Florida Senate - 2015 SB 1208
By Senator Bean
4-01067-15 20151208__
1 A bill to be entitled
2 An act relating to dietetics and nutrition; amending
3 s. 468.502, F.S.; revising the purpose and intent of
4 the Dietetics and Nutrition Practice Act; amending s.
5 468.503, F.S.; revising and providing definitions;
6 amending s. 468.504, F.S.; prohibiting the unlicensed
7 practice of medical nutrition therapy; amending s.
8 468.505, F.S.; conforming provisions; authorizing
9 certain certified individuals to use specified titles
10 and designations; amending s. 468.506, F.S.; renaming
11 the Dietetics and Nutrition Practice Council as the
12 Dietetics and Nutrition Practice Board; revising
13 provisions regarding membership of the board;
14 requiring certain board members to apply for licensure
15 within a specified time period; amending s. 468.509,
16 F.S.; requiring the board to waive the examination
17 requirement for specified applicants; conforming
18 provisions; amending s. 468.511, F.S.; making
19 editorial changes; amending s. 468.513, F.S.; revising
20 requirements for licensure by endorsement; conforming
21 provisions; amending s. 468.516, F.S.; providing that
22 a licensed dietitian or nutritionist treating a
23 patient who is under the active care of a licensed
24 physician or licensed chiropractor is not precluded
25 from ordering a therapeutic diet; amending ss.
26 468.514, 468.515, and 468.518, F.S.; conforming
27 provisions; providing an effective date.
28
29 Be It Enacted by the Legislature of the State of Florida:
30
31 Section 1. Section 468.502, Florida Statutes, is reordered
32 and amended to read:
33 468.502 Purpose and intent.—The Legislature finds that the
34 practice of dietetics and nutrition or nutrition counseling
35 plays an important part in promoting the maintenance and
36 improvement of health. The Legislature further finds that such
37 practice by unskilled and incompetent practitioners presents a
38 danger to the public health and safety. The Legislature further
39 finds that it is difficult for the public to make informed
40 choices about dietitians and nutritionists and that the
41 consequences of wrong choices could seriously endanger the
42 public health and safety. The sole legislative purpose in
43 enacting this part is to ensure that every person who practices
44 dietetics and nutrition or nutrition counseling in this state
45 meets minimum requirements for safe practice. It is the
46 legislative intent that any person practicing dietetics and
47 nutrition or nutrition counseling who falls below minimum
48 competency or who otherwise presents a danger to the public be
49 prohibited from practicing in this state. It is also the intent
50 of the Legislature that the practice of nutrition counseling be
51 authorized and regulated solely within the limits expressly
52 provided by this part and any rules adopted pursuant thereto.
53 Section 2. Section 468.503, Florida Statutes, is reordered
54 and amended to read:
55 468.503 Definitions.—As used in this part:
56 (1) “Agency” means the Agency for Health Care
57 Administration.
58 (1)(2) “Board” means the Dietetics and Nutrition Practice
59 Board of Medicine.
60 (2) “Commission” means the Commission on Dietetic
61 Registration, the accrediting body of the Academy of Nutrition
62 and Dietetics.
63 (3) “Department” means the Department of Health.
64 (4)(3) “Dietetics” means the integration and application of
65 the principles derived from the sciences of nutrition,
66 biochemistry, food, physiology, and management and from the
67 behavioral and social sciences to achieve and maintain a
68 person’s health throughout the person’s life. It is an integral
69 part of preventive, diagnostic, curative, and restorative health
70 care of individuals, groups, or both.
71 (5)(4) “Dietetics and nutrition practice” includes the use
72 of the nutrition care process for shall include assessing
73 nutrition needs and status using appropriate data; recommending
74 appropriate dietary regimens, medical nutrition therapy, food
75 and prescription drug interactions, nutrition support, and
76 nutrient intake; ordering therapeutic diets; improving health
77 status through nutrition research, counseling, and education;
78 and developing, implementing, and managing nutrition care
79 systems, which includes, but is not limited to, evaluating,
80 modifying, and maintaining appropriate standards of high quality
81 in food and nutrition care services.
82 (9)(5) “Nutrition and dietetics Dietetic technician,
83 registered” means a person who has an associate or baccalaureate
84 degree in nutrition, food and nutrition, dietetics, food
85 management, or an equivalent major course of study, from a
86 school or program that is accredited at the time of graduation
87 by an accrediting body recognized by the United States
88 Department of Education, who assists in the provision of
89 dietetic and nutrition services under the supervision of a
90 qualified professional, and who is registered with the
91 commission.
92 (6) “Licensed dietitian or nutritionist
93 dietitian/nutritionist” means a person licensed pursuant to s.
94 468.509.
95 (7) “Licensed nutrition counselor” means a person licensed
96 pursuant to s. 468.51.
97 (8) “Medical nutrition therapy” means the use of specific
98 nutrition services for the purpose of disease management or to
99 treat or rehabilitate an illness, injury, or condition.
100 (10)(8) “Nutrition assessment” means the systematic process
101 of obtaining, verifying, and interpreting biochemical,
102 anthropometric, physical, and dietary data to make decisions
103 about the nature and cause of nutrition-related problems.
104 Nutrition assessment involves initial data collection,
105 reassessment, and analysis of client or community needs and
106 provides the foundation for nutrition diagnosis and nutritional
107 recommendations, including enteral and parenteral nutrition
108 evaluation of the nutrition needs of individuals or groups,
109 using appropriate data to determine nutrient needs or status and
110 make appropriate nutrition recommendations.
111 (11) “Nutrition care process” means the systematic problem
112 solving method that dietitians and nutritionists use when
113 providing medical nutrition therapy, addressing nutrition
114 related problems, and providing safe, effective, and high
115 quality care. The nutrition care process includes four distinct,
116 but interrelated steps, including nutrition assessment,
117 nutrition diagnosis, nutrition intervention, and nutrition
118 monitoring and evaluation. As used in this subsection,
119 “nutrition monitoring and evaluation” means identifying patient
120 outcomes relevant to the nutrition diagnosis and nutrition
121 intervention plans and goals, comparing such outcomes with the
122 patient’s status or intervention goals before treatment or with
123 a reference standard to determine the progress made in achieving
124 the desired outcome of nutrition care, and whether planned
125 nutrition interventions should be continued or revised.
126 (12)(9) “Nutrition counseling” means advising and assisting
127 individuals or groups on appropriate nutrition intake by
128 integrating information from the nutrition assessment with
129 information about food, other sources of nutrients, and meal
130 preparation while considering cultural background and
131 socioeconomic status.
132 (13) “Nutrition diagnosis” means the identification of
133 nutritional problems that a licensed or registered dietician or
134 nutritionist is responsible for treating independently.
135 (14) “Nutrition intervention” means planned actions
136 intended to positively change a nutrition-related behavior, risk
137 factor, environmental condition, or aspect of health status for
138 an individual and his or her family or caregivers, target
139 groups, or the community at large.
140 (15)(10) “Preprofessional experience component” means at
141 least 900 hours of a planned and continuous supervised practice
142 experience in dietetics or nutrition.
143 (16)(11) “Registered dietitian” or “registered
144 nutritionist” means an individual registered with the commission
145 on Dietetic Registration, the accrediting body of the American
146 Dietetic Association.
147 Section 3. Section 468.504, Florida Statutes, is amended to
148 read:
149 468.504 License required.—No person may practice medical
150 nutrition therapy or engage for remuneration in dietetics and
151 nutrition practice or nutrition counseling or hold himself or
152 herself out as a practitioner of dietetics and nutrition
153 practice or nutrition counseling unless the person is licensed
154 in accordance with the provisions of this part.
155 Section 4. Paragraphs (b), (c), (d), (f), (j), (k), and (m)
156 of subsection (1) and subsections (2) and (4) of section
157 468.505, Florida Statutes, are amended to read:
158 468.505 Exemptions; exceptions.—
159 (1) Nothing in this part may be construed as prohibiting or
160 restricting the practice, services, or activities of:
161 (b) A person employed as a dietitian or nutritionist by the
162 government of the United States, if the person engages in
163 dietetics solely under direction or control of the organization
164 by which the person is employed.
165 (c) A person employed as an extension agent specializing in
166 family and consumer services a cooperative extension home
167 economist.
168 (d) A person pursuing a course of study leading to a degree
169 in dietetics and nutrition from a program or school accredited
170 pursuant to s. 468.509(2), if the activities and services
171 constitute a part of a supervised course of study and if the
172 person is designated by a title that clearly indicates the
173 person’s status as a student, intern, or trainee.
174 (f) Any dietitian or nutritionist from another state
175 practicing dietetics or nutrition incidental to a course of
176 study when taking or giving a postgraduate course or other
177 course of study in this state, provided such dietitian or
178 nutritionist is licensed in another jurisdiction or is a
179 registered dietitian or nutritionist or holds an appointment on
180 the faculty of a school accredited pursuant to s. 468.509(2).
181 (j) Any person who provides weight control services or
182 related weight control products, provided the program has been
183 reviewed by, consultation is available from, and no program
184 change can be initiated without prior approval by a licensed
185 dietitian or nutritionist dietitian/nutritionist, a dietitian or
186 nutritionist licensed in another state that has licensure
187 requirements considered by the council to be at least as
188 stringent as the requirements for licensure under this part, or
189 a registered dietitian or nutritionist.
190 (k) A person employed by a hospital licensed under chapter
191 395, by a nursing home licensed under part II of chapter 400, by
192 an assisted living facility licensed under chapter 429, or by a
193 continuing care facility certified under chapter 651, if the
194 person is employed in compliance with the laws and rules adopted
195 thereunder regarding the operation of its dietetic or nutrition
196 dietetic department.
197 (m) A person employed as a nutrition and dietetics dietetic
198 technician, registered.
199 (2) Nothing in this part may be construed to prohibit or
200 limit any person from the free dissemination of information
201 through, or from conducting a class, or seminar, or giving a
202 speech, related to nutrition.
203 (4) Notwithstanding any other provision of this part, an
204 individual registered by the commission on Dietetic Registration
205 of the American Dietetic Association has the right to use the
206 title “Registered Dietitian,” “Registered Nutritionist,” and the
207 designation “R.D.N.” “R.D.” An individual certified by the
208 Certification Board for Nutrition Specialists has the right to
209 use the title “Certified Nutrition Specialist” and the
210 designation “CNS” and an individual certified by the American
211 Clinical Board of Nutrition has the right to use the title
212 “Diplomate of the American Clinical Board of Nutrition” and use
213 the designation “DACBN.”
214 Section 5. Section 468.506, Florida Statutes, is amended to
215 read:
216 468.506 Dietetics and Nutrition Practice Board Council.
217 There is created the Dietetics and Nutrition Practice Board
218 Council under the supervision of the board. The board council
219 shall consist of six four persons licensed under this part and
220 one consumer. At least one member of the board shall be who is
221 60 years of age or older. Board Council members shall be
222 appointed by the Governor board. Licensed members shall be
223 appointed based on the proportion of licensees within each of
224 the respective disciplines. Members shall be appointed for 4
225 year staggered terms. In order to be eligible for appointment,
226 each licensed member must have been a licensee under this part
227 for at least 3 years before prior to his or her appointment. An
228 initial board member for a newly added discipline is eligible to
229 be licensed and shall apply for licensure within 1 year after
230 October 1, 2015. No board council member shall serve more than
231 two successive terms. The board may delegate such powers and
232 duties to the council as it may deem proper to carry out the
233 operations and procedures necessary to effectuate the provisions
234 of this part. However, the powers and duties delegated to the
235 council by the board must encompass both dietetics and nutrition
236 practice and nutrition counseling. Any time there is a vacancy
237 on the board council, any professional association composed of
238 persons licensed under this part may recommend licensees to fill
239 the vacancy to the Governor board in a number at least twice the
240 number of vacancies to be filled, and the Governor board may
241 appoint from the submitted list, in his or her its discretion,
242 any of those persons so recommended. Any professional
243 association composed of persons licensed under this part may
244 file an appeal regarding a board council appointment with the
245 State Surgeon General, whose decision shall be final. The board
246 shall fix council members’ compensation and pay their expenses
247 in the same manner as provided in s. 456.011.
248 Section 6. Section 468.509, Florida Statutes, is amended to
249 read:
250 468.509 Dietitian or nutritionist; Dietitian/nutritionist;
251 requirements for licensure.—
252 (1) Any person desiring to be licensed as a dietitian or
253 nutritionist dietitian/nutritionist shall apply to the
254 department agency to take the licensure examination.
255 (2) The department agency shall examine any applicant who
256 the board certifies has completed the application form and
257 remitted the application and examination fees specified in s.
258 468.508 and who:
259 (a)1. Possesses a baccalaureate or postbaccalaureate degree
260 with a major course of study in human nutrition, food and
261 nutrition, dietetics, or food management, or an equivalent major
262 course of study, from a school or program accredited, at the
263 time of the applicant’s graduation, by the appropriate
264 accrediting body agency recognized by the Commission on
265 Recognition of Postsecondary Accreditation and the United States
266 Department of Education; and
267 2. Has completed a preprofessional experience component of
268 not less than 900 hours or has education or experience
269 determined to be equivalent by the board; or
270 (b)1. Has an academic degree, from a foreign country, that
271 has been validated by an accrediting body agency approved by the
272 United States Department of Education as equivalent to the
273 baccalaureate or postbaccalaureate degree conferred by a
274 regionally accredited college or university in the United
275 States;
276 2. Has completed a major course of study in human
277 nutrition, food and nutrition, dietetics, or food management;
278 and
279 3. Has completed a preprofessional experience component of
280 at least not less than 900 hours or has education or experience
281 determined to be equivalent by the board.
282 (3) The board shall waive the examination requirement for
283 an applicant who presents evidence satisfactory to the board
284 that the applicant is:
285 (a) A registered dietitian or nutritionist who is
286 registered with the commission and in compliance with all of the
287 qualifications as stated in chapter 468 or chapter 509; or
288 (b) A certified nutrition specialist who is certified by
289 the Certification Board for Nutrition Specialists or who is a
290 Diplomate of the American Clinical Board of Nutrition and who is
291 in compliance with the qualifications under this section.
292 (4) The department agency shall license as a dietitian or
293 nutritionist dietitian/nutritionist any applicant who has
294 remitted the initial licensure fee and has passed the
295 examination in accordance with this section.
296 Section 7. Subsection (6) of section 468.511, Florida
297 Statutes, is amended to read:
298 468.511 Dietitian or nutritionist Dietitian/nutritionist;
299 temporary permit.—
300 (6) If the board determines that an applicant has not
301 passed an examination recognized by the board and is not
302 qualified to be licensed by endorsement, but has otherwise met
303 all the requirements of s. 468.509 and has applied made
304 application for the next scheduled examination, the board may
305 issue the applicant a temporary permit allowing him or her to
306 practice dietetics and nutrition under the supervision of a
307 licensed dietitian or nutritionist dietitian/nutritionist until
308 notification of the results of the examination.
309 Section 8. Section 468.513, Florida Statutes, is amended to
310 read:
311 468.513 Dietitian or nutritionist Dietitian/nutritionist;
312 licensure by endorsement.—
313 (1) The department agency shall issue a license to practice
314 dietetics and nutrition by endorsement to any applicant who the
315 board certifies as qualified, upon receipt of a completed
316 application and the fee specified in s. 468.508.
317 (2) The board shall certify as qualified for licensure by
318 endorsement under this section any applicant who complies with
319 the licensure requirements under s. 468.509 and:
320 (a) Presents evidence satisfactory to the board that he or
321 she is a registered dietitian; or
322 (b) holds a valid license to practice dietetics or
323 nutrition issued by another state, district, or territory of the
324 United States, if the criteria for issuance of such license are
325 determined by the board to be substantially equivalent to or
326 more stringent than those of this state.
327 (3) The department agency shall not issue a license by
328 endorsement under this section to any applicant who is under
329 investigation in any jurisdiction for any act which would
330 constitute a violation of this part or chapter 456 until such
331 time as the investigation is complete and disciplinary
332 proceedings have been terminated.
333 Section 9. Section 468.514, Florida Statutes, is amended to
334 read:
335 468.514 Renewal of license.—
336 (1) The department agency shall renew a license under this
337 part upon receipt of the renewal application, fee, and proof of
338 the successful completion of continuing education requirements
339 as determined by the board.
340 (2) The department agency shall adopt rules establishing a
341 procedure for the biennial renewal of licenses under this part.
342 Section 10. Subsection (1) of section 468.515, Florida
343 Statutes, is amended to read:
344 468.515 Inactive status.—
345 (2) The department agency shall reactivate a license under
346 this part upon receipt of the reactivation application, fee, and
347 proof of the successful completion of continuing education
348 prescribed by the board.
349 Section 11. Subsection (3) is added to section 468.516,
350 Florida Statutes, to read:
351 468.516 Practice requirements.—
352 (3) This section does not preclude a licensed dietitian or
353 nutritionist from independently ordering a therapeutic diet if
354 otherwise authorized to order such a diet in this state.
355 Section 12. Paragraph (a) of subsection (1) and subsection
356 (3) of section 468.518, Florida Statutes, are amended to read:
357 468.518 Grounds for disciplinary action.—
358 (1) The following acts constitute grounds for denial of a
359 license or disciplinary action, as specified in s. 456.072(2):
360 (a) Violating any provision of this part, any board or
361 department agency rule adopted pursuant thereto, or any lawful
362 order of the board or department agency previously entered in a
363 disciplinary hearing held pursuant to this part, or failing to
364 comply with a lawfully issued subpoena of the department agency.
365 The provisions of this paragraph also apply to any order or
366 subpoena previously issued by the department of Health during
367 its period of regulatory control over this part.
368 (3) The department agency shall reissue the license of a
369 disciplined dietitian or nutritionist dietitian/nutritionist or
370 nutrition counselor upon certification by the board that the
371 disciplined dietitian or nutritionist dietitian/nutritionist or
372 nutrition counselor has complied with all of the terms and
373 conditions set forth in the final order.
374 Section 13. This act shall take effect July 1, 2015.