Inside This Issue:

SUZANNE PEVEY RETIRES

I am pleased to have the opportunity to write this article to say farewell to the many professionals that I have interacted with over the years. I retired on June 30, 2004, and want to introduce you to my successor, Mr. Richard N. Burtt. Richard was employed as an attorney with the Office of Group Benefits and brings a wealth of knowledge and experience to the board office. I hope that you will show him the same support and courtesy that you have shown me over the past years!

In 1988 during the implementation of the Dietetic/Nutrition Practice Act, I was hired by Irene Gardemal, Mary Tonore, and Beth Reames to help them draft and promulgate the Board’s first Rules, Standards and Procedures. Following that task, I was offered the position of Administrator and accepted that position in October 1988. As many of you know, I was already the Administrator for the Louisiana Boards for Social Work and Speech-Language Pathology and Audiology and the addition of one more professional group was quite a challenge to both me and my staff. After working 20 years for the other Boards it was fun to take on a new profession and to help organize their office and the regulation of Dietetics and Nutrition in Louisiana. I have been fortunate to have board members (former and current) who have supported my office by appropriating the necessary funds for state of the art computers, equipment and staff development. It has been an honor to work with the professionals who have served on the Louisiana Board of Examiners in Dietetics and Nutrition.

In the beginning . . . .

It is said that for every door that closes, another one is opened.  In this case two doors are closing, and two others are opening. For Suzanne Pevey, her door as Administrator of this Board is closing. The door that she opened every morning for over 30 years with grace, dignity and energy will be locked by her at the end of the day for the last time in the near future. As she does so, she will open a new door to retirement, travel and well-deserved relaxation. In the little time that we have shared together, I am indebted to Ms. Pevey for sharing her knowledge, staff and good humor with me. She will be missed. It is with sad eyes that I watch this door close on her, but have a different view altogether of the door that is opening for me.

By way of introduction, my name is Richard Burtt, and I have been selected to become the Administrator to succeed Ms. Pevey. I, too, am closing a door. My education and experience includes a B.S. degree from LSU in Business and Public Administration with course work in Management, Economics, Accounting and Government. After this, I worked for 5 years as a Personnel Technician for the State of Louisiana. Finally, I persuaded my wife to continue working so that I might attend the LSU Law School. After three long years, I left law school with my Juris Doctorate degree, and became licensed to practice law in the State of Louisiana. My wife was awarded her PHT (Putting Hubby Through). She was delighted to have me back among the working. By this time, we had two children who were equally thrilled to get Daddy out of the house.

I became a trial attorney for the State Department of Transportation and Development trying cases all across the state. After approximately 5 years, I left DOTD to become General Counsel to the State Office of Group Benefits. This was a position that I held for a little over twenty years. In this capacity, I gained experience with the Open Meeting law, Administrative Procedures Act, administrative adjudications, additional trial work, budget responsibilities, supervisory responsibilities, civil service regulations, rule-making regulations and much more.

I look forward to the new opportunities offered by this position, and to meeting each of you. If you have time when passing through Baton Rouge, be sure to stop by the office and introduce yourself. The staff and I hope to continue to offer the same friendly and courteous treatment to which you have become accustomed.

ALBERT BARROCAS RE-APPOINTED TO BOARD

Albert Barrocas, M.D., F.A.C.S, F.A.C.N., is in the private practice of general, thoracic and vascular surgery in New Orleans, where he is also Clinical Professor at Tulane and LSU Schools of Medicine and the Tulane School of Public Health and Tropical Medicine. He is the Chief Medical Officer of Methodist Hospital where he also serves as the Medical Director of the Nutrition Support Team and the Chair of the Nutrition Institute of Louisiana.

Dr. Barrocas has been the only physician member of the Louisiana Board of Examiners in Dietetics and Nutrition since its inception in 1988. He is a Charter member of the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.), having served on its Board of Directors. He is past president of the American Society of Nutrition Support Services. In 1993, after nomination by the New Orleans and Louisiana Dietetic Associations, he was selected as Honorary Member of the American Dietetic Association (ADA) and subsequently served two terms as a Public Member at large on the ADA Board of Directors. He is a member of the Speakers Bureau of the ADA’s Ethics Committee.

Dr. Barrocas serves on the Advisory Board of the American Council for Fitness and Nutrition (ACFN). He serves as A.S.P.E.N.’s Latin American Ambassador. He was a member of the Technical Advisory Committee of the Nutrition Screening Initiative during its 13 years of existence. He is on the editorial Board of Nutrition in Clinical Practice Journal and is a reviewer of the journal, Nutrition. He has over 300 publications and presentations to his credit.

NEWLY APPOINTED BOARD MEMBERS

Peggy Bourgeois, APRN, MN, CNS, CDE was appointed to the Louisiana Board of Dietetics and Nutrition as the Licensed Registered Nurse member of the board. She has held the position of Board Chairperson since August, 2004. Peggy was also recently inducted into the Louisiana State Nurses Association Foundation Nightingale Hall of Fame. She is a graduate of Northwestern State University and Louisiana State University graduate nursing program. Peggy was Director of the Diabetes Center Baton Rouge General Medical Center for twenty-three years. Following “retirement” she started her own consulting business and is educating nurses and other professionals to improve the care of patients with diabetes.

Peggy has volunteered in professional organizations such as the American Diabetes Association (ADA) and American Association of Diabetes Educators (AADE) to influence change in patient care. Accomplishments include:

Ms. Sherry Brokenberry was appointed to the Louisiana Board of Examiners in Dietetics and Nutrition in 2004.

She received a Bachelor of Science degree in Food and Nutrition from Southern University. She graduated from the University of Michigan with a Master of Public Health degree. She did her internship at Barnes Hospital in St. Louis, Missouri.

She worked as a Staff Dietitian at the Harry S. Truman V.A. Hospital in Columbia, Missouri and as a Nutrition Clinic Dietitian at the Allen Park V.A. Hospital in Allen Park, Michigan. More recently she has worked for the Louisiana Department of Education and works as the Foodservice Supervisor for DeSoto Parish School Board in Mansfield, Louisiana, where she monitors programs to ensure guideline compliance.

CDR Professional Portfolio and Licensure Continuing Education

by Elizabeth L. Guinn, LDN, RD

The Board has established a minimum of 15 continuing education hours per licensing year for all Licensed Dietitian/ Nutritionist (LDNs) which must be submitted at the time of license renewal. The licensing year runs from July 1 thru June 30. Many licensees have questions about how the changes with the Commission on Dietetic Registration’s (CDR) Professional Portfolio affect the minimum requirements set forth by the Board for continuing education hours needed to maintain their license. Even though CDR has adopted a new format with the Professional Portfolio, they still require Dietitians to maintain a minimum of 75 educational hours over a 5 year period or 15 hour per year. To meet the annual continuing education requirements, LDNs only need to submit a photo copy of their current identification card issued by CDR. As long as the LDN is in good standing with CDR and has a current identification card, the Board accepts that they have meet the annual continuing education requirements.

The continuing educational requirements for Provisional LDNs is also15 hours per licensing year, however, they must complete Form E when renewing their license annually. The Board had designated categories in which continuing education hours are approved and which Provisional LDNs should use to obtain their continuing education. The approved categories are as follows:

1. American Dietetic Association (ADA) sponsored programs

2. State Dietetic Association ( ie LDA) sponsored programs

3. District Dietetic Association sponsored programs.

4. Other provider programs

5. Self-study programs

6. Academic course work in nutrition related areas

7. Publication in journals

8. Presentations by renewal applicant

9. Exhibits

10. Poster sessions

( See Continuing Education Fact Sheet or Form E for specifics.)

If a Provisional LDN attends any other type of continuing education that is not on the approved list, they must get pre-approval from the Board before they attend the session if they want it count towards their required hours.

Defining Nutritional Assessment, Counseling and Education

Only Licensed Dietitians/Nutritionist are allowed to provide nutritional assessments, client counseling and education right? This is a question that is often debated by LDNs around the state. In the Rules and Regulations of the licensure law the Board has clearly defined the differences between nu tritional assessment, counseling and education and who is allowed by law to provide these services to the public. The Board understands the concern of most LDNs that only a Licensed Dietitian/Nutritionist should provide these services, but when the original law was drafted, several concessions had to be made in order to get politicians to support the passage of Title 37 Chapter 41 of the Louisiana Revised Statues for Dietitians and Nutritionists. Some concessions that were made were providing exemptions to certain professionals such as physicians, dentists, chiropractors, and their office staff, nurses, and pharmacists when it is incidental to their practice but restricting them from using the title Dietitian/Nutritionist. For a complete listing of those who are exempt please refer to Article 3093 of the Practice Act.

Over the years the Board has made several changes to the law but have had to be very careful when revising the law to prevent other professions from attempting to piggyback onto our law or to make revisions to the law that could compromise the integrity of the law placing the public at risk by allowing unqualified persons to provide nutritional assessment, counseling and education. Several years ago the Board took a proactive approach to this potential problem by clearly defining the differences between nutritional assessment, counseling and education. These are defined as follows:

Nutritional Assessment- means the evaluation of the nutritional needs of individuals and groups based upon appropriate biochemical, anthropometrics, physical and dietary data to determine nutrient needs and recommend to the primary health care provider appropriate nutritional intake including enteral and parenteral nutrition regardless of setting, including but not limited to ambulatory settings, hospitals, nursing homes, and other extended care facilities.

Nutritional Counseling- is the provision of the individualized guidance on appropriate food and nutrient intake for those with special needs, taking into consideration health, cultural, socioeconomic, functional and psychological facts from the nutritional assessment. Nutritional counseling may include advice to increase or decrease nutrients in the diet; to change the timing and size of and composition of meals; to modify food textures; and in extreme instances, to change the route of administration.

Nutrition Education- imparts information about food and nutrients, diet lifestyle factors, community nutrition resources and services to people to improve their nutrition.

Nutrition Assessment and Counseling as directed by Title 37 Chapter 41 of the Louisiana Revised Statues for Dietitians and Nutritionists can only be performed by LDNs. However, Nutrition Education can be provided by other disciplines as long as the information presented is general, accurate and provided to the individual or group without the educator individualizing the information by answering any participants’ questions that are specific to the participants’ diet or nutritional status.

The main purpose of Title 37 Chapter 41 of the Louisiana Revised Statues for Dietitians and Nutritionists, and its governing Board is to protect the public from fraudulent and potentially harmful information being provided to the public. If you know of any other professions or persons who are providing nutritional assessment or counseling or improperly using the title of Dietitian/ Nutritionist, you should file a formal complaint with the Board for review. The Board takes each complaint seriously and reviews the information to determine if the complainant has violated the statues set forth by the law.

CONCERNS FOR ADEQUATE NUTRITION IN THE AGING POPULATION

by Guest Columnist Samantha Rider

Special attention should be geared to the elderly as they are the fastest growing segment of the population in most industrialized countries. Many metabolic and physiological changes occur after age fifty that have a strong influence on the nutritional status of an individual. With advancing years age-related health problems can hinder healthy eating habits. Our role as a dietitian is to determine the needs of our patients as well as trying to overcome obstacles that are negatively affecting their nutritional status.

Unfortunately little is known concerning how the nutritional needs of older people differ from that of younger adults. Much research is needed to determine how the aging process affects the body’s ability to digest, absorb, and retain nutrients. It is generally believed that the elderly population tend to intake less calories than younger people which can lead to nutritional deficiencies. The reasons for a decrease in calorie intake can be numerous. Some of the aging population may have difficulty tolerating certain foods, have different diseases that require certain dietary restrictions, or they may not have the ability to shop or prepare food for themselves. Depression resulting from changes in living conditions, certain medications, or loss of companions can also have a negative impact on the appetite resulting in a loss of interest in food. Regardless of the reason, as the intake of food decreases the consumption of protein, carbohydrates, fat, vitamins and minerals will decrease as well.

If an older person is feeling lonely this may also result in a decline in oral intake. Eating with family, friends or being a part of a group meal program offered through senior citizen programs can help encourage an older adult to eat. On average, meals eaten in a group last longer and supply more calories than meals eaten alone. It has been shown that the single elderly eat less protein, beta-carotene, vitamin E, phosphorus, calcium, zinc, and fiber than those living with others.

Nutritional intake and health status can be strongly affected by physiological changes that occur over time in the body systems. Sensory changes including a decline in vision, hearing, sense of smell and taste often affect nutritional intake. Regardless of the reason, as intake of food decreases in the elderly population, the consumption of protein, carbohydrates, fat, vitamins and minerals will decrease as well. Because of the decline in caloric consumption for the elderly it is extremely vital for the older people to intake food with a high nutritious content. Because sweets and other “empty calorie” foods provide little nutritious valve they should be limited in the diet to allow for foods that will provide nutrients needed for good health. A good practice is to limit snack chips, commercially made cakes and cookies, soft drinks, candy and alcohol.

In conclusion, the elderly population does have inevitable and irreversible physical and emotional changes that occur over time, which can cause a decline in caloric consumption. However it is our job, as dietitians, to acknowledge these changes and create successful diets that help meet their specific needs and interests. We must educate ourselves as well as the employees involved in direct patient care on ways to encourage PO intake. To quote Robert Browning “Grow old with me, the best is yet to be!”

Frequently Asked Questions

How do you get to be a member of the Louisiana Board of Examiners in Dietetics and Nutrition?

LBEDN membership is specified in the law (Louisiana Dietetic/Nutrition Practice Act of 1987). Seven people are appointed by the Governor and confirmed by the Louisiana Senate to serve on the Board for initial terms of 2-3 years. Four members are required to be licensed dietitians/nutritionists selected from a list submitted by LDA; one member is a licensed registered nurse, selected from a list submitted by the Louisiana State Nurses Association; one is a licensed physician selected from a list submitted by the Louisiana State Medical Association; and one is a someone with a baccalaureate or higher degree with a major course of study in human nutrition, food and nutrition, dietetics, or food systems management, selected from a list submitted by the Louisiana Commissioner of Agriculture and Forestry.

Since four of the seven members are nominated by LDA, dietitians wishing to serve on the Board should notify LDA of their interest. As vacancies occur, LDA can then include your name on their list of potential members, which is submitted to the Governor.

Are Board meetings open to the public?

Yes, Board meetings, with the exception of Executive Sessions, are open to the public. While public attendance is not common, dietetic interns from LSU and Southern have attended previous meetings. Times, dates, and locations of the Board meetings are published on the LBEDN web page.

What is the difference between a dietitian and a nutritionist?

In the state of Louisiana, the terms dietitian and nutritionist are interchangeable, and both titles are protected by the Louisiana Dietetic/Nutrition Practice Act of 1987. Anyone who uses either title, without holding a valid license, is in violation of the Practice Act.

If I mistakenly allow my license to lapse, how can I get it back?

Licenses expire and are renewable on June 30 of each year. The Board allows a 60-day grace period, in which persons with lapsed licenses are allowed to re-in state by simply paying a $25 late fee along with the $60 renewal fee. Individuals who fail to renew, yet who still practice dietetics in the state of Louisiana, will be considered in violation of the Practice Act. As such, the lapsed licensee will be reprimanded for practicing without a license, and will be given a Consent Agreement and Order. Once the applicant has received the Consent Agreement Order they will have 90 days in which they will be required to take and pass an Open Book Examination covering the Louisiana Dietetic/Nutrition Practice Act and the Board’s Rules and Regulations. Exams are to be completed at the Board office located in Baton Rouge. Individuals who fail to complete the exam will be required to appear before the Board.

If someone at a health club is passing out information about what kind of foods to eat for weight loss, is he is violation of the Practice Act?

The Practice Act defines dietetic/nutrition practice as the integration and application of principles derived from the sciences of nutrition, biochemistry, food, physiology, management, behavioral, and social sciences to achieve and maintain client health through the provision of nutrition care services, which includes individual and group assessment; development of individual care plans based on integration of information from assessments; and provision of counseling and other services based on a comprehensive assessment. Thus, the practice act prohibits “dietetic/nutrition practice”. It does not prohibit individuals from disseminating nutrition information that is in the public domain. Someone who just passes out information about healthy eating is not in violation of the Practice Act, as long as he/she does not call himself/herself a dietitian or nutritionist. However, if that person tries to conduct comprehensive nutritional assessments and individualized care plans without benefit of a license, that person violates the Practice Act.

Louisiana Board of Examiners in Dietetics and Nutrition Board Website

As a dietetics professional in the state of Louisiana, you may be missing a valuable resource if you are not accessing the official LBEDN website. Easy to find by itself or just a click away on the “Licensure” button from the LDA website, this space is full of information. By navigating the site, one can:

Take a look at www.lbedn.org and add it to your list of favorites for even easier access! Odds are, you’ll learn something you didn’t know and be able to use it in your practice. Your feedback is always welcome and will help the board in responding to your needs. Let us hear from you!

2005 RENEWAL SCHEDULE

NEW LICENSEES FROM 2003 NEWSLETTER—FEBRUARY 1, 2005

WEB SITES TO INVESTIGATE

www.lbedn.org Board Web address

www.eatright.org American Dietetic Association

www.eatrightlda.org Louisiana Chapter of the ADA

www.cdrnet.org Commission on Dietetic Registration

www.dmaonline.org Dietary Managers Association

Accepting Verbal Orders from Physicians

Our Practice Act nor the Rules and Regulations of the Board govern this aspect of dietetic practice, however, allowing Licensed Dietitians/Nutritionists to accept verbal orders from physicians, nurse practitioners and physician assistants, etc., is a standard practice at most healthcare facilities.

Since written and verbal orders are a function of the Medical Staff, the Medical Staff at each individual healthcare facility would have to approve the request for Licensed Dietitians/Nutritionist to begin the practice of accepting verbal orders.

Once Medical Staff approval is granted Licensed Dietitians/Nutritionists must follow the guidelines set forth by the facility and any governing or accrediting body associated with the facility.

TO THE CONSUMER:

In order to protect the public from potentially harmful dietary and nutritional advice the State of Louisiana has established licensure for dietitians and nutritionists. The licensed dietitian/nutritionist must meet and maintain national and state standards of knowledge, experience and professional ethics.

This process is assured by the Louisiana Board of Examiners in Dietetics and Nutrition. The public is welcome to consult the board through its website located at www.lbedn.org. This website provides the consumer with a current listing of dietitians/nutritionists licensed by the Board, as well as other valuable information.

WARNING TO CONSUMERS
DIETETIC AND NUTRITION PROTECTION

In response to consumer and professional concerns, the Louisiana Board of Examiners in Dietetics and Nutrition feels it is very important to address the reliability of the credentials of nutrition advisors.

In the nutrition area, non-accredited schools and other organizations issue a multitude of “degrees” and “certificates.” These documents are promoted as equivalent to established credentials that qualify the recipient as a expert in the field of nutrition. This may not be true and maybe confusing to the public. Further, this is a potentially dangerous for people who need counseling or treatment for serious nutrition-related diseases such as diabetes, high blood cholesterol and weight management.

In order to protect the public from acting on advice from unqualified and unlicensed nutrition advisors, the State of Louisiana has established a licensure system for dietitians and nutritionists based on statutory law. The public is ensured through this process that the licensed dietitians and nutritionists meets and maintains national and state standards of knowledge and experience for the profession.

The Louisiana Board of Examiners in Dietetics and Nutrition encourages the public to consult the Board through its website located at www.lbedn.org. The site outlines standards and priorities of the Board as stated in the licensure act and the Board’s Rules and Regulations.

This website also provides the consumer with a current listing of licensed dietitians and nutritionists in the State of Louisiana, as well as other important resource information.

The Board urges the citizens of Louisiana to inform and protect themselves by using the website and seeking nutrition and diet advice from dietitians and nutritionists licensed by the State. Please feel free to contact the Board through the website if questions arise or you may call (225) 756-3490.

LDNs RENEW ON LINE
FAST SERVICE — CONVENIENT

LDN Licensees have the option of renewing on-line using a credit card for payment or by sending their renewal, current CDR card and check or money order to the Board office. Provisional Licensees must renew by mail with proof of continuing education.

Your new license card will be received within a few days IF you renew at our web site. Allow 4-6 weeks if you submit your renewal form and payment by mail.

REMAINING BOARD MEETING DATES 2005

July 15

October 14

All Board Meetings will be held at the Board Office at 18550 Highland Road, Baton Rouge, LA

Ph: 225-756-3490 Fax: 225-756-3472

Website: www.lbedn.org