Florida 2023 2023 Regular Session

Florida House Bill H0517 Analysis / Analysis

Filed 05/31/2023

                     
This document does not reflect the intent or official position of the bill sponsor or House of Representatives. 
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HOUSE OF REPRESENTATIVES STAFF FINAL BILL ANALYSIS  
 
BILL #: HB 517    Nursing Education for Military Combat Medics 
SPONSOR(S): Rudman and others 
TIED BILLS:  None. IDEN./SIM. BILLS: SB 274 
 
 
 
 
FINAL HOUSE FLOOR ACTION: 117 Y’s 
 
0 N’s GOVERNOR’S ACTION: Approved 
 
 
SUMMARY ANALYSIS 
HB 517 passed the House on May 2, 2023, as SB 274. 
 
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 to include encouraging and coordinating the 
development of partnerships, including partnerships with hospitals to provide opportunities for nursing students 
to gain clinical experience, and requiring such partnerships be addressed and included in the strategic 
statewide plan for nursing manpower. 
 
The bill has an indeterminate fiscal impact. See Fiscal Comments. 
 
The bill was approved by the Governor on May 26, 2023, ch. 2023-158, L.O.F., and became effective on that 
date. 
    
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I. SUBSTANTIVE INFORMATION 
 
A. EFFECT OF CHANGES:  
 
Present Situation 
 
Postsecondary Credit for Military Training and Education Courses 
 
The Board of Governors (BOG) of the State University System 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 
                                                
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 May 1, 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 (Sep. 2022), available at 
https://www.fldoe.org/core/fileparse.php/5421/urlt/MilExpEquiv.pdf. 
7
 Section 1007.01(3), F.S.   
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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
 
 
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
 
 
                                                
8
 Section 1007.01(3)(a) and (b), F.S. 
9
 Section 1007.01(3), F.S. 
10
 Section 1007.23(1), F.S. See also r. 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 May 1, 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 May 1, 2023).  
16
 Section 464.019(9), F.S.   
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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. 
 
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 the Bill 
 
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: 
                                                
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.   
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 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; 
 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 to include encouraging and 
coordinating the development of partnerships, including partnerships with hospitals to provide 
opportunities for nursing students to gain clinical experience, and requiring such partnerships be 
addressed and included in the strategic statewide plan for nursing manpower. 
 
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:   
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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. 
 
 
 
 
                                                
21
 Florida Board of Governors, State University System of Florida, Tuition and Required Fees (2021-2022) https://www.flbog.edu/wp-
content/uploads/2021/07/2021-2022-SUS-Tuition-and-Fees-Report.pdf.  
22
 Florida Department of Education, Fall 2021-22 Student Fee Rates, available at 
https://www.fldoe.org/core/fileparse.php/19874/urlt/2021-2022-Student-Fee-Rates-Fall.pdf  
23
 Florida Department of Education, District Workforce Education Tuition and Fees (2021-2022), available at 
https://www.fldoe.org/core/fileparse.php/7529/urlt/2122W ETF-Att.pdf.