NY State Senate Bill 2017-S2628

Archive: Last Bill Status - In Senate Committee Higher Education Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Date of Action	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 03, 2018	referred to higher education
Jan 13, 2017	referred to higher education

co-Sponsors

2017-S2628 (ACTIVE) - Details

Current Committee:: Senate Higher Education
Law Section:: Education Law
Laws Affected:: Add §8007, Ed L
Versions Introduced in 2015-2016 Legislative Session:: S7692

2017-S2628 (ACTIVE) - Summary

Allows a qualified dietetic professional or qualified nutrition professional to manage the diet of a patient who is being treated in a facility by a physician for specific diseases.

2017-S2628 (ACTIVE) - Sponsor Memo

                                 BILL NUMBER:  S2628

 TITLE OF BILL :  An act to amend the education law, in relation to
management of therapeutic diet orders in a facility

 PURPOSE :

To allow hospitals to take advantage of the Centers for Medicare
&Medicaid Services (CMS) rule (Vol.79/No.91 May 12, 2014) which allows
a hospital to permit qualified dietitians or nutritionists the
authority to order therapeutic diets.

 SUMMARY OF PROVISIONS :

Section 1. Amends the education law to add a new section 8007 that
provides for management of therapeutic diet orders in a facility.
Subdivision 1 of the section provides definitions for "qualified
dietetic professional" or qualified nutrition professional",
"therapeutic diet", and "facility".

Subdivision 2 of the section provides that the management of
therapeutic diets performed by a qualified dietetic or nutrition
professional includes a review, evaluation, order and management of a
therapeutic diet to a patient who is being treated in a facility by a
physician for specific diseases or disease states in accordance with
facility policies. This section further states that the management of

parenteral and enteral nutrition was part of a therapeutic diet order
may include adjustment of a diet or nutrition regimen, however, if the
treating physician disagrees with the protocol made by the dietitian
or nutritionist, the physician will prevail. This also provides that a
qualified dietetic or nutrition professional may evaluate and if
authorized by the facility, order clinical laboratory test related to
the therapeutic diet order and order or perform routine patient
monitoring as necessary for parenteral and enteral nutrition
management.

Subdivision 3 of the section states that nothing in this section shall
authorize a qualified dietetic or nutrition professional to establish
or modify a medical diagnosis.

Subdivision 4 of the section provides that authorization of any
qualified dietetic or nutrition professionals to engage in the
management of a therapeutic diet order shall be at the discretion of
the facility.

Subdivision 5 of the section provides that nothing in this section
shall be deemed to authorize, grant or extend hospital privileges to
individuals certified as dietitians or nutritionists under this
Article.

Section 2. Sets for the effective date.

 EXISTING LAW :

The education law currently provides for the certification of
dietitians and nutritionists (CDN).

 JUSTIFICATION :

Legislation is required to allow hospitals to permit a qualified
dietitian or nutritionist to order therapeutic diets.

Previously, the CMS rue was interpreted to require physicians to be
responsible for therapeutic diet orders. However, recent CMS rule now
indicates that qualified dietitians or nutritionists are "the
professionals who are best qualified to assess a patient's nutritional
status and to design and implement a nutritional treatment plan in
consultation with the patient's interdisciplinary care team".

In addition, the CMS rules state that the qualified dietitian or
nutritionist "must be viewed as an integral member of the hospital
interdisciplinary care team, one who as the team's clinical nutrition
expert is responsible for a patient's nutritional diagnosis and
treatment in light of a patient's medical diagnosis.

Finally, the CMS rules state that "we consider all patient diets to be
therapeutic in nature, regardless of the modality used to support the
nutritional needs o the patient and that the term would most certainly
include parenteral and enteral nutrition support".

However, New York State law does not permit CDNs to make an order. In
addition, since parenteral nutrition is dispensed by a pharmacist
within the facility, current law does not allow CDNs to order
nutrition via the parenteral dispensing process.

Language is needed to provide the authority and establish parameters
for responsible practice; acknowledging the responsibilities and
oversight of physician or pharmacist in the process of delivering
nutrition care.

 LEGISLATIVE HISTORY :

2016 S.7692

 FISCAL IMPLICATIONS :

None to the State.

 EFFECTIVE DATE :
This act shall take effect on the one hundred eightieth day after it
shall have become a law; provided, however, that effective immediately
the Department of Education may promulgate any rule or regulation
necessary for the timely implementation of this act on its effective
date.

2017-S2628 (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   2628
 
                        2017-2018 Regular Sessions
 
                             I N  S E N A T E
 
                             January 13, 2017
                                ___________
 
 Introduced  by  Sens. LAVALLE, HANNON -- read twice and ordered printed,
   and when printed to be committed 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:
   §  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
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD08038-01-7

 S. 2628                             2
 
 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-
 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. 2628                             3
 
   § 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 its effective
 date.

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Senate Bill S2628

Sponsored By

Archive: Last Bill Status - In Senate Committee Higher Education Committee

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co-Sponsors

2017-S2628 (ACTIVE) - Details

2017-S2628 (ACTIVE) - Summary

2017-S2628 (ACTIVE) - Sponsor Memo

2017-S2628 (ACTIVE) - Bill Text download pdf

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Sponsored By

Kenneth P. LaValle

Archive: Last Bill Status - In Senate Committee Higher Education Committee

Actions

co-Sponsors

Kemp Hannon

2017-S2628 (ACTIVE) - Details

2017-S2628 (ACTIVE) - Summary

2017-S2628 (ACTIVE) - Sponsor Memo

2017-S2628 (ACTIVE) - Bill Text download pdf

Comments