S-0556.2                   _______________________________________________

                                                     SENATE BILL 5346

                              _______________________________________________

State of Washington                              53rd Legislature                             1993 Regular Session

By Senators Prentice, Moyer, Sellar and Winsley

Read first time 01/25/93.  Referred to Committee on Health & Human Services.

Raising the level of regulation of dietitians and nutritionists from certification to licensure.

          AN ACT Relating to dietitians and nutritionists; amending RCW 18.138.010, 18.138.020, 18.138.030, 18.138.040, 18.138.050, 18.138.060, 18.138.070, 18.138.080, 18.138.090, and 18.138.110; and adding a new section to chapter 18.138 RCW.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

        Sec. 1.  RCW 18.138.010 and 1991 c 3 s 278 are each amended to read as follows:

          (1) "Dietetics" is the integration and application of scientific principles of food, nutrition, biochemistry, physiology, management, and behavioral and social sciences in counseling people to achieve and maintain health.  Unique functions of dietetics include, but are not limited to:

          (a) Assessing individual and community food practices and nutritional status using anthropometric, biochemical, clinical, dietary, and demographic data for clinical, research, and program planning purposes;

          (b) Establishing priorities, goals, and objectives that meet nutritional needs and are consistent with available resources and constraints;

          (c) Providing nutrition counseling and education as components of preventive, curative, and restorative health care;

          (d) Developing, implementing, managing, and evaluating nutrition care systems; ((and))

          (e) Evaluating, making changes in, and maintaining appropriate standards of quality in food and nutrition care services; and

(f) Interpreting and recommending nutrient needs relative to prescribed diets in which food or nutrients need to be monitored or altered as ordered by or in consultation with health care professionals licensed to prescribe diets.

          (2) "General nutrition services" means ((the counseling and/or educating of groups or individuals in the selection of food to meet normal nutritional needs for health maintenance, which)) providing nutrition information and education for health maintenance and disease prevention for individuals and groups.  "General nutrition services" includes, but is not restricted to:

          (a) Assessing the nutritional needs for health maintenance and disease prevention of individuals and groups by planning, organizing, coordinating, and evaluating the nutrition components of community health care services;

          (b) Supervising, administering, or teaching ((normal)) in nutrition ((in)) programs for health maintenance and disease prevention for colleges, universities, clinics, group care homes, nursing homes, hospitals, private industry, and group meetings.

          (3) "((Certified)) Licensed dietitian" means any person ((certified)) licensed to practice dietetics under this chapter.

          (4) "((Certified)) Licensed nutritionist" means any person ((certified)) licensed to provide general nutrition services under this chapter.

          (5) "Department" means the department of health.

          (6) "Secretary" means the secretary of health or the secretary's designee.

        Sec. 2.  RCW 18.138.020 and 1991 c 3 s 279 are each amended to read as follows:

          (1) No persons shall practice dietetics or represent themselves as ((certified)) licensed dietitians ((or certified nutritionists)) unless ((certified)) licensed as provided for in this chapter.

          (2) No persons shall represent themselves as licensed nutritionists or practice general nutrition services unless licensed as provided for in this chapter.

(3) Persons represent themselves as ((certified)) licensed dietitians or ((certified)) licensed nutritionists when any title or any description of services is used which incorporates one or more of the following items or designations:  "((Certified)) Licensed dietitian," "((certified)) licensed dietician," "((certified)) licensed nutritionist," "D.," "((C)) L.D.," or "((C)) L.N."

          (3) The secretary may by rule proscribe or regulate advertising and other forms of patient solicitation which are likely to mislead or deceive the public as to whether someone is ((certified)) licensed under this chapter.

        Sec. 3.  RCW 18.138.030 and 1991 c 3 s 280 are each amended to read as follows:

          (1) An applicant applying for ((certification)) licensure as a ((certified)) licensed dietitian or ((certified)) licensed nutritionist shall file a written application on a form or forms provided by the secretary setting forth under affidavit such information as the secretary may require, and proof that the candidate has met qualifications set forth below in subsection (2) or (3) of this section.

          (2) Any person seeking ((certification)) licensure as a "((certified)) licensed dietitian" shall meet the following qualifications:

          (a) Be eighteen years of age or older;

          (b) Has satisfactorily completed a major course of study in human nutrition, foods and nutrition, dietetics, or food systems management, and has received a baccalaureate or higher degree from a college or university accredited by the Western association of schools and colleges or a similar accreditation agency or colleges and universities approved by the secretary in rule;

          (c) Demonstrates evidence of having successfully completed a planned continuous preprofessional experience in dietetic practice of not less than nine hundred hours under the supervision of a ((certified)) licensed dietitian or a registered dietitian or demonstrates completion of a coordinated undergraduate program in dietetics, both of which meet the training criteria established by the secretary;

          (d) Has satisfactorily completed an examination for dietitians administered by a public or private agency or institution recognized by the secretary as qualified to administer the examination; and

          (e) Has satisfactorily completed courses of continuing education as currently established by the secretary.

          (3) An individual may be ((certified)) licensed as a ((certified dietician)) licensed dietitian if he or she provides evidence of meeting criteria for registration ((on June 9, 1988,)) by the commission on dietetic registration or of certification as a dietitian by the state of Washington on or before the effective date of this act.

          (4) Any person seeking ((certification)) licensure as a "((certified)) licensed nutritionist" shall meet the following qualifications:

          (a) Possess the qualifications required to be a ((certified)) licensed dietitian; or

          (b) Has received a master's degree or doctorate degree in one of the following subject areas:  Human nutrition, nutrition education, foods and nutrition, or public health nutrition from a college or university accredited by the Western association of schools and colleges or a similar accrediting agency or colleges and universities approved by the secretary in rule; or

(c) Presents current certification as a nutritionist by the state of Washington on or before the effective date of this act.

        Sec. 4.  RCW 18.138.040 and 1991 c 3 s 281 are each amended to read as follows:

          (1) If the applicant meets the qualifications as outlined in RCW 18.138.030(2), the secretary shall confer on such candidates the title ((certified)) licensed dietitian.

          (2) If the applicant meets the qualifications as outlined in RCW 18.138.030(4), the secretary shall confer on such candidates the title ((certified)) licensed nutritionist.

          (3) The application fee in an amount determined by the secretary shall accompany the application for ((certification)) licensure as a ((certified)) licensed dietitian or ((certified)) licensed nutritionist.

        Sec. 5.  RCW 18.138.050 and 1991 c 3 s 282 are each amended to read as follows:

          The secretary may ((certify)) license a person applying for the title "((certified)) licensed dietitian" without examination if such person is licensed ((or certified)) as a dietitian in another jurisdiction and if, in the secretary's judgment, the requirements of that jurisdiction are equivalent to or greater than those of Washington state.

        Sec. 6.  RCW 18.138.060 and 1991 c 3 s 283 are each amended to read as follows:

          (1) Every person ((certified)) licensed as a ((certified)) licensed dietitian or ((certified)) licensed nutritionist shall pay a renewal registration fee determined by the secretary as provided in RCW 43.70.250.  The ((certificate)) license of the person shall be renewed for a period of one year or longer at the discretion of the secretary.

          (2) Any failure to register and pay the annual renewal registration fee shall render the ((certificate)) license invalid.  The ((certificate)) license shall be reinstated upon:  (a) Written application to the secretary; (b) payment to the state of a penalty fee determined by the secretary; and (c) payment to the state of all delinquent annual ((certificate)) license renewal fees.

          (3) Any person who fails to renew his or her ((certification)) license for a period of three years shall not be entitled to renew ((such certification)) the license under this section.  Such person, in order to obtain a ((certification)) license as a ((certified)) licensed dietitian or ((certified)) licensed nutritionist in this state, shall file a new application under this chapter, along with the required fee, and shall meet all requirements as the secretary provides.

          (4) All fees collected under this section shall be credited to the health professions account as required.

        Sec. 7.  RCW 18.138.070 and 1991 c 3 s 284 are each amended to read as follows:

          In addition to any other authority provided by law, the secretary may:

          (1) Adopt rules in accordance with chapter 34.05 RCW necessary to implement this chapter;

          (2) Establish forms necessary to administer this chapter;

          (3) Issue a ((certificate)) license to an applicant who has met the requirements for ((certification)) licensing and deny a ((certificate)) license to an applicant who does not meet the minimum qualifications;

          (4) Hire clerical, administrative, and investigative staff as needed to implement and administer this chapter and hire individuals, including those ((certified)) licensed under this chapter, to serve as consultants as necessary to implement and administer this chapter;

          (5) Maintain the official departmental record of all applicants and ((certificate)) license holders;

          (6) Conduct a hearing, pursuant to chapter 34.05 RCW, on an appeal of a denial of ((certification)) licensure based on the applicant's failure to meet the minimum qualifications for ((certification)) licensing;

          (7) Investigate alleged violations of this chapter and consumer complaints involving the practice of persons representing themselves as ((certified)) licensed dietitians or ((certified)) licensed nutritionists;

          (8) Issue subpoenas, statements of charges, statements of intent to deny ((certifications)) licenses, and orders and delegate in writing to a designee the authority to issue subpoenas, statements of charges, and statements on intent to deny ((certifications)) licenses;

          (9) Conduct disciplinary proceedings, impose sanctions, and assess fines for violations of this chapter or any rules adopted under it in accordance with chapter 34.05 RCW;

          (10) Set all ((certification)) licensing, renewal, and late renewal fees in accordance with RCW 43.70.250; and

          (11) Set ((certification)) license expiration dates and renewal periods for all ((certifications)) licenses under this chapter.

        Sec. 8.  RCW 18.138.080 and 1991 c 3 s 285 are each amended to read as follows:

          (1) There is created a ((state advisory committee)) dietetic nutrition board consisting of five members appointed by the ((secretary)) governor who shall advise the secretary concerning the administration of this chapter.  Two members of the ((committee)) board shall be ((certified)) licensed dietitians who have been engaged in the practice of dietetics for at least five years immediately preceding their appointments.  ((Two)) One member((s)) of the ((committee)) board shall be ((certified)) licensed nutritionist((s)) who ((have)) has been engaged in the provision of general nutrition services for at least five years preceding ((their)) his or her appointment((s)).  One member shall be a physician licensed under chapter 18.71 RCW.  These ((committee)) board members shall at all times be ((certified)) licensed under this chapter, except for the initial members of the ((committee)) board, who shall fulfill the requirements for ((certification)) licensing under this chapter, and the physician, who shall at all times be licensed under chapter 18.71 RCW.  The remaining member of the ((committee)) board shall be a member of the public with an interest in the rights of consumers of health services, but who does not have any financial interest in the rendering of health services.

          (2) The term of office for ((committee)) board members is four years.  The terms of the first ((committee)) board members however, shall be staggered to ensure an orderly succession of new ((committee)) board members thereafter.  Terms of office shall expire on December 31.  Any ((committee)) board member may be removed for just cause.  The ((secretary)) governor may appoint a new member to fill any vacancy on the ((committee)) board for the remainder of the unexpired term.  No ((committee)) board member may serve more than two consecutive terms whether full or partial.

          (3) ((Committee)) Board members shall be entitled to be compensated in accordance with RCW 43.03.240 and to be reimbursed for travel expenses under RCW 43.03.050 and 43.03.060.

          (4) The ((committee)) board shall have the authority to annually elect a chairperson and vice-chairperson to direct the meetings of the ((committee)) board.  The ((committee)) board shall meet at least once each year, and may hold additional meetings as called by the secretary or the chairperson.  Three members of the ((committee)) board shall constitute a quorum of the ((committee)) board.

        Sec. 9.  RCW 18.138.090 and 1991 c 3 s 286 are each amended to read as follows:

          The uniform disciplinary act, chapter 18.130 RCW, governs the issuance and denial of ((certificates)) licenses, unauthorized practices, and the disciplining of ((certificate)) license holders under this chapter.  The secretary shall be the disciplining authority under this chapter.

        Sec. 10.  RCW 18.138.110 and 1988 c 277 s 11 are each amended to read as follows:

          Nothing in this chapter shall be construed to apply to owners, operators or employees of health food stores provided the owners, operators or employees do not represent themselves to be ((certified)) licensed dietitians or ((certified)) licensed nutritionists.

NEW SECTION. Sec. 11.  A new section is added to chapter 18.138 RCW to read as follows:

          This chapter does not prohibit or restrict:

          (1) A dietetic technician or dietetic technician student engaged in dietetic practice under the supervision of a licensed dietitian.  A dietetic technician is an individual who has an associate or higher degree from a United States regionally accredited college or university with a major course of study in dietetic technology, nutrition care, food service systems management, human nutrition, nutrition education, foods and nutrition, or dietetics and has completed a documented supervised experience component in dietetic practice of not less than four hundred fifty hours under the supervision of a licensed dietitian;

          (2) A dietetic student enrolled in an approved academic program in dietetics who is under the supervision of a licensed dietitian;

          (3) A nutrition student enrolled in an advanced degree program as outlined in RCW 18.138.030 who is under the supervision of a licensed dietitian or nutritionist;

          (4) Other health care professionals licensed by the state of Washington as of the effective date of this act from engaging in the practice of dietetics or provision of general nutrition services when incidental to the practice of his or her profession;

          (5) A dietitian or nutritionist who is serving in the armed forces or the public health service of the United States or who is employed by the veterans administration whose practice is related to such service or employment;

          (6) Any person who provides weight control services, provided the program has been reviewed by, consultation is available from, and no program change can be initiated without prior approval by a licensed dietitian, a dietitian credentialed in another state that has licensure requirements at least as stringent as the requirements for licensure under this chapter; or

          (7) An educator who is in the employ of a nonprofit organization and authorized by the department; a federal, state, county, or municipal agency or other political subdivision; an elementary or secondary school; or a regionally accredited institution of higher education, insofar as the activities and services of the educator are part of his or her employment.

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