Current through Register Vol. 51, No. 3, September 1, 2024
RELATES TO:
KRS
310.070,
310.200
NECESSITY, FUNCTION AND CONFORMITY:
KRS
310.200 requires the Board of Licen-sure and
Certification for Dietitians and Nutritionists to adopt administrative
regulations to further the objectives stated therein. This administrative
regulation establishes procedures necessary to prevent abuse and fraud through
the use of telehealth, prevent fee-splitting through the use of telehealth, and
utilize telehealth in the provision of dietitian and nutrition services, and in
the provision of continuing education.
Section
1. Definitions.
(1) "Client"
means the person receiving the services of the dietitian or
nutritionist.
(2) "Educator" means
a presenter speaking to a group of individuals on a topic generally without a
focus on the specific needs of any particular individual.
(3) "Licensed healthcare professional" means
a medical doctor, registered nurse, practical nurse, nurse practitioner,
advanced practice registered nurse, physician's assistant, chiropractor,
certified diabetes educator, pharmacist, speech-language pathologist,
registered dietitian, certified nutritionist, podiatrist, audiologist, or
psychologist licensed in the jurisdiction where he or she is physically
located.
(4) "Practitioner" means a
licensed dietitian or certified nutritionist.
(5) "Telehealth" is defined by
KRS
310.200(3).
(6) "Telepractice" means the practice of
dietetics or nutrition as defined by
KRS
310.005(2) and provided by
using communication technology that is two (2) way, interactive, simultaneous
audio and video.
Section
2. Client Requirements. A licensed health care professional may
represent the practitioner at the initial meeting. A practitioner who uses
telehealth to deliver dietetics or nutrition services shall, at the initial
meeting with the client:
(1) Make attempts to
verify the identity of the client;
(2) Obtain alternative means of contacting
the client other than electronically such as by the use of a telephone number
or mailing address;
(3) Provide to
the client alternative means of contacting the licensee other than
electronically such as by the use of a telephone number or mailing
address;
(4) Provide contact
methods of alternative communication the practitioner shall use for emergency
purposes such as an emergency on call telephone number;
(5) Document if the client has the necessary
knowledge and skills to benefit from the type of telepractice provided by the
licensee; and
(6) Inform the client
in writing and document acknowledgement of the risk and limitations of:
(a) The use of technology in the provision of
telepractice;
(b) The potential
breach of confidentiality of information, or inadvertent access of protected
health information, due to technology in the provision of
telepractice;
(c) The potential
disruption of technology in the use of telepractice;
(d) When and how the practitioner will
respond to routine electronic messages;
(e) In what circumstances the practitioner
will use alternative communications for emergency purposes;
(f) Who else may have access to client
communications with the practitioner;
(g) How communications shall be directed to a
specific licensee;
(h) How the
practitioner stores electronic communications from the client; and
(i) That the practitioner may elect to
discontinue the provision of services through telehealth.
Section 3. Competence, Limits on
Practice, Maintenance, and Retention of Records. A practitioner using
telehealth to deliver services or who telepractices shall:
(1) Limit the telepractice to the area of
competence in which proficiency has been gained through education, training,
and experience;
(2) Maintain
current competency in telepractice through continuing education, consultation,
or other procedures, in conformance with current standards of scientific and
professional knowledge;
(3)
Document the client's presenting problem, purpose, or diagnosis, and include
which services were provided by telepractice;
(4) Use secure communications with each
client, including encrypted text messages, via email or secure Web sites, and
not use personal identifying information in non-secure communications;
and
(5) Ensure that confidential
communications obtained and stored electronically shall not be recovered and
accessed by unauthorized persons when the licensee disposes of electronic
equipment and data.
Section
4. Compliance with Federal, State, and Local Law.
(1) A practitioner using tele-health to
deliver dietetics or nutrition services shall comply with Section 508 of the
Rehabilitation Act,
29 U.S.C.
794(d), to make technology
accessible to a client with a disability.
(2) A person providing dietetic or nutrition
services for which an exception to licensure does not apply or who represents
himself or herself as a dietitian, licensed dietitian, or certified
nutritionist pursuant to
KRS
310.070 shall be licensed by the board if:
(a) Services are offered via telehealth;
and
(b) These services are provided
or the representation is made to a person when he or she is physically located
in Kentucky.
(3) A
person providing dietetic or nutrition services for which an exception to
licensure does not apply or who represents himself or herself as a dietitian,
licensed dietitian, or certified nutritionist pursuant to
KRS
310.070 shall be licensed by the board if:
(a) Services are offered via telehealth;
and
(b) These services are provided
or the representation is made from a physical location in Kentucky. This person
may be subject to licensure requirements in other states where the services are
received by the client.
(4) No provision of this administrative
regulation shall restrict the ability of educators to present on topics related
to dietetics and nutrition pursuant to
KRS
310.070(2)(d).
Section 5. Representation of
Services and Code of Conduct. A licensee using telehealth to deliver services
or who telepractices shall not:
(1) Engage in
false, misleading, or deceptive advertising of telepractice; or
(2) Split fees.
STATUTORY AUTHORITY:
KRS
310.200(1),
(2)
