Proposed Dietitians Administrative Rules

Chapter 116. Dietitians

Proposal Filed: March 2, 2018 – Published in the Texas Register: March 16, 2018

Deadline for Public Comment: April 16, 2018

Underlined text is new language.

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The Texas Department of Licensing and Regulation (Department) proposes changes to the rules under 16 Texas Administrative Code (TAC), Chapter 116, by amending existing rules under Subchapter A, §116.2; Subchapter C, §116.20; Subchapter D, §116.30; Subchapter E, §116.40 and §116.44; Subchapter F, §116.50; Subchapter I, §116.80 and §116.83; Subchapter J, §116.91; Subchapter K, §§116.100, 116.101, and 116.103 - 116.105; Subchapter L, §116.110; Subchapter M, §116.120; Subchapter N, §116.130; and Subchapter O, §116.142; and by repealing existing rules under Subchapter E, §116.41 and §116.43; Subchapter G, §§116.60 - 116.65; and Subchapter H, §116.70, related to the Dietitians program. These changes are collectively referred to as “proposed rules” within this preamble.

JUSTIFICATION AND EXPLANATION OF THE RULES

The rules under 16 TAC Chapter 116 implement Texas Occupations Code, Chapter 701, Dietitians. The statute and rules govern the licensing and regulation of dietitians.

This rulemaking is necessary to implement House Bill 4007 (H.B. 4007), 85 th Legislature, Regular Session (2017); eliminate unnecessary and outdated rules regarding the required preplanned professional experience programs and internships to reflect current industry practice; and make clean-up changes to the current rules identified by Department staff. These three categories of rule changes have been combined into one proposal, since there is overlap in a few of the affected rule sections and this combined proposal eliminates the need for separate rulemakings.

H.B. 4007 Changes

H.B. 4007, in part, made changes to the Dietitians statute, Occupations Code Chapter 701 . H.B. 4007 repealed the Provisional Licensed Dietitian and the Temporary Licensed Dietitian provisions. It also repealed provisions that were outdated or were barriers to efficient regulation. It also repealed redundancies in the Dietitians statute with provisions already found in Occupations Code Chapter 51, which is the enabling statute for the Texas Commission of Licensing and Regulation (Commission) and the Department and which applies to all Department programs.

Changes to Reflect Current Industry Practice Regarding Preplanned Professional Experience Programs and Internships

The proposed rules make changes to the Department’s rules regarding preplanned professional experience programs and internships. These changes eliminate unnecessary and outdated rules and reflect the current industry practice.

The Commission on Dietetic Registration (CDR) is the credentialing agency that registers dietitians on a national basis. The requirements to become a registered dietitian include completing a preplanned professional experience program, internship, or other accredited supervised program or pathway approved or recognized by CDR and passing the CDR written examination. Applicants must meet the CDR requirements to be eligible to take the CDR examination.

Under the Dietitians statute and rules, the requirements to become a Texas licensed dietitian include completing a preplanned professional experience program or internship and passing a license examination. As provided for by statute and rule, the required examination for licensure is the CDR examination.

Under the current rules, the preplanned professional experience program or internship must be approved by the Department. The current rules, however, provide that an applicant's preplanned professional experience program or internship accepted for registration by the CDR shall be acceptable for licensure by the Department.

Since applicants must qualify under CDR’s requirements to take the CDR exam, persons seeking state licensure go through the CDR process to obtain the CDR registration prior to seeking a Texas license. Applicants are not using the separate, alternative paths for preplanned professional experience programs and internships set out the current rules. Meeting the qualifications for CDR registration means that the person also meets or exceeds the qualifications for state licensure.

Based on the industry practice of persons completing preplanned professional experience programs or internships that are approved or recognized by CDR in order to meet the CDR requirements to qualify to take the CDR examination, there is no need to retain separate, alternative paths that are not approved or recognized by CDR. The proposed rules eliminate unnecessary and outdated provisions in the rules.

Clean-up Changes

The proposed rules make clean-up changes identified by Department staff since the Dietitians program was transferred from the Department of State Health Services (DSHS) to the Department effective October 3, 2016, pursuant to S.B. 202, 84th Legislature, Regular Session (2015).

Advisory Board Discussion and Recommendations

The Department staff presented the draft proposed rules to the Dietitians Advisory Board (Advisory Board) at its meeting on February 27, 2018. The Advisory Board discussed the draft proposed rules and did not make any changes. The Advisory Board recommended that the draft proposed rules be published in the Texas Register as proposed rules for public comment.

SECTION-BY-SECTION SUMMARY

The proposed rules amend §116.2, Definitions. The proposed rules amend the definition of licensee; remove the definition of provisional licensed dietitian; and renumber the definition of registered dietitian. These changes are a result of H.B. 4007.

The proposed rules amend §116.20, Degrees and Course Work. The proposed rules amend subsection (c) by removing the reference to provisional licensure. This change is a result of H.B. 4007.

The proposed rules amend § 116.30, Preplanned Professional Experience Programs and Internships. The proposed rules remove subsections (e) and (h), regarding provisional licensure and provisional licensed dietitians. These changes are a result of H.B. 4007.

In addition, the proposed rules under §116. 30 amend subsections (b), (c), and (d) to state that the Department approves, and accepts as meeting the licensure requirements, a preplanned professional experience program or an internship approved or recognized by the CDR. The proposed rules eliminate the separate, alternative paths for preplanned professional experience programs and internships that have not been used in many years. These changes reflect the current industry practice and ensure that a person seeking licensure meets or exceeds the statutory license requirements and is eligible to take the examination administered by CDR.

The proposed rules under §116.30 also remove subsections (e) and (f) to eliminate unnecessary and outdated provisions. The proposed rules re-letter current subsection (g) as new subsection (e) and update this subsection to reflect the current industry practice. The license applicant must submit a photocopy of the CDR registration card in active status to show proof of completing the preplanned profession experience program or internship. These changes are part of the changes to reflect current industry practice regarding preplanned professional experience programs and internships.

The proposed rules amend §116.40, License Examination Requirements. The proposed rules amend the title of the section and consolidate §116.41(a) into §116.40 as new subsection (d). The remaining provisions under §116.41 are being repealed as a result of H.B. 4007.

The proposed rules repeal §116.41, License Examination Qualifications. The proposed repeal is a result of H.B. 4007, which repealed outdated license examination provisions from the statute.

The proposed rules repeal §116.43, Examination Failures. The proposed repeal is a result of H.B. 4007, which repealed the restriction on retaking the licensing examination if the applicant fails the examination three times.

The proposed rules amend § 116.44, Texas Jurisprudence Examination. The proposed rules update the cross-reference to other rules and remove the reference to a provisional licensed dietitian. These changes are a result of H.B. 4007.

The proposed rules amend §116.50, Licensed Dietitians--Application and Eligibility Requirements. The proposed rules remove subsection (e) regarding the Department notifying the applicant whether the applicant qualifies to take the license examination. This change is a result of H.B. 4007, which repealed outdated license examination provisions from the statute.

In addition, the proposed rules under §116.50 provide that a license applicant shall submit a copy of a CDR registration in active status as proof that the applicant successfully completed the required preplanned professional experience program or internship and passed the required examination. The proposed rules remove the requirement that the applicant submit the internship or preplanned professional experience program documentation form. The proposed rules also add cross-references to the applicable sections in the statute and rules. These changes are part of the changes to reflect current industry practice regarding preplanned professional experience programs and internships.

The proposed rules repeal Subchapter G, Provisional Licensed Dietitians. The proposed repeal is a result of H.B. 4007, which repealed the provisional licensed dietitian provisions from the statute.

The proposed rules repeal § 116.60, Provisional Licensed Dietitians--Application and Eligibility Requirements. The proposed repeal is a result of H.B. 4007.

The proposed rules repeal § 116.61, Provisional Licensed Dietitians--Fitness of Applicants for Licensure. The proposed repeal is a result of H.B. 4007.

The proposed rules repeal § 116.62, Provisional Licensed Dietitians--Issuing Licenses and Identification Cards. The proposed repeal is a result of H.B. 4007.

The proposed rules repeal § 116.63, Provisional Licensed Dietitians--License Term; Renewals. The proposed repeal is a result of H.B. 4007.

The proposed rules repeal § 116.64, Provisional Licensed Dietitians--Upgrading to Licensed Dietitian. The proposed repeal is a result of H.B. 4007.

The proposed rules repeal § 116.65, Provisional Licensed Dietitians--Supervision. The proposed repeal is a result of H.B. 4007.

The proposed rules repeal Subchapter H, Temporary Licensed Dietitians. The proposed repeal is a result of H.B. 4007, which repealed the temporary licensed dietitian provisions from the statute.

The proposed rules repeal § 116.70, Temporary Licensed Dietitians--Application and Eligibility Requirements; License Term. The proposed repeal is a result of H.B. 4007.

The proposed rules amend § 116.80, Continuing Education--General Requirements and Hours. The proposed rules remove subsection (c) regarding provisional licensed dietitians and completing continuing education hours. This change is a result of H.B. 4007.

The proposed rules amend § 116.83, Continuing Education--Failure to Complete. The proposed rules remove the reference to provisional licensed dietitian and make a related technical change. These changes are a result of H.B. 4007.

The proposed rules amend §116.91, Rules. The proposed rules remove the placeholder language and insert the specific citation to 16 TAC Chapter 100, General Provisions for Health-Related Programs. These changes are part of the clean-up changes.

The proposed rules amend §116.100, Display of License. The proposed rules amend subsection (a) by removing the reference to provisional licensed dietitians. This change is a result of H.B. 4007.

The proposed rules amend § 116.101, Changes of Name or Address. The proposed rules amend subsection (a) by removing the reference to provisional licensed dietitians. This change is a result of H.B. 4007.

The proposed rules amend §116.103, Disclosure. The proposed rules remove subsection (b) regarding provisional licensed dietitian disclosures in advertising and announcements of services. These changes are a result of H.B. 4007.

The proposed rules amend § 116.104, Unlawful, False, Misleading, or Deceptive Advertising. The proposed rules amend subsection (c) by removing references to provisional licensed dietitian and temporary licensed dietitian. These changes are a result of H.B. 4007.

The proposed rules amend §116.105, Code of Ethics. The proposed rules amend subsection (a) by removing paragraph (12), regarding supervising provisional licensed dietitians, and by renumbering the following paragraphs. The proposed rules remove subsection (c), regarding supervising a provisional licensed dietitian or a temporary licensed dietitian, and re-letter the following subsections. These changes are a result of H.B. 4007. In addition, the proposed rules remove unnecessary subheadings in former subsections (f) and (g) (re-lettered subsections (e) and (f)). These changes are part of the clean-up changes.

The proposed rules amend §116.110, Fees. The proposed rules remove the upgrade fee for provisional licensed dietitians under subsection (b), the provisional licensed dietitian fees under subsection (c), and the temporary licensed dietitian fees under subsection (d). The proposed rules also re-letter the subsequent subsections. These changes are a result of H.B. 4007. In addition, the proposed rules remove the application processing fee for preplanned professional experience approval under subsection (b). This change is part of the changes to reflect current industry practice regarding preplanned professional experience programs and internships.

The proposed rules amend §116.120, Complaints Regarding Standard of Care. The proposed rules remove the placeholder language and insert the specific citation to 16 TAC Chapter 100, General Provisions for Health-Related Programs. These changes are part of the clean-up changes.

The proposed rules amend §116.130, Administrative Penalties and Sanctions. The proposed rules make a technical change that reflects the change made by H.B. 4007. The bill repealed the program-specific administrative penalties section in Occupations Code Chapter 701. Occupations Code Chapter 51, which applies to all the Department’s programs, includes administrative penalties provisions, which will apply to the Dietitians program. These changes are a result of H.B. 4007.

The proposed rules amend § 116.142, Licensed Dietitians Providing Diabetes Self-Management Training. The proposed rules remove subsection (g), regarding provisional licensed dietitians. This change is a result of H.B. 4007. In addition, the proposed rules revise or remove subheadings within the section. These changes are part of the clean-up changes.

FISCAL IMPACT ON STATE AND LOCAL GOVERNMENT

Brian E. Francis, Executive Director, has determined that for each year of the first five years the proposed rules are in effect, there are no estimated additional costs or reductions in costs to the state as a result of enforcing or administering the proposed rules. There are very few provisional licensed dietitians, and no temporary licensed dietitians, so the elimination of these license types will not change the cost of operating the program.

Mr. Francis has determined that for each year of the first five years the proposed rules are in effect, there will be a loss in revenue to the state as a result of enforcing or administering the proposed rules. H.B. 4007 repealed the provisional and temporary dietitian licenses, so the proposed rules will impact state revenues because these two license types and all associated fees are being eliminated from the rules.

Regarding the elimination of the provisional dietitian license, it is estimated that there will be a reduction in revenue of $656 for each year of the first five years the proposed rules are in effect. The initial provisional dietitian licensing fee was $54 and the renewal fee was $45. This license was issued for a one-year term and could only be renewed twice. In addition, there was a $20 upgrade fee from provisional to licensed dietitian. The estimated loss in revenue is based on the current number of provisional licensed dietitians (11), assuming that in each year, the Department would have processed a maximum of four initial applications, eight provisional dietitian license renewals, and four license upgrades.

The elimination of the $54 temporary license fee does not impact program revenue, since there have been no temporary licenses issued in many years and no reason to anticipate that any would be issued in the next five years. The elimination of the $350 preplanned professional experience program approval fee does not impact program revenue, since there have been no requests for approval submitted in many years and no reason to anticipate that any would be submitted in the next five years.

Mr. Francis has determined that for each year of the first five years the proposed rules are in effect, enforcing or administering the proposed rules does not have foreseeable implications relating to costs or revenues of local governments.

LOCAL EMPLOYMENT IMPACT STATEMENT

Mr. Francis has determined that the proposed rules will not affect the local economy, so the agency is not required to prepare a local employment impact statement under Government Code §2001.022.

PUBLIC BENEFITS

Mr. Francis also has determined that for each year of the first five-year period the proposed rules are in effect, the public benefit will be implementing the changes made by H.B. 4007; eliminating outdated and unnecessary provisions regarding preplanned professional experience programs and internships; and making clean-up changes of existing rules. The proposed rules will benefit the public by removing obsolete references and provisions for license types that have been eliminated from the statute; eliminating outdated provisions regarding the licensing examination; eliminating the restriction on retaking the licensing examination if the applicant fails the examination three times; providing clarity regarding the license application requirements; and eliminating outdated and unnecessary provisions regarding preplanned professional experience programs and internships to reflect the current industry practice. The proposed rules make changes to conform the rules to the updated program statute and to align the rules with current agency practice. These changes seek to ensure that the program functions efficiently and effectively for license holders and applicants and protects the health, safety, and welfare of the public.

PROBABLE ECONOMIC COSTS TO PERSONS REQUIRED TO COMPLY WITH PROPOSAL

Mr. Francis has determined that for each year of the first five-year period the proposed rules are in effect, there are no anticipated economic costs to persons who are required to comply with the proposed rules.

FISCAL IMPACT ON SMALL BUSINESSES, MICRO-BUSINESSES, AND RURAL COMMUNITIES

There will be no adverse effect on small businesses, micro-businesses, or rural communities as a result of the proposed rules.

Since the agency has determined that the proposed rules will have no adverse economic effect on small businesses, micro-businesses, or rural communities, preparation of an Economic Impact Statement and a Regulatory Flexibility Analysis, as detailed under Texas Government Code §2006.002, are not required.

ONE-FOR-ONE REQUIREMENT FOR RULES WITH A FISCAL IMPACT

Under Government Code §2001.0045, a state agency may not adopt a proposed rule if the fiscal note states that the rule imposes a cost on regulated persons, including another state agency, a special district, or a local government, unless the state agency: (a) repeals a rule that imposes a total cost on regulated persons that is equal to or greater than the total cost imposed on regulated persons by the proposed rule; or (b) amends a rule to decrease the total cost imposed on regulated persons by an amount that is equal to or greater than the cost imposed on the persons by the proposed rule. There are exceptions for certain types of rules under §2001.0045(c).

The proposed rules do not have a fiscal note that imposes a cost on regulated persons, including another state agency, a special district, or a local government. Therefore, the agency is not required to take any further action under Government Code §2001.0045.

GOVERNMENT GROWTH IMPACT STATEMENT

Pursuant to Government Code §2001.0221, the agency provides the following Government Growth Impact Statement for the proposed rules. For each year of the first five years the proposed rules will be in effect, the agency has determined the following:

(1) The proposed rules do not create or eliminate a government program.

(2) Implementation of the proposed rules does not require the creation of new employee positions

or the elimination of existing employee positions.

(3) Implementation of the proposed rules does not require an increase or decrease in future legislative appropriations to the agency.

(4) The proposed rules do require a decrease in fees paid to the agency. H.B. 4007 eliminated the provisional license, which will decrease fees paid to the agency by an estimated $656 for each year of the first five years the proposed rules will be in effect. The elimination of the temporary license by H.B. 4007 will not decrease fees paid to the agency, since there have been no temporary licenses issued in many years and no reason to anticipate that any would be issued in the next five years. The elimination of the preplanned professional experience approval fee does not decrease fees paid to the agency, since there have been no requests for approval submitted in many years and no reason to anticipate that any would be submitted in the next five years.

(5) The proposed rules do not create a new regulation.

(6) The proposed rules do not expand existing regulations, but they do repeal existing regulations. Pursuant to H.B. 4007, the proposed rules repeal the temporary and provisional license provisions and repeal certain licensing examination provisions. The proposed rules also repeal the department-approved preplanned professional experience program provisions to eliminate outdated and unnecessary provisions and to reflect current industry practice.

(7) The proposed rules do decrease the number of individuals subject to the rule's applicability. The 11 individuals currently licensed as provisional licensed dietitians will no longer be licensed in accordance with the provisions of H.B. 4007 once their existing licenses expire. They are ineligible to renew those licenses, and the Department may not issue new provisional dietitian licenses, effective September 1, 2017. Some of those provisionally licensed individuals may become fully licensed dietitians.

(8) The proposed rules do not positively or adversely affect this state's economy.

PUBLIC COMMENTS

Comments on the proposal may be submitted to Ana Villarreal, Legal Assistant, Texas Department of Licensing and Regulation, P.O. Box 12157, Austin, Texas 78711, or facsimile (512) 475-3032, or electronically: erule.comments@tdlr.texas.gov . The deadline for comments is 30 days after publication in the Texas Register.

STATUTORY AUTHORITY

The proposed rules are proposed under Texas Occupations Code, Chapters 51 and 701, which authorize the Commission, the Department’s governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51, 701, and Texas Insurance Code §1358.055. No other statutes, articles, or codes are affected by the proposal.

SUBCHAPTER A. GENERAL PROVISIONS

§116.2. Definitions.

The following words and terms, when used in this chapter, shall have the following meanings, unless the context clearly indicates otherwise:

(1) - (14) (No change.)

(15) Licensee--A person who holds a current license as a dietitian [ or provisional licensed

dietitian ] issued under the Act.

(16) - (18) (No change.)

[ (19) Provisional licensed dietitian (PLD)--A person provisionally licensed under the Act. ]

(19) [ (20) ] Registered dietitian (RD)--A person who is currently registered as a dietitian by the

Commission on Dietetic Registration.

The amendments are proposed under Texas Occupations Code, Chapters 51 and 701, which authorize the Commission, the Department’s governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51, 701, and Texas Insurance Code §1358.055. No other statutes, articles, or codes are affected by the proposal.

SUBCHAPTER C. EDUCATION REQUIREMENTS

§116.20. Degrees and Course Work.

(a) - (b) (No change.)

(c) Persons applying for licensure [ or provisional licensure ] must possess a baccalaureate or post-baccalaureate degree with a major course of study in human nutrition, food and nutrition, nutrition education dietetics, or food systems management.

(d) - (g) (No change.)

The amendments are proposed under Texas Occupations Code, Chapters 51 and 701, which authorize the Commission, the Department’s governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51, 701, and Texas Insurance Code §1358.055. No other statutes, articles, or codes are affected by the proposal.

SUBCHAPTER D. EXPERIENCE REQUIREMENTS

§116.30. Preplanned Professional Experience Programs and Internships.

(a) (No change.)

(b) The department approves, and accepts as meeting the licensure requirements, a [ The ]

preplanned professional experience program or an internship [ must be approved by the

department ] as prescribed under subsections (c) and (d).

(c) A preplanned professional experience program shall be [ : ]

[ (1) ] a preplanned professional experience program approved or recognized by the Commission

on Dietetic Registration [ ; or ]

[ (2) an individualized program, beyond the undergraduate level, that is planned and supervised by at least one licensed or registered dietitian, and is completed within three years after commencement of the program ].

(d) An internship shall [ : ]

[ (1) ] be a dietetic internship, a coordinated undergraduate program in dietetics, or a professional experience program in dietetics approved or recognized by the Commission on Dietetic Registration [ ; and ]

[ (2) have a signed statement submitted from the director of the program with the application. ]

[ (e) A person who participates in a department-approved preplanned professional experience

program or internship must: ]

[ (1) be provisionally licensed under this chapter; and ]

[(2) have a supervision agreement under this chapter. ]

[ (f) Documentation of the preplanned professional experience program or internship must be provided to the department on a department-approved form or in a manner prescribed by the department. ]

(e) [ (g) ] To show proof of completing the preplanned professional experience program or internship, an applicant [ Applicants who are registered in active status by the Commission on Dietetic Registration ] at the time of [ making ] application must [ shall ] submit a photocopy of the registration card issued by the Commission on Dietetic Registration [ or submit the registration card number ]. The registration card must be in active status. The applicant's [ internship or ] preplanned professional experience program or internship accepted for registration by the Commission on Dietetic Registration shall be acceptable for licensure by the department. [ No further proof of completion of an internship or preplanned professional experience program shall be required from the applicant. ]

[ (h) Provisional licensed dietitians shall be deemed to have met the academic requirements for admission into department approved preplanned professional experience and internship programs. ]

The amendments are proposed under Texas Occupations Code, Chapters 51 and 701, which authorize the Commission, the Department’s governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51, 701, and Texas Insurance Code §1358.055. No other statutes, articles, or codes are affected by the proposal.

SUBCHAPTER E. EXAMINATION REQUIREMENTS

§116.40. License Examination Requirements [ --General ].

(a) Except as provided by subsection (c), an applicant must pass a license examination to qualify for a dietitian license under this chapter.

(b) Pursuant to Texas Occupations Code §701.253, the examination required for licensure as a Licensed Dietitian is the examination given by the Commission on Dietetic Registration.

(c) The department shall waive the examination requirement for an applicant who, at the time of application, is a dietitian registered by the Commission on Dietetic Registration and whose registration is in active status.

(d) An applicant must meet the education and experience requirements under Texas Occupations Code §701.254 to qualify to take the licensing examination.

§116.44. Texas Jurisprudence Examination

(a) An applicant for licensure as a licensed dietitian [ or provisional licensed dietitian ] shall pass the Texas Jurisprudence Examination prescribed by the department.

(b) The Texas Jurisprudence Examination is separate from the license examination under §116.40 and §116.42 [ §116.40 - §116.43 ]. The Texas Jurisprudence Examination tests the applicant’s knowledge of the statute, rules and any other applicable law affecting the applicant’s dietetics practice.

(c) (No change.)

(d) The applicant must successfully complete the Texas Jurisprudence Examination and submit a certificate of completion prior to receiving a license as a licensed dietitian [ or a provisional licensed dietitian ].

The amendments are proposed under Texas Occupations Code, Chapters 51 and 701, which authorize the Commission, the Department’s governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51, 701, and Texas Insurance Code §1358.055. No other statutes, articles, or codes are affected by the proposal.

SUBCHAPTER F. LICENSED DIETITIANS

§116.50. Licensed Dietitians--Application and Eligibility Requirements.

(a) (No change.)

(b) An applicant must submit the following required documentation:

(1) (No change.)

[ (2) the internship or preplanned professional experience program documentation form; ]

(2) [ (3) ] official transcript(s) of all relevant college work showing successful completion of the education requirements under Texas Occupations Code §701.254(1);

(3) [ (4) ] copy of the registration card issued by the Commission on [ of ] Dietetic Registration [ , if applicable ] as proof that the applicant:

(A) successfully completed the preplanned professional experience program or internship requirements under Texas Occupations Code §701.254(2) and rule §116.30; and

(B) passed the examination prescribed under Texas Occupations Code §701.253 and rules §116.40 and §116.42;

(4) [ (5) ] the form providing information regarding other state licenses, certificates or registrations that an applicant holds or held, if applicable;

(5) [ (6) ] proof of successfully completing the Texas Jurisprudence Examination under Texas Occupations Code §701.2575 and rule §116.44; and

(6) [ (7) ] the fee required under §116.110.

(c) - (d) (No change.)

[ (e) The department will notify the applicant pursuant to §116.41, regarding whether the applicant qualifies to take the license examination. ]

(e) [ (f) ] Pursuant to Texas Occupations Code §701.151, the commission or the department shall deny the application for violation of the Act, this chapter, or a provision of the Code of Ethics in §116.105.

The amendments are proposed under Texas Occupations Code, Chapters 51 and 701, which authorize the Commission, the Department’s governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51, 701, and Texas Insurance Code §1358.055. No other statutes, articles, or codes are affected by the proposal.

SUBCHAPTER I. CONTINUING EDUCATION

§116.80. Continuing Education--General Requirements and Hours.

(a) Licensed dietitians [ and provisional licensed dietitians ] are required to take continuing education.

(b) (No change.)

[ (c) A provisional licensed dietitian must complete a minimum of six (6) continuing education hours during each one-year licensing period. ]

(c) [ (d) ] The hours must have been completed prior to the date of expiration of the license.

§116.83. Continuing Education--Failure to Complete.

(a) A person who fails to complete continuing education requirements for renewal holds an expired license and may not use the title [ titles ] “licensed dietitian”. [ or “provisional licensed dietitian.” ]

(b) (No change.)

The amendments are proposed under Texas Occupations Code, Chapters 51 and 701, which authorize the Commission, the Department’s governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51, 701, and Texas Insurance Code §1358.055. No other statutes, articles, or codes are affected by the proposal.

SUBCHAPTER J. RESPONSIBILITIES OF THE COMMISSION AND THE DEPARTMENT

§116.91. Rules.

(a) Pursuant to the authority under Texas Occupations Code §51.203, the commission shall adopt rules necessary to implement the Dietitians program. Pursuant to 16 Texas Administrative Code (TAC) §60.22, the department is authorized to propose rules.

[( b) Pursuant to §51.2031, the department will not propose changes to standards of practice rules without being proposed by the advisory board. ]

(b) [ (c) ] The commission has adopted [ will adopt ] rules governing changes to the standards of practice rules pursuant to §51.2031. These rules are located at 16 TAC Chapter 100.

The amendments are proposed under Texas Occupations Code, Chapters 51 and 701, which authorize the Commission, the Department’s governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51, 701, and Texas Insurance Code §1358.055. No other statutes, articles, or codes are affected by the proposal.

SUBCHAPTER K. RESPONSIBILITIES OF THE LICENSEE AND CODE OF ETHICS

§116.100. Display of License.

(a) This section applies to licensed dietitians [ and provisional licensed dietitians ].

(b) - (e) (No change.)

§116.101. Changes of Name or Address.

(a) This section applies to licensed dietitians [ and provisional licensed dietitians ].

(b) - (c) (No change.)

§116.103. Disclosure.

[ (a) ] A licensee shall notify each client of the name, mailing address, telephone number, and website address of the department for the purpose of directing complaints to the department by providing notification:

(1) on each written contract for services of a licensee;

(2) on a sign prominently displayed in the primary place of business of each licensee; or

(3) in a bill for service provided by a licensee to a client or third party.

[ (b) A provisional licensed dietitian must include the name and telephone number of his or her supervisor in all advertising and announcements of services including business cards and applications for employment. ]

§116.104. Unlawful, False, Misleading, or Deceptive Advertising.

(a) - (b) (No change.)

(c) As used in this section, a “health care professional” includes a licensed dietitian [ , provisional licensed dietitian, temporary licensed dietitian, ] or any other person licensed, certified, or registered by the state in a health-related profession.

§116.105. Code of Ethics.

(a) Professional representation and responsibilities.

(1) - (11) (No change.)

[ (12) A licensed dietitian shall supervise a provisional licensed dietitian in accordance with §116.65. ]

(12) [ (13) ] A licensee shall not make any false, misleading, or deceptive claims in any advertisement, announcement, or presentation relating to the services of the licensee, any person supervised by the licensee or any dietary supplement.

(13) [ (14) ] A licensee shall conform to generally accepted principles and standards of dietetic practice which are those generally recognized by the profession as appropriate for the situation presented, including those promulgated or interpreted by or under the Academy or Commission on Dietetic Registration, and other professional or governmental bodies. A licensee shall recognize and exercise professional judgment within the limits of his/her qualifications and collaborate with others, seek counsel, or make referrals as appropriate.

(14) [ (15) ] A licensee shall not interfere with an investigation or disciplinary proceeding by willful misrepresentation of facts to the department or its authorized representative or by the use of threats or harassment against any person.

(15) [ (16) ] A licensee shall report information if required by the following statutes:

(A) Texas Family Code, Chapter 261, concerning abuse or neglect of minors; or

(B) Texas Human Resources Code, Chapter 48, concerning abuse, neglect, or exploitation of elderly or disabled persons.

(b) (No change.)

[ (c) A licensed dietitian shall supervise a provisional licensed dietitian or a temporary licensed dietitian for whom the licensee has assumed supervisory responsibility. ]

(c) [ (d) ] On the written request of a client, a client's guardian, or a client's parent, if the client is a minor, a licensee shall provide, in plain language, a written explanation of the charges for client nutrition services previously made on a bill or statement for the client. This requirement applies even if the charges are to be paid by a third party.

(d) [ (e) ] A licensee may not persistently or flagrantly overcharge or overtreat a client.

(e) [ (f) ] [ Sanctions. ] A licensee shall be subject to disciplinary action by the commission or department if under the Crime Victims Compensation Act, Texas Code of Criminal Procedure, Article 56.31, the licensee is issued a public letter of reprimand, is assessed a civil penalty by a court, or has been convicted and ordered to pay court costs under the Crime Victims Compensation Act, Texas Code of Criminal Procedure, Chapter 56, Subchapter B, Article 56.55.

(f) [ (g) ] [ Applicants. ] A violation of any provision of this section by a person who is an applicant or who subsequently applies for a license (even though the person was not a licensee at the time of the violation) may be a basis for disapproval of the application.

The amendments are proposed under Texas Occupations Code, Chapters 51 and 701, which authorize the Commission, the Department’s governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51, 701, and Texas Insurance Code §1358.055. No other statutes, articles, or codes are affected by the proposal.

SUBCHAPTER L. FEES

§116.110. Fees.

(a) (No change.)

(b) Licensed Dietitian Fees:

(1) Initial application fee (includes two-year initial license)--$108; and

[ (2) License fee for upgrade of provisional licensed dietitian to licensed dietitian--$20; ]

(2) [ (3) ] Renewal application fee (for two-year license)--$90. [ ; and ]

[ (4) Application processing fee for preplanned professional experience approval--$350. ]

[ (c) Provisional Licensed Dietitian Fees: ]

[ (1) Initial application fee (includes one-year initial license)--$54; ]

[(2) License fee for upgrade of provisional licensed dietitian to licensed dietitian--$20; ]

[ (3) Renewal application fee (for one-year license; may only be renewed twice)--$45; and ]

[ (4) Application processing fee for preplanned professional experience approval--$350. ]

[ (d) Temporary Licensed Dietitian Fees. Initial application fee (includes initial license)--$54. ]

(c) [ (e) ] A duplicate/replacement fee for licenses issued under this chapter is $25.

(d) [ (f) ] Late renewal fees for licenses issued under this chapter are provided under §60.83 of this title (relating to Late Renewal Fees).

(e) [ (g) ] A dishonored/returned check or payment fee is the fee prescribed under §60.82 of this title (relating to Dishonored Payment Device).

(f) [ (h) ] The fee for a criminal history evaluation letter is the fee prescribed under §60.42 of this title (relating to Criminal History Evaluation Letters).

The amendments are proposed under Texas Occupations Code, Chapters 51 and 701, which authorize the Commission, the Department’s governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51, 701, and Texas Insurance Code §1358.055. No other statutes, articles, or codes are affected by the proposal.

SUBCHAPTER M. COMPLAINTS

§116.120. Complaints Regarding Standard of Care.

The commission has adopted [ will adopt ] rules related to handling complaints regarding standard of care pursuant to Texas Occupations Code §51.2031. These rules are located at 16 Texas Administrative Code Chapter 100.

The amendments are proposed under Texas Occupations Code, Chapters 51 and 701, which authorize the Commission, the Department’s governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51, 701, and Texas Insurance Code §1358.055. No other statutes, articles, or codes are affected by the proposal.

SUBCHAPTER N. ENFORCEMENT PROVISIONS

§116.130. Administrative Penalties and Sanctions.

If a person or entity violates any provision of Texas Occupations Code, Chapters 51 or 701, this chapter, or any rule or order of the executive director or commission, proceedings may be instituted to impose administrative penalties, administrative sanctions, or both in accordance with the provisions of Texas Occupations Code, Chapter 51 and 701 , as applicable, and any associated rules.

The amendments are proposed under Texas Occupations Code, Chapters 51 and 701, which authorize the Commission, the Department’s governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51, 701, and Texas Insurance Code §1358.055. No other statutes, articles, or codes are affected by the proposal.

SUBCHAPTER O. THE DIETETIC PROFESSION

§116.142. Licensed Dietitians Providing Diabetes Self-Management Training.

(a) (No change.)

(b) [ Diabetes self-management training. ] Diabetes self-management training covers the following training:

(1) training provided to a qualified enrollee after the initial diagnosis of diabetes in the care and management of that condition, including nutrition counseling and proper use of diabetes equipment and supplies;

(2) additional training authorized on the diagnosis of a physician or other health care practitioner of a significant change in the qualified enrollee’s symptoms or condition that requires changes in the qualified enrollee’s self-management regimen; and

(3) periodic or episodic continuing education training when prescribed by an appropriate health care practitioner as warranted by the development of new techniques and treatments for diabetes.

(c) A licensed dietitian who provides [ Providing ] diabetes self-management training as a member of a multi-disciplinary team must meet the following requirements: [ . ]

(1) Prior to beginning to provide diabetes self-management training as member of a multi-disciplinary team under Insurance Code, Title 8, Subtitle E, Chapter 1358, §1358.055(c)(2), a licensed dietitian must complete at least six (6) hours of continuing education in diabetes-specific or diabetes-related topics within the previous two years.

(2) Thereafter, to remain qualified to continue to provide such services, a licensed dietitian shall complete at least six (6) hours of continuing education biennially in diabetes-specific or diabetes-related topics.

(3) A licensed dietitian who is not a Certified Diabetes Educator and who is providing diabetes self-management training as a member of a multi-disciplinary team under Insurance Code, Title 8, Subtitle E, Chapter 1358, §1358.055(c)(2), shall confine his or her professional services to nutrition education and/or counseling, lifestyle modifications, the application of self-management skills, reinforcing diabetes self-management training, and other acts within the scope of his or her professional education and training which are conducted under the supervision of the coordinator of the multi-disciplinary team.

(d) A licensed dietitian who provides [ Providing ] the nutrition component of diabetes self-management training must meet the following requirements: [ . ]

(1) Prior to beginning to provide the nutrition component of diabetes self-management training under Insurance Code, Title 8, Subtitle E, Chapter 1358, §1358.055(c)(4), a licensed dietitian must complete at least six (6) hours of continuing education in diabetes-specific or diabetes-related topics within the previous two years.

(2) Thereafter, to remain qualified to continue to provide such services, a licensed dietitian shall show proof to the department completion of at least six (6) hours of continuing education biennially in diabetes-specific or diabetes-related topics.

(e) [ Continuing education. ] The continuing education completed under this section shall meet the requirements described in Subchapter I, Continuing Education. The continuing education completed under this section may be part of the credits required for renewal of a license.

(f) [ Submission of continuing education to the department. ] Upon written request by the department, the licensed dietitian shall submit to the department proof of completion of the continuing education completed under this section. The licensed dietitian shall submit the proof of completion in a manner and a timeframe acceptable to the department.

[ (g) Provisional Licensed Dietitians. A provisional licensed dietitian shall not provide diabetes self-management training under these rules. ]

(g) [ (h) ] [ Certified Diabetes Educator. ] This section does not apply to a licensed dietitian who is a diabetes educator certified by the National Certification Board for Diabetes Educators.

(h) [ (i) ] [ Non-application of rules. ] This section does not pertain to or restrict a licensed dietitian who does not qualify under this section from providing the nutrition component of diabetes self-management training within the scope of the license issued by the department, to a person:

(1) who is not a qualified enrollee as defined in the Insurance Code, Title 8, Subtitle E, Chapter 1358, §1358.051;

(2) who does not intend to seek payment for or reimbursement for diabetes self-management training; or

(3) without the written order of a licensed physician or other healthcare practitioner.

The repeal is proposed under Texas Occupations Code, Chapters 51 and 701, which authorize the Commission, the Department’s governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51, 701, and Texas Insurance Code §1358.055. No other statutes, articles, or codes are affected by the proposal.

SUBCHAPTER E. EXAMINATION REQUIREMENTS

[§116.41 License Examination Qualifications]

[§116.43 Examination Failures]

The repeal is proposed under Texas Occupations Code, Chapters 51 and 701, which authorize the Commission, the Department’s governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51, 701, and Texas Insurance Code §1358.055. No other statutes, articles, or codes are affected by the proposal.

[SUBCHAPTER G. PROVISIONAL LICENSED DIETITIANS]

[§116.60 Provisional Licensed Dietitians--Application and Eligibility Requirements ]

[§116.61 Provisional Licensed Dietitians--Fitness of Applicants for Licensure]

[§116.62 Provisional Licensed Dietitians--Issuing Licenses and Identification Cards ]

[§116.63 Provisional Licensed Dietitians--License Term; Renewals ]

[§116.64 Provisional Licensed Dietitians--Upgrading to Licensed Dietitian ]

[§116.65 Provisional Licensed Dietitians--Supervision]

The repeal is proposed under Texas Occupations Code, Chapters 51 and 701, which authorize the Commission, the Department’s governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51, 701, and Texas Insurance Code §1358.055. No other statutes, articles, or codes are affected by the proposal.

[SUBCHAPTER H. TEMPORARY LICENSED DIETITIANS]

[§116.70 Temporary Licensed Dietitians--Application and Eligibility Requirements; License Term ]

REVIEW BY AGENCY COUNSEL

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be a valid exercise of the agency’s legal authority.

Filed with the Office of the Secretary of State, on March 2, 2018.


Brian E. Francis

Executive Director

Texas Department of Licensing and Regulation