Bill Text: FL S1118 | 2024 | Regular Session | Introduced
Bill Title: Nursing Education Programs
Spectrum: Partisan Bill (Republican 1-0)
Status: (Failed) 2024-03-08 - Died in Rules [S1118 Detail]
Download: Florida-2024-S1118-Introduced.html
Florida Senate - 2024 SB 1118 By Senator Harrell 31-00960A-24 20241118__ 1 A bill to be entitled 2 An act relating to nursing education programs; 3 amending s. 464.019, F.S.; revising application 4 requirements for nursing education program approval; 5 requiring the Board of Nursing to deny an application 6 under certain circumstances; authorizing the board to 7 revoke a program’s approval under certain 8 circumstances; revising requirements for annual 9 reports approved programs are required to submit to 10 the board; providing for the revocation of a program’s 11 approval, and discipline of its program director, 12 under certain circumstances; revising remediation 13 procedures for approved programs with graduate passage 14 rates that do not meet specified requirements; 15 subjecting program directors of approved programs to 16 specified disciplinary action under certain 17 circumstances; deleting a provision authorizing the 18 board to extend a program’s probationary status; 19 authorizing agents of the Department of Health to 20 conduct onsite evaluations and inspections of approved 21 and accredited nursing education programs; authorizing 22 the department to collect evidence as part of such 23 evaluations and inspections; deeming failure or 24 refusal of a program to allow such evaluation or 25 inspection as a violation of a legal obligation; 26 revising rulemaking authority of the board; deleting a 27 provision authorizing approved nursing education 28 programs to request an extension to meet the board’s 29 accreditation requirements; providing an effective 30 date. 31 32 Be It Enacted by the Legislature of the State of Florida: 33 34 Section 1. Subsections (1), (2), (3), (5), and (8) and 35 paragraph (f) of subsection (11) of section 464.019, Florida 36 Statutes, are amended to read: 37 464.019 Approval of nursing education programs.— 38 (1) PROGRAM APPLICATION.—An educational institution that 39 wishes to conduct a program in this state for the prelicensure 40 education of professional or practical nurses must submit to the 41 department a program application and review fee of $1,000 for 42 each prelicensure nursing education program to be offered at the 43 institution’s main campus, branch campus, or other instructional 44 site. The program application must include the legal name of the 45 educational institution, the legal name of the nursing education 46 program, the legal name of the nursing education program 47 director, and, if such institution is accredited, the name of 48 the accrediting agency. The application must also document that: 49 (a)1. For a professional nursing education program, the 50 program director and at least 50 percent of the program’s 51 faculty members are registered nurses who have a master’s or 52 higher degree in nursing or a bachelor’s degree in nursing and a 53 master’s or higher degree in a field related to nursing. 54 2. For a practical nursing education program, the program 55 director and at least 50 percent of the program’s faculty 56 members are registered nurses who have a bachelor’s or higher 57 degree in nursing. 58 59 The educational degree requirements of this paragraph mustmay60 be documented by an official transcript or by a written 61 statement from the program director of the educational 62 institution verifying that the institution conferred the degree. 63 The program director shall certify the official transcript or 64 written statement as true and accurate. 65 (b) The program’s nursing major curriculum consists of at 66 least: 67 1. Fifty percent clinical training in the United States, 68 the District of Columbia, or a possession or territory of the 69 United States for a practical nursing education program, an 70 associate degree professional nursing education program, or a 71 professional diploma nursing education program. 72 2. Forty percent clinical training in the United States, 73 the District of Columbia, or a possession or territory of the 74 United States for a bachelor’s degree professional nursing 75 education program. 76 (c) No more than 50 percent of the program’s clinical 77 training consists of clinical simulation. 78 (d) The program has signed agreements with each agency, 79 facility, and organization included in the curriculum plan as 80 clinical training sites and community-based clinical experience 81 sites. 82 (e) The program has written policies for faculty which 83 include provisions for direct or indirect supervision by program 84 faculty or clinical preceptors for students in clinical training 85 consistent with the following standards: 86 1. The number of program faculty members equals at least 87 one faculty member directly supervising every 12 students unless 88 the written agreement between the program and the agency, 89 facility, or organization providing clinical training sites 90 allows more students, not to exceed 18 students, to be directly 91 supervised by one program faculty member. 92 2. For a hospital setting, indirect supervision may occur 93 only if there is direct supervision by an assigned clinical 94 preceptor, a supervising program faculty member is available by 95 telephone, and such arrangement is approved by the clinical 96 facility. 97 3. For community-based clinical experiences that involve 98 student participation in invasive or complex nursing activities, 99 students must be directly supervised by a program faculty member 100 or clinical preceptor and such arrangement must be approved by 101 the community-based clinical facility. 102 4. For community-based clinical experiences not subject to 103 subparagraph 3., indirect supervision may occur only when a 104 supervising program faculty member is available to the student 105 by telephone. 106 107 A program’s policies established under this paragraph must 108 require that a clinical preceptor who is supervising students in 109 a professional nursing education program be a registered nurse 110 or, if supervising students in a practical nursing education 111 program, be a registered nurse or licensed practical nurse. 112 (f) The professional or practical nursing curriculum plan 113 documents clinical experience and theoretical instruction in 114 medical, surgical, obstetric, pediatric, and geriatric nursing. 115 A professional nursing curriculum plan shall also document 116 clinical experience and theoretical instruction in psychiatric 117 nursing. Each curriculum plan must document clinical training 118 experience in appropriate settings that include, but are not 119 limited to, acute care, long-term care, and community settings. 120 (g) The professional or practical nursing education program 121 provides theoretical instruction and clinical application in 122 personal, family, and community health concepts; nutrition; 123 human growth and development throughout the life span; body 124 structure and function; interpersonal relationship skills; 125 mental health concepts; pharmacology and administration of 126 medications; and legal aspects of practice. A professional 127 nursing education program must also provide theoretical 128 instruction and clinical application in interpersonal 129 relationships and leadership skills; professional role and 130 function; and health teaching and counseling skills. 131 (h) The professional or practical nursing education program 132 has established evaluation and standardized admission criteria. 133 The admission criteria must, at a minimum, identify those 134 students who are likely to need additional educational support 135 to be successful program graduates. The program shall maintain 136 documentation of the individualized student academic support 137 plan for those students identified as in need of additional 138 preparation and educational support. 139 (i) The professional or practical nursing education program 140 has an established comprehensive examination to prepare students 141 for the National Council of State Boards of Nursing Licensing 142 Examination (NCLEX). This type of comprehensive examination must 143 be termed an exit examination that all programs will administer 144 and may not be the sole exclusion to graduation if the student 145 has otherwise successfully completed all coursework required by 146 the program. The program director is responsible for ensuring 147 that the average exit exam results of the program are placed on 148 the program’s website and reported to the board along with the 149 annual report required in subsection (3). 150 (j) The program shall submit to the board established 151 criteria for remediation that will be offered to students who do 152 not successfully pass the exit examination. A program with NCLEX 153 passage rates at least 10 percentage points below the average 154 passage rate for the most recent calendar year must offer 155 remediation at no additional cost or refer the student to an 156 approved remedial program and pay for that program for the 157 student. 158 (2) PROGRAM APPROVAL.— 159 (a) Upon receipt of a program application and review fee, 160 the department shall examine the application to determine if it 161 is complete. If the application is not complete, the department 162 shall notify the educational institution in writing of any 163 errors or omissions within 30 days after the department’s 164 receipt of the application. A program application is deemed 165 complete upon the department’s receipt of: 166 1. The initial application, if the department does not 167 notify the educational institution of any errors or omissions 168 within the 30-day period; or 169 2. A revised application that corrects each error and 170 omission of which the department notifies the educational 171 institution within the 30-day period. 172 (b) Following the department’s receipt of a complete 173 program application, the board may conduct an onsite evaluation 174 if necessary to document the applicant’s compliance with 175 subsection (1). Within 90 days after the department’s receipt of 176 a complete program application, the board shall: 177 1. Approve the application if it documents compliance with 178 subsection (1); or 179 2. Provide the educational institution with a notice of 180 intent to deny the application if it does not document 181 compliance with subsection (1). The notice must specify written 182 reasons for the board’s denial of the application. The board may 183 not deny a program application because of an educational 184 institution’s failure to correct an error or omission that the 185 department failed to provide notice of to the institution within 186 the 30-day notice period under paragraph (a). The educational 187 institution may request a hearing on the notice of intent to 188 deny the program application pursuant to chapter 120. 189 (c) A program application is deemed approved if the board 190 does not act within the 90-day review period provided under 191 paragraph (b). 192 (d) Upon the board’s approval of a program application, the 193 program becomes an approved program. 194 (e) The board shall deny an application from a program that 195 has had adverse action taken against it by another regulatory 196 jurisdiction in the United States. The board may also revoke the 197 approval of an existing approved program that has had adverse 198 action taken against it by another regulatory jurisdiction in 199 the United States. 200 (3) ANNUAL REPORT.—By November 1 of each year, each 201 approved program’s directorprogramshall submit to the board an 202 annual report comprised of an affidavit certifying continued 203 compliance with subsection (1), a summary description of the 204 program’s compliance with subsection (1), and documentation for 205 the previous academic year that, to the extent applicable, 206 describes: 207 (a) The number of student applications received, qualified 208 applicants, applicants accepted, accepted applicants who enroll 209 in the program, students enrolled in the program, and program 210 graduates. 211 (b) The program’s retention rates for students tracked from 212 program entry to graduation. 213 (c) The program’s accreditation status, including 214 identification of the accrediting agency. 215 216 The board shall terminate the program pursuant to chapter 120 if 217 the requirements of this subsection are not met. The program 218 director is also subject to discipline under s. 456.072(1)(k). 219 (5) ACCOUNTABILITY.— 220 (a)1. An approved program must achieve a graduate passage 221 rate for first-time test takers which is not more than 10 222 percentage points lower than the average passage rate during the 223 same calendar year for graduates of comparable degree programs 224 who are United States educated, first-time test takers on the 225 National Council of State Boards of Nursing Licensing 226 Examination, as calculated by the contract testing service of 227 the National Council of State Boards of Nursing. For purposes of 228 this subparagraph, an approved program is comparable to all 229 degree programs of the same program type from among the 230 following program types: 231 a. Professional nursing education programs that terminate 232 in a bachelor’s degree. 233 b. Professional nursing education programs that terminate 234 in an associate degree. 235 c. Professional nursing education programs that terminate 236 in a diploma. 237 d. Practical nursing education programs. 238 2. If an approved program’s graduate passage rates do not 239 equal or exceed the required passage rates for 1 calendar year2240consecutive calendar years, the board shall place the program on 241 probationary status pursuant to chapter 120 and the program 242 director shall submit a written remediation plan to the board. 243 The program director shall appear before the board to present 244 theaplan for remediation, which shall include specific 245 nationally recognized benchmarks to identify progress toward a 246 graduate passage rate goal. The board shall terminate a program 247 pursuant to chapter 120 if the program director fails to submit 248 a written remediation plan or fails to appear before the board 249 and present the remediation plan no later than 6 months after 250 the date of the program being placed on probation. The program’s 251 director is also subject to discipline under s. 456.072(1)(k) 252 for such failure. The program must remain on probationary status 253 until it achieves a graduate passage rate that equals or exceeds 254 the required passage rate forany1 calendar year. The board 255 shall deny a program application for a new prelicensure nursing 256 education program submitted by an educational institution if the 257 institution has an existing program that is already on 258 probationary status. 259 3. Upon the program’s achievement of a graduate passage 260 rate that equals or exceeds the required passage rate, the 261 board, at its next regularly scheduled meeting following release 262 of the program’s graduate passage rate by the National Council 263 of State Boards of Nursing, shall remove the program’s 264 probationary status. If the program, during the2calendar year 265yearsfollowing its placement on probationary status, does not 266 achieve the required passage ratefor any 1 calendar year, the 267 board mustmay extend the program’s probationary status for 1268additional year, provided the program has demonstrated adequate269progress toward the graduate passage rate goal by meeting a270majority of the benchmarks established in the remediation plan.271If the program is not granted the 1-year extension or fails to272achieve the required passage rate by the end of such extension,273the board shallterminate the program pursuant to chapter 120. 274 (b) If an approved program fails to submit the annual 275 report required in subsection (3), the board mustshallnotify 276 the program director and president or chief executive officer of 277 the educational institution in writing within 15 days after the 278 due date of the annual report. The program director shall appear 279 before the board at the board’s next regularly scheduled meeting 280 to explain the reason for the delay. The board shall terminate 281 the program pursuant to chapter 120 if the program director 282 fails to appear before the board, as required under this 283 paragraph, or if the program does not submit the annual report 284 within 6 months after the due date. 285 (c) A nursing education program, whether accredited or 286 nonaccredited, which has been placed on probationary status 287 shall disclose its probationary status in writing to the 288 program’s students and applicants. The notification must include 289 an explanation of the implications of the program’s probationary 290 status on the students or applicants. 291 (d) If students from a program that is terminated pursuant 292 to this subsection transfer to an approved or an accredited 293 program under the direction of the Commission for Independent 294 Education, the board mustshallrecalculate the passage rates of 295 the programs receiving the transferring students, excluding the 296 test scores of those students transferring more than 12 credits. 297 (e) Duly authorized agents or employees of the department 298 may conduct onsite evaluations or inspections at all reasonable 299 hours to ensure that approved programs or accredited programs 300 are in full compliance with this chapter, or to determine 301 whether this chapter or s. 456.072 is being violated. The 302 department may collect any necessary evidence needed to ensure 303 compliance with this chapter or for prosecution as deemed 304 necessary. A failure of a program to refuse or allow an onsite 305 evaluation or inspection is deemed as violating a legal 306 obligation imposed by the board or the department. 307 (8) RULEMAKING.—The board does not have rulemaking 308 authority to administer this section, except that the board 309 shall adopt rules that prescribe the format for submitting 310 program applications under subsection (1) and annual reports 311 under subsection (3), to enforce and administer subsection (5), 312 and to administer the documentation of the accreditation of 313 nursing education programs under subsection (11). The board may 314 adopt rules relating to the nursing curriculum, including rules 315 relating to the uses and limitations of simulation technology,316and rules relating to the criteria to qualify for an extension317of time to meet the accreditation requirements under paragraph318(11)(f). The board may not impose any condition or requirement 319 on an educational institution submitting a program application, 320 an approved program, or an accredited program, except as 321 expressly provided in this section. 322 (11) ACCREDITATION REQUIRED.— 323(f) An approved nursing education program may, no sooner324than 90 days before the deadline for meeting the accreditation325requirements of this subsection, apply to the board for an326extension of the accreditation deadline for a period which does327not exceed 2 years. An additional extension may not be granted.328In order to be eligible for the extension, the approved program329must establish that it has a graduate passage rate of 60 percent330or higher on the National Council of State Boards of Nursing331Licensing Examination for the most recent calendar year and must332meet a majority of the board’s additional criteria, including,333but not limited to, all of the following:3341. A student retention rate of 60 percent or higher for the335most recent calendar year.3362. A graduate work placement rate of 70 percent or higher337for the most recent calendar year.3383. The program has applied for approval or been approved by339an institutional or programmatic accreditor recognized by the340United States Department of Education.3414. The program is in full compliance with subsections (1)342and (3) and paragraph (5)(b).3435. The program is not currently in its second year of344probationary status under subsection (5).345 346The applicable deadline under this paragraph is tolled from the347date on which an approved program applies for an extension until348the date on which the board issues a decision on the requested349extension.350 Section 2. This act shall take effect July 1, 2024.