SB0204

SENATE BILL 204

57th legislature - STATE OF NEW MEXICO - first session, 2025

INTRODUCED BY

Linda M. Trujillo

AN ACT

RELATING TO HEALTH CARE; ENACTING THE NUTRITION AND DIETETICS PRACTICE ACT; AMENDING A SECTION OF THE NMSA 1978; REPEALING SECTIONS 61-7A-1 THROUGH 61-7A-15 NMSA 1978 (BEING LAWS 1989, CHAPTER 387, SECTIONS 1 THROUGH 15, AS AMENDED).

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:

SECTION 1. [NEW MATERIAL] SHORT TITLE.--Sections 1 through 15 of this act may be cited as the "Nutrition and Dietetics Practice Act".

SECTION 2. [NEW MATERIAL] DEFINITIONS.--As used in the Nutrition and Dietetics Practice Act:

A. "accreditation council" means the accreditation council for education in nutrition and dietetics or the council's successor organization;

B. "advisory board" means the nutrition and dietetics practice advisory board;

C. "commission" means the commission on dietetic registration, or the commission's successor organization;

D. "department" means the regulation and licensing department;

E. "dietetics practice" means the integration and application of scientific principles related to how food and nutrition affect human health. "Dietetics practice" includes treatment in an inpatient or outpatient setting for acute or chronic conditions, requires clinical decision-making skills and involves providing a range of nutrition care services to promote wellness and prevent, manage or treat a disease or medical condition, including:

(1) providing medical nutrition therapy to promote wellness and prevent, manage or treat diseases or medical conditions;

(2) developing and ordering therapeutic diets through oral, enteral or parenteral routes; and

(3) administering other advanced medical nutrition therapy and related support activities consistent with current competencies required of academic and supervised practice programs accredited by the accreditation council and in accordance with the Revised 2024 Scope and Standards of Practice for the Registered Dietitian Nutritionist published by the commission;

F. "dietitian" means a health care practitioner who is licensed to engage in nutrition practice or dietetics practice;

G. "medical nutrition therapy" means a nutrition-based treatment plan developed to help manage or treat or prevent a disease or medical condition and may include:

(1) nutrition assessment;

(2) nutrition diagnosis;

(3) nutrition intervention; and

(4) nutrition monitoring and evaluation;

H. "nutrition care services" means a comprehensive group of services used to design, implement and evaluate nutrition interventions for preventing or treating a disease or medical condition, including:

(1) assessing and evaluating the nutritional needs of individuals or groups and determining resources and constraints in a practice setting;

(2) ordering nutrition-related laboratory tests to check and track the status of those nutrition-related items ordered for testing;

(3) identifying nutrition problems and establishing priorities, goals and objectives to meet nutritional needs in a manner consistent with available resources and constraints;

(4) creating a personalized dietary plan and issuing and implementing orders, which may include therapeutic diets to meet nutrition needs and monitoring the effectiveness of the personalized dietary plan;

(5) determining and providing appropriate nutrition intervention, including nutrition counseling regarding food and prescription drug interactions; and

(6) evaluating, revising and maintaining appropriate standards of quality in food and nutrition services;

I. "nutrition practice" means the integration and application of scientific principles related to how food and nutrition affect human health. "Nutrition practice" requires clinical decision-making skills and consistent with the practitioner's level of competence involves providing a range of nutrition care services to promote wellness and prevent, manage or treat a disease or medical condition; provided that the treatment of chronic conditions may take place only in the outpatient setting. "Nutrition practice" includes:

(1) medical nutrition therapy;

(2) ordering oral therapeutic diets;

(3) ordering medical laboratory tests related to nutritional therapeutic treatments; or

(4) providing recommendations for vitamin, mineral or other dietary supplements;

J. "nutritionist" means a health care practitioner licensed to engage in nutrition practice;

K. "patient" means an individual who is a recipient of care or services provided pursuant to the Nutrition and Dietetics Practice Act;

L. "provisional permit" means a temporary permit to

practice as a dietitian or nutritionist that is issued to a person by the department, is valid for one year and allows the person to practice only under the supervision of a licensed dietitian or licensed nutritionist;

M. "registered dietitian" means a licensed dietitian who is credentialed by the commission as a:

(1) registered dietitian, authorized to use the corresponding abbreviation "R.D."; or

(2) registered dietitian nutritionist, authorized to use the corresponding abbreviation "R.D.N.";

N. "superintendent" means the superintendent of regulation and licensing;

O. "telehealth" means the use of electronic information and telecommunications technologies to provide health care services by a health care practitioner in one location to a recipient of the services in another location; and

P. "therapeutic diet" means a food or nutrient diet intervention provided through oral, enteral or parenteral routes, prescribed by a health care practitioner as part of a treatment to modify, eliminate, decrease or increase identified micronutrients or macronutrients in a patient's diet or to provide mechanically altered food when indicated.

SECTION 3. [NEW MATERIAL] LICENSE REQUIRED--EXEMPTIONS.--

A. Except as provided in Section 4 of the Nutrition and Dietetics Practice Act, a person shall not engage in, or offer to provide, medical nutrition therapy unless the person holds a valid dietitian or nutritionist license in good standing in this state.

B. A person who does not hold a valid dietitian or nutritionist license in good standing in this state shall not:

(1) advertise, present or represent to the public in any manner that the person is licensed or lawfully authorized to practice as a dietitian or nutritionist;

(2) use the title of licensed dietitian or dietitian nutritionist or any other title, abbreviation, letters, figures, signs or devices that indicate or could reasonably indicate to the public that the person is licensed to practice as a dietitian or dietitian nutritionist; or

(3) use the title of licensed nutritionist, nutritionist or any other title, abbreviation, letters, figures, signs or devices that indicate or could reasonably indicate to the public that the person is licensed to practice as a nutritionist.

SECTION 4. [NEW MATERIAL] LICENSING EXEMPTIONS.--It is not a violation of the Nutrition and Dietetics Practice Act for a person who is in compliance with Section 3 of that act and who:

A. is a health care provider in this state to lawfully provide medical nutrition therapy that is within the scope of the health care provider's license;

B. is serving in the armed forces or the United States public health service or employed by the United States department of veterans affairs as a dietitian or nutritionist to provide medical nutrition therapy and to use government-issued titles; provided that medical nutrition therapy provided or the title used by the dietitian or nutritionist is related to the dietitian's or nutritionist's armed forces service or United States department of veterans affairs employment;

C. disseminates non-individualized, written, general non-medical nutrition information in connection with the marketing and distribution of dietary supplements, food, herbs or food materials, including explanations of federally regulated label claims, known drug-nutrient interactions, role in various diets or suggestions for the best use and combinations of uses in a manner that does not constitute medical nutrition therapy pursuant to the Nutrition and Dietetics Practice Act;

D. provides medical weight control services for the treatment of obesity as part of:

(1) an instructional program approved in writing by at least one of the following:

(a) a licensed dietitian or licensed nutritionist in this state; or

(b) a health care provider licensed in this state whose authorized scope of practice includes medical nutrition therapy; or

(2) a plan of care that is overseen by a health care provider licensed in this state whose scope of practice authorizes the health care provider to provide medical nutrition therapy or to delegate the provision of medical nutrition therapy services to a delegated person; provided that the medical nutrition therapy services delegated are not discretionary on the part of the delegated person and do not require the exercise of professional judgment by the delegated person;

E. is delegated to assist in providing medical nutrition therapy services if the delegated person performs only support activities that are not at the delegated person's discretion and do not require the delegated person's exercise of professional judgment and the delegated person is directly supervised by a licensed dietitian, licensed nutritionist or licensed health care provider acting within the scope of the licensee's license;

F. is a student, intern or trainee of an approved or accredited dietetics or nutrition education or training program and who engages in nutrition or dietetics practice activities under the supervision of a licensed dietitian or licensed nutritionist as a part of an approved or accredited education or training program for the duration of participation in that program;

G. is recognized in the person's community as a curandero or medicine man and who advises or ministers to various community members according to traditional community practices;

H. is employed by, or under contract with, an agency of this state or an agency of a county, municipality or political subdivision of this state for the purposes of providing nutrition care services for the women, infants and children program administered by the department of health and is authorized within the discharge of that person's official duties to use the title "nutritionist"; or

I. provides individualized nutrition recommendations for wellness and the prevention of chronic disease, health coaching, holistic and wellness education, guidance, motivation, behavior change management, services for non-medical weight control or other nutrition care services; provided that the services do not constitute medical nutrition therapy.

SECTION 5. [NEW MATERIAL] ADVISORY BOARD CREATED.--

A. The superintendent shall appoint a "nutrition and dietetics practice advisory board" that is administratively attached to the department. The advisory board consists of three members who are New Mexico residents and who are appointed for staggered three-year terms. One member shall be a licensed dietitian with at least three years of dietetics practice in this state, one member shall be a nutritionist licensed in this state and one member shall be a health care provider licensed in this state.

B. An advisory board member shall not serve more than two full terms. Each advisory board member shall hold office until the expiration of the term for which the member is appointed or until a successor has been appointed. A vacancy shall be filled for the balance of the unexpired term within ninety days of the vacancy through appointment by the superintendent.

C. The advisory board shall elect biennially a chair and such other officers as appropriate to administer its duties. The advisory board shall meet at least once a year and at such other times as deemed necessary by the superintendent. Meetings shall be called by the superintendent or upon the written request of two advisory board members. Two members constitutes a quorum. A member failing to attend, after proper notice, two consecutive meetings shall automatically be removed as an advisory board member.

D. The members of the advisory board shall be reimbursed as provided for nonsalaried public officers pursuant to the Per Diem and Mileage Act and shall receive no other compensation, perquisite or allowance.

SECTION 6. [NEW MATERIAL] DEPARTMENT--DUTIES AND POWERS--RULE PROMULGATION.--In carrying out the department's duties, the superintendent may consult with the advisory board or delegate certain authority to the advisory board regarding matters deemed appropriate by the superintendent. The department, including department staff as directed by the superintendent, shall:

A. prescribe and provide for the administration of appropriate licensing examinations for qualified applicants;

B. evaluate the qualifications of applicants for licensure under the Nutrition and Dietetics Practice Act;

C. issue licenses to applicants who meet the requirements of the Nutrition and Dietetics Practice Act;

D. investigate persons engaging in practices that may violate the provisions of the Nutrition and Dietetics Practice Act;

E. revoke, suspend or deny a license in accordance with the provisions of the Uniform Licensing Act;

F. adopt an annual budget; and

G. adopt and file in accordance with the State Rules Act rules necessary to carry out the provisions of the Nutrition and Dietetics Practice Act; provided that no rule may be adopted, amended or repealed without approval by the superintendent.

SECTION 7. [NEW MATERIAL] LICENSURE--REQUIREMENTS--QUALIFIED SUPERVISOR--TERM OF LICENSE.--

A. As used in this section:

(1) "qualified supervisor" means an individual providing supervision of a supervisee; and

(2) "supervisee" means a student, intern or trainee for whom a qualified supervisor assumes full professional responsibility by verifying, directing and approving that supervisee's provision of nutrition care services, medical nutrition therapy or other supervised activities.

B. The department shall issue a dietitian license to an applicant who files a completed dietitian license application, pays all required fees and certifies and furnishes evidence satisfactory to the department:

(1) that the applicant has a valid current registration with the commission that gives the applicant the right to use the term "registered dietitian" or "R.D."; or

(2) that the applicant has:

(a) a master's degree or doctoral degree from a college or university accredited at the time of the applicant's graduation by a United States institutional accrediting body for higher education recognized by the United States department of education or the foreign equivalent and a program of study accredited by the accreditation council for education in nutrition and dietetics;

(b) completed a planned, documented and supervised practice experience in dietetics practice and nutrition practice that is approved by the department and accredited by the accreditation council and that includes at least one thousand hours of supervised practice experience under the supervision of a qualified supervisor. A supervised practice experience under this subsection shall be completed by the applicant within five years of completing the requirements under Subparagraph (a) of this paragraph unless the department, for extraordinary circumstances, grants an extension for a limited time; and

C. The department shall issue a nutritionist license to an applicant who files a completed nutritionist license application, pays all required fees and certifies and furnishes evidence satisfactory to the department that the applicant has:

(1) a master's degree or doctorate in human nutrition, nutrition education, foods and nutrition or public health nutrition from a college or university accredited at the time of the applicant's graduation by a United States institutional accrediting body for higher education recognized by the United States department of education or a doctoral degree or validated foreign equivalent in a field of clinical health care from a college or university accredited at the time of the applicant's graduation by a United States institutional accrediting body for higher education recognized by the United States department of education. Regardless of the applicant's course of study, the applicant shall have completed course work leading to competence in medical nutrition therapy that includes:

(a) fifteen semester hours of clinical or life sciences, three semester hours of which shall be in human anatomy and physiology or the equivalent; and

(b) fifteen semester hours of nutrition and metabolism, six semester hours of which shall be in biochemistry;

(2) completed a planned, documented and continuous supervised practice experience under the supervision of a qualified supervisor demonstrating competence in nutrition practice, including the provision of medical nutrition therapy approved by the department and meeting the following requirements:

(a) a supervised practice experience completed pursuant to this subsection that shall include at least one thousand hours, with a minimum of two hundred hours in nutrition assessment, nutrition intervention and nutrition monitoring and evaluation; and

(b) the practice experience is determined by the department to have prepared the applicant to provide nutrition care services for various populations of diverse cultures and genders and across the life cycle and to be able to competently formulate actionable medical nutrition therapies and interventions, education, counseling and ongoing care for the prevention, modulation and management of a range of chronic medical conditions; and

(3) completed examination requirements by demonstrating:

(a) passage of the certified nutrition specialist examination approved by the department and administered by the board for certification of nutrition specialists or its successor organization;

(b) passage of an examination on all aspects of nutrition practice that has been reviewed under a program that requires a master's degree or higher, is accredited by the national commission for certifying agencies and is approved by the department; or

(c) the applicant holds a valid current certification with the board for certification of nutrition specialists or the board's successor organization that gives the applicant the right to use the title "certified nutrition specialist".

D. Each qualified supervisor shall:

(1) be licensed in this state when supervising a supervisee who is providing medical nutrition therapy services to a patient in this state, unless the person supervising a supervisee is an employee of the federal government authorized within the discharge of the employee's official duties to provide medical nutrition therapy;

(2) only supervise a clinical activity or nutrition care service that the qualified supervisor is authorized to perform;

(3) oversee the activities of and approve and accept responsibility for the nutrition care services rendered by a supervisee;

(4) review on a regular basis the charts, records and clinical notes of each supervisee and maintain responsibility for each supervisee's clinical recordkeeping;

(5) render assistance during a supervisee's provision of nutrition care services when requested by the patient or arrange for another qualified practitioner who is lawfully able to render the nutrition care services in the qualified supervisor's absence; and

(6) develop and carry out a program for advancing and optimizing the quality of care provided by a supervisee by:

(a) together with the supervisee, identifying and documenting goals for the supervisee's practice experience;

(b) assigning the supervisee clinical tasks as appropriate based on the supervisee's level of competence;

(c) determining the supervisee's methods of communication or interaction with, and access to, the qualified supervisor; and

(d) establishing a process for evaluating the supervisee's performance.

E. A valid license issued pursuant to the Nutrition and Dietetics Practice Act shall be displayed at the licensee's place of employment.

F. A license issued pursuant to the Nutrition and Dietetics Practice Act shall be issued for a period of two years.

SECTION 8. [NEW MATERIAL] EXPEDITED LICENSURE.--

A. The department shall issue an expedited license as a dietitian or nutritionist to an applicant who presents a valid, unrestricted license as a dietitian or nutritionist in another licensing jurisdiction and is in good standing with the licensing entity of that licensing jurisdiction. The department shall, as soon as practicable but no later than thirty days after an out-of-state licensee files an application for an expedited license accompanied by the required fees, process the application and issue the expedited license in accordance with Section 61-1-31.1 NMSA 1978.

B. The department may require a licensee whose license is obtained pursuant to this section to pass a department-approved examination to continue to be licensed in New Mexico.

C. The department shall determine by rule the other states and territories of the United States and the District of Columbia from which it will not accept applicants for expedited licensure and the foreign countries from which it will accept applicants for expedited licensure. The department shall post the list of disapproved and approved licensing jurisdictions on the department's website. The list of disapproved licensing jurisdictions shall include the specific reasons for disapproval. The lists shall be reviewed annually to determine if amendments to the rule are warranted.

SECTION 9. [NEW MATERIAL] PROVISIONAL PERMIT.--A provisional permit to practice as a dietitian or nutritionist may be issued by the department upon the filing of an application and submission of evidence of successful completion of the education and supervised practice requirements and an application to take a licensing examination recognized under the Nutrition and Dietetics Practice Act. No fee in addition to the application and license fees shall be charged for the issuance of a provisional permit. The permit shall be valid for up to one year or until the person holding the provisional permit's application for licensure is approved and a license issued, whichever is first. A provisionally licensed dietitian shall only practice under a licensed dietitian, and a provisionally licensed nutritionist shall only practice under either a licensed dietitian or licensed nutritionist.

SECTION 10. [NEW MATERIAL] LICENSE RENEWAL--CONTINUING EDUCATION REQUIREMENTS.--

A. A person licensed under the Nutrition and Dietetics Practice Act shall renew that person's license biennially on or before the expiration date of the initial or renewal license.

B. The department shall issue a renewal license to the licensee upon receipt of the renewal application, the renewal fee and proof satisfactory to the department of compliance with continuing education requirements.

C. Continuing education requirements for licensees shall be established by the department; provided that:

(1) for licensed dietitians, the requirements shall be those established by the commission; and

(2) for licensed nutritionists, at least seventy-five clock hours, or the equivalent, during a five-year period shall be required to be obtained in increments of fifteen clock hours annually or as otherwise approved by the department.

D. A person who fails to renew that person's license within thirty days of expiration may be reinstated by the department and issued a renewal license upon submission of a renewal application with proof satisfactory to the department of that person's compliance with the continuing education and other requirements of the Nutrition and Dietetics Practice Act and payment of the biannual renewal fee and an additional reinstatement fee.

SECTION 11. [NEW MATERIAL] FEES.--

A. Except as provided in Section 61-1-34 NMSA 1978, the department shall establish a schedule of reasonable fees for licenses and renewal of licenses. Fees are non-refundable and shall be established based on processing requirements for each category.

B. The initial license fee shall be set in an amount not to exceed three hundred dollars ($300).

C. A license renewal fee shall be established in an amount not to exceed three hundred dollars ($300).

D. A license reinstatement fee shall be established in an amount not to exceed fifty dollars ($50.00).

SECTION 12. [NEW MATERIAL] NUTRITION AND DIETETICS FUND CREATED--DISPOSITION--METHOD OF PAYMENT.--

A. There is created in the state treasury the "nutrition and dietetics fund" to be administered by the department.

B. All money transferred to, pursuant to Section 18 of this 2025 act, received or collected by the department under that act shall be deposited with the state treasurer, who shall place the money to the credit of the nutrition and dietetics fund. Any balance in the fund at the end of a fiscal year shall not revert to the general fund.

C. Money in the nutrition and dietetics fund shall be appropriated by the legislature to the department for the purpose of implementing and administering the provisions of the Nutrition and Dietetics Practice Act.

D. Disbursements from the nutrition and dietetics fund shall be pursuant to vouchers issued and signed by the superintendent upon warrants signed by the secretary of finance and administration.

SECTION 13. [NEW MATERIAL] LICENSE--DENIAL--SUSPENSION--REVOCATION--REINSTATEMENT.--

A. The department may refuse to issue or renew or may deny, suspend or revoke a license held or applied for under the Nutrition and Dietetics Practice Act in accordance with the procedures set forth in the Uniform Licensing Act upon grounds that the licensee or applicant:

(1) is guilty of fraud or misrepresentation in the procurement of a license under the Nutrition and Dietetics Practice Act;

(2) is subject to the imposition of disciplinary action by an agency of another state that regulates dietitians or nutritionists but not to exceed the period or extent of that action;

(3) is convicted of a crime:

(a) directly related to the duties and responsibilities of a dietitian or nutritionist;

(b) that was violent or sexual in nature; or

(c) for which the licensee or applicant entered a plea of guilty or nolo contendere. The record of conviction or a certified copy of it shall be conclusive evidence of the conviction;

(4) is grossly negligent or incompetent in the practice as a dietitian or nutritionist;

(5) has failed to fulfill continuing education requirements; or

(6) has violated or aided or abetted any person to violate a provision of the Nutrition and Dietetics Practice Act or a rule promulgated pursuant to that act.

B. One year from the date of revocation of a license under the Nutrition and Dietetics Practice Act, application may be made to the department for restoration of the license. The department shall provide by rule for the criteria governing application and examination for restoration of a revoked license.

SECTION 14. [NEW MATERIAL] PENALTY--ENFORCEMENT.--

A. Violation of any provision of the Nutrition and Dietetics Practice Act is a misdemeanor.

B. The department may bring a civil action in any district court to enforce the provisions of the Nutrition and Dietetics Practice Act.

SECTION 15. [NEW MATERIAL] TERMINATION OF AGENCY LIFE--DELAYED REPEAL.--The nutrition and dietetics practice advisory board is terminated on July 1, 2031 pursuant to the Sunset Act. The board shall continue to operate according to the provisions of the Nutrition and Dietetics Practice Act until July 1, 2032. Effective July 1, 2032, the Nutrition and Dietetics Practice Act is repealed.

SECTION 16. Section 24-25-3 NMSA 1978 (being Laws 2004, Chapter 48, Section 3, as amended) is amended to read:

"24-25-3. DEFINITIONS.--As used in the New Mexico Telehealth Act:

A. "health care provider" means a person licensed to provide health care to patients in New Mexico, including:

(1) an optometrist;

(2) a chiropractic physician;

(3) a dentist;

(4) a physician;

(5) a [podiatrist] podiatric physician;

(6) an osteopathic physician;

(7) a physician assistant;

(8) a certified nurse practitioner;

(9) a physical therapist;

(10) an occupational therapist;

(11) a speech-language pathologist;

(12) a doctor of oriental medicine;

(13) a nutritionist;

(14) a psychologist;

(15) a certified nurse-midwife;

(16) a clinical nurse specialist;

(17) a registered nurse;

(18) a dental hygienist;

(19) a pharmacist;

(20) a licensed independent social worker;

(21) a licensed counselor;

(22) a community health representative; [or]

(23) a licensed athletic trainer; or

(24) a dietitian;

B. "originating site" means a place where a patient may receive health care via telehealth. An originating site may include:

(1) a licensed inpatient center;

(2) an ambulatory surgical or treatment center;

(3) a skilled nursing center;

(4) a residential treatment center;

(5) a home health agency;

(6) a diagnostic laboratory or imaging center;

(7) an assisted living center;

(8) a school-based health program;

(9) a mobile clinic;

(10) a mental health clinic;

(11) a rehabilitation or other therapeutic health setting;

(12) the patient's residence;

(13) a federally qualified health center; or

(14) a community health center; and

C. "telehealth" means the use of electronic information, imaging and communication technologies, including interactive audio, video, data communications as well as store-and-forward technologies, to provide and support health care delivery, diagnosis, consultation, treatment, transfer of medical data and education."

SECTION 17. TEMPORARY PROVISION--LICENSE STATUS.--A person who is:

A. licensed as a dietitian under the Nutrition and Dietetics Practice Act on the effective date of this act shall remain licensed as a licensed dietitian until the expiration of the license without meeting any additional requirements;

B. licensed as a nutritionist under the Nutrition and Dietetics Practice Act on the effective date of this act shall remain licensed as a licensed nutritionist until the expiration of the license without meeting any additional requirements; and

C. licensed as a dietitian with a registered dietitian credential under the Nutrition and Dietetics Practice Act on the effective date of this act shall remain licensed as a dietitian with a registered dietitian credential until the expiration of the license without meeting any additional requirements.

SECTION 18. TEMPORARY PROVISION--TRANSFER OF FUND, FUNCTIONS, PERSONNEL, PROPERTY, CONTRACTS, RULES AND REFERENCES IN LAW.--On July 1, 2025:

A. the nutrition and dietetics fund, including all money in that fund, and all other funds, functions, personnel, appropriations, money, records, furniture, equipment, supplies and other property of the nutrition and dietetics practice board shall be transferred to the regulation and licensing department;

B. all contracts of the nutrition and dietetics practice board and rules adopted by that board shall be binding on the regulation and licensing department; and

C. all references in law to the nutrition and dietetics practice board shall be deemed to be references to the regulation and licensing department.

SECTION 19. REPEAL.--Sections 61-7A-1 through 61-7A-15 NMSA 1978 (being Laws 1989, Chapter 387, Sections 1 through 15, as amended) are repealed.

SECTION 20. EFFECTIVE DATE.--The effective date of the provisions of this act is July 1, 2025.

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