Background: California RDNs have been on the licensure quest for over 20 years, as documented on our website https://www.dietitian.org/advocacy. To date, 44 states and Puerto Rico have licensure. According to The Academy, California the largest of the 6 remaining states without licensure, although we have strong title protection (B&P 2585) and a scope of practice business code (B&P 2586). One of The Academy’s top priorities for the next few years is to help these states develop their strategies toward obtaining licensure.   The California Academy Executive Board mirrors this priority and is committed to presenting legislation to California lawmakers in 2022 and beyond.

Barriers: There are several anticipated barriers to the current quest.

o   Estimated practitioner initial application costs of $400 and annual dues of $200.

o   Supervisor or oversight board creation. The current plan is to align with an existing  association board, such as the California Medical Association.

o   Establishment of a  solid plan that licensure benefits consumers.  This plan must be vetted and communicated. It will include actual cases in which harm is the result of poor unregulated practice.  This is the most important barrier to overcome and will need everyone’s input and cooperation to implement.  The Academy introduced a  new incident reporting tool this year and it is on our website as well as at eatright.org

  • Consumer Protection
    Licensure is an important guard that will allow consumers to easily identify credible public   information sources.  Nutrition and dietetics licensure will assure practitioners meet professional competence standards.  This added assurance will highlight the credibility needed for public, health insurers/other payers, and state/federal government agencies to justify and obtain nutrition care services reimbursement.
  • Practice Implications
    Licensure can open professional opportunities for licensed RDNs when healthcare  payers and similar entities recognize the high standards that licensure will require. For example, health care facilities may expand their facility-specific RDN practice scopes since licensure will provide a public process to report fraudulent or  harmful activity that would allow the state to sanction providers as necessary. Also, MNT order writing that would include diet orders, nutrition support, supplements  and laboratory tests may be more readily facilitated.  This process is based on the  implied assumption that RDN liability would be a result of MNT plan implementation.
  • Working Across State Lines Benefits
    The Academy works to implement reciprocity provisions between states with
    dietetics licensure by using the Model Practice Act to promote licensure law/related regulation consistency from one state to another. This not only allows    consumers to access qualified licensed dietitian nutritionists across state
    lines or via telehealth, but also ensures they are receiving safe and effective services from all entities. As regulations vary from state to state, practitioners who provide services in more than one state — whether through consulting or corporate positions, multi-state health systems, telehealth, or for any other reason — must be familiar and comply with each applicable states’ regulations.

Respectfully,
Brenda O’Day, MS, RDN, CNSC
Immediate Past Vice President Public Policy 2020-2022
publicpolicy@dietitian.org