HB185: HB185 Professions and businesses; repeal and reenact Chapter 11A, the Dietetics Practice Act

26 HB 185/AP House Bill 185 (AS PASSED HOUSE AND SENATE) By: Representatives Ehrhart of the 36th and Powell of the 33rd A BILL TO BE ENTITLED AN ACT To amend Title 43 of the Official Code of Georgia Annotated, re lating to professions and1 businesses, so as to repeal and reenact Chapter 11A, the "Dietetics Practice Act"; to provide2 for the licensure of dietitians and nutritionists; to provide for short titles; to provide for the3 purpose of the chapter; to pr ovide for definitions ; to establis h the Georgia Board of4 Examiners of Licensed Dietitians and Licensed Nutritionists; to provide for members,5 officers, meetings, and powers and duties of such board; to authorize the board to perform6 criminal background checks; to provide for the grant of a licen se without examination; to7 provide for eligibility for licensure as a dietitian and nutritionist; to provide for provisional8 licenses; to provide for notice of acceptance or rejection; to provide for examinations; to9 provide for requirements of licensees; to provide for refusal, suspension, or revocation of10 licenses; to provide for proceedings; to provide for protected titles; to provide for exceptions11 to licensure; to provide for statutory construction; to provide for a qualified supervisor over12 a supervised practice experience; to enter into an interstate compact; to amend Titles 9, 31,13 33, 43, and 51 of the Official Code of Georgia Annotated, relating to civil practice, health,14 insurance, professions and businesses, and torts, respectively, so as to provide for conforming15 cross-references; to provide for related matters; to provide fo r an effective date; to repeal16 conflicting laws; and for other purposes.17 H. B. 185 - 1 - 26 HB 185/AP BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:18 PART I19 Dietetics and Nutrition Practices Act20 SECTION 1-1.21 Title 43 of the Official Code of Georgia Annotated, relating to professions and businesses,22 is amended by repealing and reenacting Chapter 11A, the "Dietet ics Practice Act," as23 follows:24 "CHAPTER 11A25 ARTICLE 126 43-11A-1.27 This chapter shall be known and may be cited as the 'Dietetics and Nutrition Practices Act.'28 43-11A-2.29 The General Assembly acknowledges that the application of scientific knowledge relating30 to the practices of dietetics and nutrition is important in the treatment of diseases and31 medical conditions and in the attainment and maintenance of hea lth. The General32 Assembly acknowledges further that the rendering of sound dietetic and nutrition services33 for the treatment and management of diseases and medical conditions in hospitals, nursing34 homes, school districts, health departments, private practice a nd consultation, and other35 settings requires trained and competent professionals. It is d eclared, therefore, to be the36 purpose of this chapter to protect the health, safety, and welfare of the public by providing37 for the licensure of individuals engaged in the practices of dietetics and nutrition, including38 the provision of medical nutrition therapy.39 H. B. 185 - 2 - 26 HB 185/AP 43-11A-3.40 As used in this article, the term:41 (1) 'ACEND' means the Accreditation Council for Education in Nutrition and Dietetics42 or its successor organization.43 (2) 'Advertising' means, but is not limited to, issuing or cau sing to be distributed any44 card, sign, or other device; causing or permitting any sign or marking on or in any45 building or structure or in any newspaper, magazine, or directo ry; or causing or46 permitting any announcement on radio or any announcement or display on television, a47 computer network, or an electronic or telephonic medium.48 (3) 'Applicant' means an individual seeking a license under this article.49 (4) 'Board' means the Georgia Board of Examiners of Licensed Dietitians and Licensed50 Nutritionists established by this article.51 (5) 'Complex medical condition' means a disease state, medical condition, or clinical52 presentation that requires the provision of medical nutrition therapy by a licensed dietitian53 due to one or more of the following: instability of the patient's health status; the presence54 of multiple interacting high acuity comorbidities; a high risk of complications or rapid55 clinical deterioration; the need for intensive monitoring; or t he need for advanced56 nutrition interventions including therapeutic diets administered via enteral or parenteral57 routes. Such term includes, but is not limited to, severe maln utrition, organ failure,58 conditions requiring enteral or parenteral nutrition, renal disease requiring dialysis, severe59 metabolic disturbances, post-bariatric surgery care, and critical illness.60 (6) 'Degree' means a degree received from an educational institution that, at the time the61 degree was awarded, was accredited by a United States institutional accrediting body for62 higher education recognized by the Council for Higher Education Accreditation, or its63 successor, or by the United States Department of Education, or i t s s u c c e s s o r , o r a64 validated foreign equivalent.65 (7) 'General nonmedical nutrition information' means information on:66 H. B. 185 - 3 - 26 HB 185/AP (A) Principles of human nutrition and food preparation;67 (B) Principles of self-care and a healthy relationship with food;68 (C) Essential nutrients needed by the human body;69 (D) General and nonindividualized recommended amounts of essential nutrients in the70 human body;71 (E) Actions of nutrients in the human body;72 (F) Nonindividualized effects of deficiencies or excesses of n utrients in the human73 body; or74 (G) General education surrounding foods, herbs, and dietary supplements that are good75 sources of essential nutrients in the human body.76 (8) 'Licensed dietitian' means an individual duly licensed under this chapter as meeting77 the requirements provided for in subsection (b) of Code Section 43-11A-10 to engage in78 the practice of dietetics and the practice of nutrition, including the provision of medical79 nutrition therapy for complex and noncomplex medical conditions.80 (9) 'Licensed nutritionist' means an individual duly licensed under this chapter as81 meeting the requirements provided for in subsection (d) of Code Section 43-11A-10 to82 engage in the practice of nutrition, including the provision of medical nutrition therapy83 for noncomplex medical conditions.84 (10) 'Medical nutrition therapy' means the provision of any of the following nutrition85 care services for the treatment or management of a disease or medical condition: nutrition86 assessment, nutrition diagnosis, nutrition intervention, or nut rition monitoring and87 evaluation.88 (11) 'Medical weight control' means medical nutrition therapy provided for the purpose89 of reducing, maintaining, or gaining weight.90 (12) 'Noncomplex medical condition' means a disease state, med ical condition, or91 clinical presentation that is stable, does not involve rapid cl inical deterioration or high92 acuity care needs, and can be safely addressed through medical nutrition therapy93 H. B. 185 - 4 - 26 HB 185/AP delivered in low acuity outpatient settings by a practitioner p racticing within their94 demonstrated level of compet ence. Noncomplex conditions do not require intensive95 monitoring, do not involve multiple interacting high acuity com orbidities, and do not96 necessitate advanced interventions such as therapeutic diets de livered via enteral or97 parenteral nutrition.98 (13) 'Nonmedical weight control' means nutrition care services provided for the purpose99 of reducing, maintaining, or gaining weight that do not constit ute the treatment or100 management of a disease or medical condition. Such term includ es weight control101 services for healthy population groups to achieve or maintain a healthy weight.102 (14) 'Nutrition assessment' means the ongoing, dynamic, and sy stematic process of103 ordering, obtaining, verifying, and interpreting biochemical, a nthropometric, physical,104 nutrigenomic, and dietary data to make decisions about the nature and cause of nutrition105 related problems relative to patient or community needs. Such term includes the initial106 data collection and evaluation and any reassessment and analysis of patient or community107 needs and provides the foundation for nutrition diagnosis and n utritional108 recommendations and orders. Such term may require ordering laboratory tests to check109 and track nutritional status. The collection of such data shal l not, by itself, constitute110 nutrition assessment.111 (15) 'Nutrition care process' means the systematic problem-solving method that licensed112 dietitians use to critically think and make decisions when prov iding medical nutrition113 therapy or to address nutrition related problems and provide sa fe, effective care. Such114 term consists of four distinct but interrelated steps: nutritio n assessment, nutrition115 diagnosis, nutrition intervention, and nutrition monitoring and evaluation.116 (16) 'Nutrition care services' means any part or all of the fo llowing services provided117 within a systematic process:118 H. B. 185 - 5 - 26 HB 185/AP (A) Assessing and evaluating the nutritional needs of individu als and groups and119 determining resources and constraints in a practice setting, including ordering nutrition120 related laboratory tests to check and track nutrition status;121 (B) Identifying nutrition problems and establishing priorities, goals, and objectives that122 meet nutritional needs and are consistent with available resources and constraints;123 (C) Creating individualized dietary plans and issuing and implementing orders to meet124 the nutritional needs of healthy individuals and individuals wi th disease states or125 medical conditions, including ordering therapeutic diets, and m onitoring the126 effectiveness of such dietary plans and orders;127 (D) Determining and providing appropriate nutrition interventi ons in health and128 disease, including nutrition counseling on food and prescription drug interactions;129 (E) Developing, implementing, and managing nutrition care processes; or130 (F) Evaluating, making changes in, and maintaining appropriate standards of quality131 in food and nutrition services.132 (17) 'Nutrition counseling' means a supportive process, characterized by a collaborative133 counselor-patient relationship with individuals or groups, to establish food and nutrition134 priorities, goals, individualized action plans, and general physical activity guidance that135 acknowledge and foster responsibility for self-care to promote health and wellness or to136 treat or manage an existing disease or medical condition.137 (18) 'Nutrition diagnosis' means identifying and labeling nutritional problems managed138 and treated by a licensed dietitian or a licensed nutritionist but does not include a medical139 diagnosis of the health status of an individual.140 (19) 'Nutrition intervention' means purposefully planned actio ns, including nutrition141 counseling, intended to positively change a nutrition related b ehavior, risk factor,142 environmental condition, or aspect of the health status of an individual, his or her family143 or caregivers, target groups, or a community at large. Such te rm includes approving,144 H. B. 185 - 6 - 26 HB 185/AP ordering, and monitoring therapeutic diets and providing counse ling on food and145 prescription drug interactions.146 (20) 'Nutrition monitoring and evaluation' means identifying patient outcomes relevant147 to a nutrition diagnosis, nutrition intervention plans, and nutrition goals; comparing those148 outcomes with a patient's previous health status, nutrition intervention plans, and nutrition149 goals or with a reference standard to determine the progress made in achieving desired150 outcomes of nutrition care services; and determining whether pl anned nutrition151 interventions should be continued, revised, or concluded.152 (21) 'Patient' means an individual recipient of nutrition care services.153 (22) 'Practice of dietetics' means the integration and application of scientific principles154 derived from the study of food, nutrition, biochemistry, metabo lism, nutrigenomics,155 physiology, pharmacology, food systems, management, and behavio ral and social156 sciences to achieve and maintain optimal nutrition status of individuals and groups and157 includes the practice of nutrition. The practice of dietetics includes the provision of158 nutrition care services, including medical nutrition therapy, in person or via telehealth,159 to prevent, manage, or treat complex medical conditions and to promote wellness in160 inpatient and outpatient settings. The practice of dietetics i ncludes developing and161 ordering therapeutic diets via oral, enteral, and parenteral ro utes and providing other162 advanced medical nutrition therapy and related support activities consistent with current163 competencies required of academic and supervised practice progr ams accredited by a164 programmatic accreditor and the registered dietitian scope and standards of practice.165 (23) 'Practice of nutrition' means the integration and application of scientific principles166 derived from the study of nutrition science, cellular and syste mic metabolism,167 biochemistry, physiology, and behavioral sciences to achieve an d maintain health168 throughout the lifespan. The practice of nutrition includes the provision of nutrition care169 services, including medical nutrition therapy, in person or via telehealth, to prevent,170 manage, or treat noncomplex medical conditions and to promote wellness in low acuity171 H. B. 185 - 7 - 26 HB 185/AP outpatient settings and for the promotion of wellness. The practice of nutrition excludes172 the provision of medical nutrition therapy for complex medical conditions and the173 delivery of medical nutrition therapy in inpatient or high acuity outpatient settings. The174 practice of nutrition may include ordering oral therapeutic die ts, ordering medical175 laboratory tests related to nutritional therapeutic treatments, and recommending vitamins,176 minerals, and other dietary supplements.177 (24) 'Programmatic accreditor' means a nationally recognized organization that reviews178 specialized and professional programs and includes ACEND and such organizations as179 recognized by the board by approval, policy, or rule.180 (25) 'Provisional license' means a temporary license issued by the board pursuant to181 Code Section 43-11A-11.182 (26) 'Qualified supervisor' means an individual providing supervision who assumes full183 professional responsibility for the work of a supervisee by ver ifying, directing, and184 approving the provided nutrition care services, medical nutrition therapy, and other work185 being supervised, as provided for in Code Section 43-11A-19.186 (27) 'Registered dietitian' means an individual who is credentialed by the Commission187 on Dietetic Registration of the Academy of Nutrition and Dietet ics or its successor188 organization as a registered dietitian or a registered dietitian nutritionist and is authorized189 to use such title and the designation 'RD' or 'RDN.'190 (28) 'Supervisee' means a student, intern, or trainee providin g nutrition care services,191 medical nutrition therapy, and other work under the supervision of a qualified supervisor,192 as provided for in Code Section 43-11A-19.193 (29) 'Telehealth' means the use of electronic information and telecommunications194 technologies to provide services under this chapter between a healthcare provider in one195 location and an individual in another location to support clinical healthcare, public health,196 patient health related education, and health administration.197 H. B. 185 - 8 - 26 HB 185/AP (30) 'Therapeutic diet' means a diet intervention prescribed b y a licensed physician or198 other authorized nonphysician practitioner, including a licensed dietitian, that provides199 food, fluids, or nutrients via oral, enteral, or parenteral routes as part of the treatment of200 a medical condition to modify, eliminate, decrease, or increase identified micronutrients201 and macronutrients in a patient's diet, or to provide mechanica lly altered food when202 medically indicated. A therapeutic diet that provides food, fl uids, or nutrients via oral203 routes may be ordered by a licensed nutritionist.204 (31) 'Unrestricted practice of medical nutrition therapy' means the provision of medical205 nutrition therapy by an individual who is responsible for his o r her own practice or206 treatment procedures.207 43-11A-4.208 (a) The Georgia Board of Examiners of Licensed Dietitians in e xistence prior to209 July 1, 2026, is continued in existence thereafter as the Georg ia Board of Examiners of210 Licensed Dietitians and Licensed Nutritionists. Members of the board serving immediately211 prior to July 1, 2026, shall continue to serve out their respective terms of office and until212 their successors are appointed and qualified. The board shall consist of nine members213 representing the licensed professions and public at large as follows:214 (1) Six board members shall be licensed dietitians, including a clinical dietitian, a215 community or public health dietitian, an educator specializing in dietetics and on the216 faculty of a college or university, and a private practice dietitian;217 (2) One board member shall represent the public at large;218 (3) One board member shall be a licensed nutritionist; and219 (4) One board member shall be a physician licensed to practice medicine under220 Chapter 34 of this title.221 (b) Members of the board shall be appointed by the Governor with the confirmation of the222 Senate. Members of the board shall take office on the first da y of July immediately223 H. B. 185 - 9 - 26 HB 185/AP following the expired terms of that office and shall serve for terms of four years and until224 their successors are appointed and qualified; provided, however, that initial terms shall be225 staggered so that two members serve initial terms of two years, three members serve initial226 terms of three years, and four members serve initial terms of four years, as designated by227 the Governor. Any individual appointed to the board when the Senate is not in session may228 serve on the board without Senate confirmation until the Senate acts on that appointment. 229 No member shall serve on the board for more than two consecutive terms. Any vacancy230 shall be filled by the Governor subject to confirmation of the Senate.231 (c) All members of the board shall be reimbursed as provided for in subsection (f) of Code232 Section 43-1-2.233 (d) All members of the board shall take the constitutional oath of office.234 43-11A-5.235 (a) Members of the board representing the licensed professions shall be:236 (1) Citizens of the United States and residents of this state;237 (2) Actively engaged in their practice area; and238 (3) Licensed under this title.239 (b) The member of the board representing the public at large s hall be a citizen of the240 United States and a resident of this state and shall have no connection whatsoever with the241 practice of dietetics or the practice of nutrition.242 (c) The Governor may remove members of the board, after notice and opportunity for243 hearing, for incompetence, neglect of duty, unprofessional cond uct, conviction of any244 felony, failure to meet the qualifications of this chapter, or committing any act prohibited245 by this chapter.246 H. B. 185 - 10 - 26 HB 185/AP 43-11A-6.247 The board shall meet quarterly and shall elect from its members a chairperson, a vice248 chairperson, and any other officers as deemed necessary who shall hold office according249 to the rules adopted by the board. Additional meetings may be held upon the call of the250 chairperson of the board or at the written request of any three members of the board. Board251 meetings may be conducted by audio or video conference calls, and participation in such252 conference call shall constitute attendance at the meeting so conducted.253 43-11A-7.254 The board shall have the following powers and duties:255 (1) Enforce the provisions of this chapter, and it shall be gr anted all of the necessary256 duties, powers, and authority to carry out this responsibility;257 (2) Draft, adopt, amend, repeal, and enforce such rules as it deems necessary for the258 administration and enforcement of this chapter in the protection of public health, safety,259 and welfare;260 (3) License duly qualified applicants by examination, endorsement, or reinstatement and261 refuse to grant or renew a license to an applicant;262 (4) Set and enforce standards consistent with the provisions o f this chapter for263 qualifications, education, training, and experience of licensees continuing in or returning264 to practice;265 (5) Implement a disciplinary process;266 (6) Issue orders when a license is surrendered to the board wh ile a complaint,267 investigation, or disciplinary action against such license is pending;268 (7) Adopt, revise, and enforce rules regarding advertising by licensees, including, but not269 limited to, rules to prohibit false, misleading, or deceptive practices;270 (8) Adopt, publish in print or electronically, and enforce a code of ethics;271 (9) Establish examination and licensing fees;272 H. B. 185 - 11 - 26 HB 185/AP (10) Request and receive the assistance of state educational i nstitutions or other state273 agencies;274 (11) Prepare information of consumer interest describing the regulatory functions of the275 board and describing the procedures by which consumer complaint s are filed with and276 resolved by the board. The board shall make such information available to the general277 public and appropriate state agencies;278 (12) Adopt a seal which shall be affixed only in such manner as prescribed by the board; 279 and280 (13) Administer the Dietitian Licensure Compact contained in Article 2 of this chapter.281 43-11A-8.282 (a) As used in this Code section, the term:283 (1) 'Board' shall have the same meaning as set forth in Code Section 43-11A-3.284 (2) 'Applicant' shall have the same meaning as set forth in Code Section 43-11A-3.285 (b) The board is authorized to conduct and receive national ba ckground checks by the286 submission of fingerprints to the Federal Bureau of Investigati on through the Georgia287 Crime Information Center.288 (c) In order to determine an applicant's suitability as a lice nsed dietitian or licensed289 nutritionist, the board shall require such applicant to furnish the board with a full set of290 fingerprints that shall be submitted to the Federal Bureau of I nvestigation to enable a291 criminal background investigation to be conducted.292 (d) The board shall submit the fingerprints to the Georgia Crime Information Center. If293 no disqualifying record is identified at the state level, the G eorgia Crime Information294 Center is authorized to submit the fingerprints to the Federal Bureau of Investigation for295 a national criminal history record check.296 (e) The Georgia Crime Information Center shall notify the boar d in writing of any297 findings, including the absence of any findings. All findings received by the board shall298 H. B. 185 - 12 - 26 HB 185/AP be used by it for the exclusive purpose of carrying out its res ponsibilities under this299 chapter, shall not be a public record, shall be privileged, and shall not be disclosed to any300 other person or agency.301 (f) By applying for a license under this chapter, the applicant consents to and authorizes302 the board to perform a criminal background check as provided fo r in this Code section. 303 The applicant shall be responsible for all fees associated with the performance of such304 background check.305 43-11A-9.306 The board may grant, upon application and payment of fees, a license without examination307 to an individual who, at the time of application, either:308 (1) Holds a valid license or certification as a licensed or ce rtified dietitian, dietitian309 nutritionist, or nutritionist issued by another state, politica l territory, or jurisdiction310 acceptable to the board if the requirements for such license or certification are311 substantially equal to or greater than licensure requirements p rovided for under this312 chapter and rules and regulations promulgated by the board; or313 (2) Applies for licensure as a licensed dietitian and presents satisfactory evidence to the314 board that such individual is a registered dietitian.315 43-11A-10.316 (a) Each applicant for a license as a licensed dietitian or a licensed nutritionist shall be at317 least 18 years of age, submit a completed application upon a form and in such manner as318 the board prescribes, pay any applicable fees, have satisfactor y results from a criminal319 background check, and provide evidence of satisfaction of all a pplicable license320 requirements.321 (b) A licensed dietitian shall:322 H. B. 185 - 13 - 26 HB 185/AP (1) Possess a master's or doctoral degree and complete a program of study accredited by323 a programmatic accreditor;324 (2) Complete a documented, continuous, supervised practice experience in the practice325 of dietetics and the practice of nutrition accredited by a prog rammatic accreditor,326 consisting of not less than 1,000 hours of supervised practice under the supervision of a327 qualified supervisor as provided for in Code Section 43-11A-19. Such experience shall328 be completed within five years of earning the degree required under paragraph (1) of this329 subsection; provided, however, that the board may grant an extension for a limited time330 for extraordinary circumstances; and331 (3) Passes the examination for registered dietitians administered by the Commission on332 Dietetic Registration of the Academy of Nutrition and Dietetics o r i t s s u c c e s s o r333 organization; provided, however, that, if such examination occurred more than five years334 before the license application, the applicant shall demonstrate completion of 75 hours of335 continuing education for each five-year period post-examination.336 (c) All individuals who are licensed dietitians and who have submitted an application for337 licensure as a licensed dietitian prior to July 1, 2026, shall remain licensed so long as the338 licensee remains in good standing and maintains an active or inactive license.339 (d) A licensed nutritionist shall:340 (1) Possess a master's or doctoral degree with a major course of study in human nutrition,341 food and nutrition, community nutrition, public health nutritio n, nutrition education,342 nutrition science, clinical nutrition, applied clinical nutriti on, nutrition counseling,343 nutrition and functional medicine, nutritional biochemistry, nu trition and integrative344 health, or a comparable major or in a field of clinical healthc are, provided that such345 applicant shall complete coursework in medical nutrition therapy, science, and nutrition,346 including, but not limited to:347 (A) Fifteen semester hours of courses in clinical or life scie nces, including at least348 three semester hours in human anatomy and physiology or an equivalent subject; and349 H. B. 185 - 14 - 26 HB 185/AP (B) Fifteen semester hours of courses in nutrition and metabolism, including at least350 six semester hours in biochemistry;351 (2) Complete a documented, continuous supervised practice experience in the practice352 of nutrition consisting of not less than 1,000 hours of supervi sed practice under the353 supervision of a qualified supervisor as provided for in Code Section 43-11A-19. Such354 experience shall be completed within five years of earning the degree required under355 paragraph (1) of this subsection; provided, however, that the b o a r d m a y g r a n t a n356 extension for a limited time for extraordinary circumstances. Such experience shall meet357 the following requirements:358 (A) Include at least 1,000 hours in the following practice areas, with a minimum of 200359 hours in each practice area: nutrition assessment, nutrition intervention, and nutrition360 monitoring and evaluation; and361 (B) Include practice providing nutrition care services to populations of diverse cultures,362 genders, and ages, medical nutrition therapies and nutrition in terventions, nutrition363 education, nutrition counseling, and ongoing nutrition care services for the prevention,364 modulation, and management of a range of noncomplex medical conditions; and365 (3) Passes the certified nutrition specialist examination admi nistered by the Board for366 Certification of Nutrition Specia lists of the American Nutritio n Association, or its367 successor organization, or passes an equivalent examination on all aspects of the practice368 of nutrition that has been reviewed under a program accredited by the National369 Commission for Certifying Agencies, or its successor organizati on, or a credentialing370 entity that is approved by a two-thirds' vote of the board; provided, however, that, if such371 examination occurred more than five years before the license application, the applicant372 shall demonstrate completion of 75 hours of continuing educatio n for each five-year373 period post-examination. An applicant may satisfy the examination requirement provided374 in this paragraph if he or she holds a valid current certificat ion from the Board for375 Certification of Nutrition Specialists of the American Nutritio n Association, or its376 H. B. 185 - 15 - 26 HB 185/AP successor organization, that allows the applicant to use the ti tle 'certified nutrition377 specialist.'378 43-11A-11.379 (a) The board may issue a provisional license for an individual to engage in the practice380 of dietetics and the practice of nutrition for one year under t he supervision of a licensed381 dietitian upon the filing of an application with appropriate fees and submission of evidence382 of successful completion of the education and supervised practi ce requirements for383 licensure provided for in subsection (b) of Code Section 43-11A -10. Such provisional384 license shall be valid for one year and shall not be renewed.385 (b) The board may issue a provisional license for an individual to engage in the practice386 of nutrition for one year under the supervision of a licensed dietitian or licensed nutritionist387 upon the filing of an application with appropriate fees and sub mission of evidence of388 successful completion of the education and supervised practice requirements for licensure389 provided for in subsection (d) of Code Section 43-11A-10. Such provisional license shall390 be valid for one year and shall not be renewed.391 43-11A-12.392 After evaluation of an application and documents submitted, the board shall notify each393 applicant that the application and documents submitted are sati sfactory and accepted or394 unsatisfactory and rejected. If the application and documents are unsatisfactory and395 rejected, the notice shall state the reasons for the rejection.396 43-11A-13.397 (a) Examinations to determine qualifications for licensure as provided for in Code398 Section 43-11A-10 shall be administered to qualified applicants at least twice each calendar399 year. The examinations may be administered by a national testing service.400 H. B. 185 - 16 - 26 HB 185/AP (b) The board shall notify each examinee of the results of the examination.401 43-11A-14.402 (a) A license issued by the board is the property of the board and shall be surrendered on403 demand.404 (b) The licensee shall display the license certificate in an appropriate and public manner.405 (c) The licensee shall inform the board of any change of address.406 (d) If a licensee is not in violation of this chapter at the time of application for renewal and407 if such licensee fulfills current requirements of continuing education as established by the408 board and pays any requisite fees, such license shall be renewed biennially.409 (e) Each licensee is responsible for renewing his or her license before the expiration date.410 (f) Under procedures and conditions established by the board, a licensee may request that411 his or her license be declared inactive; provided, however, that such licensee may apply for412 active status at any time and, upon meeting the conditions set by the board, shall be413 declared active.414 43-11A-15.415 The board may refuse to grant or renew a license to an applicant or licensee; administer a416 public or private reprimand, but a private reprimand shall not be disclosed to any individual417 except the licensee; suspend the license of any licensee for a definite period or for an418 indefinite period in connection with any condition which may be attached to the restoration419 of such license; limit or restrict the license of any licensee as the board deems necessary420 for the protection of the public; revoke any license; condition a penalty upon, or withhold421 formal disposition pending, the applicant's or licensee's submi ssion to such care,422 counseling, or treatment as the board may direct; or impose a fine not to exceed $500.00423 for each violation of a law, rule, or regulation relating to th e practice of dietetics or the424 H. B. 185 - 17 - 26 HB 185/AP practice of nutrition upon a finding by a majority of the board that the applicant or licensee425 has:426 (1) Failed to demonstrate the qualifications or standards for a license contained in this427 chapter or under the laws, rules, or regulations under which licensure is sought or held. 428 It shall be incumbent upon the applicant to demonstrate to the satisfaction of the board429 that such applicant meets all the requirements for the issuance of a license, and, if the430 board is not satisfied as to the applicant's qualifications, it may deny a license without a431 prior hearing; provided, however, that the applicant shall be allowed to appear before the432 board if he or she so desires;433 (2) Knowingly made misleading, deceptive, untrue, or fraudulent representations in the434 practice of a business or profession licensed under this title or on any document435 connected therewith, or practiced fraud or deceit or intentiona lly made any false436 statement in obtaining a license to practice the licensed business or profession, or made437 a false statement or deceptive registration with the board;438 (3) Been convicted of any felony or of any crime directly rela ted to the duties and439 responsibilities of a dietitian or nutritionist in the courts of this state or any other state,440 territory, or country or in the courts of the United States; as used in this paragraph and441 paragraph (4) of this Code section, the term 'felony' shall include any offense which, if442 committed in this state, would be deemed a felony, without rega rd to its designation443 elsewhere; and, as used in this paragraph, the term 'convicted' shall include a finding or444 verdict of guilty or a plea of guilty, regardless of whether an appeal of the conviction has445 been sought;446 (4) Been arrested, charged, and sentenced for the commission of any felony, or any crime447 directly related to the duties and responsibilities of a dietitian or nutritionist where a plea448 of nolo contendere was entered to the charge, first offender tr eatment without449 adjudication of guilt pursuant to the charge was granted, or an adjudication or sentence450 was otherwise withheld or not entered on the charge. The plea of nolo contendere or the451 H. B. 185 - 18 - 26 HB 185/AP order entered pursuant to the provisions of Article 3 of Chapter 8 of Title 42, relating to452 probation of first offenders, or other first offender treatment shall be conclusive evidence453 of arrest and sentencing for such crime;454 (5) Had his or her license to practice a business or professio n licensed under this title455 revoked, suspended, or annulled by any lawful licensing authority other than the board;456 had other disciplinary action taken against him or her by any s uch lawful licensing457 authority other than the board; been denied a license by any su ch lawful licensing458 authority other than the board, pursuant to disciplinary proceedings; or been refused the459 renewal of a license by any such lawful licensing authority other than the board, pursuant460 to disciplinary proceedings;461 (6) Engaged in any unprofessional, unethical, deceptive, or de leterious conduct or462 practice harmful to the public, which conduct or practice materially affects the fitness of463 the licensee or applicant to engage in the practice of dietetics or the practice of nutrition,464 or of a nature likely to jeopardize the interest of the public, which conduct or practice465 need not have resulted in actual injury to any person or be directly related to the practice466 of dietetics or the practice of nutrition but shows that the li censee or applicant has467 committed any act or omission which is indicative of untrustworthiness; unprofessional468 conduct shall also include any departure from, or the failure to conform to, the minimal469 standards of acceptable and prevailing practice of a business or profession licensed under470 this title;471 (7) Knowingly performed any act which in any way aids, assists, procures, advises, or472 encourages any unlicensed individual or any licensee whose license has been suspended473 or revoked by a professional licensing board to practice a business or profession licensed474 under this title or to practice outside the scope of any disciplinary limitation placed upon475 the licensee by the board;476 (8) Violated a statute, law, or rule or regulation of this sta te, any other state, the477 professional licensing board regulating the business or profession licensed under this title,478 H. B. 185 - 19 - 26 HB 185/AP the United States, or any other lawful authority, without regard to whether the violation479 is criminally punishable, which statute, law, or rule or regula tion relates to or in part480 regulates the practice of dietetics or the practice of nutritio n, when the licensee or481 applicant knows or should know that such action is violative of such statute, law, or rule482 or regulation; or violated a lawful order of the board previously entered by the board in483 a disciplinary hearing, consent decree, or license reinstatement;484 (9) Been adjudged mentally incompetent by a court of competent jurisdiction within or485 outside of this state; any such adjudication shall automatically suspend the license of any486 such individual and shall prevent the reissuance or renewal of any license so suspended487 for as long as the adjudication of incompetence is in effect; or488 (10) Displayed an inability to practice a business or profession licensed under this title489 with reasonable skill and safety to the public or has become un able to practice the490 licensed business or profession with reasonable skill and safety to the public by reason491 of illness or use of alcohol, drugs, narcotics, chemicals, or any other type of material.492 43-11A-16.493 (a) Only a licensed dietitian or licensed nutritionist or a person authorized to engage in the494 practice of dietetics or the practice of nutrition under this c hapter shall engage in the495 practice of dietetics or the practice of nutrition to the exten t such services constitute496 medical nutrition therapy.497 (b) No individual shall designate or hold himself or herself out as a licensed dietitian; use498 or assume the title 'dietitian,' 'licensed dietitian,' 'dietitian nutritionist,' or 'dietician'; use or499 assume any other title indicating licensure; or append to or us e in conjunction with that500 individual's name the designation 'LD' or 'LDN,' unless the individual is a licensed dietitian501 under this chapter. No individual shall designate or hold hims elf or herself out as a502 dietitian unless the individual is licensed under this chapter or exempt as provided in Code503 Section 43-11A-18.504 H. B. 185 - 20 - 26 HB 185/AP (c) No individual shall designate or hold himself or herself out as a licensed nutritionist;505 use or assume the title 'licensed nutritionist'; use or assume any other title indicating506 licensure; or append to or use in conjunction with that individ ual's name the designation507 'LN,' unless the individual is a licensed nutritionist under this chapter. No individual shall508 designate or hold himself or herself out as a nutritionist unless the individual is licensed509 under this chapter or exempt as provided in Code Section 43-11A-18.510 (d) Use of an earned, federally trademarked nutrition credential is not prohibited.511 (e) Any individual violating the provisions of this Code secti on shall be guilty of a512 misdemeanor.513 43-11A-17.514 Proceedings under this chapter shall be governed by Chapter 13 of Title 50, the 'Georgia515 Administrative Procedure Act.'516 43-11A-18.517 Provided that the following individuals do not use titles prote cted under Code518 Section 43-11A-16 unless otherwise authorized under this Code s ection, nothing in this519 chapter shall be construed to affect:520 (1) A supervisee who is practicing while being supervised by a qualified supervisor as521 part of a course of study or a documented, continuous supervise d practice experience;522 provided, however, that such supervisee shall use a title that clearly indicates his or her523 status as a supervisee and shall not engage in the unrestricted practice of medical nutrition524 therapy;525 (2) A dietitian or nutritionist serving in the armed forces of t h e U n i t e d S t a t e s o r526 employed by any other federal agency who is using government issued titles and who is527 engaging in the practice of medical nutrition therapy, provided that such title use and528 such practice are related to such individual's service or employment;529 H. B. 185 - 21 - 26 HB 185/AP (3) An individual licensed to practice the profession of dentistry, medicine, osteopathy,530 chiropractic, nursing, or pharmacy engaging in the practice of medical nutrition therapy531 when incidental to the practice of his or her profession;532 (4) An employee of a department, agency, or division of state, county, or local533 government, or an individual contracting with any of the forego ing, who meets the534 qualifying standards of such position, is providing nutrition care services for welfare and535 public assistance programs under the Division of Family and Chi ldren Services of the536 Department of Human Services or the Special Supplemental Nutrit ion Program for537 Women, Infants, and Children under the Department of Public Health, and is authorized538 to provide such services within the discharge of his or her official duties in such position;539 (5) An individual who assists in the provision of medical nutrition therapy, provided that540 such individual performs only support activities that are not d iscretionary and do not541 require the exercise of professional judgment for their performance and such individual542 is directly supervised by a licensed dietitian, licensed nutritionist, or healthcare provider543 licensed in this state acting within the scope of such provider's license;544 (6) An individual who provides medical weight control services for individuals with545 obesity as part of:546 (A) An instructional program that has been approved in writing by a licensed dietitian,547 licensed nutritionist, or healthcare provider licensed in this state whose authorized548 scope of practice includes medical nutrition therapy; or549 (B) A plan of care that is overseen by a healthcare provider licensed in this state whose550 scope of practice otherwise authorizes such provider to provide and delegate medical551 nutrition therapy; provided, however, that the medical weight control services are not552 discretionary and do not require the exercise of professional judgment;553 (7) An individual who disseminates nonindividualized, written, general nutrition554 information in connection with the marketing and distribution o f dietary supplements,555 food, herbs, or food materials, including, but not limited to, explanations of their federally556 H. B. 185 - 22 - 26 HB 185/AP regulated label claims, any known drug-nutrient interactions, their role in various diets,557 or suggestions as how to best use and combine them; provided, h owever, that such558 information does not constitute medical nutrition therapy;559 (8) An individual engaged in the practice of the tenets of any religion, sect, or560 denomination; provided, however, that such indivi dual does not provide nor represent561 himself or herself as qualified to engage in medical nutrition therapy;562 (9) An individual who provides individualized nutrition recomm endations for general563 health and wellness and the prevention of chronic disease, health coaching, holistic and564 wellness education, guidance, motivation, behavior change manag ement, services for565 nonmedical weight control, or other nutrition care services, provided that such services566 do not constitute medical nutrition therapy;567 (10) An individual who is an operator or employee of a health food store or business that568 sells health products, including dietary supplements, food, herbs, or food materials, and569 who provides verbal general nonmedical nutrition information th at does not constitute570 medical nutrition therapy; or571 (11) A dietitian or nutritionist not located in this state who provides medical nutrition572 therapy via telehealth to a patient located in this state, provided that such individual is a573 dietitian or nutritionist licensed or certified in good standing with a scope of practice that574 includes the provision of medical nutrition therapy and has a p ractitioner-patient575 relationship with a patient who is temporarily located in this state; has a576 practitioner-patient relationship with a patient who is located in this state and such care577 is limited to temporary or short-term follow-up medical nutriti on therapy to ensure578 continuity of care; or is in consultation with a healthcare practitioner licensed in this state579 who has a practitioner-patient relationship with the patient. For purposes of this580 paragraph, the term 'temporarily' or 'temporary' means not exceeding 90 days within any581 12 month period.582 H. B. 185 - 23 - 26 HB 185/AP 43-11A-19.583 (a) A qualified supervisor shall:584 (1) Only supervise a clinical activity or nutrition care service that the qualified supervisor585 is authorized to perform;586 (2) Develop and carry out a program for advancing and optimizi ng the quality of care587 provided by a supervisee. A qualified supervisor and the super visee shall identify and588 document goals for such supervised practice experience, the assignment of clinical tasks589 as appropriate to such supervisee's evolving level of competenc e, such supervisee's590 relationship and the amount and type of access to the qualified supervisor, and a process591 for evaluating the supervisee's performance;592 (3) Oversee the activities of and approve and accept responsibility for the nutrition care593 services rendered by a supervisee;594 (4) At a minimum, be physically onsite and present where a sup ervisee is providing595 nutrition care services or be immediately and continuously available to such supervisee596 by means of two-way real-time audiovisual technology that allow s for direct,597 contemporaneous interaction by sight and sound between the qual ified supervisor and598 such supervisee; provided, however, that, if the qualified supe rvisor assigns to a599 supervisee a nutrition care service that is to be provided in a setting where the qualified600 supervisor is not routinely present, such qualified supervisor shall ensure that the means601 and methods of supervision are adequate to ensure appropriate patient care, which may602 include synchronous videoconferencing or another method of comm unication, and603 oversight that is appropriate to the care setting and the education and experience of the604 supervisee, as determined by the board by approval, policy, or rule;605 (5) Review on a regular basis the charts, records, and clinical notes of any supervisee and606 maintain responsibility for such supervisee's clinical record keeping;607 (6) Be available to render assistance during the provision of nutrition care services when608 requested by a patient; provided, however, that, if such qualif ied supervisor is not609 H. B. 185 - 24 - 26 HB 185/AP available, such qualified supervisor shall arrange for another qualified healthcare provider610 lawfully able to render nutrition care services to be available; and611 (7) Limit the assignment of nutrition care services to those services that are within the612 training and experience of a superv isee and customary to the pr actice of the qualified613 supervisor.614 (b) In order to act as a qualified supervisor, an individual shall:615 (1) Be licensed or certified in the state or territory where s uch supervised practice616 experience occurs as a dietitian, nutritionist, dietitian nutritionist, or healthcare provider617 whose scope of practice includes the provision of medical nutrition therapy;618 (2) Meet such other criteria as the board may establish by rule or regulation when a state619 or territory does not provide for licensure or certification of dietitians, dietitian620 nutritionists, or nutritionists; or621 (3) Be an employee of the federal government authorized within the discharge of his or622 her official duties to provide medical nutrition therapy and ex empt from licensure as623 provided for in paragraph (2) of Code Section 43-11A-18.624 ARTICLE 2625 43-11A-30.626 This article shall be known and may be cited as the 'Dietitian Licensure Compact Act.'627 43-11A-31.628 The Dietitian Licensure Compact is enacted into law and entered into by the State of629 Georgia with any and all other states legally joining therein i n the form substantially as630 follows:631 H. B. 185 - 25 - 26 HB 185/AP 'DIETITIAN LICENSURE COMPACT632 SECTION 1. PURPOSE633 The purpose of this Compact is to facilitate interstate Practice of Dietetics with the goal of634 improving public access to dietetics services. This Compact pr eserves the regulatory635 authority of States to protect public health and safety through the current system of State636 licensure, while also providing for licensure portability through a Compact Privilege granted637 to qualifying professionals.638 This Compact is designed to achieve the following objectives:639 A. Increase public access to dietetics services;640 B. Provide opportunities for interstate practice by Licensed Dietitians who meet uniform641 requirements;642 C. Eliminate the necessity for Licenses in multiple States;643 D. Reduce administrative burden on Member States and Licensees;644 E. Enhance the States' ability to protect the public's health and safety;645 F. Encourage the cooperation of Member States in regulating mu ltistate practice of646 Licensed Dietitians;647 G. Support relocating Active Military Members and their spouses;648 H. Enhance the exchange of licensure, investigative, and disciplinary information among649 Member States; and650 I. Vest all Member States with the authority to hold a Licensed Dietitian accountable for651 meeting all State practice laws in the State in which the patient is located at the time care652 is rendered.653 H. B. 185 - 26 - 26 HB 185/AP SECTION 2. DEFINITIONS654 As used in this Compact, and except as otherwise provided, the following definitions shall655 apply:656 A. "ACEND" means the Accreditation Council for Education in Nutrition and Dietetics657 or its successor organization.658 B. "Active Military Member" means any individual with full-time duty status in the active659 armed forces of the United States, including members of the National Guard and Reserve.660 C. "Adverse Action" means any administrative, civil, equitable or criminal action661 permitted by a State's laws which is imposed by a Licensing Authority or other authority662 against a Licensee, including actions against an individual's License or Compact Privilege663 such as revocation, suspension, probation, monitoring of the Li censee, limitation on the664 Licensee's practice, or any other Encumbrance on licensure affe cting a Licensee's665 authorization to practice, including issuance of a cease and desist action.666 D. "Alternative Program" means a non-disciplinary monitoring o r practice remediation667 process approved by a Licensing Authority.668 E. "Charter Member State" means any Member State which enacted this Compact by law669 before the Effective Date specified in Section 12.670 F. "Continuing Education" means a requirement, as a condition of License renewal, to671 provide evidence of participation in, and completion of, educat ional and professional672 activities relevant to practice or area of work.673 G. "CDR" means the Commission on Dietetic Registration or its successor organization.674 H. "Compact Commission" means the government agency whose membership consists of675 all States that have enacted this Compact, which is known as th e Dietitian Licensure676 Compact Commission, as described in Section 8, and which shall operate as an677 instrumentality of the Member States.678 I. "Compact Privilege" means a legal authorization, which is e quivalent to a License,679 permitting the Practice of Dietetics in a Remote State.680 H. B. 185 - 27 - 26 HB 185/AP J. "Current Significant Investigative Information" means:681 1. Investigative Information that a Licensing Authority, after a preliminary inquiry that682 includes notification and an opportunity for the subject Licensee to respond, if required683 by State law, has reason to believe is not groundless and, if proved true, would indicate684 more than a minor infraction; or685 2. Investigative Information that indicates that the subject L icensee represents an686 immediate threat to public health and safety regardless of whether the subject Licensee687 has been notified and had an opportunity to respond.688 K. "Data System" means a repository of information about Licensees, including, but not689 limited to, Continuing Education, examination, licensure, investigative, Compact Privilege690 and Adverse Action information.691 L. "Encumbered License" means a License in which an Adverse Ac tion restricts a692 Licensee's ability to practice dietetics.693 M. "Encumbrance" means a revocation or suspension of, or any limitation on a Licensee's694 full and unrestricted Practice of Dietetics by a Licensing Authority.695 N. "Executive Committee" means a group of delegates elected or appointed to act on696 behalf of, and within the powers granted to them by, this Compa ct, and the Compact697 Commission.698 O. "Home State" means the Member State that is the Licensee's primary State of residence699 or that has been designated pursuant to Section 6.700 P. "Investigative Information" means information, records, and documents received or701 generated by a Licensing Authority pursuant to an investigation.702 Q. "Jurisprudence Requirement" means an assessment of an individual's knowledge of the703 State laws and regulations governing the Practice of Dietetics in such State.704 R. "License" means an authorization from a Member State to either:705 1. Engage in the Practice of Dietetics (including medical nutrition therapy); or706 H. B. 185 - 28 - 26 HB 185/AP 2. Use the title "dietitian," "licensed dietitian," "licensed dietitian nutritionist," "certified707 dietitian," or other title describing a substantially similar p ractitioner as the Compact708 Commission may further define by Rule.709 S. "Licensee" or "Licensed Dietitian" means an individual who currently holds a License710 and who meets all of the requirements outlined in Section 4.711 T. "Licensing Authority" means the board or agency of a State, or equivalent, that is712 responsible for the licensing and regulation of the Practice of Dietetics.713 U. "Member State" means a State that has enacted the Compact.714 V. "Practice of Dietetics" means the synthesis and application of dietetics, primarily for715 the provision of nutrition care services, including medical nutrition therapy, in person or716 via telehealth, to prevent, manage, or treat diseases or medica l conditions and promote717 wellness.718 W. "Registered Dietitian" means a person who:719 1. Has completed applicable education, experience, examination , and recertification720 requirements approved by CDR;721 2. Is credentialed by CDR as a registered dietitian or a regis tered dietitian nutritionist;722 and723 3. Is legally authorized to use the title registered dietitian or registered dietitian724 nutritionist and the corresponding abbreviations "RD" or "RDN."725 X. "Remote State" means a Member State other than the Home Sta te, where a Licensee726 is exercising or seeking to exercise a Compact Privilege.727 Y. "Rule" means a regulation promulgated by the Compact Commission that has the force728 of law.729 Z. "Single State License" means a License issued by a Member S tate within the issuing730 State and does not include a Compact Privilege in any other Member State.731 AA. "State" means any state, commonwealth, district, or territory of the United States of732 America.733 H. B. 185 - 29 - 26 HB 185/AP BB. "Unencumbered License" means a License that authorizes a Licensee to engage in the734 full and unrestricted Practice of Dietetics.735 SECTION 3. STATE PARTICIPATION IN THE COMPACT736 A. To participate in the Compact, a State must currently:737 1. License and regulate the Practice of Dietetics; and738 2. Have a mechanism in place for receiving and investigating c omplaints about739 Licensees.740 B. A Member State shall:741 1. Participate fully in the Compact Commission's Data System, including using the742 unique identifier as defined in Rules;743 2. Notify the Compact Commission, in compliance with the terms of the Compact and744 Rules, of any Adverse Action or the availability of Current Sig nificant Investigative745 Information regarding a Licensee;746 3. Implement or utilize procedures for considering the crimina l history record747 information of applicants for an initial Compact Privilege. Th ese procedures shall748 include the submission of fingerprints or other biometric-based information by applicants749 for the purpose of obtaining an applicant's criminal history record information from the750 Federal Bureau of Investigation and the agency responsible for retaining that State's751 criminal records;752 a . A M e m b e r S t a t e m u s t f u l l y i m p l e m e n t a c r i m i n a l h i s t o r y r e c ord information753 requirement, within a time frame established by Rule, which inc ludes receiving the754 results of the Federal Bureau of Investigation record search and shall use those results755 in determining Compact Privilege eligibility.756 b. Communication between a Member State and the Compact Commission or among757 Member States regarding the verification of eligibility for a Compact Privilege shall not758 H. B. 185 - 30 - 26 HB 185/AP include any information received from the Federal Bureau of Investigation relating to759 a federal criminal history record information check performed by a Member State.760 4. Comply with and enforce the Rules of the Compact Commission;761 5. Require an applicant for a Compact Privilege to obtain or r etain a License in the762 Licensee's Home State and meet the Home State's qualifications for licensure or renewal763 of licensure, as well as all other applicable State laws; and764 6. Recognize a Compact Privilege granted to a Licensee who mee ts all of the765 requirements outlined in Section 4 in accordance with the terms of the Compact and766 Rules.767 C. Member States may set and collect a fee for granting a Compact Privilege.768 D. Individuals not residi ng in a Member State shall continue t o be able to apply for a769 Member State's Single State License as provided under the laws of each Member State. 770 However, the Single State License granted to these individuals shall not be recognized as771 granting a Compact Privilege to engage in the Practice of Dietetics in any other Member772 State.773 E. Nothing in this Compact shall affect the requirements established by a Member State774 for the issuance of a Single State License.775 F. At no point shall the Compact Commission have the power to define the requirements776 for the issuance of a Single State License to practice dietetic s. The Member States shall777 retain sole jurisdiction over the provision of these requirements.778 SECTION 4. COMPACT PRIVILEGE779 A. To exercise the Compact Privilege under the terms and provisions of the Compact, the780 Licensee shall:781 1. Satisfy one of the following:782 a. Hold a valid current registration that gives the applicant the right to use the term783 Registered Dietitian; or784 H. B. 185 - 31 - 26 HB 185/AP b. Complete all of the following:785 i. An education program which is either:786 a) A master's degree or doctoral degree that is programmatically accredited by (i)787 ACEND; or (ii) a dietetics accrediting agency recognized by the United States788 Department of Education, which the Compact Commission may by Rule determine,789 and from a college or university accredited at the time of grad uation by the790 appropriate regional accrediting agency recognized by the Counc il on Higher791 Education Accreditation and the United States Department of Education.792 b) An academic degree from a college or university in a foreign country equivalent793 to the degree described in subparagraph (a) that is programmati cally accredited794 by (i) ACEND; or (ii) a dietetics accrediting agency recognized by the United States795 Department of Education, which the Compact Commission may by Rule determine.796 ii. A planned, documented, supervised practice experience in d ietetics that is797 programmatically accredited by (i) ACEND, or (ii) a dietetics a ccrediting agency798 recognized by the United States Department of Education which t he Compact799 Commission may by Rule determine and which involves at least 10 00 hours of800 practice experience under the supervision of a Registered Dieti tian or a Licensed801 Dietitian.802 iii. Successful completion of either: (i) the Registration Examination for Dietitians803 administered by CDR, or (ii) a national credentialing examinati on for dietitians804 approved by the Compact Commission by Rule; such completion being no more than805 five years prior to the date of the Licensee's application for initial licensure and806 accompanied by a period of continuous licensure thereafter, all of which may be807 further governed by the Rules of the Compact Commission.808 2. Hold an Unencumbered License in the Home State;809 3. Notify the Compact Commission that the Licensee is seeking a Compact Privilege810 within a Remote State(s);811 H. B. 185 - 32 - 26 HB 185/AP 4. Pay any applicable fees, including any State fee, for the Compact Privilege;812 5. Meet any Jurisprudence Requirements established by the Remote State(s) in which the813 Licensee is seeking a Compact Privilege; and814 6. Report to the Compact Commission any Adverse Action, Encumbrance, or restriction815 on a License taken by any non-Member State within 30 days from the date the action is816 taken.817 B. The Compact Privilege is valid until the expiration date of the Home State License. To818 maintain a Compact Privilege, renewal of the Compact Privilege shall be congruent with819 the renewal of the Home State License as the Compact Commission may define by Rule. 820 The Licensee must comply with the requirements of Section 4(A) to maintain the Compact821 Privilege in the Remote State(s).822 C. A Licensee exercising a Compact Privilege shall adhere to the laws and regulations of823 the Remote State. Licensees shall be responsible for educating themselves on, and824 complying with, any and all State laws relating to the Practice of Dietetics in such Remote825 State.826 D. Notwithstanding anything to the contrary provided in this C ompact or State law, a827 Licensee exercising a Compact Privilege shall not be required t o complete Continuing828 Education Requirements required by a Remote State. A Licensee exercising a Compact829 Privilege is only required to meet any Continuing Education Requirements as required by830 the Home State.831 SECTION 5. OBTAINING A NEW HOME STATE LICENSE BASED ON A COMPACT832 PRIVILEGE833 A. A Licensee may hold a Home State License, which allows for a Compact Privilege in834 other Member States, in only one Member State at a time.835 B. If a Licensee changes Home State by moving between two Member States:836 H. B. 185 - 33 - 26 HB 185/AP 1. The Licensee shall file an application for obtaining a new Home State License based837 on a Compact Privilege, pay all applicable fees, and notify the current and new Home838 State in accordance with the Rules of the Compact Commission.839 2. Upon receipt of an application for obtaining a new Home State License by virtue of840 a Compact Privilege, the new Home State shall verify that the Licensee meets the criteria841 in Section 4 via the Data System, and require that the Licensee complete the following:842 a. Federal Bureau of Investigation fingerprint based criminal history record843 information check;844 b. Any other criminal history record information required by the new Home State; and845 c. Any Jurisprudence Requirements of the new Home State.846 3. The former Home State shall convert the former Home State License into a Compact847 Privilege once the new Home State has activated the new Home St ate License in848 accordance with applicable Rules adopted by the Compact Commission.849 4. Notwithstanding any other provision of this Compact, if the Licensee cannot meet the850 criteria in Section 4, the new Home State may apply its requirements for issuing a new851 Single State License.852 5. The Licensee shall pay all applicable fees to the new Home State in order to be issued853 a new Home State License.854 C. If a Licensee changes their State of residence by moving fr om a Member State to a855 non-Member State, or from a non-Member State to a Member State, the State criteria shall856 apply for issuance of a Single State License in the new State.857 D. Nothing in this Compact shall interfere with a Licensee's ability to hold a Single State858 License in multiple States; however, for the purposes of this C ompact, a Licensee shall859 have only one Home State License.860 E. Nothing in this Compact shall affect the requirements established by a Member State861 for the issuance of a Single State License.862 H. B. 185 - 34 - 26 HB 185/AP SECTION 6. ACTIVE MILITARY MEMBERS OR THEIR SPOUSES863 An Active Military Member, or their spouse, shall designate a H ome State where the864 individual has a current License in good standing. The individual may retain the Home State865 designation during the period the service member is on active duty.866 SECTION 7. ADVERSE ACTIONS867 A. In addition to the other powers conferred by State law, a Remote State shall have the868 authority, in accordance with existing State due process law, to:869 1. Take Adverse Action against a Licensee's Compact Privilege within that Member870 State; and871 2. Issue subpoenas for both hearings and investigations that require the attendance and872 testimony of witnesses as well as the production of evidence. Subpoenas issued by a873 Licensing Authority in a Member State for the attendance and testimony of witnesses or874 the production of evidence from another Member State shall be e nforced in the latter875 State by any court of competent jurisdiction, according to the practice and procedure876 applicable to subpoenas issued in proceedings pending before th at court. The issuing877 authority shall pay any witness fees, travel expenses, mileage, and other fees required by878 the service statutes of the State in which the witnesses or evidence are located.879 B. Only the Home State shall have the power to take Adverse Action against a Licensee's880 Home State License.881 C. For purposes of taking Adverse Action, the Home State shall give the same priority and882 effect to reported conduct received from a Member State as it w ould if the conduct had883 occurred within the Home State. In so doing, the Home State shall apply its own State laws884 to determine appropriate action.885 D. The Home State shall complete any pending investigations of a Licensee who changes886 Home States during the course of the investigations. The Home State shall also have887 authority to take appropriate action(s) and shall promptly repo rt the conclusions of the888 H. B. 185 - 35 - 26 HB 185/AP investigations to the administrator of the Data System. The ad ministrator of the Data889 System shall promptly notify the new Home State of any Adverse Actions.890 E. A Member State, if otherwise permitted by State law, may re cover from the affected891 Licensee the costs of investigations and dispositions of cases resulting from any Adverse892 Action taken against that Licensee.893 F. A Member State may take Adverse Action based on the factual findings of another894 Remote State, provided that the Member State follows its own pr ocedures for taking the895 Adverse Action.896 G. Joint Investigations:897 1. In addition to the authority granted to a Member State by its respective State law, any898 Member State may participate with other Member States in joint investigations of899 Licensees.900 2. Member States shall share any investigative, litigation, or compliance materials in901 furtherance of any joint investigation initiated under the Compact.902 H. If Adverse Action is taken by the Home State against a Licensee's Home State License903 resulting in an Encumbrance on the Home State License, the Lice nsee's Compact904 Privilege(s) in all other Member States shall be revoked until all Encumbrances have been905 removed from the Home State License. All Home State disciplina ry orders that impose906 Adverse Action against a Licensee shall include a statement that the Licensee's Compact907 Privileges are revoked in all Member States during the pendency of the order.908 I. Once an Encumbered License in the Home State is restored to an Unencumbered909 License (as certified by the Home State's Licensing Authority), the Licensee must meet the910 requirements of Section 4(A) and follow the administrative requ irements to reapply to911 obtain a Compact Privilege in any Remote State.912 J. If a Member State takes Adverse Action, it shall promptly notify the administrator of the913 Data System. The administrator of the Data System shall prompt ly notify the other914 Member States State of any Adverse Actions.915 H. B. 185 - 36 - 26 HB 185/AP K. Nothing in this Compact shall override a Member State's decision that participation in916 an Alternative Program may be used in lieu of Adverse Action.917 SECTION 8. ESTABLISHMENT OF THE DIETITIAN LICENSURE COMPACT918 COMMISSION919 A. The Compact Member States hereby create and establish a joi nt government agency920 whose membership consists of all Member States that have enacted the Compact known921 as the Dietitian Licensure Compact Commission. The Compact Com mission is an922 instrumentality of the Compact States acting jointly and not an instrumentality of any one923 State. The Compact Commission shall come into existence on or after the effective date924 of the Compact as set forth in Section 12.925 B. Membership, Voting, and Meetings926 1. Each Member State shall have and be limited to one (1) dele gate selected by that927 Member State's Licensing Authority.928 2. The delegate shall be the primary administrator of the Lice nsing Authority or their929 designee.930 3. The Compact Commission shall by Rule or bylaw establish a t erm of office for931 delegates and may by Rule or bylaw establish term limits.932 4. The Compact Commission may recommend removal or suspension of any delegate933 from office.934 5. A Member State's Licensing Authority shall fill any vacancy of its delegate occurring935 on the Compact Commission within 60 days of the vacancy.936 6. Each delegate shall be entitled to one vote on all matters before the Compact937 Commission requiring a vote by the delegates.938 7. Delegates shall meet and vote by such means as set forth in the bylaws. The bylaws939 may provide for delegates to meet and vote in-person or by tele communication, video940 conference, or other means of communication.941 H. B. 185 - 37 - 26 HB 185/AP 8. The Compact Commission shall meet at least once during each calendar year. 942 Additional meetings may be held as set forth in the bylaws. The Compact Commission943 may meet in person or by telecommunication, video conference, o r other means of944 communication.945 C. The Compact Commission shall have the following powers:946 1. Establish the fiscal year of the Compact Commission;947 2. Establish code of conduct and conflict of interest policies;948 3. Establish and amend Rules and bylaws;949 4. Maintain its financial records in accordance with the bylaws;950 5. Meet and take such actions as are consistent with the provisions of this Compact, the951 Compact Commission's Rules, and the bylaws;952 6. Initiate and conclude legal proceedings or actions in the n ame of the Compact953 Commission, provided that the standing of any Licensing Authori ty to sue or be sued954 under applicable law shall not be affected;955 7. Maintain and certify records and information provided to a Member State as the956 authenticated business records of the Compact Commission, and d esignate an agent to957 do so on the Compact Commission's behalf;958 8. Purchase and maintain insurance and bonds;959 9. Borrow, accept, or contract for services of personnel, incl uding, but not limited to,960 employees of a Member State;961 10. Conduct an annual financial review;962 11. Hire employees, elect or appoint officers, fix compensation, define duties, grant such963 individuals appropriate authority to carry out the purposes of the Compact, and establish964 the Compact Commission's personnel policies and programs relati ng to conflicts of965 interest, qualifications of personnel, and other related personnel matters;966 12. Assess and collect fees;967 H. B. 185 - 38 - 26 HB 185/AP 13. Accept any and all appropriate donations, grants of money, other sources of revenue,968 equipment, supplies, materials, services, and gifts, and receive, utilize, and dispose of the969 same; provided that at all times the Compact Commission shall a void any actual or970 appearance of impropriety or conflict of interest;971 14. Lease, purchase, retain, own, hold, improve, or use any property, real, personal, or972 mixed, or any undivided interest therein;973 15. Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of974 any property real, personal, or mixed;975 16. Establish a budget and make expenditures;976 17. Borrow money;977 18. Appoint committees, including standing committees, composed of members, State978 regulators, State legislators or their representatives, and con sumer representatives, and979 such other interested persons as may be designated in this Compact or the bylaws;980 19. Provide and receive information from, and cooperate with, law enforcement981 agencies;982 20. Establish and elect an Executive Committee, including a chair and a vice chair;983 21. Determine whether a State's adopted language is materially different from the model984 compact language such that the State would not qualify for participation in the Compact;985 and986 22. Perform such other functions as may be necessary or approp riate to achieve the987 purposes of this Compact.988 D. The Executive Committee989 1. The Executive Committee shall have the power to act on beha lf of the Compact990 Commission according to the terms of this Compact. The powers, duties, and991 responsibilities of the Executive Committee shall include:992 H. B. 185 - 39 - 26 HB 185/AP a. Oversee the day-to-day activities of the administration of the Compact including993 enforcement and compliance with the provisions of the Compact, its Rules and bylaws,994 and other such duties as deemed necessary;995 b. Recommend to the Compact Commission changes to the Rules or bylaws, changes996 to this Compact legislation, fees charged to Compact Member States, fees charged to997 Licensees, and other fees;998 c. Ensure Compact administration services are appropriately pr ovided, including by999 contract;1000 d. Prepare and recommend the budget;1001 e. Maintain financial records on behalf of the Compact Commission;1002 f. Monitor Compact compliance of Member States and provide compliance reports to1003 the Compact Commission;1004 g. Establish additional committees as necessary;1005 h. Exercise the powers and duties of the Compact Commission du ring the interim1006 between Compact Commission meetings, except for adopting or ame nding Rules,1007 adopting or amending bylaws, and exercising any other powers an d duties expressly1008 reserved to the Compact Commission by Rule or bylaw; and1009 i. Other duties as provided in the Rules or bylaws of the Compact Commission.1010 2. The Executive Committee shall be composed of nine members:1011 a. The chair and vice chair of the Compact Commission shall be voting members of the1012 Executive Committee;1013 b. Five voting members from the current membership of the Comp act Commission,1014 elected by the Compact Commission;1015 c. One ex-officio, nonvoting member from a recognized professi onal association1016 representing dietitians; and1017 d. One ex-officio, nonvoting member from a recognized national credentialing1018 organization for dietitians.1019 H. B. 185 - 40 - 26 HB 185/AP 3. The Compact Commission may remove any member of the Executive Committee as1020 provided in the Compact Commission's bylaws.1021 4. The Executive Committee shall meet at least annually.1022 a. Executive Committee meetings shall be open to the public, except that the Executive1023 Committee may meet in a closed, non-public meeting as provided in subsection (F)(2).1024 b. The Executive Committee shall give 30 days' notice of its meetings, posted on the1025 website of the Compact Commission and as determined to provide notice to persons1026 with an interest in the business of the Compact Commission.1027 c. The Executive Committee may hold a special meeting in accor dance with1028 subsection (F)(1)(b).1029 E. The Compact Commission shall adopt and provide to the Membe r States an annual1030 report.1031 F. Meetings of the Compact Commission1032 1. All meetings shall be open to the public, except that the Compact Commission may1033 meet in a closed, non-public meeting as provided in subsection (F)(2).1034 a. Public notice for all meetings of the full Compact Commission shall be given in the1035 same manner as required under the rulemaking provisions in Section 10, except that the1036 Compact Commission may hold a special meeting as provided in subsection (F)(1)(b).1037 b. The Compact Commission may hold a special meeting when it must meet to conduct1038 emergency business by giving 24 hours' notice to all Member States, on the Compact1039 Commission's website, and other means as provided in the Compac t Commission's1040 Rules. The Compact Commission's legal counsel shall certify th at the Compact1041 Commission's need to meet qualifies as an emergency.1042 2. The Compact Commission or the Executive Committee or other committees of the1043 Compact Commission may convene in a closed, non-public meeting for the Compact1044 Commission or Executive Committee or other committees of the Compact Commission1045 to receive legal advice or to discuss:1046 H. B. 185 - 41 - 26 HB 185/AP a. Non-compliance of a Member State with its obligations under the Compact;1047 b. The employment, compensation, discipline, or other matters, practices, or1048 procedures related to specific employees;1049 c. Current or threatened discipline of a Licensee by the Compact Commission or by a1050 Member State's Licensing Authority;1051 d. Current, threatened, or reasonably anticipated litigation;1052 e. Negotiation of contracts for the purchase, lease, or sale o f goods, services, or real1053 estate;1054 f. Accusing any person of a crime or formally censuring any person;1055 g. Trade secrets or commercial or financial information that i s privileged or1056 confidential;1057 h. Information of a personal nature where disclosure would con stitute a clearly1058 unwarranted invasion of personal privacy;1059 i. Investigative records compiled for law enforcement purposes;1060 j. Information related to any investigative reports prepared by or on behalf of or for use1061 of the Compact Commission or other committee charged with respo nsibility of1062 investigation or determination of compliance issues pursuant to the Compact;1063 k. Matters specifically exempted from disclosure by federal or Member State law; or1064 l. Other matters as specified in the Rules of the Compact Commission.1065 3. If a meeting, or portion of a meeting, is closed, the presiding officer shall state that the1066 meeting will be closed and reference each relevant exempting pr ovision, and such1067 reference shall be recorded in the minutes.1068 4. The Compact Commission shall keep minutes that fully and cl early describe all1069 matters discussed in a meeting and shall provide a full and accurate summary of actions1070 taken, and the reasons therefore, including a description of th e views expressed. All1071 documents considered in connection with an action shall be identified in such minutes. 1072 All minutes and documents of a closed meeting shall remain under seal, subject to release1073 H. B. 185 - 42 - 26 HB 185/AP only by a majority vote of the Compact Commission or order of a court of competent1074 jurisdiction.1075 G. Financing of the Compact Commission1076 1. The Compact Commission shall pay, or provide for the paymen t of, the reasonable1077 expenses of its establishment, organization, and ongoing activities.1078 2. The Compact Commission may accept any and all appropriate r evenue sources as1079 provided in subsection (C)(13).1080 3. The Compact Commission may levy on and collect an annual assessment from each1081 Member State and impose fees on Licensees of Member States to w hom it grants a1082 Compact Privilege to cover the cost of the operations and activ ities of the Compact1083 Commission and its staff, which must, in a total amount, be sufficient to cover its annual1084 budget as approved each year for which revenue is not provided by other sources. The1085 aggregate annual assessment amount for Member States shall be allocated based upon a1086 formula that the Compact Commission shall promulgate by Rule.1087 4. The Compact Commission shall not incur obligations of any kind prior to securing the1088 funds adequate to meet the same; nor shall the Compact Commission pledge the credit1089 of any of the Member States, except by and with the authority of the Member State.1090 5. The Compact Commission shall keep accurate accounts of all receipts and1091 disbursements. The receipts and disbursements of the Compact C ommission shall be1092 subject to the financial review and accounting procedures established under its bylaws. 1093 However, all receipts and disbursements of funds handled by the Compact Commission1094 shall be subject to an annual financial review by a certified or licensed public accountant,1095 and the report of the financial review shall be included in and become part of the annual1096 report of the Compact Commission.1097 H. Qualified Immunity, Defense, and Indemnification1098 1. The members, officers, executive director, employees and re presentatives of the1099 Compact Commission shall be immune from suit and liability, bot h personally and in1100 H. B. 185 - 43 - 26 HB 185/AP their official capacity, for any claim for damage to or loss of property or personal injury1101 or other civil liability caused by or arising out of any actual or alleged act, error, or1102 omission that occurred, or that the person against whom the cla i m i s m a d e h a d a1103 reasonable basis for believing occurred within the scope of Com pact Commission1104 employment, duties, or responsibilities; provided that nothing in this paragraph shall be1105 construed to protect any such person from suit or liability for any damage, loss, injury,1106 or liability caused by the intentional or willful or wanton misconduct of that person. The1107 procurement of insurance of any type by the Compact Commission shall not in any way1108 compromise or limit the immunity granted hereunder.1109 2. The Compact Commission shall defend any member, officer, ex ecutive director,1110 employee, and representative of the Compact Commission in any civil action seeking to1111 impose liability arising out of any actual or alleged act, error, or omission that occurred1112 within the scope of Compact Commission employment, duties, or responsibilities, or as1113 determined by the Compact Commission that the person against whom the claim is made1114 had a reasonable basis for believing occurred within the scope of Compact Commission1115 employment, duties, or responsibilities; provided that nothing herein shall be construed1116 to prohibit that person from re taining their own counsel at the ir own expense; and1117 provided further, that the actual or alleged act, error, or omission did not result from that1118 person's intentional or willful or wanton misconduct.1119 3. The Compact Commission shall indemnify and hold harmless any member, officer,1120 executive director, employee, and representative of the Compact Commission for the1121 amount of any settlement or judgment obtained against that pers on arising out of any1122 actual or alleged act, error, or omission that occurred within the scope of Compact1123 Commission employment, duties, or responsibilities, or that such person had a reasonable1124 basis for believing occurred within the scope of Compact Commis sion employment,1125 duties, or responsibilities, provided that the actual or alleged act, error, or omission did1126 not result from the intentional or willful or wanton misconduct of that person.1127 H. B. 185 - 44 - 26 HB 185/AP 4. Nothing herein shall be construed as a limitation on the liability of any Licensee for1128 professional malpractice or misconduct, which shall be governed solely by any other1129 applicable State laws.1130 5. Nothing in this Compact shall be interpreted to waive or otherwise abrogate a Member1131 State's state action immunity or state action affirmative defense with respect to antitrust1132 claims under the Sherman Act, Clayton Act, or any other State o r federal antitrust or1133 anticompetitive law or regulation.1134 6. Nothing in this Compact shall be construed to be a waiver of sovereign immunity by1135 the Member States or by the Compact Commission.1136 SECTION 9. DATA SYSTEM1137 A. The Compact Commission shall provide for the development, maintenance, operation,1138 and utilization of a coordinated Data System.1139 B. The Compact Commission shall assign each applicant for a Compact Privilege a unique1140 identifier, as determined by the Rules.1141 C. Notwithstanding any other provision of State law to the contrary, a Member State shall1142 submit a uniform data set to the Data System on all individuals to whom this Compact is1143 applicable as required by the Rules of the Compact Commission, including:1144 1. Identifying information;1145 2. Licensure data;1146 3. Adverse Actions against a License or Compact Privilege and information related1147 thereto;1148 4. Non-confidential information related to Alternative Program participation, the1149 beginning and ending dates of such participation, and other information related to such1150 participation not made confidential under Member State law;1151 5. Any denial of application for licensure, and the reason(s) for such denial;1152 6. The presence of Current Significant Investigative Information; and1153 H. B. 185 - 45 - 26 HB 185/AP 7. Other information that may facilitate the administration of this Compact or the1154 protection of the public, as determined by the Rules of the Compact Commission.1155 D. The records and information provided to a Member State pursuant to this Compact or1156 through the Data System, when certified by the Compact Commission or an agent thereof,1157 shall constitute the authenticated business records of the Compact Commission, and shall1158 be entitled to any associated hearsay exception in any relevant judicial, quasi-judicial, or1159 administrative proceedings in a Member State.1160 E. Current Significant Investigative Information pertaining to a Licensee in any Member1161 State will only be available to other Member States.1162 F. It is the responsibility of the Member States to report any Adverse Action against a1163 Licensee and to monitor the Data System to determine whether an y Adverse Action has1164 been taken against a Licensee. Adverse Action information pertaining to a Licensee in any1165 Member State will be available to any other Member State.1166 G. Member States contributing information to the Data System may designate information1167 that may not be shared with the public without the express permission of the contributing1168 State.1169 H. Any information submitted to the Data System that is subsequently expunged pursuant1170 to federal law or the laws of the Member State contributing the information shall be1171 removed from the Data System.1172 SECTION 10. RULEMAKING1173 A. The Compact Commission shall promulgate reasonable Rules in order to effectively1174 and efficiently implement and administer the purposes and provisions of the Compact. A1175 Rule shall be invalid and have no force or effect only if a court of competent jurisdiction1176 holds that the Rule is invalid because the Compact Commission exercised its rulemaking1177 authority in a manner that is beyond the scope and purposes of the Compact, or the powers1178 granted hereunder, or based upon another applicable standard of review.1179 H. B. 185 - 46 - 26 HB 185/AP B. The Rules of the Compact Commission shall have the force of law in each Member1180 State, provided however that where the Rules conflict with the laws or regulations of a1181 Member State that relate to the procedures, actions, and processes a Licensed Dietitian is1182 permitted to undertake in that State and the circumstances under which they may do so, as1183 held by a court of competent jurisdiction, the Rules of the Compact Commission shall be1184 ineffective in that State to the extent of the conflict.1185 C. The Compact Commission shall exercise its rulemaking powers pursuant to the criteria1186 set forth in this Section and the Rules adopted thereunder. Rules shall become binding on1187 the day following adoption or as of the date specified in the Rule or amendment, whichever1188 is later.1189 D. If a majority of the legislatures of the Member States rejects a Rule or portion of a Rule,1190 by enactment of a statute or resolution in the same manner used to adopt the Compact1191 within four (4) years of the d ate of adoption of the Rule, then such Rule shall have no1192 further force and effect in any Member State.1193 E. Rules shall be adopted at a regular or special meeting of the Compact Commission.1194 F. Prior to adoption of a proposed Rule, the Compact Commissio n shall hold a public1195 hearing and allow persons to provide oral and written comments, data, facts, opinions, and1196 arguments.1197 G. Prior to adoption of a proposed Rule by the Compact Commiss ion, and at least1198 thirty (30) days in advance of the meeting at which the Compact Commission will hold a1199 public hearing on the proposed Rule, the Compact Commission shall provide a Notice of1200 Proposed rulemaking:1201 1. On the website of the Compact Commission or other publicly accessible platform;1202 2. To persons who have requested notice of the Compact Commiss ion's notices of1203 proposed rulemaking; and1204 3. In such other way(s) as the Compact Commission may by Rule specify.1205 H. The Notice of Proposed rulemaking shall include:1206 H. B. 185 - 47 - 26 HB 185/AP 1. The time, date, and location of the public hearing at which the Compact Commission1207 will hear public comments on the proposed Rule and, if differen t, the time, date, and1208 location of the meeting where the Compact Commission will consi der and vote on the1209 proposed Rule;1210 2. If the hearing is held via telecommunication, video confere nce, or other means of1211 communication, the Compact Commission shall include the mechanism for access to the1212 hearing in the Notice of Proposed rulemaking;1213 3. The text of the proposed Rule and the reason therefore;1214 4. A request for comments on the proposed Rule from any interested person; and1215 5. The manner in which interested persons may submit written comments.1216 I. All hearings will be recorded. A copy of the recording and all written comments and1217 documents received by the Compact Commission in response to the proposed Rule shall1218 be available to the public.1219 J. Nothing in this Section shall be construed as requiring a separate hearing on each Rule. 1220 Rules may be grouped for the convenience of the Compact Commiss ion at hearings1221 required by this Section.1222 K. The Compact Commission shall, by majority vote of all members, take final action on1223 the proposed Rule based on the rulemaking record and the full text of the Rule.1224 1. The Compact Commission may adopt changes to the proposed Ru le provided the1225 changes do not enlarge the original purpose of the proposed Rule.1226 2. The Compact Commission shall provide an explanation of the reasons for substantive1227 changes made to the proposed Rule as well as reasons for substantive changes not made1228 that were recommended by commenters.1229 3. The Compact Commission shall determine a reasonable effecti ve date for the Rule. 1230 Except for an emergency as provided in Section 10(L), the effective date of the Rule shall1231 be no sooner than 30 days after issuing the notice that it adopted or amended the Rule.1232 H. B. 185 - 48 - 26 HB 185/AP L. Upon determination that an emergency exists, the Compact Commission may consider1233 and adopt an emergency Rule with 24 hours' notice, with opportunity to comment, provided1234 that the usual rulemaking procedures provided in the Compact and in this Section shall be1235 retroactively applied to the Rule as soon as reasonably possibl e, in no event later than1236 ninety (90) days after the effective date of the Rule. For the purposes of this provision, an1237 emergency Rule is one that must be adopted immediately in order to:1238 1. Meet an imminent threat to public health, safety, or welfare;1239 2. Prevent a loss of Compact Commission or Member State funds;1240 3. Meet a deadline for the promulgation of a Rule that is established by federal law or1241 rule; or1242 4. Protect public health and safety.1243 M. The Compact Commission or an authorized committee of the Compact Commission1244 may direct revision to a previously adopted Rule for purposes of correcting typographical1245 errors, errors in format, errors in consistency, or grammatical errors. Public notice of any1246 revision shall be posted on the website of the Compact Commission. The revision shall be1247 subject to challenge by any person for a period of thirty (30) days after posting. The1248 revision may be challenged only on grounds that the revision results in a material change1249 to a Rule. A challenge shall be made in writing and delivered to the Compact Commission1250 prior to the end of the notice period. If no challenge is made, the revision will take effect1251 without further action. If the revision is challenged, the rev ision may not take effect1252 without the approval of the Compact Commission.1253 N. No Member State's rulemaking requirements shall apply under this Compact.1254 H. B. 185 - 49 - 26 HB 185/AP SECTION 11. OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT1255 A. Oversight1256 1. The executive and judicial branches of State government in each Member State shall1257 enforce this Compact and take all actions necessary and appropr iate to implement this1258 Compact.1259 2. Except as otherwise provided in this Compact, venue is prop er and judicial1260 proceedings by or against the Compact Commission shall be broug ht solely and1261 exclusively in a court of competent jurisdiction where the principal office of the Compact1262 Commission is located. The Compact Commission may waive venue and jurisdictional1263 defenses to the extent it adopts or consents to participate in alternative dispute resolution1264 proceedings. Nothing herein shall affect or limit the selection or propriety of venue in1265 any action against a Licensee for professional malpractice, mis conduct, or any such1266 similar matter.1267 3. The Compact Commission shall be entitled to receive service of process in any1268 proceeding regarding the enforcement or interpretation of the C ompact and shall have1269 standing to intervene in such a proceeding for all purposes. F ailure to provide the1270 Compact Commission service of process shall render a judgment or order void as to the1271 Compact Commission, this Compact, or promulgated Rules.1272 B. Default, Technical Assistance, and Termination1273 1. If the Compact Commission determines that a Member State ha s defaulted in the1274 performance of its obligations or responsibilities under this Compact or the promulgated1275 Rules, the Compact Commission shall provide written notice to the defaulting State. The1276 notice of default shall describe the default, the proposed means of curing the default, and1277 any other action that the Compact Commission may take and shall offer training and1278 specific technical assistance regarding the default.1279 2. The Compact Commission shall provide a copy of the notice o f default to the other1280 Member States.1281 H. B. 185 - 50 - 26 HB 185/AP C. If a State in default fails to cure the default, the defaulting State may be terminated from1282 the Compact upon an affirmative vote of a majority of the delegates of the Member States,1283 and all rights, privileges, and benefits conferred on that Stat e by this Compact may be1284 terminated on the effective date of termination. A cure of the default does not relieve the1285 offending State of obligations or liabilities incurred during the period of default.1286 D. Termination of membership in the Compact shall be imposed only after all other means1287 of securing compliance have been exhausted. Notice of intent to suspend or terminate shall1288 be given by the Compact Commission to the governor, the majority and minority leaders1289 of the defaulting State's legislature, the defaulting State's Licensing Authority, and each of1290 the Member States' Licensing Authority.1291 E. A State that has been terminated is responsible for all ass essments, obligations, and1292 liabilities incurred through the effective date of termination, including obligations that1293 extend beyond the effective date of termination.1294 F. Upon the termination of a State's membership from this Comp act, that State shall1295 immediately provide notice to all Licensees within that State o f such termination. The1296 terminated State shall continue to recognize all Compact Privileges granted pursuant to this1297 Compact for a minimum of six months after the date of said notice of termination.1298 G. The Compact Commission shall not bear any costs related to a State that is found to be1299 in default or that has been terminated from the Compact, unless agreed upon in writing1300 between the Compact Commission and the defaulting State.1301 H. The defaulting State may appeal the action of the Compact Commission by petitioning1302 the U.S. District Court for the District of Columbia or the fed eral district where the1303 Compact Commission has its principal offices. The prevailing party shall be awarded all1304 costs of such litigation, including reasonable attorney's fees.1305 H. B. 185 - 51 - 26 HB 185/AP I. Dispute Resolution1306 1. Upon request by a Member State, the Compact Commission shall attempt to resolve1307 disputes related to the Compact that arise among Member States and between Member1308 and non-Member States.1309 2. The Compact Commission shall promulgate a Rule providing for both mediation and1310 binding dispute resolution for disputes as appropriate.1311 J. Enforcement1312 1. By supermajority vote, the Compact Commission may initiate legal action against a1313 Member State in default in the United States District Court for the District of Columbia1314 or the federal district where the Compact Commission has its principal offices to enforce1315 compliance with the provisions of the Compact and its promulgat ed Rules. The relief1316 sought may include both injunctive relief and damages. In the event judicial enforcement1317 is necessary, the prevailing party shall be awarded all costs of such litigation, including1318 reasonable attorney's fees. The remedies herein shall not be the exclusive remedies of the1319 Compact Commission. The Compact Commission may pursue any othe r remedies1320 available under federal or the defaulting Member State's law.1321 2. A Member State may initiate legal action against the Compact Commission in the U.S.1322 District Court for the District of Columbia or the federal dist rict where the Compact1323 Commission has its principal offices to enforce compliance with the provisions of the1324 Compact and its promulgated Rules. The relief sought may include both injunctive relief1325 and damages. In the event judicial enforcement is necessary, the prevailing party shall1326 be awarded all costs of such litigation, including reasonable attorney's fees.1327 3. No party other than a Member State shall enforce this Compact against the Compact1328 Commission.1329 H. B. 185 - 52 - 26 HB 185/AP SECTION 12. EFFECTIVE DATE, WITHDRAWAL, AND AMENDMENT1330 A. The Compact shall come into effect on the date on which the Compact statute is1331 enacted into law in the seventh Member State.1332 1. On or after the effective date of the Compact, the Compact Commission shall convene1333 and review the enactment of each of the first seven Member Stat es ("Charter Member1334 States") to determine if the statute enacted by each such Chart er Member State is1335 materially different than the model Compact statute.1336 a. A Charter Member State whose enactment is found to be materially different from1337 the model Compact statute shall be entitled to the default proc ess set forth in1338 Section 11.1339 b. If any Member State is later found to be in default, or is terminated, or withdraws1340 from the Compact, the Compact Commission shall remain in existe nce and the1341 Compact shall remain in effect even if the number of Member States should be less than1342 seven.1343 2. Member States enacting the Compact subsequent to the seven initial Charter Member1344 States shall be subject to the process set forth in Section 8(C )(21) to determine if their1345 enactments are materially different from the model Compact stat ute and whether they1346 qualify for participation in the Compact.1347 3. All actions taken for the benefit of the Compact Commission or in furtherance of the1348 purposes of the administration of the Compact prior to the effective date of the Compact1349 or the Compact Commission coming into existence shall be considered to be actions of1350 the Compact Commission unless specifically repudiated by the Compact Commission.1351 4. Any State that joins the Compact subsequent to the Compact Commission's initial1352 adoption of the Rules and bylaws shall be subject to the Rules and bylaws as they exist1353 on the date on which the Compact becomes law in that State. An y Rule that has been1354 previously adopted by the Compact Commission shall have the full force and effect of1355 law on the day the Compact becomes law in that State.1356 H. B. 185 - 53 - 26 HB 185/AP B. Any Member State may withdraw from this Compact by enacting a statute repealing1357 the same.1358 1. A Member State's withdrawal shall not take effect until 180 days after enactment of1359 the repealing statute.1360 2. Withdrawal shall not affect the continuing requirement of t he withdrawing State's1361 Licensing Authority to comply with the investigative and Advers e Action reporting1362 requirements of this Compact prior to the effective date of withdrawal.1363 3. Upon the enactment of a statute withdrawing from this Compa ct, a State shall1364 immediately provide notice of such withdrawal to all Licensees within that State. 1365 Notwithstanding any subsequent statutory enactment to the contrary, such withdrawing1366 State shall continue to recognize all Compact Privileges granted pursuant to this Compact1367 for a minimum of 180 days after the date of such notice of withdrawal.1368 C. Nothing contained in this Compact shall be construed to inv alidate or prevent any1369 licensure agreement or other cooperative arrangement between a Member State and a1370 non-Member State that does not conflict with the provisions of this Compact.1371 D. This Compact may be amended by the Member States. No amendment to this Compact1372 shall become effective and binding upon any Member State until it is enacted into the laws1373 of all Member States.1374 SECTION 13. CONSTRUCTION AND SEVERABILITY1375 A. This Compact and the Compact Commission's rulemaking authority shall be liberally1376 construed so as to effectuate the purposes and the implementation and administration of the1377 Compact. Provisions of the Compact expressly authorizing or requiring the promulgation1378 of Rules shall not be construed to limit the Compact Commission's rulemaking authority1379 solely for those purposes.1380 B. The provisions of this Compact shall be severable and if any phrase, clause, sentence,1381 or provision of this Compact is held by a court of competent jurisdiction to be contrary to1382 H. B. 185 - 54 - 26 HB 185/AP the constitution of any Member State, a State seeking participation in the Compact, or of1383 the United States, or the applicability thereof to any governme nt, agency, person, or1384 circumstance is held to be unconstitutional by a court of competent jurisdiction, the validity1385 of the remainder of this Compact and the applicability thereof to any other government,1386 agency, person, or circumstance shall not be affected thereby.1387 C. Notwithstanding Section 13(B), the Compact Commission may d eny a State's1388 participation in the Compact or, in accordance with the require ments of Section 11(B),1389 terminate a Member State's participation in the Compact, if it determines that a1390 constitutional requirement of a Member State is a material depa rture from the Compact. 1391 Otherwise, if this Compact shall be held to be contrary to the constitution of any Member1392 State, the Compact shall remain in full force and effect as to the remaining Member States1393 and in full force and effect as to the Member State affected as to all severable matters.1394 SECTION 14. CONSISTENT EFFECT AND CONFLICT WITH OTHER STATE LAWS1395 A. Nothing herein shall prevent or inhibit the enforcement of any other law of a Member1396 State that is not inconsistent with the Compact.1397 B. Any laws, statutes, regulations, or other legal requirement s in a Member State in1398 conflict with the Compact are superseded to the extent of the conflict.1399 C. All permissible agreements between the Compact Commission and the Member States1400 are binding in accordance with their terms.'"1401 H. B. 185 - 55 - 26 HB 185/AP PART II1402 Conforming cross-references1403 SECTION 2-1.1404 Title 9 of the Official Code of Georgia Annotated, relating to civil practice, is amended in1405 Code Section 9-11-9.1, relating to affidavit to accompany charge of professional malpractice,1406 by revising paragraph (8) of subsection (g) as follows:1407 "(8) Dietitians Licensed dietitians or licensed nutritionists;"1408 SECTION 2-2.1409 Title 31 of the Official Code of Georgia Annotated, relating to health, is amended in Code1410 Section 31-7-351, relating to definitions relative to Georgia L ong-term Care Background1411 Check Program, by revising paragraph (7) as follows:1412 "(7) 'Employee' means any individual who has direct access and who is hired by a facility1413 through employment, or through a contract with such facility, including, but not limited1414 to, housekeepers, maintenance personnel, dieticians, and any volunteer who has duties1415 that are equivalent to the duties of an employee providing such services. Such term shall1416 not include an individual who contracts with the facility, whether personally or through1417 a company, to provide utility, construction, communications, ac counting, quality1418 assurance, human resource management, information technology, legal, or other services1419 if the contracted services are not directly related to providin g services to a patient,1420 resident, or client of the facility. Such term shall not inclu de any healthcare provider,1421 including, but not limited to, physicians, dentists, nurses, an d pharmacists, licensed1422 dietitians and licensed nutritionists who are licensed by the Georgia Composite Medical1423 Board, the Georgia Board of Dentistry, the Georgia Board of Nursing, or the State Board1424 of Pharmacy, or the Georgia Board of Examiners of Licensed Diet itians and Licensed1425 Nutritionists."1426 H. B. 185 - 56 - 26 HB 185/AP SECTION 2-3.1427 Said title is further amended in Code Section 31-8-192, relatin g to definitions relative to1428 "health share" volunteers in medicine, by revising subparagraph (N) of paragraph (5) as1429 follows:1430 "( N ) A l i c e n s e d dietitian or licensed nutritionist licensed under Chapter 11A of1431 Title 43;"1432 SECTION 2-4.1433 Title 33 of the Official Code of Georgia Annotated, relating to insurance, is amended in Code1434 Section 33-20A-3, relating to definitions relative to patient p rotection, by revising1435 paragraph (5) as follows:1436 "(5) 'Healthcare provider' or 'provider' means any physician, d entist, podiatrist,1437 pharmacist, optometrist, psychologist, clinical social worker, advanced practice registered1438 nurse, registered optician, licensed professional counselor, physical therapist, marriage1439 and family therapist, chiropractor, athletic trainer qualified pursuant to Code1440 Section 43-5-8, occupational therapist, speech language pathologist, audiologist, licensed1441 dietitian, licensed nutritionist, or physician assistant."1442 SECTION 2-5.1443 Said title is further amended in Code Section 33-20E-2, relating to application to insurers and1444 definitions relative to surprise billing consumer protection, b y revising paragraph (9) of1445 subsection (b) as follows:1446 "(9) 'Healthcare provider' or 'provider' means any physician, other individual, or facility1447 other than a hospital licensed or otherwise authorized in this state to furnish healthcare1448 services, including, but not limited to, any dentist, podiatrist, optometrist, psychologist,1449 clinical social worker, advanced practice registered nurse, registered optician, licensed1450 professional counselor, physical therapist, marriage and family therapist, chiropractor,1451 H. B. 185 - 57 - 26 HB 185/AP athletic trainer qualified pursuant to Code Section 43-5-8, occ upational therapist,1452 speech-language pathologist, audiologist, licensed dietitian, licensed nutritionist, o r1453 physician assistant."1454 SECTION 2-6.1455 Said title is further amended in Code Section 33-24-59.27, rela ting to right to shop for1456 insurance coverage, disclosure of pricing information, and notice, by revising paragraph (4)1457 of subsection (b) as follows:1458 "(4) 'Healthcare provider' or 'provider' means any physician, d entist, podiatrist,1459 pharmacist, optometrist, psychologist, clinical social worker, advanced practice registered1460 nurse, registered optician, licensed professional counselor, physical therapist, marriage1461 and family therapist, chiropractor, athletic trainer qualified pursuant to Code1462 Section 43-5-8, occupational therapist, speech language pathologist, audiologist, licensed1463 dietitian, licensed nutritionist, or physician assistant."1464 SECTION 2-7.1465 Said title is further amended in Code Section 33-39-3, relating to definitions relative to1466 collection, use, and disclosure of information gathered by insurance institutions, by revising1467 paragraph (16) as follows:1468 "(16) 'Medical professional' means any person licensed or certified to provide healthcare1469 services to natural persons, including, but not limited to, a chiropractor, clinical licensed1470 dietitian, licensed nutritionist, clinical psychologist, dentist, nurse, occupational therapist,1471 optometrist, pharmacist, physical therapist, physician, podiatr ist, psychiatric social1472 worker, or speech therapist."1473 H. B. 185 - 58 - 26 HB 185/AP SECTION 2-8.1474 Title 43 of the Official Code of Georgia Annotated, relating to professions and businesses,1475 is amended in Code Section 43-1-28, relating to volunteers in h ealthcare specialties, by1476 revising paragraphs (2) and (3) of subsection (b) as follows:1477 "(2) 'Healthcare practitioner' means a chiropractor, registered professional nurse,1478 podiatrist, optometrist, professional counselor, social worker, marriage and family1479 therapist, occupational therapist, physical therapist, physician assistant, licensed practical1480 nurse, certified nurse midwife, pharmacist, speech-language pat hologist, audiologist,1481 psychologist, or licensed dietitian, or licensed nutritionist.1482 (3) 'Healthcare specialty' means the practice of chiropractic, nursing, podiatry,1483 optometry, professional counseling, social work, marriage and f amily therapy,1484 occupational therapy, physical therapy, physician assistance, m idwifery, pharmacy,1485 speech-language pathology, audiology, psychology, or dietetics, or nutrition."1486 SECTION 2-9.1487 Said title is further amended in Code Section 43-1-33, relating to advertisement, signage, and1488 identifier requirements for healthcare practitioners, by revisi ng subparagraph (c)(5)(D) as1489 follows:1490 "(D) Licensed dietitian or licensed nutritionist Dietitian licensed or registered pursuant1491 to under Chapter 11A of this title;"1492 SECTION 2-10.1493 Said title is further amended in Code Section 43-34-316, relati ng to exceptions relative to1494 genetic counselor licensure, by revising paragraph (5) as follows:1495 "(5) Any person using genetic data for purposes of nutritional counseling who is licensed1496 as a licensed dietitian or licensed nutritionist under Chapter 11A of this title or exempt1497 from such licensure pursuant to paragraph (10) of Code Section 43-11A-18."1498 H. B. 185 - 59 - 26 HB 185/AP SECTION 2-11.1499 Title 51 of the Official Code of Georgia Annotated, relating to torts, is amended in Code1500 Section 51-2-5.1, relating to relationship between hospital and healthcare provider1501 prerequisite to liability, notice regarding independent contrac tor status, and factors for1502 consideration in determining status, by revising paragraph (1) of subsection (a) as follows:1503 "(1) 'Healthcare professional' means a professional licensed as an audiologist,1504 chiropractor, clinical social worker, dentist, licensed dietitian, licensed nutritionist,1505 medical doctor, marriage and family therapist, registered profe ssional or licensed1506 practical nurse, occupational therapist, optometrist, osteopath ic physician, pharmacist,1507 physical therapist, physician assistant, professional counselor, podiatrist, psychologist,1508 radiological technician, respiratory therapist, or speech-language pathologist."1509 SECTION 2-12.1510 Said title is further amended in Code Section 51-16-1, relating to definitions relative to1511 pandemic business safety, by revising paragraph (6) as follows:1512 "(6) 'Healthcare provider' means any physician or other person licensed or otherwise1513 authorized in this state to furnish healthcare services, including, but not limited to, any1514 dentist, podiatrist, optometrist, pharmacist, psychologist, clinical social worker, advanced1515 practice registered nurse, registered optician, licensed professional counselor, physical1516 therapist, massage therapist, marriage and family therapist, chiropractor, athletic trainer1517 qualified pursuant to Code Section 43-5-7, occupational therapi st, speech-language1518 pathologist, audiologist, licensed dietitian, licensed nutritionist, physician assistant,1519 cardiac technician, emergency medical technician, paramedic, or related parties."1520 H. B. 185 - 60 - 26 HB 185/AP PART III1521 Effective date and repealer1522 SECTION 3-1.1523 This Act shall become effective upon its approval by the Governor or upon its becoming law1524 without such approval.1525 SECTION 3-2.1526 All laws and parts of laws in conflict with this Act are repealed.1527 H. B. 185 - 61 -