House Bill 4185

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    Florida House of Representatives - 1998                HB 4185

        By Representative Lacasa






  1                      A bill to be entitled

  2         An act relating to dietetics and nutrition

  3         practice; amending s. 468.503, F.S.; revising

  4         definitions; amending s. 468.506, F.S.;

  5         revising qualifications for membership on the

  6         Dietetics and Nutrition Practice Council;

  7         providing applicability to current members;

  8         revising provisions relating to filling

  9         vacancies; amending s. 468.51, F.S.; providing

10         for licensure of nutrition counselors by

11         examination; providing requirements therefor

12         and providing for development of the

13         examination; amending s. 468.511, F.S.;

14         providing for a temporary permit to practice

15         nutrition counseling; amending s. 468.512,

16         F.S.; authorizing nutrition counselors to an

17         additional professional title; amending s.

18         468.513, F.S.; providing for licensure of

19         nutrition counselors by endorsement; amending

20         s. 468.516, F.S.; requiring certain referral

21         for nutrition counseling and assessment at the

22         patient's request; providing an effective date.

23

24  Be It Enacted by the Legislature of the State of Florida:

25

26         Section 1.  Section 468.503, Florida Statutes, is

27  amended to read:

28         468.503  Definitions.--As used in this part:

29         (1)  "Agency" means the Agency for Health Care

30  Administration.

31         (2)  "Board" means the Board of Medicine.

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    Florida House of Representatives - 1998                HB 4185

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  1         (3)(a)  "Dietetics and nutrition practice" means the

  2  integration and application of the principles derived from the

  3  sciences of nutrition, biochemistry, food, physiology, and

  4  management and from the behavioral and social sciences to

  5  achieve and maintain a person's health throughout the person's

  6  life. It is an integral part of preventive, diagnostic,

  7  curative, and restorative health care of individuals, groups,

  8  or both.

  9         (b)(4)  "Dietetics and nutrition practice" includes

10  shall include assessing nutrition needs and status using

11  appropriate data; recommending appropriate dietary regimens,

12  nutrition support, and nutrient intake; improving health

13  status through nutrition research, counseling, and education;

14  and developing, implementing, and managing nutrition care

15  systems, which includes, but is not limited to, evaluating,

16  modifying, and maintaining appropriate standards of high

17  quality in food and nutrition care services.

18         (4)(5)  "Dietetic technician" means a person who

19  assists in the provision of dietetic and nutrition services

20  under the supervision of a qualified professional.

21         (5)(6)  "Licensed dietitian/nutritionist" means a

22  person licensed pursuant to s. 468.509.

23         (6)(7)  "Licensed nutrition counselor" means a person

24  licensed pursuant to s. 468.51.

25         (7)(8)  "Nutrition assessment" means the evaluation of

26  the nutrition needs of individuals or groups, using

27  appropriate data to determine nutrient needs or status and

28  make appropriate nutrition recommendations.

29         (8)(9)  "Nutrition counseling" means advising, and

30  assisting, and educating individuals or groups on appropriate

31  nutrition intake, including food supplements, by integrating

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    Florida House of Representatives - 1998                HB 4185

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  1  information from an assessment of an individual's nutritional

  2  status the nutrition assessment.

  3         (9)(10)  "Preprofessional experience component" means a

  4  planned and continuous supervised practice experience in

  5  dietetics or nutrition. However, a person practicing as a

  6  dietitian must be supervised by a licensed

  7  dietitian/nutritionist, and a person practicing as a nutrition

  8  counselor must be supervised by a licensed nutrition

  9  counselor, a clinical nutritionist, or a physician licensed

10  under chapter 458, chapter 459, or chapter 460 who is trained

11  in clinical nutrition.

12         (10)(11)  "Registered dietitian" means an individual

13  registered with the Commission on Dietetic Registration, the

14  accrediting body of the American Dietetic Association.

15         Section 2.  Section 468.506, Florida Statutes, is

16  amended to read:

17         468.506  Dietetics and Nutrition Practice

18  Council.--There is created the Dietetics and Nutrition

19  Practice Council under the supervision of the board. The

20  council shall consist of four persons licensed under this part

21  and one consumer who is 60 years of age or older. Two of the

22  licensed members must be practicing dietitian/nutritionists,

23  the other two licensed members must be practicing nutrition

24  counselors, and the consumer member must be knowledgeable

25  about nutrition. Council members shall be appointed by the

26  board. Licensed members shall be appointed based on the

27  proportion of licensees within each of the respective

28  disciplines. Members shall be appointed for 4-year staggered

29  terms. In order to be eligible for appointment, each licensed

30  member must have been a licensee under this part for at least

31  3 years prior to his or her appointment. No council member

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    Florida House of Representatives - 1998                HB 4185

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  1  shall serve more than two successive terms. The board may

  2  delegate such powers and duties to the council as it may deem

  3  proper to carry out the operations and procedures necessary to

  4  effectuate the provisions of this part. However, the powers

  5  and duties delegated to the council by the board must

  6  encompass both dietetics and nutrition practice and nutrition

  7  counseling. Any time there is a vacancy on the council, the

  8  board shall elicit from each any professional association

  9  composed of persons licensed under this part its

10  recommendations for may recommend licensees to fill the

11  vacancy to the board in a number at least twice the number of

12  vacancies to be filled, and the board must may appoint from

13  the submitted lists list, in its discretion, a person from

14  among the any of those persons so recommended to fill each

15  vacancy. Any professional association composed of persons

16  licensed under this part may file an appeal regarding a

17  council appointment with the director of the agency, whose

18  decision shall be final. The board shall fix council members'

19  compensation and pay their expenses in the same manner as

20  provided in s. 455.207.

21         Section 3.  Section 468.51, Florida Statutes, is

22  amended to read:

23         468.51  Nutrition counselor; renewal of licensure;

24  licensure by examination.--

25         (1)  Any person previously certified as qualified by

26  the board and holding a license to practice as a nutrition

27  counselor in this state which was issued during the period

28  from July 1, 1988, to March 30, 1997, based upon documentation

29  that the person was employed as a practitioner of nutrition

30  counseling previous to and on April 1, 1988, shall be eligible

31  to renew his or her license pursuant to s. 468.514.

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    Florida House of Representatives - 1998                HB 4185

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  1         (2)(a)  Except for a person licensed under subsection

  2  (1), any person desiring to be licensed as a nutrition

  3  counselor shall apply to the agency to take the licensure

  4  examination.

  5         (b)  The agency shall examine any applicant who the

  6  board certifies has completed the application form and

  7  remitted the application and examination fees specified in s.

  8  468.508 and who:

  9         1.a.  Possesses a postbaccalaureate degree in human

10  nutritional science from a school or program accredited by the

11  United States Department of Education; and

12         b.  Has completed a preprofessional experience

13  component of not less than 900 hours with a licensed nutrition

14  counselor, a clinical nutritionist, or a physician licensed

15  under chapter 458, chapter 459, or chapter 460 who is trained

16  in clinical nutrition, or has education or experience

17  determined to be equivalent by the board; or

18         2.a.  Possesses a baccalaureate or postbaccalaureate

19  degree in a related field of study, including biochemistry,

20  physiology, health education, premedical studies, and any

21  other such area approved by the board, from a school or

22  program accredited, at the time of the applicant's graduation,

23  by the appropriate accrediting agency recognized by the United

24  States Department of Education;

25         b.  Has met additional certification requirements for

26  training in the field of nutrition science, as recommended by

27  an agency-approved advisory committee of licensed nutrition

28  counselors and approved by the board, which are substantially

29  equivalent to the requirements for a degree in nutrition under

30  subparagraph 1.; and

31

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    Florida House of Representatives - 1998                HB 4185

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  1         c.  Has completed a preprofessional experience

  2  component of not less than 900 hours with a licensed nutrition

  3  counselor, a clinical nutritionist, or a physician licensed

  4  under chapter 458, chapter 459, or chapter 460 who is trained

  5  in clinical nutrition, or has education or experience

  6  determined to be equivalent by the board; or

  7         3.a.  Has an academic degree, from another state or

  8  foreign country, that has been validated by an accrediting

  9  agency approved by the United States Department of Education

10  as equivalent to the baccalaureate or postbaccalaureate degree

11  conferred by an accredited college or university in the United

12  States;

13         b.  Has completed a major course of study in human

14  nutritional science, as recommended by the council and

15  approved by the board, which is substantially equivalent to

16  the course of study required for a degree in human nutritional

17  science under subparagraph 1.; and

18         c.  Has completed a preprofessional experience

19  component of not less than 900 hours with a licensed nutrition

20  counselor, a clinical nutritionist, a physician licensed under

21  chapter 458, chapter 459, or chapter 460 who is trained in

22  clinical nutrition, or any other comparably trained person

23  approved by the board, or has education or experience

24  determined to be equivalent by the board.

25         (c)  The agency shall license as a nutrition counselor

26  any applicant who has remitted the initial licensure fee and

27  has passed the examination in accordance with this subsection.

28         Section 4.  Section 468.511, Florida Statutes, is

29  amended to read:

30         468.511  Dietitian/nutritionist; Temporary permits

31  permit.--

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    Florida House of Representatives - 1998                HB 4185

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  1         (1)  DIETITIAN/NUTRITIONISTS.--

  2         (a)  A temporary permit to practice dietetics and

  3  nutrition may be issued by the board on the filing of an

  4  application, payment of a temporary permit fee, and the

  5  submission of evidence of the successful completion of the

  6  educational requirement under s. 468.509. The initial

  7  application shall be signed by the supervising licensee.

  8         (b)(2)  A person practicing dietetics and nutrition

  9  under a temporary permit shall be under the supervision and

10  direction of a licensed dietitian/nutritionist.

11         (c)(3)  A temporary permit to practice dietetics and

12  nutrition shall expire 1 year from the date of issuance.

13         (d)(4)  One extension of a temporary permit to practice

14  dietetics and nutrition may be granted for good cause shown.

15         (e)(5)  If the board determines that an applicant is

16  qualified to be licensed by endorsement under s. 468.513(1),

17  the board may issue the applicant a temporary permit to

18  practice dietetics and nutrition until the next board meeting

19  at which license applications are to be considered, but not

20  for a longer period of time.

21         (f)(6)  If the board determines that an applicant has

22  not passed an examination recognized by the board and is not

23  qualified to be licensed by endorsement, but has otherwise met

24  all the requirements of s. 468.509 and has made application

25  for the next scheduled examination, the board may issue the

26  applicant a temporary permit allowing him or her to practice

27  dietetics and nutrition under the supervision of a licensed

28  dietitian/nutritionist until notification of the results of

29  the examination.

30         (2)  NUTRITION COUNSELORS.--

31

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    Florida House of Representatives - 1998                HB 4185

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  1         (a)  A temporary permit to practice nutrition

  2  counseling may be issued by the board on the filing of an

  3  application, payment of a temporary permit fee, and the

  4  submission of evidence of the successful completion of the

  5  educational requirement under s. 468.51. The initial

  6  application shall be signed by the supervising licensee.

  7         (b)  A person practicing nutrition counseling under a

  8  temporary permit shall be under the supervision and direction

  9  of a licensed nutrition counselor.

10         (c)  A temporary permit to practice nutrition

11  counseling shall expire 1 year from the date of issuance.

12         (d)  One extension of a temporary permit to practice

13  nutrition counseling may be granted for good cause shown.

14         (e)  If the board determines that an applicant is

15  qualified to be licensed by endorsement under s. 468.513(2),

16  the board may issue the applicant a temporary permit to

17  practice nutrition counseling until the next board meeting at

18  which license applications are to be considered, but not for a

19  longer period of time.

20         (f)  If the board determines that an applicant has not

21  passed the examination required by the board and is not

22  qualified to be licensed by endorsement, but has otherwise met

23  all the requirements of s. 468.51(2) and has made application

24  for the next scheduled examination, the board may issue the

25  applicant a temporary permit allowing him or her to practice

26  nutrition counseling under the supervision of a licensed

27  nutrition counselor until notification of the results of the

28  examination.

29         Section 5.  Paragraph (b) of subsection (1) of section

30  468.512, Florida Statutes, is amended to read:

31         468.512  License to be displayed.--

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    Florida House of Representatives - 1998                HB 4185

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  1         (1)

  2         (b)  A licensed nutrition counselor may use the words

  3  "nutrition counselor," "licensed nutrition counselor,"

  4  "nutritionist," or "licensed nutritionist," or "licensed

  5  clinical nutritionist" in connection with the licensee's name

  6  or place of business, to denote licensure under this part.

  7         Section 6.  Section 468.513, Florida Statutes, is

  8  amended to read:

  9         468.513  Dietitian/nutritionist; Licensure by

10  endorsement.--

11         (1)  DIETITIAN/NUTRITIONISTS.--

12         (a)  The agency shall issue a license to practice

13  dietetics and nutrition by endorsement to any applicant who

14  the board certifies as qualified, upon receipt of a completed

15  application and the fee specified in s. 468.508.

16         (b)(2)  The board shall certify as qualified for

17  licensure by endorsement under this subsection section any

18  applicant who:

19         1.(a)  Presents evidence satisfactory to the board that

20  he or she is a registered dietitian; or

21         2.(b)  Holds a valid license to practice dietetics or

22  nutrition issued by another state, district, or territory of

23  the United States, if the criteria for issuance of such

24  license are determined by the board to be substantially

25  equivalent to or more stringent than those of this state.

26         (c)(3)  The agency shall not issue a license by

27  endorsement under this subsection section to any applicant who

28  is under investigation in any jurisdiction for any act which

29  would constitute a violation of this part or chapter 455 until

30  such time as the investigation is complete and disciplinary

31  proceedings have been terminated.

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    Florida House of Representatives - 1998                HB 4185

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  1         (2)  NUTRITION COUNSELORS.--

  2         (a)  The agency shall issue a license to practice

  3  nutrition counseling by endorsement to any applicant who the

  4  board certifies as qualified, upon receipt of a completed

  5  application and the fee specified in s. 468.508.

  6         (b)  The board shall certify as qualified for licensure

  7  by endorsement under this subsection any applicant who:

  8         1.  Presents evidence satisfactory to the board that he

  9  or she is a registered nutrition counselor; or

10         2.  Holds a valid license to practice nutrition

11  counseling issued by another state, district, or territory of

12  the United States, if the criteria for issuance of such

13  license are determined by the board to be substantially

14  equivalent to or more stringent than those of this state.

15         (c)  The agency shall not issue a license by

16  endorsement under this subsection to any applicant who is

17  under investigation in any jurisdiction for any act which

18  would constitute a violation of this part or chapter 455 until

19  such time as the investigation is complete and disciplinary

20  proceedings have been terminated.

21         Section 7.  Subsection (3) is added to section 468.516,

22  Florida Statutes, to read:

23         468.516  Practice requirements; referral by other

24  practitioners.--

25         (3)  A physician licensed under chapter 458, chapter

26  459, or chapter 460 must refer a patient to a licensed

27  dietitian/nutritionist or nutrition counselor for nutrition

28  counseling and assessment at the patient's request.

29         Section 8.  The new requirements for membership on the

30  Dietetics and Nutrition Practice Council set forth in s.

31  468.506, Florida Statutes, as amended by this act, are not

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    Florida House of Representatives - 1998                HB 4185

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  1  intended to affect the term of any current member of the

  2  council and shall instead be phased in as the terms of current

  3  members expire.

  4         Section 9.  The examination required under s.

  5  468.51(2), Florida Statutes, as created by this act, shall be

  6  developed by the Agency for Health Care Administration, in

  7  consultation with an agency-approved advisory committee of

  8  nutrition counselors licensed and practicing in this state,

  9  within 1 year after the effective date of this act.

10         Section 10.  This act shall take effect October 1 of

11  the year in which enacted.

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13            *****************************************

14                          HOUSE SUMMARY

15
      Revises various provisions of law relating to dietetics
16    and nutrition practice. Revises definitions. Revises
      qualifications for membership on the Dietetics and
17    Nutrition Practice Council and provides for applicability
      as the terms of current members expire. Revises
18    provisions relating to filling vacancies on the council.
      Provides for licensure of nutrition counselors by
19    examination and for development of the examination.
      Provides for a temporary permit to practice nutrition
20    counseling. Authorizes nutrition counselors to use an
      additional professional title. Provides for licensure of
21    nutrition counselors by endorsement. Requires any
      physician, osteopathic physician, or chiropractic
22    physician to refer a patient to a licensed
      dietitian/nutritionist or nutrition counselor for
23    nutrition counseling and assessment at the patient's
      request. See bill for details.
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