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~tate of utennessee
PUBLIC CHAPTER NO. 1002
HOUSE BILL NO. 2029
By Representatives Faison, Parkinson
Substituted for: Senate Bill No. 2579
By Senators Harshbarger, Hatcher, Jackson, Bailey, Bowling, Gardenhire
AN ACT to amend Tennessee Code Annotated, Title 4 and Title 63, relative to dietetics
and nutrition.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
SECTION 1. Tennessee Code Annotated, Section 4-29-249(a)(7), is amended by
deleting the subdivision and substituting:
(7) Board of dietitian and nutritionist examiners, created by§ 63-25-106;
SECTION 2. Tennessee Code Annotated, Title 63, Chapter 25, Part 1, is amended by
deleting the part and substituting:
63-25-101. Short title.
This part is known and may be cited as the "Dietetics and Nutrition Practice Act."
63-25-102. Legislative findings.
The general assembly finds and declares that:
(1) The application of scientific knowledge relating to food is important in
the treatment of illness and disease and the attainment and maintenance of
health;
(2) There are currently no clear means for the public to identify the
qualifications of a person providing dietetic services and nutritional care for
infants, children, pregnant females, elderly persons, poor persons, overweight
persons, chronically and terminally ill persons, and fitness enthusiasts;
(3) Consumers and patients are becoming increasingly concerned about
their diets and nutrition as well as the effectiveness of the information and
services being offered to the public;
(4) In order to protect the public health, safety, and welfare, it is
necessary to define the qualifications and requirements for a person practicing as
a dietitian or nutritionist and offering dietetic or nutrition services to the public;
and
(5) It is the purpose of this chapter to restrict the use of certain titles to a
person who is professionally qualified to use such titles, ensuring that the person
is licensed to engage in the practice of medical nutrition therapy, and meets
minimum standards of proficiency and competency acquired through adequate
training and experience.
63-25-103. Part definitions.
As used in this part:
(1) "Board" means the board of dietitian and nutritionist examiners;
(2) "Complex":
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(A) Means a disease state, medical condition, or clinical
presentation that requires the provision of medical nutrition therapy by a
licensed dietitian due to one (1) or more of the following conditions:
(i) The presence of multiple or interacting high-acuity
comorbidities;
(ii) A high risk of complications or rapid clinical
deterioration;
(iii) The need for intensive monitoring; or
(iv) The need for advanced nutrition interventions,
including therapeutic diets administered via enteral or parenteral
routes; and
(8) Includes:
(i) Severe malnutrition;
(ii) Organ failure;
(iii) Conditions requiring enteral or parenteral nutrition;
(iv) Renal disease requiring dialysis;
(v) Severe metabolic disturbances;
(vi) Post-bariatric surgery care; and
(vii) Critical illness;
(3) "Degree" means a credential attainment received from an educational
institution that at the time the degree was awarded was accredited by a United
States institutional accrediting body for higher education recognized by the
Council for Higher Education Accreditation, or its successor organization, the
United States department of education, or a foreign equivalent deemed
acceptable to the board;
(4) "Department" means the department of health;
(5) "Division" means the division of health related boards within the
department;
(6) "General non-medical nutrition information" means information on any
of the following:
(A) Principles of human nutrition and food preparation;
(8) Principles of self-care and a healthy relationship with food;
(C) Essential nutrients needed by the human body;
(D) General and non-individualized recommended amounts of
essential nutrients in the human body;
(E) Actions of nutrients in the human body;
(F) Non-individualized effects of deficiencies or excesses of
nutrients in the human body; or
(G) General education surrounding food, herbs, and dietary
supplements that are good sources of essential nutrients in the human
body;
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(7) "Licensed dietitian" means a person duly licensed under this chapter
who engages in the practice of dietetics and the practice of nutrition;
(8) "Licensed nutritionist" means a person duly licensed under this
chapter who engages in the practice of nutrition;
(9) "Medical nutrition therapy" means the provision of at least one (1) of
the following nutrition care services for the purpose of management or treatment
of a disease or medical condition:
(A) Nutrition assessment;
(8) Nutrition diagnosis;
(C) Nutrition intervention; or
(D) Nutrition monitoring and evaluation;
(10) "Medical weight control" means medical nutrition therapy provided for
the purpose of reducing, maintaining, or gaining weight;
(11) "Non-complex":
(A) Means a disease state, medical condition, or clinical
presentation that is stable and that can be safely addressed through
medical nutrition therapy delivered in a low-acuity outpatient setting by a
practitioner practicing within the practitioner's demonstrated level of
competence; and
(8) Does not include:
(i) Rapid clinical deterioration;
(ii) High-acuity care needs;
(iii) The need for intensive monitoring;
(iv) Multiple interacting high-acuity comorbidities; or
(v) The need for advanced interventions, including
therapeutic diets delivered via enteral or parenteral nutrition;
(12) "Non-medical weight control":
(A) Means nutrition care services for the purpose of reducing,
maintaining, or gaining weight that do not constitute the treatment or
management of a disease or medical condition; and
(8) Includes weight control services for healthy population groups
to achieve or maintain a healthy weight;
(13) "Nutrition assessment":
(A) Means the ongoing, dynamic, and systematic process of
ordering, obtaining, verifying, and interpreting biochemical,
anthropometric, physical, nutrigenomic, and dietary data to make
decisions about the nature and cause of nutrition-related problems
relative to patient and community needs; and
(8) Includes initial data collection and reassessment and analysis
of patient or community needs;
(14) "Nutrition care services" means any of the following services
provided within a systematic process:
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(A) Assessing and evaluating the nutritional needs of individuals
and groups and determining resources and constraints in a practice
setting, including ordering of nutrition-related laboratory tests to check
and track a person's nutrition status;
(8) Identifying nutrition problems and establishing priorities, goals,
and objectives that meet nutritional needs and are consistent with
available resources and constraints;
(C) Creating individualized dietary plans and issuing and
implementing orders to meet nutritional needs of healthy individuals and
individuals with disease states, including ordering therapeutic diets and
monitoring such diets' effectiveness;
(D) Determining and providing the appropriate nutrition
intervention in health and disease, including nutrition counseling on food
and prescription drug interactions;
(E) Developing, implementing, and managing nutrition care
systems; or
(F) Evaluating, altering, and maintaining appropriate standards of
quality in food and nutrition services;
(15) "Nutrition counseling" means a supportive process, characterized by
a collaborative counselor-patient relationship with individuals or groups, to
establish food and nutrition priorities, goals, and individualized action plans and
general physical activity guidance that acknowledges and fosters responsibility
for self-care, promotes health and wellness, or treats or manages an existing
disease or medical condition;
(16) "Nutrition diagnosis":
(A) Means identifying and labeling nutrition problems managed
and treated by a licensed dietitian or licensed nutritionist; and
(8) Does not include a medical diagnosis;
(17) "Nutrition intervention":
(A) Means a planned action, including nutrition counseling,
intended to positively change at least one (1) of the following:
(i) A nutrition-related behavior;
(ii) A risk factor;
(iii) An environmental condition; or
(iv) An aspect of the health status of a person and the
person's family or caregivers, target groups, or community; and
(8) Includes approving, ordering, and monitoring therapeutic diets
and counseling on food and prescription drug interactions;
(18) "Nutrition monitoring and evaluation" means identifying patient
outcomes relevant to the nutrition diagnosis, intervention plans, and goals and
comparing those outcomes with a previous status, intervention goals, or a
reference standard to determine the progress made in achieving desired
outcomes of nutrition care and whether planned interventions should be
continued or revised;
(19) "Patient" means an individual recipient of a nutrition care service;
(20) "Practice of dietetics":
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(A) Means the integration and application of scientific principles
derived from the study of food, nutrition, biochemistry, metabolism,
nutrigenomics, physiology, pharmacology, food systems, management,
and behavioral and social sciences to achieve and maintain optimal
nutrition status of individuals and groups across a lifespan; and
(B) Includes:
(i) The provIsIon of nutrition care services, including
medical nutrition therapy, delivered in person or via telehealth, in
inpatient and outpatient settings to prevent, manage, or treat
complex diseases and medical conditions and promote wellness;
(ii) Developing and ordering therapeutic diets via oral,
enteral, and parenteral routes; and
(iii) Providing other advanced medical nutrition therapy and
related support activities in accordance with the scope and
standards of practice of the registered dietitian and consistent with
current competencies required of academic and supervised
practice programs accredited by the Accreditation Council for
Education in Nutrition and Dietetics (ACEND), or its successor
organization;
(21) "Practice of nutrition":
(A) Means the integration and application of scientific principles
derived from the study of nutrition science, cellular and systemic
metabolism, biochemistry, physiology, and behavioral sciences to support
and maintain health throughout a lifespan;
(B) Includes the provision of nutrition care services, including
medical nutrition therapy, delivered in person or via telehealth, in low
acuity outpatient settings to prevent, manage, or treat non-complex
diseases and medical conditions and promote wellness;
(C) May include, depending on the level of competency:
(i) Ordering oral therapeutic diets;
(ii) Ordering medical laboratory tests related to nutrition
interventions; or
(iii) Recommending a vitamin, mineral, or other dietary
supplement; and
(D) Does not include the provision of medical nutrition therapy for
complex conditions and the delivery of medical nutrition therapy in an
inpatient or a high-acuity outpatient setting;
(22) "Registered dietitian" means a person who is credentialed by the
Commission on Dietetic Registration, or its successor organization, as a
registered dietitian or a registered dietitian nutritionist and is authorized to use
such titles and the corresponding abbreviations "RD" or "RON";
(23) "Telehealth" means the use of real-time audio, video, or other
electronic media and telecommunication technology that enables interaction
between a practitioner and a patient in another location to support clinical health
care, public health, patient health-related education, and health administration;
(24) "Therapeutic diet":
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(A) Means a diet intervention prescribed by a physician or other
authorized practitioner, including a licensed nutritionist for oral diets or a
licensed dietitian for oral, enteral, or parenteral diets; and
(B) Includes providing food, fluids, or nutrients via oral, enteral, or
parenteral routes as part of the treatment of a disease or clinical condition
to modify, eliminate, decrease, or increase specific macronutrients in the
diet or to provide mechanically altered food when indicated; and
(25) "Unrestricted practice of medical nutrition therapy" means the
provision of medical nutrition therapy by a person who is responsible for the
person's own practice or treatment procedures.
63-25-104. Prohibited representations - License required - Construction.
(a) Except as otherwise provided under this chapter:
(1) Only a licensed dietitian may engage in the practice of dietetics and
the practice of nutrition to the extent such services constitute medical nutrition
therapy;
(2) Only a licensed nutritionist may engage in the practice of nutrition to
the extent such services constitute medical nutrition therapy;
(3) A person shall not designate or hold the person's self out as a
licensed dietitian or use or assume the titles "licensed dietitian," "dietitian,"
"dietitian nutritionist," "nutritionist," or another title indicating that the person is a
licensed dietitian or append to or use in conjunction with that person's name the
letters "LO" unless the person is a licensed dietitian pursuant to this chapter; and
(4) A person shall not designate or hold the person's self out as a
licensed nutritionist or use or assume the title "licensed nutritionist," "nutritionist,"
or another title indicating that the person is a licensed nutritionist or append to or
use in conjunction with that person's name the letters "LN" unless the person is a
licensed nutritionist pursuant to this chapter.
(b) A violation of subsection (a) or (b) is a Class A misdemeanor.
(c) This chapter does not apply to a person licensed to practice medicine or
osteopathic medicine pursuant to chapter 6 or 9 of this title.
(d) This chapter does not prohibit or restrict:
(1) A person qualified and licensed to practice another health profession
from engaging in the practice of medical nutrition therapy when incidental to the
practice of the person's profession;
(2) A student or trainee from engaging in the practice of medical nutrition
therapy, as long as the student or trainee meets the following conditions:
(A) The student or trainee practices as a part of a course of study
or as part of a planned, continuous supervised practice experience to
satisfy educational or supervised practice experience requirements
pursuant to§ 63-25-108;
(B) The student or trainee who is completing supervised practice
experience practices no more than five (5) years after completing the
education requirements, as described in § 63-25-108;
(C) The student or trainee practices only while supervised by a
qualified supervisor, as described in § 63-25-105;
(D) The student or trainee does not engage in the unrestricted
practice of medical nutrition therapy; and
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(E) The student or trainee uses a title that clearly indicates the
student or trainee is a student, intern, trainee, or supervisee while
practicing;
(3) A dietitian or nutritionist who is serving in the armed forces or the
United States public health service or is employed by the United States veteran's
administration from engaging in the practice of medical nutrition therapy or using
government-issued titles related to such service or employment;
(4) A person performing an activity and service of a nutrition educator in
the employment of a federal, state, county, or municipal agency, an elementary
or secondary school, or accredited degree granting educational institution,
insofar as such activity and service are part of a salaried position and the activity
or service does not constitute the provision of medical nutrition therapy;
(5) A person who is employed by this state, a county, a municipal agency,
or a political subdivision, or a person who contracts with the foregoing, for the
purpose of providing .nutrition services for the special supplemental nutrition
program for women, infants, and children (WIC) from providing nutrition care
services utilizing the title of "nutritionist" within the discharge of the person's
official duty;
(6) A person who does not represent themselves using a title pursuant to
this section who is providing medical weight control for obesity for one (1) of the
following:
(A) An instructional program that has been approved in writing by
at least one (1) of the following:
(i) A dietitian or nutritionist licensed in this state; or
(ii) A healthcare practitioner licensed or certified in this
state whose authorized scope of practice includes medical
nutrition therapy; or
(B) A plan of care that is overseen by a healthcare professional
licensed in this state whose scope of practice authorizes the healthcare
professional to provide and delegate medical nutrition therapy as long as
the medical weight control service is not discretionary and does not
require the exercise of professional judgment;
(7) A person who disseminates non-individualized, written, general non-
medical nutrition information in connection with the marketing and distribution of
dietary supplements, foods, herbs, or food materials including any of the
following, as long as such information does not constitute medical nutrition
therapy and the person does not use a title protected under this section:
(A) An explanation of federally regulated label claims for dietary
supplements, foods, herbs, or food materials;
(B) Any known drug-nutrient interactions regarding dietary
supplements, foods, herbs, or food materials;
(C) The role of dietary supplements, foods, herbs, or food
materials in various diets; or
(D) Suggestions on how best to use and combine dietary
supplements, foods, herbs, or food materials;
(8) A person who identifies as using earned, federally trademarked
dietetic or nutrition credentials as long as the person does not represent the
person's self using general titles protected under this section and does not offer
or provide services that constitute medical nutrition therapy unless the person is
also licensed under this chapter or otherwise exempt;
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(9) A person who provides individualized nutrition recommendations for
the wellness and primary prevention of chronic disease, health coaching, holistic
and wellness education, guidance, motivation, behavior change management,
services for non-medical weight control, or other nutrition care services if the
following applies:
(A) The service does not constitute medical nutriUon therapy;
(B) The person does not represent the person's self using titles
protected pursuant to this section; and
(C) The person does not hold the person's self out as licensed or
qualified to engage in the practice of medical nutrition therapy;
(10) An out-of-state dietitian or nutritionist who provides medical nutrition
therapy services via telehealth to a patient located in this state if the out-of-state
practitioner is a dietitian or nutritionist licensed or certified in good standing in any
state or United States territory who provides medical nutrition therapy services
via telehealth and meets one (1) of the following conditions:
(A) Works in consultation with a medical nutrition therapy
practitioner licensed in this state who has a practitioner-patient
relationship with the patient;
(B) Provides services to a patient whom the practitioner has a
current practitioner-patient relationship and the patient is temporarily
present in this state; or
(C) Provides services pursuant to a current practitioner-patient
relationship and such care is limited to either a temporary or short-term
follow-up medical nutrition therapy service to ensure continuity of care; or
(11) The dissemination of general non-medical nutrition information,
dietary education, or public health information provided orally, in writing, digitally,
or through electronic media when such information does not constitute
individualized medical nutrition therapy.
63-25-105. Qualified supervisor.
(a) A person must meet all of the following requirements to be a qualified
supervisor for purposes of this chapter:
(1) Verify, direct, and approve the nutrition care services, which includes
medical nutrition therapy, provided by a student or trainee;
(2) Develop and implement a program for advancing and optimizing the
quality of care provided by a student or trainee;
(3) Oversee, approve, and accept responsibility for the nutrition care
services rendered by the student or trainee;
(4) Review on a regular basis the charts, records, and clinical notes of the
student or trainee; and
(5) Maintain responsibility for the student's or trainee's clinical record
keeping.
(b) If supervising the provision of medical nutrition therapy, then a qualified
supervisor must satisfy all requirements listed in subsection (a) and at least one (1) of
the following requirements:
(1) Be licensed or certified in the state that the student or trainee is
engaging in the practice of medical nutrition therapy as a dietitian, nutritionist,
dietitian nutritionist, or healthcare provider whose scope of practice includes
medical nutrition therapy;
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(2) Meet any other criteria as the board may establish by rule or
regulation in a situation in which a state where the supervised practice occurs
does not provide for licensure or certification for a dietitian, dietitian nutritionist, or
nutritionist; or
(3) Meet the exemption as described in§ 63-25-104(d)(3).
(c)
(1) A qualified supervisor shall not supervise a clinical activity or nutrition
care service that the qualified supervisor is not authorized to perform.
(2) A qualified supervisor shall limit the assignment of nutrition care
services to those services that are within the training and experience of the
student or trainee and customary to the practice of the qualified supervisor.
(d) Both a qualified supervisor and the qualified supervisor's student or trainee
shall identify and document the following:
(1) Goals for supervised practice experience;
(2) The assignment of clinical tasks as appropriate to the student's or
trainee's evolving level of competence;
(3) The student's or trainee's relationship and access to the qualified
supervisor; and
(4) A process for evaluating the student's or trainee's performance.
(e)
(1) The qualified supervisor shall remain on-site where the student or
trainee is providing nutrition care services or be continuously available to the
student or trainee by means of a two-way, real-time audiovisual technology that
allows for the direct, contemporaneous interaction by sight and sound between
the qualified supervisor and the student or trainee.
(2) If the qualified supervisor assigns a nutrition care service to a student
or trainee that is to be provided in a setting where the qualified supervisor is not
routinely present, then the qualified supervisor must ensure that the means and
methods of supervision are adequate to ensure appropriate patient care, which
may include synchronous videoconferencing or another method of
communication and oversight that is appropriate to the care setting and the
education and experience of the student or trainee.
(3) If a patient requests for a qualified supervisor to be available to render
assistance during the provision of nutrition care services by a student or trainee,
then the qualified supervisor must be available. However, the qualified supervisor
may arrange for another qualified supervisor to be available to assist the student
or trainee in the initial qualified supervisor's absence if a patient made such a
request.
63-25-106. Board of dietitian and nutritionist examiners.
(a)
(1) There is created the board of dietitian and nutritionist examiners,
which consists of nine (9) members appointed by the governor, each of whom
must be a resident of this state. Five (5) members must be licensed dietitians,
two (2) members must be licensed nutritionists, one (1) member must be a
physician licensed under this title, and one (1) member must not be a licensed
healthcare professional and must represent the public at large.
(2) Each licensed dietitian or licensed nutritionist appointed to the board
must have at least five (5) years of experience in the practice or teaching of
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dietetics or nutrition. Each licensed dietitian and licensed nutritionist member of
the board must represent at least one (1) of the following areas of practice:
(A) Dietetics management;
(B) Clinical dietetics or nutrition;
(C) Dietetics or nutrition education;
(D) Community nutrition; or
(E) Consultation and private practice.
(3) Appointments may be made from lists of qualified persons submitted
to the governor by an interested dietitian, nutritionist, hospital group, or medical
group, including the Academy of Nutrition and Dietetics, the Tennessee Hospital
Association, and the Tennessee Medical Association. The governor must consult
with such interested persons or groups to determine qualified persons to fill the
positions.
(b)
(1)
(A) Each member of the board of dietitian/nutritionist examiners as
of December 31, 2027, shall serve the remainder of the member's term as
a member of the board.
(B) A member of the board of dietitian/nutritionist examiners as of
December 31, 2027, who is eligible for reappointment may be
reappointed by the governor to the board as long as the member meets
the requirements as described in subdivision (a)(2).
(2) All appointments, including reappointments as described in
subdivision (b)(1 )(8), are for terms of three (3) years.
(3) A member shall not be selected to serve on the board for more than
two (2) consecutive terms, and each member serves on the board until a
successor is appointed.
(4) A vacancy is filled by appointment by the governor for the unexpired
term.
(5) In making appointments to the board, the governor shall strive, to the
extent practicable, to reflect the geographic, racial, ethnic, gender, and cultural
diversity of the state.
(c) The board shall meet annually to select a chair and a secretary. A quorum of
the board consists of five (5) members, and the board shall meet as frequently as the
board's duties may require. The division shall perform administrative functions for the
board.
(d) Each member of the board must receive compensation for services in an
amount determined by the department, not to exceed fifty dollars ($50. 00) per diem
when actually engaged in the discharge of the board's official duties and must be
reimbursed for all travel expenses in accordance with the comprehensive state travel
regulations promulgated by the department of finance and administration and approved
by the attorney general and reporter.
63-25-107. Powers and duties of board.
In addition to the powers granted in this chapter, the board shall:
(1) Promulgate rules that are reasonably necessary for the performance
of the various duties imposed upon the board in the proper administration of this
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chapter, including adopting a code of ethics, a standard of practice, and
establishing continuing education requirements for licensure renewal. The rules
must be promulgated in accordance with the Uniform Administrative Procedures
Act, compiled in title 4, chapter 5;
(2) Set fees, after consultation with the department and subject to the
maximum limitations prescribed in this chapter, relative to the application,
examination, licensing, and license renewal in amounts sufficient to pay all of the
expenses of the board directly attributable to the performance of the board's
duties pursuant to this chapter;
(3) Develop applications and review, approve, or reject the qualifications
of applicants for licensure and to issue, in the board's name, all approved
licenses, certificates, and permits;
(4) Collect or receive all fines, fees, and moneys owed pursuant to this
chapter and to pay the same into the general fund of the state. For purposes of
implementing subdivision (a)(2), the board shall designate any fines, fees, or
moneys collected pursuant to the regulation of dietitians and nutritionists;
(5) Deny, suspend, or revoke the license of, to discipline by an
administrative penalty not to exceed five hundred dollars ($500), or to reprimand
a license holder who is guilty of violating this chapter or who is guilty of violating
the rules and regulations of the board duly promulgated pursuant to this chapter;
(6) Receive and process complaints and investigate alleged violations of
this chapter; and
(7) Administer and participate in the Dietitians Licensure Compact, as
described in part 2 of this chapter, to authorize a person who is licensed as a
dietitian in another state to practice in this state in accordance with such
compact.
63-25-108. Applications for licensure.
(a) An applicant for licensure as a dietitian must file a written application on a
form provided by the department or via online application showing to the satisfaction of
the board that such person is capable and professionally competent to safely engage in
the practice of dietetics and the practice of nutrition and meets one (1) of the following
criteria:
(1) The applicant must submit proof of completion of the following:
(A) Completion of a master's degree or doctoral degree and a
program of study accredited by the Accreditation Council for Education in
Nutrition and Dietetics (ACEND), or its successor organization;
(B) Completion of a planned, continuous supervised practice
experience in the practice of dietetics and the practice of nutrition
approved by the examining board and accredited by ACEND, or its
successor organization, that involves at least one thousand (1,000) hours
of supervised practice experience under the supervision of a qualified
supervisor, as described in § 63-25-105. An applicant must complete a
supervised practice experience under this subdivision (a)(1)(B) within five
(5) years of completing the requirements under subdivision (a)(1)(A)
unless the examining board, for extraordinary circumstances, grants an
extension for a limited time; and
(C) Completion of the registration examination for dietitians
administered by the Commission on Dietetic Registration, or its successor
organization. If an applicant passed such examination more than five (5)
years before applying for licensure, then the applicant must demonstrate
that such applicant completed seventy-five (75) hours of continuing
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education meeting the continuing education criteria of the board per each
five-year period post examination; or
(2) The applicant submits proof of holding a valid current registration with
the Commission on Dietetic Registration, or its successor organization, that gives
the applicant the right to use the term "registered dietitian" or "registered dietitian
nutritionist".
(b) An applicant for licensure as a nutritionist must file a written application on a
form provided by the department or via online application showing to the satisfaction of
the board that such person is capable and professionally competent, as determined by
the board, to safely engage in the practice of nutrition and submits proof of completion of
the following:
(1) Completion of a master's or doctoral degree with a major in human
nutrition, foods 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, a comparable titled major in a master's program,
or a doctoral degree in a field of clinical health care. The applicant must have
completed coursework leading to competence in medical nutrition therapy that
includes:
(A) Fifteen (15) semester hours of clinical or life sciences,
including at least three (3) semester hours on human anatomy and
physiology or the equivalent; and
(8) Fifteen (15) semester hours of nutrition and metabolism,
including at least six (6) semester hours in biochemistry;
(2) Completion of a planned, continuous supervised practice experience
demonstrating competence in the practice of nutrition approved by the examining
board following the requirements described in subsection (c); and
(3) Completion of the examination requirements by demonstrating:
(A) Passage of the certified nutrition specialist examination
administered by the Board for Certification of Nutrition Specialists or an
equivalent examination on all aspects of the practice of nutrition that has
been reviewed under a program that requires a master's degree or
higher, is accredited by the National Commission for Certifying Agencies,
or its successor organization, and is approved by the examining board. If
passage of the examination occurred more than five (5) years before
application, then the applicant must demonstrate completion of seventy-
five (75) hours of continuing education meeting the continuing education
criteria of the board per each five-year period post examination; or
(B) The applicant holds a valid current certification with the Board
for Certification of Nutrition Specialists, or its successor organization, that
gives the applicant the right to use the title "certified nutrition specialist".
(c)
(1) An applicant for licensure as a nutritionist shall complete a supervised
practice experience, as described in subdivision (b)(2), within five (5) years of
completing the requirements under subdivision (b)(1) unless the examining
board, for extraordinary circumstances, grants an extension for a limited time.
(2) The supervised practice experience required in subdivision (b)(2) must
have at least one thousand (1,000) hours in the following practice areas, with a
minimum of two hundred (200) hours in each practice area:
(A) Nutrition assessment;
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(8) Nutrition intervention; and
(C) Nutrition monitoring and evaluation.
(3) The board has discretion to determine whether the applicant's
experience has prepared the applicant to provide nutrition care services for
various populations of diverse cultures and genders, and across a life cycle, and
to be able to competently formulate actionable medical nutrition therapies and
interventions, education, counseling, and ongoing care for the prevention,
modulation, and management of a range of non-complex medical conditions.
(4) A supervised practice experience must be completed under the
supervision of a qualified supervisor as described in § 63-25-105.
(d)
(1) Upon renewal, the license of a person licensed as a
dietitian/nutritionist on January 1, 2028, must be converted to a dietitian license
as long as the licensee remains in good standing and maintains active or retired
status.
(2) A person who has applied for licensure as a dietitian/nutritionist prior
to January 1, 2028, is eligible for licensure as a dietitian under the requirements
in place prior to January 1, 2028. The person must comply with this chapter for
purposes of renewing such license on or after January 1, 2028,
63-25-109. Issuance of licenses - Temporary permits.
(a) The board may waive the examination, education, and experience
requirements of this chapter and grant a license as a licensed dietitian or a licensed
nutritionist to an applicant who presents proof of current licensure, certification, or
registration as a dietitian or nutritionist under the laws of another state, the District of
Columbia, or a territory of the United States, if, in the board's opinion, the educational,
experiential, and examination qualifications and requirements for the license are
substantially equivalent to the licensure process in this state for the specific license for
which the applicant is applying.
(b)
(1) The board may issue temporary permits to practice dietetics or
nutrition to an applicant upon submission of satisfactory evidence that such
person has:
(A) Completed the academic and experiential requirements to be
licensed as a dietitian or nutritionist;
(B) Applied for or taken the designated licensing examination
required pursuant to this chapter; and
(C) Paid the fee required for a temporary permit.
(2) A temporary permit expires one (1) year from the date of issuance and
may be renewed for a period not to exceed six (6) months upon submitting to the
board a satisfactory explanation of the applicant's failure to become licensed
within the one-year term.
(3)
(A) A temporary dietitian permit allows an applicant, pursuant to §
63-25-108(a), to practice under the supervision of a licensed dietitian.
(B) A temporary nutritionist permit allows an applicant, pursuant to
§ 63-25-108(b), to practice under the supervision of a licensed dietitian or
nutritionist.
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63-25-110. Disciplinary action.
(a) The board is empowered to:
(1) Deny a license;
(2) Refuse to renew a license;
(3) Suspend a license;
(4) Revoke a license or permit;
(5) Issue orders to cease and desist from certain conduct; or
(6) Discipline an applicant, licensee, permittee, or another person when
such person meets at least one (1) of the following conditions:
(A) Attempted to obtain or obtained licensure by fraud or
misrepresentation;
(8) Engaged in unethical or unprofessional conduct, including
willful acts, negligence, or a pattern of continued and repeated healthcare
liability, negligence, or incompetence in the course of professional
practice;
(C) Engaged in habitual intoxication or personal misuse of any
drug, narcotic, or controlled substance or controlled substance analogue
so as to adversely affect the person's ability to practice;
(D) Has been convicted in any court of a crime directly related to
the duties and responsibilities of a dietitian or nutritionist, was violent or
sexual in nature, or entered into a plea of guilty or nolo contendere to any
such crime;
(E) Violated any lawful order or rule or regulation rendered or
adopted by the board; or
(F) Violated this chapter.
(b) Administrative proceedings for disciplinary action against a license holder or
permittee must be conducted by the board in accordance with the Uniform
Administrative Procedures Act, compiled in title 4, chapter 5.
(c)
(1) The board is authorized to promulgate rules governing the
assessment of costs against a person found by the board to have violated any
provision of this chapter. The rules must be promulgated in accordance with the
Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
(2) The costs assessed by the board may include only costs directly
related to the prosecution of the charges against the person, including
investigatory costs when appropriate. The board shall determine the appropriate
amount of costs, if any, to be assessed in a contested case. These costs must be
reasonable and proportionate in light of the violation committed by the person.
(d)
(1) An elected officer of the board or duly appointed or elected chair has
the authority to administer an oath to a witness. Upon probable cause being
established, the board, by a vote of two-thirds (2/3) of the members to which the
board is entitled, may issue a subpoena for the attendance of a witness and the
production of any documents and records.
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(2) The sheriff of the county of residence of a person upon whom the
subpoena is served shall serve a subpoena issued by the board.
(3)
(A) The person served by subpoena has thirty (30) days to
request in writing a hearing before the board for the sole purpose of
making a special appearance to quash or modify the subpoena. The
subpoena for attendance of the person or the production of documents
and records is stayed until the board votes upon the request to quash or
modify the subpoena. A majority vote of the members to which the board
is entitled is required to quash or modify a subpoena.
(8) A motion to appeal from a decision by the board regarding a
request to quash or modify a subpoena must be made to the chancery
court in Davidson County within fifteen (15) days of such decision.
(4) If any witness fails or refuses to obey a subpoena issued by the board,
then the board may make application to any court of record in this state within the
jurisdiction of which the witness is found or resides, and the court has the power
to attach the body of the witness and compel the witness to appear before the
board and give testimony or produce documents or records as ordered. The
court may issue an order for civil contempt upon any failure to obey the court
order.
(5) Each witness who appears before the board by order of the board
receives for attendance the compensation provided by law for attendance of a
witness in a court of record, which is paid from the funds of the board in the same
manner as all other expenses of the board are paid.
(e) An action taken under this section is subject to the Fresh Start Act, compiled
in chapter 1, part 1 of this title.
63-25-111. Fees.
The board shall establish fees for applications, examinations, renewals,
reciprocity, and other related matters.
63-25-112. Failure to renew license or pay fee - Revocation and reinstatement of
license.
(a) If a licensee fails to renew the licensee's license and to pay the biannual
renewal fee after renewal becomes due, then the license is automatically revoked
without further notice of hearing, unless renewal is made and all fees paid prior to the
expiration of sixty (60) days from the date such renewal was due.
(b) A person whose license is automatically revoked as provided in subsection
(a) may have the license reinstated by the board in its discretion for good cause being
shown, upon payment of all past-due renewal fees, and upon the further payment of a
nonrefundable sum as set by the board.
63-25-113. Retirees.
(a) A person licensed to engage in the practice of dietetics or the practice of
nutrition in this state who has retired or who may hereafter retire from such practice is
not required to register if such person files with the board an affidavit form furnished by
the board. The affidavit must have the date on which the person retired from such
practice and other facts to verify the retirement as the board deems necessary.
(b) The board shall furnish the affidavit form needed by a person to prove such
person has retired from the practice of dietetics or the practice of nutrition, as described
in subsection (a).
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(c) A person who reengages in the provision of medical nutrition therapy or seeks
to utilize a title protected under this chapter following retirement must apply for a license
to engage in the practice of dietetics or the practice of nutrition with the board as
provided by this chapter and meet any requirements as may be set by the board.
63-25-114. Injunctions.
The board may make application to seek injunctive relief for a temporary or
permanent restraining order or injunction enjoining violations of this chapter.
63-25-115. Rules.
(a) The rules of the board of dietitian/nutritionist examiners that are in effect prior
to the effective date of this act remain in effect until amended or new rules are
promulgated for the board.
(b) The board may promulgate rules to effectuate this chapter. The rules must be
promulgated in accordance with the Uniform Administrative Procedures Act, compiled in
title 4, chapter 5.
SECTION 3. The headings in this act are for reference purposes only and do not
constitute a part of the law enacted by this act. However, the Tennessee Code Commission is
requested to include the headings in any compilation or publication containing this act.
SECTION 4. For the purposes of promulgating rules, this act takes effect upon becoming
a law, the public welfare requiring it. For all other purposes, this act takes effect January 1,
2028, the public welfare requiring it.
16
HOUSE BILL NO. 2029
PASSED: April 21, 2026
,
c./..---
CAMERONSEXTON,SPEAKER
HOUSE OF REPRESENTATIVES
. RANDY MCNALL
SPEAKER OF THE SENAT
APPROVED this IC, It day of '{V'\~ 2026
~
BILL LEE, GOVERNOREvery fact on this page links to its source, starting with the official bill record.