81R10231 BEF-F

By: Davis of Dallas H.B. No. 3528

A BILL TO BE ENTITLED

AN ACT

relating to the licensing and regulation of the practice of dietetics and nutrition care services.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Section 701.001, Occupations Code, is amended to read as follows:

Sec. 701.001. SHORT TITLE. This chapter may be cited as the Texas Dietetics and Nutrition Practice [Licensed Dietitian] Act.

SECTION 2. Section 701.002, Occupations Code, is amended by amending Subdivisions (3), (4), (6), (7), and (8) and adding Subdivision (6-a) to read as follows:

(3) "Dietetics" means the integration and application of [professional discipline of applying and integrating] scientific principles of food, nutrition, biochemistry, physiology, management, and behavioral and social sciences under different health, social, cultural, physical, psychological, and economic conditions for the proper nourishment, care, and education of an individual or group throughout the life cycle to achieve and maintain human health. The term includes the development, management, and provision of nutrition services.

(4) "Dietitians board" means the Texas [State] Board of Dietetics and Nutrition [Examiners of Dietitians].

(6) "Nutrition assessment" means evaluating the nutrition [nutritional] needs of an individual or group, using relevant data, to make appropriate nutrition recommendations [based on appropriate biochemical, anthropometric, physical, and dietary data to determine nutrient needs and recommend appropriate nutritional intake, including enteral and parenteral nutrition].

(6-a) "Nutrition care services" means all nutrition services provided by a licensed dietitian in each area of practice, including assessment, evaluation, counseling, research, education, monitoring, consultation, development, and implementation of food and nutrition-related services.

(7) "Nutrition counseling" means advising and assisting an individual or group on appropriate nutrition-related behavior by integrating information from the nutrition assessment [nutritional intake by integrating information from a nutrition assessment with information on food and other sources of nutrients and meal preparation consistent with cultural background and socioeconomic status].

(8) "Practice of dietetics and nutrition care [Nutrition] services" includes [means]:

(A) assessing the nutrition [nutritional] needs of an individual or group based on biochemical, anthropometric, physical, and dietary data, [and] determining constraints and resources to meet the nutrition needs of an individual or group, and recommending proper nutrition intervention, including specialized nutrition support such as determining nutrient needs for enteral and parenteral nutrition and monitoring to evaluate patient response to that treatment [in the practice];

(B) establishing priorities, objectives, and goals that meet the nutrition [nutritional] needs of the individual or group based on [and are consistent with] constraints and available resources;

(C) providing nutrition education and counseling in health and disease;

(D) developing, implementing, and managing food and nutrition [nutritional] care services [systems]; [or]

(E) evaluating, adjusting [changing], and maintaining appropriate quality standards in dietetics [food] and nutrition [nutritional] care services; and

(F) providing medical nutrition therapy in accordance with 42 U.S.C. Section 1395x(vv).

SECTION 3. Section 701.003, Occupations Code, is amended to read as follows:

Sec. 701.003. APPLICATION OF SUNSET ACT. The Texas [State] Board of Dietetics and Nutrition [Examiners of Dietitians] is subject to Chapter 325, Government Code (Texas Sunset Act). Unless continued in existence as provided by that chapter, the board is abolished September 1, 2017.

SECTION 4. Subchapter A, Chapter 701, Occupations Code, is amended by adding Sections 701.004 and 701.005 to read as follows:

Sec. 701.004. EXEMPTIONS. (a) This chapter does not apply to a person who is a:

(1) retailer that furnishes oral or written general nutrition information to a customer on food, food materials, dietary supplements, or other goods sold at the retailer's establishment in connection with the marketing and distribution of those goods at the retailer's establishment;

(2) person that furnishes oral or written general nutrition information on food, food materials, or dietary supplements;

(3) person engaged in the practice of the tenets of any religion, sect, or denomination that furnishes oral or written general nutrition information on food, food materials, or dietary supplements;

(4) person who disseminates oral or written general nutrition information, conducts a class or seminar, or gives a speech related to dietetics and nutrition care services;

(5) licensed health care professional practicing within the person's scope of practice;

(6) student or trainee working under the direct supervision of a licensed dietitian for a limited period as determined by the dietitians board, while fulfilling an experience requirement or pursuing a course of study to meet the requirements for a license under this chapter;

(7) person assisting in the practice of dietetics and nutrition care services under the direct supervision of a licensed dietitian and performing only support activities; or

(8) person providing a program of weight control services if the program has been reviewed by, consultation is available from, and no program change can be initiated without prior approval of a:

(A) dietitian registered by the Commission on Dietetic Registration; or

(B) licensed physician.

(b) This chapter does not apply to a dietitian or nutritionist serving in the United States armed forces or the United States Public Health Service or employed by the Department of Veterans Affairs when performing duties associated with that service or employment.

(c) This chapter does not apply to a dietitian or nutritionist employed by the state or a political subdivision of this state, including a school district, who is acting solely within the scope of the person's employment.

Sec. 701.005. APPLICABILITY OF OTHER LAW. This chapter does not authorize a person to medically diagnose or treat, or to attempt to medically diagnose, treat, or cure, a disease, disorder, deformity, or injury, or to otherwise engage in the practice of medicine in violation of Subtitle B.

SECTION 5. The heading to Subchapter B, Chapter 701, Occupations Code, is amended to read as follows:

SUBCHAPTER B. TEXAS [STATE] BOARD OF DIETETICS AND NUTRITION

[EXAMINERS OF DIETITIANS]

SECTION 6. Section 701.051(a), Occupations Code, is amended to read as follows:

(a) The Texas [State] Board of Dietetics and Nutrition [Examiners of Dietitians] consists of nine members appointed by the governor with the advice and consent of the senate as follows:

(1) six licensed dietitian members, each of whom has been licensed under this chapter for not less than three years before the member's date of appointment; and

(2) three members who represent the public, including one physician.

SECTION 7. Sections 701.2041(c), (e), (f), (h), and (i), Occupations Code, are amended to read as follows:

(c) If a person fails to comply with a subpoena, the dietitians [dieticians] board, acting through the attorney general, may file suit to enforce the subpoena in a district court in Travis County or in the county in which a hearing conducted by the board may be held.

(e) The board may delegate the authority granted under Subsection (a) to the executive secretary of the dietitians [dieticians] board.

(f) The dietitians [dieticians] board shall pay a reasonable fee for photocopies subpoenaed under this section in an amount not to exceed the amount the board may charge for copies of its records.

(h) All information and materials subpoenaed or compiled by the dietitians [dieticians] board in connection with a complaint and investigation are confidential and not subject to disclosure under Chapter 552, Government Code, and not subject to disclosure, discovery, subpoena, or other means of legal compulsion for their release to anyone other than the board or its employees or agents involved in discipline of the holder of a license, except that this information may be disclosed to:

(1) persons involved with the board in a disciplinary action against the holder of a license;

(2) professional dietitian licensing or disciplinary boards in other jurisdictions;

(3) peer assistance programs approved by the board under Chapter 467, Health and Safety Code;

(4) law enforcement agencies; and

(5) persons engaged in bona fide research, if all individual-identifying information has been deleted.

(i) The filing of formal charges by the dietitians [dieticians] board against a holder of a license, the nature of those charges, disciplinary proceedings of the board, and final disciplinary actions, including warnings and reprimands, by the board are not confidential and are subject to disclosure in accordance with Chapter 552, Government Code.

SECTION 8. Section 701.251(b), Occupations Code, is amended to read as follows:

(b) Unless the person holds a [an appropriate] license issued under this chapter, a person may not:

(1) use the title or represent or imply that the person has the title "dietitian" ["licensed dietitian"] or "provisional licensed dietitian" or use the letters "LD" or "PLD"; [or]

(2) use a facsimile of those titles or letters to indicate or imply that the person is a dietitian, licensed dietitian, or provisional licensed dietitian; or

(3) engage in the practice of dietetics and nutrition care services.

SECTION 9. Section 701.252(a), Occupations Code, is amended to read as follows:

(a) Each applicant for a [dietitian] license under this chapter must submit a sworn application accompanied by the application fee.

SECTION 10. Sections 701.253(c) and (e), Occupations Code, are amended to read as follows:

(c) The dietitians board shall [prepare or] approve an examination administered[. An examination prescribed by the board may be or may include an examination given] by the Commission on Dietetic Registration unless the board finds that the examination is inadequate to protect the public health and safety [or by a national or state testing service instead of an examination prepared by the board].

(e) Examinations [The dietitians board] shall be administered [administer an examination] to qualified applicants at least twice each calendar year.

SECTION 11. Section 701.254, Occupations Code, is amended to read as follows:

Sec. 701.254. QUALIFICATIONS FOR EXAMINATION. (a) To qualify for the licensing examination under this chapter, an applicant must:

(1) possess at least a baccalaureate [or postbaccalaureate] degree from a United States [, conferred by a college or university] regionally accredited college or university [at the time of conferral,] with[:

[(A)] a major course of study in human nutrition, food and nutrition, nutrition education, dietetics, or food systems management; [or

[(B) an equivalent major course of study approved by the dietitians board;] and

(2) have completed a [an internship or preplanned,] documented supervised practice [, professional] experience component [program] in dietetics [practice] of not less than 900 hours under the supervision of a licensed dietitian, a state-licensed health care practitioner, or an individual with a doctoral degree conferred by a regionally accredited college or university with a major course of study in human nutrition, food and nutrition, nutrition education, dietetics, or food systems management [or a registered dietitian approved by the board].

(b) The supervised practice experience component must be completed in the United States.

(c) The dietitians board shall determine whether a degree conferred on an applicant by an educational institution outside of the United States is equivalent to a degree conferred by a regionally accredited institution of higher education in the United States.

(d) The dietitians board shall determine whether the degree of a person who holds a doctoral degree conferred outside the United States is equivalent to a doctoral degree conferred by a regionally accredited institution of higher education in the United States before the person may supervise a practice experience component under this section.

SECTION 12. Section 701.257, Occupations Code, is amended to read as follows:

Sec. 701.257. REEXAMINATION FOR LICENSING EXAMINATION. An applicant who fails the licensing examination [three times] must comply with [provide evidence to the dietitians board that the applicant has successfully completed credit hours in the applicant's areas of weakness before] the [applicant may apply for] reexamination requirements of the entity that administers the examination under Section 701.253(c).

SECTION 13. Section 701.258, Occupations Code, is amended to read as follows:

Sec. 701.258. QUALIFIED PERSON ENTITLED TO LICENSE. The dietitians board shall issue a license under this chapter to a person who:

(1) submits an application under Section 701.252;

(2) passes the jurisprudence examination under Section 701.2575;

(3) passes the examination under Section 701.253;

(4) pays the required examination and application fees; and

(5) is otherwise [certificate as a licensed dietitian to a person] qualified for a license under this chapter.

SECTION 14. Subchapter H, Chapter 701, Occupations Code, is amended by adding Section 701.354 to read as follows:

Sec. 701.354. REIMBURSEMENT NOT MANDATED; SERVICES AUTHORIZED. (a) This chapter does not require new or additional third-party reimbursement or mandated workers' compensation benefits for services provided by a license holder under this chapter.

(b) A license holder under this chapter is qualified to provide medical nutrition therapy in accordance with 42 U.S.C. Section 1395x(vv).

SECTION 15. The following sections of the Occupations Code are repealed:

(1) Section 701.253(d); and

(2) Section 701.260.

SECTION 16. The change in law made by this Act by the enactment of Section 701.251(b)(3) applies only to the practice of dietetics and nutrition care services on or after September 1, 2009. The practice of dietetics and nutrition care services before that date is governed by the law in effect on the date the practice occurred, and the former law is continued in effect for that purpose.

SECTION 17. The changes in law made by this Act in the qualifications of public members of the Texas Board of Dietetics and Nutrition do not affect the entitlement of a member serving on the board immediately before the effective date of this Act to continue to serve for the remainder of the member's term. As the terms of board members expire, the governor shall appoint or reappoint a member who has the qualifications required for a member under Section 701.051(a)(2), Occupations Code, as amended by this Act.

SECTION 18. The changes in law made by this Act by the amendment of Sections 701.253 and 701.254, Occupations Code, apply only to a person who submits an application for a license under Chapter 701, Occupations Code, on or after the effective date of this Act. A person who submits an application before the effective date of this Act is governed by the law in effect on the date the application is submitted, and the former law is continued in effect for that purpose.

SECTION 19. The change in law made by this Act by the amendment of Section 701.257, Occupations Code, applies only to a person who submits an application for reexamination on or after the effective date of this Act. A person who submits an application for reexamination before the effective date of this Act is governed by the law in effect on the date the application is submitted, and the former law is continued in effect for that purpose.

SECTION 20. This Act takes effect September 1, 2009.