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NEW JERSEY REGISTER
VOLUME 36, NUMBER 10
MONDAY, MAY 17, 2004
RULE PROPOSAL

LAW AND PUBLIC SAFETY
DIVISION OF CONSUMER AFFAIRS
STATE BOARD OF NURSING
PROVISIONAL ACCREDITATION; CONDITIONAL ACCREDITATION: LICENSING EXAMINATION
PASS RATES; CONDITIONAL ACCREDITATION: SUBCHAPTER REQUIREMENTS; PROBATION


Proposed Repeals: N.J.A.C. 13:37-1.17 and 1.18

Proposed Amendment: N.J.A.C. 13:37-1.3

Reproposed New Rules: N.J.A.C. 13:37-1.17, 1.18 and 1.19

Authorized By: State Board of Nursing, George Hebert, Acting Executive Director.

Authority: N.J.S.A. 45:11-24.
Calendar Reference: See Summary below for explanation of exception to calendar requirement.
Proposal Number: PRN 2004-208.

Submit comments by July 16, 2004 to:

George Hebert, Acting Executive Director

State Board of Nursing

Post Office Box 45010

Newark, New Jersey 07101

The agency proposal follows:

Summary

Pursuant to its rulemaking authority in N.J.S.A. 45:11-24, the New Jersey Board of Nursing (the "Board") proposes to amend N.J.A.C. 13:37-1.3, repeal the current rules N.J.A.C. 13:37-1.17 and 1.18 and reproposes new rules N.J.A.C. 13:37-1.17, 1.18 and 1.19 in order to establish standards for placing nursing programs on conditional accreditation and probation.

The Board proposed new standards for all nursing programs on April 1, 2002 at 34 N.J.R. 1317(a). Those standards included revised procedures for placing a nursing program on conditional accreditation and probation. The proposed conditional accreditation standards required the Board to place a program on conditional accreditation if, averaged over three years, a program had less than 80 percent of students pass the licensing examination, or if a program failed to meet the requirements of Subchapter 1 of N.J.A.C. 13:37. The probation standards proposed would have required the Board to place a program on probation if it did not improve its licensing examination pass rate or if it failed to correct deficiencies that left it in violation of Subchapter 1. The Board received many comments regarding the new standards for conditional accreditation and probation. In reviewing these comments, the Board was alerted to the difficulties inherent in the standards as proposed. The commenters were concerned that the Board's proposed standards could mean that one year of lowered licensing examination pass rates could adversely affect a nursing program and culminate in the program being placed on conditional accreditation. The Board decided not to adopt the proposed rules on conditional accreditation and probation and to refer this matter to the Board's Regulatory Review Committee, April 21, 2003 at 35 N.J.R. 1678(a). The Committee, after its review, decided that it was appropriate to require that a specific amount of graduates from nursing programs pass the licensing examination the first time they take it. The Committee agreed, however, that it was inappropriate to consider a program's pass rate averaged over three years when determining if a program should be placed on conditional accreditation or probation. The Committee decided to rewrite this requirement so that programs would be placed on conditional accreditation if they do not achieve the specific pass rate for three successive years. The Committee also decided that the pass rate should be amended to 75 percent from 80 percent, which is similar to the requirements in other states. The existing rule places a program on conditional accreditation if the program fails to meet Board accreditation standards or if less than 80 percent of graduates pass the licensing examination. The unadopted amendments to this rule would have placed a program on conditional accreditation if the program failed to meet Board accreditation standards or if a program had, averaged over a three-year period, a pass rate of less than 80 percent. The reproposed amendments will place a program on conditional accreditation if it does not comply with Board accreditation standards or if, for three successive years, it has a pass rate of less than 75 percent. This proposal reproposes these new standards for conditional accreditation and probation.

The Board proposes to amend N.J.A.C. 13:37-1.3 to reflect changes that are proposed for conditional accreditation and probation. N.J.A.C. 13:37-1.3 deals with provisional accreditation of new nursing programs. The Board proposes to require new programs to obtain a 75 percent pass rate on the licensing examination for students in the first or second graduating class. The Board proposes to clarify that the pass rates are measured for those students who are taking the licensing examination for the first time.

The Board proposes to repeal the existing N.J.A.C. 13:37-1.17 and proposes a new rule in its place. Reproposed new N.J.A.C. 13:37-1.17 sets forth standards for placing a nursing program on conditional accreditation when the program does not meet the Board's requirements for passing rates on the licensing examination. Reproposed new N.J.A.C. 13:37-1.17(a) provides that a program shall be placed on conditional accreditation if it has, for three successive years, less than 75 percent of its graduating students pass the licensing examination the first time. Conditional accreditation will become effective upon the program's receipt of written notification from the Board. Reproposed new N.J.A.C. 13:37-1.17(b) allows a program to request an appearance before the Board regarding its placement on conditional accreditation status. A request for an appearance must be made within 30 days of receipt of written notification. Reproposed new N.J.A.C. 13:37-1.17(c) requires a program to notify its students that it has been placed on conditional accreditation status within 30 days of receiving written notification. Reproposed new N.J.A.C. 13:37-1.17(d) requires a program placed on conditional accreditation to submit an 18-month action plan to the Board within 90 days of receiving written notification. The action plan must have a time-line and measurable outcomes to correct deficiencies. One of the outcomes which must be contained in the action plan requires that within the next calendar year at least 75 percent of students who take the licensing examination successfully pass the first time they take it. Reproposed new N.J.A.C. 13:37-1.17(e) allows a program on conditional accreditation to request an extension of the 18-month time period imposed by subsection (d). A request for extension must set forth the reasons why the program needs such an extension. Reproposed new N.J.A.C. 13:37-1.17(f) states that a program that has met the outcomes of its action plan shall be restored to accreditation status. Reproposed new N.J.A.C. 13:37-1.17(g) provides that the eligibility of students to sit for the licensing examination is not affected if a program is placed on conditional accreditation.

Reproposed N.J.A.C. 13:37-1.18 is a new rule. This rule sets forth standards for placing a nursing program on conditional accreditation when the program does not meet the requirements of Subchapter 1 of N.J.A.C. 13:37. These standards are substantially similar to the ones the Board will follow pursuant to N.J.A.C. 13:37-1.17. Reproposed new N.J.A.C. 13:37-1.18(a) states that, if the Board receives information that alleges that a program is not meeting the requirements of Subchapter 1 of N.J.A.C. 13:37, other than N.J.A.C. 13:37-1.17, the Board shall evaluate the information and may send a representative to investigate the program. This rule clarifies that violations of N.J.A.C. 13:37-1.17 will not result in an investigation by the Board pursuant to N.J.A.C. 13:37-1.18. Violations of N.J.A.C. 13:37-1.17 will result in a program automatically being placed on conditional accreditation. Reproposed new N.J.A.C. 13:37-1.18(b) states that, if the Board determines that a program does not comply with the requirements of Subchapter 1 of N.J.A.C. 13:37, the Board shall place the program on conditional accreditation. Conditional accreditation is effective upon receipt of written notification. Reproposed new N.J.A.C. 13:37-1.18(c) allows a program to request an appearance before the Board regarding its conditional accreditation status. Any request must be made within 30 days of receipt of written notification. Reproposed new N.J.A.C. 13:37-1.18(d) requires a program to notify its students in writing that it has been placed on conditional accreditation status within 30 of receiving written notification. Reproposed new N.J.A.C. 13:37-1.18(e) requires a program placed on conditional accreditation to submit an 18-month action plan to the Board within 90 days of receiving written notification. The action plan must incorporate a time-line and measurable outcomes to correct deficiencies. Reproposed new N.J.A.C. 13:37-1.18(f) allows a program on conditional accreditation to request an extension of the 18-month time period imposed by subsection (e). Such a request has to set forth the reasons why the program needs an extension. Reproposed new N.J.A.C. 13:37-1.18(g) states that a program that has met the outcomes of its action plan shall be restored to accreditation status. Subsection (h) provides that the eligibility of students to sit for the licensing examination is not affected if a program is placed on conditional accreditation.

The Board proposes to repeal the existing rule at N.J.A.C. 13:37-1.18 and proposes a new rule at N.J.A.C. 13:37-1.19 in its place. Reproposed new N.J.A.C. 13:37-1.19 sets forth standards for placing a program on probation. A program can only be placed on probation if it is on conditional accreditation and does not meet the requirements of N.J.A.C. 13:37-1.17 or 1.18. Reproposed new N.J.A.C. 13:37-1.19(a) states that a program on conditional accreditation that does not achieve the outcomes identified in its action plan will be placed on probation. A program placed on probation may request an appearance before the Board. Reproposed new N.J.A.C. 13:37-1.19(b) requires a nursing program on probation to notify its students within 30 days of receiving notification. Reproposed new N.J.A.C. 13:37-1.19(c) prohibits a program on probation from admitting new students. This prohibition is the major difference between being on conditional accreditation and being on probation. Reproposed new N.J.A.C. 13:37-1.19(d) requires a nursing program on probation to revise its action plan with outcomes to be achieved within 12 months and to submit the plan to the Board. The action plan for a program that is on probation due to licensing examination pass rates must include as an outcome that at least 75 percent of the program's next graduating class pass the licensing examination. Reproposed new N.J.A.C. 13:37-1.19(e) allows a program to request an extension of the 12-month deadline for accomplishing its action plan outcomes. Reproposed new N.J.A.C. 13:37-1.19(f) states that a program that does not achieve the outcomes of its action plan will not be eligible for restoration of accreditation but may continue operating until the last student has left the program. The program shall lose its accreditation once the last student has left. A program that has lost accreditation may reapply for accreditation pursuant to N.J.A.C. 13:37-1.2. Reproposed new N.J.A.C. 13:37-1.19(g) states that the eligibility of students to sit for the licensing examination will not be affected if a program is placed on probation.

The Board has determined that the comment period for this proposal shall be 60 days; therefore, pursuant to N.J.A.C. 1:30-3.3(a)5, this proposal is excepted from the rulemaking calendar requirement.

Social Impact

The proposed amendment, repeals and new rules will impact nursing schools and nursing students within the State. A nursing school that does not meet the Board's required pass rate on the licensing examination or that do not meet the requirements of Subchapter 1 of N.J.A.C. 13:37 will be placed on conditional accreditation. If such programs do not correct their deficiencies, they will be placed on probation and may lose accreditation all together. The proposed amendment, repeals and new rules will affect students in that they are intended to ensure that nursing programs will effectively prepare their students for practice as licensed nurses.

Economic Impact

The proposed amendment, repeals and new rules will economically impact nursing programs that are placed on conditional accreditation or probation. Such programs are required to notify their students that they have been placed on conditional accreditation or probation. Notification of this status could negatively impact a nursing program should students seek to transfer to other programs. Programs placed on conditional accreditation or probation are also required to submit an action plan to the Board with outcomes that address the programs' deficiencies. The cost of notifying students and preparing action plans will be borne by the nursing schools. The proposed amendment, repeals and new rules will impose an economic impact on programs placed on probation as these programs will not be allowed to admit new students. With the admission of new students to the nursing program prohibited, income in the form or tuition will be diminished. The proposed amendment, repeals and new rules will also have an economic impact on those programs whose accreditation has been revoked in that such programs will be forced to close, which will impact the educational institutions under which the programs exist as they will lose the revenue from these programs.

Federal Standards Statement

A Federal standards analysis is not required because there are no Federal laws or standards applicable to the proposed amendment, repeals and new rules.

Jobs Impact

The Board believes that the proposed amendment, repeals and new rules may impact jobs in the State. A program that has been placed on probation and which does not meet the requirements of N.J.A.C. 13:37-1.19 will have its accreditation revoked. Employees of the nursing program may lose their jobs if the nursing program loses its accreditation.

Agriculture Industry Impact

The Board does not believe that the proposed amendment, repeals and new rules will have any impact on the agriculture industry of this State.

Regulatory Flexibility Analysis

If, for the purposes of the Regulatory Flexibility Act, N.J.S.A. 52:14B-16 et seq., the approximately 70 nursing programs that instruct student nurses are deemed "small businesses," then the following analysis applies.

The Act requires the Board to set forth the reporting, recordkeeping and other compliance requirements of the proposal, including the kinds of professional services likely to be needed to comply with the requirements. The Act further requires the Board to estimate the initial and annual compliance costs of the proposal with an indication of the varying impact on small businesses of differing types and sizes and to outline the manner in which the rules have been designed to minimize any adverse economic impact upon small businesses.

The costs imposed on small businesses by the proposed amendment, repeals and new rules are the same costs that are imposed on all businesses as outlined in the Economic Impact statement above.

Nursing programs that have been placed on conditional accreditation status or probation may wish to employ a consultant for assistance in drafting the action plans required by N.J.A.C. 13:37-1.17(d), 1.18(e) and 1.19(d). The Board does not believe that nursing programs will need to employ any other professional services to comply with the requirements of the proposed amendment, repeals and new rules.

The proposed amendment, repeals and new rules impose several compliance requirements on nursing programs. A program that is placed on conditional accreditation is required to notify its students that it has been placed on conditional accreditation and to submit an action plan to the Board. A program that is placed on probation is also required to notify its students and submit an action plan to the Board. A program that has had its accreditation revoked is required to continue operation until its last student has graduated or otherwise left the program.

The proposed amendment and new rules do not impose any recordkeeping or reporting requirements.

The Board believes that since the proposed amendment, repeals and new rules provide for the health, safety and welfare of the public by ensuring that nursing programs effectively educate nurses, the reproposed rules should be applied uniformly to all nursing programs irrespective of their size.

Smart Growth Impact

The Board does not anticipate that the proposed amendment, repeals and new rules will have any impact on the achievement of smart growth and implementation of the State Development and Redevelopment Plan, otherwise known as the State Plan.

Full text of the proposal follows :

<< NJ ADC 13:37-1.3 >>

13:37-1.3 Provisional accreditation

(a) (No change.)

(b) A nursing program that has been granted provisional accreditation shall not be granted accreditation until:

1. (No change.)

2. <<-Eighty->> <<+Seventy-five+>> percent of students from the first <<+or second+>> graduating class, who have taken the licensing examination, pass the <<-first time they take it->> <<+examination the first time it is taken by the student+>>; and

3. (No change.)

(c)-(f) (No change.)

<< NJ ADC 13:37-1.17 >>

13:37-1.17 Conditional accreditation<<+: licensing examination pass rates+>>

<<-(a) The Board shall place an accredited program on conditional accreditation if:->>

<<-1. The program fails to meet or maintain the standards and requirements for accreditation contained in this subchapter; or->>

<<-2. Less than 80 percent of its graduates achieve passing grades in the licensing examination.->>

<<-(b) The Board may limit the number of students enrolled in a program placed on conditional accreditation. The institution shall be given the opportunity for a hearing to appeal this decision.->>

<<-(c) The program shall be notified by letter of conditional accreditation by the Board including any conditions which must be corrected within a specific time period established by the Board.->>

<<-(d) The Board may, upon request, remove a program from conditional accreditation if it can be demonstrated that the standards and requirements contained in this subchapter have been met.->>

<<+(a) If, for three successive years, less than 75 percent of a nursing program's graduating students pass the licensing examination the first time the examination is taken, the Board shall place the program on conditional accreditation. Conditional accreditation shall become effective upon the program's receipt of the written notification.+>>

<<+(b) The nursing program may, within 30 days of receiving written notification that the program has been placed on conditional accreditation, request in writing an appearance before the Board regarding its conditional accreditation status.+>>

<<+(c) Within 30 days of receiving written notification that the nursing program has been placed on conditional accreditation, the nursing program shall notify in writing the students enrolled in the program that the program has been placed on conditional accreditation.+>>

<<+(d) A nursing program that is placed on conditional accreditation shall submit to the Board, within 90 days of receiving written notification of being placed on conditional accreditation, an 18-month action plan with a time-line and measurable outcomes to correct any deficiencies. The outcomes identified in the action plan shall include that within the next calendar year at least 75 percent of its students who take the licensing examination shall pass the first time. The outcomes shall be met within 18 months.+>>

<<+(e) A nursing program on conditional accreditation which believes that it cannot accomplish its outcomes within 18 months may request an extension of the 18-month time period from the Board. A request for an extension shall set forth the reasons why the program needs an extension.+>>

<<+(f) If the outcomes of the action plan are met within the 18-month period, the program shall be restored to accreditation status.+>>

<<+(g) The eligibility of students to sit for the licensing examination shall not be affected in the event a program is placed on conditional accreditation.+>>

<< NJ ADC 13:37-1.18 >>

<<+13:37-1.18 Conditional accreditation: subchapter requirements+>>

<<+(a) If the Board receives information alleging that a program fails to meet the requirements of this subchapter, other than N.J.A.C. 13:37-1.17, the Board shall evaluate the information and may send a field representative to investigate the program. The Board representative shall evaluate the program for compliance with this subchapter and report the results of the program evaluation to the Board.+>>

<<+(b) If the Board determines that the nursing program does not comply with the provisions of this subchapter, the Board shall place the program on conditional accreditation. Conditional accreditation shall become effective upon the program's receipt of the written notification.+>>

<<+(c) The nursing program may, within 30 days of receiving written notification that the program has been placed on conditional accreditation, request in writing an appearance before the Board regarding its conditional accreditation status.+>>

<<+(d) Within 30 days of receiving written notification that the nursing program has been placed on conditional accreditation, the nursing program shall notify in writing the students enrolled in the program that the program has been placed on conditional accreditation.+>>

<<+(e) A nursing program that is placed on conditional accreditation shall submit to the Board, within 90 days of receiving written notification of being placed on conditional accreditation, an 18-month action plan with a time-line and measurable outcomes to correct any deficiencies. The outcomes identified in the action plan shall be met within 18 months.+>>

<<+(f) A nursing program on conditional accreditation which believes that it cannot accomplish its outcomes within 18 months may request an extension of the 18-month time period from the Board. A request for an extension shall set forth the reasons why the program needs an extension.+>>

<<+(g) If the outcomes of the action plan are met within the 18-month period, the program shall be restored to accreditation status.+>>

<<+(h) The eligibility of students to sit for the licensing examination shall not be affected in the event a program is placed on conditional accreditation.+>>

<< NJ ADC 13:37-1.18 >>

<< NJ ADC 13:37-1.19 >>

13:37-<<-1.18->><<+1.19+>> Probation

<<-A program may be placed on probation when its graduates fail to achieve 80 percent passing on the licensing examinations for two consecutive years. A program placed on probation shall not admit new or transfer students into the program. The institution shall be given the opportunity for a hearing to appeal this decision.->>

<<+(a) A nursing program on conditional accreditation status that does not achieve the outcomes identified in the action plan required by N.J.A.C. 13:37-1.17(d) or 1.18(e) in 18 months, or which has not been granted an extension pursuant to N.J.A.C. 13:37-1.17(e) or 1.18(f), shall be placed on probation. A nursing program that has been granted an extension shall be placed on probation if it does not achieve the outcomes identified in the action plan by the end of the extension. A nursing program that is placed on probation may request in writing an appearance before the Board.+>>

<<+(b) The nursing program shall, within 30 days of receiving written notification that it has been placed on probation, notify the students enrolled in the program in writing that the program is on probation.+>>

<<+(c) A program on probation shall not admit new students or transfer students.+>>

<<+(d) A nursing program that is placed on probation shall revise the action plan with outcomes to be achieved in one calendar year and submit the action plan to the Board. If a program is placed on probation due to N.J.A.C. 13:37-1.17, the program action plan outcomes shall include that within the next calendar year at least 75 percent of its students who take the licensing examination shall pass the first time.+>>

<<+(e) A program on probation which believes that it cannot accomplish its outcomes within one calendar year may request an extension of the one-year time period from the Board. A request for an extension shall set forth the reasons why the program needs an extension.+>>

<<+(f) A program that does not achieve the outcomes identified in the action plan within one calendar year, and which has not been granted an extension pursuant to (e) above, shall not be eligible for restoration to accredited status. A program that has been granted an extension and does not achieve the outcomes identified in the action plan by the end of the extension shall not be eligible for restoration to accredited status. A program that is not eligible for restoration of accredited status shall continue to operate under probationary status until the last student has graduated or has otherwise left the program. Once the last student has graduated or has otherwise left the program, the program shall no longer be accredited. A program that is no longer accredited may reapply for accreditation pursuant to N.J.A.C. 13:37- 1.2.+>>

<<+(g) The eligibility of students to sit for the licensing examination shall not be affected in the event a program is placed on probation.+>>

<< NJ ADC 13:37-1.19 >>

<< NJ ADC 13:37-1.20 >>

13:37-<<-1.19->><<+1.20+>> (No change in text.)

 

  

  

  

  

  

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