STATE OF NEW YORK ________________________________________________________________________ 10491 IN ASSEMBLY 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: 1 Section 1. The education law is amended by adding a new section 8007 2 to read as follows: 3 § 8007. Management of therapeutic diet orders in a facility. 1. As 4 used in this section, the following terms shall have the following mean- 5 ings: 6 (a) "Qualified dietetic professional" or "qualified nutrition profes- 7 sional" shall be an individual who meets the following requirements: 8 (i) holds a valid license and current registration as a certified 9 dietician or certified nutritionist in accordance with this article; and 10 (ii) has net the requirements of paragraph (a) of subdivision two of 11 section eight thousand four of this article and subdivision three of 12 section eight thousand four of this article; and 13 (iii) holds a registration or certification from a national registra- 14 tion or certifying association, with standards acceptable to the depart- 15 ment, that provides education and training in parenteral and enteral 16 nutrition acceptable to the department and in accordance with the 17 commissioner's regulations. 18 (b) "Therapeutic diet" is a diet intervention that provides food or 19 nutrients via oral, enteral and parenteral routes as a part of treatment 20 of disease or clinical conditions to modify, eliminate, decrease, or 21 increase identified micro- and macro-nutrients in the diet. 22 (c) "Facility" shall mean a hospital, including any diagnostic center, 23 treatment center, or hospital-based outpatient department, residential 24 health care facility or nursing home or any facility as defined in 25 section twenty-eight hundred one of the public health law, a home care 26 agency as defined in section thirty-six hundred two of the public health 27 law or other entity that provides direct patient care under the auspices 28 of a medical director. 29 2. (a) The management of therapeutic diets performed by a qualified 30 dietetic professional or qualified nutrition professional includes a 31 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. LBD15363-04-6A. 10491 2 1 ing the ordering of food and nutrition supplements, and the management 2 of parenteral or enteral nutrition, as defined in this subdivision, to a 3 patient who is being treated in a facility by a physician for specific 4 diseases or disease states, in accordance with the policies, procedures, 5 and protocols of the facility. 6 (b) The management of parenteral nutrition as part of a therapeutic 7 diet order by a qualified dietetic professional or qualified nutrition 8 professional may include prescribing, adjusting and managing a diet or 9 nutrition regimen of a patient pursuant to a patient specific written 10 order or protocol for parenteral nutrition access made by the patient's 11 physician. Implementation or adjustments shall be made after the review 12 by the pharmacists responsible to the facility for the care of the 13 patient. The physician or facility may prohibit, by written instruction, 14 any adjustment or change in the patient's diet or nutrition regimen by 15 the qualified dietetic professional or qualified nutrition professional. 16 In the event that a treating physician or pharmacist may disagree with 17 the exercise of professional judgment by the qualified dietetic profes- 18 sional or qualified nutrition professional as it relates to the manage- 19 ment of parenteral nutrition, the judgment of the treating physician or 20 pharmacist shall prevail. 21 (c) The management of enteral nutrition as part of a therapeutic diet 22 order by a qualified dietetic professional or qualified nutrition 23 professional may include adjusting and managing a diet or nutrition 24 regimen of a patient pursuant to a patient specific written order or 25 protocol for enteral nutrition access made by the patient's physician. 26 The physician or facility may prohibit, by written instruction, any 27 adjustment or change in the patient's diet or nutrition regimen by the 28 qualified dietetic professional or qualified nutrition professional. 29 In the event that a treating physician may disagree with the exercise 30 of professional judgment by the qualified dietetic professional or qual- 31 ified nutrition professional as it relates to the management of enteral 32 nutrition, the judgment of the treating physician shall prevail. 33 (d) A qualified dietetic professional or qualified nutrition profes- 34 sional may evaluate and, only if specifically authorized by the poli- 35 cies, procedures, or protocol of the facility and only to the extent 36 necessary to discharge the responsibilities set forth in this section, 37 order clinical laboratory tests related to the management of a therapeu- 38 tic diet order for the specific diseases or disease states specified 39 within the written order or protocol, and order or perform routine 40 patient monitoring functions as may be necessary for the management of 41 parenteral and enteral nutrition. 42 3. Nothing herein shall authorize a qualified dietetic professional or 43 qualified nutrition professional to establish or modify a medical diag- 44 nosis. 45 4. The authorization of any qualified dietetic professional or quali- 46 fied nutrition professional to engage in the management of a therapeutic 47 diet order, including the management of parenteral and enteral nutri- 48 tion, shall be at the discretion of the facility. 49 5. Nothing herein contained shall be deemed to authorize, grant, or 50 extend hospital privileges to individuals certified under this article. 51 § 2. This act shall take effect on the one hundred eightieth day after 52 it shall have become a law; provided, however, that effective immediate- 53 ly the department of education may promulgate any rule or regulation 54 necessary for the timely implementation of this act on this effective 55 date.