AB742: Bill Text

AB742,2,2 An Act to repeal 448.72 (1) (a) and (b), 448.72 (1) (d), 448.72 (1) (f), 448.72 (2), 448.74 (1), 448.78 (3) (c) and 448.78 (4) (a), (b) and (c); to renumber and amend 448.70 (1), 448.70 (1m), 448.72 (1) (c), 448.72 (1) (e), 448.72 (3), 448.72 (4), 448.72 (5), 448.72 (6), 448.76, 448.78 (4) (intro.) and 448.82; to consolidate, renumber and amend 448.72 (intro.) and (1) (intro.) and 448.74 (intro.) and (2); to amend 15.406 (2) (intro.), 15.406 (2) (a), 48.981 (2) (a) 24., 146.81 (1) (em), 146.89 (1) (r), 146.997 (1) (d) 6., 180.1901 (1m) (br), 252.14 (1) (ar) 4m., 440.03 (13) (b) 23., 440.08 (2) (a) 27m., 446.02 (6m), subchapter V (title) of chapter 448 [precedes 448.70], 448.70 (2), 448.70 (3), 448.78 (intro.), 448.78 (1), 448.78 (3) (a), 448.78 (3) (b), 448.78 (5), 448.80, 448.84 (1), 448.84 (2), 448.86, 448.87 (2) (intro.) and (a), 448.87 (2) (b), 448.87 (2) (e), 448.87 (2) (g), 450.10 (3) (a) 5m., 632.895 (1) (b) 5. b. and 655.45 (1m); to repeal and recreate 440.08 (2) (a) 27m. and 448.86 (2); and to create 448.70 (1d), 448.70 (5) to (7), 448.71, 448.72 (7) and (8), 448.72 (11), 448.72 (12), 448.76 (7), 448.82 (1) and 448.86 (3) of the statutes; relating to: licensure of dietitians and requiring the exercise of rule-making authority.

Analysis by the Legislative Reference Bureau

This bill makes a number of changes to the regulation of dietitians.

Licensure and use of titles

Under current law, a person may be certified as a dietitian by the Dietitians Affiliated Credentialing Board (board) in the Department of Regulation and Licensing (DRL). With certain exceptions, current law prohibits a person who is not certified by the board from designating himself or herself as a dietitian, claiming to provide dietetic services, or using any title or initial that would represent that person as certified or licensed as a dietitian or in a nutrition-related field.

"Dietitian" is defined under current law as an individual who practices dietetics, which is defined to mean the integration and application of principles from nutritional science, biochemistry, food systems management, and other fields in order to achieve or maintain the health of an individual or group of individuals. "Dietetics" is further defined under current law to include assessing the nutritional needs of an individual or group of individuals; establishing priorities, goals and objectives to meet those nutritional needs; and providing nutritional counseling.

This bill changes the title of a person licensed by the board from "dietitian" to "dietitian or nutritionist," and defines a dietitian or nutritionist as a person who practices dietetics and nutrition care services. The bill also changes the title of the board to the Dietetics and Nutrition Care Services Affiliated Credentialing Board. The bill defines "dietetics and nutrition care services" to mean the integration and application of principles derived from the sciences of food, nutrition, management, communication, biology, physiology, behavior, and the social sciences to achieve and maintain optimal human health. The bill defines the "practice of dietetics and nutrition care services" to exclude the retail sale of food products or vitamins, but to include: 1) the assessment of the nutritional needs of an individual or group of individuals; 2) establishing priorities, goals, and objectives to meet these nutritional needs; and 3) medical nutrition therapy. The bill defines "medical nutrition therapy" as nutritional diagnostic, therapy, and counseling services provided for the purpose of managing disease.

The bill directs the board to license, not certify, persons as a licensed dietitian or nutritionist. The bill prohibits a person who is not licensed from practicing dietetics or nutrition care services. The bill also prohibits, with certain exceptions, a person who is not licensed by the board from using any of the following titles or initials: dietitian, certified dietitian, licensed dietitian, nutritionist, certified nutritionist, licensed nutritionist, dietitian and nutritionist, certified dietitian and nutritionist, licensed dietitian and nutritionist, nutrition consultant, nutritional consultant, L.D., L.N., L.D.N., or any title or initials that may tend to represent that the person is certified or licensed as a dietitian or in a nutrition-related field.

Requirements for licensure by the board

To be certified as a dietitian or nutritionist under current law, a person must do all of the following:

1. Receive a bachelor's, master's, or doctoral degree in certain fields, including human nutrition, nutrition education, and food system management, received from a college or university that the board determines is regionally accredited. If the college or university is not located in the United States, the degree must be substantially equivalent to a degree offered by a regionally accredited college or university. Alternatively, a person may receive a degree from a program approved by the board.

2. Complete at least 900 supervised hours of dietetics practice.

3. Pass the registration examination, or its equivalent, established by the American Dietetic Association (ADA).

Under current law, a person who has satisfied the educational and practice requirements described above, and who has applied to take the next available examination, may obtain a temporary dietitian certificate.

Under the bill, to be licensed by the board, an individual must do all of the following:

1. Possess a bachelor's, master's, or doctoral degree granted from a regionally accredited college or university and complete a didactic program in dietetics approved by the ADA. If the college or university is not located in the United States, the academic degree must be deemed equivalent to the degree granted by a United States regionally accredited college or university.

2. Complete 900 supervised practice hours under a supervised practice program accredited by the ADA.

3. Pass the registration examination for dietitians established by the ADA.

Under the bill, a person who satisfies the educational and practice requirements described above, and who submits a letter from the ADA verifying that person's registration eligibility status, may obtain a temporary license.

The bill requires an applicant for renewal of a license to provide DRL with the following: 1) proof of registration with the ADA; or 2) satisfactory completion of continuing education requirements established by the board by rule.

Exemptions from licensure

Current law exempts a person who is licensed or certified and lawfully practicing as any of the following from obtaining certification from the board provided the person practices within the scope of his or her license or certificate and does not claim to be a dietitian or licensed in a nutrition-related field: nurses, chiropractors, dentists, physicians, physical therapists, podiatrists, athletic trainers, occupational therapists, optometrists, pharmacists, acupuncturists, nursing home administrators, and persons to whom a practice or procedure is delegated by any of the above. In addition, current law exempts the following from obtaining certification from the board: 1) persons who are pursuing a degree or certificate from an educational program approved by the board; 2) a dietetic technician or assistant working under the supervision of a certified dietitian; 3) a dietitian serving in the U.S. armed forces; and 4) a person who markets or distributes food and other goods, who explains the use, benefits, or preparation of food and other goods, and who furnishes nutritional information about food and other goods provided that person does not claim to be a dietitian or certified dietitian and that person complies with applicable law.

Under the bill, only the following persons do not need to obtain a license from the board: 1) a physician; 2) a dietitian or nutritionist serving in the U.S. armed forces; 3) a licensed chiropractor who has obtained nutritional counseling certification; 4) a retailer that furnishes oral or written general nutrition information about food and other goods in connection with the marketing and distribution of those goods; 5) a person who is not practicing dietetics and nutrition care services who provides general nutrition information about food and other goods; and 6) a person who provides weight control services under a program of instruction approved in writing by a licensed dietitian, a physician, or a person registered as a dietitian with the ADA.

For further information see the state fiscal estimate, which will be printed as an appendix to this bill.

The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:

AB742, s. 1 Section 1. 15.406 (2) (intro.) of the statutes is amended to read:

AB742,4,6 15.406 (2) Dietitians Dietetics and nutrition care services affiliated credentialing board. (intro.) There is created in the department of regulation and licensing, attached to the medical examining board, a dietitians dietetics and nutrition care services affiliated credentialing board consisting of the following members appointed for 4-year terms:

AB742, s. 2 Section 2. 15.406 (2) (a) of the statutes is amended to read:

AB742,4,9 15.406 (2) (a) Three dietitians individuals who are certified licensed as a dietitian or nutritionist under subch. V of ch. 448.

AB742, s. 3 Section 3. 48.981 (2) (a) 24. of the statutes is amended to read:

AB742,4,11 48.981 (2) (a) 24. A dietitian or nutritionist.

AB742, s. 4 Section 4. 146.81 (1) (em) of the statutes is amended to read:

AB742,5,2 146.81 (1) (em) A dietitian certified An individual licensed as a dietitian or nutritionist under subch. V of ch. 448.

AB742, s. 5 Section 5. 146.89 (1) (r) of the statutes is amended to read:

AB742,5,12 146.89 (1) (r) "Volunteer health care provider" means an individual who is licensed as a physician under ch. 448, dentist or dental hygienist under ch. 447, registered nurse, practical nurse, or nurse-midwife under ch. 441, optometrist under ch. 449, or physician assistant under ch. 448, who is certified licensed as a dietitian or nutritionist under subch. V of ch. 448, or who is a nurse practitioner, as defined in s. 255.06 (1) (d), and who receives no income from the practice of that health care profession or who receives no income from the practice of that health care profession when providing services at the nonprofit agency or school specified under sub. (3).

AB742, s. 6 Section 6. 146.997 (1) (d) 6. of the statutes is amended to read:

AB742,5,15 146.997 (1) (d) 6. A dietician certified An individual licensed as a dietitian or nutritionist under subch. V of ch. 448.

AB742, s. 7 Section 7. 180.1901 (1m) (br) of the statutes is amended to read:

AB742,5,18 180.1901 (1m) (br) Dietitians Dietetics and nutrition care services affiliated credentialing board under subch. V of ch. 448.

AB742, s. 8 Section 8. 252.14 (1) (ar) 4m. of the statutes is amended to read:

AB742,5,21 252.14 (1) (ar) 4m. A dietitian certified An individual licensed as a dietitian or nutritionist under subch. V of ch. 448.

AB742, s. 9 Section 9. 440.03 (13) (b) 23. of the statutes is amended to read:

AB742,5,23 440.03 (13) (b) 23. Dietitian or nutritionist.

AB742, s. 10 Section 10. 440.08 (2) (a) 27m. of the statutes is amended to read:

AB742,6,2 440.08 (2) (a) 27m. Dietitian or nutritionist: November 1 of each even-numbered year; $56.

AB742, s. 11 Section 11. 440.08 (2) (a) 27m. of the statutes, as affected by 2007 Wisconsin Act 20 and 2007 Wisconsin Act .... (this act), is repealed and recreated to read:

AB742,6,6 440.08 (2) (a) 27m. Dietitian or nutritionist: November 1 of each even-numbered year.

AB742, s. 12 Section 12. 446.02 (6m) of the statutes is amended to read:

AB742,6,13 446.02 (6m) No chiropractor may provide counsel, direction, guidance, advice, or a recommendation to a patient regarding the health effects of vitamins, herbs, or nutritional supplements unless the chiropractor has been issued a certificate under sub. (2) (c). This subsection does not apply to a chiropractor licensed under this chapter who is certified licensed as a dietician dietitian or nutritionist under subch. V of ch. 448.

AB742, s. 13 Section 13. Subchapter V (title) of chapter 448 [precedes 448.70] of the statutes is amended to read:

AB742,6,16 chapter 448

AB742,6,20 SUBCHAPTER V DIETITIANS DIETETICS AND NUTRITION CARE SERVICES AFFILIATED CREDENTIALING BOARD

AB742, s. 14 Section 14. 448.70 (1) of the statutes is renumbered 448.70 (1g) and amended to read:

AB742,6,25 448.70 (1g) "Affiliated credentialing board" means the dietitians dietetics and nutrition care services affiliated credentialing board.

AB742, s. 15 Section 15. 448.70 (1d) of the statutes is created to read:

AB742,7,4 448.70 (1d) "Accreditation commission" means the commission on accreditation for dietetics education of the American Dietetic Association or its successor.

AB742, s. 16 Section 16. 448.70 (1m) of the statutes is renumbered 448.70 (4) and amended to read:

AB742,7,8 448.70 (4) "Certified Licensed dietitian or nutritionist" means an individual who is certified licensed as a dietitian or nutritionist under this subchapter.

AB742, s. 17 Section 17. 448.70 (2) of the statutes is amended to read:

AB742,7,20 448.70 (2) "Dietetics and nutrition care services" means the integration and application of principles of nutritional science, biochemistry, derived from the sciences of food science, physiology, food systems , nutrition, management, behavioral science communication, biology, physiology, behavior, and the social science in order sciences to achieve or and maintain the optimal human health of an individual or group of individuals. "Dietetics" includes assessing the nutritional needs of an individual or group of individuals and determining available resources and constraints in meeting those nutritional needs; establishing priorities, goals and objectives that meet those nutritional needs and are consistent with available resources and constraints; providing nutrition counseling; or developing, implementing and managing nutritional care systems.

AB742, s. 18 Section 18. 448.70 (3) of the statutes is amended to read:

AB742,7,23 448.70 (3) "Dietitian or nutritionist" means an individual who practices dietetics and nutrition care services.

AB742, s. 19 Section 19. 448.70 (5) to (7) of the statutes are created to read:

AB742,8,4 448.70 (5) "Medical nutrition therapy" means nutritional diagnostic, therapy, and counseling services provided to an individual or group of individuals for the purpose of managing disease. Such services include nutrition assessment, interventions, reassessment, and follow-up interventions.

AB742,8,6 (6) "Practice of dietetics and nutrition care services" includes each of the following but does not include the retail sale of food products or vitamins:

AB742,8,11 (a) Assessing the nutritional needs of an individual or group of individuals based upon biochemical, anthropometric, physical, and dietary data; determining the resources and constraints to meet the nutritional needs of that individual or group of individuals; and recommending proper nutrition intake to satisfy those needs.

AB742,8,14 (b) Establishing priorities, goals, and objectives to meet the nutritional needs of the individual or group of individuals based on available resources and constraints.

AB742,8,16 (c) Providing nutrition counseling to an individual or group of individuals regarding health and disease.

AB742,8,18 (d) Evaluating, adjusting, and maintaining standards of quality in dietetics and nutrition care services.

AB742,8,19 (e) Providing medical nutrition therapy.

AB742,8,21 (7) "Registration commission" means the commission on dietetic registration of the American Dietetic Association or its successor.

AB742, s. 20 Section 20. 448.71 of the statutes is created to read:

AB742,8,25 448.71 License required. Except as provided in s. 448.72, no person may practice dietetics and nutrition care services unless the person is licensed as a dietitian or nutritionist under this subchapter.

AB742, s. 21 Section 21. 448.72 (intro.) and (1) (intro.) of the statutes are consolidated, renumbered 448.72 (intro.) and amended to read:

AB742,9,5 448.72 Applicability. (intro.) This subchapter does not do any of the following: (1) (intro.) Require require a certificate license under this subchapter for any of the following:

AB742, s. 22 Section 22. 448.72 (1) (a) and (b) of the statutes are repealed.

AB742, s. 23 Section 23. 448.72 (1) (c) of the statutes is renumbered 448.72 (9) and amended to read:

AB742,9,15 448.72 (9) A person pursuing a supervised course of study, including internships, leading to a degree or certificate student enrolled in a dietetics educational program that is from an accredited educational program or an educational program approved by the affiliated credentialing board accreditation commission if the student's enrollment is for the purpose of meeting eligibility requirements to take the examination for dietitians established by the registration commission.

AB742, s. 24 Section 24. 448.72 (1) (d) of the statutes is repealed.

AB742, s. 25 Section 25. 448.72 (1) (e) of the statutes is renumbered 448.72 (10) and amended to read:

AB742,9,23 448.72 (10) A dietitian or nutritionist who is serving in the U.S. armed forces, as defined in s. 40.02 (57m), or in the commissioned corps of the federal public health service or is employed by the U.S. veterans administration, and who is engaged in the practice of dietetics and nutrition care services as part of that service or employment.

AB742, s. 26 Section 26. 448.72 (1) (f) of the statutes is repealed.

AB742, s. 27 Section 27. 448.72 (2) of the statutes is repealed.

AB742, s. 28 Section 28. 448.72 (3) of the statutes is renumbered 448.76 (3) and amended to read:

AB742,10,7 448.76 (3) Prohibit an An individual described in sub. (1) (e) from using s. 448.72 (10) may use the title "dietitian or nutritionist" or any letters or designation that represents or may tend to represent the individual as a dietitian or nutritionist, if the title, letters, or designation is used only in the course of the individual's service or employment.

AB742, s. 29 Section 29. 448.72 (4) of the statutes is renumbered 448.76 (4) and amended to read: