Florida Senate - 2017                                     SB 328
       
       
        
       By Senator Grimsley
       
       26-00100C-17                                           2017328__
    1                        A bill to be entitled                      
    2         An act relating to the regulation of nursing; amending
    3         s. 464.012, F.S.; removing an obsolete qualification
    4         no longer sufficient to satisfy certain certification
    5         requirements; amending chapter 2016-139, Laws of
    6         Florida; removing an obsolete qualification no longer
    7         sufficient to satisfy certain certification
    8         requirements from an act with a future effective date;
    9         amending s. 464.013, F.S.; requiring certain
   10         continuing education courses to be approved by the
   11         Board of Nursing; removing a requirement that certain
   12         continuing education courses be offered by specified
   13         entities; amending s. 464.019, F.S.; authorizing the
   14         board to conduct certain on-site evaluations; removing
   15         a limiting criterion from the requirement to measure
   16         graduate passage rates; removing a requirement that
   17         certain nursing program graduates complete a specific
   18         preparatory course; clarifying circumstances when
   19         programs in probationary status must be terminated;
   20         providing that accredited and nonaccredited nursing
   21         education programs must disclose probationary status;
   22         requiring notification of probationary status to
   23         include certain information; prohibiting a terminated
   24         or closed program from seeking program approval for a
   25         certain time; authorizing the board to adopt certain
   26         rules; requiring accredited programs to meet program
   27         accountability requirements and requirements to
   28         provide notification of probationary status; removing
   29         requirements that the Office of Program Policy
   30         Analysis and Government Accountability perform certain
   31         tasks; requiring the Florida Center for Nursing to
   32         make an annual assessment of compliance by nursing
   33         programs with certain accreditation requirements;
   34         requiring the center to include its assessment in a
   35         report to the Governor and the Legislature; removing
   36         the requirement that the Office of Program Policy
   37         Analysis and Government Accountability perform
   38         specified duties under certain circumstances;
   39         requiring the termination of a program under certain
   40         circumstances; providing effective dates.
   41          
   42  Be It Enacted by the Legislature of the State of Florida:
   43  
   44         Section 1. Subsection (1) of section 464.012, Florida
   45  Statutes, is amended to read:
   46         464.012 Certification of advanced registered nurse
   47  practitioners; fees; controlled substance prescribing.—
   48         (1) Any nurse desiring to be certified as an advanced
   49  registered nurse practitioner shall apply to the department and
   50  submit proof that he or she holds a current license to practice
   51  professional nursing and that he or she meets one or more of the
   52  following requirements as determined by the board:
   53         (a) Satisfactory completion of a formal postbasic
   54  educational program of at least one academic year, the primary
   55  purpose of which is to prepare nurses for advanced or
   56  specialized practice.
   57         (a)(b) Certification by an appropriate specialty board.
   58  Such certification shall be required for initial state
   59  certification and any recertification as a registered nurse
   60  anesthetist, psychiatric nurse, or nurse midwife. The board may
   61  by rule provide for provisional state certification of graduate
   62  nurse anesthetists, psychiatric nurses, and nurse midwives for a
   63  period of time determined to be appropriate for preparing for
   64  and passing the national certification examination.
   65         (b)(c) Graduation from a program leading to a master’s
   66  degree in a nursing clinical specialty area with preparation in
   67  specialized practitioner skills. For applicants graduating on or
   68  after October 1, 1998, graduation from a master’s degree program
   69  shall be required for initial certification as a nurse
   70  practitioner under paragraph (4)(c). For applicants graduating
   71  on or after October 1, 2001, graduation from a master’s degree
   72  program shall be required for initial certification as a
   73  registered nurse anesthetist under paragraph (4)(a).
   74         Section 2. Effective December 31, 2018, or upon enactment
   75  of the Nurse Licensure Compact into law by 26 states, whichever
   76  occurs first, section 8 of chapter 2016-139, Laws of Florida, is
   77  amended to read:
   78         Section 8. Subsection (1) of section 464.012, Florida
   79  Statutes, is amended to read:
   80         464.012 Certification of advanced registered nurse
   81  practitioners; fees.—
   82         (1) Any nurse desiring to be certified as an advanced
   83  registered nurse practitioner shall apply to the department and
   84  submit proof that he or she holds a current license to practice
   85  professional nursing or holds an active multistate license to
   86  practice professional nursing pursuant to s. 464.0095 and that
   87  he or she meets one or more of the following requirements as
   88  determined by the board:
   89         (a) Satisfactory completion of a formal postbasic
   90  educational program of at least one academic year, the primary
   91  purpose of which is to prepare nurses for advanced or
   92  specialized practice.
   93         (a)(b) Certification by an appropriate specialty board.
   94  Such certification shall be required for initial state
   95  certification and any recertification as a registered nurse
   96  anesthetist or nurse midwife. The board may by rule provide for
   97  provisional state certification of graduate nurse anesthetists
   98  and nurse midwives for a period of time determined to be
   99  appropriate for preparing for and passing the national
  100  certification examination.
  101         (b)(c) Graduation from a program leading to a master’s
  102  degree in a nursing clinical specialty area with preparation in
  103  specialized practitioner skills. For applicants graduating on or
  104  after October 1, 1998, graduation from a master’s degree program
  105  shall be required for initial certification as a nurse
  106  practitioner under paragraph (4)(c). For applicants graduating
  107  on or after October 1, 2001, graduation from a master’s degree
  108  program shall be required for initial certification as a
  109  registered nurse anesthetist under paragraph (4)(a).
  110         Section 3. Subsection (3) of section 464.013, Florida
  111  Statutes, is amended to read:
  112         464.013 Renewal of license or certificate.—
  113         (3) The board shall by rule prescribe up to 30 hours of
  114  continuing education biennially as a condition for renewal of a
  115  license or certificate.
  116         (a) A nurse who is certified by a health care specialty
  117  program accredited by the National Commission for Certifying
  118  Agencies or the Accreditation Board for Specialty Nursing
  119  Certification is exempt from continuing education requirements.
  120  The criteria for programs must be approved by the board.
  121         (b) Notwithstanding the exemption in paragraph (a), as part
  122  of the maximum 30 hours of continuing education hours required
  123  under this subsection, advanced registered nurse practitioners
  124  certified under s. 464.012 must complete at least 3 hours of
  125  continuing education on the safe and effective prescription of
  126  controlled substances. Such continuing education courses must be
  127  approved by the board and must be offered by a statewide
  128  professional association of physicians in this state accredited
  129  to provide educational activities designated for the American
  130  Medical Association Physician’s Recognition Award Category 1
  131  credit, the American Nurses Credentialing Center, the American
  132  Association of Nurse Anesthetists, or the American Association
  133  of Nurse Practitioners and may be offered in a distance learning
  134  format.
  135         Section 4. Paragraph (b) of subsection (2), subsection (5),
  136  subsection (8), paragraph (a) of subsection (9), and subsection
  137  (10) of section 464.019, Florida Statutes, are amended,
  138  paragraph (d) is added to subsection (7) of that section, and
  139  paragraph (e) is added to subsection (11) of that section, to
  140  read:
  141         464.019 Approval of nursing education programs.—
  142         (2) PROGRAM APPROVAL.—
  143         (b) Following the department’s receipt of a complete
  144  program application, the board may conduct an on-site evaluation
  145  if necessary to document the applicant’s compliance with
  146  subsection (1). Within 90 days after the department’s receipt of
  147  a complete program application, the board shall:
  148         1. Approve the application if it documents compliance with
  149  subsection (1); or
  150         2. Provide the educational institution with a notice of
  151  intent to deny the application if it does not document
  152  compliance with subsection (1). The notice must specify written
  153  reasons for the board’s denial of the application. The board may
  154  not deny a program application because of an educational
  155  institution’s failure to correct an error or omission that the
  156  department failed to provide notice of to the institution within
  157  the 30-day notice period under paragraph (a). The educational
  158  institution may request a hearing on the notice of intent to
  159  deny the program application pursuant to chapter 120.
  160         (5) ACCOUNTABILITY.—
  161         (a)1. An approved program must achieve a graduate passage
  162  rate for first-time test takers which who take the licensure
  163  examination within 6 months after graduation from the program
  164  that is not more than 10 percentage points lower than the
  165  average passage rate during the same calendar year for graduates
  166  of comparable degree programs who are United States educated,
  167  first-time test takers on the National Council of State Boards
  168  of Nursing Licensing Examination, as calculated by the contract
  169  testing service of the National Council of State Boards of
  170  Nursing. An approved program shall require a graduate from the
  171  program who does not take the licensure examination within 6
  172  months after graduation to enroll in and successfully complete a
  173  licensure examination preparatory course pursuant to s. 464.008.
  174  For purposes of this subparagraph, an approved program is
  175  comparable to all degree programs of the same program type from
  176  among the following program types:
  177         a. Professional nursing education programs that terminate
  178  in a bachelor’s degree.
  179         b. Professional nursing education programs that terminate
  180  in an associate degree.
  181         c. Professional nursing education programs that terminate
  182  in a diploma.
  183         d. Practical nursing education programs.
  184         2. Beginning with graduate passage rates for calendar year
  185  2010, if an approved program’s graduate passage rates do not
  186  equal or exceed the required passage rates for 2 consecutive
  187  calendar years, the board shall place the program on
  188  probationary status pursuant to chapter 120 and the program
  189  director shall appear before the board to present a plan for
  190  remediation, which shall include specific benchmarks to identify
  191  progress toward a graduate passage rate goal. The program must
  192  remain on probationary status until it achieves a graduate
  193  passage rate that equals or exceeds the required passage rate
  194  for any 1 calendar year. The board shall deny a program
  195  application for a new prelicensure nursing education program
  196  submitted by an educational institution if the institution has
  197  an existing program that is already on probationary status.
  198         3. Upon the program’s achievement of a graduate passage
  199  rate that equals or exceeds the required passage rate, the
  200  board, at its next regularly scheduled meeting following release
  201  of the program’s graduate passage rate by the National Council
  202  of State Boards of Nursing, shall remove the program’s
  203  probationary status. If the program, during the 2 calendar years
  204  following its placement on probationary status, does not achieve
  205  the required passage rate for any 1 calendar year, the board
  206  shall terminate the program pursuant to chapter 120. However,
  207  the board may extend the program’s probationary status for 1
  208  additional year, provided if the program has demonstrated
  209  demonstrates adequate progress toward the graduate passage rate
  210  goal by meeting a majority of the benchmarks established in the
  211  remediation plan. If the program is not granted the 1-year
  212  extension or fails to achieve the required passage rate by the
  213  end of such extension, the board shall terminate the program
  214  pursuant to chapter 120.
  215         (b) If an approved program fails to submit the annual
  216  report required in subsection (3), the board shall notify the
  217  program director and president or chief executive officer of the
  218  educational institution in writing within 15 days after the due
  219  date of the annual report. The program director shall appear
  220  before the board at the board’s next regularly scheduled meeting
  221  to explain the reason for the delay. The board shall terminate
  222  the program pursuant to chapter 120 if the program director
  223  fails to appear before the board, as required under this
  224  paragraph, or if the program it does not submit the annual
  225  report within 6 months after the due date.
  226         (c) A nursing education An approved program, whether
  227  accredited or nonaccredited, which has been placed on
  228  probationary status shall disclose its probationary status in
  229  writing to the program’s students and applicants. The
  230  notification must include an explanation of the implications of
  231  the program’s probationary status on student and applicant
  232  employment and educational opportunities, including the
  233  prospects a student wishing to matriculate at a university will
  234  face.
  235         (d) If students from a program that is terminated pursuant
  236  to this subsection transfer to an approved or an accredited
  237  program under the direction of the Commission for Independent
  238  Education, the board shall recalculate the passage rates of the
  239  programs receiving the transferring students, excluding the test
  240  scores of those students transferring more than 12 credits.
  241         (7) PROGRAM CLOSURE.—
  242         (d) A program that is terminated or closed under this
  243  section may not seek program approval under its original name or
  244  a new program name for a minimum of 3 years after the date of
  245  termination or closing.
  246         (8) RULEMAKING.—The board does not have rulemaking
  247  authority to administer this section, except that the board
  248  shall adopt rules that prescribe the format for submitting
  249  program applications under subsection (1) and annual reports
  250  under subsection (3), and to administer the documentation of the
  251  accreditation of nursing education programs under subsection
  252  (11). The board may adopt rules related to the nursing
  253  curriculum and nursing program implementation plans, which may
  254  include definitions of the various types and uses of simulation
  255  technology and limitations on the technology’s use. The board
  256  may also adopt rules related to program termination or closure
  257  under this section and the procedure for a program that is
  258  terminated or closed under this section to seek subsequent
  259  program approval. The board may not impose any condition or
  260  requirement on an educational institution submitting a program
  261  application, an approved program, or an accredited program,
  262  except as expressly provided in this section.
  263         (9) APPLICABILITY TO ACCREDITED PROGRAMS.—
  264         (a) Subsections (1)-(3), paragraph (4)(b), and paragraphs
  265  (5)(b) and (d) subsection (5) do not apply to an accredited
  266  program.
  267         (10) IMPLEMENTATION STUDY.—The Florida Center for Nursing
  268  and the education policy area of the Office of Program Policy
  269  Analysis and Government Accountability shall study the
  270  administration of this section and submit reports to the
  271  Governor, the President of the Senate, and the Speaker of the
  272  House of Representatives annually by January 30, through January
  273  30, 2020. The annual reports shall address the previous academic
  274  year; provide data on the measures specified in paragraphs (a)
  275  and (b), as such data becomes available; and include an
  276  evaluation of such data for purposes of determining whether this
  277  section is increasing the availability of nursing education
  278  programs and the production of quality nurses. The department
  279  and each approved program or accredited program shall comply
  280  with requests for data from the Florida Center for Nursing and
  281  the education policy area of the Office of Program Policy
  282  Analysis and Government Accountability.
  283         (a) The Florida Center for Nursing education policy area of
  284  the Office of Program Policy Analysis and Government
  285  Accountability shall evaluate program-specific data for each
  286  approved program and accredited program conducted in the state,
  287  including, but not limited to:
  288         1. The number of programs and student slots available.
  289         2. The number of student applications submitted, the number
  290  of qualified applicants, and the number of students accepted.
  291         3. The number of program graduates.
  292         4. Program retention rates of students tracked from program
  293  entry to graduation.
  294         5. Graduate passage rates on the National Council of State
  295  Boards of Nursing Licensing Examination.
  296         6. The number of graduates who become employed as practical
  297  or professional nurses in the state.
  298         (b) The Florida Center for Nursing shall evaluate the
  299  board’s implementation of the:
  300         1. Program application approval process, including, but not
  301  limited to, the number of program applications submitted under
  302  subsection (1); the number of program applications approved and
  303  denied by the board under subsection (2); the number of denials
  304  of program applications reviewed under chapter 120; and a
  305  description of the outcomes of those reviews.
  306         2. Accountability processes, including, but not limited to,
  307  the number of programs on probationary status, the number of
  308  approved programs for which the program director is required to
  309  appear before the board under subsection (5), the number of
  310  approved programs terminated by the board, the number of
  311  terminations reviewed under chapter 120, and a description of
  312  the outcomes of those reviews.
  313         (c) The Florida Center for Nursing shall complete an annual
  314  assessment of compliance by programs with the accreditation
  315  requirements of subsection (11), include in the assessment a
  316  determination of the accreditation process status for each
  317  program, and submit the assessment as part of the report
  318  required by this subsection For any state fiscal year in which
  319  The Florida Center for Nursing does not receive legislative
  320  appropriations, the education policy area of the Office of
  321  Program Policy Analysis and Government Accountability shall
  322  perform the duties assigned by this subsection to the Florida
  323  Center for Nursing.
  324         (11) ACCREDITATION REQUIRED.—
  325         (e) A nursing education program that fails to meet the
  326  accreditation requirements shall be terminated and is ineligible
  327  for reapproval under its original name or a new program name for
  328  a minimum of 3 years after the date of termination.
  329         Section 5. This act shall take effect July 1, 2017.