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SB-0403, As Passed Senate, July 26, 2006

HOUSE SUBSTITUTE FOR

SENATE BILL NO. 403

A bill to amend 1978 PA 368, entitled

"Public health code,"

by amending sections 16131 and 16263 (MCL 333.16131 and

333.16263), section 16131 as amended by 2006 PA 30 and section

16263 as amended by 2006 PA 54, and by adding section 16346 and

part 183A.

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

1 Sec. 16131. The terms of office of individual members of the

2 boards and task forces, except those appointed to fill vacancies,

3 expire 4 years after appointment as follows:

4 Dietetics and nutrition June 30

1 Acupuncture June 30

2 Audiologists June 30

3 Nursing June 30

4 Nursing home administrator June 30

5 Optometry June 30

6 Pharmacy June 30

7 Podiatric medicine and surgery June 30

8 Dentistry June 30

9 Chiropractic December 31

10 Counseling June 30

11 Marriage and family therapy June 30

12 Medicine December 31

13 Occupational therapists December 31

14 Osteopathic medicine and surgery December 31

15 Physical therapy December 31

16 Psychology December 31

17 Respiratory care December 31

18 Social work December 31

19 Veterinary medicine December 31

20 Sec. 16263. (1) Except as provided in subsection (2), the

1 following words, titles, or letters or a combination thereof,

2 with or without qualifying words or phrases, are restricted in

3 use only to those persons authorized under this article to use

4 the terms and in a way prescribed in this article:

5 (a) "Chiropractic", "doctor of chiropractic",

6 "chiropractor", "d.c.", and "chiropractic physician".

7 (b) "Dentist", "doctor of dental surgery", "oral and

8 maxillofacial surgeon", "orthodontist", "prosthodontist",

9 "periodontist", "endodontist", "oral pathologist", "pediatric

10 dentist", "dental hygienist", "registered dental hygienist",

11 "dental assistant", "registered dental assistant", "r.d.a.",

12 "d.d.s.", "d.m.d.", and "r.d.h.".

13 (c) "Doctor of medicine" and "m.d.".

14 (d) "Physician's assistant" and "p.a.".

15 (e) "Registered professional nurse", "registered nurse",

16 "r.n.", "licensed practical nurse", "l.p.n.", "nurse midwife",

17 "nurse anesthetist", "nurse practitioner", "trained attendant",

18 and "t.a.".

19 (f) "Doctor of optometry", "optometrist", and "o.d.".

20 (g) "Osteopath", "osteopathy", "osteopathic practitioner",

21 "doctor of osteopathy", "diplomate in osteopathy", and "d.o.".

22 (h) "Pharmacy", "pharmacist", "apothecary", "drugstore",

23 "druggist", "medicine store", "prescriptions", and "r.ph.".

24 (i) "Physical therapy", "physical therapist",

25 "physiotherapist", "registered physical therapist", "licensed

26 physical therapist", "physical therapy technician", "p.t.",

27 "r.p.t.", "l.p.t.", and "p.t.t.".

1 (j) "Chiropodist", "chiropody", "chiropodical", "podiatry",

2 "podiatrist", "podiatric", "doctor of podiatric medicine", "foot

3 specialist", "podiatric physician and surgeon", and "d.p.m.".

4 (k) "Consulting psychologist", "psychologist",

5 "psychological assistant", "psychological examiner", "licensed

6 psychologist", and "limited licensed psychologist".

7 (l) "Licensed professional counselor", "licensed counselor",

8 "professional counselor", and "l.p.c.".

9 (m) "Sanitarian", "registered sanitarian", and "r.s.".

10 (n) Until July 1, 2005, "social worker", "certified social

11 worker", "social work technician", "s.w.", "c.s.w.", and

12 "s.w.t.". Beginning July 1, 2005, "social worker", "licensed

13 master's social worker", "licensed bachelor's social worker",

14 "registered social service technician", "social service

15 technician", "l.m.s.w.", "l.b.s.w.", and "r.s.s.t.".

16 (o) "Veterinary", "veterinarian", "veterinary doctor",

17 "veterinary surgeon", "doctor of veterinary medicine", "v.m.d.",

18 "d.v.m.", "animal technician", or "animal technologist".

19 (p) "Occupational therapist", "occupational therapist

20 registered", "certified occupational therapist", "o.t.",

21 "o.t.r.", "c.o.t.", "certified occupational therapy assistant",

22 "occupational therapy assistant", or "c.o.t.a.".

23 (q) "Marriage advisor" or "marriage consultant"; "family

24 counselor", "family advisor", "family therapist", or "family

25 consultant"; "family guidance counselor", "family guidance

26 advisor", or "family guidance consultant"; "marriage guidance

27 counselor", "marriage guidance advisor", or "marriage guidance

1 consultant"; "family relations counselor"; "marriage relations

2 counselor", "marriage relations advisor", or "marriage relations

3 consultant"; "marital counselor" or "marital therapist"; "limited

4 licensed marriage and family therapist" or "limited licensed

5 marriage counselor"; "licensed marriage and family therapist" or

6 "licensed marriage counselor"; and "l.m.f.t.".

7 (r) "Nursing home administrator".

8 (s) "Respiratory therapist", "respiratory care

9 practitioner", "licensed respiratory therapist", "licensed

10 respiratory care practitioner", "r.t.", "r.c.p.", "l.r.t.", and

11 "l.r.c.p.".

12 (t) "Audiometrist", "audiologist", "hearing therapist",

13 "hearing aid audiologist", "educational audiologist", "industrial

14 audiologist", and "clinical audiologist".

15 (u) "Acupuncturist", "certified acupuncturist", and

16 "registered acupuncturist".

17 (v) "Athletic trainer", "licensed athletic trainer",

18 "certified athletic trainer", "athletic trainer certified",

19 "a.t.", "a.t.l.", "c.a.t.", and "a.t.c.".

20 (w) "Registered dietitian", "licensed dietitian",

21 "dietitian", "licensed nutritionist", "nutritionist", "r.d.",

22 "l.d.", and "l.n.".

23 (2) Notwithstanding section 16261, a person who was

24 specially trained at an institution of higher education in this

25 state to assist a physician in the field of orthopedics and upon

26 completion of training, received a 2-year associate of science

27 degree as an orthopedic physician's assistant before January 1,

1 1977, may use the title "orthopedic physician's assistant"

2 whether or not the person is licensed under this article.

3 Sec. 16346. Fees for an individual licensed or seeking

4 licensure as a dietitian or nutritionist under part 183A are as

5 follows:

6 (a) Application processing fee................ $ 20.00

7 (b) License fee, per year..................... $ 75.00

8 (c) Temporary license fee, per year........... $ 75.00

9 (d) Limited license fee, per year............. $ 75.00

10 PART 183A. DIETETICS AND NUTRITION

11 Sec. 18351. (1) As used in this part:

12 (a) "Dietetics and nutrition care services" means the

13 integration and application of the scientific principles of food,

14 nutrition, biochemistry, physiology, management, and behavioral

15 and social sciences to achieve and maintain the health of

16 individuals.

17 (b) "Dietitian" and "nutritionist" mean an individual who is

18 engaged in the practice of dietetics and nutrition, who is

19 responsible for providing dietetics and nutrition care services,

20 and who is licensed under this article as a dietitian or

21 nutritionist.

22 (c) "Practice of dietetics and nutrition care services"

23 means the provision of dietetics and nutrition care services. The

24 practice of dietetics and nutrition care services includes, but

25 is not limited to, each of the following:

26 (i) Assessing the nutrition needs of an individual or group

27 of individuals based upon biochemical, anthropometric, physical,

1 and dietary data, determining the resources and constraints to

2 meet the nutrition needs of that individual or group of

3 individuals, and recommending proper nutrition intake to satisfy

4 those needs.

5 (ii) Establishing priorities, goals, and objectives to meet

6 the nutrition needs of the individual or group of individuals

7 based on available resources and constraints.

8 (iii) Providing nutrition counseling regarding health and

9 disease.

10 (iv) Developing, implementing, and managing a nutrition care

11 system.

12 (v) Evaluating, adjusting, and maintaining a standard of

13 quality in dietetics and nutrition care services.

14 (vi) Providing medical nutrition therapy.

15 (2) In addition to the definitions in this part, article 1

16 contains general definitions and principles of construction

17 applicable to all articles in this code, and part 161 contains

18 definitions applicable to this part.

19 Sec. 18353. Beginning July 1, 2007, an individual shall not

20 use the titles "registered dietitian", "licensed dietitian",

21 "dietitian", "licensed nutritionist", "nutritionist", "r.d.",

22 "l.d.", or "l.n." unless the individual is licensed under this

23 article as a dietitian or nutritionist.

24 Sec. 18355. (1) The Michigan board of dietetics and

25 nutrition is created in the department and consists of the

26 following 7 voting members who meet the requirements of part 161:

27 (a) Two public members.

1 (b) Five members who are dietitians or nutritionists

2 licensed under this part and who meet the requirements of section

3 16135(2).

4 (2) The terms of office of individual members of the board

5 created under this part, except those appointed to fill

6 vacancies, expire 4 years after appointment on June 30 of the

7 year in which the term expires.

8 Sec. 18357. (1) An individual shall not engage in the

9 practice of dietetics and nutrition or provide or offer to

10 provide dietetics and nutrition care services unless licensed or

11 otherwise authorized under this part.

12 (2) The department, upon recommendation of the board, shall

13 promulgate rules under section 16145 to establish the minimum

14 standards for licensure as a dietician or nutritionist and as

15 necessary or appropriate to fulfill its functions under this

16 article including, but not limited to, rules establishing ethics,

17 qualifications, and fitness of applicants, complaint process, and

18 penalties for violations of this article or rules promulgated

19 under this article.

20 (3) Subject to section 16204, the department shall by rule

21 prescribe continuing education requirements as a condition for

22 license renewal. The department, in consultation with the board,

23 may adopt, by rule, the continuing education requirements

24 established by the American dietetic association or by a

25 certified program that is recognized by the national commission

26 for certifying agencies or by a nationally recognized trade

27 association.

1 (4) The department shall utilize the standards contained in

2 the clinical practice guidelines issued by the American dietetic

3 association that are in effect on July 1, 2007, which are adopted

4 by reference, as interim standards, until rules are promulgated

5 under subsection (2).

6 (5) The department, in consultation with the board, shall

7 not promulgate rules under this section that diminish competition

8 or exceed the minimum level of regulation necessary to protect

9 the public.

10 Sec. 18358. (1) Except as otherwise provided under

11 subsection (2), an individual granted a license under this part

12 shall meet 1 of the following requirements:

13 (a) Have a baccalaureate degree from a United States

14 regionally accredited institution of higher education approved by

15 the department with a major course of study in human nutrition,

16 nutrition education, foods and nutrition, dietetics, or food

17 systems management, or an equivalent course of study, as approved

18 by the department, have completed at least 900 hours of

19 postdegree or planned continuous preprofessional experience

20 supervised by a licensed dietitian or nutritionist as prescribed

21 in rules promulgated by the department, and have successfully

22 completed an examination that is approved by the department.

23 (b) Have a master's degree from a United States regionally

24 accredited institution of higher education approved by the

25 department with a major course of study in human nutrition,

26 nutrition education, foods and nutrition, dietetics, or food

27 systems management, or an equivalent course of study, as approved

1 by the department, have completed at least 900 hours of

2 postdegree or planned continuous preprofessional experience

3 supervised by a licensed health care professional who has

4 experience and knowledge in the provision of dietetics and

5 nutrition care services or by a licensed dietitian or

6 nutritionist as prescribed in rules promulgated by the

7 department, and have successfully completed an examination that

8 is approved by the department.

9 (c) Have a doctoral degree from a United States regionally

10 accredited institution of higher education approved by the

11 department with a major course of study in human nutrition,

12 nutrition education, foods and nutrition, dietetics, or food

13 systems management, or an equivalent course of study, as approved

14 by the department, and have completed at least 900 hours of

15 postdegree or planned continuous preprofessional experience

16 supervised by a licensed health care professional who has

17 experience and knowledge in the provision of dietetics and

18 nutrition care services or by a licensed dietitian or

19 nutritionist as prescribed in rules promulgated by the

20 department.

21 (2) The department shall grant a license as a dietitian or

22 nutritionist to an individual who is currently registered as a

23 dietitian by the commission on dietetic registration and fulfills

24 the standards of the commission as adopted by reference under

25 section 18357(4). An individual granted a license under this

26 subsection shall apply for licensure as a dietitian or

27 nutritionist under this part by July 1, 2008.

1 (3) The department may grant a limited license to engage in

2 the postdegree experience required under subsection (1) to an

3 individual who has completed all of the educational and the

4 examination, if applicable, requirements for licensure. A

5 limited license granted under this subsection is renewable for

6 not more than 5 years.

7 Sec. 18359. (1) The department may issue a temporary license

8 as a dietitian or nutritionist to an individual who does not meet

9 all of the requirements promulgated pursuant to section 18357 or

10 the requirements established under section 18358, if the

11 applicant does all of the following:

12 (a) Applies to the department for a temporary license within

13 1 year after July 1, 2007.

14 (b) Provides evidence to the department that he or she is a

15 dietitian who is registered with the commission on dietetic

16 registration or who meets the educational requirements prescribed

17 under section 18358(1) and satisfies either of the following:

18 (i) Has experience as prescribed under section 18358(1).

19 (ii) Has been employed as a dietitian or nutritionist for at

20 least 3 of the last 10 years immediately preceding the date of

21 the application.

22 (c) Pays the applicable fees prescribed by section 16346.

23 (2) A temporary license issued by the department under this

24 section expires within the same time period as a nontemporary

25 license issued by the department under this part. The holder of a

26 temporary license issued under this section may apply for a

27 renewal of the temporary license, but an individual may not hold

1 a temporary license for more than a total of 2 years.

2 (3) The holder of a temporary license issued under this

3 section is subject to this part and the rules promulgated under

4 this part, except for the requirements for licensure.

5 Sec. 18361. This part does not require new or additional

6 third party reimbursement or mandated worker's compensation

7 benefits for services rendered by an individual licensed under

8 this part.

9 Sec. 18363. This part does not apply to any of the

10 following:

11 (a) An individual licensed under any other part or act who

12 performs activities or services that are considered dietetics and

13 nutrition care services if those activities or services are

14 within the individual's scope of practice and if the individual

15 does not use the titles protected under section 18353.

16 (b) An individual who furnishes any kind of nutrition

17 information on food, food materials, or dietary supplements or

18 provides explanations to individuals about foods or food products

19 in connection with the marketing and distribution of those

20 products, but does not hold himself or herself out as a dietitian

21 or nutritionist.

22 (c) An individual who provides weight control services under

23 a program approved by a dietitian or nutritionist who is licensed

24 under this part or licensed by another state that has licensing

25 requirements substantially equal to those existing in this state

26 or under a program approved by a chiropractic physician, or a

27 physician, who is licensed under part 164, 170, or 175 or by