CS/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 specialized accrediting
74	agency that is nationally recognized by the United States
75	Secretary of Education to accredit nursing education programs.
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 prelicensure nursing education program to be
280	offered at the institution's main campus, branch campus, or
281	other instructional site the department. Within 90 days after
282	receipt of a program application and program review fee, the
283	board shall approve the program application if it documents
284	compliance with the standards in paragraphs (a)-(h). If the
285	program application is incomplete or does not document
286	compliance, the board shall follow the procedures in subsection
287	(3). a program application is deemed approved by the board if
288	the board does not act on the application within the timeframes
289	specified in subsection (3) or this subsection. Each program
290	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 specialized
473	accrediting agencies that are nationally recognized by the
474	United States Secretary of Education to accredit nursing
475	education programs.
476	2.  For a program's graduate passage rates, the contract
477	testing service of the National Council of State Boards of
478	Nursing.
479	(b)  The following data for each approved program, which on
480	nursing programs located in the state. The data shall include,
481	to the extent applicable:
482	1.(a)  All documentation provided by the program in its
483	applicant for each approved nursing program application if
484	submitted on or after July 1, 2009.
485	2.(b)  The summary description of the each program's
486	compliance as submitted under subsection (4) paragraph (2)(c).
487	(c)  A comprehensive list of each practical and
488	professional nursing program in the state.
489	3.(d)  The program's accreditation status for each program,
490	including identification of the accrediting agency if such
491	agency is not an accrediting agency described in s. 464.003(1)
492	body.
493	4.(e)  The Each program's approval or probationary status.
494	5.(f)  The Each program's graduate passage rates for the
495	most recent 2 calendar years rate on the National Council of
496	State Boards of Nursing Licensing Examination.
497	(g)  The national average for passage rates on the National
498	Council of State Boards of Nursing Licensing Examination.
499	6.(h)  Each program's retention rates for students tracked
500	from program entry to graduation.
501	(c)  The average passage rates for United States educated
502	first-time test takers on the National Council of State Boards
503	of Nursing Licensing Examination for the most recent 2 calendar
504	years, as calculated by the contract testing service of the
505	National Council of State Boards of Nursing. The average passage
506	rates shall be published separately for each type of comparable
507	degree program listed in sub-subparagraphs (6)(a)1.a.-d.
508
509	The information data required to be published under this
510	subsection shall be made available in a manner that allows
511	interactive searches and comparisons of individual specific
512	nursing education programs selected by the website user. The
513	board shall publish the data by December 31, 2009, and update
514	the Internet website at least quarterly with the available
515	information data.
516	(6)(5)  ACCOUNTABILITY.-
517	(a)1.  An approved program must achieve a graduate passage
518	rate that is not lower than 10 percentage points less than the
519	average passage rate for graduates of comparable degree programs
520	who are United States educated first-time test takers on the
521	National Council of State Boards of Nursing Licensing
522	Examination during a calendar year, as calculated by the
523	contract testing service of the National Council of State Boards
524	of Nursing. For purposes of this subparagraph, an approved
525	program is comparable to all degree programs of the same program
526	type from among the following program types:
527	a.  Professional nursing education programs that terminate
528	in a bachelor's degree.
529	b.  Professional nursing education programs that terminate
530	in an associate degree.
531	c.  Professional nursing education programs that terminate
532	in a diploma.
533	d.  Practical nursing education programs.
534	2.  Beginning with graduate passage rates for calendar year
535	2010, if an approved a professional or practical nursing
536	program's average graduate passage rates do not equal or exceed
537	the required passage rates rate for first-time test takers on
538	the National Council of State Boards of Nursing Licensing
539	Examination falls 10 percent or more below the national average
540	passage rate for first-time test takers educated in the United
541	States, as annually published by the contract testing service of
542	the National Council of State Boards of Nursing, for 2
543	consecutive calendar years, the board shall place the program on
544	probationary status pursuant to chapter 120 probation and the
545	program director must shall be required to appear before the
546	board to present a plan for remediation. The program shall
547	remain on probationary status until it achieves a compliance
548	with the graduate passage rate that equals or exceeds the
549	required passage rate for any one calendar year.
550	3.  Upon the program's achievement of a graduate passage
551	rate that equals or exceeds the required passage rate,
552	requirement and shall be terminated by the board, at its next
553	regularly scheduled meeting following release of the program's
554	graduate passage rate by the National Council of State Boards of
555	Nursing, shall remove the program's probationary status.
556	However, under paragraph (d) if the program, during the 2
557	calendar years following its placement on probationary status,
558	does not achieve the required passage rate for any one
559	compliance within 2 calendar year, the board shall terminate the
560	program pursuant to chapter 120 years.
561	(b)  If an approved a program fails to submit the annual
562	report required in subsection (4) (2), the board shall notify
563	the program director and president or chief executive officer of
564	the educational institution in writing within 15 days after the
565	due date of the annual report. The program director must appear
566	before the board at the board's next regularly scheduled meeting
567	to explain the reason for the delay place the program on
568	probation. The board program shall terminate the program
569	pursuant to chapter 120 remain on probationary status until it
570	submits the annual report and shall be terminated by the board
571	under paragraph (d) if it does not submit the annual report
572	within 6 months after the report's due date.
573	(c)  An approved A program placed on probationary status
574	shall disclose its probationary status in writing to the
575	program's students and applicants.
576	(d)  The board shall terminate a program that fails to
577	comply with subparagraph (2)(a)2., paragraph (a), or paragraph
578	(b) pursuant to chapter 120.
579	(7)  DISCLOSURE OF GRADUATE PASSAGE RATE DATA.-
580	(a)  For each of an approved program's or accredited
581	program's graduates included in the calculation of the program's
582	graduate passage rate, the department shall disclose to the
583	program director, upon his or her written request, the name,
584	examination date, and determination of whether each graduate
585	passed or failed the National Council for State Boards of
586	Nursing Licensing Examination, to the extent that such
587	information is provided to the department by the contract
588	testing service of the National Council for State Boards of
589	Nursing. The written request must specify the calendar years for
590	which the information is requested.
591	(b)  A program director to whom confidential information
592	exempt from public disclosure pursuant to s. 456.014 is
593	disclosed under this subsection must maintain the
594	confidentiality of the information and is subject to the same
595	penalties provided in s. 456.082 for department employees who
596	unlawfully disclose confidential information.
597	(8)(6)  PROGRAM CLOSURE.-Each approved program and
598	accredited a nursing program conducted in the state that closes
599	shall notify the board in writing and advise the board of the
600	arrangements for storage of permanent records.
601	(9)(7)  RULEMAKING.-The board does not have any rulemaking
602	authority to administer this section, except that the board
603	shall adopt a rule that prescribes the format for submitting
604	program applications under subsection (1) and annual reports
605	submitting summary descriptions of program compliance under
606	subsection (4) paragraph (2)(c). The board may not impose any
607	condition or requirement on an educational institution
608	submitting a program application, an approved program, or an
609	accredited program, a program on probationary status except as
610	expressly provided in this section. The board shall repeal all
611	rules, or portions thereof, in existence on July 1, 2009, that
612	are inconsistent with this subsection.
613	(10)  APPLICABILITY.-Subsections (1)-(4), paragraph (5)(b),
614	and subsection (6) do not apply to an accredited program. An
615	accredited program on probationary status before July 1, 2010,
616	ceases to be subject to the probationary status. If an
617	accredited program ceases to be accredited, the program may
618	apply under this section to become an approved program.
619	(8)  The Florida Center for Nursing and the Office of
620	Program Policy Analysis and Government Accountability shall
621	each:
622	(a)  Monitor the administration of this section and
623	evaluate the effectiveness of this section in achieving quality
624	nursing programs with a higher production of quality nursing
625	graduates.
626	(b)  Report its findings and make recommendations, if
627	warranted, to improve the effectiveness of this section to the
628	Governor, the President of the Senate, and the Speaker of the
629	House of Representatives by February 1, 2010.
630	(11)(9)  IMPLEMENTATION STUDY.-The Florida Center for
631	Nursing and the education policy area of the Office of Program
632	Policy Analysis and Government Accountability shall study the 5-
633	year administration of this section and submit reports to the
634	Governor, the President of the Senate, and the Speaker of the
635	House of Representatives by January 30, 2011, and annually
636	thereafter through January 30, 2015. The annual reports shall
637	address the previous academic year; set forth data on the
638	measures specified in paragraphs (a) and (b) for each
639	prelicensure practical and professional nursing program in the
640	state, as such data becomes available; and include an evaluation
641	of such data for purposes of determining whether this section is
642	increasing the availability of nursing education programs and
643	the production of quality nurses. The department and each
644	approved program or accredited program shall comply with
645	requests for data from the Florida Center for Nursing and the
646	education policy area of the Office of Program Policy Analysis
647	and Government Accountability.
648	(a)  The education policy area of the Office of Program
649	Policy Analysis and Government Accountability shall evaluate
650	program-specific data for each approved program and accredited
651	program conducted in the state, including, but not limited to:
652	1.  The number of nursing education programs and student
653	slots available.
654	2.  The number of student applications submitted, the
655	number of qualified applicants, and the number of students
656	accepted.
657	3.  The number of program graduates.
658	4.  Program retention rates of students tracked from
659	program entry to graduation.
660	5.  Graduate passage rates on the National Council of State
661	Boards of Nursing Licensing Examination.
662	6.  The number of graduates who become employed as
663	practical or professional nurses in the state.
664	(b)  The Florida Center for Nursing shall evaluate the
665	board's implementation of the:
666	1.  Program application approval process, including, but
667	not limited to, the number of program applications submitted
668	under subsection (1); the number of program applications
669	approved and denied by the board under subsection (2)
670	subsections (1) and (3); the number of denials of program
671	applications reviewed under chapter 120; and a description of
672	the outcomes of those reviews.
673	2.  Accountability Probation and termination processes,
674	including, but not limited to, the number of programs placed on
675	probationary status, the number of approved programs for which
676	the program director is required to appear before the board
677	under subsection (6), the number of approved programs terminated
678	by the board under paragraph (5)(d), the number of terminations
679	reviewed under chapter 120, and a description of the outcomes of
680	those reviews.
681	Section 6.  Subsection (4) of section 464.022, Florida
682	Statutes, is amended to read:
683	464.022  Exceptions.-No provision of this part shall be
684	construed to prohibit:
685	(4)  The practice of nursing by graduates of prelicensure
686	nursing education approved programs listed in s. 464.008(1)(c)
687	or the equivalent, pending the result of the first licensing
688	examination for which they are eligible following graduation,
689	provided they practice under direct supervision of a registered
690	professional nurse. The board shall by rule define what
691	constitutes direct supervision.
692	Section 7.  Paragraph (a) of subsection (1) and subsection
693	(2) of section 458.348, Florida Statutes, are amended to read:
694	458.348  Formal supervisory relationships, standing orders,
695	and established protocols; notice; standards.-
696	(1)  NOTICE.-
697	(a)  When a physician enters into a formal supervisory
698	relationship or standing orders with an emergency medical
699	technician or paramedic licensed pursuant to s. 401.27, which
700	relationship or orders contemplate the performance of medical
701	acts, or when a physician enters into an established protocol
702	with an advanced registered nurse practitioner, which protocol
703	contemplates the performance of medical acts identified and
704	approved by the joint committee pursuant to s. 464.003(2)(3)(d)
705	or acts set forth in s. 464.012(3) and (4), the physician shall
706	submit notice to the board. The notice shall contain a statement
707	in substantially the following form:
708	I, ...(name and professional license number of
709	physician)..., of ...(address of physician)... have hereby
710	entered into a formal supervisory relationship, standing orders,
711	or an established protocol with ...(number of persons)...
712	emergency medical technician(s), ...(number of persons)...
713	paramedic(s), or ...(number of persons)... advanced registered
714	nurse practitioner(s).
715	(2)  ESTABLISHMENT OF STANDARDS BY JOINT COMMITTEE.-The
716	joint committee created under s. 464.003(2)(3)(d) shall
717	determine minimum standards for the content of established
718	protocols pursuant to which an advanced registered nurse
719	practitioner may perform medical acts identified and approved by
720	the joint committee pursuant to s. 464.003(2)(3)(d) or acts set
721	forth in s. 464.012(3) and (4) and shall determine minimum
722	standards for supervision of such acts by the physician, unless
723	the joint committee determines that any act set forth in s.
724	464.012(3) or (4) is not a medical act. Such standards shall be
725	based on risk to the patient and acceptable standards of medical
726	care and shall take into account the special problems of
727	medically underserved areas. The standards developed by the
728	joint committee shall be adopted as rules by the Board of
729	Nursing and the Board of Medicine for purposes of carrying out
730	their responsibilities pursuant to part I of chapter 464 and
731	this chapter, respectively, but neither board shall have
732	disciplinary powers over the licensees of the other board.
733	Section 8.  Paragraph (a) of subsection (1) of section
734	459.025, Florida Statutes, is amended to read:
735	459.025  Formal supervisory relationships, standing orders,
736	and established protocols; notice; standards.-
737	(1)  NOTICE.-
738	(a)  When an osteopathic physician enters into a formal
739	supervisory relationship or standing orders with an emergency
740	medical technician or paramedic licensed pursuant to s. 401.27,
741	which relationship or orders contemplate the performance of
742	medical acts, or when an osteopathic physician enters into an
743	established protocol with an advanced registered nurse
744	practitioner, which protocol contemplates the performance of
745	medical acts identified and approved by the joint committee
746	pursuant to s. 464.003(2)(3)(d) or acts set forth in s.
747	464.012(3) and (4), the osteopathic physician shall submit
748	notice to the board. The notice must contain a statement in
749	substantially the following form:
750	I, ...(name and professional license number of osteopathic
751	physician)..., of ...(address of osteopathic physician)... have
752	hereby entered into a formal supervisory relationship, standing
753	orders, or an established protocol with ...(number of
754	persons)... emergency medical technician(s), ...(number of
755	persons)... paramedic(s), or ...(number of persons)... advanced
756	registered nurse practitioner(s).
757	Section 9.  Paragraph (c) of subsection (3) of section
758	464.012, Florida Statutes, is amended to read:
759	464.012  Certification of advanced registered nurse
760	practitioners; fees.-
761	(3)  An advanced registered nurse practitioner shall
762	perform those functions authorized in this section within the
763	framework of an established protocol that is filed with the
764	board upon biennial license renewal and within 30 days after
765	entering into a supervisory relationship with a physician or
766	changes to the protocol. The board shall review the protocol to
767	ensure compliance with applicable regulatory standards for
768	protocols. The board shall refer to the department licensees
769	submitting protocols that are not compliant with the regulatory
770	standards for protocols. A practitioner currently licensed under
771	chapter 458, chapter 459, or chapter 466 shall maintain
772	supervision for directing the specific course of medical
773	treatment. Within the established framework, an advanced
774	registered nurse practitioner may:
775	(c)  Perform additional functions as may be determined by
776	rule in accordance with s. 464.003(2)(3)(d).
777	Section 10.  Subsection (2) of section 960.28, Florida
778	Statutes, is amended to read:
779	960.28  Payment for victims' initial forensic physical
780	examinations.-
781	(2)  The Crime Victims' Services Office of the department
782	shall pay for medical expenses connected with an initial
783	forensic physical examination of a victim of sexual battery as
784	defined in chapter 794 or a lewd or lascivious offense as
785	defined in chapter 800. Such payment shall be made regardless of
786	whether the victim is covered by health or disability insurance
787	and whether the victim participates in the criminal justice
788	system or cooperates with law enforcement. The payment shall be
789	made only out of moneys allocated to the Crime Victims' Services
790	Office for the purposes of this section, and the payment may not
791	exceed $500 with respect to any violation. The department shall
792	develop and maintain separate protocols for the initial forensic
793	physical examination of adults and children. Payment under this
794	section is limited to medical expenses connected with the
795	initial forensic physical examination, and payment may be made
796	to a medical provider using an examiner qualified under part I
797	of chapter 464, excluding s. 464.003(16)(5); chapter 458; or
798	chapter 459. Payment made to the medical provider by the
799	department shall be considered by the provider as payment in
800	full for the initial forensic physical examination associated
801	with the collection of evidence. The victim may not be required
802	to pay, directly or indirectly, the cost of an initial forensic
803	physical examination performed in accordance with this section.
804	Section 11.  This act shall take effect July 1, 2010.

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