Chapter 5.65Dietitians

Section § 2585

Explanation

If you call yourself a registered dietitian in California, you need to meet certain qualifications. You could have been granted the title before 1981 or meet specific educational and practical requirements, including a degree, 900 hours of supervised practice, and passing an exam. If you call yourself a dietetic technician, registered, you also need to meet qualifications, such as being 18 or older, completing a degree, supervised practice, and an exam. Saying you're a dietitian or dietetic technician when you don't meet these criteria is a crime. Health care employees who were dietitians when this law started can keep using the title without taking the exam, as long as they meet other requirements. Those with advanced degrees in nutrition might get reimbursed for giving advice under certain conditions, but the law doesn't require them to be directly reimbursed as separate Medi-Cal providers, especially if federal law prohibits it.

(a)CA Business and Professions Code § 2585(a) Any person representing himself or herself as a registered dietitian shall meet one of the following qualifications:
(1)CA Business and Professions Code § 2585(a)(1) Been granted, prior to January 1, 1981, the right to use the term “registered dietitian” by a public or private agency or institution recognized by the State Department of Public Health as qualified to grant the title, provided that person continues to meet all requirements and qualifications periodically prescribed by the agency or institution for the maintenance of that title.
(2)CA Business and Professions Code § 2585(a)(2) Possess all of the following qualifications:
(A)CA Business and Professions Code § 2585(a)(2)(A) Be 18 years of age or older.
(B)CA Business and Professions Code § 2585(a)(2)(B) Satisfactory completion of appropriate academic requirements for the field of dietetics and related disciplines and receipt of a baccalaureate or higher degree from a college or university accredited by the Western Association of Schools and Colleges or other regional accreditation agency.
(C)CA Business and Professions Code § 2585(a)(2)(C) Satisfactory completion of a program of supervised practice for a minimum of 900 hours that is designed to prepare entry level practitioners through instruction and assignments in a clinical setting. Supervisors of the program shall meet minimum qualifications established by public or private agencies or institutions recognized by the State Department of Public Health to establish those qualifications.
(D)CA Business and Professions Code § 2585(a)(2)(D) Satisfactory completion of an examination administered by a public or private agency or institution recognized by the State Department of Public Health as qualified to administer the examinations.
(E)CA Business and Professions Code § 2585(a)(2)(E) Satisfactory completion of continuing education requirements established by a public or private agency or institution recognized by the State Department of Public Health to establish the requirements.
(b)CA Business and Professions Code § 2585(b) Any person representing himself or herself as a dietetic technician, registered shall possess all of the following qualifications:
(1)CA Business and Professions Code § 2585(b)(1) Be 18 years of age or older.
(2)CA Business and Professions Code § 2585(b)(2) Satisfactory completion of either of the following:
(A)CA Business and Professions Code § 2585(b)(2)(A) Appropriate academic requirements for dietetic technicians, registered, receipt of an associate’s degree or higher from a college or university accredited by the Western Association of Schools and Colleges or other regional accreditation agency, and at least 450 hours of supervised practice experience. Supervisors of practice experiences shall meet the minimum qualifications established by public or private agencies or institutions recognized by the State Department of Public Health to establish the qualifications.
(B)CA Business and Professions Code § 2585(b)(2)(B) Appropriate academic requirements for the field of dietetics and related disciplines and receipt of a baccalaureate or higher degree from a college or university accredited by the Western Association of Schools and Colleges or other regional accreditation agency.
(3)CA Business and Professions Code § 2585(b)(3) Satisfactory completion of an examination administered by a public or private agency or institution recognized by the State Department of Public Health to administer the examination.
(4)CA Business and Professions Code § 2585(b)(4) Satisfactory completion of continuing education requirements established by a public or private agency or institution recognized by the State Department of Public Health to establish the requirements.
(c)CA Business and Professions Code § 2585(c) It is a misdemeanor for any person not meeting the criteria of subdivision (a) or (b) to use, in connection with his or her name or place of business, the words “dietetic technician, registered,” “dietitian,” “dietician,” “registered dietitian,” “registered dietician,” “registered dietitian nutritionist,” or the letters “RD,” “RDN,” “DTR,” or any other words, letters, abbreviations, or insignia indicating or implying that the person is a dietitian, dietetic technician, registered, registered dietitian, or registered dietitian nutritionist or to represent, in any way, orally, in writing, in print or by sign, directly or by implication, that he or she is a dietitian, a dietetic technician, registered, a registered dietitian, or a registered dietitian nutritionist.
(d)CA Business and Professions Code § 2585(d) Any person employed by a licensed health care facility as a registered dietitian on the effective date of this chapter may continue to represent himself or herself as a registered dietitian while employed by a licensed health care facility, if he or she has satisfied the requirements of either paragraph (1) or paragraph (2) of subdivision (a), except that he or she shall not be required to satisfy the examination requirement of subparagraph (B) of paragraph (2) of subdivision (a).
(e)CA Business and Professions Code § 2585(e) Notwithstanding any other law or regulation that limits reimbursement to state licensed health care providers and upon referral by a physician and surgeon, the following persons may be reimbursed for the nutritional advice or advice concerning proper nutrition as set forth in Section 2068, or for the nutritional assessments, counseling, and treatments as set forth in Section 2586:
(1)CA Business and Professions Code § 2585(e)(1) Registered dietitians.
(2)CA Business and Professions Code § 2585(e)(2) Other nutritional professionals with a master’s or higher degree in a field covering clinical nutrition sciences, from a college or university accredited by a regional accreditation agency, who are deemed qualified to provide these services by the referring physician and surgeon.
(f)CA Business and Professions Code § 2585(f) Nothing in this section shall be construed to mandate direct reimbursement of registered dietitians, or other nutrition professionals described in subdivision (e), as a separate provider type under the Medi-Cal program, nor to mandate reimbursement where expressly prohibited by federal law or regulation.
registered dietitian dietetic technician supervised practice public health qualifications examination requirement licensed health care facility nutritional advice continuing education misdemeanor reimbursement Western Association of Schools and Colleges clinical nutrition sciences Medi-Cal program Nutritional professionals
(Amended by Stats. 2014, Ch. 622, Sec. 1. (SB 993) Effective January 1, 2015.)

Section § 2586

Explanation

This law spells out what registered dietitians and certain nutritional professionals can do in California. They can provide nutrition counseling and assessments when referred by a healthcare provider. These dietitians can adjust a patient's diet within the limits set by the provider and with necessary documentation. They can also receive and send orders regarding nutrition therapy but cannot administer vein nutrition themselves. In healthcare facilities, they can order lab tests for nutrition therapy if approved by a doctor. Dietetic technicians can assist under direct supervision but can't create diet plans or handle orders themselves. The law sets out supervision rules for dietitians and technicians. Those practicing against these rules face misdemeanor charges. It clarifies that other health professionals aren’t restricted in their practice by these standards.

(a)Copy CA Business and Professions Code § 2586(a)
(1)Copy CA Business and Professions Code § 2586(a)(1) Notwithstanding any other law, a registered dietitian, or other nutritional professional meeting the qualifications set forth in subdivision (e) of Section 2585 may, upon referral by a health care provider authorized to prescribe dietary treatments, provide nutritional and dietary counseling, conduct nutritional and dietary assessments, and develop and recommend nutritional and dietary treatments, including therapeutic diets, for individuals or groups of patients in licensed institutional facilities or in private office settings. The referral for medical nutrition therapy shall be accompanied by a written prescription signed by the health care provider detailing the patient’s diagnosis and including either a statement of the desired objective of dietary treatment or a diet order. The registered dietitian, or other nutritional professional meeting the qualifications set forth in subdivision (e) of Section 2585, may perform nutritional assessments and initiate nutritional interventions within the parameters of the prescribed diet order pursuant to a licensed health care facility’s approved nutrition screening policy and procedure. The registered dietitian, or other nutritional professional meeting the qualifications set forth in subdivision (e) of Section 2585, shall collaborate with a multidisciplinary team, which shall include the treating physician and the registered nurse, in developing the patient’s nutrition care plan. Unless otherwise stated in the diet order by a patient’s provider, the registered dietitian, or other nutritional professional meeting the qualifications set forth in subdivision (e) of Section 2585, may individualize the patient’s nutritional or dietary treatment when necessary, by modifying the distribution, type, or quantity of food and nutrients within the parameters of the diet order. Any modification, and the rationale for the modification, shall be documented in the patient’s record for review by the practitioner, or other licensed health care professional, who is legally authorized to prescribe and is responsible for the care of the patient. Nothing in this subdivision shall be construed to authorize a registered dietitian, or other nutritional professional meeting the qualifications set forth in subdivision (e) of Section 2585, to order or administer a central vein or peripheral vein nutrition.
(2)CA Business and Professions Code § 2586(a)(2) The services described in this subdivision may be termed “medical nutrition therapy.”
(b)CA Business and Professions Code § 2586(b) A registered dietitian, or other nutritional professional meeting the qualifications set forth in subdivision (e) of Section 2585, may accept or transmit verbal orders or electronically transmitted orders for medical nutrition therapy from the referring physician or the physician responsible for the care of the patient in a licensed health care facility.
(c)CA Business and Professions Code § 2586(c) A registered dietitian, or other nutritional professional meeting the qualifications set forth in subdivision (e) of Section 2585, may order medical laboratory tests related to medical nutrition therapy services when approved by the referring physician or the physician responsible for the care of the patient and when, in the absence of the referring physician or physician responsible for the care of the patient at a patient visit, in a clinic where there is a registered nurse on duty, a registered nurse is notified that a medical laboratory test is being ordered and is afforded an opportunity to assess the patient.
(d)Copy CA Business and Professions Code § 2586(d)
(1)Copy CA Business and Professions Code § 2586(d)(1) Notwithstanding any other law, a dietetic technician, registered meeting the qualifications set forth in Section 2585 may, under the direct supervision of a registered dietitian, assist in the implementation or monitoring of services specified in subdivision (a), but shall not develop nutritional or dietary therapy or treatments or accept or transmit verbal orders.
(2)Copy CA Business and Professions Code § 2586(d)(2)
(A)Copy CA Business and Professions Code § 2586(d)(2)(A) For purposes of this subdivision, “direct supervision” means the supervising registered dietitian shall be physically available to the dietetic technician, registered for consultation whenever consultation is required. However, in the case of a small or rural hospital, as defined in Section 124840 of the Health and Safety Code, the registered dietitian may be available for consultation by telephone or other electronic means, provided that the registered dietitian is physically on the facility site a sufficient amount of time to provide adequate supervision over and review of the work of the dietetic technician, registered.
(B)CA Business and Professions Code § 2586(d)(2)(A)(B) For purposes of this subdivision, “physically available” means physical onsite presence during regular business hours, and includes telephonic or electronic availability at all times and the ability to respond to the facility within a reasonable period of time when required. The registered dietitian shall review any activities performed by the dietetic technician, registered during any period when the registered dietitian was not physically onsite.
(3)CA Business and Professions Code § 2586(d)(3) For purposes of this subdivision, a registered dietitian shall not supervise more than two dietetic technicians, registered at one time.
(e)CA Business and Professions Code § 2586(e) It is a misdemeanor for a person specified in subdivision (e) of Section 2585 to practice in a manner inconsistent with the requirements set forth in this section.
(f)CA Business and Professions Code § 2586(f) Nothing in this section shall preclude a person specified in subdivision (b) or (e) of Section 2585 from providing information as permitted by Section 2068.
(g)CA Business and Professions Code § 2586(g) For purposes of this section, “health care provider” means any person licensed or certified pursuant to this division, or licensed pursuant to the Osteopathic Initiative Act or the Chiropractic Initiative Act.
(h)CA Business and Professions Code § 2586(h) The requirement of a written prescription shall be deemed to be satisfied by an entry in the patient records of a patient who is undergoing treatment at a licensed health care facility if the contents of the patient records reflect the information required by this section.
(i)CA Business and Professions Code § 2586(i) Nothing in this section or Section 2585 shall be interpreted to establish educational criteria or practice restrictions or limitations for other health care providers licensed under Division 2 (commencing with Section 500) or the Osteopathic Initiative Act or the Chiropractic Initiative Act.
registered dietitian nutritional counseling dietary assessments therapeutic diets medical nutrition therapy nutritional interventions diet order patient records dietetic technician direct supervision nutrition screening policy medical laboratory tests multidisciplinary team misdemeanor health care provider
(Amended by Stats. 2014, Ch. 622, Sec. 2. (SB 993) Effective January 1, 2015.)

Section § 2586.2

Explanation

This law means that someone can participate in specific activities outlined in a different part of the law, Section 2586(a), if they meet certain conditions. First, they must be involved in these activities as part of a supervised practice program for registered dietitians, which is explained in more detail in Section 2585. Second, the person must either be currently studying or have finished their required education to become a registered dietitian, as also described in Section 2585.

A person may engage in the activities set forth in subdivision (a) of Section 2586 if the person meets both of the following requirements:
(a)CA Business and Professions Code § 2586.2(a) The person is engaged in the activities as part of a supervised practice program for a registered dietitian pursuant to subparagraph (C) of paragraph (2) of subdivision (a) of Section 2585.
(b)CA Business and Professions Code § 2586.2(b) The person is enrolled in or has completed a course of study to fulfill the educational requirements for a registered dietitian in subparagraph (B) of paragraph (2) of subdivision (a) of Section 2585.
supervised practice registered dietitian educational requirements course of study subdivision (a) Section 2585 subparagraph (C) subparagraph (B) career requirements professional practice nutrition training qualification criteria
(Added by Stats. 2003, Ch. 69, Sec. 1. Effective January 1, 2004.)

Section § 2586.4

Explanation

This law allows individuals to participate in certain activities related to dietetic practice if they meet two criteria. First, they must be part of a supervised practice program for dietetic technicians. Second, they should have completed the necessary educational courses required for a registered dietetic technician.

A person may engage in the activities set forth in subdivision (d) of Section 2586 if the person meets both of the following requirements:
(a)CA Business and Professions Code § 2586.4(a) The person is engaged in the activities as part of a supervised practice program for a dietetic technician, registered pursuant to subparagraph (A) of paragraph (2) of subdivision (b) of Section 2585.
(b)CA Business and Professions Code § 2586.4(b) The person has completed a course of study to fulfill the educational requirements for a dietetic technician, registered in subparagraph (A) or (B) of paragraph (2) of subdivision (b) of Section 2585.
supervised practice program dietetic technician registered dietetic technician education requirements subdivision activities Section 2586 activities supervised practice course of study educational requirements dietetic practice
(Amended by Stats. 2014, Ch. 622, Sec. 3. (SB 993) Effective January 1, 2015.)

Section § 2586.6

Explanation

This law allows someone who has completed a supervised practice program for dietitians to work under a registered dietitian's direct supervision for up to six months or until they fail their certification exam, whichever is sooner. The person must meet certain conditions, including having written proof of program completion and having applied to take the exam while waiting for a test date.

A person may engage in the activities set forth in subdivision (a) of Section 2586 for six months from the date that he or she completed a supervised practice program, or until the person receives notice that he or she failed the examination specified in subdivision (d), whichever occurs first, if all of the following conditions apply:
(a)CA Business and Professions Code § 2586.6(a) The person performs under the direct and immediate supervision of a registered dietitian.
(b)CA Business and Professions Code § 2586.6(b) The person has completed the supervised practice program requirements under subdivision (a) of Section 2585.
(c)CA Business and Professions Code § 2586.6(c) The person has written verification, including the program director’s original signature, that the person has completed the required supervised practice program.
(d)CA Business and Professions Code § 2586.6(d) The person has applied to take the registered dietitian examination specified in subparagraph (D) of paragraph (2) of subdivision (a) of Section 2585 and is waiting for an examination date.
supervised practice program registered dietitian supervision dietitian certification exam program director's verification practice program completion dietitian examination application temporary practice period failed examination notice direct supervision requirement waiting for examination date
(Added by Stats. 2003, Ch. 69, Sec. 3. Effective January 1, 2004.)

Section § 2586.8

Explanation
This section says that after finishing their schooling, dietetic technicians can work under certain conditions for up to six months or until they find out they've failed the necessary exam. During this time, they must be supervised by a registered dietitian, have proof from their program director that they've completed their education and hold a degree, and be in line to take the certification test.
A person may engage in the activities set forth in subdivision (d) of Section 2586 for six months from the date he or she completed the academic requirements for dietetic technicians specified in subparagraph (A) or (B) of paragraph (2) of subdivision (b) of Section 2585, or until the person receives notice that he or she has failed the examination specified in subdivision (c), whichever occurs first, if all of the following conditions apply:
(a)CA Business and Professions Code § 2586.8(a) The person performs under the direct and immediate supervision of a registered dietitian.
(b)CA Business and Professions Code § 2586.8(b) The person has written verification, including the program director’s original signature, that the person has completed the educational program and possesses an associate’s degree or higher.
(c)CA Business and Professions Code § 2586.8(c) The person has applied to take the dietetic technician, registered examination specified in paragraph (3) of subdivision (b) of Section 2585 and is waiting for an examination date.
dietetic technicians six-month period supervision by dietitian academic requirements verification of education associate's degree registered dietitian dietetic technician examination educational program completion waiting for exam date
(Amended by Stats. 2014, Ch. 622, Sec. 4. (SB 993) Effective January 1, 2015.)