Chapter 4759-5 Supervision; Exemptions

4759-5-01 Supervision of persons claiming exemption.

For the purposes of the supervision requirement contained in divisions (B) and (E) of section 4759.10 of the Revised Code the dietitian who provides supervision shall be responsible for the supervision of the person claiming exemption from licensure as a dietetic technician, or dietetic technician registered, or nutrition associate and shall provide sufficient guidance and direction as to enable the person to perform competently. These individuals have completed at least a two-year associates degree or higher from a program in dietetic technology or dietetics that has been approved by the commission on accreditation for dietetics education of the "Academy of Nutrition and Dietetics." Dietetic technicians registered have also passed the national written examination administered by the commission on dietetic registration and maintain professional development / continuing education requirements for on-going registration.

The licensed dietitian is responsible and accountable for the nutrition care of patients / clients in all healthcare settings and must answer to patients, employers, licensure boards and the legal system if care is compromised.

The licensee shall not delegate the nutrition care process, but may assign tasks within the process to competent exempt practitioners for the purpose of providing the licensee with needed information and communicating with and educating patients / clients.

When supervising a person claiming exemption the licensee shall:

(A) Verify the credentials and competence of each individual exempt practitioner being supervised in the areas of dietetic practice as defined in section 4759.10 of the Revised Code. Those exempt practitioners who are competent to practice beyond minimum standards should be expected to demonstrate initial and on-going competence annually with documentation of successful audits.

The supervising dietitian can establish initial and on-going competency by individual means including but not limited to testing, evaluations, use of decision tree models and peer competency assessment. Engaging in on-going dietetics related continuing education is vital to competent practice.

(B) Provide the person being supervised with guidelines for appropriate assignments as part of the nutritional care process;

(C) Periodically establish performance criteria for the exempt practitioner, then assign tasks appropriately, direct and monitor the individual's practice. The supervising dietitian should compare actual performance with expected performance, document results and take appropriate action;

(D) Maintain written documentation of the initial and on-going competency assessment of the exempt practitioner, supervision being provided and performance of the individual, including participation in professional development / continuing education equivalent to the requirements of the commission on dietetic registration for dietetic technicians registered.

Documentation shall include, but is not limited to, dates of conferences, supervisory anecdotal notes, written evaluations and recommendations. Documentation should be maintained in the licensee's records and be available upon request of the board.

(E) The licensee shall provide supervision in a manner that protects the public. Direct supervision may be provided on-site, or supervision may be provided indirectly, as long as the licensee is immediately available by phone, e-mail, facsimile or other reliable means.

Effective: 04/01/2013
R.C. 119.032 review dates: 12/18/2012 and 12/18/2017
Promulgated Under: 119.03
Statutory Authority: 4759.05(A)
Rule Amplifies: 4759.10(B), (E)
Prior Effective Dates: 11/30/87, 2/9/98, 7/6/09

4759-5-02 Student practice exemption.

(A) For purposes of divisions (D)(1) and (D)(2) of section 4759.02 of the Revised Code, a student dietitian may only engage in dietetic practice as defined in section 4759.01(A) of the Revised Code that is a part of the academic or pre-professional program.

(B) In order for student dietetic technicians to become qualified under the exemption for dietetic technicians contained in division (B) of section 4759.10 of the Revised Code, the board recognizes that pre-professional experiences are necessary. For this reason, dietetic practice by a student dietetic technician enrolled in a program that complies with the requirements in division (B) of section 4759.10 of the Revised Code, may be performed provided the student is actively pursuing the degree and the activity is performed under the supervision of a licensed dietitian or registered dietitian. A student dietetic technician may only engage in dietetic practice as defined in section 4759.01(A) of the Revised Code that is a part of the academic or pre-professional program.

(C) When supervising a student dietitian, a dietetic intern, or a student dietetic technician the licensee is responsible for providing appropriate training and guidelines for the student's clinical experiences, including ongoing close review of medical records and monitoring of student work performance. Documentation of such should be maintained in the licensee's records.

R.C. 119.032 review dates: 12/20/2012 and 12/20/2017
Promulgated Under: 119.03
Statutory Authority: 4759.05(A)
Rule Amplifies: 4759.02(D)(1), (2) , 4759.01(A) , 4759.10(B)
Prior Effective Dates: 11/30/87, 2/9/98, 3/15/03

4759-5-03 Plan of treatment exemption.

For purposes of the exemption from licensure contained in division (F) of section 4759.10 of the Revised Code, a person when acting under the direction and supervision of a professional licensed under Chapters 4701. to 4755. of the Revised Code, need not be a licensed dietitian if the person is executing a plan of treatment authorized by and within the scope of practice of the supervising licensed professional. The written plan of treatment shall include orders, goals, objectives, and appropriate treatments. Frequency of treatment and response to interventions shall be monitored and reviewed by the licensed practitioner. The licensed practitioner shall initiate the treatment plan and shall be on site when the plan is carried out by the unlicensed person.

R.C. 119.032 review dates: 12/20/2012 and 12/20/2017
Promulgated Under: 119.03
Statutory Authority: 4759.05(A)
Rule Amplifies: 4759.10(A), (F)
Prior Effective Dates: 11/30/87, 2/9/98, 3/15/03, 3/21/08

4759-5-04 Additional nutritional activities exemption.

For purposes of division (D) of section 4759.10 of the Revised Code, the board hereby permits the woman, infant, and children's program which is part of the Ohio department of health and known as "W.I.C.", to designate a person to engage in providing such additional nutritional activities as are necessary to operate its programs, providing reasonable efforts to obtain the services of a licensee have failed. The department shall file the designation indicating the time period with the board. The designation shall expire at the end of one hundred eighty days. The designation may be renewed for additional one-hundred-eighty-day periods by action of the board.

R.C. 119.032 review dates: 12/20/2012 and 12/20/2017
Promulgated Under: 119.03
Statutory Authority: 4759.05(A)
Rule Amplifies: 4759.10(D)
Prior Effective Dates: 11/30/87, 2/9/98, 3/15/03

4759-5-05 Distribution of literature exemption.

For purposes of division (G) of section 4759.10 of the Revised Code, the free distribution of literature includes its sale.

R.C. 119.032 review dates: 12/20/2012 and 12/20/2017
Promulgated Under: 119.03
Statutory Authority: 4759.05(A)
Rule Amplifies: 4759.10(G)
Prior Effective Dates: 11/30/87, 2/9/98, 3/15/03

4759-5-06 Weight control program exemption.

For purposes of the exemption from licensure contained in division (J) of section 4759.10 of the Revised Code, a person presenting a general program of instruction for weight control need not be a licensed dietitian provided the general program of weight control is approved in writing by a licensed dietitian, physician licensed under Chapter 4731. of the Revised Code to practice medicine or surgery or osteopathic medicine or surgery, a person licensed in another state and approved by the board as having substantially equivalent licensure requirements as Ohio, or a registered dietitian.

A "general program of weight control" is a program designed for one or more population groups in order to achieve or maintain a healthy weight. It is not based on an individual nutrition assessment and does not provide medical nutrition therapy (MNT) as defined in rule 4759-2-01 of the Administrative Code. The program includes the diet plan and any information provided to customers including written guidelines for instruction to customers.

Persons presenting an approved general program of weight control are to adhere to the approved program content. The program shall be reviewed for re-approval in writing at least every two years.

R.C. 119.032 review dates: 12/20/2012 and 12/20/2017
Promulgated Under: 119.03
Statutory Authority: 4759.05(A)
Rule Amplifies: 4759.10(J)
Prior Effective Dates: 11/30/87, 2/9/98, 3/15/03