Florida Senate - 2009 CS for CS for SB 2284
By the Committees on Health and Human Services Appropriations;
and Higher Education; and Senator Haridopolos
603-05645-09 20092284c2
1 A bill to be entitled
2 An act relating to nursing programs; amending s.
3 464.003, F.S.; revising the definition of the term
4 “approved program” and defining terms for purposes of
5 the Nurse Practice Act; amending s. 464.019, F.S.;
6 revising provisions for the approval of nursing
7 programs by the Board of Nursing; requiring
8 institutions wishing to conduct certain nursing
9 programs to submit a program application and pay a
10 program review fee to the Department of Health;
11 specifying that a program application is deemed
12 approved if the board does not act within specified
13 timeframes; providing application requirements and
14 procedures; providing standards for the approval of
15 nursing programs; specifying that, upon the board’s
16 approval of a program application, the program becomes
17 an approved program; providing that programs
18 provisionally approved by the board, and certain
19 programs on probationary status, as of a specified
20 date are approved programs under the act; providing
21 that certain programs on probationary status as of a
22 specified date remain on probationary status;
23 requiring such programs on probationary status to
24 comply within a specified period with a requirement
25 related to program graduate passage rates; requiring
26 the board to terminate programs that do not comply;
27 requiring approved programs to annually submit a
28 report; specifying contents of annual reports;
29 providing for denial of program applications;
30 providing procedures for processing incomplete program
31 applications; requiring the board to provide a notice
32 of intent to deny a program application that does not
33 document compliance with certain standards;
34 authorizing an administrative hearing for review of a
35 notice of intent to deny an application; requiring the
36 board to publish on its Internet website certain data
37 about nursing programs; requiring that a nursing
38 program be placed on probation under certain
39 circumstances; requiring programs placed on probation
40 to disclose certain information to students and
41 applicants; requiring the board to terminate a nursing
42 program under certain circumstances; requiring a
43 nursing program that closes to notify the board of
44 certain information; specifying that the board, with
45 certain exceptions, does not have rulemaking authority
46 to administer the act; specifying that the board may
47 not impose any condition or requirement on program
48 approval or retention except as expressly provided in
49 the act; requiring the board to repeal certain rules
50 in existence as of a specified date; requiring the
51 Florida Center for Nursing and the Office of Program
52 Policy Analysis and Government Accountability to
53 conduct studies and submit reports to the Governor and
54 Legislature; providing an effective date.
55
56 Be It Enacted by the Legislature of the State of Florida:
57
58 Section 1. Subsection (8) of section 464.003, Florida
59 Statutes, is amended, and subsections (9) through (14) are added
60 to that section, to read:
61 464.003 Definitions.—As used in this part, the term:
62 (8) “Approved program” means a nursing program conducted in
63 a school, college, or university which is approved under by the
64 board pursuant to s. 464.019 for the education of nurses.
65 (9) “Clinical training” means direct nursing care
66 experiences with patients or clients which offer the student the
67 opportunity to integrate, apply, and refine specific skills and
68 abilities based on theoretical concepts and scientific
69 principles.
70 (10) “Clinical preceptor” means a registered nurse employed
71 by a clinical training facility who serves as a role model and
72 clinical resource person for a specified period to an individual
73 enrolled in an approved program.
74 (11) “Clinical simulation” means a strategy used to
75 replicate clinical practice as closely as possible to teach
76 theory, assessment, technology, pharmacology, and skills.
77 (12) “Community-based clinical experience” means activities
78 consistent with the curriculum and involving individuals,
79 families, and groups with the intent of promoting wellness,
80 maintaining health, and preventing illness.
81 (13) “Curriculum” means a planned sequence of course
82 offerings and learning experiences that comprise a nursing
83 education program.
84 (14) “Probationary status” means the status of a nursing
85 education program that is subject to s. 464.019(2)(a)2. or
86 (5)(a) or (b).
87 Section 2. Section 464.019, Florida Statutes, is amended to
88 read:
89 (Substantial rewording of section. See
90 s. 464.019, F.S., for present text.)
91 464.019 Approval of nursing programs.
92 (1) An institution that wishes to conduct a program for the
93 prelicensure education of professional or practical nurses shall
94 submit a program application and a program review fee of $1,000
95 to the department. Within 90 days after receipt of a program
96 application and program review fee, the board shall approve the
97 program application if it documents compliance with the
98 standards in paragraphs (a)-(h). If the program application is
99 incomplete or does not document compliance, the board shall
100 follow the procedures in subsection (3). A program application
101 is deemed approved by the board if the board does not act on the
102 application within the timeframes specified in subsection (3) or
103 this subsection. Each program application must document that:
104 (a) For a professional nursing program, the program
105 director and at least 50 percent of the program’s faculty
106 members are registered nurses who have, at a minimum, a
107 bachelor’s degree in nursing and a master’s degree in nursing or
108 a related field.
109 (b) For a practical nursing program, the program director
110 and at least 50 percent of the program’s faculty members are
111 registered nurses who have, at a minimum, a bachelor’s degree in
112 nursing.
113 (c) The program’s nursing major curriculum consists of at
114 least:
115 1. Fifty percent clinical training for a practical nursing
116 program, an associate degree professional nursing program, or a
117 professional diploma nursing program.
118 2. Forty percent clinical training for a bachelor’s degree
119 professional nursing program.
120 (d) No more than 25 percent of the program’s clinical
121 training consists of clinical simulation.
122 (e) The program has signed agreements with each agency,
123 facility, and organization included in the curriculum plan as
124 clinical training sites and community-based clinical experience
125 sites.
126 (f) The program has written policies for faculty which
127 include provisions for direct or indirect supervision by program
128 faculty or clinical preceptors for students in clinical training
129 consistent with the following standards:
130 1. The number of program faculty members equals at least
131 one faculty member directly supervising every 12 students unless
132 the written agreement between the program and the agency,
133 facility, or organization providing clinical training sites
134 allows more students, not to exceed 18 students, to be directly
135 supervised by one program faculty member.
136 2. For a hospital setting, indirect supervision may occur
137 only if there is direct supervision by an assigned clinical
138 preceptor, a supervising program faculty member is available by
139 telephone, and such arrangement is approved by the clinical
140 facility.
141 3. For community-based clinical experiences that involve
142 student participation in invasive or complex nursing activities,
143 students must be directly supervised by a program faculty member
144 or clinical preceptor and such arrangement must be approved by
145 the community-based clinical facility.
146 4. For community-based clinical experiences not subject to
147 subparagraph 3., indirect supervision may occur only when a
148 supervising program faculty member is available to the student
149 by telephone.
150 (g) The professional or practical nursing curriculum plan
151 documents clinical experience and theoretical instruction in
152 medical, surgical, obstetric, pediatric, and geriatric nursing.
153 A professional nursing curriculum plan shall also document
154 clinical experience and theoretical instruction in psychiatric
155 nursing. Each curriculum plan must document clinical training
156 experience in appropriate settings that include, but are not
157 limited to, acute care, long-term care, and community settings.
158 (h) The professional or practical nursing program provides
159 theoretical instruction and clinical application in personal,
160 family, and community health concepts; nutrition; human growth
161 and development throughout the life span; body structure and
162 function; interpersonal relationship skills; mental health
163 concepts; pharmacology and administration of medications; and
164 legal aspects of practice. A professional nursing program shall
165 also provide theoretical instruction and clinical application in
166 interpersonal relationships and leadership skills; professional
167 role and function; and health teaching and counseling skills.
168
169 Upon the board’s approval of a program application, the program
170 becomes an approved program under this section.
171 (2)(a) A professional or practical nursing program that, as
172 of June 30, 2009:
173 1. Has full or provisional approval from the board or is on
174 probationary status, except as provided in subparagraph 2.,
175 becomes an approved program under this section. In order to
176 retain approved program status, such program shall submit the
177 report required under paragraph (c) to the board by November 1,
178 2009, and annually thereafter.
179 2. Is on probationary status because the program did not
180 meet the board’s requirement for program graduate passage rates
181 on the National Council of State Boards of Nursing Licensing
182 Examination, shall remain on probationary status until the
183 program achieves compliance with the program graduate passage
184 rate requirement in paragraph (5)(a). A program that is subject
185 to this subparagraph must submit the report required under
186 paragraph (c) to the board by November 1, 2009, and annually
187 thereafter and must comply with paragraph (5)(c). If the program
188 does not achieve compliance by July 1, 2011, the board shall
189 terminate the program as provided in paragraph (5)(d).
190 (b) Each professional or practical nursing program that has
191 its application approved by the board under subsection (1) on or
192 after July 1, 2009, shall annually submit the report required
193 under paragraph (c) to the board by November 1 of each year
194 following initial approval of its application.
195 (c) The annual report required by this subsection must
196 include an affidavit certifying continued compliance with
197 subsection (1), must provide a summary description of the
198 program’s compliance with subsection (1), and must document for
199 the previous academic year for each professional and practical
200 nursing program:
201 1. The number of student applications received, the number
202 of qualified applicants, and the number of students accepted.
203 2. The number of program graduates.
204 3. The program’s graduate passage rate on the National
205 Council of State Boards of Nursing Licensing Examination.
206 4. The program’s retention rates for students tracked from
207 program entry to graduation.
208 5. The program’s accreditation status, including
209 identification of the accrediting body.
210 (3)(a) If an institution’s program application is
211 incomplete, the board shall notify the institution of any
212 apparent errors or omissions within 30 days after receipt of the
213 application and follow the procedures in s. 120.60.
214 (b) If an institution’s program application does not
215 document compliance with the standards in subsection (1), within
216 90 days after the board’s receipt of the program application,
217 the board shall provide the institution with a notice of intent
218 to deny the program application that sets forth written reasons
219 for the denial. The institution may request a hearing on the
220 notice of intent to deny the program application pursuant to
221 chapter 120.
222 (4) The board shall publish on its Internet website data on
223 nursing programs located in the state. The data shall include:
224 (a) All documentation provided by the applicant for each
225 approved nursing program application submitted on or after July
226 1, 2009.
227 (b) The summary description of each program’s compliance as
228 submitted under paragraph (2)(c).
229 (c) A comprehensive list of each practical and professional
230 nursing program in the state.
231 (d) The accreditation status for each program, including
232 identification of the accrediting body.
233 (e) Each program’s approval or probationary status.
234 (f) Each program’s graduate passage rate on the National
235 Council of State Boards of Nursing Licensing Examination.
236 (g) The national average for passage rates on the National
237 Council of State Boards of Nursing Licensing Examination.
238 (h) Each program’s retention rates for students tracked
239 from program entry to graduation.
240
241 The data required to be published under this subsection shall be
242 made available in a manner that allows interactive searches and
243 comparisons of specific nursing education programs. The board
244 shall publish the data by December 31, 2009, and update the
245 Internet website at least quarterly with the available data.
246 (5)(a) If a professional or practical nursing program’s
247 average graduate passage rate for first-time test takers on the
248 National Council of State Boards of Nursing Licensing
249 Examination falls 10 percent or more below the national average
250 passage rate for first-time test takers educated in the United
251 States, as annually published by the contract testing service of
252 the National Council of State Boards of Nursing, for 2
253 consecutive calendar years, the board shall place the program on
254 probation and the program director shall be required to appear
255 before the board to present a plan for remediation. The program
256 shall remain on probationary status until it achieves compliance
257 with the graduate passage rate requirement and shall be
258 terminated by the board under paragraph (d) if the program does
259 not achieve compliance within 2 calendar years.
260 (b) If a program fails to submit the annual report required
261 in subsection (2), the board shall place the program on
262 probation. The program shall remain on probationary status until
263 it submits the annual report and shall be terminated by the
264 board under paragraph (d) if it does not submit the annual
265 report within 6 months after the report’s due date.
266 (c) A program placed on probationary status shall disclose
267 its probationary status in writing to the program’s students and
268 applicants.
269 (d) The board shall terminate a program that fails to
270 comply with subparagraph (2)(a)2., paragraph (a), or paragraph
271 (b) pursuant to chapter 120.
272 (6) A nursing program that closes shall notify the board in
273 writing and advise the board of the arrangements for storage of
274 permanent records.
275 (7) The board does not have any rulemaking authority to
276 administer this section, except that the board shall adopt a
277 rule that prescribes the format for submitting program
278 applications under subsection (1) and submitting summary
279 descriptions of program compliance under paragraph (2)(c). The
280 board may not impose any condition or requirement on an
281 institution submitting a program application, an approved
282 program, or a program on probationary status except as expressly
283 provided in this section. The board shall repeal all rules, or
284 portions thereof, in existence on July 1, 2009, that are
285 inconsistent with this subsection.
286 (8) The Florida Center for Nursing and the Office of
287 Program Policy Analysis and Government Accountability shall
288 each:
289 (a) Monitor the administration of this section and evaluate
290 the effectiveness of this section in achieving quality nursing
291 programs with a higher production of quality nursing graduates.
292 (b) Report its findings and make recommendations, if
293 warranted, to improve the effectiveness of this section to the
294 Governor, the President of the Senate, and the Speaker of the
295 House of Representatives by February 1, 2010.
296 (9) The Florida Center for Nursing and the education policy
297 area of the Office of Program Policy Analysis and Government
298 Accountability shall study the 5-year administration of this
299 section and submit reports to the Governor, the President of the
300 Senate, and the Speaker of the House of Representatives by
301 January 30, 2011, and annually thereafter through January 30,
302 2015. The annual reports shall address the previous academic
303 year; set forth data on the measures specified in paragraphs (a)
304 and (b) for each prelicensure practical and professional nursing
305 program in the state, as such data becomes available; and
306 include an evaluation of such data for purposes of determining
307 whether this section is increasing the availability of nursing
308 programs and the production of quality nurses.
309 (a) The education policy area of the Office of Program
310 Policy Analysis and Government Accountability shall evaluate
311 program-specific data including, but not limited to:
312 1. The number of nursing education programs and student
313 slots available.
314 2. The number of student applications submitted, the number
315 of qualified applicants, and the number of students accepted.
316 3. The number of program graduates.
317 4. Program retention rates of students tracked from program
318 entry to graduation.
319 5. Graduate passage rates on the National Council of State
320 Boards of Nursing Licensing Examination.
321 6. The number of graduates who become employed as practical
322 or professional nurses in the state.
323 (b) The Florida Center for Nursing shall evaluate the
324 board’s implementation of the:
325 1. Program application approval process, including, but not
326 limited to, the number of program applications submitted under
327 subsection (1); the number of program applications approved and
328 denied by the board under subsections (1) and (3); the number of
329 denials of program applications reviewed under chapter 120; and
330 a description of the outcomes of those reviews.
331 2. Probation and termination processes, including, but not
332 limited to, the number of programs placed on probationary
333 status, the number of programs terminated by the board under
334 paragraph (5)(d), the number of terminations reviewed under
335 chapter 120, and a description of the outcomes of those reviews.
336 Section 3. This act shall take effect July 1, 2009.