Florida Senate - 2026 COMMITTEE AMENDMENT
Bill No. SB 254
Ì639802(Î639802
LEGISLATIVE ACTION
Senate . House
Comm: RCS .
02/25/2026 .
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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. Present subsections (3) and (4) of 464.008,
6 Florida Statutes, are redesignated as subsections (4) and (5),
7 respectively, a new subsection (3) and subsection (6) are added
8 to that section, and subsection (1) of that section is
9 republished, to read:
10 464.008 Licensure by examination.—
11 (1) Any person desiring to be licensed as a registered
12 nurse or licensed practical nurse shall apply to the department
13 to take the licensure examination. The department shall examine
14 each applicant who:
15 (a) Has completed the application form and remitted a fee
16 set by the board not to exceed $150 and has remitted an
17 examination fee set by the board not to exceed $75 plus the
18 actual per applicant cost to the department for purchase of the
19 examination from the National Council of State Boards of Nursing
20 or a similar national organization.
21 (b) Has provided sufficient information on or after October
22 1, 1989, which must be submitted by the department for a
23 statewide criminal records correspondence check through the
24 Department of Law Enforcement.
25 (c) Is in good mental and physical health, is a recipient
26 of a high school diploma or the equivalent, and has completed
27 the requirements for:
28 1. Graduation from an approved program;
29 2. Graduation from a prelicensure nursing education program
30 that the board determines is equivalent to an approved program;
31 3. Graduation on or after July 1, 2009, from an accredited
32 program; or
33 4. Graduation before July 1, 2009, from a prelicensure
34 nursing education program whose graduates at that time were
35 eligible for examination.
36
37 Courses successfully completed in a professional nursing
38 education program that are at least equivalent to a practical
39 nursing education program may be used to satisfy the education
40 requirements for licensure as a licensed practical nurse.
41 (d) Has the ability to communicate in the English language,
42 which may be determined by an examination given by the
43 department.
44 (3)(a) Any applicant who desires to take the licensure
45 examination for the first time more than 6 months after
46 graduation must complete a board-approved remedial course or a
47 board-developed remedial course before the applicant may be
48 approved for examination.
49 (b) The board shall develop a remedial course in
50 consultation with the Florida Center for Nursing. The course
51 must be made available on the board’s website free of charge to
52 applicants experiencing hardship, as defined by the board.
53 (6)(a) The department shall issue a temporary provisional
54 license to an applicant who is eligible to take the licensure
55 examination under subsection (1) and who seeks to practice as a
56 graduate professional nurse or graduate practical nurse, as
57 applicable.
58 (b) A temporary provisional license issued under this
59 subsection:
60 1. Is valid for a period not to exceed 180 days after the
61 date of issuance.
62 2. Is nonrenewable.
63 3. Automatically expires upon the applicant passing the
64 licensure examination and the department issuing a full license,
65 or upon the applicant’s failure to pass the examination.
66 (c) A temporary provisional licensee may practice only
67 under the direct supervision of a registered nurse or licensed
68 practical nurse, as applicable, who has filed a written protocol
69 with the department. The board shall adopt rules to implement
70 this paragraph.
71 Section 2. Subsections (1), (2), (3), (5), and (8) and
72 paragraph (f) of subsection (11) of section 464.019, Florida
73 Statutes, are amended, and paragraph (c) is added to subsection
74 (6) of that section, to read:
75 464.019 Approval of nursing education programs.—
76 (1) PROGRAM APPLICATION.—An educational institution that
77 wishes to conduct a program in this state for the prelicensure
78 education of professional or practical nurses must submit to the
79 department a program application and review fee of $1,000 for
80 each prelicensure nursing education program to be offered at the
81 institution’s main campus, branch campus, or other instructional
82 site. The program application must include the legal name of the
83 educational institution, the legal name of the nursing education
84 program, the legal name of the nursing education program
85 director, the status and outcome of any pending or closed
86 disciplinary case against the applicant in another regulatory
87 jurisdiction in the United States, and, if such institution is
88 accredited, the name of the accrediting agency. The application
89 must also document that:
90 (a)1. For a professional nursing education program, the
91 program director and at least 50 percent of the program’s
92 faculty members are registered nurses who have a master’s or
93 higher degree in nursing or a bachelor’s degree in nursing and a
94 master’s or higher degree in a field related to nursing.
95 2. For a practical nursing education program, the program
96 director and at least 50 percent of the program’s faculty
97 members are registered nurses who have a bachelor’s or higher
98 degree in nursing.
99
100 The educational degree requirements of this paragraph must may
101 be documented by an official transcript or by a written
102 statement from the program director of the educational
103 institution verifying that the institution conferred the degree.
104 The program director shall certify the official transcript or
105 written statement as true and accurate.
106 (b) The program’s nursing major curriculum consists of at
107 least:
108 1. Fifty percent clinical training in the United States,
109 the District of Columbia, or a possession or territory of the
110 United States for a practical nursing education program, an
111 associate degree professional nursing education program, or a
112 professional diploma nursing education program.
113 2. Forty percent clinical training in the United States,
114 the District of Columbia, or a possession or territory of the
115 United States for a bachelor’s degree professional nursing
116 education program.
117 (c) No more than 50 percent of the program’s clinical
118 training consists of clinical simulation.
119 (d) The program has signed agreements with each agency,
120 facility, and organization included in the curriculum plan as
121 clinical training sites and community-based clinical experience
122 sites.
123 (e) The program has written policies for faculty which
124 include provisions for direct or indirect supervision by program
125 faculty or clinical preceptors for students in clinical training
126 consistent with the following standards:
127 1. The number of program faculty members equals at least
128 one faculty member directly supervising every 12 students unless
129 the written agreement between the program and the agency,
130 facility, or organization providing clinical training sites
131 allows more students, not to exceed 18 students, to be directly
132 supervised by one program faculty member.
133 2. For a hospital setting, indirect supervision may occur
134 only if there is direct supervision by an assigned clinical
135 preceptor, a supervising program faculty member is available by
136 telephone, and such arrangement is approved by the clinical
137 facility.
138 3. For community-based clinical experiences that involve
139 student participation in invasive or complex nursing activities,
140 students must be directly supervised by a program faculty member
141 or clinical preceptor and such arrangement must be approved by
142 the community-based clinical facility.
143 4. For community-based clinical experiences not subject to
144 subparagraph 3., indirect supervision may occur only when a
145 supervising program faculty member is available to the student
146 by telephone.
147
148 A program’s policies established under this paragraph must
149 require that a clinical preceptor who is supervising students in
150 a professional nursing education program be a registered nurse
151 or, if supervising students in a practical nursing education
152 program, be a registered nurse or licensed practical nurse.
153 (f) The professional or practical nursing curriculum plan
154 documents clinical experience and theoretical instruction in
155 medical, surgical, obstetric, pediatric, and geriatric nursing.
156 A professional nursing curriculum plan must shall also document
157 clinical experience and theoretical instruction in psychiatric
158 nursing. Each curriculum plan must document clinical training
159 experience in appropriate settings that include, but are not
160 limited to, acute care, long-term care, and community settings.
161 (g) The professional or practical nursing education program
162 provides theoretical instruction and clinical application in
163 personal, family, and community health concepts; nutrition;
164 human growth and development throughout the life span; body
165 structure and function; interpersonal relationship skills;
166 mental health concepts; pharmacology and administration of
167 medications; and legal aspects of practice. A professional
168 nursing education program must also provide theoretical
169 instruction and clinical application in interpersonal
170 relationships and leadership skills; professional role and
171 function; and health teaching and counseling skills.
172 (h) The professional or practical nursing education program
173 has established evaluation and standardized admission criteria.
174 The admission criteria must, at a minimum, identify those
175 students who are likely to need additional preparation and
176 educational support to be successful program graduates. The
177 program must maintain documentation of the individualized
178 student academic support plan for those students identified as
179 in need of additional preparation and educational support.
180 (i) For each student, the professional or practical nursing
181 education program administers an exit examination that is a
182 national, standardized, and comprehensive predictor exam
183 designed to help nursing students assess their readiness for the
184 National Council of State Boards of Nursing Licensing
185 Examination (NCLEX) by identifying areas needing further study
186 and remediation. A student may not be excluded from graduation
187 on the sole basis of the exit examination if the student has
188 otherwise successfully completed all coursework required by the
189 program.
190 (j) The professional or practical nursing education program
191 has submitted to the board the established criteria for
192 remediation that will be offered to students who do not
193 successfully pass the exit examination.
194 (k) Beginning August 1, 2027, a program with a passage rate
195 more than 10 percentage points lower than the average national
196 passage rate during the same calendar year for graduates of
197 comparable degree programs who are United States-educated,
198 first-time test takers on the NCLEX, as calculated by the
199 contract testing service of the National Council of State Boards
200 of Nursing, offers a graduate nursing preceptorship to its
201 graduates. If a graduate from such a program does not pass the
202 NCLEX at the conclusion of his or her preceptorship, the
203 professional or practical nursing education program must offer
204 remediation to the graduate for free.
205 1. All programs are encouraged to offer a graduate nursing
206 preceptorship to their graduates to provide opportunities for
207 job shadowing, clinical training, nonclinical training, and
208 patient care in a hospital setting. Graduates who have been
209 issued a temporary provisional license under s. 464.008(6) may
210 participate in such preceptorships. A graduate nursing
211 preceptorship must last for 3 months, with the expectation that
212 graduates will take the NCLEX at the conclusion of the
213 preceptorship. Clinical preceptors shall oversee the
214 preceptorship programs.
215 2. By January 1, 2027, the Florida Center for Nursing shall
216 establish standards for graduate nursing preceptorships,
217 including supervision requirements. The board shall incorporate
218 the standards into rule.
219 (2) PROGRAM APPROVAL.—
220 (a) Upon receipt of a program application and review fee,
221 the department shall examine the application to determine if it
222 is complete. If the application is not complete, the department
223 must shall notify the educational institution in writing of any
224 errors or omissions within 30 days after the department’s
225 receipt of the application. A program application is deemed
226 complete upon the department’s receipt of:
227 1. The initial application, if the department does not
228 notify the educational institution of any errors or omissions
229 within the 30-day period; or
230 2. A revised application that corrects each error and
231 omission of which the department notifies the educational
232 institution within the 30-day period.
233 (b) Following the department’s receipt of a complete
234 program application, the board may conduct an onsite evaluation
235 if necessary to document the applicant’s compliance with
236 subsection (1). Within 90 days after the department’s receipt of
237 a complete program application, the board shall:
238 1. Approve the application if it documents compliance with
239 subsection (1); or
240 2. Provide the educational institution with a notice of
241 intent to deny the application if it does not document
242 compliance with subsection (1). The notice must specify written
243 reasons for the board’s denial of the application. The board may
244 not deny a program application because of an educational
245 institution’s failure to correct an error or omission that the
246 department failed to provide notice of to the institution within
247 the 30-day notice period under paragraph (a). The educational
248 institution may request a hearing on the notice of intent to
249 deny the program application pursuant to chapter 120.
250 (c) A program application is deemed approved if the board
251 does not act within the 90-day review period provided under
252 paragraph (b).
253 (d) Upon the board’s approval of a program application, the
254 program becomes an approved program.
255 (e) The board may consider adverse actions taken against a
256 nursing education program by another regulatory jurisdiction in
257 the United States in determining program approval. The program
258 director of an approved program must notify the board within 15
259 days after any adverse action is taken against the program by
260 another regulatory jurisdiction in the United States.
261 1. The board shall deny an application from an applicant if
262 another regulatory jurisdiction in the United States has
263 terminated or otherwise revoked its authority to operate a
264 nursing education program.
265 2. The board may investigate the nature of an adverse
266 action. In instances of adverse action other than termination or
267 revocation of a program’s authority to operate, the board may:
268 a. Approve the application;
269 b. Approve the application with conditions; or
270 c. Deny the application.
271 3. The board may impose disciplinary remedies on an
272 approved program against which an adverse action has been taken
273 by another regulatory jurisdiction in the United States. The
274 board may impose remedies up to and including revocation of a
275 program’s approval pursuant to rules adopted under this section.
276 (3) ANNUAL REPORT.—By November 1 of each year, each
277 approved program’s director program shall submit to the board an
278 annual report consisting comprised of an affidavit certifying
279 continued compliance with subsection (1), a summary description
280 of the program’s compliance with subsection (1), and
281 documentation for the previous academic year that, to the extent
282 applicable, describes:
283 (a) The number of student applications received, qualified
284 applicants, applicants accepted, accepted applicants who enroll
285 in the program, students enrolled in the program, and program
286 graduates.
287 (b) The program’s retention rates for students tracked from
288 program entry to graduation.
289 (c) The program’s accreditation status, including
290 identification of the accrediting agency.
291
292 The board must terminate the program pursuant to chapter 120 if
293 the requirements of this subsection are not met. Upon request,
294 the board may give an extension for good cause not to exceed 60
295 days for a program to meet the requirements of this subsection.
296 If a program director is found to be in violation of this
297 subsection, the board may impose a penalty listed in s.
298 456.072(2).
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 within 6 months after the
330 date of the program being placed on probation. The board may
331 impose a penalty listed in s. 456.072(2) on the program director
332 for such failure. The program must remain on probationary status
333 until it achieves a graduate passage rate that equals or exceeds
334 the required passage rate for any 1 calendar year. The board
335 must shall deny a program application for a new prelicensure
336 nursing education program submitted by an educational
337 institution if the institution has an existing program that is
338 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
384 deemed necessary. A program that refuses or fails to allow an
385 onsite evaluation or inspection is deemed in violation of a
386 legal obligation imposed by the board or the department.
387 (6) DISCLOSURE OF GRADUATE PASSAGE RATE DATA.—
388 (c) The program director shall ensure that the program’s
389 graduate passage rates for the most recent 2 calendar years, as
390 published by the board on its website pursuant to subsection
391 (4), are conspicuously posted on the program’s website. The
392 program’s website must include only the graduate passage rates
393 specific to that program.
394 (8) RULEMAKING.—The board does not have rulemaking
395 authority to administer this section, except that the board
396 shall adopt rules that prescribe the format for submitting
397 program applications under subsection (1) and annual reports
398 under subsection (3), to implement graduate nursing
399 preceptorships as established in paragraph (1)(k), to enforce
400 and administer subsection (5), and to administer the
401 documentation of the accreditation of nursing education programs
402 under subsection (11). The board may adopt rules relating to the
403 nursing curriculum, including rules relating to the uses and
404 limitations of simulation technology, and rules relating to the
405 criteria to qualify for an extension of time to meet the
406 accreditation requirements under paragraph (11)(f). The board
407 may not impose any condition or requirement on an educational
408 institution submitting a program application, an approved
409 program, or an accredited program, except as expressly provided
410 in this section.
411 (11) ACCREDITATION REQUIRED.—
412 (f) An approved nursing education program may, no sooner
413 than 90 days before the deadline for meeting the accreditation
414 requirements of this subsection, apply to the board for an
415 extension of the accreditation deadline for a period which does
416 not exceed 2 years. An additional extension may not be granted.
417 In order to be eligible for the extension, the approved program
418 must establish that it has a graduate passage rate of 60 percent
419 or higher on the National Council of State Boards of Nursing
420 Licensing Examination for the most recent calendar year and must
421 meet a majority of the board’s additional criteria, including,
422 but not limited to, all of the following:
423 1. A student retention rate of 60 percent or higher for the
424 most recent calendar year.
425 2. A graduate work placement rate of 70 percent or higher
426 for the most recent calendar year.
427 3. The program has applied for approval or been approved by
428 an institutional or programmatic accreditor recognized by the
429 United States Department of Education.
430 4. The program is in full compliance with subsections (1)
431 and (3) and paragraph (5)(b).
432 5. The program is not currently in its second year of
433 probationary status under subsection (5).
434
435 The applicable deadline under this paragraph is tolled from the
436 date on which an approved program applies for an extension until
437 the date on which the board issues a decision on the requested
438 extension.
439 Section 3. Subsection (4) of section 464.022, Florida
440 Statutes, is amended to read:
441 464.022 Exceptions.—No provision of this part shall be
442 construed to prohibit:
443 (4) The practice of nursing by graduates of prelicensure
444 nursing education programs listed in s. 464.008(1)(c), pending
445 the result of the first licensing examination for which they are
446 eligible following graduation, provided they practice under
447 direct supervision of a registered professional nurse; or by
448 temporary provisional licensees practicing under the direct
449 supervision of a registered nurse or licensed practical nurse,
450 as applicable. The board shall by rule define what constitutes
451 direct supervision.
452 Section 4. This act shall take effect July 1, 2026.
453
454 ================= T I T L E A M E N D M E N T ================
455 And the title is amended as follows:
456 Delete everything before the enacting clause
457 and insert:
458 A bill to be entitled
459 An act relating to nursing education programs;
460 amending s. 464.008, F.S.; requiring applicants for
461 nurse licensure seeking to take the licensing
462 examination more than 6 months after graduation to
463 first complete a remedial course approved or developed
464 by the Board of Nursing; requiring the board to
465 develop the course in consultation with the Florida
466 Center for Nursing and make it available on its
467 website for free to applicants experiencing hardship;
468 requiring the Department of Health to issue temporary
469 provisional licenses to graduate professional nurses
470 and graduate practical nurses meeting certain
471 criteria; specifying requirements for the temporary
472 provisional license; providing that temporary
473 provisional licensees may practice only under direct
474 supervision and subject to a written protocol with a
475 registered nurse or licensed practical nurse, as
476 applicable; requiring the board to adopt rules;
477 amending s. 464.019, F.S.; revising application
478 requirements for nursing education program approval;
479 specifying preceptorship requirements; requiring the
480 Florida Center for Nursing to develop graduate nursing
481 preceptorship standards by a specified date; requiring
482 the board to incorporate the standards into rule;
483 authorizing the board to consider certain adverse
484 actions in determining program approval; requiring
485 program directors to notify the board of certain
486 adverse actions within a specified timeframe;
487 requiring the board to deny a program’s application
488 under certain circumstances; authorizing the board to
489 investigate the nature of a certain adverse action and
490 take specified actions; clarifying that an approved
491 program’s director is responsible for submitting
492 certain annual reports to the board; requiring the
493 board to terminate a program under certain
494 circumstances; providing penalties for program
495 directors found to be in violation of specified
496 provisions; revising remediation procedures for
497 approved programs with graduate passage rates that do
498 not meet specified requirements; subjecting program
499 directors of approved programs to specified
500 disciplinary action under certain circumstances;
501 deleting a provision authorizing the board to extend a
502 program’s probationary status; authorizing agents or
503 employees of the department to conduct onsite
504 evaluations and inspections of approved and accredited
505 nursing education programs; authorizing the department
506 to collect evidence as part of such evaluations and
507 inspections; deeming the failure or refusal of a
508 program to allow such evaluation or inspection a
509 violation of a legal obligation; requiring program
510 directors to ensure that graduate passage rates are
511 conspicuously posted on their program’s website;
512 revising rulemaking authority of the board; deleting a
513 provision authorizing approved nursing education
514 programs to request an extension to meet the board’s
515 accreditation requirements; amending s. 464.022, F.S.;
516 providing construction; providing an effective date.