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    Florida House of Representatives - 2002                 HB 519

        By Representative Murman






  1                      A bill to be entitled

  2         An act relating to nursing shortage solutions;

  3         providing a short title; amending s. 445.012,

  4         F.S.; replacing the Careers for Florida's

  5         Future Incentive Grant Program with the Careers

  6         for Florida's Future Loan Forgiveness Program;

  7         providing for management of the program by the

  8         Office of Student Financial Assistance of the

  9         Department of Education; providing duties of

10         the department; providing criteria and

11         requirements of the program; deleting

12         provisions relating to authority and duties of

13         Workforce Florida, Inc.; deleting provisions

14         relating to awarding grants; creating the

15         Sunshine Workforce Solutions Grant Program;

16         providing legislative intent; providing

17         purposes; providing procedures, requirements,

18         and criteria for administering the program;

19         providing duties of the Department of

20         Education; amending s. 456.072, F.S.; excluding

21         nursing licensees from application of certain

22         acts constituting grounds for disciplinary

23         action; amending s. 464.018, F.S.; specifying

24         additional acts constituting grounds for

25         disciplinary action for nursing licensees;

26         amending s. 464.019, F.S.; revising rulemaking

27         authority of the Board of Nursing relating to

28         approval of nursing programs; exempting certain

29         nursing programs from certain board rules under

30         certain circumstances; providing requirements;

31         creating s. 464.085, F.S.; authorizing the

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    Florida House of Representatives - 2002                 HB 519

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  1         Department of Health to issue certain persons a

  2         nursing license under certain circumstances;

  3         providing for future repeal; repealing ss.

  4         445.0121, 445.0122, 445.0123, 445.0124, and

  5         445.0125, F.S., relating to the Careers for

  6         Florida's Future Incentive Grant Program

  7         provisions; providing an effective date.

  8

  9         WHEREAS, Florida is aggressively pursuing a K-20

10  approach in dealing with educational issues, has many

11  coordinated partnerships in place, and utilizes nationally

12  recognized mechanisms such as dual enrollment, common course

13  numbering, common prerequisites, standardized program lengths,

14  and statewide A.S. to B.S. articulation, and

15         WHEREAS, there are areas of critical workforce

16  shortages that require such a coordinated K-20 effort from

17  middle school to graduate school to take advantage of

18  partnerships and mechanisms already in place as building

19  blocks, and

20         WHEREAS, the Florida vacancy rate for nurses is 16.2

21  percent and the number of A.S. degrees awarded in Florida has

22  declined at a time when 40 percent of the workforce will be

23  over the age of 50 by 2010, NOW, THEREFORE,

24

25  Be It Enacted by the Legislature of the State of Florida:

26

27         Section 1.  This act may be cited as the "Nursing

28  Shortage Solution Act."

29         Section 2.  Section 445.012, Florida Statutes, is

30  amended to read:

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    Florida House of Representatives - 2002                 HB 519

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  1         445.012  Careers for Florida's Future Loan Forgiveness

  2  Incentive Grant Program.--

  3         (1)  The Careers for Florida's Future Loan Forgiveness

  4  Incentive Grant Program is created to encourage students in

  5  this state to obtain degrees or certificates in postsecondary

  6  programs that produce graduates with job skills in nursing

  7  advanced technology which are critical to the economic future

  8  of this state. The program shall provide for forgiveness of

  9  loans a forgivable loan that require requires a student to

10  enroll in and complete an eligible program and then to

11  maintain employment in an eligible occupation in this state

12  for 1 year for each year of loan forgiveness grant receipt.

13  The recipient must begin repayment of the grant 1 year after

14  the recipient is no longer enrolled in an eligible institution

15  or completes the program, unless the recipient obtains

16  employment in an eligible occupation.

17         (2)  The Office of Student Financial Assistance of the

18  Department of Education Workforce Florida, Inc., shall manage

19  the Careers for Florida's Future Loan Forgiveness Incentive

20  Grant Program in accordance with rules and procedures

21  established for this purpose. Workforce Florida, Inc., shall

22  contract with the Office of Student Financial Assistance in

23  the Department of Education to administer the incentive grant

24  program for students pursuing baccalaureate degrees or degree

25  career education programs that articulate into baccalaureate

26  degree programs. The office shall advertise the availability

27  of the loan forgiveness grant program and collect all

28  delinquent incentive grant repayments.

29         (a)  The Department of Education shall make payments on

30  loans from federal or state programs or commercial lending

31  institutions for the support of postsecondary study in

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    Florida House of Representatives - 2002                 HB 519

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  1  approved certificate, associate degree, or baccalaureate

  2  degree programs in nursing. The Office of Student Financial

  3  Assistance of the Department of Education shall issue awards

  4  from the incentive grant program each semester. Before the

  5  registration period each semester, the department shall

  6  transmit payment for each award to the president or director

  7  of the postsecondary education institution, or his or her

  8  representative, except that the department may withhold

  9  payment if the receiving institution fails to report or make

10  refunds to the department as required in this section.

11         (b)  Only loans to pay the costs of tuition, fees,

12  books, and living expenses shall be covered in an amount not

13  to exceed $1,800 for each year of education toward a

14  certificate, $3,000 for each year of education toward an

15  associate degree or at a lower division toward a baccalaureate

16  degree, and $6,000 for each year of education at an upper

17  division toward a baccalaureate degree. Within 30 days after

18  the end of regular registration each semester, the educational

19  institution shall certify to the department the eligibility

20  status of each student who receives an award. After the end of

21  the drop-and-add period, an institution is not required to

22  reevaluate or revise a student's eligibility status, but must

23  make a refund to the department if a student who receives an

24  award disbursement terminates enrollment for any reason during

25  an academic term and a refund is permitted by the

26  institution's refund policy.

27         (c)  Contingent upon proof of employment in an eligible

28  occupation in the area of nursing, loan principal payments

29  shall be made directly to the federal or state programs or

30  commercial lending institutions holding the loan as follows:

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    Florida House of Representatives - 2002                 HB 519

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  1         1.  Twenty-five percent of the loan principal and

  2  accrued interest shall be retired after the first year of

  3  eligible employment.

  4         2.  Fifty percent of the loan principal and accrued

  5  interest shall be retired after the second year of eligible

  6  employment.

  7         3.  Seventy-five percent of the loan principal and

  8  accrued interest shall be retired after the third year of

  9  eligible employment.

10         4.  The remaining loan principal and accrued interest

11  shall be retired after the fourth year of eligible employment.

12

13  In no case may payment for any student exceed $6,000 in any

14  12-month period. An institution that receives funds from the

15  program shall certify to the department the amount of funds

16  disbursed to each student and shall remit to the department

17  any undisbursed advances within 60 days after the end of

18  regular registration. The department may suspend or revoke an

19  institution's eligibility to receive future moneys for the

20  program if the department finds that an institution has not

21  complied with this section.

22         (3)  The Department of Education may adopt rules

23  necessary for administering the program. Workforce Florida,

24  Inc., shall allocate to each regional workforce board its

25  share of funds available for incentive grants in eligible

26  diploma, certificate, and degree career education programs

27  that do not articulate into baccalaureate programs. Each

28  regional workforce board shall administer the program,

29  including determining award recipients within funds available

30  to it for that purpose. Workforce Florida, Inc., shall

31  contract with the Office of Student Financial Assistance in

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    Florida House of Representatives - 2002                 HB 519

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  1  the Department of Education for collecting delinquent

  2  incentive grant repayments.

  3         (a)  Workforce Florida, Inc., shall reallocate any

  4  funds not encumbered by the regional workforce boards by

  5  January 31 of each year to other regional workforce boards for

  6  additional awards, in accordance with rules and procedures

  7  established for this purpose.

  8         (b)  Within 30 days after the student begins classes,

  9  the educational institution shall certify to the regional

10  workforce board the eligibility status of each student who

11  receives an award. After this report, an institution is not

12  required to reevaluate or revise a student's eligibility

13  status, but must make a refund to the regional workforce board

14  if a student who receives an award disbursement terminates

15  enrollment for any reason during the period that would permit

16  a refund by the institution's refund policy.

17         (c)  Regional workforce boards shall ensure that each

18  recipient receives maximum funding possible by coordinating

19  career education awards with Individual Training Accounts

20  funded by the federal Workforce Investment Act, Retention

21  Incentive Training Accounts funded by the federal Temporary

22  Assistance for Needy Families Act, the federal Welfare-to-Work

23  program, and other programs intended to assist incumbent

24  workers in upgrading their skills.

25         (4)  This section shall be implemented only as

26  specifically funded. If funds appropriated are not adequate to

27  provide the maximum allowable award to each eligible

28  applicant, full awards must be provided in the order of

29  priority established by Workforce Florida, Inc. Awards must

30  not be reduced to increase the number of recipients.

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    Florida House of Representatives - 2002                 HB 519

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  1         (5)  A recipient who is pursuing a baccalaureate degree

  2  shall receive $100 for each lower-division credit hour in

  3  which the student is enrolled at an eligible college or

  4  university, up to a maximum of $1,500 per semester, and $200

  5  for each upper-division credit hour in which the student is

  6  enrolled at an eligible college or university, up to a maximum

  7  of $3,000 per semester. For purposes of this section, a

  8  student is pursuing a baccalaureate degree if he or she is in

  9  a program that articulates into a baccalaureate degree program

10  by agreement of the Articulation Coordinating Committee. A

11  student in an applied technology diploma program, a

12  certificate career education program, or a degree career

13  education program that does not articulate into a

14  baccalaureate degree program shall receive $2 for each

15  vocational contact hour, or the equivalent, for certificate

16  programs, or $60 for each credit hour, or the equivalent, for

17  degree career education programs and applied technology

18  programs for which the student is enrolled at an eligible

19  college, technical center, or nonpublic career education

20  school.

21         (6)  If a recipient who is enrolled in a diploma,

22  certificate, or degree career education program that does not

23  articulate into a baccalaureate degree program transfers from

24  one eligible institution to another within the same workforce

25  region and continues to meet eligibility requirements, the

26  award shall be transferred with the student.

27         (7)  If a recipient who is enrolled in a baccalaureate

28  degree or a degree career education program that articulates

29  into a baccalaureate degree program transfers from one

30  eligible institution to another and continues to meet

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    Florida House of Representatives - 2002                 HB 519

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  1  eligibility requirements, the award shall be transferred with

  2  the student.

  3         (8)  An award recipient may use an award for enrollment

  4  in a summer term if funds are available.

  5         (9)  Funds may not be used to pay for remedial,

  6  college-preparatory, or vocational-preparatory coursework.

  7         Section 3.  Sunshine Workforce Solutions Grant

  8  Program.--

  9         (1)  The Legislature recognizes the need for school

10  districts to be able to respond to critical workforce

11  shortages in nursing. The Sunshine Workforce Solutions Grant

12  Program is created to provide grants to school districts on a

13  competitive basis to fund all or some of the costs associated

14  with establishing an exploratory program at the middle school

15  level or a comprehensive career and technical education

16  program within a high school that provides a program of study

17  in nursing that will provide a seamless transition to an

18  appropriate postsecondary education or employment.

19         (a)  A comprehensive career and technical education

20  program within a high school that provides a program of study

21  in nursing must be certified or endorsed by the nursing

22  industry to ensure that all components of the program are

23  relevant and appropriate to prepare the student for further

24  education and employment in nursing.

25         (b)  Each career and technical education program

26  offered by a high school and able to be articulated to a

27  postsecondary level must also have an articulation agreement

28  with one or more appropriate postsecondary education

29  institutions to ensure a seamless transition to a related

30  postsecondary program without a loss of credit for the

31  student.

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    Florida House of Representatives - 2002                 HB 519

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  1         (c)  Participation in work-based learning experiences,

  2  as defined in rule by the Department of Education, shall be

  3  required at the high school level.

  4         (2)  Funds awarded for a Sunshine Workforce Solutions

  5  Grant may be used for instructional equipment, laboratory

  6  equipment, supplies, personnel, student services, or other

  7  expenses associated with the development of a program in

  8  nursing.

  9         (3)  The Department of Education shall accept

10  applications from middle schools and high schools for grants

11  under the Sunshine Workforce Solutions Grant Program.

12         (a)  Applications shall contain projected enrollments

13  and projected costs for the Sunshine Workforce Solutions

14  Grants.

15         (b)  The Department of Education shall review and rank

16  each application for a grant and shall submit to the

17  Legislature a list, in priority order by middle schools and

18  high schools, of applicants recommended for grant awards.

19         (c)  Schools shall be selected based on existing

20  infrastructure that would ensure success of the program.  The

21  department shall consider statewide geographic dispersion of

22  grant funds in ranking the applications.

23         (d)  Demonstrated successful student recruitment,

24  retention, and program completion strategies shall be an

25  evaluative criteria in awarding grants under this section.

26         Section 4.  Paragraphs (aa) and (bb) of subsection (1)

27  of section 456.072, Florida Statutes, are amended to read:

28         456.072  Grounds for discipline; penalties;

29  enforcement.--

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    Florida House of Representatives - 2002                 HB 519

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  1         (1)  The following acts shall constitute grounds for

  2  which the disciplinary actions specified in subsection (2) may

  3  be taken:

  4         (aa)  Performing or attempting to perform health care

  5  services on the wrong patient, a wrong-site procedure, a wrong

  6  procedure, or an unauthorized procedure or a procedure that is

  7  medically unnecessary or otherwise unrelated to the patient's

  8  diagnosis or medical condition. For the purposes of this

  9  paragraph, performing or attempting to perform health care

10  services includes the preparation of the patient. This

11  paragraph does not apply to persons licensed under chapter

12  464, which persons are subject to the provisions of s.

13  464.018(1)(o).

14         (bb)  Leaving a foreign body in a patient, such as a

15  sponge, clamp, forceps, surgical needle, or other

16  paraphernalia commonly used in surgical, examination, or other

17  diagnostic procedures. For the purposes of this paragraph, it

18  shall be legally presumed that retention of a foreign body is

19  not in the best interest of the patient and is not within the

20  standard of care of the profession, regardless of the intent

21  of the professional. This paragraph does not apply to persons

22  licensed under chapter 464, which persons are subject to the

23  provisions of s. 464.018(1)(o).

24         Section 5.  Paragraph (o) is added to subsection (1) of

25  section 464.018, Florida Statutes, to read:

26         464.018  Disciplinary actions.--

27         (1)  The following acts constitute grounds for denial

28  of a license or disciplinary action, as specified in s.

29  456.072(2):

30         (o)1.  Performing or attempting to perform a surgical

31  procedure on the wrong patient, a wrong-site surgical

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    Florida House of Representatives - 2002                 HB 519

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  1  procedure, a wrong surgical procedure, or a surgical procedure

  2  that is medically unnecessary or otherwise unrelated to the

  3  patient's diagnosis or medical condition.

  4         2.  Leaving a foreign body in a patient when leaving

  5  the foreign body is not medically necessary, unless removal of

  6  the foreign body is not in the best interest of the patient.

  7

  8  In any case involving disciplinary action relating to a person

  9  licensed under this chapter, this paragraph supersedes s.

10  456.072(1)(aa) or (bb).

11         (2)  The board may enter an order denying licensure or

12  imposing any of the penalties in s. 456.072(2) against any

13  applicant for licensure or licensee who is found guilty of

14  violating any provision of subsection (1) of this section or

15  who is found guilty of violating any provision of s.

16  456.072(1).

17         Section 6.  Subsection (2) of section 464.019, Florida

18  Statutes, is amended, and subsection (6) is added to said

19  section, to read:

20         464.019  Approval of nursing programs.--

21         (2)(a)  The board shall adopt rules, applicable to

22  initial review and conditional approval of a program,

23  regarding educational objectives, faculty qualifications,

24  curriculum guidelines, administrative procedures, and clinical

25  training. An applicant institution shall comply with such

26  rules in order to obtain conditional program approval. No

27  program shall be considered fully approved, nor shall any

28  program be exempted from such rules, prior to the graduation

29  of the program's first class.

30         (b)  The board shall adopt rules regarding educational

31  objectives and curriculum guidelines as are necessary to grant

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    Florida House of Representatives - 2002                 HB 519

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  1  full approval to a program and to ensure that fully approved

  2  programs graduate nurses capable of competent practice under

  3  this part. Rules regarding educational objectives shall

  4  consider student attrition rate standards and retention of

  5  qualified faculty.

  6         (c)  The board shall adopt rules governing probation,

  7  suspension, and termination status of programs that fail to

  8  comply with the standards of this part.

  9         (d)  The board shall not adopt any rule limiting the

10  number of students admitted to a nursing program provided

11  appropriate faculty-to-student ratios are maintained.

12         (6)  Any nursing program that maintains accreditation

13  through an accrediting body recognized by the United States

14  Department of Education, or any nursing program located within

15  a regionally accredited institution of higher education, shall

16  be exempt from the rules of the board except as provided in

17  paragraph (2)(b), provided such exemption shall apply only to

18  the extent the program maintains a student pass rate on the

19  National Clinical Licensure Exam of not less than 7 percentage

20  points below the national average pass rate as reported

21  annually by the National Council of State Boards of Nursing.

22         Section 7.  Section 464.085, Florida Statutes, is

23  created to read:

24         464.085  Licensure by reciprocity.--

25         (1)  The department shall issue a license by

26  reciprocity to practice professional or practical nursing to

27  an applicant who, upon applying to the department and

28  remitting a fee not to exceed $100, demonstrates that he or

29  she:

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    Florida House of Representatives - 2002                 HB 519

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  1         (a)  Holds a full, valid, and unrestricted license to

  2  practice professional or practical nursing in another state of

  3  the United States.

  4         (b)  Has successfully completed a state, regional, or

  5  national examination that is substantially equivalent to the

  6  examination given by the department.

  7         (c)  Has the ability to communicate in the English

  8  language, which may be determined by an examination given by

  9  the department.

10         (2)  The department shall not issue a license by

11  reciprocity to any applicant who is under investigation in

12  another state for an act that would constitute a violation of

13  this part or chapter 456 until such time as the investigation

14  is complete, at which time the provisions of s. 464.018 shall

15  apply.

16         (3)  This section is repealed July 1, 2004, unless

17  reviewed and saved from repeal through reenactment by the

18  Legislature.

19         Section 8.  Sections 445.0121, 445.0122, 445.0123,

20  445.0124, and 445.0125, Florida Statutes, are repealed.

21         Section 9.  This act shall take effect upon becoming a

22  law.

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    Florida House of Representatives - 2002                 HB 519

    583-241C-02






  1            *****************************************

  2                          HOUSE SUMMARY

  3
      Creates the "Nursing Shortage Solution Act." Replaces the
  4    Careers for Florida's Future Incentive Grant Program with
      the Careers for Florida's Future Loan Forgiveness Program
  5    to provide for loan forgiveness of costs associated with
      degree programs in nursing. Creates the Sunshine
  6    Workforce Solutions Grant Program to provide grants to
      school districts to establish programs for studies in
  7    nursing to respond to critical workforce shortages in
      nursing. Specifies procedures performed or attempted to
  8    be performed for purposes of grounds for disciplinary
      action for nursing licensees. Revises rulemaking
  9    authority of the Board of Nursing relating to approval of
      nursing programs. Exempts accredited nursing programs
10    from board rules relating to program approval under
      certain circumstances. Authorizes the Department of
11    Health to issue professional or practical nursing
      licenses to qualified persons from other states. See bill
12    for details.

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