Bill Text: MS SB2758 | 2019 | Regular Session | Introduced
Bill Title: Licensure of Certified Diabetes Educators by the State Department of Health; provide for.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Failed) 2019-02-05 - Died In Committee [SB2758 Detail]
Download: Mississippi-2019-SB2758-Introduced.html
MISSISSIPPI LEGISLATURE
2019 Regular Session
To: Public Health and Welfare; Appropriations
By: Senator(s) Parks
Senate Bill 2758
AN ACT TO PROVIDE FOR THE LICENSURE OF CERTIFIED DIABETES EDUCATORS BY THE STATE DEPARTMENT OF HEALTH; TO PROVIDE DEFINITIONS; TO DEFINE THE SCOPE OF PRACTICE OF DIABETES EDUCATION; TO ESTABLISH AND EMPOWER A COUNCIL OF ADVISORS IN DIABETES EDUCATION; TO AUTHORIZE THE DEPARTMENT OF HEALTH TO PROMULGATE REGULATIONS FOR THE LICENSURE OF DIABETES EDUCATORS AND PRESCRIBE ITS DUTIES AND RESPONSIBILITIES; TO PROVIDE REQUIREMENTS FOR LICENSURE APPLICANTS; TO PROVIDE FOR A PROVISIONAL LICENSE; TO PROVIDE FOR PROFESSIONAL TITLES AND IDENTIFICATION OF LICENSEES AND DISPLAY OF LICENSE; TO PROVIDE FOR RENEWAL OF LICENSE AND CONTINUING EDUCATION REQUIREMENTS; TO PROVIDE STANDARDS OF CONDUCT AND DISCIPLINARY ACTION WHICH MAY BE TAKEN AGAINST LICENSEES; TO PROVIDE APPEAL PROCEDURES; TO PRESCRIBE EXCEPTIONS TO THE REQUIRED LICENSURE TO PRACTICE DIABETES EDUCATION; TO PRESCRIBE CRIMINAL PENALTIES FOR VIOLATION OF THIS ACT; TO PRESCRIBE A SCHEDULE OF FEES FOR LICENSURE; TO PROVIDE AN ADMINISTRATIVE GRIEVANCE PROCEDURE; AND FOR RELATED PURPOSES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:
SECTION 1. (1) General purpose. The purpose of these regulations is to safeguard the public's health, safety, and welfare by establishing minimum qualifications and creating exclusive titles corresponding to the level of qualifications for individuals who wish to offer diabetes self-management training and education services to the public. Further, in order to ensure the highest degree of professional conduct by those engaged in offering diabetes self-management training and education services to the public, it is the purpose of these regulations to provide and impose disciplinary sanctions, be they civil or criminal, against persons who do not meet or adhere to the procedures, qualifications, and standards set out in the Act and in these regulations.
(2) Legal authority. The Mississippi State Department of Health is authorized to establish, adopt, and enforce these rules and regulations by virtue of Sections 73-7-31 and 73-7-32, Mississippi Code of 1972.
SECTION 2. (1) Definitions. The following terms shall have the meaning set forth below, unless the context otherwise requires:
(a) "Department" means the Mississippi State Department of Health.
(b) "Advisory Council" means the Mississippi Council of Advisors in Diabetes Education. It shall also be referred to as the "advisory council."
(c) "Association" means the American Association of Diabetes Educators and its affiliates.
(d) "Mississippi Association" means the Mississippi Coordinating Body, an affiliate of the American Association of Diabetes Educators (AADE).
(e) "National Certification Board of Diabetes Educators" (NCBDE) means the National Certification Board of Diabetes Educators that is a member of the National Commission for Health Certifying Agencies.
(f) "Degree" means a degree received from a college or university that was accredited through the Council on Postsecondary Accreditation (COPA) and the U.S. Department of Education at the time the degree was conferred.
(g) "Certified Diabetes Educator" means a person certified by the National Certification Board of Diabetes Educators.
(h) "Licensed Diabetes Educator" means a person licensed pursuant to these regulations.
(i) "Provisionally Licensed Diabetes Educator" means a person provisionally licensed pursuant to these regulations.
(j) "Diabetes Self-Management Training and Education" means the integration and application of the principles derived from the sciences of physiology, nutrition, physical activity, medications, monitoring laboratory values, medical management, and behavioral/social sciences to achieve and maintain health. Diabetes self-management training and education practice includes, a comprehensive collaborative process through which people with or at risk for diabetes gain the knowledge and skills needed to modify behavior and successfully self-manage the disease and its related conditions. It may also be referred to as "diabetes education."
(k) "Diabetes educator" means one engaged in diabetes self-management training/education practice.
(l) "Direct technical supervision" means the direct, technical supervision by a licensed diabetes educator, as prescribed in regulations by the department, of the diabetes self-management training/education practice provided to an individual and/or group by a provisionally licensed diabetes educator.
(m) "Practice of diabetes education" means assessing and developing a plan of care for a person with or at risk of diabetes, identifying self-management goals for the person, providing self-management training according to the plan, evaluating the individual's outcome and recording a complete record of the individual's experience and follow-ups.
(n) "License" means the document of licensure issued by the department.
(o) "Act" means the "Mississippi Diabetes Education Practice Act of 1986."
(2) Publication. The department shall make available, upon request and payment of a fee, a list of the names and addresses of all persons licensed by the department as diabetes educators, and a list of all persons whose licenses have been suspended, revoked, denied renewal, probationary status, censured, or reprimanded during the current licensure term.
SECTION 3. Mississippi Council of Advisors in Diabetes Education ("Council"): Council structure and purpose. (1) The Council shall consist of seven (7) members as set forth in the enabling statute, for the terms indicated therein, and shall serve under the jurisdiction of the State Department of Health. The purpose of the Council is to serve in an advisory capacity to the department in matters relating to the administration and interpretation of the enabling statute.
(2) Composition. There is hereby created the Mississippi Council of Advisors in Diabetes Education consisting of five (5) members who shall be appointed by the Governor as follows:
(a) One (1) member shall be a licensed medical physician with experience in the delivery of diabetes education appointed from a list of three (3) names submitted by the State Board of Medical Licensure;
(b) One (1) member shall be a Mississippi affiliate of the American Association of Diabetes Educators leadership team member with experience in diabetes self-management training and education program development;
(c) Two (2) members shall be a licensed pharmacist; a licensed dietitian; a licensed registered nurse; a masters level exercise physiologist or specialist; or a masters level psychologist or specialist currently practicing in diabetes education and support, and appointed from a list of three (3) names from the Mississippi affiliate of the American Association of Diabetes Educators; and
(d) One (1) member shall be a citizen at large who is not employed in the health care field and lives with diabetes either personally or through a family member. At least two (2) of the members appointed under paragraph (b) or (c) of this subsection shall have completed either the credentialing program of the American Association of Diabetes Educators or the National Certification Board for Diabetes Educators.
(3) Mississippi Council of Advisors in Diabetes shall initially be appointed for staggered terms:
(a) The Governor shall initially appoint one (1) member and the citizen at large to terms of four (4) years, two (2) members to terms of three (3) years, and one (1) member to a term of two (2) years.
(b) All reappointments to the advisory council shall be for terms of four (4) years.
(c) No member shall serve more than two (2) consecutive terms and shall serve on the advisory council until his or her successor is appointed.
(4) The advisory council shall organize annually and elect: one (1) of its members as chair and one (1) of its members as secretary.
(5) The advisory council shall be placed for administrative purposes under the Office of Occupations and Professions of the Public Protection Cabinet.
(6) Meetings. The Council shall meet at least twice each year. Additional meetings may be held, at the discretion of the chairman of the Council or of the department, upon ten (10) days written notice to the Council members. A quorum shall consist of three (3) members of the Council, including the chairman, and shall be necessary for the Council to take action by vote.
SECTION 4. Responsibilities. (1) The department, with the advice of the council, shall:
(a) Promulgate administrative regulations for licensed diabetes educators, including creating a code of ethics, standards of practice, and continuing education requirements for licensed diabetes educators, based upon policies and positions adopted by the American Association of Diabetes Educators;
(b) Establish licensing and renewal of license criteria for applicants;
(c) Develop refer disciplinary actions of any individual engaged in the practice of diabetes self-management training/education to the appropriate government agency for prosecution, whether licensed or otherwise, or, in its discretion, refer same to the appropriate committee or council;
(d) Conduct disciplinary hearings, upon specified charges, of a licensee; and
(e) Direct the department to promulgate and implement rules and procedures to carry out the purpose of this Act.
SECTION 5. Licensure: Licensure requirements. An applicant for licensure shall submit to the department, verified by oath, written evidence in form and content satisfactory to the department that the applicant:
(a) Has passed an examination as administered by the National Certification Board of Diabetes Educators or other examination as approved by the department;
(b) Is in good standing in any other state or jurisdiction where licensed;
(c) Is of good moral character; and
(d) Is presently in good standing with the department.
SECTION 6. Provisional license. The board may, in its discretion, issue a provisional license for the practice of diabetes self-management training and education for a period of two (2) years, providing the applicant submits to the department, verified by oath, in form and content satisfactory to the department that the applicant:
(a) Is a resident of the State of Mississippi; and
(b) Has received a baccalaureate or post-baccalaureate degree from a college or university accredited through the U.S. Department of Education, Office of Postsecondary Education, with a major in dietetics, pharmacy, exercise physiology, nursing, psychology, social worker or even preparation as a health-care provider or an equivalent major course of study as approved by the department; and
(c) Submits proof of having successfully completed a planned program of diabetes self-management training and education experience which makes the applicant eligible for the National Certification Board of Diabetes Educators, or its successor organization; and
(i) Will be practicing only under the direct technical supervision of a licensed diabetes educator;
(ii) Is of good moral character; and
(d) In its discretion, and upon application, the department may renew a provisional license, not to exceed six (6) years, from the date of the issuance of the original provisional license.
SECTION 7. Direct technical supervision. Direct technical supervision shall mean a periodic review, by the licensed diabetes educator on file as the supervisor with the department, of the practice of the provisional licensee. A review shall be conducted no less than once a month, and shall include a written assessment of the practice of the provisional licensee.
SECTION 8. Abandonment. An application shall be deemed abandoned by the department if, after two (2) years from the date of filing, the requirements for licensing have not been completed and submitted to the department.
SECTION 9. Professional practice and identification: practice, titles and abbreviation. It shall be unlawful for any person, corporation or association to, in any manner, represent himself or itself as a diabetes educator, send out billings as providing diabetes education services or use in connection with his or its name, the titles "licensed diabetes educator," "diabetes educator" or "provisional diabetes educator" or use the letters "LDE," "PDE" or any other facsimile thereof when he or she is not licensed in accordance with the provisions of these regulations or meets the exemptions set forth herein. Notwithstanding any other provision of these regulations, a diabetes educator certified by the National Certification Board of Diabetes Educators shall have the right to use the title "Certified Diabetes Educator" and the designation "C.D.E." Certified Diabetes Educator must be licensed pursuant to these regulations to practice diabetes self-management training and education.
SECTION 10. Production and display of license. A person issued a license to practice diabetes self-management training and education by the Mississippi State Department of Health shall carry said license at all times and show said license when requested.
SECTION 11. Renewal of license. (1) General provisions.
(a) The board shall issue licenses which, upon expiration of the initial license, shall be renewed biennially.
(b) The licensure term for regular licenses shall be construed as April 1 of even-numbered years through March 31 of odd-numbered years.
(c) The Department shall issue provisional licenses which, upon expiration of the initial provisional license, shall be renewed annually.
(d) The licensure term for provisional licenses shall be construed as April 1 through March 31.
(2) Renewal of license. The department shall mail notices, at least thirty (30) days prior to the renewal date, to the last-known home address registered with the board, to the persons to whom licenses were issued or renewed during the preceding licensure term. The licensee shall:
(a) Complete the renewal form;
(b) Submit proof of continuing education credit as detailed in these regulations;
(c) Enclose the renewal fee; and
(d) File the above with the department prior to the end of the licensure term, which is the expiration date of the license.
(3) Failure to renew. A licensee who does not file, with the department, the renewal application within the renewal period will be deemed to have allowed his license to lapse. Said licensee may be reinstated by the department, in its discretion, by the payment of the renewal fee and a reinstatement fee, provided said application for reinstatement is made within two (2) years of the end of the licensure term. Any license that has lapsed for a full licensure term must, upon reapplication, meet the requirements for licensure at the time of the application.
(4) Continuing education: Requirements.
(a) Regulations set the requirement for professional continuing education units at thirty (30) clock hours to be accrued during the two-year licensure term.
(b) Licensees registered and in good standing with the National Certification Board of Diabetes Educators may submit proof, in form and content satisfactory to the department, of having met the continuing education requirements of the certified diabetes educator (CDE) credential in lieu of the provisions of this section.
(c) Individuals applying for initial licensure within a licensing term must accrue continuing education hours on a prorated scale. Written notification of required hours will be sent to the applicant at the time of licensure.
(d) Failure to accrue the required hours will automatically result in the revocation of the license.
(5) Sources of continuing education. Continuing education hours may be accrued from the following sources:
(a) Attendance at American Association of Diabetes Educators (AADE) and/or its affiliate state-level coordinating bodies sponsored meetings, the Diabetes Foundation of Mississippi, or American Diabetes Association (ADA) sponsored meetings.
(b) Meetings approved for continuing education credit by the National Certification Board of Diabetes Educators (NCBDE).
(6) Reporting procedures for continuing education: It is the responsibility of the licensee to ensure that the following criteria are met with respect to continuing education credit:
(a) Attendance at seminars, workshops, presentations, etc., approved by the American Association of Diabetes Educators, American Diabetes Association and/or the National Certification Board of Diabetes Educators are automatically accepted for credit unless sessions are duplicated. Verification of attendance may be made by a roster signed by the program chairman, submission of a continuing education certificate, or a continuing education reporting form signed by the program chairman.
(b) Presentation credits will be accrued when cited on the continuing education form.
SECTION 12. Standards of Conduct. (1) Licensees may, at the discretion of the department, have their license suspended, revoked, or denied at the time of renewal if the department determines that the licensee:
(a) Is guilty of fraud, misrepresentation, concealment of material facts, or deceit in procuring or attempting to procure a license or renewal of a license to practice dietetics.
(b) Is unfit or incompetent by reason of negligence, habits, or other causes of incompetency.
(c) Is habitually intemperate in the use of alcoholic beverage.
(d) Is addicted to, or has improperly obtained, possessed, used, or distributed habit-forming drugs or narcotics.
(e) Is guilty of dishonest or unethical conduct.
(f) Is in violation of the Code of Ethics of the American Association of Diabetes Educators or the National Certification Board of Diabetes Educators if a certified diabetes educator.
(g) Has practiced diabetes self-management training/education after his license has expired or has been suspended.
(h) Has practiced diabetes self-management training/education under cover of any permit or license illegally or fraudulently obtained or issued.
(i) Has violated, aided, or abetted others in violation of any provision of these regulations, rules of the department, or the act.
(j) Is convicted of a crime in any court other than a misdemeanor.
(k) Has engaged in any conduct considered by the Department to be detrimental to the profession of dietetics.
(2) Summary suspension. The department may summarily suspend a license without a hearing, simultaneously with the filing of a formal complaint and notice of hearing, if the department determines that:
(a) The health, safety, or welfare of the general public is in immediate danger; or
(b) The licensee's physical capacity to practice his profession is in issue; or
(c) The licensee's mental capacity to practice his profession is in issue.
(3) Complaints. All complaints concerning a licensee shall be reviewed by the department to determine what action, if any, shall be initiated.
(4) Notice of charges and hearing. (a) Following the investigative process, the department may file formal charges against the licensee. Such formal complaint shall, at a minimum, inform the licensee of the facts which are the basis of the charge and which are specific enough to enable the licensee to defend against the charges.
(b) Each licensee, whose conduct is the subject of a formal charge which seeks to impose disciplinary action against the licensee, shall be served notice of the formal charge at least fifteen (15) days before the date of hearing. A hearing shall be presided over by the department or the department's designee. Service shall be considered to have been given if the notice was personally received by the licensee, or the notice was mailed certified, return receipt requested, to the licensee at the licensee's last-known home address as listed with the state agency.
(c) The notice of the formal hearing shall consist at a minimum of the following information:
(i) The time, place, and date of hearing;
(ii) That the licensee shall appear personally at the hearing and may be represented by counsel;
(iii) That the licensee shall have the right to produce witnesses and evidence in the licensee's behalf and shall have the right to cross-examine adverse witnesses and evidence;
(iv) That the hearing could result in disciplinary action being taken against the licensee's license;
(v) That rules for the conduct of these hearings exist and it may be in the licensee's best interest to obtain a copy; and
(vi) That the board, or its designee, shall preside at the hearing and following the conclusion of the hearing shall make findings of facts, conclusions of law and recommendations, separately stated, to the board as to what disciplinary action, if any, should be imposed on the licensee.
(d) The board or its designee shall hear evidence produced in support of the formal charges and contrary evidence produced by the licensee. At the conclusion of the hearing, the board shall issue an order, within sixty (60) days.
(e) Disposition of any complaints may be made by consent order or stipulation between the board and the licensee.
(f) All proceedings pursuant to this section are matters of public record and shall be preserved pursuant to state law.
(5) Board sanctions. The Board may impose any of the following sanctions, singularly or in combination, when it finds that a licensee is guilty of any of the above offenses:
(a) Revocation of the license;
(b) Suspension of the license, for any period of time;
(c) Censure the licensee;
(d) Issue a letter of reprimand to the licensee; or
(e) Place a license on probationary status and require the licensee to submit to any of the following:
(i) Report regularly to the board upon matters which are the basis of probation;
(ii) Continue to renew professional education until a satisfactory degree of skill has been attained in those areas which are the basis of probation;
(iii) Such other reasonable requirements or restrictions as are proper;
(iv) Refuse to renew a license;
(v) Impose a cost assessment; or
(vi) Revoke probation which has been granted and impose any other disciplinary action in this subsection when the requirements of probation have not been fulfilled or have been violated.
(6) Appeal. Any person aggrieved by a decision of the department shall have a right of appeal in the manner provided for in the act and the laws of the State of Mississippi.
SECTION 13. Exceptions and exemptions: Exceptions. No person shall engage in the practice of diabetes education or represent himself to be a diabetes educator unless he is licensed by the department, except as otherwise provided in this section.
(a) A student enrolled in an approved academic program in allied health, if such practice constitutes a part of a supervised course of study, and if the student is designated by a title which clearly indicated his or her status as a student or trainee.
(b) A certified diabetes educator or patient educator who is serving in the Armed Forces or the Public Health Service of the United States or is employed by the Veteran Affairs provided such practice is related to such service or employment.
(c) Any person providing diabetes education services, including, but not limited to, nursing assistants and/or community health workers, working under the direct technical supervision of a licensed diabetes educator, except that such persons may not use the title "diabetes educator."
(d) Persons licensed or registered to practice the health professions when covered under the scope of practice of his or her profession, except that such persons may not use the title "diabetes educator."
(e) Persons who perform the activities and services of a diabetes educator in the employ of a federal, state, county or municipal agency, or another political subdivision, or a chartered elementary or secondary school or accredited degree-granting educational institution insofar as such activities and services are part of a salaried position except that such persons may not use the title "diabetes educator".
(f) Federal, state, county or local employees involved with programs providing the services of diabetes educator that help to prevent disease and maintain good health, including, but not limited to, the Cooperative Extension Service, the Child Nutrition Program, and Project Head Start, except that such persons may not use the title "diabetes educator."
(g) Individuals who do not hold themselves out to be diabetes educators from marketing or from engaging in the explanation and education of customers regarding the use of such products, except that such persons may not use the title "diabetes educator."
(h) Any person from furnishing general diabetes education, nor prevent in any way the free dissemination of literature; provided, however, no such individual may call themselves a diabetes educator unless they are licensed under this chapter by the department pursuant to these regulations.
(i) A nonresident diabetes educator may practice diabetes self-management education/training in Mississippi for five (5) days with another state's licensure or with certification of the National Certification Board of Diabetes Educators.
SECTION 14. Criminal offenses and punishment: Offenses. Any person who violates any provision of the act, or these regulations promulgated thereto shall, upon conviction thereof, be guilty of a misdemeanor. Such misdemeanor shall, upon conviction, be punishable by a fine of not more than One Thousand Dollars ($1,000.00) or by imprisonment for not more than six (6) months or by both fine and imprisonment for each offense.
SECTION 15. Fees: Method of payment. In accordance with the enabling statute, the following fees, where applicable, are payable to the State Board of Health by certified check, cashiers check, or money order. Fees paid are nonrefundable. Schedule of Fees:
(a) Initial Licensure Fee.......................... $75.00
(b) Renewal Fee.................................... $75.00
(c) Provisional License Fee........................ $50.00
(d) Provisional License Renewal Fee................ $50.00
(d) Replacement Fee................................ $50.00
(e) License Verification Fee....................... $25.00
(f) Examination Fee. Fees for examination are to be paid directly to the appropriate testing organization.
SECTION 16. Administrative grievance procedure. (1) Administrative appeals. All persons aggrieved by a decision regarding the initial application for licensure or the renewal of licensure shall have the right of administrative appeal and a hearing to be conducted according to the policy of the Department of Health.
(2) Notification. Written notice will be provided to all applicants regarding denial of an original license or a renewal license. Such notice shall contain the reason thereof and shall offer the applicant an opportunity to submit additional information pertinent to their application for a second review by the department.
(3) Hearing. (a) If requested in writing within the specified time frame a hearing will be provided in which the applicant may show cause why the license should be granted or renewed.
(b) Within sixty (60) days of the hearing, or other such time frame as determined during the hearing, written findings of fact, together with a recommendation for action on the license in question, shall be forwarded to the State Health Officer. The State Health Officer shall decide what action will be taken on the recommendation within five (5) days of its receipt. Written notice shall be provided to the applicant.
SECTION 17. This act shall take effect and be in force from and after July 1, 2019.
