HB 2029

Present law prohibits a person from engaging in the practice of dietetics/nutrition, or to use letters or a title indicating or implying that such a person is a licensed dietician/nutritionist, unless such person holds a license and complies with the rul es. This bill clarifies that, generally, only a licensed dietician or licensed nutritionist may provide services that constitute medical nutrition therapy. Further, this bill makes a violation of such prohibition a Class A misdemeanor, punishable by imp ri sonment up to 11 months 29 days; a fine of $2,500 or less; or both. However, this prohibition on medical nutrition therapy does not apply to a person licensed to practice medicine or osteopathic medicine. Further, this bill does not limit or restrict an y of the following:  A person qualified and licensed to practice another health profession from engaging in the practice of medical nutrition therapy when incidental to the practice of that profession.  A student or trainee from engaging in the practice of medical nutrition therapy, as long as the student or trainee (i) practices as part of a course of study or as part of a planned, continuous supervised practice experience; (ii) practices no more than five years after completing the education requirements; (iii) practices only while supervised by a qualified supervisor; (iv) does not engage in the unrestricted practice of medical nutrition therapy; and (v) uses a title that clearly indicates the student or trainee is a student, intern, trainee, or supervisee.  A dietician or nutritionist that is serving in the armed forces or the United States public health service or who is employed by the United States veterans administration from engaging in the practice of medical nutrition therapy or using government-issued titles related to such service or employment.  A person performing an activity and service of a nutrition educator in the employment of a federal, state, county, or municipal agency, an elementary or secondary school, or accredited degree granting educational institution, insofar as such activity and service are part of a salaried position and the activity or service does not constitute the provision of medical nutrition therapy.  A person who is employed by this state, a county, a municipal agency, or a political subdivision, or a person who contracts with such, for the purpose of providing nutrition services for the special supplemental nutrition program for women, infants, and children (WIC) from providing nutrition care services utilizing the title of "nutritionist"" within the discharge of the person's official duty.  A person, who does not represent themselves using a title protected under this bill or present law, who is providing medical weight control for obesity for one of the following: (i) an instructional program that has been approved in writing by a dietician, nutritionist, or healthcare practitioner licensed in this state; or (ii) a plan of care that is overseen by a health care professional licensed in this state and authorized to delegate medical nutrition therapy as long as the medical weight control service is not discretionary and does not require the exercise professional judgment.  A person who disseminates non-individualized, written, general non-medical nutrition information in connection with the marketing and distribution of dietary supplements, foods, herbs, or food materials, as long as such information does not constitute medical nutrition therapy and the person does not use a title protected under this bill or present law.  A person who identifies as using earned, federally trademarked dietetic or nutrition credentials as long as the person does not represent the person's self-using general titles protected under this bill and present law and does not provide services that constitute medical nutrition therapy.  A person who provides individualized nutrition recommendations for the wellness and primary prevention of chronic disease, health coaching, holistic and wellness education, guidance, motivation, behavior change management, services for non-medical weight control, or other nutrition care services if (i) the service does not constitute medical nutrition therapy; (ii) the person does not represent the person's self-using titles protected under this bill or present law; and (iii) the person does not hold the person's self out as licensed or qualified to practice medical nutrition therapy.  An out-of-state dietician or nutritionist who provides medical nutrition therapy services via telehealth to a patient located in this state if the out-of-state practitioner is a dietician or nutritionist, is licensed or certified in good standing in any state, and (i) works in consultation with a medical nutrition therapy provider licensed in this state who has a practitioner-patient relationship with the patient; (ii) provides services to a patient whom the practitioner has a current practitioner-patient relationship and the patient is temporarily in this state; or (iii) provides services pursuant to a current practitioner-patient relationship and such care is limited to either a temporary or short-term follow-up medical nutrition therapy service to ensure continuity of care. QUALIFIED SUPERVISOR This bill prohibits students and trainees from practicing nutrition care services unless they are under the supervision of a qualified supervisor. A qualified supervisor must (i) verify, direct, and approve the nutrition care services provided by a stud ent or trainee; (ii) develop and implement a program for advancing and optimizing the quality of care provided by the student or trainee; (iii) oversee, approve, and accept responsibility for the nutrition care services rendered by the student or trainee; ( iv) review on a regular basis the charts, records, and clinical notes of the student or trainee; and (v) maintain responsibility for the student or trainee's clinical record keeping. If the student or trainee is providing medical nutrition therapy, then a qualified supervisor must also (i) be licensed or certified in the state as a dietician, nutritionist, dietician nutritionist, or healthcare provider; (ii) meet any other criteria as established by the board of dietician or nutritionist examiners; or (i ii ) be a dietician or nutritionist who is serving in the armed forces or the United States public health service or is employed by the United States veteran's administration. This bill prohibits a qualified supervisor from supervising a clinical activity or nutrition care service that such supervisor is not authorized to perform. Further, the qualified supervisor must limit the assignment of nutrition care services to those that are within the training and experience of the student or trainee. This bill requires the qualified supervisor and the student or trainee to identify and document the (i) goals for the supervised practice experience; (ii) the assignment of clinical tasks as appropriate to the student or trainee's evolving level of competence; (iii) the student or trainee's relationship and access t o the qualified supervisor; and (iv) a process for evaluating the student or trainee's performance. Further, the qualified supervisor must remain on-site or be continuously available via two-wa y, real-time audiovisual technology during the provision of nutrition care services. If the services are to be provided in a location where the qualified supervisor is not routinely present, then the qualified supervisor must ensure the methods of superv ision are adequate to ensure appropriate patient care. If a patient requests a qualified supervisor to be available during the provision of nutrition care services by a student or trainee, then the qualified supervisor must generally be available. Howev er, if the qualified supervisor is not available, such qualified supervisor may arrange for another qualified supervisor to be made available. BOARD OF DIETICIAN AND NUTRITIONIST EXAMINERS Present law creates the board of dietician/nutritionist examiners to be made up of five members appointed by the governor. This bill, instead, creates the board of dietician and nutritionist examiners (""board""), to consist of nine members appointed by t he governor. Five members must be licensed dieticians, two must be licensed nutritionists, one must be a licensed physician, and one must be a non-healthcare professional appointed to represent the public at large. Licensed dieticians and nutritionists ap pointed to the board must represent one of the following areas of practice: (i) dietetics management; (ii) clinical dietetics or nutrition; (iii) dietetics or nutrition education; (iv) community nutrition; or (iv) consultation and private practice. Appoi ntments to the board may be made from lists of qualified persons submitted to the governor by an interested dietician, nutritionist, hospital group, or medical group. For initial appointments to the board, three members are appointed to four-year terms, th ree members are appointed to three-year terms, and three members are appointed for two-year terms. After the initial appointments, all regular appointments are for three-year terms. However, members may not serve more than two consecutive terms. The go vernor must strive to reflect the geographic, racial, ethnic, gender, and cultural diversity of this state in making appointments to the board. In addition to duties of the board as set out in present law, this bill requires the board to receive and process complaints and investigate alleged violations; administer and participate in the Dieticians Licensure Compact, permit the authority to pract ice dietetics and nutrition as provided for by such compact; and conduct national background checks by the submission of fingerprints to the federal bureau of investigation. However, the board is prohibited from sharing any background check reports with en tities outside of this state. LICENSURE AS A DIETICIAN Present law provides basic requirements for licensure as a dietician/nutritionist. This bill provides specific requirements for licensure as a dietician or as a nutritionist and expands on the requirements in present law. To be licensed as a dietician, this bill requires an applicant to show that they are capable and professionally competent to safely engage in the practice of dietetics and nutrition and that they show either of the following:  That the applicant has completed (i) a master's degree or doctoral degree and a program of study accredited by the Accreditation Council for Education in Nutrition and Dietetics (ACEND), or its successor organization; (ii) a planned, continuous supervised practice experience in the practice of dietetics and the practice of nutrition approved by the board and accredited by ACEND, that involves at least 1, 000 hours of supervised practice experience under a qualified supervisor; and (iii) the registration examination for dieticians administered by the Commission on Dietetic Registration.  That the applicant holds a valid current registration with the Commission on Dietetic Registration that gives the applicant the right to use the title ""registered dietician"" or ""registered dietician nutritionist."" This bill clarifies that a person licensed as a dietician or who has applied for such a license prior to July 1, 2026, remains licensed, eligible for reactivation as a dietician, or eligible for licensure under the requirements in place prior to July 1, 2026, as long as the applicant or licensee remains in good standing and maintains an active license or retired status. LICENSURE AS A NUTRITIONIST In order to be licensed as a nutritionist, this bill requires an applicant to show that they are capable and professionally competent to safely engage in the practice of nutrition and submit proof of completion of all of the following:  A master's or doctoral degree with a major in human nutrition, foods and nutrition, community nutrition, public health nutrition, nutrition education, nutrition, nutrition science, clinical nutrition, applied clinical nutrition, nutrition counseling, nutrition and functional medicine, nutritional biochemistry, nutrition and integrative health, a comparable titled major in a master's program, or a doctoral degree in a field of clinical health care. The coursework must have included (i) 15 semester hours of clinical or life sciences, including at least three semester hours on human anatomy and physiology; and (ii) 15 semester hours of nutrition and metabolism, including at least six semester hours in biochemistry.  A planned, continuous supervised practice experience demonstrating competence in the practice of nutrition, as described below.  The examination requirements by demonstrating (i) passage of the certified nutrition specialist examination administered by the Board for Certification of Nutrition Specialists or an equivalent examination that is approved by the board; or (ii) that the applicant holds a valid current certification with the Board for Certification of Nutrition Specialists that gives the applicant the right to use the title ""certified nutrition specialist."" Further, this bill generally requires applicants for licensure as a nutritionist to complete a supervised practice experience under a qualified supervisor within five years of completing the above-described requirements. The supervised practice experien ce must have at least 1, 000 hours, with a minimum of 200 hours in each of the following practice areas: (i) nutrition assessment, (ii) nutrition intervention, and (iii) nutrition monitoring and evaluation. TEMPORARY PERMITS Present law authorizes the issuance of licenses to applicants who present proof of current licensure, certification, or registration as a dietician or nutritionist under the laws of another state if the education, experiential, and examination qualificat ions and requirements are substantially equivalent to those in this state. This bill grants the board the same authorization. Present law also authorizes the issuance of temporary permits to practice dietetics/nutrition to an applicant who submits proof t hat they have (i) successfully completed the academic and experiential requirements; (ii) applied for or taken a licensing examination; and (iii) has paid the required fee. This bill grants the board the same authorization. However, this bill clarifies that a temporary dietician permit allows an applicant to practice under the supervision of a licensed dietician and that a temporary nutritionist permit allows an applicant to practice under the supervision of a licensed dietician or nutritionist. DISCIPLINARY ACTIONS Present law authorizes the board of board of dietician/nutritionist examiners to deny a license, refuse to renew a license, suspend a license, revoke a license or permit, and discipline an applicant, licensee, permittee, or other person under certain con ditions. This bill grants that same power to the new board. INJUNCTIONS This bill grants the board the ability to seek injunctive relief for a temporary or permanent restraining order or injunction enjoining violations of this bill or present law. RULEMAKING This bill authorizes the board to promulgate rules to effectuate this bill."