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PA Bulletin, Doc. No. 06-866

RULES AND REGULATIONS

Title 49--PROFESSIONAL AND VOCATIONAL STANDARDS

STATE BOARD OF NURSING

[49 PA. CODE CH. 21]

Licensed Dietitian-Nutritionists

[36 Pa.B. 2396]

   The State Board of Nursing (Board) adopts Subchapter G (relating to dietitian-nutritionists) to read as set forth in Annex A.

Statutory Authority

   Sections 2.1(k) and 11(c) of the Professional Nursing Law (act) (63 P. S. §§ 212(k) and 221(c)) authorize the Board to establish regulations regarding licensed dietitian-nutritionists (LDNs).

Background and Purpose

   The final-form rulemaking implements the act of June 29, 2002 (P. L. 651, No. 99) (Act 99), which requires the Board to regulate the practice of dietetics and nutrition in this Commonwealth and provides for the licensing of dietitian-nutritionists by the Board.

Summary of Comments and Responses to Proposed Rulemaking

   Notice of proposed rulemaking was published at 35 Pa.B. 1213 (February 12, 2005). Publication was followed by a 30-day public comment period. The Board did not receive comments from the general public. On March 16, 2005, the House Professional Licensure Committee (HPLC) submitted comments and suggestions and on April 13, 2005, the Independent Regulatory Review Commission (IRRC) submitted comments and suggestions.

§ 21.701 (relating to definitions)

   The HPLC submitted several comments to this section. The HPLC suggested revisions to the definition of ''sexual impropriety'' because subparagraph (iii) did not prohibit touching a patient's buttocks, subparagraph (iv) did not prohibit accepting a date from a patient and subparagraph (vi) allowed a licensee to provide certain information if asked by the patient. These subparagraphs were rewritten.

   The HPLC asked the Board to clarify the subparagraphs in the definition of ''sexual violation.'' Specifically, the HPLC asked the Board to define the term ''during the professional relationship.'' IRRC also asked that the Board make this change. The Board has added the definition of ''professional relationship'' to § 21.701. The HPLC also asked that the Board make subparagraphs (ii) and (iii) in the definition of ''sexual violation'' more encompassing and suggested that the Board borrow from the Pennsylvania Crimes Code. The Board has adopted the suggestion and made appropriate amendments. Third, the HPLC asked the Board to define ''sexual favors'' as used in subparagraph (v) in the definition of ''sexual violation.'' The Board has amended the language to broadly encompass sexual activity.

   The HPLC and IRRC pointed out that the Board uses the term ''patient'' and ''client'' and questioned whether this distinction was appropriate. Upon further review, the Board determined that the word ''patient'' should be used and that the term should encompass patients (hospitalized individuals), clients (nonhospitalized individuals) and family members. Therefore, the Board amended the definition of ''patient.''

   IRRC noted with confusion that the definition of ''sexual impropriety'' included discussing or commenting on ''potential sexual history.'' The Board has eliminated the word ''potential.'' In addition, IRRC recommended that the Board broaden the definition of ''sexual impropriety.'' The Board has done so.

§ 21.704 (relating to matters related to allegations of sexual impropriety or violation)

   The HPLC suggested additions to § 21.704 to clearly prohibit sexual violations and sexual improprieties and to provide that this conduct constitutes unprofessional conduct. The Board has adopted these suggestions and added subsections (a) and (b) and renumbered the remaining subsections (c)--(e).

   The HPLC asked the Board to clarify subsection (b), noting that the second sentence allowed the Board to consider a past sexual relationship between a licensee and a patient, while the first sentence provides that specific instances of a patient's sexual conduct are inadmissible in proceedings before the Board. The Board intended to allow consideration of a past sexual relationship between a licensee and a patient. For example, if an LDN is involved with an individual prior to the individual becoming the LDN's patient, the Board believes this information is relevant in determining whether the LDN committed misconduct. The Board has added language to clarify that evidence of specific instances of a patient's sexual contact with individuals other than the licensee may not be presented in a disciplinary hearing.

§ 21.711 (relating to professional conduct)

   The HPLC questioned whether subsection (a)(4) should apply to both a patient and a client. Because physicians prescribe patients diets, the Board originally intended subsection (a)(4) to apply only to clients, as patients do not have discretion in refusing to follow a prescribed diet. In a broader sense, however, a patient has the right to refuse any medial regimen. Therefore, the Board amended subsection (a)(4) to refer to a patient, as defined in § 21.701 (relating to definitions). In practice, however, an LDN would not tell a patient that the LDN disagreed with a prescribed diet. Instead, an LDN would discuss any concerns about a prescribed diet with the patient's physician.

   The HPLC recommended that subsection (b)(8) apply to both patients and clients. Because the Board has redefined patient to include patients, clients and family members, the section does now apply to both patients and clients.

   The HPLC noted a drafting error in § 21.711(b)(9), which has been corrected.

Final-form § 21.721 (relating to qualifications for licensure)

   The HPLC recommended that § 21.721 include language regarding the statutory requirement of 900 hours of supervised experience. IRRC recommended that the Board add a section which sets forth all of the initial licensure requirements and the application process. The Board believes that if its regulations are to duplicate statutory provisions, they should not repeat only certain qualifications for licensure set forth in the act. The Board added § 21.721 to include all of the statutory requirements for licensure and renumbered the following sections accordingly. The Board declines to add a section regarding application procedures, as the procedure is simply to file an application as with all other licenses in the Bureau of Professional and Occupational Affairs.

   IRRC also suggested that the final-form rulemaking include a cross-reference to section 6(c) of the act (63 P. S. § 216(c)), regarding the prohibition on licensing individuals convicted of a felony under The Controlled Substance, Drug, Device and Cosmetic Act (35 P. S. §§ 780-101--780-143). The Board does not find that it is necessary to duplicate this section of the act in the regulations.

§ 21.723 (proposed § 21.722) (relating to license renewal)

   The HPLC suggested that the Board rewrite § 21.722(b), final-form § 21.723(b), to avoid giving licensees and members of the public the impression that LDNs will retain their licenses in spite of criminal convictions or other wrongful behavior. IRRC also noted that the subsection appeared to guarantee license renewal regardless of criminal convictions. Because the renewal of a license is a ministerial act and the Board cannot refuse to renew a license without adhering to the constitutional mandates of notice and hearing before deprivation of property, the subsection was technically correct as proposed. Nevertheless, the Board has amended the subsection.

   IRRC also questioned the Board's statutory authority to require a licensee to disclose pending criminal charges. The Board has determined that this information is necessary in administering and enforcing section 14(a)(5) of the act (63 P. S. § 224(a)(5)) and that the Board is authorized to require this information under section 2.1(k) of the act.

§ 21.724 (proposed § 21.723) (relating to continuing education)

   IRRC noted that the Pennsylvania Dietetic Association (PDA) provided comments directly to IRRC asserting that ''there are other reputable groups which provide continuing professional education (CPE) but are not listed in the regulation.'' The list provided by the PDA (medical centers, Amerinet, and the like) are either already approved (medical centers) or American Dietetic Association (ADA) approved, and therefore Board-approved, or would qualify for ADA approval if they applied for ADA approval. The Board cannot list every possible existing and potential provider of CPE and declines to amend its list of preapproved providers.

   IRRC next suggested that the Board insert in the regulations a process by which an organization or individual can apply to become a Board-approved CPE provider. Persons or entities may petition the Board at any time to amend its regulations to include it as a provider under 1 Pa. Code § 35.18 (relating to petitions for issuance, amendment, waiver or deletion of regulations). Given this process, the Board sees no need to include in its regulations a process or procedure by which it will hear these requests.

   IRRC then suggested that subsection (b)(1) be amended to clearly state that an LDN may apply to the Board for CPE credit. The Board has made this amendment. IRRC then asked that the Board list the criteria the Board will use in deciding whether or not to grant CPE credits. The Board believes that the criteria for approval are sufficiently stated in final-form § 21.724 and declines to further specify the qualities of acceptable CPE.

   Finally, IRRC asked by what authority the Board proposes waiver of CPE requirements in subsection (d). The Board relies upon the authority in section 2.1(k) of the act, which grants the Board authority to adopt regulations for the practice of dietetics-nutrition and for the administration of the act. Coincident with practice is the continuing education requirement of biennial renewal. In administering the act, the Board, through subsection (d), would recognize the hardship imposed on certain licensees who are unable to complete the required CPE. If the Board were not able to recognize a hardship waiver, a licensee would have to withdraw from employment or practice. If section 11(c) of the act were construed strictly as a statutory mandate, the Board would have neither the authority to grant a waiver nor the authority to extend the time for compliance. The Board does not believe the Legislature intended this harsh result.

Fiscal Impact and Paperwork Requirements

   The final-form rulemaking will have no adverse fiscal impact on the Commonwealth or its political subdivisions. The final-form rulemaking will impose no additional paperwork requirements upon the Commonwealth, political subdivisions or the private sector.

Regulatory Review

   Under section 5(a) of the Regulatory Review Act (71 P. S. § 745.5(a)), on February 12, 2005, the Board submitted a copy of the notice of proposed rulemaking, published at 35 Pa.B. 1213, to IRRC and the Chairpersons of the Senate Consumer Protection and Professional Licensure Committee (SCP/PLC) and the HPLC for review and comment.

   Under section 5(c) of the Regulatory Review Act, IRRC, the SCP/PLC and the HPLC were provided with copies of the comments received during the public comment period, as well as other documents when requested. In preparing the final-form rulemaking, the Department has considered all comments from IRRC, the SCP/PLC, the HPLC and the public.

   Under section 5.1(j.2) of the Regulatory Review Act (71 P. S. § 745.5a(j.2)), on March 14, 2006, the final-form rulemaking was approved by the HPLC and was deemed approved by the SCP/PLC. Under section 5.1(e) of the Regulatory Review Act, IRRC met on April 19, 2006, and approved the final-form rulemaking.

Additional Information

   Further information can be obtained by contacting Ann Steffanic, Administrative Assistant, State Board of Nursing, P. O. Box 2649, Harrisburg, PA 17105-2649 or from the Department website: www.dos.state.pa.us.

Findings

   The Board finds that:

   (1)  Public notice of proposed rulemaking was given under sections 201 and 202 of the act of July 31, 1968 (P. L. 769, No. 240), (45 P. S. §§ 1201 and 1202) and the regulations promulgated thereunder, 1 Pa. Code §§ 7.1 and 7.2.

   (2)  A public comment period was provided as required by law and all comments were considered.

   (3)  The amendments to this final-form rulemaking do not enlarge the purpose of proposed rulemaking published at 35 Pa.B. 1213.

   (4)  This final-form rulemaking is necessary and appropriate for administering and enforcing the authorizing act identified in this preamble.

Order

   The Board, acting under its authorizing statute, orders that:

   (a)  The regulations of the Board, 49 Pa. Code Chapter 21, are amended by adding §§ 21.701--21.705, 21.711 and 21.721--21.725 to read as set forth in Annex A.

   (b)  The Board shall submit this order and Annex A to the Office of General Counsel and the Office of Attorney General as required by law.

   (c)  The Board shall certify this order and Annex A and deposit them with the Legislative Reference Bureau as required by law.

   (d)  This order shall take effect immediately upon publication in the Pennsylvania Bulletin.

JOANNE SORENSEN, RN, MS,   
Chairperson

   (Editor's Note: For the text of the order of the Independent Regulatory Review Commission, relating to this document, see 36 Pa.B. 2251 (May 6, 2006).)

   Fiscal Note: Fiscal Note 16A-5120 remains valid for the final adoption of the subject regulations.

Annex A

TITLE 49. PROFESSIONAL LICENSURE AND VOCATIONAL STANDARDS

PART I. DEPARTMENT OF STATE

Subpart A. PROFESSIONAL AND OCCUPATIONAL AFFAIRS

CHAPTER 21. STATE BOARD OF NURSING

Subchapter G. DIETITIAN-NUTRITIONISTS

GENERAL PROVISIONS

Sec.

21.701.Definitions.
21.702.Scope.
21.703.Applicability of general rules.
21.704.Matters related to allegations of sexual impropriety or violation.
21.705.Fees.

RESPONSIBILITIES OF THE LICENSED DIETITIAN-NUTRITIONIST

21.711.Professional conduct.

LICENSURE REQUIREMENTS

21.721.Qualifications for licensure.
21.722.Education and examination of applicants.
21.723.License renewal.
21.724.Continuing education.
21.275.Inactive status.

GENERAL PROVISIONS

§ 21.701. Definitions.

   The following words and terms, when used in this subchapter, have the following meanings, unless the content clearly indicates otherwise:

   ACN--American College of Nutrition.

   ADA--American Dietetic Association.

   Act--The Professional Nursing Law (63 P. S. §§ 211--225), which provides for the licensing of Licensed Dietitian-Nutritionists.

   Approved--Approved by the Board.

   Approved program--Those educational programs accredited by the Commission on Accreditation for Dietetics Education or the American Council on Education for dietetics-nutrition education.

   Board--The State Board of Nursing of the Commonwealth.

   CADE--Commission on Accreditation for Dietetics Education--The organization recognized by the Council on Higher Education Accreditation and the United States Department of Education as the accrediting agency for education programs that prepare individuals for the practice of dietetics-nutrition.

   CBNS--Certification Board for Nutrition Specialists--The certification body of the ACN.

   CDR--Commission on Dietetic Registration--The credentialing agency for the ADA.

   CNS--Certified Nutrition Specialist--The title given to individuals who meet the requirements of the CBNS.

   CPE--Continuing professional education, required by the act for biennial license renewal.

   Deviate sexual intercourse--The term as defined in 18 Pa.C.S. § 3101 (relating to definitions).

   Indecent contact--The term as defined in 18 Pa.C.S. § 3101.

   LDN--Licensed dietitian-nutritionist--A person holding a current license under this subchapter to practice dietetics-nutrition in this Commonwealth.

   Patient--A person upon whom or with whom an LDN is practicing dietetics-nutrition, including a client. For purposes of § 21.704 (relating to matters related to allegations of sexual impropriety or violation), any conduct prohibited with a patient is also prohibited with an immediate family member or spouse of a patient.

   Professional relationship--The relationship through which a licensed dietitian-nutritionist provides professional food and nutrition services to a patient. The relationship continues, for purposes of § 21.704, for 30 days after termination of professional services by either the licensed dietitian-nutritionist or the patient.

   RD--Registered Dietitian--The title given to an individual who meets the requirements set forth by the CDR.

   Registration Examination for Registered Dietitians--A written academic examination developed, prepared, administered and scored by the CDR.

   Sexual impropriety--The term includes the following offenses:

   (i)  Making sexually demeaning or sexually suggestive comments about or to a patient, including comments about a patient's body or undergarments.

   (ii)  Exposing a patient's body or watching a patient dress or undress, unless the patient specifically requests assistance.

   (iii)  Examining or touching the body of a patient except in the appropriate performance of the LDN's practice.

   (iv)  Discussing or commenting on a patient's sexual history, preference or performance during consultation, except when the consultation is pertinent to the issue of sexual function or dysfunction or reproductive healthcare.

   (v)  Soliciting or accepting a date from a patient.

   (vi)  Discussing information about one's sexual problems, preferences or fantasies.

   Sexual intercourse--The term as defined in 18 Pa.C.S. § 3101.

   Sexual violation--The term includes the following offenses:

   (i)  Engaging in sexual intercourse, indecent contact or deviate sexual intercourse with a patient during the professional relationship.

   (ii)  Encouraging the patient to masturbate in the presence of the dietitian-nutritionist or masturbating while a patient is present.

   (iii)  Providing or offering to provide drugs, herbs, nutritional supplements or treatment in exchange for indecent contact, sexual intercourse or deviate sexual intercourse.

   (iv)  Using or causing the use of any herb, nutritional supplement or drug affecting consciousness for the purpose of engaging in conduct that would constitute a sexual impropriety or sexual violation.

§ 21.702. Scope.

   In this subchapter the Board:

   (1)  Provides for licensure of dietitian-nutritionists who meet the qualifications set forth in the act.

   (2)  Administers the act by providing rules and regulations for the practice of dietetics-nutrition.

   (3)  Provides rules and regulations for the conduct of licensees.

   (4)  Regulates the practice of LDNs.

§ 21.703. Applicability of general rules.

   The provisions of 1 Pa. Code Part II (relating to the General Rules of Administrative Practice and Procedure) apply to the activities of and proceedings before the Board.

§ 21.704. Matters related to allegations of sexual impropriety or violation.

   (a)  A licensee may not engage in conduct constituting a sexual violation or sexual impropriety.

   (b)  Engaging in conduct constituting a sexual violation or sexual impropriety is unprofessional conduct and will subject the licensee to disciplinary action under section 14 of the act (63 P. S. § 224).

   (c)  The consent of the patient to any sexual impropriety or sexual violation is not a defense to any disciplinary charge for violation of the act or this subchapter.

   (d)  Evidence of specific instances with individuals other than the licensee, opinion evidence or reputation evidence of a patient's past sexual conduct is not admissible in proceedings brought under § 21.711 (relating to professional conduct). The Board may consider sexual relationships between the dietitian-nutritionist and the patient occurring prior to the professional relationship.

   (e)  A dietitian-nutritionist who attempts to raise as a defense an argument that conduct prohibited as a sexual violation or sexual impropriety was necessary or appropriate to the treatment of a patient shall be required to demonstrate competency in practice which relates directly to the treatment of sexual function or dysfunction. This competence may be demonstrated through educational training and supervised clinical experience.

§ 21.705. Fees.

   (a)  The following fees are charged by the Board:

Application for licensure$45
Renewal fee$45
Reactivation of inactive or lapsed license$50
License verification fee$15
License certification fee$25
Restoration after suspension or revocation$50

   (b)  In addition to the application fee prescribed in subsection (a), which is payable directly to the Board, a candidate for the Registration Examination for Registered Dietitians will also pay an additional examination fee. A candidate may contact the Commission on Dietetic Registration, 216 West Jackson Blvd., Chicago, IL 60606-6995, www.cdrnet.org for more information regarding the examination and examination fee.

   (c)  In addition to the application fee prescribed in subsection (a), which is payable directly to the Board, a candidate for the Certification Board for Nutrition Specialists examination for Certified Nutrition Specialists will also pay an additional examination fee. A candidate may contact the Certification Board for Nutrition Specialists, 300 S. Duncan Avenue, Suite 225, Clearwater, FL 33755, www.cert-nutrition.org for more information regarding the examination and examination fee.

RESPONSIBILITIES OF THE LICENSED DIETITIAN-NUTRITIONIST

§ 21.711. Professional conduct.

   (a)  Licensed dietitian-nutritionists shall:

   (1)  Conduct themselves with honesty, integrity and fairness.

   (2)  Practice dietetics based on scientific principles and current information.

   (3)  Present substantiated information and interpret controversial information without personal bias, recognizing that legitimate differences of opinion exist.

   (4)  Provide information which will enable patients to make their own informed decisions regarding nutrition and dietetic therapy, including:

   (i)  The purpose and nature of any evaluation, treatment, educational or training procedure.

   (ii)  The estimated cost of each stage of a procedure or of the entire treatment.

   (iii)  The reasonable expectations of the professional relationship.

   (iv)  The right to withdraw from treatment at any time.

   (5)  Safeguard the patient's dignity, the right to privacy and the confidentiality of patient information and make full disclosure about any limitations on the LDN's abilities to guarantee full confidentiality. This standard does not prohibit or affect reporting responsibilities under 23 Pa.C.S. Chapter 63 (relating to Child Protective Services Law), the Older Adults Protective Services Act (35 P. S. §§ 10211--10224) and other statutes which may mandate reporting of this information.

   (6)  Provide professional services with objectivity and with respect for the unique needs and values of individuals.

   (7)  Be alert to situations that might cause a conflict of interest or have the appearance of a conflict. The LDN shall provide full disclosure when a real or potential conflict of interest arises.

   (8)  Permit the use of their names for the purpose of certifying that dietetic services have been rendered only if they provided or supervised the provision of those services.

   (9)  Accurately present professional qualifications and credentials.

   (i)  Dietitian-nutritionists may use the title ''Licensed Dietitian-Nutritionist'' or abbreviation LDN only when they hold a current license issued by the Board.

   (ii)  LDNs are subject to disciplinary action for aiding another person in violating any Board requirement or aiding another person in representing himself as an LDN when that person is not currently licensed.

   (10)  Document and maintain accurate records in accordance with the acceptable and prevailing standard of recordkeeping. Discussion of a patient's sexual practices, preferences and performance shall be fully documented in the patient's chart, when applicable.

   (b)  The licensed dietitian-nutritionist may not:

   (1)  Knowingly aid, abet or assist another person to violate or circumvent a law or Board regulation.

   (2)  Discriminate, while providing dietitian-nutritionist services, on the basis of age, marital status, gender, sexual preferences, race, ethnicity, religion, diagnosis, socioeconomic status or disability.

   (3)  Knowingly permit another individual to use his license for any purpose.

   (4)  Misappropriate equipment, materials, property, drugs or money from an employer or patient.

   (5)  Solicit, borrow or misappropriate money, materials or property from a patient.

   (6)  Leave an assignment prior to the proper reporting and notification to the appropriate department head or personnel.

   (7)  Falsify or knowingly make incorrect entries into the patient's record or other related documents.

   (8)  Engage in conduct defined as a sexual violation or sexual impropriety in the course of a professional relationship.

   (9)  Advertise in a false or misleading manner. Statements which qualify as false or misleading include the following:

   (i)  Statements containing a misrepresentation of facts.

   (ii)  Statements likely to mislead or deceive because in context the statements make only a partial disclosure of the relevant facts.

   (iii)  Statements intended to, or likely to, create false or unjustified expectations of favorable results.

   (iv)  Statements relating to fees without reasonable disclosure of all relevant variables so that the statements would be misunderstood by or would be deceptive to a layperson.

   (v)  Statements conveying the impression that the LDN could influence improperly any public body, official, corporation or person on behalf of the patient.

   (vi)  Statements containing a representation or implication that is likely to cause a reasonable person to misunderstand or to be deceived, or fail to contain reasonable warnings or disclaimers necessary to make a representation or implication not deceptive.

   (vii)  Statements containing representations that the LDN is willing to perform any procedure that is illegal under the laws or regulations of the Commonwealth or the United States.

   (10)  Practice when:

   (i)  The LDN has engaged in any substance abuse that could affect the LDN's practice.

   (ii)  The LDN has been adjudged by a court to be mentally incompetent.

   (iii)  The LDN has an emotional or mental disability that affects his practice in a manner that could harm the patient.

   (11)  Accept a client or patient for treatment or continue treatment unnecessarily, if benefit cannot reasonably be expected to accrue.

   (12)  Accept or receive, or both, remuneration for making or accepting referrals.

LICENSURE REQUIREMENTS

§ 21.721. Qualifications for licensure.

   (a)  An individual may apply for licensure as a dietitian-nutritionist by submitting a written application on forms provided by the Board and remitting the application fee set forth in § 21.705 (relating to fees).

   (b)  To obtain licensure, an applicant must meet the qualifications set forth in section 6(b)(1)--(4) of the act (63 P. S. § 216(b)(1)--(4)), which include:

   (1)  Evidencing good moral character.

   (2)  Receipt of a baccalaureate or higher degree from a Board-approved program or equivalent program as set forth in section 5(b) and (c) of the act (63 P. S. § 215(b) and (c)).

   (3)  Completion of a planned continuous preprofessional experience of at least 900 hours under appropriate supervision.

   (4)  Successful completion of one of the examinations specified in § 21.722 (relating to education and examination of applicants).

§ 21.722. Education and examination of applicants.

   The Board approves educational programs that meet the requirements of section 6(b)(2) of the act (63 P. S. § 216(b)(2)) that are approved by CADE or the ACN. The Board approves the Registration Examination for Registered Dietitians and Examination of the Certification Board for Nutrition Specialists as the examinations which an applicant may complete to satisfy section 6(b)(4) of the act.

§ 21.723. License renewal.

   (a)  A license issued under section 5(e) of the act (63 P. S. § 215(e)) or under this subchapter will be valid from the date of issuance through September 30, 2006, following the issuance of the license. Each subsequent license renewal will be valid for 2 years from October 1 through September 30.

   (b)  When applying for renewal of licensure, an LDN shall:

   (1)  Complete the renewal application, including disclosing a license to practice dietetics-nutrition in any other state, territory, possession or country.

   (2)  Pay the required fee as set forth in § 21.705 (relating to fees).

   (3)  Submit proof to the Board that the LDN has satisfactorily completed a minimum of 30 hours of CPE approved by the Board in accordance with § 21.724 (relating to continuing education) during the 2 calendar years immediately preceding the application for renewal.

   (4)  Disclose any discipline imposed by a state licensing board in the previous biennial period or any criminal charges pending or criminal conviction, plea of guilty or nolo contendere, or admission into a probation without verdict or accelerated rehabilitative disposition program during the previous biennial period.

§ 21.724. Continuing education.

   (a)  Prior to renewal. One hour of CPE credit will be given for each 50-minute clock hour of CPE activity. Each LDN shall complete 30 CPE credits during the 2 calendar years immediately preceding the application for license renewal. If any activity overlaps two renewal periods, the date of completion of the activity determines the date in which the activity can be reported.

   (b)  Board-approved continuing professional education. The Board will accept for completion of the CPE requirement substantive learning experiences, subject to the limitations in paragraph (2) relating to the field of nutrition and dietetics which are not designed for the public and which are sponsored by the ADA, the ACN, by individual state dietetic associations, if the association is a member of the ADA or ACN, by approved college or dietetic programs under § 21.722 (relating to education and examination of applicants) when a certificate of attendance is issued, and courses related to the practice of dietetics-nutrition offered by the Accreditation Council for Continuing Medical Education, the Accreditation Council on Pharmaceutical Education, the American Osteopathic Association and the American Medical Association.

   (1)  In addition to lecture-based CPE courses, LDNs may apply to the Board for approval of CPE credit and the Board may, upon review by the LDN Committee, grant credit for the following:

   (i)  Case presentations, such as grand rounds or patient case studies.

   (ii)  Academic coursework and research studies approved by an institutional review board.

   (iii)  Interactive workshops.

   (iv)  Lecturers and seminars.

   (v)  Residency and Fellowship programs which are at the post baccalaureate level, and are sponsored by a United States regionally accredited college or university, or an institution accredited/approved by the Joint Committee on Accreditation of Healthcare Organizations or the National Committee for Quality Assurance.

   (2)  The Board will not accept for completion of the CPE requirement the following:

   (i)  Academic coursework or programs on office management skills, or entrepreneurship, strategic business planning, computer skills, except courses directly related to the practice of dietetics-nutrition such as accessing nutrient analysis databases.

   (ii)  Attendance at exhibits manned by detail personnel.

   (iii)  Journal clubs.

   (iv)  Professional leadership, such as holding an elective office in a dietetics or dietetics-related organization.

   (v)  Professional reading for which there is no evaluative test submitted and no certificate of completion or CPE unit awarded.

   (c)  Documentation. The licensee shall retain documentation of completion of Board-approved continuing education (as set forth in subsection (b)) for at least 5 years and shall submit this documentation upon request of the Board.

   (d)  Waiver. An LDN who can demonstrate to the Board a verified hardship may request a waiver of CPE requirements for a single biennial period. It shall be the duty of each licensee seeking waiver to notify the Board in writing and request the waiver, at least 60 days prior to the end of the biennial renewal period, which will be granted, denied, or granted in part.

§ 21.726. Inactive status.

   An LDN may request that his license be placed on inactive status. The licensee will not be required to remit the biennial renewal fee during the period when the license is on inactive status. In order to return to active status, the licensee shall submit proof of completion of a minimum of 30 hours of approved CPE in the biennial period preceding the request for reactivation and pay applicable fees. A person who requests an active status license who has been on inactive status for 5 consecutive years shall satisfy the requirements of section 6(b)(4) of the act (63 P. S. § 216(b)(4)), unless the person demonstrates that he has an active license to practice in another state or has had an RD registration or a CNS certification for at least 2 out of the last 5 years.

[Pa.B. Doc. No. 06-866. Filed for public inspection May 19, 2006, 9:00 a.m.]



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