House Bill hb0519e1

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                              CS/CS/CS/HB 519, First Engrossed/ntc



  1                      A bill to be entitled

  2         An act relating to nursing shortage solutions;

  3         providing a short title; amending s. 240.4075,

  4         F.S., relating to the Nursing Student Loan

  5         Forgiveness Program; revising provisions

  6         relating to loan repayment; providing a

  7         restriction on participation in the program;

  8         amending s. 240.4076, F.S., relating to the

  9         Nursing Scholarship Program; revising

10         eligibility provisions; revising provisions

11         relating to repayment of a scholarship under

12         certain circumstances; deleting obsolete

13         language; creating the Sunshine Workforce

14         Solutions Grant Program; providing for grants

15         to fund the establishment of exploratory

16         programs in nursing or programs of study in

17         nursing in the public schools; providing

18         requirements and procedures for application and

19         selection; amending s. 464.009, F.S.; revising

20         provisions relating to eligibility for

21         licensure by endorsement to practice

22         professional or practical nursing; providing

23         for future repeal; amending s. 464.019, F.S.;

24         revising rulemaking authority of the Board of

25         Nursing relating to approval of nursing

26         programs; exempting certain nursing programs

27         from certain board rules under certain

28         circumstances; requiring board review of a

29         nursing program under certain circumstances;

30         amending s. 464.022, F.S.; providing an

31         exemption from licensure for a nurse licensed


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                              CS/CS/CS/HB 519, First Engrossed/ntc



  1         in a territory of the United States; providing

  2         an appropriation to the Department of Health to

  3         provide grants to hospitals for nurse retention

  4         and recruitment activities; requiring matching

  5         of appropriated funds; providing for rules;

  6         providing eligibility criteria; providing an

  7         effective date.

  8

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

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

12  Shortage Solution Act."

13         Section 2.  Subsections (5) through (11) of section

14  240.4075, Florida Statutes, are renumbered as subsections (6)

15  through (12), respectively, subsection (4) is amended, and a

16  new subsection (5) is added to said section, to read:

17         240.4075  Nursing Student Loan Forgiveness Program.--

18         (4)  From the funds available, the Department of Health

19  may make loan principal repayments of up to $4,000 a year for

20  up to 4 years on behalf of selected graduates of an accredited

21  or approved nursing program. All repayments shall be

22  contingent upon continued proof of employment in the

23  designated facilities in this state and shall be made directly

24  to the holder of the loan. The state shall bear no

25  responsibility for the collection of any interest charges or

26  other remaining balance.  In the event that the designated

27  facilities are changed, a nurse shall continue to be eligible

28  for loan forgiveness as long as he or she continues to work in

29  the facility for which the original loan repayment was made

30  and otherwise meets all conditions of eligibility. Receipt of

31  funds pursuant to this program shall be contingent upon


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                              CS/CS/CS/HB 519, First Engrossed/ntc



  1  continued proof of employment in the designated facilities in

  2  this state. Loan principal payments shall be made by the

  3  Department of Health directly to the federal or state programs

  4  or commercial lending institutions holding the loan as

  5  follows:

  6         (a)  Twenty-five percent of the loan principal and

  7  accrued interest shall be retired after the first year of

  8  nursing;

  9         (b)  Fifty percent of the loan principal and accrued

10  interest shall be retired after the second year of nursing;

11         (c)  Seventy-five percent of the loan principal and

12  accrued interest shall be retired after the third year of

13  nursing; and

14         (d)  The remaining loan principal and accrued interest

15  shall be retired after the fourth year of nursing.

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17  In no case may payment for any nurse exceed $4,000 in any

18  12-month period.

19         (5)  Students receiving a nursing scholarship pursuant

20  to s. 240.4076 are not eligible to participate in the Nursing

21  Student Loan Forgiveness Program.

22         Section 3.  Subsections (2), (3), and (6) and

23  paragraphs (c) and (d) of subsection (4) of section 240.4076,

24  Florida Statutes, are amended to read:

25         240.4076  Nursing scholarship program.--

26         (2)  A scholarship applicant shall be enrolled as a

27  full-time or part-time student in the upper division of an

28  approved nursing program leading to the award of an associate

29  degree, a baccalaureate degree, or a graduate degree to

30  qualify for a nursing faculty position or as an advanced

31  registered nurse practitioner or be enrolled as a full-time or


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                              CS/CS/CS/HB 519, First Engrossed/ntc



  1  part-time student in an approved program leading to the award

  2  of an associate degree in nursing.

  3         (3)  A scholarship may be awarded for no more than 2

  4  years, in an amount not to exceed $8,000 per year. However,

  5  registered nurses pursuing a graduate degree for a faculty

  6  position or to practice as an advanced registered nurse

  7  practitioner may receive up to $12,000 per year. Beginning

  8  July 1, 1998, These amounts shall be adjusted by the amount of

  9  increase or decrease in the consumer price index for urban

10  consumers published by the United States Department of

11  Commerce.

12         (4)  Credit for repayment of a scholarship shall be as

13  follows:

14         (c)  Any recipient who does not complete an appropriate

15  program of studies, or who does not become licensed, who does

16  not accept employment as a nurse at an approved health care

17  facility, or who does not complete 12 months of approved

18  employment for each year of scholarship assistance received

19  shall repay to the Department of Health, on a schedule to be

20  determined by the department, the entire amount of the

21  scholarship plus 18 percent interest accruing from the date of

22  the scholarship payment. Moneys repaid shall be deposited into

23  the Nursing Student Loan Forgiveness Trust Fund established in

24  s. 240.4075.  However, the department may provide additional

25  time for repayment if the department finds that circumstances

26  beyond the control of the recipient caused or contributed to

27  the default.

28         (d)  Any recipient who does not accept employment as a

29  nurse at an approved health care facility or who does not

30  complete 12 months of approved employment for each year of

31  scholarship assistance received shall repay to the Department


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                              CS/CS/CS/HB 519, First Engrossed/ntc



  1  of Health an amount equal to two times the entire amount of

  2  the scholarship plus interest accruing from the date of the

  3  scholarship payment at the maximum allowable interest rate

  4  permitted by law.  Repayment shall be made within 1 year of

  5  notice that the recipient is considered to be in default.

  6  However, the department may provide additional time for

  7  repayment if the department finds that circumstances beyond

  8  the control of the recipient caused or contributed to the

  9  default.

10         (6)  The Department of Health shall adopt rules,

11  including rules to address extraordinary circumstances that

12  may cause a recipient to default on either the school

13  enrollment or employment contractual agreement, to implement

14  this section and may solicit technical assistance relating to

15  the conduct of this program from the Department of Health.

16         Section 4.  Sunshine Workforce Solutions Grant

17  Program.--

18         (1)  The Legislature recognizes the need for school

19  districts to be able to respond to critical workforce

20  shortages in nursing. The Sunshine Workforce Solutions Grant

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

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

23  with establishing an exploratory program in nursing at the

24  middle school level or a comprehensive career and technical

25  education program within a high school that provides a program

26  of study in nursing that will provide a seamless transition to

27  appropriate postsecondary education or employment.

28         (a)  A comprehensive career and technical education

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

30  in nursing must be certified or endorsed by the Florida Board

31  of Nursing to ensure that all components of the program are


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                              CS/CS/CS/HB 519, First Engrossed/ntc



  1  relevant and appropriate to prepare the student for further

  2  education and employment in nursing.

  3         (b)  For career and technical education programs in

  4  which high school credit is articulated to a related

  5  postsecondary education program, there must be an articulation

  6  agreement that ensures seamless transition from one level to

  7  the next without a loss of credit for the student.

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

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

10  required in career and technical education programs at the

11  high school level.

12         (2)  Funds awarded for a Sunshine Workforce Solutions

13  Grant may be used for instructional equipment, laboratory

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

15  expenses associated with the development of a program in

16  nursing.

17         (3)  The Department of Education shall accept

18  applications from middle schools and high schools for grants

19  under the Sunshine Workforce Solutions Grant Program.

20         (a)  Applications shall contain projected enrollments

21  and projected costs for the Sunshine Workforce Solutions

22  Grants.

23         (b)  Schools shall be selected based on existing

24  infrastructure that would ensure success of the program. The

25  department shall consider statewide geographic disbursement of

26  grant funds in ranking the applications.

27         (c)  Methods for evaluating the success of the grant

28  program, including student recruitment, retention, and program

29  completion, must be included in the application.

30         Section 5.  Subsections (1), (2), and (4) of section

31  464.009, Florida Statutes, are amended to read:


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                              CS/CS/CS/HB 519, First Engrossed/ntc



  1         464.009  Licensure by endorsement.--

  2         (1)  The department shall issue the appropriate license

  3  by endorsement to practice professional or practical nursing

  4  to an applicant who, upon applying to the department and

  5  remitting a fee set by the board not to exceed $100,

  6  demonstrates to the board that he or she:

  7         (a)  Holds a valid license to practice professional or

  8  practical nursing in another state or territory of the United

  9  States, provided that, when the applicant secured his or her

10  original license, the requirements for licensure were

11  substantially equivalent to or more stringent than those

12  existing in Florida at that time; or

13         (b)  Meets the qualifications for licensure in s.

14  464.008 and has successfully completed a state, regional, or

15  national examination which is substantially equivalent to or

16  more stringent than the examination given by the department;

17  or

18         (c)  Has actively practiced nursing in another state,

19  jurisdiction, or territory of the United States for 2 of the

20  preceding 3 years without having his or her license acted

21  against by the licensing authority of any jurisdiction.

22  Applicants who become licensed pursuant to this paragraph must

23  complete within 6 months after licensure a Florida laws and

24  rules course that is approved by the board. Once the

25  department has received the results of the national criminal

26  history check and has determined that the applicant has no

27  criminal history, the appropriate license by endorsement shall

28  be issued to the applicant. This paragraph is repealed July 1,

29  2004, unless reenacted by the Legislature.

30         (2)  Such examinations and requirements from other

31  states and territories of the United States shall be presumed


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                              CS/CS/CS/HB 519, First Engrossed/ntc



  1  to be substantially equivalent to or more stringent than those

  2  in this state.  Such presumption shall not arise until January

  3  1, 1980. However, the board may, by rule, specify states and

  4  territories the examinations and requirements of which shall

  5  not be presumed to be substantially equivalent to those of

  6  this state.

  7         (4)  The department shall not issue a license by

  8  endorsement to any applicant who is under investigation in

  9  another state, jurisdiction, or territory of the United States

10  for an act which would constitute a violation of this part or

11  chapter 456 until such time as the investigation is complete,

12  at which time the provisions of s. 464.018 shall apply.

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

14  Statutes, is amended, and subsections (6) and (7) are added to

15  said section, to read:

16         464.019  Approval of nursing programs.--

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

18  initial review and conditional approval of a program,

19  regarding educational objectives, faculty qualifications,

20  curriculum guidelines, administrative procedures, and clinical

21  training. An applicant institution shall comply with such

22  rules in order to obtain conditional program approval. No

23  program shall be considered fully approved, nor shall any

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

25  of the program's first class.

26         (b)  The board shall adopt rules regarding educational

27  objectives and curriculum guidelines as are necessary to grant

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

29  programs graduate nurses capable of competent practice under

30  this part. Rules regarding educational objectives shall

31  consider student attrition rate standards, availability of


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                              CS/CS/CS/HB 519, First Engrossed/ntc



  1  qualified faculty, and appropriate clinical training

  2  facilities. However, the board shall adopt no rule that

  3  prohibits a qualified institution from placing a student in a

  4  facility for clinical experience, regardless of whether more

  5  than one nursing program is using the same facility for

  6  clinical experience.

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

  8  suspension, and termination status of programs that fail to

  9  comply with the standards of this part.

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

11  number of students admitted to a nursing program, provided

12  appropriate faculty-to-student ratios are maintained, and

13  provided the board shall not enact any changes to

14  faculty-to-student ratios prior to 2004.

15         (6)  Any nursing program that maintains accreditation

16  through a nursing accrediting body recognized by the United

17  States Department of Education shall be exempt from the rules

18  of the board except as provided in paragraph (2)(b), provided

19  such exemption shall apply only to the extent the program

20  maintains a student pass rate on the National Clinical

21  Licensure Examination of not less than 10 percentage points

22  below the national average pass rate as reported annually by

23  the National Council of State Boards of Nursing.

24         (7)  If an institution's passing rate on the National

25  Clinical Licensure Examination drops below the standard

26  established in subsection (6) for 2 consecutive years, the

27  program must be reviewed by the board. The board may take

28  action to assist the program to return to compliance. Any

29  program having its approval rescinded shall have the right to

30  reapply.

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                              CS/CS/CS/HB 519, First Engrossed/ntc



  1         Section 7.  Subsection (8) of section 464.022, Florida

  2  Statutes, is amended to read:

  3         464.022  Exceptions.--No provision of this part shall

  4  be construed to prohibit:

  5         (8)  Any nurse currently licensed in another state or

  6  territory of the United States from performing nursing

  7  services in this state for a period of 60 days after

  8  furnishing to the employer satisfactory evidence of current

  9  licensure in another state or territory and having submitted

10  proper application and fees to the board for licensure prior

11  to employment.  The board may extend this time for

12  administrative purposes when necessary.

13         Section 8.  (1)  There is hereby appropriated from the

14  General Revenue Fund to the Department of Health for fiscal

15  year 2002-2003 the sum of $1 million. Moneys in this

16  appropriation shall be used by the Department of Health to

17  provide grants to hospitals for nurse retention and

18  out-of-state recruitment activities during the 2002-2003

19  fiscal year. These moneys are subject to a one-for-one match

20  from hospitals.

21         (2)  The Department of Health shall accept requests for

22  grants under this section beginning July 1, 2002. The

23  department shall determine grant amounts beginning December 1,

24  2002, once the amount of the appropriation in subsection (1)

25  that has been matched by additional moneys is determined and

26  the department can determine the amount of grant moneys

27  available.

28         (3)  The Department of Health shall by rule, pursuant

29  to ss. 120.536(1) and 120.54, Florida Statutes, adopt criteria

30  for grant awards. In addition to other criteria, the

31  department shall require that a hospital have experienced an


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                              CS/CS/CS/HB 519, First Engrossed/ntc



  1  average vacancy rate that exceeds the national average among

  2  nursing positions during the preceding 12 months. If the

  3  amount available for distribution is less than the aggregate

  4  amount of requests that meet the department's criteria, the

  5  department shall provide grants on a pro rata basis.

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

  7  law.

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