Indiana State Licensure

History and Background:

Indiana is currently one of many states that does not require licensure to provide

nutrition counseling or advice within the state. A nutritionist working in Indiana may

engage in a wide variety of nutrition-related services without certification(6). Titles such

as Registered Dietitian and Nutritionist seem to be the same but in reality, they are very

different from one another. A Registered Dietitian is an individual who has graduated

from an ACEND accredited university with a bachelors degree , has completed

approximately 1200 hours of a supervised practice internship, and sat for the

Commission on Dietetic Registration state examination. Once this test is passed,

individual states requirements for licensure or certification vary among different states.

Someone who provides their nutritional knowledge to a client and has not met these

requirements, as stated above, can be labeled as a nutritionist. Unlike a Registered

Dietitian, a Nutritionist is not regulated by an certifying body or state agency, there are

no prescribed educational mandates for the procession(5).

Since approximately 2011, the Academy of Nutrition and Dietetics has been

making efforts for a revision of licensure. In Indiana particularly, an additional license

is not legally required to practice as a Dietitian, however, a state certification of

dietitian,can be applied for. Currently, both a Registered Dietitian as well as a

Nutritionist can assess, counsel, and educate patients.(5). According to a statement

from the Academy of Nutrition and Dietetics House of Delegates Backgrounder,

(Having) licensure benefits the public by establishing standards for public awareness

on health provider standards and services (2).

Current Legislative and/or Regulatory Initiatives:

The state of Indiana Instructions and Application for Certification states, You

may practice dietetics / nutrition therapy services without state certification but cannot

call yourself a "Certified Dietitian" unless you are certified with this state. A dietitian

registered by the commission on dietetic registration may use the title Registered

Dietitian and the designation RD but may not profess to be a certified dietitian without

being certified by the Board (4). So what does this mean The existing law is a

Licensure Without Exclusive Scope of Practice. This law certifies Dietitians only; there

is no certification available for nutritionists. Certification gives you the right to use the

title Certified Dietitian." However, there is no certification requirement for providing

nutrition care. Although there are no practicing restrictions in this state, it is highly likely

that only those individuals who qualify for certification are eligible for insurance

reimbursement when there is insurance coverage available for nutrition services (3)

To some, this change in the law seems ridiculous and to others it seems to make

perfect sense. Those opposing this new regulation believe that Dietitians lack

preparation to delivery wellness and nutrition care outside of the hospital setting,

licensure creates a monopoly and restricts freedom of choice of provider by the public,

licensure creates job loss for non-RDs providers (such alternative providers),and

licensure requires those who practice to be members of ADA (AND) (2). With the

activation of this new licensure law, many other professionals would have to refer to the

Dietitian for patient nutritional therapy consults that may be out of their scope of practice
these include a massage therapist, health coach, and an athletic trainer just to name a

few.

The Academy of Nutrition and Dietetics has made their stance clear and has

taken the time to provide an explanation for those who are in doubt and question this

new regulation:

Licensing of dietitians and nutritionists protects the public health by establishing

minimum educational and experience criteria for those individuals who hold

themselves out to be experts in food and nutrition. The state has an obligation to

protect the health and safety of the public and licensing of dietitians and

nutritionists is consistent with this obligation... The public deserves to know that

the information being given by "experts" is based on science and is being given

by individuals with appropriate education and experience...Licensure would not

affect anyone that simply describes the nutritional value of products nor would it

affect other healthcare professionals. It would, however, provide recourse for

victims of unqualified and unscrupulous individuals dispensing improper

advice(1).

The take away from adding a state regulated licensure act, it would become illegal for

unqualified individuals to perform nutritional counseling without being licensed or

exempt (3).

Development of a Position:

As one who has spent the last several years preparing myself to enter this

profession I feel as if I pose somewhat of a bias. However, since I am not yet a

Registered Dietitian or currently receiving an income from this profession, I have tried

to see both sides of this argument. From my understanding licensure will not totally

prohibit those other than Registered Dietitians from provided nutrition information but

will prohibit those from providing individual nutrition therapy/counseling. All too often I

see unqualified individuals providing improper nutritional information without

acknowledging the client's past medical history or using science based evidence for

their recommendations. Upon receiving my Bachelor of Science in Nutrition and

Dietetics, I realised that even after a vigorous four years of study, I still had so much to

learn. Nutrition and the human body is a science, one that can not be learned overnight.

This proposed licensure regulation does not stop a Wellness Shop retailer from

assisting its consumers however it will provide recourse for victims of unqualified and

unscrupulous individuals dispensing improper advice (1).

One must agree that this will not be an easy change to make and will probably

not put a screeching halt to those unqualified individuals from providing nutrition

counseling but it is a step in the right direction. As I complete my 1200 hours of a

supervised practice internship, sit and pass for the Commission on Dietetic Registration

state examination and apply for a job as a Registered Dietitian within this workforce I

will continue to be an activist for this profession and the initiation of this proposed

licensure. It is an individual's choice who they receive health care information from...but

wouldnt you choose a Licensed Dietitian Nutritionist?

Communication of Recommendations to Policy Maker:

 I reached out to Darren R. Covington, J.D., Board Director of the Indiana Professional

Licensing Agency who specially deals with the I ndiana Dietitians Certification Board and he did

not know what I was talking about. Secondly, I found an email on EatRight.org to their House

of Delegates, of which I cited within this paper, and asked them the status of Indianas

Liscensing legislature. So far I have heard nothing.

 Resources:

1. Academy of Nutrition and Dietetics. (n.d.). Questions and Answers on the

Regulation of Dietetics Practice. Retrieved February 07, 2017, from
http://www.eatrightpro.org/resource/advocacy/quality-health-care/consumer-protecti
on-and-licensure/questions-and-answers-on-the-regulation-of-dietetics-practice

2. House of Delegates. (2011). Licensure HOD Backgrounder. Retrieved February 2,

2017, from
https://www.ftc.gov/system/files/documents/public_comments/2014/03/00012-8880
1.pdf

3. Indiana-Nutrition Advocacy. (2017). Retrieved February 07, 2017, from

http://nutritionadvocacy.org/indiana

4. Indiana Professional Licensing Agency. (n.d.). Retrieved February 07, 2017, from
http://www.in.gov/pla/2412.htm

5. Nutritionist Career Overview. (2017). Retrieved February 06, 2017, from

http://www.nutritioned.org/nutritionist.html

6. Nutrition State Law Disclosures. (2017). Retrieved February 06, 2017, from
https://www.achs.edu/nutrition-state-law-disclosures