2009 California Business and Professions Code - Section 2585-2586.8 :: Chapter 5.65. Dietitians

BUSINESS AND PROFESSIONS CODE
SECTION 2585-2586.8

2585.  (a) Any person representing himself or herself as a
registered dietitian shall meet one of the following qualifications:
   (1) Been granted, prior to January 1, 1981, the right to use the
term "registered dietitian" by a public or private agency or
institution recognized by the State Department of Health Services as
qualified to grant the title, provided that person continues to meet
all requirements and qualifications periodically prescribed by the
agency or institution for the maintenance of that title.
   (2) Possess all of the following qualifications:
   (A) Be 18 years of age or older.
   (B) Satisfactory completion of appropriate academic requirements
for the field of dietetics and related disciplines and receipt of a
baccalaureate or higher degree from a college or university
accredited by the Western Association of Schools and Colleges or
other regional accreditation agency.
   (C) Satisfactory completion of a program of supervised practice
for a minimum of 900 hours that is designed to prepare entry level
practitioners through instruction and assignments in a clinical
setting. Supervisors of the program shall meet minimum qualifications
established by public or private agencies or institutions recognized
by the State Department of Health Services to establish those
qualifications.
   (D) Satisfactory completion of an examination administered by a
public or private agency or institution recognized by the State
Department of Health Services as qualified to administer the
examinations.
   (E) Satisfactory completion of continuing education requirements
established by a public or private agency or institution recognized
by the State Department of Health Services to establish the
requirements.
   (b) Any person representing himself or herself as a dietetic
technician, registered shall possess all of the following
qualifications:
   (1) Be 18 years of age or older.
   (2) Satisfactory completion of appropriate academic requirements
and receipt of an associate's degree or higher from a college or
university accredited by the Western Association of Schools and
Colleges or other regional accreditation agency.
   (3) Satisfactory completion of the dietetic technician program
requirements by an accredited public or private agency or institution
recognized by the State Department of Health Services including not
less than 450 hours of supervised practice.
   (4) Satisfactory completion of an examination administered by a
public or private agency or institution recognized by the State
Department of Health Services to administer the examination.
   (5) Satisfactory completion of continuing education requirements
established by a public or private agency or institution recognized
by the State Department of Health Services to establish the
requirements.
   (c) It is a misdemeanor for any person not meeting the criteria of
subdivision (a) or (b) to use, in connection with his or her name or
place of business, the words "dietetic technician, registered,"
"dietitian," "dietician," "registered dietitian," "registered
dietician," or the letters "RD," "DTR," or any other words, letters,
abbreviations, or insignia indicating or implying that the person is
a dietitian, or dietetic technician, registered or registered
dietitian, or to represent, in any way, orally, in writing, in print
or by sign, directly or by implication, that he or she is a dietitian
or a dietetic technician, registered or a registered dietitian.
   (d) Any person employed by a licensed health care facility as a
registered dietitian on the effective date of this chapter may
continue to represent himself or herself as a registered dietitian
while employed by a licensed health care facility, if he or she has
satisfied the requirements of either paragraph (1) or paragraph (2)
of subdivision (a), except that he or she shall not be required to
satisfy the examination requirement of subparagraph (B) of paragraph
(2) of subdivision (a).
   (e) Notwithstanding any other provision of law or regulation that
limits reimbursement to state licensed health care providers and upon
referral by a physician and surgeon the following persons may be
reimbursed for the nutritional advice or advice concerning proper
nutrition as set forth in Section 2068, or for the nutritional
assessments, counseling, and treatments as set forth in Section 2586:
   (1) Registered dietitians.
   (2) Other nutritional professionals with a master's or higher
degree in a field covering clinical nutrition sciences, from a
college or university accredited by a regional accreditation agency,
who are deemed qualified to provide these services by the referring
physician and surgeon.
   (f) Nothing in this section shall be construed to mandate direct
reimbursement of registered dietitians, or other nutrition
professionals described in subdivision (e), as a separate provider
type under the Medi-Cal program, nor to mandate reimbursement where
expressly prohibited by federal law or regulation.

2586.  (a) Notwithstanding any other provision of law, a registered
dietitian, or other nutritional professional meeting the
qualifications set forth in subdivision (e) of Section 2585 may, upon
referral by a health care provider authorized to prescribe dietary
treatments, provide nutritional and dietary counseling, conduct
nutritional and dietary assessments, and develop nutritional and
dietary treatments, including therapeutic diets, for individuals or
groups of patients in licensed institutional facilities or in private
office settings. The referral shall be accompanied by a written
prescription signed by the health care provider detailing the patient'
s diagnosis and including a statement of the desired objective of
dietary treatment, unless a referring physician and surgeon has
established or approved a written protocol governing the patient's
treatment. The services described in this subdivision may be termed
"medical nutrition therapy."
   (b) A registered dietitian, or other nutritional professional
meeting the qualifications set forth in subdivision (e) of Section
2585, may accept or transmit verbal orders or electronically
transmitted orders from the referring physician consistent with an
established protocol to implement medical nutrition therapy.
   (c) A registered dietitian, or other nutritional professional
meeting the qualifications set forth in subdivision (e) of Section
2585, may order medical laboratory tests related to nutritional
therapeutic treatments when authorized to do so by a written protocol
prepared or approved by the referring physician and when, in the
absence of the referring physician at a patient visit, in a clinic
where there is a registered nurse on duty, a registered nurse is
notified that a medical laboratory test is being ordered and is
afforded an opportunity to assess the patient.
   (d) (1) Notwithstanding any other provision of law, a dietetic
technician, registered meeting the qualifications set forth in
Section 2585 may, under the direct supervision of a registered
dietitian, assist in the implementation or monitoring of services
specified in subdivision (a), but may not develop nutritional or
dietary therapy or treatments or accept or transmit verbal orders.
   (2) (A) For purposes of this subdivision, "direct supervision"
means the supervising registered dietitian shall be physically
available to the dietetic technician, registered for consultation
whenever consultation is required. However, in the case of a small or
rural hospital, as defined in Section 124840 of the Health and
Safety Code, the registered dietitian may be available for
consultation by telephone or other electronic means, provided that
the registered dietitian is physically on the facility site a
sufficient amount of time to provide adequate supervision over and
review of the work of the dietetic technician, registered.
   (B) For purposes of this subdivision, "physically available" means
physical onsite presence during regular business hours, and includes
telephonic or electronic availability at all times and the ability
to respond to the facility within a reasonable period of time when
required. The registered dietitian shall review any activities
performed by the dietetic technician, registered during any period
when the registered dietitian was not physically onsite.
   (3) For purposes of this subdivision, a registered dietitian shall
not supervise more than two dietetic technicians, registered at one
time.
   (e) It is a misdemeanor for a person specified in subdivision (e)
of Section 2585 to practice in a manner inconsistent with the
requirements set forth in this section.
   (f) Nothing in this section shall preclude a person specified in
subdivision (e) of Section 2585 from providing information as
permitted by Section 2068.
   (g) For purposes of this section, "health care provider" means any
person licensed or certified pursuant to this division, or licensed
pursuant to the Osteopathic Initiative Act or the Chiropractic
Initiative Act.
   (h) The requirement of a written prescription shall be deemed to
be satisfied by an entry in the patient records of a patient who is
undergoing treatment at a licensed health care facility if the
contents of the patient records reflect the information required by
this section.
   (i) Nothing in this section or Section 2585 shall be interpreted
to establish educational criteria or practice restrictions or
limitations for other health care providers licensed under Division 2
(commencing with Section 500) or the Osteopathic Initiative Act or
the Chiropractic Initiative Act.

2586.2.  A person may engage in the activities set forth in
subdivision (a) of Section 2586 if the person meets both of the
following requirements:
   (a) The person is engaged in the activities as part of a
supervised practice program for a registered dietitian pursuant to
subparagraph (C) of paragraph (2) of subdivision (a) of Section 2585.
   (b) The person is enrolled in or has completed a course of study
to fulfill the educational requirements for a registered dietitian in
subparagraph (B) of paragraph (2) of subdivision (a) of Section
2585.

2586.4.  A person may engage in the activities set forth in
subdivision (d) of Section 2586 if the person meets both of the
following requirements:
   (a) The person is engaged in the activities as part of a
supervised practice program for a dietetic technician pursuant to
paragraph (3) of subdivision (b) of Section 2585.
   (b) The person is enrolled in or has completed a course of study
to fulfill the educational requirements for a dietetic technician in
paragraph (2) of subdivision (b) of Section 2585.

2586.6.  A person may engage in the activities set forth in
subdivision (a) of Section 2586 for six months from the date that he
or she completed a supervised practice program, or until the person
receives notice that he or she failed the examination specified in
subdivision (d), whichever occurs first, if all of the following
conditions apply:
   (a) The person performs under the direct and immediate supervision
of a registered dietitian.
   (b) The person has completed the supervised practice program
requirements under subdivision (a) of Section 2585.
   (c) The person has written verification, including the program
director's original signature, that the person has completed the
required supervised practice program.
   (d) The person has applied to take the registered dietitian
examination specified in subparagraph (D) of paragraph (2) of
subdivision (a) of Section 2585 and is waiting for an examination
date.

2586.8.  A person may engage in the activities set forth in
subdivision (d) of Section 2586 for six months from the date he or
she completed the supervised practice program for dietetic
technicians, or until the person receives notice that he or she has
failed the examination specified in subdivision (d), whichever occurs
first, if all of the following conditions apply:
   (a) The person performs under the direct and immediate supervision
of a registered dietitian.
   (b) The person has completed the supervised practice program
requirements under subdivision (b) of Section 2585.
   (c) The person has written verification, including the program
director's original signature, that the person has completed the
required supervised practice.
   (d) The person has applied to take the dietetic technician
examination specified in paragraph (4) of subdivision (b) of Section
2585 and is waiting for an examination date.



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