Florida Senate - 2014                        COMMITTEE AMENDMENT
       Bill No. SB 1036
       
       
       
       
       
       
                                Ì495838YÎ495838                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  03/05/2014           .                                
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       following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Subsections (10) and (19) of section 464.003,
    6  Florida Statutes, are amended to read:
    7         464.003 Definitions.—As used in this part, the term:
    8         (10) “Clinical training” means direct nursing care
    9  experiences with patients or clients, or clinical simulation of
   10  such experiences, which offer the student the opportunity to
   11  integrate, apply, and refine specific skills and abilities based
   12  on theoretical concepts and scientific principles.
   13         (19) “Practice of practical nursing” means the performance
   14  of selected acts, including the administration of treatments and
   15  medications, in the care of the ill, injured, or infirm; and the
   16  promotion of wellness, maintenance of health, and prevention of
   17  illness of others under the direction of a registered nurse, a
   18  licensed physician, a licensed osteopathic physician, a licensed
   19  podiatric physician, or a licensed dentist; and the teaching of
   20  general principles of health and wellness to the public and to
   21  students other than nursing students. A practical nurse is
   22  responsible and accountable for making decisions that are based
   23  upon the individual’s educational preparation and experience in
   24  nursing.
   25         (23) “Required passage rate” means the graduate passage
   26  rate required for an approved program pursuant to s.
   27  464.019(5)(a) 464.019(6)(a)1.
   28         Section 2. Subsection (3) of section 464.013, Florida
   29  Statutes, is amended to read:
   30         464.013 Renewal of license or certificate.—
   31         (3) The board shall by rule prescribe up to 30 hours of
   32  continuing education not to exceed 30 hours biennially as a
   33  condition for renewal of a license or certificate. A nurse who
   34  is certified by a health care specialty program accredited by
   35  the National Commission for Certifying Agencies or Accreditation
   36  Board for Specialty Nursing Certification is exempt from
   37  continuing education requirements. The criteria for programs
   38  shall be approved by the board.
   39         Section 3. Section 464.019, Florida Statutes, is amended to
   40  read:
   41         464.019 Approval of nursing education programs.—
   42         (1) PROGRAM APPLICATION APPLICATIONS.—An educational
   43  institution that wishes to conduct a program in this state for
   44  the prelicensure education of professional or practical nurses
   45  must submit to the department a program application and review
   46  fee of $1,000 for each prelicensure nursing education program to
   47  be offered at the institution’s main campus, branch campus, or
   48  other instructional site. The Each program application must
   49  include the legal name of the educational institution, the legal
   50  name of the nursing education program, and, if such institution
   51  program is accredited by an accrediting agency other than an
   52  accrediting agency described in s. 464.003(1), the name of the
   53  accrediting agency. The application must also document that:
   54         (a)1. For a professional nursing education program, the
   55  program director and at least 50 percent of the program’s
   56  faculty members are registered nurses who have a master’s or
   57  higher degree in nursing or a bachelor’s degree in nursing and a
   58  master’s or higher degree in a field related to nursing.
   59         2. For a practical nursing education program, the program
   60  director and at least 50 percent of the program’s faculty
   61  members are registered nurses who have a bachelor’s or higher
   62  degree in nursing.
   63  
   64         The educational degree requirements of this paragraph may
   65  be documented by an official transcript or by a written
   66  statement from the educational institution verifying that the
   67  institution conferred the degree.
   68         (b) The program’s nursing major curriculum consists of at
   69  least:1. Fifty percent clinical training at a health care
   70  facility in the United States, the District of Columbia, or a
   71  possession or territory of the United States for a practical
   72  nursing education program, an associate degree professional
   73  nursing education program, or a professional diploma nursing
   74  education program.
   75         2. Forty percent clinical training at a health care
   76  facility in the United States, the District of Columbia, or a
   77  possession or territory of the United States for a bachelor’s
   78  degree professional nursing education program.
   79         (c) No more than 50 25 percent of the program’s clinical
   80  training consists of clinical simulation.
   81         (d) The program has signed agreements with each agency,
   82  facility, and organization included in the curriculum plan as
   83  clinical training sites and community-based clinical experience
   84  sites.
   85         (e) The program has written policies for faculty which
   86  include provisions for direct or indirect supervision by program
   87  faculty or clinical preceptors for students in clinical training
   88  consistent with the following standards:
   89         1. The number of program faculty members equals at least
   90  one faculty member directly supervising every 12 students unless
   91  the written agreement between the program and the agency,
   92  facility, or organization providing clinical training sites
   93  allows more students, not to exceed 18 students, to be directly
   94  supervised by one program faculty member.
   95         2. For a hospital setting, indirect supervision may occur
   96  only if there is direct supervision by an assigned clinical
   97  preceptor, a supervising program faculty member is available by
   98  telephone, and such arrangement is approved by the clinical
   99  facility.
  100         3. For community-based clinical experiences that involve
  101  student participation in invasive or complex nursing activities,
  102  students must be directly supervised by a program faculty member
  103  or clinical preceptor and such arrangement must be approved by
  104  the community-based clinical facility.
  105         4. For community-based clinical experiences not subject to
  106  subparagraph 3., indirect supervision may occur only when a
  107  supervising program faculty member is available to the student
  108  by telephone.
  109         A program’s policies established under this paragraph must
  110  require that a clinical preceptor who is, if supervising
  111  students in a professional nursing education program, to be a
  112  registered nurse or, if supervising students in a practical
  113  nursing education program, to be a registered nurse or licensed
  114  practical nurse.
  115         (f) The professional or practical nursing curriculum plan
  116  documents clinical experience and theoretical instruction in
  117  medical, surgical, obstetric, pediatric, and geriatric nursing.
  118  A professional nursing curriculum plan shall also document
  119  clinical experience and theoretical instruction in psychiatric
  120  nursing. Each curriculum plan must document clinical training
  121  experience in appropriate settings that include, but are not
  122  limited to, acute care, long-term care, and community settings.
  123         (g) The professional or practical nursing education program
  124  provides theoretical instruction and clinical application in
  125  personal, family, and community health concepts; nutrition;
  126  human growth and development throughout the life span; body
  127  structure and function; interpersonal relationship skills;
  128  mental health concepts; pharmacology and administration of
  129  medications; and legal aspects of practice. A professional
  130  nursing education program must shall also provide theoretical
  131  instruction and clinical application in interpersonal
  132  relationships and leadership skills; professional role and
  133  function; and health teaching and counseling skills.
  134         (2) PROGRAM APPROVAL.—
  135         (a)  Upon receipt of a program application and review fee,
  136  the department shall examine the application to determine if
  137  whether it is complete. If the a program application is not
  138  complete, the department shall notify the educational
  139  institution in writing of any errors or omissions within 30 days
  140  after the department’s receipt of the application. A program
  141  application is deemed complete upon the department’s receipt of:
  142         1. The initial application, if the department does not
  143  notify the educational institution of any errors or omissions
  144  within the 30-day period; or
  145         2. A revised application that corrects each error and
  146  omission of which the department notifies the educational
  147  institution within the 30-day period.
  148         (b) Within 90 days after the department’s receipt of a
  149  complete program application, the board shall:
  150         1. Approve the application if it documents compliance with
  151  subsection (1) paragraphs (1)(a)-(g); or
  152         2. Provide the educational institution with a notice of
  153  intent to deny the application if it does not document
  154  compliance with subsection (1) paragraphs (1)(a)-(g). The notice
  155  must specify set forth written reasons for the board’s denial of
  156  the application. The board may not deny a program application
  157  because of an educational institution’s failure to correct an
  158  any error or omission that of which the department failed to
  159  provide notice of to does not notify the institution within the
  160  30-day notice period under paragraph (a). The educational
  161  institution may request a hearing on the notice of intent to
  162  deny the program application pursuant to chapter 120.
  163         (c) A program application is deemed approved if the board
  164  does not act within the 90-day review period provided under
  165  paragraph (b).
  166         (d) Upon the board’s approval of a program application, the
  167  program becomes an approved program.
  168         (3) STATUS OF CERTAIN PROGRAMS.—A professional or practical
  169  nursing education program becomes an approved program if, as of
  170  June 30, 2009, the program:
  171         (a) Has full or provisional approval from the board or,
  172  except as provided in paragraph (b), is on probationary status.
  173         (b) Is on probationary status because the program did not
  174  meet the board’s requirement for graduate passage rates. Such
  175  program shall remain on probationary status until it achieves a
  176  graduate passage rate for calendar year 2009 or 2010 that equals
  177  or exceeds the required passage rate for the respective calendar
  178  year and must disclose its probationary status in writing to the
  179  program’s students and applicants. If the program does not
  180  achieve the required passage rate, the board shall terminate the
  181  program pursuant to chapter 120.
  182         (3)(4) ANNUAL REPORT.—By November 1 of each year, each
  183  approved program shall submit to the board an annual report
  184  comprised of an affidavit certifying continued compliance with
  185  subsection (1) paragraphs (1)(a)-(g), a summary description of
  186  the program’s compliance with subsection (1) paragraphs (1)(a)
  187  (g), and documentation for the previous academic year that, to
  188  the extent applicable, describes sets forth:
  189         (a) The number of student applications received, qualified
  190  applicants, applicants accepted, accepted applicants who enroll
  191  in the program, students enrolled in the program, and program
  192  graduates.
  193         (b) The program’s retention rates for students tracked from
  194  program entry to graduation.
  195         (c) The program’s accreditation status, including
  196  identification of the accrediting agency if such agency is not
  197  an accrediting agency described in s. 464.003(1).
  198         (4)(5) INTERNET WEBSITE.—By October 1, 2010, The board
  199  shall publish the following information on its Internet website:
  200         (a) A list of each accredited program conducted in the
  201  state and the program’s graduate passage rates for the most
  202  recent 2 calendar years, which the department shall determine
  203  through the following sources:
  204         1. For a program’s accreditation status, the specialized
  205  accrediting agencies that are nationally recognized by the
  206  United States Secretary of Education to accredit nursing
  207  education programs.
  208         2. For a program’s graduate passage rates, the contract
  209  testing service of the National Council of State Boards of
  210  Nursing.
  211         (b) The following data for each approved program, which
  212  includes shall include, to the extent applicable:
  213         1. All documentation provided by the program in its program
  214  application if submitted on or after July 1, 2009.
  215         2. The summary description of the program’s compliance
  216  submitted under subsection (3) (4).
  217         3. The program’s accreditation status, including
  218  identification of the accrediting agency if such agency is not
  219  an accrediting agency described in s. 464.003(1).
  220         4. The program’s probationary status.
  221         5. The program’s graduate passage rates for the most recent
  222  2 calendar years.
  223         6. Each program’s retention rates for students tracked from
  224  program entry to graduation.
  225         (c) The average passage rates for United States educated
  226  first-time test takers on the National Council of State Boards
  227  of Nursing Licensing Examination for the most recent 2 calendar
  228  years, as calculated by the contract testing service of the
  229  National Council of State Boards of Nursing. The average passage
  230  rates shall be published separately for each type of comparable
  231  degree program listed in subparagraph (5)(a)1. sub-subparagraphs
  232  (6)(a)1.a.-d.
  233         The information required to be published under this
  234  subsection shall be made available in a manner that allows
  235  interactive searches and comparisons of individual programs
  236  selected by the website user. The board shall update the
  237  Internet website at least quarterly with the available
  238  information.
  239         (5)(6) ACCOUNTABILITY.—
  240         (a)1. An approved program must achieve a graduate passage
  241  rate that is not more lower than 10 percentage points lower less
  242  than the average passage rate during the same calendar year for
  243  graduates of comparable degree programs who are United States
  244  educated, first-time test takers on the National Council of
  245  State Boards of Nursing Licensing Examination during a calendar
  246  year, as calculated by the contract testing service of the
  247  National Council of State Boards of Nursing. For purposes of
  248  this subparagraph, an approved program is comparable to all
  249  degree programs of the same program type from among the
  250  following program types:
  251         a. Professional nursing education programs that terminate
  252  in a bachelor’s degree.
  253         b. Professional nursing education programs that terminate
  254  in an associate degree.
  255         c. Professional nursing education programs that terminate
  256  in a diploma.
  257         d. Practical nursing education programs.
  258         2. Beginning with graduate passage rates for calendar year
  259  2010, if an approved program’s graduate passage rates do not
  260  equal or exceed the required passage rates for 2 consecutive
  261  calendar years, the board shall place the program on
  262  probationary status pursuant to chapter 120 and the program
  263  director shall must appear before the board to present a plan
  264  for remediation. The program must shall remain on probationary
  265  status until it achieves a graduate passage rate that equals or
  266  exceeds the required passage rate for any 1 calendar year. The
  267  board shall deny a program application for a new prelicensure
  268  nursing education program submitted by an educational
  269  institution if the institution has an existing program that is
  270  already on probationary status.
  271         3. Upon the program’s achievement of a graduate passage
  272  rate that equals or exceeds the required passage rate, the
  273  board, at its next regularly scheduled meeting following release
  274  of the program’s graduate passage rate by the National Council
  275  of State Boards of Nursing, shall remove the program’s
  276  probationary status. However, if the program, during the 2
  277  calendar years following its placement on probationary status,
  278  does not achieve the required passage rate for any 1 calendar
  279  year, the board shall terminate the program pursuant to chapter
  280  120.
  281         (b) If an approved program fails to submit the annual
  282  report required in subsection (3) (4), the board shall notify
  283  the program director and president or chief executive officer of
  284  the educational institution in writing within 15 days after the
  285  due date of the annual report. The program director shall must
  286  appear before the board at the board’s next regularly scheduled
  287  meeting to explain the reason for the delay. The board shall
  288  terminate the program pursuant to chapter 120 if it does not
  289  submit the annual report within 6 months after the due date.
  290         (c) An approved program on probationary status shall
  291  disclose its probationary status in writing to the program’s
  292  students and applicants.
  293         (6)(7) DISCLOSURE OF GRADUATE PASSAGE RATE DATA.—
  294         (a) For each graduate of the program an approved program’s
  295  or accredited program’s graduates included in the calculation of
  296  the program’s graduate passage rate, the department shall
  297  disclose to the program director, upon his or her written
  298  request, the name, examination date, and determination of
  299  whether each graduate passed or failed the National Council of
  300  for State Boards of Nursing Licensing Examination, if to the
  301  extent that such information is provided to the department by
  302  the contract testing service of the National Council of for
  303  State Boards of Nursing. The written request must specify the
  304  calendar years for which the information is requested.
  305         (b) A program director to whom confidential information
  306  exempt from public disclosure pursuant to s. 456.014 is
  307  disclosed under this subsection must maintain the
  308  confidentiality of the information and is subject to the same
  309  penalties provided in s. 456.082 for department employees who
  310  unlawfully disclose confidential information.
  311         (7)(8) PROGRAM CLOSURE.—
  312         (a) An educational institution conducting an approved
  313  program or accredited program in this state, at least 30 days
  314  before voluntarily closing the program, shall notify the board
  315  in writing of the institution’s reason for closing the program,
  316  the intended closure date, the institution’s plan to provide for
  317  or assist in the completion of training by the program’s
  318  students, and the arrangements for storage of the program’s
  319  permanent records.
  320         (b) An educational institution conducting a nursing
  321  education program that is terminated under subsection (5) (6) or
  322  closed under subparagraph (9)(b)3. (10)(b)3.:
  323         1. May not accept or enroll new students.
  324         2. Shall Must submit to the board within 30 days after the
  325  program is terminated or closed a written description of how the
  326  institution will assist in completing the completion of training
  327  of by the program’s students and the institution’s arrangements
  328  for storage of the program’s permanent records.
  329         (c) If an educational institution does not comply with
  330  paragraph (a) or paragraph (b), the board shall provide a
  331  written notice explaining the institution’s noncompliance to the
  332  following persons and entities:
  333         1. The president or chief executive officer of the
  334  educational institution.
  335         2. The Board of Governors, if the program is conducted by a
  336  state university.
  337         3. The district school board, if the program is conducted
  338  by an educational institution operated by a school district.
  339         4. The Commission for Independent Education, if the program
  340  is conducted by an educational institution licensed under
  341  chapter 1005.
  342         5. The State Board of Education, if the program is
  343  conducted by an educational institution in the Florida College
  344  System or by an educational institution that is not subject to
  345  subparagraphs 2.-4.
  346         (8)(9) RULEMAKING.—The board does not have any rulemaking
  347  authority to administer this section, except that the board
  348  shall adopt rules a rule that prescribe prescribes the format
  349  for submitting program applications under subsection (1) and
  350  annual reports under subsection (3), and to administer the
  351  documentation of the accreditation of nursing education programs
  352  under subsection (11) (4). The board may not impose any
  353  condition or requirement on an educational institution
  354  submitting a program application, an approved program, or an
  355  accredited program, except as expressly provided in this
  356  section. The board shall repeal all rules, or portions thereof,
  357  in existence on July 1, 2009, that are inconsistent with this
  358  subsection.
  359         (9)(10) APPLICABILITY TO ACCREDITED PROGRAMS.—
  360         (a) Subsections (1)-(3) (1)-(4), paragraph (4)(b) (5)(b),
  361  and subsection (5) (6) do not apply to an accredited program. An
  362  accredited program on probationary status before July 1, 2010,
  363  ceases to be subject to the probationary status.
  364         (b) If an accredited program ceases to be accredited, the
  365  educational institution conducting the program:
  366         1. Within 10 business days after the program ceases to be
  367  accredited, must provide written notice of the date that the
  368  program ceased to be accredited to the board, the program’s
  369  students and applicants, and each entity providing clinical
  370  training sites or community-based clinical experience sites for
  371  the program. The educational institution must continue to
  372  provide the written notice to new students, applicants, and
  373  entities providing clinical training sites or community-based
  374  clinical experience sites for the program until the program
  375  becomes an approved program or is closed under subparagraph 3.
  376         2. Within 30 days after the program ceases to be
  377  accredited, must submit an affidavit to the board, signed by the
  378  educational institution’s president or chief executive officer
  379  which, that certifies the institution’s compliance with
  380  subparagraph 1. The board shall notify the persons and
  381  applicable entities listed in paragraph (7)(c) subparagraph
  382  (8)(c)1. and the applicable entities listed in subparagraphs
  383  (8)(c)2.-5. if an educational institution does not submit the
  384  affidavit required by this subparagraph.
  385         3. May apply to become an approved program under this
  386  section. If the educational institution:
  387         a. Within 30 days after the program ceases to be
  388  accredited, submits a program application and review fee to the
  389  department under subsection (1) and the affidavit required under
  390  subparagraph 2., the program shall be deemed an approved program
  391  from the date that the program ceased to be accredited until the
  392  date that the board approves or denies the program application.
  393  The program application must be denied by the board pursuant to
  394  chapter 120 if it does not contain the affidavit. If the board
  395  denies the program application under subsection (2) or if
  396  because the program application does not contain the affidavit,
  397  the program shall be closed and the educational institution
  398  conducting the program must comply with paragraph (7)(b) (8)(b).
  399         b. Does not apply to become an approved program pursuant to
  400  sub-subparagraph a., the program shall be deemed an approved
  401  program from the date that the program ceased to be accredited
  402  until the 31st day after that date. On the 31st day after the
  403  program ceased to be accredited, the program shall be closed and
  404  the educational institution conducting the program must comply
  405  with paragraph (7)(b) (8)(b).
  406         (10)(11) IMPLEMENTATION STUDY.—The Florida Center for
  407  Nursing and the education policy area of the Office of Program
  408  Policy Analysis and Government Accountability shall study the
  409  implementation 5-year administration of this section and submit
  410  reports to the Governor, the President of the Senate, and the
  411  Speaker of the House of Representatives in January of each year
  412  following the effective date of this act by January 30, 2011,and
  413  annually thereafter through January 30, 2015. The annual reports
  414  shall address the previous academic year; provide set forth data
  415  on the measures specified in paragraphs (a) and (b), as such
  416  data becomes available; and include an evaluation of such data
  417  for purposes of determining whether this section is increasing
  418  the availability of nursing education programs and the
  419  production of quality nurses. The department and each approved
  420  program or accredited program shall comply with requests for
  421  data from the Florida Center for Nursing and the education
  422  policy area of the Office of Program Policy Analysis and
  423  Government Accountability.
  424         (a) The Florida Center for Nursing education policy area of
  425  the Office of Program Policy Analysis and Government
  426  Accountability shall evaluate program-specific data for each
  427  approved program and accredited program conducted in the state,
  428  including, but not limited to:
  429         1. The number of programs and student slots available.
  430         2. The number of student applications submitted, the number
  431  of qualified applicants, and the number of students accepted.
  432         3. The number of program graduates.
  433         4. Program retention rates of students tracked from program
  434  entry to graduation.
  435         5. Graduate passage rates on the National Council of State
  436  Boards of Nursing Licensing Examination.
  437         6. The number of graduates who become employed as practical
  438  or professional nurses in the state.
  439         (b) The Florida Center for Nursing shall evaluate the
  440  board’s implementation of the:
  441         1. Program application approval process, including, but not
  442  limited to, the number of program applications submitted under
  443  subsection (1); the number of program applications approved and
  444  denied by the board under subsection (2); the number of denials
  445  of program applications reviewed under chapter 120; and a
  446  description of the outcomes of those reviews.
  447         2. Accountability processes, including, but not limited to,
  448  the number of programs on probationary status, the number of
  449  approved programs for which the program director is required to
  450  appear before the board under subsection (5) (6), the number of
  451  approved programs terminated by the board, the number of
  452  terminations reviewed under chapter 120, and a description of
  453  the outcomes of those reviews.
  454         (c) For any state fiscal year in which the Florida Center
  455  for Nursing does not receive legislative appropriations, the
  456  education policy area of the Office of Program Policy Analysis
  457  and Government Accountability shall perform the duties assigned
  458  by this subsection to the Florida Center for Nursing.
  459         (11) ACCREDITATION REQUIRED.—
  460         (a) A nursing education program that prepares students for
  461  the practice of professional nursing, that was approved under
  462  this section before July 1, 2014, and that enrolled students
  463  before July 1, 2014, must become an accredited program by July
  464  1, 2019.
  465         (b) A nursing education program that prepares students for
  466  the practice of professional nursing, that was approved under
  467  this section before July 1, 2014, but did not enroll students
  468  before that date, must become an accredited program within 5
  469  years after the date of enrolling the program’s first students.
  470         (c) A nursing education program that prepares students for
  471  the practice of professional nursing and that is approved by the
  472  board after June 30, 2014, must become an accredited program
  473  within 5 years after the date of enrolling the program’s first
  474  students.
  475         (d) This subsection does not apply to a nursing education
  476  program provided by an institution that is exempted from
  477  licensure by the Commission for Independent Education under s.
  478  1005.06(1)(e).
  479         Section 4. Subsection (1) of section 456.014, Florida
  480  Statutes, is amended to read:
  481         456.014 Public inspection of information required from
  482  applicants; exceptions; examination hearing.—
  483         (1) All information required by the department of any
  484  applicant shall be a public record and shall be open to public
  485  inspection pursuant to s. 119.07, except financial information,
  486  medical information, school transcripts, examination questions,
  487  answers, papers, grades, and grading keys, which are
  488  confidential and exempt from s. 119.07(1) and shall not be
  489  discussed with or made accessible to anyone except the program
  490  director of an approved program or accredited program as
  491  provided in s. 464.019(6) 464.019(7), members of the board, the
  492  department, and staff thereof, who have a bona fide need to know
  493  such information. Any information supplied to the department by
  494  any other agency which is exempt from the provisions of chapter
  495  119 or is confidential shall remain exempt or confidential
  496  pursuant to applicable law while in the custody of the
  497  department or the agency.
  498  
  499  
  500  ================= T I T L E  A M E N D M E N T ================
  501  And the title is amended as follows:
  502         Delete everything before the enacting clause
  503  and insert:
  504                        A bill to be entitled                      
  505         An act relating to nursing education programs; amending s.
  506  464.003, F.S.; revising definitions of the terms “clinical
  507  training” and “practice of practical nursing”; conforming a
  508  cross-reference; amending s. 464.013, F.S.; exempting nurses who
  509  are certified by an accredited program from continuing education
  510  requirements; amending s. 464.019, F.S.; specifying the location
  511  of clinical training; revising the limitation on the percentage
  512  of clinical training that may consist of clinical simulation;
  513  deleting obsolete requirements; authorizing the Board of Nursing
  514  to adopt certain rules relating to documenting the accreditation
  515  of nursing education programs; deleting the requirement that the
  516  Office of Program Policy Analysis and Government Accountability
  517  participate in an implementation study and revising the terms of
  518  the study; requiring nursing education programs that prepare
  519  students for the practice of professional nursing to be
  520  accredited; providing an exception; amending s. 456.014, F.S.;
  521  conforming a cross-reference; providing an effective date.
  522