Heather Kokesch Del Castillo v. Secretary, Florida Department of Health

26 F.4th 1214
CourtCourt of Appeals for the Eleventh Circuit
DecidedFebruary 18, 2022
Docket19-13070
StatusPublished
Cited by28 cases

This text of 26 F.4th 1214 (Heather Kokesch Del Castillo v. Secretary, Florida Department of Health) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eleventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Heather Kokesch Del Castillo v. Secretary, Florida Department of Health, 26 F.4th 1214 (11th Cir. 2022).

Opinion

USCA11 Case: 19-13070 Date Filed: 02/18/2022 Page: 1 of 26

[PUBLISH] In the United States Court of Appeals For the Eleventh Circuit

____________________

No. 19-13070 ____________________

HEATHER KOKESCH DEL CASTILLO, Plaintiff-Appellant, versus SECRETARY, FLORIDA DEPARTMENT OF HEALTH,

Defendant-Appellee.

Appeal from the United States District Court for the Northern District of Florida D.C. Docket No. 3:17-cv-00722-MCR-HTC ____________________ USCA11 Case: 19-13070 Date Filed: 02/18/2022 Page: 2 of 26

2 Opinion of the Court 19-13070

Before BRANCH, LUCK, and ED CARNES, Circuit Judges. LUCK, Circuit Judge: Heather Kokesch Del Castillo, an unlicensed dietician and nutritionist, claims that Florida’s Dietetics and Nutrition Practice Act, which requires a license to practice as a dietician or nutrition- ist, violates her First Amendment free speech rights to communi- cate her opinions and advice on diet and nutrition to her clients. The district court granted summary judgment for the Florida De- partment of Health, which enforces the Act, on Del Castillo’s First Amendment free speech claim because, the district court con- cluded, it was bound by our decision in Locke v. Shore, 634 F.3d 1185 (11th Cir. 2011). Locke held that a similar state licensing scheme for commercial interior designers did not violate the free speech rights of unlicensed interior designers. Del Castillo argues that the district court erred, and we are not bound by Locke, because Locke was abrogated by the Supreme Court’s decision in National Institute of Family & Life Advocates v. Becerra, 138 S. Ct. 2361 (2018). So the narrow question for us is whether Locke is still good law after NIFLA. After reviewing what we said in Locke, what the Supreme Court said in NIFLA, and our prior panel precedent rule, we hold that it is. And because Locke is still good law, we conclude that we are bound to affirm the dis- trict court’s summary judgment for the department. USCA11 Case: 19-13070 Date Filed: 02/18/2022 Page: 3 of 26

19-13070 Opinion of the Court 3

FACTUAL BACKGROUND Del Castillo owned and operated a health-coaching business called Constitution Nutrition. She started her business in Califor- nia, which did not require her to have a license to operate it. After moving to Florida in 2015, Del Castillo continued to run her busi- ness—meeting online with most of her clients and meeting in per- son with two clients who lived in Florida. She described herself as a “holistic health coach” and not as a dietician. Del Castillo tailored her health coaching to each client, which included dietary advice. She advertised her business in a local health magazine, on Face- book, and on flyers at a local gym. Del Castillo’s business focused on “[o]ne-on-one health coaching,” which she described as “meeting with clients and dis- cussing overall health and wellness, as well as goal setting.” She gave them tailored advice on dietary choices, exercise habits, and general lifestyle strategies. For example, Del Castillo recom- mended vitamin supplements to some clients with low energy and told them to consult with their physicians before taking the supple- ments. For another client with food intolerances, Del Castillo rec- ommended health goals that fit within a list of foods to avoid pro- vided by the client’s doctor. Before her initial consultation with a new client, Del Castillo would ask them to fill out a “health history form.” The health his- tory form sought general background information about the client, like his or her age and occupation, as well as particulars about the client’s dietary health, including past serious illness or recent USCA11 Case: 19-13070 Date Filed: 02/18/2022 Page: 4 of 26

4 Opinion of the Court 19-13070

weight change. Del Castillo used this form to get an overall picture of her client’s health but did not make medical conclusions. In- stead, she would recommend that a client consult a doctor if the client had experienced something unusual like drastic weight loss. Del Castillo never held herself out to her clients as a health care professional, never gave a diagnosis or provided medical treat- ment, and never gave advice contrary to physician advice. Del Castillo had a certificate in holistic health coaching that she received from an online school. But she did not have a Florida dietician or nutritionist license. Del Castillo was not qualified to receive a license because she lacked the necessary education and professional experience. Del Castillo’s lack of a license eventually became a problem for her business. Florida regulates dietetics and nutrition counsel- ing through the Dietetics and Nutrition Practice Act. Fla. Stat. §§ 468.501–.518. The Act defines “[d]ietetics” as “the integration and application of the principles derived from the sciences of nutrition, biochemistry, food, physiology, and management and from the be- havioral and social sciences to achieve and maintain a person’s health throughout the person’s life.” Id. § 468.503(4). It defines “[n]utrition counseling” as “advising and assisting individuals or groups on appropriate nutrition intake by integrating information from the nutrition assessment.” Id. § 468.503(10). The Act provides that “[d]ietetics and nutrition practice” “include[s] assessing nutri- tion needs and status using appropriate data; recommending ap- propriate dietary regimens, nutrition support, and nutrient intake; USCA11 Case: 19-13070 Date Filed: 02/18/2022 Page: 5 of 26

19-13070 Opinion of the Court 5

ordering therapeutic diets; improving health status through nutri- tion research, counseling, and education; and developing, imple- menting, and managing nutrition care systems.” Id. § 468.503(5). And, relevant to this appeal, the Act provides that “[n]o person may engage for remuneration in dietetics and nutrition practice or nu- trition counseling or hold himself or herself out as a practitioner of dietetics and nutrition practice or nutrition counseling unless the person is licensed in accordance with the provisions of this part.” Id. § 468.504. Under the Act, a person who knowingly engages in unlicensed “dietetics and nutrition practice or nutrition counseling for remuneration” commits “a misdemeanor of the first degree.” Id. § 468.517(1), (2). In March 2017, a licensed dietician filed a complaint against Del Castillo with the Florida Department of Health, alleging that Del Castillo was violating the Act by providing nutritionist services without a license. The department’s practice was to investigate every complaint, so it opened an investigation into Del Castillo. A department investigator posed as a client and contacted Del Cas- tillo about her services. In response, Del Castillo described her ser- vices and provided the investigator with a health history form to fill out. The department concluded that Del Castillo was violating the Act and, in May 2017, sent her a citation and a cease-and-desist order. Del Castillo paid the department $500.00 in fines and $254.09 in investigatory fees for “providing individualized dietary advice in exchange for compensation in Florida.” USCA11 Case: 19-13070 Date Filed: 02/18/2022 Page: 6 of 26

6 Opinion of the Court 19-13070

PROCEDURAL HISTORY Del Castillo brought a 42 U.S.C. section 1983 action against the department, claiming that the Act, as applied to her, violated her First Amendment free speech rights.

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