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 certain nursing programs to submit a program
9application and pay a program review fee to the Department
10of Health; specifying that a program application is deemed
11approved if the board does not act within specified
12timeframes; providing application requirements and
13procedures; providing standards for the approval of
14nursing programs; specifying that, upon the board's
15approval of a program application, the program becomes an
16approved program; providing that programs provisionally
17approved by the board, and certain programs on
18probationary status, as of a specified date are approved
19programs under the act; providing that certain programs on
20probationary status as of a specified date remain on
21probationary status; requiring such programs on
22probationary status to comply within a specified period
23with a requirement related to program graduate passage
24rates; requiring the board to terminate programs that do
25not comply; requiring approved programs to annually submit
26a report; specifying contents of annual reports; providing
27for denial of program applications; providing procedures
28for processing incomplete program applications; requiring
29the board to provide a notice of intent to deny a program
30application that does not document compliance with certain
31standards; authorizing an administrative hearing for
32review of a notice of intent to deny an application;
33requiring the board to publish on its Internet website
34certain data about nursing programs; requiring that a
35nursing program be placed on probation under certain
36circumstances; requiring programs placed on probation to
37disclose certain information to students and applicants;
38requiring the board to terminate a nursing program under
39certain circumstances; requiring a nursing program that
40closes to notify the board of certain information;
41specifying that the board, with certain exceptions, does
42not have rulemaking authority to administer the act;
43specifying that the board may not impose any condition or
44requirement on program approval or retention except as
45expressly provided in the act; requiring the board to
46repeal certain rules in existence as of a specified date;
47requiring the Florida Center for Nursing and the Office of
48Program Policy Analysis and Government Accountability to
49conduct studies and submit reports to the Governor and
50Legislature; providing an effective date.
51
52Be It Enacted by the Legislature of the State of Florida:
53
54     Section 1.  Subsection (8) of section 464.003, Florida
55Statutes, is amended, and subsections (9) through (14) are added
56to that section, to read:
57     464.003  Definitions.--As used in this part, the term:
58     (8)  "Approved program" means a nursing program conducted
59in a school, college, or university which is approved under by
60the board pursuant to s. 464.019 for the education of nurses.
61     (9)  "Clinical training" means direct nursing care
62experiences with patients or clients which offer the student the
63opportunity to integrate, apply, and refine specific skills and
64abilities based on theoretical concepts and scientific
65principles.
66     (10)  "Clinical preceptor" means a registered nurse
67employed by a clinical training facility who serves as a role
68model and clinical resource person for a specified period to an
69individual enrolled in an approved program.
70     (11)  "Clinical simulation" means a strategy used to
71replicate clinical practice as closely as possible to teach
72theory, assessment, technology, pharmacology, and skills.
73     (12)  "Community-based clinical experience" means
74activities consistent with the curriculum and involving
75individuals, families, and groups with the intent of promoting
76wellness, maintaining health, and preventing illness.
77     (13)  "Curriculum" means a planned sequence of course
78offerings and learning experiences that comprise a nursing
79education program.
80     (14)  "Probationary status" means the status of a nursing
81education program that is subject to s. 464.019(2)(a)2. or
82(5)(a) or (b).
83     Section 2.  Section 464.019, Florida Statutes, is amended
84to read:
85(Substantial rewording of section. See
86s. 464.019, F.S., for present text.)
87     464.019  Approval of nursing programs.--
88     (1)  An institution that wishes to conduct a program for
89the prelicensure education of professional or practical nurses
90shall submit a program application and a program review fee of
91$1,000 to the department. Within 90 days after receipt of a
92program application and program review fee, the board shall
93approve the program application if it documents compliance with
94the standards in paragraphs (a)-(h). If the program application
95is incomplete or does not document compliance, the board shall
96follow the procedures in subsection (3). A program application
97is deemed approved by the board if the board does not act on the
98application within the timeframes specified in subsection (3) or
99this subsection. Each program application must document that:
100     (a)  For a professional nursing program, the program
101director and at least 50 percent of the program's faculty
102members are registered nurses who have, at a minimum, a
103bachelor's degree in nursing and a master's degree in nursing or
104a related field.
105     (b)  For a practical nursing program, the program director
106and at least 50 percent of the program's faculty members are
107registered nurses who have, at a minimum, a bachelor's degree in
108nursing.
109     (c)  The program's nursing major curriculum consists of at
110least:
111     1.  Fifty percent clinical training for a practical nursing
112program, an associate degree professional nursing program, or a
113professional diploma nursing program.
114     2.  Forty percent clinical training for a bachelor's degree
115professional nursing program.
116     (d)  No more than 25 percent of the program's clinical
117training consists of clinical simulation.
118     (e)  The program has signed agreements with each agency,
119facility, and organization included in the curriculum plan as
120clinical training sites and community-based clinical experience
121sites.
122     (f)  The program has written policies for faculty which
123include provisions for direct or indirect supervision by program
124faculty or clinical preceptors for students in clinical training
125consistent with the following standards:
126     1.  The number of program faculty members equals at least
127one faculty member directly supervising every 12 students unless
128the written agreement between the program and the agency,
129facility, or organization providing clinical training sites
130allows more students, not to exceed 18 students, to be directly
131supervised by one program faculty member.
132     2.  For a hospital setting, indirect supervision may occur
133only if there is direct supervision by an assigned clinical
134preceptor, a supervising program faculty member is available by
135telephone, and such arrangement is approved by the clinical
136facility.
137     3.  For community-based clinical experiences that involve
138student participation in invasive or complex nursing activities,
139students must be directly supervised by a program faculty member
140or clinical preceptor and such arrangement must be approved by
141the community-based clinical facility.
142     4.  For community-based clinical experiences not subject to
143subparagraph 3., indirect supervision may occur only when a
144supervising program faculty member is available to the student
145by telephone.
146     (g)  The professional or practical nursing curriculum plan
147documents clinical experience and theoretical instruction in
148medical, surgical, obstetric, pediatric, and geriatric nursing.
149A professional nursing curriculum plan shall also document
150clinical experience and theoretical instruction in psychiatric
151nursing. Each curriculum plan must document clinical training
152experience in appropriate settings that include, but are not
153limited to, acute care, long-term care, and community settings.
154     (h)  The professional or practical nursing program provides
155theoretical instruction and clinical application in personal,
156family, and community health concepts; nutrition; human growth
157and development throughout the life span; body structure and
158function; interpersonal relationship skills; mental health
159concepts; pharmacology and administration of medications; and
160legal aspects of practice. A professional nursing program shall
161also provide theoretical instruction and clinical application in
162interpersonal relationships and leadership skills; professional
163role and function; and health teaching and counseling skills.
164
165Upon the board's approval of a program application, the program
166becomes an approved program under this section.
167     (2)(a)  A professional or practical nursing program that,
168as of June 30, 2009:
169     1.  Has full or provisional approval from the board or is
170on probationary status, except as provided in subparagraph 2.,
171becomes an approved program under this section. In order to
172retain approved program status, such program shall submit the
173report required under paragraph (c) to the board by November 1,
1742009, and annually thereafter.
175     2.  Is on probationary status because the program did not
176meet the board's requirement for program graduate passage rates
177on the National Council of State Boards of Nursing Licensing
178Examination, shall remain on probationary status until the
179program achieves compliance with the program graduate passage
180rate requirement in paragraph (5)(a). A program that is subject
181to this subparagraph must submit the report required under
182paragraph (c) to the board by November 1, 2009, and annually
183thereafter and must comply with paragraph (5)(c). If the program
184does not achieve compliance by July 1, 2011, the board shall
185terminate the program as provided in paragraph (5)(d).
186     (b)  Each professional or practical nursing program that
187has its application approved by the board under subsection (1)
188on or after July 1, 2009, shall annually submit the report
189required under paragraph (c) to the board by November 1 of each
190year following initial approval of its application.
191     (c)  The annual report required by this subsection must
192include an affidavit certifying continued compliance with
193subsection (1), must provide a summary description of the
194program's compliance with subsection (1), and must document for
195the previous academic year for each professional and practical
196nursing program:
197     1.  The number of student applications received, the number
198of qualified applicants, and the number of students accepted.
199     2.  The number of program graduates.
200     3.  The program's graduate passage rate on the National
201Council of State Boards of Nursing Licensing Examination.
202     4.  The program's retention rates for students tracked from
203program entry to graduation.
204     5.  The program's accreditation status, including
205identification of the accrediting body.
206     (3)(a)  If an institution's program application is
207incomplete, the board shall notify the institution of any
208apparent errors or omissions within 30 days after receipt of the
209application and follow the procedures in s. 120.60.
210     (b)  If an institution's program application does not
211document compliance with the standards in subsection (1), within
21290 days after the board's receipt of the program application,
213the board shall provide the institution with a notice of intent
214to deny the program application that sets forth written reasons
215for the denial. The institution may request a hearing on the
216notice of intent to deny the program application pursuant to
217chapter 120.
218     (4)  The board shall publish on its Internet website data
219on nursing programs located in the state. The data shall
220include:
221     (a)  All documentation provided by the applicant for each
222approved nursing program application submitted on or after July
2231, 2009.
224     (b)  The summary description of each program's compliance
225as submitted under paragraph (2)(c).
226     (c)  A comprehensive list of each practical and
227professional nursing program in the state.
228     (d)  The accreditation status for each program, including
229identification of the accrediting body.
230     (e)  Each program's approval or probationary status.
231     (f)  Each program's graduate passage rate on the National
232Council of State Boards of Nursing Licensing Examination.
233     (g)  The national average for passage rates on the National
234Council of State Boards of Nursing Licensing Examination.
235     (h)  Each program's retention rates for students tracked
236from program entry to graduation.
237
238The data required to be published under this subsection shall be
239made available in a manner that allows interactive searches and
240comparisons of specific nursing education programs. The board
241shall publish the data by December 31, 2009, and update the
242Internet website at least quarterly with the available data.
243     (5)(a)  If a professional or practical nursing program's
244average graduate passage rate for first-time test takers on the
245National Council of State Boards of Nursing Licensing
246Examination falls 10 percent or more below the national average
247passage rate for first-time test takers educated in the United
248States, as annually published by the contract testing service of
249the National Council of State Boards of Nursing, for 2
250consecutive calendar years, the board shall place the program on
251probation and the program director shall be required to appear
252before the board to present a plan for remediation. The program
253shall remain on probationary status until it achieves compliance
254with the graduate passage rate requirement and shall be
255terminated by the board under paragraph (d) if the program does
256not achieve compliance within 2 calendar years.
257     (b)  If a program fails to submit the annual report
258required in subsection (2), the board shall place the program on
259probation. The program shall remain on probationary status until
260it submits the annual report and shall be terminated by the
261board under paragraph (d) if it does not submit the annual
262report within 6 months after the report's due date.
263     (c)  A program placed on probationary status shall disclose
264its probationary status in writing to the program's students and
265applicants.
266     (d)  The board shall terminate a program that fails to
267comply with subparagraph (2)(a)2., paragraph (a), or paragraph
268(b) pursuant to chapter 120.
269     (6)  A nursing program that closes shall notify the board
270in writing and advise the board of the arrangements for storage
271of permanent records.
272     (7)  The board does not have any rulemaking authority to
273administer this section, except that the board shall adopt a
274rule that prescribes the format for submitting program
275applications under subsection (1) and submitting summary
276descriptions of program compliance under paragraph (2)(c). The
277board may not impose any condition or requirement on an
278institution submitting a program application, an approved
279program, or a program on probationary status except as expressly
280provided in this section. The board shall repeal all rules, or
281portions thereof, in existence on July 1, 2009, that are
282inconsistent with this subsection.
283     (8)  The Florida Center for Nursing and the Office of
284Program Policy Analysis and Government Accountability shall
285each:
286     (a)  Monitor the administration of this section and
287evaluate the effectiveness of this section in achieving quality
288nursing programs with a higher production of quality nursing
289graduates.
290     (b)  Report its findings and make recommendations, if
291warranted, to improve the effectiveness of this section to the
292Governor, the President of the Senate, and the Speaker of the
293House of Representatives by February 1, 2010.
294     (9)  The Florida Center for Nursing and the education
295policy area of the Office of Program Policy Analysis and
296Government Accountability shall study the 5-year administration
297of this section and submit reports to the Governor, the
298President of the Senate, and the Speaker of the House of
299Representatives by January 30, 2011, and annually thereafter
300through January 30, 2015. The annual reports shall address the
301previous academic year; set forth data on the measures specified
302in paragraphs (a) and (b) for each prelicensure practical and
303professional nursing program in the state, as such data becomes
304available; and include an evaluation of such data for purposes
305of determining whether this section is increasing the
306availability of nursing programs and the production of quality
307nurses.
308     (a)  The education policy area of the Office of Program
309Policy Analysis and Government Accountability shall evaluate
310program-specific data including, but not limited to:
311     1.  The number of nursing education programs and student
312slots available.
313     2.  The number of student applications submitted, the
314number of qualified applicants, and the number of students
315accepted.
316     3.  The number of program graduates.
317     4.  Program retention rates of students tracked from
318program entry to graduation.
319     5.  Graduate passage rates on the National Council of State
320Boards of Nursing Licensing Examination.
321     6.  The number of graduates who become employed as
322practical or professional nurses in the state.
323     (b)  The Florida Center for Nursing shall evaluate the
324board's implementation of the:
325     1.  Program application approval process, including, but
326not limited to, the number of program applications submitted
327under subsection (1); the number of program applications
328approved and denied by the board under subsections (1) and (3);
329the number of denials of program applications reviewed under
330chapter 120; and a description of the outcomes of those reviews.
331     2.  Probation and termination processes, including, but not
332limited to, the number of programs placed on probationary
333status, the number of programs terminated by the board under
334paragraph (5)(d), the number of terminations reviewed under
335chapter 120, and a description of the outcomes of those reviews.
336     Section 3.  This act shall take effect July 1, 2009.


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