CS/CS/HB 1337

1	A bill to be entitled
2	An act relating to nursing; amending s. 456.014, F.S.;
3	authorizing the disclosure of certain confidential
4	information required of nursing license applicants to
5	certain persons; amending s. 464.003, F.S.; providing and
6	revising definitions; amending s. 464.008, F.S.; revising
7	requirements for graduation from certain nursing education
8	programs for nursing license applicants seeking to take
9	the licensing examination; amending s. 464.015, F.S.;
10	revising restrictions on nursing graduates who may use
11	certain titles and abbreviations; amending s. 464.019,
12	F.S.; revising requirements for the approval of nursing
13	education programs by the Board of Nursing, including
14	application requirements and procedures for the review and
15	approval or denial of applications; revising requirements
16	for the approval of nursing education programs meeting
17	certain requirements before a specified date; providing
18	for retroactive application; revising requirements for the
19	submission of annual reports by approved programs;
20	revising requirements for the information published on the
21	board's Internet website; revising accountability
22	requirements for an approved program's graduate passage
23	rates on a certain licensing examination; revising
24	procedures for placing programs on, and removing such
25	programs, from probationary status; requiring termination
26	of programs under certain circumstances; requiring certain
27	representatives of programs that fail to submit annual
28	reports to appear before the board; requiring the
29	Department of Health to disclose certain confidential
30	information about a program's graduates to the program
31	director under certain circumstances; requiring program
32	directors to maintain the confidentiality of such
33	information; providing penalties for unlawful disclosure
34	of confidential information; revising requirements for the
35	closure of programs; revising the board's authority to
36	adopt rules; exempting accredited programs from specified
37	requirements; providing requirements for an accredited
38	program that ceases to be accredited; conforming
39	provisions; deleting obsolete provisions; revising
40	requirements for the Florida Center for Nursing's
41	evaluation of the board's implementation of certain
42	accountability provisions; conforming cross-references;
43	amending s. 464.022, F.S.; conforming provisions; amending
44	ss. 458.348, 459.025, 464.012, and 960.28, F.S.;
45	conforming cross-references; providing an effective date.
46
47	Be It Enacted by the Legislature of the State of Florida:
48
49	Section 1.  Subsection (1) of section 456.014, Florida
50	Statutes, is amended to read:
51	456.014  Public inspection of information required from
52	applicants; exceptions; examination hearing.-
53	(1)  All information required by the department of any
54	applicant shall be a public record and shall be open to public
55	inspection pursuant to s. 119.07, except financial information,
56	medical information, school transcripts, examination questions,
57	answers, papers, grades, and grading keys, which are
58	confidential and exempt from s. 119.07(1) and shall not be
59	discussed with or made accessible to anyone except the program
60	director of an approved program or accredited program as
61	provided in s. 464.019(7), members of the board, the department,
62	and staff thereof, who have a bona fide need to know such
63	information. Any information supplied to the department by any
64	other agency which is exempt from the provisions of chapter 119
65	or is confidential shall remain exempt or confidential pursuant
66	to applicable law while in the custody of the department or the
67	agency.
68	Section 2.  Section 464.003, Florida Statutes, is reordered
69	and amended to read:
70	464.003  Definitions.-As used in this part, the term:
71	(1)  "Accredited program" means a program for the
72	prelicensure education of professional or practical nurses that
73	is conducted in the United States at an educational institution,
74	whether in this state, another state, or the District of
75	Columbia, and that is accredited by a specialized nursing
76	accrediting agency that is nationally recognized by the United
77	States Secretary of Education to accredit nursing education
78	programs.
79	(13)(1)  "Department" means the Department of Health.
80	(5)(2)  "Board" means the Board of Nursing.
81	(20)(3)(a)  "Practice of professional nursing" means the
82	performance of those acts requiring substantial specialized
83	knowledge, judgment, and nursing skill based upon applied
84	principles of psychological, biological, physical, and social
85	sciences which shall include, but not be limited to:
86	(a)1.  The observation, assessment, nursing diagnosis,
87	planning, intervention, and evaluation of care; health teaching
88	and counseling of the ill, injured, or infirm; and the promotion
89	of wellness, maintenance of health, and prevention of illness of
90	others.
91	(b)2.  The administration of medications and treatments as
92	prescribed or authorized by a duly licensed practitioner
93	authorized by the laws of this state to prescribe such
94	medications and treatments.
95	(c)3.  The supervision and teaching of other personnel in
96	the theory and performance of any of the above acts described in
97	this subsection.
98
99	A professional nurse is responsible and accountable for making
100	decisions that are based upon the individual's educational
101	preparation and experience in nursing.
102	(19)(b)  "Practice of practical nursing" means the
103	performance of selected acts, including the administration of
104	treatments and medications, in the care of the ill, injured, or
105	infirm and the promotion of wellness, maintenance of health, and
106	prevention of illness of others under the direction of a
107	registered nurse, a licensed physician, a licensed osteopathic
108	physician, a licensed podiatric physician, or a licensed
109	dentist. A The professional nurse and the practical nurse is
110	shall be responsible and accountable for making decisions that
111	are based upon the individual's educational preparation and
112	experience in nursing.
113	(7)(c)  "Clinical nurse specialist practice" means the
114	delivery and management of advanced practice nursing care to
115	individuals or groups, including the ability to:
116	(a)1.  Assess the health status of individuals and families
117	using methods appropriate to the population and area of
118	practice.
119	(b)2.  Diagnose human responses to actual or potential
120	health problems.
121	(c)3.  Plan for health promotion, disease prevention, and
122	therapeutic intervention in collaboration with the patient or
123	client.
124	(d)4.  Implement therapeutic interventions based on the
125	nurse specialist's area of expertise and within the scope of
126	advanced nursing practice, including, but not limited to, direct
127	nursing care, counseling, teaching, and collaboration with other
128	licensed health care providers.
129	(e)5.  Coordinate health care as necessary and appropriate
130	and evaluate with the patient or client the effectiveness of
131	care.
132	(2)(d)  "Advanced or specialized nursing practice" means,
133	in addition to the practice of professional nursing, the
134	performance of advanced-level nursing acts approved by the board
135	which, by virtue of postbasic specialized education, training,
136	and experience, are appropriately performed by an advanced
137	registered nurse practitioner. Within the context of advanced or
138	specialized nursing practice, the advanced registered nurse
139	practitioner may perform acts of nursing diagnosis and nursing
140	treatment of alterations of the health status. The advanced
141	registered nurse practitioner may also perform acts of medical
142	diagnosis and treatment, prescription, and operation which are
143	identified and approved by a joint committee composed of three
144	members appointed by the Board of Nursing, two of whom must be
145	advanced registered nurse practitioners; three members appointed
146	by the Board of Medicine, two of whom must have had work
147	experience with advanced registered nurse practitioners; and the
148	State Surgeon General or the State Surgeon General's designee.
149	Each committee member appointed by a board shall be appointed to
150	a term of 4 years unless a shorter term is required to establish
151	or maintain staggered terms. The Board of Nursing shall adopt
152	rules authorizing the performance of any such acts approved by
153	the joint committee. Unless otherwise specified by the joint
154	committee, such acts must be performed under the general
155	supervision of a practitioner licensed under chapter 458,
156	chapter 459, or chapter 466 within the framework of standing
157	protocols which identify the medical acts to be performed and
158	the conditions for their performance. The department may, by
159	rule, require that a copy of the protocol be filed with the
160	department along with the notice required by s. 458.348.
161	(17)(e)  "Nursing diagnosis" means the observation and
162	evaluation of physical or mental conditions, behaviors, signs
163	and symptoms of illness, and reactions to treatment and the
164	determination as to whether such conditions, signs, symptoms,
165	and reactions represent a deviation from normal.
166	(18)(f)  "Nursing treatment" means the establishment and
167	implementation of a nursing regimen for the care and comfort of
168	individuals, the prevention of illness, and the education,
169	restoration, and maintenance of health.
170	(22)(4)  "Registered nurse" means any person licensed in
171	this state to practice professional nursing.
172	(16)(5)  "Licensed practical nurse" means any person
173	licensed in this state to practice practical nursing.
174	(6)  "Clinical nurse specialist" means any person licensed
175	in this state to practice professional nursing and certified in
176	clinical nurse specialist practice.
177	(3)(7)  "Advanced registered nurse practitioner" means any
178	person licensed in this state to practice professional nursing
179	and certified in advanced or specialized nursing practice,
180	including certified registered nurse anesthetists, certified
181	nurse midwives, and nurse practitioners.
182	(4)(8)  "Approved program" means a nursing program for the
183	prelicensure education of professional or practical nurses that
184	is conducted in the state at an educational institution and that
185	is in a school, college, or university which is approved under
186	s. 464.019 for the education of nurses. The term includes such a
187	program placed on probationary status.
188	(10)(9)  "Clinical training" means direct nursing care
189	experiences with patients or clients which offer the student the
190	opportunity to integrate, apply, and refine specific skills and
191	abilities based on theoretical concepts and scientific
192	principles.
193	(8)(10)  "Clinical preceptor" means a registered nurse or
194	licensed practical nurse who is employed by a clinical training
195	facility to serve who serves as a role model and clinical
196	resource person for a specified period to students an individual
197	enrolled in an approved program.
198	(9)(11)  "Clinical simulation" means a strategy used to
199	replicate clinical practice as closely as possible to teach
200	theory, assessment, technology, pharmacology, and skills.
201	(11)(12)  "Community-based clinical experience" means
202	activities consistent with the curriculum and involving
203	individuals, families, and groups with the intent of promoting
204	wellness, maintaining health, and preventing illness.
205	(12)(13)  "Curriculum" means a planned sequence of course
206	offerings and learning experiences that comprise a nursing
207	education program.
208	(21)(14)  "Probationary status" means the status of an
209	approved a nursing education program that is placed on such
210	status pursuant subject to s. 464.019(2)(a)2. or (5)(a) or (b).
211	(14)  "Educational institution" means a school, college, or
212	university.
213	(15)  "Graduate passage rate" means the percentage of a
214	program's graduates who, as first-time test takers, pass the
215	National Council of State Boards of Nursing Licensing
216	Examination during a calendar year, as calculated by the
217	contract testing service of the National Council of State Boards
218	of Nursing.
219	(23)  "Required passage rate" means the graduate passage
220	rate required for an approved program pursuant to s.
221	464.019(6)(a)1.
222	Section 3.  Subsection (1) of section 464.008, Florida
223	Statutes, is amended to read:
224	464.008  Licensure by examination.-
225	(1)  Any person desiring to be licensed as a registered
226	nurse or licensed practical nurse shall apply to the department
227	to take the licensure examination. The department shall examine
228	each applicant who:
229	(a)  Has completed the application form and remitted a fee
230	set by the board not to exceed $150 and has remitted an
231	examination fee set by the board not to exceed $75 plus the
232	actual per applicant cost to the department for purchase of the
233	examination from the National Council of State Boards of Nursing
234	or a similar national organization.
235	(b)  Has provided sufficient information on or after
236	October 1, 1989, which must be submitted by the department for a
237	statewide criminal records correspondence check through the
238	Department of Law Enforcement.
239	(c)  Is in good mental and physical health, is a recipient
240	of a high school diploma or the equivalent, and has completed
241	the requirements for:
242	1.  Graduation from an approved program;
243	2.  Graduation from a prelicensure nursing education
244	program that the board determines is, or its equivalent to an
245	approved program;
246	3.  Graduation on or after July 1, 2009, from an accredited
247	program; or
248	4.  Graduation before July 1, 2009, from a prelicensure
249	nursing education program whose graduates at that time were
250	eligible for examination as determined by the board, for the
251	preparation of registered nurses or licensed practical nurses,
252	whichever is applicable.
253
254	Courses successfully completed in a professional nursing
255	education program that which are at least equivalent to a
256	practical nursing education program may be used to satisfy the
257	education requirements for licensure as a licensed practical
258	nurse.
259	(d)  Has the ability to communicate in the English
260	language, which may be determined by an examination given by the
261	department.
262	Section 4.  Subsections (3) and (4) of section 464.015,
263	Florida Statutes, are amended to read:
264	464.015  Titles and abbreviations; restrictions; penalty.-
265	(3)  Only persons who are graduates of prelicensure nursing
266	education approved programs listed in s. 464.008(1)(c) or the
267	equivalent may use the term "Graduate Nurse" and the
268	abbreviation "G.N.," pending the results of the first licensure
269	examination for which they are eligible.
270	(4)  Only persons who are graduates of prelicensure nursing
271	education approved programs listed in s. 464.008(1)(c) or the
272	equivalent may use the term "Graduate Practical Nurse" and the
273	abbreviation "G.P.N.," pending the results of the first
274	licensure examination for which they are eligible.
275	Section 5.  Section 464.019, Florida Statutes, is reordered
276	and amended to read:
277	464.019  Approval of nursing education programs.-
278	(1)  PROGRAM APPLICATIONS.-An educational institution that
279	wishes to conduct a program in this state for the prelicensure
280	education of professional or practical nurses must shall submit
281	to the department a program application and a
282	of $1,000 for each prelicensure nursing education program to be
283	offered at the institution's main campus, branch campus, or
284	other instructional site the department. Within 90 days after
285	receipt of a program application and program review fee, the
286	board shall approve the program application if it documents
287	compliance with the standards in paragraphs (a)-(h). If the
288	program application is incomplete or does not document
289	compliance, the board shall follow the procedures in subsection
290	(3). a program application is deemed approved by the board if
291	the board does not act on the application within the timeframes
292	specified in subsection (3) or this subsection. Each program
293	application must include the legal name of the educational
294	institution, the legal name of the nursing education program,
295	and, if such program is accredited by an accrediting agency
296	other than an accrediting agency described in s. 464.003(1), the
297	name of the accrediting agency. The application must also
298	document that:
299	(a)1.  For a professional nursing education program, the
300	program director and at least 50 percent of the program's
301	faculty members are registered nurses who have, at a minimum, a
302	master's or higher bachelor's degree in nursing or a bachelor's
303	and a master's degree in nursing and a master's or higher degree
304	in a field or a related to nursing field.
305	2.(b)  For a practical nursing education program, the
306	program director and at least 50 percent of the program's
307	faculty members are registered nurses who have, at a minimum, a
308	bachelor's or higher degree in nursing.
309
310	The educational degree requirements of this paragraph may be
311	documented by an official transcript or by a written statement
312	from the educational institution verifying that the institution
313	conferred the degree.
314	(b)(c)  The program's nursing major curriculum consists of
315	at least:
316	1.  Fifty percent clinical training for a practical nursing
317	education program, an associate degree professional nursing
318	education program, or a professional diploma nursing education
319	program.
320	2.  Forty percent clinical training for a bachelor's degree
321	professional nursing education program.
322	(c)(d)  No more than 25 percent of the program's clinical
323	training consists of clinical simulation.
324	(d)(e)  The program has signed agreements with each agency,
325	facility, and organization included in the curriculum plan as
326	clinical training sites and community-based clinical experience
327	sites.
328	(e)(f)  The program has written policies for faculty which
329	include provisions for direct or indirect supervision by program
330	faculty or clinical preceptors for students in clinical training
331	consistent with the following standards:
332	1.  The number of program faculty members equals at least
333	one faculty member directly supervising every 12 students unless
334	the written agreement between the program and the agency,
335	facility, or organization providing clinical training sites
336	allows more students, not to exceed 18 students, to be directly
337	supervised by one program faculty member.
338	2.  For a hospital setting, indirect supervision may occur
339	only if there is direct supervision by an assigned clinical
340	preceptor, a supervising program faculty member is available by
341	telephone, and such arrangement is approved by the clinical
342	facility.
343	3.  For community-based clinical experiences that involve
344	student participation in invasive or complex nursing activities,
345	students must be directly supervised by a program faculty member
346	or clinical preceptor and such arrangement must be approved by
347	the community-based clinical facility.
348	4.  For community-based clinical experiences not subject to
349	subparagraph 3., indirect supervision may occur only when a
350	supervising program faculty member is available to the student
351	by telephone.
352
353	A program's policies established under this paragraph must
354	require a clinical preceptor, if supervising students in a
355	professional nursing education program, to be a registered nurse
356	or, if supervising students in a practical nursing education
357	program, to be a registered nurse or licensed practical nurse.
358	(f)(g)  The professional or practical nursing curriculum
359	plan documents clinical experience and theoretical instruction
360	in medical, surgical, obstetric, pediatric, and geriatric
361	nursing. A professional nursing curriculum plan shall also
362	document clinical experience and theoretical instruction in
363	psychiatric nursing. Each curriculum plan must document clinical
364	training experience in appropriate settings that include, but
365	are not limited to, acute care, long-term care, and community
366	settings.
367	(g)(h)  The professional or practical nursing education
368	program provides theoretical instruction and clinical
369	application in personal, family, and community health concepts;
370	nutrition; human growth and development throughout the life
371	span; body structure and function; interpersonal relationship
372	skills; mental health concepts; pharmacology and administration
373	of medications; and legal aspects of practice. A professional
374	nursing education program shall also provide theoretical
375	instruction and clinical application in interpersonal
376	relationships and leadership skills; professional role and
377	function; and health teaching and counseling skills.
378
379	Upon the board's approval of a program application, the program
380	becomes an approved program under this section.
381	(3)(2)  STATUS OF CERTAIN PROGRAMS.-
382	(a)  A professional or practical nursing education program
383	becomes an approved program if that, as of June 30, 2009, the
384	program:
385	(a)1.  Has full or provisional approval from the board or,
386	except as provided in paragraph (b), is on probationary status,
387	except as provided in subparagraph 2., becomes an approved
388	program under this section. In order to retain approved program
389	status, such program shall submit the report required under
390	paragraph (c) to the board by November 1, 2009, and annually
391	thereafter.
392	(b)2.  Is on probationary status because the program did
393	not meet the board's requirement for program graduate passage
394	rates. Such program on the National Council of State Boards of
395	Nursing Licensing Examination, shall remain on probationary
396	status until it the program achieves a graduate passage rate for
397	calendar year 2009 or 2010 that equals or exceeds the required
398	passage rate for the respective calendar year and compliance
399	with the program graduate passage rate requirement in paragraph
400	(5)(a). A program that is subject to this subparagraph must
401	disclose its probationary status in writing to the program's
402	students and applicants submit the report required under
403	paragraph (c) to the board by November 1, 2009, and annually
404	thereafter and must comply with paragraph (5)(c). If the program
405	does not achieve the required passage rate compliance by July 1,
406	2011, the board shall terminate the program pursuant to chapter
407	120 as provided in paragraph (5)(d).
408	(b)  Each professional or practical nursing program that
409	has its application approved by the board under subsection (1)
410	on or after July 1, 2009, shall annually submit the report
411	required under paragraph (c) to the board by November 1 of each
412	year following initial approval of its application.
413	(4)  ANNUAL REPORT.-By November 1 of each year, each
414	approved program shall submit to the board an
415	(c)  The annual report comprised of required by this
416	subsection must include an affidavit certifying continued
417	compliance with paragraphs (1)(a)-(g) subsection (1), must
418	provide a summary description of the program's compliance with
419	paragraphs (1)(a)-(g) with subsection (1), and documentation
420	must document for the previous academic year that, to the extent
421	applicable, sets forth for each professional and practical
422	nursing program:
423	(a)1.  The number of student applications received, the
424	number of qualified applicants, applicants and the number of
425	students accepted, accepted applicants who enroll in the
426	program, students enrolled in the program, and.
427	2.  the number of program graduates.
428	3.  The program's graduate passage rate on the National
429	Council of State Boards of Nursing Licensing Examination.
430	(b)4.  The program's retention rates for students tracked
431	from program entry to graduation.
432	(c)5.  The program's accreditation status, including
433	identification of the accrediting agency if such agency is not
434	an accrediting agency described in s. 464.003(1) body.
435	(2)(3)  PROGRAM APPROVAL.-
436	(a)  Upon receipt of a If an institution's program
437	application and review fee, the department shall examine the
438	application to determine whether it is complete. If a program
439	application is not complete incomplete, the department board
440	shall notify the educational institution in writing of any
441	apparent errors or omissions within 30 days after the
442	department's receipt of the application and follow the
443	procedures in s. 120.60. A program application is deemed
444	complete upon the department's receipt of:
445	1.  The initial application, if the department does not
446	notify the educational institution of any errors or omissions
447	within the 30-day period; or
448	2.  A revised application that corrects each error and
449	omission of which the department notifies the educational
450	institution within the 30-day period.
451	(b)  Within 90 days after the department's receipt of a
452	complete program application, the board shall:
453	1.  Approve the If an institution's program application if
454	it documents does not document compliance with paragraphs
455	(1)(a)-(g); or the standards in subsection (1), within 90 days
456	after the board's receipt of the program application, the board
457	shall
458	2.  Provide the educational institution with a notice of
459	intent to deny the program application if it does not document
460	compliance with paragraphs (1)(a)-(g) that sets forth written
461	reasons for the denial. The notice must set forth written
462	reasons for the board's denial of the application. The board may
463	not deny a program application because of an educational
464	institution's failure to correct any error or omission of which
465	the department does not notify the institution within the 30-day
466	notice period under paragraph (a). The educational institution
467	may request a hearing on the notice of intent to deny the
468	program application pursuant to chapter 120.
469	(c)  A program application is deemed approved if the board
470	does not act within the 90-day review period provided under
471	paragraph (b).
472	(d)  Upon the board's approval of a program application,
473	the program becomes an approved program.
474	(5)(4)  INTERNET WEBSITE.-By October 1, 2010, the board
475	shall publish the following information on its Internet website:
476	(a)  A list of each accredited program conducted in the
477	state and the program's graduate passage rates for the most
478	recent 2 calendar years, which the department shall determine
479	through the following sources:
480	1.  For a program's accreditation status, the specialized
481	accrediting agencies that are nationally recognized by the
482	United States Secretary of Education to accredit nursing
483	education programs.
484	2.  For a program's graduate passage rates, the contract
485	testing service of the National Council of State Boards of
486	Nursing.
487	(b)  The following data for each approved program, which on
488	nursing programs located in the state. The data shall include,
489	to the extent applicable:
490	1.(a)  All documentation provided by the program in its
491	applicant for each approved nursing program application if
492	submitted on or after July 1, 2009.
493	2.(b)  The summary description of the each program's
494	compliance as submitted under subsection (4) paragraph (2)(c).
495	(c)  A comprehensive list of each practical and
496	professional nursing program in the state.
497	3.(d)  The program's accreditation status for each program,
498	including identification of the accrediting agency if such
499	agency is not an accrediting agency described in s. 464.003(1)
500	body.
501	4.(e)  The Each program's approval or probationary status.
502	5.(f)  The Each program's graduate passage rates for the
503	most recent 2 calendar years rate on the National Council of
504	State Boards of Nursing Licensing Examination.
505	(g)  The national average for passage rates on the National
506	Council of State Boards of Nursing Licensing Examination.
507	6.(h)  Each program's retention rates for students tracked
508	from program entry to graduation.
509	(c)  The average passage rates for United States educated
510	first-time test takers on the National Council of State Boards
511	of Nursing Licensing Examination for the most recent 2 calendar
512	years, as calculated by the contract testing service of the
513	National Council of State Boards of Nursing. The average passage
514	rates shall be published separately for each type of comparable
515	degree program listed in sub-subparagraphs (6)(a)1.a.-d.
516
517	The information data required to be published under this
518	subsection shall be made available in a manner that allows
519	interactive searches and comparisons of individual specific
520	nursing education programs selected by the website user. The
521	board shall publish the data by December 31, 2009, and update
522	the Internet website at least quarterly with the available
523	information data.
524	(6)(5)  ACCOUNTABILITY.-
525	(a)1.  An approved program must achieve a graduate passage
526	rate that is not lower than 10 percentage points less than the
527	average passage rate for graduates of comparable degree programs
528	who are United States educated first-time test takers on the
529	National Council of State Boards of Nursing Licensing
530	Examination during a calendar year, as calculated by the
531	contract testing service of the National Council of State Boards
532	of Nursing. For purposes of this subparagraph, an approved
533	program is comparable to all degree programs of the same program
534	type from among the following program types:
535	a.  Professional nursing education programs that terminate
536	in a bachelor's degree.
537	b.  Professional nursing education programs that terminate
538	in an associate degree.
539	c.  Professional nursing education programs that terminate
540	in a diploma.
541	d.  Practical nursing education programs.
542	2.  Beginning with graduate passage rates for calendar year
543	2010, if an approved a professional or practical nursing
544	program's average graduate passage rates do not equal or exceed
545	the required passage rates rate for first-time test takers on
546	the National Council of State Boards of Nursing Licensing
547	Examination falls 10 percent or more below the national average
548	passage rate for first-time test takers educated in the United
549	States, as annually published by the contract testing service of
550	the National Council of State Boards of Nursing, for 2
551	consecutive calendar years, the board shall place the program on
552	probationary status pursuant to chapter 120 probation and the
553	program director must shall be required to appear before the
554	board to present a plan for remediation. The program shall
555	remain on probationary status until it achieves a compliance
556	with the graduate passage rate that equals or exceeds the
557	required passage rate for any one calendar year.
558	3.  Upon the program's achievement of a graduate passage
559	rate that equals or exceeds the required passage rate,
560	requirement and shall be terminated by the board, at its next
561	regularly scheduled meeting following release of the program's
562	graduate passage rate by the National Council of State Boards of
563	Nursing, shall remove the program's probationary status.
564	However, under paragraph (d) if the program, during the 2
565	calendar years following its placement on probationary status,
566	does not achieve the required passage rate for any one
567	compliance within 2 calendar year, the board shall terminate the
568	program pursuant to chapter 120 years.
569	(b)  If an approved a program fails to submit the annual
570	report required in subsection (4) (2), the board shall notify
571	the program director and president or chief executive officer of
572	the educational institution in writing within 15 days after the
573	due date of the annual report. The program director must appear
574	before the board at the board's next regularly scheduled meeting
575	to explain the reason for the delay place the program on
576	probation. The board program shall terminate the program
577	pursuant to chapter 120 remain on probationary status until it
578	submits the annual report and shall be terminated by the board
579	under paragraph (d) if it does not submit the annual report
580	within 6 months after the report's due date.
581	(c)  An approved A program placed on probationary status
582	shall disclose its probationary status in writing to the
583	program's students and applicants.
584	(d)  The board shall terminate a program that fails to
585	comply with subparagraph (2)(a)2., paragraph (a), or paragraph
586	(b) pursuant to chapter 120.
587	(7)  DISCLOSURE OF GRADUATE PASSAGE RATE DATA.-
588	(a)  For each of an approved program's or accredited
589	program's graduates included in the calculation of the program's
590	graduate passage rate, the department shall disclose to the
591	program director, upon his or her written request, the name,
592	examination date, and determination of whether each graduate
593	passed or failed the National Council for State Boards of
594	Nursing Licensing Examination, to the extent that such
595	information is provided to the department by the contract
596	testing service of the National Council for State Boards of
597	Nursing. The written request must specify the calendar years for
598	which the information is requested.
599	(b)  A program director to whom confidential information
600	exempt from public disclosure pursuant to s. 456.014 is
601	disclosed under this subsection must maintain the
602	confidentiality of the information and is subject to the same
603	penalties provided in s. 456.082 for department employees who
604	unlawfully disclose confidential information.
605	(8)(6)  PROGRAM CLOSURE.-
606	(a)  An educational institution conducting an approved
607	program or accredited a nursing program in this state, at least
608	30 days before voluntarily closing the program, that closes
609	shall notify the board in writing of the institution's reason
610	for closing the program, the intended closure date, the
611	institution's plan to provide for or assist in the completion of
612	training by the program's students, and advise the board of the
613	arrangements for storage of the program's permanent records.
614	(b)  An educational institution conducting a nursing
615	education program that is terminated under subsection (6) or
616	closed under subparagraph (10)(b)3.:
617	1.  May not accept or enroll new students.
618	2.  Must submit to the board within 30 days after the
619	program is terminated or closed a written description of how the
620	institution will assist in the completion of training by the
621	program's students and the institution's arrangements for
622	storage of the program's permanent records.
623	(c)  If an educational institution does not comply with
624	paragraph (a) or paragraph (b), the board shall provide a
625	written notice explaining the institution's noncompliance to the
626	following persons and entities:
627	1.  The president or chief executive officer of the
628	educational institution.
629	2.  The Board of Governors, if the program is conducted by
630	a state university.
631	3.  The district school board, if the program is conducted
632	by an educational institution operated by a school district.
633	4.  The Commission for Independent Education, if the
634	program is conducted by an educational institution licensed
635	under chapter 1005.
636	5.  The State Board of Education, if the program is
637	conducted by an educational institution in the Florida College
638	System or by an educational institution that is not subject to
639	subparagraphs 2.-4.
640	(9)(7)  RULEMAKING.-The board does not have any rulemaking
641	authority to administer this section, except that the board
642	shall adopt a rule that prescribes the format for submitting
643	program applications under subsection (1) and annual reports
644	submitting summary descriptions of program compliance under
645	subsection (4) paragraph (2)(c). The board may not impose any
646	condition or requirement on an educational institution
647	submitting a program application, an approved program, or an
648	accredited program, a program on probationary status except as
649	expressly provided in this section. The board shall repeal all
650	rules, or portions thereof, in existence on July 1, 2009, that
651	are inconsistent with this subsection.
652	(10)  APPLICABILITY TO ACCREDITED PROGRAMS.-
653	(a)  Subsections (1)-(4), paragraph (5)(b), and subsection
654	(6) do not apply to an accredited program. An accredited program
655	on probationary status before July 1, 2010, ceases to be subject
656	to the probationary status.
657	(b)  If an accredited program ceases to be accredited, the
658	educational institution conducting the program:
659	1.  Within 10 business days after the program ceases to be
660	accredited, must provide written notice of the date that the
661	program ceased to be accredited to the board, the program's
662	students and applicants, and each entity providing clinical
663	training sites or community-based clinical experience sites for
664	the program. The educational institution must continue to
665	provide the written notice to new students, applicants, and
666	entities providing clinical training sites or community-based
667	clinical experience sites for the program until the program
668	becomes an approved program or is closed under subparagraph 3.
669	2.  Within 30 days after the program ceases to be
670	accredited, must submit an affidavit to the board, signed by the
671	educational institution's president or chief executive officer,
672	that certifies the institution's compliance with subparagraph 1.
673	The board shall notify the persons listed in subparagraph
674	(8)(c)1. and the applicable entities listed in subparagraphs
675	(8)(c)2.-5. if an educational institution does not submit the
676	affidavit required by this subparagraph.
677	3.  May apply to become an approved program under this
678	section. If the educational institution:
679	a.  Within 30 days after the program ceases to be
680	accredited, submits a program application and review fee to the
681	department under subsection (1) and the affidavit required under
682	subparagraph 2., the program shall be deemed an approved program
683	from the date that the program ceased to be accredited until the
684	date that the board approves or denies the program application.
685	The program application must be denied by the board pursuant to
686	chapter 120 if it does not contain the affidavit. If the board
687	denies the program application under subsection (2) or because
688	the program application does not contain the affidavit, the
689	program shall be closed and the educational institution
690	conducting the program must comply with paragraph (8)(b).
691	b.  Does not apply to become an approved program pursuant
692	to sub-subparagraph a., the program shall be deemed an approved
693	program from the date that the program ceased to be accredited
694	until the 31st day after that date. On the 31st day after the
695	program ceased to be accredited, the program shall be closed and
696	the educational institution conducting the program must comply
697	with paragraph (8)(b).
698	(8)  The Florida Center for Nursing and the Office of
699	Program Policy Analysis and Government Accountability shall
700	each:
701	(a)  Monitor the administration of this section and
702	evaluate the effectiveness of this section in achieving quality
703	nursing programs with a higher production of quality nursing
704	graduates.
705	(b)  Report its findings and make recommendations, if
706	warranted, to improve the effectiveness of this section to the
707	Governor, the President of the Senate, and the Speaker of the
708	House of Representatives by February 1, 2010.
709	(11)(9)  IMPLEMENTATION STUDY.-The Florida Center for
710	Nursing and the education policy area of the Office of Program
711	Policy Analysis and Government Accountability shall study the 5-
712	year administration of this section and submit reports to the
713	Governor, the President of the Senate, and the Speaker of the
714	House of Representatives by January 30, 2011, and annually
715	thereafter through January 30, 2015. The annual reports shall
716	address the previous academic year; set forth data on the
717	measures specified in paragraphs (a) and (b) for each
718	prelicensure practical and professional nursing program in the
719	state, as such data becomes available; and include an evaluation
720	of such data for purposes of determining whether this section is
721	increasing the availability of nursing education programs and
722	the production of quality nurses. The department and each
723	approved program or accredited program shall comply with
724	requests for data from the Florida Center for Nursing and the
725	education policy area of the Office of Program Policy Analysis
726	and Government Accountability.
727	(a)  The education policy area of the Office of Program
728	Policy Analysis and Government Accountability shall evaluate
729	program-specific data for each approved program and accredited
730	program conducted in the state, including, but not limited to:
731	1.  The number of nursing education programs and student
732	slots available.
733	2.  The number of student applications submitted, the
734	number of qualified applicants, and the number of students
735	accepted.
736	3.  The number of program graduates.
737	4.  Program retention rates of students tracked from
738	program entry to graduation.
739	5.  Graduate passage rates on the National Council of State
740	Boards of Nursing Licensing Examination.
741	6.  The number of graduates who become employed as
742	practical or professional nurses in the state.
743	(b)  The Florida Center for Nursing shall evaluate the
744	board's implementation of the:
745	1.  Program application approval process, including, but
746	not limited to, the number of program applications submitted
747	under subsection (1); the number of program applications
748	approved and denied by the board under subsection (2)
749	subsections (1) and (3); the number of denials of program
750	applications reviewed under chapter 120; and a description of
751	the outcomes of those reviews.
752	2.  Accountability Probation and termination processes,
753	including, but not limited to, the number of programs placed on
754	probationary status, the number of approved programs for which
755	the program director is required to appear before the board
756	under subsection (6), the number of approved programs terminated
757	by the board under paragraph (5)(d), the number of terminations
758	reviewed under chapter 120, and a description of the outcomes of
759	those reviews.
760	Section 6.  Subsection (4) of section 464.022, Florida
761	Statutes, is amended to read:
762	464.022  Exceptions.-No provision of this part shall be
763	construed to prohibit:
764	(4)  The practice of nursing by graduates of prelicensure
765	nursing education approved programs listed in s. 464.008(1)(c)
766	or the equivalent, pending the result of the first licensing
767	examination for which they are eligible following graduation,
768	provided they practice under direct supervision of a registered
769	professional nurse. The board shall by rule define what
770	constitutes direct supervision.
771	Section 7.  Paragraph (a) of subsection (1) and subsection
772	(2) of section 458.348, Florida Statutes, are amended to read:
773	458.348  Formal supervisory relationships, standing orders,
774	and established protocols; notice; standards.-
775	(1)  NOTICE.-
776	(a)  When a physician enters into a formal supervisory
777	relationship or standing orders with an emergency medical
778	technician or paramedic licensed pursuant to s. 401.27, which
779	relationship or orders contemplate the performance of medical
780	acts, or when a physician enters into an established protocol
781	with an advanced registered nurse practitioner, which protocol
782	contemplates the performance of medical acts identified and
783	approved by the joint committee pursuant to s. 464.003(2)(3)(d)
784	or acts set forth in s. 464.012(3) and (4), the physician shall
785	submit notice to the board. The notice shall contain a statement
786	in substantially the following form:
787	I, ...(name and professional license number of
788	physician)..., of ...(address of physician)... have hereby
789	entered into a formal supervisory relationship, standing orders,
790	or an established protocol with ...(number of persons)...
791	emergency medical technician(s), ...(number of persons)...
792	paramedic(s), or ...(number of persons)... advanced registered
793	nurse practitioner(s).
794	(2)  ESTABLISHMENT OF STANDARDS BY JOINT COMMITTEE.-The
795	joint committee created under s. 464.003(2)(3)(d) shall
796	determine minimum standards for the content of established
797	protocols pursuant to which an advanced registered nurse
798	practitioner may perform medical acts identified and approved by
799	the joint committee pursuant to s. 464.003(2)(3)(d) or acts set
800	forth in s. 464.012(3) and (4) and shall determine minimum
801	standards for supervision of such acts by the physician, unless
802	the joint committee determines that any act set forth in s.
803	464.012(3) or (4) is not a medical act. Such standards shall be
804	based on risk to the patient and acceptable standards of medical
805	care and shall take into account the special problems of
806	medically underserved areas. The standards developed by the
807	joint committee shall be adopted as rules by the Board of
808	Nursing and the Board of Medicine for purposes of carrying out
809	their responsibilities pursuant to part I of chapter 464 and
810	this chapter, respectively, but neither board shall have
811	disciplinary powers over the licensees of the other board.
812	Section 8.  Paragraph (a) of subsection (1) of section
813	459.025, Florida Statutes, is amended to read:
814	459.025  Formal supervisory relationships, standing orders,
815	and established protocols; notice; standards.-
816	(1)  NOTICE.-
817	(a)  When an osteopathic physician enters into a formal
818	supervisory relationship or standing orders with an emergency
819	medical technician or paramedic licensed pursuant to s. 401.27,
820	which relationship or orders contemplate the performance of
821	medical acts, or when an osteopathic physician enters into an
822	established protocol with an advanced registered nurse
823	practitioner, which protocol contemplates the performance of
824	medical acts identified and approved by the joint committee
825	pursuant to s. 464.003(2)(3)(d) or acts set forth in s.
826	464.012(3) and (4), the osteopathic physician shall submit
827	notice to the board. The notice must contain a statement in
828	substantially the following form:
829	I, ...(name and professional license number of osteopathic
830	physician)..., of ...(address of osteopathic physician)... have
831	hereby entered into a formal supervisory relationship, standing
832	orders, or an established protocol with ...(number of
833	persons)... emergency medical technician(s), ...(number of
834	persons)... paramedic(s), or ...(number of persons)... advanced
835	registered nurse practitioner(s).
836	Section 9.  Paragraph (c) of subsection (3) of section
837	464.012, Florida Statutes, is amended to read:
838	464.012  Certification of advanced registered nurse
839	practitioners; fees.-
840	(3)  An advanced registered nurse practitioner shall
841	perform those functions authorized in this section within the
842	framework of an established protocol that is filed with the
843	board upon biennial license renewal and within 30 days after
844	entering into a supervisory relationship with a physician or
845	changes to the protocol. The board shall review the protocol to
846	ensure compliance with applicable regulatory standards for
847	protocols. The board shall refer to the department licensees
848	submitting protocols that are not compliant with the regulatory
849	standards for protocols. A practitioner currently licensed under
850	chapter 458, chapter 459, or chapter 466 shall maintain
851	supervision for directing the specific course of medical
852	treatment. Within the established framework, an advanced
853	registered nurse practitioner may:
854	(c)  Perform additional functions as may be determined by
855	rule in accordance with s. 464.003(2)(3)(d).
856	Section 10.  Subsection (2) of section 960.28, Florida
857	Statutes, is amended to read:
858	960.28  Payment for victims' initial forensic physical
859	examinations.-
860	(2)  The Crime Victims' Services Office of the department
861	shall pay for medical expenses connected with an initial
862	forensic physical examination of a victim of sexual battery as
863	defined in chapter 794 or a lewd or lascivious offense as
864	defined in chapter 800. Such payment shall be made regardless of
865	whether the victim is covered by health or disability insurance
866	and whether the victim participates in the criminal justice
867	system or cooperates with law enforcement. The payment shall be
868	made only out of moneys allocated to the Crime Victims' Services
869	Office for the purposes of this section, and the payment may not
870	exceed $500 with respect to any violation. The department shall
871	develop and maintain separate protocols for the initial forensic
872	physical examination of adults and children. Payment under this
873	section is limited to medical expenses connected with the
874	initial forensic physical examination, and payment may be made
875	to a medical provider using an examiner qualified under part I
876	of chapter 464, excluding s. 464.003(16)(5); chapter 458; or
877	chapter 459. Payment made to the medical provider by the
878	department shall be considered by the provider as payment in
879	full for the initial forensic physical examination associated
880	with the collection of evidence. The victim may not be required
881	to pay, directly or indirectly, the cost of an initial forensic
882	physical examination performed in accordance with this section.
883	Section 11.  This act shall take effect July 1, 2010.

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