Source: http://regulations.delaware.gov/AdminCode/title24/3800.shtml
Timestamp: 2019-04-22 18:29:52+00:00

Document:
"Medical nutrition therapy" means the use of specific nutrition services to treat, or rehabilitate an illness, injury, or condition. Medical nutrition therapy includes nutrition assessment, intervention, education, and counseling.
“Nutrition assessment” means the evaluation of the nutritional needs of individuals or groups based on appropriate nutrient intake, biochemical values, anthropometric measures, physical and metabolic parameters, socio-economic factors, current medical diagnosis and medications, enteral and parenteral nutrition or dietary data to determine nutrient needs and recommend appropriate medical nutrition therapy.
"Nutrition Care Services" means assessing the nutritional needs of individuals or groups, determining resources and constraints in the practice setting, and providing appropriate nutritional recommendations, counseling or education.
“Nutrition counseling” means advising and assisting individuals or groups on appropriate nutritional intake by integrating information from the nutrition assessment with information on food and other sources of nutrients and meal preparation consistent with cultural background and socioeconomic status.
“Nutritional Care Plan” means a plan of care developed by a licensed Dietitian/Nutritionist that includes: the design and implementation of nutrition programs/plans, which include goals and objectives for individuals and groups for the maintenance of health and prevention of disease; the design and implementation of therapeutic nutrition regimens, including enteral and parenteral nutrition for the management of nutritionally related health disorders; establishing priorities, goals, and objectives that meet nutritional needs and are consistent with available resources and constraints; developing, implementing, and managing nutrition care systems; and evaluating, making changes in, and maintaining appropriate standards of quality in food and nutrition care services.
“Nutritional care standards” means policies and procedures pertaining to the provision of nutritional care in institutional and community settings.
"Nutritional education" means a planned program based on learning objectives with expected outcomes designed to modify nutrition-related behaviors.
2.1.1	A major course of study [24 Del.C. §3806(2)] must include 3 semester credits with content in biochemistry, 3 semester credits with content in human physiology, and 12 semester credits of courses with major content in human nutrition and/or dietetics including 3 semester credits in nutrition and disease or diet therapy.
2.3.2.1	Each supervisor shall have administrative responsibility for the area of the professional practice experience OR provide a letter from the area's administrator showing approval for him/her to officially function as a supervisor of the applicant's experience for the purposes of this chapter.
2.3.2.2	The supervisor shall have access to relevant patient/client records in the site of the professional practice experience. In order to guide the applicant and to have a basis for evaluation, the supervisor shall review performance by periodic observation, either directly or by some recording of the nutrition services.
2.3.2.3	If there is more than one supervisor and/or facility for different parts of the experience, information and verification of each part is required.
2.3.2.4.1	the name and address of the facility providing the professional practice experience and name of the area within the facility where the professional practice experience occurred.
2.3.2.4.2	the name, address, phone and title of the official supervisor who is supervising the qualifying experience for purpose of obtaining the certification. The supervisor for the purpose of certification may be different than the administrative supervisor of the unit in the facility.
2.3.2.4.3	a summary of the nature of nutrition services performed, along with dates and hours spent performing them.
2.3.2.4.4	evidence that the supervisor was either a registered dietitian, a licensed dietitian or a certified dietitian/nutritionist or a certified nutrition specialist in Delaware or any other state at the time of supervision; or the supervisor was a licensed health care professional or individual with a doctoral degree from an accredited college or university with expertise in human nutrition. A copy of the current license, certification, or registration must be provided.
2.3.2.4.5	the applicant will send the description of the qualifying experience noted above to the professional practice experience supervisor for verification.
2.3.2.4.6.1	that the applicant participated in nutrition services under his/her supervision, indicating the total number of hours.
2.3.2.4.6.2	that the applicant performed the nutrition services at a satisfactory level and followed the Code of Ethics in the course of this qualifying experience.
2.4.1	The satisfactory completion of the registration examination established by the Commission on Dietetic Registration (CDR), the examination of the Certification Board for Nutrition Specialists (CBNS) or another national examination acceptable to the Board and approved by the Director of Professional Regulation is required. [24 Del.C. §3806(a)(4)].
2.4.1.1	The passing score shall be the passing score established by the exam provider.
2.4.2	The cost of the examination shall be borne by the applicant.
2.5	Individuals seeking a waiver under the provisions of 24 Del.C. §3806(f) of the qualifications for licensure specified in 24 Del.C. §3806(a)(1)-(4) and 24 Del.C. §3806(b) must document at least 10 years or greater work experience in the field of nutrition as defined in 24 Del.C. §3802(3) acceptable to the Board.
3.1	The Board may grant licensure to registered, certified or licensed dietitians/nutritionists holding a valid license issued by another jurisdiction whose standards of licensure are equal to or greater than those of 24 Del.C. Ch. 38.
3.2	The applicant shall include, as part of the application, copies of state licensing and/or practice statutes and regulations pertaining to the practice of dietetics and nutrition for each jurisdiction through which he/she is seeking reciprocity.
3.3	The Applicant shall include letters of good standing from all jurisdictions in which the applicant is licensed or registered.
3.4	“Standards of licensure” as used in 24 Del.C. §3807, shall refer to the qualifications of applicants set forth at §3806.
4.1	"Continuing professional education" (CPE) as specified in the Dietician/Nutritionist Licensure Act, 24 Del.C. §3808, must meet the content requirements of The American Dietetic Association for CPE credit. One hour of CPE credit shall be given for each hour of CPE activity.
4.1.1	To renew his or her license a LDN must obtain thirty (30) hours of CPE during each two year certification period.
4.1.1.1	CPE requirements shall be prorated for new LDNs as follows: If the new LDN has been licensed less than 1 year, CPE is not required for renewal, if the new LDN has been licensed for more than 1 year but less than 2 years, half of the 30 CPE hours (15 hours) are required. If licensed for 2 or more years, the full 30 hours of CPE is required.
4.1.1.2	Extensions of time: An extension of time to complete CPE requirements will be granted to any LDN who can demonstrate to the Board an acceptable cause. The LDN must petition the Board for an extension. Should the Board deny the request, the LDN must complete the requirements to maintain licensure. Examples of circumstances for which the Board may grant extensions of time include, but are not limited to, prolonged illness or extended absence from the country.
4.2	Proof of continuing education is satisfied with an attestation by the licensee that he or she has satisfied the requirements of Rule 4.0.
4.2.1	Attestation may be completed electronically if the renewal is accomplished online. In the alternative, paper renewal documents that contain the attestation of completion may be submitted.
4.2.2	Licensees selected for random audit will be required to supplement the attestation with attendance verification pursuant to Rule 4.3.
4.3	Random audits will be performed by the Board to ensure compliance with the CPE requirements.
4.3.1	The Board will notify LDNs within sixty (60) days after the license renewal date that they have been selected for audit.
4.3.2	LDNs selected for random audit shall be required to submit verification within ten (10) days of receipt of notification of selection for audit.
4.3.3.1	Proof of attendance. While course brochures may be used to verify contact hours, they are not considered to be acceptable proof for use of verification of course attendance.
4.3.3.6	Number of hours of CPE course.
4.3.4	The CPE activities must be performed within the two year period prior to renewal of licensure. If an activity overlaps two renewal periods, the date of completion of the activity determines the date in which the activity can be reported.
4.3.5	The current document published by CDR, describing CPE guidelines for registered dietitians shall be used as a guide to interpret requirements of CDR for CPE.
4.3.6	The Board will accept the decisions of CDR and CBNS for appropriateness of CPE activities and reserves the right to approve or disapprove any other activity deemed appropriate for CPE, using current CDR standards as criteria.
4.3.7	The Board may establish maximum hours allowed for any type of activity in the two-year period.
4.3.7.1	A maximum of 15 CPE hours shall be allowed for selfstudy programs.
4.3.7.2	A maximum of 6 CPE hours shall be allowed for exhibits.
4.3.7.3	A maximum of 10 CPE hours shall be allowed for poster presentations.
4.4	The Board shall review all documentation requested of any licensee shown on the audit list. If the Board determines the licensee has met the requirements, the licensee's license shall remain in effect. If the Board initially determines the licensee has not met the requirements, the licensee shall be notified and a hearing may be held pursuant to the Administrative Procedures Act. This hearing will be conducted to determine if there are any extenuating circumstances justifying the apparent noncompliance with these requirements. Unjustified noncompliance of these regulations shall be considered grounds for discipline in the practice of dietetics and nutrition, pursuant to 24 Del.C. §3811. The minimum penalty for unjustified noncompliance shall be a letter of reprimand.
4.5	Any licensee denied renewal or disciplined pursuant to these rules and regulations may contest such ruling by filing an appeal pursuant to the Administrative Procedures Act.
5.1	The biennial licensure period expires on May 31 of every odd-numbered year. A licensee may have his/her license renewed by submitting a renewal application to the Board by the renewal date and upon payment of the renewal fee prescribed by the Division of Professional Regulation (Division) along with an attestation of completion of the continuing education requirements. License renewal may be accomplished online at the Division’s website. Alternatively, licensees may submit paper renewal documents. Requests for paper renewal forms must be directed to the Division.
5.2	Any licensee who fails to renew his/her license by the renewal date may reactivate his/her license during the one (1) year period immediately following the license expiration date provided the licensee pays a late fee in addition to the prescribed renewal fee, submits an application on an appropriate form to the Board and provides proof that he/she completed the required continuing education.
5.3	No LDN will be permitted to renew his/her license once the one-year period has expired but the former licensee may re-apply under the same conditions that govern applicants for licensure under 24 Del.C. Ch. 38.
6.1	The LDN provides professional service with objectivity and with respect for the unique needs and values of individuals, avoiding discrimination on the basis of race, creed, gender, national origin, age or disability.
6.2	The LDN accurately presents professional qualifications and credentials and does not permit the use of these credentials by an unqualified person.
6.3	The LDN remains free of conflict of interest and promotes or endorses products/services in a manner that is neither false nor misleading.
6.4	The LDN assumes responsibility and accountability for personal competence in practice through continuing professional education and adherence to accepted standards of practice.
6.5	The LDN shall recognize and exercise professional judgment within the limits of his/her qualifications and shall not accept or perform professional responsibilities which the LDN is not qualified to perform.
6.6	The LDN practices nutrition/dietetics based on scientific principles and current substantiated information without personal bias, enabling clients to make informed decisions.
6.7	The LDN maintains the confidentiality of information obtained from clients and maintains records relating to services provided to a client in the course of a professional relationship.
6.8	The LDN conducts himself/herself with honesty, integrity and fairness, advertises services in a factual, straightforward manner, and fulfills professional commitments in good faith.
6.9	The LDN shall not engage in dietetic practice while under the influence of alcohol or drugs which impair the provision of such practice.
6.10	The LDN shall be responsible for reporting alleged misrepresentation or violations of the Code of Ethics to the State Committee of Dietetics/Nutrition.
7.0	Crimes Substantially Related To Provision Of Dietetic/Nutrition Services.
7.1.1	“Conviction” means a verdict of guilty by whether entered by a judge or jury, or a plea of guilty or a plea of nolo contendere or other similar plea such as a “Robinson” or “Alford” plea unless the individual has been discharged under §1024 of Title 10 (domestic violence diversion program) or by §4764 of Title 16 (first offenders controlled substances diversion program). Including all crimes prohibited by or punishable under Title 18 of the United States Code Annotated (U.S.C.A.) such as, but not limited to, Federal Health Care offenses.
7.2.44	§780 Female genital mutilation.
7.3.4	§811 Criminal mischief, Felony.
7.3.11	§832 Robbery in the first degree.
7.3.26	§903 Unlawful use of credit card; Felony.
7.4.10	§1112 Sexual offenders; prohibitions from school zones.
7.4.12	§1113 Criminal non-support and aggravated criminal non-support.
7.6	Any crime which involves offenses against a public health order and decency which may tend to bring discredit upon the profession, specifically including the below listed crimes from Title 11 of the Delaware Code Annotated which evidence a lack of appropriate concern for the safety and well being of another person or persons in general or sufficiently flawed judgment to call into question the individuals ability to make health care decisions or advise upon health care related matters for other individuals.
7.6.8	§1333 Trading in human remains and associated funerary objects.
7.6.12	§1340 Desecration of burial place.
7.7.13	§4774 Drug Paraphernalia (felony).
7.9	Any crime which is a violation of Title 24, Chapter 38 (Dietetics and Nutrition Practice Act) as it may be amended from time to time.
7.10	Crimes substantially related to the provision of services as a LDN shall be deemed to include any crimes under any federal law, state law, or valid town, city or county ordinance, that are substantially similar to the crimes identified in this rule.
8.5	Failure to cooperate fully with the participating Board chairperson or that chairperson's designate or designates or the Director of the Division of Professional Regulation or his/her designate in regard to the Voluntary Treatment Option or to comply with their requests for evaluations and screens may disqualify the regulated professional from the provisions of the Voluntary Treatment Option, and the participating Board chairperson or that chairperson's designate or designates shall cause to be activated an immediate investigation and institution of disciplinary proceedings as appropriate.
9.1	Telehealth is the use of electronic communications to provide and deliver a host of health-related information and health-care services, including dietetics and nutrition-related information and services, over large and small distances. Telehealth encompasses a variety of health care and health promotion activities, including education, advice, reminders, interventions, and monitoring of interventions.
9.2.1.1	The licensee shall have an active Delaware license in good standing to practice telehealth in the state of Delaware.
9.2.1.2	Licensees understand that this rule does not provide licensees with authority to practice telehealth to clients located in any jurisdiction other than Delaware, and licensees bear responsibility for complying with laws, rules, and/or policies for the practice of telehealth set forth by other jurisdictional boards dietetics and nutrition.
9.2.1.3	Licensees practicing telehealth shall comply with all of these rules of professional conduct and with requirements incurred in state and federal statutes relevant to the practice of dietetics and nutrition.
9.2.2.1.3	The potential disruption of electronic communication in the use of telehealth.
9.2.3	Confidentiality: The licensee shall ensure that the electronic communication is secure to maintain confidentiality of the patient's medical information as required by the Health Insurance Portability and Accountability Act (HIPAA) and other applicable Federal and State laws. Confidentiality shall be maintained through appropriate processes, practices and technology, including disposal of electronic equipment and data.
9.2.4.1	The licensee shall be responsible for determining and documenting that telehealth is an appropriate level of care for the patient.
9.2.4.2	The licensee shall comply with the Board's law and rules and regulations and all current standards of care requirements applicable to onsite care.
9.2.4.3	The licensee shall limit the practice of telehealth to the area of competence in which proficiency has been gained through education, training and experience.
9.2.4.4	All initial evaluations shall be performed face to face and not through audio-only communication.
9.2.4.5	The licensee shall document in the file or record which services were provided by telehealth.

References: §3806
 §3806
 §3806
 §3806
 §3806
 §3802
 §3807
 §3806
 §3808
 §3811
 §1024
 §4764
	§780
	§811
	§832
	§903
	§1112
	§1113
	§1333
	§1340
	§4774