Michael Stroka, JD, MBA, MS, CNS, CCN Executive Director, Certification Board for Nutrition Specialists Presentation at International Society of Sports Nutrition Annual Conference June 23, 2012 Mstroka@CBNS.org Disclaimer: This information does not constitute legal advice. This cannot substitute for legal counsel. 1
1. Private vs. government-issued credentials 2. Types of government regulation of nutrition advice 3. Anatomy of a licensing law 4. Impact on professionals who provide nutrition advice 2
Many Professions Use Nutrition Advice as a Tool in their Work: Credentialed Nutritionist Registered Dietitian MD / DO Pharmacist (drug-nutrient interaction) Nurse Chiropractor Personal Trainer (nutrition and exercise) Naturopath (prevention and therapeutic diets) Health Coaches Others 3
1. Private vs. government-issued credentials 2. Types of government regulation of nutrition advice 3. Anatomy of a licensing law 4. Impact on professionals who provide nutrition advice 4
Registered Certified Licensed Private Credentials Example: Registered Dietitian (RD) Examples: Certified Nutrition Specialist (CNS) Certified Sports Nutritionist (CISSN) X State Governmentissued Credentials Title Protection Only: California Title Protection Only: New York Certified Dietitian Nutritionist (CDN) Usually Exclusive Scope of Practice: Illinois Licensed Dietitian Nutritionist (LDN) 5
Certified Clinical Nutritionist (CCN) Certified Nutrition Specialist (CNS) Certified Nutritionist (CN) Certified Nutrition Counselor (CNC) Certified Sports Nutritionist (CISSN) Diplomate American Clinical Board Nutrition (DACBN) First Line Therapist (FLT) Registered Dietitian (RD) More 6
Certified Nutrition Specialist Certified Sports Nutritionist Registered Dietitian Emphasis Medical Nutrition Therapy (MNT), Clinical Nutrition Counseling Sports Nutrition MNT and Acute care, Food Service Management, Community Nutrition Minimum Education Masters or Doctoral degree Bachelors Bachelors Supervised Practice 1,000 hours NA 900/1,200 hours Exam 95% Clinical nutrition science & assessment 5% professional issues 100% Sports nutrition 62% Food and nutrition sciences, nutritioncare, & counseling/ communication 38% Food service systems & Operations management 7
1. Private vs. government-issued credentials 2. Types of government regulation of nutrition advice 3. Anatomy of a licensing law 4. Impact on professionals who provide nutrition advice 8
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1. Private vs. government-issued credentials 2. Types of government regulation of nutrition advice 3. Anatomy of a licensing law 4. Impact on professionals who provide nutrition advice 10
Type of Regulatory Regime Statute vs. Rules Scope of Practice (Activities covered by the law), e.g. Assessment Counseling Monitoring Supplements Requirements 1. Academic 2. Exam Registered Dietitian Exam (AND) Certified Nutrition Specialist Exam (CBNS) 3. Supervised Experience Exemptions Board Makeup Penalties 11
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In Exclusive-Scope states, illegal to provide nutrition counseling unless: 1. You obtain a nutrition license; or 2. You are exempted (e.g. if you are a licensed professional with nutrition explicitly in your scope of practice) Professionals commonly barred from nutrition counseling: Acupuncturists, Athletic Trainers, Chiropractors, Credentialed Nutritionists, Exercise Physiologists, Health Coaches, Herbalists, Naturopaths, Pharmacists, Physical Therapists, Personal Trainers, and others 12
Florida Dietetics and Nutrition Practice Act 468.502 Purpose and intent. The Legislature finds that the practice of dietetics and nutrition or nutrition counseling by unskilled and incompetent practitioners presents a danger to the public health and safety. The Legislature further finds that it is difficult for the public to make informed choices about dietitians and nutritionists and that the consequences of wrong choices could seriously endanger the public health and safety. It is the legislative intent that any person practicing dietetics and nutrition or nutrition counseling who falls below minimum competency or who otherwise presents a danger to the public be prohibited from practicing in this state. 14
1. Regime: Licensure with Exclusive Scope of Practice 2. Scope of Practice: 468.503 (4) Dietetics and nutrition practice shall include assessing nutrition needs and status using appropriate data; recommending appropriate dietary regimens, nutrition support, and nutrient intake; improving health status through nutrition research, counseling, and education; 8) Nutrition assessment means the evaluation of the nutrition needs of individuals or groups, using appropriate data to determine nutrient needs or status and make appropriate nutrition recommendations. (9) Nutrition counseling means advising and assisting individuals or groups on appropriate nutrition intake by integrating information from the nutrition assessment. 15
468.504 License required. No person may engage for remuneration in dietetics and nutrition practice or nutrition counseling or hold himself or herself out as a practitioner of dietetics and nutrition practice or nutrition counseling unless the person is licensed in accordance with the provisions of this part. 468.517 Penalties. (2) A person who violates any provision of this section commits a misdemeanor 16
Requirements: Education: BS in a dietetics major, or equivalent course of study determined by board/council Mirrors RD curriculum, including administration of food service or nutrition programs Supervised Practice Experience: 900 hours approved by board/council Including (c) A minimum of 200 hours in Food Service Systems Management Exam: Registered Dietitian exam only 17
1. Private vs. government-issued credentials 2. Types of government regulation of nutrition advice 3. Anatomy of a licensing law 4. Impact on professionals who provide nutrition advice 18
468.505 Exemptions (a) A person licensed in this state under [certain profession licensing laws], when engaging in the profession or occupation for which he or she is licensed, or of any person employed by and under the supervision of the licensee when rendering services within the scope of the profession or occupation of the licensee. (g) A person who markets or distributes food, food materials, or dietary supplements, or any person who engages in the explanation of the use and benefits of those products or the preparation of those products, if that person does not engage for a fee in dietetics and nutrition practice or nutrition counseling. 19
Florida Nutrition Counseling Illegal for: Athletic Trainers Credentialed Nutritionists Exercise Physiologists Health Coaches Herbalists Naturopaths Physical Therapists Personal Trainers Many States Nutrition Counseling Illegal for: Acupuncturists Chiropractors Nurses Pharmacists Athletic Trainers Credentialed Nutritionists Exercise Physiologists Health Coaches Herbalists Naturopaths Physical Therapists Personal Trainers And More 20
Boards and individuals encouraged to seek out/report suspected cases of harm or unauthorized practice Laws increasingly pressure licensees to report unlicensed practitioners: Wyoming: The board may revoke, suspend or refuse to renew any license if it finds that the person: Has violated or aided or abetted others in violation of any provision of this act. Florida: 468.517 Prohibitions; penalties. (1) A person may not knowingly: (f) Employ unlicensed persons to engage in dietetics and nutrition practice or nutrition counseling; or (g) Conceal information relative to any violation of this part. (2) A person who violates any provision of this section commits a misdemeanor 13
Dr. Liz Lipski, PhD, CCN PhD in Clinical Nutrition from the Union Institute (regionally accredited) Board Certified in Clinical Nutrition (CCN) Doctoral Studies & Educational Director (nutrition) at Hawthorn University Faculty at Saybrook University and Institute For Functional Medicine Prolific author, trainer of health professionals, over 30 yrs in practice Barred from Practice by North Carolina Dietetics Board 14
In a State With: Protect Yourself: No Regulation Keep abreast of attempts to change the law Title Protection Only Do not use restricted title (e.g. Dietitian Nutritionist ) Keep abreast of attempts to change the law Licensure (Exclusive Scope) Either: Do not engage in individualized nutrition advice, e.g. Assessment Counseling or Obtain License or Change the Law All Read Your Laws! 23
Disclaimer: This information does not constitute legal advice. This is a preliminary interpretation of language of state statutes, and cannot substitute for legal counsel. 24
Disclaimer: This information does not constitute legal advice. This is a preliminary interpretation of language of state statutes, and cannot substitute for legal counsel. 25
Disclaimer: This information does not constitute legal advice. This is a preliminary interpretation of language of state statutes, and cannot substitute for legal counsel. 26
Disclaimer: This information does not constitute legal advice. This is a preliminary interpretation of language of state statutes, and cannot substitute for legal counsel. 27
Disclaimer: This information does not constitute legal advice. This is a preliminary interpretation of language of state statutes, and cannot substitute for legal counsel. 28
Know your state s current regulatory regime Read your nutrition law Search nutrition licensing [your state] Read your own profession s licensing law Protect yourself and your ability to practice Email me at MStroka@cbns.org to stay updated 29
Michael Stroka, JD, MBA, MS, CNS, CCN Executive Director, Certification Board for Nutrition Specialists Presentation at International Society of Sports Nutrition Annual Conference June 23, 2012 Mstroka@CBNS.org 30