December 17, 2002
LICENSURE OF NURSES FROM PUERTO RICO
By: Saul Spigel, Chief Analyst
You asked how a nurse licensed in Puerto Rico can become licensed in Connecticut. You also asked for a summary of a 2002 Florida law on this issue (House Bill 519, ch. 2002-230, copy attached).
Nurses licensed in Puerto Rico (or any other U.S. territory or state) are eligible for “license by endorsement” in Connecticut if they have taken and passed the National Clinical Licensure Exam, commonly known as the NCLEX. License by endorsement means that Connecticut recognizes that the nurse's home state or territory has licensing standards that are substantially the same as ours.
Puerto Rico licenses nurses who have passed its own Nursing Board of Examiners' exam, which is given in Spanish, or the NCLEX, which is given in English. Candidates for a nurse's license in Puerto Rico may, but do not have to, take and pass the NCLEX exam, but they must in Connecticut. Consequently, if a nurse with a license in Puerto Rico has passed only the commonwealth's Spanish-language test, he or she must pass the NCLEX to be licensed here.
The Department of Public Health is responsible for licensing registered and practical nurses in Connecticut. You can obtain a copy of the license application and other information at its website http://www.dph.state.ct.us/Licensure/licensure.htm. The National Council of State Boards of Nursing is responsible for the NCLEX. You can get information on the exam at NCLEX Candidate Bulletin.
Florida's new law opens up licensure by endorsement to registered and practical nurses who (1) hold a valid license from a U.S. territory (e.g., Puerto Rico, Virgin Islands, Guam) or (2) if they do not hold a current license, have actively practiced nursing in a territory or another state for two of the past three years without sanction by the jurisdiction's licensing authority. The latter option sunsets on July 1, 2004, unless the legislature reinstates it. The new law also provides grants to school districts for nursing exploration and career education programs, provides incentives for health care professionals to volunteer in schools, and revises the state's nursing scholarship and loan forgiveness programs and the criteria for approving nursing schools.
FLORIDA ACT 230
Florida Act 230 (2002, House Bill 519) addresses the state's nursing shortage in a variety of ways, including broadening its license by endorsement law. It also provides grants to school districts for middle school nursing exploration and high school nursing career and technical education programs; provides incentives for health care professionals to volunteer in public schools; and revises the nursing loan forgiveness and scholarship programs and the criteria for approving nursing schools.
License by Endorsement
Act 230 opens up licensure by endorsement to registered and practical nurses who (1) hold a valid license from a U.S. territory (e.g., Puerto Rico, Virgin Islands, Guam) or (2) if they do not hold a current license, have actively practiced nursing in a territory or another state for two of the past three years without sanction by the territory's or state's licensing authority. In the former case, the territory's license standards must be equal to, or more stringent than, Florida's. Florida requires nurses to pass the NCLEX to receive a license. The act presumes all territories' standards are substantially equivalent to Florida's, but it allows the state Nursing Board to specify territories that are not equivalent.
The act allows nurses who have practiced nursing in another state or territory for two of the previous three years to be licensed by endorsement if no action has been taken against their license during that time. Nurses licensed under this provision must complete a Nursing Board-approved course on Florida nursing laws and rules within six months of receiving their license. They must also undergo a national criminal history check.
The act also allows nurses licensed in a territory to work for up 60 days after applying for a license. The nursing board can extend this time for administrative purposes as necessary (Act 230, §§ 5 and 8).
Nursing Education Programs in Public Schools
The act creates a competitive Sunshine Workforce Solutions Grant program for school districts to establish a (1) middle school nursing exploration programs or (2) high school comprehensive career and technical education program. The latter must include work-based experiences and must be certified or endorsed by the state Nursing Board as appropriate for preparing students for further nursing education. Schools may use grant funds for personnel, instructional and laboratory equipment, supplies, student services, and other costs associated with developing the program (Act 230, § 4).
Incentives for Health Care Volunteers in Schools
The act creates two incentives for health care providers who volunteer in public schools' health services programs. It waives their biennial licensing fee, and it makes their volunteer hours count for 25% of the continuing education hours required for license renewal. The school district must pick up any increase in volunteers' liability insurance premiums. Providers in active practice must volunteer at least 80 hours a year; retired providers for at least 400 hours a year to be eligible. The act applies to physicians; osteopaths; chiropractors; podiatrists; optometrists; registered, licensed, and advanced practice nurses; dentists and dental hygienists; speech and physical therapists, and audiologists (Act 230, § 9)
Nursing Scholarships and Loans
The act removes the penalty that nurses receiving state scholarships faced if they failed to accept a job at an approved facility or failed to work for 12 months for each year of scholarship aid they received. Previously, they had to pay back twice the amount of their scholarship plus interest. Under the act, they have to repay only the scholarship amount, plus 18% interest (Act 230 § 3).
The act also specifies that students receiving state scholarships are not eligible for state student loan repayments, which can total up to $4,000 a year for four years (Act 230 § 2).
Nursing Education Programs
The state Nursing Board is responsible for approving nursing education programs. The act makes several revisions in the law governing its approvals. These include requiring the board to exempt any program that is accredited by another nursing accreditation body recognized by the U.S. Department of Education from its rules on educational objectives, faculty qualifications, curriculum, and clinical training. But the exemption applies only if the program's graduates' pass rate on the NCLEX is no more than 10 percentage points less than the national average (that is, if the national average pass rate is 80%, the program's rate is at least 70%). The board must review any program whose pass rate falls below this standard for two consecutive years.