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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 program approval; 4
requiring the Board of Nursing to deny an application 5
under certain circumstances; authorizing the board to 6
revoke a program's approval under certain 7
circumstances; revising requirements for annual 8
reports approved programs are required to submit to 9
the board; providing for the revocation of a program's 10
approval, and discipline of its program director, 11
under certain circumstances; revising remediation 12
procedures for approved programs with graduate passage 13
rates that do not meet specified requirements; 14
subjecting program directors of approved programs to 15
specified disciplinary action under certain 16
circumstances; revising program-specific data the 17
Florida Center for Nursing evaluates for certain 18
programs; deleting a provision authorizing the board 19
to extend a program's probationary status; authorizing 20
agents of the Department of Health to conduct onsite 21
evaluations and inspections of approved and accredited 22
nursing education programs; authorizing the department 23
to collect evidence as part of such evaluations and 24
inspections; deeming failure or refusal of a program 25
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to allow such evaluation or inspection as a violation 26
of a legal obligation; revising rulemaking authority 27
of the board; deleting a provision authorizing 28
approved nursing education programs to request an 29
extension to meet the board's accreditation 30
requirements; providing an effective date. 31
32
Be It Enacted by the Legislature of the State of Florida: 33
34
Section 1. Subsections (1), (2), (3), (5), (8), and (10) 35
and 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
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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 educa tion 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 must may 60
be documented by an officia l 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
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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 a s 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 train ing 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 clini cal 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 activi ties, 99
students must be directly supervised by a program faculty member 100
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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., indir ect 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 experienc e and theoretical instruction in 114
medical, surgical, obstetric, pediatric, and geriatric nursing. 115
A professional nursing curriculum plan must shall also document 116
clinical experience and theoretical instruction in psychiatric 117
nursing. Each curriculum plan mu st 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 121
program provides theoretical instruction and cl inical 122
application in personal, family, and community health concepts; 123
nutrition; human growth and development throughout the life 124
span; body structure and function; interpersonal relationship 125
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skills; mental health concepts; pharmacology and administration 126
of 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 tea ching and counseling skills. 131
(h) The professional or practical nursing education 132
program has established evaluation and standardized admission 133
criteria. The admission criteria must, at a minimum, identify 134
those students who are likely to need additional educational 135
support to be successful program graduates. The program must 136
maintain documentation of the individualized student academic 137
support plan for those students identified as in need of 138
additional preparation and educational support. 139
(i) The professional or practical nursing education 140
program has an established comprehensive examination, known as 141
an exit examination, to prepare students for the National 142
Council of State Boards of Nursing Licensing Examination. The 143
exit examination must be administer ed before program completion. 144
However, successful passage may not be required for graduation. 145
The program director is responsible for posting the average exit 146
examination results of the program on the program's website. 147
(j) The professional or practical nursing education 148
program has submitted to the board the established criteria for 149
remediation that will be offered to students who do not 150
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successfully pass the exit examination. 151
(2) PROGRAM APPROVAL. — 152
(a) Upon receipt of a program application and revie w fee, 153
the department shall examine the application to determine if it 154
is complete. If the application is not complete, the department 155
must shall notify the educational institution in writing of any 156
errors or omissions within 30 days after the department's 157
receipt of the application. A program application is deemed 158
complete upon the department's receipt of: 159
1. The initial application, if the department does not 160
notify the educational institution of any errors or omissions 161
within the 30-day period; or 162
2. A revised application that corrects each error and 163
omission of which the department notifies the educational 164
institution within the 30 -day period. 165
(b) Following the department's receipt of a complete 166
program application, the board may conduct an onsite evaluation 167
if necessary to document the applicant's compliance with 168
subsection (1). Within 90 days after the department's receipt of 169
a complete program application, the board shall: 170
1. Approve the application if it documents compliance with 171
subsection (1); or 172
2. Provide the educational institution with a notice of 173
intent to deny the application if it does not document 174
compliance with subsection (1). The notice must specify written 175
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reasons for the board's denial of the application. The board may 176
not deny a program application because of an educational 177
institution's failure to correct an error or omission that the 178
department failed to provide notice of to the institution within 179
the 30-day notice period under paragraph (a). The educational 180
institution may request a hearing on the notice of intent to 181
deny the program application pursuant to chapter 120. 182
(c) A program application is deemed approved if the board 183
does not act within the 90 -day review period provided under 184
paragraph (b). 185
(d) Upon the board's approval of a program application, 186
the program becomes an approved program. 187
(e) The board shall deny an application from a program 188
that has had adverse action taken against it by another 189
regulatory jurisdiction in the United States. The board may also 190
revoke the approval of an existing approved program that has had 191
adverse action taken against it by another regulatory 192
jurisdiction in the United States. 193
(3) ANNUAL REPORT.—By November 1 of each year, each 194
approved program's director program shall submit to the board an 195
annual report comprised of an affidavit certifying continued 196
compliance with subsection (1), a summary description of the 197
program's compliance with subsection (1), and documentation for 198
the previous academic year that, to the extent applicab le, 199
describes: 200
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(a) The number of student applications received, qualified 201
applicants, applicants accepted, accepted applicants who enroll 202
in the program, students enrolled in the program, and program 203
graduates. 204
(b) The program's retention rates for stu dents tracked 205
from program entry to graduation. 206
(c) The program's accreditation status, including 207
identification of the accrediting agency. 208
(d) The program's average exit examination results. 209
210
The board must terminate the program pursuant to chapter 12 0 if 211
the requirements of this subsection are not met. The program 212
director is also subject to discipline under s. 456.072(1)(k) 213
for such failure. 214
(5) ACCOUNTABILITY. — 215
(a)1. An approved program must achieve a graduate passage 216
rate for first-time test takers which is not more than 10 217
percentage points lower than the average passage rate during the 218
same calendar year for graduates of comparable degree programs 219
who are United States educated, first -time test takers on the 220
National Council of State Boards of Nursing Licensing 221
Examination, as calculated by the contract testing service of 222
the National Council of State Boards of Nursing. For purposes of 223
this subparagraph, an ap proved program is comparable to all 224
degree programs of the same program type from among the 225
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following program types: 226
a. Professional nursing education programs that terminate 227
in a bachelor's degree. 228
b. Professional nursing education programs that termi nate 229
in an associate degree. 230
c. Professional nursing education programs that terminate 231
in a diploma. 232
d. Practical nursing education programs. 233
2. An approved program with graduate passage rates which 234
do not equal or exceed the required passage rate fo r the most 235
recent calendar year must offer remediation to students who do 236
not successfully pass the program's exit examination at no 237
additional cost or pay for remediation from a board -approved 238
remedial program. 239
3.2. If an approved program's graduate pas sage rates do 240
not equal or exceed the required passage rates for 1 calendar 241
year 2 consecutive calendar years , the board must shall place 242
the program on probationary status pursuant to chapter 120 and 243
the program director must submit a written remediation plan to 244
the board. The program director must shall appear before the 245
board to present the a plan for remediation, which must shall 246
include specific nationally recognized benchmarks to identify 247
progress toward a graduate passage rate goal. The board must 248
terminate a program pursuant to chapter 120 if the program 249
director fails to submit a written remediation plan or fails to 250
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appear before the board and present the remediation within 6 251
months after the program is placed on probation. The program's 252
director is also subject to discipline under s. 456.072(1)(k) 253
for such failure. The program must remain on probationary status 254
until it achieves a graduate passage rate that equals or exceeds 255
the required passage rate for any 1 calendar year. The board 256
must shall deny a program application for a new prelicensure 257
nursing education program submitted by an educational 258
institution if the institution has an existing program that is 259
already on probationary status. 260
4.3. Upon the program's achievement of a graduate passage 261
rate that equals or exceeds the required passage rate, the 262
board, at its next regularly scheduled meeting following release 263
of the program's graduate passage rate by the National Council 264
of State Boards of Nursing, shall remove the program's 265
probationary status. If the program, during the 2 calendar year 266
years following its placement on probationary status, does not 267
achieve the required passage rate for any 1 calendar year , the 268
board must may extend the program's probationary status for 1 269
additional year, provided the program has demonstrated adequate 270
progress toward the graduate passage rate goal by meeting a 271
majority of the benchmarks established in the remediation plan. 272
If the program is not granted the 1 -year extension or fails to 273
achieve the required pa ssage rate by the end of such extension, 274
the board shall terminate the program pursuant to chapter 120. 275
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5. If an approved program's graduate passage rate is below 276
30 percent in a calendar year, the program must reimburse the 277
total cost of tuition and fee s paid by each student who failed 278
to pass the National Council of State Boards of Nursing 279
Licensing Examination as a first -time test taker in that 280
calendar year. The program must outline its plan for meeting 281
this requirement in its written remediation plan under 282
subparagraph (5)(a)3. 283
(b) If an approved program fails to submit the annual 284
report required in subsection (3), the board must shall notify 285
the program director and president or chief executive officer of 286
the educational institution in writing with in 15 days after the 287
due date of the annual report. The program director must shall 288
appear before the board at the board's next regularly scheduled 289
meeting to explain the reason for the delay. The board must 290
shall terminate the program pursuant to chapter 120 if the 291
program director fails to appear before the board, as required 292
under this paragraph, or if the program does not submit the 293
annual report within 6 months after the due date. 294
(c) A nursing education program, whether accredited or 295
nonaccredited, which has been placed on probationary status must 296
shall disclose its probationary status in writing to the 297
program's students and applicants. The notification must include 298
an explanation of the implications of the program's probationary 299
status on the students or applicants. 300
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(d) If students from a program that is terminated pursuant 301
to this subsection transfer to an approved or an accredited 302
program under the direction of the Commission for Independent 303
Education, the board must shall recalculate the passag e rates of 304
the programs receiving the transferring students, excluding the 305
test scores of those students transferring more than 12 credits. 306
(e) For each student who fails to pass the National 307
Council of State Boards of Nursing Licensing Examination as a 308
first-time test taker, and for at least 1 calendar year 309
following his or her graduation date, an approved program on 310
probationary status must offer such student remediation at no 311
additional cost to the student or pay for remediation from a 312
board-approved remedial program. 313
(f) Duly authorized agents or employees of the department 314
may conduct onsite evaluations or inspections at all reasonable 315
hours to verify that approved programs or accredited programs 316
are in full compliance with this chapter, or to deter mine 317
whether this chapter or s. 456.072 is being violated. The 318
department may collect any necessary evidence needed to verify 319
compliance with this chapter or for prosecution as deemed 320
necessary. The failure of a program to allow an onsite 321
evaluation or inspection is deemed a violation of a legal 322
obligation imposed by the board or the department. 323
(8) RULEMAKING.—The board does not have rulemaking 324
authority to administer this section, except that the board 325
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shall adopt rules that prescribe the format for sub mitting 326
program applications under subsection (1) and annual reports 327
under subsection (3), to enforce and administer subsection (5), 328
and to administer the documentation of the accreditation of 329
nursing education programs under subsection (11). The board may 330
adopt rules relating to the nursing curriculum, including rules 331
relating to the uses and limitations of simulation technology , 332
and rules relating to the criteria to qualify for an extension 333
of time to meet the accreditation requirements under paragraph 334
(11)(f). The board may not impose any condition or requirement 335
on an educational institution submitting a program application, 336
an approved program, or an accredited program, except as 337
expressly provided in this section. 338
(10) IMPLEMENTATION STUDY. —The Florida Center for Nursing 339
shall study the administration of this section and submit 340
reports to the Governor, the President of the Senate, and the 341
Speaker of the House of Representatives annually by January 30. 342
The annual reports shall address the previous acad emic year; 343
provide data on the measures specified in paragraphs (a) and 344
(b), as such data becomes available; and include an evaluation 345
of such data for purposes of determining whether this section is 346
increasing the availability of nursing education program s and 347
the production of quality nurses. The department and each 348
approved program or accredited program shall comply with 349
requests for data from the Florida Center for Nursing. 350
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(a) The Florida Center for Nursing shall evaluate program -351
specific data for ea ch approved program and accredited program 352
conducted in the state, including, but not limited to: 353
1. The number of programs and student slots available. 354
2. The number of student applications submitted, the 355
number of qualified applicants, and the number of students 356
accepted. 357
3. The number of program graduates. 358
4. Program retention rates of students tracked from 359
program entry to graduation. 360
5. Program exit examination results. 361
6. The number of students offered remediation due to exit 362
examination performance and the number of students who completed 363
remediation. 364
7. The impact of exit examinations and remediation on 365
graduation rates and graduate passage rates on the National 366
Council of State Boards of Nursing Licensing Examination. 367
8.5. Graduate passage rates on the National Council of 368
State Boards of Nursing Licensing Examination. 369
9.6. The number of graduates who become employed as 370
practical or professional nurses in the state. 371
(b) The Florida Center for Nursing shall evaluate the 372
board's implementation of the: 373
1. Program application approval process, including, but 374
not limited to, the number of program applications submitted 375
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under subsection (1), the number of program applications 376
approved and denied by the board under subsection (2), the 377
number of denials of program applications reviewed under chapter 378
120, and a description of the outcomes of those reviews. 379
2. Accountability processes, including, but not limited 380
to, the number of programs on probationary status, the number of 381
approved programs for which the program director is required to 382
appear before the board under subsection (5), the number of 383
approved programs terminated by the board, the number of 384
terminations reviewed under chapter 120, and a description of 385
the outcomes of those revi ews. 386
(c) The Florida Center for Nursing shall complete an 387
annual assessment of compliance by programs with the 388
accreditation requirements of subsection (11), include in the 389
assessment a determination of the accreditation process status 390
for each program, and submit the assessment as part of the 391
reports required by this subsection. 392
(11) ACCREDITATION REQUIRED. — 393
(f) An approved nursing education program may, no sooner 394
than 90 days before the deadline for meeting the accreditation 395
requirements of this sub section, apply to the board for an 396
extension of the accreditation deadline for a period which does 397
not exceed 2 years. An additional extension may not be granted. 398
In order to be eligible for the extension, the approved program 399
must establish that it has a graduate passage rate of 60 percent 400
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or higher on the National Council of State Boards of Nursing 401
Licensing Examination for the most recent calendar year and must 402
meet a majority of the board's additional criteria, including, 403
but not limited to, all of the following: 404
1. A student retention rate of 60 percent or higher for 405
the most recent calendar year. 406
2. A graduate work placement rate of 70 percent or higher 407
for the most recent calendar year. 408
3. The program has applied for approval or been approved 409
by an institutional or programmatic accreditor recognized by the 410
United States Department of Education. 411
4. The program is in full compliance with subsections (1) 412
and (3) and paragraph (5)(b). 413
5. The program is not currently in its second year of 414
probationary status under subsection (5). 415
416
The applicable deadline under this paragraph is tolled from the 417
date on which an approved program applies for an extension until 418
the date on which the board issues a decision on the requested 419
extension. 420
Section 2. This act shall take effect July 1, 2025. 421