Re: Digest Number 645

May 20, 2006

Hello Colleagues,

Niki asked " I am curious if you are aware of the bill being drafted

to license IBCLCs in Texas. "

I am on the ILCA Licensure Taskforce and the Chair of the Licensure

Committee for the Pennsylvania Breastfeeding Coalition. The licensure issue

is separate from the USILCA development, but having a US Affiliate will make

it simpler to endorse licensure efforts. Those of us on the taskforce

believe licensure is needed in the US, but may not be a desired step or

necessary in other coutnries.

The ILCA Licensure Taskforce was started in November 05 and is just

beginning work. Our stated objectives are to:

-Explore and identify a strategy or process for achieving licensure

-Develop a cost estimate for the strategy/process

-Develop a resource/action kit to help state affiliates with this issue

-Determine the status of having IBCLC declared as a health profession by

the US Bureau of health Professions

-Contacting the Centers for Medicare and Medicaid to establish the IBCLC as

an accepted provider under Medicaid

-Contacting the American Medical Association and developing CPT codes for

lactation care and services

-Checking on the status of the alpha codes for allied health providers

Licensure can achieved on a state by state basis with substantial in-person

lobbying

All we need to do is get one of these bills passed and a precedent is set.

Texas and Massachusetts are leading in progress, below is a summary of the

current status of states:

Massachusetts – Marsha

We have a senate bill (second time around!) to license the IBCLC lactation

consultant. It was reported out favorably by the Joint Health Committee and

is now in the Health Care Financing Committee. We are approaching licensing

here because our state department of public health, hospitals, and insurers

recognize licensed health care professionals when writing policy,

determining staffing regulations, and determining reimbursement eligibility.

TEXAS – Barbara Clay

SOUGHT LICENSURE IN 1997 RE VIEWED 2001

Seeking title protection (rather than practice protection.) Currently a

drafting language for a bill to be introduced next session.

Georgia- Arlene Toole

I have contacted several legislators to get their feedback. Seeking a

sponsor.

Kansas- Jan Riordan

Applying for licensure for a new profession in KS is called “credentialing”.

Kansas has two main Regulatory Boards: the Board of Healing Arts (medicine,

dentistry, etc) and the Board of Nursing (RNs, LPNs, ARNPs)

In discussing lactation consulting with the state staff, it appears that our

profession would be placed under Kansas State Department of Health and

Environment, Health Occupation Credentialing as the regulatory body.

Getting a separate board would be next to impossible

Briefly, this is how it works:

A request for credentialing is made to the Kansas State Department of Health

and Environment, Health Occupations. The request must include rationale for

why credentialing is needed and the criterion. The application looks

extensive.

The process takes about two years. I noted that it costs $1000 to submit the

application.

I will be attending a legislative meeting in the State Capitol in February

and will pursue more info then.

North Carolina (Ann Calandro)

Tennessee (Marcie Singleton)

Beginning to investigate.

VERMONT Kirsten Berggren, PhD

Below is the text of the bill as introduced:

Subject: Health; professions; lactation consultants; sunrise review

Statement of purpose: This bill proposes to direct the office of

professional regulation to make a preliminary assessment of whether and at

what level a licensing program for lactation consultants should be

established and regulated.

AN ACT RELATING TO LACTATION CONSULTANTS

It is hereby enacted by the General Assembly of the State of Vermont:

Sec. 1. OFFICE OF PROFESSIONAL REGULATION; SUNRISE REVIEW;

LACTATION CONSULTANTS

The office of professional regulation shall make a preliminary assessment,

pursuant to 26 V.S.A. § 3105(d), of whether and at what level lactation

consultants should be regulated. The office shall file a report of this

assessment with the general assembly by January 1, 2007.

Louisiana Zeretzke

Licensure falls under the Department of Health and Hospitals (DHH) in They

try to avoid creating new boards so their first effort always is to create a

sub-licensure category for an existing board.

The lobbyist who has helped us get all of the bf bills passed here told me

that DHH would likely try to give such a responsibility to the Board of

Nursing here.

And may I add that health care is in such turmoil here after the hurricanes,

I'm not sure what would happen just now if we pursued this.

PENNSYLVANIA Judy Gutowski

Recently, I met again with my state Senator and reviewed possible avenues

for legislative support in PA. He is a freshman Senator. He has not been

successful garnering support on his own to move this along. He is

collaborating with a Senator who is working on other breastfeeding

legislation and they agreed to work together. They haven't decided the best

way politically to move forward yet.

I gave a presentation to the Western PA LC Association (WPLCA) PA

Breastfeeding

Coalition (PABC). The PABC agreed to support licensure efforts and I was

officially made chair of the committee. Mulford is the chair of the

Public Policy committee for this Coalition and is on the committee with me.

and I had a teleconference with a professional lobbying firm.

They are looking at how they can possibly help us, pro- bono, since we don't

have any money. We had a discussion with their representatives from

Pittsburgh, burgh, and Washington DC. We are waiting for them to

gather some political assessments and will have another teleconference soon.

I set up a Yahoo group for PA and we now have 24 members who are

interested in helping and waiting to hear what they can do. Anyone in PA who

is interested in supporting Licensure is welcome to email me and I will sned

you an invitatio to join the Yahoo group.

I am happy to answer any other questions you may have about

licensing.

Judy Gutowski, BA, IBCLC, RLC

Breastfeeding Matters

May 20, 2006

Judith:

Thank you for your post! Its enlightening to hear of the efforts being made toward licensure at the state level, and all these women are to be commended for their hard work. Because I am located in Texas, I certainly appreciate the efforts of Barbara Clay and all her colleagues, working diligently to bring title protection to Texas. In light of the IBLCEs recent approval of a second credential, title protection legislation is very desirable, in my own mind.

I also back Massachusetts's efforts to establish licensure legislation. Only when the various states' Departments of Public Health, and the hospitals and insurers within each state, recognize the IBCLC credential as a licensed Health Care Professional, will the profession be truly available to women and children who cannot afford to pay out of pocket. This is a huge issue in my rural location, and in my opinion, the needs of the majority of clients needing professional lactation services continue to go unmet. I know this will not change until IBCLCs are accepted providers under Medicaid. I also recognize that even in families who have insurance, insurers, for the most part, are reluctant to reimburse for professional lactation services.

I do recognize that it takes a huge amount of effort to set any precedent. I will not even pretend to understand how legislation is passed, but I now realize that we have many people, all over the country working toward similar goals. If just one state is able to set a precedent, I recognize that other states will have an advantage in pursuing their own legislation. If ILCA could coordinate these efforts, on a national level, by realizing their objectives of *recognition of the IBCLC credential as a health profession by the US Bureau of Health Professions

*establishing the IBCLC as an accepted provider under Medicaid

*developing CPT codes for lactation care and services under the AMA

I truly believe that professional lactation services would become widely available to US clients. I believe that when this happens, we will see an amazing increase in breastfeeding in this country.

I apologize if this post, or my previous post offends anyone. I admit that I am impatient for this great change to take effect. I also admit that I recognize the change will not be forthcoming tomorrow or next week, or even next month. I write as one who is deeply concerned for the welfare of my clients. I see so many dyads fall through the cracks in the current health care system, and I long for the time when all women and their children can receive the professional lactation assistance they need, in a timely manner, and in their immediate community. I honestly don't believe that our bottle feeding culture will evolve until our services are more available.

I also write as one who is struggling to provide a living for my family. I came to this profession with a genuine interest in helping women and babies overcome whatever issues were preventing them from enjoying their breastfeeding relationship. I, myself, have overcome many hurdles to establish myself as a professional in this field. While I still retain my original interest in assisting those who need BF help, I have been operating in the red for more than 6 years now. Although I remain committed to this field, I am unable to make much of a living in the area of the country where I live.

Unless IBCLCs are recognized as professionals and are able to be reimbursed for their services, sometime in the near future, I will have to work outside of this field which I deeply believe in. If this happens, not only will there be no professional services available in my area, but the profession will loose one of its dedicated members. It occurs to me that there are probably other IBCLCs in my position. I do find this work deeply satisfying, on many levels, but, I also feel that I am entitled to payment for my services. I have 12 years of college education, and about 7 years of lactation specific education and experience. If it is impossible for an IBCLC to make a living, in this particular part of the country, how many professionals will join the IBCLC ranks here? How many women and children will continue to go unserved?

While you have answered many of my questions, your post also elicits more questions. How is the ILCA Licensure Taskforce related to/coordinated with the USLCA Education and Licensure Committee? Are these separate groups working on the same issues? Would you recommend that I contact Laurie Beck with further questions? If so, could you provide her address?

Judith, in closing, I want to personally thank you for all the hard work you do, not only on behalf of your individual clients, but on behalf of all the lactation consultants in PA, and at the regional level on behalf of ILCA members everywhere. I certainly appreciate that you have made yourself available to answer questions about licensure. I know that there are many IBCLCs with questions and this is a wonderful forum to share the answers to these questions. Thanks for taking the time to address my concerns and questions.

Niki Konchar, IBCLC

(member of USLCA as of 5/15/2006)

May 20, 2006

I just want to express my appreciation for the tremendous investment in time and energy that these women have made on behalf of our profession. This is wonderful to hear about.Lynnette Hafken, MA, LLLL, IBCLC Hello Colleagues, Niki asked " I am curious if you are aware of the bill being drafted to license IBCLCs in Texas. " I am on the ILCA Licensure Taskforce and the Chair of the Licensure Committee for the Pennsylvania Breastfeeding Coalition. The licensure issue is separate from the USILCA development, but having a US Affiliate will make it simpler to endorse licensure efforts. Those of us on the taskforce believe licensure is needed in the US, but may not be a desired step or necessary in other coutnries. The ILCA Licensure Taskforce was started in November 05 and is just beginning work. Our stated objectives are to: -Explore and identify a strategy or process for achieving licensure -Develop a cost estimate for the strategy/process -Develop a resource/action kit to help state affiliates with this issue -Determine the status of having IBCLC declared as a health profession by the US Bureau of health Professions -Contacting the Centers for Medicare and Medicaid to establish the IBCLC as an accepted provider under Medicaid -Contacting the American Medical Association and developing CPT codes for lactation care and services -Checking on the status of the alpha codes for allied health providers Licensure can achieved on a state by state basis with substantial in-person lobbying All we need to do is get one of these bills passed and a precedent is set. Texas and Massachusetts are leading in progress, below is a summary of the current status of states: Massachusetts – Marsha We have a senate bill (second time around!) to license the IBCLC lactation consultant. It was reported out favorably by the Joint Health Committee and is now in the Health Care Financing Committee. We are approaching licensing here because our state department of public health, hospitals, and insurers recognize licensed health care professionals when writing policy, determining staffing regulations, and determining reimbursement eligibility. TEXAS – Barbara Clay SOUGHT LICENSURE IN 1997 RE VIEWED 2001 Seeking title protection (rather than practice protection.) Currently a drafting language for a bill to be introduced next session. Georgia- Arlene Toole I have contacted several legislators to get their feedback. Seeking a sponsor. Kansas- Jan Riordan Applying for licensure for a new profession in KS is called “credentialing”. Kansas has two main Regulatory Boards: the Board of Healing Arts (medicine, dentistry, etc) and the Board of Nursing (RNs, LPNs, ARNPs) In discussing lactation consulting with the state staff, it appears that our profession would be placed under Kansas State Department of Health and Environment, Health Occupation Credentialing as the regulatory body. Getting a separate board would be next to impossible Briefly, this is how it works: A request for credentialing is made to the Kansas State Department of Health and Environment, Health Occupations. The request must include rationale for why credentialing is needed and the criterion. The application looks extensive. The process takes about two years. I noted that it costs $1000 to submit the application. I will be attending a legislative meeting in the State Capitol in February and will pursue more info then. North Carolina (Ann Calandro) Tennessee (Marcie Singleton) Beginning to investigate. VERMONT Kirsten Berggren, PhD Below is the text of the bill as introduced: Subject: Health; professions; lactation consultants; sunrise review Statement of purpose: This bill proposes to direct the office of professional regulation to make a preliminary assessment of whether and at what level a licensing program for lactation consultants should be established and regulated. AN ACT RELATING TO LACTATION CONSULTANTS It is hereby enacted by the General Assembly of the State of Vermont: Sec. 1. OFFICE OF PROFESSIONAL REGULATION; SUNRISE REVIEW; LACTATION CONSULTANTS The office of professional regulation shall make a preliminary assessment, pursuant to 26 V.S.A. § 3105(d), of whether and at what level lactation consultants should be regulated. The office shall file a report of this assessment with the general assembly by January 1, 2007. Louisiana Zeretzke Licensure falls under the Department of Health and Hospitals (DHH) in They try to avoid creating new boards so their first effort always is to create a sub-licensure category for an existing board. The lobbyist who has helped us get all of the bf bills passed here told me that DHH would likely try to give such a responsibility to the Board of Nursing here. And may I add that health care is in such turmoil here after the hurricanes, I'm not sure what would happen just now if we pursued this. PENNSYLVANIA Judy Gutowski Recently, I met again with my state Senator and reviewed possible avenues for legislative support in PA. He is a freshman Senator. He has not been successful garnering support on his own to move this along. He is collaborating with a Senator who is working on other breastfeeding legislation and they agreed to work together. They haven't decided the best way politically to move forward yet. I gave a presentation to the Western PA LC Association (WPLCA) PA Breastfeeding Coalition (PABC). The PABC agreed to support licensure efforts and I was officially made chair of the committee. Mulford is the chair of the Public Policy committee for this Coalition and is on the committee with me. and I had a teleconference with a professional lobbying firm. They are looking at how they can possibly help us, pro- bono, since we don't have any money. We had a discussion with their representatives from Pittsburgh, burgh, and Washington DC. We are waiting for them to gather some political assessments and will have another teleconference soon. I set up a Yahoo group for PA and we now have 24 members who are interested in helping and waiting to hear what they can do. Anyone in PA who is interested in supporting Licensure is welcome to email me and I will sned you an invitatio to join the Yahoo group. I am happy to answer any other questions you may have about licensing. Judy Gutowski, BA, IBCLC, RLC Breastfeeding Matters

May 20, 2006

I just want to express my appreciation for the tremendous investment in time and energy that these women have made on behalf of our profession. This is wonderful to hear about.Lynnette Hafken, MA, LLLL, IBCLC Hello Colleagues, Niki asked " I am curious if you are aware of the bill being drafted to license IBCLCs in Texas. " I am on the ILCA Licensure Taskforce and the Chair of the Licensure Committee for the Pennsylvania Breastfeeding Coalition. The licensure issue is separate from the USILCA development, but having a US Affiliate will make it simpler to endorse licensure efforts. Those of us on the taskforce believe licensure is needed in the US, but may not be a desired step or necessary in other coutnries. The ILCA Licensure Taskforce was started in November 05 and is just beginning work. Our stated objectives are to: -Explore and identify a strategy or process for achieving licensure -Develop a cost estimate for the strategy/process -Develop a resource/action kit to help state affiliates with this issue -Determine the status of having IBCLC declared as a health profession by the US Bureau of health Professions -Contacting the Centers for Medicare and Medicaid to establish the IBCLC as an accepted provider under Medicaid -Contacting the American Medical Association and developing CPT codes for lactation care and services -Checking on the status of the alpha codes for allied health providers Licensure can achieved on a state by state basis with substantial in-person lobbying All we need to do is get one of these bills passed and a precedent is set. Texas and Massachusetts are leading in progress, below is a summary of the current status of states: Massachusetts – Marsha We have a senate bill (second time around!) to license the IBCLC lactation consultant. It was reported out favorably by the Joint Health Committee and is now in the Health Care Financing Committee. We are approaching licensing here because our state department of public health, hospitals, and insurers recognize licensed health care professionals when writing policy, determining staffing regulations, and determining reimbursement eligibility. TEXAS – Barbara Clay SOUGHT LICENSURE IN 1997 RE VIEWED 2001 Seeking title protection (rather than practice protection.) Currently a drafting language for a bill to be introduced next session. Georgia- Arlene Toole I have contacted several legislators to get their feedback. Seeking a sponsor. Kansas- Jan Riordan Applying for licensure for a new profession in KS is called “credentialing”. Kansas has two main Regulatory Boards: the Board of Healing Arts (medicine, dentistry, etc) and the Board of Nursing (RNs, LPNs, ARNPs) In discussing lactation consulting with the state staff, it appears that our profession would be placed under Kansas State Department of Health and Environment, Health Occupation Credentialing as the regulatory body. Getting a separate board would be next to impossible Briefly, this is how it works: A request for credentialing is made to the Kansas State Department of Health and Environment, Health Occupations. The request must include rationale for why credentialing is needed and the criterion. The application looks extensive. The process takes about two years. I noted that it costs $1000 to submit the application. I will be attending a legislative meeting in the State Capitol in February and will pursue more info then. North Carolina (Ann Calandro) Tennessee (Marcie Singleton) Beginning to investigate. VERMONT Kirsten Berggren, PhD Below is the text of the bill as introduced: Subject: Health; professions; lactation consultants; sunrise review Statement of purpose: This bill proposes to direct the office of professional regulation to make a preliminary assessment of whether and at what level a licensing program for lactation consultants should be established and regulated. AN ACT RELATING TO LACTATION CONSULTANTS It is hereby enacted by the General Assembly of the State of Vermont: Sec. 1. OFFICE OF PROFESSIONAL REGULATION; SUNRISE REVIEW; LACTATION CONSULTANTS The office of professional regulation shall make a preliminary assessment, pursuant to 26 V.S.A. § 3105(d), of whether and at what level lactation consultants should be regulated. The office shall file a report of this assessment with the general assembly by January 1, 2007. Louisiana Zeretzke Licensure falls under the Department of Health and Hospitals (DHH) in They try to avoid creating new boards so their first effort always is to create a sub-licensure category for an existing board. The lobbyist who has helped us get all of the bf bills passed here told me that DHH would likely try to give such a responsibility to the Board of Nursing here. And may I add that health care is in such turmoil here after the hurricanes, I'm not sure what would happen just now if we pursued this. PENNSYLVANIA Judy Gutowski Recently, I met again with my state Senator and reviewed possible avenues for legislative support in PA. He is a freshman Senator. He has not been successful garnering support on his own to move this along. He is collaborating with a Senator who is working on other breastfeeding legislation and they agreed to work together. They haven't decided the best way politically to move forward yet. I gave a presentation to the Western PA LC Association (WPLCA) PA Breastfeeding Coalition (PABC). The PABC agreed to support licensure efforts and I was officially made chair of the committee. Mulford is the chair of the Public Policy committee for this Coalition and is on the committee with me. and I had a teleconference with a professional lobbying firm. They are looking at how they can possibly help us, pro- bono, since we don't have any money. We had a discussion with their representatives from Pittsburgh, burgh, and Washington DC. We are waiting for them to gather some political assessments and will have another teleconference soon. I set up a Yahoo group for PA and we now have 24 members who are interested in helping and waiting to hear what they can do. Anyone in PA who is interested in supporting Licensure is welcome to email me and I will sned you an invitatio to join the Yahoo group. I am happy to answer any other questions you may have about licensing. Judy Gutowski, BA, IBCLC, RLC Breastfeeding Matters

May 20, 2006

Judith,

Here in Quebec (Canada), our association wants to work at a similar process

(licensure) to gain professional credebility and right to practice in Health

Care settings such as clinics and hospitals.

We would greatly appreciate any help we can get with this process. Do you

or anyone else involved in the licensure project have any recommendations on

how to proceed ?

Ghislaine Reid, IBCLC

Montreal, Quebec, Canada

Health; professions; lactation consultants; sunrise review