Senate committee advances bill to tighten nursing-education standards, require exit exams and remediation

Senators on the Committee on Health Policy voted to report Senate Bill 526 favorably after adopting an amendment that returns the probation period for struggling nursing programs to two years.

The bill, sponsored by Senator K. Harrell, would require practical nursing and registered nursing programs to establish admission criteria, administer an exit exam prior to NCLEX testing, provide remediation for students who fail the exit exam, and permit the Department of Health to conduct on-site inspections. It also directs the Board of Nursing to deny program approval for programs that have had adverse actions in other jurisdictions and authorizes discipline of a nursing program director for certain failures.

Supporters said the measures are intended to increase passage rates on the National Council Licensure Examination (NCLEX), the required exam for nursing licensure in the United States. "For the last 10 years we have had terrible scores," Harrell said, noting Florida ranked near the bottom on NCLEX pass rates. Harrell said the bill is designed to prevent students from graduating from programs that do not prepare them to pass the national exam.

Committee members pressed the sponsor on access concerns. Senator Berman asked whether denying applications from programs with out-of-state adverse actions could reduce training availability in underserved areas. Harrell replied that the Board of Nursing could consider extenuating circumstances and that the bill is intended to bar "fly-by-night" operators who previously obtained approvals after adverse actions elsewhere.

Testimony from the sector included Bob Harris of the Florida Association of Independent Nursing Schools, who said private postsecondary schools educate many nontraditional students and warned the bill as drafted could close programs that serve those students. Harris said private schools account for a large share of nursing enrollments and urged language that requires remediation but avoids unintended closures. Tamisha Scott, a small private-school owner, described working closely with individual students and said private programs fill gaps for nontraditional learners.

The committee adopted a late-filed amendment (barcode 538,912) that restores a two-year probation period for programs falling below the statute's performance threshold. The bill as amended also removes the Board of Nursing's previously authorized extension power for accreditation timelines and clarifies termination and reporting obligations.

The roll call on Senate Bill 526 as amended was unanimous in committee. The committee recorded all yes votes and the bill was reported favorably to the next stage.

Implementation steps in the bill assign inspection authority to the Department of Health and enforcement and discipline functions to the Board of Nursing. The sponsor said she is open to additional changes, such as incentives or preceptorships, to encourage timely NCLEX exam-taking and early employment after graduation.