DIETITIANS

chapter 81	licensure of dietitians	
chapter 82	continuing education for dietitians	
chapter 83	discipline for dietitians	
CHAPTER 81
LICENSURE OF DIETITIANS
[Prior to 6/26/02, see 645—Ch 80]
645—81.1(152A) Definitions. For purposes of these rules, the following definitions shall apply:
“Active license” means a license that is current and has not expired.
“Board” means the board of dietetics.
“Consultation” means the practice of providing professional advice to another dietitian or other professional in a particular case and for a limited time, in affiliation with, and at the request of, a dietitian licensed in this state.
“Dietetics” means the integration and application of principles derived from the sciences of nutrition, biochemistry, physiology, food management and from behavioral and social sciences to achieve and maintain an individual’s health.
“Grace period” means the 30-day period following expiration of a license when the license is still considered to be active. In order to renew a license during the grace period, a licensee is required to pay a late fee.
“Inactive license” means a license that has expired because it was not renewed by the end of the grace period. The category of “inactive license” may include licenses formerly known as lapsed, inactive, delinquent, closed, or retired.
“Licensee” means any person licensed to practice as a dietitian in the state of Iowa.
“License expiration date” means the fifteenth day of the birth month every two years following initial licensure.
“Licensure by endorsement” means the issuance of an Iowa license to practice dietetics to an applicant who is currently licensed in another state.
“Nutrition assessment” means the evaluation of the nutrition needs of individuals and groups based upon appropriate biochemical, anthropometric, physical, and dietary data to determine nutrient needs and to recommend appropriate nutritional intake, including enteral and parenteral nutrition.
“Nutrition counseling” means advising and assisting individuals or groups, with consideration of cultural background and socioeconomic status, about appropriate nutritional intake by integrating information from the nutrition assessment with information about food and other sources of nutrients and meal preparation.
“Reactivate” or “reactivation” means the process as outlined in rule 645—81.15(17A,147,272C) by which an inactive license is restored to active status.
“Reciprocal license” means the issuance of an Iowa license to practice dietetics to an applicant who is currently licensed in another state which has a mutual agreement with the Iowa board of dietetics to license persons who have the same or similar qualifications as those required in Iowa.
“Registered dietitian” means a dietitian who has met the standards and qualifications of the Commission on Dietetic Registration, a member of the National Commission for Health Certifying Agencies.
“Reinstatement” means the process as outlined in 645—11.31(272C) by which a licensee who has had a license suspended or revoked or who has voluntarily surrendered a license may apply to have the license reinstated, with or without conditions. Once the license is reinstated, the licensee may apply for active status.
“Supervision of nonlicensees” means any of the following: delegation of duties, direct oversight, or indirect oversight of employees or other persons not licensed by the board.
[ARC 9606B, IAB 7/13/11, effective 8/17/11]
645—81.2(152A) Nutrition care. The primary function of dietetic practice is the provision of nutrition care services that shall include:
	1.	Assessing the nutrition needs of individuals and groups and determining resources and constraints in the practice setting.
	2.	Establishing priorities, goals, and objectives that meet nutrition needs and are consistent with available resources and constraints.
	3.	Providing nutrition counseling concerning health and disease.
	4.	Developing, implementing, and managing nutrition care systems.
	5.	Evaluating, making changes in, and maintaining appropriate standards of quality in food and nutrition services.
645—81.3  Reserved.
645—81.4(152A) Requirements for licensure. The following criteria shall apply to licensure:
	81.4(1) The applicant shall complete the application online at ibplicense.iowa.gov.
	81.4(2) The applicant shall complete the application according to the instructions contained in the application. If the application is not completed according to the instructions, the application will not be reviewed.
	81.4(3) Each application shall be accompanied by the appropriate fees. The fees are nonrefundable.
	81.4(4) No application will be considered by the board until the applicant satisfactorily completes the registration examination for dietitians administered by the Commission on Dietetic Registration (CDR). The board will accept the passing score set by the CDR. Verification of satisfactory completion may be established by one of the following:
	a. 	The applicant sends to the board a copy of the CDR registration card;
	b. 	The CDR sends an official letter directly to the board to verify that the applicant holds registration status; or
	c. 	The CDR posts web-based verification that the applicant holds registration status.
	81.4(5) A license is not required for dietitians who are in this state for the purpose of consultation, in accordance with rule 645—81.1(152A), when they are licensed in another state, U.S. territory, or country, or have received at least a baccalaureate degree in human nutrition from a U.S. regionally accredited college or university.
	81.4(6) Incomplete applications that have been on file in the board office for more than two years shall be considered invalid and shall be destroyed.
[ARC 9606B, IAB 7/13/11, effective 8/17/11; ARC 5405C, IAB 1/27/21, effective 3/3/21]
645—81.5(152A) Educational qualifications.
	81.5(1) The applicant shall possess a baccalaureate degree or postbaccalaureate degree from a U.S. regionally accredited college or university with a major course of study in human nutrition, food and nutrition, nutrition education, dietetics, or food systems management, or in an equivalent major course of study, which meets minimum academic requirements as established by the Accreditation Council for Education in Nutrition and Dietetics (ACEND) of the Academy of Nutrition and Dietetics (AND) and is approved by the board.
	81.5(2) A foreign-trained dietitian shall:
	a. 	Provide an official letter sent directly from the Commission on Dietetic Registration (CDR) to the board to verify that the applicant has met the minimum academic and didactic program requirements of the CDR. Foreign degree equivalency evaluation requirements of the Accreditation Council for Education in Nutrition and Dietetics (ACEND) of the Academy of Nutrition and Dietetics (AND) are listed on the ACEND website at: www.eatrightpro.org/acend/students-and-advancing-education/information-for-students/foreign-degree-evaluation-agencies; and
	b. 	Provide evidence of meeting all other requirements in these rules.
[ARC 9606B, IAB 7/13/11, effective 8/17/11; ARC 1835C, IAB 1/21/15, effective 2/25/15; ARC 5405C, IAB 1/27/21, effective 3/3/21]
645—81.6(152A) Supervised experience. The applicant shall complete an accredited competency-based supervised experience program approved by the Accreditation Council for Education in Nutrition and Dietetics (ACEND) of the Academy of Nutrition and Dietetics (AND).
[ARC 9606B, IAB 7/13/11, effective 8/17/11; ARC 1835C, IAB 1/21/15, effective 2/25/15]
645—81.7(152A) Licensure by endorsement. An applicant who has been a licensed dietitian under the laws of another jurisdiction shall file an application for licensure by endorsement with the board office. The board may receive by endorsement any applicant from the District of Columbia or another state, territory, province or foreign country who:
	1.	Submits to the board a completed application;
	2.	Pays the licensure fee;
	3.	Shows evidence of licensure requirements that are similar to those required in Iowa;
	4.	Provides a copy of the Commission on Dietetic Registration (CDR) registration card or an alternate form of verification of passing the registration examination, as stated in 81.4(4)“a”; and
	5.	Provides verification of license(s) from every jurisdiction in which the applicant has been licensed, sent directly from the jurisdiction(s) to the board office. Web-based verification may be substituted for verification direct from the jurisdiction’s board office if the verification provides:
	●	Licensee’s name;
	●	Date of initial licensure;
	●	Current licensure status; and
	●	Any disciplinary action taken against the license.
[ARC 9606B, IAB 7/13/11, effective 8/17/11; ARC 5405C, IAB 1/27/21, effective 3/3/21]
645—81.8  Reserved.
645—81.9(152A) License renewal.
	81.9(1) The biennial license renewal period for a license to practice dietetics shall begin on the sixteenth day of the licensee’s birth month and end on the fifteenth day of the licensee’s birth month two years later. The licensee is responsible for renewing the license prior to its expiration. Failure of the licensee to receive notice from the board does not relieve the licensee of the responsibility for renewing the license.
	81.9(2) An initial license issued by the board may be valid for an 18- to 29-month period. When an initial license is renewed, it will be placed on a two-year renewal period identified in subrule 81.9(1).
	81.9(3) A licensee seeking renewal shall:
	a. 	Meet the continuing education requirements of rule 645—82.2(152A) and the mandatory reporting requirements of subrule 81.9(4). A licensee whose license was reactivated during the current renewal compliance period may use continuing education credit earned during the compliance period for the first renewal following reactivation; and
	b. 	Submit the completed renewal application and renewal fee before the license expiration date.
	81.9(4) Mandatory reporter training requirements.
	a. 	A licensee who, in the scope of professional practice or in the licensee’s employment responsibilities, examines, attends, counsels or treats children in Iowa shall indicate on the renewal application completion of training in child abuse identification and reporting as required by Iowa Code section 232.69(3)“b” in the previous three years or condition(s) for waiver of this requirement as identified in paragraph 81.9(4)“e.”
	b. 	A licensee who, in the course of employment, examines, attends, counsels or treats adults in Iowa shall indicate on the renewal application completion of training in dependent adult abuse identification and reporting as required by Iowa Code section 235B.16(5)“b” in the previous three years or condition(s) for waiver of this requirement as identified in paragraph 81.9(4)“e.”
	c. 	The course(s) shall be the curriculum provided by the Iowa department of human services.
	d. 	The licensee shall maintain written documentation for three years after mandatory training as identified in paragraphs 81.9(4)“a” to “c,” including program date(s), content, duration, and proof of participation.
	e. 	The requirement for mandatory training for identifying and reporting child and dependent adult abuse shall be suspended if the board determines that suspension is in the public interest or that a person at the time of license renewal:
	(1)	Is engaged in active duty in the military service of this state or the United States.
	(2)	Holds a current waiver by the board based on evidence of significant hardship in complying with training requirements, including an exemption of continuing education requirements or extension of time in which to fulfill requirements due to a physical or mental disability or illness as identified in rule 645—4.14(272C).
	f. 	The board may select licensees for audit of compliance with the requirements in paragraphs 81.9(4)“a” to “e.”
	81.9(5) Upon receiving the information required by this rule and the required fee, board staff shall administratively issue a two-year license. In the event the board receives adverse information on the renewal application, the board shall issue the renewal license but may refer the adverse information for further consideration or disciplinary investigation.
	81.9(6) A person licensed to practice dietetics shall keep the license certificate and wallet card(s) displayed in a conspicuous public place at the primary site of practice.
	81.9(7) Late renewal. The license shall become late when the license has not been renewed by the expiration date on the renewal. The licensee shall be assessed a late fee as specified in 645—subrule 5.6(3). To renew a late license, the licensee shall complete the renewal requirements and submit the late fee within the grace period.
	81.9(8) Inactive license. A licensee who fails to renew the license by the end of the grace period has an inactive license. A licensee whose license is inactive continues to hold the privilege of licensure in Iowa, but may not practice as a dietitian in Iowa until the license is reactivated. A licensee who practices as a dietitian in the state of Iowa with an inactive license may be subject to disciplinary action by the board, injunctive action pursuant to Iowa Code section 147.83, criminal sanctions pursuant to Iowa Code section 147.86, and other available legal remedies.
	81.9(9) Renewal of a reactivated license. A licensee who reactivates the license in accordance with rule 645—81.15(17A,147,272C) will not be required to renew the license until the next renewal two years later if the license is reactivated within six months prior to the license renewal date.
[ARC 9606B, IAB 7/13/11, effective 8/17/11; ARC 5068C, IAB 7/1/20, effective 8/5/20; ARC 5774C, IAB 7/14/21, effective 8/18/21]
645—81.10 to 81.14  Reserved.
645—81.15(17A,147,272C) License reactivation. To apply for reactivation of an inactive license, a licensee shall:
	81.15(1) Submit a reactivation application on a form provided by the board.
	81.15(2) Pay the reactivation fee that is due as specified in 645—subrule 5.6(4).
	81.15(3) Provide verification of current competence to practice dietetics by satisfying one of the following criteria:
	a. 	If the license has been on inactive status for five years or less, an applicant must provide the following:
	(1)	Verification of the license(s) from every jurisdiction in which the applicant is or has been licensed and is or has been practicing during the time period the Iowa license was inactive, sent directly from the jurisdiction(s) to the board office. Web-based verification may be substituted for verification from a jurisdiction’s board office if the verification includes:
	1.	Licensee’s name;
	2.	Date of initial licensure;
	3.	Current licensure status; and
	4.	Any disciplinary action taken against the license.
	(2)	Verification of completion of 30 hours of continuing education within two years of the application for reactivation.
	b. 	If the license has been on inactive status for more than five years, an applicant must provide the following:
	(1)	Verification of the license(s) from every jurisdiction in which the applicant is or has been licensed and is or has been practicing during the time period the Iowa license was inactive, sent directly from the jurisdiction(s) to the board office. Web-based verification may be substituted for verification from a jurisdiction’s board office if the verification includes:
	1.	Licensee’s name;
	2.	Date of initial licensure;
	3.	Current licensure status; and
	4.	Any disciplinary action taken against the license.
	(2)	Verification of completion of 60 hours of continuing education within two years of application for reactivation.
645—81.16(17A,147,272C) License reinstatement. A licensee whose license has been revoked, suspended, or voluntarily surrendered must apply for and receive reinstatement of the license in accordance with 645—11.31(272C) and must apply for and be granted reactivation of the license in accordance with 645—81.15(17A,147,272C) prior to practicing dietetics in this state.
645—81.17(152A,272C) Telehealth visits. A licensee may provide dietetic services to an individual or a group utilizing a telehealth visit if the dietetic services are provided in accordance with all the requirements of this chapter.
	81.17(1) “Telehealth visit” means the provision of dietetic services by a licensee to an individual or a group using technology where the licensee and the individual or group are not at the same physical location for the therapy session.
	81.17(2) A licensee engaged in a telehealth visit shall utilize technology that is secure and HIPAA-compliant and that includes, at a minimum, audio and video equipment that allows two-way real-time interactive communication between the licensee and the individual or group. A licensee may use non-real-time technologies to prepare for a session or to communicate with an individual or a group between sessions.
	81.17(3) A licensee engaged in a telehealth visit shall be held to the same standard of care as a licensee who provides in-person dietetic services. A licensee shall not utilize a telehealth visit if the standard of care for the particular services cannot be met by using technology.
	81.17(4) Any licensee who provides a telehealth visit to an individual or a group located in Iowa shall be licensed in Iowa.
	81.17(5) Prior to the first telehealth visit, a licensee shall obtain informed consent from the individual or group specific to the services that will be provided in a telehealth visit. At a minimum, the informed consent shall specifically inform the individual or group of the following:
	a. 	The risks and limitations of the use of technology to provide dietetics services;
	b. 	The potential for unauthorized access to protected health information; and
	c. 	The potential for disruption of technology during a telehealth visit.
	81.17(6) A licensee shall identify in the clinical record when dietetic services are provided utilizing a telehealth visit.
[ARC 5405C, IAB 1/27/21, effective 3/3/21]
These rules are intended to implement Iowa Code chapters 17A, 147, 152A and 272C.
[Filed emergency 4/4/86—published 4/23/86, effective 4/4/86]
[Filed 2/17/87, Notice 10/8/86—published 3/11/87, effective 4/15/87]
[Filed 4/29/88, Notice 3/23/88—published 5/18/88, effective 6/22/88]
[Filed 10/27/88, Notice 8/24/88—published 11/16/88, effective 12/21/88]
[Filed 9/29/89, Notice 7/26/89—published 10/18/89, effective 11/22/89]
[Filed 5/11/90, Notice 4/4/90—published 5/30/90, effective 7/4/90]
[Filed 10/11/91, Notice 8/21/91—published 10/30/91, effective 12/4/91]
[Filed 4/23/92, Notice 3/4/92—published 5/13/92, effective 6/17/92]
[Filed emergency 7/6/92—published 7/22/92, effective 7/6/92]
[Filed 4/7/95, Notice 1/4/95—published 4/26/95, effective 5/31/95]
[Filed 11/25/98, Notice 10/21/98—published 12/16/98, effective 1/20/99]
[Filed 6/11/99, Notice 4/7/99—published 6/30/99, effective 8/4/99]
[Filed 12/23/99, Notice 10/6/99—published 1/12/00, effective 2/16/00]
[Filed 10/13/00, Notice 8/23/00—published 11/1/00, effective 12/6/00]
[Filed 8/30/01, Notice 5/30/01—published 9/19/01, effective 10/24/01]
[Filed 6/7/02, Notice 4/3/02—published 6/26/02, effective 7/31/02]
[Filed 6/19/03, Notice 4/2/03—published 7/9/03, effective 8/13/03]
[Filed 6/17/04, Notice 3/31/04—published 7/7/04, effective 8/11/04]
[Filed 6/15/05, Notice 3/30/05—published 7/6/05, effective 8/10/05]
[Filed 12/2/05, Notice 10/12/05—published 1/4/06, effective 2/8/06]
[Filed 12/11/08, Notice 7/30/08—published 1/14/09, effective 2/18/09]
[Filed ARC 9606B (Notice ARC 9426B, IAB 3/9/11), IAB 7/13/11, effective 8/17/11]
[Filed ARC 1835C (Notice ARC 1728C, IAB 11/12/14), IAB 1/21/15, effective 2/25/15]
[Filed ARC 5068C (Notice ARC 4935C, IAB 2/26/20), IAB 7/1/20, effective 8/5/20]
[Filed ARC 5405C (Notice ARC 5156C, IAB 8/26/20), IAB 1/27/21, effective 3/3/21]
[Filed ARC 5774C (Notice ARC 5452C, IAB 2/24/21), IAB 7/14/21, effective 8/18/21]