Florida Senate - 2025 COMMITTEE AMENDMENT
Bill No. CS for SB 526
Ì698194NÎ698194
LEGISLATIVE ACTION
Senate . House
Comm: RCS .
04/15/2025 .
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The Appropriations Committee on Health and Human Services
(Harrell) recommended the following:
1 Senate Amendment (with title amendment)
2
3 Delete everything after the enacting clause
4 and insert:
5 Section 1. Subsection (5) is added to section 464.008,
6 Florida Statutes, and subsection (1) of that section is
7 republished, to read:
8 464.008 Licensure by examination.—
9 (1) Any person desiring to be licensed as a registered
10 nurse or licensed practical nurse shall apply to the department
11 to take the licensure examination. The department shall examine
12 each applicant who:
13 (a) Has completed the application form and remitted a fee
14 set by the board not to exceed $150 and has remitted an
15 examination fee set by the board not to exceed $75 plus the
16 actual per applicant cost to the department for purchase of the
17 examination from the National Council of State Boards of Nursing
18 or a similar national organization.
19 (b) Has provided sufficient information on or after October
20 1, 1989, which must be submitted by the department for a
21 statewide criminal records correspondence check through the
22 Department of Law Enforcement.
23 (c) Is in good mental and physical health, is a recipient
24 of a high school diploma or the equivalent, and has completed
25 the requirements for:
26 1. Graduation from an approved program;
27 2. Graduation from a prelicensure nursing education program
28 that the board determines is equivalent to an approved program;
29 3. Graduation on or after July 1, 2009, from an accredited
30 program; or
31 4. Graduation before July 1, 2009, from a prelicensure
32 nursing education program whose graduates at that time were
33 eligible for examination.
34
35 Courses successfully completed in a professional nursing
36 education program that are at least equivalent to a practical
37 nursing education program may be used to satisfy the education
38 requirements for licensure as a licensed practical nurse.
39 (d) Has the ability to communicate in the English language,
40 which may be determined by an examination given by the
41 department.
42 (5) Pursuant to s. 464.019(1)(k) establishing graduate
43 nursing preceptorships, the department shall issue a provisional
44 license to such graduates who also meet the criteria in
45 paragraphs (1)(b), (c), and (d).
46 Section 2. Subsections (1) through (6) and (8) and
47 paragraph (f) of subsection (11) of section 464.019, Florida
48 Statutes, are amended to read:
49 464.019 Approval of nursing education programs.—
50 (1) PROGRAM APPLICATION.—An educational institution that
51 wishes to conduct a program in this state for the prelicensure
52 education of professional or practical nurses must submit to the
53 department a program application and review fee of $1,000 for
54 each prelicensure nursing education program to be offered at the
55 institution’s main campus, branch campus, or other instructional
56 site. The program application must include the legal name of the
57 educational institution, the legal name of the nursing education
58 program, the legal name of the nursing education program
59 director, and, if such institution is accredited, the name of
60 the accrediting agency. The application must also document that:
61 (a)1. For a professional nursing education program, the
62 program director and at least 50 percent of the program’s
63 faculty members are registered nurses who have a master’s or
64 higher degree in nursing or a bachelor’s degree in nursing and a
65 master’s or higher degree in a field related to nursing.
66 2. For a practical nursing education program, the program
67 director and at least 50 percent of the program’s faculty
68 members are registered nurses who have a bachelor’s or higher
69 degree in nursing.
70
71 The educational degree requirements of this paragraph must may
72 be documented by an official transcript or by a written
73 statement from the program director of the educational
74 institution verifying that the institution conferred the degree.
75 The program director shall certify the official transcript or
76 written statement as true and accurate.
77 (b) The program’s nursing major curriculum consists of at
78 least:
79 1. Fifty percent clinical training in the United States,
80 the District of Columbia, or a possession or territory of the
81 United States for a practical nursing education program, an
82 associate degree professional nursing education program, or a
83 professional diploma nursing education program.
84 2. Forty percent clinical training in the United States,
85 the District of Columbia, or a possession or territory of the
86 United States for a bachelor’s degree professional nursing
87 education program.
88 (c) No more than 50 percent of the program’s clinical
89 training consists of clinical simulation.
90 (d) The program has signed agreements with each agency,
91 facility, and organization included in the curriculum plan as
92 clinical training sites and community-based clinical experience
93 sites.
94 (e) The program has written policies for faculty which
95 include provisions for direct or indirect supervision by program
96 faculty or clinical preceptors for students in clinical training
97 consistent with the following standards:
98 1. The number of program faculty members equals at least
99 one faculty member directly supervising every 12 students unless
100 the written agreement between the program and the agency,
101 facility, or organization providing clinical training sites
102 allows more students, not to exceed 18 students, to be directly
103 supervised by one program faculty member.
104 2. For a hospital setting, indirect supervision may occur
105 only if there is direct supervision by an assigned clinical
106 preceptor, a supervising program faculty member is available by
107 telephone, and such arrangement is approved by the clinical
108 facility.
109 3. For community-based clinical experiences that involve
110 student participation in invasive or complex nursing activities,
111 students must be directly supervised by a program faculty member
112 or clinical preceptor and such arrangement must be approved by
113 the community-based clinical facility.
114 4. For community-based clinical experiences not subject to
115 subparagraph 3., indirect supervision may occur only when a
116 supervising program faculty member is available to the student
117 by telephone.
118
119 A program’s policies established under this paragraph must
120 require that a clinical preceptor who is supervising students in
121 a professional nursing education program be a registered nurse
122 or, if supervising students in a practical nursing education
123 program, be a registered nurse or licensed practical nurse.
124 (f) The professional or practical nursing curriculum plan
125 documents clinical experience and theoretical instruction in
126 medical, surgical, obstetric, pediatric, and geriatric nursing.
127 A professional nursing curriculum plan must shall also document
128 clinical experience and theoretical instruction in psychiatric
129 nursing. Each curriculum plan must document clinical training
130 experience in appropriate settings that include, but are not
131 limited to, acute care, long-term care, and community settings.
132 (g) The professional or practical nursing education program
133 provides theoretical instruction and clinical application in
134 personal, family, and community health concepts; nutrition;
135 human growth and development throughout the life span; body
136 structure and function; interpersonal relationship skills;
137 mental health concepts; pharmacology and administration of
138 medications; and legal aspects of practice. A professional
139 nursing education program must also provide theoretical
140 instruction and clinical application in interpersonal
141 relationships and leadership skills; professional role and
142 function; and health teaching and counseling skills.
143 (h) The professional or practical nursing education program
144 has established evaluation and standardized admission criteria.
145 The admission criteria must, at a minimum, identify those
146 students who are likely to need additional educational support
147 to be successful program graduates. The program must maintain
148 documentation of the individualized student academic support
149 plan for those students identified as in need of additional
150 preparation and educational support.
151 (i) For each student, the professional or practical nursing
152 education program administers an exit examination that is a
153 national, standardized, and comprehensive predictor exam
154 designed to help nursing students assess their readiness for the
155 National Council of State Boards of Nursing Licensing
156 Examination (NCLEX) by identifying areas needing further study
157 and remediation. The exit examination may not be the sole
158 exclusion to graduation if the student has otherwise
159 successfully completed all coursework required by the program.
160 (j) The professional or practical nursing education program
161 has submitted to the board the established criteria for
162 remediation that will be offered to students who do not
163 successfully pass the exit examination.
164 (k) Beginning August 1, 2026, a program with more than 10
165 percentage points lower than the average passage rate during the
166 same calendar year for graduates of comparable degree programs
167 who are United States-educated, first-time test takers on the
168 NCLEX, as calculated by the contract testing service of the
169 National Council of State Boards of Nursing, shall offer a
170 graduate nursing preceptorship to its graduates. All programs
171 are encouraged to offer a graduate nursing preceptorship to
172 their graduates to provide opportunities for job shadowing,
173 clinical training, nonclinical training, and patient care in a
174 hospital setting. A graduate nursing preceptorship must last for
175 3 months, with the expectation that graduates will take the
176 NCLEX at the conclusion of the preceptorship. Graduate
177 registered nurses and graduate licensed practical nurses must be
178 supervised by clinical preceptors. The department shall issue
179 temporary provisional registered nurse licenses to a graduate of
180 a registered nursing program. The department shall issue
181 temporary provisional licensed practical nurse licenses to a
182 graduate of a licensed practical nursing program. If the
183 examination, professional or practical nursing education program
184 must offer remediation to the graduate for free. By January 1,
185 2026, the Florida Center for Nursing shall establish standards
186 for graduate nursing preceptorships, including supervision
187 requirements. The board shall incorporate the standards into
188 rule.
189 (2) PROGRAM APPROVAL.—
190 (a) Upon receipt of a program application and review fee,
191 the department shall examine the application to determine if it
192 is complete. If the application is not complete, the department
193 must shall notify the educational institution in writing of any
194 errors or omissions within 30 days after the department’s
195 receipt of the application. A program application is deemed
196 complete upon the department’s receipt of:
197 1. The initial application, if the department does not
198 notify the educational institution of any errors or omissions
199 within the 30-day period; or
200 2. A revised application that corrects each error and
201 omission of which the department notifies the educational
202 institution within the 30-day period.
203 (b) Following the department’s receipt of a complete
204 program application, the board may conduct an onsite evaluation
205 if necessary to document the applicant’s compliance with
206 subsection (1). Within 90 days after the department’s receipt of
207 a complete program application, the board shall:
208 1. Approve the application if it documents compliance with
209 subsection (1); or
210 2. Provide the educational institution with a notice of
211 intent to deny the application if it does not document
212 compliance with subsection (1). The notice must specify written
213 reasons for the board’s denial of the application. The board may
214 not deny a program application because of an educational
215 institution’s failure to correct an error or omission that the
216 department failed to provide notice of to the institution within
217 the 30-day notice period under paragraph (a). The educational
218 institution may request a hearing on the notice of intent to
219 deny the program application pursuant to chapter 120.
220 (c) A program application is deemed approved if the board
221 does not act within the 90-day review period provided under
222 paragraph (b).
223 (d) Upon the board’s approval of a program application, the
224 program becomes an approved program.
225 (e) The board shall deny an application from a program that
226 has had adverse action taken against it by another regulatory
227 jurisdiction in the United States. The board may also revoke the
228 approval of an existing approved program that has had adverse
229 action taken against it by another regulatory jurisdiction in
230 the United States. For purposes of this paragraph, the term
231 “adverse action” means any administrative, civil, or criminal
232 action imposed by a licensing board or other state authority
233 against a program. The term includes actions such as revocation,
234 suspension, probation, or any other encumbrance affecting the
235 program’s authorization to operate.
236 (3) ANNUAL REPORT.—By November 1 of each year, each
237 approved program’s director program shall submit to the board an
238 annual report consisting comprised of an affidavit certifying
239 continued compliance with subsection (1), a summary description
240 of the program’s compliance with subsection (1), and
241 documentation for the previous academic year that, to the extent
242 applicable, describes:
243 (a) The number of student applications received, qualified
244 applicants, applicants accepted, accepted applicants who enroll
245 in the program, students enrolled in the program, and program
246 graduates.
247 (b) The program’s retention rates for students tracked from
248 program entry to graduation.
249 (c) The program’s accreditation status, including
250 identification of the accrediting agency.
251
252 The board must terminate the program pursuant to chapter 120 if
253 the requirements of this subsection are not met. Upon request,
254 the board may give an extension for good cause not to exceed 60
255 days for a program to meet the requirements of this subsection.
256 If a program director is found to be in violation of this
257 subsection, the board may impose a penalty listed in s.
258 456.072(2).
259 (4) INTERNET WEBSITE.—The board shall publish the following
260 information on its Internet website:
261 (a) A list of each accredited program conducted in the
262 state and the program’s graduate passage rates for the most
263 recent 2 calendar years, which the department shall determine
264 through the following sources:
265 1. For a program’s accreditation status, the specialized
266 accrediting agencies that are nationally recognized by the
267 United States Secretary of Education to accredit nursing
268 education programs.
269 2. For a program’s graduate passage rates, the contract
270 testing service of the National Council of State Boards of
271 Nursing.
272 (b) The following data for each approved program, which
273 includes, to the extent applicable:
274 1. All documentation provided by the program in its program
275 application.
276 2. The summary description of the program’s compliance
277 submitted under subsection (3).
278 3. The program’s accreditation status, including
279 identification of the accrediting agency.
280 4. The program’s probationary status.
281 5. The program’s graduate passage rates for the most recent
282 2 calendar years.
283 6. Each program’s retention rates for students tracked from
284 program entry to graduation.
285 (c) The average passage rates for United States educated,
286 first-time test takers on the National Council of State Boards
287 of Nursing Licensing Examination for the most recent 2 calendar
288 years, as calculated by the contract testing service of the
289 National Council of State Boards of Nursing. The average passage
290 rates shall be published separately for each type of comparable
291 degree program listed in subparagraph (5)(a)1., and individually
292 for each approved nursing program.
293
294 The information required to be published under this subsection
295 shall be made available in a manner that allows interactive
296 searches and comparisons of individual programs selected by the
297 website user. The board shall update the Internet website at
298 least quarterly with the available information.
299 (5) ACCOUNTABILITY.—
300 (a)1. An approved program must achieve a graduate passage
301 rate for first-time test takers which is not more than 10
302 percentage points lower than the average passage rate during the
303 same calendar year for graduates of comparable degree programs
304 who are United States educated, first-time test takers on the
305 National Council of State Boards of Nursing Licensing
306 Examination, as calculated by the contract testing service of
307 the National Council of State Boards of Nursing. For purposes of
308 this subparagraph, an approved program is comparable to all
309 degree programs of the same program type from among the
310 following program types:
311 a. Professional nursing education programs that terminate
312 in a bachelor’s degree.
313 b. Professional nursing education programs that terminate
314 in an associate degree.
315 c. Professional nursing education programs that terminate
316 in a diploma.
317 d. Practical nursing education programs.
318 2. If an approved program’s graduate passage rates do not
319 equal or exceed the required passage rates for 2 consecutive
320 calendar years, the board must shall place the program on
321 probationary status pursuant to chapter 120 and the program
322 director must submit a written remediation plan to the board.
323 The program director must shall appear before the board to
324 present the a plan for remediation, which must shall include
325 specific nationally recognized benchmarks to identify progress
326 toward a graduate passage rate goal. The board must terminate a
327 program pursuant to chapter 120 if the program director fails to
328 submit a written remediation plan or fails to appear before the
329 board and present the remediation plan no later than 6 months
330 after the date of the program being placed on probation. The
331 board may impose a penalty listed in s. 456.072(2) on the
332 program director for such failure. The program must remain on
333 probationary status until it achieves a graduate passage rate
334 that equals or exceeds the required passage rate for any 1
335 calendar year. The board must shall deny a program application
336 for a new prelicensure nursing education program submitted by an
337 educational institution if the institution has an existing
338 program that is already on probationary status.
339 3. Upon the program’s achievement of a graduate passage
340 rate that equals or exceeds the required passage rate, the
341 board, at its next regularly scheduled meeting following release
342 of the program’s graduate passage rate by the National Council
343 of State Boards of Nursing, shall remove the program’s
344 probationary status. If the program, during the 2 calendar years
345 following its placement on probationary status, does not achieve
346 the required passage rate for any 1 calendar year, the board
347 must may extend the program’s probationary status for 1
348 additional year, provided the program has demonstrated adequate
349 progress toward the graduate passage rate goal by meeting a
350 majority of the benchmarks established in the remediation plan.
351 If the program is not granted the 1-year extension or fails to
352 achieve the required passage rate by the end of such extension,
353 the board shall terminate the program pursuant to chapter 120.
354 (b) If an approved program fails to submit the annual
355 report required in subsection (3), the board must shall notify
356 the program director and president or chief executive officer of
357 the educational institution in writing within 15 days after the
358 due date of the annual report. The program director must shall
359 appear before the board at the board’s next regularly scheduled
360 meeting to explain the reason for the delay. The board must
361 shall terminate the program pursuant to chapter 120 if the
362 program director fails to appear before the board, as required
363 under this paragraph, or if the program does not submit the
364 annual report within 6 months after the due date.
365 (c) A nursing education program, whether accredited or
366 nonaccredited, which has been placed on probationary status must
367 shall disclose its probationary status in writing to the
368 program’s students and applicants. The notification must include
369 an explanation of the implications of the program’s probationary
370 status on the students or applicants.
371 (d) If students from a program that is terminated pursuant
372 to this subsection transfer to an approved or an accredited
373 program under the direction of the Commission for Independent
374 Education, the board must shall recalculate the passage rates of
375 the programs receiving the transferring students, excluding the
376 test scores of those students transferring more than 12 credits.
377 (e) Duly authorized agents or employees of the department
378 may conduct onsite evaluations or inspections at any time during
379 business hours to ensure that approved programs or accredited
380 programs are in full compliance with this chapter, or to
381 determine whether this chapter or s. 456.072 is being violated.
382 The department may collect any necessary evidence needed to
383 ensure compliance with this chapter or for prosecution as deemed
384 necessary. A failure of a program to refuse or allow an onsite
385 evaluation or inspection is deemed a violation of a legal
386 obligation imposed by the board or the department.
387 (6) DISCLOSURE OF GRADUATE PASSAGE RATE DATA.—
388 (a) For each graduate of the program included in the
389 calculation of the program’s graduate passage rate, the
390 department shall disclose to the program director, upon his or
391 her written request, the name, examination date, and
392 determination of whether each graduate passed or failed the
393 National Council of State Boards of Nursing Licensing
394 Examination, if such information is provided to the department
395 by the contract testing service of the National Council of State
396 Boards of Nursing. The department shall disclose to the program
397 director the average passage rate for graduates from its program
398 written request must specify the calendar years for which the
399 information is requested.
400 (b) A program director to whom confidential information
401 exempt from public disclosure pursuant to s. 456.014 is
402 disclosed under this subsection must maintain the
403 confidentiality of the information and is subject to the same
404 penalties provided in s. 456.082 for department employees who
405 unlawfully disclose confidential information.
406 (c) The program director is responsible for ensuring that
407 the graduate average passage rate, as reported by the
408 department, is posted on the program’s website.
409 (8) RULEMAKING.—The board does not have rulemaking
410 authority to administer this section, except that the board
411 shall adopt rules that prescribe the format for submitting
412 program applications under subsection (1) and annual reports
413 under subsection (3), to implement graduate nursing
414 preceptorships as established in paragraph (1)(k), to enforce
415 and administer subsection (5), and to administer the
416 documentation of the accreditation of nursing education programs
417 under subsection (11). The board may adopt rules relating to the
418 nursing curriculum, including rules relating to the uses and
419 limitations of simulation technology, and rules relating to the
420 criteria to qualify for an extension of time to meet the
421 accreditation requirements under paragraph (11)(f). The board
422 may not impose any condition or requirement on an educational
423 institution submitting a program application, an approved
424 program, or an accredited program, except as expressly provided
425 in this section.
426 (11) ACCREDITATION REQUIRED.—
427 (f) An approved nursing education program may, no sooner
428 than 90 days before the deadline for meeting the accreditation
429 requirements of this subsection, apply to the board for an
430 extension of the accreditation deadline for a period which does
431 not exceed 2 years. An additional extension may not be granted.
432 In order to be eligible for the extension, the approved program
433 must establish that it has a graduate passage rate of 60 percent
434 or higher on the National Council of State Boards of Nursing
435 Licensing Examination for the most recent calendar year and must
436 meet a majority of the board’s additional criteria, including,
437 but not limited to, all of the following:
438 1. A student retention rate of 60 percent or higher for the
439 most recent calendar year.
440 2. A graduate work placement rate of 70 percent or higher
441 for the most recent calendar year.
442 3. The program has applied for approval or been approved by
443 an institutional or programmatic accreditor recognized by the
444 United States Department of Education.
445 4. The program is in full compliance with subsections (1)
446 and (3) and paragraph (5)(b).
447 5. The program is not currently in its second year of
448 probationary status under subsection (5).
449
450 The applicable deadline under this paragraph is tolled from the
451 date on which an approved program applies for an extension until
452 the date on which the board issues a decision on the requested
453 extension.
454 Section 3. This act shall take effect July 1, 2025.
455
456 ================= T I T L E A M E N D M E N T ================
457 And the title is amended as follows:
458 Delete everything before the enacting clause
459 and insert:
460 A bill to be entitled
461 An act relating to nursing education programs;
462 amending s. 464.008, F.S., requiring the Department of
463 Health to issue provisional licenses to graduate
464 licensed practical nurses and graduate registered
465 nurses under the supervision of clinical preceptors;
466 amending s. 464.019, F.S.; revising application
467 requirements for nursing education program approval;
468 providing preceptorship requirements; requiring the
469 Florida Center for Nursing to develop graduate nursing
470 preceptorship standards by a specified date; requiring
471 the Board of Nursing to incorporate the standards into
472 rule; clarifying that the Board of Nursing must
473 publish the graduate average passage rate of each
474 approved nursing program on its website; requiring the
475 board to deny an application under certain
476 circumstances; requiring the board to revoke an
477 existing program’s approval under certain
478 circumstances; defining the term “adverse action”;
479 revising requirements for annual reports approved
480 programs are required to submit to the board;
481 requiring the board to terminate a program under
482 certain circumstances; providing penalties for program
483 directors found to be in violation of specified
484 provisions; revising remediation procedures for
485 approved programs with graduate passage rates that do
486 not meet specified requirements; subjecting program
487 directors of approved programs to specified
488 disciplinary action under certain circumstances;
489 deleting a provision authorizing the board to extend a
490 program’s probationary status; authorizing agents or
491 employees of the department to conduct onsite
492 evaluations and inspections of approved and accredited
493 nursing education programs; authorizing the department
494 to collect evidence as part of such evaluations and
495 inspections; deeming failure or refusal of a program
496 to allow such evaluation or inspection as a violation
497 of a legal obligation; requiring the department to
498 disclose graduate average passage rates to each
499 program director; providing that program directors are
500 responsible for ensuring that graduate average passage
501 rates are posted on the program’s website; revising
502 rulemaking authority of the board; deleting a
503 provision authorizing approved nursing education
504 programs to request an extension to meet the board’s
505 accreditation requirements; providing an effective
506 date.