Georgia 2023 2023-2024 Regular Session

Georgia House Bill HB844 Introduced / Bill

Filed 03/29/2023

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House Bill 844
By: Representatives Ehrhart of the 36
th
 and Powell of the 33
rd
 
A BILL TO BE ENTITLED
AN ACT
To amend Title 43 of the Official Code of Georgia Annotated, relating to professions and
1
businesses, so as to repeal and reenact Chapter 11A, the "Dietetics Practice Act"; to provide2
for the licensure of dietitian nutritionists and nutritionists; to provide for a short title; to3
provide for the purpose of the chapter; to provide definitions; to establish the Georgia Board4
of Examiners of Licensed Dietitian Nutritionists and Licensed Nutritionists; to provide for5
powers, members, officers, and meetings of such board; to provide for the grant of a license6
without examination; to provide for eligibility for licensure as a dietitian nutritionist and7
nutritionist; to provide for provisional licenses; to permit applications to be made under oath;8
to provide for such board to notify applicants of acceptance or rejection; to provide for9
examinations; to provide for certain requirements of licensees; to provide for refusal,10
suspension, or revocation of licenses; to provide for exceptions to licensure; to provide for11
proceedings; to provide for statutory construction; to provide for scope of practice; to provide12
for a qualified supervisor over a supervised practice experience in the practice of nutrition13
and dietetics; to amend the Official Code of Georgia Annotated, so as to provide for14
conforming cross-references; to provide for related matters; to provide for an effective date;15
to repeal conflicting laws; and for other purposes.16
BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:17 23 LC 52 0288
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PART I
18
Practice of Nutrition and Dietetics Act19
SECTION 1-1.20
Title 43 of the Official Code of Georgia Annotated, relating to professions and businesses,21
is amended by repealing and reenacting Chapter 11A, the "Dietetics Practice Act," as22
follows:23
"CHAPTER 11A
24
43-11A-1.25
This chapter shall be known and may be cited as the 'Practice of Nutrition and Dietetics26
Act.'27
43-11A-2.28
The General Assembly acknowledges that the application of scientific knowledge relating29
to nutrition is important in the treatment of disease and in the attainment and maintenance30
of health and acknowledges further that the rendering of sound dietetic or nutrition services31
for the treatment or management of diseases or medical conditions in hospitals, nursing32
homes, school districts, health departments, private practice and consultation, and other33
settings requires trained and competent professionals.  It is declared, therefore, to be the34
purpose of this chapter to protect the health, safety, and welfare of the public by providing35
for the licensure and regulation of the activities of persons engaged in the practice of36
nutrition and dietetics.37
43-11A-3.38
As used in this chapter, the term:39 23 LC 52 0288
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(1)  'Advertising' means, but is not limited to, issuing or causing to be distributed any40
card, sign, or other device; causing or permitting any sign or marking on or in any41
building or structure or in any newspaper, magazine, or directory; or causing or42
permitting any announcement on radio or any announcement or display on television, a43
computer network, or an electronic or telephonic medium.44
(2)  'Applicant' means any person seeking a license under this chapter.45
(3)  'Board' means the Georgia Board of Examiners of Licensed Dietitian Nutritionists46
and Licensed Nutritionists established by this chapter.47
(4)  'Certified nutrition specialist' means a person who is credentialed by the Board for48
Certification of Nutrition Specialists or its successor organization as a certified nutrition49
specialist and is authorized to use such title and the designation 'CNS.'50
(5)  'Degree' means a degree received from a college or university accredited by the51
appropriate regional accrediting agency recognized by the Council for Higher Education52
Accreditation or its successor organization and the United States Department of53
Education at the time the degree was received, or a validated foreign equivalent as54
recognized by the board by approval, policy, or rule.55
(6)  'General nonmedical nutrition information' means information on:56
(A)  Principles of human nutrition and food preparation;57
(B)  Principles of self care and a healthy relationship with food;58
(C)  Essential nutrients needed by the human body;59
(D)  General and nonindividualized recommended amounts of essential nutrients in the60
human body;61
(E)  Actions of nutrients in the human body;62
(F)  Nonindividualized effects of deficiencies or excesses of nutrients in the human63
body; or64
(G)  General education surrounding foods, herbs, and dietary supplements that are good65
sources of essential nutrients in the human body.66 23 LC 52 0288
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(7)  'Licensed dietitian nutritionist' means a person duly licensed under this chapter as67
meeting the requirements provided for in subsection (a) of Code Section 43-11A-9 to68
practice nutrition and dietetics, including the provision of medical nutrition therapy,69
subject to the scope of practice provisions provided in Code Section 43-11A-19.70
(8)  'Licensed nutritionist' means a person duly licensed under this chapter as meeting the71
requirements provided for in subsection (b) of Code Section 43-11A-9 to practice72
nutrition and dietetics, including the provision of medical nutrition therapy, subject to the73
scope of practice provisions provided in Code Section 43-11A-19.74
(9)  'Medical nutrition therapy' means the provision of the following nutrition care75
services for the treatment or management of a disease or medical condition:76
(A)  Nutrition assessment, including ordering laboratory tests to check and track77
nutrition status;78
(B)  Nutrition diagnosis;79
(C)  Nutrition intervention, including approving, ordering, and monitoring therapeutic80
diets, and nutrition counseling on therapeutic diets and food and prescription drug81
interactions; and82
(D)  Nutrition monitoring and evaluation.83
(10)  'Medical weight control' means medical nutrition therapy provided for the purpose84
of reducing, maintaining, or gaining weight.85
(11)  'Nonmedical weight control' means nutrition care services provided for the purpose86
of reducing, maintaining, or gaining weight that do not constitute the treatment or87
management of a disease or medical condition.  Such term includes weight control88
services for healthy population groups to achieve or maintain a healthy weight.89
(12)  'Nutrition assessment' means the ongoing, dynamic, and systematic process of90
ordering, obtaining, verifying, and interpreting biochemical, anthropometric, physical,91
nutrigenomic, and dietary data to make decisions about the nature and cause of nutrition92
related problems relative to patient or community needs.  Such term includes the initial93 23 LC 52 0288
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data collection and evaluation and any reassessment and analysis of patient or community94
needs.  Such term provides the foundation for nutrition diagnosis and nutritional95
recommendations; provided, however, that the collection of data does not, by itself,96
constitute nutrition assessment.97
(13)  'Nutrition care process' means the systematic problem solving method that licensed98
dietitian nutritionists and licensed nutritionists use to critically think and make decisions99
when providing medical nutrition therapy or to address nutrition related problems and100
provide safe, effective, high-quality nutrition care services.  Such term consists of four101
distinct, but interrelated steps: nutrition assessment, nutrition diagnosis, nutrition102
intervention, and nutrition monitoring and evaluation.103
(14)  'Nutrition care services' means any part or all of the following services provided104
within a systematic process:105
(A)  Assessing and evaluating the nutritional needs of individuals and groups and106
determining resources and constraints in a practice setting, including ordering nutrition107
related laboratory tests to check and track nutrition status;108
(B)  Identifying nutrition problems and establishing priorities, goals, and objectives that109
meet nutritional needs and are consistent with available resources and constraints;110
(C)  Creating individualized dietary plans, including therapeutic diets; issuing and111
implementing dietary orders to meet the nutritional needs of healthy individuals and112
individuals in acute and chronic disease states; and monitoring the effectiveness of such113
dietary plans and orders;114
(D)  Determining and providing appropriate nutrition interventions in health and115
disease, including nutrition counseling on food and prescription drug interactions;116
(E)  Developing, implementing, and managing nutrition care systems; or117
(F)  Evaluating, making changes to, and maintaining appropriate standards of quality118
in food and nutrition services.119 23 LC 52 0288
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(15)  'Nutrition counseling' means a supportive process, characterized by a collaborative120
counselor-patient or counselor-client relationship with individuals or groups, to establish121
food and nutrition priorities, goals, individualized action plans, and general physical122
activity recommendations that acknowledge and foster responsibility for self care to123
promote health and wellness or to treat or manage an existing disease or medical124
condition.125
(16)  'Nutrition diagnosis' means identifying and labeling nutritional problems managed126
and treated by a licensee but does not include a medical diagnosis of the health status of127
an individual.128
(17)  'Nutrition intervention' means purposefully planned interventions, including129
nutrition counseling, intended to positively change a nutrition related behavior, risk130
factor, environmental condition, or aspect of the health status of an individual, target131
group, or community at large.132
(18)  'Nutrition monitoring and evaluation' means identifying patient outcomes relevant133
to a nutrition diagnosis, nutrition intervention plans, and nutrition goals, and comparing134
those outcomes with a patient's previous health status, nutrition intervention plans, and135
nutrition goals, or reference standards to determine the progress made in achieving136
desired outcomes of nutrition care services and whether planned nutrition interventions137
should be continued or revised.138
(19)  'Patient' means an individual recipient of nutrition care services, whether in an139
outpatient, inpatient, or nonclinical setting.140
(20)  'Practice of nutrition and dietetics' means the integration and application of scientific141
principles derived from the study of food, nutrition, biochemistry, metabolism,142
nutrigenomics, physiology, and food systems and management, and from behavioral and143
social sciences, for achieving and maintaining health throughout the lifespan.  Such term144
is primarily the provision of nutrition care services, including medical nutrition therapy,145 23 LC 52 0288
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in person or via telehealth, to prevent, manage, or treat diseases or medical conditions and146
to promote wellness.147
(21)  'Provisionally licensed dietitian nutritionist' or 'provisionally licensed nutritionist'148
means a person provisionally licensed as provided for in Code Section 43-11A-10.149
(22)  'Qualified supervisor' means an individual providing supervision who assumes full150
professional responsibility for the work of the supervisee by verifying, directing, and151
authorizing the provided nutrition care services and other work being supervised, as152
provided for in Code Section 43-11A-20.153
(23)  'Registered dietitian nutritionist' means a person who is credentialed by the154
Commission on Dietetic Registration or its successor organization as a registered dietitian155
nutritionist or a registered dietitian and is authorized to use such title and the designation156
'RDN' or 'RD.'157
(24)  'Supervisee' means a student, intern, or trainee providing nutrition care services and158
other work under the supervision of a qualified supervisor, as provided for in Code159
Section 43-11A-20.160
(25)  'Telehealth' means the use of electronic information and telecommunications161
technologies to provide services under this chapter between a healthcare provider in one162
location and an individual in another location to support clinical healthcare, public health,163
patient health related education, and health administration.164
(26)  'Therapeutic diet' means a diet intervention prescribed by a licensed physician or165
planned, ordered, or implemented by a licensed dietitian nutritionist or licensed166
nutritionist that provides food or nutrients via oral, enteral, or parenteral routes as part of167
the treatment of a disease or medical condition to modify, eliminate, decrease, or increase168
identified micronutrients and macronutrients in a patient's diet, or to provide169
mechanically altered food when indicated.170 23 LC 52 0288
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(27)  'Unrestricted practice of medical nutrition therapy' means the application of dietetics171
and nutrition knowledge and skills by an individual who regulates and is responsible for172
his or her own practice or treatment procedures.173
43-11A-4.174
(a)  The Georgia Board of Examiners of Licensed Dietitians in existence prior to July 1,175
2023, is continued in existence thereafter as the Georgia Board of Examiners of Licensed176
Dietitian Nutritionists and Licensed Nutritionists.  Those persons serving as members of177
the board immediately prior to July 1, 2023, shall continue to serve out their respective178
terms of office and until their successors are appointed and qualified.  The board shall179
consist of seven members as follows:180
(1)  Four members shall be licensed dietitian nutritionists and two members shall be181
licensed nutritionists; provided, however, that, of those six members, at least one member182
shall be from each of the following areas of the practice of nutrition and dietetics: clinical183
nutrition and dietetics, community or public health nutrition and dietetics, and the private184
practice of nutrition and dietetics; provided, further, that at least one member shall be an185
educator on the faculty of a college or university specializing in the field of nutrition and186
dietetics; and187
(2)  One member shall represent the public at large.188
(b)  Members of the board shall be appointed by the Governor with the confirmation of the189
Senate.  Members of the board shall take office on the first day of July immediately190
following the expired terms of that office and shall serve for terms of four years and until191
their successors are appointed and qualified.  Those persons serving as members of the192
board immediately prior to July 1, 2023, shall continue to serve out their respective terms193
of office and until their respective successors are appointed and qualified.  Any person194
appointed to the board when the Senate is not in session may serve on the board without195
Senate confirmation until the Senate acts on that appointment.  No member shall serve on196 23 LC 52 0288
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the board for more than two consecutive terms.  Any vacancy shall be filled by the197
Governor subject to confirmation of the Senate.198
(c)  All members of the board shall be reimbursed as provided for in subsection (f) of Code199
Section 43-1-2.200
(d)  All members of the board shall take the constitutional oath of office.201
43-11A-5.202
(a)  Professional members of the board shall:203
(1)  Be citizens of the United States and residents of this state;204
(2)  Have engaged in the practice of nutrition and dietetics for compensation for not less205
than five years; and206
(3)  Be licensed under this chapter.207
(b)  Consumer members of the board shall be appointed by the Governor from the public208
at large, shall be citizens of the United States and residents of this state, and shall have no209
connection whatsoever with the practice of nutrition and dietetics.210
(c)  The Governor may remove members of the board, after notice and opportunity for211
hearing, for incompetence, neglect of duty, unprofessional conduct, conviction of any212
felony, failure to meet the qualifications of this chapter, or committing any act prohibited213
by this chapter.214
43-11A-6.215
The board shall meet annually and shall elect from its members a chairperson, a vice216
chairperson, and any other officers as deemed necessary who shall hold office according217
to the rules adopted by the board.  In addition to its annual meeting, the board shall hold218
at least two other meetings each year as provided by the rules adopted by the board.219 23 LC 52 0288
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43-11A-7.220
The board shall have the power to:221
(1)  Enforce the provisions of this chapter, and it shall be granted all of the necessary222
duties, powers, and authority to carry out this responsibility;223
(2)  Draft, adopt, amend, repeal, and enforce such rules as it deems necessary for the224
administration and enforcement of this chapter in the protection of public health, safety,225
and welfare;226
(3)  License duly qualified applicants by examination, endorsement, or reinstatement;227
(4)  Implement a disciplinary process;228
(5)  Enforce qualifications for licensure;229
(6)  Set standards for competency of licensees continuing in or returning to practice;230
(7)  Issue orders when a license is surrendered to the board while a complaint,231
investigation, or disciplinary action against such license is pending;232
(8)  Adopt, revise, and enforce rules regarding advertising by licensees, including, but not233
limited to, rules to prohibit false, misleading, or deceptive practices;234
(9)  Adopt, publish in print or electronically, and enforce a code of ethics;235
(10)  Establish examination and licensing fees;236
(11)  Request and receive the assistance of state educational institutions or other state237
agencies;238
(12)  Prepare information of consumer interest describing the regulatory functions of the239
board and describing the procedures by which consumer complaints are filed with and240
resolved by the board.  The board shall make the information available to the general241
public and appropriate state agencies;242
(13)  Establish continuing education requirements; and243
(14)  Adopt a seal which shall be affixed only in such manner as prescribed by the board.244 23 LC 52 0288
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43-11A-8.245
The board may grant, upon application and payment of proper fees, a license without246
examination to a person who, at the time of application, holds a valid license or247
certification as a licensed or certified dietitian nutritionist, dietitian, or nutritionist issued248
by another state, political territory, or jurisdiction acceptable to the board if, in the board's249
opinion, the requirements for such license or certification are substantially the same as the250
requirements of this chapter and rules and regulations promulgated by the board.251
43-11A-9.252
(a)  Each applicant for a license as a licensed dietitian nutritionist shall be at least 18 years253
of age, submit a completed application upon a form and in such manner as the board254
prescribes, pay any applicable fees, and:255
(1)  Present evidence satisfactory to the board that the applicant holds a current and valid256
registration as a registered dietitian nutritionist; or257
(2)  Submit proof of:258
(A)  Completion of:259
(i)  A master's or doctoral degree with a major course of study in dietetics, human260
nutrition, food and nutrition, nutrition education, food systems management, or an261
equivalent course of study from a college or university accredited at the time of the262
applicant's graduation by the appropriate regional accrediting agency recognized by263
the Council for Higher Education Accreditation or its successor organization and the264
United States Department of Education and accredited by the Accreditation Council265
for Education in Nutrition and Dietetics or its successor organization; or266
(ii)  An academic degree from a college or university in a foreign country that the267
board determines is equivalent to a degree and major course of study provided for in268
division (i) of this subparagraph;269 23 LC 52 0288
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(B)  Satisfactory completion of a documented, supervised experience component in the270
practice of nutrition and dietetics accredited by the Accreditation Council for Education271
in Nutrition and Dietetics or its successor organization, consisting of not less than 1,000272
hours supervised by a qualified supervisor as provided for in Code Section 43-11A-20;273
(C)  Passage of the examination for registered dietitian nutritionists administered by the274
Commission on Dietetic Registration or its successor organization; and275
(D)  Completion of such other requirements as may be prescribed by the board.276
(b)  Each applicant for a license as a licensed nutritionist shall be at least 18 years of age,277
submit a completed application upon a form and in such manner as the board prescribes,278
pay any applicable fees, and submit proof of:279
(1)  Completion of:280
(A)  A master's or doctoral degree with a major course of study in human nutrition, food281
and nutrition, community nutrition, public health nutrition, nutrition education, nutrition282
science, clinical nutrition, applied clinical nutrition, nutrition counseling, nutrition and283
functional medicine, nutritional biochemistry, nutrition and integrative health, or a284
substantially equivalent course of study from a college or university accredited at the285
time of the applicant's graduation by the appropriate regional accrediting agency286
recognized by the Council for Higher Education Accreditation or its successor287
organization and by the United States Department of Education; provided, however,288
that the applicant has completed coursework leading to competence in medical nutrition289
therapy, including, but not limited to:290
(i)  Fifteen semester hours of courses on clinical or life sciences, including at least291
three semester hours on human anatomy and physiology or an equivalent subject; and292
(ii) Fifteen semester hours of courses on nutrition and metabolism, including at least293
six semester hours on biochemistry;294
(B)  An academic degree from a college or university in a foreign country that the board295
determines is equivalent to a degree and major course of study provided for in296 23 LC 52 0288
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subparagraph (A) of this paragraph; provided, however, that the applicant has297
completed coursework leading to competence in medical nutrition therapy, including,298
but not limited to:299
(i)  Fifteen semester hours of courses on clinical or life sciences, including at least300
three semester hours on human anatomy and physiology or an equivalent subject; and301
(ii)  Fifteen semester hours of courses on nutrition and metabolism, including at least302
six semester hours on biochemistry;303
(C)  A master's or doctoral degree in a clinical healthcare field from a college or304
university accredited at the time of the applicant's graduation by the appropriate305
regional accrediting agency recognized by the Council for Higher Education306
Accreditation or its successor organization and the United States Department of307
Education; provided, however, that the applicant has completed coursework leading to308
competence in providing medical nutrition therapy, including, but not limited to:309
(i)  Fifteen semester hours of courses on clinical or life sciences, including at least310
three semester hours on human anatomy and physiology or an equivalent subject; and311
(ii)  Fifteen semester hours of courses on nutrition and metabolism, including at least312
six semester hours on biochemistry; or313
(D)  An academic degree from a college or university in a foreign country that the314
board determines is equivalent to a degree and major course of study provided for in315
subparagraph (C) of this paragraph; provided, however, that the applicant has316
completed coursework leading to competence in providing medical nutrition therapy,317
including, but not limited to:318
(i)  Fifteen semester hours of courses on clinical or life sciences, including at least319
three semester hours on human anatomy and physiology or an equivalent subject; and320
(ii)  Fifteen semester hours of courses on nutrition and metabolism, including at least321
six semester hours on biochemistry;322 23 LC 52 0288
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(2)  Completion of a planned, documented, and continuous supervised practice323
experience demonstrating competence in providing nutrition care services and medical324
nutrition therapy approved by the board and meeting all of the following requirements:325
(A)  An applicant shall complete a supervised practice experience under this paragraph326
within five years of completing the requirements provided for in paragraph (1) of this327
subsection; provided, however, that the board in its discretion may grant an extension328
for extraordinary circumstances;329
(B)  A supervised practice experience provided for in this paragraph shall:330
(i)  Involve at least 1,000 hours in the following practice areas, with a minimum of331
200 hours in each practice area: conducting nutrition assessment and nutrition332
diagnosis, nutrition intervention, and nutrition monitoring and evaluation;333
(ii)  Be under the supervision of a qualified supervisor as provided for in Code334
Section 43-11A-20; and335
(iii)  Prepare students to provide nutrition care services for various populations of336
diverse cultures, genders, and ages, and to be able to competently formulate337
actionable medical nutrition therapies and nutrition interventions, nutrition education,338
nutrition counseling, and ongoing nutrition care services for the prevention,339
modulation, and management of a range of acute and chronic medical conditions;340
(3)  Satisfaction of examination requirements by:341
(A)  Passage of the certified nutrition specialist examination administered by the Board342
for Certification of Nutrition Specialists or its successor organization, or passage of an343
equivalent examination on all aspects of the practice of nutrition and dietetics that is344
accredited by the National Commission for Certifying Agencies or its successor345
organization and that is approved by the board; or346
(B)  A current and valid certification from the Board for Certification of Nutrition347
Specialists or its successor organization that allows the applicant to use the title348
'certified nutrition specialist' or the designation 'CNS'; and349 23 LC 52 0288
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(4)  Completion of such other requirements as may be prescribed by the board.350
(c)  All persons licensed or who have submitted an application for licensure prior to July 1,351
2023, shall remain licensed, be eligible for reactivation, or be eligible for licensure under352
the requirements in place at the time of licensure or application, so long as the applicant353
or licensee remains in good standing and maintains an active or inactive license if obtained354
or once it is obtained.  Such persons shall be licensed dietitian nutritionists.355
43-11A-10.356
The board, at its discretion, may issue a provisional license for an individual to practice as357
a provisionally licensed dietitian nutritionist or provisionally licensed nutritionist for one358
year under the supervision of a licensed dietitian nutritionist or licensed nutritionist upon359
the filing of an application with appropriate fees and submission of evidence of successful360
completion of a substantial portion of the requirements for licensure as provided for in361
Code Section 43-11A-9; provided, however, that the board, at its discretion, may allow362
such licensee to renew such provisional license for a length of time determined by the363
board; provided, further, that the board may require a renewal fee for such licensee to364
maintain such provisional license.365
43-11A-11.366
The board may require that all applications be made under oath.367
43-11A-12.368
After evaluation of an application and other evidence submitted, the board shall notify each369
applicant that the application and evidence submitted are satisfactory and accepted or370
unsatisfactory and rejected.  If the application and evidence are unsatisfactory and rejected,371
the notice shall state the reasons for the rejection.372 23 LC 52 0288
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43-11A-13.373
(a)  Examinations to determine competence shall be administered to qualified applicants374
at least twice each calendar year.  The examinations may be administered by a national375
testing service.  The board shall prescribe or develop the examinations, which may include,376
but are not limited to:377
(1)  The examination for registered dietitian nutritionists administered by the Commission378
on Dietetic Registration or its successor organization;379
(2)  The examination for certified nutrition specialists administered by the Board for380
Certification of Nutrition Specialists or its successor organization; or381
(3)  Any other equivalent examination evaluating knowledge of the practice of nutrition382
and dietetics that is accredited by the National Commission for Certifying Agencies or383
its successor organization and approved by a two-thirds' vote of the board.384
(b)  The board shall notify each examinee of the results of the examination.385
43-11A-14.386
(a)  A license issued by the board is the property of the board and shall be surrendered on387
demand.388
(b)  The licensee shall display the license certificate in an appropriate and public manner.389
(c)  The licensee shall inform the board of any change of address.390
(d)  The license shall be renewed biennially if the licensee is not in violation of this chapter391
at the time of application for renewal and if the applicant fulfills current requirements of392
continuing education as established by the board.393
(e)  Each licensee is responsible for renewing his or her license before the expiration date.394
(f)  Under procedures and conditions established by the board, a licensee may request that395
his or her license be declared inactive; provided, however, that such licensee may apply for396
active status at any time and upon meeting the conditions set by the board shall be declared397
active.398 23 LC 52 0288
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43-11A-15.399
The board may refuse to grant or renew a license to an applicant; administer a public or400
private reprimand, but a private reprimand shall not be disclosed to any person except the401
licensee; suspend the license of any licensee for a definite period or for an indefinite period402
in connection with any condition which may be attached to the restoration of such license;403
limit or restrict the license of any licensee as the board deems necessary for the protection404
of the public; revoke any license; condition the penalty upon, or withhold formal405
disposition pending, the applicant's or licensee's submission to such care, counseling, or406
treatment as the board may direct; or impose a fine not to exceed $500.00 for each violation407
of a law, rule, or regulation relating to the profession regulated by this chapter upon a408
finding by a majority of the board that the licensee or applicant has:409
(1)  Failed to demonstrate the qualifications or standards for a license contained in this410
chapter or under the laws, rules, or regulations under which licensure is sought or held.411
It shall be incumbent upon the applicant to demonstrate to the satisfaction of the board412
that such applicant meets all the requirements for the issuance of a license, and, if the413
board is not satisfied as to the applicant's qualifications, it may deny a license without a414
prior hearing; provided, however, that the applicant shall be allowed to appear before the415
board if he or she so desires;416
(2)  Knowingly made misleading, deceptive, untrue, or fraudulent representations in the417
practice of a business or profession licensed under this title or on any document418
connected therewith, or practiced fraud or deceit or intentionally made any false419
statement in obtaining a license to practice the licensed business or profession, or made420
a false statement or deceptive registration with the board;421
(3)  Been convicted of any felony or of any crime involving moral turpitude in the courts422
of this state or any other state, territory, or country or in the courts of the United States;423
as used in this paragraph and paragraph (4) of this Code section, the term 'felony' shall424
include any offense which, if committed in this state, would be deemed a felony, without425 23 LC 52 0288
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regard to its designation elsewhere; and, as used in this paragraph, the term 'convicted'426
shall include a finding or verdict of guilty or a plea of guilty, regardless of whether an427
appeal of the conviction has been sought;428
(4)  Been arrested, charged, and sentenced for the commission of any felony, or any crime429
involving moral turpitude, where:430
(A)  A plea of nolo contendere was entered to the charge;431
(B)  First offender treatment without adjudication of guilt pursuant to the charge was432
granted; or433
(C)  An adjudication or sentence was otherwise withheld or not entered on the charge.434
The plea of nolo contendere or the order entered pursuant to the provisions of Article 3435
of Chapter 8 of Title 42, relating to probation of first offenders, or other first offender436
treatment shall be conclusive evidence of arrest and sentencing for such crime;437
(5)  Had his or her license to practice a business or profession licensed under this title438
revoked, suspended, or annulled by any lawful licensing authority other than the board;439
had other disciplinary action taken against him or her by any such lawful licensing440
authority other than the board; was denied a license by any such lawful licensing441
authority other than the board, pursuant to disciplinary proceedings; or was refused the442
renewal of a license by any such lawful licensing authority other than the board, pursuant443
to disciplinary proceedings;444
(6)  Engaged in any unprofessional, immoral, unethical, deceptive, or deleterious conduct445
or practice harmful to the public, which conduct or practice materially affects the fitness446
of the licensee or applicant to practice a business or profession licensed under this title,447
or of a nature likely to jeopardize the interest of the public, which conduct or practice448
need not have resulted in actual injury to any person or be directly related to the practice449
of the licensed business or profession but shows that the licensee or applicant has450
committed any act or omission which is indicative of bad moral character or451
untrustworthiness; unprofessional conduct shall also include any departure from, or the452 23 LC 52 0288
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failure to conform to, the minimal standards of acceptable and prevailing practice of the453
business or profession licensed under this title;454
(7)  Knowingly performed any act which in any way aids, assists, procures, advises, or455
encourages any unlicensed person or any licensee whose license has been suspended or456
revoked by a professional licensing board to practice a business or profession licensed457
under this title or to practice outside the scope of any disciplinary limitation placed upon458
the licensee by the board;459
(8)  Violated a statute, law, or any rule or regulation of this state, any other state, the460
professional licensing board regulating the business or profession licensed under this title,461
the United States, or any other lawful authority, without regard to whether the violation462
is criminally punishable, which statute, law, or rule or regulation relates to or in part463
regulates the practice of a business or profession licensed under this title, when the464
licensee or applicant knows or should know that such action is violative of such statute,465
law, or rule or regulation; or violated a lawful order of the board previously entered by466
the board in a disciplinary hearing, consent decree, or license reinstatement;467
(9)  Been adjudged mentally incompetent by a court of competent jurisdiction within or468
outside of this state; any such adjudication shall automatically suspend the license of any469
such person and shall prevent the reissuance or renewal of any license so suspended for470
as long as the adjudication of incompetence is in effect; or471
(10)  Displayed an inability to practice a business or profession licensed under this title472
with reasonable skill and safety to the public or has become unable to practice the473
licensed business or profession with reasonable skill and safety to the public by reason474
of illness or use of alcohol, drugs, narcotics, chemicals, or any other type of material.475
43-11A-16.476
(a)  Except as provided in Code Section 43-11A-18, no person shall engage in or offer to477
provide medical nutrition therapy unless the person is licensed under this chapter.478 23 LC 52 0288
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(b)  Except as provided in subsection (e) of this Code section, no person shall designate or479
hold himself or herself out as a licensed dietitian nutritionist or use or assume the title480
'dietitian nutritionist,' 'licensed dietitian nutritionist,' 'dietitian,' 'dietician,' or any other title481
indicating that the person provides medical nutrition therapy or is a licensed dietitian482
nutritionist, or append to or use in conjunction with that person's name the designation483
'LDN' or 'LD' unless the person is a licensed dietitian nutritionist.484
(c)  Except as provided in subsection (e) of this Code section, no person shall designate or485
hold himself or herself out as a licensed nutritionist or use or assume the title 'nutritionist,'486
'nutrition counselor,' 'nutrition specialist,' 'nutrition therapy practitioner,' 'nutrition therapy487
consultant,' 'master nutrition therapist,' or any other title indicating that the person is a488
licensed nutritionist unless the person is licensed under this chapter.489
(d)  Except as provided in subsection (e) of this Code section, no person shall use or490
assume any title indicating that the person is a licensed nutritionist, or append to or use in491
conjunction with that person's name the designation 'LN' unless the person is a licensed492
nutritionist.493
(e)  Use of an earned, federally trademarked nutrition credential is not prohibited; provided,494
however, that such use shall not give a person the right to practice medical nutrition495
therapy or to use the general titles of 'dietitian,' 'dietitian nutritionist,' or 'nutritionist' unless496
such person is also licensed under this chapter.  Notwithstanding any law to the contrary,497
a person may use a lawfully earned federally trademarked title, including the following:498
(1)  A registered dietitian or registered dietitian nutritionist may use the titles 'registered499
dietitian' or 'registered dietitian nutritionist' and use in conjunction with his or her name500
the designation 'RD' or 'RDN.'501
(2)  A certified nutrition specialist may use the title 'certified nutrition specialist' and use502
in conjunction with his or her name the designation 'CNS.'503
(f)  Any person violating the provisions of this Code section shall be guilty of a504
misdemeanor.505 23 LC 52 0288
H. B. 844
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43-11A-17.506
Proceedings under this chapter shall be governed by Chapter 13 of Title 50, the 'Georgia507
Administrative Procedure Act.'508
43-11A-18.509
Nothing in this chapter shall be construed to affect:510
(1)  A supervisee who is:511
(A)  Practicing as a part of a course of study or as part of a supervised practice512
experience to satisfy the educational or supervised practice experience requirements513
provided for in Code Section 43-11A-9;514
(B)  Completing a supervised practice experience provided for in Code515
Section 43-11A-9 not more than five years after completing the education requirements516
provided for in Code Section 43-11A-9; and517
(C)  Practicing while supervised by a qualified supervisor as provided for in Code518
Section 43-11A-20;519
provided, however, that such supervisee shall not engage in the unrestricted practice of520
medical nutrition therapy; provided, further, that such supervisee shall use a title that521
clearly indicates his or her status as a supervisee;522
(2)  A dietitian or nutritionist serving in the armed forces of the United States or any other523
federal agency who is engaging in the practice of medical nutrition therapy and such524
practice is related to such individual's service or employment;525
(3)  Persons licensed to practice the professions of dentistry, medicine, osteopathy,526
chiropractic, nursing, or pharmacy engaging in the practice of medical nutrition therapy527
when incidental to the practice of their professions; provided, however, that such persons528
shall not use any protected titles as provided in Code Section 43-11A-16;529
(4)  A nonresident dietitian, dietitian nutritionist, or nutritionist practicing medical530
nutrition therapy in this state for five days without a license or up to 30 days per year if531 23 LC 52 0288
H. B. 844
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such person holds licensure from another state and the requirements for licensure are532
substantially the same as the requirements in this chapter;533
(5)  Employees of a department, agency, or division of state, county, or local government534
engaging in the practice of medical nutrition therapy within the discharge of official535
duties when such practice is directed by or in consultation with a licensed dietitian536
nutritionist or licensed nutritionist;537
(6)  A person who assists the provision of medical nutrition therapy if such person538
performs only support activities that are not discretionary and do not require the exercise539
of professional judgment for their performance and such person is directly supervised by540
a licensed dietitian nutritionist, licensed nutritionist, or a healthcare provider licensed in541
this state acting within the scope of such provider's license;542
(7)  A person who provides medical weight control services for persons with prediabetes543
or obesity as part of:544
(A)  An instructional program that has been approved in writing by:545
(i)  A licensed dietitian nutritionist or licensed nutritionist;546
(ii)  A dietitian, dietitian nutritionist, nutritionist, or other healthcare provider licensed547
or certified in another state that has licensure or certification requirements that are at548
least as stringent as this chapter, and other relevant laws under Title 43, and whose549
licensed scope of practice includes medical nutrition therapy;550
(iii)  A registered dietitian nutritionist; or551
(iv)  A certified nutrition specialist; or552
(B)  A plan of care that is overseen by a healthcare provider licensed in this state whose553
scope of practice otherwise authorizes such provider to provide and delegate medical554
nutrition therapy; provided, however, that the medical weight control services are not555
discretionary and do not require the exercise of professional judgment;556
(8)  A person who disseminates nonindividualized, written, general nutrition information557
in connection with the marketing and distribution of dietary supplements, food, herbs, or558 23 LC 52 0288
H. B. 844
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food materials, including, but not limited to, explanations of their federally regulated559
label claims, any known drug-nutrient interactions, their role in various diets, or560
suggestions as how to best use and combine them; provided, however, that such561
information does not constitute medical nutrition therapy and such person shall not use562
any protected titles as provided in Code Section 43-11A-16 and shall not hold himself or563
herself out as qualified to engage in the practice of medical nutrition therapy;564
(9)  The practice of the tenets of any religion, sect, or denomination whatsoever;565
provided, however, that a member of such religion, sect, or denomination shall not use566
any protected titles as provided in Code Section 43-11A-16 and shall not hold himself or567
herself out as qualified to engage in the practice of medical nutrition therapy;568
(10)  A person who provides individualized nutrition recommendations for the wellness569
and primary prevention of chronic disease, health coaching, holistic and wellness570
education, guidance, motivation, behavior change management, services for nonmedical571
weight control, or other nutrition care services; provided, however, that such services do572
not constitute medical nutrition therapy and such person shall not use any protected titles573
as provided in Code Section 43-11A-16 and shall not hold himself or herself out as574
qualified to engage in the practice of medical nutrition therapy; or575
(11)  A person who is an operator or employee of a health food store or business that sells576
health products, including dietary supplements, food, herbs, or food materials, and who577
provides verbal general nonmedical nutrition information that does not constitute medical578
nutrition therapy.579
43-11A-19.580
(a)  A licensed dietitian nutritionist or licensed nutritionist shall provide nutrition care581
services using systematic, evidence based problem solving methods of the nutrition care582
process to address nutrition related problems and provide safe, effective, quality nutrition583 23 LC 52 0288
H. B. 844
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care services and medical nutrition therapy for patients and clients in both clinical and584
community settings.585
(b)  A licensed dietitian nutritionist or licensed nutritionist may:586
(1)  Accept or transmit verbal, delegated, or electronically transmitted orders from the587
referring healthcare provider consistent with applicable laws and rules, including any588
controlling facility or employer protocols established to implement medical nutrition589
therapy;590
(2)  Order patient diets, including therapeutic diets;591
(3)  Conduct swallow screens, place nasogastric or nasoenteric feeding tubes, and592
evaluate, order, and administer enteral or parenteral nutrition therapy that consists of593
enteral feedings or specialized intravenous solutions; provided, however, that the licensed594
individual is a registered dietitian nutritionist or a certified nutrition support clinician or595
meets other requirements established by the board by rule that are consistent with the596
competencies necessary for conducting swallow screens, placing nasogastric or597
nasoenteric feeding tubes, and evaluating, ordering, and administering enteral and598
parenteral nutrition therapies;599
(4)  Order medical laboratory tests related to medical nutrition therapy;600
(5)  Implement prescription drug dose adjustments in an inpatient setting for specific601
disease treatment protocols within the limits of his or her knowledge, skills, judgment,602
and current evidence informed clinical practice guidelines as indicated in a facility,603
medical staff, or medical director approved protocol, and as approved by and under the604
delegation of a licensed prescribing healthcare provider;605
(6)  Implement prescription drug dose adjustments in an outpatient setting for specific606
disease treatment protocols within the limits of his or her knowledge, skills, and607
judgment, and as approved by and under the delegation of a licensed prescribing608
healthcare provider;609 23 LC 52 0288
H. B. 844
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(7)  Recommend or order vitamin, mineral, and other dietary supplements or discontinue610
use of unnecessary vitamin, mineral, and dietary supplements; and611
(8)  Provide services constituting the practice of nutrition and dietetics via telehealth;612
provided, however, that such services shall be appropriate for the individual or group613
receiving such services and the level of care provided shall meet the required level of care614
for such individual or group.615
(c)  A licensed dietitian nutritionist may develop and manage food service operations that616
have the chief function of providing food and nutrition care, including therapeutic diets,617
to manage or treat disease states and medical conditions.618
(d)  Nothing in this Code section shall be construed to:619
(1)  Authorize licensees under this chapter to prescribe or initiate drug treatment other620
than as provided in this Code section; or621
(2)  Limit the ability of any other licensed healthcare provider in this state to conduct622
swallow screens, place nasogastric or nasoenteric feeding tubes, or evaluate, order, or623
administer therapeutic diets; provided, however, that such activities fall within the scope624
of the license held by such provider.625
43-11A-20.626
(a)  To qualify as a qualified supervisor for purposes of this chapter, an individual shall627
meet the following requirements:628
(1)  If the supervisee is providing medical nutrition therapy, the qualified supervisor shall629
be:630
(A)  A registered dietitian nutritionist;631
(B)  A licensed dietitian nutritionist or licensed nutritionist;632
(C)  An individual licensed or certified in another state as a dietitian, dietitian633
nutritionist, nutritionist, or other qualified nutrition professional who is authorized by634
such state to provide medical nutrition therapy; or635 23 LC 52 0288
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(D)  A healthcare provider licensed or otherwise authorized by this state or another state636
to provide nutrition care services for the treatment or management of disease and637
medical conditions; or638
(2)  If the supervisee is providing nutrition care services that do not constitute medical639
nutrition therapy, the qualified supervisor shall be:640
(A)  An individual meeting the requirements provided for in paragraph (1) of this641
subsection;642
(B)  An individual who has at least three years of experience practicing clinical643
nutrition within the five years immediately preceding the start of the supervised practice644
experience and who holds a doctoral degree with a major course of study in dietetics,645
human nutrition, food and nutrition, community nutrition, public health nutrition,646
naturopathic medicine, nutrition education, nutrition, nutrition science, clinical647
nutrition, applied clinical nutrition, nutrition counseling, nutrition and functional648
medicine, nutritional biochemistry, nutrition and integrative health, or an equivalent649
course of study approved by the board; or650
(C)  An individual who obtained a doctoral degree outside the United States with a651
major course of study as provided for in subparagraph (B) of this paragraph; provided,652
however, that the board determines that the doctoral degree is equivalent to a doctoral653
degree granted by a regionally accredited college or university in the United States.654
(b)  A qualified supervisor shall:655
(1)  Only supervise a clinical activity or nutrition care service for which the qualified656
supervisor is qualified and authorized to perform;657
(2)  Be licensed in this state if the supervisee is providing medical nutrition therapy to an658
individual located in this state;659
(3)  Develop and carry out a program for advancing and optimizing the quality of660
nutrition care services provided by a supervisee; provided, however, that such qualified661
supervisor and supervisee shall identify and document:662 23 LC 52 0288
H. B. 844
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(A)  The goals for such supervised practice experience;663
(B)  The assignment of clinical tasks as appropriate to the supervisee's evolving level664
of competence;665
(C)  The supervisee's relationship and the amount and type of access to the qualified666
supervisor; and667
(D)  The process for evaluating the supervisee's performance;668
(4)  Oversee the activities of and authorize and accept responsibility for the nutrition care669
services rendered by the supervisee;670
(5)  At a minimum, be physically on-site and present where the supervisee is providing671
nutrition care services or be immediately and continuously available to the supervisee by672
means of two-way real-time audiovisual technology that allows for the direct,673
contemporaneous interaction by sight and sound between the qualified supervisor and the674
supervisee; provided, however, that, if the qualified supervisor assigns to a supervisee a675
nutrition care service that is to be provided in a setting where the qualified supervisor is676
not routinely present, such qualified supervisor shall ensure that the means and methods677
of supervision are adequate to ensure appropriate patient care, which may include678
synchronous videoconferencing or another method of communication, and oversight that679
is appropriate to the care setting and the education and experience of the supervisee, as680
determined by the board by approval, policy, or rule;681
(6)  Review on a regular basis the charts, records, and clinical notes of any supervisee and682
maintain responsibility for such supervisee's clinical record keeping;683
(7)  Be available to render assistance during the provision of nutrition care services when684
requested by the patient; provided, however, that, if such qualified supervisor is not685
available, such qualified supervisor shall arrange for another qualified healthcare provider686
lawfully able to render nutrition care services to be available; and687 23 LC 52 0288
H. B. 844
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(8)  Limit the assignment of nutrition care services to those services that are within the688
training and experience of the supervisee and customary to the practice of the qualified689
supervisor."690
PART II691
Conforming cross-references692
SECTION 2-1.693
The Official Code of Georgia Annotated is amended by replacing "clinical dietitian" and694
"dietitian" with "dietitian nutritionist or nutritionist" and by replacing "dietitians" with695
"dietitian nutritionists or nutritionists" wherever such terms occur in:696
(1)  Code Section 9-11-9.1, relating to affidavit to accompany charge of professional697
malpractice; 698
(2)  Code Section 31-2A-14, relating to Georgia Diabetes Control Grant Program, advisory699
committee, administration of authorized grant programs, and grant criteria;700
(3)  Code Section 31-8-192, relating to definitions;701
(4)  Code Section 33-20A-3, relating to definitions;702
(5)  Code Section 33-20E-2, relating to application to insurers and definitions;703
(6)  Code Section 33-24-59.27, relating to right to shop for insurance coverage, disclosure704
of pricing information, and notice;705
(7)  Code Section 33-39-3, relating to definitions;706
(8)  Code Section 43-1-28, relating to volunteers in health care specialties;707
(9)  Code Section 43-1-33, relating to advertisement, signage, and identifier requirements708
for health care practitioners;709
(10)  Code Section 51-2-5.1, relating to relationship between hospital and health care710
provider prerequisite to liability, notice regarding independent contractor status, and factors711
for consideration in determining status; and712 23 LC 52 0288
H. B. 844
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(11)  Code Section 51-16-1, relating to definitions.
713
SECTION 2-2.714
Title 43 of the Official Code of Georgia Annotated, relating to professions and businesses,715
is amended by replacing "dietetics" with "nutrition and dietetics" wherever such term occurs716
in:717
(1)  Code Section 43-1-28, relating to volunteers in health care specialties; and718
(2)  Code Section 43-22A-13, relating to compliance with state and federal regulations.719
SECTION 2-3.720
Said title is further amended in Code Section 43-34-316, relating to exceptions, by revising721
paragraph (5) as follows:722
"(5)  Any person using genetic data for purposes of nutritional counseling who is licensed723
as a dietitian nutritionist or nutritionist
 under Chapter 11A of this title or exempt from724
such licensure pursuant to paragraph (10) of Code Section 43-11A-18."725
PART III726
Effective date and repealer provision 727
SECTION 3-1.728
This Act shall become effective upon its approval by the Governor or upon its becoming law729
without such approval.730
SECTION 3-2.731
All laws and parts of laws in conflict with this Act are repealed.732