STATE BOARD
OF NURSING[49 PA. CODE CH. 21] Biennial Renewal Fees [30 Pa.B. 2265] The State Board of Nursing (Board) proposes to amend §§ 21.5, 21.147 and 21.253 (relating to fees) by revising biennial renewal fees to read as set forth in Annex A. The proposed amendments would increase the biennial license renewal fee for registered nurses from $21 to $45, for licensed practical nurses from $16 to $40, and for certified registered nurse practitioners (CRNPs) from $26 to $50.
A. Effective Date
The new fees would be effective on final publication in the Pennsylvania Bulletin and will apply to the biennial renewals commencing after July 1, 2000.
B. Statutory Authority
The proposed amendments are authorized under section 11.2(a), (b) and (d) of The Professional Nursing Law (63 P. S. § 221.2(a), (b) and (d)) and section 17.5(a) and (b) of the Practical Nurse Law (63 P. S. § 667.5(a) and (b)). Section 11.2(a), (b) and (d) of The Professional Nursing Law and section 17.5(a) and (b) of the Practical Nurse Law require the Board to fix the fees required for renewal of licenses and certificates by regulation. In addition, these provisions require the Board to increase fees by regulation to meet or exceed projected expenditures if the current revenues raised by fees, fines and civil penalties are not sufficient to meet projected expenditures and to increase fees in an amount to insure that adequate revenues are raised to meet the required enforcement efforts.
C. Background and Need for Amendments
As noted previously, the Board's licensure laws require that the Board fund enforcement and operating expenses through biennial renewal fees, fines and penalties. The biennial renewal fees fund nearly all of the Board's costs.
In accordance with these laws, the Board in conjunction with the Department of State's Budget and Financial Management Office and its Revenue Office has reviewed biennially the actual expenditures and revenue history of the Board against its projected expenses and revenue. For the past 4 biennial renewal periods, the Board's license renewal fees, which were established by regulation in 1992, were sufficient to meet expenditures.
At its September 28, 1999, Board meeting, the Board reviewed a summary of the Board's revenues and expenses since the last biennial cycle. The summary, prepared by the Offices of Revenue and Budget and presented in the following table format, demonstrated that the Board must raise fees to meet or exceed projected expenditures and thereby comply with section 11.2(a) and (b) of The Professional Nursing Law and section 17.5(a) and (b) of the Practical Nurse Law.
FY98-99 FY99-00 (Actual) (Projected) Beginning Balance $429,038.32 ($802,116.45) Revenue $2,713,548.01 $3,510,613.00 Prior Year returned Funds $93,297.22 $43,650.20 Total Revenue $3,235,883.55 $2,752,146.75 Expenses $4,038,000.00 $4,486,000.00 Remaining Balance ($802,116.45) ($1,733,853.25) As the foregoing indicates, the Board last recorded a positive revenue/expenditure balance on June 30, 1998, of $429,038.32. As of June 30, 1999, the Board had a negative revenue/expenditure balance and experienced a deficit of $802,116.45. The Budget Office projects a 1999-2000 fiscal year deficit of $1,733,853.25.
During the fiscal year ending June 30, 1999, Board costs showed a substantial increase over the prior fiscal year in Board administration costs and investigation and hearing costs. Board administration included the costs of making licensing information available on the Internet ($37,000) and a new phone system ($60,000), which greatly enhance customer service; new software and computers ($16,000), which are an investment in the future of the Board; and newsletter mailing ($118,206.40). Additionally, the Board experienced a fire in 1994. Since that time, the Board has been absorbing the increased costs of obtaining new equipment and leasing office space without a corresponding increase in biennial renewal fees. The following chart shows the increase in disciplinary actions relating to the law enforcement and hearing costs centers.
Increase Fy 92-93 Fy 98-99 (% increase) Cases opened 327 596 269 (82.27%) Cases closed 281 604 323 (114.95%) Disciplinary
actions76 176 100 (131.58%) The following is a summary of expenditure charges for fiscal year June 30, 1998, to June 30, 1999:
BPOA Administration $348,774.20 Commissioner's office $256,959.70 Law Enforcement $358,841.24 Board Member Expenses $46,405.61 Test Administration $200.00 Hearing Expenses $139,732.47 Central Support Services $746,420.07 Board Administration $1,120,566.14 Professional Health Monitoring
Program$271,608.77 Public Information Office $4,522.54 Legislative and Regulatory Analysis $60,647.56 Legal Office $595,189.82 Rolled Expenditures $44,481.67 ______ Total Board Costs $3,994,349.80 D. Description of Proposed Amendments
The proposed amendments would increase the biennial renewal fee for practical nurses, professional nurses and CRNPs. The following table outlines the affected biennial renewal fees and proposed changes:
License Current Fee Proposed Fee Licensed Practical Nurse $16 $40 Registered Nurse $21 $45 CRNP $26 $50 The Budget Office anticipates that the proposed new fees will enable the Board to recapture the current deficit and meet its estimated expenditures for the 2000-2002 biennial cycle.
The proposed new fees will affect a total licensee population of 257,986 (197,171 registered nurses, 4,422 CRNPs and 56,393 licensed practical nurses). The Board estimates these fees will generate $13,175,515 in biennial revenue. If the proposal is effectuated, the revenue would be used to recapture projected deficits totaling $2.8 million by the end FY 00-01 and to fund anticipated expenditures from FY 01-02 through FY 03-04 of $12.7 million.
E. Compliance with Executive Order 1996-1
In accordance with Executive Order 1996-1 (February 6, 1996), in drafting and promulgating the regulations the Board considered the regulations as both required by law and the least restrictive means of covering the costs of services required to be performed by the Board.
F. Fiscal Impact
The proposed amendments will increase the biennial renewal fees for licensed practical nurses, registered nurses and CRNPs. Licensed practical nurses, registered nurses and CRNPs will pay an additional $24 for biennial renewal. The proposed amendments should have no other fiscal impact on the private sector, the general public or political subdivisions.
G. Paperwork Requirements
The proposed amendments will require the Board to alter some of its forms to reflect the new biennial renewal fees; however, the proposed amendments should not create additional paperwork for the private sector.
H. Sunset Date
The Professional Nursing Law and the Practical Nurse Law require that the Board monitor its revenue and cost on a fiscal year and biennial basis. Therefore, no sunset date has been assigned.
I. Regulatory Review
Under section 5(a) of the Regulatory Review Act (71 P. S. § 745.5(a)), on April 20, 2000, the Board submitted a copy of these proposed amendments to the Independent Regulatory Review Commission (IRRC) and to the Chairpersons of the House Professional Licensure Committee and Senate Consumer Protection and Professional Licensure Committee for review and comment. In addition to submitting the proposed amendments, the Board has provided IRRC and the Committees with a copy of a detailed Regulatory Analysis Form prepared by the Board in compliance with Executive Order 1996-1, ''Regulatory Review and Promulgation.'' A copy of this material is available to the public upon request.
Under section 5(g) of the Regulatory Review Act, if IRRC has objections to any portion of the proposed amendments, it will notify the Board within 10 days after the expiration of the Committees' review period. The notification shall specify the regulatory review criteria which have not been met by that portion. The Regulatory Review Act specifies detailed procedures for review, prior to final publication of the amendments, by the Board, the General Assembly and the Governor of objections raised.
J. Public Comment
Interested persons are invited to submit written comments, suggestions or objections regarding this proposed rulemaking to Ann Steffanic, Administrator, State Board of Nursing, P. O. Box 2649, Harrisburg, PA 17105-2649, within 30 days following publication of this proposed rulemaking in the Pennsylvania Bulletin. Please reference No. 16A-5113 (Biennial Renewal Fees), when submitting comments.
SUSANNE M. KELLY, BSN, RN,
ChairpersonFiscal Note: 16A-5113. No fiscal impact; (8) recommends adoption.
Annex A TITLE 49. PROFESSIONAL AND
VOCATIONAL STANDARDSPART I. DEPARTMENT OF STATE Subpart A. PROFESSIONAL AND
OCCUPATIONAL AFFAIRSCHAPTER 21. STATE BOARD OF NURSING Subchapter A. REGISTERED NURSES GENERAL PROVISIONS § 21.5. Fees.
(a) The following fees are charged by the Board:
* * * * * Biennial renewal of license . . . . . . . . . . . . . $[21] 45
* * * * * Subchapter B. PRACTICAL NURSES GENERAL PROVISIONS § 21.147. Fees.
(a) The following fees are charged by the Board:
* * * * * Biennial renewal of license . . . . . . . . . . . . $[16] 40
* * * * * Subchapter C. CERTIFIED REGISTERED NURSE PRACTITIONERS GENERAL PROVISIONS § 21.253. Fees.
The following fees are charged by the Board:
* * * * * Biennial renewal of certification . . . . . . . . . . $[26] 50
* * * * * [Pa.B. Doc. No. 00-745. Filed for public inspection May 5, 2000, 9:00 a.m.]
