The New York State Senate

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

                                  7660

                       2019-2020 Regular Sessions

                          I N  A S S E M B L Y

                              May 14, 2019
                               ___________

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 delivering nutrition
  care through therapeutic diets

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

  Section  1.  Legislative  findings  and  declaration of purpose.   The
legislature finds that the Center for  Medicaid  and  Medicare  Services
(CMS) issued a new rule that permits hospitals to allow qualified dieti-
tians and nutritionists to order therapeutic diets in the Federal Regis-
ter  Volume  79,  Number  91  on  May 12, 2014. CMS rules are related to
federal reimbursement of services. The CMS rules state  that  dietitians
and 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 inter-
disciplinary care team,  one  who,  as  the  team's  clinical  nutrition
expert,  is responsible for a patient's nutritional diagnosis and treat-
ment in light of a patient's medical diagnosis.  The  CMS  rule  further
states  that  all  patient  diets  are  considered  to be therapeutic in
nature, regardless of the modality used to support the nutritional needs
of the patient and that the term would most certainly include parenteral
and enteral nutrition support. The legislature finds that CMS  issued  a
similar  rule  for  long  term  care  facilities in the Federal Register
Volume 81, Number 192 on October 4, 2016. Since CMS rules emphasize that
the state law governs the scope of practice, the legislature finds  that
the  current  scope  of  practice for certified dietitians and certified
nutritionists does not specifically allow for the ordering of  therapeu-
tic  diets.  The legislature intends to provide language which is needed
to allow the state of New York to deliver nutrition care via therapeutic

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

                                                           LBD11593-01-9

A. 7660                             2

diets through recognized dietetic  and  nutrition  professionals,  in  a
manner deemed as being appropriate and efficient.
  §  2.  Section  8001  of  the education law is amended by adding a new
subdivision 4 to read as follows:
  4. NOTWITHSTANDING ANY OTHER PROVISION  OF  LAW  TO  THE  CONTRARY,  A
CERTIFIED  DIETITIAN  OR  CERTIFIED  NUTRITIONIST  MAY PRESCRIBE, ORDER,
WRITE, REVIEW, EVALUATE, MONITOR AND MANAGE THERAPEUTIC DIETS, INCLUDING
ENTERAL AND PARENTERAL NUTRITION,  IN  HOSPITALS,  INCLUDING  DIAGNOSTIC
CENTERS, TREATMENT CENTERS, HOSPITAL-BASED OUTPATIENT DEPARTMENTS, RESI-
DENTIAL HEALTH CARE FACILITIES OR NURSING HOMES OR ANY OTHER FACILITY AS
DEFINED  IN  SECTION  TWENTY-EIGHT HUNDRED ONE OF THE PUBLIC HEALTH LAW,
WHEN COMPETENCY IS DETERMINED BY THE MEDICAL DIRECTOR OR GOVERNING  BODY
OF SUCH FACILITY.
  § 3. This act shall take effect on the one hundred eightieth day after
it  shall have become a law. Effective immediately, the addition, amend-
ment and/or repeal of any rule or regulation necessary for the implemen-
tation of this act on its effective date are authorized to be  made  and
completed on or before such effective date.