CS/CS/HB 1337

1
A bill to be entitled
2An act relating to nursing; amending s. 456.014, F.S.;
3authorizing the disclosure of certain confidential
4information required of nursing license applicants to
5certain persons; amending s. 464.003, F.S.; providing and
6revising definitions; amending s. 464.008, F.S.; revising
7requirements for graduation from certain nursing education
8programs for nursing license applicants seeking to take
9the licensing examination; amending s. 464.015, F.S.;
10revising restrictions on nursing graduates who may use
11certain titles and abbreviations; amending s. 464.019,
12F.S.; revising requirements for the approval of nursing
13education programs by the Board of Nursing, including
14application requirements and procedures for the review and
15approval or denial of applications; revising requirements
16for the approval of nursing education programs meeting
17certain requirements before a specified date; providing
18for retroactive application; revising requirements for the
19submission of annual reports by approved programs;
20revising requirements for the information published on the
21board's Internet website; revising accountability
22requirements for an approved program's graduate passage
23rates on a certain licensing examination; revising
24procedures for placing programs on, and removing such
25programs, from probationary status; requiring termination
26of programs under certain circumstances; requiring certain
27representatives of programs that fail to submit annual
28reports to appear before the board; requiring the
29Department of Health to disclose certain confidential
30information about a program's graduates to the program
31director under certain circumstances; requiring program
32directors to maintain the confidentiality of such
33information; providing penalties for unlawful disclosure
34of confidential information; revising requirements for the
35closure of programs; revising the board's authority to
36adopt rules; exempting accredited programs from specified
37requirements; providing requirements for an accredited
38program that ceases to be accredited; conforming
39provisions; deleting obsolete provisions; revising
40requirements for the Florida Center for Nursing's
41evaluation of the board's implementation of certain
42accountability provisions; providing for the performance
43of certain duties of the Florida Center for Nursing by the
44Office of Program Policy Analysis and Government
45Accountability under certain circumstances; conforming
46cross-references; amending s. 464.022, F.S.; conforming
47provisions; amending ss. 458.348, 459.025, 464.012, and
48960.28, F.S.; conforming cross-references; providing an
49effective date.
50
51Be It Enacted by the Legislature of the State of Florida:
52
53     Section 1.  Subsection (1) of section 456.014, Florida
54Statutes, is amended to read:
55     456.014  Public inspection of information required from
56applicants; exceptions; examination hearing.-
57     (1)  All information required by the department of any
58applicant shall be a public record and shall be open to public
59inspection pursuant to s. 119.07, except financial information,
60medical information, school transcripts, examination questions,
61answers, papers, grades, and grading keys, which are
62confidential and exempt from s. 119.07(1) and shall not be
63discussed with or made accessible to anyone except the program
64director of an approved program or accredited program as
65provided in s. 464.019(7), members of the board, the department,
66and staff thereof, who have a bona fide need to know such
67information. Any information supplied to the department by any
68other agency which is exempt from the provisions of chapter 119
69or is confidential shall remain exempt or confidential pursuant
70to applicable law while in the custody of the department or the
71agency.
72     Section 2.  Section 464.003, Florida Statutes, is reordered
73and amended to read:
74     464.003  Definitions.-As used in this part, the term:
75     (1)  "Accredited program" means a program for the
76prelicensure education of professional or practical nurses that
77is conducted in the United States at an educational institution,
78whether in this state, another state, or the District of
79Columbia, and that is accredited by a specialized nursing
80accrediting agency that is nationally recognized by the United
81States Secretary of Education to accredit nursing education
82programs.
83     (13)(1)  "Department" means the Department of Health.
84     (5)(2)  "Board" means the Board of Nursing.
85     (20)(3)(a)  "Practice of professional nursing" means the
86performance of those acts requiring substantial specialized
87knowledge, judgment, and nursing skill based upon applied
88principles of psychological, biological, physical, and social
89sciences which shall include, but not be limited to:
90     (a)1.  The observation, assessment, nursing diagnosis,
91planning, intervention, and evaluation of care; health teaching
92and counseling of the ill, injured, or infirm; and the promotion
93of wellness, maintenance of health, and prevention of illness of
94others.
95     (b)2.  The administration of medications and treatments as
96prescribed or authorized by a duly licensed practitioner
97authorized by the laws of this state to prescribe such
98medications and treatments.
99     (c)3.  The supervision and teaching of other personnel in
100the theory and performance of any of the above acts described in
101this subsection.
102
103A professional nurse is responsible and accountable for making
104decisions that are based upon the individual's educational
105preparation and experience in nursing.
106     (19)(b)  "Practice of practical nursing" means the
107performance of selected acts, including the administration of
108treatments and medications, in the care of the ill, injured, or
109infirm and the promotion of wellness, maintenance of health, and
110prevention of illness of others under the direction of a
111registered nurse, a licensed physician, a licensed osteopathic
112physician, a licensed podiatric physician, or a licensed
113dentist. A The professional nurse and the practical nurse is
114shall be responsible and accountable for making decisions that
115are based upon the individual's educational preparation and
116experience in nursing.
117     (7)(c)  "Clinical nurse specialist practice" means the
118delivery and management of advanced practice nursing care to
119individuals or groups, including the ability to:
120     (a)1.  Assess the health status of individuals and families
121using methods appropriate to the population and area of
122practice.
123     (b)2.  Diagnose human responses to actual or potential
124health problems.
125     (c)3.  Plan for health promotion, disease prevention, and
126therapeutic intervention in collaboration with the patient or
127client.
128     (d)4.  Implement therapeutic interventions based on the
129nurse specialist's area of expertise and within the scope of
130advanced nursing practice, including, but not limited to, direct
131nursing care, counseling, teaching, and collaboration with other
132licensed health care providers.
133     (e)5.  Coordinate health care as necessary and appropriate
134and evaluate with the patient or client the effectiveness of
135care.
136     (2)(d)  "Advanced or specialized nursing practice" means,
137in addition to the practice of professional nursing, the
138performance of advanced-level nursing acts approved by the board
139which, by virtue of postbasic specialized education, training,
140and experience, are appropriately performed by an advanced
141registered nurse practitioner. Within the context of advanced or
142specialized nursing practice, the advanced registered nurse
143practitioner may perform acts of nursing diagnosis and nursing
144treatment of alterations of the health status. The advanced
145registered nurse practitioner may also perform acts of medical
146diagnosis and treatment, prescription, and operation which are
147identified and approved by a joint committee composed of three
148members appointed by the Board of Nursing, two of whom must be
149advanced registered nurse practitioners; three members appointed
150by the Board of Medicine, two of whom must have had work
151experience with advanced registered nurse practitioners; and the
152State Surgeon General or the State Surgeon General's designee.
153Each committee member appointed by a board shall be appointed to
154a term of 4 years unless a shorter term is required to establish
155or maintain staggered terms. The Board of Nursing shall adopt
156rules authorizing the performance of any such acts approved by
157the joint committee. Unless otherwise specified by the joint
158committee, such acts must be performed under the general
159supervision of a practitioner licensed under chapter 458,
160chapter 459, or chapter 466 within the framework of standing
161protocols which identify the medical acts to be performed and
162the conditions for their performance. The department may, by
163rule, require that a copy of the protocol be filed with the
164department along with the notice required by s. 458.348.
165     (17)(e)  "Nursing diagnosis" means the observation and
166evaluation of physical or mental conditions, behaviors, signs
167and symptoms of illness, and reactions to treatment and the
168determination as to whether such conditions, signs, symptoms,
169and reactions represent a deviation from normal.
170     (18)(f)  "Nursing treatment" means the establishment and
171implementation of a nursing regimen for the care and comfort of
172individuals, the prevention of illness, and the education,
173restoration, and maintenance of health.
174     (22)(4)  "Registered nurse" means any person licensed in
175this state to practice professional nursing.
176     (16)(5)  "Licensed practical nurse" means any person
177licensed in this state to practice practical nursing.
178     (6)  "Clinical nurse specialist" means any person licensed
179in this state to practice professional nursing and certified in
180clinical nurse specialist practice.
181     (3)(7)  "Advanced registered nurse practitioner" means any
182person licensed in this state to practice professional nursing
183and certified in advanced or specialized nursing practice,
184including certified registered nurse anesthetists, certified
185nurse midwives, and nurse practitioners.
186     (4)(8)  "Approved program" means a nursing program for the
187prelicensure education of professional or practical nurses that
188is conducted in the state at an educational institution and that
189is in a school, college, or university which is approved under
190s. 464.019 for the education of nurses. The term includes such a
191program placed on probationary status.
192     (10)(9)  "Clinical training" means direct nursing care
193experiences with patients or clients which offer the student the
194opportunity to integrate, apply, and refine specific skills and
195abilities based on theoretical concepts and scientific
196principles.
197     (8)(10)  "Clinical preceptor" means a registered nurse or
198licensed practical nurse who is employed by a clinical training
199facility to serve who serves as a role model and clinical
200resource person for a specified period to students an individual
201enrolled in an approved program.
202     (9)(11)  "Clinical simulation" means a strategy used to
203replicate clinical practice as closely as possible to teach
204theory, assessment, technology, pharmacology, and skills.
205     (11)(12)  "Community-based clinical experience" means
206activities consistent with the curriculum and involving
207individuals, families, and groups with the intent of promoting
208wellness, maintaining health, and preventing illness.
209     (12)(13)  "Curriculum" means a planned sequence of course
210offerings and learning experiences that comprise a nursing
211education program.
212     (21)(14)  "Probationary status" means the status of an
213approved a nursing education program that is placed on such
214status pursuant subject to s. 464.019(2)(a)2. or (5)(a) or (b).
215     (14)  "Educational institution" means a school, college, or
216university.
217     (15)  "Graduate passage rate" means the percentage of a
218program's graduates who, as first-time test takers, pass the
219National Council of State Boards of Nursing Licensing
220Examination during a calendar year, as calculated by the
221contract testing service of the National Council of State Boards
222of Nursing.
223     (23)  "Required passage rate" means the graduate passage
224rate required for an approved program pursuant to s.
225464.019(6)(a)1.
226     Section 3.  Subsection (1) of section 464.008, Florida
227Statutes, is amended to read:
228     464.008  Licensure by examination.-
229     (1)  Any person desiring to be licensed as a registered
230nurse or licensed practical nurse shall apply to the department
231to take the licensure examination. The department shall examine
232each applicant who:
233     (a)  Has completed the application form and remitted a fee
234set by the board not to exceed $150 and has remitted an
235examination fee set by the board not to exceed $75 plus the
236actual per applicant cost to the department for purchase of the
237examination from the National Council of State Boards of Nursing
238or a similar national organization.
239     (b)  Has provided sufficient information on or after
240October 1, 1989, which must be submitted by the department for a
241statewide criminal records correspondence check through the
242Department of Law Enforcement.
243     (c)  Is in good mental and physical health, is a recipient
244of a high school diploma or the equivalent, and has completed
245the requirements for:
246     1.  Graduation from an approved program;
247     2.  Graduation from a prelicensure nursing education
248program that the board determines is, or its equivalent to an
249approved program;
250     3.  Graduation on or after July 1, 2009, from an accredited
251program; or
252     4.  Graduation before July 1, 2009, from a prelicensure
253nursing education program whose graduates at that time were
254eligible for examination as determined by the board, for the
255preparation of registered nurses or licensed practical nurses,
256whichever is applicable.
257
258Courses successfully completed in a professional nursing
259education program that which are at least equivalent to a
260practical nursing education program may be used to satisfy the
261education requirements for licensure as a licensed practical
262nurse.
263     (d)  Has the ability to communicate in the English
264language, which may be determined by an examination given by the
265department.
266     Section 4.  Subsections (3) and (4) of section 464.015,
267Florida Statutes, are amended to read:
268     464.015  Titles and abbreviations; restrictions; penalty.-
269     (3)  Only persons who are graduates of prelicensure nursing
270education approved programs listed in s. 464.008(1)(c) or the
271equivalent may use the term "Graduate Nurse" and the
272abbreviation "G.N.," pending the results of the first licensure
273examination for which they are eligible.
274     (4)  Only persons who are graduates of prelicensure nursing
275education approved programs listed in s. 464.008(1)(c) or the
276equivalent may use the term "Graduate Practical Nurse" and the
277abbreviation "G.P.N.," pending the results of the first
278licensure examination for which they are eligible.
279     Section 5.  Section 464.019, Florida Statutes, is reordered
280and amended to read:
281     464.019  Approval of nursing education programs.-
282     (1)  PROGRAM APPLICATIONS.-An educational institution that
283wishes to conduct a program in this state for the prelicensure
284education of professional or practical nurses must shall submit
285to the department a program application and a program review fee
286of $1,000 for each prelicensure nursing education program to be
287offered at the institution's main campus, branch campus, or
288other instructional site the department. Within 90 days after
289receipt of a program application and program review fee, the
290board shall approve the program application if it documents
291compliance with the standards in paragraphs (a)-(h). If the
292program application is incomplete or does not document
293compliance, the board shall follow the procedures in subsection
294(3). a program application is deemed approved by the board if
295the board does not act on the application within the timeframes
296specified in subsection (3) or this subsection. Each program
297application must include the legal name of the educational
298institution, the legal name of the nursing education program,
299and, if such program is accredited by an accrediting agency
300other than an accrediting agency described in s. 464.003(1), the
301name of the accrediting agency. The application must also
302document that:
303     (a)1.  For a professional nursing education program, the
304program director and at least 50 percent of the program's
305faculty members are registered nurses who have, at a minimum, a
306master's or higher bachelor's degree in nursing or a bachelor's
307and a master's degree in nursing and a master's or higher degree
308in a field or a related to nursing field.
309     2.(b)  For a practical nursing education program, the
310program director and at least 50 percent of the program's
311faculty members are registered nurses who have, at a minimum, a
312bachelor's or higher degree in nursing.
313
314The educational degree requirements of this paragraph may be
315documented by an official transcript or by a written statement
316from the educational institution verifying that the institution
317conferred the degree.
318     (b)(c)  The program's nursing major curriculum consists of
319at least:
320     1.  Fifty percent clinical training for a practical nursing
321education program, an associate degree professional nursing
322education program, or a professional diploma nursing education
323program.
324     2.  Forty percent clinical training for a bachelor's degree
325professional nursing education program.
326     (c)(d)  No more than 25 percent of the program's clinical
327training consists of clinical simulation.
328     (d)(e)  The program has signed agreements with each agency,
329facility, and organization included in the curriculum plan as
330clinical training sites and community-based clinical experience
331sites.
332     (e)(f)  The program has written policies for faculty which
333include provisions for direct or indirect supervision by program
334faculty or clinical preceptors for students in clinical training
335consistent with the following standards:
336     1.  The number of program faculty members equals at least
337one faculty member directly supervising every 12 students unless
338the written agreement between the program and the agency,
339facility, or organization providing clinical training sites
340allows more students, not to exceed 18 students, to be directly
341supervised by one program faculty member.
342     2.  For a hospital setting, indirect supervision may occur
343only if there is direct supervision by an assigned clinical
344preceptor, a supervising program faculty member is available by
345telephone, and such arrangement is approved by the clinical
346facility.
347     3.  For community-based clinical experiences that involve
348student participation in invasive or complex nursing activities,
349students must be directly supervised by a program faculty member
350or clinical preceptor and such arrangement must be approved by
351the community-based clinical facility.
352     4.  For community-based clinical experiences not subject to
353subparagraph 3., indirect supervision may occur only when a
354supervising program faculty member is available to the student
355by telephone.
356
357A program's policies established under this paragraph must
358require a clinical preceptor, if supervising students in a
359professional nursing education program, to be a registered nurse
360or, if supervising students in a practical nursing education
361program, to be a registered nurse or licensed practical nurse.
362     (f)(g)  The professional or practical nursing curriculum
363plan documents clinical experience and theoretical instruction
364in medical, surgical, obstetric, pediatric, and geriatric
365nursing. A professional nursing curriculum plan shall also
366document clinical experience and theoretical instruction in
367psychiatric nursing. Each curriculum plan must document clinical
368training experience in appropriate settings that include, but
369are not limited to, acute care, long-term care, and community
370settings.
371     (g)(h)  The professional or practical nursing education
372program provides theoretical instruction and clinical
373application in personal, family, and community health concepts;
374nutrition; human growth and development throughout the life
375span; body structure and function; interpersonal relationship
376skills; mental health concepts; pharmacology and administration
377of medications; and legal aspects of practice. A professional
378nursing education program shall also provide theoretical
379instruction and clinical application in interpersonal
380relationships and leadership skills; professional role and
381function; and health teaching and counseling skills.
382
383Upon the board's approval of a program application, the program
384becomes an approved program under this section.
385     (3)(2)  STATUS OF CERTAIN PROGRAMS.-
386     (a)  A professional or practical nursing education program
387becomes an approved program if that, as of June 30, 2009, the
388program:
389     (a)1.  Has full or provisional approval from the board or,
390except as provided in paragraph (b), is on probationary status,
391except as provided in subparagraph 2., becomes an approved
392program under this section. In order to retain approved program
393status, such program shall submit the report required under
394paragraph (c) to the board by November 1, 2009, and annually
395thereafter.
396     (b)2.  Is on probationary status because the program did
397not meet the board's requirement for program graduate passage
398rates. Such program on the National Council of State Boards of
399Nursing Licensing Examination, shall remain on probationary
400status until it the program achieves a graduate passage rate for
401calendar year 2009 or 2010 that equals or exceeds the required
402passage rate for the respective calendar year and compliance
403with the program graduate passage rate requirement in paragraph
404(5)(a). A program that is subject to this subparagraph must
405disclose its probationary status in writing to the program's
406students and applicants submit the report required under
407paragraph (c) to the board by November 1, 2009, and annually
408thereafter and must comply with paragraph (5)(c). If the program
409does not achieve the required passage rate compliance by July 1,
4102011, the board shall terminate the program pursuant to chapter
411120 as provided in paragraph (5)(d).
412     (b)  Each professional or practical nursing program that
413has its application approved by the board under subsection (1)
414on or after July 1, 2009, shall annually submit the report
415required under paragraph (c) to the board by November 1 of each
416year following initial approval of its application.
417     (4)  ANNUAL REPORT.-By November 1 of each year, each
418approved program shall submit to the board an
419     (c)  The annual report comprised of required by this
420subsection must include an affidavit certifying continued
421compliance with paragraphs (1)(a)-(g) subsection (1), must
422provide a summary description of the program's compliance with
423paragraphs (1)(a)-(g) with subsection (1), and documentation
424must document for the previous academic year that, to the extent
425applicable, sets forth for each professional and practical
426nursing program:
427     (a)1.  The number of student applications received, the
428number of qualified applicants, applicants and the number of
429students accepted, accepted applicants who enroll in the
430program, students enrolled in the program, and.
431     2.  the number of program graduates.
432     3.  The program's graduate passage rate on the National
433Council of State Boards of Nursing Licensing Examination.
434     (b)4.  The program's retention rates for students tracked
435from program entry to graduation.
436     (c)5.  The program's accreditation status, including
437identification of the accrediting agency if such agency is not
438an accrediting agency described in s. 464.003(1) body.
439     (2)(3)  PROGRAM APPROVAL.-
440     (a)  Upon receipt of a If an institution's program
441application and review fee, the department shall examine the
442application to determine whether it is complete. If a program
443application is not complete incomplete, the department board
444shall notify the educational institution in writing of any
445apparent errors or omissions within 30 days after the
446department's receipt of the application and follow the
447procedures in s. 120.60. A program application is deemed
448complete upon the department's receipt of:
449     1.  The initial application, if the department does not
450notify the educational institution of any errors or omissions
451within the 30-day period; or
452     2.  A revised application that corrects each error and
453omission of which the department notifies the educational
454institution within the 30-day period.
455     (b)  Within 90 days after the department's receipt of a
456complete program application, the board shall:
457     1.  Approve the If an institution's program application if
458it documents does not document compliance with paragraphs
459(1)(a)-(g); or the standards in subsection (1), within 90 days
460after the board's receipt of the program application, the board
461shall
462     2.  Provide the educational institution with a notice of
463intent to deny the program application if it does not document
464compliance with paragraphs (1)(a)-(g) that sets forth written
465reasons for the denial. The notice must set forth written
466reasons for the board's denial of the application. The board may
467not deny a program application because of an educational
468institution's failure to correct any error or omission of which
469the department does not notify the institution within the 30-day
470notice period under paragraph (a). The educational institution
471may request a hearing on the notice of intent to deny the
472program application pursuant to chapter 120.
473     (c)  A program application is deemed approved if the board
474does not act within the 90-day review period provided under
475paragraph (b).
476     (d)  Upon the board's approval of a program application,
477the program becomes an approved program.
478     (5)(4)  INTERNET WEBSITE.-By October 1, 2010, the board
479shall publish the following information on its Internet website:
480     (a)  A list of each accredited program conducted in the
481state and the program's graduate passage rates for the most
482recent 2 calendar years, which the department shall determine
483through the following sources:
484     1.  For a program's accreditation status, the specialized
485accrediting agencies that are nationally recognized by the
486United States Secretary of Education to accredit nursing
487education programs.
488     2.  For a program's graduate passage rates, the contract
489testing service of the National Council of State Boards of
490Nursing.
491     (b)  The following data for each approved program, which on
492nursing programs located in the state. The data shall include,
493to the extent applicable:
494     1.(a)  All documentation provided by the program in its
495applicant for each approved nursing program application if
496submitted on or after July 1, 2009.
497     2.(b)  The summary description of the each program's
498compliance as submitted under subsection (4) paragraph (2)(c).
499     (c)  A comprehensive list of each practical and
500professional nursing program in the state.
501     3.(d)  The program's accreditation status for each program,
502including identification of the accrediting agency if such
503agency is not an accrediting agency described in s. 464.003(1)
504body.
505     4.(e)  The Each program's approval or probationary status.
506     5.(f)  The Each program's graduate passage rates for the
507most recent 2 calendar years rate on the National Council of
508State Boards of Nursing Licensing Examination.
509     (g)  The national average for passage rates on the National
510Council of State Boards of Nursing Licensing Examination.
511     6.(h)  Each program's retention rates for students tracked
512from program entry to graduation.
513     (c)  The average passage rates for United States educated
514first-time test takers on the National Council of State Boards
515of Nursing Licensing Examination for the most recent 2 calendar
516years, as calculated by the contract testing service of the
517National Council of State Boards of Nursing. The average passage
518rates shall be published separately for each type of comparable
519degree program listed in sub-subparagraphs (6)(a)1.a.-d.
520
521The information data required to be published under this
522subsection shall be made available in a manner that allows
523interactive searches and comparisons of individual specific
524nursing education programs selected by the website user. The
525board shall publish the data by December 31, 2009, and update
526the Internet website at least quarterly with the available
527information data.
528     (6)(5)  ACCOUNTABILITY.-
529     (a)1.  An approved program must achieve a graduate passage
530rate that is not lower than 10 percentage points less than the
531average passage rate for graduates of comparable degree programs
532who are United States educated first-time test takers on the
533National Council of State Boards of Nursing Licensing
534Examination during a calendar year, as calculated by the
535contract testing service of the National Council of State Boards
536of Nursing. For purposes of this subparagraph, an approved
537program is comparable to all degree programs of the same program
538type from among the following program types:
539     a.  Professional nursing education programs that terminate
540in a bachelor's degree.
541     b.  Professional nursing education programs that terminate
542in an associate degree.
543     c.  Professional nursing education programs that terminate
544in a diploma.
545     d.  Practical nursing education programs.
546     2.  Beginning with graduate passage rates for calendar year
5472010, if an approved a professional or practical nursing
548program's average graduate passage rates do not equal or exceed
549the required passage rates rate for first-time test takers on
550the National Council of State Boards of Nursing Licensing
551Examination falls 10 percent or more below the national average
552passage rate for first-time test takers educated in the United
553States, as annually published by the contract testing service of
554the National Council of State Boards of Nursing, for 2
555consecutive calendar years, the board shall place the program on
556probationary status pursuant to chapter 120 probation and the
557program director must shall be required to appear before the
558board to present a plan for remediation. The program shall
559remain on probationary status until it achieves a compliance
560with the graduate passage rate that equals or exceeds the
561required passage rate for any one calendar year.
562     3.  Upon the program's achievement of a graduate passage
563rate that equals or exceeds the required passage rate,
564requirement and shall be terminated by the board, at its next
565regularly scheduled meeting following release of the program's
566graduate passage rate by the National Council of State Boards of
567Nursing, shall remove the program's probationary status.
568However, under paragraph (d) if the program, during the 2
569calendar years following its placement on probationary status,
570does not achieve the required passage rate for any one
571compliance within 2 calendar year, the board shall terminate the
572program pursuant to chapter 120 years.
573     (b)  If an approved a program fails to submit the annual
574report required in subsection (4) (2), the board shall notify
575the program director and president or chief executive officer of
576the educational institution in writing within 15 days after the
577due date of the annual report. The program director must appear
578before the board at the board's next regularly scheduled meeting
579to explain the reason for the delay place the program on
580probation. The board program shall terminate the program
581pursuant to chapter 120 remain on probationary status until it
582submits the annual report and shall be terminated by the board
583under paragraph (d) if it does not submit the annual report
584within 6 months after the report's due date.
585     (c)  An approved A program placed on probationary status
586shall disclose its probationary status in writing to the
587program's students and applicants.
588     (d)  The board shall terminate a program that fails to
589comply with subparagraph (2)(a)2., paragraph (a), or paragraph
590(b) pursuant to chapter 120.
591     (7)  DISCLOSURE OF GRADUATE PASSAGE RATE DATA.-
592     (a)  For each of an approved program's or accredited
593program's graduates included in the calculation of the program's
594graduate passage rate, the department shall disclose to the
595program director, upon his or her written request, the name,
596examination date, and determination of whether each graduate
597passed or failed the National Council for State Boards of
598Nursing Licensing Examination, to the extent that such
599information is provided to the department by the contract
600testing service of the National Council for State Boards of
601Nursing. The written request must specify the calendar years for
602which the information is requested.
603     (b)  A program director to whom confidential information
604exempt from public disclosure pursuant to s. 456.014 is
605disclosed under this subsection must maintain the
606confidentiality of the information and is subject to the same
607penalties provided in s. 456.082 for department employees who
608unlawfully disclose confidential information.
609     (8)(6)  PROGRAM CLOSURE.-
610     (a)  An educational institution conducting an approved
611program or accredited a nursing program in this state, at least
61230 days before voluntarily closing the program, that closes
613shall notify the board in writing of the institution's reason
614for closing the program, the intended closure date, the
615institution's plan to provide for or assist in the completion of
616training by the program's students, and advise the board of the
617arrangements for storage of the program's permanent
618     (b)  An educational institution conducting a nursing
619education program that is terminated under subsection (6) or
620closed under subparagraph (10)(b)3.:
621     1.  May not accept or enroll new students.
622     2.  Must submit to the board within 30 days after the
623program is terminated or closed a written description of how the
624institution will assist in the completion of training by the
625program's students and the institution's arrangements for
626storage of the program's permanent records.
627     (c)  If an educational institution does not comply with
628paragraph (a) or paragraph (b), the board shall provide a
629written notice explaining the institution's noncompliance to the
630following persons and entities:
631     1.  The president or chief executive officer of the
632educational institution.
633     2.  The Board of Governors, if the program is conducted by
634a state university.
635     3.  The district school board, if the program is conducted
636by an educational institution operated by a school district.
637     4.  The Commission for Independent Education, if the
638program is conducted by an educational institution licensed
639under chapter 1005.
640     5.  The State Board of Education, if the program is
641conducted by an educational institution in the Florida College
642System or by an educational institution that is not subject to
643subparagraphs 2.-4.
644     (9)(7)  RULEMAKING.-The board does not have any rulemaking
645authority to administer this section, except that the board
646shall adopt a rule that prescribes the format for submitting
647program applications under subsection (1) and annual reports
648submitting summary descriptions of program compliance under
649subsection (4) paragraph (2)(c). The board may not impose any
650condition or requirement on an educational institution
651submitting a program application, an approved program, or an
652accredited program, a program on probationary status except as
653expressly provided in this section. The board shall repeal all
654rules, or portions thereof, in existence on July 1, 2009, that
655are inconsistent with this subsection.
656     (10)  APPLICABILITY TO ACCREDITED PROGRAMS.-
657     (a)  Subsections (1)-(4), paragraph (5)(b), and subsection
658(6) do not apply to an accredited program. An accredited program
659on probationary status before July 1, 2010, ceases to be subject
660to the probationary status.
661     (b)  If an accredited program ceases to be accredited, the
662educational institution conducting the program:
663     1.  Within 10 business days after the program ceases to be
664accredited, must provide written notice of the date that the
665program ceased to be accredited to the board, the program's
666students and applicants, and each entity providing clinical
667training sites or community-based clinical experience sites for
668the program. The educational institution must continue to
669provide the written notice to new students, applicants, and
670entities providing clinical training sites or community-based
671clinical experience sites for the program until the program
672becomes an approved program or is closed under subparagraph 3.
673     2.  Within 30 days after the program ceases to be
674accredited, must submit an affidavit to the board, signed by the
675educational institution's president or chief executive officer,
676that certifies the institution's compliance with subparagraph 1.
677The board shall notify the persons listed in subparagraph
678(8)(c)1. and the applicable entities listed in subparagraphs
679(8)(c)2.-5. if an educational institution does not submit the
680affidavit required by this subparagraph.
681     3.  May apply to become an approved program under this
682section. If the educational institution:
683     a.  Within 30 days after the program ceases to be
684accredited, submits a program application and review fee to the
685department under subsection (1) and the affidavit required under
686subparagraph 2., the program shall be deemed an approved program
687from the date that the program ceased to be accredited until the
688date that the board approves or denies the program application.
689The program application must be denied by the board pursuant to
690chapter 120 if it does not contain the affidavit. If the board
691denies the program application under subsection (2) or because
692the program application does not contain the affidavit, the
693program shall be closed and the educational institution
694conducting the program must comply with paragraph (8)(b).
695     b.  Does not apply to become an approved program pursuant
696to sub-subparagraph a., the program shall be deemed an approved
697program from the date that the program ceased to be accredited
698until the 31st day after that date. On the 31st day after the
699program ceased to be accredited, the program shall be closed and
700the educational institution conducting the program must comply
701with paragraph (8)(b).
702     (8)  The Florida Center for Nursing and the Office of
703Program Policy Analysis and Government Accountability shall
704each:
705     (a)  Monitor the administration of this section and
706evaluate the effectiveness of this section in achieving quality
707nursing programs with a higher production of quality nursing
708graduates.
709     (b)  Report its findings and make recommendations, if
710warranted, to improve the effectiveness of this section to the
711Governor, the President of the Senate, and the Speaker of the
712House of Representatives by February 1, 2010.
713     (11)(9)  IMPLEMENTATION STUDY.-The Florida Center for
714Nursing and the education policy area of the Office of Program
715Policy Analysis and Government Accountability shall study the 5-
716year administration of this section and submit reports to the
717Governor, the President of the Senate, and the Speaker of the
718House of Representatives by January 30, 2011, and annually
719thereafter through January 30, 2015. The annual reports shall
720address the previous academic year; set forth data on the
721measures specified in paragraphs (a) and (b) for each
722prelicensure practical and professional nursing program in the
723state, as such data becomes available; and include an evaluation
724of such data for purposes of determining whether this section is
725increasing the availability of nursing education programs and
726the production of quality nurses. The department and each
727approved program or accredited program shall comply with
728requests for data from the Florida Center for Nursing and the
729education policy area of the Office of Program Policy Analysis
730and Government Accountability.
731     (a)  The education policy area of the Office of Program
732Policy Analysis and Government Accountability shall evaluate
733program-specific data for each approved program and accredited
734program conducted in the state, including, but not limited to:
735     1.  The number of nursing education programs and student
736slots available.
737     2.  The number of student applications submitted, the
738number of qualified applicants, and the number of students
739accepted.
740     3.  The number of program graduates.
741     4.  Program retention rates of students tracked from
742program entry to graduation.
743     5.  Graduate passage rates on the National Council of State
744Boards of Nursing Licensing Examination.
745     6.  The number of graduates who become employed as
746practical or professional nurses in the state.
747     (b)  The Florida Center for Nursing shall evaluate the
748board's implementation of the:
749     1.  Program application approval process, including, but
750not limited to, the number of program applications submitted
751under subsection (1); the number of program applications
752approved and denied by the board under subsection (2)
753subsections (1) and (3); the number of denials of program
754applications reviewed under chapter 120; and a description of
755the outcomes of those reviews.
756     2.  Accountability Probation and termination processes,
757including, but not limited to, the number of programs placed on
758probationary status, the number of approved programs for which
759the program director is required to appear before the board
760under subsection (6), the number of approved programs terminated
761by the board under paragraph (5)(d), the number of terminations
762reviewed under chapter 120, and a description of the outcomes of
763those reviews.
764     (c)  For any state fiscal year in which the Florida Center
765for Nursing does not receive legislative appropriations, the
766education policy area of the Office of Program Policy Analysis
767and Government Accountability shall perform the duties assigned
768by this subsection to the Florida Center for Nursing.     
769     Section 6.  Subsection (4) of section 464.022, Florida
770Statutes, is amended to read:
771     464.022  Exceptions.-No provision of this part shall be
772construed to prohibit:
773     (4)  The practice of nursing by graduates of prelicensure
774nursing education approved programs listed in s. 464.008(1)(c)
775or the equivalent, pending the result of the first licensing
776examination for which they are eligible following graduation,
777provided they practice under direct supervision of a registered
778professional nurse. The board shall by rule define what
779constitutes direct supervision.
780     Section 7.  Paragraph (a) of subsection (1) and subsection
781(2) of section 458.348, Florida Statutes, are amended to read:
782     458.348  Formal supervisory relationships, standing orders,
783and established protocols; notice; standards.-
784     (1)  NOTICE.-
785     (a)  When a physician enters into a formal supervisory
786relationship or standing orders with an emergency medical
787technician or paramedic licensed pursuant to s. 401.27, which
788relationship or orders contemplate the performance of medical
789acts, or when a physician enters into an established protocol
790with an advanced registered nurse practitioner, which protocol
791contemplates the performance of medical acts identified and
792approved by the joint committee pursuant to s. 464.003(2)(3)(d)
793or acts set forth in s. 464.012(3) and (4), the physician shall
794submit notice to the board. The notice shall contain a statement
795in substantially the following form:
796     I, ...(name and professional license number of
797physician)..., of ...(address of physician)... have hereby
798entered into a formal supervisory relationship, standing orders,
799or an established protocol with ...(number of persons)...
800emergency medical technician(s), ...(number of persons)...
801paramedic(s), or ...(number of persons)... advanced registered
802nurse practitioner(s).
803     (2)  ESTABLISHMENT OF STANDARDS BY JOINT COMMITTEE.-The
804joint committee created under s. 464.003(2)(3)(d) shall
805determine minimum standards for the content of established
806protocols pursuant to which an advanced registered nurse
807practitioner may perform medical acts identified and approved by
808the joint committee pursuant to s. 464.003(2)(3)(d) or acts set
809forth in s. 464.012(3) and (4) and shall determine minimum
810standards for supervision of such acts by the physician, unless
811the joint committee determines that any act set forth in s.
812464.012(3) or (4) is not a medical act. Such standards shall be
813based on risk to the patient and acceptable standards of medical
814care and shall take into account the special problems of
815medically underserved areas. The standards developed by the
816joint committee shall be adopted as rules by the Board of
817Nursing and the Board of Medicine for purposes of carrying out
818their responsibilities pursuant to part I of chapter 464 and
819this chapter, respectively, but neither board shall have
820disciplinary powers over the licensees of the other board.
821     Section 8.  Paragraph (a) of subsection (1) of section
822459.025, Florida Statutes, is amended to read:
823     459.025  Formal supervisory relationships, standing orders,
824and established protocols; notice; standards.-
825     (1)  NOTICE.-
826     (a)  When an osteopathic physician enters into a formal
827supervisory relationship or standing orders with an emergency
828medical technician or paramedic licensed pursuant to s. 401.27,
829which relationship or orders contemplate the performance of
830medical acts, or when an osteopathic physician enters into an
831established protocol with an advanced registered nurse
832practitioner, which protocol contemplates the performance of
833medical acts identified and approved by the joint committee
834pursuant to s. 464.003(2)(3)(d) or acts set forth in s.
835464.012(3) and (4), the osteopathic physician shall submit
836notice to the board. The notice must contain a statement in
837substantially the following form:
838     I, ...(name and professional license number of osteopathic
839physician)..., of ...(address of osteopathic physician)... have
840hereby entered into a formal supervisory relationship, standing
841orders, or an established protocol with ...(number of
842persons)... emergency medical technician(s), ...(number of
843persons)... paramedic(s), or ...(number of persons)... advanced
844registered nurse practitioner(s).
845     Section 9.  Paragraph (c) of subsection (3) of section
846464.012, Florida Statutes, is amended to read:
847     464.012  Certification of advanced registered nurse
848practitioners; fees.-
849     (3)  An advanced registered nurse practitioner shall
850perform those functions authorized in this section within the
851framework of an established protocol that is filed with the
852board upon biennial license renewal and within 30 days after
853entering into a supervisory relationship with a physician or
854changes to the protocol. The board shall review the protocol to
855ensure compliance with applicable regulatory standards for
856protocols. The board shall refer to the department licensees
857submitting protocols that are not compliant with the regulatory
858standards for protocols. A practitioner currently licensed under
859chapter 458, chapter 459, or chapter 466 shall maintain
860supervision for directing the specific course of medical
861treatment. Within the established framework, an advanced
862registered nurse practitioner may:
863     (c)  Perform additional functions as may be determined by
864rule in accordance with s. 464.003(2)(3)(d).
865     Section 10.  Subsection (2) of section 960.28, Florida
866Statutes, is amended to read:
867     960.28  Payment for victims' initial forensic physical
868examinations.-
869     (2)  The Crime Victims' Services Office of the department
870shall pay for medical expenses connected with an initial
871forensic physical examination of a victim of sexual battery as
872defined in chapter 794 or a lewd or lascivious offense as
873defined in chapter 800. Such payment shall be made regardless of
874whether the victim is covered by health or disability insurance
875and whether the victim participates in the criminal justice
876system or cooperates with law enforcement. The payment shall be
877made only out of moneys allocated to the Crime Victims' Services
878Office for the purposes of this section, and the payment may not
879exceed $500 with respect to any violation. The department shall
880develop and maintain separate protocols for the initial forensic
881physical examination of adults and children. Payment under this
882section is limited to medical expenses connected with the
883initial forensic physical examination, and payment may be made
884to a medical provider using an examiner qualified under part I
885of chapter 464, excluding s. 464.003(16)(5); chapter 458; or
886chapter 459. Payment made to the medical provider by the
887department shall be considered by the provider as payment in
888full for the initial forensic physical examination associated
889with the collection of evidence. The victim may not be required
890to pay, directly or indirectly, the cost of an initial forensic
891physical examination performed in accordance with this section.
892     Section 11.  This act shall take effect July 1, 2010.


CODING: Words stricken are deletions; words underlined are additions.