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March 31, 2005
S. Printed 3/31/05--S.
Read the first time January 11, 2005.
To whom was referred a Bill (S. 103) to amend Title 40 Code of Laws of South Carolina, 1976, by adding Chapter 20 to enact the "South Carolina Dietetics Licensure Act" so as to establish the South Carolina, etc., respectfully
That they have duly and carefully considered the same and recommend that the same do pass with amendment:
Amend the bill, as and if amended, page 2, immediately before line 10 by inserting:
/ Section 40-20-5. Unless otherwise provided for in this chapter, Article 1, Chapter 1 applies to dietitians regulated or administered, or both, by the Department of Labor, Licensing and Regulation. If there is a conflict between this chapter and Article 1, Chapter 1, the provisions of this chapter control. /
Amend the bill, further by deleting Section 40-20-20(3) on page 2, lines 21 - 24 and inserting:
/ (3) 'Registered dietitian' means an individual who is registered by the Commission on Dietetic Registration of the American Dietetic Association. /
Amend the bill, further by deleting Section 40-20-20(5) on page 2, lines 29-31 and inserting:
/ (5) 'Registered Dietetic Technician' means a person registered according to the criteria established for registered dietetic technicians by the Commission on Dietetic Registration of the American Dietetic Association. /
Amend the bill further, as and if amended, in Section 40-20-49(A), page 3, line 20, immediately after / Governor / by inserting / with the advice and consent of the Senate /;
Amend the bill, further Section 40-20-40(A) page 3, line 19 after / Dietetics / by inserting / under the administration of the Department of Labor, Licensing and Regulation /
Amend the bill, further by deleting Section 40-20-50(4) and (5) on page 4, lines 19 - 26 and inserting:
/ (4) keep a register of all persons licensed. The register must include the name of every license holder and the last known place of employment and residence. The board annually shall compile and make available a list of dietitians licensed to practice in this State. An interested person may obtain a copy of this list upon request to the board and payment of an amount fixed by the board./
Amend the bill, further page 4, immediately after line 26 by inserting:
/ Section 40-20-55. The Department of Labor, Licensing and Regulation:
(1) shall provide all administrative, fiscal, investigative, inspectional, clerical, secretarial, and license renewal operations and activities of the board in accordance with Section 41-1-50;
(2) shall investigate complaints and violations of this chapter as provided for in Section 40-1-80;
(3) on behalf of the board and in accordance with Section 40-1-210, may petition an administrative law judge, in the name of the State, for injunctive relief against a person violating this chapter. /
Amend the bill further, as and if amended, in Section 40-20-60(3), page 4, by deleting on line 36 /post-baccalaureate / and inserting / baccalaureate /;
Amend the bill, further Section 40-20-100(A) page 6, line 11 by deleting /./ and inserting /;/ and immediately after line 11 by inserting
/ (11) engaging in any activity that is beyond the scope of practice of dietetics as set forth in this chapter. /
Amend the bill, further by deleting SECTION 2 of the bill and inserting:
/SECTION 2. Persons engaging in the practice of dietetics or nutrition, as defined in this act, on this act's effective date are not required to comply with the requirements of this act; however before July 1, 2009, such person must comply with continuing education requirements as may be established by the board in regulation.
SECTION 3. This act takes effect July 1, 2005./
Renumber sections to conform.
Amend title to conform.
HARVEY S. PEELER, JR. for Committee.
EXPLANATION OF IMPACT:
This bill establishes a South Carolina Board of Dietetics, which would require approximately $100,000 - $250,000 annually in other funds to operate. Costs include personal service and employer contributions for 1.50 - 3.00 FTEs, including administrative staff and investigators; and operating expenses, including travel and per diem for the seven board members. Since Section 40-20-90 (B) of the bill provides that fees be established to cover the administration of this chapter, there will be no cost to the General Fund of the State.
This estimate is based on expenses for comparable licensing boards with similar number of licensees at the Department of Labor, Licensing and Regulation, although this board would be separate from that agency. There are approximately 850 practicing dietitians in South Carolina.
Office of State Budget
TO AMEND TITLE 40 CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING CHAPTER 20 TO ENACT THE "SOUTH CAROLINA DIETETICS LICENSURE ACT" SO AS TO ESTABLISH THE SOUTH CAROLINA BOARD OF DIETETICS AND TO PROVIDE FOR ITS MEMBERS, POWERS, AND DUTIES; TO PROVIDE FOR THE LICENSURE AND REGULATION OF PERSONS ENGAGING IN THE PRACTICE OF DIETETICS OR NUTRITION, INCLUDING ESTABLISHING CRITERIA FOR LICENSURE AND LICENSE RENEWAL; TO ESTABLISH THE SCOPE OF PRACTICE FOR DIETITIANS; AND TO PROVIDE GROUNDS FOR MISCONDUCT AND PENALTIES FOR MISCONDUCT, INCLUDING CRIMINAL PENALTIES.
Whereas, the General Assembly finds that the practice of dietetics in South Carolina affects the public health, safety, and welfare and should be subject to regulation and control in the public interest to protect the public from the unauthorized and unqualified practice of dietetics and from unprofessional conduct by persons licensed to practice dietetics; and
Whereas, the General Assembly also recognizes the practice of dietetics to be a dynamic and changing art and science, the practice of which is continually evolving to embrace contemporary ideas and more sophisticated methods to ensure patient health and progress; and
Whereas, the General Assembly further expresses its intent that nothing in this act may be construed to allow, authorize, or otherwise permit a practitioner of dietetics to practice medicine or surgery. Now, therefore,
Be it enacted by the General Assembly of the State of South Carolina:
SECTION 1. Title 40 of the 1976 Code is amended by adding:
Section 40-20-10. This chapter may be cited as the 'South Carolina Dietetics Licensure Act'.
Section 40-20-20. As used in this chapter:
(1) 'Board' means the South Carolina Board of Dietetics.
(2) 'Dietetics' or 'nutrition' means the integration and application of principles derived from the science of nutrition, biochemistry, physiology, food, and management and from behavioral and social sciences to achieve and maintain a healthy status. The primary function of dietetic practice is the provision of nutrition care services.
(3) 'Registered dietitian' means a person registered according to the criteria established for registered dietetic technicians by the Commission on Dietetic Registration of the American Dietetic Association.
(4) 'Licensed dietitian' means an individual licensed in good standing to practice dietetics or nutrition pursuant to the provisions of this chapter. For purposes of this chapter, 'dietitian' is synonymous with 'registered dietitian' and 'nutritionist'.
(5) 'Registered Dietetic Technician' means an individual who is registered by the Commission on Dietetic Registration of the American Dietetic Association.
(6) 'Nutrition care services' or 'medical nutrition therapy' means any part or all of the following:
(a) assessing the nutritional needs of individuals and groups and determining resources and constraints in the practice setting;
(b) establishing priorities, goals, and objectives that meet nutritional needs and are consistent with available resources and constraints;
(c) providing nutritional counseling in health and disease;
(d) developing, implementing, and managing nutrition care systems;
(e) evaluating, making changes in, and maintaining appropriate standards of quality in food and nutrition services;
(f) transcribing a verbal order into patient records for cosignature by the ordering physician and implementing a physician's written and verbal orders which pertain to the practice of dietetics, if the practice of dietetics is specifically authorized by the medical director and the health care facility where the care is taking place. In the delivery of dietetic home care, this care must be authorized specifically by the physician sponsor.
(g) implementing nutrition related orders under a protocol approved by the medical staff of a licensed health care facility. 'Nutrition care services' or 'medical nutrition therapy' does not include the retail sale of food products or vitamins and minerals.
Section 40-20-30. Individuals holding themselves out to be dietitians and nutritionists employed to provide dietetic and medical nutrition therapy for inpatients, outpatients, and home patients must be licensed in accordance with this chapter.
Section 40-20-40. (A) There is created the South Carolina Board of Dietetics composed of the following seven members to be appointed by the Governor:
(1) One member shall represent the public at large and must not be a dietitian, an agent or employee of a person engaged in the profession of dietetics, a licensed health care professional, an agent or employee of a health care institution, a health care insurer, or a health care professional school, a member of any allied health care profession, or the spouse of any of these individuals.
(2) One member must be employed by a hospital and recommended by the South Carolina Hospital Association.
(3) Five members must be dietitians licensed to practice in this State and recommended by the South Carolina Dietetic Association:
(a) one must be a professional whose primary practice is clinical dietetics.
(b) one must be a professional whose primary practice is community or public health dietetics.
(c) one must be a professional whose primary practice is consulting in dietetics.
(d) one must be a professional whose primary practice is in management of nutritional services.
(e) one must be an educator on the faculty of a college or university, specializing in the field of dietetics.
(B) Board members shall serve for terms of two years and until their successors are appointed and qualify. Vacancies must be filled in the manner of the original appointment for the unexpired portion of the term, and no member may serve more than two full two-year terms consecutively The Governor may remove a member of the board in accordance with Section 1-3-240. Members of the board shall serve without compensation; however, members may receive mileage, subsistence, and per diem as provided by law for members of state boards, commissions, and committees.
Section 40-20-50. The board shall:
(1) evaluate the qualifications and supervise the examinations of applicants for licensure;
(2) determine the qualifications and make appropriate recommendations regarding issuance of licenses to qualified dietitians;
(3) recommend whether to issue or renew licenses under the conditions prescribed in this chapter and may recommend continuing professional education;
(4) keep a register of all persons licensed. The register must include the name of every license holder and the last known place of employment and residence. The board annually shall compile and make available a list of dietitians licensed to practice in this State. An interested person may obtain a copy of this list upon request to the board and payment of an amount fixed by the board;
(5) shall hear all disciplinary cases and recommend findings of fact, conclusions, and sanctions.
Section 40-20-60. An applicant for licensure as a dietitian shall file a written application on forms provided by the board showing to the satisfaction of the board that the applicant:
(1) is of good moral character; and
(2) has successfully completed the requirements for current registration as a registered dietitian by the Commission on Dietetic Registration; or
(3) has passed an examination as prescribed by the board and has received a post-baccalaureate degree from a regionally accredited college or university or a master's degree in human nutrition, nutrition education, foods and nutrition, public health nutrition, or an equivalent major course of study as approved by the board.
Section 40-20-70. An applicant for licensure who has obtained his or her education outside of the United States and its territories must meet the requirements for current registration as a registered dietitian by the Commission on Dietetic Registration.
Section 40-20-80. (A) A license issued under this chapter is subject to biennial renewal as prescribed by the board. The board may recommend additional requirements for license renewal to obtain evidence of a dietitian's continued competency. The board may provide for the late renewal of a license upon payment of a late fee.
(B) An inactive license is subject to expiration and may be renewed, but renewal does not entitle the dietitian, while the license remains inactive, to engage in the licensed activity of dietetics or to hold himself or herself out as a dietitian. If a license suspended on disciplinary grounds is reinstated, the dietitian, as a condition of reinstatement, shall pay the renewal fee and any applicable late fee.
Section 40-20-90. (A) The board shall prescribe fees for:
(1) initial licensure;
(2) renewal of license fee;
(3) late renewal fee.
(B) The fees established pursuant to subsection (A) must be set in an amount sufficient, to the extent feasible, to cover the cost of administration of this chapter.
Section 40-20-100. (A) The board may revoke or suspend a dietitian's license or impose any other reasonable limitation on a dietitian's practice if the dietitian engages in any of the following conduct and this conduct is likely to endanger the health, welfare, or safety of the public:
(1) using a false, fraudulent, or forged statement or engaging in a fraudulent, deceitful, or dishonest act in connection with any licensure requirement;
(2) having an addiction to alcohol or drugs to such an extent as to render the licensee unfit to practice dietetics;
(3) having been convicted for the illegal or unauthorized practice of dietetics;
(4) knowingly performing any act which in any way assists an unlicensed person to practice dietetics;
(5) having a physical or mental disability that renders further practice by the licensee dangerous to the public;
(6) violating the code of ethics for the profession of dietetics;
(7) engaging in any dishonorable, unethical, or unprofessional conduct that is likely to deceive or harm the public;
(8) using a false or fraudulent statement in any document connected with the practice of dietetics;
(9) intentionally violating or attempting to violate, directly or indirectly, or assisting in or abetting the violation of or conspiring to violate any provision of this chapter;
(10) committing an act, during the course of practice conducted pursuant to a license issued under this chapter, that constitutes fraud, dishonest dealing, illegality, incompetence, or gross negligence.
(B) The suspension or revocation of a dietitian's license or the imposition of probationary conditions upon a dietitian may be recommended by the board after a hearing is conducted.
Section 40-20-110. This chapter does not apply to:
(1) a student enrolled in an approved academic program in dietetics or nutrition who is engaging in the practice of dietetics or nutrition, if the practice constitutes a part of a supervised course of study, and if the student is designated by a title which clearly indicates his status as a student or trainee;
(2) a dietitian or nutritionist who is serving in the Armed Forces or who is employed by any other federal agency and who is engaging in the practice of dietetics or nutrition if this practice is related to the individual's military service or federal employment;
(3)(a) a person in a licensed healthcare profession providing diet, food, or nutrition information within the scope of his or her practice, except that the person may not represent himself or herself as a 'dietitian' or 'nutritionist',
(b) an employee of a physician or osteopath who works in the private office of and under the direction and supervision of a physician or osteopath, if that employee does not engage in the practice of dietetics or nutrition or use the titles 'dietitian' or 'nutritionist';
(4) a person who performs the activities and services of a nutrition educator in the employment of a federal, state, county, or municipal agency, or another political subdivision, or a chartered elementary or secondary school or an accredited degree-granting educational institution if these activities and services are part of a salaried position;
(5) an employee who is engaging in the practice of dietetics or nutrition within the discharge of his or her official duties who is authorized to use the title 'dietitian' or 'nutritionist' and who is not registry-eligible or registered currently with the Commission on Dietetic Registration as of July 1, 2005;
(6) a nonresident registered dietitian or nutritionist practicing dietetics or nutrition in this State for five days without a license or up to thirty days a year with licensure from another state if the requirements for licensure in the other state are substantially equal to the licensure requirements contained in this chapter;
(7) a person marketing or distributing food, food materials, or food supplements or a person who is engaging in an explanation of the use or preparation of these products or a person who is furnishing general nutrition information related to these products in connection with the marketing or distribution of these products, if that person does not represent himself or herself as a dietitian or nutritionist and does not engage in medical nutritional therapy; or
(8) a person providing weight control services through a program that does not allow program change to be initiated without prior approval by a licensed dietitian or nutritionist and the program has been reviewed by, and consultation is available from, a dietitian or nutritionist licensed in another state, which has licensure requirements at least as stringent as the requirements for licensure under this chapter, or a dietitian registered by the Commission on Dietetic Registration of the American Dietetic Association.
Section 40-20-120. Nothing in this chapter may be construed to require direct third-party reimbursement to persons licensed under this chapter.
Section 40-20-130. (A) It is unlawful for a person not licensed under this chapter, or whose license has been suspended or revoked by the board, to hold himself or herself out as a dietitian, nutritionist, licensed dietitian, or licensed nutritionist, alone or in combination, or use with the letters 'LD', 'LN', 'LDN' or any facsimile or combination in any words, letters, abbreviations, or insignia.
(B) A person who violates subsection (A) is guilty of a misdemeanor and, upon conviction, must be fined not more than three hundred dollars or imprisoned for not more than ninety days, or both."
SECTION 2. This act takes effect July 1, 2005.
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