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PRINTER'S NO. 1055
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
1020
Session of
2021
INTRODUCED BY MEHAFFIE, CARROLL, CIRESI, GUENST, HANBIDGE,
HARKINS, HELM, HERSHEY, IRVIN, ISAACSON, KULIK, LEWIS
DELROSSO, McNEILL, MILLARD, MULLINS, NEILSON, N. NELSON,
O'MARA, ORTITAY, OTTEN, PASHINSKI, PEIFER, PENNYCUICK,
PICKETT, SANCHEZ, SMITH, STRUZZI, WARREN AND ZABEL,
MARCH 26, 2021
REFERRED TO COMMITTEE ON PROFESSIONAL LICENSURE, MARCH 26, 2021
AN ACT
Amending the act of May 22, 1951 (P.L.317, No.69), entitled "An
act relating to the practice of professional nursing;
providing for the licensing of nurses and for the revocation
and suspension of such licenses, subject to appeal, and for
their reinstatement; providing for the renewal of such
licenses; regulating nursing in general; prescribing
penalties and repealing certain laws," further providing for
definitions, for State Board of Nursing and for dietitian-
nutritionist license required; providing for scope of
practice of licensed dietitian nutritionists and
nutritionists and for practice or teaching of dietetics and
nutrition, further providing for unauthorized practices and
acts not prohibited, for temporary practice permit, for
examinations and certificates and for fees and qualifications
for licensure; providing for nutritionists and
qualifications; and further providing for persons entitled to
practice, for licenses, duration, renewal fee and inactive
status, for reporting of multiple licensure, for continuing
nursing education, for punishment for violations, for
refusal, suspension or revocation of licenses and for
injunction or other process.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Section 2(5), (7), (9) and (10) of the act of May
22, 1951 (P.L.317, No.69), known as The Professional Nursing
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Law, are amended and the section is amended by adding paragraphs
to read:
Section 2. Definitions.--When used in this act, the
following words and phrases shall have the following meanings
unless the context provides otherwise:
* * *
(5) "Treating" means selection and performance of those
therapeutic measures essential to the effective execution and
management of the nursing regimen or medical nutrition therapy,
and execution of the prescribed medical regimen.
* * *
[(7) The "Practice of dietetics-nutrition" means the
integration and application of principles derived from the
sciences of food nutrition, biochemistry, physiology, management
and behavior to provide for all aspects of nutrition therapy for
individuals and groups, including nutrition therapy services and
medical nutrition therapy, compatible with dietitian-
nutritionist education and professional competence.]
* * *
[(9) "Licensed dietitian-nutritionist" means a dietitian-
nutritionist who holds a current license under this act.]
(10) "Medical nutrition therapy" means the [component of
nutrition therapy that concerns determining and recommending
nutrient needs based on nutritional assessment and medical
problems relative to diets prescribed by a licensed physician,
including:
(i) tube feedings;
(ii) specialized intravenous solutions;
(iii) specialized oral solutions; and
(iv) interactions of prescription drugs with food or
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nutrients.] provision of nutrition care services for the purpose
of treating or managing disease or medical conditions. The term
includes the provision of all of the following services:
(i) Interpreting anthropometric, biochemical, clinical and
dietary data in acute and chronic disease states and
recommending or ordering nutrient needs based on the dietary
data, including, but not limited to, tube feedings and
parenteral nutrition.
(ii) Food and nutrient counseling regarding prescription
drug interactions.
(iii) Developing and managing food service operations for
the management or treatment of disease, including operations
with the primary function of nutrition care or recommending or
ordering therapeutic diets.
(iv) Medical weight control.
* * *
(16) "Accreditation Council for Education in Nutrition and
Dietetics" means the autonomous accrediting agency for education
programs that prepares students to begin careers as registered
dietitians or registered dietitian nutritionists.
(17) "Board for Certification of Nutrition Specialists"
means the entity that serves as the credentialing body for
certified nutrition specialists.
(18) "Certified nutrition specialist" means an individual
certified as a nutrition specialist by the Board for
Certification of Nutrition Specialists that authorizes the
individual to use the title "certified nutrition specialist" and
the abbreviation "C.N.S." to indicate that the individual is a
certified nutrition specialist.
(19) "Commission on Dietetic Registration" means the
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credentialing agency of the Academy of Nutrition and Dietetics.
(20) "Dietetics" means the integration, application and
communication of practice principles derived from the food,
nutrition, social, business and basic sciences to achieve and
maintain the optimal nutrition status of an individual.
(21) "Dietitian" or "dietitian nutritionist" means an
individual licensed under this act who may be referred to as a
nutritionist, a dietitian nutritionist or a dietician.
(22) "Diplomate of the American Clinical Board of Nutrition"
means an individual certified as a diplomate by the American
Clinical Board of Nutrition that authorizes the individual to
use the title "diplomate of the American Clinical Board of
Nutrition" and the abbreviation "D.A.C.B.N." to indicate that
the individual is a diplomate of the American Clinical Board of
Nutrition.
(23) "Family member" means a parent, child, spouse, former
spouse, an individual related by consanguinity or affinity, a
current or former sexual or intimate partner or an individual
who shares biological parenthood.
(24) "General nonmedical nutrition information" means
information on any of the following:
(i) Principles of good nutrition and food preparation.
(ii) Food that should be included in the normal daily diet.
(iii) The essential nutrients needed by the human body.
(iv) The recommended amounts of essential nutrients in the
human body.
(v) The actions of nutrients in the human body.
(vi) The effects of deficiencies or excesses of nutrients in
the human body.
(vii) Food, herbs and supplements that are good sources of
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essential nutrients in the human body.
(25) "Licensed dietitian nutritionist" means an individual
who is licensed as a dietitian nutritionist under this act.
(26) "Licensed nutritionist" means an individual who is
licensed as a nutritionist under this act.
(27) "Medical weight control" means medical nutrition
therapy for the purpose of reducing, maintaining or gaining
weight.
(28) "Nutrition" means the science of food and nutrients,
including the action, interaction and balance of food and
nutrients in relation to health and disease and the process by
which humans ingest, absorb, transport, utilize and excrete food
substances.
(29) "Nutrition assessment" means the systematic process of
obtaining, verifying and interpreting biochemical,
anthropometric, physical, nutrigenomic and dietary data in order
to make decisions about the nature and cause of nutrition-
related problems. The term does not include the mere collection
of data. The term includes an ongoing, dynamic process that:
(i) involves an initial data collection and a reassessment
and analysis of client or community needs; and
(ii) provides the foundation for nutrition diagnosis and
nutritional recommendations, including enteral and parenteral
nutrition.
(30) "Nutrition care services" means the provision of any of
the following within a systematic process:
(i) Assessing and evaluating the nutritional needs of an
individual and determining the resources and constraints in a
practice setting, including ordering laboratory tests to check
and track nutrition status and monitoring the effectiveness of
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dietary plans and orders.
(ii) Establishing priorities, goals and objectives that meet
nutritional needs and are consistent with available resources
and constraints.
(iii) Providing nutrition counseling regarding health and
disease.
(iv) Developing, implementing and managing nutrition care
systems.
(v) Evaluating, making changes in and maintaining
appropriate standards of quality in food and nutrition services.
(vi) Ordering therapeutic diets.
(31) "Nutrition diagnosis" means identifying and labeling
nutritional problems managed and treated by a dietitian
nutritionist or nutritionist. The term does not include the
medical differential diagnosis of the health status of an
individual.
(32) "Nutrition intervention" means purposefully planned
actions and counseling intended to positively change a
nutrition-related behavior, risk factor, environmental condition
or aspect of the health status for an individual.
(33) "Nutrition monitoring and evaluation" means identifying
patient outcomes relevant to a nutrition diagnosis and comparing
the outcomes with the patient's previous health status,
intervention goals or reference standards to determine the
progress made in achieving desired outcomes of nutrition care
and whether planned interventions should be continued or
revised.
(34) "Nutritionist" means a licensed dietitian nutritionist,
licensed nutritionist, dietitian or dietitian nutritionist.
(35) "Practice of dietetics and nutrition" means the
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integration and application of scientific principles derived
from the study of food, nutrition, biochemistry, metabolism,
nutrigenomics, physiology, food management, behavioral and
social sciences in achieving and maintaining health throughout
the lifespan of an individual and providing nutrition care
services, including medical nutrition therapy and telehealth for
the prevention, management and treatment of disease. The term
does not include the medical differential diagnosis of the
health status of an individual. The term includes, but is not
limited to, any of the following:
(i) Nutrition assessment, nutrition diagnosis, nutrition
intervention, nutrition monitoring or the evaluation of
nutrition care plans.
(ii) Nutrition support, including the ordering of parenteral
and enteral nutrition.
(iii) Dietary and nutritional counseling and education,
including counseling and education regarding food and nutrient
and prescription drug interactions.
(iv) The development and administration of nutrition care
standards and systems.
(36) "Registered dietitian" or "registered dietitian
nutritionist" means an individual who is registered as a
dietitian or a dietitian nutritionist with the Commission on
Dietetic Registration that authorizes the individual to use the
title "registered dietitian nutritionist" or "registered
dietitian" and the abbreviation "R.D.N." or "R.D."
(37) "Therapeutic diet" means a diet intervention prescribed
by a physician or other authorized nonphysician practitioner
that provides food or nutrients via oral, enteral or parenteral
routes as part of the treatment of a disease or diagnosed
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clinical condition for purpose of modifying, eliminating,
decreasing or increasing identified micro-nutrients and macro-
nutrients in the diet.
Section 2. Sections 2.1(a) and 3.1 of the act are amended to
read:
Section 2.1. State Board of Nursing.--(a) The State Board
of Nursing shall consist of the Commissioner of Professional and
Occupational Affairs, three members appointed by the Governor,
with the advice and consent of a majority of the members elected
to the Senate, who shall be [persons] individuals representing
the public at large, and nine members appointed by the Governor,
with the advice and consent of a majority of the members elected
to the Senate, six of whom shall be registered nurses, graduated
from schools of nursing where practical and theoretical
instruction is given, at least three of whom shall possess
Masters' degrees in nursing, two of whom shall be licensed
practical nurses and one of whom shall be a licensed [dietitian-
nutritionist] dietitian nutritionist or licensed nutritionist
who shall possess a Master's degree or higher degree, and all of
whom shall have been engaged in nursing or the practice of
[dietetics-nutrition] dietetics and nutrition in this
Commonwealth for the five-year period immediately preceding
appointment. [The dietitian-nutritionist member of the board
initially appointed need not be licensed by the licensure
examination adopted by the board but, at the time of
appointment, must have satisfied the education and experience
requirements of this act for licensure as a dietitian-
nutritionist.] In making appointments to the Board, the Governor
shall give due consideration to providing representation from
diversified fields of nursing or [dietetics-nutrition] dietetics
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and nutrition, including, but not limited to, specialized nurses
or [dietitian-nutritionists] dietitian nutritionists or
nutritionists of all types. The [persons] individuals
representing the public at large may not have a financial
interest in the provision of goods and services for [dietitian-
nutritionists] dietitian nutritionists or nutritionists and may
not be a [dietitian-nutritionist] dietitian nutritionist or
nutritionist or have a household member who is a [dietitian-
nutritionist] dietitian nutritionist or nutritionist.
* * *
Section 3.1. [Dietitian-Nutritionist] Dietitian Nutritionist
or Nutritionist License Required.--(a) [It shall be unlawful
for any individual to hold himself or herself forth as a
licensed dietitian-nutritionist unless he or she shall first
have obtained a license pursuant to this act.] The following
apply:
(1) Only individuals who have received licenses as licensed
[dietitian-nutritionists] dietitian nutritionists or licensed
nutritionists pursuant to this act may use the letters "L.D.N."
or "L.N." in connection with their names. A dietitian registered
by the Commission on Dietetic Registration may use the title
"registered dietitian" or "registered dietitian nutritionist"
and the letters "R.D." or "R.D.N." in connection with the
dietitian's name. A nutritionist certified by the Board for
Certification of Nutrition Specialists may use the title
"certified nutrition specialist" and the letters "C.N.S." in
connection with the nutritionist's name.
(2) It shall be unlawful for an individual who is not
licensed as a dietitian nutritionist or nutritionist pursuant to
this act to engage in any of the following actions:
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(i) Provide medical nutrition therapy with or without
compensation.
(ii) Use or allow a business entity or a business entity's
employees, agents or representatives to use any of the following
titles or abbreviations:
(A) "Dietitian nutritionist" or "nutritionist."
(B) "Dietitian or "dietician."
(C) "Nutrition counselor" or "nutrition specialist."
(D) "L.D.N."
(E) "L.D."
(F) "L.N."
(G) "Nutritional therapy practitioner" or "nutritional
therapy consultant."
(H) "Certified nutrition therapy practitioner."
(I) "Master nutrition therapist."
(J) "Licensed dietitian nutritionist" or "licensed
nutritionist."
(K) Any other designation, words, letters or insignia in
connection with a name indicating a license to practice
dietetics and nutrition or medical nutrition therapy.
[(b) Nothing in this section shall be construed to require
or preclude third-party insurance reimbursement. Nothing herein
shall preclude an insurer or other third-party payor from
requiring that a licensed dietitian-nutritionist obtain a
referral from a licensed physician, dentist or podiatrist or
that a licensed dietitian-nutritionist file an evaluation and
treatment plan with the insurer or third-party payor as a
precondition of reimbursement.]
(c) Nothing in this section shall be construed to prohibit
an individual from using a title trademarked by the United
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States Patent and Trademark Office.
Section 3. The act is amended by adding sections to read:
Section 3.2. Scope of Practice of Licensed Dietitian
Nutritionists and Nutritionists.
(a) A licensed dietitian nutritionist or licensed
nutritionist shall provide nutrition care services using
systematic, evidence-based approaches for nutrition assessment,
nutrition diagnosis, nutrition intervention and nutrition
monitoring and evaluation for all of the following purposes:
(1) Addressing nutrition-related problems.
(2) Providing safe, effective, quality nutrition care
services and medical nutrition therapy for patients and clients
in clinical and community settings.
(b) A licensed dietitian nutritionist or licensed
nutritionist may accept or transmit oral, verbal, delegated or
electronically transmitted orders from a referring practitioner
consistent with the applicable laws of this Commonwealth in
conjunction with protocols established by the licensed dietitian
nutritionist or licensed nutritionist to implement medical
nutrition therapy.
(c) A licensed dietitian nutritionist or licensed
nutritionist may order patient diets, including therapeutic
diets, in accordance with the provisions of this act.
Therapeutic diets ordered under this subsection may include oral
or enteral and parenteral nutrition therapy consisting of
specialized enteral or intravenous solutions as authorized under
this subsection. Enteral and parenteral nutrition therapy may
only be ordered under this subsection by a licensed dietitian
nutritionist or licensed nutritionist who meets any of the
following criteria:
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(1) The licensed dietitian nutritionist or licensed
nutritionist is a registered dietitian nutritionist.
(2) The licensed dietitian nutritionist or licensed
nutritionist is certified as a nutrition support clinician by
the National Board of Nutrition Support Certification.
(3) The licensed dietitian nutritionist or licensed
nutritionist meets other requirements as determined by the Board
that are consistent with the competencies necessary for
evaluating, ordering and administering enteral and parenteral
nutrition.
(d) Nothing in this section shall be construed to limit the
ability of a licensed health care practitioner in this
Commonwealth, other than a licensed dietitian nutritionist or
licensed nutritionist, in accordance with the scope of the
license held by the health care practitioner.
Section 3.3. Practice or Teaching of Dietetics and
Nutrition.
(a) Nothing in this act shall be construed to prohibit any
of the following:
(1) An individual licensed to practice dietetics and
nutrition from engaging in the practice or teaching of dietetics
and nutrition within the scope of the individual's license.
(2) An individual enrolled in an accredited course on
dietetics and nutrition recognized by the Board from performing
any action necessary to complete the individual's course of
study or engaging in the practice of dietetics and nutrition
under a supervisor in accordance with section 6(b)(7) for a time
period of no more than five (5) years after the individual
completes the course of study. The Board, in its discretion, may
grant a limited extension to the time period specified under
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this paragraph in the event of extraordinary circumstances to
allow an individual to satisfy the qualifications for licensure
under section 6. Extraordinary circumstances may include a
circumstance when an individual who legally provides medical
nutrition therapy in another state has not met the
qualifications for licensure under section 6 within the time
period specified under this paragraph.
(3) An individual from practicing dietetics and nutrition
within the scope of the individual's official duties when
employed by the Federal Government, serving in the United States
Armed Forces or employed by any State agency or entity.
(4) An individual who does not hold himself or herself out
to be a licensed dietitian nutritionist or licensed nutritionist
from furnishing or explaining general nonmedical nutrition
information regarding the use of food, food materials, herbs or
dietary supplements.
(5) An individual from providing medical weight control
through a program or instruction that has been approved in
writing by any of the following:
(i) A licensed dietitian nutritionist or licensed
nutritionist in this Commonwealth.
(ii) A dietitian nutritionist or nutritionist licensed in
another state that has licensure requirements substantially
equivalent to the licensure requirements in this Commonwealth as
determined by the Board .
(iii) A dietitian registered by the Commission on Dietetic
Registration.
(iv) A certified nutritionist specialist certified by the
Board for Certification of Nutrition Specialists.
(v) A diplomate of the American Clinical Board of Nutrition.
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(vi) A licensed physician or other licensed health care
provider in this Commonwealth who is lawfully authorized to
provide nutrition care services for the purpose of treating or
managing a disease or medical condition.
(6) A nutrition and dietetic technician from providing
nutrition care services under the supervision of a licensed
dietitian nutritionist or licensed nutritionist.
(7) An individual from providing nutrition information,
guidance, encouragement, individualized nutrition
recommendations, behavioral change management, coaching,
assessments, weight control services or nutrition care services
that do not constitute medical nutrition therapy on the
condition that the individual does not hold himself or herself
out as a licensed dietitian nutritionist , licensed nutritionist
or medical nutrition therapy provider or otherwise violate the
provisions of this act .
(8) An individual trained, licensed or certified under any
other law of this Commonwealth from engaging in a practice
within the scope of the individual's license or certification.
(9) An individual from providing nutrition care services
while under the direct supervision of a health care provider
licensed in this Commonwealth who is lawfully authorized to
provide nutrition care services for the purpose of treating or
managing a disease or medical condition.
(b) Nothing in this act shall be construed to authorize the
Board to regulate practitioners licensed or certified by other
licensing boards.
Section 4. Sections 4(1), (3), (4), (5) and (6) and 4.1 of
the act are amended to read:
Section 4. Unauthorized Practices; Acts not Prohibited.--
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This act confers no authority to practice dentistry, podiatry,
optometry, chiropractic, medicine or surgery, nor does it
prohibit--
(1) Home care of the sick by friends, domestic servants,
nursemaids, companions, [or] household, or home care aides of
any type, so long as such [persons] individuals do not represent
or hold themselves out to be licensed nurses, licensed
registered nurses, [or] registered nurses, or licensed dietitian
nutritionists or licensed nutritionists; or use in connection
with their names, any designation tending to imply that they are
licensed to practice under the provisions of this act nor
services rendered by any physicians, osteopaths, dentists or
chiropractors, podiatrists, optometrists, or any [person]
individual licensed pursuant to the act of March 2, 1956
(P.L.1211, No.376), known as the "Practical Nurse Law."
* * *
(3) The practice of professional nursing or dietetics and
nutrition, including the provision of medical nutrition therapy,
by [a person] an individual temporarily in this Commonwealth
licensed by another state, territory or possession of the United
States or a foreign country, with registration, certification or
licensure requirements equivalent to the licensure requirements
under this act, in compliance with an engagement made outside of
this Commonwealth, which engagement requires that such [person]
individual accompany and care for a patient while temporarily in
this Commonwealth: Provided, however, That said engagement shall
not be of more than six (6) months' duration.
(4) The practice of professional nursing or dietetics and
nutrition, including the provision of medical nutrition therapy,
pursuant to a temporary practice permit, by a graduate of an
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approved program of professional nursing or by an individual
satisfying the educational requirements for dietetics and
nutrition in Pennsylvania or any other state, working under
qualified supervision, during the period not to exceed one (1)
year between completion of his or her program and notification
of the results of a licensing examination taken by such [person]
individual, and during such additional period as the Board may
in each case especially permit.
(5) The practice of professional nursing or dietetics and
nutrition, including the provision of medical nutrition therapy,
pursuant to a temporary practice permit, by [a person] an
individual who holds a current license or other evidence of the
right to practice professional nursing or dietetics and
nutrition, as that term is defined in this act, issued by any
other state, territory or possession of the United States or the
Dominion of Canada, with registration, certification or
licensure requirements equivalent to the licensure requirements
under this act, during the period that an application filed by
such [person] individual for licensure in Pennsylvania is
pending before the Board, but not for a period of more than one
(1) year and during such additional period as the Board may in
each case especially permit.
(6) The practice of professional nursing or dietetics and
nutrition, including the provision of medical nutrition therapy,
within the definition of this act, by any [person] individual
when such [person] individual is engaged in the practice of
nursing or dietetics and nutrition as an employee of the United
States.
Section 4.1. Temporary Practice Permit.--In order for [a
person] an individual to practice professional nursing or
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dietetics and nutrition, including medical nutrition therapy,
during the one (1) year period from completion of his or her
education program or the one (1) year period from the
application for licensure by [a person] an individual who holds
a current license issued by any other state, territory or
possession of the United States or the Dominion of Canada, with
registration, certification or licensure requirements equivalent
to the licensure requirements under this act, the Board may
issue a temporary practice permit which is nonrenewable and
valid for a period of one (1) year and during such additional
period as the Board may in each case especially permit, except
that the temporary practice permit shall expire if such [person]
individual fails the licensing examination.
Section 5. Sections 5(b), (c) and (e) and 6(b) of the act
are amended and the sections are amended by adding a subsection
to read:
Section 5. Examinations and Certificates.--* * *
(b) The Board may admit to examination any [person]
individual who has satisfactorily completed an approved nursing
education program for the preparation of registered professional
nurses or an approved [dietetics-nutrition] dietetics and
nutrition education program in Pennsylvania or such a program in
any other state, territory or possession of the United States,
considered by the Board to be equivalent to that required in
this Commonwealth at the time such program was completed, and
who meets the requirements of character and preliminary
education.
(c) The Board may admit to examination any [person]
indivi dual who has satisfactorily completed a nursing education
program for the preparation of registered professional nurses or
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an approved [dietetics-nutrition] dietetics and nutrition
education program in a country or territory not mentioned above
who has been licensed, registered, or duly recognized there as a
professional nurse, dietitian-nutritionist, dietitian or
nutritionist provided such a program is considered by the Board
to be equal to that required in this Commonwealth at the time
such program was completed and who meets the requirements of
character and preliminary education.
* * *
[(e) A person who meets the requirements of section 6 and
who, in addition, has been engaged in the practice of dietetics-
nutrition for a period of five (5) years during the seven (7)
years immediately preceding the effective date of this
subsection or a person who provides evidence of current
registration as a registered dietitian-nutritionist by the
Commission of Dietetic Registration of the American Dietetic
Association shall be considered to meet the requirements of this
act. This person shall be licensed without the necessity of
taking the examination if an application is made to the Board
within one (1) year of the effective date of this subsection and
the appropriate fee is paid.]
(f) The Board shall accept the examination for a dietitian
or nutritionist administered by the Commission on Dietetic
Registration, the Board for Certification of Nutrition
Specialists or the American Clinical Board of Nutrition in lieu
of the examination required for a dietitian or nutritionist
under this section.
Section 6. Fees; Qualifications for Licensure.--* * *
(b) An applicant applying for licensure as a [dietitian-
nutritionist] dietitian nutritionist shall submit a written
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application on forms provided by the Board evidencing and
insuring to the satisfaction of the Board that the applicant:
(1) Is of good moral character.
[(2) Has received a baccalaureate or higher degree from a
Board-approved, regionally accredited college or university,
including a major course of study in human nutrition, food and
nutrition, dietetics or food systems management.
(3) Has completed a planned continuous preprofessional
experience component in dietetic practice of not less than nine
hundred (900) hours under the supervision of a registered
dietitian, a dietitian-nutritionist licensed under this act or
an individual with a doctoral degree conferred by a regionally
accredited college or university in the United States with a
major course of study in human nutrition, food and nutrition,
nutrition education, dietetics or food systems management as
approved by the Board.
(4) Has satisfactorily completed an examination approved by
the Board. The Board shall contract with a professional testing
organization for the examination of qualified applicants for
licensure. All written, oral and practical examinations shall be
prepared and administered by a qualified and approved
professional testing organization in the manner prescribed for
written examinations by section 812.1 of the act of April 9,
1929 (P.L.177, No.175), known as "The Administrative Code of
1929."]
(5) Be at least eighteen (18) years of age.
(6) Pay any fees required by the Board.
(7) Meets any of the following criteria:
(i) Provides evidence of current and valid registration as a
registered dietitian or registered dietitian nutritionist with
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the Commission on Dietetic Registration.
(ii) Submits proof of completion of all of the following
educational, supervised practice experience and examination
requirements:
(A) A baccalaureate degree, master's degree or doctoral
degree that meets the competency requirements in dietetics as
required by the Board with a major course of study in human
nutrition, foods and nutrition, dietetics, food systems
management, nutrition education, nutrition, nutrition science,
clinical nutrition, applied clinical nutrition, nutrition
counseling, nutrition and functional medicine, nutritional
biochemistry, nutrition and integrative health, or an equivalent
course of study from a regionally accredited college or
university or an academic degree from a college or university in
a foreign country validated as equivalent by the Board, that
meets the competency requirements of a program accredited by the
Accreditation Council for Education in Nutrition and Dietetics
as approved by the Board.
(B) Has successfully completed a planned clinical program in
the practice of dietetics and nutrition that meets the
competency requirements of a supervised practice accredited by
the Accreditation Council for Education in Nutrition and
Dietetics as approved by the Board. A planned clinical program
under this clause shall include no less than one thousand
(1,000) hours under the supervision of any of the following:
(I) A dietitian nutritionist licensed in this Commonwealth
or registered, certified or licensed in any other state with
requirements equivalent to the licensure requirements under this
act as approved by the Board.
(II) A dietitian nutritionist registered with the Commission
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on Dietetic Registration.
(C) Has passed the registration examination for dietitian
nutritionists administered by the Commission on Dietetic
Registration.
* * *
(d) An individual who meets the requirements for licensure
under this act as a dietitian nutritionist before the effective
date of this subsection and who is a registered dietitian,
registered dietitian nutritionist or certified nutrition
specialist shall be licensed as a licensed dietitian
nutritionist if an application is made to the Board within one
year from the effective date of this subsection and the
appropriate fee is paid as determined by the Board by
regulation. An individual licensed as dietitian nutritionist
under this act on the effective date of this subsection shall be
eligible to maintain and renew a license as a licensed dietitian
nutritionist in accordance with this act without satisfying any
additional requirements for licensure.
Section 6. The act is amended by adding a section to read:
Section 6.3. Nutritionists; Qualifications.-- An applicant
must satisfy or comply with all of the following requirements to
be eligible for licensure as a nutritionist:
(1) Be at least eighteen (18) years of age.
(2) Be of good moral character.
(3) Submit a completed application as required by the Board.
(4) Pay any fees as required by the Board.
(5) Submit proof that the applicant has received a master's
degree or doctoral degree from a regionally accredited college
or university or has an academic degree from a college or
university in a foreign country that has been validated as
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equivalent by the Board, with all of the following:
(i) A
major course of study in human nutrition, food and
nutrition, community nutrition, public health nutrition,
nutrition education, nutrition, nutrition science, clinical
nutrition, applied clinical nutrition, nutrition counseling,
nutrition and functional medicine, nutritional biochemistry,
nutrition and integrative health or a comparable major course of
study in a field of clinical health care.
(ii) A course of study leading to competence in medical
nutrition therapy, including the completion of all of the
following:
(A) Fifteen (15) semester hours of clinical or life sciences
coursework with at least three (3) semester hours in human
anatomy and physiology or the equivalent subjects.
(B) Fifteen (15) semester hours of nutrition and metabolism
coursework with at least six (6) semester hours in biochemistry.
(6) Complete a Board-approved internship or a documented,
supervised practice experience in nutrition care services and
the provision of medical nutrition therapy for not less than one
thousand (1,000) hours, involving no less than two hundred (200)
hours of all of the following:
(i) Nutrition assessment.
(ii) Nutrition intervention, education, counseling or
management.
(iii) Nutrition monitoring or evaluation under the
supervision of an individual specified under clause (A), (B) or
(C). A supervisor under this subparagraph shall be licensed in
this Commonwealth if supervising an applicant providing medical
nutrition therapy to an individual located in this Commonwealth.
Any of the following may be supervisors under this subparagraph:
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(A) A certified nutrition specialist, a diplomate of the
American Clinical Board of Nutrition, a registered dietitian
nutritionist, a licensed dietitian nutritionist or a licensed
nutritionist in this Commonwealth.
(B) A health care practitioner licensed in any state or
jurisdiction whose scope of practice includes the provision of
nutrition care services for the purpose of treating or managing
a disease or medical condition.
(C) An individual with a doctoral degree conferred by
regionally accredited college or university or a college or
university in a foreign country validated as no less stringent
by the Board with a major course of study in human nutrition,
food and nutrition, dietetics, nutrition education, nutrition,
nutrition science, clinical nutrition, applied clinical
nutrition, nutrition counseling, nutrition and functional
medicine, nutritional biochemistry, nutrition and integrative
health or an equivalent course of study.
(7) Meet any of the following criteria:
(i) Successfully pass an examination administered by the
Board for certification of nutrition specialists or the
examination administered by the American Clinical Board of
Nutrition.
(ii) Hold a v alid current certification with the Board for the
certification of nutrition specialists that authorizes the
applicant to use the title "certified nutrition specialist" or
the abbreviation "C.N.S." or a valid current certification with
the American Clinical Board of Nutrition that authorizes the
applicant to use the title "Diplomate, American Clinical Board
of Nutrition" or the abbreviation "D.A.C.B.N."
Section 7. Section 8 heading and (b) of the act are amended
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to read:
Section 8. [Persons] Individuals Entitled to Practice.--* *
*
(b) The Board shall issue to each [person] individual who
meets the [dietitian-nutritionist] dietitian nutritionist or
nutritionist licensure requirements of this act a certificate
setting forth that such [person] individual is licensed as a
[dietitian-nutritionist] dietitian nutritionist or nutritionist
and entitled to use the title ["licensed dietitian-nutritionist"
and the letters "L.D.N."] "licensed dietitian nutritionist" and
the letters "L.D.N." or licensed as a nutritionist and entitled
to use the title "licensed nutritionist" and the letters "L.N."
and authorized to practice dietetics and nutrition and provide
medical nutrition therapy. A record of all [persons] individuals
licensed as [dietitian-nutritionists] dietitian nutritionists or
nutritionists in this Commonwealth shall be kept in the office
of the Board and shall be open to public inspection and copying
upon payment of a nominal fee for copying the record.
Section 8. Section 11(c) of the act is amended and the
section is amended by adding subsections to read:
Section 11. Licenses; Duration; Renewal Fee; Inactive
Status.--* * *
(c) A [dietetics-nutrition] dietitian nutritionist or
nutritionist license issued under this act shall not be renewed
unless the licensee applying for renewal submits proof to the
Board that during the two (2) calendar years immediately
preceding the application for renewal the licensee has
satisfactorily completed a minimum of thirty (30) hours of
continuing [dietetic-nutrition] dietetic and nutrition education
approved by the Board by regulation.
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(d) Upon the payment to the Board of a fee and the
submission of a written application on a form provided by the
Board by a nutritionist or dietitian who is registered,
certified or licensed in another state with registration,
certification or licensure requirements no less stringent to the
licensure requirements under this act, the Board shall license
the nutritionist or dietitian without an examination.
(e) A member of the United States Armed Forces or the
member's spouse who is registered, certified or licensed as a
dietitian nutritionist or nutritionist in another state with
registration, certification or licensure requirements no less
stringent than the licensure requirements under this act may be
licensed as a dietitian nutritionist in this Commonwealth by
providing a proof of licensure in the other state in accordance
with regulations promulgated by the Board. A member or the
member's spouse who qualifies for licensure as a dietitian
nutritionist under this subsection shall be exempt from paying
the initial licensure application fee. If a member or the
member's spouse does not qualify for licensure as a dietitian
nutritionist under this subsection, the member or the member's
spouse shall apply for licensure as specified under this act and
shall be exempt from paying the initial licensure application
fee.
Section 9. Sections 11.1, 12.1(g)(1), 13(b), 14(a)(1), (2.1)
and (4) and (b) introductory paragraph and (6) and 15.4 of the
act are amended to read:
Section 11.1. Reporting of Multiple Licensure.--Any licensed
professional nurse or [dietitian-nutritionist] dietitian
nutritionist or nutritionist of this Commonwealth who is also
licensed to practice nursing or [dietetics-nutrition] licensed
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as a dietitian nutritionist or nutritionist in any other state,
territory, possession or country shall report this information
to the Board on the biennial registration application. Any
disciplinary action taken or pending investigation or
investigation resolved unfavorably against the applicant in
other states shall be reported to the Board on the biennial
registration application or within ninety (90) days of final
disposition, whichever is sooner. Multiple licensure shall be
noted by the Board on the licensee's record, and such state,
territory, possession or country shall be notified by the Board
of any disciplinary actions taken against said licensee in this
Commonwealth.
Section 12.1. Continuing Nursing Education.--* * *
(g) In lieu of meeting the requirements of this section:
(1) Certified registered nurse practitioners and
[dietetics-nutrition] dietitian nutritionist and nutritionist
licensees shall fulfill the requirements for continuing
education in accordance with sections 8.1 and 11,
respectively.
* * *
Section 13. Punishment for Violations.--* * *
(b) In addition to any other civil remedy or criminal
penalty provided for in this act, the Board, by a vote of the
majority of the maximum number of the authorized membership of
the Board as provided by law or by a vote of the majority of the
duly qualified and confirmed membership or a minimum of five (5)
members, whichever is greater, may levy a civil penalty of up to
one thousand dollars ($1,000) on any current licensee who
violates any provision of this act or on any [person] individual
who practices nursing or holds himself or herself forth as a
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licensed [dietitian-nutritionist] dietitian nutritionist,
dietitian or nutritionist without being properly licensed to do
so under this act or on the responsible officers or employes of
any corporation, copartnership, institution or association
violating any of the provisions of this act. The Board shall
levy this penalty only after affording the accused party the
opportunity for a hearing, as provided in Title 2 of the
Pennsylvania Consolidated Statutes (relating to administrative
law and procedure).
Section 14. Refusal, Suspension or Revocation of Licenses.--
(a) The Board may refuse, suspend or revoke any license in any
case where the Board shall find that--
(1) The licensee is on repeated occasions negligent or
incompetent in the practice of professional nursing or
[dietetics-nutrition] dietetics and nutrition.
* * *
(2.1) The licensee is unable to practice [dietetics-
nutrition] dietetics and nutrition with reasonable skill and
safety to individuals or groups by reason of mental or physical
illness or condition or physiological or psychological
dependence upon alcohol, hallucinogenic or narcotic drugs or
other drugs which tend to impair judgment or coordination so
long as such dependence shall continue. In enforcing this clause
(2.1), the Board shall upon probable cause have authority to
compel a licensee to submit to a mental or physical examination
as designated by it. After notice, hearing, adjudication and
appeal as provided for in section 15, failure of a licensee to
submit to such examination when directed shall constitute an
admission of the allegations against him or her unless failure
is due to circumstances beyond his or her control, consequent
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upon which a default and final order may be entered without the
taking of testimony or presentation of evidence. A licensee
affected under this paragraph shall at reasonable intervals be
afforded an opportunity to demonstrate that he or she can resume
a competent practice of [dietetics-nutrition] dietetics and
nutrition with reasonable skill and safety to individuals or
groups.
* * *
(4) The licensee has committed fraud or deceit in:
(i) the practice of nursing, or in securing his or her
admission to such practice or nursing school; or
(ii) the practice of [dietetics-nutrition] dietetics and
nutrition or in securing his or her license as a dietitian-
nutritionist.
* * *
(b) When the Board finds that the license of any nurse or
[dietitian-nutritionist] dietitian nutritionist or nutritionist
may be refused, revoked or suspended under the terms of
subsection (a), the Board may:
* * *
(6) Restore or reissue, in its discretion, a suspended
license to practice professional or practical nursing or
[dietetics-nutrition] dietetics and nutrition and impose any
disciplinary or corrective measure which it might originally
have imposed.
Section 15.4. Injunction or Other Process.--It shall be
unlawful for any [person] individual to practice or attempt to
offer to practice nursing or provide or attempt to offer to
provide medical nutrition therapy or hold himself or herself
forth as a licensed [dietitian-nutritionist] dietitian
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nutritionist or nutritionist, as defined in this act, without
having at the time of so doing a valid, unexpired, unrevoked and
unsuspended license issued under this act. The unlawful practice
of nursing or the unlawful provision of medical nutrition
therapy as defined in this act may be enjoined by the courts on
petition of the Board or the Commissioner of Professional and
Occupational Affairs. In any such proceeding, it shall not be
necessary to show that any [person] individual is individually
injured by the actions complained of. If it is determined that
the respondent has engaged in the unlawful practice of nursing
or the unlawful provision of medical nutrition therapy, the
court shall enjoin him or her from so practicing unless and
until he or she has been duly licensed. Procedure in such cases
shall be the same as in any other injunction suit. The remedy by
injunction hereby given is in addition to any other civil or
criminal prosecution and punishment.
Section 10. This act shall take effect in 60 days.
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