Bill Summary – FastDemocracy

SECOND REGULAR SESSION
                        HOUSE BILL NO. 1961
                               103RD GENERAL ASSEMBLY


                               INTRODUCED BY REPRESENTATIVE PETERS.

     4056H.01I                                                                    JOSEPH ENGLER, Chief Clerk


                                                AN ACT
     To amend chapter 324, RSMo, by adding thereto sixteen new sections relating to dietitians.


     Be it enacted by the General Assembly of the state of Missouri, as follows:

             Section A. Chapter 324, RSMo, is amended by adding thereto sixteen new sections,
 to be known as sections 324.214, 324.218, 324.1800, 324.1805, 324.1810, 324.1815,
 324.1820, 324.1825, 324.1830, 324.1835, 324.1840, 324.1845, 324.1850, 324.1855,
 324.1860, and 324.1865, to read as follows:
             324.214. 1. For purposes of this section, the following terms mean:
         (1) "License", a license, certificate, registration, permit, accreditation, or
 military occupational specialty that enables a person to legally practice an occupation or
 profession in a particular jurisdiction;
         (2) "Military", the Armed Forces of the United States, including the Air Force,
 Army, Coast Guard, Marine Corps, Navy, Space Force, National Guard, and any other
 military branch that is designated by Congress as part of the Armed Forces of the
 United States, and all reserve components and auxiliaries. The term "military" also
 includes the military reserves and militia of any United States territory or state;
         (3) "Nonresident military spouse", a nonresident spouse of an active-duty
 member of the Armed Forces of the United States who has been transferred or is
 scheduled to be transferred to the state of Missouri, or who has been transferred or is
 scheduled to be transferred to an adjacent state and is or will be domiciled in the state of
 Missouri, or has moved to the state of Missouri on a permanent change-of-station basis;
         (4) "Oversight body", any board, department, agency, or office of a jurisdiction
 that issues licenses;

     EXPLANATION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is
     intended to be omitted from the law. Matter in bold-face type in the above bill is proposed language.
HB 1961                                          2

         (5) "Resident military spouse", a spouse of an active-duty member of the Armed
 Forces of the United States who has been transferred or is scheduled to be transferred to
 the state of Missouri or an adjacent state and who is a permanent resident of the state of
 Missouri, who is domiciled in the state of Missouri, or who has Missouri as his or her
 home of record.
         2. Any person who holds a valid current dietitian license issued by another state,
 a branch or unit of the military, a territory of the United States, or the District of
 Columbia, and who has been licensed for at least one year in such other jurisdiction,
 may submit to the committee an application for a dietitian license in Missouri along with
 proof of current licensure and proof of licensure for at least one year in the other
 jurisdiction.
         3. The committee shall:
         (1) Within six months of receiving an application described in subsection 2 of
 this section, waive any examination, educational, or experience requirements for
 licensure in this state for the applicant if it determines that there were minimum
 education requirements and, if applicable, work experience and clinical supervision
 requirements in effect and the other jurisdiction verifies that the person met those
 requirements in order to be licensed or certified in that jurisdiction. The committee
 may require an applicant to take and pass an examination specific to the laws of this
 state; or
         (2) Within thirty days of receiving an application described in subsection 2 of
 this section from a nonresident military spouse or a resident military spouse, waive any
 examination, educational, or experience requirements for licensure in this state for the
 applicant and issue such applicant a license under this section if such applicant
 otherwise meets the requirements of this section.
         4. (1) The committee shall not waive any examination, educational, or
 experience requirements for any applicant who has had his or her license revoked by an
 oversight body outside the state; who is currently under investigation, who has a
 complaint pending, or who is currently under disciplinary action, except as provided in
 subdivision (2) of this subsection, with an oversight body outside the state; who does not
 hold a license in good standing with an oversight body outside the state; who has a
 criminal record that would disqualify him or her for licensure in Missouri; or who does
 not hold a valid current license in the other jurisdiction on the date the committee
 receives his or her application under this section.
         (2) If another jurisdiction has taken disciplinary action against an applicant, the
 committee shall determine if the cause for the action was corrected and the matter
HB 1961                                          3

 resolved. If the matter has not been resolved by that jurisdiction, the committee may
 deny a license until the matter is resolved.
         5. Nothing in this section shall prohibit the committee from denying a license to
 an applicant under this section for any reason described in section 324.217.
         6. Any person who is licensed under the provisions of this section shall be subject
 to the committee's jurisdiction and all rules and regulations pertaining to the practice as
 a dietitian in this state.
         7. This section shall not be construed to waive any requirement for an applicant
 to pay any fees.
             324.218. 1. An applicant who has not previously taken or passed an examination
 recognized by the committee and who meets the qualifications of subsection 2 of section
 324.210 may obtain without examination a nonrenewable temporary license by paying a
 temporary-license fee and submitting to the committee an agreement-to-supervise form
 that is signed by a licensed dietitian who has agreed to supervise the applicant. Such
 temporary licensee may practice dietetics, but any such practice shall be under the
 supervision of a dietitian licensed in this state.
         2. (1) Any dietitian who has agreed to supervise a temporary licensee shall hold
 an unencumbered license to practice dietetics in this state and shall provide the
 committee proof of active dietetics practice in this state for a minimum of one year
 before supervising the temporary licensee.
         (2) The supervising dietitian shall not be an immediate family member of the
 temporary licensee. The committee shall define the term "immediate family member"
 for purposes of this subdivision and the scope of such supervision by rule.
         3. (1) The dietitian who has agreed to supervise the applicant for a temporary
 license shall submit to the committee a signed and notarized form prescribed by the
 committee attesting that the applicant for a temporary license shall begin employment
 at a location in this state within seven days of issuance of the temporary license.
         (2) If the temporary licensee's employment described in subdivision (1) of this
 subsection ceases, the supervising dietitian shall notify the committee within three days
 of such cessation.
         4. A licensed dietitian shall not supervise more than one temporary licensee at a
 time.
         5. The temporary license obtained by an applicant under this section shall expire
 the date the committee is notified by the supervising dietitian that the temporary
 licensee's employment has ceased or within one hundred eighty days of its issuance,
 whichever occurs first.
HB 1961                                          4

             324.1800. 1. Sections 324.1800 to 324.1865 shall be known and may be cited as
 the "Dietitian Licensure Compact".
         2. The purpose of this Compact is to facilitate interstate Practice of Dietetics
 with the goal of improving public access to dietetics services. This Compact preserves
 the regulatory authority of States to protect public health and safety through the
 current system of State licensure, while also providing for licensure portability through
 a Compact Privilege granted to qualifying professionals.
         3. This Compact is designed to achieve the following objectives:
         (1) Increase public access to dietetics services;
         (2) Provide opportunities for interstate practice by Licensed Dietitians who meet
 uniform requirements;
         (3) Eliminate the necessity for Licenses in multiple States;
         (4) Reduce administrative burden on Member States and Licensees;
         (5) Enhance the States' ability to protect the public's health and safety;
         (6) Encourage the cooperation of Member States in regulating multistate
 practice of Licensed Dietitians;
         (7) Support relocating Active Military Members and their spouses;
         (8) Enhance the exchange of licensure, investigative, and disciplinary
 information among Member States; and
         (9) Vest all Member States with the authority to hold a Licensed Dietitian
 accountable for meeting all State practice laws in the State in which the patient is
 located at the time care is rendered.
             324.1805. As used in this Compact, and except as otherwise provided, the
 following definitions shall apply:
         (1) "ACEND" means the Accreditation Council for Education in Nutrition and
 Dietetics or its successor organization.
         (2) "Active Military Member" means any individual with full-time duty status in
 the active armed forces of the United States, including members of the National Guard
 and Reserve.
         (3) "Adverse Action" means any administrative, civil, equitable or criminal
 action permitted by a State's laws which is imposed by a Licensing Authority or other
 authority against a Licensee, including actions against an individual's License or
 Compact Privilege such as revocation, suspension, probation, monitoring of the
 Licensee, limitation on the Licensee's practice, or any other Encumbrance on licensure
 affecting a Licensee's authorization to practice, including issuance of a cease and desist
 action.
HB 1961                                         5

         (4) "Alternative Program" means a non-disciplinary monitoring or practice
 remediation process approved by a Licensing Authority.
         (5) "Charter Member State" means any Member State which enacted this
 Compact by law before the Effective Date specified in section 324.1855.
         (6) "Continuing Education" means a requirement, as a condition of License
 renewal, to provide evidence of participation in, and completion of, educational and
 professional activities relevant to practice or area of work.
         (7) "CDR" means the Commission on Dietetic Registration or its successor
 organization.
         (8) "Compact Commission" means the government agency whose membership
 consists of all States that have enacted this Compact, which is known as the Dietitian
 Licensure Compact Commission, as described in section 324.1835, and which shall
 operate as an instrumentality of the Member States.
         (9) "Compact Privilege" means a legal authorization, which is equivalent to a
 License, permitting the Practice of Dietetics in a Remote State.
         (10) "Current Significant Investigative Information" means:
         (a) Investigative Information that a Licensing Authority, after a preliminary
 inquiry that includes notification and an opportunity for the subject Licensee to
 respond, if required by State law, has reason to believe is not groundless and, if proved
 true, would indicate more than a minor infraction; or
         (b) Investigative Information that indicates that the subject Licensee represents
 an immediate threat to public health and safety regardless of whether the subject
 Licensee has been notified and had an opportunity to respond.
         (11) "Data System" means a repository of information about Licensees,
 including, but not limited to, Continuing Education, examination, licensure,
 investigative, Compact Privilege and Adverse Action information.
         (12) "Encumbered License" means a License in which an Adverse Action
 restricts a Licensee's ability to practice dietetics.
         (13) "Encumbrance" means a revocation or suspension of, or any limitation on a
 Licensee's full and unrestricted Practice of Dietetics by a Licensing Authority.
         (14) "Executive Committee" means a group of delegates elected or appointed to
 act on behalf of, and within the powers granted to them by, this Compact, and the
 Compact Commission.
         (15) "Home State" means the Member State that is the Licensee's primary State
 of residence or that has been designated pursuant to section 324.1825.
         (16) "Investigative Information" means information, records, and documents
 received or generated by a Licensing Authority pursuant to an investigation.
HB 1961                                           6

       (17) "Jurisprudence Requirement" means an assessment of an individual's
knowledge of the State laws and regulations governing the Practice of Dietetics in such
State.
       (18) "License" means an authorization from a Member State to either:
       (a) Engage in the Practice of Dietetics (including medical nutrition therapy); or
       (b) Use the title "dietitian," "licensed dietitian," "licensed dietitian nutritionist,"
"certified dietitian," or other title describing a substantially similar practitioner as the
Compact Commission may further define by Rule.
       (19) "Licensee" or "Licensed Dietitian" means an individual who currently
holds a License and who meets all of the requirements outlined in section 324.1815.
       (20) "Licensing Authority" means the board or agency of a State, or equivalent,
that is responsible for the licensing and regulation of the Practice of Dietetics.
       (21) "Member State" means a State that has enacted the Compact.
       (22) "Practice of Dietetics" means the synthesis and application of dietetics as
defined by state law and regulations, primarily for the provision of nutrition care
services, including medical nutrition therapy, in person or via telehealth, to prevent,
manage, or treat diseases or medical conditions and promote wellness.
       (23) "Registered Dietitian" means a person who:
       (a) Has completed applicable education, experience, examination, and
recertification requirements approved by CDR;
       (b) Is credentialed by CDR as a registered dietitian or a registered dietitian
nutritionist; and
       (c) Is legally authorized to use the title registered dietitian or registered dietitian
nutritionist and the corresponding abbreviations "RD" or "RDN."
       (24) "Remote State" means a Member State other than the Home State, where a
Licensee is exercising or seeking to exercise a Compact Privilege.
       (25) "Rule" means a regulation promulgated by the Compact Commission that
has the force of law.
       (26) "Single State License" means a License issued by a Member State within
the issuing State and does not include a Compact Privilege in any other Member State.
       (27) "State" means any state, commonwealth, district, or territory of the United
States of America.
       (28) "Unencumbered License" means a License that authorizes a Licensee to
engage in the full and unrestricted Practice of Dietetics.
           324.1810. 1. To participate in the Compact, a State must currently:
       (1) License and regulate the Practice of Dietetics; and
HB 1961                                         7

         (2) Have a mechanism in place for receiving and investigating complaints about
 Licensees.
         2. A Member State shall:
         (1) Participate fully in the Compact Commission's Data System, including using
 the unique identifier as defined in Rules;
         (2) Notify the Compact Commission, in compliance with the terms of the
 Compact and Rules, of any Adverse Action or the availability of Current Significant
 Investigative Information regarding a Licensee;
         (3) Implement or utilize procedures for considering the criminal history record
 information of applicants for an initial Compact Privilege. These procedures shall
 include the submission of fingerprints or other biometric-based information by
 applicants for the purpose of obtaining an applicant's criminal history record
 information from the Federal Bureau of Investigation and the agency responsible for
 retaining that State's criminal records;
         (a) A Member State must fully implement a criminal history record information
 requirement, within a time frame established by Rule, which includes receiving the
 results of the Federal Bureau of Investigation record search and shall use those results
 in determining Compact Privilege eligibility.
         (b) Communication between a Member State and the Compact Commission or
 among Member States regarding the verification of eligibility for a Compact Privilege
 shall not include any information received from the Federal Bureau of Investigation
 relating to a federal criminal history record information check performed by a Member
 State;
         (4) Comply with and enforce the Rules of the Compact Commission;
         (5) Require an applicant for a Compact Privilege to obtain or retain a License in
 the Licensee's Home State and meet the Home State's qualifications for licensure or
 renewal of licensure, as well as all other applicable State laws; and
         (6) Recognize a Compact Privilege granted to a Licensee who meets all of the
 requirements outlined in section 324.1815 in accordance with the terms of the Compact
 and Rules.
         3. Member States may set and collect a fee for granting a Compact Privilege.
         4. Individuals not residing in a Member State shall continue to be able to apply
 for a Member State's Single State License as provided under the laws of each Member
 State. However, the Single State License granted to these individuals shall not be
 recognized as granting a Compact Privilege to engage in the Practice of Dietetics in any
 other Member State.
HB 1961                                         8

       5. Nothing in this Compact shall affect the requirements established by a
Member State for the issuance of a Single State License.
       6. At no point shall the Compact Commission have the power to define the
requirements for the issuance of a Single State License to practice dietetics. The
Member States shall retain sole jurisdiction over the provision of these requirements.
           324.1815. 1. To exercise the Compact Privilege under the terms and provisions
of t