Dietetics licensure.

WORKING DRAFT

ORIGINAL SENATE
FILE

NO.
0093

ENROLLED ACT NO. 74, SENATE

SIXTY-FIRST LEGISLATURE OF THE STATE OF
WYOMING
2011 GENERAL SESSION

AN ACT relating to professions and occupations; creating the dietetics licensing board; specifying membership; specifying board duties, powers and immunity; providing for licensure of dietitians; specifying requirements for licensure; providing exceptions; granting rulemaking authority; providing definitions; specifying grounds for denial, suspension, revocation or restriction of license; providing for hearings and appeals; providing
for injunctive relief
; providing an appropriation; and providing for effective dates.

Be It Enacted by the Legislature of the State of
Wyoming
:

Section 1.
W.S. 33
‑
47
‑
101 through 33
‑
47
‑
11
0
are created to read:

CHAPTER 47
DIETETICS LICENSURE ACT

33
‑
47
‑
101.

Short title.

This
act shall be known and may be cited as the
"
Dietetics Licensure Act.
"

33
‑
47
‑
102.

Definitions.

(a)

As used in this
article
:

(i)

"
Board
"
means the dietetics licensing board;

(ii)

"
Commission
"
means the
c
ommission on
d
ietetic
r
egistration
, the credentialing agency for the American dietetic association
;

(iii)

"
Dietetics
"
means the integration and application of principles derived from the sciences of food, nutrition, management, communication, and biological, physiological, behavioral, and social sciences to achieve and maintain optimal human health
.
"
Dietetics
"
includes the nutrition care process and medical nutrition therapy.
"
D
ieteti
cs
"
do
es
not include medical differential diagnosis of the health status of an individual
;

(
i
v)

"General non
medical nutrition information
"
means information on
any one (1) or more of the following
:

(A)

Principles of good nutrition and food preparation;

(B)

Food to be included in the normal daily diet;

(C)

The essential nutrients needed by the body;

(D)

Recommended amounts of the essential nutrients, based on established standards
;

(E)

The actions of nutrients on the body;

(F)

The effects of deficiencies or
excesses of nutrients;

(G)

Food and supplements that are good sources of essential nutrients
.

(v)

"
Medical
n
utrition
t
herapy
"
means the use of specific nutrition services for the purpose of disease management to treat or rehabilitate an illness, injury or condition and includes:

(A)

Interpreting dietary data and recommending nutrient needs relative to medically prescribed diets, including but not limited to tube feedings, specialized intravenous solutions and specialized oral feedings;

(B)

Food and prescription drug interactions; and

(C)

Developing and managing food service operations whose chief function is nutrition care and provision of medically prescribed diets.

(v
i
)

"
Medically
p
rescribed
d
iet
"
means a diet prescribed when specific food or nutrient levels need to be monitored, altered, or both
,
as a component of a treatment program from an individual whose health status is impaired or at risk due to disease, injury or surgery and may only be performed as initiated by or in consultation with a physician licensed in this state or an individual authorized
by a state license to prescribe

medical care
;

(
vii
)

"
Nutrition
a
ssessment
"
means the systematic process of obtaining, verifying and interpreting biochemical, anthropometric, physical and dietary data in order to make decisions about the nature and cause of nutrition related problems. It is an ongoing, dynamic process that involves not only initial data collection but also reassessment and analysis of client or community needs and provides the foundation for nutrition diagnosis and nutritional recommendations including enteral and parenteral nutrition
;

(
viii
)

"
Nutrition
c
are
p
rocess
"
means the systematic problem

solving method that dietitians use to critically think and make decisions when providing medical nutrition therapy or to
address nutrition related problems and provide safe, effective
,
high quality care. The nutrition care process consists of four
(4)
distinct but interrelated steps including nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring and evaluation
;

(
i
x)

"
Nutrition
d
iagnosis
"
means identifying and labeling nutritional problems that a dietetics practitioner is responsible for treating independently
;

(x)

"
Nutrition
i
ntervention
"
means purposefully planned actions intended to positively change a nutrition

related behavior, risk factor, environmental condition or aspect of health status for an individual
, the individual's
family
,
caregivers, target groups or
the
community at large
;

(xi)

"
Nutrition
m
onitoring and
e
valuation
"
means identifying patient
or
client outcomes relevant to the nutrition diagnosis and intervention plans and goals, and comparing those outcomes with previous status, intervention goals or a reference standard to determine the progress made in achieving desired outcomes of nutrition care
. The purpose of nutrition monitoring and evaluation is to determine
whether planned interventions should be continued or revised
;

(xii)

"
Registered
d
ietitian
"
means an individual registered with the
c
ommission
or its
successor organization
;

(xi
ii
)

"
Th
is
act
"
means W.S. 33
‑
47
‑
101 through 33
‑
47
‑
11
0
.

33
‑
47
‑
103.

Exemptions;
p
ersons and
practices n
ot
a
ffected
.

(a)

The following shall not be considered to be practicing dietetics under this act:

(i)

A q
ualified member of
a
legally recognized profession who
is
otherwise licensed or certified by this state
,

while
performing services consistent with
the license or certification
, provided the
member
do
es
not
purport
to be practicing
dietetics
and do
es
not
claim
to be
a
dietitian
;

(ii)

A student enrolled in an accredited program in dietetics
while
engag
ed

as part of the program
in the practice of dietetics under the supervision of a licensed dietitian
;

(iii)

A dietitian who is serving in the armed forces or the public health service of the United States,
who
is employed by the
v
eterans
a
dministration or a Wyoming
d
epartment of
h
ealth nutritional services program under the supervision of a licensed dietitian,
while
engag
ed
in the practice of dietetics provided
the
practice is related to
that
service or employment
;

(iv)

A person employed by a school district who is responsible for menu planning, purchasing of food, meal preparation or food safety, who uses general nonmedical nutrition information in the performance of the person's duties and who does not purport to be practicing dietetics and does not claim to be a dietitian;

(v)

A retailer
who
furnishes oral or written general nonmedical nutrition information related to food, food materials or dietary supplements or the marketing of food, food materials or dietary supplements
;

(v
i
)

A person who is employed as an instructor at a U
nited
S
tate
s
regionally accredited college or university with a major course of study in human nutrition, nutrition education, public health nutrition, food and nutrition, dietetics or food systems management or an equivalent major course of study as approved by the board
;

(vi
i
)

A person providing weight control services
;

(vii
i
)

A nonresident registered dietitian licensed
in another state
if the requirements for licensure are
at least as stringent as
the requirements for licensure contained in this act
, or registered
by the commission
if the state of residence does not
require
licensure,
while
practic
ing
dietetics in this state for up to twenty (20) days annually
;

(ix)

A person offering general nonmedical nutritional information, either as part of the sales of nutritional products or independently, who does not represent that they are a licensed dietician.

33
‑
47
‑
104
.

Board
c
reated;
m
embership;
a
ppointment;
t
erms;
r
emoval;
m
eetings;
immunity
.

(a)

The dietetics
licensing board

is created.
The board shall regulate the practice of
dietetics
in the state
by providing for the licensing and regulation of persons engaged in the practice of dietetics
to ensure the safety of the public seeking nutritional advice.

(b)

The board shall consist of three (3) members.

The initial board shall consist of one (1) member
of the public and
two (2) registered dietitians who shall have been engaged in the practice of dietetics for a period of not less than five (5) years immediately preceding appointment to the board. Thereafter, dietitian members shall be licensed under this act prior to appointment to the board.

(
c
)

The governor shall appoint the members of the board.
T
he initial
appointments shall be for staggered terms with
one (1) registered dietitian appointed for a term of three (3) years, one (1) member of the public appointed for a term of two (2) years and one (1) registered dietitian appointed for a term of one (1) year.

Thereafter, members shall be appointed for
three
(
3
) year terms.

(
d
)

Vacancies in the board shall be filled by appointment by the governor as provided in subsection (b) of this section for the balance of an unexpired term
. E
ach member shall serve until
the member's
successor is appointed and qualified.

The governor may remove any member from the board as provided in W.S. 9
‑
1
‑
202.

(
e
)

The board shall meet at least twice each year and shall elect a chairman at the first meeting each year. The board may convene at the request of the chairman or as the board may determine for any other meeting as may be deemed necessary
by the chairman
to transact
the board's
business
. The board shall adopt rules for the transaction of its business
.

Two (2) board members
shall
constitute a quorum
.

(
f
)

Members of the board shall not receive compensation for their services but shall receive mileage and per diem in the same manner and amount as state employees while engaged in the discharge of official duties.

(
g
)

Members of the board shall have the same immunities from personal liability as state employees for actions taken in the performance of their duties under this act, as provided in W.S. 1
‑
39
‑
104.

33
‑
47
‑
105.

Board
p
owers
and authority
.

(a)

The board shall:

(i)

Examine, license and renew the licenses of duly qualified applicants;

(ii)

Maintain an up-to-date list of every person licensed to practice dietetics under this act. The list shall show the licensee’s last known place of employment
, the license issue
date and
the registration number
of
the
license;

(iii)

Keep a record of all proceedings of the board and make the record available to the public for inspection during regular business hours;

(iv)

Maintain an up-to-date list of persons whose licenses have been suspended, revoked or denied. Th
e
list shall include the names, type and cause of action, date and penalty incurred and the length of penalty. Th
e
list shall be available for public inspection during regular business hours
and
shall be supplied to similar boards in other states upon request;

(v)

Establish reasonable
fees for
application,
examination, licensing, certification, specialty examination designation, renewal
, late renewal, reinstatement
and other services provided pursuant to W.S. 33
‑
1
‑
201
;

(
v
i)

A
dopt rules and regulations
related to application, fees, discipline, suspension and revocation.

(b)

The board
may
:

(i)

Employ personnel or enter into an agreement as necessary to perform the functions of the board;

(ii)

Establish relicensure requirements and procedures as are appropriate, including adopting and publishing a code of ethics as well as compliance guidance opinions as deemed necessary by the board;

(i
ii
)

Secure the services of resource consultants.

Resource consultants shall receive travel and per diem expenses in the same manner and amount as state employees while engaged in consultative service to the board;

(
i
v)

Enter into contracts with
appropriate
organizations for the purpose of developing, administering, grading or reporting the results of licensing examinations. The contracting organizations shall be capable of providing an examination which meets the standards of the
c
ommission
or an equivalent
organization
. The examination shall
be validated and nationally recognized as testing dietetic core competencies
;

(v)

Establish continuing education requirements for license renewal
.

33
‑
47
‑
106.

Licensure;
application; q
ualifications;
i
ssuance and
revocation of l
icenses;
f
ees;
t
emporary
p
ermits
.

(a)

An applicant for a license to practice dietetics shall submit to the board written evidence, verified by oath, that the applicant:

(i)

Has received a
b
accalaureate or
p
ost
b
accalaureate
d
egree from a U
nited
S
tates
regionally accredited college or university with a major course of study in human nutrition, nutrition education, public health nutrition, food and nutrition, dietetics, food systems management or an equivalent major course of study as approved by the board. Applicants who have obtained
a degree
outside
of
the
United States
and its territories
shall
have their academic degree validated
by the board
as equivalent to
the same degree
conferred by a regionally accredited college or university in the
United States
;

(ii)

Has completed a documented supervised preprofessional practice experience component in
d
ietetics of not less than
nine hundred (
900
)
hours under the supervision of a registered dietitian, a licensed dietitian or an individual with a doctoral degree conferred by a U
nited
S
tates
regionally accredited college or university with a major course
of
study in human nutrition, nutrition education, food and nutrition, dietetics or food systems management;

(iii)

Has successfully completed the registration examination for dietitians administered by the
c
ommission or an examination of an equivalent level approved by the board;

(i
v
)

H
as reached the age of majority; and

(v)

Has
not
been convicted of a felony or a misdemeanor that relates adversely to the practice of
dietetics,
or the ability to practice
dietetics
, in the courts of this state, another jurisdiction or another country.

As used in this paragraph,
"
conviction
"
includes a finding or verdict of guilt, an admission of guilt, a plea of nolo contendere
,
a plea agreement
in which
the defendant has pled guilty yet not admitted to all the facts that comprise the crime
or a conditional plea as part of a deferred prosecution or deferred sentencing agreement
.

(b)

Until June 30, 2012
, the board shall waive the examination
required by subsection (a) of this section
and shall grant a license to any applicant who:

(i)

M
akes satisfactory application to the board and is registered with the
c
ommission
;
or

(ii)

R
eceived a baccalaureate or post

baccalaureate degree from a U
nited
S
tates
regionally accredited college or university with a program in dietetics or an equivalent major course of study as approved by the board and
who
has completed a board approved practical experience and met the educational requirements
for registration by
the
c
ommission
or its equi
valent.

(
c
)

If an applicant fails to complete the requirements for licensing within one (1) year from the date of filing
an application
, the application
shall be
deemed to be abandoned.

(
d
)

The board may issue a temporary permit to practice dietetics for a period of six (6) months to an applicant for licensing, provided:

(i)

T
he applicant is currently practicing or has within the last twelve (12) months practiced
as a
licensed

dietiti
an
in another state, territory or country
that required licensure of
dietitians
;

(ii)

T
he applicant is currently practicing or has within the last twelve (12) months practiced
as a
registered

dietiti
an
in another state, territory or country
that did not require licensure of
dietitians
; or

(iii)

T
he applicant is a student in a
c
ommission approved dietetics education program who expects to graduate within thirty (30) calendar days
of the application filing date
. Upon notification that a student in an approved program who has received a temporary permit under this section fails to successfully complete the program, the permit shall immediately expire.

(
e
)

On payment of an additional fee
established pursuant to W.S. 33
‑
47
‑
105(a)(v)
, the board may extend a permit to practice dietetics for an additional period not to exceed six (6) months from the date of issuance of the original permit.

(
f
)

Upon payment of a fee
established pursuant to W.S. 33
‑
47
‑
105(a)(v)
, the board shall issue a license to practice dietetics to an applicant who
was
a dietitian
registered
prior to July 1, 2011

by the
c
ommission or its equivalent.

(
g
)

U
nless licensed to practice under this act
,

n
o person shall represent himself to the public as being
a dietitian or a
licensed dietitian. Only a person holding a license to practice dietetics in this state may use the title
"
l
icensed
d
ietitian
"

or
the abbreviation
"
LD
"
to indicate that the person is a licensed dietitian
.

33
‑
47
‑
107.

License r
enewal
, r
evocation;
h
earings
.

(a)

A
licensed dietitian shall renew the
license every two (2) years. The board shall notify and provide applications for renewal
to licensed dietitians
at least sixty (60) calendar days prior to expiration
of the license. A
licensee
seeking renewal
shall complete the application for renewal and return it to the board with the renewal fee
at least fifteen (15) days
before the
license expiration
date. The renewal request
shall
be accompanied by evidence satisfactory to the board
that the licensee has
compli
ed
with this act and
complet
ed any applicable
continuing education
requirements.

(b)

Upon receipt of the application for renewal and the fee, the board shall
promptly
verify its contents and issue
a renewal license
.

(c)

A licensee who fail
s
to
submit a timely application for renewal
may be reinstated by the board upon payment of the renewal fee and reinstatement fee
established
by the board provided that the request for reinstatement is made within ninety (90) days of the
license expiration date
.

(d)

A licensed dietitian who does not engage in the practice of dietetics
following expiration of the dietitian's license
is not required to pay the renewal fee
and shall be deemed inactive
. If
an inactive licensee
desires to resume the practice of dietetics, the license
shall be reissued upon application to the board, payment of renewal and reinstatement fee
s
and
submission of
evidence that the applicant sat
isf
ies
the current requirements
for licensure.

(e)

Fees received by the board and any monies collected under this act shall be deposited
and credited to the board as provided in W.S. 33
‑
1
‑
202
.

(f)

The board may revoke, suspend or refuse to renew any license or permit or place on probation, reprimand a licensee or deny a license to an applicant if it finds that the person:

(i)

Is guilty of fraud or deceit in procuring or attempting to procure a license or renewal of license to practice dietetics;

(ii)

Is unfit or incompetent by reason of negligence, habits or other causes of incompetency as defined in the rules and regulations
of
the board;

(iii)

Is addicted to a drug or intoxicant to a degree
that
render
s
the licensee unsafe or unfit to practice dietetics;

(iv)

Is guilty of unprofessional conduct as defined by rules
of
the board, or has violated the code of ethics adopted and published by the board;

(v)

Has practiced dietetics under cover of any permit or license illegally or fraudulently obtained or issued, or under a license that has expired or been suspended;

(vi)

Has violated or aided or abetted others in violation of any provision of this act.

(g)

Upon filing of written complaint with the board charging a person with having been guilty of any of the acts
prohibited by
this act, the executive director or other authorized employee of the board shall
conduct
an
appropriate
investigation. If the board finds reasonable grounds
to substantiate
the
allegations of the
complaint,
the board may refuse to grant, revoke, suspend or restrict the license of an applicant or licensee.

(h)

The applicant or licensee shall be afforded an opportunity for a hearing on the
board's action under subsection
(f) or (g) of this section. Notices, hearings and appeals shall be in accordance with the Wyoming Administrative Procedure Act.
The board may issue subpoenas for the attendance of witnesses and the production of necessary evidence in any hearing before it. Upon request of the respondent or his counsel, the board shall issue subpoenas on behalf of the respondent.

33
‑
47
‑
108.

Reciprocity
.

Reciprocity may be provided for dietitians
licensed
in
other states
which
have laws at least as stringent as this act, or registered dietitians if their previous state of residence does not
require
licensure, provided that the applicant meets the
requirements of W.S. 33
‑
47
‑
106
.

33
‑
47
‑
109.

Disclosure of
i
nformation
.

A
licensed dietitian

or any person employed in a licensed dietitian's professional practice
shall not disclose without the consent of the client any communication made by
a
client to the
dietitian

or the dietitian's employees
in the course of professional practice,
except as required by law.

33
‑
47
‑
110.

I
njunctive relief.

The board may seek an injunction in the district court to enjoin any person from violating this act.

Section 2.

There is appropriated twenty thousand dollars ($20,000.00) from the general fund to the department of administration and information. This appropriation shall be for the period beginning with the effective date of this section and ending June 30, 201
2
. This appropriation shall only be expended for the purpose of providing necessary support and executive secretary services for the dietetics licensing board created under section 1 of this act. Notwithstanding any other provision of law, this appropriation shall not be transferred or expended for any other purpose and any unexpended, unobligated funds remaining from this appropriation shall revert as provided by law on June 30, 2012. The board shall submit a standard budget request for the fiscal biennium beginning July 1, 2012 and for subsequent biennia through the normal budget process.

Section
3
.

(a)

Except as provided in subsection (b) of this section, this act is effective July 1, 201
1
.

(b)

W.S. 33
‑
47
‑
104 and 33
‑
4
7
‑
105 created by
section 1 of
this act and section 2 of this act are effective immediately upon completion of all acts necessary for a bill to become law as provided by Article 4, Section 8 of the Wyoming Constitution. The
dietetics licensing
board may immediately commence drafting and adoption of rules and regulations for the implementation of this act and may immediately accept applications for
dietitian
licenses to be issued on or after July 1, 201
1
.

(END)

Speaker of the House

President of the Senate

Governor

TIME APPROVED: _________

DATE APPROVED: _________

I hereby certify that this act originated in the Senate.

Chief Clerk

1