Legislative audit says the dietitian board is dead weight
CHARLESTON — A regulatory board review by the Legislative Auditor’s Office recommended that West Virginia government shed some pounds by eliminating the board that licenses dietitians in the state.
The Joint Standing Committee on Government Organization and the Joint Committee on Government Operations received a report during its Monday meeting from the West Virginia Legislative Auditor’s Performance Evaluation and Research Division.
State code requires reviews of all state regulatory boards at least once every 12 years, with the West Virginia Board of Licensed Diatitians up for review this year.
According to the review, the Legislative Auditor’s Office recommended eliminating the Board of Licensed Dietitians, calling the board duplicative. Auditors said the Board of Licensed Dietitians mirrors what the National Commission on Dietetic Registration already does.
“… The Board fully duplicates the Commission on Dietetic Registration (CDR), which is a national regulatory organization over dietitians,” the report stated. “The Legislative Auditor finds that the Board primarily verifies that West Virginia dietitians are in compliance with the CDR and issues or renews a state credential. The Legislative Auditor concludes that the CDR offers adequate protection to the citizens of the state …”
Auditors concluded that the Legislature could simply codify title protection for licensed dietitians and nutritionists by statute, requiring that dietitians be licensed through the National Commission on Dietetic Registration.
If the Legislature chooses not to eliminate the Board of Licensed Dietitians, auditors recommend the Legislature consider defining more specific practices in defining the scope of proactive for the board, requiring the board to maintain a database of dietitians and nutritionists in the state, ensure it handles complaints, and improve its website.
This isn’t the first time auditors have recommended eliminating the Board of Licensed Dietitians, first created in 1997. The Legislative Auditor’s Office recommended eliminating the board in 1999 and 2000. The Legislature followed the advice of auditors in 2001 but brought the board back during a special session in 2002. Auditors once again called for the board’s elimination in 2010.
“The primary finding of the 1999 review was the Board provided no demonstrable net benefit to West Virginia’s public,” auditors wrote in the report released Monday. “In each review, the Legislative Auditor recommended the termination of the Board, consolidation of the Board, or use of a lesser form of regulation.
“The Legislative Auditor sees no reason to change the previous recommendations,” the report continued. “There is no compelling public need for a board that mirrors the national credential by simply verifying a person’s compliance with the CDR, and provides title protection. The risk of harm is relatively low, the CDR has a complaint process, other safeguards exist that would protect the public in the absence of the Board, and title protection can be established statutorily.”
In a written response to the Legislative Audit report, the board said it believes strongly that a state-level agency is needed to monitor dietitians and nutritionists. The board said its elimination would “wreak immediate havoc” on healthcare policy in West Virginia.
“Registered dietitian nutritionists practicing in West Virginia are ‘health care practitioners’ under West Virginia law and by virtue of being included in that term, RDNs are immediately integrated into the West Virginia health care regulatory and payment structure in hundreds of ways,” the board wrote.
“Eliminating dietetics licensure would not only wreak immediate havoc on hospital interdisciplinary teams, state facility regulations, health insurance plans and reimbursement policies, the provision of services via telehealth, and a multitude of other aspects of the health care system, it would also drastically limit the duties RDNs can undertake and the care they can provide as previously authorized services now become illegal for them to provide,” the board continued.
“It should be noted that elimination of licensure would not ‘wreak immediate havoc’ on any aspect of healthcare,” the auditors wrote in response to the board. “Eliminating the Board would not affect the RD scope of practice once the Legislature codifies title protection and certification by the Commission on Dietetic Registration as the required credential.
“There is simply no need for a board to enforce title protection and act as a rubber stamp for the CDR credential,” the auditors continued. “A registered dietitian would remain a health care practitioner with a scope of practice as currently codified in West Virginia Code. In addition, as previously noted, elimination of licensure would not prevent reimbursement from insurance.”