Assembly Bill A10491

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  10491

                          I N  A S S E M B L Y

                              May 31, 2016
                               ___________

Introduced by M. of A. JAFFEE -- read once and referred to the Committee
  on Higher Education

AN  ACT  to amend the education law, in relation to management of thera-
  peutic diet orders in a facility

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1.  The education law is amended by adding a new section 8007
to read as follows:
  S 8007. MANAGEMENT OF THERAPEUTIC DIET ORDERS IN A FACILITY.  1.    AS
USED IN THIS SECTION, THE FOLLOWING TERMS SHALL HAVE THE FOLLOWING MEAN-
INGS:
  (A)  "QUALIFIED DIETETIC PROFESSIONAL" OR "QUALIFIED NUTRITION PROFES-
SIONAL" SHALL BE AN INDIVIDUAL WHO MEETS THE FOLLOWING REQUIREMENTS:
  (I) HOLDS A VALID LICENSE AND  CURRENT  REGISTRATION  AS  A  CERTIFIED
DIETICIAN OR CERTIFIED NUTRITIONIST IN ACCORDANCE WITH THIS ARTICLE; AND
  (II)  HAS  NET THE REQUIREMENTS OF PARAGRAPH (A) OF SUBDIVISION TWO OF
SECTION EIGHT THOUSAND FOUR OF THIS ARTICLE  AND  SUBDIVISION  THREE  OF
SECTION EIGHT THOUSAND FOUR OF THIS ARTICLE; AND
  (III)  HOLDS A REGISTRATION OR CERTIFICATION FROM A NATIONAL REGISTRA-
TION OR CERTIFYING ASSOCIATION, WITH STANDARDS ACCEPTABLE TO THE DEPART-
MENT, THAT PROVIDES EDUCATION AND TRAINING  IN  PARENTERAL  AND  ENTERAL
NUTRITION  ACCEPTABLE  TO  THE  DEPARTMENT  AND  IN  ACCORDANCE WITH THE
COMMISSIONER'S REGULATIONS.
  (B) "THERAPEUTIC DIET" IS A DIET INTERVENTION THAT  PROVIDES  FOOD  OR
NUTRIENTS VIA ORAL, ENTERAL AND PARENTERAL ROUTES AS A PART OF TREATMENT
OF  DISEASE  OR  CLINICAL  CONDITIONS TO MODIFY, ELIMINATE, DECREASE, OR
INCREASE IDENTIFIED MICRO- AND MACRO-NUTRIENTS IN THE DIET.
  (C) "FACILITY" SHALL MEAN A HOSPITAL, INCLUDING ANY DIAGNOSTIC CENTER,
TREATMENT CENTER, OR HOSPITAL-BASED OUTPATIENT  DEPARTMENT,  RESIDENTIAL
HEALTH  CARE  FACILITY  OR  NURSING  HOME  OR ANY FACILITY AS DEFINED IN
SECTION TWENTY-EIGHT HUNDRED ONE OF THE PUBLIC HEALTH LAW, A  HOME  CARE
AGENCY AS DEFINED IN SECTION THIRTY-SIX HUNDRED TWO OF THE PUBLIC HEALTH
LAW OR OTHER ENTITY THAT PROVIDES DIRECT PATIENT CARE UNDER THE AUSPICES
OF A MEDICAL DIRECTOR.
  2.  (A)  THE  MANAGEMENT OF THERAPEUTIC DIETS PERFORMED BY A QUALIFIED
DIETETIC PROFESSIONAL OR QUALIFIED  NUTRITION  PROFESSIONAL  INCLUDES  A
REVIEW,  EVALUATION, ORDER AND MANAGEMENT OF A THERAPEUTIC DIET, INCLUD-
              

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD15363-04-6

A. 10491                            2

ING THE ORDERING OF FOOD AND NUTRITION SUPPLEMENTS, AND  THE  MANAGEMENT
OF PARENTERAL OR ENTERAL NUTRITION, AS DEFINED IN THIS SUBDIVISION, TO A
PATIENT  WHO  IS BEING TREATED IN A FACILITY BY A PHYSICIAN FOR SPECIFIC
DISEASES OR DISEASE STATES, IN ACCORDANCE WITH THE POLICIES, PROCEDURES,
AND PROTOCOLS OF THE FACILITY.
  (B)  THE  MANAGEMENT  OF PARENTERAL NUTRITION AS PART OF A THERAPEUTIC
DIET ORDER BY A QUALIFIED DIETETIC PROFESSIONAL OR  QUALIFIED  NUTRITION
PROFESSIONAL  MAY  INCLUDE PRESCRIBING, ADJUSTING AND MANAGING A DIET OR
NUTRITION REGIMEN OF A PATIENT PURSUANT TO A  PATIENT  SPECIFIC  WRITTEN
ORDER  OR PROTOCOL FOR PARENTERAL NUTRITION ACCESS MADE BY THE PATIENT'S
PHYSICIAN.  IMPLEMENTATION OR ADJUSTMENTS SHALL BE MADE AFTER THE REVIEW
BY THE PHARMACISTS RESPONSIBLE TO THE  FACILITY  FOR  THE  CARE  OF  THE
PATIENT. THE PHYSICIAN OR FACILITY MAY PROHIBIT, BY WRITTEN INSTRUCTION,
ANY  ADJUSTMENT  OR CHANGE IN THE PATIENT'S DIET OR NUTRITION REGIMEN BY
THE QUALIFIED DIETETIC PROFESSIONAL OR QUALIFIED NUTRITION PROFESSIONAL.
  IN THE EVENT THAT A TREATING PHYSICIAN OR PHARMACIST MAY DISAGREE WITH
THE EXERCISE OF PROFESSIONAL JUDGMENT BY THE QUALIFIED DIETETIC  PROFES-
SIONAL  OR QUALIFIED NUTRITION PROFESSIONAL AS IT RELATES TO THE MANAGE-
MENT OF PARENTERAL NUTRITION, THE JUDGMENT OF THE TREATING PHYSICIAN  OR
PHARMACIST SHALL PREVAIL.
  (C)  THE MANAGEMENT OF ENTERAL NUTRITION AS PART OF A THERAPEUTIC DIET
ORDER BY  A  QUALIFIED  DIETETIC  PROFESSIONAL  OR  QUALIFIED  NUTRITION
PROFESSIONAL  MAY  INCLUDE  ADJUSTING  AND  MANAGING A DIET OR NUTRITION
REGIMEN OF A PATIENT PURSUANT TO A PATIENT  SPECIFIC  WRITTEN  ORDER  OR
PROTOCOL  FOR  ENTERAL NUTRITION ACCESS MADE BY THE PATIENT'S PHYSICIAN.
THE PHYSICIAN OR FACILITY MAY  PROHIBIT,  BY  WRITTEN  INSTRUCTION,  ANY
ADJUSTMENT  OR  CHANGE IN THE PATIENT'S DIET OR NUTRITION REGIMEN BY THE
QUALIFIED DIETETIC PROFESSIONAL OR QUALIFIED NUTRITION PROFESSIONAL.
  IN THE EVENT THAT A TREATING PHYSICIAN MAY DISAGREE WITH THE  EXERCISE
OF PROFESSIONAL JUDGMENT BY THE QUALIFIED DIETETIC PROFESSIONAL OR QUAL-
IFIED  NUTRITION PROFESSIONAL AS IT RELATES TO THE MANAGEMENT OF ENTERAL
NUTRITION, THE JUDGMENT OF THE TREATING PHYSICIAN SHALL PREVAIL.
  (D) A QUALIFIED DIETETIC PROFESSIONAL OR QUALIFIED  NUTRITION  PROFES-
SIONAL  MAY  EVALUATE  AND, ONLY IF SPECIFICALLY AUTHORIZED BY THE POLI-
CIES, PROCEDURES, OR PROTOCOL OF THE FACILITY AND  ONLY  TO  THE  EXTENT
NECESSARY  TO  DISCHARGE THE RESPONSIBILITIES SET FORTH IN THIS SECTION,
ORDER CLINICAL LABORATORY TESTS RELATED TO THE MANAGEMENT OF A THERAPEU-
TIC DIET ORDER FOR THE SPECIFIC DISEASES  OR  DISEASE  STATES  SPECIFIED
WITHIN  THE  WRITTEN  ORDER  OR  PROTOCOL,  AND ORDER OR PERFORM ROUTINE
PATIENT MONITORING FUNCTIONS AS MAY BE NECESSARY FOR THE  MANAGEMENT  OF
PARENTERAL AND ENTERAL NUTRITION.
  3. NOTHING HEREIN SHALL AUTHORIZE A QUALIFIED DIETETIC PROFESSIONAL OR
QUALIFIED  NUTRITION PROFESSIONAL TO ESTABLISH OR MODIFY A MEDICAL DIAG-
NOSIS.
  4. THE AUTHORIZATION OF ANY QUALIFIED DIETETIC PROFESSIONAL OR  QUALI-
FIED NUTRITION PROFESSIONAL TO ENGAGE IN THE MANAGEMENT OF A THERAPEUTIC
DIET  ORDER,  INCLUDING  THE MANAGEMENT OF PARENTERAL AND ENTERAL NUTRI-
TION, SHALL BE AT THE DISCRETION OF THE FACILITY.
  5. NOTHING HEREIN CONTAINED SHALL BE DEEMED TO  AUTHORIZE,  GRANT,  OR
EXTEND HOSPITAL PRIVILEGES TO INDIVIDUALS CERTIFIED UNDER THIS ARTICLE.
  S 2. This act shall take effect on the one hundred eightieth day after
it shall have become a law; provided, however, that effective immediate-
ly  the  department  of  education may promulgate any rule or regulation
necessary for the timely implementation of this act  on  this  effective
date.