STATE OF NEW YORK ________________________________________________________________________ 357--A 2017-2018 Regular Sessions IN ASSEMBLY January 5, 2017 ___________ Introduced by M. of A. ROSENTHAL, PAULIN -- read once and referred to the Committee on Higher Education -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said commit- tee AN ACT to amend the education law, in relation to the licensure of lactation consultants and providing for establishment of a lactation consultant licensing board The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Short title. This act shall be known and may be cited as 2 the "lactation consultant practice act". 3 § 2. The education law is amended by adding a new article 166-A to 4 read as follows: 5 ARTICLE 166-A 6 LACTATION CONSULTANTS 7 Section 8750. Legislative intent. 8 8751. Definitions. 9 8752. Practice of lactation consultation and use of title 10 "licensed lactation consultant". 11 8753. Lactation consultant licensing board composition and 12 terms. 13 8754. Lactation consultant licensing board responsibilities. 14 8755. Requirements for a professional license. 15 8756. Exemptions. 16 8757. Professional misconduct. 17 § 8750. Legislative intent. The legislature acknowledges that the 18 application of specific knowledge and skill is required to evaluate and 19 manage clinical problems in lactation and breastfeeding that diminish 20 the health and well being of families and acknowledges that the render- 21 ing of such care in institutional and private practice settings requires 22 trained and competent professionals. Furthermore, the legislature EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD01708-02-7A. 357--A 2 1 declares it to be the purpose of this article to protect the health, 2 safety and welfare of the public by providing for the licensure and 3 regulation of the activities of persons engaged in clinical evaluation 4 and management of lactation and breastfeeding. 5 § 8751. Definitions. As used in this article, the following terms 6 shall have the following meanings: 7 1. The practice of the profession of "lactation consultation" shall 8 mean the clinical evaluation, management, and provision of preventive 9 medical counseling to assist families with lactation and infant feeding 10 problems and/or to prepare for normal infant feeding. Normal infant 11 feeding is defined as being consistent with the recommendations of the 12 American Academy of Pediatrics and the World Health Organization recom- 13 mendations. Such services may include, but may not be limited to: 14 (a) collecting health and feeding histories relevant to lactation, 15 feeding from the breast, human milk feeding (from assistive devices such 16 as bottles, cups, syringes, feeding tubes etc.) and/or the feeding of 17 substitutes for human milk; 18 (b) conducting an evaluation of: 19 i. the breasts of the client who is intending to lactate, currently 20 lactating, and/or in the process of ceasing to lactate which may 21 include, as needed, a physical examination; 22 ii. milk production and as needed, milk expression (manually or by 23 other means using tools of the trade or other aids) to induce, maintain, 24 augment, and/or reduce lactation; 25 iii. the feeding behavior with direct feeding from the breast and/or 26 feeding using assistive feeding devices, on and off the breast; 27 iv. the sucking efficacy of the infant or young child which may 28 include, as needed, a visual or digital exam of the infant's oral cavi- 29 ty; 30 v. the adequacy of intake and growth by the infant or young child 31 using observations of swallowing patterns, which may include, but not be 32 limited to, the use of a digital weighing scale; 33 (c) determining the nature and severity of any lactation or feeding 34 problems based on the history and evaluation; 35 (d) demonstration of improved techniques, supplies, and/or equipment 36 to improve lactation, feeding from the breast, human milk feeding, 37 and/or the feeding of substitutes for human milk as needed; 38 (e) provision of preventive clinical consulting and/or education to 39 the client-defined family; 40 (f) development of a plan of care in consultation with the family 41 which may include, as needed, provisions for appropriate follow-up; 42 (g) collaboration and communication with other health care practition- 43 ers as needed, including referrals to other appropriate health care 44 practitioners when existing problems fall outside the scope of licensed 45 lactation consultants; 46 2. Where the title "licensed lactation consultant" is used in this 47 article it shall mean a clinical practitioner who evaluates and manages 48 lactation and infant feeding problems and provides preventive clinical 49 consulting to prevent or minimize the occurrence of potential problems. 50 The term "international board certified lactation consultant (IBCLC)" is 51 reserved for those who are certified and registered by the International 52 Board of Lactation Consultant Examiners (IBLCE). 53 3. "Board" shall mean the state board for lactation consultation 54 created by section eighty-seven hundred fifty-three of this article. 55 § 8752. Practice of lactation consultation and use of title "licensed 56 lactation consultant". Only a person licensed pursuant to sectionA. 357--A 3 1 eighty-seven hundred fifty-five of this title shall be authorized to use 2 the title "lactation consultant" or "licensed lactation consultant". 3 § 8753. Lactation consultant licensing board composition and terms. 4 1. (a) A state board for lactation consultation shall be appointed by 5 the board of regents on the recommendation of the commissioner for the 6 purpose of assisting the board of regents and the department on matters 7 of professional licensing and professional conduct in accordance with 8 section sixty-five hundred eight of this title. The board shall be 9 composed of not less than eight members. Seven members of the board must 10 be licensed lactation consultants, except that the members of the first 11 board will be grandfathered as eligible for the board if they registered 12 as IBCLCs and have been actively practicing in New York state for the 13 preceding five years. One member of the board will represent the client 14 or care receiving community. 15 (b) Among the seven licensed lactation consultant members: 16 i. six of the seven must have five years of experience immediately 17 prior to appointment to the board, except that for the first five years 18 after the establishment of the board may count prior experience as an 19 IBCLC; 20 ii. one of the seven licensed members must have been licensed within 21 the last two years prior to appointment to the board. 22 2. At least two licensed lactation consultant members shall have 23 specific experience in the last two years as: 24 (a) owners of their own practices; 25 (b) employees in a hospital setting or a similar large institutional 26 setting; 27 (c) employees in a public health clinic or similar setting such as the 28 federal special supplemental nutrition program for women, infants and 29 children; and/or 30 (d) participants in a group practice, either community based or 31 private. 32 At least two members must represent the autonomy of the profession by 33 holding no other license than licensed lactation consultant. Reasonable 34 attempts will be made to ensure diversity among other complementary 35 professional licenses held by board members who are licensed in addi- 36 tional professions. 37 3. Of the members first appointed, initially one shall be appointed 38 for a one year term, two shall be appointed for a two year term and two 39 shall be appointed for a three year term, two shall be appointed for a 40 four year term and one shall be appointed for a five year term so that 41 as nearly as possible an equal number of seats on the board shall termi- 42 nate annually as specified in section sixty-five hundred eight of this 43 title. Thereafter all members shall serve for five year terms. Board 44 members may be reappointed for a second term. 45 4. Members of the board must declare that they will not violate the 46 international code of marketing of breast-milk substitutes. During their 47 term, board members may not engage in activities which might create a 48 financial or professional conflict of interest with their duties to 49 uphold the standards of the licensing for the profession. Such activ- 50 ities shall include, but are not limited to owning, sitting on the board 51 of, being an employee of, or holding a financial interest in an inde- 52 pendently accredited certification and examination program for lactation 53 consultants. 54 § 8754. Lactation consultant licensing board responsibilities. The 55 purpose of the lactation consultant licensing board is to assist the 56 board of regents on matters of professional licensing, practice andA. 357--A 4 1 conduct. As stated in section sixty-five hundred eight of this title, 2 each member of the board shall receive an honorarium up to one hundred 3 dollars as prescribed by the board of regents for each day devoted to 4 board work, and shall be reimbursed for necessary expenses. The board 5 shall elect from its members a chairman and vice-chairman annually, 6 shall meet upon call of chairman or the department, and may adopt bylaws 7 consistent with this title and approved by the board of regents. A 8 quorum for the transaction of business by the board shall be five 9 members. The board must provide for a period of public commentary before 10 changes are made to the requirements for licensure for lactation consul- 11 tation. An executive secretary shall be appointed by the board of 12 regents on the recommendation of the commission. Any member may be 13 removed from a board by the board of regents for misconduct, incapacity 14 or neglect of duty. 15 § 8755. Requirements for a professional license. To qualify for a 16 license as a lactation consultant, an applicant shall fulfill the 17 following requirements: 18 1. Application. File an application with the department and provide: 19 (a) A copy of a high school diploma or the equivalent. 20 (b) Transcripts and other documentation showing completion of the 21 specified prerequisites and lactation specific education, except that 22 those who submit proof that they were certified by the IBLCE prior to 23 enactment of this article, will be grandfathered as exempt. 24 (c) An authorized certification of completion (or exemption) for the 25 New York state mandated two hours of coursework or training related to 26 child abuse. 27 (d) Documentation verifying three hundred clinical hours by an IBLCE 28 were completed concurrently or after completing the prerequisites and 29 lactation specific coursework, except that those who submit proof that 30 they were certified by the IBCLC prior to enactment of this article, 31 will be grandfathered as exempt. 32 (e) Proof of having passed the comprehensive lactation exam adminis- 33 tered by the IBLCE (or an equivalent or higher level exam) after 34 completion of the educational and supervision requirements. 35 2. Prerequisites. 36 (a) Attain a high school diploma or the equivalent (e.g. a New York 37 State High School Equivalency Diploma via the Test Assessing Secondary 38 Completion after January second, two thousand sixteen or the General 39 Educational Development). 40 (b) Complete at least twenty-four semester credits in health science 41 courses from an accredited institution of higher learning, advanced 42 placement high school classes and/or receive the equivalent credit from 43 College Level Examination Program through independent study. Course 44 content may include, but is not limited to, biology, human anatomy, 45 human physiology, infant and child growth and development, nutrition, 46 psychology and/or counseling or communication skills, and sociology or 47 cultural sensitivity or cultural anthropology. 48 (c) Complete coursework or training offered by an institution of high- 49 er learning or continuing education courses in basic life support, 50 medical documentation, medical terminology, occupational safety and 51 security for health professional, universal precautions and infection 52 control and professional ethics for health professionals. 53 (d) Further, as mandated by the state of New York for professions, 54 complete two hours of training related to child abuse. 55 3. Education in human lactation and breastfeeding. Within five years 56 prior to sitting for the exam, complete at least ninety hours in humanA. 357--A 5 1 lactation and breastfeeding that have been verified by IBLCE or the 2 equivalent from any other certifying body that provides continuing 3 education recognition points as determined by the board and in accord- 4 ance with the commissioner's regulations and in compliance with the 5 international code of marketing of breastmilk substitute. 6 4. Supervised experience. After having completed the prerequisites and 7 educational requirements listed above, complete a minimum of three 8 hundred directly supervised hours of clinical practice evaluating and 9 managing lactation and infant feeding problems. Chief supervisors must 10 have at least five years experience as a licensed lactation consultant 11 or, during the first five years after the enactment of this article, the 12 equivalent experience as an IBCLC. Applicants who live in geographically 13 isolated areas that render direct supervision infeasible may, on an 14 individual basis, have their chief supervisor submit a plan for consid- 15 eration by the board that describes how the supervisor will support and 16 evaluate the acquisition of the clinical skills required for the profes- 17 sion of lactation as defined in this act. Such a plan may include 18 options such as in-person workshops of mastery of skills that require 19 direct physical contact and electronic supervision for mastery of those 20 skills that do not. The plan must encompass the Competencies for the 21 Practice of International Board Certified Lactation Consultants by the 22 IBLCE or an equivalent or higher level of competencies as determined by 23 the board and in accordance with the commissioner's regulations. 24 5. Examination. After having completed the educational and supervision 25 requirements, pass the exam administered by the IBLCE or another exam- 26 ination determined by the board to have the equivalent or higher stand- 27 ards and in accordance with the commissioner's regulations. 28 6. Reregistration. Complete at least forty-five hours of continuing 29 education in lactation, related fields and ethics every three years as 30 approved by the IBLCE or any other certifying body that is credentialed 31 to provide Continuing Education Recognition Points by the National 32 Commission for Certifying Agencies of the Institute of Credentialing 33 Excellence and determined by the board to have the equivalent or higher 34 standards and in accordance with the commissioner's regulations. 35 7. Age. Be at least twenty-one years of age. 36 8. Character. Be of good moral character as determined by the depart- 37 ment. 38 9. Fee. Pay a fee to be determined for initial licensure, and a fee to 39 be determined for each triennial registration. 40 § 8756. Exemptions. 1. As provided in section sixty-five hundred five 41 of this title, this article reaffirms that no definition of the practice 42 of lactation consultation shall be construed to restrain or restrict the 43 performance of similar acts authorized in the definitions of other 44 professions. 45 2. Furthermore, nothing contained in this article shall be construed 46 to prohibit or limit the practice of students, interns, or persons 47 preparing for lactation consultation under the qualified supervision of 48 the licensee. 49 § 8757. Professional misconduct. In addition to the definitions of 50 misconduct under section sixty-five hundred nine of this title, it shall 51 further constitute professional misconduct to discriminate on the basis 52 of gender identity, or sexual orientation or status as a legal guardian 53 (or in the process of becoming a legal guardian) of an infant or child 54 who is not biologically related to that infant or child. 55 § 3. This act shall take effect on the one hundred twentieth day after 56 it shall have become a law; provided, however, that any actions neces-A. 357--A 6 1 sary for the implementation of the provisions of this act on its effec- 2 tive date are authorized and directed to be completed on or before such 3 effective date.