HB 1337

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

CODING: Words stricken are deletions; words underlined are additions.