Considerations When Using the Scope of Dietetics Practice Framework Decision Tree

  1. Background on the Scope of Dietetics Practice Framework (SODPF)

    Use ADA’s SODPF tool to help you answer the questions you posed about your scope of practice, as well as others that may come up in the future. Please see the March 2006 Journal article which contains the Scope of Dietetics Practice Framework Decision Tree (page 461), a decision analysis tool which you can work through to determine if something is within your scope of practice.

  2. Professional licensure, certification, business code, or other legal recognition statutes and/or rules

    To ensure that this service is not precluded by the law of your state, consult your state’s professional practice laws (statutes) and regulations (rules), if any. Your state dietetics association or licensure board for registered dietitians is likely to be your best resource. For this information please go to ADA’s member-only Web site.

  3. Governmental regulations, health care facility accreditation standards, and health care facility policies and procedures

    In addition, while the registered dietitian has the training and skills to perform a particular activity, this does not mean that it is automatically acceptable in the state or facility where he/she works. The registered dietitian must understand:

    • The federal, state, and local laws which may outline specific requirements for food and nutrition services and related employees such as registered dietitians regarding this activity.
    • The facility’s accreditation organizations standards related to this activity:
      - Joint Commission on Accreditation of Healthcare Organizations (JCAHO) www.jointcommission.org/Standards/
      - Healthcare Facility Accreditation Program (HFAP) www.do-online.osteotech.org/index.cfm?PageID=acc_hfmain
    • The facility’s policies and procedures related to the activity.

    All of these should be considered in the decision as to whether or not the activity may be performed by a registered dietitian.

  4. Documented personal scope of practice

    Your personal human resources file should include your current job description and documentation of any new education, training, supervision, and competence to perform new skills.

  5. Reimbursement requirements

    The fact that an activity is an acceptable part of the scope of practice does not mean that health plan insurers, including Medicare, will provide reimbursement for it. You should review the provisions of your facility’s or individual provider contract and the plan to determine whether coverage is likely to be allowed or denied.

  6. Liability insurance

    Performing within the scope of practice is prudent from the standpoint of liability and insurance coverage. Even certain activities that fall within your scope may give rise to liability claims or be excluded from coverage under a professional liability insurance policy. Practitioners concerned about a particular practice should review the provisions of their policy or consult with their insurer. You may not in all instances by able to rely upon your employer’s insurance coverage, which may not be specifically tailored to dietetics practice. Without professional liability protection, you could end up, in the event of a claim against you, being responsible for paying all attorney fees and related costs as your personal expense. Professional Liability Insurance administered by Marsh, a service of Seabury & Smith is available for private practice or traditional employment.

For more information:
In addition to the SODPF article, ADA has developed other resources to assist you in determining your individual scope of practice. These include the ADA/Commission on Dietetic Registration (CDR) Code of Ethics for the Profession of Dietetics, the Commission on Accreditation of Dietetics Education (CADE) Entry-Level Educational Competencies, the Nutrition Care Process and Model, the Standards of Practice, and the Standards of Professional Performance located on ADA’s member-only Web site (www.eatright.org). You can quickly access these resources by entering your member number and password and locating the “Practice” sub-navigation tab on the left side of the ADA home page; clicking the “Practice” tab will take you to all of these resources.

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