CS/CS/HB 1209

1
A bill to be entitled
2An act relating to nursing programs; amending s. 464.003,
3F.S.; revising the definition of the term "approved
4program" and defining terms for purposes of the Nurse
5Practice Act; amending s. 464.019, F.S.; revising
6provisions for the approval of nursing programs by the
7Board of Nursing; requiring institutions wishing to
8conduct a nursing program to submit a program application
9and pay a program review fee to the Department of Health;
10providing application requirements and procedures;
11providing standards for the approval of nursing programs;
12specifying that, upon the board's approval of a program
13application, the program becomes an approved program;
14providing that programs provisionally approved by the
15board, and certain programs on probationary status, as of
16a specified date are approved programs under the act;
17providing that certain programs on probationary status as
18of a specified date remain on probationary status;
19requiring such programs on probationary status to comply
20within a specified period with a requirement related to
21program graduate passage rates; requiring the board to
22terminate programs that do not comply; requiring approved
23programs to annually submit a report; specifying contents
24of annual reports; providing for denial of program
25applications; providing procedures for processing
26incomplete program applications; requiring the board to
27provide a notice of intent to deny a program application
28that does not document compliance with certain standards;
29authorizing an administrative hearing for review of a
30notice of intent to deny an application; requiring the
31board to publish on its Internet website certain data
32about nursing programs; requiring that a nursing program
33be placed on probation under certain circumstances;
34requiring programs placed on probation to disclose certain
35information to students and applicants; requiring the
36board to terminate a nursing program under certain
37circumstances; requiring a nursing program that closes to
38notify the board of certain information; specifying that
39the board, with certain exceptions, does not have
40rulemaking authority to administer the act; specifying
41that the board may not impose any condition or requirement
42on program approval or retention except as expressly
43provided in the act; requiring the board to repeal certain
44rules in existence as of a specified date; requiring the
45Florida Center for Nursing and the Office of Program
46Policy Analysis and Government Accountability to conduct a
47study and submit reports to the Governor and Legislature;
48providing an effective date.
49
50Be It Enacted by the Legislature of the State of Florida:
51
52     Section 1.  Subsection (8) of section 464.003, Florida
53Statutes, is amended, and subsections (9) through (14) are added
54to that section, to read:
55     464.003  Definitions.--As used in this part, the term:
56     (8)  "Approved program" means a nursing program conducted
57in a school, college, or university which is approved under by
58the board pursuant to s. 464.019 for the education of nurses.
59     (9)  "Clinical training" means direct nursing care
60experiences with patients or clients which offer the student the
61opportunity to integrate, apply, and refine specific skills and
62abilities based on theoretical concepts and scientific
63principles.
64     (10)  "Clinical preceptor" means a registered nurse
65employed by a clinical training facility who serves as a role
66model and clinical resource person for a specified period to an
67individual enrolled in an approved program.
68     (11)  "Clinical simulation" means a strategy used to
69replicate clinical practice as closely as possible to teach
70theory, assessment, technology, pharmacology, and skills.
71     (12)  "Community-based clinical experience" means
72activities consistent with the curriculum and involving
73individuals, families, and groups with the intent of promoting
74wellness, maintaining health, and preventing illness.
75     (13)  "Curriculum" means a planned sequence of course
76offerings and learning experiences that comprise a nursing
77education program.
78     (14)  "Probationary status" means the status of a nursing
79education program that is subject to s. 464.019(2)(a)2. or
80(5)(a) or (b).
81     Section 2.  Section 464.019, Florida Statutes, is amended
82to read:
83(Substantial rewording of section. See
84s. 464.019, F.S., for present text.)
85     464.019  Approval of nursing programs.--
86     (1)  An institution that wishes to conduct a program for
87the education of professional or practical nurses shall submit a
88program application and a program review fee of $1,000 to the
89department. Within 90 days after receipt of a program
90application and program review fee, the board shall approve the
91program application if it documents compliance with the
92standards in paragraphs (a)-(h). If the program application is
93incomplete or does not document compliance, the board shall
94follow the procedures in subsection (3). Each program
95application must document that:
96     (a)  For a professional nursing program, the program
97director and at least 50 percent of the program's faculty
98members are registered nurses who have, at a minimum, a
99bachelor's degree in nursing and a master's degree in nursing or
100a related field.
101     (b)  For a practical nursing program, the program director
102and at least 50 percent of the program's faculty members are
103registered nurses who have, at a minimum, a bachelor's degree in
104nursing.
105     (c)  The program's nursing major curriculum consists of at
106least:
107     1.  Fifty percent clinical training for a practical nursing
108program, an associate degree professional nursing program, or a
109professional diploma nursing program.
110     2.  Forty percent clinical training for a bachelor's degree
111professional nursing program.
112     (d)  No more than 25 percent of the program's clinical
113training consists of clinical simulation.
114     (e)  The program has signed agreements with each agency,
115facility, and organization included in the curriculum plan as
116clinical training sites and community-based clinical experience
117sites.
118     (f)  The program has written policies for faculty which
119include provisions for direct or indirect supervision by program
120faculty or clinical preceptors for students in clinical training
121consistent with the following standards:
122     1.  The number of program faculty members equals at least
123one faculty member directly supervising every 12 students unless
124the written agreement between the program and the agency,
125facility, or organization providing clinical training sites
126allows more students, not to exceed 18 students, to be directly
127supervised by one program faculty member.
128     2.  For a hospital setting, indirect supervision may occur
129only if there is direct supervision by an assigned clinical
130preceptor, a supervising program faculty member is available by
131telephone, and such arrangement is approved by the clinical
132facility.
133     3.  For community-based clinical experiences that involve
134student participation in invasive or complex nursing activities,
135students must be directly supervised by a program faculty member
136or clinical preceptor and such arrangement must be approved by
137the community-based clinical facility.
138     4.  For community-based clinical experiences not subject to
139subparagraph 3., indirect supervision may occur only when a
140supervising program faculty member is available to the student
141by telephone.
142     (g)  The professional or practical nursing curriculum plan
143documents clinical experience and theoretical instruction in
144medical, surgical, obstetric, pediatric, and geriatric nursing.
145A professional nursing curriculum plan shall also document
146clinical experience and theoretical instruction in psychiatric
147nursing. Each curriculum plan must document clinical training
148experience in appropriate settings that include, but are not
149limited to, acute care, long-term care, and community settings.
150     (h)  The professional or practical nursing program provides
151theoretical instruction and clinical application in personal,
152family, and community health concepts; nutrition; human growth
153and development throughout the life span; body structure and
154function; interpersonal relationship skills; mental health
155concepts; pharmacology and administration of medications; and
156legal aspects of practice. A professional nursing program shall
157also provide theoretical instruction and clinical application in
158interpersonal relationships and leadership skills; professional
159role and function; and health teaching and counseling skills.
160
161Upon the board's approval of a program application, the program
162becomes an approved program under this section.
163     (2)(a)  A professional or practical nursing program that,
164as of June 30, 2009:
165     1.  Has full or provisional approval from the board or is
166on probationary status, except as provided in subparagraph 2.,
167becomes an approved program under this section. In order to
168retain approved program status, such program shall submit the
169report required under paragraph (c) to the board by November 1,
1702009, and annually thereafter.
171     2.  Is on probationary status because the program did not
172meet the board's requirement for program graduate passage rates
173on the National Council of State Boards of Nursing Licensing
174Examination, shall remain on probationary status until the
175program achieves compliance with the program graduate passage
176rate requirement in paragraph (5)(a). A program that is subject
177to this subparagraph must submit the report required under
178paragraph (c) to the board by November 1, 2009, and annually
179thereafter and must comply with paragraph (5)(c). If the program
180does not achieve compliance by July 1, 2011, the board shall
181terminate the program as provided in paragraph (5)(d).
182     (b)  Each professional or practical nursing program that
183has its application approved by the board under subsection (1)
184on or after July 1, 2009, shall annually submit the report
185required under paragraph (c) to the board by November 1 of each
186year following initial approval of its application.
187     (c)  The annual report required by this subsection must
188include an affidavit certifying continued compliance with
189subsection (1), must provide a summary description of the
190program's compliance with subsection (1), and must document for
191the previous academic year for each professional and practical
192nursing program:
193     1.  The number of student applications received, the number
194of qualified applicants, and the number of students accepted.
195     2.  The number of program graduates.
196     3.  The program's graduate passage rate on the National
197Council of State Boards of Nursing Licensing Examination.
198     4.  The program's retention rates for students tracked from
199program entry to graduation.
200     5.  The program's accreditation status, including
201identification of the accrediting body.
202     (3)(a)  If an institution's program application is
203incomplete, the board shall notify the institution of any
204apparent errors or omissions within 30 days after receipt of the
205application and follow the procedures in s. 120.60.
206     (b)  If an institution's program application does not
207document compliance with the standards in subsection (1), within
20890 days after the board's receipt of the program application,
209the board shall provide the institution with a notice of intent
210to deny the program application that sets forth written reasons
211for the denial. The institution may request a hearing on the
212notice of intent to deny the program application pursuant to
213chapter 120.
214     (4)  The board shall publish on its Internet website data
215on nursing programs located in the state. The data shall
216include:
217     (a)  All documentation provided by the applicant for each
218approved nursing program application submitted on or after July
2191, 2009.
220     (b)  The summary description of each program's compliance
221as submitted under paragraph (2)(c).
222     (c)  A comprehensive list of each practical and
223professional nursing program in the state.
224     (d)  The accreditation status for each program, including
225identification of the accrediting body.
226     (e)  Each program's approval or probationary status.
227     (f)  Each program's graduate passage rate on the National
228Council of State Boards of Nursing Licensing Examination.
229     (g)  The national average for passage rates on the National
230Council of State Boards of Nursing Licensing Examination.
231     (h)  Each program's retention rates for students tracked
232from program entry to graduation.
233
234The data required to be published under this subsection shall be
235made available in a manner that allows interactive searches and
236comparisons of specific nursing education programs. The board
237shall publish the data by December 31, 2009, and update the
238Internet website at least quarterly with the available data.
239     (5)(a)  If the program's graduate passage rate on the
240National Council of State Boards of Nursing Licensing
241Examination falls 10 percent or more below the national average,
242as published by the contract testing service of the National
243Council of State Boards of Nursing, for 2 consecutive years, the
244program shall be placed on probation and the program director
245shall be required to appear before the board to present a plan
246for remediation. The program must achieve compliance with the
247graduate passage rate in this paragraph within the next 2
248consecutive years.
249     (b)  If a program fails to submit the annual report
250required in subsection (2), the board shall place the program on
251probation. The program must submit the annual report within 6
252months after the program is placed on probation.
253     (c)  A program placed on probationary status shall disclose
254its probationary status in writing to the program's students and
255applicants.
256     (d)  The board shall terminate a program that fails to
257comply with subparagraph (2)(a)2., paragraph (a), or paragraph
258(b) pursuant to chapter 120.
259     (6)  A nursing program that closes shall notify the board
260in writing and advise the board of the arrangements for storage
261of permanent records.
262     (7)  The board does not have any rulemaking authority to
263administer this section, except that the board shall adopt a
264rule that prescribes the format for submitting program
265applications under subsection (1) and submitting summary
266descriptions of program compliance under paragraph (2)(c). The
267board may not impose any condition or requirement on an
268institution submitting a program application, an approved
269program, or a program on probationary status except as expressly
270provided in this section. The board shall repeal all rules, or
271portions thereof, in existence on July 1, 2009, that are
272inconsistent with this subsection.
273     (8)  The Florida Center for Nursing and the Office of
274Program Policy Analysis and Government Accountability shall
275each:
276     (a)  Monitor the administration of this section and
277evaluate the effectiveness of this section in achieving quality
278nursing programs with a higher production of quality nursing
279graduates.
280     (b)  Report its findings and make recommendations, if
281warranted, to improve the effectiveness of this section to the
282Governor, the President of the Senate, and the Speaker of the
283House of Representatives by February 1, 2010.
284     (9)  The Florida Center for Nursing and the education
285policy area of the Office of Program Policy Analysis and
286Government Accountability shall jointly study the 5-year
287administration of this section and submit a report to the
288Governor, the President of the Senate, and the Speaker of the
289House of Representatives by January 30, 2011, and annually
290thereafter through January 30, 2015. Each annual report shall
291address the previous academic year and shall include data and
292analysis on the following measures for each practical and
293professional nursing program in the state, as such data becomes
294available:
295     (a)  An evaluation of the program application approval
296process, including, but not limited to, the number of program
297applications submitted under subsection (1); the number of
298program applications approved and denied by the board under
299subsections (1) and (3), respectively; the number of denials of
300program applications reviewed under chapter 120; and a
301description of the outcomes of those reviews.
302     (b)  An evaluation as to whether nursing program
303availability has increased in the state and the quality of
304nurses produced by these programs, including, but not limited
305to:
306     1.  The number of programs and student slots available.
307     2.  The number of student applications submitted, the
308number of qualified applicants, and the number of students
309accepted.
310     3.  The number of program graduates.
311     4.  Program retention rates of students tracked from
312program entry to graduation.
313     5.  Graduate passage rates on the National Council of State
314Boards of Nursing Licensing Examination.
315     6.  The number of graduates who become employed as
316practical or professional nurses in the state.
317     (c)  An evaluation of compliance with this section,
318including, but not limited to, the number of programs placed on
319probationary status, the number of programs terminated by the
320board under paragraph (5)(d), the number of terminations
321reviewed under chapter 120, and a description of the outcomes of
322those reviews.
323     Section 3.  This act shall take effect July 1, 2009.


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