License Dietitians and Nutritionists

Section 1. Legislative findings and declaration of purpose. The legislature finds that the application of scientific knowledge relating to dietetics and nutrition is important in effective care, treatment and prevention of disease or trauma and in the attainment and maintenance of health, and acknowledges that the rendering and communication of sound dietetic and nutrition services in hospitals, nursing homes, extended care and ambulatory care settings, school districts, health departments, private practice and consultation, and in other settings requires trained and competent professionals. The legislature further finds that it is necessary in the provision of medical nutrition therapy, and therapeutic diets, for such professionals to be licensed under article 157 of the education law to ensure quality nutrition care, consisting of a nutrition assessment, nutrition diagnosis, nutrition intervention and the monitoring and evaluation of outcomes directly related to the nutrition care process. Therefore, it is hereby declared to be the purpose of this act to protect the health, safety, and welfare of the public by providing for the licensure and regulation of the activities of persons engaged in the practice of dietetics and nutrition.

§ 2. Section 8000 of the education law, as added by chapter 635 of the laws of 1991, is amended to read as follows:

§ 8000. Introduction. This article applies to the use of the titles ["certified dietitian" and "certified nutritionist"] "licensed nutritionist" or "LN" and "licensed dietitian/nutritionist" or "LDN" and the practice of dietetics and nutrition. The general provision for all

EXPLANATION--Matter in italics (underscored) is new; matter in brackets

[ ] is old law to be omitted.

LBD11273-01-9

S. 5442 2

professions contained in article one hundred thirty of this title shall apply to this article.

§ 3. Section 8001 of the education law, as added by chapter 635 of the laws of 1991, is amended to read as follows:

§ 8001. [Definitions] Dietetic and nutrition practice. [1. Dietetics and nutrition are herein each defined as the integration and application of principles derived from the sciences of nutrition, biochemistry, physiology, food management and behavioral and social sciences to achieve and maintain people's health.

2. Where the title "certified dietitian" or "certified nutritionist" is used in this article it shall mean "certified dietitian", "certified dietician", or "certified nutritionist".

3. A certified dietitian or certified nutritionist is one who engages in the integration and application of principles derived from the sciences of nutrition, biochemistry, physiology, food management and behavioral and social sciences to achieve and maintain people's health, and who is certified as such by the department pursuant to section eight thousand four of this article. The primary function of a certified dietitian or certified nutritionist is the provision of nutrition care services that shall include:

(a) Assessing nutrition needs and food patterns;

(b) Planning for and directing the provision of food appropriate for physical and nutrition needs; and

(c) Providing nutrition counseling.]

1. Dietetic and nutrition practice is the application of medical nutrition therapy and elements of nutrition care, which includes nutrition assessment, nutrition diagnosis, diet or nutrition intervention, counseling, evaluation and monitoring for the prevention or treatment of nutrition related illnesses, nourishment and malnourishment.

2. A licensed nutritionist and licensed dietitian/nutritionist shall have the authority, as necessary, and limited to the practice of dietetics and nutrition, to order diagnostic tests and devices, and laboratory tests, as established by the board in accordance with the commissioner's regulations.

3. A licensed nutritionist and licensed dietitian/nutritionist may order, write, review, evaluate, monitor and manage therapeutic diets including enteral and parenteral diets.

§ 4. The education law is amended by adding a new section 8001-a to read as follows:

§ 8001-a. Definitions. For purposes of this article: 1. "Medical nutrition therapy" is an evidence based application of nutrition care focused on prevention, delay or management of diseases and conditions, and involves an in-depth assessment, intervention and periodic reassessment.

2. "Nutrition diagnosis" in the context of dietetics and nutrition practice means the identification and labeling of existing nutrition problems expressed in terms of etiology, signs and symptoms. Nutrition diagnosis is distinct from a medical diagnosis. Nothing in this section shall authorize a licensed nutritionist or licensed dietitian/nutritionist to make a medical diagnosis.

3. "Nutrition assessment" means the systematic process of obtaining, verifying, and interpreting biochemical, anthropometric, nutrigenomic, physical and dietary data in order to make decisions about the nature and cause of nutrition related problems. The mere collection of these data for use in a nutrition assessment is not a nutrition assessment and

S. 5442 3

does not require a license in dietetics and nutrition as set forth in this article.

4. "Nutrition intervention" is a purposefully planned action, including, but not limited to, the recommendation or ordering of food and nutrition supplements designed to positively change nutrition related behavior, risk factor, environmental condition or aspects of health status for individuals, groups, or the community.

§ 5. Section 8002 of the education law, as added by chapter 635 of the laws of 1991, is amended to read as follows:

§ 8002. [Use] Practice and authorization of titles. Only a person [certified] licensed or otherwise authorized under this article shall [be authorized to] practice dietetics and nutrition or use the title ["certified dietitian", "certified dietician", or "certified nutritionist"] "licensed nutritionist" or "LN" or "licensed dietitian/nutritionist" or "LDN"; provided, however, that nothing in this article shall prevent an individual from using any title obtained from a national credentialing body.

§ 6. Section 8003 of the education law, as amended by chapter 282 of the laws of 1992, is amended to read as follows:

§ 8003. State board for dietetics and nutrition. A state board for dietetics and nutrition shall be appointed by the board of regents, on recommendation of the commissioner, for the purpose of assisting the board of regents and the department on matters of [certification] licensure, practice and professional conduct in accordance with section sixty-five hundred eight of this [chapter] title.

The board shall consist of not less than [thirteen] eleven members, [ten] four of whom shall be [certified dietitians or certified nutritionists, except that the members of the first board need not be certified but shall be persons who are eligible for certification under the provisions of this article prior to their appointment to the board] licensed dietitian/nutritionists and four of whom shall be licensed nutritionists pursuant to this article. The [first] board, with respect to members representing the profession, shall consist of [five] four members [registered] credentialed by a national dietetic association having [registration] credentialing standards acceptable to the department and [five] four members who are [members of or registered] credentialed by a national nutritional association having [membership and/or registration] credentialing standards acceptable to the department; provided, however, that no such credentialed member shall be also credentialed by a national nutrition association, nor a national dietetic association, respectively. [Thereafter, members of the profession appointed to such board shall be certified pursuant to this article. To the extent reasonable, the board of regents should insure the state board is broadly representative of various professional interests within the dietetic and nutritional community. Three members] Two members shall be representatives of the general public and one member shall be a physician licensed under article one hundred thirty-one of this title. Such physician member shall not be a member of or credentialed by a national dietetic or national nutrition association. An executive secretary to the board shall be appointed by the board of regents on the recommendation of the commissioner.

§ 7. Section 8004 of the education law is REPEALED and a new section 8004 is added to read as follows:

§ 8004. Requirements for professional license. 1. To qualify for a license as a licensed nutritionist, an applicant shall fulfill the following requirements:

S. 5442 4

(a) File an application with the department;

(b) Education:

(1) Have received a master's or doctoral degree in nutrition or a nutrition-related science from a program registered by the department or determined by the department to be the substantial equivalent, in accordance with the commissioner's regulations; or a master's or doctoral degree in a healthcare field from a program registered by the department or determined by the department to be the substantial equivalent, in accordance with the commissioner's regulations; and

(2) Have completed coursework covering content areas including but not limited to:

(i) Biochemistry;

(ii) Metabolism in health and disease;

(iii) Anatomy and physiology;

(iv) Clinical and life sciences;

(v) Human nutrition, across the life cycle in health and disease;

(vi) Nutrition assessment and evaluation;

(vii) Medical nutrition therapy, planning and implementation;

(viii) Food content, safety and quality; and

(ix)Professional orientation and ethics.

(c) Experience:

(1) Complete a minimum of one thousand hours of supervised experience relevant to the practice of dietetics and nutrition in a planned, continuous experience satisfactory to the department and in accordance with the commissioner's regulations. A practicum completed as part of a graduate level program shall be considered supervised experience for the purposes of this paragraph in accordance with the commissioner's regulations.

(2) Supervised experience shall be under the supervision of an individual with experience in the practice of dietetics and nutrition who is licensed under this article or is a licensed healthcare professional under this title, satisfactory to the department and in accordance with the commissioner's regulations. Satisfactory experience obtained in an entity operating under a waiver issued by the department pursuant to section sixty-five hundred three-a of this title may be accepted by the department notwithstanding that such experience may have been obtained prior to the effective date of such section sixty-five hundred three-a of this title and/or prior to the entity having obtained a waiver. The department may, for good cause shown, accept satisfactory experience that was obtained in a setting that would have been eligible for a waiver but which has not obtained a waiver from the department or experience that was obtained in good faith by the applicant under the belief that appropriate authorization had been obtained for the experience, provided that such experience meets all other requirements for acceptable experience.

(3) Experience obtained prior to the effective date of this section shall have been supervised by a certified dietitian/nutritionist or by an individual credentialed by or recognized as a supervisor by a national dietetic credentialing organization or national nutritional credentialing organization. Such national credentialing organizations must be accredited by the national commission for certifying agencies, and approved by the department as having credentialing standards substantially equivalent to standards set forth for licensure pursuant to this article.

S. 5442 5

(4) Experience shall be relevant to the practice of dietetics and nutrition under varying conditions of health and disease, social, physical, psychological and economic status.

(d) Examination: Pass an examination satisfactory to the board and in accordance with the commissioner's regulations; provided that such examination shall test a level of knowledge and experience equivalent to that obtained by an individual satisfactorily meeting the requirements of paragraphs (b) and (c) of this subdivision;

(e) Pay a fee of one hundred seventy-five dollars to the department for admission to a department conducted examination and/or initial certification, a fee of eighty-five dollars for each reexamination, a fee of one hundred fifteen dollars for an initial certification for persons not requiring admission to a department conducted examination, a fee of one hundred seventy-five dollars for each triennial registration period;

(f) Be at least eighteen years of age; and

(g) Be of good moral character as determined by the department.