Florida Senate - 2014                      CS for CS for SB 1036
       
       
        
       By the Committees on Education; and Health Policy; and Senator
       Grimsley
       
       
       
       
       581-02769-14                                          20141036c2
    1                        A bill to be entitled                      
    2         An act relating to nursing education programs;
    3         amending s. 464.003, F.S.; revising definitions;
    4         amending s. 464.013, F.S.; exempting nurses who are
    5         certified by an accredited program from continuing
    6         education requirements; amending s. 464.019, F.S.;
    7         specifying the location of clinical training; revising
    8         the limitation on the percentage of clinical training
    9         that consists of clinical simulation; deleting
   10         obsolete requirements; authorizing the Board of
   11         Nursing to adopt certain rules relating to documenting
   12         the accreditation of nursing education programs;
   13         deleting the requirement that the Office of Program
   14         Policy Analysis and Government Accountability
   15         participate in an implementation study and revising
   16         the terms of the study; requiring nursing education
   17         programs that prepare students for the practice of
   18         professional nursing to be accredited; providing an
   19         exception; amending s. 456.014, F.S.; conforming a
   20         cross-reference; providing an effective date.
   21          
   22  Be It Enacted by the Legislature of the State of Florida:
   23  
   24         Section 1. Subsections (10), (19), and (23) of section
   25  464.003, Florida Statutes, are amended to read:
   26         464.003 Definitions.—As used in this part, the term:
   27         (10) “Clinical training” means direct nursing care
   28  experiences with patients or clients, or clinical simulation of
   29  such experiences, which offer the student the opportunity to
   30  integrate, apply, and refine specific skills and abilities based
   31  on theoretical concepts and scientific principles.
   32         (19) “Practice of practical nursing” means the performance
   33  of selected acts, including the administration of treatments and
   34  medications, in the care of the ill, injured, or infirm; and the
   35  promotion of wellness, maintenance of health, and prevention of
   36  illness of others under the direction of a registered nurse, a
   37  licensed physician, a licensed osteopathic physician, a licensed
   38  podiatric physician, or a licensed dentist; and the teaching of
   39  general principles of health and wellness to the public and to
   40  students other than nursing students. A practical nurse is
   41  responsible and accountable for making decisions that are based
   42  upon the individual’s educational preparation and experience in
   43  nursing.
   44         (23) “Required passage rate” means the graduate passage
   45  rate required for an approved program pursuant to s.
   46  464.019(5)(a) 464.019(6)(a)1.
   47         Section 2. Subsection (3) of section 464.013, Florida
   48  Statutes, is amended to read:
   49         464.013 Renewal of license or certificate.—
   50         (3) The board shall by rule prescribe up to 30 hours of
   51  continuing education not to exceed 30 hours biennially as a
   52  condition for renewal of a license or certificate. A nurse who
   53  is certified by a health care specialty program accredited by
   54  the National Commission for Certifying Agencies or Accreditation
   55  Board for Specialty Nursing Certification is exempt from
   56  continuing education requirements. The criteria for programs
   57  shall be approved by the board.
   58         Section 3. Section 464.019, Florida Statutes, is amended to
   59  read:
   60         464.019 Approval of nursing education programs.—
   61         (1) PROGRAM APPLICATION APPLICATIONS.—An educational
   62  institution that wishes to conduct a program in this state for
   63  the prelicensure education of professional or practical nurses
   64  must submit to the department a program application and review
   65  fee of $1,000 for each prelicensure nursing education program to
   66  be offered at the institution’s main campus, branch campus, or
   67  other instructional site. The Each program application must
   68  include the legal name of the educational institution, the legal
   69  name of the nursing education program, and, if such institution
   70  program is accredited by an accrediting agency other than an
   71  accrediting agency described in s. 464.003(1), the name of the
   72  accrediting agency. The application must also document that:
   73         (a)1. For a professional nursing education program, the
   74  program director and at least 50 percent of the program’s
   75  faculty members are registered nurses who have a master’s or
   76  higher degree in nursing or a bachelor’s degree in nursing and a
   77  master’s or higher degree in a field related to nursing.
   78         2. For a practical nursing education program, the program
   79  director and at least 50 percent of the program’s faculty
   80  members are registered nurses who have a bachelor’s or higher
   81  degree in nursing.
   82  
   83  The educational degree requirements of this paragraph may be
   84  documented by an official transcript or by a written statement
   85  from the educational institution verifying that the institution
   86  conferred the degree.
   87         (b) The program’s nursing major curriculum consists of at
   88  least:
   89         1. Fifty percent clinical training at a facility in the
   90  United States, the District of Columbia, or a possession or
   91  territory of the United States for a practical nursing education
   92  program, an associate degree professional nursing education
   93  program, or a professional diploma nursing education program.
   94         2. Forty percent clinical training at a facility in the
   95  United States, the District of Columbia, or a possession or
   96  territory of the United States for a bachelor’s degree
   97  professional nursing education program.
   98         (c) No more than 50 25 percent of the program’s clinical
   99  training consists of clinical simulation.
  100         (d) The program has signed agreements with each agency,
  101  facility, and organization included in the curriculum plan as
  102  clinical training sites and community-based clinical experience
  103  sites.
  104         (e) The program has written policies for faculty which
  105  include provisions for direct or indirect supervision by program
  106  faculty or clinical preceptors for students in clinical training
  107  consistent with the following standards:
  108         1. The number of program faculty members equals at least
  109  one faculty member directly supervising every 12 students unless
  110  the written agreement between the program and the agency,
  111  facility, or organization providing clinical training sites
  112  allows more students, not to exceed 18 students, to be directly
  113  supervised by one program faculty member.
  114         2. For a hospital setting, indirect supervision may occur
  115  only if there is direct supervision by an assigned clinical
  116  preceptor, a supervising program faculty member is available by
  117  telephone, and such arrangement is approved by the clinical
  118  facility.
  119         3. For community-based clinical experiences that involve
  120  student participation in invasive or complex nursing activities,
  121  students must be directly supervised by a program faculty member
  122  or clinical preceptor and such arrangement must be approved by
  123  the community-based clinical facility.
  124         4. For community-based clinical experiences not subject to
  125  subparagraph 3., indirect supervision may occur only when a
  126  supervising program faculty member is available to the student
  127  by telephone.
  128  
  129  A program’s policies established under this paragraph must
  130  require that a clinical preceptor who is, if supervising
  131  students in a professional nursing education program, to be a
  132  registered nurse or, if supervising students in a practical
  133  nursing education program, to be a registered nurse or licensed
  134  practical nurse.
  135         (f) The professional or practical nursing curriculum plan
  136  documents clinical experience and theoretical instruction in
  137  medical, surgical, obstetric, pediatric, and geriatric nursing.
  138  A professional nursing curriculum plan shall also document
  139  clinical experience and theoretical instruction in psychiatric
  140  nursing. Each curriculum plan must document clinical training
  141  experience in appropriate settings that include, but are not
  142  limited to, acute care, long-term care, and community settings.
  143         (g) The professional or practical nursing education program
  144  provides theoretical instruction and clinical application in
  145  personal, family, and community health concepts; nutrition;
  146  human growth and development throughout the life span; body
  147  structure and function; interpersonal relationship skills;
  148  mental health concepts; pharmacology and administration of
  149  medications; and legal aspects of practice. A professional
  150  nursing education program must shall also provide theoretical
  151  instruction and clinical application in interpersonal
  152  relationships and leadership skills; professional role and
  153  function; and health teaching and counseling skills.
  154         (2) PROGRAM APPROVAL.—
  155         (a)  Upon receipt of a program application and review fee,
  156  the department shall examine the application to determine if
  157  whether it is complete. If the a program application is not
  158  complete, the department shall notify the educational
  159  institution in writing of any errors or omissions within 30 days
  160  after the department’s receipt of the application. A program
  161  application is deemed complete upon the department’s receipt of:
  162         1. The initial application, if the department does not
  163  notify the educational institution of any errors or omissions
  164  within the 30-day period; or
  165         2. A revised application that corrects each error and
  166  omission of which the department notifies the educational
  167  institution within the 30-day period.
  168         (b) Within 90 days after the department’s receipt of a
  169  complete program application, the board shall:
  170         1. Approve the application if it documents compliance with
  171  subsection (1) paragraphs (1)(a)-(g); or
  172         2. Provide the educational institution with a notice of
  173  intent to deny the application if it does not document
  174  compliance with subsection (1) paragraphs (1)(a)-(g). The notice
  175  must specify set forth written reasons for the board’s denial of
  176  the application. The board may not deny a program application
  177  because of an educational institution’s failure to correct an
  178  any error or omission that of which the department failed to
  179  provide notice of to does not notify the institution within the
  180  30-day notice period under paragraph (a). The educational
  181  institution may request a hearing on the notice of intent to
  182  deny the program application pursuant to chapter 120.
  183         (c) A program application is deemed approved if the board
  184  does not act within the 90-day review period provided under
  185  paragraph (b).
  186         (d) Upon the board’s approval of a program application, the
  187  program becomes an approved program.
  188         (3) STATUS OF CERTAIN PROGRAMS.—A professional or practical
  189  nursing education program becomes an approved program if, as of
  190  June 30, 2009, the program:
  191         (a) Has full or provisional approval from the board or,
  192  except as provided in paragraph (b), is on probationary status.
  193         (b) Is on probationary status because the program did not
  194  meet the board’s requirement for graduate passage rates. Such
  195  program shall remain on probationary status until it achieves a
  196  graduate passage rate for calendar year 2009 or 2010 that equals
  197  or exceeds the required passage rate for the respective calendar
  198  year and must disclose its probationary status in writing to the
  199  program’s students and applicants. If the program does not
  200  achieve the required passage rate, the board shall terminate the
  201  program pursuant to chapter 120.
  202         (3)(4) ANNUAL REPORT.—By November 1 of each year, each
  203  approved program shall submit to the board an annual report
  204  comprised of an affidavit certifying continued compliance with
  205  subsection (1) paragraphs (1)(a)-(g), a summary description of
  206  the program’s compliance with subsection (1) paragraphs (1)(a)
  207  (g), and documentation for the previous academic year that, to
  208  the extent applicable, describes sets forth:
  209         (a) The number of student applications received, qualified
  210  applicants, applicants accepted, accepted applicants who enroll
  211  in the program, students enrolled in the program, and program
  212  graduates.
  213         (b) The program’s retention rates for students tracked from
  214  program entry to graduation.
  215         (c) The program’s accreditation status, including
  216  identification of the accrediting agency if such agency is not
  217  an accrediting agency described in s. 464.003(1).
  218         (4)(5) INTERNET WEBSITE.—By October 1, 2010, The board
  219  shall publish the following information on its Internet website:
  220         (a) A list of each accredited program conducted in the
  221  state and the program’s graduate passage rates for the most
  222  recent 2 calendar years, which the department shall determine
  223  through the following sources:
  224         1. For a program’s accreditation status, the specialized
  225  accrediting agencies that are nationally recognized by the
  226  United States Secretary of Education to accredit nursing
  227  education programs.
  228         2. For a program’s graduate passage rates, the contract
  229  testing service of the National Council of State Boards of
  230  Nursing.
  231         (b) The following data for each approved program, which
  232  includes shall include, to the extent applicable:
  233         1. All documentation provided by the program in its program
  234  application if submitted on or after July 1, 2009.
  235         2. The summary description of the program’s compliance
  236  submitted under subsection (3) (4).
  237         3. The program’s accreditation status, including
  238  identification of the accrediting agency if such agency is not
  239  an accrediting agency described in s. 464.003(1).
  240         4. The program’s probationary status.
  241         5. The program’s graduate passage rates for the most recent
  242  2 calendar years.
  243         6. Each program’s retention rates for students tracked from
  244  program entry to graduation.
  245         (c) The average passage rates for United States educated
  246  first-time test takers on the National Council of State Boards
  247  of Nursing Licensing Examination for the most recent 2 calendar
  248  years, as calculated by the contract testing service of the
  249  National Council of State Boards of Nursing. The average passage
  250  rates shall be published separately for each type of comparable
  251  degree program listed in subparagraph (5)(a)1. sub-subparagraphs
  252  (6)(a)1.a.-d.
  253  
  254  The information required to be published under this subsection
  255  shall be made available in a manner that allows interactive
  256  searches and comparisons of individual programs selected by the
  257  website user. The board shall update the Internet website at
  258  least quarterly with the available information.
  259         (5)(6) ACCOUNTABILITY.—
  260         (a)1. An approved program must achieve a graduate passage
  261  rate that is not more lower than 10 percentage points lower less
  262  than the average passage rate during the same calendar year for
  263  graduates of comparable degree programs who are United States
  264  educated, first-time test takers on the National Council of
  265  State Boards of Nursing Licensing Examination during a calendar
  266  year, as calculated by the contract testing service of the
  267  National Council of State Boards of Nursing. For purposes of
  268  this subparagraph, an approved program is comparable to all
  269  degree programs of the same program type from among the
  270  following program types:
  271         a. Professional nursing education programs that terminate
  272  in a bachelor’s degree.
  273         b. Professional nursing education programs that terminate
  274  in an associate degree.
  275         c. Professional nursing education programs that terminate
  276  in a diploma.
  277         d. Practical nursing education programs.
  278         2. Beginning with graduate passage rates for calendar year
  279  2010, if an approved program’s graduate passage rates do not
  280  equal or exceed the required passage rates for 2 consecutive
  281  calendar years, the board shall place the program on
  282  probationary status pursuant to chapter 120 and the program
  283  director shall must appear before the board to present a plan
  284  for remediation. The program must shall remain on probationary
  285  status until it achieves a graduate passage rate that equals or
  286  exceeds the required passage rate for any 1 calendar year. The
  287  board shall deny a program application for a new prelicensure
  288  nursing education program submitted by an educational
  289  institution if the institution has an existing program that is
  290  already on probationary status.
  291         3. Upon the program’s achievement of a graduate passage
  292  rate that equals or exceeds the required passage rate, the
  293  board, at its next regularly scheduled meeting following release
  294  of the program’s graduate passage rate by the National Council
  295  of State Boards of Nursing, shall remove the program’s
  296  probationary status. However, if the program, during the 2
  297  calendar years following its placement on probationary status,
  298  does not achieve the required passage rate for any 1 calendar
  299  year, the board shall terminate the program pursuant to chapter
  300  120.
  301         (b) If an approved program fails to submit the annual
  302  report required in subsection (3) (4), the board shall notify
  303  the program director and president or chief executive officer of
  304  the educational institution in writing within 15 days after the
  305  due date of the annual report. The program director shall must
  306  appear before the board at the board’s next regularly scheduled
  307  meeting to explain the reason for the delay. The board shall
  308  terminate the program pursuant to chapter 120 if it does not
  309  submit the annual report within 6 months after the due date.
  310         (c) An approved program on probationary status shall
  311  disclose its probationary status in writing to the program’s
  312  students and applicants.
  313         (6)(7) DISCLOSURE OF GRADUATE PASSAGE RATE DATA.—
  314         (a) For each graduate of the program an approved program’s
  315  or accredited program’s graduates included in the calculation of
  316  the program’s graduate passage rate, the department shall
  317  disclose to the program director, upon his or her written
  318  request, the name, examination date, and determination of
  319  whether each graduate passed or failed the National Council of
  320  for State Boards of Nursing Licensing Examination, if to the
  321  extent that such information is provided to the department by
  322  the contract testing service of the National Council of for
  323  State Boards of Nursing. The written request must specify the
  324  calendar years for which the information is requested.
  325         (b) A program director to whom confidential information
  326  exempt from public disclosure pursuant to s. 456.014 is
  327  disclosed under this subsection must maintain the
  328  confidentiality of the information and is subject to the same
  329  penalties provided in s. 456.082 for department employees who
  330  unlawfully disclose confidential information.
  331         (7)(8) PROGRAM CLOSURE.—
  332         (a) An educational institution conducting an approved
  333  program or accredited program in this state, at least 30 days
  334  before voluntarily closing the program, shall notify the board
  335  in writing of the institution’s reason for closing the program,
  336  the intended closure date, the institution’s plan to provide for
  337  or assist in the completion of training by the program’s
  338  students, and the arrangements for storage of the program’s
  339  permanent records.
  340         (b) An educational institution conducting a nursing
  341  education program that is terminated under subsection (5) (6) or
  342  closed under subparagraph (9)(b)3. (10)(b)3.:
  343         1. May not accept or enroll new students.
  344         2. Shall Must submit to the board within 30 days after the
  345  program is terminated or closed a written description of how the
  346  institution will assist in completing the completion of training
  347  of by the program’s students and the institution’s arrangements
  348  for storage of the program’s permanent records.
  349         (c) If an educational institution does not comply with
  350  paragraph (a) or paragraph (b), the board shall provide a
  351  written notice explaining the institution’s noncompliance to the
  352  following persons and entities:
  353         1. The president or chief executive officer of the
  354  educational institution.
  355         2. The Board of Governors, if the program is conducted by a
  356  state university.
  357         3. The district school board, if the program is conducted
  358  by an educational institution operated by a school district.
  359         4. The Commission for Independent Education, if the program
  360  is conducted by an educational institution licensed under
  361  chapter 1005.
  362         5. The State Board of Education, if the program is
  363  conducted by an educational institution in the Florida College
  364  System or by an educational institution that is not subject to
  365  subparagraphs 2.-4.
  366         (8)(9) RULEMAKING.—The board does not have any rulemaking
  367  authority to administer this section, except that the board
  368  shall adopt rules a rule that prescribe prescribes the format
  369  for submitting program applications under subsection (1) and
  370  annual reports under subsection (3), and to administer the
  371  documentation of the accreditation of nursing education programs
  372  under subsection (11) (4). The board may not impose any
  373  condition or requirement on an educational institution
  374  submitting a program application, an approved program, or an
  375  accredited program, except as expressly provided in this
  376  section. The board shall repeal all rules, or portions thereof,
  377  in existence on July 1, 2009, that are inconsistent with this
  378  subsection.
  379         (9)(10) APPLICABILITY TO ACCREDITED PROGRAMS.—
  380         (a) Subsections (1)-(3) (1)-(4), paragraph (4)(b) (5)(b),
  381  and subsection (5) (6) do not apply to an accredited program. An
  382  accredited program on probationary status before July 1, 2010,
  383  ceases to be subject to the probationary status.
  384         (b) If an accredited program ceases to be accredited, the
  385  educational institution conducting the program:
  386         1. Within 10 business days after the program ceases to be
  387  accredited, must provide written notice of the date that the
  388  program ceased to be accredited to the board, the program’s
  389  students and applicants, and each entity providing clinical
  390  training sites or community-based clinical experience sites for
  391  the program. The educational institution must continue to
  392  provide the written notice to new students, applicants, and
  393  entities providing clinical training sites or community-based
  394  clinical experience sites for the program until the program
  395  becomes an approved program or is closed under subparagraph 3.
  396         2. Within 30 days after the program ceases to be
  397  accredited, must submit an affidavit to the board, signed by the
  398  educational institution’s president or chief executive officer
  399  which, that certifies the institution’s compliance with
  400  subparagraph 1. The board shall notify the persons and
  401  applicable entities listed in paragraph (7)(c) subparagraph
  402  (8)(c)1. and the applicable entities listed in subparagraphs
  403  (8)(c)2.-5. if an educational institution does not submit the
  404  affidavit required by this subparagraph.
  405         3. May apply to become an approved program under this
  406  section. If the educational institution:
  407         a. Within 30 days after the program ceases to be
  408  accredited, submits a program application and review fee to the
  409  department under subsection (1) and the affidavit required under
  410  subparagraph 2., the program shall be deemed an approved program
  411  from the date that the program ceased to be accredited until the
  412  date that the board approves or denies the program application.
  413  The program application must be denied by the board pursuant to
  414  chapter 120 if it does not contain the affidavit. If the board
  415  denies the program application under subsection (2) or if
  416  because the program application does not contain the affidavit,
  417  the program shall be closed and the educational institution
  418  conducting the program must comply with paragraph (7)(b) (8)(b).
  419         b. Does not apply to become an approved program pursuant to
  420  sub-subparagraph a., the program shall be deemed an approved
  421  program from the date that the program ceased to be accredited
  422  until the 31st day after that date. On the 31st day after the
  423  program ceased to be accredited, the program shall be closed and
  424  the educational institution conducting the program must comply
  425  with paragraph (7)(b) (8)(b).
  426         (10)(11) IMPLEMENTATION STUDY.—The Florida Center for
  427  Nursing and the education policy area of the Office of Program
  428  Policy Analysis and Government Accountability shall study the
  429  implementation 5-year administration of this section and submit
  430  reports to the Governor, the President of the Senate, and the
  431  Speaker of the House of Representatives in January of each year
  432  following the effective date of this act by January 30, 2011,and
  433  annually thereafter through January 30, 2015. The annual reports
  434  shall address the previous academic year; provide set forth data
  435  on the measures specified in paragraphs (a) and (b), as such
  436  data becomes available; and include an evaluation of such data
  437  for purposes of determining whether this section is increasing
  438  the availability of nursing education programs and the
  439  production of quality nurses. The department and each approved
  440  program or accredited program shall comply with requests for
  441  data from the Florida Center for Nursing and the education
  442  policy area of the Office of Program Policy Analysis and
  443  Government Accountability.
  444         (a) The Florida Center for Nursing education policy area of
  445  the Office of Program Policy Analysis and Government
  446  Accountability shall evaluate program-specific data for each
  447  approved program and accredited program conducted in the state,
  448  including, but not limited to:
  449         1. The number of programs and student slots available.
  450         2. The number of student applications submitted, the number
  451  of qualified applicants, and the number of students accepted.
  452         3. The number of program graduates.
  453         4. Program retention rates of students tracked from program
  454  entry to graduation.
  455         5. Graduate passage rates on the National Council of State
  456  Boards of Nursing Licensing Examination.
  457         6. The number of graduates who become employed as practical
  458  or professional nurses in the state.
  459         (b) The Florida Center for Nursing shall evaluate the
  460  board’s implementation of the:
  461         1. Program application approval process, including, but not
  462  limited to, the number of program applications submitted under
  463  subsection (1); the number of program applications approved and
  464  denied by the board under subsection (2); the number of denials
  465  of program applications reviewed under chapter 120; and a
  466  description of the outcomes of those reviews.
  467         2. Accountability processes, including, but not limited to,
  468  the number of programs on probationary status, the number of
  469  approved programs for which the program director is required to
  470  appear before the board under subsection (5) (6), the number of
  471  approved programs terminated by the board, the number of
  472  terminations reviewed under chapter 120, and a description of
  473  the outcomes of those reviews.
  474         (c) For any state fiscal year in which the Florida Center
  475  for Nursing does not receive legislative appropriations, the
  476  education policy area of the Office of Program Policy Analysis
  477  and Government Accountability shall perform the duties assigned
  478  by this subsection to the Florida Center for Nursing.
  479         (11) ACCREDITATION REQUIRED.—
  480         (a) A nursing education program that prepares students for
  481  the practice of professional nursing, that was approved under
  482  this section before July 1, 2014, and that enrolled students
  483  before July 1, 2014, must become an accredited program by July
  484  1, 2019.
  485         (b) A nursing education program that prepares students for
  486  the practice of professional nursing, that was approved under
  487  this section before July 1, 2014, but did not enroll students
  488  before that date, must become an accredited program within 5
  489  years after the date of enrolling the program’s first students.
  490         (c) A nursing education program that prepares students for
  491  the practice of professional nursing and that is approved by the
  492  board after June 30, 2014, must become an accredited program
  493  within 5 years after the date of enrolling the program’s first
  494  students.
  495         (d) This subsection does not apply to a nursing education
  496  program provided by an institution that is exempted from
  497  licensure by the Commission for Independent Education under s.
  498  1005.06(1)(e).
  499         Section 4. Subsection (1) of section 456.014, Florida
  500  Statutes, is amended to read:
  501         456.014 Public inspection of information required from
  502  applicants; exceptions; examination hearing.—
  503         (1) All information required by the department of any
  504  applicant shall be a public record and shall be open to public
  505  inspection pursuant to s. 119.07, except financial information,
  506  medical information, school transcripts, examination questions,
  507  answers, papers, grades, and grading keys, which are
  508  confidential and exempt from s. 119.07(1) and shall not be
  509  discussed with or made accessible to anyone except the program
  510  director of an approved program or accredited program as
  511  provided in s. 464.019(6) 464.019(7), members of the board, the
  512  department, and staff thereof, who have a bona fide need to know
  513  such information. Any information supplied to the department by
  514  any other agency which is exempt from the provisions of chapter
  515  119 or is confidential shall remain exempt or confidential
  516  pursuant to applicable law while in the custody of the
  517  department or the agency.
  518         Section 5. This act shall take effect July 1, 2014.