In North Carolina, we have been fortunate to be at the forefront in delivering safe, accurate, cost effective nutrition care because we have had Licensure laws in place that safeguard who can deliver MEDICAL NUTRITION THERAPY. The North Carolina Board of Dietetics governs licensure and we have always been self funded. Right now, there are opponents asking our House of Representatives to pass HOUSE BILL 676 which will cause EVERYONE in North Carolina to lose any and all insurance benefits for nutrition services. This has gone to committee, here is the bill and you can see the sponsors of this bill Here is my letter to our Representatives:
My name is Tracy Owens and I am a registered, licensed dietitian. I am writing to urge you to please oppose House Bill 676 which seeks to eliminate Licensure of dietitians in North Carolina. There are numerous and compelling reasons to oppose this action.
First, our board is self funding, we do not cost the state of North Carolina one penny, nor do we have any sponsors.
Secondly, our licensure does not prohibit ANYONE from speaking, writing, coaching, etc on foods and nutrition, it only restricts who can provide MEDICAL NUTRITION THERAPY.
Thirdly, Licensure in fact protects the public by establishing a baseline of education for who can provide nutrition counseling for cancer, kidney disease, diabetes, high blood pressure, calculating tube feedings for critically ill patients in ICU, calculating tube feedings for babies in the neonatal intensive care units and much more.
Do bloggers know how many carbohydrates a patient with a hypoglycemic reaction should consume to raise their blood sugar? Can they teach a person how many units of insulin to take for x amount of carbohydrates? Does a person with a weekend degree in nutrition know how many grams of protein a kidney patient needs who is in end stage renal disease–and keep in mind, it depends on whether or not they are in dialysis. In addition, this patient with kidney disease must also know how many milligrams of potassium and sodium and fluid to consume. I provide care for numerous patients with gestational diabetes, and according to the American Diabetes Association nutrition care is a standard of care. Do the people who oppose our licensure know how to teach a patient how to check their blood sugar and what level the fasting blood sugar should be? Do they know where their blood sugar should be 2 hours after each meal? Do they know how many grams of carbohydrates to prescribe to this pregnant patient and how to translate that into food examples? As just one example, with medical nutrition therapy for gestational diabetes, we are trying to prevent the complications of high blood sugars, which are numerous, one being a large baby that now requires a C-section on the part of the mother which is now more dangerous, and I think we could agree that this is less cost effective .
If our opponents are nearby, I would encourage that you engage them and find out if they in fact know these answers and can readily provide them, because you are now looking at who you want to provide this care. If you pass this bill you strip us away from being able to do this because we will no longer be covered by insurance.
Licensed dietitians are now considered ancillary care providers with many insurance companies. We are recognized by insurance companies as medical professionals with a minimum of a Baccalaureate degree in accredited program, we have completed at least 900 hours of approved clinical practice and passed an examination that assures our qualifications.
Lastly, if this bill passes, the NC Legislature will have delivered a one-two punch to every single citizen of North Carolina. By eliminating this standard of care for medical nutrition therapy, everyone is now at huge risk for not only getting grossly incorrect information, but our services will no longer be covered at all by insurance companies. While 44 other states and the District of Columbia and Puerto Rico have statutory provisions for the professional regulation of dietitians/nutritionisits, NC is ready to take a giant leap backwards.
When looking at the cost/benefit…how does this benefit our state, our budget, the health and safety of our citizens? Please oppose House Bill 676.
Tracy Owens, MPH, RD, CSSD, LDN