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

26 F.4th 1214
Court of Appeals for the Eleventh Circuit·Decided February 18, 2022·No. 19-13070·Published·Cited by 28 cases

Opinion

[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

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 nutritionist , violates her First Amendment free speech rights to communicate her opinions and advice on diet and nutrition to her clients. The district court granted summary judgment for the Florida Department of Health, which enforces the Act, on Del Castillo’s First Amendment free speech claim because, the district court concluded , 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 district court’s summary judgment for the department.

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 California , which did not require her to have a license to operate it. After moving to Florida in 2015, Del Castillo continued to run her business —meeting online with most of her clients and meeting in person 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 Facebook , 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 discussing 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 recommended vitamin supplements to some clients with low energy and told them to consult with their physicians before taking the supplements . For another client with food intolerances, Del Castillo recommended health goals that fit within a list of foods to avoid provided 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 history 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 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. Instead , 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 treatment , 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 counseling 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 behavioral 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 nutrition needs and status using appropriate data; recommending appropriate dietary regimens, nutrition support, and nutrient intake;

19-13070 Opinion of the Court 5

ordering therapeutic diets; improving health status through nutrition research, counseling, and education; and developing, implementing , 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 nutrition 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 Castillo about her services. In response, Del Castillo described her services 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.”

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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. She sought a declaratory judgment that the Act is “unconstitutional to the extent that [it] prohibit[s] [her] and others similarly situated from offering individualized advice about diet and nutrition.” She also requested injunctive relief and attorneys’ fees and costs.

After discovery, both parties moved for summary judgment.

The department argued that the Act was a lawful regulation of the dietetics and nutritionist profession. Because any restriction of Del Castillo’s speech was merely incidental to the regulation of professional conduct, the department maintained, the Act was not subject to First Amendment scrutiny and did not violate Del Castillo’s free speech rights. The department relied on our decision in Locke, which upheld Florida’s licensing scheme for interior designers against a free speech challenge similar to Del Castillo’s challenge in this case because that regulation governed occupational conduct with only an incidental effect on speech.

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

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