Florida Senate - 2009 CS for SB 2284 By the Committee on Higher Education; and Senator Haridopolos 589-04054-09 20092284c1 1 A bill to be entitled 2 An act relating to nursing programs; amending s. 3 464.003, F.S.; providing definitions; amending s. 4 464.019, F.S.; providing an approval process for 5 practical and professional nursing programs; requiring 6 a program application and fee; specifying a timeframe 7 within which the Board of Nursing must approve the 8 application or issue a notice of intent to deny; 9 specifying the standards each program application must 10 document; providing that an approved program 11 application constitutes an approved nursing program; 12 providing that programs approved by the board or on 13 specified probationary status on a specified date 14 retain approval status; providing conditions in which 15 a nursing program may remain on probationary status; 16 requiring programs to annually submit an affidavit 17 certifying specified compliance and a report to the 18 board; authorizing an applicant to respond to a notice 19 of intent to deny an application; requiring the board 20 to issue a notice indicating its approval or 21 disapproval of the program application; providing 22 administrative review for applications that are 23 denied; requiring the board to publish specified 24 information about nursing programs on its website; 25 providing criteria for a program’s placement on 26 probation; requiring programs placed on probation to 27 disclose this status to students and applicants; 28 authorizing the board to terminate a program under 29 specified circumstances; requiring a nursing program 30 that closes to notify the board of specified record 31 storage; providing that the board does not have any 32 rulemaking authority; requiring the Florida Center for 33 Nursing and Office of Program Policy Analysis and 34 Government Accountability to evaluate and report on 35 the administration of the act; specifying required 36 report contents; providing an effective date. 37 38 Be It Enacted by the Legislature of the State of Florida: 39 40 Section 1. Subsection (8) of section 464.003, Florida 41 Statutes, is amended, and subsections (9) through (15) are added 42 to that section, to read: 43 464.003 Definitions.—As used in this part, the term: 44 (8) “Approved program” means a nursing program conducted in 45 a school, college, or university which is approved underby the46board pursuant tos. 464.019 for the education of nurses. 47 (9) “Clinical training” means direct nursing care 48 experiences with patients or clients which offer the student the 49 opportunity to integrate, apply, and refine specific skills and 50 abilities that are based on theoretical concepts and scientific 51 principles. 52 (10) “Clinical preceptor” means a registered nurse employed 53 by the clinical training facility who serves as a role model and 54 clinical resource person for a specified period of time to an 55 individual enrolled in an approved nursing education program. 56 (11) “Clinical simulation” means a strategy used to 57 replicate clinical practice as closely as possible to teach 58 theory, assessment, technology, pharmacology, and skills. 59 (12) “Community-based clinical experience” means activities 60 consistent with the curriculum and involving individuals, 61 families, and groups with the intent to promote wellness, 62 maintain health and prevent illness. Structured nursing services 63 are not available, and invasive procedures may not be performed 64 at sites used for community-based clinical experiences. 65 (13) “Curriculum” means the planned sequence of course 66 offerings and learning experiences that comprise the nursing 67 education program. 68 (14) “Probationary status” means a nursing education 69 program subject to s. 464.019(2)(a)2., s. 464.019 (5)(a), or s. 70 464.019 (5)(b). 71 Section 2. Section 464.019, Florida Statutes, is amended to 72 read: 73 (Substantial rewording of section. See 74 s. 464.019, F.S., for present text.) 75 464.019 Approval of nursing programs.— 76 (1) An institution that wishes to conduct a program for the 77 education of professional or practical nurses shall submit a 78 program application and a program review fee of $1,000 to the 79 department. Within 90 days after receipt of a program 80 application and fee, the board shall approve a program 81 application that documents compliance with the standards in 82 paragraphs (a)-(h) or shall issue a notice of intent to deny 83 under subsection (3). Each program application must document 84 that: 85 (a) The program director and at least 50 percent of the 86 faculty members for a professional nursing program are 87 registered nurses who have, at a minimum, a bachelor’s degree in 88 nursing and a master’s degree in nursing or a related field. 89 (b) The program director and at least 50 percent of the 90 faculty members for a practical nursing program are registered 91 nurses who have, at a minimum, a bachelor’s degree in nursing. 92 (c) At least 50 percent of the program’s professional or 93 practical nursing major curriculum consists of clinical 94 training. 95 (d) No more than 25 percent of the program’s clinical 96 training consists of clinical simulation. 97 (e) The program has signed agreements with each agency, 98 facility, and organization included in the curriculum plan as 99 clinical training sites and community-based clinical experience 100 sites. 101 (f) The program has written policies for faculty which 102 include provisions for direct or indirect supervision by program 103 faculty or clinical preceptors for students in clinical training 104 consistent with the following standards: 105 1. The number of program faculty members equals at least 106 one faculty member directly supervising every 12 students unless 107 the written agreement between the program and the agency, 108 facility, or organization providing clinical training sites 109 allow more students, up to 18, to be directly supervised by one 110 program faculty member. 111 2. For a hospital setting, indirect supervision may occur 112 only if there is direct supervision by an assigned clinical 113 preceptor; a supervising program faculty member is available by 114 telephone; and such arrangement is approved by the clinical 115 facility. 116 3. For community-based clinical experiences that involve 117 student participation in invasive or complex nursing activities, 118 students must be directly supervised by a program faculty member 119 or clinical preceptor, and such arrangement must be approved by 120 the community-based clinical facility. 121 4. For community-based clinical experiences not subject to 122 subparagraph 3., indirect supervision may occur only when a 123 supervising program faculty member is available to the student 124 by telephone. 125 (g) The professional or practical nursing curriculum plan 126 documents clinical experience and theoretical instruction in 127 medical, surgical, obstetric, pediatric, and geriatric nursing. 128 A professional nursing curriculum plan shall also document 129 clinical experience and theoretical instruction in psychiatric 130 nursing. Each curriculum plan must document clinical training 131 experience in appropriate settings that include, but are not 132 limited to, acute care, long-term care, and community settings. 133 (h) The professional or practical nursing program provides 134 theoretical instruction and clinical application in personal, 135 family, and community health concepts; nutrition; human growth 136 and development throughout the life span; body structure and 137 function; interpersonal relationship skills; mental health 138 concepts; pharmacology and administration of medications; and 139 legal aspects of practice. A professional nursing program shall 140 also provide theoretical instruction and clinical application in 141 interpersonal relationships and leadership skills; professional 142 role and function; and health teaching and counseling skills. 143 144 An approved program application shall constitute an approved 145 nursing program. 146 (2)(a) A professional or practical nursing program that: 147 1. Has full or provisional approval from the board or that 148 is on probationary status, as of June 30, 2009, except as 149 provided in subparagraph 2., shall be considered approved under 150 this section. In order to retain approved status, such program 151 shall submit the report required under paragraph (c) to the 152 board by November 1, 2009, and annually thereafter. 153 2. Is on probationary status as of June 30, 2009, because 154 it did not meet the board’s requirement for program graduate 155 pass rates on the National Council of State Boards of Nursing 156 Licensing Examination, shall remain on probationary status until 157 it achieves compliance with the program graduate pass rate 158 requirement in paragraph (5)(a). Such program must achieve 159 compliance within 2 consecutive years after the date it was 160 placed on probation by the board. A program that is subject to 161 this subparagraph must submit the report required under 162 paragraph (c) to the board by November 1, 2009, and annually 163 thereafter; and comply with paragraph (5)(c). If the program 164 does not achieve compliance within the timeframe specified by 165 this subparagraph, it shall be terminated by the board as 166 provided in paragraph (5)(d). 167 (b) Each professional or practical nursing program that has 168 its application approved by the board under subsection (1) on or 169 after July 1, 2009, shall annually submit the report required 170 under paragraph (c) to the board by November 1 of each year 171 following initial approval of its application. 172 (c) The annual report required by this subsection must 173 include an affidavit certifying continued compliance with 174 paragraphs (1)(a)-(h) and must document for the prior academic 175 year for each professional and practical nursing program: 176 1. The number of student applications received, the number 177 of qualified applicants, and the number of students accepted. 178 2. The number of program graduates. 179 3. The program’s graduate pass rate for the National 180 Council of State Boards of Nursing Licensing Examination. 181 4. The program’s retention rates for students followed from 182 program entry to graduation. 183 5. The program’s accreditation status, including 184 identification of the accrediting body. 185 (3) If the board determines that the program application 186 does not document compliance with the standards in paragraphs 187 (1)(a)-(h), the board shall provide the applicant with a notice 188 of intent to deny which shall set forth written reasons for the 189 denial. Within 30 days after receipt of the notice of intent to 190 deny, the applicant may submit to the board documentation 191 rebutting the board’s reasons for denial. Within 30 days after 192 receipt of such documentation from an applicant, the board shall 193 issue a notice indicating its approval or denial of the program 194 application. An applicant may request a hearing on the denial of 195 its program application pursuant to chapter 120. 196 (4) The board shall publish data on nursing programs 197 located in this state on its Internet website. The data shall 198 include all documentation provided by the applicant for each 199 approved nursing program application; a comprehensive list of 200 each practical and professional nursing program in the state; 201 the accreditation status for each program, including 202 identification of the accrediting body; each program’s approval 203 or probationary status; each program’s graduate pass rate for 204 the National Council of State Boards of Nursing Licensing 205 Examination; the national average pass rate for the National 206 Council of State Boards of Nursing Licensing Examination; and 207 each program’s student retention rates, from program entry to 208 graduation. This information shall be made available in a manner 209 that allows interactive searches and comparisons of specific 210 programs. This information shall be published by December 31, 211 2009, and updated at least quarterly. 212 (5)(a) If the program’s graduate pass rate on the National 213 Council of State Boards of Nursing Licensing Examination falls 214 10 percent or more below the national average, as published by 215 the contract testing service of the National Council of State 216 Boards of Nursing, for 2 consecutive years, the program shall be 217 placed on probation, and the program director shall be required 218 to appear before the board to present a plan for remediation. 219 The program must achieve compliance with the graduate pass rate 220 in this paragraph within the next 2 consecutive years. 221 (b) If a program fails to submit the annual report required 222 in subsection (2), the program shall be placed on probation. The 223 program must submit the annual report or document compliance, as 224 appropriate, within 6 months after its is placed on probation. 225 (c) A program placed on probationary status shall disclose 226 this status in writing to its students and applicants. 227 (d) The board shall terminate a program that fails to 228 comply with subparagraph (2)(a)2., paragraph (a), or paragraph 229 (b) pursuant to chapter 120. 230 (6) A nursing program that closes shall notify the board in 231 writing and advise the board of the arrangements for storage of 232 permanent records. 233 (7) The board does not have any rulemaking authority to 234 administer this section. 235 (8) Beginning July 1, 2009, the Florida Center for Nursing 236 and the Office of Program Policy Analysis and Government 237 Accountability shall each: 238 (a) Monitor the administration of this section and evaluate 239 its effectiveness in achieving quality nursing programs with a 240 higher production of quality nursing graduates. 241 (b) Report its findings and make recommendations, if 242 warranted, to improve the effectiveness of this section to the 243 Governor, the President of the Senate, and the Speaker of the 244 House of Representatives by February 1, 2010. 245 (9) The Florida Center for Nursing and the Education Policy 246 Area of the Office of Program Policy Analysis and Government 247 Accountability shall jointly study the 5-year administration of 248 this section and submit a report to the Governor, the President 249 of the Senate, and the Speaker of the House of Representatives 250 on January 30, 2011, and annually thereafter through January 30, 251 2015. Each annual report shall address the previous academic 252 year and shall include data and analysis on the measures 253 specified in paragraphs (a)-(c) for each practical and 254 professional nursing program in this state, as such data becomes 255 available. 256 (a) To evaluate the program application approval process, 257 the report shall address the number of program applications 258 submitted under subsection (1); the number of program 259 applications approved and denied by the board under subsections 260 (1) and (3), respectively; the number of denials of program 261 application reviewed under chapter 120; and a description of the 262 outcomes of those reviews. 263 (b) To evaluate whether nursing program availability has 264 increased in this state and the quality of nurses produced by 265 these programs, the report shall address the number of programs 266 and student slots available; the number of student applications 267 submitted, the number of qualified applicants, and the number of 268 students accepted; the number of program graduates; program 269 student retention rates, from program entry to graduation; 270 graduate pass rates on the National Council of State Boards of 271 Nursing Licensing Examination; and the number of graduates who 272 become employed as practical or professional nurses in this 273 state. 274 (c) To evaluate compliance with this section, the report 275 shall address the number of programs placed on probationary 276 status, the number of programs terminated by the board under 277 paragraph (5)(d), the number of terminations reviewed under 278 chapter 120, and a description of the outcomes of those reviews. 279 Section 3. This act shall take effect July 1, 2009.