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ARIZONA HOUSE OF REPRESENTATIVESFifty-sixth Legislature First Regular Session |
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HB 2558: dietitian nutritionists; licensure.
Sponsor: Representative Hernandez A, LD 20
Committee on Health & Human Services
Overview
Allows the Director of the Department of Health Services (DHS Director) to create licensing for Licensed Dietitian Nutritionists (LDN) and implement an Advisory Committee to assist the DHS Director in administrative functions and duties related to LDN licensing.
History
The Department of Health Services (DHS) is responsible for providing a majority of public health programs in the state addressing such topics as: 1) disease prevention and control; 2) health promotion; 3) community public health; 4) environmental health; 5) maternal and child health; 6) emergency preparedness; and 7) regulation of healthcare-related institutions.
The Academy of Nutrition and Dietetics (Academy) defines Registered Dietitian Nutritionists (RDN) as practicing food and nutrition experts with education in an accredited dietetics program who have completed supervised practice and the national exam. The Commission on Dietic Registration (Commission) is a credentialing agency for the Academy and is responsible for providing and enforcing credentialing standards, requirements and the national exam for registered dieticians and RDNs.
Current statute allows hospitals to grant registered dieticians or nutritional professionals ordering abilities for diets, enteral feeding, nutritional supplementation or parenteral nutrition if authorized by a member of medical staff (A.R.S. § 36-416).
Provisions
Prescription Orders
1.
Allows an LDN in either a hospital, if
authorized or granted standing ordering privileges by medical staff, or a nonhospital
health care institution to make a prescription order consisting of:
a) diets or a change in diet orders;
b) enteral feeding;
c) durable medical equipment related to nutrition;
d) nutritional supplementation;
e) parenteral nutrition;
f) medical nutrition therapy; and
g) laboratory tests to check and track nutrition status. (Sec. 3, 4)
2. Directs hospitals or nonhospital health care institutions to have written policies and procedures that:
a) allow LDN's to issue orders or perform medical nutrition therapy; and
b) prescribe necessary qualifications for qualified nutrition professionals to issue orders and any restrictions on their ability to issue orders. (Sec. 3, 4)
3. Requires nonhospital health care institutions to respond to adverse events that ensue from orders issued by an LDN or unlicensed dietician nutritionist. (Sec. 3)
Licensing and the Advisory Committee
4. Authorizes the DHS Director to license all applicants qualifying for the practice of dietetics and nutrition, authorize all disbursements, adopt qualifications and standards and scope of practice consistent with the Academy. (Sec. 5)
5. Grants the DHS Director the authority to appoint an Advisory Committee to offer recommendations and aid in the completion of duties including:
a) addressing disciplinary actions;
b) issuing and renewing licenses;
c) denying, suspending, revoking or refusing to renew a license;
d) developing and publishing rules; and
e) requiring licensees to produce records of patients involved in complaints on file with DHS. (Sec. 5)
6. Includes the DHS Director, a licensed physician, three LDNs and one public member be appointed to the committee and outlines committee member qualifications. (Sec. 5)
7. Lists the licensure requirements for an LDN as:
a) submitting a nonrefundable application fee;
b) holding either a current registration as a registered dietitian or registered dietitian nutritionist;
c) having a baccalaureate degree, master's degree or doctoral degree from a qualified university with a major in a nutrition and dietetics-related field;
d) completing an accredited and approved planned clinical program consisting of at least 1,000 hours of supervised experience;
e) passing the examination for registered dieticians from the Commission or another equally accredited exam approved by the DHS Director; and
f) having good moral character and not having a license suspended or revoked in the past two years in any state. (Sec. 5)
8. Allows the DHS Director to waive educational requirements for applicants who have taken equivalent coursework in another country. (Sec. 5)
9. Allows the Advisory Committee to recommend to the DHS Director a waiver of the educational requirements if an applicant submits satisfactory proof that they received the required professional education. (Sec. 5)
Assessment of Fees and Management of Monies
10. Permits the DHS Director to prescribe and collect fees for the following:
a) an application for a license;
b) the issuance of a license or duplicate license;
c) the renewal of a license; and
d) late fees. (Sec. 5)
11. Stipulates that all monies collected regarding licensure and duties of the Advisory Committee have 10% be put into the state General Fund including civil penalties and the remaining 90% into the Health Services Licensing Fund. (Sec. 5)
Issuance and Maintenance of License
12. Makes licenses valid for two years and requires renewal upon the expiration of the license. (Sec. 5)
13. Requires licensees to meet the qualifications and continuing education requirements set by the DHS Director. (Sec. 5)
14. Mandates a licensee to notify the DHS Director of their place of practice and whether they change the address of that location and the DHS Director must maintain a record of these locations to provide notice. (Sec. 5)
15. Ensures that individuals have appropriate licensing when practicing and using proper titles in the field of dietetics and nutrition and asserts that any violation of this would be considered consumer fraud. (Sec. 5)
Active-Duty Military Licensure Extension
16. Specifies that licenses for military or national guard members do not expire while on active duty and are extended 180 days after return or release from service. (Sec. 5)
17. Outlines processes for extensions and renewal of licenses for military members. (Sec. 5)
Licensure Violations and Legal Actions
18. Specifies what constitutes a denial, revocation or suspension of a license as:
a) being convicted of a felony or misdemeanor involving moral turpitude;
b) securing a license through fraud or deceit;
c) engaging in unprofessional conduct or incompetence; and
d) using a false name in practice. (Sec. 5)
19. Allows DHS to deny a license without a hearing unless the denied applicant requests one. (Sec. 5)
20. Grants the DHS Director the authority to revoke or suspend a license either permanently or temporarily and requires a hearing before the official action. (Sec. 5)
21. Authorizes the DHS Director to file a letter of concern, issue a decree of censure, prescribe a period of probation, restrict or limit the practice of a licensee in place of denying, revoking or suspending a license. (Sec. 5)
22. Requires the DHS Director to notify a licensee's employer if disciplinary action has been initiated against that licensee. (Sec. 5)
23. Permits the DHS Director to enforce these provisions through injunction and prevents a prior or current proceeding from barring an enforcement proceeding. (Sec. 5)
24. Establishes that any violation of these provisions constitutes a class 3 misdemeanor. (Sec. 5)
25. Provides the DHS Director the ability to impose a civil penalty not exceeding $500 for violations of these provisions in addition to any other penalties. (Sec. 5)
26. Enables the Attorney General or the County Attorney to bring an action in the appropriate Superior Court to enforce the imposed civil penalties. (Sec. 5)
Miscellaneous
27. Exempts the DHS from rulemaking requirements for one year following the effective date. (Sec. 6)
28. Contains a legislative intent clause. (Sec. 7)
29. Modifies terms. (Sec. 1)
30. Defines terms. (Sec. 3, 4, 5)
31. Makes conforming changes. (Sec. 2, 3)
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35. HB 2558
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