Michigan Office of Administrative Hearings and Rules

611 W. Ottawa Street

Lansing, MI 48909

Phone: 517-335-8658 Fax: 517-335-9512

AGENCY REPORT TO THE

JOINT COMMITEE ON ADMNINISTRATIVE RULES (JCAR)

1. AgencyInformation

Agency name:

Licensing and Regulatory Affairs

Division/Bureau/Office:

Bureau of Professional Licensing

Name of person completing this form:

Andria Ditschman

Phone Number of person completing this form:

517-241-9255

E-mail of person completing this form:

ditschmana@michigan.gov

Name of Department Regulatory Affairs Officer reviewing this Form:

Elizabeth Arasim

2. Rule Set Information

ORR assigned rule set number:

2018-33 LR

Title of proposed rule set:

Board of Nursing

3. Purpose for the proposed rules and background:

MCL 24.242 and 24.245

Agency Report to JCAR-Page 2

The purpose of the Board of Nursing Rules is to regulate the prelicensure education, licensure,

specialty certification, licensure renewal, relicensure, continuing education for licensed nurses, and

the nursing professional fund scholarship program. The proposed rules are intended to: add specific

dates to the rules where appropriate; delete an incorrect reference to MCL 333.16186(1) of the code;

clarify how long an applicant has to take and pass the NCLEX exam; clarify the length of time an

applicant has to submit continuing education for relicensure before the application expires; clarify

definitions related to nursing education programs; add a definition for “capstone course”; require a

nursing education program to show it has met the NCLEX scores required by the rules before being

granted full approval; clarify the requirements in a comprehensive self-study report after full approval

of the nursing education program; move the definition of major and minor program changes to the

rule regarding program changes; change the term self-study to final approval report for initial

program approval; allow an accredited program to submit a letter of accreditation or reaccreditation

from an accrediting agency in lieu of a self-study report; designate a permanent change in seats in an

education program as a major program change, and require minor program changes to be evaluated

by the Board instead of the Department; require certain information in a request for a minor program

change; modify the required pass rates in the evaluation of an education program; require a change in

a director of an education program to be submitted to the Board; clarify the educational background

required for non-nurse faculty who teach non-nursing courses that are health related; limit the use of

preceptors; clarify the faculty to student ratio requirements in an education program; require an

education program report and final approval report for evaluation of an education program; add

requirements for suspended education programs; clarify when continuing education must be

completed for relicensure; clarify the type of academic course that is acceptable continuing education;

and clarify the requirements to obtain a scholarship from the nurse professional fund scholarship

program.

4. Summary of proposed rules:

MCL 24.242 and 24.245

Agency Report to JCAR-Page 3

The proposed revisions to the rules will clarify how long an applicant has to take and pass the

NCLEX exam; clarify the length of time an applicant has to submit continuing education for

relicensure before the application expires; clarify definitions related to nursing education programs;

add a definition for “capstone course”; require a nursing education program to show it has met the

NCLEX scores required by the rules before being granted full approval; clarify the requirements in a

comprehensive self-study report after full approval of the nursing education program; amend the

definition of major and minor program changes; rename the term self-study to final approval report

for initial program approval; allow an accredited program to submit a letter of accreditation or

reaccreditation from an accrediting agency in lieu of submitting a self-study report; designate a

permanent change in seats in an education program as a major program change, and require minor

program changes to be evaluated by the Board instead of the Department; require certain information

in a request for a minor program change; modify the required pass rates that can trigger an the

evaluation of an education program; require that a nursing education program notify the Board of a

change in the director of an education program; clarify the educational background required for non-

nurse faculty who teach non-nursing courses that are health related; limit the use of preceptors;

clarify the faculty to student ratio requirements in an education program; allow for an evaluation of a

nursing program to be done when a program fails to submit the required reports in a timely fashion or

fails to apply for full approval in accordance with the rules; add requirements to reactivate a program

that suspended admissions; clarify when continuing education must be completed for relicensure;

clarify the type of academic course that is acceptable continuing education; and clarify the

requirements to obtain a scholarship from the nurse professional fund scholarship program.

5. List names of newspapers in which the notice of public hearing was published and

publication dates:

Marquette Mining Journal – April 30, 2018

Flint Journal – May 5, 2018

Grand Rapids Press – May 5, 2018

6. Date of publication of rules and notice of public hearing in Michigan Register:

5/15/2019

7. Date, time, and location of public hearing:

5/22/2019 09:00 AM at G. Mennen Williams Building Auditorium , 525 W. Ottawa Street, Lansing,

Michigan

8. Provid the link the agency used to post the regulatory impact statment and cost-benefit

analysis on its website:

https://dtmb.state.mi.us/ARS_Public/Transaction/RFRTransaction?TransactionID=34

9. List of the name and title of agency representative(s) attending public hearing:

Andria Ditschman, Senior Policy Analyst; LeAnn Payne, Board Support

10. Persons submitting comments of support:

None.

11. Persons submitting comments of opposition:

MCL 24.242 and 24.245

Agency Report to JCAR-Page 4

Lesley Morgan, PHD, MBA, ARNP, Dean, School of Nursing, Baker College

Carole Stacy, MSN, MA, RN, President, American Nurses Association (ANA)-Michigan and Tobi

Lyon Moore, MBA, Executive Director, ANA-Michigan

James Sullivan

Barbara Wieszciecinski, MSN, RN, Dean of Health Sciences and Director of Nursing Academic

Affairs, Mid Michigan College

12. Identify any changes made to the proposed rules based on comments received during the

public comment period:

Name &

Comments made at Written

Agency Rationale Rule number

Organization public hearing

Comments

for change

& citation

changed

1

Lesley Morgan,

Dean of

Continue with the The Board agrees 338.10305c

current preceptor with the (1)(b)

Nursing, Baker

College

qualifications

which allow an

suggestion to

delete the

associate’s degree requirement that a

of nursing (ADN) preceptor possess

educated nurse

with 5 years of

experience to

precept a

a degree at the

same or higher

level as the

students who are

bachelor’s degree enrolled in the

of nursing (BSN) program, have

student. At Baker demonstrated

College,

competencies that

are appropriate for

the student’s

learning

experience, or

possess at a

especially in

more remote

locations of

Muskegon and

Cadillac, the

majority of the

working

experienced

nurses are

educated at the

ADN level.

Baker College

minimum, an

associate’s degree

or diploma in

nursing, as each

preceptor must be

approved by the

faculty of the

uses a preceptor program, must

model for the possess at least 1

capstone course year of clinical

and there are not nursing

enough available experience, and a

BSN preceptors supervisor

for the BSN

recommendation.

students at these

MCL 24.242 and 24.245

Agency Report to JCAR-Page 5

campuses. Until

Baker College

established the

BSN programs in

these areas 4

years ago there

were only ADN

programs. It is

Baker College’s

hope that as it

continues to

graduate students

that remain in the

community the

number of

available BSN

preceptors will

increase, but at

this time there are

not enough to

support the

preceptor model.

2

Carole Stacy

and Tobi Lyon

Moore, ANA-

Michigan

List verification To clarify the rule, 338.10204(3)

from other

Canadian

the Board agrees (a)

that the rules 338.10204(2)

(c)

provinces along should not

with College of reference only one 338.10210(3)

Nurses of Ontario Canadian College (a)

(CNO) as an

exception to

of Nurses. Since 338.10210(2)

existing R (c)

certification from 338.10208 already 338.10204(4)

the Commission includes (d) and

on Graduates of exemptions from 338.10210(4)

Foreign Nursing CGFNS

(d)

Schools

certification for

338.10207(1)

(CGFNS).

Canadian Colleges (f)

of Nurses, all 338.10301(h)

references to CNO (iv)

will be deleted,

and a reference to 338.10310(d)

existing R

338.10303(c)

338.10208 will be

added to R

Clarify the

process for

338.10204 and R

338.10210.

approval by the

MCL 24.242 and 24.245

Agency Report to JCAR-Page 6

Board for a

review course.

The Board agrees

with the

suggestion to

clarify the Board’s

review course

approval process

and is requiring

the review course

to include NCLEX

subject areas,

NCLEX style

questions,

The rule for

relicensure lacks simulated

evidence to

support the

examinations, and

test taking

effectiveness of a strategies.

skill competency

evaluation. The

focus is on acute The Board agrees

care and the rule with the

does not

suggestion to

encompass the

full range of

clarify the rule to

state: “certification

practice settings. of competency

must cover the

following skills

utilizing nursing

process.” The

certification of

skill competency

is used instead of a

review course, as a

minimal baseline,

As this rule is

written, it is

possible for

students to do

their clinical

experience in

to determine an

applicant’s ability

to return to

practice along

with completing

the required

psychiatric/menta continuing

l health nursing in education.

settings that are

not specific to

psychiatric

The Board agrees

mental health.

The language

with the

suggestion for

MCL 24.242 and 24.245

Agency Report to JCAR-Page 7

should be

consistent with

the other

consistency with

other provisions in

the rule.

specialties and

read “must

consist of the

study of nursing

care for patients

with an acute or

chronic mental

health or

psychiatric

disorder.”

Eliminate the

remainder of the

sentence.

The Board agrees

with the

suggestion to

clarify that a site

visit is required.

Replace the

statement, “the

board may

require a site

visit” with “the

board will require

a site visit” as

initial program

approval should

include a site visit

and written report The Board agrees

by the nurse with the

consultant as part suggestion to

of the application clarify which

process, which is “compiled

consistent with

national

accreditation

guidelines.

statistics” are

acceptable, by

adding the

following to the

rule: “provided

from the National

Clarify the term Council of State

“compiled

statistics”

Boards of

Nursing.”

regarding

NCLEX

examination pass

rates. State the

MCL 24.242 and 24.245

Agency Report to JCAR-Page 8

sources that are

acceptable.

The word

3

James Sullivan

The Board agrees 338.10303a

with the (1)(b)

“report” is

missing, and the suggestion to add

rule does not

the word “report.”

match the

definition in R

338.10301(l). It

should state: “(b)

The sponsoring

agency shall

submit a final

program approval

report to the

board. The report

must provide an

update of the self-

study that was

submitted for

initial approval

pursuant to R

338.10303(b),

review the

program’s

progress since

initial approval

was granted, and

include a review

and evaluation of

program

implementation.”

MCL 24.242 and 24.245

Agency Report to JCAR-Page 9

Clarify how The Board agrees 338.10303c

4

Barbara

Wieszciecinski,

Dean of Health

Services and

Director of

Nursing

Academic

Affairs, Mid

Michigan

classes offered at with the

(1)(f)

a different

location other

than the main

suggestion to

clarify how classes

offered at a

program location different location

are treated in the from the original

rules. Clarify if a educational

separate

educational

program will be

treated in the

College

location requires rules.

additional

reporting,

director support,

budget, director

of nursing,

separate faculty.

Clarify the

definition of a

separate

educational

location: is a

location in a brick

and mortar

building; is it a

location where a

separate cohort

attends a program

or where a

different

educational

program is

offered (LPN vs

RN); and is there

a minimum

distance between

locations to

qualify for a

separate

educational

location.

13.Date Report Completed:

11/14/2019

MCL 24.242 and 24.245