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    PROPOSAL
    Maryland Register
    Issue Date:  December 9, 2016
    Volume 43 • Issue 25• Pages 1418—1419
     
    Title 10
    DEPARTMENT OF HEALTH AND MENTAL HYGIENE
    Subtitle 27 BOARD OF NURSING
    10.27.21 Registered Nurse — Forensic Nurse Examiner
    Authority: Health Occupation Article, §§8-205 and 8-312, Annotated Code of Maryland
    Notice of Proposed Action
    [16-322-P]
    The Secretary of Health and Mental Hygiene proposes to amend Regulations .02—.05 and .07 under COMAR 10.27.21 Registered Nurse — Forensic Nurse Examiner. This action was considered by the Board at its regular meeting on July 27, 2016, notice of which was placed on the Board’s website on June 1 and July 1, 2016, pursuant to the General Provisions Article, §3-302(c), Annotated Code of Maryland.
    Statement of Purpose
    The purpose of this action is to:
    (1) Add certain definitions;
    (2) Clarify the terms and requirements for the 2-year renewal certification period;
    (3) Repeal obsolete terms;
    (4) Require new forensic nurse examiner (FNE) training programs to be approved by the Board prior to conducting the training and have a curriculum similar to existing registered nurse – forensic nurse examiner (RN-FNE) training programs;
    (5) Provide more flexibility in approving faculty by allowing the coordinators to evaluate the competency of prospective faculty;
    (6) Clarify that all changes in a training program have to be approved by the Board before the date of the first class; and
    (7) Make stylistic and corrective changes.
    Comparison to Federal Standards
    There is no corresponding federal standard to this proposed action.
    Estimate of Economic Impact
    The proposed action has no economic impact.
    Economic Impact on Small Businesses
    The proposed action has minimal or no economic impact on small businesses.
    Impact on Individuals with Disabilities
    The proposed action has no impact on individuals with disabilities.
    Opportunity for Public Comment
    Comments may be sent to Michele Phinney, Director, Office of Regulation and Policy Coordination, Department of Health and Mental Hygiene, 201 West Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499 (TTY 800-735-2258), or email to dhmh.regs@maryland.gov, or fax to 410-767-6483. Comments will be accepted through January 9, 2017. A public hearing has not been scheduled.
    .02 Definitions.
    A. (text unchanged)
    B. Terms Defined.
    (1) “Alternate light source (ALS)” means equipment that produces visible and invisible light at various wave lengths to enhance the visualization of evidence.
    [(1)] (2)[(3)] (4) (text unchanged)
    [(4)] (5) “Clinical preceptor” means an RN-FNE educator or physician who has credentials and experience in forensic examinations.
    [(5)] (6) (text unchanged)
    (7) “FNE program” means a facility authorized by the Department of Health and Mental Hygiene to provide forensic nursing services.
    [(6)] (8)[(10)] (12) (text unchanged)
    [(11)] (13) “Program coordinator” means an RN-FNE designated by the facility to manage and oversee the [SAFE] FNE program.
    [(12)] (14)[(14)] (16) (text unchanged)
    [(15] (17) “RN-FNE Educator” means an individual who [is :
    (a) Currently licensed and certified in Maryland as a:] Has a current:
    (i) License to practice as a registered nurse in Maryland;
    (ii) Multistate licensing privilege to practice registered nursing under the Nurse Licensure Compact; or
    (iii) Certification to practice as an advanced practice registered nurse in Maryland; and
    (b) Is certified under this chapter as a:
    (i) Registered Nurse Forensic Examiner — Adult (RN-FNE-A);
    (ii) Registered Nurse Forensic Examiner — Pediatric (RN-FNE-P); or
    (iii) Registered Nurse Forensic Examiner — Adult and Pediatric (RN-FNE-AP); and
    [(b)] (c) [Qualified] Is qualified to teach the theoretical and clinical portions of the RN-FNE training program.
    [(16)] (18)—[(19)] (21) (text unchanged)
    [(20) “SAFE program” means a facility authorized by the Department of Health and Mental Hygiene to provide forensic nursing services.]
    [(21)] (22)[(25)] (26) (text unchanged)
    .03 Authorization to Practice.
    A. (text unchanged)
    B. An applicant applying for certification to practice as an RN-FNE-A, RN-FNE-P or RN-FNE-AP shall:
    (1)—(3) (text unchanged)
    [(4) An applicant for certification as an RN-FNE-P or RN-FNE-AP, shall complete a training program that includes the following standardized curricula approved by the Board:
    (a) The standardized curriculum designed for the RN-FNE-A; and
    (b) The standardized curriculum designed for the RN-FNE-P;]
    [(5)] (4) [(6)] (5) (text unchanged)
    C. In addition to the requirements listed in §B of this regulation, an applicant applying for certification as an RN-FNE-P or RN-FNE-AP shall complete a training program that includes the following standardized curricula approved by the Board:
    (1) The standardized curriculum designed for the RN-FNE-A; and
    (2) The standardized curriculum designed for the RN-FNE-P.
    [C.] D.[D.] E. (text unchanged)
    .04 Scope and Standards of Practice.
    A. An RN-FNE may perform the following tasks and functions with respect to the age group for which the RN-FNE is certified under Regulation .03 of this chapter:
    (1)—(3) (text unchanged)
    (4) Perform the forensic evidentiary physical assessment, which may include use of an ALS;
    (5)—(14) (text unchanged)
    B. (text unchanged)
    C. The program coordinator:
    (1) (text unchanged)
    (2) Has responsibility for oversight and administration of the facility’s RN-FNE training program and the practice of the facility’s [RN-FNE’s] RN-FNEs;
    (3)—(9) (text unchanged)
    D. (text unchanged)
    .05 Standards for Training Programs.
    A. (text unchanged)
    B. New RN-FNE training programs shall:
    (1) Be approved by the Board before implementation of the FNE training program;
    (2) Ensure that the didactic and clinical experiences are the same as existing FNE programs;
    [(1)] (3)[(2)] (4) (text unchanged)
    C. An application for a new FNE program shall be submitted to the Board at least 6 months before the date of the first class.
    [C.] D.—[F] G. (text unchanged)
    [G.] H. Faculty Qualifications.
    (1) An RN-FNE educator who meets the requirements of this section or a physician whose credentials demonstrate experience in the skills required in forensic evidentiary examinations is qualified to teach both theory and clinical portions of the curriculum and may serve as clinical preceptor for the clinical practicum of the FNE training program.
    (2) An RN-FNE educator who teaches in an RN-FNE training program or is the clinical preceptor of the training program shall:
    (a) [Possess at least:] Be approved by the coordinator of the FNE program: and
    (i) Have 2 years of experience as an RN-FNE or as a SANE, if from another state; [or]
    (ii) Have 1 year of FNE experience with ten forensic examinations performed; or
    (iii) Be deemed by the FNE program coordinator to have the necessary FNE experience and competencies;
    (b)—(d) (text unchanged)
    (3) The clinical preceptor for the clinical practicum of the FNE training program shall document the clinical competency of the RN-FNE candidate at the completion of the clinical practicum.
    [H. The Board shall approve all changes, additions, or deletions to the course before implementation.]
    I. All changes, additions, or deletions to the FNE training program shall be submitted to the Board for approval not later than 3 months before the date of the first class.
    .07 Renewal of Certification.
    A. (text unchanged)
    B. Beginning January 1, 2016, renewal requirements will change to reflect the 2-year biennial license renewal that was [fully] implemented during 2015.
    C. [Beginning January 1, 2016, an] An FNE who has an even-numbered birth year shall be required [at their next renewal]:
    (1) Beginning January 1, 2016, to complete the renewal requirements under [§F] §E of this regulation; and
    (2) Beginning January 1, 2018, to complete the renewal requirements under §F of this regulation.
    D. Beginning January 1, 2017, an FNE who has an odd-numbered birth year shall be required to complete the renewal requirements under [§G] §F of this regulation.
    [E. After January 1, 2019, an FNE with an odd -numbered birth year will be required to complete the renewal requirements under §F of this regulation.]
    [F.] E. Before the certification to practice as an RN-FNE expires, the individual [with a birth year ending in an odd-numbered year] may renew for an additional term, if the RN-FNE:
    (1)—(2) (text unchanged)
    (3) Has completed the following evidentiary examinations:
    (a)—(c) (text unchanged)
    (d) Completed the following requirements:
    (i)—(iii) (text unchanged)
    (iv) Have a minimum number of cases submitted to peer review annually in accordance with [§H] §G of this regulation;
    (4)—(6) (text unchanged)
    [G.] F. Before the certification to practice as an RN-FNE expires, the individual may renew for an additional term, if the RN-FNE:
    (1)—(2) (text unchanged)
    (3) Has completed the following evidentiary examinations[;]:
    (a)—(c) (text unchanged)
    (d) Completed the following requirements:
    (i) (text unchanged)
    (ii) If applying for renewal as an RN-FNE-P, has observed six evidentiary examinations on children who are younger than 13 years old[,]; or [if]
    (iii) If applying for renewal as an FNE-AP, has observed six evidentiary examinations on children who are younger than 13 years old, has observed an additional six evidentiary examinations on adult patients 13 years old or older, and has performed ten speculum examinations on adult patients 13 years old or older, for a total of twelve evidentiary examinations observed and [twenty] ten speculum examinations performed; and
    [(iii)] (iv) Have a minimum number of cases submitted to peer review annually in accordance with [§H] §G of this regulation;
    (4)—(6) (text unchanged)
    [H.] G. (text unchanged)
    [I.] H. If the individual does not meet the requirement of [§§F(2) and G(2)] §§E(2) and F(2) of this regulation, the individual shall complete a Board-approved course before becoming eligible for renewal of the certification.
    [J.] I. With respect to the requirement set forth in [§§F(3) and G(3)] §§E(3) and F(3) of this regulation, an examination performed on a live model or by simulation may substitute for evidentiary examinations for the purpose of certificate renewal.
    VAN T. MITCHELL
    Secretary of Health and Mental Hygiene