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S04999 Summary:

Amd Ed L, generally
Provides for the licensure of dietitians and nutritionists; defines the practice thereof.
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S04999 Text:

                STATE OF NEW YORK
                               2013-2014 Regular Sessions
                    IN SENATE
                                       May 3, 2013
        Introduced  by  Sen. LAVALLE -- read twice and ordered printed, and when
          printed to be committed to the Committee on Higher Education
        AN ACT to amend the education law,  in  relation  to  the  licensure  of
          dietitians and nutritionists
          The  People of the State of New York, represented in Senate and Assem-

        bly, do enact as follows:
     1    Section 1. Legislative findings and declaration of purpose. The legis-
     2  lature finds that the application of scientific  knowledge  relating  to
     3  nutrition  is  important  in effective care, treatment and prevention of
     4  disease or trauma and in the attainment and maintenance of  health,  and
     5  acknowledges  that the rendering and communication of sound dietetic and
     6  nutrition services in hospitals, nursing homes, extended care and  ambu-
     7  latory  care  settings,  school  districts,  health departments, private
     8  practice and consultation, and in other settings  requires  trained  and
     9  competent professionals. The legislature further finds that it is neces-
    10  sary  in  the  provision  of  medical nutrition therapy for such profes-
    11  sionals to be licensed under article 157 of the education law to  ensure

    12  quality  care  through a standardized nutrition care process, consisting
    13  of a nutrition assessment, nutrition diagnosis,  nutrition  intervention
    14  and  the  monitoring  and evaluation of outcomes directly related to the
    15  nutrition care process. Therefore, it  is  hereby  declared  to  be  the
    16  purpose  of  this  act to protect the health, safety, and welfare of the
    17  public by providing for the licensure and regulation of  the  activities
    18  of persons engaged in the practice of dietetics and nutrition.
    19    § 2. Section 8000 of the education law, as added by chapter 635 of the
    20  laws of 1991, is amended to read as follows:
    21    § 8000. Introduction.    This article applies to the use of the titles
    22  ["certified   dietitian"   and   "certified   nutritionist"]   "licensed
    23  dietitian/nutritionist"  or  "LDN"  and  the  practice  of dietetics and

    24  nutrition.  The general provision for all professions contained in arti-
    25  cle one hundred thirty of this title shall apply to this article.
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.

        S. 4999                             2
     1    § 3. Section 8001 of the education law, as added by chapter 635 of the
     2  laws of 1991, is amended to read as follows:
     3    § 8001. [Definitions]  Dietetic and nutrition practice.  [1. Dietetics
     4  and nutrition are herein each defined as  the integration  and  applica-
     5  tion of principles derived from the sciences of nutrition, biochemistry,

     6  physiology,  food  management  and  behavioral  and  social  sciences to
     7  achieve and maintain people's health.
     8    2. Where the title "certified dietitian" or  "certified  nutritionist"
     9  is  used in this article it shall mean "certified dietitian", "certified
    10  dietician", or "certified nutritionist".
    11    3. A certified dietitian or certified nutritionist is one who  engages
    12  in  the  integration  and  application  of  principles  derived from the
    13  sciences of nutrition, biochemistry,  physiology,  food  management  and
    14  behavioral  and social sciences to achieve and maintain people's health,
    15  and who is certified as such by the department pursuant to section eight
    16  thousand four of this article.   The primary  function  of  a  certified

    17  dietitian  or  certified nutritionist is the provision of nutrition care
    18  services that shall include:
    19    (a) Assessing nutrition needs and food patterns;
    20    (b) Planning for and directing the provision of food  appropriate  for
    21  physical and nutrition needs; and
    22    (c)  Providing  nutrition counseling.] Dietetic and nutrition practice
    23  is the application of  medical  nutrition  therapy  and  a  standardized
    24  nutrition  care process, including nutrition assessment, nutrition diag-
    25  nosis, nutrition intervention, and nutrition evaluation  and  monitoring
    26  for the prevention or treatment of nutrition related illnesses, nourish-
    27  ment, and education of individuals and groups throughout the lifecycle.

    28    §  4.  The  education law is amended by adding a new section 8001-a to
    29  read as follows:
    30    § 8001-a. Definitions. For  purposes  of  this  article:  1.  "Medical
    31  nutrition  therapy"  is  an  evidence based application of the nutrition
    32  care process focused on prevention, delay or management of diseases  and
    33  conditions,  and  involves an in-depth assessment, periodic reassessment
    34  and intervention.
    35    2. "Nutrition diagnosis" in the context  of  dietetics  and  nutrition
    36  practice  means  the  identification  and labeling of existing nutrition
    37  problems expressed in terms of etiology, signs and  symptoms.  Nutrition
    38  diagnosis is distinct from a medical diagnosis.
    39    3.  "Nutrition  assessment" means the systematic process of obtaining,

    40  verifying, and interpreting biochemical,  anthropometric,  physical  and
    41  dietary  data  in  order to make decisions about the nature and cause of
    42  nutrition related problems. Nutrition assessment is an ongoing,  dynamic
    43  process that involves initial data collection, reassessment and analysis
    44  of  client  or community needs and provides the foundation for nutrition
    45  diagnosis and nutritional recommendations including enteral  and  paren-
    46  teral  nutrition.  The mere collection of these data for use in a nutri-
    47  tion assessment is not a nutrition assessment and  does  not  require  a
    48  license in dietetics and nutrition as set forth in this article.
    49    4. "Nutrition intervention" is a purposefully planned action, designed

    50  to  positively  change nutrition related behavior, risk factor, environ-
    51  mental condition or aspects of health status for individual, groups,  or
    52  the community.
    53    § 5. Section 8002 of the education law, as added by chapter 635 of the
    54  laws of 1991, is amended to read as follows:
    55    § 8002. [Use]  Authorization of [titles] title.  Only a person [certi-
    56  fied] licensed under this article shall be authorized to use  the  title

        S. 4999                             3
     1  ["certified  dietitian", "certified dietician", or "certified nutrition-
     2  ist"] "licensed dietitian/nutritionist" or "LDN".
     3    §  6.  Section 8003 of the education law, as amended by chapter 282 of

     4  the laws of 1992, is amended to read as follows:
     5    § 8003. State board for dietetics and nutrition.   A state  board  for
     6  dietetics  and  nutrition shall be appointed by the board of regents, on
     7  recommendation of the commissioner, for the  purpose  of  assisting  the
     8  board of regents and the department on matters of [certification] licen-
     9  sure,  practice  and  professional  conduct  in  accordance with section
    10  sixty-five hundred eight of this chapter.
    11    The board shall consist of not  less  than  [thirteen]  nine  members,
    12  [ten]  seven  of whom shall be [certified dietitians or certified nutri-
    13  tionists, except that the members of the first board need not be  certi-
    14  fied   but shall be persons who are eligible for certification under the

    15  provisions of this article prior to  their  appointment  to  the  board]
    16  licensed  pursuant  to this article.  The [first] board, with respect to
    17  members representing  the  profession,  shall  consist  of  [five]  four
    18  members  [registered]  credentialed  by  a national dietetic association
    19  having [registration] credentialing standards acceptable to the  depart-
    20  ment and [five] three members who are [members of or registered] creden-
    21  tialed  by  a national nutritional association having [membership and/or
    22  registration] credentialing  standards  acceptable  to  the  department.
    23  [Thereafter,  members of the profession appointed to such board shall be

    24  certified pursuant to this article.] To the extent reasonable, the board
    25  of regents should insure the state board is  broadly  representative  of
    26  various  [professional interests] practice areas within the dietetic and
    27  [nutritional] nutrition community.  [Three members] One member shall  be
    28  [representatives]  representative  of  the general public and one member
    29  shall be a physician licensed under article one  hundred  thirty-one  of
    30  this  title.  An  executive secretary to the board shall be appointed by
    31  the board of regents on the recommendation of the commissioner.
    32    § 7. Section 8004 of the education law, as added by chapter 635 of the
    33  laws of 1991, subparagraph 2 of  paragraph  (a)  of  subdivision  2  and

    34  subparagraph  2  of  paragraph (b) of subdivision 2 and subdivision 3 as
    35  amended by chapter 282 of the laws  of  1992,  is  amended  to  read  as
    36  follows:
    37    § 8004. Requirements  for  [certification]  professional license.   To
    38  qualify for [certification] a license, an applicant  shall  fulfill  the
    39  following requirements:
    40    1. File an application with the department;
    41    2.  [(a)(1)  Have received an education including a bachelor's degree,
    42  or   its   equivalent   as   determined   by    the    department,    in
    43  dietetics/nutrition  or  an equivalent major course of study which shall
    44  include appropriate core curriculum courses in dietetics/nutrition  from
    45  an  accredited  college  or university as approved by the department, in

    46  accordance with the commissioner's regulations; and
    47    (2) Have completed a planned,  continuous,  experience  component,  in
    48  accordance with the commissioner's regulations, in dietetic or nutrition
    49  practice  under  the  supervision  of a certified dietitian or certified
    50  nutritionist or a dietitian or nutritionist who is registered by or is a
    51  member of a national dietetic association or national nutrition  associ-
    52  ation  having  registration  or  membership  standards acceptable to the
    53  department; such experience shall be satisfactory to the  board  and  in
    54  accordance with the commissioner's regulations; or
    55    (b)(1)  Have  received  an education including an associates degree in
    56  dietetics or nutrition acceptable to the department,

        S. 4999                             4

     1    (2) In the last fifteen years have completed ten years  of  experience
     2  and education in the field of dietetics or nutrition satisfactory to the
     3  board in accordance with the commissioner's regulations. These ten years
     4  must  be  the  full time equivalent of any combination of post secondary
     5  dietetic  or  nutrition education and dietetic or nutrition work experi-
     6  ence satisfactory to the board in  accordance  with  the  commissioner's
     7  regulations, and
     8    (3) Have obtained the endorsement of three dietitians or nutritionists
     9  acceptable to the department] Have received a bachelor's degree or high-

    10  er  which  includes  appropriate  major course of study in dietetics and
    11  nutrition, or a bachelor's degree or higher and post graduate completion
    12  of a major course of study in dietetics and nutrition;  from  a  program
    13  registered  by  the department or determined by the department to be the
    14  substantial equivalent, in  accordance  with  the  commissioner's  regu-
    15  lations.  Major course of study in dietetics and nutrition shall include
    16  but not be limited to such areas as human  nutrition,  nutrition  educa-
    17  tion,  food and nutrition, dietetic or food systems and management which
    18  addresses the practice of dietetics and nutrition under  varying  condi-
    19  tions of health and disease, social, physical, psychological and econom-

    20  ic status for appropriate nutrition care;
    21    3.  During the first two years after the effective date of this subdi-
    22  vision, complete at a minimum, nine hundred hours  in  the  practice  of
    23  dietetics  and  nutrition  in  a planned, continuous, accredited program
    24  experience under the supervision of an individual licensed  pursuant  to
    25  this  article, in accordance with  the commissioner's regulations; after
    26  which and thereafter, such experience shall include at a minimum  twelve
    27  hundred hours;
    28    a.  an  accredited  experience  program  shall provide experience in a
    29  variety of settings, which may include hospitals, clinics, corporations,
    30  and public health programs and include a formal  outcome  evaluation  of

    31  competency in dietetics and nutrition practice.
    32    b.  practice  in  an  accredited experience program shall be under the
    33  supervision of a licensed dietitian/nutritionist, except  prior  to  the
    34  effective  date  of this subdivision a supervisor need only be certified
    35  as a dietitian or nutritionist pursuant to this  article  prior  to  the
    36  effective  date  of  this  subdivision  or  shall  be  credentialed by a
    37  national  dietetic  credentialing  organization  or  credentialed  by  a
    38  national  nutritional credentialing organization. Such national dietetic
    39  credentialing organization or national nutrition credentialing organiza-
    40  tion must be accredited by the national commission for certifying  agen-

    41  cies  and  approved  by  the department and have credentialing standards
    42  substantially equivalent to standards set forth for  licensure  pursuant
    43  to this article;
    44    [3.]  4.  Pass an examination satisfactory to the board and in accord-
    45  ance with the commissioner's regulations; provided that such examination
    46  shall test a level  of  knowledge  and  experience  equivalent  to  that
    47  obtained  by  an  individual  satisfactorily meeting the requirements of
    48  [paragraph (a) of  subdivision]  subdivisions  two  and  three  of  this
    49  section;
    50    [4.]  5.  Pay a fee of one hundred seventy-five dollars to the depart-
    51  ment for admission to a department conducted examination and for initial
    52  certification, a fee of eighty-five dollars for  each  reexamination,  a

    53  fee  of  one  hundred  fifteen  dollars for an initial certification for
    54  persons not requiring admission to a department conducted examination, a
    55  fee of one hundred [fifty-five] seventy-five dollars for each  triennial
    56  registration period;

        S. 4999                             5
     1    [5.] 6. Be at least eighteen years of age;
     2    7. Be of good moral character as determined by the department.
     3    § 8. Section 8005 of the education law, as added by chapter 635 of the
     4  laws of 1991, is amended to read as follows:
     5    § 8005. Special  provisions.  1.  Nothing  [contained  in this article
     6  shall be deemed to alter, modify or impair any conditions of  employment

     7  relating  to  service  in the federal government, the state of New York,
     8  its political  subdivisions,  including  school  districts,  or  special
     9  districts  and  authorities  or any facilities or institutions under the
    10  jurisdiction of or subject to the certification of  any  agency  of  the
    11  state  of  New York or its political subdivisions] in this article shall
    12  prohibit or limit any state, county or municipal employee engaged in the
    13  practice of dietetics and nutrition on the date the chapter of the  laws
    14  of two thousand thirteen which amended this section takes effect for the
    15  period during which they maintain such employment with such governmental
    16  unit  within  the context of such employment and shall be limited to the

    17  services provided upon such effective date, however, this section  shall
    18  not  authorize the use of any title authorized pursuant to this article.
    19  Provided however, that employees engaged in the  practice  of  dietetics
    20  and nutrition hired two years after such effective date shall be subject
    21  to all the requirements of this article.
    22    2.  This article shall not prohibit dietetic and nutrition practice by
    23  a corporation, provided that such practice is carried on by  a  licensed
    24  dietitian/nutritionist  or  a  person  exempt  under  this  article.   A
    25  violation of this subdivision shall be a class A misdemeanor.
    26    § 9. Section 8006 of the education law, as added by chapter 635 of the
    27  laws of 1991 and subdivision 2 as amended by chapter 282 of the laws  of

    28  1992, is amended to read as follows:
    29    §  8006.  Special  conditions.    [A person shall be certified without
    30  examination provided that, within three years of the effective  date  of
    31  this article, the individual:
    32    1.  files  an application and pays the appropriate fees to the depart-
    33  ment; and
    34    2.  (a) is registered as a dietitian or  nutritionist  by  a  national
    35  dietetic or national nutrition association having registration standards
    36  acceptable to the department;
    37    (b)  meets  the  requirements  of subparagraph one of paragraph (a) of
    38  subdivision two and subdivision five of section eight thousand  four  of
    39  this article and has been actively engaged in the provision of nutrition

    40  care  services  for a minimum of three years during the five years imme-
    41  diately preceding the effective date of this article; or
    42    (c) meets all the requirements of paragraph (b) of subdivision two and
    43  subdivision five of section eight thousand four of  this  article.]  Any
    44  person  who  is  licensed as a certified dietitian or a certified nutri-
    45  tionist (CDN) on the effective date of the chapter of the  laws  of  two
    46  thousand  thirteen  which  amended  this  section shall be licensed as a
    47  licensed dietitian/nutritionist without meeting any additional  require-
    48  ments.
    49    § 10. The education law is amended by adding two new sections 8007 and
    50  8008 to read as follows:

    51    §  8007. Exemptions.  This article shall not be construed to affect or
    52  prevent:
    53    1. A licensed physician from  practicing  his  or  her  profession  as
    54  defined  under  articles  one hundred thirty-one and one hundred thirty-
    55  one-B of this title; a registered  professional  nurse  or  a  certified
    56  nurse  practitioner  practicing  his  or her profession as defined under

        S. 4999                             6
     1  article one hundred thirty-nine of this title; or qualified  members  of
     2  other  professions  licensed under this title from performing work inci-
     3  dental to the practice of their professions, except  that  such  persons
     4  may not hold themselves out under the title authorized by this article;

     5    2.  An individual from engaging in the practice of dietetics or nutri-
     6  tion while participating in the  education  or  experience  requirements
     7  defined  in subdivisions two and three of section eight thousand four of
     8  this article;
     9    3. Any person who does not hold himself or herself out to be  licensed
    10  pursuant  to  this article from furnishing general non-medical nutrition
    11  information on food or dietary supplements; engaging in the  explanation
    12  to  customers about food or food products in connection with the market-
    13  ing and distribution of those products; provided that  nothing  in  this
    14  subdivision shall be deemed to authorize the provision of medical nutri-
    15  tion therapy.  For purposes of this subdivision,

    16    "general  non-medical  nutrition information" means information on the
    17  following: (a) "Principles of good nutrition and food  preparation;  (b)
    18  Food  to  be included in the normal daily diet; (c) The essential nutri-
    19  ents needed by the body; (d) Recommended amounts of the essential nutri-
    20  ents, based on established standards; (e) The actions  of  nutrients  on
    21  the  body;  (f) The effects of deficiencies or excesses of nutrients; or
    22  (g) Food and supplements that are good sources of  essential  nutrients;
    23  and
    24    4.  A  person  from  presenting  a  general program of instruction for
    25  weight control provided the general program is approved in writing by  a
    26  licensed dietitian, a dietitian registered by the Commission of Dietetic

    27  Registration  of  the American Dietetic Association or a licensed physi-
    28  cian.
    29  provided that, no title, sign, card or device  shall  be  used  in  such
    30  manner  as  to  tend  to convey the impression that the person rendering
    31  such service is licensed pursuant to this article.
    32    5. An individual employed by a WIC program  as  a  "competent  profes-
    33  sional  authority"  as  defined in 7 C.F.R § 246.2 (1895) from providing
    34  nutrition services within such WIC  program.  For  the  purpose  of  the
    35  subdivision the term "WIC program" shall mean a program authorized by 42
    36  U.S.C. § 1786.
    37    § 8008. Limited permit. The department shall issue a limited permit to

    38  an  applicant  for licensure who has met all the requirements of section
    39  eight thousand four of this article, but has not yet passed the examina-
    40  tion. 1. The duration of a limited permit shall not exceed one year from
    41  the time of its first issue and the department may for good cause  renew
    42  a  limited  permit  provided  that no applicant shall practice under any
    43  limited permit for more than a total of two years.
    44    2. All practice under a limited permit shall be under the  supervision
    45  of an individual licensed pursuant to this article.
    46    3. The fee for each limited permit shall be seventy-five dollars.
    47    § 11. This act shall take effect one year after it shall have become a
    48  law;  provided however, that effective immediately, the addition, amend-

    49  ment and/or repeal of any rule or regulation necessary for the implemen-
    50  tation of this act on its effective date is authorized and  directed  to
    51  be  made  and completed by the department of education on or before such
    52  effective date.
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