September 29, 2020
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       Florida Senate - 2010                                    SB 2530
       
       
       
       By Senator Alexander
       
       
       
       
       17-01916A-10                                          20102530__
    1                        A bill to be entitled                      
    2         An act relating to nursing; amending s. 456.014, F.S.;
    3         authorizing the disclosure of certain confidential
    4         information required of nursing license applicants to
    5         certain persons; amending s. 464.003, F.S.; providing
    6         and revising definitions; amending s. 464.008, F.S.;
    7         revising requirements for graduation from certain
    8         nursing education programs for nursing license
    9         applicants seeking to take the licensing examination;
   10         amending s. 464.015, F.S.; revising restrictions on
   11         nursing graduates who may use certain titles and
   12         abbreviations; amending s. 464.019, F.S.; revising
   13         requirements for the approval of nursing education
   14         programs by the Board of Nursing, including
   15         application requirements and procedures for the review
   16         and approval or denial of applications; revising
   17         requirements for the approval of nursing education
   18         programs meeting certain requirements before a
   19         specified date; providing for retroactive application;
   20         revising requirements for the submission of annual
   21         reports by approved programs; revising requirements
   22         for the information published on the board’s Internet
   23         website; revising accountability requirements for an
   24         approved program’s graduate passage rates on a certain
   25         licensing examination; revising procedures for placing
   26         programs on, and removing such programs, from
   27         probationary status; requiring termination of programs
   28         under certain circumstances; requiring certain
   29         representatives of programs that fail to submit annual
   30         reports to appear before the board; requiring the
   31         Department of Health to disclose certain confidential
   32         information about a program’s graduates to the program
   33         director under certain circumstances; requiring
   34         program directors to maintain the confidentiality of
   35         such information; providing penalties for unlawful
   36         disclosure of confidential information; revising the
   37         board’s authority to adopt rules; exempting accredited
   38         programs from specified requirements; conforming
   39         provisions; deleting obsolete provisions; revising
   40         requirements for the Florida Center for Nursing’s
   41         evaluation of the board’s implementation of certain
   42         accountability provisions; conforming cross
   43         references; amending s. 464.022, F.S.; conforming
   44         provisions; amending ss. 458.348, 459.025, 464.012,
   45         and 960.28, F.S.; conforming cross-references;
   46         providing an effective date.
   47  
   48  Be It Enacted by the Legislature of the State of Florida:
   49  
   50         Section 1. Subsection (1) of section 456.014, Florida
   51  Statutes, is amended to read:
   52         456.014 Public inspection of information required from
   53  applicants; exceptions; examination hearing.—
   54         (1) All information required by the department of any
   55  applicant shall be a public record and shall be open to public
   56  inspection pursuant to s. 119.07, except financial information,
   57  medical information, school transcripts, examination questions,
   58  answers, papers, grades, and grading keys, which are
   59  confidential and exempt from s. 119.07(1) and shall not be
   60  discussed with or made accessible to anyone except the program
   61  director of an approved program or accredited program as
   62  provided in s. 464.019(7), members of the board, the department,
   63  and staff thereof, who have a bona fide need to know such
   64  information. Any information supplied to the department by any
   65  other agency which is exempt from the provisions of chapter 119
   66  or is confidential shall remain exempt or confidential pursuant
   67  to applicable law while in the custody of the department or the
   68  agency.
   69         Section 2. Section 464.003, Florida Statutes, is reordered
   70  and amended to read:
   71         464.003 Definitions.—As used in this part, the term:
   72         (1) “Accredited program” means a program for the
   73  prelicensure education of professional or practical nurses that
   74  is conducted in the United States at an educational institution,
   75  whether in this state, another state, or the District of
   76  Columbia, and that is accredited by a national accrediting
   77  agency recognized by the United States Department of Education
   78  for the agency’s specialization in nursing education.
   79         (13)(1) “Department” means the Department of Health.
   80         (5)(2) “Board” means the Board of Nursing.
   81         (20)(3)(a) “Practice of professional nursing” means the
   82  performance of those acts requiring substantial specialized
   83  knowledge, judgment, and nursing skill based upon applied
   84  principles of psychological, biological, physical, and social
   85  sciences which shall include, but not be limited to:
   86         (a)1. The observation, assessment, nursing diagnosis,
   87  planning, intervention, and evaluation of care; health teaching
   88  and counseling of the ill, injured, or infirm; and the promotion
   89  of wellness, maintenance of health, and prevention of illness of
   90  others.
   91         (b)2. The administration of medications and treatments as
   92  prescribed or authorized by a duly licensed practitioner
   93  authorized by the laws of this state to prescribe such
   94  medications and treatments.
   95         (c)3. The supervision and teaching of other personnel in
   96  the theory and performance of any of the above acts described in
   97  this subsection.
   98  
   99  A professional nurse is responsible and accountable for making
  100  decisions that are based upon the individual’s educational
  101  preparation and experience in nursing.
  102         (19)(b) “Practice of practical nursing” means the
  103  performance of selected acts, including the administration of
  104  treatments and medications, in the care of the ill, injured, or
  105  infirm and the promotion of wellness, maintenance of health, and
  106  prevention of illness of others under the direction of a
  107  registered nurse, a licensed physician, a licensed osteopathic
  108  physician, a licensed podiatric physician, or a licensed
  109  dentist. A The professional nurse and the practical nurse is
  110  shall be responsible and accountable for making decisions that
  111  are based upon the individual’s educational preparation and
  112  experience in nursing.
  113         (7)(c) “Clinical nurse specialist practice” means the
  114  delivery and management of advanced practice nursing care to
  115  individuals or groups, including the ability to:
  116         (a)1. Assess the health status of individuals and families
  117  using methods appropriate to the population and area of
  118  practice.
  119         (b)2. Diagnose human responses to actual or potential
  120  health problems.
  121         (c)3. Plan for health promotion, disease prevention, and
  122  therapeutic intervention in collaboration with the patient or
  123  client.
  124         (d)4. Implement therapeutic interventions based on the
  125  nurse specialist’s area of expertise and within the scope of
  126  advanced nursing practice, including, but not limited to, direct
  127  nursing care, counseling, teaching, and collaboration with other
  128  licensed health care providers.
  129         (e)5. Coordinate health care as necessary and appropriate
  130  and evaluate with the patient or client the effectiveness of
  131  care.
  132         (2)(d) “Advanced or specialized nursing practice” means, in
  133  addition to the practice of professional nursing, the
  134  performance of advanced-level nursing acts approved by the board
  135  which, by virtue of postbasic specialized education, training,
  136  and experience, are appropriately performed by an advanced
  137  registered nurse practitioner. Within the context of advanced or
  138  specialized nursing practice, the advanced registered nurse
  139  practitioner may perform acts of nursing diagnosis and nursing
  140  treatment of alterations of the health status. The advanced
  141  registered nurse practitioner may also perform acts of medical
  142  diagnosis and treatment, prescription, and operation which are
  143  identified and approved by a joint committee composed of three
  144  members appointed by the Board of Nursing, two of whom must be
  145  advanced registered nurse practitioners; three members appointed
  146  by the Board of Medicine, two of whom must have had work
  147  experience with advanced registered nurse practitioners; and the
  148  State Surgeon General or the State Surgeon General’s designee.
  149  Each committee member appointed by a board shall be appointed to
  150  a term of 4 years unless a shorter term is required to establish
  151  or maintain staggered terms. The Board of Nursing shall adopt
  152  rules authorizing the performance of any such acts approved by
  153  the joint committee. Unless otherwise specified by the joint
  154  committee, such acts must be performed under the general
  155  supervision of a practitioner licensed under chapter 458,
  156  chapter 459, or chapter 466 within the framework of standing
  157  protocols which identify the medical acts to be performed and
  158  the conditions for their performance. The department may, by
  159  rule, require that a copy of the protocol be filed with the
  160  department along with the notice required by s. 458.348.
  161         (17)(e) “Nursing diagnosis” means the observation and
  162  evaluation of physical or mental conditions, behaviors, signs
  163  and symptoms of illness, and reactions to treatment and the
  164  determination as to whether such conditions, signs, symptoms,
  165  and reactions represent a deviation from normal.
  166         (18)(f) “Nursing treatment” means the establishment and
  167  implementation of a nursing regimen for the care and comfort of
  168  individuals, the prevention of illness, and the education,
  169  restoration, and maintenance of health.
  170         (22)(4) “Registered nurse” means any person licensed in
  171  this state to practice professional nursing.
  172         (16)(5) “Licensed practical nurse” means any person
  173  licensed in this state to practice practical nursing.
  174         (6) “Clinical nurse specialist” means any person licensed
  175  in this state to practice professional nursing and certified in
  176  clinical nurse specialist practice.
  177         (3)(7) “Advanced registered nurse practitioner” means any
  178  person licensed in this state to practice professional nursing
  179  and certified in advanced or specialized nursing practice,
  180  including certified registered nurse anesthetists, certified
  181  nurse midwives, and nurse practitioners.
  182         (4)(8) “Approved program” means a nursing program for the
  183  prelicensure education of professional or practical nurses that
  184  is conducted in the state at an educational institution and that
  185  is in a school, college, or university which is approved under
  186  s. 464.019 for the education of nurses. The term includes such a
  187  program placed on probationary status.
  188         (10)(9) “Clinical training” means direct nursing care
  189  experiences with patients or clients which offer the student the
  190  opportunity to integrate, apply, and refine specific skills and
  191  abilities based on theoretical concepts and scientific
  192  principles.
  193         (8)(10) “Clinical preceptor” means a registered nurse or
  194  licensed practical nurse who is employed by a clinical training
  195  facility to serve who serves as a role model and clinical
  196  resource person for a specified period to students an individual
  197  enrolled in an approved program.
  198         (9)(11) “Clinical simulation” means a strategy used to
  199  replicate clinical practice as closely as possible to teach
  200  theory, assessment, technology, pharmacology, and skills.
  201         (11)(12) “Community-based clinical experience” means
  202  activities consistent with the curriculum and involving
  203  individuals, families, and groups with the intent of promoting
  204  wellness, maintaining health, and preventing illness.
  205         (12)(13) “Curriculum” means a planned sequence of course
  206  offerings and learning experiences that comprise a nursing
  207  education program.
  208         (21)(14) “Probationary status” means the status of an
  209  approved a nursing education program that is placed on such
  210  status pursuant subject to s. 464.019(2)(a)2. or (5)(a) or (b).
  211         (14) “Educational institution” means a school, college, or
  212  university.
  213         (15) “Graduate passage rate” means the percentage of a
  214  program’s graduates who, as first-time test takers, pass the
  215  National Council of State Boards of Nursing Licensing
  216  Examination during a calendar year, as calculated by the
  217  contract testing service of the National Council of State Boards
  218  of Nursing.
  219         (23) “Required passage rate” means the graduate passage
  220  rate required for an approved program pursuant to s.
  221  464.019(6)(a)1.
  222         Section 3. Subsection (1) of section 464.008, Florida
  223  Statutes, is amended to read:
  224         464.008 Licensure by examination.—
  225         (1) Any person desiring to be licensed as a registered
  226  nurse or licensed practical nurse shall apply to the department
  227  to take the licensure examination. The department shall examine
  228  each applicant who:
  229         (a) Has completed the application form and remitted a fee
  230  set by the board not to exceed $150 and has remitted an
  231  examination fee set by the board not to exceed $75 plus the
  232  actual per applicant cost to the department for purchase of the
  233  examination from the National Council of State Boards of Nursing
  234  or a similar national organization.
  235         (b) Has provided sufficient information on or after October
  236  1, 1989, which must be submitted by the department for a
  237  statewide criminal records correspondence check through the
  238  Department of Law Enforcement.
  239         (c) Is in good mental and physical health, is a recipient
  240  of a high school diploma or the equivalent, and has completed
  241  the requirements for:
  242         1. Graduation from an approved program;
  243         2. Graduation from a prelicensure nursing education program
  244  that the board determines is, or its equivalent to an approved
  245  program;
  246         3. Graduation on or after July 1, 2009, from an accredited
  247  program; or
  248         4. Graduation before July 1, 2009, from a prelicensure
  249  nursing education program whose graduates at that time were
  250  eligible for examination as determined by the board, for the
  251  preparation of registered nurses or licensed practical nurses,
  252  whichever is applicable.
  253  
  254  Courses successfully completed in a professional nursing
  255  education program that which are at least equivalent to a
  256  practical nursing education program may be used to satisfy the
  257  education requirements for licensure as a licensed practical
  258  nurse.
  259         (d) Has the ability to communicate in the English language,
  260  which may be determined by an examination given by the
  261  department.
  262         Section 4. Subsections (3) and (4) of section 464.015,
  263  Florida Statutes, are amended to read:
  264         464.015 Titles and abbreviations; restrictions; penalty.—
  265         (3) Only persons who are graduates of prelicensure nursing
  266  education approved programs listed in s. 464.008(1)(c) or the
  267  equivalent may use the term “Graduate Nurse” and the
  268  abbreviation “G.N.,” pending the results of the first licensure
  269  examination for which they are eligible.
  270         (4) Only persons who are graduates of prelicensure nursing
  271  education approved programs listed in s. 464.008(1)(c) or the
  272  equivalent may use the term “Graduate Practical Nurse” and the
  273  abbreviation “G.P.N.,” pending the results of the first
  274  licensure examination for which they are eligible.
  275         Section 5. Section 464.019, Florida Statutes, is reordered
  276  and amended to read:
  277         464.019 Approval of nursing education programs.—
  278         (1) PROGRAM APPLICATIONS.—An educational institution that
  279  wishes to conduct a program in this state for the prelicensure
  280  education of professional or practical nurses must shall submit
  281  to the department a program application and a program review fee
  282  of $1,000 for each certificate, associate degree, or bachelor’s
  283  degree prelicensure nursing education program to be offered at
  284  the institution’s main campus, branch campus, or other
  285  instructional site the department. Within 90 days after receipt
  286  of a program application and program review fee, the board shall
  287  approve the program application if it documents compliance with
  288  the standards in paragraphs (a)-(h). If the program application
  289  is incomplete or does not document compliance, the board shall
  290  follow the procedures in subsection (3). a program application
  291  is deemed approved by the board if the board does not act on the
  292  application within the timeframes specified in subsection (3) or
  293  this subsection. Each program application must document that:
  294         (a)1. For a professional nursing education program, the
  295  program director and at least 50 percent of the program’s
  296  faculty members are registered nurses who have, at a minimum, a
  297  master’s or higher bachelor’s degree in nursing or a bachelor’s
  298  and a master’s degree in nursing and a master’s or higher degree
  299  in a field or a related to nursing field.
  300         2.(b) For a practical nursing education program, the
  301  program director and at least 50 percent of the program’s
  302  faculty members are registered nurses who have, at a minimum, a
  303  bachelor’s or higher degree in nursing.
  304  
  305  The educational degree requirements of this paragraph may be
  306  documented by an official transcript or by a written statement
  307  from the educational institution verifying that the institution
  308  conferred the degree.
  309         (b)(c) The program’s nursing major curriculum consists of
  310  at least:
  311         1. Fifty percent clinical training for a practical nursing
  312  education program, an associate degree professional nursing
  313  education program, or a professional diploma nursing education
  314  program.
  315         2. Forty percent clinical training for a bachelor’s degree
  316  professional nursing education program.
  317         (c)(d) No more than 25 percent of the program’s clinical
  318  training consists of clinical simulation.
  319         (d)(e) The program has signed agreements with each agency,
  320  facility, and organization included in the curriculum plan as
  321  clinical training sites and community-based clinical experience
  322  sites.
  323         (e)(f) The program has written policies for faculty which
  324  include provisions for direct or indirect supervision by program
  325  faculty or clinical preceptors for students in clinical training
  326  consistent with the following standards:
  327         1. The number of program faculty members equals at least
  328  one faculty member directly supervising every 12 students unless
  329  the written agreement between the program and the agency,
  330  facility, or organization providing clinical training sites
  331  allows more students, not to exceed 18 students, to be directly
  332  supervised by one program faculty member.
  333         2. For a hospital setting, indirect supervision may occur
  334  only if there is direct supervision by an assigned clinical
  335  preceptor, a supervising program faculty member is available by
  336  telephone, and such arrangement is approved by the clinical
  337  facility.
  338         3. For community-based clinical experiences that involve
  339  student participation in invasive or complex nursing activities,
  340  students must be directly supervised by a program faculty member
  341  or clinical preceptor and such arrangement must be approved by
  342  the community-based clinical facility.
  343         4. For community-based clinical experiences not subject to
  344  subparagraph 3., indirect supervision may occur only when a
  345  supervising program faculty member is available to the student
  346  by telephone.
  347  
  348  A program’s policies established under this paragraph must
  349  require a clinical preceptor, if supervising students in a
  350  professional nursing education program, to be a registered nurse
  351  or, if supervising students in a practical nursing education
  352  program, to be a registered nurse or licensed practical nurse.
  353         (f)(g) The professional or practical nursing curriculum
  354  plan documents clinical experience and theoretical instruction
  355  in medical, surgical, obstetric, pediatric, and geriatric
  356  nursing. A professional nursing curriculum plan shall also
  357  document clinical experience and theoretical instruction in
  358  psychiatric nursing. Each curriculum plan must document clinical
  359  training experience in appropriate settings that include, but
  360  are not limited to, acute care, long-term care, and community
  361  settings.
  362         (g)(h) The professional or practical nursing education
  363  program provides theoretical instruction and clinical
  364  application in personal, family, and community health concepts;
  365  nutrition; human growth and development throughout the life
  366  span; body structure and function; interpersonal relationship
  367  skills; mental health concepts; pharmacology and administration
  368  of medications; and legal aspects of practice. A professional
  369  nursing education program shall also provide theoretical
  370  instruction and clinical application in interpersonal
  371  relationships and leadership skills; professional role and
  372  function; and health teaching and counseling skills.
  373  
  374  Upon the board’s approval of a program application, the program
  375  becomes an approved program under this section.
  376         (3)(2)STATUS OF CERTAIN PROGRAMS.—
  377         (a) A professional or practical nursing education program
  378  becomes an approved program if that, as of June 30, 2009, the
  379  program:
  380         (a)1. Has full or provisional approval from the board or,
  381  except as provided in paragraph (b), is on probationary status,
  382  except as provided in subparagraph 2., becomes an approved
  383  program under this section. In order to retain approved program
  384  status, such program shall submit the report required under
  385  paragraph (c) to the board by November 1, 2009, and annually
  386  thereafter.
  387         (b)2. Is on probationary status because the program did not
  388  meet the board’s requirement for program graduate passage rates.
  389  Such program on the National Council of State Boards of Nursing
  390  Licensing Examination, shall remain on probationary status until
  391  it the program achieves a graduate passage rate for calendar
  392  year 2009 or 2010 that equals or exceeds the required passage
  393  rate for the respective calendar year and compliance with the
  394  program graduate passage rate requirement in paragraph (5)(a). A
  395  program that is subject to this subparagraph must disclose its
  396  probationary status in writing to the program’s students and
  397  applicants submit the report required under paragraph (c) to the
  398  board by November 1, 2009, and annually thereafter and must
  399  comply with paragraph (5)(c). If the program does not achieve
  400  the required passage rate compliance by July 1, 2011, the board
  401  shall terminate the program pursuant to chapter 120 as provided
  402  in paragraph (5)(d).
  403         (b) Each professional or practical nursing program that has
  404  its application approved by the board under subsection (1) on or
  405  after July 1, 2009, shall annually submit the report required
  406  under paragraph (c) to the board by November 1 of each year
  407  following initial approval of its application.
  408         (4) ANNUAL REPORT.—By November 1 of each year, each
  409  approved program shall submit to the board an
  410         (c) The annual report comprised of required by this
  411  subsection must include an affidavit certifying continued
  412  compliance with paragraphs (1)(a)-(g) subsection (1), must
  413  provide a summary description of the program’s compliance with
  414  paragraphs (1)(a)-(g) with subsection (1), and documentation
  415  must document for the previous academic year that, to the extent
  416  applicable, sets forth for each professional and practical
  417  nursing program:
  418         (a)1. The number of student applications received, the
  419  number of qualified applicants, applicants and the number of
  420  students accepted, accepted applicants who enroll in the
  421  program, students enrolled in the program, and.
  422         2. the number of program graduates.
  423         3. The program’s graduate passage rate on the National
  424  Council of State Boards of Nursing Licensing Examination.
  425         (b)4. The program’s retention rates for students tracked
  426  from program entry to graduation.
  427         (c)5. The program’s accreditation status, including
  428  identification of the accrediting agency if such agency is not
  429  an accrediting agency described in s. 464.003(1) body.
  430         (2)(3)PROGRAM APPROVAL.—
  431         (a) Upon receipt of a If an institution’s program
  432  application and review fee, the department shall examine the
  433  application to determine whether it is complete. If a program
  434  application is not complete incomplete, the department board
  435  shall notify the educational institution in writing of any
  436  apparent errors or omissions within 30 days after the
  437  department’s receipt of the application and follow the
  438  procedures in s. 120.60. A program application is deemed
  439  complete upon the department’s receipt of:
  440         1. The initial application, if the department does not
  441  notify the educational institution of any errors or omissions
  442  within the 30-day period; or
  443         2. A revised application that corrects each error and
  444  omission of which the department notifies the educational
  445  institution within the 30-day period.
  446         (b) Within 90 days after the department’s receipt of a
  447  complete program application, the board shall:
  448         1. Approve the If an institution’s program application if
  449  it documents does not document compliance with paragraphs
  450  (1)(a)-(g); or the standards in subsection (1), within 90 days
  451  after the board’s receipt of the program application, the board
  452  shall
  453         2. Provide the educational institution with a notice of
  454  intent to deny the program application if it does not document
  455  compliance with paragraphs (1)(a)-(g) that sets forth written
  456  reasons for the denial. The notice must set forth written
  457  reasons for the board’s denial of the application. The board may
  458  not deny a program application because of an educational
  459  institution’s failure to correct any error or omission of which
  460  the department does not notify the institution within the 30-day
  461  notice period under paragraph (a). The educational institution
  462  may request a hearing on the notice of intent to deny the
  463  program application pursuant to chapter 120.
  464         (c) A program application is deemed approved if the board
  465  does not act within the 90-day review period provided under
  466  paragraph (b).
  467         (d) Upon the board’s approval of a program application, the
  468  program becomes an approved program.
  469         (5)(4)INTERNET WEBSITE.—The board shall publish the
  470  following information on its Internet website:
  471         (a) A list of each accredited program conducted in the
  472  state and the program’s graduate passage rates for the most
  473  recent 2 calendar years, which the department shall determine
  474  through the following sources:
  475         1. For a program’s accreditation status, the national
  476  accrediting agencies recognized by the United States Department
  477  of Education for their specialization in nursing education.
  478         2. For a program’s graduate passage rates, the contract
  479  testing service of the National Council of State Boards of
  480  Nursing.
  481         (b) The following data for each approved program, which on
  482  nursing programs located in the state. The data shall include,
  483  to the extent applicable:
  484         1.(a) All documentation provided by the program in its
  485  applicant for each approved nursing program application if
  486  submitted on or after July 1, 2009.
  487         2.(b) The summary description of the each program’s
  488  compliance as submitted under subsection (4) paragraph (2)(c).
  489         (c) A comprehensive list of each practical and professional
  490  nursing program in the state.
  491         3.(d) The program’s accreditation status for each program,
  492  including identification of the accrediting agency if such
  493  agency is not an accrediting agency described in s. 464.003(1)
  494  body.
  495         4.(e)The Each program’s approval or probationary status.
  496         5.(f)The Each program’s graduate passage rates for the
  497  most recent 2 calendar years rate on the National Council of
  498  State Boards of Nursing Licensing Examination.
  499         (g) The national average for passage rates on the National
  500  Council of State Boards of Nursing Licensing Examination.
  501         6.(h) Each program’s retention rates for students tracked
  502  from program entry to graduation.
  503         (c) The average passage rates for United States educated
  504  first-time test takers on the National Council of State Boards
  505  of Nursing Licensing Examination for the most recent 2 calendar
  506  years, as calculated by the contract testing service of the
  507  National Council of State Boards of Nursing. The average passage
  508  rates shall be published separately for each type of comparable
  509  degree program listed in sub-subparagraphs (6)(a)1.a.-c.
  510  
  511  The information data required to be published under this
  512  subsection shall be made available in a manner that allows
  513  interactive searches and comparisons of individual specific
  514  nursing education programs selected by the website user. The
  515  board shall publish the data by December 31, 2009, and update
  516  the Internet website at least quarterly with the available
  517  information data.
  518         (6)(5)ACCOUNTABILITY.—
  519         (a)1. An approved program must achieve a graduate passage
  520  rate that is not lower than 10 percentage points less than the
  521  average passage rate for graduates of comparable degree programs
  522  who are United States educated first-time test takers on the
  523  National Council of State Boards of Nursing Licensing
  524  Examination during a calendar year, as calculated by the
  525  contract testing service of the National Council of State Boards
  526  of Nursing. For purposes of this subparagraph, an approved
  527  program is comparable to all degree programs of the same program
  528  type from among the following program types:
  529         a. Professional nursing education programs that terminate
  530  in an associate degree.
  531         b. Professional nursing education programs that terminate
  532  in a bachelor’s degree.
  533         c. Practical nursing education programs that terminate in a
  534  certificate.
  535         2. Beginning with graduate passage rates for calendar year
  536  2010, if an approved a professional or practical nursing
  537  program’s average graduate passage rates do not equal or exceed
  538  the required passage rates rate for first-time test takers on
  539  the National Council of State Boards of Nursing Licensing
  540  Examination falls 10 percent or more below the national average
  541  passage rate for first-time test takers educated in the United
  542  States, as annually published by the contract testing service of
  543  the National Council of State Boards of Nursing, for 2
  544  consecutive calendar years, the board shall place the program on
  545  probationary status pursuant to chapter 120 probation and the
  546  program director must shall be required to appear before the
  547  board to present a plan for remediation. The program shall
  548  remain on probationary status until it achieves a compliance
  549  with the graduate passage rate that equals or exceeds the
  550  required passage rate for any one calendar year.
  551         3. Upon the program’s achievement of a graduate passage
  552  rate that equals or exceeds the required passage rate,
  553  requirement and shall be terminated by the board, at its next
  554  regularly scheduled meeting following release of the program’s
  555  graduate passage rate by the National Council of State Boards of
  556  Nursing, shall remove the program’s probationary status.
  557  However, under paragraph (d) if the program, during the 2
  558  calendar years following its placement on probationary status,
  559  does not achieve the required passage rate for any one
  560  compliance within 2 calendar year, the board shall terminate the
  561  program pursuant to chapter 120 years.
  562         (b) If an approved a program fails to submit the annual
  563  report required in subsection (4) (2), the board shall notify
  564  the program director and president or chief executive officer of
  565  the educational institution in writing within 15 days after the
  566  due date of the annual report. The program director must appear
  567  before the board at the board’s next regularly scheduled meeting
  568  to explain the reason for the delay place the program on
  569  probation. The board program shall terminate the program
  570  pursuant to chapter 120 remain on probationary status until it
  571  submits the annual report and shall be terminated by the board
  572  under paragraph (d) if it does not submit the annual report
  573  within 6 months after the report’s due date.
  574         (c) An approved A program placed on probationary status
  575  shall disclose its probationary status in writing to the
  576  program’s students and applicants.
  577         (d) The board shall terminate a program that fails to
  578  comply with subparagraph (2)(a)2., paragraph (a), or paragraph
  579  (b) pursuant to chapter 120.
  580         (7) DISCLOSURE OF GRADUATE PASSAGE RATE DATA.—
  581         (a) For each of an approved program’s or accredited
  582  program’s graduates included in the calculation of the program’s
  583  graduate passage rate, the department shall disclose to the
  584  program director, upon his or her written request, the name,
  585  examination date, and determination of whether each graduate
  586  passed or failed the National Council for State Boards of
  587  Nursing Licensing Examination, to the extent that such
  588  information is provided to the department by the contract
  589  testing service of the National Council for State Boards of
  590  Nursing. The written request must specify the calendar years for
  591  which the information is requested.
  592         (b) A program director to whom confidential information
  593  exempt from public disclosure pursuant to s. 456.014 is
  594  disclosed under this subsection must maintain the
  595  confidentiality of the information and is subject to the same
  596  penalties provided in s. 456.082 for department employees who
  597  unlawfully disclose confidential information.
  598         (8)(6)PROGRAM CLOSURE.—Each approved program and
  599  accredited a nursing program conducted in the state that closes
  600  shall notify the board in writing and advise the board of the
  601  arrangements for storage of permanent records.
  602         (9)(7)RULEMAKING.—The board does not have any rulemaking
  603  authority to administer this section, except that the board
  604  shall adopt a rule that prescribes the format for submitting
  605  program applications under subsection (1) and annual reports
  606  submitting summary descriptions of program compliance under
  607  subsection (4) paragraph (2)(c). The board may not impose any
  608  condition or requirement on an educational institution
  609  submitting a program application, an approved program, or an
  610  accredited program, a program on probationary status except as
  611  expressly provided in this section. The board shall repeal all
  612  rules, or portions thereof, in existence on July 1, 2009, that
  613  are inconsistent with this subsection.
  614         (10) APPLICABILITY.—Subsections (1)-(4), paragraph (5)(b),
  615  and subsection (6) do not apply to an accredited program. An
  616  accredited program on probationary status before July 1, 2010,
  617  ceases to be subject to the probationary status. If an
  618  accredited program ceases to be accredited, the program may
  619  apply under this section to become an approved program.
  620         (8) The Florida Center for Nursing and the Office of
  621  Program Policy Analysis and Government Accountability shall
  622  each:
  623         (a) Monitor the administration of this section and evaluate
  624  the effectiveness of this section in achieving quality nursing
  625  programs with a higher production of quality nursing graduates.
  626         (b) Report its findings and make recommendations, if
  627  warranted, to improve the effectiveness of this section to the
  628  Governor, the President of the Senate, and the Speaker of the
  629  House of Representatives by February 1, 2010.
  630         (11)(9)IMPLEMENTATION STUDY.—The Florida Center for
  631  Nursing and the education policy area of the Office of Program
  632  Policy Analysis and Government Accountability shall study the 5
  633  year administration of this section and submit reports to the
  634  Governor, the President of the Senate, and the Speaker of the
  635  House of Representatives by January 30, 2011, and annually
  636  thereafter through January 30, 2015. The annual reports shall
  637  address the previous academic year; set forth data on the
  638  measures specified in paragraphs (a) and (b) for each
  639  prelicensure practical and professional nursing program in the
  640  state, as such data becomes available; and include an evaluation
  641  of such data for purposes of determining whether this section is
  642  increasing the availability of nursing education programs and
  643  the production of quality nurses. The department and each
  644  approved program or accredited program shall comply with
  645  requests for data from the Florida Center for Nursing and the
  646  education policy area of the Office of Program Policy Analysis
  647  and Government Accountability.
  648         (a) The education policy area of the Office of Program
  649  Policy Analysis and Government Accountability shall evaluate
  650  program-specific data for each approved program and accredited
  651  program conducted in the state, including, but not limited to:
  652         1. The number of nursing education programs and student
  653  slots available.
  654         2. The number of student applications submitted, the number
  655  of qualified applicants, and the number of students accepted.
  656         3. The number of program graduates.
  657         4. Program retention rates of students tracked from program
  658  entry to graduation.
  659         5. Graduate passage rates on the National Council of State
  660  Boards of Nursing Licensing Examination.
  661         6. The number of graduates who become employed as practical
  662  or professional nurses in the state.
  663         (b) The Florida Center for Nursing shall evaluate the
  664  board’s implementation of the:
  665         1. Program application approval process, including, but not
  666  limited to, the number of program applications submitted under
  667  subsection (1); the number of program applications approved and
  668  denied by the board under subsection (2) subsections (1) and
  669  (3); the number of denials of program applications reviewed
  670  under chapter 120; and a description of the outcomes of those
  671  reviews.
  672         2. Accountability Probation and termination processes,
  673  including, but not limited to, the number of programs placed on
  674  probationary status, the number of approved programs for which
  675  the program director is required to appear before the board
  676  under subsection (6), the number of approved programs terminated
  677  by the board under paragraph (5)(d), the number of terminations
  678  reviewed under chapter 120, and a description of the outcomes of
  679  those reviews.
  680         Section 6. Subsection (4) of section 464.022, Florida
  681  Statutes, is amended to read:
  682         464.022 Exceptions.—No provision of this part shall be
  683  construed to prohibit:
  684         (4) The practice of nursing by graduates of prelicensure
  685  nursing education approved programs listed in s. 464.008(1)(c)
  686  or the equivalent, pending the result of the first licensing
  687  examination for which they are eligible following graduation,
  688  provided they practice under direct supervision of a registered
  689  professional nurse. The board shall by rule define what
  690  constitutes direct supervision.
  691         Section 7. Paragraph (a) of subsection (1) and subsection
  692  (2) of section 458.348, Florida Statutes, are amended to read:
  693         458.348 Formal supervisory relationships, standing orders,
  694  and established protocols; notice; standards.—
  695         (1) NOTICE.—
  696         (a) When a physician enters into a formal supervisory
  697  relationship or standing orders with an emergency medical
  698  technician or paramedic licensed pursuant to s. 401.27, which
  699  relationship or orders contemplate the performance of medical
  700  acts, or when a physician enters into an established protocol
  701  with an advanced registered nurse practitioner, which protocol
  702  contemplates the performance of medical acts identified and
  703  approved by the joint committee pursuant to s. 464.003(2)(3)(d)
  704  or acts set forth in s. 464.012(3) and (4), the physician shall
  705  submit notice to the board. The notice shall contain a statement
  706  in substantially the following form:
  707         I, ...(name and professional license number of
  708  physician)..., of ...(address of physician)... have hereby
  709  entered into a formal supervisory relationship, standing orders,
  710  or an established protocol with ...(number of persons)...
  711  emergency medical technician(s), ...(number of persons)...
  712  paramedic(s), or ...(number of persons)... advanced registered
  713  nurse practitioner(s).
  714         (2) ESTABLISHMENT OF STANDARDS BY JOINT COMMITTEE.—The
  715  joint committee created under s. 464.003(2)(3)(d) shall
  716  determine minimum standards for the content of established
  717  protocols pursuant to which an advanced registered nurse
  718  practitioner may perform medical acts identified and approved by
  719  the joint committee pursuant to s. 464.003(2)(3)(d) or acts set
  720  forth in s. 464.012(3) and (4) and shall determine minimum
  721  standards for supervision of such acts by the physician, unless
  722  the joint committee determines that any act set forth in s.
  723  464.012(3) or (4) is not a medical act. Such standards shall be
  724  based on risk to the patient and acceptable standards of medical
  725  care and shall take into account the special problems of
  726  medically underserved areas. The standards developed by the
  727  joint committee shall be adopted as rules by the Board of
  728  Nursing and the Board of Medicine for purposes of carrying out
  729  their responsibilities pursuant to part I of chapter 464 and
  730  this chapter, respectively, but neither board shall have
  731  disciplinary powers over the licensees of the other board.
  732         Section 8. Paragraph (a) of subsection (1) of section
  733  459.025, Florida Statutes, is amended to read:
  734         459.025 Formal supervisory relationships, standing orders,
  735  and established protocols; notice; standards.—
  736         (1) NOTICE.—
  737         (a) When an osteopathic physician enters into a formal
  738  supervisory relationship or standing orders with an emergency
  739  medical technician or paramedic licensed pursuant to s. 401.27,
  740  which relationship or orders contemplate the performance of
  741  medical acts, or when an osteopathic physician enters into an
  742  established protocol with an advanced registered nurse
  743  practitioner, which protocol contemplates the performance of
  744  medical acts identified and approved by the joint committee
  745  pursuant to s. 464.003(2)(3)(d) or acts set forth in s.
  746  464.012(3) and (4), the osteopathic physician shall submit
  747  notice to the board. The notice must contain a statement in
  748  substantially the following form:
  749         I, ...(name and professional license number of osteopathic
  750  physician)..., of ...(address of osteopathic physician)... have
  751  hereby entered into a formal supervisory relationship, standing
  752  orders, or an established protocol with ...(number of
  753  persons)... emergency medical technician(s), ...(number of
  754  persons)... paramedic(s), or ...(number of persons)... advanced
  755  registered nurse practitioner(s).
  756         Section 9. Paragraph (c) of subsection (3) of section
  757  464.012, Florida Statutes, is amended to read:
  758         464.012 Certification of advanced registered nurse
  759  practitioners; fees.—
  760         (3) An advanced registered nurse practitioner shall perform
  761  those functions authorized in this section within the framework
  762  of an established protocol that is filed with the board upon
  763  biennial license renewal and within 30 days after entering into
  764  a supervisory relationship with a physician or changes to the
  765  protocol. The board shall review the protocol to ensure
  766  compliance with applicable regulatory standards for protocols.
  767  The board shall refer to the department licensees submitting
  768  protocols that are not compliant with the regulatory standards
  769  for protocols. A practitioner currently licensed under chapter
  770  458, chapter 459, or chapter 466 shall maintain supervision for
  771  directing the specific course of medical treatment. Within the
  772  established framework, an advanced registered nurse practitioner
  773  may:
  774         (c) Perform additional functions as may be determined by
  775  rule in accordance with s. 464.003(2)(3)(d).
  776         Section 10. Subsection (2) of section 960.28, Florida
  777  Statutes, is amended to read:
  778         960.28 Payment for victims’ initial forensic physical
  779  examinations.—
  780         (2) The Crime Victims’ Services Office of the department
  781  shall pay for medical expenses connected with an initial
  782  forensic physical examination of a victim of sexual battery as
  783  defined in chapter 794 or a lewd or lascivious offense as
  784  defined in chapter 800. Such payment shall be made regardless of
  785  whether the victim is covered by health or disability insurance
  786  and whether the victim participates in the criminal justice
  787  system or cooperates with law enforcement. The payment shall be
  788  made only out of moneys allocated to the Crime Victims’ Services
  789  Office for the purposes of this section, and the payment may not
  790  exceed $500 with respect to any violation. The department shall
  791  develop and maintain separate protocols for the initial forensic
  792  physical examination of adults and children. Payment under this
  793  section is limited to medical expenses connected with the
  794  initial forensic physical examination, and payment may be made
  795  to a medical provider using an examiner qualified under part I
  796  of chapter 464, excluding s. 464.003(16)(5); chapter 458; or
  797  chapter 459. Payment made to the medical provider by the
  798  department shall be considered by the provider as payment in
  799  full for the initial forensic physical examination associated
  800  with the collection of evidence. The victim may not be required
  801  to pay, directly or indirectly, the cost of an initial forensic
  802  physical examination performed in accordance with this section.
  803         Section 11. This act shall take effect July 1, 2010.

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