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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
A bill to be entitled 1
An act relating to nursing education programs; 2
amending s. 464.019, F.S.; revising application 3
requirements for nursing education programs; 4
requiring, rather than authorizing, certain degree 5
requirements to be documented in a specified manner; 6
requiring the program director to certify certain 7
documentation as true and accurate; providing 8
additional requirements for program applications; 9
requiring the Board of Nursing to deny an application 10
under certain circumstances; authorizing the board to 11
revoke the approval of specified existing programs; 12
requiring each program director to submit an annual 13
report and written remediation plan to the board; 14
requiring the board to terminate a program under 15
certain circumstances; providing a penalty; removing 16
provisions authorizing an extension of a program's 17
probationary status; authorizing certain agents and 18
employees of the Department of Health to conduct 19
onsite evaluations and inspections under certain 20
circumstances; authorizing the department to collect 21
evidence for certain purposes; providing that a 22
failure of a program to refuse to allow such 23
evaluation or inspection is deemed a certain 24
violation; revising rulemaking authority; conforming a 25
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provision to changes made by the act; providing an 26
effective date. 27
28
Be It Enacted by the Legislature of the State of Florida: 29
30
Section 1. Subsections (1) and (3), paragraphs (a) and (b) 31
of subsection (5), subsection (8), and paragraph (f) of 32
subsection (11) of section 464.019, Florida Statutes, are 33
amended, paragraph (e) is a dded to subsection (2), and paragraph 34
(e) is added to subsection (5) of that section, to read: 35
464.019 Approval of nursing education programs. — 36
(1) PROGRAM APPLICATION. —An educational institution that 37
wishes to conduct a program in this state for the p relicensure 38
education of professional or practical nurses must submit to the 39
department a program application and review fee of $1,000 for 40
each prelicensure nursing education program to be offered at the 41
institution's main campus, branch campus, or other i nstructional 42
site. The program application must include the legal name of the 43
educational institution, the legal name of the nursing education 44
program, the legal name of the nursing education program 45
director, and, if such institution is accredited, the na me of 46
the accrediting agency. The application must also document that: 47
(a)1. For a professional nursing education program, the 48
program director and at least 50 percent of the program's 49
faculty members are registered nurses who have a master's or 50
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higher degree in nursing or a bachelor's degree in nursing and a 51
master's or higher degree in a field related to nursing. 52
2. For a practical nursing education program, the program 53
director and at least 50 percent of the program's faculty 54
members are registered n urses who have a bachelor's or higher 55
degree in nursing. 56
57
The educational degree requirements of this paragraph must may 58
be documented by an official transcript or by a written 59
statement from the program director of the educational 60
institution verifying th at the institution conferred the degree. 61
The program director shall certify the official transcript or 62
written statement as true and accurate. 63
(b) The program's nursing major curriculum consists of at 64
least: 65
1. Fifty percent clinical training in the Un ited States, 66
the District of Columbia, or a possession or territory of the 67
United States for a practical nursing education program, an 68
associate degree professional nursing education program, or a 69
professional diploma nursing education program. 70
2. Forty percent clinical training in the United States, 71
the District of Columbia, or a possession or territory of the 72
United States for a bachelor's degree professional nursing 73
education program. 74
(c) No more than 50 percent of the program's clinical 75
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training consists of clinical simulation. 76
(d) The program has signed agreements with each agency, 77
facility, and organization included in the curriculum plan as 78
clinical training sites and community -based clinical experience 79
sites. 80
(e) The program has written policies for faculty which 81
include provisions for direct or indirect supervision by program 82
faculty or clinical preceptors for students in clinical training 83
consistent with the following standards: 84
1. The number of program faculty members equals at least 85
one faculty member directly supervising every 12 students unless 86
the written agreement between the program and the agency, 87
facility, or organization providing clinical training sites 88
allows more students, not to exceed 18 students, to be directly 89
supervised by one program faculty member. 90
2. For a hospital setting, indirect supervision may occur 91
only if there is direct supervision by an assigned clinical 92
preceptor, a supervising program faculty member is available by 93
telephone, and such arrangement is app roved by the clinical 94
facility. 95
3. For community-based clinical experiences that involve 96
student participation in invasive or complex nursing activities, 97
students must be directly supervised by a program faculty member 98
or clinical preceptor and such arra ngement must be approved by 99
the community-based clinical facility. 100
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4. For community-based clinical experiences not subject to 101
subparagraph 3., indirect supervision may occur only when a 102
supervising program faculty member is available to the student 103
by telephone. 104
105
A program's policies established under this paragraph must 106
require that a clinical preceptor who is supervising students in 107
a professional nursing education program be a registered nurse 108
or, if supervising students in a practical nursing educatio n 109
program, be a registered nurse or licensed practical nurse. 110
(f) The professional or practical nursing curriculum plan 111
documents clinical experience and theoretical instruction in 112
medical, surgical, obstetric, pediatric, and geriatric nursing. 113
A professional nursing curriculum plan shall also document 114
clinical experience and theoretical instruction in psychiatric 115
nursing. Each curriculum plan must document clinical training 116
experience in appropriate settings that include, but are not 117
limited to, acute ca re, long-term care, and community settings. 118
(g) The professional or practical nursing education 119
program provides theoretical instruction and clinical 120
application in personal, family, and community health concepts; 121
nutrition; human growth and development throughout the life 122
span; body structure and function; interpersonal relationship 123
skills; mental health concepts; pharmacology and administration 124
of medications; and legal aspects of practice. A professional 125
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nursing education program must also provide theo retical 126
instruction and clinical application in interpersonal 127
relationships and leadership skills; professional role and 128
function; and health teaching and counseling skills. 129
(h) The professional or practical nursing education 130
program has established eval uation and standardized admission 131
criteria. The admission criteria must, at a minimum, identify 132
those students who are likely to need additional preparation and 133
educational support to be successful program graduates. The 134
program shall maintain documentatio n of the individualized 135
student academic support plan for those students identified as 136
in need of additional preparation and educational support. 137
(i) The professional or practical nursing education 138
program has an established comprehensive examination to prepare 139
students for the National Council of State Boards of Nursing 140
Licensing Examination (NCLEX). This type of comprehensive 141
examination must be termed an exit examination that all programs 142
will administer and may not be the sole exclusion to graduation 143
if the student has otherwise successfully completed all 144
coursework required by the program. The program director is 145
responsible for ensuring that the average exit examination 146
results of the program are posted on the program's website and 147
reported in the program's annual report to the board as 148
required under subsection (3). 149
(j) The program shall submit to the board established 150
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criteria for remediation that will be offered to students who do 151
not successfully pass the exit examination. A program with NCLEX 152
passage rates at least 10 percentage points below the average 153
passage rate for the most recent calendar year must offer 154
remediation at no additional cost or refer the student to an 155
approved remedial program and pay for that program for the 156
student. 157
(2) PROGRAM APPROVAL.— 158
(e) The board shall deny an application from a program 159
which has had adverse action taken against it by another 160
regulatory jurisdiction in the United States. The board may also 161
revoke the approval of an existing approved program that ha s had 162
adverse action taken against it by another regulatory 163
jurisdiction in the United States. 164
(3) ANNUAL REPORT.—By November 1 of each year, each 165
approved program's director program shall submit to the board an 166
annual report comprised of an affidavit ce rtifying continued 167
compliance with subsection (1), a summary description of the 168
program's compliance with subsection (1), and documentation for 169
the previous academic year that, to the extent applicable, 170
describes: 171
(a) The number of student applications r eceived, qualified 172
applicants, applicants accepted, accepted applicants who enroll 173
in the program, students enrolled in the program, and program 174
graduates. 175
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(b) The program's retention rates for students tracked 176
from program entry to graduation. 177
(c) The program's accreditation status, including 178
identification of the accrediting agency. 179
180
The board shall terminate the program pursuant to chapter 120 if 181
the requirements of this subsection are not met. The program 182
director is also subject to discipline under s. 456.072(1)(k). 183
(5) ACCOUNTABILITY. — 184
(a)1. An approved program must achieve a graduate passage 185
rate for first-time test takers which is not more than 10 186
percentage points lower than the average passage rate during the 187
same calendar year for graduate s of comparable degree programs 188
who are United States educated, first -time test takers on the 189
National Council of State Boards of Nursing Licensing 190
Examination, as calculated by the contract testing service of 191
the National Council of State Boards of Nursin g. For purposes of 192
this subparagraph, an approved program is comparable to all 193
degree programs of the same program type from among the 194
following program types: 195
a. Professional nursing education programs that terminate 196
in a bachelor's degree. 197
b. Professional nursing education programs that terminate 198
in an associate degree. 199
c. Professional nursing education programs that terminate 200
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in a diploma. 201
d. Practical nursing education programs. 202
2. If an approved program's graduate passage rates do not 203
equal or exceed the required passage rates for 1 2 consecutive 204
calendar year years, the board shall place the program on 205
probationary status pursuant to chapter 120 and the program 206
director shall submit a written remediation plan to the board. 207
The program director shall appear before the board to present 208
then a plan for remediation, which shall include specific 209
nationally recognized benchmarks to identify progress toward a 210
graduate passage rate goal. The board shall terminate a program 211
pursuant to chapter 120 if t he program director fails to submit 212
a written remediation plan or fails to appear before the board 213
and present the remediation plan no later than 6 months after 214
the date of the program being placed on probation. The program's 215
director is also subject to di sciplinary action under s. 216
456.072(1)(k) for such failure. The program must remain on 217
probationary status until it achieves a graduate passage rate 218
that equals or exceeds the required passage rate for any 1 219
calendar year. The board shall deny a program app lication for a 220
new prelicensure nursing education program submitted by an 221
educational institution if the institution has an existing 222
program that is already on probationary status. 223
3. Upon the program's achievement of a graduate passage 224
rate that equals or exceeds the required passage rate, the 225
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board, at its next regularly scheduled meeting following release 226
of the program's graduate passage rate by the National Council 227
of State Boards of Nursing, shall remove the program's 228
probationary status. If the pro gram, during the 2 calendar year 229
years following its placement on probationary status, does not 230
achieve the required passage rate for any 1 calendar year , the 231
board must may extend the program's probationary status for 1 232
additional year, provided the progr am has demonstrated adequate 233
progress toward the graduate passage rate goal by meeting a 234
majority of the benchmarks established in the remediation plan. 235
If the program is not granted the 1 -year extension or fails to 236
achieve the required passage rate by the end of such extension, 237
the board shall terminate the program pursuant to chapter 120. 238
(b) If an approved program fails to submit the annual 239
report required in subsection (3), the board must shall notify 240
the program director and president or chief execut ive officer of 241
the educational institution in writing within 15 days after the 242
due date of the annual report. The program director shall appear 243
before the board at the board's next regularly scheduled meeting 244
to explain the reason for the delay. The board shall terminate 245
the program pursuant to chapter 120 if the program director 246
fails to appear before the board, as required under this 247
paragraph, or if the program does not submit the annual report 248
within 6 months after the due date. 249
(e) Duly authorized agents or employees of the department 250
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may conduct onsite evaluations or inspections at all reasonable 251
hours to ensure that approved programs or accredited programs 252
are in full compliance with this chapter, or to determine 253
whether this chapter or s. 456.072 is being violated. The 254
department may collect any necessary evidence needed to ensure 255
compliance with this chapter or for prosecution as deemed 256
necessary. A failure of a program to refuse to allow an onsite 257
evaluation or inspection is deemed a violation of a legal 258
obligation imposed by the board or the department. 259
(8) RULEMAKING.—The board does not have rulemaking 260
authority to administer this section, except that the board 261
shall adopt rules that prescribe the format for submitting 262
program applications under subsection (1) and annual reports 263
under subsection (3), to enforce and administer subsection (5), 264
and to administer the documentation of the accreditation of 265
nursing education programs under subsection (11). The board may 266
adopt rules relating to the nursing curriculum, including rules 267
relating to the uses and limitations of simulation technology, 268
and rules relating to the criteria to qualify for an extension 269
of time to meet the accreditation requirements under paragraph 270
(11)(f). The board may not impose any condition or requirement 271
on an educational institution submitting a program application, 272
an approved program, or an accredited program, except as 273
expressly provided in this section. 274
(11) ACCREDITATION REQUIRED. — 275
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(f) An approved nursing education program may, no sooner 276
than 90 days before the deadline for meeting the accreditation 277
requirements of this subsection, apply to the board for an 278
extension of the accreditation deadline for a period which does 279
not exceed 2 years. An addi tional extension may not be granted. 280
In order to be eligible for the extension, the approved program 281
must establish that it has a graduate passage rate of 60 percent 282
or higher on the National Council of State Boards of Nursing 283
Licensing Examination for the most recent calendar year and must 284
meet a majority of the board's additional criteria, including, 285
but not limited to, all of the following: 286
1. A student retention rate of 60 percent or higher for 287
the most recent calendar year. 288
2. A graduate work placement rate of 70 percent or higher 289
for the most recent calendar year. 290
3. The program has applied for approval or been approved 291
by an institutional or programmatic accreditor recognized by the 292
United States Department of Education. 293
4. The program is in full compliance with subsections (1) 294
and (3) and paragraph (5)(b). 295
5. The program is not currently in its second year of 296
probationary status under subsection (5). 297
298
The applicable deadline under this paragraph is tolled from the 299
date on which an appro ved program applies for an extension until 300
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the date on which the board issues a decision on the requested 301
extension. 302
Section 2. This act shall take effect July 1, 2024. 303