Florida Senate - 2010 CS for SB 2530
By the Committee on Health and Human Services Appropriations;
and Senators Alexander and Crist
603-04849-10 20102530c1
1 A bill to be entitled
2 An act relating to nursing; amending s. 456.014, F.S.;
3 authorizing the disclosure of certain confidential
4 information required of nursing license applicants to
5 certain persons; amending s. 464.003, F.S.; providing
6 and revising definitions; amending s. 464.008, F.S.;
7 revising requirements for graduation from certain
8 nursing education programs for nursing license
9 applicants seeking to take the licensing examination;
10 amending s. 464.015, F.S.; revising restrictions on
11 nursing graduates who may use certain titles and
12 abbreviations; amending s. 464.019, F.S.; revising
13 requirements for the approval of nursing education
14 programs by the Board of Nursing, including
15 application requirements and procedures for the review
16 and approval or denial of applications; revising
17 requirements for the approval of nursing education
18 programs meeting certain requirements before a
19 specified date; providing for retroactive application;
20 revising requirements for the submission of annual
21 reports by approved programs; revising requirements
22 for the information published on the board’s Internet
23 website; revising accountability requirements for an
24 approved program’s graduate passage rates on a certain
25 licensing examination; revising procedures for placing
26 programs on, and removing such programs from,
27 probationary status; requiring termination of programs
28 under certain circumstances; requiring certain
29 representatives of programs that fail to submit annual
30 reports to appear before the board; requiring the
31 Department of Health to disclose certain confidential
32 information about a program’s graduates to the program
33 director under certain circumstances; requiring
34 program directors to maintain the confidentiality of
35 such information; providing penalties for unlawful
36 disclosure of confidential information; revising
37 requirements for the closure of programs; revising the
38 board’s authority to adopt rules; exempting accredited
39 programs from specified requirements; providing
40 requirements for an accredited program that ceases to
41 be accredited; conforming provisions; deleting
42 obsolete provisions; revising requirements for the
43 Florida Center for Nursing’s evaluation of the board’s
44 implementation of certain accountability provisions;
45 conforming cross-references; amending s. 464.022,
46 F.S.; conforming provisions; amending ss. 458.348,
47 459.025, 464.012, and 960.28, F.S.; conforming cross
48 references; providing an effective date.
49
50 Be It Enacted by the Legislature of the State of Florida:
51
52 Section 1. Subsection (1) of section 456.014, Florida
53 Statutes, is amended to read:
54 456.014 Public inspection of information required from
55 applicants; exceptions; examination hearing.—
56 (1) All information required by the department of any
57 applicant shall be a public record and shall be open to public
58 inspection pursuant to s. 119.07, except financial information,
59 medical information, school transcripts, examination questions,
60 answers, papers, grades, and grading keys, which are
61 confidential and exempt from s. 119.07(1) and shall not be
62 discussed with or made accessible to anyone except the program
63 director of an approved program or accredited program as
64 provided in s. 464.019(7), members of the board, the department,
65 and staff thereof, who have a bona fide need to know such
66 information. Any information supplied to the department by any
67 other agency which is exempt from the provisions of chapter 119
68 or is confidential shall remain exempt or confidential pursuant
69 to applicable law while in the custody of the department or the
70 agency.
71 Section 2. Section 464.003, Florida Statutes, is reordered
72 and amended to read:
73 464.003 Definitions.—As used in this part, the term:
74 (1) “Accredited program” means a program for the
75 prelicensure education of professional or practical nurses which
76 is conducted in the United States at an educational institution,
77 whether in this state, another state, or the District of
78 Columbia, and is accredited by a specialized nursing accrediting
79 agency that is nationally recognized by the United States
80 Secretary of Education to accredit nursing education programs.
81 (13)(1) “Department” means the Department of Health.
82 (5)(2) “Board” means the Board of Nursing.
83 (20)(3)(a) “Practice of professional nursing” means the
84 performance of those acts requiring substantial specialized
85 knowledge, judgment, and nursing skill based upon applied
86 principles of psychological, biological, physical, and social
87 sciences which shall include, but not be limited to:
88 (a)1. The observation, assessment, nursing diagnosis,
89 planning, intervention, and evaluation of care; health teaching
90 and counseling of the ill, injured, or infirm; and the promotion
91 of wellness, maintenance of health, and prevention of illness of
92 others.
93 (b)2. The administration of medications and treatments as
94 prescribed or authorized by a duly licensed practitioner
95 authorized by the laws of this state to prescribe such
96 medications and treatments.
97 (c)3. The supervision and teaching of other personnel in
98 the theory and performance of any of the above acts described in
99 this subsection.
100
101 A professional nurse is responsible and accountable for making
102 decisions that are based upon the individual’s educational
103 preparation and experience in nursing.
104 (19)(b) “Practice of practical nursing” means the
105 performance of selected acts, including the administration of
106 treatments and medications, in the care of the ill, injured, or
107 infirm and the promotion of wellness, maintenance of health, and
108 prevention of illness of others under the direction of a
109 registered nurse, a licensed physician, a licensed osteopathic
110 physician, a licensed podiatric physician, or a licensed
111 dentist. A The professional nurse and the practical nurse is
112 shall be responsible and accountable for making decisions that
113 are based upon the individual’s educational preparation and
114 experience in nursing.
115 (7)(c) “Clinical nurse specialist practice” means the
116 delivery and management of advanced practice nursing care to
117 individuals or groups, including the ability to:
118 (a)1. Assess the health status of individuals and families
119 using methods appropriate to the population and area of
120 practice.
121 (b)2. Diagnose human responses to actual or potential
122 health problems.
123 (c)3. Plan for health promotion, disease prevention, and
124 therapeutic intervention in collaboration with the patient or
125 client.
126 (d)4. Implement therapeutic interventions based on the
127 nurse specialist’s area of expertise and within the scope of
128 advanced nursing practice, including, but not limited to, direct
129 nursing care, counseling, teaching, and collaboration with other
130 licensed health care providers.
131 (e)5. Coordinate health care as necessary and appropriate
132 and evaluate with the patient or client the effectiveness of
133 care.
134 (2)(d) “Advanced or specialized nursing practice” means, in
135 addition to the practice of professional nursing, the
136 performance of advanced-level nursing acts approved by the board
137 which, by virtue of postbasic specialized education, training,
138 and experience, are appropriately performed by an advanced
139 registered nurse practitioner. Within the context of advanced or
140 specialized nursing practice, the advanced registered nurse
141 practitioner may perform acts of nursing diagnosis and nursing
142 treatment of alterations of the health status. The advanced
143 registered nurse practitioner may also perform acts of medical
144 diagnosis and treatment, prescription, and operation which are
145 identified and approved by a joint committee composed of three
146 members appointed by the Board of Nursing, two of whom must be
147 advanced registered nurse practitioners; three members appointed
148 by the Board of Medicine, two of whom must have had work
149 experience with advanced registered nurse practitioners; and the
150 State Surgeon General or the State Surgeon General’s designee.
151 Each committee member appointed by a board shall be appointed to
152 a term of 4 years unless a shorter term is required to establish
153 or maintain staggered terms. The Board of Nursing shall adopt
154 rules authorizing the performance of any such acts approved by
155 the joint committee. Unless otherwise specified by the joint
156 committee, such acts must be performed under the general
157 supervision of a practitioner licensed under chapter 458,
158 chapter 459, or chapter 466 within the framework of standing
159 protocols which identify the medical acts to be performed and
160 the conditions for their performance. The department may, by
161 rule, require that a copy of the protocol be filed with the
162 department along with the notice required by s. 458.348.
163 (17)(e) “Nursing diagnosis” means the observation and
164 evaluation of physical or mental conditions, behaviors, signs
165 and symptoms of illness, and reactions to treatment and the
166 determination as to whether such conditions, signs, symptoms,
167 and reactions represent a deviation from normal.
168 (18)(f) “Nursing treatment” means the establishment and
169 implementation of a nursing regimen for the care and comfort of
170 individuals, the prevention of illness, and the education,
171 restoration, and maintenance of health.
172 (22)(4) “Registered nurse” means any person licensed in
173 this state to practice professional nursing.
174 (16)(5) “Licensed practical nurse” means any person
175 licensed in this state to practice practical nursing.
176 (6) “Clinical nurse specialist” means any person licensed
177 in this state to practice professional nursing and certified in
178 clinical nurse specialist practice.
179 (3)(7) “Advanced registered nurse practitioner” means any
180 person licensed in this state to practice professional nursing
181 and certified in advanced or specialized nursing practice,
182 including certified registered nurse anesthetists, certified
183 nurse midwives, and nurse practitioners.
184 (4)(8) “Approved program” means a nursing program for the
185 prelicensure education of professional or practical nurses which
186 is conducted in the state at an educational institution and is
187 in a school, college, or university which is approved under s.
188 464.019 for the education of nurses. The term includes such a
189 program placed on probationary status.
190 (10)(9) “Clinical training” means direct nursing care
191 experiences with patients or clients which offer the student the
192 opportunity to integrate, apply, and refine specific skills and
193 abilities based on theoretical concepts and scientific
194 principles.
195 (8)(10) “Clinical preceptor” means a registered nurse or
196 licensed practical nurse who is employed by a clinical training
197 facility to serve who serves as a role model and clinical
198 resource person for a specified period to students an individual
199 enrolled in an approved program.
200 (9)(11) “Clinical simulation” means a strategy used to
201 replicate clinical practice as closely as possible to teach
202 theory, assessment, technology, pharmacology, and skills.
203 (11)(12) “Community-based clinical experience” means
204 activities consistent with the curriculum and involving
205 individuals, families, and groups with the intent of promoting
206 wellness, maintaining health, and preventing illness.
207 (12)(13) “Curriculum” means a planned sequence of course
208 offerings and learning experiences that comprise a nursing
209 education program.
210 (21)(14) “Probationary status” means the status of an
211 approved a nursing education program that is placed on such
212 status pursuant subject to s. 464.019(2)(a)2. or (5)(a) or (b).
213 (14) “Educational institution” means a school, college, or
214 university.
215 (15) “Graduate passage rate” means the percentage of a
216 program’s graduates who, as first-time test takers, pass the
217 National Council of State Boards of Nursing Licensing
218 Examination during a calendar year, as calculated by the
219 contract testing service of the National Council of State Boards
220 of Nursing.
221 (23) “Required passage rate” means the graduate passage
222 rate required for an approved program pursuant to s.
223 464.019(6)(a)1.
224 Section 3. Subsection (1) of section 464.008, Florida
225 Statutes, is amended to read:
226 464.008 Licensure by examination.—
227 (1) Any person desiring to be licensed as a registered
228 nurse or licensed practical nurse shall apply to the department
229 to take the licensure examination. The department shall examine
230 each applicant who:
231 (a) Has completed the application form and remitted a fee
232 set by the board not to exceed $150 and has remitted an
233 examination fee set by the board not to exceed $75 plus the
234 actual per applicant cost to the department for purchase of the
235 examination from the National Council of State Boards of Nursing
236 or a similar national organization.
237 (b) Has provided sufficient information on or after October
238 1, 1989, which must be submitted by the department for a
239 statewide criminal records correspondence check through the
240 Department of Law Enforcement.
241 (c) Is in good mental and physical health, is a recipient
242 of a high school diploma or the equivalent, and has completed
243 the requirements for:
244 1. Graduation from an approved program;
245 2. Graduation from a prelicensure nursing education program
246 that the board determines is, or its equivalent to an approved
247 program;
248 3. Graduation on or after July 1, 2009, from an accredited
249 program; or
250 4. Graduation before July 1, 2009, from a prelicensure
251 nursing education program whose graduates at that time were
252 eligible for examination as determined by the board, for the
253 preparation of registered nurses or licensed practical nurses,
254 whichever is applicable.
255
256 Courses successfully completed in a professional nursing
257 education program that which are at least equivalent to a
258 practical nursing education program may be used to satisfy the
259 education requirements for licensure as a licensed practical
260 nurse.
261 (d) Has the ability to communicate in the English language,
262 which may be determined by an examination given by the
263 department.
264 Section 4. Subsections (3) and (4) of section 464.015,
265 Florida Statutes, are amended to read:
266 464.015 Titles and abbreviations; restrictions; penalty.—
267 (3) Only persons who are graduates of prelicensure nursing
268 education approved programs listed in s. 464.008(1)(c) or the
269 equivalent may use the term “Graduate Nurse” and the
270 abbreviation “G.N.,” pending the results of the first licensure
271 examination for which they are eligible.
272 (4) Only persons who are graduates of prelicensure nursing
273 education approved programs listed in s. 464.008(1)(c) or the
274 equivalent may use the term “Graduate Practical Nurse” and the
275 abbreviation “G.P.N.,” pending the results of the first
276 licensure examination for which they are eligible.
277 Section 5. Section 464.019, Florida Statutes, is reordered
278 and amended to read:
279 464.019 Approval of nursing education programs.—
280 (1) PROGRAM APPLICATIONS.—An educational institution that
281 wishes to conduct a program in this state for the prelicensure
282 education of professional or practical nurses must shall submit
283 to the department a program application and a program review fee
284 of $1,000 for each prelicensure nursing education program to be
285 offered at the institution’s main campus, branch campus, or
286 other instructional site the department. Within 90 days after
287 receipt of a program application and program review fee, the
288 board shall approve the program application if it documents
289 compliance with the standards in paragraphs (a)-(h). If the
290 program application is incomplete or does not document
291 compliance, the board shall follow the procedures in subsection
292 (3). a program application is deemed approved by the board if
293 the board does not act on the application within the timeframes
294 specified in subsection (3) or this subsection. Each program
295 application must include the legal name of the educational
296 institution, the legal name of the nursing education program,
297 and, if such program is accredited by an accrediting agency
298 other than an accrediting agency described in s. 464.003(1), the
299 name of the accrediting agency. The application must also
300 document that:
301 (a)1. For a professional nursing education program, the
302 program director and at least 50 percent of the program’s
303 faculty members are registered nurses who have, at a minimum, a
304 master’s or higher bachelor’s degree in nursing or a bachelor’s
305 and a master’s degree in nursing and a master’s or higher degree
306 in a field or a related to nursing field.
307 2.(b) For a practical nursing education program, the
308 program director and at least 50 percent of the program’s
309 faculty members are registered nurses who have, at a minimum, a
310 bachelor’s or higher degree in nursing.
311
312 The educational degree requirements of this paragraph may be
313 documented by an official transcript or by a written statement
314 from the educational institution verifying that the institution
315 conferred the degree.
316 (b)(c) The program’s nursing major curriculum consists of
317 at least:
318 1. Fifty percent clinical training for a practical nursing
319 education program, an associate degree professional nursing
320 education program, or a professional diploma nursing education
321 program.
322 2. Forty percent clinical training for a bachelor’s degree
323 professional nursing education program.
324 (c)(d) No more than 25 percent of the program’s clinical
325 training consists of clinical simulation.
326 (d)(e) The program has signed agreements with each agency,
327 facility, and organization included in the curriculum plan as
328 clinical training sites and community-based clinical experience
329 sites.
330 (e)(f) The program has written policies for faculty which
331 include provisions for direct or indirect supervision by program
332 faculty or clinical preceptors for students in clinical training
333 consistent with the following standards:
334 1. The number of program faculty members equals at least
335 one faculty member directly supervising every 12 students unless
336 the written agreement between the program and the agency,
337 facility, or organization providing clinical training sites
338 allows more students, not to exceed 18 students, to be directly
339 supervised by one program faculty member.
340 2. For a hospital setting, indirect supervision may occur
341 only if there is direct supervision by an assigned clinical
342 preceptor, a supervising program faculty member is available by
343 telephone, and such arrangement is approved by the clinical
344 facility.
345 3. For community-based clinical experiences that involve
346 student participation in invasive or complex nursing activities,
347 students must be directly supervised by a program faculty member
348 or clinical preceptor and such arrangement must be approved by
349 the community-based clinical facility.
350 4. For community-based clinical experiences not subject to
351 subparagraph 3., indirect supervision may occur only when a
352 supervising program faculty member is available to the student
353 by telephone.
354
355 A program’s policies established under this paragraph must
356 require a clinical preceptor, if supervising students in a
357 professional nursing education program, to be a registered nurse
358 or, if supervising students in a practical nursing education
359 program, to be a registered nurse or licensed practical nurse.
360 (f)(g) The professional or practical nursing curriculum
361 plan documents clinical experience and theoretical instruction
362 in medical, surgical, obstetric, pediatric, and geriatric
363 nursing. A professional nursing curriculum plan shall also
364 document clinical experience and theoretical instruction in
365 psychiatric nursing. Each curriculum plan must document clinical
366 training experience in appropriate settings that include, but
367 are not limited to, acute care, long-term care, and community
368 settings.
369 (g)(h) The professional or practical nursing education
370 program provides theoretical instruction and clinical
371 application in personal, family, and community health concepts;
372 nutrition; human growth and development throughout the life
373 span; body structure and function; interpersonal relationship
374 skills; mental health concepts; pharmacology and administration
375 of medications; and legal aspects of practice. A professional
376 nursing education program shall also provide theoretical
377 instruction and clinical application in interpersonal
378 relationships and leadership skills; professional role and
379 function; and health teaching and counseling skills.
380
381 Upon the board’s approval of a program application, the program
382 becomes an approved program under this section.
383 (3)(2) STATUS OF CERTAIN PROGRAMS.—
384 (a) A professional or practical nursing education program
385 becomes an approved program if that, as of June 30, 2009, the
386 program:
387 (a)1. Has full or provisional approval from the board or,
388 except as provided in paragraph (b), is on probationary status,
389 except as provided in subparagraph 2., becomes an approved
390 program under this section. In order to retain approved program
391 status, such program shall submit the report required under
392 paragraph (c) to the board by November 1, 2009, and annually
393 thereafter.
394 (b)2. Is on probationary status because the program did not
395 meet the board’s requirement for program graduate passage rates.
396 Such program on the National Council of State Boards of Nursing
397 Licensing Examination, shall remain on probationary status until
398 it the program achieves a graduate passage rate for calendar
399 year 2009 or 2010 which equals or exceeds the required passage
400 rate for the respective calendar year and compliance with the
401 program graduate passage rate requirement in paragraph (5)(a). A
402 program that is subject to this subparagraph must disclose its
403 probationary status in writing to the program’s students and
404 applicants submit the report required under paragraph (c) to the
405 board by November 1, 2009, and annually thereafter and must
406 comply with paragraph (5)(c). If the program does not achieve
407 the required passage rate compliance by July 1, 2011, the board
408 shall terminate the program pursuant to chapter 120 as provided
409 in paragraph (5)(d).
410 (b) Each professional or practical nursing program that has
411 its application approved by the board under subsection (1) on or
412 after July 1, 2009, shall annually submit the report required
413 under paragraph (c) to the board by November 1 of each year
414 following initial approval of its application.
415 (4) ANNUAL REPORT.—By November 1 of each year, each
416 approved program shall submit to the board an
417 (c) The annual report comprised of required by this
418 subsection must include an affidavit certifying continued
419 compliance with paragraphs (1)(a)-(g) subsection (1), must
420 provide a summary description of the program’s compliance with
421 paragraphs (1)(a)-(g) with subsection (1), and documentation
422 must document for the previous academic year which, to the
423 extent applicable, sets forth for each professional and
424 practical nursing program:
425 (a)1. The number of student applications received, the
426 number of qualified applicants, applicants and the number of
427 students accepted, accepted applicants who enroll in the
428 program, students enrolled in the program, and.
429 2. the number of program graduates.
430 3. The program’s graduate passage rate on the National
431 Council of State Boards of Nursing Licensing Examination.
432 (b)4. The program’s retention rates for students tracked
433 from program entry to graduation.
434 (c)5. The program’s accreditation status, including
435 identification of the accrediting agency if such agency is not
436 an accrediting agency described in s. 464.003(1) body.
437 (2)(3) PROGRAM APPROVAL.—
438 (a) Upon receipt of a If an institution’s program
439 application and review fee, the department shall examine the
440 application to determine whether it is complete. If a program
441 application is not complete incomplete, the department board
442 shall notify the educational institution in writing of any
443 apparent errors or omissions within 30 days after the
444 department’s receipt of the application and follow the
445 procedures in s. 120.60. A program application is deemed
446 complete upon the department’s receipt of:
447 1. The initial application, if the department does not
448 notify the educational institution of any errors or omissions
449 within the 30-day period; or
450 2. A revised application that corrects each error and
451 omission of which the department notifies the educational
452 institution within the 30-day period.
453 (b) Within 90 days after the department’s receipt of a
454 complete program application, the board shall:
455 1. Approve the If an institution’s program application if
456 it documents does not document compliance with paragraphs
457 (1)(a)-(g); or the standards in subsection (1), within 90 days
458 after the board’s receipt of the program application, the board
459 shall
460 2. Provide the educational institution with a notice of
461 intent to deny the program application if it does not document
462 compliance with paragraphs (1)(a)-(g) that sets forth written
463 reasons for the denial. The notice must set forth written
464 reasons for the board’s denial of the application. The board may
465 not deny a program application because of an educational
466 institution’s failure to correct any error or omission of which
467 the department does not notify the institution within the 30-day
468 notice period under paragraph (a). The educational institution
469 may request a hearing on the notice of intent to deny the
470 program application pursuant to chapter 120.
471 (c) A program application is deemed approved if the board
472 does not act within the 90-day review period provided under
473 paragraph (b).
474 (d) Upon the board’s approval of a program application, the
475 program becomes an approved program.
476 (5)(4) INTERNET WEBSITE.—By October 1, 2010, the board
477 shall publish the following information on its Internet website:
478 (a) A list of each accredited program conducted in the
479 state and the program’s graduate passage rates for the most
480 recent 2 calendar years, which the department shall determine
481 through the following sources:
482 1. For a program’s accreditation status, the specialized
483 accrediting agencies that are nationally recognized by the
484 United States Secretary of Education to accredit nursing
485 education programs.
486 2. For a program’s graduate passage rates, the contract
487 testing service of the National Council of State Boards of
488 Nursing.
489 (b) The following data for each approved program, which on
490 nursing programs located in the state. The data shall include,
491 to the extent applicable:
492 1.(a) All documentation provided by the program in its
493 applicant for each approved nursing program application if
494 submitted on or after July 1, 2009.
495 2.(b) The summary description of the each program’s
496 compliance as submitted under subsection (4) paragraph (2)(c).
497 (c) A comprehensive list of each practical and professional
498 nursing program in the state.
499 3.(d) The program’s accreditation status for each program,
500 including identification of the accrediting agency if such
501 agency is not an accrediting agency described in s. 464.003(1)
502 body.
503 4.(e) The Each program’s approval or probationary status.
504 5.(f) The Each program’s graduate passage rates for the
505 most recent 2 calendar years rate on the National Council of
506 State Boards of Nursing Licensing Examination.
507 (g) The national average for passage rates on the National
508 Council of State Boards of Nursing Licensing Examination.
509 6.(h) Each program’s retention rates for students tracked
510 from program entry to graduation.
511 (c) The average passage rates for United States educated
512 first-time test takers on the National Council of State Boards
513 of Nursing Licensing Examination for the most recent 2 calendar
514 years, as calculated by the contract testing service of the
515 National Council of State Boards of Nursing. The average passage
516 rates shall be published separately for each type of comparable
517 degree program listed in sub-subparagraphs (6)(a)1.a.-d.
518
519 The information data required to be published under this
520 subsection shall be made available in a manner that allows
521 interactive searches and comparisons of individual specific
522 nursing education programs selected by the website user. The
523 board shall publish the data by December 31, 2009, and update
524 the Internet website at least quarterly with the available
525 information data.
526 (6)(5) ACCOUNTABILITY.—
527 (a)1. An approved program must achieve a graduate passage
528 rate that is not lower than 10 percentage points less than the
529 average passage rate for graduates of comparable degree programs
530 who are United States educated first-time test takers on the
531 National Council of State Boards of Nursing Licensing
532 Examination during a calendar year, as calculated by the
533 contract testing service of the National Council of State Boards
534 of Nursing. For purposes of this subparagraph, an approved
535 program is comparable to all degree programs of the same program
536 type from among the following program types:
537 a. Professional nursing education programs that terminate
538 in a bachelor’s degree.
539 b. Professional nursing education programs that terminate
540 in an associate degree.
541 c. Professional nursing education programs that terminate
542 in a diploma.
543 d. Practical nursing education programs.
544 2. Beginning with graduate passage rates for calendar year
545 2010, if an approved a professional or practical nursing
546 program’s average graduate passage rates do not equal or exceed
547 the required passage rates rate for first-time test takers on
548 the National Council of State Boards of Nursing Licensing
549 Examination falls 10 percent or more below the national average
550 passage rate for first-time test takers educated in the United
551 States, as annually published by the contract testing service of
552 the National Council of State Boards of Nursing, for 2
553 consecutive calendar years, the board shall place the program on
554 probationary status pursuant to chapter 120 probation and the
555 program director must shall be required to appear before the
556 board to present a plan for remediation. The program shall
557 remain on probationary status until it achieves a compliance
558 with the graduate passage rate that equals or exceeds the
559 required passage rate for any one calendar year.
560 3. Upon the program’s achievement of a graduate passage
561 rate that equals or exceeds the required passage rate,
562 requirement and shall be terminated by the board, at its next
563 regularly scheduled meeting following release of the program’s
564 graduate passage rate by the National Council of State Boards of
565 Nursing, shall remove the program’s probationary status.
566 However, under paragraph (d) if the program, during the 2
567 calendar years following its placement on probationary status,
568 does not achieve the required passage rate for any one
569 compliance within 2 calendar year, the board shall terminate the
570 program pursuant to chapter 120 years.
571 (b) If an approved a program fails to submit the annual
572 report required in subsection (4) (2), the board shall notify
573 the program director and president or chief executive officer of
574 the educational institution in writing within 15 days after the
575 due date of the annual report. The program director must appear
576 before the board at the board’s next regularly scheduled meeting
577 to explain the reason for the delay place the program on
578 probation. The board program shall terminate the program
579 pursuant to chapter 120 remain on probationary status until it
580 submits the annual report and shall be terminated by the board
581 under paragraph (d) if it does not submit the annual report
582 within 6 months after the report’s due date.
583 (c) An approved A program placed on probationary status
584 shall disclose its probationary status in writing to the
585 program’s students and applicants.
586 (d) The board shall terminate a program that fails to
587 comply with subparagraph (2)(a)2., paragraph (a), or paragraph
588 (b) pursuant to chapter 120.
589 (7) DISCLOSURE OF GRADUATE PASSAGE RATE DATA.—
590 (a) For each of an approved program’s or accredited
591 program’s graduates included in the calculation of the program’s
592 graduate passage rate, the department shall disclose to the
593 program director, upon his or her written request, the name,
594 examination date, and determination of whether each graduate
595 passed or failed the National Council for State Boards of
596 Nursing Licensing Examination, to the extent that such
597 information is provided to the department by the contract
598 testing service of the National Council for State Boards of
599 Nursing. The written request must specify the calendar years for
600 which the information is requested.
601 (b) A program director to whom confidential information
602 exempt from public disclosure pursuant to s. 456.014 is
603 disclosed under this subsection must maintain the
604 confidentiality of the information and is subject to the same
605 penalties provided in s. 456.082 for department employees who
606 unlawfully disclose confidential information.
607 (8)(6) PROGRAM CLOSURE.—
608 (a) An educational institution conducting an approved
609 program or accredited a nursing program in this state, at least
610 30 days before voluntarily closing the program, that closes
611 shall notify the board in writing of the institution’s reason
612 for closing the program, the intended closure date, the
613 institution’s plan to provide for or assist in the completion of
614 training by the program’s students, and advise the board of the
615 arrangements for storage of the program’s permanent records.
616 (b) An educational institution conducting a nursing
617 education program that is terminated under subsection (6) or
618 closed under subparagraph (10)(b)3.:
619 1. May not accept or enroll new students.
620 2. Must submit to the board within 30 days after the
621 program is terminated or closed a written description of how the
622 institution will assist in the completion of training by the
623 program’s students and the institution’s arrangements for
624 storage of the program’s permanent records.
625 (c) If an educational institution does not comply with
626 paragraph (a) or paragraph (b), the board shall provide a
627 written notice explaining the institution’s noncompliance to the
628 following persons and entities:
629 1. The president or chief executive officer of the
630 educational institution.
631 2. The Board of Governors, if the program is conducted by a
632 state university.
633 3. The district school board, if the program is conducted
634 by an educational institution operated by a school district.
635 4. The Commission for Independent Education, if the program
636 is conducted by an educational institution licensed under
637 chapter 1005.
638 5. The State Board of Education, if the program is
639 conducted by an educational institution in the Florida College
640 System or by an educational institution that is not subject to
641 subparagraphs 2.-4.
642 (9)(7) RULEMAKING.—The board does not have any rulemaking
643 authority to administer this section, except that the board
644 shall adopt a rule that prescribes the format for submitting
645 program applications under subsection (1) and annual reports
646 submitting summary descriptions of program compliance under
647 subsection (4) paragraph (2)(c). The board may not impose any
648 condition or requirement on an educational institution
649 submitting a program application, an approved program, or an
650 accredited program, a program on probationary status except as
651 expressly provided in this section. The board shall repeal all
652 rules, or portions thereof, in existence on July 1, 2009, that
653 are inconsistent with this subsection.
654 (10) APPLICABILITY TO ACCREDITED PROGRAMS.—
655 (a) Subsections (1)-(4), paragraph (5)(b), and subsection
656 (6) do not apply to an accredited program. An accredited program
657 on probationary status before July 1, 2010, ceases to be subject
658 to the probationary status.
659 (b) If an accredited program ceases to be accredited, the
660 educational institution conducting the program:
661 1. Within 10 business days after the program ceases to be
662 accredited, must provide written notice of the date that the
663 program ceased to be accredited to the board, the program’s
664 students and applicants, and each entity providing clinical
665 training sites or community-based clinical experience sites for
666 the program. The educational institution must continue to
667 provide the written notice to new students, applicants, and
668 entities providing clinical training sites or community-based
669 clinical experience sites for the program until the program
670 becomes an approved program or is closed under subparagraph 3.
671 2. Within 30 days after the program ceases to be
672 accredited, must submit an affidavit to the board, signed by the
673 educational institution’s president or chief executive officer,
674 that certifies the institution’s compliance with subparagraph 1.
675 The board shall notify the persons listed in subparagraph
676 (8)(c)1. and the applicable entities listed in subparagraphs
677 (8)(c)2.-5. if an educational institution does not submit the
678 affidavit required by this subparagraph.
679 3. May apply to become an approved program under this
680 section. If the educational institution:
681 a. Within 30 days after the program ceases to be
682 accredited, submits a program application and review fee to the
683 department under subsection (1) and the affidavit required under
684 subparagraph 2., the program shall be deemed an approved program
685 from the date that the program ceased to be accredited until the
686 date that the board approves or denies the program application.
687 The program application must be denied by the board pursuant to
688 chapter 120 if it does not contain the affidavit. If the board
689 denies the program application under subsection (2) or because
690 the program application does not contain the affidavit, the
691 program shall be closed and the educational institution
692 conducting the program must comply with paragraph (8)(b).
693 b. Does not apply to become an approved program pursuant to
694 sub-subparagraph a., the program shall be deemed an approved
695 program from the date that the program ceased to be accredited
696 until the 31st day after that date. On the 31st day after the
697 program ceased to be accredited, the program shall be closed and
698 the educational institution conducting the program must comply
699 with paragraph (8)(b).
700 (8) The Florida Center for Nursing and the Office of
701 Program Policy Analysis and Government Accountability shall
702 each:
703 (a) Monitor the administration of this section and evaluate
704 the effectiveness of this section in achieving quality nursing
705 programs with a higher production of quality nursing graduates.
706 (b) Report its findings and make recommendations, if
707 warranted, to improve the effectiveness of this section to the
708 Governor, the President of the Senate, and the Speaker of the
709 House of Representatives by February 1, 2010.
710 (11)(9) IMPLEMENTATION STUDY.—The Florida Center for
711 Nursing and the education policy area of the Office of Program
712 Policy Analysis and Government Accountability shall study the 5
713 year administration of this section and submit reports to the
714 Governor, the President of the Senate, and the Speaker of the
715 House of Representatives by January 30, 2011, and annually
716 thereafter through January 30, 2015. The annual reports shall
717 address the previous academic year; set forth data on the
718 measures specified in paragraphs (a) and (b) for each
719 prelicensure practical and professional nursing program in the
720 state, as such data becomes available; and include an evaluation
721 of such data for purposes of determining whether this section is
722 increasing the availability of nursing education programs and
723 the production of quality nurses. The department and each
724 approved program or accredited program shall comply with
725 requests for data from the Florida Center for Nursing and the
726 education policy area of the Office of Program Policy Analysis
727 and Government Accountability.
728 (a) The education policy area of the Office of Program
729 Policy Analysis and Government Accountability shall evaluate
730 program-specific data for each approved program and accredited
731 program conducted in the state, including, but not limited to:
732 1. The number of nursing education programs and student
733 slots available.
734 2. The number of student applications submitted, the number
735 of qualified applicants, and the number of students accepted.
736 3. The number of program graduates.
737 4. Program retention rates of students tracked from program
738 entry to graduation.
739 5. Graduate passage rates on the National Council of State
740 Boards of Nursing Licensing Examination.
741 6. The number of graduates who become employed as practical
742 or professional nurses in the state.
743 (b) The Florida Center for Nursing shall evaluate the
744 board’s implementation of the:
745 1. Program application approval process, including, but not
746 limited to, the number of program applications submitted under
747 subsection (1); the number of program applications approved and
748 denied by the board under subsection (2) subsections (1) and
749 (3); the number of denials of program applications reviewed
750 under chapter 120; and a description of the outcomes of those
751 reviews.
752 2. Accountability Probation and termination processes,
753 including, but not limited to, the number of programs placed on
754 probationary status, the number of approved programs for which
755 the program director is required to appear before the board
756 under subsection (6), the number of approved programs terminated
757 by the board under paragraph (5)(d), the number of terminations
758 reviewed under chapter 120, and a description of the outcomes of
759 those reviews.
760 Section 6. Subsection (4) of section 464.022, Florida
761 Statutes, is amended to read:
762 464.022 Exceptions.—No provision of this part shall be
763 construed to prohibit:
764 (4) The practice of nursing by graduates of prelicensure
765 nursing education approved programs listed in s. 464.008(1)(c)
766 or the equivalent, pending the result of the first licensing
767 examination for which they are eligible following graduation,
768 provided they practice under direct supervision of a registered
769 professional nurse. The board shall by rule define what
770 constitutes direct supervision.
771 Section 7. Paragraph (a) of subsection (1) and subsection
772 (2) of section 458.348, Florida Statutes, is amended to read:
773 458.348 Formal supervisory relationships, standing orders,
774 and established protocols; notice; standards.—
775 (1) NOTICE.—
776 (a) When a physician enters into a formal supervisory
777 relationship or standing orders with an emergency medical
778 technician or paramedic licensed pursuant to s. 401.27, which
779 relationship or orders contemplate the performance of medical
780 acts, or when a physician enters into an established protocol
781 with an advanced registered nurse practitioner, which protocol
782 contemplates the performance of medical acts identified and
783 approved by the joint committee pursuant to s. 464.003(2) s.
784 464.003(3)(d) or acts set forth in s. 464.012(3) and (4), the
785 physician shall submit notice to the board. The notice shall
786 contain a statement in substantially the following form:
787
788 I, ...(name and professional license number of
789 physician)..., of ...(address of physician)... have hereby
790 entered into a formal supervisory relationship, standing orders,
791 or an established protocol with ...(number of persons)...
792 emergency medical technician(s), ...(number of persons)...
793 paramedic(s), or ...(number of persons)... advanced registered
794 nurse practitioner(s).
795 (2) ESTABLISHMENT OF STANDARDS BY JOINT COMMITTEE.—The
796 joint committee created under s. 464.003(2) s. 464.003(3)(d)
797 shall determine minimum standards for the content of established
798 protocols pursuant to which an advanced registered nurse
799 practitioner may perform medical acts identified and approved by
800 the joint committee pursuant to s. 464.003(2) s. 464.003(3)(d)
801 or acts set forth in s. 464.012(3) and (4) and shall determine
802 minimum standards for supervision of such acts by the physician,
803 unless the joint committee determines that any act set forth in
804 s. 464.012(3) or (4) is not a medical act. Such standards shall
805 be based on risk to the patient and acceptable standards of
806 medical care and shall take into account the special problems of
807 medically underserved areas. The standards developed by the
808 joint committee shall be adopted as rules by the Board of
809 Nursing and the Board of Medicine for purposes of carrying out
810 their responsibilities pursuant to part I of chapter 464 and
811 this chapter, respectively, but neither board shall have
812 disciplinary powers over the licensees of the other board.
813 Section 8. Paragraph (a) of subsection (1) of section
814 459.025, Florida Statutes, is amended to read:
815 459.025 Formal supervisory relationships, standing orders,
816 and established protocols; notice; standards.—
817 (1) NOTICE.—
818 (a) When an osteopathic physician enters into a formal
819 supervisory relationship or standing orders with an emergency
820 medical technician or paramedic licensed pursuant to s. 401.27,
821 which relationship or orders contemplate the performance of
822 medical acts, or when an osteopathic physician enters into an
823 established protocol with an advanced registered nurse
824 practitioner, which protocol contemplates the performance of
825 medical acts identified and approved by the joint committee
826 pursuant to s. 464.003(2) s. 464.003(3)(d) or acts set forth in
827 s. 464.012(3) and (4), the osteopathic physician shall submit
828 notice to the board. The notice must contain a statement in
829 substantially the following form:
830 I, ...(name and professional license number of osteopathic
831 physician)..., of ...(address of osteopathic physician)... have
832 hereby entered into a formal supervisory relationship, standing
833 orders, or an established protocol with ...(number of
834 persons)... emergency medical technician(s), ...(number of
835 persons)... paramedic(s), or ...(number of persons)... advanced
836 registered nurse practitioner(s).
837 Section 9. Paragraph (c) of subsection (3) of section
838 464.012, Florida Statutes, is amended to read:
839 464.012 Certification of advanced registered nurse
840 practitioners; fees.—
841 (3) An advanced registered nurse practitioner shall perform
842 those functions authorized in this section within the framework
843 of an established protocol that is filed with the board upon
844 biennial license renewal and within 30 days after entering into
845 a supervisory relationship with a physician or changes to the
846 protocol. The board shall review the protocol to ensure
847 compliance with applicable regulatory standards for protocols.
848 The board shall refer to the department licensees submitting
849 protocols that are not compliant with the regulatory standards
850 for protocols. A practitioner currently licensed under chapter
851 458, chapter 459, or chapter 466 shall maintain supervision for
852 directing the specific course of medical treatment. Within the
853 established framework, an advanced registered nurse practitioner
854 may:
855 (c) Perform additional functions as may be determined by
856 rule in accordance with s. 464.003(2)(3)(d).
857 Section 10. Subsection (2) of section 960.28, Florida
858 Statutes, is amended to read:
859 960.28 Payment for victims’ initial forensic physical
860 examinations.—
861 (2) The Crime Victims’ Services Office of the department
862 shall pay for medical expenses connected with an initial
863 forensic physical examination of a victim of sexual battery as
864 defined in chapter 794 or a lewd or lascivious offense as
865 defined in chapter 800. Such payment shall be made regardless of
866 whether the victim is covered by health or disability insurance
867 and whether the victim participates in the criminal justice
868 system or cooperates with law enforcement. The payment shall be
869 made only out of moneys allocated to the Crime Victims’ Services
870 Office for the purposes of this section, and the payment may not
871 exceed $500 with respect to any violation. The department shall
872 develop and maintain separate protocols for the initial forensic
873 physical examination of adults and children. Payment under this
874 section is limited to medical expenses connected with the
875 initial forensic physical examination, and payment may be made
876 to a medical provider using an examiner qualified under part I
877 of chapter 464, excluding s. 464.003(16)(5); chapter 458; or
878 chapter 459. Payment made to the medical provider by the
879 department shall be considered by the provider as payment in
880 full for the initial forensic physical examination associated
881 with the collection of evidence. The victim may not be required
882 to pay, directly or indirectly, the cost of an initial forensic
883 physical examination performed in accordance with this section.
884 Section 11. This act shall take effect July 1, 2010.