AB440: Bill Text

AB440,2,2 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), 251.06 (3) (e) 2., 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 (title) and (1), 448.86 (2), 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); and to create 448.70 (1d), 448.70 (1r), 448.70 (6) and (7), 448.71, 448.72 (7), 448.72 (11), 448.72 (12), 448.76 (7), 448.82 (1), 448.86 (3) and 448.865 of the statutes; relating to: licensure of dietitian nutritionists 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.

This bill directs the board to license, not certify, persons as "dietitian nutritionists." With certain exceptions, 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 certain titles or initials.

"Dietitian" is defined under current law as an individual who practices dietetics, which means, generally, using certain nutrition principles to achieve or maintain the health and assess the nutritional needs of and provide nutritional counseling to an individual or group of individuals.

This bill changes the title of the board to the Dietetics and Nutrition Care Services Affiliated Credentialing Board. This bill changes the title of a person licensed by the board from "dietitian" to "dietitian nutritionist." In the bill, a dietitian nutritionist is a person who practices dietetics and nutrition care services. The bill defines "dietetics and nutrition care services," generally, as the integration and application of certain scientific principles to achieve and maintain optimal human health. In the bill, the practice of dietetics and nutrition care services includes assessing nutritional needs and dietetic and nutrition therapy and excludes the retail sale of food products or vitamins.

Requirements for licensure by the board

Under current law, to be certified as a dietitian, a person must: 1) receive a bachelor's, master's, or doctoral degree in certain nutrition fields from a college or university that the board determines is accredited or receive a degree from a program in nutrition approved by the board; 2) complete at least 900 supervised hours of dietetics practice; and 3) pass the registration examination, or its equivalent, established by the American Dietetic Association (ADA). A person who has satisfied these educational and practice requirements and who has applied to take the next available examination, may obtain a temporary dietitian certificate.

Under the bill, to be licensed as a dietitian nutritionist by the board, a person must: 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; 2) complete 900 supervised practice hours under a supervised practice program accredited by the ADA; and 3) pass the registration examination for dietitians established by the ADA. A person who satisfies these educational and practice requirements and who submits a letter from the ADA verifying their registration eligibility status, may obtain a temporary license.

The bill requires an applicant for renewal of a license to provide DRL with proof of registration with the ADA or 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 in certain fields 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. 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, the following persons do not need to obtain a license from the board: 1) a licensed or certified nurse, chiropractor, dentist, physician, physical therapist, podiatrist, athletic trainer, occupational therapist, optometrist, pharmacist, or acupuncturist lawfully practicing within the scope of that license or certificate; 2) a dietitian nutritionist serving in the U.S. armed forces; 3) a retailer that furnishes oral or written general nutrition information about food and other goods; 4) a person who is not practicing dietetics and nutrition care services who provides general nutrition information about food and other goods, provided the person discloses to the person's client that the person is not licensed as a dietitian nutritionist; and 5) a person who provides weight control services under a program of instruction approved in writing by a licensed dietitian nutritionist, a physician, or a person registered as a dietitian with the ADA.

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

AB440, s. 1 Section 1. 15.406 (2) (intro.) of the statutes is amended to read:

AB440,4,2 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:

AB440, s. 2 Section 2. 15.406 (2) (a) of the statutes is amended to read:

AB440,4,5 15.406 (2) (a) Three dietitians individuals who are certified licensed as a dietitian nutritionist under subch. V of ch. 448.

AB440, s. 3 Section 3. 48.981 (2) (a) 24. of the statutes is amended to read:

AB440,4,7 48.981 (2) (a) 24. A dietitian nutritionist.

AB440, s. 4 Section 4. 146.81 (1) (em) of the statutes is amended to read:

AB440,4,10 146.81 (1) (em) A dietitian certified An individual licensed as a dietitian nutritionist under subch. V of ch. 448.

AB440, s. 5 Section 5. 146.89 (1) (r) of the statutes is amended to read:

AB440,4,21 146.89 (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, or pharmacist under ch. 450, who is certified as a dietitian nutritionist under subch. V of ch. 448, or who is a nurse practitioner, as defined in s. 255.06 (1) (d), or who performs functions described for pharmacy technicians in rules promulgated by the pharmacy examining board, 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).

AB440, s. 6 Section 6. 146.997 (1) (d) 6. of the statutes is amended to read:

AB440,4,24 146.997 (1) (d) 6. A dietician certified An individual licensed as a dietitian nutritionist under subch. V of ch. 448.

AB440, s. 7 Section 7. 180.1901 (1m) (br) of the statutes is amended to read:

AB440,5,2 180.1901 (1m) (br) Dietitians Dietetics and nutrition care services affiliated credentialing board under subch. V of ch. 448.

AB440, s. 8 Section 8. 251.06 (3) (e) 2. of the statutes is amended to read:

AB440,5,7 251.06 (3) (e) 2. A public health nutritionist, who is a certified licensed dietitian nutritionist, as defined in s. 448.70 (1m) (5), is credentialed as a registered dietitian by the Commission on Dietetic Registration, and meets qualifications that the department shall specify by rule.

AB440, s. 9 Section 9. 252.14 (1) (ar) 4m. of the statutes is amended to read:

AB440,5,10 252.14 (1) (ar) 4m. A dietitian certified An individual licensed as a dietitian nutritionist under subch. V of ch. 448.

AB440, s. 10 Section 10. 440.03 (13) (b) 23. of the statutes is amended to read:

AB440,5,12 440.03 (13) (b) 23. Dietitian nutritionist.

AB440, s. 11 Section 11. 440.08 (2) (a) 27m. of the statutes, as affected by 2007 Wisconsin Act 20, is amended to read:

AB440,5,16 440.08 (2) (a) 27m. Dietitian nutritionist: November 1 of each even-numbered year.

AB440, s. 12 Section 12. 446.02 (6m) of the statutes is amended to read:

AB440,5,23 446.02 (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 nutritionist under subch. V of ch. 448.

AB440, s. 13 Section 13. Subchapter V (title) of chapter 448 [precedes 448.70] of the statutes is amended to read:

AB440,6,1 chapter 448

AB440,6,5 SUBCHAPTER V DIETITIANS DIETETICS AND NUTRITION CARE SERVICES AFFILIATED CREDENTIALING BOARD

AB440, s. 14 Section 14. 448.70 (1) of the statutes is renumbered 448.70 (1g) and amended to read:

AB440,6,10 448.70 (1g) "Affiliated credentialing board" means the dietitians dietetics and nutrition care services affiliated credentialing board.

AB440, s. 15 Section 15. 448.70 (1d) of the statutes is created to read:

AB440,6,14 448.70 (1d) "Accreditation commission" means the commission on accreditation for dietetics education of the American Dietetic Association or its successor.

AB440, s. 16 Section 16. 448.70 (1m) of the statutes is renumbered 448.70 (5) and amended to read:

AB440,6,18 448.70 (5) "Certified Licensed dietitian nutritionist" means an individual who is certified licensed as a dietitian nutritionist under this subchapter.

AB440, s. 17 Section 17. 448.70 (1r) of the statutes is created to read:

AB440,6,23 448.70 (1r) "Dietetic and 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.

AB440, s. 18 Section 18. 448.70 (2) of the statutes is amended to read:

AB440,7,11 448.70 (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.

AB440, s. 19 Section 19. 448.70 (3) of the statutes is amended to read:

AB440,7,14 448.70 (3) "Dietitian nutritionist" means an individual who practices engages in the practice of dietetics and nutrition care services.

AB440, s. 20 Section 20. 448.70 (6) and (7) of the statutes are created to read:

AB440,7,17 448.70 (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:

AB440,7,22 (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.

AB440,7,25 (b) Establishing priorities, goals, and objectives to meet the nutritional needs of the individual or group of individuals based on available resources and constraints.

AB440,8,2 (c) Providing nutrition counseling to an individual or group of individuals regarding health and disease.

AB440,8,4 (d) Evaluating, adjusting, and maintaining standards of quality in dietetics and nutrition care services.

AB440,8,5 (e) Providing dietetic and nutrition therapy.

AB440,8,7 (7) "Registration commission" means the commission on dietetic registration of the American Dietetic Association or its successor.

AB440, s. 21 Section 21. 448.71 of the statutes is created to read:

AB440,8,11 448.71 License required. Except as provided in s. 448.72, no person may engage in the practice of dietetics and nutrition care services unless the person is licensed as a dietitian nutritionist under this subchapter.

AB440, s. 22 Section 22. 448.72 (intro.) and (1) (intro.) of the statutes are consolidated, renumbered 448.72 (intro.) and amended to read:

AB440,8,16 448.72 Applicability. (intro.) This No license is required under this subchapter does not do any of the following: (1) (intro.) Require a certificate under this subchapter for any of the following:

AB440, s. 23 Section 23. 448.72 (1) (a) and (b) of the statutes are repealed.

AB440, s. 24 Section 24. 448.72 (1) (c) of the statutes is renumbered 448.72 (9) and amended to read:

AB440,9,2 448.72 (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.

AB440, s. 25 Section 25. 448.72 (1) (d) of the statutes is repealed.

AB440, s. 26 Section 26. 448.72 (1) (e) of the statutes is renumbered 448.72 (10) and amended to read:

AB440,9,10 448.72 (10) A dietitian 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.

AB440, s. 27 Section 27. 448.72 (1) (f) of the statutes is repealed.

AB440, s. 28 Section 28. 448.72 (2) of the statutes is repealed.

AB440, s. 29 Section 29. 448.72 (3) of the statutes is renumbered 448.76 (3) and amended to read:

AB440,9,19 448.76 (3) Prohibit an An individual described in sub. (1) (e) from using s. 448.72 (10) may use the title "dietitian nutritionist" or any letters or designation that represents or may tend to represent the individual as a dietitian nutritionist, if the title, letters, or designation is used only in the course of the individual's service or employment.

AB440, s. 30 Section 30. 448.72 (4) of the statutes is renumbered 448.76 (4) and amended to read:

AB440,9,24 448.76 (4) Prohibit an An individual who is registered as a dietitian with the registration commission on dietetic registration of the American Dietetic Association from using may use the title " dietitian" or "registered dietitian" or the initials, "R.D.".

AB440, s. 31 Section 31. 448.72 (5) of the statutes is renumbered 448.76 (5) and amended to read:

AB440,10,6 448.76 (5) Prohibit an An individual who is registered as a dietetic technician with the registration commission on dietetic registration of the American Dietetic Association from using may use the title "dietetic technician" or," "dietetic technician registered" registered," or the initials, "D.T.R.".

AB440, s. 32 Section 32. 448.72 (6) of the statutes is renumbered 448.76 (6) and amended to read:

AB440,10,14 448.76 (6) Prohibit an An individual from using may use the title "dietitian",," "dietitian nutritionist," "licensed dietitian" or," "licensed dietitian nutritionist," "certified dietitian"," or certified dietitian nutritionist" if the person is licensed or certified as a dietitian or dietitian nutritionist under the laws of another state which has licensure or certification requirements that the affiliated credentialing board determines to be substantially equivalent to the requirements under s. 448.78.

AB440, s. 33 Section 33. 448.72 (7) of the statutes is created to read:

AB440,10,18 448.72 (7) A person who is lawfully practicing within the scope of a license or certificate granted under chs. 441, 446, or 447, subchs. I to IV, VI, and VII of ch. 448, or 449 to 451.

AB440, s. 34 Section 34. 448.72 (11) of the statutes is created to read: