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.