STAND. COM. REP. NO. 488

                                 Honolulu, Hawaii
                                                   , 1999

                                 RE: H.B. No. 749
                                     H.D. 2




Honorable Calvin K.Y. Say
Speaker, House of Representatives
Twentieth State Legislature
Regular Session of 1999
State of Hawaii

Sir:

     Your Committee on Consumer Protection and Commerce, to which
was referred H.B. No. 749, H.D. 1, entitled: 

     "A BILL FOR AN ACT RELATING TO DIETITIANS,"

begs leave to report as follows:

     The purpose of this bill is to establish a licensure program
for dietitians that restricts the use of the title "licensed
dietitian" to those persons meeting specified educational and
other requirements.

     More than 70 persons and organizations submitted testimony
supporting this measure, approximately one-third of which were
registered dietitians, with the remainder being physicians,
pharmacists, health care administrators, and private citizens.
Testimony opposing this bill was received from three private
citizens and the Vocational Licensing Division of the Department
of Commerce and Consumer Affairs (DCCA).

     From the testimony submitted, your Committee gathers that
there is a need to provide the public assistance in identifying
those who are qualified to provide reliable and accurate
nutrition information.  There was testimony from physicians and
other health care professionals that nutrition plays a critical
role in the prevention and treatment of the most prevalent
chronic illnesses and diseases in Hawaii, including obesity,
hypertension, diabetes, and cardiac and renal diseases, and that
misinformation about nutrition may result in physical harm.  In
addition, the amount of misinformation available in the community

 
 
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has increased with the growing awareness of the importance of
diet in maintaining health.  Testifiers stated that persons who
are particularly vulnerable to misinformation are the elderly,
the chronically ill with conditions causing pain and suffering,
and persons discharged from hospitals under early release
policies, with intravenous and other life-saving devices.  There
was testimony that to date, more than 40 documented cases of harm
related to unsound dietetic practice have occurred in Hawaii.
Testifiers stated that anyone can purport to be a dietitian in
Hawaii, and that credentials used by persons practicing in the
field may include up to 13 different credentials such as, "CNC"
and "NMD," some of which are granted by unaccredited sources.

     DCCA objected to the licensing terminology used by the bill,
stating that requirements for licensure under this bill were
identical to those for registered dietitians, and therefore, that
certification would be the more appropriate term.  DCCA testified
that under a regulatory scheme recognized by the national Council
on Licensure, Enforcement and Regulation, the Legislative
Auditor, and DCCA, minimum standards for licensure should
generally exceed those of a private credentialing agency, and:

     (1)  Licensing is a process by which a government agency
          grants individuals permission to engage in a specified
          profession; and

     (2)  Certification is a form of regulation that grants legal
          use of a designated title to individuals who have met
          predetermined qualifications, where noncertified
          individuals may still offer similar services to the
          public but may describe themselves as being certified.

DCCA suggested that the term "licensed" be changed to
"certified."

     Your Committee believes that it would be beneficial to move
this measure along to allow further discussion, and requests the
Committee on Finance to examine the issue of certification versus
licensure.  Your Committee has amended this bill to delete its
exemption provisions, which, contrary to the title protection
intended under this bill, imply that licensure is required to
practice dietetics.  In addition, technical, nonsubstantive
amendments have been made for purposes of clarity, consistency,
and style.


 
 
 
 
                                 STAND. COM. REP. NO. 488
                                 Page 3

 
     As affirmed by the record of votes of the members of your
Committee on Consumer Protection and Commerce that is attached to
this report, your Committee is in accord with the intent and
purpose of H.B. No. 749, H.D. 1, as amended herein, and
recommends that it be referred to the Committee on Finance in the
form attached hereto as H.B. No. 749, H.D. 2.

                                   Respectfully submitted on
                                   behalf of the members of the
                                   Committee on Consumer
                                   Protection and Commerce,



                                   ______________________________
                                   RON MENOR, Chair