Bill Text: IL SB1229 | 2013-2014 | 98th General Assembly | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Amends the Dietitian Nutritionist Practice Act. Provides that a "medically prescribed diet" may only be performed as initiated by or in consultation with a physician licensed under the Medical Practice Act of 1987 acting within the scope of his or her practice. Effective immediately.

Spectrum: Partisan Bill (Democrat 3-0)

Status: (Passed) 2013-08-02 - Public Act . . . . . . . . . 98-0148 [SB1229 Detail]

Download: Illinois-2013-SB1229-Amended.html

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Sen. Iris Y. Martinez

Filed: 4/9/2013

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AMENDMENT TO SENATE BILL 1229
AMENDMENT NO. ______. Amend Senate Bill 1229, AS AMENDED,
by replacing everything after the enacting clause with the
following:
"Section 5. The Dietitian Nutritionist Practice Act is
amended by changing Sections 10 and 95 and by adding Section 17
as follows:
(225 ILCS 30/10) (from Ch. 111, par. 8401-10)
(Section scheduled to be repealed on January 1, 2023)
Sec. 10. Definitions. As used in this Act:
"Address of record" means the designated address recorded
by the Department in the applicant's or licensee's application
file or license file as maintained by the Department's
licensure maintenance unit. It is the duty of the applicant or
licensee to inform the Department of any change of address and
those changes must be made either through the Department's

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website or by contacting the Department.
"Board" means the Dietitian Nutritionist Practice Board
appointed by the Secretary.
"Certified clinical nutritionist" means an individual
certified by the Clinical Nutrition Certification Board.
"Certified nutrition specialist" means an individual
certified by the Certification Board for of Nutrition
Specialists.
"Department" means the Department of Financial and
Professional Regulation.
"Dietetics and nutrition services" means the integration
and application of principles derived from the sciences of food
and nutrition to provide for all aspects of nutrition care for
individuals and groups, including, but not limited to:
(1) nutrition counseling; "nutrition counseling" means
advising and assisting individuals or groups on
appropriate nutrition intake by integrating information
from the nutrition assessment;
(2) nutrition assessment; "nutrition assessment" means
the evaluation of the nutrition needs of individuals or
groups using appropriate data to determine nutrient needs
or status and make appropriate nutrition recommendations;
(3) medically prescribed diet; "medically prescribed
diet" is one form of medical nutrition therapy and means a
diet prescribed when specific food or nutrient levels need
to be monitored, altered, or both as a component of a

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treatment program for an individual whose health status is
impaired or at risk due to disease, injury, or surgery and
may only be performed as initiated by or in consultation
with a physician licensed under the Medical Practice Act of
1987 acting within the scope of his or her practice, except
that a medically prescribed diet for a resident of a
nursing home shall only be performed as initiated by or in
consultation with a physician licensed to practice
medicine in all of its branches;
(4) medical nutrition therapy; "medical nutrition
therapy" means the component of nutrition care that deals
with the systematic use of food and oral supplementation,
based on the nutrition assessment and individual health
status and need to manage health conditions; medical
nutrition therapy; "medical nutrition therapy" means the
component of nutrition care that deals with:
(A) interpreting and recommending nutrient needs
relative to medically prescribed diets, including, but
not limited to, enteral feedings, specialized
intravenous solutions, and specialized oral feedings;
(B) food and prescription drug interactions; and
(C) developing and managing food service
operations whose chief function is nutrition care and
provision of medically prescribed diets;
(5) nutrition services for individuals and groups;
"nutrition services for individuals and groups" includes,

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but is not limited to, all of the following:
(A) providing nutrition assessments relative to
preventive maintenance or restorative care;
(B) providing nutrition education and nutrition
counseling as components of preventive maintenance or
restorative care; and
(C) developing and managing systems whose chief
function is nutrition care; nutrition services for
individuals and groups does not include medical
nutrition therapy as defined in this Act; and
(6) restorative; "restorative" means the component of
nutrition care that deals with oral dietary needs for
individuals and groups; activities shall relate to the
metabolism of food and the requirements for nutrients,
including dietary supplements for growth, development,
maintenance, or attainment of optimal health.
"Diplomate of the American Clinical Board of Nutrition"
means an individual certified by the American Clinical Board of
Nutrition.
"Licensed dietitian nutritionist" means a person licensed
under this Act to practice dietetics and nutrition services, as
defined in this Section. Activities of a licensed dietitian
nutritionist do not include the medical differential diagnosis
of the health status of an individual.
"Practice experience" means a preprofessional, documented,
supervised practice in dietetics or nutrition services that is

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acceptable to the Department in compliance with requirements
for licensure, as specified in Section 45. It may be or may
include a documented, supervised practice experience which is a
component of the educational requirements for licensure, as
specified in Section 45.
"Registered dietitian" means an individual registered with
the Commission on Dietetic Registration, the accrediting body
of the Academy of Nutrition and Dietetics, formerly known as
the American Dietetic Association.
"Secretary" means the Secretary of Financial and
Professional Regulation.
"Telepractice" means the delivery of services under this
Act by means other than in-person, including, but not limited
to, telephone, email, internet, or other methods of electronic
communication. Telepractice is not prohibited under this Act
provided that the provision of telepractice services is
appropriate for the client and the level of care provided meets
the required level of care for that client. Individuals
providing services regulated by this Act via telepractice shall
comply with and are subject to all licensing and disciplinary
provisions of this Act.
(Source: P.A. 97-1141, eff. 12-28-12.)
(225 ILCS 30/17 new)
Sec. 17. Other activities subject to licensure under this
Act.

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(1) Enteral and parenteral nutrition therapy shall consist
of enteral feedings or specialized intravenous solutions and
shall only be performed by an individual licensed under this
Act who:
(a) is a registered dietitian registered with the
Commission on Dietetic Registration, the accrediting body
of the Academy of Nutrition and Dietetics, formerly known
as the American Dietetic Association;
(b) is a certified nutrition support clinician as
certified by the National Board of Nutrition Support
Certification; or
(c) meets the requirements set forth in the rules of
the Department.
(2) Developing and managing food service operations whose
chief function is nutrition care shall only be performed by an
individual licensed under this Act.
(225 ILCS 30/95) (from Ch. 111, par. 8401-95)
(Section scheduled to be repealed on January 1, 2023)
Sec. 95. Grounds for discipline.
(1) The Department may refuse to issue or renew, or may
revoke, suspend, place on probation, reprimand, or take other
disciplinary or non-disciplinary action as the Department may
deem appropriate, including imposing fines not to exceed
$10,000 for each violation, with regard to any license or
certificate for any one or combination of the following causes:

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(a) Material misstatement in furnishing information to
the Department.
(b) Violations of this Act or of rules adopted under
this Act.
(c) Conviction by plea of guilty or nolo contendere,
finding of guilt, jury verdict, or entry of judgment or by
sentencing of any crime, including, but not limited to,
convictions, preceding sentences of supervision,
conditional discharge, or first offender probation, under
the laws of any jurisdiction of the United States (i) that
is a felony or (ii) that is a misdemeanor, an essential
element of which is dishonesty, or that is directly related
to the practice of the profession.
(d) Fraud or any misrepresentation in applying for or
procuring a license under this Act or in connection with
applying for renewal of a license under this Act.
(e) Professional incompetence or gross negligence.
(f) Malpractice.
(g) Aiding or assisting another person in violating any
provision of this Act or its rules.
(h) Failing to provide information within 60 days in
response to a written request made by the Department.
(i) Engaging in dishonorable, unethical or
unprofessional conduct of a character likely to deceive,
defraud, or harm the public.
(j) Habitual or excessive use or abuse of drugs defined

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in law as controlled substances, alcohol, or any other
substance that results in the inability to practice with
reasonable judgment, skill, or safety.
(k) Discipline by another state, the District of
Columbia, territory, country, or governmental agency if at
least one of the grounds for the discipline is the same or
substantially equivalent to those set forth in this Act.
(l) Charging for professional services not rendered,
including filing false statements for the collection of
fees for which services are not rendered. Nothing in this
paragraph (1) affects any bona fide independent contractor
or employment arrangements among health care
professionals, health facilities, health care providers,
or other entities, except as otherwise prohibited by law.
Any employment arrangements may include provisions for
compensation, health insurance, pension, or other
employment benefits for the provision of services within
the scope of the licensee's practice under this Act.
Nothing in this paragraph (1) shall be construed to require
an employment arrangement to receive professional fees for
services rendered.
(m) A finding by the Department that the licensee,
after having his or her license placed on probationary
status, has violated the terms of probation.
(n) Willfully making or filing false records or reports
in his or her practice, including, but not limited to,

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false records filed with State agencies or departments.
(o) Allowing one's license under this Act to be used by
an unlicensed person in violation of this Act.
(p) Practicing under a false or, except as provided by
law, an assumed name.
(q) Gross and willful overcharging for professional
services.
(r) (Blank).
(s) Willfully failing to report an instance of
suspected child abuse or neglect as required by the Abused
and Neglected Child Reporting Act.
(t) Cheating on or attempting to subvert a licensing
examination administered under this Act.
(u) Mental illness or disability that results in the
inability to practice under this Act with reasonable
judgment, skill, or safety.
(v) Physical illness, including, but not limited to,
deterioration through the aging process or loss of motor
skill that results in a licensee's inability to practice
under this Act with reasonable judgment, skill, or safety.
(w) Advising an individual to discontinue, reduce,
increase, or otherwise alter the intake of a drug
prescribed by a physician licensed to practice medicine in
all its branches or by a prescriber as defined in Section
102 of the Illinois Controlled Substance Act.
(2) The Department may refuse to issue or may suspend

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without hearing, as provided for in the Code of Civil
Procedure, the license of any person who fails to file a
return, or pay the tax, penalty, or interest shown in a filed
return, or pay any final assessment of the tax, penalty, or
interest as required by any tax Act administered by the
Illinois Department of Revenue, until such time as the
requirements of any such tax Act are satisfied in accordance
with subsection (g) of Section 2105-15 of the Civil
Administrative Code of Illinois.
(3) The Department shall deny a license or renewal
authorized by this Act to a person who has defaulted on an
educational loan or scholarship provided or guaranteed by the
Illinois Student Assistance Commission or any governmental
agency of this State in accordance with item (5) of subsection
(a) of Section 2105-15 of the Civil Administrative Code of
Illinois.
(4) In cases where the Department of Healthcare and Family
Services has previously determined a licensee or a potential
licensee is more than 30 days delinquent in the payment of
child support and has subsequently certified the delinquency to
the Department, the Department may refuse to issue or renew or
may revoke or suspend that person's license or may take other
disciplinary action against that person based solely upon the
certification of delinquency made by the Department of
Healthcare and Family Services in accordance with item (5) of
subsection (a) of Section 1205-15 of the Civil Administrative

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Code of Illinois.
(5) The determination by a circuit court that a licensee is
subject to involuntary admission or judicial admission, as
provided in the Mental Health and Developmental Disabilities
Code, operates as an automatic suspension. The suspension shall
end only upon a finding by a court that the patient is no
longer subject to involuntary admission or judicial admission
and the issuance of an order so finding and discharging the
patient.
(6) In enforcing this Act, the Department, upon a showing
of a possible violation, may compel an individual licensed to
practice under this Act, or who has applied for licensure under
this Act, to submit to a mental or physical examination, or
both, as required by and at the expense of the Department. The
Department may order the examining physician to present
testimony concerning the mental or physical examination of the
licensee or applicant. No information shall be excluded by
reason of any common law or statutory privilege relating to
communications between the licensee or applicant and the
examining physician. The examining physicians shall be
specifically designated by the Department. The individual to be
examined may have, at his or her own expense, another physician
of his or her choice present during all aspects of this
examination. The examination shall be performed by a physician
licensed to practice medicine in all its branches. Failure of
an individual to submit to a mental or physical examination,

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when directed, shall result in an automatic suspension without
hearing.
A person holding a license under this Act or who has
applied for a license under this Act who, because of a physical
or mental illness or disability, including, but not limited to,
deterioration through the aging process or loss of motor skill,
is unable to practice the profession with reasonable judgment,
skill, or safety, may be required by the Department to submit
to care, counseling, or treatment by physicians approved or
designated by the Department as a condition, term, or
restriction for continued, reinstated, or renewed licensure to
practice. Submission to care, counseling, or treatment as
required by the Department shall not be considered discipline
of a license. If the licensee refuses to enter into a care,
counseling, or treatment agreement or fails to abide by the
terms of the agreement, then the Department may file a
complaint to revoke, suspend, or otherwise discipline the
license of the individual. The Secretary may order the license
suspended immediately, pending a hearing by the Department.
Fines shall not be assessed in disciplinary actions involving
physical or mental illness or impairment.
In instances in which the Secretary immediately suspends a
person's license under this Section, a hearing on that person's
license must be convened by the Department within 15 days after
the suspension and completed without appreciable delay. The
Department shall have the authority to review the subject

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individual's record of treatment and counseling regarding the
impairment to the extent permitted by applicable federal
statutes and regulations safeguarding the confidentiality of
medical records.
An individual licensed under this Act and affected under
this Section shall be afforded an opportunity to demonstrate to
the Department that he or she can resume practice in compliance
with acceptable and prevailing standards under the provisions
of his or her license.
(Source: P.A. 96-1482, eff. 11-29-10; 97-1141, eff. 12-28-12.)
Section 99. Effective date. This Act takes effect upon
becoming law.".