0168-sb 0416

AN ACT relative to licensure of dietitians.

SPONSORS: Sen. D'Allesandro, Dist 20; Sen. Brown, Dist 17; Sen. Trombly, Dist 7; Rep. O'Neil, Rock 22; Rep. Burkush, Hills 45

I. Establishes a board of licensed dietitians and gives the board certain powers and duties relative to the practice of licensed dietitians.

II. Establishes requirements for qualification, training, and experience for licensed dietitians.

III. Establishes penalties for violations of laws relative to the practice of dietitians.

IV. Defines terms relevant to the practice and regulation of licensed dietitians.

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

Be it Enacted by the Senate and House of Representatives in General Court convened:

168:1 New Chapter; Licensed Dietitians. Amend RSA by inserting after chapter 326-G the following new chapter:

326-H:1 Short Title. This chapter may be cited as the "Dietitians Licensure Act."

326-H:2 Purpose. The general court recognizes that dietitians play an important role in treating illness, injury, and other medical conditions; and in improving the quality of life of seriously ill patients; all of which can result in cost savings to the health care system. The general court finds and declares that the practices of dietitians in the state of New Hampshire affect public health, safety, and welfare; these practices make important and distinct contributions to patient care, and it is in the public's best interest to have qualified individuals who practice in this profession. In doing so, the general court recognizes that there are many aspects of nutrition and it is not the purpose of this act to restrict the ability of any person to provide advice, counseling, or assessments in matters of food, diet, or nutrition and to receive compensation for such services, thereby assuring that all persons can obtain nutrition and dietary information, dietary counseling, and information regarding food, food products, dietary supplements, and their proper use, from any source of that person's choosing. The purpose of this act, therefore, is to establish regulations and standards of qualification, training, and experience for individuals who are practicing dietitians.

II. "Commission on Dietetic Registration" means the national autonomous credentialing body.

III. "Dietitian" means a person who is a food and nutrition professional who meets the minimum academic and professional requirements that have enabled that individual to be credentialed by the Commission on Dietetic Registration as a registered dietitian.

(c) Employed by the Veterans Administration, provided such dietetic activities are related to such service or employment; or

(d) Licensed, certified, or registered under other laws of this state who is performing services within his or her authorized scope of practice.

II. Nothing in this chapter shall be construed to restrict, prevent, or otherwise interfere with a person who does not hold himself or herself out as a licensed dietitian from providing advice, counseling or assessments in matters of food, diet or nutrition; or from marketing or distributing food products, including dietary supplements as defined by the federal Dietary Supplement Health and Education Act; or from providing explanations to or communicating with customers with regard to the uses of such products.

I. No person shall practice or represent himself or herself as a dietitian in this state without first applying for and receiving a license from the board to practice as a licensed dietitian.

II. Licensees shall use the title "licensed dietitian" and the recognized abbreviation "LD".

326-H:6 Scope of Practice. Licensed dietitians shall be authorized to practice applications from food, nutrition, biochemistry, physiology, management, behavioral, and social sciences used in the treatment of illness, injury and other medical conditions, and the maintenance of human health.

I. There is established a board of licensed dietitians, consisting of 5 members. Initial appointments shall be made pursuant to RSA 326-H:8. Thereafter, the board shall be appointed by the governor with consent of the executive council and shall consist of 4 licensed dietitians and one public member.

II. Members of the board shall serve 3-year terms, shall hold office until successors are appointed and qualified, and shall serve no more than 2 consecutive terms.

III. The board may remove a member for malfeasance, misfeasance, or nonfeasance.

IV. Each member of the board shall be reimbursed for in-state actual and necessary travel expenses incurred in the discharge of official duties at the state employee mileage rate.

V. All members of the board shall have been residents of this state for at least 3 years immediately preceding appointment to the board. The public member shall not be, nor ever have been, a member of the dietitian profession nor have or have had a material, financial interest in either the provision of dietitian services or an activity directly related to the dietitian profession, including the representation of the board or profession for a fee at any time during the 5 years preceding appointment.

VI. The commissioner of the department of health and human services shall provide administrative services to the board. All administrative services shall be a cost to the board and shall be reimbursed by fees collected by the board through rules adopted under RSA 326-H:10.

I. The initial appointments to the board shall be made by the governor with the consent of the executive council and shall serve initial terms as follows: 2 practicing dietitians who shall serve a term of one year; and 2 practicing dietitians and one public member who shall serve a term of 2 years.

II. The initial board members shall be appointed within 6 months of January 1, 2001. The initial chairperson shall be elected from among the board members no later than the second meeting of the board.

III. Maintain a true record of the board's official acts which shall be public and open to inspection at all reasonable times, except for records compiled in connection with disciplinary proceedings.

IV. Adopt a code of ethics for the practices of licensed dietitians in this state.

(a) The application procedures for licensure or temporary licensure to practice as a licensed dietitian in this state.

II. The fees established by the board shall be sufficient to produce estimated revenues equal to 125 percent of the direct operating expenses of the board for the previous fiscal year.

326-H:11 Immunity from Civil Action. No civil action shall be maintained against the board or any member of the board or its agents or employees, against any organization or its members, or against any other person for or by reason of any statement, report, communication, or testimony to the board or determination by the board in relation to proceedings under this chapter.

326-H:12 Requirements for Licensure. To be eligible to be a licensed dietitian under this chapter, an applicant shall:

I. Hold a baccalaureate or higher degree from a regionally accredited college or university in the United States and have completed a major course of study in human nutrition, nutrition education, food and nutrition, dietetics, public health nutrition, or food systems management;

II. Have successfully completed a dietetic internship of no less than 900 hours, pre-professional practice program, or coordinated program with documented experience in the practice of dietetics under supervision of a registered, certified, or licensed dietitian;

III. Have successfully passed the examination administered by the Commission on Dietetic Registration; and

IV. Maintain continuing professional education requirements as determined by the board.

326-H:13 Reciprocity. The board may, in its discretion, grant a license under this chapter to an individual certified or licensed in another state if it determines that the requirements or standards for certification or licensure in that state are equivalent to, or greater than, those established by this chapter.

I. The board shall license as a dietitian each applicant who proves to the satisfaction of the board his or her qualifications under this chapter and under rules adopted by the board under RSA 326-H:10. The board shall issue to each person qualified a license, which shall be prima facie evidence of the right of the person to whom it is issued to represent himself or herself as a licensed dietitian subject to the conditions and limitations of this chapter.

II. All licenses issued by the board shall be valid for 2 years from the date of issuance and shall be renewed biennially or reissued pursuant to rules adopted and upon payment of fees established by the board. The board shall cause notification of impending license expiration to be sent to each licensed person at least 60 days prior to the expiration of the license.

III. Any person licensed under this chapter who seeks to renew his or her license shall provide to the board satisfactory documentation of the required continuing professional education.

IV. Any person who fails to renew a license issued under this chapter may be issued a license only upon reapplication for licensure.

326-H:15 Continuing Professional Education. It shall be deemed sufficient for the renewal of a license issued under this chapter for an applicant for renewal to have completed 20 hours of continuing professional education related to the relevant practice in the previous 24 months. Continuing education programs shall be approved by the board.

326-H:16 Suspension and Revocation of License. The board, after a hearing, may suspend or revoke the license of any person who:

II. Has been convicted of a class A felony or found guilty of malpractice or gross misconduct in practice as a dietitian.

III. Has engaged in dishonest or unethical conduct which the board has specified in rules adopted under RSA 326-H:10 as sufficient to merit suspension or revocation.

IV. By reason of negligent habits, neglect, willful action, or other causes engaged in actions inconsistent with the health of the person or persons under the care of the licensee.

I. The board shall take no disciplinary action without a hearing. At least 14 days prior to hearing, both parties to a disciplinary proceeding shall be served, either personally or by registered mail, with a written copy of the complaint filed and notice of the time and place for hearing. All complaints shall be objectively received and fairly heard by the board, but no complaint shall be acted upon unless in writing. A hearing shall be held on all written complaints received by the board within 3 months of the date notice of a complaint was received by the accused, unless otherwise agreed to by the parties. Written notice of all disciplinary decisions made by the board shall be given to both parties to the proceeding upon their issuance.

II. The board may administer oaths or affirmations, preserve testimony, and issue subpoenas, upon the approval of the attorney general, for witnesses and for documents relative to formal investigations or adjudicatory hearings.

III. Witnesses summoned before the board shall be paid the same fees as witnesses summoned to appear before the superior court, and such summons issued by any justice of the peace shall have the same effect as though issued for appearance before such court.

326-H:18 Reinstatement. Any person whose license has been suspended or revoked by the board may apply to the board, in writing, to request a hearing for reinstatement. Upon a hearing, the board may issue a new license or modify the suspension or revocation of the license.

I. Sell, fraudulently obtain, or furnish any license established under this chapter or aid and abet such conduct.

II. Practice as a licensed dietitian under the guise of any diploma, permit, certificate, license, or record illegally or fraudulently obtained or issued.

III. Impersonate in any manner a licensed dietitian by use of any title that contains the word "dietitian", use of the abbreviation "LD", or use any words, signs, symbols, or devices which represent a person licensed under this chapter.

IV. Fail to notify the board of the suspension, probation, or revocation of any past or present license, certification, or registration required to practice as a dietitian in this or any other jurisdiction.

V. Make false representations or impersonate or act as proxy for another person or allow or aid any person to impersonate him or her in connection with any examination or application for licensure or request to be licensed.

The Department of Health and Human Services indicates this bill will increase state expenditures by $13,269 in FY 2001 and by $24,538 each year thereafter. State unrestricted revenue will increase by $32,500 in FY 2001 and each year thereafter. There will be no fiscal impact on county and local revenue or expenditures.

The Department indicates there are 500 dieticians who would be licensed under this bill. A license fee of $65 per licensee would provide the necessary revenue to support 125% of the Board's administrative costs. The Department's expenditure estimate includes: salary and benefits for a Program Specialist, labor grade 18, for two days per week, supplies, postage, telephone, copies and mileage reimbursement for nine Board members. In FY 2001, the expenditure estimate includes five days or rule writing, one day of administrative hearing training, and one-half year of operating expenditures.

Description FY 2001 FY 2002 FY 2003

Personnel, Labor Grade 18,max for 2 days/week $ 6,295 $12,590 $12,590

Benefits 1,950 3,900 3,900

Current Expenses 2,350 4,700 4,700

Board Member Mileage (9 members) 1,674 3,348 3,348

Rule Writing/Administrative Hearing Training 1,000 - -

Total $13,269 $24,538 $24,538