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 under by the
   46  board pursuant to s. 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         464.019Approval 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.