HB 796 Modernize/Nutrition Practice Act – Another Perspective

Hey folks!

Last year we had a post on the blog titled Stop the HB 796, Modernize Dietetics/Nutrition Practice Act (click the link to check it out). We were contacted by a reader who let us know that we were misinformed about the bill, and that it was actually something she thought we should be supporting instead of opposing. She graciously offered to write a blog post explaining the issues. Check out the post below for another perspective on the bill.

 

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Guest post written by: Nicole Spear MS, CNS, CFMP

As wholistic health experts continue to gain momentum in recognition and authority for managing chronic health conditions, it becomes increasingly important for consumers to join in the fight for ‘real’ food and ‘real’ health. The USDA dietary guidelines, which are failing Americans, are still being heavily promoted through television, schools and institutions, and traditional medical facilities. Fortunately, state laws are slowly changing to reflect the principles that science proves. However, not every state has been willing to embrace the education that wholistic practitioners can offer and North Carolina is among the most hostile.

If we act quickly though, there is an opportunity to change the laws of North Carolina and pave the way for the remainder of the “hostile” states to follow. Last year, following a victory lawsuit against blogger Steve Cooksey, the current Dietetics/Nutrition Practice Act was favorably amended to recognize wholistic practitioners as qualified to give nutrition advice for the purpose of managing disease. This bill, HB 796, Modernize Dietetics/Nutrition Practice Act, successfully passed the House, but now sits in a Senate committee, awaiting a hearing and vote. Sadly, many bills get lost in committee and never receive a hearing unless the chairman of the committee hears from constituents and consumers, prompting a decision to move the bill forward. Therefore, it is important that chairman Tom Apocada hears from individuals, concerned about the health of this country.

Problem #1: Extreme limitations against wholistic healthcare practitioners

Current Law: requires that only Registered Dieticians (RDs), licensed by the Academy of Nutrition and Dietetics, can provide nutrition care to individuals.

H796 Amendment: provides allowances for advanced wholistic nutrition professionals licensed under The Board for Certification of Nutrition Specialists℠ (BCNS℠) or The American Clinical Board of Nutrition (ACBN).

Wholistic practitioners such as chiropractors, naturopaths, integrative/alternative medical doctors and other alternative health care providers seek nutrition credentialing through alternative agencies that are not governed by USDA nutrition standards and the Academy of Nutrition and Dietetics, the credentialing agency for dieticians (RDs or LDNs). The conferred credentials are awarded to candidates whose qualifications often exceed those of the registered dietician (RD). However, these qualified, wholistic practitioners are prohibited from giving nutrition counsel that would help individuals with medical conditions and diseases.

The severe limitations of the current law were brought before the state in 2011 when the North Carolina Board of Dietetics/Nutrition denied Liz Lipski, PhD, CCN, CNS, CHN the right to practice as a nutritionist in North Carolina (NC). Despite the fact that her education and experience far exceeds that which the current law requires, she was still denied the right to work on the basis that she was not credentialed by the Academy of Nutrition and Dietetics.

Problem #2: Monopolization of the North Carolina Board of Dietetics/Nutrition (NCBDN)

Current Law: requires the North Carolina Board of Dietetics/Nutrition to be created of 7 members, 5 of which must serve under the private association that credentials RDs.

H796 Amendment: expands the requirements for the North Carolina Board of Dietetics/Nutrition to include at least 3 members with alternative credentials, breaking the monopolization by the Academy of Nutrition and Dietetics.

Problem #3: Ancient language does not meet Medicaid/Medicare standards, prohibiting alternative practitioners from treating individuals with these benefits.

Current Law: allows only a registered dietician (RD) to practice “nutrition care services” defined as the following:

  • Assessing the nutritional needs of individuals and groups, and determining resources and constraints in the practice setting;
  • Establishing priorities, goals, and objectives that meet nutritional needs and are consistent with available resources and constraints;
  • Providing nutrition counseling in health and disease;
  • Developing, implementing, and managing nutrition care systems; and
  • Evaluating, making changes in, and maintaining appropriate standards of quality in food and nutrition services.

 

H796 Amendment: changes the term, “nutrition care services” to “medical nutrition therapy” defined as “the provision of nutrition care services for the purpose of managing or treating a medical condition” and expands this practice to wholistic healthcare practitioners.

Some opposition to this bill has been incorrectly raised due to this change in terminology. Both phrases refer to the use of nutrition for the purpose of managing and/or treating a medical condition. The newer terminology is used in Medicaid/Medicare documentation as acceptable treatment options and is the correct terminology to represent the care given by both dieticians and wholistic nutritionists.

H796 expands the current law to allow individuals with Medicaid/Medicare benefits to seek the help of wholistic nutritionists, for medical nutrition therapy. This is currently denied to individuals in North Carolina.

Protecting Free Speech

If you are under the assumption that HB 796 limits the ability of the layman or non-certified health coach from sharing nutrition advice, you are mistaken. Section 13 of HB 796 lists an entire group of individuals that this law does not apply to and those exclusions include the general public speaking to one another, so long as they do not claim to be a nutritionist or dietician. Therefore, HB796 does not restrict family members or friends from giving nutrition advice to one another. Nor does it restrict trainers and health advocates from helping individuals using nutritional advice. It only restricts the practice of medical nutrition therapy to those practitioners claiming to be a certified or licensed nutritionist or dietician.

The Bottom Line

In summary, HB796 expands the rights of wholistic practitioners to use food and nutrition to manage and treat medical conditions. It does not limit the general public from offering nutrition advice to one another. It also eliminates the monopoly that the Academy of Nutrition and Dietetics holds over the North Carolina Board of Dietetics/Nutrition.

The support of HB 796 would be a tremendous victory for consumers, healthcare advocates, and wholistic practitioners who believe in the power of food to heal. The success of this bill will not only positively affect the constituents of North Carolina, but concerned individuals in the entire country. A victory in any state, is a victory for all!

Here is a link to the amended bill: http://www.ncleg.net/Sessions/2015/Bills/House/PDF/H796v2.pdf

 

Your Participation

What can you do? I urge you to consider sending an email to the Senate Rules Committee chairman, Tom Apodaca at tom.apodaca@ncleg.net and tell him to bring HB 796 to the floor for a hearing and a vote.

Following is a sample letter you may use:

 

Dear Senator Tom Apodaca:

I am writing you to fervently urge the Senate Rules Committee to hold a hearing on HB 796, The Modernize Dietetics/Nutrition Practice Act.

H796 favorably amends the current Dietetics/Nutrition Practice Act to be more inclusive and provide better nutrition care and services to the residents of NC. H796 also creates job positions for highly qualified nutrition professionals who are currently denied jobs in this state.

Current Law: requires that only Registered Dieticians (RDs), licensed by the Academy of Nutrition and Dietetics, can provide nutrition care to individuals.

H796: provides allowances for advanced nutrition professionals licensed under The Board for Certification of Nutrition Specialists℠ (BCNS℠) or The American Clinical Board of Nutrition (ACBN).

The current law limits the dispensing of nutrition advice to Registered Dieticians (RDs) and Licensed Dieticians (LDs) only. This has been established because members of the Academy of Nutrition and Dietetics, the licensing board for RDs and LDs, monopolize the North Carolina Board of Dietetics/Nutrition (NCBDN). While these licenses are important for nutrition education, other agencies, such as The Board for Certification of Nutrition Specialists℠ (BCNS℠) are licensing candidates whose qualifications often exceed those required for an RD or LD. However, individuals holding these higher credentials are not able to work legally as nutritionists in the state of North Carolina, under the current law. Therefore, they are forced to either move to another state or work under the auspices of another credential.

Current Law: requires the North Carolina Board of Dietetics/Nutrition to be created of 7 members, 5 of which must serve under the private association that credentials RDs

H796: expands the requirements for the North Carolina Board of Dietetics/Nutrition to include at least 3 members with a CNS and/or DACBN credential

    • The Academy of Nutrition and Dietetics does not dispute that it favors exclusionary practice and benefit rights for its RDs
    • The Academy of Nutrition and Dietetics continues to argue for restrictive regulation that unduly favors their private professional association and reduces competition for nutrition services

 

North Carolina needs many more nutrition care providers with a variety of backgrounds to serve a broader sector of individuals seeking nutritional advice for improving their health. Nutrition education and counseling helps individuals eat better to avoid diseases and lowers health care costs. There are many excellent training opportunities and credentials outside of the dietetics model and RD credential. These other nutrition providers deserve the right to practice in the state of NC, and the consumer deserves the right to choose a practitioner that best matches their needs.

In summary, HB 796 would:

  • Expand the diversity of well-qualified practitioners who could become licensed, employed in the growing nutrition field, and offering services to North Carolinians
  • Broaden the unlicensed provision of preventive, healthy nutrition information to improve the health of our citizens
  • Create a more diverse licensing board
  • Allow dietitians and nutritionists to provide better and more expedient nutrition care to hospital patients by updating the practice act with language adopted in May 2014 by Centers for Medicare and Medicaid

 

Please, I urge you to give HB 796 a hearing and vote it out of committee for a floor vote.

Respectfully,

[Your Name]

 

Original Source: HB 796 Modernize/Nutrition Practice Act – Another Perspective

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