SENATE BILL NO. 88 An Act relating to licensure of dietitians and nutritionists; and providing for an effective date. HANS NEIDIG, STAFF, SENATOR DAVE DONLEY, stated that SB 88 would codify professional title licensure of dietitians and nutritionists, while helping to ensure the quality of such services and protecting consumers. SB 88 represents sound public policy because it protects Alaskans from the potential harm that could be caused by untrained individuals working in the field. This would be accomplished by having standards which differentiate between individuals who are qualified nutritionists and dietitians and those who are not. Mr. Neidig noted that SB 88 contains provisions which ensure that individuals practicing nutrition, obtain a bachelor's, masters or doctoral degrees from an accredited school to work in Alaska. Mr. Neidig advised that the licensing of dietitians and nutritionist enables the public to identify individuals who are qualified by education, experience and examination to provide nutrition care services. Recognition defines the dietetics and nutrition practice which includes the integration and application of the principles derived from the sciences of nutrition, biochemistry, food physiology, management and behavioral and social sciences to achieve and maintain the health of the citizens of Alaska. He pointed out that the bill would not establish a new board. The licensing program will be conducted by the Division of Occupational Licensing and will have no cost to the State. Representative Foster asked if the nutritionists that live in village areas would be responsible to fly to Anchorage every couple of years to update their certification. Mr. Neidig replied that there is no examination requirement. CATHERINE REARDON, DIRECTOR, DIVISION OF OCCUPATIONAL LICENSING, DEPARTMENT OF COMMERCE AND ECONOMIC DEVELOPMENT, corrected that there is an examine for only the initial license; there is no obligation to take it more than once. The applicant will be paying for the national test directly, not through State government and that the test would be offered only in Anchorage. (Tape Change HFC 99 - 122, Side 2). Representative Foster voiced concern for those individual nutritionists who have been working in the field, who do not have the accredited dietitian or nutritionist requirements. He asked if they would be "grandfathered" in. Ms. Reardon stated that would need to be a policy decision for the Legislature. A "practice" restriction could be placed in the legislation, or employers could have the option to change the titles of those employees. LINDA WILD, ALASKA DIETETIC ASSOCIATION, JUNEAU, testified that the Alaska Dietetic Association strongly supports the legislation. Currently, thirty-nine states have some form of licensing of dietitians and nutritionists. There are two main reasons for supporting the license dietitians and nutritionists. The proposed legislation recently reintroduced in Congress that would provide coverage in the outpatient portion of the federally funded Medicare program for medical nutrition therapy services, a 75 cent phrase for nutrition therapy, furnished by registered dietitians and qualified nutrition professionals. Currently, Medicare provides reimbursement for nutrition services only in portion A, or in the hospital portion of the program. Ms. Wild continued, the reason dietitians care about this is that the proposed legislation stipulates that reimbursable services be provided by dietitians or nutrition professionals who are licensed in the states in which they work. She stressed that dietitians and nutritionists must be part of the health care team, and they need to be licensed. The proposed change to Medicare is one of the big reasons there has been a push in recent years to license dietitians and nutritionists, in addition to the increasing emphasis on preventative health care. Good nutrition is a big part of that prevention. Ms. Wild continued, an additional reason for the requesting the licensure is professional recognition. Licensure will put nutrition professionals on an equal footing with other professionals. The bill before the Committee is known as "title licensure" or "title protection". This means that only those professionals meeting the educational and experience criteria will be licensed as dietitians and nutritionists. The bill would hold minimum qualifications for professionals in the field and would provide guidance to the public. Representative Grussendorf asked if there was work experience which could fulfill criteria needed to obtain the license. Ms. Wild replied that staff working in the school system is not required to be licensed, however, those with job titles of dietitian or nutritionist would need to have the license. She did not know of any people in the State of Alaska, who had those job titles that would qualify for licensing. Ms. Wild pointed out that there is another category called "diet tech", which does not require licensure. Co-Chair Therriault questioned what restrictions would the legislation implement. Ms. Wild explained that the bill would require any person calling themselves a dietitian or nutritionist be licensed. In response to concerns voiced by Representative Foster, Ms. Wild explained that the examination would allow a person to become a registered dietitian. It could be taken in Anchorage and would be a one time only test. Representative Kohring inquired if industry was requesting the proposed legislation. Ms. Wild replied that "shock" had been voiced with the $410 biannual fee request, but are confident that will be for the first cycle only. After that, there will be renewal charges, a more simple process. She advised that there is strong support for the legislation. Representative Foster MOVED to report CSSB 88 (FIN) out of Committee with individual recommendations and with the accompanying fiscal note. There being NO OBJECTION, it was so ordered. CS SB 88 (FIN) was reported out of Committee with "no recommendation" and with a fiscal note by Department of Commerce and Economic Development dated 4/7/99.