Weight control programs falling under the Act and Rules must be reviewed by a dietitian/nutritionist who is currently licensed and in good standing in North Carolina and is enrolled in or has completed a Board-approved training program. The NCBDN maintains a data base of certified reviewers. In locating a licensed dietitian/nutritionist and certified reviewer in your area to review your weight control program, you may contact Carolyn Hannah at the NCBDN Executive Office in Raleigh, at 919.861.5580 or 800.849.2936.

PRIOR TO THE REVIEW

It is in your program's best interest to be adequately prepared prior to incurring the time and expense of a review. Before contracting with a licensed dietitian/nutritionist to perform a review, carefully study the Guidelines to determine if your program is ready to be reviewed. If you do not have a copy, you should contact the Office of the Executive Secretary to purchase the Guidelines. You may want to use Form WCP-C, "Checklist for Reviewing A Weight Control Program" to evaluate your program. If you have many questions concerning whether or not your program is in compliance with the Rules and Guidelines, consider contracting with a licensed dietitian/nutritionist for consultative services to help you prepare for the review.

When you contract with a reviewer, she/he should provide you with an estimate of her/his fees for this service. Once you contract with a reviewer, she/he will call the Office of the Executive Secretary of the NCBDN to request the date of your program's last review and the result of that review.

MATERIALS TO HAVE READY

You will need to have the following materials ready for the reviewer on the day of the review:

1. All active client files readily accessible for random sampling,
2. Personnel files that include credentials of all program providers,
3. Samples of program material, including written nutrition education handouts, recorded education materials, lesson or instructional plans, food plans, screening tools, consent forms, and any materials associated with maintenance/follow-up program,
4. Marketing materials,
5. Samples of supplements, food, or food products sold/distributed by program provider for use in program, and
6. Service agreement or contract for nutrition consultation.

The reviewer will need a private area to review these materials.

DURING THE REVIEW

When the reviewer arrives to perform the review, she/he will ask to meet with the authorized person (s) from your program. The reviewer will then review all program materials for compliance with the "Weight Control Guidelines on Nutrition," using Form WCP-C, "Checklist for Reviewing A Weight Control Program" to document her/his findings and recommendations, as indicated. In particular, the reviewer will be examing the materials for the following information:

1. Client files: Review at least 10% of all client files, checking for the following information:
   • signed consent form (see Standard 6),
   • client screening form-Check to see if clients are appropriately assigned to a risk category and level of care (see Standard 2, 3). If Form WCP-C is not used, determine if the client screening form contains the same elements (see Appendix C),
   • physician release form (for moderate and high risk clients). If Form WCP-PR is not used, determine if the physician release form contains the same elements (see Appendix D),
   • weight goal, as appropriate-If a weight goal is set, evaluate it for appropriateness (see Standard 9), and
   • weight records-Evaluate rate of weight loss for safety (see Standard 10).
2. Personnel files: Do the qualifications of the program providers meet the risk level of the clients? (See Standard 4).
3. Food Plan: Review for nutritional adequacy. If nutrition supplements are indicated to meet the RDAs, is there documentation available to demonstrate supplements are recommended and appropriately used by clients? (See Standard 11, 12, 13).
4. Program Marketing Materials: If the program materials make claims about the achievement of weight loss or long-term maintenance of weight loss or control, is scientifically valid data (not case histories) available to support these claims? (See Standard 7).
5. Nutrition Education Materials: Do the nutrition education materials provide appropriate and accurate information? (See Standard 14-18).
6. Weight Maintenance: Does the weight maintenance component include the components listed in Standard 21?
7. Nutrition Consultation: Is there an active agreement or contract between the weight control program and a licensed dietitian/nutritionist to provide consultative services to the program? (See Standard 8). Check the date of the letter to determine that the agreement is still active. Contact the licensed dietitian/nutritionist to verify the agreement and to determine if he/she is licensed and in what state he/she is practicing. If licensed in North Carolina, contact the NCBDN to verify that the dietitian/nutritionist is licensed in North Carolina. If licensed in a state other than North Carolina, contact NCBDN to verify that the licensure requirements of that state are equivalent or as stringent as those in North Carolina and to obtain the telephone and/or fax numbers for the executive office of the licensure board in that state. Then contact that state licensure board to verify that the dietitian/nutritionist is licensed in that state. If the consultation occurs in a state that does not have a licensure law, then contact the Commision on Dietetic Registration to verify that the dietitian/nutritionist is registered.
8. Other:
   • For Level II and III Care, is there documentation available to demonstrate that clients received nutrition consultation with a licensed dietitian/nutritionist at the beginning of the active phase of the program? (See Standard 4).
   • Are BMI charts and calibrated scales available in the facility?

REPORT ON THE REVIEW OF THE WEIGHT CONTROL PROGRAM FOR NORTH CAROLINA BOARD OF DIETETICS/NUTRITION AND COMMENT PERIOD

After reviewing all program materials, the reviewer will complete Form WCP-R, "Report on the Review of the Weight Control Program for North Carolina Board of Dietetics/Nutrition." The reviewer should complete the top section of program information on both pages and one of the sections A-either "Review with Recommendation for Approval" or "Review without Recommendations for Approval" and attach the completed Form WCP-C, "Checklist for Reviewing A Weight Control Program". If the reviewer is not recommending approval, she/he must describe the specific deficiences of the program and attach appropriate supporting documentation. Depending on the nature of the deficiences, the reviewer may recommend approval with suggestions for improving the program. The reviewer will sign the Report at the bottom of page 1, including her/his North Carolina License Number.

The reviewer must deliver the Report Form in person to the authorized person (s) at your program for their review and signature. Their signature does not indicate agreement with the report, rather, it only indicates that they have read the report. The reviewer will be submitting the report to the NCBDN for final action. Keep in mind that once you have contracted with a licensed dietitian/nutritionist to perform a review, she/he must submit a Report to the Board, no matter what the results of the review are. The NCBDN will inform the authorized person (s) at your program of the Board's approval or denial and any actions your program may need or want to take. The program must attach to the Report a list of persons directly providing weight control services who are not licensed according to GS 90, Article 25. You will be given the weight control program's copy of the Report.

If the reviewer does not recommend approval, you have ten (10) working days after the date of the review to submit your comments on the Report Form and send by certified mail to the NCBDN. If your program is not approved, you have 60 days from the date of receipt of denial from the Board to rememdy any noted deficiences and have a second review by a reviewer. If desired, you can use another licensed dietitian/nutritionist for consultation to remedy the deficiences and second review. After three reviews in which approval is denied, or a maximum of 120 days of providing the weight control services without filed official approval from the Board, the person (s) who is (are) providing the weight control services shall be in violation of the Act.