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78R6118 MXM-F
By: Goodman H.B. No. 1834
A BILL TO BE ENTITLED
AN ACT
relating to the regulation of clinical nutritionists; providing a
civil penalty.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subtitle M, Title 3, Occupations Code, is
amended by adding Chapter 703 to read as follows:
CHAPTER 703. CLINICAL NUTRITIONISTS
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 703.001. GENERAL DEFINITIONS. In this chapter:
(1) "Board of health" means the Texas Board of Health.
(2) "Clinical nutrition" means the health
professional discipline that applies principles derived from
current nutritional knowledge and biochemical and physiological
scientific knowledge to promote optimal health.
(3) "Clinical nutrition practice" means the practice
of clinical nutrition according to the guidelines set forth in the
scope of practice of clinical nutrition adopted under this article.
(4) "Clinical nutritionist" means a health
professional who applies clinical nutrition principles.
(5) "Commissioner" means the commissioner of public
health.
(6) "Department" means the Texas Department of Health.
(7) "Institution of higher education" has the meaning
assigned by Section 61.003, Education Code.
(8) "Nutritional supplements" includes food,
vitamins, minerals, botanicals, nutraceuticals, glandulars, amino
acids, trace elements, chemical supplements, homeopathic remedies,
macronutrients, micronutrients, herbs, and metabolites designed to
augment clinical deficiencies in the human body.
(9) "Nutritionists board" means the Texas State Board
of Examiners of Clinical Nutritionists.
(10) "Supervision" means control exercised over a
provisionally registered clinical nutritionist, student,
assistant, or technician working within the same facility as the
supervising clinical nutritionist.
Sec. 703.002. DEFINITION OF CLINICAL NUTRITION. (a) In
this section:
(1) "Nutritional assessment" means the evaluation of
individual and group nutritional needs, recognizing biochemical
individuality, to determine factors necessary to restore or
maintain healthy physiological function. The term includes the use
of appropriate tests and observations interpreted in terms of
optimal values and nutrition and lifestyle analysis to determine an
appropriate nutritional program, including:
(A) a case history;
(B) anthropometric measurements;
(C) physical signs; and
(D) biochemical data, including laboratory
tests.
(2) "Nutritional counseling" means communication of
the various aspects of clinical nutrition background information
and assessments, including:
(A) previously poor health habits, including
diet;
(B) evaluation of appropriate tests and
laboratory assessments to demonstrate individual differences that
produce a decline in good health; and
(C) the recommendation of an appropriate diet and
supplementation program, including micronutrients,
macronutrients, herbs, amino acids, trace elements, and
metabolites.
(b) Clinical nutrition is a specialization in the science of
nutrition that requires an understanding of nutrition biochemistry
that enables the practitioner to competently assess and evaluate
signs of nutritional deficiency or imbalance, through the use or
disuse of specific foods, vitamins, minerals, herbs, amino acids,
trace elements, glandulars, or other substances as necessary to
maintain optimal health.
(c) Clinical nutrition may be practiced through a
client-counselor relationship and requires knowledge of:
(1) basic concepts of human physiology derived from
medical and scientific literature;
(2) basic human anatomy derived from medical and
nutritional texts;
(3) nutrient roles and functions derived from medical
and scientific literature;
(4) human nutritional requirements to:
(A) provide individual client guidelines; and
(B) implement lifestyle modifications;
(5) the effects of nutritional imbalances, both
deficiencies and excesses, derived from clinical evaluation and
research findings;
(6) medical and scientific terminology;
(7) pharmacological and environmental effects on
nutritional status derived from findings from medical and
scientific literature;
(8) the effects of socioeconomic influence, food
selection, and food preparation on the nutritional status of
clients;
(9) the process of nutritional assessment and
evaluation through the use of appropriate clinical tests based on
previously collected data to document or confirm suspected
nutritional deviations or abnormalities;
(10) pertinent anatomical characteristics relevant to
nutritional status, including a client's weight, height, posture,
body fat, and musculature;
(11) the process of evaluation and interpretation of a
client's clinical data by careful analysis and application of
clinical judgment to formulate an appropriate nutritional
protocol;
(12) nutritional counseling skills and case
management;
(13) referral practices and skills for referring the
client to a licensed health care practitioner; and
(14) office management, state and federal laws, and
liability insurance acquired by reading the state and federal
codes, statutes, and laws and seeking legal counsel.
(d) Engaging in practice as a clinical nutritionist as
described by this chapter is not the practice of medicine as defined
by state law.
Sec. 703.003. SUNSET PROVISION. The Texas State Board of
Examiners of Clinical Nutritionists is subject to Chapter 325,
Government Code (Texas Sunset Act). Unless continued in existence
as provided by that chapter, the nutritionists board is abolished
and this chapter expires September 1, 2007.
[Sections 703.004-703.050 reserved for expansion]
SUBCHAPTER B. BOARD OF EXAMINERS OF CLINICAL NUTRITIONISTS
Sec. 703.051. BOARD; MEMBERSHIP. (a) The Texas State Board
of Examiners of Clinical Nutritionists consists of nine members
appointed by the governor as follows:
(1) three members who are clinical nutritionists who
hold a registration issued under this chapter, who do not have an
additional primary practice, and who have been registered under
this chapter for at least the three years preceding the person's
appointment to the nutritionists board;
(2) three members who are health care practitioners,
as described by Subsection (c); and
(3) three members who represent the public.
(b) Appointments to the nutritionists board shall be made
without regard to the race, color, disability, sex, religion, age,
or national origin of the appointee.
(c) The professional discipline of clinical nutrition
includes six primary areas of expertise: clinical, educational,
research, management, consultation, and community service. In
appointing health care practitioners to the nutritionists board,
the governor shall consider the broad spectrum of health care
practitioners who practice clinical nutrition in those areas of
expertise and attempt to achieve a continuing balance of
representation among those practitioners. Health care
practitioners eligible for appointment under Subsection (a)(2)
include physicians, chiropractors, dentists, and clinical
nutritionists. To be eligible for appointment under Subsection
(a)(2), the appointee must have at least two years of experience in
clinical nutrition practice, clinical nutrition education, or
clinical nutrition research.
Sec. 703.052. ELIGIBILITY OF PUBLIC MEMBERS. A person may
not be a public member of the nutritionists board if the person or
the person's spouse:
(1) is registered, certified, or licensed by a
regulatory agency in the field of clinical nutrition;
(2) is employed by or participates in the management
of a business entity or other organization regulated by or
receiving money from the nutritionists board;
(3) owns or controls, directly or indirectly, more
than a 10 percent interest in a business entity or other
organization regulated by or receiving money from the nutritionists
board; or
(4) uses or receives a substantial amount of tangible
goods, services, or funds from the nutritionists board, other than
compensation or reimbursement authorized by law for nutritionists
board membership, attendance, or expenses.
Sec. 703.053. MEMBERSHIP AND EMPLOYEE RESTRICTIONS. (a) In
this section, "Texas trade association" means a cooperative and
voluntarily joined statewide association of business or
professional competitors in this state designed to assist its
members and its industry or profession in dealing with mutual
business or professional problems and in promoting their common
interest.
(b) A person may not be a member of the nutritionists board
and may not be a board employee employed in a "bona fide executive,
administrative, or professional capacity," as that phrase is used
for purposes of establishing an exemption to the overtime
provisions of the federal Fair Labor Standards Act of 1938 (29
U.S.C. Section 201 et seq.), and its subsequent amendments, if:
(1) the person is an officer, employee, or paid
consultant of a Texas trade association in a field regulated by the
nutritionists board; or
(2) the person's spouse is an officer, manager, or paid
consultant of a Texas trade association in a field regulated by the
nutritionists board.
(c) A person may not be a member of the nutritionists board
or act as the general counsel to the nutritionists board if the
person is required to register as a lobbyist under Chapter 305,
Government Code, because of the person's activities for
compensation on behalf of a profession related to the operation of
the nutritionists board.
Sec. 703.054. TERMS. Members of the nutritionists board
serve staggered six-year terms, with three members' terms expiring
on February 1 of each odd-numbered year.
Sec. 703.055. GROUNDS FOR REMOVAL FROM NUTRITIONISTS BOARD.
(a) It is a ground for removal from the nutritionists board that a
member:
(1) does not have at the time of appointment the
qualifications required by Section 703.051;
(2) does not maintain during service on the
nutritionists board the qualifications required by Section
703.051;
(3) is ineligible for membership under Section 703.052
or 703.053;
(4) cannot, because of illness or disability,
discharge the member's duties for a substantial part of the member's
term; or
(5) is absent from more than half of the regularly
scheduled nutritionists board meetings that the member is eligible
to attend during a calendar year without an excuse approved by a
majority vote of the nutritionists board.
(b) The validity of an action of the nutritionists board is
not affected by the fact that it is taken when a ground for removal
of a nutritionists board member exists.
(c) If the executive director has knowledge that a potential
ground for removal exists, the executive director shall notify the
presiding officer of the nutritionists board of the potential
ground. The presiding officer shall then notify the governor and
the attorney general that a potential ground for removal exists. If
the potential ground for removal involves the presiding officer,
the executive director shall notify the next highest ranking
officer of the nutritionists board, who shall then notify the
governor and the attorney general that a potential ground for
removal exists.
Sec. 703.056. PER DIEM; REIMBURSEMENT. (a) Each member of
the nutritionists board is entitled to receive a per diem at the
rate set by the legislature for state employees in the General
Appropriations Act for each day the member engages in the business
of the nutritionists board.
(b) A member is entitled to reimbursement for
transportation expenses as provided by the General Appropriations
Act.
Sec. 703.057. OFFICERS. (a) The governor shall designate a
member of the nutritionists board to serve as the presiding officer
of the nutritionists board to serve in that capacity at the pleasure
of the governor.
(b) The nutritionists board shall elect other officers from
its membership as provided by the rules of the nutritionists board.
Sec. 703.058. MEETINGS. The nutritionists board shall hold
at least two regular meetings each year as provided by rules adopted
by the nutritionists board.
Sec. 703.059. TRAINING. (a) A person who is appointed to
and qualifies for office as a member of the nutritionists board may
not vote, deliberate, or be counted as a member in attendance at a
meeting of the nutritionists board until the person completes a
training program that complies with this section.
(b) The training program must provide the person with
information regarding:
(1) this chapter;
(2) the programs operated by the nutritionists board;
(3) the role and functions of the nutritionists board;
(4) the rules of the nutritionists board, with an
emphasis on the rules that relate to disciplinary and investigatory
authority;
(5) the current budget for the nutritionists board;
(6) the results of the most recent formal audit of the
nutritionists board;
(7) the requirements of:
(A) the open meetings law, Chapter 551,
Government Code;
(B) the public information law, Chapter 552,
Government Code;
(C) the administrative procedure law, Chapter
2001, Government Code; and
(D) other laws relating to public officials,
including conflict-of-interest laws; and
(8) any applicable ethics policies adopted by the
nutritionists board or the Texas Ethics Commission.
(c) A person appointed to the nutritionists board is
entitled to reimbursement, as provided by the General
Appropriations Act, for the travel expenses incurred in attending
the training program regardless of whether the attendance at the
program occurs before or after the person qualifies for office.
Sec. 703.060. USE OF TECHNOLOGY. The nutritionists board
shall develop and implement a policy requiring the executive
director and nutritionists board employees to research and propose
appropriate technological solutions to improve the nutritionists
board's ability to perform its functions. The technological
solutions must:
(1) ensure that the public is able to easily find
information about the nutritionists board on the Internet;
(2) ensure that persons who want to use the
nutritionists board's services are able to:
(A) interact with the nutritionists board
through the Internet; and
(B) access any service that can be provided
effectively through the Internet; and
(3) be cost-effective and developed through the
nutritionists board's planning processes.
Sec. 703.061. NEGOTIATED RULEMAKING AND ALTERNATIVE
DISPUTE RESOLUTION PROCEDURES. (a) The nutritionists board shall
develop and implement a policy to encourage the use of:
(1) negotiated rulemaking procedures under Chapter
2008, Government Code, for the adoption of nutritionists board
rules; and
(2) appropriate alternative dispute resolution
procedures under Chapter 2009, Government Code, to assist in the
resolution of internal and external disputes under the
nutritionists board's jurisdiction.
(b) The nutritionists board's procedures relating to
alternative dispute resolution must conform, to the extent
possible, to any model guidelines issued by the State Office of
Administrative Hearings for the use of alternative dispute
resolution by state agencies.
(c) The nutritionists board shall designate a trained
person to:
(1) coordinate the implementation of the policy
adopted under Subsection (a);
(2) serve as a resource for any training needed to
implement the procedures for negotiated rulemaking or alternative
dispute resolution; and
(3) collect data concerning the effectiveness of
those procedures, as implemented by the nutritionists board.
[Sections 703.062-703.100 reserved for expansion]
SUBCHAPTER C. EXECUTIVE DIRECTOR AND PERSONNEL
Sec. 703.101. EXECUTIVE DIRECTOR. The nutritionists board
shall employ an executive director.
Sec. 703.102. EXECUTIVE DIRECTOR POWERS AND DUTIES. In
addition to other duties prescribed by this chapter and by the
department, the executive director shall:
(1) administer registration activities for the
nutritionists board;
(2) keep full and accurate minutes of the transactions
and proceedings of the nutritionists board;
(3) serve as custodian of the files and records of the
nutritionists board;
(4) prepare and recommend to the nutritionists board
plans and procedures necessary to implement the purposes and
objectives of this chapter, including rules and proposals on
administrative procedures;
(5) exercise general oversight of persons employed by
the department in the administration of this chapter;
(6) investigate complaints and present formal
complaints;
(7) attend all meetings of the nutritionists board as
a nonvoting participant;
(8) handle the correspondence of the nutritionists
board; and
(9) obtain, assemble, or prepare reports and
information as directed or authorized by the nutritionists board.
Sec. 703.103. PERSONNEL AND FACILITIES. (a) The
department shall provide the basic personnel and facilities
required to administer this chapter. The department personnel
administering this chapter act as agents of the nutritionists
board.
(b) The department by agreement may secure services as it
considers necessary to administer this chapter and provide
compensation for those services.
(c) The department may employ, on a full-time or part-time
basis, the professional consultants, technical assistants, and
employees necessary to administer this chapter.
Sec. 703.104. DIVISION OF RESPONSIBILITIES. The
nutritionists board shall develop and implement policies that
clearly separate the policymaking responsibilities of the
nutritionists board and the management responsibilities of the
executive director and the staff of the nutritionists board.
Sec. 703.105. QUALIFICATIONS AND STANDARDS OF CONDUCT
INFORMATION. The executive director or the executive director's
designee shall provide to members of the nutritionists board and to
board employees, as often as necessary, information regarding the
requirements for office or employment under this chapter, including
information regarding a person's responsibilities under applicable
laws relating to standards of conduct for state officers or
employees.
Sec. 703.106. EQUAL EMPLOYMENT OPPORTUNITY POLICY; REPORT.
(a) The executive director or the executive director's designee
shall prepare and maintain a written policy statement that
implements a program of equal employment opportunity to ensure that
all personnel decisions are made without regard to race, color,
disability, sex, religion, age, or national origin.
(b) The policy statement must include:
(1) personnel policies, including policies relating
to recruitment, evaluation, selection, training, and promotion of
personnel, that show the intent of the nutritionists board to avoid
the unlawful employment practices described by Chapter 21, Labor
Code; and
(2) an analysis of the extent to which the composition
of the nutritionists board's personnel is in accordance with state
and federal law and a description of reasonable methods to achieve
compliance with state and federal law.
(c) The policy statement must:
(1) be updated annually;
(2) be reviewed by the state Commission on Human
Rights for compliance with Subsection (b)(1); and
(3) be filed with the governor's office.
Sec. 703.107. STATE EMPLOYEE INCENTIVE PROGRAM. The
executive director or the executive director's designee shall
provide to nutritionists board employees information and training
on the benefits and methods of participation in the state employee
incentive program.
[Sections 703.108-703.150 reserved for expansion]
SUBCHAPTER D. POWERS AND DUTIES
Sec. 703.151. GENERAL POWERS AND DUTIES OF NUTRITIONISTS
BOARD. The nutritionists board shall:
(1) adopt an official seal;
(2) adopt and publish a code of ethics; and
(3) establish the qualifications and fitness of
applicants for registration, including renewed and reciprocal
registration.
Sec. 703.152. GENERAL RULEMAKING AUTHORITY. (a) The
nutritionists board may adopt rules as necessary to implement this
chapter.
(b) In adopting rules, the nutritionists board shall
consider the rules and procedures of the board of health and the
department and shall adopt procedural rules consistent with similar
rules and procedures of those entities.
Sec. 703.153. RULES RESTRICTING ADVERTISING OR COMPETITIVE
BIDDING. (a) The nutritionists board may not adopt a rule
restricting advertising or competitive bidding by a person
regulated by the nutritionists board except to prohibit a false,
misleading, or deceptive practice.
(b) In its rules to prohibit false, misleading, or deceptive
practices, the nutritionists board may not include a rule that:
(1) restricts a person's use of any medium for
advertising;
(2) restricts a person's personal appearance or voice
in an advertisement;
(3) relates to the size or duration of an
advertisement by a person; or
(4) restricts a person's advertisement under a trade
name.
Sec. 703.154. FEES. After consulting the commissioner or
the department, the nutritionists board by rule shall set fees in
amounts reasonable and necessary to cover the cost of administering
this chapter.
Sec. 703.155. MONEY. (a) The department shall account for
money received under this chapter.
(b) The department shall deposit all money received under
this chapter to the credit of the registered clinical nutritionists
account in the general revenue fund. Money in the account may be
appropriated only to the department for administration of this
chapter.
Sec. 703.156. SEAL. (a) The nutritionists board by rule may
require a registration holder to:
(1) obtain a seal authorized by the nutritionists
board, bearing the registration holder's name and the legend
"Registered Clinical Nutritionist"; and
(2) affix the seal to formal documentation of
nutrition services provided by the registration holder.
(b) If the nutritionists board adopts rules under
Subsection (a), the rules must require a registration holder to
comply with Subsection (a)(2) by maintaining a facsimile of the
registration holder's seal on file at the location where services
are provided if:
(1) the services are provided:
(A) in a facility licensed under the Health and
Safety Code;
(B) on behalf of a local, state, or federal
government agency; or
(C) under other circumstances determined
reasonable and necessary by the nutritionists board; and
(2) the facsimile is maintained on file at all times
during which the services are provided.
Sec. 703.157. POWERS AND DUTIES OF BOARD OF HEALTH. To
implement this chapter, the board of health:
(1) shall request and receive any necessary assistance
from state institutions of higher education or other state
agencies;
(2) shall prepare information of consumer interest
describing the regulatory functions of the board of examiners of
clinical nutritionists, the procedures by which consumer
complaints are filed and resolved, and the profession of clinical
nutrition;
(3) shall prepare a list of registered clinical
nutritionists and persons holding provisional or temporary
registrations under this chapter, and make this information
available to the public, registration holders, and appropriate
state agencies; and
(4) may require the attorney general or the
appropriate county or district attorney to sue to enjoin a
violation of this chapter in addition to any other action,
proceeding, or remedy authorized by law.
[Sections 703.158-703.200 reserved for expansion]
SUBCHAPTER E. PUBLIC INTEREST INFORMATION
AND COMPLAINT PROCEDURES
Sec. 703.201. PUBLIC INTEREST INFORMATION. (a) The
nutritionists board shall prepare information of public interest
describing the functions of the nutritionists board and the
nutritionists board's procedures by which complaints are filed with
and resolved by the nutritionists board.
(b) The nutritionists board shall make the information
available to the public and appropriate state agencies.
Sec. 703.202. CONTACT INFORMATION. (a) The nutritionists
board by rule shall establish methods by which consumers and
service recipients are notified of the name, mailing address, and
telephone number of the nutritionists board for the purpose of
directing complaints to the nutritionists board. The nutritionists
board may provide for that notification:
(1) on each registration form, application, or written
contract for services of a person regulated by the nutritionists
board;
(2) on a sign prominently displayed in the place of
business of each person regulated by the nutritionists board; or
(3) in a bill for services provided by a person
regulated by the nutritionists board.
(b) The nutritionists board shall list along with its
regular telephone number any toll-free telephone number
established under state law that may be called to present a
complaint about a health professional.
Sec. 703.203. RECORDS OF COMPLAINTS. (a) The
nutritionists board shall maintain a file on each written complaint
filed with the nutritionists board. The file must include:
(1) the name of the person who filed the complaint;
(2) the date the complaint is received by the
nutritionists board;
(3) the subject matter of the complaint;
(4) the name of each person contacted in relation to
the complaint;
(5) a summary of the results of the review or
investigation of the complaint; and
(6) an explanation of the reason the file was closed,
if the nutritionists board closed the file without taking action
other than to investigate the complaint.
(b) The nutritionists board shall provide to the person
filing the complaint and to each person who is a subject of the
complaint a copy of the nutritionists board's policies and
procedures relating to complaint investigation and resolution.
(c) The nutritionists board, at least quarterly until final
disposition of the complaint, shall notify the person filing the
complaint and each person who is a subject of the complaint of the
status of the complaint unless the notice would jeopardize an
undercover investigation.
(d) The nutritionists board shall review a complaint
regarding:
(1) incompetency, misconduct, gross negligence,
fraud, misrepresentation, or dishonesty in the performance of the
functions or duties of a registration holder; and
(2) the use of any controlled substance or drug or the
use of alcoholic beverages to an extent that the use impairs a
person's ability to perform the work of a clinical nutritionist.
Sec. 703.204. GENERAL RULES REGARDING COMPLAINT
INVESTIGATION AND DISPOSITION. (a) The nutritionists board shall
adopt rules concerning the investigation of a complaint filed with
the nutritionists board. The rules adopted under this subsection
shall:
(1) distinguish between categories of complaints;
(2) ensure that a complaint is not dismissed without
appropriate consideration;
(3) require that the nutritionists board be advised of
a complaint that is dismissed and that a letter be sent to the
person who filed the complaint explaining the action taken on the
dismissed complaint;
(4) ensure that the person who filed the complaint has
an opportunity to explain the allegations made in the complaint;
and
(5) prescribe guidelines concerning the categories of
complaints that require the use of a private investigator and the
procedures for the nutritionists board to obtain the services of a
private investigator.
(b) The nutritionists board shall:
(1) dispose of each complaint in a timely manner; and
(2) establish a schedule for conducting each phase of
a complaint that is under the control of the nutritionists board not
later than the 30th day after the date the complaint is received by
the nutritionists board.
(c) Each party to the complaint shall be notified of the
projected time requirements for pursuing the complaint. Each party
shall be notified of any change in the schedule established under
Subsection (b)(2) not later than the seventh day after the date the
change is made.
(d) The executive director shall notify the nutritionists
board of a complaint that is not resolved in the time prescribed by
the nutritionists board for resolving the complaint so that the
nutritionists board may take necessary action on the complaint.
Sec. 703.205. PUBLIC PARTICIPATION. (a) The nutritionists
board shall develop and implement policies that provide the public
with a reasonable opportunity to appear before the nutritionists
board and to speak on any issue under the jurisdiction of the
nutritionists board.
(b) The nutritionists board shall prepare and maintain a
written plan that describes how a person who does not speak English
can be provided reasonable access to the nutritionists board's
programs.
[Sections 703.206-703.250 reserved for expansion]
SUBCHAPTER F. REGISTRATION REQUIREMENTS
Sec. 703.251. REGISTRATION REQUIRED; EXEMPTIONS. (a)
Except as provided by Subsection (b), a person may not use the title
of or advertise services as a clinical nutritionist or associate
clinical nutritionist unless the person holds a registration issued
under this chapter.
(b) This chapter does not prohibit a person from providing
oral nutritional information as an operator or employee of a health
food store or business that sells health products, including
dietary supplements, foods, or food materials, or disseminating
written nutritional information in connection with the
distribution of those products. This chapter does not prohibit or
limit any person from conducting a class or seminar or from giving a
speech related to nutrition. This chapter does not apply to a
health care practitioner licensed under another law who provides
nutritional counseling under the scope of that license.
Sec. 703.252. REGISTRATION APPLICATION. (a) Each
applicant for a clinical nutritionist registration must submit a
sworn application, accompanied by the application fee. The
applicant must specify the category of registration for which the
person is applying.
(b) The nutritionists board shall prescribe the application
form and may by rule establish dates by which applications and fees
must be received. The rules must be consistent with present rules
of the department related to application dates of other licenses or
registrations.
(c) Each registration application must be accompanied by
proof of liability insurance coverage:
(1) issued by an insurer authorized by the Texas
Department of Insurance to engage in the business of liability
insurance in this state; and
(2) in amounts prescribed by the nutritionists board
as appropriate for the category of registration for which the
person is applying.
Sec. 703.253. EXAMINATION. (a) Except as provided by
Subsection (c), an applicant must pass a competency examination to
qualify for a registration under this chapter.
(b) The nutritionists board by rule may adopt an examination
given by an approved scientific nutritionists board of clinical
nutritionist experts, instead of an examination prepared by the
nutritionists board.
(c) The nutritionists board may waive the examination
requirement for an applicant who, at the time of application, is
registered as a clinical nutritionist by the Commission on Clinical
Nutritionist Registration or another professional certification
board recognized by the nutritionists board.
Sec. 703.254. QUALIFICATIONS FOR EXAMINATION. To qualify
for the registered clinical nutritionist examination under this
chapter, an applicant must:
(1) possess a baccalaureate or postbaccalaureate
degree, conferred by an accredited institution of higher education,
with:
(A) a major course of study in human nutrition,
nutrition, or nutrition education; or
(B) an equivalent major course of study approved
by the nutritionists board; and
(2) have completed an internship or preplanned,
documented, professional experience program in clinical nutrition
practice of not less than 900 hours under the supervision of a
registered clinical nutritionist or a licensed physician or dentist
who provides nutritionists board-approved training in the field of
clinical nutrition.
Sec. 703.255. INVESTIGATION. (a) Not later than the 45th
day after the date a properly and timely submitted application is
received and not later than the 30th day before the next examination
date, the department shall notify an applicant in writing of the
receipt and investigation of the applicant's application and any
other relevant evidence relating to applicant qualifications
established by nutritionists board rule.
(b) The notice must state whether the applicant has
qualified for examination based on the application and other
submitted evidence. If the applicant has not qualified, the notice
must state the reasons for the applicant's failure to qualify.
Sec. 703.256. EXAMINATION RESULTS. (a) Not later than the
30th day after the date a person takes a licensing examination under
this chapter, the nutritionists board shall notify the person of
the results of the examination.
(b) If the examination is graded or reviewed by a testing
service:
(1) the nutritionists board shall notify the person of
the results of the examination not later than the 14th day after the
date the nutritionists board receives the results from the testing
service; and
(2) if notice of the examination results will be
delayed for longer than 90 days after the examination date, the
nutritionists board shall notify the person of the reason for the
delay before the 90th day.
(c) The nutritionists board may require a testing service to
notify a person of the results of the person's examination.
(d) If requested in writing by a person who fails an
examination under this chapter, the nutritionists board shall
furnish the person with an analysis of the person's performance on
the examination.
Sec. 703.257. REEXAMINATION. An applicant who fails the
examination three times must provide evidence to the nutritionists
board that the applicant has successfully completed credit hours in
the applicant's areas of weakness before the applicant may apply
for reexamination.
Sec. 703.258. QUALIFIED PERSON ENTITLED TO REGISTRATION.
The nutritionists board shall issue the appropriate clinical
nutritionist registration under this chapter to a person who meets
the qualifications for the registration. The registration must
specify on its face the category under which the person is
registered.
Sec. 703.259. PROVISIONAL REGISTRATION. (a) The
nutritionists board may issue a registration to use the title
"provisionally registered clinical nutritionist" to an applicant
who files an application, pays an application fee, and submits
evidence of successful completion of the educational requirements
under Section 703.254.
(b) A provisionally registered clinical nutritionist must
practice under the supervision and direction of a registered
clinical nutritionist. The supervising registered clinical
nutritionist must sign the application.
(c) A provisional registration expires on the first
anniversary of the date of issuance and, if the supervising
registered clinical nutritionist signs the renewal application,
may be renewed annually not more than twice by complying with the
renewal procedures under Section 703.301.
(d) A provisionally registered clinical nutritionist shall
comply with Sections 703.351 and 703.352.
Sec. 703.260. TEMPORARY REGISTRATION. (a) On receipt of an
application and payment of an application fee, the nutritionists
board may grant a temporary registration to an applicant who:
(1) is registered in good standing as a clinical
nutritionist in another state that has registration requirements
that are substantially equivalent to the requirements of this
chapter;
(2) has passed a national or other examination
recognized by the nutritionists board relating to clinical
nutrition; and
(3) is sponsored by a person registered by the
nutritionists board under this chapter with whom the temporary
registration holder may practice.
(b) The nutritionists board may waive the requirement of
Subsection (a)(3) if the nutritionists board determines that
compliance with that provision is a hardship to the applicant.
(c) A temporary registration is valid until the date the
nutritionists board approves or denies the temporary registration
holder's application for a license. The nutritionists board shall
issue a registration under this chapter to the holder of a temporary
registration if:
(1) the temporary registration holder passes the
competency examination required by Section 703.253;
(2) the nutritionists board verifies that the
temporary registration holder meets the academic and experience
requirements for a registration under this chapter; and
(3) the temporary registration holder satisfies any
other registration requirements under this chapter.
(d) The nutritionists board must complete the processing of
a temporary registration holder's application for a registration
not later than the 180th day after the date the nutritionists board
issues the temporary registration. The nutritionists board may
extend this deadline to receive pending examination results.
Sec. 703.261. INACTIVE STATUS. The nutritionists board by
rule may provide for a registration holder to place the person's
registration on inactive status. The nutritionists board by rule
shall provide for a time limit for a registration to remain on
inactive status.
Sec. 703.262. DUPLICATE REGISTRATION. The nutritionists
board shall issue a new registration to replace a registration that
is lost, destroyed, or mutilated, subject to nutritionists board
rules and on payment of a reasonable fee.
Sec. 703.263. RECIPROCITY. The nutritionists board may
waive any prerequisite to obtaining a registration for an applicant
who holds a registration issued by another jurisdiction with which
this state has a reciprocity agreement. The nutritionists board
may make an agreement, subject to the approval of the governor, with
another state to allow for registration by reciprocity.
[Sections 703.264-703.300 reserved for expansion]
SUBCHAPTER G. REGISTRATION RENEWAL; CONTINUING EDUCATION
Sec. 703.301. REGISTRATION RENEWAL. The nutritionists
board shall renew the registration of a qualified clinical
nutritionist in good standing who:
(1) returns a completed renewal form in the manner
prescribed by the nutritionists board;
(2) submits evidence of completion of the minimum
number of continuing education hours required by nutritionists
board rule; and
(3) pays the required renewal fee before the
registration expires.
Sec. 703.302. TERM OF REGISTRATION; EXPIRATION DATE. (a) A
registration is valid for one year after the date of issuance and
may be renewed annually.
(b) The nutritionists board by rule may adopt a system under
which registrations expire on various dates during the year. For
the year in which the registration expiration date is changed, a
registration fee payable on the original expiration date shall be
prorated on a monthly basis so that the registration holder pays
only that portion of the fee allocable to the number of months the
registration is valid. The registration holder shall pay the total
registration renewal fee on renewal of the registration on the new
expiration date.
Sec. 703.303. REGISTRATION RENEWAL PROCEDURE. (a) A
person who is otherwise eligible to renew a registration may renew
an unexpired registration by paying the required renewal fee to the
nutritionists board before the registration expiration date. A
person whose registration has expired may not engage in activities
that require a registration until the registration has been
renewed.
(b) A person whose registration has been expired for 90 days
or less may renew the registration by paying to the nutritionists
board a renewal fee that is equal to 1-1/2 times the normally
required renewal fee.
(c) A person whose registration has been expired for more
than 90 days but less than one year may renew the registration by
paying to the nutritionists board a renewal fee that is equal to two
times the normally required renewal fee.
(d) A person whose registration has been expired for one
year or more may not renew the registration. The person may obtain
a new registration by complying with the requirements and
procedures for obtaining an original registration.
(e) A person who was registered in this state, moved to
another state, and is currently registered and has been in practice
in the other state for the two years preceding the date of
application may obtain a new registration without reexamination.
The person must pay to the nutritionists board a fee that is equal
to two times the normally required renewal fee for the license.
(f) Not later than the 30th day before the date a person's
registration is scheduled to expire, the nutritionists board shall
send written notice of the impending expiration to the person at the
person's last known address according to the records of the
nutritionists board.
Sec. 703.304. STAGGERED RENEWAL OF REGISTRATIONS. The
nutritionists board by rule may adopt a system under which
registrations expire on various dates during the year. For the year
in which the registration expiration date is changed, the
nutritionists board shall prorate registration fees on a monthly
basis so that each registration holder pays only that portion of the
registration fee that is allocable to the number of months during
which the registration is valid. On renewal of the registration on
the new expiration date, the total registration renewal fee is
payable.
Sec. 703.305. CONTINUING EDUCATION. (a) The nutritionists
board by rule shall establish a minimum number of hours of
continuing education required for registration renewal under this
chapter.
(b) The nutritionists board may assess the continuing
education needs of registration holders and may require
registration holders to attend continuing education courses
specified by the nutritionists board. The nutritionists board
shall develop a process to evaluate and approve continuing
education courses.
(c) The nutritionists board shall identify the key factors
for the competent performance of professional duties. The
nutritionists board shall adopt a procedure to assess a
registration holder's participation in continuing education
programs.
[Sections 703.306-703.350 reserved for expansion]
SUBCHAPTER H. PRACTICE BY REGISTRATION HOLDER
Sec. 703.351. PRACTICE STRATEGIES FOR CLINICAL
NUTRITIONISTS. (a) A registered clinical nutritionist may work,
independently in a general office setting or as a member of a health
care team, as a nutritionist, nutritional coach, or nutritional
advisor in a corporation, providing referrals to and receiving
referrals from licensed physicians, chiropractors, nurses,
pharmacists, and dentists.
(b) In providing services under this chapter, a registered
clinical nutritionist may:
(1) plan and direct appropriate preventative and
therapeutic nutritional needs, including individual formulation of
enteral and parenteral nutrition;
(2) provide nutritional counseling and education to
increase client understanding of nutritional principles and
physiological and biochemical pathways to increase individual
choices for optimizing health;
(3) evaluate, develop, and formulate therapeutic
nutrition plans, which may include the recommendation of
nutritional supplements, including micronutrients,
macronutrients, and metabolites, as considered appropriate to
attain optimal health; and
(4) develop and administer nutrition care standards
and systems.
Sec. 703.352. DISPLAY OF REGISTRATION. (a) Each
registration holder shall display the person's registration in an
appropriate and public manner.
(b) A registration issued by the nutritionists board is the
property of the nutritionists board and must be surrendered on
demand.
Sec. 703.353. REGISTRATION HOLDER INFORMATION. A
registration holder shall keep the department informed of the
registration holder's current address.
Sec. 703.354. PROHIBITED USE OF SEAL. (a) A person may not
use a seal authorized by the nutritionists board unless the person
holds a registration issued under this chapter.
(b) A person may not affix a seal to a document if the
registration of the registration holder named on the seal is
expired, suspended, or revoked.
[Sections 703.355–703.400 reserved for expansion]
SUBCHAPTER I. PROHIBITED ACTS; DISCIPLINARY PROCEDURES
Sec. 703.401. PROHIBITED ACTS. (a) Unless the person holds
an appropriate registration issued under this chapter, a person may
not:
(1) use any title, or represent or imply that the
person has the right to use any title, that includes the term
"clinical nutritionist";
(2) use any initials that represent or imply that the
person holds a registration under this chapter; or
(3) use any facsimile of those titles or initials in
any manner to indicate or imply that the person is registered under
this chapter.
(b) Unless the person holds an appropriate registration or
certification issued by the Commission on Clinical Nutritionist
Registration or another organization recognized by the
nutritionists board, a person may not use any title or initials, or
any facsimile of those titles or initials, or represent or imply
that the person has the right to use any title implying such a
registration or certification.
Sec. 703.402. GROUNDS FOR DISCIPLINARY ACTION. The
nutritionists board shall revoke, suspend, or refuse to renew a
registration or shall reprimand a registration holder for a
violation of this chapter, a rule of the nutritionists board, or the
code of ethics adopted by the nutritionists board.
Sec. 703.403. HEARING. (a) If the nutritionists board
proposes to suspend or revoke a person's registration, the person
is entitled to a hearing.
(b) A member or employee of the nutritionists board or a
department employee who carries out the functions of the
nutritionists board and who proposes to make a decision, a finding
of fact, or a conclusion of law in a proceeding pending before the
nutritionists board may communicate directly or indirectly with a
party to the proceeding or with the party's representative only if
notice and an opportunity to participate are given to each party.
Sec. 703.404. SCHEDULE OF SANCTIONS. The State Office of
Administrative Hearings shall use the schedule of sanctions adopted
by the nutritionists board by rule for a sanction imposed as the
result of a hearing conducted by the office.
Sec. 703.405. PROBATION. The nutritionists board may place
on probation a person whose registration is suspended. If a
registration suspension is probated, the nutritionists board may
require the person:
(1) to report regularly to the nutritionists board on
matters that are the basis of the probation;
(2) to limit practice to the areas prescribed by the
nutritionists board; or
(3) to continue or review professional education until
the person attains a degree of skill satisfactory to the
nutritionists board in those areas that are the basis of the
probation.
Sec. 703.406. MONITORING OF REGISTRATION HOLDER. (a) The
nutritionists board by rule shall develop a system for monitoring a
registration holder's compliance with this chapter.
(b) Rules adopted under this section must include
procedures to:
(1) monitor for compliance a registration holder who
is ordered by the nutritionists board to perform certain acts; and
(2) identify and monitor registration holders who
represent a risk to the public.
Sec. 703.407. ADMINISTRATIVE PROCEDURE. A proceeding to
suspend or revoke a registration under this subchapter is governed
by Chapter 2001, Government Code.
[Sections 703.408-703.450 reserved for expansion]
SUBCHAPTER J. CIVIL PENALTY
Sec. 703.451. CIVIL PENALTY. (a) A person who violates
this chapter or a rule adopted by the board under this chapter is
liable to the state for a civil penalty of $1,000 for each day of
violation.
(b) At the request of the board, the attorney general shall
bring an action to recover a civil penalty authorized by this
section.
SECTION 2. (a) Until September 1, 2004, the Texas State
Board of Examiners of Clinical Nutritionists shall waive the
examination requirement under Chapter 703, Occupations Code, as
added by this Act, and issue a registration under that chapter to
any person who:
(1) presents evidence satisfactory to the Texas State
Board of Examiners of Clinical Nutritionists that the person has at
least five years of approved documented experience in the field of
clinical nutrition;
(2) holds an authorization of good standing for
clinical nutritionist status issued by a nationally recognized
professional certification entity approved by the Texas State Board
of Examiners of Clinical Nutritionists; or
(3) is a licensed physician, chiropractor, dentist,
pharmacist, or registered nurse who has:
(A) appropriate academic credentials in the
field of human nutrition or a directly related field approved by the
nutritionists board; or
(B) a minimum of three years' experience in the
practice of clinical nutrition.
(b) The governor shall appoint the initial members of the
Texas State Board of Examiners of Clinical Nutritionists not later
than December 1, 2003. In making the initial appointments, the
governor shall designate one clinical nutritionist appointee, one
health care practitioner appointee, and one public appointee for
terms expiring February 1, 2005, one clinical nutritionist
appointee, one health care practitioner appointee, and one public
appointee for terms expiring February 1, 2007, and one clinical
nutritionist appointee, one health care practitioner appointee,
and one public appointee for terms expiring February 1, 2009.
(c) A person appointed as a clinical nutritionist member of
the Texas State Board of Examiners of Clinical Nutritionists before
September 1, 2005, is not required to be registered under Chapter
703, Occupations Code, as added by this Act, but the person must be
eligible to hold a registration issued under that chapter, may not
have an additional primary practice, and must have at least three
years of professional experience in the field of clinical
nutrition.
SECTION 3. (a) Except as provided by Subsection (b) of this
section, this Act takes effect September 1, 2003.
(b) Section 703.251 and Subchapters I and J, Chapter 703,
Occupations Code, as added by this Act, take effect January 1, 2004.