This chapter establishes the standards by which the Board may impose a disciplinary sanction, civil fine, or administrative monetary penalty, not to exceed: $5,000, on an individual licensed under Health Occupations Article, Title 5, Annotated Code of Maryland, for an act or omission prohibited under Health Occupations Article, §5-311, Annotated Code of Maryland; or $50,000 on an individual who violates Health Occupations Article, §5-401 or 5-402, Annotated of Maryland. In this chapter, the following terms have the meanings indicated. Terms Defined. “Board” means the State Board of Dietetic Practice. “Civil fine” means a monetary fine imposed by the Board in accordance with Health Occupations Article, §5-403, Annotated Code of Maryland. “Licensee” means an individual licensed by the Board to practice dietetics. “Penalty” means monetary penalty. “Sanction” means a disciplinary action reprimanding, restricting, suspending or revoking a licensee. After a hearing under Health Occupations Article, §5-312, Annotated Code of Maryland, and COMAR 10.56.04, and subject to the guidelines set forth in Regulation .05 of this chapter, the Board may discipline a licensee or impose an administrative monetary penalty of $5,000 or less on a licensee who is found to have committed a violation of Health Occupations Article, Title 5, Annotated Code of Maryland, and this subtitle. The Board may impose a penalty under §A of this regulation: In addition to suspension or revocation of a license; or Instead of suspension of a license. Depending on the facts and circumstances of each case, and to the extent that they apply, the Board may consider the following aggravating and mitigating factors in determining whether the sanction in a particular case should fall outside the range of sanctions established by the guidelines. These factors may include, but are not limited to, the following: Mitigating factors: The licensee’s lack of a prior disciplinary record; The licensee self-reported the violation to the board; The licensee’s full and voluntary admissions of misconduct to the board and cooperation during board proceedings; The licensee implemented remedial measures to correct or mitigate harm arising from the misconduct; The licensee made timely good-faith effort to make restitution or to rectify the consequences of the misconduct; Evidence of rehabilitation or rehabilitative potential; Absence of premeditation to commit the misconduct; Absence of potential harm to public or adverse impact; The licensee’s conduct was an isolated incident and not likely to recur; and The licensee’s prior community service and present value to the community; and Aggravating factors: The licensee has a previous criminal or administrative disciplinary history; The violation was committed deliberately or with gross negligence or recklessness; The violation had the potential for, or caused, serious patient harm; The violation was part of a pattern of detrimental conduct; The licensee was motivated to perform the violation by his or her financial gain; The vulnerability of the patient or patients; The licensee attempted to hide error or misconduct from patients or others; The licensee concealed, falsified or destroyed evidence or presented false testimony or evidence; The licensee failed to cooperate with the investigation; Previous attempts at rehabilitation of the licensee were unsuccessful; and The licensee committed the violation under the guise of treatment. The existence of one or more of these factors does not impose on the Board or an administrative law judge any requirement to articulate its reasoning for not exercising its discretion to impose a sanction outside of the range of sanctions set forth in this subtitle. Nothing in this regulation requires the Board or an administrative law judge to make findings of fact with respect to any of these factors. Subject to the provisions of this section, the Board may impose the following sanctions and penalties for violations of the Maryland Licensed Dietitian-Nutritionists Act and its regulations according to the minimum and maximum sanctions and penalties set forth as follows: If a licensee is found in violation of more than one category enumerated in this chapter, the ranges with the maximum sanction and the range with the maximum penalty associated with those categories shall be applied. A licensee or unlicensed individual shall pay to the Board a penalty or civil fine imposed under this chapter by the date the Board’s order is issued, unless the Board’s order specifies otherwise. Filing an appeal under State Government Article, §10-222, Annotated Code of Maryland, or Health Occupations Article, §5-313, Annotated Code of Maryland, does not automatically stay payment of a penalty or civil fine imposed by the Board under this chapter. If a licensee fails to pay, in whole or in part, a penalty imposed by the Board under this chapter, the Board may not restore, reinstate, or renew a license until the penalty has been paid in full. The Board may refer all cases of delinquent payment to the Central Collection Unit of the Department of Budget and Management to institute and maintain proceedings to ensure prompt payment. The Board shall pay all monies collected under this chapter into the State's General Fund. The Board may impose a civil fine of no less than $1,000 and no more than $50,000 against an individual who: Practices dietetics without a license in violation of Health Occupations Article, §5-401, Annotated Code of Maryland; or Misrepresents or implies to the public by use of the protected titles in violation of Health Occupations Article, §5-402, Annotated Code of Maryland. Factors to be used in determining the amount of the fine may include, but are not be limited to, the following: The extent to which the individual derived any financial benefit from the unauthorized practice or misrepresentation of title; The willfulness of the unauthorized practice or misrepresentation of title; Actual or potential harm caused by the unauthorized practice or misrepresentation of title; The cost of the investigation; and The length of time in which the individual engaged in the unauthorized practice or misrepresentation of title. Health Occupations Article, §§1-606, 5-205, 5-206, 5-311, 5-311.1, and 5-403(b), Annotated Code of Maryland Effective date: August 13, 2007 (34:16 Md. R. 1432) Chapter revised effective April 16, 2012 (39:7 Md. R. 495) Regulation .01 amended effective March 2, 2015 (42:4 Md. R. 434) Regulation .02B amended effective March 2, 2015 (42:4 Md. R. 434) Regulation .06A, B amended effective March 2, 2015 (42:4 Md. R. 434) Regulation .07 adopted effective March 2, 2015 (42:4 Md. R. 434)