An Update from the Academy of Nutrition and Dietetics on Florida Licensure Case

11/9/2021 – This is an update for all nutrition and dietetics practitioners about the Academy's ongoing initiatives related to the long-awaited decision by the 11th U.S. Circuit Court of Appeals whether an unlicensed individual’s desire to provide medical counseling implicates free speech rights that override the state of Florida’s ability to require health care professionals to be licensed before practicing. The court’s decision on the lawsuit Kokesch Del Castillo v. Secretary, Florida Department of Health is expected at any time. The Academy is not a party in the lawsuit.

The Academy’s position remains consistent: Medical nutrition therapy and other complex nutrition and dietetics services should only be provided by qualified individuals with the specialized education and training of RDNs or, at minimum, meet state licensure standards. The Academy continues to advocate for these regulatory policies that protect consumers and ensure patients can trust that their health care services are provided by qualified practitioners.

The Academy believes the constitutional challenge to Florida’s Dietetics and Nutrition Practice Act brought in the lawsuit has the potential to negatively affect licensure and practice requirements for health care professions in Florida and elsewhere. As we have noted, this lawsuit was filed by a public-interest law firm ideologically opposed to licensure for all professionals. The plaintiff, who markets herself as a health coach, sought to provide MNT without either a license or the qualifications needed to obtain one, arguing that the license requirement violated her First Amendment right to free speech without government interference.

This novel and flawed theory relies upon a refusal to acknowledge that nutrition counseling, which involves speech within a patient-counselor relationship, is part of the practice of dietetics and therefore differs from routine, non-individualized advice that might be given in books or grocery stores. A decision in the plaintiff’s favor would hinder states' ability to regulate any largely verbal element of health care practice, including telehealth, patient counseling, and any other patient encounter conducted without specific physical contact. Such a radical interpretation threatens to revoke consumer protections provided by health professions’ licensure laws and must be rejected. Note, however, that the pending court decision is only a step in the litigation process and merely answers whether the plaintiff is able to continue her lawsuit; regardless of the outcome, many more steps likely remain before any ultimate determination is made that affects dietetics licensure in Florida.

When the court’s decision is announced, the Academy will send another communication outlining expected next steps, including any anticipated appeals by either side.

Please know the Academy will continue its steadfast advocacy for strong licensure laws that protect the public by ensuring nutrition care is provided by knowledgeable, credentialed experts like you.

To read more about this court case, please see previous updates from the Academy in July and September 2020.