Florida Senate - 2025 SB 526 By Senator Harrell 31-00793-25 2025526__ 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 programs 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 programs 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 programs 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 boards 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: 37 464.019Approval 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 institutions 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 programs 51 faculty members are registered nurses who have a masters or 52 higher degree in nursing or a bachelors degree in nursing and a 53 masters 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 programs faculty 56 members are registered nurses who have a bachelors or higher 57 degree in nursing. 58 59 The educational degree requirements of this paragraph must may 60 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 programs 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 bachelors degree professional nursing 75 education program. 76 (c)No more than 50 percent of the programs 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 programs 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 must 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 must 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). The comprehensive examination must be 143 termed an exit examination that all programs will administer and 144 may not be the sole exclusion to graduation if the student has 145 otherwise successfully completed all coursework required by the 146 program. The program director is responsible for ensuring that 147 the average exit examination results of the program are placed 148 on the programs website and reported to the board along with 149 the annual report required in subsection (3). 150 (j)The professional or practical nursing education program 151 has submitted to the board the established criteria for 152 remediation that will be offered to students who do not 153 successfully pass the exit examination. A program with NCLEX 154 passage rates at least 10 percentage points below the average 155 passage rate for the most recent calendar year must offer 156 remediation at no additional cost or refer the student to an 157 approved remedial program and pay for that program for the 158 student. 159 (2)PROGRAM APPROVAL. 160 (a)Upon receipt of a program application and review fee, 161 the department shall examine the application to determine if it 162 is complete. If the application is not complete, the department 163 must shall notify the educational institution in writing of any 164 errors or omissions within 30 days after the departments 165 receipt of the application. A program application is deemed 166 complete upon the departments receipt of: 167 1.The initial application, if the department does not 168 notify the educational institution of any errors or omissions 169 within the 30-day period; or 170 2.A revised application that corrects each error and 171 omission of which the department notifies the educational 172 institution within the 30-day period. 173 (b)Following the departments receipt of a complete 174 program application, the board may conduct an onsite evaluation 175 if necessary to document the applicants compliance with 176 subsection (1). Within 90 days after the departments receipt of 177 a complete program application, the board shall: 178 1.Approve the application if it documents compliance with 179 subsection (1); or 180 2.Provide the educational institution with a notice of 181 intent to deny the application if it does not document 182 compliance with subsection (1). The notice must specify written 183 reasons for the boards denial of the application. The board may 184 not deny a program application because of an educational 185 institutions failure to correct an error or omission that the 186 department failed to provide notice of to the institution within 187 the 30-day notice period under paragraph (a). The educational 188 institution may request a hearing on the notice of intent to 189 deny the program application pursuant to chapter 120. 190 (c)A program application is deemed approved if the board 191 does not act within the 90-day review period provided under 192 paragraph (b). 193 (d)Upon the boards approval of a program application, the 194 program becomes an approved program. 195 (e)The board shall deny an application from a program that 196 has had adverse action taken against it by another regulatory 197 jurisdiction in the United States. The board may also revoke the 198 approval of an existing approved program that has had adverse 199 action taken against it by another regulatory jurisdiction in 200 the United States. 201 (3)ANNUAL REPORT.By November 1 of each year, each 202 approved programs director program shall submit to the board an 203 annual report comprised of an affidavit certifying continued 204 compliance with subsection (1), a summary description of the 205 programs compliance with subsection (1), and documentation for 206 the previous academic year that, to the extent applicable, 207 describes: 208 (a)The number of student applications received, qualified 209 applicants, applicants accepted, accepted applicants who enroll 210 in the program, students enrolled in the program, and program 211 graduates. 212 (b)The programs retention rates for students tracked from 213 program entry to graduation. 214 (c)The programs accreditation status, including 215 identification of the accrediting agency. 216 217 The board must terminate the program pursuant to chapter 120 if 218 the requirements of this subsection are not met. The program 219 director is also subject to discipline under s. 456.072(1)(k) 220 for such failure. 221 (5)ACCOUNTABILITY. 222 (a)1.An approved program must achieve a graduate passage 223 rate for first-time test takers which is not more than 10 224 percentage points lower than the average passage rate during the 225 same calendar year for graduates of comparable degree programs 226 who are United States educated, first-time test takers on the 227 National Council of State Boards of Nursing Licensing 228 Examination, as calculated by the contract testing service of 229 the National Council of State Boards of Nursing. For purposes of 230 this subparagraph, an approved program is comparable to all 231 degree programs of the same program type from among the 232 following program types: 233 a.Professional nursing education programs that terminate 234 in a bachelors degree. 235 b.Professional nursing education programs that terminate 236 in an associate degree. 237 c.Professional nursing education programs that terminate 238 in a diploma. 239 d.Practical nursing education programs. 240 2.If an approved programs graduate passage rates do not 241 equal or exceed the required passage rates for 1 calendar year 2 242 consecutive calendar years, the board must shall place the 243 program on probationary status pursuant to chapter 120 and the 244 program director must submit a written remediation plan to the 245 board. The program director must shall appear before the board 246 to present the a plan for remediation, which must shall include 247 specific nationally recognized benchmarks to identify progress 248 toward a graduate passage rate goal. The board must terminate a 249 program pursuant to chapter 120 if the program director fails to 250 submit a written remediation plan or fails to appear before the 251 board and present the remediation plan no later than 6 months 252 after the date of the program being placed on probation. The 253 programs director is also subject to discipline under s. 254 456.072(1)(k) for such failure. The program must remain on 255 probationary status until it achieves a graduate passage rate 256 that equals or exceeds the required passage rate for any 1 257 calendar year. The board must shall deny a program application 258 for a new prelicensure nursing education program submitted by an 259 educational institution if the institution has an existing 260 program that is already on probationary status. 261 3.Upon the programs achievement of a graduate passage 262 rate that equals or exceeds the required passage rate, the 263 board, at its next regularly scheduled meeting following release 264 of the programs graduate passage rate by the National Council 265 of State Boards of Nursing, shall remove the programs 266 probationary status. If the program, during the 2 calendar year 267 years following its placement on probationary status, does not 268 achieve the required passage rate for any 1 calendar year, the 269 board must may extend the programs probationary status for 1 270 additional year, provided the program has demonstrated adequate 271 progress toward the graduate passage rate goal by meeting a 272 majority of the benchmarks established in the remediation plan. 273 If the program is not granted the 1-year extension or fails to 274 achieve the required passage rate by the end of such extension, 275 the board shall terminate the program pursuant to chapter 120. 276 (b)If an approved program fails to submit the annual 277 report required in subsection (3), the board must shall notify 278 the program director and president or chief executive officer of 279 the educational institution in writing within 15 days after the 280 due date of the annual report. The program director must shall 281 appear before the board at the boards next regularly scheduled 282 meeting to explain the reason for the delay. The board must 283 shall terminate the program pursuant to chapter 120 if the 284 program director fails to appear before the board, as required 285 under this paragraph, or if the program does not submit the 286 annual report within 6 months after the due date. 287 (c)A nursing education program, whether accredited or 288 nonaccredited, which has been placed on probationary status must 289 shall disclose its probationary status in writing to the 290 programs students and applicants. The notification must include 291 an explanation of the implications of the programs probationary 292 status on the students or applicants. 293 (d)If students from a program that is terminated pursuant 294 to this subsection transfer to an approved or an accredited 295 program under the direction of the Commission for Independent 296 Education, the board must shall recalculate the passage rates of 297 the programs receiving the transferring students, excluding the 298 test scores of those students transferring more than 12 credits. 299 (e)Duly authorized agents or employees of the department 300 may conduct onsite evaluations or inspections at all reasonable 301 hours to ensure that approved programs or accredited programs 302 are in full compliance with this chapter, or to determine 303 whether this chapter or s. 456.072 is being violated. The 304 department may collect any necessary evidence needed to ensure 305 compliance with this chapter or for prosecution as deemed 306 necessary. A failure of a program to refuse or allow an onsite 307 evaluation or inspection is deemed a violation of a legal 308 obligation imposed by the board or the department. 309 (8)RULEMAKING.The board does not have rulemaking 310 authority to administer this section, except that the board 311 shall adopt rules that prescribe the format for submitting 312 program applications under subsection (1) and annual reports 313 under subsection (3), to enforce and administer subsection (5), 314 and to administer the documentation of the accreditation of 315 nursing education programs under subsection (11). The board may 316 adopt rules relating to the nursing curriculum, including rules 317 relating to the uses and limitations of simulation technology, 318 and rules relating to the criteria to qualify for an extension 319 of time to meet the accreditation requirements under paragraph 320 (11)(f). The board may not impose any condition or requirement 321 on an educational institution submitting a program application, 322 an approved program, or an accredited program, except as 323 expressly provided in this section. 324 (11)ACCREDITATION REQUIRED. 325 (f)An approved nursing education program may, no sooner 326 than 90 days before the deadline for meeting the accreditation 327 requirements of this subsection, apply to the board for an 328 extension of the accreditation deadline for a period which does 329 not exceed 2 years. An additional extension may not be granted. 330 In order to be eligible for the extension, the approved program 331 must establish that it has a graduate passage rate of 60 percent 332 or higher on the National Council of State Boards of Nursing 333 Licensing Examination for the most recent calendar year and must 334 meet a majority of the boards additional criteria, including, 335 but not limited to, all of the following: 336 1.A student retention rate of 60 percent or higher for the 337 most recent calendar year. 338 2.A graduate work placement rate of 70 percent or higher 339 for the most recent calendar year. 340 3.The program has applied for approval or been approved by 341 an institutional or programmatic accreditor recognized by the 342 United States Department of Education. 343 4.The program is in full compliance with subsections (1) 344 and (3) and paragraph (5)(b). 345 5.The program is not currently in its second year of 346 probationary status under subsection (5). 347 348 The applicable deadline under this paragraph is tolled from the 349 date on which an approved program applies for an extension until 350 the date on which the board issues a decision on the requested 351 extension. 352 Section 2.This act shall take effect July 1, 2025.