine an appropriate alternate national certification examination for licensure in those specialty areas for which no specific examination existed for the specialty area.

(3) A written request for waiver of the national certification requirement must be submitted.

(d) Waivers from the master's degree requirement may be granted to qualified certificate-prepared nurse-midwives and women's health care nurse practitioners who complete their APRN programs on or before December 31, 2006. Applicants must meet all other APRN education requirements as stated in this chapter.

(1) Petitioners approved on the basis of this waiver shall be limited to providing APRN care within the geographical boundaries of the State of Texas. This shall not prevent the individual from utilizing Nurse Licensure Compact privileges to practice as a registered nurse.

(2) The applicant must submit all required documentation necessary to demonstrate that the requirements (except for the master's degree) for licensure have been met.

(3) The applicant must submit a written request for waiver of the master's degree requirement.

(e) Exemptions granting authorization to utilize licensure titles not otherwise authorized by this chapter may be granted to qualified petitioners who completed their APRN education programs prior to the date specified. Petitioners must meet all other education and national certification requirements as stated in this chapter,

(1) The following specialty titles may be considered for exemption for individuals who completed their APRN education program prior to January 1, 2010, but are not qualified to utilize a title authorized by this chapter:

(A) Acute Care Clinical Nurse Specialist,

(B) Critical Care Nurse Practitioner;

(C) Cardiovascular Clinical Nurse Specialist;

(D) Emergency Nurse Practitioner or Clinical Nurse Specialist;

(E) Family Clinical Nurse Specialist;

(F) Home Health Clinical Nurse Specialist;

(G) Maternal (Parent)-Child Health Clinical Nurse Specialist (with or without subspecialization);

(H) Oncology Nurse Practitioner or Clinical Nurse Specialist;

(I) Pediatric Critical Care Nurse Practitioner;

(J) Perinatal Nurse Practitioner or Clinical Nurse Specialist;

(K) School Nurse Practitioner; and

(L) Women's Health Clinical Nurse Specialist.

(2) The following titles may be considered for exemption if the individual is not qualified to utilize a licensure title authorized by this chapter for qualified applicants who completed their APRN education programs prior to January 1, 2015:

(A) Acute Care Adult Nurse Practitioner;

(B) Adult Health Clinical Nurse Specialist;

(C) Adult Nurse Practitioner;

(D) Community Health Clinical Nurse Specialist;

(E) Critical Care Clinical Nurse Specialist;

(F) Gerontological Clinical Nurse Specialist; and

(G) Gerontological Nurse Practitioner.

(3) Those individuals licensed on the basis of this exemption shall be limited to providing advanced practice nursing care within the geographical boundaries of the State of Texas. This shall not prevent the individual from utilizing Nurse Licensure Compact privileges to function as a registered nurse.

(4) The applicant must submit all required documentation necessary to demonstrate that all requirements for licensure have been met.

(5) The applicant must submit a written request for exemption and indicate the desired title.

(6) APRNs licensed on the basis of this exemption shall use the APRN title specified on the licensure document provided by the Board.

(f) Exemptions from specific curricular requirements may be granted to otherwise qualified applicants based on the education requirements set forth in Board rules that were in effect at the time the applicants completed their APRN education programs.

(g) Applicants who are endorsing APRN licensure in Texas and have practiced in the APRN role and population focus in another state for a minimum of 24 months following completion of the APRN education program who are required to take a single academic course in order to meet the education requirements for Texas licensure may be issued a six-month temporary permit as specified in §221.10 of this chapter to practice in a limited capacity while completing the academic course.

(1) Only those applicants who need to complete a dedicated, graduate-level course in advanced health assessment, advanced physiology and pathophysiology, or advanced pharmacotherapeutics may be considered for a permit. If more than one course is required, the applicant shall not be eligible for the permit.

(2) Prescriptive authority shall not be granted to applicants who are granted limited authority to practice under this provision.

(3) Applicants who practice under this provision shall practice under the supervision of a qualified preceptor who meets the requirements of §221.10 of this chapter.

(4) The applicant must demonstrate that all other education and licensure requirements set forth in this chapter have been met before the six month temporary permit may be issued.

(5) Six month temporary permits issued for this purpose may be issued one time only. Six month temporary permits issued for the purpose of completion of an academic course cannot be extended or renewed.

(6) The APRN candidate shall submit:

(A) an application for a six-month temporary permit as specified in §221.10 of this chapter to be used for completion of the requirements specified in this chapter; and

(B) evidence of a current, valid license or privilege to practice as a registered nurse in the state of Texas.

Source Note: The provisions of this §221.7 adopted to be effective February 25, 2001, 26 TexReg 1509; amended to be effective May 15, 2005, 30 TexReg 2668; amended to be effective February 27, 2019, 44 TexReg 833