President’sMessage—YourVoiceisNeededThe2015MontanaLegislatureisinsession!TheMTANDpublicpolicycommitteeishardatworkbutweneedyourhelp.OnecriticalbillisHB249,whichaddressestheexpansionofMedicaidExpansion—thehearingisthisweek!Weareverysupportiveofthisbill(seebelow).Pleasetake iveminutestodaytosendamessagetoyourlegislatoraskingforhis/hersupportofit.Itissimple;youcaneithersendamessagebyemailatthislink:http://leg.mt.gov/css/Sessions/64th/legwebmessage.asporbyleavethemamessagebyphonebycalling(406)444‐4800.Hereisanexampleofwhatyoumightsayorwrite:“TheMontanaAcademyofNutrition&Dietetics‐thatIrepresent‐supportsHouseBill249.TheAcademyrepresents225licenseddietitians/nutritionistswhoworkinavarietyofhealthandcommunitysettings.Iurgeyou,asamemberoftheHouseHealthandHumanServicescommitteetostronglysupportthisbillandurgeallmembersofyourcommitteetodothesame.Currentlyupto70,000lowandmiddleincomeMontananslivingbelow138%ofthefederalpovertylineareuninsured;includingveterans,seniorcitizens,andAmericanIndians.ThisbillwillalsohelpimprovethecareofMontananssufferingfromamentalillness.Expansionwillbring$5.4billionfederaldollarsinbetweenJuly2015‐2021.Thisfundingwillresultinapproximately12,000newjobs,decreasethecostofun‐compensatedhealthcare,anddecreaseseriousandexpensivehealthproblemsthatcouldhavebeentreatedsoonerandwithlessexpenseandlossofqualityoflife.TheMontanaMedicalAssociation,theMontanaHospitalAssociation,theAssociationofMontanaHealthCareProviders,MontanaPrimaryCareAssociation,MontanaPublicHealthAssociation,MontanaNursesAssociation,andmoreorganizationssupportthisbill.”Wewouldwelcomeyourinvolvementinourpublicpolicycommittee!Otherbillswewillbefollowingareconcerninglocalfood,foodsafetyandfoodinsecurityissues.Stayintouchandthankyouinadvanceforspeakinguponnutritionandhealthrelatedissues.‐KatieBark,MTANDPresident;barksnmt@gmail.com;or(406)570‐5980.

thisissue

10Reasons:MTANDFNCE&LegislativeSummitP.2

Events:NNM&EllynSatterTrainingP.3

Delegate’sCorner&MDIUpdateP.4

Nominations,BreakfastPSAs,OsteoporosisP.5

MNTReimbursement&LicensureP.6

TimetoVOTE!&GAPTrainingP.7

StrongHearts,HealthyCommunitiesP.8

W I N T E R

15 OFFICIAL NEWSLETTER OF THE MONTANA ACADEMY of NUTRITION and DIETETICS

Food forThought

Newsletter Mission

Providefactual,informative,

andinterestinginformation.

Provideinsightandinventive

ideastopeopleinterestedin

dieteticsinMontana.

Promotehealthfullifestyles

throughideasand

contributions.

Top10ReasonstoattendMTANDFNCEHelena, May 27 ‐29, 2015

1. 14CEU’sin3days.2. InternExpoonMay27andlearnfromalleighteenaboutthisyear’smostinteresting

cases–BonusCEUsforlearningatthesepresentations!!!3. NutritionEthicssessionwillsatisfyyourmandatoryCEUrequirement.4. Meetexhibitorsand indouthowyoucanusetheirgreatproductsandservices.5. SpeakersfromMontanaandacrosstheUnitedStates.6. TourtheStateCapitol….MeetmoversandshakersinMontanapolitics(thinkchocolate&

wineintherotunda—seebelow).7. TouradairyfarmwiththeWesternDairyCouncil(localandsustainableinaction).8. Getyouryogamovesontohelpretainwhatyouhavelearned.9. MeetyourMTANDBoardofDirectors.10.Networkwithyourcolleaguesandnutritionfriends!RegistrationopensApril1,somarkyourcalendarsandmakeplanstomeetinHelena!

AdvocacyandDietetics...ChocolateandWine...What:CelebrationofGrassRootsAdvocacy:fromtherighttovotetoMNTandChildNutritionWhere:MontanaCapitolReceptionRoomWhen:May28,2015,7:00‐8:30PMTheMTANDPublicPolicyCommitteeinvitesyoutoattendtheeventoftheyear!TeresaNece,Director,GrassrootsAdvocacy;MonicaJ.Lindeen,CommissionerofSecuritiesandInsurance,MontanaStateAuditor(invited);andFirstLadyLisaBullock(invited)willbespeakingonavarietyofadvocacyanddieteticstopics.There’smore!TourtheCapitol,theMontanaWomen’sSuffrageExhibit,andfreewineandsnackswhilesocializingwilltopoffthisevent.‐DebJones,djones@stpetes.organdLynnPaul,lpaul@montana.edu.

"Theinchesweneedareallaroundus.”‐AlPacino,AnyGivenSunday

InDecembertheMontanaOf iceofBudgetandPolicyheldits2ndAnnualLegislativeSummitinHelena.Inattendancewererepresentativesfromorganizedlaborgroups,majorhealthandsocialjustice‐typeorganizations,andincludedfourMTANDmembersandanintern!Duringthetwodaysummit,welearnedaboutthebasicsofthelegislativeprocessatthestatelevel.Didyouknowthateverystatehasdifferentrulesabouthowtheirlegislatureruns?Montana'sonlymeetsinoddnumberedyearsandisinsessionfornomorethan90days.Thetwodaysofferedworkshopsessionswherewepracticedtalkingtolegislators,creatingmessagesthat"tellastory"whendiscussingourpriorities,andalotofinvaluablenetworkingwithotherhealth‐relatedstategroups.TheSummitendedwithapresentationbyDr.AvisJones‐DeWeever,whoisanationallyrecognizedauthorityoncreatingadvocacymessagingforminorityandwomen'sissues.ShepresentedonsomeofthevaluesthatMontanansshareandrecommendedweavingouradvocacymessagesaroundthesevalues.SomeofthesharedMontanavaluesshecitedincludedtheimportanceoftakingcareofourneighbors,connectiontotheenvironment/outdoors,andprideinbeingMontanans!‐KristenKrane,(Anderson),LegislativeCommittee.

This Quarter’s Quote

HealthPolicyLegislativeSummitUpdate

Delegate’sCorner Firstofall,thankyousomuchforelectingmetotheHouseofDelegatestorepresentYOU!My irstpriorityinthisroleistoensurethatallMontanaRDshaveavoiceinthedecisionsthataremadethatimpactourprofession.TheHouseofDelegatesmetinOctober.Discussionwascenteredaroundtwoissues;andplansforbothhavebeenvotedon,andwillmoveforward.Iwillkeepyoupostedastheseissuesmoveforward.ImprovingBusinessskillsoftheRDConsiderbroadeningthescopeofbusinessandmanagementcompetencies(knowledge,skill,judgmentandattituderequirements)fornutritionanddieteticsthroughoutapractitioner’scareer.Thesecompetenciesassisttode inetherolesformanagementandadministrationinfoodindustry,foodservice,productdevelopment,marketing,communications,clinicalnutrition,publichealthandcommunitynutrition,research,academia,consultationandprivatepractice.Increasingthenumberofinternshipsand/orpreceptors:Thereareavarietyofgoalshere,includingidentifyingnewmodelsforpreceptoruse;identifyingavarietyofincentivesandrecognitionforpreceptors;andstreamliningtheprocesstoestablishnewsupervisedpracticesitesandpreceptors.Ifyouhaveanyquestionsorcomments,pleasedon’thesitatetoreachouttome.‐TamiWaite,MTANDDelegate,delegate@mtand.org.

Forty‐oneof46MDIgraduates(2011‐2014)areemployedinprofessionalpositionsasofthisletterdate.73%oftheMDIgraduatesfrom2011‐14areemployedintheWesternRockyMountainandAlaskanregions,demonstratingthepositiveimpactofMDIinpreparinghighlycapableentry‐levelfoodandnutritionprofessionalswhoareworkingandservingthenutritionandhealthcareneedsofMontanaandthewesternmountaincommunities.MDIcompletedtheAccreditationCouncilforEducationin

NutritionandDietetics(ACEND)accreditationprocessthispastSeptemberandallwentverywell.AthreepersonreviewteamspentthreedaysatMSUandnearbysupervisedpracticesites.Thereviewersenjoyedalocalfoodsluncheonpreparedbysixinternsintheirsustainablefoodsystemsrotations.Thefarmtotablemeal inishedoffwithhomemadepumpkin‐bananasquashicecream,harvestedfromTowne’sHarvestGarden.Asatestamenttothedeliciousmeal,aswellastheprogrammaticsuccessoftheyoungprogram,MDIreceivedhighmarksinallcategories,andtherecommendationsoftheACENDreviewersisforfullcandidacy.The inaldecisioncomesfromtheACENDBoardattheirannualmeetinginJune2015.WeweretoldbythereviewteamthatMDIrankedinthetop10%ofprogramstheyhadreviewed.Ofcoursethatfeltgreat!ItisagreattestimonyofhowmanypeoplearecommittedandinvolvedinMDIsuccess–kudostoallthoseprofessionalsthatprovidehoursofmentoringanddedicationtoprovidequalityexperiencesforemergingdieteticprofessionals.‐ColeenKaiser,RDN,MS,LN,Director;(406)994‐5002,coleenk@montana.edu.

MontanaDieteticInternshipUpdate

AsktheExpertOsteoporosis&SpecialNeedsQ:Whatimpactdointellectualanddevelopmentaldisabilitieshaveonanindividual'sbonehealth?A:Asapublichealthnutritionist,I'vebeenprivilegedtoworkwiththeSpecialOlympicsHealthyAthletesprogramformanyyears.Myinteresthasbeeninpromotingbonehealthforpeoplewithintellectualanddevelopmentaldisabilities(I/DD)whosadlyexperiencemorethantheirfairshareofosteoporosis,fractures,prematuretoothlossandotherconsequencesofinadequatebonehealth.Q:So,whatcanwedotohelppreventthecascadeofproblemsseenwithosteoporosisandfracturesinpeoplewithI/DD?A:PublicandprivatehealthcareprovidersshouldscreenindividualswithI/DDforriskfactorsassociatedwithlowBMD.Thosewithlowbonedensityshouldhaveinterventionatanearlystagetopreventmorbidityandimprovetheirqualityoflife.Routinetestingof25‐hydroxyvitaminD(25D)levelsisappropriateinmost,ifnotall,peoplewithI/DD.AndtomaintainoptimallevelsofvitaminD,peoplewithI/DDneedindividualizedsupplementadvice,basedontheirweight,age,skincolor,latitude,season,sunexposureandcurrentserumvitaminDlevels.‐MaryPittawayGlobalClinicalAdvisor‐HealthPromotionSpecialOlympicsInternational

CallforNominationsforAwardofExcellenceforNutritionAdvocacySince2008,theMontanaAcademyofNutritionandDieteticshaschosenone,twoorthreenon‐dietitianstohonorwithanAwardofExcellenceforNutritionAdvocacyattheannualMTANDFNCEmeeting.Theawardispresentedforthepurposeofrecognizinganindividual(s)whohasworkedtooptimizethehealthforMontanansbysupportandpromotionoffoodandnutrition.Criteriafortheawardarethefollowing: MTANDmembersareencouragedtosubmitnomineesfortheaward.However,the

nomineecannotbeamemberofMTAND. ThenomineemustbeaMontananfromeithertheprivateorpublicsector. Thenomineemusthaveworkedactivelyandconsistentlyforaminimumof ive(5)years

promotingandsupportingfood,nutrition,andhealthylifestyles,anddemonstratingknowledgeandunderstandingoftheissuesandpoliciesinvolved.

The2015awardnominationdeadlineisMarch23,2015.FurtherinformationandthenominationformmaybeaccessedontheMTANDwebsite(underAdvocacy)orbycontacting:PattiSteinmuller,PublicPolicyCommitteeAwardsChair,psteinmul@msn.comor(406)763‐4145.

Breakfast:EveryChild,EveryDayResearchshowsoneinevery ivechildrenmaybehungryandthatteachersreportteachingstudentswhoregularlycometoschoolhungry.DidyouknowthatmanyMontanachildrendonoteatbreakfast?Only40%ofMontanateensreportedeatingbreakfasteveryday(2013MontanaYouthRiskBehaviorSurvey).Sometimesfamiliesdonothaveenoughfood;othersdonothaveenoughtimeinthemorning.However,eatingbreakfasteverydayisaninvestmentinchildren’shealth,behaviorandschoolsuccess.Childrenwhoregularlyeatbreakfast: Arehappier,healthierandlesslikelytobeoverweight Behavebetterinschoolandaretardyorabsentless Scorehigherinmath,readingandstandardizedtests AremorelikelytograduatefromhighschoolSimplyput,eatingbreakfastcanchangechildren’slives.MontanaActionforHealthyKids(MTAFHK)iscommittedtoensuringthatallMontanahaveaccesstoschoolbreakfast.MTAFHKandit’spartnershavecreatedeight30‐secondBreakfastPSAs(PublicServiceAnnouncements)foruseacrossMontana(audioandtext iles).AllBreakfast:EveryChild,EveryDayPSAsareavailableforfreedownloadatwww.m bn.org/breakfast.‐MollyStenberg,MTAFHKChair,stenberg@montana.edu.

MaximizingMNTReimbursementOnesizedoesnot itallwhenitcomestoreimbursementforMedicalNutritionTherapy(MNT).WhenaskedaboutreimbursementforRDNservicesmystandardansweris,“Itdepends.”Itdependsontheinsurancecompany,thebene iciary’splan,deductibles,diagnosisandothervariables.Toimprovethirdpartypaymentconsider: Verifyingbene itspriortoservice,inquireaboutspeci icdiagnosisandscopeofbene it Pre‐authorization Billing“Incident‐tobilling”whichreferstoabillingmechanism,allowingservices

furnishedinanoutpatientsettingtobeprovidedbyauxiliarypersonnel(RegisteredDietitian)andbilledundertheprovider'snationalprovideridenti ication(NPI)number.

PreventativeMedicalServices/WellnessBene itsmaybeanalternativeifMNTisnotaspeci iedbene it,

SubmitLettersofMedicalNecessityifclaimsaredenied Withmorepeoplechoosinghigh‐deductibleplans,affordablegroupprogramsareagood

alternativetoindividualMNT.FordetailsontheabovesuggestionsandotherinformationonreimbursementrefertotheAcademyofNutrition&Dieteticsonlineresourceswww.eatright.org/coverage.‐JacquelineSikoski,MS,RDN,LN,jsikoski@bdh‐boz.com.

ThispastfallIhadtheopportunitytoattendtheConsumerProtectionandLicensureSummit.IhopethisarticlehelpsyoulearnsomethingnewaboutlicensureasIwasfortunatetodo.WhatisMontana’sscopeofpractice?AccordingtheMontana’slicensurestatute,http://leg.mt.gov/bills/mca_toc/37_25.htm;onlyanutritionistcanprovidethefollowingservices: assessingthenutritionneedsofindividualsandgroupsanddeterminingresourcesandconstraintsinthepracticesetting;

establishingprioritiesandobjectivesthatmeetnutritiveneedsandareconsistentwithavailableresourcesandconstraints;

providingnutritioncounselingforanyindividual; developing,implementing,andmanagingnutritioncaresystems;and evaluating,adjusting,andmaintainingappropriatestandardsofqualityinfoodandnutritionservices.

Whydoesthisscopeofpracticematter?Ourscopeofpracticeissomethingweshouldallworktodefendwhenquestionedorchallenged.RDsinmanystatesdonothaveade inedscopeofpracticetodifferentiatethemselvesandtheirnutritionservicesfromthosepromotedbyunquali iedindividuals.WhowouldchallengeRDlicensureandwhy?Mainly,thoseindividualsororganizationswhochallengeRDlicensurearethosewhowouldliketooffernutritionservicestothepublicforafeebutdonothavetheeducation,training,andsupervisedpracticeexperienceofanRD.NextstepsThereisanopportunitytoeducatedietitiansinMontanaabouttheimportanceoflicensureandscopeofpractice.ItisourresponsibilitytoreportunsafenutritionpracticetotheMontanaBoardofMedicalExaminers:http://bsd.dli.mt.gov/license/bsd_boards/med_board/board_page.asp.‐ByTaraRay,RD,LNwithPattiSteinmuller,MS,RD,CSSD,LN.

ConsumerProtection&LicensureProtect Your Pract ice & the Publ ic ’ s Health

"Greatskillisneverdevelopedwithoutgreateffort.”‐Unknown

AttentionMTANDMembers:Checkyoure‐mailboxonNationalRDNDay,March11,foryourchancetovote!Yourvotewillimpactthefutureofourstateaf iliate.VotingforMTANDof icesandawardswillbeopenMarch11toApril10.

Ifthatisn'tenoughofareasontovote—wewillbeawardingacoolprizetooneluckymemberwhovotesinthisyear'selection!Ifyouareinterestedinbeingincludedontheballotinthefutureorhaveanyquestions,pleasecontactChristineEmersonatcemerson@mt.govor406‐444‐2502.

This Quarter’s Quote

MTANDElectionsopenMarch11Voteforachancetowinaprize!

GAPTrainingGoodAgriculturalPractices(GAP)forProduceisanewfoodsafetyinitiativeandsomefoodvendorsarerequiringMontanaproducerstohaveafarmfoodsafetyplanand/orbeGAPcerti ied.LynnPaul,EdD,RD,MSUExtensionFoodandNutritionSpecialist,co‐organizedandfacilitatedaGAPWorkshopforTrainers,EducatorsforProducers,September9‐11,2014,inBozeman.Over40farmersandprofessionalsattendedthis3‐dayworkshop.FeaturingforemostnationalGAPProgramtrainers,Dr.BetsyBihnandMs.GretchenWallatCornellUniversity,theworkshopwasintendedtohelpproducegrowersandGAPtrainersunderstandfoodsafetyrisksthatmayexistonthefarm,howtoconductariskassessmentoftheirownfarm,andhowtodevel‐opawrittenfarmfoodsafetyplan.In‐depthsubjectmatterrelatedtoGAPandFSMA,pertinentGAPeducationresourcesandinformationfordeliveringGAPgrowertrainingswasprovidedtogrowersandtrainers.FormoreinformationaboutGAP:http://www.ams.usda.gov/AMSv1.0/gapghp.

‐LynnPaul,lpaul@montana.edu

ThankyouforyourVote!ThenationalelectionsfortheAcademyconcludedFebruary22.Thankyouforvoting!

Oncetheresultsarein,ifwegetthehighestparticipationinourcategoryMTANDwillwinaFREEtriptothenationalFNCE.

www.eatright.org/elections

InThisIssueGetdetailsontheupcomingMDAFNCE,checkoutupcomingevents&muchmoreAsalways,ifyouhaveideas,thoughtsorwouldliketosubmitanarticleforthenextnewsletter,contactKimPullman,NewsletterEditor,kpullman@mt.gov."FoodforThought"isMTAND'squarterlynewsletter.MembersmayreceivethisnewsletterelectronicallyviaMTAND’slistserv,orbymail.

FoodForThought—Winter2015

Deadlineforsubmissionsforthenextissue:May1,2015

QuarterlyPublicationDates:February28May30July30

November30

POBOX1197HELENA,MT59601

StrongHearts,HealthyCommunities StrongHearts,HealthyCommunities(SHHC)isaresearchandcommunityinvolvementprogramthataddressesruralcardio‐vasculardisease(CVD)healthdisparitiesthroughcivicengagementandimplementationofacommunity‐basedintervention.MontanaStateUniversity(MSU)Extensioneducatorswillleadthefront‐linecommunityengagementandprogramimplementationactivitiesin12medicallyunderservedruraltowns.Communitysubjectswillparticipateininteractiveeducationalprogramsthatincludeexercise,nutrition,andotherCVDpreventioneducationandskills.Theinterventionwillalsoincludecommunity‐wideeventsandactivitiestoraiseawarenessandaccessoflocalresources.MSUExtensionFoodandNutritionSpecialistLynnPaul,EdD,RD,istheprincipalinvestigatorforMontana’ssectionofthisnew4‐yearSHHCgrantproject.MontanawashonoredtobechosenasthesoleresearchsiteforCornell’sNationalInstitutesofHealthR01grants.‐LynnPaul,lpaul@montana.edu.