This docum ent does not reflect the intent or official position of the bill sponsor or House of Representatives.
STORAGE NAME: h0517d.EEC
DATE: 3/29/2023
HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: HB 517 Nursing Education for Military Combat Medics
SPONSOR(S): Rudman and others
TIED BILLS: None. IDEN./SIM. BILLS: SB 274
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Postsecondary Education & Workforce
Subcommittee
17 Y, 0 N McDaniel Kiner
2) Higher Education Appropriations Subcommittee 13 Y, 0 N Peters Smith
3) Education & Employment Committee McDaniel Hassell
SUMMARY ANALYSIS
The bill creates the “Pathway for Military Combat Medics Act.” The bill expands existing law for awarding
postsecondary credit for military training and education courses to include the application of military combat
medic training and education toward postsecondary credit (credit) or career education clock hours (clock
hours) in accredited nursing education programs.
The bill directs the Articulation Coordinating Committee (ACC) to form a workgroup to develop a process for
prioritizing and determining postsecondary course equivalencies, as well as the minimum credit or clock hours
that must be awarded in an accredited nursing education program for military training and education required
for service in specified positions. The process must be approved by the State University System's Board of
Governors (BOG) and the State Board of Education (SBE). Furthermore, it calls for the ACC to approve a list
of postsecondary course equivalencies, as well as credit and clock hours awarded for such courses and
training, which must be approved by the BOG and SBE in the statewide articulation agreement. Finally, the
approved list must be used by state universities, Florida College System (FCS) institutions, and career centers
to award credit or clock hours, which must be transferable.
The bill revises a primary goal of the Florida Center for Nursing by requiring that partnerships with hospitals to
provide opportunities for nursing students to gain clinical experience be included in the strategic statewide plan
for nursing manpower.
The bill has an indeterminate fiscal impact. See Fiscal Comments.
This bill takes effect upon becoming law.
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DATE: 3/29/2023
FULL ANALYSIS
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Present Situation
Postsecondary Credit for Military Training and Education Courses
The Board of Governors of the State University System (BOG) and the State Board of Education (SBE),
in consultation with the Department of Veterans’ Affairs, are required to adopt regulations and rules,
respectively, to create a system for the uniform award of postsecondary credit (credit) or career
education clock hours (clock hours) based on military training and education.
1
The Articulation Coordinating Committee (ACC) must approve a prioritized list of postsecondary course
equivalencies and the minimum credit or clock hours that must be awarded for courses taken or
occupations held by individuals during their service in the military. The list must then be adopted in the
statewide articulation agreement by the BOG and SBE. The list must be updated annually.
2
The current list includes credit or clock hour equivalencies for 46 military occupations, which include
Practical Nurse, Combat Medic Specialist, and Special Operations Combat Medic.
3
The American
Council on Education (ACE) Military Guide
4
is used as a foundation to determine equivalences,
including courses for military occupations. For example, a military veteran that served as a Combat
Medic Specialist can currently receive a minimum of 29 credit hours for courses in the system such as
Medical Emergencies (3 credit hours), Advanced Pre-Hospital Trauma (4 credit hours), and
Fundamentals of Nursing (7 credit hours).
5
State universities, Florida College System (FCS) institutions, and career centers operated by school
districts must award credit or clock hours, as applicable, for approved courses and occupations
included in the list, if the credit or clock hours are applicable to the student’s degree or certificate.
Institutions may also grant additional credit or clock hours, if appropriate. Credit awarded on these
bases is guaranteed to transfer to other public postsecondary institutions as if the credit was earned at
the receiving institution.
6
Articulation Coordinating Committee
The Commissioner of Education, in consultation with the Chancellor of the State University System,
establishes the Articulation Coordinating Committee (ACC), whose primary role is to recommend
statewide articulation policies.
7
Specifically, the ACC must monitor articulation between education
systems, propose guidelines for articulation agreements, publish lists of general education and
common prerequisite courses, establish dual enrollment course equivalencies to high school credit, and
annually review the Statewide Articulation Agreement.
8
The Office of K-20 Articulation within the
Department of Education provides administrative support to the ACC.
9
1
Section 1004.096, F.S.; see also Board of Governors Regulation 6.013 and Rule 6A-10.024, F.A.C.
2
Id.
3
Articulation Coordinating Committee, Credit or Clock Hour for Military Experience Equivalency List (Sept. 2022), available at
https://www.fldoe.org/core/fileparse.php/5421/urlt/MilExpEquiv.pdf.
4
American Council on Education, The ACE Military Guide, https://www.acenet.edu/Programs-Services/Pages/Credit-
Transcripts/Military-Guide-
Online.aspx?gclid=CjwKCAiA_vKeBhAdEiwAFb_nrZ8jsFyi7IgkhcHOCpUFzOhUZb8bDy0M_FWMQDEOU_YpBGwrpEPdwhoC
5MUQAvD_BwE (last visited Mar. 16, 2023).
5
Board of Governors, 2023 Legislative Bill Analysis for SB 274, (Mar. 16, 2023).
6
Articulation Coordinating Committee, Credit or Clock Hour for Military Experience Equivalency List (Sept. 2022), available at
https://www.fldoe.org/core/fileparse.php/5421/urlt/MilExpEquiv.pdf.
7
Section 1007.01(3), F.S.
8
Section 1007.01(3)(a) and (b), F.S.
9
Section 1007.01(3), F.S. STORAGE NAME: h0517d.EEC PAGE: 3
DATE: 3/29/2023
Statewide Articulation Agreement
The SBE and the BOG are required to enter into a statewide articulation agreement, which the SBE
must adopt by rule.
10
The agreement must preserve Florida’s “2+2” system of articulation and facilitate
the seamless articulation of student credit across and among Florida’s educational entities. Specifically,
the statewide articulation agreement includes provisions that govern:
articulation between secondary and postsecondary education;
the admission of associate in arts degree graduates to the upper division of a state university;
articulation of career credit to academic credit programs;
the application of acceleration mechanisms to postsecondary credit; and
general education requirements.
Florida Postsecondary Nursing Education Programs
Florida’s postsecondary education institutions offer a variety of nursing education programs that
prepare students for varying levels of licensure. Licensed practical nurse (LPN) clock-hour programs
are offered at 28 career centers and 13 FCS institutions, while all 28 FCS institutions offer associate of
science in nursing (ASN) or bachelor of science in nursing (BSN) programs.
11
Ten state universities
offer 20 pre-licensure nursing education programs. Seventeen of the 30 Independent Colleges and
Universities of Florida (ICUF) member institutions offer nursing education programs.
12
Approved versus Accredited Nursing Education Programs
Educational institutions that wish to conduct a program in the state of Florida for the prelicensure
education of professional or practical nurses must meet specified requirements to be approved by the
Florida Board of Nursing (BON).
13
An “approved” nursing education program is a program for the prelicensure education of professional or
practical nurses that is conducted in the state of Florida at an educational institution and is approved
and regulated by the state of Florida.
14
An “accredited” nursing education program is a program for the prelicensure education of professional
or practical nurses that is conducted in the United States at an educational institution, whether in
Florida, another state, or the District of Columbia, and is accredited by a specialized nursing accrediting
agency that is nationally recognized by the United States Secretary of Education to accredit nursing
education programs.
15
Accredited programs do not have to meet requirements related to program
application, approval, or submission of annual reports to the BON.
16
All approved and accredited programs must meet accountability requirements related to graduate
passage rate on the National Council of State Boards of Nursing Licensing Examination.
10
Section 1007.23(1), F.S. See also Rule 6A-10.024, F.A.C.
11
Staff of the Florida House of Representatives, Legislative Bill Analysis for CS/HB 5201 (2022).
12
Id.
13
See s. 464.019, F.S. See also Florida Board of Nursing, Education and Training Programs, https://floridasnursing.gov/education-
and-training-programs/ (last visited Mar. 16, 2023).
14
Section 464.003(4), F.S. The program must be approved according to the requirements established in s. 464.019, F.S. Id.
15
Section 464.003(1), F.S. Eligible nursing associations are: Accreditation Commission for Education in Nursing (ACEN),
Commission on Collegiate Nursing Education (CCNE) or National League for Nursing Commission for Nursing Education
Accreditation (NLN CNEA). Florida Board of Nursing, What is the difference between an “approved” and an “accredited”
prelicensure nursing education program in Florida? https://floridasnursing.gov/help-center/what-is-the-difference-between-an-
approved-and-an-accredited-pre-licensure-nursing-education-program-in-florida/ (last visited Mar. 16, 2023).
16
Section 464.019(9), F.S. STORAGE NAME: h0517d.EEC PAGE: 4
DATE: 3/29/2023
All approved nursing programs, except those specifically excluded,
17
must seek accreditation within five
years of enrolling the program’s first students.
18
Florida Center for Nursing
The Florida Center for Nursing (center) was established by the Legislature in 2001, to address the
issues of supply and demand for nursing, including the recruitment, retention, and utilization of nurse
workforce resources.
19
The center’s primary goals are to:
20
Develop a strategic statewide plan for nursing manpower in this state by:
o Conducting a statistically valid biennial data-driven gap analysis of the supply and
demand of the healthcare workforce. Demand must align with the Labor Market
Estimating Conference.
o Developing recommendations to increase nurse faculty and clinical preceptors, support
nurse faculty development, and promote advanced nurse education.
o Developing best practices in the academic preparation and continuing education needs
of qualified nurse educators, nurse faculty, and clinical preceptors.
o Collecting data on nurse faculty, employment, distribution, and retention.
o Piloting innovative projects to support the recruitment, development, and retention of
qualified nurse faculty and clinical preceptors.
o Encouraging and coordinating the development of academic-practice partnerships to
support nurse faculty employment and advancement.
o Developing distance learning infrastructure for nursing education and advancing faculty
competencies in the pedagogy of teaching and the evidence-based use of technology,
simulation, and distance learning techniques.
Enhance and promote recognition, reward, and renewal activities for nurses in the state by:
o Promoting nursing excellence programs such as magnet recognition by the American
Nurses Credentialing Center.
o Proposing and creating additional reward, recognition, and renewal activities for nurses.
o Promoting media and positive image-building efforts for nursing.
Effect of Proposed Changes
HB 517 creates the “Pathway for Military Combat Medics Act.” The bill amends s. 1004.096, F.S.,
relating to postsecondary credit for military training and education courses, to apply military combat
medic training and education toward postsecondary credit or career education clock hours in
accrediting nursing education programs. The bill establishes a process similar to those established for
the award of credit for military training and education and law enforcement training.
The bill requires the ACC to, by July 15, 2023, convene a workgroup to establish a process for
determining postsecondary course equivalencies and the minimum credit or clock hours that must be
awarded in an accredited nursing education program for military training and education required for
service as an Army Combat Medic Specialist, a Navy or Fleet Marine Force Hospital Corpsman, an Air
Force or Space Force Aerospace Medical Service Technician, or a Coast Guard Health Services
Technician.
The workgroup must consist of the following 13 members:
The chair of the ACC, or his or her designee, serving as chair;
Four members representing academic affairs administrators and faculty from state universities,
appointed by the chair of the BOG;
Four members representing academic affairs administrators and faculty from FCS institutions,
appointed by the chair of the SBE;
17
Excluded institutions are those exempt from licensure by the Commission of Independent Education under s. 1005.06(1), F.S.
Section 464.019(11)(d), F.S.
18
Section 464.019(11)(a)-(d), F.S.
19
Chapter 2001-277, s. 97, Laws of Fla., and s. 464.0195, F.S.
20
Section 464.0195, F.S. STORAGE NAME: h0517d.EEC PAGE: 5
DATE: 3/29/2023
Two members representing faculty from career centers, appointed by the SBE; and
Two members representing veterans, appointed by the executive director of the Florida
Department of Veterans Affairs.
The Office of K-20 Articulation must provide administrative support for the workgroup.
The workgroup must ensure that the award of credit or clock hours does not impair an accredited
program’s ability to comply with requirements relating to the state approval of nursing education
programs. The workgroup must provide recommendations regarding the determination process for
awarding credit or clock hours to the BOG and the SBE by December 1, 2023, for approval at each
board’s next meeting that allows for adequate public notice.
Upon the BOG and the SBE approval of the workgroup’s process recommendations, the ACC must
facilitate a review of military training and education for the specified military occupations to determine
postsecondary course equivalencies and the minimum credit or clock hours that must be awarded.
Within one year after BOG and SBE approval of the ACC workgroup recommended process, the ACC
must approve a prioritized list of postsecondary course equivalencies and the minimum credit or clock
hours that must be awarded in an accredited program for such military training and education. The list
must then be adopted in the statewide articulation agreement by the BOG and SBE at the next meeting
of each board allowing for adequate public notice. The list must be updated annually.
The bill revises a primary goal of the Florida Center for Nursing by requiring that partnerships with
hospitals to provide opportunities for nursing students to gain clinical experience be included in the
strategic statewide plan for nursing manpower.
B. SECTION DIRECTORY:
Section 1. Provides the title, “Pathway for Military Combat Medics Act”.
Section 2. Amends s. 464.0195, F.S.; revises a primary goal of the Florida Center for Nursing to
provide that development of a statewide plan for nursing manpower must include the
encouragement and coordination of the development of partnerships with hospitals
which provide opportunities for nursing students to obtain clinical experience.
Section 3. Amends s. 1004.096, F.S.; defining the term “accredited program”; requires that the
ACC convene a workgroup to establish a process for determining postsecondary course
equivalencies and the minimum postsecondary credit or career education clock hours
that must be awarded in accredited nursing education programs for military training and
education required for service in specified positions; provides for the composition of and
the provision of administrative support to the workgroup; requires that the workgroup
ensure that the award of credit for military training and education does not impair a
nursing education program’s ability to comply with requirements relating to the approval
of nursing education program; requires the workgroup to provide, by a specified date,
recommendations regarding the determination process to the BOG and SBE for
approval; requires that, upon approval of the recommendations, the ACC facilitate the
review of military training and education received by individuals who served in specified
positions and the determination of minimum postsecondary credit or career education
clock hours awarded for specified military training and education; requires that the ACC,
within a specified timeframe and annually thereafter, approve a prioritized list of
postsecondary course equivalencies and the minimum postsecondary credit or career
education clock hours that must be awarded for such training and education; requires
the BOG and SBE to adopt the prioritized list; requiring that the minimum postsecondary
credit or career education clock hours be delineated in a required statewide articulation
agreement; requires state universities, Florida College System institutions, and career
centers to award postsecondary credit or career education clock hours in nursing STORAGE NAME: h0517d.EEC PAGE: 6
DATE: 3/29/2023
education programs based on the prioritized list; authorizes the award of additional
postsecondary credit or career education clock hours; providing that such postsecondary
credit or career education clock hours are transferable.
Section 4. Provides the act shall take effect upon becoming law.
II. FISCAL ANALYSIS & ECONOMIC IMPACT STATEMENT
A. FISCAL IMPACT ON STATE GOVERNMENT:
1. Revenues:
None.
2. Expenditures:
See Fiscal Comments.
B. FISCAL IMPACT ON LOCAL GOVERNMENTS:
1. Revenues:
None.
2. Expenditures:
None.
C. DIRECT ECONOMIC IMPACT ON PRIVATE SECTOR:
Should the workgroup process result in identifying additional course equivalencies for military training
and experience, students may be eligible to receive postsecondary credit toward an accredited pre-
licensure nursing program. Credits from this experience may save the student time and money while
pursuing a nursing degree or certification at a public postsecondary education institution.
D. FISCAL COMMENTS:
State universities, FCS institutions, and school district career centers will no longer receive tuition and
fee revenues from qualifying students for their military-related articulated postsecondary nursing
education credits. While the number of qualifying students is unknown, for Fiscal Year 2021-2022, the
average cost of tuition and fees was $201.01 per credit hour
21
for SUS institutions; $106.85 per credit
hour
22
for FCS institutions; and $2.33 per clock hour
23
for school district career centers. The fiscal
impact to public postsecondary institutions pertaining to students taking fewer credit or clock hours is
indeterminate. Any expenses incurred during the articulation or implementation process can be
absorbed within participating entities’ existing resources.
III. COMMENTS
A. CONSTITUTIONAL ISSUES:
1. Applicability of Municipality/County Mandates Provision:
None.
21
Florida Board of Governors, State University System of Florida, Tuition and Required Fees, 2021-22 (located at
https://www.flbog.edu/wp-content/uploads/2021/07/2021-2022-SUS-Tuition-and-Fees-Report.pdf).
22
Florida Department of Education, Finance Publications, Student Fees, 20212-2022 Student Fee Rates Fall (located at
https://www.fldoe.org/core/fileparse.php/19874/urlt/2021-2022-Student-Fee-Rates-Fall.pdf).
23
Florida Department of Education, State Funding for Districts, Tuition & Fees, 2021-22 District Workforce Education Tuition and
Fees (located at https://www.fldoe.org/core/fileparse.php/7529/urlt/2122WETF-Att.pdf). STORAGE NAME: h0517d.EEC PAGE: 7
DATE: 3/29/2023
2. Other:
None.
B. RULE-MAKING AUTHORITY:
None.
C. DRAFTING ISSUES OR OTHER COMMENTS:
None.
IV. AMENDMENTS/COMMITTEE SUBSTITUTE CHANGES
Not applicable.