Section 217.4 - Requirements for Initial Licensure by Examination for Nurses Who Graduate from Nursing Education Programs Outside of United States' Jurisdiction(a) Criteria for nurse applicants for initial licensure applying under this section. (1) A licensed vocational nurse applicant must: (A) have either: (i) successfully completed an approved program for educating vocational/practical (second level general nurses) nurses within the four years immediately preceding the filing of an application for initial licensure in Texas by providing a credential evaluation service full education course-by-course report from a credential evaluation service approved by the Board; or(ii) successfully completed an approved program for educating vocational/practical (second level general nurses) nurses by providing a credential evaluation service full education course-by-course report from a credential evaluation service approved by the Board and practiced as a second level general nurse within the four years immediately preceding the filing of an application for initial licensure in Texas; and(B) have achieved an approved score on an English proficiency test acceptable to the Board, unless a substantial portion of the applicant's nursing program of study, as determined by the Board, was conducted in English.(2) A registered nurse applicant must either: (A) have successfully completed an approved program for educating registered (first level general nurses) nurses within the four years immediately preceding the filing of an application for initial licensure in Texas by providing a credential evaluation service full education course-by-course report from a credential evaluation service approved by the Board, which verifies that the applicant: (i) has the educational credentials equivalent to graduation from a governmentally accredited/approved, post-secondary general nursing program of at least two academic years in length;(ii) received both theory and clinical education in each of the following: nursing care of the adult which includes both medical and surgical nursing, maternal/infant nursing, nursing care of children, and psychiatric/mental health nursing; and(iii) has achieved an approved score on an English proficiency test acceptable to the Board, or the equivalent, unless a substantial portion of the applicant's nursing program of study, as determined by the Board, was conducted in English; or(B) have practiced as a first level general nurse within the four years immediately preceding the filing of an application for initial licensure in Texas and have successfully completed an approved program for educating registered (first level general nurses) nurses by providing a credential evaluation service full education course-by-course report from a credential evaluation service approved by the Board, which verifies that the applicant: (i) has the educational credentials equivalent to graduation from a governmentally accredited/approved, post-secondary general nursing program of at least two academic years in length;(ii) received both theory and clinical education in each of the following: nursing care of the adult which includes both medical and surgical nursing, maternal/infant nursing, nursing care of children, and psychiatric/mental health nursing; and(iii) has achieved an approved score on an English proficiency test acceptable to the Board, or the equivalent, unless a substantial portion of the applicant's nursing program of study, as determined by the Board, was conducted in English.(3) All applicants must file a complete application for registration containing data required by the Board attesting that all information contained in, or referenced by, the application is complete and accurate and is not false or misleading, and the required application processing fee which is not refundable.(4) All applicants must pass the NCLEX-PN (LVN applicants) or NCLEX-RN (RN applicants) as a Texas applicant within four years of completion of the requirements for graduation or within four years of the date of eligibility.(5) All nurse applicants must submit fingerprints for a complete criminal background check.(6) All nurse applicants must pass the jurisprudence exam approved by the Board, effective September 1, 2008.(b) Credential evaluation service (CES). (1) A CES wishing to be approved by the Board must meet the following requirements: (A) The CES must be a member of a national credentialing organization that sets performance standards for the industry. The CES must adhere to the prevailing standards for the industry.(B) The CES must specialize in the evaluation of international nursing education and licensure.(C) The CES must be able to demonstrate its ability to accurately analyze academic and licensure credentials for purposes of United States comparison, with course-by-course analysis of nursing academic records.(D) The CES must be able to manage the translation of original documents into English.(E) The CES must inform the Board in the event applicant documents are found to be fraudulent.(F) The CES must have been in the business of evaluating nursing education for a minimum of five years.(G) The CES must cite all references used in its evaluation in its credentials report.(H) The CES report must identify the language of nursing instruction and the language of textbooks for nursing education. (I) The CES must use only original source documentation in evaluating nursing education.(J) The CES report must describe the comparability of the foreign education to United States standards.(K) The CES report must detail course clock hours for theory and clinical components of nursing education.(L) The CES must be able to issue an evaluation report within a reasonable time period, not to exceed six weeks. (M) The CES must have an efficient and accessible process for answering customer queries.(N) The CES must be able to provide client references/reviews upon request.(O) The CES must have an established record retention policy.(P) The CES must be able to provide testimony for Board hearings, if required.(2) The CES must complete the form(s) and affidavit required by the Board, submit all required documentation, and receive approval from the Board before providing a report for Board consideration. The Board will maintain a list of approved CES providers.(c) An applicant who has not passed the NCLEX-PN or NCLEX-RN within four years of completion of the requirements for graduation or within four years of the date of eligibility must complete an appropriate nursing education program in order to be eligible to take or retake the examination.(d) Should it be ascertained from the application filed, or from other sources, that the applicant should have had an eligibility issue determined by way of a petition for declaratory order pursuant to the Occupations Code § 301.257, then the application will be treated and processed as a petition for declaratory order under § 213.30 of this title (relating to Declaratory Order of Eligibility for Licensure), and the applicant will be treated as a petitioner under that section and will be required to pay the non-refundable fee required by that section.(e) Accustomation Permit. (1) An applicant who has graduated from an accredited nursing program outside the United States may apply to the Board for a six month accustomation permit by completing an application. An applicant holding an accustomation permit under this subsection may participate in nursing education courses and clinical experiences.(2) An applicant is eligible to apply for an accustomation permit under this subsection only if the applicant has: (A) graduated from an accredited nursing program outside the United States;(B) never taken the NCLEX-PN (LVN applicants) or NCLEX-RN (RN applicants); and(C) successfully completed a credential evaluation service course-by-course report from a Board approved credential evaluation service.(3) An applicant holding an accustomation permit under this subsection may only participate in nursing education courses and clinical experiences under the direct supervision of a registered nurse who holds a current and unencumbered Texas license. For purposes of this subsection only, direct supervision requires a registered nurse to be working with the applicant at all times. At no time shall an applicant be left alone with a patient.(f) Upon initial licensure by examination, the license is issued for a period ranging from six months to 29 months depending on the birth month. Licensees born in even-numbered years shall renew their licenses in even-numbered years; licensees born in odd-numbered years shall renew their licenses in odd-numbered years.22 Tex. Admin. Code § 217.4
The provisions of this §217.4 adopted to be effective September 1, 1999, 24 TexReg 4001; amended to be effective July 14, 2003, 28 TexReg 5532; amended to be effective September 28, 2004, 29 TexReg 9189; amended to be effective April 11, 2005, 30 TexReg 2065; amended to be effective April 16, 2006, 31 TexReg 3031; amended to be effective September 26, 2007, 32 TexReg 6519; amended to be effective May 14, 2009, 34 TexReg 2767; amended to be effective July 12, 2010, 35 TexReg 6083; amended to be effective April 4, 2011, 36 TexReg 2123; Amended by Texas Register, Volume 41, Number 28, July 8, 2016, TexReg 5054, eff. 7/14/2016; Amended by Texas Register, Volume 45, Number 34, August 21, 2020, TexReg 5910, eff. 8/24/2020; Amended by Texas Register, Volume 46, Number 29, July 16, 2021, TexReg 4239, eff. 7/1/2021 and expired 7/30/2021