TKK:bjk&kjf:jf
2009 - 2010 LEGISLATURE
September 23, 2009 - Introduced by Representatives Pasch, Hebl, Danou,
Spanbauer, Fields, A. Ott, Zepnick, Soletski, Richards, Suder and Lothian,
cosponsored by Senators Vinehout, Carpenter, Lehman, Taylor and Plale.
Referred to Committee on Health and Healthcare Reform.
AB440,2,2
1An Act to repeal 448.72 (1) (a) and (b), 448.72 (1) (d), 448.72 (1) (f), 448.72 (2),
2448.74 (1), 448.78 (3) (c) and 448.78 (4) (a), (b) and (c);
to renumber and
3amend 448.70 (1), 448.70 (1m), 448.72 (1) (c), 448.72 (1) (e), 448.72 (3), 448.72
4(4), 448.72 (5), 448.72 (6), 448.76, 448.78 (4) (intro.) and 448.82;
to consolidate,
5renumber and amend 448.72 (intro.) and (1) (intro.) and 448.74 (intro.) and
6(2);
to amend 15.406 (2) (intro.), 15.406 (2) (a), 48.981 (2) (a) 24., 146.81 (1)
7(em), 146.89 (1) (r), 146.997 (1) (d) 6., 180.1901 (1m) (br), 251.06 (3) (e) 2., 252.14
8(1) (ar) 4m., 440.03 (13) (b) 23., 440.08 (2) (a) 27m., 446.02 (6m), subchapter V
9(title) of chapter 448 [precedes 448.70], 448.70 (2), 448.70 (3), 448.78 (intro.),
10448.78 (1), 448.78 (3) (a), 448.78 (3) (b), 448.78 (5), 448.80, 448.84 (1), 448.84 (2),
11448.86 (title) and (1), 448.86 (2), 448.87 (2) (intro.) and (a), 448.87 (2) (b), 448.87
12(2) (e), 448.87 (2) (g), 450.10 (3) (a) 5m., 632.895 (1) (b) 5. b. and 655.45 (1m); and
13to create 448.70 (1d), 448.70 (1r), 448.70 (6) and (7), 448.71, 448.72 (7), 448.72
14(11), 448.72 (12), 448.76 (7), 448.82 (1), 448.86 (3) and 448.865 of the statutes;
1relating to: licensure of dietitian nutritionists and requiring the exercise of
2rule-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
1Section
1. 15.406 (2) (intro.) of the statutes is amended to read:
AB440,4,22
15.406
(2) Dietitians
Dietetics and nutrition care services affiliated
3credentialing board. (intro.) There is created in the department of regulation and
4licensing, attached to the medical examining board, a
dietitians dietetics and
1nutrition care services affiliated credentialing board consisting of the following
2members appointed for 4-year terms:
AB440, s. 2
3Section
2. 15.406 (2) (a) of the statutes is amended to read:
AB440,4,54
15.406
(2) (a) Three
dietitians individuals who are
certified licensed as a
5dietitian nutritionist under subch. V of ch. 448.
AB440, s. 3
6Section
3. 48.981 (2) (a) 24. of the statutes is amended to read:
AB440,4,77
48.981
(2) (a) 24. A dietitian
nutritionist.
AB440, s. 4
8Section
4. 146.81 (1) (em) of the statutes is amended to read:
AB440,4,109
146.81
(1) (em)
A dietitian certified
An individual licensed as a dietitian
10nutritionist under subch. V of ch. 448.
AB440, s. 5
11Section
5. 146.89 (1) (r) of the statutes is amended to read:
AB440,4,2112
146.89
(1) (r) "Volunteer health care provider" means an individual who is
13licensed as a physician under ch. 448, dentist or dental hygienist under ch. 447,
14registered nurse, practical nurse, or nurse-midwife under ch. 441, optometrist
15under ch. 449,
or physician assistant under ch. 448,
or pharmacist under ch. 450,
who
16is certified as a dietitian
nutritionist under subch. V of ch. 448, or who is a nurse
17practitioner, as defined in s. 255.06 (1) (d), or who performs functions described for
18pharmacy technicians in rules promulgated by the pharmacy examining board, and
19who receives no income from the practice of that health care profession or who
20receives no income from the practice of that health care profession when providing
21services at the nonprofit agency or school specified under sub. (3).
AB440, s. 6
22Section
6. 146.997 (1) (d) 6. of the statutes is amended to read:
AB440,4,2423
146.997
(1) (d) 6.
A dietician certified An individual licensed as a dietitian
24nutritionist under subch. V of ch. 448.
AB440, s. 7
25Section
7. 180.1901 (1m) (br) of the statutes is amended to read:
AB440,5,2
1180.1901
(1m) (br)
Dietitians
Dietetics and nutrition care services affiliated
2credentialing board under subch. V of ch. 448.
AB440, s. 8
3Section
8. 251.06 (3) (e) 2. of the statutes is amended to read:
AB440,5,74
251.06
(3) (e) 2. A public health nutritionist, who is a
certified licensed dietitian
5nutritionist, as defined in s. 448.70
(1m) (5), is credentialed as a registered dietitian
6by the Commission on Dietetic Registration, and meets qualifications that the
7department shall specify by rule.
AB440, s. 9
8Section
9. 252.14 (1) (ar) 4m. of the statutes is amended to read:
AB440,5,109
252.14
(1) (ar) 4m.
A dietitian certified An individual licensed as a dietitian
10nutritionist under subch. V of ch. 448.
AB440, s. 10
11Section
10. 440.03 (13) (b) 23. of the statutes is amended to read:
AB440,5,1212
440.03
(13) (b) 23. Dietitian
nutritionist.
AB440,5,1615
440.08
(2) (a) 27m. Dietitian
nutritionist: November 1 of each even-numbered
16year.
AB440, s. 12
17Section
12. 446.02 (6m) of the statutes is amended to read:
AB440,5,2318
446.02
(6m) No chiropractor may provide counsel, direction, guidance, advice,
19or a recommendation to a patient regarding the health effects of vitamins, herbs, or
20nutritional supplements unless the chiropractor has been issued a certificate under
21sub. (2) (c). This subsection does not apply to a chiropractor licensed under this
22chapter who is
certified licensed as a
dietician dietitian nutritionist under subch. V
23of ch. 448.
AB440, s. 13
24Section
13. Subchapter V (title) of chapter 448 [precedes 448.70] of the
25statutes is amended to read:
AB440,6,5
2SUBCHAPTER V
3DIETITIANS DIETETICS AND NUTRITION
4
CARE SERVICES AFFILIATED
5
CREDENTIALING BOARD
AB440, s. 14
7Section
14. 448.70 (1) of the statutes is renumbered 448.70 (1g) and amended
8to read:
AB440,6,109
448.70
(1g) "Affiliated credentialing board" means the
dietitians dietetics and
10nutrition care services affiliated credentialing board.
AB440, s. 15
11Section
15. 448.70 (1d) of the statutes is created to read:
AB440,6,1412
448.70
(1d) "Accreditation commission" means the commission on
13accreditation for dietetics education of the American Dietetic Association or its
14successor.
AB440, s. 16
15Section
16. 448.70 (1m) of the statutes is renumbered 448.70 (5) and amended
16to read:
AB440,6,1817
448.70
(5) "
Certified Licensed dietitian
nutritionist" means an individual who
18is
certified licensed as a dietitian
nutritionist under this subchapter.
AB440, s. 17
19Section
17. 448.70 (1r) of the statutes is created to read:
AB440,6,2320
448.70
(1r) "Dietetic and nutrition therapy" means nutritional diagnostic,
21therapy, and counseling services provided to an individual or group of individuals for
22the purpose of managing disease. Such services include nutrition assessment,
23interventions, reassessment, and follow-up interventions.
AB440, s. 18
24Section
18. 448.70 (2) of the statutes is amended to read:
AB440,7,11
1448.70
(2) "Dietetics
and nutrition care services" means the integration and
2application of principles
of nutritional science, biochemistry, derived from the
3sciences of food
science, physiology, food systems
, nutrition, management,
4behavioral science communication, biology, physiology, behavior, and
the social
5science in order sciences to achieve
or and maintain
the optimal human health
of an
6individual or group of individuals. "Dietetics" includes assessing the nutritional
7needs of an individual or group of individuals and determining available resources
8and constraints in meeting those nutritional needs; establishing priorities, goals and
9objectives that meet those nutritional needs and are consistent with available
10resources and constraints; providing nutrition counseling; or developing,
11implementing and managing nutritional care systems.
AB440, s. 19
12Section
19. 448.70 (3) of the statutes is amended to read:
AB440,7,1413
448.70
(3) "Dietitian
nutritionist" means an individual who
practices engages
14in the practice of dietetics
and nutrition care services.
AB440, s. 20
15Section
20. 448.70 (6) and (7) of the statutes are created to read:
AB440,7,1716
448.70
(6) "Practice of dietetics and nutrition care services" includes each of the
17following but does not include the retail sale of food products or vitamins:
AB440,7,2218
(a) Assessing the nutritional needs of an individual or group of individuals
19based upon biochemical, anthropometric, physical, and dietary data; determining
20the resources and constraints to meet the nutritional needs of that individual or
21group of individuals; and recommending proper nutrition intake to satisfy those
22needs.
AB440,7,2523
(b) Establishing priorities, goals, and objectives to meet the nutritional needs
24of the individual or group of individuals based on available resources and
25constraints.
AB440,8,2
1(c) Providing nutrition counseling to an individual or group of individuals
2regarding health and disease.
AB440,8,43
(d) Evaluating, adjusting, and maintaining standards of quality in dietetics
4and nutrition care services.
AB440,8,55
(e) Providing dietetic and nutrition therapy.
AB440,8,7
6(7) "Registration commission" means the commission on dietetic registration
7of the American Dietetic Association or its successor.
AB440, s. 21
8Section
21. 448.71 of the statutes is created to read:
AB440,8,11
9448.71 License required. Except as provided in s. 448.72, no person may
10engage in the practice of dietetics and nutrition care services unless the person is
11licensed as a dietitian nutritionist under this subchapter.
AB440, s. 22
12Section
22. 448.72 (intro.) and (1) (intro.) of the statutes are consolidated,
13renumbered 448.72 (intro.) and amended to read:
AB440,8,16
14448.72 Applicability. (intro.)
This No license is required under this 15subchapter
does not do any of the following: (1) (intro.) Require a certificate under
16this subchapter for any of the following:
AB440, s. 23
17Section
23. 448.72 (1) (a) and (b) of the statutes are repealed.
AB440, s. 24
18Section
24. 448.72 (1) (c) of the statutes is renumbered 448.72 (9) and
19amended to read:
AB440,9,220
448.72
(9) A
person pursuing a supervised course of study, including
21internships, leading to a degree or certificate student enrolled in
a dietetics
22educational program that is from an accredited
educational program or an
23educational program approved by the
affiliated credentialing board accreditation
24commission if the student's enrollment is for the purpose of meeting eligibility
1requirements to take the examination for dietitians established by the registration
2commission.
AB440, s. 25
3Section
25. 448.72 (1) (d) of the statutes is repealed.
AB440, s. 26
4Section
26. 448.72 (1) (e) of the statutes is renumbered 448.72 (10) and
5amended to read:
AB440,9,106
448.72
(10) A dietitian
nutritionist who is serving in the U.S. armed forces, as
7defined in s. 40.02 (57m), or in the commissioned corps of the federal public health
8service or is employed by the U.S. veterans administration, and who is engaged in
9the practice of dietetics
and nutrition care services as part of that service or
10employment.
AB440, s. 27
11Section
27. 448.72 (1) (f) of the statutes is repealed.
AB440, s. 28
12Section
28. 448.72 (2) of the statutes is repealed.