By Sibley S.B. No. 1269
77R4553 PB-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the licensing and regulation of clinical nutritionists;
1-3 providing a criminal penalty.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Subtitle M, Title 3, Occupations Code, is amended
1-6 by adding Chapter 703 to read as follows:
1-7 CHAPTER 703. LICENSED CLINICAL NUTRITIONISTS
1-8 SUBCHAPTER A. GENERAL PROVISIONS
1-9 Sec. 703.001. SHORT TITLE. This chapter may be cited as the
1-10 Licensed Clinical Nutritionist Act.
1-11 Sec. 703.002. DEFINITIONS. In this chapter:
1-12 (1) "Board of health" means the Texas Board of Health.
1-13 (2) "Clinical nutrition" means the health professional
1-14 discipline that applies principles derived from current nutritional
1-15 knowledge and biochemical and physiological scientific knowledge to
1-16 promote optimal health.
1-17 (3) "Clinical nutrition practice" means the practice
1-18 of clinical nutrition according to the guidelines set forth in the
1-19 scope of practice of clinical nutrition adopted under this article.
1-20 (4) "Clinical nutritionist" means a health
1-21 professional who applies clinical nutrition principles.
1-22 (5) "Commissioner" means the commissioner of public
1-23 health.
1-24 (6) "Department" means the Texas Department of Health.
2-1 (7) "Institution of higher education" has the meaning
2-2 assigned by Section 61.003, Education Code.
2-3 (8) "Licensed clinical nutritionist" means a person
2-4 licensed under this chapter.
2-5 (9) "Medical nutrition therapy" means the assessment
2-6 of a patient's nutritional status followed by nutritional therapies
2-7 when that assessment and therapy is prescribed by a physician and
2-8 is reimbursable under a health benefits plan.
2-9 (10) "Nutritional assessment" means the evaluation of
2-10 individual and group nutritional needs, recognizing biochemical
2-11 individuality, to determine factors necessary to restore or
2-12 maintain healthy physiological function. The term includes the use
2-13 of appropriate tests and observations interpreted in terms of
2-14 optimal values and nutrition and lifestyle analysis to determine an
2-15 appropriate nutritional program, including:
2-16 (A) a case history;
2-17 (B) anthropomorphic measurements;
2-18 (C) physical signs; and
2-19 (D) biochemical data, including laboratory
2-20 tests.
2-21 (11) "Nutritional counseling" means communication of
2-22 the various aspects of clinical nutrition background information
2-23 and assessments, including:
2-24 (A) previously poor health habits, including
2-25 diet;
2-26 (B) evaluation of appropriate tests and
2-27 laboratory assessments to demonstrate individual differences that
3-1 produce a decline in good health; and
3-2 (C) the recommendation of an appropriate diet
3-3 and supplementation program, including micronutrients,
3-4 macronutrients, herbs, amino acids, trace elements, and
3-5 metabolites.
3-6 (12) "Nutritional supplements" include food, vitamins,
3-7 minerals, botanicals, nutraceuticals, glandulars, amino acids,
3-8 trace elements, chemical supplements, homeopathic remedies,
3-9 macronutrients, micronutrients, herbs, and metabolites designed to
3-10 augment clinical deficiencies in the human body.
3-11 (13) "Nutritionists board" means the Texas State Board
3-12 of Examiners of Clinical Nutritionists.
3-13 (14) "Provisionally licensed clinical nutritionist"
3-14 means a person who holds a provisional license issued under this
3-15 chapter.
3-16 (15) "Supervision" means control exercised over a
3-17 student, assistant, or technician working within the same facility
3-18 as the supervising clinical nutritionist.
3-19 Sec. 703.003. CLINICAL NUTRITION PRACTICE. (a) Clinical
3-20 nutrition is a specialization in the science of nutrition that
3-21 requires an understanding of nutrition biochemistry that enables
3-22 the practitioner to competently assess and evaluate signs of
3-23 nutritional deficiency or imbalance, through the use or disuse of
3-24 specific foods, vitamins, minerals, herbs, amino acids, trace
3-25 elements, glandulars, or other substances as necessary to maintain
3-26 optimal health.
3-27 (b) Clinical nutrition is practiced through a
4-1 client-counselor relationship and requires knowledge of:
4-2 (1) basic concepts of human physiology derived from
4-3 medical and scientific literature;
4-4 (2) basic human anatomy derived from medical and
4-5 nutritional texts;
4-6 (3) nutrient roles and functions derived from medical
4-7 and scientific literature;
4-8 (4) human nutritional requirements to:
4-9 (A) provide individual client guidelines; and
4-10 (B) implement lifestyle modifications;
4-11 (5) the effects of nutritional imbalances, both
4-12 deficiencies and excesses, derived from clinical evaluation and
4-13 research findings;
4-14 (6) medical and scientific terminology;
4-15 (7) pharmacological and environmental effects on
4-16 nutritional status derived from findings from medical and
4-17 scientific literature;
4-18 (8) the effects of socioeconomic influence, food
4-19 selection, and food preparation on the nutritional status of
4-20 clients;
4-21 (9) the process of nutritional assessment and
4-22 evaluation through the use of appropriate clinical tests based on
4-23 previously collected data to document or confirm suspected
4-24 nutritional deviations or abnormalities;
4-25 (10) pertinent anatomical characteristics relevant to
4-26 nutritional status, including a client's weight, height, posture,
4-27 body fat, and musculature;
5-1 (11) the process of evaluation and interpretation of a
5-2 client's clinical data by careful analysis and application of
5-3 clinical judgment to formulate an appropriate nutritional protocol;
5-4 (12) nutritional counseling skills and case
5-5 management;
5-6 (13) referral practices and skills for referring the
5-7 client to another licensed health care practitioner; and
5-8 (14) office management, state and federal laws, and
5-9 liability insurance acquired by reading the state and federal
5-10 codes, statutes, and laws and seeking legal counsel.
5-11 (c) Engaging in practice as a clinical nutritionist as
5-12 described by this chapter does not constitute the practice of
5-13 medicine as defined by state law.
5-14 Sec. 703.004. SUNSET PROVISION. The Texas State Board of
5-15 Examiners of Clinical Nutritionists is subject to Chapter 325,
5-16 Government Code (Texas Sunset Act). Unless continued in existence
5-17 as provided by that chapter, the nutritionists board is abolished
5-18 and this chapter expires September 1, 2005.
5-19 SUBCHAPTER B. BOARD OF EXAMINERS OF CLINICAL NUTRITIONISTS
5-20 Sec. 703.051. BOARD; MEMBERSHIP. (a) The Texas State Board
5-21 of Examiners of Clinical Nutritionists consists of nine members
5-22 appointed by the governor with the advice and consent of the senate
5-23 as follows:
5-24 (1) three members who are clinical nutritionists who
5-25 hold a license issued under this chapter, who do not have an
5-26 additional primary practice, and who have been licensed under this
5-27 chapter for at least the three years preceding the person's
6-1 appointment to the nutitionists board;
6-2 (2) three members who are health care practitioners,
6-3 as described by Subsection (c) of this section; and
6-4 (3) three members who represent the public.
6-5 (b) Appointments to the nutritionists board shall be made
6-6 without regard to the race, color, disability, sex, religion, age,
6-7 or national origin of the appointee.
6-8 (c) The professional discipline of clinical nutrition
6-9 includes six primary areas of expertise: clinical, educational,
6-10 research, management, consultation, and community service. In
6-11 appointing health care practitioners to the nutritionists board,
6-12 the governor shall consider the broad spectrum of health care
6-13 practitioners who practice clinical nutrition in those areas of
6-14 expertise and attempt to achieve a continuing balance of
6-15 representation among those practitioners. Health care
6-16 practitioners eligible for appointment under Subsection (a)(2)
6-17 include physicians, chiropractors, dentists, and clinical
6-18 nutritionists. To be eligible for appointment under Subsection
6-19 (a)(2), the appointee must have at least two years of experience in
6-20 clinical nutrition practice, clinical nutrition education, or
6-21 clinical nutrition research.
6-22 Sec. 703.052. ELIGIBILITY OF PUBLIC MEMBERS. A person is not
6-23 eligible for appointment as a public member of the nutritionists
6-24 board if the person or the person's spouse:
6-25 (1) is registered, certified, or licensed by a
6-26 regulatory agency in the field of clinical nutrition;
6-27 (2) is employed by or participates in the management
7-1 of a business entity or other organization regulated by or
7-2 receiving money from the nutritionists board;
7-3 (3) owns or controls, directly or indirectly, more
7-4 than a 10 percent interest in a business entity or other
7-5 organization regulated by or receiving money from the nutritionists
7-6 board; or
7-7 (4) uses or receives a substantial amount of tangible
7-8 goods, services, or funds from the nutritionists board, other than
7-9 compensation or reimbursement authorized by law for nutritionists
7-10 board membership, attendance, or expenses.
7-11 Sec. 703.053. MEMBERSHIP AND EMPLOYEE RESTRICTIONS. (a) In
7-12 this section, "Texas trade association" means a nonprofit,
7-13 cooperative, and voluntarily joined association of business or
7-14 professional competitors in this state designed to assist its
7-15 members and its industry or profession in dealing with mutual
7-16 business or professional problems and in promoting their common
7-17 interest.
7-18 (b) An officer, employee, or paid consultant of a Texas
7-19 trade association in the field of clinical nutrition may not be a
7-20 nutritionists board member and may not be an employee of the
7-21 nutritionists board who is exempt from the state's position
7-22 classification plan or is compensated at or above the amount
7-23 prescribed by the General Appropriations Act for step 1, salary
7-24 group A17, of the position classification salary schedule.
7-25 (c) A person who is the spouse of an officer, manager, or
7-26 paid consultant of a Texas trade association in the field of
7-27 clinical nutrition may not be a nutritionists board member and may
8-1 not be an employee of the nutritionists board who is exempt from
8-2 the state's position classification plan or is compensated at or
8-3 above the amount prescribed by the General Appropriations Act for
8-4 step 1, salary group A17, of the position classification salary
8-5 schedule.
8-6 (d) A person may not serve as a member of the nutritionists
8-7 board or act as the general counsel to the nutritionists board if
8-8 the person is required to register as a lobbyist under Chapter 305,
8-9 Government Code, because of the person's activities for
8-10 compensation on behalf of a profession related to the operation of
8-11 the nutritionists board.
8-12 Sec. 703.054. TERMS. Members of the nutritionists board
8-13 serve staggered six-year terms, with three members' terms expiring
8-14 on February 1 of each odd-numbered year.
8-15 Sec. 703.055. GROUNDS FOR REMOVAL FROM NUTRITIONISTS BOARD.
8-16 (a) It is a ground for removal from the nutritionists board that
8-17 a member:
8-18 (1) does not have at the time of appointment the
8-19 qualifications required for appointment to the nutritionists board;
8-20 (2) does not maintain during service on the
8-21 nutritionists board the qualifications required for appointment to
8-22 the nutritionists board;
8-23 (3) cannot, because of illness or disability,
8-24 discharge the member's duties for a substantial part of the
8-25 member's term; or
8-26 (4) is absent from more than half of the regularly
8-27 scheduled nutritionists board meetings that the member is eligible
9-1 to attend during a calendar year, unless the absence is approved by
9-2 a majority vote of the nutritionists board.
9-3 (b) The validity of an action of the nutritionists board is
9-4 not affected by the fact that it is taken when a ground for removal
9-5 of a nutritionists board member exists.
9-6 (c) If the executive director has knowledge that a potential
9-7 ground for removal exists, the executive director shall notify the
9-8 presiding officer of the nutritionists board of the potential
9-9 ground. The presiding officer shall then notify the governor that
9-10 a potential ground for removal exists.
9-11 Sec. 703.056. PER DIEM; REIMBURSEMENT. (a) Each member of
9-12 the nutritionists board is entitled to receive a per diem at the
9-13 rate set by the legislature for state employees in the General
9-14 Appropriations Act for each day the member engages in the business
9-15 of the nutritionists board.
9-16 (b) A member is entitled to reimbursement for transportation
9-17 expenses as provided by the General Appropriations Act.
9-18 Sec. 703.057. OFFICERS. The nutritionists board shall elect
9-19 from its members a presiding officer and an assistant presiding
9-20 officer to serve in those capacities as provided by the rules of
9-21 the nutritionists board.
9-22 Sec. 703.058. MEETINGS. The nutritionists board shall hold
9-23 at least two regular meetings each year as provided by rules
9-24 adopted by the nutritionists board.
9-25 Sec. 703.059. TRAINING. (a) Before a nutritionists board
9-26 member may assume the member's duties and before the member may be
9-27 confirmed by the senate, the member must complete at least one
10-1 course of a training program established by the nutritionists board
10-2 under this section.
10-3 (b) The training program established by the nutritionists
10-4 board must provide information to a participant regarding:
10-5 (1) this chapter;
10-6 (2) the programs operated by the nutritionists board;
10-7 (3) the role and functions of the nutritionists board;
10-8 (4) the rules of the nutritionists board, with an
10-9 emphasis on the rules that relate to disciplinary and investigatory
10-10 authority;
10-11 (5) the current budget for the nutritionists board;
10-12 (6) the results of the most recent formal audit of the
10-13 nutritionists board;
10-14 (7) the requirements of Chapters 551, 552, 2001, and
10-15 2002, Government Code;
10-16 (8) the requirements of the conflict-of-interest laws
10-17 and other laws relating to public officials; and
10-18 (9) any applicable ethics policies adopted by the
10-19 nutritionists board or the Texas Ethics Commission.
10-20 (c) In developing the training program, the nutritionists
10-21 board shall consult with the governor's office, the attorney
10-22 general's office, and the Texas Ethics Commission.
10-23 (d) If another state agency is given the authority to
10-24 establish the training requirements, the nutritionists board shall
10-25 use that training rather than develop its own program.
10-26 SUBCHAPTER C. EXECUTIVE DIRECTOR AND PERSONNEL
10-27 Sec. 703.101. EXECUTIVE DIRECTOR. The nutritionists board
11-1 shall employ an executive director.
11-2 Sec. 703.102. EXECUTIVE DIRECTOR POWERS AND DUTIES. In
11-3 addition to other duties prescribed by this chapter and by the
11-4 department, the executive director shall:
11-5 (1) administer licensing activities for the
11-6 nutritionists board;
11-7 (2) keep full and accurate minutes of the transactions
11-8 and proceedings of the nutritionists board;
11-9 (3) serve as custodian of the files and records of the
11-10 nutritionists board;
11-11 (4) prepare and recommend to the nutritionists board
11-12 plans and procedures necessary to implement the purposes and
11-13 objectives of this chapter, including rules and proposals on
11-14 administrative procedures;
11-15 (5) exercise general supervision over persons employed
11-16 by the department in the administration of this chapter;
11-17 (6) investigate complaints and present formal
11-18 complaints;
11-19 (7) attend all meetings of the nutritionists board as
11-20 a nonvoting participant;
11-21 (8) handle the correspondence of the nutritionists
11-22 board; and
11-23 (9) obtain, assemble, or prepare reports and
11-24 information as directed or authorized by the nutritionists board.
11-25 Sec. 703.103. PERSONNEL AND FACILITIES. (a) Department
11-26 personnel shall administer this chapter as agents of the
11-27 nutritionists board.
12-1 (b) If necessary to administer this chapter, the department
12-2 by agreement may:
12-3 (1) obtain and provide compensation for services; and
12-4 (2) may employ professional consultants, technical
12-5 assistants, or other persons on a full-time or part-time basis.
12-6 (c) Department facilities shall be used as necessary to
12-7 administer this chapter.
12-8 Sec. 703.104. DIVISION OF RESPONSIBILITIES. The nutritionists
12-9 board shall develop and implement policies that clearly define the
12-10 respective responsibilities of the nutritionists board and the
12-11 staff of the nutritionists board.
12-12 Sec. 703.105. QUALIFICATIONS AND STANDARDS OF CONDUCT
12-13 INFORMATION. The nutritionists board shall provide, as often as
12-14 necessary, to its members and employees information regarding
12-15 their:
12-16 (1) qualifications for office or employment under this
12-17 chapter; and
12-18 (2) responsibilities under applicable laws relating to
12-19 standards of conduct for state officers or employees.
12-20 Sec. 703.106. EQUAL EMPLOYMENT OPPORTUNITY POLICY; REPORT.
12-21 (a) The executive director or the executive director's designee
12-22 shall prepare and maintain a written policy statement to ensure
12-23 implementation of an equal employment opportunity program under
12-24 which all personnel decisions are made without regard to race,
12-25 color, disability, sex, religion, age, or national origin. The
12-26 policy statement must include:
12-27 (1) personnel policies, including policies relating to
13-1 recruitment, evaluation, selection, training, and promotion of
13-2 personnel, that are in compliance with Chapter 21, Labor Code;
13-3 (2) a comprehensive analysis of the nutritionists
13-4 board workforce that meets federal and state guidelines;
13-5 (3) procedures by which a determination can be made of
13-6 significant underuse in the board workforce of all persons for whom
13-7 federal or state guidelines encourage a more equitable balance; and
13-8 (4) reasonable methods to appropriately address those
13-9 areas of underuse.
13-10 (b) A policy statement prepared under Subsection (a) must:
13-11 (1) cover an annual period;
13-12 (2) be updated annually;
13-13 (3) be reviewed by the state Commission on Human
13-14 Rights for compliance with Subsection (a)(1); and
13-15 (4) be filed with the governor.
13-16 (c) The governor shall deliver a biennial report to the
13-17 legislature based on the information received under Subsection (b).
13-18 The report may be made separately or as part of other biennial
13-19 reports to the legislature.
13-20 Sec. 703.107. CAREER LADDER PROGRAM; PERFORMANCE
13-21 EVALUATIONS. (a) The executive director or the executive
13-22 director's designee shall develop an intra-agency career ladder
13-23 program. The program must require intra-agency posting of all
13-24 nonentry level positions concurrently with any public posting.
13-25 (b) The executive director or the executive director's
13-26 designee shall develop a system of annual performance evaluations
13-27 based on measurable job tasks. All merit pay for nutritionists
14-1 board employees must be based on the system established under this
14-2 subsection.
14-3 SUBCHAPTER D. POWERS AND DUTIES
14-4 Sec. 703.151. GENERAL POWERS AND DUTIES OF NUTRITIONISTS
14-5 BOARD. The nutritionists board shall:
14-6 (1) adopt an official seal;
14-7 (2) adopt and publish a code of ethics;
14-8 (3) establish the qualifications and fitness of
14-9 applicants for licenses, including renewed and reciprocal licenses;
14-10 (4) revoke, suspend, or deny a license, probate a
14-11 license suspension, or reprimand a license holder for a violation
14-12 of this chapter, the code of ethics, or the rules of the
14-13 nutritionists board; and
14-14 (5) establish reasonable and necessary fees to
14-15 administer this chapter.
14-16 Sec. 703.152. GENERAL RULEMAKING AUTHORITY. (a) The
14-17 nutritionists board may adopt rules as necessary to implement this
14-18 chapter.
14-19 (b) In adopting rules, the nutritionists board shall
14-20 consider the rules and procedures of the board of health and the
14-21 department and shall adopt procedural rules consistent with similar
14-22 rules and procedures of those entities.
14-23 Sec. 703.153. RULES RESTRICTING ADVERTISING OR COMPETITIVE
14-24 BIDDING. (a) The nutritionists board may not adopt a rule
14-25 restricting advertising or competitive bidding by a person
14-26 regulated by the nutritionists board except to prohibit a false,
14-27 misleading, or deceptive practice.
15-1 (b) The nutritionists board may not include in rules to
15-2 prohibit false, misleading, or deceptive practices by a person
15-3 regulated by the nutritionists board a rule that:
15-4 (1) restricts the person's use of any medium for
15-5 advertising;
15-6 (2) restricts the person's personal appearance or use
15-7 of the person's voice in an advertisement;
15-8 (3) relates to the size or duration of an
15-9 advertisement by the person; or
15-10 (4) restricts the use of a trade name in advertising
15-11 by the person.
15-12 Sec. 703.154. FEES. After consulting the commissioner or the
15-13 department, the nutritionists board by rule shall set fees in
15-14 amounts reasonable and necessary to cover the cost of administering
15-15 this chapter.
15-16 Sec. 703.155. FUND ACCOUNT. (a) The department shall
15-17 receive and account for money received under this chapter.
15-18 (b) The department shall deposit the fees to the credit of
15-19 the licensed clinical nutritionist fund account. The licensed
15-20 clinical nutritionist fund account is an account in the general
15-21 revenue fund that may be appropriated only for the administration
15-22 of this chapter.
15-23 Sec. 703.156. SEAL. (a) The nutritionists board by rule may
15-24 require a license holder to:
15-25 (1) obtain a seal authorized by the nutritionists
15-26 board, bearing the license holder's name and the legend "Licensed
15-27 Clinical Nutritionist"; and
16-1 (2) affix the seal to formal documentation of
16-2 nutrition services provided by a license holder.
16-3 (b) If the nutritionists board adopts rules under Subsection
16-4 (a), the rules must require a license holder to comply with
16-5 Subsection (a)(2) by maintaining a facsimile of the license
16-6 holder's seal on file at the location where services are provided
16-7 if:
16-8 (1) the services are provided:
16-9 (A) in a facility licensed under the Health and
16-10 Safety Code;
16-11 (B) on behalf of a local, state, or federal
16-12 government agency; or
16-13 (C) under other circumstances determined
16-14 reasonable and necessary by the nutritionists board; and
16-15 (2) the facsimile is maintained on file at all times
16-16 during which the services are provided.
16-17 Sec. 703.157. POWERS AND DUTIES OF BOARD OF HEALTH. To
16-18 implement this chapter, the board of health:
16-19 (1) shall request and receive any necessary assistance
16-20 from state institutions of higher education or other state
16-21 agencies;
16-22 (2) shall prepare information of consumer interest
16-23 describing the regulatory functions of the board of examiners of
16-24 clinical nutritionists, the procedures by which consumer complaints
16-25 are filed and resolved, and the profession of clinical nutrition;
16-26 (3) shall prepare a registry of licensed clinical
16-27 nutritionists, provisional licensed clinical nutritionists, and
17-1 persons holding temporary licenses under this chapter, and make
17-2 this information available to the public, license holders, and
17-3 appropriate state agencies; and
17-4 (4) may request the attorney general or the
17-5 appropriate county or district attorney to institute a suit to
17-6 enjoin a violation of this chapter in addition to any other action,
17-7 proceeding, or remedy authorized by law.
17-8 SUBCHAPTER E. PUBLIC INTEREST INFORMATION
17-9 AND COMPLAINT PROCEDURES
17-10 Sec. 703.201. PUBLIC INTEREST INFORMATION. (a) The
17-11 nutritionists board shall prepare information of public interest
17-12 describing the functions of the nutritionists board and the
17-13 nutritionists board's procedures by which complaints are filed with
17-14 and resolved by the nutritionists board.
17-15 (b) The nutritionists board shall make the information
17-16 available to the public and appropriate state agencies.
17-17 Sec. 703.202. COMPLAINTS. (a) The nutritionists board by
17-18 rule shall establish methods by which consumers and service
17-19 recipients are notified of the name, mailing address, and telephone
17-20 number of the nutritionists board for the purpose of directing
17-21 complaints to the nutritionists board. The nutritionists board may
17-22 provide for that notification:
17-23 (1) on each registration form, application, or written
17-24 contract for services of a person regulated by the nutritionists
17-25 board;
17-26 (2) on a sign prominently displayed in the place of
17-27 business of each person regulated by the nutritionists board; or
18-1 (3) in a bill for services provided by a person
18-2 regulated by the nutritionists board.
18-3 (b) The nutritionists board shall list along with its
18-4 regular telephone number any toll-free telephone number established
18-5 under state law that may be called to present a complaint about a
18-6 health professional.
18-7 Sec. 703.203. RECORDS OF COMPLAINTS. (a) The nutritionists
18-8 board shall keep an information file on each complaint filed with
18-9 the nutritionists board. The file must include:
18-10 (1) the name of each person contacted in relation to
18-11 the complaint;
18-12 (2) a summary of the results of the review or
18-13 investigation of the complaint;
18-14 (3) an explanation of the reason the file was closed,
18-15 if the nutritionists board closed the file without taking action
18-16 other than to investigate the complaint; and
18-17 (4) other relevant information.
18-18 (b) The nutritionists board shall provide to the person
18-19 filing the complaint and to each person who is a subject of the
18-20 complaint a copy of the nutritionists board's policies and
18-21 procedures relating to complaint investigation and resolution.
18-22 (c) The nutritionists board, at least quarterly until final
18-23 disposition of the complaint, shall notify the person filing the
18-24 complaint and each person who is a subject of the complaint of the
18-25 status of the complaint unless the notice would jeopardize an
18-26 undercover investigation.
18-27 (d) The nutritionists board shall review a complaint
19-1 regarding:
19-2 (1) incompetency, misconduct, gross negligence, fraud,
19-3 misrepresentation, or dishonesty in the performance of the
19-4 functions or duties of a license holder; and
19-5 (2) the use of any controlled substance or drug or the
19-6 use of alcoholic beverages to an extent that the use impairs a
19-7 person's ability to perform the work of a clinical nutritionist.
19-8 Sec. 703.204. GENERAL RULES REGARDING COMPLAINT
19-9 INVESTIGATION AND DISPOSITION. (a) The nutritionists board shall
19-10 adopt rules concerning the investigation of a complaint filed with
19-11 the nutritionists board. The rules adopted under this subsection
19-12 shall:
19-13 (1) distinguish between categories of complaints;
19-14 (2) ensure that a complaint is not dismissed without
19-15 appropriate consideration;
19-16 (3) require that the nutritionists board be advised of
19-17 a complaint that is dismissed and that a letter be sent to the
19-18 person who filed the complaint explaining the action taken on the
19-19 dismissed complaint;
19-20 (4) ensure that the person who filed the complaint has
19-21 an opportunity to explain the allegations made in the complaint;
19-22 and
19-23 (5) prescribe guidelines concerning the categories of
19-24 complaints that require the use of a private investigator and the
19-25 procedures for the nutritionists board to obtain the services of a
19-26 private investigator.
19-27 (b) The nutritionists board shall:
20-1 (1) dispose of each complaint in a timely manner; and
20-2 (2) establish a schedule for conducting each phase of
20-3 a complaint that is under the control of the nutritionists board
20-4 not later than the 30th day after the date the complaint is
20-5 received by the nutritionists board.
20-6 (c) Each party to the complaint shall be notified of the
20-7 projected time requirements for pursuing the complaint. Each party
20-8 shall be notified of any change in the schedule established under
20-9 Subsection (b)(2) not later than the seventh day after the date the
20-10 change is made.
20-11 (d) The executive director shall notify the nutritionists
20-12 board of a complaint that is not resolved in the time prescribed by
20-13 the nutritionists board for resolving the complaint so that the
20-14 nutritionists board may take necessary action on the complaint.
20-15 Sec. 703.205. PUBLIC PARTICIPATION. (a) The nutritionists
20-16 board shall develop and implement policies that provide the public
20-17 with a reasonable opportunity to appear before the nutritionists
20-18 board and to speak on any issue under the jurisdiction of the
20-19 nutritionists board.
20-20 (b) The nutritionists board shall prepare and maintain a
20-21 written plan that describes how a person who does not speak English
20-22 can be provided reasonable access to the nutritionists board's
20-23 programs.
20-24 SUBCHAPTER F. LICENSE REQUIREMENTS
20-25 Sec. 703.251. LICENSE REQUIRED; EXEMPTIONS. (a) Except as
20-26 provided by Subsection (b), a person may not practice as a clinical
20-27 nutritionist unless the person holds a license issued under this
21-1 chapter.
21-2 (b) This chapter does not prohibit a person from providing
21-3 oral nutritional information as an operator or employee of a health
21-4 food store or business that sells health products, including
21-5 dietary supplements, foods, or food materials, or disseminating
21-6 written nutrition information in connection with the distribution
21-7 of those products. This chapter does not prohibit or limit any
21-8 person from conducting a class or seminar or from giving a speech
21-9 related to nutrition. This chapter does not apply to a health care
21-10 practitioner licensed under another law who provides nutritional
21-11 counseling under the scope of that license.
21-12 Sec. 703.252. LICENSE APPLICATION. (a) Each applicant for a
21-13 clinical nutritionist license must submit a sworn application,
21-14 accompanied by the refundable application fee. The applicant must
21-15 specify the category of license for which the person is applying.
21-16 (b) The nutritionists board shall prescribe the application
21-17 form and may by rule establish dates by which applications and fees
21-18 must be received. The rules must be consistent with present rules
21-19 of the department related to application dates of other licenses.
21-20 (c) Each license application must be accompanied by proof of
21-21 liability insurance coverage:
21-22 (1) issued by an insurer authorized by the Texas
21-23 Department of Insurance to engage in the business of liability
21-24 insurance in this state; and
21-25 (2) in amounts prescribed by the nutritionists board
21-26 as appropriate for the category of license for which the person is
21-27 applying.
22-1 Sec. 703.253. EXAMINATION. (a) Except as provided by
22-2 Subsection (c), an applicant must pass a competency examination to
22-3 qualify for a license under this chapter.
22-4 (b) The nutritionists board by rule may adopt an examination
22-5 given by an approved scientific nutritionists board of clinical
22-6 nutritionist experts, instead of an examination prepared by the
22-7 nutritionists board.
22-8 (c) The nutritionists board may waive the examination
22-9 requirement for an applicant who, at the time of application, is
22-10 registered as a registered clinical nutritionist by the Commission
22-11 on Clinical Nutritionist Registration or another professional
22-12 organization recognized by the nutritionists board.
22-13 Sec. 703.254. QUALIFICATIONS FOR EXAMINATION. To qualify for
22-14 the licensing examination under this chapter, an applicant must:
22-15 (1) possess a baccalaureate or postbaccalaureate
22-16 degree in science, conferred by an accredited institution of higher
22-17 education, with:
22-18 (A) a major course of study in human nutrition,
22-19 nutrition, or nutrition education; or
22-20 (B) an equivalent major course of study approved
22-21 by the nutritionists board; and
22-22 (2) have completed an internship or preplanned,
22-23 documented, professional experience program in clinical nutrition
22-24 practice of not less than 900 hours under the supervision of a
22-25 licensed clinical nutritionist or a licensed physician or dentist
22-26 who provides nutritionists board-approved training in the field of
22-27 clinical nutrition.
23-1 Sec. 703.255. INVESTIGATION. (a) Not later than the 45th
23-2 day after the date a properly submitted and timely application is
23-3 received and not later than the 30th day before the next
23-4 examination date, the department shall notify an applicant in
23-5 writing of the receipt and investigation of the applicant's
23-6 application and any other relevant evidence relating to applicant
23-7 qualifications established by the nutritionists board rule.
23-8 (b) The notice must state whether the applicant has
23-9 qualified for examination based on the application and other
23-10 submitted evidence. If the applicant has not qualified, the notice
23-11 must state the reasons for the applicant's failure to qualify.
23-12 Sec. 703.256. EXAMINATION RESULTS. (a) The nutritionists
23-13 board shall notify each examinee of the results of the examination
23-14 not later than the 30th day after the date the examination is
23-15 administered.
23-16 (b) If the examination is graded or reviewed by a testing
23-17 service:
23-18 (1) the nutritionists board shall notify the person of
23-19 the results of the examination not later than the 14th day after
23-20 the date the nutritionists board receives the results from the
23-21 testing service; and
23-22 (2) if notice of the examination results will be
23-23 delayed for longer than 90 days after the examination date, the
23-24 nutritionists board shall notify the person of the reason for the
23-25 delay before the 90th day.
23-26 (c) The nutritionists board may require a testing service to
23-27 notify a person of the results of the person's examination.
24-1 (d) If requested in writing by a person who fails the
24-2 examination, the nutritionists board shall furnish the person with
24-3 an analysis of the person's performance on the examination.
24-4 Sec. 703.257. REEXAMINATION. An applicant who fails the
24-5 examination three times must provide evidence to the nutritionists
24-6 board that the applicant has successfully completed credit hours in
24-7 the applicant's areas of weakness before the applicant may apply
24-8 for examination.
24-9 Sec. 703.258. QUALIFIED PERSON ENTITLED TO LICENSE. The
24-10 nutritionists board shall issue the appropriate clinical
24-11 nutritionist license under this chapter to a person who meets the
24-12 qualifications for the license. The license must specify on its
24-13 face the category under which the person is licensed.
24-14 Sec. 703.259. PROVISIONAL LICENSE. (a) The nutritionists
24-15 board may issue a license to use the title "provisionally licensed
24-16 clinical nutritionist" to an applicant who files an application,
24-17 pays an application fee, and submits evidence of successful
24-18 completion of the educational requirements under Section 703.254.
24-19 (b) A provisionally licensed clinical nutritionist must
24-20 practice under the supervision and direction of a licensed clinical
24-21 nutritionist. The supervising licensed clinical nutritionist must
24-22 sign the application.
24-23 (c) A provisional license expires on the first anniversary
24-24 of the date of issuance and, if the supervising licensed clinical
24-25 nutritionist signs the renewal application, may be renewed annually
24-26 not more than twice by complying with the renewal procedures under
24-27 Section 703.301.
25-1 (d) A provisionally licensed clinical nutritionist shall
25-2 comply with Sections 703.351 and 703.352.
25-3 Sec. 703.260. TEMPORARY LICENSE. (a) On receipt of an
25-4 application and payment of an application fee, the nutritionists
25-5 board may grant a temporary license to an applicant who:
25-6 (1) is licensed in good standing as a clinical
25-7 nutritionist in another state that has licensing requirements that
25-8 are substantially equivalent to the requirements of this chapter;
25-9 (2) has passed a national or other examination
25-10 recognized by the nutritionists board relating to clinical
25-11 nutrition; and
25-12 (3) is sponsored by a person licensed by the
25-13 nutritionists board under this chapter with whom the temporary
25-14 license holder may practice.
25-15 (b) The nutritionists board may waive the requirement of
25-16 Subsection (a)(3) if the nutritionists board determines that
25-17 compliance with that provision is a hardship to the applicant.
25-18 (c) A temporary license is valid until the date the
25-19 nutritionists board approves or denies the temporary license
25-20 holder's application for a license. The nutritionists board shall
25-21 issue a license under this chapter to the holder of a temporary
25-22 license if:
25-23 (1) the temporary license holder passes the competency
25-24 examination required by Section 703.253;
25-25 (2) the nutritionists board verifies that the
25-26 temporary license holder meets the academic and experience
25-27 requirements for a license under this chapter; and
26-1 (3) the temporary license holder satisfies any other
26-2 license requirements under this chapter.
26-3 (d) The nutritionists board must complete the processing of
26-4 a temporary license holder's application for a license not later
26-5 than the 180th day after the date the nutritionists board issues
26-6 the temporary license. The nutritionists board may extend this
26-7 deadline to receive pending examination results.
26-8 Sec. 703.261. INACTIVE STATUS. The nutritionists board by
26-9 rule may provide for a license holder to place the person's license
26-10 on inactive status. The nutritionists board by rule shall provide
26-11 for a time limit for a license to remain on inactive status.
26-12 SUBCHAPTER G. LICENSE RENEWAL
26-13 Sec. 703.301. LICENSE RENEWAL. The nutritionists board shall
26-14 renew the license of a qualified clinical nutritionist in good
26-15 standing who:
26-16 (1) returns a completed renewal form in the manner
26-17 prescribed by the nutritionists board;
26-18 (2) submits evidence of completion of the minimum
26-19 number of continuing education hours required by nutritionists
26-20 board rule; and
26-21 (3) pays the required renewal fee before the license
26-22 expires.
26-23 Sec. 703.302. TERM OF LICENSE; EXPIRATION DATE. (a) A
26-24 license is valid for one year from the date of issuance and may be
26-25 renewed annually.
26-26 (b) The nutritionists board by rule may adopt a system under
26-27 which licenses expire on various dates during the year. For the
27-1 year in which the license expiration date is changed, a license fee
27-2 payable on the original expiration date shall be prorated on a
27-3 monthly basis so that the license holder pays only that portion of
27-4 the fee allocable to the number of months the license is valid. The
27-5 license holder shall pay the total license renewal fee on renewal
27-6 of the license on the new expiration date.
27-7 Sec. 703.303. LICENSE RENEWAL PROCEDURE. (a) A person may
27-8 renew an unexpired license by paying the required renewal fee to
27-9 the nutritionists board before the license expiration date.
27-10 (b) A person whose license has been expired for 90 days or
27-11 less may renew the license by paying to the nutritionists board the
27-12 required renewal fee and a fee that is equal to half the amount of
27-13 the required renewal fee. If a license has been expired for more
27-14 than 90 days but less than one year, the person may renew the
27-15 license by paying to the nutritionists board a fee equal to twice
27-16 the amount of the required renewal fee.
27-17 (c) Except as provided by Section 703.304, a person whose
27-18 license has been expired for one year or more may not renew the
27-19 license. The person may obtain a new license by complying with the
27-20 requirements and procedures for obtaining an original license.
27-21 (d) Not later than the 30th day before a person's license
27-22 expiration date, the nutritionists board shall send written notice
27-23 of the impending expiration to the person at the person's last
27-24 known address according to the records of the nutritionists board.
27-25 Sec. 703.304. RENEWAL OF EXPIRED LICENSE BY OUT-OF-STATE
27-26 PRACTITIONER. The nutritionists board may renew without examination
27-27 an expired license of a person who was licensed in this state,
28-1 moved to another state, and is licensed and has been in practice in
28-2 the other state for the two years preceding the date the person
28-3 applies for renewal. The person must pay to the nutritionists board
28-4 a fee that is equal to twice the required renewal fee for the
28-5 license.
28-6 Sec. 703.305. CONTINUING EDUCATION. (a) The nutritionists
28-7 board by rule shall establish a minimum number of hours of
28-8 continuing education required for license renewal under this
28-9 chapter.
28-10 (b) The nutritionists board may assess the continuing
28-11 education needs of license holders and may require license holders
28-12 to attend continuing education courses specified by the
28-13 nutritionists board. The nutritionists board shall develop a
28-14 process to evaluate and approve continuing education courses.
28-15 (c) The nutritionists board shall identify the key factors
28-16 for the competent performance of professional duties. The
28-17 nutritionists board shall adopt a procedure to assess a license
28-18 holder's participation in continuing education programs.
28-19 Sec. 703.306. DUPLICATE LICENSE. The nutritionists board
28-20 shall issue a new license to replace a license that is lost,
28-21 destroyed, or mutilated, subject to nutritionists board rules and
28-22 on payment of a reasonable fee.
28-23 SUBCHAPTER H. PRACTICE BY LICENSE HOLDER
28-24 Sec. 703.351. PRACTICE STRATEGIES FOR CLINICAL
28-25 NUTRITIONISTS. (a) A licensed clinical nutritionist may work
28-26 independently in a general office setting, or as a member of a
28-27 health care team, as a nutritionist, nutritional coach, or
29-1 nutritional advisor in a corporation, providing referrals to and
29-2 receiving referrals from licensed physicians, chiropractors,
29-3 nurses, pharmacists, and dentists.
29-4 (b) In providing services under this chapter, a licensed
29-5 clinical nutritionist may:
29-6 (1) plan and direct appropriate physical and
29-7 therapeutic nutritional needs, including individual formulation of
29-8 enteral and parenteral nutrition;
29-9 (2) provide nutritional counseling and education to
29-10 increase client understanding of nutritional principles and
29-11 physiological and biochemical pathways to increase individual
29-12 choices for optimizing health;
29-13 (3) evaluate, develop, and formulate therapeutic
29-14 nutrition plans, which may include the recommendation of
29-15 nutritional supplements, including micronutrients, macronutrients,
29-16 and metabolites, as considered appropriate to attain optimal
29-17 health; and
29-18 (4) develop and administer nutrition care standards
29-19 and systems.
29-20 Sec. 703.352. DISPLAY OF LICENSE. (a) Each license holder
29-21 shall display the person's license in an appropriate and public
29-22 manner.
29-23 (b) A license issued by the nutritionists board is the
29-24 property of the nutritionists board and must be surrendered on
29-25 demand.
29-26 Sec. 703.353. LICENSE HOLDER INFORMATION. A license holder
29-27 shall keep the department informed of the license holder's current
30-1 address.
30-2 Sec. 703.354. PROHIBITED USE OF SEAL. (a) A person may not
30-3 use a seal authorized by the nutritionists board unless the person
30-4 holds a license issued under this chapter.
30-5 (b) A person may not affix a seal to a document if the
30-6 license of the license holder named on the seal is expired,
30-7 suspended, or revoked.
30-8 SUBCHAPTER I. PROHIBITED ACTS; DISCIPLINARY PROCEDURES
30-9 Sec. 703.401. PROHIBITED ACTS. (a) Unless the person holds
30-10 an appropriate license issued under this chapter, a person may not:
30-11 (1) use any title, or represent or imply that the
30-12 person has the right to use any title, that includes the term
30-13 "clinical nutritionist";
30-14 (2) use any initials that represent or imply that the
30-15 person holds a license under this chapter; or
30-16 (3) use any facsimile of those titles or initials in
30-17 any manner to indicate or imply that the person is licensed under
30-18 this chapter.
30-19 (b) Unless the person holds an appropriate registration or
30-20 certification issued by the Commission on Clinical Nutritionist
30-21 Registration or other organization recognized by the nutritionists
30-22 board, a person may not use any title or initials, or any facsimile
30-23 of those titles or initials, or represent or imply that the person
30-24 has the right to use any title implying such a registration or
30-25 certification.
30-26 Sec. 703.402. GROUNDS FOR DISCIPLINARY ACTION. The
30-27 nutritionists board shall revoke or suspend a license, refuse to
31-1 renew a license, place on probation a person whose license has been
31-2 suspended, or reprimand a license holder for a violation of this
31-3 chapter, a rule of the nutritionists board, or the code of ethics
31-4 adopted by the nutritionists board.
31-5 Sec. 703.403. HEARING. (a) If the nutritionists board
31-6 proposes to suspend or revoke a person's license, the person is
31-7 entitled to a hearing.
31-8 (b) A member or employee of the nutritionists board or a
31-9 department employee who carries out the functions of the
31-10 nutritionists board and who proposes to make a decision, a finding
31-11 of fact, or a conclusion of law in a proceeding pending before the
31-12 nutritionists board may communicate directly or indirectly with a
31-13 party to the proceeding or with the party's representative only if
31-14 notice and an opportunity to participate are given to each party.
31-15 Sec. 703.404. SANCTIONS. The State Office of Administrative
31-16 Hearings shall use the schedule of sanctions adopted by the
31-17 nutritionists board by rule for a sanction imposed as the result of
31-18 a hearing conducted by the office.
31-19 Sec. 703.405. PROBATION. The nutritionists board may require
31-20 a license holder whose license suspension is probated to:
31-21 (1) report regularly to the nutritionists board on
31-22 matters that are the basis of the probation;
31-23 (2) limit practice to the areas prescribed by the
31-24 nutritionists board; or
31-25 (3) continue or review professional education until
31-26 the person attains a degree of skill satisfactory to the
31-27 nutritionists board in those areas that are the basis of the
32-1 probation.
32-2 Sec. 703.406. MONITORING OF LICENSE HOLDER. (a) The
32-3 nutritionists board by rule shall develop a system for monitoring a
32-4 license holder's compliance with this chapter.
32-5 (b) Rules adopted under this section must include procedures
32-6 to:
32-7 (1) monitor for compliance a license holder who is
32-8 ordered by the nutritionists board to perform certain acts; and
32-9 (2) identify and monitor license holders who represent
32-10 a risk to the public.
32-11 Sec. 703.407. ADMINISTRATIVE PROCEDURE. A proceeding to
32-12 suspend or revoke a license under this subchapter is governed by
32-13 Chapter 2001, Government Code.
32-14 SUBCHAPTER J. CRIMINAL PENALTIES
32-15 Sec. 703.451. CRIMINAL PENALTY. (a) A person commits an
32-16 offense if the person knowingly or intentionally violates this
32-17 chapter or a rule adopted by the nutritionists board or board of
32-18 health under this chapter.
32-19 (b) An offense under this section is a Class B misdemeanor.
32-20 SECTION 2. (a) Until September 1, 2002, the Texas State
32-21 Board of Examiners of Clinical Nutritionists shall waive the
32-22 examination requirement under Chapter 703, Occupations Code, as
32-23 added by this Act, and grant a license under that chapter to any
32-24 person who:
32-25 (1) presents evidence satisfactory to the Texas State
32-26 Board of Examiners of Clinical Nutritionists that the person has at
32-27 least five years of approved, documented experience in the field of
33-1 clinical nutrition;
33-2 (2) holds a clinical nutrition authorization in good
33-3 standing issued by a national certifying entity recognized by the
33-4 nutritionists board; or
33-5 (3) is a licensed physician, chiropractor, dentist,
33-6 pharmacist, or registered nurse who has:
33-7 (A) appropriate academic credentials in the
33-8 field of human nutrition or a directly related field approved by
33-9 the nutritionists board; or
33-10 (B) a minimum of three years' experience in the
33-11 practice of clinical nutrition.
33-12 (b) The governor shall appoint the initial members of the
33-13 Texas State Board of Examiners of Clinical Nutritionists not later
33-14 than December 1, 2001. In making the initial appointments, the
33-15 governor shall designate one clinical nutritionist appointee, one
33-16 health care practitioner appointee, and one public appointee for
33-17 terms expiring February 1, 2003, one clinical nutritionist
33-18 appointee, one health care practitioner appointee, and one public
33-19 appointee for terms expiring February 1, 2005, and one clinical
33-20 nutritionist appointee, one health care practitioner appointee, and
33-21 one public appointee for terms expiring February 1, 2007.
33-22 (c) A person appointed as a clinical nutritionist member of
33-23 the Texas State Board of Examiners of Clinical Nutritionists before
33-24 September 1, 2005, is not required to be licensed under Chapter
33-25 703, Occupations Code, as added by this Act, but the person must be
33-26 eligible to hold a license issued under that chapter, may not have
33-27 an additional primary practice, and must have at least three years
34-1 of professional experience in the field of clinical nutrition.
34-2 (d) The Texas State Board of Examiners of Clinical
34-3 Nutritionists shall hold its initial meeting at the time and place
34-4 designated by the governor.
34-5 SECTION 3. (a) Except as provided by Subsection (b) of this
34-6 section, this Act takes effect September 1, 2001.
34-7 (b) Sections 703.251 and 703.451, Chapter 703, Occupations
34-8 Code, as added by this Act, take effect January 1, 2002.